THERE IS PLENTY OF ACTIVITY throughout the
world focusing on encrypting personal health
(and other) information on credit card-sized plastic
?smart? cards. These cards are embedded with
a computer chip and could provide easy access to
essential health information. As with many new
technologies, there is debate about smart cards in
health.
In July 2004 the Federal Minister for Health
and Ageing at that time, the Hon Tony Abbott,
announced that ?Australians will have access to a
new Medicare smart card as part of the government?s
electronic health agenda to improve the
quality and accessibility of patient information
across the health system?.1 This led to the introduction
of the Health and Social Services smart
card initiative. The business case for this initiative
suggested that this card could replace around 17
government issued ?health? cards, while improving
proof of identify arrangements.2 While in
opposition, the Labor Party opposed the notion of
the smart card, claiming it was an identity card by
stealth,3 and at the time of writing, it appears that
the health smart card has been put on the backburner
while the Government sorts out the priorities.
In this issue, Mohd Rosli and his Melbourne
colleagues report on a study of patient and staff
perceptions about health smart cards (page 136).
In this study, 270 emergency department patients
and 92 staff completed self-administered questionnaires.
The findings among patients and staff
generally supported the introduction of smart
cards with the majority reporting that the advantages
outweighed the disadvantages. The majority
of the respondents indicated that the cards should
be brought into use, and that they would use one
if offered. However, the study did find that a large
proportion of staff and patients were not aware of
health smart cards at all. A fundamental change in
the structure of our relationship with the government
had been proposed through the Health and
Social Services smart card initiative, and yet the
findings of this study suggest that the Australian
public was ill prepared to discuss the implications.
Where is the information sharing, the discussion
and the debate that can help shape our
health care system for the future?
In our last issue of 2008 we included a call for
student papers. I would like to remind all readers
of this important initiative, reproduced overleaf,
as I believe this is an effective way to begin to
encourage the necessary discussion and debate.
Over the Air Smart Card Update via Secure
Channel Protocol & Universal E-Card
