This appeared last week:
Is My Health Record becoming useful to GPs?
Five months after the opt-out period ended, has Australia’s digital health repository hit the threshold for usefulness?
Some GPs give an emphatic yes, while others say it is still a work in progress.
But that may depend on where GPs are based, with some states seeing far higher hospital uptake than others.
Following months of at times tense debate around privacy and security provisions for the digital health record, around 90% of Australians now have a My Health Record, a system built by the Australian Digital Health Agency (ADHA).
Around 90% of general practices and 83% of pharmacies have now signed up. More than 700 hospitals are connected, and the ADHA estimates around 20 million clinical documents are now online, including 3.3 million discharge summaries.
But progress has been piecemeal, with one expert telling newsGP Victoria’s decentralised hospital network is making sign-up slower than in other states where public hospitals are centralised.
Public hospitals in Victoria have lagged, with only 35% connected as of December last year.
South Australia has had a major shift within the last fortnight, with news that almost all of SA Health’s public hospitals and the publicly owned pathology provider SA Pathology are now connected and uploading results, giving GPs easier access to test results and discharge summaries.
Adelaide GP Dr Daniel Byrne welcomed the news, telling Pulse+IT he believed My Health Record would be a ‘game changer’ for the way he practises.
Dr Byrne told newsGP the expansion in South Australia means that My Health Record is now of genuine use to him.
‘Now that I can look up medications, pathology, radiology, and discharge summaries, it is useful,’ he said.
‘In the previous five years [before the shift to opt-out], there was nothing in there. It was a chicken-and-egg thing – you won’t use it because there’s nothing there, and nothing is there because people weren’t using it.’Dr Byrne recently had a patient return from emergency, with all tests ‘laid out perfectly’ in their record.
‘It was too good to believe, but it was true,’ he said. ‘That was only two weeks ago, and I’ve used it multiple times since, looking up MRI results and helping patients with complex diseases.
‘I’ve had patients say, the hospitals never told me this [about their illness]. GPs are expert at decoding test results into patient-friendly language.’
Dr Byrne said it is useful for GPs to know that patients would be able to see their own test results seven days after being entered into My Health Record, with the gap to allow doctors to contact their patients in the meantime.
Dr Byrne believes the private sector now needs to get on board.
‘They’ll have to,’ he said.
‘I’ll move my pathology testing to SA Pathology more and more, because I know that if one of my patients ends up in a hospital in Queensland, doctors there will be able to access their pathology results. We have so many retirees who go to Queensland for winter.
‘I’ve had patients come to see me and I try to look up their test results. But the computer says they opted out, so I say I can’t look them up. My patients say, “I didn’t know that. No one told me”.
‘People opted out [of My Health Record] from fear and not realising there are benefits.’
Sydney GP Dr Deepa Garg credits My Health Record with saving one of her patients from an unnecessary hospitalisation.
The patient attended hospital for testing before knee-replacement surgery, and Dr Garg received and entered the ECG result into a Shared Health Summary and uploaded it to the patient’s My Health Record.
Later that evening, the patient had a difficult family event and felt sudden chest pain. An ambulance took her to hospital, where a doctor checked her My Health Record and saw the ECG results. After checking her medications, ensuring there was no pulmonary embolism and observing the patient, she was discharged from hospital.
Dr Garg said that before the widespread rollout of the electronic record, her patient would have been kept overnight and had many tests done.
‘All of it fell into place and she didn’t have to stay in hospital. So much time and money was saved,’ Dr Garg told newsGP.
‘I’m sold on it. I’ve been uploading for a long time already, but this was a beautiful example. It showed how good it can be.’
The patient’s discharge summary arrived the next morning, allowing Dr Garg to follow up – without needing to make a single call or chase information.
‘Fax and phone are inaccurate, and there’s privacy issues too. You don’t know who’s calling, so you have to send a consent form if they’re not an authorised person. It’s such a waste of my time,’ she said.
‘There’s such a scope for benefit [with My Health Record]. There will always be someone to say the sky is going to fall. Now we can show it didn’t.’
Dr Garg has called for more specialists to sign up to further reduce her dependence on snail mail.
‘Post is so inefficient. I’ve got two people at the front desk scanning letters and putting them in our system,’ she said.
‘It’s double- or triple-handling of information. There’s so much scope for efficiency.’
But Queensland GP and former RACGP Vice President Dr Edwin Kruys, who was on the My Health Record expansion program steering group, said he is still waiting for enough data to make the system personally useful.
‘It appears more data is uploaded to the record than ever before, which is good news,’ he said.
‘If you ask me personally, have I found it to be useful, I’d have to say not yet.
‘I guess this is partly because several healthcare organisations in my part of the world are not yet able to upload, or do so only sporadically, and possibly also because Queensland Health gives GPs access to “the viewer”, which is the electronic health provider portal where we can already look up public hospital patient information, such as pathology and imaging results.’
More here:
What are others seeing from / at the coal-face?
David.
13 comments:
Surely David, you and your readers would all have to agree that this is really good news all round.
"Dr Byrne recently had a patient return from emergency, with all tests ‘laid out perfectly’ in their record. ‘It was too good to believe, but it was true,’ he said."
.... all the tests laid out perfectly.
