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, June 25, 2019

Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety And Security Matters. Lots Of Interesting Perspectives - Week 49.

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 also get a large run most weeks. There are a lot of actors out there trying all sorts of things on!
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Inside the police database that holds 40 million private records and any officer can access

23 June, 2019
An ABC investigation has exposed privacy breaches of the central police records database that holds files on millions of Australians.
The Computerised Operational Policing System (COPS) database holds more than 40 million records that can be accessed by NSW's 16,000 police officers.
Lawyers have warned the data breaches uncovered by the ABC show people's information stored in COPS is at risk.

Key points:

  • The COPS database keeps information on victims, offenders and incidents requiring police action
  • A police accountability lawyer says privacy breaches could have long-term ramifications
  • NSW Police say the COPS database follows national guidelines
Single mother-of-three Talia Odone from Cooma had separated from her boyfriend when she became aware he had received information held on a COPS file.
She suspected her ex-boyfriend's neighbour — a policeman — had some involvement in the matter.
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Can 'smart' ring give BlackRock fund managers the edge?

Virginia Furness
Jun 22, 2019 — 7.15am
London | After years of using the internet, satellites, algos and other innovations to mine 'Big Data' for that edge over rivals, the world's biggest investment firm is trialling a gizmo that puts the focus back on humans -- its own portfolio managers.
In an world where marginal gains can translate into millions of dollars of returns BlackRock, which manages $US6.5 trillion ($9.4 trillion) in assets, is betting that healthier, happier fund managers make smarter investment decisions -- and wearable smart technology can help optimise their performance.
Several fund managers from BlackRock's European equities team now wear smart-tech rings that collate data on their sleep patterns, heart rate and other health indicators, according to three sources at the firm who are familiar with the trial.
The large, black ring is made by Oura, an Finland-based company which describes the $US300 ring on its website as "a secret weapon for personal improvement".
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Google Chrome has become surveillance software. It's time to switch

Geoffrey A. Fowler
Jun 21, 2019 — 10.56pm
You open your browser to look at the web. Do you know who is looking back at you?
Over a recent week of web surfing, I peered under the hood of Google Chrome and found it brought along a few thousand friends. Shopping, news and even government sites quietly tagged my browser to let ad and data companies ride shotgun while I clicked around the web.
This was made possible by the web's biggest snoop of all: Google. Seen from the inside, its Chrome browser looks a lot like surveillance software.
Lately I've been investigating the secret life of my data, running experiments to see what technology really is up to under the cover of privacy policies that nobody reads. It turns out, having the world's biggest advertising company make the most-popular web browser was about as smart as letting kids run a candy shop.
It made me decide to ditch Chrome for a new version of nonprofit Mozilla's Firefox, which has default privacy protections. Switching involved less inconvenience than you might imagine.
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Privacy obligations post-opt out for My Health Record

Hosted by Australian Digital Health Agency

Do you work within a GP clinic, Community Pharmacy, Public or Private Hospital? Is your organisation registered for My Health Record? If you have answered ‘yes’ to either of these questions this webinar will be a must attend.

This interactive webinar will inform healthcare providers of their privacy obligations when interacting with the My Health Record. Learning outcomes of this webinar include:
  • Governing access to My Health Record system and how this applies to your organisation
  • Ensuring appropriate policies are in place to adhere to legalisation requirements
  • Complying with consumer wishes in regard to accessing and uploading information
Please note, this webinar is a live repeat of the webinar previously held in April 2019.

Webinar - 'Privacy obligations post-opt out for My Health Record - Healthcare organisations' Details: 
Please note, registrations close 24hrs prior to each webinar event. Presentation slides will be made available following the event to individuals who have registered to attend the webinar.
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Inquest into the death of Melissa King

