Senate Estimates – Community Affairs Committee - Transcript - October 23, 2019 - More Obfuscation On Show!

Here is the Senate Hansard Transcript of the relevant ADHA sections.

The session reported here occurred around midday of that day. Comments after the transcript..

Part 1.

Senator GRIFF: Chair, I just have a few questions in relation to My Health Record, which is the next section, but if I can ask them now for the record because I think they will have to be taken on notice?

CHAIR: A question on notice. Okay.

Senator GRIFF: So if you're okay with me asking those questions in relation to the My Health Record?

CHAIR: Are you comfortable with that? Yes.

Senator GRIFF: The questions I have in relation to that are: what percentage of patients seen by a GP have their My Health Record accessed during consultation or immediately after? I'm not sure whether that is known, but I think that is an interesting question. I will run through them, but I don't expect you'll be able to answer all of them. The next question is: what proportion of patients who attend an emergency department have their My Health Record accessed? What proportion of Australian citizens who have a My Health Record have accessed their own record, particularly if they are accessed more than once, apart from the initial setup? What degree, if any, of data mining has taken place so far in relation to the My Health Record? It is really those first three that I'd be interested in. I don't expect that you'll be able to answer them now, but if you can that's fantastic.

Mr Kelsey: If I could say, first of all, that we very much appreciate taking those on notice so that we can provide the most detailed data where that's available. We are aware of increasingly large numbers of patients and consumers accessing their health records. As things stand, since the expansion program was initiated at the end of February, 278,000 consumers have accessed their record for the first time and many others are accessing it on a more routine basis. I can certainly give you data on the number of hospital connections or the number of the activity within those hospitals in terms of document uploads, if that will help. But we will take, if we may, the specific questions on notice.

Senator GRIFF: So at this stage 278,000 out of 24 million, is it?

Mr Kelsey: Roughly speaking.

Senator GRIFF: Who have actually accessed their record?

Mr Kelsey: For the first time since opt-out. There are many others who are doing so, but since the point of opt-out.

Senator GRIFF: When do you think you will be able to provide those answers?

Ms McMahon: I can provide some statistics on hospital connections. We currently have 616 public hospitals and health services across the country connected to the My Health Record and 216 private hospitals and clinics also connected. In terms of volumes of documents, we currently have 4.7 million discharge summaries from hospitals in the My Health Record and a range of other things, so pathology reports, 22.41 million—a number of those come from the public health system but also the private system—and diagnostic imaging, 4.11 million reports as well. Those are the volumes.

Senator GRIFF: That's all useful, but again, as I read out the questions at the beginning, what is the  proportion of patients who attended an emergency department and the like? If you could respond to those other questions on notice that would be appreciated.

Mr Kelsey:  We will provide what we can.

Part 2:

Senator O'NEILL: I look forward to that. If I can go just to a couple of quick ones on My Health Record, you told the committee previously that 2.5 million Australians opted out of the My Health Record before records were created and another 30,402 Australians cancelled their records between 22 February and 14 April 2019. Can you tell me how many Australians have cancelled their records since 14 April?

Mr Kelsey: Yes. Let me just find the cancellation figures.

Ms Beauchamp: I did table some information this morning around both opt-out and cancelled records. We've had 23,528 records cancelled since 22 February 2019. At the same time 22,129 people have opted back in since the same time as well.

Senator O'NEILL: I think we might have a couple of questions on notice but also I notice you've provided us with some data this morning that might be helpful in discerning that. If I can now go to the NHMRC IT project?

Senator ROBERTS: On the My Health Record data, the government has delayed implementation and invested vast amounts of money promoting the My Health Record to achieve its current implementation level. Has the time and extra cost been worth it?

Mr Kelsey: Currently almost all public hospital services are connected to My Health Record and where discharge summaries are being created those are being uploaded where a person doesn't withdraw their consent. We have now got to a point where well over 80 per cent of community pharmacies for the first time in Australia are uploading dispense medicine information from the My Health Record. We have got the vast majority of public pathology and radiology services uploading to the My Health Record and a very significant proportion of private radiology and pathology services uploading. This is really the first time, certainly the first time in Australia, that these kinds of data have been available to front-line clinical staff and of course the consumer so that at the point of care in real time this information can be shared. We put in place a whole series of different methodologies to evaluate the impact of My Health Record. Obviously it's early days but we are seeing very clearly from the clinical front-line very meaningful impact being achieved, particularly through access to medicines information. For example, in Royal Perth Hospital the toxicology department and the emergency department now mandate the use of My Health Record when it is triaging patients with suspected overdoses or other poison incidents so that their previous history of medication, and particularly those that have been dispensed, can be ascertained by emergency staff. That is just an example of a trend in hospitals in particular. Obviously out of hospital clinical staff are beginning to really value access to this kind of critical information at the point of care.

