13 May 2021

More than 20% of MHR shared health summary data is likely garbage


A Department of Health audit of GP uploaded shared health summaries reveals that the state of My Health Record data integrity may be a lot worse than people think.

Earlier this month the Department of Health (DoH) took its new data matching powers out for its first test drive in the form of an audit of all GP practices which upload shared health summaries to the My Health Record (MHR) as part of the ePIP, and what it found wasn’t pretty.

1106 practices which were paid ePiP last quarter ended up being denied the payment this quarter after DoH data matched records with the Australian Digital Health Agency (ADHA) and found that these practices had “not met the shared health summary upload requirements for a payment quarter under the Practice Incentives Program eHealth Incentive (ePIP)”. Overall, about 5300 practices are uploading summaries.

The good news is that the department has provided quite a bit of information for those practices which have missed out this quarter on what to do to make sure they get in line for next quarter, so the problem is likely to go away over time for those practices affected. If you’re interested in that detail you can start HERE.

The bad news is that ePIP to incentivise shared health summary uploading by GP practices has been running for a few years now and this is the first time a detailed check has been made of the integrity of the data GPs have been uploading.

Depending on how the Australian Digital Health Agency (ADHA) has been treating the summaries that are not up to standard in the past, that might mean that up to 20% of all the shared health summary data in the MHR database is garbage. It could be more or less than 20% depending on the profile – primarily how many GPs they have – of the 1106 practices who failed to upload proper data.

Wild Health asked the ADHA to clarify what they’ve been doing with the tainted data until now and to confirm if the up to 20% of this important data set in the MHR is tainted, but their media department has not gotten back to us yet. We will update you if they do.

It seems unlikely however that the ADHA had itself identified this problem prior to the audit, as if it had it surely would have reported so much poor data to the DoH before this audit.

This likely means that for several years now at least 20% of the shared health summary data set, and perhaps a lot more, given the issues that GPs have had in getting going on the uploads, is tainted and unusable.

One question that should be on the minds of the ADHA and the DoH is that if this tainted data is still sitting inside the MHR shared health summary data set, does that represent any potential issues of patient safety?

We have put some further questions to the department asking it to detail some of the reasons GP practices had not met “the requirements”.

It doesn’t seem to be that they failed to upload the minimum number of summaries required as the system rejects a practice straight away if the required number of the summaries aren’t uploaded.

It seems like it is something the department has managed to audit within the summary data itself. It should be interesting to find out what constitutes some of the fails. Are some of the summaries dummy summaries or automated summaries which aren’t loading real or meaningful data?

We’ll get back to you if and when we find out.

The audit fail might mark the start of a more sensible approach by the ADHA and the DoH to retrieving certain types of data for the MHR.

It is well known that many GP practices do the absolute minimum amount of work to meet their ePIP payment requirement, and in doing this, the integrity of the entire shared health summary data set might be called into question, at least as the data sits now.

Part of the problem is that the DoH decided that they wanted to introduce GP practices slowly to the concept of having to upload summaries given how burdensome and time consuming uploading is for busy GPs. So even though the majority of practices now upload summaries, they are only required to upload a very small percentage of their entire patient data set. This means that the data set overall wouldn’t cover more than about 25-30% of the entire patient population that should have summaries in the MHR.

But there’s bigger problems even in the limited data that is being uploaded because in figuring out out how to semi automate summary uploads and meet the audit requirements, many practices are uploading data which isn’t useful at all, but does meet minimum audit requirements.

As an example, a practice can take one common set of summaries which are easiest to upload, for example, children’s immunisation summaries, and load them in bulk.

The DoH audit is likely to be the start of getting the shared health summary data to be improved over time, but many experts believe that there is not enough time or money for GP practices to ever make the data set useful in the manner that was originally envisaged. GP practices simply haven’t got the time or money to worry about the integrity of the shared health summary data set they send each month to the ADHA.