Lack of national clinical guidelines
Fragmented, inaccurate records
High error rates
A major study called Care Track: assessing the appropriateness of health care delivery in Australia was released in 2012. It showed that Australians receive “appropriate” health care in only 57 per cent of medical consultations. This does not come as a surprise to this who have experienced the health industry, either as a patient or working as clinical staff.
Disconnected technology systems, a confusing payment system with multiple payers and a resistance by hospitals and clinical groups towards reform, all play a role in this problem.
The landmark CareTrack study, published in the Medical Journal of Australia, found that although there were pockets of high quality in Australian health care, there was also unnecessary and unwarranted variations in clinical practice.
Research teams from the University of New South Wales and the University of South Australia spent two years tracking actual medical care delivered to patients.
Overall 1,150 patients were studied during 2009 – 2010, over 35,573 episodes of medical treatments.
Medical care was compared to ‘Best Practice Clinical Standards’. Major treatments were reviewed such as cardiac care, back pain, depression, asthma and stroke.
The study showed substantial differences in different doctors practice. They also discovered substantial differences between different hospitals practice. And within different hospital, some did far better than others in consistently providing high levels of care.
Some hospitals proved ‘Best Practice’ in 86% of patients care. Other hospitals achieved ‘Best Practice’ in only 32% of patient care.
In only 57 per cent of encounters with healthcare providers, are Australians receiving best practice care.
The study concluded that barriers to more effective and uniform care included a lack of national clinical standards.
The $2 million CareTrack research project was undertaken as one part of an $8.4 million National Health and Medical Research Council program grant, Patient safety; enabling and supporting change for a safer more effective health system, awarded in 2009.
Best Practice Clinical Guidelines are extremely difficult for patients to find, most don’t know these guidelines even exist.
The National Health and Medical Research Council publishes a few, in highly academic format. The National Institute for Health and Care Excellence, a UK site has a much larger number, set out in far more organised and readable manner.
In frustration at the lack of coordinated data, some doctors have put together blogs offering to share information on Best Practice.
Wikihospitals believes that this information should be on line, free and easily available for all patients and health professionals to access and understand.