Tuesday, February 09, 2016

It Seems That The Evidence That The PCEHR Is A Dud Is Building. The Waste Continues.

This article appeared last week:

E-health records have few fans, study confirms

1 February 2016
MORE patients than clinicians use My Health Record, and most users – both doctors and patients – are generally negative about the system.
But much of the negativity may be because users don’t understand the system, a new factor analysis of studies shows.
By March 2015, about 9% of all Australians were registered with the My Health Record (MyHR) system, previously known as the PCEHR, with some 5000 GP practices (almost 75% of those eligible) and 11,000 clinicians on board, and 44,000 shared health summaries available.
But the analysis notes that most people viewing the information on the system are consumers, with around 20,000 patient viewings per month.
According to the study, published in the Internal Medicine Journal, the potential reasons for GPs not accessing the system are:
  • Doctors believing they know most of what they need to about their patients.
  • The “clunky” MyHR summary display.
  • The fear of missing important information, placing doctors at risk of litigation.
  • The lack of evidence showing the system helps deliver better patient outcomes.
“These findings suggest that Australian consumer and healthcare providers are generally negative towards the PCEHR [now MyHR],” it says. 
“Participants’ uncertainty appears to stem from not knowing the mechanics of the PCEHR”. 
The analysis found that although most Australians appeared ambivalent or negative about the value of the system, a large minority of 42% seemed positive.
More here:
Here is the abstract.

Positive beliefs and privacy concerns shape the future for the Personally Controlled Electronic Health Record

  1. E. C. Lehnbom1,*,
  2. H. E. Douglas2 and
  3. M. A. B. Makeham2
Article first published online: 27 JAN 2016
DOI: 10.1111/imj.12956

Abstract

The uptake of the Personally Controlled Electronic Health Record (PCEHR) has been slowly building momentum in Australia. The purpose of the PCEHR is to collect clinically important information from multiple healthcare providers to provide a secure electronic record to patients and their authorised healthcare providers that will ultimately enhance the efficiency and effectiveness of healthcare delivery. Reasons for the slow uptake of the PCEHR and future directions to improve its usefulness is discussed later.
Paid access to the rather short article is found here:
(Note: The article was submitted in April 2015 and is actually a re-analysis of a study which was actually published in 2014.
“A more recent study sought to survey the Australian general public’s perceptions of having a PCEHR and found that the perceived value and risk associated with the PCEHR were the two most important variables explaining attitudes.7 This survey used questionnaires borrowed from consumer acceptance of interactive communication technology studies, which were not specifically developed for the PCEHR; therefore, its use in examining the attitudes towards the PCEHR is limited. To establish what constituted the key attitudes towards PCEHR in Australia, we performed a factor analysis on previously published data.9”
Here are the 2 references cited
7. Andrews L, Gajanayake R, Sahama T. The Australian general public’s perceptions of having a personally controlled electronic health record (PCEHR). Int J Med Inform 2014; 83: 889–900.
9. Lehnbom EC, Brien JE, McLachlan AJ. Knowledge and attitudes regarding the personally controlled electronic health record: an Australian national survey. In- tern Med J 2014; 44: 406–9.)
This said, it is hard to argue with the concluding recommendations:
“Future efforts to improve to uptake and usability of the PCEHR should focus on alternative structures to present in- formation to enable healthcare providers to find quickly the information they are looking for; evaluate the impact of PCEHR on healthcare delivery and patient outcomes to provide evidence that having a PCEHR makes a difference and track the awareness and knowledge of consumers and healthcare providers of the PCEHR’s potential  benefits.”
I have a sense hell may freeze over before we see these recommendations actually implemented - time will tell I guess.
I do wonder just why these publication are not available without paid subscriptions. DoH should be making them available!
David.

3 comments:

Anonymous said...

The Department is getting out of the eHealth business and dumping total responsibility on the ADHA. Mr Madden has overseen the Department's efforts for the last 5 years under the direction of Jane Halton who has now moved on.

While it's only Tuesday you already have 57 votes responding to the question: "Who Is Most To Blame For The PCEHR Fiasco?" with the vast majority answering The Department of Health.


Anonymous said...

30 hours later it's now 91 votes and more importantly with 75% of voters blaming the Department of Health for the PCEHR fiasco. The sooner they get completely out of the eHealth business leaving it to market forces the better.

Anonymous said...

The 'market' in the form of consultancy organisations, recruiters and other assorted bottom-feeding, parasitic vendors already have lobbied for these inefficient and ineffective projects, where such wastage becomes ongoing profit. There is a revolving door of careerists between government and these sorts of organisations/vendors. (Its true of anything linked to the 'market', in particular infrastructure.) You must be more articulate than a religious hope for the 'market' (whatever that really is) to resolve this. Perhaps you mean like allowing individual healthcare providers choose what solution they want, rather than some self-seeking interests impose theirs? I believe that might be more democratic, innovative and successful elsewhere, despite the (mis)perception of chaos?