Commencing in 2005 the Biosense program has attempted to aggregate clinical data into a central database or biosurveillance data directly from hospital systems. Circumventing local and state departments in many scenarios. Costing in excess of $100 and running over several years, the system was conceived due to a previous inability to aggregate and analyse information at a national level. The primary risks to the implementation of the system are:
* Project:Patient’s privacy and security might not be “safe” as BioSense is government program therefore they could use some of this information for their own advantage. * Structure: System may not be able to spot that there is an epidemic problem in my hospital, it will show the problem on a wider scale. * Technology:Hospital must standardize its existing medical data in to BioSense format * Experience:Staff will need to be trained to be able work with the program. In the health sector risk is managed at two overlapping levels: 1. Strategic/management level
2. Day-to-day staff/patient operational level.
A key tool to implementing the Clinical Governance and Risk Management Standards is the adoption of a national approach to risk management based on the Australia and New Zealand Risk Management Standards. Using this standard the project risks for BioSense could be seen as Description| Likelihood (0-5)| Impact (0-5)| Total| Mitigation| Misuse of the system at national level| 1| 3| 3| Governance arrangements| System won't spot issue at local level| 4| 2| 8| Local Systems will provide this assurance| Data formatting and standards will need changing on local system| 5| 4| 20| Training | Experience with using the system will be poor potentially leading to issues| 3| 1| 3| Education prior to deployment|
The use of the BioSense Project is a voluntary undertaking and is not mandated at a national level. However many hospitals are rejecting this opportunity because of a perceived disproportion of effort. It has been said that the “transition would be both time consuming and over burdensome). This is couple with the lack of a national standard on data coding and system configuration at the local level which have resulted in copious local systems which have to then integrate with BioSense, which can only compound the perception felt, as this introduces training, procedural and cultural changes prior to being able to use BioSense. On the other hand information technology cannot provide value-adding activities, in our case transforming and distributing information, enhance performance without supportive changes in organisation and management. Due to the concerns the majority of hospitals have yet to jump on the BioSense bandwagon.
2.0 Difficulties with Implementation
The BioSense software converts the local hospital data to the HL7 format. This is the international standard for health data systems. This data is then encrypted and transmitted to the central database every quarter of an hour, via the internet to the larger database from which analytics can take place.
One of the most critical items to the successful delivery of care, at any level, is the information and the information exchanges which take place between the patient, the clinical staff and the organisation. To diagnose illnesses and then to successfully treat the patient effectively, staff looking after these patients must have access to the different types of clinical data. These are the patient’s health record, access to a medical evidence repository and a system or systems which guides through the care pathway.
The integration of these critical information sources and systems requires education, decision making support, information management and effective communication tools. To enable patients to be adequately informed and to be involved in their only delivery of care, they must have access to the same information, albeit, it a...