Consumers Are Ready to Accept the Transition to Online and Electronic Records If They Can Be Assured of the Security Measures

Prajesh Chhanabhai, BSc, MSc, HINZ, ACM NZ Chapter; Alec Holt BSc, DipSci, MCom (Otago), MNZRS, PhD (Otago)

In This Article

National Health Index

An initiative that has been used in New Zealand to store nonidentifiable health information is the National Health Index (NHI) number. One of the problems with implementing the EHR has been the question of how to store patient information that will be linked to a nonidentifiable system. The NHI system is one such mechanism that could be employed to achieve this. It is made up of 3 letters and 4 numbers that are uniquely associated with a certain individual. Initially the NHI number was used exclusively in the hospital to record admissions and to ensure that the hospital was aware of any medical warnings. This has changed, as the NHI number is used by all healthcare instances involving an individual. Each instance is referenced and recorded by the patient's NHI number, thus allowing for the connection of separate records and allowing a patient health summary to be built up.[17] Currently, the NHI number stores information, such as name and address, date of birth, sex, and ethnicity. The New Zealand Health Information Service (NZHIS) is quick to point out that the NHI number is not a health record; rather it is used to correctly make a match with one's health record.[18] The NZHIS also claims that 95% of health consumers have an NHI number that is given to them automatically at birth.[18] However, the number of people who actually do know their NHI number may actually differ.

The NHI number concept has not been received well by the Privacy Commissioner. In a report published in 1998, the author found that the way in which the NHI system was being implemented would not be providing any benefits to the health consumer.[17] The key finding in the report was that inconsistent information was being given out by North Health in their promotion of the NHI number. The Privacy Commission found that the information was misleading. Accordingly, the report gave a number of arguments against the NHI scheme. Essentially the claim put forward by both the NZHIS and North Health was counterclaimed by the Commission, who argued that all the benefits proposed were for activities that were not being carried out by caregivers initially and, thus, did not add value to the healthcare of a patient. The statement, "The main effect of interconnection through a common unique identifier will presumably be to facilitate the collection of information which the patient has not authorised,[17]" indicated that it was believed that the NHI number, in its current use, was used in a manner that is oblivious to the health consumer. Coney[19] also declared that for the NHI scheme to be effective, it was important for the public at large to be fully informed about the system thus becoming part of the actual system, which is essentially the stepping stone to building the EHR.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: