5 ms·

The Australian government is paying doctors to upload patient records to a centralised government controlled database. The Australia government is incentivisin

The Australian government is paying doctors to upload patient records to a centralised government controlled database. The Australia government is incentivising doctors to sell client data to the government. What part of this is ok in any sense?

ekianjo 8y ago
how is that compatible with doctor patient confidentiality?
- Torwald 8y ago
  Who protects doctors from attacks, when they get attacked because they value patient confidentiality over conformity to such governmental programs and maybe peer pressure?
  - vertex-four 8y ago
    In my country, healthcare professionals form a union - so hopefully them?
- systoll 8y ago
  The federal law says you can't upload data if the patient tells you not to. Max penalty for that seems to be 2 years imprisonment, though I doubt we'll see that. Some states have further restrictions which expand the scope of this -- for instance, in NSW, uploading anything about HIV would be illegal, even with patient consent. The Australian Medical Association has said that the interaction of the MHR system with their code of ethics implies that doctors must get positive consent from patients. In practice, your new patient registration forms are getting another checkbox.
msamwald 8y ago
It seems overall okay if you accept the premises that A) A centralized health record system can do substantial good by improving effectiveness and transparency of healthcare processes, and enabling medical progress through data re-use. B) Doctors won't lift a finger to do extra work if they have no selfish incentive for doing so.
- TheSpiceIsLife 8y ago
  C) the database never gets hacked, or leaked, or otherwise exfiltrated
  - jopsen 8y ago
    Even if there is a risk of this. It might be a risk worth taking. Edit: I don't know the specifics, but I sometimes wonder what good stats on more health records could do for future treatments.
    - vertex-four 8y ago
      I wouldn’t intentionally place my health records out of my own control, because I have significant risk to my life if those records become public. Having certain illnesses and medical history is inherently political in 2018 - being trans can result in violence against you, talking to your doctor about STIs - even just prevention - can get you kicked out of your home, having medicated/treated schizophrenia will result in losing job/housing/etc opportunities. This isn’t going to change even if all those records become public in some way.
      - pimmen 8y ago
        But you also have a significant risk to your life if your doctor can't get to them and orders the wrong treatment. The risk of that happening to you is actually significantly higher than dying from a lot of pretty common illnesses.
        michaelt 8y ago
        But you also have a significant risk to your life if your doctor can't get to them and orders the wrong treatment. Don't you think I'm in a better position to make that decision than a central government bureaucrat, given that I have my medical records and an incentive to protect my own privacy, and he has neither?
Tharkun 8y ago
AFAIK the same thing has happened in Belgium. There are several databases, allegedly controller by hospital networks, which you can access using government ID. There's supposedly an opt-in clause, but I've certainly never opted in and all my x-rays are on the interwebz. Must be nice to be a 21st century government, where you can access any data on anyone in your country.
- Insanity 8y ago
  That is the case indeed. However the ehealth-ehub system (which I assume you are talking about) is not automatically in-sync with the data the hospitals have about you. When it is necessary to receive the data, the system will poll the hospital for the required data. Then we have "NexuzHealth" in Belgium, which is an app you can install that shows you which data the hospital has about you. It's a network of 20+ hospitals but you can only view your data if you are actually a patient at these hospitals, and the goal was to provide the _patients_ with the same information doctors can see about you. Something you would normally not know about. Source: I work in one of these hospitals (software engineer) but not directly related to the app nor the ehealth system, so this is my (limited) understanding of how it works from being around the people actually implementing this.
deleted 8y ago
[deleted]

ekianjo 8y ago

how is that compatible with doctor patient confidentiality?

Torwald 8y ago
Who protects doctors from attacks, when they get attacked because they value patient confidentiality over conformity to such governmental programs and maybe peer pressure?
- vertex-four 8y ago
  In my country, healthcare professionals form a union - so hopefully them?
systoll 8y ago
The federal law says you can't upload data if the patient tells you not to. Max penalty for that seems to be 2 years imprisonment, though I doubt we'll see that. Some states have further restrictions which expand the scope of this -- for instance, in NSW, uploading anything about HIV would be illegal, even with patient consent. The Australian Medical Association has said that the interaction of the MHR system with their code of ethics implies that doctors must get positive consent from patients. In practice, your new patient registration forms are getting another checkbox.

msamwald 8y ago

It seems overall okay if you accept the premises that A) A centralized health record system can do substantial good by improving effectiveness and transparency of healthcare processes, and enabling medical progress through data re-use. B) Doctors won't lift a finger to do extra work if they have no selfish incentive for doing so.

TheSpiceIsLife 8y ago
C) the database never gets hacked, or leaked, or otherwise exfiltrated
- jopsen 8y ago
  Even if there is a risk of this. It might be a risk worth taking. Edit: I don't know the specifics, but I sometimes wonder what good stats on more health records could do for future treatments.
  - vertex-four 8y ago
    I wouldn’t intentionally place my health records out of my own control, because I have significant risk to my life if those records become public. Having certain illnesses and medical history is inherently political in 2018 - being trans can result in violence against you, talking to your doctor about STIs - even just prevention - can get you kicked out of your home, having medicated/treated schizophrenia will result in losing job/housing/etc opportunities. This isn’t going to change even if all those records become public in some way.
    - pimmen 8y ago
      But you also have a significant risk to your life if your doctor can't get to them and orders the wrong treatment. The risk of that happening to you is actually significantly higher than dying from a lot of pretty common illnesses.
      - michaelt 8y ago
        But you also have a significant risk to your life if your doctor can't get to them and orders the wrong treatment. Don't you think I'm in a better position to make that decision than a central government bureaucrat, given that I have my medical records and an incentive to protect my own privacy, and he has neither?

Tharkun 8y ago

AFAIK the same thing has happened in Belgium. There are several databases, allegedly controller by hospital networks, which you can access using government ID. There's supposedly an opt-in clause, but I've certainly never opted in and all my x-rays are on the interwebz. Must be nice to be a 21st century government, where you can access any data on anyone in your country.

Insanity 8y ago
That is the case indeed. However the ehealth-ehub system (which I assume you are talking about) is not automatically in-sync with the data the hospitals have about you. When it is necessary to receive the data, the system will poll the hospital for the required data. Then we have "NexuzHealth" in Belgium, which is an app you can install that shows you which data the hospital has about you. It's a network of 20+ hospitals but you can only view your data if you are actually a patient at these hospitals, and the goal was to provide the _patients_ with the same information doctors can see about you. Something you would normally not know about. Source: I work in one of these hospitals (software engineer) but not directly related to the app nor the ehealth system, so this is my (limited) understanding of how it works from being around the people actually implementing this.

deleted 8y ago

[deleted]