This appeared a few days ago.
450,000 patient records uploaded to Your Health Summary
Sunday, 27 June 2021
NEWS - eHealthNews.nz editor Rebecca McBeth
Primary care
health records of close to half a million patients across Auckland have been
uploaded to the shared care record system, Your Health Summary (YHS).
The solution is designed to ensure better continuity of care and safety for
patients by ensuring their important health information is accessible by
authorised healthcare providers that deliver care in a range of care settings,
says YHS clinical director Daniel Calder.
The summary includes information about medications, allergies, results and
long-term health conditions and is supported by the Northern Region Health
Co-ordination Centre and Metro Auckland PHOs.
Nearly 150 practices have signed up since it went live in April 2020, with
450,000 patient records from across Auckland uploaded to Your Health Summary, and 315 clinicians have submitted signed access
applications.
Currently, authorised healthcare providers in participating GP clinics, urgent
care clinics and Covid-19 vaccination centres can apply for access, so existing
users are GPs and nurses working in these settings.
“The next step is to enable access to hospital colleagues and a particular
priority would be Emergency Departments as this is another setting where many
patients require urgent medical attention and clearly could benefit from access
to this system,” Calder explains.
For the shared record system to be effective, it needs a good level of coverage
within the region and he encouraged those clinics that have not joined, to
urgently prioritise it.
“It is a critical part of supporting patient and whānau care during the current
Covid pandemic, when patients who are confirmed or suspected to have Covid-19
may require urgent healthcare services outside of their regular practice,” he
says.
“YHS is also of significant benefit to the most vulnerable in our population
who do not always receive care for health conditions from the same provider.”
More here:
https://www.hinz.org.nz/news/571328/450000-patient-records-uploaded-to-Your-Health-Summary-.htm
This report piqued my interest so I followed up to the website:
https://www.yourhealthsummary.org.nz/
Here is the ‘About Us’
Your Health Summary is a secure database that holds a summary of your primary care health record.
The purpose of Your Health Summary is to make sure that you can be provided with the very best care if you need to see a doctor outside of your usual general practice.
Information about your medication, allergies or any conditions that may affect your care when you cannot see your regular GP are included which means that if you can’t see a doctor in your regular GP clinic, or need urgent care, that tests are not repeated that are not necessary.
To see what is included in your personal health summary, you will need to check your general practice patient portal. Not all practices have a patient portal though, so you may need to call your general practice to find out how you can access your health summary.
You can choose to ‘opt off’ from having the summary of your health information shared. This could though, mean delays in your treatment as any new GP you see may have to conduct tests you have already had, and need to spend more time to find out important medical history during the consultation.
To opt off, email your contact details to contact@yourhealthsummary.org.nz and one of the team will be in touch to advise next steps.
Your Health Summary is an initiative between the Northern Region Health Co-ordination Centre (NRHCC) and all Metro-Auckland Primary Health Organisations (PHOs).
Here is the link:
https://www.yourhealthsummary.org.nz/about-1
Very worthwhile is the video introduction on this page:
https://www.yourhealthsummary.org.nz/resources
The key differences from the #myHealtthRecord as I can see are:
1. It is a regional system – Just for Auckland in this case – not national.
2. It is a health summary that is essentially live with what is in the patients Practice Management from their home practice and does not include patient notes or any admin data and is specifically not to be used for clinician and population health assessment.
3. It is clinician led and only clinicians use it – after rigorous sign-up procedures. It is intended for use with a patient that is in front of you in the surgery and is not a local in your patient management system.
4. Systems are in place to ensure data currency and relative completeness with no effort on the home clinician’s part.
5. It is not run by Government and it is voluntary on the part of clinicians who seem to like it.
6. There is a clear emphasis on patient consent and patient data protection at each encounter.
Given it has been replicated all over NZ it seems to be pretty successful!
The system seems to be commercially provided and a subset of the Indici PMS.
See here:
https://www.indici.co.nz/index.html
This looks to me to be pretty close to the #myHealthRecord done right to me.
Who will tell the ADHA?
David.
4 comments:
A fax machine glued to a filing cabinet would make a better alternative to the My Health Record. Agree the Kiwis have delivered what seems to be a useful service and one loosely coupled enough to evolve overtime.
While the YHR looks good at face value and indeed, done properly, should be a very good thing, there are a number of aspects of it that need careful scrutiny.
It is still only being used by half of Auckland's practices, thus covering only half of the population. Privacy issues seem to be stopping further growth.
There is no consultation with individual patients. Practices are signed up (en masse) and then all of their consultation data is automatically extracted - patients have no idea this is happening.
The initiative is run by Procare - a primary healthcare organisation (PHO) that is about to undergo serious scrutiny during the major healthcare reforms which have already signalled major changes for PHOs- compulsory membership no longer!
At one point Procare claimed patients had all signed consent forms. Procare publicly retracted this four hours later and have not commented since.
A number of practices (30-40%) and at least one GP system vendor have completely refused to participate because of the serious privacy issues - mostly arising from lack of informed consent. Procare has reportedly responded by stemming their funding - reportedly to the tune of $60k per practice. This is very difficult for all concerned in a cash starved health system.
And so the battle for control of patient records rages. This is one of a number of competing initiatives- which is all well and good, but let's get the privacy settings absolutely right before going any further.
It is a pity to see otherwise good initiatives founder in the rush to cut corners.
Kind regards from the Shaky Isles,
Tom Bowden
Hi Tom
Thank you for taking an interest in Your Health Summary (YHS) and recognising the great potential that this patient safety initiative holds for people in our region. YHS is a regional collaboration between the District Health Boards (DHBs) and the Primary Health Organisations (PHOs). Consumers have given clear feedback that they would like a more joined up healthcare system and YHS is one of the key enablers to achieve this. Over 130 GP clinics are participating to date and this is increasing with pace. Similar systems have been operational elsewhere in NZ for some time, so Auckland is in many ways following in their footsteps. The Office of the Privacy Commissioner is well-aware of Your Health Summary and has no objections.
The vast majority of consumers are very positive about this initiative. As an example, the clinic that I work in has over 12,500 registered patients and we emailed all of them before participating in Your Health Summary. Not a single patient wanted to be opted out. Instead, quite a few patients were surprised that we were not already sharing this type of information with other healthcare providers. Your Health Summary is sharing a core set of data and information, rather than the full clinical record. Clinicians authorised to use Your Health Summary must ask for consent at the time of accessing a patient record and all access is subject to audit. There is no cost for clinics to participate in YHS as this is funded by the DHBs. Although participation in Your Health Summary is strongly recommended, no clinic has been financially penalised for not participating in this safety initiative.
Your Health Summary is a significant step towards creating a more unified healthcare system and ensuring that the relevant information is available to the right person, at the right time.
Kind regards
Daniel Calder
Clinical Director for Your Health Summary
Daniel,
Thanks for the description of YHS.
I've always been more interested in the information in proposed and actual health record systems and a couple of phrases in your comment caught my eye.
The first is: "Your Health Summary is sharing a core set of data and information"
What is this set of core data? and who produces it?
The second is "ensuring that the relevant information is available to the right person, at the right time."
What do you mean by "the right person"?
Does each "person" get a different view of the core data depending on the needs of that person when delivering healthcare services? Or do all people accessing the information see the same set of information and need to extract whatever subset they need in order to deliver their specific healthcare services to a patient whose needs change over time?
IMHO, the biggest problem with My Health Record is information curation, or more precisely the burden of curation. So I was wondering how you guys have addressed the problem.
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