Paper patients' notes out, digital records in

By: Louise Hall

BY THE end of next year, every public hospital in NSW will move from paper patient notes to electronic medical records that can be accessed by any health worker, the Government has announced.
The Minister for Health, John Della Bosca, said the $100 million project to digitise 250 hospitals will save money by eliminating duplicate diagnostic tests and imaging. It will also improve patient safety by alerting staff to a deteriorating patient and reduce the likelihood of errors.
Mr Della Bosca said doctors, nurses, allied health and social workers will be able to access a centralised repository of a patient's medical chart, laboratory results, prescriptions and referrals, no matter where the patient enters the health system.
Peter Garling, SC, recommended an urgent roll-out of electronic medical records (eMR) in his special commission of inquiry into acute care services, which found NSW's record-keeping system is "a relic of the pre-computer age" that puts patient safety at risk.
He said various hospitals and community health centres have established ad hoc databases but they were "spasmodic and patchy". The inability of distinct IT systems to synchronise with each other and lack of IT support staff meant clinicians had to rely on incomplete data to make important medical decisions and spent time chasing information.
Mr Della Bosca said the Government would make implementing information and communication technology within its capital works program a priority, which will make NSW Health the biggest IT user in Australia.
A basic eMR system that allowed clinicians to order diagnostic tests and view results online was successfully trialled at St George, Calvary, Sutherland and Lismore hospitals last year and by last month 20 hospitals were using it.
"Prior to the introduction of eMR, some requests for medical imaging and pathology could require referral back to the requesting clinician due to incomplete or illegible hand-written records," Mr Della Bosca said.
"This technology will improve the efficiency of hospital care and free up doctors and nurses to focus on patients and not paperwork, which will further improve patient safety."
The next step will link hospital-based records to primary care providers, such as GPs, by way of an electronic discharge summary.
But the Health Action Plan For NSW, released in March, revealed the Government would not meet Mr Garling's 18-month deadline for a digital radiological imaging system. This is to be set up in every public hospital to electronically transmit medical images to remote locations.
And an electronic health record, which would extend patients' information beyond hospital walls to all GPs, specialists and health systems in other states, was not possible without a national e-health strategy, it said.
A report commissioned by the Federal Government last December found state and federal governments have spent $5 billion on electronic health initiatives over the past 10 years but have made little progress towards creating a national system for sharing information.
NSW Health has admitted that two previous attempts to implement electronic medical records in 1991 and 1999 had failed, at a cost of $12 million and $30 million respectively.
The National Health and Hospitals Reform Commission has recommended an individual patient-controlled electronic health record owned by the patient who decides which health care providers can access it.