Sunday, October 25, 2015

I Wonder Do Consumers Know Just What Nonsense About e-Health Is Being Spoken In Their Name?

This appeared during the week:
Media release
Tuesday 20 October, 2015

 eHealth can deliver better health, and protect privacy

An effective national eHealth system would deliver significant benefits to patients and taxpayers and it would be concerning if solvable concerns over privacy created unnecessary hurdles to the full development of eHealth, the Consumers Health Forum (CHF) says.
Parliament’s Joint Committee on Human Rights has raised concerns about “limitations” to the right to privacy under the Government’s proposed change to an “opt out” system.  The opt out change would ensure all Australians were automatically included in national electronic patient records system unless they requested not to be part of the system.
Currently the eHealth system is based on an opt-in approach under which individuals have to take active steps to sign on to the system.  “The result has been lacklustre, with only about 10 per cent of Australians joining over the past three years ” says CHF Chief Executive Officer, Leanne Wells.
“We would be concerned if the new MyHealth Record project was weighed down over concerns with privacy of the kind raised by the Committee in such a way as to hinder progress of this long-awaited reform..
“”Patient and system benefits far outweigh privacy concerns although that is not to say that patient privacy does not need active management safeguards.  The choice to opt out of the scheme would remain available for people who have privacy concerns.
“The Consumers Health Forum has strongly supported an opt out approach, with rigorous privacy and security safeguards, because we believe a population-wide eHealth system will deliver substantial advantages to patient care and a cost effective health system.
“It is remarkable that the health system so often remains blinkered by 20th Century paper-based communications.  In an era when much of everyday life is assisted by information technology, the health system which itself is so dependent on accessible, accurate and speedy information, is still often depending on insecure and inefficient faxes.
“Australia needs to move to population-wide eHealth so that everybody can benefit from fewer mistakes, less duplication of tests and scans and a vastly improved, de-identified population health information system that can reveal the strengths and weaknesses of the system and guide better treatments and consumer knowledge.
“Experience in countries like the United Kingdom and New Zealand has found that an opt-out approach has been well-received.  It’s time for Australia to move on,” Ms Well said.
The Consumers Health Forum has written to the chairman of the Joint Committee on Human Rights, Mr Philip Ruddock, expressing its concerns about the report which can be found at: http://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Human_Rights/Completed_inquiries/2015/Twenty-ninth_Report_of_the_44th_Parliament
ENDS
The release will be found at their website - when they actually put it on their site.
This is a classic example of the ‘magical thinking’ we see from non-technically sophisticated organisations who seem, for reasons that are not clear, to take the view that ‘more ehealth is good’ and less ehealth is bad!
First - take this paragraph:
“It is remarkable that the health system so often remains blinkered by 20th Century paper-based communications.  In an era when much of everyday life is assisted by information technology, the health system which itself is so dependent on accessible, accurate and speedy information, is still often depending on insecure and inefficient faxes.
I assume this means that their view is that most GPs are running their practices on paper and are not using electronic communications to and from pathology and radiology providers. That is just plain wrong for most! They just have zilch interest by and large in the flawed PCEHR
Second - take this paragraph:
“Australia needs to move to population-wide eHealth so that everybody can benefit from fewer mistakes, less duplication of tests and scans and a vastly improved, de-identified population health information system that can reveal the strengths and weaknesses of the system and guide better treatments and consumer knowledge.
All this requires GPs with even more improved quality systems - not a secondary PCEHR. Worse, of course we see the Government agenda (the CHF gets lot of government funding)  and of course what is wanted by the CHF is a huge data-base to mine.
Third the CHF would do well to investigate the fate of the care.data system in the UK. Given it was opt-out and public concerns had it deferred / shut down maybe it is not time to ‘move-on’.
Fourth just what justifies the CHF trying to just shut down discussion when even the Labor inventors of the PCEHR plan a Senate enquiry to look at the matters raised by the Committee.
There are a lot of people who have health information privacy concerns and just imagining that DoH will address the complex issues raised by the Committee to everyone’s satisfaction is fantasy - on the basis of their track record to date.
The PCEHR is a system which lacks evidence for both clinical utility, value and safety and was ill conceived. With opt-out there is also a significant risk it will become even more privacy invasive. Until clear and valid responses to all the concerns raised by the HR Committee are made available and seen to be reasonable, the evidence free assertions of the CHF are frankly just insulting.
David.

3 comments:

Anonymous said...

David - it is my belief that GP's have been trying to get away from the tyranny that is the fax...but DHS still requires faxes to be used for a range of communications with various parts of DHS - including confirming eligibility for the last ePIP!

Dr David More MB PhD FACHI said...

Typical opinionated comments from the CHF. Thanks for that!

David

Bernard Robertson-Dunn said...

Who will need a doctor?
http://dilbert.com/strip/2015-10-25