Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, April 15, 2019

Weekly Australian Health IT Links – 15th April, 2019.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

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Again a sadly quiet week with even the Senate Estimates being pretty boring.
Again the NBN is in lots of news – there must be an election coming
One bit of fun was the MJA Supplement mentioned earlier in last week which has largely been exposed as a paid ‘puff piece’ from the ADHA. I wonder why money is spent when there is not much to say?
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Fresh woes for Northern Beaches Hospital as IT system fails to launch due to 'unacceptable errors'

By Carrie Fellner
April 8, 2019 — 8.29pm
"Unexpected" failures have delayed the launch of a new IT system that would allow Northern Beaches Hospital to electronically share vital patient information with other hospitals in the local health district.
It's the latest in a litany of problems for the troubled 488-bed hospital, which opened at Frenchs Forest last November.
The Health Information Exchange will allow the private operator of the Northern Beaches Hospital to access previous medical records from across the health district, including from Manly and Mona Vale hospitals.
But the chief executive of the Northern Sydney Local Health District, Deb Willcox, told a board meeting in February that the system had been unable to be released after testing encountered "unacceptable errors and omissions" in the data.
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Drop the phone: Millions turn to the internet to book GP appointments

By Hamish Hastie
April 8, 2019 — 2.26pm
It’s dinnertime, the kids are sick, runny-nosed and screaming at the top of their lungs.
They need to see a doctor tomorrow but it's after hours, and there is small hope of hearing anyone on the other end of the phone, with that racket going on in the background.
More than two million GP appointments are booked each week in Australia, according to the Royal Australian College of GPs, and situations such as the one above are turning patients and parents to the internet in droves to get the bookings done.
Despite reports of tampering with patient reviews, and concerns over how it used patient data, the nation’s biggest online GP booking site Healthengine revealed more than 9 million appointments were booked in 2018 – a 35 per cent increase compared to 2017.
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Payment system stopping GPs doing digital consults

  • 1:00AM April 8, 2019
Australians want doctors to increase their use of digital technology to save time and money but medical professionals are resisting the push because archaic payment systems don’t reimburse them for the effort.
A new health report out today by EY showed that of the doctors surveyed, 51 per cent acknowledged that video consults would produce better and more efficient patient outcomes, and two in five admitted that managing patients virtually in real-time would increase productivity. Despite that, 76 per cent of doctors have no plans to introduce technologies that would enable virtual visits.
“The doctors see it could result in better outcomes, but like all of us, they need to be paid for it,” EY Oceania health leader Jenny Parker said. “The Medicare system needs to be re-imagined to see that digital health technology and the delivery of that is a vital part of healthcare in Australia.”
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Prescription monitoring is here, but we need to tread carefully to avoid unintended harms

April 11, 2019 6.11am AEST
A new prescription monitoring program in Victoria aims to identify people using prescription medicines unsafely. 
Author:  Suzanne Nielsen
Associate Professor and Deputy Director, Monash Addiction Research Centre, Monash University
Drug-related deaths in Australia have almost doubled over the past ten years, in large part because of the increased use of opioids. In 2016, middle aged people using combinations of prescription drugs were the most likely to die a drug-related death.
Prescription monitoring aims to tackle this issue by allowing health professionals who are prescribing or dispensing high-risk medicines to see a patient’s prescription history.
This may help a doctor to make decisions about a patient’s care, or a pharmacist to decide if they should dispense certain medicines to a patient; with the aim of reducing harm.
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Here’s how St John of God Health Care embarked on digital transformation

Hafizah Osman | 08 Apr 2019
St John of God Health Care (SJGHC) has delivered on its five-year redevelopment plan, having placed investments in intelligent infrastructure and technology to meet the growing needs of healthcare. 
SJGHC has 24 facilities and more than 3400 beds across New South Wales, Victoria and Western Australia, and provides a range of medical, surgical, maternity, rehabilitation and mental health services.
Together with a collection of digital health companies, the organisation has also been involved in the build of a high-tech house for people with intellectual disabilities.
Leading the transformation of SJGHC’s Western Australia operations for more than four years was former WA Executive Director John Fogarty, who told HITNA that the organisation started off on its digital implementation work in 2014.  
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ADHA seeking feedback for National Health Interoperability Roadmap

