My Health Record, eight years on
It's birthday time again for Australia's My Health Record system, which will next week celebrate eight years in operation following two years of gestation. And a difficult birth it was, as we not-so-fondly remember. Our reminiscing was inspired not just by its approaching birthday on July 1 but by a press release from the Australian Digital Health Agency, proudly boasting of a surge in use of the system during the COVID-19 crisis.
The term “surge in use” took us back to 2011 and 2012, when we were breathless with anticipation about the new baby, then known as the PCEHR. Some of our first online stories were about how the medical software industry was approaching the impending birth: first with trepidation, followed by alarm, and then with horror.
Not to worry, we were told: the new baby is going to be an absolute knock-out, able to save the healthcare system $11.5 billion over 15 years!.
As it turned out, the actual birth was short and not very memorable, mainly because the system didn't work and no one could sign up for it. General practices were not ready, the software vendors were not ready, even the online registration process was not ready. We found a way nonetheless and joined 800 other people in signing up in the first week, but it was pretty much downhill after that.
Remember when all of the PCEHR clinical leads from NEHTA all resigned en masse because everything was so terrible? Remember when what little information there was on the system was someone else's prescription details on one of our records?
Remember when the first clinical documents couldn't even be uploaded through practice management software as none of it was connected yet? Remember when $8 million was promised to get pathology and diagnostic imaging added and that took another three years? Remember when the Department of Health set a target of 500,000 registrations in the first year, got 320,000 and promptly stopped setting targets?
We remember DoHA's terrible ads for the system in 2013, the long decision on whether to keep the system going in 2014, the change to My Health Record in 2015, the decision to move to opt-out in 2016, the very dodgy decision by the AMA and RACGP to sign compacts to promote the system in 2017, and the completely botched opt out process in 2018.
The last 18 months have seen a little light on the hill, with the hysteria dying down and more documents going up, but the spotlight on the cost of the system and its meagre benefits continue. As of the 2017-2018 budget, direct funding for the system has totalled $1,578,716,000, with an extra $143,915,000 for the Healthcare Identifiers Service and the odd couple of grand here and there funding this and that project. The estimate is that since its go-live eight years ago, the system has cost close to $2 billion. Ongoing funding will be needed in this year's budget.
Returning to ADHA's press release this week, we were pleased to see that there had a been a lift in the “use” of the system during COVID-19. We've put the term “use” in quotation marks as although there has been a welcome uplift in the number of healthcare providers connecting to the system and uploading data – and according to the ADHA the vast majority of the 22 million records now have something in them – actual use is something a bit different. It brings us back to an opinion piece we ran back in May 2012 by Bryn Evans, titled Will the PCEHR have meaningful use?
We have to say that on its eight birthday, that still remains to be seen.
That brings us to our poll question for the week: Has the $2 billion investment in the My Health Record been money well spent? Vote yes or no here and feel free to add in your comments.
Last week we asked: are you concerned about Big Tech firms encroaching on healthcare? 81 per cent said yes, 19 per cent said no.