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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 any 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, and found interesting.
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https://www.nejm.org/doi/full/10.1056/NEJMp2213873
A Step toward Interoperability of Health IT
David Blumenthal, M.D., M.P.P.
December 10, 2022 DOI: 10.1056/NEJMp2213873
Although virtually all patient information is now recorded electronically, the persistent inability to move this information easily from place to place has remained a major frustration for patients, clinicians, and policymakers in the United States. It wasn’t supposed to be this way.
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which used incentives and penalties to spur rapid adoption of electronic health records (EHRs), also envisioned private and secure health information exchange for the country.1 Robust exchange of patient data has the potential to improve the quality of care and support efforts to hold key actors accountable for its costs.
But technical and economic obstacles have prevented the realization of this vision. Now, by adopting a regulation that went into full effect on October 6, 2022, the federal government has taken a potentially important step toward effective exchange of health information. The regulation was issued by the Office of the National Coordinator for Health Information Technology (ONC), an agency within the federal Department of Health and Human Services (HHS), which is implementing provisions of the 21st Century Cures Act.2 Enacted in 2016, the Cures Act was intended to address both the technical and economic barriers to health information exchange.
The technical obstacles come in two forms. First, it has proven complex and costly to connect the many EHRs that providers have adopted. Second, there was a lack of consensus regarding the full set of standards for defining and communicating about clinical terms in patients’ records. Implementing such standards would ensure that terms have the same definitions in software used in various records, so that the records present exchanged information to EHR users in a meaningful way.
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https://www.innovationaus.com/the-blindspot-in-australias-approach-to-privacy-reform/
The blindspot in Australia’s approach to privacy reform
Jordan
Wilson-Otto
Contributor
10 December 2022
After the horrific and upsetting breaches involving Optus, Medibank and others, the federal government acted swiftly, dramatically bolstering our privacy regime. The penalties facing Australian businesses that infringe our privacy – in the order of $50 million or 30 percent of turnover in a given period – are arguably now among the heaviest in the world.
But despite the boost to the penalties, there remains a major flaw in our approach to privacy that we must act fast to correct.
December 10 is Human Rights Day, which marks the day that the Universal Declaration of Human Rights was adopted by the United Nations General Assembly in 1948. It’s the perfect time to remind ourselves that privacy is one of the human rights articulated in that declaration. Yet the way we frame privacy in public policy and reform discussions in Australia is too frequently not grounded in this truth.
The primary driver for privacy reform in Australia in recent years has been the Digital Platforms Inquiry, conducted by the Australian Competition and Consumer Commission (ACCC) and which concluded in 2019. It’s this inquiry that recommended the recent penalty hike, the review of the Privacy Act that is currently underway, the introduction of an online privacy code for social media platforms, and a range of other privacy and data-related reforms.
A fundamental premise of the inquiry, and of the ACCC, is that privacy laws are important because they support and enable competition and consumer protection objectives. The idea goes that by empowering consumers to make informed choices about how their data is processed, we can correct bargaining power imbalances and information asymmetries and so increase competition and encourage innovation.
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https://digitalhealth.org.au/blog/ceih-chias-graduate/
CEIH CHIAs graduate
Dec 5, 2022 | AIDH news, CHIA, Member news, Membership
Over the past three years, the Commission on Excellence and Innovation in Health (CEIH) have supported staff from across the state to complete the Certified Health Informatician Australasia (CHIA) certification. Last week on 30 November, CEIH facilitated a graduation and networking event at the Flinders University at Victoria Square campus for all of the CHIA graduates. This meant that graduates could finally and officially be recognised for the work they had done, even the 2020 group sponsored study group who were not able to celebrate their achievements due to pandemic restrictions.
Out of the over 150 CEIH and SA Health sponsored CHIA graduates, almost one-third were able to attend the event.
