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This weekly blog is to explore the news around 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 still dated 6 December, 2018! How pathetic is that for transparency? Secrecy unconstrained!
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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China’s bid to control the internet
China is pushing the UN for a radical change to the way the internet functions — a New IP that experts say ‘should frighten every single person’. And then there’s the undersea cable wars...
By Alan Dupont
May 16, 2020
Imagine trying to manage the impact of the coronavirus without the internet and a robust telecommunications sector. If we couldn’t communicate and transact in real time, economic activity would grind to a halt and social contact would be even more difficult. And there would be no COVIDSafe app, an important tool in the government’s recovery strategy.
Australia is already more wired than most nations, and the digital world is expanding rapidly as the coronavirus has forced business, schools, universities and government services online. Videoconferencing platforms such as Zoom are booming and the much maligned National Broadband Network finally is starting to realise its potential. But if these networks were to become untrustworthy or disrupted for any length of time it would be hard for the country to function effectively.
Fortunately, we are now much better informed and protected from many cyber threats. Passwords, antivirus software and cybersecurity are firmly entrenched in our personal lives and business culture. Governments and telecommunications companies have invested heavily in measures designed to protect overall system security. But these measures may not be enough if China is successful in setting the rules and designing the architecture of a new internet, because the one-party state’s internet vision reflects authoritarian values that are diametrically opposed to ours.
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PhD scholarship in Digital Health
PhD scholarship in Digital Health: Want to explore how digital technologies can help patients and consumers? Come and study Digital Health through Macquarie University’s PhD Scholarship – Digital health for patients and healthcare consumers. You’ll join the Centre for Health Informatics, Australian Institute of Health Innovation, a research-intensive institute and world-leading healthcare system innovators. Your topic will be tailored according to interests and experience.
Deadline: 30 Jun 2020
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ASIO vows to consider privacy, proportionality, and human rights in IPO process
The agency said it will carry over existing, domestic methods to the International Production Orders Bill and resulting US CLOUD Act.
The Telecommunications Legislation Amendment (International Production Orders) Bill 2020 (IPO Bill) requires law enforcement agencies in Australia to consider privacy, proportionality, and human rights before making a request to access data. As currently drafted, it doesn't require the Australian Security Intelligence Organisation (ASIO) to do the same.
On Thursday, ASIO Deputy Director-General of Enterprise Service Delivery Peter Vickery said that ASIO would, where it can, make the same considerations as law enforcement bodies when making an application.
"Our [current] procedure is we start from the lowest level of intrusion that we possibly can and the lowest level of invasiveness in terms of privacy that we possibly can, and go into those more intrusive if absolutely required," Vickery told the Parliamentary Joint Committee on Intelligence and Security (PJCIS).
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The three-day project that became one of the most viewed websites
A simple page of statistics, compiled in a few days, has become a widely cited source of information globally, but there are questions about its veracity.
Henry Dyer
May 15, 2020 – 12.31pm
In 2004, before he reached the age of 20, Andrey Alimetov created what has become one of the most viewed websites of the coronavirus pandemic, Worldometer.
The site has shot into the top 100 Alexa rankings. Coronavirus data collated by Worldometer has gone on to be cited by the United Kingdom government, politicians, media outlets, and commentators – British journalist Peter Hitchens has taken to tweeting out a “Daily Worldometer check” comparing the UK and Sweden’s statistics. Wikipedia editors have debated whether or not it should be used as a source. Conspiracy theorists and a right-wing American think-tank have speculated that a Chinese company is behind Worldometer. So, can the site be trusted, and who’s behind it?
At the time, $US2000 was a lot of money, and I wasn’t even 20 back then so it was a no-brainer.
— Andrey Alimetov, founder, Worldometer
Even from its foundation, Worldometer has been about people dying. Its original page, archived online, contained estimates for figures on Earth’s population, deaths this year, death today, deaths by communicable diseases this year, and a raft of other categories such as numbers of newspapers circulated in that year, cars produced, and coal consumption. The site used Javascript and your computer’s clock to calculate the live count, meaning the archived version still works for 2020, albeit using data that even then was only “somewhat correct for 2003-2004 years”.
