Two prominent healthcare CIOs have backed the federal government’s national e-health initiative despite early teething problems and slow uptake across Australia.
As of midnight 24 September, only 10,577 Australians had registered for a personally controlled electronic health record (PCEHR) scheme – up from around 5000 in mid-August – since its launch on July 1, according to the Department of Health and Ageing (DoHA).
Around 90 per cent had registered online, despite some reports that users are frustrated with the arduous process of enrolling to access a single record of their medical history, gathered from multiple systems.
A DoHA spokesperson told CIO Australia that the PCEHR was a deliberately staged process and the department is “very happy with the uptake considering there has not been much publicity so far”.
Publicity so far has primarily consisted of a mobile truck touring Australia, educating the public about electronic health initiatives.
Mal Thatcher, CIO at Mater Hospital, expected progress was going to be slow without “critical mass in the sector in relation to an e-health capability”.
“It’s a little like telcos deploying the next-generation of mobile networks but very few consumers have compatible devices. Having said that you can’t just sit back and wait for compatible devices; perhaps it’s the chicken and egg conundrum,” he said.
“Momentum will slowly build as both consumers and healthcare providers [gain] confidence in the system and ultimately it will be worthwhile.”
According to Thatcher, there are “always integration issues to be deal with when one considers the complex nature of health IT systems interoperability”.
“Mater fortunately and perhaps fortuitously has a mature architecture for interoperability and data integration,” he said. “This issue of vendor software compliance with the PCEHR will make or break [the system] so time will tell.”
No incentives for private healthcare
Thatcher believes the real challenge for the PCEHR is that there is still no a commercial model for private healthcare organisations to participate other than in primary care.
“While the [government] is providing financial incentives for GPs to complete health summaries, there are no incentives for private hospitals or private specialists to actively engage.
“The current incentives that drive Mater’s participation relate to provide the best possible care for patients. However, this has to be financially sustainable.”
Consortium to deliver critical mass
Bill Vargas is CIO of the Sydney Children’s Hospitals Network, which incorporates The Children’s Hospital at Westmead and is part of a Greater Western Sydney e-health consortium, one of 12 similar electronic health programs across Australia.
The group is a collaborative consortium consisting of e-health NSW, Nepean Blue Mountains Local Health District (LHD), Western Sydney LHD, The Children’s Hospital at Westmead, Western Sydney and Nepean Blue Mountains Medicare Local, which has implemented a system called 'HealtheNet for Greater Western Sydney (GWS)'.
The system enables healthcare providers in the group, with the consent of the patient, to share summary information from their existing source systems – such as electronic medical records (EMR) – and uses the National 'health identifier' for potentially millions of patients across the region.
Eventually, with the approval of patients, this data will be fed into the national PCEHR platform. Several pilots involving GPs in these regions are expected to be completed in around 12 months.
According to Vargas, the ongoing development, participation from individuals and healthcare service providers in the PCEHR program is going to be a slow process, due to the complexity of the program.
“It’s a massive task given the evolving standards that are required to make it a secure messaging system for clinical information and the maturity of core source systems [used by healthcare service providers],” he said.
“We [the consortium] have encountered similar issues around meeting standards and changes required across multiple systems but we are getting there. We can now feed data from the source EMRs all the way down to the GP’s desktop in a few of our pilots, some which are in testing and some are live in production.”
Ultimately, the HealtheNet for Greater Western Sydney (GWS) Consortium’s separate system will deliver a “fairly large critical mass” of patients to the PCEHR, Vargas said.
“We are talking about a large catchment base of patients that potentially will run into the millions and will provide a good base of records [for the national PCEHR],” he said.
Vargas believes the PCEHR will become extremely useful when it reaches the critical mass that it needs and “people will start seeing the benefits of the national eHealth program over time".
“Sharing patient data electronically does enhance communication between clinicians and leads to better healthcare,” he said. “Time and time again a lack of information has created issues in healthcare and this will be one huge step to resolving this ongoing problem."
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