Mark Butler (Hindmarsh, Australian Labor Party, Minister for Health and Aged Care) Share this | Hansard source

I move:

That this bill be now read a second time.

Since Medicare was introduced 40 years ago, technology has advanced immeasurably.

Back in 1984, 'cutting edge' meant a Sony Walkman in your pocket, an Apple Macintosh on your desk and a fax machine in your office.

Walk into so many health settings today, you'll find a smartphone in your pocket, a fitness tracker on your wrist, and in the corner where the fax machine used to be there is another fax machine.

That's right: a technology first invented in 1964—20 years before Medicare—is still frustratingly, maddeningly, all too common in Australian healthcare settings.

When we came to government, My Health Record was in dire need of an upgrade.

It was still using the old PDF format that Labor installed when we were last in government.

It was cutting edge then, but it is beyond clunky now.

For almost 10 years, nothing was done to upgrade the technology that underpinned it.

While the broader economy went through a digital revolution that reshaped industries, My Health Record sat there, gathering dust.

Without investment, My Health Record remained little more than 'a shoebox of PDFs'.

Unsurprisingly, there isn't much confidence in such an outdated system.

In the most recent Health of the Nation survey by the Royal College of General Practitioners, 31 per cent of GPs—effectively one in three—said they rarely or never use My Health Record.

Even fewer specialists use it: half of them haven't even registered with it.

We have to do better.

The Strengthening Medicare Taskforce, which brought together clinicians, consumers and experts from right across the health sector, called on us to do better.

In the 2023 budget, we announced almost $1.1 billion in funding to modernise digital health infrastructure and to upgrade My Health Record to a data rich platform.

This bill gives effect to recommendations made by the Strengthening Medicare Taskforce.

The taskforce recommended that My Health Record should be modernised to significantly increase the health information available to individuals and to their healthcare professionals, including by requiring the sharing of health information by default.

It also called for significant improvements to the way that patients' information is shared across the health system.

Consumers now expect their healthcare providers to have access to the information that they need, and, far too often, they don't.

When we announced the government's intentions to introduce these reforms, just one in five diagnostic reports in radiology were being shared or uploaded to My Health Record.

The other four reports, out of five, simply disappeared into the digital ether.

And only one in two pathology reports were shared at the same time.

Patients just find this so frustrating, because every lost test result means another day off work, another waiting room, another procedure and, for some, yet another gap fee.

It's a complete waste of time and money for patients and for the health system.

If a patient gets a diagnostic scan or a pathology test, then those results should be shared or uploaded to their My Health Record.

This was happening by exception. It was not the norm.

Implementation and engagement with the sector

Last year, the government announced that we intended to make it the norm.

Australians are accessing their My Health Record in unprecedented numbers.

In September this year, individuals' views of their health information via My Health Record are up 70 per cent on the same time a year ago.

These numbers highlight that consumers are crying out for better access to their own information.

In the past year, the Department of Health and Aged Care and the Australian Digital Health Agency have worked tirelessly to support the pathology and diagnostic imaging sectors to uplift their systems and their staff, in readiness for sharing tests and scans by default.

This has already seen great results.

Many labs that were not sharing, or sharing only in limited circumstances, are now routinely making patient results available to My Health Record.

In May last year, just one in five diagnostic imaging reports were being sent to My Health Record.

A year later, it's now one in three reports.

While this is an improvement, it's still too low and too slow.

Framework for sharing to My Health Record

The reforms I introduce today introduce a framework that will require key health information to be shared to patients' My Health Record.

We're starting with pathology and diagnostic imaging. However, this framework will position the My Health Record system to deliver access to key information, and become a routine, central part of our health system.

Medicare provides universal access to health care for Australians. Today we're enhancing the My Health Record framework to provide better access to Australians' health information to reduce the fragmentation and duplication that currently exists and also to deliver better health outcomes.

The bill will establish requirements so that where Medicare rebates are claimed for key services, there will be a requirement to share information about that service to My Health Record.

And the bill will require healthcare corporations to share health information about their patients to their patients' My Health Record.

This complementary framework will not affect a patient's Medicare benefits.

It will however empower patients to actively engage as partners in their own health care.

Patient controlled

The bill complements the existing consumer-controlled nature of My Health Record, and continues to put patients first.

Patients will have access to their information so that they can have informed discussions with their healthcare providers, if they choose to.

