Quote Of The Year

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

or

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

Tuesday, October 30, 2018

Commentators and Journalists Weigh In On The MyHR Debate And Related Matters. Lots Of Interesting Perspectives - Week 15.

Note: I have excluded (or marked out) any commentary taking significant  funding from the Agency or the Department of Health on all this to avoid what amounts to paid propaganda. (e.g. CHF, RACGP, AMA, National Rural Health Alliance etc. where they were simply putting the ADHA line – viz. that the myHR is a wonderfully useful clinical development that will save huge numbers of lives at no risk to anyone – which is plainly untrue) (This signifies probable ADHA Propaganda)
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AMA Submission - My Health Record - Community Affairs Legislation Committee Inquiry

26 Oct 2018

AMA advocated strongly to protect the confidentiality of information the patient discloses to their treating doctor.  It is vital that sensitive patient health data uploaded to the My Health Record does not become a ‘honey-pot’ for law enforcement agencies.  This would not only threaten the doctor-patient relationship, it would undermine community confidence in the My Health Record system.
The AMA welcomes the amendments in My Health Record (Strengthening Privacy) Bill 2018 (the Bill).  If passed by the Parliament, it will prohibit the System Operator (the Australian Digital Health Agency) from disclosing My Health Record data to a law enforcement body without a warrant or judicial order and severely limit the circumstances in which a judicial order can be issued.  In fact, because of the amendments in this Bill,  it will be harder for law enforcement organizations to get a warrant for patient data from a My Health Record, than it would be to get a warrant to access information from the patient’s treating health practitioner.  The net effect of the Bill will restore the status quo to recognize the primary source of patient data, disclosed under the authority of a warrant, will be data stored in the clinical software of the treating medical practitioners and/or hospital.  The Bill also ensures all clinical data in a person’s My Health Record is deleted when a person opts out – another win for AMA advocacy.
Related document (Public): 

Published: 26 Oct 2018
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My Health Record: A Huge Threat to Patient Privacy With Little Benefit

DOCTORS REFORM SOCIETY

My Health Record: A Huge Threat to Patient Privacy With Little Benefit
The botched rollout of the compulsory My Health Record (MHR) is about to be forced on millions of unsuspecting Australians as the Government creates a mega database about the private lives of every Australians. As the new Member for Wentworth, Kerryn Phelps and the Senate Inquiry found it was currently not fit for purpose, data could be sold to private companies for commercial gain, and  the Government is not telling Australians what it was planning.
“The MHR is no longer the well intentioned community based collaboration of doctors and IT specialists with their patients for an e-record,” said Dr Tim Woodruff, President, Doctors Reform Society. “It is now a top-down government compulsory data collection scheme”
“The MHR as it now stands is close to useless for most patients because the Government has failed to implement it properly and it now poses a high risk to patient privacy and eventually, to the doctor-patient relationship,” said Dr Woodruff
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Last Chance To Opt Out Of #MyHealthRecord, Australians!

from the deadline-is-november-15 dept

Australia's controversial and clumsy rollout of its "My Health Record" program this summer didn't cause the "spill" -- what Australians call an abrupt turnover of party leadership in Parliament — that gave the country a new Prime Minister in August. But it didn't improve public trust in the government either. The program — which aims to create a massive nationally administered database of more or less every Australian's health care records — will pose massive privacy and security risks for the citizens it covers, with less-than-obvious benefits for patients, the medical establishment, and the government.
Citizen participation in the new program isn't quite mandatory, but it's nearly so, thanks to the government's recent shift of the program from purely voluntary to "opt-out." Months before the planned rollout, which began June 16, at least one poll suggested that a sizable minority of Australians don't want the government to keep their health information in a centralized health-records database.
In response to ongoing concern about the privacy impact of the program (check out #MyHealthRecord on Facebook and Twitter), the new government is pushing for legislative changes aimed at addressing the growing public criticism of the program. But many privacy advocates and health-policy experts say the proposed fixes, while representing some improvements on particular privacy issues, don't address the fundamental problem. Specifically, the My Health Record program, which originally was designed as a voluntary program, is becoming an all-but-mandatory health-record database for Australian citizens, held (and potentially exploited) by the government.
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No plans to pay GPs for uploading to My Health Record: Senate Estimates

