However, despite the emphasis on promoting participation, a decade on and only about six million Australians had registered for the EHR program, out of a population of 25 million.
A change in the national government led to changes to the scheme, including rebranding as My Health Record, a new sponsoring agency (the Digital Health Agency) and, most importantly, a change from user opt-in to opt-out. This is where the project started to encounter serious difficulties: the public had not been properly prepared for this shift, and was mistrustful of the EHR program, despite patient organizations and many HCPs promoting the potential benefits.
The big concern was privacy. The governing legislation – developed when My Health Record was an opt-in model – was relatively lax about releasing information, however this was no longer appropriate for a more wide-ranging opt-out-only public EHR, and attracted criticism from the public, HCPs and their organizations. Healthcare professionals also cautioned against private health insurers having access to My Health Record data. The privacy settings of the record were difficult to navigate for end users, and there were concerns over how easy the records would be to hack, further weakening support.