[LINK] Roxon revives smartcard plan

Bernard Robertson-Dunn brd at iimetro.com.au
Tue Jun 16 09:47:11 EST 2009

This smartcard plan is nothing like the access card project, so I don't 
know why they are using the term "revives".

I suppose it's because both have a chip. Watch for all the FUD about to 
fly around.

Roxon revives smartcard plan
Karen Dearne
June 16, 2009
The Australian

A NEW Medicare smartcard is on the agenda, as policy makers grapple with 
ways to give doctors and nurses secure access to patient information 
held electronically in either a centralised database or local and 
regional systems.

Federal Health Minister Nicola Roxon has indicated that a smartcard -- a 
plastic card containing a tiny chip -- will soon replace the old 
magstripe Medicare card, to support the shift to widespread availability 
of e-health records.

The card will hold individual healthcare identifiers -- a unique number 
that will be issued to all Australians -- so that each person's records 
can be correctly identified and linked.

But the costs for what will inevitably be a large-scale project are yet 
to be confirmed.

All healthcare providers will need new card readers, as well as access 
to a secure internet messaging system linking doctors' rooms, public and 
private hospitals, specialist and community clinics, pathology and 
radiology labs and even the aged-care sector.

According to the National E-Health Strategy, the identifier program will 
cost about $400million over 10 years, while the associated 
authentication services and standards work will cost a further $360m.

The strategy, developed by Deloitte and adopted by the Australian Health 
Ministers Conference last year, forecasts a total $2.6 billion spend on 
new e-health services over the next 10 years, but says tangible benefits 
to patients and cost-savings would be about $5.7bn in current dollars.

Human Services Minister Chris Bowen will have to navigate the sensitive 
policy issues yet to be resolved without sparking the uproar that 
defeated the plan by Coalition human services minister Joe Hockey for a 
single health and welfare access card that many believed would become a 
de-facto national identity card.

Mr Hockey had picked up the original Medicare smartcard project, 
launched by then health minister Tony Abbott in 2004, and abandoned just 
two years later.

Trialled in Tasmania, the $4.5m Medicare smartcard attracted little 
interest, with only 1 per cent of eligible Tasmanians willing to 
register for it.

The high costs of enrolling individuals, issuing cards and providing 
technical support also proved to be a big factor in the demise of the 
access card. According to KPMG, these requirements accounted for the 
bulk of the expected $1.1bn spend.

Although Ms Roxon has said participation in e-health records schemes 
would be voluntary, the suggestion the identifier would be placed on the 
Medicare card rang alarm bells over consent issues and possible 
"function creep".

Australian Privacy Foundation health spokeswoman Juanita Fernando has 
already called on Ms Roxon to clarify whether the smartcard "is not 
simply a redesigned Australia Card".

A spokeswoman for the National E-Health Transition Authority, which has 
contracted with Medicare to develop the universal health identifiers 
(UHIs), said "more detailed design information would be made available 
for public discussion" later this year.

"Australia's health ministers requested public consultation when they 
announced in March that there would be an allocated health 
identification number," she said.

Meanwhile, the agreed National Smartcard Framework, released by the 
Australian Government Information Management Office last December, 
points to the likely direction of the present Medicare project.

"The limited memory capacity of even the most sophisticated smartcards 
means they are not able to store a great deal of healthcare-related 
information," the framework says.

"In any case, the dynamic and decentralised nature of longitudinal 
personal health information means most shared e-health record 
architectures today do not envisage using smartcards as more than 
security keys to access data."

But there would be room for consumer eligibility for services and 
entitlements, as well as emergency data such as medical condition 
alerts, prescriptions and allergies.

It recommends smartcards with on-chip capabilities for the generation of 
public key infrastructure keys and digital signatures for e-health and 
professional use.

Such systems are already being developed as part of the National 
Authentication Service for Health, or NASH, which will have 
responsibility for registering and certifying healthcare providers.

The work on NASH is being undertaken by NEHTA, which will also have 
responsibility for operating the service.


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

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