Doug Hendrie 25/10/2018 3:33:58 PM
The Federal Government does not plan to remunerate GPs for the time taken to upload health data to My Health Record.
Australian Greens leader Richard Di Natale believes the My Health Record current system would result in a loss of income for GPs. (Image: Parliament of Australia)
At a Senate Estimates hearing on Wednesday, Department of Health (DoH) primary care and health systems policy deputy secretary, Caroline Edwards, said there were no specific proposals to pay GPs for the time required to use My Health Record.

She was responding to a question from leader of the Australian Greens Richard Di Natale, who said the current system would result in a loss of income for GPs.

‘You’re asking GPs to do something that takes time, [so] they see less patients and they lose income,’ he said. ‘I support them [using My Health Record], but you’re putting another impost on GPs who have been right royally screwed over because of the [MBS rebate] freeze.
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October 25 2018 - 4:00PM

My Health Record initiative polarises community

·         Chris Bath
Opting in: Health Minister Greg Hunt has dismissed a senate inquiry recommendation to allow another 12 months for residents to 'opt out' of the My Health Record database.
Over 1.1 million Australians have ‘opted out’ of having their medical records kept on the My Health Record database.
The window to opt out of the database closes on November 15, on which date everyone with a medicare card that hasn’t opted out will automatically have a My Health Record generated, despite a senate inquiry recommending residents be given another 12 months to decide amidst calls for a privacy and security review.
The My Health Record system was created as a centralised online summary of a person’s health records.
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Cyber security a risk to small business project wins

By Tony Featherstone
25 October 2018 — 12:05am
Your company tries to secure project work from a corporate. The tender requires an explanation of your firm’s cyber security strategy and key staff involved in this area.
You narrowly lose the tender because a rival has better cyber security resources. Cyber security has suddenly become a bigger factor in whether your firm wins or loses jobs.
Welcome to the world of cyber security and its impact on supply networks. Small and medium-size enterprises (SMEs) that do not adjust to rising expectations in industry and government risk being left behind.
(think - General Practices)
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October 24 2018 - 10:30AM

Bellingen VIEW looks at ‘My Health Record’ initiative

·         Megan Octigan
Community  ADHA Propaganda
Bellinger Valley VIEW's Sydette Anderson thanks guest speaker Lyn Parnell from North Coast Primary Health Network at the group's meeting this month on October 15. Photo supplied.
Bellinger Valley VIEW Club took a look into the benefits of a health information database at their meeting this month with guest speaker Lynne Parnell, the senior project officer for the North Coast Primary Health Network. 
The ‘My Health Record’ initiative offers an online summary of each individual’s health information, which builds up over time and is available to participating doctors.
This is a convenient way to track your health information, especially if you move interstate or are in an emergency situation which makes it difficult to relay current or past health issues and medications.
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Morrison government under pressure to rewrite My Health Record legislation

By Dana McCauley
24 October 2018 — 6:02pm
The federal government has come under increased pressure to suspend the rollout of its controversial My Health Record system and is considering rewriting its legislation, after a Senate inquiry highlighted major privacy failings and as the number of Australians to opt out exceeds 1.1 million.
Nationals senator Nigel Scullion revealed in Senate estimates on Wednesday that the government is considering further amendments to its legislation to address lingering privacy concerns raised by respected medical and privacy experts.
Added to the government's worries is independent Kerryn Phelps, the former Australia Medical Association president on track to be confirmed as the winner of Saturday's Wentworth byelection, who vowed to use her position on the crossbench to pressure a minority Morrison government on the issue.
Dr Phelps, a strident critic of My Health Record, told Fairfax Media she would be in Canberra on Thursday to meet with crossbenchers and seek their support for a suspension of the e-health system's rollout and the establishment of a new inquiry to ensure that it is bullet proof.
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Cook slams 'data industrial complex', says Apple backs federal privacy law

