This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
The Productivity Commission’s report on the failure of the
federal government’s My Health Record portal should concern all Australians not
only as taxpayers, but as health care consumers in a rapidly ageing society.
May 8, 2024 – 6.38pm
The Productivity Commission’s report on the failure of the
federal government’s My
Health Record portal should concern all Australians not only as taxpayers,
but as health care consumers in a rapidly ageing society.
Despite the $2 billion invested in what was supposed to be a centralised
digital access point for patients’ most important health data, poor
interoperability and clunky usability means that just a tiny fraction of the
documents uploaded – 2 per cent – are viewed by other clinicians.
My Health Record aims to centralise health records, allowing patient information to be readily available to various medical professionals across the country.
And with just under a third of specialists and 6 per
cent of aged care facilities using the portal, much important information
remains locked in individual health providers’ digital systems.
Enabling a consumer-focused health revolution
means challenging the political economy and provider capture of Medicare.
As rising health costs threaten to put unsustainable fiscal pressure on
government budgets, the
Productivity Commission estimates that better use of electronic health data
could save upwards of $5 billion a year on avoiding duplicate tests, shortening
hospital stays, creating workforce efficiencies including through AI and
automation, and by enabling Telehealth to remotely manage and treat patients.
The current fragmentation of health data reflects the siloed nature of a
medical system that pays different doctors and other health professionals to
care for different conditions. That system is outdated when the bulk of the
community’s healthcare needs involve increasing numbers of older patients with
multiple chronic diseases.
The goal of health reform should be to move away from paying individual
practitioners for fee–for-service inputs, and move to a system that funds
comprehensive chronic care and rewards providers who keep Australians
healthier.
Enabling a consumer-focused health revolution means challenging the
political economy and provider capture of Medicare.
But a start can be made by ensuring patient data is electronically available
with just a few clicks.
Fixing Australia’s digital health black hole is also the first step towards
using big data to find out what keeps people well in an older and sicker
nation.
A new smartphone app will alert Australians in real time if an identity thief tries to use their personal data to commit fraud.
Attorney-General Mark Dreyfus has announced an $11 million budget commitment for an online register that informs people if their data is being used to steal money or fake an identity.
The Credential Protection Register was set up after the high-profile 2022 Optus data breach, allowing exposed Optus customers to check if their personal credentials were being used maliciously. The government says it has blocked 300,000 hacking attempts.
Now Labor is expanding the program to allow the broader community, including those who have never been caught up in a data breach, to proactively check if their details have been compromised via the app.
“The register enables people who have had their personal details stolen to quickly lock down their information to prevent their data being used for identity crime and theft,” Dreyfus said in a statement.
“This in turn disrupts black market sales of stolen personal documents and illegal activities that rely on those stolen credentials including scams, money laundering and fraud.Qantas says it has resolved an issue that allowed users the ability to see other passengers' details, including boarding passes, on their phones.
“The mobile application will allow an individual to be notified, in real time, if someone is using their identity without their consent.”
The app, which is scheduled to be operational by the end of the year, would allow individuals to know in real time if someone has used their passport to update their details at the Australian Taxation Office, for example. In this situation, the individual could immediately act to counter the fraud.
The existing register has prevented attempts at fraud, including someone using a compromised passport to try to create a myGov account, and a bid to establish new phone plans using a compromised driver’s licence.
The government is confident the register itself will not be susceptible to hacking attempts because it says the tool does not act as a database and stores no personal information.
“We live in a world where data breaches and cyberattacks are now all too commonplace, and where cybercriminals and nefarious state actors seek out our personal information for financial gain or global strategic advantage,” he said.
“The global economy relies on data and personal information. We are all constantly producing valuable personal information as we go about our daily lives.
“Just about all of us are online, nearly all of the time, but in return for this Australians are increasingly being asked to share their personal information in online transactions. And they expect that when they do, their information will be protected and that they will maintain control over it.”
Here is the actual release: Mobile app to protect identity credentials from cyber crooks
The Hon Mark Dreyfus KC MP
5 May 2024
Media Release
The Albanese Government will provide an additional $11 million in the 2024-25 Budget for a mobile app and secure website that will enable all Australians to easily and swiftly protect their identity credentials from cyber crooks.
