A Detailed Look At The Digital Divide It Is Well Worth Being Aware Of. Lots Of Information!

This appeared a few days ago:

Measuring Australia's digital divide: the Australian digital inclusion index 2017

01 Aug 2017

RMIT University

Julian Thomas, Chris Wilson, Jo Barraket, Julie Tucker, Ellie Rennie, Scott Ewing, Trent MacDonald

The 2017 ADII provides the most comprehensive picture of Australia’s online participation to date.

DOI 10.4225/50/596473db69505

Description

The ADII has been created 
to measure the level of digital inclusion across the Australian population and to monitor this level over time. Using data collected by Roy Morgan Research, the ADII has been developed through a collaborative partnership between RMIT University, Swinburne University of Technology, and Telstra.

The ADII was first published in 2016, providing the most comprehensive picture of Australia’s online participation to date. The ADII measures three vital dimensions of digital inclusion: Access, Affordability, and Digital Ability. It shows how these dimensions change over time, according to people’s social and economic circumstances, as well as across geographic locations. Scores are allocated to particular geographic regions and sociodemographic groups, over a four-year period (2014, 2015, 2016, and 2017). Higher scores mean greater digital inclusion.

Access is about how and where we access the internet, the kinds of devices we have, and how much data we can use. Affordability is about how much data we get for our dollar, and how much we spend on internet services as a proportion of our income. Digital Ability is about our skill levels, what we actually do online, our attitudes towards technology, and our confidence in using it. Taken together, these measures give us a unique, multi-faceted picture of digital inclusion.

The ADII compiles numerous variables into a score ranging
 from 0 to 100, with 100 representing a hypothetically perfect level of digital Access, Affordability, and Ability. Australia’s overall national score has increased from 52.7 in 2014 to 56.5 in 2017 (a 3.8-point increase over four years). Australia’s overall performance indicates 
a moderate level of digital inclusion, with mixed progress across different ADII dimensions, geographic areas, and sociodemographic groups.

PUBLICATION DETAILS

Resource Type: 

Research report

DOI:  10.4225/50/596473db69505

Pagination: 47 p.

Alternative Title: The Australian digital inclusion index 2017

Here is the link:

http://apo.org.au/node/97751

The Executive Summary is really useful.

Executive Summary

Australians go online to access a growing range of education, information, government, and community services. Increasingly,

they also participate in online communities and create digital content. But some people are missing out on the benefits of connection.

Digital inclusion is based on the premise that everyone should be able to make full use of digital technologies – to manage their health and wellbeing, access education and services, organise their finances, and connect with friends, family, and the world beyond.

The Australian Digital Inclusion Index (ADII) was first published in 2016, providing the most comprehensive picture of Australia’s online participation to date. The ADII measures three vital dimensions of digital inclusion: Access, Affordability, and Digital Ability. It shows how these dimensions change over time, according to people’s social and economic circumstances, as well as across geographic locations. Scores are allocated to particular geographic regions and sociodemographic groups, over a four-year period (2014, 2015, 2016, and 2017). Higher scores mean greater digital inclusion. This new ADII report incorporates data collected up to March 2017 and updates our findings from 2016.

Overall, digital inclusion is growing in Australia

Australians are spending more time – and are doing more – online. Since 2014, when data was first collected, Australia’s overall digital inclusion score has improved by 3.8 points, from 52.7 to 56.5. In 2016–2017 alone, Australia’s score rose by 2.0 points, from 54.5 to 56.5. Scores for every state and territory also increased over this period. While their individual scores increased by varying amounts, the relative ranking of states and territories remains unchanged since the 2016 report.

Table 1: Ranked scores for states and territories (ADII 2017)

Rank	State/Territory	ADII Score	Points change since 2016	Ranking change since 2016
1	ACT	59.9	+0.1	–
2	Victoria	57.5	+1.7	–
3	New South Wales	57.4	+2.5	–
4	Northern Territory*	56.9	+2.4	–
5	Western Australia	56.2	+2.1	–
6	Queensland	55.3	+1.8	–
7	South Australia	53.9	+2.4	–
8	Tasmania	49.7	+1.6	–
	Australia	56.5	+2.0	–

* Sample <100 b="" caution.="" style="mso-bidi-font-weight: normal;" treat="" with="">Source:

Roy Morgan Research, April 2016–March   2017

Access continues to improve

The gaps between digitally included and excluded Australians are substantial and widening

Across the nation, digital inclusion follows some clear economic and social contours. In general, Australians with low levels of income, education, and employment are significantly less digitally included. There is still a ‘digital divide’ between richer and poorer Australians.