Apple backs the passage of a federal privacy law in the United States which should be based on four essential rights, the company's chief executive, Tim Cook, has told a privacy conference in Brussels.
Cook told the International Conference of Data Protection and Privacy Commissioners on Wednesday that firstly, people should have the right to have data collected about them minimised.
In what appeared to be a reference to companies like Google and Facebook, which trade on personal information, he slammed what he described as the "data industrial complex", accusing it of surveillance.
"Our own information, from the everyday to the deeply personal, is being weaponised against us with military efficiency," Cook said. And he added, ""We shouldn’t sugarcoat the consequences. This is surveillance. And these stockpiles of personal data serve only to enrich the companies that collect them."
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My Health Record opt-outs now sit at over 1.1 million

An additional 200,000 Australians have opted out, but it is sitting under ADHA's 5 percent target.
By Chris Duckett | October 24, 2018 -- 06:41 GMT (17:41 AEDT) | Topic: Security
Despite the number of Australians having removed themselves from the creation of a My Health Record now hitting 1.147 million, the agency responsible is happy with the result.
The Australian Digital Health Agency (ADHA) told Senate Estimates on Wednesday the opt-out rate was under 5 percent. In July, Australian Health Minister Greg Hunt revealed that the government was expecting a My Health Record opt-out rate of 10 percent.
The previous update by ADHA had 900,000 opt-outs as of September 12. The figures include opt-outs via the website and call centre, but not those being processed by paper forms.
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AskDocQ: Brisbane Doctor Fiona Bisshop Gives Her Verdict On ‘My Health Record’

Dr Fiona Bisshop 23 October, 2018
Every Australian will soon have a My Health Record — an online summary of their health information — unless they opt out before November 15. Last month, Brisbane LGBTIQ health specialist and QNews Magazine contributor Dr Fiona Bisshop put a series of questions to the Australian Digital Health Agency regarding issues that have arisen around the My Health Record system, which is designed to allow Australians to keep track of their important medical information all in one place. Now Dr Bisshop is asking the ADHA one more question of critical importance to younger Australians, and giving her verdict on My Health Record.

Dr Bisshop: If someone is under 18, can they prevent their parents having access to their MHR? This is very important for young LGBT people who may not be out and are having STI testing or getting contraception.

My Health Record: When a child turns 14, they will be able to choose whether to manage their own My Health Record, or allow their authorised representative to continue to manage their record.
They can make this choice by logging into their My Health Record (via their myGov account). When they login, they will be prompted to choose whether they want to take control of their record.
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Privacy watchdog primed for action on data breaches

  • By Angelene Falk
  • 11:00PM October 22, 2018
Human error and deception. Compromised credentials. One-off incidents.
This is the reality of most data breaches notified to the Office of the Australian Information Commissioner since mandatory reporting began in February.
Unlike the serial offending corporates portrayed in The Australian last week, the statistics highlight the human factor in data breaches.
At a time of high privacy awareness, the community expects those entrusted with their personal information to act as ethical stewards. They also expect regulators to take action to prevent breaches and to detect and remedy their issues.
Our focus as privacy regulator is to deliver outcomes for those affected by breaches of the Privacy Act.
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Denham Sadler October 22, 2018

Opt-out to pass before MHR change

Decision time: The My Health Record reforms unlikely to arrive in time for opt-out
The federal government’s series of amendments to improve the security and privacy of the My Health Record system are now unlikely to be passed before the opt-out period ends.
The amendments, announced by Health Minister Greg Hunt following sustained criticism of My Health Record (MHR), require that law enforcement agencies obtain a warrant before they are able to access data stored on the system, and allow users to permanently delete their record at any time.
The amendments were introduced to the lower house in August, with the support of the Opposition. But the legislation was not debated in the upper house last week. The Senate does not sit again until 12 November, just three days before the MHR opt-out period comes to an end.
With a number of further amendments to be moved by the Greens and Opposition, it is now unlikely that they will be passed before the opt-out period concludes.
This led to Greens leader Richard Di Natale and Labor senator Murray Watt to move a motion in the Senate late last week to “express disappointment that the federal government has chosen not to follow through on their commitment to the Australian people to strengthen the legislation which governs the My Health Record, meaning that any choices that the Australian people make about opting out will not be sufficiently informed”.
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Taking the stress out of frontline pharmacy care

