MyHR inquiry a predictable yawnfest

This week's proceedings in eHealth kicked off with yet another Senate committee inquiry into the My Health Record on Tuesday night, where we saw pretty much the same old faces repeating the same old things to the same old committee members.

One new face was former AMA president Kerryn Phelps, who delivered a pretty good speech on why she loathes the My Health Record with all her being, repeating arguments we have all heard before at numerous other Senate committee inquiries.

Professor Phelps was insistent that we needed a full parliamentary inquiry into this Orwellian new system and that opt-out be delayed for a full year. It's doubtful anyone will listen unless she does what she is rumoured to be considering and stand as an independent in the Wentworth by-election, but even then she's unlikely to be successful.

There were some other relatively new faces on the AMA and RACGP table, with Chris Moy and Kean-Seng Lim representing the former and Nathan Pinskier the latter. All three doctors made a lot of sense and argued their cases extremely well, but you wonder at times if they should have bothered. With the privacy advocates predictably repeating their same arguments from the last six years, it was pretty much impossible to find anything new to shout about.

This inquiry was called mainly to score a few points against a flailing government, and most of the committee members on the opposition side have been through these inquiries before, along with the copious amounts of evidence given at Senate Estimates over the years.

The contempt with which the government viewed the whole thing was obvious when it rolled out Liberal Senator Slade Brockman and former Jacqui Lambie Network turned independent turned Nationals Senator Steve Martin, who looked utterly bewildered by proceedings, to run interference. They weren't called on to do much of that, and while there will be another day of proceedings on Monday, in the end we expect that even if it's the committee's majority opinion that opt-out is further delayed, the government is not bound to agree to it, and probably won't.

Meanwhile, in yet another mark against the appalling communications campaign run by ADHA, one of the Pulse+IT team had a chat to her 82-year-old neighbour about this new record, and she appeared as bewildered by it as Senator King. With type 2 diabetes and bad sciatica, our neighbour visits her GP, a specialist and her pharmacist regularly, so you would have expected her to have heard something about this newfangled record. Not a peep.

Another on the Pulse+IT team had his own experience with the My Health Record this week. Our publisher Simon took himself off to his local radiologist for an X-ray on a dodgy shoulder, and while he had little expectation that the practice would be able to upload the resulting report to the My Health Record – another indictment of the system after six years – he did have some hope of being able to add details from the report as a personal note to his record to help him keep track of when, where and why he had the X-ray.

Within 30 minutes of leaving the clinic he had a PDF of the report, a PDF copy of his GP's referral – complete with a “Do not send to the My Health Record” section with a checkbox so small it was almost non-existent – and a URL where he could take a look at the X-rays online.

But could he add these to his personally controlled electronic health record? Not on your life. There is a section called personal health summary, which allows consumers to add medicines, allergies and adverse reactions and which can be viewed by clinicians, and another section confusingly called personal health notes, which can't be viewed by clinicians but doesn't allow you to do much anyway.

You can't upload a document to it, and the free text fields only accept alphanumeric characters, so he couldn't even add in the link to his images. URLs have forward slashes, but that's not allowed on the My Health Record.

There are obvious reasons why clinicians insisted pretty early on in the piece that they not be able to view documents uploaded by patients – no one has time for that, and there would most certainly be some joker who would decide to upload a photo of his privates for his GP's viewing pleasure – but that not even patients can upload their own stuff means its not really much use as a personal health record.

It's also obvious that existing apps like Healthi and Tyde and some others on the market will grow into a digital health platform where patients can access data from several health records, of which the MyHR is just one. But again, that sort of negates the big sell of the MyHR as the one place where all of your health data is kept.

And as we reported yesterday on a submission to the inquiry by Grahame Grieve, it may never achieve the value to healthcare so fervently hoped for by so many simply because the architecture underpinning it is not really fit for purpose. Mr Grieve saw back in 2011 that the CDA structure of the system would never be able to achieve what the developers had hoped and actually spurred him on to investigate emerging web standards and develop FHIR.

We do apologise for continuing to harp on about the MyHR when so much else is happening in health IT – western Sydney is planning interesting stuff with a diabetes app, WA Health is developing a digital health strategy, and Apple has released a shiny new piece of jewellery it is calling a medical device – but everyone keeps wanting to talk about the MyHR, even if it's a yawnfest. Feel free to drop by our Facebook Chat page, where we can't get enough of it.

Our story on the new Apple Watch garnered a great comment from a reader on how it's clinical value is complete bollocks, so we thought we'd ask for your thoughts. Is an ECG app in the Apple Watch of any clinical use? Sign up to our weekend edition to vote or leave your thoughts below.

Our poll last week asked: Do you think patient consent for data health sharing needs tighter regulation? Yes, by a large margin, our readers say: 73 per cent said yes, 27 per cent said no.

Comments  

# Jennifer Gilder 2018-09-15 09:00
As a Health Information Manager heavily promoting the MyHealthRecord in my community, may I take task with your comments. Our PHN is working hard getting out to the Nepean Blue Mountains LHD community. As a user of the MyHealthRecord I find it invaluable and enjoy chatting with my supportive GP practice. They have embraced the benefits for the quality and safety of the care to their patients. Jenny Gilder MRA CHIM FHIMAA
# Ian Mcknight 2018-09-15 17:57
Hi Jennifer,
Without wishing to talk for Kate, I think her comments reflect frustration with the ongoing debate amongst politicians etc and the recrossing of old ground, rather than the MyHR itself. Indeed the editorials on the MyHR in this blog have often been a lot more sensible and constructive than the criticisms from others. The reality is though,that the public education campaign nationally has been almost non-existent, and geez, I've worked with Registrar GPs who have never been told a thing about the MyHR in their GP training.
Actually if the staff member at Pulse had wanted to upload his xray to the MyHR, he could have sent the PDF to the Advance Care Directive section and labelled the Author as "Shoulder x-ray". I know it's a really silly work around, but would have achieved the aim of getting the document up on the record. and wouldn't have caused any harm.
I have no doubt that with greater clinician and patient buy in, will come greater functionality. The sooner Opt-Out is finished and we have the majority of people with a record, the better.
Ian McKnight

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