It will also facilitate over 50 digital health community conversations in the coming months about digital technology's role in health care.
By Campbell Kwan | April 8, 2019 -- 01:05 GMT (11:05 AEST) | Topic: Digital Transformation
The Australian Digital Health Agency (ADHA) on Friday opened an online consultation on the nation's health system, seeking feedback on how it could improve communication between healthcare professionals and their patients via secure digital channels.
The consultation is part of a nationwide series of discussions to help co-design the National Health Interoperability Roadmap, which will contain the standards and priorities used to implement Australia's "more modern" health system, and is a key priority of the agency's National Digital Health Strategy published in July last year.
The National Digital Health Strategy was created to improve how healthcare providers communicate with other professionals and their patients via secure digital channels so that the "best health and care decisions" can be made.
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8 April 2019

The future of ‘ultra cheap’ medicine

Posted by Francine Crimmins
Small, portable ultrasound machines can fast-track diagnosis and are changing the face of emergency medicine, experts say.
The ultrasound machine, once a cumbersome, space-consuming device, now comes as a small probe delivering images to a smartphone to be read in “real-time”.
“You can have your iPhone in one hand, the ultrasound in the other and you can suddenly see a whole lot more of the heart than you would otherwise be seeing,” says Dr Ben Smith, the emergency ultrasound fellowship director of the University of Tennessee.
Dr Smith, speaking at the annual SMACC emergency medicine conference earlier this month, says portable ultrasounds can be used to complement a physical exam.
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Govt to keep, strengthen internet gateway scheme

By Justin Hendry on Apr 8, 2019 1:00PM

Opts to fix problems with more targeted program.

The federal government will overhaul its shared gateway scheme to give agencies more flexibility while maintaining a universal cyber security baseline after concerns were raised about the current model.
In its long-awaited response [pdf] to the 2017 cyber security compliance inquiry released on Wednesday, the government agreed to alter the decade-old policy aimed at consolidating internet gateways to reduce the risk of successful cyber-attack.
It will “mandate a core internet gateway reduction program” for all Commonwealth entities to capture high-risk threats, but will grant agencies the freedom to deploy services that best serve their cyber security posture.
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ASD confirms data stolen in Parliament IT breach

By Justin Hendry on Apr 10, 2019 12:37AM

But exfil only netted non-confidential data.

Australian Signals Directorate chief Mike Burgess has confirmed data was stolen by a state-sponsored actor during February’s malicious attack against Parliament House.
In what appears to be the first public admission of the data exfiltration, Burgess told senate estimates last week that a limited amount of non-confidential data had made its way into the hands of attackers.
It was revealed during the agency’s damage assessment of the security breach, which has now been wrapped up and handed to government for consideration.
“There was a small amount of data taken; none of that was deemed sensitive, but the assessment of that is a matter for the parliament themselves,” Burgess said.
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Department of Parliamentary Services establishes cyber security branch

CTO leads new DPS branch
Rohan Pearce (Computerworld) 11 April, 2019 11:53
The Department of Parliamentary Services has launched a new branch dedicated to cyber security.
Ian McKenzie, the CPS CTO, leads the DPS cyber security branch as assistant secretary. McKenzie remains the department’s designated chief information security officer and reports to DPS chief information officer Antony Stinziani.
The establishment of the branch follows the creation of a DPS cyber security operations centre, courtesy of $9 million allocated to the CSOC launch in last year’s budget, and reflects the “increasing sophistication of targeted threats directed at Australia and its institutions,” DPS secretary Rob Stefanic told a Senate Estimates hearing earlier this week.
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Sectra inks $94m NSW Health imaging IT system deal

By Justin Hendry on Apr 11, 2019 12:20PM

After successful six-month PoC.

NSW Health has handed a $94 million deal to medical imaging IT and cyber security firm Sectra to roll out a new state-wide enterprise radiology imaging solution.
The Swedish-based company picked up the 13-year deal for the radiology information system and picture archiving and communication system (RIS-PACS) earlier this week.
It follows a six-month proof of concept that began in May 2018 to ensure the solution met the needs of healthcare professionals and patients in what is Australia’s largest public health system.
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NSW Health modernises medical imaging systems

Hafizah Osman | 12 Apr 2019
NSW Health has rolled out a new radiology information system and picture archiving and communication system (RIS-PACS) across 11 of its organisations. 
The organisations involved include nine local health districts, the Sydney Children’s Hospitals Network and NSW Health Pathology’s Forensic and Analytical Science Service, and aim to improve the way in which more than 1.8 million medical images are captured, used and archived across these organisations annually. 
The deployments, the result of a partnership with Swedish-based secure communications company Sectra, are expected to take around three years to roll out and follow a six-month proof-of-concept trial. 
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NSW Health in Australia Orders Radiology Solution From Sectra for Enterprise Access to Images

