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."

Thursday, April 29, 2021

It Seems The Great And The Good Reckon The ADHA Are Full Of It As Far As Global Digital Superiority Is Concerned!

These 2 reports of a recent international discussion appeared last week:

First we had:

https://wildhealth.net.au/three-nations-one-digital-health-message/

22 April 2021

Three nations, one digital health message

ADHA Big Data Booking Engine Cloud COVID-19 DoH EHR/EMR Hospital Insights Interoperability NHS Technology

Posted by Felicity Nelson and Talia Meyerowitz-Katz

A curious thing happens when you put digital health experts from America, Scotland and Australia side-by-side on a webinar panel. While the accents change from speaker to speaker, the message remains constant.

The core lesson from the Wild Health webinar (which you can watch on demand here) was that everyone wins when we put aside differences and pitch in to build sturdy, lasting, interoperable digital infrastructure – and we can win big in the middle of a global pandemic.

But each country has its own unique challenges and there’s always more work to be done.

The panel was chaired by Jeremy Knibbs, the publisher of Wild Health.

Representing Australia on the panel was Grahame Grieve (Founder of FHIR, global interoperability consultant and principal of Health Intersections) and Professor Dorota Gertig (Medical Director, Population Health at Telstra Health and a public health physician).

Professor George Crooks OBE (Chief Executive of the Digital Health & Care Innovation Centre) tuned in from Scotland.

And from the US, Wild Health invited Steven Posnack (Deputy National Coordinator for Health Information Technology) and Aashima Gupta (Director, Global Healthcare Strategy and Solutions, Google Cloud).

In Scotland, the pandemic generated “top-down permission” and the “bottom-up need” for change, leading to some truly impressive leaps in the use of ICT architecture and cloud-based digital technology in COVID contact tracing, said Professor Crooks.

Because the cloud infrastructure was already established, the government could quickly switch on a new application, allowing citizens to participate in the contact tracing process.

“The beauty is that it puts the citizens at the centre, they do their own contact tracing,” said Professor Crooks.

“And the average time from getting a positive notification to an individual starting self-contact tracing is 12 minutes,” he said. “And 55-60% of citizens actually actively participate within an hour and a half of that notification.”

In the US, major legislation pushed through in 2010 meant that 90% of US hospitals already had electronic medical records before the pandemic hit, said Mr Posnack.

COVID accelerated the expansion of digital health. “How we work has changed,” he said. “In the past year, I have set foot in the office once as a government employee running a government agency.”

Some provisions have been made to expand telehealth but there’s been a reluctance to establish payment methods, he said.

There is also more appetite for health information from patients now. “Everyone wants access to their test results,” he said. “Everyone wants access to their vaccination status.”

The US has the HIPAA law, which provides a right for citizens to gain access to their health information.

“My optimistic hope is that this may help prompt people to seek greater access and more engagement in their care overall from a digital health perspective,” he said.

Unfortunately, Australia’s digital health infrastructure was “very solution focused, very insular in in the way it’s conceived”, said Grahame Grieve

“Instead of building an infrastructure that leads to new integrated market development, it seems that we’ve headed towards an infrastructure that sucks everything into what it is,” he said.

“It’s very frustrating to see how that approach isn’t developing into, what I think we need, which is a resilient and adaptable architecture.”

Lots more here:

https://wildhealth.net.au/three-nations-one-digital-health-message/

and the next day:

23 April 2021

Why the UK and US are now in front of us in digital health

ADHA Government Interoperability MHR

Posted by Jeremy Knibbs

Last week’s Wild Health webinar on lessons from the US, the UK and Australia from COVID induced digital health innovation, sponsored by Telstra Health, revealed two countries now in front of us and moving much faster towards a more interoperable ecosystem as a result of COVID induced digital health innovation. What happened?

If you ask virtually any senior digital health staffer in any advanced country what was the greatest leap forward that COVID induced in their healthcare set up the inevitable answer is telehealth. In the UK, the US and Australia, telehealth made leaps of various sizes, often associated with governments accepting that they needed to establish pay signals the system for it to be used more effectively.

But while vastly applicable and useful in the crisis, in some ways the telehealth story belies what COVID really did in many countries, which was put their existing interoperability infrastructures to the ultimate test.

In last week’s Wild Health Webinar, digital health leaders from the US, the UK and Australia were asked what COVID induced innovations were significant and real, and what ones were more potentially illusionary. Which ones might slowly slide backwards despite the hype?

As expected, Telehealth was an initial winner nominated for each country. Notably in the UK, video telehealth took off, whereas in Australia video has not taken at all. It feels likely that video telehealth was able to take off because of existing or developing infrastructure in that country, especially around delivery of hospital outpatient services.

Three years ago the UK moved to put all of its health service providers and vendors a notice that the intention moving forward from that point was “cloud first”.  The NHS put a lot of detail around what they were expecting. It wasn’t a new standard (the route taken by the US) but it might have been as good as. If as provider you were going to doddle and not upgrade towards new web sharing technologies you would be in trouble. As a vendor there was nothing to do but start developing systems which met the criteria.

