Executive Summary
The main discourse of the study aims to address the discussions on the EHR and EHR vendor. The study has further stated on the various types of the evaluations which are seen to be based on the both primary and secondary recommendations. Moreover, the analysis of the investment are considered with the evaluation of the approaches used in thee analysis. In addition to this, the various discourse of the study will also include the various aspects of the financial benefits and costs, non-financial benefits and costs, risk of implementation, organizational change impact and real options for the future digital opportunities support by the investments. Some of the various types of the other aspects of the study is able to show the benefits claimed in terms of the project governance and oversight, risk management and target measures. This section is followed with the study which have been further seen to be evaluated per the ethical and Social Implication. This section has discussed on the various types of the relevant aspect of the information which are seen to be covered as per relevant ethical and social principles. This section of the study has also discussed on the relevant aspects of the potential risks and threats to the patients and the staff. The final section of the report has stated on the short comings of the analysis. The list of appendixes has included all the excerpts of the information collected from the primary analysis. The main findings of the study implies that Availability of state of art technology in healthcare systems and the severity of the workforce issue in healthcare system is seen to be occasional in nature which states more number of skilled doctors available in the country is identified as the main strength of the company. Whereas, there is a significant scope of providing an improved healthcare access in the remote areas of New South Wales. In addition to this, The government needs to introduce more policies for the private concerns so that they include healthcare service with a better outlook with implementation of EHR systems.
Introduction
The report intends to state on the various types of the considerations which is based on the doctor’s practice along with the challenges as per the marketplace and various types of the challenges which are being faced by them. In addition to this, the report has also discussed on the operational problems along with the issues and opportunities. The main explanations on the background of the report is considered with the relevant discussions on the EHR and EHR vendor. The study has further stated on the various types of the evaluations which are seen to be based on the both primary and secondary recommendations. The main form of the analysis of the investment are considered with the evaluation of the approaches used in thee analysis. In addition to this, the various discourse of the study will also include the various aspects of the financial benefits and costs, non-financial benefits and costs, risk of implementation, organizational change impact and real options for the future digital opportunities support by the investments. Some of the various types of the other aspects of the study has been able to show the benefits claimed in terms of the project governance and oversight, risk management and target measures. The next evaluations of the study have been further seen to be evaluated per the ethical and Social Implication. This section has discussed on the various types of the relevant aspect of the information which are seen to be covered as per relevant ethical and social principles. This section of the study has also discussed on the relevant aspects of the potential risks and threats to the patients and the staff. The final section of the report has stated on the short comings of the analysis. The list of appendixes has included all the excerpts of the information collected from the primary analysis (Government of South Australia 2014).
Background information
The Australian health system is seen to be led by the various type of the health system which is world class both in terms of the effectiveness and efficiency. The country has shown improving performance in terms of the various performing group of the countries for a healthy life expectancy and health expenditure per person. The Australian population has been depicted to be in good health status with an average life expectancy with a birth rate of 81.4 years. There are several groups which is able to consider the various types of the factors which are seen to be associated to the various types of the considerations for poor health status, notably among the aboriginal and Torres Strait Islander peoples. In the public sector hospitals, the country is seen to be having more than 70% of the total health expenditure in Australia which is depicted to be funded by the government. In addition to this, the Australian Government is seen to set the various types of the national health policies and subsidies provided by the “State and Territory governments and the private sector” (NHS Connecting for Health 2014).
Some of the main concerns for the doctors has been seen in terms of the private sector and the private health insurance. It is discerned that in most of the cases the private health insurers do not cover the fees such as medical fees for the general practice services. The e-health record has been depicted to be started in Australia in 2000. The main depiction based on the development of the stand-alone and state-wide systems began from July 1, 2012. Despite of this the system is seen to be widely criticised in terms of the stakeholders and in favour of the national system. In various situation the policies by the government policies are affected in terms of the development of the EHR system. Despite of the present opposition by the support of the e-health the opposition has debating in terms of the PCEHR system which was seen to be implemented by the present government. The multi-tier approach by the large private sector and Australia’s multi-tier is seen to be evident in terms of the e-health systems. For instance, the federal government is also depicted to provide fund to both the individual and hospital services and state/territory government thereby providing more than 50% funding for the public hospitals (Wounds Australia 2017).
