Interesting times in eHealth

Thursday, 11 June 2015

The potential of eHealth to enhance the delivery of health services in rural and remote communities has always been apparent to the National Rural Health Alliance. The Alliance has supported the advancement of ‘digital health’, not as a replacement for health services, but as an effective and efficient use of technology to overcome some of the challenges associated with rural and remote practice. Our support for the use of technology continued at the recent 13th National Rural Health Conference in Darwin. There was a strong focus on tele-health and eHealth in rural and remote health with over 10 presentations given on the subject as part of a dedicated concurrent session on applications of tele-health, and a colloquium on the health service applications of broadband in rural areas.

Prior to the Conference, the Alliance attended a briefing by the Commonwealth Department of Health on proposed changes to the Personally Controlled Electronic Health Record (PCEHR). Mr Paul Madden, Department Deputy Secretary and Chief Information and Knowledge Officer, gave a presentation on the transition from the PCEHR to ‘My Health Record’ (MHR). One of the key differences is the shift to an opt-out participation trial.

Here are some key facts regarding the PCEHR system:

  • More than 2.2 million people are currently registered on the system.
  • Registrations are increasing at a rate of about 10,000 per week with the top states being NSW, VIC and QLD.
  • 7,654 healthcare organisations are registered to access the PCEHR system.
  • The Government has committed $485.1 million over four years to improve the operations of eHealth records, bring in new eHealth governance arrangements and conduct trials of participation arrangements, including opt-out systems.

While it is encouraging to see continued support for the PCEHR, a number of important operational questions remain unanswered. For example, how will the new online training system fit in with the demands of already busy GPs in rural and remote practice? Will the hardware for new systems be affordable? Will the new MHR portals be user-friendly for patients and practitioners who have to engage with it through an opt-out model? A recent blog by Dr David More noted that, even after the Department of Health gave evidence at this month’s Budget Senate Estimates, we are no clearer on how useability will be improved, how practitioner incentives will change, or if an evaluation will be conducted on how things have run to date. For more details on the proposed changes to the PCEHR please read the Electronic Health Records and Health Identifiers: Legislation Discussion Paper.

 On 3 June 2015, the Alliance also attended the Health-e-Nation Leadership Summit in Sydney. Close to 100 eHealth leaders gathered to discuss ‘Integrating care in a time of change’. A host of national and international speakers gave keynote addresses and participated in panel discussions on:

  • Delivering results through integrated care and population health;
  • Person-centred care and valuing outcomes;
  • Integrating prevention, primary and aged care;
  • Quality and financial sustainability of health systems; and
  • Patient centred medical homes.

The dominant theme of the day was around person/patient centred care. Speaker after speaker highlighted how, with the right application and management systems, technology offers practical and cost effective solutions to formulating and delivering health services that are based on the needs of the individual. Dr Joseph Siemienczuk, Chief Medical Officer of US Health company Kryptiq, and Pete Knox, Executive Vice President of Bellin Medical, both outlined successful cases of how eHealth had supported person-centred care that led to better health outcomes for less cost. They also spoke of how eHealth can support healthier, happier and socially connected communities through population health programs. For more information on Pete Knox’s or Joseph Siemienczuk’s presentain please go to http://ehealthspace.org/

However, despite all the exciting possibilities that exist with eHealth, the elephant in the room was the lack of affordable and reliable internet and mobile connection for people in rural and remote Australia. This matter was raised by the Alliance and other rural health representatives, who pointed out that without the ability to connect to adequate broadband and telecommunication services in the first place, all the technology in the world is of limited effect.