My Health Record: what now?
Like any big change to behaviour in a system as complex as healthcare, the introduction of My Health Record (MHR) while offering great benefits, continues to pose complex challenges for all of us: consumers and clinicians alike.
The end of the opt-out period in January in which about 10 per cent of Australians decided not to be part of MHR, left the remaining 90 per cent of us as part of a system where important health interactions involving Medicare and PBS are already being uploaded to our personal site, or are ready to be once the record is activated.
We are at the beginning of a watershed development in our health system. Once fully-operational and with investments in continuous improvements, MHR should transform the administration of our health care, enabling instant, precise and comprehensive communication of our health record to the individual patient and to health providers in the patient’s care team.
Yet the promise of MHR is still distant for many consumers and doctors, the majority of whom are yet to actively engage with each other in deploying MHR to their benefit.
We know that people may encounter obstacles in trying to use the MHR, either in registering and/or in having a doctor who is prepared to help them complete their health record.
Many doctors have yet to actively use MHR to prepare summary records for their patients. Many continue to express doubts about the usefulness of MHR.
There are also residual concerns about issues of privacy and uncertainty about the requirement for people to use a PIN if they wish to set controls on who can view their record.
So, there is still much to be done to educate consumers and doctors about making the most of MHR. To the sceptics it is worth noting that the GPs and their patients with chronic illness who are routine users of MHR are enthusiastic supporters of MHR.
The Consumers Health Forum is joining the Australian Digital Health Agency to help consumers find their way and get better educated about MHR.
The MHR opt-out phase was but an early bump on the digital pathway - and it is unfinished business. Trust, confidence and use among consumers is integral to its social licence and value to consumers and striving to ensure doctors and other healthcare providers use it is also critical to fully realise the MHR benefits. These are important ongoing bodies of work.
At the same time, there are other imperatives. While we need to finish what we started with MHR, we can’t afford to not vigorously embrace the many other benefits that digital health offers.
The digital revolution may have transformed many of the transactions of modern life but its full impact on health care is yet to come. Digital will be everywhere in health care, on and in our bodies, our homes, clinics, hospitals, pharmacies, aged care facilities and research centres. The ambitious National Digital Health Strategy endorsed by the Council of Australian Government (COAG) and its companion Framework for Action chart the way.
There is much more to do in ensuring interoperability so that different parts of the health system, the hospitals, GPs, and individual consumers can “talk” or communicate records to each other via a seamless data network.
The rapid spread of health apps for personal care and health information will increasingly require more community engagement and scrutiny – and possibly regulation. Digital records will enable big advances to both clinical and consumer information such as the National Child Health eCollaborative digitising the baby book to harmonise pregnancy and baby records offering a new world of benefits for parents.
Digital health has the power to enhance equity of access to health care by bringing more effective telehealth to rural areas poorly served by the health workforce and by supporting improvements in care for older people. It can also facilitate better organised, coordinated and focused care for people with multiple and complex chronic illnesses.
We know poor health literacy and low levels of patient activation impedes access to healthcare and better health outcomes. People report that they generally think they’ve got good health literacy – until they get sick and start navigating the complex web of services they need. Good, quality assured information on trusted digital platforms is essential to better and faster access.
Readily accessible health information on digital platforms will also support more effective self-management and self-care. It will stimulate health literacy through easier to understand information that will boost health awareness and engagement in personal health care.
And artificial intelligence, robotics and other forms of machine-assisted, personalised medicine is a whole new and emerging world in its own right carrying many implications for policy, regulation, models of care and workforce education and development.
For most of us who have adapted to modern technology have accepted that while it can be pesky and challenging to change, the nuisance ends up being worthwhile.
We face an enormous set of issues in Australian healthcare to do with access, equity and affordability. With the right enabling policy, levels of investment, consumer protections and community social licence, MHR and our wider digital health horizon offers the prospect of advances that can truly help us live healthier lives.