Here are a few I have come across the last week or so.
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General Comment
What an amazing week with an incompetent Parliament passing laws to extend the PCEHR! Other stuff also included.
What a disaster for e-Health in Australia as the mindless ill-conceived juggernaut just rolls on!
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12 Nov 2015
The Senate Community Affairs Legislation Committee has recommended that the Health Legislation Amendment (eHealth) Bill be passed, with proposed increased penalties for misuse of My Health Record information. The Bill proposes, among other things, to change the name of the PCEHR system to the My Health Record system and enable trials of opt-out participation.
The Senate Community Affairs Legislation Committee tabled its report on the Health Legislation Amendment (eHealth) Bill this week. The report noted the AMA argued against the introduction of increased civil penalties and new criminal penalties in relation to unauthorised use or disclosure of My Health Record information. However, the committee considered that these penalties are justified as deterrent measures to protect the privacy of system participants.
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Bill officially passes parliament.
The Australian government has been given the go-ahead to create a digital health record for every Australian by default pending the success of trials of the model, after the bill for opt-out records passed the parliament today.
The change in approach was a response to slow take-up of the former Labor government's PCEHR scheme, which allowed individuals to opt-in to the digital health record.
The Health Legislation Amendment (eHealth) Bill 2015 today passed the Senate with no amendments, allowing the government to trial opt-out e-health records in two locations in Queensland and NSW, covering around one million individuals.
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The health records of Australians are set to go online by default, with the new system to be trialled first in northern Queensland and in the Blue Mountains.
The medical records of all Australians are set to go online after legislation to revamp the e-health system and get more people using it cleared Parliament.
The new My Health Record system is to be trialled first in north Queensland and the NSW Blue Mountains region, and will be rolled out nationally if it proves a success.
Australians will need to opt-out of the system if they don't want an e-health record, as opposed to the current model, which started out as the Personally Controlled E-health Record System, which required patients to opt-in.
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Privacy group call for opt-out to be dumped
A parliamentary inquiry has endorsed a government bill that will enable the national eHealth system to potentially be shifted to an 'opt-out' model.
Health minister Sussan Ley in September introduced the Health Legislation Amendment (eHealth) Bill 2015.
The bill implements recommendations from the 2013 review of the Personally Controlled Electronic Health Record (PCEHR), including renaming the record to 'My Health Record'.
The bill will allow the minister to apply opt-out participation to particular areas, which will enable trials of new approaches intended to boost participation in the system.
A report from the Senate's Community Affairs Legislation Committee was tabled yesterday in the upper house and recommends that the bill be passed.
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26 minutes ago
A PARLIAMENTARY committee has been labelled "dangerously naive" after giving its tick of approval to electronic health records for all Australians.
A SENATE inquiry into government legislation says tough penalties will address any fears of sensitive medical details being accessed or used inappropriately.
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The Privacy Foundation has accused the Australian Senate of ignoring privacy concerns in making the e-health record system opt-out.
The Australian Privacy Foundation has accused the Senate of being "dangerously naive" in thinking that opt-out e-health records could be secured against breaches of privacy.
Bernard Robertson-Dunn, a member of the Privacy Foundation who has also constructed IT systems for several government departments, said it is "patently absurd" for the Senate inquiry committee to think that Australian laws will do anything to deter criminals and cyber attacks from overseas.
The Senate had said it would institute penalties for privacy breaches in order to address concerns over the misuse of confidential medical information.
The Senate had ignored expert advice by changing the e-health records to be opt-out, according to the Privacy Foundation, with the likelihood of personal information being stolen and published in an attack similar to the Ashley Madison hack increasing with the more data that is stored.
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Privacy foundation slams 'dangerously naive' Senators
Australia's peak privacy body has lambasted the country's Senate for being ignorant about the implications of the country's new e-health records.
What was once called the Personally Controlled Electronic Health Record (PCEHR), re-branded My Health Record this year to give it a smiley face, is the government's attempt to dragoon Australians into a national health database.
Looking behind the mask, however, the Australian Privacy Foundation reckons the e-health system looks more like it was designed for spooks and revenue-collectors than for doctors or patients.
Coming in for special criticism is the Senate committee recommendation (full report here) that My Health Record be changed from an opt-in system to an opt-out system. That decision seems designed to boost the chronically low take-up of a system that this year got a budget allocation of more than AU$450 million (its 15-year estimated cost from 2010 to 2025 is $3.6 billion).
