Get the lowdown on My Health Record


pharmacist computer laptop technology digital my health record

How long will it take to use, when should it be used, and why? With the system rolled out across more software platforms, AJP provides a go-to guide on what it’s all about

Last week the agency behind My Health Record (MHR) announced that in addition to Fred Dispense and Aquarius Dispense, the system will now be available using enhanced versions of Minfos, POS Works and RxOne software.

According to the Australian Digital Health Agency, as at 29 October there were 1,402 community pharmacies already connected to MHR, which had sent almost 3 million structured dispense records through the system.

“The recent completion of connections by Minfos, POS Works and RxOne software brings the opportunity to connect to the My Health Record to thousands more pharmacies across Australia,” says the agency.

There are also 6,257 general practices connected that have sent over 10 million structured prescription records to the MHR, it says.

In other big news, the PSA and the Minister for Health have announced a partnership to push MHR across more pharmacies.

While it’s not clear whether funding will be directly provided, or how much, the agreement will see government support for the PSA to deliver:

  • Digital health guidelines and practice change for pharmacists;
  • A review and update of the National eHealth Record System Guidelines;
  • Development of MHR-related policies; and
  • Accredited training and tools including online modules, workshops and a webinar.

Do you use MHR?

A recent small AJP poll found that while 50% of respondents had a personal MHR, only 15% of pharmacies actually used it.

And while nearly 50% said they thought the system was “beneficial for healthcare practitioners and patients”, 25% said they had privacy concerns about it.

Pharmacists contacted by AJP also mentioned concerns about lack of collaboration between different healthcare professionals, and financial incentives for using MHR.

“We signed up for it years ago but we haven’t actually used it,” says Nick Logan, proprietor of Nick Logan Pharmacist Advice in Artarmon, NSW.

“There was a complete lack of enthusiasm from the doctors. If we’re doing MedsChecks it would be a perfect opportunity, but the doctors have – my understanding is – they’ve shown no interest in it.”

Would Mr Logan use MHR if there was strong collaboration between doctors and pharmacists?

“Absolutely. There can only be positive outcomes from an electronic health record.

“It was really poorly designed at the outset. Modern pharmacy technology is evolving really significantly.”

He adds that pharmacists need a financial incentive to get involved.

“The best thing would be for the government to pay pharmacists a fee for setting it up, and doing Medschecks and Diabetes MedsChecks. People need to be incentivised to do the work, to set them up.”

Paul Jones from Moodie’s Pharmacy in Bathurst, NSW, also currently does not use MHR and says he’s unsure about its benefits.

“If it’s got a clinical benefit to patients or improves their outcomes… but I’m not sure about that.

“From a pharmacist point of view, the information is there for you to access. If you’re not paid to do it, what’s going to happen is people won’t use it.

“I would use it to access hospital discharge summaries, I would feel comfortable uploading MedsChecks if we got paid to do that, or if we were monitoring blood pressure in a patient.”

Mr Jones also mentions the benefits for clozapine patients, in being able to access blood test results  “providing the pathology results were uploaded and we knew they would be there”.

We asked the Australian Digital Health Agency, which is in charge of rolling out the MHR digital system, to clear the air and provide further information on MHR: what it is, how to use it and why should you consider it?

1. Why should pharmacists use My Health Record?

My Health Record enhances clinical decision making and consumer care, particularly when consumers are cared for by multiple healthcare providers and visit multiple healthcare organisations, says the agency.

It provides pharmacists access to clinically relevant information from other healthcare providers including:

  • Hospital discharge summaries
  • GP shared health summaries
  • Consumer-entered information about OTC medications and other supplements

There is also significant potential for pharmacists to use digital health records as a tool to communicate with other health professionals, particularly during transitions of care.

My Health Record will provide access to verifiable clinical information such as a shared health summary, which is really useful when a pharmacist is sitting down with a patient for a MedsCheck or Home Medication Review.

The benefit to patients is safer and more effective care.

2. In simple terms, what are the steps involved for pharmacists using the software?

Uploading clinical documents

To upload clinical documents (dispense records), pharmacists will need to use conformant FRED Dispense, Minfos, POS Works, or RxOne pharmacy software, register with My Health Record, and obtain National Authentication Service for Health (NASH) Public Key Infrastructure (PKI) certificates.

Pharmacists will then be able to access My Health Record directly from the ‘dispense’ screen. For noting, each pharmacy dispensing software may have a slightly different display of the My Health Record radio button however the actual upload of the dispense record occurs automatically.

To support the upload of dispense records, pharmacists and pharmacy staff will need to ensure that each individual’s/customer’s profile includes the following information:

  • First name
  • Surname
  • Date of birth
  • Gender
  • Medicare number (and individual reference number)/Department of Veterans’ Affairs number

Accessing/viewing My Health Record

When a pharmacist is using conformant software, a patient’s record can be accessed directly from the ‘dispense’ screen. Pharmacists can also access relevant clinical information via the My Health Record provider portal.

3. Will pharmacists be using it for every patient/script?

No. My Health Record will best support a pharmacist’s practice if it is used in relevant clinical situations. For example, when a pharmacist needs to confirm allergies and adverse drug relations, or to access more information on the individual’s medical history or diagnoses, or verify discharge medications.

4. How long will using the software take out of pharmacists’ time every day?

The use of My Health Record for dispense record upload is not expected to adversely impact on pharmacists workflows, especially once the registration and training processes are completed.

MHR will add efficiencies to Medchecks, diabetes checks, HMRs, and managing patients at transitions of care by providing real-time access to recent, relevant and reliable information to inform clinical assessment and decision making.

