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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 were dated 6 December, 2018 and we have seen none since!
It is worth pointing out that it was only in last little while ( beginning end July 2020 ) the ADHA took down the notification regarding the most recent minutes notification. Embarrassed I guess – as they should be!
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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Why WeChat ban is a major event US-China rupture and how it could hit Australia
The United States’ decision to ban WeChat next month is the most important escalation yet of the threat to the Australian economy posed by America’s confrontation with China.
It is a far bigger deal than the executive order banning TikTok that was issued on the same day as the WeChat one – August 6 – and is potentially far more damaging to this country than either the banning of Huawei or Trump’s three-year-old trade war with China.
That’s because about a billion Chinese people use WeChat for just about everything, including when they travel. If they can’t use it somewhere, it’s doubtful they’ll go there.
If Australia was obliged, or persuaded, to join the US in banning WeChat, or decided independently to do so, it would likely mean the end of tourism and international students from China, not that there’s much of that going on at the moment thanks to the coronavirus, but everyone hopes these things will eventually come back as lucrative exports and, more importantly, generators of employment.
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https://www.afr.com/companies/media-and-marketing/the-twitter-war-on-journalism-20200811-p55kon
The Twitter war on journalism
The social media site was meant to democratise opinions. Is it bullying the press into submission?
Aaron Patrick Senior correspondent
Aug 14, 2020 – 11.09am
There was a point in a mind-numbing hour-and-a-half press conference last week when Twitter unleashed on a 33-year-old female reporter who had the temerity to try to pin down the Victorian Premier, Daniel Andrews.
Rachel Baxendale, a reporter covering politics for The Australian, pushed Andrews to disclose those in his government responsible for hiring security guards who, instead of quarantining COVID-19 travellers, fraternised with them.
Abuse began pouring onto the social media site. Baxendale was accused of being a stooge for News Corp, which is known for its newspapers' tough coverage of Labor governments, and a troll for Tim Smith, a Liberal MP who had dated her younger sister.
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https://www.afr.com/technology/why-andrew-forrest-fears-the-age-of-the-algorithm-20200814-p55lmn
Why Andrew Forrest fears the age of the algorithm
Brad Thompson Reporter
Aug 14, 2020 – 4.17pm
What is behind billionaire Andrew Forrest’s latest crusade, this time a tilt at the tech giants and their growing power unfettered by anywhere near the regulation he sees in the mining industry where he made his fortune?
He’s worried about the age of the algorithm, in his words a “scary environment” where machines make most of the decisions.
Artificial intelligence and autonomous technology are already a big part of his mining empire, but he thinks there are lines that can't be crossed by powerful companies like Google, Facebook, Amazon, Microsoft, Alibaba and Tencent.
The issue of lax regulation of tech giants became personal late last year when his image and name and those of family members were used repeatedly in criminal scams perpetuated on Facebook and Twitter.
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Pandemic response should prioritise advance care planning, says report
Thursday, 13 August, 2020
A report released by Advance Care Planning Australia (ACPA) recommends that advance care planning (ACP) conversations should be happening now with older Australians and those with chronic conditions to avoid scenarios where people hospitalised with coronavirus who would rather forgo invasive treatment are not unnecessarily ‘competing’ with people who want it. ACP helps people advocate for the type of care they would want if they were unable to speak for themselves.
The report — Advance care planning in Australia during the COVID-19 outbreak: Now more important than ever — finds that ACP could be used as part of Australia’s response to the COVID-19 crisis by helping to manage surges in healthcare demand and reduce the need for rationing care.
The report reveals that 75% of older Australians do not have a plan to guide their treatment should they become suddenly unwell, meaning that decisions will be made for them.
Encouraging people to state their preferences and plan their care now means that individuals, their family and doctor are prepared when a health crisis occurs and the individual is no longer able to make their own treatment decisions.
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A Facebook failure would be a global disaster
· The Times
Facebook has become so powerful its collapse would have “catastrophic social and economic consequences”, researchers say.
The world’s largest social media company has become so essential to many societies, it is suggested that a special framework should be in place if it folds, similar to those for banks, critical infrastructure and national utilities.
A study by a team at Oxford University’s Internet Institute argues that regulators have not made sufficient plans for what would happen if the platform, which has 2.7 billion users, went under. “The potential demise of Facebook might seem highly unlikely but the implications need to be taken seriously”, lead author Carl Ohman said.
