NACCHO Aboriginal eHealth news : Will all Aboriginal clients be automatically enrolled for an e-Health record ?

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All AUSTRALIANS would be automatically enrolled for an e-Health record and have to opt out to protect their health privacy under sweeping changes to the $1 billion white elephant.

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A government review of the troubled computer system is also considering changing the extent to which patients control what appears on the record.

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And doctors could get paid to upload patient health summaries onto the record to get more clinicians involved in using it.

Launched in July 2012 the Personally Controlled Electronic Health Record was meant to bring medical records into the digital age and contain an electronic patient health summary, a list of allergies and medications and eventually X-rays and test results.

Seventeen months after it was launched only a million people have signed up for the record and only one per cent of these records has a clinical summary uploaded by a doctor.

A government inquiry into the record headed by Uniting Care Health chief Richard Royle has been charged with overhauling the struggling policy.

The intention of his panel is “not to kill it but build on the foundation base”, he says.

“If there is one consistent theme it is that the industry wants to see it work,” says the man who will next year launch Australia’s first digitally integrated hospital.

Voluntary sign-ups for e-health records have been slow and the Consumer’s Health Forum which previously backed an opt-in record has told the inquiry it now wants an opt-out system.

“Australia should bite the bullet and make joining the national e-Health records system automatic for everyone unless they actively choose to opt out,” CHF spokesman Mark Metherell says.

“An opt out model is one of the issues we’re looking at,” says Mr Doyle.

Doctors have told the inquiry they won’t trust the record unless patients are prevented from changing or withholding any clinical data such as an abortion or mental illness from the record.

They say they need this information so they have a proper understanding of all the medications and health conditions the person has to get a correct diagnosis and ensure there are no medication mix-ups.

Mr Royle says the inquiry is considering the personal control issue but “don’t assume the AMA position is the prevailing view,” he said.

The Consumer’s Health Forum says “if there is to be opt out full personal control of the health record must be central to the system and if possible strengthened”.

Consumers who had health procedures such as an abortion or a mental illness they may want to hide would be worried if they lost control over the record.

The changes would completely change the nature of the Personally Controlled e-Health Record which the previous Labor government promised would be voluntary and controlled by the patient.

The review set up by incoming Health Minister Peter Dutton has received over 82 submissions and the inquiry has been told the record won’t be useful until a critical mass of patients and doctors begin using it.

Health Minister Peter Dutton has ridiculed the slow progress with the record and doctors have argued they are unlikely to quickly embrace the record until they get paid to upload patient health summaries.

The review is also looking at whether involving private information technology providers who run private e-health records could improve the system.

A draft report is due to go to Health Minister Peter Dutton before Christmas.

NACCHO eHealth review submissions close 22 Nov :eHealth vital for Aboriginal Community Controlled Health

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Front page story from this weeks NACCHO Health News -Australia’s first Aboriginal health newspaper (Out this week in the KOORI MAIL)

The chair of National Aboriginal Community Controlled Health Organisation’s  (NACCHO) has welcomed the Federal  Health Minister Peter Dutton’s recent announcement for  a review of the current Personally Controlled Ehealth Records (PCEHR ) program, but has called on the Federal Government to support the continued use by Aboriginal community controlled health services (ACCH’S).

Update 21 November from NACCHO/AMSANT

The Federal Government have announced a review of the national eHealth Record System (PCEHR) with submissions to be completed by this Friday 22nd November.

 This is a very important review for the Aboriginal Community Controlled Health Sector to be involved in, as the sector has a 10 year history of being early, enthusiastic and skilled implementers and utilisers of eHealth, a basic foundation tool towards closing the gap through improved record sharing and data accuracy to ultimately improve health service provision and outcomes for Aboriginal people.  

 Note that the submission must be less than 1000 words and address the following areas:

  • Your  experience on the level of consultation with key stakeholders during the  development phase
  • The level  of use of the PCEHR by health care professions in clinical settings
  • Barriers  to increasing usage in clinical settings
  • Comments on standards for Terminology, language and technology
  • Key clinician utility and usability issues
  • Key patient usability issues
  • Suggested Improvements to accelerate adoption of the platform

Please return the submission or any comments today  Simon.Stafford@amsant.org.au who will complete it and ensure it is submitted by Friday 22nd November.. Thank you.

Mr. Mohamed said he agreed with the minister that the concept of electronic health records must be fit for purpose and cost effective and that the review should be able to put the controversial electronic health records program back on track.

“Given the state of Aboriginal health in this country and the fact the our Aboriginal population is expected to grow to over a million by 2031 we need to educate healthcare professionals on the role of Telehealth and ehealth technology can play to help close the gap.

