Assessment Of Australia’s Health Information System And Strategies For Improvement

Regulation and Policies in Australia’s Health Information System

Australia has give top priorities to the making of policies that regulate the health information systems such regulations include the Health Records Act. These priority area are executed by committees such as the Australian Commission on Safety and Quality in Health Care which is mandated with ensuring that medical providers adhere to the stipulations of the health policies and regulations. Such committees are also tasked with coming up with and ensuring that health care providers adhere to procedures, methods and policies that are set aside to aid in implementing, measuring and monitoring health information systems. The government has also come up with health care policies to guide the measurement of vital statistics.

To regulate service delivery, a top priority for the nation, agencies such as the Australian Commission on Safety and Quality in Health Care has been tasked with ensuring that all services offered are top-notch and compliant to the Public Service Act (1999). Service delivery is also regulated by the Health Records Act which also seeks to look out for continued improvement of health care services as well as collection and handling of health data. The service delivery input ensures that derives are delivered in time, affordable cost and quality (Smith et al, 2011).

According to the Department of Health, measurement on notifiable disease reporting is carried out by the National Notifiable Diseases Surveillance System (NNDSS). This body is mandated with collection of data about notifiable diseases within the nation. Human resources are very important and have been given priority by the Australian government. Some of the Human resources information systems developed in this sector are aimed at capturing staff information in a registry (Hersh, 2010). The information captured include staff names and ID. This system also focuses on the welfare of the staff as well as their performance which can be tracked and analyzed over some time.

Census data collection is also an area of priority to the government. This is because the Australian government ensures that population data and other demographic details are collected every less than ten years in order to advise the government decisions. Data about the umber of births and deaths witnessed in the nation is captured through a civil registration process stipulated by the legislation. In addition, the government has come up with a policy where all medical records that touch on the health information systems is presented to parliament every one year in order to be used by the parliamentary representatives to make policies (Policy Frameworks, 2015).

Agencies responsible for Australia’s Health Information System

Assessment of quality of the data is also a top priority for the government. There are many policies and procedures that have been put across to ensure that the nation collects data that is meaningful and comprehensive. The quality of data includes its consistency and ability to reflect the real situation on the ground. Quality of data is achieved through enhanced data collection technology, training of staff to ensure that they know exactly how to look out for data, proper recording and storing of data and proper transmittance of data to relevant medical offices.

However, in as much as the government has tried its level best to ensure that health information systems are streamlined, there are still some issues that need to be addressed and improved. One such issue is the institution of surveys to collect data about the effectiveness and the use of health information systems (Garde et al., 2006). Although the surveys capture a lot of data, there is still more to be done, and more surveys offered frequently can be used to collect even more data than is currently being collected. Such surveys can be issued at the point of care where as many patients as possible can be able to access the surveys as well as health care specialists (Eysenbach & Consort-EHEALTH Group, 2011 ).

The training of staff on data handling is also an issue that needs to be given a more keener insight. Training enables the employees to be able to know what data to collect, how to handle the data and the proper privacy measures to take in order to ensure patient health information is preserved and restricted. Although some level of training has been reported, there is still much more that needs to be done since the technology and policies surrounding health information systems is constantly changing. Constant changes require constant training in order to ensure that the staff is always up to date.

Most of the data is also not publicly available for use by external bodies, and even some internal sources for that natter. Sharing of most of the health information systems is not open and free. This restricts the extent to which managers and clinicians are able to access the data for planning, priority setting and resource allocation. Lack of access of this data causes the health care information systems to lack harmony. This data, if made freely and openly accessible could be used to transform the health information systems in the nation,and indeed in other nations (Reports & statistics – Australian Institute of Health and Welfare, 2018).

Importance of Human Resources in Australia’s Health Information System

There are numerous ways through which the different areas of improvement that have been mentioned above can be addressed. In the case of access to health information systems data, there could be safe and very effective ways that can be developed that can help in the access and use of the data collected. One such ways is through the development of an interconnected system ran from one command post that can be able to regulate the flow and access of health information data between the different people and organizations that require this data. Having a common command post will ensure that data collection is harmonized and that area that lack adequate data can be easily detected. In addition, running access to data from one command post will reduce the delays associated with searching for data, often physically from the respective health care center that are in custody of the required data.

Another strategy that would address the issue is the development of local and national database systems where information can be stored. This would create a hierarchy of command posts each manning different regions, and ultimately ending in a single database for the whole nations. Data can then be accessed by registered and authorized persons in order to be used for planning, monitoring and evaluation of the effectiveness of the health information systems (Mantas  et al, 2011).  

