Australian Medical Association

The AMA has drafted the AMA Guide to Using the PCEHR (the draft Guide) to assist medical practitioners to consider if they want to participate in the PCEHR system and if so, how they might use the PCEHR in their day-to-day practice.

The draft Guide has been informed by consultation with medical indemnity insurers and representatives of medical colleges, associations and societies. It has been written by medical practitioners for medical practitioners.

The AMA conducted a survey of its members in January 2012 to ensure that the draft Guide to Using PCEHR is as useful and relevant to practising medical practitioners as possible. Responses were used to prioritise and inform the guidance given in the document.

The Personally Controlled Electronic Health Record System (the PCEHR) is an Australian Government program to provide Australians with a system of access to health information relating to consumers of healthcare.

The AMA has drafted the AMA Guide to Using the PCEHR to assist medical practitioners to consider if they want to participate in the PCEHR system and if so, how they might use the PCEHR in their day-to-day practice.

The AMA submission on the exposure draft of the Personally Controlled Electronic Health Records Bill 2011 highlights that the safety objects of the legislation will be undermined by the opt-in design of the system and the ability of patients to to effectively remove clinical documents from their PCEHR. The submission also makes several suggestions to improve the transparency of the governance arrangements for the PCEHR and to clarify the operation of the civil penalty provisions.

The AMA submission to the Department of Health and Ageing on the Personally Controlled Electronic Health Record System: Legislation Issues Paper should be read in conjunction with the concerns expressed in our submission on the PCEHR Draft Concept of Operations.

The AMA submission on the proposed PCEHR expresses concerns that the proposed form of the PCEHR will provide only limited safety benefits and these are significantly outweighed by its inherent clinical and medico-legal risks for medical practitioners and the administrative burden it will impose on medical practices.

The AMA submission highlights that the Australian Guidelines for the Prevention and Control of Infection in Healthcare 2010 already govern the management of health care practitioners who have blood-borne viruses and makes the point that there is no need to de-register a medical practitioner because they have a blood-borne virus.  The AMA has asked the Board to clarify its role in regulating the scope of practice of medical practitioners who are infected with a blood-borne virus in isolation from the way this issue is managed by medical practitioners and the health care organisations in which they practice.  The AMA has suggested the Board undertake a second round of consultation once it has clarified what action would constitute a breach of guidelines and that action the Board might take in such cases.

The AMA submission on Medicare funding for online consultations calls for funding not to be limited to video consultations only, but include telephone calls, emails and other non-video online consultations that are necessary for providing care to patients who are remote to the specialist caring for them.  The submission also says that the MBS items should be drafted broadly to enable treating doctors to use their clinical judgment to determine when an online consultation is clinically relevant for their patient and the clinically appropriate technology to use to provide the service.

The AMA Council of Doctors-in-Training has made a submission to the National e-Health Transition Authority on electronic discharge summaries. The paper examines, from the junior medical officer perspective, impediments to creating high-quality discharge summaries and presents solutions to the barriers identified.

The Productivity Commission is conducting an inquiry into Caring for Older Australians.

The AMA submission to the inquiry is based on existing AMA policy and general themes discussed at a consultation convened by the AMA between the Productivity Commission and AMA member geriatricians, old age psychiatrists, general practitioners, and rehabilitation and palliative care specialists on 2 July 2010.

The AMA supports the introduction of healthcare identifiers as an important e-health building block. The healthcare identifier will uniquely identify individuals and healthcare providers for the purposes of securely accessing and sharing health information.

The AMA has made one submission to the Senate Community Affairs Committee and three submissions to the Department of Health and Ageing on this issue.

This position statement supports the development of a shared electronic medical record that links reliable and relevant medical information across healthcare settings. Such a record would provide treating doctors with relevant clinical information that enables them to make informed decisions and treat their patients most effectively.

The AMA supports individuals taking responsibility for their own health and acknowledges that a ‘person-controlled’ electronic health record could encourage patients to take greater control of their own health care. However, a ‘person-controlled’ record would have limited clinical use because it may not contain the relevant information clinicians’ need. A system that allows a shared EMR between health care providers is needed in addition to any person-controlled health record.

AMA Submission to the Community Affairs Legislation Committee on the Healthcare Identifiers Bill 2010 and Healthcare Identifiers (Consequential Amendments) Bill 2010

The AMA considers healthcare identifiers are an essential building block towards the implementation of electronic health records, and we are therefore a strong supporter of their introduction. Healthcare identifiers will facilitate the secure access to, and appropriate sharing of, electronic patient information by healthcare providers.

We support the passage of the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010.

Establishment of the Healthcare Identifier Service was agreed to by the Council of Australian Governments in 2006 as part of the national approach towards accelerating work on electronic health records to improve the safety of patients and improve efficiency for healthcare providers.

In July 2009, the Department of Health and Ageing released a discussion paper on legislative proposals to support the establishment and implementation of unique identifiers for healthcare purposes and the privacy of health information.

The AMA submission on the discussion paper is supported by the AMA Position Statement on Unique Healthcare Identifiers in 2008.

The AMA Position Statement on Electronic Prescription Transfer Systems – 2009 supports the development of an electronic prescription transfer system as a fundamental building block for a broader eHealth system in Australia. It sets out the high level principles that should underpin an electronic prescription transfer system.

The development of an e system in Australia is supported by:

1. the National eHealth Strategy
2. the KPMG Consultancy in Electronic Prescribing and Dispensing Final Report (commissioned by the Department of Health and Ageing);
3. the National Health and Hospital Reform Commission (NHHRC) Interim Report, including the supplementary paper on person-controlled electronic health records; and
4. commercial vendors actively promoting their prescribing systems.

The AMA position on other aspects of eHealth are set out in the following position statements:

AMA Position Statement – Unique Healthcare Identifiers – 2008
AMA Position Statement – Connectivity – 2007
AMA Position Statement – Safety and Quality of E-Health Systems – 2006

The new PIP eHealth Incentive starts in August 2009.

The advice relates to secure messaging by a eligible suppliers, public key infrastructure (PKI) certificates and the electronic clinical resources that are required to meet program guidelines.

AMA Position Statement: Unique Healthcare Identifiers - 2008

AMA Position Statement: Connectivity - August 2007

AMA Position Statement: Safety and Quality of E-Health Systems - 2006

AMA Position Statement: On-Line and other Broadband Connected Medical Consultations - 2006

The AMA convened an E-Health Forum on 7th and 8th December 2005 in Canberra.

Medical Taskforce on Informatics - Final Report