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, August 06, 2018

Weekly Australian Health IT Links – 6th August, 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 3 and what a fiasco – there is little else to say.
-----  Opt-Out News Start.

Statement on notifiable data breaches

Thursday, August 2, 2018 - 15:15
In the operation of the My Health Record, the Australian Digital Health Agency (the Agency) has reconfirmed there has not been a security or privacy breach, meaning that there has been no unauthorised viewing of any individual’s health information.
There are now close to six million people who have chosen to have a My Health Record.
The system has been operating for six years.
To ensure transparency, the Agency must report notifiable data breaches to the Information Commissioner and will continue to do so.
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State and territory governments reaffirm unanimous support for My Health Record

Health ministers from across Australia unanimously reaffirmed their support for My Health Record and the national opt out approach at the Council of Australian Government Health Council meeting in Alice Springs.
3 August 2018
Health ministers from across Australia unanimously reaffirmed their support for My Health Record and the national opt out approach at the Council of Australian Government Health Council meeting in Alice Springs.
I welcome the bi-partisan support from both Labor and Liberal state governments for this important health reform.
As health ministers noted at the meeting, the expert clinical advice is that My Health Record will deliver better health care for patients.
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Parents encouraged to use e-health records

A day after the opt-out period for the federal government's controversial electronic health system was extended, parents are being urged to learn more about it.
3 August, 2018
Australian parents have been told storing their children's information on the federal government's controversial electronic health system may save their life in an emergency.
The Digital Health Agency behind My Health Record says children are at risk of serious harm if their parents can't remember information such as their allergies and immunisation history, which the system can keep handy.
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Alarming new My Health Record privacy flaw

My Health Record: Sensitive health information could be made available to more than your GP
Sue Dunlevy,
National Health Reporter, News Corp Australia Network
August 3, 2018 10:00pm
A MAJOR privacy flaw has been identified in the $2 billion My Health Record which means podiatrists and dietitians will be able to see if you have a mental illness or sexually transmitted disease.
The former deputy privacy commissioner of NSW and privacy consultant Anna Johnston says she is very concerned the default setting of the My Health Record is open access and it needs to be changed.
Every Australian will get an online My Health Record that will reveal if they have had an abortion, a mental illness, a drug addiction or sexually transmitted disease unless they opt out by November 12.
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Minister wrong on privacy, says News Corp

There have been nine data breaches involving My Health Record to date, claims an article in News media

Health Minister Greg Hunt has on a number of occasions asserted that there have been no breaches of the system as yet.
“Almost a quarter of Australians have a My Health Record and that’s roughly six million Australians, so there have been no releases,” the Minister told ABC News Breakfast’s Michael Rowland on 1 August.
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3 August 2018

ADHA in bid to quell MHR privacy fears

Posted by Julie Lambert
Health Minister Greg Hunt has ordered digital health boss Tim Kelsey to hose down security fears around vulnerable Australians using My Health Record.
“The advice I have is that there are very, very strong protections, but we’re always working with different groups,” the minister said.
“The head of the Digital Health Agency will meet with … those groups and take their concerns very seriously.”
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Data breach; privacy breach? What has gone on with the My Health Record system

By Katherine Gregory on AM
Share
The Federal Government moved this week to improve safeguards around the My Health Record system, telling Australians their private data would remain just that — private.
But is that a promise it can realistically make?
Last year's Information Commission report reveals there have already been a number of breaches of the My Health Record system.
But the Government maintains no-one's privacy was put at risk.
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Labor calls for My Health Record to be suspended

Greg Hunt backs down on My Health Record amid public outcry

  • 8:34AM August 1, 2018
Labor health spokeswoman Catherine King has called for the online My Health Record system to be suspended until privacy concerns can be allayed, despite Health Minister Greg Hunt announcing measures to bolster privacy and security overnight.
Following a public outcry highlighted by 20,000 Australians pulling out of the scheme on the day the three month opt out period began last month, Mr Hunt last night met with Australian Medical Association President Tony Bartone and Royal Australian College of General Practitioners President-elect Harry Nespolon.
The Health Minister agreed to legislate to ensure a court order is required for police or government agencies to gain access to people’s health data, to ensure records are expunged if people opt out of the system, and to discuss extending the three month-opt out period another month to mid November with state and territory health ministers this week.
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My Health Privacy Changes 'Just A Few Band-Aids', More Needed

Josh Butler

Ten daily Senior News Reporter

"It’s a bit of a joke," critics said.

The government's abrupt backdown on certain privacy issues around the My Health Record system is welcome but does not go far enough, according to critics who remain concerned about security of sensitive data.
Health minister Greg Hunt announced on Tuesday that protections would be strengthened around the disclosure of health information from the government database. The My Health Records Act 2012 allows system operators to legally disclose health information if "reasonably necessary" to prevent or investigate crimes, or for "the protection of public revenue" -- but the Australian Digital Health Agency said internal policies, which are superseded by legislation, would require a court order to pass on health info.
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E-health records opt out period extended

The deadline to opt out of the federal government's controversial electronic My Health Records system has been extended by a month.
Marnie Banger
Australian Associated Press August 2, 201811:23am
Australians will have a month longer than planned to opt out of the federal government's controversial electronic health records system.
Health Minister Greg Hunt told reporters in Alice Springs, ahead of a meeting with state and territory health ministers on Thursday, that the mid-October opt out deadline has been pushed back.
The move comes after Mr Hunt revealed on Wednesday the My Health Records laws will be changed so police and government agencies will need a court order to obtain patient data.
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Data breaches linked to My Health Record kept secret

by Sue Dunlevy
2nd Aug 2018 3:28 AM
A NEWS Corp investigation can reveal there has already been nine data breaches involving the Federal Government's My Health Record system.
The revelation comes as Health Minister Greg Hunt bowed to mounting public pressure and strengthened privacy provisions relating to accessing the record.
Mr Hunt also announced there would be changes to the deletion of records and also extended the opt-out period after meeting with doctors from the Australian Medical Association and College of General Practitioners on Tuesday night.
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Hunt backs down over My Health Record's patient privacy

Growing backlash prompts government promise to remove legal ambiguity
1st August 2018
Police and government agencies will no longer be able to access a patient's clinical information in My Health Record without a warrant, the Minister for Health has promised.
The billion-dollar system has copped a public backlash over the lower legal thresholds that allow its operator, the Australian Digital Health Agency, to pass on clinical information without court oversight if it “reasonably believes” it is necessary to protect the public revenue or could prevent the breach of any law that imposes a penalty or sanction.
But Minister for Health Greg Hunt has announced the 2012 legislation underpinning third-party access to My Health Record will be changed to “remove any ambiguity”.
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OAIC welcomes strengthening of privacy protections in My Health Records

1 August 2018
Statement from the acting Australian Information Commissioner and acting Privacy Commissioner Angelene Falk
I welcome the Government’s decision to strengthen privacy protections under the My Health Records Act.
The proposed amendments to require a court order to release any My Health Record information without consent will create certainty and enhance privacy safeguards for all Australians.
Significantly, the proposed amendment to allow an individual to permanently delete their record will give the community greater control over their health information.
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Labor still wants My Health Record suspended, even after concessions from Greg Hunt

Greg Hunt backs down on My Health Record amid public outcry

Rachel Baxendale

  • August 1, 2018
Former health minister Tanya Plibersek says Labor still wants the online My Health Record program suspended, despite Health Minister Greg Hunt announcing measures to bolster privacy and security overnight.
Following a public outcry highlighted by 20,000 Australians pulling out of the scheme on the day the three month opt out period began last month, Mr Hunt last night met with Australian Medical Association President Tony Bartone and Royal Australian College of General Practitioners President-elect Harry Nespolon.
The Health Minister agreed to legislate to ensure a court order is required for police or government agencies to gain access to people’s health data, to ensure records are expunged if people opt out of the system, and to discuss extending the three month-opt out period another month to mid November with state and territory health ministers this week.
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Govt moves to reinforce My Health Record privacy

By Ry Crozier on Jul 31, 2018 7:00AM

Promises to strengthen laws, let records be deleted.

