My Health Record: Where Do You Sit?
We’ve all heard about it and, it seems everyone has quite different points of view - from health care providers to patients and privacy advocates on what the rollout of My Health Record will mean for the health industry.
So what exactly is My Health Record?
As most of you know, the My Health Record, first introduced in 2012, is the new system being implemented to replace the Personally Controlled Electronic Health Record (PCEHR) or eHealth record. The purpose of My Health Record (“MHR”) remains unchanged – it is an online portal designed to enable health care providers access to the complete health history of their patients. Great right? A patient’s entire medical history at the click of a button. The benefits are obvious if perhaps a little idealistic:
increased safety for patients
improve clinical diagnosis and decision making
continuity and consistency of care
However, feedback on the new system is divided:
While most providers support (in principle) a centralised and complete health file for their patients, the new system is heavily criticised for the burden it places on GPs. Especially sole practitioners to manage, upload and document patient interactions. Practitioners also argue that in addition to the time they must invest in making each record, they must respond to patient requests to remove or update a record. Sole practitioner GPs to major hospitals alike have made submissions that this is an onerous process creating additional administrative work.
And then what about the need to respect patient privacy?
MHR allows patients to have complete control over their records. Patients will be able to:
allow or refuse access to individual practitioners, or entire groups of healthcare providers
‘hide’ items from view
request their health practitioner to remove previously uploaded records
The ability for patients to have this level of control was included to address the submissions of patients and privacy groups, who were concerned about certain care providers having access to sensitive medical information that was not relevant to them, for example, dentists having access to medical records.
What will be the impact on Doctors to manage patient confidentiality?
While patient control was necessary to “sell” the new system to patients, doctors claim that it severely impacts on the legitimacy of the record. Doctors might not have a full view of a patient's medical history, in certain circumstances, this could pose a clinical risk. Patient privacy was and is a persistent discussion point for healthcare providers who feel that the new system imposes more obligations upon them to protect patient privacy. As it stands, Doctors are already subject to strict privacy obligations under the Privacy Act 1988 (Cth). With the new My Health Record Rules (the “Rules”), healthcare providers could be subjected to both civil and criminal penalties for any unauthorised collection, use or disclosure of any information in the MHR system. The Rules impose strict reporting obligations. All must practices report on both actual breaches as well as potential breaches of patient privacy. Fines are significant (up to $21,000 for an individual and $105,000 for body corporate) for breach or non-compliance. As a consequence, and potentially rightly so, some medical practitioners are indicating they are reluctant to incur the increased administrative cost and privacy risk of the new system.
Does the value of the information the new system will provide outweigh the costs of administrating?
Let’s assume for a moment the concerns regarding patient privacy and the clinical value of the My Health Record system can be overcome, General Practitioners must also weigh up the costs of implementing and maintaining it. To sweeten the deal, eligible health care providers are being encouraged to implement the software through financial incentives. Practices that meet eligibility requirements, such as uploading a minimum number of health summaries are receiving incentives to use the system. (currently up to $12,500 per quarter). However, health care providers have raised concerns to be eligible for any rebate the administrative cost of using the systems exceeds the value of the technology rebate.
Despite concerns, the new system is making fast progress:
The new opt-out system was initially trialled in Northern Queensland and the Blue Mountains (NSW). Despite concerns of GPs and other healthcare providers, My Health Record has already seen a significantly higher uptake than its predecessor, with over 5 million individual registrations and nearly 600 million Medicare documents uploaded. The system is on track for expansion in 2018 where it will transition to an opt-out model nationally. It goes without saying that patients, particularly those with complicated needs are benefiting from the continuity of care, greater access to their health records, and clearer, more streamlined communication between patients and care providers. But Privacy is and remains the biggest sticking point; the Australian Digital Health Agency continues to work with the Office of the Australian Information Commissioner to balance patients’ needs against clinical requirements.
Where to from here?
Is the system undermined with the ability for patients to control what information is available and what isn’t? Time will tell. Technology is transforming how we live all aspects of our lives, the rollout of this initiative and several others earmarked by the Health Agency only goes to support this “digital” transformation. Placing further emphasis on Medical Practitioners having watertight patient privacy and compliance policies.
Contact us if you would like to have more information. Our lawyers at You Legal will be happy to assist you in whatever way we can.