The Australian government should follow the lead of the US and the EU by breaking down silos in digital health through legislation, argues the Australian Medical Association (AMA).

“Those of us who work in the public hospital system are constantly frustrated, certainly in Victoria, about the fact that various health record systems don’t easily interact with each other,” Julian Rait, MBBS, the vice president of the AMA, told Medscape News Australia.

An AMA report released at the end of January calls on the government to pass legislation that forces digital health software providers to share data with each other. “Without a nationally agreed regulatory framework with defined regulations and standards — re-enforced and mandated by legislation — the promised benefits of interoperability will never be realized,” the report stated.

Australia’s health software vendors have no legal obligation to share data with each other. This situation creates friction, additional work, and a risk for errors when patients move from one service provider to another, the AMA argued.

“There are instances where different departments within a hospital are using software which is incompatible with [that of] other departments,” stated the AMA report. “In an extreme example, clinical notes taken in the emergency department must be printed off and physically carried to other departments, including the intensive care unit , where these notes are then re-typed into the ICU software.”

Interoperability, the seamless flow of data between service providers, would facilitate faster healthcare delivery, reduce the duplication of work, create opportunities for research and improve data access for patients in rural and remote communities or those travelling between states, the AMA argued.

Progress Abroad and at Home

In 2016, the US enacted the 21st Century Cures Act, which prohibits information blocking: the unreasonable restriction of the exchange of health records. Similarly, the EU Data Act went into effect in September last year, establishing enforceable interoperability standards for the EU.

Australia should have penalties like those outlined in these Acts, and software vendors that don’t comply with interoperability standards should face fines, the removal from government contracts, and licensing restrictions, the AMA argued.

So far, the Australian government has been taking a gentler approach. Since 2023, it has worked on building interoperability standards through the Fast Healthcare Interoperability Resources (FHIR) program called Sparked. Within this program, the government has collaborated with the Commonwealth Scientific and Industrial Research Organization, the Australian Digital Health Agency (ADHA), and the not-for-profit Health Level Seven Australia (HL7).

Everyone in the room at Sparked meetings (including clinicians, regulators, engineers, and business analysts) is in “ferocious agreement that we should share healthcare information,” Grahame Grieve, HL7’s product director for the international FHIR upon which the Australian standards are based and a stakeholder in the Sparked program, told Medscape News Australia. But “there’s ferocious disagreement about almost every technical detail,” he said.

Sparked is now starting to produce and publish interoperability standards for Australia. Most of the software vendors “have long been on board” with adopting these standards, but a few “haven’t played ball,” said Grieve.

Expanding the My Health Record

Beginning in July, the federal government will require that all pathology and imaging providers upload data to the My Health Record, a repository for health information that is managed by the federal government.

This “share by default” policy could soon be expanded to cover medicines, and doctors could be ineligible for Medicare benefits if they fail to upload the required data to the My Health Record, Peter O’Halloran, the chief digital officer at the ADHA, told Medscape News Australia.

This policy would provide immediate financial incentives for data sharing, whereas overseas interoperability legislation often leaves governments chasing down infringements long after they occur, by which time the consumer has already lost out, said O’Halloran.

Usage of the My Health Record surged following the announcement of the “share by default” legislation. The numbers of weekly clinician views of pathology and diagnostic imaging reports increased roughly threefold to fourfold between May 2023 and August 2025.

As of January, around 3.9 million pathology reports and 370,000 diagnostic imaging reports were being uploaded each week to the My Health Record. These numbers represent a 70% and a 139% increase since May 2023, respectively.

Health professionals have shared around 2 billion documents to the My Health Record since its inception in 2012. Around 4 in 10 specialists have used the platform. “We’ve seen a dramatic increase in the adoption of My Health Record by both consumers and clinicians,” said O’Halloran.

Once healthcare providers are forced to upload to the My Health Record, software providers will quickly fall in line with the new expectations of their customers and align with interoperability standards, argued O’Halloran.

But the government’s focus on mandatory uploading to My Health Record is “deflecting the issue” and “a bit of a cop-out,” according to Rait. “The problem doesn’t lie with the doctors, it lies with the systems,” he said.

My Health Record “is a bit clunky” and “doesn’t really provide easy access to the full medical history,” said Rait. In emergencies, doctors don’t “have all day to search through a pile of PDFs inside the My Health Record to find the history. We think there needs to be much better interoperability between health record systems so that it's easier to see and find information quickly.”

In some hospitals, however, the My Health Record is fully integrated into existing practice software, Clair Sullivan, MBBS (Hons), MD, an endocrinologist and the director of the Digital Health Centre at University of Queensland in Brisbane, Australia, told Medscape News Australia. Thanks to this integration, Sullivan can easily locate not only a patient’s latest pathology report but also every test that has ever been uploaded to the My Health Record.

My Health Record puts patients in control of their own data, she added. “It empowers patients so they can see their results. They can track their results over time. They can also pick up things that we might miss.”

In an emergency, patients could use the 1800Medicare app on their phone to quickly bring up all their blood tests, prescriptions, and scans, said Sullivan. “That is an absolute, once-in-a-generation change in the way that health information is managed.”

The next step will be shifting My Health Record from PDFs to “fluid data” that can be aggregated and analyzed so we can learn from it, said Sullivan.

O’Halloran, Sullivan, and Rait reported having no relevant financial relationships. Grieve reported consulting for the Australian government and worked with the US government on FHIR.

Felicity Nelson is a freelance journalist based in Sydney, Australia.