eHealth: What it means for youPresenters: Michelle McClure and Kathy Rainbird

March 2013

Connecting health care

Introducing eHealth • Better decisions• Better access to information• Better co-ordination• Better care for individuals

Better health

What is eHealth?

e-health is the electronic collection, management, use, storage and sharing of healthcare information.

eHealth Records

Secure messaging

Telehealth

ePrescribing

eSpecialist Letters

eReferrals

Electronically received results

eHealth

Extrapolating ehealth evidence

• 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 the average time spent on referrals by 97%.

• For Your Information, Australia Audit Commission, Canberra, 1995 5. Karl A Stroetmann KA, Jones T, Dobrev A, Stoetmann VN, ‘An Evaluation of the Economic Impact of Ten European E-Health Applications’, 2007 6. Ibid

Benefits of eHealth

• Improvements to patient care • Access to patient history: administrative &

clinical efficiencies • Better communications with other health care

providers: leading to better coordinated care • Efficiency: time saved by not searching for

clinical documentation • Innovations: clinical support tools that make work

easier • Data cleansing tools: better quality data results

in better practice management and clinical care

eHealth Record

In July 2012 the Australian Government introduced a personally controlled electronic health (eHealth) record system

People seeking health care in Australia can now choose to register for an eHealth record

Healthcare organisations that choose to participate will, over time, have access to important health information, helping provide safer, more efficient care for consumers

Benefits of the eHealth Record

• Reducing unnecessary tests, hospitalisations & follow-up specialist visits

• Better access to patient data • Allow more time for treating patients • Patients with chronic conditions can better

monitor their healthcare • Secure, online access to patient information

can improve patient safety • Better access to hospital information

What will eHealth records include?

Two set of information – clinical and personalAs the system grows, an eHealth record may contain the following:• A shared health summary – including medical

conditions, medications, allergies, previous adverse reactions and immunisations

• Event summaries• Hospital discharge summaries

What will an eHealth record look like?

How it works…

Common misconceptions

Progress notes will be shared Patients can change the record It will take too much time for little reward

Common misconceptions

Progress notes will be shared Patients can change the record It will take too much time for little reward

Common misconceptions

Progress notes will be shared Patients can change the record It will take too much time for little reward

Common misconceptions

Progress notes will be shared Patients can change the record It will take too much time for little reward

Does it replace existing records?

eHealth records don’t replace existing medical records

Healthcare professionals will continue to take and review clinical notes – the eHealth record system provides a summary of key health information, so other healthcare professionals can see relevant information

Who will have access to a patient's eHealth record?

Healthcare professionals working for a registered healthcare organisation can enter information into the clinical record, ensuring it is clinically relevant and accurate

Patients can enter their own information as an aide-memoire for their own use and a summary of information including demographics and basic health information.

What about in an emergency?

Healthcare professionals may access a patient’s eHealth record in an emergency, where patient consent is not possible but the person’s life or safety may be at risk

This is consistent with existing privacy laws

What can patients enter?

Personal Health Information

Personal health summary

Viewable by healthcare professionals

Personal health notes

Private use. Not viewable by healthcare

professionals

What are the next steps for eHealth?

People seeking healthcare in Australia can now register for an eHealth record

The eHealth system will grow, as will the benefits, as more Australians and healthcare professionals register

How can patients register for an eHealth record

• Online: www.ehealth.gov.au• Over the phone: 1800 723 471• In person: at a Department of Human

Services service centre offering Medicare services

• In writing: by completing a registration form from a service centre offering Medicare services, or downloading it from www.ehealth.gov.au

What can I do to prepare to access the eHealth record system?

Your organisation will need a Healthcare Provider Identifier – Organisation (HPI-O) and to be registered for eHealth

To participate in the eHealth record system as a healthcare professional you will need a Healthcare Provider Identifier – Individual (HPI-I)

How do I access the eHealth record system?

To access the eHealth record system via clinical software, and be able to add to a patient’s eHealth record, you will need conformant Clinical Information System (CIS) desktop software

Access via Clinical Information System will only be possible as updated software becomes available

If you don’t have CIS desktop software, you’ll be able to view records as read only via the Provider Portal

In Summary

eHealth records will allow you to access a summary of your patients’ important information, assisting you to…• Save time• Allow for more coordinated care • Reduce possibility of adverse events • Provide better health outcomes for patients

eHealth Records

Secure messaging

Telehealth

ePrescribing

eSpecialist Letters

eReferrals

Electronically received results

eHealth

ePrescribing

What is ePrescribing?

ePrescribing is the secure transfer of prescription information between prescribers and dispensers.

Prescriptions are transferred electronically via the Prescription Exchange Service.

GP Patient

Pharmacist

Prescription

Exchange

2. Provides prescription with barcode based ‘access key’1. Submits

prescription3. Chooses pharmacy and presents script with ‘access key’ barcode4. Scans barcode

to retrieve ePrescription

5. Submits dispense record

Diagram adapted from NEHTA ePrescriptions Overview, May 2012

6. Dispense notification (optional)

ePrescribing software

There are 2 approved ePrescribing products: –eRx –MediSecure

These are interoperable through the prescribing exchange service

But… why?

ePrescribing is easyePrescriptions mean:• No more illegible handwritten prescriptions• Fewer transcription errors • Faster dispensing with no manual transfer of

prescription data• This allows more time for patient engagement if needed

• Fewer pharmacy call backs to GPs

Benefits

• Widespread use of ePrescribing will make it easier to implement more sophisticated systems

• eg to share medicines information and improve medication management

• Dispense notifications (optional)• Improved work flow for pharmacies

And remember….

• It’s not mandatory, and for some practices and pharmacies it might not be viable

• However, NPS encourages all general practices and pharmacies to seriously consider ePrescribing, and to implement it if possible

• It’s a small, but crucial step towards improved quality and safety

Future Benefits

May be one day we will no longer need paper scripts

• No more rewriting lost scripts!

eHealth Records

Secure messaging

Telehealth

ePrescribing

eSpecialist Letters

eReferralsElectronically received

results

eHealth

Further information

• Visit www.ehealth.gov.au or call the Helpline: 1800 723 471

• RACGP http://www.racgp.org.au/your-practice/e-health/ehealthrecords/epip/

• South West WA Medicare Local http://www.sw-medicarelocal.com.au/ or email Michelle McClure mmcclure@sw-medicarelocal.com.au

ReferencesAustralia Audit Commission, Canberra, 1995 5. Karl A Stroetmann KA, Jones T, Dobrev A,

Stoetmann VN, ‘An Evaluation of the Economic Impact of Ten European E-Health Applications’, 2007 6. Ibid

National E-Health Transition Authority. Retrieved January 2013, from www.ehealthinfo.gov.au.

Otto, K. (2012, December 18). Callenges with eHealth adoption. Retrieved from www.trainitmedical.com.au.

eHealth