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This weekly blog is to explore the larger issues around Digital Health, data security, data privacy, AI / ML. technology, social media 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 over 16 months of radio silence, and worse, while the CEO, COO and the Chief of Staff have gone, still no change. I wonder will things improve at some point, given the acting CEO seems not to care, as well. I think it is fair to assume no change will come in the foreseeable future.
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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Organised effort helping drive 5G coronavirus conspiracy theory
By Ryan Gallagher
Updated April 10, 2020 — 9.47amfirst published at 9.43am
London: A conspiracy theory linking 5G technology to the outbreak of the coronavirus is quickly gaining momentum, with celebrities including actor Woody Harrelson promoting the idea. But the theory is also getting a boost from what some researchers say is a coordinated disinformation campaign.
Marc Owen Jones, a researcher at Hamad bin Khalifa University in Qatar, who specialises in online disinformation networks, analysed 22,000 recent interactions on Twitter mentioning "5G" and "corona," and said he found a large number of accounts displaying what he termed "inauthentic activity."
He said the effort bears some hallmarks of a state-backed campaign.
"There are very strong indications that some of these accounts are a disinformation operation," Jones said.
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9 April 2020
COVID-induced telehealth: wrecking ball or transformation?
The fundamental utility of universal telehealth has been unquestionable for some time.
Overseas, in some HMOs and in some well set up Scandinavian countries, primary care providers will do up to 65% of all their work via telehealth, such is its efficiency and effectiveness.
Get sick at a conference in Florida, do a call with your GP in Boston, and pick up your meds at a pharmacist around the corner following your call. Don’t spend time in traffic or getting home from work early to wait 40 minutes in your GP practice for a repeat on Lipitor. Manage your older chronic health care patients more effectively in between the need for face-to-face assessments. Free up GP time for more important consultations. Create much more efficiencies for the GP and the patient. And so on.
Telehealth had to arrive in some more substantive form at some point.
But in the last two weeks, we’ve seen telehealth items go from 84 mostly obscure and rarely used MBS items, to 363 items, all used in everyday primary care. And we’ve done it without any training or education for those using it – doctors and patients – and without any meaningful and functional infrastructure in place for GPs.
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http://medicalrepublic.com.au/is-this-an-infomercial-by-a-federal-minister-for-medicaldirector/27397
9 April 2020
Is this an infomercial by a federal minister for MedicalDirector?
Posted by Jeremy Knibbs
This strange video has surfaced promoting MedicalDirector’s new integrated telehealth offering alongside a somewhat confusing announcement by the government to upgrade GP internet access for free via the NBN
NBN Co will be supporting delivery of enhanced telehealth services by upgrading Australian GP clinics to 50Mbps download and 20Mbps upload connections at no extra cost for a period of six months.
Which is great.
But it is all part of a broader effort by NBN Co to support the delivery of enhanced services to all Australians for the period of the crisis, particularly those families and businesses that are requiring extra bandwidth from home.
The NBN offer is across the board to all GP practices using any telehealth solution.
Why then is a Federal Minister fronting a video that could easily be mistaken for an infomercial for only one vendor in the country, of a possible 15 or so telehealth vendors?
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Digital health to the rescue
Pharmacies across Australia will have electronic prescriptions available by the end of May to ease stresses created by the telehealth system.
The Australian Digital Health Agency (ADHA) announced the new initiative under the Australian Government’s National Health Plan for COVID-19 to support primary care during the pandemic.
“Electronic prescriptions are now being fast-tracked to allow patients to receive vital healthcare services while maintaining physical distancing and, where necessary, isolation,” ADHA says.
“This will allow people in self-isolation convenient access to their medicines and will lessen the risk of infection being spread in general practice waiting rooms and at community pharmacies.”
The plan is designed to support telehealth and will allow a doctor to produce an electronic prescription that patients can then share with a pharmacy.
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'Emotionally enmeshed' GP suspended over telehealth opioid scripts
The GP said she had empathised with the patient’s 'feeling of helplessness'
9th April 2020
A GP who prescribed pethidine on more than 88 occasions to her patient over the phone has been dubbed naïve and banned from practising for three months.
Victorian Civil and Administrative Tribunal was told the patient originally presented in “pain and distress”, complaining of recurrent shoulder dislocations in 2014.
She opted to prescribe pethidine after he told her it would allow him to relocate his shoulder himself.
Despite living in Queensland, the patient consulted with the Melbourne-based GP once or twice each month.
But the distances between them meant that of the 227 private scripts she wrote over a two-and-a-half year period, at least 88 scripts were issued over the phone.
