Australia health IT faces privacy fears

Australia's electronic health records projects are underfunded and face a backlash from the public over privacy and security issues, vendors and privacy advocates say.

Anna Johnston, chairwoman of the Australian Privacy Foundation, said she has serious concerns about the overall state of privacy laws at the national level when it comes to the protection of confidential information contained in electronic health records. She said she is particularly concerned by what she believes is an erosion of patient privacy in the planned Health e-Link project in New South Wales, which includes Australia's largest city, Sydney.

Johnston said she has seen internal memos from the New South Wales government that indicate that Health e-Link would require patients to opt out of electronic records rather than today¹s stronger provisions, which require patients to opt in to the records.

She said that the change to an opt-in provision could be accomplished at the executive level without going through parliament, a step that would erode strong protections in a patient privacy bill enacted in 2002. Johnston said she feared that New South Wales' attempts to erode privacy protections for electronic records could set a precedent for the rest of the country.

She said she also has concerns about the HealthConnect test program scheduled to start in Tasmania next month. HealthConnect uses smart cards for Medicare insurance, and Johnston worries that confidential medical information on the cards could be subject to misuse.

HealthConnect, which is funding electronic health care systems in South Australia and the Northern Territory, has provided little direction on privacy issues while the states and territories each have their own privacy statutes. This lack of national direction and multiple state laws begs for new national patient privacy legislation as Australia moves toward development of a nationwide electronic records systems.

Alby Creevey, Asia-Pacific director of health care for SeeBeyond Technology, which is installing patient registries in several Australian states, agreed with Johnston that growing public concerns about electronic records need to be addressed.

"The privacy issue is not going away," Creevey said.

Creevey said he is equally concerned about the low level of funding for HealthConnect. He said the program needs to spend far more than the $99 million that the Department of Health and Ageing has provided for electronic health record systems in Tasmania and South Australia.

That amount can fund systems in thinly populated states, but it remains far short of the significantly larger investments required for systems to serve states on Australia¹s east coast, which contains 80 percent of the country's population.

Despite a quick start on statewide electronic health record systems in Australia, Creevey said he believes it will take the country a decade to complete a nationwide deployment -- roughly the same time frame expected for the United States to develop such a system, Creevey said.