The failure thus far of the Australian healthcare sector to reap the enormous potential for IT to improve the delivery and quality of medical services in Australia represents a massive opportunity for the Australian channel.
Whether it’s the personally controlled electronic healthcare records (PCEHR) system or the generous federal government subsidies to encourage the uptake of telehealth, it seems no matter how clever or potentially game-changing an initiative is, convincing decision makers within the medical profession has always been a challenge, and is expected to remain so for some time.
Typically in healthcare, disjointed data is collected across highly fragmented systems that are still often predominantly paper-based. For those that have evolved into electronic forms, most have poor interoperability with other electronic systems used by various payers, providers, or government agencies.
Yet with the push for universal digital records systems and generally better communications systems linking hospitals, GPs, specialists, insurance companies, health funds, the government and patients, healthcare organisations have little choice but to invest in new systems that make true interoperability possible.
According to Martin Greenlees, general manager with Sydney-based systems integrator Workstar, healthcare professionals are among the hardest to market IT solutions to. On the one hand they’re highly skilled and knowledgeable people who demand a particular level of respect, while they are also usually uninterested in IT, despite using extremely sophisticated equipment on a daily basis.
“The technology they use in theatres is phenomenal yet all of them struggle with a keyboard and a mouse,” Greenlees says, regardless of what seems generally to be a “strong sense of not wanting to be left behind”.
Workstar has made significant investments in education and training, which it sees as especially important for helping healthcare professionals to understand the value of technology and how to use it.
The company markets a customisable learning suite called Nexus, which Greenlees says has proved especially effective in helping healthcare organisations to build tailored education programs that are appealing and effective for doctors and other professionals. It has also worked to help affect behavioural change with the department of health and ageing.
Rhenu Buller, a senior member of analyst Frost and Sullivan’s health team in Australia, also emphasises the uniqueness of healthcare professionals as customers of IT solutions providers.
“[Healthcare] organisations are stuck in their ways,” she says. “To get a change of habit you have to follow the processes; training and proper change management are critical factors.”
Slow uptake
Both the PCEHR and telehealth programs have seen sluggish uptake, a problem which Buller thinks might have been averted had Australia not been in such a hurry.
“We need to take a step back; Australia developed healthcare systems very quickly,” she says. “A longer roadmap for IT adoption might have been a step in the right direction.”
Nevertheless, true to form, the current government has been remiss in promoting awareness and uptake of its expensive programs. Dr Mike Civil is a HIT (health IT) expert and spokesperson for the Royal Australian College of General Practitioners (RACGP). He challenges the proposition that health professionals, in particular GPs, have been slow to adopt technology.
He estimates around 96 percent of Australian GPs have some sort of clinical desktop system.
“GPs are pretty IT literate.”
However, he concedes the uptake of technologies such as telehealth has been a little disappointing.
“One of the big stumbling blocks is what software to use and how can doctors be sure it will succeed in communicating with specialists at the other end.”
The slow uptake comes as a surprise given the federal government has said the telehealth rebate will end in 2014; a strategy calculated to spur doctors into action, yet one which appears to be achieving minimum success, despite the fact GPs currently get paid the rebate simply for conducting consultations over Skype.
On the other hand, Chris Reeve, operation manager with Victoria’s Hume Rural Health Alliance (HRHA) has entirely practical reasons for not always embracing the latest and greatest. The group is only now moving from XP to Win7.
“We don’t like to be on the bleeding edge – we generally stay a generation behind because of support; we wait until first service pack is out,” Civil says.
NBN boon
Provided it eventually achieves a meaningful degree of penetration, the NBN is expected to deliver a major boon to ehealth in Australia. However, according to former nurse and now head of HIT with Polycom, Ron Emerson, advances in compression technology are helping to improve the capabilities of existing network technologies.
Polycom, he says, has developed compression algorithms that can deliver high definition, 720p and 30 frames per second, with speeds as sluggish as 512kbps. Encouragingly, the growing community of younger health professionals is providing significant impetus in improving the understanding and deployment of technology within organisations.
“The younger generation coming through is incredibly tech savvy,” says Workstar’s Greenlees.
Of course this has seen a rapid proliferation of mobile devices, a trend which Polycom’s Emerson says has meant his and many other traditionally hardware-based companies are fast evolving into software companies.
“Our approach now is device agnostic.”
Getting personal
IT companies are at the vanguard of arguably the most exciting emerging trend in healthcare – personalised medicine. Since the mapping of the human genome some 10 years ago, the costs of high-speed, computer-based sequencing technology has plummeted to the point where people are able to have their entire genetic map charted for around $1000.
This has massive implications, not only for healthcare itself, but also the IT professionals who service it. While initiatives like PCEHR will focus initially on standard forms of healthcare data such as x-rays, MRI scans and traditional clinical reporting, the falling costs of genetic testing means that complex DNA data will also be thrown into the mix.
Yet clinical patient information is just one part of the picture. Health data also includes financial information resulting from highly complex billing and claims processing, as well as a wealth of administrative and demographic data which must be collected and stored to meet legal and compliance requirements.
ARCGP is among the professional organisations working together and with the federal government to develop technology standards for the sharing storage and securing of healthcare data. Yet it seems it may be a while before any meaningful progress is made.
“Australia is really interesting in the sense that state and federal systems run on many different platforms,” says Frost and Sullivan’s Buller. “There are no national standards.”
This is making it harder for health organisations to justify investment in solutions for clever health analytics, despite the fact prices have come down, she adds.
“We are moving into much more advanced [data] analysis but we are also seeing challenges with hospitals having to justify the spend in terms of ROI,” she says.
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