Forum: Critique highlights need for better health information

Poor communication cited as hospital safety risk

A recent critique of the health system highlights the need for better communication among health providers. In his annual report to the parliamentary health select committee, health and disability commissioner Ron Paterson says improved access to hospital information could increase safety standards.

All of New Zealand’s 21 district health boards were deemed equally unsafe by the report, and all have their particular pressure points.

Paterson says New Zealand is falling behind the rest of the world when it comes to publishing quality comparative data. He says the information would not have to identify individual clinicians but instead could be in the form of DHB reports posted on websites.

He’d like to see such a system running by the end of the year, he says.

A major obstacle to patient safety was the 21 health boards all going their own way. Paterson points the finger of responsibility directly at the Ministry of Health.

Flashback to December, when HealthLink chief executive Tom Bowden distributed a wide-ranging document addressed to “health opinion leaders”, in which he severely criticised health IT strategies and policies. He described them as confused and ineffective.

New Zealand’s innovation had stalled, he said, despite earlier having created one of the world’s best IT-enabled primary care systems.

New standards were not being implemented — and very few new services had been developed or contemplated — he said. In addition, there was no widely agreed strategy to support investment in service development.

Bowden said a complex range of government agencies now left little room for involvement by the private sector organisations that had previously led the way.

Promised additions of key infrastructure had not been delivered on, a coherent IT strategy was a thing of the past, and the small amount of funding available was being spent on projects under the direct control of government agencies.

There were three main issues, said Bowden. These were lack of strategic direction, lack of clarity concerning the government’s role in IT, and lack of funding.

There was also no proposed architecture allowing for the sharing of records. All this sounds remarkably like Paterson’s key concerns: lack of communication and individual health boards going their own way.

Bowden went on to say there was ambiguity over the government’s role, as well as disquiet about the number of government-related entities dabbling in IT projects.

He quoted a senior Health Ministry staff member saying the Health Information Service’s 12 action zones were just the usual laundry list of solutions to the perennial basket of problems.

Senior ministry staff have been equally direct in their comments to Computerworld, describing the ministry atmosphere as toxic.

News that the Ministry of Health is pushing for a single health identifier for each person, to clean up both patient and doctors’ records, and make them more accessible when needed, is welcome. Although people are supposed to have just one identifier — their National Health Index (NHI) number — they often, in fact, have several such identifiers.

National statistics on deaths in hospitals were released last week, showing 40 deaths due to mistakes over 12 months.

That makes reflective reading for the ministry mandarins and for Health Minister David Cunliffe.

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