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NZ Doctor Series - Privacy Matters (# 23)

July 2010

As you probably know, last year the Ministry of Health asked for Expressions of Interest (EOI) on improving primary health care, to make it ‘Better, Sooner, More Convenient'. Nearly eighty were received in all, each one relating to a different project. These EOIs have now been received and assessed. The successful ones have moved on to planning and implementation.

One of the themes that has emerged is the increased use of electronic health records, whether to create ...

NZ Doctor Series - Privacy Matters (# 22)

June 2010

The development of national Electronic Health Records (EHRs) is big business around the world. Australia alone is set to spend more than half a billion dollars on it before 2012. UK and US spending dwarfs that.

In New Zealand we have some elements of culture and infrastructure, such as the National Health Index, that put us well ahead of the international game. The recent draft National Health IT Plan has a go at charting the next step.[1]

But first - do we act...

NZ Doctor Series - Privacy Matters (# 21)

May 2010

Vox populi, vox dei ('the voice of the people is the voice of God') is a phrase with an impressive pedigree. Its first known mention is in a letter to Charlemagne in 798 AD. While many medieval concepts have not stood the test of time (witch burning, the sale of indulgences) this is one that still has a lot of value.

As Privacy Commissioner, my responsibility is to help protect New Zealanders' information. Naturally I can't do that properly without listening to the 'vox...

NZ Doctor Series - Privacy Matters (# 20)

April 2010

Information kept where no-one can get it is a bit like a miser's gold buried at the end of his garden. Just as with money, information's value isn't intrinsic - what really matters is how you use it, disclose it or dispose of it.

In general you can treat information in line with the purpose you obtained it for, so day to day uses and disclosures will present no problem.

But what about when you shut up shop, or your practice or PHO joins with another agency? PH...

NZ Doctor Series - Privacy Matters (# 19)

March 2010

American lawyers do pretty well for themselves, by all accounts. Scalded by a coffee at McDonalds? Sue. Drop some olive oil in a supermarket, then bruise yourself falling over? Sue! Drink yourself to cirrhosis on Jack Daniels? SUE!

Whether true or not, these well-worn tales typify the States' litigation-happy culture. In 2004, costs associated with this kind of claim amounted to a quarter of a trillion dollars.

In New Zealand, by contrast, fall off a ladder an...

NZ Doctor Series - Privacy Matters (# 18)

November 2009

Freedom of the press is one of the planks our democracy stands on. In the abstract this is an undeniable positive. As the saying goes, 'sunlight is the best disinfectant'. Dealing with press freedom directly, though, can be a little harrowing. What should you say to a reporter on the other end of the phone at 5.00 pm on a Friday?

One answer, of course, is ‘nothing' - but things are rarely that simple. What if you want to get your side of the story across, or to de...

NZ Doctor Series - Privacy Matters (# 17)

September 2009

Early physicians thought mental illnesses was influenced by the phases of the moon. The term ‘lunatic' is a remnant of this tendency to blame external agencies for the inexplicable.

Of course, we're all much more civilised these days...and yet, in some ways, a similar stigma remains.

This can make treating a patient with a mental health condition more complex than it should be. There is an expectation, perhaps fostered by some kinds of media coverage, tha...

NZ Doctor Series - Privacy Matters (# 16)

July 2009

We have always lived in a world of networks. In the past, these networks were social; of trust, kin and obligation. Nowadays, it is arguably the computer networks surrounding us that have a greater effect on our lives.

However, one of the oddities of ubiquitous technology is that we notice it most when it's not there. For instance, patients going from practice to practice may be surprised that their medical records and health information have not gone with them. Th...

NZ Doctor Series - Privacy Matters (# 15)

June 2009

Public health programmes are an unambiguous benefit of civilisation. Clean water, applied epidemiology and immunisation have saved untold thousands of lives over the centuries. And, by dint of focused international effort, scourges like smallpox, polio and tuberculosis have been virtually eliminated.

Of course diseases don't stand still, and nor does medical science. The swine flu scare is an example of the kind of new threat that can spring up unannounced. Are...

NZ Doctor Series - Privacy Matters (# 14)

7 April 2009

Where do you stand when one of your patients is suspected of a crime and the Police are seeking information about him? How about when you think a patient's actions are putting her family in danger? Where should the balance lie between public safety and patient trust?

Dilemmas about whether or not to disclose confidential information can have very sharp horns, particularly when you're the one that's caught on them. Privacy law recognises that dilemmas will arise and...

NZ Doctor Series - Privacy Matters (# 13)

11 February 2009

It's fair to say Dr Robert Guthrie was 'thinking of the children' in 1958 when he devised a test for phenylketonuria, based on a few spots of a newborn baby's blood.

The heelprick sample taken for the 'Guthrie Test' is now used to check for a wide range of treatable metabolic conditions. It's a brief paediatric procedure that provides a clear, risk-free benefit to newborns and their parents. So far so good.

But what about the...

NZ Doctor Series - Privacy Matters (# 12)

19 November 2008

New Zealanders trust their GPs. That trust enables good care and comes about from repeated contact. Trust is a treasure of a kind, and once lost is hard to regain.'

But dilemmas can arise when you get requests (or demands) for your patients' health information from other agencies in the health sector when you have been entrusted with their information and want to protect it. How best to resolve the competing claims?

For example, if you're a GP in the Auckl...

Show Me the Money : Remedies under the Privacy Act

This article by Katrine Evans, Assistant Commissioner (Legal) at the Office of the Privacy Commissioner, was published in a special privacy issue of the Victoria University of Wellington Law Review (vol. 36, no. 3), October 2005.

View the article.

NZ Doctor Series - Privacy Matters (# 11)

24 September 2008

In Ancient Greece, when you had a difficult question and needed some divine guidance, you could go to Delphi and consult the Oracle there. The answer you got was provided as a riddle that could be very obscure - Delphic, in fact.

Nowadays instead of an oracle we have the Internet. Many people's first action is to fire up a search engine when stumped. Naturally information about health is a popular search choice and it's easy to print off relevant web pages for l...

NZ Doctor Series - Privacy Matters (# 10)

30 July 2008

There's a saying in show business, 'never work with children or animals'. As a GP you can at least avoid the latter, barring late-career retraining as a vet. But kids are a given. So what special privacy challenges might they present and how best to resolve them?

Most of the time, naturally, there won't be any problems. Parents will come in with their sick children and you'll treat them, talking to the parents and the children as necessary to find out what's wrong a...

NZ Doctor Series - Privacy Matters (# 9)

4 June 2008

We are all, literally, made of information. The DNA that instructs your cells to grow and replicate can be sequenced into endless glossolalic strings of letters. Your own DNA could be written down and presented to you. The book of your life could be read just as you read this article.

In fact, for some people, this is already being done. The Human Genome Project finished its first complete sequence in 2003. A Google-backed Internet start-up called 23andme will review...

Comparison Paper on Health Privacy Laws

"Overseas Privacy Regimes : Internal research paper comparing New Zealand's Health Information Privacy Code 1994 with the health privacy laws of Victoria, Ontario and the United States".

This is an internal research paper prepared to assist in the 2007 amendment of the Health Information Privacy Code 1994. It considers the health privacy laws of three foreign national (US) and regional (Ontario, Victoria) jurisdictions and compares them to the New Zealand regime.