Quote Of The Year

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


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, July 02, 2018

Weekly Australian Health IT Links – 2nd July, 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

What a week with HealthEngine all over and a range of other stuff. Enjoy the browse and wonder at the intensity of the annoyance at HealtEngine. Bluntly – they goofed. Well done ABC.

What do Australian women think of My Health Record?

The Australian government has met with difficulties in persuading Australians to register with its national electronic health record system, My Health Record. Just one in five Australians have a My Health Record. I have just submitted an article for peer review that reports on the findings from the Australian Women and Digital Health Project in which the participants talked about their attitudes to and experiences with My Health Record in interviews and focus groups. As the Australian Digital Health Agency moves towards an opt-out process to register as many Australians as possible, the findings from this study offer important insights into what Australian women think of My Health Record.
The full preprint version of the article can be accessed here: Article – My Health Record preprint.
25 June 2018

The truth about My Health Record

From 16 July 2018 for three months, patients and GPs in Australia will be given the opportunity to opt out of the government’s My Health Record system.
Patients and GPs will need full and accurate information about My Health Record and its potential impact on their lives, healthcare and, in the case of GPs, their business practices to decide to opt out, or not. 
At this stage we do not know what information the government will be telling consumers, patients and GPs regarding My Health Record and the opt-out process when the opt-out period commences. 
When that information becomes available, we will need to trust that the government has been open and transparent in informing consumers and health providers about costs, benefits and risks of a system that will contain large amounts of very personal, private and sensitive data about our lives.

What the new data breach laws mean for medical practices

Authored by Hugo Wilcken
IN APRIL 2017, a man found piles of outpatient letters stuffed into a garbage bin in Sydney’s inner west. A subcontractor for a company involved in transcribing medical missives sent from specialists to GPs had been supposed to take them to the post office, but, inexplicably, had just shoved them into the bin instead. The data breach involved over 1600 medical letters containing private information on over 700 patients from the Royal North Shore and a number of other hospitals.
Medical data breaches are common, and while most are not as egregious as the above, all are now subject to new mandatory data breach notification laws, which came into effect in February 2018. Under these laws, any organisation subject to the Privacy Act (including all medical practices) which incurs an “eligible data breach” is obliged to alert the Australian Information Commissioner and the people whose data have been compromised.
An eligible breach is defined as any unauthorised access, disclosure or loss of personal information that is likely to result in “serious harm to any of the individuals to whom the information relates”. The penalties for failing to disclose such breaches are not to be sniffed at: up to $360 000 for individuals and up to $1.8 million for organisations.

Deleting negative reviews? You may be breaking the law

Monday, 25 June, 2018
Regulated health services that selectively edit reviews or testimonials have the potential to break the law, prompting AHPRA to publish further guidance for advertisers.
A recent example of an organisation only publishing positive reviews and removing all negative information from consumer reviews shows the importance of advertisers understanding their advertising obligations under all relevant legislation.
Selectively editing reviews or testimonials has the potential to be false, misleading or deceptive and, therefore, unlawful. For example it is inherently misleading to:
  • edit a review that is negative to make it positive, as this falsely presents the feedback;
  • edit a review that has a mix of negative and positive comments so that the published review only has positive comments, as this falsely implies that the reviewer only had positive feedback; or
edit a review so that it no longer accurately reflects all the reviewer’s feedback and presents an inaccurate or false impression of the reviewer’s views.

Diabetes sufferers can monitor glucose levels with smartphone app now in Australia

Available for compatible iPhones and Androids, the FreeStyle LibreLink app enables FreeStyle Fibre users to monitor glucose levels directly via smartphones.
Taking another step forward in making glucose monitoring seamlessly fit into a user's daily lifestyle, health company Abbott's "FreeStyle LibreLink app" is now available in Australia.
People with diabetes in Australia and using the FreeStyle Libre system are now able to access glucose data directly from their smartphones, eliminating the need to carry the separate FreeStyle Libre reader (a handheld device used to scan the FreeStyle Libre sensor to get a glucose result).

