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Shared e-health records an exclusive club

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Little more than 11,000 shared health summaries have been created under the previous Government’s electronic health record system.
A Senate Estimates hearing was told that around 1.13 million people so far have registered for a Personally Controlled Electronic Health Record (PCEHR), but minimal take-up by medical practitioners has meant that few shared health summaries have been created.
The result underlines AMA concerns that the system as currently configured is too complex and cumbersome for medical practitioners to use, and there are not sufficient incentives to encourage greater take-up.
Department of Health Secretary Jane Halton defended the rate of take-up of the PCEHR, which she said was “reasonable” and in line with experience in the Northern Territory with the adoption of its electronic health record system.
“In terms of our expectations about what is a reasonable take-up rate, I think the answer is, compared to our domestic experience, yes, it is reasonable; and compared to what I know about international experience, yes, it is reasonable,” Ms Halton told the Estimates hearing on 20 November.
The hearing was told that 6,040 health care provider organisations, including individual general practices and health networks such as the Queensland public hospital system, had registered with the system.
The number included 4714 general practices.
But Health Department officials admitted that the limited adoption of the scheme so far meant that only about 400 patients could have their discharge summaries uploaded to the PCEHR by their hospital.
The Coalition has been highly critical of the PCEHR and the cost (so far estimated to be around $1 billion) of establishing e-health systems.
AMA President Dr Steve Hambleton has been appointed by the Abbott Government to a three-member panel to review the PCEHR and report on changes and improvements by mid-December.
But Ms Halton said progress should be measured not only in terms of the number of shared summaries created so far, but also the enormous amount of work that had gone into establishing the building blocks of a uniform national electronic health system, including the development of unique identifiers.
“Let’s be clear. The $1 billion is comprised of a number of elements. The large majority of the billion dollars is actually [spent on] things like the standards that underpinned the use of all IT systems in the health space,” the Health Department Secretary said. “Those things are fundamental to the operation of electronic systems in states and territories. The PCEHR is actually the smaller proportion of that amount. The majority of it is actually creating the things that prevent a ‘rail gauge’ problem in terms of electronic commerce, communication and clinical information.”
The hearing also heard that private organisations hired by the Department had delivered the bulk of the patient registrations to date, with minimal take-up coming from public notices or information from Medicare Locals.
Adrian Rollins