A new hope for the My Health Record?

It looks like we’ve entered a new chapter in the Australian digital health story. After several rocky episodes it seems the force is with us and Australia’s digital health record system is on the road to recovery. At the same time there are challenges ahead.

When it comes to the national electronic My Health Record (formerly PCEHR) there is no shortage of scepticism among health professionals. Many have disengaged after unsuccessful encounters with earlier clunky versions of the system.

A lot of work has been done to make the interface easier to use. Accessing the system and uploading a shared health health summary has now become a fairly simple process – as it should be.

Towards opt-out in 2018

The My Health Record will get a massive boost in the middle of 2018 when the system changes to opt-out. Currently Australians have to actively sign up if they want a digital shared health record but next year every Australian will have a record – unless they opt out.

Earlier this month the Council of Australian Governments (COAG) approved Australia’s new digital strategy which carries the title ‘Safe, seamless and secure: evolving health and care to meet the needs of modern Australia‘.

The strategy outlines plans between now and 2022 for secure messaging between providers and with patients, telehealth, interconnectivity and interoperability, electronic prescribing and dispensing, test beds for new digital health technologies, development of health apps & tools and workforce training and upskilling.

Digital health strategic priorities
Digital health strategic priorities 2018-2022. Source: National Digital Health Strategy

The Australian Digital Health Agency (ADHA) has indicated it wants to co-design an implementation framework with the broader healthcare sector.

ADHA CEO Tim Kelsey said on Norman Swan’s RN that it is not just another strategy document: “I want to reassure people that this is going to be about delivery and people should hold me and the agency to account for delivering actual real benefit.”

Kelsey also admitted that at the moment the My Health Record doesn’t have as much clinical value as most doctors would want, but that a record of dispensed PBS medications is currently available. More clinical content will be coming soon, such as radiology and pathology.

Challenges ahead

The strategy document acknowledges some of the issues doctors have with regards to security, safety and use of the data: “They [doctors] need assurance that the digital systems they use support them to meet their obligations to keep their patients’ health information secure and private, and that health data will be used safely and appropriately to improve patient outcomes.”

Doctors have also voiced concerns about the medicolegal risks that come with accessing a patient’s My Health Record, for example when diagnostic tests and images will be available that may not have been reviewed and actioned by the requesting clinician. Clear guidance is required on how the reports are to be handled and who is responsible.

Most clinicians will not have an issue with de-identified data in the My Health Record being used for research or public health purposes, but transparency around secondary use of data will be welcomed and would encourage engagement with the system.

Uploading of shared health summaries is happening in general practice but concerns have been raised about the quality of some of the data. The current incentive payments seem to encourage volume. However, if the uploaded clinical content is not useful, others may not engage or upload data from their end. A classic case of the chicken and the egg.

New hope

It seems the Australian Digital Health Agency has sorted out many of the governance issues and is becoming a more transparent, engaging enterprise. An effective implementation strategy will genuinely address the barriers to engagement with the MyHealth Record and not just sprout benefits. I believe there is hope for Australia’s digital health record.

13 thoughts on “A new hope for the My Health Record?

  • As a patient with 7 specialists (endo, gastro, demotologist, rheumatologist, gyno, colorectal, opthalmologist) a GP, physio….. I really hope they get it working.

    Getting results of MRIs, bloods, etc from one to another, especially if you add a new member to the group like I did on Friday, is currently horrific. Turning myself into a medical secretary is not what I want to be doing with my time.

    This is important to get right.

    I signed up to the early version when I first was diagnosed. Absolutely useless. As a patient I beg the medical profession to get on board.

    Liked by 2 people

  • There’s hope for the eHealth when the government takes responsibility for the transmission of data, takes responsibility for the hijacking of data and removes the potential criminalisation of doctors – (how very degrading and disgusting to place blame on a doctor for the hijacking of data by a hacker) just think about it for a while. For eHealth to really work in a Medicare environment, the government ought to provide all Medicare providers with a secure box to interface the transmission of eHealth data – then, and only then will the system work for all!


  • Hi Edwin, I am a GP in rural practice WA and I agree with everything you say. We are here very passionately trying to work together as primary care team on “My Health Record.” So even though we are cynical, we do the groundwork and hope for the best that one day it will come good in respect to what you see.
    In our health setting, we work a lot with state health as rural doctors do. Our work is also a bit more complex and hence it is important for us to share information with our consultants in a meaningful and efficient way. However there is little understanding within our state department and hence we cannot progress much.
    This is rather frustrating, because we’re starting to feel that, we shouldn’t do all that work if it doesn’t make sense to somebody else to use My Health Record.” So I’d like to add to the story that public health and rural health policy makers and managers need to do more to empower clinicians (especially their allied health, nurses, diabetes educators). They can do so in various ways: make the programs to use My Health Record user friendly, In WA they have developed their own programs (NACS should a state health departments be allowed to do this?). Other things state health can do: allow clinicians access, make patients understand and get their buy in for the national record. Just look at the benefits such as cost savings, preventing hospital admissions, improving care culture and work relations.
    We’ve looked at the systems available in our public hospital and it’s not useable even though possible. When we suggest the benefits, health administration doesn’t really see it and so they need to get it through others as well.
    So I’m just hoping that somebody reads this and does something valuable with my impression to help country GPS, but possibly this is relevant to other stakeholders as well. So please help if you do agree.

    Liked by 1 person

  • In the last 5 years I have done a lot of locum work, so the following comment relates to many practices I have worked in, many clinical files I have used, and therefore viewed.
    As the GP fee items have become increasingly parsimonious over the last 20 years, the time spent by the average GP in a patient consultation has continued to diminish. The clinical content covered is less. The content and the detail in the clinical file is less. Acronyms (commonly unique to that doctor) abound. What is written is much less than what is needed in an account of a consultation that will be understood by another health professional not in that clinic.
    This is a widespread, generic problem. The critical point will be reached when the current clinical record is expected to be inserted with a SOAP structure, and one has a multiplicity of clinical problems to discuss.
    I compare this with the letters I receive from specialists. Although my suspicion is that the content of these no longer is fully dictated, rather is significantly templated, with relevant ‘variables’ changed or inserted at the appropriate locations. And specialists simply deal with their own organ system. The specialist ‘general physician’ has all but disappeared. Physicians have looked to subspecialty procedural work as their major income source. Quite understandably. Now GPs will be expected to fill that gap, on present – or less – remuneration, considering the time needed to be spent to create a readable, comprehensive clinical record. And the time that then MUST be spent obtaining the ‘informed consent’ of the patient, before it is uploaded to the ‘Medicare cloud’. Which time will include time for reading, then for negotiation, as the patient considers the implications of releasing that information. And there will need to be an explicit recorded demonstration of that consent – for the explicit content intended to be uploaded.
    How much time will this take? Who will pay for that time? Certainly the patient will expect not to pay for it.


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