Sunday, May 10, 2015

A Random Thought On What The Government Is Up To On The PCEHR?

Is it possible, with new governance, shutting NEHTA, trials and legislation to get passed etc. that the Government is thinking $125M per year is cheap to get this thing off our back into the very vague future?

After all the funds are little more than a rounding error in the Health Budget.

It might drag on into a pitiful fizzle after the next election no matter who wins.

Views and Comments?



Anonymous said...

It's all about ditching NEHTA in response to the slick talk of some major vendors and consulting organisations positioning to drag more revenue out of the Government's coffers whilst selling the pitch they can help the government avoid political embarrassment. The bureaucrats are sold on the thought there's plenty of work for them and they sell the idea to the Minister and all the while they continue living in hope for another 4 years or more sucking up the oxygen wherever they find it.

Bernard Robertson-Dunn said...

For those with long memories that go back as far as the Australia Card and the Human Services Access Card (a badly thought through initiative of guess who? Joe Hockey), when it looks like a National ID system, walks like a National ID system, sounds like a National ID system, apathy turns into vehement opposition.

Making the health record opt-out will create far more problems for the government (this government, and Sussan Ley specifically) than they currently have with a system that nobody wants.

Everybody's ehealth record number will be a defacto National ID. Not everybody has a tax file number, a medicare number or any other form of ID. Everybody will have a health record, probably allocated at birth. Even if some people opt-out, there will probably be a health record for them, just not visible to them.

Traditionally Australians have not trusted federal governments when it comes to National ID schemes. I don't think that this government is perceived as trustworthy enough to sell it to an already skeptical population.

I don't think the politicians, their advisors or the public servants understand what they are getting themselves into.

Anonymous said...

Yes it will be interesting to see the reaction. I for one could ignore a system that didnt contain any useful information and was not used. But if its opt out, it requires me to respond..with the question do I trust government, the public sector managers and vendors and consultants with my health data - this includes not to have it breached misused or sold out the back - to the denial of everyone.

The answer is simple NO i dont.

Anonymous said...

This is urgent, does anyone know where I can opt out now!!!

Karen Dearne said...

Bernard is correct. The move to opt-in was seen by politicians as a way to get around all the tricky identity, privacy and consent issues.

Even worse, the health record is only accessible to citizens via a single entry point, a mygov account which links to all public service agencies, and which may soon also be extended to state govt departments.

In many ways, I think creating a national ID system has always been a higher priority for govts than providing a better health system for users.

Medicare is the only govt agency utilised by all citizens.

In any event, it is complete madness to think they can create and operate a universal system when they are totally overwhelmed by the minute number already involved...

There will be a long battle ahead to get a safe and useful outcome in this space, and I wouldn't be starting with the PCEHR

Anonymous said...

If it adds any value, I agree that is about "[dragging] more revenue out of the Government's coffers", as indicated by Anon at May 10, 2015 8:41 PM. At about $120 million a year, and last years budget allocated $140 million which nobody can really see (probably just for 'maintenance' - ongoing employment and profiteering). Certainly none of that money 'trickled down' to the Medicare Local Officer's who should be helping in supporting it in the field. (Even if it were futile.) I wonder how many resources the PHN's will get to assist their spreadsheet jockeys in their eHealth benchmarks? Sorry I mean functions?

Anonymous said...

Here is an interesting question - will opt out be like deleting your facebook account? IE you delete your access to it but Facebook doesnt delete the data - and still monitises it.

Mayan said...

Could you point us to the website with opt-out information?

Prediction: there will be a market for doctors who keep their records on paper.

Karen Dearne said...

Interesting point, Mayan. This is where the PCEHR stuff is now hidden..

Here is the Dept of Human Services privacy policy, and what data they collect

This is information about the Healthcare Identifiers already issued to every Australian

This is where to sign up for a mygov account to access your PCEHR (you used to be able to sign up just for Medicare Online)

Here is the mygov privacy policy

and the mygov security policy (read this one carefully - you have to do most of it yourself)

Oh, and the mygov terms of use. These will terrify

3. Our Responsibilities
3.1 General

The department will take reasonable care in providing information and services through the myGov website. However, the department does not warrant that you will have continuous access to myGov, nor does it accept liability for any loss, damage, cost or expense (to any person or property) including consequential or indirect loss or any loss of profits, data or revenue that could arise as a result of your use of myGov or a DHS Member Service or your inability to access myGov or a DHS Member Service.
The department makes no representation that the material on any Other Agency or Approved Digital Mailbox website is accurate, complete, current or does not infringe the intellectual property rights or any other rights of any person. The department does not authorise or accept responsibility for the reproduction of any material on myGov or Other Agency or Approved Digital Mailbox website.
Return to top
3.2 Security

The department has responsibilities relating to the security of your myGov account information and will use all reasonable endeavours to meet these responsibilities.
Your myGov account information can only be accessed by department officers who are authorised to access this information. All access by the department to myGov is audited and monitored by the department and officers are trained on a regular basis about their privacy obligations.
The department will use all reasonable endeavours to ensure that your information is accurately recorded and not corrupted or changed. For more information please see our security statement.
The department is responsible for:
the security of information while it is collected by, stored on or passing through the myGov systems; and
the security of the links from the departments systems to systems under the control of Other Agencies.
Other Agencies are responsible for the security of information while it is collected by, stored on or passing through systems within their control.

Anonymous said...

I would love to know how they plan to inform the entire population that they HAVE a record and how they can opt-out of the system. I shall be first in the queue.
The original system wasn't designed to cope with a record for each individual for those who remember back all those years ago to something called a ConOps - so a massive redesign has to be on the cards.
This was as well as Karen's comments re the identity/privacy/security issues. An individual had to consent to their record being created by a GP in the system as designed at the moment and to what information can be uploaded.
The government are treading on dangerous ground if they plan to remove that right, they have a lot more explaining to do to those of us with concerns about the security and confidentiality of our health information.

Karen Dearne said...

Another issue is that while the govt may be able to force citizens into having a PCEHR, there is no real way to similarly compel medical providers...

Except perhaps by withholding funds for organisations and individual practitioners who don't comply

Bernard Robertson-Dunn said...

As David has already pointed out, $125/yr is nothing, especially when you look at what is required to change the design from Personally Controlled, opt-in to Government Controlled (for the unaware majority) opt-out.

There are some very big gaps in what we are being told. Either because they haven't thought it through, or they just haven't got round to fixing up their communications strategy.

My guess is the former.

Anonymous said...

If each of us is forced to have a PCEHR, then what will be the default access to my record? Will discharge summaries, health summaries, medication details and Medicare data be automatically loaded into my record, and then be accessible by any health care provider in Australia (if I do nothing to personally control access to my record)?
For example, if I go to my local pharmacy to have a script dispensed, can the pharmacist see why I was in hospital last month? Or my Advance Care Directive? Can my GP see that I saw a different GP last week (to get another opinion or for another matter)?
Currently, you can choose an option which effectively hides the fact that you have a record. I am guessing that will no longer be an option if everyone has a record.
But will a GP be able to see that their patient has opted out of having a PCEHR?
How will young adults be set up - automatically with their parents having access to control their record? What will happen if a parent opts a child out, but the child later decides to revoke the opt-out decision?
Too many questions! But surely they have thought of these issues already...

Anonymous said...

"My guess is the former."


That's been the problem with this from the start - the majority of things haven't been thought through properly. No real structured analysis.