Quote Of The Year

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

or

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

Monday, July 30, 2018

Weekly Australian Health IT Links – 30th July, 2018.

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

General Comment

Opt-out Week 2 and what a fiasco – there is little else to say.
-----  Opt-Out News Start.

Minister moves on MHR privacy

The Health Minister is working with stakeholders such as doctor groups to address concerns about privacy and security

In a doorstop with reporters this week, Greg Hunt said that “I’ve spoken to both the President of the AMA and the incoming President of the College of GPs today, and I’ll be meeting with each of them next week to talk about their concerns and any suggestions they have for strengthening the current situation”.
Mainstream media have reported on confusion as to whether law enforcement would be able to access an individual’s My Health Record without a warrant, while concerns have also been expressed about whether insurers will have access.
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PM flags My Health Record 'reassurances' as RACGP expresses concern

Change appears to be coming to My Health Record, although the details are far and few between.
By Chris Duckett | July 26, 2018 -- 06:12 GMT (16:12 AEST) | Topic: Security
The federal government has promised doctors it will strengthen privacy provisions around its My Health Record scheme -- but how remains unclear.
Incoming president of the Royal Australian College of GPs (RACGP) Harry Nespolon said the assurance followed talks with Health Minister Greg Hunt earlier this week.
"The minister has agreed to work to satisfactorily strengthen the privacy provisions governing My Health Record, in regards to the legislation in line with government policy and practice," he said in a letter to members on Thursday.
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My Health Record privacy concerns will be addressed, Malcolm Turnbull promises, amid ongoing criticism

By political correspondent Louise Yaxley
The Federal Government has tried to reassure people that privacy will be protected in the My Health Record system.

Key points:

  • Critics of the scheme have questioned the level of privacy protections and number of agencies with access to data
  • Australian Medical Association, College of General Practitioners raised concerns with Health Minister Greg Hunt
  • Malcolm Turnbull says those concerns will be addressed, without specifying how
Concern about potential problems with privacy has been growing in recent days.
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AMA president seeks clarity over My Health Record access

Australian Medical Association president Dr Tony Bartone says he will seek a meeting with the health minister
Rohan Pearce (Computerworld) 25 July, 2018 16:18
Australian Medical Association president Dr Tony Bartone says that he has received written undertakings from health minister Greg Hunt and the Department of Health that an individual’s My Health Record data will not be accessed by law enforcement agencies in the absence of a court order.
In a statement released earlier this month the Australian Digital Health Agency, which operates the MHR system, said it “has not and will not release any documents without a court/coronial or similar order.”
“No documents have been released in the last six years and none will be released in the future without a court order/coronial or similar order,” the agency said.
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Doctors stage intervention on My Health Record

By Julian Bajkowski on Jul 25, 2018 3:42PM

Ready to operate on minister.

The head of the powerful Australian Medical Association has put both the government and opposition on notice it is ready to draw fresh political blood over the escalating privacy row surrounding My Health Record.
Addressing the National Press Club in Canberra on Wednesday, AMA president Tony Bartone said he would do “whatever it takes” to address privacy concerns, including potentially forcing the government to change legislation, to finally make the scheme a practical reality.
The doctor’s group is continuing to firmly back the wider e-health construct, and My Health Record, as it has since its inception which Bartone described as “difficult”.
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25 July 2018

Bartone slams poor prep on MHR rollout

Posted by Julie Lambert
AMA President Dr Tony Bartone will seek a meeting with health Minister Greg Hunt in the next few days to resolve security and privacy concerns plaguing the My Health Record roll-out.
Dr Bartone also told journalists he has been defending the controversial opt-out health-record because the government agency in charge had done a poor job of explaining it to the public.
“The reason you might think I’m the front man for the government on their promotion and communications campaign is because it has been done so poorly,” he said, speaking after his address to the National Press Club.
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My Health Record data error creates 'bureaucratic nightmare' for Melbourne woman

