The My Health Record (formerly the Patient Controlled Electronic Health Record) is a repository of documents and data about your health and health care, in addition to and separate from that kept by your GP or hospital. Every Australian has a mygov account containing information such as taxation and Centrelink data, and the My Health Record is accessed through your mygov account.
My Health Record is not a copy of your GP's notes or your hospital file. At best it contains a series of summaries of your health history (called Shared Health Summaries) from your GP, as well as copies of discharge summaries from any hospital admission. It also contains reports of pathology and medical imaging tests that have been done for you, and claims on Medicare and the Pharmaceutical Benefits Scheme
What are the potential benefits of having a My Health Record?
It is intended to improve access by health professionals to information about your health and health care . There is extensive evidence that large numbers of errors are made in the health care system every day, and that some of these errors are made because of inadequate information on the part of the healthcare professional making the decision. Some of these errors result in poor outcomes or even death. The My Health Record is an attempt to provide a universal system of health records, to reduce these errors.
Take the example of someone with a complex medical history who is travelling interstate when they have a serious medical event that lands them in hospital. If the hospital can't easily contact your usual GP or general practice for information, it would be useful to the hospital staff to have an accurate list of that person's medical history and medications, especially if the person is not well enough to convey this information.
A large body of information such as this is also potentially useful for health research and planning, to improve the health of the Australian population in the medium to long term.
What are the potential downsides of having a My Health Record?
Firstly, there is no mechanism for automatically updating the record. The information contained in it is only as up to date as the last uploaded summary. Much of this work falls to your GP. There is an incentive payment for accredited practices to perform this work (called an e-health Practice Incentive Payment), although this requirement has been added on to a pre-existing list of requirements with no additional funding.
Secondly, there have been some concerns raised about confidentiality - who has access to your record. Through a series of privacy settings you are able to set who is allowed to access the document. In an emergency, any health professional or organisation is able to gain access to a record for a defined period of time. All access to the My Health Record is logged on the record, so you are able to see which organisation has accessed it (although not necessarily which individual).
Thirdly there have been concerns raised about what the information on the record will be used for, especially if accessed by bodies such as Police, the Australian Taxation Office, the Courts and Centrelink. The Minister for Health has recently clarified that access by any of these organisations will require a warrant.
Fourthly, individuals have the ability to control which documents are visible on the record. This creates problems for a health care professional viewing it, especially if they are making a decision without all necessary information, or they are being asked to verify information from a partial record.
Finally the whole system is only as good as the people using it, so individuals who are not information technology literate (both patients and health care professionals) will be at a disadvantage.
Why is this important now?
Up until 16 July 2018, new My Health Records were only created by voluntary "opt in" on the part of individual Australians with their express consent. The Department of Health has announced an "opt out" period from 16 July 2018 - 15 December 2018. What this means is that unless active steps are taken to prevent it, a My Health Record will be created for each Australian by the end of 2018.
What do you think Doc/Nurse?
We are currently adopting a cautious, practical and selective approach to the My Health Record, noting that many people, particularly those with complex illness, stand to benefit from having this information in a central repository. For the remainder of our patients whose histories might not be so complex, it is an individual decision as to whether you feel the positives outweigh the negatives.
For more information, please go to www.myhealthrecord.gov.au www.myhealthrecord.gov.au>
