The following release dropped into view via the NEHTA RSS feed a day or so ago.
The original seems to have come from the Royal Australian College of General Practitioners.
Health Records Security Top Priority
22 January 2010
A general practice at the heart of the Black Saturday bushfires, awarded the Royal Australian College of General Practitioners (RACGP) 2009 Victoria General Practice of the Year Award, has worked tirelessly to get the practice back on its feet a year on from the fires.
One of the painfully slow after-effects of the Black Saturday bushfires has been to rebuild all of the vital community information that was lost, including the medical records of all the patients at the Marysville Medical Clinic, now located in Buxton.
When the Marysville Clinic burnt to the ground that day, along with it went all the files, paper records and patient history of many families and individuals living in the area.
Dr Lachlan Fraser, the solo rural GP in Marysville, had back-ups of the data, but the copies saved off-site were burned when his secretary lost her home and nearly her life in the township.
Thankfully they also had an old back up version that was kept in, Alexandra, half an hour north, an area that was also threatened with fire. But the clinic had still lost the past year and half of data, so along with the task of setting up and working from a temporary building, they has also had to re-establish vital medical data for patients.
“We perhaps had half of the information we would have liked and in particular it meant that we lost our recent records that involved patient pathology results or x-rays that we needed to follow up. It has meant that we needed to reconstruct patient histories which is a huge process and extra work during this difficult time for everyone,” said Dr Fraser.
Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.
NEHTA is the lead organisation supporting the national vision for e-health in Australia.
“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.
“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.
For this reason, the RACGP, which is the largest representative body for Australia's urban and rural general practitioners, is determined that GPs such as Dr Lachlan Fraser be a leader in the adoption of e-health in Australia.
“We are currently developing the next edition of the RACGP Standards for General Practices (4 th edition) and are working with NEHTA to make sure that the Standards are now fully integrated with e-health so that our RACGP members can deliver the highest standard of care to their patients,” said Dr Chris Mitchell, RACGP President and GP in northern New South Wales.
“The new RACGP Standards for General Practices will ensure that what the Marysville Medical Clinic and also GPs in flood affected areas of Australia have gone through will never have to be repeated.
“Trauma and grief counselling are high on the list of immediate services provided in these circumstances. However, maintaining high quality health services such as diabetes management and access to pathology results is very important, particularly for our patients with chronic diseases. The quick re-establishment of high quality general practice services can help high risk patients who lost everything back to health,” he said.
Dr Fraser agreed and added that electronic records would be a far better way to safeguard patient records which could then be accessed by healthcare providers anywhere in Australia and so helpful for those who did not re-settle in the same location.
Publication Date: 22 January 2010
Authorised By: Media
The release is found here:
http://www.racgp.org.au/media2010/35858
The release is also found here (complete with RACGP Logo)
http://www.nehta.gov.au/media-centre/nehta-news/590-bushfire-release
and it has appeared overseas here:
http://www.medicalnewstoday.com/articles/176861.php
With the title:
Health Records Security Top Priority, Australia
What just amazes me here is the arrant nonsense spouting from the mouth of NEHTA CEO.
“Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.
NEHTA is the lead organisation supporting the national vision for e-health in Australia.
“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.
“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.”
This is just wrong, most especially the paragraph I have bolded. A severe fire anytime in the present, or next few fire seasons, would lead to the same outcomes and NEHTA knows it!
Now I, like all Australians, was greatly saddened, and horrified, by the awful loss of life and property in the Black Friday fires a little over a year ago.
This said there is just no excuse for this release. Nowhere in any NEHTA plan is the provision of off-site GP record archiving that has even been mooted let alone costed and funded, which is what is being suggested here.
An off-site summary record may be a twinkle in NEHTA’s eye, but after a year of trying they have not had that funded, let alone a more comprehensive provider record.
What is also undeniable is that if we sadly have another event like Black Friday in the next few years there is a high likelihood that there will be exactly the same outcome for the local GPs data – as there is nothing NEHTA has yet done or even planned, or will do in the foreseeable future, which would make the least bit of difference.
A different release from the College pointing out that natural disasters do happen, using this sad case as an example, and alerting GPs to think about secure cloud based encrypted backup over the internet would be much more sensible – as might be a review of possible providers of such services the College could endorse. Maybe such a suggestion for the next set of RACGP Standards?
The College should withdraw this present ill-conceived release in my view. I am sure many of those with serious e-Health knowledge and experience within the College, and there are many, would find this release rather opportunistic if not just offensive.
NEHTA should also apologise for making claims there is no way they can justify. I bet this release was not initiated by the College, but, of course, I am always open to surprises!
David.
14 comments:
It isn't just NEHTA that doesn't get it, you don't appear to either.
A national database of personal details combined with medical information is anathema to many Australians.
It may come as a surprise to you, but it isn't only politicians and bureaucrats who aren't generally trusted - health professionals are not always considered to be the most ethical of creatures either.