A Melbourne woman has "zero faith" in the Federal Government's controversial My Health Record system after attempts to correct her personal medical details turned into a "bureaucratic nightmare".
When Louise Beaumont, 55 from Pascoe Vale, logged on to the system she was surprised to find a record for a Valium prescription, even though she had never taken the drug.
"I thought I'd call My Health Record to say that this is an incorrect entry and can we correct it… and I thought given that it is my information that would be a relatively straightforward exercise. It wasn't," she told ABC Radio Melbourne.
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Guild's Quilty puts his weight behind My Health Record

He says it's a great opportunity to boost pharmacy practice
25th July 2018
The Pharmacy Guild’s David Quilty is rallying pharmacists to help boost public support for My Health Record.
He says pharmacists are currently practising with “one hand tied beyond their back”, which is why they need to endorse My Health Record.
Until now, they’ve operated as “health islands”, relying on their dispensing records, scripts and patient recollections, the executive director writes in Forefront.
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Ed Husic will opt out of My Health Record unless government solves privacy issues

Rachel Baxendale July 25, 2018
Labor frontbencher Ed Husic says he will opt out of the My Health Record system if he does not see evidence that the government has adequately addressed privacy concerns.
Mr Husic, who is Labor’s spokesman on the digital economy, made the comments after Opposition Leader Bill Shorten said the revelation that a Liberal MP has opted out of the My Health Record scheme “should ring alarm bells” for Australians.
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My Health Record website won't let blind users opt out

Page full of errors and doesn’t work with most screenreaders, Vision Australia says
Blind and vision-impaired Australians have been unable to opt out of My Health Record because the website has failed a range of vision accessibility requirements, Vision Australia says.
The organisation, the country’s largest provider of low-vision services, has identified “more than a dozen ways” the My Health Record website was unusable by those with impaired vision.
Karen Knight, Vision Australia’s general manager of advocacy, said this was making it sometimes impossible for users to opt out or to find out more about the scheme.
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My Health Record opt-outs tracking at less than 10 percent: Hunt

Everything is rosy for Australia's health minister when it comes to My Health Record.
By Chris Duckett | July 24, 2018 -- 03:36 GMT (13:36 AEST) | Topic: Security
Australian Health Minister Greg Hunt has revealed that the government was expecting a My Health Record opt-out rate of 10 percent, and so far, from the government's point of view, it is tracking better than that.
"We were expecting up to 90 percent would be enrolled, and looks like it will be more than that now," Hunt told 2GB on Tuesday. "So it's actually tracking ahead of our positive expectations."
The minister also said Health's systems have been "working continuously", with a 90 percent success rate on interactions.
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Police can access My Health Record without court order, parliamentary library warns

Advice from independent researcher contradicts health minister and raises more privacy concerns
The health minister, Greg Hunt, was wrong to claim that patients’ My Health Record could only be accessed by police with a court order, according to advice from the parliamentary library.
The parliamentary library has warned the law governing MyHealth Records represents a “significant reduction” in safeguards on police getting medical records because the operator cannot routinely require them to get a warrant.
Hunt and the Australian Digital Health Agency have both said that the agency in charge of the medical records “will not release any documents without a court/coronial or similar order”.
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Millions to opt out of My Health Record as backlash builds

By Dana McCauley
24 July 2018 — 9:16pm
The number of Australians choosing to opt out of My Health Record could run into the millions, as criticisms of the scheme continue to mount and doctors threaten a boycott to protect their patients' privacy.
Health Minister Greg Hunt revealed on Tuesday that the federal government expected as many as 10 per cent of eligible patients to reject the program, a figure that would mark a significant increase on the rate of those who declined to participate during last year's trial.
My Health Record is scrambling to put through new restrictions on mobile phone apps that use its data.
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AMA chief who says My Health Record will save lives does not have one himself

