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, September 16, 2018

It Looks Like The myHR Has Just Become Way More Political And Change May Be More Likely – Possibly.

Just as I was deciding what this week’s poll was going to address I noticed on Twitter that Kerryn Phelps had decided to stand in the Wentworth bye-election. More interesting was the report on Insiders was that a major reason was the myHR and what was going on with it.
You can read about it all here and note that the myHR gets an early mention:
Additionally we have the Senate Inquiry tomorrow with a very interesting line-up of witnesses:
Monday 17 September 2018

Committee Room 2S1 Parliament House, Canberra

Time
Witness
4.00 pm
Mr Paul Shetler
4.30 pm
Consumers Health Forum of Australia Ms Leanne Wells, Chief Executive Officer Mr Dean Hewson, Digital Health Adviser
5.00 pm
Health Intersections Pty Ltd (Submission 14)
5.30 pm
Australian Council of Trade Unions
Mr Lance McCallum, National Campaign Coordinator Mr Christopher Watts, Social Policy Advisor

Health Services Union

Electrical Trades Union of Australia
Mr Trevor Gauld, National Policy Officer
6.30 pm
Dinner break
7.00 pm
Law Council of Australia (via teleconference)
Mr Morry Bailes, President
Ms Olga Ganopolsky, Chair, Privacy Law Committee of the Business Law Section Dr Natasha Molt, Director of Policy

Maurice Blackburn Lawyers
Mr Tom Ballantyne, Head of the Victorian Medical Law practice
7.45 pm
Department of Health
Ms Caroline Edwards, Deputy Secretary
Ms Tania Rishniw, First Assistant Secretary, Portfolio Strategies Division
Mr Brian Kelleher, Assistant Secretary, Digital Health Branch, Portfolio Strategies Division

Australian Digital Health Agency

Office of the Australian Information Commissioner
Ms Angelene Falk, Australian Information Commissioner and Privacy Commissioner Ms Melanie Drayton, Acting Deputy Commissioner
Ms Sarah Ghali, Acting Assistant Commissioner, Regulation and Strategy

Just what Paul Shelter will say –is hard to know but this offers a clue:

Ex-DTO chief slams "significantly flawed" My Health Record

Would probably opt-out.

Former Digital Transformation Office chief Paul Shetler has labelled the rollout of the My Health Record “significantly flawed”, citing issues with its security model and design as barriers to take-up.
Speaking on ABC Radio on Wednesday, Shetler criticised the Australian Digital Health Agency for not altering the personal electronic health record system's “weird security model” to meet its new circumstances.
The current security model requires users to manually set privacy settings to restrict access to the record or avoid sharing certain types of information after a record has been created.
Lots more here:
Health Intersections is, of course Grahame Grieve and we also have an inkling on his tack!

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.
Read the full submission here:
There is very detailed coverage of Grahame's views, with comments from other stakeholders found here:

https://www.healthcareit.com.au/article/%E2%80%9Cnot-fit-purpose%E2%80%9D-fhir-creator-my-health-record-senate-inquiry-gets-underway
 
The article's title is:

 “Not fit for this purpose”: FHIR creator on My Health Record as the Senate inquiry gets underway
 
Lynne Minion | 13 Sep 2018
 
Well worth a read!
 
We know the Consumer Health Forum has a rather pro view of the opt-out process but has expressed the odd concern recently.
The unions have expressed concerns regarding employer access to the myHR as I recall.
After the dinner break will be interesting with a number of legal entities and then the Department of Health, the Agency and the OAIC.
All in all what now comes out with the Report due October 8, 2018 will be fascinating as will be what the Government does with the recommendations.
We have a crucial few weeks coming up to see this fiasco sorted. Let’s hope!
David.

13 comments:

Anonymous said...

.... and Paul Madden has just evaporated into thin air

Anonymous said...

No option is without its complications. That said a centralised solution for a distributed business problem doesn't work and there is scant if any evidence that is can for Australia, and when the centralisation is government, then it is even worse. The governments role is to facilitate safe, secure, interconnection not own it. The original design for a set of federated repositories was lost or seen as to hard by those with other agendas, and the ADHA lost many if not all that understood things at that level. Somehow the perception that that was all too hard may have been premature, the central system approach has proven just as difficult and probably far more expensive.

Bernard Robertson-Dunn said...

Kerryn Phelps as an independent to replace Malcolm Turnbull.

Now that would set the cat among the pigeons. The Coalition would lose their majority, although Kerryn has said she would not try and destabilise the government.

She may want her views on myhr to be recognised though. Most, if not all the other independents have a similar view.

The Health Minister hasn't got his legislation through the Senate yet.

Could be a game changer.

Anonymous said...

Paul Madden is on long service leave since sometime in January or February 2018. The timing might see him return as this new Digital Officer the ADHA is on the Greg hunt for.

Bernard Robertson-Dunn said...

Just guessing but the CSIRO might be waking up to the con trick ADHA is playing on Australians in general and the government in particular.

Last week was this report:

"CSIRO using serverless compute to analyse the human genome"
https://www.zdnet.com/article/csiro-using-serverless-compute-to-analyse-the-human-genome/

Which included this:

"Working for the eHealth research program within CSIRO, which is the largest digital health agency in Australia, Bauer said the teams are focused on improving healthcare through using digital technologies and services.