The government will redraft part of the My Health Record legislation to make it harder for agencies and police to gain access to the contents of an electronic health record.
Health Minister Greg Hunt announced the change on Tuesday night following an emergency meeting with the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) over mounting privacy concerns that threaten to derail the My Health Record project.
Hunt said that police and government agencies wanting to access any health record information would now need a court order to access it.
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Health Minister backs down on My Health Record

By Dana McCauley
31 July 2018 — 8:53pm
Federal Health Minister Greg Hunt has bowed to pressure and agreed to tear up the controversial legislation behind the My Health Record to protect patients from having their medical records accessed by police.
Following crisis talks with the head of the Australian Medical Association in Melbourne on Tuesday night, Mr Hunt confirmed in a statement that the My Health Record Act will be redrafted.
"The amendment will ensure no record can be released to police or government agencies, for any purpose, without a court order," the statement said.
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Doctors to hold crisis talks with Health Minister Greg Hunt over My Health concerns

By Dana McCauley
31 July 2018 — 4:03pm
Federal Health Minister Greg Hunt will hold crisis talks with the head of the Australian Medical Association in Melbourne tonight following ongoing concerns about the safety of the system.
Privacy concerns about the My Health Record Act - including the section that empowers authorities to access patient records without a warrant - will be discussed at the meeting, after the association's president, Tony Bartone, last week vowed to do "whatever it takes" to safeguard patients' interests.
It is understood that support for a redrafting of the legislation has grown within the Liberal Party after last weekend's byelections, in which Labor bolstered its position in part by attacking the Turnbull government's record on health.
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Bill Shorten links Cricket Australia furore to My Health Record

  • July 31, 2018
Bill Shorten has linked privacy concerns over the Turnbull government’s My Health Record scheme to allegations the Tasmanian Liberal government leaked personal information about a woman who had attacked their policy on abortion to her employer Cricket Australia.
Angela Williamson, 39, yesterday revealed she had to leave the state to have a pregnancy terminated and was sacked last month by CA after a government staffer alerted cricket authorities to her critical tweet about access to abortion.
Mr Shorten, the federal Labor leader, seized on the news, saying it showed Liberals in both levels of government needed to “smarten up their act” on privacy.
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Australians are 'rightly' concerned about trusting My Health Record, says Privacy Commissioner

By Ben Grubb
Updated31 July 2018 — 2:14amfirst published at 1:00am

Talking points

  • There were 242 breach notifications made in the quarter under the NDB scheme
  • The healthcare industry was the top sector for reporting data breaches
  • The main causes of data breaches were malicious or criminal attacks
  • Human error accounted for 88 breach notifications
  • The notification scheme doesn't paint a full picture of breaches, say experts
Australians are “rightly” concerned about the Turnbull government’s controversial My Health Record scheme and the security and privacy requirements of the record may need to change in order for government to maintain the public's trust, Australia’s Acting Privacy Commissioner says.
In an interview with Fairfax Media, federal Acting Privacy Commissioner Angelene Falk said she had been in discussions with Health Minister Greg Hunt and the Australian Digital Health Agency, which administers My Health Record, about her concerns with the system.
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Greg Hunt pushed opt-out My Health record on states

Sean Parnell

  • 12:00AM July 31, 2018
The backlash against an all-but-compulsory My Health Record comes 16 months after the commonwealth told the states of the “reach and relative simplicity of national communications, education and readiness” to move to an opt-out model.
Leaked documents suggest the Turnbull government may have underestimated the level of privacy and security concerns over electronic records.
Only two weeks into a three-month opt-out period, key stakeholders want the communi­cations campaign ramped up and the legislation tightened, worried Australians will unnecessarily abandon the scheme.
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Denham Sadler
July 30, 2018

AMA push for MHR changes

Australia’s most powerful doctors' group is urging the Commonwealth to clarify the contradictions between its assertions that no medical information will be passed on to authorities with a warrant and the actual legislation underpinning it.
Australian Medical Association president Tony Bartone told the National Press Club last week that he would meet with Health Minister Greg Hunt, calling on government to do “whatever it takes” to remove the ambiguity currently surrounding the MHR service, including potentially amending the legislation.
While Mr Hunt and the agency behind MHR, the Australian Digital Health Agency, have maintained that no sensitive data stored on the electronic record would be handed over to authorities without a warrant, this requirement is not reflected in the legislation.
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Life insurers cautious about My Health Record

BY HARRISON WORLEY  |  MONDAY, 30 JUL 2018   10:55AM
As My Health Record draws criticism and scrutiny, life insurers are cautious as to the merits of the initiative and its potential implications for the industry.
The e-health policy has hogged much media attention in the last fortnight as Federal members of parliament on both sides of the political spectrum voiced concerns about privacy issues; and in the wake of about 20,000 Australians opting out at the first opportunity two Mondays ago.

Currently life insurers are unable to access My Health Record data, alongside health insurers - which have been lobbying the Federal Government for secondary access. Life insurers are cautious as to how the data could be used to improve customer health and insurance efficiencies.
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30 July 2018

Police can access medical data MHR or not

Posted by Felicity Nelson
An examination of the legislation underpinning Medicare Australia has revealed that the precedent for the police accessing MyHealthRecord without a warrant was set a long time ago.
Medicare Australia is legally allowed to share linked PBS and MBS data with law enforcement without a court order, so long as the disclosure is “reasonably necessary” to enforce criminal law, a law imposing a pecuniary penalty, or the protection of the public revenue.
Once linked, PBS and MBS data can tell a very detailed story about an individual’s medical history. 
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State threat to derail My Health Record rollout

  • The Australian
  • 12:00AM July 30, 2018

Deborah Cornwall

Queensland Health Minister Steven Miles has threatened to derail the federal government’s three month opt-out deadline for the My Health Record in an expected showdown at the Council of Australian Governments meeting in Alice Springs this week.
In a letter to federal Health Minister Greg Hunt on Friday, Mr Miles accused him of botching the rollout of the MHR and creating “very serious concerns” about the privacy implications for Australians, including uncertainty about who would be given access to a patient’s private health record.
“You are no doubt also aware of the flood of news stories and opinion urging consumers to opt out for a wide range of reasons, ­including the system being vulnerable to hacking,” Mr Miles said in the letter. “At this point in time, it is clear that the Australian government and ADHA (Australian Digital Health Agency) are failing to adequately address the broader community concerns.”
-----  Non Opt Out News i.e. All The Rest!

“Yet another wake-up call”: Privacy Commissioner releases new data breach report, with health sector top of the list

Lynne Minion | 31 Jul 2018
The healthcare sector has topped the list for data breaches once again, with the Office of the Australian Information Commissioner releasing its delayed quarterly report into the Notifiable Data Breaches scheme, with most caused by malicious conduct and human error.
According to the report released today, 49 notifications of data breaches in healthcare were made from April to 30 June 2018, surpassing the finance sector’s 36 notifications. A total of 242 notifications were received during the quarter.
Included within the healthcare component were breaches reported by online booking app HealthEngine, which connects to the Federal Government’s My Health Record, and Family Planning NSW.
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Chronic care patients forced to have My Health Records to access government's Health Care Homes program

Lynne Minion | 03 Aug 2018
The Federal Government’s Health Care Homes is forcing patients to have a My Health Record to receive chronic care management through the program, raising ethical questions and concerns about discrimination.
The government’s Health Care Homes trial provides coordinated care for those with chronic and complex diseases through more than 200 GP practices and Aboriginal Community Controlled Health Services nationally, and enrolment in the program requires patients to have a My Health Record or be willing to get one.
But GP and former AMA president Dr Kerryn Phelps claimed the demand for patients to sign up to the national health database to access Health Care Homes support is unethical.
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Data tool used to redesign clinical care at Waitemata DHB

Wednesday, 25 July 2018  
eHealthNews editor Rebecca McBeth
Waitemata DHB is using a business intelligence tool to drive the redesign of clinical care.
The board bought the Qlik Sense business intelligence tool in June 2017. Head of analytics Delwyn Armstrong says a key focus of the project is the implementation of change in clinical processes, driven by access to data.
“We started with a strong mandate that the data needed to be used not so much for operational reporting, but for clinicians to help them understand their patient load and patterns of care,” she says.
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  • Updated Aug 3 2018 at 11:00 PM

