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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’s pretty sad!
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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https://wolandscat.net/2022/05/15/a-lingua-franca-for-e-health-takes-shape-with-graphitehealth/
A Lingua Franca for e-health takes shape with GraphiteHealth
Colleagues in e-health often say to me: why don’t you make openEHR easier to map to <insert popular interop standard> (used to be HL7v3, then HL7 CDA, now, HL7 FHIR… DSTU2/3/4/5?).
To which I usually reply: if you are implying there is any easy way to connect to today’s favourite message formalism, there’s not, there are only moderately difficult ways – which is why no-one has an automatic converter.
There are at least two reasons for this:
- easy mappings are not available because the industry refuses to agree on the principle of a single source of clinical models, and the necessary underlying terminologies and ontologies; instead standards organisations publish standards frameworks and downstream profiling efforts (HL7 FHIR profilers Argonaut, DaVinci etc) create their own standards from them (‘profiling’ = creating a new standard) and we are back to non-interoperability;
- the main incumbent e-health standards body (HL7) is still working on the basis of manually defined message (aka ‘resource’) content, to which all systems must map, in order to obey the standard. However, today, systems have their own models – and major paradigms e.g. patient-centric EHR – which are different and usually better than the lowest common denominator standard, so this forced mapping is just a cost. NB: other industries don’t use the manual message approach; they agree models instead, and systems just serialise their data in and out of them.
While these two conditions remain true in e-health, the only ‘easy’ thing you can do is obey today’s message standards, and limit your interoperability to about 5% of the content richness inside your systems.
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https://www.innovationaus.com/no-privacy-reform-commitments-from-major-parties/
No privacy reform commitments from major parties
Brandon
How
Reporter
20 May 2022
The Coalition is uncommitted to privacy reform and Labor remains silent despite broad support from independents and minor parties, according to the Australian Privacy Foundation.
Updated on Thursday, the Australian Privacy Foundation’s (APF) election scorecard indicated support for its recommended privacy priorities. The group invited 100 political parties and independent candidates to express whether they supported the APFs privacy priorities released in April.
Included in the privacy priorities are six legislative amendments aimed at bringing privacy protection under Australian law “into the 21st century and up to the standard of peer developed countries”. This includes removing exemptions under the Privacy Act for employee records, registered political parties and political ‘acts and practices’, and journalism, aside from reports on public officials in the performance of their duties.
APF chair David Vaile said that a majority of the minor parties supported all the priorities, but many responses lacked an explanation. However, he praised South Australian Senator Rex Patrick for committing to introduce legislation to amend the Privacy Act 1988 to properly safeguard sensitive voter information” if re-elected and calling on the major political parties to “end their exemption from national privacy safeguards”.
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‘Substantial gaps’ in Meta’s Australian election policies: Reset Australia
Denham
Sadler
National Affairs Editor
19 May 2022
Meta’s public statements and efforts around election integrity on its platform in Australia have been “inadequate and incomplete”, and systemic regulation is needed on the issue, according to Reset Australia, after the US tech giant revealed it won’t offer all the same protections in Australia as it did for the American presidential election.
Tech reform advocacy group Reset Australia sent an open letter to Facebook parent company Meta in early May, with 24 questions on federal election integrity. Four days later, Meta Australia head of public policy Josh Machin responded in a public blog.
But this response still left many unanswered questions, Reset Australia’s Dhakshayini Sooriyakumaran said, and showed that the company is not taking this issue seriously enough.
“We appreciate that Meta took the time to respond to our letter, as the public deserves much more detail and depth than what was provided in their initial March 2022 blog post about their election preparation,” Ms Sooriyakumaran told InnovationAus.com.
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Accessibility and workforce priorities to unlock potential of precision health
May 16, 2022 | Advocacy, Genomics, InGeNA, Publications
The power of genomics has been embraced by Australians and precision health is here to stay.
The community has become increasingly engaged with genomics during the public health response to COVID-19. As contact tracing, variants and sequencing have become household words, many more Australians are aware of the important role genomics has played during the pandemic.
In its election statement, Genomics and precision medicine in Australia: Priorities for an incoming government, InGeNA says the incoming government has the opportunity to build on Australia’s growing genomics expertise and enable consumers to benefit from the new age of precision health.
Precision health, underpinned by the field of genomics, is relevant today to all Australians regardless of where they live.
Precision health can ensure that people reach the right diagnostic test and receive the right treatment at the right time, reducing the diagnostic odyssey experienced by many patients.
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https://chf.org.au/publications/consumer-explainer-what-does-digital-health-interoperability-mean
Consumer explainer - what does digital health interoperability mean?
In December 2021 CHF provided a submission in response to a consultation by the Australian Digital Health Agency on the National Digital Healthcare Interoperability Plan. It soon became clear that many were not sure what interoperability meant and why it was important in the context of the health system.