The EHR initiatives are viewed as an opportunity for having fundamental improvement in terms of the public health sector in Australia. Australian has taken EHR system as a national approach in implementing this for most individuals. Additionally, the Australian public has demonstrated a strong support for such implementation process which is depicted in the NEHTA study. Based on the study, in Australia more than 80% of 2700 nationwide participants strongly supported for the establishment of EHR systems and EHR vendors. This gave immediate access to the important medical information for saving lives and improving services in addition to this this also provided some relief to those patients who were suffering from chronic illness. Based on the study, it provided “ubiquitous health records” which means that health records can be accessed everywhere (World Health Organization 2014).
Key Recommendations
The primary data collected in order to state the key recommendations are based on 30 respondents who are medical practitioners working in various regions in Australia. Some of the main questions asked to the practitioners is listed below as follows
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Survey on challenges faced by the doctors |
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We appreciate your time and willingness to be a part of our survey |
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Place of Origin |
Australia |
Others |
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Question |
Please tick on the appropriate box |
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1. Main challenges faced as a doctor |
Financial Obligations of the Customer |
Adoption of E-HR |
Formal Organizational Communication |
Legislative Barriers |
Lack of effective clinical procedures |
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4 |
3 |
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1 |
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2. Severity of Workforce issue |
Never |
Occasionally |
Neutral |
Often |
Very Often |
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5 |
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3 |
2 |
1 |
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3. Key barriers for implementing the health and safety practices |
Worker attitudes |
Staff do not understand the problems/risks at work |
Lack of workers participation in the health and safety process |
Organization resistance to change |
Lack of Safety culture |
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5 |
4 |
3 |
2 |
1 |
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4. Factors affecting workforce issue |
Commitment by the top management |
Safety culture in the organization |
Participation of the Workforce in safety activities |
Staff Recognition of the problem/risk |
Identification of the safety issues |
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5. Rate Technology implementation in healthcare? |
Scale of 1 to 10 |
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6. Have Demographic changes impacted the healthcare services? |
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No |
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7. Have Technology costs impacted the healthcare services? |
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No |
Don’t Know/ Not Sure |
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8. Do you think rapid urbanization health issues are increasing the problem of health system |
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No |
Don’t Know/ Not Sure |
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9. Perception of the workers taking health & safety seriously |
Permanent Workers |
Temporary Workers |
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10. How will you rate Government initiative for Rural healthcare concerns? |
Scale of 1 to 10 |
Some of the main responses collected from the primary data are listed as follows:
Figure: Responses on main challenges faced as a doctor
(Source: As Created by the Author)
Figure: Responses on Severity of Workforce Issue
(Source: As Created by the Author)
Figure: Responses on Severity of Workforce Issue
(Source: As Created by the Author)
Figure: Responses on Factors Affecting Workforce Issue
(Source: As Created by the Author)
Figure: Responses on rate of technology implementation in healthcare
(Source: As Created by the Author)
Figure: Responses on Rational for Demographic Changes Impact in The Healthcare Services
(Source: As Created by the Author)
Figure: Responses on Rational for technology impact cost in The Healthcare Services
(Source: As Created by the Author)
Figure: Perception of workers taking health and safety seriously
(Source: As Created by the Author)
Figure: Responses on Government initiative for rural healthcare concerns
(Source: As Created by the Author)
Recommendations based on primary sources
Challenges Faced as a Doctor
Based on the evaluation of data collected from the primary sources from healthcare practitioners in Australia, it can be seen that the main challenges as a doctor is depicted with the adoption of EHR. This is evident with a total of 60% responses collected from 30 doctors based in Australia. In addition to this, based on the responses in several cases the main problem associated to the adoption of the EHR is often discerned with impact of policy and economic uncertainty and issue of unified approach. Therefore, the Australian government needs to give an augmented focus towards EHR implementation process (King et al. 2014).
Technology implementation in healthcare
The information collected from the primary data source clearly shows that most of the respondents agree that there is a high degree of technology implemented within the healthcare systems in Australia. This is evident with the total percentage of 46.7% who have stated in favour of such a high degree of technological innovation in healthcare practices. It needs to be further noted that while some of them have considered it as a boon, other have considered this as a curse to the healthcare system. Henceforth, it is recommended to make sure that the doctors are up to date with the knowledge of latest technological alternatives before proceeding with traditional methods of surgery (Shortliffe and Cimino 2014).
