Private pathology sector “deeply concerned” over PCEHR plan

The peak body representing private pathology practices in Australia has expressed its concern over the government's plans for pathology and the PCEHR, saying it was not consulted on the recent announcement of an extra $8 million to make test results and diagnostic imaging reports available in the system.

Katherine McGrath, CEO of Pathology Australia – formerly known as the Australian Association of Pathology Practices – said the sector had serious concerns over patient safety and that the $8m announcement was part of a “pre-election rush”.

“We are deeply concerned about the current approach that the government is taking regarding pathology and the PCEHR,” Professor McGrath said. “That announcement was made without any prior consultation. We have since had a meeting but we have had very little information about what the intention is, and some of the options that they are canvassing we believe have very serious consequences for patient safety.”

Professor McGrath told Pulse+IT last year that the pathology sector was keen to become part of the PCEHR and that requesting doctors wanted to see pathology results integrated into the system, but that pathology had special needs that weren't being taken into account.

She said at the time that a method to safely add pathology results to the PCEHR had been designed and tested and was capable of being delivered, but that there were financial ramifications that the government needed to consider. In February this year, she said the Department of Health and Ageing had not wanted to talk about cost recovery and negotiations had not progressed.

Since then, Pathology Australia, which represents large pathology groups such as Healthscope Pathology and Sonic Healthcare, owner of brands such as Douglass Hanly Moir, Sullivan Nicolaides and Melbourne Pathology, had dropped its demands for funding and was willing to participate, but that the preferred models had been “dismissed out of hand”.

“This is a very serious problem,” she said. “We have always cooperated with the government on this issue and have tried to work with them. Our attempts to cooperate have been effectively dismissed out of hand, even though in recent times we've offered to work with them, to do it for nothing.

“We previously asked for appropriate funding but we've made an offer to them in recent times to get it up and going at no cost, but we were still dismissed out of hand. We believe that the rush to get information into the PCEHR is being done now without regard to the consequences.”

A spokesperson for the Department of Health and Ageing said DoHA “is in fact discussing with key stakeholders, including Pathology Australia”.

“We have assured everyone that we wish to engage them and on the design for pathology and PCEHR,” she said.

“We will be consulting with all key stakeholders, again including Pathology Australia, on the proposed model for including pathology reports in the PCEHR.

“Of course, patient safety will be a priority, just as it is for all other aspects of the eHealth record.”

Actual details of exactly how test results and radiology reports will be uploaded to the PCEHR are not available. A number of models are possible – including the pathology practice directly uploading routine results with abnormal results held back, the results sent to the patient's GP first and then uploaded in consultation with the patient, or a health information exchange model – but the government has not made clear which it was pursuing.

This mirrors the announcement earlier this year of $10 million to add advance care directives to the PCEHR. The government has yet to make clear exactly how this will happen.

Pathology Australia's preferred model, which would allow cumulative results to be added, thereby assuaging pathology practices' concerns over out of date results, had not been taken up, but Professor McGrath said that was not the main problem.

“[The government] has rejected that model. That's fine – there were some constraints in that model imposed by NEHTA and the PCEHR architecture proposed at that time. We agree that there are simpler ways to do it and you can streamline it. We are happy to work with them on a more streamlined, efficient way, but the message we are getting at the moment is that they are going to do it without us, and we think that's deeply concerning and will be a disaster.”

She said the sector had no real concerns with a model in which test results were first seen by the patient's GP and then uploaded by the GP in consultation with the patient.

“We don't disagree with that,” she said. “What we do disagree with is that just directly uplifting it from desktop systems runs the risk of not having the most recent results, some results not being there, and patients being misled by incomplete and confused information.

“The risk then is of maintaining reliability and accuracy. Who is accountable for making sure the latest result and amended results are up there? The GP or the pathology provider?”

She said the Royal College of Pathologists of Australasia also had serious concerns about the government's plans. The RCPA has been contacted for comment.

In her July 17 announcement that $8 million had been allocated to the plan, Minister for Health Tanya Plibersek said the money would be used for the changes required to software systems and the development of specifications.

The change to private pathology and radiology practices would be “very minimal”, she said. “There's not actually a lot of extra work for the diagnostic imaging or pathology companies – it is simply what we can do with that information. Instead of having it scattered in 50 inboxes in different parts of the system, we have all of that information attached to the one person's medical record.”

Professor McGrath said the announcement was “just a pre-election rush to be able to claim success that the PCEHR is working, and I think their rush to claim success means that they are compromising patient safety. We are deeply concerned about patient safety.”

Posted in Australian eHealth

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