15 March 2023

Victorian patient info sharing around the corner

Hospital Political Technology

Victoria’s health information sharing network bill moved one step closer to becoming law last Thursday, with government amendments to the bill passed in the upper house.

If passed by the lower house, from next February Victorian public health services would be able to share and access key patient data via an electronic network.

Information could include medicines prescribed to the patient, details of allergies, admissions histories and discharge summaries, hospital outpatient consultations, and lab and imaging results. 

Under the plan, a range of public health services would have to disclose information to the network. Initially, these are set to include ambulance services; public, metropolitan and denominational hospitals; registered community health centres; and some other public health services.

Legal and privacy advocacy groups – including the Law Institute of Victoria, Liberty Victoria and Digital Rights Watch – raised concerns about privacy, since patients cannot opt out of the scheme (as they can with the federal My Health Record).

However, the Greens pushed for the introduction of a “privacy management framework” that would, among other provisions, protect the identity of patients who may be at risk of harm such as domestic violence survivors by allowing them to adopt an alias.

The framework would also guarantee patients can obtain information on who has accessed their files, with further measures introduced to protect certain sensitive types of health information.

Labor – which doesn’t have a majority in the Legislative Council – accepted the amendments, allowing the bill to now go back to the lower house.

Professor Stephen Duckett welcomed the result, noting it implemented the recommendations of the Targeting Zero report produced by a commission he had chaired several years ago.

“The reasons we made that recommendation a decade ago remain true now, and there are a couple of them,” Professor Duckett, former program director at the Grattan Institute told Wild Health.

“First, we can’t measure the quality of care, such as readmission rates. If a patient is admitted to the Royal Melbourne, gets discharged and is sent home, but then something goes wrong and they get readmitted to St Vincent’s Hospital, with this network we can actually trace that.

“At the moment, we can’t compare readmission rates across hospitals because the second admission isn’t captured – in order to measure a readmission rate, we have to have an identifier across all hospitals.”

The Victorian database is effectively a state version of the federal My Health Record, whose key benefit is to prevent patients from having to provide clinical information to multiple providers on multiple occasions.

“Patients are sick and tired of having to repeat their information over and over again,” Professor Duckett said, “and they have an expectation that if they’ve told one part of the health system then a another part of the health system understands it.

“In Victoria, each hospital is essentially a separate organisation and they’re not allowed to share the information about patients without their consent.”

However, while the Victorian initiative is designed to complement My Health Record, Professor Duckett was circumspect about its contribution to an interoperable health system.

“Australia is aeons behind other countries in terms of having interoperability as a single electronic record, the ability to share [information] and so on,” he said. “If you go to more or less any country in Europe you will see this – so every little helps is my view.”

In introducing the bill to the Assembly in early February, Victorian Health Minister Mary-Anne Thomas said it “recognises the challenges of siloed information across the Victorian public healthcare system, and the importance of strengthening the system for the health and wellbeing of all Victorians”.

“We recognise that a consolidated picture of a patient’s medical and health history is essential to the provision of the safe and high-quality care in our public hospitals,” Ms Thomas said.

If you are interested in the topics of healthcare reform and want to be part of the conversation on how we move our system forward, Wild Health is hosting the Australian Health Leaders’ Summit this May in Canberra. You can see the full agenda and get your tickets here. Be quick though as tickets are going fast. We hope to see you there.