SWSLHD and Bowral's Health - 54

E-health records one step closer

24th Nov 2011

Andrew Bracey and AAP   all articles by this author

Medical Observer

THE federal government has taken another step towards setting up its patient-controlled electronic health records (PCEHRs) system, with Health Minister Nicola Roxon introducing the legislation to Parliament yesterday.

Ms Roxon said the proposed national system – which has attracted criticism from doctors for the lack of remuneration offered to GPs who would be responsible for helping to set up and maintain the records – would drag
the management of health records into the 21st century.

She said individuals' health information was fragmented rather than attached to the patient, resulting in unnecessary retesting, delays and medical errors.

Hospital studies have indicated that 9–17% of tests are unnecessary duplicates, and 18% of medical errors are attributed to inadequate patient information.

Ms Roxon said a government analysis estimated the net economic benefit of e-health records at $11.5 billion to 2025.

The absence of such records demonstrated the difficulties of health reform – "the fragmentation, the vested interests and the balancing priorities".

Ms Roxon said the bill would set up the legal basis for the new system when it starts on 1 July 2012.

She said any Australian would be able to register to have a PCEHR and would be able to decide who could access it and the extent of the access.

Patients and organisations authorised to access the information would be subject to existing privacy laws.

The health department will initially run the system, though this may be transferred to a statutory authority.

An independent council would advise on clinical, privacy and security matters.

Debate on the Personally Controlled Electronic Health Records Bill 2011 was adjourned.

 
Tags: PCEHR, E-health, Roxon, legislation

SWSLHD and Bowral's Health - 35

Four fixes needed for PCEHR

• By Michael Woodhead on  20 October 2011 - 6Minutes

The success of the PCEHR is threatened by the lack of GP input into the program and lack of a Medicare rebate to recognise the extra workload it will create for GPs, the RACGP says.

In a statement released this week,  the College says  the lack of clinical input into the design and implementation of an electronic record system was one of the key reasons for the demise of the UK’s e-health program.

It says the Department of Health and Ageing, NEHTA and the RACGP need to reach agreement on critical issues “such as data quality and ownership within the PCEHR, the PCEHR’s links with clinical software, and possible impact on clinical and practice workflows which will be a disincentive to widespread adoption. “

RACGP president Professor Claire Jackson says the College is also concerned about the lack of any incentives  for general practice for additional tasks such as creating PCEHR documents and obtaining informed consent.

The College has also highlighted two other critical areas of the PCEHR that need attention, citing the need to get patient s from high risk groups to “opt in” and the clinical and medicolegal risks of allowing  patients to alter their clinical record.

A program is needed to encourage PCEHR uptake by the groups that will most likely to benefit, namely patients with chronic and complex conditions, older Australians, Aboriginal people and mothers with new-born children, it says.

SWSLHD and Bowral's Health - 34

E-health record failure blamed on top-down approach

• By Gemma Collins on  18 October 2011

The failure of the UK’s e-health program has been blamed on rushed implementation, failure to engage clinicians and a top-down government-driven partnership with private contractors. 

A review of the UK’s program, similar to the $500 million PCEHR planned in Australia, concluded that it was “time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients.”

Researchers who reviewed five areas where the IT system was implemented through partners such as Cerner and iSoft, blamed the program’s ‘top down’ approach which led to an “unrealistic, politically driven timeline from the outset”, with “multiple tensions” between the creators and NHS staff.

In their review (link) the authors suggest there needs to be a clear vision and realistic timescale from the start with more “user involvement” of local clinicians and health staff in decision making.

They say a key lesson is the need to “move away from technology driven models of implementation,” and to “consider the merits of participating in the development of open source systems as opposed to the purchase of commercially developed systems.”

Large scale procurement projects were used in an effort to save money, but these often resulted in the ‘tail wagging the dog’ and programs being influenced by the particular type of software implemented.

 

  Comments

Yet another monumental waste of taxpayer funds. With all the privacy restrictions placed on the EHR by well-meaning but misguided people, it will only serve those who don't cause problems within the health system but would potentially generate a lot of wasted time and effort - if doctors had the time to actually do what is being asked. The drug dependent patients and doctor-shoppers where this initiative could be useful will just restrict their EHR access. What's the point of such a system? As in the UK, no benefits, just cost and effort. Why can't we learn from the experiences of others but be doomed to repeat them? Count me out. I'll give my patients a one-page summary where necessary.

Dr. Igor Jakubowicz | 18 October 2011 at 15:43