Interoperability has to do with the way computer software systems can connect and communicate with each other. In healthcare, it is the ability of different information technology systems and software applications (programs) to communicate, exchange data and use the relevant health information provided. In basic terms, it means creating a connected health system
In all CHF’s research on consumer experiences with new digital health innovations, a constant theme is dissatisfaction with the lack of sharing of, or ability to access a patient’s relevant health information by providers as they move across the health system, often in different care settings. For those people who have multiple healthcare providers, this causes real frustration, and indeed, concerns around quality and safety of care. Consumers consistently find it perplexing and frustrating that at each encounter with a provider they must repeat their health story repeatedly.
Many of the health care events experienced by consumers occur in a range of different settings; general practice, hospitals, Emergency (EDs), and specialists for example. When we realise that each setting may use different computer software that doesn’t talk to other computer software, the value of ensuring they can talk to each other becomes clear. The benefits of creating a truly connected health system where a patient’s providers have access to all relevant patient health information for decision making and can share information with other providers on relevant history, diagnosis, treatments, pathology and diagnostic imaging tests, are immense.
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-https://wildhealth.net.au/indigenous-health-spotlight-can-tech-help-unlock-better-care-everywhere/
18 May 2022
Indigenous health spotlight: Can tech help unlock better care everywhere?
Sponsored
Just as the pandemic has accelerated digital transformation and technology, it’s doing the same for health equity in the ANZ region. While COVID-19 has devastated many lives, it’s also provided a policy window to intervene in the social determinants (the non-medical factors that influence health outcomes) of health equity.
For the first time, policies that were considered unthinkable pre-COVID were introduced almost overnight as society dealt with the unprecedented effects of a global pandemic. The government provided financial support that enabled communities to have sufficient resources in a time of great uncertainty.
Yet despite this step in the right direction, the ANZ region still has a long way to go in fully addressing the social causes of health inequity.
So the question then is, how can innovative thinking and digital health solutions help health care become more equitable and inclusive, in order to achieve better health outcomes for all?
In a recent Wolters Kluwer webinar, Better Care Everywhere: Enhancing Health Equity Across ANZ, an expert panel discussed the region’s dire health equity problem. They delved into the challenges, shared insights, and determined ways innovation could be leveraged to cut the bias.
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https://wildhealth.net.au/dementia-app-research-reveals-big-gaps-for-the-market/
20 May 2022
Dementia app research reveals big gaps for the market
Poor UX (user experience), short-term players and lack of content regulation – the dementia app marketplace has some serious gaps. With 250 people diagnosed with dementia each day in Australia, it’s an area ripe for development for product managers who can implement human-centred design.
In this episode of the Wild Health podcast, CSIRO researcher Georgina Chelberg shares her research on the dementia app market. She points out the weaknesses and opportunities for smart-phone tools that serve people with dementia and their families.
“There is significant opportunity for quality digital innovations, including apps, to support home-based, independent dementia care,” Ms Chelberg said.
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https://wildhealth.net.au/forget-submarines-defence-dives-deep-on-digital-health/
20 May 2022
Forget submarines, Defence dives deep on digital health
The Department of Defence has started work on a digital health system for our entire defence force that looks like it would make a pretty neat blueprint for the future of interoperability in Australian healthcare.
Last week the Department of Defence (DoD) finally gave its blessing to letting the public officially know about a healthcare project that is very big: JP2060 phase 4 (they should probably come up with a sexier name), a $299 million health knowledge management system that, if developed as specified, should be a blueprint for how healthcare interoperability could one day work in Australia.
It’s not as big as a fleet of nuclear subs, sure – $116 billion by the time one hits the water in 20 years or so, ouch – but in the context of Australian healthcare, and in particular the idea of an interoperable system that seamlessly shares data between all points of a healthcare system compass (tertiary, primary, allied, pharmacy, even dental), it is very big and interesting.
A few key points around the project:
- More than 95% of work will be delivered by Australian industry, including seven locally owned and operated medical software groups, with the centrepiece being a system originally developed as a ground-up cloud system for GPs in Australia: MediRecords.
- The system will be both entirely cloud based, linking every point of care from primary to dental to allied and hospital, but able to operate offline functionally when needed (as you probably are going to need at some point in defence).
- The solution being developed will help in the everyday management of ADF personnel within and without Australia – 85,000 personnel, including 58 primary care clinics – but will also be deployed at point of injury through the evacuation chain to rehabilitation and recovery.
- The solution will record, store, aggregate and analyse health data for the entire ADF population, unifying primary and occupational care with emergency and hospital care data in a manner that Australian governments have only aspired to thus far as far as broader population health management is concerned
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AI to help diagnose whether COVID patient will suffer severe effects
By Stuart Layt
May 19, 2022 — 8.17pm
Researchers hope to develop a simple blood test to check whether people will develop severe symptoms of COVID-19 by combining traditional genetic research with cutting-edge machine learning.