Australia June 20 2019
On 14 June 2019, the Coroner's Court of New South Wales released its findings into the death of Melissa King. The circumstances of her death highlight the risks associated with the use of electronic progress notes as a means of communicating concerns about the treatment decisions made in respect of patients.
Background
Ms King was 33 years old at the time of her death at Blacktown Hospital. On Wednesday 10 August 2016, she had called the National Home Doctor Service on account of having vomiting and diarrhoea for two to three days. The service referred her to Mount Druitt Hospital from which she was transferred to Blacktown Hospital. She had a history of chronic alcohol use and malnutrition, weighing 40kg upon her admission to hospital.
At Blacktown Hospital, she was treated with fluid and electrolyte replacement and was admitted to the ICU. She was ultimately diagnosed with urinary tract sepsis, severe malnutrition with electrolyte metabolic derangements, notable low sodium and a number of other micronutrients, deranged liver function and ascites, pulmonary effusions and obstructive renal calculus diagnosed by CT. Further investigations into the cause of her symptoms were arranged. A CT scan showed bowel wall thickening which suggested inflammatory bowel disease.
In replenishing her depleted micronutrients, one consideration for her treating team was the risk of ‘re-feeding syndrome' whereby a malnourished person who starts receiving artificial refeeding is at risk of a potentially fatal shift in fluids and electrolytes. That risk was identified in the records. There was fluctuation in her response to refeeding and also in relation to her overall condition. She had periods of lucidity, deterioration, confusion and agitation. On 15 August she began complaining of ongoing abdominal discomfort. An endocrinology registrar noted that her abdomen was distended and bowel sounds were difficult to hear.
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Facebook posts can predict who has diabetes

The social media platform is often better than demographic data at spotting illness: study
20th June 2019
Trawling through Facebook posts could help identify which patients have diabetes, with US research showing the language used in posts can predict 21 medical conditions.
In fact, Facebook is better than demographic data (age, sex and race) at predicting 10 of the conditions, researchers from Penn Medicine at the University of Pennsylvania have found.
They report in PLOS One that the social media platform used by more two billion people is superior for flagging diabetes, with common red-flag words including “god”, “pray” and “family”.
 Facebook is also a better bet for spotting pregnancy (females only), anxiety, depression and psychoses.
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Relationships with robots: Social AI surpasses humans in healthcare

20th June 2019
What use are social robots in healthcare? Do they have a therapeutic benefit? Do patients liken them to their humanoid counterparts?
Australian researchers have attempted to answer some of these questions with a systematic review of randomised controlled trials (RCTs).
For the uninitiated, if a robot provides social interventions, such as education, it’s a social robot.
As the researchers point out, social robots are new phenomena, meaning mostly experimental studies so far. But they did find 27 RCTs.
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After my miscarriage, 'big data' kept haunting me

By Bridget de Maine
June 19, 2019 — 12.00am
When I fell pregnant, it wasn't long before every corner of the digital landscape was celebrating my news. A few Google searches for local obstetricians on my morning commute soon yielded a near barrage of advertising dressed as advice to my palm. "Have you thought about dressing your newborn in a linen bonnet?", suggested Instagram. You’ll need bigger clothes. This maternity brand is having a sale! nudged Google.
I eventually allowed the heavy-handed hints to lead me to a baby-tracking app and entered my due date.
Not long after the confirmation during a holiday with my husband, I started to bleed. With a tentative, “It looks like that’s what’s happening” from a local doctor sporting a comfy sweater and a face of pity, we went home and I began to contemplate what it all meant.
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Spying on our own citizens' data: why Australia must tread carefully

By Ian McKenzie
June 20, 2019 — 12.00am
Two distinct proposals are under examination for a significant expansion of the role of the Australian Signals Directorate, the agency that until now has been focused on foreign signals intelligence, support to military operations, cyber warfare and information security. One of these proposals presents its challenges, but deserves consideration. The other is particularly serious and without precedent. It would involve the secret disruption, on our home soil, of the computers and data of Australians who are yet to be convicted of a crime.
The first proposal is for the ASD to work inside Australian critical infrastructure companies to help them defend against cyber attack that could do untold harm to our economic wellbeing, and even pose a national security risk.
The second is to use the ASD offensive cyber disruption capabilities in Australia against hardened criminal networks, including paedophiles and organised crime.
The first is a logical extension of ASD’s core business of information security – traditionally only for government, but increasingly necessary for our major businesses, especially critical infrastructure. It is, however, not without some risk.
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Winning at smarter healthcare with Track and Monitor

Business and Enterprise
Posted on June 19, 2019

We’re on a mission to make life better for every Australian through amazing technology and connectivity. That’s why we’re proud of our indoor equipment tracking proof of concept using Track and Monitor, which has just won the 2019 IoT Festival Award for best healthcare project.

