E-Health and the Implementation of the PCEHR Health Consumer Forum

E-Health and the Implementation of the PCEHR Health Consumer Forum Dr Mukesh Haikerwal AO NEHTA Head of Clinical Leadership Engagement & Clinical Safety August 2012, Victoria Room, MELBOURNE 3000 1 National E-Health Transition Authority www.nehta.gov.au

Mukesh Haikerwal AO General Medical Practitioner Head Clinical Leadership, Engagement Unit & Clinical Safety: NeHTA, Professorial Fellow, Flinders University, Adelaide Chair of Council, World Medical Association Broadband Champion (DBCDE) Chair beyondblue Doctors Mental Health Programme 19 th President, Australian Medical Association Ex-Commissioner, National Health & Hospitals Reform Commission NHMRC Healthcare Committee CSIRO / Australian E-Health Research Centre: RIAC 2 National E-Health Transition Authority www.nehta.gov.au

Billions of Dollars are being invested worldwide Canada Health Infoway AUS$ $11,7bn/10yrs Germany Gesundheitskarte AUS$ 11,8bn/10yrs Lombardy AUS$ 2bn/10yrs Hong Kong AUS$ 220M/10yrs USA - Barack Obama Plan AUS$ 28bn/5 yrs $1320/capita UK Connecting for Health AUS$ 26bn/10yrs Singapore AUS$ 190M/2yrs $466.7M/2 years $21/capita 5 National E-Health Transition Authority www.nehta.gov.au Source: Various publicly available sources available on the Ineternet From Booz & Company

Primary Care Primary Care AIHW 2012: Australia s Health The primary care sector: Despite its critical importance, the Australian primary care setting has not experienced the same national focus on data collection, collation and reporting as other areas of the health system, such as hospitals... there are little data or only poor quality data collected about a particular service type at any level of government. Source: AIHW 2011a. 6 National E-Health Transition Authority www.nehta.gov.au

Why involve the Private Hospitals and Private Health Insurers? 130 Million Source: AIHW 2011a. 7 National E-Health Transition Authority www.nehta.gov.au

Public Hospitals and Outpatients Outpatient services: Public hospitals In 2009 10, public hospitals: Provided more than 42 million service episodes for nonadmitted patients (not including ED services) 16.8 million occasions where individuals received a service through specialised public hospital outpatient clinics Source: AIHW 2011a. 8 National E-Health Transition Authority www.nehta.gov.au

Public Hospitals and Admissions 8.5 Million Source: AIHW 2011a. 9 National E-Health Transition Authority www.nehta.gov.au

Public Hospitals and Outpatients 6.2 Million 17 Million Source: AIHW 2011a. 10 National E-Health Transition Authority www.nehta.gov.au

Why involve the Private Hospitals and Private Health Insurers? 1.9 million elective surgery hospitalisations in 2009/10 661,000 in public hospitals 1.2 million in private hospitals Number increased between 2005 06 and 2009 10 average : 1.5% each year for public hospitals 4.9% for private hospitals Source: AIHW 2011a. 11 National E-Health Transition Authority www.nehta.gov.au

Page 12 Healthcare Identifiers the Flagship

What is an ehealth Record? From July 2012 onwards, every Australian can choose to register for an ehealth Record (formerly known as a Personally Controlled Electronic Health Record (PCEHR)): REGISTRATION WENT LIVE BY PHONE 1/7/2012; Walk in 2/7/2012; ON-LINE.on-LINE!8000+ Registrations The ehealth Record will allow patients and the healthcare professionals of their choice, secure online access to their vital health information There will be an area for patient to enter data for their own use 13 National E-Health Transition Authority www.nehta.gov.au

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Existing Hospital Referral Workflow 1.Receive fax 2. Lookup patient to retrieve UR 4. Make sure enough information to triage patient 3. Manually enter referral information in IT system. 9. Enter triage information FILE REFERRAL Send confirmation letter to GP 5. Photocopy fax letter to GP if incorrect 6. Put copy in a collection for clinical review 8. Get folder back from doctor, enter triage information into IT system 7. Doctor goes to OPD, picks up folder: does clinical triage 25 National E-Health Transition Authority www.nehta.gov.au

Existing Hospital Referral Workflow 1.Receive SMD referral X letter to GP if incorrect SMD X X 2. Patient matching: IHI ELECTRONICA LLY X X X 4. Make sure enough information to triage patient X 5. Photocopy fax 6. Put copy in a collection for clinical review 7. Doctor goes to OPD, picks up folder: does clinical triage 3. UPLOAD referral information in IT system. 9. Enter X triage information FILE REFERRAL Send confirmation letter to GP 8. Get X folder back from doctor, enter triage information into IT system X X X SMD 26 National E-Health Transition Authority www.nehta.gov.au

Julie Smith Scenario Steps Exit Scenario Key Scenario Steps (click to enter): Step 1 Julie gets access to PCEHR online services Step 2 Julie verifies her ehealth identity online Step 3a Julie creates her PCEHR Step 3b Julie sets up for a Record Access Code Create aus.gov account Verify Identity Completes Registration Access PCEHR

2700 52800 1 Julie Smith 04/01/1973

Julie Smith Julie Smith

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National support: Learning centre portal 54

Danger signs Not a critical mass Not enough useful information The system is too confusing and too complex Privacy and security are not addressed up front and central Balance Access to information and Security Clinical Utility / Clinical Safety Benefits are over-promised and under delivered The Governance of the system is unclear Responsibility for data quality and breaches Absence of must haves: Medications, Pathology 55 National E-Health Transition Authority www.nehta.gov.au

Health IT Truck.on the Road! 56 National E-Health Transition Authority www.nehta.gov.au

Health IT Truck.on the Road! 57 National E-Health Transition Authority www.nehta.gov.au

Thank you, Questions? Useful websites: www.nehta.gov.au www.ehealthinfo.gov.au www.yourhealth.gov.au http://www.abc.net.au/7.30/content/ 2012/s3524583.htm 58 National E-Health Transition Authority www.nehta.gov.au