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Concern over use and abuse of care plan items has been a long-running and heated topic of discussion among GPs.
This year, the Professional Services Review raised the issue of computer-generated templates — seen by most doctors as a way of dealing with the red tape headaches inherent in the Medicare system.
A regular problem, according to the PSR, is that practice software automatically updates chronic disease management (CDM) care plans, by simply changing the date.
The computer is set to remind the practice to produce new MBS care plans as soon as the patient becomes eligible.
But some of these templates are so automated that they verge on the ridiculous.
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Online CBT programs have no benefit in depression because patients fail to engage with them, a major evaluation by GPs has found.
UK researchers have recommended against routine use of online CBT after their randomised controlled trial in 100 primary care practices found that programs such as the widely recommended MoodGYM conferred no benefit compared with usual GP care.
Almost one quarter of patients dropped out within four months of being offered the Australian-developed free program, or a commercial program called 'Beat the Blues', showed the research by the Department of Health Sciences at the University of York.
In addition, only about one in six of the 378 participants completed all the assigned computerised CBT sessions.
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12 November 2015
Problems with information technology (IT) in general practice are creating risks for patient care, a study led by researchers at Macquarie University, Flinders University and the University of New South Wales has found. The TechWatch study, published in BMJ Quality and Safety, examined the effects of IT errors on patient safety in general practice
The researchers asked 87 General Practitioners (GPs) across Australia to report any IT incidents over a 19 month period between 2012-2013 that could lead to patient harm or near miss events, finding that IT issues were at fault for 90 reported incidents during this period. While some of the patient safety risks were carried over from historical paper records system, there were an array of additional disruptions in workflow and hazards for patients unique to IT.
“Our results show that IT problems can disrupt care delivery and pose risks to patient safety,” said Associate Professor Farah Magrabi from the Australian Institute of Health Innovation and the NHMRC Centre for Research Excellence in E-Health at Macquarie University.
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Practice software problems are wasting doctors’ time and have the potential to lead to dangerous prescribing errors, research shows.
On average GPs spend two hours a week troubleshooting software issues such as frozen screens, problems with software updates, and disappearing or mismatching patient data, according to a study of 87 GPs across Australia.
If replicated nationwide, this suggests that Australia's 22,600 GPs spend a total of two million hours per year fixing IT problems.
The study found that software issues also put patients at risk, with GPs in the study reporting 90 incidents that either caused patient harm or led to a near miss event over a 19-month period.
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9 November 2015
SEVEN GP practices assessed for eHealth PCEHR privacy safeguard compliance all failed to fulfil the requirements — sometimes for simply not activating the screensaver lock when a computer was left unattended.
That assessment is one of five audits the Office of the Australian Information Commissioner (OAIC) has undertaken, according to its 2014–15 report.
The report refers to the audits and says no complaints of breaches were made to the independent PCEHR overseer, but that “a number of recommendations” had been accepted by the health department.
One of these assessments, not contained in the annual report, scrutinised eHealth security in the seven clinics — all active eHealth system users and Health Provider Organisation (HPO) members — between December 2014 and April 2015.
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You leave a data trail every time you tap your card to make a payment, dial a phone number or use the internet. But would you be willing to let that data tracking into the bedroom, the gym and the doctor’s surgery?
National Australia Bank’s insurance arm is about to test that proposition by handing out smartwatches that collect data on resting heart rate, sleep patterns and exercise to some of their life insurance customers, in what is believed to be a first for wearable technology in Australia. In exchange for agreeing to sign over information collected by the watch and then meeting good health goals, MLC is offering discounts on life insurance policies of up to 10 per cent.
It is being pitched as an initiative to try to get customers into healthy habits that will reduce their need to claim.
“It’s a bet that if they can achieve healthy habits for three, six, nine, 12 months then habits are habits and it’s hard to get out of habits,” the general manager of insurance for NAB and MLC, David Hackett, said.
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- Nov 10 2015 at 6:01 AM
- Updated Nov 10 2015 at 6:10 AM
MLC smartwatch lightens insurance burden
You're being watched.
Your breathing, heartbeats, the hours that you sleep and wake are being monitored by an Intel-built smart watch on your wrist.
