Saturday, June 27, 2015

The PCEHR Automatic Opt In Trial Might Become A Rather Messy And Complicated Business.

A couple of weeks ago I wrote a blog on the proposed Opt-In/Out PCEHR Trails.
You can read this and the 26 comments here:
Thinking a little more about all this the messier it seems this will all be.
To me there are some really interesting issues - and remember just how mobile Australians are -are around choosing and then keeping track of the trial population.

Either it will have accepted that, at best, most of the individuals in an area will be opted out - or everyone in the area will need to be tracked in some hopefully inexpensive and effective way. Frankly option 1 is the only feasible approach so we will start with a trial that will be compromised to some extent.
Another interesting issue is being able to actually get in touch with every citizen, explain to them what is happening, and make sure that they do not want to be opted out. I can just see the ruckus that flows if people don’t understand what the letter or whatever from the Government means, only to find a record exists and has contents they are simply not happy with.
An associated problem is going to be how a clinician, in an opted-in area, handles access to the patient record when the patient actually did not know the record existed (It was Government mail and they just threw it out - and so on). There might be a legion of startled doctors and patients with all this.
The purpose of all this is to ask what readers think will be the biggest issues that the conduct of the proposed trials. I have suggested a few here and a few weeks ago. What do you think are going to be the stumbling blocks? and while typing how long do you think the trials should run and how should they be evaluated?

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