April 09, 2019 2:21am   Comments
SYDNEY and LINKÖPING, Sweden, April 9, 2019 /PRNewswire/ -- Medical imaging IT and cybersecurity company Sectra (STO: SECT B) has signed a 13-year contract with NSW Health in Australia for an enterprise radiology imaging solution across Australia's largest public health system. It will provide 11 NSW Health organizations with a common platform and the ability to seamlessly share images and information across departments and locations, resulting in better patient outcomes.
"We are pleased to confirm that we have entered into an agreement with Sectra to provide 11 Local Health Districts and specialty networks across NSW Health with a new, state-of-the-art digital capability on an 'as a service' basis. The enterprise radiology imaging service comprises a common platform for handling all image information, which allows efficient collaboration around medical images and information across the multiple clinical teams and health organizations," said Dr Zoran Bolevich, eHealth NSW Chief Executive and NSW Health Chief Information Officer.
Dr Bolevich continued; "The platform will provide patients with more modern and improved services such as SMS reminders for appointments and secure access to their images via an on-line portal."
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InterSystems Invites Bendigo Health to Join TrakCare Global Reference Program

BENDIGO, Australia, April 10, 2019   Executives from global software company InterSystems, including CEO, founder, and owner Phillip T. (Terry) Ragon, and head of Asia Pacific business, Luciano Brustia, today visited Bendigo Health to announce that the state-of-the-art hospital has been selected to join the international reference site program for InterSystems TrakCare™.

TrakCare is a unified healthcare information system that facilitates streamlined, shared workflows across care settings and provides a unified record for each patient.

“InterSystems is excited to partner with Bendigo Health,” Mr. Brustia said. “At InterSystems, we are passionate about innovation.  Bendigo Health is part of a vibrant community of customers spanning 26 countries who are using TrakCare to improve the patient experience, improve patient safety, and provide efficiencies for their care teams. Bendigo Health is more than a hospital; they are a leader within their region, and I am pleased that an organisation of their size with a diverse population to serve has accepted the challenge of becoming a reference site.
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Seniors Reablement Trial for Independence and Mobility

The Australian Government is committed to helping senior Australians remain living in their own homes as long as possible.
5 April 2019

The Morrison Government is committed to helping senior Australians remain living in their own homes as long as possible, launching a new $29.2 million trial to establish the best supports for maintaining mobility and independence.

This project will provide important options for the futures of older Australians, as we increasingly live to 100 or more and is a fundamental part of our Government’s More Choices For A Longer Life measures to promote better ageing.

Research shows that focusing on an individual’s strengths and goals helps sustain their independence and can reduce and delay the need for more complex support, including residential care.
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$4.4 Million for Indigenous Data and Research

The Morrison Government is investing $4 million in activities aimed at ensuring people with mental health challenges get the support and treatment they need.
9 April 2019
The Morrison Government is investing $4 million in activities aimed at ensuring people with mental health challenges get the support and treatment they need.
The work will be undertaken by the Australian Institute of Health and Welfare and will focus on the needs of Aboriginal and Torres Strait Islander peoples.
The work follows recommendations made in the Government’s Fifth National Mental Health and Suicide Prevention plan, which outlines eight ‘priorities’ to be achieved by 2022.
As part of the project, the Australian Institute of Health and Welfare will establish a Mental Health and Suicide Prevention Clearinghouse.
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Amazon plans to launch over 3,000 satellites to offer broadband internet

To offer high-speed broadband connectivity to people globally who lack basic access to broadband internet
Reuters (ARN) 05 April, 2019 09:02
Amazon.com has confirmed its plan to build a network of over 3,000 satellites through "Project Kuiper" to provide high speed internet.
The project will launch a constellation of low-Earth orbit satellites that will provide low-latency, high-speed broadband connectivity to people globally who lack basic access to broadband internet, the company said.
Details of the project were filed with the United Nation's International Telecommunication Union last month.
Amazon's satellite project faces stiff competition from similar ventures from billionaire entrepreneur Elon Musk's rocket company SpaceX and Airbus-backed OneWeb among others. In February, OneWeb launched its first six satellites.
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ACMA releases compliance priorities

