Wednesday, September 19, 2018

The Arguments For Staying In The myHR Pretty Flimsy I Believe. Let’s Us Explore A Few Facts.

There is a lot of exaggeration in the arguments we hear from the increasingly desperate proponents of the myHR.
The first argument is that myHR will allow us to get rid of the dreaded fax machine (which apparently contributed to the death of a patient a while ago – which is only partly true given the failure of physicians to follow up tests they ordered.) and what  fabulous boon to all that would be.
Sadly, with extremely rare exceptions, the fax machine has worked very well and has got thousands of results accurately and cheaply into the hands of the right doctor when needed – including specialists – who right now do not have the alternative is place, as what they have works well 99.9% of the time. The clinical community does not see the myHR as useful but over time they may just see secure message relayed reports as useful. Time will tell but saying messages good, faxes totally bad ignores the reality for now or in the foreseeable future. The simple truth is that the fax will die out when there is a better, cheaper and easier to use substitute that has widespread connectivity and interoperability.  Over to you technology innovators and implementers!
The second argument is that the myHR is a useful record in an emergency. If someone looked it up in an emergent situation and it actually had current easily accessible information that just might be true. With so many GP not wanting to have a bar of the myHR most won’t and presently with so many ‘zombie accounts’ (about 4 million of the 6 million records) even with opt-out it will take years – if ever.
There are a lot of simpler and easy alternatives like a short summary printed out by your GP and carried in the wallet etc. Remember the cost in GP time to have myHR records updated at reasonable frequency will cost over a $1billion a year. The thing would want to make a huge proven difference to be worth anywhere near that amount!  An honest cost / benefit analysis of the whole program is well overdue.
Third and linked are all the claims for savings with better medication information, test results and so on. There is just no on the ground evidence for this is the community environment that I know of - and I have looked. Sure this works to a degree in highly automated hospitals but using the myHR as an information source – slow, incomplete  and clumsy as it is - will not get similar results and has not been shown to be able to. It is all hope against experience.
Fourth the claim for endorsement of all the peak Digital Health entities is weakened by their close, often financial relationships with the ADHA, and for some of them an increasing recognition there are still many questions to be resolved with opt-out. As for the claim of supporting innovation most of the Digital Health industry thinks the opposite is true! (Note: I do understand the worry many of these peak entities have regarding ongoing funding etc. from Government if the myHR falls over. The point is that the myHR is a fundamental enemy of the sort of innovation that is actually needed - we are letting the awful be the enemy of the worthwhile and useful!)
When you mix this with all the risks with various populations – adolescents, the digitally deprived, the mentally ill and HIV carriers etc. this is a national experiment which needs to be rethought and done properly – not done at the behest of some data hungry health bureaucrats.
This is al not as simple as the ADHA propagandists would have you believe.
David.

The Hansard Transcript For The myHR Senate Inquiry Has Been Published.

Here is the link:

http://parlinfo.aph.gov.au/parlInfo/download/committees/commsen/c11da67a-4c01-42c5-9a03-529d794e8735/toc_pdf/Community%20Affairs%20References%20Committee_2018_09_17_6586.pdf;fileType=application%2Fpdf#search=%22committees/commsen/c11da67a-4c01-42c5-9a03-529d794e8735/0000%22

David.

Link To Senate myHR Inquiry Session Monday Afternoon 17 Sep 2018

Here you go:

http://parlview.aph.gov.au/mediaPlayer.php?videoID=416692&operation_mode=parlview

David

Tuesday, September 18, 2018

Commentators and Journalists Weigh In On The MyHR Debate And Related Matters. Lots Of Interesting Perspectives - 9.

Note: I have excluded any commentary taking significant  funding from the Agency or the Department of Health on all this to avoid what amounts to paid propaganda. (e.g. CHF, RACGP, AMA, National Rural Health Alliance etc. where they were simply putting the ADHA line – viz. that the myHR is a wonderfully useful clinical development that will save huge numbers of lives at no risk to anyone – which is plainly untrue) (This signifies probable ADHA Propaganda)
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Submission to the Senate inquiry on My Health Record

Posted on September 11, 2018 by Grahame Grieve
This is the submission I made to the Australian Senate with regard to its inquiry into the My Health Record. 
Executive Summary
My remarks relate to the following parts of the terms of reference:
  a. the expected benefits of the My Health Record system;
  b. how My Health Record compares to alternative systems of digitising health records internationally;
Recommendation:
The Department of Health (DOH) and the Australian Digital Health Agency (ADHA) work with the community to define an alternative architecture for a federated system for healthcare data exchange. This would allow for the implementation of the National Digital Health Strategy, and stimulate innovation to improve health, and leverage international standards and programs.
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GP-run school clinic to close due to teens’ data privacy fears

Doug Hendrie 13/09/2018 3:41:32 PM
A ground-breaking Tasmanian school health clinic will close due to fears that sensitive data uploaded to My Health Record may be seen by parents.
GPs are concerned young people will not divulge sensitive information due to fear it could be seen in My Health Record.
GP Dr Robert Walker has run a student health clinic at Rosny High School, which has around 1000 students, in Hobart for 10 years. It is one of only two GP-run school health clinics in Tasmania.
But he will close the clinic on 15 November, the day all Australians who have not opted out of My Health Record will have a record made for them.
‘About 15% of our young patients have a [My Health Record], presumably enrolled by their parents and almost all without their knowledge,’ he wrote in a blog post.
‘These students are really distressed by having a [My Health Record] and now worry about their confidentiality.
-----
Published Sep 12 2018

