The ins and outs of My Health Record

The government has insisted that the 9.9% My Health Record opt-out rate is squarely in line with expectations, but Labor is unimpressed.

More than nine in 10 Australians have now been allocated a My Health Record, but millions have opted out due to privacy and other concerns. The federal government and Labor are now sparring over the participation rate in the controversial digital health record project.

According to the Australian Digital Health Agency (ADHA), at the conclusion of the opt-out period, My Health Record had a participation rate of 90.1%.

ADHA Chief Executive Tim Kelsey nevertheless told a Senate Estimates hearing last month that the rate is roughly in line with expectations, as indicated by Minister for Health Greg Hunt in July.

But with roughly 25.4 million people eligible for Medicare, this means more than 2.5 million citizens have opted out. A further 300,000 had been allocated a My Health Record but cancelled it at the time of the hearing, roughly four weeks after the end of the opt-out period.

Based on statistics presented by ADHA in October, it appears that roughly half of those opting out did so after the government yielded to pressure in November to extend the opt-out deadline by two and a half months.

During an interview on ABC radio, Hunt said he was “very pleased” with the 90% participation rate. “I was speaking to representatives from international health bodies ... and they said if a country has a 90% participation rate that would be extraordinary internationally,” he said.

But Labor Shadow Minister for Health and Medicare Catherine King said the opt-out statistics are indicative of “just how badly the botched Liberal rollout damaged public trust” in digital health records.

“Labor supports a national digital health record — which is why we created one when we were last in government,” she said.

“But the government’s rushed implementation of an opt-out model created a range of problems and severely undermined public support for a system that could deliver enormous health benefits for all Australians.”

Addressing concerns

The government insists that Australians who have been allocated a My Health Record will be able to demand its permanent deletion at any time, while individuals who have opted out will be able to create a record at any stage.

“The new permanent delete functionality means Australians will always have the choice not to have a record and they can remove all of their data from the My Health Record system,” ADHA Chief Medical Advisor Meredith Makeham said in January.

“At any time in their lives, they can delete their record — and no copy will be kept.”

New laws passed by parliament last year sought to assuage the concerns that had motivated the decisions to opt out of the system. Insurers and employers were prohibited from accessing or demanding access to the information stored in My Health Records under any circumstance.

In addition, law enforcement agencies were prohibited from accessing an individual’s My Health Record without a warrant or court order.

But Shadow Minister King said lingering privacy concerns remain that must be addressed to restore Australians’ confidence in the system.

Labor is calling on the government to instruct the Privacy Commissioner to conduct an independent review of the system. “If they fail to do so, a Shorten Labor Government will,” she said.

She said the review should consider factors including determining the appropriate balance between utility of the system and maintaining privacy and security of individuals, whether particular protections are needed for vulnerable people including minors and victims of domestic violence, and whether changes to default access settings are needed due to the shift from an opt-in to an opt-out model.

Benefits

Meanwhile, ADHA statistics show that as of late January, 82% of general practices, 84% of community pharmacies and 75% of public hospitals in Australia were connected to the My Health Record system.

More data is also emerging showing the potential benefits of adopting an electronic medical records system. Research conducted for the Pharmaceutical Society of Australia (PSA) by the Quality Use of Medicines and Pharmacy Research Centre at the University of South Australia has found that My Health Record can play a key role in reducing the number of medication-related hospital admissions and adverse events.

The research calculates the annual cost of medication-related problems in Australia at nearly $1.4 billion, equivalent to 15% of total Pharmaceutical Benefits Scheme expenditure.

Nearly 250,000 Australians are hospitalised each year as a result of medication errors, inappropriate use and other medication-related misfortunes, with a further 400,000 presenting to emergency departments.

The report found that listing discharge summaries in My Health Record will enable pharmacists to proactively monitor dosages according to renal function.

PSA National President Dr Chris Freeman said such an approach has the potential to significantly reduce the number of medication-related hospital admissions.

“At least 50% of medicine-related problems are preventable, but only if we remove the siloed approach to medicines management,” he said.

“If medicine harm was a chronic disease it would already be a national health priority. This report highlights that governments, pharmacists and other health professionals need to work together to reduce the alarming incidence of medication errors, misadventure, misuse and interactions.”

Image credit: ©iStockphoto.com/Factoria Singular

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