By the time the COVID pandemic hit, NHS cloud based solutions like Carenotes allowed staff to view and share patient medical records from a desktop or mobile device anywhere in the UK.

----- Lots omitted

The My Health Record, which should have been the centre piece of a crisis like COVID, if it was ever going to live up to the government’s promises, was almost entirely missing in action.

Unfortunately, Australia’s digital health infrastructure is  “very solution focused, very insular in in the way it’s conceived”, Grahame Grieve, the founder of FHIR, told the Webinar.

“Instead of building an infrastructure that leads to new integrated market development, it seems that we’ve headed towards an infrastructure that sucks everything into what it is,” he said.

“It’s very frustrating to see how that approach isn’t developing into, what I think we need, which is a resilient and adaptable architecture.”

The best that we could manage in Australia was expediting a program for electronic script writing, a program that was initially going to take a year, and we managed to get up in a raw working form in about three months.

Ironically, this program, which is yet to be fully implemented, is a case of cloud based and distributed architecture in the system. But it has virtually nothing to do with our supposed backbone project of the My Health Record.

If you read between the lines on the Wild Health webinar, which looked at COVID induced digital health innovation between the UK, the US and Australia, the single biggest message that was apparent is that Australia is stuck in the past as far as digital health is concerned.

Such a view might come as a surprise to most of our politicians, who don’t really understand the basics, but, ironically, have been given the My Health Record to point to as just how great progress has been in Australia.

While there was much in place to facilitate much better interoperability in the US and the UK systems when COVID hit, there simply wasn’t in Australia.

If it was meant to be the My Health Record, then what COVID demonstrated probably for once and for all was that this project is an interoperability dead end for the country.

We need to back up, check out in more detail what other countries are doing with modern distributed and open systems, and rethink our approach.

Part of that approach should probably also take note of both the US and the UK, which as base did not try to dictate technology or systems but gave the market context and direction, in the case of the US via an enforced standard, and in the case of the UK, at least by notice to everyone in the system that they should be hubbing around cloud, and then setting up support services to help align providers and vendors.

Both the UK and the US in varying degrees announced and dictated the future for vendors and providers, via some sort of standard setting, and then made sure they gave everyone the time and the support to make the transition.

In some ways, our government’s persistence now with the My Health Record is laziness brought about by a feeling that things are OK. That we managed the pandemic better than anyone else, and our health system is largely better than anyone else’s.

Both things are true.

But it’s a stark reality that our digital health policy and infrastructure are backwards now and fast starting to hold back the potential of our whole healthcare system.

It’s patients that will bear the brunt of this lazy approach in the end.

It’s a climate change like problem for Australian policy makers.

It’s difficult to see today, and there is a lot of politics resisting changing our current settings.

But like climate change, a weak digital health infrastructure and leadership from government, is going to blow up in our faces sooner or later. Likely, in a big way.

You can watch the Wild Health Webinar on which the ideas in this article are based HERE.

Here is the link:

https://wildhealth.net.au/why-the-uk-and-us-are-now-in-front-of-us-in-digital-health/

Seems like a good idea to watch and see what you think! Fascinating stuff.

The key lessons I took from the discussion from an OZ perspective were:

1. The #myHR is a useless piece of dated infrastructure that needs to go.

2. OZ needs to re-awaken its e-Health Standards processes and start moving towards distributed data management and interoperability.

3, The Digital Health Industry sees the #myHR as irrelevant and is just ignoring it.

David.

Wednesday, April 28, 2021

I Can See Vested Interests And Chancers Written All Over This Proposal And Advocacy.

Noticed this last week:

TAC International Forum

When: April 27, 2021 all-day

Contact: ITAC Conference Secretariat 08 8981 5119

Event website

The Aged Care Industry Information Technology Council will be holding regular International Innovation and Technology Across Care (ITAC) Forums from April 2021. This International Forum will speak to Recommendation 68 “every approved provider of aged care uses a digital care management system meeting a standard set by the Australian Digital Health Agency” as recommended by the Royal Commission into Aged Care Quality and Safety. Specifically the Royal Commission outlines that the integration of My Health Record would be an initial accreditation criteria. Come to the first ITAC International Forum to hear from international expert Professor Greg Alexander on the USA’s experience in integrated data collection along with national leading projects being delivered by the Australian Digital Health Agency in conjunction with the ACIITC.

Here is the link:

https://www.australianageingagenda.com.au/event/itac-international-forum/

There is also this:

April 20, 2021 6:06 am AEST

Government urged to fund GP aged care visits and nursing home infrastructure

The AMA is calling for increased funding to support and encourage more GPs to visit patients in nursing homes as well as greater investment in nursing home facilities to make it easier for GPs to deliver the care that people in nursing homes deserve.

The call comes as AMA members report significant barriers to delivering care and deterring doctors from visiting aged care facilities altogether.

Problems include:

  • incompatible IT systems
  • lack of nursing staff to identify patients and assist GPs with clinical handovers
  • no clinically equipped private examination rooms available
  • lack of physical access with no parking, and the need for personalised swipe cards and access codes
  • lack of adequate financial support for doctors’ visits

These hamper the delivery of quality patient care for our older Australians.