Training of staff that works in the health information management sector is also a strategy that needs to be explored in order to enhance the skills of these employees. The failure of the staff to be updated on the specific changes in regulation and policies surrounding health information systems could be one main reason why there could exist large inconsistencies in the process of data collection and its use by managers and clinicians. More comprehensive training can be used as a means of enhancing the collection and use of the data.

The use of the budgetary allocations by the government is also a top priority that the nation has given to the development of the health information systems. However, there has been several instances where reports of the misuse or misappropriation of funds has occurred. This affects the use of the information systems. In order to help in ensuring that the money has been used effectively, the parliament can be used as the main platform to regulate the appropriate use of the budgetary allocation. There needs to be more allocation for the health information systems in order to enable the different agencies involved in this system to be able to carry out their activities. Additionally, increased allocation in the budget can help to enhance the training of the staff. The individual managers in the health centers can also be effective in the regulating the budgetary usage in order to ensure that the health institutions do not run out of funds or misuse their budgetary allocations. Integrity at work can be best enforced from within the organization rather than through laws and regulations put by the national assembly. As a result, the role of the managers and the clinicians in ensuring integrity is observed in use of resources is critical.

Data Quality in Australia’s Health Information System

Some of the other agencies that should take up responsibility of implementing the required change include public and private learning institutions. Institutions such as the Australian College of Health Informatics among others are tasked with the role of offering health information systems education to learners in order to enhance the understanding of health information systems and thus, streamline the use of the health information systems in the health care. Such institutions can offer training to managers and clinicians on the importance and manner of using the health information systems. These agencies are also responsible for developing the standards for professional practice and education in Health Informatics. It is such bodies that can be of greatest help in assisting the government to be able to come up with effective policies that will enhance implementation of the systems. The Australian College of Health Informatics also participates in research, as a means of establishing evidence-based guidance and initiatives that can be effectively adopted by the nation. Learning institutions can make a huge impact if they enhance their training an research activities. Such institutions can be responsible for issuing surveys and interpreting the data that is often collected from this surveys to give meaningful interpretations.

The Australian Commission on Safety and Quality is also one of the agencies that can be of utmost assistance in the bid to improve the quality of health care information data. This agency is mandated with coming up with policies that are applicable can be used to help to implement a more secure and effective data management system. This includes ensuring that proper research has been done and that the data can be used in the making of policy and planning. This agency can come up with policies that would ensure that staff members are well trained and are conversant with the use of technology for health information systems.

Another important agency that can be of great help in streamlining health information systems is the Australian Institute of Health and Welfare. This organization develops, collects, analyses and reports information of several critical facts in the health information status throughout the nation. The data collected by this organization can be of great assistance in guiding other player in the sector on how to effectively collect and manage data. The data management design used by the agency can be replicated to other organizations in order to eradicated inconsistencies and challenges faced by these players when they are collecting data and handling the data. The Australian Institute of Health and Welfare can help to create training materials for health information management.

Challenges in Accessing Health Information Systems Data

The Department of Health also needs to increase its involvement and surveillance of the health information system and the extent to which the players in the sector adhere to the policies and procedures that have been stipulated. Being the ultimate body in the health sector the Ministry of Health should increase its involvement by offering training of the members of staff involved in the management of the data in order to ensure that management of health information systems is harmonized and effective. Direct involvement of the department will hep to ensure that all players access equal treatment and that issues affecting the access, collection, transformation and use of heath information data are detected early enough and resolved.

Additionally, the parliament of the nation need to be up to task to be able to come up with policies that would be effective in monitoring the effectiveness of health care information systems. The parliament is the absolute body mandated with the development of the policies and procedures that guide the health information system. The parliament needs to develop strategies and policies that will guide the collection of data, the use of the data and the sharing of the data. The parliament also has the ability to form task forces that can be mandated with executing different strategies aimed at making the health information systems more effective. The parliament is the body that can be tasked with regulating who access what level of information, and the extent to which the data can be used. The parliament can also give authority to different agencies to regulate the powers that would define their roles.

Creation of a network that would enhance the sharing of data between different parties that have interest in the health data would be an important improvement. As it is at the moment, there is no formidable networking system that takes care of this niche. In fact, third parties have little to no access to health data collected by the government and its officials. This limitations restricts their ability to carry out research and to come up with effective solutions to the health data collection and management challenges.

