Tuesday, June 11, 2019

Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety And Security Matters. Lots Of Interesting Perspectives - Week 47.

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: I have also broadened this section to try to cover all the privacy and security compromising and impacting announcements in the week – along with the myHR. It never seems to stop! Sadly social media platforms get a large run this week and most weeks. Sadly there is also the need to recognize pollie based risks to privacy!
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Healthcare Executives and Employees Are Hacker Targets – 5 steps to Protect Them

Tom Crampton

Cybersecurity Community of Practice Steering Committee Member
Cyber criminal activity continues to spread rapidly across Australian businesses of all sizes and in all industries. Healthcare is no exception, and frontline employees and ‘C-suite’ executives are increasingly the prime targets. While businesses may feel overwhelmed by the growing risk of cyber attacks and criminal activity, there are simple things that can be done now to manage the immediate risks.

Cyber crime rising – 61% of all data breaches are criminal

For the first three months of 2019, 131 or 61% of the breaches of personal or confidential information reported to the Office of the Australian Information Commissioner (OAIC) were criminal or malicious in nature. Other breaches were attributed to human error (35%) and systems faults (4%). A total of 215 breaches were reported.
The breached information included data about customers, stakeholders and other confidential business information. While the majority of data breaches involved smaller businesses and the exposure of the personal information of 100 individuals or fewer (68% of data breaches), one incident alone affected 10 million people!
Of the 131 criminal or malicious breaches, 87 were the result of cyber criminal activities including:
  • tricking employees into disclosing sensitive information or passwords (“phishing”);
  • electronic ‘break-ins’ (“hacking”);
  • introducing malicious software into a business to damage it or hold data to ransom (“malware” or “ransomware”);
  • automated guessing of customer or employee system logins (“brute force” attacks) and;
  • a number of incidents where the methods used by the criminals remain unknown.
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The e-health literacy demands of Australia’s My Health Record: a heuristic evaluation of usability

1 Oct 2017
Description
My Health Record is Australia’s electronic personal health record system, which was introduced in July 2012. As of August 2017, approximately 21 percent of Australia’s total population was registered to use My Health Record. Internationally, usability issues have been shown to negatively influence the uptake and use of electronic health record systems, and this scenario may particularly affect people who have low e-health literacy. It is likely that usability issues are negatively affecting the uptake and use of My Health Record in Australia.
The objective of this paper is to identify potential e-health literacy–related usability issues within My Health Record through a heuristic evaluation method. Between September 14 and October 12, 2016, three of the authors conducted a heuristic evaluation of the two consumer-facing components of My Health Record—the information website and the electronic health record itself. These two components were evaluated against two sets of heuristics— the Health Literacy Online checklist and the Monkman Heuristics. 
……
ICYMI!
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Seeking champions for My Health Record

5/06/2019

The Australian Digital Health Agency (ADHA) are looking to produce a suite of case study videos which demonstrate clear benefits of use.

The ADHA are looking for both consumers and healthcare providers who have experienced a real benefit from using My Health Record. The ADHA are particularly interested to show benefit for parents of young children, the elderly, teens, people with a complex health condition, and Aboriginal and Torres Strait Islander people.

Stories relating to every day benefits such as time savings, health information in one place, security and privacy, accessible anywhere anytime - are also sought after. Please email Robert.Corrigan@digitalhealth.gov.au by Friday 7 June 2019 if you are interested in this opportunity.
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Record number of sign ups to My Health Record in Australian pharmacies

