The following appeared a few days ago.
Debate needed on patient records
Karen Dearne | August 04, 2009
CONSUMER groups frustrated by the slow pace on e-health are forming a coalition to pressure the federal government to release secret documents and engage in an open debate over plans for a national patient record-sharing system.
The Consumer-Centred E-Health Coalition is a response to "government secrecy and lack of consultation" launched by the Australian Privacy Foundation, the Public Interest Advocacy Centre, Cancer Voices and the University of NSW's Cyberspace Policy and Law Centre.
Their outrage was sparked by the narrow focus and limited opportunity to comment on the Healthcare Identifiers and Privacy discussion paper -- key components of a broad e-health rollout, says convener Juanita Fernando, chairwoman of the APF's health committee.
In particular, they are demanding the release of two Privacy Impact Assessments (PIAs) -- the first produced in 2006 and the second completed earlier this year -- to provide broader insight into the issues canvassed.
"The main issue is the lack of information," Dr Fernando said. "Despite years of work, millions of dollars spent and many consultations, including with consumer groups, most of the reports and findings have been set aside.
"Why are they hidden from public scrutiny? All government-held information and assessments of e-health implementations should be available to underpin public debate. Then we can finally start making progress towards implementing e-health."
With the $98 million Unique Healthcare Identifier program due to start next year, the discussion paper proposes quick fixes to overcome legal obstacles in the short term, while promising wider consultation down the track.
.....
Privacy fears allayed in moves to federal e-health
FEDERAL Privacy Commissioner Karen Curtis says individual healthcare identifiers could be assigned to Australians ahead of wider health privacy reform.
"My office notes that the issuing of IHIs by themselves does not create a national framework for an electronic health record; rather it is one of the building blocks towards that very important public policy initiative," Ms Curtis said.
"With appropriate safeguards in place, IHIs could be issued ahead of the broader reform."
Ms Curtis said national consistency in privacy laws was being considered by the federal government in response to the Australian Law Reform Commission's recent report.
Meanwhile, Ms Curtis's office was preparing a submission on the current identifiers discussion paper. "We would expect that the Australian Health Ministers Advisory Council will conduct a further comprehensive consultation prior to the introduction of an e-health record framework," she said.
Ms Curtis rejected concerns that consumers were being excluded and said government agencies were "encouraged" to undertake and publish privacy impact assessments.
More here:
http://www.australianit.news.com.au/story/0,24897,25876770-5013040,00.html
It was quickly followed by the following.
Secret report reveals e-health ID findings
Karen Dearne | August 04, 2009
INDIVIDUAL healthcare identifiers are likely to be seen as a new national identity number, sparking considerable community concern, according to an unpublished privacy impact assessment (PIA) conducted by Galexia in 2006.
"Apart from the Tax File Number and proposals for actual national ID cards - the Australia card in 1985-87 and the Health and Welfare Access card in 2005-06 - the IHI is the most significant proposal for a comprehensive national identification product," the consultancy firm warns in a document obtained by The Australian.
"In these circumstances, it is likely that the only way to manage community expectations is to consider strengthening the limits on the use of the IHI, by prohibiting its use outside the health sector in specific legislation."
The PIA, prepared for the National E-Health Transition Authority, is one of two such reports being sought by consumer advocates as they respond to a health ministers' discussion paper, Healthcare Identifiers and Privacy, which proposes an early start to an IHI rollout.
Galexia pointed to the legal obstacles prohibiting the use of Medicare numbers for other purposes, and warned of "significant privacy compliance hurdles" arising from the proposed use of Medicare's Consumer Directory Management System as a source for individual numbers.
.....
Federal Privacy Commissioner Karen Curtis yesterday told The Australian that individual identifiers could be assigned to Australians ahead of the broad health privacy reform recommended by the Australian Law Reform Commission and under federal government consideration.
Consumer and privacy advocates say there can be no progress on e-health adoption without resolution of the key privacy, consent, security and governance arrangements.
More here:
http://www.australianit.news.com.au/story/0,24897,25880888-15306,00.html
I have consistently been impressed with the command of the e-Health domain that has been demonstrated by the Federal Privacy Commissioner’s office under Ms Curtis’s leadership.
See here:
http://aushealthit.blogspot.com/2007/09/vale-access-card-dead-as-dodo.html
and here:
http://aushealthit.blogspot.com/2009/07/useful-and-interesting-health-it-news.html
and so I am quite curious to understand why she is not demanding access to all the relevant work undertaken by NEHTA and Department of Health as part of preparing her submission on the proposed legislation.
Even more I would like to also be able to see their assessments!
I have been a minor contributor to a submission from the Australian College of Health Informatics on the proposed legislation around the NEHTA IHI proposal and have made the point there, as in earlier blogs, that reviewing proposed legislation in an information vacuum is just a waste of time – or worse. This all has the feel of being asked to comment on shape and nature of an elephant by being shown a single tusk!
(Note you still have a day or so to make your own submission. Closes August 14. See here:
http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation)
I am really looking forward to what the Federal Privacy Commissioner has to say in her submission and I really hope it reveals she, at least, has had access to all the information she needed. For that not to have been so makes the consultation process a double travesty!
David.
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