Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, June 09, 2009

Latest on the Health-Card from the Australian.

I have just been alerted to this brand new article.

Govt denies records will be stored on Medicare card

Karen Dearne | June 09, 2009

A SPOKESWOMAN for federal Health Minister Nicola Roxon has rejected suggestions the Government is planning to put people's health records on the Medicare card, blaming misunderstanding and confusion in media reports.

But she failed to rule out plans for a central database of medical records - a controversial issue that is bound to resurrect the spectre of bureaucratic control over sensitive personal information that led to the defeat of the Howard government's health and welfare services Access Card regime.

Rather than patient records being loaded directly onto a computer chip embedded in each card, as indicated in news stories yesterday, the spokeswoman said Medicare cards would likely contain the unique personal identity numbers that give doctors and hospitals access to individual files stored centrally.

"The theory is that the card will provide access to a central database, but the details are yet to be worked out," the spokeswoman said. "Participation in the e-health record system will be voluntary, and the healthcare identifier will be made as secure as possible, so that medical records are kept secure."

Ms Roxon's remarks to a Courier-Mail journalist that "every Australian would be allocated a unique health identifier", most likely on a chip-card, resulted in a "misleading" reference to the use of Medicare cards for this purpose, the spokeswoman said.

But Ms Roxon expanded detail on her e-health vision in further interviews on Sky News and in AAP wire service reports.

According to Sky News, Ms Roxon said there should be "no privacy concerns over plans for the new medical card, which would be designed to store a patient's records on one computer chip". People could choose what procedures or tests were recorded on it, and nominate which health professionals were able to access the data.

Much more here:


I have to say this well researched article very neatly identifies the various inconsistencies on what has been said as well as providing good background to augment reader’s understanding of the context.

I think this really confirms Ms Roxon needs to clarify just what she is planning as I said in my post.

It is crucial to recognise that once the data on any EHR (or EHR Card) is potentially incomplete or out of date - as the Minister’s comments make clear can easily be the case – the value of the card is greatly diminished from a clinical perspective.

The full article is well worth a browse.



Anonymous said...

This is all so ridiculous, when it really should be so simple.

There is a role for a EHR, especially within each state health service. NSW has literally hundreds of systems that hold patient clinical data, not counting all of the systems that hold associated data like community care, etc. It only makes sense to aggregate or index these different data sources in some fashion before exposing that data out to patients, primary care providers, pharmacy, etc. This is what an EHR is designed to do. The most important role of an EHR is preventing adverse events and improving the quality of care.

There's also a role for a PHR, ie. a patient record controlled by the patient that can still have clinical data in it either fed from an EHR or from the thousands of primary care providers (most of whom are private organisations). The role of a PHR is to engage patients in their own health care, especially around managing their wellness or chronic diseases.

There is a role for a Smartcard or some other form of identity - why? Because we need to know that the patient seeking access to their record is who they say they are, and a health provider organisation seeking the first access can prove they have the patient's ok (which can be inferred from the patient handing over their card). But to store medical data on the smartcard is lunacy. (As an incidental remark, it typically costs $10 to issue and manage a FIPS compliant smart card, which on average need to replaced every 2 years due to damage, theft or loss. That's at least $100 million per year for Australia, and that's for a FIPS card which is relatively simple - not the kind of card being discussed which is more complex)

These are three totally distinct concepts. The Minister, NEHTA, NHHRC and DOHA seem to mix them up on a daily basis.

Dr David G More MB PhD said...

So right..thank you


Anonymous said...

Sitting at the top of the pyramid is the Minister who is in charge and responsible for overseeing all of this. Is it too much to hope that her media minders will have the fortitude and common sense to give her this blog and the above comment to read in full, not paraphrased. Perhaps, if her bureaucrats won't give it to her, someone in her electoral office who has her best interests at heart will do so.