The communications regulator, the Australian Communications and Media Authority, has released its compliance priorities for 2019-20 for the telecoms and communications industries, including telecommunications consumer safeguards.
The ACMA says its authority-wide strategic approach to setting annual compliance priorities helps to streamline its work and provides “greater transparency and clarity for industry”, as well as guiding efforts to deliver effective compliance and, where necessary, targeted enforcement action.
The compliance approach to setting annual priorities replaces ACMA’s previous practice of setting priority compliance areas for some of its activities.
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Phone, Internet complaints down for the last six months of 2018: report

Complaints by Australian telecommunications users about landline, mobile and Internet services fell in the last six months of 2018 by 27.7% to 60,998 compared to the corresponding six month period in 2017.
The latest six-monthly update report published on Thursday (today) by the Telecommunications Industry Ombudsman reveals that between July and 31 December 2018, complaints  decreased, with both Australian residential consumers and small businesses making just shy of 61,000 complaints for the six months.
And the fall in complaints reported was across all states and territories compared to the corresponding period in 2017.
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Labor asks why 183,000 cannot get even 25Mbps on FttN

The Australian Labor Party has questioned why 183,000 households who have fibre-to-the-node connections on the NBN cannot get even the minimum speeds of 25Mbps as of March.
NBN Co made the admission in a written reply to the Senate Standing Committee on Environment and Communications, saying: "As at 4 March 2019, of the 2.4 million active FttN services approximately 183,000, or 7.6% were reporting a Layer 1 VDSL attainable synchronisation rate equivalent to less than 25Mbps downstream rate at Layer 2."
Shadow Communications Minister Michelle Rowland said this had occurred even though the government had promised that all Australia would have access to a minimum of 25Mbps by the end of 2016.
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Optus CEO says 5G offers gigabit upgrade path for NBN, pushes new model for last mile

NBN currently an ‘underwhelming’ experience for customers, Optus chief executive says
Rohan Pearce (Computerworld) 08 April, 2019 11:45
Optus CEO Allen Lew has called for the government and NBN Co to consider 5G wireless technology as an upgrade path for those parts of the National Broadband Network where performance is limited by the use of copper wiring, and as an alternative to laying additional fibre to households to deliver faster speeds.
The chief executive today said the government should consider a scheme run in a somewhat similar fashion to the Mobile Blackspot Program, with NBN Co leasing 5G capacity from telcos, which would bid to provide 5G coverage in a particular area.
In remarks prepared for the CommsDay Summit in Sydney, Lew described the current experience of the NBN for many people as “underwhelming”. The CEO argued that connecting to the NBN is “painful” for many customers, and said the telco industry had inadequate processes to respond to service outages.
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NBN Co "should" set entry-level broadband prices at ADSL levels

By Ry Crozier on Apr 8, 2019 7:37PM

Regulator finally weighs in on price pressure.

NBN Co “should” be anchoring the price of entry-level broadband services to existing ADSL fees instead of trying to drive up retail costs for consumers, the Australian Competition and Consumer Commission (ACCC) has said.
The statement, made by ACCC chairman Rod Sims, was - in many ways - a long overdue incursion on a year-long bid by NBN Co to punish over 1.25 million entry-level users, either by hiking prices or reducing quality of service.
For the first time, Sims laid out the ACCC’s position on a consistent set of changes being forced onto the market by NBN Co that has seen prices go up and some retailers axe cheaper plans altogether.
Sims was highly critical of NBN Co’s trajectory, though he did not commit to intervene, saying only that NBN Co should “revisit” its offers to the lower end of the broadband market.
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Optus offers to install and repair NBN services itself

By Ry Crozier on Apr 8, 2019 11:33PM

As wait times to get connected blow out.