5 June, 2019 - 9:45 ADHA Propaganda
Australian pharmacies have signed up to the My Heath Record system in record numbers over the past year, according to new data released today by the Australian Digital Health Agency.
In April 2018, prior to the beginning of the opt-out period, only 33% of pharmacies were registered with My Health Record, which climbed to 83% as at April 2019. Pharmacists are also uploading and viewing My Health Record more often, with a 667% increase in the number of dispense records uploaded to My Health Record and a 942% increase in the number of record views, comparing April 2018 to April 2019.
Jurisdiction
% registered to access My Health Record
April 2018
April 2019
New South Wales
34%
84%
Victoria
29%
82%
Queensland
39%
89%
South Australia
26%
93%
Western Australia
27%
74%
Tasmania
57%
97%
Australian Capital Territory
8%
76%
Northern Territory
58%
97%
When a pharmacy is connected to the My Health Record system, pharmacists can upload a patient’s medicines information to their My Health Record, each time the medicines are dispensed. Pharmacists can check to see whether that patient’s medications have changed recently, by viewing any hospital discharge summaries in the patient’s record. The real-time updates can help other pharmacists and healthcare providers gain visibility of what medications patients are taking, and help those providers make more informed decisions about those patients’ care.
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9 out of 10 general practices signed up to My Health Record

5 June, 2019 - 9:45 ADHA Propaganda
General practices are leading the charge in signing up to My Health Record, according to new data released by the Australian Digital Health Agency.
In April 2018, 82% of general practices were connected to My Health Record, which tipped over to 92% in April 2019. General practitioners are also viewing and using My Health Record more often. In the 12 months to April 2019, there was a:
  • 13% increase in the number of shared health summaries uploaded by GP organisations.
  • 52% increase in the number of prescription records uploaded by GP organisations.
  • 60% increase in the views of clinical documents by GP organisations.
Jurisdiction
% of general practices connected to My Health Record
April 2018
April 2019
New South Wales
82%
92%
Victoria
79%
87%
Queensland
91%
100%
South Australia
88%
95%
Western Australia
89%
98%
Tasmania
73%
77%
Australian Capital Territory
79%
85%
Northern Territory
74%
78%
“General practice has led the health system in being computerised. They have been of benefit in making the care of our patients better and easier in improving information access and automating simple processes like prescription writing,” says Adelaide-based general practitioner and Chair of the AMA Federal Ethics Committee, Dr Chris Moy.
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Recent data breaches - a timely reminder of how to communicate

Australia June 3 2019
Data breaches are on the rise; in frequency and impact. Latest statistics state that since January 2019, Australian entities have reported over 215 eligible data breaches, with one such breach affecting over 10 million individuals. Recent incidents have shown that when a data breach (which is likely to cause serious harm) occurs, it is important to notify affected individuals transparently and appropriately.
Canva data breach
Australian technology company Canva recently experienced a cyberattack that saw the usernames, emails and passwords of approximately 139 million users stolen when a hacker gained access to Canva's systems. Canva initially notified customers via email, however this notification has been criticised by several industry players.
The criticism revolves around the security incident notification content being subsumed within the broader marketing content of the email. By not giving sufficient emphasis to the security breach, it is argued that many customers would not have adequately read the email, and therefore would not have been properly notified of the data breach.
Canva has subsequently released a more succinct message across its website and social media channels disclosing the details of the breach more emphatically and continues to maintain an ongoing status update of the breach investigation as it unfolds.
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Where does your data go and who has control of it?

Wednesday 5 June 2019 9:06AM (view full episode)
Every day, as consumers move through the online and mobile world, they generate data, but researchers remain concerned that there are not enough safeguards about how that data is stored, interpreted and then sold on to others within the data economy.
How does the data we generate relate to new initiatives such as open banking, which will commence partial operations from July 1?
Life Matters talks to Lauren Solomon, CEO of the Consumer Policy Research Centre, and Dr Katharine Kemp, lecturer with the UNSW Faculty of Law, whose research focuses on open banking and data economics, and your rights as an online consumer.