The funding over four years will build on the success of the Credential Protection Register which allows Australians to see when and how their identity credentials are being used to verify their identity, regardless of whether their credentials have been compromised.
Since it was established in October 2022 following the Optus data breach, the Register has blocked over 300,000 attempts to use stolen identity credentials.
The Register enables people who have had their personal details stolen to quickly lock down their information to prevent their data being used for identity crime and theft.
This in turn disrupts black market sales of stolen personal documents and illegal activities that rely on those stolen credentials including scams, money laundering and fraud.
The mobile application will allow an individual to be notified, in real time, if someone is using their identity without their consent.
Individuals will then be able to act immediately to control their identity credentials by enabling or disabling their use for verification.
These changes will give Australians full control of when and how their identity credentials are being used and allow them to disrupt illegal use of their identity.
This funding is in addition to the $3.3 million provided by the Government in the Mid-Year Economic and Fiscal Outlook to enhance the Register.
For more information on how to protect your identity – visit the IDMatch website.
I have to say I can’t work out how this would actually work without manual detail entry. It sounds great but I need a few more details to become a believer!
Less than 2 per cent of documents in the My Health Record system are being looked at by doctors, with incomplete records, poor interoperability and clunky usability frustrating patient and clinical use of the $2 billion federal portal, according to a new Productivity Commission report.
“Despite major investment in the My Health Record system, patient data is still fragmented and spread across different digital systems maintained by individual healthcare providers,” commissioner and economist Catherine de Fontenay said.
“The usability of MHR [currently described as a ‘shoebox of PDFs’] needs to improve in tandem with its coverage. Government should work to break down or ‘atomise’ data in MHR to make it more useful.”
Telehealth can save nearly $900 million in travel time and waiting room costs, says the Productivity Commission.
“We estimate that making better use of data in electronic medical records systems can save up to $5.4 billion per year by reducing the length of time patients spend in hospital, and $355 million in duplicated tests in the public hospital system alone.”
Dr de Fontenay said artificial intelligence and automation presented a major productivity opportunity for healthcare. She cited studies suggesting 30 per cent of the tasks currently undertaken by the healthcare workforce could be automated, equal to 11 hours a week.
The commission’s report said My Health Record was intended to be a central access point for a patient’s most important health data, but despite an investment of more than $2 billion, it continued to be “plagued by incomplete records and poor usability”.
There are now 23 million records with 1.2 billion documents in the federal portal, but the report said only a fraction were being accessed by clinicians.
“Commission estimates suggest that around 2 per cent of documents uploaded by healthcare providers are viewed by other healthcare providers,” the report says.
“For clinicians who do use MHR, it is not clear that they regularly use it as a source of information.
“Providers are generally more likely to upload information to MHR than they are to actually view it.”
Dr de Fontenay said the lack of take-up of the federal portal was resulting in state governments expanding their own state-based medical reporting systems, including to patients, further fragmenting health information.
Reduce decision-making time
She said the electronic medical report systems enabled modern digital workflows, reducing decision-making time. This, in turn, shortened hospital admissions stays, yielding an estimated $5.4 billion in savings based on 2020-21 costs.
The report also found virtual health initiatives such as telehealth could save up to $480 million in travel cost times and around $415 million in surgery wait times.
“Telehealth use has exploded since 2020, but uptake of remote patient monitoring and digital therapeutics has lagged behind,” Dr de Fontenay said.
With less than a third of specialists and only 6 per cent of aged care providers using the MHR system, the federal government is mandating the uploading of diagnostic imaging and pathology results.
“But getting the information onto the system is only half the challenge – clinicians also need to draw on this valuable information,” the report says.
“If this is to occur, mandatory uploading will need to be accompanied by changes that allow practitioners to efficiently search large volumes of data and display reports in a way that is easy to read and accessible.”
Dr de Fontenay also picked up previous recommendations to have health information presented in formats that enable easy searching rather than PDFs, which are problematic to search.
“Shifting towards storing data in an atomised format would help. Atomisation would involve storing individual pieces of information at their most basic level, rather than in a format that is more difficult to reduce,” she said.
She said the greatest potential benefits of this change would be realised if MHR information was capable of being used by other digital systems.
