This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
Thursday, October 18, 2018
Courtesy Sue Dunlevy - News Corp - Hunt Has Ruled Out Opt Out Extension.
Health Minister Greg Hunt refuses to comply with a Senate Committee call for the opt out period for My Health Record to be extended by 12 months
David.
28 comments:
Anonymous
said...
There are three components to the report: the first is the Chair’s report (Rachel Siewert, Australian Greens), the second (from page 73) is the Coalition Senators’ (Government) Dissenting Report and the third is the Labor Senators’ Additional Comments (p77).
The government will be making a formal response in time.
The Minister has advised the Agency that there will be no change to the opt out date of November 15.
Regards, Ronan
Ronan O’Connor Executive General Manager Core Services Systems Operations
So Minister shunt sticks two fingers up the the Australian public and the Senate committee. I am sure by month end the spineless backstadder will relax his position.
The problem you have is that the Government seems to be imploding and Labor will be the Government rather soon I suspect. Wentworth is a real curve ball....
What they are saying needs to be noticed and you need to be planning for that outcome.
If you ignore the Labor / Greens majority report it might go very badly for the ADHA.
David I don’t believe that is posted by this Ronan chap. It looks like a paste from an internal communication. There are some unhappy campers at ADHA I hear, some sort of restructure going on. Some venting is my guess.
I agree with you, this will not do the Prime Minister much good. I wonder if he approved the statement? Come across a bit like a little boy who has been naughty and his toy has been taken off him.
AFAIK, this is the first and only independent review of the PCEHR/myhr. It has attracted a wide range of opinions, views and concerns.
Much of the report is political and has been phrased in a particular manner and sometimes it is necessary to read between the lines or look behind what has been said.
My initial reading of the recommendations: Recommendation #1 says that access to a patient's health records is far too easy and that the default should be no access. Considering the aim of the systems was to make access to health data much easier, this is a damming criticism of the whole system.
It was observed by some before the report came out that making access codes the default would return the system to opt-in. In fact it goes far beyond that - it says that patients should have to actively decide who sees their data. This probably makes the system totally unworkable. It could well be that the committee is aware of this and that it is a politically acceptable way of saying - scrap the system.
Many of the other recommendations also concern issues around access.
Recommendations 10 through 12 are a savage criticism of the ADHA and its pathetic media strategy.
Minister Hunt's immediate rejection of recommendation 12 "We will not be extending it further as it would not be appropriate to delay the benefits to patients" is completely in line with the government's one sided view of the system. They can only see benefits (which have never been justified) and take no account of the costs and risks, many of which have been detailed in the Senate report.
IMHO, the government is being irresponsible and reckless.
The unintended consequences of the move to opt-out is that it has highlighted the flaws and risks in the system. It has given the Labor party the ammunition to wedge the Coalition and come out as defenders of the people.
The fate of myhr now rests with politicians. If the Liberals lose Wentworth tomorrow, it's anyone's guess what will happen. If the Labor party wins the next election, it is highly likely there will be major changes to the whole initiative.
If, by some miracle the Coalition is in government in a year's time, the demise of the system will take longer.
My prediction, FWIW, is that the system is now dead in the water. The costs are way too high; GPs and specialists are unlikely to embrace it; alternatives that are more appealing to patients and health providers are available now and will become even more attractive in the near future.
The only uncertainty is timing and how much money the government is going to waste.
The government would be advised to take heed of the old saying: when you are in a hole, don't keep digging, you'll only get deeper into the mess.
Good analysis Bernard, and agree this does look a reasonable exit pathway. Mr Hunt has made an odd and rash move here. The press will have a field day, as you point out Wentworth is not looking good for Priminister Morrison.
Me Hunt cannot be in a strong position before this, the public may not take to kindly to the tone and indifference displayed my Mr Hunt, is this the final act of a liability?
