OVUM評論：Personally controlled Electronic Health Records

AUD$466.7 million over two years is provided to fund the creation of a personally controlled “national e-Health records system”, which will enable Australians to check their medical history and provide electronic access to others if they wish. The system, it is claimed, will be a “key building block of the National Health and Hospitals Network”, and will provide summaries of a patients’ health information (including medications and immunisations and medical test results) and secure any-time, any-place access for both patients and health care providers to the patient’s health records. It will feature “rigorous governance and oversight to maintain privacy” and is also expected to provide the national standards, planning and core national infrastructure required to form the basis of a national e-Health records system.

While the funding is clearly in the right direction, industry reaction is typified by confusion as to exactly what the system will achieve and how it will operate in practice. AUD 466.7 million seems either too little or too much, depending on the scope of the initiative – Too little to actually create a national e-Health records system that is efficiently integrated into the hundreds of systems already operating within the sector. And too much to be prudently spent in such a short time frame – given the complexity of the situation, the legendary slow pace of government procurement and the Government’s track record of implementing complex operational projects ‘in a hurry’.

The key question on people’s minds is ‘how will the data in the system be populated?’ If the system is to be a ‘manual integration layer’ – i.e. a portal that providers and patients will voluntarily key data into – then the danger is that it will become another (duplicative) overhead task for already stressed healthcare professionals. This may be reasonable if it is a transition step on the path to a more seamlessly integrated future state, but how can one be confident about this when the system is only funded for 2 years? Uncertainty about the Government’s long term goals will be a significant obstacle for healthcare professional’s commitment to investing the time and energy to trialing and supporting the implementation of the system.

Providers throughout the sector will value an initiative by the Government to create a ‘better mousetrap’ – a fit for purpose health record system that gets everyone on the same page around a patient’s health history and current treatment. If the system offers a better, faster, cheaper way forward than each provider reinventing the wheel individually then it will be adopted and gain the critical mass of acceptance required becoming the common platform. A critical precursor of this, however, is confidence that this is the right horse to back. In this regard the Government’s decision to only underwrite funding for 2 years is a curious show of its commitment to what is an essential element of long term reform of the sector.