What it means for you.

www.ehealthinfo.gov.au

eHealth What it means for you

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While Australia’s healthcare system is among the best in the world, the ways in which we collect and share health information can be significantly improved. eHealth will introduce electronic services to improve upon inefficient and difficult to access paper-based systems.

In time, eHealth records will include information about a patient’s medical

history, such as immunisations, allergies, test results, prescribed medications, hospital discharge summaries, referrals to specialists and specialist’s letters.

With the right protections in place, the electronic management of your health information has the potential to transform the way healthcare is delivered.

What is eHealth?

From July 2012, all Australians can choose to register for a personally controlled electronic health record.

Imagine having access to your personal health information whenever you need it. Imagine all your healthcare providers having, with your permission, appropriate access to your health information when and where they require it, to assist you in your healthcare.

What is eHealth?

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How will eHealth affect the way my health is managed?

The first step you usually take if there is a problem with your health is to visit a doctor at a Medical Centre.

eHealth will transform your interaction with the healthcare system by connecting health information to provide high quality, safe care for all Australians.

For example:

NOW:You are meeting a friend for dinner and on the way to the restaurant you fall over and injure your leg. You visit an after-hours medical centre nearby and spend the first part of the consultation recalling your medical history, allergies, vaccinations and the medications that you may be taking.

THE eHEALTH FUTURE: With your permission, the doctor you are visiting will be able to access a summary of your health information electronically. The doctor can spend less time gathering information about your medical history and more time assessing and treating your condition.

Visiting a medical centre

Visiting a medical centre

Getting an X-ray or blood test

Visiting a specialist

Leaving the hospital

Going to the pharmacy

Visiting your local GP

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How will eHealth affect the way my health is managed?

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You often leave a consultation with a paper referral for a blood test or an X-ray (diagnostic imaging). In Australia each year there are approximately 16 million diagnostic imaging examinations performed1 and 33.6 million pathology episodes2. Up to one in six (17%) pathology and diagnostic tests are unnecessary duplicates3.

eDiagnostic tests include both pathology and diagnostic imaging, which will come online in the next two years.

For example:

NOW:The doctor assesses your leg and orders an X-ray. You attend an X-ray (diagnostic imaging) centre with your paper referral. After the X-ray you are advised that you will need to return to pick up your X-ray report and films to take it to your next appointment with the doctor.

THE eHEALTH FUTURE: With eDiagnostics, the doctor will send the referral electronically to the X-ray centre. They will be able to retrieve the referral electronically when you arrive and be able to send the X-ray report to the doctor electronically. In some cases the X-ray films will also be accessible electronically via a web browser from your doctor’s clinic.

Getting an X-ray or blood test

How can I be confident that my privacy is protected?

Privacy protection and appropriate security are critical aspects to eHealth. Successful delivery of both will allow an individual to access their health information electronically, limit any opportunity for inappropriate access and ensure trust and confidence in the system. A combination of technical, policy, governance and legislative safeguards are in place to facilitate access by the right people and prevent inappropriate access and use of healthcare information.

eDiagnostics will:

reduce the need for duplicate testing. reduce the chance of lost or mis-matched results. improve the way tests are ordered and reported. strengthen consumer privacy through secure electronic

transfer and storage of diagnostic information.

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Getting an X-ray or blood test

1. QUDI: The Quality Use of Diagnostic Imaging Program. The Royal Australian and New Zealand College of Radiologists, 2011. Available from: http://www.qudi.net.au/qudi/2. Medicare Australia Statistics. Medicare by MBS category processed from July 2007 to June 2010. 3. 2009 Australian Institute of Health and Welfare and the University of Sydney report, Clare Bayram.

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It is not uncommon to either misplace referrals or forget to take it with you when you visit the specialist. Even if referrals are faxed, there is still a need for data entry into local electronic health systems at the specialist centre.

For example:

NOW:The X-ray confirms that you have broken your leg. The doctor refers you to an orthopaedic surgeon to discuss what treatment is best for you. When you visit the orthopaedic surgeon you must remember to take your X-rays and referral.

THE eHEALTH FUTURE: With eReferrals, the doctor will send the referral electronically to the orthopaedic surgeon, so the only thing you need to bring with you will be your X-ray films. During the consultation your orthopaedic surgeon will be able to download the referral and the X-ray report. In some cases he may also be able to view your X-ray films via the web.

Visiting a specialist

How can I be confident that the information about my health is sent securely?

The specifications that have been developed will allow electronic health information to flow securely (encrypted) between the many different types of software systems used in different parts of Australia’s health system.

eReferrals will:

Streamline the way a clinician compiles information. Ensure that they can’t get misplaced. Improve referral and specialist letter response processes. Increase the specialist’s clinical time with the patient by

reducing administrative tasks. Reduce consumer inconvenience and unnecessary

appointments. Enable safe and timely handover of clinical care.