My Health Record: think about the status quo before opting out

Featuring

Chris Bain
Professor of Practice in Digital Health  Probable ADHA Propaganda
In 2017, Victorian resident Mettaloka Halwala died after his cancer test results that showed signs of fatal lung toxicity were faxed to the wrong number. The Victorian coroner ruled his death could have been prevented had he not been let down by a systemic failure of healthcare management.
Considering this tragedy, it’s important to think about the status quo when deciding to opt-out of the My Health Records (MHR) system, and the status quo is poor.
As you read this, reams of healthcare data is being sent between health professionals in the mail, via fax, through conversations on the phone or in person, via SMS or MMS, through WhatsApp and similar systems, and in small pockets of secure messaging.
When you think about this, it’s no wonder that health information goes missing. There are numerous examples of paper medical files being found in bins and inadequately disposed of, and examples of medical records found by complete strangers.
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CSIRO lays out action plan for Australia’s digital health future

Staff writer | 12 Sep 2018
Consumer distrust in data sharing, poor digital health literacy and system interoperability problems are major challenges to the effectiveness and sustainability of Australia’s healthcare system, according to a new CSIRO report aimed at highlighting solutions.
Released on Wednesday, the Future of Health: Shifting Australia’s focus from illness treatment to health and wellbeing management report is aimed at shaping future investments in the health system to help shift the focus on illness treatment to health and wellbeing management within the next 15 years.
“While there has been a broad social shift, purposefully and inadvertently, to sharing personal information in other sectors, consumer trust can be rapidly eroded if the confidentiality, integrity, or availability of their information is threatened,” the report’s authors stated.
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“Not fit for this purpose”: FHIR creator on My Health Record as the Senate inquiry gets underway

Lynne Minion | 13 Sep 2018
A global digital health leader has called for a rethink on the fundamental technology underpinning My Health Record, adding his clout to the submissions to the Senate inquiry into My Health Record.
Creator of the FHIR standard Grahame Grieve, who has provided technical advice to the My Health Record program since its inception, has called for an overhaul of the national health information platform, which he says was built on technology that was state-of-the-art in 2007.
In the decade since, according to Grieve’s submission to the parliamentary inquiry, technology and society have changed through the introduction of smartphones, wearables, cloud computing and high-speed broadband, and with these tech advances have come major developments in data exchange protocols.
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Helping patients to help themselves is good for the health economy

MEDIA RELEASE THURSDAY, 13 SEPTEMBER 2018
 Australia’s premier scientific body, the CSIRO has pinpointed empowering consumers as a key to improving Australia’s health, confirming a message the Consumers Health Forum has highlighted for years.
In its Future of Health report, the CSIRO put “empowering consumers” as its number one point in shifting Australia’s focus from illness treatment to health and wellbeing management.
“The report states that consumers are an ‘underutilised resource in the health sector’, which CHF is seeking to turn around by encouraging consumer involvement in direction and design of health care services wherever possible,” the CEO of the Consumers Health Forum, Leanne Wells said.
“As the report says, consumers can be empowered by a greater focus on the prevention of illness, and manage their health by improving health literacy, reducing information asymmetry, expanding telehealth services and developing consumer-focused health solutions.
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My Health Record needs to be compared to fax-based reality: AMA

The Australian Medical Association has said privacy experts are comparing My Health Record with a utopian ideal, not a doctor's lived reality.
By Chris Duckett | September 12, 2018 -- 05:57 GMT (15:57 AEST) | Topic: Security
The debate surrounding Australia's My Health Record has seen a forensic privacy and security analysis of the new system, but not one looking at the current ways doctors and health providers communicate, the Australian Medical Association (AMA) has said.
Speaking to the Senate Community Affairs References Committee on Tuesday night, AMA South Australia vice president Dr Chris Moy said the current state of affairs for doctors is primitive, and has its own privacy vulnerabilities.
"The most common form of urgent communication is fax -- that's the real world that we live in," Moy said. "This isn't particularly private because I don't know where it ends up, where it is -- and it is absolutely no use [asking me to send a fax] if I am not there after-hours.
"We are living in this faxland.
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RACGP warns of parents’ ability to see teenagers’ data on My Health Record

Doug Hendrie 12/09/2018 2:43:39 PM
The RACGP has alerted the Government to growing concerns regarding parents’ access to teenagers’ sensitive health data on My Health Record.
Dr Nathan Pinskier, Chair of the RACGP Expert Committee – eHealth, believes the issue of teenagers’ privacy is shaping up as a major concern among GPs.
At a Senate committee inquiry into My Health Record last night in Canberra, Dr Nathan Pinskier, speaking on behalf of the RACGP, called for a halt to the current policy allowing authorised representatives access to teenage children’s health data.  
Prior to the hearing, Dr Pinskier told newsGP that the issue is shaping up as a major concern among GPs, particularly in terms of sensitive areas such as sexual health.
‘Say a patient is 15 and has a sexually transmitted infection. If a parent sees [that data], it would cause significant consequences,’ he said.
‘How many kids at 14 think, “I can get my documents, take control and de-link my parents?”
‘And if they did that, what would the parents say when they realise they can no longer access their child’s records? It’s fraught with peril.’
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12 September 2018

Phelps warns of hidden landmines in MHR legislation

Posted by Julie Lambert
Former AMA president Dr Kerryn Phelps has demanded a full review of the My Health Record legislation to look for more “hidden landmines” after an outcry by doctors over access loopholes.
Dr Phelps has also told a Senate inquiry into the MHR that it should seek a public examination of the business case for the Australian Digital Health Agency to guard against possible future privatisation and monetisation of patients’ data.
“We have to ask what is the real underlying motivation for this massive exercise in data mining. Surely it’s not primarily the patients’ best interests,” she said, addressing the Senate Community Affairs committee by videolink on Tuesday.
The high-profile Sydney GP said she had been alarmed at the access provisions revealed when she read the MHR legislation, despite assurances by the health minister and the ADHA that “policy” was in place to protect patients.
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Australia a ‘digitally-divided society’ finds global index

