The government has been preparing for the launch of personally controlled e-health records (PCEHRs) for two years, but what will be available on 1 July will be far from a complete e-health record system.
When the government announced the e-health record system in 2010, it was vague in detailing exactly what would be on offer from July 2012. The intention was that personally controlled electronic health records would be “rolled out from July 2012”, but what the Australian public would actually be able to do from day one was a mystery.
Previous Health Minister Nicola Roxon held press conferences extolling the virtues of the system, which she said would eventually be like accessing a bank account online.
As time went on, the government defined what exactly would be available on day one. In early 2011, Australians were informed that “by 1 July next year, Australians who want to register for a personal e-health record can do so”.
In mid-2011, the government said that people would be able to register online, by phone or in person at Medicare outlets by providing a full name, an individual healthcare identifier and a Medicare number or Department of Veterans Affairs number, in addition to their gender and address. These details will be verified with a trusted source. The users will then be provided with an activation code to access their record.
By early 2012, amid claims of National E-Health Transition Authority (NEHTA) mismanagement of the records system and systemic problems with the development of individual health-identifier specifications, the government has maintained that Australians will be able to register for e-health records from 1 July.
In the Budget this year, the government committed to pumping $233.7 million into e-health over the next two years in order to get the e-health record system up and running, with 500,000 people expected to register for the service in the next financial year.
At the time, Minister for Health Tanya Plibersek said that uptake for e-health records would be gradual.
“The roll-out of the national e-health system will be gradual and carefully managed — this is the sensible and prudent way to implement such a large and transformational infrastructure project,” she said.
It seems that she will be right, as there won’t be anything really to take up from the government’s deadline. According to the Department of Health and Ageing deputy secretary Rosemary Huxtable, registration for an e-health record will be just about all that is available in just under a month at launch time.
“From day one, the focus is very much on consumer registration, so it will be the capacity of consumers to ring through the Medicare call centre or attend a shopfront and register for the record,” Huxtable said in a Budget Estimates hearing last week.
But while the department is pushing to have online registration available from 1 July, Huxtable said that online access may be delayed for a few weeks.
“Basically, once a consumer has registered, they then will be able to go in through a consumer portal and put information into their record. That can include information about allergies or reactions, and information about complementary medicines. There will be an area of the record where they can provide consumer-entered notes so they can keep their own notes on health events. That is the first tranche of functionality.”
The next phase of the roll-out will not occur until September, when GPs are provided with software upgrades in order to upload patient information to the e-health record system, she said.
“The next tranche of functionality is around provider registration and the capacity of providers to upload clinical information. That will follow within a few months of 1 July,” she said. “That will be more like September.”
Immunisation information, Pharmaceutical Benefit Scheme information, Medicare Benefit Scheme information and organ-donation information will also be made available in the next few months, she said.
The readiness of GPs to deliver e-health records across the board is a contentious issue, she said.
“There is already a … health summary review that is being trialled in the wave sites. There is a level of readiness in some regard. In pathology — and I am not necessarily across all the technical detail with that element — there is work that needs to be done to get that sector to a greater state of readiness,” she said.
“The business case that underpinned the funding of the [personally controlled e-health record] always recognised that there would be a number of release stages. Our aim is to get as much information into the record from 1 July as possible.”
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