BARRIERS TO PCEHR UPTAKE ON THE FRONTLINE Misinformation and hype have dogged the PCEHR throughout its development, and many doctors are still confused about its purpose. It’s very early days yet, but in the meantime, general and specialist practices are drowning under the load of scanning of clinical documents send by fax or post. While we wait for the PCEHR to become embedded in medical practice, we must begin to tackle secure messaging.
KATRINA OTTO BEd (Adult), DipBus, Cert IV Principal, Train IT Medical email@example.com
As we wait for the federal Health Minister to reveal his plans for the PCEHR, it is worthwhile to look back and assess how far we have come with the system, and how far we still have to go. Having trained hundreds of clinicians and practice managers in the use of healthcare software over the last 15 years, I know from practical experience just how hard it is to get any consensus on how a system should look and feel, and the eHealth system is no different. I remember running some training sessions at a software conference some years ago when NEHTA gave a presentation on the concept of the PCEHR. In those early days, the negativity about the concept was extraordinary. That has dissipated somewhat, especially when clinicians actually begin to use the system, but some negativity is still there.
About the author Katrina Otto is owner and principal of Train IT Medical and offers software training and practice management consultancy services across Australia. An experienced practice manager, she is also a qualified teacher and has been delivering accredited qualifications in medical administration and technology for the past 20 years.
I will detail the main barriers to wider adoption as I see them, but first I would like to emphasise that I have seen huge progress in the last year as doctors have begun to discuss not just the concept, but the practical use of the system. There is no getting around the fact there will be a lot of work for clinicians and practice managers, either cleaning up data or adding clinical data, and things do not move quickly in the medical world.
However, the more we rush it the more likely it is that it’s going to end up as a failure, whereas it could be fantastic. I have trained people who have been using eHealth tools for many years, and they are far more accepting of the PCEHR than most. They can see that it is not taking up more time, but actually saving time in other areas and improving safety. That being said, here are some of the barriers to more widespread use of the system. 1. GPs are not being remunerated for their time and effort Every doctor I have met agrees the PCEHR ideally would be helpful for accessing patient’s up-to-date medical information. The problem lies in who will keep that information up to date. It predominantly falls on the GPs, but to keep it up to date in their software is a constant, ongoing workload, particularly for patients with chronic illnesses. Every time that patient sees a specialist or allied health professional or is discharged from hospital, the GP ideally updates that patient’s health summary, even though they may not see the patient again for a year or even possibly ever see them again. And they don’t get paid to do that. The other option is to wait until the patient makes an appointment to get their