IT-enabled home care the key to health in the next millennium
Federal Health Minister Dr Michael Wooldridge has launched a new initiative, which is expected to shift resources away from hospital-based care and into the home.
Dr Wooldridge opened the Centre for Online Health today at The University of Queensland's St Lucia campus. The opening was be broadcast live on the Internet at: www.coh.uq.edu.au
The launch at level six, General Purpose Building South in Staff House Road, included live links facilitated by Picturetel to CSIRO in Sydney, a demonstration of international emergency care to San Diego using technology developed in Brisbane by Distributed Systems Technology Centre (DSTC), and a home care presentation by the Centre and Apple.
Centre for Online Health director and head of UQ's Psychiatry Department Professor Peter Yellowlees said the Centre would undertake research to move the health system away from its concentration on institutional care, to providing increasing levels of care in the home supported by appropriate information technologies.
Major partners of the Centre include Queensland Health, DSTC, CSIRO, Sun Microsystems, Data General, Blue Care and the Wesley Group of Hospitals.
"If bed days in hospitals and nursing homes were reduced by only 10 percent per year, there would be a potential shift of resources from hospitals to community systems of over $2 billion per annum in Australia," he said.
Dr Yellowlees said the health care environment in the 20th century had focused on hospitals and other health care institutions which consumed the majority of the 8.5 percent of Australia's gross domestic product presently spent on health.
"In 1996-7, some $21billion per year was allocated by the various different health sectors in Australia to provide institutional care in hospitals and nursing homes," he said. "It is clear that this model of care, with the increasing associated costs and ageing population, is simply unsustainable in the 21st century.
"Moreover, the rise of ?consumerism' with more importance placed on patients being informed about their disorders, means there will have to be greater future collaboration with patients, and a stronger health care system focus on patients' needs."
Professor Yellowlees said the Centre would capitalise on the world class standard of health care in Australia, and the nation's high uptake rate of effective information technologies. There were more mobile telephones and video recorders per head of population than anywhere in the world, and Internet usage levels in the Australian adult population were already about 40 percent, with an even gender distribution.
"The Centre is designing clinically driven Internet based systems that will link general practices and public and private hospital and health systems to patients in their home," he said.
"Such links will also be available to home care nurses, who will inevitably be given prescribing and other high-level treatment rights for patients in future through the use of various clinical guidelines and pathways. At the same time patients will be monitored more effectively in their homes with a variety of new cardiac and respiratory monitors. They will be able to choose whether they see their doctors or home care providers face to face or via the Internet.
"Several exciting new interface approaches for accessing information are being designed particularly for the elderly, who are inevitably likely to resist the use of keyboards. The systems include voice navigation and control systems, touch screens, smart cards and the telephone."
Professor Yellowlees said it seemed inevitable that patients would have shared electronic records in the near future. Several trials were occurring internationally in this field at present. Patients would be able to access their health care information through browser enabled televisions, perhaps via cable TV networks, from their home. This approach to health care, besides being more focused on patients, and in particular reducing the need for institutional care, would empower and inform patients, and cause considerable changes to the therapeutic relationships that patients had with their treating teams.
"The field of online health care is extraordinarily exciting, but it is crucial that it is led by clinicians and that the ?solutions' are not provided by technologists," he said.
"It is likely that home care nursing will become very much more important in the next millennium than it is now, and will expand in ways that we cannot today even imagine. The future will be one where we have less health care boundaries, where health becomes a global, and often virtual, enterprise and where patients have much more access and choice.
"Health professionals are, on the whole, simply not ready for these sorts of changes, unfortunately, and it is crucial that they start to think about these issues, to drive changes in a manner that makes the best clinical sense, and not behave like dinosaurs wishing that everything would simply remain the way it was 20 years ago."
Media: Further information, Professor Peter Yellowlees, telephone 3365 4671, mobile 0413 587960, Web: www.coh.uq.edu.au
