Breathing new life into healthcare IM

The latest move in healthcare is to apply contemporary information management techniques for not only patient records, but also patient care. Alicia Camphuisen reports.

After applying the latest information management (IM) techniques to maintain administrative resources, the health sector is seeking to focus on a new goal: using the same principles to improve the quality of patient care.

"One of the significant moves in the past year is definitely the use of IT in clinical and patient healthcare," said chair of the Health Informatics Society of Australia (HISA), Dr Peter Adkins. "IT has previously been used to manage the business side of health, but is now being used by health professionals to communicate more with patients and with each other."

Patients are now the focus of information management in healthcare, with the Federal Government providing an additional $15 million this year for training.

Professor Peter Yellowlees from the University of Queensland's Department of Psychiatry, believes this has come from a growing understanding by the IT industry that health has more specific needs than can be addressed with an out-of-the-box electronic records management solution, and by clinicians who are realising that if IM is to suit their sector, they must be involved in its development and integration. "It's a period of rennovation. IT is understood to be important, and clinicians are more prepared to embrace it," he said.

Health professionals' increasing involvement in IM is evidenced by continuing changes to the national Casemix system, the 11 year old Federal, State, and Territory initiative which provides scientific classifications of patient care based on differences in outcome, quality or cost of care.

UPDATED BY VICTORIAN GOVT

Described as inadequate and still acknowledged as less than perfect (Image & Data Manager, September/

October 1998), Casemix classification formulae is being updated by the Victorian Government, said decision support manager at Melbourne's Royal Women's Hospital, Dean Athan.

As they invest more energy in IM, clinicians are also teaming with governments, other professionals, and vendors in projects that should establish more conclusively strategies that suit the needs of all concerned, from nurses and maintenance staff to information managers. Two such endeavours are the Centre for Online Health and the Collaborative Health Informatics Centre (see below).

According to Prof Yellowlees, while the health sector's move toward using IM to improve the quality of care is encouraging, "health has taken a while to use IM in this way".

"It's a completely different direction for the sector, which has tended to look at measuring quantity," he added. Electronic records are still seen as valuable, but now more as a clinical tool that supports professionals in the quality of care they provide for patients.

As IM becomes more pervasive to healthcare, clinicians from both the public and private sector agree that the culture of resistance to new technology will need to be eroded. "IT systems are designed to facilitate the process of care and hopefully make it more efficient, and through that, more accessible," said Prof Yellowlees. "Clinicians need to become more IT literate to take full advantage of these systems."

IMPROVING SKILLS

"Computers are being used for a greater range of functions in health, from PCs on desktops to mobile terminals for nurses," said HISA's Dr Adkins. "But lots of upskilling needs to be done, as a large section of the workforce has not used the technology before."

To propel this process, the Federal Government has invested $15 million in education and training across the sector.

Amidst the new approaches to successfully integrating IM into the public and private sectors of health, Professor of Health Informatics at the University College London, David Ingram, believes that now this new focus has been adopted collaboratively by clinicians and IT, it must be a primary objective. "Clinical Information systems should be at the heart of ensuring the quality of care provided. There must be consensus and coherence, clinically and technically, in how that care is delivered and coordinated."