The Strengthening Medicare Taskforce told us that when people can access and are supported to use and understand their own health information, they're better able to actively participate in their care and to make informed decisions.

The bill will not change the patient-controlled nature of My Health Record. Individuals can continue to choose not to have a My Health Record. Or they can choose for certain records not to be shared. Patient choice will remain under these amendments.

Whether or not a patient chooses to engage with the information in their My Health Record, under the changes this bill introduces, they can expect information will nonetheless be available.

Patient safety

The framework puts patients first and is designed with patient safety in mind.

We heard during consultation that it will not always be in an individual patient's interests for them to access their information before discussing it with their healthcare team.

If a healthcare provider is concerned that it may not be in a person's interest to access information via My Health Record without the support of a qualified healthcare provider, a healthcare provider can elect for an individual record not to be shared.

Electing not to upload should not be the norm. But where a healthcare provider has a reasonable concern for an individual's safety or wellbeing so as to warrant not uploading, this exception will provide an appropriate safeguard so that the right supports are in place for patients when they are needed.

A clinical reference group, chaired by the Australian Commission on Safety and Quality in Health Care and the Australian Digital Health Agency, was established to advise on this proposal and ensure the safe implementation of these reforms.

This clinical reference group, with representatives from government, peaks and consumers, will also develop guidance materials to support healthcare providers with the new framework for sharing to My Health Record.

Support for providers to connect

The Australian Digital Health Agency has invested to support providers to connect to My Health Record.

However, notwithstanding that investment, we understand that some healthcare providers have not yet made the decision to connect to My Health Record.

The framework I announce today is not designed to be punitive. It is designed to bring about a culture of sharing.

For those providers that require assistance to connect, they will be able to make formal application to request time to put the necessary technical settings in place to enable them to engage with the My Health Record System.

While this formal extension period is in place, they will be able to continue to claim Medicare benefits, while working with the Australian Digital Health Agency to set up the necessary connections so that eventually all patients will be entitled to the same levels of access to their information.

Enforcement

I said the bill is not designed to be punitive. However, if organisations do not do the right thing by their patients, this bill will provide the powers necessary to ensure compliance with the requirement to upload.

Patients will not have to wait for uploads to get their Medicare benefits.

And patients will not lose benefits if providers fail to share to My Health Record.

Where Medicare is payable, if uploads do not follow, providers will be liable to repay the cost of the benefit.

Conclusion

Let's be clear about why our government is so committed to this.

Yes, it will make healthcare professionals' lives easier, by helping them to be more efficient and more effective.

Yes, there will be flow-on benefits across the system, helping to ensure that every precious dollar in the Medicare system goes to patient care.

Those things are obviously important.

But the reason why we are driving so hard towards that digital future is not provider benefit or system benefit so much as patient benefit.

Patient benefit is—and always will be for this government—our northern star.

Patients desire and deserve access to their own health data, and agency over how it is used and how it is shared.

Patients should not have to rely on the goodwill or the good management of private providers to be able to access their own health data.

Digital health technologies should empower patients to monitor and take charge of their own health and wellbeing, so that they can interact confidently with healthcare providers and build their own health literacy.

This is what drives our government's efforts, in the year of Medicare's 40th birthday.

As well as being better for patients, this is also better for the bottom line of healthcare providers.

Because every dollar that goes to a needless or duplicate test or scan, is a dollar that doesn't fund lifesaving medicines or our hardworking doctors, nurses and other health professionals.

Every minute a GP doesn't spend searching through My Health Record for a result that may or may not have been stuffed into 'the PDF shoebox', is a minute that they can spend caring for their patient.

Every minute a practice nurse doesn't have to spend manually entering a patient's data into their My Health Record, is a minute that they could be administering a childhood vaccination.

The Productivity Commission estimates that more than $5 billion a year could be saved by reforming Australia's digital health infrastructure.

Beyond the savings, it is—quite simply—what patients nowadays expect and deserve.

By the time Medicare reaches its next milestone birthday, we can confidently expect that the humble fax machine will no longer clutter the offices of health professional settings.

Like the Sony Walkman or the Apple Macintosh, the fax machine will finally become little more than a museum relic.

I'm sure I speak for patients everywhere when I say: that day can't come soon enough. I commend the bill to the House.

Debate adjourned.

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