Credits

Producer
Erica Vowles
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What government should have learnt from Apple before e-health failure

Ten per cent of Australians have opted out of the government's My Health Record, yet millions of people let Apple, Samsung and Fitbit track their daily habits.
Seamus Byrne
Jun 3, 2019 — 4.00pm
For public servants and healthcare professionals still scratching their heads about how they failed to convince Australians on the benefits of registering for the national electronic health record, the best advice would be to learn from the masters.
Tech giants have been convincing millions of people around the world to turn a blind eye to any niggling privacy doubts in favour of new products for years. And aren’t we supposed to trust our government more than corporations?
It’s been almost a decade since the first Fitbit hit the market, encouraging people everywhere to turn their daily routine into health data and improve their fitness one step at a time.
The ‘quantified self’ era was born, with millions around the world eager to turn daily statistics built upon their fitness regimen into an analysis of personal improvement.
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Message from the Vice-Chancellor

4 June 2019
Dear all, 
It is with profound regret I inform you we have been victims of a data breach that has affected personal data belonging to our community.  
In late 2018, a sophisticated operator accessed our systems illegally. We detected the breach two weeks ago.  
For the past two weeks, our staff have been working tirelessly to further strengthen our systems against secondary or opportunistic attacks. I'm now able to provide you with the details of what occurred.  
We believe there was unauthorised access to significant amounts of personal staff, student and visitor data extending back 19 years.  
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EY creates a cybersecurity fortress

  • 12:00AM June 4, 2019
Professional services firm Ernst & Young is looking to capitalise on the cybersecurity craze in corporate Australia, launching a cyber­security centre in Melbourne. It is the largest such facility in the Asia-Pacific, according to the firm’s global advisory leader, Kris Lovejoy.
The 233sq m facility in Melbourne is the latest addition to the EY footprint of cybersecurity centres across the globe, and Ms Lovejoy said the multi-million-dollar building would act as a key line of defence protecting businesses and governments in an increasingly threatening cybersecurity landscape.
She pointed to research showing that 77 per cent of organisations were still operating with only limited cybersecurity and ­resilience, while 87 per cent of ­organisations warned they did not yet have a sufficient budget to provide the levels of cybersecurity and resilience they wanted.
 “If you think about the ways in which cybersecurity has grown up over the years, it was very tools-­focused,” she said. “What happened over time was that organisations implemented lots of technologies to protect themselves, like firewalls and antivirus.
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Facebook ordered to turn over data privacy records

By Jonathan Stempel on Jun 3, 2019 12:57PM

After data for 87m users accessed by Cambridge Analytica.

A US judge ordered Facebook Inc to give shareholders emails and other records concerning how the social media company handles data privacy, after data for 87 million users was accessed by the British political consulting firm Cambridge Analytica.
In a 57-page decision on Thursday, which followed a one-day trial in March, Vice Chancellor Joseph Slights of the Delaware Chancery Court said shareholders demonstrated a "credible basis" to believe Facebook board members may have committed wrongdoing related to data privacy breaches.
Slights noted that Facebook had at the time of the 2015 Cambridge Analytica breach been subject to a US Federal Trade Commission consent decree that required it to bolster its data security measures. The breach was not revealed until March 2018.
"Evidence presented at trial provides a credible basis to infer the board and Facebook senior executives failed to oversee Facebook's compliance with the consent decree and its broader efforts to protect the private data of its users," Slights wrote.
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Take note, patients prefer their doctors 'au naturel'

Antony is a medical reporter with a special interest in technology and pharmacy.
3rd June 2019
Open Notes is a bit of a phenomenon in US digital health.
It began as an experiment involving 5500 patients and three GP clinics in 2010 and has now spread to 38 million patients attending 150 US healthcare organisations.
It’s not a bit of software. It’s a policy of getting GP clinics and hospitals to let patients see doctors’ clinical notes about them — unaltered, au naturel — via an online portal.
Despite starting with GPs, all specialties, even psychiatrists, are now getting involved.
Earlier this month, the largest study of Open Notes was published in the Journal of Medical Internet Research.
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AI assistant that takes your meeting minutes raises capital

