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This weekly blog is to explore the larger issues around Digital Health, data security, data privacy, AI / ML. technology 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 behaviour of a federal public agency gone rogue – and it just goes on! When you read this it will be well over 12 months of radio silence, and better still the CEO, COO and the Chief of Staff have also gone. I wonder will things improve now?
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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My Health Record for Rural and Remote Clinicians
ADHA Propaganda
As part of ACRRM’s ongoing commitment to supporting its members use of digital health, this webpage has been developed to provide detailed information and educational resources to better use the My Health Record. The following contains a brief commentary on the benefits of the My Health Record from the current ACRRM president, Dr Ewen McPhee.
New features in My Health Record
Improvements in functionality are being made to the Commonwealth’s My Health Record system since it was introduced in 2012. These enhancements include new views of patient information to help medical practitioners obtain health information about a patient’s health status in a timely manner.
New functionality:
- A medicines information view
- A pathology and diagnostic imaging summary view
Education
To learn more about how My Health Record can assist rural clinicians to deliver better care, access our online course Digital Health in Rural and Remote Australia - Better Health, Easier to Deliver.
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ASD ‘gave uni advance notice of hacker attack’
The Australian Signals Directorate responded to 1097 “cyber incidents”, including breaches of classified government networks, over a three-year period, triggering calls from MPs to strengthen efforts to protect official information from foreign actors.
The security agency has also revealed that it alerted the ANU to the prospect of malicious cyber threats before the November 2018 hack in which an unauthorised actor gained access to the university’s network along with nearly two decades of student records.
The nature of the ASD response to the 1097 cyber incidents from 2015 to last year varied and ranged from “telephone conversations through to deployment of staff resources and tools to assist in mitigating the incident”.
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In a troubling first, AI employed in mass online influence campaign
By Tony Romm and Isaac Stanley-Becker
December 21, 2019 — 9.05am
Washington: Facebook and Twitter on Friday disabled a global network of hundreds of fake accounts that pushed pro-Trump messages and covered its tracks using inauthentic photos generated with the aid of artificial intelligence.
The use of AI to trick social media companies, deceive unsuspecting users and essentially create people who do not exist marked a major, troubling new development, according to disinformation researchers, who expressed fresh alarm that such tactics could have implications for the 2020 presidential election.
The tech giants' takedown targeted the BL, a US-based media company that Facebook linked to Epoch Media Group. The organisation has criticised the Chinese government, and it has ties to the Falun Gong, a Chinese spiritual movement.
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What’s App? - End of Year Round-up on mHealth App Developments
An Irish Times special report estimates that over seven million patients worldwide are actively using digital health apps as part of their care plan. The availability of remote and mobile healthcare solutions relating to fitness, wellbeing, health and medical treatment could be life-changing for those living in countries lacking easy access to medical care.
Advantages of mHealth apps include streamlining the exchange of health information and a better user experience. From a data perspective, apps can use big data to analyse unstructured data and identify patterns and environmental factors that will improve patient treatment.
Government adoption
With this in mind, many governments are encouraging the uptake of mHealth apps.
In the UK, the NHS website has a digital library showcasing mHealth apps. It lists mHealth apps that have been deemed as clinically safe. The functionality of the apps is varied and provides services like repeat prescriptions services, speech and language therapy, and instant access to medical records. Patients can even use certain apps to monitor their conditions such as diabetes.
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A new draft code of practice for consumer IoT devices - hardening IoT supply chains
As the use of Internet of Things (IoT) devices in Australia continues to climb, the last few months have seen a flurry of activity from the Australian Government regarding IoT regulation. First, in late October 2019, Australia signed a Statement of Intent regarding the security of IoT with the Five Eyes nations (an alliance between Australia, Canada, New Zealand, the United Kingdom and the United States) committing to collaborate with industry and standards bodies to provide better protection to users through better device security design. Following that commitment, in November 2019 the Department of Home Affairs, Australian Signals Directorate and Australian Cyber Security Centre together released a Draft Code of Practice titled Securing the Internet of Things for Consumers (Draft Code).
The Draft Code – Principles
The Draft Code is intended to be a voluntary suite of measures that set certain standards for consumer IoT devices. It contains 13 principles that apply to different entities in the IoT supply chain – device manufacturers, IoT service providers and mobile application developers.
The Government has stated that the first three principles are the highest priority to achieve the greatest benefit:
- No duplicated default or weak passwords – passwords should be unique, unpredictable, complex and unfeasible to guess, and not resettable to a common factory default.
- Implement a vulnerability disclosure policy – entities should implement a vulnerability disclosure policy, have a public point of contact for reporting issues for this policy and act on vulnerabilities in a timely manner.
- Keep software securely updated – software should be securely updateable, updates should be timely, not affect device functionality, be distributed by secure IT infrastructure and should not change user-configurated preferences, security or privacy settings. Consumers should be made aware of end-of-life policies and the necessity of updates for their devices.