According to Mantas et al., 2010,In the creation of such a network, current technology would be of great help. There are many avenues at this age in time that would be used to enhance access and sharing of information between different people in completely different geographical areas. Such avenues include the iCloud platform. The iCloud platform has already been used in the business worked for many reasons such as to interconnect offices and employees. Data can be stores through an iCloud system and shared between and among authorized parties. In this strategy, the government can come up with an iCloud data storage system that can carry data for as many users as possible, and enable sharing of the data with third parties.

Strategies for Improvement – Development of a Common Command Post

It has also been identified that the utilization of data by clinicians and physicians as well as managers has not hit the optimum. The utilization of the data collected in making of decisions and policies within the field of public health could have a great impact in increasing the quality of service offered as well as procedures of collection and storage of the data (Mantas et al., 2010). As much as some of the clinicians and managers are making use of the data, there are many more who do not make use of the data. This hinders the development of the public health sector in Australia.

One improvement that can be introduced in the system would be to enforce through legislation the periodic review of the operations of health institutes in order to evaluate their compliance to policies that have been developed after review of the data. By ensuring that all institutions comply to standards policies, the government will prevent a situation where some managers deliberately choose not to consider the information for planning, priority setting or resource allocation and action. Subjecting all institutions to a level ground could help to stabilize and enforce the coherent use of the information collected by the health information systems 

Implementation of the suggestions above can be achieved easily and more conveniently if deadlines and timelines are set within which the different strategies should have been implemented (Mantas et al., 2010). Deadlines enhance speed to achieve as well as increasing motivation to the parties involved in order to ensure that success is achieved. The timeline within which the improvements can be implemented can be well established. This can be done through a clear analysis of the different situation that need to be carried out. One such area of improvement that needs to be worked on with a timeline is the training of the staff members that are involved in the use of health information data. The members of staff that are involved with collection of data at the grass root level, the managers and clinician need to be trained within the fastest time possible. According to Smith et al., training would require development of a training curriculum that can be adopted nationwide and be effective. This can be done within five years. This is because the development of a curriculum is a long process which can be tedious and its effectiveness needs to be assessed. Development of a curriculum also needs to be followed by close monitoring of the system to ensure that it is effective. Before the system is rolled out, there would require to be a period of time when the curriculum is given to experts who will look into the curriculum and advise on the issues that require special address and adjustment. Before a final curriculum that would be effective can be developed, five years can easily lapse.

Strategies for Improvement – Creation of Local and National Database Systems

The other issue that require address is the development of a system that would collect data from local health care facilities and store the same on national serves that can store the information and allow access to authorized persons. The development of this software would also require accompanying hardware utilities as well as proper training of employees that are required for the operation of the system. Software development and development of a database can take up to two years since the system needs to be rolled out for trial before it is officially launched for field use. The development would require some six months for training of the developers and designers, another one year for the actual development and field testing and another half an year for testing and maintenance of the database system (Smith et al., 2011). Usually, a new database system requires some time before it gets to a time where it is clearly understood and used effectively.

The establishment of a shared network where health data will be stored and accessed and the creation of policies within the nation where the health workers will be regulated by a similar policy will help to increase the quality of the health services and the quality of the data collected. Such policies will work to bring about a complete overhaul of the system, thus making sure that data collection, handling and protection is maintained at an all-time best. The more regulation there will be, the more the heat will be created, and hence the increase in the urge to strictly follow the required procedures for data handling. Policy and procedures is the first strategy that needs to be addressed (Policy Frameworks, 2015)..

