Patient access to their own information a benefit of My Health Record: ACHI

The Australasian College of Health Informatics (ACHI) has welcomed the move to expand the My Health Record to almost all Australians, saying it had long supported the concept of consumer access to health information.

The college would now like to see the system move to a data-driven model so consumers are able to be involved in the management of their care.

The college said it believed that while there are legitimate concerns about some aspects of the program, near universal coverage and availability will more effectively drive change that the current low uptake.

Posted in Australian eHealth

Tags: ACHI, My Health Record

Comments  

-1 # Lynne Everett 2018-07-17 09:55
So many issues with a system that will "have value one day". "Consumers" basically still means people who are English literate, computer literate and have access to a computer/device and internet. What about prescribed medications that don't appear in PBS data? What about people who haven't heard about the MyHR, let alone opt-out, and don't know that information will be there for clinicians to see, let alone that, technically, it's patient controlled and they can, technically, remove incorrect information or discuss it with with their GP? What about people who need to prove their identity without enough of the documents required? Six years and over a billion dollars...
+1 # Ian Mcknight 2018-07-18 14:46
So many issues with perspective and accuracy...
The system has value now, it will only increase in value as people accept and use it. It will one day have massive value.
The non-english literate patients are a great example of a group that would massively benefit from not having to explain their health issues and medications to a non-familiar clinician. The clinician would refer to their MyHR and take information generated by a clinician. Also certainly there would be health focused rather than "my data" focused elderly patients who wouldn't feel the need to access the record, but would happily benefit from not having to meticulously explain their medical circumstances to every clinician they see
"what about prescribed non PBS.". If the GP is maintaining the patient's clinical record well then these will be reflected in the health summary uploaded by the practice.
Re "haven't heard about the MyHR...", if they haven't already, I'm tipping they will over the next 3 months.. Just to be clear they can't edit clinical documents from the record, but they can remove the document as a whole. You will always be able to locate or create unusual cases or exceptions, but it's completely misguided to withhold a benefit to the vast majority of people because there are a tiny number that it won't be as straightforward for.
"what about people who need to prove their identity....." Obviously all the auto created records won't have this issue, also if you have visited a practice 3 or more times and they have seen your medicare card, they can sign you up in a flash.
"six years and over a billion dollars.." for a nationwide health repository that meets privacy and security requirements and can be accessed correctly by hundreds of different clinical systems and medicare databases. What would you have quoted Lynne? Would you have saved money by not creating advertising materials for people that had never heard of it ? Have you looked at how much money is spent on duplicated pathology requests, or hospital admissions due to medication errors??
Everyone, should have a MyHR in my opinion, but if you are young and healthy you can certainly cope without one. If you are elderly or have significant health issues, or have language difficulties, you absolutely should have one, and anybody who tries to tell you otherwise is doing you a big dis-service.
# Lynne Everett 2018-07-19 10:28
I didn't say it had no value, I was quoting the article. I also never said that there was no benefit to these patients; this article is talking about the benefit to consumers being able to access their own information and the people I mentioned generally won't have that.
Yes, non-PBS prescriptions will be reflected in the SHS, but when patients have multiples of these from multiple clinics they all need to be reviewed to obtain accurate information, a time-consuming process.
I'm well aware that patients can't edit documents; I'm also aware that incorrect information can be sent up and one of the points to personal control is being able to identify this information and discuss it with the clinician responsible or hide it -- if you have the ability to do this. I certainly never advocated withholding anything from anyone on the basis that the system isn't perfect.
In regard to proving identity, I'm talking about opt-out, not being signed up. People who don't have driver's licences and/or passports or one name and DOB will find it extremely hard to opt-out if they choose to do so.
We each have our opinions.
# Ian Mcknight 2018-07-19 10:58
Ok Lynne, I understand your angle a little better now.
My concern is that there will always be exceptions or people at the fringes of any big initiative, I just feel that there is disproportionat e focus on this as opposed to the overwhelming good that can come from this initiative it it is accepted as opposed to publicly maligned every step of the way. The group that you described may find it hard to opt out, but they have 3 months to "find a way", plus the fact that they can exit the system at any time after that. Also, and sorry to generalize, but if their opt out difficulties stem from language or communication issues, then they are in the group that absolutely should have a my health record.
I felt that your non-pbs comment was saying that these meds wouldn't be reflected in the record, not that they are there but hard to sort out, apologies for the misunderstandin g. I'm sure that you are aware that there is an auto-created medications report in the MyHR that takes information from the various source documents in the record and summarizes them . I'm not a clinician, so maybe this report doesn't function as well as I imagine, but I'm wondering how you deal with this issue in the non MyHR world.
I'm confident that there isn't a perfect system anywhere, but as there are many of us that don't read past the headline, I wish there was more balance in the publicly aired part of the debate, hence my reply.
# Lynne Everett 2018-07-19 11:54
Thanks Ian.
Part of my problem is I come from a non-MyHR world which has an existing system where the various documents containing prescribing information are much easier to access. I am a clinician and have been involved in this project since the start; it's very disappointing considering what it could have been, hence my original comment on the cost and what we have at this point.
# Ian Mcknight 2018-07-19 14:29
Hi Lynne,
Often in the non MyHR the non-familiar clinician has no information in front of them. To me, them and subsequently the patient are the chief beneficiaries of this, and we should never lose sight of that fact. I know you know the intent and the background, and come from a position of knowledge, and I get that this is falling short of what you would like it to be. But once we have everyone playing in the same place, then we can evolve and improve that place. There is benefit now in the system, and if people would embrace it, then ALL resources could be directed into improving the MyHR, rather than the current situation of trying to defend it and persuade clinicians to use it. You have to know that a project of this magnitude has to be an evolving process and the MyHR in 5 years will be an improvement on what we have now, in the same way that the current version has more functionality than the 2013 version. What we don't want is politicians and bureaucrats baulking at funding any improvements because of low take-up of the system. The phrase "leap of faith" comes to mind. :-)

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