In a highly anticipated announcement, the Minister for Health the Hon. Greg Hunt confirmed on Monday the My Health Record (MHR) opt-out three-month window will commence from 16 July to 15 October 2018. Every Australian will be offered a MHR unless they choose to opt-out during this period.
The COAG Health Council unanimously agreed to the move from opt-in to opt-out in August 2017 to increase adoption rates. The announcement comes after the government recently released the framework to guide the secondary use of MHR system data for research or public health purposes.
Here we outline how practices can prepare for the transition and answers to patient’s questions.
From 15 May, AHPRA, in partnership with organisations aligned with the National Alliance of Self Regulating Health Professions, will distribute letters to all health practitioners providing information about the opt-out process.
A national communications strategy will also be implemented by the Australian Digital Health Agency (the Agency) to inform all Australians of the benefits of digital health and to explain the opt-out process.
Following the three-month opt-out phase, a 30 day reconciliation period will commence to process paper forms arriving by mail.
The Agency has suggested practices can add this information to their websites to redirect patients to the MHR website for more information.
During the opt-out period, patients who do not want a MHR can opt-out by visiting the MHR website or calling 1800 723 471 for assistance. They will not have a record created for them.
Opt-out forms will be provided upon request to patients, and additional support provided for Aboriginal and Torres Strait Islanders, people from non-English speaking backgrounds, those with limited digital literacy and living in rural and remote areas.
A MHR will be created for all Australians with a Medicare card or Department of Veterans’ Affairs card who do not opt-out. However, the MHR will not contain any content. The patient’s MHR will be activated when the patient logins for the first time or when a healthcare provider accesses the record during treatment. Two years of Medicare and PBS records will then be added to the MHR, unless a patient chooses not to include this information. Patients will also be able to upload personal notes, advanced care documentation, and medication and allergy information.
Patients can cancel their MHR at any time after the end of the opt-out period. Their MHR will be archived in accordance with the MHR legislation. Patients who opted out can change their mind and reactivate their MHR at any time.
Patients provide a ‘standing consent’ for all healthcare organisations involved in their care to upload clinical information to their record. Providers do not need to obtain consent on each occasion prior to uploading clinical information. However, the AMA’s Guide to using the My Health Record (currently under review), recommends advising a patient you will be uploading information to their MHR, particularly if this information might be considered sensitive.
Patients can ask their healthcare provider not to add specific test reports and other medical information to their MHR. Patients can also restrict access to specific information by applying a Limited Access Code to that specific document – or by applying a Personal Access Code to the entire record.
If a patient requests that a clinical document is not uploaded, a provider is obliged to follow this request.
Under the MHR system, authorised representatives, such as a parent or legal guardian, have control of their child’s MHR from 0 to 14 years.
A child can take control of their MHR between the ages of 14 and 18.
Anyone under 14 who can prove to the MHR System Operator they are a ‘mature minor’, can take control of their existing record.
The Agency has developed Australia’s National Digital Health Strategy – Safe, Seamless, and Secure, which proposes seven priority outcomes to be achieved by 2022.
A key focus is on secure communication through digital channels, with the aim of ending dependence on paper-based correspondence and fax or post. A number of initiatives will also test digital empowerment of a range of health reform areas including telehealth and end-of-life and emergency care. The test bed projects will run for two years to inform the national roll-out of these initiatives across Australia.
The Australian Digital Health Agency offers online training for health practitioners and patients on MHR and has developed a series of educational webinars.
By: Georgie Haysom, BSc, LLB (Hons), LLM (Bioethics), GAICD, Head of Advocacy, Avant
May 16, 2018