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Australia's next tech unicorn
Nuix is arguably the most promising and least well-known Australian software company to build a global business. An IPO would easily value the company at $1 billion.
May 16, 2020 – 12.00am
Scientist David Sitsky knew he had a potentially huge global business when his algorithm was used by one of the largest employers in Canberra to find inappropriate images attached to emails.
This was the first commercial validation of Sitsky's software and its capacity to analyse vast amounts of unstructured data, in the form of emails and attached files, and find things with forensic accuracy.
The software was developed while Sitsky was working at ANU writing software for parallel supercomputers.
Twenty years later the company he founded, Nuix, is being used around the world to uncover fraud, protect personal data, meet regulatory compliance obligations, win complex legal cases and catch criminals.
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Coronavuirus: Chinese and Iranian hack attacks jeopardise hunt for vaccine
· The Wall Street Journal
Chinese hackers are targeting US universities, pharmaceutical and other healthcare firms in a bid to steal intellectual property related to coronavirus treatments and vaccines and the intrusions may be jeopardising progress on medical research, US officials said in an alert on Thursday.
The alert came as US officials charge that China and Iran since at least January 3 have waged cyberattacks against US firms and institutions working to find a vaccine for COVID-19.
The attacks have raised the prospect among some officials that the efforts could be viewed by the Trump administration as a direct attack on US public health, they said, because the attacks may have hindered vaccine research in some cases.
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Medical officers bullish about app privacy
The deputy chief medical officer says privacy issues regarding the COVIDSafe app have been solved, as parliament nears passing laws to boost protections.
Matt Coughlan
Australian Associated Press May 13, 2020 3:31am
One of Australia's top medical officers has declared all privacy issues surrounding the coronavirus tracing app have been solved.
Deputy chief medical officer Paul Kelly said all states and territories had now signed up to allow their health officials to use the data.
"We are now absolutely certain privacy and data security issues are all taken care of in terms of states and territories agreeing to our proposals," he told reporters in Canberra on Wednesday.
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Webinar: Where to for telehealth’s brave new world?
May 14, 2020
Wild Health publisher Jeremy Knibbs is joined by GP leaders in digital health – Dr Amandeep Hansra and Dr Nathan Pinskier, Dr Mukesh Haikerwal, and Dr Harry Nespolon, the president of the RACGP, to discuss pressing issues arising from the transition to telehealth.
Three months into the new telehealth reality, four experts reflect on the implications of this rapid digital expansion and look to future consequences for GP practices and their patients.
Discussing concerns around sustainability and the unintended consequences of such a hasty implementation, the panellists nevertheless agree that telehealth integration is ultimately a good thing. Covid-19 has revealed existing flaws in the system, and the experts say that this is an opportunity to review and improve on current methods.
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The rise (and rise) of the non PMS cloud based vendors
May 14, 2020
The traditional dominance of the patient management systems (PMS) as the primary care digital gatekeepers is starting to be challenged
By the middle of March this year, general practices across the country were suddenly facing mayhem. Patients were starting to panic over COVID-19. They were arriving, often without appointments on mass, asking for help, information, and even to be tested, when they were showing no COVID-19 symptoms. The situation started to become unsafe and dire. One GP Wild Health spoke to described the a new patient condition of “coronavirus anxiety syndrome” that was rapidly spirally out of control.
Within two weeks of the first signs of drama however, both of Australia’s major GP appointment engines, HotDoc and HealthEngine, had developed and deployed specific modules to their patient-facing appointment apps, which significantly improved the effectiveness of GP practices in managing COVID-19 situation at the time.
Between them, these two groups can which reach over 10 million patients through their apps, and are used by more than 80% of the country’s GP practices.
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https://wildhealth.net.au/what-happened-to-our-dysfunctional-health-innovation-killing-bureaucracie/
What happened to our dysfunctional innovation-killing health bureaucracies?
