Friday, 14 May 2010
The deputy director-general of NSW Health, Dr Tim Smyth said the state is working actively on the introduction of e-medical records and is going for a business case to provide electronic prescribing service.
Dr Smyth regards privacy worries related to electronic medical records are overemphasized and can trigger unnecessary concerns.
He said, "I've never seen privacy as an obstacle and it's often used as an excused by some players not to do anything."
He said in a speech at an e-health forum in Sydney, people often confused privacy which is data a person wants other people to know, with the security of that information.
Dr Smyth said, "Being able to transfer information is critical (and) e-health has the potential to reduce errors."
With Healthelink, health records are only accessible by authorized health care providers under the signed contract to "respect the privacy of records and to maintain confidentiality of the information".
David Roffe, CIO of St Vincent's & Mater Health Sydney said people in chronic care usually want to share their health information.
He sad e-health systems for the management of medication cut down errors and NEHTA-compliant secure messaging is the way forward.Adam Powick, consultant of Delloitte e-health stated, "People place a great deal of trust in the health system and for good reason."
The use of passwords, with regard to information security remains a concern, said Dr Smyth, as NSW doctors who moved, for example, from Blacktown hospital to another in the city have to change their passwords due to different systems operated, and he is working to get the issue solved.
Wednesday, 12 May 2010
By: Terry Deefholts
THE electronic medical records (EMR) system meant to streamline hospital data continues to frustrate North Coast doctors more than six months after its installation.
One US study has found software produced by the same company has increased paediatric mortality in one emergency department (ED).
The study, entitled Unexpected Increased Mortality After Implementation of a Commercially Sold Computerised Physician Order Entry (CPOE) System, was completed by eight doctors and related to the implementation of a CPOE system (produced by Cerner) in the Children’s Hospital of Pittsburgh in 2002.
It found the mortality rate at the hospital increased from 2.8 per cent (39 of 1394) before the CPOE implementation to 6.57 per cent (36 of 548) after CPOE implementation.
Local doctors warned of an increase in mortality rates before the current Surginet system, another Cerner product, was introduced in Grafton last year.
Chairman of Grafton Base Hospital’s Medical Staff Council Dr Allan Tyson yesterday blasted the system, saying standard computer skills were no help when using Surginet.
Dr Tyson referred to a time-and-motion study conducted by a fellow North Coast doctor which found it took four times longer to properly record patient records in the Cerner system than writing it down in the old paper method.
It is understood the same doctor video-recorded doctors struggling to use the system.
“No one is objecting to the concept of electronic records; we know it is the way we have to go,” Dr Tyson said. “But this system is very user un-friendly.”
A screenshot of some Cerner software which local doctors say is similar to the GBH system which is dangerous and inefficient.
He gave one example in which the enter key didn’t save data and move on, deleting and going back instead.
“Queensland and Victoria are using different software, both of which are better as far as I’m aware,” he said.
Another doctor, who has worked in the GBH ED, contacted The Daily Examiner but preferred to remain nameless, described the EMR system as a “total disaster”.
“It’s been bought by the State and rolled out across all NSW hospitals at a cost of between $70 million and 100 million,” the doctor said. “Some patients are still not having notes written. It is easy to document notes in the wrong patient’s chart and the rest of the hospital is still using paper, so the notes from the ED aren’t even in the notes for the rest of a patient’s admission. I have found that it hampers my ability to quickly assess what is going on with a patient when a medical emergency team is called to the ward.”
The doctor said he was about to start a letter-writing campaign on the issue because “to sit back and do nothing is to tacitly approve of the use of an inefficient and potentially dangerous system”.
Professor Peter Croll, head of Information Technology at Southern Cross University, said the Queensland Health payroll system that underpaid, overpaid and missed paying staff was an example of IT systems failing to meet expectations.
Professor Croll quoted Professor Jon Patrick’s critical essay on the failings with the Cerner system which concluded “any clinical information system has to be changeable promptly and at the will of each independent clinical community”.
“The ability to cope with change is often one of the biggest omissions in IT deployment,” Professor Croll said. .
Professor Peter Croll will deliver a free lecture on the risks and benefits of eHealth at the Coffs Harbour campus of Southern Cross University tonight from 5.30pm. RSVP to Donna McIntyre on 6620 3503.