Quote Of The Year

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

Monday, May 28, 2018

Weekly Australian Health IT Links – 28th May, 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

Well this week was all about the reaction to Tim Kelsey’s evangelical speech at the National Press Club on Wednesday. The Press Club gave him a good hearing but seemed a little sceptical if I read the mood of the reporters correctly. There are links to text and video on the blog if you want to watch / read again.
Also lots of activity on the GDPR which came into effect on May 25, 2018.
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Digital Heath Agency: ‘No conspiracy’ to keep My Health Record opt-out quiet

‘There is no Big Brother’ says CEO Tim Kelsey
George Nott (Computerworld) 24 May, 2018 16:41
The CEO of the Australian Digital Health Agency (ADHA) – the body responsible for implementing and operating the My Health Record – has rejected claims Australian’s right to opt-out of the electronic health record system is not being sufficiently communicated.
Australians will have three months from mid-July to opt out of having a My Health Record automatically created for them. After the opt-out deadline has passed the record cannot be deleted, only made “unavailable” to health providers and individuals, the Department of Health revealed last year.
Speaking at the National Press Club in Canberra today, ADHA chief Tim Kelsey highlighted the clinical benefits of the majority of Australians having electronic health records, and countered claims that the agency was keeping the opt-out right quiet to achieve it.
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Australian Digital Health Agency CEO Tim Kelsey grilled on My Health Record system at National Press Club

Sue Dunlevy, News Corp Australia Network
THERE is no conspiracy to keep Australians in the dark about the new online health record to be given to every Australian at the end of this year, the head of the agency rolling it out says.
Tim Kelsey has confirmed there will be no national radio, television or newspaper advertising campaign informing Australians the record will be created for them at the end of this year unless they opt out.
Households will not even get a letter explaining the new record, the head of the government’s Australian Digital Health Agency says.
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Stay in the network

Pharmacists told to get ready for Australia’s revolutionary new opt-out e-health record network

Pharmacists will need support and education to ensure their patients achieve the optimum benefit from Australia’s soon-to-be implemented opt-out My Health Record system.   
Australian Digital Health Agency CEO Tim Kelsey delivered his Your Health in Your Hands – the Digital Evolution of Health and Care in Australia speech at the National Press Club yesterday and outlined the collaboration needed between governments, consumers and clinicians to make data and technology work better for modern health.
In particular he discussed the importance of the pending shift to an opt-out e-health record and the role of each sector in making this work best to improve health care and decision making. 
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DENHAM SADLER
May 23, 2018

My Health Record an 'abuse of trust'

E-Health
Digital rights advocates are calling on Australians to opt-out of the My Health Record service after labelling the government’s approach to the digital service an “abuse of trust”.
My Health Record is an electronic health record that has been in the works for more than five years. It is currently available as an opt-in service requiring informed consent, with the government claiming that more than five million Australians now having a record.
The government recently announced that it would instead move to an opt-out model due to a low uptake of the service, with Australians given a three-month period to actively remove consent before being given an online record by default.
The three-month opt-out period will begin from 16 July.
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Health report confirms: consumers want control of their own health data

23 May, 2018
Australians want ownership and control of their own health data and want to be asked for consent when their data is used by either government, private companies or researchers.
This stand-out finding was revealed today in the Engaging Consumers in their Health Data Journey Report jointly published by Consumers Health Forum and NPS MedicineWise.
The comprehensive report was generated through qualitative interviews, literature reviews, a round table discussion with key stakeholders and consumer representatives, and a nationally representative survey of 1,013 Australians.
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Privacy concerns over My Health Record system

20 May, 2018 / 04:13
Rev. Bill spoke to Bernard Robertson-Dunn, chair of the Health Committee for The Australian Privacy Foundation, about the My Health Record opt-out function and privacy concerns as healthcare industries sign up to connect with My Health Record.
Download this podcast here
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LETTERS: Keep your health record online for emergencies