There are at least two levels to this inquiry, the public and the private. The public is the submissions, the evidence and the report. The private are all the unpublished inputs and comments that have been made to the committee and other senators.
I have been told that people from the UK were most unhappy with the spin Tim Kelsey put on his evidence regarding what happened in the UK and have made their concerns known to the committee.
This is unlikely to be made public but the Labor party and a number of independents are now probably very much aware of the character of the people promoting and running myhr and will take this into account when determining how to move forward.
I have been told that the Labor party is very worried about future risk with very little benefit to them. The tone of the recommendations reflects these concerns. IMHO, Minister Hunt has now lost control of the health records agenda. He is totally at the mercy of the Senate - he needs them to pass his legislation. He is in a no win situation. Politically he cannot capitulate to the demands of the Senate. If he ignores them or tries to fight them, he can't win.
To me it looks very much like Tim has no friends. Minister Hunt can't be happy he's been put into this situation; the Labor party wouldn't risk leaving him where he is if they gain power.
What Labour put in place in the form of the PCEHR has moved the idoption of and advancement in health IT. At the time it provided a means to an end. The Department got to maternal with it and actually created a series of dis-benefits. I am looking forward to the incoming Health Ministers vision of the future and the very necessary role Government can play in building a clinically lead standards based eHealth eco-system.
I have since the appointment had my reservations about this Tim Kelsey bloke, and my concerns sadly have been proven to be well founded.
Correction to my earlier comment: Recommendation 13, not 12.
Minister Hunt's immediate rejection of recommendation 13 "We will not be extending it further as it would not be appropriate to delay the benefits to patients" is completely in line with the government's one sided view of the system. They can only see benefits (which have never been justified) and take no account of the costs and risks, many of which have been detailed in the Senate report.
The government's response to Recommendation 1 is telling:
'Applying access codes by default would represent a "serious implementation challenge for many Australians", particularly those "who did not (or could not) want to receive their PIN online".'
So, access codes are a "serious implementation challenge for many Australians". And yet the government claims that patients can protect their valuable and sensitive health data if they want to by setting access codes.
Pleased to see Kelsey and Co have been pulled into the middle (light?) of the day at senate estimates on Wednesday, rather than the usual end of the queue at a quarter to midnight...
And I'm looking forward to their appearance, given there seems to be more time allocated as well...
@10:19PM agree this matter is not trivial. What else is the Minister and the public as a whole being lied to about? The CEO and COO can no longer be trusted. The ADHA obviously is an Agency in disarray and does not even have basic governance in place. We are expected to trust this lot to safe guard personal records? They can’t even look after there own government records.
Reading through the FOI requests, this is far from a good look. The Agency seems to believe it is above the law and shows complete disregard and total disrespect to all involved.
How has this happened to once respected institutions?
As an example of the depth of false information - Digital Information Systems Used for Accounting and Corporate Records Management
I worked at ADHA until very recently, SharePoint as they claim is not the EDRMS. There is no records management system, document management is shared drives but predominantly people use desktops, confluence or email to store information. The place was a mess and the IT Director was a total idiot.
Big shake up at ADHA this week with several SES and EL2 staff going - redundancies and "resignations". They might have got this one thing right because most of the people given the boot were either completely useless or quite destructive to culture. Apparently they had 5 different comms directors each running different teams - no wonder the comms is such a disorganised mess!
@10:13 AM, cannot local and IT Director but did find this role - General Manager- Commercial Services (CIO). Certainly does not appear to be CIO material. Perhaps it is one of those jobs for the boys we hear about?
Imagine providing misinformation to a student writing a thesis. The ADHA is shameless.
Returning the real world - Metadata laws under fire as 'authority creep' has more agencies accessing your information. This surely is an alarming move, one I can see the MHR being caught up in if not willingly offered
The burning question for me is - why the need to distort the facts and blatantly lie. This are not isolated, nor are they simple errors. There seems to be a very real Strategy at play here. Why?????
