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The Forum > Article Comments > eHealth > Comments

eHealth : Comments

By Andrew Leigh, published 15/3/2012

eHealth will allow all a patient's medical professionals access to all of their records.

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I totally agree with the concept of a shared electronic health record but our current plans do not go nearly far enough.

I understand that only summary information is to be shared. In reviewing a complex patient the information provided by a minor player in the patient's care may be the most important. For example suppose the district nurse who goes to change a dressing finds out that the patient is filling prescriptions but not taking them. This is critical information for the GP to know so that a discussion can take place with the patient so that alternative therapies can be instigated.

The ehealth records seem to be electronic medical records.

Where is the capacity to add home monitoring data to the record - data like home blood glucose monitoring, holter monitoring or blood pressure monitoring? This is very valuable data for the clinical team to monitor.

Where is the capacity to put lifestyle data into the record? For chronic disease patients measures of physical activity, nutrition, substance (alcohol, drug, tobacco) use, and sleep are important measures that would be vital to preventing recurrence or complications of chronic diseases and even used for at risk patients to defer or stop the development of disease.

And why oh why is this opt-in? With chronic disease expanding at a faster rate than we will be able to cope with and medical/health costs predicted to skyrocket surely an opt-out model would be more beneficial. Despite the chattering classes the vast majority of the population support appropriate transfers of information.
Posted by John Wellness, Thursday, 15 March 2012 3:30:26 PM
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From someone working in a state Emergency Dept, there are undoubtedly benefits to the incoming PCEHR system. But I agree with commenter above that there a number of reasons why it will prove an insufficient tool for clinicians - amongst them the summary nature of the record, and the opt-in nature of the program.

Discussed in more detail here: http://cousinzoidfarb.blogspot.com.au/2012/03/electronic-health-records.html

Lets hope that development of a more comprehensive system doesn't stall after the introduction of the PCEHR
Posted by CousinZoidfarb, Thursday, 15 March 2012 3:57:50 PM
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OK, OK, so long as I can have a prominent E-record telling those "emergency" people: "Doctors, my body is my own and you are not allowed to touch it under any circumstances".
Posted by Yuyutsu, Friday, 16 March 2012 3:39:29 AM
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They will only touch your body if you give them your pass word.
Posted by 579, Friday, 16 March 2012 7:40:16 AM
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The ability for a person, or anyone they authorise, to access their own health records is embedded in existing privacy legislation. We could have had ehealth 10 years ago if we wanted.

The current approach of basing identification around an ehealth id is fundamentally flawed and it is proving expensive and difficult to implement. The reason is that the ehealth id's have to be protected by people who hold them. It means that every health provider is going to have to change their systems to include the ehealth id and then put in place expensive systems to protect the id and the health records. However, it gets worse because all health problems are going to have to be coded in standard ways and that is challenging - and expensive.

We do not need an ehealth id with all the expense and privacy issues it introduces. There is a standards initiative called User Managed Access being developed by the Kantara group. This allows users to manage their own information. UMA is cheap to deploy and there are successful implementations of the idea in wide spread use today.

We do not need to predefine health conditions. We can do it when a new provider comes on to the system and they can define what data they have. With UMA the system can define on the fly (much like google does with search) what each data item means.

The government could allow UMA implementations to run in parallel with the government ehealth and this would guarantee its takeup and significantly reduce the running and implementation costs.
Posted by Fickle Pickle, Monday, 19 March 2012 8:32:52 AM
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