25 May 2018, 3:30 a.m.
A PERSON’S life can be saved in an emergency with an online health record.
I urge all country people to ensure they have a My Health Record – an online summary of all their health information.
Country people are more likely to be brought into an emergency department from a heart attack, car accident or diabetic coma. 
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Media release - Nation empowered through improved digital health services

24 May 2018
Digital information is the bedrock of high quality healthcare. Harnessing the power of the modern information revolution is one of the first priorities for governments to improve the safety and efficiency of healthcare through better use of data and technology.
Australian Digital Health Agency CEO Tim Kelsey delivered his Your Health in Your Hands – the Digital Evolution of Health and Care in Australia speech at the National Press Club today and outlined the collaboration needed between governments, consumers, clinicians, and entrepreneurs to make data and technology work better for modern health.
“Australia has one of the best systems in the world – by any measure. We are at the forefront of medical research, we have world-class facilities, and the people that provide care are among the most highly skilled and committed professionals anywhere.
Note – This links to speech transcript and to a list of myHR Supporters so everyone can be assured the myHR is a fabulous idea.
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IT glitch hits Queensland Health, taking down clinical systems

Lynne Minion | 22 May 2018
Queensland Health moved quickly to fix an IT meltdown last week that brought down clinical systems statewide.
Access to patient records, as well as admissions, transfer and medication systems were disrupted by the glitch that hit at about 10am on Thursday.
Department staff worked with the state government's primary ICT services provider CITEC to solve the problems with the online-based systems, and contingency arrangements were activated to minimise any impact on services.
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Should you trust what e-records tell you?

22 May 2018

TECH TALK

GPs are repeatedly told that electronic medical records will fix the problems of faulty memories, illegible hospital handover notes and patients who aren’t faithful to one GP (but don’t tell you). But do you trust what your computer says?
Researchers from Perth read the electronic patient records of almost 1000 patients and then checked with the real-life patient if they were accurate.
The results focused on whether patients had received their flu vaccination or not. These searches found that, in 84% of cases, the electronic records and the patients’ memories were the same. However, in 16% of cases, the computer said no but the patient said yes — or the other way around.
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Queensland needs real-time prescription monitoring 'urgently', coroner says, amid opioid deaths

21 May, 2018
A prescription monitoring system to prevent "doctor shopping" in Queensland is needed urgently within the next two years, rather than the state waiting for a national scheme to come online, an inquest into four opioid deaths has found.
Coroner James McDougall examined the deaths of William House, Jodie Anne Smith, Vanessa Joan White and Daniel Keith Milne between 2012 and 2014.
Medical bodies including the Australian Medical Association and the Pharmacy Guild have repeatedly called for a real-time monitoring system to be introduced in Queensland to prevent addicts from visiting different doctors to collect multiple opioid prescriptions.
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‘Urgency’ to implement real-time script monitoring: coroner

An inquest into four deaths related to opioid prescribing and doctor shopping has highlighted the urgent need for real-time monitoring

A joint inquest into four recent deaths was recently held in the Coroners Court of Queensland with the aim to consider the issues associated with misuse of opioid prescription medication in Queensland and, more broadly, Australia.
Coroner James McDougall explored the circumstances surrounding the deaths of William House, 30 years old at the time of his death; Jodie Anne Smith, 41 years old at the time of her death; Vanessa Joan White, 38 years old at the time of her death; and Daniel Keith Milne, 40 years old at the time of his death.
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Australia’s My Health Record to include diagnostic imaging reports and assist in better palliative care

Teresa Umali
21 May 2018
Australians will receive improved diagnostic imaging reports after Perth Radiological Clinic (PRC), NSW Health and Mater Group announce connections to My Health Record. At the same time, the My Health Record system also caters to the complex needs of palliative care patients.
Having a My Health record is important because it provides an online summary of a person’s key health information, which is controlled by the individual, allowing access to health care providers involved in a person’s care in order to deliver better health outcomes for patients.
An announcement by the Australian Digital Health Agency discussed how Australians will receive improved diagnostic imaging reports after Perth Radiological Clinic (PRC), NSW Health and Mater Group announce connections to My Health Record. An enhanced access to diagnostic imaging reports will be granted to Australians living in Western Australia, New South Wales and Queensland after the Perth Radiological Clinic (PRC), NSW Health, and the Mater Group, respectively, have all announced connections to My Health Record.
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It’s time to put consumers in the driver’s seat in Big Data economy

