My Health Record: Potential safety risks for victims of domestic violence

For most members of the general population, the Australian Government’s new online health database will simply be a convenient centralised electronic catalogue, containing patients’ information and histories, available for access by authorized health professionals.  The My Health Record system, which is opt-out (meaning that all Australians who do not actively opt-out will have a personal profile created on the system) promises to facilitate more comprehensive, thorough and accountable patient file management for Australian patients. However, the concept of the system has not been introduced without criticism: growing concerns, particularly with respect to cybersecurity and patient privacy, led to a Senate Inquiry late last year. Now, with only one week until the launch of the system, further concerns have been raised.

Organisations such as the Women’s Legal Service Queensland (WLSQ) and the Law Council of Australia have expressed alarm at the safety risks to victims of domestic violence potentially posed by the system. Unless specific criteria can be satisfied, there remains the risk to victims of family and domestic violence that a perpetrator (parent or guardian) who poses a threat to the health and safety of the child or other family members may be entitled to access victims’ details (including Centrelink details, locations of a patient’s doctors and pharmacies, etc) as an authorized representative.

Amendments passed late last year provide that the title of authorized representative is revoked in circumstances where, under a court order or other law, a parent or guardian is not permitted to be with the child unsupervised, or is found to be a risk to the health or safety of the child. Whilst this is reassuring for those victims of domestic and family violence who have obtained court orders, the reality is that many cases of domestic and family violence go unreported; and those that are reported can take many months to reach Court, let alone result in an order. The necessity of established legal evidence of a safety threat could leave many victims of undisclosed coercive or abusive relationships at risk.

Patients’ safeguards and security measures

In response to growing concerns, My Health Record has implemented various safeguards to help protect users of the service who may be vulnerable or at risk of harm, such as the ability to:

• Set privacy and security controls, such as an access pin;
• Register for My Health Record under a pseudonym;
• Set up notifications to see when someone has accessed your My Health Record;
• Choose what information you provide and allow on your My Health Record, and
• Contact the My Health Record helpline at any time (1800 723 471).

Further, the My Health Records Amendment (Strengthening Privacy) Bill 2018 was passed with the specific objective of improving safety measures and protecting patients’ privacy, largely in response to concerns relating to victims of domestic and family violence. The new laws enshrine a patient’s right to delete their My Health Record at any time and prescribe that law enforcement and other government agencies must obtain a court order in order to access data contained in a patient’s My Health Record.

The opt-out approach: awareness is key

As articulated by the CEO of WLSQ, Angela Lynch –

“The ‘opt-out’ approach is particularly dangerous if victims are unaware they have active My Health Records, the types of information contained on these records, and the potential for perpetrators to access this information. It is not uncommon for highly dangerous perpetrators to constantly monitor women’s lives including who she communicates with, where she goes and her access to information. Perpetrators often have access to (and in fact demand) access to all such accounts including her passwords, controlling every aspect of her life.”

If individuals do not wish to have a My Health Record profile created for them, they are required to access the My Health Record website and fill in the required form to ensure that they have officially opted-out of the system. To complete the opt-out process, individuals will need to provide their Medicare information and provide government-issued ID.

If you wish to opt-out of My Health Record, you have until 31 January to do so. More information on the system, security measures and your rights as a user are available on the My Health Record website.

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