Getting the right PCEHR

AMA President Dr Steve Hambleton presented to the Senate Community Affairs Committee Inquiry into the PCEHR legislation via teleconference on Monday 6 February to explain the AMA’s Submission to the Inquiry.

Here is an edited extract of his opening remarks to the Committee …

Most AMA members are enthusiastic about using shared electronic health records.  They know that with the right system, they can improve the patient healthcare experience.

The right sort of shared record system will help doctors deliver better care.  They will have important information about their patients to help them make good clinical decisions.

Some of my elderly patients can tell me the strength and name of their tablets and some the colour and size of their tablets, but many others can't.  With new patients, I have to question them about that and it takes a little longer to work out what the medication is. 

With a good system, I can at least confirm my assumptions by reading what the last doctor prescribed.  This would be an improvement over the current situation.

A good system will save extra costs for repeat tests.  It will save time chasing down results.  Treatment can happen more quickly.

This is why the AMA supports the long-term goal.  The proposed system could be improved to make it much more useful for treating doctors.

The reality of patients having to opt-in means that when doctors look for a patient’s record, they will often find there isn’t one.  Our submission highlights that we don’t know what the opt-in rate will be.

If doctors were to find that most of their patients had a PCEHR, they would be more likely to keep using the system.  But they will quickly become reluctant users if they look for and can’t find a record for their patient.

For better patient care, the AMA advocates for an opt-out system that provides treating doctors with access to the key clinical information to inform their clinical decisions.

We are uncertain about how much of the system will be available on 1 July 2012, and how well the system will be connected to health care providers.

The Parliament may pass the legislation.  Some of the technical work might be finished. 

But there will be no benefit for patients and medical practitioners until appropriate, interoperable, tested, and affordable practice software is available for providers to connect up to the system.

In terms of the legislation, the AMA is concerned about the administrative impact on medical practices.

Medical practitioners who decide to use the system will have to adapt their clinical workflows and train their staff to work within the requirements of the legislation.

Doctors will have to consider the impact of this additional workload and the changes to clinical workflow on the fees they charge their patients.

The biggest impact will be on general practitioners.

GPs will take on the role of ‘nominated healthcare providers’ and create and maintain the ‘shared health summary’.  This is a key feature of the PCEHR.

This is a very specific clinical task.  GPs will work with their patients to ensure that a complete and accurate summary is available to be used by other health care providers in their clinical decisions, and this will take time.

It is only reasonable that patients should receive a Medicare rebate for this very important clinical service so that the PCEHR system truly works to improve patient care and reduce waste and risk in health care.

The full AMA submission is available at http://ama.com.au/node/7302

JF