‘Radicalised’ teen shot
dead after stabbing in Perth
By Paul Garvey Senior Reporter
and Tricia Rivera Journalist
12:00PM May 5, 2024
A 16-year-old boy who was believed to have been radicalised has been shot dead in Western Australia after allegedly stabbing another person and charging at police.
WA Premier Roger Cook and Police Commissioner Col Blanch disclosed details about the incident at a press conference in Perth on Sunday morning, saying the teen called police just after 10pm on Saturday to let them know he was going to “commit acts of violence”.
Mr Cook said members of the Muslim community had made multiple calls to 000 concerned about the boy shortly before the incident occurred. He said authorities believed that the boy had been “radicalised”.
The victim of the attack is currently in hospital with a stab wound to the back. He is in a serious but stable condition.
The boy is known to police and was involved in a countering violent extremism program. He joined the program in 2022.
The incident took place in a carpark outside a Bunnings store in Willetton.
The Premier labelled the incident as “extremely confronting’.
“A 16 year old male with a knife who had already wounded a member of the public rushed attending officers. In response, a police officer discharged his firearm.
“There are indications he had been radicalised online. But I want to reassure the community at this stage it appears that he acted solely and alone.
“Members of the WA Muslim community who were concerned by his behaviour contacted police prior to the incident, and I thank them for their help.”
Commissioner Blanch said police received a call from the young man before the attack.
“That male indicated that he was going to commit acts of violence. He didn’t provide his name nor location and the phone was in a phone call was in terminated.,” Mr Blanch said.
“Some minutes later, police received another triple zero call from a person ... stating that a male with a knife was running around the car park.”
He said three officers attended the location within three minutes of the call and were confronted with the man who was wielding a large kitchen knife.
“Two officers drew the tasers and one of the officers drew his firearm and challenged the male to put down the knife which he did not comply.”
The 16-year-old allegedly rushed one of the officers who tried to deploy a taser on him.
Commissioner Blanch said a second taster was also used but it did not have the “full desired effect”.
“The male continued to advance on the third officer with a firearm, who fired a single shot and fatally wounded the male,” he said.
“He was taken to hospital and declared deceased at approximately 11pm.
“It’s a very tragic event in Western Australia. It saddens me that I have to be here today talking about it.”
He said that the officers acted in line with their training,
Anthony Albanese said their was no place violent extremism in Australia.
“My thoughts are with those who have been affected by the incident in the Perth suburb of Willetton overnight,” the Prime Minister said in a statement.
“I have spoken with WA Premier Roger Cook this morning, and I thank the WA Police for acting swiftly to contain the incident.”
Mr Albanese said he had received a briefing on the incident from ASIO Director-General Mike Burgess and Australian Federal Police Commissioner Reece Kershaw and that there is “no ongoing threat” to the community at this time.
“We are a peace-loving nation and there is no place for violent extremism in Australia,” he said.
I am really beginning to wonder just what is happening here. It seems clear that none of these incidents are unexpected by people close to the affected nippers and it is very sad more cannont / has not been done to address the underlying issues.
Issues of this sort do not come out of a “clear blue sky” in my view and those close to the problems cannot just ignore the warning signs, if catastrophes are to be avoided. That said it can be very hard to identify the individuals who will really run off the rails vs those who can make it safely to the station! This is really an amazingly difficult for any health system!
I have teen-age grandchildren and I know just how hard it can be to be sure that all is within reasonable bounds…..
That said some of the behaviour we have seen recently is clearly of concern and needs well-thought out and effective responses!
Is it my imagination or are these problems becoming more common?
The DoHAC has scrapped a seven-day delay in patients viewing
pathology and diagnostic imaging results, against the advice of medical
colleges.
The My Health Record changes were one recommendation of the
Strengthening Medicare Taskforce.
Patients
will be able to access certain test results immediately and without the
supervision or oversight of their doctor, following a change to My Health
Record (MHR) access rules.
It says this change will give both patients and their doctors better access to
information, empower patients to participate in their own healthcare, and
reduce duplication.
While there will still be a delay in some circumstances, such as where there is
evidence of clinical safety or other risks, the
decision overrides serious concerns from the RACGP and other medical groups
about the potential risks of making results immediately available to patients.
