Slow uptake of the government's planned personally controlled e-health records (PCEHR) will be better for the system, according to Health Minister Nicola Roxon, who said that it may not be able to cope with 100 per cent adoption on day one.
At the unveiling of the government's final concept of operations report for the PCEHR system in Canberra yesterday, Roxon refused to be drawn on what level of take-up for the opt-in system she was expecting from the launch on 1 July 2012, instead saying that it will be better if fewer people sign up for the system on day one.
"I don't think that there will be 95 per cent, you know, from day one on 1 July. In fact, I don't think that the system would necessarily easily be able to cope with the creation of a health summary for each and every patient on the first day of the new system," she said.
"Having the e-health wave sites so that there are earlier adopters, so that there will be hundreds of thousands of Australians who are already in the system when it ticks over being able to have those patients enthusiastically waiting to be able to join on 1 July, means that we will see an uptake, which will be a gradual one. I think that's good for the system, and I think that's good for the patients."
Despite expecting a slow uptake, Roxon defended making the system opt-in instead of opt-out, saying that patients would ultimately see the benefit of signing up to get an e-health record.
"The best way for us to encourage people to have an e-health record is to show them how it will work, for them to see the potential," she said. "I don't make apologies that the opt-in does give the consumer the ability to do it, to make the decision whether they want to be in or not, but I think they will be easily convinced when they see just how effective and efficient this can be, and when they're assured about the privacy protections that this will be good for their care."
The Australian Medical Association was one of the organisations criticising Roxon for her opt-in approach, saying that patients should have to opt out of having the record.
"The opt-in system has resulted in incredibly complex rules for patients to give their doctors access to their PCEHR," AMA president Dr Steve Hambleton said in a statement.
"We will have a system that doctors and other health practitioners are keen to embrace, but won't be able to because their patients haven't yet given them access to their records."
He also said that he was disappointed that the government had failed to listen to medical advice when it finalised the concept of operations.
"Little has changed from the draft plan despite the sound advice provided by many medical groups, including the AMA, about what should be included on a patient's health record," he said.
"The government has caved in to minority consumer groups. Under the proposed arrangements, people will be able to alter their health record without consultation with their doctor.
"Patients could entirely remove from their record clinical documents that they had previously considered worth sharing with healthcare providers."
This was dangerous, and could undermine all of the potential benefits of an electronic health record, he said.
Roxon would not rule out offering a Medicare rebate to doctors to set up e-health records in their clinics, but said that there was nothing on the cards to that effect at this stage. She argued that many doctors already keep electronic records, and that they would see the value in adopting the government's national e-health record scheme.
Last month, it was announced that a group led by global technology management company Accenture had been selected to build the IT infrastructure for the PCEHR system in a deal worth $76.6 million.
Yesterday, the government moved to simplify some aspects of access to the record, making just one list of organisations that will have access to the list, controlled by the patient themselves.
Updated at 1:01pm, 13 September 2011: comment added from the AMA.