This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Tuesday, January 31, 2017
Is There A Lesson In All This For The Health Sector? - I Suspect So!
Few can be unaware of the issues around the use of data-mining to attempt to identify individuals who have been overpaid from Government coffers.
This is a good summary if you have not been paying attention.
It has become the most widely cited figure in the Centrelink robo-debt debate: that 20 per cent of the debts identified by its data-matching machine are wrong.
But the figure itself is wrong. The true number of mistakes is almost certainly higher, perhaps as high as 90 per cent.
Twenty per cent has become the accepted truth in part because the figure is big - big enough for critics to use to condemn the data-matching program and big enough for Centrelink to use to fob off requests for the truth.
Even Malcolm Turnbull's disenchanted former digital transformation chief Paul Shelter embraced it.
"All I can say is, if they were a commercial company, you would go out of business with a 20 per cent failure rate, a known 20 per cent failure rate, you would go out of business," he told The Guardian this month.
Labor frontbencher Anthony Albanese backed him up, wrongly saying that "on the government's own figures, 20 per cent of people who've been sent debt letters, often accompanied by threats of debt collection agencies being involved, have been sent them on a false basis".
The 20 per cent isn't the proportion of debt letters sent out that are false. We won't know that for a long time, if ever. Some people have been paying up even when the debt letters are wrong, sometimes because they don't have the records to argue otherwise, sometimes because they trust the government, and sometimes because they can't be bothered dealing with Centrelink.
Here is where the 20 per cent figure comes from. Between July and December, Centrelink's computer sent out 232,000 letters asking people to log on to a website to confirm or update their income history. Around 169,000 did so. (An email to Fairfax Media from the office of Human Services Minister Alan Tudge implies that none of the 63,000 who did not log on have been issued with debt notices. Their cases are "are still active and in progress or require further review".)
Published: January 24, 2017 - 10:58PM
Of the loads of films I saw last year, the most memorable was Ken Loach's I, Daniel Blake. I go to the movies for escapist entertainment, not to give my emotions a good workout but, even so, it left a lasting impression.
It was the story of a 59-year-old carpenter in Newcastle, England, whose cardiologist told him not to go back to work for a few months after he'd had a heart attack on the job.
What we saw was Blake's mistreatment at the job centre he went to for social security payments at the height of the Cameron government's austerity spending cuts.
It was run like an assembly line, with "clients" processed as fast as possible, with a complete lack of flexibility or consideration.
Nothing Blake said was listened to, but at his first sign of frustration he was rebuked for his utterly unacceptable behaviour and threatened with removal by security guards. He was repeatedly threatened with the "sanction" of having his dole suspended for such crimes as being late for his appointment.
He got nowhere when he visited the centre, had to hang on for ages when he phoned, and was always being told to fill out forms online. Small problem: he didn't have a computer and didn't know how to use one.
Sorry, online forms are "mandatory".
Why would a government treat its citizens so badly? Well, reading between the lines you saw the centre had been handed over to a private business. It probably underquoted to get the contract and had turned the centre into a sausage machine in the hope of saving enough on staff to make a profit.
I thought of Daniel Blake when I read of the way the Turnbull government is using an "automated debt recovery program" to harass former users of Centrelink.
It's using a computer program to go back several years, checking Centrelink benefit payments against records from the Tax Office, to look for apparent overpayments and demand the money be repaid.
Trouble is, the exercise is hugely prone to error. Eligibility for social security benefits is assessed on a fortnightly basis, whereas tax information is annual. The machine merely divides the annual figures by 26 and often gets the wrong answer.
The simple lesson we can all take from this is that the Government is not over endowed in skills in getting such IT programs to work as desired – and certainly does not seem to grasp the needs for rigorous system design and testing.
With the Department of Health busily trying to gather a large national data-base of patient information we have to assume they have in mind some use for the data. Clearly the clinical utility of the information would not make such an exercise worthwhile – so what are they up to?
Maybe they want to manage fraud, maybe regulate access to services or maybe something else?