Transcript - Dr Michael Gannon, Radio Adelaide - Electronic Health Record

JENNIE LENMAN:    Alarms have been raised after a journalist, Paul Farrell, was able to purchase his own Medicare card details online via the deep, dark web. This huge breach in patient security has many Australians worried, and doctors are concerned for the safety of patient confidentiality.  Joining us now to discuss this is Australian Medical Association President, Dr Michael Gannon.

MICHAEL GANNON:      Good morning Jennie, how are you?

JENNIE LENMAN:   Very well, thank you. What's the biggest concern to you regarding the leak of highly confidential patient records online?

MICHAEL GANNON:    Well, certainly we would have been very concerned if that was the case, but I've been given reassurances yesterday by both the Minister for Human Services Alan Tudge, and by Tim Kelsey, the head of the Australian Digital Health Agency, that this in no way represents a breach of the electronic health records. So, about 5 million Australians have a My Health Record, an electronic health record, and you need a number of individual bits of information to open that. The Medicare number is not sufficient, so I'm satisfied that that is not going to be an issue. What is a concern is exactly how this journalist was able to get hold of this Medicare number, and that's the subject of an ongoing Australian Federal Police investigation.

JENNIE LENMAN: Right.So his claims are being totally disputed by the Federal Government, or just parts of his claims?

MICHAEL GANNON:    Certainly, there's no doubt that people on the dark web – and the reason it's the dark web is because that's where people go to do things that you shouldn't be doing; it's the place where people can fraudulently obtain all sorts of things – but I don't think there's any question that someone has been able to avail themselves of Medicare numbers. What I am satisfied has been closed off is the assertion being made that this meant that there'd been a hack into the Medicare supercomputer, if you like, or that there was any threat to personal, confidential patient information on the My Health Record.

JENNIE LENMAN:    Right. So do you know what third party buyers could do with the information they can currently get from the Medicare details online?

MICHAEL GANNON:    Well, theoretically, if you've got a Medicare number you could pose as someone else and use it as one part of identity fraud. You get a certain number of points for your Medicare number; you certainly need a whole lot of other points to do something like get a passport. So it's concerning from that point of view. The second thing is that you might avail yourself of health services that you're not entitled to. So I suppose one thing that Australians take for granted is the high level to which their health is subsidised by the Government, by taxpayers, and you could potentially use that number to access something like the Pharmaceutical Benefits Scheme, certainly get a patient rebate for seeing a doctor. So, you know, that is of concern, but certainly you need a whole lot more information than a Medicare number to hack into yours or someone else's medical records.

JENNIE LENMAN:    Do you think that in the wake of this breach there should be more done to secure patient records, or are you feeling pretty confident about it?

MICHAEL GANNON:    Well, one theory is that these numbers have been obtained through a doctor's surgery. Now, if that's the case, we might see a system that greatly assists patient care greatly diminished. So what could happen is that every day of the week thousands – many thousands – of patients turn up to see a doctor without their Medicare card, and in good faith the receptionist will say, well don't worry, I can look it up on the computer. And then they can see the doctor, not face that barrier to access of care, and be sorted out. Now, that's an entirely appropriate use of a clever computer system.

Of course, if that's the method by which these numbers are making their way onto effectively what is a black market, well then the Government might have to look at that system and its security. But that would be a great shame, because the truth is that every day that assists the care of thousands of people who, through no great fault of their own, have forgotten to bring a Medicare card to an appointment, it would be a great shame if we saw that system closed off. If this is a breach where one or a few individuals have used this generous system to profit individually, well then they should face the full effect of the law.

JENNIE LENMAN:   Dr Michael Gannon, President of the Australian Medical Association, is with us. And you mentioned My Health Record; next year, the Federal Government will be implementing the digital file scheme, storing patient records online. Tell us more about that one.

MICHAEL GANNON:    Well, we see the My Health Record very much as the future. There are numerous advantages, and again our greatest concern about this potential breach was that if the faith of the community in the integrity of information on the electronic health record is tested, it won't succeed. If the faith of doctors and other health professionals in the My Health Record is tested, it won't succeed. But the hope is that we will have information that effectively goes with you wherever you go. So if you're from Adelaide, but you fall ill on holiday in Cairns, well then a doctor or nurse seeing you there can glean valuable personal information. If you walk into a hospital emergency department, they can look at the records from your GP or from private radiology or pathology providers.

So the electronic health record has the potential to have so many positive effects. We might see less adverse drug reactions; we might see less allergic reactions; we might see less duplication of tests, less exposure to ionising radiation from things like x-rays and CTs because people can see the tests that you've already had. So this is very much the future. It's something that we want to see succeed. The electronic health record has had a long and chequered history; we've been trying to get this done in Australia for a decade; it's cost well over $1.5 billion already. We want to see it succeed, but we must have guarantees as for its security, otherwise doctors and patients simply won't buy into the process.

JENNIE LENMAN:   And are you putting pressure on the Federal Government to ensure there is some kind of encryption or some kind of good security measures on this?

MICHAEL GANNON:   Well, look, again, I suppose if any good has happened out of this story it's that we've received those kind of confirmations, and again that's it's been an opportunity for the people in charge of the My Health Record to make that case. So, for example, one really important feature of the electronic health record is real-time surveillance. So, in other words, there are people keeping an eye on who is accessing patient records and if there is any sign of fraudulent or nefarious access they've got methods of detecting that.

Secondly, there's a record of exactly who, where, and when has accessed the patient record. Now, I can tell you that if someone is reading your record in a hospital or down at a local clinic, we don't know that. That's an advantage of the electronic health record. So I suppose if anything good has come out of this, it has been the ability for the agency to reassure doctors and patients that they've thought of these issues and there are multiple levels of security protecting this confidential information.

6 July 2017

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