Tenth overall, but 'deep disparities' within
George Nott (CIO) 12 September, 2018 00:01
Australia has been ranked as the tenth most ‘digitally ready’ nation, in a new index by Cisco and Gartner. But the research exposes a significant ‘digital divide’ between the states and territories, with Tasmania and the Northern Territory being left behind.
The Cisco Digital Readiness Index, released today, measured the digital readiness of 118 countries, based on seven metrics.
While Australia scored highly overall, the report revealed “deep disparities across the country” and “widespread unevenness”.
Those in the Australian Capital Territory were given a digital readiness score of 21.14, while Tasmania scoring 9.65 and the Northern Territory scoring just 4.80.
The score is based on metrics including: human capital (total labour force, adult literacy rate, population and years of schooling); basic human needs (life expectancy, mortality rate, sanitation, access to electricity); ease of doing business; and the start-up environment.
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AMA pushes for assurances on data protection at My Health Record inquiry

Marnie Banger AAP
September 11, 2018 3:09PM

Topics

AUSTRALIA’S most powerful doctors’ group wants further assurances that data on the federal government’s controversial e-health records system won’t ever be handed to private health insurers.
The Australian Medical Association will on Tuesday make the push at a parliamentary inquiry examining the My Health Record system.
AMA President Tony Bartone says the group is happy with strict restrictions blocking private health insurers from accessing the data, with people’s identities removed.
But he wants the status of the rules to be upgraded so they could only be changed through parliament.
“That would give the parliament the opportunity to see any changes and ensure that the Australian public is protected,” Dr Bartone told ABC Radio on Tuesday.
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Protect data from private insurers: AMA

The Australian Medical Association will be among those presenting at an inquiry into My Health Record, pushing for assurances on data protection.
Marnie Banger
Australian Associated Press September 11, 20182:10pm
Australia's most powerful doctors' group wants further assurances that data on the federal government's controversial e-health records system won't ever be handed to private health insurers.
The Australian Medical Association will on Tuesday make the push at a parliamentary inquiry examining the My Health Record system..
AMA President Tony Bartone says the group is happy with strict restrictions blocking private health insurers from accessing the data, with people's identities removed.
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Transcript:   AMA President, Dr Tony Bartone, RN, Breakfast with Fran Kelly

11 Sep 2018

Transcript:   AMA President, Dr Tony Bartone, RN, Breakfast with Fran Kelly, Tuesday, 11 September 2018
Subject:   My Health Record

FRAN KELLY:   Well, the Federal Government's My Health system is back in the spotlight with a Senate inquiry into the database holding its first public hearing today. This comes just weeks after Health Minister Greg Hunt announced new privacy measures to restore public trust in the system.
   [Excerpt]
GREG HUNT:   No police or government agency will be able to access any records without a court order. That's the existing policy, but the legislation from 2012 under Labor will be strengthened to do that. Secondly, we will also ensure that if somebody seeks to cancel their record, it will be deleted from the system permanently.
   [End of excerpt]
FRAN KELLY:   Health Minister Greg Hunt speaking last month. But privacy advocates still say that greater protection of personal health information is needed, while private health insurers continue to lobby to get access to the data.
The AMA is appearing at today's public hearing. President of the AMA is Dr Tony Bartone. Dr Tony Bartone, welcome back to Breakfast.
TONY BARTONE:   Good morning, Fran.
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My Health Record lets down the patients who could use it the most

Some diseases are judged more worthy than others. People with mental health issues, addiction and obesity know it
 ‘Whether or not we should trust the medical system to advocate for our personal wellbeing is a debate worth having. But it is also beside the point. Many don’t trust it, whether for lack of resources or want of empathy, and that itself is a problem when it’s a matter of public health.’
It seemed like such a good idea: a digital vault for all of our health records accessible by a variety of healthcare providers. But for all of their promise, digital systems like My Health Record risks letting down the very people it could help most unless we acknowledge what makes a disease a disease.
Any database of personal health records has to deal with two fundamental problems. One is a fear that healthcare providers might act less as an advocate for our personal wellbeing, and more as a gate keeper who judges our right to treatment.
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Mums hiding from violent exes fear they'll be found via My Health Record

Pilar Mitchell | September 11, 2018

"This places our safety at risk - he has threatened to kill," one terrified mum said.
It takes a hell of a lot of courage for a woman to leave her violent partner - so many women right now are desperately wanting to run out the door with their children - but they often talk themselves out of it due to paralysing fear. 
And now that fear is being escalated with their children’s My Health Records allowing  these dangerous ex-partners access to sensitive information including the family’s new address.
The reason for this because although an individual’s My Health Record is private and can only be accessed by the record owner and medical professionals, when the individual is a minor, records are visible to parents, The Daily Telegraph has revealed.
In a happy home, there is no issue for concern, but in a situation where an abused mother has fled her home, a child’s My Health Record holds sensitive data that could help a violent ex-partner track down his family.
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My Health Record: privacy and data access under microscope

Tuesday 11 September 2018 6:36AM (view full episode)
The outcry over privacy protections in the online health database My Health Record has faded over the last month, but privacy advocates are ready to renew their fight against the system, as a Senate inquiry into the database holds its first public hearing today.
As criticism of the plan to add every Australian to the register, unless they opt out, grew louder in July, Health Minister Greg Hunt took steps to strengthen privacy measures.
Those changes haven't satisfied the critics.
Private health insurers are still lobbying hard to get access to the data, although they say they don't want to see any patients' names attached.

