The consultation paper for the current MyHR Review by the former head of the Office of the Australian Information Commissioner features some pertinent questions but overall is unduly celebratory and in places arguably serves to soften discourse about further erosion of privacy protection.
It is thus a disappointing document that should be read carefully, contextualised with the controversy over the development and implementation of MyHR alongside grudging last minute changes to the legislation after cogent concerns by civil society.
Amid self-congratulation about MyHR - perhaps inevitable in an internal review - the paper includes the following questions -
1. Is MHR providing important practical healthcare benefits to consumers and providers? Could more be done to improve the benefits that are provided? Could more be done to generate better public understanding of the healthcare benefits of MHR?
2. Are there any particular features of MHR that make healthcare recipients or providers reluctant or disinclined to use it? Is there unnecessary complexity in MHR legislation?
3. Is the scope and purpose of MHR clear? Is there a need to define or explain MHR more clearly, and how it relates to other health information systems and practices?
4. Should the future direction of MHR be spelt out more than at present? What issues should be covered in a futures roadmap or strategic plan?
5. Should the prohibited purpose provision in the MHR Act be amended to reduce the adverse impact on health practitioners? How could this best be done – for example, by excluding specific conduct from the scope of the prohibition, or removing the penalty for a breach of the prohibition?
6. Should the MHR Act provisions relating to managing the health information of minors be revised? For example, should the MHR age category of 14-17 be combined with the age category 18 and above? Have the age settings for information access and control under MHR that are different to those in Medicare or in state and territory laws given rise to any issues that should be addressed?
7. Should adjustments be made to how the principle of consumer control is embodied in MHR legislation? Is it appropriate to have a category of hidden documents? Should the emergency override function be reformulated?
8. Should the MHR Act contain more comprehensive guidance regarding access to and use of health information in the MHR of a deceased person? What rules would be appropriate?
9. What key factors should be taken into consideration during the development of the Rule that will support implementation of the Framework to guide the secondary use of My Health Record system data, to ensure there is a robust legal framework for that to occur?
10. Should any aspects of the privacy protections in MHR legislation be revisited and possibly altered – either to ensure better privacy protection, or to facilitate digital health innovation?
11. Has the Office of the Australian Information Commissioner been given an appropriate role and powers to oversight the privacy and data handling aspects of the MHR system?
12. Should the data breach notification scheme in the MHR Act be revised and possibly harmonised with the data breach notification scheme in the Privacy Act?
13. Are appropriate arrangements in place for handling complaints about MHR matters?
14. Should the category of people authorised to author and upload a shared health summary be widened, and in particular, to include a midwife who is not a registered nurse?
15. Should the MHR Act provisions relating to nominated healthcare providers be revised to make it easier to identify who is the nominated provider?
16. Should changes be implemented that provide better support for MHR by the Healthcare Identifiers Act?
17. Are the criminal and civil penalty provisions in the MHR Act appropriate, or do they act as a practical deterrent to the more effective operation of MHR? If so, what changes should be made?
18. Are the functions, powers and responsibilities of the System Operator adequately and suitability defined in the MHR Act?
19. Are there any particular aspects of the MHR Act that should be reconsidered and possibly amended to better support the policy objectives of the MHR system?