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    Raymond Bange

    I agree with Professor Davies that a personal electronic health record would be a welcome step forward in enhancing the delivery of improved health care.

    Reliable health information is particularly significant in the delivery of out-of-hospital emergency medical services (EMS), and paramedics are among the health professionals who should be able to take immediate advantage of such a record because of the common need for speedy interventions under emergency conditions.

    Paramedic practitioners must make judgements on the best interventions to apply when dealing with unconscious or incoherent patients who are severely injured, and the difficulties in diagnosis are exacerbated if the patient is unable to communicate their symptoms to the paramedic.

    The provision of accurate and up-to-date health details of an individual would be invaluable in assisting paramedics to make critical decisions on the most appropriate course of action to take and thereby enhance the quality and safety of emergency out of hospital health care.

    From a patient viewpoint, emergency care starts well before the hospital door and the benefits that could be realised through better access to health records will require specific access provisions as well as special safeguards to prevent identity fraud and other misuse of data.

    That being the case, it is clear that paramedics must be included among the group of authorised health providers with direct access to these records but with the additional proviso that they can access a patient record unilaterally in emergency cases.

    So I note with some amazement that the NHHRC has not highlighted the role of EMS as a critical component of primary health care nor has it identified the clinical dimensions of paramedic practice.

    This glaring omission is all the more obvious when one finds that there is currently no national registration system for paramedics as health professionals or recognition by the Commonwealth as allied health professionals. In addition, there is no national accreditation regime for the various EMS providers (public or private).

    Paramedics anywhere in Australia should have greater and more flexible authority to access patient records than many other health professionals. One of the best ways to achieve this would be to ensure they are registered on a national database of practitioners like the proposed COAG arrangements for other health professionals.
    In that way the strict requirements of practitioner competence and adherence to ethical practice standards would be assured.

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