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, January 22, 2019

Commentators and Journalists Weigh In On The MyHR Debate And Related Matters. Lots Of Interesting Perspectives - Week 27.

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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Note: This week has just covered all the privacy compromising announcements in a week – along with the myHR. It never seems to stop!
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How you fatten the internet giants

  • By Hugo Rifkind
  • The Times
  • 10:21AM January 19, 2019
One morning in April 2002 engineers at Google’s headquarters noticed something odd about the previous night’s search-datalog.
The phrase “Carol Brady’s maiden name” had spiked in popularity not once, but five times, and each time at 48 minutes past the hour. Why, they wondered, the rush of interest in the backstory of a 1970s television character?
They realised that the spikes corresponded to the American time zones, from the east coast to Hawaii, where viewers the previous evening had been stumped by a particular question on Who Wants to Be a Millionaire?
Today, this all seems pretty obvious. Yet even a decade and a half later, many people still don’t understand how internet giants make their money.
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How to think about data in 2019

It is tangible human beings, not abstract “data”, that power the online economy
Dec 22nd 2018
“DATA”, RUNS a common refrain, “is the new oil.” Like the sticky black stuff that comes out of the ground, all those 1s and 0s are of little use until they are processed into something more valuable. That something is you.
Seven of the world’s ten most valuable companies by market capitalisation are technology firms. Excluding Apple, which makes money by selling pricey gadgets, and Microsoft, which charges businesses for its software and services, all are built on a foundation of tying data to human beings. Google and Facebook want to find out as much as it is possible to know about their users’ interests, activities, friends and family. Amazon has a detailed history of consumer behaviour. Tencent and Alibaba are the digital wallets for hundreds of millions of Chinese; both know enough about consumers to provide widely used credit scores.
Where tech companies have blazed a trail, others have followed. Consumer brands in every industry collect data on their customers to improve design and advertise products and services. Governments have looked at these firms and instituted their own systems to gather information on their citizens. Narendra Modi, India’s prime minister, cites Facebook as an inspiration. That is apparent in the ever-expanding reach of Aadhaar, an ID system for India’s 1.3bn residents that is required for nearly every government service imaginable.
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Jan 17, 2019, 11:27am

Apple Has Just Ushered In The Era Of Digital Health

John Nosta
It’s been coming for a long time--digital health, health tech, mHealth or whatever you’d like to call it.
And it’s been slow and problematic.
But the tides seem to be shifting, and dramatically at that.  There are recent events that may have the muscle to drive this new era of consumer health tech and one is name behind it.  That's Apple.
I was struck to hear Tim Cook's recent proclamation on Apple's future reported in a recent story.
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Facebook faces record fine over privacy

Facebook could be facing a record fine over data mining firm Cambridge Analytica vacuuming up details about 87 million users without their permission.
Associated Press January 19, 20197:31am
Facebook may be facing the biggest fine ever imposed by the US Federal Trade Commission for privacy violations involving the personal information of its social network's 2.2 billion users.
The Washington Post reported the FTC is considering hitting Facebook with a penalty that would top its previous record fine of $US22.5 million ($A31.3 million), which it dealt to Google in 2012.
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Apple's digital health plan puts the iPhone and Apple Watch at the heart of your wellbeing

Apple has been gradually building out its health strategy; here's what it looks like right now.
By Jo Best | January 16, 2019 -- 10:05 GMT (21:05 AEDT) | Topic: Digital Health and Wellness
Digital health is where big tech firms want to be right now: from Amazon to IBMMicrosoft to Google, hardware and software companies are scrambling to up their presence in the healthcare sector. Apple has been quietly expanding into the space for a number of years as its devices and its CEO Tim Cook even recently said that in future the company's greatest contribution to humanity would be considered to be 'about health'.
The first signs of Apple's burgeoning interest in health came with the launch of its HealthKit platform and Health app, which debuted alongside the first Apple Watch. Back then, it was consumer wellness that Apple was talking about, helping users track their exercise, diet, and other lifestyle metrics, with the idea that if you know how much you're doing, you might be encouraged to do more.
However, the launch of CareKit and ResearchKit around the same time showed that Apple was also thinking about how to work with medical professionals as well as consumers. The company has also been making it easier for users of its devices to share data with their healthcare provider, and making sure that the data it gathers is as useful and accurate as insurers and physicians need it to be.  
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Why tech giants don't need to spy on you to know what you're up to

