My Health Record has the potential to save lives and deliver economic benefits but the system needs improvements and doctors don’t have time to talk patients through the opt-out process, according to the Australian Medical Association.
In its Pre-Budget Submission 2018-19, the doctors’ advocacy group this week claimed the federal government needs to invest in improving the national repository of Australians’ healthcare information for it to reach its potential.
“The AMA believes a fully functioning and widely used My Health Record will not only save money but save lives. Ongoing improvements will help ensure its success,” the submission says.
“Electronic medical records promise much,” the AMA says, with early wins predicted to be reduced adverse drug events and duplication of diagnostic tests. Developing the platform’s functions could lead to additional gains.
“We note government estimates anticipate that the My Health Record will generate savings of around $123 million by 2020-21. Further iterations of the My Health Record could become even more useful to clinicians and patients alike via features such as recording specific prosthesis details, enabling targeted notification of drug recalls, and providing the opportunity for understanding of aged care directives and patient wishes.”
But the submission claims “more work is required” to minimise the burden on doctors and ensure interoperability with healthcare provider software.
“The return on investment will hinge in the short term on ease of use for medical practitioners who upload the clinical data. Interoperability with the multiple software packages used across the medical profession and broader health sector must be seamless.”
The submission warns useability problems will discourage doctors from embracing the technology and could consume time otherwise spent concentrating on patients.
“Problems uploading specialists’ letters, poor search functionality, time-consuming adaptations to existing medical practitioner work practices, or inappropriate workarounds will erode clinical utility and deter doctor use – and, more importantly, take time away from focusing on the patient.”
In 2018 the federal government plans to create a My Health Record for every Australian unless they opt out, and the AMA cautions that the public communication campaign surrounding the uptake of this major health infrastructure project is for the government to conduct, not doctors.
“Doctors do not have time to talk their patients through the My Health Record arrangements for opt-out, privacy, setting access controls in standing consent for health providers to upload health information. This is the work of the government. Doctors must be allowed to focus on what they do best – caring for patients,” the submission says.
“The shift to opt-out arrangements in mid to late 2018 is also a critical success factor. Some Australians will be surprised to learn that a My Health Record has been created for them without their explicit consent. The communication campaign must reach as many Australians as possible, and promote a positive attitude towards the My Health Record created for them.”
The AMA also says that privacy and security of health information and the disclosure of data are “hot button issues” for doctors and patients, and the government needs to carefully manage confidentiality in order to maintain continued participation in My Health Record post opt-out.
In its submission, the AMA calls on the Government to:
- Guarantee doctors will not bear unnecessary costs for guiding patients through the intricacies of the My Health Record system for arrangements for opt-out, privacy, setting access controls in standing consent for health providers to upload health information
- Fully fund an opt-out communication campaign to avoid widespread fear-driven decisions to opt out
- Appreciate the high level of community concern about the My Health Record’s impact on patient privacy and health data security
- Invest in the ongoing improvement of the clinical utility of the My Health Record to enable it to become a value-add tool for clinicians in their day to day delivery of quality patient care
- Provide specific support for specialists to adopt the My Health Record
- Fund work to achieve a seamless interface between the My Health Record and My Aged Care
- Accelerate the establishment of health data standards needed to make interoperability a short-term reality.
The AMA claims the success of this project could be affected by the roll-out of another major federal government infrastructure project, the NBN.
“The lack of reliable broadband is also a barrier that will need to be addressed if nationwide, digitised health care is to be achieved.”
In other healthcare recommendations, the AMA calls on the government to boost funding for public hospitals to support them in delivering the reform agenda in the 2020 Hospital Agreement.
“The design and collection of patient outcome data, analytics, outcome reviews, and a redesign of patient-led care will cost time and money. Adding more work, without the matching additional resources, will lock them into a cycle of struggle.”
The provision of funding for the use of genomics in pathology services is recommended for the prevention and treatment of disease.
In terms of aged care, the AMA is calling on the government to introduce new telehealth Medicare items to compensate GPs and other medical specialists for time spent organising and coordinating services for patients.
The government has also been called upon to provide “urgently needed and overdue funding” to improve the My Aged Care (MAC) system to avoid delays in accessing care, develop a faster and more effective referral pathway, and bring about interoperability between MAC, clinical software, My Health Record and aged care providers’ systems.