My Health Record has pulled a “confusing” software design flaw after inquiries by The New Daily, just days before the opt-out deadline that was twice pushed back over a privacy backlash.

The flaw was spotted by a former worker on the controversial e-health network, who said it could risk patient privacy.

Rachel De Sain, the former head of innovation and development at the Australian Digital Health Agency (ADHA), supports the “life-saving” My Health Record.

But the digital health strategist said poor design of external software could unnecessarily burden health workers and put patient privacy at risk.

She said a mistake could lead to negative headlines and risked the government “throwing the baby out with the bathwater” in election year.

Thursday is the deadline to opt out, before Australians are automatically signed up. About 6.45 million people are already enrolled while 1.147 million had opted out by October.

Finding the flaw

Ms De Sain had a routine blood test last week and watched as the pathologist entered information into the system.

She noticed a new button to block individual items from uploading to My Health Record and said the pathologist had not been informed or trained on how to use it.

Clicking the button merely changed its colour to a slightly different shade of blue.

“The visual design of the button made it difficult to tell whether clicking on or off gave consent or removed it,” Ms De Sain told The New Daily.

There are numerous external software systems that connect health care providers to My Health Record.

“[ADHA] has been made aware that the design of this particular function appears confusing to some users and, as a result, has contacted the vendor to review the presentation,” an ADHA spokesperson said after being alerted by The New Daily.

“The agency works very closely with the clinical software community to regularly release My Health Record system upgrades. Part of this work includes constantly reviewing and making improvements in partnership with vendors to the user interface of My Health Record.”

The blue button had been disabled by Tuesday morning.

Ms De Sain told The New Daily the design needed to be more user-friendly to minimise errors.

She said a simple change like making the button green to send information to My Health Record and red to stop it uploading could solve the issue, though that would cause problems for clinicians with colour blindness.

“This is not about blame, be it the Department of Health, the agency, software vendors or the clinical staff. It’s a complex rollout and things will take time to become normalised,” Ms De Sain said.

“But there is definitely an opportunity to identify where we can make improvements. Some of them really minor ones, like making a button green and red – that will make a difference.”

Ms De Sain was responsible for Australia’s digital health strategy in her former role at ADHA. She is CEO of codesain, a health strategy and innovation agency that advises public and private sector organisations.

ADHA said the patient’s consent to upload results is recorded by the GP in their local clinical information system and this is made clear on the pathology request form.

“It is clear to the pathology service that information should not be uploaded to My Health Record if that is an individual’s preference,” the ADHA statement said.

The track record

Some doctors have raised concerns that omissions in records could lead to inappropriate treatment in an emergency, by failing to list a patient’s medications or allergies.

That’s what led Independent Wentworth MP Dr Kerryn Phelps to question whether doctors could be liable if their patient suffers a mishap because of an incomplete My Health Record.

ADHA last week said 82 per cent of general practices and 84 per cent of pharmacies were connected.

One-quarter of public hospitals have not signed up, and some clinicians use paper or another system that isn’t connected.

The deadline to opt out was pushed back in November when the website crashed in a rush to opt out over privacy fears.

New laws came into effect last week strengthening patient data privacy.

Insurers and employers will not be able to access or request access to a My Health Record and law enforcement will need a warrant.

The reforms also strengthened protections for 14 to 17-year-olds and those at risk of domestic violence.

All information will now be deleted if a patient decides to quit.

The Australian Medical Association (AMA) supports the e-health system after campaigning for the strengthened privacy protections.

Consumers Health Forum of Australia also backs the reformed system.

Some privacy and health advocacy groups still hold concerns about data security.

The Office of the Australian Information Commissioner (OAIC) independently assesses ADHA’s privacy activities and has not made an adverse finding to date.