Guests

Tony Bartone - Australian Medical Association
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My Health Record could be used to track women hiding from violent partners

Sue Dunlevy, National Health Reporter, News Corp Australia Network
September 10, 2018 9:13pm
WOMEN in violent relationships fear their partner will be able to track down their hiding places through their child’s My Health Record, a leaked submission into a senate inquiry claims.
News Corp has learned The Australian Digital Health Agency’s (ADHA) default position is to allow those parents access to their children’s My Health records which could contain information such as residential addresses or the pharmacy or GP used by the parent.
And where there is a dispute between separated parents over who can access the child’s record, the ADHA will suspend both parents’ access to the record until it investigates and decides which parent should have access.
“We work on the instruction of either of the parents who have equivalent status,” the Australian Digital Health Agency told its steering committee on August 20.
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My Health data revolution ‘can save lives’

  • 12:00AM September 10, 2018
The heads of Australia’s private health industry have argued that the federal government has lost the narrative on the rollout of My Health Record as they backed the initiative and called for greater use of data to fuel preventive care.
Mark Fitzgibbon, head of health insurer NIB, also rejected suggestions insurers could be accessing data from the digital health record system.
“Forget the idea insurers can use somebody’s individual health profile to disadvantage them — in our world of community rating, enshrined in the legislation and our culture, we charge people the same price irrespective of age and health status,” he said.
The rollout of the e-health initiative lost momentum as privacy concerns dominated headlines, forcing Health Minister Greg Hunt to commit to change the laws protecting consumers and their data. A Senate inquiry is also set to examine the security measures around the e-health records, which Australians have until October 15 to opt out of.
Medibank chief executive Craig Drummond was confident the government would work through the issues, adding that the insurer supported the digital record.
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Data fears may spark opt-out choice in WA from My Health Record

Cathy O'Leary
The West Australian
Sunday, 9 September 2018 4:43PM
Cracks are appearing in WA support for the Federal Government’s controversial My Health Record, with a cybersecurity expert calling on people to opt out.
Dr David Glance, from the University of WA, who spoke at a public talk on online safety at a City of Perth event this week, said he had opted out along with many family, friends and colleagues in the security industry.
He said data in the health records was limited but just having prescription details was enough for someone to tell that you were taking antidepressants.
Health Consumers’ Council executive director Pip Brennan said that while she personally opted in two years ago, she felt conflicted.
She advised people who had sensitive medical information such as a mental health diagnosis or drug issues and were unsure to opt out.
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Comments welcome!
David.

A Small Example Of What Nonsense Bureaucrats Will Put Up To Justify Doing What They Want.

Over a year ago this was published:

Changes to My Health Record System

Aust Gov
1st June 2017
Regulation Impact Statement - Department of Health
The Government announced changes to its My Health Record system as part of the 2017-18 Budget. The My Health Record system will change to an opt-out model.
As a result of these changes, every Australian will have a My Health Record unless they prefer not to. Transition to opt-out participation will bring forward benefits to patients and medical service providers many years sooner than the current opt-in arrangements.
The Office of Best Practice Regulation (OBPR) assessed the Regulation Impact Statement (RIS) prepared by the Department of Health as best practice.
The RIS estimated the average annual regulatory savings of the proposal to be $3.13 million. The OBPR has agreed to this estimate.
Here is the link:
The benefits claimed are here:
Impact on Government
There will be a short term cost for Government to support an increase to the capacity of the My Health Record system and to undertake public communication campaigns, healthcare provider-readiness activities and training and education to support National Opt Out arrangements.
For a one-off cost of $180.9 million over four years (to the end of FY 2020/21) to implement Opt Out arrangements nationally, benefits will be delivered within the forward estimates period, and much sooner than under a continuation of the existing arrangements. 
The Government would gain significant economic benefits and return on this investment through reductions in the growth of healthcare costs arising from improvements such as:
  • reduced hospital admissions;
  • improved individual care including better management of chronic disease; and
  • a more efficient healthcare system.

Health Benefits
Broader participation and meaningful use of the My Health Record system will put the person at the centre of their healthcare and support sustainability through better availability and use of health information, which has the potential to enhance policy formulation, innovation and allocation of resources thus improving the quality and the safety of healthcare and service delivery costs.

Encouraging increased participation and effective use of the My Health Record system can lead to improved coordination and better integration of the healthcare system, resulting in a reduction in adverse events and in duplication of treatments and tests.
The reductions in time taken in finding information and the performance of unnecessary investigations would result in improved productivity for the health workforce.
Enhancing participation and meaningful use of the My Health Record system will be of particular benefit to individuals with chronic and complex conditions, older Australians, Indigenous Australians, mothers and newborn children, and individuals living in rural and regional areas, as they are more likely to access healthcare from numerous healthcare providers.
In addition, it would mean that individuals and their families will be able to go anywhere in Australia to receive high quality and convenient healthcare, reducing the time and costs associated with undertaking duplicate tests or repeating information.
Increasing the uptake and meaningful use of the My Health Record system would lead to:
·         Improved health outcomes, avoided hospital admissions and saved lives through fewer adverse drug events (more Australians die each year because of medication errors than from road accidents), better coordination of care for people seeing multiple healthcare providers, and better informed treatment decisions ($2.10 billion estimated over ten years);
·         A much more efficient health system. For example, healthcare providers will spend less time searching for information about their patients ($2.81 billion estimated over ten years);
·         Avoided duplication of diagnostic tests - pathology and diagnostic imaging ($2.08 billion estimated over ten years);
·         Putting the person at the centre of their healthcare, so they play a greater role and take greater responsibility for their own health ($1.41 billion estimated over ten years);
·         Enabling innovation and developments in healthcare through secondary uses of health information, enabling unprecedented levels of insight into population health outcomes, which better-inform policy decisions, make resourcing more sustainable, and inspire new clinical developments ($6.19 billion estimated over ten years).

