beyond pt 0 23/1

educe the duplication of assessment processes so that each agency agrees
to work from a shared assessment information base. More systematic
implementations of integrated patient information storage and
communications systems are also being explored, most notably in the
Northern Territory with its new Community Care Information System.
The GP is in the best position to act as the gatekeeper and information
switcher between hospital systems and community care systems. Again, a
standard electronic health record is seen as a necessary enabling tool.
Domiciliary nursing care is a high volume distributed service which
requires extensive information exchange between nurses in the field and
organisational databases. The Royal District Nursing Service in
Melbourne is experimenting with mobile communications for hand-held
devices operated by nurses.
Community pharmacy services
Community pharmacies are a key service channel in the Australian health
system, with around 15 per cent of Commonwealth health outlays
accounted for by therapeutic drugs dispensed through pharmacies under
the Pharmaceutical Benefits Scheme.
Issues associated with pharmacy services involve action to ensure
appropriate use of medication where indicated and to reduce
inappropriate use of medication.
The Pharmacy Guild of Australia has documented a wide range of
research studies showing the economic and health benefits which may
flow from more effective community pharmacy services involving
information management and compliance support for prescribed drugs.
Hospital services
Both public and private hospital systems in Australia have information
and communications systems of highly variable quality and utility. Larger
public and private hospitals have made some progress in basic
computerisation of internal information functions but the use of
technologies for communicating externally to the hospital or for
supporting clinical transactions is generally primitive.
Innovative developments are often limited to one section of the hospital
with little integration within an overall e-commerce strategy for the
hospital. A widespread weakness in change management for
implementation of new information and communications tools for
hospitals means that many promising pilot studies cannot be replicated in
the wider system and that more than half of all hospital information
technology systems initiatives fail.
More recently some individual hospitals have implemented new and more
integrated systems. St Vincent’s Hospital in Melbourne has implemented a
range if information and communications systems supporting clinical care,
including sophisticated information management systems for the Intensive
Care Unit and systems which have permitted total re-engineering of the
admissions process by decentralising admissions processes to wards,
eliminating the central admissions facility. The new Children’s Hospital in
Sydney is being designed around a paperless record system which will
automate transactions such as ordering tests and reporting them back
within the hospital.
124