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This weekly blog is to explore the larger issues around Digital Health, data security, data privacy and related matters.
I will also try to highlight ADHA Propaganda when I come upon it.
Just so we keep count, the latest Notes from the ADHA Board are dated 6 December, 2018! Secrecy unconstrained! This is really the behavior of a federal public agency gone rogue – and it just goes on! When you read this is will be 11 months + of radio silence. I wonder how far the ANAO report is away?
Note: Appearance here is not to suggest I see any credibility or value in what follows. I will leave it to the reader to decide what is worthwhile and what is not! The point is to let people know what is being said / published that I have come upon.
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Data roles help keep our medical system healthy
By Sue White
November 16, 2019 — 12.00am
Like many of his peers, Cheens Lee, stumbled upon his career in health information management.
When he got there he realised he’d found a way to make an important contribution to the health system without touching patients.
“In a hospital setting we tend to be the people in the middle that translate information between clinicians and [the] IT teams. We are pivotal in health system implementation as we understand both sides of the equation,” says Lee, president of the Health Information Management Association of Australia.
Cheens Lee says health information managers have an important role to play as the “custodians” of health data within hospitals.
Given the noise around the Australian government’s My Health Record project, it’s no surprise many believe paper records are already almost non-existent.
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Apple wants to know about your menstrual cycle
Natasha Singer
Nov 15, 2019 — 11.27am
New York | Harvard School of Public Health has announced a women's health study that aims to enroll one million women over a decade using Apple's iPhones, apps and money.
Michelle Williams, dean of Harvard's T.H. Chan School of Public Health, said she hoped the new study of women, called the Apple Women's Health Study, would enable researchers to learn much more about how women's bodies and reproductive health change over time.
Through surveys, she said, women participating in the study may choose to provide qualitative information about their menstrual cycles, pregnancies, menopause and other health issues. Through the study's app, they may also choose to automatically share fitness, heart rate and other quantitative data gathered by their iPhones or Apple Watches.
"I'm most excited about the fact that we'll be able to collect women's menstrual cycle information in ways that we've not really done before," Williams said.
"Having this data on a large modern cohort is so relevant to clinical women's health today because a lot of the decision-making and diagnostic protocols that we're currently using are from data from 50 years ago, when the social environment was different."
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Vale Joan Edgecumbe
Nov 11, 2019 | HISA news, Membership
Joan Edgecumbe was one of HISA’s founding members and over HISA’s 25-year history she occupied the role of Executive Officer, committee member and Board member, until her retirement in 2011.
She worked at The Royal Women’s Hospital Melbourne for over 40 years, and until her retirement in 2015, she was part of the eHealth Education team.
Joan’s outstanding contribution to Australia’s digital health community through her knowledge, and drive for health informatics was documented in this brief history developed to celebrate HISA’s 25th anniversary in 2018.
On the announcement of Joan’s passing HISA’s inbox was flooded with messages of condolence and reflections on people’s memories of Joan. The messages have been so touching that we thought they deserved to be read by many. So we encourage you to submit any thoughts on this page. We will make sure they are passed on to Joan’s family.
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Now the DTA wants its digital ID used for porn age verification
It would require for the program to be extended to the private sector.
By Asha Barbaschow | November 14, 2019 -- 01:17 GMT (12:17 AEDT) | Topic: Security
The Digital Transformation Agency (DTA) believes the Australian government's digital identity play would be a valuable tool in verifying an individual's age before allowing them access to online pornographic material.
In a submission to the House of Representatives Standing Committee on Social Policy and Legal Affairs' inquiry, launched in September, the DTA said its program could be used to reduce technological barriers in achieving stronger age verification requirements by providing a "convenient alternative for users to verify their age".
"Digital Identity does not involve a unique identifier, nor does it allow tracking of online activities. Instead, it provides a means for a person to authenticate their identity online," the DTA wrote in its submission [PDF].
The agency said its Trusted Digital Identity Framework (TDIF) and other governance frameworks would extend to any online wagering and online pornography sites which seek to verify age through the Digital Identity system.
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AI roadmap pitches $315b industry
AI will create thousands of new jobs every year, help us live longer and improve our quality of life, according to a national road map to be released by the government today.
Nov 15, 2019 — 12.00am
Key Points
- Economy Digital technologies, including AI, could be worth $315b to the Australian economy by 2028.
- Jobs Australian industry will need up to 161,000 new specialist AI workers by 2030, with 20,000 additional workers per year until 2023.
- Agriculture Agricultural robot called Agbot II, developed by QUT, is tipped to save farming sector $1.3b per year by automating weed removal and improving agricultural productivity.