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Personal data handling and processing in Australia
Legitimate processing of PII
Legitimate processing – grounds
Does the law require that the holding of PII be legitimised on specific grounds, for example to meet the owner’s legal obligations or if the individual has provided consent?
There is no such requirement under Australian law. However, the APPs provide that an APP entity may only hold, use or disclose personal information for the primary purpose for which it was collected, or any other purpose that is related to the purpose for which the information was collected. Typically, parties in Australia have a privacy policy that explains the various uses that may be made of personal information so that it can be used for multiple purposes.
Legitimate processing – types of PII
Does the law impose more stringent rules for specific types of PII?
The Privacy Act distinguishes between personal information generally and sensitive information specifically. Sensitive information includes:
- any information or opinion about an individual’s racial or ethnic origin, political opinions, membership of a political association, religious beliefs or affiliations, philosophical beliefs, membership of a professional or trade association, membership of a trade union, sexual orientation or practices, or criminal record;
- health or genetic information about an individual; and
- biometric information and templates.
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Automating the big state will need more than computers
Robodebt showed the limits not of new technology, but a whole model of running the government.
Dec 19, 2019 — 4.00pm
Robodebt – the automated Centrelink debt issuance program that was found invalid by a federal court last month – is not just an embarrassment for the government. It is the first truly twenty-first century administrative policy debacle.
Australian governments and regulators increasingly want to automate public administrative processes and regulatory compliance, taking advantage of new generations of technologies like artificial intelligence and blockchain to provide better services and controls with lower bureaucratic costs. There are good reasons for this. But our would-be reformers will need to study how robodebt went wrong if they want to get automation right.
The robodebt program (officially described as a new online compliance intervention system) was established in 2016 to automate the monitoring and enforcement of welfare fraud. Robodebt compared an individual’s historical Centrelink payments with their averaged historical income (according to tax returns held by the Australian Taxation Office). If the Centrelink recipient had earned more money than they were entitled to under Centrelink rules, then the system automatically issued a debt notice.
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The federal government’s response to the ACCC’s Digital Platforms Inquiry is a let down
Katharine Kemp, Senior Lecturer, Faculty of Law, UNSW, and Co-Leader, ‘Data as a Source of Market Power’ Research Stream of The Allens Hub for Technology, Law and Innovation, UNSW and Rob Nicholls, Senior lecturer in Business Law. Director of the UNSW Business School Cybersecurity and Data Governance Research Network, UNSW
Today, the federal government responded to the recommendations of the Australian Competition and Consumer Commission’s (ACCC) “world-leading” Digital Platforms Inquiry.
The response, however, is a less-than world-leading roadmap for reform.
Few dispute the ACCC’s inquiry was ground breaking, as it held to account tech giants including Google and Facebook, and the power they wield over media, advertising and consumers.
But the government’s plan for reform lags behind other major global jurisdictions, where greater privacy protections have been enacted.
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The government must make sure technology serves public interest. The alternative is a libertarian free-for-all
From big tech to robodebt to My Health Record, Australians are rightly concerned about the automating of decisions
Wed 18 Dec 2019 12.15 AEDT
Falling levels of trust in our public institutions have become the backing track for the demise of the progressive political project and the rise of populist strongmen who promise to take back control.
Government becomes a problem to be solved, a “bubble”, a “swamp” of compromised technocrats and bean-counters operating against the interests of hard-working common folk, the “quiet Australians” whose will for a simple life is constantly being frustrated.
One of the drivers of this collapse has been the impact of technological change on our body politic, the anger-driven echo chambers of social media, the fake news and disinformation, the increasingly sophisticated targeting designed to reinforce what we already think.
Numerous benchmark surveys, including Essential’s own, document this decline, which tracks closely the destruction in traditional media models at the expense of these platforms.
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Tim Kelsey leaves Australia’s health IT agency to join HIMSS
The former NHS head of information has left his role as CEO of Australia’s federal health IT agency to join the US Health Information Management and Systems Society (HIMSS) in an international analytics role.
Jon Hoeksema – 17 December, 2019
Tim Kelsey, who was NHS England’s head of information and patients between 2011-15, has been in charge of the Australian Digital Health Agency (ADHA) for the past three years, responsible for the development of Australia’s national digital health strategy and expansion of the My Health Record (MHR) system.
MHR is an online summary of the key health information in Australia. The programme provoked a public backlash by moving to an opt-out model, that has led to over one million Australians opting out.
The MHR project bears similarities to the failed NHS Care.data project that Kelsey led during his time at NHS England. Trumpeted as a game changer in health research, Care.data proved in practice a spectacular flop after failing to win either public trust or professional confidence, and not putting patients adequately in control of consent.
