Re-platforming options for the My Health Record (MHR) system will soon be up for consideration, with an Australian Digital Health Agency (ADHA) spokesperson confirming that a request for information will be released in the next few months to inform plans to modernise the infrastructure underpinning Australia’s mammoth patient health database.
An open-source, cloud-based environment has already been flagged as a possibility for the MHR by Department of Health (DoH) Special Adviser for Strategic Health Systems and Information Management Paul Madden at Senate Estimates in May last year. He also said that the re-platforming decision was one of many “variables” that needed to be squared away to accurately gauge how much the MHR system will cost beyond 2019-20.
“The variables in there include the re-platforming of the system to an open source environment, using cloud technology… which will be something we will not know the cost of until we hit the market to get a view on that”, Madden said last year. “Our commitment is to come back to the budget in 2019 to paint out those costs for the four years beyond.”
ADHA is scoping out MHR re-platforming options early, with the existing contract with the Accenture-led consortium not set to expire until 2020. As the “National Infrastructure Operator”, Accenture is tasked with running and maintaining MHR’s infrastructure. The prime contractor works with Oracle and Orion Health to provide the core systems and portals behind MHR.
Accenture was awarded the contract to design, build, integrate and test the then-personally controlled electronic health record system (PCEHR) back in 2011, and has signed 13 contracts worth a total of $709.53 million with DoH in relation to the MHR in that time. With the original infrastructure now over seven years old, ADHA recognise the importance of modernising the environment supporting the MHR, particularly as the agency gears up to transition the system to opt-out by default across the country.
The move to opt-out by default is currently waiting on an announcement from the Health Minister Greg Hunt. From a date specified by the Minister, Australians will be given a three-month period to opt out of having a MHR created for them.
Two trials held in northern Queensland and western Sydney in 2016 informed the planning for the expansion program.
According to Madden speaking at Senate Estimates, the $374 million over two years (including $94 million in capital) allocated in the 2017-18 budget for the MHR is more or less split evenly between implementing the national rollout of opt-out arrangements ($185 million), and continuing operations ($182 million). A further $6.8 million went to “provider registration redevelopment”.
The MHR is the cornerstone of ADHA’s August 2017-released Digital Health Strategy, with its primary goal to make health information available “whenever and wherever it is needed” by 2022. Achieving this objective first depends on ensuring health data is captured and collected in a manner that is commonly understood and easily transferable. Accordingly, new draft interoperability standards are expected by the end of the financial year.
With the MHR soon to become one of Australia's largest and most sensitive databases, the security of the system will remain a priority. According to ADHA Executive General Manager for Core Services Systems Operations Ronan O'Connor speaking to PulseIT, cyber security will be the sole focus of one of the remaining releases scheduled in the lead up to the opt out rollout. There have also been “some enhancements for monitoring and surveillance”, said O’Connor.