“AMA Members have signaled their intention to reduce nursing home visits and even cease them altogether and this is the last thing we want right now, when we know our older loved ones are suffering from a lack of medical care inside nursing homes,” AMA President, Dr Omar Khorshid said.

“Instead we should be attracting more doctors into aged care by supporting them to take the time away from their busy practices and visit patients in nursing homes. That way GPs can continue their relationships with their elderly patients who move into aged care.

“Most GPs bulk bill their patients in aged care, but they themselves are out of pocket as a result as the current Medicare rebate is woefully inadequate to cover the time spent in nursing homes with patients and what we call ‘non-contact time’ – the time spent on a patient’s care outside of their consultation.

“We are calling for increased Medicare funding so that GPs can work with nurses to deliver the quality and quantity of care that older Australians expect, and deserve, in a way that is sustainable for the health system.

“We’ve estimated this to cost $145 million in 2021-22 and $643 million over four years to 2024-25 in our new modelling. It’s a relatively small ask when we’ve identified over $21 billion of savings that can be made in addressing preventable hospital admissions from aged care,” Dr Khorshid said.

AMA Vice President, Dr Chris Moy, is a GP who works in aged care. He says there are a whole raft of non-contact activities carried out by GPs to support their aged care patients.

“Things like needing to discuss treatment with relatives and nursing home staff – it’s almost like looking after three patients, not just one – as well as the mountain of paperwork that goes with that takes time and doctors must be supported in doing this,” Dr Moy said.

“Additionally, incompatible IT systems often mean crucial patient information gets lost and that’s bad news for the older person.

“It’s ridiculous to talk about innovative digital technologies when they don’t work for the patient and their doctor.

“The My Health Record, My Aged Care, nursing home IT and GP clinical software all need to be able to talk to each other for the benefit of the patient and all involved in their care.

“Often we can’t examine our aged care patients in private because there are no available rooms for this. Nursing homes need clinically equipped examination rooms to preserve the person’s dignity.

“Just making sure a GP is supported in visiting a resident who has deteriorated can make the difference between them having to be transferred to hospital or not. Being able to treat the resident in their home is better for the individual and the health system.”

“We’ve identified a suite of needs for both the patient and GP in nursing home settings and if the Government is serious about reforming aged care, they should allocate resources to these areas.

“All of this speaks to our call to put health care back into aged care by boosting the number of doctors and nurses in aged care, and ultimately improving the health of our precious but often most vulnerable members of our community residing in the aged care system.”

Details of $21 billion in potential savings identified by the AMA are contained in our latest report: ‘Putting Health Care Back Into Aged Care

Here is the link to the release:

https://www.miragenews.com/government-urged-to-fund-gp-aged-care-visits-546064/

And this:

Sandy CheuApril 20, 2021

Providers encouraged to take part in clinical software survey

Residential aged services are invited to take part in a national survey investigating the uptake of clinical software and its impact on resident outcomes.

Aged care technology peak body Aged Care Industry Information Technology Council is undertaking the survey in partnership with the Australian Digital Health Agency.

It aims to identify what clinical software residential aged care facilities in all locations are using, how they are using it and the impact it has on resident outcomes.

ACIITC chair of the National Home Care Group Anne Livingstone said there has been little research in this area and this survey aimed to provide a snapshot in time.

“We don’t have a benchmark in time about the uptake of this software and also whether being sophisticated in your use of clinical platforms is assisting in improving the quality and safety of the services you provide,” Ms Livingstone told Australian Ageing Agenda.

“We’re looking at particularly the types of software that are used, its success and contribution to greater levels of quality and safety and high level of outcomes for individuals,” Ms Livingstone said.

More here:

https://www.australianageingagenda.com.au/technology/providers-encouraged-to-take-part-in-clinical-software-survey/

Reading all this you can draw a few conclusions:

First no-one knows that IT , of any sort, is being used in Aged Care.

Second – from the AMA – there are  zillion problems to be solved before anyone could give a fig about access to the #myHR.

Third a daylong conference, replete with ‘international fireman’ who knows diddlysquat about the Australian Aged Care IT environment – is likely to degenerate to an ADHA spin job on the value of the #myHR.

Bottom line is pretty clear as revealed in this recent poll!

Sunday, April 04, 2021

AusHealthIT Poll Number 573 – Results – 4th April, 2021.

Here are the results of the poll.

Do You Believe Digital Health And The #myHealthRecord Should Be A Priority In Improving The Aged Care System Over Responses Like Improved Funding, Quality Food, Improving Staffing Etc.?

Yes 1% (1)

No 99% (73)

I Have No Idea 0% (0)

Total votes: 74

It seems an overwhelming majority think that we need to fix the care, safety, staffing and food before the tech!

Here is the link:

https://aushealthit.blogspot.com/2021/04/aushealthit-poll-number-573-results-4th.html

The Aged Care sector may certainly need better IT but the #myHR is at the very bottom of the list of needs IMVHO!

What do  you think?

David.

 

Tuesday, April 27, 2021

Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety, Social Media And Security Matters. Lots Of Interesting Perspectives - April 27, 2021.

