E-health record grind worries NSW Health

 

Halts internal projects.

New South Wales health minister Jillian Skinner has expressed disappointment at failed attempts to hit benchmarks set for the federally funded personally controlled electronic health record, which she claimed had held back plans for state-based e-health projects.

Skinner said that while the widespread uptake of the PCEHR "has the potential to revolutionise the medical practice", major issues still required resolution for the electronic health records project, which aims to provide individuals with a system that ties together information from GPs and hospitals.

The health minister pointed to data integrity as well management and access to records as key concerns she felt had not properly been resolved by the federal Department of Health and Ageing and lead agency the National E-Health Transition Authority.

"Unless patients believe that the system is being operated for the individual benefit and not simply to make life easier for the bureaucracy, then they will neither include the material which ideally should be included, nor grant the access which should ideally be granted," she told an industry lunch on Tuesday.

"Unless the treating physician or nurse feels that they are dealing with a record which is both comprehensive and has integrity, they will be reluctant to rely upon it as they should. So we need to get all those factors correct."

The $628.3 million PCEHR project went live for the first time on July 1, enabling Australian citizens to register for an electronic record in a Medicare office or by phone.

However, key components of the system — such as online registration, a consumer portal and compatibility with GP computer systems — failed to meet the deadline, set two years after the initiative was first announced.

Those components are expected to be added progressively to the system over the next six months, with other core features being added over coming years.

"I worry that the expectation has been raised there by people who think they're going to have everything singing and dancing as of last Sunday but that's not the case," Skinner said, pointing to significant issues in standards development and testing as one reason for the delays.

"The development of standards was very, very slow."

Trials of the electronic health records initiative included two major testing sites in NSW, both in collaboration with NSW Health and tying in elements of the state's own failed e-health project.

Those elements tested by state hospitals in western Sydney — such as a "blue book" of medical information for expecting mothers and newborns — would be released as mobile applications within coming weeks.

But projects not explicitly tied to the electronic health record system — such as a trial linking doctors at Westmead Children's Hospital with GPs in surrounding areas — have been potentially delayed by the lack of functionality available in the first tranche of PCEHR releases, according to Skinner.

"A lot of this depends on how advanced the Commonwealth is in its electronic records," Skinner said. "We're continuing to move on — we're not waiting for that."

The records system has been criticised by medical software vendors for lack of extensive standards, and by security experts for becoming a potential hacking target.

The latter concern seems to have proved correct after The Australian reported a hack of the Accenture-built pilot systems was detected four months before official launch.

The newspaper cited sources saying the consortium had only delivered 40 percent of the project's agreed scope by July 1, falling significantly short of plans for a more comprehensive launch.

Despite Skinner's comments, the federal opposition has been largely uncritical of the e-health project, voting in favour of the underpinning legislation last month despite protests from some Liberal senators over privacy concerns.

"We support [the PCEHR] very much at a national level but there's still a long way to go in pulling them together," Skinner said.

"It's steady as she goes, I think this is really terribly important for future healthcare but it's a relatively slow, incremental process."

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E-health record grind worries NSW Health
 
 
 
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