Sunday, July 28, 2013
I Am Not Sure DoHA And NEHTA Have Thought Through Pathology And Radiology Results In The NEHRS / PCEHR.
A week or so ago Tanya Plibersek announced the spending of some $8M on the following.
17 July 2013
Patients will soon be able to have pathology and diagnostic imaging results uploaded to their eHealth records thanks to an $8 million Federal Government investment.
The Minister for Health, Tanya Plibersek, said it will mean things like a patient’s blood test and x-ray results could be stored securely online as part of their own personal eHealth record.
“This is a landmark next step in the evolution of the Government’s national eHealth records system,” Ms Plibersek said.
“We expect both doctors and patients will find the new functionality useful, as it will reduce the need for them to chase down results or duplicate tests.
“In an emergency, having this kind of information on a patient’s eHealth record could save lives.”
Both patients and healthcare professionals will be able to access results uploaded to a record.
“The $8 million investment includes funding for planning and design work associated with upgrading medical software used by doctors so results can be downloaded or uploaded at the click of a button,” Ms Plibersek said.
“This work will pave the way for x-ray and MRI images themselves to be stored on a patient’s eHealth record in the future.
The new functionality is expected to roll out in the first half of 2014.
The full spin laden release is found here:
At present pathology and radiology results go to the doctor of the patient who requested the tests be done (often electronically - especially in pathology) where they are reviewed and then discussed with the patient on their next visit or by phone if some more urgent action is required.
Thus what cannot happen is that any results go via any path into the PCEHR other than after clinician review and discussion. If they do then we can all see what will happen. Patients will read results - see something that concerns them - whether it should or not - and be calling, e-mailing or whatever anxious and concerned.
We are also going to have the anxious types worrying when they don’t need to if it takes longer than a day or so to be able to see their results in their PCEHR.
What we get by offering this is anxious patients and harassed clinicians who will have their usual workflows interrupted and worse then have to spend time closely reviewing results to make sure there are no contents in the report the patient does not want on their PCEHR. This says nothing of the time needed to locate if each patient with some results has a PCEHR, wants the information sent and getting consent to do so!
Of course we also know the pathology and radiology providers are also aware that their results are a professional opinion - usually with some interpretation - and they are also going to be concerned about results being misunderstood etc. with possible liability issues etc. to say nothing about consent issues.
The most innocuous test can pin-point a diagnosis the patient may not want disclosed. Examples include measurements of Serum Lithium (points to serious mental illness) and various drug levels that point to Epilepsy or even a blood sugar that may reveal diabetes.
To me this is a feel good announcement made by a Minister at an e-Health Conference way before any careful discussion with clinician groups has been had. All them would have made it very clear that there are all sorts of traps for the unwary in making this initiative work properly. The technology is the very least of it!
Posted by Dr David More MB PhD FACHI at Sunday, July 28, 2013