Research Release: CHIME-GP Reports

Between 2018 and 2021 the Agency led several coordinated research activities and pilot programs in clinical settings across Australia as part of the first National Digital Health Strategy and the Agency’s commitment to driving innovation (as outlined in the Framework for Action).

The research focused on identifying use and uptake of My Health Record, as well as pain points in healthcare settings and digital health as an underpinning for improving health outcomes.

The Clinical and Healthcare Improvement through My Health Record Usage and Education in General Practice (CHIME-GP) study directly investigated the link between My Health Record and real-world benefits.

The study, delivered by Medcast Pty Ltd in an Australian general practice setting, focused on an education intervention for rational prescribing and investigation ordering. The intervention delivered training on how general practitioners (GPs) could use My Health Record to assist with decision-making, through assessing whether it was necessary to order additional diagnostic tests or prescribe certain medicines. It investigated whether GPs doing the intervention led to reductions in health service utilisation and costs in the context of use of a national digital health record system (i.e. My Health Record).

Phase one of the study (conducted between February and November 2018) was a pilot where the educational intervention was developed and tested by a small group of participants. While limited in its approach, the pilot generated promising suggestive results. Most notably, the educational intervention was broadly acceptable to target end users (GPs). There was also potential reduction in government expenditure on healthcare related to deprescribing, requesting fewer diagnostic tests and reduction in medication-related complications and side effects.

Phase two of the CHIME-GP study (which took place between June 2019 and October 2021) leveraged learnings from the first and used a more robust methodology on a larger scale. The collaborative study with the University of Wollongong identified key research insights, including: 

• Online education for using My Health Record to reduce unnecessary pathology tests has promising positive impacts on cost-saving, particularly if intervention effects can be scaled.
• A "halo effect" – where education about reducing one type of unnecessary procedure also impacted other types of procedures – was apparent, particularly between pathology and imaging.
• The online modality of this educational intervention supports scaling up.

The Agency has undertaken a concerted education effort including producing and delivering eLearning modules, webinars, podcasts, train the trainer sessions, virtual classroom sessions and pre-recorded videos that have reached approximately 40,000 healthcare professionals. 

These activities along with others are used to drive consumer engagement, and the impact that COVID-19 has had on the use of digitally enabled care can be seen across the health landscape and in the use of My Health Record, as seen in the latest statistics. 

Highlights are:

• Among healthcare providers, public hospitals are the most prolific in viewing of My Health Record documents, recording a 160% increase over the past financial year. GP viewing was up 119%. 
• In the 2021–22 financial year, 74% more pathology reports were uploaded than in the previous year, and pharmacies uploaded 85 million dispense records – a 38% increase on the previous year. 
• Demonstrating a "network effect" across the health system, cross-organisation activity last financial year saw the number of documents viewed and uploaded by other organisations increase by 119%.  Even specialists – traditionally less engaged with My Health Record – increased document views uploaded by other organisations by 458% over the same period.
• Consumer access to the system is on average 50% of the time on a mobile device and during key holiday periods as high as 75%. 
• Consumer views of the record increased 292% since June last year - with 76 million documents looked at compared with 19 million the previous year. Consolidated immunisation views increased by more than 1,066% for the same period.
• Going forward, the Agency will continue to identify and provide user-friendly digital tools that help connect the healthcare system to improve health outcomes for all Australians. 

We note that no My Health Record data was analysed as part of this research study – only data from GPs’ clinical information systems was analysed at an aggregate level in order to draw conclusions on behaviour change following undertaking the educational intervention.

External publications

Protocol paper:
Bonney, A., Metusela, C., Mullan, J., Barnett, S., Rhee, J., Kobel, C., & Batterham, M. (2021). Clinical and healthcare improvement through My Health Record usage and education in general practice (CHIME-GP): a study protocol for a cluster-randomised controlled trial. Trials, 22(1), 1-15. https://link.springer.com/article/10.1186/s13063-021-05438-8