[LINK] Patients may have to foot e-health bill
brd at iimetro.com.au
Fri May 1 14:14:45 AEST 2009
Patients may have to foot e-health bill
April 30, 2009
PATIENTS may have to pay for their own electronic health records, with
the key healthcare reform body urging the federal Government to mandate
"person-controlled" systems commercially available from providers like
Microsoft and Google.
"We believe that the rapid development of new IT applications required
across the health sector to give people the opportunity to have an
electronic health record is best undertaken by commercial IT developers
in an open competitive market," the National Health and Hospitals Reform
Commission (NHHRC) said in a supplementary paper released today.
While tech-savvy patients are increasingly keen to manage their own
medical records, public agencies worldwide have opted to maintain
control over health information-sharing systems to ensure
confidentiality, technical security and data quality.
But in an unexpected turnaround, the NHHRC said "every Australian should
be able to choose where and how their personal e-health record will be
stored, backed-up and retrieved", and that the record should be "at all
times owned and controlled by that person".
Instead of providing a national health IT infrastructure, the
Government's role should be "to regulate privacy and technical
standards", and allow the market to come up with products that suit both
consumers and healthcare providers
"By 2012, every Australian should be able to have a personal e-health
record," said NHHRC chair Christine Bennett. "The Government must
legislate to ensure the privacy of a person's e-health data, while
enabling secure access to the data by the person's authorised health
To thwart likely objections from doctors over sharing information
contained in their patients' records, the NHHRC wants the payment of
public and private benefits to health and aged care services "to be
dependent upon the provision of data to patients, their authorised
carers and other health providers, in a format that can be integrated
into a personal e-health record".
Microsoft has previously told the NHHRC it was feasible to establish an
affordable, consumer-controlled e-health record nationwide within one
year. Its HealthVault web-based platform has been designed to allow
people to collect, store and share their own medical information with
doctors and family members.
The commission's interim blueprint, released late last year, has been
criticised for its failure to put information technologies at the heart
of planned health sector reform.
While today's paper said the nationwide adoption of individual e-health
records would return between $7-$9 billion in economic benefits from
increased productivity and reduced adverse events over 10 years, the
federal and state governments have baulked at providing the necessary
But the NHHRC believes there is no need to finance patients for the
creation and maintenance of their own e-health records.
Instead, it calls for public funding for "an appropriate social
marketing strategy" to inform consumers and health professionals about
the significant benefits and safeguards of the proposed new approach to
It also calls for significant funding and resources to help doctors move
to the new arrangements.
"Engaging private and public healthcare providers to invest in IT
systems and infrastructure, change work practices and participate in
personal e-health records will be critical to success," the NHHRC said.
"Vendors must ensure their systems are compliant with national standards
and can receive and send data with patient consent and appropriate
AushealthIT blogger David More warned that the NHHRC approach was
"unbalanced" as it over-emphasised the role of the personally held
record "and fails to recognise the importance of the provider's records".
"In my view, the person's own record needs to be adjunctive to the
records, and systems, used by each health professional to optimise the
care they deliver," Dr More said. "The care provider needs information
of known provenance and trustworthiness from external sources such as
referring doctors and labs.
"As well, the benefits case for health IT rests on clinical decision
support provided at the point of care, and that is not recognised
clearly enough in this approach."
brd at iimetro.com.au
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