Consumer information session on e-health

How is consumer feedback used to improve health services in the ACT?

HCCA Health Issues Group:

Are you interested in how consumer feedback is used in the ACT to improve health services?  are you interested in how consumers can provide feedback? 

Thursday June 17 2010, 12.00 –2.00 at the HCCA offices in Hackett

A light lunch will be served at the beginning of the event.  Please contact the office if you can join us.

At this forum we will have two speakers, and time for your questions on:

The work of the Health Services Commissioner from the ACT Human Rights Commission.
Mary Durkin, the Health Services Commissioner will come and talk about the role of office in dealing with complaints about health services and health service providers. Her presentation will cover the types of matters that the Commissioner can investigate, the process for handling complaints, the outcomes that might be achieved, and how complaints can be used to inform system improvements.

and

The work of the Consumer Engagement Team in ACT Health
Robyn Jensen is the team leader for the Consumer Engagement Team. She will speak about:
• the team’s role in managing consumer feedback across ACT Health,
• working with HCCA to provide consumer representatives on ACT Health committees,
• and other ways that they assist ACT Health to engage with consumers.

Note: Out of respect for the access needs of people with chemical sensitivities and people experiencing breathing related allergies and illness, please avoid using perfume, aftershave, essential oils or other highly fragranced products when attending this event.

National Health Reform - Consumer Information Session in Canberra

On 29 April 2010 the Hon Mark Butler MP (Parliamentary Secretary for Health) spoke with members of CHF and HCCA at Scarborough House, Woden.  

Photo: Russell McGowan, Mark Butler, Darlene Cox and Carol Bennett at the Consumer Information Session

Mr Butler spoke about the Government's reform agenda announced in the National Health and Hospitals Network for Australia's Future.  He also spoke about the key issues that emerged from the consideration of the context for health reform by the National Health and Hospital Reform Commission (NHHRC) consideration of the health system.  His presentation included a summary of the recommendations arising from the Preventative Health Taskforce, Primary Care Task Force as well as the NHHRC.

The challenges in the Australian health system include:

• fragmentation of care
• gaps and poor coordination of services
• pressure on public hospitals and health professionals
• unsustainable funding model
• too much waste and inefficiency, and
• not enough local clinical engagement

Participants were fortunate in that the timing allowed us to ask Mr Butler about the agreement that had been reached at the Council of Australian Governments (COAG) on 19-20 April 2010. 

The COAG communique is worthwhile reading.  The Communique claims that the reforms will deliver better health and hospitals by:

• helping patients receive more seamless care across sectors of the health system;
• improving the quality of care patients receive through high-performance standards and improved engagement of local clinicians; and
• providing a secure funding base for health and hospitals into the future.

The rhetoric is good and we look forward to further consumer involvement in fleshing out the detail.

One area of interest is the 4 hour targets for the emergency departments.  This target is for consumers to be triaged, admitted, or referred and discharge within 4 hours.  It is in the process of being rolled out in WA and South Australia and will work from triage category 1 - 5 over a progressive period.  This is a signficant improvement.  Mr Butler cited figures that more than 600 000 people wait more than 8 hours at ED each year.  He also pointed to the ACT figures that show taht  only 58% people are seen within clincially recommended time for their triage category.  He compared this with NSW where 78% of people are seen in within the clinically recommended time.

Consumers need to be a little cautious about embracing such targets as we need meaningful performance indicators.  we need to push for indicators for improvement which involve reform to clinical practices to improve outcomes for consumers.  The UK introduced 4 hour targets and the BBC reported that there is a practice of 'fiddling' ED waiting time targets.