It is anticipated that benefits in health outcomes will be skewed towards vulnerable families as they currently face more challenges in accessing timely and appropriate healthcare and will have more to benefit from increased participation and meaningful use of the My Health Record system. Based on current experience, these people are less likely to participate in the existing opt in model as they are more likely to be challenged by the registration process. Vulnerable population groups may include Aboriginal and Torres Strait Islander people, families with a member who has a mental illness, families in which English is a second language, and families with low socio-economic status. These groups are expected to experience more pronounced benefits as the My Health Record system will help reduce the burden carried by these families.
----- End extract from Pages 7 and 8.
The move to opt out was to provide $14.59 Billion over 10 years of which almost half was derived from Secondary Use Initiatives rather than clinical benefit.
This is the  clearest statement yet of what the myHR is actually for. It is not as Mr Shetler said Your Health Record but a Government Record of your health information!
We can only marvel as to how these figures were derived but the Government does not show its working….
Read closely and you will also see the so called beneficiaries are likely those who will not have the means or capacity (internet etc.) to interact and use the myHR. The wrong side of the Digital Divide.
What a fudge.
David.

Are You Amazed By What Mr Kelsey Told Us? - I Sure Am.

Besides the amazing lack of insight of the Liberal Senators regarding the issues being raised by witnesses at the Senate Inquiry Into The myHR yesterday afternoon there were two figures that struck me.

First was the admission that at least 900,000 citizens had opted out - as those in the paper based opt-out channel were yet to be counted and would add some more.

Then Mr Kelsey said that was about 3% of the population who could opt-out - there being that choice for all those that had an Individual Health Identifier - an IHI. He then said there were about 28 million of those.

Given there is only a population of 25 million in Australia, who are the other 3 million? Some are visitors etc. but I bet there are all sorts of duplicates, dead people and so on as well, in what can't be a very accurate IHI database. I wonder is this due to under-resourcing of the areas that maintain the IHI system.

It seems the ADHA really does not even know who it is actually going to 'opt-out' with any certainty and that will be a real ongoing data integrity issue.

What a mess. And the admission of the lack of a Business Case etc. for the whole thing just adds to the sense of ad-hoc-ery!

David.

p.s.

And the quote of the session - Paul Shetler - "The myHealthRecord in not your health record, it is a Government Health Record about you." Not sure many want one of those?

D.


Monday, September 17, 2018

Weekly Australian Health IT Links – 17th September, 2018.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A quiet week, waiting for the second session of the Senate Inquiry and to see what comes out of it. This post appears just as the second session starts.

Watch from this page:

https://www.aph.gov.au/Watch_Read_Listen

The report is due on 8 October, 2018 just so you know.
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Digital health round-up: Australian government proposes changes to MyHealth Record

September, 2018
As Australia signed in new prime minister Scott Morrison following a leadership coup, its beleaguered government is trying to stave off another crisis by publishing legislation designed to reassure the public over the security of its electronic health record system.
Australia wants to introduce an opt-out-based electronic health record system, known as MyHealth Record.
But there are concerns it would be too easy for law enforcement authorities to access the records, which would be kept for 30 years even if citizens asked for them to be deleted.
A new bill proposes that should someone ask for their record to be deleted, the agency will only be allowed to retain the citizen’s name and health identifier, and the name and identifier of the person who asked for the account to be cancelled – such as a parent, for example.
Under the amendments, records will only be accessed under a judicial order, reported the IT website The Register.
-----

Poll - AMA Portal

My Health Record: staying in or opting out?
  • Opting out (70%, 205 Votes)
  • Staying in (30%, 86 Votes)
Total Voters: 291


Current Sep 14, 2018
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Apple debuts biggest iPhone yet, health-oriented watch

By Stephen Nellis and Sonam Rai on Sep 13, 2018 6:29AM

Looks to get users to upgrade to more expensive devices.

Apple Inc introduced its largest iPhone ever and a new line of watches that can detect heart problems on Wednesday as it looks to get users to upgrade to more expensive devices in the face of stagnant global demand for smartphones.
The relatively small changes to its lineup, following last year's overhauled iPhone X, were widely expected by investors, who sent the company's shares down 1.5 percent.
The strategy has been successful, helping Apple's stock up more than 30 percent this year and making it the first publicly traded U.S. company to hit a market value of more than US$1 trillion.
"It is pretty consistent with past iPhone release days where we see short-term sell the news but things will probably get a lot better in the weeks and months ahead, particularly with a strong holiday sales season expected," said Jake Dollarhide, chief executive of Longbow Asset Management.
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Google to fight 'right to be forgotten' extension across globe

A 2015 order from the French privacy regulator, CNIL, to Google, telling the search engine company to extend the European Union's so-called "right to be forgotten" to all its websites around the globe will be appealed by Google on Tuesday.
The dispute, that will come before the EU's Court of Justice in Luxembourg, is the most prominent case to test the limits of jurisdiction with regards to data, The Wall Street Journal  reported.
The initial order to Google came from the EU in 2014 as iTWire reported. A ruling by the Court of Justice in May that year found that European law gave people the right to ask search engines like Google to remove results for queries that included their names.
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Tetris-like program could speed breast cancer detection

Thursday, 6 September 2018
Researchers from the University of Adelaide’s Australian Institute for Machine Learning (AIML) are developing a fully-automated medical image analysis program to detect breast tumours. The program uses a unique style to focus on the affected area.
In conjunction with an MRI scan, this autonomous program – using artificial intelligence − employs the traversal movement and style of a retro video game to examine the breast area.
University of Adelaide PhD candidate Gabriel Maicas Suso and Associate Professor Gustavo Carneiro from AIML developed the program.
“Just as vintage video game Tetris manipulated geometric shapes to fit a space, this program uses a green square to navigate and search over the breast image to locate lesions. The square changes to red in colour if a lesion is detected,” says Mr Maicas.Suso.
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NSW Health builds prototype big data platform