- Safety AI systems could help reduce the 1137 deaths and 57,000 injuries every year on Australian roads.
Artificial intelligence will improve productivity, give Australia the opportunity to establish new world-leading companies and create thousands of new jobs every year, according to a national road map to be released by the government today.
The 60-page report has been compiled since an initial discussion paper was released in April by CSIRO division Data61 and will be unveiled by Minister for Industry, Science and Technology Karen Andrews ahead of a summit to discuss strategies for developing a national AI research and business ecosystem in Canberra.
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If Dr Google’s making you sick with worry, there’s help
November 14, 2019 11.26am AEDT
Authors
Associate Professor and MRFF/NHMRC Career Development Fellow, UNSW
Lecturer in Psychology, Department of Neuroscience, Psychology and Behaviour, University of Leicester
It’s a busy day at the office and your left eye has been twitching uncontrollably. So, out of curiosity and irritation you Google it.
Various benign causes — stress, exhaustion, too much caffeine — put your mind at ease initially. But you don’t stop there. Soon, you find out eye twitches could be a symptom of something more sinister, causing you to panic.
You ruin the rest of the day trawling through web pages and forums, reading frightening stories convincing you you’re seriously ill.
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Josh Frydenberg says federation a 'handbrake' on Australia's productivity
Treasurer says Australians should be ‘under no illusions about the inefficiencies that exist in our federation’
Thu 14 Nov 2019 04.00 AEDT Last modified on Thu 14 Nov 2019 04.01 AEDT
Josh Frydenberg says state and territory treasurers have agreed to draw up potential productivity enhancing reforms in transport, health, skills and environmental regulation. Photograph: Mike Bowers/The Guardian
Federation reform could be the secret to improving productivity in Australia and avoiding blurred responsibility in fields such as health, the treasurer, Josh Frydenberg, has suggested.
In a speech to be delivered at the University of Adelaide on Thursday, Frydenberg reveals that state and territory treasurers have agreed to draw up potential productivity enhancing reforms in policy areas including transport, health, skills and environmental regulation.
Note: He cites #MyHealthRecord as a productivity tool!
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Eight things the government knows but won't tell you
By Nick Bonyhady
November 13, 2019 — 11.24pm
Surgery conducted on the wrong body part, elderly Australians assaulted in their aged care homes and high-rise buildings wrapped in cladding that is ready to burn.
Each of these things has happened - and the government knows where, when, and how each occurred - but the details remain secret.
For every piece of data the government won't reveal, there is more information that is technically available but so difficult to access it is out of reach for most Australians.
That leaves people in the dark when they're making some of the most important decisions of their lives like picking an aged care facility or choosing medical treatment.
And for every piece of data the government won't reveal, there is more information that is technically available but so difficult to access it is out of reach for most Australians.
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ACCC joins Forrest in criticising Facebook’s fake ads
Australian Competition & Consumer Commission boss Rod Sims has thrown his support behind miner Andrew Forrest’s push for Facebook to take more action over fraudulent advertising on its platforms.
Mr Sims said the ACCC would investigate both the potential legal exposure of Facebook as a result of it posting fraudulent advertisements, and whether hosting such ads on its platforms should be made illegal.
Mr Sims said he shared Mr Forrest’s concerns about Facebook’s efforts to stamp out the advertising, which has been used by scammers to lure victims.
“At its heart, there’s a question of responsibility here,” Mr Sims said. “To have a position of basically no responsibility for what’s on the platform is of great concern and is fundamentally unsustainable.”
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Legal and ethical issues with the use of AI in health & aged care
The development and use of artificial intelligence in health, aged care and biotechnology is creating opportunities and benefits for health care providers and consumers. Already AI is being used in medical fields such as diagnostics, e-health and evidenced based medicine, although there would appear to be some way to go with the reliability of using AI interrogation of free text data fields in medical records. Deciphering doctor’s hand-written notes is an issue.
Hall & Wilcox has been working with international and Australian clients at the cutting edge of innovation who are using AI to detect falls in hospitals and residential aged care facilities, to determine pain using face recognition software and who are using AI in predictive medicine.
A number of legal, regulatory, ethical and social issues have arisen with the use of AI in the health care sector. The issues is: Can the law keep up with the pace?
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'Computer says no': Artificial intelligence proving sexist to the core
By Harry de Quetteville
November 13, 2019 — 10.24am
It was the sketch show Little Britain that popularised the phrase "computer says no". The line struck a chord with millions who had experienced utter impotence as faceless, unexplainable calculations affected crucial aspects of their lives, such as banking or shopping.
Some 15 years later those sketches seem more prophesy than comedy.
