Above: CEO of NEHTA, Peter Fleming

By Yasmin Noone

No goal is too big when you have inspiration.

CEO of the National E-Health Transition Authority (NEHTA), Peter Fleming, has likened the once thought impossible but successful job of putting a man on the moon to one other major task currently at hand – the creation of the Personalised eHealth Record (PCEHR) system for all Australians.

 During the Health Infomatics Conference in Brisbane, earlier this month, Mr Fleming described the establishment of the eHealth system as a massive “challenge”. But, he said, once overcome, it will significantly change the world in which we live and make a huge difference to the health care system of the future.

“With an ageing population and increasing costs, we do have to do something to address where we are at today,” Mr Fleming said.

"The world doesn’t remain stagnant and nor can we.”

Developing and implementing the new eHealth system is a “dive in the sand”, likened “to putting a man on the moon”.

“We are getting to a point where we can realise the dream. It is for all of us to pick up on that [goal] and make it successful. This is our big chance to make a difference.

“…We must aim towards that. We can’t do it as an individual. We must do it together.”

PCEHR’s are expected to be a secure, electronic record of an individual’s medical history, stored and shared in a network of connected systems. It will make information such as test results, discharge summaries, vaccination and medication histories and compressive medical records available to a range of health and care professionals.

The record is also meant to be accessible from anywhere throughout Australia.

It's a matter of privacy

The looming eHealth d-date that NEHTA is working towards is the 1 July 2012. This is when consumers will be able to register for a PCEHR.

However, despite the excitement circulating, many civil libertarians have expressed concern that the new system will free up the channels of information at the expense of an individual’s privacy.

Mr Fleming quelled the issue during his presentation, saying that the consumer willbe able to control their own eHealth record as they will decide what information it contains, what information it should exclude (for example, mental or sexual health details) and who as access to it.

“There are also a number of controls and legislative controls that would ensure privacy as well. The consumer will be at the centre of the [eHealth record] and have access to the record but so will the professionals who have been given access to it.”

Small steps towards a big goal

One of the key steps which moved NEHTA closer towards its 2012 goal was the creation of the Healthcare Identifiers (HI) Service last year.

The HI Service, currently operational in various places across the country, involves the allocation of a unique 16-digit number to each Australian resident enrolled either with Medicare or the Department of Veteran’s Affairs programs. This enables the accurate identification of the person who receives care, the clinician who provided care and the healthcare organisation they work for.

The successful creation of the HI Service in 2010 was widely publicised as a significant milestone. Yet, at the conference Mr Flemming admitted that the general public may not be aware of other milestones reached since then.

As he explained, NEHTA is currently collaborating with the Tasmanian Department of Health and Human Services (TDHHS), ACT Health and the Department of Health Victoria on ‘early adopter’ HI Service integration projects.

It is also working with Northern Territory Department of Health and Families (NTDHF) to develop a Web Services Secure Messaging Application (WSMA version 1).

Mr Fleming said that all of the pre-implementation projects will support the successful implementation of the actual eHealth system in the lead up to July next year.

“We want to get [the system] right in once place and then roll it out. We want to do this all once, get it right and share what we are doing.”

“This is our opportunity to prove what we’ve been talking about for decades and beyond…and to get it right.”

At the end of Mr Fleming’s presentation, he was asked about the process of consumer engagement currently employed, when the public would be consulted about the new system and whether or not their comments would be taken into consideration. 

Mr Fleming said that NEHTA is currently engaging and communicating with a number of key health peak bodies, and clinical and consumer engagement groups. Each representative then goes back to their organisation to report on what is being done and they also suggest what should be happening. This, he commented creates "feedback loops from both sides”.

Mr Fleming also mentioned that further public consultation will prove to be a matter of “getting the timing right”. Consumers should not be engaged before sufficient detail is made available yet they must be consulted before the project’s completion. The trick is deciphering the right time.

Guest speaker and Deloitte partner, Adam Powick, also addressed the issue of consumer engagment later in the conference at a different concurrent session.  

Mr Powick said he supported Mr Fleming's statement about timing and stressed the importance between striking the right balance between engaging consumers too early and releasing information too late.

It is dangerous to "engage the community on ehealth before we are able to deliver it”

“It'll be just like carbon tax if you are unable to explain."

“The trick is targeted communication..."