MyHR use should be compulsory: trial report

The government is being urged to consider ways to require all healthcare providers to use the MyHR system

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Uploading patients’ information to the My Health Record system should be made compulsory for GPs as part of a one-step, national opt-out strategy, a government-commissioned analysis has concluded.

 The report, based on data and follow-up interviews on participation trials held at four locations last year, said support for the automatic creation of My Health Records was almost universal – albeit for different reasons – among individuals and healthcare providers. 

But opinions differed among healthcare professionals on questions of whether the system added to providers’ costs or if the practice incentive payment e-Health (ePIP) worked. 

“General practitioners interviewed do not see the ePIP as being a major determinant of their use of the My Health Record system,” the report by Siggins Miller consultancy said. 

“Conversely, their practice managers say it is, and believe that without ePIP healthcare provider use of the My Health Record system would decrease.” 

Data matching patient health-summary uploads and ePIP targets suggested the mandatory upload requirement played a significant role in GPs’ use of the system, it said.  

Across all healthcare providers interviewed, the average time per patient for using My Health Record was reported to be approximately three minutes, the report said. While pharmacists reported they saved time per patient, all other healthcare providers said they lost time.  

“From surveys, there were no significant differences over time or between trials in the time spent by healthcare providers in using the My Health Record system per patient. Healthcare providers interviewed mainly feel the My Health Record adds time (and therefore cost) to their work, but cannot quantify it,” the report said.

 “On the other hand, practice managers and practice nurses who do most of the administrative work involved in chasing up information about patients from other healthcare providers, (including hospitals) feel that having the My Health Record system has, or will, decrease that time significantly with overall gains in the efficiency of the practice.”

 The opt-out trials, covering close to one million patients, were held from March to October 2016  in the north Queensland and Blue Mountains Nepean PHN areas.   

Smaller “opt-in” trials focused on ways to boost participation were held at Ballarat hospital in Victoria and a number of corporate-owned practices in Western Australia.  

“Once the My Health Record was explained to individuals, (briefly during focus groups) all but a very small number of focus group participants in both opt-in and opt-out sites were very positive about the My Health Record and its benefits for them, their families, dependants and the health system,” the Siggins Miller report said.

 Consistently, individuals felt it should be compulsory for healthcare providers to use the MyHR system, it said.

 “The logic behind the view is that: ‘if the benefits are so good, then why wouldn’t doctors use the My Health Record system for the good of their patients?’; ‘if the cost to taxpayers [of the system] is as high as it would seem to be, then why wouldn’t the government make it compulsory for practitioners to use it?’”

 The report urged the government to consider ways to require all healthcare providers to use the system, by using its purchasing power directly (as in aged care), through initiatives (Health Care Homes) and via PHNs’ commissioning of services. 

The paper concluded there was no reason not to proceed to a national opt-out approach in a single step, but recommended a number of enhancements.  They included:

 * inclusion of pathology and diagnostic imaging reports (public and private);

* stimulation of the creation and launch of accredited third party MyHR applications to facilitate access and use;

• improved healthcare provider registration and online authentication processes;

• improved individual registration and evidence of identity processes;

• improved user-friendliness for individuals and healthcare);

• a summary view of medications and MBS data;

• improved access to MyHR for all pharmacies through connected pharmacy software;

• streamlining and improving myGov or removing My Health Record from myGov.