In 2017, people in low income households have a digital inclusion score of 41.1, which is 27 points lower than those in high income households (68.1). Worryingly, the gap between people in low and high income households has widened over the past four years, as has the gap between older and younger Australians. Particular geographic communities are also experiencing digital exclusion. Tasmania remains Australia’s least digitally included state on 49.7 (6.8 points below the national average), followed by South Australia on 53.9 (2.6 points below).

Nationally, Digital Access has improved steadily over the past four years, from 62.2 in 2014 to 69.6 in 2017. Australians are accessing the internet more often, using an increasingly diverse range of technologies, and with larger data plans than ever before.

Digital Ability remains an area for further improvement

Nationally, all three components of Digital Ability have improved over time: Attitudes (up 4.1 points since 2014), Basic Skills (up 6.1 points), and Activities (up 4.2). However, all three have risen from a low base. Digital Ability remains an important area for attention for policy makers, business, education, and community groups interested in improving digital inclusion.

Affordability remains a challenge for some excluded groups, although value has improved

Affordability is the only sub-index to have declined since 2014, despite a slight recovery in the preceding 12 months. While the value of internet services has improved, households are spending a growing proportion of their income on them (from 1% in 2014 to 1.19% in 2017). Thus, despite increasing value, Australia’s overall Affordability score has fallen. This trend is reason for concern, particularly for people on low incomes.

Mobile-only users are less digitally included

More than four million, or one in five, Australians access the internet solely through a mobile device. This means they have a mobile phone or internet dongle with a data allowance, but no fixed connection. Mobile-only use is linked with socioeconomic factors, with people in low income households (29.8%), those who are not employed (24.0%), and those with low levels of education (27.6%) more

likely to be mobile-only. Despite the benefits of mobile internet, this group is characterised by a relatively high degree of digital exclusion. In 2017, mobile-only users have an overall ADII score of 42.3, some 14.2 points below the national average (56.5).

Table 2: Ranked scores for groups with low digital inclusion (ADII 2017)

Rank	Select Demographic	ADII Score	Points change since 2016	Ranking change since 2016
1	Household Income Q5 (Under $35k)	41.1	+1.9	–
2	Age 65+ years	42.9	+1.4	–
3	Disability	47.0	+2.2	↑1
4	Less Than Secondary Education	47.4	+2.7	↓1
5	Household Income Q4 ($35-60k)	49.3	+2.9	–
6	Indigenous Australians	49.5	+2.8	–
7	Unemployed	50.2	+2.2	–
8	Age 50-64 years	54.0	+1.6	–
9	Secondary Education	57.1	+1.6	–
10	Household Income Q3 ($60-100k)	57.5	+1.5	–
	Australia	56.5	+2.0	–

Source: Roy Morgan Research, April 2016–March 2017

The ‘age gap’ is substantial and widening

People aged 65+ are Australia’s least digitally included age group (42.9, or 13.6 points below the national average). This ‘age gap’ has been steadily widening since 2015 (by approximately

0.5 points each year). As we explain in the section on older Australians (see p. 14), it is important to note the differences that exist amongst the diverse 65+ age group.

Women are less digitally included, particularly those aged 65+

Overall, Australian women have an ADII score 2.0 points below the score for men. While the gap between men and women is small in younger age cohorts (0.8 points for people aged 14–24; 1.0 points for those aged 25–34), the gap widens to 2.9 points in the 35–49 age group, and is largest among those aged 65+ (3.3 points).

For people with disability digital inclusion is low, but improving

Australians with disability have a low level of digital inclusion (47.0, or 9.5 points below the national average). However, nationally, their inclusion has improved steadily since 2014 (up 5.2 points), outpacing the national average increase over that period (3.8 points). It is important to note that the ADII data defines Australians with disability as those who are receiving either the disability support pension (DSP) from Centrelink, or a disability pension from the Department of Veterans’ Affairs. The ADII results therefore represent outcomes for a distinct subset of the wider community of Australians with disability.