CareMonkey ranked first amongst Australian healthcare start-ups for online medical records

CareMonkey named number one Australian medical and healthcare start-up in top 10 report released by medicalstartups.org.
CareMonkey – the world’s fastest growing cloud platform for online medical records, forms and excursion management – ranked first in medicalstartups.org’s top 10 list of Australia’s best medical and healthcare start-ups.
The report, titled Top 10 medical and healthcare startups in Australia, cited CareMonkey’s ability to provide “instant access to emergency and medical data for authorised carers on mobile devices” as a unique and vital product capability.
“The multi-award winning CareMonkey system [is] a health, safety and productivity solution for families, schools, clubs, businesses, community service organisations and other groups with a duty-of-care,” stated the report.

AMA backs investigation into HealthEngine

Association concerned about any irregularities or threats related to patient privacy and patient consent following privacy claims against the doctor appointment booking service
Byron Connolly (CIO) 29 June, 2018 13:50
The Australian Medical Association on Friday said it is supporting the government’s decision to ask the Office of the Australian Information Commissioner (OAIC) to inquire into the data privacy procedures of HealthEngine.   
Health minister Greg Hunt ordered an ‘urgent review’ into Australia’s largest online doctor appointment booking service after an ABC report that the company funnelled medical information about hundreds of users to law firms seeking clients for personal injury claims.

HealthEngine may be in breach of privacy law in sharing patient data

June 27, 2018 3.20pm AEST
Online users are not able to give totally informed consent if their permission is sought for multiple things at once.


  1. Paul MalugaSessional Academic, Solicitor, Macquarie University
This week it was reported an online medical appointment service, HealthEngine, was sharing patients’ private information with a firm of solicitors specialising in personal injury claims.
As reported, HealthEngine, which boasts 15 million annual users, requested details of the patent’s symptoms and medical conditions as part of their booking process. It then passed this information to law firm Slater and Gordon at an average rate of 200 patients per month. This was called a “referral partnership pilot” program, and operated between March and August of 2017.

Outrage Over Claims That Telstra Backed Health Start-Up Shared Patient Data

HealthEngine, a Telstra-backed online appointment-booking service, has been sharing medical information with personal-injury law firm Slater and Gordon, according to an ABC report.
The information has reportedly been used for targeted advertising, seeking clients for personal injury claims. The news has brought strong condemnation from Electronic Frontiers Australia and other groups with an interest in privacy issues, who fear HealthEngine may also have a data sharing arrangement with the Government’s MyHR medical records system.
According to the ABC, the Slater and Gordon “referral partnership pilot” saw HealthEngine give the law firm details of around 200 clients a month between March and August last year.

Your data on Health Engine and My Health Record: what they’re telling you vs what they’re not

26 June 2018
Yesterday an ABC investigation revealed that data given to the app Health Engine, which allows you to book GP appointments, is allegedly giving patient data to third parties without express consent. This has caused concern from users, who are unsure who could have their data, or what kind of data they may have unwittingly handed over. It has also caused people to think about the upcoming My Health Record system run by the Federal Government, and whether their data will be secure on a government system. Brian Carlton has often talked of his concerns over My Health Record. He speaks with Chair of the Health Committee of the Australian Privacy Foundation, Dr Brendan Robertson-Dunn, about the systems, and why we should be wary of them.

New HealthEngine scandal raises scrutiny of digital health consent practices as Health Minister orders urgent review

Lynne Minion | 25 Jun 2018
The digital health sector’s interpretation of patient consent and its use of people’s health data has been placed under increased scrutiny with claims HealthEngine has brought the medical profession into disrepute and behaved with impunity following the company’s latest scandal.
The future of Australia's most successful online GP appointment booking service appears uncertain after patients and doctors rose to condemn its privacy practices and the Health Minister Greg Hunt ordered an "urgent review" following an ABC investigation that exposed the company for funnelling private patient information to legal firms searching for personal injury cases.
Hundreds of patients were ensnared in the practice by the Perth-based start-up, which is part-owned by Telstra, Google and Seven West Media, with secret documents obtained by the ABC from law firm Slater and Gordon revealing HealthEngine was providing a daily list of patients who had booked appointments via the platform and met certain criteria within a "referral partnership pilot".

