Sometimes You Just Have To Weep. This is One of Those Times.

The following appeared at 6minutes.com.au today.

Pseudonym identifier a bit Mickey Mouse

• By Michael Woodhead on 27 April 2011

Patients may now apply for an individual healthcare identifiers (IHI) as ‘Michael Mouse’ – or any other pseudonym – but they won’t be eligible for Medicare or PBS rebates.

Medicare Australia has released forms that allow anyone who has concerns about their privacy or safety to apply for an IHI in a fictitious name, so as to conceal their identity.

The IHI service is intended as a gateway to e-health schemes such as the Personally-Controlled E-Health Record (PCEHR) due to start operating in July next year.

People who wish to have an IHI but remain anonymous can select a fictitious first name and surname, and must also give a false date of birth, so long as it is within six months of their real date of birth.

More here:

http://www.6minutes.com.au/news/pseudonym-identifier-a-bit-mickey-mouse

The forms can be downloaded from the page found here:

http://www.medicareaustralia.gov.au/public/health-identifier/

The article and the form then have some really amazing revelations!

In the section Important things you should know about Pseudonym IHIs

1.You can only hold one Pseudonym IHI at a time.

2.You can choose to merge the Pseudonym IHI with the IHI in your real name at any time.

3. If you seek treatment using your Pseudonym IHI, you will not be able to claim benefits from Programs administered by Medicare Australia, such as Medicare and the PBS.

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So what this means is you can have a protected identity but no PBS or Medical Benefits for you or you can be identified and claim benefits.

This I do not believe was the intent of the Government. As I understood it the Pseudonym IHI was to allow you to be a ‘full citizen’ and be able to have a PCEHR and claim benefits - but just not to disclose your real name when accessing care. As it is reported and I read, to describe what they seem to have come up with as ‘Mickey Mouse’ really flatters the nit wits who have implemented all this.

What I suspect is an un-intended consequence of what has been done is that various records held by Medicare (PBS, Immunisation and Claims) will not be able to be linked to the ‘fake’ IHI and so will not be accessible while you are in anonymous mode.

It also seems that real IHI linked records will be held separate until you give up the Pseudonym IHI and then who knows what sort of information mess will flow. It is not clear if you can have a ‘live’ Pseudonym IHI as well as a verified IHI simultaneously. It is also not clear what IHI you would use to access the IHI and PCEHR portal (when the latter exists).

The bottom line is that the geniuses at Medicare and NEHTA need to go back to the drawing board and come up with a way to have anonymous care and a continuing link to a verified IHI and payments managed behind the scenes. That is what was intended for those who need to protect their identity and that is what should be delivered.

David.