Exploring adolescent and clinician perspectives on Australia’s national digital health record, My Health Record
Laura Beaton A B , Ian Williams A and Lena Sanci AA Department of General Practice, The University of Melbourne, Third Floor, 780 Elizabeth Street, Melbourne, Vic. 3004, Australia.
B Corresponding author. Email: laurajbeaton@gmail.com
Australian Journal of Primary Health 27(2) 102-108 https://doi.org/10.1071/PY20169
Submitted: 15 July 2020 Accepted: 19 January 2021 Published: 15 March 2021
Abstract
Adolescence is often a time when risk-taking behaviours emerge and attendance at primary health care is low. School-based health services can serve to improve access to health care. Clinicians play a key role in improving adolescents’ health literacy and capacity to make informed care decisions. Australia’s national digital health record, My Health Record (MHR), has posed significant challenges for both clinicians and adolescents in understanding impacts on patient privacy. Guidance is required on how best to communicate about MHR to adolescents. This exploratory qualitative study aims to examine adolescents’ understanding of MHR, clinicians’ knowledge of MHR and their use of MHR with adolescents. Focus groups with students, school health and well-being staff and semistructured interviews with GPs and nurses were undertaken in one regional and one urban secondary school-based health service in Victoria. Transcripts from audio recorded sessions were examined using thematic analysis. Resulting themes include minimal understanding and use of MHR, privacy and security concerns, possible benefits of MHR and convenience. The results suggest opportunities to address gaps in understanding and to learn from adolescents’ preferences for digital health literacy education. This will support primary care clinicians to provide best-practice health care for adolescents.
Keywords: adolescent health, digital health, health literacy, primary care, school-based program.
References
Anoshiravani A, Gaskin GL, Groshek MR, Kuelbs C, Longhurst CA (2012) Special requirements for electronic medical records in adolescent medicine. The Journal of Adolescent Health 51, 409–414.| Special requirements for electronic medical records in adolescent medicine.Crossref | GoogleScholarGoogle Scholar | 23084160PubMed |
Australian Commission on Safety and Quality in Health Care (2013) Consumers, the health system and health literacy: taking action to improve safety and quality. Consultation Paper. Available at https://www.safetyandquality.gov.au/sites/default/files/migrated/Consumers-the-health-system-and-health-literacy-Taking-action-to-improve-safety-and-quality1.pdf [Verified 20 June 2020]
Australian Digital Health Agency (2020) ‘My Health Record for teens’. Available at https://www.myhealthrecord.gov.au/for-teens [Verified 12 July 2020]
Bayer R, Santelli J, Klitzman R (2015) New challenges for electronic health records: confidentiality and access to sensitive health information about parents and adolescents. Journal of the American Medical Association 313, 29–30.
| New challenges for electronic health records: confidentiality and access to sensitive health information about parents and adolescents.Crossref | GoogleScholarGoogle Scholar | 25562260PubMed |
Booth ML, Knox S, Kang M (2008) Encounters between adolescents and general practice in Australia. Journal of Paediatrics and Child Health 44, 699–705.
| Encounters between adolescents and general practice in Australia.Crossref | GoogleScholarGoogle Scholar | 19077068PubMed |
Braun V, Clarke V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.
| Using thematic analysis in psychology.Crossref | GoogleScholarGoogle Scholar |
Frazer C, Ratchford F, Roch J (2017) Enabling adolescent electronic access to personal health information. Studies in Health Technology and Informatics 234, 115–119.
Gaskin G, Bruce J, Anoshiravani A (2016) Understanding parent perspectives concerning adolescents’ online access to personal health information. Journal of Participatory Medicine 8, e3
Goldstein RL, Anoshiravani A, Svetaz MV, Carlson JL (2020) Providers’ perspectives on adolescent confidentiality and the electronic health record: a state of transition. The Journal of Adolescent Health 66, 296–300.
| Providers’ perspectives on adolescent confidentiality and the electronic health record: a state of transition.Crossref | GoogleScholarGoogle Scholar | 31831320PubMed |
Gray SH, Pasternak RH, Gooding HC, Woodward K, Hawkins K, Sawyer S, Anoshiravani A (2014) Recommendations for electronic health record use for delivery of adolescent health care. Journal of Adolescent Health 54, 487–490.