Medical company shared patient details with plaintiff lawyers

  • The Australian
  • 12:00AM June 26, 2018

Sean Parnell

Revelations a doctor-booking company shared patient details with law firms may undermine public confidence in the digital health sector, a consumer advocacy group warned yesterday.
The Office of the Australian Information Commissioner is examining ABC reports that online booking provider HealthEngine provided patient details to plaintiff lawyers Slater and Gordon.
HealthEngine chief Marcus Tan would not comment on suggestions 1200 referrals were made during a six-month pilot program last year, or why the arrangement was discontinued.

HealthEngine under fire from privacy organisations

Online booking service targeted over passing end users’ details on to law firms
Rohan Pearce (Computerworld) 26 June, 2018 06:30
Online doctor booking service HealthEngine has been condemned in a joint statement by Future Wise, Australian Privacy Foundation and Electronic Frontiers Australia.
An ABC investigation revealed that the company, which is part owned by Telstra and SevenWest Media, had been operating a lead-generation service, passing the details of its users on to law firms in some cases.
In a statement HealthEngine founder, CEO and medical director Dr Marcus Tan said that the company “does not provide any personal information to third parties without the express consent of the affected user or in those circumstances described in our privacy policy”.
  • Updated Jun 25 2018 at 5:14 PM

HealthEngine admits client data provided to law firms, but only with consent

Seven West Media and Telstra Ventures-backed medical appointment booking platform HealthEngine is facing its second scandal in a month, as it was forced to respond to allegations on Monday that it shared hundreds of users' personal medical information to law firms seeking clients for personal injury claims.
In a response to the claims exposed by the ABC, the Office of the Australian Information Commissioner told The Australian Financial Review it was making inquiries with HealthEngine.
Documents obtained by the ABC showed that Slater and Gordon had received the details of an average of 200 clients a month between March and August last year via a referral partnership pilot and this had resulted in 40 new clients for the firm.

HealthEngine 'shared medical information with personal injury lawyers'

GP booking website allegedly helped law firm advertise directly to patients
25th June 2018
GP booking website HealthEngine is in trouble again, this time accused of sharing patient information with personal injury lawyers who used it to target patients with advertisements.
Law firm Slater and Gordon allegedly received information on 200 patients every month for at least six months from HealthEngine, according to the “secret documents” obtained by the ABC.
When a patient makes an appointment, the website asks them to add details of their symptoms, including whether they relate to a workplace injury or traffic accident.

HealthEngine patients’ exposure: when on line is out of line

The revelation that the doctor appointments company, HealthEngine, has reportedly shared hundreds of patient details with law firms raises disturbing questions about the potential hazards surrounding the privacy and security of on line medical information and of the need for consumer privacy protection to be approached with the utmost care, transparency and due diligence, the Consumers Health Forum said today.
“Patients depending on the convenience of booking a doctor’s appointment online are unwittingly being drawn into what appears to be a lawyer marketing scheme, exposing them to unwanted and intrusive approaches,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“We are all eager to see our experience of the health system improved by digital solutions: there is much we can all benefit from.  Health has lagged behind other services sectors for too long in this regard.
25 June 2018

Would you like a lawyer with that?

Posted by Julie Lambert
Doctors have responded with shock to news that online GP booking service HealthEngine has been passing on patients’ information to third parties, including law firms seeking clients for personal injury and accident claims.
An ABC News investigation said HealthEngine was handing over details on 200 potential clients per month on average in a six-month period last year to major law firm Slater and Gordon.
Documents obtained from Slater and Gordon showed 40 of the referrals became clients of the firm as a result of the six-month “referral partnership pilot”.