Formal proceedings were opened by Tina Hardin (Executive Director, Clinical Informatics and Innovation, CEIH), who discussed how CEIH is investing in CHIAs as future thought leaders in the health excellence and innovation space. Dr Angie Abdel Shafei (Director of Healthcare Management at Flinders University) welcomed CEIH and the CHIA graduates to the Flinders University Victoria Square campus and gave an overview of study opportunities in 2023. Mark Brommeyer (Senior Lecturer in Health Care Management, Flinders University and CHIA examination board member) wrapped up formal proceedings with an inspiring speech on how as informaticians, CHIAs can reduce the gaps between existing healthcare practices and set collective goals for improved healthcare quality.
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Brisbane crypto exchange collapses, suspends 30,000 accounts
December 9, 2022 — 3.26pm
Brisbane-based cryptocurrency exchange Digital Surge has collapsed into administration, suspending more than 30,000 user accounts after it was caught up in the downfall of troubled international exchange FTX.
Administrators at KordaMentha were appointed to the business on Thursday. Customers at the exchange have been unable to access their funds for the past two weeks, with the company saying in late November it was suspending accounts.
This was due to the business holding “a portion” of its assets – Australian dollars and crypto – on FTX to facilitate trades. FTX spectacularly collapsed last month after it was revealed the company did not have sufficient client funds.
In a statement, KordaMentha administrator Scott Langdon said Digital Surge had entered into administration to protect the interest of customers and creditors, praising the co-operation of the business’s directors.
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Andy Penn names the nation’s biggest emerging cyber threat
Lucas Baird Reporter
Dec 9, 2022 – 1.20pm
Hostile countries are hunting for ways to breach widely used computer programs and technologies, posting what they find to the dark web so that cybercriminals can cripple major corporations and hurt rival economies.
That’s according to former Telstra chief executive Andy Penn, who is chairing an expert cybersecurity board appointed by Prime Minister Anthony Albanese.
The board, which also includes Air Marshal Mel Hupfeld and Cyber Security Co-operative Research Centre chief Rachael Falk, was appointed on Thursday and has been tasked with developing a new federal cybersecurity strategy for 2030.
Mr Penn told AFR Weekend that geopolitical tensions were at a level not seen since the Cold War, and that companies must take responsibility for their own cyber risks.
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https://www.lexology.com/library/detail.aspx?g=82c9c7df-5efd-4f52-a7d2-cd8b1a8e88ce
What to expect from upcoming electronic surveillance reform in Australia
Corrs Chambers Westgarth Philip Catania, Matthew Lee and Jonathan Bean
Australia December 6 2022
The Australian Government will soon release an exposure draft for the proposed reforms of Australia’s electronic surveillance regime. The proposed reforms are intended to harmonise existing laws to provide a unified governance framework, cater for technological changes and expand the range of government agencies which may exercise electronic surveillance powers.
The electronic surveillance powers of government agencies are spread across four separate acts (Acts), which are subject to inconsistent thresholds and requirements. Some of the current laws, which were drafted based on technological assumptions and definitions dating back to the 1970s, are struggling to keep up with rapid technological advancements. The Government released a discussion paper in December 2021 highlighting these items, and is expected to issue an exposure draft of the proposed electronic surveillance legislation for public comment in late 2022.
Below, we discuss the key changes proposed in the discussion paper and industry responses which may shape the upcoming legislation.
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Gov sets target to make Australia "most cyber secure country" by 2030
By Ry Crozier on Dec 8, 2022 1:50PM
Unveils details of cyber strategy rebuild.
Australia has set a target to become “the most cyber secure country in the world by 2030”, and will use a reworked national cyber security strategy as the vehicle to enable that.
Minister for Home Affairs Clare O’Neil unveiled the ambition at a National Press Club address on Thursday.
The government had flagged plans to recast the cyber security strategy back in August, but details at the time had been scant.
O’Neil indicated it would be less of a recast and more of a completely “new cyber security strategy for Australia.”
“The cyber security strategy will help Australia bring the whole nation into the fight to help protect our citizens and to protect our economy,” she said.