By Lauren Solomon • 21/05/2018
If the public doesn’t feel it can say no, all the privacy policies and terms and conditions can’t solve society’s data governance woes.
The Australian government has allocated $44.6 million over four years in this year’s budget to establish the new Consumer Data Right (CDR). This investment is slated to support the ACCC, OAIC and CSIRO to establish appropriate rules and standards and to ensure the impacts of the CDR are consistent with the Privacy Act.
This is a welcome step, because our latest research uncovers the yawning gap between public expectation and current practices when it comes to data collection, sharing and use.
In a survey of 1004 Australians conducted for the Consumer Policy Research Centre by Roy Morgan Research from March to April this year, 94% of those surveyed did not read the privacy policies or terms and conditions for all the products they signed up to in the past 12 months.
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  • May 20 2018 at 8:38 PM

Government orders report into AI dangers

The government will spend almost half a million dollars researching the risks of artificial intelligence and the internet of things.
Two reports will be produced by the Australian Council of Learned Academies (ACOLA) to look at how Australia can maximise the benefits of the new technologies, but avoid negative impact on the economy and individuals.
General Manger of ACOLA, Dr Angus Henderson, said a lot of countries had been quicker off the mark with artificial intelligence, including near neighbours such as Singapore. He said Australia had plenty of AI and Internet of Things capability in the shape of companies such as Siemens, GE and CISCO which had big operations in the here.
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Australian ​Department of Health using blockchain for medical research records

Australian secure cloud provider Vault Systems and blockchain startup Agile Digital have combined forces to provide the department with an immutable record for tracking health data research.
By Asha McLean | May 20, 2018 -- 22:00 GMT (08:00 AEST) | Topic: Innovation
The Australian Department of Health is working on a proof of concept that uses blockchain to record who is accessing its medical data.
Teaming up with secure cloud provider Vault Systems to host the data, and local startup Agile Digital for its distributed ledger technology, the department is exploring blockchain as means to prove who is accessing medical data, why they're accessing it, and to securely record research queries.
Speaking with ZDNet about the project, Agile Digital executive director David Elliot said the department was seeking a platform that supports research on health data, while maintaining privacy on citizen data.
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4 ways scammers target GPs — and how to protect yourself

24 May 2018

SPECIAL FEATURE

Some criminals see doctors as rich pickings
Like other small businesses, general practices are vulnerable to being cheated because they don’t always have the resources or systems to detect security breaches. There’s also a perception that GPs can afford to pay up and that makes them attractive targets.
Here’s a look at the four scams directed at general practices and some tips to prevent them: 

1: Cybercrime 

Dr Nathan Pinskier, the chair of the RACGP Expert Committee on eHealth & Practice Systems, says while there aren’t any meaningful statistics, there’s anecdotal evidence that general practices are being targeted more frequently by cyberattacks. The
major threats include: 
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Is health care ready for virtual medicine?

Authored by Hugo Wilcken
IN AUSTRALIA, where communication between doctors is still regularly done by post and fax, medicine using virtual reality (VR) technology may seem a bit like science fiction. But according to a Perspective published in the MJA, “virtual medicine” could transform the way we treat patients in the future.
In his article, Dr Brennan Spiegel, director of health research at Cedars-Sinai Medical Center in Los Angeles, California, says that research into the health benefits of VR – where users wear goggles with interior screens that immerse them in a lifelike, three-dimensional world – has been ongoing for years, but that implementation has been stymied by the high cost of the technology. However, recent advances have driven down those costs dramatically, making it feasible for virtual medicine to enter into the medical mainstream.
Dr Spiegel focuses on three areas where virtual medicine has the most potential. The first is distraction therapy for pain. For example, VR has been found to be effective in lessening pain during bandage changes for severe burns, as well as during routine procedures such as intravenous line placements or dental procedures. Although it’s not fully understood how VR reduces pain, simple distraction is likely to be key.
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Family Planning’s epic security fail

