PCEHR lost in the political turmoil

It seems like just yesterday that Department of Health CIO Paul Madden was taking great delight in taking the mickey out of Pulse+IT's seemingly obsessive reporting on all things PCEHR.

In fact, it was at the Rural Medicine Australia (RMA) conference in Sydney last November, when Mr Madden, responding to our question as to why most people found out about what was happening with the PCEHR through the pages of Pulse+IT rather than official channels like NEHTA or DoH itself, gently mocked us for writing about its slings and arrows so constantly.

We're still writing about it, but it's getting harder and harder to keep up the enthusiasm for what now seems to be considered a forgotten relic of previous adventures. Figures on the tiny amount of shared health summaries on the system seem to show that most GPs have lost their enthusiasm entirely. (After one year of operation, the PCEHR contained 2000 SHSs; by the end of two years of operation, this had grown to 23,000. Last December, the number was 38,200.)

And we don't expect the situation to improve in the short term. Newly appointed health minister Sussan Ley has enough on her plate at the moment placating the hordes of GPs who have burst into rare, unified voice over the mooted changes to Medicare rebates and the on-again, off-again GP co-pay, so we don't expect her to have much time to consider the fate of the PCEHR any time soon.

She may well have to with the next federal budget looming in May. If the government wants to find some savings, the tidy $100 million or so that it costs to run the PCEHR might be saved if the government decides to shut the whole thing down. While some in the eHealth sector wouldn't have a problem with this in the slightest, it still raises the question of whether we will see similar sized investments in eHealth ever again.

The fate of NEHTA also rests in the balance. Remember back to the Royle review, when the panel recommended that it be dissolved and a new authority established? Nothing has been heard about that since, although the organisation's seeming terminal decline was prolonged for an extra year with an injection of funds in the 2014 budget. But with only a couple of months to go until the circus starts up again, its odds of surviving continue to look bleak.

What to do about the PCEHR is further clouded by confirmation from the department just last week that it hasn't even received the government's response to the Royle review or the consultations meetings that were held in September. Former health minister Peter Dutton seems to have forgotten to finish that piece of work before he departed, unlamented by most, to the wilds of immigration and border control.

So, we have no government response to the review, a new minister on training wheels learning about a hugely complex portfolio, and a make-or-break budget looming in three months. Will the PCEHR stay? Will NEHTA go? And what, many will ask, has been achieved so far after funnelling almost $1 billion into a system that very few seem to be using?

Your thoughts are most welcome.


0 # Brett McPherson 2015-02-06 12:33

I believe the PCEHR ( My e-Health record or similar name ) is here to stay.
This is a generational change - albeit very slow on the uptake and immediate value. Perhaps we aim to have specific patient groups, new born babies, etc register and have data uploaded.
In the years ahead, there will be benefit - but someone has to start the process.
0 # Betty Boo 2015-02-06 13:51
I am an ex employee of NEHTA so you could say I am bias. A lot a very good people worked very hard on the PCEHR. We believed in it, I believe in it. I have never explained it to anyone and had them say “that a really dumb idea”, everyone has always like the concept. I think it is the way of the future the problem is the Medicos and the Department. GP’s resist having to use it without monetary incentives and the Department seems to not want to tell anyone about it and has shut down NEHTA on any attempts to publicise it.
0 # Thinus 2015-02-08 17:01
Betty Boo your post sums it all up for me - you want medicos to use it on your terms with minimal input from those of us at the coalface and when it does not work then we are the problem. I assume you do realise that most of us are not on a cushy public servant income and that time is actually money for us ? Also that this fiasco has yet shown any evidence based benefits for our patients?

The sheer audacity of a (n) (ex) public servant blaming Medicos and specifically GPs for this monstrous waste of money is beyond belief.
0 # Betty Boo 2015-02-09 16:40
Thinus, and there is lies the problem. It’s all about you and not the patient. How could it reflect any evidence based benefits when you don’t upload to it. It’s called the Personnel Controlled Electronic Record not the Doctor Controlled. I have a right to request my GP upload my information onto my health care record. And by the way I was never on a cushy public servant income.
0 # Thinus 2015-02-09 17:51
Let's clarify a few issues here:
1. This is not Moscow - my business is mine and I make the rules in terms of what services I offer to my patients. It is not up to NEHTA, the Government or the patient to decide this for me
2. A patient may have the right to request that their summary is uploaded to the PCEHR - I have the right to refuse when:
a. I feel the security/privac y is insufficient
b. I fail to see the clinical advantage
c. I fail to get adequately remunerated for my time and effort

And yes - you are right - I am making this about me given that I will be the one sued when something goes wrong and that I am expected to spend the time and effort on this.
Nice Freudian slip by the way - "Personnel Controlled Electronic Record" - perhaps indicative of the lack of understanding that I am NOT an employee of anyone?


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