Sue Dunlevy, National Health Reporter, News Corp Australia Network
July 24, 2018 9:38pm
EXCLUSIVE
THE President of the Australian Medical Association, Dr Tony Bartone, has admitted he does not have a My Health Record even though he is a key advocate of the controversial system.
The Victorian GP is one of the strongest proponents of the online record - which will be given to every Australian unless they opt out by October - and has claimed it will “save lives”.
However, he has told News Corp he does not actually have a My Health Record himself even though it was launched six years ago.
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  • Updated Jul 24 2018 at 11:45 PM

Lower threshold for release of medical information from My Health Record site

The expansion of Australia's national digital medical record system will see a significant reduction in legal barriers for the release of private information to law enforcement agencies.
Australians have until October 15 to opt out of the online My Health Record, a system which privacy and digital rights activists believe could be vulnerable to hackers.
Analysis by the Parliamentary Library said data from the system, first established by the Gillard government, was able to be provided to government bodies for purposes unrelated to health care, including going to state and federal police, financial regulatory authorities and agencies tasked with protecting public revenue.
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Bill Shorten says Tim Wilson opting out of My Health scheme should ring alarm bells

  • The Australian
  • 2:33PM July 24, 2018

Rachel Baxendale

Bill Shorten says the revelation that a Liberal MP has opted out of the My Health Record scheme “should ring alarm bells” for Australians.
Liberal backbencher Tim Wilson yesterday called for the government’s My Health Record program to be an “opt-in” scheme, revealing he would be opting out of having his health data stored in the system.
The Member for Goldstein’s comments came after 20,000 Australians contacted My Health Record to have their personal medical details taken out of the system within a day of the three-month opt-out period beginning last week.
Mr Shorten said he had not decided to opt out of the system, which was instigated by Labor, and supported the principle of being able to have health information stored digitally, but was concerned about the government’s track record with digital projects.
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Criminals could target My Health system

Australia's human rights commissioner has warned the My Health Record system could be a honey-pot for criminals.
Matt Coughlan
Australian Associated Press July 24, 20188:52am
The Human Rights Commissioner believes the government's controversial digital health records system needs to improve, warning it could be a "honey-pot" for criminals.
Edward Santow said Australia could do better with the maligned My Health Record system, saying many people were concerned about secondary uses of personal health data.
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Blind and low vision community neglected in My Health Record opt-out process

23 July 2018
Leading blindness and low vision service provider Vision Australia has expressed extreme frustration that the My Health Record online opt-out option cannot be accessed by all people who are blind or have low vision. 
Australians have until October 15 to opt out of My Health Record. If an individual does not opt out by that date they will automatically be given an online My Health Record, which could contain clinical documents, prescriptions and other private medical information.
People who are blind or have low vision cannot use the online opt-out option because it fails to meet accessibility standards.
Vision Australia Policy Advisor Kate Begley said it’s inexcusable that accessibility was not better considered by the Australian Digital Health Agency prior to the roll out of the opt-out process.
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My Health Record agency adds 'reputation', 'public interest' cancellation options to app contracts

By Clare Blumer and Pat McGrath, ABC Investigations
24 July, 2018
My Health Record is scrambling to put tough new restrictions on mobile phone apps that use its sensitive patient data, including an option to cancel if the companies damage the system's reputation.
Companies Telstra, HealthEngine, Tyde and Healthi already have access to My Health Record information such as Medicare records, test results, scans and prescriptions, for their app users to view on mobile phones.
The Australian Digital Health Agency (DHA), which is facing a crisis of confidence over its ability to safely store sensitive health data in My Health Record, has sent out a heavily amended agreement to the four app companies.
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  • Updated Jul 23 2018 at 1:00 PM

Labor calls for opt-out period to be extended for health record digital system

Labor has called on the Coalition to extend an opt-out deadline for a national digital medical record system, coming as a Liberal backbencher revealed he has removed his own data.
Tim Wilson, chairman of Parliament's standing committee on health, said on Monday individuals should be required to sign up for the new My Health Record system rather than opt-out before the October 15 deadline.
As many as 20,000 people used the first day of the opt-out period to remove their records from the system, amid growing security and privacy concerns.
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Liberal Tim Wilson opts out of My Health Record and says it should be opt-in