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Coronavirus: Would you support a contact tracing app in Australia to fight COVID-19 spreading?
There is an instance where I might support a COVID-19 contact tracing app on my phone.
Sure, we are often horrified about how smartphones track our every movement, glean our personal information and collate our consumer transactions to learn about our spending habits and sell it to third parties.
Concern about privacy is rightly at the forefront of people’s minds when considering installing a specialist app on our phones to track the spread of coronavirus, and our possible personal scrapes with it.
Some tracking apps overseas have proved effective while ignoring privacy concerns. At times they have bordered on a new age version of a leper carrying around their bell as happened centuries ago.
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Wednesday, 08 April 2020 12:13
Human Rights Law Centre calls for ‘greater transparency’ for Govt’s Covid 19 phone app
Australia’s Human Rights Law Centre has called for greater transparency to be given to the Federal Government’s recently launched Coronavirus Australia app.
The call comes from the Human Rights Law Centre’s Digital Rights Watch, Access Now and the Centre for Responsible Technologies, for greater transparency “around the use of these highly invasive technologies”, with a warning that their use must be limited to the current crisis or “Australia’s democracy would be forever changed”.
The Law Centre says the app has been downloaded over 500,000 times in Australia, “yet there is little publicly available information about what data is being collected from people and how that private information is being used and kept safe”.
The Coronavirus Australia app is designed to keep people up-to-date with official information regarding the spread of COVID-19, but the Law Centre notes that it also asks for people’s location data if they identify as being in isolation.
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'It can be lonely': What you might not know about telehealth
Dr Amandeep Hansra describes what she has learnt from 10 years of doing remote consults.
8th April 2020
Since the COVID-19 pandemic began, tens of thousands of GPs have started caring for their patients remotely.
For many this has meant doing consults via telehealth for the first time.
Dr Amandeep Hansra, part of the expert review team behind the RACGP's telehealth guide, explains the potential pitfalls facing doctors confronted by a new way of working.
Australian Doctor: What’s something GPs may not realise about telehealth if they’re just starting out?
Dr Hansra: It can be lonely for the GP, especially if you are only doing telephone consultations.
That’s the feedback I have received from people who are just starting out and working from home. They can lose the enjoyment of their usual work.
I know it’s not always an option, but if you can do telehealth from your practice, at least you’ll have some interaction with others, like the reception staff and the other GPs.
Given the issues around coronavirus and making sure staff are safe, a move to telehealth is important.
Dr Amandeep Hansra was part of the review team for the RACGP's telehealth video consultations guide. You can read these guidelines here.
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'I will be breaking the law': GP calls for SafeScript boycott
Doctors who fail to check real-time script tracking software could be fined $16,000
8th April 2020
A GP who helped develop Victoria’s real-time script tracking software has urged other doctors to break the law and boycott the system.
On 1 April, it became compulsory for all doctors and pharmacists in the state to check the software, called SafeScript, before prescribing or dispensing all schedule 8 drugs and some schedule 4 drugs.
The system integrates with GP software to issue red, amber or green pop-up notifications, with both red and amber alerts requiring the doctor to review the patient history to assess whether it is safe or appropriate to prescribe a monitored medication.
GPs who fail to take “all reasonable steps” to check the database can be fined more than $16,000.
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Telehealth will be a first port-of-call, doctors say
7 April, 2020
With the government fast-tracking the roll-out of telehealth services, doctors are assuring patients there is no additional chance of misdiagnoses.
Digital Health Agency spokesperson Dr Andrew Rochford tells Deborah Knight telehealth is as easy as getting on the phone or an online video conference with your GP for an initial consultation.
“Given the extreme circumstances we’re in, we need to start looking at ways of harnessing digital to protect ourselves and protect everyone else.
“Telehealth is a way of you not going out of the home and going to your doctor, unless you definitely need to be there.”
He says telehealth patients can give their GPs a clearer picture by measuring their own temperature, weight and even heart rate from the safety and comfort of their homes.
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Your phone is watching you, and could be our exit strategy
Intrusive technology may provide one of the paths out of the shutdown and restrictions being experienced by Australian society.
Apr 7, 2020 – 5.34pm
Imagine giving permission for your movements and your contacts, including those unknown to you, to be tracked via your mobile phone every time you leave the house.
It may sound more like a dystopian vision of Australia. It may also become a practical trade-off for the choice between having people stuck at home indefinitely or able to resume partially normal lives more quickly.
The national cabinet will have to wrestle with the concept of how to manage even a partial opening of the economy without unleashing the coronavirus to rampage through the community and the health system in an uncontrolled manner.
