Update 13 September 2018 7:45pm

The RACGP has a news report confirming the impending closure of the clinic

GP-run school clinic to close due to teens’ data privacy fears


This comment was posted to David More’ blog on 7 September 2018


(Blog comment attached, below)

It would seem that at least one GP believes an opt-out MyHR could kill young people.

Dr Bob Walker’s front-line, point-of-care experience should trump any of the spin and rhetoric coming from the likes of the government, AMA and RACGP.

If there is even the slightest risk an opt-out MyHR could kill young people, the move to opt-out should not proceed. Dr Bob’s experience strongly suggests that there is more than a slight risk, especially if taken across all students in Australia.

The problem the government now has is this:

If Dr Bob’s clinic closes there is a risk some students might die.

If Dr Bob’s clinic doesn’t close there is a risk some students might die.

This is only one GP’s experience, there may well be other similar scenarios involving young people and there may be other communities also at risk. There has never been any analysis of the uses of the system or the negative consequences of the type identified by Dr Bob.

The PCEHR/My Health Record has always been a technology solution to a vague problem summarised as: Health Data is good, more Health Data accessed by more people is better. This is naive, simplistic and totally wrong.

The Dep Health/NEHTA/ADHA/ really haven’t thought this thing through. Even with opt-in, there is still a risk of harm.

Stopping the opt-out process is the only short term option.

The only longer term option is for a proper review of the system, its objectives, risks, implementation, impact on Australian health care, value, projected costs over the next 100 years and alternative approaches should be conducted by a body independent of the ADHA, the Department of Health, or any other participant with a vested interest in its outcome.

The only sensible outcome of such a review is likely to be to abandon the system.

The blog posting:

Dr Bob Walker said…

“Hi, my name is Dr Bob Walker and I am a GP working in Lindisfarne, Tasmania but I also run student clinics in our local Y11/Y12 State Co-Ed College. Over the last 10 years these Clinics have been highly successful and we have had thousands of consultations providing non judgmental, evidence based advice in strictly confidential surroundings.

Our Clinics are easy access/drop in and all students are bulk billed. The local path lab provide bulk billed tests and we record and prescribe using our practice software. In this time we have clearly dropped the pregnancy rate, significantly limited the spread of sexually transmitted diseases (STDs) and done a lot of good mental health work. Not one of the students who have engaged with us in this time have taken their lives.

However, the arrival of My health Record (MHR)is a total disaster as our Clinics will be a lot harder to run. After a lot of soul searching we plan to close our Clinics on 15 November – a very backward step for youth health.

About 15% of our young patients have a MHR, presumably enrolled by their parents and almost all without their knowledge. These students are really distressed by having a MHR and now worry about their confidentiality. If we do not tick a box on our path referrals to avoid results going onto their MHR, parents and others can see the results of STD and HIV screens. If a pharmacist slips up and fails to block a dispensing activity, scripts for contraceptives and medications for STDs are also visible. All Medicare items numbers including the names and locations of doctors, all path results and all scripts appear on these records up to the age of 14yrs. Medicare limits these flows between 14 and 18yrs unless we slip up as mentioned.

However, Health Summaries, with explosive diagnoses can be uploaded by hurried/unthinking providers for all age groups. After 18yrs, all new data uploads is clearly visible to home viewers. The ADHA proudly states that young people can take over their records and limit access but this is easier said than done and our students (and quite tech savvy ones, too) have found this quite difficult. Also, parents can put pressure on their teens to open up a private record and if they do not comply, suspicions and arguments arise. As doctors we have all had cases where a young person would have been seriously injured, made homeless or possibly suicided had details of their medical record been seen by others. Doctors will now become targets even though we are treating mature minors and only working in their best interest and safety. I am saddened by the lack of consultation by the ADHA with us youth health workers.

The support of MHR from the AMA and the Royal Australian College of GPs is not based on a sound knowledge of how young people interact with our health system. As a GP, I can see the benefit of a well maintained, up to date and accurate MHR for older people and other patients with complex health conditions, multiple medications, serious allergies, drug addictions and complex psychiatric illnesses. However the risks to young people far outweigh the advantages of the current ‘Opt Out’ System. There has to be a better way and I hope the forthcoming Senate Enquiry will recommend a modified ‘Opt In’ system and spare our young people from what is now a cruel cyber threat to their wellbeing.

If anyone reading this can influence Government policy at this critical time, your action will be much appreciated by young Australians.”

Other stories on this topic

  1. Freezing out the folks: default My Health Record settings don’t protect teens’ privacy The Conversation
  2. Default MHR settings don’t protect teens’ privacy The Medical Republic
  3. My Health Record undermines teens’ right to medical privacy, critics fear ABC Science
  4. Mums hiding from violent exes fear they’ll be found via My Health Record Kidspot