kitedoc
Well-Known Member
- Messages
- 4,785
- Location
- Adelaide, South Australia
- Type of diabetes
- Type 1
- Treatment type
- Pump
- Dislikes
- black jelly beans
Hi@SamJB, please excuse me if I just add in some thoughts about the Aussie system as a contrast. I apologise for any perceived highjacking behaviour and ensure your thread is returned nourished, brushed clean and well-behaved.
From my reading and attending orientation sessions about the MyHealthRecord (MHR)system (more of that later):
Basically all Aussies have a right through State laws to view their health records, except for Freedom Of Information provisions, such as where a doctor considers that access to a part of the record might cause undue stress and ill-health to the patient. Naturally many people view FOI provisions with skepticism as to possible biases in favour of health professionals trying to hide things.
So my GP cannot block access of me to my health record results etc. and would have a difficult time proving that knowing my latest HBA1C is a threat to my health (rather the opposite)!!
There is also an under-utilised right that can legally (at least according to lawyers I have consulted) flow from this access right, and that is actually the right to write in their patient record.
Unfortunately the Aussie 'field' of health record management is littered with partly successful but often incompatible computerised medical record systems from primary care (e.g.GP) through to hospital level. Sound familiar? And these system have ignored the patients' right to wrote in their own record as there is no easy provision for this to happen.
Excuses of staff and possible replies:: "Sorry it is not allowed" (show me where?)., "we cannot bring the computer to your bed". (please wheel me out there then, or please provide mobile technology so that I can) and the classic: under legislation you have to fill out an application form and it takes 3 weeks for a reply. (No good to me. Can I please see the Head Administrator AND my specialist? Otherwise I shall ring my MP, GP and the papers).
For some years now the Aussie Federal Government has been trying to implement a central computerised health record system to overcome problems of access by hospitals/Casaulty departments, and all health professionals to patient records, and for patients to also have access and input into their health record.
The process has been dogged by poor adaption of the lessons learned in other countries; concerns, somewhat exaggerated by the media, about security issues; and resistance of health professionals to devote unremunerated time in formulating and uploading patient health summaries. to this initiative, MyHealthRecord.(MHR) (surprise, surprise - no one does things for free, even for the Government. What did the Govt expect) ?
In theory (at least), if I enrol in this programme (which I actually have) I should be able to access results, prescription and medication history and health summaries. But the clinical part of the MHR has to be filled in.
This allows successful link ups with pathology/imaging services AND my GP doing his bit to provide an initial summary to which other health professionals can add, such as after an operation/hospital admission/specialist visit etc.
Hold ups/issues: The Government started with an opt-in scheme approx. 10 years ago and the uptake was (swear word) abyssmal.
So they moved this year to an opt-out system, you have a MHR created and so does your child and anyone over 18 automatically and you have until end of this month (I think it is) to 'opt out'.
There is a section for me to fill out things like my medication and allergies, basic identification information, next of kin etc.
The 'clinical section' can only be added to my registered health professionals but I have the right to block anything (but not necessarily all) I disagree with, block but not clarify/challenge e.g. if I believe that my history of mental illness has been inaccurately reported I can opt to block it. Hopefully I can present the reasons to say, my GP, and have the clinical record altered by him. As I think you can imagine my doctor may have qualms at altering a section clinical record signed by a psychiatry registrar etc.
Of course it would be very unwise to have information such as allergies and sensitivities to medication blocked.
I choose to stay in the MHR system because it gave me protection against lack of information if I was admitted to a hospital unconscious. Yes, I also have a Medic Alert bracelet which provides clinical information too but having a centralised system should give more comprehensive information. It is perhaps nice to have the Medic Alert system though as a back up !!
My personal beef is that if I have an important piece of information about my health that I wish read by a health professional AND my doctor or other health professional thinks the information is trivial, controversial etc and they refuse to include it in the 'clinical section" of MHR. Think about it - if i am taken to Casualty/Emergency unconscious, what part of my MHR will the nurse and doctor read first ? Yes the 'clinical part'. Will they read my Very Important Matter To Me information in my section of the record? Depends how busy they are, how acute my condition is, and the health professionals' own training and biases.
Finding a way to allow/tag/link what concerns me most to what the clinician will read early on has run into roadblocks which you would not believe.
Thus I have taken the risk, personally of only filling out my section of the MHR, using the medication comments sections to note down my medical conditions, insulin pump settings AND the Very Important Matter (to)Me (VIME).
