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."

Tuesday, April 30, 2019

Commentators and Journalists Weigh In On Digital Health And Related Privacy And Security Matters. Lots Of Interesting Perspectives - Week 41.

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 and most weeks. Sadly there is also the need to recognize pollie based risks to privacy!
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Chinese media accuses Australia of becoming a ‘surveillance state’

  • April 26, 2019
A Chinese academic has accused Australia of becoming a “surveillance state” with the passage of telecommunications legislation last year giving security agencies more power over phone and internet companies to intercept communications.
The strongly worded article in Friday’s China Daily by Xu Ke, the executive director of the Centre for the Digital Economy at the University of International Business and Economics in Beijing, says Australia is in danger of “sliding into the abyss of a surveillance state” with the passage of the legislation.
Headed “Australia opens Pandora’s box with surveillance bill,” it accuses the federal government of taking advantage of the fact that Australia does not have a Bill of Rights to pass the law and to use “Australia as a breakthrough to force large global technology companies to yield.”
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It's time political parties started taking data protection seriously

By David Wroe
April 25, 2019 — 11.45pm
When the major political parties were spared the tedium of complying with the Privacy Act in 2000, the then-Howard government argued their exemption would enhance political communication and free up the democratic process.
It was a controversial enough view at the time, but it has become almost ludicrously counterproductive in the years since.
None of the parties wanted to talk about what they'd done to improve security since the cyber attack on Parliament's computer network earlier this year.Credit:
Technology in 2019 means malign actors can steal data and then use it to manipulate elections. That includes data on individual voters.
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'Democracy at stake': Parties warned Australia at risk of US-style cyber manipulation

By David Wroe
April 25, 2019 — 11.45pm
Former privacy tsars and technology experts have warned the major political parties they must dramatically strengthen their cybersecurity to protect the growing mountains of private data gathered on voters that could be used by foreign adversaries to manipulate elections.
More than two months since the Morrison government revealed that the three major parties had all been victims of a cyber attack early in the year, the Liberal, Labor and National parties have provided scant detail on how they were affected, nor what they have done to improve their defences.
The Liberal, Labor and National parties were hit by a sophisticated cyber attack.
Labor and the Nationals told The Sydney Morning Herald and The Age this week they did not believe confidential data had been accessed or stolen in their cases.
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Facebook CEO Mark Zuckerberg makes fresh call for global internet rules

  • April 25, 2019
Facebook boss Mark Zuckerberg has called for global guidelines on harmful content and privacy, admitting the tech giants cannot be trusted to write their own rules.
The executive, whose company is still dogged by controversies over privacy and is facing fines of up to $US5 billion ($7bn) from the US Federal Trade commission, has conceded on an earnings call that governments should bear the responsibility for regulating the tech giants, who have failed at self-regulating.
“If the rules for the internet were being written from scratch today, I don’t think people would want private companies to be making so many decisions around speech, elections and data privacy without a more robust democratic process,” Mr Zuckerberg said.
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23 reasons not to reveal your DNA

April 2019
DNA testing is a booming global business enabled by the internet. Millions of people have sent samples of their saliva to commercial labs in hopes of learning something new about their personal health or heritage, primarily in the United States and Europe. In some places, commercial tests are banned. In France, you could face a fine of around $4,000 USD for taking one.
Industry giants Ancestry.com, 23andMe, MyHeritage and FamilyTreeDNA market their services online, share test results on websites, and even offer tutorials on how to search for relatives in phone directories, or share results in social media. They often also claim rights to your genetic data and sell access to their databases to big pharmaceutical and medtech companies.
In terms of internet health, it’s part of a worrying trend of corporations to acquire personal data about people and act in their own best interests, not yours. OK, so test results can also lead to important discoveries about your personal health, and can also be shared for non-profit biomedical research in the public interest. But before you give in to your curiosity, here are 23 reasons not to reveal your DNA – one for each pair of the chromosomes in a human cell.
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Facebook beats profit estimates, sets aside $US3b for privacy penalty

