Note: I have excluded (or marked out) any commentary taking significant funding from the Agency or the Department of Health on all this to avoid what amounts to paid propaganda. (e.g. CHF, RACGP, AMA, National Rural Health Alliance etc. where they were simply putting the ADHA line – viz. that the myHR is a wonderfully useful clinical development that will save huge numbers of lives at no risk to anyone – which is plainly untrue) (This signifies probable ADHA Propaganda)
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Note: I have also broadened this section to try to cover all the privacy and security compromising and impacting announcements in the week – along with the myHR. It never seems to stop! Sadly social media platforms get a large run this week.
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Fake news is warping democracy, says ADFA’s Tom Sear
Australian Defence Force Academy cyber security expert Tom Sear argues that there will be no simple fix for fake news warping our democracy, but we ignore the threat at our peril.
Tom Sear
News Corp Australia Network April 17, 20191:58pm
As we head into a federal election, Australian democracy is not ready to defend itself against the cyber manipulation of our political process.
The threats are coming from within and beyond our borders.
There’s been a lot of talk about foreign influence in the 2016 US election. There, the Russian Internet Research Agency’s (IRA) aim was to exploit cultural divisions like race and religion to create conflict and undermine trust in institutions and the political process.
The same operatives who spiked America’s social media with disruptive content are also active here.
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‘Serious consequences’: Voters concerned fake news will impact on the Australian federal election
Fake news has real consequences, and a new poll shows just how quickly this has become a major issue for voters, while Kerryn Phelps has revealed her concern about being a target once again.
Claire Bickers
News Corp Australia Network April 17, 20191:43pm
Sixty per cent of Australian voters are concerned about fake news hitting the election campaign, with young people most worried about its impact.
It comes as Wentworth MP Kerryn Phelps and cricketer Shane Warne were hit by fake news within days of the election being called.
A majority of Australians in all age groups are worried about the spread of misinformation, a YouGov Galaxy poll taken exclusively for News Corp shows.
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Better connections: Your health, your say
Australian Digital Health Agency
Currently, most digital health systems are unable to talk to each other. Information collected about a patient – for example in a hospital or a GP practice – often can’t be made available to others involved in a patient’s care.
The Australian Digital Health Agency is facilitating a national conversation to develop a blueprint for a more modern, digitally connected health system. The Better Connections: Your health, your say conversation aims to capture the expectations and priorities of a better-connected healthcare system. The outcome of these consultations will be a set of national standards that will provide a roadmap to industry partners and government for the future development and implementation of digital health technologies and system connectivity.
The Interoperability Program seeks to connect patient information from multiple systems and sources to enhance clinical outcomes, improve healthcare delivery and improve patient experiences within the health system.
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Roger McNamee on Mark Zuckerberg and ‘the Facebook catastrophe’
- The Deal
- 12:00AM April 18, 2019
Roger McNamee was an early investor in Facebook. But that has not stopped him from attacking the giant in articles, interviews and more recently a book. Zucked: Waking up to the Facebook catastrophe, was published by Penguin in February. As he notes in the book, almost three years “have passed since I first observed bad actors exploiting Facebook’s algorithms and business model to harm innocent people. I could not have imagined then the damage to democracy, public health, privacy, and competition that would be enabled by internet platforms I loved to use.”
McNamee argues that the politics of countries including the United States and Brazil “have been transformed in ways that may persist for generations”. If you live in Myanmar or Sri Lanka, he claims, “your life may have been threatened”.
He writes: “We are running an uncontrolled evolutionary experiment, and the results are terrifying. We were not prepared for the social turmoil and political tumult unleashed by internet platforms. They emerged so quickly, and their influence over both person and commerce spread so rapidly, that they overwhelmed cultural, political, and legal institutions. Some will be tempted to relax now that the (US) 2018 midterm elections have come and gone without obvious foreign interference. Instead, I hope they will see that foreign meddling in campaigns is merely one symptom of a much larger problem ... for which the internet platforms themselves must be called to account.”
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Why Denmark is reducing hospitals while we are building more
Jill Margo
Updated Feb 19, 2019 — 3.48pm, first published at 3.03pm
Denmark has become a world leader in healthcare because, long before others, it realised the existing model was broken.
While other countries have been responding to growing demand by building more hospitals along traditional lines, the Danes have been reducing them.
In 1999, Denmark had 98 hospitals. Today it has 32.
