Include transfer info in electronic records: IT council

The Personally Controlled Electronic Health Record (PCEHR) must sufficiently cover patient discharge and transfer summary between acute and aged services, providers have told the eHealth review.

The Personally Controlled Electronic Health Record (PCEHR) must include sufficient patient discharge/transfer functionality, complete medication records and meaningful capture of vital signs for health conditions.

That’s according to the Aged Care Industry Information Technology Council (ACIITC) in its submission to the federal government’s review of the PCEHR.

ACIITC, which is a joint venture of Leading Age Services Australia (LASA) and Aged & Community Services Australia (ACSA), said that discharge from hospitals and transfers between aged and health services was a key area to complete the “integrated health concept” in critical information flow.

Given that an older Australian who is admitted to a hospital stays there for eight days on average, a transfer document has information that is essential for quality care, typically covering food, prosthetics, cognitive capacity, dermatology, continence, medicines and updated care directives. 

However, considerable energy is wasted in hospitals and residential facilities in the transfer of residents between one another, “usually with minimal or no formal documentation,” the ACIITC submission said.

“The introduction of a transfer document in both directions would simplify the exchange of information between both settings thus removing the current highly inefficient transfer mechanism,” it said.

Similarly, given the increased use of telehealth services for the monitoring of vital signs for health conditions, the PCEHR must capture this in a meaningful way as the older person travels across the health system.

Elsewhere, the submission noted that payments had been made to state hospitals and GPs to facilitate their implementation of eHealth and the PCEHR. “What plans exist to financially facilitate the aged care sector to participate in adopting the PCEHR,” it asked.

Involved in development

The PCEHR was a revolution for consumers and healthcare providers, however aged services had been left behind as there was no effective voice or aged care industry representation in governance arrangements with respect to PCEHR, said Adjunct Professor John Kelly, CEO of ACSA.

The ACIITC submission pointed out that aged service providers come second only to the state health system in volume and it called on the federal government to involve the sector in any further development of the PCEHR.

“The PCEHR represents a national infrastructure that enables consumers to use primary care, state hospitals and the aged care sector,” said Patrick Reid, CEO of LASA. “Primary and acute care providers have been funded with incentive and continual payments to implement PCEHR but there has been no similar funding of age services.”

Adj Prof Kelly said that despite proposing solutions on how to engage with aged care with respect to the PCEHR by participating in several consultations, providing briefings over the last few years and delivering the Pathfinder project for the Commonwealth Department of Health within six months, “we are yet to see an emergence of a coherent and consistent endorsed strategy for older Australians that will realise the objectives of this national investment.”

Doctors: opt-out is best

Elsewhere, the Australian Medical Association has called for the PCEHR to be an opt-out system, rather than the current opt-in arrangement.

In its submission to the review, the AMA said: “A patient opt-out system would ensure high consumer participation, particularly from patients with high needs, which would provide doctors with a better incentive to commit to using the system.”

The AMA also suggested:

  • ensuring key clinical information is available to all treating doctors, for all of their patients with electronic health records;
  • moving quickly to assist other medical specialties and healthcare organisations to have the capability to view and upload relevant documents to the PCEHR; and
  • ensuring that medical software provides seamless access and upload of agreed documents and information to the PCEHR.

The PCEHR review is due to report back to Health Minister Peter Dutton by mid-December 2013.

Related AAA coverage: eHealth review to probe private sector buy-in 

Tags: aciitc, acsa, john-kelly, lasa, patrick-reid, pcehr,

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