NBN Co should train and certify retail service providers to perform installations and repairs to cut down a backlog of work causing delays of up to three months, says Optus CEO Allen Lew.
Lew told the CommsDay Summit in Sydney that NBN Co and retail service providers (RSPs) needed to “act as partners” and not opponents to fix NBN delivery issues.
He reiterated Optus’ “long-time support” for the NBN - but the project’s ongoing problems appeared to be wearing even Lew down.
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5G an opportunity for NBN: NetComm

The deployment of 5G technology could present a significant opportunity for NBN Co, according to NetComm director of marketing and communications, Els Baert.
"We should not ask how much of a threat is 5G to the NBN, we should ask how much of an opportunity does 5G represent?," said Baert.
"First of all, there will always be a need for a ubiquitous broadband network, something which has shown itself to be difficult to achieve.
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NBN Co prices affecting plan affordability, says ACCC chief

The pricing introduced by NBN Co in the last six months has led to the cost of basic NBN plans becoming an affordability issue for Australians on lower incomes, the chairman of the Australian Competition and Consumer Commission, Rod Sims, says.
He told a conference in Sydney on Monday that NBN plans were more expensive than the equivalent ADSL plans, pointing out that an ADSL Internet and voice plan with 100Gb of data cost about $50 a month.
And, Sims added, an ADSL plan with unlimited data was available for about $60.
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Optus slams NBN quality, calls for 5G replacement

Apr 8, 2019 — 4.47pm
The NBN's fibre-to-the-node technology is holding Australia back, and it will take the private sector's 5G networks to make the nation's internet globally competitive.
That is the view of Singtel Optus chief executive Allen Lew, who on Monday called for the private sector to be brought in to replace ageing NBN technology with ultra-fast 5G fixed-wireless broadband.
Under Mr Lew's solution, which would be a radical shift for the government-owned fixed-line monopoly, mobile network operators such as Optus, Telstra and Vodafone would bid to replace FTTN technology with their own mobile technology.
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'Make the best of what we have': Labor rules out sweeping NBN overhaul in new policy

By Fergus Hunter
April 9, 2019 — 10.00am
Labor has ruled out a rapid, large-scale upgrade of the National Broadband Network in a newly unveiled strategy that concedes there are now entrenched "realities" the party cannot overcome if it wins government in May.
Promising to "make the best of what we have" as a result of the Coalition's $50 billion NBN rollout, Labor's communications spokeswoman Michelle Rowland has committed to a review of the vexed project and $185 million in spending to boost some Australians' internet connections.
$125 million of the money will fund improvements for up to 750,000 people by fixing in-home wiring problems. $60 million will go into trials providing another 20,000 people with high-speed fibre connections, exploring a "pathway for future upgrades" over ten years funded by joint public-private investment.
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Labor rules out pumping more fibre into NBN

  • April 9, 2019
Labor has ruled out pumping more fibre in a hurry into the National Broadband Network but will tip an extra $185 million into the project if it comes to power.
Speaking at the Commsday Summit in Sydney, Labor communications spokeswoman Michelle Rowland said it’s too late to overturn Coalition’s multi-technology approach to the NBN, given that the rollout of the network has entered its final phase.
“Labor will not be offering a quick fix, nor will we be making promises we cannot keep,” she said.
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Labor pledges economic review of NBN if voted in

The Australian Labor Party has said it would review the economics of the NBN, including the implications of the multi-technology mix, on the cash-flow of the NBN Co, the company which is rolling out the network, if it were voted back into office in the forthcoming Federal Election.
No mention was made of a possible write-down of the value of the network, which has been canvassed quite  a  few  times.
Opposition Leader Bill Shorten and Shadow Communications Minister Michelle Rowland said on Tuesday the party would look at the capital structure, pricing evolution, and whether the NBN Co was able to invest in future infrastructure upgrades under a number of market scenarios.
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NBN Co may fix in-home cabling free for 750,000 homes

By Justin Hendry , Ry Crozier on Apr 9, 2019 10:01AM

Under new Labor proposal.

NBN Co will foot the bill to upgrade in-home wiring at up to 750,000 premises in the fibre-to-the-node footprint under a plan floated by the federal opposition today.
The major upgrade project is the centrepiece of Labor’s plan to reinvigorate the troubled NBN for both households and businesses across Australia.
Shadow communications minister Michelle Rowland told the CommsDay Summit in Sydney that it currently costs $150 to have in-home wiring problems "rectified under a standard installation".
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NBN Co's enterprise play catches ACCC's gaze

By Ry Crozier on Apr 8, 2019 8:01PM

Regulator unconvinced it isn’t just mission creep.

NBN Co’s shift into the enterprise space is being watched “closely” by the Australian Competition and Consumer Commission (ACCC), which remains unconvinced the move is not simply “mission creep”.
The government-backed network builder launched enterprise services at the end of October last year, and is hoping to sign on 900,000 enterprise and government customers by FY22.
The move has long been seen by other telcos as scope creep, since it plants NBN Co as a well-funded competitor in a space with already significant served by a range of operators.
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NBN Co's wireless congestion likely worse than reported

By Ry Crozier on Apr 9, 2019 5:58PM

Urgent work underway to fix one in ten backhaul links suffering packet loss.