The Australian Financial Review Healthcare Summit in Sydney was told on Tuesday that against some domestic opposition, the Danish health system was radically transformed to make it financially sustainable for the multiple challenges ahead.
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18 April 2019
I Am Not an InstaDoc*; This Is Not InstaMedicine*
*(I know these words are used for Instagram pictures of beautiful medical professionals and gory surgical procedures, but I choose to use them as words of instancy in the practice of medicine.)
The other day a patient called every hour to inquire about the status of her elective cardiology referral. She had been thoroughly evaluated twice at the hospital for chest pain and wanted a consultation.
Another patient called three times the same day because she had seen “Ambulance Chaser” legal firm advertisements about lawsuits against manufacturers of generic valsartan, which may have traces of Chinese cancer causing chemicals.
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EU law will force takedown of extremist content in an hour
- 18 April 2019
- Written by Sam Varghese
New European legislation will make it mandatory for Google, Facebook and Twitter to remove extremist content within an hour of it being posted or else face fines up to 4% of turnover for repeat offences.
The European Parliament voted 308 to 204 with 70 abstentions to back the proposal meant to solve the problem of internet hosting services being misused for terrorism.
The EU move comes in the wake of the killing of 50 Muslims at a mosque in Christchurch by an Australian white supremacist gunman on 15 March.
The shooter live-streamed his rampage on Facebook and it remained on the social media site for more than an hour. Numerous copies were uploaded to YouTube and linked off Twitter as well.
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Your ship is sinking. What's the one medical resource you'd save?
Dr Fogarty is a GP on the NSW Central Coast. He is a long-time columnist and is much-loved for his Fog’s Blogs that offer a humorous insight into general practice.
18th April 2019
Which one medical information resource would you take with you to the desert island?
Put another way, what is your most valued medical resource?
Australian Doctor’s How to Treat (conflict declared) is great, and is essential reading, but it’s about how to treat, less about how to access services.
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The eight pillars of the digital health revolution
Authored by Bianca Phillips
This article is the final in a series on the making of the digital health revolution. It provides an overview of what has been discussed to date as well as some additional thoughts.
Personalised medicine
In the article Digital health success hinges on four principles, co-authored with Dr Bernard Robertson-Dunn, we provided an overview of personalised medicine and an overview of pharmacogenomics, epigenomics, exposomics, transcriptomics, proteomics, phenomics, microbiomics and metabolomics.
We proposed the idea that the shift to a personalised medicine model of care would require the application of four principles:
- the acquisition of more and better data from the patient at the time and point of care;
- diagnostic tools and models that understand and interpret these data;
- treatment that addresses the cause of the problem; and
- a health care system that efficiently uses this radically different approach to clinical medicine.
Telemedicine for diabetes and heart failure
In the article Telemedicine for diabetes and heart failure: an evidence review, co-authored with Dr Denise O’Connor and Professor Leonard Gray, we observed that the “evidence from systematic reviews and overviews indicates that telemedicine can improve blood glucose control in people with diabetes and provide similar health outcomes in the management of heart failure as to face to face or telephone delivery of care.”
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When can I access My Health Record?
PDL has issued guidance on the use of My Health Record, including on privacy, consent and emergency access
With the participation rate in MHR ranked as 90.1% by the Government at the end of the opt-out period, it’s important pharmacists know and understand the circumstances in which it can be accessed, PDL says in its latest practice alert.
“Currently, patients provide ‘standing consent’ when they register for an MHR, which enables health care providers directly involved in a patient’s care to upload clinical information to their record,” observes PDL.
“Generally, there is no requirement for a health care provider to obtain the patient’s consent prior to viewing, or uploading clinical information to the MHR system.”
However, it is good practice to advise patients when information is being uploaded.
PDL highlights that a patient’s record can be accessed outside a consultation, as long as the access is for the purpose of providing health care to the patient.
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A healthy dose of caution: An analysis of Australia's My Health Record
Digital health records provide an array of benefits. Emergency care can be enhanced through quick access to important patient information. The duplication of diagnostic tests can be avoided and patients no longer need to recant their medical history and pharmaceutical prescriptions to every new health professional they see.[1]
Australia, along with other countries, has acknowledged the significant improvements in efficiency, quality and delivery of healthcare services that shared digital health systems can provide. My Health Record (MHR) is Australia's version of such a digital health system, acting as a national e-health record system operated and maintained by the Australian Digital Health Agency (ADHA). Although the window to ‘opt out’ of the MHR system has closed, Australians are still able to choose whether they maintain their MHR, restrict access to certain information or delete their online record entirely. Universal issues regarding data privacy, security, use and participation continue to undercut the utility of the MHR platform, with the Australian public maintaining a healthy sense of caution regarding the Government’s ability to safeguard some of Australia’s most sensitive personal information.