22 October 2018 ADHA Propaganda
Peter Crothers’ day can change minute by minute. He’s a pharmacist working in the outback community of Bourke, in far western New South Wales. The nature of his job means he can quickly go from an empty shop to having nine people who all need attention at once – some with serious issues.
“Pharmacies don’t operate on an appointment system. We’re more like emergency departments in hospitals – people just come in and we have to deal with them,” Peter says. “It can be stressful and we’re often under time pressure. But the thing we most often feel stressed about is not having enough information.”
Pharmacists are the most accessible healthcare professionals. It’s a particularly special role in Bourke, which has about 2,600 locals and lies 800 kilometres from Sydney.
The township has a mixed demographic, with a large public service component and an important pastoral industry. Bourke also has a significant indigenous community, making up about 32 per cent of its population. From a health perspective, this makes Bourke diverse needs – high and low income, varying degrees of health literacy, local and remote communities.
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Lawyer warns to check your medical privacy rights before 15 November

Published: 23rd of October 2018 Comments:
Business Community Health & Wellness Law & Safety
Leading privacy lawyer Travis Schultz has warned that people concerned about protecting their medical privacy have less than a month left to opt out of the My Health Record (MHR) system.
The principal of Travis Schultz Law said if individuals did not explicitly remove themselves from the MHR system by 15 November, the federal government would create and store a digital copy of your medical record and make it available to numerous health care providers.
“MHR disregards global best practice for informed consent, because it requires people to opt out of the system rather than asking for express consent to use your personal information,” Mr Schultz said.
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Liverpool doctor explains the benefits of My Health Record

Cindy Ngo, Liverpool Leader
October 23, 2018 3:15pm ADHA Propaganda
A southwest Sydney GP says the introduction of online medical records for all Australians will allow medical practitioners to treat patients properly and save an “enormous amount” of money.
South Western Sydney Primary Health Network director Sayeed Khan, a GP at Allcare Medical Centre in Hammondville, is encouraging patients not to opt-out of the My Health Record system.
The system contains patients’ health information, which can be viewed online by healthcare providers anywhere, at any time.
The online summary will give them access to details such as allergies, medications being taken by the patient, medical conditions they have been diagnosed with and pathology results.
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Parliamentary Librarian ‘did not feel pressured’ to revise My Health Record post

By Stephen Easton • 23/10/2018
Dr Dianne Heriot, the head of the Parliamentary Library, is adamant that she independently decided to revise a blog post about how law enforcement agencies could access My Health Record data following complaints from Health.
“I made a decision,” she told Senator Penny Wong, who raised the issue in supplementary estimates hearing yesterday. “I did not feel pressured to make that decision.”
Heriot revealed that not only did the department’s chief operating officer relay the unusual demand in a phone call followed by several “URGENT” emails, as we’ve previously reported, it was considered so important and pressing matter that Health secretary Glenys Beauchamp had to speak to her personally.
The Parliamentary Librarian and the head of her research branch, Johnathan Curtis, both said there was no indication at their end of any involvement from Health Minister Greg Hunt or his office, but Wong is sceptical.
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Report recommends overhaul of My Health Record, but key changes not supported by Coalition

Monday, 22 October 2018 06:18 Robert Merkel, Lecturer in Software Engineering, Monash University Press Releases - The Conversation
The opt-out period for My Health Record closes on November 15.
The Senate Standing Committee on Community Affairs report into the My Health Record system was released last Thursday. It has recommended several substantial changes to the way My Health Record operates that attempt to address security and privacy concerns raised about the system.
Key recommendations were supported by Labor and Greens committee members, but not by Coalition committee members. Health Minister Greg Hunt has also rejected the recommendation to extend the opt-out deadline. There is less than four weeks until the opt-out period ends on November 15.
My Health Record is a centralised digital repository of individual health information. It was originally proposed as an “opt-in” system in 2011. But in a process originally planned to be complete by October 2018, it was switched to “opt-out”, meaning records will be created for all Australians unless they explicitly choose not to have one. This change has generated controversy.
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Legal confusion: Whose medical record is it anyway?

