In the face of criticism of the decision to modernise the existing electronic medical record system rather than scrapping it and starting over, two big hitters have come out swinging.
High-profile commentator Dr Norman Swan has called the $2 billion government spend on modernising the My Health Record “shameful”, sparking a spirited defence from two of the sector’s biggest hitters.
“So, $2 billion on a My Health Record that is still PDFs? It’s shameful,” said Dr Swan, moderating a panel at the AIDH’s HIC2025 conference in Melbourne on Monday. He later modified his statement to “the investment for the return is shameful”.
“Is the universal medical record for the system, as well as the consumers, My Health Record? And if so, we’re in deep shit. I just want to understand this.”
Daniel McCabe, first assistant secretary of Medicare benefits and the digital health division at the Department of Health, Disability and Ageing, was quickly on the front foot.
“Yes, we want My Health Record to be the national system that summarises all critical information,” he said.
“We are modernising the system now so that it’s capturing data in FHIR-based atomic data, not in PDFs.
“Within the next 12 months, we will start to transition the system away from PDFs so that we can capture diagnostic results atomically, that can be used not only to track longitudinal issues for patients, but also so that we can start to get better population insights on where the burden of disease is.
“We’re about to do the same thing for medications prescribed and dispensed in Australia, whether it be in private, online models through the PBS, or locally in state and territory hospital systems.
“I think we’re on the cusp of making that big transition.”
That includes parts of the private sector, said Mr McCabe.
“Anyone that is getting Medicare funded will be required to add data into that system,” he said.
“We have more work to do with private hospitals.”
Mr McCabe said he believed private hospitals would want government to invest in their digital transformations.
“It’s not something that we’re looking to do,” he said.
“We think that that’s an obligation that private hospital systems need to consider themselves, but it’s an area that we will work with them to support.”
Bettina McMahon, CEO of Healthdirect Australia, also jumped in to defend the MHR modernisation.
“If we look at the investment of other health systems in the world, the Commonwealth Institute – which is a US-based think tank – out of 11 major economies, ranked the Australian health system first in terms of access, equity and outcomes, and digital was called out as a key part of that,” she said.
“So, I take your point, but apart from Scandinavia and Estonia, Australia’s the only country in the world that has a national electronic health record.
“So let’s not forget that this is foundational. We’ve got the system in place. We’ve got a lot of people using it.
“Yeah, it might be PDFs, but we’re streets ahead. You know, other countries would give their hind teeth to be in the position we’re in with healthcare identifiers.”
Mr McCabe said there was a danger of forgetting who was at the heart of the My Health Record and its modernisation.
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“One of the really important things that we forget about in all of these conversations is about consumers or patients in the health system, and the need or right for them to have access to their health information,” he said.
“We have a very provider-centric conversation at the moment about making sure we bring doctors on the journey to do this, but we need to turn this around, so Australians have a right to have what’s written about them known to them.
“We will – we are – having conversations about what we’re going to do in primary care to really support patients having more agency in their healthcare in that sector, making sure that we can support true multidisciplinary care.
“We have in primary care, for the last 20 years, invested almost $2 billion in e-health incentives to uplift primary care. We haven’t done that in any of the other sectors, and I’m not sure that we’re going to.”
HIC2025 is on in Melbourne on 18, 19 and 20 August.