By Jason Nurse
Updated17 January 2019 — 11:55amfirst published at 11:51am
If you’ve ever wondered if your phone is spying on you, you’re not alone. One of the most hotly debated topics in technology today is the amount of data that firms surreptitiously gather about us online. You may well have shared the increasingly common experience of feeling creeped out by ads for something you recently discussed in a real life conversation or an online interaction.
This kind of experience has led to suggestions that tech firms are secretly recording our private conversations via smartphones or other internet-connected devices such as smart TVs, Amazon Echo or Google Home. Or that they are reading our private messages even when they are supposedly encrypted, as with Facebook’s WhatsApp. If this were proven to be true, it would reveal a huge conspiracy that could do untold damage to the tech industry – which makes it seem somewhat far-fetched. But recent revelations about the degree to which Facebook users’ data has been shared certainly won’t help to convince people that the big firms aren’t spying on them.
Facebook said it did not give some companies access to user's data without their permission, responding to a New York Times report.
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"My Health Records" illegally accessed with 42 suspected cases reported

Opt out period ends 31st January 2019
The online medical records of Australians have been breached only weeks after the My Health website crashed as thousands tried to opt out for privacy reasons.
The Australian Digital Health Agency has revealed in its annual report 42 suspected cases of unauthorised viewing of e-health records.
The revelation has been made only six weeks after the federal government extended until January 31 the deadline to opt out of the My Health regime, where doctors and other health professionals can access a patient's medical records with a login and password. 
Members are advised to seriously consider whether your health record is beneficial to your interests of privacy in the workplace.
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My Health Record empowering older Australians to travel with peace of mind

16 January, 2019 - 11:30 ADHA Propaganda
Australia’s peak body representing the interests of older people has urged retirees travelling Australia to consider the benefits of a My Health Record.
For many Australians, retirement signals the start of a new and exciting period of life.
More free time brings the opportunity to travel the country.
But if you have health problems, travelling as an older person can be complicated.
“My Health Record is a secure online summary of your important health information that can help,” said Ian Yates, chief executive of COTA Australia, the peak organisation advancing the rights, interests and futures of Australians as they age.
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Canberra weighs national data policy amid Chinese takeovers

17 Jan 2019 — 11:00 PM
The federal government is investigating enacting a national data policy, a framework that would help law-enforcement agencies and the foreign investment regulator better adjudicate on sensitive cases.
While Australia has piecemeal data legislation around privacy and cyber security there is no overarching policy on how to treat what is increasingly being viewed as a critical national asset.
The issue has flared in recent weeks due to Chinese group Jangho proposing a $2 billion takeover bid for Healius, a company which holds medical records for millions of Australians.
Government sources have indicated "discussions are happening at very senior levels" around the formulation of a national data policy, but it remained "a principle rather than policy" at this stage.
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When doctors explain privacy, teens raise more sensitive topics

Understanding confidentiality paves the way for more open discussions between adolescents and their doctors
17th January 2019
Adolescents and young adults may be more willing to talk about sensitive topics with their doctors if they've had a talk about confidentiality, new findings suggest.
Only about one-third of adolescents talk about confidentiality with their healthcare provider, but those who report doing so are more likely to discuss potentially sensitive issues, according to the US study in Pediatrics.
"Sometimes we forget that adolescents don't understand the way the practice operates, the way the clinic operates, so we need to explain that to them," says study author Dr John Santelli of Columbia University in New York.
To investigate factors that could facilitate these conversations, Dr Santelli and colleagues surveyed more than 1500 13-26-year-olds about whether they had discussed any of 11 specific topics with their doctor at their most recent visit.
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As it stalks Healius, Jangho looks to tout data protection credentials to FIRB

16 Jan 2019 — 11:00 PM
China's Jangho Group will try to demonstrate to the foreign investment regulator that it can be trusted with Australians' sensitive medical data as it continues its takeover pursuit of health giant Healius.
The Shanghai-listed Jangho will point to its steadfast custodianship of clinical data generated by Vision Eye Institute, the formerly ASX-listed ophthalmology network it bought in 2015.
The company is looking to position itself as a great owner of healthcare assets, ahead of a possible sweetened offer from its $2 billion bid for Healius that was lobbed on January 3.
The proposal was swiftly rejected by the company's board a few days later, but the parties have agreed to keep talking.
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Most Facebook users unaware site keeps list of their interests

Nearly three-fourths of Facebook users studied in a survey by the Pew Research Centre were unaware that the site was maintaining a list of their interests, and 51% were not comfortable with being categorised.
The survey covered 963 nationally representative American adult users of the social media site and was conducted between 4 September and 1 October last year.
In a blog post detailing the study, Pew said users could see how the site had categorised their interests by visiting the "Your ad preferences" page.
Eighty-nine percent of the users were unaware that this list was being created by the algorithm used by Facebook.
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HIMSS19 Global Conference and Exhibition

