It would be an understatement to say that digital technology has transformed the way we engage with the world around us in so many facets of our lives, such as communications, business and banking, travel and social interactions. Our healthcare services have generally been much slower in the development of digital tools to support us with understanding and interacting with our health and care needs. There are some good reasons for caution here – our health systems and care providers are focused on the important principle of ‘First, do no harm’, and innovation needs to be balanced with the assurance of safety as a fundamental feature of new design.
However there is a shift in the way we are now able to experience and understand our health and care needs, and one sign of this is the development and planned expansion of our national My Health Record system, supported by the recent federal budget announcement of $374 million over the next two years, and due for delivery to all Australians by the end of 2018 – unless they choose not to have one.
My Health Record is a secure online summary of your health information. When I explain it to my patients in general practice, I use an analogy of an online bank account, where all of your healthcare providers can ‘deposit’ pieces of your health information. This means that you, as the owner of that health information, will now have the ability to see things such as your medications, allergies, GP created health summaries with all of your important diagnoses, your discharge summaries, your immunisations, and increasingly now your pathology and imaging test results. This also means that all of the healthcare providers you see will also have immediate online access to that important information, with your permission, helping you make safe and better informed decisions about your health and care together, at the moment you need it.
As well as that access to your information being incredibly convenient for you and providing you with support so you don’t need to try to remember all these details, this is a system that could really save your life in an emergency. A clinician could access the record if you were unable to communicate and immediately know more about your history, medications and allergies.
And there are numerous other benefits of My Health Record for both individuals and our health system. It is likely we’ll see a huge return on our investment in making the system widely available and improving the richness of clinical information going in as hospitals, primary care, pharmacy and providers of imaging and pathology increasingly connect and contribute information for people. It is predicted that we will see a reduction in unnecessary test duplication, as clinicians will have visibility of pathology and imaging recently done in either a hospital or community setting. It will also reduce avoidable hospital admissions, providing improved care coordination for people with chronic and complex care conditions. We will see a reduction in medication errors, currently a huge burden terms of patient safety and cost, with around 230,000 admissions per year attributed to medication errors and 2 of every 3 patients admitted to a hospital experiencing some form of medication error.
A common question about the My Health Record system is around privacy and security – will my information be safe? It is important to understand that this is truly a patient controlled record, and you decide who can see it and who can contribute information to it. You choose who you want to share it with, and there are a range of sophisticated privacy controls that you can enable. For example, there are password protections of the system, so that nobody can view it unless you share your code. You can block healthcare provider organisations from viewing it altogether, or either password protect or even effectively block documents within it from view. You can even enable an alert to your mobile phone or email if a new provider accesses your record – and everything is kept in an audit trail, so you have full visibility of anyone who has ever interacted with your My Health Record. There are bank level cybersecurity protections around the system, and our My Health Record legislation very strongly supports your privacy rights and contains criminal penalties for anyone who inappropriately accesses the system, including custodial sentences. We have close to 5 million Australians in the system currently, which has been operating for 5 years, and there have been no known inappropriate privacy breaches of the My Health Record system to date.
Perhaps one of the most important benefits that we will see as the My Health Record system is offered to all Australians is our ability to truly engage in patient-centred care, as people are better connected to their clinical history and details, and able to make better informed decisions in meaningful partnerships with their health and care providers. I look forward to that, both as a clinician and as a one of the 24 million people in Australia who will be empowered with access to my own health information through My Health Record.
Clinical Professor Meredith Makeham is the Chief Medical Adviser for the Australian Digital Health Agency