The details of how and when the Act will be implemented in an environment of ongoing digital health projects, like the HIE, remain mysterious.
The federal government will give pathology and diagnostic imaging companies time to get their technological ducks in a row before enforcing the provisions of the Health Legislation Amendment (Modernising My Health Record—Sharing by Default) Bill 2024 tabled in parliament this week.
If the health minister’s speech preceding the second reading of the Bill is any guide, then providers will be given support.
“For those providers that require assistance to connect, they will be able to make formal application to request time to put the necessary technical settings in place to enable them to engage with the My Health Record system,” Mark Butler told parliament.
“While this formal extension period is in place, they will be able to continue to claim Medicare benefits, while working with the Australian Digital Health Agency to set up the necessary connections so that eventually all patients will be entitled to the same levels of access to their information.”
Mr Butler said the Bill was not designed to be punitive.
“However, if organisations do not do the right thing by their patients, this bill will provide the powers necessary to ensure compliance with the requirement to upload,” he said.
“Patients will not have to wait for uploads to get their Medicare benefits, and patients will not lose benefits if providers fail to share to My Health Record.
“Where Medicare is payable, if uploads do not follow, providers will be liable to repay the cost of the benefit.”
The Australasian Institute of Digital Health threw its weight behind the reforms, with CEO Anja Nikolic acknowledging the need for a “capability uplift”.
“Following the very sluggish use of My Health Record, it’s evident that these measures are required to reap the benefits of a system designed to enhance information sharing for better patient outcomes,” she said.
“The changes to My Health Record will make it much easier for health consumers and healthcare providers to locate and utilise health information.
“We need the government to invest in practical, relevant learning programs to support the transition to a digital future for health.
“Minister Butler said he wants a digital health system based on ‘a culture of sharing’ – the AIDH fully supports this approach, but it will require a capability uplift for the healthcare workforce,” Ms Nikolic said.
In a LinkedIn post published today, Christopher Skene, cofounder and CTO of cloud-based medical asset storage platform Aurabox, said there were problems with proposals in the Bill.
“I’m all for forcing the diagnostic providers to open up their data safely and securely to those who need it,” said Mr Skene.
“That’s a huge problem costing Australia nearly a third of its imaging and pathology budget (if not more), but this won’t move the dial.
“This is doing nothing to improve the privacy controls around personal health data (which are so bad the UK won’t accept Australia as a safe harbour for PII), enable real digital access to an individual personal health data, or encourage organisations to adopt the new FHIR world the government is so keen on.”
Mr Skene said there were several smaller issues with the Bill – specialists who do their own imaging but don’t use software to send reports to MHR; complex patients with complex sets of results; most systems still run on-premises and not in the cloud – but there was a much bigger problem to be dealt with.
“The government is currently planning to roll out a FHIR-based health information exchange,” he said.
“This is very likely to be a single, one-size-fits-all portal controlled by the Australian Digital Health Agency.
“The data that portal can provide (FHIR) is going to be fundamentally different from the CDA data held in MHR.
“Even if the government converts the data on the fly so it can be read, this will still force many companies to go through two huge, expensive, fundamentally different projects to integrate with disparate government IT systems.
“This will have the long-term effect of delaying and complicating the HIE rollout.”
In an interview with HSD late yesterday, Emma Hossack, CEO of the Medical Software Industry Association, said her biggest concern with the Bill was timing.
“Our job is to make it work,” she said.
“All we want is to make sure we know the specs and to have an appropriate time [to conform].
“If the Bill is passed [next week] and it’s to go into effect on 1 January, that would be a disaster.
“The sensible thing to do is to time the enforcing of the Act with the other projects that are running to modernise the My Health Record.
“We’re worried about all these projects cascading on each other.”