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