Opinion: There's incorrect data on My Health Record again and it needs to be fixed

Of all the people in all the world that this should happen to twice, it just happens to be me. My personal My Health Record is showing details of a prescription for a drug that was never prescribed for me for a condition I don't even have – again.

Long-time readers will remember the drama back in May 2013 when I discovered two records in the PBS section of what was then known as my PCEHR, one for a diuretic and one for an antacid, neither of which were mine and for which there was no corresponding MBS record showing a visit to a doctor.

Posted in Australian eHealth

Tags: My Health Record


+5 # Jon Carrano 2018-04-10 08:01
Kate, if anything, I think your experience highlights the value of MyHealthRecord in providing additional audits on the health information accumulated in your prescription records. Assuming the same root cause of the problem, incorrect entry of the record at the pharmacy, is the culprit in the current example, it confirms the need to improve that initial process & for pharmacy staff to be more vigilant in processing scripts. MyHealthRecord is not the problem in this scenario but is in fact helping provide additional scrutiny of your records to ensure they are correct.
0 # ADHA staffer 2018-04-10 09:13
@Jon Carrano
Only if you know there's an error lurking within MHR ...

... and that's the point of the article.

Until the processes entering MHR data can be proven to be squeaky-clean with no chance of errors, it should NOT be captured.

You just can't trust it, especially in times of need ... which, again, is the other point of the article.
+1 # Lynne Everett 2018-04-10 09:19
Ahh but that's not its main purpose and a clinician, in an emergency situation such as Kate described, who finds a record of a drug being dispensed and then checks the SHS (which clearly states it may be incomplete) for the prescription and doesn't find same will probably err on the side of the drug having been given.
Combine this with the situation we're finding where adverse reaction information is not being displayed despite being in the patient record and the clinician who sees a script dispensed for penicillin (which didn't happen) and no adverse reaction information clearly visible will not have any reason to suspect an existing adverse reaction to that drug class.
If that isn't bad enough we still have no Rural prescribing info -- not good enough all round.
+3 # Troy Bailey 2018-04-10 10:21
Agree Jon,
Lets not bury our heads in the sand and say, as long as we don't see it it's not happening otherwise our great grand children will still be having this conversation. The breakdown in the system occurred at every point, Pharmacist, Patient and another Pharmacist. Remember that this level of scrutiny has never been placed on Pharmacists before, welcome to the world of general practice. There needs to be more focus placed on Pharmacies with a carrot and stick approach similar to general practice. (is that practice now using the barcodes?, all are in my region)
To stop entering data until we can guarantee there are no errors means all health services should stop using digital health and revert to paper, ow but paper has more errors than digital. The MyHR is a summary of your health information for unplanned events, lets not loose site of the larger need for interoperable point-to-point secure message delivery, and the need for all clinicians to continue cleaning-up their data.
0 # Andrew Griffin 2018-04-11 07:54
The only patient identity validation done by DHS with PBS claim data transmitted by the pharmacy is "does the patient name match the Medicare number supplied?". That's it. No IHI, DOB, gender, address information is sent. If the patient's level of reimbursement is as the pharmacy expected (general vs concession vs entitlement) then they will see no other error message returned.
Put that with a natural desire to avoid fragmented patient records by merging apparent matching records from different addresses, and the fact that Medicare numbers can change multiple times over a typical patient's life (family card at birth, individual card as a teen, joining a partner's card and vice versa), and it becomes clear that Kate's experience is only rare in that she is a health IT journalist who keeps an eye on her MyHR and is conscious (most of the time). I'd wager that every pharmacy in Australia will have dozens of records with incorrect Medicare numbers against prescription supplies made. Many thousands of people will be able to discover these errors once we move to opt-out.
Bottom line - this is billing information that is only as accurate as it needs to be for billing purposes. It's a shame that this desire to "pad the numbers" of records has put the entire system in jeopardy by this avoidable undermining of public trust.
+1 # Ian Mcknight 2018-04-10 11:56
This is so disappointing, I hope the GPs that I am taking for an ehealth refresher at lunchtime haven't read this.I imagine\hope that this will turn out to be human error by a pharmacist. Of course, that doesn't help us, human error has always been a possibility, but whereas before it may have remained undetected, in today's world it is now communicated far more widely (like fake news and dodgy opinions!). The fact that errors of this kind can find it's way to a hopefully trusted repository is just bad news. Totally agree with Troy that the governments carrot/stick now needs to find it's way to pharmacies and even non-connected public hospitals. We also have to remember that human error at the GP end in terms of software use, can mean an incorrect diagnosis or missing condition from an uploaded health summary. So human error will always have the potential to affect MyHR information. I think PBS information needs to stay in the MYHR though, I have had some GPs relate that it is the most appealing feature. As I said, a really disappointing occurrence, but as always I'll say the benefits available from MyHR make it worth persevering with.
0 # Andrew Griffin 2018-04-11 08:16
In my opinion, the human error was the decision to use billing data (PBS and MBS) as proxy clinical information in the first place! Thankfully, there is movement right now to get proper, validated dispensing information into MyHR - hopefully this will provide a fig leaf to cover a reversal of the original decision before long.
0 # Alison Craswell 2018-04-11 10:01
With my consumer hat on, what if the drug had been an antipsychotic or misoprostol? And then the repeat appears again on the record. ED clinicians erring on the side that is a correct entry are not immune from decision making coloured by stigma. The error from 2013 was corrected but still remains on the record. As records become data heavy, search functionality may then be used that does not account for rectifications later in the data. I agree that data should not be automatically populated into MHR unless it can be shown to be rigorous but if this was the case, the records would currently be empty. Working towards closed loop data entry has to be the way forward.
0 # Andrew Griffin 2018-04-11 10:11
Even a record for a common antibiotic (as in this latest case) has potential for serious clinical risk, as an ED doctor could easily assume that previous supplies made reflect no known allergy to that medication. With an unconscious patient unable to testify otherwise, ordering something that the patient has (apparently) had before may appear to be the safest option.
0 # Lynne Everett 2018-04-11 10:23
My point precisely
0 # Gregory Wyatt 2018-04-11 12:04
Same happened to me recently, Kate. We were to be visited by a PHN staff member to extol the virtues of the MyHR and shortly before she arrived I was showing my MyHR to my wife (partner in work and life) and my sister (our practice nurse). There was a recent dispensing record for Lyrica and Endone, neither of which I have ever taken or been prescribed. I reported this to DHS and they did follow up and suggested that it was an error at the pharmacy. When I was next at my pharmacy I asked him to check - he said "we dispensed Lyrica and Endone for you a couple of weeks ago". I advised him they weren't mine and he checked his records - turns out he has another customer called Gregory Wyatt! This explains why, about 12 months ago, a repeat authorisation for one of my medications had an incorrect address on it. They have taken steps to warn "Beware, there is another customer with the same name". My MyHR has been corrected.
0 # Kate McDonald 2018-04-11 12:10
I reckon DHS is going to be inundated when there's 20 million more records all of a sudden.

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