MP says scheme has benefits but people shouldn’t have to go through process of opting out
Liberal MP Tim Wilson says people should have to opt in to My Health Record, not be there by default. Photograph: Lukas Coch/AAP
Australians should have to opt in for digital medical records rather than go through a process to remove themselves, says a government MP who has opted out.
Liberal backbencher Tim Wilson has removed himself from the My Health Record system and believes that should be the default position.
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Peak GP body’s alleged support for My Health Record called into question

The Royal Australian College of General Practitioners has distanced itself from the government's My Health Record roll-out, as the agency responsible for the scheme deals with accusations of defamation.
Jul 23, 2018
The agency behind the roll-out of the government’s My Health Record scheme has been caught out misrepresenting the views of Australia’s peak GP body, claiming incorrectly that the group supported adoption of the centralised digital health record’s controversial opt-out approach.
It comes as Labor's spokesperson for health Catherine King urged the Turnbull government to extend the opt-out period beyond three months "so the government can launch a comprehensive information campaign to educate the public and restore their trust in this reform".
It also comes as the Turnbull government lost support of opt-out not only from its own backbencher Tim Wilson, but also Labor backbencher Pat Conroy, who said at the weekend he had “zero confidence” in the system’s implementation. Wilson said all systems, such a My Health Record, “should be opt-in and people should be able to freely choose to opt in to a system rather than have to go through the process of opting out”.
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Demands for My Health Record opt-out to be extended

By Justin Hendry on Jul 23, 2018 11:30AM

Community backlash widens.

The federal opposition has called for an extension of the My Health Record opt-out window after “significant and growing concern” from the community, but says it supports the project in-principle.
Shadow minister for health Catherine King today appealed to the government to extend the three-month period that began last week to give individuals adequate time to “make an informed choice”.
“There has been significant and growing community concern about the My Health Record since the beginning of the op-out period on 16 July,” she said.
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Tim Wilson opts out of My Health, calls for opt in scheme

  • The Australian
  • 9:38AM July 23, 2018

Rachel Baxendale

Liberal backbencher Tim Wilson has called for the government’s My Health Record program to be an “opt-in” scheme, revealing he will be opting out of having his health data stored in the system.
Mr Wilson’s comments come as Labor calls for the October deadline for opting out of the scheme it set up to be extended, and after 20,000 Australians contacted My Health Record to have their personal medical details taken out of the system within a day of the three-month opt-out period beginning last Monday.
“I don’t think it will surprise anybody that my instinctive position should always be as a Liberal that systems should be opt-in and people should be able to freely choose to opt in to a system rather than have to go through the process of opting out, and that includes myself,” Mr Wilson told Sky News.
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'Zero confidence': Labor MP in push for opt-in digital health records

By Ben Grubb
22 July 2018 — 5:11pm
As the fallout continues over the government's handling of the opt-out My Health Record scheme, a Labor backbencher has become the first to publicly disown the opt-out model both Labor and the Liberal Party support, pushing for a change back to opt-in for the scheme he says he now has "zero confidence" in.
All Australians will get a My Health Record unless they opt out by October 15. The file will be accessible by up to 900,000 healthcare professionals, all of whom will have the ability to access it unless consumers place PINs or other access restrictions on their file to lock it down. Even then, such restrictions can be overridden in emergency situations by authorised professionals.
"The rollout of this has been mishandled from the start by this government," federal Labor MP Pat Conroy told ABC News 24 on Saturday.
-----  Non Opt Out News i.e. All The Rest!