‘Maintaining the seven-day rule allows consumers to have access to their health
information, albeit with a small delay that allows their GP or other clinician
to discuss their results with them,’ the
college said in a submission last year.
‘We do not consider the benefit of real-time access to results outweighs the
potential harm of consumers misinterpreting results or receiving unfortunate
results with no immediate clinical support.’
Dr Emil Djakic,a member of the RACGP Expert Committee – Funding and Health
System Reform, told newsGP
the changes mean medical information could reach patients in a way that cannot
be contextualised by their GP.
‘Some patients are very literate and will be more than happy to look, some
patients will not even bother looking at it, and there’ll be a few that will
look at it and probably see some pretty scary outcomes,’ he said.
‘Some of the language in these reports does create quite a lot of anxiety
without a level of health literacy, so that is concern.
‘It comes with a responsibility, and that is the responsibility of the patient
who, on viewing that data, has to accept what they’re seeing is something
they’re reading without any assistance or interpretation.’
The changes were one of the recommendations of the Strengthening Medicare
Taskforce, which also called for public and private pathology and
diagnostic imaging providers to share their reports to MHR by default.
However, Dr Djakic said the lack of a seven-day access delay means some
patients could see their results and choose not to follow-up with their
healthcare provider.
‘They will choose to interpret it themselves because it avoids a visit to the
doctor, or a phone call, or a consult – there are all sorts of reasons that the
consumer might choose to say, “that’s adequate for me”,’ he said.
‘We need to be making sure it’s somehow reflected in My Health Record that this
consumer has viewed the data and if they don’t proceed with engaging with the
appropriate clinician, to help steer them through that data.’
The volume of pathology and diagnostic imaging reports uploaded is also in the
rise, with both up around one third in just one year.
As the popularity of MHR continues to grow and as patients demand more
digitised and modernised access to their healthcare records, Dr Djakic said GPs
must adapt.
‘In health system reform, we’re clearly keen to see data move more easily and
make the patient the centre of their healthcare, and this is a step to that,’
he said.
‘We’re seeing these sorts of adaptions every day, and our industry is in the
midst of seeing what this means, how it works, and how we continue to serve the
patient with the best possible care with this information.
‘We’re in this reform space where we’re looking at how do we how to manage this
in a way that meets the patient’s needs as safely, and with as much care and
quality as required.’
To accommodate the access changes, the Australian Digital Health Agency will
soon begin helping healthcare providers to meet the new requirements.
This
looks to me rather like a population wide experiment that will probably work
out most of the time but my cause all sorts of problems with a few. I hope
there is a safety net to catch those patients but I am not sure there is.
Protesters seek to wash
away the ‘sin’ of their own privilege by donning keffiyeh
12:00AM May 4, 2024
Whatever happened to the sin of “cultural appropriation”? You remember that wacky idea. It involved blue-haired woke activists raging against anyone who dared to “appropriate” the culture of a different ethnic group. On campuses across the Anglo-American world, “cultural appropriators” were forever being called out.
Whether it was a white dude sporting dreadlocks or a drunk student putting on a sombrero, the cry would go up: “Stop stealing other people’s culture!” I’m not joking about the sombreros. Student officials at the University of East Anglia in England went so far as to ban non-Mexican students from donning Mexican headgear on the basis that it’s “racist”.
Pop singer Katy Perry was accused of “appropriating black culture” after wearing her hair in cornrows. Even the sainted Beyonce got it in the neck after sporting a sari in a Coldplay video. Is she “misusing Indian culture”, pondered the lunatic BBC?
Cultural appropriation, declared the Oxford Dictionary, refers to “Western appropriations of non-Western (culture)”. You must never do this, barked PC finger-waggers. Yet fast forward to today and cultural appropriation seems to be acceptable again. In fact, it’s all the rage.
Right-on campuses are awash with upper-class white kids wearing the garb of “non-Western” people. No, not the sombrero or forbidden Afro hairstyles but the keffiyeh. Everywhere you look, from Los Angeles to London to Sydney, students are adorned in these checkered scarfs from the Middle East.
The kind of people who just a few years ago would have harangued some white girl for getting a Japanese-style tattoo now spend their days decked out in Arab attire.
They call it solidarity, of course. We wear the keffiyeh to show our support for the beleaguered Palestinians, they say.
