E-health pros, and privacy concerns

This article in the Sydney Morning Herald today has a close look at the Government's e-health plans, with $466 million on the table and enthusiastic support from some medical circles as well as privacy advocates' fear of "a stalking horse for another run at a national identity card. They also fear e-health records will mean Big Brother peeking through the keyhole of a very private place: the consulting room."(Update: Health Minister says safeguards are in place.)

As it is, the new health database will, from the start, be a ''honeypot'' of personal information. Its authorised uses already include management, funding, monitoring and evaluation of healthcare, as well as research, says Professor Graham Greenleaf, director of the Cyberspace Law and Policy Centre at the University of NSW.
''The legislation is basically setting up a surveillance system by instalments, without anyone really knowing what else might be in the package,'' he says. He believes the identifier should not have been rolled out without all future uses defined: ''There are an awful lot of secondary uses that are made possible by this … but we don't know how they are going to be carried out or what degree of patient consent will be involved.''
Greenleaf argues that the way the identifiers program has begun - without telling all Australians their number, or offering them the chance to refuse to have a number - does not inspire confidence in the government's commitment to patient consent.
''And it doesn't look like the individual can effectively bail out of the [identifiers] system. The patient has no right to ask any doctor not to use that number [in his own clinic records] … This is not just 'doctor knows best'. It's 'everyone else knows best'.'' Finally, Greenleaf warns that the identifiers legislation fails to protect against Medicare payments becoming dependent on whether a person has an e-record.
The Victorian Privacy Commissioner, Helen Versey, is troubled, too: by the automatic assignment of identifiers; by the way they can be given to any healthcare provider a person has seen in the past; and by ''the freedom with which the identifier can then be used or disclosed … the collection and the uses … do not require the consent or even the giving of notice to the individual concerned. It is difficult to see how this matches the government's claims of a 'patient-controlled' e-health record.'' Like Fernando and Greenleaf, Versey also believes ''some level of function creep is guaranteed''.