No decision on trial sites or enabling legislation for opt-out PCEHR

The federal government is now making available recent statistics on the uptake and use of the PCEHR on its eHealth website but has still not released promised legislation enabling an opt-out version of the system and there is still no decision on the location or make-up of the $51 million trial sites of opt-out models.

There is also no word as yet on the make-up of an implementation taskforce that is expected to oversee the transition of responsibilities for eHealth from the National E-Health Transition Authority (NEHTA) to a proposed new Australian Commission for eHealth (ACeH).

Recent stats added to the website show that uploads of electronic hospital discharge summaries to the PCEHR have surged since the start of the year but that uploads of the most crucial clinical document – the shared health summary – are still vanishingly small.

The statistics show that 2,373,110 people had registered for a PCEHR as of August 28, or about 10 per cent of the population. The ACT has the highest percentage of consumer registrations on 17 per cent of its population and WA the lowest.

The total consumer figure is an increase of about 300,000 in the last nine months. There are now 55,052 shared health summaries in the system, up from about 38,200 in December 2014, and 192,602 discharge summaries, up from 85,960. Specialist letters have also begun to gather steam, with 3261 now uploaded.

The federal government ended a lot of uncertainty over the future of the system in the May federal budget with an allocation of $485 million over three years, including $51 million to run trial sites for its preferred opt-out model.

However, legislation to make necessary amendments to the PCEHR and the Healthcare Identifiers (HI) Service acts to enable opt-out trials to begin has still not been introduced to Parliament. A discussion paper on the proposed changes was opened for public comment in June and legislation was expected in August.

In addition to enabling changes to the individual participation arrangements, the amendments are also required to make a number of fundamental changes to the system as recommended by the 2013 Royle review.

This includes changing the name to the My Health Record, enabling the creation of the ACeH and the dissolution of NEHTA, and significant changes to the onerous participation agreements originally required of general and specialist medical practices and other healthcare provider organisations.

A spokesperson for the department told Pulse+IT in July that arrangements for an implementation taskforce to oversee the transition from NEHTA to the new eHealth Commission were being finalised and were expected to be established in August. However, no official announcement on this taskforce have been made.

The government had also promised to release the names of the chosen sites for trialling different opt-out models of the PCEHR this month. The trials are supposed to begin next April and received $51 million for their operation in the 2015-2016 federal budget.

However, despite inviting the states and territories to nominate potential trial sites at the COAG Health Ministers' meeting in Darwin on August 7 and an expectation that the chosen sites – expected to be between two and five – would be announced by the Health Minister this month, the DoH spokesperson said there was no word as yet on whether a decision had been made.

The department also moved to quash rumours that the introduction of the new Windows 10 operating system would strike a “mortal blow” to the PCEHR due to incompatibility issues and the potential that some security certificates would no longer be valid.

Clinical software vendors have been testing their products for compatibility with Windows 10 since its release in July. While there have been few problems, many are recommending caution before practices install the new OS.

“The PCEHR provider and consumer portals are testing positively with the new Windows 10 operating system, and the National Authentication Service for Health (NASH) certificates will work with Windows 10,” the DoH spokesperson said.

“It is acknowledged that clinicians mainly access PCEHR functions and information through their clinical information systems.

“The department will work with software vendors to ensure the PCEHR functions continue to operate effectively as they and the users of their systems upgrade to Windows 10.”

The $485 million announced in May brought total direct spending on the PCEHR since it was first announced in 2010 to just over $1.2 billion. NEHTA has also received funding of almost $1 billion since it was established in 2005.

Posted in Australian eHealth


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