ehealth and the personally controlled electronic health record (PCEHR) system Health Information Management Association of Australia 2012 National Conference Gold Coast, 30 October 2012 Ms Rosemary Huxtable Deputy Secretary Department of Health and Ageing
National Health Reform The eight streams of Health Reform Hospitals Primary care Aged care Mental health Standards Workforce Prevention ehealth National Health Reform Agreement signed by all jurisdictions in August 2011
PCEHR Benefits Every year the average Australian has approximately 22 interactions with the health system generating patient notes and records, including: 4 visits to a GP; 12 pharmacy prescriptions; 3 visits to a medical specialist; 2 visits to an allied health professional (e.g. a physiotherapist); and an annual visit to the dentist
PCEHR Benefits In 2010-11, Deloitte modelled that the net direct benefits of the national PCEHR system are expected to be approximately $11.5 billion over the 2010 to 2025 period. The benefits accrue for two key areas Reduced avoidable hospital admissions and GP visits due to the more effective medication management - $10.237 billion; and Improved continuity of care - $1.308 billion The availability of more information for healthcare providers on medications, alerts and allergies will reduce errors and accrue benefits over time
Strategic Direction As part of National Health Reform and the National E-Health Strategy, an integrated ehealth record system identified as important to: improve safety and quality reduce waste and inefficiency improve continuity of care underpin an agile, patient-centred, health system
National ehealth Foundations The System will leverage ehealth foundation services: Healthcare Identifiers Service Authentication Services Clinical Terminology Service Proof of Record Ownership Service National Health Provider Service Directory Template Service
PCEHR for Consumers
PCEHR for Healthcare Providers Providers Access provider portal Use clinical software Register consumers from within GP practice Create shared health and event summaries Receive discharge summaries
Frank Harding Scenario Frank departs Melbourne. He attends ED in Cairns Frank visits a GP in Port Douglas Frank views his PCEHR while in Coffs Harbour Frank visits his regular GP in Melbourne View PCEHR Create / Send Electronic Discharge Summary View PCEHR Create / Send GP Event Summary View PCEHR View PCEHR Create Event Summary 12
SMITH, HARDING, Julie Frank Born: 14-Apr-1972 Born: 21-May-1946 (39y) Welcome: Frank Harding 13
Wrap up of Frank Harding Scenario Other GP ED & inpatient Regular GP Value for ED / Hospital / Other GP Quick access to relevant summary data Improved clinical decisions due to availability of information Value for Consumer Safer transition between care providers Quick access to relevant healthcare information Don t need to remember details of previous events Improved communication with clinicians Consumer can play a more active role in own health Value for Frank s Usual GP Supports workflow (integration of local CIS and PCEHR) Quick access to relevant summary data Reduced need for unnecessary repeat diagnostic tests Enhanced collaboration between clinicians 14
Lead ehealth sites Brisbane South Division (Accoras) Calvary Healthcare Project (ACT) Cradle Coast, North-West Area Health Service Project (Tasmania) FRED IT Group (MedView) Greater Western Sydney ehealth Consortium (NSW Department of Health) Hunter Urban Medicare Local Inner East Melbourne Medicare Local Joint ehealth Data Initiative (Department of Defence) Mater Misericordiae Health Services (Brisbane) Medibank Private Limited Metro North Brisbane Medicare Local Northern Territory Department of Health and Families St Vincents and Mater Health Sydney
Northern Territory My ehealth Record Views of SEHRs Year 7 Year 6 Years 1-5 2010-11 Monthly av. = 12,980 Mean: 12,9 Range: 6,090 to 18,830 16
ehealth sites experience Mater Hospital Brisbane: Electronic access to patient Shared Health Summary. Available to hospital based healthcare professionals and GP or midwives and community nurses for in-home care. Supports continuity of care.
ehealth sites experience New South Wales:
PCEHR Promotion The Department is working with consumer and provider organisations to promote the PCEHR system to key cohorts: Communication material available at ehealth.gov.au Online PCEHR Learning Centre available at ehealth.gov.au National mail-outs Information included in all DHS Parent/Birthpacks from 1 January 2013 Letter to GPs advising of the epip incentive Web forums Medicare Locals training program
Privacy and Security The National PCEHR System: Allows personal control over and access by consumers to their ehealth records. Has implemented audit trails, enabling consumers to check by whom and when their ehealth record was accessed. Closely monitors and logs transactions so that inappropriate access can be detected. Healthcare Providers will protect data held in the system by: Complying with existing professional guidelines, which requires them to protect the patient in confidence data stored in their systems. Complying with the PCEHR Rules and Regulations underpinning the PCEHR legislation, and notifying the System Operator if suspect activities occur.
The role of Health Information Managers in the PCEHR HIMs play a central role with number of HIMs expected to grow Understand the system Opportunity for health information managers to consider possibilities of a new source of shared information Understand how the PCEHR can be used in your organisation.
Where to next? Rollout of the system will continue and form the cornerstone of the ehealth system in Australia; discharge summaries, pathology, medical imaging Integration and use with telehealth systems Stimulate innovation Provide opportunities for the private sector