[LINK] Govt denies records will be stored on Medicare card

Bernard Robertson-Dunn brd at iimetro.com.au
Wed Jun 10 09:21:52 EST 2009

Govt denies records will be stored on Medicare card
Karen Dearne
June 09, 2009
The Australian

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.

Medicare Australia has been developing a unique healthcare identifier 
scheme for patients, doctors and other medical providers since January 
2008 under a contract with the National E-Health Transition Authority, 
as part of its "building blocks" work on an Australian health 
information-sharing system.

Last December, Ms Roxon and her state counterparts agreed to adopt a 
National E-Health Strategy produced by Deloitte after extensive 
consultations with stakeholders.

Deloitte does not recommend the creation of a central database; instead 
it has designed a distributed repository system that brings together 
each patient's data from the various doctors, hospitals, pharmacists or 
diagnostic labs they have visited. Over time, the records will be 
expanded to form a full patient record.

But so far, Ms Roxon has refused to commit funding for implementation of 
a nationwide system, despite Deloitte's estimate that the necessary 
infrastructure would cost a modest $1.5 billion over five years, 
compared with the nation's total annual health spend of $90 billion.

The minister's spokeswoman told The Australian Ms Roxon was waiting for 
"another series of recommendations" to come from the National Health and 
Hospitals Reform Commission (NHHRC), which is due to report at the end 
of June.

But despite the spokeswoman's assurances that "e-health is very much a 
priority" for the NHHRC, the commission attracted strong criticism from 
medical and consumer groups for failing to mention health IT in its 
initial report, and ignoring the fundamental role for electronic systems 
in healthcare reform.

In what was seen as another misstep, a paper rushed out by the NHHRC in 
April urged the federal Government to mandate the use of 
"person-controlled" e-health record systems available from commercial 
software providers like Microsoft and Google rather than proceeding with 
the national strategy. Cost savings may be an issue, as under the new 
proposal patients would pay for their own e-health records.

Meanwhile, Ms Roxon might ponder the fate of the Coalition's planned 
HealthConnect system -- based on a Medicare smartcard launched with much 
fanfare by then health minister Tony Abbott late in 2004 and quietly 
scrapped by mid-2006.

More than $4.5 million was spent developing the smartcard, which 
featured a chip offering far greater data capacity than the magnetic 
strips still used on Medicare cards. The chip was intended to support a 
range of health-related applications, and include a PIN for user access 
to personal health records over the web or via kiosks in doctors' 
waiting rooms and Medicare offices.

Piloted in Tasmania, plans for a nationwide rollout were dropped when 
only one per cent of eligible Tasmanians expressed interest in 
registering for the card.

Then-Human Services minister Joe Hockey had another go at introducing a 
smartcard after Medicare became part of his portfolio; his $1.1 billion 
Access Card program was eventually rejected as a national identity 
scheme in the same vein as the long-discredited Australia Card.


Bernard Robertson-Dunn
Canberra Australia
brd at iimetro.com.au

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