Oh this is a pure Shakespearean Comedy of Errors. How on earth could an august a body as the RACGP permit such empty rhetoric to be released in the media. Has it no quality controls in place? I can’t imagine what its members will say. The sooner they pull this down off their web site the better. Hopefully it hasn’t as yet been distributed out to the general media.
There is nothing new here. We have all known this since the hurricane in New Orleans. Many keep thier heads in the sand instead of in the clouds. The answer is in the cloud - it has been and people refuse to take the step and move there. It should now be Health IT 1.01
David de Bhal
Virtual Practice
I think the College got conned somehow. It is hard to imagine NEHTA’s clinical lead Dr Haikerwal would have supported a story that wrapped the bushfires and NEHTA together with Peter Fleming’s blatantly inaccurate claim that NEHTA’s work “means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed”. We all know that is simply just not true. In fact it is wrong, irresponsible and totally misleading to make such claims.
It smells like media spin out of control, it smacks of opportunism of the most insensitive kind.
It is difficult to imagine how anyone in the RACGP with a modicum of understanding about the status quo of ehealth and NEHTA could support that position. The first thing that should be done to fix this “arrant nonsensical claim” by NEHTA’s CEO is to withdraw this story before it causes further embarrassment to everyone.
As NEHTA's spinmachine has popped a gasket a head change is required.
David, I think it was AOK for Peter Fleming to say that “in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.” But is was inappropriate to say that “this means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed.” But bear in mind that even Dr Mitchell fell into the same trap when referring to a similar experience that “GPs in flood affected areas of Australia have gone through will never have to be repeated.”
Would you not agree that it would have been much better for them to have said … when that day comes we will never again have to worry ………… Would you be happy if they amended the media release to that end?
This is very sad. All power to Dr Lachlan Fraser, the solo rural GP in Marysville Medical Clinic and the well deserved RACGP 2009 Victoria General Practice of the Year Award. It’s a great story of farsightedness and good practice having a second set of ‘old’ back-ups held in another location at Alexandria. The RACGP would lose nothing in telling the story without referring to NEHTA at all. Until NEHTA demonstrates it has implemented something of relevance to general practice it should get out of the limelight and leave it to the likes of Lachlan Fraser. Well done Lachlan.
My view is that there is no evidence that NEHTA is ever planning to deliver a system of nationally accessible, detailed, operational clinical records for use by providers and that this means the premise of this release is profoundly flawed and unacceptably wrong. It just should be withdrawn with an apology.
I also find the link to Black Friday in the midst of of the fire season pretty off.
David.
Of course NEHTA knows it is not quite accurate but with the objective of maximising its credibility it is to be expected NEHTA will milk it for its worth. Fair cop I say.
What systems are NEHTA referring to here? Presumably more than a health summary. Where are these systems and who is funding it?
However, back to the real world. I don't have any problem with the concept of cloud computing within the realm of General Practice. However, without exception, all of my GP clients think differently and to date, have not been prepared consider this option as the next step for their practice based systems. The issues are not technical - 'merely' hearts and minds (a much larger barrier).
I would suggest that the RACGP would achieve more by presenting viable hosting options using currently available technologies.
Any hosting options that make any sense would be variants of some form of 'cloud computing' I believe. The point I made is valid I believe and needs GP policy makers to push for that or a similar outcome.
David.
Two points here: in 2008 I and a colleague from the local GP Division were called early in the morning to a local solo practice which had burnt to the ground overnight. Shivering in the car park of the local shopping centre, our first question to the shaken GP was "Did you backup yesterday?". In reply she produced a zip drive (yes, remember them)from her coat pocket which had a backup set of data from 5pm the previous day. After rummmaging around the junk boxes of the PC suppliers of the city, we found a zip drive, my colleague installed the clinical package plus data to the GPs home PC, and she was seeing patients at home about 3 hours later.
We rather shamelessly used this incident, which was locally well publicised at the time, to drive home to GPs the importance of basic (in this case very basic) DRP procedures within their practices.
Second point - DRP for GP practice software and data continues to be one of the most neglected features of the move by practices to networked clinical systems. I'm aware of commercial enterprises which offer a complete remote managed solution to the problem (at a cost), which can and does include daily imaging of both servers and even individual PCs so that a whole of network replacement rollout can occur.
Whether this is an acceptable or cost-effective solution for smaller and/or rural and remote practices is a moot point, and similarly these sorts of practices might not have acceptable bandwidth available to take advantage of cloud based systems, with or without some subsidised assistance.
Certainly delineation of what constitutes an acceptable (and legal)archival and retrieval policy would be a good start to a national approach to a set of clinical DRP guidelines for general practitioners. At the moment we seem to be stuck with the old chestnut of backup fully, often and store offline - and of course the hardy perennial of do a test restore from backup occasionally!!
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