Facebook, co-founded by Mark Zuckerberg in 2004, is the biggest social media company in the world. Once Instagram, WhatsApp and Messenger are added, it has 3.14 billion active users, two-fifths of the world’s population.
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https://onlinelibrary.wiley.com/doi/10.1111/imj.14945
Utilisation of the Australian government initiative MyHealth Record to support the clinical approach to factitious disorder
David R. Alchin Kristen Overton Duncan George Michael Murphy Anne P. F. Wand
First published: 06 August 2020
https://doi.org/10.1111/imj.14945
Abstract
Recently, the Australian Digital Health Agency launched MyHealth Record to the public. As of July 2019, 90.1% of Australians hold records with this service, allowing 16 400 health organisations access to >28 million clinical documents. The streamlining of patient data was intended to facilitate sharing of information and improve communication between medical providers, while promoting efficiency in clinical practice. We have identified a hitherto unrecognised application of this infrastructure in the identification and management of factitious disorder, a rare yet highly diagnostically challenging condition involving intentional feigning of illness, which presents a significant resource burden to the Australian health system.
The Australian government's roll‐out of the national electronic medical records database, MyHealth Record (MHR), was recently completed. The Australian Digital Health Agency (ADHA) reports 90.1% of Australians are active with this service, and as of July 2019, 16 400 health organisations have linked into MHR, enabling access to >28 000 000 clinical documents.1 The aim of MHR is to streamline the collection, storage and sharing of patient information, in order to avoid problems that occur when there is a breakdown in clinical communication.2 Adoption of this database may facilitate an individual clinician's understanding of the role and opinions of other providers who have been involved in a patient's care, while not replacing clinical handover where possible.3 Continuity of care is emphasised: ultimately the imperative is to improve overall clinical standards within Australian healthcare. However, given the infancy of this new health infrastructure the full benefits are likely yet to be realised. In this paper, the potential utility of MHR to improve the management of factitious disorder (FD) is discussed, an important function not previously specified by the ADHA nor reported in prior literature.
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https://www.ddwmphn.com.au/upcoming-events/free-digital-health-webinar
FREE Digital Health webinar
Want some stability to your delivery of patient-centered care? ADHA Propaganda
With a dash of digital health knowledge and by integrating My Health Record into your daily practice, you'll be set on the right path to glory.
Well, what are the chances... The Australian Primary Health Care Nurses Association (APNA) and the Australian Digital Health Agency are launching a monthly webinar series that will help you use My Health Record to its full potential.
The upcoming webinars will be on the following dates:
- 3 September 2020
- 1 October 2020
- 5 November 2020
- 3 December 2020
Start
12:30pm,
Thursday 3rd September 2020
Finish
12:30pm
Thursday 3rd December 2020
Where
Online - Via Zoom
Organiser
The Australian Primary
Health Care Nurses Association (APNA)
CPD
Points Available?
No
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http://medicalrepublic.com.au/myhealth-up-for-sale-hot-on-healiuss-heels/32993
12 August 2020
MyHealth up for sale, hot on Healius’s heels
General practice Insurance KnowCents Telehealth
Following the sale of Healius’s GP centre business to BGH Capital for $500 million, Crescent Capital, another local PE player, is seeking to offload its majority stake in the MyHealth Medical Group for a price that would value the group at $300m-plus.
The sale has likely been prompted by the price that BGH paid for Healius, which some analysts have suggested is at the higher end of the value spectrum, and the possibility that BGH itself might be interested in bidding, in a roll-up play that would create the largest general practice corporate in the country – knocking long time number one IPN off that perch.
Other rumoured bidders are one or two of our larger private health insurance providers, one of whom apparently ran the pencil over Healius recently when it was up for sale. If that occurred then the value of general practice assets across the country would likely continue to grow as other private insurers would need to consider their competitive position.
Two reasons BGH might be happy to keep paying a premium and do a roll-up is the transformational effect that looks apparent in the rollout of telehealth more universally across primary care, combined with agile and highly efficient distributed cloud-based practice management software, which is starting to gain traction in the market. The most recent boost to this trend has been COVID-19, which has put a lot of pressure on general practice services to be far more mobile and nimble.
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Software Developer
Community Announcement
Electronic Prescribing
Technical Framework Documents
The Australian Digital Health Agency has released an update to the technical framework information to support software vendors implement electronic prescribing. This updates the technical framework documents released on 5th June 2020.
This update includes changes to the
- Electronic Prescribing - Participating Software Conformance Profile document, and
- Electronic Prescribing - Conformance Test Specifications.
