No matter which side of politics you support, and to the many in
the "neither" camp, it is fair to say that the Federal
government has had some unfortunate outcomes with the delivery and
implementation of, what many see to have been, meritorious policies
and ideas. The implementation of the pink bats and school halls
schemes were marked by numerous controversies and, on occasions,
subject to the processes of trial and error.
Most people seem to agree that the introduction of electronic
health records (EHR) is both a good idea and good policy. People
may argue about whether consumers should opt out rather than in,
and its cost. But its stated objective of overcoming the
fragmentation of health information, improving the availability and
quality of health information, reducing the occurrence of adverse
medical events and improving the coordination and quality of health
care provided by different health care providers is difficult to
Effective delivery and implementation of the EHR scheme is non
negotiable. Government and others simply can't afford to get
things wrong. People's health and well being is the very
subject matter of the system. This is one of the conclusions
reached by the US Institute of Medicine (IOM) in a report entitled
"Health IT And Patient Safety – Building Safer
Systems For Better Care" released on 8 November 2011. The
transition to electronical medical records in the US is in full
swing. The report was commissioned at the request of the US
government department responsible for coordinating the development
of the National Health IT infrastructure.
The IOM is all in favour of the shift to electronic records and
says in its report:-
"When designed and used appropriately, health IT is
expected to help improve the performance of health professionals,
reduce operational and administrative costs and enhance public
However, the report also refers to studies which suggest that
fully designed Health IT can create new hazards in the already
complex delivery of medical care. The study committee refers to
dosing errors, failure to detect life threatening illnesses, delay
in pending treatment and loss of data as risks associated with
electronic health records which may lead to serious injury and
sometimes death. Such errors and delay might be caused by poor
human-computer interaction, computer crashes, quirky systems and
technology that doesn't communicate with a rival company's
Closer to home, Graham Ingram, General Manger at AusCert
recently delivered a paper on what he saw to be serious security
concerns that he had with the proposed EHR system. He queried the
ability of the government to protect such records from external
attack. In fact Mr Ingram said that such assurances could not be
"You can secure the back-end systems, absolutely . . .
what they haven't realised is that if you allow insecure end
points to connect with that system, it is no longer
If I can access my electronic health record from the Qantas
Club or internet café, we have a problem. If we can't
secure the machines, we can't secure the
Mr Ingram suggests that personally controlled electronic health
records be accessible at secured terminals installed at health care
facilities, Medicare offices or other institutions where access can
be logged and controlled.
The people responsible for developing Australia's EHR system
are leaders in their field. It is safe to say that they will
address the concerns set out in the IOM Report. Those raised by Mr
Ingram will also demand some careful consideration. Whatever the
process, the outcome must be as close as the government can get to
a seamless transition from paper to paperless for those who opt in
to the scheme.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
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What happens if a patient, particularly a mental health patient,.
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