About this event ADHA Propaganda

The HIMSS Global Conference and Exhibition brings together more than 45,000 health information and technology professionals, clinicians, executives and market suppliers from around the world. 
Topics include:
  • Clinical Informatics and Clinician Engagement
  • Clinically Integrated Supply Chain
  • Consumer, Patient Engagement and Digital/Connected Health
  • Consumerization of Health
  • Culture of Care and Care Coordination
  • Cybersecurity, Privacy and Security
  • Data Science/Analytics/Clinical and Business Intelligence
  • Disruptive Care Models
  • Grand Societal Challenges
  • Health Informatics Education, Career/Workforce Development and Academia
  • Health Information Exchange, Interoperability, Data Integration and Standards
  • Healthcare Applications and Technologies Enabling Care Delivery
  • Healthy Aging and Technology
  • Improving Quality Outcomes Through Health Information and Technology
  • Innovation, Entrepreneurship and Venture Investment
  • Leadership, Governance and Strategic Planning
  • Population Health Management and Public Health
  • Precision Medicine and Genomics
  • Process Improvement, Workflow and Change Management
  • Public Policy, Reporting and Risk Management
  • Safe Information and Technology Practices for Patient Care
  • Social, Psychosocial and Behavioral Determinants of Health
  • Telehealth
  • User Experience (UX), Usability and User-Centered Design

Who should attend?

Clinical executives, physicians, nurses, senior executives, patient advocates, innovators and entrepreneurs, programmers, educators, investors, compliance officers, security professionals, information and technology executives, pharmacists, students, government employees, hospitalists and others.
For more information: https://www.himssconference.org/.
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15 January 2019

Physician authority and influence online

Social Media
When I look on Twitter here’s how I see physician authority and influence:
  • Authority – These are the true leaders in medicine with deep knowledge, experience and credibility in their domain. These are the leaders among physicians. The power hitters. And not necessarily academics.
  • Influence – Those with lots of followers or influence as determined by social media metrics.
    Some influencers have authority. Others are poseurs who dress-up influence as authority. Many are somewhere in between. Physicians among the public are categorically considered to have authority although this is relative. Physicians with authority among other physicians is less common.
Conflation of physician authority and influence

The problem is that the consuming world conflates physician authority and influence. But popularity has no correlation with credibility or competence. Digital health is lousy, with empty-minded, parroting self-promoters who have thousands of fawning followers. What they know is limited by what they read on Twitter 10 minutes earlier.
Or as the New Yorker taught us years ago: on the internet no one knows you’re a dog. Perhaps democratised media’s biggest challenge is trying to suss out the self-made “authorities”.
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Australian’s My Health Record Program Found Data Breaches

The Annual Report of the agency Australian Digital Health Agency (ADHA) for the year 2017–18 suggested that they found near about 42 data breaches. The Office of the Australian Information Commissioner (OAIC) concerns over ensuring the data security or reliability breaches. But they claim that the malicious attack for integrating the My Health Record System. The one breach incidence resulted from unauthorized access to this My Health Record due to incorrect parental authorization to a child.
Two breaches in contrast to the Medicare program showed the improper records in the My Health Record affected the individual. This breach offered access to the authority and led to suspect the fraud.
This report from ADHA recognized that of these 42 breaches, 17 breaches caused due to data integrity action introduced by the Department of Human Services. Remaining cases of breaches occurred due to frauds in the Medicare programs and unauthorized claims in the My Health Records.
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Denham Sadler
January 15, 2019

MHR reports 42 data breaches

Policy
Unknown iceberg: The digital health agency's reported breaches don't tell full story
There were more than 40 breaches involving My Health Record data in a year, the agency behind the program has revealed in its annual report. But experts fear this may only be the “tip of an unknown iceberg”.
The information on the contentious My Health Record system was always going to garner attention, but the Australian Digital Health Agency’s annual report was dropped in the quiet period between Christmas and New Year’s.
The report revealed 42 data breaches from July 2017 to June 2018, but said there were “no purposeful or malicious attacks”.
The ADHA reported three of the breaches to the Office of the Australian Information Commissioner, with one involving the unauthorised access after an incorrect Parental Authorised Representative was assigned to a child, and the other two due to suspected Medicare fraud.
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“My Health Record” Concerns

