Another Labor Party boondoggle coming up

A new health records system that will be incomplete and may not be accessible to your doctor!

ALMOST $500 million is being spent on an e-health record system that will not provide real-time medical information at the point of care. Instead, it will serve copies of some clinical documents uploaded from doctors' systems in a voluntary program that puts the control of access in patients' hands.

The long-awaited draft concept of operations for the personally controlled e-health record, to be released today by the Health Department, shows how clinical documents will be pulled together by a "viewing service" and displayed in a format for viewing by patients and health professionals.

Critically, the system will not support clinical decision-making and lacks sophisticated analytics capabilities.

The design gives people a great deal of control over access to records held in the Personally Controlled Electronic Health Record system and consumers will be able to add their own notes to a GP-managed health summary record.

Consumers will access the system via a portal. Doctors also will initially access patient records through a separate provider portal, although in time their systems will be integrated with the PCEHR repository.

A novel approach is the ability for individuals to set access parameters, including requiring providers to use an access code (a PIN or passphrase selected by the patient) to verify consent.

Other controls will be "include" and "exclude" lists for participating healthcare organisations and an ability to limit access to certain documents within in the record.

This ranges from the default "general access" to "no access", which restricts viewing to the original source provider of the information.

Documents loaded to the system will carry a date stamp, but it will be up to medical providers to ensure patient records are consistently updated.

Consumers will be able to identify unauthorised activity through an audit trail, and there is a process for errors to be referred to the originating provider for correction and replacement.

Where clinical documents are loaded into the wrong person's record, the system operator, initially Medicare, will work with those concerned to fix the problem.

But patients have no control over the source material held in doctors' records, and medical providers will still share patient data through existing channels.

As a secondary system that will not replace doctors' records and which may not provide a complete set of patient information, it is unclear whether GPs and others will want to rely on it. So far, it has been understood the system would pull data from wherever it is held to provide a real-time view and support interactive alerts or warnings at the point of care. But the concept of operations states: "An individual's PCEHR may not represent a complete set of health information."

In fact, the system will only contain copies of documents pushed up by treating doctors with the patient's explicit consent. It is unclear how the currency, quality and provenance of this material will be guaranteed.

But with the live and complete data still locked in doctors' clinical systems, the public health benefits of real-time interventions --avoiding adverse drug events, better management of chronic conditions and improved prevention -- will remain elusive.


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