The recent focus on strict social distancing measures and shutdown or near closure of most retail businesses is succeeding in drastically reducing the numbers of new Australian infections, although the government is still warning it’s too early to be certain.
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Tuesday, 07 April 2020 13:11
COVID-19: Healthcare system needs new technologies to meet ‘challenges’, says ATSE
Australia’s healthcare system must quickly incorporate technologies including remote consulting, wearable monitors and full digitisation if it is to meet the challenges of the coming decade, an investigation by the Australian Academy of Technology and Engineering (ATSE) has found.
“These are new health technologies that are desperately needed as the world responds to the coronavirus pandemic,” says ATSE, adding that “such innovations could transform health delivery”.
“Even before the coronavirus pandemic, our year-long examination of the health system identified the changes needed to meet rising demands, particularly in regard to chronic and age-related diseases,” said ATSE President, Professor Hugh Bradlow FTSE.
Professor Bradlow says the response to coronavirus could have been different if the disease had emerged after all four recommendations had been fully implemented.
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Shipbuilder Austal was hacked with stolen creds sold on dark web
By Ry Crozier on Apr 8, 2020 7:05AM
Provides full post-mortem of late 2018 attack.
Austal, the ASX-listed shipbuilder and defence contractor, was compromised in late 2018 by an attacker who used login credentials purchased on a dark web forum, but who then failed to extract much of value or secure a ransom to have it returned.
CEO David Singleton provided a full post-mortem of the mid-October 2018 breach last week - which he said included a grilling from senior government ministers - and revealed cyber defences put in place afterwards had saved the company from credential phishes as recently as the past fortnight.
Singleton said the company was breached in October 2018 using stolen credentials sold on the dark web, a place he characterised as a kind of “parallel universe… where criminals hide and where criminality is rife”.
“I still don't really know what [the dark web] is,” Singleton told a recent industry event.
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https://itwire.com/telecoms-and-nbn/mobile-industry-group-slams-rumours-linking-5g-and-covid-19.html
Tuesday, 07 April 2020 11:13
Mobile industry group slams rumours linking 5G and COVID-19
The head of the Australian Mobile Telecommunications Association, a lobby group for the mobile industry, has described claims being spread that there is a connection between 5G and COVID-19 as "false" and "the worst kind of fake-news misinformation".
In a statement, AMTA chief executive Chris Althaus said some reports in the media had given prominence to conspiracy theories about 5G, suggesting that there was a link to the coronavirus pandemic.
"These false claims are the worst kind of fake-news misinformation and are both irresponsible and completely unacceptable during a genuine health crisis," he said.
“It is important that the community is provided with clear, factual science based information."
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ACCC Chair Sims Zooms In On CV19 Comms Risk
By Computer Daily News| 7 Apr 2020
CANBERRA: Rod Sims, chairman of the Australian Competition and Consumer Commission, has detailed COVID-19-induced communications risks that the ACCC hopes to mitigate.
Speaking via Zoom at a Comms Day conference yesterday, Sims said response to the crisis by the communications sector has been encouraging – but the ACCC has had concerns about how consumers without a working service might get online.
He said this includes people who have moved into premises not yet connected to the NBN, and about telcos giving consumers the flexibility to move to plans or services they need – and then shifting back when their needs reduce.
Also, he said, telcos need to be open with customers if they have to implement service restrictions.
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Australian health sector does not have 'cybersecurity problem', says insurer
By Ry Crozier on Apr 7, 2020 6:58AM
Despite consistently high number of notifiable data breaches.
Australia’s healthcare sector does not have a “broader cybersecurity problem” despite consistently reporting higher numbers of data breaches than other industries, according to medical indemnity insurer MIGA.
In a parliamentary submission published on Monday afternoon [pdf], MIGA defended the security record of the “private healthcare sector”, arguing that notifiable data breach (NDB) numbers needed to be understood in “context”.
Health service providers have “consistently reported the most data breaches compared to other industry sectors since the start of the NDB scheme”, according to the Office of the Australian Information Commissioner (OAIC).
Breach numbers from 2018 were cited by the Australian National Audit Office (ANAO) as evidence of the level of cybersecurity risks present in the health sector. The numbers have stayed high since.
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6 April 2020
‘Perfect storm’ for general practice
It’s a time of anxiety, financial and otherwise, for GPs faced with empty waiting rooms amid an all-enveloping economic downturn.
But there are also glimmers of hope ahead, according to RACGP president Dr Harry Nespolon, who says the crisis has brought general practice a few steps into the 21st century and forced a recognition of its fundamental role in the health system.