Recommendations based on secondary sources
Based on the secondary resources the main challenge of EHR has been clearly depicted with government policies which affect the overall development of EHR. In addition to this, some of the other problems faced by the government is depicted with design and implementation of e-health systems. Based on the sources of other sources of secondary information it can be clearly depicted that one of the major problems faced by the doctor in Australia is based on increasing cost of technology. Therefore, the main recommendations are for secondary research will be seen with implementing a cost-effective method which is best suited for technological considerations and implementation of electronic systems in healthcare services (McDonald, Tang and Hripcsak 2014).
Strategic Context
It needs to be discerned that the strategic context of health care system in Australia is based on three levels of state, territory, federal and local government involvement in the “Primary Health Care (PHC) system” along with certain interest of both private and public components. It is also discerned that the division of responsibility among the State and Federal governments are set on working across various jurisdiction and eliminate any problem faced by public health care is in Australia. The Medicare system introduced by the government was in the year 1984. The government of Australia funded most of the health services associated with taxation. In addition to this, the Medicare levy is presently set at 1.5% of the total taxable earnings but lower for all the income earners (Australia, 2014). At 1% surcharge the government levies on the income earners without private health insurance. It is also considered that the Medicare covers most of the general practice consultations along with this the Austrian government funds and the pharmaceutical benefits scheme substantially encompasses the various costs of medications (McDonald, Tang and Hripcsak, 2014b). The SWOT is based on the various excerpts of financial information collected from Greenway Technologies. These are necessary for consideration of investment in the company.
Strengths
Weakness
Opportunities
Threats
Analysis of the investment
The important considerations taken into account under the evaluation approach used in the analysis are depicted with
The healthcare Systems has a difficult scope of considering the financial benefits and costs with the implementation of capital budgeting model. The model will comprise of the various types of capital budgeting techniques like NPV, ROI and IRR. The main rationale for implementation of capital budgeting-based model because of its conduciveness in ascertaining the future value of the project with the appropriate discounting factor applicable. In this case, the most appropriate measure for the discounting factor can be included with the corporate tax rate. In addition to this the healthcare companies can also conduct breakeven analysis which will highlight the total breakeven point in units and volume which is required to be fulfilled by the healthcare centres (World Health Organization 2017).
Figure: Cost Benefit Analysis
(Hripcsak, Albers and Perotte 2015)
Rationale for Investment
Based on the depiction of various types of financial implications such as increasing debt equity, the company is on the verge of losing investors as it does not provide any commitment for declaring dividends. The company’s risk and liability kept on increasing by rising derivative liability from $ 56057 in 2016 to $ 105643 in 2017. There was a significant increase in dependency of the company in long-term debt as Greenway technologies did not have any long-term debt in 2014. Therefore, by considering various financial indicators such as debt equity ratio it is not recommended to invest in the company.
Some of the non-financial benefits consideration needs to be taken into account with the use of balanced scorecard approach by the industry.
The balanced scorecard approach of the industry will be based on four main perspectives which are stated below as follows:
Financial perspectives
The financial perspectives of the healthcare need to be considered with maximising the return is, managing the operating costs and bringing an overall profitable growth and organisations. Some of the main depictions will be inferred from the financial evaluation performed in the capital budgeting methods such as NPV, ROI and IRR. Similarly, to the financial perspective, the healthcare industry will set target for the next three years and measure the success based on achievement of the individual targets (Hripcsak, Albers and Perotte 2015).
Customer perspectives
The healthcare industry needs to consider these perspectives as for the changes which could lead to customer loyalty and increase customer satisfaction rating. The main measure for taking these initiatives will be based on the measurement drivers as per responses given by several patients and their satisfaction level with the healthcare services. Similarly, to the financial perspective, the healthcare industry will set target for the next three years and measure the success based on achievement of the individual targets (Hripcsak, Albers and Perotte 2015).
Internal process
This will be considered with the various aspects of business group, continual public support, customer service excellence and optimisation of core business processes. The internal process objectives will comprise of the various factors affecting the business growth of the company. Such factors will include the assessment on capitalisation on the regulation opportunities, using of alliances and joint ventures, optimisation of cross group and research and development activities. The measure for the internal process will be considered with measures such as revenue from deregulated products, revenue from new services, customer services were alliances and joint ventures and employee productivity and improvement.
Learning and growth
Some of the learning and growth objectives set by the industry in the next three May comprise of the factors which will ensure market-driven scale and world-class leadership to introduce new technologies in the healthcare system. In addition to this, the learning and growth will be measured with factors such as Strategic skill coverage ratio, patient satisfaction rating and hours spent in strategic skill training for the doctors in Australia. They initiatives will be considered with various types of competency profiling and training programs (Hanauer et al. 2014).