HealthEngine responds to ABC story

HealthEngine is Australia’s largest online health marketplace and we put thousands of patients in contact with health professionals across Australia every day.
We respect the privacy of our users and appreciate the trust they place in us.
I would like to reassure users that HealthEngine does not provide any personal information to third parties without the express consent of the affected user or in those circumstances described in our privacy policy.
June 26 2018 - 4:14PM

My Health Record digital system is coming

The My Health Record system is being rolled out across Australia.
People living in Mount Isa will soon discover a digital improvement in healthcare called “My Health Record” to help manage their health and wellbeing.
The Australian Digital Health Agency is visiting Mount Isa to inform regional stakeholders about the system.
Every Australian will be offered a My Health Record at the end of 2018 unless they choose not to have one during the three month opt out period that will run from July 16 to October 15, 2018.
June 27 2018 - 7:54AM

Editorial: My Health Record system useful but needs security

Derek Barry
There is a significant change coming this year to the way we manage our health, a new digital system called My Health record coming by the end of this year.
The federal government, through its primary health networks is promoting My Health Record as “a digital improvement in healthcare that is useful in managing (people’s) health and wellbeing.”
Under the system every Australian will be offered a My Health Record by at the end of 2018 unless they choose not to have one during the three month opt out period that will run from July 16 to October 15.

National Children’s Digital Health Collaborative improves children’s lives in Australia

By: Teresa Umali
Published: 27 Jun 2018
The first among many workshops by the National Children’s Digital Health Collaborative was successful in its aim to explore ways on how digital health technology can improve the health and wellbeing of the children in Australia through their insights and experiences.
An announcement made by the Australian Digital Health Agency highlighted the first workshop held by the National Children’s Digital Health Collaborative in order to share the experiences and stories as well as gain a deeper understanding of their roles as parents, carers and families in the Collaborative. Their thoughts and ideas will help design the digital solutions and tools that will ultimately impact their child’s development. 
The National Children’s Digital Health Collaborative held a very successful first workshop for consumer representatives from across the nation. This is on line with its mission to help make Australia the best place to be raised and to raise healthy children.

1,000 provider education sessions, and counting!

The Australian Digital Health Agency, State and Territory health services and PHNs band together to keep clinicians informed about the expansion of the My Health Record system.
July 29, 2018
With the approaching commencement of the My Health Record expansion opt out period, the Agency’s provider readiness team has continued to drive forward at pace. The entire team has rallied to deliver over 1,000 education sessions across Australia, including sessions with public hospital clinicians, primary health, and Aboriginal and Torres Strait Islander community controlled health organisations. The team have travelled to some of the most remote regions in Australia to ensure that clinicians are prepared to support consumers with questions for the expansion, including engagement with the Royal Flying Doctor Service to ensure readiness for regional care providers.
Moreover, through arrangements with key clinical and regulatory peak bodies – including the AMA, the RACGP, and the ACRRM – opportunities for clinical messaging to providers from their peak bodies have been secured.1 This approach is complemented through broad messaging to every AHPRA-registered clinician and self-regulated professionals through the NASRHP.2

HISA launches new Digital Health Executive Network

Digital health executives across Australia will be targeted by a new professional development program designed to build capacity in the health workforce.
Australia’s Digital Health Executive Network (DHEN) is an initiative of HISA following demand from members who expressed the need for professional development and recognition schemes recognising their unique roles in healthcare.
Planning is underway for a certification program and the first professional development event will be held as part of HIC 2018 in Sydney on 29 July.

Paper Review: the Babylon Chatbot

June 29, 2018 § Leave a comment
[For convenience I collect here and slightly rearrange my Twitter review of a recent paper comparing the performance of the Babylon chatbot against human doctors. As ever my purpose is to focus on the scientific quality of the paper, identify design weaknesses, and suggest improvements in future studies.]
Here is my peer review of the Babylon chatbot as described in the conference paper at https://marketing-assets.babylonhealth.com/press/BabylonJune2018Paper_Version1.4.2.pdf
Please feel free to correct any misunderstandings I have of the evaluation in the tweets that follow.
To begin, the Babylon engine is a Bayesian reasoner. That’s cool. Not sure if it qualifies as AI.
The evaluation uses artificial patient vignettes which are presented in a structured format to human GPs or a Babylon operator. So the encounter is not naturalistic. It doesn’t test Babylon in front of real patients.

