Need to know
- By early 2019, electronic health records will be set up for every Australian, including children. They can be accessed by you, your doctor and other healthcare professionals.
- Six million Australians already have a record – some without their knowledge
- Health care experts welcome the new centralised record, but security experts warn of data breaches that can expose sensitive data
In early 2019, the federal government will set up an electronic health record for all your health data – including sensitive issues like mental health treatments and other conditions you may wish to remain private – unless you opt out by 31 January 2019.
Doctors will be able to access your record to assist in their treatment of you, which could be essential in emergency situations. But security experts warn privacy breaches are only a matter of time.
There's been a lot of public discussion since the opt-out period started. So we've looked into the pros and cons to help you decide if you want in or out.
My Health Record is a digital collection of reports relating to your health, such as prescriptions, doctors records, imaging and other test results. What it means is that instead of having files with every doctor you've seen, test results at a pathology lab, prescription records at various pharmacies and so on, all this information will be in one central online location accessible by authorised health professionals.
Relaunch of existing program
Technically what we're seeing now is the My Health Record Expansion Program. The original Personally Controlled Electronic Health Record (PCEHR) program was launched in 2012 as an opt-in system, with low uptake by the public.
The current push is to expand the system by making it opt-out so that by default, everyone has a record made for them unless they specifically request not to have one.
The data that will be added isn't new, but it's currently stored by Medicare, your doctor, hospital or other health professionals, sometimes in a paper-based system. What's new is that electronic records will be stored in one central place.
Information can be added to your health record by various health professionals and businesses, government agencies and yourself. It can be accessed by authorised health professionals, such as doctors, pharmacists, hospital staff and allied health professionals (for example nurses or physiotherapists).
The sorts of things that might go in there include doctor's reports, such as hospital discharge summaries, and results from tests and scans. It also includes all your Medicare claims and you can add your allergies and even an advanced care plan.
You can access and manage your record. You can set a PIN and restrict access to some or all documents stored on the record. You can even connect any health apps you're using to your record.
In an emergency, health care professionals will be able to override the safeguards to make sure they get all the information needed to provide you with appropriate care.
You may already have a record
Some people may already have a record, having set one up – perhaps without even realising – under the original system (the PCEHR). Almost 6 million people currently have a record. Check if you're one of them.
If you miss the deadline to opt-out or you already have a record, you can cancel it but your doctor and other healthcare providers may keep copies of any records they have uploaded to your record and store them in their own record-keeping systems.
The main benefit of My Health Record is that all of your and your children's healthcare professionals will know the medication you're taking and the conditions you're treated for.
People who are most likely to benefit are those who:
- have complex health conditions
- take multiple prescription medicines
- get treatment from various doctors and other health professionals
- live in remote and rural areas
- are elderly
- don't speak English very well
- have difficulty remembering and/or communicating all the details of their medical story.
My Health Record should lead to better and well-coordinated treatment, while preventing unnecessary tests, harmful side effects caused by medication mix-ups, or even avoidable hospital admissions.
There are safeguards in place, so you can manage your My Health Record by installing a PIN and limiting the access to some or all documents to make sure that your emergency contact, carer and healthcare professional only have access to appropriate information.
But security experts warn that centrally stored information always brings the risk that in the event of a data breach there could be serious implications for you. And it would not be the first time healthcare data has been accessed by hackers.
If you can't decide whether you want to stay in or opt out, you can always opt out now, then rejoin at a later stage.
You can use the step-by-step guides on the My Health Record website, and if you run into trouble call the helpline on 1800 723 471.
Further details are below for different situations.
Medical experts such as the Australian Medical Association, the National Rural Health Alliance and the Consumers Health Forum have welcomed the new system and asked consumers to use the opt-out period to inform themselves about the benefits or otherwise of taking part.
Security experts, while acknowledging the potential benefits of having a centralised record system, warn that the safeguards could be breached which could expose sensitive information.
Medical experts stress the benefits
- Australian Medical Association
- Consumers Health Forum
- National Rural Health Alliance
"My Health Record can save lives"
Australian Medical Association
"The current system of medical records means that we may have incomplete information on a patient – especially if the patient has recently seen another specialist or has been discharged from a hospital. The My Health Record will result in doctors having access to better information, in a more timely fashion, via secure means. Less time chasing up paperwork means more time can be spent treating our patients," says Australian Medical Association president Dr Michael Gannon.
Consumers Health Forum
"My Health Record is a key step in the shift from health consumers as passive patients, to consumers as active partners in their own care," says Consumers Health Forum CEO Leanne Wells.
"For too long, healthcare has lagged behind in exploiting the clear benefits of information technology to provide prompt, secure, and precise patient information. For these benefits to be realised and a consumer-centred and digitally enabled healthcare system to become a reality, consumers will need to be involved in using and improving innovations such as My Health Record," Wells says.
National Rural Health Alliance
"Australians living in rural and remote areas are more likely to end up in an emergency department from a heart attack, car accident or diabetic coma," says National Rural Health Alliance CEO Mark Diamond.
"If they're unconscious, and the medical team doesn't have access to their health history, the team may not be able to provide life saving care," Diamond says.
"A My Health Record means that all your important health information is at the fingertips of your doctor, nurse or surgeon," he says. "Simply put, My Health Record can save lives."
Security experts warn of potential data breaches
- Professor Vijay Varadharajan – Global Innovation Chair in Cyber Security, University of Newcastle
- Professor Katina Michael – School of Computing and Information Technology, University of Wollongong
- Dr Cassandra Cross – Faculty of Law, The Queensland University of Technology
"A honeypot of health data, waiting to be hacked"
Professor Vijay Varadharajan – Global Innovation Chair in Cyber Security, University of Newcastle
"Having access to patient records can be highly useful, especially when it comes to requiring them in the case of emergency or even with old age patients. However data security and patient privacy are critical when it comes to healthcare information.
"From a technical point of view, there are access controls in place. However, the data itself, at this stage, is in plain format, it is not encrypted. Hence there is a potential for leakage if a breach occurs. With the growth in malware and security attacks, we cannot rule this possibility out."
Professor Katina Michael – School of Computing and Information Technology, University of Wollongong
"The type of confidential information stored on an electronic health record is unlike having merely your identity credentials stolen – it is like having your whole personhood exposed in terms of your condition, medication, past acts and more. There are massive implications for those working in pressured workplaces who may have their health record used against them – e.g. pilots, doctors, surgeons, healthcare workers.
"We need to make people aware of the pros and cons of opting-out, but we also need better, more honest reporting by government about some of the potential risks, in essence, to better inform the public. What we have now is a major honeypot of health data, waiting to be hacked for the taking and be available on the dark web."
Dr Cassandra Cross – Faculty of Law, The Queensland University of Technology
"The current My Health Record places a strong onus on individual consumers themselves to regulate the privacy and security settings of their record. In requiring an 'opt-in' model on the privacy settings of the record, this means that many people are unlikely to modify these settings. This may be through a lack of knowledge that the settings exist, uncertainty on how to do this, or an inability to successfully navigate the system.
"There are also genuine concerns over the likelihood of data being compromised in some way. While it is argued that there are strong security measures in place, it is naïve to assert that these are 100% foolproof (as demonstrated through data breach incidents with many previous organisations). Health data is an increasingly common and attractive source of data for criminals, and their ability to use personal information to gain reward is a reality."
Stock images: Getty, unless otherwise stated.