Health Smart Cards: what do ED staff and patients think?

A majority of emergency department (ED) patients and staff support the introduction and use of health smart cards, according to survey results published in the Australian Health Review. 
 
This article appears in the February 2009 issue of the Australian Health Review, the peer reviewed journal of the Australian Healthcare and Hospitals Association. 

“Most emergency department staff and patients see many potential benefits from introducing health smart cards, including the need to quickly access information on medical histories, medications and allergies when people first appear at the door,” said co-author, Associate Professor David Taylor from Austin Health. 
 
“The advantages of smart cards to record health information include their large memory capacity, owner identification, non-computer based readability and most importantly the immediate access to a person’s medical history in emergency situations.
 
“Our survey found there are differences in the benefits and possible disadvantages perceived by patients and staff.  A larger percentage of patients had not heard of smart card technology in health settings but had a higher level of support for their introduction.  Patients identified fewer disadvantages, supporting other research that shows the public is keen to see a reliable electronic health record and interface sooner rather than later.
 
“Staff and patients understandably express concerns over key issues of confidentiality and privacy, for slightly different reasons.  Patients are interested in controlling who can access their medical information. Most identified doctors and nurses as the main clinicians they wish to view their records.  Patients also want input and access to the information stored on the cards in order to exercise some control over their health care.  However, staff would wish to see more items of information stored than patients to assist decision-making in an emergency.
 
“Staff are more concerned with the currency and accuracy of the health information stored on the cards (or the data source the cards might tap into). Given that the majority of survey participants believe health smart cards should be optional to use, this is particularly important. This finding raises the issues of acceptability of a compulsory system and the effectiveness of an opt-in system.
 
“This research indicates that further work must be done to determine the nature of any opt-in/opt-out system.  There is also a clear need for the public and hospital staff to be made aware of smart card technology as part of healthcare.  With the inevitable introduction of electronic health records in the Australian health system, it is now time to help consumers and professionals understand what information is needed and the best way to access it,” said Associate Professor Taylor.