And if you're proven to be healthy and hit the set goals, you could save hundreds of dollars in insurance premiums each year.
That is the new proposition by life insurance giant MLC, which has become Australia's first insurer to use smart watch technology to track customers' habits and reward them for good behaviour.
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November 11, 2015 1.08pm AEDT
Author Julian Elliott
Head of Clinical Research in the Department of Infectious Diseases, Alfred Hospital and Monash University and Senior Research Fellow at the Australasian Cochrane Centre, Cochrane Collaboration
“What if we, as government, got out of the way and gave consumers full access to their own personalised health data and full control over how they choose to use it?” Health Minister Sussan Ley asked in her recent speech to the National Press Club.
Ley sketched out a new health landscape populated by consumers who shared their personal e-health records with app developers, dietitians and retailers in return for products and services tailored to their particular health needs.
“The great digital health revolution,” the minister concluded, “lies literally in the palms of consumers, rather than government.”
On one level this rings true. There have never been more ways to monitor our personal health and well-being, and share and compare our findings. We can track our activity, diet, exercise, emotions and sleeping habits on our mobiles, Fitbits, Apple watches and apps. We can even have our genomes sequenced.
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Date November 9, 2015
Technology Reporter
If you were able to help find a cure for cancer without lifting a finger, it would be a no-brainer, right?
Well now you can, thanks to a new Android app created by the Garvan Institute of Medical Research, and Vodafone Foundation Australia, which funds health and well-being projects that use mobile technology.
Two years in the making and with the help of Melbourne app developer b2cloud, DreamLab harnesses unused capacity in your smartphone while you're sleeping to crunch medical data for cancer research.
The researchers are hoping to get 100,000 users signed up in the first year, which would allow them to process data around 3000 times faster than they currently are, and complete their first phase of research into four cancers: breast, ovarian, prostate and pancreatic.
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Verification services expanded across the Tasman.
Australia and New Zealand have inked an agreement that will allow organisations to electronically verify proof of ID documents issued by either federal government as well as Australian states and territories.
Australia’s document verification service (DVS) has been in use since 2007, and gives authorised government and non-government organisations the ability to check the authenticity of documents they have received against the government’s own records.
The system is run by the Attorney-General’s Department.
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Monday, 9 November, 2015
Australian CBT program reduces suicidal thoughts
AN Australian-designed, web-based cognitive behaviour therapy (CBT) program has reduced suicidal ideation among US medical interns by 60%, highlighting its potential as an efficacious public health measure in a country where one physician dies by suicide every day, according to the authors of research published in
JAMA Psychiatry. The 199 interns from multiple specialties were randomised to the web-based therapy group — MoodGYM, developed at the Australian National University’s National Institute for Mental Health Research — or an attention-control group, who received emails with general information about depression, suicidal thinking and local mental health professionals. MoodGYM is a free, online interactive CBT- and interpersonal-based therapy program for young people experiencing mild to moderate levels of depression or anxiety. All interns in the study also completed study activities lasting 30 minutes each week for 4 weeks before starting the internship year. Suicidal ideation was assessed 3 months before students started their intern year and then at 3, 6, 9 and 12 months of their intern year. Over the year, 12% of interns in the MoodGYM therapy reported suicidal ideation during at least one follow-up assessment, compared with 21.2% of students in the control group. The researchers wrote that the findings were important, given that suicidal ideation increased 370% over the first 3 months of the internship year. “With approximately 24 000 medical trainees beginning internship each year, dissemination of a pragmatic, no-cost, feasible, and efficacious prevention program could have substantial public health benefits”, they wrote. Further research using a larger sample would be required to determine whether MoodGYM had any impact on suicide rates, they wrote. An
accompanying editorial suggested MoodGYM “inoculated” interns at a critical time in their lives, by providing knowledge and skills that would “enable them to be resilient to the stresses of internship, depression, and suicidal ideation”.
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Created on Monday, 09 November 2015
The National E-Health Transition Authority was established in 2005 by the Council of Australian Governments (COAG) to identify and jointly develop the necessary foundations and services – the building blocks – for a national eHealth infrastructure: 'NEHTA's WORK 2005-15' PDF (424.56 kB)
NEHTA is continuing to work with stakeholders on the widespread adoption and use of eHealth across the healthcare community until the Australian Commission for eHealth commences operations in July 2016.
