Friday, March 18, 2022

I Wonder What Power Crazed Bureaucrat Thought This Was A Good Idea?

This appeared last week:

‘Absolute authority’: Call to halt plan to collect all Victorians’ medical records

By David Estcourt and Rachel Eddie

March 11, 2022 — 5.00am

The Law Institute of Victoria has asked the Andrews government to withdraw a bill, which would centralise the medical records of every patient in the public health system, over privacy concerns and because patients cannot opt out of the scheme.

The Health Legislation Amendment (Information Sharing) Bill, which is likely to pass into law in the upper house in coming months, aims to improve health outcomes by electronically sharing patient data across public hospitals and services through a central database.

The existing framework only allows providers to share information internally, leading to medical errors, delays and inefficiencies.

Under the plan, patients would have no ability to opt-in or out of the new database before it launches in February next year. Insurance companies will not have access to the database.

The Law Institute of Victoria wants the government to withdraw the bill and engage in greater consultation with industry over privacy concerns and the inability of patients to control their recorded medical history.

“It confers absolute authority over medical information to the health profession. There’s nothing in this bill that prevents health information that’s not appropriate bring handed over to the treating doctors,” said health law committee member Bill O’Shea.

The state government believes the database will complement and support My Health Record – the national system for sharing health information between hospitals, GPs and pharmacies, introduced in 2018 – and bring the state into line with NSW and Queensland.

About 2.5 million people withdrew from the My Health Record when it moved to an opt-out system following public outcry.

Chief executive of the Health Issues Centre consumer advocacy group, Danny Vadasz, shared Mr O’Shea’s concerns that patients would not have the right to opt out of the proposed new framework, particularly people with a mental health diagnosis or those who are HIV positive.

“These are people who could be subject to either conscious or unconscious bias and discrimination in seeking medical care for what could be a completely unrelated issue ... what’s accessible could prejudice the way in which they’re treated,” Mr Vadasz said.

The database was a recommendation of an independent report commissioned by the government in 2015 following a series of baby deaths at the Djerriwarrh Health Services’ Bacchus Marsh Hospital.

Victoria’s medical community has argued there are persuasive health benefits to the proposed model.

Lots more here:

https://www.smh.com.au/national/victoria/absolute-authority-call-to-halt-plan-to-collect-all-victorians-medical-records-20220309-p5a33m.html

To me this is vast bureaucratic overreach. Especially given that there is little to no evidence that systems of this sort actually make a difference! (Am happy to be updated if things have changed.)

Three key issues - excluding technical, security and data protection issues.

1. The individual can’t opt out.

2. The individual appears not the be able to review, delete or correct information held in the system.

3. Any health provider can access the system without demonstrating a clinical need apparently.

This all goes way further than the #myHealthRecord where the individual can opt out and also selectively protect sensitive information for them if they wish.

Until these issues are sorted this legislation should not pass I believe. Right now it is a bloody outrage!!!

David.

 

6 comments:

  1. Dr Ian ColcloughMarch 19, 2022 9:15 AM

    "The database was the recommendation of an independent report ... "

    The bureaucracy unquestioningly embraced the recommendation, thereby giving it a life and energy of it's own.

    This is a classic example of how such projects begin and grow out of control to the point of being politically too big to be allowed to fail.

    The same 'evolution' occured with My Health Record. The 'independent recommendation' was accepted willy-nilly!

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  2. When bureaucrats commission external consultants to write a strategy report, by definition, they (the bureaucrats) don't have the competency to understand the full nature of the subject or the potential and real consequences of their subsequent decisions and actions.

    Neither do they realise their own incompetence.

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  3. "When bureaucrats commission external consultants to write a strategy report, by definition, they (the bureaucrats) don't have the competency to understand the full nature of the subject or the potential and real consequences of their subsequent decisions and actions.

    Neither do they realise their own incompetence."

    That is what is known as the Dunning-Kruger effect: https://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect

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  4. I don't think you're right Oliver. The bureaucrats do appreciate their limited competence that's why they retain consultants to advise and recommend. That's not Dunning-Kruger.

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  5. "... that's why they retain consultants to advise and recommend"

    The trouble is the bureaucrats don't understand the advice or the recommendations or, even more importantly, how to implement the decisions they make.

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  6. Given the general behaviour of the Victorian Government (The most openly totalitarian, but all are guilty) you would have to conclude that they knew exactly what they were doing and while they are probably clueless about how to achieve it technically, they are after a means of surveillance. My Health record achieves nothing of any great use clinically but achieves much the same, except for the opt out clause which makes it less useful to government, they fixed that here. Its been apparent to me that the clinical functionality of these systems is at the bottom of the list, rather than the top. For individual care high quality accurate data that is reliable to use for reasoning is essential. For surveillance slight flagging errors are not an issue. This week my phone notifications told me I have a new bill for $xxx due on this date and that was inside a pdf attachment to a gmail account. It seems pdf surveillance is already deployed widely!

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