Might be the need to lie because the truth is so telling, or they have been lying for so long they don’t know when they are. Some in more countries than others but for just as long.
AnonymousOctober 20, 2018 11:27 AM. The claim of being “CIO” is false. It is however a reflection of many over inflated egos the ADHA seems to have amassed.
The face saving option for Hunt would be to continue with the opt-out date as is, but not create any records for a while - say mid next year when it is likely to be another party's responsibility.
I don't see how they can create records before the legislative amendments aren't just passed, but implemented - what will happen if someone cancels a record but then law enforcement accesses it before it can be deleted, for example?
At the very least, they could create records in phases - start with just the over 45s or something.
Maybe they could start with the 4 million HI numbers that a Obote the actual number of humans in Australia. I am sure the ADHA is bust confusing the senate committee so they relax their positions
Surely it's an AUTOMATIC process, in that after the deadline has passed everyone who has not opted out is Registered as having a My Health Record with the record's demographic details being automatically populated from information held on each individual in the Medicare database; even although the Medicare database contains many more records than there are people in Australia like duplicates, aliases, false identities, deceased people and expats.
That would be my assumption as well, although there would be a manual step where someone would need to enter a command line to execute the process. That maybe a safety step to ensure a system does not inadvertently and irrevocably commence the conscription process.
There will also be a month I believe where requests by post and fax are processed.
There's something seriously wrong with a national data system when a lawyer "recommends the seeking of professional advice from a privacy law expert if you’re unsure of what to do."
"Lawyer warns to check your medical privacy rights" https://www.lawyersweekly.com.au/sme-law/24293-lawyer-warns-to-check-your-medical-privacy-rights
Among other things he says:
“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.
“Many Australians are not fully informed of how their My Health Record information will be used, nor are they aware of the potential data security risks that come from data sharing and storing digital records online.”
28 comments:
There are three components to the report: the first is the Chair’s report (Rachel Siewert, Australian Greens), the second (from page 73) is the Coalition Senators’ (Government) Dissenting Report and the third is the Labor Senators’ Additional Comments (p77).
The government will be making a formal response in time.
The Minister has advised the Agency that there will be no change to the opt out date of November 15.
Regards, Ronan
Ronan O’Connor
Executive General Manager
Core Services Systems Operations
So Minister shunt sticks two fingers up the the Australian public and the Senate committee. I am sure by month end the spineless backstadder will relax his position.
This will not play well for the LNP.
Great to hear from you Ronan,
The problem you have is that the Government seems to be imploding and Labor will be the Government rather soon I suspect. Wentworth is a real curve ball....
What they are saying needs to be noticed and you need to be planning for that outcome.
If you ignore the Labor / Greens majority report it might go very badly for the ADHA.
David.
David I don’t believe that is posted by this Ronan chap. It looks like a paste from an internal communication. There are some unhappy campers at ADHA I hear, some sort of restructure going on. Some venting is my guess.
I agree with you, this will not do the Prime Minister much good. I wonder if he approved the statement? Come across a bit like a little boy who has been naughty and his toy has been taken off him.
AFAIK, this is the first and only independent review of the PCEHR/myhr. It has attracted a wide range of opinions, views and concerns.
Much of the report is political and has been phrased in a particular manner and sometimes it is necessary to read between the lines or look behind what has been said.
My initial reading of the recommendations:
Recommendation #1 says that access to a patient's health records is far too easy and that the default should be no access. Considering the aim of the systems was to make access to health data much easier, this is a damming criticism of the whole system.
It was observed by some before the report came out that making access codes the default would return the system to opt-in. In fact it goes far beyond that - it says that patients should have to actively decide who sees their data. This probably makes the system totally unworkable. It could well be that the committee is aware of this and that it is a politically acceptable way of saying - scrap the system.
Many of the other recommendations also concern issues around access.
