The NSW Government has announced a $536 million investment over eight years in eHealth.

About half the money ($286 million) is being invested in a ‘Whole of System Digital Platform,’ which is intended to enhance the digital infrastructure supporting the clinical and other health-related systems across the state.

Most of the remainder ($236 million) is for an extension of the state’s eMeds digital patient records program. The rest is mostly a re-announcement of existing eHealth funding.

NSW Treasurer Dominic Perrottet says eHealth is “arguably the most important revolution in modern healthcare.” He says the funds will deliver health information and services more effectively and efficiently.

“The investment will provide value and safety to patients and practitioners, decrease costs by freeing up clinician time and improve the quality and portability of health care services.”

There is nothing in Perrotet’s announcement that indicates eMeds will become an opt-out system – where patient records are automatically included unless the patient or doctor says otherwise.

This is despite opt-out being recognised as a necessary pre-condition to a successful electronic patient record program in a major report commissioned by the Federal Government.

Plans to introduce electronic patient records in Australia go back to 2005, when the Howard Government set up the National Electronic Health Transition Authority (NEHTA) to examine how to implement the technology, which had been recommended in many previous studies.

NEHTA recommended an electronic patient record system, which was introduced in 2012 as the Personally Controlled Electronic Health Record (PCEHR). Revamped considerably two years ago, it has now reached 20 percent coverage of the Australian population.

NSW Health Minister Brad Hazzard, also quoted in the Government’s announcement, said that research shows electronic systems can reduce medication errors, which could result in significant patient harm, by more than 50 percent.

“Nearly all patients who are hospitalised will take at least one medication during their stay. Given the sheer volume dispensed, mistakes are a very real possibility.

“Notes might be illegible, errors can be made transcribing medication charts, or charts can be lost but this technology helps ensure patients get the right medication at the right time.”

These same advantages were recognised in a 2014 review of the PEHCR – which at that stage had very low take-up rates – by consultancy Deloitte.

The review found that the system was failing because its use was not mandatory, that many clinicians were opposed to it on privacy grounds, and that it was cumbersome and difficult to use.

The Government responded by injecting more money into the system to address some of its technical failings, and by renaming it My Health Record. It has now had more than $1 billion invested in it.

The Deloitte review recommended a change to an opt-out system, which has now been implemented on a trial basis in some locations. The Federal Government is still considering the results of the trial, which may have a bearing on the success of the NSW plan.