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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! Its 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/2021/04/17/what-is-interoperability/#more-1830

What is interoperability?

Posted on 17/04/2021 by wolandscat

There are some rather obscure definitions of health IT’s favourite term interoperability floating around, for example:

Wikipedia: Interoperability is a characteristic of a product or system, whose interfaces are completely understood, to work with other products or systems, at present or in the future, in either implementation or access, without any restrictions

Cambridge dictionary: the degree to which two products, programs, etc. can be used together, or the quality of being able to be used together.

These definitions are not wrong, but don’t quite capture the whole picture. First we need to clear up one thing, which is the question of semantic interoperability, often distinguished from syntactic interoperability. The former is usually understood as the ability of systems to share meaning, or similar, while the latter just means they agree on how to share data or API calls concretely. For healthcare IT, and indeed most industries, the only interesting interoperability is the semantic kind; if you have not achieved that, there is more work to do. So here, ‘interoperability’ means ‘semantic interoperability’.

The following is my definition.

interoperability (def):
the level of interoperability between distinct components of an information processing environment (applications, services, systems etc) is proportional to their ability to correctly communicate their internal semantics to each other, without special measures, other than syntax or technology adaptation.

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https://www.innovationaus.com/states-aligned-on-digital-identity-data-sharing/

States ‘aligned’ on digital identity, data sharing

Joseph Brookes
Senior Reporter

19 April 2021

State, territory and Commonwealth digital ministers have agreed to press ahead with the Prime Minister’s plan for national consistent digital identity and data sharing schemes, and noted the rollout of COVID-19 vaccination certificates.

Last week, Prime Minister Scott Morrison announced the federal government’s plan to greatly increase data sharing between public sector agencies and private organisations through new legislation would be expanded to state and territory governments.

On Friday, Ministers responsible for digital and data from each of Australia’s state and territory governments except Tasmania met with Commonwealth Employment Minister Stuart Robert, who has retained control of whole of government digital projects in his new portfolio.

Ministers “discussed development of the intergovernmental agreement to support national data sharing between governments” at the meeting. The agreement will eventually be considered by state and territory Premiers at National Cabinet.

-----

https://www.innovationaus.com/a-reasonable-robot-in-the-eyes-of-the-law/

A reasonable robot in the eyes of the law

Stuart Corner
Contributor

21 April 2021

Whether it’s driving a car, making a medical diagnosis by referencing a database of historical cases, finding potential new drugs, or playing chess, artificial intelligence is increasingly performing tasks as well as – and in some cases better than – humans.

Humans are subject to the rule of law. Kill or injure someone while driving a car and you might find yourself charged with negligence, or worse.

But what happens when an autonomous vehicle kills someone? A robot is not subject to the law. So is the car manufacturer liable, or the developer of the software? And how do you pinpoint the cause of such an accident?Treating humans and artificial intelligence as equals before the law

University of Surrey (UK) professor of Law and Health Sciences Ryan Abbott argues that the law should not discriminate between AI and human behaviour and proposes a new legal principle of equal treatment that he claims will ultimately improve human wellbeing.

Meet the Reasonable Robot

Professor Abbott has made his case in a book The Reasonable Robot: Artificial Intelligence and the Law and he discussed his proposal with Professor Jeannie Marie Paterson from the University of Melbourne’s Centre for AI and Digital Ethics (CAIDE) in a webinar co-hosted by CAIDE and the Australian Society for Computers and Law (AUSCL).

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https://www.innovationaus.com/data-commissioner-defends-new-sharing-scheme/

Data Commissioner defends new sharing scheme

Denham Sadler
Senior Reporter

21 April 2021

The government has struck the right balance with its sweeping new data-sharing scheme which will “streamline” service delivery, the Data Commissioner has told a Senate committee hearing, which also heard a range of legal and privacy concerns about the new scheme.

A senate committee is currently conducting a whirlwind inquiry into the Data Availability and Transparency Act, which marks a significant expansion of the sharing of public sector data between agencies and private organisations.

At a public hearing on Tuesday morning, interim National Data Commissioner Deborah Anton backed the controversial new scheme, saying that the government and general public has to “engage sensibly with risk”, in a rare public appearance.

Following Ms Anton’s appearance, a number of legal organisations and civil and digital rights advocates panned the proposed data-sharing scheme, raising concerns around a lack of privacy safeguards, weak consent requirements and the bypassing of existing privacy laws.

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https://www.zdnet.com/article/services-australia-penalised-for-breaching-privacy-of-a-vulnerable-customer/

Services Australia penalised for breaching privacy of a vulnerable customer

The agency's process for updating personal information in a domestic violence situation was not only alarming, but was found to be a breach of privacy by the Information Commissioner, too.

By Asha Barbaschow | April 22, 2021 -- 06:17 GMT (16:17 AEST) | Topic: Security

The Australian Information Commissioner has issued Services Australia with a notice to pay a customer AU$19,890 as atonement for breaching her privacy.

The woman was in receipt of Centrelink benefits administered by the Department of Human Services, now Services Australia.

At the time, she lived with her then-partner, and as such, her entitlements were calculated by taking his income into consideration as their respective online accounts were linked.