May 14, 2020
A heartening and perhaps surprising revelation from COVID-19 is that government has been harbouring a lot of latent talent for rapid and effective digital innovation and implementation. Can we somehow leverage that moving forward?
As far as I can remember, if you were trying to innovate in digital, health or otherwise, it was once a safe assumption to make that you needed to steer well clear of government if possible.
Unfortunately for digital health innovators, this was virtually impossible because health has to have more governance and oversight of risk, and in health, the government holds the cheque book for nearly everything that goes on. If you add to this starting point the vendor induced problems in digital health – that many run on old models of closed systems with gated data and breaking out of that too quickly can kill their businesses – then you’re some way to understanding why digital health has progressed mostly at the pace of a poorly snail in Australia for the last couple of decades.
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Telehealth services shaping healthcare delivery beyond COVID-19
14 May, 2020
The delivery of healthcare at a distance, using information communications technology (telehealth) can be used to connect and provide patient care, assessments, education and supervision. It has traditionally been associated with overcoming barriers to health service provision in rural and regional areas, for primary care and as a means of supporting the ‘hospital in the home’ initiatives for hospital-admitted patients or managing a patient’s ongoing care after discharge from hospital. However, in order to enable social distancing, the federal government recently introduced new Medicare items during the COVID-19 pandemic to fund telehealth services for patients in metropolitan parts of the country. Private health insurers have also recognised the provision of allied health services such as tele-physiotherapy and the provision of treatment outside of the hospital setting. These are important developments in the use of telehealth services that may change community expectations about how healthcare can and should be delivered in the future. However, it remains to be seen whether public and private funding of telehealth services will be implemented permanently after the pandemic is over.
New Medicare rebates for telehealth and telephone attendances
On 13 March 2020, temporary telehealth items were included onto the Medicare Benefits Schedule (MBS) to allow people to access essential Medicare funded health services via videoconference or telephone while in isolation in their homes and reduce the risk of community exposure to COVID-19. These items are specified in the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Determination 2020 and will only be available until 30 September 2020.
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Australian Digital Health Agency (ADHA) – Secure Messaging Standard
CareRight (6.66) complies with new Australian industry standards around secure messaging.
CareRight now integrates with Australian provider directories compliant with the Australian Profile for Provider Directory Services (PD 2 on FHIR R4). These directories are maintained by secure messaging vendors, and allows CareRight users to easily search for, import and automatically maintain contact records for Australian doctors.
In addition, CareRight’s secure messaging sends and receives secure messages formatted using the latest standards produced by HL7 Australia.
This new functionality was implemented as part of the Australian Digital Health Agency’s Secure Messaging Industry Offer.
CareRight offers secure messaging via Argus, Medical-Objects and HealthLink(NZ)
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Austin Health expands use of My Health Record
14 May 2020 ADHA Propaganda
From 11 May 2020 Austin Health are expanding the use of My Health Record (MHR) to include pathology and diagnostic imaging results for emergency department and inpatients only. The Austin previously only uploaded discharge summaries.
Important information to note:
- Patients will be able to access their pathology results in MHR 14 days after they’ve had their tests at Austin Health, GPs will be able to see the results in 7 days.
- They’ll also be able to access their diagnostic imaging results in MHR 21 days after they’ve had their tests at Austin Health. GP’s will be able to see the results in 14 days.
- Only final results will be posted to MHR no interim results.
- Austin Health will always ask patients for their consent to have their information uploaded to their MHR on every visit.
You can find further resources about the use of MHR from the My Health Record Website.
With Austin Health.
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France to force web giants to delete some content within the hour
By Staff Writer on May 14, 2020 2:19PM
Or face a fine of up to 4 percent of their global revenue.
Social networks and other online content providers will have to remove paedophile and terrorism-related content from their platforms within the hour or face a fine of up to 4 percent of their global revenue under a French law voted in on Wednesday.
