On Friday wehad an intervention in the PCEHR conversation by the Health Minister.
Pulling E-Health Together, Not Tearing it Apart
Articleby Minister for Health and Ageing Nicola Roxon and published on 6 Minutes.
16September 2011
Thisweek we took eHealth to the Federal Parliament, demonstrating to politicianshow records will make a real difference to patient care in the hospitals, GPsurgeries and pharmacies in their electorates.
Thesame demonstration will soon travel to different parts of the country, helpingclinicians, consumers and others in the health system understand how connectingthe patientjourney will make a real difference.
Whatwe were able to show to politicians is that this is not a technology system –it is a health system. It will improve care for patients, reduce medicationerrors and avoid unnecessary tests.
Thedisplay also demonstrates how eHealth is real, and no longer a vague plan forthe future. We now have over a million healthcare identifiers downloaded to beused, lead implementation sites underway, secure messaging being used andpatient consultations being undertaken through videoconferencing.
Andfrom next July, Australians will be able to register for an eHealth record.
Yesterdaywe released the finalisedplans for the service which will be built by our infrastructurepartners. These were released following long and detailed consultation withclinicians, health consumers and ICT industry professionals across the country.
Nowthat we’re getting on with the job, it is important that people who wanteHealth to be delivered get behind the program. I am buoyed by the enthusiasmthat there is for eHealth across the spectrum of professional groups and thecommunity.
Overthe past decade of inaction it was easy for everyone to agree – because sincenothing was being done, no decisions had to be made.
Butnow that the Gillard Government is actually getting on with the job – itcreates the environment in which differing interest groups want to get theirhands on the steering wheel. That’s obviously impossible.
Forinstance, we’ve seen the AMA saying we’re not listening to doctors. Thiscouldn’t be further from the truth. They should try telling that to the Collegeof GPs that has endorsed the plan, the leaders of the program include formerPresidents of the AMA and RACGP, and the over 50 clinical leadsthat are closely engaged in the program.
Thetruth is that while the AMA haven’t won every single discussion about how therecords will work, we agree on most of the design of the system. We’ll never beable to agree on every single detail because the Government has to take all theright advice and make decisions that are in the overall interest of thecommunity and patients, not one professional group.
Whatthe AMA needs to consider is whether they will be a partner to deliver eHealth,or whether they will act in opposition and miss this once in a generationopportunity.
Byworking for the collective good, everyone can help us deliver a solution tobenefit patients and clinicians. The alternative option is to try and tearapart consensus on this program and leave a legacy of mountains of paper inhospitals and GP surgeries – unconnected and stuck in a luddite time warp.
Itwould be a waste to miss this opportunity to transform our health system.
Forour part, we will continue to push ahead with this program in a way thatengages our hard working clinicians, but unapologetically also making sure thatthis is a system that has patients at its heart.
The pressrelease is found here:
Theoriginal publication in 6minutes.com.au is found here:
There wasa report of the intervention here:
Minister urges AMA not to reject PCEHR
- By Michael Woodhead on 16 September 2011
Healthminister Nicola Roxon has rejected AMA claims that the government has failed tolisten to doctors in the design and implementation of the PCEHR.
Inan opinion article in today’s 6minutes, the minister says compromise is essential ina project that involves so many different groups, and she urges the AMA to comeon board as a partner rather than “tear apart consensus” and leave medicalrecords in a Luddite time warp.
.....
TheRural Doctors Association of Australia also said it supported the PCEHR programbut was disappointed that no special rebate will be paid to doctors.
“Manyrural doctors are already working long hours and struggle to keep theirpractices economically viable. Given this, they may be reluctant to participatein the PCEHR system without appropriate incentives for the time they will haveto spend creating and updating the electronic records,” said RDAA president DrNola Maxfield.
Thisarticle is found here:
MissRoxon was presumably reacting to this release from the AMA.
Medical advice missing from e-health records plan
12 September 2011 - 4:14pm
AMAPresident, Dr Steve Hambleton, said today that the AMA was disappointed thatthe Government has failed to heed medical advice in finalising its Concept ofOperations for the personally controlled electronic health record (PCEHR).
DrHambleton said the proposals could ‘de-medicalise’ electronic patient healthinformation.
“Littlehas changed from the draft plan despite the sound advice provided by manymedical groups, including the AMA, about what should be included on a patient’shealth record.
“TheGovernment has caved in to minority consumer groups.
“Underthe proposed arrangements, people will be able to alter their health recordwithout consultation with their doctor.
“Patientscould entirely remove from their record clinical documents that they hadpreviously considered worth sharing with healthcare providers.
“Thisis a very dangerous precedent that could undermine all the potential benefitsof an electronic health record.”
DrHambleton said that the AMA would prefer the system to be opt-out, not opt-in.
“Theopt-in system has resulted in incredibly complex rules for patients to givetheir doctors access to their PCEHR,” Dr Hambleton said.
