Australia has decided to be bold and take on a major technological health reform (and public health researchers are frothing for the big data implications). They are currently rolling out a national, centralized electronic health record (EHR) for anyone who holds a Medicare card. Unless they explicitly chose to opt-out of the program, all Australians will have a My Health Record by the end of 2018. The EHR will contain a variety of data such as health summaries from general practitioners, medication lists, hospital stays, test results, organ donation preferences, immunization status, etc. To protect patient rights and privacy, and to promote active involvement of patients in their care, patients can tailor their records and chose what information will show up and to whom.
As a community nurse, I’m very excited by the idea of a centralized EHR. I’m sure most health care professionals can relate to the struggle of gathering up-to-date information from our patients who visit multiple doctors and pharmacies. Too often is quality of care compromised by poor interdisciplinary communication. In my home country of Canada, there are a variety of projects and calls for action underway to bring centralized EHRs to and across provinces. A recent Canadian benefits evaluation study points to increased quality and efficiency of patient care through the use of “connected health information”, and in the grander context of every day use of technology, it seems obvious that centralized EHRs would be healthcare’s next big step in patient data management. Furthermore, let’s not forget to mention the gold mine of public health information that a centralized system can provide to facilitate research in the field.
But let’s get back to Australia. Over the past few months, a flurry of concerns and criticism about My Health Record have emerged. Respected newspapers such as The Guardian and the Sydney Morning Herald have been publishing articles relating some major issues with the security of the EHRs as well general data management and protection concerns. Furthermore, My Health Record’s utility is being criticized as patients and doctors can chose what information will and won’t appear, thus being at times counterproductive and time consuming.
As I mentioned earlier, I’ve seen first hand the damage that poor communication and scattered patient information can do (not to mention the tension headaches I’ve suffered). I’m optimistic that a centralized EHR system will benefit both health professionals and patients in terms of the quality of care received, save all parties involved time and money, as well as give momentum to research in the public health realm. Will there be many hurdles until things are running smoothly? Absolutely. What new health procedures or programs have ever been launched seamlessly? The Australian government needs to step up to the challenge, and I hope they do. Data confidentiality and security need to be a priority. Comprehensive training programs need to be put in place for health professionals, and the public will definitely need coaching to get the hang of things (I’m not going to lie, current instructions on the website seem a tad overwhelming). But at the end of the day, I think we need to applaud Australia for taking on such a monumental and audacious project, and I hope that the health professionals and citizens in Australia will continue to be critical, but equally contribute to solving the inevitable issues that will arise.