beyond pt 0 23/1

Whilst this level of cost saving is available theoretically, it is unlikely that
these savings are achievable, given the high failure rate of hospital IT
projects and the industry-wide cooperation that is required for full
achievement. However the PECC project does report at least one 500 bed
hospital which has achieved savings of this magnitude.
Efficiencies resulting from clinical quality/safety improvements
There are significant gains in health outcomes and decreases in ‘episode
of care’ and whole-of-life costs arising from utilisation of e-commerce
tools in clinical care.
Box 6.2
Avoiding adverse reactions
The president of the Australian National Patient Safety Foundation, Professor Bill
Runciman, is reported as estimating the national cost of admitting patients to public
hospitals due to adverse reactions to medicines at about $500 million per year.
‘It’s huge. It’s over ten per cent of the annual pharmaceutical budget, which is
$4 billion,’ Professor Runciman is reported as saying.
Professor Runciman, the head of anaesthetics and intensive care at Adelaide
university is reported as saying that the main drugs involved in adverse events in
Australia are anti-coagulants, anti-inflammatories used in arthritis treatment and
drugs used for heart failure and blood pressure.
An associate professor of medicine at Harvard Medical School, Dr David Bates, was
reported as saying ‘US studies show that up to 80 per cent of adverse drug events
could be prevented by computerised drug ordering.’
Source: Sydney Morning Herald, 14 March 1998.
Preventable adverse events resulting from failures of information flow
among health providers account for eight per cent of hospital activity
measured in bed-days. The cost of inappropriate use of pharmaceuticals is
estimated at $500 million per annum. Australian research shows that
general practitioners are unaware of 26 per cent of the medications being
taken by their older patients, and amongst this age group adverse
reactions to medication is estimated to cause one third of emergency
hospital admissions.
On the positive side, there are significant health benefits which are
achievable if doctors prescribe more knowledgeably or consumers comply
with prescribed treatment (or even to have the prescription filled) have
been well documented. The estimated benefits from this improvement is
also estimated to be of the order of $500 million, extrapolating from
US studies.
The rise of evidence-based medicine has seen the proliferation of clinical
guidelines by various authoritative sources. Medical practitioners can now
have access to professional information services which can form the basis
of ‘expert systems’ whereby information from a variety of sources can be
brought to bear on a particular patient episode and the prescription of
therapies by the medical practitioner.
An early example of this is the Clinical Information Access Project which
the New South Wales Health Department has made available to health
professionals in the public health system.
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