Yolanda Redrup Reporter
Jun 3, 2019 — 10.00am
The co-founder of Aussie cyber security company Bugcrowd, Chris Raethke, has closed a seed funding round for his new venture, an artificial intelligence-enabled meeting assistant called Notiv that can transcribe a meeting as it happens and then pull out key insights.
Mr Raethke joined forces with voice technology veteran Dr Iain McCowan to create Notiv, with the pair raising $1.4 million from Steve Baxter’s Transition Level Investments, Full Circle VC and Black Sheep Capital.
It is the second start-up for both founders, with Dr McCowan having previously sold his microphone business Dev-Audio to US company Biamp Systems in 2014.
Speaking to The Australian Financial Review, Mr Raethke said the idea for Notiv came from his experiences at Bugcrowd, where he experimented with recording technology to make meetings more effective and efficient.
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Digital therapeutics: how do we bring order from chaos?

Authored by Shane Galgey Ruth Webster
THE era of technology is well and truly upon us, and the presence of digital therapeutics in the form of applications for mobile phones and tablets is ubiquitous. So why is there a lag in genuine disruptive change in health care?
A recent article reported that in the past 10 years, since smartphones have become widespread, the estimated number of available mobile health (mHealth) apps has exponentially increased to approximately 325 000, and this is on the rise. These apps range from symptom checkers, self-monitoring, remote monitoring, and adherence and rehabilitation facilitators, to management of clinical and financial records, and health care professional finders.
The potential ability of health apps (known as digital therapeutics) to increase awareness, improve prevention, aid diagnosis and assist in disease management is obvious. Yet, the medical community as a whole, although generally accepting of the use of apps as part of a broader clinical toolkit, are slow in their utilisation or recommendation to patients. Furthermore, a large proportion of the population don’t even download these apps, or when they do, there is a rapid decline in utilisation, with 30-day retention rates of 59% across all prescribed mHealth apps, according to the latest report from the IQVIA Institute for Human Data Sciences. So much so, that there is little evidence that many of them actually make a difference from a health perspective.
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Co-design and deliberative engagement: what works?

30 May 2019
This third Democracy 2025 report documents findings from a systematic review into what works in public participation.
Uniquely, the report integrates expertise from two distinct approaches to citizen engagement, co-design and deliberative engagement. Each approach offers different yet complementary insights into the variables that lead to effective citizen engagement, providing useful evidence that can inform public sector capability in this area. This report contributes to the growing body of evidence on effective citizen engagement by developing a conceptual model for assessing the quality and impacts of representation and nonrepresentation related variables.
The conceptual model draws on 33 case studies and 36 theoretical studies to identify six key variables that interact to influence outcomes in co-design and deliberative engagement.
 Publication Details
Issue:  Democracy 2025 Report no.3
Copyright: Democracy 2025 2019
Language: English
Published year only: 2019
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Blog: Digital Health — will human practitioners ever be replaced?


Digital health records, biotechnology and Artificial Intelligence is assisting practitioners to improve patient care, but with an increasing number of us self-diagnosing via the web, practitioners are cautioning against ‘app’ diagnosis.

Catherin Bennett ADHA Propaganda
Jun 1

The short answer is yes. Human health practitioners may be replaced, but only in certain cases.

Scary thought really. But did you ever consider even five years ago that we would be able to access millions, if not billions, of pieces of information that could provide a diagnosis for a health problem? Or an ‘app’ that tells us what to eat based on our blood and body type? We can search the web for answers to health questions, but how accurate can it be when it’s based on generalised information? Should we self-diagnose based on a key word search?
In years past we have relied on the informed, tried and tested knowledge of our local General Practitioner (GP) who knew our family’s health history from birth. Today, many of us turn to the internet first to self-diagnose and self-sooth, feeling better for knowing someone else out there has experienced the same problem. Or, feeling you’ve found the solution based on information that is ‘close enough’. But ultimately, this depersonalised land of information can land us in a place of confusion and potential miss-diagnosis. Once we hit this point, or don’t feel better, most of us turn to our local GP.
Self-diagnosis through the internet is forcing GP’s to plead with people to be informed by doing some research, but if they are experiencing concerning symptoms to seek out help from a qualified practitioner.
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Comments welcome!
David.

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