Changes to the Electronic Prescribing - Participating Software Conformance Profile v2.2.1 includes the following important revisions:
- Minor change to DS-22.
- Strikethrough applied to MI-4.
- No changes have been made to Prescribing, Dispensing, or Mobile Application conformance requirements. Prescribe, dispense and mobile developers working in accordance with previous version Electronic Prescribing - Participating Software Conformance Profile v2.2 are not impacted.
Changes to the Electronic Prescribing - Conformance Test Specifications includes the following important revisions:
- Conformance Test Specifications -
Test Cases - PDS
As per changes to the Conformance Profile (version 2.2.1).
Reflects a modification of the requirement for specific error messaging. - Conformance Test Specification -
Test Cases - Prescribe
Reflects a modification of the requirement for specific error messaging. - Conformance Test Specification -
Test Cases - Dispense
Reflects a modification of the requirement for specific error messaging. - Conformance Test Specification -
Test Cases - Mobile Intermediary
As per changes to the Conformance Profile (version 2.2.1).
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TikTok caught in privacy breach
12 August, 2020
TikTok skirted a privacy safeguard in Google’s Android operating system to collect unique identifiers from millions of mobile devices, data that allows the app to track users online without allowing them to opt out, a Wall Street Journal analysis has found.
The tactic, which experts in mobile-phone security said was concealed through an unusual added layer of encryption, appears to have violated Google policies limiting how apps track people and wasn’t disclosed to TikTok users. TikTok ended the practice in November, the Journal’s testing showed.
The findings come at a time when TikTok’s Beijing-based parent company, ByteDance Ltd., is under pressure from the White House over concerns that data collected by the app could be used to help the Chinese government track US government employees or contractors. TikTok has said it doesn’t share data with the Chinese government and wouldn’t do so if asked.
The identifiers collected by TikTok, called MAC addresses, are most commonly used for advertising purposes. The White House has said it is worried that users’ data could be obtained by the Chinese government and used to build detailed dossiers on individuals for blackmail or espionage.
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Forward Slash podcast: ‘Framework would fill gap’ in AI ethics
The Australian Human Rights Commission is investigating the implications of artificial intelligence as a matter of priority, with commissioner Edward Santow saying Australia should be taking a lead role when it comes to preventing unethical use of our data.
The HRC is busy preparing a landmark report into human rights and technology, to be released by the end of the year, following criticisms that tech companies rely on algorithms that are inherently biased, and entrench inequalities.
“New technology like AI can threaten human rights in really profound ways,” Mr Santow told The Australian for the latest episode of its Forward Slash podcast.
“We want to be very clear-eyed about what those risks are, so we can address them and truly grasp the opportunities that new technology brings, without having side effects. This major project on human rights and technology will be the biggest thing that I do in my term as Human Rights Commissioner.”
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Managing an insidious side effect of a typical digital hospital’s growth pains
August 10, 2020
A serious collateral complication of the eclectic nature of how we are building digital capability in Australian hospitals is the waste, confusion and fatigue that care teams can encounter as a result of the burgeoning sources of patient data and alarm systems in the ward.
The emergence of digital systems in Australian hospitals has, for the most part, followed an eclectic and fraught path over the past two decades. State by state, different major electronic health record (EHR) and patient administration systems (PAS) vendors have fought hard for the major public hospital contracts, but depending on size, legacy systems, state funding and state by state strategy and organisation, the introduction of digital capability into Australian hospitals has tended to be plagued by implementation issues, key among them integration to legacy systems.
Now, another issue is emerging as the base systems are surrounded by other bedside data generation from systems such as physiological monitors, ventilators, IV pumps, dialysis, nurse call and real-time care team location services.
One of the promises of a modern digital hospital set up is the simultaneous management of multiple patients with multiple data points, on many integrated and co-ordinated devices.
…..
A Wild Health webinar from 3pm to 4pm AEST August 27
REGISTER for FREE HERE and also receive the *Spyglass Whitepaper on Trends in Patient Data and Alarm Management.
Administration queries on the webinar can be directed to talia@medicalrepublic.com.au.
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http://medicalrepublic.com.au/telehealth-a-rocket-ship-without-seat-belts/32922
11 August 2020
Telehealth – a rocket ship without seat belts?
Everything happened so fast. One minute, Medicare-rebated telehealth was a distant dream and the next it was March 2020 and phone and video consults were being rolled out in a matter of days all around the country, fully funded by government.
Between March and the end of June, seven million MBS-funded telehealth consultations were conducted in Australia.
