Australians are debating whether or not to opt out of the centralised electronic government health record system, MyHealth.  If you don’t specifically opt out, you are ‘in’.  In principle, this is a no-brainer, though there are practical issues and risks, as always.  Here’s why you should do nothing…and therefore opt in.Reasons for Opting In

1. Precedent. Who remembers the privacy scares over having a centralised tax number or Medicare number?  These were both big ‘big brother’ issues at the time, but are now just accepted as normal.  Several Scandinavian and some other countries already have this.
2. It already exists! It seems it has been operating already for 6 years on an ‘opt in’ basis.  It has 6 million people in the system already, with little/no evidence of privacy problems.  This suggests that it will operate, but be sub-optimal if only part of the population is enrolled.
3. Better diagnosis is likely. A centralised history enables a doctor to consider a person’s total medical history from a factual perspective, particularly regarding what prescriptions and frequency the patient has been diagnosed before.  This must help a doctor, compared with relying on the subjective –  perhaps deliberately biased –  memory of the person.
4. It’s more efficient, quicker. If you’ve ever had to go to a new doctor, you know you have to give a lot of basic information all over again.  What a waste of paperwork and time for everyone.  Just look up your history electronically and get on with the current issues.
5. Cheating will be less possible. For people who doctor-shop and get multiple prescriptions at the same time, electronic recording will pick this up.  In our over-prescribed society, this is an important benefit to stop rorts.

But the system, like most, will have its downsides.

Reasons for Concern

1. The system is inefficient, too costly. Probably true.  But stopping it and starting again is probably a worse option (though this has been done with large systems before, eg Qld Health payroll system recently).  Probably better to try to fix the existing inefficiencies.  The same argument applies for cost, unfortunately.
2. Loss of privacy will occur. Giving outside agencies (eg police, insurance companies) access is certainly risky, even though – properly used – these agencies would benefit from better, more accurate information.
3. The truth comes out. People often don’t give accurate medical information to insurance companies or employers.  They might not like the system to know they had a mental breakdown, suffer from AIDS, MS or some other risky condition.  Here, we have to rely on the integrity of doctors and the system risk management.  Undoubtedly there will be individuals who suffer but, if millions benefit, we can’t hold up benefits for the whole society just because a small number of individuals are disadvantaged.
4. The system will be hacked. Certainly this will be true…but our whole world, every system, faces this concern.  Why is our health information more important

Summary:  Short-term concerns, but long-term gains

The negatives are largely short-term – suspicion of how the system might work – while the positives are about the long-term benefits for health care management.

Unfortunately, the media publishes sensational ‘bad news’ stories and provides ‘balance’ with one pro/one anti story, giving readers the idea that the negatives are at least as important as the positives.

The government has certainly done a very poor job of communicating the benefits of the system, how it will be implemented, experience from other countries and what safeguards are included.  My bet is that, in 10 year’s time we will wonder what all the fuss was about and will be confident that this system improves health care management in this country.