The law says a patient is entitled to access their records. Can you ever say no?
Georgie Haysom
23rd October 2018
The frustration in your practice manager’s voice is obvious.
“Here’s another solicitor’s letter saying send all Ms Lee’s records. They’re not her records, they belong to the practice. Do we really have to hand them all over?”
Technically it’s true that patient records do not belong to the patient. However, under Australian law, patients are generally entitled to access them.
They can also request that you provide a copy to a third party.
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Big Brother given new access to Australians' personal data

  • By Fergus Hanson
  • 11:00PM October 22, 2018
Many of us are unaware a transformational digital initiative is about to involve every Australian: digital identity. Many are probably equally unaware of the problems with the approach, including the risk of a Western version of China’s social credit system that can effectively rank individuals and shape behaviour.
The new digital identity, known as GovPass, is the latest attempt to roll out a national identity scheme. Its forebears, the Hawke government’s Australia Card and the Howard government’s Access Card, fell over in the face of community backlash. GovPass, which is enabled by a new database of biometric ­templates that has been ­established for every Australian, makes them seem quaint.
In principle, a digital identity is not a bad idea. It is an essential microeconomic reform for a 21st century economy that has the ­potential to deliver significant productivity and efficiency gains.
It will allow you to quickly confirm your personal details, entitlements and authorisations, such as proving you are over 18 years, delegating the pick-up of prescriptions or automatically con­firming your concession status.
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Children need more My Health Record privacy, says inquiry

It has called for parent access to be revoked by default when children turn 14
22nd October 2018
Allowing parents to access their children’s My Health Record by default even after the child turns 14 may be putting the safety of young patients at risk, a Senate inquiry has concluded.
The inquiry has spent two months examining the billion-dollar system as it moves to an opt-in model.
More than two million children and adolescents already have records and the number will increase dramatically as files are uploaded next month.
Doctors have been concerned that youngsters will be bamboozled by the process for preventing their parents from accessing their files, which requires them to go through the My Gov website.
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Government rejects senate inquiry recommendation to extend My Health Record opt-out period by 12 months

Health minister Greg Hunt has rejected the recommendation from a senate inquiry into My Health Record to extend the scheme’s opt-out period by another 12 months. The inquiry also called for sweeping changes to the ehealth scheme as Australians have just weeks remaining to opt out.
An extension beyond the current November 15th opt-out deadline is necessary to strengthen My Health Record’s privacy and security provisions, according to the senate inquiry’s final report. Labor senators also argued an independent privacy review is necessary.
Minister Hunt already extended the scheme’s controversial opt-out period once in August, amid public backlash over privacy and security flaws. But another will not happen, Hunt says, so as to not “delay the benefits to patients”.
“The opt-out date has already been extended and the opt outs are travelling at a significantly lower rate than expected,” a spokesperson for Minister Greg Hunt said.
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More Aussies wary about privacy breaches

Privacy complaints to a commonwealth watchdog have soared by 18 per cent in the past year, a Senate committee has been told.
Daniel McCulloch
Australian Associated Press October 22, 201810:57am
Australians are increasingly concerned about protecting their personal information, with privacy complaints to a commonwealth watchdog soaring 18 per cent in the past year.
Information Commissioner Angelene Falk has received 2947 privacy complaints in the past financial year, along with almost 20,000 inquiries about privacy rights.
Ms Falk has initiated 21 investigations into serious and repeated data breaches over the past year, including an ongoing inquiry into Facebook.
The investigation is centred on the unauthorised release and use of the personal information of more than 300,000 Australian Facebook users.
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Metadata laws under fire as 'authority creep' has more agencies accessing your information

By political reporter Melissa Clarke
Posted Fri 19 October, 2018 at 7:30pm
More government agencies are accessing people's phone and internet records than originally envisaged, in what critics are describing as "authority creep".