  • Michael Connory
  • The Australian
  • 9:23AM May 21, 2018
It seems ANZAC Day 2018 will be remembered by 8000 New South Wales women as more than just Australia’s National Day of mourning to honour the sacrifice of the fallen in conflicts of theatre Australia has been engaged in.
For them, April 25, will have an equally different side to it. It will be remembered as the day, Family Planning NSW, failed to protect their privacy and health details.
ANZAC Day shouldn’t be thought of as a day when hackers were able to crack through Family Planning NSW’s security, it has greater prominence of elevation in our minds, but for 8000 women, it will have a different meaning now.
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Grieving mum calls for hospital records overhaul after teen daughter's suicide

25 May, 2018
"Rani was a really beautiful soul who unfortunately just got caught up in some really bad situations."
Those are the words of grieving mum Kerrie Stanley, and already you know how this story ends.
It's a painful one. And familiar.
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eHealth program targets young people’s ‘big six’ behaviours to reduce chronic disease risk

Friday, 25 May 2018
University of Newcastle researchers have collaborated on a world-first eHealth initiative aiming to target young people’s ‘big six’ behaviours to help reduce their chronic disease risk.
Associate Professor Frances Kay-Lambkin and Professor David Lubans are part of the online Health4Life Initiative, launched today at UNSW Sydney.
Led by UNSW’s Professor Maree Teesson AC, the project aims to help to help thousands of young Australian high school children reduce their chance of developing chronic diseases, including heart disease and mental health disorders, by preventing and modifying lifestyle risk behaviours that commonly emerge in adolescence.
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My Health Record Data for ´Research and Public Health Purposes´

PulseLine is pleased to report last week the Federal government announced that Australians who don’t want a personal electronic health record will have three months from July 16 to October 15 to opt-out of the national scheme. Under the framework, medical information would be made available to third parties for public health and research purposes from 2020 unless individuals opted out.
The Medical Technology Association of Australia (MTAA) welcomes the release of the framework to guide the secondary use of My Health Record system data. The guiding principles within the framework align with MTAA´s position to allow third parties access the data for public health and research purposes.
To inform on how data on the My Health Record system can be used for research and public health purposes while preserving privacy and security of data in the system, the Australian government developed the framework in consultation with key stakeholders.
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Govt's high-risk IT project watchlist falls to 14

By Justin Hendry on May 23, 2018 9:30AM

DTA drops four, adds two.

The number of federal government IT projects considered high-risk by the Digital Transformation Agency has fallen to 14 after four projects were downgraded and one was cancelled.
The DTA has been keeping tabs on high-risk projects since it was tasked with identifying all government IT projects valued at more than $10 million in early 2017.
It looked to categorise projects as part of its digital investment review by confidence of delivery, with the most high-risk ones assigned an ‘engage’ classification.
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GDPR: data protection in an uncertain and insecure cyber world, says top lawyer

The biggest change in laws governing data protection is due to take effect in the European Union on 25 May and a seasoned practitioner of the law in the UK says the most important part of the General Data Protection Regulation is the overall protection of data in what is an "uncertain and insecure cyber world".
Rashda Rana, a state counsel in the UK, told iTWire in a detailed interview that management consulting firm Oliver Wyman had estimated that the EU would reap about US$6 billion in fines from organisations that were not in compliance during the first year of the GDPR. This, despite all parties having had two years to fall in line with the regulation.
A high-profile lawyer in the UK, Rana has also had extensive experience in international commercial litigation and arbitration as counsel and arbitrator in other jurisdictions including Australia, New York, Paris, Milan, Brazil, Hong Kong, Singapore, Malaysia and China.
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Data sharing can cost you a pretty penny

