Mr Shane Solomon, Head of Healthcare, KPMG Australia

Topic: A glimpse of the future – using e-health to provide system wide clinical benefits of real value to consumers

E-health is the most important micro reform for the health system

“In Hong Kong I worked every day in the future e-health environment that Australia aspires to.”

Hong Kong

  • 40 hospitals
  • 74 GP clinicis
  • 55,000 staff
  • 1M annual admissions
  • 13M ambulatory visits
  • Its cost is a fraction of other systems that support universal healthcare access.  Healthcare is less than 3% of GDP.

Hong Kong’s Health IT System

  • Single integrated clinical management system
  • More than 10 years of corporate data in 8.9M persons
  • Response time of less than 1 second – having very wide pipes is important.
  • Started in 1990
  • 700K hits per day
  • Average less than 7 minute consultation – not bad medicine, able to be efficient due to the high quality electronic system.
  • Cited examples in surgical safety and pharmacy and admission risk reduction for the elderly (HARRPE)
  • See http://www.ha.org.hk

Some of their achievements:

  • Relatively low level of resources can achieve huge success.
  • “These examples are just a few of what I experienced every day in Hong Kong”
  • Reduced waiting times
  • Keep people out of hospital
  • Major efficiency gains in specialist and GP consultations
  • Safer pharmacy
  • Improved surgical audit, identifying high risk surgical practice

Lessons for Australia:

1.       Take a long term view.  Be patient and manage expectations about what can be achieved in the short term.  .

2.       Integration of information is not easy.  Much effort in change management needed.  Major institutional and clinical change management challenges in Australia are much bigger than Hong Kong.

3.       Extensive clinical engagement is needed.  HK record was created by clinicians working with developers.  Not just ‘tick the box’ engagement.  Finding out what clinicians find valuable is the most important and crucial step.  They need to see some benefits.

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