While many health practitioners in Australia are now using digital records, they have yet to realise its benefits.

Despite significant investment, My Health Record, Australia's digital health records system, "continues to be plagued by incomplete records and poor usability," a new Productivity Commission report noted.

Since the use of the MHR is not mandatory for patients and clinicians, there are gaps in information available in the system that "substantially lessens" its value. 

"[If] the availability of patient information is inconsistent, MHR will not be a reliable source of information for many clinicians," the report noted. 

"And if use among clinicians is low, then healthcare providers may see less value in uploading information to MHR. This can create a negative feedback loop potentially undermining the value of MHR for information sharing," it stressed.

Less than a third of people with MHR or about 6.7 million have access to their records. Meanwhile, while almost all GPs are registered in the system, they can choose not to enter patient data into MHR, even for individuals who have opted in.

This gap is further evidenced by the number of diagnostic reports uploaded to the MHR: the latest data from the Australian Institute of Health and Welfare shows that roughly one-third of the 27 million diagnostic test reports produced each year are uploaded to the system. 

WHY IT MATTERS

The MHR supports a broad range of health information, such as pathology and diagnostic imaging reports, episodes of care, and prescriptions. But some pieces of high-value information are yet to be automatically uploaded to it, including ECGs, and actual diagnostic images. 

The commission projects that if care providers can make better use of EMR data, it can save them up to A$5.8 billion ($3.8 billion) in costs each year.  

THE LARGER CONTEXT

The MHR was initially conceived to tie in fragmented health information stored across the health system. It is intended to be 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 A$2 billion thus far in the MHR, including A$429 million ($290 million) for its modernisation in last year's budget. This year, additional $57.4 million ($38 million) has been allocated for upgrading the EMR system. 

The Australian government is already working to expand the coverage of health information available on MHR, including mandating pathology and diagnostic imaging service providers to upload reports to the MHR by default. Strengthening Medicare Task Force's report last year has also called for the default sharing of health information from both private and public practitioners to the MHR and allow its use at the point of care. 

However, mandating information sharing alone, the latest Productivity Commission's report said, will have to be "accompanied by changes that will allow clinicians to efficiently search large volumes of data and display reports in a way that is easy to read and accessible." In enhancing usability, the commission suggests a shift to an "atomised" data format, or storing information at their most basic level. 

Besides that, the MHR must be better integrated with workflows across clinical settings. Healthcare software providers can be encouraged to help enable this seamless integration by raising their incentives. 

Additionally, the government is making efforts to improve data interoperability across the health system. It has been working with HL7 to establish a consistent adoption of FHIR digital health standards. Australia's current information management and sharing landscape has been described as "uncoordinated" and "disconnected" with states and territories running their respective EMR and health data management solutions.