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Big news from Down Under: the Sydney Morning Herald reports that a group of fifty consumer health advocates has unanimously backed an “opt-out” process for enrollment in electronic health records, reversing their previous position.

The issue is whether by default all patients have an EHR. “Opt-out” means you’re in by default – your records will be stored electronically – and you can opt out if you want. “Opt-in” means you do not have an EHR unless you specifically ask for one.

The group, the Consumer Health Forum, cites evidence from the neighboring country of New Zealand, in which only 100 people out of a million opted out. They also cited the expected improvement in care and reduction in cost, two patient benefits which outweigh the privacy concerns previously expressed by the Forum.

The government’s Ministry of Health does not agree, and still advocates opt-in. “‘The government firmly believes staged implementation, including ‘opt in’, is the right way to build confidence in e-health records for the ultimate benefit of patients,” said Health Minister Nicola Roxon.

e-Patient impact: For the e-patient movement this hints at a continuing cultural shift, which may favorably influence adoption of electronic medical records, which strongly support participatory medicine. (As SPM President Dr. Danny Sands once said, “How can patients participate, if they can’t see the data?”)

In Australia as well as the US (and elsewhere), privacy advocates have long expressed concern about abuse of private data in these systems. This concern, understandably, impedes adoption and slows growth. An attitude shift among those advocates may foretell a broader shift.

The timing in the U.S. is auspicious, as we continue the work of computerizing American healthcare. A significant consumer push is expected in September, and this shift in the wind is quotable fact: it appears that another responsible party has shifted to preferring the benefits of information being available at the point of care.

We’d welcome contact from any members of the Consumer Health Forum. Comment here, or email to blog at

Another hat tip to the daily ICMCC Newspage (subscribe) for this one.


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