Akanksha Rana
Apr 25, 2019 — 7.58am
New York | Facebook blew away Wall Street profit estimates in the first quarter as it kept a lid on the costs of making its social networks safer, and set aside $US3 billion ($4.3 billion) to cover a settlement with US regulators, calming investors who had worried about the outcome of a months-long federal probe.
Shares of the world's biggest online social network jumped more than 10 per cent after hours on Wednesday (Thursday AEST).
The US Federal Trade Commission has been investigating revelations that Facebook inappropriately shared information belonging to 87 million of its users with the now-defunct British political consulting firm Cambridge Analytica.
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Facebook Under Fire Over Fake News About Upcoming Federal Election

The Australian Electoral Commission (AEC) is reported to have asked Facebook to remove four items of unauthorised election content from the social media platform in the lead up to the 18 May federal election.
The AEC, in partnership with ASIO and the Australian Signals Directorate, is said to be ramping up efforts to prevent the publication and circulation disinformation.
A special electoral integrity taskforce is receiving daily briefings over content that’s being circulated on social media, with the AEC saying a proactive approach will help ensure that the democratic process is not tainted as a result of false information.
The taskforce was trialled during last year’s Super Saturday by-elections and the recent NSW election, and operates 24 hours a day.
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CCPA vs. GDPR: 10 Things to Do Now to Prepare for the Strictest US Privacy Law

European Union, USA April 18 2019
In this privacy briefing, Fenwick & West’s team of privacy lawyers and industry veterans compare the requirements of the California Consumer Privacy Act (CCPA) with those of the European Union’s General Data Protection Regulation (GDPR). The good news: If you’ve already been working on GDPR compliance, you can leverage that work to comply with the CCPA. Instead of starting from scratch, read on for the 10 practical steps toward CCPA compliance.
CCPA Enforcement Deadlines – A Moving Target
Even though the California Department of Justice is continuing its rulemaking process for the California Consumer Privacy Act (CCPA) and the California legislature is considering further amendments (e.g. expanding the private right of action and removing the cure period; excluding employee data), businesses must comply with the CCPA on January 1, 2020. The good news is that enforcement actions by the AG will be barred until six months after the publication of the final regulations or July 1, 2020, whichever is earlier. If your company has gone through the process of preparing for the GDPR, you know that preparing for compliance requires substantial investments of time and resources. As we wrote last July, there are steps companies can take now (See “California’s New Landmark Data Privacy Regulation and What Companies Need to Do to Comply”).
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Companies track staff emails to monitor dissent and predict unrest

Edmund Tadros Professional services editor
Apr 23, 2019 — 11.25am
An Australian professional services firm has said businesses can do away with ineffective staff surveys by using a potentially controversial software tool, developed by an MIT professor, to analyse the emails of staff and assess how they are feeling.
Boutique consulting firm Blackhall & Pearl Talent Services said it has been using the software, called Condor, to analyse emails for its clients to provide a real-time view of staff sentiment and predict how they might act.
Managing partner Alec Bashinsky said the software could find "honest digital signals" in staff communications, such as emails and instant messages, and identify "misconduct red flags", while tracking productivity, team cohesion and the effectiveness of change programs.
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Australian business cyber failings at 'crisis' levels: IBM

Apr 23, 2019 — 12.00am
Australian businesses are struggling to find qualified people to fill increasingly important cyber security roles, leaving them vulnerable to the growing threat from cyber criminals, a new global study by IBM has found.
This failure to take sufficient measures to protect against cyber attacks has already seen Australian businesses report one of the fastest increases in cyber incidents in the world.
The study, commissioned by IBM Resilient and conducted by the Ponemon Institute, found just 22 per cent of Australian businesses reported that staffing for cyber security was sufficient. That backed up a report released late last year that estimated Australia needed to train an additional 18,000 people by 2026 to fight cyber crime. 
Of the 11 countries and regions surveyed in the IBM report, Australia saw the biggest increase in cyber security incidents over the past 12 months, with 70 per cent of respondents reporting an increase. The global average was 55 per cent.
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AEC puts heat on Facebook over election threat

