In the recent years, the world has experienced the growth and penetration of the internet into several sectors of the economy. Coupled with the growth of networking and the growth of communication technology, the E-healthcare systems have become largely accepted in healthcare as essential for efficient patient care (Consumers Health Forum of Australia, 2014). The adoption of E-healthcare in Australia has helped bring down the number of medical errors, increase the quality of health care, minimize the cost of healthcare and help patients have an understanding of their healthcare needs in order to make proper health choices (Showell, 2014)
Having seen the importance of e-health systems, it is paramount that governments take seriously the development of these systems for the advancement of healthcare (Cornwall, 2013). Australia has made numerous steps with regard to the adoption and integration of E-healthcare systems. Since the year 2000, Australia has made efforts to come up with their own E-Health Records Systems (International Organization for Standardization, 2015).
In the year 2000, Australia made considerations of adopting EHR systems. The first system of this kind is called Mediconnect. This system collected and stored information regarding medicines and exchanged this information to doctors, pharmacists and even patients. The field tests for this system were done in Ballarat and Launceston. The tests provided the much-needed information regarding the implementation of EHR systems (Xu, 2013)
The concepts behind this system and the lessons learned from its implementation were used in the development and implementation of HealthConnect (Tang, 2016).The HealthConnect is a country-wide network of several EHRs, which collects, stores and exchanges information regarding individuals' health. This program was developed from 2004 to 2009. HealthConnect was very useful in the laying down of health infrastructure in the country (Cornwall, 2013).
Another key development in the e-health systems happened in 2010 to 2012 when the Australian Government invested several millions of dollars for the release of the Personally Controlled Electronic Health Record System (PCEHR) (Mennerat, 2014). The first version of the PCEHR was released by the Australian government on July 1st, 2012. This healthcare system has provided economic benefits to both to the government and to the private sector in addition to laying the ground for future advancement in E-healthcare systems. These E-healthcare systems are expected to reduce government expenditure on health by about $7 billion (Xu, 2013)
The rationale behind the establishment of the EHR system was that many Australians make multiple hospital visits, and area tended to by different health care workers (Jha, 2013). During these visits, information was kept in files only accessed by individual physicians. This way of doing things brings about a situation where files could be inconsistent or lost and hence the information may not be available during emergency situations. EHR system corrects this problem by compiling a patient's personal data, medications given; discharge summaries, tests performed and care plans (Xu, 2013). This information is easily retrieved when needed especially during emergencies and special health conditions.
The EHR system then provided a basis for My Health Record. My Health Record contains the same information that is found in the EHR. This information includes- immunizations given to patients, diagnoses made, medications and physician contact information. This system, is, however, set up in such a way that it is accessible and manageable by patients themselves. This information helps patients to monitor and manage their health in an environment where they are assured confidentiality. The information contained in My Health Record comes from patients and physicians (Jha, 2013).
The EHR system and My Health Record are related in many ways. First, they both contain the same type of information. The only difference is the target audience the information is meant for. While the EHR system targets physicians, the My Health Record targets patients. Second, My Health Record was founded on the EHR system. The information and knowledge that was used to come up with My Health Record was obtained from the experience with EHR system implementation (Xu, 2013). Patients can use My Health Record to manage their health while health care workers use the EHR to manage patient's health. Both of them represent a new phase of healthcare where information is now freely available in a convenient way.
Current Scheme, Use and Implementation Status of EHRs/My Health Record (Including Implementation Issues)
The Australian government has taken seriously the countrywide implementation of the EHR and My Health Record. The public has also been very supportive of the system after seeing the effects of the change and are in strong support of both the EHR and My Health Record (Department of Health and Ageing, 2014). They also prefer that the government implements and manages both systems. The implementation of My Health Record has been successful over time and in 2012, the PCEHR Act was passed to support the effective operation of the system.
The act covered governance of the PCEHR the registration of the public, collection and use of information and the enforcement of the system. In July 2012, My Health Record was released, individuals were free to register and give information so they can access their health information online.
