11:57am, 24 Feb 2010 Dr Phil Rutherford

Most health records are already recorded electronically. The issues now is (a) how to capture the health records which exist for pre-electronic era (particularly for the more elderly patients), and (b) how to coordinate them into one concise report.

I do not agree that the number of people who flit between health care providers is so extensive that we need bother introducing this system to cater to their needs. I think most people have their own doctor, dentist etc., who know them far more intimately than than most. But, they will not always know them in as great a detail as will their health care provider who may see them on a weekly, if not daily, basis and be able to note far more about the patients than a doctor who might not see them for months. Therefore, unless all of the needs and details of an individual are going to be captured then I think having a system which does not contain all of the information about a person is going to be more dangerous than having no system at all.

12:18pm, 21 Jan 2010 melbguy

I think Australians should have the option to have one. BUT it is the individual that should have control over who sees their record, or more accurately, who sees which components of the record. For example many people would not want one provider to know that they are being treated by another provider for something sensitive such as depression, anxiety, sexual health checks, etc. It should remain the person's choice as to who sees what. This is the great advantage of the current system - consumer has a lot of control as to what they tell providers.

3:31pm, 24 Nov 2009 HP

Better access to information will reduce duplication of effort and improve coordination of care. The consumer should have control over their information by nominating which providers they would like to share their information with. Mechanisms for sharing and storing this information will need to be developed to ensure the information is secure

5:53pm, 21 Nov 2009 bernard

The sharing of information electronically with patients should be available now. You do not need a complete Electronic Health Record before you start sharing information with the patients electronically.

5:52pm, 21 Nov 2009 bernard

The Electronic Health Record should help the sharing of information between practitioners and patients. If patients do not have access it is very difficult to take responsibility for our own care.

The number of times my elderly parents could not even remember or pronounce the condition that a GP mentioned in the consultation is ridiculous. The required treatment is just as often forgotten. I should not have to take time off work to accompany my parents so that I get this information. I do not see why the practitioner could not provide these details with my parents.

Secondly, if I am a person with complex needs eg 4-5 conditions, I should not have to tell my story multiple times. I have had friends who had to repeat a long story 4 or 5 times within 2 days. Patients should be able to write it down and add to their written story so that we do not repeat it 20 times to different practitioners and other personnel and then have to worry if we forgot to mention a significant detail. Patients need to be able to tell their own story.

10:10am, 18 Nov 2009 flow

This would reduce the impact of doctor shopping and provide healthcare providers with consistency in information access to provide consistent and appropriate care for presenting patients. It is very difficult at times to work with the current paper based system and provide optimal care when pieces of the individual health picture are missing, particularly after hours, on weekends, when medical records of health service providers are closed when patients present to hospital or ED. I would want the healthcare staff treating me to have all of my available information at hand. Perhaps then we will not need ask the same questions more than once to gain a complete clinical picture to provide the most appropriate clinical care.

7:05pm, 16 Nov 2009 Peta

I am a mother of a beautiful daughter, 6, who has complex medical needs and severe disabilities. I envisage numerous scenarios where a national e-health record could lead to a better overall health system, providing hospitals, GP’s, state disability services, state education services and community based organisations are utilise the e-health information provided.

Two important areas where I see it would help me care for my daughter are:

Care Management: -After a initial few years where we were intensely involved with the hospital system now much of the practical help I receive is from community based support networks allied health professionals, and Qld Ed settings and private practioners. Expensive testing such as x-rays on hips and mri’s are routinely done, information is already presented in an electronic format from the hospital and relayed by a specialist. Currently there is now practical way, besides my verbal, to convey this useful information outside the tertiary hospital system to those involved in the day-to-day care management.

Medications: A Doctor authorised list of current medications on e-health would streamline a very inefficient process that currently requires me to provide paper based yearly updates and doctor authority letters each time medication changes to respite providers, Qld Ed etc. It could also help with the rescripting process at the hospital pharmacy.

I think it would be a necessary step towards more family-centred care.

1:00pm, 04 Nov 2009 fledgeling

The option of carrying a complete medical record from one provider to the next is a useful one. My concern is that there be a choice about it. Such a system should be opt-in rather than opt-out, meaning that an individual patient's records are not even aggregated without permission. As well, those who have opted in should still have an easy way to choose whether a particular provider even knows that their records are aggregated in this way, in order to retain complete choice as to whether to make the aggregate available to that provider.

7:47pm, 29 Oct 2009 rossy47

Given the fact that so many people with complex care needs drift between doctors and hospitals, anything that help doctors and nurses see their diagnoses and treatments would be very helpful. For example, tests would not have to repeated etc.