ATTACHMENT A – HIS RAPID ASSESSMENT TOOL 

Number	Criteria for Success	Present*	Functioning*	Adequate*	Sustainable*	Reference(s) in support of claim. (Only links are required, no detailed justification.)
HIS RESOURCES
1	Is there a national cross-sectoral HIS committee?	no	yes	yes	no	Australian Research Integrity Committee (ARIC) www.arc.gov.au/australian-research-integrity-committee-aric 00001.
2	Is there a written national HIS policy?	no	no	no	yes	The National Health Information Agreement (NHIA) www.himaa.org.au/memberarea/journal/30_1_2001/christensen/christensen.html Department of Health | Privacy Policy www.health.gov.au/internet/main/publishing.nsf/content/privacy-policy 00001.
3	Is there HIS related legislation to measure Vital Statistics	no	no	no	yes	Australia’s National Digital Health Strategy – Australian Digital Health … https://www.digitalhealth.gov.au/…/australias…health…/ADHA-strategy-doc-(2ndAug)… 00001. Cached
4	Is there HIS related legislation to measure Service Delivery	no	yes	no	yes	Policy and Legislation | Department of Finance https://www.finance.gov.au/policy-legislation.html 00001.  00002.
5	Is there HIS related legislation to measure Notifiable Disease Reporting	yes	yes	yes	yes	National Notifiable Diseases Surveillance System (NNDSS) www.health.gov.au/nndssdata 00001.
Financial and Human Resources
6	Are there human resources uniquely identified as HIS?	yes	no	no	no	Roles and responsibilities – Australian Digital Health Agency https://www.digitalhealth.gov.au/get-started-with-digital-health/…/roles-responsibilities
7	Are there clear lines of responsibility for HIS?	yes	no	yes	no	Roles and responsibilities – Australian Digital Health Agency https://www.digitalhealth.gov.au/get-started-with-digital-health/…/roles-responsibilities 00001.
8	Is there an allocated budget line within the health department for HIS activities?	yes	yes	yes	yes	Department of Health – Health Budget 2017–18 www.health.gov.au › Home › About us › Budget › 2017-2018 00001.
Infrastructure
9	Is there sufficient hardware available for HIS use?	no	yes	no	no	Health Information Systems (CRH608) – Courses & Units – University … www.utas.edu.au/courses/chm/units/crh608-health-information-systems 00001.
10	Is there sufficient software available for HIS use?	no	yes	no	no	Health Information Systems (CRH608) – Courses & Units – University … www.utas.edu.au/courses/chm/units/crh608-health-information-systems 00001.
11	Is there sufficient networking infrastructure to support HIS use?	no	no	no	yes	Digital health links – HISA – Health Informatics Society of Australia https://www.hisa.org.au/links/
INDICATORS
12	Are there national core indicators to measure Health determinants?	yes	yes	yes	yes	Indicators of Australia’s health https://www.aihw.gov.au/getmedia/…/ah16-7-1-indicators-australias-health.pdf.aspx 00001.
13	Are there national core indicators to measure Health system inputs and outputs?	yes	yes	yes	yes	Monitoring the building blocks of health systems www.who.int/workforcealliance/knowledge/toolkit/26.pdf 00001.
14	Are there national core indicators to measure Health outcomes and status?	yes	yes	yes	yes	Core, Hospital-based Outcome Indicators https://www.safetyandquality.gov.au/…/indicators/core-hospital-based-outcome-indica… 00001.
15	Is there a national strategy for collection of health indicators?	no	yes	no	no	National Core Indicators https://www.nationalcoreindicators.org/ 00001.
DATA SOURCES
Population Based
16	Is there a complete population census undertaken at least every 10 years?	yes	yes	yes	yes	Census – Australian Bureau of Statistics www.abs.gov.au/census
17	Is there a Civil Registration process in place for all births and deaths?	yes	yes	yes	yes	Births, deaths and marriages registries | australia.gov.au https://www.australia.gov.au/information-and…/births-deaths-and-marriages-registries 00001.
18	Are periodic surveys undertaken to capture information for key health issues?	no	no	yes	no	Australian Health Survey – Australian Bureau of Statistics https://www.abs.gov.au/websitedbs/D3310114.nsf/home/AHS+Output+Strategy:+Overview+of+the+Australian+Health+Survey
Institution Based
19	Are individual health records maintained for recording the ongoing treatment of patients?	yes	yes	yes	yes	My Health Record https://www.myhealthrecord.gov.au/
20	Are there appropriate health service records collected?	yes	yes	yes	no	My Health Record https://www.myhealthrecord.gov.au/ 00001.
21	Are there appropriate resource records collected, including finance and human resources?	yes	yes	yes	no	Australia’s Natural Resources Database | Informit https://www.informit.org/index-product-details/STREAMLINE
DATA MANAGEMENT
Data Storage, Management and Transmission
22	Are there written procedures for data storage, including security and destruction?	yes	yes	yes	yes	Data Protection 2017 | Laws and Regulations | Australia | ICLG https://iclg.com/practice-areas/data-protection/data-protection-2017/australia
23	Is there a centralised database or data warehouse that combines all health data collections?	No response required as there is no centralised database in Australia and at present is not a viable option.
24	Are there defined, locally appropriate mechanisms in place for data transmission?		yes			Data Protection 2017 | Laws and Regulations | Australia | ICLG https://iclg.com/practice-areas/data-protection/data-protection-2017/australia
INFORMATION PRODUCTS
25	Are staff appropriately skilled to transform data into information at national level?	yes	no	yes	no	The Transformation of Official Statistics – Australian Bureau of Statistics www.abs.gov.au/…nsf/…/Australian+Statistician+-+Speeches+-+2016+Transformation
26	Are staff appropriately skilled to transform data into information at divisional/provincial/local level?	yes	no	yes	no	The Transformation of Official Statistics – Australian Bureau of Statistics www.abs.gov.au/…nsf/…/Australian+Statistician+-+Speeches+-+2016+Transformation
27	Are there tools and procedures available to assess the quality of data?	yes	yes	yes	yes	ABS Data Quality Framework – NSS Quality Data Tool https://www.nss.gov.au/dataquality/aboutqualityframework.jsp 00001.  00002.
28	Is there a set of national health data standards and definitions that are used across all health data collections?	yes	yes	yes	yes	National Statistical Service ? Standards, Classifications and Data Dictionaries www.nss.gov.au/nss/home.NSF/…/Standards,+Classifications+and+Data+Dictionaries
DISSEMINATION AND USE
Demand, Analysis, Policy and Advocacy
29	Are managers and clinicians using information for policy and advocacy?	yes	no	no	no	The notion of evidence-based policy in Australia is dead | afr.com www.afr.com/opinion/…/listening-to-your-own-great-advice-20161212-gt94c2
Planning, Priority Setting and Resource Allocation, Implementation and Action
30	Is an annual health report submitted to Parliament each year?	yes	yes	yes	yes	Department of Health | Annual Reports www.health.gov.au › Home › About us › Annual Reports
31	Are health managers using information for planning, priority setting or resource allocation and action?	yes	no	no	no	The notion of evidence-based policy in Australia is dead | afr.com www.afr.com/opinion/…/listening-to-your-own-great-advice-20161212-gt94c2
32	Are clinicians using information for planning, priority setting or resource allocation and action?	yes	no	no	no	The notion of evidence-based policy in Australia is dead | afr.com www.afr.com/opinion/…/listening-to-your-own-great-advice-20161212-gt94c2
33	Is data readily available to internal and external users, e.g. on the internet or intranet?	no	no	no	no	My Health Record identified data to be made available to third parties https://www.healthcareit.com.au/article/my-health-record-identified-data-be-made-available-third-parties

