Electronic Health Records (EHR, EMR)

Queensland Ambulance Service (QAS) has rolled out a digital system that aims to give paramedics greater access to a patient’s vital medical information in an emergency. The SafeMate emergency medical information program is under trial for Medibank customers with chronic illnesses that are living in Queensland. Patients must be enrolled under Medibank’s CareComplete chronic disease management service. The SafeMate program houses a patient’s medical and personal information that they enter online. QAS personnel can then access this data by scanning a QR code on a patient's SafeMate card using iPads. “This is crucial information that a patient wants the paramedic to know in a medical emergency,” Queensland Government Minister for Ambulance Services Steven Miles said. “Paramedics will use their operational iPads to tap the patient’s SafeMate card or device, and the medical information will appear on the screen. It eliminates the time it would normally take a paramedic to ask the patient a range of questions in order to obtain their medical history and other pertinent details.” This gives paramedics access to important information, such as details on allergies and medical history, letting them identify best courses of treatment earlier and improving patient outcomes. It also aims to reduce paramedic and patient stress, time-consuming hospital visits and costs in the health system, in addition to improving ambulance efficiencies. Prior to December 1 last year, paramedics were unable to access these records as the organisation was not in the Australian Health Practitioner Regulation Agency (AHPRA) regulated health profession registry. [Read more: EMRs and the Royal Flying Doctor Service – how the iconic institution approaches innovation | Head of eHealth Queensland on stunning ieMR stats and a future of interstate digital health collaboration] The digital system is a testament to Queensland’s ongoing digitisation journey, with the launch of a digital hospital program to improve the state’s healthcare and patient outcomes. In December last year, through findings from a report tabled by the Queensland Audit Office (QAO), Miles outlined the benefits of the digital hospital program in Queensland. He said that as a result of the digital hospital program, Queenslanders face improved health service delivery and patient outcomes, including a reduction in unplanned readmission rates, faster access of clinical information by medical staff and more legible patient records. “Digital hospitals are making Queensland hospitals safer than ever before. Doctors and nurses have told me when I’ve visited hospitals that the digital system helps them do their jobs and helps patients,” Miles said. Ambulance Victoria has also ramped up its digitisation strategy, with the organisation most recently announcing that it will soon deploy a predictive analytics platform for its paramedics to access real-time information, enhancing and accelerating its decision making as the need for emergency services grows.

The document includes changes made due to comments from stakeholders and it contains new standards and updated characteristics.

The health system's Physician Services Group worked with IT leadership to help aggregate EHR prescribing data and make it available to its providers.

The agency’s Annual Report 2017–18 identified that “42 data breaches (in 28 notifications) were reported to the Office of the Australian Information Commissioner (OAIC)… concerning potential data security or integrity breaches”, but with “no purposeful or malicious attacks compromising the integrity or security of the My Health Record system”. Of the 42 instances, one breach resulted from unauthorised access to a My Health Record as a result of an incorrect parental authorised representative being assigned to a child. Two breaches resulted from suspected fraud against the Medicare program, where the incorrect records appeared in the My Health Record of the affected individual and were viewed without authority by the individual undertaking the suspected fraudulent activity. The ADHA report also identified that 17 breaches were a result of data integrity activity initiated by the Department of Human Services to “identify intertwined Medicare records (that is, where a single Medicare record has been used interchangeably between two or more individuals)”. The remaining 22 breaches were from suspected fraud against the Medicare program involving unauthorised Medicare claims being submitted, and the incorrect records appearing in the My Health Record of the affected customers. An ADHA spokesperson confirmed that in all instances, the Department of Human Services took action to correct the affected My Health Records. “Errors of this type occur due to either alleged fraudulent Medicare claims or manual human processing errors, as was the case for the breaches reported during the 2017-2018 financial year. There has been no reported unauthorised viewing of any individual’s health information from a notifiable data breach,” the spokesperson said. “In each case, the affected individuals have been contacted and the OAIC has examined the circumstances of the breach and no unauthorised breach has been determined.” The ADHA spokesperson added that there are more than 6.3 million people with a My Health Record, but in the six years of its operations, there have been “no reported unauthorised views of a person’s health information”. “When a person’s health information is stored in different places – hospitals, doctors’ offices, filing cabinets, computers – they don’t know who is accessing it or when. In a My Health Record, every access is listed in a person’s record access history. A person can be notified by text message about who is accessing their record or restrict access to all or parts of their record,” the spokesperson said. On 26 November 2018, the Federal Parliament passed legislation to strengthen privacy protections in My Health Records Act 2012 without debate or division.   The new legislation means that Australians can opt in or opt out of My Health Record at any time in their lives. Records will be created for every Australian who wants one after 31 January and after then, they have a choice to delete their record permanently at any time. “At the time of writing, almost one quarter of all Australians have registered for a My Health Record. That figure is expected to change dramatically with the transition to an opt out system early in the 2018–19 financial year,” ADHA CEO Tim Kelsey said in the report. “Once this resource becomes almost ubiquitous across the Australian health system, clinical workflows and consumer behaviours will gradually and irrevocably change to take advantage of its many benefits. “For many people the benefits of digital health will be realised gradually, as health and medical data gradually accumulates to form a comprehensive medical history,” Kelsey said. This article first appeared on Healthcare IT News Australia.