Senator ROBERTS: Presumably it would improve care and also health?

Mr Kelsey: Yes. What we're hearing is a range of improvements that are being facilitated, which range from, frankly, outcomes being improved in the emergency department because for the first time emergency physicians can see what medicines have been dispensed to a person, right through to just better coordination of care in the out of hospital environment. So people are able to be discharged into a knowing relationship with out of hospital clinicians. Care plans can be more easily developed—a range of benefits which are beginning to be realised in the Australian community. And what we look forward to doing, of course, is bringing back over the coming months more statistical evidence of that impact being realised on the ground.

Senator ROBERTS: There was a breach of security in Victorian hospitals recently apparently—access to people's records. My Health Record stores a large amount of very confidential information about Australians and it would be like having one's whole life exposed if they were compromised. What are the safety precautions you've taken to make sure the information is kept confidential and, in particular, is the record stored in Australia or overseas?

Mr Kelsey: So that I can be crystal clear about this, no health information, no information on the My Health Record, is stored overseas. It is prohibited, firstly. Secondly, the Victorian hospital issues didn't in any way affect My Health Record or the integrity of the My Health system and, thirdly, as I've had the privilege of describing this to estimates before, we have in place a series of very advanced cyber security protections for the My Health Record. I'm very happy to list some of those for the committee, but as you would imagine, we operate to the highest standards, assured and audited by other government agencies, including the Australian Signals Directorate, to that effect. There have been no instances of security breach of the My Health Record but at the same time of course there is no absolutely no complacency, and we are constantly reviewing ways to improve the cyber security protections of the My Health Record through our dedicated cybersecurity centre.

Senator ROBERTS: What about general practitioners' records on the cloud?

Mr Kelsey: We don't operate cloud services for general practice.

Senator ROBERTS: Can people access general practitioners and then get in through there?

Mr Kelsey: No, they can't.

Senator ROBERTS: We've also heard—I don't know if it is true—that specialists aren't receiving anywhere near the same level of support to adopt the My Health Record as that provided to GPs. That was a mistake the British apparently made and it slowed down the adoption of their records system. What have you done to make sure that specialists get adequate training as well as GPs?

Mr Kelsey: Perhaps I could ask my colleague to answer that question.

Ms McMahon: Over the last three years of the agency's operation we've focused initially on general practice, public and private hospitals, pathology sector and pharmacy. This financial year we've started focusing on specialists. When we appeared before this committee in February we reported at that point that in addition to the public health system, because of course specialists do work in public hospitals and private hospitals and access  the record that way, we had 271 medical specialist organisations in February who were directly connected. That's increased 185 per cent since our last appearance; so we now have 742 medical specialist organisations. We are also working directly with a number of software providers who service medical specialists to improve the usability of software and the way it connects and uses the My Health Record to improve the experience of those specialists in connecting to this information.

Senator ROBERTS: How far do you have to go? How many agencies or how far down the track are you as a percentage of capturing your target?

Ms McMahon: In terms of the software vendors?

Senator ROBERTS: No, in terms of how many other specialists, how many other health practitioners?

Ms McMahon: I will need to provide the denominator to you on notice. We've got a number of specialists working in the public and private hospitals. In terms of them practising through their rooms, I will need to take that on notice too to find the total number.

----- End transcript.

In the first part we see Mr Kelsey simply not answering the question regarding clinical look-ups etc and then saying that ‘they will provide what they can’ when we all know that have the stats.

The fun figure was that only 1.15% of those dragooned into having a #myhr had actually accessed it. (278,000 or the 24 million or so)

There is really no hard information in part 2 other than the numbers joining and leaving the #myHR are just about evening out!

Again of course it seems hard to provide numbers.

Transparency Central the ADHA is not! Actually they are secretive, obstructive and dangerous individuals who have no idea what public service means!

David.