Professor Sudha Rao, a group leader at QIMR Berghofer’s Gene Regulation and Translational Medicine Laboratory, has been awarded a $250,000 fellowship to develop her work using epigenetics to determine a person’s risk of developing severe COVID-19 symptoms.
Epigenetics is a study of how environmental factors change how a person’s genes express themselves, and Rao believes it could be at the heart of why some people get severely affected by COVID-19 and others do not.
“What I and my lab have done is we think we know which epigenetic biomarkers to look for, they haven’t been identified previously,” she said.
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‘Significant weaknesses’: Report exposes major flaws in Western Australia’s contact tracing system
NCA NewsWire
May 19, 2022
Western Australia’s Covid-19 contact tracing system is plagued with “significant weaknesses” that put people’s highly sensitive personal and medical information at risk, a damning report has found.
As of March 2022, WA Health’s Public Health Covid-19 Unified System (PHOCUS) held information about 128,600 Covid-positive people, 41,400 close and casual contacts and 50,400 travellers.
Although no data leak was found, there was no way to detect “inappropriate changes or snooping”.
“I expected to find robust access controls for such sensitive medical and personal information, however we found a number of significant weaknesses,” Auditor-General Caroline Spencer said in her report tabled in parliament.
“WA Health has provided an external vendor with unnecessary system access, and it did not adequately log and monitor who had accessed information to detect inappropriate changes or snooping.”
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https://www.itnews.com.au/news/wa-health-criticised-over-covid-19-data-management-580213
WA Health criticised over Covid-19 data management
By Richard Chirgwin on May 19, 2022 11:50AM
Audit finds insufficient protections in PHOCOS.
Western Australia’s auditor-general has criticised lax protection of personal data collected as part of the state’s response to the Covid-19 pandemic.
Caroline Spencer said in a statement (PDF) WA Health’s Public Health COVID Unified System (PHOCOS) “contains some of the most sensitive and consequential data” the state has collected in the last two years.
In the report (PDF), Spencer wrote that “WA Health does not adequately log and monitor who has accessed information to detect inappropriate changes or snooping, and has provided an external vendor with inappropriate access to personal and medical information.”
She was also critical of the public information offered by WA Health.
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Sydney start-up Vantari VR signs partnerships with hospitals to use virtual training to erase errors
May 19, 2022
The future of healthcare is virtual – student doctors and nurses who practise treating patients in virtual reality modules have been found to reduce medical errors as much as 40 per cent, according to research.
In the study, conducted by the University of Wollongong in partnership with Vantari VR, about four dozen students conducted arterial blood gas collection. Of those students, 25 were given training with Vantari VR’s Arterial Blood Gas insertion module, and 19 were not.
Those who received training were found to perform as much as 32 per cent better than students without training, were 39 per cent more likely to adhere to safety and hygiene standards, and made 40 per cent less errors.
In the study, university staff monitored the students completing procedures on virtual patients using a cloud-based platform called Vantari Connect.
Heading up the project was lead researcher Shiva Pedram, from the university’s SMART Infrastructure Facility.
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https://www.itnews.com.au/news/australias-id-systems-deficient-unfit-for-online-review-580179
Australia's ID systems 'deficient', unfit for online: review
By Justin Hendry on May 19, 2022 7:05AM
Exclusive: Report urges greater use of biometrics, face verification.
Identity verification in Australia needs an overhaul to make better use of biometrics, according to an independent review the government has kept secret for three years.
The formerly secret review also recommends the government make its facial verification system available to the private sector.
Commissioned in 2018, the review was led by former Attorney-General's Department secretary Roger Wilkins and IDCARE managing director David Lacey. It was handed to the government in 2019, but never released.
iTnews has now obtained the review under freedom of information laws, and can now reveal the findings and 26 recommendations it contains, which remain under consideration by the Department of Home Affairs.
The full PDF of the review can be viewed here.
According to a spokesperson from the department, the review is one of many sources informing its “work on identity protection and resilience, and the lawful, ethical and appropriate use of biometrics”.
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Bupa, Cabrini Health partner for at-home hospital care
Wednesday, 18 May, 2022
Cabrini Health and Bupa have formed a strategic partnership to expand new models of care services, as part of an extension of their contract.
The contract and partnership will see Bupa fund part of Cabrini’s innovative alternative models of care with a focus on care in the home, while also ensuring Bupa customers will be covered with no additional out-of-pocket hospital costs from Cabrini.
Cabrini Health Chief Executive Officer Sue Williams said, “We’ve been developing new models of care for some time now, and this partnership with Bupa recognises our innovation in home care and support, following a hospital admission.”