Some of the main risk of the implementation program can be depicted with the increasing nature of cost and adaptability of the new changes. As a business needs to go through rigorous changes for achieving all the four objectives, it will take a considerable amount of time for implementing all the necessary changes to the system. Furthermore, there would be a significant consideration of supporting workforce which is essential in the healthcare operations.
Figure: Measurement of risk among the healthcare operators in Australia
(Source: Lu et al. 2015)
The organisational change impact it be considered with the implementation of various financial measures such as capital budgeting technique and non-financial measures such as balanced scorecard approach.
The real and future opportunities of the investment needs to be based on the initial investment proposed by the government in the healthcare segment and the corporate tax rate prescribed for operating healthcare systems in Australian (Australia 2017).
Benefits realisation
The project governance and oversight will be considered with the benefits realisation map. The primary consideration for the benefits realisation of the project will be based on two key questions, namely what is the reason of conducting the program and secondly how the industry is going to realise the benefits. The benefits realisation maps suitable for the healthcare industry in Australia is found below as follows:
Figure: Benefits map for Benefits Realisation
(Source: Bradley 2016)
The risk management will be measured with the use of risk metrics for the relevant parameters and segregating the risk as far low priority list, media parity disk and high priority. Risk.
The target major factors are based on the set target for the next three years and comparing the same with the achieve objectives.
Ethical and Social Implications
Over the last 10 years, technology and evidence-based personalised medicine care have been contemplating with various types of social implications, ethical implication and legal implication. In the recent years, the implication of personalised medicine has been depicted with an increased scope of complexity (Confidentiality and Health 2014). This trend is likely to continue in the next few decades. The main ethical consideration needs to be taken into account with increased amount of health information. This is particularly evident with personalised medicine information which is being treated as a high dimensional data generally concerned with issues raised by “generating, aggregating, analyzing, storing and use of health information for personalized medicine” (South Australia Health 2015).
Privacy is a second important aspect which is a significant type of information focusing on health privacy. The relevant scope of the concept deals with confidentiality of the information which should not be disclosed without prior consent of the individuals. The pragmatic example of confidentiality can be depicted in cases of health practitioner publishing about information thereby keeping the personal details of the patient confidentiality as per his/her request. In addition to this, with the advent of EHR networks, the industrial world is facing an increased challenge of privacy risks due to the clinical encounters which essentially deals with individual’s longitudinal information (South Australia Health 2015).
Limitations
The limitations to the implementation of healthcare policies is depicted with various types of technological and cost constraints. In several cases, implementation of EHR requires several classification of data as per the specialised division of health care system. This is not only time taking in nature but also does not guarantee the success of implementation (Network Health South Australia 2015).
Conclusion
The main discourse on the background information have stated that The country has shown improving performance in terms of the various performing group of the countries for a healthy life expectancy and health expenditure per person. The Australian population is depicted to be in good health status with an average life expectancy with a birth rate of 81.4 years. There are several groups which has been able to consider the various types of the factors which are seen to be associated to the various types of the considerations for poor health status, notably among the aboriginal and Torres Strait Islander peoples. In the public sector hospitals, the country is seen to be having more than 70% of the total health expenditure in Australia which is depicted to be funded by the government. The information collected from the primary data source clearly shows that most of the respondents agree that there is a high degree of technology implemented within the healthcare systems in Australia. This is evident with the total percentage of 46.7% who have stated in favour of such a high degree of technological innovation in healthcare practices. In addition to this, as per evaluation of data collected from the primary sources from healthcare practitioners in Australia, it can be seen that the main challenges as a doctor is depicted with the adoption of EHR. This is evident with a total of 60% responses collected from 30 doctors based in Australia. The recommendations are for the secondary sources will include implementing a cost-effective method which is best suited for technological considerations and implementation of electronic systems in healthcare services. The main strength of the healthcare industry includes Availability of state of art technology in healthcare systems, the severity of the workforce issue in healthcare system is seen to be occasional in nature which states more number of skilled doctors available in the country, the rate of technology implementation is also depicted to be significantly high in the country and significant increase in EHR implementations. In addition to this, with the advent of EHR networks, the industrial world is facing an increased challenge of privacy risks due to the clinical encounters which essentially deals with individual’s longitudinal information.
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