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Created on Monday, 09 November 2015
Putting the eHealth record system into business is a useful resource for Responsible Officers (ROs) and Organisation Maintenance Officers (OMOs) and their responsibilities in managing their organisations for the Healthcare Identifiers (HI) Service, NASH PKI Certificate for Organisations and the eHealth record system.
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November 9, 2015 6.21am AEDT
A digitally integrated identity card with comprehensive security could simplify many transactions with government and business. Shutterstock
Author Matthew Sorell
Senior Lecturer, School of Electrical and Electronic Engineering, University of Adelaide
Australian e-government is a long way behind many other developed nations. Our national leadership has utterly failed to comprehend why e-government should have been a national priority decades ago, and continues to offer little in the way of policy direction.
Hence, our current solutions are a bizarre mish-mash of inconsistent approaches, making it confusing and frustrating for Australians. Every mis-step sets back public trust in online government services. Usability, reliability and security are the keys.
The Australian Tax Office (ATO), for example, provides online data entry, but inadequate explanatory guidance. Searching the ATO website is risky because it also contains obsolete material from previous years.
The ATO communicates by print-formatted electronic documents to a separate MyGov email inbox, making reference to non-existent additional information, yet two-way communication is not possible through this service.
If the Digital Transformation Office is appropriately funded, empowered and motivated, then a top-down review of government services may be able to address the usability and reliability issues over time. Of much greater concern and urgency is the challenge of digital identity.
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A relatively cheap software upgrade featuring all the functions of the $422 million Enterprise Patient Administration System - and more - was purchased by SA Health but never implemented, InDaily can reveal.
Adelaide Wednesday November 11, 2015
Bension Siebert @Bension1
The beleaguered EPAS, billed as a statewide solution to slow, paper-based and outdated e-health records systems, has been plagued by doctors’ complaints that it slows down care and risks patients’ safety.
Despite the complaints, however, SA Health has persisted with implementing the system.
But InDaily can now reveal the department purchased a software upgrade to another system – OACIS – in 2009, which boasts all of the health record functions of EPAS.
SA Health would not reveal the cost of the upgrade, but InDaily understands it is significantly cheaper than the $422 million spent on EPAS.
And unlike EPAS, an older version of OACIS is already installed on SA Health computer systems in hospitals across the state.
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Patients at a Repatriation General Hospital clinic now wait up to nine months longer than they did before the installation of the State Government’s e-health records system, a senior doctor says.
Bension Siebert @Bension1
A senior clinician at the Repat told InDaily his patients now had to wait for up to a year to receive their first appointment.
Before the introduction of the Enterprise Patient Administration System (EPAS), he said, patients would wait a maximum of three months for an appointment at the specialist clinic.
“We could boast the fastest time, from referral to actually getting surgery, of pretty much any public hospital in Australia,” the doctor said.
“My waiting list was no more than … three months.
“That’s blown out longer and longer and now it’s hit the 12-month mark.”
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Department stays silent about offloading services.
The Department of Health is staying silent on its proposed sale of Medicare payments to the private sector, despite sailing past the date it originally scheduled to have contracts signed without any movement.
In August 2014, the department issued a request for expressions of interest from organisations to take over the processing and payment of $19 billion in medical benefits claims, $10 billion in pharmaceutical claims and nearly $2.5 million worth of veterans affairs claims every year.
Facing a mammoth IT upgrade bill to replace the ageing system that calculates the Medicare and DVA entitlements, the government instead opted to test the market and see whether any private sector companies already equipped to deliver similar functions - like private health insurers, general insurers or banks - would be interested in taking over the work.
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Evolves to become even more dangerous.
The fourth version of the CryptoWall ransomware has landed in the wild, equipped with better evasion techniques and tactics to thwart antivirus protection and detection.
Ransomware attacks computers and encrypts user files and folders via infected email attachments, with attackers demanding ransom payments to unlock the scrambled documents.
Users are told to make the payment by a specific deadline or risk having the private key to unlock the files deleted.
The active CryptoWall ransomware spawned from CryptoLocker, which is thought to have extorted more than $3 million from victims before the botnet used to distribute it - Gameover Zeus - was taken down last year.
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Enjoy!
David.