"Computer says no": There may be no real-life receptionist Carol Beer, but Little Britain's sketches seem to have become reality.
For today, computers are deputised to make more and more critical decisions about what we can and can't do, what we are and are not entitled to. They are trusted to analyse ever greater reams of data and to draw conclusions about the future: about whether criminals will reoffend; whether job applicants will become good workers; or, in the case of Jamie Heinemeier Hansson, what the credit limit for her Apple Card should be.
Not very much, was the answer. Or at least, nothing like as much as her husband, the entrepreneur David Heinemeier Hansson, despite the fact that they share their assets.
He grew so frustrated with the fact that he was allowed to spend 20 times as much on his card that he posted an expletive-laced series of Tweets describing Apple Card as "such a ------- sexist program".
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Merkel urges EU to seize control of data from US tech titans
Guy Chazan
Nov 13, 2019 — 11.30am
Berlin | Angela Merkel has urged Europe to seize control of its data from Silicon Valley tech giants, in an intervention that highlights the EU’s growing willingness to challenge the US dominance of the digital economy.
The German chancellor said the EU should claim “digital sovereignty” by developing its own platform to manage data and reduce its reliance on the US-based cloud services run by Amazon, Microsoft and Google.
“So many companies have just outsourced all their data to US companies,” Ms Merkel told German business leaders.
“I’m not saying that’s bad in and of itself — I just mean that the value-added products that come out of that, with the help of artificial intelligence, will create dependencies that I’m not sure are a good thing.”
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My Health Record Opt Out Switch Led to Surge in Privacy Complaints, 35 Data Breach Notifications
Switching Australia’s ehealth system, known as My Health Record, to an opt out model led to a surge in privacy complaints, the privacy watchdog revealed in its annual report on digital health.
The Office of the Australian Information Commissioner says it has now received over 60 privacy complaints and 35 data breach notifications regarding the My Health Record system, which has been operational since January. It also received 145 inquiries about the controversial ehealth system.
My Health Record switched to an opt out model in January meaning any Australian Medicare holder who did not explicitly opt out of the system had a digital record created for them which could be shared with medical professionals. The system is managed by the government agency, Australian Digital Health Agency (ADHA).
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Digital nation: how Australia became a digital health pioneer
Rachel de Sain is one of the women behind Australia’s groundbreaking digital health strategy, which resulted in a 90% uptake of electronic medical records across the country. Here she shares her story and the insights she learned along the way.
The use of the internet and modern technology such as, smartphones, apps, cloud storage, and extensive data analytics has vastly changed the way that humans interact with one another. With the advent of these technologies, and the many benefits they bring, it is of little surprise that governments worldwide are looking to leverage new digital tools to improve the delivery of healthcare.
Australia is one such country that has vastly increased its uptake of digital healthcare. For example, its national patient health record, called ‘My Health Record’, is a consolidated digital summary of Australian residents’ medical information and has more than a 90% participation rate – the highest participation rate in a novel national health record system in the world.
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Aussies relaxed about big data
Australians have mixed feelings about the pervasive presence of technology in their lives, with the Governance Institute of Australia’s 2019 Ethics Index highlighting a surprising level of acceptance with the use of big data to target consumers and Artificial Intelligence (AI)-based traffic management and public surveillance programs.
Governance Institute of Australia chief executive Megan Motto said the index (which surveys more than 1,000 people with various political and socio-economic backgrounds about their perceptions of ethical issues and conduct) shows the public still grappling with the pros and cons of the technology trends starting to dominate their lives.
“We are definitely seeing a mixed response when it comes to the ethics of technology,” she told The Australian.
According to Ms Motto, consumers are more open to the use of technology when it’s applied to solve existing problems.
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Google’s data haul sparks call to reform privacy act
Google's harvesting of Australians' location data represents the tip of the iceberg according to the Consumer Policy Research Centre (CPRC) chief executive Lauren Solomon, who is calling for urgent reform of the Privacy Act to better protect consumers against the murky and vague data practices of the tech giants.
Ms Solomon is hosting a Melbourne data conference, dubbed Data (R)Evolution, later this month alongside ACCC chair Rod Sims and eSafety Commissioner Julie Inman Grant, an event she hopes will shift the needle on consumer protections.
She is calling for the introduction of a Consumer Data Right, which will aim to empower more Australian consumers with control over their data.
"We need to raise awareness of these issues," Ms Solomon said. "We need to bring in different communities and get a shared understanding. These issues are multidimensional and require collective input from a lot of different people.
"From our perspective we need swift privacy reform as a matter of urgency."
