My Health Record an expensive 'white elephant', critics say

A federal government health initiative is now 10 years and has cost upwards of $2 billion. But in the eyes of many, it’s a white elephant and a failure.

Who remembers the cybersecurity and privacy concerns that plagued the introduction of My Health Record, the system that aimed to give healthcare providers up-to-date information at the touch of a button – especially important for older Australians with health issues? And the furore that resulted in new legislation in 2018 to allow you to opt in or opt out at any time?

My Health Record was ‘born’ in 2012 after then health minister Nicola Roxon announced the Personally Controlled Electronic Health Record (PCEHR) as a “key building block of the National Health and Hospitals Network”.

Going live on 1 July 2012, the PCEHR was part of the government’s policy to develop a lifetime electronic health record for all Australians. Its name changed to a more user-friendly My Health Record, but that did not alter the reputation it had already gained of being not user-friendly.

A decade later, and many are asking if My Health Record has been another government white elephant. The Australian Digital Health Agency’s latest annual report reveals that only 2.69 million of the 23 million people registered for a My Health Record accessed it in 2020-21.

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That figure is actually an increase of 14 per cent on the previous year, but that increase was largely driven by people accessing COVID vaccination records and test results.

Why is it that only 12 per cent of registered My Health Record users are actually accessing their records?

A major factor appears to be a serious lack of actual records. Leanne Wells, CEO of the Consumers Health Forum (CHF), said day-to-day health records from consultations, emergency department visits, hospital discharges, pathology and diagnostic testing were still missing from many records.

“These items represent the vital health information that should be shared between health service providers, however, consumers report that their expectations are not met when these are not visible, or are only visible on supply from some, but not all, providers,” Ms Wells said.

While most patients appear to be more than willing for their health information to be shared with and between healthcare providers, the providers are, in general, not doing so.

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“The lack of sharing and access to relevant health information causes frustration and concerns about safety and quality of care,” Ms Wells said.

Asked why health providers were not uploading relevant documents, Ms Wells pointed to issues with system design that made uploading records a less than straightforward process for clinicians and GPs in particular.

Alexandra Mullins, a PhD candidate with Monash University’s school of Public Health and Preventive Medicine, conducted a survey in an attempt to identify the barriers prevented a greater uptake in My Health Record usage.

The results of the research, published by the National Library of Medicine, identified several factors, including outdated content, a lack of trust, a low perception of value, no patient record and multiple medical record systems.

Study participants said training and a simple raising of awareness were needed to improve My Health Record use in the emergency departments – a need stressed by physicians.

As an exercise, I registered myself for My Health Record access, having not used the system before. I found the process of registering and then providing the system with access through the MyGov portal somewhat laborious.

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While it was reassuring to a degree that access to my personal information is not easy to obtain, the length of time it took to set up access via the HealthNow app made me consider giving up a couple of stages.

Having overcome those hurdles and accessed my records, I found a record of my discharge from hospital in April after a shoulder operation, and a COVID test pathology report from Austin Hospital in December.

I have since had other COVID tests at another medical facility, but the pathology reports for those do not appear in my records.

Given that more than $2 billion has been spent on My Health Record since 2012, more complete records than that will be needed for the system to shed the tag of ‘white elephant’ in the eyes of more than a few users.

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