"One effect of 'linking' records meant that if the complainant were to update her address using her online account, her partner's address on his online account would also be updated to reflect the change, and vice versa," the commissioner's finding detailed. "The agency's practice was to continue to keep such records linked unless and until it verified any claimed separation on the part of one of the linked individuals."

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https://www.smh.com.au/technology/the-artisanal-genius-of-creating-iphone-breaking-hacks-20210416-p57jup.html

The ‘artisanal genius’ of creating iPhone-breaking hacks

By Tim Biggs

April 24, 2021 — 12.01am

A small Australian security outfit Azimuth had a brief moment in the sun this month after revelations that the company had helped the FBI unlock the iPhone of a shooter following a 2015 mass killing.

With Apple refusing to help, the bureau had to turn to private expertise and Azimuth had the right wares. And the company’s success has shone a light on an elite cohort of hackers: experts who build software not to steal information but to help law enforcement agencies.

Founded by coder Mark Dowd, Azimuth is a boutique hacking shop that specialises in developing so-called zero day exploits - unique tools designed to take advantage of newly-discovered weaknesses in software - and has over the years delivered the goods to a number of global government agencies.

Zero day exploits in software can’t be fixed by security updates until after they’ve done their job and they can be used to create tools for very specific hacking scenarios, such as helping the FBI crack open an iPhone.

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https://www.smh.com.au/national/nsw/nsw-plans-to-lead-reform-for-digital-birth-certificate-20210423-p57lx3.html

NSW plans to lead reform for digital birth certificate

By Tom Rabe

April 24, 2021 — 5.00am

Australians would have access to a digital birth certificate under a cross-jurisdictional plan spearheaded by the NSW government.

NSW Customer Service Minister Victor Dominello said the state government was researching the development of a national digital birth certificate, with a concept plan expected to be completed later this year.

NSW Customer Service Minister Victor Dominello, seen with Premier Gladys Berejiklian, says the state government is researching the development of a national digital birth certificate. Credit: Edwina Pickles

Mr Dominello said the digital shift within government had been spurred by the coronavirus pandemic, which had also prompted the state to develop QR code check-ins and digital stimulus vouchers.

“There is no question that COVID, for NSW, has turbocharged digital adoption,” Mr Dominello said, adding that he believed his state was best placed to develop the new birth certificate.

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https://www.afr.com/policy/economy/scammer-s-paradise-why-you-should-change-your-online-habits-20210407-p57h9h

Scammer’s paradise: why you should change your online habits

It is becoming increasingly easy for scammers to build a profile of their victims as more information is handed over online and ultimately ends up in the wrong hands.

Max Mason Senior reporter

Apr 23, 2021 – 1.04pm

It started with what appeared to be a legitimate email from Australia Post and ended with the loss of nearly $5000.

The victim, who later reported the scam and agreed to share their story anonymously via the competition watchdog, had recently received a delivery from Australia Post. The email requested $1.99 for a delivery – such a small and unassuming sum that it appeared to be unpaid postage from the sender.

The payment site generated a legitimate SMS from a bank with a security code. The process was repeated three times after what appeared to be a glitch, but upon checking their credit card, the victim discovered three payments totalling $4847.16 had been made to a company.

“At first glance it appeared legit,” the victim says. “The generation of the security code from the bank actually gives a false sense of security and legitimacy.”

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https://www.australianageingagenda.com.au/event/itac-international-forum/

ITAC International Forum

When: April 27, 2021 all-day  ADHA Propaganda

Contact: ITAC Conference Secretariat 08 8981 5119

Email

Event website

Conferences Paid Conferences

ITAC Newsletter

The Aged Care Industry Information Technology Council will be holding regular International Innovation and Technology Across Care (ITAC) Forums from April 2021. This International Forum will speak to Recommendation 68 “every approved provider of aged care uses a digital care management system meeting a standard set by the Australian Digital Health Agency” as recommended by the Royal Commission into Aged Care Quality and Safety. Specifically the Royal Commission outlines that the integration of My Health Record would be an initial accreditation criteria. Come to the first ITAC International Forum to hear from international expert Professor Greg Alexander on the USA’s experience in integrated data collection along with national leading projects being delivered by the Australian Digital Health Agency in conjunction with the ACIITC.

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https://wildhealth.net.au/three-nations-one-digital-health-message/

22 April 2021

Three nations, one digital health message

ADHA Big Data Booking Engine Cloud COVID-19 DoH EHR/EMR Hospital Insights Interoperability NHS Technology

Posted by Felicity Nelson and Talia Meyerowitz-Katz

A curious thing happens when you put digital health experts from America, Scotland and Australia side-by-side on a webinar panel. While the accents change from speaker to speaker, the message remains constant.

The core lesson from the Wild Health webinar (which you can watch on demand here) was that everyone wins when we put aside differences and pitch in to build sturdy, lasting, interoperable digital infrastructure – and we can win big in the middle of a global pandemic.

But each country has its own unique challenges and there’s always more work to be done.

The panel was chaired by Jeremy Knibbs, the publisher of Wild Health.