“Andthere are still concerns around medico-legal liability associated with theelectronic health record.
“TheAMA is a huge supporter of e-health and the benefits it can bring to the healthsystem, but we cannot support aspects of the system that do not improve on whatwe have now and which potentially create risks to patient health.
“Wewill have a system that doctors and other health practitioners are keen toembrace but won’t be able to because their patients haven't yet given themaccess to their records.
“Australiahas the opportunity to be a world leader in electronic health but it won’thappen with the very complex health record announced today,” Dr Hambleton said.
Therelease is here:
Wehave also had the Rural Doctors Association of Australia react.
Patient controlled e-health records: Better support needed to ensure ruraluptake
The Rural Doctors Association of Australia(RDAA) has warned that rural practices will need adequate support to ensure thesuccess of a Patient Controlled Electronic Health Records (PCEHR) system in thebush.
RDAA was responding to comments made this weekby the Federal Health Minister, Nicola Roxon, that at this stage no specialrebate will be paid to doctors to cover their time in creating health summariesfor PCEHRs.
RDAA wrote to the Minister earlier this month advising that,without such a rebate, many rural practices will find it difficult to meet thechallenges associated with implementing a PCEHR system.
“RDAA supports the PCEHR as a means of making important patientinformation available to doctors working in different locations and withdifferent systems” acting RDAA President, Dr Nola Maxfield, said.
“This is particularly relevant for rural patients who are mostlikely to be transferred away from their local community in the event of amedical emergency or serious illness.
“However, we have a number of concerns about the likely uptake ofthe PCEHR system in rural and remote areas.
“Many rural doctors are already working long hours and struggle tokeep their practices economically viable. Given this, they may be reluctant toparticipate in the PCEHR system without appropriate incentives for the timethey will have to spend creating and updating the electronic records.
Fullrelease is here:
Inthe presence of this response I find two sections from the Minister veryworrying:
First:
“For instance, we’ve seen the AMAsaying we’re not listening to doctors. This couldn’t be further from the truth.They should try telling that to the College of GPs that has endorsed the plan,the leaders of the program include former Presidents of the AMA and RACGP, andthe over50 clinical leadsthat are closely engaged in the program.
The truth is that while the AMAhaven’t won every single discussion about how the records will work, we agreeon most of the design of the system. We’ll never be able to agree on everysingle detail because the Government has to take all the right advice and makedecisions that are in the overall interest of the community and patients, notone professional group.”
TheMinister is assuming here she can undertake the implementation of the PCEHRwithout at least tacit support from the AMA and the RDAA. She clearly does nothave that support at present and she surely can’t imagine she is on a winnerwithout such support. What is happening here is she is trying to ‘verbal’ theAMA etc. to support a plan they know is flawed. That is a looser of an approachif I have ever seen one!
“What the AMA needs to consider iswhether they will be a partner to deliver eHealth, or whether they will act inopposition and miss this once in a generation opportunity.
By working for the collectivegood, everyone can help us deliver a solution to benefit patients andclinicians. The alternative option is to try and tear apart consensus on this programand leave a legacy of mountains of paper in hospitals and GP surgeries –unconnected and stuck in a luddite time warp.
It would be a waste to miss thisopportunity to transform our health system.
For our part, we will continue topush ahead with this program in a way that engages our hard working clinicians,but unapologetically also making sure that this is a system that has patientsat its heart.”
Whatthe Minister should be considering here is that the PCEHR she has been advisedto try and implement is by no means the best approach to this mythical‘e-health’ she is conceptualising at a remarkably simplistic level.
Iam perfectly sure both the AMA and the RDAA would be thrilled to work withGovernment in implementing a practical workable e-Health Strategy and but sadlythe present ConOps is just not it!
Thebottom line is that the RACGP thinks the PCEHR needs some work according totheir most recent release:
Seehere:
“DrBennett pointed out however, that some aspects of the plan still needed to beworked out.
“As highlighted inprevious College submissions, we would have preferred to have a default optionof the patient’s usual GP being the nominated healthcare provider. However, theCollege acknowledges that in some very remote areas without full-time generalpractice services, this role is best filled by a healthcare provider other thana GP.
The RACGP is also concernedthat the current plan doesn’t offer any incentives for GPs and urges theGovernment to consider how this additional effort will be acknowledged.
“We would like tosee amendments to the Medicare Benefits Schedule to recognise the additionalworkload GPs will undertake in consultations initiating and maintaining thepatient’s shared health summary and other elements of the PCEHR,” Dr Bennettsaid.”
Full release here:
-and the AMA and the RDAA are pretty convinced it is not a goer in its presentform.
SorryMinister you have a lemon here of the same sort as a number of other Laborplans.
Ihope your advisers are brave enough to tell you that without medical professionsupport this will be a huge unused white elephant!
David.