Ballarat Health Services and Coregas, a division of the Wesfarmers Group, encountered a complex problem that we thought we could offer some valuable expertise to: how do you stop vital healthcare equipment from going missing? Together with our partners, we worked to ensure that valuable and specialised equipment was never out of reach, so that caregivers could spend more time doing exactly that: giving care.
Any hospital is a big place, where gear is constantly moved around to support the care and healing of different patients. Knowing where that equipment is – such as wheelchairs and bariatric care beds – is vital to not only providing care, but it’s also incredibly important from an accounting perspective. If a hospital can’t provide a clear chain of custody for this crucial equipment, it may need to be replaced before its serviceable life is over – especially if it is lost altogether!
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Health at the centre: responsible data sharing in the digital society

6 Jun 2019
The digitisation of health data creates opportunities for more personalised healthcare and prevention. When combined, different digital services make it possible to access, share and use electronic health data, including outside the healthcare domain. The public and political discussion no longer centres on the mere digitisation of patient records. A further aim is to activate people to work on improving their health using their own data. The expectation is that by controlling their data, people will be able to take charge of their healthcare.
At the same time, it remains to be seen whether this will lead to better healthcare advice, whether people will actually manage their health better, and whether it is even desirable for them to control more of their data. This report shows that responsible and secure data sharing is best achieved by remaining small in scale and by focusing on what is truly necessary. It gives government, the healthcare sector and policymakers the tools they need to ensure that digital health data services are used for the benefit of a ‘socially responsible digital society’. The quality of the data and of good and appropriate healthcare are at the centre here, with people being protected against the unwanted use of their data.
The report describes the outcomes of the investigation into four significant services that are emerging in parallel and that allow individuals to access, share and use health data, i.e. online portals run by healthcare institutions (which offer patients a ‘view’ into their own medical records and supporting digital programmes), health apps (‘digital coaches’), personal health environments (PHEs, a personal data vault Health at the centre 15 in which people can store and manage all their health data digitally from a single comprehensive overview), and public platforms (collective online databases, where people can share stories and health data with others). 
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Data61 wants to 'vaccinate' machine learning algorithms against attacks

By Matt Johnston on Jun 20, 2019 7:17AM

Recognising and fending off attacks.

The Commonwealth Scientific and Industrial Research Organisation’s Data61 has developed a set of techniques to protect machine learning algorithms from attacks, similar to how vaccines work in living creatures.
Machine learning techniques, now in common use across most industries and easily visible even in Google suggestions, gather vast amounts of data over time to work out which qualities meet the criteria of algorithms and which can be dismissed.
Data61’s machine learning group leader, Dr Richard Nock, said that by adding a layer of noise (ie, an ‘adversary’) over an image, attackers could deceive machine learning models into misclassifying the image.
“Adversarial attacks have proven capable of tricking a machine learning model into incorrectly labelling a traffic stop sigh as a sped sign, which could have disastrous effects in the real world,” Nock said.
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The International Encryption Debate: Privacy Versus Big Brother

Many governments, including the United States, are attempting to restrict the use of encryption services like WhatsApp and Snapchat to allow for a greater opportunity for surveillance. Although increased reliance on technology such as emails and texts has provided greater opportunity to gather evidence of criminal activity, in part because many communications are now memorialized forever, law enforcement agencies around the world complain that encryption technologies make it difficult to catch criminals and terrorists and therefore should be restricted.
Turning the traditional concept of privacy on its head, governments appear to be positing that the totality of every individual’s digital communications should be left open for scrutiny by government investigators in case some come to be suspected of wrongdoing at a later time. Not surprisingly, this Big-Brotheris-watching approach has met with resistance from public rights and civil liberty activists.
Before the technology explosion, two individuals desiring a private conversation might have opted for a phone call, secure in the expectation that the information shared during the call was not subject to eternal preservation. Indeed, such privacy generally is perceived as a human right. A detailed and extensive body of wiretap statutes and case law in the United States, arising from Fourth Amendment protections against unreasonable searches, insures that telephone conversations remain private absent evidence of probable cause that the subject individuals are actively involved in criminal mischief and issuance of a warrant by a court. The shift from oral conversation to digital communications should not change these fundamental privacy protections and assumptions.
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Are we in danger of missing the medical AI on ramp?

  June 18, 2019    

One of our iconic medical AI experts warns that AI is finally impacting the frontline of medicine seriously, with all its potential for good and bad outcomes but it’s such a hyped topic, Australia might end up organising for it too late to take proper advantage of this long coming revolution.