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Visiting a specialist

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When you leave the hospital you usually receive a discharge summary letter which contains information about your health event, diagnosis, medications that were prescribed and recommendations for follow-up treatment. A copy is often also posted or faxed to your GP. It is important that your appropriate healthcare providers receive this information in a timely manner to help determine your ongoing care needs.

However, discharge summaries may be misplaced or delayed in reaching your healthcare provider, so you have to rely on memory to communicate information about your hospital event to, for example, your GP.

For example:

NOW:The orthopaedic surgeon recommends surgery to repair your leg and you are admitted into hospital. You make a speedy recovery and are discharged from hospital. You receive a discharge summary report from the orthopaedic surgeon which you need to take to your next appointment with the doctor.

THE eHEALTH FUTURE: With eDischarge Summaries your doctor will receive the discharge summary electronically (and securely) which will contain information about the surgery, the medications that were prescribed (or changed) and recommendations for post-operative management.

Leaving the hospital 4

Leaving the hospital

eDischarge Summaries will:

Ensure that discharge summaries are clear and legible.

Improve diagnostic information available in the eDischarge Summaries.

Increase privacy through secure electronic transfer and storage of discharge information.

Improve ongoing care through accurate and timely communication and clinical handover across healthcare providers.

Reduce potentially preventable hospitalisations. Reduce unplanned readmission

(i.e. within 28 days of the last admission). Decrease medical errors and adverse events

(e.g. medication prescribing errors).

How can I be confident that the right health information is associated with my health record?

A unique 16-digit number called a healthcare identifier has been assigned to all individuals enrolled in the Medicare program, or those who are issued with a Department of Veterans’ Affairs (DVA) treatment card and others who seek healthcare in Australia. This identifier ensures that the right health information is associated with the right individual at the point of care.

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Think about the last time you went to a doctor to get a prescription and presented it to a pharmacy. On average well over two hundred million scripts are dispensed yearly in Australia1. The manual prescribing and dispensing of these prescriptions requires repeated data input, manual signing and lots of paper. You can often experience delays in obtaining prescriptions, issues when prescriptions are lost and even confusion over exactly what medications you should be taking and when.

Nearly one in three unplanned hospital admissions in those over 75 years are associated with prescribing errors2. Hence, preventable medication errors cost around $380 million per year in the public hospital system alone3. As further electronic medication management initiatives gather pace, such as medication history lists and medication profiles, more comprehensive medication information will be available to assist in reducing medication errors.

For example:

NOW:Upon discharge from the hospital the orthopaedic surgeon writes a prescription for medication for pain relief. You take the prescription to a pharmacy and you wait while the pharmacist tries to decipher the handwritten information on the prescription and re-enters the information into their dispensing system.

THE eHEALTH FUTURE: The prescription you receive from the orthopaedic surgeon has a barcode. You take the prescription to a pharmacy and the pharmacist scans the barcode to retrieve the information contained on the prescription which includes the medication that needs to be dispensed.

Going to the pharmacy

ePrescriptions will:

Reduce the opportunity for dispensing errors. Create clear and accessible information about the

medications you’re taking, reducing medication errors caused by misunderstanding of instructions.

Create a more efficient prescribing and dispensing process.

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1. The Pharmacy Guild of Australia: Media release: Health Minister views eRx Script Exchange. Canberra: The Pharmacy Guild of Australia; 2009. Available from http://www.guild.org.au

2. Chan. M, 2001, Internal Medicine Journal, Adverse drug events as a cause of hospital admission in the elderly; 31: 199-205.

3. Australian Institute of Health and Welfare, Australia’s Health no 8, June 2002.

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Going to the pharmacy

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After being discharged from hospital you decide to visit your local GP for follow-up care.

For example:

NOW:When you visit your local GP you describe how you injured your leg, the surgery you had and the medication that was prescribed. You also have to remember to take your discharge summary (if you have one) and to bring along your X-ray report and films.

THE eHEALTH FUTURE: eHealth will allow your GP to access information about the consultation you had at the after-hours medical centre, the X-ray report, your consultations with the orthopaedic surgeon, information about the treatment you received in hospital and the prescriptions that were dispensed at the pharmacy. At home, you can also choose to access your eHealth record to see a summary of your health information which now includes information about your recent healthcare event.

Visiting your local GP6

Visiting your local GP

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For more informationwww.ehealthinfo.gov.au www.medicareaustralia.gov.au www.yourhealth.gov.au

This publication was produced by the National E-Health Transition Authority (NEHTA) on behalf of the governments of Australia. This publication may be reproduced in whole or in part for work, study or training purposes, subject to the inclusion of an acknowledgement of the source.

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