Providers, patients and payers all still lack access to patient where and when they need it, the Office of the National Coordinator for Health IT said.

Maryland-based Meritus worked with the Missouri health system's IT arm, Mercy Technology Services, to get a more advanced version of the electronic health record up and running.

At HIMSS19, John Rekart, chief of quality management and informatics at the California Department of Corrections and Rehabilitation will show how homegrown analytics enabled a 25 percent post-implementation reduction in sentinel events.

The number of data breaches involving My Health Record has risen year-on-year, from 35 incidents in the last financial year to 42 incidents this year, a report by the Australian Digital Health Agency (ADHA) has shown. The agency’s Annual Report 2017–18 identified that “42 data breaches (in 28 notifications) were reported to the Office of the Australian Information Commissioner (OAIC)… concerning potential data security or integrity breaches”, but with “no purposeful or malicious attacks compromising the integrity or security of the My Health Record system”. Of the 42 instances, one breach resulted from unauthorised access to a My Health Record as a result of an incorrect parental authorised representative being assigned to a child.  Two breaches resulted from suspected fraud against the Medicare program, where the incorrect records appeared in the My Health Record of the affected individual and were viewed without authority by the individual undertaking the suspected fraudulent activity. The ADHA report also identified that 17 breaches were a result of data integrity activity initiated by the Department of Human Services to “identify intertwined Medicare records (that is, where a single Medicare record has been used interchangeably between two or more individuals)”. The remaining 22 breaches were from suspected fraud against the Medicare program involving unauthorised Medicare claims being submitted, and the incorrect records appearing in the My Health Record of the affected customers. An ADHA spokesperson confirmed to HITNA that in all instances, the Department of Human Services took action to correct the affected My Health Records. “Errors of this type occur due to either alleged fraudulent Medicare claims or manual human processing errors, as was the case for the breaches reported during the 2017-2018 financial year. There has been no reported unauthorised viewing of any individual’s health information from a notifiable data breach,” the spokesperson said.  “In each case, the affected individuals have been contacted and the OAIC has examined the circumstances of the breach and no unauthorised breach has been determined.” [Read more: Australia leads the world in personal control of electronic health records | Is the My Health Record technology out of date?] The ADHA spokesperson added that there are more than 6.3 million people with a My Health Record, but in the six years of its operations, there have been “no reported unauthorised views of a person’s health information”. “When a person’s health information is stored in different places – hospitals, doctors’ offices, filing cabinets, computers – they don’t know who is accessing it or when. In a My Health Record, every access is listed in a person’s record access history. A person can be notified by text message about who is accessing their record or restrict access to all or parts of their record,” the spokesperson said. On 26 November 2018, the Federal Parliament passed legislation to strengthen privacy protections in My Health Records Act 2012 without debate or division. The new legislation means that Australians can opt in or opt out of My Health Record at any time in their lives. Records will be created for every Australian who wants one after 31 January and after then, they have a choice to delete their record permanently at any time. “At the time of writing, almost one quarter of all Australians have registered for a My Health Record. That figure is expected to change dramatically with the transition to an opt out system early in the 2018–19 financial year,” ADHA CEO Tim Kelsey said in the report.] [Read more: Is it possible to build an Australia that is driven by patient-led healthcare? | Game changer: Creator of FHIR writes about approaching critical mass and a growing data sharing revolution] “Once this resource becomes almost ubiquitous across the Australian health system, clinical workflows and consumer behaviours will gradually and irrevocably change to take advantage of its many benefits.  “For many people the benefits of digital health will be realised gradually, as health and medical data gradually accumulates to form a comprehensive medical history,” Kelsey said.

The medical device integration tool can deliver data to clinicians within Epic’s workflow.