10:13am, 29 Oct 2009 rotraut123

I agree with the concept of every Australian having their own electronic record. I also support the idea of the person or their authorised decision-maker gatekeeping the access.

My key concern is whether they are able to access this information so as to ensure its accuracy and relevance and how they might acivate changes to records entered by a third party.

A further concern is where information is accessed without appropriate advice might this in some circumstances be harmful.

1:05pm, 23 Oct 2009 Christine

Having all my health records together seems to be a good idea. Our lives have become so busy that it can be a challenge to keep any sort of health diary of when this vaccination was done, when I saw my GP, specialist or dentist, and what I have paid for which procedure. Not only that, but most Australians these days live in cities, and may visit different doctors, clinics, emergency departments and pharmacies. How difficult it can be to keep tabs on all these different things if the information is not put together. And what if I need treatment in a hurry and am not conscious to give my blood group details?

10:35am, 23 Oct 2009 catherine

the concept sounds easy and appealing but I feel there is an assumption that citizens have access to the internet and have skills to do this. My experience is that the high users of health do not have this access. The change management remain a lengthy process & data consistency for sharing health information is still another complex factor. Imagine the role of the carer keeping the this current; the multiple languages required ; the accuracy etc. Australia has to have more e-health success stories that start as pilots and test all the variables and engage all users of health information. that is why there have been funded projects. Its not the technology that fails but the engagement and process and business changes that are complex and often not well understood. our first hurdle is to get used to a national identifier (other countries have this) then get used to storing information virtually. Discussion is good; but implements/trail in a willing community settng and evaluate it from all aspects as a stepping stone to the inevitable.

5:18pm, 21 Oct 2009 isabelle ellis

I don't think we are functioning as a health system now. I personally would like to be able to go to my health care provider whether they be a private practitioner, the ED of my local hospital or to get my pap smear and have my information available to them; and also have my presenting problem information uploaded by them.

I would like to do that in what ever State of Territory I am in so please can we just make it happen. This needs national leadership Minister Roxon.

3:12pm, 21 Oct 2009 ozilero

It is interesting that one of the dominant concerns that people have with an electronic health record system is whether their personal information will be protected, yet we hand over very similar information to banks and other financial institutions. Why are we more concerned about whether someone gets access to our health information than we are about our financial security?

The answer is, we probably aren’t. Both are important to us. So it should be fairly obvious that if we can protect one type of information, we can do so with any other type of information.

I also agree with comments made on this blog against a patient-controlled record. While patients should be able to choose who has access to their record, they should not freely be able to choose what information is or is not recorded. Certainly they should have access to the record and if there is any concerns about the information recorded, patients should be able to apply to an appropriate authority to have the records amended in the same way that we may apply under the Freedom of Information Act 1982 to have our personal information on government records amended. There is no charge for this service.

10:47pm, 20 Oct 2009 vixone

I think e-records are a great idea, however we the individual , should be able to choose what e-records and information we share.

If you require a second or even third opinion (or in my case 8th) it's best if that is done from scratch, with a new Dr and without the influence of a prior Medical Practitioners diagnosis. It can be hard enough finding the main problem in a lot of medical conditions as is. Without the above M.D's interpretation and records of such following you around.

8:43pm, 20 Oct 2009 cmartin

There are some clear benefits from having a National e-health record. In particular, having a central database for your pathology and radiology test results will reduce duplication & thereby save public money.

However, the idea of the record being controlled by the patient, rather than health professionals is problematic and appears somewhat of a gimmick.

The key concerns are (1) that if patients pick & choose what information to provide to professionals, critcical information could be witheld. Rather obvious examples are people with psychotic illness who do not beleive they are unwell.

(2) If patients are able to edit the information on file it is likely to be written using non-standard terminology - which inevitably leads to error.

Most people have little interest in what is written in their medical file and certainly do not want the responsibilty of maintaining it. It is an unfortunate truism that people obsessed enough with their health to want to write in their own medical files are likely to be the same ones whose entries are not going to enhance their care.

7:04pm, 20 Oct 2009 ruralnurse

I absolutely agree , everyone should carry personal health records on themselves. I have purchased a USB card which details my meds, allergies and nok. I t also has my photo. my doctors name and number and anything else relevent. This may well save my life one day. This card is not much thicker than a credit card.

5:16pm, 20 Oct 2009 tdicko

I agree so long as the electronic information is stored in an anonymous and highly-encrypted fashion. Can you imagine how disastrous it would be if a system like this was compromised and all records had names, addresses, birth dates - all kinds of personal information along with a persons entire medical history? Not something I'd want distributed across the world.