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https://www.innovationaus.com/new-cyber-strategy-to-consider-data-localisation-rules-oneil/
New cyber strategy to consider data localisation rules: O’Neil
Brandon
How
Reporter
8 December 2022
Home Affairs and Cybersecurity minister Clare O’Neil is considering local data storage requirements in Australia to improve the security of sensitive data, as the government begins work on a new cybersecurity strategy.
Following her address to the National Press Club on Thursday, Ms O’Neil described data localisation as “really important” and said that it is “absolutely untrue” that data can be held equally safe wherever it is located.
“Data localisation is going to very much be a feature of the discussion that the cyber strategy has, and indeed the work of the National Resilience Taskforce does,” she told InnovationAus.com.
“We have existed for a long time in the benign belief that wherever data is located it can be equally held safe and I think anyone who kind of pays vague attention to these matters knows today that that is absolutely untrue, so it’s part of the work with my department.”
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Medibank to go offline as it completes cybersecurity overhaul after Russian attack
By JARED LYNCH
12:01AM December 8, 2022
Medibank will shut down its IT systems – also closing its retail stores and customer contact centre – this weekend to complete an overhaul of its online security as it reels from the nation’s biggest cyber heist.
Medibank, Australia’s biggest health insurer, will turn itself offline from 8.30pm on Friday until Sunday to “further strengthen our systems and enhance security protections”. Cybersecurity experts from Microsoft’s Asia Pacific operations will oversee the upgrade at Medibank’s headquarters in Melbourne.
It comes after Russian hackers infiltrated Medibank’s customer database, which contained the personal information and health records of almost 10 million current and former policyholders, after buying a high-level logon from an online criminal forum.
After Medibank refused to pay a $15m ransom, the hackers published the data online under folders with names relating to abortion, drug and alcohol abuse and various mental health disorders on the dark web.
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Data collection legal minefield for elite sport
By JAMIE WALKER
9:00PM December 6, 2022
Elite athletes could own and demand payment for their performance data, creating a legal minefield in Australian sport leading into the 2032 Brisbane Olympics.
The scenario is outlined in a report by the CSIRO and Australian Sports Commission on the megatrends that will shape the way Australians play and compete over the coming decade.
The study, released on Wednesday, explores “new ways of thinking” about the growing volume of digital information athletes generate while training and competing, especially at the peak levels of international and professional sport.
Wearable devices amass data on location, heart rate, diurnal patterns and sleep cycles, while more sophisticated patches and strips can collect sensitive personal information on hormone levels, menstrual cycles and blood sugars, all in order to boost performance, the report finds.
This wealth of information would be useful to health insurers, medical researchers, advertisers, sports betting services, gaming companies and sports talents scouts, the report says.
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In brief: digital healthcare in Australia
Clayton Utz Colin Loveday, Greg Williams, Ken Saurajen, Mihkel Wilding and Sheena McKie
Australia December 6 2022
Data protection, privacy and digitisation in healthcare
Digitisation
What are the legal developments regarding digitisation in the healthcare sector and industrial networks or sales channels?
Developing the opportunities presented by the digital enablement of healthcare services has been an ongoing policy priority in Australia in recent years. In 2018, the Australian Digital Health Agency released the National Digital Health Strategy, outlining its strategic direction for digital health in Australia from 2018 to 2022. The report outlined that by 2022:
- all Australians will be able to have a personally controlled digital summary of their health information, which can be accessed by those individuals and their healthcare providers (called a ‘My Health Record’);
- healthcare providers will be able to contribute to and use health information in the My Health Record on behalf of their patients; and
- all Australians will be able to access their information at any time online and through mobile applications.
At the time of writing, the rollout of the My Health Record system in Australia has been mostly successful, despite the fact that the overall use of the platform by Australians (including Australian healthcare providers) remains low, as reflected in the Australian Digital Health Agency's Annual Report 2020-2021.
