Tuesday, January 31, 2012

Consumers need to opt in to ehealth records

Adam Cresswell wrote a piece in last week’s Weekend Australian highlighting concerns raised by doctors and consumer groups about likely low take-up rates for the electronic health records and calling for basic changes to keep the scheme on track.  The article focuses on comments from CHF in its submission to the Senate inquiry on the legislation to the program, in which it argues in favour of an opt-out, rather than an opt-in system. 

HCCA also presented a submission to this inquiry, strongly supporting the opt-in model.  This view is based on discussion of consumer members of the ACT ehealth Consumer Reference Group.

In an ideal world, opt-out has many strong arguments in its favour.  However, the reality of getting the PCEHR successfully implemented requires giving up some health data principles.  The introduction of the PCEHR represents a major shift in public perception and if the system to realise its potential, both health care providers and health care consumers need to be supportive and to be supported.  We are not there yet!

If everyone has a PCEHR, but few access it, what use is that?  Let those that know about it and want it be the trail seekers.  We have to start slowly otherwise it will fail.

There is also an issue around the incentives that are required to entice practitioners to become nominated providers in the system.  There is considerable discussion around the need for the Government to provide payment.  Why should the medical profession take on more tasks without being paid?  No amount of saying in the long run it will be beneficial to clinicians and their patients will bring about the change needed.  The demand for the time of our clinicians is strong and in some areas we do not have enough clinician to meet the needs of our communities. Some feel strongly that to expect them to add to their workload is a big ask and would mean other 'services' can't be provided.  A mechanism to engage clinicians to become nominated providers and to upload documents to the PCEHR has to be agreed soon so that consumers are not disadvantaged.

HCCA understands why the Government has adopted an “opt in” policy for consumer participation in the system and continues to support it, although we remain concerned that allowing clinicians to withhold records from the system may disadvantage consumers who choose to opt in and that some form of mechanism to limit this possibility needs to be incorporated in the EHR implementation. This, we believe, will enable it to better cater to consumer needs.

Darlene Cox
Executive Director

Friday, January 20, 2012

New Northside Hospital for Canberra

The ACT Government has released a report identifying the University of Canberra as their preferred site for the construction of the new Northside Hospital.
The ACT Government has indicated that there is a need to enhance public hospital facilities on the north side of Canberra to accommodate the growing health needs of our population over the next 20 years. The ACT Health Capital Asset Development Plan was developed as a blueprint for the redevelopment of the ACT health system.  A discussion paper on options for northside hospital services was issued in February 2011. As a result of that that process, the Government decided to building a stand-alone sub-acute facility in North Canberra. HCCA has been advocating for the establishment of a specialised sub-acute care facility for some time; this is reflected in our submission of November 2010 to the Government Standing Committee on Health, Community and Social Services Inquiry into Public Hospital Options as well as our response to the Government consultation on this matter in 2011.  The HCCA Submission is available online (160kb Pdf)
The HCCA has been very supportive of the decision to build  a sub acute hospital and has not seen a need to replicate The Canberra Hospital in North Canberra.  We have advocated that a sub-acute facility or community hospital, supported by primary health care centres around Canberra, would better meet the needs of the Canberra community. A community hospital with sub-acute and non-acute services will supplement the new enhanced primary health care centres. Planning for these centres is well developed with the new centres in Belconnen and Gunghalin expected to be opened in this year.  
The new Northside Hospital could be designed, built and staffed to provide rehabilitation services for people recovering after an operation (e.g. a hip replacement), an illness (e.g. a heart attack) or an injury (e.g. a fall or car accident). This would improve the potential for recovery as less time would be spent in an acute hospital (ie, Calvary or TCH). It could also include geriatric evaluation and management services, transition care and other step-up or step-down programs.
We have also suggested the facility could house a second secular hospice for the ACT and will participate in consultations with the Government for the review of the Palliative Care Strategy this year. 
The community recognises that people with serious mental illness need access to a range of treatment and support services, connected across the spectrum of care. We believe there is scope to include this in the development of the Hospital at the University of Canberra.  This would complement the successful step up step down facilities currently in place in the community.
A sub-acute facility on the University of Canberra grounds is vital to meet the needs of our community.   
The selection of the site is very important; it needs to be accessible, which means close to major transport routes. One of the failings of the Village Creek Rehabilitation Centre was the site selection.  The services, once you are inside the building, are excellent but being tucked away in a suburban setting has caused difficulty for some consumers and carers when accessing the Centre.  the University of Canberra is located to arterial roads and public transport, has sufficient area for dedicated parking, is close to the Belconnen Town Centre and is within easy travelling distance for people living in Gungahlin and the future Molonglo Valley development
In addition it would create valuable connections with the Faculty of Health Science and provide clinical placements for students in areas including, but not limited to, nursing and midwifery, pharmacy, physiotherapy and psychology.  We agree with the Government that the relationship should assist with staff recruiting and training, and should assist the university in undertaking health research.
The community wants assurance that decisions regarding the planning and design of our health system are taken on sound advice, based on identified clinical need and community needs and sound economic judgement.  We are satisfied with the range of issues the Government has considered in identifying the most appropriate site for the new hospital.
We look forward to being involved in the community discussion on the matter.
Darlene Cox
Executive Director

Consumer Representative Training Course

Are you, or a member of your family, a patient, carer or user of health care services? Then you are a health care consumer

Do you want a better understanding of the Health System in the ACT?
Are you interested in learning new skills to help yourself and others?
Have you thought about getting involved in a Health Directorate Committee?
Do you have questions or feedback about the health system?

This course will answer your questions and provide you with the necessary skills to help you to make a really valuable contribution to the health system.

We invite you to come along, learn some new skills and meet other health care consumers in a friendly atmosphere over the two day course.

After completing the course (you must attend both days), you will receive a certificate of participation, which enables you to nominate as a consumer representative on a Health Directorate Committee.

Course Date:  Friday 23 & 30 March 2012: 10am-2pm

HCCA Meeting Room, Sports House, 100 Maitland Street, 
Hackett ACT 2602

This course is free and morning tea and lunch will be provided. Please tell us of any dietary requirements.  Transport assistance may be available. Please ask for details.

To find out more and to register for course (you must attend both sessions) please contact us: Tel: 6230 7800: email adminofficer@hcca.org.au

Consumer Representative Training Courses are held 3 times a year.
If you miss this one, please ask about the June and September courses.