Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Sunday, April 08, 2018

The Trick Is To Build Your House On The Rock And Not Upon The Sand. Same Applies To Digital Health!

This appeared over the weekend.
  • Updated Apr 6 2018 at 11:00 PM

Australia's e-health push lifts start-up Tyde

When serial entrepreneur Dean McEvoy looks for new investment opportunities he searches for someone who is in love with solving a problem. And that is what he found with Tyde creator Romain Bonjean.
French-born Bonjean and his co-founders Shamus Cooper and Sudeep Gohil (both are Tyde advisers) launched the health business two years ago. Tyde is the first consumer-focused app for the federal government's My Health Record platform that is being rolled out by the Australian Digital Health Agency.
It's a single point to access and manage records, appointments and prescriptions that has real-time treatment adherence data, and that allows multiple users to interact in real time. Users can join the entire family's health records together.
"We got a great team in health informatics," says the 40-year-old Bonjean. "It is quite a complex activity to get the right architecture, connect properly, and the security and safety and privacy measures put in place are second to none. It makes banking and stock broking look like child's play next to it.
"Fundamentally we are a consent engine. We have the right to store a copy of your record and we are the only ones in the market to have this level 4 certification."
Tyde started with seed capital of just $800,000 and now has raised an additional $3 million from investors such as McEvoy, who first met Bonjean via start-up accelerator Startmate. Other investors include Christopher Hill from Chicago Ventures, who sold his Spotlite business to UnitedHealth Group for an estimated $US400 million. Alan Jones of KPMG's High Growth Ventures (also adviser/mentor for start-up incubator BlueChilli) and several Melbourne-based family offices have put in money too.
McEvoy – best known for selling Australia's first group buying site Spreets.com to Yahoo!7 in an estimated $40 million deal – is also chief of industry technology group TechSydney. He says companies like Tyde, with a major focus on consent by the user, will become even more important given the Facebook-Cambridge Analytica story that this week revealed even more users, 87 million, were compromised in the scandal enveloping the social media giant.

Future of medicine

"Romain is one of the most resilient founders I've seen," McEvoy says. "I believe people fall in love with problems. I could see that he was so passionate about health and I could see he was really passionate about wanting to help people. That's how I look for investments, I Iook for people who fall in love with a problem because they will keep working until they find a solution.
Tyde provides a single point to access and manage records, appointments and prescriptions that has real-time treatment adherence data, and that allows multiple users to interact in real time.
"What's going on right now with Facebook is going to drive a greater demand for companies like Tyde. Your health data is so private and so important.
Lots more here:
I have to say I was somewhat startled when I read this. Among the things I seem to have noticed are:
1. Tyde is holding a copy of your myHR data – when you can’t as I understand it? (See para. 5)
2. They are linking records for a whole family which hardly seems to make no sense in terms of privacy or utility.
3. They appear to be melding some myHR data and other data from their own app for appointments and prescriptions in some way undefined in the article. One wonders about data synchronization etc?
If you go here there is a little more:

Tyde: Features

Tyde is an application that puts you at the centre of your health, securely consolidating all your health information in one place, giving you secure fingerprint access to all your records. Tyde allows you to create your very own ‘personal health journal’, so no details are lost along the way.
If you go to the website you read the following:

Connect and access all your official health records

In a matter of minutes you can sign up, log on and connect all of your medical information using our simple MyHealth Record access. Once registered you will always have your information in the palm of your hand, constantly updated and always ready.
Tyde is a registered Portal Operator with the Australian Government Digital Health Agency and My Health Record.
I wonder what is meant by the term ‘official health records’ – which we all know is more than often pretty incomplete and hard to navigate? Where do GP and specialist records fit etc.?
A collection of apparently smart people have provided $3M extra funding so I hope they know what they are doing. I personally would not build any business on the sayso of and expectations of the ADHA and the myHR! The analogy in the title is pretty true I reckon!
David.

8 comments:

Anonymous said...

Tyde says:
'Fundamentally we are a consent engine. We have the right to store a copy of your record..."

Some questions about that, if I consent and Tyde then holds a 'copy' of my My Health Record:

If Tyde has a copy of my main record, then if I remove a document from my main record, will Tyde reflect this in its copy of my record? Or do I need to go into the Tyde copy and remove it there also?
Likewise, if I have allowed a representative to have access to my main record, then if this changes - i.e. I remove the representative's access, then will this be reflected in Tyde's copy of my record?
Similarly if I am a parent of a child, and am fleeing from an abusive partner, then will that partner be able to use the Tyde app to find my location?
If a clinician uploads something to my record in error, and then removes or replaces that item, then will this be reflected in Tyde's copy of my record?
If Tyde has a copy of my record, then where is that copy being stored? Is it on my phone or a server or a cloud somewhere ?

I thought that mobile apps connecting with the MyEHR system would only be able to view my record, not take a copy and use it for other purposes.
Does anyone know what really happens here? Is the government off the hook if something goes wrong because I have given my consent to someone like Tyde?
I agree build on the Rock, so you wont get washed out by the Tyde.



Anonymous said...

Maybe the ATO and Medicare could follow suit? Or someone could tap the ADHA on the shoulder and remind them to pull their head in. No one ever mentioned commercialising my most private health information. At least other apps only act as a view into my GP system.

Wonder what backdoor this creates into the rest of the health system and myGov services?

Bernard Robertson-Dunn said...

