Is slow PCEHR rollout curbing clinicians' enthusiasm?

Field-testing of the PCEHR in actual clinical practice shows a wide variation of the amount of time it takes to prepare and upload a shared health summary to the system, but on average it seems to take about 3.6 minutes, NEHTA CEO Peter Fleming said.

Addressing an eHealth session at the recent Rural Medicine Conference in Cairns, Mr Fleming said a study by NSW GP and former NEHTA clinical lead Chris Mitchell of five different sites actively using the system showed that it could take as little as seconds to upload a summary, but it depended on the accuracy of the data within the existing clinical information system.

Mr Fleming told the conference, organised by the Australian College of Rural and Remote Medicine (ACRRM) and the Rural Doctors Association of Australia (RDAA), that it also depended on which GP clinical system was being used, as all have a slightly different interface.

“It clearly depends on the patient and the more you do it the quicker it becomes, but it is dependent on the accuracy of the data in there,” Mr Fleming said.

“The key to creating a shared health summary ... is making sure the data in your system is accurate. That varies by patient and by clinic, but on average across the five sites it is about 3.6 minutes.”

Mr Fleming said NEHTA planned to extend the study of the PCEHR in action to 50 sites, but that each one would be different.

However, a question was raised from a member of the audience about how this would affect the remuneration of GPs using the system. An average of 3.6 minutes would not be enough to extend a B consultation into a C, and yet over the course of a day, it could add an hour to the GP's workload.

Fionna Granger, assistant deputy secretary of the eHealth division of the Department of Health, said she couldn't make much comment in advance of the Health Minister's review of the system, but that she expected this question to be covered by the review panel.

Former ACRRM president and current board member Jeff Ayton said a lot of the feedback that the college was receiving from rural and remote Australia was that there was a danger that current users of the system are going to lose their enthusiasm and turn the system off.

This was echoed by an audience member who works for an Aboriginal Medical Service in rural NSW, which is obliged to use the system despite the local hospital not being able to access it.

“As someone on the ground, I find that no one in our service knows what eHealth does for us,” she said. “What can I take back to my service to convince them that it is worth doing, that we have to do it?”

Ms Granger said the department accepted that eHealth has to get to the point “where there are enough people on the system to make it worthwhile”.

“Our Northern Territory colleagues find it immensely valuable, particularly in that they have an indigenous and very mobile population,” she said.

“Over time your hospital will connect, that's when you start to get the value. But it is a staged rollout and that is sensible.”

Posted in Australian eHealth

Comments   

# Paul Campbell 2013-11-08 14:11
"Slow" roll out? Considering this is a major change management process, I suggest that the roll out is moving well. When you consider that it is the GP plus their staff plus all the hospital staff plus allied health, pharmacists and so on who have to change the way they do things, is it any wonder that it has taken a while from when it was released for production (July '12) to get to the first million consumers and 5 or so thousand health care professionals?
# Terry Hannan 2013-11-08 14:32
Simon, several points here on this article.
1. Mr Fleming's statement: “It clearly depends on the patient and the more you do it the quicker it becomes, but it is dependent on the accuracy of the data in there,” Mr Fleming said. “The key to creating a shared health summary ... is making sure the data in your system is accurate. That varies by patient and by clinic, but on average across the five sites it is about 3.6 minutes.” What the hell does the accuracy of the data mean? At face value this demonstrates a poor understanding of what clinicians are trying to do in care delivery.
2. The statement "However, a question was raised from a member of the audience about how this would affect the remuneration of GPs using the system. An average of 3.6 minutes would not be enough to extend a B consultation into a C, and yet over the course of a day, it could add an hour to the GP's workload" should concern all us even more. Is the delivery and use if HIT about $ earned or care of the patient? What are the costs incurred by poor HIT (e.g. PCEHR) and poor patient outcomes and failed clinical decision making in clinical practice. What cost burdens are the clinicians causing to the health system by using and ACCEPTING poor clinical decision support tools or NON-EVALUATED ones?
# Dr Lou Lewis 2013-11-10 22:57
It seems to me the seems to that no one, apart from the government and some remote rural and ( the PCREHR) and yet government is determined that it be a available for every patient in Australia. I find this rather frightening and see the end of privacy and confidentiality in the medical field. I see the pCEHR as a incredible tracking system for the population especially with respect to their health aspects. Furthermore it will become so easy for criminals to hack into and individuals personal medical record and the information gained could be used for a number of illegal activities such as identity theft and we would be, as proponents of the system, almost accessories to such criminal element.
I just can't for the life of me believe that the government has the interest of the patient at heart and will use the information it has for his own purposes. Governments only care about governments and keeping the people under their control by any means possible. How could we possibly believe what they say especially when they themselves are such hypocrites and have one set of rules them and another set for the rest of us.
What is the difference, between Julia Gillard and Tony Abbot? answer: nothing.
Faithfully yours,
Dr. Lou Lewis
# Stephane Windsor 2013-11-13 10:54
Good luck to any criminal trying to hack into my electronic health record. When I set it up I had more hoops to jump through (for security) than I have ever seen for internet banking or similar. The system cross checked medicare number, bank details and I was required to set up 3 secret questions. When I log into my record I am required to enter the username, password and I am prompted for answers to my security questions. When my doctor uploads to my record am sent a text message advising this has occurred. Seems to e this electronic health record is more secure than the Vatican. The personally controlled electronic health records act 2012 regulates what the PCEHR can and can't be used for. It would appear the PCEHR has the same degree of collection use and disclosure as GP clinical records. As an end user - I'm impressed

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