The Australian Medical Association said the personally controlled e-health record system should be an opt-out — not opt-in — service to boost consumer participation.
It said the personally controlled aspect of the e-health record system was a double-edged sword.
“The AMA supports individuals taking responsibility for their own health and recognises that personally controlled electronic health records could empower and encourage patients to do this,” the AMA said in its submission to the government’s PCEHR review.
“But it must be recognised that as a design feature of the PCEHR, patient control means that the PCEHR cannot be relied on as a trusted source of key clinical information.”
The AMA said an opt-out process would have been better as many people were not able to opt-in to the PCEHR.
“People who do not have the capacity to sign the registration form or have the legal documents in place to nominate an authorised representative to operate their PCEHR on their behalf.
“It may be that many of the people would benefit the most from the PCEHR may never have one – a consequence of the opt-in aspect of the PCEHR implementation.
“An opt-out system would have negated these particular barriers to consumer participation,” it wrote.
Low consumer participation was a barrier to medical practitioners who would be reluctant to use the system as a vast majority of patients don’t have a record or were active users.
In opposition, Health Minister Peter Dutton said that while more than 650,000 people had registered for an e-health record, only 4000-plus shared health summaries were created.
The summaries are generated by a patient’s GP and contain diagnoses, allergies and medications.
According to the submission, GP desktop software that interfaces with the PCEHR was built quickly and was not fit for regular use.
“Early experiences are that clinical workflow is neither seamless nor intuitive, adding to the time spent by doctors in accessing and uploading documents to the system.
“The AMA welcomes the work of the clinical usability program to address usability issues. This work should continue,” it wrote.
The association has called for a “practice” environment that is easily accessible from the desktop so healthcare practitioners can test drive the PCEHR before they use it in a clinical context.
“The PCEHR is governed by complex legislative arrangements that carry penalties for ‘unauthorised use’.
“As such, there is no environment for a medical practitioner who wants to explore how they might use the PCEHR in clinical practice to do so in a way that does not risk contravening the legislation,” the submission says.
AMA vice-president Professor Geoffrey Dobb said that while the AMA acknowledges concerns that patient privacy is paramount, it must be “balanced with the need for the PCEHR to make healthcare safer, more efficient and more effective”.
“Without fundamental change to increased clinical confidence, the PCEHR does not serve the best interests of patients.
“As a result, it would be rejected by many doctors and would fail,” Professor said.
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