  • Tim Ebbeck
  • The Australian
  • 12:00AM May 22, 2018
At the end of 2017, Australia’s Actuaries Institute surveyed the chief risk officers of APRA-regulated institutions.
Among other things, the risk officers were asked to name the top three risks facing their businesses in the coming year. The results were hardly surprising given the current environment. In first place was regulatory and legislative change, followed by increased competition and therefore lower profits, and in third, cyber risks.
To be clear, I don’t think any business should see these as separate risks given the growing pressure on the heads of risk to safeguard their data. The European Union’s General Data Protection Regulation standards take effect on Friday, May 25, and any Australian firm that sells products and services in the EU, or monitors the behaviour of individuals there, will have to fall in line with these stricter privacy laws.
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Some firms apprehensive, others see opportunity as GDPR date approaches

With just a few days to go before the European Union's General Data Protection Regulation comes into effect, companies are scrambling to be compliant.
A great many organisations are unlikely to meet the deadline, with an estimate made by management consulting firm Oliver Wyman had estimated that the EU would reap about US$6 billion in fines from organisations that were not in compliance during the first year.
Below are some comments from companies as they try to get ready for what is the biggest change in laws governing personal data anywhere in the world.
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Microsoft to extend GDPR rights to users worldwide

Microsoft will extend the same rights that are at the heart of the European Union's General Data Protection Regulation to all its users worldwide, the company has announced.
A blog post by corporate vice-president and deputy general counsel, Julie Brill, also praised the "strong leadership by the European Union on these important issues".
Outlining Microsoft's support for the GDPR since it was first proposed in 2012, Brill said: "That’s why today we are announcing that we will extend the rights that are at the heart of GDPR to all of our consumer customers worldwide.
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Why you should read all those GDPR privacy policy updates

By Brian X Chen
24 May 2018 — 9:01am
You have probably noticed a flood of emails and alerts from companies in the past few weeks informing you about changes to their privacy policies.
Don't ignore them.
Yes, there is a lot of legalese to wade through. But resist the temptation to immediately delete those emails or close the alerts right away. They may contain important information about managing your digital privacy at a time when it's become clear that our online data is far from safe.
From emails to pop-ups, companies are coming up with various ways to get your 'consent' and comply with the new laws.
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Attention Aussie businesses: you’re not immune to GDPR

  • Scott Leader
  • The Australian
  • 10:07AM May 24, 2018
On a global stage, instances of data misuse and breaches are becoming all too familiar to businesses, and you needn’t look far to find examples.
Security breaches send a sobering message to any business or individual with data online; you are not immune. While digital platforms such as Facebook are moving swiftly to respond by educating their customers on revised data collection and privacy policies — and many other businesses are following suit — it’s surprising to learn how complacent the majority of individuals and businesses remain when it comes to data security.
In Australia, we’ve recently seen the Data Breach Notification Laws come into effect, with many organisations left underprepared and unaware of both their obligations to comply and the consequences for failing to do so. Sixty data breaches were reported in the first six weeks of the law coming into effect, with a majority of these breaches due to human error. As we continue to conduct business in a globalised world, we are likely to see many more policies and regulations come into force to keep us protected and these policies will increasingly cross borders.
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Optus fined $1.5m for forcing HFC customers onto NBN

By Ry Crozier on May 23, 2018 8:37AM

Chasing migration payment 'bounty'.

Optus has been fined $1.5 million by the federal court for trying to force customers off its HFC network and onto the NBN in a bid to fast-track migration payments from NBN Co.
The penalty amounts to around double what Optus is said to have made from the initiative, which was found to have misled customers over their rights.
The Australian Competition and Consumer Commission (ACCC) said Optus told around 14,000 of its HFC customers that their services would be disconnected - “in as little as 30 days in some cases” if they did not move to the NBN.
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Optus fined $1.5 million for misleading customers over NBN transition

Optus has been fined $1.5 million in the Federal Court for misleading customers by telling them their services would be disconnected if they did not move from its HFC network to the National Broadband Network (NBN).
Optus told 14,000 of its customers, during the period from October 2015 to March 2017, that their internet services would be disconnected - in as little as 30 days in some cases - unless they transitioned to an NBN plan.

