NSW Health Providing Online and Integrated Health Records

Medical consultations are happening all the time in a variety of circumstances. Any time a patient consults a healthcare practitioner a large amount of information is generated. Managing that information is central to a smoothly functioning health system. Where once that information was recorded in hard copy on paper and needed to be physically transported, we now live in the digital age and that information can exist and be managed in a digital and online form.

These electronic health records form the basis of what is known as e-health and NEHTA is putting into place the structures that will allow e-health to become part of the Australian health scene on a national scale. However, on a state-based level in Australia independent and successful pilot projects are underway such as the Healthelink project in NSW.

Healthelink
The Healthelink Electronic Health Record (EHR) pilot is the beginning of NSW Health’s strategy to provide an online and integrated electronic record of an individual’s health care provided across public and private health settings. The project began planning in 2004 and by March 2006 the Maitland Hospital began contributing data to Healthelink followed by The Children’s Hospital at Westmead in September that year.

Currently almost 45,000 people have been enrolled and have a Healthelink electronic health record. There are seven hospitals and nine community health centres directly involved in the pilot and there are over 150 general practitioners participating. The pilot phase of Healthelink includes a potential patient population of 170,000 people in the greater western Sydney and Maitland areas.

Already there are well over 200 healthcare providers who have access to their patient’s Healthelink records. These providers work in hospital emergency departments, community health and in general practice.

Healthelink in action
For the individual, Healthelink means that for the first time ever people will be able to access a summary of their health information online and free of charge. Those same people can allow others to view their information at their discretion. Individuals will also be able to contribute information to their electronic health record, and then that information will be viewable by their healthcare provider. This means that information can be added as it arises and individuals will not need to recall every detail of their health history every time they visit a new healthcare provider. Those healthcare providers will have access to the same summary information when making their clinical decisions. Overall, individuals will be empowered by Healthelink to participate in decisions about their healthcare through a more detailed knowledge of their own health history.

For the authorised clinician, Healthelink gives access to their patient’s health history, which is built up over time potentially involving many different healthcare providers. Healthcare providers can quickly access a variety of information about their patient’s visits to participating GPs, community health centres and hospitals. This enables providers to obtain a snapshot of their patient’s health. To take just one example, imagine the boon that this access to patient history could provide for a locum doctor in the absence of your regular GP. Healthelink also has the potential to help healthcare providers reduce adverse events by giving them a total view of their patient’s health care and to reduce unnecessary duplication of testing.

Dr Mukesh Haikerwal, past-President of the Australian Medical Association says, “The great benefit of an EHR is that many of an individual’s details that are useful for ongoing management will be assembled in one place. That facilitates better decision making by the practitioner. It can also improve delivery of care by having access to what has already been done, so that you can build on it.”

Progress report
Early feedback indicates that the Healthelink pilot has been a success in terms of its ability to transfer information between multiple providers and provide ready access for clinicians and consumers. The technological capability driving this project is a major achievement given the complexity of sharing information in the healthcare environment. Based on their experiences in the pilot, the overwhelming majority of healthcare providers surveyed were positive about the benefits the EHR can achieve and the potential it can have in effectively delivering healthcare.

The Healthelink EHR pilot will continue to operate until June 2009. Subject to the approval of a business case, a state-wide rollout could commence in 2009-10.