The big news of the week was the announcement by the Department of Health and Aged Care of a new consultation on two measures to improve health information sharing in Australia, one covering the removal of the seven-day delay on posting test reports to the My Health Record and the other on mandating uploading results by default.
It’s debatable whether a consultation period on the latter issue is necessary considering the government has very clearly signalled that it is intent on making it so, but debate on the abolition of the seven-day delay is probably a good thing.
The seven-day delay was first introduced as a result of intense bargaining back in the early days of the much-lamented PCEHR – still fondly known as the pecker – and way before pathology or radiology providers even had the slightest notion of how they would interface with the system.
While the pecker’s promoters hoped that test results would flow to the system immediately, it was quite clear there was no way this could be done using the technology the PCEHR was built on. None of the diagnostic providers were even using the Healthcare Identifiers Service, and nor was there any agreement on terminology or standards beyond LOINC codes.
The colleges of pathology and radiology, along with the public and private providers, were utterly aghast at the idea of uninterpreted data being exposed to patients immediately, and insisted that the full report be uploaded rather than just the results. This could only be done as a PDF uploaded in a CDA wrapper and things haven’t changed much since.
They also insisted on a week-long delay so that the requesting doctor had time to receive and read the results and talk to the patient if necessary. There was also a well-founded fear that patients would misinterpret the results and ring their doctor or practice demanding answers.
This has been an issue that continues to hold back information sharing using technology platforms, including the implementation of patient portals. Despite numerous healthcare organisations that use portals – from healthcare homes to public hospitals – reporting that they work perfectly well, there is still a reluctance to release the data too readily.
It’s probably time now to change that. A huge effort has gone into remedying the terminology issues that have plagued the diagnostic sector and almost all providers are now linked to My Health Record. Like other great leaps forward, immediate release of test results was given a boot along by the pandemic, with COVID test results uploaded immediately they were available. Flu results, INR ranges and HbA1c results are also reported immediately.
And a huge amount of work has gone into making the diagnostic sector compatible with new standards and preparing it for interoperability – the new FHIR specifications for eRequesting and the CSIRO’s FHIR accelerator Sparked are incredibly exciting – so now is probably the time to make a change with the seven-day delay. Its time has probably come and gone.
As to sharing information by default? Most of our readers agree with the concept. When we polled this question back in May, following the policy signal in the federal budget, most readers were in favour. We can’t see anything changing this now.
DoHAC says it hopes to legislate for sharing by default next year, with the rule to come into force by December 2024. We doubt there will be the same resistance experienced back in 2014.
That brings us to our poll question for the week:
Should test results be made available on My Health Record as soon as possible?
Vote here and leave your comments below.
Last week we asked: Is healthy funding the key to Sparked’s potential? This was popular with readers: 90 per cent said yes, just 10 per cent said no.
We also asked: What do you hope to see achieved in two years’ time? Here’s what you said.