Artificial intelligence passes recreation of UK's GP exam and performs against doctors in simulated tests

Jonah Comstock | 28 Jun 2018
A UK startup says its AI can pass England’s GP exam and go head-to-head with top doctors in a simulated diagnostic environment in what is being heralded as a step forward for humanity.
In groundbreaking research published this week, the Babylon Health technology scored 81 per cent in the GP test against the average passing score for medical students of 72 per cent. It also performed well against clinicians in identifying symptoms and triage in a simulated setting.
The implications, according to Babylon Health founder, could be considerable for access to healthcare worldwide.

Smart start-ups transform healthcare with VR, games and holograms

By Esther Han
24 June 2018 — 12:00am
In a sparsely furnished room Ben Dunn wobbles and swivels as he tries to escape a sloth of zombie teddy bears.
Mr Dunn, the 25-year-old head of start-up company Swibo, is testing its core product Swibo Tilt, which uses a smartphone app to turn a wobble board into a game controller, turning otherwise boring strength exercises into fun games.
"We know balance training is good for recovering from injury and preventing injuries like ankle sprains, but the compliance rate is low, so we turned something mundane into something engaging and measurable," he said.

Royal Adelaide Hospital goes live with digital system to monitor recovery room patients

Lynne Minion | 25 Jun 2018
SA Health has had a digital health win with its new post-surgery cloud-based patient monitoring system going live at the state’s flagship Royal Adelaide Hospital.
Delivered by Allscripts in partnership with iProcedures, the iPro Post-Anaesthesia Care Unit module (PACU) allows recovery room nurses to record patients’ post-operative data in real time.
Designed by anaesthesiologists to improve patient safety, documentation, hospital efficiency and medication management, more than 1000 patients have already been administered in the system since it was implemented two weeks ago.

EPAS under review

Stephen Wade MLC
Better Services
The Marshall Liberal Government has appointed an independent expert panel to review the state-wide implementation of the Enterprise Patient Administration System.
Minister for Health and Wellbeing Stephen Wade said the panel, led by independent Chair, Shane Solomon, will begin the review next month
“EPAS has been an enormous frustration for many clinicians and a rolling disaster for South Australian taxpayers,” said Minister Wade.

SA Govt to review EPAS system

By Dylan Bushell-Embling
Tuesday, 26 June, 2018
The South Australian Government has launched a review of the state’s controversial Enterprise Patient Administration System (EPAS), following a series of cost overruns and complaints from users.
The government has convened an expert panel led by independent chair Shane Solomon to review the usability, value for money and security of the EPAS system.
The review will also look at the impact of EPAS on productivity in hospitals. The review is expected to be complete within nine months.

Answers sought on SA’s $471m electronic patient records system

  • The Australian
  • 8:55PM June 26, 2018

Michael Owen

An independent panel will spend the next five months reviewing a partial rollout of a flawed $471 million electronic patient records system in South Australia’s public hospitals.
The Marshall government yesterday announced a three-person panel will from next month undertake a review into the ­implementation of the Enterprise Patient Administration System, which under the previous Labor government was to cost $220m in 2013 but came in at $471m.
Health Minister Stephen Wade suspended the EPAS rollout within a fortnight of the Liberals winning the state election in March. Yesterday, Mr Wade said the panel would examine the system’s usability, value for money, security, productivity in hospitals, and any possible improvements.

Allegations not proven – but still published?

Would you visit a doctor who has, next to his or her name in the public register, a mention of a court proceeding or tribunal hearing?
Or would you prefer to see another doctor, even if the small print on the register stated ‘allegations not proven’?
I often find the legalese speak on AHPRA’s website difficult to understand. A recent report recommended that the register should include web links to published disciplinary decisions and court rulings – which AHPRA has been implementing.
  • Jun 25 2018 at 3:02 PM

DTA boss departure the latest drama as government trundles on digital transformation

by Ed Husic
It's been a big month for government digital transformation – but not the one you'd expect.
First, the plug was pulled on a multimillion-dollar Australian apprentice management system, developed for the Department of Education and Training by NEC.
Then, the Australian Criminal Intelligence Commission's biometrics project – a significant initiative previously overseen by the current digital transformation minister and also developed by NEC – was canned.
Then, out of the blue the head of the government's Digital Transformation Agency, Gavin Slater leaves, after a 16-month stint.

