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 29, 2019

Commentators and Journalists Weigh In On The MyHR Debate And Related Matters. Lots Of Interesting Perspectives - Week 28.

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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MHR deadline looming

The Australian Digital Health Agency has highlighted that anyone can choose to have or delete a My Health Record at any time in their life, as the number of connected pharmacies skyrocket

The extended My Health Record opt-out deadline is approaching: on Thursday, January 31.
The Agency says that 84% of community pharmacies are now connected to My Health Record – the increase in pharmacy connections has tripled in the past six months, it says.
Meanwhile 82% of general practices and 75% of public hospitals are now connected.
As of this week, 6.45 million Australians have a My Health Record.
As of 24 January, a function has been activated in the My Health Record system that allows a person to permanently delete their record at any time, including any backups, following the introduction of new laws to strengthen the privacy and security protections within the system.
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We need a primary health care national minimum data set

Editor: Mark Ragg Author: Rebecca Haddock and Nigel Harding on: January 22, 2019In: general practice, primary health care, Primary Health Network, Primary Health Networks, public health
Australia has no national minimum data set for primary health care.
This means that no comprehensive, ongoing data set exists in this country that can show how and why people use and access primary health care services, what occurs in individual consultations, and the resulting health outcomes. This is despite substantial government and individual investment in primary health care services.
For a health system to effectively and efficiently meet the needs and expectations of Australians, data collection and reporting in primary health care is essential. We need to be able to monitor changes and improvements in primary care services over time and understand the impact of different care models for those at risk of poor health.
The Deeble Institute for Health Policy Research’s recent paper Call for the establishment of a primary health care national minimum data set, by Maddy Thorpe and Sharon Sweeney of Brisbane South Primary Health Network (PHN), has highlighted that the ongoing collection of data from general practice using standardised definitions and coding would create enormous benefits for service planning and delivery.
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How healthcare can prepare for My Health Record roll-out

Article by Proofpoint APJ vice president Tim Bentley

  • An important article when you consider whether or not to sign up for My Health Record 21 Jan 19
Australians have until January 31 to decide if they will opt out of a nationwide My Health Record initiative designed to ensure healthcare providers have instant online access to important patient information.
At the same time, cybercrime is the fastest growing crime in the world, and Australia’s healthcare sector is the continent’s biggest target according to a July report from the Australian Information Commissioner.
While Australian healthcare cybersecurity teams are in a constant fight to defend patient information from cybercriminals, there are three important steps healthcare providers can take to proactively secure their systems from online compromise.
Train healthcare staff to spot cyberattacks that target them.
Cybercriminals have shifted methods from attacking network infrastructure to attacking users directly to break into systems and access patient information.
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EXPERT REACTION: Pros and cons of MyHealthRecord as opt-out looms

Publicly released: Thu 24 Jan 2019 at 1550 AEDT | 1750 NZDT
With the extended MyHealthRecord opt out deadline fast approaching on January 31, experts weigh up the advantages and disadvantages of the system. More expert comments will be added as they come in.
Organisation/s: ATSE, University of Wollongong, The University of Melbourne, The Society of Hospital Pharmacists of Australia (SHPA)

Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Professor Hugh Bradlow is President of the Australian Academy of Technology and Engineering and former Chief Scientist at Telstra.
"Collecting health data across the population will lead to better health outcomes by showing how effective interventions are and allowing treatments to be personalised based on the experience of thousands of other patients.
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My Health Record: government warned of 'significant' patient data glitch

Exclusive: Leaked document says problem potentially left personal medical information out of date or missing, but agency says safety not compromised
Government officials were warned a “significant” technical glitch affecting the My Health Record system threatened to leave patient information incomplete or out of date, a leaked briefing shows.
The My Health Record system relies on doctors and medical practices using their own IT systems to upload clinical information about patients, to help ensure continuity of care and improve interactions with healthcare providers.
An internal briefing to the Australian Digital Health Agency’s data integrity group last month, obtained by Guardian Australia, shows that a software bug began to affect the system in early 2016, which prevented some clinical information systems used by medical practices “from uploading clinical documents to the My Health Record system”.
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David Thodey and friends push hard for AI regulation ahead of election

By Julian Bajkowski on Jan 25, 2019 12:10PM

Push to create tech policy dream team.

