The Privacy Foundation Is Not Happy With Government Regarding The PCEHR. Others Also Have Concerns.

This has been released very recently.

http://www.privacy.org.au/

3 November 2013

Public Statement: PCEHR

The Australian Privacy Foundation (APF) notes that large numbers of practitioners are signing up for the Practice Incentives Program (PIP), which is tied to the Personally Controlled Electronic Health Record (PCEHR).1

The APF further notes that very few of those practitioners are populating their patients' PCEHRs.2-3

The APF also observes that numbers of patients are signing up for the PCEHR, which is tied to the plethora of assisted registration services that do not explain governance or safety issues. Very few of the patients have initiated the population of PCEHRs post their assisted registration. 4-5

This is good for bureaucrats in two ways:

1. it inflates the apparent take-up rate for the PCEHR

2. it enables the exploitation of individuals' personal health-care data for administrative purposes.6

But the multi-millions poured into the PCEHR project are delivering very little indeed in the way of positive outcomes for patients or clinicians.4

The APF and others argued, over many years, that the design of the PCEHR disclosed that the motivations were administrative, not health care. The cynical behaviour described above reaffirms what APF argued.

It is deplorable, both because of the waste of vast sums of taxpayer money on administrative convenience, and because of the exploitation of personal data for the benefit of public servants, not patients.

References

1. http://www.medicareaustralia.gov.au/provider/incentives/pip/

2. Australian Medical Association. E-health records in need of urgent help: GPs, 21/10/13

https://ama.com.au/node/13019

3. Australian Medical Association. AMA Puts flawed PCEHR on the mend. 22/10/13

http://aushealthit.blogspot.com.au/

4. McDonald, K. DOHA rejects claims patients “inveigled” into PCEHR sign-up. Pulse IT,

http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1563:doha-rejects-claimspatients-inveigled-into-pcehr-sign-up&catid=16:australian-ehealth&Itemid=327

5. McDonald, K. DOHA rejects claims patients “inveigled” into PCEHR sign-up. Pulse IT,

http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1563:doha-rejects-claimspatients-inveigled-into-pcehr-sign-up&catid=16:australian-ehealth&Itemid=327

6. Kruys, E. The PCEHR moving forward. 23/09/13. http://doctorsbag.wordpress.com/2013/09/23/the-pcehr-movingforward/

Last week we also had this appear.

Australia: Update on Personally Controlled Electronic Health Records - legal and privacy issues

Last Updated: 28 October 2013

Holman Webb

By Alison Choy Flannigan

As part of the 2010/11 Federal budget, the Government announced a $466.7 million investment over two years for a national Personally Controlled Electronic Health Record (PCEHR) system for all Australians who choose to register on-line, from 2012-2013. This initiative has the potential to be a revolutionary step for Australian health care, in terms of both consumer's access to their own health information and improvement in information which will be available to health professionals when they treat a patient.

Lots omitted  here:

There are a number of medico-legal and privacy issues which arise with the PCEHR. Some of these are summarised below:

Medico-legal

• If a medical practitioner consults with a patient and is negligent in entering information onto the PCEHR, there are more clinicians relying upon it, so the potential for liability from a negligent assessment of a patient or negligently prepared medical record increases.
• Health professionals must be mindful that the PCEHR is not a complete medical record and must continue to be vigilant in continuing to obtain independent information from patients. Information may be excluded from the PCEHR at the request of a patient and missing information is unlikely to be flagged.
• If a medical practitioner has relied upon information on the PCEHR which is incorrect, then the medical practitioner will need to track the author of the original information to join as a cross-defendant.
• If a patient instructs a medical practitioner not to include information on the PCEHR then the medical practitioner will be under an obligation to inform the patient the risks and consequences of this.
• Direct access to a medical record may be denied if providing access would pose a serious threat to the life or health of any individual. In those cases, the patient is usually provided access through another medical practitioner. If consumer access requests are dealt with centrally, measures should be implemented to ensure that a clinical assessment is made in relation to whether or not a patient's request for access or information could pose a serious threat to the life or health of any individual. Arguably such information should not be included in the PCEHR.
• Often a request for access can be an indicator of a potential claim which can be resolved quickly by the clinician by early discussions with the patients. There should be a mechanism so that relevant clinicians are informed if there is a potential claim early.

Privacy issues

There are also a number of privacy issues, including:

• Obtaining adequate privacy consent from patients;
• Ensuring that the systems can accurately implement the consent options of patients, such as limiting access or prohibiting access to the PCEHR to health professionals nominated by patients.
• Ensuring that only information which is required to provide treatment for the patient is collected.
• Privacy issues if the system involves a number of system vendors and subcontractors or cloud computing.
• Uniformity of the usage of medical terms and abbreviations and clear handwriting is preferred to protect data quality.
• Clear understanding of the information flows and potential for leakage of personal health information to unapproved persons or overseas.
• Data security issues.
• Patient and participating health professional identification and verification issues.
• Education and training of participating health professionals.

Full article here:

http://www.mondaq.com/australia/x/271206/data+protection/Update+on+Personally+Controlled+Electronic+Health+Records+legal+and+privacy+issues

There are some really good issues for the enquiry into the PCEHR to sort out here!

David.