5. How can pharmacists be assured that MHR is safe and secure?

The Australian Digital Health Agency has a comprehensive set of processes and technology controls in place to protect health and personal information.

The system has strong security, which ensures information is only stored and accessed by trusted connected health systems and users such as healthcare providers and consumers.

The MHR system has been engineered to provide high levels of redundancy to meet operational requirements to meet the digital health demands of the Australian population. The risks faced by the system have been assessed and taken into consideration in the development of the system architecture, and the design balances the need for information availability against the security and privacy risks to the system.

The Agency’s Cyber Security Centre continually assesses the cyber security risks to the system, and monitors the system for evidence of suspicious behaviour. This includes utilising specialist security real-time monitoring tools that are configured and tuned to automatically detect events of interest or notable events.

Examples of this include:

  • Overseas access by consumers and healthcare providers;
  • Multiple failed logins from the same computer or device;
  • Multiple logins within a short period of time;
  • Logins to the same record from multiple computers and devices at the same time;
  • High transaction rate for a given healthcare provider ; and
  • Certain instances of after business hours access and all instances of emergency access.

A game changer?

On announcement of PSA’s new partnership with the Australian Digital Health Agency and the Australian Government to roll out MHR, PSA National President Shane Jackson said the system is a “game changer” in clinical care.

“Pharmacists will be able to understand what’s happened to the patient in hospital, what changes may have been made, and what they need to do to follow up,” says Dr Jackson.

“My Health Record really shines a light on a patient’s health status so you can tailor their care.”

Does your software provider integrate with My Health Record? Will you be implementing it anytime soon? Let us know in the comments section below.

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9 Comments

  1. geoff
    13/11/2017

    1. why do we need to enter date of birth AND medicare number to upload data? Useless duplication.
    2. the article says it will not be used for every script- what happens if an important condition, lab result or allergy is available on the record but is missed ? If available it should be checked for every script (in the same way history is checked) but that is an additional clinical task that must be remunerated adequately. How would our insurers treat an instance where something important was available but missed because of some sketchy guideline ?
    It could be a great system but if not compulsory and adequately remunerated then maybe legally safer not to participate? If the government wants the benefits it will need to be funded.

    • Ron Batagol
      13/11/2017

      Couldn’t agree more, and I’ve been saying just that ( i.e.: MUST HAVE COMPLETE MEDICATION RECORD) since the idea was mooted!! Opt-out is better than opt-in in that respect,BUT still leaves the potential for gaps in critical information. (think- patients may want to “opt out” on diagnoses in such areas as psychotropics, sexual health etc.etc. and, obviously some of these may potentially have important interactions and other clinical &/or medico-legal issues!!). You could allow health practitioners to have access to the complete record in an emergency and sign privacy verification etc. BUT then you could still miss important info. in a “supposed” routine history review/scan!! Needs some form of compulsoriness or “quasi-compulsoriness” to allow access when needed, obviously with appropriate level of funding to achieve this!!

      • Debbie Rigby
        14/11/2017

        My Health Record is not intended to be a single source of truth. For community pharmacists it will provide additional patient information that we don’t normally have access to eg diagnoses, discharge summaries. We still need to take a good medication history and ask about allergies and previous ADRs. MyHR may be used as confirmation or fill the gap in patient recall or understanding.

      • Debbie Rigby
        14/11/2017

        In the 2 PHN trials of My Health Record only 2% of people opted-out. It must be patient controlled and respect consumer’s rights to privacy. Relationships and communication skills may fill the gaps in medical or medication history if the patient chooses to hide certain information.

    • Jarrod McMaugh
      13/11/2017

      I can only agree wholeheartedly with your second point.

      With the first point – the requirement of two disctinct unique identifiers can assist with errors. There have already been instances of pharmacies uploading information to one person when it should have been for another person.

      It’s also possible to have incorrect data in your dispensing software. Having two unique points of data that are both wrong is less likely (but not impossible).

    • Debbie Rigby
      14/11/2017

      The Agency is working with pharmacy industry peak bodies to develop professional guidelines and My Health Record policies and procedures for use in pharmacies, aiming to provide guidance on legal liability issues concerning the My Health Record.

      Declaration: I am a Clinical Reference Lead with the Digital Health Agency.

    • Debbie Rigby
      14/11/2017

      Geoff, the demographic information including date of birth and medicare number are required to assist identify the right patient for clinical safety reasons. This information is already captured in an electronic prescription so if a pharmacist dispenses from a prescription exchange service then this information will automatically be in the dispense record.

      • geoff
        14/11/2017

        You are correct as DOB and medicare number are automatically captured with an electronic script without the dispense tech or pharmacist checking either. We already provide name ,address and medicare, why add an extra administrative task/responsibility that can be matched automatically by government computers and exceptions checked? Technology is improving exponentially but this seems to be designing clunky bureaucratic system along the lines of the NDSS/ DA ordering and payment process, the onerous requirements to access the DAA fee in the 6CPA, requirements to dispense Clozapine, etc. I suggest again the system should provide instantaneous alerts rather need to be interrogated…….is this part of the planning?
        Regards, Geoff

        • Jarrod McMaugh
          14/11/2017

          Geoff, don’t think of it as an administrative burden, think of it as a medicolegal safety measure to ensure you are getting things right.

          You mention name, address, and medicare above. I have quite a few families where the same data applies to multiples members of that family (except perhaps the subnumerate…. so that’s one digit different between 2 or 3 people).

          DOB is fairly unique… and as you’ve said it appears automatically if you dispense a script via a PES.

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