Why artificial intelligence will have very human frailties

It's 2022 and Australia has its first artificial intelligence scandal. 
A freak storm has just hit Melbourne, and an algorithm designed to help emergency services deal with high volumes of requests for help has a stunning and unusual flaw – calls from men are shown to be getting attention faster than calls from women.
It's an extreme example that would never happen. But when you hear from Catriona Wallace,  the chief executive and founder of ASX-listed Flamingo AI, which develops machine learning software for financial services, you start to think it just could be possible. 
"Ninety per cent of coders who are actually coding and tagging the data that will go into algorithms are male," she told The Australian Financial Review's Innovation Summit this week
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Don’t worry, world-leading AI expert doesn’t know what AI is either

Too much power in hands of too few says former Time Inc data chief JT Kostman
George Nott (Computerworld) 03 August, 2018 12:45
 “On any shortlist I’m considered to be one of the world’s leading experts on applied artificial intelligence,” said JT Kostman at a NetApp breakfast in Sydney yesterday.
The American’s claim has substance. Kostman is a former Time Inc chief data officer, was once Samsung Electronics’ chief data scientist, and says he has advised the US Department of Homeland Security, the FBI and the Department of Defense on AI and analytics.
But even he isn’t quite sure exactly what AI is.
“I don’t think anybody really does know what artificial intelligence is. I’m not sure that I’m really sure, what it really means. My definition of AI, truly, I define artificial intelligence as getting computers to do stuff that they do on TV and in the movies. That’s really a great definition of AI. That’s what AI really is,” he says.
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Thousands of SA children's medical test results online for 13 years: SA Health

4th August, 2018.
SA Health has revealed that thousands of children's medical test results have been publicly available online for the past 13 years.
The data with the names, date of birth and test results for about 7,200 pathology tests was embedded in a document on the Women's and Children's Hospital website from 2005.
It was removed in 2006, but two other document-storing websites kept it available until Thursday, when the department's IT security teams asked them to remove the data.
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Private health providers called out in quarterly Australian data breach report

OAIC finds private health service providers and finance are the two most-breached sectors from April to end of June.
By Chris Duckett | July 31, 2018 -- 00:42 GMT (10:42 AEST) | Topic: Security
The Office of the Australian Information Commissioner (OAIC) has released its first full quarterly update since the Notifiable Data Breach scheme (NDB) came into effect in February, and once again, private health continues to be the most breached sector.
For the period April to June, OAIC received 242 notifications, an increase of more than 380 percent compared to the previous period's 63 notifications. One breach impacted over 1 million Australians, the office said, with 52 affecting between 100 and 1,000 people, 55 between 11 and 100 individuals, 42 hitting from two to 10 people, and 51 events affecting a single person.
Nearly half of all notified breaches involved financial details, and almost all involved contact information such as home address, phone number, or email address.
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3 August 2018

ADHA chief’s surprising admission on the MHR

Posted by Jeremy Knibbs
With all the “hoo haa” over the MHR in the last few weeks, you could excuse the Australian Digital Health Agency’s head honcho, Tim Kelsey, for getting just a little rattled when faced with some fast and hard technical questions about the future of the electronic health record.
But in a very small session at this week’s Health Informatics Conference in Sydney, Mr Kelsey said one thing that was either him deflecting on the run, or a pretty big admission that the current iteration of the MHR is nothing like it will be in the near future and a lot of the hard work of the ADHA could soon be redundant.
The whole thing started with a question to the founder of a new health information sharing standard FHIR, which is starting to gain huge traction in the US, and which is being touted as a major piece of the digital health puzzle on efficient and secure health information sharing over the web.
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3 August 2018

Why telehealth still has a long way to go

Posted by Julie Lambert
Seven years after specialists were granted rebates for remote telehealth consultations, rural GPs hope their time has finally arrived to break the access barrier for patients in the bush.
Dr Ramu Nachiappan, a GP in Broken Hill in New South Wales for 27 years, is indignant that general practice has been locked out of technology-aided solutions to the problems of time and distance that impede rural healthcare.
“Medicare’s requirement for physical attendance by GPs is very restrictive of our ability to provide service for rural patients, especially isolated patients and patients who are unable to come at a certain time or have transport problems,” he said.
“In my humble view, when they rolled out video consulting for specialists they should have done the same for GPs. There is no Medicare rebate for a GP to take part in a video consultation except as a chaperone sitting with their patient.
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Navigating mandatory personal data breach notification obligations around the world: what do I need to do?

In February 2018 mandatory personal data breach notification laws were introduced in Australia as part of amendments to the Privacy Act 1988 (Cth), requiring organisations to notify eligible data breaches to both the impacted individuals and the Australian Information Commissioner. The introduction of mandatory personal data breach notifications reflects a growing global trend towards giving individuals more control and awareness over how organisations that access their personal data behave. This is also reflected in the recent introduction in Europe of the General Data Protection Regulation (GDPR), and the recent Californian Consumer Privacy Act of 2018, introducing many GDPR like rights for individual consumers in that state from 2020.
The reality for organisations handling personal data is that these laws often reference vague concepts, which may require that different standards of protection and breach notification be applied in each country or region, while potentially exposing the organisation to very significant financial penalties for non-compliance. This makes a difficult task for compliance officers to ensure that relevant regulatory requirements are met. Further complicating the task is the fact that the GDPR (and indeed other privacy regulations) can apply without there being an obvious link to an organisation's day-to- day operations, simply by virtue of where personal data is stored or processed, or where customers reside.
Below is an overview of requirements for notification of personal data breaches in some key jurisdictions.
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Canadian pharmacist snooped in the health records of 46

A pharmacist spied on the electronic health records of people she knew and shared what she saw with her spouse

Catherine Tully, the Information and Privacy Commissioner for the Canadian province of Nova Scotia, has released privacy breach investigation reports regarding the activities of the pharmacist.
On December 21, 2017, she began investigating a series of privacy breaches involving a pharmacist, Robyn Keddy, who was employed as the manager of a rural community pharmacy operated by the Sobeys National Pharmacy Group.
The Commissioner determined that the pharmacist had inappropriately accessed personal health information, including prescription history and medical conditions of 46 individuals over a period of two years.
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Minister sorry after health records found in derelict aged-care building

3 August 2018 — 9:15am
NSW Health Minister Brad Hazzard has promised an investigation after sensitive patient records were found in an abandoned building.
More than 1000 confidential medical records were found strewn around a room at the former site of the Garrawarra Centre for Aged Care in Helensburgh, between Sydney and Wollongong, the ABC reported on Thursday.
"To those people whose medical records were put in such storage arrangements in the early 2000s, I express my sincere apologies and can assure them and their families I will get NSW Health to do whatever I can to rectify the situation," Mr Hazzard said in a statement.
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NSW Government criticised after hundreds of medical files found abandoned in derelict aged care building

3 August, 2018
Privacy advocates are demanding the New South Wales Government explain how hundreds of medical files were left abandoned in a derelict building south of Sydney.

Key points:

  • New South Wales Health says it is investigating the matter
  • It says the site was accessed illegally
  • ABC sources maintain the building was not secured
The privacy breach, uncovered in a triple j Hack and ABC News investigation, is believed to be one of the largest of its kind in Australian history.
The documents date from 1992 to 2002 and were found at the former Garrawarra Centre for Aged Care in Helensburgh.
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Medicare payments overhaul procurement dumped

By Justin Hendry on Aug 3, 2018 7:00AM

Bespoke platform shelved.

The federal government has radically altered plans to overhaul its 30-year-old Medicare payments processing system, opting not to proceed with the planned procurement of a new platform.
The Department of Health has been working to replace the health and aged care payments system since early 2016.
The system currently delivers 600 million payments worth $50 billion every year for Medicare, the pharmaceutical benefits scheme, veterans and aged care recipients.
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Children's Health Qld looks to real-time data analytics

By Ry Crozier on Aug 2, 2018 12:00PM

Powering referral triage, future health policy and more.