Optus took the action despite the fact that under the terms of its contract it could not force disconnection within the timeframe it claimed.
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NBN Co ditches 100/40Mbps wireless plans

National Broadband Network provider NBN Co has killed off plans to offer a 100/40Mbps fixed-wireless service, with NBN Co chief Bill Morrow confirming the decision in a Senate Estimates committee hearing.
There are widespread media reports this morning, including  by the ABC, that Morrow told the committee  yesterday “we killed it”, basing the decision on economic grounds.
According to the ABC report Morrow said consistently achieving 100mbps would cost "billions and billions of dollars" — a taxpayer spend he described as "outrageous".
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Enjoy!
David.

1 comment:

Bernard Robertson-Dunn said...

There is a very important news item in David’s roundup.

Should you trust what e-records tell you?

https://www.medicalobserver.com.au/professional-news/should-you-trust-what-e-records-tell-you

It’s behind a paywall, so I shall quote liberally where needed.

“GPs are repeatedly told that electronic medical records will fix the problems of faulty memories, illegible hospital handover notes and patients who aren’t faithful to one GP (but don’t tell you). But do you trust what your computer says?

Researchers from Perth read the electronic patient records of almost 1000 patients and then checked with the real-life patient if they were accurate.

The results focused on whether patients had received their flu vaccination or not. These searches found that, in 84% of cases, the electronic records and the patients’ memories were the same. However, in 16% of cases, the computer said no but the patient said yes — or the other way around.”

And

“They also looked at the accuracy of electronic records covering the presence of diabetes, asthma, chronic heart disease or pregnancy.

They found that concordance was highest for diabetes (96%), then heart disease (92%), pregnancy (90%) and asthma (89%).”

For those of you not familiar with things like error, accuracy and reliability analysis if you want an assessment of the data as a whole you multiply the individual rates.

As an example, taking the above accuracy rates (0.84, 0.96, 0.92, 0.90, 0.89), that gives an overall accuracy of 0.594 or 59.4% accuracy.

How do you suppose a medic would react if told that a patient’s electronic record with five data points in was probably only 60% correct, with no indication of which data were incorrect?

As another example, suppose there are 14 elements in a health record each with an accuracy rate of 95%. The total record accuracy rate would be under 50%.

And it only takes four elements to have an accuracy rate of 84% (as in the flu vaccination example above) for the accuracy rate to be less than 50%

Accuracy rates can be subject to a number of factors, including – errors in data entry, errors in taking a patient’s history, errors in tests, ageing of data.

A general rule, the more data in a health record and the older the data, the less the accuracy is likely to be.

Do you suppose ADHA will be alerting GPs and consumers to this research?

Do we know if ADHA has released any reports, evidence or research on the safety of health records?

The ADHA strategy says this:

“The interoperability of clinical data is essential to high-quality, sustainable healthcare – this means that patient data is collected in standard ways and that it can be shared in real time with them and their providers.

By the end of 2018, a public consultation on draft interoperability standards will confirm an agreed vision and roadmap for implementation of interoperability between all public and private health and care services in Australia. Base-level requirements for using digital technology when providing care in Australia will be agreed, with improvements in data quality and interoperability delivered through adoption of clinical terminologies, unique identifiers and data standards.”

Is source data quality a critical success factor in the strategy? No. Is that because of a single minded focus on technology not medical information? Quite probably. Will interoperability and standards improve data quality? No.

ADHA thinks that the magic of technology will drive data quality. I don’t support that belief; IMHO, they need to justify such an assertion.

I don’t believe that ADHA has any real understanding of the nature and complexity of medical and health data in the health care system. Their approach is built on a simplistic assumption that health data is good, more data is better and that patients and health professionals will delight in the oceans of data myhr will deliver. I’m not convinced.