Major IT industry chess pieces could be starting to move ahead of the prospect of a Labor federal government.
Two of Australia’s highest-profile technology and scientific leaders have launched a push to propel formal local regulation of artificial intelligence and automation ahead of a looming national election, a move that dovetails neatly with persistent calls from unions for policy intervention in the field.
David Thodey and Genevieve Bell have fronted an open letter to “Australia's business, academic, technology and government leaders” to create a new “specific organising body to guide and advance the development of ethical frameworks, policy, and regulation.”
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New function expected to strengthen public trust in My Health Record

Australians are now able to permanently delete their My Health Record, with planned changes officially coming into effect.
A new My Health Record function will give people the option to permanently delete their record at any time.
Individuals who wanted to opt out of My Health Record could previously only restrict the access of doctors and other officials.
However, the Australian Digital Health Agency (ADHA) has created a new function that enables people to permanently delete their record at any time, including whatever back-ups that may have existed.
Consumers Health Forum of Australia CEO Ms Leanne Wells said the added feature should strengthen public trust in the system.
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Banks slam weak privacy, security settings for consumer data and open banking

By Julian Bajkowski on Jan 24, 2019 12:16PM

Treasury under fire for rosy risk assessment.

Australia’s banks have rolled a hand grenade under the federal government’s push to create a Consumer Data Right regime to underpin open banking and contestable accounts across utilities, warning current privacy and security assumptions are riddled with understated risks and cyber fraud holes.
In an emboldened pushback to Treasury, the Australian Banking Association (ABA) has used a submission on the laws to directly challenge key security and risk assumptions contained in the Privacy Impact Assessment (PIA) for the proposed Consumer Data Right that remains in legislative limbo ahead of the election.
The banks’ chief criticism is that Treasury is looking at security risks surrounding transferable consumer data through rose-tinted glasses. They argue that hackers and cyber criminals, who already routinely assail banks and payments schemes can and will do anything to get data intended for Accredited Data Recipients (ADRs).
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My Health Record accounts reach 6.45m as opt-out deadline draws near

From next Thursday, a record will be automatically created for those who have not opted out of the Australian government's online medical file.
By Asha McLean | January 23, 2019 -- 22:13 GMT (09:13 AEDT) | Topic: Security
The deadline for opting out of a My Health Record is now only a week away, with an online medical file to be automatically created if an individual does not choose to remove themselves from the controversial initiative.
Previously, the January 31 deadline meant that after this date, a record would be created and could not be deleted in its entirety. However, following legislative amendments, individuals can now choose to have or cancel a My Health Record at any time.
According to system operator the Australian Digital Health Agency (ADHA), 6.45 million individuals currently have a My Health Record.
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Insurers gaining 'open-ended access' to medical records slammed as 'unfair privacy breach'

By national consumer affairs reporter Amy Bainbridge and the Specialist Reporting Team's Emily Clark
Julie Gilbert has no idea what her insurance company knows about her medical history.

Key points:

  • Australians who declare mental health treatments on insurance applications are often forced to grant access to their medical records
  • Legal advocates argue "open-ended" access is an "unfair breach of consumers' privacy"
  • They want to limit insurers' access to five years worth of records
When she applied for income protection and life insurance, Ms Gilbert declared she had received counselling for sexual abuse she said she suffered as a child.
For the application to proceed, she had to grant the insurer access to her records. Her GP and specialist were then obligated to hand over the records the insurer asked for, but she had no idea just how much information was passed along.
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Should companies pay to collect your data?

By Tony Featherstone
24 January 2019 — 12:01am
If data is the new boom asset for business, why do we give it away freely? And should companies pay us to collect, analyse and make money off our data?
Consider how much data you gave business over Christmas. Buying gifts provided a retailer with information on your shopping habits and location.
When you asked Apple’s Siri for gift ideas, you helped it become more intuitive and valuable. Same too with Google Maps when you used it for directions and let it track your phone. Or when you gave health information to Fitbit or other fitness devices.
Consider what’s ahead. Advancements in software that detects human emotions will enable our facial expressions and body language to become data for industry. Companies will use video algorithms to analyse our response to products, experiences and entertainment.
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My Health Record enshrines choice

24 January 2019 — Media release
A change in the law enabling people to delete permanently their My Health Record, should strengthen public trust in the system, the Consumers Health Forum says.
“This change will reassure those people who were concerned that their decision to opt out of MHR would not prevent their record being accessed by officials at some later time,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“The Australian Digital Health Agency says that from today (24 January), a function has been activated in the My Health Record system that allows a person to permanently delete their record at any time, including any backups and that all records previously cancelled will also be permanently deleted from the system.
“This step comes as Australians have just one more week to decide whether or not to opt out of MHR, one of the most significant developments in our health system for many years.
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You always have a choice with My Health Record

23 January, 2019 - 15:15 ADHA Sourced
Australians can choose to have or cancel a My Health Record at any point in their life.
New laws to strengthen the privacy and security protections within My Health Record mean that from tomorrow, a function has been activated in the My Health Record system that allows a person to permanently delete their record at any time, including any backups.
All records that have previously been cancelled will also be permanently deleted from the system.
If a person changes their mind, they can choose to register for a record to enjoy the benefits of controlling their health information securely in one place to support their health and care.
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22 January 2019

What will Apple be remembered for?

