The Australian government’s former digital boss has warned a new ehealth record system has the potential to become another government “tech wreck” and they would “probably opt out” of My Health Record because of its security model.
On Monday, 20,000 Australians took their first opportunity to opt out of My Health Record, several reportedly waiting over an hour on the phone to do so because of a “minor internal connection issue”.
Speaking to ABC radio, the former Digital Transformation Agency (DTA) CEO suggested the surge in opt outs revealed the public’s dissatisfaction with the system and warned that while a digital health record was a “nice idea” in theory, a lack of consideration for user needs and unsuitable security significantly restricted My Health Record.
“I think one of the issues that you have now is that [the Australian government] spent about $2 billion and over a decade developing a piece of software without a clearly defined set of needs that it meets, either for the practitioner or for the patient and as a result you’ve got to now make it mandatory.”
My Health Record switched to an opt out system this week after failing to attract users under the opt in model of the previous six years. Australian citizens now have three months to opt out of My Health Record or a permanent digital record will be created on their behalf.
While figures from the government agency responsible for My Health Record, the Digital Health Agency (DHA), say nearly six million people have signed up for the a digital health record, analysis suggests very few people are actually using it.
Three years ago, while still at the DTA, the former executive said they received briefings that revealed only one per cent of Australians were actually using the system and many practitioners saw no advantage over their pre-existing record systems.
The DHA maintains My Health Record will significantly benefit patients and they will have complete control over what data is uploaded and who accesses their records. They also say the system has wide support from medical professionals. However, the digital chief handpicked by Malcom Turnbull in 2015 to lead the government’s digital transformation said the program’s roll out was significantly flawed and opposed the switch to an opt out model.
“You don’t spring something on people and tell them ‘we’re going to be doing this’, with no preparation, with no clear understanding of what the benefits are, without having designed it around user needs and then with this weird security model.”
A Which-50 feature article on My Health Record in May revealed the opt out period would not be accompanied by a traditional media campaign as the DHA CEO denied there was a “conspiracy” to conceal the switch.
Security and Privacy concerns
The opt out switch comes amid concerns over the systems privacy and security features, many of which require user action to enable. According to the former DTA CEO that requirement only makes sense under an opt in system and the current security model is “unsuited” and “symptomatic of the way the government handles IT in these big projects”.
“I think it’s problematic. Those kind of security settings kind of make sense for an opt-in system … but when it becomes an opt-out system, and you find out all your data is on there, ‘oh, and by the way it’s all being shared’, well, no — I think that’s one of the flaws,” the former executive said.
“The role out of this has been significantly flawed. It’s got a lot of similarities to what happened in the UK.”
The former government digital chief said the DHA had failed to “learn from history”.
A similar digital health record system in the UK – care.data – which included staff now involved with My Health Record had failed, but the Australian government was not heading the warning, according to the ex-DTA CEO.
“It failed and it was actually stopped for very similar reasons. When it was introduced, it was introduced as an opt out system. People there didn’t particularly like it. They had concerns about the privacy of their data an ultimately it had to be stopped.”