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Should patients be able to immediately access results via MHR?
The DoH is looking to modernise My Health Record to include the default sharing of pathology and imaging reports, but the RACGP has concerns.
Pathology and diagnostic imaging results will soon be uploaded to My Health Record by default.
The seven-day delay rule for uploading pathology and diagnostic imaging results to My Health Record (MHR) should remain in place, the RACGP has said.
The recommendation was included in a recent submission to the Department of Health and Aged Care (DoH), which is planning to ensure all pathology and diagnostic imaging providers share their reports to MHR by default by the end of 2024.
According to the DoH, this change has emerged out of the Strengthening Medicare Taskforce to ‘empower’ patients and make it easier for healthcare providers to coordinate care and make clinical decisions.
However, while the college supports default sharing as it could reduce duplicate testing, lowering both Medicare and patient out-of-pocket costs, it also indicated there are risks associated with making those results immediately available to patients.
‘Maintaining the seven-day rule allows consumers to have access to their health information, albeit with a small delay that allows their GP or other clinician to discuss their results with them,’ the submission states.
‘We do not consider the benefit of real-time access to results outweighs the potential harm of consumers misinterpreting results or receiving unfortunate results with no immediate clinical support.
‘If the seven-day rule is to be removed, the RACGP recommends evaluation is undertaken to provide data that this change to the My Health Record has achieved the goal of supporting better patient health outcomes.’
In addition to opposing the immediate sharing of pathology and diagnostic imaging results, the college has also said any updates to MHR need to be supported by a ‘thorough and wide-reaching’ communication campaign, targeted at both consumers and healthcare providers.
‘Communication with healthcare providers should begin well in advance of any changes coming into place,’ it states.
‘Peak primary healthcare organisations should be engaged to deliver information to their members to raise awareness of these changes, discuss potential impacts and provide direction on where to obtain assistance if required.
‘[Public] messaging should include information reinforcing the My Health Record is a consumer-controlled record and consumers are able to manage the privacy controls of their record to restrict access to specific healthcare organisations.
‘GPs should not be expected to explain the changes to patients during consultations, so consumer resources available through practices, such as posters or flyers that GPs can refer their patients to, would be helpful.’
The submission goes on to point out that practical barriers need to be overcome ahead of the changes being adopted.
‘Some RACGP members have described the My Health Record interface for viewing test results within their clinical information systems as “clunky, hard to navigate, and slow”,’ the RACGP said.
‘It has also been noted it is particularly difficult to see each result where multiple test reports are available and that it is difficult to access images.
‘Results will need to be sent to My Health Record as atomic data to support the seamless integration of reports into general practice clinical systems.’
Once the mandatory uploading of pathology and diagnostic imaging is in place, the college says general practice systems will need to:
- efficiently search large volumes of data to ensure ease of access to relevant reports
- be responsive to ensure there are no system delays when displaying data
- display reports in a way that is easy to read and accessible
- provide consistency in terminology and reporting to support safe quality care.
The DoH’s consultation period has now closed, and it is working with the Australian Digital Health Agency to institute the recommended changes. It is expecting providers share pathology and diagnostic imaging reports to MHR by 30 June 2024, with a legal obligation to do so in place by December of that year.
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