Security and confidentiality safeguards received particular focus in industry discussions surrounding the introduction of the My Health Record system. Like various other industries, the healthcare sector annually reports on data breaches stemming from malicious cyberattacks. Amendments were made to the Security of Critical Infrastructure Act 2018 (Cth) in both 2021 and 2022 which affect the healthcare sector and its digitisation, including affording the government certain interventionist powers to respond to serious cybersecurity incidents that impact upon the ability of Australia's critical infrastructure assets to deliver essential services.
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Cybersecurity and patient safety: why we need to do better
By Lani Refiti, ANZ Regional Director, Claroty
Wednesday, 30 November, 2022
In February 2021, with the COVID-19 pandemic raging, the Australian Cyber Security Centre (ACSC) issued its 2020 Health Sector Snapshot, saying, “COVID-19 has fundamentally changed the cyber threat landscape for the health sector, with malicious actors increasingly targeting and compromising health networks, which are already under pressure in a pandemic operating environment.”
Taking into account the chronic understaffing currently affecting Australian hospitals, it has never been more essential for health providers to ensure their networks are protected from malicious cyber actors who wish to disrupt essential services or compromise business-critical systems to profit from ransom.
The healthcare sector is not alone among critical organisations experiencing ransomware attacks. According to Claroty’s report, The Global State of Industrial Cybersecurity 2021: Resilience Amid Disruption, 80% of critical infrastructure organisations worldwide experienced a ransomware attack during the year.
Any attack on critical infrastructure can result in public disruption or even life-threatening consequences, but healthcare organisations are particularly vulnerable. A vital life-saving procedure might be delayed, monitoring equipment might fail to report a change in vital signs or transport of a seriously ill patient might be disrupted.
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https://www.afr.com/technology/blockchains-what-are-they-good-for-20221206-p5c441
Blockchains: What’s the point of them, really?
Why go to the trouble and expense of maintaining a ledger in many places to then carry it around every time a transaction takes place?
Paul Krugman
Dec 6, 2022 – 2.13pm
A year ago bitcoin and other cryptocurrencies were selling at record prices, with a combined market value of around $US3 trillion ($4.5 trillion); glossy ads featuring celebrities – most infamously Matt Damon’s “Fortune Favours the Brave” – filled the airwaves. Politicians, including, alas, the mayor of New York, raced to align themselves with what seemed to be the coming thing.
Since then, the prices of crypto assets have plunged, while a growing number of crypto institutions have collapsed amid allegations of scandal. The implosion of FTX, which appears to have used depositors’ money in an attempt to prop up a related trading firm, has made the most headlines, but it’s only one entry on a growing list.
We are, many people say, going through a “crypto winter.” But that may understate the case. This is looking more and more like Fimbulwinter, the endless winter that, in Norse mythology, precedes the end of the world – in this case the crypto world, not just cryptocurrencies but the whole idea of organising economic life around the famous “blockchain.”
And the real question, it seems to me, is why so many people – not just naive small investors, but also major financial and business players – bought into the belief that this bad idea was the wave of the future.
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https://www.lexology.com/library/detail.aspx?g=a9ca343d-ddd7-4869-8808-83affcef7da0
Australia's massive new privacy penalties become law, but will be clarified
Ashurst John Macpherson, Tim Brookes, Amanda Ludlow, Geoff McGrath and Andrew Hilton
Australia December 2 2022
The Australian Government will look at clarifying key aspects of new penalties as part of its broader privacy review
What you need to know
- Australia has passed legislation to introduce massive new privacy penalties – maximum penalties can now reach the greater of A$50m, three times the benefit of a contravention, or (where the benefit can't be determined) 30% of domestic turnover.
- New powers will make the privacy regulator better able to investigate, coordinate with other regulators, keep the public informed, and assess privacy compliance. New information-gathering powers include a power to issue an infringement notice for a failure to provide information when required, with associated civil penalties and a criminal offence for systemic conduct or a pattern of behaviour resulting in multiple failures to comply.
