IfG.CC -
Institute for eGovernment

Security experts say answers to the identity verification questions are so widely known it would allow a person to set up an e-health record for someone else by telephone if they wanted to access that individual's health details, such as medication or medical procedures.

On Wednesday, federal Health Minister Sussan Ley announced two new trials of the so-far-unsuccessful, personally controlled electronic health record – rebadged as “My Health Record”.

These will run at the start of 2016 in rural north Queensland and the Blue Mountains in New South Wales.

The key difference from the current system is that enrolment has been switched to opt out rather than opt in. This means any of the one million patients included in the trials who don’t want their data shared will have to actively ask not to be part of the system.

Imagine if any medical practitioner could access your healthcare records at the click of a mouse. The emergency department could treat you more quickly, specialists could compare test results instantly and you wouldn’t have to remember the last time you had a tetanus shot.

Welcome to the world of eHealth, a program the Government has invested $466 million in. Its aim is to create PCEHRs (Personally Controlled Electronic Health Records) that centralise a patient’s healthcare information and, with their permission, present it to registered healthcare providers.

And a Health spokeswoman says new legislation will be needed before the introduction of the Gillard government's $467 million personally controlled e-health record system in July 2012.

While an announcement on the successful tenderer for the $218m smartcard and public key infrastructure is still pending, the spokeswoman said NASH had not been a mandatory requirement for the initial sites.

A NEHTA Specification Dashboard provided on March 14 to the ICT Implement Group managing the introduction of the personally controlled e-health record system included an unusual disclaimer.

A NeHTA spokeswoman has told The Australian the plan would be released “within the next seven days”.

The organisation recently announced a series of “tiger teams” to fast-track critical technical specifications needed for the PCEHR build.

As of next year, Australians will be able to sign up for a Personally Controlled Electronic Health Record (PCEHR). The prospect of having a single record containing a complete medical and health history is seductive - but it could also pose a computer security issue for many aged care providers and recipients.

The Government has recently hired IBM to develop a $24 million computer system that is intended to ensure only the right people can access information stored in those PCEHR records. It's an important step, but there are some who worry it does not go far enough.

To that end, the government set aside A$467 million and targeted an ambitious launch date of July 1, 2012.

Medical groups such as the Australian Medical Association lauded the notion, asserting that a shared electronic health record would help doctors deliver better care as they’d have access to a patient’s full clinical records no matter where he was treated. Health and consumer advocates were equally effusive. The proposed system would yield improved health outcomes, reduce medical mistakes and provide confidential health records.

Aged and palliative care are two of the key focus areas for a $20.6 million pilot program announced by the federal government in April. The national broadband network enabled Telehealth Pilots Program will provide funding for innovative schemes over the next two years.

The government hopes that the ability to harness technology to support high quality palliative care in home or aged care settings could deliver massive economic benefits, while responding to patient preferences regarding their ability to die in their own homes.

According to Dr Terry Cutler, chairman of the ARC Centre for Excellence in Creative Industries and Innovation (CCI) and principal of Cutler & Company, a nationwide e-health platform could help overcome looming staff shortages and rising costs in the healthcare sector.

“National health budgets are escalating out of control and we are spending $100 billion a year on healthcare,” says Dr Cutler. “Health experts predict that we will face major skills shortage in the sector - but employing more staff is not the answer, as there is little correlation between the number of doctors and health outcomes.

Australia’s peak health industry bodies have warned of the Federal Government’s e-health solutions becoming “siloed” without greater attention to standards surrounding implementation of technology for doctors and practitioners.

Both the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) expect there to be little in the way of further funding for e-health initiatives in Tuesday’s federal budget, following the government’s $467 million pour in to personally controlled electronic health records (PCEHR) last year. The government has also committed nearly $400 million to subsidising telehealth services from 1 July next year.

In 2010, $466.7 million of funding was allocated for a period of two years to launch a personally-controlled e-health record (PCEHR) system for all Australians from 1 July.

Funding for the program was scheduled to run out this year, however the program has been given a $233.7 million boost in the 2012-2013 Federal Budget.

The call follows an international report which found while the United States government was spending billions of dollars in incentive payments to encourage doctors to adopt electronic health records, those records could in some instances threaten patient safety.

The Institute of Medicine in the US is now recommending an independent agency be set up to monitor health information technology.

All Australians should be automatically signed up to the national health records system, according to a patients lobby group.

Consumer Health Forum, which represents more than 2 million consumers, says Australia should “bite the bullet” and make joining the system automatic unless patients choose to opt out.

The peak consumer body has turned to the Joint Select committee inquiry into Cyber-Safety for Senior Australians to raise additional concerns, including clarification around notification of data breaches on PCEHR records.

Some items have yet to be properly tested, which means complete rollout will take a few more months.

The opt-in PCEHR scheme allows consumers to enter personal information, medical history and medication details. They can choose which healthcare organisations can see and edit their record, and view a log of those who have accessed and added information to the record.

The Royal Australian College of General Practitioners (RACGP) has been given until October 2011 to create standards for video consultations with GPs.

The college revealed late Friday that it had been engaged by the Department of Health and Ageing to develop the telehealth standards.

College president Claire Jackson said the creation of nationwide telehealth standards were important, "given Medicare rebates and financial incentives for video consultations [with] patients in outer metropolitan, regional and remote Australia, across a range of specialties, will be available from 1 July 2011."

The $3.4 million digital information system replaces handwritten bedside notes and complements a similar system used in the wards.

It captures, displays and stores information about a patient's progress, assessment and treatment.

Health Minister Katy Gallagher says the new system will improve patient safety and clinical outcomes by reducing transcription and documentation errors.

The trial 'telehealth system' uses over-bed cameras, microphones and speakers to allow doctors in Canberra to assess critically ill patients in emergency departments at Queanbeyan, Moruya, Batemans Bay and Cooma.

The Federal Government has provided over $2 million for the trial which is being rolled out in selected south-east New South Wales sites.

The Department of Health and Ageing has agreed to resume the funding required to develop the technical standards that underpin its $466.7 million personally controlled electronic health record initiative.

The department had reportedly cut funding to an e-health standards development program by Standards Australia over the current financial year.