Present – the criteria is met or has been met in the past

Functioning – the statement can be answered positively and evidence is available that this is happening regularly

Adequate – the statement can be answered positively and is meeting most needs

Sustainable –the criteria been in place and functioning without external support for some time

References

Australasian College of Health Informatics – Australasian College of Health Informatics (ACHI). (2018). Retrieved from https://www.achi.org.au/ 

Australia’s National Digital Health strategy – Australian Digital Health Agency. (2018). Retrieved from https://www.digitalhealth.gov.au/about-the-agency/publications/australias-national-digital-health-strategy 

Clinical Ethics Committee (CEC) | ACT Health. (2018). Retrieved from https://health.act.gov.au/about-us/clinical-ethics-committee 

Clinical Ethics Committee (CEC) | ACT Health. (2018). Retrieved from https://health.act.gov.au/about-us/clinical-ethics-committee 

Department of Health and Human Services. (2018). Retrieved from https://www.dhhs.tas.gov.au/ 

Eysenbach, G., & Consort-EHEALTH Group. (2011). CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions. Journal of medical Internet research, 13(4).

Health Records Act. (2018). Retrieved from https://www2.health.vic.gov.au/about/legislation/health-records-act 

Hersh, W. (2010). The health information technology workforce: estimations of demands and a framework for requirements. Applied clinical informatics, 1(2), 197.

Hersh, W., Margolis, A., Quirós, F., & Otero, P. (2010). Building a health informatics workforce in developing countries. Health Affairs, 29(2), 274-277.

Hovenga, E. J. (Ed.). (2010). Health informatics: an overview(Vol. 151). Ios Press.

Garde, S., Harrison, D., Huque, M., & Hovenga, E. J. (2006). Building health informatics skills for health professionals: results from the Australian Health Informatics Skill Needs Survey. Australian Health Review, 30(1), 34-45.

Mantas, J., Ammenwerth, E., Demiris, G., Hasman, A., Haux, R., Hersh, W., … & Wright, G. (2010). Recommendations of the International Medical Informatics Association (IMIA) on education in biomedical and health informatics. Methods of information in medicine, 49(02), 105-120.

Policy Frameworks. (2018). Retrieved from https://www.health.wa.gov.au/circularsnew/current_policies.cfm 

Reports & statistics – Australian Institute of Health and Welfare. (2018). Retrieved from https://www.aihw.gov.au/reports-statistics 

Smith, S. E., Drake, L. E., Harris, J. G. B., Watson, K., & Pohlner, P. G. (2011). Clinical informatics: a workforce priority for 21st century healthcare. Australian Health Review, 35(2), 130-135.