By Justin Hendry on Sep 11, 2018 6:55AM

Health system performance in its sights.

eHealth NSW has kicked off the development of a prototype big data platform aimed squarely at improving the performance of the state's healthcare system, particularly how services are delivered and envisaged.
The digital arm of NSW Health is half way through a six-month proof of concept project with the Royal North Shore Hospital that it hopes will serve as the basis for an enterprise-wide solution.
NSW Health CIO and eHealth NSW CEO Zoran Bolevich revealed the platform during his keynote at a recent event hosted by the Australian Information Industry Association (AIIA).
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Take heart, not all health apps are deadbeats

Despite their bad rap, a new Aussie study shows health apps can be helpful
Antony Scholefield
13th September 2018
Health apps, despite their proliferation, have copped a hiding from researchers in recent years, with little reliable evidence that they work. But a new study might change that view.
The Australian study looked at medication adherence among patients with coronary heart disease using two apps — ‘My heart, my life’ and ‘Medisafe’. 
Two groups of about 50 patients were given each app and tracked for three months. Another 50 controls had no app.
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Hospital workers in WA breach patient records 40 times over three years and keep their jobs

Lynne Minion | 14 Sep 2018
Patient records were breached 40 times by hospital workers in Western Australia who accessed confidential information inappropriately from 2014 and 2017, with none of them losing their jobs.
According to WA’s The Sunday Times, which was provided with the concerning stats following numerous requests to the Department of Health, the employees were disciplined with written warnings, counselling, a formal reprimand, training and an “improvement action”.
Fourteen of the breaches occurred at Perth’s South Metropolitan Health Service, which includes the state’s flagship Fiona Stanley Hospital.
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Digital rights groups call for government to scrap surveillance bill

Proposed legislation ‘effectively enacts insecurity by design’
Rohan Pearce (Computerworld) 11 September, 2018 12:42
A coalition of digital rights groups has called for the government’s draft surveillance bill to be scrapped wholesale, saying that it “effectively enacts insecurity by design” and will create “extremely broad powers with almost no oversight without any substantive justification”.
The government has argued that its proposal to increase the ability of police and national security organisations to access online services will not weaken the security of services relied on by millions of Australians.
The exposure draft of the Telecommunications and Other Legislation Amendment (Assistance and Access) Bill 2018 would create new powers for law enforcement agencies to demand tech companies cooperate with requests for assistance and in some circumstances even build new tools that would allow for user security to be bypassed during investigations.
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  • Sep 12 2018 at 10:13 AM

Is AI funding overheated? Beware the hype about artificial intelligence.

by James Titcomb
In 1964, an American computer scientist named John McCarthy set up a research centre at California's Stanford University to explore an exciting new discipline: artificial intelligence.
McCarthy had helped coin the term several years earlier, and interest in the field was growing fast. By then, the first computer programs that could beat humans at chess had been developed, and thanks to plentiful government grants at the height of the Cold War, AI researchers were making rapid progress in other areas such as algebra and language translation.
When he set up his laboratory, McCarthy told the paymasters who had funded it that a fully intelligent machine could be built within a decade. Things did not pan out. Nine years after McCarthy's promises, and after millions more had been ploughed into research around the world, the UK government asked the British mathematician Sir James Lighthill to assess whether it was all worth it.
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ACCC wants public input on Consumer Data Right rules

The Australian Compeition and Consumer Commission (ACCC) is seeking public submisssions on the Consumer Data Right (CDR) compliance rules currently being developed, and which will allow consumers to require their bank to share their data with accredited service providers.
The consumer watchdog issues a notice on Wednesday seeking feedback from consumers, businesses and community organisations on the approach and positions the ACCC proposes to take in setting up the rules for the CDR.
As part of the consultstion process the ACCC will be holding a number of stakeholder forums seeking input on the Rules Framework.
The CDR is a competition and consumer reform announced by the Australian Government in May 2018 and the ACCC has been delegated the lead role in rule-making, consumer education and enforcement.
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DTA embeds proof-of-life test in Govpass to thwart ID fraud

By Justin Hendry on Sep 13, 2018 6:55AM

Australia gets a national selfie check.

The Digital Transformation Agency has picked digital security firm Idemia to provide a crucial liveness detection test for the government’s soon-to-be piloted Govpass platform to prevent the creation of fraudulent digital identities.
Previously known as Morpho, the French firm has been tasked with weeding out fakes, impostors and pretenders that, if allowed through. could compromise the integrity of the government’s single authentication credential known as myGovID.
The government is hoping that millions of of Australians will self-enroll to its new opt-in scheme, a process that offers big savings over traditional over-the-counter checks. But to get that process right, it first needs software that can tell if a person is there for real.
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Chronic disease care plan revamp in the works

The MBS Review Taskforce is proposing to cut rebates for GP management plans and increase funding for follow-up
12th September 2018
Rebates for preparing chronic disease patient care plans would be cut in favour of bigger government spending on follow-up consults, under a draft proposal from the MBS Review Taskforce.
The review’s general practice and primary care committee has asked the AMA and RACGP to comment on a draft plan to revamp GP Medicare items, including a ban on a level B attendance for any consult less than six minutes and a new level E item.
But the report remains confidential and will not be shared with the broader profession or the public unless the taskforce approves it for release at its next meeting on 18 September.
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Chief Digital Officer

