For the very first time I find myself agreeing with Tony Abbott. Not because of his views on climate change, and definitely not because of his views on homosexuality, but simply because he expressed reservations about introducing an e-Health records system.

Could the black dog leave a digital trace? Artwork by Warren Brown of The Daily Telegraph

The national e-Health records system is due to be rolled out in 2012, and would allow health providers to access patient summaries that include conditions, medications, test results allergies, and vaccinations as well as an indexed summary of specific health events and the related practitioner.

One of the obvious benefits of this system is that it will potentially promote consistent care across jurisdictions. But when it comes to the kind of sensitive information exchanged during psychological treatment, this level of transparency is equally undesirable.

Some psychologists worry the introduction of e-Health records will deter already apprehensive Australians from seeking critical psychological help, especially if it eventually becomes tied to claiming Medicare benefits.

If this is the case, e-Health records threaten to undermine the effectiveness of both Labor and the Coalition’s commitments to mental health and suicide prevention.

Dr Alexander Blaszczynski, a practicing psychologist and Professor of Clinical Psychology at the University of Sydney, is convinced that although there are some clear advantages to national e-Health system, its introduction will deter people from seeking psychological treatment for fear that their clinical information won’t remain confidential:

“The key issue is that it will make some people with certain conditions less inclined to seek out and accept treatment. I generally work in the field of impulse control and behavioural disorders, and that sort of patient information is highly sensitive. If you’re treating a politician or a high profile executive who engages in illicit behaviours, gambling or something like bondage they won’t want to risk that coming out in the public domain. They certainly won’t want that information on a server that could potentially be available to general physicians and allied health providers,” he said.

Bondage aside, it’s a sobering thought. It is well known that mental health problems are a risk factor for both self-harm and suicide, and the number of people with untreated mental health issues in Australia is already shamefully high — around 65 per cent of the national population and around 75 per cent of the youth population.

To add a public face to the problem, Opposition finance spokesman Andrew Robb spoke out last year about his own battle with a depressive condition. Robb said it took him decades to confront his condition and seek assistance, partly because of a stigma surrounding mental health issues. “There are millions of people who couldn’t - they probably do what I did and just live with it,” he said.

A national e-Health record system will potentially exacerbate what is an endemic cultural problem by deterring those who are already apprehensive about seeking psychological help. In doing so, the introduction of e-Health records would undermine any efforts made by the government to address mental health and suicide prevention in the next term, regardless of which party wins power. 

Since 2007 Australians have been able to claim up to 12 sessions with a registered psychologist under Medicare if referred by their doctor. In addition to this, Labor has promised to provide an additional $22.9m for psychological counselling services for about 12,500 people (each year) who have attempted suicide or were at risk of attempting it. While the Coalition has promised to deliver 60 additional youth Headspace sites and 20 Early Psychosis Intervention Centres.

To varying extents, both policies represent admirable allocations of funding for suicide prevention efforts in Australia. But the simultaneous introduction of e-Health records (an initiative that ultimately has the support of both major parties) is going to undermine the effectiveness of either policy if it drives patients away from seeking help in the first place.

To their credit, in their initial announcement the government outlined that e-Health records will be an opt-in system that won’t be linked to the provision of health care benefits. Laura Ryan, a spokesperson for the Minister for Health and Ageing, confirmed that even if there is a large public take up of the system, “It will remain entirely voluntary.”

Additionally, Ryan was adamant that the Australians “Will be in complete control of the record being established and can choose what is added to the record and what people can see.” If Australians are allowed this level of control over the content of their e-Health records, it would certainly go some way in assuaging public and professional concerns regarding privacy and the confidentiality of psychological treatment.

Looking back, I probably should have asked her to sign something.

According to Dr Blaszczynski, “It would be grossly naive to believe that the department will honour those assurances in the long term.” Looking at the evidence, his cynicism is certainly justified.

The government announced Personally Controlled Electronic Health Records for All Australians (emphasis added) 13 months after the National Health and Hospitals Reform Commission recommended health care providers be able to send and receive patient information by 2012-2013.

The NHHRC also recommended that “The Commonwealth Government must mandate that the payment of public and private benefits for all health and aged care services be dependent upon the provision of data to patients, their authorised carers, and their authorised health providers, in a format that can be integrated into a personal electronic health record.”

In other words: health rebates should be linked to the practitioner’s ability to send and receive patient information. For patients, this means they’ll need to have an e-Health record to be able to claim Medicare.

But future intentions are always unknowable to an extent, a point made obviously clear in the government’s own e-Health records announcement, which concludes: “Subject to progress in rolling out the core e-Health infrastructure, the Government may consider future investments, as necessary, to expand on the range of functions delivered under an electronic health record system.”