For other "manifestly illicit" content, companies such as Facebook, Twitter, YouTube, Instagram and Snapchat will have 24 hours to remove it, according to the law, which sets up a specialised digital prosecutor at the courts and a government unit to observe hate speech online.
Justice Minister Nicole Belloubet told parliament the law will help reduce online hate speech.
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In Canada, Albertans wary of 'Big Brother' with use of COVID-19 digital-tracing app
By Steve Scherer on May 14, 2020 6:46AM
The hard part is convincing people to use it.
As the spread of the new coronavirus in Canada slows, the western province of Alberta has rolled out a digital-tracing tool to monitor outbreaks as quarantine restrictions ease. The hard part is convincing people to use it.
On May 1, Alberta launched Canada's first smartphone app to trace and call people who have come into contact with an individual infected with COVID-19, the disease caused by the novel coronavirus, so that they can isolate themselves and prevent further spread.
But so far, only about 165,000 Albertans, or less than 4 percent of the population, have downloaded it. By contrast, the Singapore app -- the model for Alberta -- has 1.4 million users, or almost 25 percent of the population on the Southeast Asian island.
"We all know we need to increase the uptake," said Jia Hu, the medical officer for Alberta Health Services who is leading the rollout of the app. "People are scared of the government having their data. That's why we made it as lean as possible."
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Apple-Google virus-tracking rules put apps around the world in a bind
By Gerrit De Vynck, Natalia Drozdiak and Helene Fouquet
May 14, 2020 — 10.59am
The Australian government's COVIDSafe app faces continued scrutiny over its inability to run on iPhones in the background, but the software is not alone in its technological stumbles. Public health agencies from across the world are struggling to accomplish their digital contact tracing goals, because of restrictions on data collection built into smartphone systems by Apple and Google.
It's leaving public health officials with few options but to use a system designed by Apple and Google themselves, which the tech companies say preserves privacy and works seamlessly on almost all devices, but those same privacy features lock authorities out of collecting information they can use to track the broader spread of virus, spot larger patterns and plan reopenings.
"The [Apple and Google framework] gives you an indication that you've been in contact with someone that was positive, but it doesn't do anything for the health department and its contact-tracing efforts," said Vern Dosch, a former technologist who is helping run contact tracing efforts for the US state of North Dakota.
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How robots could deliver urgent triage in our hospitals
DXC Technology
By Ian Manovel, Digital Consulting Healthcare and Life Sciences, DXC Technology
Wednesday, 13 May, 2020
By Ian Manovel, Digital Consulting Healthcare and Life Sciences, DXC Technology
Wednesday, 13 May, 2020
As the urgency of maintaining population health becomes a pressing reality, governments and regions seek innovative solutions to the impending crisis in the health system. Australia has a world-class health system but there is little spare capacity in our hospital emergency departments to admit large numbers of seriously ill citizens. We must think and work smarter to optimise our health system before it is inundated by a tsunami of acutely unwell patients.
We are all in this together
In Australia, a mobile platform could be used to quickly reach and engage large populations to undertake quick surveys, capture accurate clinical and mobile data then understand the health status of individuals at risk using COVID-19 assessment protocols.
If hundreds of thousands or even millions used a mobile app linked to a control centre console, COVID-19 clinical and operational teams could review real-time information and send notifications to state and federal health services and quarantine centres to activate specific pathways such as self-isolation or quarantine. Mobile geolocation features combined with large-scale functionality in the platform could be used to notify users, activate quarantine management, and provide home monitoring and care coordination.
For this to work effectively individuals would need to consent to share their health status in the app — for their own good and for the good of the wider community. My Health Record might be a good digital place to capture that consent given that 90% (22.7m) of Australians have one. This would allow government public health services to better coordinate the national response by delivering local health care that meets the needs of local communities and citizens.
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PAW 2020: ‘Reboot Your Privacy’ by improving email data handling practices
This week is Privacy Awareness Week, an annual initiative run by the Office of the Australian Information Commissioner (OAIC). The theme, "Reboot Your Privacy", challenges organisations to "Ctrl+Alt+Delete" their approach to privacy. The timing is apt given the heightened data risk associated with businesses operating online due to COVID-19.
