The eHR will provide a national view of the health status which will enable cohorts to be identified for example, the number of pre-diabetics compared to the number of diabetics, and the medications being prescribed to both groups. The individual’s health status can be monitored overtime including co-morbidities, and the cost/benefit of different treatment options. The broader health status information provided by an eHR will enable a step change in how the Government can make investment decisions, target public health initiatives, monitor the effectiveness of programmes, and will allow health to work more effectively with other agencies to improve outcomes. The impact of diabetics to the economy can be measured by looking at broader social outcomes e.g. employment outcomes for individuals in this cohort. Annex 2: International Experience Table 1: International Experience The majority of western economies have started to implement a national eHR over the last 5 10 years, with varying success. New Zealand is learning from each example below with – close alignment to the more successful approaches taken in Denmark, Scotland and Singapore. Outcome Approach Primary Care-led, starting with medications information: Patient information is shared between 100% of general First initiative was to link electronically prescription practices and Pharmacies. information between general practice and pharmacy in the Consumers have read only community. Further developed the national eHR with lab access to their eHR on-line. results and allergies and adverse reactions information. Separate crown-entity leading Progressively populating the eHR with more complex the next phase of investment. hospital/specialist records. Denmark Regional approach connecting to a national SPINE: £12B invested initially up to 2009 with limited results. New The government created the largest Digital/ICT approach focused on keeping project in the world. The approach was ambitious, the SPINE and enabling new however, and lacked clinical leadership or buy-in. services via an incremental Clinicians refused to share information and the 4 main investment model technology companies selected were not able to deliver to expectations. The approach was ceased in 2010 and England completely re-thought. NHS
The eHR will provide a national view of the health status which will enable cohorts to be identified for example, the number of pre-diabetics compared to the number of diabetics, and the medications being prescribed to both groups. The individual’s health status can be monitored overtime including co-morbidities, and the cost/benefit of different treatment options. The broader health status information provided by an eHR will enable a step change in how the Government can make investment decisions, target public health initiatives, monitor the effectiveness of programmes, and will allow health to work more effectively with other agencies to improve outcomes. The impact of diabetics to the economy can be measured by looking at broader social outcomes e.g. employment outcomes for individuals in this cohort. Annex 2: International Experience Table 1: International Experience The majority of western economies have started to implement a national eHR over the last 5 – 10 years, with varying success. New Zealand is learning from each example below with close alignment to the more successful approaches taken in Denmark, Scotland and Singapore. Approach Outcome Denmark Primary Care-led, starting with medications information: First initiative was to link electronically prescription information between general practice and pharmacy in the community. Further developed the national eHR with lab results and allergies and adverse reactions information. Progressively populating the eHR with more complex hospital/specialist records. Patient information is shared between 100% of general practices and Pharmacies. Consumers have read only access to their eHR on-line. Separate crown-entity leading the next phase of investment. NHS England Regional approach connecting to a national SPINE: The government created the largest Digital/ICT project in the world. The approach was ambitious, however, and lacked clinical leadership or buy-in. Clinicians refused to share information and the 4 main technology companies selected were not able to deliver to expectations. The approach was ceased in 2010 and completely re-thought. £12B invested initially up to 2009 with limited results. New approach focused on keeping the SPINE and enabling new services via an incremental investment model
electronic-health-record-strategic-assessment.docx