If the plan to introduce e-Health records in 2012 goes ahead it will certainly have a detrimental effect on the confidence of some Australians in the privacy of medical or psychological treatment. The effect of deterrence would only be avoided if the e-Health program remains voluntary and under the complete control of the patient.

Whether that will actually happen, is about as questionable as the burial of Work Choices.

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75 comments

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    • Brian Taylor says:

      06:47am | 18/08/10

      well written Brittany, we’ll see what happens saturday night, lets hope Tony gets in

    • Steve says:

      09:37am | 18/08/10

      Yep back to the good old days like under Howard where we deported mentally ill people (Cornelia Rau) without even recognising that she was an Australian citizen who needed treatment.

    • Petem says:

      09:49am | 18/08/10

      Tony has shown little regard for people with mental health problems. That’s his track record. He thinks the homeless and the mentally ill deserve what they get. And that’s exactly what they did get under 10 years of cold-hearted Howard. Non. People. Status.

      Good overview of the issues Brittany but I hope you can dig deeper into an industry that really hasn’t moved much past the 1960’s even under such a competent visionary health manager as Abbott. You seem to have a fair hand.

    • Howler says:

      09:58am | 18/08/10

      Steve,

      The mentally ill don’t always make cognisant coversationalists, unless of course you are a Labor voter.

    • Hamish says:

      10:44am | 18/08/10

      Petem, the fact that Tony Abbott has announced a mental health policy which provides the sector with significant extra funding and has been appluaded by many high-profile mental health experts would suggest what you say is incorrect.

      Labor has had three years to do something about mental health (as well as the Whitlam and Hawke/Keating governments since the 1960s) and they haven’t. Their pathetic me-too mental health policy announcement (which was widely panned) suggests they are the ones who don’t care about mental health.

    • Steve says:

      12:02pm | 18/08/10

      @ Howler the whole point of having accurate records available to health care professionals is so that artocities like what happened to Cornelia Rau are never repeated.  By the way Tony Abbott was the Minister for Health at the time but was too busy threatening drug companies over RU-486 to take much interest in mental health.

    • Robert Smissen, rural SA, God's own country says:

      01:01pm | 18/08/10

      DSteve how convenient of you to forget that the state LABOR governments stuffed up especially NSW, who after letting her wander away from a secure unit, did nothing. @Petem, a wise man will if given the right data change his mind, a fool never does

    • Ryan says:

      01:54pm | 18/08/10

      @Steve: oh well, at least he didn’t kill her and three others through some unmanaged trumped up rort of a scheme.

    • dead to me says:

      06:52am | 18/08/10

      Can anyone really believe that the same Labor government that messed up the BER and insulation installation program can competently roll out eHealth? It will waste money and create more problems, we already know that will happen, it is a given under a Labor government.

    • Lyrian says:

      06:52am | 18/08/10

      I’m 29, I’ve moved suburbs, states, and even countries. I have a chronic wrist problem, travel overseas often which requires me to know my vaccination history, can’t remember my blood type, and have no idea where around Sydney my X-ray results, ultrasounds, blood tests, and other medical results are.

      Now I’m in Melbourne, I’m overwhelmed at the prospect of starting from scratch - again - with a physician who has no idea of my medical history at all. The result? I’m putting off treatment. All treatment. Altogether.

      To the Australian Government I ask - where is my electronic health record?

      Make it opt-in, make it so I can choose if a consultation is even recorded on my health record if you must, but DO give me the choice, please.

    • Tone says:

      08:22am | 18/08/10

      start your own, using a web-based filing system like Google documents, Microsoft workspaces or even

      http://www.google.com/health/

    • Phil says:

      08:23am | 18/08/10

      With great respect Lyrian, if you either cant or dont know someone or even your local GP to be able to write the major things down, and are so lazy so as to need the government to do it for you, I truely pity you. Surely you would know your condition, and a small card could be kept on your person for reference if needed. GP’s can have files transfered upon your written authorisation, even if a fee is payable for copying it.

      Its about time we took personal responsability for ourselves in this country. My best mate is a diabetic, so he wears a chain with his status, blood type and always carried his insulin, and items for hi or low sugars.

      I have a heart complaint, so I carry a small list of medications, blood type etc. In any case as soon as you are admitted to hospital they do a blood test to find type drugs etc.

      I dont expect the government to do everything for me, I take responsability to maintain my medication, seek treatment when neccessary. Regardless of condition, a new specialist will diagnose you each time to make sure they dont miss something.

    • Phil says:

      08:42am | 18/08/10

      Ask your new Doctor to write to your old Doctor for your medical history.  Quiet often they are only too happy to provide it to your new Doctor.