‘Use this app twice daily’: how digital tools are revolutionising patient care

July 24, 2018 6.06am AEST
New electronic devices are being used by people of all ages to track activity, measure sleep and record nutrition. Shutterstock

Authors

  1. Caleb Ferguson
Senior Research Fellow, Western Sydney University
  1. Debra Jackson
Professor, University of Technology Sydney
  1. Louise Hickman
Associate Professor of Nursing, University of Technology Sydney
Imagine you’ve recently had a heart attack.
You’re a lucky survivor. You’ve received high-quality care from nurses and doctors whilst in hospital and you’re now preparing to go home with the support of your family.
The doctors have made it clear that the situation is grim. It’s a case of: change your lifestyle or die. You’ve got to stop smoking, increase your physical activity, eat a healthy balanced diet (whilst reducing your salt), and make sure you take all your medicine as prescribed.
But before you leave the hospital, the cardiology nurse wants to talk to you. There are a few apps you can download on your smartphone that will help you manage your recovery, including the transition from hospital to home and all the health-related behavioural changes necessary to reduce the risk of another heart attack.
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19 Jul 2018

Data & the understanding gap

Michael Morris
Technology, Media & Telecommunications Partner, Allens
Patients – and the general public – were left reeling by revelations in June medical-appointment booking provider HealthEngine had allegedly provided user medical information to law firms.
HealthEngine provides an app requiring users to provide details of their medical conditions (including recent accidents) when booking GP appointments and is accused of disclosing these details to one or more personal injury law firms.
"Common market practice for privacy compliance… does not match up with consumer expectations regarding data transparency.” 
Regardless of whether HealthEngine did in fact breach privacy law the case reveals a bigger issue lying beneath the surface – common market practice for privacy compliance in this space does not match up with consumer expectations regarding data transparency.
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Queensland’s new digital health system failures ‘putting patients’ lives at risk’

7:59pm Jul 26, 2018
Queensland's digital health system fail
Queensland’s new digital hospital system is riddled with bugs, regularly fails and is putting patients’ lives at risk, according to senior doctors.
An ongoing 9NEWS investigation has revealed a series of system outages at the Princess Alexandra Hospital – the first hospital to have the technology implemented.
A major outage at the PA Hospital on May 17 meant doctors couldn’t access records or administer certain drugs, causing vital treatment to be delayed.
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Westmead Hospital treats bloated pharma prices with Sydney Uni software

By Matt Johnston on Jul 27, 2018 7:10AM

Data drill dumps Excel.

Westmead Hospital in Sydney has deployed new price optimisation software developed by the University of Sydney to ratchet down the cost of thousands of pharmaceuticals and prune its $3 million a month price tag of dispensing medications.
It's a small but highly significant development that offers the potential to rein in drug costs across public hospitals by using price data to hunt out the best deals in a similar way to how aggregators for hotel and airline bookings scour the web for the best deals.
Westmead’s head pharmacist Dr David Ing said the cost of drugs and medical supplies can vary greatly between suppliers, with prices sometimes fluctuating from month to month.
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Subpoenaed Medical Records - What Should Practitioners Do?

Medical practitioners are often requested to release their patients’ medical records to courts under subpoenas. However some medical organisations have concerns that some subpoenas issued for improper purposes have the potential to stigmatise vulnerable people and damage patient–practitioner relationships.
This article explains what a subpoena is and what practitioners can do if they want to object to their patients’ medical records being used as evidence in court proceedings.
What is a subpoena?
A subpoena is a court order issued to a person at the request of a party in a court proceeding. A party may seek a subpoena as a way to obtain relevant information for use as evidence in a court matter. Subpoenas can be issued to compel a person to give evidence in court, produce documents to the court or both. A subpoena for production requires a person to provide the court with the documents outlined in the subpoena by a specified date and time. Importantly, these documents are provided to the court, and not to the party who requested that they be produced.
What does a practitioner need to provide?
If a practitioner has been issued with a subpoena for production of documents, the schedule to the subpoena will outline the specific documents that need to be provided to the court. Medical practitioners are often requested to produce patients’ clinical notes, test results, reports and referrals.
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Keeping ahead of healthcare cyber threats

