My Health Record clinical safety program in Austalia

Neville Board
eHealth and Medication Safety

Australian Commission on Safety and Quality in Health Care.

 The Australian Commission on Safety and Quality in Health Care (the Commission) is a national agency that leads and coordinates national improvements in safety and quality in health care across Australia. Its supports healthcare professionals, organisations and policy makers who work with patients and carers. The Commission is jointly funded by the federal, state and territory governments of Australia.


The My Health Record system shares with other electronic health records (EHRs) the potential to

  • improve continuity of care,
  • improve clinician access to treatment and diagnostic information, leading to better outcomes for consumers,
  • reduce medicine related adverse events,
  • enable a consumer centred approach to health care, and
  • promote the greater portability of consumer health information.

 However, growing international evidence identifies how EHRs are also susceptible to certain clinical safety risks, including missing or incorrect data and patient misidentification. In addition, technology-related clinical safety risks can also manifest in EHR implementation. These include data transfer and information display issues, hardware and software failures, and incompatible terminologies. By the very nature of EHRs, such system-related issues have the ability to rapidly impact on a greater magnitude of clinical records in comparison to traditional, paper-based clinical records. 

 The Australian Government Department of Health is the My Health Record system operator. The National eHealth Transition Authority (NEHTA) develops clinical safety cases as part of the development of each release of the Record, and manages incidents referred by the system operator.

 The Commission was appointed to conduct a clinical safety program for the My Health Record system (formerly the called the personally Controlled Electronic Health record or PCEHR), starting with its launch on July 1, 2012.

 This presentation will describe the drivers, elements and findings of the clinical safety program over its first three years of operation.

 The external clinical safety oversight of the PCEHR system has been undertaken through a mix of strategies comprising:

  • Clinical safety oversight and governance, through a dedicated, advisory group comprising senior clinicians, safety and IT experts, convened by the Commission,
  • Structured clinical safety reviews of specific elements of the PCEHR, conducted twice yearly,
  • London Protocol reviews of a small number of incidents escalated to the Commission
  • Analyses of samples of calls to the Helpline for clinical safety issues

 Through these processes, the Commission makes recommendations to the system operator regarding future functionality, design elements and supporting processes to enhance clinical safety.


Mr Board’s team at the Commission has developed a cumulative antibiogram standard to support the national approach to antimicrobial stewardship, and guides for establishing hospital electronic medication management and discharge systems.

 Currently, he is responsible for the Commission Medication Safety and My Health Record clinical safety program. His team is conducting safety reviews and incident reviews, and has developed a clinical incident management framework for the My Health Record program in Australia. They develop national medication charts designed to optimise safety, and are specifying onscreen presentation of medications for clinical information systems.