Third party mobile app developers are beginning to utilise My Health Record (MyHR) data, contributing to patient-centric healthcare efforts.
As part of a broader shift towards preventative healthcare, patient-centric care is about empowering citizens to take more control of their health needs to improve patient outcomes and lower operational costs.
Chamonix’s “Healthi” app and “Tyde” are among the first citizen-facing apps developed by third parties that allow users to view their MyHR’s on their phones. The apps follow the release of the Australian Digital Health Agency’s (ADHA’s) own 'My Child's eHealth Record app', which has been available for download since 2013 according to Pulse IT.
According to ADHA Executive General Manager, Innovation and Development Rachel De Sain speaking at an Australian Information Industry Association (AIIA) Healthcare briefing in May 2017, the purpose of opening the MyHR system to third-party mobile developers is to make the system more accessible, promote greater provider and patient engagement, and ultimately improve the quality of care. Improving user access to the system via external mobile applications is one of several improvements for the MyHR in 2016-17 identified in ADHA’s inaugural Corporate Plan.
By opening Mobile Enablement APIs to third party developers, users will have the choice to interact with the MyHR system through an interface they prefer, rather than the generic government offering. Developers will be able to create apps that cater to specific health conditions, which will make it easier for users to input accurate and useful health information for clinicians to use.
According to De Sain, mobile and web apps could eventually interact with the MyHR system in five ways: consumer or self-care, consumer-mediated health services, provider direct connection, consumer connection via platform, and provider access. So far, only consumer or self-care models have been cleared, with Chamonix’s Healthi app the first to go live.
Unsurprisingly, the biggest challenge has been ensuring Mobile Enablement APIs are secure and clinically safe. As a highly sensitive database, De Sain says the effectiveness and pervasiveness of the rules and regulations dictating how third parties interact with the system will remain a priority.
With $374.2 million over two years in the 2017-18 budget, including $94 million in capital, the Federal Government recently committed to expanding the MyHR system through the implementation of opt-out arrangements. The funding follows a Council of Australian Governments (COAG) Health Council meeting in March that saw health ministers from the federal, state and territory governments agree to a national rollout of the opt-out model following successful trials in far north Queensland and the Nepean/Blue Mountains region in New South Wales.
The MyHR – formerly the Personally Controlled Electronic Health Record (PCEHR) – links up data from healthcare providers, Medicare and the individual to create a combined online summary of an individual’s health information. Before it was introduced, patients had no control over their health data, which is typically spread across a vast number of different locations and incompatible computer systems.
Despite good intentions, a 2013 review of the then-PCEHR identified low take-up of the opt-in system and a number of other concerns, including usability issues “at all stages of engagement from registration to reinstatement”, and highly bureaucratic governance processes that “did not effectively balance the needs of government and private sector organisations”.
In 2015, PCEHR was relaunched as MyHR, with $485 million over four years allocated in the budget towards redevelopment, including funding for the foundations of eHealth and trialling opt-out arrangements. The funding was accompanied by then-Minister for Health Susan Ley’s expanded vision for the MyHR, which was captured in an address to the National Press club in October 2015: “The great digital health revolution lies literally in the palms of consumers”.
“What if you, as a consumer, were able to take your personal Medicare and Pharmaceutical Benefits Scheme data to a health care service; to an app developer; to a dietician; to a retailer and say how can you deliver the best health services for my individual needs?” asked Ley.
State and territory jurisdictions are also looking individually at how to transition the patient from being a ‘passenger’ to a ‘driver’ of their own healthcare.
In Queensland, the focus is on completing and improving the integrated electronic medical records (ieMR) program, according to the recently released Digital Health Strategic Vision for Queensland 2026, which will “drive improvements in clinical practice, workforce efficiency and resource utilisation”.
A more comprehensive ieMR will enable predictive health delivery, which will help shift the focus to preventative rather than reactive care, and ultimately pave the way for personalised healthcare through genomic medicine. Where it has been adopted, genomic science is already improving the accuracy of diagnoses, and allowing clinicians to spot illnesses early by collecting and sharing health data on a large scale.