In the past two years, the default for health data quietly flipped from “ask first” to “share unless you object” – in the United States through regulatory increments, and in Australia on a single legislated date. This piece traces who actually made that decision, what the evidence really says about immediate test-result release, and which objections still stand.
If you are weighing a My Health Record opt out for yourself or advising patients on one, the defaults quietly changed on 1 July – and knowing what is now shared automatically is the first step. Health services wanting to get ahead of these changes can start with the Digital Health Readiness Index.

