Sunday, December 19, 2010

The Government Is Heading In the Wrong Direction with the PCEHR - AMA.

The following appeared a few months ago and I sadly missed it. Maybe not such a bad thing considering 3 months and a Summit have now passed and we don’t seem all that much further ahead.

Too soon for hallelujahs?

24th Aug 2010

Are personalised e-health records truly the solution to the system’s ills? In the final of her series, Caroline Brettingham-Moore finds the experts are less than confident.

Caroline Brettingham-Moore

AFTER a decade of stalls and setbacks, calls for a national electronic healthcare records system may have finally been answered.

But what sort of record we get for the amount of money the Federal Government has committed to the project is something the experts are still arguing over.

In May, Health Minister Nicola Roxon announced all Australians would be able to regis­ter for a personally controlled electronic health record (PCEHR) by 2012.

And with only $467 million to invest over two years it would appear the minister has pulled a rabbit out of her hat.

At the time of the announcement, sceptics branded it “misleading” and “hot air” after the Government failed to provide any detail as to how the money would be spent. But just last week, the Minister revealed that $12.5 million of this budget would be given to three divisions in Queensland, NSW and Victoria to pilot a national rollout of PCEHRs.

Brisbane division GPpartners, while welcoming the funds, remains wary of whether the two years of funding will be enough to get the project working. Others have also expressed concern over the total $467 million package.

Health IT consultant Dr David More warns the money, which is well below the Deloitte’s recommendation of $1.5 billion over five years, will not deliver what is promised.

He says the shallow period allocated for funding the project will turn off possible IT vendors.

“What will happen after two years and who would bother if there is no confidence of some reasonable follow-on?” he asks.

“Surely this is an emergency fig leaf to cover the naked lack of e-health policy...”

Tricky definitions

So what does “personally controlled electronic health record” actually mean? Ms Roxon told a news conference in June that “the easiest way to think of it is how you access your bank details online”.

Unfortunately, this explanation was not well received by industry insiders, who questioned whether the minister actually understood the concept herself.

“Do banks ever hand over bits of their records to random third parties on request of their patients, I mean customers, with or without consent,” said one comment on Dr More’s blog, Australian Health IT, said.

Another said: “If you link your health record to your home loan, you might avoid account fees.”

So why does Australia need a PCEHR?

Ms Roxon says the record will provide summaries of a patient’s health information, including medi­cations, immunisations and test results. It will also give patients and healthcare providers secure access to their e-health records via the Internet.

It is estimated 8% of medical errors in Australia are due to inadequate patient information. Between 2% and 3% of hospital admissions in Australia are linked to medication errors. This equates to about 190,000 admissions a year, costing the health system $660 million.

According to an analysis by Booz and Company, the benefits of a comprehensive e-health system could save between 5000 and 10,000 lives by 2020 by reducing medical errors .

Obviously clear, quickly available information will help to reduce adverse events, avoid unnecessary tests and save scarce health resources.

Much more here:

http://www.medicalobserver.com.au/news/too-soon-for-hallelujahs

Clearly things were not clear at that point. Move forward 3 months, and while again it took me a few days to catch up this appeared just over a week ago.

http://ama.com.au/node/6277

AMA plan to get the ‘e-health revolution started

AMA President, Dr Andrew Pesce, said today that the Government should concentrate its efforts on delivering the most easily achievable aspects of an electronic medical record in order to get Australia’s much-anticipated ‘e-health revolution’ started.

Dr Pesce said that the AMA has long been a supporter of the Government’s e-health agenda but it is time that people started seeing some results.

"The Government should concentrate all its efforts on getting pathology results, diagnostic imaging results, hospital discharge summaries, and medications dispensed information onto an electronic medical record,” Dr Pesce said.

“This is basic information, yet critical to patient care. It is currently available in electronic format, but it is not easily or instantly accessible to doctors in all situations when they are providing care for patients.

“If it were possible for doctors to electronically access this patient information in ‘real time’, while protecting patient privacy, a significant amount of the e-health ambition would be realised.

“Over time, other aspects of electronic health records could be developed to fully realise the potential of e-health to improve patient care.

“To be successful, the electronic medical record must be easy to use, support what doctors already do, and be compatible with current clinical practice methods.

“The AMA e-health plan satisfies these criteria and would give e-health in Australia the kick-start it needs," Dr Pesce said.

10 December 2010

The source is the AMA web site here:

http://ama.com.au/node/6277

The post by the AMA was reported here

AMA Plan To Get The ‘e-health Revolution Started, Australia

Written By: sara on December 12, 2010 0

AMA President, Dr Andrew Pesce, said that the Government should concentrate its efforts on delivering the most easily achievable aspects of an electronic medical record in order to get Australia’s much-anticipated ‘e-health revolution’ started.

Dr Pesce said that the AMA has long been a supporter of the Government’s e-health agenda but it is time that people started seeing some results.

“The Government should concentrate all its efforts on getting pathology results, diagnostic imaging results, hospital discharge summaries, and medications dispensed information onto an electronic medical record,” Dr Pesce said.

“This is basic information, yet critical to patient care. It is currently available in electronic format, but it is not easily or instantly accessible to doctors in all situations when they are providing care for patients.

“If it were possible for doctors to electronically access this patient information in ‘real time’, while protecting patient privacy, a significant amount of the e-health ambition would be realised.

“Over time, other aspects of electronic health records could be developed to fully realise the potential of e-health to improve patient care.

“To be successful, the electronic medical record must be easy to use, support what doctors already do, and be compatible with current clinical practice methods.

“The AMA e-health plan satisfies these criteria and would give e-health in Australia the kick-start it needs,” Dr Pesce said.

Source: Australian Medical Association

More here:

http://biomedme.com/general/ama-plan-to-get-the-e-health-revolution-started-australia_25356.html

So let us be quite clear here. The organisation that NEHTA and DoHA will have to most rely on to gain traction with their PCEHR initiative are saying the major thrust of the plan is wrong.

These two paragraphs say it all:

“The Government should concentrate all its efforts on getting pathology results, diagnostic imaging results, hospital discharge summaries, and medications dispensed information onto an electronic medical record,” Dr Pesce said.

“This is basic information, yet critical to patient care. It is currently available in electronic format, but it is not easily or instantly accessible to doctors in all situations when they are providing care for patients.”

The bottom line here is that we need to address the grey before the beige on this NEHTA (from the Summit presentation) graphic! (It is fun to have the odd funny graphic to brighten things up). Let’s get the information flows between providers really working and reliable and then worry about indexes, summaries and the like.



All this just confirms the view I have been putting for a while now. This is the same we might be hearing from all sort of others if they were not so busy trying to work out if all these funds on offer from DoHA and NEHTA are an huge opportunity or a disastrous threat!

You know where I stand on that!

David.

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