The nationwide electronic health record

the Australian case

Abstract

Introduction. Given the historical fragmentation of health information systems generated by multiple local, regional, and national initiatives for deployment of information and communication technologies, many countries have sought solutions to allow interoperability of existing systems or the proposition of single systems to collect clinical data on a national scale. Objective. To study the Australian case of implementation of the patient electronic medical record on a national scale, considered a successful initiative in the international scenario and aimed at patient empowerment. Methods. A qualitative descriptive study was carried out based on a documentary survey, including scientific articles and gray literature. Results. A total of 1301 PubMed papers related to the electronic medical record of Australia were retrieved and, after applying inclusion and exclusion criteria, 23 articles related to the current initiative were selected and five documents obtained from official and from non-governmental agencies websites. Four central aspects were observed: context of the health system, implementation process, characteristics and evaluations on the Australian electronic health record. Conclusion. Even though the Australian initiative electronic health record has received international recognition, many barriers still need to be overcome to improve acceptance by population and health professionals involved in its use. Furthermore, a nationwide shared patient-controlled health record deeply alters traditional power relations, usually physician-centered, requiring a comprehensive review of health work processes.