Austria

[Andreas von Heydwolff <106624.446@compuserve.com>]

Dear listmembers,

thanks for much information about the situation in the US.
This contributes to my basis for thinking about privacy
issues here in Austria. In this country there are now plans
underway to introduce a server based system by which
patients' insurance status will be checked in doctors'
offices before their second visit. 

To achieve this batch files would be transmitted once per
working day between all offices in the country and the
umbrella organization of the public health insurers.
Patients would bring a smart card, it would be entered the
first time the pt. comes to an office in a given quarter,
and the entry would be matched not later than the next
office day with a "hotlist" distributed by the insurance
organization. Switching doctors of the same specialty in a
quarter would result in the loss of the first doctor's right
to bill for more than the first visit because he could have
known that the pt. went elsewhere from the hotlist.
Especially in psychiatry, where confidence in one's mental
health professional sometimes needs some searching, this
would compromise confidentiality - noone should know Joe Doe
visited a colleague unless the pt. wants to tell. But the
insurer organization would send files about Joe around in
several steps, first in his region, later all over the
country. Makes me shiver as this software could be a
prototype for other surveillance too, but how to argument
against it when few people seem to care here?

My discussion with the physicians' association who currently
would accept this proposal grudgingly, and others, would be
based on the assumption that these admin. data are *medical*
data as defined by an EU directive of 1997 about medical
data: 

"...the expression "medical data" refers to all personal
data concerning the health of an individual. It refers also
to data which have a clear and close link with health as
well as to genetic data;"

The draft for a law that would regulate the implementation
however seems not to see these data as medical data.

Have there been conflicts you know of about the scope of the
definition of med. data? In one recent thread of this list
this seemed to be the case.

What would your view be? Besides all that I see the admin.
and abuse-fighting arguments as cover ups for much further
reaching plans for implementation of electronic
prescriptions and health records, but this is another cup of
coffee.

Greetings,

Andreas von Heydwolff, M.D., Jungian Analyst
Salzburg, Austria, Europe
health privacy site in German and English:
http://ourworld.compuserve.com/homepages/gesundheitsdatenschutz