My Health Record will be Ineffective

Being able to opt out of the new My Health Record is going to make it difficult for GPs. Doctors will not be able to make a correct diagnosis with no record being available. The government is wrong in saying that the new system will have a summary of health information. It won't. GPs will be the ones updating information.

my health record path nowhere mja insight 25 july 2018 doctor portal home find doctor tools back tools resources gp desktop doctors health jobs bookshop learning events mja insight sign log profile privacy logout sign log home find doctor tools back resources gp desktop doctors health jobs bookshop learning events mja insight log sign log email address username email password log forgot password didn't receive activation email × subscribe home news views polls current issue previous issues mja mja podcasts search more_vert home news views polls current issue previous issues mja search × july 2018 health record path nowhere authored bernard robertson-dunn related links health record health care choice australians mja insight issue 25 july 2018 impending move opt out health record potentially have significant impact gps their work practices suggested gps need make informed decisions regarding their system advice they give patients following summary health record its context government’s broader agenda acquisition health datasets well way government attempting persuade gps participate its health record according government’s website health record secure online summary health information gives impression patient signs health record registered opt-out scheme they get summary their health information they won’t opt-out scheme register patient health record patient wants their health record contain shared health summary shs they must appoint nominated service representative often their gp work them populate manage regularly update information won’t happen automatically isn’t simple matter clicking button uploading data government’s website says first time you log health record there may little information information added visiting healthcare provider gp pharmacist hospital you begin add personal health information notes straight away data health record not health information they.

data relating patient’s medical treatment system not designed store health data weight height blood type alcohol smoking exercise patterns health record simple document database based primarily pdf files simply aggregated being integrated managed clinical perspective owned controlled federal government attached clinical hospital pharmacy imaging pathology systems upload medical data download medical data ironically supposedly personal health record patient cannot print copy their health information health record additional record system top addition gps’ existing systems requires extra effort manage yet offers benefit gp not data already gp’s existing clinical system pdf format data files makes difficult time consuming access lack context makes their research analytics problematic uploading shs not simply matter clicking button patient’s gp takes unknown responsibility liability sense has not yet been defined legislation tested court ama’s guide medical practitioners the personally controlled electronic health record system makes clear uploading shs not trivial exercise government’s website says creating shs nominated healthcare provider needs ensure aspects have been completed verify accuracy information contains assessing its content nominated healthcare provider should take account relevant information patient’s health record health record may include discharge summaries recent mja insight article critical its analysis title gps want clinical handovers not discharge summaries authors said real world gps grappling being thrown links hospital electronic records systems ‘the viewer’ investigations likely uploaded delay health record raw data unfiltered disorganised more throw handover being thrown raw data being expected catch them way akin hospital doctor being given.

login gp clinic’s patient management system being expected extrapolate referral probably applies equally summary documents shs discharge summaries event summaries issue raw data health record applies test results context useless best dangerous worst patients low health literacy numerical skills confusion meaning results common many tests reported same form doctor sees them even savvy patients may find ‘literally meaningless’ … situations we run risk patients misinterpreting there problem there assuming there’s problem there isn’t addition summary documents test results there data derived government systems health record not designed replace existing clinical systems appropriate federal government not directly involved responsible delivery health care services health record additional source summary health care data data derived existing health care systems words not data patient’s health record already their gp’s clinical system far largest number documents come medicare system comprising billing data minimal clinical information pharmaceutical benefits scheme prescription data 677 177 059 combined compared clinical documents 477 845 reported 29 april 2018 health record context announcements australian digital health agency website seem suggest government extending health record order relate medicare benefits schedule pharmaceutical benefits scheme data health care activities detailed data held gp hospital systems difficult see useful either clinicians medical researchers help gps know health record not initiative government pursuing regard health data government using data include australian bureau statistics project multi agency data integration project madip designed link data department social services department health department human services australian taxation office australian bureau statistics purpose madip create enduring linked publicly accessible research dataset hand help government agencies researchers respond nationally important policy service delivery questions practice incentives program – activities include continual improvements quality care enhanced capacity improved access health outcomes patients new division department health provider benefits integrity division responsible.