With the new deadline of 31 January 2019 to opt-out of the My Health Record system, I thought it might be helpful to highlight some of the implications for separating families, especially those with children and domestic violence concerns.
The My Health Record scheme was initially and opt-in process, but in 2017 the Government changed this to automatically enrol the whole population unless individuals proactively opt-out.
Concerns were raised last year about the ability of perpetrators of domestic violence to use their parental status to create a My Health Record for their children without the knowledge or consent of the other parent (in this case, the aggrieved). This My Health Record would then allow the perpetrator to obtain information about visits with doctors and pharmacies and potentially track down their victims.
The Women’s Legal Service Qld published a very informative media release on the subject which is worth reading: https://wlsq.org.au/dv-victim-my-health-record-safety-risks/
In response to these concerns, the Australian Digital Health Agency has addressed the issue, available on the following links.
If you choose to opt-out for yourself or on behalf of your children, here’s the link the do it:
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FIRB to closely scrutinise Healius, Chinese medical takeovers

14 Jan 2019 — 11:00 PM
A Chinese takeover bid for Australia's largest network of medical centres and pathology clinics is set to be closely scrutinised by the Foreign Investment Review Board, after its head singled out the protection of healthcare data as a key area of concern.
The chairman of FIRB, David Irvine, said in May last year the government had an obligation to protect the personal data of Australians by regulating who had access to it and how it was stored.
"That obligation becomes relevant for FIRB as a result of growing foreign investor interest in data-sensitive assets such as healthcare services and data centres," Mr Irvine told an investor forum in Sydney.
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Data & privacy: A monumental year

2018 was a monumental year for data privacy and protection - globally and in New South Wales. 
On a global scale, the introduction of the EU General Data Protection Regulation (GDPR), the Facebook-Cambridge Analytica data scandal, and Equifax’s record £500,000 fine (and US$287,000,000 remediation costs) for a 2017 security breach has brought data privacy and protection to the forefront of both government and business considerations. 
On a local scale, data privacy and protection continues to make headlines. 
In this article, we recap the big events (and breaches) that have shaped the data and privacy landscape in NSW this year, stemming from the overreach of data using technology.
In March, a NSW resident successfully challenged Transport for NSW’s collection of personal data through the Opal card ticketing system. The complainant argued against the mandatory registration of pensioner and concession Opal cards, which tracked the public transport movements of an identifiable user. The NSW Civil and Administrative Tribunal ruled in favour of the complainant, finding that there was little basis for the collection of the travel information for the stated purpose of enforcement of entitlement to the concession/pensioner travel card. However, the Tribunal has since overturned the decision, allowing an appeal by Transport for NSW in August. 
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Why data privacy is hot and machine learning is not

by Rafael Laguna — 7 hours ago in Contributors
Looking back on the past twelve months, we will all remember cybersecurity scares, revelations of data malpractices, and countless large-scale data breaches. Allegations ranged from Google’s non-consensual tracking of user location data to (unlikely) instances of China covertly installing microscopic spy chips on US tech hardware.
It’s clear that data privacy will underpin innovation and technological advancement in 2019, while the latest buzzword tech is set to go the way cryptocurrency went last year (who saw that coming?). As a member of the recently fashionable – not to mention increasingly lucrative – open source community, I wanted to share my predictions for the year ahead.

On the rise: Data ownership and the internet

The bellwether blunder from the past 12 months has to be the Facebook-Cambridge Analytica data scandal, where it was alleged that the poached data of millions was used to influence voter behavior for key political decisions, including Trump’s election and the Brexit referendum.
Thus Mark Zuckerberg’s purported clandestine global practises were brought to the forefront of public debate, which according to one survey preceded five per cent of Brits deleting their Facebook accounts.
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Digital health success hinges on four principles

Bianca Phillips
Bernard Robertson-Dunn
This is the third article in a series on the making of the digital health revolution.
Dr Topol’s book is excellent in describing the problems with the current health care industry. At the end of the book he observes:
“Not a single aspect of health and medicine today will ultimately be spared or unaffected in some way. Doctors, hospitals, the life science industry, government, and its regulatory bodies: all are subject to radical transformation.”
Dr Topol’s book was written over a decade after a report from the Committee on Quality Health Care in America, which was part of the Institute of Medicine – Crossing the quality chasm: a new health system for the 21st century.
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China has a very unhealthy interest in our medical data

By Clive Hamilton
13 Jan 2019 — 11:00 PM
Chinese companies are required by law to obey directives from Beijing's intelligence agencies. So why would our regulators permit a giant Australian healthcare provider that is privy to highly sensitive records on hundreds of thousands of Australians to be acquired by a Chinese company?
The Jangho Group, a Shanghai-based building supplies company, wants to take over Healius, an Australian company that operates 2400 pathology centres and 70 medical centres, and partners with about 1500 GPs and other health specialists.
Security agencies around the world have noticed an alarming spike of cyberattacks aimed at health records, with state-based actors in China the leading suspects. Last July, it was reported that 1.5 million medical records were stolen in Singapore in a cyberattack experts believe came from state-based hackers in China.
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Comments welcome!
David.

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