The creation of shared electronic records is a test that the Australian health system has yet to pass.

Indigenous health should be a very promising proving ground for e-health applications. Indigenous people have much higher rates of chronic disease and typically use wholly government-funded or government-run health facilities. Therefore, e-health has more than the usual potential to improve treatment. As well, the predominance of government health provision should mean fewer than the usual problems of coordination and interoperability of systems.

Although the federal and Northern Territory governments have both promoted e-health initiatives and, on paper, much progress seems to have been made, I suspect that the usual caveats concerning the gulf between what's supposed to be and what's actually happening remain in order.

Katherine was the site of one of the first and most extensive Health Connect trials. As part of this trial, all the indigenous health clinics in the area computerized all their patient records and made them available to the other clinics in the trial.

According to the NT health department, a shared electronic health record is now "progressively" being implemented. This could mean that significant health facilities in the Territory mostly have electronic records and that at least some of them are able to access the records of others. I hope that's the case. It certainly should be, several years down the track from the Katherine trial.

As part of its roll call of initiatives, though, the health department also states that the shared electronic health record is being extended to "three major GP practices" in Darwin. It also says that the Medchart medicine management system is to be implemented and that the Primary Care Information System is to be rolled out across remote area health facilities. Call me cynical, but I suspect this means that GP practices are not yet part of the shared record, neither is information about the drugs particular patients are taking, nor are such records as currently exist yet generating follow up treatment.

If I'm right (and I'll try to explore this on my next trip to the Territory) e-health there is pretty much as elsewhere: a jigsaw that's missing several pieces and has yet to be put together.

In general, many health service providers still think that record keeping is less important than actual treatment and still think of their records as being for their own exclusive use. Overcoming this culture remains extremely difficult because it's rarely an urgent priority for any particular key decision-maker.

The creation of shared electronic records is a test that the Australian health system has yet to pass.

The Hon. Tony Abbott MHR is the federal member for Warringah, and shadow minister for families, community services and indigenous affairs.

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The INDIGENOUS E-HEALTH online forum with the Hon. Tony Abbott MHR opens on Monday, 24 November 2008.

Participation is simple and free. If you aren't already, sign in to become an Open Forum member. Go to the INDIGENOUS E-HEALTH forum page, write your comments, questions and suggestions.

The Hon. Tony Abbott MHR will be personally responding to submissions from Monday, 24 to Friday, 28 November 2008.