  • 12:00AM April 19, 2019
The Australian Electoral Commission has asked Facebook to remove four items of unauthorised election content from the social media service as the agency ramps up efforts to prevent disinformation during the election campaign in partnership with the nation’s top security agencies.
Australian Electoral Commissioner Tom Rogers said yesterday he was receiving daily briefings from a special electoral integrity taskforce, which includes the Australian Signals Directorate and ASIO, on threats potential threats to the democratic process.
“The major task in my view for the cyber taskforce is to make sure all of our electoral systems are safe and secure, and that is occurring constantly. But at the same time we are also very alert to this idea of disinformation,” Mr Rogers said.
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‘Extremely risky’ $1.2 million voter data project abandoned by Liberals

By Max Koslowski
April 21, 2019 — 11.45pm

Talking points

  • i360 is a world-leading campaign tool that uses personal voter information to help parties zero in on swing voters
  • The Liberal Party hoped i360 would take the place of Feedback, a decades-old tool party insiders believe is outdated
  • Feedback is run by Parakeelia, a Liberal Party-owned company that has paid the party over $2 million this decade
The Liberal Party has abandoned a $1.2 million data harvesting system amid a botched rollout and fears sensitive voter information was at risk, as the government deals with an internal rift over software once touted as its electoral "silver bullet".
Liberal sources who have worked with the party on its digital campaign strategy over the past three years say a rift between the federal organisation and state branches underpinned the ditching of i360, a controversial American voter data machine the party used in recent state elections in Victoria and South Australia.
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Secure messaging’s existential crisis

April 16, 2019    

If the various key stakeholders in secure messaging really walked  the talk on this vital part of healthcare interoperability in Australia, why do we have virtually no progress in the last decade? Something fundamental is still wrong.

Best Practice (BP), our largest primary care patient management system vendor, and Medical Objects (MO) , one of our top three secure messaging system vendors, have a few important things in common. Both were founded by doctors with a technical bent, and a desire to make things easier, safer and more efficient for their colleagues. Both founders retain firm control of their company’s destiny after more than two decades, despite many offers to sell out to major corporates (BP is owned 30% by Sonic). And  both have (or have had) head offices in very strange locations – BP in Bundaberg (their HQ is now Brisbane, but they maintain their Bundaberg office), and MO is atop a Chemist Warehouse in a suburban shopping mall in Maroochydore.
What comes with that, apart from the travel time you have to put in to get a face to face interview, is a certain coal-face practicality, and honesty, about what they are doing and hope to achieve.
I hired a car and travelled the one hour and 28 minutes from Brisbane’s CBD to sunny Maroochydore, with the hope of getting a coal face and frank view of what might be happening in Australia’s secure messaging ecosystem. After months of talking to and researching the work of various stakeholders, I wasn’t getting close to an understanding why we still find ourselves with so little progress, over something which most stakeholders will tell you is one of the key pieces of our digital health future. And which, even as it stands today, is a major fulcrum in the system for patient safety, and system efficiency.
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Comments welcome!

David.


The Health Informatics Society Of Australia and the Australasian College Of Health Informatics Are Contemplating A Merger.

