Too much personal control reduces the effectiveness of the PCEHR
AMA Submission to the PCEHR Review
AMA Vice President, Professor Geoffrey Dobb, said today that the overriding emphasis on ‘personal control’ of the Personally Controlled Electronic Health Record (PCEHR) has stalled its implementation.
The AMA’s views on the way forward for the PCEHR are detailed in its submission to the Federal Government’s Review of the PCEHR, released today.
Professor Dobb said that there should have been equal emphasis on clinical utility in the development of the PCEHR.
”Despite the clear input by clinicians of the clinical needs of the PCEHR, the ‘personal control’ concept prevailed over the core objective of improving the efficiency and effectiveness of the delivery of health care,” Professor Dobb said.
“Unless certain core medical information was meaningfully available to treating practitioners, the PCEHR would provide no benefits above the current system and would be rejected by doctors.
“The current PCEHR arrangements allow patients to restrict access to information that has been agreed to by patients to be uploaded by doctors to the PCEHR, and patients can remove those documents without trace.
“To encourage use of the PCEHR, and to gain the most health benefits from the PCEHR, GPs, community specialists, and emergency department specialists must be confident that the PCEHR contains accurate, up-to-date information.
“We support people taking greater responsibility for their own health, and the PCEHR has the potential to assist with this, but patient control should not mean that the PCEHR cannot be relied upon as a trusted source of key clinical information.
“The AMA acknowledges concerns that patient privacy is paramount, but this must be balanced with the need for the PCEHR to make health care safer, more efficient, and more effective.
“Without a fundamental change to increased clinical confidence, the PCEHR does not serve the best interests of patients. As a result, it would be rejected by many doctors and would fail.
“Patients can remain confident that there are strong safeguards in the PCEHR legislation to prevent access to their records without appropriate reason, and deal with any breaches accordingly.”
Professor Dobb said that the AMA also recommends the PCEHR be an opt-out system, rather than the current opt-in arrangement.
“A patient opt-out system would ensure high consumer participation, particularly from patients with high needs, which would provide doctors with a better incentive to commit to using the system,” Professor Dobb said.
“Doctors would be much more likely to fully embrace the new system if a majority of their patients had a PCEHR.”
In its submission, the AMA offers the following priority improvements to accelerate adoption of the PCEHR:
- address clinical utility and increased patient safety by ensuring key clinical information is available to all treating doctors, for all of their patients with Electronic Health Records;
- address clinical utility and increased patient safety by moving quickly to assist other medical specialties and healthcare organisations to have the capability to view and upload relevant documents to the PCEHR;
- address clinical useability by ensuring that medical software provides seamless access and upload of agreed documents and information to the PCEHR; and
- ensure that when existing and new functionality is added to the PCEHR, such as pathology and diagnostic imaging results, it is streamlined and does not create new work activities for treating clinicians.
The AMA submission to the PCEHR Review is at https://ama.com.au/submission-
The PCEHR Review will report back to Health Minister, Peter Dutton, by mid-December 2013.
26 November 2013
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