Tuesday, February 18, 2014
Now A Few Have Tried To Use It, We Are Discovering What A Mess The PCEHR Is! Old Saying Confirmed
There is an old saying that the proof of the pudding is in the eating. To support that view we have this that popped up today.
18th Feb 2014
THE personally controlled electronic health record (PCEHR) is garbling patient information GPs upload, creating confusing and potentially misleading records, an e-health expert has warned.
The latest criticism of the billion-dollar scheme from former National Electronic Health Transition Authority (NEHTA) chief clinical lead, Dr Mukesh Haikerwal, comes as the health sector awaits the release of the review ordered by Health Minister Peter Dutton late last year.
A de-identified patient record entered into the PCEHR by Dr Haikerwal, and supplied to MO, shows that the reverse chronological order of visits was jumbled up and appeared in the e-health record in random order.
For the PCEHR to be usable, particularly for complex patients with multiple comorbidities, the most recent information must be displayed first with the patient’s history listed chronologically in reverse order, Dr Haikerwal said.
“The way it is rendered into the PCEHR is like a blender. You can see in the PCEHR view it becomes a mishmash both in terms of content — alphabetical or not — and date,” he said.
“Although it is there and may be better than nothing, it is only just better than nothing.”
Information labelled ‘past’ and ‘current’ in the original patient history also became mixed up in the PCEHR.
“Depending which CIS platform you use, it is likely to render differently, but each appears to have its own quirks,” said Dr Haikerwal.
Lots more here:
Although Dr Haikerwal goes on later to say “Flawed though it is, there is much that can be rescued from the PCEHR. But this is a pretty stark depiction of what the flaw is in the most central document in the whole system,” it is clear he has major concerns and great frustration with the way all this has and is being delivered.
What we are hearing, from a key sponsor of the idea of the PCEHR, is a clear recognition that the PCEHR has been a disastrous mess and the more it is used the more confusing (and clearly dangerous) the whole system has become.
It seems to me we are at real risk of doing some real harm to real patients sometime very soon with this system.
The clear implication is that the PCEHR - as it presently exists - should now be taken down and, if it is to continue, a total rethink is undertaken of how information is managed and displayed before it is allowed to be accessed again. To just muddle on is just absurd on the basis of what Dr Haikerwal is saying. That information of this quality is fed from vendor systems to the PCEHR and then available for display shows how poor the overall conception and implementation of both practice systems and the central hub are.
Of course a total rethink of who manages, plans, governs and leads this program - which surely can’t now be seen as the initial PCEHR - is also critically needed.
Additionally some clarity as to just what the 'new' PCEHR is for, who it is for and what it is intended to do might be a help in the re-design!
Posted by Dr David G More MB PhD at Tuesday, February 18, 2014