According to the system’s website, healthcare providers other than the Hospital Authority and Department of Health can only view and upload patients’ medical records with their consent.

The bureau said it would revise the eHR Ordinance to streamline the consent mechanism to help residents in “unlocking the flow of electronic health records from the private sector to their personalised electronic health records account”.

According to the paper submitted to Legco’s health services panel, proposed changes include streamlining the consent process and requiring service providers to store certain health data from consenting patients on their personal accounts.

Other options on the table are codifying patients’ uses and contributions to the system, as well as making the platform more portable and easier to handle.

“Record comprehensiveness, completeness, accessibility and portability in eHealth are of paramount importance,” the bureau wrote.

“To support the development, we need to refine the data collection, sharing and use mechanism and legal framework for the protection of data privacy and system security prescribed under the eHR Ordinance.”

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The eHealth system launched in March 2016 and allows public and private healthcare providers to share patients’ electronic records, with the latter’s permission.

Alongside the city’s 43 public hospitals and 330 public clinics, all 13 private hospitals and about 2,970 private healthcare institutions were registered to use the platform by the end of 2023, the bureau said.

The system also covers more than 12,500 doctors, 760 dentists, 875 traditional Chinese medicine practitioners, about 40,700 other professionals and around 5,400 service points.

The bureau said that 80 per cent of residents had registered for the scheme as of last year, producing more than 3.75 billion individual health records as of December 31.

“On the citizens’ side, the number of eHealth registrants soared almost fivefold from 1.2 million in 2019 to about 6 million in 2023,” it noted.

“This was largely attributed to the use of eHealth for the population-wide Covid-19 Vaccination Programme including vaccine administration and vaccination record, with eHealth registration incorporated into the booking and inoculation workflow.”

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Over the past three months, the number of times healthcare providers viewed patient records rose to more than 250,000 per month. The private sector accounted for over 60 per cent of that figure.

The bureau noted the information uploaded by private healthcare providers accounted for less than 1 per cent of all platform data.

“The limited contribution of the private sector to eHRs has become an obstacle to facilitating continuity of care,” it wrote.

The bureau said its proposed revamp would include introducing functions such as “eBooking”, “eIdentification”, “eImaging Report” and “Portable eHealth Record”.

The bureau estimated that the upgrade would cost close to HK$1.39 billion, citing a complex development process to ensure greater “functionality, security protection and reliability” than previous iterations.

“eHealth+ development will entail groundbreaking changes to the existing infrastructure in order to strengthen the technical capacity and capability in meeting the many new and revolutionary business needs,” it wrote.

“For example, the eHealth app will turn into a single-entry point for personal health management, government-subsidised programmes and access to cross-sectoral healthcare services.”

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Tim Pang Hung-cheong, a patients’ rights campaigner from the Society for Community Organisation, said some residents might not give their consent to have their data shared due to privacy concerns.

“They may be unsure how the system will protect their personal information or whether other healthcare institutions are able to access their data once they give consent. The government needs to explain its data protection mechanism clearly,” he said.

“Some patients may feel that their medical history is sensitive. For example, they may be immunocompromised, carriers of a certain disease or suffer from mental illnesses. They may not consent to share their information with private practitioners.”

But his group had been looking into the development of eHealth and observed the protection offered by the system was “sufficient”, he added.

He agreed with the government’s proposal to streamline the consent process, saying doing so could allow a smoother exchange of medical data between public and private institutions and enable residents to better understand their conditions.

He said most private healthcare providers might be reluctant to upload patients’ data as doing so would increase their workload and they would not want other institutions to be able to access information related to their treatments.

Alex Lam Chi-yau, chairman of concern group Hong Kong Patients’ Voices, also said not many private healthcare providers had asked for data sharing consent from patients.

“For example, a doctor may be operating a small private clinic by himself and he may not find it necessary to upload his patients’ records to the system,” he said. “The clinic may not have the capacity to upload the data due to its small scale and the work required for the action.”

While agreeing that authorities could require the private healthcare providers to input essential data into the system with patients’ permission, Lam urged caution in implementing the measure as it could mean sensitive information would be accessed by more parties.