Challenges faced by the current health care system in Australia

In the present scenario the health care system of Australia that is publically funded is unable to reach the desired level of effectiveness. The reason behind this can be stated as the lack of patient information and their medical history. The  pen paper based record keeping system is not easily accessible for the health service providers, that leads to the loss of precious time in critical situations of  patients where they need fast medical treatment after any trauma or accident. In addition to that the pen paper based records are vulnerable and can be destructed due to different natural calamities which may cause in loss of the patient records.

One of the most important issue that is faced by the health service providers throughout Australia is the cost related to the maintenance of the records using the pen paper based system is expensive even though the efficiency provided by this kind of records is not satisfactory. The time required to record, retrieve and update the patient records can be crucial in case of any accident or in medical emergency. This traditional health record keeping system is also responsible for redundant medical tests and reports of the patients whipch again consumes lot of time in the whole health care service. 

Support in the medical decision making:    The proposed system of “My Health Record” will be helpful for the medical service providers to make the most suitable medical decision for a specific patient.  When the users (patients) are in a certain traumatic medical situation, then using the My Heath Record system they can get the medical history of the patient so that they can start the treatment avoiding the regular medical tests.

Improved quality of service by including the patients in the system: My Health Record will encourage the people to take a have active part in the health care services they get and to enhance the quality and proficiency of the services.  This enables the services providers to screen patients, analyze their health condition in re regular intervals and recognize the health issues before they have a huge impact on a certain patient.

Better coordination between the different health care services and facilities:  As the data of the patients can be uploaded and retrieved from anywhere using the internet, then in case a patient is affected by severe illness while they are away from the home city and known doctors, the medical service providers attending the patient can access My Health Record to retrieve the patient medical data in order to provide faster and best health care service.    

Benefits of My Health Record

 Improved accessibility: My Health Record will be used to store key medical information such as emergency contacts for any patient, allergies to certain drugs, recent tests completed and to set access controls so that the data is not accessible to un authorized users. The imperative medicinal data can be accessible at one place online using the “My health Records”. The viewer of this records can be controlled by the patient themselves.  Therefore any individual’s health related data is effectively made available to their approved hospitals, health care facilities, specialists or doctor’s. Regardless of the possibility that the patient move or travel throughout Australia, the data can be easily accessible by the patient and authorized viewers on the web, from anyplace, at any time. In the event that the patient need, they can get to their health data from any device connected with internet. While controlling the viewers of the data.

Secured personal health data:  There rules and regulations to restrict the viewers of someone’s personal health data will make the personal health data will be more secure. In addition to that, as the data is stored in digital format then these kind of data are not vulnerable to the natural calamities. Only the registered health care facilities and medical practitioner will be able access the My Health Record.  

Convenience to the patient:  Using the My Health Record online patient data storage, the patient did not have to remember the different test results done previously. Therefore with My Health Record, the end users patients can be upload the test related data such as the chronic condition of t the patients, detailed description of the recently done medical tests and their results and share them with their own medical consultants and health service provider facilities. 

 While considering the stakeholders one of the most important stakeholder is the senior management. In most of the cases, this is considered as the top most decision making department of the organization and they play very crucial role in the daily operations of any health organization including the implementation of the My Health Record.

The managers at the health care facilities act as providers of the system that works to implement the information system for the patients. As an example, if the system requires integration with other information systems in the facility, the manager is expected to arrange funds for the development and acquisition of those systems. They are also expected to designate the personnel that are required to develop the online health record system “My Health record”.

Stakeholders of My Health Record

 The development team is responsible for requirement gathering from the other stakeholders so that requirements of every stakeholder can be addressed in the developed My Health Record system.

Doctors, operational staff and the primary health care facilities will be the end users of the proposed My Health Record system.  The operational staff would be able to contribute to greater quality of care in a more cost-effective manner for their patients, for example through the use of the past health records form My Health Record, as well as improve patient care delivery.

The suppliers and the investors are the sponsors of the project to development of My Health record for the patients.

 After the system is developed the patients will be using the system to store the personal health data.

Government and other regulatory authorities will be responsible for maintenance of the international standards while developing the “My Health Record.” The Policy makers and legislators of the country have to ensure that the confidentiality of the personal data for which they have to make decisions and direct the development of the system aligned to the specific objectives through the use of international standards.

Implementation of the My Health record will be capable to offer improvements in the efficiency, quality, and safety of health care services provided to the patients in the commonwealth. In the late 1960s, the emergence of the computer-based hospital information systems helped the health care industry to provide better services.  This systems were adopted and   used in main hospitals, small hospitals and health care facilities which increased efficiency of the health care services.

