NEHTA aims for meaningful use for PCEHR

The National E-Health Transition Authority (NEHTA) has established a clinical usability steering committee to oversee potential improvements to the PCEHR to make it more useful and usable for clinicians and consumers.

A steering group for NEHTA's new Clinical Usability Programme (CUP) will meet for the first time next week to provide strategic oversight of the CUP and as an “escalation point” for issues affecting the safe and meaningful use of the PCEHR in the clinical setting.

The steering committee will be chaired by NEHTA's head of clinical leadership, safety and stakeholder management, Mukesh Haikerwal, who has been the driving force in establishing the group.

Dr Haikerwal said the idea was to assess problems with the usability and usefulness of the PCEHR and find ways to fix them.

“The idea is that something has been delivered, it has got some great potential but it needs to be made more useful, usable and safe,” Dr Haikerwal said. “This is to call out the various parts of the current build to try and address the problems of usefulness, usability and utility.”

Asked if this should have been done while the PCEHR was being designed and before it was launched, Dr Haikerwal quoted Francis Urquhart of House of Cards fame, saying “you may say that but I couldn't possibly comment”.

The first issue being tackled is GP desktop software and the interfaces that have been designed by the different vendors to the PCEHR within their clinical systems. Dr Haikerwal said each software product is different in the way users build shared health summaries, for example.

“Each package and the way they display data and documents is different and it would be potentially confusing if there was not some coming together in the way in which that is done,” he said.

“When I look at doing a shared health summary, there are bits on there that make little sense and need to be reviewed, for example the date order in which we put up the shared records. It doesn't put the most recent one on the top – it puts the most recent one on the bottom.

“They also pull out of the list what they consider from the desktop system a procedure. I've just done one today, and it didn't pull out surgery to carcinoma of the colon as a procedure. Luckily it did pull out the coronary bypass graft as a procedure.

“You can see that it could be so good if it could be improved. We are not dealing with a blank sheet – we are dealing with a significant build so we have something to tweak.”

Dr Haikerwal said each vendor was being consulted individually about the issues identified with their software, and meetings will be held with the vendors as a group to discuss problems in a de-identified way. Software vendors for the general practice and medical specialist sectors met with the RACGP in early May to discuss the results of the roll out of compliant software, with many finding out how other companies designed their interfaces for the first time.

Pulse+IT understands that any changes to the software suggested by the CUP are not mandatory, and that most of the issues are understood to be minor. Each software vendor was given licence to create its own look when designing its interface to the PCEHR, as long as it followed the technical specifications created by NEHTA.

Another issue the CUP and the steering group may consider is the matter of incorrect data being unintentionally uploaded to the PCEHR, as happened to this reporter two months ago when incorrect PBS data was added to my record. That circumstance is also being investigated by the Australian Commission on Safety and Quality in Health Care (ACSQHC).

“That is a perfect example,” Dr Haikerwal said. “Medicare made [PBS data] a clinical tool by joining it to the eHealth record. I personally use the information on there to verify medications with my patients. There is some rigour needed.”

Dr Haikerwal estimates he has personally created about 60 shared health summaries, which he takes his time with to ensure clinical coding is correct and the data is clean. “I've also done a large number of event summaries and they too have clunky bits in them that we need to work through.

“The number one issue we are looking at is the user interface and the next one is on the actual utility. I'm not trying to be difficult – I'm trying to help improve it. Nobody expects perfection, but we expect it to be admitted if there are problems because then you can fix them. That is what this is all about.”

The steering group will also include NEHTA CEO Peter Fleming and representatives from the Department of Health and Ageing.

Posted in Australian eHealth

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