This popped into my inbox this morning:
Dear David
Today, the Health Informatics Society of Australia (HISA) and the Australasian College of Health Informatics (ACHI) are announcing that we are consulting our Members, Fellows and stakeholders with a proposal to combine our two organisations, to form a new peak body for digital health and health informatics.
We believe a new peak body will provide significant benefits to members both as individuals and organisationally that will flow onto many thousands of stakeholders across our health and care sector.
As a valued member, we are requesting your input, feedback and suggestions on this important proposal.
The consultation period launches today and will run for eight weeks until Tuesday 25 June.
This question has been discussed and evaluated by the Board of HISA and the ACHI Council for over a year. Our organisations have worked together collaboratively since ACHI was formed 20 years ago and today that relationship is as strong and strategic as ever. We believe that combining our forces and building a new organisation will strengthen our ability to deliver on the core outcomes you've grown to expect and to deliver better and more strategic programs that best serve all stakeholders as health progresses into the digital age.
We will take on board your suggestions before we proceed to a formal vote of members later in 2019. The proposal for consultation is available here (PDF) and the feedback survey here.
You can also find a consultation calendar of events and more channels for discussion and feedback on the HISA and ACHI websites.  
On behalf of the HISA Board and the ACHI Council, thank you for taking the time to consider this proposal. We look forward to hearing from you.
Dr David Hansen
Chair
Health Informatics Society of Australia
Angela Ryan
President
Australasian College of Health Informatics
I have spoken with Angela Ryan and she indicated those managing the consultation are happy to receive comment from any interested party regarding the merger using the e-mail below.
I sort of wonder where the ADHA, MSIA and HIMAA fit into all this, if at all.
There is no doubt a clearer, professional voice on Digital Health matters would be a good thing in maybe balancing some of the rather single-minded views that are out there at present.
What are your views?
David.

Monday, April 29, 2019

Weekly Australian Health IT Links – 29th April, 2019.

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

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An very interrupted week with very little seemingly going on and the election in full swing. Poor old digital health is way down the agenda!
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Health apps may not disclose sharing your personal information

By Linda Carroll on Apr 26, 2019 11:59AM

Black Dog Institute report finds privacy shortfall.

While nine out of ten phone apps for depression and smoking cessation assessed in a recent study were found to be sharing user data with third parties, only two out of three disclosed they were doing so.
Much of that data, including linkable identifiers, was shared with Google and Facebook, among others, but barely half of apps sharing data with those two giant companies told users about it, researchers report in JAMA Network Open.
“If you download a mental health or smoking cessation app, there’s a high chance it will share marketing, advertising or usage tracking data with either Facebook or Google,” said the study’s lead author Kit Huckvale, a postdoctoral research fellow at the Black Dog Institute in Randwick, Australia.
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Why does information security matter in general practice?

GP – and former IT systems administrator – Dr David Adam wants GPs to know why information security matters.
26 Apr 2019
Dr Adam, a member of the RACGP Expert Committee – Practice Technology and Management, will be presenting one of the RACGP’s upcoming eHealth webinars, which will take place on Tuesday 30 April and Thursday 2 May.

He recently spoke with newsGP about the importance of information security.

What do GPs need to know about information security?
As we deal with more and more information in our practice, we need to understand the systems that provide and store this information.

Like the human body, we need to know how they work, but also how they can fail and what steps can be taken to avoid harm.
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Industry prepares medical professionals for remote healthcare delivery

Hafizah Osman | 23 Apr 2019
Two Australian organisations have joined forces in a bid to improve remote healthcare delivery and attract more doctors to rural and remote communities across Australia.
Swinburne University of Technology has partnered with CSIRO startup Coviu to embed digital health technology in the classroom, clinic and research by using the latest telehealth technology to treat Australian's remotely. 
The partnership will see Coviu, a company which specialises in online health consultations by using AI to connect doctors with hard-to-reach patients, provide access to its technology for Swinburne students, researchers and clinical services to redefine models of healthcare. 
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The doctor will FaceTime you now: developments in telemedicine and digital health