identifying investigating treating incorrect claiming inappropriate practices fraud department consulting stakeholders intention changing number acts proposed changes would amend health insurance act 1973 health insurance act 1973 dental benefits act 2008 allow department directly collect information employing organisations corporations hospital authorities practice records persuasion government planning actively promote health record gps variety techniques technologies information its intention available request expression interest rei government calls test beds repeated objective test beds project identify benefits health record not costs not risks not evaluate health record identify benefits says slide 16 21 minutes 30 seconds presentation available youtube their purpose promote innovation address australia’s highest priority health challenges generating evidence new approaches improve health outcomes tender documentation says rei process intended enable agency establish test bed projects produce evidence positive impact new digitally enabled services models care demonstrate they sustainable scalable first tranche test beds should include health record system utilised create new digitally enabled services models care particularly rapidly implemented already underway addendum test bed rei australian digital health agency provided information its activities six evaluation projects mentioned youtube presentation evaluating gps primary care health record improve their patients’ health improved medicines management sharing information reducing unnecessary duplication diagnostic services national prescribing service nps medicinewise university melbourne evaluating gps hospitals health record improve their patients’ health improved medicines management reducing unnecessary duplication diagnostic services reducing hospital admissions length stay pencs western sydney primary health network university western sydney nsw.

health educating gps health record improve their management patients’ medicines specifically deprescribing inappropriate medicines reduce unnecessary duplication diagnostic services project specific multifaceted education intervention medcast university wollongong quarterly tracking health care providers investigate awareness readiness attitudes experience regarding health record system early 2019 mcnair yellowsquares rodika research services changing clinical behaviour primary care using health record improve uploading viewing documents sharing useful accurate information informed clinical decision making project involves discipline behavioural economics behavioural insights team australia evaluating performance health record system conducting data analytics de-identified administrative non-clinical health record data investigate impact medicine management ordering diagnostic services adherence evidence-based care patterns health care associated costs conclusion australian digital health agency operators custodians health record government have failed understand health care professionals need better access current accurate well formatted managed high quality patient data few patients want access their medical data achieved minimal zero cost government improved interoperability patient portal access gp systems – available sweden gps benefit tools assist them understand data make better decisions current accurate point care data much more important historical data current focus health medical records danger turning gps data entry clerks lead burnout ineffective pseudo health summary record system doesn’t meet needs health professionals patients increase costs reduce medical effectiveness put patient privacy risk better sharing patient data health professionals has significant potential medical benefits giving them government doesn’t especially intent monitor question activities.

decisions health professionals unintended consequence health professionals further distracted health care having ify their activities decisions quo vadis health record health record replaces nothing nothing gps apart increasing their workload nothing patient gp can’t minimal cost required path nowhere major privacy risk potentially lead further bureaucratic inefficiencies may provide insights gp work practices clinical methodologies government has made plans persuade gps participate health record using variety mechanisms ly far unannounced would wise gps fully aware nature health record full range uses government make data system benefits patients techniques government contemplating bringing bear gps potentially health providers future health record hands gps dr bernard robertson-dunn not gp health care professional he trained electronic automation engineer has phd modelling electrical activity human small intestine has had 40 years modelling architecting designing large scale information systems ly government environments he has been following progress has contributed debate health record years he has association affiliation vendor government organisation he chair health committee australian privacy foundation statements opinions expressed article reflect views authors not represent official policy ama mja mja insight stated find doctor job gp desktop doctors health book track cpd buy textbooks guidelines visit doctorportal poll health record staying opting out select staying opting out older polls results loading 20 thoughts health record path nowhere anonymous says july 2018 49 excellent comments fully agree never heard guy but they should give him job govt health record make white elephants obsolete anonymous says july 2018 11 22 have watched diligent gp registrars sifting reams unhelpful allied health uploads searching important material success each them gave we have eventually multi billion repository mainly useless documents.

let’s call haystack needles hard find brendon wickham says july 2018 11 35 statement based primarily pdf files not correct documents cda format them computable it’s computable has already been used enhance content example medicines view extracts medication data different documents presents single view document types pdf pathology result main example many gps uploading shs has become simple task get point they find way embed their consultation workflow particularly their interaction patient granted data quality barrier needs work but gps not solely responsible work … it’s le practice usability clinical software improved lot it’s true hasn’t been tested court there apparent medico-legal risks tasks responsibilities involved different gps currently doing bernard robertson-dunn says july 2018 47 pm brendon re shs website used say creating shs nominated healthcare provider needs ensure aspects have been completed verify accuracy information contains assessing its content nominated healthcare provider should take account relevant information patient’s health record has now disappeared however there still reference ama’s guide medical practitioners the personally controlled electronic health record system say article makes clear uploading shs not trivial exercise based primarily pdf files were changed many documents based pdf files would there anything else substance you’d see modified there major question you willing give answer health benefits there patient’s data given government there number ways achieving government’s aims better health record giving health data government making system opt-out diminishes much usefulness reliability system comments would useful appreciated prof paul says july 2018 52 pm doubt matter time we see legal clerks spending hours days trolling info find trivial details have been looked basis hugely speculative ‘negligence’ claims.

