Tuesday, May 14, 2013

It Seems They Plan To Put Information On Advanced Care Directives On the NEHRS / PCEHR.

This press release appeared a few days ago.

Advance Care Plans to be Included on E-Health Records

Telling your loved ones how you wish to be cared for as you get close to the end of your life will become easier.
9 May 2013
Telling your loved ones how you wish to be cared for as you get close to the end of your life will become easier, with the Gillard Government to invest $10 million to enable Advance Care Directives to be stored on the Personally Controlled Electronic Health Record.
“Most families want to be true to the wishes of their loved ones as they approach the end of their lives, and Advance Care Directives allow that to happen,” said Ms Plibersek.
“Including Advanced Care Directives on the Personally Controlled Electronic Health Record will mean people will be able to share their end of life plans with any of their chosen doctors, hospitals, family or carers,” said Ms Plibersek.
Announcing the initiative at the 4th International Society of Advance Care Planning and End of Life Care Conference, Ms Plibersek said it would ensure all Australians could have control over their end-of-life care.
“Because it’s online, the advance care plan will be easily available,” Ms Plibersek said.
“For example, if an elderly man from the Gold Coast is admitted to a hospital while visiting his family in Melbourne, his treating doctors and nurses would have access to information about his end of life care wishes.
“That could include information about any treatments he does or does not want under particular circumstances.
“Around 110,000 people each year need some form of end-of-life care. More than half of all deaths occurred in hospitals, yet most Australians would prefer to die in their own homes.
“This suggests that many people do not get their wish in terms of where they spend their final days. It can be a difficult conversation for patients, families and health professionals alike, but having patient intentions clearly expressed in an advanced care plan will make it easier for their wishes to be met,” Ms Plibersek said.
Ms Plibersek said the Australian Government was also providing an additional $800,000 over two years for the evidence-based Respecting Patient Choices advance care planning project led by Melbourne-based expert Associate Professor Bill Silvester, President of the International Society of Advance Care Planning and End of Life Care.
Associate Professor Silvester has worked with many patients on end-of-life care planning and welcomes the addition of advance care directives to Australia’s eHealth record system.
“By putting advance care directives online, it guarantees the patient is at the centre of their health care. For example, if a patient is admitted to hospital, doctors will be able to quickly see exact details of their wishes for end-of-life care. It ensures that the patient stays front and centre and maintains control of what will be happening to them when they can no longer speak for themselves,” said Associate Professor Silvester.
There will be consultation with consumers and healthcare providers on the design of the proposed system to ensure it is fit for use nationally and fit for purpose for consumers and clinicians.
The Government is also providing $50 million to deliver community-based palliative care and infrastructure-support services under the Better Access to Palliative Care in Tasmania program - grant applications are open to all private and non-government providers of palliative care services until 30 May.
An Advance Care Directive is a written document regarding someone's wishes for their future health care.
The release is found here:
There are reports found here:

PCEHRs to host advance care directives

9 May, 2013 Antonio Bradley 
Advance Care Directives are set to be added to patients’ e-health records, with the Federal Government finding $10 million to fund the change. 
In an announcement Thursday, Health Minister Tanya Plibersek said there would now be consultation with healthcare providers to ensure the new system would be “fit for use”. 
However, it remains unclear how the $10 million will be used to enable elderly patients’ personally controlled electronic health records to be updated with the directives. 
Studies over the last decade in Australia have found that only between 0.2% and 5% of patients in aged-care facilities have care plans. 
More here:
And here:

Gov invests $10m in another eHealth initiative

End of life plans will provide doctors and carers with information on how people wish to be cared for at the end of their life
The Federal Government will invest $10 million in an eHealth initiative which will enable people to provide information on the health care they wish to receive at the end of their life.
The Advance Care Directives will be stored on the controversial Personally Controlled Electronic Health Record (PCEHR) system.
The Federal Government will also provide a further $800,000 over two years for the Respecting Patient Choices care planning project.
Users’ end of life plans will be able to be viewed by nominated doctors, hospitals, family members or carers.
More here:
This is an area about which I have a more than nodding acquaintance having been an Intensive Care Specialist for a good few years before becoming involved in e-Health.
Point 1. is making sure all around you know and understand your end-of life wishes is a really fabulous and important idea.
Point 2. Is that having a written directive readily available - and most especially for people who are in Nursing Homes and other similar facilities is a great idea also.
Point 3. I for one would only act on such directives if I had confirmed the patient’s desires very recently from either the patient or next of kin. I would also make sure there was a note in the patient’s record noting the source of the directive and its contents.
Point 4. I am not sure anyone would or should act on a directive contained in a NEHRS without contemporaneous confirmation from the patient or next of kin.
For these reasons, and given the potential gravity of the actions that may follow, I am by no means convinced this is a good idea. However having a note in the NEHRS saying a Directive exists and where it can be found is, I believe, a useful thing to do, as was trialled at one of the Wave sites.

1 comment:

Anonymous said...

So. Exactly how is the $10 million to be spent? What is the business plan?