Nice set of numbers turns sour

The Australian Digital Health Agency and the Department of Health put on a brave face at Senate Estimates this week when they popped up yet again to be interrogated about the My Health Record. A couple of hours earlier ADHA had quietly released details on the number of people who had opted out of the system, and at 9.9 per cent of the eligible population, representing about 2.5 million people, it was not a figure they seemed keen on shouting from the rooftops.

Their defence of the number seems to have changed as well. Asked how the figure of 9.9 per cent opting out compared to international experience, ADHA CEO Tim Kelsey told Senate Estimates that as Australia was leading the world with a system that provides patients with control over their record, there was nothing really to compare it to.

Well, just last year the very same Mr Kelsey was telling another Senate inquiry that in the UK's national data opt-out exercise the rate was 2.7 per cent, and in Austria it was three per cent. The Department of Health has always touted two to three per cent as an international benchmark going back to PCEHR days, and they were very happy with the 1.9 per cent opting out during the 2016 trials. The three per cent who had opted out of the current system by late September 2018 was, in our estimation, a nice set of numbers for the government, all things considered.

The high drama that accompanied the end of the opt-out period in November and its subsequent extension to January 31 obviously spooked many people about the system and they have obviously rushed to get out as quickly as they could. The scaremongering was intense and was accompanied by the stench of a failing government that many people simply do not trust anymore.

The experience sheets home how poorly thought-out ADHA's marketing campaign was, relying as it did on the media to educate the general public. That was not a smart thing to do, as coverage was relentlessly negative and ill-informed, and it is continuing. Outlets like the Guardian, which should know better, are still getting it wrong, including in a story from earlier this month claiming that general practices were pocketing up to $50,000 in bonuses to sign patients up to the My Health Record.

“[ADHA] was unable to say how many clinics were receiving incentive payments to sign people up for My Health Record or how much had been paid out to date,” the Guardian says. That's probably because clinics didn't receive any payments for signing people up, and ADHA wouldn't be expected to know how many practices claim the ePIP as it doesn't run the program. The figures are readily available from the Department of Health, which does.

It also erroneously drew a link between these bogus bonus payments and ruthless general practices that have apparently signed up their patients to receive a massive $6.50 windfall. The fact that some patients are unaware that they had a record certainly needs investigation, but it wasn't for the money, that's for sure.

Greg Hunt hedged his bets last year when he said he would be happy with 90 per cent of the population opting in, but we reckon he'd be disappointed. We also seriously question his judgement when fronting the media the day before the ultimate opt-out cut-off date in January. Asked if he could guarantee that people won't have their information wrongfully exposed, Mr Hunt decided to say yes.

This was not smart. No one can guarantee that there won't be a hack or a breach and to say otherwise is silly. It is likely enough that there will be a breach sooner or later and there will certainly be multiple attempts at it. Consumers should have been told that there is a definite risk of a privacy breach in signing up for a record but that they should weigh that risk against the benefits of having access to their own information and the ability to share it with their healthcare providers.

Still, there will shortly be 22.5 million people – nine out of 10 Australians – holding a shared health record, something that is a bit of a first. There will undoubtedly be numerous problems with incorrect information appearing on the system that will be regularly reported, but in the long term, that may be of benefit in helping with data quality.

As always with the My Health Record and its predecessor, it all comes down to one thing: is this record clinically useful? That remains to be seen, but the attitude of most people we have spoken to in the industry this week is, it's done now so let's get on with it.

Interestingly, our poll from last week asked if you thought the MyHR opt-out rate would be over 10 per cent or under. While 41.5 per cent of readers said over and 58.5 per cent said under, considering the end result was 9.9 per cent, we're going to call it a draw.

Our other top stories this week included some serious questions for MedicalDirector over its progress with its Helix product, and some very serious questions for HealthEngine over its texting habits. At the end of the week, even these stories were becoming overshadowed by reports of a ransomware attack on a cardiology practice in Melbourne. The hackers are here, and they are not going to go away.

That brings us to our poll question for the week: Can health data security ever be guaranteed?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.


0 # Paul Campbell 2019-02-23 09:14
Can health data security ever be guaranteed? It depends on the context. In a GP Clinic? No. In MHR? Yes
+4 # Ian Mcknight 2019-02-24 00:14
Great summary of the whole scenario by Kate, summarising all the weakness in the governments marketing "strategy" for MyHR. 9.9% is disappointing, but frankly expected. Sadly we live in an era of major distrust in most institutions. Politicians rightly aren't trusted, media organisations trade in hyperbole and exaggeration instead of truth, possibly more than ever before. Internet and social media provide open-slather forums for peddling incorrect information, as well as massive opportunities for scammers, and royal commisions show us that previously reasonably respected financial institutions are lying to us as a matter of policy.
Gerg Hunt's reply to the data guarantee question was foolish, but I understand his motivations. Any negative answer would have been trumpeted from the front pages, conveniently omitting the context it came with.
I believe that part of the 10% will actually drift back into the system with the passing of time and the embedding of reality. At least with 90% we can now move forward and realise the benefits.

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