The future use of Electronic Health Records for reshaped health statistics: opportunities and challenges in the Australian context Denise Carlton Director Health and Disability Statistics

Outline Benefits of e-health – statistical potential Australia’s health system - the backdrop for e-health The model proposed for Australia Issues faced Where to from here

The benefits of e-health Health system outcomes –Patient-centred information for care delivery –Better coordination and timeliness –Improved patient safety –Better preventative health strategies –Longitudinal information for clinical researchers –Increased self-management/self advocacy for patients –Improve efficiency

The benefits of e-health Statistical potential –Longitudinal data –Comprehensive data –New analytical power Statistical risks –Long transitional period (hybrid systems) –Statisticians secondary users

Key health information providers National statistical organisations –ABS - population health surveys, private hospitals collections, surveys of general practitioners, data standards –AIHW - State administrative data, surveys, data standards Commonwealth government –Medicare/Department of Health - public health system claims and pharmaceuticals State/territory governments –administrative collections, –state based CATI health surveys PHIAC –private health insurance data

Goals –Improving the quality of health care services –Streamlining multi-disciplinary care management via shared patient health records –Improving clinical and administrative efficiency, by standardising health care information –Maintaining high standards of patient privacy and information security. Formation of National E-Health Transition Authority (NEHTA) in 2004

E-health in Australia: the proposed model Unique Health Indicators (UHIs) –identifiers for receivers and providers of health care (IHIs and HPIs) –contain only basic demographic information –facilitate access to shared health records Underpinned by legislative environment –National Health Information Regulatory Framework (NHIRF)

General issues around introduction of e-health Upfront costs Resistance by time-poor clinicians Skills Heightened sensitivity around privacy Secondary use is a lower priority

Statistical issues around introduction of e-health Scope and coverage Standards and classifications Data access and sharing New partners

E-health in Australia: where to from here? Initial implementation in 2010 –Lead up work to embed critical statistical requirements Post implementation –Towards a new information base –Maintaining continuity and consistency of nation evidence base on health