Safeguarding Patient Confidentiality in Accessing Electronic Health Records

Guest: Kylie Ward

Presenter: Henry Acosta

Guest Bio: Adjunct Professor Kylie Ward has had a successful and celebrated career as a Nursing Leader and Health and Aged Care Executive in Australia for over 20 years. She has held positions of Managing Director, Director of Clinical Operations, Director of Nursing and Midwifery, Director of the Division of Medicine, Associate Director of Women’s and Children’s Health and Executive Director of Nursing and Midwifery in three major health services in NSW and Victoria. She has been a NUM, After Hours Coordinator, Campus Manager, Bed Manager and Patient Flow Manager. Her clinical background is in intensive care and aged care.

Kylie has enjoyed a long history with ACN and the organisations that ACN is founded upon, RCNA and the College of Nursing. After years of membership and involvement in both organisations including RCNA Chapter Chair of Sydney West Kylie was awarded Fellowship of both organisations in 2007. In 2009 Kylie was awarded a Wharton Fellowship from the University of Philadelphia, Pennsylvania. Understanding the history and commitment of these two great organisations to nursing professionalism in Australia Kylie is committed to honouring the past to lead the Australian College of Nursing as a dynamic and influential key professional organisational well into the future.

Segment overview: In today’s Health Supplier Segment, we are joined by returning guest Adjunct Professor Kylie Ward from the Australian College of Nursing here to discuss the topic of Electronic Health Records of Patients and their safety. According to Kylie, a national shared electronic health record means that as people move between health care providers, or even move between states, clinical professionals have a single trusted source of information. This information that could be vital such as a person’s allergies or medications, they can quickly and easily access. She also said that the ACN supports moves towards a national op-out approach to My Health Record and wants to ensure the vast majority of Australians take up this opportunity to improve their health care. Kylie mentioned that security concerns could play a factor in people choosing to wait to participate. She believes that nurses must be involved in the development, implementation and ongoing maintenance of My Health Record.

TRANSCRIPT – Electronic Health Records

Henry Acosta: Hello, I’m Henry Acosta and you’re listening to Health Professional Radio. Our guest today is returning on the show, her name is Kylie Ward and she is the CEO of the Australian College of Nursing or better known as the ‘ACN’. The ACN is the national professional organization for all nurse leaders and its aim is to ensure the Australian community receive the highest quality of nursing care for now and in the future. Kylie is with us today to talk about the recent news about the electronic health records, how it is imperative for nurses to help with the improvements on their current system to create a better, safe and more reliable one. Welcome back to the show Kylie and thank you so much for coming back.

Kylie Ward: Pleasure.

H: Can you tell us about the current news that’s happening around the e-health records today?

K: Yes. This has certainly created a bit of a media storm and some concern over the last couple of weeks and it was a great concern to us at the Australian College of Nursing because nurses very much need to be assured that their patient’s information is secure. And as you know, we advocate for patients only if they cannot advocate for themselves. So we’ve been doing a little bit, we put out a press release, we’ve been doing a little bit of investigating ourselves and we’re very confident with the government that their is an effective investigation being undertaken. There’s criminal implications in it, but one of the things that I would like to give assurance for the community and for health professionals is that in this particular instance, with the breach of the Medicare information that it could not be tracked into My Health Record. So that’s very comforting for us, as the profession of nurses.

H: What do we have to know about the current system of health today?

K: The My Health Record has been around in different forms for some time. And to be perfectly honest, it’s been a long journey to get to where we are today. And it hasn’t always been smooth and it hasn’t always given clinicians including nurses peace of mind. But the Australian Digital Health Agency has been doing a lot of work and we’ve been working collaboratively with them and in consultation to really get a system that is user-friendly, obviously for consumers and where clinicians also find it user friendly and have confidence. So we’ve strongly articulated and advocated for an opt-out model, originally that was an opt-in model with limited outtake and we think that the opt-out model is the best model for the Australian community.

H: What do you mean by opt-out model?

K: Basically, we all get a My Health Record and if we don’t want our information on the My Health Record, then we can opt-out of the system. But there’s so many advantages and positive aspects of having a My Health Record and an electronic platform for clinicians to access.

H: Well, it sound like a great idea to have an opt-out model since people may not want to be in it but I think no one is going to decline on having a very convenient way of sharing your health records to doctors. With regards to nurses and the ACN, did you guys help create the My Health Record and what did you guys do to help improve it?