- Australian privacy laws will apply to organisations doing business in Australia whether or not personal information is collected in Australia. This creates significant uncertainty about how Australia's privacy laws will apply to multi-national businesses, and will impact business and data governance structures.
- These reforms are only the first tranche of a comprehensive review of Australia's privacy laws for the digital era. The final report on the review will be delivered to the Government by the end of this year.
- While we don't know when this report will be made public, issues raised by Senate committees provide pointers to likely areas of focus. Expect further clarification on how the massive new penalties will apply.
What you need to do
- Invest where it matters and be risk-informed – New penalties arrive in the context of ongoing cyber-security and tech skill shortages, technology budgets that are already stretched, expectations of a global economic slowdown and increasingly aggressive cyber threats. Organisations will need to make tough risk-informed investment decisions to appropriately prioritise security, resilience and harm reduction.
- Paper-based compliance is a thing of the past – With massive new penalties and public accountability, organisations must actively manage privacy risks. This means having a detailed understanding of personal information dataflows through a corporation or company group, and undertaking Privacy Impact Assessments and audits to identify and mitigate privacy risks.
- Invest in harm reduction – Cyber defence and resilience is only part of the puzzle – take steps to minimise the risk of harm in the event of a successful cyberattack by minimising the collection and retention of personal information, particularly more sensitive information that could put individuals at risk. This should be an ongoing focus – continue to test what data needs to be collected and retained, and investigate digital identity verification and privacy enhancing technologies.
- Understand and plan for financial exposure – Include the new penalties in organisational risk management strategies to help calibrate and reset the business case for cyber and privacy spend.
- Revisit regulator engagement in incident response plans – Clarify information flows and decision-making protocols. Make sure you have the processes in place to assess and provide timely and accurate responses to requests for information from regulators.
- Understand and address disclosure risks – Understand whether disclosures to regulators might breach confidentiality obligations to suppliers, customers and partners. Information required to be provided under law will have different consequences from that provided voluntarily. Consider negotiating changes to key contracts to allow greater transparency.
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GPs in the dark over visits to hospital
3:32PM December 5, 2022
Patients who are discharged from hospital are often left with incomplete diagnoses and no ongoing treatment as a result of a lack of handover plans with GPs, who are calling for greater co-ordination of care.
A study analysing data held in NSW Health’s Lumos program, which tracks millions of patients’ trajectories through the health system, shows that patients who are promptly followed up by their GP after a hospital admission are much less likely to need to return to hospital.
But doctors say patients are left with instructions to make their own appointments with their GP and are often not seen within the required five days after discharged because their doctors often have no idea they have been in hospital.
“There is often real gaps in care between the handover from a hospital back into the community,” said Royal Australian College of General Practitioners NSW chair Charlotte Hespe, who recently presented the research at the college’s annual conference.
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AI safeguards needed to prevent discrimination: Aus Human Rights Commission
By Athina Mallis on Dec 1, 2022 11:08AM
Artificial intelligence (AI) enhances workflows and creates better decision-making in an organisation, but there needs to be safeguards in place to prevent potential discrimination, according to the Australian Human Rights Commission (AHRC)
The AHRC together with the Actuaries Institute released a guidance resource designed to help actuaries and insurers to comply with the federal anti-discrimination legislation when AI is used in pricing or underwriting insurance products.
The guidance was developed after a 2021 report by the AHRC that looked at the human rights impacts of new and emerging technologies, including AI-informed decision-making.
One of the recommendations of that report was that a set of guidelines be developed for use by government and non-government organisations on complying with federal anti-discrimination laws when AI has been used in decision making.
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https://www.itnews.com.au/news/medlab-pathology-faces-questions-over-data-breach-timeline-588757
Medlab Pathology faces questions over data breach timeline
By Staff Writer on Dec 6, 2022 6:40AM
As OAIC launches investigation.
Medlab Pathology has joined Optus and Medibank in being formally investigated by the Office of the Australian Information Commissioner (OAIC) over a data breach.
The company disclosed a cyber incident in late October that had occurred at the start of 2022.
