The nature of humans means we are often dubious about things we don’t understand. We’re always looking for the catch and waiting to be disappointed. The job of marketers (good ones at least) is to recognise this and make marketing not only engaging, but informative and relevant.
So why exactly does there seem to be so much controversy surrounding the Australian government’s My Health Record program? Is it simply a case of poor marketing, or is there a deeper issue?
My Health Record isn’t something new. Originally called the Personally Controlled Electronic Health Record (PCEHR), the system has been around since 2012 and already six million are enrolled in it, many of whom are unaware how they were enrolled into it.
Although it’s not new, much of the available media would indicate a large percentage of people are unfamiliar with the system and its uses. Humans being humans, there’s always a fear of the unknown, but how grounded are these fears? Blockchain suffered similar scepticism until it was better understood, and now it’s hailed as a revolutionary technology.
The analogy with blockchain isn’t by chance. My Health record isn’t built on blockchain (yet), but it employs some of the same principles with the provision of access keys via PKI (Public Key Infrastructure). This system not only regulates access, but like blockchain, ensures the content hasn’t been altered and keeps a full record of every key that accessed a record, what they accessed and what they did with the information.
There’re also trials using blockchain which have had some good successes. In particular the recent government trial using blockchain to allow researchers to access medical information contained within platforms such as My Health Record.
So if the new system is more secure than ever before, and provides every patient with instant access to their health record whenever they need it, you’d think we’d be happy. You’d be wrong.
Almost 90% of Australians believe the information they share with their doctor should be confidential. One of the selling points of My Health Record is that clinical researchers will have access to more data than ever before, which should help expedite research and development in many historically challenging areas. However, it then came to light that the police would also have access, as well as a host of unsubstantiated rumours that insurers and various other private business might be able to gain access.
As well as a fear of the unknown, there’s also a fear of the known. In particular, fear of the repercussions of a data breach.
Approximately 33% of all data breaches this year related to health information. This stat sounds terrifying, and it’s easy to see how negative publicity could easily spin on such things. It’s only when you investigate further that the details become less scary. Over 50% of those data breaches were caused by human error and 44% through cyber attacks. Given those stats, the technology being employed for the My Health Record system actually makes everyones details far safer. Which is a good thing.
The entire My Health Record system is also permissioned. Every one of us can opt out completely, and even if we don’t, we can decide what information is and isn’t allowed to be stored, and of that information, what can and can’t be accessed. Yes, it’s an effort we didn’t used to have to make, but we still have the power to control our privacy if we want to.
What may appear worrying, is the number of medical professionals who are opting out. Anecdotal data from ‘Business for Doctors’ claims that reportedly the ratio of doctors ‘opting out’ vs ‘remaining in’ is as high as 10:1, whilst online polls on the popular ‘GPs Down Under’ Facebook group are consistently showing opt-out rates of between two thirds and three quarters of GP respondents. It’s easy to see how this could make the general public nervous.
There have also been criticisms of the UX of the system, calling it clunky and slow. It’s not that the criticisms are wrong, but UX is hard at the best of times. I’m not defending anyone, but this is one of the biggest digital projects ever undertaken in Australia. It’s also the first version, and should improve over time. Designing with the user in mind is crucial, but usually you can narrow down user groups to a number of fixed personas. When your user group is every person in Australia, that’s a hard ask by anyone’s standards.
The issues currently appear to center around the data the system will host and the legislation around how the data and the system itself may be used. From a doctor’s perspective, if patients can permission parts of their records, they don’t end up with a complete picture. Also, if data isn’t in a uniformed format, that can make trying to extrapolate meaningful results from it incredibly complex.
The marketing of My Health Record could have arguably been better. I’ve had nothing through the post, nothing in the mail and seen nothing in the media, social or otherwise. Some of my colleagues have seen Facebook posts, but that’s about the extent of it. The only details I’ve discovered has been through research and news articles. Nothing from those responsible for the system explaining what I should do or why I’m getting it. It almost feels like the marketing campaign revolves around trying to keep the whole thing as quiet as possible.
Fraser Gordon is general manager at Engaging.io.