As far as the adoption curve goes, you are at the tail end. Health care is widely regarded and acknowledged as the most rigid, slow to adopt market on the planet. Life saving medication and surgical devices sometimes taking over a decade to hit the shelves of pharmacies and theatres around the world. The behaviours of the healthcare professionals, mainly doctors, are that of the latest adopters in the innovation adoption curve. New technology and innovation is not only incredibly slow to market due to governmental regulation, but uptake is unanimously decelerated by the sectorial oligarchy which is the medical profession. Unsurprisingly, this leaves us with medical technology akin to using a Nokia 3310 pulling up to the McDonalds car park to get free wifi so you can navigate Opera browser to look up when the next episode of the OC is on. And even more staggering is that 15% of physicians in the US are still using paper based records (https://www.cdc.gov/nchs/fastats/electronic-medical-records.htm). So when we investigate the cause of poorly adopted government funded EHR’s it is difficult to find the root of the adoption dilemma.
Welcome to Denmark! Where the sky is hardly ever blue but the position of their state wide EHR is far from dim. A doctor in Denmark can sit back in their chair at the local while quietly sipping on a Carlsberg at 4:10 in the afternoon knowing they have completed the same days work as their US counterparts. Due to 98% uptake of the EHR in Denmark, doctors on average have 50 minutes less administrative work to complete. This is not to say we are exactly comparing apples to apples though as the US, UK, Canada and Australia having significantly larger and geographically isolated populations. That being said, Denmark has had its challenges during the development of the EHR (in the late 90s mind you). There were some barriers for physician uptake with the system. The first role out included a categorical need to code each patient, effectively requiring health care professionals to “double up” on data entry for each patient. From here in 2006 the government pushed out a new system that was effectively a database to plug into any practice management or patient management system and universally adapt to what doctors and other healthcare professionals where already using. Jens Andersen of sunded.dk commented “What we found is that EHR adoption must be done by evolution rather than revolution”. A sentiment that will resonate with almost all healthcare professionals looking to uptake government EHR initiatives around the world.
In Australia the eHealth system has been built and rebuilt and finally at a stage where it aims to plug into multiple systems. Hopefully, this will result in lower barriers to uptake by healthcare professionals and ultimately a level of efficacy of the system. The greatest threat to a country wide EHR is lack of use and with that the subsequent inefficiencies created without widespread uptake. A universal electronic health record in Australia provides multiple benefits in terms of continuity of care and patient outcomes but the real benefit is to the economy. The number of repeated tests, procedures and consultations funded by the government costs over $7 billion annually to tax payers. So far, the country has spent $1 billion on my health record and is edging closer to a user-friendly platform for healthcare professions and patients alike to seamlessly use.
Finally, talking specifically about Australia, the stubbornness in our medical fraternity and possibly the low level of focus on health by all Australians may be the biggest barriers to uptake of the eHealth platform. One of the key differentiation points between Denmark and Australia is the trust in the government and that they will eventually build the right platform. We have very much a mentality of “if it has failed us once we won’t give you another shot” which may result in downfalls in user uptake of the EHR. The success of the platform and ultimately a centralised computer database for all Australians health bears on our ability to accept change and have faith. From Time magazine online, a quote from Dr Phanareth of Frederiksberg University Hospital “Sometimes, a lack of resistance is all you need for change to happen.”
Note: Hippocamp is committed to the success of the Australian My Health Record and establishing a centralised database. In the coming months we will be aiming to work with the Australian government to see how Hippocamp fits in to this over arching goal.