This also on the topic of the week:
22 November 2023
Real-time diagnostics may prompt patient panic: RACGP
Diagnosis pathology Political RACGP
The college is worried that providing real-time results to patients on My Health Record will prompt a barrage of concerned calls to GPs and lead to misinterpretation.
While the RACGP supports pushing providers to upload pathology and diagnostic test results to My Health Record by default, it has stressed the importance of a seven-day delay to ensure patients aren’t going it alone.
In September, the Department of Health and Aged Care launched consultation on its plans to modernise My Health Record following recommendations made by the Strengthening Medicare Taskforce Report.
The federal government has since promised two years of funding dedicated to modernising My Health Record, including requiring providers to upload diagnostic imaging and pathology results to the platform.
“If a patient gets a diagnostic scan or pathology test, then those results should be uploaded. At the moment, this happens by exception. It is not the rule. I intend to make it the rule,” said Health Minister Mark Butler in May.
In its response to the consultation, the RACGP supported the proposal that would require providers to share pathology and diagnostic imaging by default.
But the college stressed that this shouldn’t replace communication between providers or a patient’s relationship their general practitioner.
As such, the college recommended that the seven-day delay rule – which dictates that pathology and diagnostic imaging results should only be available to patients after a week-long buffer period – should remain in place.
“Maintaining the seven-day rule allows consumers to have access to their health information, albeit with a small delay that allows their GP or other clinician to discuss their results with them,” said the college.
“We do not consider the benefit of real time access to results outweighs the potential harm of consumers misinterpreting results or receiving fortunate results with no immediate clinical support.”
According to a survey conducted by the AMA, 65% of patients agreed that they would want to speak to a clinician before receiving life changing results, noted the submission.
“While most patients will usually receive normal results, many will not, and receiving possibly life changing news via My Health Record with no support or context from the clinician who ordered the test is not appropriate,” read the submission.
The college raised concerns that real time access for consumers may cause distress and prompt patients to contact their GP to inquire about their results.
“Before viewing results, patients should see a message reminding them that their results need to be interpreted by a clinician and to not take action until they have spoken with clinician who requested the tests,” the college said.
“It should be emphasised that the clinician will be in contact with them, which is current standard practice for the follow up of test results.”
Results that are already available in real time such as influenza and HbA1c should be an exception to the seven-day rule, added the college.
If their advice isn’t heeded, the RACGP has called for a post-implementation evaluation into whether the change affected patient health outcomes.
The college added that a “thorough and wide-ranging communication campaign” was vital to ensure consumers are aware of the availability of their results on My Health Record and the burden is not on GPs to explain.
“GPs should not be expected to explain the changes to patients during consultations, so consumer resources available through practices (such as posters or flyers) that GPs can refer their patients to would be helpful,” the submission said.
The RACGP also noted that it was important for healthcare providers to be in the know well in advance of the rollout of any changes.
Beyond changes to availability of documents, the group said the “clunky, hard to navigate and slow” interface could do with a facelift.
The system will need to be responsive, efficient, consistent in terminology and have data input in a way that is easy to integrate into general practice clinical systems and allows large volumes of data to be sifted through with ease, added the college.
The consultation is now closed to submissions.
More here:
https://www.medicalrepublic.com.au/real-time-diagnostics-may-prompt-patient-panic-racgp/102960
It will be interesting to see what is finally
done in this area! I think the College warning is a bit over the top!
David.
3 comments:
In a way, David, the RACGP is reaping what it sowed. Colleges, peak bodies and so-called advocacy groups have all let this happen. Their need to be relevant, funded, and the wish-washy positions have allowed TheirHR to become the burden it is. The latest response is too weak, too little and too late.
The pivotal problem with the My Health Record now, and into the future, is the same as it has always been. The design of the system across the User Interface (UI).
The UI has always been a hotch-potch yet no-one in ADHA, the Department, and the technology consultants involved, have been prepared to acknowledge and accept this most basic fundamental fact.
Now, in response to the political embarrassment flowing from the non-use of this failed, clunky, simplistic system, a completely new redevelopment of the MHR is about to commence!
The same mindsets will be involved as before. The same approach to system design will be embraced. A new clunker will be developed and another failed and hugely costly system will emerge once again.
A different approach is required.
It is not difficult to think differently provided you know how. I despair at watching the bureaucratic and technological stupidity that continues to prevail.
Ian is spot on. The bureaucrats and their technology developers were driven by their hunger for more data. So they started their development by working with a database mentality; collect everything we can think of. We'll worry about what the 'users' want and need later. That is a classic cart before the horse approach ensuring architectural design problems are deeply embedded within the basic system foundations from the outset. It's a technology driven approach to problem solving without understanding or paying any attention to the real problems that need to be solved to meet the users' needs. It's all too late to think about the UI after that.
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