Jeremy Forrester, the principal consultant at IT4GP – an IT service provider for GP clinics – and the CIO at digital GP clinic Qoctor, says his company has never been busier.
As the lockdown hit, GPs were quickly pushing through a suite of IT changes to make telehealth and remote working possible.
With so many GP clinics enacting the same changes at the same time, the demand on IT and software service providers spiked, causing delays at helpdesks and frustrated customers, says Mr Forrester.
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MEDIA RELEASE
11 August 2020
Real-time GP data could be key to COVID pandemic management
A
new project is underway to build a real-time reporting system that shows where
and how COVID-19 is impacting Australia’s health system, based on de-identified
data from 500 general practices across NSW and Victoria.
The Digital Health Cooperative Research Centre (CRC) project is a collaboration
between three Primary Health Networks (PHNs) in Victoria (Eastern Melbourne,
Gippsland and South Eastern Melbourne) along with Macquarie University, Outcome
Health and the Royal College of Pathologists of Australasia (Quality Assurance
Programs).
“In this project we’ll use real time data to guide our decision-making,” says
Dr Elizabeth Deveny, the CEO of South Eastern Melbourne PHN.
“COVID-19 has shown us how fast things can change in a health environment,” she
says.
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Time for digital reform as Covid-19 accelerates change in our lives
Andy Penn and Tim Reed
From telehealth to working from home, virtual meetings to online shopping, digital payments to online learning, COVID-19 is changing our lives and accelerating Australia’s shift to a digital economy.
The pace of change has been dramatic. Out of necessity we have taken more steps in the past few months than in the past five years toward establishing a vibrant digital economy in this country. Importantly we now know what’s possible and we now know the benefits, as businesses, governments and the broader community embrace digital tools, possibilities and opportunities.
What is critical now is that as a nation we continue to build on this momentum to drive connectivity, productivity and efficiency and — importantly — create a new wave of much-needed employment.
There has never been a more important time for Australia to focus on bringing a digital future to life — paperless, cashless and virtual — so we can come out of COVID-19 stronger and more capable as a nation. But realising and maximising the opportunity will mean ensuring all parts of our economy and society are well equipped to transition to a digital economy, particularly small-to-medium enterprises.
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Silicon Valley should fear Trump's tech aggression
By James Titcomb
August 11, 2020 — 7.05am
On the face of it, few companies have more to gain from Donald Trump's increasingly hostile attitude towards Chinese technology companies than Facebook. TikTok, the video app that the president has promised to ban if it remains owned by China's ByteDance, is possibly the biggest challenge to Facebook's social media hegemony. If a TikTok-shaped hole emerges in the market, it is most likely to be filled by Facebook-owned Instagram, which launched a near-clone of TikTok last week.
Mark Zuckerberg has done plenty to help stoke anti-TikTok sentiment. In a speech about internet censorship last year, he name-checked the app as an example of a Chinese approach to the internet that was "focused on very different values" to the West.
Zuckerberg's warning was designed more to ward off regulators threatening to weaken Facebook than to encourage them to ban TikTok, but it is certainly possible that the social network's powerful lobbying operation has played a hand in the White House's recent threat to ban the Chinese-owned app, as well as the Chinese messaging service WeChat.
Last week, Trump signed an executive order prohibiting American companies from doing business with TikTok's parent company ByteDance within 45 days. If carried through, this would cut off business from US advertisers, and more importantly, force Apple and Google to remove it from their App Stores. In effect, it would constitute a ban on the app unless Microsoft successfully negotiates an acquisition of TikTok.
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No tears for China, but let's not pretend Microsoft's TikTok deal is fine
The diplomatic goal regarding Chinese technology has to be about changing its bad conduct, rather than having the US adopt the same anti-competitive bully tactics.
Paul Smith Technology editor
Aug 11, 2020 – 12.00am
It is perhaps the debilitating effects of living in 2020 and the subsequent numbing towards shocking headlines, but it seems odd how the extraordinary moves by the US towards matching China's stance on technology competition is being normalised.
The gradually unfolding car crash in ad hoc policy making and internet balkanisation will not be simply undone, even if US President Donald Trump is booted out of office in November.
The US President has been talking tough on China for a long time, which perhaps explains why there was less amazement at the executive orders signed on Friday to ban social network TikTok and all-encompassing mega-app WeChat (owned by Tencent.) But in the context of the broader evolution of the tech world, this is a hugely damaging episode.