    • Reg says:

      11:25am | 18/08/10

      When I have changed doctor I have always asked for my medical file and received it. The subsequent doctor holds that file until I change again.

      A USB dongle off your key-ring offers even more flexibility as long as the doctors can arrange to offer such a feed from their computers. You can even back it up on your computer or all sorts of other places around the globe.

    • Bitten says:

      02:33pm | 18/08/10

      Lyrian, responsibility for your health actually lies with you. Get organised petal! Grow up! Oh, sorry, we’re in Australia aren’t we, we don’t like to grow up or accept responsibility for ourselves…

    • Tarzan says:

      07:25am | 18/08/10

      Wow, E-Health and NBN sounds like that Indian call centre style GP practise could be true. How long will it be before some 14 year old can hack into the E health system and give it to Wikipedia? Imagine finding out all the details of our famous Aussie Celebrities and Judges and Politicians. It would make some good reading.

    • Harriet says:

      09:09am | 18/08/10

      Howard government and Indian call centres, yes that is when they sprung up. And who can forget Howard using automated calls to annoy you at dinner time. Yes Liberals know about outsourcing to countries with cheap labour. Your choice, workchoices!

    • The Badger says:

      09:24am | 18/08/10

      It is not necessary to understand things in order to argue about them.
      Pierre Augustin Caron de Beaumarchais

    • Sherekahn says:

      12:53pm | 18/08/10

      There was a TV program called “the sick men who govern us.”
      I believe E-Health would be beneficial.
      Somebody should be looking at our society and modern way of life very seriously, to determine just WHY so many people are stressed.
      My belief is that it is the Greed of Businessmen/Women and the GDP.
      Stop trying to make everyone more wealthy, we just don’t need it !

    • Marian Dalton says:

      08:39am | 18/08/10

      Sorry, but all this is just scare-mongering. The E-health idea is designed to be entirely within a patient’scontrol, for the purposes of streamlining health care. It’s no more or less secure than the current system - an unscrupulous person could take your medical records and leak them to the media whether they’re electronic or not.

      Or have people forgotten how women’s medical records were read into Hansard during a debate over the introduction of RU486?

      Currently records get misplaced, tests go missing and sometimes you have to really fight to get your records transferred to a new doctor. This is especially true if you want to change GPs because you are unhappy with the treatment you are getting.

      E-health not only provides you with control over the disposition of your own records, it allows you to move between providers as necessary and help develop treatment plans where needed to treat chronic conditions.

      It’s irresponsible to play upon the insecurities of people suffering from mental illness by suggesting that their secrets ‘will’ be uncovered, and they ‘will’ be stigmatised. There’s absolutely no evidence to suggest that this would be the case - and plenty of evidence from other countries to prove the usefulness of E-health.

    • n_dude says:

      01:19pm | 18/08/10

      Absolutely correct. I also cannot see how mental health patients could feel stigmatised by an electronic record of their condition. If anything it could help a doctor or specialist when they are dealing with a health problem which the patient cannot communicate to the practitioner (often the case with mental health patients).

    • Bede Mudge says:

      01:52pm | 18/08/10

      @n_dude Yes… anyone who is paranoid about people that they don’t know accessing their mental health records must have mental issues or something!

    • Jamie says:

      04:38pm | 18/08/10

      Bede Mudge - I would think it is obvious that if someone is paranoid, the idea of having their records on paper will be equally distasteful.

      All in all, I agree that this is scaremongering. There might be a few patients who will be put off by EHealth, but on a whole, I think the people who stay away from getting treatment for fear of information being recorded in an EHealth system probably stay away from getting treatment in any case, for fear of a less ethical psychologist or having hard evidence available on their conditions or tendencies (be it on paper or in a clinic’s IT system).

      EHealth has so many benefits, it shouldn’t be dismissed over a scare campaign like this.

    • Tedd says:

      08:44am | 18/08/10

      There are significant advantages to medical professionals having access to all information about a patient via a single portal, particularly given the degree of specialisation that involves several specialists involved in evaluating and treating a single condition.

    • Nicole says:

      08:59am | 18/08/10

      This is a gross invasion of privacy. I don’t want it and if Labor get in and introduce this crap, everyone’s privacy will be exposed. Jooolya’s got some stupid policies and ideas, but this one takes the cake. Big Brother can shove it!

    • Reg says:

      11:35am | 18/08/10

      Ohhhhh Nicole don’t take on so. Stick a USB drive on your key-ring and then any time they want the police can plug it in and find out all about you. It would also save lots and lots of leg-work and environmental damage. And please, stop bossing your brother around. smile

    • Nicole says:

      11:55am | 18/08/10

      What a brilliant idea Reg. I knew one day you’d have one. I’ve got three big bros and I like to boss them around.

