What recent My Health Record changes mean for GPs

In a bid to provide ‘better and faster access’ for patients, new Australian laws mean pathology and diagnostic imaging reports will soon be shared to My Health Record (MHR) by default.
 
In anticipation of the upcoming changes, passed by the Federal Parliament earlier this year, the RACGP has updated its related position statements on responding to patient requests for tests not considered clinically appropriate and testing initiated by other healthcare clinicians.
 
These aim to help GPs understand what their responsibilities are in following up tests that have been initiated by other healthcare providers and manage requests for tests that may not be clinically necessary.
 
Currently, pathology and diagnostic imaging reports can be uploaded by providers who choose to participate in MHR. Once uploaded, the reports are immediately available to healthcare provider organisations involved in a patient’s healthcare. 
 
But with the new laws soon to be rolled out, and as pathology and diagnostic imaging providers get ready for these changes, the RACGP is reminding GPs to be prepared.
 
‘The MHR Rules will require constitutional corporations operating pathology labs and diagnostic imaging centres to upload specific test results and reports,’ says the Department of Health and Aged Care (DoHAC).
 
‘This requirement is expected to extend to other healthcare providers in the future as the rules are implemented.’
 
Although the legislation has passed, the Government is yet to set a timeline for when the changes will be developed or take effect, with consultation work still occurring.
 
While the changes do not impact GPs in how they upload to MHR, patients may request more information about their test results, and also still have the option to not have them shared to MHR. GPs can manage this in their clinical information systems.
 
Dr Rob Hosking, Chair of the RACGP Expert Committee – Practice Technology and Management, said there are pros and cons as a result of the changes, with interpreting results, administration, and patient health literacy key areas of concern.
 
‘The pros are that we won’t have to spend as much time running around chasing information, particularly if the patient attended a hospital or another practice – we should be able to find out that information via the MHR fairly quickly,’ he told newsGP.
 
‘But the biggest disadvantage is that we don’t want people to rely on that as a method of communication, because it’s a very poor communication tool.
 
‘It’s a useful resource if you’re going in to look for something, but … when we open a patient’s file we have no idea if there’s something new in MHR, we don’t get notified.
 
‘So this is a problem that if hospitals or non-GP specialists start to rely on that as a way of us being able to access the information, it’s a bit of a backward step in terms of accessing the information relevant to that patient for follow up.’
 
The RACGP previously raised concerns around the potential scrapping of the seven-day delay in patients viewing pathology and diagnostic imaging results, to provide them with faster access.
 
The existing seven-day consumer access delay policy is not addressed in the new laws and ‘any future changes will involve further consultation’.
 
While the changes are eventually expected to allow patients greater access to their key health information and to take ownership of their healthcare, Dr Hosking is concerned that if patients check their MHR for results before they go back to their GP, it may cause unnecessary stress.
 
‘We may get some distressed patients calling and wanting to speak to a doctor straight away about a test that is actually only very mildly abnormal, and we would ignore it, but some anxious patients might get very distressed by it,’ he said.
 
‘The exposure of test results without a delay is what a lot of patients want, but GPs and other health professionals are concerned that without the appropriate training and knowledge, people will make mistakes looking at that information before they’ve had a chance to discuss it l with the doctor.’
 
The Australian Digital Health Agency (ADHA) Clinical Reference Group, which Dr Hosking also sits on, is currently looking at prioritising what results should be withheld from immediate release, which he says can vary from person to person.
 
‘There are patients who are experts in their own medical problems, who have had a disease for many years, and they know what their results mean,’ he said.
 
‘But then there are others who have routine testing, or even sophisticated testing, they don’t know how to interpret the results.
 
‘These results are meant for communication from health professional to health professional, they are not always in a format for patients to be able to understand.
 
‘So some may be alarming, and some may be falsely reassuring.’
 
Dr Hosking recommends the Government-funded Pathology Tests Explained as a useful tool for GPs to assist patients in finding out more information about their results.
 
For the disadvantage relating to GPs’ administrative load, he said the patient reports are hard to find in MHR and in a format ‘not as useful’ when downloaded.
 
‘When downloading them into our clinical information system, whether Best Practice or Medical Director, they end up in “correspondence” instead of “results”, that’s a quirk of the way they’ve developed the system,’ he said.
 
‘So, we’re back to effectively scanning in documents that are not terribly useful, rather than to reference – it’s still better to have the information, but it becomes less useful over time because they’re not in a coded format.’
 
Dr Hosking says the ADHA is working on improving the format of MHR so that ‘hopefully it will be a better interface for GPs’.
 
In addition to the RACGP’s updated positions statements on the MHR changes, the DoHAC has an FAQs page.
 
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clinical information systems diagnostic imaging digital health healthcare literacy My Health Record pathology reports