14. IT requirements in primary care

As the gateway to the health system, and a focus for policy change and investment going forward, primary care needs efficient and effective ICT (information, communication, technology) to help deliver its potential. Sadly, our systems remain clunky, server-based, disconnected from other parts of the health system, and don’t provide meaningful intelligence on how we’re improving patient populations (or not). And MyHealth isn’t going to cut it.

I believe the requirements for improved workflows in primary care include the following:

1. Patient register – a way to track patients longitudinally, especially those with chronic disease needing ongoing care and monitoring
2. Risk stratification – a way to differentiate service intensity and approach according to patient risk, particularly if capitated payments are tiered
3. Shared records – we must have a way to track all touchpoints of a patient’s interaction across their journey through the health system, and pick-up gaps in care
4. Care plans – a way to plan pro-active care for those with health risks or chronic disease, especially for multi-morbid patients
5. Patient portal – embedded tools to help patients improve motivation, capacity and opportunity for self-management
6. Virtual communications – moving away from fax machine and paper; we must be able to use technology and mobile Apps to enable more efficient interactions
7. Billings and payments – tracking of capitated budgets, service payments and the cost of care pathways (so we can evaluate value for money)
8. Appointments – a way to automate the booking, recall and workflow processes
9. Reporting – providing data back to clinicians and patients to improve care; and
10. Data analytics – using data for health system evaluation and research.

Reconciling this list of requirements against current market options means we are well short of where we need to be; start-ups are well placed to enter this space as building from scratch from first principles has the advantage of not being beholden to existing functionality and user behaviours. Watch this space!