Bupa Health Insurance Managing Director Chris Carroll said the partnership was an example of providers and funders working collaboratively with a ‘patient first’ mindset.
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Allergies & Adverse Reactions and Medicines Information
Available Medicines Information
This page contains information on:
- What is the 'Medicines Information’ view?;
- What is contained in the Allergies & Adverse Reactions table?;
- What is contained in the Medicines Preview table?; and
- Why are only the most recent Shared Health Summary and Discharge Summary displayed?
What is the ‘Medicines Information’ view?
This view provides an overview of medicines, allergies and adverse reaction information available in a patient’s My Health Record at the point in time the view is accessed.
Medicines related information in the view is sourced from the following documents (if they are present in the patient’s record):
- The most recent Shared Health Summary
- The most recent Discharge Summary
- Event Summaries, Specialist Letters and eReferrals since the most recent Shared Health Summary
- 2 years of the most recent Pharmaceutical Benefits Scheme, Prescription and Dispense information
- The patient’s Personal Health Summary
What is contained in the Allergies & Adverse Reactions table?
Information in the Allergies & Adverse Reactions table is sourced from all documents in the patient’s My Health Record. It includes:
- the most recent instance of each allergy or adverse reaction described in clinician-authored documents; and
- any additional allergies or adverse reactions described in the patient’s Personal Health Summary.
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There’s only one party that has a plan for digital assets: Andrew Bragg
9:54PM May 16, 2022
After five week of election campaigning, it may be that voters have become fatigued by the relentless grind of news and discussion, having heard a great deal about the choices they face on national security and on the economy.
So it is easy to lose sight of the fact that there are still fundamental differences between the Coalition and Labor. The Liberal Party supports the individual, their ability to make their own decisions, to be treated fairly, and to engage in private enterprise.
By contrast, members of the ALP pledge support for “the democratic socialisation of industry, production, distribution and exchange”. Disagreements between MPs are only permissible behind closed doors. Crossing the floor of parliament leads to expulsion.
This is why the Coalition has a policy for cryptocurrency or digital assets, and the ALP does not. Digital assets embed the rights of ownership on blockchain. This has the potential to create a market which is transparent, trustless and decentralised.
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It is time to reinvest in quality improvement collaboratives to support Australian general practice
Andrew W Knight, John Fraser and C Dimity Pond
Med J Aust
2022; 216 (9): 438-440. || doi: 10.5694/mja2.51502
Published online: 16 May 2022
Supporting improved general practice is urgent, and quality improvement collaboratives are an effective Australian strategy
Australia faces serious challenges to the effectiveness and sustainability of its health system, including barriers to access, rising costs, chronic disease rates, an ageing population, and overstretched hospitals.1,2 High quality primary care is recognised to underpin effective and efficient health systems.2,3,4 The coronavirus disease 2019 (COVID‐19) pandemic has starkly illuminated the problems and demonstrated the importance of supporting general practice for health care delivery in Australia.
Australian general practice is among the highest quality in the world.2,5 However, significant stresses have emerged: professional isolation and fragmentation of care persist, and relative funding cuts over many years have constrained the capacity for change and driven inequity of access.2 Multiple reviews of primary care have culminated in the impending finalisation of the Primary Health Care 10 Year Plan.6 The final consultation draft of the plan presents a vision of digitally enabled, person‐centred and integrated primary care. Embedding continuous quality improvement in general practice is seen as essential to the future needs of the health system. Quality improvement collaboratives, useful in the past, may be an important future strategy.
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https://www.lexology.com/library/detail.aspx?g=ba98fbc5-c760-4ffc-b0c5-246f1edf1c91
Reference to "medical reasons" breached obligations to keep health information private
Australia May 12 2022
The circumstances of a use or disclosure on the relevant individual need to be considered when determining if there has been a breach of the Health Privacy Principles or other privacy principles.
The intersection of Health Privacy Principles (HPPs) and the functions of a public body has been explored in a recent decision in the NSW Civil and Administrative Tribunal, demonstrating the potentially broad application of the HPPs to practical scenarios.
In EIG v North Sydney Council [2022] NSWCATAD 127, the Council had received health information from an individual serving in a public role, and had to make an assessment on whether to disclose this in performing the functions of the Council. Its decision led to a breach of HPPs 4 and 11 under the Health Records and Information Privacy Act 2002 (NSW) (HRIP Act).
The HRIP Act applies both to NSW public sector agencies and private sector organisations in relation to the collection, storage, use and disclosure of a person's “health information”. The HRIP Act is similar, but applies in addition to, the obligations applying to NSW public sector agencies (as applicable) under the Privacy and Personal Information Protection Act 1998 (NSW) (PPIP Act) and private sector organisations under the Privacy Act 1988 (Cth); there are similar Health Privacy Principles in Victoria and the Australian Capital Territory.
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David.
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