NBN Co may have under-reported levels of congestion on its fixed wireless network after revealing one in ten - or 250 - microwave and fibre transmission links suffer unacceptable levels of packet loss, and that this isn't captured in publicly-reported numbers.
The network builder said today it is performing a fast-tracked piece of work to add capacity to the 250 impacted links, with improvements expected before the federal election.
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Telstra, TPG, Vocus and Optus say they aren't an NBN bottleneck

By Ry Crozier on Apr 12, 2019 9:43AM

Argue the real problem - or solution - lies with NBN Co.

Telstra and Vocus, who are among a handful of telcos that supply dark fibre or backhaul services to and from NBN points of interconnect, say their services are not a bottleneck to the NBN user experience, and that any bottleneck sits with NBN Co itself.
Four telcos - Telstra, TPG, Optus and Vocus - responded earlier this week to a proposal by the Australian Competition and Consumer Commission (ACCC) to impose a data collection exercise on the industry - known as a record keeping rule or RKR.
The proposed data collection would require industry players to submit detailed data regularly on connections they maintained to NBN points of interconnect (PoI), where access seekers such as retail services providers connect.
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Remarkable first-ever image of black hole revealed

Updated April 11, 2019 — 12.19am first published April 10, 2019 — 11.31pm
Scientists on Wednesday revealed the first-ever glimpse of a super-massive black hole, as the Event Horizon Telescope released the first results of its findings in a "ground-breaking" discovery that proves Albert Einstein's theory of general relativity.
The research was conducted by the Event Horizon Telescope (EHT) project, an international collaboration begun in 2012 to try to directly observe the immediate environment of a black hole using a global network of Earth-based telescopes.
The scientific team used a global network of telescopes to gain insight into the massive celestial objects with gravitational fields so strong no matter or light can escape.
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Enjoy!
David.

Sunday, April 14, 2019

It Really Is Just A Farce How The ADHA Is Being Run. It Needs Urgent And Meaningful Repair!

First we need a bit of background. Take this partial page:
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Board Papers

The intent of the Australian Digital Health Agency Board (Board) is to publish as many Board documents as is feasible. Generally Board papers are published after the minutes for that meeting have been accepted. This is usually at the next Board meeting. When clarification or correction of the minutes is required, publication of the Board papers may be delayed.
Board documents that are draft, not finalised or sensitive will not be published.

Board Meeting 6 December 2018 – Board Papers (Download)

Board Meeting 22-23 August 2018 – Board Papers (Download)

Board Meeting 14 June 2018 – Board Papers (Download)

----- End Extract.
Here is the link:
There are a few things to note here:
1. The Board was on auto-pilot while most of the opt-out saga was happening! Clearly it was a matter of supreme indifference to them. The did not apparently meet for a crucial 4 months – against the usual 2 monthly meeting schedule.
2. The papers are totally incomplete and even those that are provided are often missing important parts. See Item 19 in the latest lot – missing the crucial appendix.
3. When December rolls round – that we get to hear about months later – the tone is that all the discussion regarding opt-out is wonderful.
This extract from the CEO Report  – when read closely shows just how startled they were:
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My Health Record