Now who would you complain about that?
Looks to me as though people are using myhr in ways that they have been told by the government not to.
The phrase "It is important to remember that the My Health Record system is not intended to be a communication tool" used to be on the www.myhealthrecord.gov.au website but for some unfathomable reason has disappeared. Neither is it found on https://www.digitalhealth.gov.au/
Must be an oversight.
However that doesn't mean it has totally disappeared from the internet.
Here is an example:
https://www.ipn.com.au/gp/wa-lansdale-kingsway-medical-centre/news-events/article/what-is-my-health-record/
It used to be in one of the www.myhealthrecord.gov.au FAQs. Here's an extract
https://privacy.org.au/Campaigns/MyHR/info.html#already_existing_record
Here's what the government used to say:
“My Health Record will not replace existing medical records. It is an additional tool that brings together a summary of an individual’s significant health information that is important to their ongoing care.
Healthcare providers will continue to take and review clinical notes. It is important to remember that the My Health Record system is not intended to be a communication tool – it will not replace the need to communicate important health information directly to individuals or other healthcare providers treating them.”
Surely David, you and your readers would all have to agree that this is really good news all round.
I will wait a bit longer if you don’t mind, one or two random accounts does not make a success. It is good to see and the reliance and complacency with MHR data will be linked to mis-adventures. After all one stray fax gets the mob excited so a new digital version will be a trump sized one
@11:40 AM "Looks to me as though people are using myhr in ways that they have been told by the government not to."
You don't seem too happy about that! Wouldn't you agree that perhaps a little more flexibility in attitude could be in order? How about acknowledging that distant horizons become clearer with use and as functionality improves a greater understanding of what is possible begins to emerge.
I'd be happy to be flexible in attitude if the ADHA could explain how a system not intended to be a communication tool changes such that it now can be used as a communication tool.
Especially when the architecture/design hasn't changed. The high level system architecture is still available on the www.digitalhealth.gov.au site and the document states that it will be updated, but hasn't.
"(The architecture) will be updated to reflect the PCEHR design developed by the National Infrastructure Partner."
The architecture document itself says "The PCEHR System is not a replacement for existing clinical communications — existing provider-to-provider communications, such as Referrals, Discharge Summaries, pathology Requests and Result Reports, Prescriptions etc., will continue to flow using existing communication channels. The PCEHR System provides a new complementary communication channel."
I can only go on what the government says and it says it's not intended to be used as a communication tool.
I'll change my views when the evidence changes. What do you do?
"How about acknowledging that distant horizons become clearer with use and as functionality improves a greater understanding of what is possible begins to emerge". Sounds like a load of 'consultant speak' to me - distant horizons and emerging possibilities?
Let's get to the point here and be realistic and practical.
Taking Dr Kruy's point, it must be confusing for GPs if they go to one system - the Qld Viewer to see a complete set of the patient's information, but only from the public system, and then they can also go to the My Health Record, which might also have some of the non-public information - but perhaps not all of it, and no way of telling if it is complete or current. Or the patient may have masked something.
The poor GP must then compare both sets of information from the two systems - - how? by printing it out or writing it down on a scrap of paper? Is any GP software sophisticated enough to compare and compile the two sets of information?
Perhaps we can simply point them to the distant horizons and fuzzy possibilities?
Its amazing how a system that was supposed to reduce data fragmentation is actually increasing it.
As Ronald Reagan once said
The most terrifying words in the English language are: I'm from the government and I'm here to help
And he was just a B grade actor.
“How about acknowledging that distant horizons become clearer.....” oh dear oh Josh sounds like a little buzzword cratification slipped out there sunshine.
My Health Record is based on the concept of standing consent,” Australian Digital health Agency chief Tim Kelsey explained to a Senate Estimates Committee.
This means their doctor can access the record and even trigger its activation without the patient’s knowledge or consent. Doctors are not required to get their patients consent to upload a shared health summary onto the My Health Record that can reveal if a person had an abortion, a sexually transmitted disease, is impotent or has a mental illness.
Once the record is activated two years’ worth of Medicare and prescription data is downloaded onto the record and this can also reveal sensitive or embarrassing health conditions.
Once that information is uploaded it can be accessed by hundreds of thousands of health practitioners including podiatrists, optometrist and physiotherapists unless the patient sets up a PIN number or other privacy controls to protect it.
https://www.dailytelegraph.com.au/news/national/why-patients-cant-use-their-my-health-record/news-story/359a80445ea1fb49998e87bf018a0685
@July 10, 2019 8:14 PM. That is gobsmacking. This Tim Kelsey tosser is getting bold. Bold enough if not stopped to do a lot of damage to a fragile government
@8:24 PM hey, Tim Kelsey is only doing what he has been told (asked) to do. If he understood what he was being asked to do he wouldn't have done it unless his actions are overridden by a psychopathic personality trait. It seem to me the government / department are the root cause of the My Health Record mess and they hide behind a veil of confusion, politics, legalities, committees and lies.
July 10, 9:23 PM. While I agree the bureaucracy/department ultimately have encouraged this affront to not only healthcare professionals everywhere but the country as a whole. I cannot agree that your little Timmy is some how an unwitting pawn in all this. His tactics and verbal assault is a replication of his UK rise and fall.
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