Quote Of The Year

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

Tuesday, December 25, 2018

Commentators and Journalists Weigh In On The MyHR Debate And Related Matters. Lots Of Interesting Perspectives - Week 23.

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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Sensored to death: How machine learning in the cloud will destroy all privacy

The combination of IoT sensors and data lakes become a powerful tool for pattern analysis, but has serious privacy implications for the consumer and the employee in the workplace.
By Jason Perlow | December 19, 2018 -- 19:52 GMT (06:52 AEDT) | Topic: Big Data Analytics
n late October, I had the privilege of moderating a panel on the subject of artificial intelligence and machine learning at Unbound Miami, a boutique (but excellent) trade show that specializes in showcasing disruptive technologies such as cryptocurrency and blockchain. 
The show and the panel was highly engaging with some really great speakers, including Dr. Alex Liu of IBM, Anthony DeLima of NEORIS, Prof. Sara Rushinek of University of Miami Business School, and Ylan Kazi at UnitedHealth, and I'm glad I am finally able to show it to you.
Since the show, I have been thinking a lot about the subject of machine learning in the cloud, and how it is likely to impact our lives in the near future. There are many aspects of this technology that have potentially very positive benefits, but as with any disruptive technology, there are pitfalls.
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Home Affairs cannot be bothered listing all agencies with access to metadata

With a disclosure notice or court order, government agencies otherwise exempted are able to tap Australia's metadata stores.
By Chris Duckett | December 21, 2018 -- 23:37 GMT (10:37 AEDT) | Topic: Security
The Department of Home Affairs says it would take "considerable time and resources" for it to determine how many agencies across Australia's three tiers of government have accessed metadata held under the nation's data retention laws.
Responding to Questions on Notice, Home Affairs pointed out another of the loopholes that gives agencies, not on the list of 21 enforcement agencies, the ability to access metadata.
"Section 280(1)(b) of the Telecommunications Act 1997 creates an exemption to the general prohibition against the disclosure of metadata for Commonwealth, state, or territory entities that are not enforcement agencies," Home Affairs said.
"The authorities that can utilise this exemption are not specified."
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From ideas boom to innovation bust: How Australia turned against tech

By Emma Koehn & John McDuling
22 December 2018 — 12:36am
On December 7, 2015, an upbeat Malcolm Turnbull unveiled his first major policy initiative since becoming prime minister: the 'Ideas Boom', a $1 billion package of measures designed to boost innovation.
"We want to be a culture, a national culture of innovation, of risk-taking" Turnbull, who couldn't stop talking about 'disruption' or the need to be 'agile' back then, declared at a press conference at the CSIRO in Canberra.
Nearly three years to the day from the unveiling of that policy, the federal government's retreat from innovation, and standing within the tech community, sank to its nadir.
On December 6 encryption laws, universally condemned by local startups and global tech giants alike, were passed by parliament, with bipartisan support, on the last sitting day of the year.
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https://www.smh.com.au/business/small-business/australia-s-100-million-scam-problem-the-threat-has-become-personal-20181220-p50nfd.html

Australia's $100 million scam problem: The threat has become personal

By Emma Koehn
22 December 2018 — 12:37am
Australians have lost more than $100 million from scam activity so far this year and a shift in approach from criminals means the threat has become more personal.
While phone and internet schemes have traditionally focused on exploiting "greed" through promises like prize winnings and vouchers, cybersecurity experts say Australians have increasingly been targeted with sophisticated communications that use their actual details and systems to gain access to funds.
"The reason this has been successful is they’ve been either able to impersonate a domain name or compromise an account. People are becoming compromised often without necessarily knowing that they have been," says Barracuda Networks' senior sales engineer, Mark Lukie.
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Hospital patients' details being used to steal drugs and medicines by doctors and nurses

Exclusive by Allyson Horn
21 December, 2018
A number of Queensland patients have had their personal details used to illegally access and steal drugs and medications in hospitals and health centres.

