Sunday, February 09, 2014

The Symptoms Of Poor Governance In The E-Health Domain Just Keep Emerging. Really Needs To Be Fixed In The PCEHR Review.

There was a very interesting talk on the ABC’s Health Report last Monday,
Here is the home page of the talk with links (lasts about 8 mins).

Privacy in health care

Direct link to audio download.
Monday 3 February 2014 5:49PM

John Glover argues privacy restrictions are keeping important information from researchers

Some would argue that the whole issue of privacy has been taken too far – denying health researchers and planners the kind of information they need to deliver the right care at the right time and at the right price to the community. 
And while that information does not need to breach privacy – according to a leading public health researcher - it is being kept away from those who need it most.

Guests

John Glover : Director of the Public Health Information Development Unit, University of Adelaide

Credits

Presenter: Dr Norman Swan
Producer : Katie Silver
Here is the link to the page:
The essence of what was said was that for an unknown reason access to vital data-sets from Medicare which are used  for examining health issue distribution and disease trends was being made progressively inaccessible to legitimate researchers for no apparent reason - the trend being odder as in the past there had been much easier access provided.
Additionally - because of years of experience with no privacy issues of any sort arising - there seems no obvious reason for problems.
Even worse there seems to be no effective external arbiter to make sure Medicare and DoH are behaving reasonably.
This is a really nice example of two things:
1. Just how unaccountable the bureaucrats can be.
2. How we lack proper information governance for health information and how it is used.
Interestingly I am also hearing of another example where lack of governance is really causing issues - and this is related to how drug information is sorted and presented to clinicians on their prescribing screens. Many experts say what is presently being done is unsafe but the bureaucrats are not listening and worse it seems that there is no one to appeal to (ombudsmen, regulators etc.) to get a proper technical review.
Amazingly we also has this appear:

Chemists plan health checks

  • SUE DUNLEVY
  • NT News
  • February 07, 2014 11:00PM
PHARMACISTS will become fat cops under a plan to measure the weight, blood pressure, blood sugar and cholesterol of all Australians once a year.
A leaked Department of Health document shows chemists plan to start the health checks in October so 1.5 million Australians can have their waistlines measured by Christmas.
The findings would be uploaded to a national Health Census and added to a patient's e-health record.
Chemists would also ask people about their smoking and alcohol intake under the Pharmacy Guild's plan to develop an early-warning plan for diseases it says will save the Government money.
The Pharmacy Guild has detailed the plan in a confidential policy proposal before the Government.
The plan says up to 60 per cent of people with pre-diabetes could be prevented from progressing.
Chemists would be paid $50 for each 30-minute consultation and the initial program would cost the Government $75 million.
More here:
So now we are to have pharmacists upload health check data to the PCEHR and be charging $50 for a 30-minute consult! This has all the flavour of something (pushed by the Pharmacy Guild as a money spinner) that will never happen to me - but should it come to pass, the information governance, privacy and consent issues would be more than complicated
What is needed in all these cases is a proper e-Health governance entity with the skills and authority  to manage issues like this.
Maybe it might just come from the PCEHR Review or am I dreaming!
David.

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