It is often said that the true mark of adulthood is when you realise from this point onwards that you’re now in charge of organising all of your appointments. And yes, this includes ringing them up to book an appointment (as daunting as many of us might find that).

Since that frightening realisation, you may have heard of the ongoing debate surrounding the government’s recent roll-out of the ‘My Health Record’ program.  Put simply, My Health Record (MHR) is “an online summary of your key health information” [1]. Though the due date to “opt-out” of having a record has since passed (31 January 2019), what does MHR really mean for you?

Well, there is no simple answer to this question. However, there are key points surrounding this debate that are worth considering. So, without further ado, it is time to bring out one of the most important tools in any Economist’s toolkit; the trusty Cost-Benefit Analysis.

Proponents of My Health Record have put forth a plethora of reasons as to why it benefits you. Most notably, it offers the opportunity for enhanced connectivity across a frequently fragmented health system. The program allows healthcare professionals to access information regarding medications, allergies, immunisation records as well as hospital and GP care summaries [2]. This inter-connective approach could be critical in reducing lives lost in emergencies by allowing health workers to view important information regarding medications, drug allergies and medical history. A significant quantity of health data is available in both the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data as well as the Australia Immunisation Register and the Australian Organ Donor Register. Linking this data together could result in potentially significant benefits as it could facilitate the improvement of knowledge of diseases and their risk factors [2].

Furthermore, it gives people control to manage their data and who sees it [1]. MHR is one of the first steps to giving patients more power and knowledge about their health [2]. It is a very early nudge in the direction of presenting health records in such a way that is comprehensible to Australians.

However, there are growing concerns over allowing people more control over what comprises their health file. It is at the discretion of the owner as to what data is actually uploaded [1]. Vital information can be manipulated or even removed from the file at the discretion of the owner and without any consultation from healthcare professionals. Hence, MHR is technically not a clinically-reliable medical recorded nor was it designed to operate as such, as it is not up-to-date in the data or comprehensive. It is only a summary of key patient information [3]. Subsequently, contradictory to what proponents of the scheme believe, in an emergency, MHR is not a reliable record. In fact, many clinicians do not use the MHR due to the incompleteness of information within it [3].

Additionally, even the Australian Digital Health Agency (ADHA), that operates the system of MHR, is aware that there are risks involved with transmitting and storing personal information within the system. In light of the recent stream of health data breaches overseas as well as in Australia, there is only growing concerns over security. Most notable is the perceived parallels between this system and that of the failed initiative in the UK, known as care.data [4].

Lastly, there is continued controversy over the scheme’s switch from an “opt-in” to “opt-out” stance. Originally, people could choose to opt-in and then from there had control over the privacy settings and further dissemination of their data. However, under the now “opt-out” version of the scheme, there is no express consent requested from the patient before the creation of a health file in their name [3]. Those who did not opt out before the cut-off date have had their health records automatically stored and shared [3]. In addition to this, there was little fanfare regarding the cut-off date. It is debatable whether proper measures had been taken to properly advertise the MHR and explain it fully before the choice to opt-out expired [5].

In closing, the My Health Record is a complex and controversial matter. As the system develops, it will no doubt be interesting to see what follows.

-Georgina Kirby


[1]https://www.myhealthrecord.gov.au/for-you-your-family/what-is-my-health-record

[2]https://theconversation.com/my-health-record-the-case-for-opting-in-99850

[3]https://theconversation.com/my-health-record-the-case-for-opting-out-99302

[4]https://www.theguardian.com/commentisfree/2018/jul/20/there-is-no-social-license-for-my-health-record-australians-should-reject-it?CMP=Share_iOSApp_Other

[5]https://www.news.com.au/technology/online/security/australian-governments-controversial-my-health-record-system-slammed-as-failure/news-story/9f45df2927fe0b85c28a461343dd4704

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