Pharmacists are being advised to use passwords, activate automatic screen savers and train staff within new guidelines designed to help increase their uptake of the federal government’s My Health Record and improve patient care.
According to My Health Record Guidelines for Pharmacists, a co-production of the Pharmaceutical Society of Australia and the Australian Digital Health Agency, pharmacists should use MHR to access patients’ clinical data including information on medicines, allergies and medical conditions to improve healthcare.
“Pharmacists have a professional responsibility to review their practice and integrate the use of the My Health Record system into patient care, where appropriate. Pharmacists are encouraged to display a sign to advise their patients of their use of, or decision not to use, the My Health Record system,” the guidelines say.
But the protocols provide the caveat that the information contained within MHR doesn’t provide the full picture of a person’s health.
“Not all healthcare providers use the My Health Record system or upload every clinical patient interaction, therefore it cannot be assumed to be a complete record.”
Via MHR, pharmacists are given access to health summaries, discharge summaries, imaging reports, pathology results, referrals, specialist letters, immunisation records, and prescription and dispense records.
Pharmaceutical Society of Australia National President Dr Shane Jackson said greater digital capability among pharmacists will improve their contribution to medication safety and the quality use of medicines.
“Having access to information will allow pharmacists to deliver more effective and efficient care,” Jackson said.
“Pharmacists have a professional responsibility to review their practice and where necessary build on their digital health competency to integrate use of the My Health Record system into patient care.”
Queensland pharmacist and chair of the working group that devised the guidelines, Chris Campbell, said MHR integration will aid in clinical tasks such as dispensing and medication review.
“Until now, pharmacists have been dispensing, counselling, providing advice, and conducting medication reconciliation partially blindfolded,” Campbell said.
“My Health Record helps to lift the veil and our contributions will further cement pharmacists as an integral member of the primary healthcare team.”
The guidelines advise that pharmacists at a participating organisation providing care to a patient can view information in the relevant My Health Record without obtaining the consent of the individual. Patients are considered to have provided “standing consent” when they register for a MHR. There is no requirement for a patient to be present when the pharmacist is viewing their record.
Pharmacists will also be able to contribute patient health information to MHR, and the guidelines provide pharmacists with advice on the legislative requirements for patient consent in cases involving sensitive diagnoses and treatments.
In certain emergency situations the need for consent in the collection, use or disclosure of information in a patient’s My Health Record can be waived. Organisations will also be able to override the passcode and access controls to gain unrestricted access to the patient’s MHR for five days. Emergency access will be logged in the MHR and patients can choose to be notified when access has occurred, the document says.
The protocols provide data security advice to pharmacy organisations to minimise misuse of the My Health Record system such as: “screen saver mode is automatically activated when a page is inactive for more than one minute, clinical information systems are password protected, passwords are changed regularly.”
The guidelines also include instructions on how to manage clinical incidents, including the uploading of a document to the wrong patient’s MHR. (In which case, the pharmacist should delete the incorrect document from the dispensing software immediately and insert ‘incorrect identity’. If unable to delete, the pharmacist should contact the My Health Record helpline to allow them to do it. A correct version can then be uploaded and the incident should be recorded in the pharmacist’s notes.)
Organisations must also train all pharmacy staff before they access the system for the first time or if new system functionality is introduced.
Pharmacists can access the records through conformant software in their clinical information system or use the provider portal, which allows them to search and view patient health records through a web browser. Non-pharmacist staff can only use the My Health Record system if a pharmacist delegates them access, and penalties exist for unauthorised access.
But despite regulatory requirements, and changes to work practices and workflows, the guidelines say, “the My Health Record system does not replace direct sharing of health information (i.e. in person or via telephone) between healthcare providers or with patients.”
By the end of 2018, every Australian will have been provided with a My Health Record unless they have taken steps to opt out during a three-month period yet to be announced by the Minister for Health.