Queensland GP says digital health can improve clinical care
Queensland GP and obstetrician Ewen McPhee is a member of the Agency's Clinical Usability Programme (CUP) and is outspoken about the value of the My Health Record system to his patients.
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Digital health can improve clinical care
The My Health Record system may be unfairly getting a bad rap because of confusion among many clinicians, says a rural GP.
Emerald Queensland GP and obstetrician Ewen McPhee is outspoken about the value of the My Health Record system to his patients and says it surprises him more practitioners are not actively participating.
"It is about improving your clinical care, improving your medical record and making sure your patient is as well looked after as they can be if you are not there to do it yourself. "But the conversation has been muddied by confusion – what the My Health Record system is, its role and place, and the risk associated with being involved," he says.
"We really need to define what the My Health Record is intended to do."
Dr McPhee says through his professional travels, speaking with colleagues and in training registrars he has addressed various misconceptions.
GPs are not using the My Health Record
"Recently at a forum I attended, someone said ‘There are no GPs using the My Health Record system' and I thought well I do and I don't think I am alone. We started the process of becoming digital health-enabled fairly early in the piece and eventually got to the point we were able to upload Shared Health Summaries and to download discharge summaries from the regional hospital in Emerald."
People think that a My Health Record is going to replace their in-practice medical record
"It is not intended to replace your own records. It is really about building capacity around medication management, feedback, shared information and shared resources – and that is going to improve patient safety and patient outcomes."
Why would you use a My Health Record when you have normal secure messaging?
"One of the big challenges in Queensland is that when you use secure messaging and send it, none of the pathology is included. If you use the My Health Record system you get the pathology results as well so you get more information – more timely."
What happens if the GP puts their information out there and a critical decision is made that leads to a bad outcome?
"GPs worry about the medico-legal and privacy angle, and the Government has to clarify that. It is my understanding that most medico-legal opinion supports the use of the My Health Record, but I would encourage GPs who are concerned to seek an opinion. To make the system work we all need to be on there and sharing this information. At this point the My Health Record is just a health summary and as clinicians we should all have excellent health summaries. That is just a simple accreditation requirement regardless of whether you have a digital health system."
Developing change, even just within one practice, is quite hard because people are embedded in their own processes
"Getting clean data and getting uploads done is really the thing to focus on for GPs. At the end of the day it is about your own personal motivation for why you do things. It's made my practice better, and so I really drive it. We also have a belief that if we are going to claim money for something like an ePIP we should at least be doing what is required."
GPs don't have the time
"I personally update records as I see a patient. If I change the medication for an elderly diabetic patient, I will obviously update the clinical record and upload the summary. It doesn't take long – it is just an extra click to upload the new summary. It has certainly sharpened my concentration to ensuring the health summary is excellent, that I have got all the information in there that I would expect if someone else had to look after my patient when I wasn't there."
A mantle of safety
For Dr McPhee who has practiced in Emerald for more than 25 years, the benefits to his patients' safety are clear. "There is none of that delay getting information back from the hospital on what transpired."
"I had a 73-year-old man with a My Health Record who came to the practice through his diabetic educator and unfortunately he was quite pale and very unwell with chest pain. He went via ambulance to hospital and he will be assessed and managed but when he comes back to the practice we will automatically have his health summary and his pathology.
"AThe My Health Record system provides a mantle of safety for your patient that may improve communication, may improve outcomes, may allow people to be managed more safely particularly if they cannot speak for themselves."
"We now need a critical mass of GPs getting on board and actually just doing shared health summaries and really starting to build capacity for the system to develop," he said.
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