Technology
Posted by Jeremy Knibbs
If you ask yourself, what does Apple mean to you, you’re going to come up with something like, wasting half my life on social media, or, causing me to go on anti-anxiety medication because I’m constantly on edge about what’s coming on my phone.
In summary, Apple is the iPhone, which has radically changed all our lives for ever.
But according to Apple’s CEO Tim Cook, if we cast ourselves into the future, and ask the question again, we are apparently going to say: “healthcare.”
“If you zoom out into the future, and you look back, and you ask the question: ‘What was Apple’s greatest contribution to mankind?’, it will be about health,” he told reporters in the US this week.
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How clinical decision support systems can save lives

By Dr Rohin Rameswarapu*
Monday, 21 January, 2019
“Prescription: A physician’s guess at what will best prolong the situation with least harm to the patient.” — Ambrose Bierce
I still vividly remember that morning. It was 8:00 am and it was a crowded ward with a long hallway and smell of bleach in the air. I was a green hospital intern at that time and I was administering routine medications to patients.
Suddenly, I heard a strange noise from the corner of the long corridor of the medical ward. I immediately rushed there and saw that a boy aged about 12 was sweating profusely and almost losing consciousness. Beside him was my colleague with a syringe in his hand. He looked extremely nervous. Apparently, there had been an error in drug administration. Our immediate priority was to stabilise the young boy and take him out of harm’s way, which we were able to do successfully.
Investigation revealed that my colleague had correctly followed the consultant physician’s prescription by administering the right drug, right dose and right route. However, the drug had interacted with another administered drug, which led to the patient’s sudden deterioration. The doctor was given neither a prompt nor warning about the potential drug-drug interaction. There was no way to alert him to rethink the decision to administer the drug, except his own memory and judgement.
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Is the 10-year challenge a boon to Facebook's facial recognition tech?

By Jacey Fortin
22 January 2019 — 11:46am
The 10-year challenge was all fun and memes until last week after a tweet moved thousands of people to worry: are we unknowingly helping giant corporations to improve their algorithms for biometric identification and age progression?
The challenge gained widespread traction on social media this month. It calls for posting two photos of yourself side by side — one from today and one from a decade ago — to show how you've changed. People are participating mostly on Facebook and Instagram, which is owned by Facebook.
Some made jokes, paid tribute to old hairstyles or drew attention to issues like global warming. Celebrities posted glamour shots that showed negligible changes from one decade to the next. (Singer Mariah Carey won this round. "I don't get this 10 year challenge," she wrote in a tweet, along with two identical photos side by side. "Time is not something I acknowledge.")
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Discharge summary versus clinical handover: language matters

Authored by
Katrina McLean
Michael Rice
Nick Tellis
This article is part of a monthly series from members of the GPs Down Under (GPDU) Facebook group, a not-for-profit GP community-led group with over 6000 members, that is based on GP-led learning, peer support and GP advocacy. 
IN our earlier article we described the concept of “passing the baton” when talking about transfers of patient care. All patients come from their communities and to their communities they shall return. In this transition from tertiary hospital to primary care, they benefit from timely, safe, effective clinical handover as defined in the National Safety and Quality Health Service Standards.
In primary care, communication matters, perhaps more so than in tertiary care. Words matter. The language we use matters. It informs thought at conscious and subconscious levels and influences behaviour.
The words “discharge summary” evoke feelings of an administrative process at best, and various unsavoury processes at worst. The accidental discharge, the dishonourable discharge, and the smelly discharge all come to mind. The words “clinical handover” instantly sound more professional. They reflect the sort of interaction between clinicians of which we want to be part. Clinical handover is a term familiar to both clinicians and administrators. It is taught in medical schools around the country and practised between junior and senior doctors within our hospitals.
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Comments welcome!
David.

11 comments:

Trevor3130 said...

Not from a journalist, but an anonymous editorialist
There are evident, potentially life-saving benefits to doctors and surgeons having access to information in an emergency, for example.
"Life-saving" always glistens, but some good examples of how that could come about would be handy.

From Singaporean health minister apologizes for data leakage of 14,200 with HIV
He got the information from his partner Ler Teck Siang, who was head of the National Public Health Unit (NPHU) with the Ministry of Health from March 2012 to May 2013 and had access to the HIV Registry.

Trevor3130 said...