I’m not buying it. Since when did solidarity involve fancy dress? I don’t remember those 1960s kids who protested against the Vietnam war putting on bamboo conical hats in mimicry of the Vietnamese peasants who often felt the heat of US bombs. Or Western supporters of the Quit India Movement wearing white dhotis in the style of Mohandas Gandhi.
The keffiyeh craze feels more like radical chic than meaningful activism. The Arab cloth has become an essential fashion item for the woke, the mandatory uniform of the self-righteous. Keffiyeh-wearing is less about drawing attention to the plight of the Palestinians than drawing attention to “you”. Pulling on a keffiyeh is a shortcut to the moral high ground. Hipsters will smile at you in the street. Your local craft coffee house may even give you your macchiato for free.
When I see students camping out for Gaza with keffiyehs wrapped around their necks and faces, I don’t think: “Now that’s solidarity” – I think: “Now that’s showing off.” It’s an act of moral distinction, a way for the educated elites to differentiate themselves from the supposedly indifferent throng.
These keffiyeh wearers are plundering foreign culture far more egregiously than some legless bloke in a sombrero propping up the student bar. For they don’t only dress up like Gazans, they creepily mimic their living conditions, too.
Witness the student leader at Columbia University in New York City – in a keffiyeh, of course – saying that she and her fellow campers required “humanitarian aid”. Do you want us to “die of dehydration and starvation”, she crazily asked university bosses.
There is something gross about privileged kids on an Ivy League campus cosplaying as victims of a humanitarian crisis. These people could have pizza Deliverooed at a moment’s notice.
In one truly cringe-worthy clip, a group of Columbia students could be seen receiving “humanitarian aid” through the college gates. I say humanitarian aid – it was probably just their Starbucks order or a blueberry muffin from a local bodega.
It came off as a crass re-enactment of the scenes we’ve seen in Gaza: hyper-privileged Ivy Leaguers masquerading as the wretched of the earth.
When mainly Jewish counter-protesters confronted the Gaza camp at the University of California, Los Angeles, the campers denounced them as “Zionist thugs”.
This is what life must be like for the Palestinians, some said. These people have no shame. It’s not enough to appropriate Palestinian scarfs – they want to appropriate Palestinian suffering, too.
This is a new, strange and unsettling kind of activism. It’s not ’60s-style solidarity with foreign struggles. And it actually goes beyond radical chic, beyond politics as fashion statement.
No, this is about coveting suffering. These activists, it seems to me, crave the moral rush of oppression, the thrill of persecution. They pull on the garb of a beleaguered people to escape, however fleetingly, the spoilt, pampered reality of their own lives, to taste that most prized of social assets in the woke era: victimhood. In draping the keffiyeh around their shoulders, they get to be someone else for a while. Someone less bourgeois, less white. Someone a little more exotic, a little more interesting.
It’s not politics – it’s therapy. They seek to wash away the “sin” of their own privilege through mimicking what they consider to be the least privileged people on earth: the Palestinians. It’s not Gaza they want to save but their own souls. It feels as if they’re more interested in what Palestine can do for them than in what they can do for Palestine. Palestine becomes little more than a source of meaning, a fountain of purpose, in the lives of bored youths on leafy campuses.
It’s a toxic mix of narcissism and racism, with Arabs reduced to the lowly role of soothing the white guilt of privileged Westerners.
Listen, that’s not solidarity, it’s the opposite – selfishness.
I may have this wrong but is seems to me there is a war happening in Gaza and people are dying because of it. To me the rights and wrongs of this conflict have been lost with the passage of time and so what we now need to do is work out a way forward for both the Israelis and he Palestinians.
Much smarter and better informed people than me have tried for a long time (100+ years) to solve this conflict and have failed so it really does seem that the only solution involves the two sides being separated and getting on with their respective lives – enclosed and separated by agreed borders. How we get there is well above my pay grade but get there we must!
There is way too much suffering, starvation etc. happening in this tiny speck of land and the world really has a responsibility to end it. It is a blight on all our consciences until it is addressed and I hold in awe those from MSF and WCK (among others) who are working to reduce the suffering….
I really hope that sanity will soon prevail, while understanding there is little I can do to actually fix things!
Every once in a while you just need to let off a little steam and hope sanity is a little closer than it was!