For the medical facilities, doctors and patients the most important issues is to maintain a standard for the medical services provided to the patients. The major significance of the proposed My Health Record as suggested by most of stakeholders is the systemic storage of medical information of the patients. This allowed easy data collection and retrieval of the patient’s record   for diagnosis and medicinal purposes.

 From the management and managers perspective, the use of the “My Health Record” will be helpful in the efficient use of the available human resources by reducing the manual processing of the data for documentation minimized.  As the system would be helpful in improving the communication between the different stakeholders, encourage information sharing and promote work efficiencies among different departments in the health care facilities.

For the patients My Health Record could offer timely access to the medical reports and images as soon as they were uploaded by medical facilities, which will speed up diagnosis process and treatment decision-making for the concerned physicians. The faster diagnosis process will benefit the patients by providing better health care services to them. Individual medical information of the patients would be retrieved by the staffs or the doctors of a medical facility in an efficient and systematic way improving the overall performance of the medical services. Drug allergy and medication repetition could be avoided as the staffs at the facilities will have convenient access to medication history of an individual. Availability of medical history to the medical staff would also help with making diagnosis for the patients.

Implementation of My Health Record can improve efficiency, quality, and safety of healthcare services

While developing the online health record system it is important to know the drawbacks of the existing system and the functionalities required by the different stakeholders. This Questionnaire is intended for survey research. In addition to that the answers against this question are will help the team to determine the current situation. The responses against the following questioners will be used to find the difference between the status “before” and “after” the implementation of My Health Record system.

1. According to you what are the present issues in managing the patient health record using the traditional approach?
2. b) According to you what are the anticipated problems in the adoption of the “My Health Record” system in your hospital or primary health care facility?
3. c) Do you think the proposed system will improve the patient information privacy, confidentiality, security and transparency?
4. d) Will the system help the doctors and other medical service providers in better decision making?
5. e) According to you what are the anticipated benefits from the proposed system?
6. f) What is the best option for the application to deploy so that the easy accessibility can be ensured?
7. g) How can we improve the number of times a patient’s data is accessed by any health service provider?
8. h) How much of your time is spent in processing of the patients data manually?
9. i) What will be the deployment strategy for the developed system?
10. J) In case of any emergency what will be the recovery strategy to overcome the failure?

Most patients’   health care needs can be arranged as a blend of intense scenes, treatment of endless conditions, and prescribed precaution and wellbeing advancement exercises. Moreover, essential care experiences are regularly the aftereffect of a patient giving undifferentiated manifestations, a situation in which the doctor must assess both displaying side effects and patient history to decide the in all likelihood conclusion for the patient.

As shown in the above use case for My Health Record, the users will schedule an appointment to get the health care services. In this context the doctor or the health care service provider will access his/ her medical records.

After the treatment the health service provider will update the patients’ medical history and the results from the medical tests.

In the next use case, the system administrator will be responsible for maintain the integrity, confidentiality and security of the data by restricting the access levels.

The above use case is the expanded form of the health care services in the previously given use case. In this use case the patient can allow or disallow someone from accessing to their medical and personal records.  The doctors or the health care service providers will be responsible for viewing and updating the records of a patients who is under their guidance. The administrator of the system will be responsible for maintain the standards of the data and creating or removing users from the system.

The developed system must confirm and approve all the patient information inserted in the system. The clients (patients and medical service providers) must be advised if there is occurrence of mistakes distinguished over the span of utilizing the   system, the framework just permits the head to erase records in the database, and the framework ought to have the capability to add new functionalities (Abbas & Khan, 2014).  The system should have a high reliability level and performance levels. The developed My Health Record system must require high levels of input validation and error correction. The system will only allow browsing of the patient’s records only after acquiring their patients consent. Other nonfunctional requirements includes Performance that will be measured  in terms of  response time, throughput i.e the number of operations performed per second by the medical service providers or the patients.

Significance of My Health Record

Following are the critical system qualities that will available in the developed system,

1. a) The developed system will typically integrate with the existing systems of the health care facilities.
2. b) The system will be scalable as per the need of the health care facilities.
3. c) The next most important quality of the developed system comes in the form of reports (Weiskopf & Weng, 2013). The system is only as good as the reports it generates. The capability to produce information that helps in the decision-making process by the doctors or service providers is a key attribute for this kind of system.

