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The Guardian - AU
The Guardian - AU
National
Paul Karp

An improved My Health Record will be at centre of push to modernise primary healthcare

Medicare card
The Strengthening Medicare Taskforce has agreed to improve and expand the use of My Health Record. Photograph: Dave Hunt/AAP

The under-utilised and much-maligned My Health Record will be at the centre of a push to modernise primary healthcare, with better digital systems to be discussed at national cabinet.

The Strengthening Medicare Taskforce has agreed to improve and expand the use of the platform, with a broader range of health professionals able to access and add to digital health records a key recommendation of its report to drive improvements in primary care.

On Friday the Australian Medical Association will also call for stronger safeguards to protect patient data, warning that European-style privacy laws should be considered to prevent health data being used to boost private profits rather than health.

The Allied Health Professions Australia and Australian Primary Health Care Nurses Association have welcomed expanded use of My Health Record, pointing to its increased use during Covid and utility providing more seamless healthcare.

My Health Record is an online electronic summary of a person’s health information set up in 2012 to improve continuity of care by creating one centralised record for each patient.

The record was upgraded to an opt-out system in 2018, with more than 1m exiting the system over privacy concerns.

Although the Australian Digital Health Agency boasts that 23.5m Australians have My Health Records, some consider the system a failure due to its $2bn price tag and the small proportion of records that have been accessed.

In 2022 some 5.35m records were viewed, up from 4.37m in 2021, with Covid vaccination certificates driving renewed interest in the platform. The ADHA boasts that a quarter of a million patients who previously opted out have now re-registered.

In December, the taskforce agreed on the need for “a modern, digitally enabled and data driven primary care system”.

“This will require critical reforms to My Health Record (MHR) to improve its functionality, scope of information uploaded, integration with clinical software systems, and improve access for a broader range of health professionals to provide better person centred outcomes,” its communique said.

The ADHA data shows 99% of general practitioners are registered and use My Health Record but just 31% of specialists are registered and only 13% have used it.

Antony Nicholas, a taskforce member and the chair of Allied Health Professions Australia, said the government had spent hundreds of millions on software to connect GPs to My Health Record but “never done” the same for allied health professionals or specialists.

“The vast majority of software is currently non-compliant which means there is no way for an allied health professional, unless they’ve bought GP practice software, to upload information into [My Health Record],” he told Guardian Australia.

Karen Booth, a taskforce member and president of the Australian Primary Health Care Nurses Association, confirmed that “allied health don’t have access into the system yet but it’s coming”.

Booth said My Health Records are used “not nearly enough” in primary care, describing the system to link the records of different healthcare professionals as a “win-win” for patients and those treating them.

The AMA will on Friday release a new position paper on data governance and patient privacy, calling for “a broader national discussion around the privacy protections and ownership of data in the digital health systems, based on the general data protection regulation”.

In January, the attorney general, Mark Dreyfus, confirmed Australia was considering implementing such reforms.

The AMA president, professor Stephen Robson, said appropriate use of health data can enhance the provision of care for patients, improve health outcomes, increase equitable and individualised care, while minimising duplication and gaps in care.

The AMA is particularly concerned about technology companies moving into the healthcare space and access by private health funds.

“The AMA does not support sharing health information … with private health funds outside the existing statutory schemes,” Robson said. “Patients’ medical information must be protected to maintain the clinical independence of their healthcare pathway.”

Consumer Health Forum spokesperson Melissa Le Mesurier said it wants “greater investment in, and consumer education around, digital health”.

“We’d like to see funding to modernise My Health Record to make it easier to use, and better connect data across all parts of the health system.

“We realise that, for a variety of reasons, some people will never heavily engage with digital health but we need to support all Australians to access their information and add their own information, so My Health Record is a more interactive experience.”

Ahead of Friday’s national cabinet meeting, state and territories have called on the commonwealth to restore 50-50 hospital funding and increase the Medicare rebate, despite the federal health minister, Mark Butler, indicating reforming primary care rather than providing more funding will be the priority.

The New South Wales premier, Dominic Perrottet, wants a NSW trial for pharmacists to prescribe antibiotics, a move which GPs have warned could result in over-prescription and worsen medicine shortages.

Butler has foreshadowed major changes to primary care, which will include funding to encourage “blended” services, such as medical centres offering access to nurses, physiotherapists and other allied health professionals instead of just general practitioners.

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