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 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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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.

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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.”

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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.”

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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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