In this article, we explore how organisations can manage privacy, data security and regulatory risk in respect of their email data handling practices – which is high on the OAIC's regulatory enforcement agenda.
Privacy Awareness Week – time to Reboot Your Privacy
Privacy Awareness Week (PAW) runs from 4-10 May 2020, and is an opportunity for the Office of the Australian Information Commissioner (OAIC) to raise awareness of current privacy and cybersecurity issues amongst the community. It is also an opportunity for the OAIC to emphasise best practice data handling requirements to meet community expectations about respecting and protecting personal information.
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AI's role in modern-day health care
With the impacts of COVID-19 being felt across the globe, the global healthcare sector has turned to technology to aid and accelerate innovation in the hope of combatting the pandemic.
The Australian Government has launched the COVIDSafe app to help digitally trace people who have come into contact with confirmed COVID-19 cases. Once the information is collected, artificial intelligence (AI) will examine and analyse the data, allowing the industry to better manage exposure to the virus.
There are countless other examples of AI and data analytics being applied in the fight against COVID-19. What’s important to note is this shift towards AI and data-led solutions isn’t unique to the current pandemic.
Historically, technologies like AI have been used to help reduce patient waiting times, support the development of custom-made medicines and reduce clinical disparity. Big data has also been used to manage previous worldwide health issues like the Ebola outbreak. Here are just a few examples of other ways AI is changing health care for the better:
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Queensland next to upload photos to national face matching database
By Justin Hendry on May 13, 2020 6:22AM
Will join Victoria, SA and Tasmania.
Queensland will become the next state or territory to share driver’s licence information with the federal government’s controversial national facial biometrics matching database, the Department of Home Affairs has revealed.
In answers to questions on notice from senate estimates, the department said the sunshine state would become the fourth jurisdiction to upload data to the National Driver Licence Facial Recognition Solution (NDLFRS).
It will join Victoria, South Australia and Tasmania, which uploaded their driver’s licence details and photographs to the system in December 2018, August 2019 and December 2019, respectively.
Remaining states and territories, including Western Australia, NSW, the ACT and the NT, will “follow over the next 18 months”, Home Affairs said in response to questions from Greens senator Nick McKim.
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The role of the patient in the emerging era of Participatory Medicine
Most clinician-patient interactions today are largely a clinician-orchestrated approach. However, in Participatory Medicine, the patient plays a much more active role in the process of care.
04 May 2020
Participatory Medicine ushers in some very real changes to the way healthcare functions today.
Most clinician-patient interactions today are largely a clinician-orchestrated approach. However, in Participatory Medicine, the patient plays a much more active role in the process of care.
This approach is perhaps best encapsulated by the concept of “let patients help”. It encourages the patient to take an active part in as many aspects of their care journey as possible, from data capture to goal setting and decision making.
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'False sense of security' risk from COVIDSafe app: Rex Patrick
May 11, 2020 – 12.00am
Senate crossbencher Rex Patrick has warned poor performance of the government's coronavirus smartphone app risks doing more harm than good, and the system can't be relied on for any easing of restrictions in Australia.
After more than 5 million Australians have downloaded the COVIDSafe application, Prime Minister Scott Morrison and senior health officials are pushing for wider uptake under the three-stage exit plan from business closures and physical distancing rules.
The source code for the app was released on Friday and Labor is in negotiations with the Coalition about legislation set to be put to Parliament this week.
But Senator Patrick says many users are unaware of poor performance when the app isn't running in the foreground of a phone's operating system, or when a phone is locked.
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Amazon and security concerns hamper COVIDSafe app push
May 12, 2020 – 12.00am
The local boss of Amazon Web Services has said it would seek to protect any data from the COVIDSafe contact tracing app against potential attempts by the US government to access it, but could not guarantee it would not be forced to hand the data over by a US government order.
