A release promoting extra safeguards for national e-health identifier by its governing body has been labelled ‘chaff’ from a long-term industry advocate.
The Healthcare Identifiers Bill 2010 proposes that unique healthcare identifiers be in operation within 10 years, spearheaded by Medicare. Each Australian will have a unique record held in a single national database that can be accessed by different health professionals.
Pundits and analysts say e-health identifiers can improve communication between pharmacies and doctors and introduce transparency into patient medical histories, but many are concerned that the government is not paying dues to privacy concerns or addressing governance issues.
More and Associates consultant, Dr David More, said the governing National E-Health Transition Authority (NEHTA) has not provided enough information on record content and access and how health providers will be authenticated.
“The reason is pretty clear. Those involved do not have a clue what they are doing and more than that are not telling the public — in other than carefully spun press releases,” Moore said in a post on his e-health blog.
“How, in detail, will 600,000 health care providers be authenticated… what will be the workflow impact, how will fraud be prevented and what exactly will it cost? …Where is the quality of openness and appropriateness of public administration we should be seeing?”
The commentary follows recent criticism from Mater Hospital chief information officer, Malcolm Thatcher, who said the government needs to introduce management of health identifiers, secure messaging, common terminologies, patient privacy and industry incentives.
“I am not confident, yet still have hope that the Federal Government understands the commitment necessary to successfully implement e-health in this country — a commitment of time, large amounts of money and resources that go well beyond a single term of government,” Thatcher said.
The Federal Health Minister, Nicola Roxon, has said e-health identifiers will be assigned to Australians from mid this year, inflaming opinion that the plan is too immature to be launched.
“I still have concerns however about the extent to which the Government and NEHTA have thought through the need for providing a user-held token for the storage of the individual (patient) health identifier to avoid incorrect retrieval of patient identifiers based on demographic data and the human error,” Thatcher said.
Other industry identities have previously warned that policy development is too lax and will impede the e-health rollout. NSW Professor Branko Cellar said government health departments have ignored workable e-health technologies in favour of existing solutions to mitigate risk and accountability.
“A recent premier came to visit and was impressed by [telehealth] technology but even though [he] may want it, no one in the health department was incentivised to take it on because their seats are more carefully retained if they do more of the same — they see disruptive technology as too risky,” Cellar said.
NEHTA clinical lead, Dr Mukesh Haikerwal, said new confidentiality arrangements forcing health professionals to authenticate prior to accessing the e-health system will safeguard patient data.
“Patient confidentiality is vitally important to us in our work and the good thing about the healthcare identifier is that it not only makes the system safer, more accurate and up-to-date, it also carries with it additional safeguards over and above what exists today,” Dr Haikerwal said in a statement. “There is also a very strict audit trail so that any individual can know that someone has accessed their record in the system which is an additional layer of security. "You will never satisfy everyone in regards to privacy, but I have far more confidence in the future of e-health and the security of its records than I do in the current system."