The most vulnerable need our assistance with e-health

BuddeComm is a great supporter of e-health – we believe that e-health will enable societies to much better manage their healthcare systems. Healthcare costs are going through the roof and despite recessions and financial crises this industry continues to grow. The biggest growth areas are chronic diseases and old age, and there is no end in sight as these categories are the key drivers behind this industry. Currently the growth in these sectors is leading to significant problems in all aspects of the healthcare service:

an increasing number of customers (patients), and in particular patients who cannot afford healthcare costs, are competing for limited resources;
pressure on hospitals;
pressure on medical and other healthcare staff;
decline in customer service and decline in quality of lifestyle.

Apart from trying to get people to live a healthier lifestyle, which is often an uphill battle, there is no way to manage the spiralling costs other than to use e-health. For that reason we have argued that broadband infrastructure should be used to develop e-health services delivered directly to people’s homes. It has been estimated that e-health can save the country $30 billion over a period of ten years. This nearly pays for the total infrastructure costs of the NBN.

However infrastructure, of course, is not enough. The government needs to develop healthcare policies that will stimulate e-health. This is a very tricky area as there are many conflicting interests within the sector – many silos and many ivory towers, all of which want to protect their own fiefdoms. Egos are another major issue in this industry and it is sometimes very difficult for the different disciplines to come to a more holistic approach towards healthcare.

It was good to see that in conjunction with NBN policies the government also started to address the e-health policies and – apart from e-health cost coverage under Medicare – the most fundamental of them has been the Personally Controlled E-health Record (PCEHR) system. This is an essential basic element for any e-health service, as patient records need to be made available electronically before any e-health system can operate properly.

After a ten-year investigation on this topic the government finally decided it had had enough of all of the vested interests’ delays in developing the policy framework for the system and set the implementation date for 1 July 2012. In order to overcome the privacy issues – which had been the major reason for the delays – the government put the ownership of the patient records into the hands of the patients themselves, and he or she can decide who can and cannot have access to the data.

You won’t find it surprising that we were among the first to register for the e-health record. The form is very easy and can be downloaded from the internet, or obtained in other ways. Cumbersome – but unavoidable – is the need for the document to be verified for secure privacy. I used my local GP for this and mailed the copy to the Department of Health. Within a week I received a call from them to set up my passwords and again, as expected, a few more cumbersome privacy elements were added to the procedure.

Fifteen minutes later I could log on and have a look at the service. I was told that my Medicare records would not appear until after mid-August and that only the records from the last two years would be available. I am not quite sure if the older data can or will be added, or how it will be done, so that will need to be looked at later.

There is also a section for private notes and I used some of my own historical data to list my lower back problems. This is only available to me but I am sure there must be ways that I can share this with other medics. The site is well-designed, easy to use and easy to navigate.

Any person using the internet will be able to use the PCEHR service. Others – and unfortunately this will include a very large section of the heaviest users of the healthcare system – will require assistance, both in relation to the registration and to the service itself. At the same time it will be this group that will benefit the most. Some 1,300 people die every year because of wrong, non-existing or inaccessible patient records.

The first-line medical staff could play a key role here – reception and admin staff, perhaps supplemented by local volunteers. For example, local GPS, regional healthcare centres could organise information evenings, hands-on demonstration/training, and so on. And, of course, family and friends can also play a key role in making sure that those who will benefit the most actually do get connected. It is up to all of us to make this a truly inclusive healthcare service.

Paul Budde