There was around 40 minutes for questions from the floor.  Below are a few of the questions and the answers Mr Butler gave:

Q: People with palliative care needs have to go to hospital to get the care they need in terms of pain and sympton relief?  do these announcements deliver more sub-acute care for people needing palliative care?
A: The Sub-acute care funding does not relate to palliative care.
Note: this means that consumers need to continue to advocate for community based palliative care and access to sub-acute care for people who need palliative care.
Q: How will this plan improve health outcomes for women? Is there any dedicated funding for women's health?
A: Women's health is not specifically dealt with in this agreement
Q: There are activity based funding payments on basis of outputs delivered by providers but what about incentives to reward prevention?
A: There will be incentives to jurisdictions to improve prevention
Q: there is lots of talk about consumer centred care but it seems once again we are talking about health economics and health financing.  How does the government plan to engage with consumers to make sure there is nothing about us without us?
A: These reforms will bring the consumer to the centre of each sector and level of care.  this will enable consumers to be at the centre of care as individuals as as communities.  the community based governance will enable community input into how services will be delivered.  The Primary Health Care Organisations will provide more 'patient centred care' (Mr Butler's words) with case management by multidisciplinary team rather than consumers accessing the health silos.
Q: Is there an architecture for governance that enables consumers and the community to have a discussion about how it will hang together in respect of the electronic agenda that has to support all of this?
A:  With respect to e-health, the Prime Minister will make comments about this in the future and it is reflected in the communique to COAG
Note: the Communique says "COAG noted the importance of continuing to work towards a National Individual Electronic Health Record system and agreed to prioritise discussions over the coming months to move towards the implementation phase".

Consumer Information Session with Parliamentary Secretary for Health, 29 April 2010

The Consumers Health Forum of Australia (CHF) and Health Care Consumers' Association (HCCA) are co-hosting an information session to discuss the Federal Government’s proposed National Health and Hospitals Network with the Hon Mark Butler MP, Parliamentary Secretary for Health.

The consultation forum is planned for Thursday 29 April 2010 (09:00am to 10:30am) in Canberra. The venue is the Department of Health and Ageing Theatrette in Scarborough House, Woden.

We hope that many of our members will be able to attend this important event which will provide an avenue for consumer information and discussion on the hospitals reform debate.

Please register your interest to attend with Lindee Russell, CHF Project Officer by phoning (02) 6273 5444.

Please note that unfortunately funds to support attendance are not available. If you have any special needs please ensure you let us know.

Personal Health Records

One of the great potential benefits from consumers in the plan to roll out e-health programs is the improvement in the connection and integration of care. The development of personal held records which can be considered as a is of particular interest to comsumers.  This record would be owned and controlled by the individual consumer and the information it contains could be shared with designated clinicians, providing them with information that would assist them in treating our conditions. The National Health and Hosptial Reform Commission (NHHRC) developed this idea in their final report.

Recommendations 13, 115 and 120 of the NHHRC Final Report are about the need for every Australian to be able to have a personal electronic health record that will at all times be owned and controlled by that person. This is important to support people’s decision making and management of their own health. The Commission called for this by 2012.

Many consumers are already doing this in hard copy or on their computers. Many of the people we speak with you have Chronic Conditions understand that a personal held record is an important tool in managing their own health and making decisions. One of our members had a red A4 folder which he and his wife always travelled with. The folder has details of his diagnosis, medication, hospital visits, doctors and test results. Another consumer has told us about his simple, A4 double sided document that he keeps in this wallet. One of the participants in our recent training for consumer representatives. Julie Derrett spoke with Brian and he shared his story:

Brian has a heart condition and has had numerous visits to the emergency department for his condition. He carries with him a little red book which lists all of his medication history, strength, dosage, date started and reasons for any changes. He also has a letter from his cardiologist which explains his condition and his medical history.
When doctors at the ED ask him what medications he is on, he simply produces the red book. Doctors comment, “I wish all patients did this, it helps so much with diagnosis and misdiagnosis in the ED”
When travelling interstate in a rural area the letter from the cardiologist proved to be invaluable. ED staff in a regional centre were able to contact B’s cardiologist and get advice so that the right medications were administered quickly.
This simple paper based, personally held record has meant that Brian has received timely, well informed advice and treatment when he has attended the emergency department. He thinks that everyone who has a chronic condition should have something like this. If not a small book, then a fold out credit card sized summary document that could be carried in your wallet.

We are interested to collect stories from consumers about personal held health records. We would like to know the information you collect, when do you use it? when have you found it to be of most value? have you changed over time the information you have in the record?