The project was shelved in early 2014 and finally scrapped in 2016 after expert reviews called for better security provisions and new patient opt-outs.
Kelsey was NHS England’s director of patients and information between 2011 and 2015, enjoying a close personal relationship to Secretary of State Jeremy Hunt and helping to secure extra investment in NHS IT.
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Australia’s first privacy class action settles
On 9 December 2019 the Supreme Court of NSW approved a settlement of a class action alleging invasion of privacy (the first Australian case of this kind). The Court’s reasons for doing so were published on 12 December 2019.
The approved settlement sum was A$275,000, to be allocated between 108 class members (all being employees of the NSW Ambulance Service, part of the NSW state government). If all class members were to receive an equal amount, each member would receive a little over A$2,500. A separate amount of $250,000 was approved to be paid as costs to the lawyers acting for the plaintiffs.
The allegation was that a contractor engaged by the Ambulance Service had made an unauthorised disclosure of certain details of workers compensation claims made by the class members against their employer. The unauthorised recipient of that information was a solicitor at a law firm, who reported the contractor to the police because he suspected that the contractor was not authorised to provide the information to him. The unauthorised disclosure occurred about a year after the contractor had ceased working for the Ambulance Service.
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How AI can help prevent physician burnout
An ageing population, a shortage of staff and a lack of funding are behind a steadily increasing workload and higher expectations of care in the medical industry. This is quickly culminating in what the World Health Organization now officially recognises as ‘burnout’, with Australian doctors exhibiting high levels of burnout including emotional exhaustion (32%) and cynicism (35%), according to BeyondBlue.
It would be reasonable to believe that interactions with patients and delivery of satisfactory care are some of the most stressful aspects of a profession in health care. However, it is administration processes and clinical documentation requirements that are exacerbating burnout rates of healthcare professionals to unprecedented levels.
Research has found that between creating documentation (which clinicians spend around 11 hours a week doing), looking for lost notes, duplicating records and other administrative tasks, up to half of a clinician’s time can be spent on documentation. This means that only around 13% of their working time is spent caring for patients.
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Human rights and technology: discussion paper
17 Dec 2019
New technologies are emerging at extraordinary speed, with unprecedented social and economic consequences. Change is so pervasive that this era has been termed the ‘Fourth Industrial Revolution’.
The Human Rights and Technology Project (Project) considers the implications for our human rights, and how we should respond to protect and promote those rights.
Informed by extensive public consultation, this discussion paper uses a human rights approach to identify and analyse the challenges and opportunities for human rights protection and promotion in the context of new and emerging technologies. It considers what is needed in terms of regulation, governance and leadership, and makes concrete proposals to reform laws, policy and practice.
The discussion paper is published at a critical time for Australia. There are several inquiries and consultations currently being conducted, with a view to shaping Australia’s response to the Fourth Industrial Revolution. There is a general consensus that this era presents risks and opportunities, and Australia needs to address both.
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Human Rights Commission wants moratorium on expanding facial recognition
By Julian Bajkowski on Dec 17, 2019 1:26PM
Until laws are passed to regulate automated decision making.
Australia’s human rights watchdog has taken a bite out of the rapidly expanding facial recognition and biometric matching market, proposing the government institute an interim ban on using the controversial technology for decision making because it is flaky and struggles with people of colour.
In a sharply critical assessment of unregulated technology allowed to run amok, the Australian Human Rights Commission says a “legal moratorium on the use of facial recognition technology in decision making that has a legal, or similarly significant, effect for individuals” is needed “until an appropriate legal framework has been put in place.”
The push for a ban is contained in the AHRC’s latest discussion paper (pdf) on the interplay between human rights obligations and recent and emerging technology like artificial intelligence, automation and machines and sensors that can see and hear and could soon have serious consequences.
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How do I manage risks when unlocking the potential value of health data?
While there has been a trend towards decluttering our homes, the opposite has been happening with data – The amount of data that is tracked, collected, stored and transferred online is growing exponentially. The healthcare, pharmaceuticals and life sciences industry is no exception to this transformation given the growth of new health data sources – such as personal health apps, wearable tracking devices and customer loyalty schemes.
The growth in health data presents new opportunities for businesses to unlock value. Alongside these opportunities, businesses will need to manage a number of risks, including unauthorised disclosure and intervention from other regulators.
Download below to explore:
- what is health data;
- the trends that have coincided with the growth in health data; and
- how businesses should be managing their risk when unlocking value from health data.
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It’s thanks to you: MHR
Pharmacies have been the biggest contributor to the success of My Health Record to date, according to new statistics published by the Australian digital Health Agency
The Australian Digital Health Agency has published updated statistics showing more detailed activity on My Health Record, with Agency Chief Medical Adviser, Professor Meredith Makeham, saying that the new insights have been required.