Navigating the tyde website is as bad as myhealthrecord.gov.au where a lot of information is hidden away in the privacy statement.

Go to the main page:
https://tyde.com/
scroll down and click on
https://help.tyde.com/hc/en-us

Then scroll down to
https://help.tyde.com/hc/en-us/categories/115000152091-FAQs

Then click on
https://help.tyde.com/hc/en-us/articles/115000225432-What-health-information-will-Tyde-download-from-the-My-Health-Record-

and you discover that the only data that is downloaded to Tyde are patient details, PBS and Medicare data.

The Tyde site says that "Information in your My Health Record can include your personal details and important health information such as discharge summaries from hospitals, allergies, medical conditions and treatments, medicine details and test or scan reports."
https://help.tyde.com/hc/en-us/articles/115000223351-What-is-My-Health-Record-

but most of that can't be downloaded, even though they say:

"Why does Tyde want access to My Health Record?"

"After you consent to import your My Health Record, ...".
https://help.tyde.com/hc/en-us/articles/115000223371-Why-does-Tyde-want-access-to-My-Health-Record-

It is quite possible that the site has not been updated since May 2107 and that other things are downloaded.

The site, as it stands is inconsistent, specifically the claim "connect all of your medical information using our simple MyHealth Record access. Once registered you will always have your information in the palm of your hand, constantly updated and always ready." is something of an exaggeration.

These two bits of information are informative:

"How do I input information to include as part of the health information?
Click on the plus icon which is in the bottom right of your timeline. There you can add notes about your health."
https://help.tyde.com/hc/en-us/articles/115000223611-How-do-I-input-information-to-include-as-part-of-the-health-information-

and...

"What health information will Tyde send to the My Health Record?
We currently do not send any information to My Health Record."
https://help.tyde.com/hc/en-us/articles/115000225452-What-health-information-will-Tyde-send-to-the-My-Health-Record-

In other words, if you want your GP's system, myhr and the tyde app to be consistent you have to work very hard at it.

If you want to have a SHS you have to see your GP who will create a SHS for you and upload it to myr. You can then sign on to the myhr portal, look at the SHS, write down the details, log into your tyde app and enter the details yourself.

I may have got this all wrong, but from what I know about myhr and have read on the Tyde website, it's a reasonable conclusion.

And this is easy to use? helpful?

If all this Digital Health is the way of the future, heaven help the health care system in Australia.

A question to the blog readership:
Do any of the GP clinical systems have the capability to create a word or pdf file containing a summary of a patient's medical record?

Might be a lot more useful, you could even put it on your phone.

Bernard Robertson-Dunn said...

This little video provides some more info:
https://help.tyde.com/hc/en-us/articles/360000126915-Using-your-My-Health-Record-information

It implies that you can see your MBS/PBS and clinical documents on your phone. It doesn't say that you can download clinical documents.

At 1' 25" it demonstrates that you can see you have a number of event summaries. It has the name of the person who uploaded it and the date. You have to click on each one to find out what's in it.

This video
https://help.tyde.com/hc/en-us/articles/360000117715-Sharing-and-updating-your-Health-Information

implies that you can send a snapshot of the information in your app

"Sharing your health information
A doctor may request for you to share your health information. To accept the request,"

It doesn't tell you what information you are sharing (e.g. what you have put in Tyde, or what is in myhr, or both"

I do get the feeling that rather than reducing data fragmentation myhr and Tyde (and possibly other apps) are increasing fragmentation.

Trevor3130 said...

From the Tyde site I selected the Android install, my phone (linked through Google) was detected and I went ahead with the installation from my desktop. Google permission asked only for my (stored) Gmail password, but not the extra verification step of my Yubico dongle. Disconcerting.
Opened the phone app and registered with Tyde using alternative nom and email. I bypassed the option to use fingerprint login. The next section was about using MyGov login, so I backed out.
The login to my other email was notified, but there was no requirement to confirm.
Uninstalled.

I'd have felt more comfortable with the identification/authentication processes if they'd insisted on 2-factor (SMS to nominated phone, or Authenticator) from the outset. But, I use Ubuntu & Android, so guess Apple & Microsoft may be different.

Anonymous said...

If the ADHA endorses Tyde on behalf of the Australian Government one must assume that legal and privacy teams have signed of on this product and the use of ‘a consent’ model is also Government approved.

Bernard Robertson-Dunn said...

re " the only data that is downloaded to Tyde are patient details, PBS and Medicare data." The website is out of date and will be corrected.

After a bit of digging, I've discovered that Tyde extracts all information (that is legally available to the patient) and stores it encrypted on a server somewhere. This is updated each time you log onto the Tyde app.

that means the video

https://help.tyde.com/hc/en-us/articles/360000126915-Using-your-My-Health-Record-information

shows the patient reading myhr data from the Tyde server.

It looks as though Tyde is trying to do things that myhr can't do or does very badly, which isn't a bad thing. Conceptually it could do it the way Meditracker does it - mainly through GPs systems, in which case myhr wouldn't be necessary, at least not if improving clinical medicine was the goal.

Sharing your data with health professionals is a good thing. The government needs to explain a bit better why they should get a copy of bits of it. And why everyone should have a myhr, even if they have no interest in it.

Anonymous said...

Taken from a new (promotional) article


"Fundamentally we are a consent engine. We have the right to store a copy of your record and we are the only ones in the market to have this level 4 certification

What is this level 4 certification?