Breached data included pathology test results, credit card numbers with individuals’ names, and Medicare card numbers with individuals’ names.
The OAIC said in a statement that it would investigate Medlab’s protection of personal information and its compliance with Australian privacy principles.
The provider could face civil penalties of up to $2.2 million per contravention, if the OAIC determined it had sufficient evidence to file federal court proceedings.
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ASX CHESS project showed ‘hubris’, was a ‘profound failure’
James Eyers Senior Reporter
Updated Dec 5, 2022 – 1.29pm, first published at 1.26pm
The ASX will be hit with more intense regulatory supervision to ensure it invests in the existing settlement and clearing system after its plan to rebuild it collapsed last month, ASIC chairman Joe Longo said.
Australia’s top corporate cop said the failure had “significantly shaken” confidence in ASX’s ability to manage technology projects
“This is an extraordinary example of hubris on the part of ASX,” Mr Longo told the parliamentary joint committee on corporations and financial services in Sydney on Monday.
He called on the Albanese government to provide regulators – the Australian Securities and Investments Commission, Reserve Bank of Australia and the competition regulator – with new legislative powers to direct the ASX to improve governance, or to intervene around pricing, as flagged by The Australian Financial Review last week.
The failed project to replace CHESS has triggered a $250 million write-down at ASX and similar losses across the rest of the market.
Mr Longo said ASIC and the RBA want detail from ASX on how it plans to compensate custodians, registries and brokers who invested in good faith to connect to the new system.
Because it would now take between five and eight years for a new CHESS system to be created, Mr Longo said ASIC and the RBA wanted to “verify” commitments by ASX it will invest in the existing system, which arranges payment and transfers ownership for $5 billion of equities traded each day.
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Cyber risk in data honeypots from health insurance app craze: ACCC
By Jared Lynch
6:13PM December 4, 2022
Health insurers are creating big honeypots of customer data via rewards schemes and wellness apps, heightening the risk of another Medibank-style cyber attack, Australia’s consumer watchdog warns.
Smartphone apps and customer reward programs have proliferated in Australia’s health insurance industry as funds seek to offer more value to attract and retain policyholders.
Such strategies have been used for years by Australia’s big retailers – Myer One, Woolworths Everyday Rewards and Qantas Frequent Flyer, for example – to gain greater insights into customer behaviour and bolster revenue, including through target marketing.
But the Australian Competition & Consumer Commission has warned health insurers that they must be “alive to the highly sensitive nature of the personal information they may be collecting and using”, particularly in the wake of the Medibank attack – Australia’s biggest cyber heist.
The regulator also warns that data harvested from wellness apps and rewards schemes could be used for other purposes – including health funds sharing or selling it to third parties.
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Government to scrutinise media laws as NZ forces Google, Meta to bargain
By Zoe Samios and Jessica Yun
December 5, 2022 — 5.00am
Communications Minister Michelle Rowland has conceded parts of Australia’s landmark news media bargaining laws are “lacking” as multicultural broadcaster SBS publicly demanded a crackdown against Meta for its failure to strike commercial deals with smaller publishers.
In New Zealand, the Ardern government has revealed its own plans to introduce laws that will force tech giants Google and Meta into negotiations for use of news content in the country, after smaller outlets became concerned they were unable to strike commercial agreements with the digital giants. The move has been described by Meta as a failure to understand the way its relationships with publishers work.
Australia’s news media bargaining code was introduced last year in an effort to force Google and Facebook to pay eligible large and small news publishers to display articles in the search engine and “newsfeed”. It was introduced after the competition regulator found there was an imbalance of bargaining power between media companies and digital platforms.
Its introduction led to millions of dollars worth of deals between the digital giants and media companies including Nine Entertainment Co, owner of this masthead, News Corp Australia, publisher of The Australian and Herald Sun, the ABC and Guardian Australia.
