Opinion: new approach to eHealth, but will it be a waste?

Alison Verhoeven

Alison Verhoeven is the chief executive of the Australian Healthcare and Hospitals Association (AHHA).

The AHHA cautiously welcomes the government’s investment in eHealth, newly rebadged as MyHealthRecord.

Centrelink’s investment in IT systems, and the Department of Health’s investment in expanded analytical capability, have the potential to positively contribute to improved health data resources for Australia, particularly if health data linkage programs are supported.

Such eHealth records have the potential to be an effective tool supporting high quality healthcare, but a comprehensive approach that addresses the needs of both clinicians and consumers is required. Efforts also need to be made to ensure the wasteful approaches of the past are brought to an end.

The uptake by both patients and clinicians of the former personally controlled electronic health record (PCEHR) has been extremely limited. To make the appropriate treatment decisions and develop suitable care plans, clinicians require timely access to relevant parts of their patients’ medical history.

It is heartening to note that Dr Steve Hambleton, chair of the panel carrying out the review of chronic disease funding, has suggested the potential for eHealth records to be linked to Medicare-funded care plans for patients with complex problems. However, this will require an eHealth system that meets the needs of both clinicians and patients.

The government rushed a review of the PCEHR through in six weeks in late 2013, but then didn’t release the report for a further six months. Twelve months later the government has not released a formal response to the review, relying on piecemeal budget responses instead.

The AHHA supported a move to an opt-out system in our submission to the PCEHR Review in 2013 and we welcome the adoption of this approach by the government. Our other key messages to the review remain relevant and should inform the further development of the PCEHR:

  • Focus on enhancing information exchange between systems rather than developing additional data repositories
  • Identify and address the barriers to clinician and patient participation
  • Provide incentives to engage clinicians beyond hospitals and general practice, and
  • Achieve a suitable balance between the clinician’s need for information and the patient’s right to privacy.

These remain our priorities but, given the lack of information from the government, it is difficult to know if this new allocation of funds will finally deliver some significant progress or if it will be more of the same staggering steps towards the goal of a better connected health system.

Posted in Australian eHealth

Comments   

# Diane 2015-05-14 02:46
First do no harm. You can't see that betraying patient trust by taking information they shared with you in confidence, and then putting it online in a hackable database, might do harm?
# Ian McKnight 2015-05-14 18:00
Diane, As opposed to your completely un-hackable General Practice Database made impregnable by it's $120 Dick Smith router you mean?

Any IT system is ultimately breachable given the right combination of skill, persistence and desire. A skewed appraisal of risk by certain health practitioners is one of the factors holding back what could become a huge improvement in clinician efficiency and therefore patient care across the country
# Diane 2015-05-15 12:37
Quoting Ian McKnight:
Diane, As opposed to your completely un-hackable General Practice Database made impregnable by it's $120 Dick Smith router you mean?

Any IT system is ultimately breachable given the right combination of skill, persistence and desire.


Which is why patients should have full control over what format their medical records are stored in.
# Peter 2015-05-18 13:01
While I agree with Ian that local clinical practices are not terribly secure they are less of a target because of obscurity. I think that a national database becomes a significant target because of the breadth of the data it contains, and because it is exposed to a far wider user base (anyone authorised to access patient data). If an Opt Out approach was taken it should only contain the minimum of data needed to identify a patient by default. The patient should still have total control over all clinical content.
# Ian 2015-05-18 13:12
I haven't seen the full detail, but I would fully anticipate the opt-out model to be as you say(Peter), a minimal data set, principally demographics, but establishing the facility/capabi lity for everyone to have clinical information uploaded to their electronic health record. Enabling of this functionality and removing the process of setting it up, would be the big gain by Opt-out. After that it is clinical information uploaded with the patients consent, as it is now.

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