Smart health cards or health smart cards?

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.