Electronic Health Records

The Commonwealth Government is in the process of exploring the rollout of a Personally Controlled Electronic Health Record enabling all Australians to have access to their health information.

The Personally Controlled Electronic Health Records will transform healthcare, altering doctor-patient relationships and empowering individuals to take a more proactive approach towards their health. However a number of
issues surrounding their implementation remain unanswered. A research cluster at IBES is exploring a number of issues surrounding electronic health records.

Multi-site electronic health record
Making pathology reports smarter
Ethical and social issues

Multi-site electronic health record, clinical viewer and personal patient record to improve clinical outcomes for immigrants and refugees requiring specialist care

Refugee patients usually have multiple and complex health conditions requiring lengthy medical follow-up. Typically they may see both a General Practitioner (GP) and a specialist multiple times over the course of months to years. This presents issues relating to continuity of health records for individuals who may visit multiple clinicians during the course of their treatment.

This project developed a pilot web-based electronic health record system to overcome this issues. The system is being deployed in specialist refugee health clinic at the Royal Melbourne Hospital, and Dandenong and Geelong hospitals. The system links to hospital pathology systems and provides data for monitoring health to clinicians.

The system makes use of cloud computing facilities, providing an interface to generate care plans and specialist summaries. The research team is also exploring the use of videoconferencing to provide real-time specialist support for GPs by enabling them to virtually consult with specialists, as well as interpreters, via video conferencing.

By connecting GPs and specialists across different hospitals and clinics, patient care will be optimised through the facilitation, coordination and specialist management of patients with complex health issues. Real-time engagement will avoid delays and duplication leading to better health outcomes. Providing support to GPs in regional areas will allow for the efficient use of limited specialist resources.

This research project was completed in April 2012.

This findings from this research form the basis of the Refugee Health clinical hub – a model for integrated clinical care using the National Broadband Network project supported by the Victorian Government's Broadband-Enabled Innovation Program (BEIP).

Research Team

Research Team
Researcher/s	Department
Beverley-Ann Biggs, Georgia Paxton, Marienne Hibbert, Karin Leder, Thomas Schulz, Libby Matchett, Daniel O’Brien	Royal Melbourne Hospital
Andrew Block	Dandenong Hospital
Eugene Athan	Geelong Hospital
Peter Cross, Jason Lohrey, Mike Pollitt	Arcitecta

Making pathology reports smarter

Pathology reports are currently designed as a concise record of test results. Unfortunately, the technical emphasis of these reports makes them difficult to understand for many patients, representing a communication barrier between patient and physician. A more user-friendly report design that helps patients more easily understand their pathology results would enable greater engagement by patients in achieving positive health outcomes.

This project is developing a new type of pathology report that will enable a patient with a chronic disease to better understand, monitor and manage their condition through a customised health tool. The smarter pathology reports developed by the project team use message matching to connect the health message, the pathology results, with the patients preferred manner of delivery, to drive health-behaviour outcomes from the presented information.

The smarter pathology reports are activated via a small questionnaire to illicit patients' presentation preference, with tailored messages sent from a centralised server to mobile phones. Patients also have the ability to log into the system and view their reports any time.

This project has received additional support from the Commonwealth Department of Health and Ageing.

This research project was completed in September 2011.

Research Team

Research Team
Researcher/s	Department
Reeva Lederman, Suelette Dreyfus	Computing and Information Systems
Stephen Smith	Monash University
Paul Monagle	Royal Children's Hospital

Publications

S Dreyfus, R Lederman, SP Smith, P Monagle 2011 'Customising Pathology Report Design for Patient Use' Electronic Journal of Health Informatics 6 (2)

Ethical and social issues

The Australian Government is currently designing a system that will make everybody's key medical information and history available through a single access point. The system is called the Personally Controlled Electronic Health Record and its implementation raises a number of ethical and social issues.

Some of the challenges arising from the implementation of Personally Controlled Electronic Health Records include: how responsibilities change among stakeholders such as patients and clinicians; how conflict is resolved; how privacy and confidentiality is managed, and how patients accessing their own health information affects their relationship with health providers.

The researchers on this project are exploring the views and practices of stakeholders to identify key ethical challenges. Along with cultural concerns, these exploration challenges are leading to the development of resources to inform policy making around electronic health records.

The project is developing practical ethical guidelines and decision-making resources to address current needs in relation to electronic health records that will inform policy and consultation by the National E-Health Transition Authority (NEHTA) and other government bodies as Personally Controlled Electronic Health Records are progressively rolled out across Australia.

This research project was completed in February 2012.

Research Team

Research Team
Researcher/s	Department
Craig Fry, Michael Arnold, Merle Spriggs	Historical and Philosophical Studies
Chris Pearce	General Practice

Institute for a Broadband-Enabled Society