Specialists will face a new push to connect to the Government’s My Health Record system over the next year, the Australian Digital Health Agency (ADHA) says.

More than a decade after the e-health initiative was first announced, and despite almost two billion dollars funding, it appears that very few specialists are using the MHR in their private practices to view or upload patient data.

Dr Jill Tomlinson, AMA Federal Councillor and a plastic and reconstructive surgeon in Melbourne, said she understood between 10-20% of private specialist were now registered for the MHR, but only about 5% were actively using the system – for example to view patient records or upload new data.

The ADHA was unable to provide the limbic with specific data on how many private specialists are either registered or actively using the My Health Record (MHR) system and the Agency’s website only lists current data on the proportion of GPs and pharmacists that are connected.

However, it revealed at the end of 2017 that just 3% of specialist provider organisations were connected to the system.

A higher proportion of specialists can potentially access the record in their private or public hospital work – as at 30 June 2020, 67% of private hospitals with inpatient facilities were registered for the MHR, and 53% were actively using the system.

Only 16% of day hospital/surgeries were registered, with just 5% using actively using the MHR.

That compares to 94% of GPs being registered, and 84% using the record.

GPs get priority for MyHealthRecord

The ADHA said its initial focus was getting primary health providers connected, but it was turning its attention to increasing use of the MHR by specialists over the next 12 months.

In July, it provided $40,000 to each of nine specialist software vendors to upgrade their systems so they could seamlessly integrate specialists’ clinical information systems to the MHR.

The software upgrades – expected to be available in this year or next year – should enable specialists to upload letters and prescriptions records to patients’ MHR records as part of their existing clinical workload.

“In addition to funding, the Agency will provide design expertise to work with each vendor’s design teams to co-produce improvements in design with their users,” the ADHA said in a statement.

“Many specialists already use My Health Record through software systems they use in public and private hospitals. Having easy access to My Health Record in their private clinics s well will insure a more complete picture of a patient is available during specialist consultations and improve continuity across care settings.”

Dr Tomlinson said she had been registered to use the MHR in her private rooms since 2017 and could view patient histories. While she had uploaded some patient summaries to the MHR, she could not directly upload letters via her practice software system, as it was not integrated.

She said technology was among a number of barriers to specialists connecting to the MHR, with some specialists still using paper records for their patients.

“It requires some technical skills to set it up within a practice and someone in the practice must take the time out of their busy schedule to set it up and work out how to use it,” she said.

Incentive payments for specialists

Negative press and privacy concerns that emerged in 2018-19 when the MHR moved to being an ‘opt-out’ system may also have deterred some specialists from getting on board, she said.

Specialists have previously called for access to GP-style incentive payments to connect to the MHR system.

While the ADHA could not comment on whether it was considering financial incentives for specialists, Dr Tomlinson said that would be “one way to encourage people to connect and get set up”.

“it is hard to know where the tipping point is and at what point financial incentives would be absolutely 100% the answer,” she said. “For a lot of specialist practices, even with financial incentives, the technology barriers are a major barrier to connecting.”

However, Dr Tomlinson said there was an increasingly strong business case for practices to use digital records to reduce use of faxes and phone calls.

Patients were also increasingly keen for their doctors to be able to use digital options including telehealth and electronic records, she said.

“I think it is something where the tide is turning,” she said.