Australian AWS managing director Adam Beavis spoke to The Australian Financial Review on Monday, as IT security specialists flagged fresh concerns about the app following the release of its source code over the weekend.
AWS was controversially awarded the contract to host the data obtained from citizens' phones, leading to concerns that the US government could theoretically demand access to information under its own laws governing US companies.
The Attorney-General's Department deputy secretary Sarah Chidgey last week said the government had received legal advice that it was inconceivable the US could access app data under the country's Clarifying Lawful Overseas Use of Data (CLOUD) Act, but Mr Beavis was unwilling to say whether he agreed with her.
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Misleading government COVIDSafe app messaging undermines its value
James Turner
May 11, 2020 – 12.07pm
The world is in the grip of a pandemic and despite its massive impact on our way of living, our economy, our national prosperity and our place in the world, Australians are squabbling about an app.
The Australian government has made two mistakes with its communications around the COVIDsafe app. The first is to double down on its efficacy, rather than trusting in Australians to make informed pragmatic choices. The second mistake was to create of a measure of behaviour that is now leading to undesirable outcomes.
It’s reasonable to assume that it’s the sheer desire to protect Australians and reboot our economy that is driving the government rhetoric around the benefits of downloading the app, but reality is that – right now - there’s no evidence that the app will work.
That’s not a reason to ignore it, but it is a particularly good reason to avoid rhetoric if we’re interested in trust.
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Covid 19 Tracking App: To Download, or Not To Download?
30/04/2020 by Sonia Hickey & Ugur Nedim
More than two million people have downloaded the Federal Government’s COVIDSafe app since its release on Sunday, and the government is hoping for about 3 million more Australians to do so.
But many are concerned about the app for a range of reasons – including the level of access it will give to their data, how it may curtail privacy and personal freedom (after all, without privacy there is no freedom), how the data will be stored, how the information gathered may eventually be used or shared, how safe the data will be from hackers and which company will be responsible for its storage and safekeeping.
Data collection and use
While most understand the app’s stated purpose: to help health authorities trace and prevent COVID-19’s spread by contacting people who may have been in proximity (to a distance of about 1.5 metres) with a confirmed case, for 15 minutes or more.
The majority also understand – in general terms – how Bluetooth technology is used to record users’ contact with other app users. The app says collected data is encrypted and can’t be accessed by other apps or users without a decryption mechanism. It also says the data is stored locally on users’ phones and isn’t sent to the government (remote server storage).
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Efficacy, ideology and COVIDSafe
Questions remain over measuring the effectiveness of the Australian government’s tracking app, COVIDSafe, along with the mission creep it is sure to entail
By Dr James Parker, University of Melbourne
Two weeks ago, governments in Queensland and Western Australia announced that they would start lifting some restrictions on movement and gatherings. Hours after these announcements, COVIDSafe, Australia’s new ‘contact tracing’ app, was released.
It’s hard to imagine that the timing was a coincidence.
The federal government had already signalled that the app would be one of three key pillars of Australia’s ‘exit strategy’ from shutdown.
Amid all the talk of ‘war bonds’ and ‘national service’, text message campaigns and promises that the app would help us get back to the pub, that exit strategy is now being implemented.
COVIDSafe has so far been downloaded 5.5 million times, or about halfway towards the government’s target of 40 per cent of the population.
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Health systems struggle to keep up with hackers
By Dylan Bushell-Embling
Tuesday, 12 May, 2020
Tuesday, 12 May, 2020
Training programs and tighter regulations could pose the answer to Australian and other health systems struggling to keep ahead of cyber attackers, according to research from UNSW.
The research found that health systems internationally are finding it difficult to keep up with the growing use of cyber technology by nefarious actors.
Hospitals are still often running outdated, legacy operating systems that can be easily exploited by hackers.
The ongoing digitalisation of nearly all systems, such as radiology, pathology and patient records, is also posing a challenge because corresponding cybersecurity requirements have not been evolving as quickly.