Technology now plays a part in practically every area of our daily lives, from smartphones and contactless payments to digital media and smart refrigerators. So it was only a matter of time before the realms of technology and healthcare collided. As ever, our Lexology contributors have kept their fingers on the pulse of telemedicine and digital health; this blog post highlights some of the key trends they’re covering.
DLA Piper kicked off the year with a top three of predictions for AI and the IoT: the key takeaway being that, as flagged by Microsoft CEO Satya Nadella in 2015, “every business will become a software business” – but is the healthcare sector ready? Recognising the need for healthcare providers to get to grips with this new area, Greensfelder Hemker & Gale PC recently launched a new four-part series with an article examining the regulations and risks within the telehealth sector. The piece stated that as yet, no federal law exists in this area – so providers need to rely on the same laws as apply to ‘brick-and-mortar’ providers, including HIPAA. Despite the lack of federal regulation, public agencies are starting to invest in the sector – for example, as discussed by Buchalter, the Federal Communications Commission’s Connected Care Pilot Program will result in a $100 million telehealth investment. The Centers for Medicare & Medicaid Service (CMS) and the Veterans Association are also getting involved, working on budgetary aid for telehealth services; Morgan Lewis & Bockius LLP reports on these and other legislative developments as part of its Tele-Tuesdays series. CMS is also relaxing the billing requirements for telehealth services – Brouse McDowell’s handy podcast looks at the three new ‘virtual care’ codes applicable in 2019.
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ACT Health embarks on connected health strategy with Spectralink Versity

Hafizah Osman | 26 Apr 2019
ACT Health is rolling out Wavelink’s Spectralink Versity enterprise mobility solution across five of its facilities, including Canberra Hospital.  
The deal involves the roll out of 2000 of the Spectralink Versity handsets by July. 
Spectralink Versity is an Android smartphone, purpose-built for healthcare. It is durable, waterproof, and has secure messaging capabilities, in addition to personalised settings for each user.  
A higher-grade model has a barcode scanner, which enables integration into EMRs. 
ACT Health will be using a combination of both models. 
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Google questioned over reports of massive device tracking database

By Staff Writer on Apr 24, 2019 12:24PM

US congressional leaders raise concerns.

The top Democrats and Republicans on the US House Energy and Commerce Committee on Tuesday wrote to Google chief executive Sundar Pichai raising concerns about reports of a massive database known as Sensorvault containing precise consumer location information on hundreds of millions of devices.
The letter seeks a briefing and answers on how this information is used and shared, citing a New York Times report that the database includes nearly every consumer with an Android mobile device, in some cases storing information dating to 2009.
The report said the database is used to fulfil geofence warrants obtained by law enforcement agencies, which seek details of all phones in a particular area at a particular time.
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Google gets FAA green light for drone delivery of consumer items

  • By Andy Pasztor
  • The Wall Street Journal
  • April 24, 2019
Alphabet’s Wing aviation unit has received the first US authorisation to operate a fleet of unmanned aircraft for consumer-goods deliveries, a move that could jump-start various companies’ commercial drone services nationwide.
The Federal Aviation Administration’s decision represents a regulatory coup for Wing in a budding, fiercely competitive industry. Amazon.com and other companies are vying for similar approvals to transport food and small consumer goods to residential customers.
Industry officials in the past have said it was likely to take until 2020 or 2021 for the FAA to implement wide-ranging drone rules establishing a framework for package deliveries.
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No, drone delivery still isn’t ready for prime time

Despite incremental progress and limited regulatory approval in the U.S. and Australia, drone delivery still isn’t a viable option in the vast majority of use cases.
Fredric Paul (Network World) 24 April, 2019 22:47
April has a been a big month for drone delivery. First, Alphabet’s Wing Aviation drones got approval from Australia’s Civil Aviation Safety Authority (CASA), for public deliveries in the country, and this week Wing earned Air Carrier Certification from the U.S. Federal Aviation Administration. These two regulatory wins got lot of people got very excited. Finally, the conventional wisdom exulted, drone delivery is actually becoming a reality.
Not so fast.