On 14 November, the Hon Greg Hunt MP, Minister for Health (the Minister) agreed to extend the opt out date to 31 January 2019 —  a milestone in the high profile and welcome debate about the role that My Health Record (MHR) and digital health more generally can play to support improved health and wellbeing in Australia.
If we look back on the really major reforms of the past 40 years, they have happened with considerable community interest and debate, with the engagement of all political parties, and frequently involved modification as a result. This is healthy civic and political democracy at work — and a signal of the importance of MHR as a reform.
On 15 November, the Senate passed the My Health Records Amendment (Strengthening Privacy) Bill 2018
(the Bill). The Bill will need to go back to the House of Representatives, which sits again on 26 November 2018. If passed by the House of Representatives in its current form, it will then be assented and become law.
A key operational change is the extension of the opt out period to 31 January 2019 in light of the legislative timetable. We are currently working through the nature of the Australian Digital Health Agency’s (the Agency) activities during this extension and will update you when those plans have been clarified. It is important to note that if the legislation is enacted, it will mean that people can permanently delete their MHR at any time after 31 January 2019 — in effect, to opt out at any point thereafter. The Agency will continue to support community awareness and understanding of MHR as well as explain the implications of the legislative changes while improving provider connections and clinical adoption of the service.
 There are a number of amendments in the Bill that strengthen MHR’s privacy and security protections:
Briefly, the changes will:
  •  confirm the current Agency policy that law enforcement agencies can only obtain access with a court or similar order;
  • confirm the prohibition on access to MHRs for insurance or employment purposes within the My Health Record Act 2012;
  •  remove parents as authorised representatives when a child turns 14 — meaning they will not have default access to that child’s MHR unless given express approval to do so by the record recipient;
  • strengthen existing protections for people at risk of family and domestic violence;
  • allow Australians to permanently delete their records, and any backups, when they cancel their record;
  • clarify that the Agency cannot delegate its powers to anyone other than the Department of Health (Health) and the Chief Executive of Medicare;
  • make clear that the system cannot be privatised or used for commercial purposes; and
  • make the principles contained in the Framework to guide secondary uses of data law.

This will be backed up by harsher penalties and fines for inappropriate or unauthorised use.
The legislation and record of the debate is available on the Australian Parliament House website.
Budget Estimates
On 24 October 2018, the Agency appeared alongside Health for Additional Budget Estimates. We were asked a number of questions regarding MHR, focusing on the communications activities, making system changes to give effect to hard delete, and some of the clinical and consumer feedback received by the Senate Committee on the MHR system.
Consumer communications
Consumer communications and engagement has been significant during the opt out period, covering numerous channels including, but not limited to, print, video, radio, social media, digital, community events and a television campaign. Key communication materials have been translated into over 19 languages, including several Indigenous languages. These activities have given more than 10 times reach across the eligible population, which includes temporary and permanent residents as well as Australian citizens.
The focus of resources and communication activities based on research, has been to educate Australians and their trusted healthcare providers about MHR and how it benefits them, and to inform Australians that they will get a record in 2019 unless they choose not to have one.
Information has been made available in over 15,000 health care locations including general practices (GP), pharmacies, public and private hospitals, and via Aboriginal Medical Services and National Aboriginal Community Controlled Health Organisations. Australia Post has provided information on MHR via over 4,000 post offices, including over 2,000 rural and remote locations, reaching up to two million Australians over the three month opt out period. MHR information has been included in all Medicare letters sent out during the opt out period, and information is also available at libraries nationally.
Hundreds of national and local advocate organisations — the Consumers Health Forum of Australia among them — are also promoting awareness through their networks. 31 Primary Health Networks (PHN) have conducted more than 3,200 community events during the opt out period.
Awareness and education has continued across the country for registered health practitioners, in partnership with clinical peak bodies, such as the Royal Australian College of General Practitioners (RACGP), the Pharmacy Guild and Pharmaceutical Society of Australia (PSA), PHNs, jurisdictions and private providers.
The primary focus of media reporting has continued on the security and privacy of the system, the protections in legislation around third-party access to records, particularly by law enforcement agencies, and subsequently the Minister’s announcement of the proposed amendments to legislation.
----- End Extract.
You could be forgiven for asking just why all this was not properly consulted in advance, rather than having two forced extensions of opt-out as public annoyance rose.  The move to full record deletion on request is a major change to the whole Program and has gone rather unremarked. The Agency clearly misread the public mood for having large scale change sprung on them!
The CEO Report is an attempt as retrospective history revision and backside covering in my view. As for the ADHA Board the wholesale change seen recently was months too late!
What do others think?
David.

AusHealthIT Poll Number 470 – Results – 14th April, 2019.


Here are the results of the poll.

With The Federal Election Due In The Next Month Or So, How Do You Rate Minister Hunt's Performance In Digital Health Over The Last Term Of Government?

Excellent 1% (1)

Good 0% (0)

Okay 6% (9)

Poor 57% (92)

Terrible 36% (58)

I Have No Idea 1% (2)

Total votes: 162

What an clear-cut poll again. Only one reader was keen on Mr Hunt (Thanks Greg for voting) and 93% rated his efforts as poor or worse. I would mark that as a fail!

Any insights on the poll welcome as a comment, as usual.

A more than reasonable turnout of votes!

It must have been a fairly easy question as just 2/162 readers were not sure what the appropriate answer was.

Again, many, many thanks to all those that voted!

David.