Academic journal article Australian Health Review

Good Health Information - an Asset Not a Burden!

Academic journal article Australian Health Review

Good Health Information - an Asset Not a Burden!

Article excerpt

Introduction

The focus on good health information has never been greater. With Health coming under increasing scrutiny and the impetus for real reform in Australia gaining momentum,1 there is a growing expectation that the health system and individual clinicians are able to provide evidence of their performance to the public. Patients, too, are rating their clinicians.1,2 Most recently, the Final Report of the National Health and Hospitals Reform Commission3 and the Final Report of the Garling Inquiry into Acute Care in NSW Public Hospitals4 have highlighted the need for good quality data to inform the delivery of healthcare.

The recommendations made in each report are a core element of the Federal Government's health reforms, with proposals for strong national standards and transparent reporting that are locally relevant. Despite the broader debate around the healthcare reforms, the recommendations concerning reporting have received widespread acceptance.

The intention of the reforms is to drive improved performance across the Health and hospital system, with funding increasingly linked to performance. This approach will provide Australians with access to transparent and nationally comparable performance data and information on their local hospitals and Health services, allowing individuals to make more informed choices and helping to ensure the continued improvement of the standard of care patients. New governance and funding arrangements under the National Health and Hospitals Networks will also require the establishment of robust and nationally consistent information management systems.

There has, however, been little acknowledgement of the importance of good information management and the need for high quality data underpinning the reforms. Data quality is complex and the focus of extensive research.5,6 The need for good quality data in healthcare is widely recognised, and wellestablished approaches to evaluating and improving data quality have been developed.7-9 The importance of managing data quality strategically has been highlighted by Kerr and colleagues.8,9

Jurisdictions such as NSW Health have initiated reporting through a separate agency, the NSW Bureau of Health Information, with responsibility for public reporting and performance monitoring, as well as ad hoc data supply and analysis, evaluation and research. Despite the best of intentions, such a bureau is more likely to focus on broad system performance and rely on historical performance data rather than locally relevant and current information.

Significant change also has to occur across the system at the local level to ensure local relevance of information. Health services need to focus on growing an information culture underpinned by a performance management framework that is meaningful to clinicians and managers and supports them in their daily work. Only then will clinicians and mangers start to value the information they have as an asset, with their contribution to the overall reform agenda becoming more visible.

Health has generally struggled to promote the effective use of information in managing services on a day to day basis, with very few facilities around the world able to claim that they have a mature information environment.10

Many managers, particularly clinical managers, have little training in information management and are often unsure as to what information they actually need to manage their service. The utility of available information to quality improvement and process redesign is often undervalued. In addition to the existing culture, Health reporting is hampered by having disparate information systems which are mostly poorly integrated. Information is often inconsistent and not sufficiently timely to be of real value.

Clinicians, clerical staff and managers need timely, consistent and accurate data, collated as a byproduct of daily activities, and delivered in a format that is easy to interpret. …

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