While Health Minister Nicola Roxon said consumers would "truly control" their personal electronic health records at her e-health forum last week, attendees did not see a draft concept of operations, showing a patient portal tacked on to a public/private providers' shared e-health record system (SEHR).
The confidential draft for the $467 million personally controlled e-health record (PCEHR) system was produced by the National E-Health Transition Authority, just before the forum.
The Australian has obtained a key system design diagram, which shows there is no mechanism for consumers to manage access by their doctors.
On the contrary, it appears providers will continue operating largely as they do now. An e-health analyst who examined the material said it revealed an SEHR with "an access path for the consumer" on top. "The diagram shows that while patients will have a window on some of their information, the routine flow between GPs, specialists, pathology and so on will remain unchanged," he said. "It will also remain as invisible to the ordinary consumer as it always has been.
"The present design also makes it clear that NEHTA plans -- at the very least -- to create a virtual repository of summary clinical information, with all the attendant hazards that brings."
Ms Roxon had said the PCEHR would not involve the creation of a "massive data repository". Instead, the system would link data held in GPs' systems, at the pharmacy and within hospitals.
The draft design shows there will initially be regional and state SEHRs set up for the three lead implementation sites, with a national repository and Medicare databases linked in at an early stage. Later on, a range of personal health record, registry and diagnostic imaging repositories will be made available through the service layer.
NEHTA clinical lead Nathan Pinskier told The Australian discussions on the shape of the PCEHR were still proceeding. "The model currently being proposed is one of a series of conformant repositories interlinked through an indexing system," he said.
Dr Pinskier said NEHTA was working with the Royal College of General Practitioners on the core data set needed for a patient record summary.
"It's proposed that GPs act as the custodian of data for people who opt in," he said.
But the e-health analyst said it was unclear why medical providers would volunteer information from their own systems.
"Doctors are unlikely to bear additional costs and effort to provide patient information to the PCEHR unless there are some pretty significant incentives for doing so," he said.
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Autor(en)/Author(s): Karen Dearne
Quelle/Source: Australian IT, 07.12.2010
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