It means I cannot access my results thru my MHR etc at this this stage but my VIME is where it can be noticed.
I shall start a thread as more 'progress' happens (fingers and toes crossed).
From my reading and attending orientation sessions about the MyHealthRecord (MHR)system (more of that later):
Basically all Aussies have a right through State laws to view their health records, except for Freedom Of Information provisions, such as where a doctor considers that access to a part of the record might cause undue stress and ill-health to the patient. Naturally many people view FOI provisions with skepticism as to possible biases in favour of health professionals trying to hide things.
So my GP cannot block access of me to my health record results etc. and would have a difficult time proving that knowing my latest HBA1C is a threat to my health (rather the opposite)!!
There is also an under-utilised right that can legally (at least according to lawyers I have consulted) flow from this access right, and that is actually the right to write in their patient record.
Unfortunately the Aussie 'field' of health record management is littered with partly successful but often incompatible computerised medical record systems from primary care (e.g.GP) through to hospital level. Sound familiar? And these system have ignored the patients' right to wrote in their own record as there is no easy provision for this to happen.
Excuses of staff and possible replies:: "Sorry it is not allowed" (show me where?)., "we cannot bring the computer to your bed". (please wheel me out there then, or please provide mobile technology so that I can) and the classic: under legislation you have to fill out an application form and it takes 3 weeks for a reply. (No good to me. Can I please see the Head Administrator AND my specialist? Otherwise I shall ring my MP, GP and the papers).
For some years now the Aussie Federal Government has been trying to implement a central computerised health record system to overcome problems of access by hospitals/Casaulty departments, and all health professionals to patient records, and for patients to also have access and input into their health record.
The process has been dogged by poor adaption of the lessons learned in other countries; concerns, somewhat exaggerated by the media, about security issues; and resistance of health professionals to devote unremunerated time in formulating and uploading patient health summaries. to this initiative, MyHealthRecord.(MHR) (surprise, surprise - no one does things for free, even for the Government. What did the Govt expect) ?
In theory (at least), if I enrol in this programme (which I actually have) I should be able to access results, prescription and medication history and health summaries. But the clinical part of the MHR has to be filled in.
This allows successful link ups with pathology/imaging services AND my GP doing his bit to provide an initial summary to which other health professionals can add, such as after an operation/hospital admission/specialist visit etc.
Hold ups/issues: The Government started with an opt-in scheme approx. 10 years ago and the uptake was (swear word) abyssmal.
So they moved this year to an opt-out system, you have a MHR created and so does your child and anyone over 18 automatically and you have until end of this month (I think it is) to 'opt out'.
There is a section for me to fill out things like my medication and allergies, basic identification information, next of kin etc.
The 'clinical section' can only be added to my registered health professionals but I have the right to block anything (but not necessarily all) I disagree with, block but not clarify/challenge e.g. if I believe that my history of mental illness has been inaccurately reported I can opt to block it. Hopefully I can present the reasons to say, my GP, and have the clinical record altered by him. As I think you can imagine my doctor may have qualms at altering a section clinical record signed by a psychiatry registrar etc.
Of course it would be very unwise to have information such as allergies and sensitivities to medication blocked.
I choose to stay in the MHR system because it gave me protection against lack of information if I was admitted to a hospital unconscious. Yes, I also have a Medic Alert bracelet which provides clinical information too but having a centralised system should give more comprehensive information. It is perhaps nice to have the Medic Alert system though as a back up !!
My personal beef is that if I have an important piece of information about my health that I wish read by a health professional AND my doctor or other health professional thinks the information is trivial, controversial etc and they refuse to include it in the 'clinical section" of MHR. Think about it - if i am taken to Casualty/Emergency unconscious, what part of my MHR will the nurse and doctor read first ? Yes the 'clinical part'. Will they read my Very Important Matter To Me information in my section of the record? Depends how busy they are, how acute my condition is, and the health professionals' own training and biases.
Finding a way to allow/tag/link what concerns me most to what the clinician will read early on has run into roadblocks which you would not believe.
Thus I have taken the risk, personally of only filling out my section of the MHR, using the medication comments sections to note down my medical conditions, insulin pump settings AND the Very Important Matter (to)Me (VIME).
It means I cannot access my results thru my MHR etc at this this stage but my VIME is where it can be noticed.
I shall start a thread as more 'progress' happens (fingers and toes crossed).