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Faster and cheaper than the NBN: fibre companies show the way
May 11, 2020 – 2.17pm
Mark Hellinger, a freelance filmmaker from Melbourne, used to drag himself out of bed at 3am just to check that his film uploads hadn't crashed.
The uploads took 12 hours.
"Half the time I'd wake up and there would be error and I would have to start again," he says.
Then his apartment complex got fibre-to-the-premises, from the small Melbourne internet infrastructure provider DGtek, and the uploads now "are basically instantaneous" and never fail.
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To market COVIDSafe app, learn from the virus itself
May 11, 2020 – 12.00am
Marketing experts say 5 million downloads of the COVIDSafe app is a solid start, but its developers should better leverage these "early adopters" into pressuring their personal networks to also get the app.
Andrew Whitford, an online marketing expert and founder of Removify and TrafficZoom, says the government can not bank on initial download rates continuing apace if broadscale adoption is the goal.
This is because the psychology of those first 5 million Australians is fundamentally different to any second wave.
"There's a thing called the 'diffusion of innovation theory', which is about when you introduce a product to market. What does it take to get mass market acceptance?" Mr Whitford said.
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Doctor–patient communication and relationship in telehealth
Sabe Sabeson
Danny Tucker
Danny Tucker
TELEHEALTH involves the provision of health care using technology such as videoconferencing and telephones. It has traditionally been used by clinicians to improve access to care for regional and rural communities and vulnerable populations. As part of measures to control the spread of coronavirus disease 2019 (COVID-19), telehealth has rapidly gained acceptance as a routine model for providing care at home, even for metropolitan patients. Professionals adopting this mode of communication include GPs, specialists and other health care providers. This model has proven useful for regular consultations and supervision of oral and intravenous therapies. Acknowledging some limitations, safe provision of care using telehealth is possible, but some elements still require face to face interaction.
The approach to telehealth is well established and many organisations have developed guidelines. Typically, a distant clinician provides a service to patients, and other health professionals, such as pharmacists, nurses and pathologists, provide support for documentation, prescribing, ordering of investigations and performing physical examinations. In most outreach settings, the patient is known to a small number of visiting clinicians.
However, the role of telehealth has been extended in the recent months due to the COVID-19 pandemic and doctors may have to alter their approaches to doctor–patient communication in telehealth by factoring in additional considerations as listed below:
- Clinicians may have to rely on family members as support persons for the patient. Attending family members who don’t reside in the same house may need to consider physical distancing policies. Other members may be encouraged to join a consultation via videoconferencing.
- Medication prescriptions and investigations may have to be organised by the providing clinicians themselves.
- It is important to consider converting to telephone consultation if internet congestion interrupts video calls.
- End-of-life discussions and breaking bad news – conversations that are usually undertaken face to face – may need to occur via telehealth. Current frameworks for end-of-life and breaking bad news discussion apply to telehealth, with attention to technical considerations.
- Consultations may take place by specialists, GPs and junior medical officers who are not familiar with the patient. Confirmation of patient identity must occur.
- Working from home and dialing into homes may require mechanisms for maintaining the privacy of both doctor and patients.
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Friday, 08 May 2020 12:10
‘Strategic risk’ approach to dealing with consumer data right compliance, enforcement, say ACCC, OAIC
Australia’s competition watchdog, the Australian Competition and Consumer Commission (ACCC) and the Office of the Australian Information Commissioner (OAIC) say they will adopt a “strategic risk-based approach to compliance and enforcement” in dealing with breaches of the Consumer Data Right Compliance and Enforcement Policy.
The policy was jointly released on Friday by the two regulatory agencies, outlining the approach that they have adopted to "encourage compliance with, and address breaches of, the Consumer Data Right regulatory framework".
The policy has been developed following consultation with current and future data holders and recipients.
‘‘The Consumer Data Right is an important reform that will give consumers greater access to and control over their data,” ACCC Commissioner Sarah Court said.
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Comments more than welcome!
David.
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