defence funds respond paying out repeated moderate amounts expensive fight courts doctors premiums start sky rocket poor patients better off but partners lay firms able afford another luxury yacht not sure ‘wealth transfer’ meant work entire system it’s current form joke huge medico-legal risk anonymous says july 2018 59 pm patient multiple chronic conditions would have preferred billions wasted 30 years project had been spent primary secondary prevention has anyone decided time taken gp uploads added billed time gp consultation mine doesn’t bulk bill try find consultation time increases end paying for better outcome opt out soon possible enough us become irrelevant hopefully cancelled anonymous says july 2018 05 pm has always been more political ification billions spent people’s jobs system works unfortunately recent stick gps carrot pathology companies approach easy predict going happen gp ‘persuasion’ government words more appropriate fact gps hospital doctors bearing brunt system denial has been its biggest oversight has been forgotten way ‘myhealthrecord’ glory gps hospital doctors have responsibility care patients well incomplete records they forced look contribute untested medico-legal risk not contribute aim not take time alleges there lies problem ‘myhealthrecord’ would open their eyes answer right there they want anonymous says july 2018 40 pm excellent review confirms previously held thoughts programme high time society le outed purveyors schemes great wasters money they millions spent white elephant idea better used improve real health outcomes providing more actual health services we spending much time form rather content e.g plan process racgp gets more points actually updating learning new clinical information less mba’s more mbbs’s bsc’s anonymous says july 2018 15 pm agree agree agree promises sky but burden workers brendon wickham says july 2018 03 pm hi bernard i’ll respond order importance i’m assuming major question referring so-called secondary last time i’ll scare quotes – prefer abide record many times principle data means there never secondary question must health record data not given government agencies.

secondary mechanism following comment i’m not sure that’s actually you meant nevertheless secondary then answer should obvious secondary framework answers pretty well its appendices good methodology deep understanding context data useful insights derived going well should lead improvements outcomes patients better healthcare system overall caveat may not go well deep understanding not present i’d stronger reassurance involved accountable pay price should anything go wrong there indeed number ways improving healthcare system assume that’s you mean achieving government’s aims better health record but that’s limit comment can’t tell you mean seems you’re conflating secondary opt out you clarify it’s interesting website longer says … should take account relevant information patient’s health record understand why it’s gone current usability health record clinical software not make possible ama’s advice probably fair certainly not trivial but then doctor not trivial becomes problem workflow needs happen done either easily great difficulty depends components practice’s system working together possible shs upload fairly simple task gp confident data practice supporting her patient awareness practice data used re-used incorporated improvement then should quick fit easily consult conditions often not met improvements clinical software should have been place day have finally made technically easy but there elements friction but true many aspects clinical practice judging benefits uploading shs probably comes not you think concept shared electronic health record good think think we have starting point now should get better saying many documents based pdf files still misleading hardly making point you’re ignoring benefits atomic cda benefits already realised e.g medicines view you make difficult focus pdf manageable it’s not there few would change example – you say government has failed understand.

health care professionals need better access current accurate well formatted managed high quality patient data you’re talking here unicorn data ly doesn’t exist healthcare healthcare data extremely complex take us get workable shareable state incidentally health record help getting shape re-uses data – few patients want access their medical data encourage you read opennotes follow epatientdave statement isn’t true health literacy incredibly important outcomes more health literate person more important they find data but even non-health literate patients find themselves frustrated lack access effort improve situation usually leads increased health literacy – you should not compare insurance-driven system usa australia ehrs absolutely causing problem north american doctors but experience not shared same degree their australian counterparts though feel hospital clinicians wrestling usa software i’m not saying rosy usability needs much better there needs much richer understanding patient clinician experience but work field don’t think criticism reflects broader context health record fits anonymous says july 2018 14 pm another completely useless but costly squillions thought bubble previous federal labor government anonymous says july 2018 11 52 pm think public needs made aware system especially risks privacy negligible positives professional friends gps intend opt out many tertiary educated acquaintances risk people unaware need opt out short window opportunity mental health patients substance issues face real possibility discrimination their details uploaded mukesh haikerwal says july 2018 47 bravo bernard excellent piece hope widely disseminated read heed paid push has become hefty shove citizens have month window opt-out being opted-in become out-out system they really need access someone hold their hands guide them – not web-site podcast youtube video – but real person explaining record works today aspirations future log enable security settings actually good x00 000 ahpra registants eligible providers have fun enrolling understanding using.