Indigenous digital inclusion is low, but improving

Indigenous Australians also have low digital inclusion (49.5, or 7.0 points below the national average). However, their ADII score has improved by 4.5 points over four years (outpacing the national average gain of 3.8). It is important to note that the ADII data collection did not extend to remote Indigenous communities.

Some   Australians are particularly digitally excluded

The ADII points to several sociodemographic groups that are Australia’s most digitally excluded in 2017, with scores well below the national average (56.5). In ascending order, these groups are: people in low income households (41.1), people aged 65+ (42.9), people with a disability (47.0), people who did not complete secondary school (47.4), Indigenous Australians (49.5), and people not in paid employment (50.2).

Geography plays a critical role

The ADII reveals substantial differences between rural and urban areas. In 2017 digital inclusion is 7.9 points higher in capital cities (58.6) than in country areas (50.7). The overall ‘Capital–Country gap’ has narrowed slightly since 2015, from 8.5 (2015), to 8.3 (2016), to 7.9 (2017). However, this is not reflected in all states and territories. While South Australia, Western Australia, and Queensland narrowed the gap between capital city and country residents, the gap widened in Victoria, New South Wales, and Tasmania.

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This report shows just how far we are from full digital inclusion. The implications for the ADHA and the myHR are obvious.

David.

New Zealand Seems To Be Making Some Great Headway With A Simple Summary Record.

This appeared last week:

HealthOne an e-health record for all?

Liane Topham-Kindleyliane@nzdoctor.co.nzTuesday 01 August 2017, 1:40PM

The electronic shared health records system HealthOne is operating throughout the South Island as of today, with Nelson Marlborough DHB officially joining the system.

Now all DHBs in the South Island have access to HealthOne allowing general practice teams, hospital clinicians, pharmacists and a growing number of community providers access to shared information including test results, allergies, medications, previous hospital admissions and appointments and medical imaging.

It’s a significant achievement given the Government has been grappling for years to try to establish a national electronic health record.

Southern DHB chief medical officer Nigel Millar told delegates at last week’s RNZCGP conference that HealthOne is not an electronic health record, rather, it is a summary of patient information.

However, he later acknowledged in an interview with New Zealand Doctor that potentially there is no reason why an electronic health record could not be developed from this embryo.

One e-health system, how about one PMS?

HealthOne was initially developed through a partnership between Canterbury DHB, Pegasus Health and Orion Health and has been rolled out across the south via the Southern DHBs’ alliance.

Canterbury DHB’s general manager of planning, funding and decision support, Carolyn Gullery, told New Zealand Doctor in June that it costs about $2.4 million a year to run, but she expected that figure may reduce once the system is operating in all South Island DHBs.

Now that there is one shared electronic patient records system, New Zealand Doctor asked Ms Gullery today whether she considers one practice management system (PMS) for the South Island is the next step, but she says this is not a critical factor.

More here:

https://www.nzdoctor.co.nz/news/2017/august-2017/01/healthone-an-e-health-record-for-all.aspx

Very interesting indeed and showing how there is more than one way to meet most of the stated objectives of the myHR.

David.

How Refreshing To Encounter Such An Honest Man Who Knows Access To The myHR Can Never Be Really Secure.

This appeared last week:

How ADHA is trying to secure GP clinics

By Allie Coyne on Aug 3, 2017 6:30AM

As opt-out change looms.

It’s no secret that your local doctor’s office is unlikely to have the best protections when it comes to securing your personal health records.

In this small business environment, technology often gets pushed to the bottom of the priority list when contending with life or death matters.

It means medical practices often fall victim to ransomware attacks that exploit vulnerabilities in old software - like the recent WannaCry epidemic - and hold patient and practice data to ransom.

Health services was the second most frequently breached industry in 2016, according to Symantec. Medical records also fetch a pretty penny on the black market, at somewhere around US$10 per record on average.

