CHF rejects doctor control of PCEHR, urges opt-out

The Consumers Health Forum (CHF) has rejected the Australian Medical Association's call to restrict the ability of consumers to control their individual records, but has agreed with its call to change the system to an opt-out model.

CHF spokesman Mark Metherell said the AMA's demand for doctor control of eHealth records was “a refusal to accept that the world has moved on from the 'secret doctors’ business' of paper-based records that patients rarely see”.

“We reject the Australian Medical Association’s view that personal control of eHealth records need interfere with good medical practice,” Mr Metherell said. “Having the patient play an active role in their health records should be a plus for patient outcomes.

“There is strong evidence that a well-informed patient is likely to have better outcomes than patients who are left in the dark by doctors.”

He said the current patient controls available in the PCEHR are not extreme and simply enable patients to decide what information about them goes onto the record.

He said experience to date shows that this is not a big issue and that the vast majority of people who have registered so far have chosen to allow doctors full access to all their records.

The CHF has long advocated an opt-out system and Mr Metherell said it supports the AMA's call for a new model.

“International experience shows the opt-out option would lead more quickly to comprehensive take-up and ensure health care consumers with complex needs are more likely to get the benefits of more accurate and accessible health records,” he said.

“But the opt-out provision makes it even more important for the consumer and patient to have the power to control what goes on the record.

“It is time for the medical profession to catch up with the rest of the world and harness the power of information technology for the good of their patients and nation’s health system.”

In its submission to the review panel, the CHF says the “personally controlled” aspect of the PCEHR is “what makes it such a powerful consumer resource”.

“Consumers value the PCEHR and are supportive of its ongoing development. However, keeping in mind the current challenges around implementation, there are areas that will need a stronger emphasis and focus to ensure ongoing consumer confidence and trust in the eHealth system. It is vital that the PCEHR is a functional system that meets the needs of consumers.”

The CHF has also put out a call for the governance arrangements to be reviewed, particularly with a view to the appointment of an independent PCEHR system operator.

At the moment, the system operator is the Department of Health. Under the PCEHR Act which established the system, the role of DoH as system operator is due to be reviewed next year.

The submission states that an opt-out model would allow 'healthy' consumers who might not normally register for a record to participate, which could have particular value if they experience a health emergency.

It would also allow vulnerable and disadvantaged consumers to bypass the notoriously difficult sign-up process.

It points to research into the UK's Summary Care Record which showed that clinicians are unlikely to look for eHealth records if there is not widespread utilisation of the system.

“Experiences of eHealth record systems in the United Kingdom and Germany also suggest that is very difficult to reestablish trust in the system if it lacks initial functionality,” it states.

“CHF suggests the reconsideration of an ‘opt-out’ model in light of the overwhelming evidence from other jurisdictions,” it says, but reiterates that consumer access and control is fundamental to the acceptance of any opt-out model.

“Consumers consulted by CHF overwhelmingly argued that ‘personal control’ means more than simply having access to their record. Consumers have told CHF that they want to actively participate in the management of their record, rather than passively enable providers to enter information.”

Other submissions

To review a table of submissions to the PCEHR review compiled by Pulse+IT, click here. This resource will be updated as more submissions become public.

Posted in Australian eHealth

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