The PCEHR

Today I had a couple of patients asking me about the PCEHR. I advised them that our practice is ready and able to play this game but there were so many unresolved issues that we would not actively promote this to anyone. Two of the main issues are:

1. Each Healthcare Provider signs a participation agreement with the Government – it is sixteen pages long but one paragraph stands out. It states: “You grant us a perpetual, irrevocable, royalty-free and license-fee free, worldwide, non-exclusive licence (including a right to sub-license) to use, reproduce, copy,
   modify, adapt, publish and communicate (including to other healthcare provider organisations and to organisations that store health information) material you
   have uploaded to the PCEHR system for the purposes of the PCEHR system”             To me this poses an unacceptable risk to the patient
   
2. GPs are usually the nominated Curator of the PCEHR and the expectation is that we would sit down with the patient and decide what to upload in the form of a Shared Health Summary” This document is not an interactive document that we can change as we need to – instead it is like a pdf file that has to be removed and replaced each time something has changed. The first time this is done we therefore need to sit down with the patient and go through every item to make sure this should be uploaded – not everybody wants issues such as pregnancy terminations, drug abuse or HIV status placed into the PCEHR. Once the document has been vetted by the patient it is uploaded. The problem arises when something has to be added to this record. The process involves us having to remove the old document and uploading a new one. Our Electronic Health Records system will however each time include every single item in that summary – regardless of the fact that the patient may have previously indicated that something should not be included. We would have to go through the document line by line every single time as we are at great medicolegal risk if we accidentally upload something that we had been told several versions ago, several years ago, not to include. No busy GP has time to do this. Remember that this is also not a replacement of our own record system – it is a time consuming duplication and I cannot see the punters being happy if I charge them for my time spent on this