1. IFHRO/AHIMA CONGRESS Washington DC 13 October 2004 Health information privacy A New Zealand Perspective Blair Stewart Assistant Privacy Commissioner New Zealand

3. 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

4. DHB elections currently being held

5. 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

6. 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

7. Independent public official Dispute resolution: –Investigates, conciliates complaints (c 1000pa, <4% proceed to a tribunal) –Watchdog, public education, policy roles –Issues binding codes

8. 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)

9. Continuing/future issues and concerns Difficulty of reconciling patient confidentiality with inexorable drive to share information

10. Continuing/future issues and concerns Diminished individual control/autonomy (might EHR offer the converse?)

11. Role of health information management/health record professionals

12. In NZ a statutory role of “privacy officer” within every agency: Encourage compliance Deal with access/correction requests Assist with investigations

13. It is critical for good privacy outcomes that health information professionals play an active role in privacy planning and implementation I

14. Further information Office of the Privacy Commissioner New Zealand www.privacy.org.nz