Children’s Health Queensland is embarking on a “health intelligence” program of work that aims to bring together real-time data streams to improve clinical and policy decisions.
Chief digital officer Alastair Sharman told iTnews that health intelligence - essentially an umbrella term for data analytics initiatives - is one of four “key streams of work” that the agency has driven over the past few years.
A large part of the momentum for digital transformation at CHQ came from the 2014 establishment of the $1.2 billion Lady Cilento children’s hospital in Brisbane.
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TGA eyes tougher regulation for smartphone health apps

Endocrinologists say most glycaemic control apps pose a risk of inappropriate dosing
31st July 2018
Smartphone apps that offer therapeutic advice, such as insulin dosage calculations, will be assessed by the TGA for safety under a new proposal to protect patients.
The national medicines watchdog is preparing to examine the regulation of health apps following criticism from clinicians that most apps used by patients have not been proven to be efficacious or accurate.
Writing in the MJA, endocrinologists say glycaemic control apps are categorised as Class I (low risk) devices, and therefore escape independent assessment.
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Healthcare start-up Tyde puts emphasis on privacy and security

Supratim Adhikari

  • 12:00AM July 31, 2018
Digital healthcare start-up Tyde has appointed Tyro co-founder Andrew Rothwell as chief operating officer and brought in a new head of people, culture and operations, Reshmi Buthello, as the ­debate around the government’s My Health Record program hits fever pitch.
Tyde, which is one of the four official medical apps connected to the MHR system, raised $3 million in April to support the national rollout of its new mobile platform aimed at helping Australians manage their medical data.
According to Mr Rothwell, Tyde stands apart from its peers not only when it comes to securing the health data, but also on its ­effective use of the data to deliver better patient outcomes.
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https://www.itnews.com.au/news/cyber-attacks-rise-in-australias-data-breach-numbers-499323

Cyber attacks rise in Australia's data breach numbers

By Ry Crozier on Jul 31, 2018 7:08AM

Health sector continues to have most incidents.

Most cyber attacks disclosed as potential data breaches by Australian companies last quarter involved compromised user credentials.
The Office of the Australian Information Commissioner released its highly-anticipated first full quarter of numbers under the notifiable data breaches (NDB) scheme in the early hours of this morning. [pdf]
The report reveals the OAIC received 242 notifications in the first full quarter of the scheme’s operation.
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Health sector tops the list as Australians hit by 300 data breaches since February

AUSTRALIA introduced mandatory disclosure laws earlier this year — and we now know just how vulnerable our data is.
news.com.au July 31, 20188:10am
HEALTHCARE data is highly coveted by cyber criminals and the health sector is the biggest target of hackers in Australia, according to new data.
The Office of the Australian Information Commissioner (OAIC) has revealed Aussies have been the victim of more than 300 major data breaches this year — with hackers and criminals getting access to the private data of hundreds of thousands of people.
The 305 breaches have taken place in just the past five months, since February 22, when Australia’s new mandatory reporting laws came into force which demand businesses disclose when they have been hacked.
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Health service providers suffer the most data breaches, as overall numbers jump

ABC Science
By technology reporter Ariel Bogle
Australia's health service providers suffered more data breaches than any other sector between April 1 and June 30, 2018, according to the Office of the Australian Information Commissioner (OAIC).
Out of a total of 242 breach notifications, 49 were reported by the health sector — mostly due to human error.

Key points:

  • The OAIC received 242 data breach notifications between 1 April to 30 June 2018
  • The private health sector reported the most data breaches of all sectors
  • Most reported breaches overall were due to malicious or criminal attacks, followed by human error
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Notifiable Data Breaches second Quarterly report released

Tuesday, 31 July 2018
The Office of the Australian Information Commissioner (OAIC) has received 242 notifications under the Notifiable Data Breaches (NDB) scheme in the period 1 April to 30 June 2018, according to the second quarterly statistical report on data breach notifications received under the scheme, released today. This is the first full quarter of operation of the NDB scheme since it commenced on 22 February 2018.
The growing number of notifications under the scheme demonstrates an awareness by entities of their obligations to notify the OAIC and affected individuals where a breach of personal information is likely to result in serious harm. The report provides statistical information on breaches occurring in Australia and the reasons why they happen. Understanding causes will help everyone to take steps to prevent reoccurrence.
Since the scheme commenced on 22 February 2018, the OAIC has received 305 notifications in total.
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Software cuts through costly hospital pharmaceutical procurement

24 July 2018
Software helping select the most cost-effective pharmaceuticals
The University of Sydney has developed a software program which could significantly reduce the amount spent by the nation's hospitals currently estimated at more than three billion dollars a year.
The ground-breaking software, which streamlines the pharmaceutical purchasing process, is also expected to free up hospital staff for activities more closely related to patient care.
The software was developed in conjunction with Sydney’s Westmead Hospital by Dr Aldo Saavedra, a Senior Research Scientist with the University’s Faculty of Health Sciences, and Dr Erick Li, a senior lecturer in the Business School’s Discipline of Business Analytics.
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  • Jul 30 2018 at 1:57 PM

Ed Husic's AI centre of excellence to focus on ethical, humanist AI

The Labor party's $3 million pledge for a new artificial intelligence centre of excellence will aim to make Australia a hub of "ethical" AI development at a watershed moment of backlash against the internet giants, opposition spokesman for the digital economy Ed Husic has told The Australian Financial Review Innovation Summit.
Mr Husic said 2018 would be remembered as a "threshold year" in technology as momentous as 2007, when the internet surpassed 1 billion users, the iPhone and the Android operating system were launched, and Airbnb and bitcoin were conceived.
"Ten years later, 2018 has emerged as the threshold year for how​ we use those tools and how they are used on us," Mr Husic said.
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Digital health receives funding boost from Federal Government

King & Wood Mallesons

Australia’s digital health sector received a major boost in April this year when the Federal Government announced a $55 million cash injection to launch the new Digital Health Cooperative Research Centre (CRC) and its programs which will bring together a consortium of more than 60 health, medical technology and pharmaceutical companies, universities and research institutes operating across the health, aged care and disability sectors. Combined with the Government’s investment, the Digital Health CRC will have more than $111 million in cash funding and $118 million in-kind contributions to invest in a range of collaborative research and development programs that are set be rolled out from July 2018.
The research and innovation programs driven by the Digital Health CRC and its partners will focus on “optimising the use of evidence to improve personal healthcare, wellbeing and health and human services policy, planning and management and in doing so advance the Australian economy[1]. More specifically, the Centre’s research agenda will be developed to achieve three major outcomes:
  • Improving the health, welfare, quality of life and wellbeing of citizens;
  • Improving the efficiency and integrity of health services; and
  • Increasing the value of every health dollar spent[2].
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Clinicians can drive innovation in digital health age

Zachary Tan
Raghav Murali-Ganesh
George Margelis
SIMILAR to many other facets of our lives, the delivery of health care is undergoing a period of rapid digital change. The advent of innovative new technologies in health care, including mobile applications, wearable devices and artificial intelligence, has entered mainstream discourse, and health care is often described as the last frontier of “disruption”. Indeed, given time, these technologies have promise in empowering patients and transforming the way we prevent, diagnose and manage disease – fundamentally changing the clinician–patient relationship.
Digital health innovation has a checkered history in delivery. As we enter this period of transformation, we believe that clinicians should be at the forefront of this change. Clinicians, working with other stakeholders, are best placed to ensure that future innovations are safe, effective and genuinely clinically useful.
Call to arms
Clinicians see the inefficiencies that are harming patients daily. Poor information transfer between primary and hospital care, non-adherence with treatment, and poor engagement with chronic disease care are examples in which the correct digital health intervention may reduce preventable patient morbidity and unnecessary health care costs.
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Diabetes apps: regulation concerns grow

Authored by Sarah Colyer
PATIENTS with diabetes should be warned about the potential for insulin dosing errors with glycaemic control smartphone apps, experts warn, as regulators struggle to oversee the rapidly growing sector.
There are over 1500 diabetes apps available online – a number growing faster than any other health care sector, according to Dr Rahul Barmanray and Dr Esther Briganti, Melbourne endocrinologists writing in this week’s MJA.
“Although apps increasingly advise on insulin doses, there is minimal published information on safety and efficacy, despite these apps effectively providing drug treatment recommendations without health care professional oversight,” they wrote.
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  • Updated Jul 29 2018 at 10:00 PM

We're missing a huge health data opportunity, says Daniel Petre

Australia is missing a big opportunity by ignoring the potential for Medicare data and machine learning to transform diagnosis and treatment of common diseases, such as heart disease, diabetes, melanoma and oesophageal cancer, says venture capitalist Daniel Petre.
Mr Petre acknowledged valid concerns over health data security, which have flared up because police and tax officials can access health records without a warrant. He said tax officials should never have access to health data and police should need to get a warrant, but the debate about the value of a repository of health data had "lost all perspective".
"If I fall sick I want the doctor I am seeing to know everything about every treatment I have ever had," said Mr Petre. "The more she knows the better the chances are that I will get an effective diagnosis and treatment. In terms of data use by third parties there is a big difference between someone getting my health data with my name attached and someone getting health data on a 50-year-old male and using this data to create predictive diagnosis tools that will save lives."
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The robot will see you now: could computers take over medicine entirely?

