There Is A New Review Of The #myHealthRecord Which Says What We All Know – Its Not Much Use!

This appeared a few days ago.

My Health Record ‘patchy’ and needs more funding, better direction

After years of development, privacy debates and around $2 billion in funding, Australia’s electronic health record is set for further changes

Sean Parnell

Friday February 12, 2021

Health Record is yet to live up to its potential, a government-initiative review has found.

Digital health records had been subject to a slow uptake, with some system clashes and many facilities still using fax machines, until the Federal Government agreed to make the My Health Record (MHR) opt-out instead of opt-in.

Since then, the number of consumers and providers actively using the system has increased, but a newly-released government review has found MHR is yet to live up to expectations.

“A view that has been widely expressed is that MHR has not fully met the promise or the expectation that many held for it,” wrote Professor John McMillan, who conducted the review.

“Two criticisms stand out. The first is that there is limited or uneven content in many MHR records. The second is that there is insufficient involvement in MHR by healthcare providers, both in uploading personal health information to MHR and in accessing a patient’s MHR when providing health care to them. These weaknesses can shake public and practitioner confidence in the utility of MHR and in that way be self-perpetuating.”

While McMillan pointed to the COVID-19 pandemic having improved public confidence in electronic systems, and practices such as telehealth, he said there was still uneven MHR use in the health system and some providers using it less. This, he said, could be due to the “patchy and out-of-date” information found on an MHR.

“This is a source of disappointment and frustration for consumers and providers alike,” McMillan wrote.

“This has not shaken MHR foundations but led people to ask more constructively how MHR can evolve, how confidence and trust in the system can be strengthened and – at a practical level – how upload and access to MHR content can be improved.”

McMillan has recommended the government provide a more stable funding base for the MHR – and maybe commit to future legislative improvements – and also look at whether new incentives are required for providers.

More here:

https://inqld.com.au/news/2021/02/12/my-health-record-patchy-and-needs-more-funding-better-direction/

The report being quoted is here:

Review of the My Health Records legislation

A review of the My Health Records legislation has been completed by Professor John McMillan AO. Read the key findings and recommendations in the final report. These will inform future revisions of the legislation to make sure that the system works as well as it can for all Australians.

Collection description

Professor John McMillan AO led the review to improve the legislation. The review included how to:

• better support patients accessing multiple health care providers
• reduce duplication of treatment
• avoid adverse health events
• actively involve patients in their own health care.

This review was required under the My Health Records Act 2012.

Contact

For more information about the report and its recommendations, email MHRlegislationreview@health.gov.au.

Reports

Review of the My Health Records legislation – Final report

1 December 2020

Report

Legislation review of the My Health Records Act 2012 – Terms of Reference

26 June 2020

Terms of reference

We aim to provide documents in an accessible format. If you're having problems using a document with your accessibility tools, please contact us for help.

Last updated: 

11 February 2021

Publication type: Collection

Audience: General public

Here is the link:

https://www.health.gov.au/resources/collections/review-of-the-my-health-records-legislation

To me the key information is here (p13-14):

Perspectives on the operation of MHR

Following is a brief summary of the 6 themes outlined in the consultation paper and the comments that were made in response in submissions to this review. Three additional numbered topics (7–9) are added at the end of this section – to highlight some common themes that run through all other issues; to note relevant digital innovation and system projects that under underway within the Australian Digital Health Agency (the Agency); and to make 4 recommendations for government to act on the findings of this review.

1.    Strong cross-sectional support for MHR

Support for MHR was expressed in 3 ways – there was endorsement of the contemporary need to integrate health service delivery and technology through a digital records system; examples were given of how individuals have benefited from being able to access MHR information for health consultation purposes; and there was acknowledgement of the compelling design features of MHR (such as consumer control, independent privacy oversight, and modern infrastructure). Many professional associations have published a statement of support on their website.

2.    MHR as a supplementary health record

MHR operates alongside and does not aim to replace other health records systems maintained by hospitals, medical clinics / GPs, pathologists, pharmacists and others. Those systems adequately satisfy most record-keeping requirements. A challenge, consequently, is to convey a stronger understanding of where MHR has added value (often described as the challenge of spelling out ‘the value proposition’ of MHR for different sectors).

3.    Mixed assessment of MHR performance

Two common criticisms of MHR are the patchy and out-of-date content in many MHR records; and uneven use among health providers (with specialists, allied health and private pathology being singled out for special mention). This is a source of disappointment and frustration for consumers and providers alike. This has not shaken MHR foundations but led people to ask more constructively how MHR can evolve, how confidence and trust in the system can be strengthened and – at a practical level – how upload and access to MHR content can be improved.

4.    Linking MHR to other digital health initiatives

This theme comes up in many ways. One is that commentators point to recent examples of the sharp uptake and reliance on technology in healthcare delivery – such as telehealth, e-prescribing, and electronic messaging. Another is to point out that MHR has to move away from being a static / read only / digital filing cabinet. Linked to that is a call to re-platform MHR – for example, to apply artificial intelligence to reorganise how MHR content is presented and can be searched, to add extra functions such as message alerts for consumers and providers, and to connect with other health information services through smartphone apps and mobile device options.

5.    Laying out an MHR roadmap

Submissions to this review strongly endorsed a call for the Agency to prepare a futures roadmap to explain the direction that MHR is expected to take in coming years. The roadmap could elaborate on the priority outcomes and principles set out in Australia’s National Digital Health Strategy, which was prepared by the Agency. There is particular interest in engaging in practical and detailed discussion on meeting the 3 strategic objectives in the strategy – ‘increased consumer participation’, ‘increased core clinical content’ and ‘extensive adoption by healthcare providers’.

6.    Ensuring the MHR Act supports digital health innovation

The MHR system is anchored in the MHR Act, which is highly prescriptive of the structure and operation of the MHR system. Proposed changes to the MHR system may run up against the rigidity and complexity of the Act. It may, for example, inhibit digital innovation, as organisations that are authorised to access and use health information under the Act do not include software vendors or entities such as primary health networks that facilitate but do not provide health care. There is strong interest in exploring options for providing better personalised health support to individuals, through apps and mobile and wearable device options that allow MHR data to be integrated with other personal health information.

----- End Extract

In summary:.

1. The MHR is a Supplementary Record which few seem to see the need for.

2. The data in the MHR is incomplete and largely out of date.

3. The Review noticed that more useful technologies were rapidly adopted and used as the MHR was languishing. Lesson – the MHR is not really useful or valued.

4. No one knows where the MHR is going and it does not look likely to reach its strategic objectives.

5. The legislation around the MHR (and the system itself) actively inhibit Digital Health innovation.

6. The idea of the MHR looks superficially great but it is not actually delivering.

7. Providers are not really going to use this junk unless it is much better and they are paid to do so. (I can't see that happening!)

So what the Report really concludes is that the legislation is not really the problem the MHR is!

A fine example of a Report condemning an initiative with faint praise. When will this rubbish stop do you think?

David.