Who knows what was going through the mind of the Melbourne hospital pharmacist who decided to take a peek at the medical records of a staggering 7000 people they were not involved in the care of. Even over four years that’s a hell of a lot, and as far as we are aware that number is in addition to the records that the pharmacist was authorised to access as part of their duty of care.
Healthcare professionals snooping in medical records is in no way a new thing – as our favourite correspondent Terry Hannan points out – but surely the pharmacist knew that every access would be logged and they’d be busted eventually. From the scant details available it seems that curiosity was the reason for the snooping as opposed to more nefarious purposes.
How they were exposed is also not yet known – one media outlet claims it was a colleague who noticed an unusual access of their My Health Record, which must have been in addition to the EMR access. Another said it was a patient who spotted the problem. Whatever it was, they were found out and punished, but that it happened for four years before they were exposed is a bit of a worry.
Alfred Health says it’s looking into “whether there is technology available to improve the detection of unusual behaviour in the electronic medical record system, while still ensuring seamless access for time critical patient care”. We’re not sure this exists, and may be counter-productive if it does.
It’s timely that this episode was revealed this week when the Health Information Management Association of Australia (HIMAA) held its 40th conference in Brisbane, as part of the wider International Federation of HIM Associations’ 20th congress. If there is a more fearsome group of people dedicated to health information privacy and confidentiality than HIMs, we have yet to meet them.
One of the highlights of the conference was former Australian deputy chief medical officer Michael Kidd’s presentation on the slow and at times hilarious progress of digital health in primary care, but it was also noteworthy for a couple of presentations on how hospital health information managers have experienced the introduction of EMRs. It has not been easy: paper still abounds, hybrid records are the norm, and unfortunately HIMs are often asked to take a back seat to IT people and clinicians in decision making when it comes to EMR implementations.
ACT Health’s DHR roll-out has been widely lauded, by Pulse+IT as much as anyone, while the shambolic roll-out of what was formerly known as EPAS in South Australia has had its fair share of bad press, but there were very obvious similarities in the HIM experience of the two projects. The lesson? Listen to HIMs. They know what they are talking about.
It turned out to be a big week in digital health this week. Magentus company Genie Solutions revealed a big breakthrough in interoperability this week with the release of an electronic booking solution it has worked on with Healthscope. It is built using FHIR standards, similar to the eRequesting solution that Genie has pioneered with Sonic Healthcare, and as such is open for other private hospitals to take advantage of. Genie really should be congratulated for its foresight on this. It will help Genie’s customers to be sure, but Genie is kicking goals whereas elsewhere there wasn’t even an attempt.
And finally, eHealth NSW this week revealed the cost of its single digital patient record project. The contract shows it will cost $1 billion over 10 years, a vast sum but not an unexpected one. While we still query the merit of ripping out the Cerner EMR, into which huge effort has gone over the last 20 years in NSW, as well as what will be a hugely problematic replacement of iPM and Cerner’s PAS, the project will proceed.
NSW Health Pathology for one is very pleased that they will be moving from five LIMS to one, and Hunter New England LHD really does need a contemporary system. And we hear that the gobsmacking cost of implementing Epic will be lessened somewhat in gobsmackishness when compared to the annual cost of maintaining Cerner. Still. One billion dollarydoos for an EMR. It had better be good.
That brings us to our poll question for the week:
Are contemporary electronic health records snoop-proof?
Vote here and leave your comments below.
Last week, we asked: Are you confident that the goals of the interoperability plan are achievable? Most were but it wasn’t a big margin: 60 per cent said yes, 40 per cent said no.
We also asked: if you said yes, how will the goals be measured? If no, what are the main barriers? Here’s what you said.