A lifesaving record… or a threat?

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My Health Record could save your life one day, says AMA president, and Dr Shane Jackson agrees – but leading doctor Professor Kerryn Phelps shares her strong concerns

“Shocking” and “a disaster” were just some of the terms recently used by the Shadow Minister for Health and Medicare Catherine King to describe the start of My Health Record’s opt-out period, as about 20,000 Australians opted out of the system on the first day.

Much of the focus during the opt-out period has been around privacy, with one data expert calling the record “a major honeypot of health data, waiting to be hacked”.

Meanwhile Health Minister Greg Hunt defended the system as having military-grade security, reassuring Australians that it has never been breached.

As the public debate continues, some health professionals have come out publicly in support of My Health Records while others have shared their privacy concerns.

The AMA has written to the public urging people to embrace the system.

“For more than a decade, successive governments have worked to make an electronic health record a reality,” AMA President Dr Tony Bartone says in an opinion piece published on Tuesday by the Sydney Morning Herald.

“The electronic record can save lives,” says AMA president Dr Tony Bartone in the SMH.

Dr Bartone reassures that the benefits of My Health Record far outweigh the possible concerns.

“The AMA and the medical profession have been strong supporters of such a record. It is a great asset for the health system.

“The electronic record will also go a long way to addressing the intractable problem of delayed or non-existent handovers of admitted patients to their GPs on discharge. It will reduce medical harm due to polypharmacy, which is a big issue.

“The electronic record can save lives … We must push ahead with this My Health Record,” he urges.

However at the same time past AMA president Professor Kerryn Phelps has written her own opinion piece entitled: “Why My Health Record worries me”.

She shares concerns about the legislation surrounding the record, which allows use or disclosure of health information included in a healthcare recipient’s My Health Record if “reasonably necessary” for use by the police and other agencies including the ATO.

“Excuse me? What could ‘protection of public revenue’ possibly have to do with enhancing the healthcare of an individual, or protecting public health? Rhetorical question I know, but to avoid any confusion, the answer is: nothing,” says Professor Phelps.

“While there are many people whose healthcare could be enhanced by having this type of record, it is essential that we look at some of the potential adverse effects on healthcare,” she continues.

“The impact on women who have terminations could be profound. Abortion is still illegal in Queensland, and the other states are all over the shop. The same applies to STIs, especially HIV/AIDS.”

Professor Phelps calls on the AMA and RACGP to “qualify their support for My Health Record and demand that the legislation be amended so that disclosure of personal health information be confined to healthcare practitioners with the patient’s permission only, and for the patient’s benefit only”.

She is also calling for the Government to extend the opt-out period, a message that has been reiterated this week by the Shadow Health Minister.

PSA national president Dr Shane Jackson, who is also a clinical reference lead for the Australian Digital Health Agency (ADHA), says PSA has always been a staunch supporter of digital health initiatives, including the My Health Record.

However he says it should ultimately be up to the individual to decide whether or not to have one.

“We believe the opt-out program will accelerate the potential benefits of the My Health Record system, so we’re supportive of the sentiment of the AMA president’s article,” Dr Jackson tells AJP.

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“For those people who have got chronic disease, who see a number of different healthcare professionals involved in their care, there’s no doubt that the potential benefits far outweigh the risks in being involved in the My Health Record system,” says Dr Shane Jackson.

“He highlights, for example, medication misadventure – the oft-quoted term around 230,000 hospital admissions costing $1.2 billion annually.

“That’s just the tip of the iceberg. That [figure] doesn’t include the general practice visits, or visits to community pharmacy because patients have got medication-related problems. So the cost in fact is likely to be much more.”

However Dr Jackson believes that in the face of privacy concerns, the decision to have a My Health Record should be an individual choice.

“They need to weigh up the pros and cons with regards to participation in the My Health Record. Certainly for those people who have got chronic disease, who see a number of different healthcare professionals involved in their care, there’s no doubt that the potential benefits far outweigh the risks in being involved in the My Health Record system.

“There’s a number of levels of controls that the patient can implement to govern who has access to the My Health Record, so they can put access controls on the system, they can hide records or put access codes on records if they desire,” he explains.

“The security controls are very robust and, in addition, there’s significant penalties if people access the record inappropriately.

“People should feel comfortable about opting in to the My Health Record, but again it’s an individual’s decision.”

Meanwhile the ADHA is reportedly “scrambling” to put tough new restrictions on mobile phone apps that use its sensitive patient data, including an option to terminate contracts if the companies damage the system’s reputation, reveals the ABC.

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1 Comment

  1. Ron Batagol

    It is pleasing to see that the Government will address recent concerns raised over privacy issues , and who can access records in the “My Health Record” .
    ( see “My Health Record privacy concerns will be addressed, Malcolm Turnbull promises, amid ongoing criticism”.At:http://www.abc.net.au/news/2018-07-26/my-health-care-privacy-concerns-to-be-addressed-turnbull-says/10039342)

    This is certainly an issue that needs to be clarified, but it is no surprise that any new multi-faceted health information system such as this will have “teething problems” that need to be addressed in order to maximise consumer confidence and trust in the system.

    The Conversation Article by Jim Gillespie from the University of Sydney on 16th, July (“My Health Record- the case for opting in” https://theconversation.com/my-health-record-the-case-for-opting-in-99850), summarised some of the key advantages of the proposed system stating:
    “The scheme gives health care professionals access to information on your medications and allergies, immunisation records, summaries of hospital and GP care, investigation reports, and advance care plans.
    This information could save lives in emergencies by providing health workers with information about drug allergies, medications, and medical history. Better continuity in the management of this information would help reduce the 27% of clinical incidents in Australian hospitals currently caused by medication (mis)management”.

    I wrote about the importance of doctors and other health professionals managing patients in an emergency situation having access to the patient’s complete medical and therapeutic records in my comments on the AJP article “MHR Security under the spotlight” 16/7/18.

    In my comments, I highlighted examples of some common clinically important drug interactions which could conceivably be amongst those selected as “opt outs” by some patients, and therefore not available from the My Health Record.

    I also suggested a method of working towards making these records available when required in medical emergencies.
    (See https://ajp.com.au/news/mhr-security-under-the-spotlight/#disqus_thread)

    Ron Batagol

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