Why Australian doctors don’t use My Health Record as often
Although many healthcare providers in Australia are now using digital records, they have yet to realize the benefits.
Despite significant investment, My Health Record, Australia’s digital health record system, “is still plagued by incomplete records and poor usability”, according to a new report from the Productivity Commission.
Because use of the MHR is not mandatory for patients and physicians, there are gaps in the information available in the system that “substantially reduce” its value.
“(If) the availability of patient information is inconsistent, MHR will not be a reliable source of information for many physicians,” the report said.
“And when usage among physicians is low, providers may see less value in uploading information to MHR. This can create a negative feedback loop that potentially undermines the value of MHR for information sharing,” the report points out.
Less than a third of people with MHR or about 6.7 million have access to their data. Although almost all GPs are registered in the system, they can now choose not to enter patient data in the MHR, even if people have registered for this.
This gap is further evidenced by the number of diagnostic reports uploaded to the MHR: the most recent data from the Australian Institute of Health and Welfare shows that around a third of the 27 million diagnostic test reports produced each year are uploaded to the system are uploaded.
WHY IT MATTERS
The MHR supports a wide range of health information, such as pathology and diagnostic imaging reports, episodes of care, and prescriptions. But some valuable information still needs to be automatically uploaded to it, including ECGs and actual diagnostic images.
The committee predicts that if healthcare providers can make better use of EMR data, it could save them up to US$5.8 billion ($3.8 billion) in costs annually.
THE GREATER CONTEXT
The MHR was originally intended to connect fragmented health information stored in the healthcare system. It is intended to provide a central access point for viewing patient data and a nationally consistent platform for data sharing. Given its potential to improve care coordination and patient safety, the Australian Government has invested as much as $2 billion in the MHR to date, including A$429 million ($290 million) for its modernization in last year’s budget. An additional $57.4 million ($38 million) has been allocated to you this yearimproving the EMR system.
The Australian Government is already working to expand the coverage of health information available on MHR, including requiring pathology and diagnostic imaging providers to upload standard reports to the MHR. Strengthening last year’s Medicare Task Force report also called for the standard sharing of health information from both private and public health care providers to the MHR and enabling its use at the point of care.
However, simply making information sharing mandatory, according to the latest Productivity Commission report, will need to be “accompanied by changes that will enable doctors to efficiently search large amounts of data and display reports in a way that is easy to readable and accessible.” To increase usability, the committee proposes a shift to an “atomized” data format, or storing information at the most basic level.
In addition, the MHR needs to be better integrated with workflows in clinical environments. Healthcare software providers can be encouraged to enable this seamless integration by increasing their incentives.
In addition, the government is making efforts to improve data interoperability across the healthcare system. We collaborated with HL7 to create a consistent application of FHIR digital health standards. Australia’s current information management and information sharing landscape has been described as ‘uncoordinated’ and ‘disconnected’ with states and territories using their respective EMR and health data management solutions.