NSW Health is ‘reticent’ to capture data from the primary care sector, and there is a lack of demonstrable integration with primary care providers.
The ability of NSW Health’s single digital patient record initiative to improve data sharing and care delivery depends on the extent to which it is integrated with the primary care sector, PHN senior executives have told the Special Commission into Healthcare Funding.
Appearing before the commission in Wagga Wagga recently, Narelle Mills, interim CEO of policy, strategy and innovation at Murrumbidgee PHN, said without confirmation that the record would be completely integrated with the primary sector, she was “unsure” whether it would be enough to achieve interoperability across the NSW health system.
“The first issue is that we do not yet know if and when there would be access to that system for primary care providers,” Ms Mills said.
“As I understand it, potentially that would be some time after implementation in the New South Wales system itself.
“There’s certainly a willingness to have that discussion, and I think that’s a first step, but I’m not sure that the single digital patient record will necessarily solve some of those data-sharing issues and that ability to measure outcomes in the system.
“There’s intention and there’s goodwill, but the reality of that is just not there.”
Melissa Neal, senior policy advisor at Murrumbidgee PHN agreed, highlighting the ministry’s reticence to capture data from the primary care sector when working with PHN staff to build and implement the statewide collaborative commissioning initiative.
“Just focusing on data sharing, very early on in collaborative commissioning there were quite a lot of discussions with the Ministry of Health, who were really only focused on gathering data from the patient flow portal, which is an LHD-based system,” Ms Neal said.
“For some time — essentially up to eight months – we advocated strongly that we should not just be looking at data in terms of outcome purely from an acute system perspective.
“The intent of the pathway is to direct people away from that acute system, therefore there’s a whole range of data and information in the primary care setting that should be considered as part of the targets [or] success of that program.
“We’ve made a very small step in that we’re now gathering some of that data and work [is] being undertaken in that primary care setting, [but] we need to build in [data sharing] consent processes with general practices to ensure that data can be shared with the LHDs, for example, as part of the evaluation of that [collaborative commissioning] program.”
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Varying access to upgraded technology across general practices was also a major barrier to streamlining information sharing across the NSW health system, Ms Mills said, with many practices still receiving discharge summaries via fax.
“From a PHN perspective, we’ve recently undertaken some work with [Murrumbidgee LHD] around ensuring that GPs are set up to receive electronic discharge summaries, [since] a number of our practices are still receiving fax discharges,” she said.
“Working with our general practices to improve electronic uptake will also improve [data sharing].”
