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Why clinicians don’t like national e-health

Why clinicians don’t like national e-health

And what needs to be done to change their minds

If a recent survey by <i>Australian Doctor</i> is anything to go by, many general practitioners (GPs) across the country don’t want to participate in the challenged national e-health program.

There are two key reasons for this: time and money. In recent months, several prominent healthcare professionals have criticised the time it takes to prepare information that can be submitted to a patient's personally controlled electronic health record (PCEHR), particularly to ensure the accuracy of data recorded about a patient’s health.

They’re also concerned about information contributed to a PCEHR system being viewed by the wider health community and the time it takes to ensure the data is concise.

As expected, the majority of Australians will nominate their GP as their primary healthcare provider. Consequently, some GPs claim they will spend even more time managing their patient’s shared health summaries.

Although GPs are compensated by Medicare – through several MBS codes – for contributing information to the PCEHR, they believe that having to complete these administrative tasks will mean there’s less time available to care for patients.

But over time, the national e-health program will actually enable GPs to focus more on treating their patients.

As a patient’s primary healthcare provider, the national PCEHR system will help GPs co-ordinate care and cut the amount of time spent chasing information from other healthcare providers, such as hospitals, pharmacies, and specialists.

This will particularly benefit older Australians, and people living with chronic disease or ongoing health conditions.

So given the potential, how can GPs be encouraged to contribute the necessary clinical information so the benefits of the PCEHR will be realised?

Perhaps most importantly, software vendors need to demonstrate maturity in their implementations to support the PCEHR to make access easy and ensure little impact to current work practices. This will go a long towards encouraging GP adoption.

Creating a consumer’s shared health summary could be (and should be) as simple as pressing a button.

The information required in the standardised electronic summary can be updated from the GPs clinical software that stores local consumer e-health records and should require little or no human involvement.

In addition, the GP’s clinical software should provide seamless access to a consumer’s PCEHR and make available information that they would not currently have access to. It should present a consolidated summary of a consumer’s important health information through the series of views already provided by the PCEHR.

This will ensure that the right information is available to GPs in the right format to help them make the right decisions at the time of care.

Government support

The Department of Health and Ageing (DoHA) is providing funds through its Practice Incentives Program (PIP) to encourage GPs and software vendors to support the PCEHR initiative.

The incentive aims to keep general practices up to date with the latest software developments in e-health, and in May this year, a PIP for the PCEHR was introduced. GPs need to recognise the investment being made by the federal government and software vendors.

The attractiveness of the national e-health record cannot be denied; health information stored within a consumer’s PCEHR has the potential to speed up the decisions at the time of care.

This national record also enables early intervention through more informed clinical decision support, a reduction in medication errors, and improved diagnostic and treatment decisions.

Monetary compensation for supporting consumer PCEHRs has largely been addressed, and in time, so will the ease of use.

Consumers will experience significantly improved clinical outcomes from having a PCEHR when GPs invest time in recommending their patients participate and they accept responsibility for providing updates to e-health records.

This is particularly crucial for those patients whose quality of life is affected by poor health.

Brett Avery is an e-health solution architect and has spent the past seven years researching and developing software solutions for the health sector. He is also a member of the CIO Executive Council’s Pathways Leadership Development Program.

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Tags e-healthmedicarePCEHRBrett AveryDohaThe Department of Health and Ageingpersonally controlled electronic health record

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