Doctors to share patients' details

Doctors in Auckland will soon have automatic access to their patients' private records from other clinics, including information on sexual and mental health.

The new system starts with hospital doctors next month and will include GPs and other primary care clinics by the end of the year.

Patients can refuse to let their records go on to the shared database but some health advocates remain concerned about privacy.

Auckland's three district health boards have been devising the TestSafe laboratory test results system over the past year.

It will allow doctors to access records of their patients who may have sought medical help on sexual, reproductive or mental health matters at other clinics.

TestSafe will connect the hospitals' clinicians and laboratories with the region's community laboratory company to provide hospital doctors with better, faster access to all of a patient's available test results and prevent unnecessary duplication of tests.

The aim is to improve continuity of care, reduce the chances of medical mistakes and reduce publicly funded laboratory costs. A second phase will extend the scheme to GPs and other primary care clinics by the end of this year.

Women's health, HIV-Aids, family planning and mental health groups are worried by this second phase, which they fear will endanger patients' privacy, despite planned safeguards.

A health board document says clinicians' use of the system will be electronically monitored and any privacy breaches could lead to dismissal.

The document says security in the primary care part of the scheme is under review.

"It is expected that new security features will be implemented as part of this stage of TestSafe."

Waitemata board chief executive Dwayne Crombie said yesterday that the main safeguard was allowing people to "opt off".

Patients would tell their general practitioner to tick a box on the lab test order form stating that they did not want the results shared on TestSafe. Alternatively, they could opt off for those results later by phoning an 0800 number that would be set up.

Dr Crombie agreed that if a patient had not opted off for a test ordered by someone other than their regular GP, the regular GP would be able to learn of the test and see the results.

"But if we have role-based security, ideally they will only be able to look at patients they or their practice has an interest in," he said.

"Role-based security" was also being explored for hospital staff. It would mean that only those clinicians with a legitimate interest in a patient would have access to that person's file on the regional database.

Extending the system to all health records was a possibility, he said, but it had not been considered in the current project.

Women's Health Action director Jo Fitzpatrick said an opt-off system was cumbersome. It was unlikely all doctors would inform women of this choice.

She and Auckland Women's Health Council co-ordinator Lynda Williams said the system should instead be opt-on, assuming results were not shared unless patients consented.

Mental Health Foundation chief executive Judi Clements said making mental health service consumers' records more readily accessible could detrimentally affect them.

People with mental problems could encounter discrimination in accessing physical health services and that must not be aggravated.

Bruce Kilmister, chairman of the HIV-positive advocacy group Body Positive, said men having an HIV test often chose a doctor other than their usual GP.

"I don't have any confidence in the medical profession keeping this information completely confidential - outside of hospital physicians."

Family Planning Association executive director Gill Greer said an opt-off system increased the risk of an administrative lapse occasionally leading to patients' information being available, against their wishes, to their regular doctor.