eHealth

Many aspects of our Australian healthcare system are migrating to new electronic services, called eHealth.  eHealth is "the combined use of electronic communication and information technology in the health sector" (The World Health Organisation). 

eHealth is a major focus for the Australian Government. Central to a move to eHealth services for the Australian government’s eHealth reform program is the Personally Controlled Electronic Health Record (PCEHR).

Through a PCEHR, patients can access their personal health information, whenever they need it. And, with patient permission, their healthcare team can access their health information when they need it.  

The benefits to patients from eHealth are vast.

As an example, in January 2011, the Hon. Nicole Roxon, Minister for Health estimated that E-health, including PCEHR, will help prevent medication errors that cause an estimated 190,000 hospital admissions each year.  This improvement in health outcomes is paralleled in financial benefits. Deloitte Consulting has estimated that for every dollar invested in eHealth in Australia, we’ll see more than two dollars back.

The introduction of a PCEHR is expected to overcome the suboptimal or inadequate patient care that can be partly attributed to paper-based medical records. Traditional paper based records can be lacking in accuracy, completeness, availability, and legibility. By allowing better accessibility, accuracy, and completeness of medical records, the PCEHR is expected to improve patient care.

A PCEHR should improve care coordination between healthcare providers. Since the prevalence and incidence for chronic diseases are on the rise, a multidisciplinary approach is used in the management of complex chronic diseases. It was found that in the US, electronic health record implementation improves care coordination by improving sharing of and access to medical information as well as communication of treatment objectives (Graetz, Reed et al. 2009).

PCEHR should provide safer, faster care, based on better access to patient history. For example, in Scotland, (Sullivan, Donnan et al. 2004) shared patient medical records improve care for patients with illnesses such as coronary heart disease, as identification of patients at high risk is critical to ensure prompt delivery of secondary prevention. The shared electronic medical records allow ease of identification of those patients with high risks. 

PCEHR gives patients access to their own information - improves adherence to preventive care measures and chronic disease management. In the UK, another PCHER equivalent, The Patient Access to Electronic Records System (PAERS), promotes shared decision making between patients and their doctors. Fisher and colleagues (2009) reported that for those able to access their own medical records, 76% of those surveyed indicated that they feel more involved in their health care; 62% understood better what was discussed at appointments with doctors (Bhavnani, Fisher et al. 2011). 

Improvements in patient care can be reflected in reductions in ambulatory care. Improvements in patient care can be reflected in the changes that resulted from the implementation of shared patient e-medical record. There were reductions in access to ambulatory care, more effective telephone contacts, reduction in radiology and pathology services by 14% and 18% respectively (Garrido, Jamieson et al. 2005). 

Standards and quality

An important feature of eHealth is interoperability.

Interoperability is the capability of an organisation or system to use, offer and exchange business or technical services with another organisation or system. The National eHealth Transition Authority (NEHTA) is guiding the development of eHealth systems through nationally defined standards for interoperability. These standards enable eHealth systems to evolve without being constrained by propriety software products. These developments have the support of the Australian government as part of the overall eHealth transformation to improve the quality and safety of our healthcare system.

NEHTA’s Compliance, Conformance and Accreditation (CCA) program is responsible for developing a national framework assuring that systems comply with Australian specifications and demonstrate appropriate standards of interoperability, security and clinical safety in the way they handle and exchange information.

Aged Care