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Hambleton appointed to pivotal e-health role

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Immediate-past AMA President Dr Steve Hambleton has been appointed to a pivotal role in the development of the nation’s e-health system as Health Minister Peter Dutton considers a major overhaul of the troubled $1 billion electronic health record scheme inherited from the previous Government.

The National E-Health Transition Authority has announced the appointment of Dr Hambleton as Chair of the organisation, replacing David Gonski, who occupied the position for six years.

In a statement announcing the appointment, NEHTA said Dr Hambleton brought to the role “clinical expertise and leadership… [which] will be vital in ensuring that e-health becomes widely adopted in clinical settings across Australia”. 

The former AMA President has a long-standing interest in e-health, and was a member of the three-person panel appointed by Mr Dutton to review the Labor Government’s Personally Controlled Electronic Health Record (PCEHR) system.

The PCEHR has been the subject of sharp criticism from the medical profession, which argued that the ability of patients to alter their health record fundamentally compromised its clinical usefulness, because doctors could rely on it to contain all medically relevant information.

Adoption of the scheme has been underwhelming. Since it was launched in mid-2012, little more than one million people have registered an interest in having a PCEHR record, and only a handful of medical practices have created records for their patients.

But Dr Hambleton told Australian Medicine that, despite the flaws in the PCEHR, the basic building blocks for an e-health system had already been put in place by NEHTA, and it was a matter of improving on what was already there rather than scrapping everything and starting again.

He said NEHTA had overseen the creation of individual health identifiers, standard terminology and coding for prescriptions and descriptions of diseases, and protocols for secure messaging.

Dr Hambleton said what was need was to get e-health record system built on these foundations right, and the Government was committed to getting a fully- functioning e-health system established.

“The future is uncertain for this particular entity [the PCEHR] but it is not for e-health,” the former AMA President said. “The Minister is fully supportive of e-health.”

The appointment of Dr Hambleton is seen as significant in light of criticism of NEHTA and the PCEHR that both suffered from lack of engagement with clinicians, a view underlined by the mass walk-out of clinical advisers from NEHTA in August last year, led by clinical lead Chair and former AMA President Dr Mukesh Haikerwal.

The walk-out rocked the organisation and reflected deep frustration with the limited voice clinicians and other key stakeholders were given in the development of the PCEHR.

Dr Hambleton said engagement with clinicians was “critical”.

“We need to make sure we engage with all clinicians – GPs, public hospitals, private hospitals, surgeons, emergency physicians, pathologists, radiologists and so on to make sure the system is as streamlined and simple as possible to use,” he said.

He said Australia’s health system was “way behind” other countries in terms of electronic communication with patients and between clinicians.

“We need to make sure we deliver,” Dr Hambleton said.   

The PCEHR review, the findings of which were released by the Government in May, has called for a major overhaul of the system, including a change in the name to My Health Record and making it an opt-out system.

Significantly, in light of Dr Hambleton’s appointment, the review also recommended that NEHTA be dissolved and replaced by an Australian Commission for Electronic Health, which would be advised by committees that included clinicians.

Changing the system to an opt-out arrangement is seen as a critical change that would make electronic health records more clinically useful, because knowing every patient had a record would encourage doctors to use the system.

The Federal Government has committed $140 million to continue the roll-out of the PCEHR while it considers the findings of the review, though it appears likely there will be a fundamental overhaul.

Mr Dutton said last month that the Government “fully supports the concept of a national e-health record system, but it needs to be effective, functional and easy for all Australians to use, while being clinically relevant to our doctors, nurses and other frontline health care providers”.

Adrian Rollins

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