PCEHR registrations hit 1.5 million mark

The latest figures from the Department of Health show that consumer registrations for the PCEHR have reached 1,514,805, exceeding the department's target for the system by a number of months.

After a slow start in which the forecast of 500,000 registrations for the first year of operation was missed by several weeks, patient sign-ups for the second year have now exceeded the 1.5 million mark estimated by the department in the 2012-2013 budget papers.

Based on international experience, it hopes to have a further 700,000 registrations by July 2015, which it seems more than likely to reach on current figures but which are dependent on the new government's plans for the system.

According to internal DoH documents seen by Pulse+IT, the vast majority of these registrations were facilitated by Aspen Medical, which was hired last year to assist consumers to register in general practices and in public hospitals.

The figures show that Aspen, whose contract finished at the end of last year, registered over 730,000 people. More than 260,000 have registered online, and another 200,000 through the Department of Human Services' administration portal.

Assisted registration through Medicare Locals and the assisted registration tool, which has been used to sign patients up by healthcare providers, total over 176,000. Registrations for newborns through Medicare's FA101 forms are also included.

While consumer registrations are continuing, figures for uploading clinical documents appear to be well behind.

Electronic discharge summaries have overtaken the number of shared health summaries on the system by 20,000 to 16,000. More than 200 public hospitals are now connected and are predominantly using it to load discharge summaries.

A Pulse+IT source who did not wish to be named said the small number of shared health summaries - the primary clinical document - was a major concern and showed that clinicians in the primary care sector had "disengaged" with the system over perceptions that it had little clinical value and uncertainty over its future remained.

More than 700 event summaries have been loaded, as well as four specialist letters and three eReferral notes.

Consumers have entered many of their own notes, including over 33,000 health summaries, 11,000 consumer notes and almost 5000 advance care directive custodian reports. The Child eHealth Record (CeHR) – which parents, GPs and community nurses can access – has over 4000 documents, but none have been entered by clinicians.

The National Prescription and Dispense Repository holds almost 95,000 records, over 90 per cent of them dispense documents.

Actual viewing of documents seems to be improving with 484 unique providers and 8328 unique consumers accessing the system in the week of February 26 to March 4.

The documents show that as of March 4, the PCEHR has been used by healthcare providers to view 11,858 clinical documents.

Improvements and complaints

NEHTA has also released details of improvements to the system interfaces following sustained criticism of its lack of usability from clinicians.

According to NEHTA's website, it worked with peak bodies to produce guidance material for software vendors on improvements that could be made under its clinical usability program (CUP).

NEHTA said the focus of the first release of the guidance material was specific to improving the usability of the shared health summary and viewing and downloading documents from the PCEHR.

The improvements will be made through each vendor's new releases and are all due to be implemented before June.

NEHTA has recommended that certain columns and headings be displayed in clinical documents to allow clinicians more clarity when selecting clinical documents from the PCEHR list view.

It also recommended that administrative data, which is the first thing seen when opening a record, be hidden from the clinician's view and clinical data shown first.

When creating a shared health summary and filling out the medical history section, NEHTA has recommended that medical history be no longer separated into sub-groupings, but displayed as one list in chronological order.

A final recommendation is that improvements be made to assist clinicians when checking if a PCEHR exists for the patient. Rather than the clinician having to check themselves, the software will instead search and validate both the Healthcare Identifier and PCEHR status in the background when the patient's record is opened.

According to NEHTA, when a PCEHR is found, a record status indicator will turn green and be displayed to the clinician. β€œAn entry point to PCEHR functionality will be displayed prominently on the patient chart,” the organisation said.

The Department of Health has also taken note of consumer complaints about the system. Departmental documents show that of the 200-odd complaints made since December 4 last year, over 70 relate to access issues, registration difficulty or unique email requirements for the MyGov website, which consumers must use to register online.

Dissatisfaction with the design or operation of the PCEHR totalled 22 complaints between December 4 and March 5, while 15 were recorded for the assisted registration process.

Only one complaint was made on the grounds of privacy with the PCEHR operation, nine privacy or consent concerns were made about the assisted registration process, and three were concerns over personal information through the DHS registration process. Only one of those complaints remains unresolved.

Posted in Australian eHealth

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