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AMA at centre of PCEHR overhaul


The AMA has been given a central role in overhauling the troubled shared electronic health record scheme after President Dr Steve Hambleton was appointed by the Abbott Government to a three-member review panel.

Health Minister Peter Dutton has selected Dr Hambleton, along with UnitingCare Health Executive Director Richard Royle and Australia Post Chief Information Officer Andrew Walduck, to undertake a six-week assessment of the $1 billion Personally Controlled Electronic Health Record (PCEHR) system, which has so far failed to attract much interest from the medical profession or patients.

Mr Dutton said the Government embraced the opportunities for better health care offered by electronic health records, but the PCEHR as currently structured fell well short of fulfilling this potential.

“There are only a few hundred doctors that are actually uploading details into people’s files, and it has been a scandal,” Mr Dutton said on Sky television. “So, on those numbers, it runs out at about $200,000 a patient in terms of the investment the former Government made.”

“The Government fully supports the concept of electronic health records, but it must be fit for purpose and cost effective,” the Minister added.

Dr Hambleton said the focus of the review was to find ways to improve the PCEHR, not kill it off.

“The intent is to fix it, not to take it out,” he said. “The Minister’s belief is that this is something we should be salvaging.”

On the face of it, the review panel faces a huge task.

While more than one million people have registered for a shared health summary, only a few hundred have been uploaded by a handful of doctors, with most shunning the technology because in its current form they do not see it as useful or of benefit to either them or their patients.

Dr Hambleton admitted that “the goodwill for the original proposal has really evaporated…the profession is very unhappy because they cannot see the benefit”.

But he is confident that the PCEHR can be changed and improved in ways that will make it clinically relevant and easy to use for both practitioners and patients.

Dr Hambleton said many people were unaware that most of the essential building blocks for a useful e-health record system were already in place.

“I got off the plane with a top IT expert [last week] and told him is was on a review of the PCEHR and he said ‘What’s that?’ and then said it would require a system of unique health identifiers.

“The fact is, we already have that, as well as a classification system for diseases. A lot of the fundamental work has been done.”

Instead, the review has been set a number of tasks aimed at making the PCEHR a system that is useful for doctors and patients alike, and one that they both want to use.

Mr Dutton has asked it to:

·        identify gaps between the expectations of users and what has been delivered;

·        the extent of consultation with end users; the use of the PCEHR by health care professionals in clinical settings;

·        clinician and patient usability issues;

·        new functions that would improve its usefulness;

·        incentives to boost usage;

·        potential integration with comparable private sector products; and

·        the future role of the private sector in providing solutions, and the policies that might help encourage this.

Dr Hambleton said he would be guided in the review by the central question for doctors of “how does [the PCEHR] fit into my day. To work, it needs to fit in with the workflow seamlessly, and there must be tangible benefits, not all of which are necessarily financial”.

Review Chair Mr Royle told iTnews the PCEHR presented an invaluable opportunity to vastly improve the understanding and management of population health.

He said data collected through the electronic health record could be aggregated and used to analyse the frequency and spread of disease and examine disparities in health.

“What this would essentially be doing is taking the PCEHR to another level,” he told iTnews.

Dr Hambleton said the review’s tight deadline – it is due to report to the Minister in mid-December – precluded any public hearings.

Instead, the panel has begun to invite submissions from key stakeholders, as well as organisations and individuals who have participated in previous consultations on the scheme.

Dr Hambleton said the AMA would make a submission to the review.

Adrian Rollins