There will be different level of access level for different level of persons. This access levels must be shown or produced if any one tries to access the system without having authority.

1. a) The users will be able to create, alter delete the data only after successful login to the system which will ensure the proper usability and reliability of the system.
2. b) The system will provide easy log in steps to the clients (patients or medical service providers).
3. c) If any error occurs, then the system will show a proper error message to the users. In this way the improved performance by the system can be ensured.
4. d) Patients must be able to control who has access to their medical history using the system. This will ensure the security of the patient’s medical and personal data (Abbas & Khan, 2014).

Cloud computing or the cloud based applications are the emerging commercial application deployment model that helps the organizations to reduce (even eliminate) the requirement to maintain in-house high-cost software, hardware’s and network infrastructures to manage the applications. It also reduces or even eliminates the high-cost of recruiting technically skilled professionals to operate and support the in-house IT solutions and technical infrastructures to maintain the information system applications (Abbas & Khan, 2014). Through the use of resource time-sharing and virtualization, the Cloud   based solutions offers diverse opportunities (in terms of on-demand services) for different organizational needs of the health care facilities.

Use of the cloud services in the management of patients medical data makes it more efficient to handle the growing amount of patients’ data and information generated through the electronic and personal health records systems by using the My Health Record System. The complexity in the management of the data can be viewed from the perspective of required data storage and the count of the servers needed to process these enormous amounts of data of the patients.  The use of the cloud based solution for My Health record will facilitate the medical staff and patients to use smart phones and tablets to access healthcare services from anywhere.

Suitable authentication methods for the users added to the role-based system provides secure environment to store and process patients’  medical and personal data. In case of the migration of the healthcare data to the cloud, there are some security precautions that needs to be taken. One of those important precautions includes data encryption at the time of the migration. Even though data encryption seems be the most secure technique to handle patient’s data, however not all the systems are compatible with encryption methods (King et al., 2014). This is due to the multiple users who each have a role-based access, nevertheless their access level might overlap because of their job roles and responsibilities which requires different level of access to the database of the patient’s record.

Pros

1. In this approach the end results of the projects are known to the project team.
2. It helps the project team to complete the project in the given time frame.
3. Documentation is done in every stage that helps in better understanding of the requirements.

Cons

1. As the planning is done initially then the requirements have to be specified at the beginning of the project.
2. It is considered as one of the rigid approaches as it cannot accommodate any kind of changes after the project is initiated.
3. The communication between the project team and the clients happens only at the beginning or end of the project.    

Pros

1. This approach assumes that the course of action for the projects needs to be adjusted with the progress of the project.
2. Support repeated development that helps in risk management related to the project.
3. Can accommodate any kind of change request at any phase of the project.
4. Incorporates the clients at every stage of the project so that their requirements can be fulfilled at the same time improves the clients expertise.

Cons

1. Only suitable for large size projects where the complexity and the projects are much higher.
2. Requires skilled personnel in the team so that the uncertainties and risks related to the project (Appari, Eric Johnson & Anthony, 2013).
3. As each stage of the project includes risk management thus increases the risk related to the project.  

Many components or factors can influence the chosen approach for the development of the My Health Record. While assessing the approach to develop the system, it must be determined that, whether the project is in the familiar domain of the project team with an anticipated way, or new type of project with uncertain outcomes.

How My Health Record can benefit patients

The predictive approach assumes that the project can be planned at first and then executed as per the plan (Weiskopf & Weng, 2013).  The predictive approach gives a direct, particular improvement plan organized around creating a pre-decided system or result inside a particular time allotment.

Evolving projects that face changing conditions are most requires adaptive approach.  The approach suggests to divide the project into little parts over an undetermined timetable to permit extreme adaptability in coordinating the course of the project (King et al., 2014). This approach also helps in the fulfilling all the requirements from the different stakeholders. Therefore as the development of My Health Record is a complex project including various types of stakeholders thus the Adaptive approach will be suitable for this project.

The adaptive approach   is an organized and methodical process for persistently enhancing choices, administration approaches, and practices by gaining from the results of choices beforehand taken in the project (Appari, Eric Johnson & Anthony, 2013). This approach incorporates the fundamental standards of coordinated project administration, for example, iterative procedures and innovative business conditions. Likewise, adaptive approach includes the dynamic utilization of quantitative techniques to quantify project execution and apply figuring out how to enhance choices in the middle of the project. This approach integrates assumptions and new learning from the previous phases when planning the next project iterations.

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