"The CSIRO released its Future of Health [PDF] report this week, which outlined the organisations 15-year vision of healthcare in Australia."

CSIRO's report sort of mentions myhr but doesn't give it much credence.

Then there's this:

Clinician Perceptions of My Health Record in Mental Healthcare: Medication Management and Sharing Mental Health Information.
Timothy Kariotis , Keith Harris
http://www.publish.csiro.au/PY/justaccepted/PY17181

Abstract

"My Health Record is a national personally controlled electronic health record, which is projected to be used by all Australian health professionals by 2022.

It has also been proposed for use in mental health care, but there is limited information on how clinicians will successfully implement it.

This study interviewed seven general practitioners, and four psychologists in Tasmania, Australia.

Participants were asked about information continuity and barriers and benefits to using My Health Record in mental health care. Thematic analysis identified two pertinent themes: Medication Management, and Mental Health Information.

Participants reported MHR could improve the quality and frequency of medication information shared between clinicians but wanted additional medication-related alert features.

Mental health information issues were broad in scope and included concerns over sensitive data that might be accessed through My Health Record, and completeness of information.

Participants also reported barriers to MHR use, including time burdens and privacy and confidentiality concerns. My Health Record used in mental health care may improve the timely sharing of medication-related information, but clinicians’ concerns regarding the sharing of patients’ highly sensitive mental health information need to be addressed.

PY17181 Accepted 08 September 2018"

Not exactly glowing praise.

I wonder what is being said behind the scenes. Maybe one of those non-published submissions could have come from the CSIRO - the largest digital health agency in Australia.

Anonymous said...

Can it get any more embarrassing. The Departments submission references the Concept of Operations, the link is to the APF website, the link is broken

So the ADHA and the Department cannot even manage their own records. Why do they need to reference private organisations to link Government records??

Bernard Robertson-Dunn said...

The first time it is referenced it is:

https://privacy.org.au/Campaigns/MyHR/docs/PCEHR_110912_Concept_of_Operations.pdf%20Last%20accessed%2010/9/2018

which works.

The second time it is referenced it is:
URL: https://www.privacy.org.au/Campaigns/MyHR/docs/PCEHR_110912_Concept_of_Operations.pdf Last accessed 10/9/2018

"Last accessed 10/9/2018"

All they had to do was to downlaod it and put it up on one of their own websites.

Mind you, you can see why they don't want to draw attention to it. It contains some features that might have made it a bit more acceptable: e.g. proper interoperability, NASH and data repositories with very little being uploaded to the National Repository.

Anonymous said...

They have to reference a third party website for concept of operations for one of their own systems? Pretty much sums the ADHA up. That and the linked in posting this week from a previous executive. Seems all the rumours of what a cultural hell hole were and are true. Sooner they dismiss that little group of friends in there the better.

Anonymous said...

Well the ADHA did not come across all that well and certainly provided little comfort they are in control. The % game is cute but fooled no one.

Tim Kelsey seemed to refer to people simply as IHI figures, so that tellls me a lot about the mans care factor, he also looked very uncomfortable and basic body language indicated not all was quite true.

On the % matter, IHI cannot optout only people, and only people over the age of 16, and then only people who do not already have a record ( regardless of whether they wanted one or not). So
6 million already tag with a record
4.5 million person 15 years and under
So in actual fact the number of optout is around 6.21%

% to one side 9000000 “people” have made a conscious effort to optout. In real terms that is staggeringly high.

And that is people ADHA, you know those flesh and blood things that fund you and make up the human species.

Bernard Robertson-Dunn said...

Don't forget, it is estimated that about 25% of Australians do not have computers / internet access.

If someone were to do a survey to find out how many people were aware of the opt-out program and were able to opt-out then I reckon 900,000 out of that number would be a lot higher.

But this whole thing is spin anyway. There are signs the Labor party is getting nervous about taking the thing over when they win the next election. There's no political upside, only risk.

One amazing thing that came out of yesterday's hearing is the admission there was no business case for opt-out. That's not really surprising, because if you do one there is no financial justification for the thing - the costs are enormous and the benefits ephemeral.

Anonymous said...

In response to your body language question it is commonly agreed in this field that the following indicates:

Scratching one’s neck.
As a rule, people do it with the index finger of their dominant hand. The average person scratches his neck 5 times a day. This gesture is questioned. That is, if the person says something like, “Yes! I totally agree with you,” and thus reaches out to scratch his/her neck, it means that in fact he or she does not agree, and doubts.

Pulling the collar.
Quite a familiar gesture, right? It looks as if it becomes stuffy and a person finds it hard to breathe. Cheating leads to high blood pressure and sweating, especially if the cheater is afraid of being caught in a lie.

I am not passing judgement. However, watching the committee members these gestures where not lost on them.

Anonymous said...

What do you all think of the ADHA's claim at the inquiry that 59% of Australians are aware of My Health Record and opt out?

Anonymous said...

I think 88.7% of the 51% either have one so don’t count and 57% know because they are waiting to be able to cancel. 76% of people never question a %