Representing Australia on the panel was Grahame Grieve (Founder of FHIR, global interoperability consultant and principal of Health Intersections) and Professor Dorota Gertig (Medical Director, Population Health at Telstra Health and a public health physician).
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https://wildhealth.net.au/why-the-uk-and-us-are-now-in-front-of-us-in-digital-health/

23 April 2021

Why the UK and US are now in front of us in digital health

ADHA Government Interoperability MHR

Posted by Jeremy Knibbs

Last week’s Wild Health webinar on lessons from the US, the UK and Australia from COVID induced digital health innovation, sponsored by Telstra Health, revealed two countries now in front of us and moving much faster towards a more interoperable ecosystem as a result of COVID induced digital health innovation. What happened?

If you ask virtually any senior digital health staffer in any advanced country what was the greatest leap forward that COVID induced in their healthcare set up the inevitable answer is telehealth. In the UK, the US and Australia, telehealth made leaps of various sizes, often associated with governments accepting that they needed to establish pay signals the system for it to be used more effectively.

But while vastly applicable and useful in the crisis, in some ways the telehealth story belies what COVID really did in many countries, which was put their existing interoperability infrastructures to the ultimate test.

In last week’s Wild Health Webinar, digital health leaders from the US, the UK and Australia were asked what COVID induced innovations were significant and real, and what ones were more potentially illusionary. Which ones might slowly slide backwards despite the hype?

As expected, Telehealth was an initial winner nominated for each country. Notably in the UK, video telehealth took off, whereas in Australia video has not taken at all. It feels likely that video telehealth was able to take off because of existing or developing infrastructure in that country, especially around delivery of hospital outpatient services.

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https://www.theaustralian.com.au/business/technology/our-luck-will-run-out-on-ransomware/news-story/b370af28b811d0a5197ca1c23475ab01

‘Our luck will run out’ on ransomware

JAMES WRIGHT

Dear board members of Australia, it is your responsibility to protect the data of your customers, staff and other stakeholders.

Despite the fast-accelerating threat of cyber attacks – in sharp focus following the attacks on Nine and parliament – the imperative to safeguard data too often lacks the priority it deserves. Ethical responsibility will soon shift to legal, criminal liability as part of the Government’s cyber security strategy and following recent comments from Secretary of the Department of Home Affairs, Mike Pezzullo.

Overseas, the issue came tragically to a head late last year with the first ever ransomware-related death, attributed to an attack on Germany’s Düsseldorf University Hospital. This is incredibly worrying, particularly with the revelation in March that Melbourne’s Eastern Health had to postpone elective surgeries due to a suspected cyber-attack. Cyber security is officially no longer an issue for just financial or reputational damage – lives are quite literally at stake.

There is no more important place to get our systems right than in healthcare, particularly as we rely heavily on technology for the vaccine rollout and contact tracing to keep citizens safe from the very real virus that has broken through our quarantine systems time and time again.

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https://www.theaustralian.com.au/business/technology/australian-european-regulators-unite-against-big-tech/news-story/21f737476df918cb259b2f84bc6e9984

Australian, European regulators unite against Big Tech

David Swan

April 21, 2021

Australia’s competition tsar Rod Sims will urge the federal government to amend competition laws to make it easier to block mergers and acquisitions, particularly by Big Tech, with the ACCC joining with regulators in Europe to issue a rare joint statement about the issue.

The ACCC joined its counterparts and the UK and Germany to issue a warning about the dominance of the world’s tech giants, warning that COVID-19 was no reason to allow mergers that should otherwise be blocked.

“Competition can only be maintained by ensuring anticompetitive mergers do not happen. This is even more so in a fast-developing digital world impacted by the coronavirus pandemic,” the statement reads.

“We believe that in the world today there is a real need for strong merger enforcement from competition agencies globally to ensure that high concentration levels do not become the accepted norm, and to maintain and promote competition for the benefit of consumers.”

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https://www.smh.com.au/business/companies/a-global-tipping-point-for-reining-in-big-tech-has-arrived-20210421-p57kyi.html

A global tipping point for reining in Big Tech has arrived

By Paul Mozur, Cecilia Kang, Adam Satariano and David McCabe

April 21, 2021 — 10.15am

China fined the internet giant Alibaba a record $US2.8 billion ($3.7 billion) this month for anti-competitive practices, ordered an overhaul of its sister financial company and warned other technology firms to obey Beijing’s rules.

Now the European Commission plans to unveil far-reaching regulations to limit technologies powered by artificial intelligence.

And in the United States, President Joe Biden has stacked his administration with trustbusters who have taken aim at Amazon, Facebook and Google.

Around the world, governments are moving simultaneously to limit the power of tech companies with an urgency and breadth that no single industry had experienced before. Their motivation varies. In the United States and Europe, it is concern that tech companies are stifling competition, spreading misinformation and eroding privacy; in Russia and elsewhere, it is to silence protest movements and tighten political control; in China, it is some of both.

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https://www.itnews.com.au/news/govt-data-access-should-be-gated-privacy-assessment-finds-563586

Govt data access should be gated, privacy assessment finds

By Justin Hendry on Apr 20, 2021 3:04PM

No access under planned data sharing laws without accreditation.