Key points:

  • Queensland Health Ombudsman investigated nearly 40 complaints about drug theft in the last financial year
  • Patient details were fraudulently used to steal the restricted or controlled drugs in multiple cases
  • More than three-quarters of the matters occurred in the most populated regions, Brisbane and the Gold Coast
The Queensland Health Ombudsman investigated nearly 40 complaints about drug theft in the last financial year, and labelled the practice "a serious risk to public health and safety".
In multiple cases, patient details were fraudulently used to steal the restricted or controlled drugs.
"For example, one practitioner working in a public health facility stole medication through an automated electronic dispensing system by entering legitimate patient details; the medication — which cannot be accessed without a patient's information — was neither prescribed nor dispensed to the patient, but taken by the practitioner for personal use," the ombudsman found.
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21 December 2018

Police access to health records raises privacy concerns

Government MBS TheHill
Posted by Felicity Nelson
Thousands of records containing sensitive information such as HIV-status, past abortions and mental health issues are being requested by the police every year – and doctors and privacy experts are deeply concerned about it.
The battle for greater privacy protection around My Health Record (MHR) data appears to have been won, with the government pushing through legislative changes in November requiring police to get a warrant in order to access MHR data.
What has largely escaped the public’s attention thus far is that there are two other, equally-sensitive datasets held by the Department of Human Services that federal, state and territory police forces have been quietly accessing for years.
The police are not legally required to get a warrant to obtain Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) data.
An investigation by The Medical Republic recently revealed that the police were requesting around 2,600 MBS and/or PBS records every year.
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2018 digital review: AI on the rise in pharma

Digital technology is playing an increasingly important role in healthcare, and in the pharma industry as it searches for ways to find new drugs, while cutting costs and reducing expensive trial failures. 2018 will be remembered as the year when technology such as AI began to catch on in healthcare and pharma, reports Richard Staines.
The UK government’s life sciences tsar, Sir John Bell, set the tone for 2018, when he went on record to say that artificial intelligence (AI) could save billions of pounds for the NHS.
Bell told the BBC that researchers at an Oxford hospital have AI technology for diagnosing heart disease that could shave £2.2 billion from the NHS’ pathology spend.
Another AI system developed by a company called Optellum could allow more than 4,000 cancer patients a year to be diagnosed earlier.
This could save £10 billion if adopted in the US and EU, according to the company’s science and technology officer, Dr Timor Kadir.
The UK government has also backed AI-based health research including five new centres for artificial intelligence in health, focusing on areas including pathology, radiology, and imaging.
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My Health Record: Remain in or opt out?

We all need to be fully aware who has access to our health data, when they can access it, what it’s being used for and the potential implications.


After 31 January 2019, every Australian, including all people living with HIV (PLHIV), will have a My Health Record (MHR) account established by the Australian Digital Health Agency (ADHA), if they have not opted out.
MHR is an online summary of your key health information, operated by the Australia Digital Health Agency, which once activated can include information from GPs, specialists, pharmacists, pathology labs or diagnostic imaging providers. The main benefit of MHR is all your health information will be in one place. For example, prescriptions, medical conditions, allergies, test results, medicines you’ve had dispensed by your pharmacist and your visits to your doctor, referral letters between your doctors, and GP visit and hospital summaries.
We’ve heard from a range of people including PLHIV that they’re excited by and will benefit from MHR. These are PLHIV who are ageing, those living with comorbidities and complex care needs, and likely to have numerous hospital admissions. PLHIV are eager to own their health information and MHR will empower them in shared decision process making with their doctors, when seeing multiple healthcare providers. MHR will reduce the duplication of tests and waiting times for test results, as well as the risk of adverse events, and could save your life in an emergency.
Concerns remain about some primary and secondary uses of MHR.  People who choose to remain in the MHR are providing informed consent for the linking of their health data, which is the ‘secondary use’ of MHR data. PLHIV have also shared concerns about data control and ownership of health data. You can choose to have a MHR but make a decision not to share your health information for research and clinical trials.  While the Framework to guide the secondary use of My Health Record system data has been published, the first release of secondary use data will not occur until at least 2020 under the custodianship of the Australian Institute of Health and Welfare (AIHW).
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Digital hospitals improve health for Queenslanders: report