They already perform remotely controlled operations – now robots look set to be the physicians of the future
Hands-off healing: urologist Greg Shaw with the £1.5m machine which helps the UCH team do 600 prostate operations a year. Photograph: Jude Edginton for the Observer
Like all everyday miracles of technology, the longer you watch a robot perform surgery on a human being, the more it begins to look like an inevitable natural wonder.
Earlier this month I was in an operating theatre at University College Hospital in central London watching a 59-year-old man from Potters Bar having his cancerous prostate gland removed by the four dexterous metal arms of an American-made machine, in what is likely a glimpse of the future of most surgical procedures.
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Enjoy!
David.

Sunday, August 05, 2018

I Think It Is Useful To Do A Little Stock-Take As We Move Into Week Four Of Opt-Out.

Well it has been amazing and I have to say trying to keep up has made me feel rather like being as busy as a one-armed paper hanger!
I see this short note as trying to put together an impressionistic ‘first draft of history’
The main things I have noticed have been:
1. The public reaction has been more intense and more rapid than any-one would really have imagined. It seems that the lack of preparatory public information has been a major mistake on the part of the ADHA has been a mistake.
2. The Profession (AMA, RACGP) has rather been caught on the hop as far as their wholehearted backing being offered for years and then a few days later having to come out a few days later saying they support change as the Minister attempted damage control.
The current president of the AMA is clearly not suited for the role he has found himself in. He has little technical understanding and is basically just mouthing the talking points from the ADHA.
The former AMA presidents – especially Prof. Kerryn Phelps – have totally undermined his efforts and rather made him look like a goose.
3. The Digital Health Professional Groups (HISA, ACHI, HIMAA) have equally fallen into the same trap and have been guilty of not looking hard enough as the possible holes in the Government’s plans. Equally, and wisely, some key digital strategists have been pretty critical of what has been done for years.
4. The mainstream media have taken to the issues raised with considerable gusto with News Ltd. The Guardian, Fairfax and The ABC all running very significant coverage. There is a sense of emerging campaigns from both the ABC and NewsCorp.
5. The technical sites have, of balance, been pretty scathing and have been winding up their criticism lately (ZDNet especially).
6. The discussion of what is a breach and what is not has spun out of the spinners control and the ADHA is now looking pretty shifty. Additionally we have seen all sorts of paper and electronic health data breaches in just the last few days.
7. The ADHA Twitter account has been a model of irrelevance tweeting about tiny meetings happening in Perth while all hell breaks loose elsewhere.
8. ADHA media has been denialist and not prepared to even consider that there might be some downsides for some in having and using a myHR.
9. There has been a studied non-discussion of all those Australians who might be on the wrong side of the digital, health, intellectual or financial divide, and how they are to be dealt with in the world of the myHR.
10. It seems clear that trust in Government and Digital Technology is at a low ebb (Census Fail, Cambridge Analytica.)
All in all I reckon it has been an appalling mess which has damaged most it has touched. Both my polls and those of Pulse+IT see some pretty major damage having been done to trust and confidence in the myHR Program.
Stilgherrian gets it right I hear from Friday.

My Health Record: Canberra is still missing the point

No, Minister. It's not just about law enforcement access to digital health records. The Australian government needs to address all the concerns. A media circus in a playground won't help.

By | | Topic: Security


"There's a lot of interest around the My Health Record system," said Anthony Kitzelmann, chief information security officer at the Australian Digital Health Agency (ADHA). Such understatement! But fears about the security of ADHA's IT systems shouldn't top our list.
The My Health Record systems achieved "96.7 percent compliance" with the Australian government's Protective Security Policy Framework (PSPF) and Information Security Manual (ISM) at the protected level for health data, Kitzelmann told the SINET61 cybersecurity innovation conference in Melbourne on Wednesday.
ADHA is "always keeping in mind that this isn't our data. It belongs to our citizens, and it has to be held to the highest standards," he said. While developing its security controls, ADHA consulted with organisations such as the Australian Medical Association (AMA), the Royal Australian College of General Practitioners (RACGP), and, allegedly, consumers.
While your writer did use the recent Singapore medical data breach to highlight the possibilities for misuse, no system can be perfect. There's currently no reason to believe that ADHA hasn't secured their systems to the best of their ability.
The real concerns were, and still are, the vast potential for misuse by the 900,000 healthcare workers who can access the system, ill-thought privacy controls, complex access control that will be difficult for ordinary humans to operate, the as-yet-unspecified "secondary use" of the data, and of course the extensive warrantless access by enforcement bodies.
Health Minister Greg Hunt has finally emerged from his state of denial, kinda. But apart from adding the ability to properly delete your record, his supposed backdown on Tuesday night really only addressed the last of those concerns.
Worryingly for Hunt, recent appearances have shown the minister thinks the privacy issues transmogrified a fortnight ago, when the medico associations raised their concerns."We've responded very quickly to the AMA and the College of GPs. They have spoken to us over the last couple of weeks, and therefore we have responded within a two-week period," Hunt told journalists earlier this week. 

More here:


The last 2 paragraphs typify the whole ugly mess:
"BREAKING: The Australian Digital Health Agency has invited the media to a Sydney playground to film three generations of the one family who have a My Health Record," tweeted journalist Greg Dyett on Thursday morning.
Yeah, sure, that'll most definitely fix it."
What is your view? Have I roughly got it?
David.

AusHealthIT Poll Number 434 – Results – 5th August, 2018.

Here are the results of the poll.

Is Tightening The Legislation Around The Confidentiality Of The myHR Enough To Make It (And Opt-Out) An Overall Success?

Yes 2% (6)

Maybe 1% (2)

No 96% (236)

I Have No Idea 0% (1)

Total votes: 245

There seems to be a near consensus that not enough has been done.

Any insights welcome as a comment, as usual.

A really, great turnout of votes! The most ever indeed!

It must have been a really easy question as 1/245 readers were not sure what the appropriate answer was.

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

David.

Saturday, August 04, 2018

Weekly Overseas Health IT Links – 4th August, 2018

Here are a few I came across last week.
Note: Each link is followed by a title and 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.
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Interoperability now the top priority for NHS IT Leaders

Interoperability has become the highest single priority issue for NHS IT Leaders, according to the findings of the 2018 NHS IT Leadership Survey.
26 July 2018
An overwhelming 82% of respondents said that interoperability that enabled systems and staff to share information on patients was their highest priority. In the 2017 edition of the survey, the figure was just 51%.
The next highest priorities identified were clinical engagement, identified by 76%; moving to paperless working (73%); and ensuring a reliable, resilient, secure infrastructure (67%).
The annual NHS IT Leadership Survey, carried out by Digital Health Intelligence, exclusively surveys the priorities and concerns of NHS digital leaders, including the most senior IT professionals and doctors and nurses working on digital projects.
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NHS England ‘to publish AI code of conduct later this year’

NHS England plans to publish a code of conduct for the use of artificial intelligence (AI) in healthcare later this year.
Hanna Crouch – 19 July, 2018
Harpreet Sood, associate CCIO at NHS England, made the announcement at The King’s Fund’s Digital Health and Care Congress 2018 on 11 July.
When questioned by an audience member about concerns regarding AI use in the NHS, Sood said NHS England was hoping to publish a “basic terminology of what AI means” and a code of conduct later in 2018.
Sood added that the documents will help provide ‘principles’, ‘guidance’ and ‘transparency’ for the use of AI within the NHS.
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IBM’s Watson gave unsafe recommendations for treating cancer

