The following appeared today.
PCEHR an expensive legal trap: AMA
- By Gemma Collins on 1 June 2011
The AMA has spoken out against proposals for the Personally Controlled Electronic Health Record System saying it will create “medicolegal risks” and a financial burden for doctors.
In its submission to the Department of Health on the draft concepts of the introduction of the PCEHR, (see link) the AMA says the proposals have “fundamental flaws” and its complex design could see medical practitioners unable to access or contribute to it.
The doctors’ group insists the flaws are a consequence of the decision to make the record system opt-in rather than opt-out, which will lead to doctors not able to find a record for some of their patients, which could eventually see them giving up on the system altogether.
It says giving patients the option of several access settings will mean doctors may not be able to access important information.
Meanwhile the doctor’s obligation to discuss the system’s clinical risks with their patients will create a “medicolegal minefield”.
Here is the summary of the AMA Submission:
AMA Submission to the Department of Health and Ageing on the Draft Concept of Operations Relating to the introduction of a Personally Controlled Electronic Health Record System
31 May 2011 - 5:00pm
The AMA submission on the proposed PCEHR expresses concerns that the proposed form of the PCEHR will provide only limited safety benefits and these are significantly outweighed by its inherent clinical and medico-legal risks for medical practitioners and the administrative burden it will impose on medical practices.
The AMA submission advocates for:
- a shared electronic medical record (that sits within a personally-controlled electronic health record) that contains reliable and relevant medical information about individuals that has been posted by medical practitioners;
- health consumer participation in the PCEHR to be opt-out. An opt-in system will mean that doctors eventually give up looking for PCEHRs after failing to find them for other patients; and
- system protocols that align with clinical workflows and integrate with existing medical practice.
The submission highlights that the proposed PCEHR:
- will be extremely complex to use because it is built around exceptions to clinician access and input to the record;
- allows health care providers who are not medical practitioners to upload information;
- allows patients to hide key pieces of medical information, thus compromising its usefulness to medical practitioners;
- creates significant exposure to medico-legal liability for participating medical practitioners;
- must not impose penalties on medical practitioners if they do not use the PCEHR; and
- imposes significant administrative and financial burdens on participating medical practitioners and practices.
The submission concludes that the cumulative effect of these points will mean that medical practitioners are unlikely to use the PCEHR in the form proposed.
The full submission is linked to from this page:
To me this spells the end of the present incarnation of the PCEHR. The AMA is clearly not happy Joyce and unless they are on board no amount of change management will be enough!
No substantial change in the Health System has ever succeeded without at least tacit support from the AMA and their Submission is a long way from that!
They have been saying they are not happy for quite a while as has been mentioned on the blog.
(Point 8 of the body of the Submission).
I can see it all now - Ms Roxon and Ms Halton blaming the AMA for blocking their brilliant proposal when in actuality they are actually saving them from themselves.
Time for the ‘big rethink’! That the AMA is not ‘pre lined up’ only shows how incompetent NEHTA and the e-Health Group at DoHA actually are.