Tuesday, November 11, 2014

The Consumers Health Forum (CHF) Has A Dummy Spit And Reveals A Distorted View Of The Caring Professions.

We had an interesting, evidence free press release from the Consumer Health Forum (CHF) a few days ago.

Doctors: the health evolution is here, move on or move out

3 November 2014 - 
Many lives and billions of dollars, could be saved by personally-controlled electronic health records yet their full potential is threatened by self-interested doctors who wrongly claim they are putting patients’ interests first.
“There is widespread support for the introduction of a personally-controlled electronic health record, including from consumers, medical leaders and other providers, as revealed in the latest edition of CHF’s journal  Health Voices, published today,” says CEO Adam Stankevicius.  “Australia has already waited far too long for an effective national eHealth system --- more than ten years since government funding began in earnest. 
----- End Extract.
Here is the link to the .pdf.
There is reporting here.

Consumers and doctors clash over health records

Date November 8, 2014 - 6:17PM

Dan Harrison

Health and Indigenous Affairs Correspondent

A patient advocacy group has accused doctors of being motivated by self-interest in arguing against patients having direct access to test results via electronic health records.
Pathology and diagnostic imaging reports will be able to be added to electronic health records in the next update of the system, due later this year. 
Patients will be able to access these results following a seven-day delay, which is designed to give doctors time to manage communication of results with their patients.
But the Royal Australian College of General Practitioners is fighting the change, arguing that patients should not be able to access test results until they have been reviewed by the doctor who ordered them. 
College president Frank Jones said doctors had a responsibility to first check the results of tests they had ordered.
"The College has no issue whatsoever with patients having access to their medical records ... it's how it happens that is our concern," he said.
In a statement this week, the college said it would sometimes be undesirable for patients to find out results before any discussion with their GP in which the doctor could provide contextual advice and support. 
Lots more here:
Also we had this:

College told to ditch self-interest over patients' pathology results

3 November, 2014 30 comments
The RACGP has been told to ditch "self-interest" and stop blocking patients from prompt access to their pathology results.
The row is brewing over the decision to automatically upload virtually all pathology and diagnostic imaging results on to the PCEHR after seven days.
The college fears patients will learn they have serious conditions like melanomas or sexual diseases like chlamydia on the system before the GP has been able to contact them.
But the stance has outraged the Consumers Health Forum of Australia (CHF), which says that full potential of the e-health system is "threatened by self-interested doctors who wrongly claim they are putting patients' interests first".
In a media release entitled Doctors: the health evolution is here, move on or move out, the CHF CEO Adam Stankevicius said: "The RACGP is arguing against patients learning the results of path tests on 'safety' grounds, asserting that patients getting bad news before hearing it from them could be subject to ‘unnecessary distress'.
Lots more here:
I will choose to ignore the suggestion that doctors are pursuing ‘self - interest’ as I have no idea just what interest any doctor would have (except in very unusual circumstances) of not sharing patient results with the patient. What this seems to be is part of some CHF ‘Class War’ against doctors for the most obscure of ‘political’ reasons.
What I am even more amazed about is the first paragraph here:
“Many lives and billions of dollars, could be saved by personally-controlled electronic health records yet their full potential is threatened by self-interested doctors who wrongly claim they are putting patients’ interests first.”
Clearly there is no evidence of any sort that the PCEHR is working and it is at present just blind faith that it will in the future offer benefits that are being suggested.
Having results shared between pathologists, clinicians and their patients is the way it has always worked and it has worked pretty well.
Before just such an outrageous statement and claim for benefit is made - maybe the CHF might like to demonstrate just where the benefits claimed will come from over the present, already electronically enabled systems.
The magical thinking we see from groups like this, and the lack of evidence offered, makes one wonder why anyone would take the CHF seriously.


Bernard Robertson-Dunn said...

re: “Many lives and billions of dollars, could be saved by personally-controlled electronic health records.”

IMHO, this is the give away. If they really think that eHealth Records are a good thing, they wouldn't use the term "personally controlled".

They are just toeing the government line, probably for some unstated political reason.

Dr David More MB PhD FACHI said...

Think Federal Govt. Funding!


Anonymous said...

I am starting to think we should save even more money and just allow patients to order their own tests and check the results as clearly doctors have an equal conflict of interest in test ordering. That way we can avoid the need for a doctors visit all together.

While we are at it we should allow electrical work to be done by anyone and get work experience students to service Qantas planes. The productivity gains are potentially enormous!

Where is the evidence that all patients can make sense of results? They must have done a trial of this before an actual go live date haven't they??? O dear no, but there is no evidence either way so we will just do it anyway. This is a ship of fools. Its as least as safe as giving poorly trained ukraine rebels an advanced ground to air missile system to play with. "This result indicates a military plane, launch missile".

Bernard Robertson-Dunn said...

At least with an opt-in model that very few people want or make use of, the potential harm is likely to be quite small.

Now, going to opt-out - that's a whole different kettle of worms.

Anonymous said...

Can someone tell me what opt-in actually means: I am assuming it means everyone has a record unless they explicitly say they don’t want one.
Then everyone gets their Medicare/PBS/organ donation/vaccination details duplicated across from the national systems where they are currently held. (Hopefully all matched against the right person, and not against the person who is the ‘claimer’ in the family).
Then as a default, each time you have a hospital discharge, or a GP visit or a medication dispensed or any sort of health event (pathology test, imaging), a document gets posted to your record – unless you explicitly ask for it not to be (opt out for the document).
Then as a default, if you choose not ever to opt out at any level, there will be a record of all of your health data from registered providers, which you can see and which anyone who works for a registered health provider can see.
Does opt out also apply to providers – i.e. all are participating unless they choose to opt out?

Anonymous said...

opt in - I choose to join a record system, and no record is created unless I make such a election

opt-out - a record is created for everyone, unless they elect to opt out of that decision made for them.

Opt in is challenged by getting people to be bothered enough to make that decision - so struggles with numbers

Opt out is challenged by informed consent. Just because someone has not opted out does not mean that they would be happy having a record - they may not know it exists or mayn't know the consequences of having such a record.