Currently, the government has joined efforts with ICT providers to develop the system further and to increase the level of adoption of the system. The government and the private sector have joined efforts in the implementation of both systems (Jha, 2013). EHR system has been well implemented and is used by the majority of general practitioners. There are however, challenges in the implementation of My Health Record and therefore the government is working harder to ensure a national implementation (Tang, 2016).
According to research, the EHR system has been largely adopted by general practitioners with about 90 percent of them using this system (Department of Health and Ageing, 2014). This picture is also seen in New Zealand, U.K and the Netherlands. The adoption of this system in hospitals is however, poor at about ten percent (Xu, 2013). My Health Record has been adopted and continues to be adopted by many people but there is still much to be taken into consideration to ensure the full implementation of the system.
Implementing the two systems met several challenges. During the time of implementation of both systems, the both sides of government supported the implementation of the EHR but the opposition was against the implementation of My Health Record (Tang, 2016). It delayed the establishment of My Health Record. Its implementation was however, done by the current government and has therefore picked up. The uncertainty about the state of the economy also affected the implementation of the two systems. The economic benefits of the systems are not felt until about ten years are after implementation. Therefore, it was easy to slow down implementation because of the unforeseen economic benefits (Benatallah & Paik, 2013).
The government was the main player in the implementation of both programs. The implementation also included the private sector. However, the government is the sole source of funding. Implementation is faced with challenges in that there is widespread uncertainty regarding the use of E-healthcare systems. Some physicians view patient information as private and competitive and are not impressed by the idea of providing this information for access by other physicians. The attitude from physicians slowed down the implementation of the EHR (Library Association of Australia & Australian Society of Archivists, 2014).
Privacy interest are one of the reasons the implementation if the two systems, especially that of My Health Record. Many patients and professionals were not comfortable with the idea of having such confidential information in such an easily accessible space. All the information of the two systems is stored in a central database which if breached, could impact the wellbeing of millions of people. This issue of privacy is of greater concern when it comes to My Health Record (Rodrigues, 2013).
Many Australians are not sure how their highly confidential information will be used and whether the information is safe from breaching. A research showed that more than 80 percent of Australians do not trust the security and privacy of My Health Record (Williams & Samarth, 2013). Even after the assurance that only patients themselves have access to the information, the individuals are not convinced that the information will still be safe after they choose to withdraw from the system (Gardner & Barraclough, 2013).
Future Plans to Expand the Implementation of EHRs/My Health Record.
For implementation to be successful, the government should continue to fund the implementation of the systems (Cornwall, 2013). As opposed to the system whereby individual will have to pay for use of the systems, government funding will ensure a more widespread implementation of the systems. Second, the practice of patience is of help in the implementation of the two systems. My Health Record, like I stated above starts to pay off after ten years. The government has chosen to continue with its investment despite the lack of immediate economic returns (Rogers & Reardon, 2014).
For proper implementation, there are plans to make possible the access to and management of health information through mobile devices. It is of help especially in the rural parts of the country who do not have readily available internet connection. Given that many people have access to smart phones with the internet; the availability of the option of use of mobile phones will help with the proper implementations of the EHR and My Health Record. It applies especially to My Health Record (Gunter, 2015).
Another plan to help with successful implementation is the use of a patient-centered approach to implementation (Iacovino, 2016). Patients play a central role in the reason for development of these systems and without patients agreeing to use My Health Record then the system's implementation will fail. One way of achieving that trust is training patients to understand the logic behind the use of these systems and the benefits that are to be found in My Health Record (Church, 2014). For the EHR system, consulting with physician and listening to their concerns will aid in its implementation. There is also a plan to gain more confidence from patients and healthcare workers. It is to be done through the assurance of privacy. In order achieve this, the government is working with Private IT industry to develop systems that are hard to breach and those that patients can trust the safety of their confidential information (Barraclough & Gardner, 2014).
As we have seen above, the country has welcomed the idea of E-healthcare as a way of making healthcare more efficient. The government has and is still in support of these systems given their contribution to reduced healthcare expenditure in the long run. The two systems have been implemented but still have a long way to go to ensure full implementation. There is promise in the future of these systems given the plans that are underway to ensure successful implementation (Brown, 2013).
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