Monday, May 14, 2012

It’s Time To Check What We Were Promised With The PCEHR Two Years Ago.

Here is the press release - (I have highlighted the important and not delivered bits in italics):

Personally Controlled Electronic Health Records for All Australians

Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication.
11 May 2010
Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication.
The $466.7 million investment over the next two years will revolutionise the delivery of healthcare in Australia.
The national e-Health records system will be a key building block of the National Health and Hospitals Network.
This funding will establish a secure system of personally controlled electronic health records that will provide:
  • Summaries of patients’ health information – including medications and immunisations and medical test results;
  • Secure access for patients and health care providers to their e-Health records via the internet regardless of their physical location;
  • Rigorous governance and oversight to maintain privacy; and
  • Health care providers with the national standards, planning and core national infrastructure required to use the national e-Health records system.
Benefits for patients
Patients for the first time will be empowered with easy-to-access information about their medical history - including medications, test results and allergies - allowing them to make informed choices about their healthcare.
They will be able to present for treatment anywhere in the country, and give permission for health professionals to access their relevant history at the touch of a button.
Patients will no longer have to remember every detail of their care history and retell it to every care provider they see. Parents will not have to remember the vaccinations their child has had, and doctors and nurses won’t have to thumb through paper records.
Patients will control what is stored on their medical records and will decide which medical professionals can view or add to their files, meaning privacy will be strengthened.
A personally controlled electronic heath record will have two key elements:
  • a health summary view including conditions, medications, allergies, and vaccinations; and
  • an indexed summary of specific healthcare events.
Benefits for health providers and the health system
Poor availability of health information across care settings can be frustrating and time consuming for patients and health professionals alike.
It can also have damaging effects on a patient’s health outcomes through avoidable adverse drug events and lack of communication between health care providers.
About 2-3 per cent of hospital admissions in Australia are linked medication errors. It equates to 190,000 admissions each year and costs the health system $660 million.
About 8 per cent of medical errors are because of inadequate patient information.
Clear, quickly available information will reduce such incidents, avoid unnecessary tests and save scarce health resources.
Implementation of personally controlled electronic health records
Personally controlled electronic health records will build on the foundation laid by the introduction of the Individual Health Care Identifiers later this year. Under this, every Australian will be given a 16-digit electronic health number, which will only store a patient’s name, address and date-of-birth. No clinical information will be stored on the number, which is separate to an electronic health record.
Implementation will initially target key groups in the community likely to receive the most immediate benefit, including those suffering from chronic and complex conditions, older Australians, Indigenous Australians and mothers and newborn children.
This investment includes funding for the first two years of the individual electronic health record business case developed in consultation with all states and territories and the National Electronic Health Transition Authority (NEHTA).
Subject to progress in rolling out the core e-Health infrastructure, the Government may consider future investments, as necessary, to expand on the range of functions delivered under an electronic health record system.
Reforms to take health system into 21st century
A national e-Health records system was identified as a national priority by the National Health and Hospitals Reform Commission and the draft National Primary Health Care Strategy. It was also supported by the National Preventative Health Strategy.
The Government’s reform plans in primary, acute, aged and community care also require a modern e-Health infrastructure. It is a key foundation stone in building a health system for the 21st century.
A personally controlled electronic health record will not be mandatory to receive health care. For those Australians who do choose to opt in, they will be able to register online to establish a personally controlled e-Health record from 2012-13.
The release is here:
Here is a link to the points about all this I made at the time:
If ever there was a fantasy wish list that has not been delivered this is it. Any review of the areas in italics reveals that gross exaggeration was the name of the game. This sentence is just wonderful...
“The $466.7 million investment over the next two years will revolutionise the delivery of healthcare in Australia.”
What? Nothing has changed that anyone can detect and right now we have an advertising blitz running saying what they imagine well be and asking for you to be reminded to register for your own record when they are ready.
This extract from a 2010 interview is telling:
MELINDA HOWELLS: Nicola Roxon says half a billion dollars is a big commitment.

NICOLA ROXON: Governments of past have put off making the decision to do this and our focus will be absolutely on these stages and of course there is business plan for the stages that can come after that. This investment, however, will give the momentum to taking electronic health records that step closer to reality in Australia.
Full interview here:
So back in 2010 there was a plan, funding was contingent on actual progress none of which is evident but some (lesser) funding has emerged and thing were to be revolutionised in two year. Shows how silly it is to say stuff like this when you don’t understand what you are saying.
If there is actually a plan (especially a newly modified one - which I doubt) - it would be good to see it to see if it has any more chance of being delivered.
At least the new minister seems to realise things were rather over-egged two years ago and is easing back on the expectations. She was doing that job really well until this astonishing outburst in her most recent release:
“eHealth will support a better healthcare experience for patients and improved support and decision-making for healthcare providers. It has been estimated that net benefits from the current PCEHR program will reach $11.5 billion over 15 years to 2025.”
The release is here:
Show us the reports that confirm this we all say in unison. Given the NEHRS design has never actually been implemented anywhere in the world it is clearly a piece of fantastical thinking on the part of an advisor or a straight out ‘porkie’. You choose.