…as government policies go, it’s a no-brainer and for multiple reasons.
At last, hope on the horizon for a fully functional universal electronic health records system for Australia.
As part of the 2015 budget, Minister for Health Sussan Ley has announced the ‘redevelopment’ of “the significantly under performing Personally Controlled Electronic Health Record (PCEHR) system set up under the previous Labor Federal Government.”
It’s music to my ears. Not for any political reasons – it’s a policy direction begun under the Howard Government, then developed and implemented (albeit in a limited, handicapped way) under the Gillard Government. Now, with any luck, it will be finessed and hopefully enabled to really fly, by the current Abbott Government.
No, despite the inevitable opportunistic politicking of all governments over some hot-button issues – notably concerns from some quarters about privacy which have seriously thwarted the project in the past – electronic health records have the support of all sides of politics. And rightly so because, as government policies go, it’s a no-brainer and for multiple reasons.
The central reason is that it will be better for our health.
Better health outcomes
If our health and medical history is held centrally and updated over time, we will get better regular health care and better long-term outcomes. Theoretically, better, more informed decisions about our care will be made in full knowledge of our medical history – current and previous medications, chronic illnesses, allergies, blood tests, x-rays, previous history of illness, falls, fractures, hospitalisations and more.
We will be able to decide who has access to certain elements of the record where it is not necessary or critical. But in cases of emergency hospital admissions or ambulance attendances, for example, timely access to all our vital information can mean the difference between life and death.
The e-health record is a particular boon for older people who are more likely to be taking a number of medications and whose frailty may put them at greater risk of harm from emergency treatment.
Aged care is an important case in point. A perennial problem for people in aged care is the lack of communication between the aged care facility and hospital when residents are admitted. Crazy as it seems, people arriving at the hospital are frequently received and treated as a ‘blank canvas’, ignorant of the person’s previous history, current medications or even next of kin arrangements.
Relying on the person themselves, a semi-informed relative, or a casual weekend duty nurse from the care facility to provide the relevant information, it’s easy to see how mistakes can get made, with potentially disastrous consequences.
And that’s just at the negative end of the spectrum. On the flip side, greater sharing of a our medical history among health professionals can lead to much better coordinated, calibrated and personalised preventive care and support.
When our health care professionals have the full picture, they are more likely to be able to help us work toward health goals or at least monitor and prevent big negative events. When you combine e-health records with some of the newer self-monitoring health technologies, then chronic conditions like diabetes and heart disease can have a whole different set of outcomes.
Better health economics
The other big ticket reason why the government is pressing ahead with this initiative – and why it is a plank of the 2015 budget – is that an electronic health record system will also deliver big cost savings to the escalating health budget. Reduced duplication of tests and x-rays; fewer errors in prescribing and dispensing medications; fewer avoidable admissions to hospital; improved primary care and continuity of care; increased efficiencies for health services – all these things have cost savings.
According to the Minister, a fully-functioning national e-health system could save taxpayers $2.5 billion per year within a decade by reducing inefficiencies, with an additional $1.6 billion in annual savings also delivered to the states.
So, needless to say I’m a fan.
But what is even more exciting about the news is that the ‘redevelopment’ of the PCEHR involves changing it from an ‘opt-in system’ – where we all had to actively seek to set the thing up – to an ‘opt-out system’ where, all going well with the proposed trials, we will all get one automatically unless we actively seek not to.
There were reasons why the former government went with this approach the first time but it was nonetheless a shame. There is and always was a plethora of evidence to show that opt-in systems always struggle with adoption.
myHealth Record, coming soonish
There are other administrative and governance tweaks being introduced but this is the single most important one. Well, apart from giving it a new name. It turns out the ‘Personally Controlled Electronic Health Record’ never really caught on as a name. Not even the marginally catchier, ‘PCEHR’. Who would have thought?
The PCEHR Mark II will henceforth be known as myHealth Record. The new moniker was in fact the first of 38 recommendations made in the Report from the Review of the PCEHR (a review hastily established to investigate and report to the then newly minted Health Minister Peter Dutton in November 2013).
Both these key recommendations were actually delivered to the Government in the December 2013 report so they haven’t exactly rushed into it. And they’re not rushing into it now either.
According to Minister Ley, “The real problem with the sluggish uptake of the current e-health system is not the concept, but the previous Labor Government’s trademark rushing of the rollout without thinking it through properly.”
Accordingly there will be trials of the new MO to be completed “to ensure public confidence in the system” is maintained.
Still, we’re getting close now and I think we should all be really pleased.
