[LINK] Patients may have to foot e-health bill

Bernard Robertson-Dunn brd at iimetro.com.au
Fri May 1 14:14:45 AEST 2009

Patients may have to foot e-health bill
Karen Dearne
April 30, 2009
The Australian

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."


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

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