He says that current privacy frameworks like the Health Identifiers Bill 2010 should assist the shift from paper-based healthcare systems to electronic systems and ease fears about the security of personal information.
“I understand the existing privacy constraints, but I believe that by changing to electronic we are not changing those constraints, we’re simply changing the medium," Smith says. "The trouble is that the perception is causing a lot more confusion than is necessary.”
NBN and e-health: But what about the applications?
A June 2010 report — Telemedicine in the context of the National Broadband Network — prepared by National ICT Australia (NICTA) for the Department of Broadband, Communications and the Digital Economy argues: "There is no doubt that health care systems will undergo fundamental transformations over the next several decades. Pervasive broadband access will be genuinely disruptive. We have the opportunity to use the NBN as a catalyst to advance Australia into a leading position in telehealth-care as an integral part of healthcare more broadly."
Telemedicine is defined by NICTA as "that subset of e-health that deals with medical diagnostic and treatment services, at a distance… Tele-medicine provides health care, decision support services, and information management, with an anywhere, anytime access model"
The report identifies a number of aspects of telehealth services that the NBN stands to affect, such as videoconferencing for remote diagnosis and the increased speed of data transfer.
A submission by the Medical Technology Association of Australia (MTAA) to the parliamentary inquiry into the NBN notes that many of these services can be delivered even without a near-ubiquitous high-bandwidth network like the NBN. However, it adds that the NBN can offer greater access and decreased costs, and make telehealth services faster and more efficient.
In addition to better access to staples of telehealth such as patient record storage and retrieval, including bandwidth-hogging MRI and CAT scan results, for example, and enhanced remote diagnosis and teaching through tools such as videoconferencing, the MTAA submission argues that the NBN is perhaps capable of changing the fundamental nature of healthcare delivery in Australia.
The role of remote consultation with specialists through videoconferencing is a fairly obvious tool that can be enhanced through a network like the NBN. However, it can be easy to miss just how significant this can be in a country with such a dispersed population such as Australia. The Royal Australasian College of Physicians' submission to the same inquiry identified some of the social and personal impacts that the NBN could have on patients, their families and their communities through technologies such as this.
These include the ability of a patient to receive care without leaving their region, reducing disruptions to families and a patient's employment; "closer involvement of the patient's regular GP (or other health care professional) in care"; improved "confidence in those with chronic conditions that they can continue to live in and participate in their local communities and still have access to specialist health care"; and improved viability of communities in regional areas thanks to better healthcare access.
Beyond the potential for remote consultation and its impact on the equity of access to healthcare in Australia, the MTAA notes emerging technologies that can take advantage of a new national network. For example, remote monitoring of patients implanted with cardiac sensors as an alternative to a check-up, monitoring of vital signs, remote tracking of diabetic patients' insulin levels, and the delivery of health education to a patient's home.
Just how much of this makes it into the real world will be discovered over the coming years. However, if nothing else the scale of change the NBN can potentially bring to the realm of healthcare makes clear that the network is not merely about technology; it can be part of fundamentally changing how Australians live their lives and conduct business. When it comes to health it stands to upset assumptions that have been part of Australia for a long time — the iniquity of the town and country divide when it comes to access, for example, and the extent to which serious health conditions can affect people's quality of life.
Follow Chloe Herrick on Twitter: @chloe_CW
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