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Australian ITMay 05, 2009 12:11am AEST | Make this site your homepage
THE AUSTRALIAN


THE lack of a connected health IT infrastructure will hamper Australia's efforts to contain swine flu, e-health experts warn.

Nations with good e-health capacity are analysing vast volumes of patient data taken from providers' systems in near real-time, but federal and state health planners are forced to rely on fragmented and poorly resourced data sharing networks.

"If there is an e-health infrastructure, we have the potential to deal with disease outbreaks before they become pandemics. The technology is already available," iSoft chief operating officer Andrea Fiumicelli said.

"Time is of the essence. In the past, the spread of diseases was measured in months, today it is a matter of hours because of the rapid movement of goods and people around the world.

"Information technology is the only way to meet the time challenge in collecting and sharing information in a pandemic."

Once doctors, hospitals, labs and researchers are all using e-health software, it becomes possible to automatically analyse patient records or medical processes to identify risks, flag alerts and speed up diagnostic or treatment responses.

Mr Fiumicelli said the emerging field of biosurveillance combined traditional healthcare IT applications with complex data analysis tools such as grid analysis -- in which detection algorithms were distributed across many networked computers to process information much faster than any single PC could.

"You need a way of capturing data across medical specialties at a central point so you can detect threats early enough to allow time to develop therapies and reduce the risk of a pandemic," he said. "We need to be able to share this information across borders and as close to real-time as we can get."

In Mexico, iSoft has a $1.5million contract with the Nuevo Leon State Healthcare Department to supply an integrated care system at 10 hospitals and 470 health centres. Mr Fiumicelli said the iSoft application was providing large amounts of data for analysis and provision to Mexican authorities and the World Health Organisation.

"When we have the IT infrastructure and software to automatically manage medical records we can begin to cross-check a patient's lab results with their diagnostic imaging results," he said. "We can do data mining against historical research into infection types, or cross-reference what is happening to a specific patient against medical protocols defined by the World Health Organisation."

Australia still had limited e-health resources and provider connectivity, so it was unable to adopt these techniques.

Instead, local health authorities were communicating by email and fax in some instances.

Health Minister Nicola Roxon yesterday failed to respond to questions about the department's Biosecurity Surveillance System, the Health Alert Network and a web-based management system called NetEpi. All these communication systems have been criticised as seriously inadequate.

The Hong Kong Hospital Authority was using a data integration platform installed during the SARS (severe acute respiratory syndrome) outbreak in 2004 to lead its response to the latest challenge, said Neil Gow, Asia-Pacific director of integration specialist Informatica.

Originally deployed to replace a fax-based information sharing process, Informatica was able to bring together data from 30 clinical systems across 43 hospitals and 120 outpatient centres within five days.

The aim was to co-ordinate medical, audit and performance reporting across the organisation, but the system also collected and analysed frontline clinical care data with immediate benefits in improved care, alerts to new diseases and public health research, Mr Gow said.

Informatica's platform -- effectively an infrastructure that allowed users to pull together certain information for further analysis -- overcame a key obstacle, he said.

"The big challenge for health is the age and varied nature of the IT systems that are in use, from mainframes to the most modern web architectures," he said. "The strength of our technology lies in its ability to access data no matter the format and no matter where it resides in a system."

Because it is no longer necessary for all users to standardise on a single format, the costs of enterprise reporting, computer modelling and data mining are greatly reduced.

"The more standardised everyone is, the simpler the solution will be, but for many organisations it's a challenge, and you simply have to accept the data in the format presented."

Over time, data quality will be improved and errors removed.

Informatica's platform now includes an identity resolution feature, which could help to identify patients as they move around the system and trace people who have been in contact with infectious carriers, he said.