Recommendations 10 through 12 are a savage criticism of the ADHA and its pathetic media strategy.
Minister Hunt's immediate rejection of recommendation 12 "We will not be extending it further as it would not be appropriate to delay the benefits to patients" is completely in line with the government's one sided view of the system. They can only see benefits (which have never been justified) and take no account of the costs and risks, many of which have been detailed in the Senate report.
IMHO, the government is being irresponsible and reckless.
The unintended consequences of the move to opt-out is that it has highlighted the flaws and risks in the system. It has given the Labor party the ammunition to wedge the Coalition and come out as defenders of the people.
The fate of myhr now rests with politicians. If the Liberals lose Wentworth tomorrow, it's anyone's guess what will happen. If the Labor party wins the next election, it is highly likely there will be major changes to the whole initiative.
If, by some miracle the Coalition is in government in a year's time, the demise of the system will take longer.
My prediction, FWIW, is that the system is now dead in the water. The costs are way too high; GPs and specialists are unlikely to embrace it; alternatives that are more appealing to patients and health providers are available now and will become even more attractive in the near future.
The only uncertainty is timing and how much money the government is going to waste.
The government would be advised to take heed of the old saying: when you are in a hole, don't keep digging, you'll only get deeper into the mess.
Good analysis Bernard, and agree this does look a reasonable exit pathway. Mr Hunt has made an odd and rash move here. The press will have a field day, as you point out Wentworth is not looking good for Priminister Morrison.
Me Hunt cannot be in a strong position before this, the public may not take to kindly to the tone and indifference displayed my Mr Hunt, is this the final act of a liability?
There are at least two levels to this inquiry, the public and the private. The public is the submissions, the evidence and the report. The private are all the unpublished inputs and comments that have been made to the committee and other senators.
I have been told that people from the UK were most unhappy with the spin Tim Kelsey put on his evidence regarding what happened in the UK and have made their concerns known to the committee.
This is unlikely to be made public but the Labor party and a number of independents are now probably very much aware of the character of the people promoting and running myhr and will take this into account when determining how to move forward.
I have been told that the Labor party is very worried about future risk with very little benefit to them. The tone of the recommendations reflects these concerns. IMHO, Minister Hunt has now lost control of the health records agenda. He is totally at the mercy of the Senate - he needs them to pass his legislation. He is in a no win situation. Politically he cannot capitulate to the demands of the Senate. If he ignores them or tries to fight them, he can't win.
To me it looks very much like Tim has no friends. Minister Hunt can't be happy he's been put into this situation; the Labor party wouldn't risk leaving him where he is if they gain power.
What Labour put in place in the form of the PCEHR has moved the idoption of and advancement in health IT. At the time it provided a means to an end. The Department got to maternal with it and actually created a series of dis-benefits. I am looking forward to the incoming Health Ministers vision of the future and the very necessary role Government can play in building a clinically lead standards based eHealth eco-system.
I have since the appointment had my reservations about this Tim Kelsey bloke, and my concerns sadly have been proven to be well founded.
Correction to my earlier comment: Recommendation 13, not 12.
Minister Hunt's immediate rejection of recommendation 13 "We will not be extending it further as it would not be appropriate to delay the benefits to patients" is completely in line with the government's one sided view of the system. They can only see benefits (which have never been justified) and take no account of the costs and risks, many of which have been detailed in the Senate report.
The government's response to Recommendation 1 is telling:
'Applying access codes by default would represent a "serious implementation challenge for many Australians", particularly those "who did not (or could not) want to receive their PIN online".'
So, access codes are a "serious implementation challenge for many Australians". And yet the government claims that patients can protect their valuable and sensitive health data if they want to by setting access codes.
Hypocrites.
Pleased to see Kelsey and Co have been pulled into the middle (light?) of the day at senate estimates on Wednesday, rather than the usual end of the queue at a quarter to midnight...
And I'm looking forward to their appearance, given there seems to be more time allocated as well...