Drone delivery still in pilot/testing mode

Despite some small-scale successes and the first signs of regulatory acceptance, drone delivery remains firmly in the carefully controlled pilot/test phase (and yes, I know drones don’t carry pilots).
For example, despite getting FAA approval to begin commercial deliveries, Wing is still working up beginning delivery trials to test the technology and gather information in Virginia later this year. 
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Western Australia establishes precision health council for improved health outcomes

Early priorities of the council will include identifying and enhancing successful precision health initiatives already operating in WA's health system, and determining key areas that could benefit from increased integration of precision health measures.
April 26, 2019 02:53 AM
Earlier this week, the Western Australia (WA) Government announced the establishment of a new Ministerial Council that will advise the State Government on opportunities to further develop and support precision health advances.
Precision health uses new and emerging technologies to enhance disease prevention and early detection, and improve patient outcomes through treatments tailored to patients' individual genetic profiles, as well as their variable responses to the environment and lifestyle. 
The Precision Health Council will be chaired by South Metropolitan MLC Kate Doust and is expected to hold its first meeting within the coming months.
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One hour a day: World Health Organisation issues first guidelines for kids' screen time

By Rachel Siegel and Craig Timberg
April 25, 2019 — 4.03am
Children younger than a year old shouldn't be exposed to any electronic screens, according to guidelines issued Wednesday by the World Health Organisation.
The United Nations agency, issuing its first such guidelines, also recommended that children ages two to four have no more than one hour of "sedentary screen time" - including playing computer games or watching TV - per day. It emphasised that young kids need be physically active and get enough sleep, habits that go a long way in preventing obesity and other diseases later in life.
Children are being urged to go outside and take a break from handheld devices or risk short-sightedness.
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A GP's guide to the impact of digital screens on young eyes

How much is too much for children's vision, and how can you help parents set limits?
17th April 2019
Without doubt, more of us are spending longer on screens in our increasingly digital world. GPs are likely to encounter parents asking about the effects on their children’s visual and brain development.
‘Screen time’ includes any time looking at a screen, including television, computers, smartphones, tablets and video consoles.
As ophthalmologists, we are seeing an increase in device-related dry eye, and a new syndrome called ‘digital eye strain’, which tends to predominantly affect adults.
In children and adolescents, there is an increase in myopia, or short sightedness, directly related to increased hours performing near tasks.
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The evolving role of the CCIO – A chat with Dr Mark Simpson, CCIO, eHealth NSW

Healthcare IT News spoke to Dr Simpson about his new appointment as CCIO at eHealth NSW, the major projects he will be working on and his thoughts on the evolving role of the CCIO.
April 24, 2019 12:00 AM
eHealth NSW has been established as a distinct organisation within the New South Wales (NSW) Ministry of Health in Australia to provide statewide leadership on the shape, delivery and management of ICT-led healthcare. One of the most recent appointments at the agency is its new Chief Clinical Information Officer, Dr Mark Simpson, who joined in January this year.
Healthcare IT News learnt from Dr Simpson in an email interview about his new role at eHealth NSW, major projects that he will be working on, as well as his thoughts on the evolving role of the CCIO.
Could you tell us more about your role as CCIO at eHealth NSW?
I’m hugely excited to have started work as the Chief Clinical Information Officer for eHealth NSW, a role in which I am working collaboratively with NSW Health clinicians from across the state on transformative digital health strategies, programs and services. It’s an exciting time to join eHealth NSW. The 10-year eHealth Strategy for NSW Health: 2016-2026 has led to a great core level of coordinated delivery of digital services across the state, and the next six years will secure the consolidation of that fantastic start – as well as encouraging a much broader engagement of the clinical nursing and allied health professionals who are at the heart of this digital strategy.  
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Audit finds inefficiencies, overlaps in health networks

