Govt refuses to extend My Health Record opt-out period as trend slows

The federal government will not accept a recommendation made in last week's Senate committee report into the My Health Record that the opt-out period be extended, arguing it was important that people experienced the benefits of the system as quickly as possible and they could opt out in future if they wished.

So far, 1,141,700 people have opted out of having a record, which represents an extra 240,000 opt-outs in the last month. The first two months saw 900,000 people opt out.

Department of Health deputy secretary for health systems policy Caroline Edwards told a Senate Estimates committee hearing that the slowing trend was expected.

Posted in Australian eHealth

Tags: My Health Record


-1 # Donna Bartlett 2018-10-25 10:04
I cant believe that 5% is considered an acceptable opt-out rate!
I cant believe that the Government thinks 5% is an acceptable opt-out rate for a system that is so critical!
+1 # QLD Health staffer 2018-10-25 13:55
I can't believe that only 5% have....
-1 # Tasmania Health Service staffer 2018-10-26 09:36
Deletion can only be enabled if the legislation passes - which is unlikely IMO.
0 # Troy Bailey 2018-10-28 14:05
Lets start counting the number of lives that are saved due to the MyHR and SafeScripts, and hope its not our own. Its interesting to see that those who need the data the most are the largest group to be opting themselves out. I wonder if many of our health professionals understand what their patients go through and want? What will they do when the shoe is on the other foot?
0 # Ian Mcknight 2018-10-30 10:43
Excellent call Troy! We don't hear enough of this kind of commentary. I've come across th\s recently, people in rural areas being spooked by others into opting out, even people who have been signed up for a couple of years. Turning a health issue into an exaggerated privacy nightmare is scaring off some of the very people that should have a MyHR.
On the other hand just about every young hospital based GP I have spoken to can't understand why a shared integrated system isn't already in place. Stories of having to hand-over their patient to the next rostered Dr without having progressed the care at all because it's after-hours etc.Sadly the reluctance of mainstream medicos to get properly behind this initiative is hampering the potential effectiveness of our younger doctors. Across the board, empathy seems to have taken a back seat.
0 # Ivor Jones 2018-10-30 14:35
“(it is) important that people experience the benefits of the system as quickly as possible” – yes, valid point, and there are indubitably cohorts who will benefit, but what about the cohorts who will experience dis-benefits? If you’re a DV victim for example, the MyHR may bring significant dis-benefits. Or if your medical records are involved in a case of mis-identificat ion - as this publication reported quite some time ago – well, let’s just hope you’re as lucky as Kate was. So, I propose that the MyHR be subject to a production readiness assessment. To borrow a concept from aviation, we need three greens before clearing for take-off;
1. Are the interests of DV victims adequately protected? (To be determined by their advocates, not the ADHA)
2. Has the mis-identificat ion problem been solved? Given how long ago this was raised, ADHA should be able to provide the protocol for resolving mis-identificat ion in the MyHR, (who is responsible for what) and metrics on both how often this is expected to occur, and expected resolution time and effort.
And looking at the technology rather than the patients;
3. Is the infrastructure going to be ready? ADHA to advise on the status of their actions to resolve Issue 6 in the Royle Report (“lack of … an effective test environment”) and provide access to an independent professional testing organisation to perform load testing.
For what it’s worth, I agree that the privacy ‘debate’ has been a largely unhelpful distraction from consideration of these issues, which have the potential not only to cause harm to individuals but to render the whole system inoperative. After all, are your tech-savvy young doctors going to be quite so keen on the system if they can’t be reasonably sure that the medication record for the person with IHI x on the screen is actually the right one for the flesh-and-blood patient in front of them?
0 # Ian Mcknight 2018-10-31 00:21
It's a sad sign of the times that domestic violence has its own abbreviation, but I'm not sure what specific risks to this group aren't already there in existing systems like online banking etc. Access to the record involves a password and a pin sent to the mobile of the record holder. Yes you can be intimidated into giving the perpetrator your phone, but then obviously you can be intimidated into revealing any other information. If it's the fact of being a DV victim being present in the medical record, well the patient has the right to not have that condition uploaded, or to place a further password on the record or the document itself or both.
Actually I think the young doctors will take the tradeoff of a once in a blue moon pharmacy mishap for being able to verify what appears under "current" medications on the referral form with actual dispensing information from local pharmacies. If we critiqued our current medical record systems to the same level as we do the MyHR, then we would have to scrap everything.
As for load testing, while it's hard to test a national system in terms of usage, it's certainly not unfixable if there becomes an issue then relevant tech resources like bandwidth, memory, disk space etc will be added.
0 # Ivor Jones 2018-11-09 14:01
The report into the two opt-out trial implementations identified that the creation of a (then) large number of 'shell' records all at once caused performance issues. And we learn in Testing 101 the principle that errors cluster (i.e. Where you find one, likely there are more). The system operator has had ample time to identify and rectify such defects, but have they? An independent tester could tell us. Also, a middleware component commonly used to connect to the MHR by - shall we say - some of the larger HPOs imposes software-level response-time and capacity issues. If these factors cause the system to slow down unacceptably post go-live, the problem is not amenable to a simplistic 'throw more hardware at it' resolution. Given the investment of taxpayer dollars in the system, it seems entirely reasonable to me that the system operator provides some objective evidence that this and other risks are adequately mitigated. Of course we could just take a "she'll be right" approach, as for example Queensland Health did with their new payroll systems in 2010 - and look how well that turned out. As for the domestic violence question, once again the current regime for sharing and protecting their Information is completely beside the point when the MyHR comes online. As I said I'm interested to hear from those who work with, support and advocate for this cohort - because on this issue, a "she'll be right" attitude is simply not good enough.
0 # Ian Mcknight 2018-11-09 18:46
I don't think mine or anyone else's attitude to this can be fairly classified as "She'll be right" in the same way as "paralysed by perfection" might seem an unfair description of the naysayers stance. But yes, I want this implemented so the ACTUAL everyday benefits can be experienced and factored into any discussion. Do we really want to line up every tech "expert" every privacy afficianado and every lobbyist and invite them to conjure up all their nightmare scenarios so we can put the MyHR through the test on every single one of them, and if the score isn't perfect, then the armchair cynics can pat themselves on the back for helping the country avoid a disaster. (Shame they werern't around when we invented the wheel!) Of course by making us wait for this process to occur almost certainly means new threats will emerge to evaluate, so the testing cycle will continue until momentum is lost and we can all go back to nodding our heads and complaining about the government and the health system. No Thanks !
As for "simplistic" hardware solutions, well last time I checked databases were scalable, the sort of tech additions that fix speeds for smaller systems can certainly be scaled to larger operations. And in case anyone missed the memo, the MyHR will be by no means the largest database in existence, or even close to it. There are far bigger, climate, telecommunicati ons, research and retail systems.

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