E-health record should be opt-out: Review

The Personally Controlled Electronic Health Record (PCEHR) should be renamed 'My Health Record' — MyHR — and shift to an opt-out model, according to a review of the system commissioned by the federal health minister, Peter Dutton.

The review was conducted last year and completed in December but not released by the Department of Health until now. The review was led by Richard Royle, executive director of the UnitingCare Health group in Queensland and vice-president of the Australian Private Hospitals Association. The other members of the group who conducted the review were AMA chief Dr Steve Hambleton and Australia Post CIO Andrew Walduck.

The report (PDF) concludes that there is overwhelming support for an electronic health record system in Australia but a "change in approach however is needed to correct early implementation issues and to review the strategy and role that a shared electronic health record plays in a broader system of health care".

The 38 recommendations contained in the report include dissolving National Electronic Health Transition Authority (NeHTA) — the organisation that has overseen the rollout of the PCEHR — and replace it with the Australian Commission for Electronic Health (ACeH) reporting directly to the Standing Council on Health. The new governance structure would include technical, jurisdictional, consumer advisory, and security committees.

System operation of the MyHR would be centralised under the Department of Human Services, under contract from the ACeH.

The review panel recommended "a change in the focus of the medical record and the name to reflect more of a partnership between the clinician and the patient but is should be noted that MyHR will retain all of the personal controls that exist in the current PCEHR," the report states.

The transition to an opt-out model for the record should take effect from the 1 January next year. The change would increase the value of the record to healthcare professionals and help drive their use of it, the report states.

The new name for the electronic health record reflects "a modern naming convention for digital service". "As the adoption and embrace of the digital age accelerates the need to differentiate between digital and physical sources is losing it’s [sic.] relevance," the report states.

Among the recommendations is also a shift in architecture to use a "decentralized information repository model" that would be "linked via MyHR".

"This may impact on the work that has currently already been done but will enable MyHR to provide access to existing private and publicly held repositories without the need for wholesale duplication of records," the report states.

The federal budget included $140 million for the electronic health record rollout and other e-health measures.

The government "continues to work with stakeholders with regard to the recommendations from the recent PCEHR review to determine how best to proceed. The Government is committed to supporting improved productivity across the health sector and greater convenience for providers and patients," budget papers stated.

"Implementation issues have plagued the PCEHR from day one, but the Abbott Government will get it back on track so that it provides real benefits to patients and health professionals alike," said a statement on the funding issued by the office federal health minister, Peter Dutton.

Most clinicians are not using the system, the minister's statement said.

Copyright © 2014 IDG Communications, Inc.

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