ACN President Professor Christine Duffield FACN and Sharon Downman FACN at the 2019 National Nursing Forum.
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Last year, in collaboration with the Australian Digital Health Agency (the Agency), Australian College of Nursing appointed six Nurse Champions to drive engagement with the My Health Record (MHR) across the country.
Sharon Downman FACN, a nurse and midwife with over 30 years’ experience, was one of the selected nurses for the Nurse Champion Program. We spoke with Sharon about her experience as a Nurse Champion and using and implementing MHR into her workplace.
What made you apply to become a Nurse Champion for My Health Record?
I have always been interested in technology and how to best utilise it to obtain and access patient health care information that can be available to clinicians and patients. I am passionate about having a health care system that will support the people that it is for.
I previously worked at St Stephen’s Hospital which is now known as Australia’s first fully digital hospital. I also currently tutor students at James Cook University in the Informatics for Health Professionals Subject for the Master of Leadership and Management (Nursing).
From an IT perspective, it is also a chance to help educate people and learn how to use the benefits as I understand the system. For those who don’t understand the system, they may not be able to provide feedback as they are not sure what it is meant to do or look like in the first place.
I advocate for the use of the My Health Record due to my own personal patient experiences, as well as an opportunity from my experience as a nurse and as a supporter/carer for my daughter from when she was requiring treatment.
What has been your experience so far working with the My Health Record system?
My experience with MHR as a Nurse Champion has focused on patient engagement. For those who are living with chronic illnesses, or have multiple or complicated histories, or patients who can’t remember what medications they are taking, MHR is just an extra tool to assist with patient history collection.
The usual process would be to have the nurses call the patient’s GP to ask what medication the patient is currently taking, and whether they can fax that information and the patient’s history over to us. With MHR, while the patient is passing on their Medicare details, we are involving the patient in the process by asking questions like ’are you happy for me to open your MHR?’ as well what their name and date of birth is.
Often, the patient will be required to provide a third identifier in the form of a text message which is used to open their Record and we can then go through their history together. With this approach, we are delivering patient-centric care as we are involving the patient and they know what we are doing.
The use of MHR is easy enough once you are in there to navigate and view the admissions page, and if there have been any event discharge summaries that have been recently uploaded.
I have also found the Agency educators very helpful in sharing the information and getting us onboard with MHR.
Have there been any challenges concerning MHR?
From a facility-perspective, the biggest challenge has been setting up the processes for it to be used, such as liaising with the legal team to ensure that we are covered policy-wise and the system’s security, audit processes, and background administration. We also needed a build-in for patients who don’t want their details on the MHR system and block automatic event discharge summaries from being uploaded.
In regards to security concerns, consumers can easily check their Record themselves, and set up their own alerts, as well as choose what information they do not want shared or displayed. Not every patient will need a MHR, and some may choose not to have a Record or want all their information listed so it is mostly patient-controlled.
What do you think are the main benefits for nurses and health professionals having a My Health Record?
I think the main benefit from having an MHR for nurses and health professionals is that the MHR becomes a resource which patients can access and provide themselves to whichever health care setting they present to.
Patients who come in think that all health care settings and organisations talk to each other and share information. An example from my own experience was when my daughter required emergency services – she was admitted to a public hospital but was being treated privately, and as such, neither hospital could view or access the other’s records on her.
In a separate experience, I was asked by health professionals who were attending to my daughter if I knew what medication she was currently taking. Luckily, I had a photo of the prescription from when I’d met the doctor earlier. If I hadn’t done that – as I am sure most people wouldn’t have either – we would have had to wait until the doctor’s clinic was open the next day to find that information, in which case my daughter would not have received the timely care that she did.
In those sorts of instances, for the patient and the health professionals present to be able to access an MHR with those details would be life-saving.
- What do you think are the main benefits for patients in having a My Health Record?
The benefits for patients in having an MHR are very similar to nurses and health professionals.
For patients who don’t have a long history, I would say that having an MHR is not necessary. However, people living with chronic illnesses would have the most benefits in using the MHR, in particular those who have multiple illnesses or have complicated histories. This is because they get tired of having to tell a lot of different people the same thing repeatedly.
I have been seeing and talking to quite a few patients who don’t know a lot about MHR, even if they do have a Record. So, we have been providing education to inform the patients and involving them in the discussion by sharing what it’s for and what they can use it for, such as entering in your allergies, and an advanced enduring power of attorney for when you go to hospital.
MHR may also be of assistance in cases where patients are asked ‘Do you remember what your medications are?’, ‘Who was the last person you visited?’, or even if someone had had a surgery and they had forgotten the name of their doctor.