Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, September 09, 2018

If Ever A Blog Comment Deserved To Be A Full Blog Post This Has To Be It! What A Stark And Worrying Warning.

This popped up first thing Saturday.
Dr Bob Walker said...
Hi, my name is Dr Bob Walker and I am a GP working in Lindisfarne, Tasmania but I also run student clinics in our local Y11/Y12 State Co-Ed College. Over the last 10 years these Clinics have been highly successful and we have had thousands of consultations providing non judgmental, evidence based advice in strictly confidential surroundings.
Our Clinics are easy access/drop in and all students are bulk billed. The local path lab provide bulk billed tests and we record and prescribe using our practice software.
In this time we have clearly dropped the pregnancy rate, significantly limited the spread of sexually transmitted diseases (STDs) and done a lot of good mental health work. Not one of the students who have engaged with us in this time have taken their lives.

However, the arrival of My health Record (MHR)is a total disaster as our Clinics will be a lot harder to run. After a lot of soul searching we plan to close our Clinics on 15 November - a very backward step for youth health. About 15% of our young patients have a MHR, presumably enrolled by their parents and almost all without their knowledge.
These students are really distressed by having a MHR and now worry about their confidentiality. If we do not tick a box on our path referrals to avoid results going onto their MHR, parents and others can see the results of STD and HIV screens.
If a pharmacist slips up and fails to block a dispensing activity, scripts for contraceptives and medications for STDs are also visible. All Medicare items numbers including the names and locations of doctors, all path results and all scripts appear on these records up to the age of 14yrs. Medicare limits these flows between 14 and 18yrs unless we slip up as mentioned. However, Health Summaries, with explosive diagnoses can be uploaded by hurried/unthinking providers for all age groups.
 After 18yrs, all new data uploads is clearly visible to home viewers. The ADHA proudly states that young people can take over their records and limit access but this is easier said than done and our students (and quite tech savvy ones, too) have found this quite difficult. Also, parents can put pressure on their teens to open up a private record and if they do not comply, suspicions and arguments arise.
As doctors we have all had cases where a young person would have been seriously injured, made homeless or possibly suicided had details of their medical record been seen by others. Doctors will now become targets even though we are treating mature minors and only working in their best interest and safety. I am saddened by the lack of consultation by the ADHA with us youth health workers.
The support of MHR from the AMA and the Royal Australian College of GPs is not based on a sound knowledge of how young people interact with our health system. As a GP, I can see the benefit of a well maintained, up to date and accurate MHY for older people and other patients with complex health conditions, multiple medications, serious allergies, drug addictions and complex psychiatric illnesses. However the risks to young people far outweigh the advantages of the current 'Opt Out' System.
There has to be a better way and I hope the forthcoming Senate Enquiry will recommend a modified 'Opt In' system and spare our young people from what is now a cruel cyber threat to their wellbeing. If anyone reading this can influence Government policy at this critical time, your action will be much appreciated by young Australians.
Here is the link (I have opened the paragraphs for ease of reading):
Needless to say I became more and more worried the more closely I read this post.
Not only is the myHR not going to help these adolescents but there is a real and present risk it will do major if not potentially catastrophic harm.
This is not made up and the risk is simply not acceptable. The issue of the problem with adolescents has been raised before but this is pretty a pretty vivid and dramatic realization of the concern.
Please explain the risks to those in your network to overcome the ADHA spin.
Thank you Dr. Bob for the effort of posting!
David.

12 comments:

Anonymous said...

Been staring at the screen in disbelief wondering what to say.

Bernard Robertson-Dunn said...

This has been raised before, along with risks to families in domestic violence situations:

"My Health Record undermines teens' right to medical privacy, critics fear"
http://www.abc.net.au/news/science/2018-07-26/my-health-record-teenagers-medical-privacy-concerns/10030762

Anyone would think the government hadn't thought through this whole MyHR and opt-out mess.

Anonymous said...

It has Bernard, not just with a real life example. I am sure this is the tip of the iceberg.

Dr David G More MB PhD said...

They just didn't think through the answer through to the question - 'What could possibly go wrong?" with opt-out. Minter Ellison had told them in 2015 but they ignored it...

David.

Anonymous said...

'What could possibly go wrong?" They ignored everything they were ever told right from the start. Day one. Way before Opt-out was even dreamed up. And now it has just got 100% worse.

Like Anon @4:39, I too am horrified by Dr Bob's words. The thought of what may happen to these young people if these Clinics are closed thanks to the MyHR doesn't bear thinking about. As you say David, it could be potentially catastrophic. This opt-out crap needs to be stopped NOW.

Anonymous said...

Would be nice to see the clinical views from the ADHA, chief medical officer? What does the Consumer Health Forum have to say? Or are these victims the wrong type of consumer?

Bernard Robertson-Dunn said...

T9im will be speaking at the AIIA Manager's Forum in Canberra next week.

https://www.aiia.com.au/events/upcoming-events/australian-capital-territory-events/act/canberra-managers-forum

He's brave.

The two biggest issues that are attracting questions about My Health Record are:

1. Could Opt-out My Health Record kill people?

https://privacy.org.au/could-opt-out-my-health-record-kill-people/

i.e. the subject of this blog posting

And

2.the reports today that insurance companies want access to myhr data.

Anonymous said...

"the reports today that insurance companies want access to myhr data."
Who of us out here in sanity land didn't see that one coming - like a train……

As you say Bernard, Tim is very brave - or stupid - I know where my money is.

Anonymous said...

it's fantastic - the results you have achieved with students in time you have been running these clinics.
It's disappointing to me that you have chosen to close down the clinics instead of problem solving this.
Those students who feel at risk can cancel their records and not have one altogether. I feel as providers we can be doing more to help students increase their own health literacy particularly through the IT channels and MHR is (albeit) a small part of that opportunity.

Anonymous said...

"Those students who feel at risk can cancel their records and not have one altogether." Not if their parents have control, which they usually do until age 18.

Anonymous said...

Those students who feel at risk

Why exactly should anyone be adding to their risk?

Anonymous said...

It is good to see the RACGP and press are picking up this story.