For now, COVID-19 is the perfect storm for GPs, medically and economically, he told The Medical Republic.
Routine work was now hazardous, yet a lack of it threatened their livelihood.
In the latest online survey conducted by TMR, 54% of 175 respondents said revenue was more than 30% down on last year.
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Respect for human rights must come at the centre of any technological drive to fight coronavirus
By Lizzie O'Shea
April 5, 2020 — 11.59pm
A problem like COVID-19 is so monumental in scale and ferocity that it creates an understandable temptation to race to use any method at our disposal to prevent its spread.
One tactic that has been floated in a number of places is to make use of the vast and ubiquitous technologies of surveillance that already permeate our digital lives. But before rushing ahead with any such proposals, we need to ensure human rights are protected because doing so is both critically important to our chances of getting through this crisis and ensuring we have a democracy at the other end.
Singapore, South Korea, Israel and China have all experimented with reorienting networked technologies to map contact tracing and monitor those who were required to self-isolate. These efforts include utilising mobile phone networks to track confirmed cases, tapping urban CCTV networks, some armed with facial recognition software to identify individuals, and mapping of the populace through the aggregation of digital sources. There are reports that a number of liberal democracies, including Australia, are considering following suit.
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Guidance on the processing of personal data and cybersecurity in the context of the COVID-19 pandemic
Paolo Balboni – ICT Legal Consulting Founding Partner – and his team, without the presumption of completeness, has proceeded to map official resources that provide guidance on the correct processing of personal data in the context of COVID-19 and Cybersecurity-related information on working remotely in the context of the pandemic.
An updated version of the list can be found on Paolo Balboni’s personal blog.
Cybersecurity: Information on working remotely in the context of the COVID-19 pandemic
European Commission, ENISA, CERT-EU and Europol – COVID-19 Joint Statement
EU Agency for Cybersecurity (ENISA) – Tips for cybersecurity when working from home
Europol – Safe Teleworking Tips and Advice; How criminals profit from the COVID-19 pandemic; Make your home a Cyber Safe Stronghold
France – Cybermalveillance.gouv.fr platform, IT security recommendations for teleworking in crisis situations
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Mobile phone tracking should be used to stop virus
April 5, 2020 — 4.54pm
It is difficult to think of anyone more irresponsible at this time of coronavirus crisis than those people who returned from a skiing trip to Colorado with COVID-19 a couple of weeks ago and then insouciantly wandered around Melbourne, infecting dozens of people.
Yet Prime Minister Scott Morrison has decided that he is not ready to adopt a technology — based on mobile phone apps widely used in other countries such as Taiwan and Singapore — which could have kept track of people who are in isolation but who refuse to do the right thing.
After the council of chief medical officers suggested using the technology, Mr Morrison said last week that using mobile phone data to track and contain the disease was not consistent with what Australian society “understands and accepts”.
The prime minister is right that using mobile phone data involves serious privacy risks and, if badly managed, might reduce community support for other important measures such as lockdowns.
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Google location data shows Australia grinding to halt
By Juha Saarinen on Apr 4, 2020 9:42PM
Are Canberrans still hitting supermarkets and heading outdoors?
Google has published a set of reports using the location data it collects from users via its services and software such as Maps to provide insights into how COVID-19 movement restrictions worldwide are affecting communities' mobility.
Compared to a median baseline during the five week period between January 3 and February 6 this year, Australians visted retail outlets and recreation places such as museums, libraries, restaurants and theme parks about 45 per cent less recently, the report summary suggests.
Grocery and pharmacy visits dropped by almost a fifth, and people went to parks and beaches just over a third less than usual.
Google's location data for public transport hubs fell by 58 per cent, and workplaces saw a drop by a third.
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Google tracking shows the shutdown is working
Apr 5, 2020 – 10.53am
The blue dot on your Google Maps is watching you and the economy like never before.
Since the first week of January, Google has tracked the movement of people via their locator function and it's showing a 58 per cent drop in visits to public transport stations and stops, a 33 per cent drop in visits to usual workplaces and a 13 per cent rise for people staying at their homes.
Restrictions on people movement due to the COVID-19 outbreak has seen visits to retail and recreational areas such as restaurants, cafes, shopping centres, theme parks, museums, libraries, and movie theatres are down 45 per cent.
The COVID-19 Community Mobility Report shows trends over several weeks with the most recent data representing just 2 to 3 days ago, which is how long it takes to produce the reports.
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Comments more than welcome!
David.
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