Doctors fed it hypothetical scenarios, not real patient data

By Angela Chen@chengela Jul 26, 2018, 4:29pm EDT
IBM’s Watson supercomputer gave unsafe recommendations for treating cancer patients, according to documents reviewed by Stat. The report is the latest sign that Watson, once hyped as the future of cancer research, has fallen far short of expectations.
In 2012, doctors at Memorial Sloan Kettering Cancer Center partnered with IBM to train Watson to diagnose and treat patients. But according to IBM documents dated from last summer, the supercomputer has frequently given bad advice, like when it suggested a cancer patient with severe bleeding be given a drug that could cause the bleeding to worsen. (A spokesperson for Memorial Sloan Kettering said this suggestion was hypothetical and not inflicted on a real patient.)
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Homeland Security warns of spike in ERP system attacks

The web-based applications are designed to help organizations manage finances, HR issues and more – meaning they contain troves of personal data sought by nation-state hackers and other cybercriminals.
July 26, 2018 03:59 PM

The U.S. Department of Homeland Security is warning organizations across healthcare and beyond of increased nation-state, criminal group and hacktivist activity against enterprise resource planning systems used to manage finances, human resources and other business activities.
The alert comes just two days after two investigative reports on the activity spike by security firms Onapsis and Digital Shadows.
ERPs are web-based applications designed to manage everyday business operations, which means the systems hold a trove of valuable information. According to the report, the increase in zero-day exploits and vulnerabilities are mostly surrounding Oracle and SAP products, the largest providers of cloud-based ERPs.
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Survey finds most practices have portals, but don’t derive benefits

Published July 27 2018, 5:09pm EDT
Most physician group practices offer portals, a recent survey suggests that they’re not getting much value from them.
The survey, by the Medical Group Management Association, found that nine out of every 10 responding practices have a portal in place. The ability for patients to access information electronically is one capability prescribed by the federal Meaningful Use financial incentive program.
However, portal functionality available to patients can vary. While 43 percent of respondents have a portal that accepts patient-generated health data for clinician review, 37 percent don’t have that capability and remaining respondents were not sure if their portal offered it.
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NHS test drones for blood and medical test delivery between London hospitals

Early research says using drones could save $21 billion annually to the broader UK economy.
July 26, 2018 10:28 AM
A fleet of drones flying over London rooftops carrying life-saving blood and medical results between hospitals could be on the horizon, but a UK report has found regulatory and infrastructure obstacles need to be overcome.
The Flying High report by innovation foundation Nesta studied the possible rapid transportation of light medical deliveries between hospitals in the UK’s capital and says the increased speed and reliability could cut costs and improve patient care. But barriers include the need for air traffic control systems to allow drones to operate at scale without interfering with each other or traditional aircraft. 
The project team collaborated with five UK city-regions and experts from the NHS and emergency services, as well as technology experts and regulators, to study use-cases for drones, including when car accidents and fires occur.
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July 25, 2018 / 9:13 PM / 2 days ago

Study warns of rising hacker threats to SAP, Oracle business software

LONDON (Reuters) - At least a dozen companies and government agencies have been targeted and thousands more are exposed to data breaches by hackers exploiting old security flaws in management software, two cyber security firms said in a study published on Wednesday.
The Department of Homeland Security issued an alert citing the study by security firms Digital Shadows and Onapsis that highlights the risks posed to thousands of unpatched business systems from software makers Oracle (ORCL.N) and SAP (SAPG.DE).
These can enable hackers to steal corporate secrets, the researchers said.
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2 UN agencies create focus group for AI in global healthcare

Written by Anuja Vaidya (Twitter | Google+)  | July 25, 2018 | Print  | Email
Two United Nations specialized agencies — the International Telecommunication Union and the World Health Organization — established the ITU Focus Group on AI for Health.
The focus group will develop an international standards framework for the way AI is used in the healthcare sector. It will engage experts, including researchers, engineers and policy makers, to create guidelines steering the creation of national policies around the safe and appropriate use of AI in healthcare. It will also identify use cases of AI in the health sector that can be scaled globally.
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Verma: Many providers are holding patient medical records hostage

Published July 26 2018, 7:35am EDT
Many healthcare providers are holding medical records hostage by denying patients access to their own health data.
That’s the message CMS Administrator Seema Verma delivered on Wednesday in a speech at The Commonwealth Club of California in San Francisco.
“The use of electronic health records has merely replaced paper silos with electronic ones, while providers—and the patients they serve—still have difficulty obtaining health records,” Verma told the audience.
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HIT Think Cloud vs. data center—how to make the best decision

Published July 26 2018, 5:21pm EDT
It’s hard to get by without some kind of formal data management system. If an organization isn’t collecting and actively using data that’s been collected on patients and customers, it may not be able to reach them; and if it isn’t using data to optimize operations, it will be working at less-than-peak efficiency indefinitely.
However, data storage and management bring a new web of complexity to an organization. It can try to handle it all itself by investing in a data center and recruiting the right people to handle its management, or it can pay money to an outside firm to handle those responsibilities.
Each approach comes with its share of advantages and disadvantages, so HIT executives should make the decision that’s right for their organizations.
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Blockchains for biomedicine and health care are coming. Buyer: be informed

By Andy Coravos and Noah Zimmerman
July 25, 2018
Dom Smith/STAT
In a First Opinion piece on how blockchain technologies could affect health care and the life sciences, its landscape map included 48 projects covering areas like decentralized health records and data marketplaces. Just six months later, the map has tripled in size, covering nearly 150 projects that have raised more than $660 million in private and blockchain-funded (crypto) markets.
While a blockchain health care unicorn has yet to be crowned, the health care industry has seen substantial interest from developers and investors. The dizzying pace has made it difficult to assess what is going on in this space. That’s why Elektra Labs, a startup backed by the National Science Foundation I-Corps, joined forces with the newly-formed Center for Biomedical Blockchain Research at the Icahn School of Medicine at Mount Sinai to create a dataset and accompanying framework for understanding and tracking developments in health care and biomedical blockchains.
At its core, a blockchain is a digital ledger (similar to a spreadsheet) in which transactions are recorded chronologically and openly. The ledger is decentralized, with multiple copies stored across a large network of computers. It does not rely upon a central authority, like a bank or broker, to verify transactions. Participants who update the ledger can be paid for their work using a digital currency or token, like Bitcoin, Ethereum, or a specialty token customized for a specific project.
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How an academic medical center integrated AI into its Epic EHR to improve diagnoses

The department of emergency medicine at the University of Maryland uses imaging-oriented technology as a virtual specialist in the ER.
July 25, 2018 09:26 AM
Emergency room physicians are almost always asking themselves, “What’s in front of me right now? Is this independent from the problem the patient has or is it part of the problem?” To answer these questions effectively, the physicians must know a lot about many different diseases.
“To master skin diagnoses, for example, I read a lot of atlases and earlier books from dermatologists, but the problem myself and my colleagues would run into is that we had the information available but not the visual component to answer the question, ‘What is it I’m looking at?’” said Brian Browne, MD, chair of the department of emergency medicine at the University of Maryland.
To overcome these challenges, Browne and his team deployed an imaging-based, artificial intelligence-powered clinical decision support tool from vendor VisualDx. The tool uses more than 100,000 medial images, available through a desktop or a smartphone.
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A CIO's take on EHR optimization: Engaging clinicians via many methods is critical to understanding their needs

Penn Medicine’s Mike Restuccia explains why instituting an end user survey is such an important, and eye-opening, step to take.
July 25, 2018 10:02 AM
We’ve officially entered into the “dog-days” of summer here in the mid-Atlantic states. When I think back to the biting cold wintertime in January it seemed that summer would never appear, yet it has arrived in full force. I use this metaphor because it closely resembles the electronic health record (EHR) optimization challenges that many of us face. 
After years of toiling, building and deploying, users are asking for more out of their EHR; and rightfully so! Industry statistics indicate that users in all industries tend to use between 50 percent and 60 percent of the functionality provided in their core application suite. 
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RDP backdoors cost just $10 on dark web: How to avoid getting hacked

With access to hacked machines cheaply available and thousands of new ports being added daily, it’s imperative to shore up this preventable threat.
July 25, 2018 09:08 AM
Over the last six months, brute force attacks on Remote Desktop Protocols have become a common headline. Consider the cases of LabCorp, the city of Atlanta, multiple health systems, Colorado Department of Transportation and others.
Most recently, in fact, Cass Regional Medical Center’s EHR went down for a week after a brute force attack on its RDP. The recent attack on LabCorp was reportedly caused by an RDP attack using the notorious SamSam ransomware.
While officials have yet to confirm the cause of the system outage, RDP attacks are a common method for the SamSam virus. And just this year, SamSam took down Allscripts for a week, again, officials did not confirm the hacker’s entry point.
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Google Cloud joins NIH initiative to create a biomedical database

