[LINK] Centralised IHI architecture [was: Building the Australian National Health Network]

[Stephen Wilson]

Marghanita da Cruz wrote:
> If you want your records to be private, then I would guess
> you can go to the doctor/hospital pay the full amount and
> not expect a rebate from Medicare.
That method works when Medicare is only involved in paying.  But the new 
paradigm where Medicare operates the IHI service (and in time, maybe the 
IEHR as well?) has them involved in all clinical events where the IHI is 
looked up and extracted, or verified.  If patients want to avail 
themselves of the IHI (and for the sake of argument, let's assume that 
patient identification is a good thing) then they cannot avoid having 
Medicare involved in the interaction.

My real beef is not actually with Medicare, it's with the centralised 
IHI architecture arrived at by NEHTA.  Whomever operates a centralised 
IHI directory, I think the structural privacy problem is that this 
architecture centralises IHI resolution and creates needless event 
logs.  Why should *anyone* know about my consultation with a family 
planning clinic, ER, drug & alcohol service or mental health service, 
apart from me and my clinician, and secondarily, other clinicians that I 
have consented to be involved? 

Cheers,

Steve.

Stephen Wilson
Managing Director
Lockstep Group

Phone +61 (0)414 488 851

www.lockstep.com.au <http://www.lockstep.com.au>


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