 “We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run” – Amara’s Law
Artificial Intelligence (AI) has a PR problem in Australia. It’s been coming so long, with such hype and promise, and failed to deliver so spectacularly so much – IBM Watson and cancer diagnosis, as our most recent example – that many in the sector aren’t really sure what is going on.
Last week, one of our most recognised experts in the field of medical AI, Professor Enrico Coiera, The Director of the Australian Institute of Health Informatics, made the situation clear. AI is here already, going very big overseas already, and unless we organised ourselves faster for the change, we could miss out on significant opportunities locally, or worse, end up with AI medical failures through poor governance and education.
He told Wild Health that Australia would never likely  be a hub for serious medical AI development, given the money behind and the march of the major global digital distribution platforms like Google, Apple and Amazon, but the Australian healthcare eco system was an ideal testing ground for major overseas investors and this was a way in for Australia in the medical AI revolution. Australia benefits hugely from significant involvement in the global clinical drug trials market.
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Cybercriminals set their sights on identity information

By Eve Maler, Vice President of Innovation and Emerging Technology, ForgeRock
Identity information remains the holy grail of cybercriminals. Australian organisations across a wide range of industries – including healthcare, government, and financial services – store and manage billions of consumer data records. As such, they are finding themselves under a constant barrage of cyberattacks. Even though investments in information security products and services have been on the rise, with $165 billion invested in 2018, it has done little to deter the persistent activity of cybercriminals.
In a move to increase awareness and accountability around information security practices, the Office of the Australian Information Commissioner (OAIC) made amendments to the Privacy Act which came into effect in February 2018. The legislation requires Australian businesses to disclose any breach that involves personal customer data. Known as the Notifiable Data Breaches (NDB) scheme, it regulates the reporting and notification of eligible data breaches to the OAIC and impacted individuals.
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The sick man of the cyber-security sphere…it’s time the Australian healthcare industry took a preventative approach to high tech ‘contagion’

by Priyanka Roy, Marketing Analyst at ManageEngine
Which industry is Australia’s worst offender when it comes to data breaches and cyber-security threats?
If you answered healthcare then congratulations, you’re on the money.
Health service providers were responsible for 58 of the 215 notifiable data breaches reported in the first quarter of 2019 according to the Office of the Australian Information Commissioner (OIAC), Australia’s privacy watchdog.
It was a similar story in the December 2018 quarter (54 of 262 documented breaches) and in the  September 2018 quarter (45 of 245 documented breaches).
They’re concerning statistics, particularly when considered against the backdrop of public concern about patient privacy generated by the national roll-out of Australia’s controversial electronic health record My Health Record in 2018.
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Engineer's 'smart speaker firewall' guards against Alexa eavesdropping

June 17, 2019 — 10.55pm
Chuck Carey is an experienced engineer and self-described technophile, but he's also wary of the proliferation of data-hoovering, internet-connected devices such as the microphone/speaker combos used with digital assistants such as Amazon Alexa and Google Assistant.
"While I have three Echo Dots, I have always been suspicious of what gets collected by them," says Carey, of Kirkland, Washington. "So I tried to solve that problem: how to keep Jeff's minions out of my private stuff."
Last month Carey posted to GitHub his prototype design for a 'smart speaker firewall'.
It is a box with a lid. Clap or snap twice – as with one of the original smart home products, the Clapper – and the lid pops open, allowing the device to be used as normal. Clap twice more and it closes and turns on a noise designed to prevent the device's sensitive microphones from detecting anything outside the box.
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Pharmacist Shared Medicines List

There’s a new way for you and your healthcare providers to securely access a list of medicines you take uploaded by your pharmacist. 

What is the Pharmacist Shared Medicines List? 

Soon your pharmacist will have the software to connect to and be able to upload a document called the Pharmacist Shared Medicines List to your My Health Record.
The Pharmacist Shared Medicines List is a list of medicines that may include those prescribed by your doctor, non-prescription medicines including over-the-counter or complementary medicines (such as vitamins or herbal medicines) you may take. This list will include details on how and when you take your medicines at the time the list was created. 
If your pharmacist has uploaded a Pharmacist Shared Medicines List, you can find it in the ‘Documents’ section in your My Health Record.

What is the difference between the Pharmacist Shared Medicines List and the Medicines Information view?