A privacy impact assessment of the federal government’s planned public sector data sharing scheme has called for agencies to be subject to the same accreditation requirements as the private sector.

The independent PIA [pdf], released last week, is the third assessment of the reforms, which are bookended as the Data Availability and Transparency Bill (DATB) currently before parliament.

If passed, the bill will allow accredited users and data service providers (ADSPs) to access data for three purposes: service delivery, informing policy and programs and research and development.

Under the legislation, the National Data Commissioner (NDC) will be responsible for accrediting data users and ADSPs, with organisations wishing to access data required to undergo assessment and provide information to support their claim.

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https://www.zdnet.com/article/critics-label-data-sharing-bill-as-eroding-privacy-in-favour-of-bureaucratic-convenience/

Critics label data-sharing Bill as 'eroding privacy in favour of bureaucratic convenience'

The Australian Privacy Foundation and the NSW Council for Civil Liberties are among those labelling the country's pending data-sharing Bill as a threat to basic fairness and civil liberties.

By Asha Barbaschow | April 20, 2021 -- 06:29 GMT (16:29 AEST) | Topic: Security

Australia's pending data-sharing Act has been touted by the government as allowing the public service to make better use of the data it already holds, but Dr Bruce Baer Arnold from the Australian Privacy Foundation would argue it does so at the cost of privacy protections.

"The Honourable Stuart Robert has promoted the legislation as providing, 'Strong privacy and security foundations for sharing within government'. It's both deeply regrettable and very unsurprising that the Bills do not provide those foundations," he told the Senate Committee probing the Data Availability and Transparency Bill 2020.

"The Bill reflects the ongoing erosion of Australian privacy law in favour of bureaucratic convenience."

He added that he believed the Bill would obfuscate recurrent civil society requests for privacy protections.

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https://www.australianageingagenda.com.au/technology/providers-encouraged-to-take-part-in-clinical-software-survey/

by Sandy Cheu April 20, 2021

Posted in Technology

Providers encouraged to take part in clinical software survey

Residential aged services are invited to take part in a national survey investigating the uptake of clinical software and its impact on resident outcomes.

Aged care technology peak body Aged Care Industry Information Technology Council is undertaking the survey in partnership with the Australian Digital Health Agency.

It aims to identify what clinical software residential aged care facilities in all locations are using, how they are using it and the impact it has on resident outcomes.

ACIITC chair of the National Home Care Group Anne Livingstone said there has been little research in this area and this survey aimed to provide a snapshot in time.

“We don’t have a benchmark in time about the uptake of this software and also whether being sophisticated in your use of clinical platforms is assisting in improving the quality and safety of the services you provide,” Ms Livingstone told Australian Ageing Agenda.

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https://www.cesphn.org.au/general-practice/education/external-education/4650-my-health-record-a-practical-demonstration-accessing-immunisation-information

My Health Record a Practical Demonstration - Accessing Immunisation Information

Thursday, 22 April 2021 | 2.00pm ADHA Propaganda

Online

This webinar will cover the enhancements to the My Health Record immunisation information that is available within Clinical Information Systems (currently scheduled to be released in late April 2021), National Provider Portal and the Consumer Portal.

There will be a new consolidated Immunisation View, that will extract data from AIR as well as documents within the individual's My Health Record. These enhancements aim to increase usability and access to immunisation information, including any COVID-19 vaccinations received.

Webinars will run regularly till 30 June 2021.

Link for more information and registrations: https://register.gotowebinar.com/rt/3436850561444501005?source=Bulletin

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https://www.afr.com/politics/federal/industry-hails-digital-s-return-to-centre-of-government-20210419-p57kdo

Industry hails digital’s return to centre of government

Tom Burton Government editor

Apr 20, 2021 – 12.02pm

The return of the Digital Transformation Agency to the Prime Minister’s department under a senior cabinet minister marks a major elevation of digital, say industry experts, providing a much-needed strengthening between policy and delivery.

This will be especially so for integrated services like those involving the birth of a child, common functions such as digital identity, and key cross-government digital initiatives such as data sharing, cyber security and privacy modernisation.

The DTA’s shift from the Social Services portfolio to a powerful central agency, overseen by Employment Minister Stuart Robert, was widely welcomed by industry and experts who have been calling for a more robust, co-ordinated approach to digital initiatives and over $6 billion in federally sponsored annual transformation projects.

These include the creation of a new super registry for business, the expansion of consumer data rights and open markets, new critical infrastructure security requirements, a permissions platform to support visas and export controls, and the development of a signature “Digital Australia platform” being developed for the upcoming budget.

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https://www.miragenews.com/government-urged-to-fund-gp-aged-care-visits-546064/

April 20, 2021 6:06 am AEST

Government urged to fund GP aged care visits and nursing home infrastructure

The AMA is calling for increased funding to support and encourage more GPs to visit patients in nursing homes as well as greater investment in nursing home facilities to make it easier for GPs to deliver the care that people in nursing homes deserve.

The call comes as AMA members report significant barriers to delivering care and deterring doctors from visiting aged care facilities altogether.

