Optometry Australia (OA) is urging caution over potential changes to the way Ahpra uses its register, with the regulator considering listing more information – such as a practitioner’s disciplinary history – which would be available to the public.
Optometry’s peak body is commenting on the regulator’s ‘Public consultation on a draft data strategy’ (full PDF available here), which will guide how it uses data it collects and holds on health practitioners, including optometrists and ophthalmologists.
OA has lodged a submission in response and, although not publicly available at the time of writing, it contains “a mixed, but generally positive response to the questions raised”.
Changes to the way the Australian Health Practitioner Regulation Agency (Ahpra) handles the public register is potentially the most contentious part of the proposed new strategy.
Ahpra believes there may be value in making more information available on the public register, including things like additional qualifications, cultural safety training and authority to prescribe.
But it is also proposing listing a practitioner’s “regulatory action history”. According to Ahpra, the register doesn’t include previous registration or restriction information such as when a practitioner has previously been suspended, even where that information is in the public domain – such as in media reports.
“Optometry Australia understands and supports the need for the public to be able to access information to inform their healthcare choices. Notably, however, not all disciplinary history would be objectively useful for this purpose and careful consideration of what disciplinary history is listed should be made,” OA interim CEO Ms Skye Cappuccio said.
“We also have some concerns about ongoing publication of disciplinary history – beyond what is required for intended protective effect of the regulatory action. The discussion paper lists, and we would agree that there is ‘potential for detriment to their practice/reputation if restrictions they have met and no longer apply, remain on the register as historical records. Continuing to publish disciplinary history could have ongoing consequences for practitioners, beyond the intended protective effect of the regulatory action’.”
OA noted that from 2018, links to adverse tribunal decisions and court decisions are already published on a practitioner’s record on the national register.
“We understand that the links remain on the register – even if the sanctions imposed by that decision are no longer on the register – to ensure transparency for patients, potential patients and the public. Further consultation between the regulator, peak bodies and patient groups may be required in this area to strike the right balance.”
Ahpra said there needed to be careful assessment, balancing competing interests of the public versus the practitioner’s career.
To highlight a flaw in the current approach, it presented a case study involving a medical practitioner in a rural local women’s health service with a history of ‘notifications’ involving female patients and inappropriate communication and poor approaches to consent and physical examination. Regulatory action was taken, including conditions for education, supervised practice and mentoring. Because the practitioner met these conditions, there is nothing on the public register to alert an employer or the public to their disciplinary history.
Subsequeently, a new patient learns about the practitioner’s history from the local media, and was surprised not to see this reflected on the public register.
This therefore leaves the patient concerned about potential risks to themselves and questioning whether they should continue seeing the practitioner. Meanwhile, the practitioner feels they have met the conditions and it would be detrimental to their career if the conditions were permanently displayed on the public register.
In response to making more information available like qualifications, prescribing authorisation and areas of special interest, Cappuccio said one of the objectives of the National Scheme was to facilitate public choice and access to healthcare provided by registered health practitioners.
“Optometry Australia believes the inclusion of additional information on the public register would assist patients in making informed decisions about their healthcare and would also help practitioners differentiate areas of professional interest and skills,” she said.
The second focus area of Ahpra’s strategy is its data sharing arrangements with other organisations.
The third area explores ways for the regulator to put its 10 years of regulatory data to greater use by using machine learning and advanced analytics. The body believes this could provide additional insights that could be combined with other sources to make its regulatory work more effective and efficient.
For example, in its registration processes, these technologies could help expedite applications, including from overseas-
qualified and registered practitioners.
And in notifications processes, advanced data analytics could review previous decisions and a range of predictive factors to then create new tools to triage higher risk matters, and manage increasing caseloads effectively.
Cappuccio said this could be “extremely important for patients and practitioners” as notifications continue to increase – up 6.5% last year to 10,800 across all registered health professions.
“And concerns remain over timeframes involved in dealing with these complaints. We would hope that this could be used to help improve efficiencies and processing times at Ahpra,” she said.
Overall, as a custodian of this data, Ahpra said it faced growing demand for both the data it makes public now through existing services, and what it could make available in the future, subject to privacy and confidentiality obligations.
“We recognise that while meeting the National Law and privacy requirements, there may be more opportunities to use and share some of the data we hold to give value to practitioners, the public and the broader health system, including improved public safety, practitioner regulation and workforce planning,” it stated.