    • Reg says:

      12:18pm | 18/08/10

      Spoiled stupid by your doting brothers AND it shows. smile Ta.

    • The Badger says:

      09:21am | 18/08/10

      Your concerns about privacy are the same concerns corporations and government organizations have been dealing with for many years.

      Privacy and confidentiality are essential and are built into the human resources “systems” of all large corporations.

      You would deny Australians all of the benefits associated with e-health because you have no understanding or desire to learn how these issues are dealt with everyday by a myriad of private and public organizations.

      Perhaps you should read up on how these issues are dealt with currently before you write such nonsense.

    • BT says:

      09:26am | 18/08/10

      To my knowledge it is not compulsory to have your medical records included in the system but I can see the benefits for the disabled and the elderly for example. The author has written a very sensitive and thoughtful piece, and has covered a lot of the issues people with mental illness are concerned about. I believe though, that any good psychologist or psychiatrist will maintain their own records and put only the very basic necessities on the system if the patient agrees to it and don’t think there will be much of an issue. As Tarzan says though, the risk of internet fraud and hacking are a concern, and I will definately opt out of the eHealth system if it eventuates. Imagine how desperate insurance companies would be to get their hands on all that patient information?

    • Cam says:

      11:11am | 18/08/10

      The advantages of E-health for the patient far outweigh the disadvantages - have a read here:

      http://www.ehealthinfo.gov.au/

      Paper files are no more secure.  The Health Services Commissioners of this country are overworked dealing with problems relating to hard files being mismanaged, lost, destroyed, left on the sidewalk etc.  The fear about E-health reminds me of the fear about internet banking in it’s early days.

      As far as the fear of insurance companies illegally getting hold of such information -  I don’t think it would be hard to demonstrate that they gained the information inappropriaely, and I think they would be in serious trouble - no different to now.  And I may be wrong, but aren’t subscribers supposed to keep insurance companies informed of their condition anyway as per the terms of their cover?  There’s heaps of medical information already on the net in the form of online Medicare accounts - I haven’t heard of any dodgy insurance outcomes linked to this as yet.

    • BT says:

      12:04pm | 18/08/10

      Cam, I appreciate your comments but I’m still not entirely convinced. Paper files may not be more secure than online files, but anyone wishing to obtain that information from paper files would have only a limited amount of information to access from one provider, therefore any damage caused would be relatively minor (although obviously not if you were an individual concerned). On a mass scale this could be devastating. And all medical records must be destroyed by a special service that specialises in that area, I’ve never heard of them being left on a footpath?

      In reference to your second paragraph, I don’t think it would be all that easy to prove in court who the culprit was if an insurance company managed to get patient files, and even if it could, once the information is “out there” any control over it will have been lost entirely. Besides, any government worker with access could sell the information too - it’s open to so many people that I’m sure one of them would be willing to sell their soul to the devil if the price was right.

    • Cam says:

      11:10am | 19/08/10

      Fair points, BT.

      Re: the footpath files - I work in the industry, and I have seen this happen.  Hence the damage-limitation activities and stress in the offices of the HSC.  Breaches do not always involve the actual medical file, other files (eg research records) often contain excerpts of medical files and are identifiable.  The various custodians of the different file types are not always aware of or attentive to their responsibilities.

    • Wackett says:

      10:03am | 18/08/10

      For all the un-informed, this policy started under the Liberal government - there was a trial of e-health records in Tasmania 5 or 6 years ago that went with the introducation of Medicare online (claiming from your doctors office) and PBS Online (Pharmarcies claiming form the PBS online). It was a opt-in trial and found to be successful. Obviously a nation wide rollout is problematic and security is the main concern - just don’t say ‘‘If Julia brings this in blah blah blah, because it was Tony that started it (as health minister).

    • Maxi says:

      11:06am | 18/08/10

      Labor organise e-Health? Someone must be smoking the good stuff if you seriously believe these bunch of incompetent politicians can deliver anything on time and under budget. For God’s sake they have just created unemployed doctors in a country with a doctor shortage!

    • Reg says:

      12:02pm | 18/08/10

      .... and here my friends is a perfect example of why Liberals are accused of running a NEGATIVE campaign.

      Thank you Maxi.

    • Against the Man says:

      06:43pm | 18/08/10

      The truth isn’t always negative, in this case it is only because Labor allows it to be so.

      And here my friends is why Labor supports live in denial that their party is a hopeless organisation…............

    • Chris says:

      11:09am | 18/08/10

      While any medical records are potentially open to unwanted exposure there is an added vulnerability if they are put on line at any time.  They will be hacked. They will allow insurance companies, investigators, employers and others to access them. They will also restrict what doctors feel free to note and add to the stress they are under. 
      This is a disaster waiting to happen and could lead to very expensive litigation (which may fail for political and financial reasons) that could do immense harm to individuals.  Unfortunately it will almost certainly happen because it will give the government of the day access to information that can be used to target groups for any number of purposes - especially at election time.