By David Oakley, Managing Director, ServiceNow ANZ
The healthcare industry is among the most preferred prey of cybercriminals. Whether they’re targeting sensitive health information to extract ransom from a medical provider, or for blackmail or identity theft purposes, hackers are becoming faster and more intelligent.
In the last two years, 50 percent of healthcare organisations have experienced a data breach. This is according to ServiceNow’s recent State of Vulnerability Response in Healthcare Report.
Look no further than the WannaCry ransomware attack in 2017, which locked up National Health System computers in the UK and demanded ransom. This caused appointments to be cancelled and surgeries delayed. We’re continuing to see healthcare organisations suffer massive breaches. Earlier this month, the operator of Singapore’s largest group of healthcare institutions, SingHealth, was the victim of a major cyber-attack. Non-medical personal data of 1.5 million patients were accessed
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1.5 million affected by hack targeting Singapore’s health data

Local media say the hack is believed to be state-sponsored

By
Singapore has been hit by what local media is calling the country’s “worst” cyber attack. Hackers targeting Singapore’s largest health care institution, SingHealth, stole the personal profiles of some 1.5 million patients along with the details of prescriptions for 160,000 others. Included in the latter group was Singapore’s prime minister, Lee Hsien Loong, who the Ministry of Health said was targeted “specifically and repeatedly.”
The attacks were outlined in a government briefing this morning, which stated that the hack was “not the work of casual hackers or criminal gangs.” It’s not yet known who was behind the attack, but local media reports that it’s believed to be state-sponsored. “This was a deliberate, targeted, and well-planned cyberattack,” said the Singapore government.
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Healthcare data breach in Singapore affected 1.5M patients, targeted the prime minister

In what’s believed to be the biggest data breach in Singapore’s history, 1.5 million members of the country’s largest healthcare group have had their personal data compromised.
The breach affected SingHealth, Singapore’s biggest network of healthcare facilities. Data obtained in the breach includes names, addresses, gender, race, date of birth and patients’ national identification numbers. Around 160,000 of the 1.5 million patients also had their outpatient medical information accessed by unauthorized individuals. All patients affected by the hack had visited SingHealth clinics between May 1, 2015 and July 4, 2018, Singapore newspaper The Straits Times reports.
“Investigations by the Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System confirmed that this was a deliberate, targeted and well-planned cyberattack,” a press release from Singapore’s Ministry of Health stated. “It was not the work of casual hackers or criminal gangs.”
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Hackers steal 1.5 million people's personal data in cyber attack on Singapore's health service

More than a quarter of city state's population illegally copied by hackers 'looking for embarrassing information about prime minister'

Hackers have stolen personal information about 1.5 million people in a major cyber attack on the Singapore government’s health database.
More than a quarter of the city state’s population was affected by the “deliberate, targeted and well-planned” attack, in which data on patients who visited clinics between May 2015 and 4 July this year was illegally accessed and copied.
“It was not the work of casual hackers or criminal gangs,” the government said, adding those responsible had been looking to obtain personal details about the prime minister and the medicines he had been proscribed.
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CPD of the future: artificial intelligence and big data

Authored by Heather Mack
RAPID advances in computing and artificial intelligence are forecast to change medical education. As part of the spectrum of medical education, continuing professional development (CPD) is likely to be similarly transformed over the next decade.
CPD is part of the medical education continuum between post-graduate medical training and transition to retirement. Arguably, CPD is the most important component of medical education as it covers all Australia’s medical practitioners working as clinicians (83 731 in 2015) for the many years of their professional practice, many more person-years of education than medical students and post-graduate trainees combined. Because of its long duration, CPD is more subject to change over time. CPD is increasingly recognised as an academic discipline with its own curriculum, evidence base, educators and governance structures. In Australia, the accrediting body for CPD is the Australian Medical Council (through accreditation of specialist medical colleges), the training organisation is the specialist colleges, and the training provider is health services, colleges and self-directed learning.
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Bionic limbs: a touch futuristic but no longer science-fiction