Salary: N/A
Location: Australia
Company: Australian Digital Health Agency
Chief Digital Officer
Reporting to the CEO, the Chief Digital Officer leads the Innovation and Development team and is responsible for the coordinating the strategic, innovation and technical aspects of the digital health programme. This includes the following key aspects - Strategic leadership coordination and management of the digital health strategy and associated work programme, open innovation, design authority and design integration, specifications, product development, benefits evaluation programmes of work and provision of PMO services.
Furthermore, the position is responsible for leading a forward thinking approach to every aspect of the Digital Health strategy. This includes overviewing the current programs underway as well as being the “visionary” on the future direction of the Digital strategy delivered by the Agency. Stakeholder engagement both internally and externally is a critical aspect of the role.
This position is at the same time a strategic and ‘hands on role’ focused on deliverables against agreed timeframes. An open communication style with transparency and clarity at the heart of all programs is essential to succeed in the role.
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Media release: Global Digital Health leaders meet in London to collaborate on the evolving digital health landscape

9 September 2018: Digital health leaders have recently come together in London at the third Global Digital Health Partnership (GDHP) summit, to collaborate and share their experiences, and to support the improved delivery of digital health services around the world. The leaders represented 23 countries and territories and the World Health Organization (WHO). Following the summit on 3-4 September, representatives attended the Health and Care Innovation Expo on 5-6 September and the NHS Digital showcase on 7 September in Manchester.
Chair of the Global Digital Health Partnership and Chief Executive of the Australian Digital Health Agency, Mr Tim Kelsey commented on the significance of the partnership for countries around the world.
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Why every GP should have this app

It's a great addition to your armamentarium
Dr Rob Park
14th September 2018
PRODUCT REVIEW: HOT APPS
I’ll be honest, I was really excited about this app. The online version of the eTG was a steady companion as a medical student.
As a GP, these guidelines are still available when I need quick, high-quality and reliable therapeutic guidance.
And now I can do this on my mobile.
The eTG complete mobile app is as streamlined as I would expect from a company that maintains high standards as its core business.
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NSW birth certificates, property titles and motor rego headed for the blockchain

Secure Logic reveals ambitions for blockchain platform
George Nott (CIO) 10 September, 2018 12:37
Secure Logic, makers of the blockchain platform underpinning the NSW Government’s digital driver’s licence pilot, has revealed its ambitions for the technology across a bevy of state government services.
The Sydney-based tech firm today launched TrustGrid, which it describes as a “secure, decentralised and immutable ledger of transactions.” The platform allows agencies and organisations such as hospitals and financial institutions to “create private consortiums of trust entities on the fly”.
The technology powered the NSW Government’s digital driver’s licence pilot earlier this year, during which 1,400 Dubbo residents used their digital ID in roadside police checks, pubs and liquor stores.
A second pilot will take place in Sydney’s Eastern Suburbs – covering Bondi, Bondi Junction, Bronte, Clovelly, Coogee, Randwick and Waverley – in November.
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Secure Logic says its new blockchain platform will 'improve delivery of government services'

Sydney-based tech solutions provider Secure Logic says its new "TrustGrid" platform that will help combat identity related crimes and underpin the digitisation of government services, like motor registration, property titles and birth certificates.
Secure Logic says "TrustGrid is an advanced blockchain solution that delivers a secure, decentralised and immutable ledger of transactions. It enables government agencies and vetted private organisations such as hospitals and financial institutions to create private consortiums of trust entities on the fly.
"Earlier this year, the technology powered the NSW Government’s digital driver’s licence pilot with 1,400 Dubbo residents and is set to be used again as a second pilot takes place in Sydney’s Eastern Suburbs in November, where residents will be able to show digital identification in pubs and clubs and for roadside police checks."
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Australia, world hit by sharp rise in mobile fraud attacks

Fraud attacks on mobile transactions in Australia have increased 26% this year compared to 2017, with a new cybercrime report also revealing that attacks have risen sharply around the world.
According to the report from security firm ThreatMetrix - a LexisNexis Risk Solutions Company - mobile fraud has reached 150 million global attacks in first half of 2018 with attack rates rising 26% year-over-year in Australia alone.
The report also reveals that Asia Pacific countries including Australia, Japan and Singapore featured in the top five target destinations among countries perpetrating the highest number of attacks globally - UK, US, China and Canada.
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CSIRO using serverless compute to analyse the human genome

The CSIRO is using AWS Lamba to allow analysis of the 20 exabytes of data coming from genomics every year.
By Asha McLean | September 14, 2018 -- 01:16 GMT (11:16 AEST) | Topic: Innovation
By 2025, it is estimated that 50 percent of world's population will have had their genome sequenced, which according to Commonwealth Scientific and Industrial Research Organisation (CSIRO) transformational bioinformatics team leader Dr Denis Bauer means that genomic data will be larger than the data held by Twitter, YouTube, and astronomy combined.
Genomics is the study of information encoded in an individual's DNA, allowing researchers to study how genes impact health and disease.
The genome holds the blueprint for every cell in an individual's body and with so much information encoded in the genome it comes as no surprise Australia's peak research organisation is investing heavily in exploring its possibilities.
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Orion shareholders to vote on Rhapsody sale this month

Tuesday, 11 September 2018   (0 Comments)
eHealthNews.nz editor Rebecca McBeth
Orion shareholders will vote on plans to sell the company’s Rhapsody division to Hg at an annual shareholders’ meeting later this month.
The Notice of Meeting for the company’s annual shareholders’ meeting details Orion’s plans to split up the business, selling Rhapsody and 25 per cent of its population health management business for $225 million.
Orion will maintain full control of its hospitals division and has recently announced a new version of its hospital information system, Enterprise.
Rhapsody is Orion Health’s integration engine and is an integral part of the company’s suite of applications used by health providers across New Zealand.
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National digital ID deal ends isolation

