New Zealand - Doctors in Auckland to share patients' details...
[2006-04-19 NZ Herald]


Doctors to share patients' details
19.04.06

By Martin Johnston


Doctors in Auckland will soon have automatic access to their
patients' private records from other clinics, including information
on sexual and mental health.

The new system starts with hospital doctors next month and will
include GPs and other primary care clinics by the end of the year.

Patients can refuse to let their records go on to the shared
database but some health advocates remain concerned about privacy.

Auckland's three district health boards have been devising the
TestSafe laboratory test results system over the past year.

It will allow doctors to access records of their patients who may
have sought medical help on sexual, reproductive or mental health
matters at other clinics.

TestSafe will connect the hospitals' clinicians and laboratories
with the region's community laboratory company to provide hospital
doctors with better, faster access to all of a patient's available
test results and prevent unnecessary duplication of tests.

The aim is to improve continuity of care, reduce the chances of
medical mistakes and reduce publicly funded laboratory costs. A
second phase will extend the scheme to GPs and other primary care
clinics by the end of this year.

Women's health, HIV-Aids, family planning and mental health groups
are worried by this second phase, which they fear will endanger
patients' privacy, despite planned safeguards.

A health board document says clinicians' use of the system will be
electronically monitored and any privacy breaches could lead to
dismissal.

The document says security in the primary care part of the scheme is
under review.

"It is expected that new security features will be implemented as
part of this stage of TestSafe."

Waitemata board chief executive Dwayne Crombie said yesterday that
the main safeguard was allowing people to "opt off".

Patients would tell their general practitioner to tick a box on the
lab test order form stating that they did not want the results
shared on TestSafe. Alternatively, they could opt off for those
results later by phoning an 0800 number that would be set up.

Dr Crombie agreed that if a patient had not opted off for a test
ordered by someone other than their regular GP, the regular GP would
be able to learn of the test and see the results.

"But if we have role-based security, ideally they will only be able
to look at patients they or their practice has an interest in," he
said.

"Role-based security" was also being explored for hospital staff. It
would mean that only those clinicians with a legitimate interest in
a patient would have access to that person's file on the regional
database.

Extending the system to all health records was a possibility, he
said, but it had not been considered in the current project.

Women's Health Action director Jo Fitzpatrick said an opt-off system
was cumbersome. It was unlikely all doctors would inform women of
this choice.

She and Auckland Women's Health Council co-ordinator Lynda Williams
said the system should instead be opt-on, assuming results were not
shared unless patients consented.

Mental Health Foundation chief executive Judi Clements said making
mental health service consumers' records more readily accessible
could detrimentally affect them.

People with mental problems could encounter discrimination in
accessing physical health services and that must not be aggravated.

Bruce Kilmister, chairman of the HIV-positive advocacy group Body
Positive, said men having an HIV test often chose a doctor other
than their usual GP.

"I don't have any confidence in the medical profession keeping this
information completely confidential - outside of hospital
physicians."

Family Planning Association executive director Gill Greer said an
opt-off system increased the risk of an administrative lapse
occasionally leading to patients' information being available,
against their wishes, to their regular doctor.

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Email Martin Johnston