Australia's My Health Record program
MHR is Australia's national eHealth record system, operated and maintained by ADHA. Implemented initially in 2012 as the Personally Controlled Electronic Health Record (PCEHR), the system operated on an opt-in basis whereby individuals voluntarily registered for a PCEHR and consented to their health information being uploaded.[2] In 2018 the Australian Government announced the PCEHR would be renamed 'My Health Record' and legislation was introduced to transform the model to an opt-out program.[3] Under the new system, an MHR is created for every Australian unless he/she elects to opt-out. The deadline for opting out was originally mid November 2018 but was extended to 31 January 2019 due to widespread controversy regarding data security, privacy and how the MHR system will operate,[4] as well as the delayed release of a Senate Inquiry report into the MHR system (MHR Inquiry).[5]
Notwithstanding such controversy, the Australian Government's decision to migrate across to an opt-out model was well-intentioned, with aims of increasing the number of individuals and healthcare providers participating in the system.[6] Further, the transition formed part of Australia's broader National Digital Health Strategy with the strategic outcome of ensuring that health information is available whenever and wherever it is needed.[7]
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Digital health records provide an array of benefits. Emergency care can be enhanced through quick access to important patient information. The duplication of diagnostic tests can be avoided and patients no longer need to recant their medical history and pharmaceutical prescriptions to every new health professional they see.[1]
Australia, along with other countries, has acknowledged the significant improvements in efficiency, quality and delivery of healthcare services that shared digital health systems can provide. My Health Record (MHR) is Australia's version of such a digital health system, acting as a national e-health record system operated and maintained by the Australian Digital Health Agency (ADHA). Although the window to ‘opt out’ of the MHR system has closed, Australians are still able to choose whether they maintain their MHR, restrict access to certain information or delete their online record entirely. Universal issues regarding data privacy, security, use and participation continue to undercut the utility of the MHR platform, with the Australian public maintaining a healthy sense of caution regarding the Government’s ability to safeguard some of Australia’s most sensitive personal information.
Australia's My Health Record program
MHR is Australia's national eHealth record system, operated and maintained by ADHA. Implemented initially in 2012 as the Personally Controlled Electronic Health Record (PCEHR), the system operated on an opt-in basis whereby individuals voluntarily registered for a PCEHR and consented to their health information being uploaded.[2] In 2018 the Australian Government announced the PCEHR would be renamed 'My Health Record' and legislation was introduced to transform the model to an opt-out program.[3] Under the new system, an MHR is created for every Australian unless he/she elects to opt-out. The deadline for opting out was originally mid November 2018 but was extended to 31 January 2019 due to widespread controversy regarding data security, privacy and how the MHR system will operate,[4] as well as the delayed release of a Senate Inquiry report into the MHR system (MHR Inquiry).[5]
Notwithstanding such controversy, the Australian Government's decision to migrate across to an opt-out model was well-intentioned, with aims of increasing the number of individuals and healthcare providers participating in the system.[6] Further, the transition formed part of Australia's broader National Digital Health Strategy with the strategic outcome of ensuring that health information is available whenever and wherever it is needed.[7]
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Life is too short to not love what you do
By Laini Bennett
Tuesday, 16 April, 2019
Around the same time as the ‘#Metoo’ movement began in the US, Dr Louise Schaper was being introduced as a panellist at a technology conference in Australia. Unsurprisingly, she was the only female on the panel.
Dr Schaper waited patiently as, one by one, her male counterparts were introduced and their long biographies read out. When it came to her turn, instead of reading her bio, the MC instead chose to comment on her dress.
“Isn’t Louise looking lovely today everyone?” he asked the audience, her PhD and position as CEO of the Health Informatics Society of Australia (HISA) seemingly forgotten.
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Today's tip: read the fine print on health apps – if you can
Antony is a medical reporter with a special interest in technology and pharmacy.
17th April 2019
A few weeks ago, Australian Doctor reported on a study that exposed how far and wide health data can spread when patients enter it into ‘free’ medicine-related apps.
It showed that information added into 24 apps ended up in the hands of 237 organisations.
