IFHRO/AHIMA CONGRESSWashington DC13 October 2004
Health information privacy
A New Zealand Perspective
Blair Stewart
Assistant Privacy Commissioner
New Zealand
New Zealand at a glance
• 4 million people somewhere in the SW Pacific
• About 8500 doctors, 36500 nurses/midwives
• 445 hospitals (85 public, 360 private)
• 23,825 hospital beds • National 24/7 no fault
comprehensive accident compensation scheme
• 21 elected District Health Boards
DHB elections currently being held
Digital health records in NZ• Practically all general practices use
computers • 1999: estimated 30-40% all GPs used some
form of EHR (EPR?) and 47.5% NZ GPs use Internet to support clinical practice* …now?
• National Health Index No assigned to everyone
• National Practitioner Index plan• No national EHR but various local or
specialised projects to promote interconnectivity
* Source: NZ Ministry of Health, WAVE report, 2001
NZ Privacy Act 1993
Law covers all personal information:• in whatever form (e.g. manual or
electronic)
• in both public and private sectors
12 information privacy principles (based on OECD)
Privacy Commissioner
Privacy Commissioner
• Independent public official • Dispute resolution:
– Investigates, conciliates complaints (c 1000pa, <4% proceed to a tribunal)
– Watchdog, public education, policy roles
– Issues binding codes
Health Information Privacy Code 1994
• Sectoral code applying across health sector
• Tailored, flexible, enforceable• 12 rules (collection, use,
disclosure, security, access, correction, retention, unique identifiers)
Continuing/future issues and concerns
Difficulty of reconciling patient confidentiality with inexorable drive to share information
Continuing/future issues and concerns
Diminished individual control/autonomy (might EHR offer the converse?)
Role of health information management/health record
professionals
Role of health information management/health record
professionalsIn NZ a statutory role of “privacy
officer” within every agency:• Encourage compliance• Deal with access/correction
requests• Assist with investigations
It is critical for good privacy outcomes that health information professionals play an active role in privacy planning and implementation
I
Further information
Office of the Privacy CommissionerNew Zealand
www.privacy.org.nz