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https://medicalrepublic.com.au/gps-hospitals-sharing-data-in-real-time-in-act/82709
5 December 2022
GPs, hospitals sharing data in real time in ACT
Is Canberra’s new EHR the first step in the quest for interoperability?
GPs can now update patient hospital records in an Australian first as ACT Health trials an Epic digital health record transformation.
The trial has made Canberra “the most digitally advanced” jurisdiction in Australia according to Mallory Heinzeroth, Epic’s project head for the Canberra project.
“GPs can now review the real-time record for a patient, update the allergies, medications and problem list. They can place electronic referrals, monitor their status as well as write notes about care provided,” Ms Heinzeroth said.
Although GPs were excited about these features, let’s not mistake the Epic product as being interoperable. The Digital Health Record Link (DHR Link) is a cloud-based application powered by Epic’s Health Planet Link software. GPs will be credentialed to access a specific, consented subset of their patients records and will log in via an authentication spine including multiple-factor identification.
Michelle O’Brien, digital health consultant, said it was a step towards interoperability but it still did not create a single point of truth for a patient’s health records.
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https://medicalrepublic.com.au/gps-can-squeeze-value-from-health-data/82715
5 December 2022
GPs can squeeze value from health data
Health data should be shared and used to make savings in primary care, according to recommendations from last month’s RACGP crisis summit in Canberra.
The RACGP has called for policies that support GPs’ collecting and sharing of health data in a white paper based on the college’s October crisis summit, while also outlining measures recommended by summit attendees and designed to rescue general practice.
“[A data] strategy should clearly articulate the key purpose and enablers for data collection, linkage and use in general practice, as well as the value and importance of general practice data to the practice and to their patients,” the college said in the white paper, released during the RACGP’s GP22 conference in Melbourne.
“GPs and their patients need to be aware of how their data, including patient records, are being used and for what purpose.”
The strategy should include the following principles, according to the paper:
- Shared data from general practice should be used for service planning, resource allocation, quality improvement and research.
- Shared data from general practice must not be used for disciplining or penalising general practice.
- GPs must be recognised partners in the governance of data collection and usage activities, including research and evaluation, from design to delivery.
- General practice data are owned by general practices and GPs. These data have value, and the ownership of these data by GPs needs to be addressed in its use. Data should be used to demonstrate outcomes and value so that savings can be invested back into primary care.
- Protection of data is critical to address privacy and security concerns. Data should be de-identified but able to be linked regionally. It should be able to be re-identified back at the practice to facilitate support for individual patients.
- Transparent and ethical frameworks should guide the capture and sharing of general practice data and highlight the uses of data captured in general practice.
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https://insightplus.mja.com.au/2022/47/artificial-intelligence-fights-for-acceptance-in-health-care/
Artificial intelligence fights for acceptance in health care
Roshan Karri
Mark Plummer
EARLY in the COVID-19 pandemic, progressive respiratory failure developed in approximately 5% of unvaccinated adults with COVID-19, typically one week after the onset of coryzal symptoms (here and here).
Worldwide, almost two-thirds of patients admitted to intensive care with respiratory failure secondary to severe COVID-19 in 2020 required invasive mechanical ventilation. Requirement for mechanical ventilation carries a high mortality rate and is both labour and resource intensive, so identifying cohorts at high risk for mechanical ventilation is a priority. From a patient perspective, delaying an inevitable intubation increases the risk of sudden respiratory arrest, and unplanned airway management increases the risk of staff infection.
Conversely, avoiding intubation where possible decreases the risk from intubation itself and the sequelae of mechanical ventilation, including ventilator-induced lung injury, nosocomial infection, pressure injuries, and thrombosis. Accordingly, developing tools to accurately predict patients at risk of deteriorating is a priority.
The Short Period Incidence Study of Severe Acute Respiratory Infections (SPRINT-SARI) Australia registry has been prospectively collecting comprehensive data on critically ill patients with COVID-19 admitted to Australian intensive care units (ICUs) from February 2020. Through careful oversight and standardised collection protocols, the strength of the database lies in its consistency and reliability, applied throughout more than 50 hospitals nationwide. Additionally, the data collected are highly granular, including more than 100 demographic, clinical, and laboratory findings per patient-stay.