Hafizah Osman | 18 Dec 2018
A new report has backed Queensland’s digital hospital program, confirming that it is improving healthcare and patient outcomes in the state. 
The report, tabled by the Queensland Audit Office (QAO), highlighted the benefits of the digital hospital program in Queensland, while making recommendations to improve governance of the future rollout.
Key findings from the report identified that as a result of the digital hospital program, Queenslanders face improved health service delivery and patient outcomes, as well as a reduction in unplanned readmission rates. 
It found that medical staff can access clinical information faster and that patient records are more legible. 
Minister for Health and Ambulance Services Steven Miles said the digital hospital program is “one of the most significant health advances in decades”. 
Note: I think the author was reading a different report to the copy I saw. This is the most glass half full report I have ever read!
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GDPR helps drive growth in privacy tech

There has been rapid growth of technology vendors offering to help enterprises meet their obligations under the GDPR and other privacy regimes
Rohan Pearce (Computerworld) 19 December, 2018 14:41
Over the past year and a half the dialogue around privacy, and the social implications of violations of privacy, has shifted significantly, according to Trevor Hughes. Partly that shift has been driven by the Cambridge Analytica scandal, said Hughes, who is the president and chief executive officer of the International Association of Privacy Professionals (IAPP).
However, beyond that particular case, he thinks that increasingly there has been recognition “that we leapt headlong into the digital economy, to the digital revolution, and we’re sort of cleaning up some of the issues that that’s created now,” the IAPP CEO told Computerworld.
“Privacy is transitioning,” Hughes said. “There is this recognition that it is no longer just about individual harm. It’s not about ‘have you violated my data’ or ‘how have you used my data in a way that I wasn’t expecting or I find offensive or problematic’. There are societal level concerns associated with privacy now.”
That includes a recognition that “violations of privacy, misuse of data create real challenges for open and fair elections, democracies generally, fundamental freedoms broadly – things like free speech and other things,” he added. “Even freedom of thought and choice.”
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Australia finally gets a new digital economy strategy

By Justin Hendry on Dec 19, 2018 11:36AM

Highlights four areas to focus efforts.

The federal government has finally released its revamp of Australia’s national digital economy strategy to seize the potential economic benefits presented by new technology.
The strategy, dubbed Australia’s tech future [pdf], has been developed over the last 15 months in collaboration with businesses, academia and the community to help develop digital skills and deliver better services.
It replaces the existing digital economy strategy, which was last revised in May 2016 after first being released by the then Department of Communications in May 2011.
Minister for Industry, Science and Technology Karen Andrews said the strategy – which was originally slated for release in first half of this year – identifies where Australia’s efforts should be focused in the years ahead to amplify the digital economy.
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Labor to lift lid on algorithms

  • 1:01PM December 18, 2018
A Shorten Labor government would investigate the tech giants’ secretive algorithms, with the party revealing key aspects of its technology agenda should it wins next year’s federal election.
The ACCC last week flagged a review into Google and Facebook’s well-guarded algorithms, and now Labor has followed suit. The party used its national conference in Adelaide to pass a motion that AI technology needs to be safe, trustworthy and under the ultimate control of human decision-makers.
The motion, which passed on Monday, said a Labor government would implement reporting mechanisms to “help track how privately devised and managed algorithms impact on the income and prices generated on digital platforms, including ride sharing and food delivery, to help prevent exploitation and worsening inequality.”
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Psychologists’ home details posted online in HBF breach

