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Reset expectations on e-health: AMA

The Australian Medical Association (AMA) has called on the Federal Government to "reset expectations" that it will deliver e-health records to Australians by July this year.
Written by Josh Taylor, Contributor

The Australian Medical Association (AMA) has called on the Federal Government to "reset expectations" that it will deliver e-health records to Australians by July this year.

Stethoscope

(Littman image by Katrin Morenz, CC BY-SA 2.0)

AMA President Dr Steven Hambleton told a Senate hearing this morning that the government's proposed deadline for the launch of its personally controlled e-health record (PCEHR) system for all Australians by 1 July 2012 is "problematic".

"We have a real problem with the level of expectation that has been set ... and the actual ability for doctors to deliver on that day. Even if the legislation is passed [and] the framework is available, there are many, many practices that will simply not be able to communicate with that piece of software."

He said that many medical practices would also be concerned about their risks in terms of recording who has access to the record and when, stating that much of the software around today doesn't have the ability to do that.

He said that the AMA supports e-health records, but said it will be a few years before it is completely up and running.

"I think we need to reset expectations both in the profession and the public, so we understand that there's not going to be a comprehensive personally controlled electronic health record available, or indeed accessible, by most software on that day," he said.

Hambleton said that if the AMA wanted anything delivered by 1 July, it would be the sharing of medication lists. He said this would halve the consultation time for many elderly patients, and would reduce confusion among health practitioners that aren't often aware of the different names for both original and generic medications.

"If we can share accurate, up-to-date medication lists, this will save lives. This is so important ... so we don't prescribe things people are allergic to, so we don't prescribe things people are sensitive to," he said. "Most people are pretty happy to share their medication lists."

Hambleton said that the e-health system should be opt out instead of opt in, because if the information isn't there from the beginning, it would deter doctors from returning to the system to look for information in the future.

"The reality of patients having to opt in means that when the doctor looks for a record, they'll often find there isn't one," he said. "They'll quickly become reluctant users if they look for and can't find a record."

He said much of the implementation of the e-health system at this point has not been driven by the clinicians themselves, and this, too, would deter uptake.

"We've got to make sure it remains clinically driven, and can sit in the workflows as much as possible."

In the time since its creation, Hambleton said that the National E-Health Transition Authority's (NEHTA) communication with the medical industry has improved, and although NEHTA came under fire last month for stopping the roll-out of desktop software in the lead clinical trial sites because of issues with specifications, Hambleton said that this was the right move by the organisation.

"Recognising it now, rather than when we're trying to roll it out, was very good, and making a decision to stop the development is a good one. I'm very pleased that NEHTA: one, had the systems in place to recognise it; and two, took action quickly; and three, is actually communicating with their clinical leads and the profession," he said.

"I think we can see the benefits four or five years down the track, and I think it is going to be that long."

He said that decreasing NEHTA's funding after 1 July from hundreds of millions of dollars to tens of millions of dollars could be a mistake, as the authority will still be needed to bring health practices on board.

"Somebody needs to be sitting there to keep driving that momentum."

Later today, the inquiry will hear from the Medical Software Industry Association, the Australian Privacy Foundation, NEHTA and the Department of Health and Ageing.

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