I'm smitten by Shoshana Zuboff's 'The Age of Surveillance Capitalism' (600pp) so I hope someone from behavioural economics/psychology can help. It's my conclusion, so far, that the commercial imperative is implicit in all massive collections of personal data; that it's inevitable some consideration has been given within ADHA as to how our personal information (that we ourselves have kept in separate folders, and/or hidden) can be "sold on" to providers so they can create demands for their products; that our own concepts of privacy have been well discounted by the business models of FAANG and that our own ignorance as to what we've already given away in online transactions has given the legal force to dismiss our quaint concerns; that the ability given in MyHR for users to obscure or block access to anything we choose is a loophole for data-miners to mooch around in the data that we do not so redact from view.

Anonymous said...

Tim Kelsey opened the doors for Google Deepmind at the NHS and look at how the NHS is unable to rein them in and control the agreement. Nothing Tim Kelsey has done here is any different than the implementation path that had care.data at it heart. It is clear to me the goal is not a life saving system built on standards and quality software (ADHA has demonstrated a clear disregard for both) but simply an erosion of law. Why? it is hard to fathom other than Tim would be little more than a pawn.

Trevor3130 said...

The current stream of propaganda - that medication errors will be prevented by MyHR - based on a very precise number (of something) needs a good look. Is the claim based on a theory of perfect knowledge of pharmacotherapeutics, or on the belief that all medication mishaps are collected, or both? I'd have thought that the increasing complexity of medication regimens together with increasing numbers and co-morbities (eg age) mean that unexpected outcomes will occur at a certain level, since our collective knowledge is not perfect. Secondly, it would serve well for public trust if full disclosures were made by tertiary-care institutions. For instance, are all instances of under-dosing and over-dosing recorded and audited?

Dr Ian Colclough said...

Trevor, the medication errors claim by the ADHA has received increasing prominence of late because all the other claims around the benefits of the My Health Record have fallen into a big black hole and proven too difficult for the ADHA to deliver.

As the message about medication misadventure and adverse events has taken hold the ADHA has found it expedient to adopt it as the highest profile justification for the MHR. Sadly, until they can define the problem they are trying to solve they will continue grasping at straws looking for claims to justify what it is they think they are trying to do.

Bernard Robertson-Dunn said...

The myhr is a) optional (in the sense that a patient can opt-out and/or hide documents) and b) not real time

Maybe that's why Victoria and Tasmania have their own Real Time Prescription Monitoring solutions:

https://www.painaustralia.org.au/media/newsletters/issue-73/real-time-monitoring-ahead

and the Federal Government is trying to build a national system.

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2017-hunt071.htm

RTPM seems to have no part to play in myhr except for ADHA's desperate attempts to protect its sunk costs and save face (and a few lucrative executive jobs).

In fact, having medication data all over the place will just confuse matters and increase costs, when doctors try to keep the data consistent.

Anonymous said...

@ 4:48 PM "In fact, having medication data all over the place will just confuse matters and increase costs, when doctors try to keep the data consistent."

By "all over the place" I assume you mean in the GPs record, the specialists record, the hospital's record, the pharmacy's record, the dentist's record, the RACF record and the PBS record (which doesn't record private scripts).

Perhaps this is an example chaos management by disruption with the intent of driving change.

Could we be witnessing the crest of a new wave of unanticipated adverse events and medication mishaps?

Anonymous said...

I wonder what Dr Kerry Phelps MP and her medical colleagues think about that!

Anonymous said...

Just news innovative ways criminals will take advantage of an over engineered mess. MyHR provides all the virtual patients to generate scripts for, and the electrol role will provide additional supporting information and the list goes on. Meanwhile honest people get stuck with red tape and excuses.

Anonymous said...

Could we be witnessing the crest of a new wave of unanticipated adverse events and medication mishaps? February 01, 2019 5:58 PM

Not possible? Everything is going just fine? It's only a few teething problems which always happens with big system roll-outs - cast your mind back to the QLD Payroll system, SA ePAS and Royal Adelaide Hospital, VIC HealthSmart.

A new wave of unanticipated adverse events simply won't happen - will they?

You decide.

https://www.brisbanetimes.com.au/national/queensland/queenslanders-health-at-risk-from-electronic-medical-record-software-clinicians-say-20190129-p50u8i.html

Queenslanders’ health at risk from electronic medical record software, clinicians say
By Lucy Stone 29 January 2019 — 9:54pm

AND

https://www.brisbanetimes.com.au/national/queensland/no-lessons-learned-from-payroll-disaster-queensland-health-was-warned-20190129-p50u8l.html

'No lessons learned' from payroll disaster, Queensland Health was warned
By Lucy Stone 30 January 2019 — 9:49pm

What did you decide?

Anonymous said...

@11.05 AM .... I decided that if doctors don't use the My Health Record then we probably won't see an increase in adverse events and medication mishaps in primary care, however, this won't stop them increasing in the hospitals. Of course, if Discharge Summaries are deficient or plain wrong, that will affect the GP.