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PCEHR falls short of start-up target

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Registrations for e-health records have fallen well short of Government expectations as the system struggles to attract the interest of doctors and their patients.

Figures released by the Department of Health and Ageing show that in its first 12 months barely 407,000 people signed on for a personally controlled electronic health record (PCEHR) – 100,000 less than planned when the system was launched in July 2012.

AMA President Dr Steve Hambleton said that although there was significant potential for electronic records to enhance care, the PCEHR was being hampered by problems with its design and implementation.

Dr Hambleton said the AMA supported the concept of an electronic health record as a way to reliably provide key clinical information about a patient.

But he warned that, in its present form, the PCEHR fell short of what was needed, both in its design and its implementation.

“A system that allows multiple health practitioners to share clinical information about a patient is good for patients and good for the health care system,” the AMA President said in a column in Pulse+IT. “[But], as the PCEHR has rolled out and clinical practice software has become more integrated, we are seeing significant constraints on the clinical usefulness and usability of the health record, flowing from its original design.”

It has been estimated that the Commonwealth has spent $1 billion developing and rolling out the PCEHR, including $50 million allocated to Medicare Locals so they can help GP clinics become PCEHR-ready.

But Dr Hambleton said implementation had so far been flawed, with mismatches between the readiness of patients and practices to use the system causing confusion and disappointment.

“It is difficult to know where patients are being registered, and where practices are already providing PCEHR services, and to what extent the two align,” he said. “A patient who has been convinced to register for a PCEHR should not be confused and disappointed by discovering their medical practice is not ready to participate.”

According to Department figures, more than 4000 health care organisations and 4600 individual providers have registered with the PCEHR system, but Dr Hambleton said those practices that had begun using the PCEHR system had done so with “very little” support.

He said a clinical advisory group should immediately be appointed to improve implementation and make the system much more clinically useful.

“It is now up to the medic al profession to drive improvements so it can achieve its purpose,” the AMA President said. “We need to make using the system easier, to get practices using the current system more confident in their processes and usage. There is a long way to go here.

“Clearly it’s not the time to introduce non-core functions that distract us from the main task.”

Dr Hambleton said that to “truly get the ball rolling” on clinical use of the PCEHR, the Government needed to consider paying doctors an incentive to complete a certain number of PCEHR records for their patients.

See also, “So far, PCEHR an empty record”, p22.

Adrian Rollins