eHealth records: Government seeks to clear way for opt-out system

The federal government has introduced a bill that will allow trials of an opt-out approach for the national eHealth record system.

The Health Legislation Amendment (eHealth) Bill 2015, introduced into the House of Representatives today, will rename the Personally Controlled Electronic Health Record (PCEHR) to My Health Record.

The proposed legislation implements the government's $485 million budget announcement on eHealth, health minister Sussan Ley said when introducing the bill to the house.

The bill is based on a 2013 review of the PCEHR and a review of the Healthcare Identifiers Service, which is a foundation of the electronic health records system.

Ley said that the 2013 PCEHR review found "overwhelming support" for a national eHealth record system but that a change in approach was needed to fix implementation issues and boost confidence in the system from clinicians and consumers.

The review of the Healthcare Identifiers Service, also conducted in 2013, found the need for some adjustments to better support access to and sharing of information in the electronic health record system, the minister said..

The changes in the bill are just one small part of the government's broader digital health agenda, the minister said.

"This bill takes the first important steps to reboot our national electronic health records system to deliver an effective system that will help improve the health of all Australians as well as realising the benefits that instant access to, and sharing of, electronic health records can provide," Ley said in her speech.

The bill will boost participation in the national eHealth record system as well as the system's usability, she said.

Currently, only around 10 per cent of Australians have a national eHealth record, the minister said.

"Healthcare providers have overwhelmingly indicated through the review process that if the majority of their patients have a My Health Record they would be much more willing to use it," Ley said.

"This means more doctors would add their patients' health information to it and this will improve the overall value of the system for both patients and the health care providers who care for them."

To boost participation and as part of implementing the recommendations from the PCEHR review, the government is planning trials in 2016 of different participation arrangements to "identify the optimal approaches for maximising participation in this system," Ley said.

"This will include trials of opt-out participation arrangements," the minister said.

The Department of Health has previously indicated that it expects the trials to cover two to five different areas and around a million individuals.

Extensive information campaigns about how to opt-out will be carried out before the trials are conducted, and the criteria and process for selecting sites will be made public before they are chosen, Ley said.

The Health Legislation Amendment (eHealth) Bill 2015 will allow the minister to apply opt-out participation to particular areas in order to facilitate the trials.

Individuals will still have control over access to their health record, including instructing healthcare providers to not add particular information to their record. If the trials are judged to be successful, the bill allows the government to extend the opt-out approach nationally.

The bill also boosts penalties for deliberate misuse of information from the system, introducing potential criminal penalties as well as the current civil penalties. However, neither civil nor criminal penalties are triggered for mistakes.

No more NEHTA

"The Australian Commission for eHealth will be established in coming months to oversee the operation and evolution of national eHealth systems," Ley said.

"Among other things, this commission will become the system operator of the My Health Record. This commission is intended to remove the complexities associated with the current governance arrangements, strengthen accountability and improve transparency and stake holder involvement."

An implementation taskforce to oversee the transition of responsibilities from the Department of Health and NEHTA to the new organisation is currently being established.

After the transition, NEHTA will be disbanded; the Department of Health will still be responsible for the policy underlying national digital health programs and for the supporting legislation.

If the bill is passed it will also establish a new mechanism to allow the government to authorise new entities to handle health care identifiers and other protected information.

"The My Health Record system has the potential to change the nature of healthcare in Australia and become a widely accepted, everyday part of good healthcare management," the minister said.

"These improvements we are making get us closer to reaching that goal."

Debate on the bill was adjourned.

Copyright © 2015 IDG Communications, Inc.

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