1. Leveraging Assets: Experiences and challenges in ensuring finances, human resources, asset management and legislation enable a functioning health information system at all levels. Dr Robyn Lawrence Executive Director Innovation and Health System Reform Delivering a Healthy WA

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3. Outline Value of health information What is needed Leveraging resources for health information Leveraging health information to maximise resource uitilisation Overcoming the challenges

4. Value of Health Information Health multi-billion dollar business Financial information alone not sufficient Require knowledge about: – the volume of services provided –the outcome of the services –service gaps Inform public and government Plan for the future

5. Value for Who? Patients and carers Health providers Health administrators Researchers Government

6. Requirements Data Reliability: –Timeliness –Consistency –Standardisation Data Integrity Analysis and interpretation

7. Human Resources Data only as good as the point of entry / collection In general people enter much of the data –Variability Clear consistency: –Definitions –Process Sufficient numbers and skill

8. Human Resources Involving the patient in consent Data analysis and communication to all stakeholders Ensuring appropriate use –Risk of excessive requirements for inappropriate purposes Ensuring appropriate governance –Data custodian process Asset management, including ICT support

9. Asset Management Timely data requires input points Automation of collection Forced standardisation of inputs Integration of new assets with data collection systems –data linkage

10. Legislation Required to comply with legislation – both Commonwealth and State / Territory –Varying Acts covering public vs private –Additional legislation also with impact Lack of understanding: –Limit appropriate use –Loss of trust of consumers –Loss of trust of providers Legislative compliance must be built into systems.

11. Finances Everything has a cost….. –Legislative compliance –Sufficient skilled human resources –Appropriate asset management –Overarching controls But, should be able to offset the cost and measure the benefit if we do it right

12. Why the Challenge HR Assets Finance Legislation But really:- –Trust –Independence –Alignment of outcomes to provision

13. The HR Challenge Inputs: –Relevance of the information for more than the immediate task – clinical and non-clinical –Adequate skilled staff numbers Output: –Skills to ensure reliable data addressing the issue Interpretation and use: –Information can often have multiple interpretations –Frequently source of distrust by all involved

14. The Asset Challenge Supporting infrastructure to collect robust information. Value of electronic collection. Automation probably better than manual.

15. The LegislationChallenge Too many variables. Designed to address the “use” issue. Health care provided in multiple sectors / providers. Patients frequently belong to high risk vulnerable groups.

16. The Finance Challenge Costs ROI can be difficult to measure –usually done by surrogate means, but underpinning success factor may be good health information: Access to appropriate information Timely access to clinical information which is shared.

17. Overcoming the Challenge Return on investment for all stakeholders. Identify key drivers of need –not information for information’s sake Even bad data can sometimes bring about change –both in practice and in improving the data quality Leadership and commitment to make a difference for the PATIENT and our community

18. Safety and Quality Many key indicators monitored using health information at local level VLADs in Queensland Timely response to clinical practice concerns

19. Safety and Quality VLAD Plot – Mortality-Acute Myocardial Infarction

20. Planning Western Australia Clinical Services Framework Local information on volumes and utilisation Demographic projections by local government area Comparison to National utilisation, bed days etc Plan where our services will be

21. Clinical Service Redesign

22. Clinical Research As simple as “do we know if this program works?”

23. Elective Surgery

25. Health Service Administration Cost of service –efficiency and effectiveness Comparators Everything should be able to be measured against patient activity

26. Clinical Care Shared information: –Patient self management –All care providers Critically links to all other aspects Hence the patient will always remain central

27. Public Reporting Nothing improves data quality quicker than being in the public eye!

28. Summary The best human resources with an understanding of the importance of information –the advocates Patients as advocates Physical assets to support standardisation, automation and reliability Consistent legislation to support use, but protect individuals Identify ROI / benefits realisation

29. So ….