Consumer Health Issues - Hot Topics

Current hot issues for health consumers include:

Self-Management and Self Care/Health Literacy

Consumers need clarity about the expectations of self-management, and for health professionals to recognise when self-management is not appropriate.  Difficulties with making self-management effective were closely linked to poor health literacy.

This is made harder for those people living with more than one chronic disease, and it is even more important that information is as clear and unambiguous as possible. Good communication skills are even more essential.  Health professionals must be clear, concise and provide information in a format appropriate for individuals’ needs and cultural background.  This will empower consumers to have control over their condition.

Palliative and End of Life Care

Palliative and end-of-life care are areas of concern for health consumers. Palliative care is defined by the World Health Organisation as  “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”. Consumers are concerned about the limited availability of specialist palliative care services in NSW, and also the lack of palliation in aged care homes and other health services.

One important issue relevant to palliative and end of life care is the support available for people to die at home. 70% of people say they would prefer to die at home, but only 16% do so. Supporting people's choice to die at home means making available sufficient community palliative care, respite options and other health and care services.

There is an increasing focus on the importance of palliative care; in 2012, the NSW government launched their Plan to Increase Access to Palliative Care 2012-2016.

The eHealth Revolution!

eHealth refers to the use of computer technology and telecommunications to deliver health care more effectively.

Computer and telecommunications technology are used throughout the health system, but many of these systems are not connected or delivered in an orderly way. In recognition of the importance of eHealth, the Council of Australian Governments has agreed on a National eHealth Strategy which aims to improve quality and safety, reduce inefficiency and improve health outcomes for consumers.
Major pieces of this reform strategy include:

• Providing consumers with access to Personally Controlled Electronic Health Records (PCEHR)
• Development of telehealth services
• Development of eDiagnostics - an electronic referral and communications system for diagnostic testing
• Electronic prescribing
• Government investment in computer and communications infrastructure for health providers and consumers

For more information, see www.ehealth.gov.au

The two areas of reform that will have the greatest impact on the care consumers recieve are PCEHR and telehealth.

Personally Controlled Electronic Health Records (PCEHR) are secure, electronic health records containing individual health information which are stored and shared through a network of connected systems.

The information contained in these records is selected and authorised by the consumer who also decides which health providers have access. These records form only one part of the consumer’s health record, as each provider retains their own existing record system.

From July 2012, all health consumers have been able to opt in to the PCEHR system. The system is still under construction and will provide greater value to the consumer in the longer term. Some data which is not available now on consumers’ records will be available in the future – for example, blood test results and X-rays.

The value of the system to the consumer will also increase as more GPs and other clinicians register for the scheme and set up their practices to use the records. GPs are being encouraged to register for the scheme through a Practice Incentives Program (PIP) eHealth Incentive. Payments under this Incentive will be available to practices that meet new requirements – essentially upgrading their systems to make PCEHR use possible. More detailed information about the PIP scheme is available here.

When consumers register for a PCEHR, if their GP is also registered for the scheme, there is an opportunity for their existing health summary to be placed on their record. It is important that consumers check what is on the record to ensure accuracy and that no significant information has been excluded. Where specialists have compatible systems, there will be an opportunity for referrals and letters to be added to the consumer’s PCEHR.

Some consumers are concerned about the security of the PCEHR system or of their health providers’ systems.  There is a range of security protocol in place – for example, consumers can access the audit log for their eHealth record online, which will tell them who has accessed their record and at what times. Consumers also have the final say over who can view their record, and can select different levels of access for their different providers.

Telehealth refers to the delivery of health services and health information using communications technology. Telehealth includes the delivery of in home health services using various technologies.

Medicare item numbers are now available for certain telehealth consultations. A range of health professionals can participate in telehealth, as can residential aged care homes. Telehealth is available for people outside of inner metropolitan areas, residents of aged care homes, and consumers using an Aboriginal Medical Service or Aboriginal Community Controlled Health Service.

One issue that remains as a barrier to effective telehealth is the difficulty of internet connection in some areas; this will improve as the National Broadband Network is installed across rural and remote NSW.