A presentation given by Dr Ralph Hanson on Electronic Health Records at the CHA Conference The Journey, in October 2012.

1. Perspectives on eHealth and the
Personally Controlled Electronic Health
Record (PCEHR)
Dr Ralph Hanson FRACP
Clinical Lead
The National E-Health Transition Authority
23rd October 2012

2. Objectives
• Set the scene
• Strategic context
• Build the case for eHealth
• Brief introduction to the National eHealth
Record System (PCEHR)
• Start a conversation on the opportunities and
benefits for Child Health
• A reality check

3. What eHealth could look like today

4. Health system faces a significant challenge
in providing future health services
CHALLENGES
• Rapidly increasing demand for high quality, safe health
services in an environment of constrained financial and
human resources.
• Key demand drivers include:
– Ageing population
– Increased prevalence of chronic diseases
– New diagnosis and treatment technologies
– Rising consumer expectations
• Current workforce, service delivery methods and
models of care will not be able to cope with this rising
demand.
• Can eHealth make a difference?

5. Strategic context

6. Building a case for eHealth
Healthcare in Australia albeit of reasonably high quality faces
some challenges:
• Care is fragmented.
• Inefficiencies abound.
• Stakeholders don’t communicate effectively.
• Tasks better suited to technology are completed manually.
• Design, build and technology opportunities out of synch
with models of care.
• Clinicians have little time and incentive to adopt new
technologies, many of which significantly change
established workflows for which they may not be
reimbursed.

7. The need to share health information
• Every year Australians have an average of 22
interactions with the health system,
including: Approximately 13% of
health provider
 4 visits to a GP consultations have missing
information
 12 prescriptions
 3 visits to a specialist.
• Most of the information from these visits is
currently held in paper-based records in
separate locations. Most of these records are
not shared electronically.
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8. The health care we provide is not always safe or efficient
Some facts…
• It is estimated 5,000 patients die each year due to adverse
medical events
•Up to one in six (18%) medical errors are due to inadequate
patient information
•Almost two million Australians experience an adverse drug event
each year and approximately 138,000 of these end up in hospital.
•53% of medication mistakes are considered ‘definitely
preventable’
•Clinicians spend around a quarter of their time collecting
information rather than treating patients
• ePrescription systems in Sweden, the US and Denmark increased
health provider productivity per prescription by over 50%
• eReferrals in Europe reduced average time spent on referrals by
97%

9. Translating reform into the National
eHealth Strategy
eHealth is one of the most important opportunities to:
o Improve the quality and safety of healthcare
o Reduce waste and inefficiency
o Improve continuity and health outcomes for patients

10. What is happening in eHealth in Australia?
• eHealth is an all encompassing term
• Being pursued at a National and Jurisdictional
level
• In all health care settings private and public
• Varying stages of maturity
• Progress often slow but getting there.....

11. Where does NEHTA fit in?
Lead the uptake of eHealth systems of national
significance; and coordinate the progression and
accelerate the adoption of eHealth by delivering urgently
needed integration infrastructure and standards for
health information.
eHealth Foundation Services Priority eHealth Solutions
Secure
Identifiers Authentication Terminology Messaging eDiagnostics eDischarge eReferral eMedications

12. Who is delivering the eHealth records
system?
DOHA
Benefits National External
National Department
And Change and Delivery
Infrastructure of Human
Partner NEHTA Evaluation Adoption Assurance
Services
Partner Partner Advisor
(NIP) (DHS)
(BEP) (NCAP) (EDAA)
eHealth record system implementation is a partnership between
governments, NEHTA and the market.

13. What is an eHealth record – the National
eHealth Record System(PCEHR)?
• An eHealth record is a secure electronic summary of a
patient’s health records.
• eHealth records will not replace existing medical records.
• The eHealth record system provides an active online
record that over time will follow patients as they move
through Australia’s health system
• All those seeking care in Australia will be eligible for an
eHealth record. Registration for an eHealth record is
voluntary and will not be required in order to receive
health care.
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15. The Personally Controlled Electronic
Health Record Key Principles
o Participation is voluntary
(Opt-in)
o Provider access is under
consumer control
o The PCEHR is not a
replacement for
organisational clinical
records
o The clinical component
contains copies, not
originals
o The ‘Source of truth’
remains where it is today –
in local clinical records

16. From 1 July 2012, Australians have been able to register
online for an eHealth record & Health Care Organisations
are able to register to participate in the system
• National infrastructure in place
• A starting point
• Value of the system will grow gradually
over time
• A guide is available to help healthcare
organisations register
• As more consumers and healthcare
providers join up, the system’s
functionality will expand, more features
will become available, and the benefits
will grow accordingly
www.ehealth.gov.au

17. National eHealth Record Rollout
Timeline Functionality
July 2012 Consumers started registering for an eHealth record, setting their access controls
and creating their own consumer health summary record
Next Steps As providers become ready the eHealth record system will include the sharing of:
 Shared health summaries
 Health overview
 Event summaries
 Discharge summaries
 Specialist letters
 eReferrals
 Medicare data, including child immunisation data, organ donor register data,
DHS data and PBS and RPBS data
Healthcare professionals can, with patient consent, access the above information
through:
 Conformant clinical information systems

18. Are consumers ready?
o High technology take-up rate
o Four in five Australians want to move from paper based
records
o 77% support eHealth record system once explained
o Most consumers believe they have knowledge required
to use eHealth records
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19. Are healthcare professionals ready?
o 96% + GPs have access to computer and internet in offices
o 95% of GPs use electronic patient medical records
o Most GPs have access to patient information required to
create eHealth record
o 38% of GPs agree they would encourage their patients to
register for an eHealth record
o Allied health professionals and medical specialists still
face a fragmented software vendor landscape
o Likely long lead time in moving to universal hospital
access to eHealth record
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20. Specific issues for children, young
people and families
Challenges Opportunities
• Delayed registration • Lifelong record
• Personal control • Shared / Integrated care
• Child • Greater involvement in care
• Adolescent / Young person • Move to an Electronic Child
From 14 Health Record
From 18 • Enhance benefits of CHR eg
• Representatives Improve immunisation
• Authorised
status
• Nominated

21. Where to from here?
• Significant opportunities for healthcare
organisations to improve efficiency and
effectiveness through eHealth
• Immediate need to get eHealth ready to
support clinical care and facilitate participation
in the National electronic health record
system

22. The reality check :……eHealth improving the patient
experience?
Change is about people not the technology!

23. Thank you and Questions
www.ehealth.gov.au
www.nehta.gov.au
23 National E-Health Transition Authority
www.nehta.gov.au