K: We have certainly had significant consultation and we’ve got feedback and information from our members and nurses from all over the country to be included in the consultation and in the development and implementation of the My Health Record, there’s nurses that are employed within the Australian Digital Health Agency, who also understand the importance of bringing the nursing perspective to the table and I think that gives peace of mind and so we work very closely and collaboratively in being engaged with the development of the My Health Record. And of course I cannot emphasize enough how important nurses are as the interface between the health system and the community of reassuring patients that this is a great opportunity to have consistency of care, to have transparency in information for health professionals. So it’s very important that nurses are aware of these and are able to promote this in their practice.

H: Since there was some bad news with regards to the other system, what kind of assurances can you give the public right now with regards to the My Health Record?

K: From what I can understand and in my conversations, such as direct conversations with the federal government and the Australian Digital Health Agency, I can give every assurance that the My Health Record is completely safe and secure. The incident was actually the selling of the Medicare number that had no access through any kind of portal to be able to access the information on the My Health Record. And to the nurses all around the country, that give us great assurance that what we’re promoting and what we’re encouraging patients to use, gives us peace of mind that their information is safe and secure. The yearning area that I do have concern is that for the government to know that the roll out is effective and for nurses to know that these systems are in the best interest for the patients in the communities we serve. We need to be at the highest level of the decision making table. And so I’m pleased that the review is being conducted from the federal government and the minister’s office to investigate what happened in the black web, but I’m concerned that nurses weren’t invited to be participating at the highest levels of that review and whilst, we will be consulted and we will contribute to that. It’s again another example of where nurses should be at the highest level of decision-making but are not.

H: Are there any misconceptions that you want to address?

K: Yes. I certainly want all nurses and health professionals to know that the My Health Record not only benefits the communities that we serve and our patients, it has great opportunities for nurses and clinicians to really provide the very high standard of care and very safe and appropriate care. So for nurses particularly, the provider portal where we can actually enter into that portal, we get to access a collective summary of patient’s medications. So for example, if somebody was presented in an emergency department or with limited cognitive function or cognitively impaired, we are able to access the information that isn’t the requirement of the family, or friends or carers presenting with patient or if the patient isn’t able to communicate that to ask themselves. So there’s an enormous amount of benefit in terms of safety and appropriate care that can make tremendous differences for patients all around Australia.

H: It sounds like it’s really helpful especially for nurses as you guys are in the forefront of the medical care industry.

K: Yes. Nurses are very influential here because our patients and the community trust us and because we are providing care all day, everyday, everywhere for a nurse to be able to understand the system ourselves and then seek with patients and help them to navigate and understand the system or with our other medical and clinical colleagues. Nurses are incredibly influential in the uptake and actually using the My Health Record within the system.

H: I see. For all our listeners right now, be it other health professionals from other professions and even nurses, what’s your main takeaway message for them?

K: My main takeaway message for nurses everywhere is to understand who we are, what we do and how important we are to the system and that the Australian College of Nursing will continue to passionately advocate for us to be at the highest level of decision making and that it is not okay for us to be left out, as the professionals continually are where the decisions are made and the resources are allocated and the discussions they had. So we will continue to pursue that.

H: And for those interested in or maybe interested with you Kylie or even the ACN, what’s the best way to do that?

K: You can put into Google the Australian College of Nursing or look us up at acn.edu.au. There are numbers on there, 1800 numbers to contact us. And we’ve got teams, offices in Sydney and Canberra and of course our members, thousands of members all around the country where people can access.

H: And does your website give out news with regards to the e-health records?

K: Yes. We’ll put up there our position statement and one of the things that your listeners may like to know is we’re just about to launch our position statement on nursing infomedic so that we’ll have some key priorities and what nurses can do around information systems and clinical and nursing infomedic. So that will be all on the website in the next few weeks. We’re just looking at the official launch of that position statement.

H: That sounds great. So for our listeners, you can keep updated with their website. That’s all our questions for today Kylie and thank you so much for coming back on the show.

K: Absolute pleasure. Great afternoon.

H: And that was Kylie Ward, CEO of the Australian College of Nursing. We just finished talking about how electronic health records can be good for patient but it must be available in a safe and reliable way. If you’re interested in listening to more health-related interviews, medical research and fitness-lifestyle interviews, you can visit us at www.hpr.fm. Please like, follow and subscribe to us on our major social media outlets. Audio is also available for download and streaming on iTunes, SoundCloud and YouTube. I’m Henry Acosta and this is Health Professional Radio.

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