Has the new online health system introduced by the federal government increased the domestic violence risk for already vulnerable families?
Women’s agencies have raised very serious safety questions with the federal government’s new online health service, My Health Record, saying domestic violence perpetrators can potentially access victims’ confidential health records.
This was disputed by the federal government.
Women’s Legal Service chief executive Angela Lynch doubted those who framed the online service had considered the situation of women experiencing domestic violence.
“There can be some quite catastrophic consequences if these concerns are not taken into account by policymakers,” Ms Lynch said.
She warned the service would be linked to the MyGov online service, which set out government welfare payments.
“It means that if an abusive partner has a victim’s log-in they can already get a range of details through that MyGov website,” Ms Lynch said. “The victim’s address, her Centrelink details and that sort of thing,” she said.
The Australian Institute of Health and Welfare’s February 2018 study into family and domestic violence in Australia reports one in six women experienced, since the age of 15, physical and/or sexual violence by a current or previous co-habiting partner.
Ms Lynch said anti-domestic violence groups were now impressing on women to change their MyGov log-in details as soon as they left an abusive relationship.
A My Health Record media spokesman said an individual can only access another person’s My Health Record if they are appointed by the individual as a “nominated representative”, where they can view the information, or an “authorised representative” where they can control the information.
However, women’s agencies say this situation does not consider the real extent of controlling behaviour by some men in domestic violence situations.
Ms Lynch said the situation put great pressure on local doctors and called for policymakers to consult immediately with domestic violence groups.
“We know that some of the greatest disclosures around domestic violence are actually made to GPs. Women trust their GPs to disclose this information,” she said.
Queensland’s Minister for Women and Child Safety Di Farmer said she was concerned to hear of the potential for increasing domestic violence risk.
“It is vitally important that no sensitive health information, or any information that can identify the whereabouts of victims of family or domestic violence, gets into the wrong hands,” Ms Farmer said.
“If the potential for inappropriate access to sensitive information has been identified, the federal government must take all necessary action to ensure any weak points in the system are strengthened as a matter of the highest priority.”
Domestic Violence Risk in Online Health System in the UK
Australia is not the first country to introduce an online health record system. In the UK, NHS England wants to give all patients online access to their GP medical records. On the surface, this may seem like a good idea. NHS England says the public will be more informed and have more control over their healthcare. They say this will lead to better outcomes for patients and greater efficiency for GP practices.
Online services already exist allowing patients to order prescriptions, book appointments, view some test results and see a summary of their health records.
The final step is to allow patients to see exactly what their GP has written about them. But little consideration has been given to the potential unintended consequences of online access to what the GP has written. Most concerning is the risk that vulnerable patients may be coerced into giving away their login details to abusive relatives, increasing the domestic violence risk.
Many abusers gain access to and control their partner’s mobile phones and email accounts. It is not a huge leap to assume abusers will be able to access their partner’s and children’s online records. This is worrying as GPs are often the first professional victims of abuse will confide in. As a result, victims might stop reporting domestic violence to their GP, reducing their opportunities to get help. Or the abuser may discover the disclosure, putting both the victim and their children at risk.
In a recent study, GPs were interviewed about how and why they record information in families affected by domestic abuse. The GPs described struggling to know what to write because they were trying to balance conflicting demands. These included needing to make a full legal record of the abuse, reminding themselves about the abuse their patient had endured, and sharing information about the abuse with other professionals to reduce harm for the victim and their children. No one discussed recording information to empower patients. Many GPs were concerned that online access might allow the abuser to see what they had written, making the situation worse.