Senator Alan Eggleston


  • eHealth

Personally Controlled Electronic Health Records Bill 2011

Earlier this month I had the opportunity to travel to London for a Commonwealth Economic Forum and, as is obviously the case when leaving the country for foreign travel, the most important thing a person does is pass through immigration. I was very impressed by the fact that in our airports these days an electronic system looks at passports and confirms the identity of individuals. That is an example of IT being used in a very positive way. I think the introduction of electronic health records is a similar technological advance which will lead to greater efficiencies in the health industry, especially when a person away from their home base is struck by illness and their medical records can be available through the system of e-health records.

As has been said by other speakers, the coalition supports the concept of personally controlled electronic health records and the amendments to this bill. There is no doubt that the benefits of having an accessible electronic health record available around the country are great and have been referred to by many other speakers. This system is commonly referred to as e-health. It is certainly an exciting advancement, extending the scope of primary health care and protecting patients who are travelling. The efficiencies e-health can create are not new concepts to the coalition. Under the last coalition government, computerisation of general practice increased from 17 per cent in 1997 to about 94 per cent 10 years later. That meant that 94 per cent of general practices around the country had computers and patient records were kept much more systematically. The data within them was much more easily accessible to medical practitioners and to people doing research, for example, into the efficacy of drugs for the treatment of hypertension in which a general practice might have been participating. Accessing the records of the serial measurements of a patient's blood pressure is much easier with computers in general practice. Linking general practices to make up a huge pool of patients has been used widely in the United Kingdom to test new drugs, to record outcomes and to file those outcomes back to the university or wherever the trial was being facilitated, all linked by the internet.

The real value of this system is that when a patient who is away from their home becomes ill it is possible with an e-health record system that they can go to a hospital or perhaps to a medical practice anywhere in the country where their medical records will be accessible. This will mean that people can be treated much more quickly and effectively because the detail of their histories will be accessible. Very often people are not as aware of the details of their medical history as one might hope or imagine they would be. That is going to be one of the great benefits of electronic health records.

It has been forecast that by 2020 e-health capabilities could save up to $7.6 billion a year in health costs by reducing duplication and errors, by improving productivity and by providing better adherence to best practice principles. The government's own numbers suggest that the benefits of e-health records alone in Australia would be $11.5 billion saved by the year 2025. That is an incredibly large figure which in itself justifies completely the introduction of the system.

In addition, the same report suggests that a full e-health program can help avoid up to 5,000 deaths annually once the system is in full operation. That is a very important and practical consideration as well. It again shows how beneficial this program potentially will be to the Australian public.

The report further states that, annually, a fully implemented e-health system could avoid up to two million primary care and outpatients visits, 500,000 emergency department visits and 310,000 hospital admissions. They are amazing figures that testify to the efficiencies and cost savings that this system will introduce to our health system.

Importantly, it will also mean that patients have their entire medical history available to them anywhere they travel. A patient with a patient-controlled electronic health record who becomes ill while travelling has their full medical history available to the doctor or emergency department they visit. These are very important benefits.

The downside of the electronic health record system is the protection of patient privacy. There are very legitimate concerns about patient privacy in relation to the introduction of electronic health records. We all know that it is very easy to hack into computer systems. Persons' health records are often very important to their capability of getting a job or insurance. People are quite rightly concerned that the privacy of their health records should be protected, not only for those reasons but just for the general issue of privacy and confidentiality of a person's health records and for the protection of the privacy of the doctor-patient relationship. For this reason the issue of privacy is the biggest concern that people have in association with the idea of the introduction of electronic health records. I think it is very important that the government and those who are responsible for setting up this system make sure that the question of privacy is uppermost in their minds and that the absolute confidentiality of health records is protected. It is a very important consideration.
The idea of electronic health records, and having wide accessibility to them, is one that is under consideration around the world. When I was at the United Nations in 2010, I met a British doctor who was interested in an e-health system in which medical records could be accessible anywhere in the world. In my view it is very bold thinking of his to contemplate a system whereby wherever you were in the world your health records could be accessed through the internet by responsible individuals in a hospital. It would be very hard to set up such a system, but not impossible in this day and age.

Unfortunately, the British experiment with e-health was not a great success. After expending a great deal of money, unfortunately the United Kingdom's system was scrapped, in late 2011. The British had spent some $12 billion on their e-health equivalent of this proposal. So we do have to make sure that the system is efficiently managed and that the concerns for patient privacy are respected. But overall I think the benefits that this system will bring to Australia and to the Australian public are great, and the coalition endorses this system, as I do as a former medical practitioner. I can see great benefits in having access at your fingertips to a patient's records and to the records of an individual from some other part of the country who might come in to see you. It is certainly going to be an interesting exercise to see how this system develops. But I am sure that, with goodwill and concern, once this system is up and running we will have a very useful tool to ensure that the health of Australians is protected wherever they travel in this country.

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