Govt rejects trashing of its digital reputation

By Ry Crozier on Jun 28, 2018 6:30AM

Slams suggestions that it can't execute.

The government has largely rejected a new report that tries to cast its digital nous as dysfunctional and prone to failure.
The committee report [pdf] into the ‘digital delivery of government services’ was finally published on Wednesday evening, after being pushed back several times.
The report's assessment of government and public sector readiness and ability to execute on digital projects is searing, and left government representatives unimpressed with its broad-brush imputations.

Labor wants to fine NBN Co for bad service

By Ry Crozier on Jun 24, 2018 9:52AM

Joins Telstra in pushing to penalise network builder.

The federal opposition wants to create its own NBN service guarantee that would see NBN Co fined every time contractors missed appointments or made installation errors.
Labor leader Bill Shorten and shadow minister for communications Michelle Rowland unveiled the policy on Sunday morning.
“Right now your retail provider is accountable to you and the Telecommunications Industry Ombudsman, yet it’s not really clear who the NBN Co is accountable to when something goes wrong,” Rowland said.
“It’s no wonder that a lack of accountability is one of the biggest complaints about the NBN.”

Labor plan no fix for systemic NBN, service issues: Greens

The Australian Labor Party's plans for a service guarantee for those who use Australia's national broadband network, the NBN, is of little use as it does not tackle the systemic issues dogging the network or improve the customer experience, the Australian Greens claim.
Greens NBN spokesperson Jordon Steele-John said the NBN Co had been set up to fail by the Liberal Party and mere fines would do little to solve the issues around broadband access in the country.
On Sunday, Labor Shadow Communications Minister Michelle Rowland said,if the party regained power at the next Federal Election, there would be fines imposed if service standards were not met and these would increase proportionately with downtime. Additionally, she said appropriate compensation caps would apply.

Inside NBN’s fibre to the curb rollout

NBN eyes dual-mode DPUs for G.fast FTTC deployment
Rohan Pearce (Computerworld) 27 June, 2018 06:30
Although it is still early days for the roll out of fibre to the curb, NBN says that its efforts to ensure a smooth migration process from the legacy copper network to FTTC have paid off when it comes to end user satisfaction.
But although the company is quick to talk up the performance characteristics of the technology, including a relatively easy upgrade path to gigabit speeds, NBN says that the additional challenges in rolling out FTTC, particularly compared to fibre to the node (FTTN), mean that it’s not ready dump its use of FTTN.
NBN formally launched FTTC services in April. Currently around 1.5 million premises are expected to be connected using the technology.

Aussies may have lost interest in the NBN: study

A newly published study has questioned whether Australians have now lost interest in their national broadband network, the NBN, given the time it is taking to roll out the network nationally and the negative stories about disappointing speeds and connection issues.
According to the study, by competitive intelligence search company SEMrush, it appears that there was a huge peak in interest in the NBN around February 2017, but since then there has been a downward trend in interest about when the network is being installed at individual homes.
But, SEMrush suggests that, given only 3.9 million homes and businesses were connected by May 2018 (according to NBN Co), which is an increase of just 1.6 million over the past year, the drop in interest is unlikely to be due to the increase in installed customers.


Anonymous said...

Certainly not a good week. Clearly the lack of discipline is coming home to roost. One can only imagine what surprises await the minister come optout.

Anonymous said...

With the NHS discovering some 150,000 people who opted out of having their health information shared, had in fact had the health information regularly shared it might be useful for the ADHA to go on record as to how conformance and compliance is being handled in design and in operations. Other than some validator tool I can find little evidence any checks and balances are in place to protect the general public or healthcare workers and institutions.

Anonymous said...

Further trouble for HealthEngine. A media release issued last Friday afternoon when no-one was paying attention.