    • Joan says:

      11:25am | 18/08/10

      As a health professional I was involved in small trial using ehealth card back in 2000 it sounds good, access to data available… but not so simple in reality. Accuracy of data on card… not all Dr`s or pharmacy, pathology, enter data accurately or even bothered, some data may be dated. The ideal perfect health world doesn’t exist, . If I had depression/anxiety back in 2000 and got over it 2001, I don’t want to share that today with pathologist , or other professional. If I have a hand operation today the surgeon doesn’t need that type of information and I don’t what him to know.

    • BT says:

      12:11pm | 18/08/10

      Good point Joan. Mental illness can be transient and there is, despite what anyone tells you, a significant stigma still attached to it. Once it’s on your record it is never forgotten and can limit your chances for certain jobs if you are forced to sign over your medical history in say a high security job for example, even if you are totally fine. I know of one case in the UK where one lady was suspected - though not confirmed - to have schitzophrenia and in the end didn’t have it, but lost her dream job anyway as she had to disclose her entire medical history. She never got her job back.

    • Tedd says:

      02:07pm | 18/08/10

      Surely, given the frequency of mental health issues these days, in people and in the media, these are yesterdays concerns.  Knowledge of them in an employee in the past, or presently allows for support and hopefully support is more likely than vilification.

    • Biteme says:

      03:03pm | 18/08/10

      Ted, imagine your were seated in row 26A on a 747-400 from Melbourne to Hong Kong. Would you rather the Pilot have a medical history of Diabetes or Psychotic Behaviour?  Ok, now tell me where the stigma comes from: YOU!

    • iansand says:

      11:29am | 18/08/10

      I can just imagine the reaction of a paranoid schizophrenic to this.  Even if it was opt in.

      For most of us I think it is a fine idea.  I have a couple of minor health issues (diet controlled type 2 diabetes and hypertension controlled by medication).  I would like to think that this information, and information about my medication, was available to a treating emergency physician should I be unable to communicate for some reason.

    • Ella says:

      11:30am | 18/08/10

      Overall, I actually think it is a good idea. I don’t see the problem with including basic mental health records if the only people who have access to it are your mental health practitioner, your GP and yourself. In many cases the GP would already know you have a mental health issue because they are making the medicare referral, and if they don’t they should know about it because it can affect how they respond to certain symptoms i.e. if you were to show up suffering insomnia or with stomach problems that might be symptoms of stress or anxiety. They can respond differently is they know you have already sought counselling.

      Plus if you are claiming stuff on medicare now there are probably already records of it somewhere which shows you had a scan, saw a doctor or psychologist.

    • Richard says:

      11:33am | 18/08/10

      Reference to Hamish - may I point out that the Liberals had 12 years - many of those years with Abbott has Health Minister - to do something about Mental Health but very little was done.  I do however agree that the proposals he is taking to this election are far superior to those of the Labor Party.  The problem with Abbott’s policy is that it is not new money - it is all taken from the existing budget by redirecting money already planned to be spent so patients in other areas suffer.  I would love to see his policy adopted by whoever is the government after Saturday but it has to be new/additional money.  As a society we have to accept that we have to pay for 21st Century Health - it does not come cheap.

    • Reg says:

      11:47am | 18/08/10

      Please people, this is what USB drives are for and I know of an Australian who lost one in Germany and the German finder traced him within hours. There are separate provisions for ownership and data. Of course there’s a risk in recording anything, just as there is a risk in forgetting. Make your choice.

      I have a mentally handicapped son and his privacy prevents me from knowing certain things about his treatment. When I try and ascertain the path of his referrals I can go mental trying to sort the fact from the fanciful.

      His is a situation where this information is vital and yet everyone except the mentally damaged person is prevented from accessing it.

    • jg says:

      11:50am | 18/08/10

      may I point out that the Liberals had 12 years

      If we’re going to use that argument then we could point out that Hawke and Keating could have done something as well.

    • n_dude says:

      01:26pm | 18/08/10

      And I guess during that time technology and the internet existed to make this a reality. You really are full of it.

      Howard and Abbott initiatied the trial, but never saw it through despite having a number of years. Labor have only had one term (>3 years) in office and are looking to push this through.

    • The Scarlet Pimpernel says:

      11:51am | 18/08/10

      The simple solution is to make the penalties severe and then actually apply them.