We recognised in our recent Investing in Healthy Futures for Generational Change plan 2013-2030 that five years on from setting targets to “Close the Gap”, Aboriginal Community Controlled Health Organisations (ACCHOs) have been responsible for many of the health gains achieved  and that ehealth records have and will have into the future play a vital role  in recording improvements ,identifying risk factors, performing health checks, planning care, and managing and treating high-risk individuals” Mr Mohamed said

“The ACCHS sector has successfully embraced the concept of a national ehealth program to ensure continuity of care for a frequently mobile population with high incidence of illness. ACCHSs are often small health organisations that rely on external providers, including cardiac and renal specialists, physiotherapists, pathologists and radiographers.

If a patient say from Tennant Creek is visiting a clinic in Alice Springs   the administering health professional has in the past been locked out of the patient’s complex medical history, unless they go through the cumbersome process of requesting a health summary from the home clinic, which in turn may also be limited in historic information.

A shared electronic health record has enabled will our Aboriginal patients to receive health care consistent with their condition, treatment history and specialist advice, reducing risk of over treatment or testing.

“Our ACCHs PCEHR systems will meet the needs of a mobile population; enabling a patient to receive health care consistent with their condition, treatment history and specialist advice, reducing risk of over treatment or testing; captures important data that is otherwise easily lost; allows for information sharing and broad analysis; empowers the patients, affording greater flexibility and choice of health care provider.

“The national ehealth record system would do well to mimic the model of Aboriginal Community Controlled Health Services – regional, locally controlled health services that promote participation and are responsive to local need rather than a big one size fits all model.” Mr Mohamed said

The goals of PCEHR already align well with NT Aboriginal Health KPI Information System to contribute to improving primary health care services for Aboriginal Australians in the Northern Territory by building capacity at the service level and the system level to collect, analyse and interpret data that will:

  • Inform understanding of trends in individual and population health outcomes;
  • Identify factors influencing these trends; and
  • Inform appropriate action, planning and policy development.

Mr Mohamed as active implementers of the PCEHR, the ACCHS sector looks forward to participating in this review in its pursuit of the highest quality and continuity of health care for Aboriginal people towards Closing the Gap.

NACCHO ehealth news:Failed $1 billion electronic health records system faces the axe

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LABOR’S bungled $1 billion electronic health records system will be reviewed after being used by so few people it ended up costing $200,000 per patient.

Health Minister Peter Dutton yesterday said just a few hundred doctors were using the system with just 5000 patients using the Personally Controlled Electronic Health Records program which has previously been described as “shambolic”.

NACCHO Aboriginal ehealth technology news: Telehealth,ehealth and the Aboriginal digital divide

Peter Dutton shifts into high gear for e-health overhaul

A lack of software had prevented many doctors even accessing patient records.

“The problem is that the former government spent about $1 billion in this area and the number of people actively using the records numbers in the thousands,” he told Sky News. “There are only a few hundred doctors actually uploading details into people’s files. It has been a scandal. On those numbers it runs at about $200,000 a patient.”

Executive director of the UnitingCare Health Group in Queensland, Richard Royle, who is also vice president of the Australian Private Hospitals Association, has been given the job of reviewing the program.

Are online medical records safe?

Australian Medical Association president Dr Steve Hambleton will help with the review.

Mr Dutton said: “The government fully supports the concept of electronic health records but it must be fit for purpose and cost effective.”

He compared the roll-out of the e-health records program to the cost blowouts associated with the National Broadband Network.

The review will be open to submissions from the public

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NACCHO ehealth opportunity alert:an initiative to register people to the Personally Controlled Electronic Health Record (PCEHR)

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NACCHO Affiliates are being informed of this initiative, so they can choose to take up the opportunity to work with the Department and the dedicated workforce to offer Assisted Registration to their member health service patients.

The Department of Health and Aging is currently conducting an initiative to register people to the Personally Controlled Electronic Health Record (PCEHR) using a dedicated Assisted Registration workforce (Aspen Medical) supplied through McKinsey and Company (National Change and Adoption Partners).

They will concentrate on conducting Assisted Registration activities, until 30 June 2013, in a variety of healthcare settings across the country.

To ensure that this initiative meets the needs of our Sector, Winnunga Nimmityjah Aboriginal Health Service in Canberra has piloted with Aspen Medical a very successful campaign which has to date registered over 260 Winnunga clients and staff for an eHealth record.

As such, NACCHO Affiliates are being informed of this initiative, so they can choose to take up the opportunity to work with the Department and the dedicated workforce to offer Assisted Registration to their member health service patients.