Cathy O'Leary The West Australian
Wednesday, 19 December 2018 5:01AM
WA’s biggest health insurer has admitted to a privacy breach that led to the private addresses of psychologists being published on a TripAdvisor-style healthcare website.
HBF said this week that it had notified the Office of the Australian Information Commissioner and written to more than 7000 psychologists after realising it had provided some personal addresses to the online directory Whitecoat.
It conceded that the mistake had potentially put at harm psychologists who worked from home.
Chief executive John Van Der Wielen also confirmed that his organisation had ended its association with Whitecoat — the patient rating site it helped relaunch in July 2016 with fellow insurers Bupa and nib.
He said the decision was not related to the privacy breach, which fully came to light a few weeks ago when an upset psychologist complained that their personal address had been published on Whitecoat.
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New advice to improve hospital-GP communication

Current efforts are inconsistent and too often fail to meet best practice, says AMA president
18th December 2018
The AMA wants hospitals to inform GPs about a patient’s unplanned admission and discharge within 24 hours.
Concerned that patients are being let down by ineffective communication between hospitals and GPs, the organisation has released updated guidelines to improve transfer-of-care arrangements.
AMA president Dr Tony Bartone says communication efforts are inconsistent, with too many transfers not meeting best practice.
“Unfortunately, missing discharge summaries and slow — or no — communication too often lead to poor patient outcomes,” he said in a statement.
Evidence shows that the risk of readmission rate is 79% higher within seven days of discharge, and 37% higher in the following month, for patients who are sent home without a discharge summary from hospital.
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When a GP spoke out over discharge summaries, it led to real change

Dr Katrina McLean called for major improvements to discharge summaries – and her local hospitals responded.

In March this year, Dr Katrina McLean and two colleagues called for improved clinical handovers between hospitals and GPs.

Nine months later, and as more GPs called for urgent change, Dr McLean – who is also an Assistant Professor at Bond University – told newsGP that speaking out has led to direct improvements in communication with hospitals on the Gold Coast, where she works.

‘There is a long way to go but, locally, I feel we are in a much stronger position than we were 18 months ago,’ she said.

Dr McLean used her March article, published in MJA Insight, to illustrate the impact on GPs of poor-quality or late discharge summaries to the Chair of the Gold Coast Hospital and Health Service, who took the issue to the board.

The result? A commitment that local hospitals would work towards better communication with GPs.
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17 December 2018

How big data has created a big crisis in science

Clinical Research
Posted by The Conversation
There’s an increasing concern among scholars that, in many areas of science, famous published results tend to be impossible to reproduce.
This crisis can be severe. For example, in 2011, Bayer HealthCare reviewed 67 in-house projects and found that they could replicate less than 25 percent. Furthermore, over two-thirds of the projects had major inconsistencies. More recently, in November, an investigation of 28 major psychology papers found that only half could be replicated.
Similar findings are reported across other fields, including medicine and economics. These striking results put the credibility of all scientists in deep trouble.
What is causing this big problem? There are many contributing factors. As a statistician, I see huge issues with the way science is done in the era of big data. The reproducibility crisis is driven in part by invalid statistical analyses that are from data-driven hypotheses – the opposite of how things are traditionally done.
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Tech stand-off may trigger digital divide

Clive Hamilton
  • 11:00PM December 16, 2018
The arrest in Canada of Huawei executive Meng Wanzhou could be a turning point in the struggle over who will attain technological dominance in the 21st century. For both China and the US, the contest is existential because whoever dominates cutting-edge technologies will also prevail economically and militarily.
The Chinese Communist Party shot itself in the foot when in 2015 and again in 2017 it passed laws obliging Chinese companies such as Huawei to act on any request to undertake intelligence work. Private as well as state-owned enterprises are now extensions of the party.
The laws were vital evidence for those who favoured banning Huawei from Australia’s 5G network, a ban now being copied by other Western nations. The 5G “fibre to the phone” network will be the control system for pretty much everything — at the heart of big data, autonomous vehicles, smart cities, the internet of things and much more, including weapons systems.
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Comments welcome!
David.

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