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Smethurst's High Court challenge a 'high stakes' test for press freedom
By Fergus Hunter
November 12, 2019 — 12.55am
News Corp journalist Annika Smethurst's High Court challenge against secrecy laws looms as a significant and unprecedented test of the constitution's protections for democratic freedoms, according to constitutional law experts.
The first hearings in Smethurst's case will take place in Canberra on Tuesday and Wednesday, five months after the journalist's home was raided by police as part of a leak investigation. Smethurst's lawyers are challenging the criminal law used to justify the search warrant, arguing it is unconstitutional overreach.
In April 2018, Smethurst revealed an internal proposal to expand the domestic role of electronic intelligence agency the Australian Signals Directorate. The story was based on leaked documents and the police search warrant cited the section of the Crimes Act that prohibits unauthorised release of official secrets.
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Investment notes: HealthMatch
By Paul Bassat
Our job is fun; we get the privilege of supporting amazing entrepreneurs building businesses that have a positive impact on the community. We have co-led HealthMatch’s $6m Series A, supporting their mission to streamline clinical trial recruitment and enable life-saving drugs to reach the market faster.
Surgeon, founder
HealthMatch was founded by Manuri Gunawardena in 2017 as a direct result of her personal experiences as a medical student. Manuri had always dreamed of being a surgeon, but her career took a radical turn as a result of an internship at an oncology research institution. While working on personalised medicine for brain cancer, she learnt about the clinical trials market. In particular, Manuri discovered that luck and randomness played a central role in whether a patient was able to participate in a potentially life-saving clinical trial.
Founders of startups make enormous personal sacrifices. Manuri’s decision to pursue a different career path to the one she had dreamed of illustrates her commitment to and passion for HealthMatch. I find her willingness to openly state that the metric for success is not financial gain but positive impact on patient’s lives both brave and inspiring. Manuri’s talent and her passion were evident from our first interactions with her.
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Keeping faith with consumer trust
Consumer trust is a complex conversation as it works on many levels depending on where – and on how – a brand operates in the business spectrum. But there is no disguising the importance of organising your development or transformation around customers needs.
For three brands – Xinja, Lion and Sigma Healthcare – that development has been at the forefront of its current thinking and future planning.
They are companies at very different, yet in some ways very similar, places in the business spectrum.
As the world moves into the era of open banking, the online-only so-called neo-banks such as Xinja – banks with no shopfronts, and no branches – are potential beneficiaries of the failure by the big banks to meet trust responsibilities.
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Privacy fears over proposed Medicare data matching scheme
Laws don't go far enough.
Serious privacy concerns have been raised with proposed laws that would see Medicare data matching activities expanded to better detect fraudulent or incorrect claims.
The legislation, which was first unveiled in September, will introduce a new data matching scheme for the Department of Health to access and share health information for Medicare compliance purposes.
The proposed changes would give the department unrestricted freedom to access sensitive Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data currently accessible in only “narrow circumstances”.
Under the legislation, at least some of this information could be disclosed to other federal government agencies for both Medicare compliance purposes and to “assist them in performing their functions”.
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This GP learnt an important lesson from sharing his screen
11th November 2019
I ran late the other morning. My first patient, an internal transfer, was already waiting.
Booting up my laptop seemed to take forever. Usually I try to poke around at least a little in the electronic medical record before I enter the exam room, even when I know the patient well, in order to remind myself of what we are supposed to do in today’s visit.
I decided to walk in cold because I was so late. All I did before unplugging my laptop was open the encounter note of the man I had never seen before.
I knocked on the door and introduced myself — first and last name, I only call myself 'doctor' with children or if I walk into a crisis-type situation where being a doctor allows or requires you to take charge.
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data Why is it locked up?
Crunching official data helps evaluate policies. Potential embarrassment is the wrong reason for governments to keep it under wraps, Warwick McKibbin and Robert Breunig write.
As the engines of economic growth slow in Australia, there is a need for innovative policy changes to both raise economic growth but also to improve the wellbeing of Australia more generally. Design of good policy depends on a solid foundation of good data.
A recent workshop at The Australian National University convened by the Centre for Applied Macroeconomic Analysis, the Centre of Excellence in Population Aging Research, and the ANU Tax and Transfer Policy Institute explored this issue in great depth.
Governments hold vast banks of administrative data which, if mobilised, can be a potent force for policy development. In the hands of non-political quality research institutions, these data can fundamentally change the quality of policy design.
It’s not an outlandish proposition. Private companies routinely identify patterns from big data to pinpoint just about every conceivable aspect of consumer decisions. In Australia, there is a reluctance to put government data to better use outside of government, as experience from Australia and from around the world demonstrates that this reluctance causes valuable lost opportunities.
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Comments more than welcome!
David.
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