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https://insightplus.mja.com.au/2022/47/safety-and-quality-in-primary-care-whither-goest/
Safety and quality in primary care: whither goest?
Jillann Farmer
“The fundamental problem … in the overall approach to primary care interventions is that they have focused on individual entities – doctors and their prescribing, pharmacists and their dispensing, private hospitals and their medication management. However, nobody has yet bitten off the enormous challenge of the highest risk part of all of it: the interfaces between all of those elements, and the things that can go wrong when patients move between independent providers who are not working from common datasets.”
A FEW weeks ago, I received a discharge notification letter and medication list for a patient discharged from a private hospital. The medication list was issued by the hospital pharmacy and indicated two changes to medications that had occurred during her admission. The discharge notification letter was prepared by the nursing staff of the hospital.
The pharmacy documented that the patient’s telmisartan 40 mg daily had been ceased, and they should take candesartan 8 mg daily. I pulled up their medical record and made the appropriate changes, thinking little more of it, noting that they had an appointment a couple of weeks out.
About two weeks later, a letter from the specialist arrived written after a post-discharge review. It did not specifically document changes to medication, so I did not undertake a medication reconciliation. I failed to remember that changes had been advised by the pharmacy.
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David.
7 comments:
The MJA article on AI by Karri & Plummer refers to an item from Macquarie that concludes
As practices diversify into new revenue streams through collocation of specialists, allied health practitioners and referral businesses such as pharmacies and pathologists, they have a burning need for a unified and secure patient platform on which to collaborate. Such a system speeds patients through the medical practice, cuts human error from multiple data entry and inconsistent record tagging, and saves money through efficiencies. A single view of the patient helps physicians and their support staff to spend more quality time with patients and waste less time on low-value administrative tasks.
Financial systems have learnt that the security of data on their customers depends on not being part of a unified platform. If the day comes when somebody, say, a healthcare insurer, builds a system designed to ease the journeys of their clients through healthcare while allowing patients free read-only access to those records, then a high price will be levied to ensure their system's security.
The MSIA have released the following “drop the mic”
Mic drop on 2022! This has just been published by the Medical Journal of Australia: "[H]ealth systems are now shifting from perceiving digital health as a cost that needs to be recouped to a quality improvement tool that can positively transform health care. This is because large‐scale digital health implementations, such as electronic medical records (EMRs), provide significant quality and safety benefits, including:
– reduced unwarranted variation in care;
– reduced preventable harm;
– improved patient centredness; and
– enhanced opportunities for monitoring, risk management, and quality improvement."
Digital health systems are developed with patients and clinicians front of mind.
That's because this industry is populated by good people creating good technologies for a good purpose.
@6:49AM There you go David, so now you know. The Medical Software Industry Association have hit back.
Looks as though the claim "[H]ealth systems are now shifting from perceiving digital health as a cost that needs to be recouped" has not been proven and/or accepted, so the programmers are having to make some other unjustified claims.
If any of the digital health systems were of actual value, users would be flocking to them. I Haven't seen much evidence of that having happened.
@10:32 AM The My Health Record perfectly fits your observation.
> If any of the digital health systems were of actual value, users would be flocking to them. I Haven't seen much evidence of that having
in real life, of course, there's all sorts of systems for there is actual value for someone, but the users are not flocking to them. There are digital health systems of real value, and users are flocking to them (not in this country so much). There are also digital health systems of negative value that users are flocking to as well. As well as digital health systems of value that no one wants to use... all combinations exist. It's just really hard to tell which is which prospectively
They say there are two types of software - the one everyone complains about and the one no one uses. It is true some really are a bit rubbish but the newer generation are improving. A lot of legacy are reflective of technology reality of their day.
Promotional material is what it is, I am not sure it is fair to ask industry to portrait themselves in a different light
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