Can MHR help reduce medication misadventure?


graph made of medicines

My Health Record can help prevent medication misadventures that see more than 230,000 people end up in hospital each year, says Dr Steve Hambleton

Each year, approximately 230,000 Australians are admitted to hospital as a result of medication misadventure, costing our health system $1.2 billion each year.

Dr Steve Hambleton, Deputy Chairman of the My Health Record Steering Committee and former AMA President said most of these medical misadventures are preventable.

“Medication mistakes that land people in hospital can cause serious illness and in worst cases, can kill,” said Dr Hambleton.

“It’s extraordinary that 230,000 people end up in hospital each year due to medical misadventures that are in most cases avoidable. That’s almost four times the number of people who are hospitalised as a result of motor vehicle accidents.

“We all need to take medicine from time to time and it’s a daily routine for many Australians. Yet most of us are blissfully unaware of how things can go wrong.

“Australia’s doctors are currently hampered by a lack of patient information, especially at the time when they need it most. That’s where having a My Health Record can make such a difference because it can alert them to any medicine and allergy dangers which could save your life in an emergency.”

Examples of medication misadventure

Unknown allergy – A patient tells a GP they suffered a medication reaction but can’t remember the name of the drug. Dr Hambleton had a patient who had anaphylaxis to a recently supplied medication – it started with ‘P’ but that was as much as he knew. He was quite sick in hospital and they managed his illness successfully. Could this have been penicillin? It was actually Piptaz which contains a semi-synthetic penicillin and would be expected to cross react.

Interaction between drugs – Anti-depressant SSRIs, one of the most commonly prescribed for depression, can interact with Tramadol, a commonly prescribed painkiller. The reaction can have serious and even fatal consequences if not recognised. Two prescribers both choosing the right drug without knowledge of the other can lead to trouble. Another classic is the combination of an ACE inhibitor (for blood pressure) a diuretic (for blood pressure) and a NSAID (for arthritis) that can lead to a substantial decrease in kidney function. It could be as simple as ibuprofen over the counter for arthritis.

Multiple Brands – Dr Hambleton had a patient with diabetes who was given a generic drug and they unfortunately took the new drug and their existing supply with devastating consequence. The result was a hypoglycaemic episode while driving that lead to a major car accident with multiple vehicles.

“My Health Record places Australians in control of their own healthcare and, where permitted by the individual, gives healthcare providers secure digital access to key health information at the point of care, wherever that may be,” says the Australian Digital Health Agency (ADHA).

“Its benefits include reduced hospital admissions, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and more informed treatment decisions.

“Australians can manage privacy and control access to their My Health Record including what information gets uploaded and who has access such as family members, carers and healthcare providers.”

The agency has had to deal with several hurdles following the roll-out of the opt-out period for My Health Record.

This period has now been extended to 15 November.

A leaked government document dated 20 August has detailed the ADHA’s response to a raft of concerns about My Health Record, including doctors’ claims they couldn’t sign up, plans yet to be made for securing the details of children in care, and a communications strategy that had failed to adequately reach some vulnerable groups.

According to Healthcare IT News, the My Health Record Expansion Program steering group had raised a number of concerns about the national health database, with data privacy, the safety of domestic violence victims, technical problems and clinician burden among them.

The ADHA Q&A document reportedly reveals the government’s plans to scale up call centre resources in the last four weeks of the opt out period, and its refusal to release the numbers of those who have opted out or cancelled their My Health Records.

The ADHA also reportedly dismissed calls to change default security settings on people’s records from open access to healthcare providers to passcode protected, claiming it would “effectively render the system opt-in.”

Meanwhile this month Health Minister Greg Hunt introduced the My Health Records Amendment (Strengthening Privacy) Bill 2018 into Parliament.

The bill removes the ability for health information in My Health Records to be disclosed to law enforcement agencies and government agencies without a court order or the healthcare recipient’s consent.

It will also require the government to permanently delete stored health information for a person “as soon as practicable” (within 24 to 48 hours) after they have cancelled their My Health Record.

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