This will be of significance to health services with larger centralised populations with access to a waiting room area, aged care facility or groups of patients where Aspen staff are able to inform and register patients individually.
The Assisted Registration process offers patients a quick, personalised and well-informed way of applying to register for a national eHealth record.

Previous to this process, consumers seeking to apply to participate in the PCEHR, would either do so on the internet, by post, by phone call or at a Medicare office.

The Assisted Registration process allows patients of a health service to fill in a one page application form, and have their identity verified either using a 100 point documentary ID check, or by being a known customer of the health care service. Patients have the opportunity to ask the trained Aspen staff members about the PCEHR and what it would mean for them.

The experience at Winnunga is that patients are quick to see the benefits of having an eHealth record, and are keen to opt in to the system.

The dedicated Aspen workforce tailor their approach to each setting. All  staff deployed will have undergone cultural competency training, and will work with the Affiliates and the service to understand the local context and needs of their patients. The staff would be happy to sign a client confidentiality agreement. Male and female staff members can be deployed if requested. In fact, where there are vacancies, Aspen are open to employing people recommended by the health service to be Assisted Registration staff.

Using Aspen Medical authorised staff members to assist your patients to register does not alter your connectivity with your patients. PCEHR compliant practice software will flag who has an eHealth record (provided the patient has chosen to allow access to clinicians in your service).

Please note that Aspen Medical is not in a position legally to provide a list of patients who have registered through them to a service, however they are more than willing to provide you with data on registration numbers.

Greg Henschke (Acting NACCHO eHealth Project Manager) will be contacting NACCHO Affiliates, with the aim of identifying services that would be interested in participating in this PCEHR consumer registration program.

This resource is currently available until 30th June 2013 and deployment will be managed nationally through DoHA.

It is important to note that the dedicated workforce are not unlimited and we will need to move quickly to identify where we could best use them for our sector.

As more consumers and healthcare practitioners become registered and use the eHealth record system, benefits of the system will be realised through efficiency in healthcare services and increased access to health information.

To this end, I would strongly encourage you to consider working with the Department and the dedicated workforce to offer Assisted Registration to our sector.

For more information on the PCEHR and Assisted Registration,

contact Greg Henschke (Acting NACCHO eHealth Project Manager,

greg.henschke@amsant.org.au

08 89446651 / 0400448159)

or go to the website http://www.ehealth.gov.au .

Aboriginal community case study (resent with new link): Northern Territory integrates PCEHRs with telehealth

The Northern Territory is demonstrating its nation leading ehealth work with a new video showcasing the integration of telehealth consultations with shared electronic health records (PCEHR) in Aboriginal communities.

VIEW HERE

As published ehealthspace.org December 2012

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Bridging the Digital Divide presents the care journey of a person in a remote community requiring a mixture of primary and secondary care for a serious injury.

Making use of the Territory’s My eHealth Record and its “Health eTowns” Telehealth Program, the patient receives treatment from a remote area nurse with real time clinical review and advice remotely from a doctor and a specialist burns nurse in Darwin over the course of their infirmity.

Speaking with ehealthspace.org, the NT Dept of Health’s Director of strategic ehealth systems, Jackie Plunkett, explained the importance of using shared care records in conjunction with telehealth. “The two go hand in hand. I’m a firm believer that you can’t have one without the other because when combined they make a powerful service delivery mechanism.”

VIEW HERE

The My eHealth Record has demonstrated the value of an EHR system once it reaches critical mass, with approximately 50,000 patients registered and clinicians using the system a rate of 30,000 patient record views per month.

Additionally, over two thirds of these views take place in a primary care setting, helping to take pressure of the hospital system.

By comparison Ms Plunkett said the telehealth program is still in its early stages, but even so it is now being used in 47 remote communities, all regional hospitals in the Territory plus six hospitals in the WA Kimberley region.

“It’s a growing field. Some of the services commonly performed at remote clinics with the use of telehealth include pre-admission and post surgical assessments. Renal reviews are also being introduced at the moment.”

Ms Plunkett said another important aspect for the indigenous community of both telehealth and the My eHealth Record is the ability to treat people with dignity and cultural sensitivity.

This can be particularly important in the healthcare setting where the urgency of a situation can make communication difficult for a patient having to deal with linguistic and cultural differences, she said.

“My eHealth Record has been a great cultural fit, hence its widespread adoption. And the uptake of telehealth thus far in remote communities has likewise been incredible.”

For further infomation about

NACCHO eHealth

NACCHO TELEHEALTH

Bridging the Digital Divide has been produced by the Northern Territory Government Department of Health with additional funding from the federal Digital Regions Initiative.

© eHealthspace.org Limited

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