Specialists warn they will be unable to join the national digital health system unless critical hurdles are overcome.
About a fifth of the population (5.5 million people) now have a My Health Record, and over 10,000 healthcare providers are also signed up to use it, according to latest figures from the Australian Digital Health Agency (ADHA).
About two thirds of providers registered with the system are general practices, and almost 1000 are public and private hospitals.
But it seems medical specialists are slow to adopt the system.
To date 268 specialist practices have signed up, with almost 69,000 letters written by specialists to GPs uploaded, but only 46 e-referrals recorded .
The figures from the ADHA show that 793 public hospitals and over 6000 GP practices have uploaded about 3 million discharge and shared health summaries, while over 16 million prescription and dispensing records have been added to the system.
The Royal Australasian College of Physicians says the low uptake of the My Health Record by specialists is down to the government’s failure to consult meaningfully. In a submission made to government last year, the College said implementation efforts for digital health had focused on primary care, with GP practices offered financial incentives to use the system and enrol patients.
Other barriers to specialist adoption of e-health system of include time constraints and the lack of a simple workable digital health system that was nationally accepted by all health providers, the college said in the submission document.
It warned the government it must consult specialists properly if it wanted to recruit the “critical mass” needed to meet desired outcomes of its National Digital Health Strategy.
“Digital health will struggle to gain widespread uptake and use until these issues are adequately addressed,” it said.
The College also cautioned that the uptake drivers targeted at general practice may not be suitable for specialists who work across multiple practices and in hospitals and “broader policy design should be cognisant of this distinction”.
Problems with interoperability of electronic health systems and software between healthcare sectors and regions must also be overcome, the College said.
But the government says it’s not too worried about the low uptake rates among specialists for now.
Bettina McMahon of the Australian Digital Health Agency said it had deliberately prioritised high volume data from hospitals, pharmacies, pathology and imaging and general practice.
“We are trying to do this in a logical sequence, by focusing on hospital discharge summaries, medicines information, pathology test results and shared health summaries from GP…that makes most sense to get that content in early and all of those sectors are highly computerised,” she told the limbic.
The lower levels of office computerisation of specialist practices was also a factor in the agency’s priorities, she added.
“When we go to specialists, we do absolutely have a level of computerisation there, but it’s often not as high, so in terms of consulting with them we want them to start using and benefiting from the information that will be there when everyone gets a record,” said Ms McMahon, who is chief operating officer for the ADHA’s government and industry collaboration, strategy and delivery programs.
“While we are not engaging heavily with specialists to be uploading…we are consulting quite heavily with them on how they can use the record,” she added. “So yes it will be great if everybody uploads specialist letters but that’s to come.”
Another line of work being pursued by the agency involves developing a standard that will enable interoperability between secure messaging software, so doctors can be weaned off the fax machine for communicating between each other.
A recent study found more than half of all doctors still use fax as their primary mode to send letters, followed by mailed letters (27%). Just 12% named electronic referrals as their primary mode of transmission.
While most practitioners (72%) said they would like to increase their use of electronic referrals, the main barrier cited was that other practitioners were not set up to participate or did not have compatible system.
“Somewhat ironically, the key barrier to eReferral use was peers not using eReferrals,” said the authors of a study involving 204 specialists, GPs and allied health staff in Tasmania, .
“A greater emphasis on software usability and interoperability is required,” the researchers concluded in their paper published in the Australian Journal of General Practice.