Going forward it might be beficial if they were playing left-right-out. Who amongst them has a medical background or even run or built a hospital?
I would like to draw attention to this - www.zdnet.com/google-amp/article/adhas-non-process-for-releasing-my-health-record-data-revealed/
This is not good.
@10:19PM agree this matter is not trivial. What else is the Minister and the public as a whole being lied to about? The CEO and COO can no longer be trusted. The ADHA obviously is an Agency in disarray and does not even have basic governance in place. We are expected to trust this lot to safe guard personal records? They can’t even look after there own government records.
Reading through the FOI requests, this is far from a good look. The Agency seems to believe it is above the law and shows complete disregard and total disrespect to all involved.
How has this happened to once respected institutions?
As an example of the depth of false information - Digital Information Systems Used for Accounting and Corporate Records Management
I worked at ADHA until very recently, SharePoint as they claim is not the EDRMS. There is no records management system, document management is shared drives but predominantly people use desktops, confluence or email to store information. The place was a mess and the IT Director was a total idiot.
Big shake up at ADHA this week with several SES and EL2 staff going - redundancies and "resignations". They might have got this one thing right because most of the people given the boot were either completely useless or quite destructive to culture. Apparently they had 5 different comms directors each running different teams - no wonder the comms is such a disorganised mess!
And the architects of the mess? No the CEO and COO will remain to repeat their blunders again and probably get rewarded handsomely for it.
@10:13 AM, cannot local and IT Director but did find this role - General Manager- Commercial Services (CIO). Certainly does not appear to be CIO material. Perhaps it is one of those jobs for the boys we hear about?
Imagine providing misinformation to a student writing a thesis. The ADHA is shameless.
Returning the real world - Metadata laws under fire as 'authority creep' has more agencies accessing your information. This surely is an alarming move, one I can see the MHR being caught up in if not willingly offered
The burning question for me is - why the need to distort the facts and blatantly lie. This are not isolated, nor are they simple errors. There seems to be a very real Strategy at play here. Why?????
Might be the need to lie because the truth is so telling, or they have been lying for so long they don’t know when they are. Some in more countries than others but for just as long.
AnonymousOctober 20, 2018 11:27 AM. The claim of being “CIO” is false. It is however a reflection of many over inflated egos the ADHA seems to have amassed.
The face saving option for Hunt would be to continue with the opt-out date as is, but not create any records for a while - say mid next year when it is likely to be another party's responsibility.
I don't see how they can create records before the legislative amendments aren't just passed, but implemented - what will happen if someone cancels a record but then law enforcement accesses it before it can be deleted, for example?
At the very least, they could create records in phases - start with just the over 45s or something.
Maybe they could start with the 4 million HI numbers that a Obote the actual number of humans in Australia. I am sure the ADHA is bust confusing the senate committee so they relax their positions
Surely it's an AUTOMATIC process, in that after the deadline has passed everyone who has not opted out is Registered as having a My Health Record with the record's demographic details being automatically populated from information held on each individual in the Medicare database; even although the Medicare database contains many more records than there are people in Australia like duplicates, aliases, false identities, deceased people and expats.
Perhaps I've missed something?
That would be my assumption as well, although there would be a manual step where someone would need to enter a command line to execute the process. That maybe a safety step to ensure a system does not inadvertently and irrevocably commence the conscription process.
There will also be a month I believe where requests by post and fax are processed.
There's something seriously wrong with a national data system when a lawyer "recommends the seeking of professional advice from a privacy law expert if you’re unsure of what to do."
"Lawyer warns to check your medical privacy rights"
https://www.lawyersweekly.com.au/sme-law/24293-lawyer-warns-to-check-your-medical-privacy-rights
Among other things he says:
“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.
“Many Australians are not fully informed of how their My Health Record information will be used, nor are they aware of the potential data security risks that come from data sharing and storing digital records online.”
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