But a spokeswoman for Health Minster Greg Hunt said the 90 per cent participation rate was "in line with expectation" and that "Australians can opt in and out at any time in their lives.” Labor has pledged to commission an independent Privacy Commissioner review of the My Health Record system if it wins the coming election. Health department bureaucrat Caroline Edwards told a Senate estimates hearing in Canberra on Wednesday the figure represented an opt-out rate of 9.9 per cent of Australians eligible for a Medicare card. Ms Edwards said My Health Records were being suspended by warring parents who could not agree on "what should happen to a record", with an "administrative process" being undertaken to determine who had authority to decide what should happen to their child's record. The process was established after domestic violence advocates raised concerns that a child's My Health Record could be used by a parent's violent ex-partner to track down their estranged family in hiding, potentially putting lives at risk.

Australian Digital Health Agency chief executive Tim Kelsey said the "aggregate figure" took account of anyone who had opted out of, or back into My Health Record, saying some people had reversed their earlier decision to opt-out after the Parliament legislated to address concerns with the system. For those people who had initially opted in, but later opted out and requested their digital medical records be permanently deleted - as allowed from January 24 under the new legislation - the agency would do so within 90 days. Mr Kelsey would not comment on how the opt-out rate compared with similar e-health systems overseas, saying there was "no other personally controlled electronic health system of this kind" anywhere else in the world. "There really isn't a comparison for a similar kind of opt-out rate in a similar scheme," he said. "Australia is leading the field."

Digital Health Agency chief operating officer Bettina McMahon said the notifiable data breaches reported by the agency to the Office of the Australian Information Commissioner concerned incorrect registration of My Health Records and fraudulent Medicare activity. Mr Kelsey said the agency was monitoring the progress of My Health Record and was "already beginning to see the benefits", citing reports that pharmacists and GPs in flood-ravaged Townsville were accessing the system to ensure that displaced patients were prescribed the right medications. Mr Kelsey noted that peak health bodies including the Australian Medical Association had supported the move from an opt-in to an opt-out model, in order to secure a high enough participation rate to make the My Health Record useful. AMA President Tony Bartone said while the e-health system would not be a "magic bullet", it would enable significant improvement to patient outcomes if empowered to its highest capability. "What we need is to ensure the quality of data is at its most optimum," Dr Bartone said.

"That requires time and investment." He said this must include completing the roll-out of hospital IT upgrades nationally, and improving software to enable patient data from discharge summaries to be more easily integrated with GPs' software systems. Ms Edwards said that the ADHA was working to fix an ongoing software comparability issue that was preventing hundreds of medical practices from uploading patient documents to the My Health Record system. She said the software bug affected a small minority of practices who had not updated their software since 2016, when a Microsoft bug had impacted on digital signatures. The agency started contacting the affected medical practices in December and advising them to upgrade their systems.