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https://www.afr.com/policy/economy/accc-code-will-test-big-tech-s-news-value-20200810-p55k57
ACCC code will test big tech's news value
The ACCC's mandatory code will test if big tech firms can recognise the respective value of both the generation and the distribution of news and information.
Aug 11, 2020 – 12.00am
Competition regulators in Spain, Europe and Australia have concluded that the dominance of tech giants such as Google and Facebook over the digital pipes and conduits of the online world give them market power that warrants regulatory correction.
In important respects, they have become digital utilities similar to electricity wire or water pipe companies. Similar thinking was on display at US Congressional hearings last month that further roped in Amazon and Apple.
Australian Consumer and Competition Commission chairman Rod Sims says that correcting the imbalance in negotiating power is the core purpose of the commission’s world first mandatory code between the giant global tech platforms and the mostly-local Australian media companies.
The important policy issue is that the otherwise beneficial reduction in the costs of distributing information has undercut the value and business model of news-gathering professional journalism, polarised the nature of public debate and undermined the foundations of a well-informed and lively democracy.
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We have no strategy for tackling the dark side of digital
The federal government's cyber plan is long on action but short on any organising principles. This is alarming.
Lesley Seebeck Contributor
Aug 11, 2020 – 12.00am
Last week’s release of the government’s latest Cyber Security Strategy shows just what a difficult area this is for policymakers. Officials in the Department of Home Affairs had been tasked to prepare a strategy addressing a phenomenon that affects every facet of Australian society, economy and national security – and to do so at a time when our dependency on digital technologies is increasing sharply. The tasking, moreover, comes from a government with a preference for action over theory.
Doing good strategy is hard. It requires a clear vision of our preferred outcome, a sound assessment of likely threats, a frank appreciation of our own capability and the resources available to counter those threats and grasp opportunities, an organising principle to guide actions and priorities, and an identifiable point of leverage that will allow us to maximise our gains and minimise our losses.
By that standard, the government’s Cyber Security Strategy 2020, doesn’t contain much strategy. It’s more like a set of guidelines for co-operation between government, business and the community.
It’s a good example of how modern policy consultation – focus groups in the larger capitals in 2019, a session with subject matter experts in early 2020, and through an expert industry group, also this year – muddies thinking and messaging.
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Reimagining healthcare in Australia:
The role of digital in future health delivery
PANEL
- Kulleni Gebreyes – Partner, Deloitte US
- Brendan Murphy – Secretary, Department of Health
- Leanne Wells – Chief Executive Officer, Consumer Health Forum
- Steve Hambleton - former State and Federal President, Australian Medical Association
SYNOPSIS
There
is no question that we’ve seen a rapid acceleration of Australia’s virtual care
capacity as a result of the COVID-19 global pandemic. However, there are
a myriad of questions relating to the role of virtual health in Australia and
how we ensure that the capability meets the ultimate aspiration for this model
in the future.
Join our expert panel as we explore fundamental considerations including:
- What the path from telehealth to virtual care looks like and how we best navigate it
- The pace we need to deliver scale and value to ensure it remains viable
- How we increase value through a hybrid virtual care model
- Whether we are ready for this hybrid care model and if everyone, from clinicians to patients, actually want it
WHEN
Thursday 10th September, 9am - 10am AEST
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https://www.itnews.com.au/news/accc-sides-with-banks-in-screen-scraping-warning-war-551529
ACCC sides with banks in screen scraping warning war
By Justin Hendry on Aug 10, 2020 5:15PM
Says warnings aren’t anti-competitive, despite fintech claims.
Australia’s competition watchdog has sided with the major banks over accusations that warning customers against using third-party fintech apps and other services that employ screen scraping constitutes an abuse of market power.
In answers to questions on notice from the senate fintech inquiry, the Australian Competition and Consumer Commission said it had decided not to open an investigation into the warnings after receiving complaints from two unnamed financial players.
The ACCC received the complaints of “anti-competitive conduct relating to the issue of banks warning their customers about screen scraping” in March after the banks appeared before a hearing of inquiry.
“The alleged conduct relates to major banks warning their customers about the security and safety dangers of screen scraping, such as the risks associated with providing sensitive information, for example passwords, to third parties,” it said.
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FREE WEBINAR
Tele-trials:
Thursday 20 August
(6-7.30pm AEST)
Tele-trials offer an
innovative way to enhance, improve and extend clinical trials and potentially
overcome disparities, enable access to new treatments and improve patient
outcomes.
