Sunday, June 22, 2008

Glossary

Many of us struggle with the terms used in the health system.

Over the time we will add to the listing of terms. We have arranged them alphabetically.

advisory committee
a group of people, representing different points of view which gives advice to the organisation or department which established it

confidentiality
sensitive information provided to members of boards and committees must be kept private, with access limited to appropriate persons. Confidentiality agreements may be used to ensure that members are aware of their responsibilities regarding confidentiality

Carer
Carers are those who provide unpaid care and support to ‘family members or friends who have a chronic or acute condition, mental illness, disability, or who are frail aged’

Consumer
The ACT Health Consumer Feedback Standards define consumer to mean:
  • People who directly access a health service;
  • Their nominated representative or representative with legal authority
  • Their carer, family member or advocate
  • Groups of consumers or consumer organisations; or
  • Members of the community
Consumer Participation
We use Fiona Tito-Wheatland's definition
is the process of involving health consumers in decision-making about their own health care and in health service planning, policy development, priority setting and addressing quality issues in the delivery of health services. Consumers may participate as individuals, groups, organisations of consumers, consumer representatives, or communities.

consumer representative
a person appointed to a board or committee to represent the interests or perspectives of consumers

minutes
an official written record of what occurred at the meeting

confirmation of minutes
Minutes are sent to members after a meeting and are confirmed as a true and accurate record at the next meeting. If members do not agree that the minutes are accurate, they can ask that they be considered for alteration

matters arising (from minutes)
this is an agenda item that provides members an opportunity to ask about progress on any matter in the minutes of the previous meeting that is not listed elsewhere on the agenda

Thursday, June 19, 2008

e-health

e-health is a convenient shorthand for national electronic health information. for consumers the electronic tag is important as the electronic/digital element provides the potential to provide consumers and health care providers with accessible up-to date health information of a good quality. however, it is important to recognise that the "e-" is the technology. The technology will allow the data to be easily updated, readily accessed and can assist in achieving better quality and uniformity data. The e-technology will provide the medium and a stimulus for better health information that is more accessible to consumers.

Report on CHF Workshop on “Delivering e-health for consumers”
held in Canberra on 12/13 June 2008



I recently participated in the Consumers Health Forum (CHF) national workshop to discuss electronic health information (e-health), the potential areas of benefit and concern and consumers’ expectations. There were useful sessions that gave participants up-to date information about national strategies, priorities and policies that were being developed in the e-health information realm. These were presented by the Commonwealth Department of Health and Ageing, the National e-Health Transition Authority and CHF. There was also a valuable session the issues around e-prescribing. These presentations provided a structure for the subsequent debate and discussion.

The workshop promoted discussion on a number of aspects of e-health with the objective of defining a number of activities in the development of national e-health priorities that consumers see as being a priority. The range of consumer foci and priorities around e-health are however diverse and include a personal health record; greater e-health information emphasis on wellness and issues such as environmental conditions; the content of, access to and protection of national e-health information data; the desirability of mandatory participation versus voluntary participation; e-medication summaries; remote prescribing and medication review; e-discharge summaries/plans; e-“save-my-life’ basic health record; e-referrals; e-pathology results and digital imaging.

These issues are ones that were seen as important from a consumer point of view, assisted health care providers in improving care and provided a suitable basis (or building block) on which the broader e-health network can be developed. There was not a unanimous view from the consumer participants at the workshop on some of the issues, for example the voluntary versus mandatory issue and the priority ranking. These are therefore, e-health issues on which consumers may be called to express a view as e-health develops and may need to be better informed.

Tony

Wednesday, June 18, 2008

Final report for Australia 2020 summit


The final report on health (PDF 458kb) is out for Australia 2020 summit.

At the moment we are taking our time in the office working through the document.

We will include items of interest in Consumer Bites over the coming Months.