      1. Deregistration of any company found to be using patients’ records illicitly, regardless of whether it is a public or private company and no matter how big or influential it is.
      2. Criminal charges against directors of said companies with minimum 20 year sentences.
      3. Criminal charges against the procurer of said records with minimum sentence of 30 years, 20 year non-parole period.
      4. Criminal charges against any journalist who publishes any details of anyone’s medical records with a minimum custodial component of 5 years.
      5. Criminal charges against the editor of any newspaper which publishes anyone’s medical details with a minimum custodial component of 5 years.

      With those potential penalties, I doubt there would be too many people around who’d chance it.

    • Reg says:

      12:14pm | 18/08/10

      SP, I thought Liberals were against rules and regulations, perhaps you’ve changed sides. I’m sure by now that we all know the risk of failing to back-up data and paper records are notoriously less reliable than digital ones. Well, except when the BIG magnetic pulse deletes then all.

      Modern technology makes individual responsibility for record keeping easy. All that’s needed is organisation and more back-up. The government of the AMA can do the organisation. Just do it eh?

    • chris says:

      01:34pm | 18/08/10

      too late if the damage has already been done and the information has already been disseminated

    • Dave says:

      01:08pm | 18/08/10

      I don’t believe that as part of the current IT&T debate, the costs of developing
      Electronic Health Records (EHR) & Care Planning (whilst highly desirable
      & efficient) has been factored into the Health Initiatives put
      forward by the major Parties. Julia Gillard specifically mentioned
      access to such records in the ALP’s election campaign recently. These
      costs will be ‘mind blowing’ & we’ll need to understand the learning’s
      of previous Govts & the incremental steps involved to achieve such a
      goal. You can also imagine the technological, legal & political hurdles
      that will obstruct a clear path to an inter-operable EHR system, when
      one considers the Private, Public, State, Federal & Global interests. $43B for a NBN with huge redundancy? Wait until you’re billed for the rest!

    • TracyS says:

      01:29pm | 18/08/10

      There are some definite practical advantages with a functional E-Health system.

      I work as a doctor, and I’ve lost count of the times where I’ve seen patients who cannot recall the name of their medication (it’s the pink one, and I think it starts with a “Z”, or maybe an “X”, and it’s quite small…) or which previous doctor prescribed it, as many people do see more than 1 GP and also get care provided by various specialist clinics these days. For the sake of safe prescribing, I’ve longed for consistent and up to date medication records at the very least.

      I can also see benefits in the followup of test results as there would be a record of which tests were ordered, and therefore need to have the results checked, even if a person happens to be seeing a different doctor.

      As long as it is well implemented, I think it couldn’t happen soon enough.

    • Joan says:

      02:28pm | 18/08/10

      And you reckon esystem will have accurate data?  All those pathology tests,  different Drs, pharmacists, do you think you will be able to trust the information as gospel, do you think that each one will put the info on online/card whatever it is accurately and be current?. How accurate are your own current records?

    • Bitten says:

      03:05pm | 18/08/10

      TracyS, if a human being cannot be bothered taking responsibility for their own health and their medications such that they cannot communicate adequately and accureately to you, their health practitioner, then you should decline to treat them until they pull their fingers out and take some responsibility for giving you the correct information. You are placing yourself at an unacceptable risk of suit for negligence if you prescribe or treat a patient without accurate knowledge of their medical history and prescription history.  The High Court has given us their view on this issue in Cattanach v. Melchior when they decided that a patient who lied to their doctor about their medical history was entitled to compensation from the doctor due to the fact that as a result of the patient’s lie, the doctor proceed with certain treatment that was different to what would have been done if the patient had told the doctor the truth.

    • iansand says:

      04:03pm | 18/08/10

      Bitten - While I agree about taking responsibility I can imagine a couple of circumstances where that may be difficult.

      What if I am hit by the proverbial bus, and am lying unconscious in casualty?

      Or separated parents?  With the best will in the world a non-custodial parent may not be across the full medical history of their child.

    • TracyS says:

      04:47pm | 18/08/10

      Joan - that is why I qualified my comment stating that a “functional E-Health system” and a “well implemented” system were important. I currently use computerised records which automatically records the prescriptions and the pathology and imaging requests I generate, so I’m reasonably confident that at least those aspects of my notes are very current and accurate. The stuff I type in is unfortunately subject to my not-so-slick typing skills, but at least my colleagues are not subject to my even worse hand writing…

      Bitten, you are right on so many counts. What usually happens is that I inefficiently spend time on the phone ringing around to different doctors and pharmacies trying to get enough information so that I can provide safe treatment - a time consuming and frustrating exercise. Of course, if a doctor choses not to provide treatment to a patient, they expose themselves to criticism and censure for refusing to provide a service. Can’t win either way.

