Haikerwal resignation raises concerns about PCEHR: AMA

The Australian Medical Association (AMA) has issued a statement on the resignation of NEHTA's head of clinical leadership, Mukesh Haikerwal, and other members of the clinical leads team, saying it raises “serious concerns” about clinical input into decision-making in the implementation of the PCEHR.

Pulse+IT understands that Dr Haikerwal actually resigned several days ago, along with a number of other clinicians who have acted as clinical leads for NEHTA.

Melbourne GP and researcher Chris Pearce confirmed to Medical Observer that he had resigned, but said it was because he wanted to concentrate on research. MO also reported that many of the clinical leads' contracts with NEHTA had come to an end this month.

AMA president Steve Hambleton said in a statement that the organisation had long advocated that the success of the PCEHR depended on how it met clinical needs.

“The PCEHR simply will not be effective if doctors – the people who patients trust most with their health care – do not have a say on what goes on the electronic medical record and how that information is accessed and used, and by whom,” Dr Hambleton said.

“This has been a sticking point for the medical profession all along. That is why the AMA has pushed for a more consultative approach to the PCEHR implementation with priority to be given to ailments, treatments, tests, and medications.

“This is the sort of expertise that Dr Haikerwal and his colleagues brought to NEHTA and the whole e-health sector.

“Mukesh has been a passionate advocate for e-health in this country, on behalf of doctors and patients, for more than a decade.

“The AMA is proud of his direction and leadership in this important area of medicine, and we are disturbed that he has chosen to resign.”

Dr Hambleton said the “unrest and disquiet” came at a difficult time as the federal election neared, with much more work to be done to refine eHealth systems.

“Clinical guidance and input remains crucial to a successful implementation,” he said. “There are still some fundamental aspects of the design that means the PCEHR is not useful from the medical practitioners' perspective.

“If the system is not being used by clinicians, we need to know why, and then make the necessary changes.

“We cannot afford to lose the significant investment that the nation has made in this important health infrastructure.

“With the Government in caretaker mode, DoHA and NEHTA must urgently assure the health sector and the public that the PCEHR remains on track, and that clinicians will continue to have a major role in decision-making.”

Posted in Australian eHealth


0 # Phil Coppin 2013-08-16 13:41
I want to control who accesses what on my PCEHR, not the mechanic I pay!

AMA is just about helping doctors retain control of the patient record but they don't own it and while I trust my GP, he isn't going to get control. As soon as that happens, I opt out of the PCEHR, assuming I have the right to opt-out?
0 # Tim 2013-08-16 14:08
Phil, I think that the concern from a lot of health care providers is that the information in the PCEHR will be next to worthless if it cannot be relied upon. If anyone can simply alter, add or remove details from the PCEHR then there will be no reliability. I think they have a valid concern. Why would you want to hide your medical history from those that are trying to help you anyway?
0 # TIM S 2013-08-16 16:18
Tim (no relation!), your comment illustrates the misinformation still around. The PCEHR will simply contain what clinicians wish to have uploaded - care summaries, ED and hospital discharge summaries, medication lists, other event summaries and links to pathology and imaging results. The patient cannot alter or change these.

The patient can of course add - but this is in their separate section - whatever other health information they like.

Patients already choose what to tell their doctor when having a consultation and there are times when patients don't tell them everything now. All doctors have experienced this. So it has nothing to do with the PCEHR, it has everything to do with human nature.

The PCEHR is not a substitute for the GP or specialist or allied health professionals own practice record. It is a helpful addition that will, over time, have information available that is not currently easily available to the doctor or other treating health professionals.

To date the overwhelming majority of consumers have adopted the default access setting - any health professional treating me can see anything that is uploaded to their PCEHR.

Let's get on with it and make it useful and stop worrying about things that are either not actually an issue or even if they are, they are not worth worrying about.
0 # Phil Coppin 2013-08-18 17:27
Tim : Exactly my point but much more eloquent. Doctors continually complain about the PCEHR not being clinically useful. I am not sure exactly what that means but assume it means it doesn't have the correct information uploaded.

If I am correct then start talking to patients and start uploading the clinically valuable records. And don't forget that it isn't intended to benefit just one group like GPs but the whole health sector. Over time its value will increases as the data uploaded grows and it will save lives.

And the PCEHR complaint software for other professionals like specialists, allied health and hospitals will be developed because there is a commercial opportunity!

So my advice to doctors and all other health professionals is get with the program and stop complaining because more and more people are enrolling and the "I want to upload some data to my PCEHR" request is coming to your consulting room soon.

And consumers need to vote with their feet if they get the response I did from my GP...."None of my patients are interested". The height of arrogance and ignorance. I have a new GP!!!

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