The AMA Offers Some Input On The Possible Future Of The myHR. They Are Not Yet Convinced By Any Means I Would Say!

It is the season for Pre-Budget Submission for the 2018/19 financial year. Here it the link to that provided by the AMA.

https://ama.com.au/gp-network-news/ama-pre-budget-submission-strong-gp-emphasis

There was relevant comment provided here:

AMA calls for improvements to My Health Record for it to reach potential

Lynne Minion | 15 Dec 2017

My Health Record has the potential to save lives and deliver economic benefits but the system needs improvements and doctors don�t have time to talk patients through the opt-out process, according to the Australian Medical Association.

In its Pre-Budget Submission 2018-19, the doctors� advocacy group this week claimed the federal government needs to invest in improving the national repository of Australians� healthcare information for it to reach its potential.

�The AMA believes a fully functioning and widely used My Health Record will not only save money but save lives. Ongoing improvements will help ensure its success,� the submission says.

�Electronic medical records promise much,� the AMA says, with early wins predicted to be reduced adverse drug events and duplication of diagnostic tests. Developing the platform�s functions could lead to additional gains.

�We note government estimates anticipate that the My Health Record will generate savings of around $123 million by 2020-21. Further iterations of the My Health Record could become even more useful to clinicians and patients alike via features such as recording specific prosthesis details, enabling targeted notification of drug recalls, and providing the opportunity for understanding of aged care directives and patient wishes.�

But the submission claims �more work is required� to minimise the burden on doctors and ensure interoperability with healthcare provider software.

Lots more here:

http://www.healthcareit.com.au/article/ama-calls-improvements-my-health-record-it-reach-potential

Here is what the AMA had to say on the myHR (Page 23 on)

10. My Health Record.

The My Health Record will offer digital access to a core summary of important patient clinical data when it matters most� at the time of treatment � irrespective of the clinician�s specialty or physical location in Australia.

Electronic medical records promise much. Early wins are expected in reduced duplication of diagnostic tests and reduced adverse drug events. A recent study estimated that admissions  due to adverse drug events could be as high as 230,000 per year, and cost $1.2 billion per year.  It has the potential to improve the information flow between hospital doctors and general practitioners when patients present to hospital and are discharged.

We note Government estimates anticipate that the My Health Record will generate savings of around $123 million by 2020-21. Further iterations of the My Health Record could become even more useful to clinicians and patients alike via features such as recording specific prosthesis details, enabling targeted notification of drug recalls, and providing the opportunity for understanding of aged care directives and patient wishes.

But more work is required. The return on investment will hinge in the short term on ease of use for medical practitioners who upload the clinical data. Interoperability with the multiple software packages used across the medical profession and broader health sector must be seamless.

Problems uploading specialists� letters, poor search functionality, time-consuming adaptations   to existing medical practitioner work practices, or inappropriate workarounds will erode clinical utility and deter doctor use � and, more importantly, take time away from focusing on the patient.

Doctors do not have time to talk their patients through the My Health Record arrangements for opt-out, privacy, setting access controls in standing consent for health providers to upload health information. This is the work of the Government. Doctors must be allowed to focus on what they do best � caring for patients. The lack of reliable broadband is also a barrier that will need to be addressed if nationwide, digitised health care is to be achieved.

The shift to opt-out arrangements in mid to late 2018 is also a critical success factor. Some Australians will be surprised to learn that a My Health Record has been created for them without their explicit consent. The communication campaign must reach as many Australians as possible, and promote a positive attitude towards the My Health Record created for them.

Privacy, health data security, and health data disclosure are also hot button issues � for doctors and patients. These will need to be carefully managed to maintain a high level of participation post opt-out.

The AMA believes a fully functioning and widely used My Health Record will not only save money but save lives. Ongoing improvements will help ensure its success.

This forms up to an AMA Position shown on the next page:

AMA POSITION

The AMA calls on the Government to:

�           guarantee that doctors will not bear unnecessary costs for guiding patients through the intricacies of the My Health Record system for arrangements for opt-out, privacy, setting access controls in standing consent for health providers to upload health information;

�           fully fund an opt-out communication campaign to avoid widespread fear-driven decisions to opt out;

�           appreciate the high level of community concern about the My Health Record�s impact on patient privacy and health data security;

�           invest in the ongoing improvement of the clinical utility of the My Health Record so it becomes a value add tool for clinicians in their day to day delivery of quality patient care;

�           provide specific support for specialists to adopt the My Health Record;

�           fund work to achieve a seamless interface between the My Health Record and My Aged Care; and

�           excellerate the establishment of health data standards needed to make interoperability a short-term reality.

When you read what the AMA actually says � typo and all � it seems pretty clear that the AMA thinks:

1. The myHR is by no means fully evolved as far as being useful and user friendly.

2. The Government needs to spend a good deal more to get there.

3. Electronic records hold great promise � i.e. after 5 years we are yet to see realisation of that promise.

4. We are concerned that there may be additional costs that we might see doctors saddled with. For us it all has to be overall cost neutral or better.

5. Much of the populace are concerned about security and privacy and may be somewhat startled by the introduction of opt-out if the communication and explanation is not very well conducted.

6. Given time is money there is concern a lot may be wasted on poor systems and explaining opt-out.

7. Health Information Standards need a lot of work.

I would say their position is as negative as it could be given they have signed a Memorandum of Understanding on all things myHR, among others, with the Government. Here is the link about that:
https://www.australiandoctor.com.au/news/racgp-ama-formed-pre-budget-pacts-govt
and also here:
http://www.health.gov.au/internet/main/publishing.nsf/Content/0FFB2BE666C5627ECA25811B002759EB/$File/Shared%20vision%20AMA.pdf

They clearly see there is a long and expensive way to go with success by no means guaranteed. They also see the move to opt-out as a big risk � as so many of us do!

David.