    • Biteme says:

      01:56pm | 18/08/10

      this e-health as with most other decisions is about money. And we need to ask ourselves who will benefit most from each decision. If you look behind you will see the benefactors.
      Imagine a national database of all Australians and their medical conditions. There psychological status, their BMI, their current and previous medications, their family problems, in some cases even their sexual fantasies are told to health professionals.
      Now ask yourself who would pay for information like that?
      1: Banks (assess loan suitabilities)
      2: Insurance Companies (argument for rejecting payouts)
      3: Pharmaceutical Companies (they can track drug sales, and demographics)
      4: Big Business (any reason they want)
      5: NHS, (they will discover people shopping for Doctors)
      6: Hackers (for blackmail)
      I’m for e health, but it should be limited and held only on your local Doctors computer. It should not be available on a national wide database that any junior clerk from the Health Department can access.

    • Em says:

      02:36pm | 18/08/10

      This article just furthers the idea that mental health issues are something to keep hidden.

      How long will it take for society to consider having a mention of bipolar disorder or schizophrenia on your patient record to be much the same as diabetes or cancer? Sigh.

    • Biteme says:

      02:56pm | 18/08/10

      Em, well may you say schizophrenia or bi polar should be spoken about.
      But to say telling people about this illness to cancer is not the same. People who suffer from psychosis may exhibit unpredictable behaviours. That can include incomprehensible language to violence. Most of us learn first aid to help some one having a heart attack, but how would you deal with someone suffering an acute psychotic episode. Now you may understand why people are a little afraid when they hear you suffer psychosis: we don’t know how to deal with it. Don’t try to sugar coat mental illness.

    • Rosemary says:

      03:26pm | 18/08/10

      And where is patient privacy in this? when seeking another doctor for a private and the individual’s opinion most of all I am left to wonder. Many can not get any health care at all as doctors refuse health care for some I know of but we don’t want to know of these people only the media approved ones as i have found. Free specialists care not at all pay first that some cannot do so on pensions. Ops for sleep disorders including catatonia facts found still wait for years even though doctor refused to treat thyroid to an endo, no TSI function even on hormone replacement for same, heart specialist, Arthritis, dental to dentist and diabetes weight gains to severally obese directly caused from Mental health medications and non treatment. I guess the death cert one day will say well we know what it will say nothing of the facts this is for sure. . But that is the Bundy hospital and doctors for you and the RBH no better as repeated journey though on the list for over 4 years. Two Doctor’s refuses to support this one patient and the hospital will not support either other than to establish the established. Now where was the money spent again. Leaves me to wonder.

    • Imogen says:

      03:37pm | 18/08/10

      It is worrying that the Federal Labor Government seeks to implement this, as they failed to run a Home Insulation Scheme without four workers dying.  It would have been easy for the Federal Labor government to make TAFE training mandatory (short-courses at least), for employees installing the insulation.

      Further, combined with the Federal Labor Government Internet Filter and possible collection of all our web-sites visited histories, all this centralised data on individuals is seriously adding up to a breach of privacy.  Labor refuses to allow an optional internet filter.  How long will this optional e-health record last?  I believe strongly in my individual freedoms and democracy, and I will vote Liberal for these reasons.

    • Reg says:

      04:10pm | 18/08/10

      Imogen,  in view of this…

      “I believe strongly in my individual freedoms and democracy, and I will vote Liberal for these reasons.”, 

      why are you advocating this,.....

      ” It would have been easy for the Federal Labor government to make TAFE training mandatory (short-courses at least), for employees installing the insulation.”

      Independence on one hand and compulsion on the other?

      The installers were the small to medium businesses, the independence of which you so strongly defend. Under the rules of Imogen, surely they should therefore shoulder responsibility for their failures as well? No?

    • Imogen says:

      09:15pm | 18/08/10

      Reg - you do not understand the difference between education and democracy.  Let me explain:

      Mandatory TAFE training for insulation installers would ensure that they have the education and knowledge to safely do their job.  For safety reasons electricians, plumbers and structural landscapers are required to undertake a TAFE course before they can work in those jobs.  Educating Australians to ensure they can do their work competently and safely is a separate issue to Democracy.

      Democracy is a system of government where citizens have the right to vote in a secret ballot to elect their government.  Individual freedoms, such as every citizen’s vote being of equal weight and every citizen being equal before the law, developed with the concept of Democracy.

      Having an understanding of the appropriate limits of government power to prevent it from encumbering individual freedoms is very important.

      As explained above, in my opinion a mandatory Internet Filter, a record of the web-sites I have visited, and an e-health record are invasions of my privacy and amount to a limitation of my individual freedoms.  I do not desire to live in a society where my private information is easily obtained.

