issues and consider the implications of the recommendations. It is important to note that the feedback I am getting from government is also positive and shares my view that eHealth has a strong future. Ultimately, we all want to see meaningful use of the PCEHR. It needs to be delivered in a seamless way that fits with the way health practitioners work. Importantly, the right people need to be registered – those with complex and chronic disease and those who need to see multiple providers. Having a system where we can access a patient’s medical information quickly would make our job quicker, safer and more efficient. Let’s take a look at some facts. The cost of delivering healthcare in Australia has reached almost 10 per cent of GDP, and chronic disease in Australia is responsible for about 80 per cent of the total Australian healthcare burden. Changing demographics and the increasing prevalence of chronic and complex disease are driving demand for greater efficiency and effectiveness in healthcare delivery. Every year Australians have an average of 22 interactions with the health system, including: four visits to a GP, 12 prescriptions, and three visits to a specialist. Most of the information from these interactions with patients is held in separate clinical information systems, with a mix of hard copy, paper-based records. Most of these records can’t be shared electronically from practitioner to practitioner. Evidence from research into medication safety indicates that significant patient harm and sub-optimal use of medicines frequently result from the discontinuity that occurs when patients visit different healthcare providers. This is one of the fundamental drivers for eHealth as the benefits will be realised by the reduced incidence of adverse drug events per hospital separation, thereby resulting in
“... the feedback I am getting from government is also positive and shares my view that eHealth has a strong future.” Dr Steve Hambleton
reduced patient harm and mortality in hospital settings. The lack of a cohesive approach to records management also significantly increases the risk of errors such as misdiagnoses, lack of awareness of adverse reactions to treatment, and the over prescribing of medications. Almost two million Australians experience an adverse drug event each year and approximately 200,000 of these end up in hospital. Clinical studies have proven that adverse drug events can drop by up to 60 per cent through better surveillance of prescribing behaviour. This is why access to a patient’s medication history is so important.
Program of work NEHTA’s program of work for the next 12 months represents a focus on adoption and meaningful use, creating a critical mass of users who are connected and meaningfully using eHealth to deliver better healthcare. While it is essential that the focus on quality and safety benefits remains front and centre, there needs to be strong emphasis on ensuring that reliable information from a connected community of healthcare providers is available in the record. NEHTA and the Commonwealth have been working with representatives of the peak health bodies and leadership groups, through a Clinical Usability Program (CUP), to ensure that NEHTA can provide
appropriate guidance to software vendors to improve the usability of the PCEHR in their products. The CUP has three scheduled releases for GP desktop software vendors regarding usability improvements based on the advice of GP consultation workshops. These improvements cover issues such as providing consistent presentation across the vendor packages, removing spurious information from vendor screens and providing a consistent approach to populating the shared health summary. Importantly, all of the usability improvements have been driven by clinicians. The eHealth ‘technical solution’ has been delivered and all stakeholders including the Commonwealth, the state and territory jurisdictions, the NEHTA board and the peak health bodies are working together to improve usability and drive meaningful use. We await the government’s final determination of the Royle review recommendations, which will set the course for the future direction of the PCEHR. I see a lot of opportunity for eHealth to deliver better clinical outcomes for patients and save the sector money. As former AMA president and a member of the PCEHR review panel, I see it as a natural progression to accept the role of NEHTA chair and to provide the NEHTA board with a direct connection to my colleagues at the frontline of Australian healthcare.
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