being visible electronic health record – cui bono se benefit – dro http view du 30090274 .wzqbty5vcee.twitter anonymous says july 2018 11 mukesh – people cancel their record time opt-out period opt-out period hasn’t started yet meaning consumer awareness activities have yet really ramp-up mr robertson-dunn doesn’t seem understand information record isn’t visible patient helping them further understand their health but visible their health care providers true bulk useful information come gps but minute takes upload shs would great benefit patient overall wouldn’t anonymous says july 2018 12 35 pm wonder consumer awareness activities you expecting opt-out period tim kelsey head adha stated his recent press club address there would letters sent out patients nor would there tv radio campaign rather they would rely gps pharmacists educate patients heaven help time-pressed gps check-out chicks chemist warehouse supposed explain ins outs complex government policy bernard robertson-dunn says july 2018 17 pm course understand information record isn’t visible patient many people have access it downloaded myhr prohibitions authorisations don’t apply not government has free unconstrained access data protect public revenue it’s legislation – look something mentioned article behavioural economics techniques department health using it’s division bert http internet main publishing.nsf content behavioural-economics-research there’s report here you find interesting gp letter experiment bl dy hell bert https news gp-letter-experiment-so-what-bldy-hell-bert anonymous says july 2018 44 pm re true bulk useful information come gps but minute takes upload shs would great benefit patient overall wouldn’t response – uploading shs not necessarily great benefit patient done ad-hoc believe – ad-hoc snapshot health information – reliable don’t we want real time data re impact each consultation assumptions – standard consultation booked 15 minutes – maybe 12 minutes patient maybe minutes creating medical record additional – minutes myhealthrecord suggests either consultation time made shorter patient attend longer potentially pay higher fee medicare time goes 20 minutes has financial modelling been made available healthcare professionals.

community re issues even extra 90 seconds admin average gp consult means something 12.5 patient consulting time lost disclosure – currently working gp piotr says july 2018 39 pm think you’e never been doctor public hospital on-call weekend trying get information patient presenting ed unconscious peers provide collateral history even scarce information available emergency access health record extremely useful allows us provide better care let’s make effort make out wasted millions rather criticise resist anonymous says july 16 2018 02 pm own experience patient believe e-record obtaining second independent medical opinion condition become impossible independent second opinion saved me radical ‘suspected cancer’ surgery gp specialist radiologist another specialist surgeon suggested needed have surgery order save life 17 years track still alive never had cancer questions many patients have died medical errors doctors not knowing patients’ medical history serious adverse side effects medications won’t admitted doctors pharmaceutical companies outcome e-health records x number patients’ lives saved wouldn’t admission x numbers lives were lost past we were never told why there risk medical records not patient being treated broke leg end er important doctors learn e-health records three years ago antibiotics sinus infection checking records has taken longer relieve pain plaster leg unconscious er patient doesn’t carry personal identification kind e-health records useless then skills doctors nurses assess condition still believe doctors nurses well trained capable assess condition unconscious patient ‘doctor medication shopping’ yes there risk patients opt out may consult several doctors order get may dependency causing addictive medications yet pharmacies already keep records.

minimizes risk really would see is being made mandatory pharmaceutical companies pharmacists include detailed patient information each every packet prescription medication patient having ask horrified gps write x number tablets day potent prescription medications even cause drowsiness have ‘mild’ side effects accumulated not ‘mild’ wonder grand-parents parents managed survive their mid-eighties e-health records ken wilson says july 24 2018 41 billing information system good way checking you had last skin cancer check colonoscopy screen bowel cancer 60 i’m skin check annually colonoscopy every years you get reminders gp skin clinic specialist sometimes reminder system fails example they put new computer system simply lose records leave reply cancel reply email address not published comment name comment anonymously name hidden email always hidden email poll australian climate change inaction threatens lives select strongly agree agree neutral disagree strongly disagree older polls results loading latest tweets blurred lines happens misconduct comes patient 2ugh9ad thanks to… web status 1…

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