If you have a Pharmacist Shared Medicines List in your My Health Record, your healthcare providers will be able to quickly access your most up-to-date information. 
This document can only be added to your My Health Record by your pharmacist. 
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17 June 2019

We need a rethink on ‘health on credit’ plans

Posted by Grant Holloway
The news that Queensland-based pharmacy chain TerryWhite Chemmart stores are trialling a credit platform which would allow customers to purchase prescription drugs and pay for them via instalments, raises some disturbing questions.
The Afterpay digital service at pharmacies is being promoted as positive for customers, allowing them to spread out the cost of their prescriptions over four “interest free” fortnightly payments.
The trial is being run in five pharmacy locations in Queensland with a view to gathering feedback from both customers and pharmacists about the product, and assessing the potential expansion of the service to other pharmacies, according to a report in Pharmacy Daily.
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Friday, 14 June 2019 12:01

Rights body calls for govt to put people, not cost savings, first

The Federal Government is putting cost savings first and people second through its increasing use of technology and algorithms to control the lives of Australians who are in need and seeking income support, the Human Rights Law Centre says.
Tech developments should not be at the cost of human rights, the HRLC said in a submission to the UN Special Rapporteur on poverty.
Monique Hurley, a Lawyer at the Centre, said computer-automated penalties and robo-debt were causing distress and risked driving struggling families deeper into poverty.
“Computers making decisions about peoples’ livelihoods can be the difference between a child having food or going hungry,” said Hurley.
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Comments more than welcome!
David.

6 comments:

Bernard Robertson-Dunn said...

Another release of obfuscated statistics, this time dated 26 May
https://www.myhealthrecord.gov.au/sites/default/files/my_health_record_dashboard_-_26_may_2019.pdf?v=1561352401

Try as they might to fudge the data, some useful information can be estimated, even from data that has been rounded to 2 significant figures.

Just looking at four data points, first the dates
28-Apr-19 26-May-19 (= 28 Days)

and the number of SHS uploads.
2,600,000 2,700,000

The numbers have been rounded but we know that the unrounded numbers lie between about
2,555,000 2,745,000
and
2,645,000 2,655,000

This means that the absolute maximum number of SHS that have been uploaded in the 28 days is between 10,000 and 190,000

The daily rate of uploads therefore lies between about 350 and 6700

This is revealing because the daily rate of SHS upload in the last few months of 1018 bounced around between about 2,000 and 3,000. In October it was twice over 3,100

The most likely current rate could be 3,400 (half way between 350 and 6,700)

Another estimate is that it is unlikely to be below say 2,500 therefore a better estimate is 2,500 + (6,700-2,500)/2 which is 4,600

The number of people who have been registered for a myhr has gone up from about 6.4 million to 22.3 million, an increase by a factor of about 3.3

16 million extra people have been registered and hardly any have a SHS.

Not exactly a spectacular outcome.

No doubt the cry will be "Give it time". Unfortunately the data in a SHS ages rapidly.

Even if the daily rate of SHS uploads goes to 20,000 (which is greater than the order of magnitude that was achieved before opt-out), that means about 7 million will be uploaded in a year.

Out of the 22.5 million Australians registered only about 31% will have a SHS less than one year old.

And including the 10% who opted out, that drops to 29%

The government will probably make its usual claim that 90% of Australians have an on-line summary of their health data.

The reality is that fewer than 30% will ever have a SHS that might be of some use.

The other 70% will be either empty of a summary or suspect.

And without a current summary all those other documents and prescription data are worse than useless.

Anonymous said...

Thanks Bernard, look forward to seeing the next set of numbers. We will know if the trend is pointing to low use if

- the rounding remains the same number as this month
- they don't publish

Anonymous said...

This page may be a better source?

https://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Digital_Health

Bernard Robertson-Dunn said...

Thank you, a much better source. I was not aware of it.

There is exact data for SHS uploads for every month in 2018.

Here is a graph of daily uploads.

http://www.drbrd.com/docs/myhr/PHN_SHS_2018.JPG

Considering the publicity given to myhr during the second half of 2018, one might have expected a bit of an increase.

Anonymous said...

June 26, 2019 1:52 PM. Thanks for sharing this is useful data. This does highlight that it is a rotten apple in the health department barrel that is presenting an image of secrecy and misinformation. How so much reputation damage can be done by so few.

Anonymous said...

I wonder why the data is over 3 months old. We are nearly at the end of June and they've only published the data up to February.

About as transparent as a brick wall.