Individuals can access their records on mobile phones, and can decide what information is uploaded and who can see it.

For example, if a person is admitted to hospital they can access their My Health Record and opt to allow hospital staff access to their GP summaries, known allergies, medicines, X-rays and test reports.

The aim of the record is for a person’s health information to be shared quickly, enabling medical providers to make prompt and informed treatment decisions, and to prevent duplicate medical testings, while at the same time promoting individual control and participation in their health.

Secondary uses of the My Health database also exist.

My Health Record data from consenting patients is already being used in a number of secondary use pilot projects across Australia. This includes:

If a user provides unlimited access to information held in their record and does not opt out from sharing their data for secondary uses, their information will be accessible to a wider audience as de-identified data from 2020.

Federal Health Minister Greg Hunt said these secondary uses will drive policy development, be used for research purposes, and importantly, would not be used for non-health or commercial purposes.

For example, he said he marketing and insurance companies will not be given access to the de-identified health data.

Further, he said the My Health Record system had multiple layers of security, including defence level encryption, secure gateways and firewalls, authentication mechanisms, and malicious content filtering.

“The My Health Record system will help save and protect lives and is supported by healthcare consumers, doctors and the medical community across Australia. It is subject to some of the strongest legislation in the world to prevent unauthorised use,” Mr Hunt said.

Launceston general physician and health informatics expert Terry Hannan said any benefits to the e-health system could be overshadowed by usability issues and poor digital literacy.

Dr Hannan is a long-term proponent of e-health, having been involved in the development of an informatics health system that greatly assisted the HIV/AIDS crisis in Kenya, which is now used in developing countries via OpenMRS.

He said the accuracy and reliability of the medical data that is uploaded to the My Health Record could be questionable, and he doubted the effectiveness of the record in an emergency acute situation, providing a recent example of an emergency department patient who tried unsuccessfully for 20 minutes to log into the record and show staff.

The possibility of data security breaches was also a concern.

“I am not knocking the concept, the philosophy is correct, but is this the best way to deliver the system? Some of us are questioning that," he said.

Of the current My Health informatic system, Dr Hannan said the site itself was confusing, and public education about how to correctly use the system seemed to be lacking.

He said there were no clear patient benefits and many medical providers were also not familiar with the system.

“I tried to make my own My Health Record, it gave me three security codes and none of them worked,” Dr Hannan said.

“[Further] the boxes to enter the allergies or the medications are free-text by non-medical people, with no drop-down box options, no code,” he said.

“We know that junior medical doctors and even senior doctors make errors doing this [free text], but here we will have patients who are not e-health literate and may not even be digitally literate, entering information. That is error prone.”

Dr Hannan added that My Health could not be a true representation of patient health due to medical inaccuracies regularly entered into GP and hospital reports, which was concerning.

He gave a recent example of a patient document that said the patient had five allergies, and also had received five surgeries in one day, all of which were incorrect.

“We currently have GP medical records, which we know can be inaccurate and incomplete, which are essentially uncoded, and being uploaded in PDF documents to the record,” he said.

Coded medical information is assessed and categorised for easier storage, retrieval and analysis of the information, but this is not being utilised in My Health.

Dr Hannan said a better model, found in the OpenMRS system adopted in Kenya, Bangladesh and some developed countries, would code the clinical data and allow information to be entered at the time of the care encounter.

He said this coded model allowed two data uses; the first was to manage national health care and the second was for direct clinical care.

In this latter usage, alerts, reminders and automated interpretations and predictions from changes in patient data occurred, and allowed deteriorating patients to be noticed, which will not occur under the My Health model.

Ultimately Dr Hannan questioned whether the My Health Records and database could accurately reflect the status of health care delivery in Australia if the information held in the records was not timely, and inaccurate.