22 April, 2019
An audit has found that “ambiguity” in the governance structure of NSW local health districts and poor engagement with medical staff is hampering performance. 
The audit, released on April 18, found the responsibilities of local health districts (LHDs), which provide public hospitals and related health services to local communities, are in some cases unclear, potentially resulting in duplications and inefficiencies.
The audit also found that more collaboration is needed with medical staff in key decisions affecting the NSW health system.
While the responsibilities of LHDs and their relationship with other bodies are generally understood by board members, staff and stakeholders, there is ambiguity around more complex functions which needs addressing, the NSW Auditor said.
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Labor's AI vision for Melbourne

Paul Smith Technology Editor
Apr 23, 2019 — 12.01am

Key Points

  • A Labor government would set up a $4m AI centre of excellence in Melbourne.
  • The centre will combine business and academic expertise, with an ethics focus.
  • Labor is pressuring global tech firms to invest in local companies developing AI
Labor has chosen Melbourne to be the home of a planned $4 million national centre of excellence for artificial intelligence, forming a partnership with the Victorian government to target AI development initiatives that could benefit society as well as commercial interests.
The Opposition has also begun putting pressure on international technology firms operating venture funds in Australia to direct some of their money towards local companies working on socially progressive AI initiatives.
The plan to create an AI centre was first flagged by Labor's shadow Minister for the Digital Economy Ed Husic at The Australian Financial Review's annual Innovation Summit last year, but in addition to $3 million of federal funding, the Victorian Labor government has  promised $1 million as part of its push to have the centre in Melbourne.
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ePIP exemption guidance

This guidance is for general practices that have received a Practice Incentives Program eHealth Incentive (ePIP) compliance letter and are considering applying for an exemption. General practices should consult this table prior to applying for an exemption and satisfy themselves that there is evidence to support their claim.
Please note: Any evidence provided should not include information that could identify a patient or otherwise compromise their privacy. All supporting information should have individual patient information de-identified prior to submission.
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Encryption law: tech sector waiting for someone else to bell the cat

Australians may not have learnt much from the on-again, off-again election campaign that began on 11 April, but one thing has been made abundantly clear: the technology sector in this country is made up of wimps who are afraid to make anything, even an encryption law which they claim could destroy their industry, into an election issue.
The Telecommunications and Other Legislation Amendment (Assistance and Access) Act 2018 became law on 6 December last year and there was hope among the tech boffins that a review instituted by the Parliamentary Joint Committee on Intelligence and Security, with a reporting date of 3 April, would provide some solace.
But the PJCIS did what politicians do best and kicked the issue down the road, asking the Independent National Security Legislation Monitor, Dr James Renwick, to review the law and report back by 1 March 2020.
Not a single amendment was recommended and a week or so later, the election was called. This means that the entire technology sector will have to wait, with what is literally the sword of Damocles dangling over it, for another year.
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Labor faces reality on NBN but the dream died long ago

Liberal party may crow that its version of the NBN won out, but that's because it oversaw the network for most of its life.
By Chris Duckett for Null Pointer | April 9, 2019 -- 07:46 GMT (17:46 AEST) | Topic: Networking
It's quite fitting that it took ten argumentative years since the National Broadband Network kicked off on April 6, 2009, for Labor to finally make do with what is in the ground.
The network is pretty much done -- either the build is complete, or designs and contracts have been signed off across the nation, and the Turnboolean NBN has won out, warts and all.
Anyone expecting the Labor party to descend from the skies and present a plan endorsing the return to a full fibre rollout where possible has ignored the one topic that has constantly dogged the project: Cost.
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Enjoy!
David.

Sunday, April 28, 2019

Grahame Grieve Discusses Some Of The Issues Surrounding Interoperability.

I only noticed this a few days ago and felt it was worth a mention.

How does Australian interoperability become reality?

 

How do we take our current and somewhat vaguely expressed desire for improvement in interoperability in Australia, and turn it into something real? Fast Interoperability Healthcare Resource (FHIR) founder, Grahame Grieve, has some ideas.

