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Concern for patient safety with e-records

Patient safety under the proposed electronic health records system cannot be guaranteed less than three months before it is scheduled to start.

Safeguards to prevent and correct snafus with doctors' software, such as medication mistakes, have yet to be provided for in the national e-health scheme beginning on July 1.

The electronic health record scheme is due to start on July 1.
The electronic health record scheme is due to start on July 1. Photo: Andrew Quilty

The warning has come from three experts, including Mukesh Haikerwal, chief clinical adviser to the e-health transition agency.

They warn that the lack of a national clinical safety system to deal with glitches in doctors' desktop computers and electronic devices such as iPhones and iPads means that "it is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not".

"There is no guarantee that harm events will be rapidly identified or remediated when it is in operation," they write in an editorial, published in the Medical Journal of Australia today.

Their warning is the latest challenge to confront the e-health plan, which has attracted growing criticism about security and privacy concerns spurred by the uncertain performance of the body responsible for the e-health rollout, the National e-Health Transition Agency.


E-health has been the subject of complaints from industry "ranging from accusations of ineffective oversight and failure of administrators to acknowledge design flaws, to warnings that the system will not succeed because its implementation has been ill-considered and rushed", an analysis by the Parliamentary Library has stated.

Dr Haikerwal, the lead clinical adviser to the agency, says the need for robust monitoring will become more important as the system users grow along with the delivery of more complex patient data to a wider circle of health practitioners, including doctors, hospitals and other professionals.

He denies the failure to make arrangements yet for the oversight of software and other gadgetry served by the system is an oversight and that e-health would take time to roll out.

Dr Haikerwal, who also chairs the World Medical Association, says that as doctors and others rely on patient details transmitted from elsewhere, an error in blood pressure readings, for instance, could prompt a drug dose error with life and death implications.

The Medical Journal editorial, whose other authors are Enrico Coiera, the director of the Centre for Health Informatics, and Michael Kidd, executive dean of the faculty of health sciences at the University of NSW, says the benefits of the technology should not be overshadowed by avoidable patient harm.

The authors raise the risk of wider patient safety problems, such as if medication names and doses were incorrectly displayed.