On January 19, 2018, The Daily Telegraph revealed that Australian taxpayers have spent almost AUD $1.7 billion (€1.1 billion, US$1.4 billion) on My Health Record (MyHR), the national digital health record, which many doctors refuse to use.
All Australian citizens will get a MyHR account in 2018 unless they opt out of the system but some doctors are warning of issues with its ease of use and fear patients don’t understand the privacy implications.
My Health Record: specialists are reluctant
Five years after My Health Record’s launch, five million Australians have chosen to set up a MyHR account. However, less than one in twelve of Australia’s 31,000 medical specialists are registered to use the My Health Record and they still rely on GPs faxing them referral letters and patient information.
For the electronic records to be useful, general practitioners have to download a summary of their patient’s health condition, but this has happened in fewer than one in four cases.
Restricted accessibility
In 2017, 1,442 general practitioners reported that they had not uploaded enough shared health summaries on My Health Records to qualify for a government incentive payment and 1,191 have been asked to repay the money.
Dr Rob Hosking the deputy chair of the Royal Australian College of General Practitioners e-health committee supports the concept of a digital record but he questions who uses it.
« None of the hospitals my patients attend have access to the My Health Record, » he told the Daily Telegraph . None of the specialists he sends his patients to use the record either and he explains that he has to use a separate private secure messaging service to communicate with specialists because he can not do it via MyHR.
« It’s quicker to pick up the phone and call the pharmacists to find out what medicines the patient is on because the [My Health Record] user interface is difficult to use. »
Technical problems
Dr. Hosking also notes that if doctors record a shared health summary on a patient’s record, there is no incentive or reminder to update it if a new medication is prescribed or if the patient develops a new health problem and that the basic treatment is therefore no longer suitable.
Australian Medical Association warns
The Australian Medical Association (AMA) has also warned in its budget submission that the record is plagued with some problems.
« Problems uploading specialists’ letters, poor search functionality, time-consuming adaptations to existing medical practitioner work practices, or inappropriate workarounds will erode clinical utility and deter doctor use and, more importantly, take time away from focusing on the patient, » the report says.
A lack of communication
The problems encountered so far with My Health Record will reach a critical mass this year, The Daily Telegraph said, as the government switches from an opt in system and sets up a digital MyHR account for every Australian unless they opt out.
The Australia Digital Health Agency says there will be no television, radio or print advertising campaign to make Australians aware of the fact that a digital health record will automatically be created for them. Patients will be able to learn more about it from social media and posters in doctors’ offices.
Doctors do not have time to inform patients about MyHR
Through its budget submission, the AMA has told the government that doctors do not have the time to educate the public about My Health Record.
« Doctors do not have time to talk their patients through the My Health Record arrangements for opt-out, privacy, setting access controls in standing consent for health providers to upload health information. This is the work of the government. Doctors must be allowed to focus on what they do best, caring for patients, » the document says.
« Some Australians will be surprised to learn that a My Health Record has been created for them without their explicit consent, » the AMA added.
Australian Digital Health Agency promises to improve its system
« The Agency is working closely with many specialist peak bodies to increase the use adoption of electronic record keeping and the use of clinical information systems in specialist practices, » a spokesperson for the Australian Digital Health Agency said (source: The Daily Telegraph).
To improve its device, the agency has recently released a new medicines view which consolidates medicines information from multiple sources across a patient’s My Health Record, and it says it now takes just thirty seconds to be able to view this.