Jul 25, 2018 1:40pm
Google Cloud is the first to join a new initiative by the National Institutes of Health (NIH) to create a biomedical database, the agency announced on Tuesday.
Google will provide cloud computing services as part of NIH’s Science and Technology Research Infrastructure for Discovery, Experimentation and Sustainability (STRIDES) Initiative, which aims to give researchers access to biomedical data sets. The agency’s initial focus is to make “high-value data sets more accessible through the cloud” as well as incorporate artificial intelligence and machine learning to optimize research.
As part of its agreement, more than 2,500 academic institutions will be able to use Google Cloud’s storage, computing and machine learning capabilities.
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7 Ways to Better Secure Electronic Health Records

Healthcare data is prime targets for hackers. What can healthcare organizations do to better protect all of that sensitive information?
7/24/2018
11:00 AM
January was not a particularly bad month for electronic health record (EHR) breaches. Still, in just those 31 days, nearly a half-million records were exposed to unauthorized viewers.
According to the HIPAA Journal, the top four breaches in January were all the result of hacking or an IT incident, exposing more than 387,000 records. While these numbers pale in comparison to the tens of millions of records involved in recent credit bureau and social media hacks, the sensitive nature of the records amplify the damage done.
What's more, the number of records lost to hacking or IT incident has steadily increased year over year since 2009 (though authors of the "January 2018 Healthcare Data Breach Report" note that at least some of that increase could be due to a lack of reporting in earlier years). 
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Senate confirms Robert Wilkie to head VA, will prioritize EHR project

After months without a permanent leader, Wilkie will be tasked with ‘righting the ship’ and is set to focus on the Cerner EHR project, already underway.
July 24, 2018 10:42 AM
Robert Wilkie, a Department of Defense under secretary was confirmed as Department of Veterans of Affairs Secretary on Monday, giving the troubled agency a permanent leader for the first time since March.
The vote of 86-9 makes Wilkie the first VA Secretary to not be unanimously confirmed. Nine Democrats and Bernie Sanders, I-Vermont, dissented. Sanders expressed concern that Wilkie would align with the Trump administration to privatize VA healthcare.
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HIT Think How incentives and deadlines could accelerate interoperability

Published July 25 2018, 5:48pm EDT
Earlier this year, the ONC released the Trusted Exchange Framework and Common Agreement (TEFCA), which responds to a mandate included in 2016’s 21st Century Cures Act and lays out principles, terms and conditions on which to base an interoperability framework that healthcare organizations can embrace.
“Patients who have received care from multiple doctors and hospitals should have their medical history electronically accessible on demand by any other treating provider in a network that signed the Common Agreement,” noted National Coordinator for Health IT Donald Rucker in a recent blog post.
To achieve that goal, TEFCA is divided into two parts—Part A, or the principles ,and Part B, the terms and conditions, which is also where the rubber meets the road for many who live in the healthcare IT world.
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NHS to bolster hospital IT with $540 million in new spending

The UK's new Secretary of State for Health and Social Care says tech transformation is coming to the National Health Service as he pledges big investments.
July 23, 2018 03:32 PM
In his first major speech since becoming the new Health and Social Care Secretary, Matt Hancock has put information technology atop his list of priorities for improving the National Health Service.
And he's backing his words with big money – the UK will invest around $540 million for hospital IT, according to reports, with another $98 million earmarked to help those trusts who still rely on paper make the move to electronic health records.
Hancock said his top three priorities for the NHS were "workforce, technology and prevention," and he said the millions in new funding were needed to boost the efficiency and morale of providers and the engagement of patients.
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Medical errors reported during computer conversion at Banner Health's Tucson facilities

Jul 23, 2018 Updated Jul 23, 2018
Banner-University Medical Center’s nine-story tower, 1501 N. Campbell Ave., will cost $426.7 million and cover 670,000 square feet. It is to be finished in April.
There were “numerous” reports of medical errors after Banner Health’s conversion to a new computer system at its Tucson facilities late last year, state records show.
Records of an Arizona Department of Health Services investigation into complaints about Banner’s computer conversion released to the Star after a public-records request were heavily redacted.
But the records indicate Banner’s Oct. 1 switch adversely affected patients and caused a high level of frustration among some staff members.
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Calculator can predict heart age, risk for heart disease

By Allen Cone  |  July 23, 2018 at 10:47 AM
July 23 (UPI) -- A new online health calculator is available that can predict a person's heart age and risk for heart disease based on a variety of factors.
Researchers developed and validated the Cardiovascular Disease Population Risk Tool, or CVDPoRT, based on data from the Canadian Community Health Surveys of 104,219 Ontario residents, who were between age 20 and 105. The surveys also included data from 2001 to 2007 of hospitalizations and deaths.
The tool was published Monday in Canadian Medical Association Journal and is available online.
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EXCLUSIVE Survey: Industry Execs Express Confidence in Interoperability Advancements

July 23, 2018
by Rajiv Leventhal
New research from Healthcare Informatics asks leading industry organizations their perceptions on key health IT issues
A survey of 459 leading health IT executives reveals that many industry stakeholders see themselves as far along on their interoperability journeys, but less advanced in their value-based care and risk-based contracting progressions.
The research, conducted this summer by Healthcare Informatics, generated 459 responses from healthcare stakeholders spanning various types. Entities such as ACOs (accountable care organizations) and health information exchanges (HIEs) were the highest-volume responders (43 percent of the total), while healthcare providers (25 percent) ranked next highest in response rate. Additional respondents included vendors, payers, teaching universities, and associations, among others.
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Health Data Breach Tally: Lots of Hacks, Fewer Victims

Bigger Organizations 'Have Invested Wisely' in Breach Prevention. What About Smaller Ones? Marianne Kolbasuk McGeeJuly 23, 2018
Hacker attacks are still dominating the data breaches added to the official federal tally so far this year. But compared to the mega-breaches of past years, this year's biggest hacks have been relatively small.
As of Monday, some 199 breaches affecting 3.9 million individuals had been added to the Department of Health and Human Services' HIPAA Breach Reporting Tool website, commonly called the "wall of shame." The website lists health data breaches affecting 500 or more individuals.
By comparison, the 2015 cyberattack on Anthem Inc. affected nearly 79 million individuals. Plus, 2015 attacks against Premera Blue Cross, Excellus BlueCross BlueShield, and UCLA Health affected many millions more.
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Deep learning can be useful in screening for pulmonary diseases

Published July 24 2018, 7:26am EDT
Computer-aided review of X-rays can help diagnose people with lung illnesses such as tuberculosis and pneumonia.
Such review, augmented by deep learning, can help lead to earlier detection and treatment of these conditions, especially in remote areas where specialists are typically in short supply, according to new research.
About one third of people in the world may be infected with tuberculosis. In 2016, there were more than 10 million cases of active tuberculosis, resulting in 1.3 million deaths. It’s the No. 1 cause of death for an infectious disease, and more than 95 percent of these deaths occurred in developing countries. Pneumonia is also prevalent, affecting 450 million people a year around the world, resulting in about 4 million deaths annually.
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Portal to make largest Alzheimer's genetic database available to researchers

Published July 24 2018, 7:11am EDT
Researchers will soon have access to the largest genetic database on Alzheimer’s disease through a new portal designed to make large-scale DNA sequence data available to qualified investigators.
The portal for the National Institute on Aging Genetics of Alzheimer's Disease Data Storage Site (NIAGADS) is currently undergoing beta testing involving a small number of investigators, with broader access slated to begin next month.
Whole-genome sequence data for 5,000 subjects, including Alzheimer's cases and cognitively normal controls, are being made available to researchers. An additional 20,000 subjects will become available next year to the research community as part of the Alzheimer's Disease Sequencing Project, a National Institute on Aging initiative to fully sequence the DNA of as many as 25,000 individuals.
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AI scours 1.2 million appointments to cut doc office wait times

