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22 Nov 2016

There is no doubt the evolution of the shared electronic medical record, or the My Health Record as it is now known, has been a costly exercise, with more than $1 billion spent to date. Many observers would argue that is a lot of buck for little or no bang.

Certainly, the My Health Record is not yet perfect. But a recent demonstration of its use to the AMA Council of General Practice (AMACGP) was promising, and GPs who had previously dismissed it might consider taking a second look.

We all want the My Health Record to work. It has the potential to support much better patient care, particularly when your patients see another doctor or health care provider.

By uploading key medical information via a Shared Health Summary, you are making sure other doctors who may be treating your patient in an emergency situation, or while they are away on holiday, have the information they need to appropriately care for your patient, thereby reducing the likelihood of your patient experiencing an adverse medical event or unnecessary testing.

Of course, this is a two-way street. The investment you make in providing accurate and up-to-date medical information about your patient for other doctors and health care providers will be repaid when you benefit from the information they upload to another patient’s My Health Record.

The vast majority of the Government’s investment so far in e-health has funded the building blocks of the e-health system, such as the physical and governance infrastructures, enabling frameworks and privacy protections. To the GP on the ground, this does not mean much for day-to-day patient care.

However, there has been a lot of working going on in the background to make the My Health Record more useful and easy to use. The AMA sat on the Clinical Usability Group of the National eHealth Transition Authority (now Australian Digital Health Agency) and we have driven significant changes. The demonstration provided to the AMACGP highlighted how easy it is to access a My Health Record, as well as to create and upload a Shared Health Summary.

For most practices, the process for Assisted Registration of patients is also much simpler. As long as the patient is known to the practice or have their driver’s licence with them, they can be easily registered for the My Health Record using the practice’s existing clinical software. Patients do not have to be registered with MyGov to be registered this way for the My Health Record.

The My Health Record is now at a point where we can begin to realise the benefits of a shared electronic medical record.

These benefits will only come ‘on scale’ when there is a critical mass of registrants. A welcome sign has been Government’s willingness to test ‘opt-out’ arrangements to increase uptake of the My Health Record. The current trials have seen very few patients opt out and, if this trend continues, they will prove the basis for the extension of those arrangements across the whole population.

The requirement to upload a minimum number of Shared Health Summaries under the revised PIP eHealth Incentive has provided a catalyst for more engagement. My patients willingly consent to having a SHS created for them, once they understand the information uploaded to their My Health Record will help facilitate their care, should they unexpectedly end up in hospital.

From the AMA perspective, the My Health Record should include core clinical information for all patients. This information should not be subject to patient access controls. I know that I will only be able to deliver the best care for patients when I have access to their full health record. This must include a current list of medications, allergies and adverse reactions, discharge summaries, recent test results and clinical observations, advanced care directives, advance care plans and resuscitation plans.

Provided the Government and the new Australian Digital Health Agency listens to the input of clinicians, we appear to be on the cusp of delivering a shared electronic health record that operates universally with optimum ease of use and seamless integration across health care providers. Clearly, more work needs to be done to ensure GPs are properly funded to work with the My Health Record and that specialists, other health care professionals and hospitals start to adopt this important clinical tool.

I would not have been so positive 12 months ago, but having used the My Health Record in my own practice and seen the recent demonstrations, I am becoming increasingly optimistic about its future.

If you are not already participating in the My Health Record, a range of training resources have been made available to assist you. They can be viewed at: http://www.digitalhealth.gov.au/using-the-my-health-record-system/digital-health-training-resources/software-demonstrations

 


Published: 22 Nov 2016