24 July 2018
Remember the Six Million Dollar Man? Well, he’s now a reality, writes Heather Wiseman.
A quiet determination sets across Raj Singh’s face. Still coming to terms with having lost his right arm above the elbow just four months ago, the young cricket enthusiast has pushed his stump snug into a tailor-made socket of soft moulded plastic.
He’s getting ready to concentrate, hard.
The socket is studded with 17 electrodes, each with a dangling coloured wire. The wires are plugged into a small black box that talks to a nearby laptop, courtesy of Bluetooth.
The whole contraption looks like a high-school electronics project, but serious genius is hiding behind the amateur-hour aesthetics.
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Millions of documents uploaded to Midland clinical portal

Monday, 23 July 2018  
eHealthNews editor Rebecca McBeth
More than 2.3 million documents have been uploaded to the Midland Clinical Portal since it went live in August 2017.
MCP provides a single point of access for clinical information from across the Midland region – Bay of Plenty, Lakes, Hauora Tairāwhiti, Taranaki and Waikato district health boards.
The first phase of the project was fully rolled out in February this year and provides a read-only view of real-time patient information via a shared instance of Orion Health’s Clinical Portal product visible across the five DHBs.
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Australian government ‘drunk on surveillance’

Alarm over assault on encryption, push for national facial recognition system
Rohan Pearce (Computerworld) 25 July, 2018 06:30
Bipartisan attacks on privacy in the name of law enforcement and national security are an indication that Australia is abdicating its commitment to human rights, according to Brett Solomon.
Solomon, the executive director of international digital rights group Access Now, is in Australia as part of the Human Rights and Technology Conference — an initiative of the Human Rights Commission.
Government moves to increase law enforcement agencies’ ability to access encryption communications and the support at both a federal and state level for the creation of a national facial recognition system are two of the recent developments that have alarmed human rights advocates.
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Why the platform will replace today’s interoperability standards in healthcare

Posted on by wolandscat
For decades, most of us working in health informatics and e-health have lived on the assumption that ‘interoperability’ is one of the main things we are trying to achieve, and that it is the most important because the lack of it blocks progress on nearly every other priority. In the last decade, the gold version of interoperability has become ‘semantic interoperability’, a fabled Nirvana in which today’s sewers of recalcitrant proprietary data are magically transformed into a sea of pure Evian whose meaningful molecules will be ‘understood’ by drooling next generation apps that will instantly discover what is wrong with each of us, and tell us how to fix it.
I have no doubt that exactly the same delusions afflict at least some other domains, perhaps less those that simply cannot afford systems not to talk the same language, such as mobile telephony and industrial control.
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  • Jul 25 2018 at 9:30 AM

NBN write-down 'inevitable': Damning S&P report

Global credit ratings agency Standard & Poors has released a damning assessment of the National Broadband Network's long term commercial viability, saying a politically damaging government write-down was now "inevitable."
In a stinging analysis S&P said NBN Co's current expectations about customer uptake were unrealistic without major changes to its pricing model, and forecast significant competitive mobile infrastructure investment by local telecommunications firms would hit NBN's prospects.
The analysis said that while NBN would likely achieve the two key policy aims of bridging the digital divide between metropolitan and regional areas and engineering the structural separation of Telstra, it was doing so at an enormous cost to taxpayers, subscribers, and incumbent telecommunications providers.
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Telcos obligated to test NBN copper connections, not fix them, under new rules

By Adam Turner
24 July 2018 — 11:33am
Telcos must check that copper-based NBN connections can deliver on their speed promises under the latest migration rules, but no one will be forced to fix copper lines that are found wanting.
Australians who supply their own modem, rather than purchasing a modem from their telco, may also miss out on the performance test that is designed to ensure that customers aren't paying for unobtainable NBN speeds.
Telcos must take "all reasonable steps" to perform the speed test, but won't be to blame if they are unable to test a service due to the fact a customer is using a "consumer supplied modem". In this event, the onus is on the end user to report any issues with their new NBN service.
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NBN write-down 'appears inevitable': S&P