Kang M, Sanci L (2018) ‘Freezing out the folks: default My Health Record settings don’t protect teens’ privacy’. The Conversation. Available at https://theconversation.com/freezing-out-the-folks-default-my-health-record-settings-dont-protect-teens-privacy-100598 [Verified 12 July 2020]
Keeton V, Soleimanpour S, Brindis CD (2012) School-based health centers in an era of health care reform: building on history. Current Problems in Pediatric and Adolescent Health Care 42, 132–156.
| School-based health centers in an era of health care reform: building on history.Crossref | GoogleScholarGoogle Scholar | 22677513PubMed |
Menachemi N, Collum TH (2011) Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy 4, 47–55.
Patton GC, Olsson CA, Skirbekk V, Saffery R, Wlodek ME, Azzopardi PS, Stonawski M, Rasmussen B, Spry E, Francis K, Bhutta ZA, Kassebaum NJ, Mokdad AH, Murray CJL, Prentice AM, Reavley N, Sheehan P, Sweeny K, Viner RM, Sawyer SM (2018) Adolescence and the next generation. Nature 554, 458–466.
| Adolescence and the next generation.Crossref | GoogleScholarGoogle Scholar | 29469095PubMed |
Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H, (HLS-EU) Consortium Health Literacy Project European (2012) Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 12, 80
| Health literacy and public health: a systematic review and integration of definitions and models.Crossref | GoogleScholarGoogle Scholar | 22276600PubMed |
Stablein T, Loud KJ, DiCapua C, Anthony DL (2018) The catch to confidentiality: the use of electronic health records in adolescent health care. The Journal of Adolescent Health 62, 577–582.
| The catch to confidentiality: the use of electronic health records in adolescent health care.Crossref | GoogleScholarGoogle Scholar | 29422435PubMed |
The Department of Health (2018) ‘My Health Record: National Optout.’ Available at https://www1.health.gov.au/internet/main/publishing.nsf/Content/my-health-record-national-opt-out [Verified 20 June 2020]
The Office of the National Coordinator for Health Information Technology (2015) What are the differences between electronic medical records, electronic health records, and personal health records? Available at https://www.healthit.gov/providers-professionals/faqs/what-are-differences-between-electronic-medical-records-electronic [Verified 20 June 2020]
Tylee A, Haller DM, Graham T, Churchill R, Sanci LA (2007) Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet 369, 1565–1573.
| Youth-friendly primary-care services: how are we doing and what more needs to be done?Crossref | GoogleScholarGoogle Scholar | 17482988PubMed |
Van Kasteren Y, Maeder A, Williams PA, Damarell R (2017) Consumer perspectives on MyHealth Record: a review. Studies in Health Technology and Informatics 239, 146–152.
Walsh L, Hemsley B, Allan M, Adams N, Balandin S, Georgiou A, Higgins I, McCarthy S, Hill S (2017) The e-health literacy demands of Australia’s My Health Record: a heuristic evaluation of usability. Perspectives in Health Information Management 14, 1f
Williams RL, Taylor JF (2016) Four steps to preserving adolescent confidentiality in an electronic health environment. Current Opinion in Obstetrics & Gynecology 28, 393–398.
| Four steps to preserving adolescent confidentiality in an electronic health environment.Crossref | GoogleScholarGoogle Scholar |
World Health Organization (2012) ‘Making health services adolescent friendly – developing national quality standards for adolescent friendly health services’. (World Health Organization Department of Maternal, Newborn, Child and Adolescent Health) Available at https://www.who.int/maternal_child_adolescent/documents/adolescent_friendly_services/en/ [Verified 20 June 2020]
World Health Organization (2013) ‘Health literacy’. (World Health Organization Regional Office for Europe) Available at https://apps.who.int/iris/bitstream/handle/10665/128703/e96854.pdf [Verified 20 June 2020]