Problems include:

  • incompatible IT systems
  • lack of nursing staff to identify patients and assist GPs with clinical handovers
  • no clinically equipped private examination rooms available
  • lack of physical access with no parking, and the need for personalised swipe cards and access codes
  • lack of adequate financial support for doctors’ visits

These hamper the delivery of quality patient care for our older Australians.

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https://www.afr.com/technology/what-do-we-do-when-google-does-evil-things-20210418-p57k91

What do we do when Google does evil things?

The ACCC’s win showed that even turning off location history isn’t enough to tell Google not to keep a history of your location.

John Davidson Columnist

Apr 19, 2021 – 4.29pm

The notion that a company as big and ubiquitous as Google would resort to deliberately misleading and deceiving Australians into giving away what they thought was private information about themselves is shocking, to say the least.

But that’s exactly what was revealed last week, when the Federal Court of Australia agreed with the Australian Competition and Consumer Commission and found that Google engaged in misleading and deceptive conduct when it kept collecting and storing location data from Android phones, even after users had explicitly turned their phone’s “Location History” setting to “off”.

A Federal Court has just found that Big Tech is watching you, even when you think it’s not. 

It seems that turning off location history wasn’t enough of a signal to Google, to tell it to stop keeping a history of your location. You had to turn it off in another place in your Android phone, too (“Web & App Activity”), before Google really took you seriously and stopped tracking you.

It’s shocking behaviour, to be sure, but it’s hardly surprising.

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https://www.itwire.com/business-it/aiia-urges-morrison-government-to-fully-fund-a-national-ai-strategy.html

Monday, 19 April 2021 17:10

AIIA urges Morrison Government to fully fund a National AI Strategy

By Alex Zaharov-Reutt

The Australian Information Industry Association (AIIA) is calling on the Federal Government to allocate $250 million in the May budget to ensure Australia becomes a global leader in AI (artificial intelligence) research and commercialisation and doesn’t fall behind its international peers.

When the Government does announce its National Artificial Intelligence (AI) Strategy it must come with significant funding over the $29.9 million it currently contributes over four years. The Australian Government commissioned the Artificial Intelligence: Solving problems, growing the economy and improving our quality of life, in November 2019 to assist its AI Roadmap which outlines the many opportunities and benefits available from investing in a National AI Strategy.

The AIIA is urging the Federal Government to support AI efforts, and focus on supporting R&D through to commercialisation of innovative products and services.

This will help to maximise the return for Australian businesses and boost the AI sector and ensure our traditional industries remain internationally competitive including in agriculture, finance, health and manufacturing.

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https://www.itwire.com/security/rising-number-of-data-breaches-must-signal-a-change-in-security-strategy-94544.html

Monday, 19 April 2021 13:35

Rising number of data breaches must signal a change in security strategy

By Daniel Lai

Guest Opinion: It’s widely known that data breaches pose a costly threat to any organisation, but the trend to work from home since the start of the coronavirus crisis a year ago has presented a new set of challenges for IT and security professionals.

This year, the Office of the Australian Information Commissioner (OAIC) released its Notifiable Data Breaches Report, which unveiled an 18 per cent increase in reported breaches due to human error. This was by far the highest percentage increase across the categories and accounted for 38 per cent of breaches overall.

The OAIC warned organisations to reduce the risk of data breaches and prioritise training staff, as well as putting systems in place for detecting and containing breaches. The reality is this: even with user training and visibility, human error is ultimately inevitable, and working from home is likely to increase that error rate. Instead, we must update our security approach to match the new challenge.

Cybersecurity professionals recognise that there is an issue here. Recent research of 287 security professionals conducted by Cybersecurity Insiders found almost three-quarters of organisations are concerned about the security risks of having employees working from home, especially the threat of sensitive data leaving the perimeter. The apps that worry them the most; file sharing (68%), the web (47%), video conferencing (45%), and messaging (35%).

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https://which-50.com/mhr-is-the-ever-given-of-healthcare-transformation-can-it-be-freed-2/

Opinion: MHR is the Ever Given of healthcare transformation — can it be freed?

Jeremy Knibbs April 19, 2021

The first part of this article, outlining the many problems with My Health Record, appeared on Friday.

The Australian Digital Health Authority (ADHA) has a tender out to re-platform the My Health Record (MHR) program. The project is the government’s answer to a lot of the criticisms laid out in Friday’s instalment. The revised platform will provide some snazzy technology bridges for data sharing with the big central database, including open APIs and cleaner integration with Fast Interoperability Healthcare Resources (FIHR). 

But it’s still a big old database of disorganised information in the far corner of a government server room which a patient and a tech vendor have to access back and forth for any data to flow.

Why put a giant old database in the middle of the process? Why not just help patients by facilitating distributed technology to talk to a patient’s mobile phone when needed?

Past the embarrassment of having to mothball a $2 billion white elephant, the bureaucrats in charge would be giving up a lot of control if they let the market work as it should. They wouldn’t be running a giant and important data project, and they wouldn’t have oversight of all that important data. They would lose a lot of perceived power in guiding digital health.

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Comments more than welcome!

David.