Public lecture: Health costs and policy in an ageing Australia

Menzies Centre for Health Policy: Public Health Policy Oration

Mr Garry Banks has been Chairman of the Productivity Commission since its inception in 1998. In addition to his role as Chief Executive he has personally headed national inquiries on major policy and regulatory topics – including Private Health Insurance, National Competition Policy and the Economic Implications of an Ageing Australia. Gary chaired the 2006 Taskforce on Reducing Regulatory Burdens on Business and was a member of the West Review of higher education in 1997. He chairs the inter-governmental Steering Committee for the Review of Government Service Provision, and was the initial convenor for its report Overcoming Indigenous Disadvantage.

Date: Thursday 26 June
Time: 5.00 pm
Venue:
Finkel Lecture Theatre, The John Curtin School of Medical Research, Building 131, Garran Road Acton, Canberra

To reserve your place and for catering purposes please send RSVP to laura.vitler@anu.edu.au by no later than Friday 20 June

Monday, June 16, 2008

SELECT COMMITTEE ON ESTIMATES 2008-2009

Representatives of HCCA appeared before the SELECT COMMITTEE ON ESTIMATES 2008-2009 Reference: Appropriation Bill 2008-2009) on 19 March 2008.

The PROOF TRANSCRIPT OF EVIDENCE is available. The comments by the representatives from HCCA are on pages 71 - 76 of the pdf (440kb).

HCCA gave a comment on the ACT Government budget and then answered questions from the Committee regarding:
  • electronic health initiatives
  • the importance of ambulatory care facilities
  • the women’s’ and children’s precinct at The Canberra Hospital
  • levle of community consulgtation reagrding the process with redesiging health services
  • and preventive health

Friday, June 13, 2008

Blogging and nonprofit organisations

I have been reading a blog by a woman called Beth Kanter. She is an American educator and networker and has played a large role in helping non-profit organisations embrace the potential of social media. Every time I read her blog I am excited at how this technology can help us achieve our goals at HCCA. I listened to a couple of presentations Beth gave at the Connecting Up 08 conference I attending in Brisbane in May. Her enthusiasm for connection, collaboration and content is infectious.

Beth posted yesterday after attending a session on Social Networking and Web Tools for Chicago Nonprofits. I would encourage you to read her post. It is a summary of a panel discussion on how non-profit organisations are using social media. They address a range of questions which Beth summarises for us, including:

  • How do you managed user-generated content? How much time does it take? How much staff?
  • How you ever encountered problems related to your funding and what you're doing on the site? How you moderate inappropriate behavior or conversation?
  • What are some resources if you don't understand social networking? What are some resources to help your constituents?

National Mental Health Agenda


I attended the Grace Groom Memorial Lecture at the National Press Club this week as the guest of Medicines Australia.

Dr Grace Groom was the former CEO of the Mental Health Council of Australia. Dr Groom died in 2006. She made a strong contribution to mental health reform in Australia and this is recognised each year by an annual Grace Groom Memorial Lecture Series, organised by the Mental Health Council of Australia.

The Hon Nicola Roxon MP, the Minister for Health and the Minister responsible for mental health was the guest speaker for the 2008 Memorial Lecture.

The Minister outlined the Government's reform agenda for mental health and announced funding for a range of projects. She also announced the members of the new Advisory Council on Mental Health, to be led by former head of the Mental Health Council, John Mendoza. The Pdf of the media release is available on the DOHA website.

The speech was in keeping with the Government's commitment to early intervention and prevention that was outlined earlier this year. In April the Government established a new National Preventative Health Task Force, made up of health experts from around Australia. The task force is to develop strategies to tackle the health challenges caused by tobacco, alcohol and obesity, and develop a National Preventative Health Strategy by June 2009.

One of the ideas that interested me was the increased use of technology to help people better manage their mental health and wellbeing.

The Black Dog Institute will receive $1.8 million for a mobile tracker system that uses the internet and mobile phones to help people track their wellbeing in areas including mood, appetite, sleep, medication, physical activity, and drug and alcohol use. The information is fed back to the users on how they are going, and alerts are sent when things aren’t going well, along with links to appropriate self-help tools.

