My Health Record

What is a My Health Record?

My Health Record is an Australian Government initiative that provides the technology to store an online summary of a person’s health information. It’s not intended to be a person’s entire medical record and, over time, it will include:

• information about medical conditions a person has had
• information about treatments being undertaken
• a list of medicines prescribed and dispensed
• reference to any allergies or adverse reactions experienced
• immunisation records
• test and scan results, such as blood tests and ultrasounds
• hospital discharge summaries
• referral letters doctors have written.

Benefits of a My Health Record for a child in care

A My Health Record enables a child’s medical and pharmaceutical history to be stored on a single record. Healthcare providers can view and add clinical records to the child’s My Health Record from anywhere in Australia, enabling continuity of healthcare and improved information sharing. This is particularly valuable for children in care, whose care arrangement and treating health care professionals may change.

A My Health Record can:

• give health care providers improved access to a child’s health history and health information, and help them to provide a holistic response to the child’s care
• reduce unnecessary test duplication due to lack of knowledge about a child’s past health experiences
• improve medication safety because of easy access to a child’s health information
• give Child Safety staff more timely access to the child’s health information, helping a Child Safety Officer (CSO) understand what the child’s health needs are and the treatments being provided
• provide young people with direct access to their own healthcare information, and
• improve a young person’s skills in self-managing their healthcare as they begin transitioning to adulthood.

My Health Record isn’t designed to replace a healthcare provider’s clinical records and will not provide a complete picture of a child’s health status and needs. There is no requirement for healthcare providers to enter records into a person’s My Health Record and, at the current time, not all healthcare providers are participating.

Child Safety staff still need to continue to gather information about the child’s health needs from other sources, such as the child, their parents, you as the child’s carer, as well as their healthcare providers.

Children in Care portal

The Australian Government has also developed an IT system called the Children in Care portal for statutory child protection authorities across Australia. This portal enables Child Safety staff (and similar interstate authorities) to be linked to the My Health Record of some, but not all, children in care under 14 years of age, as their Authorised Representative. This portal is not available to care services or to foster or kinship carers.

There are strict requirements associated with the use of the Children in Care portal. Child Safety staff are required to have ‘parental responsibility’ for the child and the appropriate court authority, such as a child protection order granting custody (including interim custody) or guardianship to the Chief Executive.

Authorised representatives for a child in care

Under the My Health Record system, all children under 14 years of age will have their My Health Record managed on their behalf by an Authorised Representative. For a child in the general community this will usually be a child’s parent/s or their legal guardian.

For a child subject to a child protection order granting guardianship to the Chief Executive, their Authorised Representative will be the child’s CSO with case responsibility.

For a child subject to a child protection order granting custody to the Chief Executive, including interim orders, the Authorised Representative will usually be the child’s parent/s. For some children–such as those with complex health needs–it may be helpful for the child’s CSO to also view and manage the child’s My Health Record as an Authorised Representative. In these circumstances, the CSO will share this role with the child’s parent/s.

As the child’s Authorised Representative, the CSO will be able to:

• view or add information in the child’s record
• view or remove other Authorised Representatives, and
• add or remove nominated representatives, in accordance with the child’s views and best interests.

A CSO will not cancel a child’s My Health Record, as this action would permanently delete the child’s health information.

For a child subject to a permanent care order, or an order granting long-term guardianship to a family member or other suitable person, the child’s guardian will register as the child’s Authorised Representative through myGov.

Nominated representatives for a child in care

When a CSO has linked himself/herself to the child’s My Health Record as the child’s Authorised Representative, the CSO may, in some circumstances, invite the child’s carer to be the child’s Nominated Representative. This may occur when:

• the child in your care is subject to a child protection order granting guardianship to the Chief Executive, and the care arrangement is a stable one with the intention to be long-term
• the child has high or complex health needs and access to the child’s record will directly assist you in meeting the child’s health needs
• the child’s views about your access to their record has been sought and considered, and
• you agree to represent the child’s views and preferences and to using your personal myGov account to activate access.

A Nominated Representative is someone who has been invited–and given permission–to access another person’s My Health Record.

A child’s CSO–when they are the Authorised Representative for a child under 14 years of age–may invite the child’s carer to be a Nominated Representative for the child so that the carer can view or help manage the child’s My Health Record.

This will not occur for every child in care and the decision will be made on a case-by-case basis, depending on the child’s needs and circumstances. For example, it may be appropriate for a carer to be invited to be a Nominated Representative for a child’s My Health Record where the child has complex health needs and is in a stable long-term care arrangement.

There are 3 types of access for a Nominated Representative:

• general access, which enables the Nominated Representative to view most documents in the record, excepting any restricted documents, or
• restricted access, where they can view all documents including restricted ones, or
• full access, where they can view all documents and add information to the child’s My Health Record.

It is a requirement of the My Health Records Act 2012 for the Nominated Representative to act in accordance with the views and preferences of the record holder (the child in care).

Privacy considerations when viewing a child’s My Health Record

Your access as the child’s Nominated Representative is only provided so you can manage the child’s health care needs. Information in the record should not be used, or disclosed, for any other purpose.

Due to the strong legislation supporting My Health Records, harsh fines and penalties apply for inappropriate or unauthorised use of information in a child’s My Health Record. Civil fines can be up to $315,000, and criminal penalties up to 5 years’ jail time.

When you are no longer the child’s carer, you have no authority to access their My Health Record. Child Safety will remove your access.

How to access a record as a Nominated Representative

To access a child’s record as a Nominated Representative you must be willing to use your personal account that you have linked to the My Health Record system, but you do not need to have your own My Health Record.

After you’ve been provided with a personal access code (PAC), follow these steps to establish the link to the child’s record:

1. log in to the My Health Record system through your myGov
2. select ‘Create or access a My Health Record for someone else’
3. select ‘Enter a code to Access Someone Else’s My Health Record’
4. look for ‘Identity Verification Code’ or ‘Personal Access Code’ and enter the code you were given, along with the child’s surname and date of birth
5. after reading the ‘Participant Information’ section, tick the ‘I agree’ box and select the ‘Continue’ button.

You will now be able to access the record by selecting the child’s name from the My Health Record welcome screen.

Will a child’s address be secure if they have a My Health Record?

A child’s address is not displayed in the My Health Record system, however clinical records written by healthcare providers may include information about where the child is living.

To ensure the safety of a child subject to a Child Protection Order granting custody or guardianship to the Chief Executive, or the safety of the child’s carers or other persons, the My Health Record system allows a child’s CSO to take immediate action to secure a child’s My Health Record.

Where Child Safety has determined the parent/s are a significant risk to the child or another person, should they know where their child is living, and the child is under 14 years of age, the CSO can prevent the child’s parent/s from accessing their child’s My Health Record.

When a child turns 14 years old

The My Health Record system automatically provides for young people to take control of their own My Health Record when they are 14 years of age, should they choose to. The young person may need assistance to create a myGov account to manage their My Health Record, and this should be discussed with the child’s CSO.

As the record holder, the young person will need to be aware of the actions they can take to manage their My Health Record. They can decide to:

• continue or cancel their record
• invite Nominated Representatives to access their My Health Record
• set access and privacy controls.

The CSO will provide the young person with the information they require to safely and appropriately take control of their record when they are 14 years of age.