Key points:

  • Access to metadata was initially restricted to 22 government agencies, but state-based agencies have blown that figure out
  • Because they are accessing metadata and not content of communications, no warrant is required
  • It is not known how many agencies are now able to request metadata
Controversial laws which came into force last year compel telecommunications companies to retain metadata on their customers, including information on who you call or text, where you make calls from, and who you send emails to.
To allay privacy concerns, access to the metadata was limited to 22 specific police and intelligence agencies, such as the Australian Federal Police, ASIO and state police forces.
But a parliamentary hearing has been told that number has blown out.
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My Health Record system: final report

18 Oct 2018
Description
The My Health Record (MHR) system is an electronic health record system that commenced operation in July 2012. Although the system was originally designed on an opt-in basis, in May 2017 the government announced that the MHR system would transition to an opt-out system. Members of the Australian public were originally given a three-month period to elect to opt-out. The deadline to opt-out was later extended to a four-month period concluding on 15 November 2018.
In July and August 2018, concerns were raised in the media by medical commentators, general practitioners, IT professionals and journalists about the utility and security of the MHR system and whether members of the public should exercise their right to 'opt-out' of the new system.
In this inquiry, the Community Affairs References Committee has considered the views of a wide range of stakeholders to assess whether the MHR system is working and how it can be improved to make MHR a more effective tool to support patients and improve healthcare delivery.
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Comments welcome!
David.

9 comments:

Anonymous said...

That Digital Health Evidence Review that somebody posted about in a comment somewhere on here has come out too. See https://www.digitalhealth.gov.au/get-started-with-digital-health/digital-health-evidence-review

Bernard Robertson-Dunn said...

What a load of rubbish.

It's a comparison of electronic record systems. It's a bit like comparing brands of cigarettes - they are all bad for you.

It's also comparing apples with oranges. myhr is a passive summary system but the "evidence" tries to give the invalid impression that the benefits of full medical record systems might also be obtainable from myhr.

The one section that isn't about comparing record systems only looks at benefits, although it does contain this un-referenced and unexplored sentence "There remains debate regarding the impact of shared digital health records with evidence for benefits as well as challenges (e.g. negative impacts on clinician-patient relationship, productivity and workflow)."

That this sentence or any reference to a debate about the lack of benefit is excluded from the Key Findings is a dead giveaway, as is the use of the weasel-word "challenges".

It's all spin. In research terms it's called confirmation bias. The one thing it isn't is evidence that myhr is worth the $2b spent or that doctors will use it.

Anonymous said...

This coming out of 9 news Queensland make for some interesting reading - Secret report raises questions about Queensland's medical records system

A little ball tampering has exposed Cricket Australia as a fruad, maybe we need a royal commission into health IT dealings.

Anonymous said...

Interesting they leave out the 2015-16 care.data termination and the communications and privacy debacle that it was. This and any references to failures globally sadly diminishes the value of the work and to an extent pays disrespect to those who undertook the research and analysis.

Anonymous said...

Bernard it certainly does seem emerged in xHR comparison. Based on that I don’t think Gartner will be worries by the competition.

Anonymous said...

The big question is this: are they fooling themselves and hence the Australian people or are they deliberately trying to fool the Australian people?

Anonymous said...

Based on this statement from the report I will leave it to the readers to contemplate

Despite different implementation approaches, there are similarities in the reported factors that are critical for success. These include the commitment and involvement of all stakeholders, good organisational management, and interdisciplinary teams with information technology (IT) experience. [2] For all countries, the implementation of EHRs and PHRs is an iterative process that evolves over time as population needs shift, and as technology evolves to meet those needs.

Anonymous said...

On the subject of Gartner, Canberra would be wise to take note: https://which-50.com/neglecting-privacy-can-endanger-your-entire-digital-transformation-says-gartner/

With Peter Dutton pulling strings, and with puppets the the health minister and CEO and COO of ADHA, trust will be hard to regain.

Dr Ian Colclough said...

@ 11:54 AM try writing this same paragraph from the other side of the mirror. Take the 'opposite' approach. It's the ultimate exercise in mental gymnastics; it's illuminating and exciting because it opens up a whole new way of thinking about the problem they are wrestling with but clearly don't understand.