In this webinar, our esteemed panelists will discuss:
- How tele-trials have transformed clinical trials and the rapid advances made due to COVID-19
- Ways tele-trials can improve access to healthcare for rural, remote and regional communities, and vulnerable groups such as Culturally and Linguistically Diverse (CaLD) and Aboriginal and Torres Strait Islander populations
- What education or other supports are necessary to assist the clinical trials sector to more broadly embrace tele-trials and other digital health technologies
- Anticipated benefits of tele-trials including workforce development opportunities and cost advantages
- Potential barriers, best practice guidelines, patient perspectives, international adoption and future directions.
This
webinar is proudly brought to you by DHCRC, Curtin University and La Trobe
University.
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High stakes in news media code clash between ACCC and Google, Facebook
In some ways the ACCC’s draft code of conduct on Google and Facebook would act like an import tariff, protecting employment in a local industry from imports.
The difference is that the money would flow direct to the local businesses, not the government, and would be paid for something in return – that is, summaries and links to news stories – not simply a tax that evens up prices.
What makes it a little bit like a tax is the poison pill provision in the bill that makes the process virtually compulsory for Google and Facebook, which I failed to take into account when I wrote about this last week.
Section 5 of the draft bill says the digital platforms can’t discriminate between news businesses, registered or not, “in relation to crawling, indexing, ranking, displaying or presenting … news content”.
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http://medicalrepublic.com.au/griping-few-shouldnt-rain-on-e-scripts-parade/32786
10 August 2020
Griping few shouldn’t rain on e-scripts’ parade
Success in national digital health programs is rare. It should be celebrated in these gloomy times.
The prescience of Health Minister Greg Hunt in funding e-prescriptions in the 2018 Budget was remarkable. It enabled the health software industry to create foundations for seamless access to medications by consumers in the pandemic.
So what about the reports of confusion over e-prescribing. Is it a real concern? Or is it a small gripe in what is an exemplary collaboration between the health software industry, peak bodies Medical Software Industry Association, PGA, ACRRM PSA, RACGP and the commonwealth and state governments?
In ordinary times, software deployments roll out beta sites to settle inevitable user and environmental issues. That was the plan. But these are extraordinary times – just like the bushfire period in December, when pharmacies and dispensing software companies worked with their peak bodies the PGA and MSIA over Christmas to enable continuous dispensing in just a week for bushfire victims. Not ideal, but necessary. And it worked.
This should be all about patients. The fact patients are demonstrating clear desire to get connected to paperless prescriptions vindicates the e-prescribing program. We are all more than capable of stepping up to the expectation. It hasn’t exactly been sprung upon us. Stakeholders including consumers, the RACGP, AMA, PGA, PSA and the MSIA have been in workshops facilitated by the Australian Digital Health Agency since January 2019. Its hard to understand the claim of “widespread confusion” over contradictory statements. We have all been in this together.
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Comments more than welcome!
David.
1 comment:
This is an interesting article.
"Utilisation of the Australian government initiative MyHealth Record to support the clinical approach to factitious disorder"
https://onlinelibrary.wiley.com/doi/10.1111/imj.14945
The authors obviously have expertise in factitious disorder and I have no doubt it is a serious but rare problem, however their statements about MHR are so far from reality that it brings into question the value of the paper.
According to the abstract
"We have identified a hitherto unrecognised application of this infrastructure in the identification and management of factitious disorder, a rare yet highly diagnostically challenging condition involving intentional feigning of illness, which presents a significant resource burden to the Australian health system."
In other words, the patient games the system
The article makes the statement:
"Diagnosing FD is often only possible through systematically sourcing collateral information and scrutinising any available medical records. Unless suspicious clinicians invest considerable time to confirm objectively or discredit reported conditions while investigating new symptoms, the diagnosis will be missed. The rollout of MHR presents a solution through facilitating a centralised record of medications, investigations, specialist referrals, discharge summaries and medical history, regardless of where patients present."
The most obvious reason MYHR is an unsuitable source of clinical data for the diagnosis of FD is that the patient has the ability to delete every document in the system other than a few, one of which is the Shared Health Summary - which can only come from one GP.
Even if the patient doesn't delete documents in their MHY, then they can easily prevent many, if not all, getting into it. Even more likely, they may decide not to have one in the first place or they can delete the whole thing if they've got one.
As the paper says "In this paper, the potential utility of MHR to improve the management of factitious disorder (FD) is discussed, an important function not previously specified by the ADHA nor reported in prior literature."
There's a good reason for that - its capability cannot support this function.
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