Tuesday, November 19, 2013
It Is Interesting To See An Editorial In The SMH Pointing Out E-Health Failure On Mr Abbott’s Part.
This editorial appeared last week in the Sydney Morning Herald.
Date November 11, 2013
How could 22 doctors overlook the signs that one man was suffering from a serious drug addiction? Nathan Attard, 34, died alone, in an apartment infested with stray animals and filled with rubbish and drug paraphernalia, a Sydney coroner's court has heard. Doctors had prescribed him an array of medication including Xanax, morphine, Seroquel and Valium.
After the conclusion of the inquest into Attard's death, Deputy State Coroner Carmel Forbes is expected to recommend a statewide computerised system that would allow doctors and pharmacists to share information and detect patients who are prescription shopping. Such a system is overdue. For years health authorities have been calling for an electronic prescription monitoring system, without result.
''Failure to establish an electronic patient record within five years would be an indictment against everyone in the system, including the government," Prime Minister Tony Abbott said in 2003 during his first formal speech as he took over the health portfolio under John Howard's leadership. He failed that time, let's hope his government does not fail again. The former Labor government began introducing an e-health system but like many of its commitments the roll-out was plagued with difficulties. Just before the election several experts charged with rolling out the billion-dollar project quit the program amid claims the Department of Health and Ageing was more concerned with signing people up to the systems than providing a record that could be usefully managed by doctors.
More than 650,000 people have applied for e-health records but GPs have created only about 4000 shared-health summaries for their patients, which list their diagnoses and medications, because there is no clear financial incentive for GPs to spend the time to input all the information into the patient records. The Australian Medical Association has called for the government to overhaul the scheme. AMA president Steve Hambleton fears concerns over privacy have trumped common sense. Under the system being developed, patients will be able to go in and delete records after a doctor has entered them. This means doctor shoppers, especially those who accumulate prescription drugs, could remove records showing their behaviour.
To allay privacy concerns, patients could have control over who had access to their records. These records should be viewable by patients, but not changeable (to prevent, for example, doctor shoppers deleting multiple prescriptions from different doctors). Privacy concerns are valid, and people should be able to opt-out from e-records, but for the rest of the community privacy concerns should not trump the implementation of an efficient, useful national electronic system.
The full editorial is here:
This is a very interesting editorial marred by an sad error in fact regarding the ability of the patient to alter the medically entered Shared Health Summary - they can’t.
The editorial makes the very powerful and rather sad point that both sides of politics have really failed to deliver a useable national health record system, while sadly failing to point out that the idea of value of a national e-health record is not something that is by any means certain.
While the editorial seems to be of the view that there is intrinsic goodness and value in a national record system I would suggest there may be less risky and cheaper ways to address the issues that the National EHR is intended to target. A boost to the clinical use of IT in all aspects and then some regional health information sharing mechanism could be a better approach.
The need for leadership, governance and a well-considered overall strategy seems often not too be mentioned as well. As well, being really clear as to the business case for action is also vital.
All in all a ‘curate’s egg’ of an editorial but it is good to see some discussion of e-health in the mainstream media. Coverage has been pretty thin in the last year or two!
Posted by Dr David More MB PhD FACHI at Tuesday, November 19, 2013