It has been a long time coming – over a decade in fact – but the Australian Digital Health Agency finally released a mobile app for the My Health Record this week. We won’t go as far as saying it was worth the whole wait, but we will say the app is pretty good and might prove to be that one step that makes consumers actually want to use their record.
There have been several tries in past for a mobile app, most notably Chamonix’s healthi and Telstra Health’s HealthNow and a couple of others that were turned on and then off again, but these only allow authenticated access to My Health Record and don’t actually download any data. There were also a few personal health records like Wanngi and Snug that waited in vain to link to the system. We have been around long enough to remember similar hopes as far back as 2015.
It has been a difficult path towards mobility, with the mobile gateway closed down in 2018 and not resurrected until more recently, when Chamonix was awarded a contract to develop the digital health mobile channel. That also had to wait as Deloitte rolled out the new Health API gateway, which the my health app is using.
The Chamonix, Deloitte and the agency teams have now gone live with the app, and a quick test run tells us that it works pretty well. It looks pretty and is easily navigable, although the perennial issues still face it. The My Health Record is built on HL7’s clinical document architecture (CDA) standard and as such, is a series of documents. That doesn’t make for the best user experience on mobile (although it is far better than the MyHR web app experience).
There is also the perennial issue of PBS and MBS data making up the bulk of the clinical information and adding a bit of confusion when filtering. For example, our app shows a long list of our repeat prescriptions, with the PBS benefit and the dispense record showing up for the same script. It looks to the uninitiated just as a series of duplicate scripts.
(Personally, we reckon this data is great in that we can see when and from what pharmacy the script was dispensed, but frustratingly there is nothing corresponding in the prescription record for who prescribed it or when. There is an MBS record for our GP consultation and we of course know that is when the script was written, but this does not come up as a separate entry in the medicines record. This is the same problem we have with our full My Health Record.)
On the other hand, being able to filter by immunisations is great. We can see all four of our COVID shots, and if we move over to Medicare services we can see where and by whom they were administered. But there is also a separate COVID-19 vaccination and test tile, which lists them all, the date administered, our vaccination certificate for international travel, and also the most recent COVID-19 and respiratory test results. This is a nice little addition and works seamlessly.
We also really like the ability to have mobile access to pathology test reports. This is another great little addition – click on the test results tile, see a list of your most recent tests, click on that test and you are able to see the PDF of your report. While it’s not atomic data, it is still something that few of us have had easy access to in the past, all in one place.
The my health app is much more intuitive and easy to use than the full system, and it looks like the agency has got the security sorted through several stages of authentication. Ultimately though, will it “save” the My Health Record’s bacon? We think that is secure in the long term anyway, but having an easy to use app will help with the user numbers no end.
We also suspect that the ability to use the my health app while in an actual consultation with a healthcare professional will do more to increase uptake than anything else. When was your last test or vaccination? A couple of clicks and Bob’s your aunty. This has always been the promise of the My Health Record; we are pleased that it has finally eventuated.
That brings us to our poll question for the week. We have the most informed and expert readership of any digital health community out there, so let us know what you think.
Has the my health app saved the My Health Record? Vote here and let us know what you like about the app or what you think should have been done differently. You can also leave your comments anonymously below.
Meanwhile, last week we asked: Are privacy concerns being taken seriously enough in Victoria’s health information sharing bill?
Readers were pretty evenly split: 45 per cent said yes, 55 per cent said no. We also asked why you thought so. Here’s what you said.
You have (partly) hit the nail on the head with the observation that My Health Record is built on HL7 CDA.
Yes, CDA allows the rendering of the underlying data structure as a document. However, the standard is designed to allow granular coded data to be embedded into that data structure. This design allows a human-readable rendering of those data to find their way up to the document. But crucially, it allows those machine-readable data to be exposed to software applications that can do something meaningful and far more useful with them than expose a series of soft documents.
The My Health Record’s biggest design flaw was to consciously duck (and it was a conscious decision) the mandated capture of granular data. This flaw was then compounded by failing to contemporaneously address the issue of semantic interoperability.
Had these capabilities, fundamental to any meaningfully usable summary care record, been addressed at the time, (and there was plenty of advice advocating for such activities), the My Health Record story could well have been significantly different.
As it is, granular data appears to still be patchy at best. And we have a whole new generation of bureaucrats at the ADHA evangelising for consultation, local experimentation, and central evaluation of interoperability initiatives as if the concept was bleeding edge.
Einstein’s (alleged) definition of insanity anyone? Oh, for the preservation of corporate memory and lessons learned from it. FHIR is indeed the future, but CDA, leveraged to its full capability, would be a bloody good bridge.
So will the my health app save the My Health Record? From a consumer engagement perspective – Perhaps for a while. From an informatics-driven health outcomes perspective? Without granular data and a national approach to semantic interoperability, it will likely turn out to be lipstick.
So, has the my health app saved the My Health Record? Readers were split down the middle 50:50.
We had a few optional questions: If yes, what do you like about it? If no, what should have been done differently? Here’s what you said:
– Need more content in the My Health Record
– Relies too much on their being data in the mhr. Where are the conditions and allergies. GPS will still have to manually upload this which is the issue at hand for real use and value
– Data it is accessing is still of little use.
– Dark mode is great. It’s a great platform for further features
– It should have been based on an open FHIR API thus allowing the app to access multiple health information sources, not just the My Health Record.
– The longitunal approach
– It is a great step forward and easy to use, however it does not go far enough as it needs to allow the patient to be part of the management of their ongoing care. It is a view only app.
We often discuss about patient centered care, but the app does not allow the patient (or carer) to input into their own record. Being able to add notes, documents, highlight current medications taken, etc. and the capability to share this information with their clinicians would make it a far more functional tool and enhance the quality of care.
We have to allow the consumer to be involved and drive the next steps in this change required to have patient centered care.
– The features are great but it needs the support of a strategy to incentivise health practitioners and consumers to participate in Ehealth record
– You forget about Healthdirect’s app which released this functionality a long time ago.
– Unfortunately, a successful MHR is an enormous project and an unattainable goal for many reasons.
– People are still concerned about data sharing around the government departments.
– Like the app and will be promoting it with patients. Easy to use
– Created a functional product 10yrs ago
– the range of data available
– It’s not reliant on a third party app to access this information anymore
– I like the app I previously accessed records through Healthi – Governtment though needs to enforce uploads by all GPs Pharmacist etc the opt out works for those who dont want this but for those of us who do we need to ensure all the data is there atm ,medical professionals dont upload even when asked .
– The PDF and non live aspect of the information limits this still, and
Difficulties with getting clinicians to add information, and
A patient held record should be able to include documents added by the patient.