Solution underway to prevent pathology posts to PCEHR

The Department of Health (DoH) says it is working with the pathology sector to develop a way to ensure certain pathology reports are not uploaded to the PCEHR if a patient withdraws consent.

A DoH spokesperson confirmed that the sector had agreed to a model in which pathology and diagnostic imaging reports are uploaded to the PCEHR by the diagnostic provider and made available to healthcare providers immediately.

Patients would then be able to access the reports after a seven-day delay, which would allow the requesting doctor to review the reports and consult with the patient if necessary.

“Following consultation with a range of stakeholders it was agreed that a seven-day delay for release of reports to patients provides a reasonable time frame for healthcare providers to manage communication of results with their patients while minimising risks to safety caused by reports where appropriate follow-up does not occur,” the spokesperson said.

“This position is supported by the majority of stakeholders including pathology providers, the Australian Commission on Safety and Quality in Health Care, clinical peak bodies, consumer groups, jurisdictions and medical indemnity insurers.

“The model is simple without increasing clinical risk for patients. It has limited impact on clinical workflow and reduces the risk that reports are missed and not available on the PCEHR.

“The Department is working with pathology stakeholders on an alternate workflow when there are changes to patient consent.”

As reported last week, the department seems to have accepted the view of the profession that it was necessary to find a way to ensure certain reports are not posted.

The chair of the Royal College of Pathologists of Australasia's (RCPA) informatics committee, Michael Legg, told Pulse+IT that it was his understanding that work was continuing on how to do this.

“There has to be the opportunity for the patient and requester to decide whether it is appropriate to post it or not at the time of request, even accounting for the current policy of having a time delay before the report could be viewed by the patient,” Dr Legg said.

“In my view it would depend on the nature and policy of the requester’s practice what the default would be but in any event there has to be a way of signalling that this report should not be posted to the PCEHR.

“That means that you have to have a way of being able to post a report at a later time, which may be after review of the results and/or discussion with the patient depending on the agreement they have.”

DoH CIO Paul Madden told the Rural Medicine Australia (RMA) conference in Sydney on Friday that the department had undertaken a range of consultations with the clinical colleges, the private pathology sector, GPs, medical defence organisations and public pathology providers on the 'high-level design' of the system.

He said another meeting would be required to finalise some outstanding issues, but that the capability to view pathology and DI reports on the PCEHR would be available in the next release, due next month.

“We have reached the point where we've pretty much agreed the high-level design for getting pathology reports to the PCEHR,” Mr Madden said.

“There have been some detailed issues to work through, some just to make sure that all of the parties to that arrangement are in fact happy with the way that clinical risks and access to information are managed to get the best outcome for patient and clinician.

“We have a further workshop and we have been in communication with the Royal College of Pathologists of Australasia to work through some of those issues and I think we've reached a point of agreement on the design at the very high level, but we still need to run a further consultation session to bring that to a conclusion.

“I'm expecting that we should be able to announce the final design in a matter of weeks.”

While the capability to view diagnostic reports will be available, it is unclear as to when the information will start to flow. Pathology and radiology practices will need to register to use both the PCEHR and the Healthcare Identifiers (HI) Service before they are able to upload any data.

The department's spokesperson said DoH understood that some pathology practices have already registered for the HI Service.

“Pathology practices will need to register with both the HI service and the PCEHR system to send information to the PCEHR,” the spokesperson said.

“Changes will be required to pathology and diagnostic imaging software to post reports to the PCEHR system. NEHTA is in early engagement with industry on the required changes.”

Release 5 of the PCEHR – which was originally scheduled for May but was postponed due to the change of government and lack of clarity about the future of the system – is expected next month.

In addition to pathology and DI reports, it will also feature fixes for a number of faults in the system along with some improvements necessitated by the transfer of the Northern Territory's My eHealth Record (MeHR) to the national system.

The MeHR is able to accept pathology and diagnostic imaging reports already. Pulse+IT understands that the NT government insisted on the capability before it agreed to transition its successful system, which currently has 60,000 patients, hundreds of thousands of documents and between 50,000 and 60,000 clinical views a month.

Release 5 will also feature a Health Record Overview that addresses the needs of NT and other clinicians as well as usability improvements to the landing page.

Posted in Australian eHealth

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