eHealth and hospitals—wider vision, open minds and better research needed

Friday, October 27, 2017

‘Without the right vision, attitudes and research base, eHealth initiatives in hospitals can end up being extraordinarily expensive mistakes’, Alison Verhoeven, Chief Executive of the Australian Healthcare and Hospitals Association, said today.

The Association’s Deeble Research Institute has released an evidence brief, The impact of eHealth upon hospital practice: synthesis of current literature.

‘In many quarters eHealth is seen in and of itself as a way to improve financial and clinical outcomes in hospitals through greater efficiency—but the available research shows mixed results’, Ms Verhoeven said.

‘I think it’s fair to say that, in Australia, we have had variable success in our attempts to digitise  and integrate health records, provider ordering, prescribing and decision support systems.

‘In many ways we should not be surprised.

‘Leaving aside the well-known difficulties posed by our federated system of government, our evidence brief suggests that there are three main areas of difficulty for policymakers.

‘The first is the wide range of potential impacts. eHealth technologies can affect a great number and variety of stakeholders—patients, clinicians, hospitals, and health services, across a wide range of locations and a wide range of outcome types (efficiency, effectiveness, short term, long term).

‘If the vision is just about fixing up records in your own hospital or even your own state, the project’s success will be very limited. Project directors need to think big and wide, and of expanded possibilities.

‘A hypothetical example is that maybe, with the right eHealth support systems, it would be possible for GPs to admit patients to hospital in an orderly, coordinated and clinically supportable way.

‘The second area is what we call ‘emerging impacts’, which are the surprising and unpredictable effects of eHealth efforts. This can often be a result of the whole field moving and changing all the time—for example the basis of clinical judgments, staff movements, codes of practice, funding decisions, and so on.

‘eHealth policies and practices, and the people administering them, need to be open, flexible and adaptable, so that the project is not constrained by current practice or pre-existing expectations.

‘The third area of difficulty is the ‘uncertain impacts’—an eHealth initiative may work amazingly well in one area, but not so much in another.

‘The trouble is that through a lack of research in Australia particularly, we don’t know why—we don’t know the current or potential drivers of eHealth success in the Australian context, and we need to.

'Digital healthcare is clearly here to stay, however, and is the way of the future—we need to harness the benefits for both patients and the health system as a whole’, Ms Verhoeven said.

The evidence brief is available at https://ahha.asn.au/publication/evidence-briefs/evidence-brief-16-impacts-ehealth-upon-hospital-practice-synthesis.

For more information on the AHHA, visit http://ahha.asn.au.
The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, community and primary healthcare services.

Media enquiries: Alison Verhoeven, Chief Executive, Australian Healthcare and Hospitals Association, 0403 282 501