Summary by EMR INDUSTRY
- 22 doctors overlook the signs that one man was suffering from a serious drug addiction?Nathan Attard, 34, died alone, in an apartment infested with stray animals and filled with rubbish and drug paraphernalia.
- After the conclusion of the inquest into Attard’s death, Deputy State Coroner Carmel Forbes is expected to recommend a statewide computerised system that would allow doctors and pharmacists to share information and detect patients who are prescription shopping.
- ”Failure to establish an electronic patient record within five years would be an indictment against everyone in the system, including the government,” Prime Minister Tony Abbott said in 2003 during his first formal speech as he took over the health portfolio under John Howard’s leadership.
- The former Labor government began introducing an e-health system but like many of its commitments the roll-out was plagued with difficulties.
- More than 650,000 people have applied for e-health records but GPs have created only about 4000 shared-health summaries for their patients, which list their diagnoses and medications, because there is no clear financial incentive for GPs to spend the time to input all the information into the patient records.
Original News
How could 22 doctors overlook the signs that one man was suffering from a serious drug addiction? Nathan Attard, 34, died alone, in an apartment infested with stray animals and filled with rubbish and drug paraphernalia, a Sydney coroner’s court has heard. Doctors had prescribed him an array of medication including Xanax, morphine, Seroquel and Valium.
After the conclusion of the inquest into Attard’s death, Deputy State Coroner Carmel Forbes is expected to recommend a statewide computerised system that would allow doctors and pharmacists to share information and detect patients who are prescription shopping. Such a system is overdue. For years health authorities have been calling for an electronic prescription monitoring system, without result.
”Failure to establish an electronic patient record within five years would be an indictment against everyone in the system, including the government,” Prime Minister Tony Abbott said in 2003 during his first formal speech as he took over the health portfolio under John Howard’s leadership. He failed that time, let’s hope his government does not fail again. The former Labor government began introducing an e-health system but like many of its commitments the roll-out was plagued with difficulties. Just before the election several experts charged with rolling out the billion-dollar project quit the program amid claims the Department of Health and Ageing was more concerned with signing people up to the systems than providing a record that could be usefully managed by doctors.
More than 650,000 people have applied for e-health records but GPs have created only about 4000 shared-health summaries for their patients, which list their diagnoses and medications, because there is no clear financial incentive for GPs to spend the time to input all the information into the patient records. The Australian Medical Association has called for the government to overhaul the scheme. AMA president Steve Hambleton fears concerns over privacy have trumped common sense. Under the system being developed, patients will be able to go in and delete records after a doctor has entered them. This means doctor shoppers, especially those who accumulate prescription drugs, could remove records showing their behaviour.
While Attard’s case is extreme, many Australians have become doctor shoppers in part because of the corporatisation of general practice and the rising gap between Medicare rebates and doctor charges. This month the AMA will recommend that GPs increase their charges from $71 to $73. This means patients will be left more than $36 out of pocket for a GP visit that in many cases lasts only a matter of minutes. Those who seek a bulk-billing GP usually find they have to use large clinics where GPs operate on a roster and patients must see whoever is available.
This makes treatment more difficult, especially for complex psychological and pain-related problems for which much addictive medication is prescribed. If Attard’s GPs had been able to access an electronic record, his death could have been prevented. But not under a system where overworked GPs are unlikely to enter the information in the first place, or where patients are able to delete it.
Any calls for NSW to go it alone in implementing an e-health system should be heard with caution. The health system already has too much duplication and does not need more state systems that are incompatible at a federal level. The problems implementing the e-health system nationally point to the challenges of implementing such a system. Cost is also an issue, as doctors and pharmacists will likely want significant funding invested to make the system easy to use.
Privacy is also a concern. Governments now collect more data on citizens than ever. General practice is federally controlled, so the state government imposing a system of data collection that carries privacy risks is an unwarranted intrusion when a federal system is already under way. The previous government proposed giving each Australian an identification number to be used to call up records from all the hospitals, clinics and doctors the patient ever visited.
To allay privacy concerns, patients could have control over who had access to their records. These records should be viewable by patients, but not changeable (to prevent, for example, doctor shoppers deleting multiple prescriptions from different doctors). Privacy concerns are valid, and people should be able to opt-out from e-records, but for the rest of the community privacy concerns should not trump the implementation of an efficient, useful national electronic system. source
