It Seems That The Evidence That The PCEHR Is A Dud Is Building. The Waste Continues.

This article appeared last week:

E-health records have few fans, study confirms

David Rowley

1 February 2016

MORE patients than clinicians use My Health Record, and most users – both doctors and patients – are generally negative about the system.

But much of the negativity may be because users don’t understand the system, a new factor analysis of studies shows.

By March 2015, about 9% of all Australians were registered with the My Health Record (MyHR) system, previously known as the PCEHR, with some 5000 GP practices (almost 75% of those eligible) and 11,000 clinicians on board, and 44,000 shared health summaries available.

But the analysis notes that most people viewing the information on the system are consumers, with around 20,000 patient viewings per month.

According to the study, published in the Internal Medicine Journal, the potential reasons for GPs not accessing the system are:

• Doctors believing they know most of what they need to about their patients.
• The “clunky” MyHR summary display.
• The fear of missing important information, placing doctors at risk of litigation.
• The lack of evidence showing the system helps deliver better patient outcomes.

“These findings suggest that Australian consumer and healthcare providers are generally negative towards the PCEHR [now MyHR],” it says. 

“Participants’ uncertainty appears to stem from not knowing the mechanics of the PCEHR”. 

The analysis found that although most Australians appeared ambivalent or negative about the value of the system, a large minority of 42% seemed positive.

More here:

Here is the abstract.

Positive beliefs and privacy concerns shape the future for the Personally Controlled Electronic Health Record

1. E. C. Lehnbom^1,*,
2. H. E. Douglas² and
3. M. A. B. Makeham²

Article first published online: 27 JAN 2016

DOI: 10.1111/imj.12956

Abstract

The uptake of the Personally Controlled Electronic Health Record (PCEHR) has been slowly building momentum in Australia. The purpose of the PCEHR is to collect clinically important information from multiple healthcare providers to provide a secure electronic record to patients and their authorised healthcare providers that will ultimately enhance the efficiency and effectiveness of healthcare delivery. Reasons for the slow uptake of the PCEHR and future directions to improve its usefulness is discussed later.

Paid access to the rather short article is found here:

http://onlinelibrary.wiley.com/doi/10.1111/imj.12956/abstract

(Note: The article was submitted in April 2015 and is actually a re-analysis of a study which was actually published in 2014.

“A more recent study sought to survey the Australian general public’s perceptions of having a PCEHR and found that the perceived value and risk associated with the PCEHR were the two most important variables explaining attitudes.7 This survey used questionnaires borrowed from consumer acceptance of interactive communication technology studies, which were not specifically developed for the PCEHR; therefore, its use in examining the attitudes towards the PCEHR is limited. To establish what constituted the key attitudes towards PCEHR in Australia, we performed a factor analysis on previously published data.9”

Here are the 2 references cited

7. Andrews L, Gajanayake R, Sahama T. The Australian general public’s perceptions of having a personally controlled electronic health record (PCEHR). Int J Med Inform 2014; 83: 889–900.

9. Lehnbom EC, Brien JE, McLachlan AJ. Knowledge and attitudes regarding the personally controlled electronic health record: an Australian national survey. In- tern Med J 2014; 44: 406–9.)

This said, it is hard to argue with the concluding recommendations:

“Future efforts to improve to uptake and usability of the PCEHR should focus on alternative structures to present in- formation to enable healthcare providers to find quickly the information they are looking for; evaluate the impact of PCEHR on healthcare delivery and patient outcomes to provide evidence that having a PCEHR makes a difference and track the awareness and knowledge of consumers and healthcare providers of the PCEHR’s potential  benefits.”

I have a sense hell may freeze over before we see these recommendations actually implemented - time will tell I guess.

I do wonder just why these publication are not available without paid subscriptions. DoH should be making them available!

David.