But the study didn’t answer the question of whether patients can make informed decisions on how their health data is used.
The way people gloss over online terms and conditions has been exposed before — perhaps most colourfully by a UK video games store.
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Infant health record
Your baby’s infant health record is an important book that records information, in one place, about their health, growth and development. It’s a permanent record of their early years which will be useful throughout their life. So, it’s important not to lose this book and to take it with you to all your baby’s appointments.
Take your baby’s health record book to every health check so your doctor or nurse can record their growth and development.
What is the infant health record?
Your baby’s infant health record is a coloured book that records important information about your baby, including their growth, vaccinations and any health issues. The book might be blue, purple, red, green or yellow, depending on which state or territory you get it in.
The infant health record will be in the newborn information pack given to you in hospital when you have your baby.
The book helps all the health professionals who look after your baby to work together — and with you. It records all the important information they need, from when your child is born to when they start school.
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Hospital Pathology Reports and My Health Record
15 April 2019 ADHA Propaganda
Did you know you can view hospital pathology reports via the My Health Record system?
In addition to discharge summaries and other types of clinical documents, pathology reports requested by hospitals within both the SLHD and SESLHD catchment areas are now being uploaded to patient records. This provides numerous benefits and supports delivery of patient care by reducing unnecessary duplicate testing and time spent locating or requesting copies of results.
Uploaded reports are immediately available for healthcare professionals to view and become visible to patients after seven days.
If you have any enquiries regarding My Health Record, please contact the team via myhealthrecord@cesphn.com.au.
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Building a digital-literate workforce in healthcare
Hafizah Osman | 16 Apr 2019
With an ageing population and the introduction of new technologies, the healthcare industry in Australia is, no doubt booming. But is this growth substantiated with the relevant skilled employment it requires?
Australia has been paving the way for the growth in healthcare. Federal and state governments have recently been investing millions towards building and upgrading healthcare precincts, such as the South Australia healthcare precinct, and universities are opening their doors to institutes that focus on digital transformation.
Most recently, Deakin University unveiled a new institute for health transformation, while Murdoch University launched a research centre at its Perth campus, with a focus on precision medicine.
And according to a McKinsey Australia report, powerful new automation technologies such as machine learning, artificial intelligence (AI) and advanced robotics are already transforming the Australian economy, workplace, education system and community.
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EU govts give approval for tougher copyright rules
- 16 April 2019
- Written by Sam Varghese
New copyright rules in the member states of the European Union will mean that Google will have to pay publishers for any snippets it uses from their publications, while Facebook will have to change its algorithms to filter out protected content.
The new rules were backed by a majority of the bloc's governments on Monday, after they were passed by the European Parliament in Brussels last month.
Nineteen countries, including France and Germany, backed the Copyright Directive, while Belgium, Estonia and Slovenia abstained. Finland, Italy, Luxembourg, the Netherlands, Poland and Sweden opposed the changes.
Online platforms will now have to sign licensing deals with individuals, companies or organisations to use their work online.
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15 April 2019
The devil in the detail of digital healthcare
The benefits of moving from paper to electronic medical records hardly need stating: metal cabinets full of dead-tree files and illegibly handwritten notes and prescriptions are health hazards that don’t belong in the 21st century.
But digital systems can also endanger patients in new ways and make life harder for doctors, which prompts the question: have we exchanged one set of problems for another?
You’d think so after reading “Death by a thousand clicks”, a months-long investigation into electronic health records (EHRs) in the US, one of a series of stories by Kaiser Health News and Fortune, published last month.
Journalists Fred Schulte and Erika Fry spoke to more than 100 doctors, patients, IT experts and administrators, policy leaders, lawyers, government officials and software company executives to uncover a $A5 trillion healthcare system “idling at the crossroads of progress”.
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Is this the start of pay for performance?
Zilla is a freelance reporter.
15th April 2019
As D-Day for the biggest shake-up in the history of the multimillion-dollar GP Practice Incentives Program looms, the Department of Health is wrangling a growing array of last-minute changes.
A new and improved Practice Incentives Program (PIP) was slated to begin more than three years ago with the scrapping of five PIP payments covering asthma, quality prescribing, cervical screening, diabetes and aged care access.
The funding was then to be redirected to a new PIP Quality Improvement (QI) Incentive to reward practices for showing improvements in their patient care.
The problem was that the QI incentive was something of a mystery to GPs, with little information forthcoming from the federal Department of Health.
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Comments welcome!
David.
