The National Health and Hospitals Reform Commission Lets Australia Down I Fear.

The following has appeared in the News Ltd papers today. It seems clear this is a set of leaks from the NHHRC Final report.

Health records to go online

Article from The Advertiser

BEN PACKHAM, STEVE LEWIS

July 20, 2009 12:01am

EVERY Australian will be able to see their medical records online and keep a personalised "health diary" in a key reform promising better care and big taxpayer savings.

Family GPs and other medicos will be forced to link patient records to a proposed national database or miss out on Medicare payments, The Advertiser can reveal.

But Prime Minister Kevin Rudd's health reform body has called for patients, and not doctors, to have the ultimate say over who sees their medical records.

......

Central to the reform agenda is the introduction of a national electronic-health system, containing confidential and potentially life-saving information. To maintain privacy standards, medical professionals would have to get patient permission to access the data, which would be dispersed across the country.

New privacy legislation would protect the information from prying eyes. But emergency provisions could allow access to the data in times of medical crisis, such as after a car accident or during a serious allergic reaction.

Giving people access to their own records is seen as vital to ensure consumer acceptance of the proposed e-health revolution.

This would allow individuals to go online and update their medical records and add information relevant to self-management and healthy lifestyles.

Medical professionals have long hoped for a national e-health system, which could save up to $8 billion over 10 years by giving medical professionals better information about patients. The number of medical errors could be cut, chronic disease management would be improved and unnecessary duplication of tests and scans would be eliminated.

Under the commission's recommendations, it is understood every Australian would have an electronic health file by mid-2012, and all health care providers would have to accept data from other providers by January 2013.

Those without internet access would be able to view their records under proposed equality measures.

GPs, specialists, pharmacists and other allied health professionals would become "e-enabled" quickly to ensure the system worked.

The plan to deny Medicare payments to GPs who do not sign up to the system will anger the powerful doctors' lobby which hopes to secure incentives for its members to co-operate.

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More here:

http://www.news.com.au/adelaidenow/story/0,22606,25806145-5006301,00.html

In the following I will ignore all the points made other than the e-Health related ones.

On the basis that what is reported, and it is similar to what I have seen in drafts of the Final Report, this seems to be what the NHHRC has in mind.

Let me say clearly and directly I disagree with just about every aspect of these proposals.

To my mind these proposals lack an evidence base, ignore the major benefits cases of e-Health, are impractical as they guaranteed to really annoy most clinicians and suggest timelines that are utterly unrealistic.

I have made the arguments around most of these points here:

http://aushealthit.blogspot.com/2009/05/nhhrc-gets-e-health-very-badly-wrong-at.html

As have others – as covered here:

http://aushealthit.blogspot.com/2009/05/nhhrc-told-to-work-out-what-it-is.html

If the government can’t see that what we need is proper automation of our professional health services with point of care decision support, a dramatic upgrade of standardised, content rich, information flows between the various professional actors (doctors, nurses, pharmacists, allied health and so on), implementation of standardised secure messaging and e-prescribing, improvements in the business of health systems and quality leadership and governance of the way e-Health is managed and delivered we are, to be clear about it – stuffed!

If the final report does not recommend, and the government decide to agree to, run tracks both of implementation of the Deloittes National E-Health Strategy and developing a pragmatic approach to the deployment of Personal Health Records we will wind up in a humongous mess.

Take it from me, medical professionals have not been asking to be forced to contribute to patient held records. They have been asking to be given the tools they need to enable them to do a better job of caring for their patients.

This proposal, if true, is really just ‘magical thinking’ on the part of some very ignorant people in the NHHRC.

All I can do is hope News Corp have got the wrong end of the stick.

David.

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