By John McDuling
25 July 2018 — 9:26am
The NBN risks being relegated to a “network of last resort” amid the rise of 5G mobile services,  and a write-down of the massive infrastructure project by the federal government "appears inevitable" global credit ratings agency Standard & Poors has declared.
In a new report that will reverberate throughout the telecommunications industry and in Canberra, S&P said official forecasts for the take-up of the NBN of between 73 per cent and 75 per cent by 2021 will be "difficult to achieve", raising the prospect the government will be forced to slash the value of the asset on its books.
It cited the NBN's controversial pricing structure, and rapid advances in mobile technologies - which could enable people to abandon fixed line internet connections altogether at home -as the factors behind a write-down, which would be politicially sensitive and potentially affect the Federal budget.
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Enjoy!
David.

Sunday, July 29, 2018

There Are Many Groups In The Community Who Will Really Struggle With The myHR Opt-Out.

As we all know with most programs delivered by Government Opt-In is the best way to proceed. You can think everything from Age Pensions to Medicare Claims. No-one forces you to take the money or claim a pension if you don’t want to.
With the myHR it seems it has been decided we are to given a record whether we want it or not unless we take advantage of the period available to opt-out of having a record which only runs till October 15, 2018.
The core point is that to stay out of the system you need to know what is going on and be able to record your preference via the internet, phone or attendance at an appropriate Government office.
Absent a major public advertising campaign many citizens will just wind up with a record they may, or may not, have wanted with all the possible downsides.
The groups who are quite likely to be disadvantaged by this process include.
1. Those who are never users of the Internet.
These people may make up to 20% of the population and so will miss most of the ADHA communication.
Here is a link:
2. Those who struggle with English.
3. Those who are homeless and so really focused on other issues.
4. Those with low literacy and low educational levels.
5. Those who suffer from intellectual disability of some sort (Brain Injury, Alzheimer’s etc., Inherited Diseases etc.)
6. Those who are incarcerated.
7. Those out of the country for the next few months.
8. Those so flat out with the rest of their lives that all this just slips under the radar.
9. Those who don't understand the technology at all, passive and trusting patients, limited cognitive capacity for understanding consequences or visualizing risk from intangible data dealings, or limited education, etc.
10. Those with limited language capacity, especially about esoteric high tech, biomedical and bureaucratic topics like these: either no or limited English language (older migrants), the very young, or those with other language difficulties. 
11. Those people who feel obliged to take whatever is given, perhaps because they fear their health care will be compromised if they say no to this, as they are uninformed about the difference between a useful EHR system and this one, and have no access to the necessary independent info and advice? Some chronically ill.
I am sure there are a host of others I have missed – feel free to comment. I am not sure how many are covered by these overlapping groups but it surely runs close to 30% of the population.
The conclusion I reach from all this is that the opt-out approach is fundamentally flawed and dishonest. If the myHR was useful and worthwhile dragooning users would not be needed.I believe the exclusion of so many from the possibility of a free choice is plain wrong and unethical.
I know what I say will not change anything but that the approach is wrong and discriminatory needs to be pointed out and I suspect the truth of this is beginning to be recognised.
The myHR really should be fundamentally redesigned with a clear set of clinical and patient objectives, be voluntary and attractive to its users, be targeted towards those who it may benefit from a new system and cease being a Government data hoover.
If this can’t happen then the ADHA should just drop the whole program and move to focus on things that might actually be good value for the public penny and the Health System in the Digital Health space.
David.

AusHealthIT Poll Number 433 – Results – 29th July, 2018.

Here are the results of the poll.

Does The Huge Singapore Health Data Breach (Of A System Technically Similar To The myHR) Doom The Australian Opt-Out Initiative?


Yes 86% (175)

No 9% (19)

I Have No Idea 4% (9)

Total votes: 203

Basically most think that the huge Singapore Breach was a game changer! With all that has gone on since last Sunday (disappearing documents, political noise etc.) it will be hard to know overall but I am sure it has had a major impact.

Any insights welcome as a comment, as usual.

A really, great turnout of votes!

It must have been a slightly harder question as 9/203 readers were not sure what the appropriate answer was.

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

David.