  • 12:00AM September 14, 2018
A landmark agreement between the federal, state and territory governments to end the “isolation” of digital transformation projects will be ratified in Sydney today in a deal that will help ­develop a national “digital identity” with biometric scanning.
The inaugural meeting of the Australian Digital Council, chaired by Minister for Human Services and Digital Transformation Michael Keenan, will be opened by Scott Morrison with all state and territory ministers present, except Victoria’s.
Mr Keenan said governments had often “jealously guarded” their data and digital projects, which made no sense in a federation where Australians and businesses often had to deal with multiple levels of bureaucracy each month.
“Governments have tended to work on their digital projects in isolation and, in some cases, in competition with each other,” Mr Keenan said.
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Inclusive or invasive? Digital ID stirs debate

By Carey L. Biron
14 September 2018 — 9:41pm
Washington: Digital identity systems are a "revolutionary" way to provide the world's most vulnerable with access to essential services, but steps must be taken to protect privacy, philanthropists, businesses and charities said on Friday.
More than 1 billion people globally have no way of proving their identity, according to the World Bank, which experts say excludes them from basic services such as education and healthcare.
But technologies like blockchain and mobile phones can support private digital identity systems that can be accessed anywhere, said Dakota Gruener of the ID2020 Alliance, a public-private consortium promoting the UN 2030 Sustainable Development Goal (SDG) of providing legal identity for everyone.
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Govts agree to unite on digital, data

By Justin Hendry on Sep 14, 2018 6:58AM

New ministerial council born.

Federal, state and territory governments will convene at the first ever sitting of the Australian Digital Council to commit to crucial new cross-jurisdiction agreements around digital services and data.
Ministers from all eight Australian governments will converge on Sydney today for the first of what will become a biannual inter-jurisdictional meeting designed to improving collaboration.
Chaired by the Federal Minister for Human Services and Digital Transformation Michael Keenan, the Council is expected to agree to focus on accelerating the development of digital services and improving data sharing across borders by working together.
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Mobile-enabled InterSystems TrakCare supports better healthcare decision making

New mobile user interface designed to improve electronic medical record adoption and patient safety, speed clinical workflows and improve the patient experience

SYDNEY, Australia, September 12, 2018 – InterSystems, a global leader in health information technology, today announced that the InterSystems TrakCare® unified healthcare information system has added a mobile, touchscreen-enabled user interface to optimise the user experience and other enhancements that support better healthcare decision making.
TrakCare’s mobile-enabled user interface supports streamlined electronic medical record (EMR) workflows and delivers context-rich, concise information wherever and whenever it is needed. Clinical notes can be created with a few swipes and taps, images and barcodes captured via camera, and additional information captured via voice.
Using mobile devices at the point of care can support doctors and nurses to make better decisions and allows them to capture and access accurate data more easily and quickly. This promotes EMR adoption, supports patient safety, speeds up clinical workflows, creates a better patient experience, and allows other carers to make better decisions as well.
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Nvidia's Clara smartens up medical instruments

Nvidia's new Clara platform is aimed at applying the power of AI and modern graphics technologies to medical instruments.
Combining Nvidia's Xavier module with Turing GPUs and a new software development kit, Nvidia Clara is intended as a platform that can take the massive amounts of data generated by medical instruments, such as ultrasound and X-ray machines, visualising it, and potentially recommending actions.
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Apple Watch announcements proved more exciting than new iPhones, again

By Peter Wells
13 September 2018 — 1:33pm
During Apple’s event last September, despite the iPhone's dramatic redesign, the standout announcement for me were the changes to the Apple Watch. Bringing a 4G antenna to the Watch was the first step in letting this tiny computer one day stand alone, and not simply be a satellite to the phone.
Once again this year the Apple Watch was most improved in the line-up, with more noticeable changes to hardware, a greater focus on health, and a promise of a more powerful ecosystem of apps with watchOS 5. Jeff Williams, Apple’s chief finance officer summed up the pillars of the new watch as “staying connected, living an active life and looking after your health”.
The Watch simply looks better, with a larger display, easier to read fonts, an overall thinner design and new live widgets that give the user so much more information in a single glance. A watch is too small to interact with most of the time, so you want it to always have the information you need, waiting for you.
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UNSW researchers find FTTP NBN worth the extra billions

By Ry Crozier on Sep 11, 2018 11:46AM

Economists tally social costs of policy shift.

Australia would have seen stronger social benefits by sticking to a majority fibre NBN model, with UNSW researchers estimating the uplift from FTTP would have outweighed the additional outlay.
The researchers - UNSW Professor of Economics Richard Holden, UNSW Professor of Law Rosalind Dixon, and economics consultant Alex Rosenberg - launched a paper [pdf] last night that proposed a new way of calculating returns on government investment.
They propose the use of what they call ‘social return accounting’, pitched as a way to measure how much value a project generates beyond purely economic concerns.
However, what is likely to be of significant interest is the application of social return accounting to the NBN, and what Australia lost by moving away from Labor’s mostly fibre-to-the-premises (FTTP) model.
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NBN Co agrees to improve wholesale deals with RSPs

NBN Co, the company rolling out Australia's national broadband network, has given the competition watchdog a court-enforceable undertaking to improve its wholesale arrangements with retail service providers within three months.
The undertaking was given in the context of the ACCC’s inquiry into NBN wholesale service standards which was begun in late 2017 to determine whether NBN wholesale service standards are appropriate, and to consider whether regulation is necessary to improve consumer experiences.
A statement from the Australian Competition and Consumer Commission said the company had offered the undertaking after being shown an interim access determination that the ACCC proposed to make.
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Enjoy!
David.