Single digital patient medical records – where it is up to?

NSW Health has been embarking on a digital transformation of the organisation, including electronic patient medical records and managing medication via its e-Meds system.

So, after more than a decade, what progress has been made on the digital change and where is NSW Health up to in relation to the creation of Single Digital Patient Record (SDPR)?

NSW Health first introduced Electronic Medical Records in 2007. The system was upgraded in 2013 and again in 2014 and 2015. Health is now in the process of making it a more effective and efficient tool.

Health has introduced other digital systems including electronic medication management (eMeds) which monitors the medication dispensed to a patient. eMeds is now operational in 177 hospitals across the state and is expected to be fully functioning in another 25 by mid next year.

eHealth NSW CEO Zoran Bolevich said eMeds supports doctors, nurses and pharmacists to more safely prescribe, review, reconcile, dispense and record the administration of medicines.

“eMeds systems significantly reduce the risk of medication errors and potential and actual adverse drug events, resulting in increased patient safety and better outcomes of care,” Bolevich said.

“By providing more accurate and complete information about a patient’s medications, which can be shared between health professionals in different locations, it provides a greater ability to analyse trends and identify evidence-based best practice to improve patient safety and quality healthcare.”

With the EMR and EMeds systems now operating, the focus for eHealth now changes to the development of the Single Digital Patient Record (SDPR).

NSW Health recently announced its intention to issue a Request for Information seeking input from the market on solutions, services and learned experiences. It also held an industry briefing earlier this month.

The goal of the SDPR according to NSW Health is to provide a holistic, state-wide view of a patient’s health care information which will result in safe, high-quality healthcare and a more consistent ICT user experience for healthcare providers. 

The SDPR initiative is focused on clinical systems that support the delivery of patient care in NSW public hospitals (such as EMRs) rather than on patient-controlled electronic health records (such as the national My Health Record).

“The benefits of an SDPR include improved safety and quality in the continuity of patient care; a consistent patient experience; a consistent and enhanced clinician experience with EMR systems; greater ease of integration with community-based and private healthcare providers; and enhanced ability to implement consistent data analytics and clinical decision support,” Bolevich said.

Health professionals using the e-health system to access patient records. Source: NSW Health

One of the major issues people were worried about with the Federal Government’s My Health Record was privacy concerns over who could access the records.

NSW Health has moved to allay those concerns. It said NSW Health EMR systems can be accessed only by authorised staff and are subject to strict security controls.

The systems are auditable and NSW Health staff must undertake privacy training and sign a confidentiality undertaking which sets out their privacy obligations.

WHAT IS THE DIFFERENCE BETWEEN THE TWO?

New Economy Media has been told the My Health Record being administered by the Australian Digital Health Agency (Commonwealth government funded) is a consumer controlled health record, where the consumer is able to control what data is shared and who can see it.

It can be accessed by health professionals but the consumer decides what others get to see.

There are differences between the My Health Record and the proposed NSW SDPR.

The likely intent of the latter is to enable quick access to data from all instances when a person interacts with the NSW Health system. This is seen as being vital for patient care. It can be expected that a benefit will arise when a patient presents to multiple care settings, e.g an emergency department that is different to the local health district where they normally reside and routinely receive outpatient care for a chronic condition like diabetes.

The SDPR could in this case support the provision of  timely and appropriate clinical care. Whilst there is already connectivity between systems and sites, it can be improved.

 WHAT ARE THE BENEFITS?

Without a way of sharing a person’s health information between different care settings, things can go wrong, so the benefits of electronic health records outweigh the perceived disadvantages.

This is all about providing better care, the right care at the right time, something that the general population would expect from the health system, New Economy Media has been told.

If you deliver the right care at the right time, you get better outcomes, greater productivity and longer life spans. Access to complete and accurate data supports care delivery.

NSW Health has declined to provide a time frame for the introduction of the SDPR.