“While we have published general participation statistics in the past, this update has been tailored for consumers following research which showed that more insight and relevance was needed about the statistics,” said Prof Makeham.
“The update provides a more granular view of how My Health Record is being used and how this is changing over time.”
The Agency says that its My Health Record statistics will be published on the My Health Record website regularly to provide more transparency around how the system is being used by consumers and healthcare providers.
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'Very worrying': Call for AI, facial recognition reforms to prevent discrimination
December 17, 2019 — 12.00am
The Australian Human Rights Commission has unveiled draft proposals to prevent discrimination driven by artificial intelligence (AI) and intrusive facial recognition.
Human Rights Commissioner Edward Santow said there were concerning developments in Australia and abroad that underscored the need for reform in the digital space.
The discussion paper proposes federal legislation requiring individuals to be informed where AI is used in a decision that affects their human rights, a general rule that whoever deploys AI is legally liable for its use, and a tort of serious invasion of privacy that would extend outside the digital arena. It also suggests a "moratorium on the potentially harmful use of facial recognition technology in Australia" until there is a legal framework to safeguard human rights.
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We need laws about AI, not self-regulation
Dec 17, 2019 — 12.01am
Companies and government departments using artificial intelligence technology must be accountable through laws – not merely industry codes of ethics – to allow customers to understand and potentially challenge decisions made using AI, the Australian Human Rights Commission says.
In a clarion call for the regulatory approach on AI to be reconsidered, the commission wants a new national strategy for AI, to ensure the powerful technology is governed by core democratic principles.
It wants a legal moratorium on the use of facial recognition technology in significant decision-making until a proper legal framework is in place, and for enhanced transparency to require customers be told when AI systems are being used in decisions affecting individual rights.
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Monday, 16 December 2019 23:12
Big growth in sharing patient info by healthcare providers on My Health Record
Peter DinhamADHA Propaganda
The Australian Digital Health Agency has reported a 140% growth of healthcare providers sharing and collaborating on patient information following the upgrading of the My Health Record system announced in September.
The agency says pharmacies are currently the biggest contributors to the system, uploading over 4 million documents every month with GPs also adding between 2 and 3 million documents every month.
In September, as reported by iTWire, the agency said that more than 31 million clinical documents and more than 1.3 billion Medicare documents had already been uploaded to the My Health Record digital health program, with patients benefiting from improved usability online.
Note: A classic example of re-writing a press release without really understanding what it means!
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Welcome to the medical man caves
Online telehealth services focussing on specific men’s health concerns are addressing a very real gap in the market
Francine Crimmins, 16 December 2019
If you were to walk into the Mount Sinai medical centre in Harlem, New York, you’d be forgiven for thinking you’d accidently entered a stereotypical American sports bar instead of a clinic.
The male patients in the waiting room are sitting on plush couches and watching live sports on giant flat-screen TVs while the walls are lined with memorabilia featuring the local hockey team.
It’s more “man cave” than doctor’s office, and that’s the point. The clinic offers a relaxed place for men charge up their smartphones, help themselves to hot drinks, and most importantly, wait to see a doctor.
And this new style of clinic isn’t the only model vying to capture a slice of the male health market. In the online space, men are being swamped with advertisements for online services offering “real doctors” and “real treatments” the instant they enter their health concerns into a browser.
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It's time to update Australia's outdated film and TV rules for the streaming era
December 16, 2019 — 12.15am
Australia's film and TV sector is changing very fast. The traditional free to air television networks are facing declining audiences; while subscription video on demand (SVOD) services like Netflix, Stan and Disney+ are growing strongly.
Four years ago less than two per cent of Australian homes had SVOD services while now it is nearly 60 per cent.
As the Australian Competition and Consumer Commission identified in its recent Digital Platforms report, the free to air television networks face extensive regulatory requirements, including obligations to broadcast designated amounts of Australian drama, children's and pre-school programs and documentaries - while the SVOD services have no such requirement.
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Government relying on eBay for hardware not a great idea, APS Review suggests
Thodey Review reveals cost to government of legacy IT
By Rohan Pearce
Editor, Computerworld | 13 December 2019 15:09 AEDT
A major government IT system is so out of date that replacement hardware for it needs to be sourced from second-hand parts sold on eBay.
The Immigration Records Information System, which processes visa applications, was originally rolled out in 1989; hardware to support the system hasn't been produced for a decade. The system is one of the examples of the burden that legacy IT imposes on the work of the Australian Public Service cited by the Independent Review of the APS.
The government today released the final report of the review, which was led by former Telstra CEO David Thodey, as well as its response to the review panel’s recommendations.
Another example the report cites of aging IT still delivering a critical function for the government is the Medicare payment system which relies on a “complex web of legacy and inflexible ICT systems”, encompassing 200 applications and 90 datasets.
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Comments more than welcome!
David.
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