The example given is a woman reporting that she has been feeling anxious and not sleeping well. The system would send her an alert pointing to tools for managing anxiety and giving tips for sleeping better. The alert may also recommend discussing the issues with a GP or clinician. Reports can be printed off so that consumers can take them to their clinicians.

There is another project run through Swinburne University of Technology for Anxiety Online — an online program helping people with anxiety disorders work through a module of cognitive behaviour therapy, either independently or with the assistance of a trained therapist.



Tuesday, June 10, 2008

The medical home: another model for managing chronic conditions?

I have been reading around the concept of the “medical home” . This has been a hot topic in the US in terms of disease management. US Physicians from the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP) and the American Osteopathic Association (AOA) have offered their support to the medical home model.

I can't say that I am across the whole concept but I am interested in how it is developing in terms of primary care reform.

In short the term medical home describes:

a health care model in which individuals use primary care practices as the basis for accessible, continuous, comprehensive and integrated care. The goal of the medical home is to provide a patient with a broad spectrum of care, both preventive and curative, over a period of time and to coordinate all of the care the patient receives.

Source Deloitte Centre for Health Solutions


The research documents the critical features of the medical home which they have identified as forming the platform for guided self-care management. This can be useful in our discussions in terms of primary care model and managing chronic conditions.,

If you are interested in reading more about this you might like to follow the links below:

The American Academy of Pediatrics (AAP) introduced the medical home concept in 1967, referring to a central location for archiving a child’s medical record. In its 2002 policy statement, AAP expanded the concept to refer to primary care that emphasizes timely access to medical services, enhanced communication between patients and their health care team, coordination and continuity of care, and an intensive focus on quality and safety.

In 2007, a set of seven principles describing the characteristics of a practice-based care model was issued by four physician membership organizations representing over 300,000 physicians. The authoring organizations are: the American Academy of Family Physicians, the American College of Physicians, the American Osteopathic Association, and AAP. The clinicians represented by these organizations provide the majority of primary care in the United States.

Source ICIC

“Disease Management and the Medical Home Model: Competing and Complimentary” — has been published in the peer reviewed journal of Disease Management and Health Outcomes. The author has arranged with the publisher to make copies available through his website.

It seems that there are more challenges to moving to this model that solutions at this stage. There are issues around the start up costs for clinicians and services, including IT infrastructure as well as training for clinicians.

US Study into consumer attitudes and expectations of health care

I stumbled across an American research study by the Deloitte Center for Health Solutions through one of the research blogs I regularly check (Resource Connection).

The blog posted a good summary which led me to seek the Executive Summary:
Deloitte’s 2008 Survey of Health Care Consumers, an online poll of more than 3,000 Americans ages 18-75, provides an important and timely perspective on health care consumerism. The survey assesses consumers’ behaviors, attitudes, and unmet needs related to health, health care and health insurance. It also points to six discrete segments of the overall consumer market, providing a profile of their key characteristics and differences. Each segment presents opportunities and risks for health care industry stakeholders.

The conceptual framework upon which this research is built reflects what they consider to be the five major domains of health care consumer activity:
  1. use of traditional health services from medical professionals and hospitals,
  2. use of alternative and non-conventional approaches to care,
  3. self-directed care,
  4. information seeking and
  5. financing.
It is based on the company's belief that consumers will play a significant and increasingly important role in the U.S. health care system’s efforts to improve quality, reduce errors, increase access to services, reduce unnecessary costs, and promote laws and campaigns that address its issues and challenges.

Wednesday, June 4, 2008

In the media

Russell McGowan did an interview with The Canberra Times yesterday regarding the availability of GPs. An excerpt from the article, that appears on the front page of today's paper, says:

Health Care Consumers of the ACT president Russell McGowan said yesterday some people were missing out on primary health care as a result of the serious shortage of GPs.

The problem was exacerbated by the bulk-billing rate, which was the lowest in the country.

''There is yet another element and that's to do with affordability,'' he said.

''Some people choose not to go to primary health-care services and they leave it until it becomes more of a crisis and they present at emergency departments.''