Published July 24 2018, 4:11pm EDT
A Quebec tech company said it can cut wait times in doctors’ offices to less than 20 minutes and save patients 6.5 million hours a year in the Canadian province alone.
Bonjour Sante, which manages bookings for more than 300 clinics in Quebec, teamed up with Montreal’s flagship AI lab to create an algorithm predicting delays. The model looks at tens of thousands of past appointments through 1,900 parameters—from the weather to the type of medical-file software the doctor uses. Two hours before the scheduled time, patients receive a text estimating when the doctor will actually see them.
The service is currently offered at 10 clinics in the Bonjour Sante network at no additional charge. Founder Benoit Brunel said potential paying clients include hospitals and eventually, other industries struggling with needless waits.
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HIT Think How bad data is worse than no data at all

Published July 24 2018, 12:49pm EDT
Accurate and reliable data can bring context to research studies, help people understand trends, aid executives in knowing what’s working well for achieving organizational goals and much more.
However, data discernment is crucial. Bad data can completely negate all the positive factors of trustworthy information.
Some glaring imperfections in data can be spotted right away. For example, those working closely with healthcare data might find various misspelled names or cases in which an entry appears two or more times in a list but should only be there once or date-related inaccuracies.
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Hackers breach 1.5 million Singapore patient records, including the prime minister's

In what officials say was a "deliberate," highly targeted attack, cybercriminals repeatedly targeted Singapore Prime Minister Lee Hsien Loong’s personal records.
July 20, 2018 12:45 PM
Hackers breached the Singapore government’s health database with a “deliberate, targeted and well-planned” cyberattack, accessing the data of about 1.5 million patients, including Prime Minister Lee Hsien Loong, for almost a full week.
The cybercriminals initially breached a front-end workstation to gain privileged account credentials to obtain privileged access into the database. Officials said they detected unusual activity on July 4, but the hack began on June 27.
The investigation found the hackers didn’t tamper with the records, rather they exfiltrated the data. Officials said the attack was well-planned, and it wasn’t the work of “casual hackers or criminal gangs.”
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Here's what cybersecurity professionals at companies actually do, and why they're so vital

  • Cybersecurity headlines can be interpreted by looking at them as from the viewpoint of a chief information security officer or CISO.
  • The title, referring to the top cyber executive at a company, was first used at Citigroup in the mid-90s, when the bank hired Steve Katz to set up a new kind of security office.
Published 9:09 AM ET Sat, 21 July 2018 
Stephen Katz is the first person to take on the role of chief information security officer.
There's so much cybersecurity news these days, from elections integrity to stolen credit reports to the latest cybersecurity start-up, sometimes it feels like you need a decoder ring to make sense of it all.
One way to start breaking through the jargon and intrigue is to try viewing these issues through the lens of the Chief Information Security Officer (CISO), typically the top cybersecurity executive at a company.
The CISO role dates back to 1994, when banking giant Citigroup (then Citi Corp. Inc.) suffered a series of cyberattacks from a Russian hacker named Vladimir Levin. The bank created the world’s first formal cybersecurity executive office, and hired Steve Katz to run it.
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US health care companies begin exploring blockchain technologies

July 19, 2018 8.42pm AEST

Author Ana Santos Rutschman

Assistant Professor of Law, Saint Louis University
The sprawling U.S. health care industry has trouble managing patient information: Every doctor, medical office, hospital, pharmacy, therapist and insurance company needs different pieces of data to properly care for patients. These records are scattered all over on each business’s computers – and some no doubt in filing cabinets too. They’re not all kept up to date with current information, as a person’s prescriptions change or new X-rays are taken, and they’re not easily shared from one provider to another.
For instance, in Boston alone, medical offices use more than two dozen different systems for keeping electronic health records. None of them can directly communicate with any of the others, and all of them present opportunities for hackers to steal, delete or modify records either individually or en masse. In an emergency, doctors may not be able to get crucial medical information because it’s stored somewhere else. That can result in direct harm to patients.
There might be a way out, toward a health care system where patients have accurate and updated records that are secure against tampering or snooping, and with data that can be shared quickly and easily with any provider who needs it. In my work on health care innovation at the Center for Health Law Studies, at Saint Louis University School of Law, I have been following the rise of a technology that may help us address the weaknesses in today’s health care record-keeping: blockchain.
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Study finds EHR implementation still taking too much time, causing serious errors

Jul 23, 2018 3:48pm
While physicians have long complained about the administrative burden of EHRs, a new study quantifies some of those concerns and shows how even commonly used platforms can complicate simple tasks.
The study, published last week in the Journal of the American Medical Informatics Association (JAMIA), suggests wide variability in the usability and safety of EHRs.
Researchers observed how long it took four groups of physicians and residents to complete common tasks—like ordering an X-ray or prescribing Tylenol—using EHR platforms made by two major vendors, Epic and Cerner. They also measured how many errors the providers made.
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FDA issues guidance on how to use EHR data in clinical studies

Published July 23 2018, 7:02am EDT
The Food and Drug Administration has issued guidance to industry on using electronic health record data in clinical investigations including those involving human drugs and biological products, as well as studies conducted in clinical practice settings.
“EHRs may have the potential to provide clinical investigators and study personnel access to real-time data for review and can facilitate post-trial follow-up on patients to assess long-term safety and effectiveness of medical products,” the FDA’s guidance states. “In addition, there are opportunities for long-term follow up of large numbers of patients, which may be of particular importance in studies where the outcome of interest occurs rarely, such as in prophylaxis studies.”
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HIT Think Why patient matching needs a dual-track approach

Published July 23 2018, 12:50pm EDT
Patient matching with records affects all of us, most of the time without our knowledge.
Whether it is the receptionist at a doctor’s office asking for your date of birth or someone on a care team pulling records from a Health Information Exchange, one of two things is happening behind the scenes. An identifier is establishing your identity across different silos of information, or some kind of statistical matching is being performed.
The identifier is a simple solution, but historically has not been viable. Despite this, our current technology landscape offers two tools to make a universal patient identifier (UPI) practical—the advent of big data and the ubiquity of smartphones.
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Opioid prescribing principles can help doctors fight the epidemic

Published July 23 2018, 4:45pm EDT
The opioid epidemic has become an unprecedented crisis, says Dr. Halee Fischer Wright, president and CEO at MGMA. “Through our research, we’ve put forward both current best practices for, and barriers to, preventing prescription opioid abuse and treating addiction,” she adds.
The association suggests three ways to support development of an effective opioid prescription policy:
* Lines of communication must be open and clear between all parties, including patients, providers, staff members and pharmacists. This helps ensure all parties understand proper use of opioids and can recognize potential misuse.
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Enjoy!
David.

Friday, August 03, 2018

Now Here Is A Very Good Idea Which I Am Sure The ADHA Would Not Have The Guts To Do.

This appeared a few days ago…

A CIO's take on EHR optimization: Engaging clinicians via many methods is critical to understanding their needs

Penn Medicine’s Mike Restuccia explains why instituting an end user survey is such an important, and eye-opening, step to take.
July 25, 2018 10:02 AM
We’ve officially entered into the “dog-days” of summer here in the mid-Atlantic states. When I think back to the biting cold wintertime in January it seemed that summer would never appear, yet it has arrived in full force. I use this metaphor because it closely resembles the electronic health record (EHR) optimization challenges that many of us face. 
After years of toiling, building and deploying, users are asking for more out of their EHR; and rightfully so! Industry statistics indicate that users in all industries tend to use between 50 percent and 60 percent of the functionality provided in their core application suite. 
Given this stat, providing on-going education and system personalization to the staff becomes a natural next step and an excellent opportunity to empower users with more system proficiency. When clinicians are live on the EHR for several months after implementation they gain a better idea of how the system flows and are more familiar with specifically what needs to be adjusted. 
In addition to building upon user education, we have also taken the step to administer the KLAS organization’s Arch Collaborative Survey, which measures a user’s overall satisfaction with the EHR. This is not a survey that is for the faint of heart as the results — and most particularly the comments — can really get your attention. 
Lots more here:
Can you imagine a survey of a statistically meaningful sample of GPs and Specialists and patients regarding the level of satisfaction with and  what they like, dislike, want, have concerns about and so on with the myHR.
Actually asking some balanced, reasonable and evidence-based questions would create a platform to maybe build some trust etc. If taken notice of, it would also dramatically change what the myHR is today I believe.
What do you think?
David.