But with the shift to an online health record for every Australian looming - and in light of the recent access control issues raised in the discovery of black market sales of Medicare details - strengthening these weak links in the chain becomes all the more pertinent.

From next year every Australian will get an e-health record, unless they explicitly remove their consent.

It means the Australian Digital Health Agency (ADHA) will be in charge of securing around 22 million e-health records within a big ecosystem of healthcare providers.

“We’ve worked on the basis that one record is worth US$1 and we’ve got 22 million of them - is that enough for somebody to get out of bed and try to steal our data? I think it is,” ADHA chief information security officer Anthony Kitzelmann told the Technology in Government conference.

This is why the ADHA will spend $15.8 million this year alone shoring up the security of the My Health Record system.

This focus on security was also behind the hiring of Kitzelmann, a former Lockheed Martin CISO who joined the agency in February.

But one of ADHA's biggest challenges is working out what an applicable standard for digital health in Australia looks like in lieu of any prescriptive documentation.

“Is the ISM an appropriate standard? Is the ISO standard applicable? HIPAA regulations out of the US? Which one works, which is fit for purpose?” Kitzelmann said.

An internal review conducted in the lead-up to the policy switch to opt-out e-health records found that there were elements of all these standards that could apply to Australia’s e-health ecosystem.

More importantly what came out of the review process was that ADHA needed to change its focus and move to a risk-based governance model.

“If we have a large jurisdiction that has 130,000 employees and a massive investment in their health strategy, we’d expect them to sit [high up] in terms of their security performance,” Kitzelmann said.

“But how do we measure when it’s a general practice run by a husband and wife, the husband is the GP and the wife is the receptionist, IT support and nurse at lunchtime? What do we expect them to do to protect citizen records in an appropriate way? And how do we help them get that balance?

“Because we know quite well they’re going to be sitting on a Windows XP machine that has vulnerabilities up the kazoo, and that it’s going to be a point of egress into the national system that we need to mitigate and manage.

"[However] we also need to understand that it’s irresponsible of us to say ‘you need to be on Windows 10, patched within 24 hours, and running this AV software’ - it’s just not going to happen.”

ADHA’s solution to this problem has been to amalgamate elements of all the relevant standards into a risk-based governance model that helps GPs have “good clinical hygiene with their cyber security practices”.

It is currently working with the Royal Australian College of General Practitioners to develop a single standard that provides “practical, commonsense guidelines” outlining what clinics can do to be more secure.

However, Kitzelmann said ADHA recognised that while GPs would “try their best”, they would “never be truly secure”.

Lots more here:

https://www.itnews.com.au/news/how-adha-is-trying-to-secure-gp-clinics-469963

As Anthony says you can never have all those GP practices, pharmacies and so on be secure. Given these are all likely access points to the myHR it is hard to see just how the central data base can itself be secure.

My view is that the cat has been belled and that if you want to be sure your private information to stay private you will manage carefully what personal information makes it to the myHR. If you are not sure you are on top of all the access controls etc. it would be prudent to simply opt-out.

David.

Postscript:


The  views expressed are not isolated. See here:

Australia's inside-out digital health strategy

If patients are to be 'put at the centre of their healthcare', they need to be put at the centre of their health data.

By Stilgherrian for The Full Tilt | August 7, 2017 -- 07:21 GMT (17:21 AEST) | Topic: Security

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Here ares the relevant paragraphs.

"If patients are to be "put at the centre of their healthcare", and their biggest worry is that their confidential health data might be breached, then surely this whole strategy is inside out.

Surely you don't mitigate the data breach risks by pouring all that data into a massive, complex system that can be accessed by tens of thousands of people.

If patients are meant to be at the centre of their healthcare, then maybe they should be carrying the data. After all, medical practitioners only need that data if the patient is right there in front of them.

Give every Australian resident a USB stick to carry around their neck on a string, like soldiers wear dog tags recording their blood type. Or maybe a wristband with some Bluetooth cleverness.

And of course the last para. is a ripper.

"With the Australian government's well-known track record with this sort of big IT project, we can obviously rest assured that everything will run smoothly as expected."

Here is the link:

http://www.zdnet.com/article/australias-inside-out-digital-health-strategy/

D.