The PCEHR Review

The Department of Health has decided to engage a consultant to help them formulate their response to the PCEHR review. The focus is to be on the implementation of the system. In my view they are asking the wrong question.

In eHealth there seems to be an implicit assumption that, by gathering more and more data on a patient, better health decisions and outcomes can be achieved.

I have never seen this assumption validated and IMHO, it is false to the extent that the more useless information you have on a patient, the harder it will be for a health care professional to sort through it all, separating the good from the dross.

When it comes to personal health care, what I believe is necessary is relevant and current data, not more data. The relevance and quality of much health data deteriorates over time. There should be at least something in the eHealth strategy and in the PCEHR about addressing this issue.

The fact that there is nothing mentioned anywhere about data quality means that the real question about the PCEHR is not “has the PCEHR been implemented right?” but “is the PCEHR the right system?”.

My answer to that question is conditional: Is the PCEHR intended to support decision making to achieve better health outcomes of individual patients? If this is true, then No, it will just make things worse and carers will drown in irrelevant data.

Is the real reason for the existence of the PCEHR to gather as much information as possible about as many Australians as possible? If this is true, then Maybe, but the government is being disingenuous and misleading and its not solving the right problem.

The push to opt-out strongly suggests the second reason.

The only saving grace is that a system intended for the second reason, but used for the first, cannot not succeed. Unfortunately, its failure will take a long time, cost a lot of money and put the adoption of effective and efficient health information systems back by decades.

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