      It is unsurprising that a Labor voter cannot understand the difference between compulsory education to foster knowledge and safety on the one hand and individual freedoms and democracy on the other.  Good bye Australian Democracy - fools like Reg get the vote…

    • Rosemary says:

      03:43pm | 18/08/10

      In reply to Biteme says.
      Dealing with any health system causes many Forgotten Australians to suffer not any kind of psycosis but often comes the attitudes displayed by the so called sane health staff is amazing to this Forgotten Australian who had a heart attack.
      God help any who are in fact mentally ill. I have advocated and supported persons and others along the way until I suffered an apparant heart attack. Which was as much dirrectly due to injuries as a child from abuses suffered of the physical kind spinal fall and head injury hips and others as an adult. Further to the abuses I received when while waiting for stenting taking several days. Dumped as soon as in much worse heart health shape than before I was subjected to treatment add on over 5 drugs I likely never needed but suffered for several years until I was nearest to death as I’d like to be without any healing at all from medical staff.  After all heart health is as important for abused as any from say smoking perhaps as I suffered as a child any symptoms I had at the time of heart attack which I add was muscular and skeletal, same kind of symptoms never mentioned of course and was as much heart failure most of all..

    • Reg says:

      03:54pm | 18/08/10

      My son had chronic epilepsy from two and a half, a stroke at 5 with 50 to 60 seizures a day only controllable in later years with high doses of Sodium Valporate.

      By age 20 the SV had triggered schizophrenia. Now that his seizures have abated and his schizophrenia diminished, his doctor has said there in no reason he should not drive a car.  I am appalled, shocked and horrified. His short term memory and his erratic decision making are clear evidence that he should not be allowed on the road and yet the driving instructors still take his money. I am powerless do do anything except tell him I think it is a bad idea.

    • Marilyn Shepherd says:

      06:23pm | 18/08/10

      Why should mental illness be any more interesting or special than Crohn’s disease?

      We make such a meal of mental illness in this country but most of it is bollocks.

      Lifeline is about mental health yet we don’t want to stop that.

    • iansand says:

      08:05pm | 18/08/10

      Many suffers will be delighted to discover that mental illness is bollocks.  Have you ever met someone who suffers from schizophrenia, bipolar disorder or depression?  Do you think they are making it all up?

    • Wendy Bell says:

      07:00pm | 18/08/10

      I have to write something because my computer accidently liked this article and i dont know how to undo it!

      As a person who has had to go to a number of doctors over a long period of time and have to re-tell my story over and over again because Doctor’s do not share information - i cannot see how it would be a bad thing that your ‘new’ doctor or psychologist does not know what is going on in terms of your treatment

      There are substantial and extensive benefits to the system

    • Had Enough says:

      08:08pm | 18/08/10

      I asked for a data printout of who had accessed my Medicare Records. When I received it , it was covered in yellow lines.  My medical information had been given out and Medicare refused to give me the names of the people they had given this infromation to. After repeated requests, their LEGAL department told me they refuse to answer any more of my questions. I did note that on one doctors visit my file had been accessed 3 times by 3 different people in 3 different states. I would like Madam Bligh, Mr Abbott and Madam Gillard to give me and explaination.  If the author of this article would like to know the full story behind this, which is a doosy, contact me on my email address.

    • Tarzan says:

      10:43pm | 18/08/10

      I’m not surprised about this. And the very smart people of Australia will let it slide away. Maybe write to your MP and ask him to enact the freedom of information act. If that don’t work keep talking about it to Talk back radio ect. The government rely on apathy or people just being to busy to do anything about it.  If ever you find out who accessed it name and shame them in a public forum.

    • BT says:

      09:14am | 19/08/10

      Wow, that is very interesting. I encourage you to find out who was responsible for this and publish it too. I’d like to know who’s tapping in to confidential information…

    • Had enough says:

      04:40pm | 19/08/10

      Tarzan, This information was requested under the Freedom of Information. What I obtained for the fee they charged was a page of yellow lines and a 40(1)(d) ruling. The letter I received states “the information recorded in these doculments would or could reasonably be expected, if disclosed, to have a substantial adverse effect on the proper and efficient conduct of operations of Medicare Australia”. This was their response back in 2006. I have since obtained damaging evidence by accident on certain parties, so I am going back to them armed with this evidence. E Health no way. It will still be abused.

    • tea job news says:

      07:55am | 01/11/10

      Persuade Report,sun danger team star apply particularly connection trust investment place along touch an doctor activity gain exist investigate element record sector bird thin theatre though ever operate beginning level chief item class big visit threat recent youth overall state description agree poor reveal economy believe representative urban factor library household until apart used sorry come little obvious sort top narrow low museum concern leadership circle appointment affect actually search report there buy gun situation alright equally positive worry remove living further way position fish sky

 

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