By Grahame Grieve
Interoperability is a hard problem; it’s important to understand that it’s about information management, and it’s about people.
It’s not actually a technology problem – even though people use the word ‘technology’ a lot in respect to solving the issues we face around interoperability. But it’s not a technology problem, it’s a people problem, and an information management problem. Technology comes and goes. Information management is where the hard stuff is.
In my role as FHIR product director, I talk about interoperability a lot, and about FHIR. I realise that a lot of people misunderstand what Fast Healthcare Interoperability Resource (FHIR) is – yes, it’s got technology in it, but it’s not so much about technology. FHIR is really two important things – a community of people, and a set of agreements about information management and exchange.
The really valuable thing FHIR has is people and the culture that it helps people build. It’s a culture of sharing and openness and it’s starting to transform healthcare IT around the world.
The FHIR standard and the FHIR community don’t exist to deliver solutions to any real world problems, they exist to enable other people to do it.  Our job is to get IT out of the way. The challenge then, and the biggest challenge by far, is developing the right story, the right solutions and actually deploying this stuff.
When I set out on the FHIR journey I had three goals in mind:
  • To disrupt and force change on healthcare IT standards – that’s mostly in the bag.
  • To disrupt and force change on healthcare IT- that’s on going.
  • To disrupt and force change on health itself- that’s starting.
There are three stages to the journey that we’re on.
The first is getting the basic capabilities into international standards. These are platform standards that we can build solutions on.
But there are all sorts of solutions-  informatics, theory, international collaboration. And they can all be used differently, so…
The second stage is to take those standards and say “this is what we’re going to do with them here in this context.”
This is a set of agreements that we can run, in our smaller local communities where we have much more to agree about (as compared to what everyone in the world can agree on collectively). We need to work with how our systems work and work together as a group of people to figure out what these local guidelines or rules should be, test them, and integrate that process into a standards cycle that is sustainable.
The third phase is to actually turn those local agreements into operating software, operating market agreements – things that actually work and are available to our providers. That can transform how we do health.
Around the world FHIR is scoring goals in the first and second stages, but it’s the third stage that’s the hardest stage, by a long shot. And the challenge, for me, is that each of these stages means different people, different culture, different processes, and the handover between stages causes a lot of noise and potential disconnect. Getting continuity to try and run the process to the ground in each local community is the hard part, and it’s increasingly our focus.
I’m afraid I believe that in Australia, we’re starting at the back of the pack:
We’ve had a working standards process in the past, but we don’t currently.
We’ve had some consensus in the community in times gone past, but we don’t now (or, at least we don’t have it well enough established again).
We’ve launched this interoperability journey repeatedly for a number of years (maybe we missed a year here and there).
What we need is belief that we collectively can get it properly moving and solved.
If you look at the history of interoperability, the great interoperability technology and techniques tend to be invented primarily in four countries – USA, Russia, China, and Australia. In health, in fact, Australia has dominated the creation of interoperability technologies and techniques for decades (e.g. openEHR then FHIR).
But if you look around the world at countries that have actually taken those assets and made them work, they’re small countries. They’re the ones that can work together to drive the technology home into working solutions. Despite what some people say, it’s not actually about size. It’s about culture.
There is vastly more found here:
This whole article is worth a careful read.
I would be interested to hear how others see the perspectives offered.
Certainly when Grahame says all this is ‘very hard’ I find myself in furious agreement!
David.

AusHealthIT Poll Number 472 – Results – 28th April, 2019.

Here are the results of the poll.

Do You Expect More Success With An Approach To Health Information Interoperability And Sharing Based On Health Information Networks (US) Or A Centralised My Health Record (AUS)?


The Australian Way 3% (3)

The US Way 43% (46)

Neither 24% (26)

A Mixed Approach 30% (32)

I Have No Idea 1% (1)

Total votes: 108

What a really interesting poll again. The US approach was most approved. I would be very interested to understand what people were thinking with the other responses as to what might work!

Any insights on the poll welcome as a comment, as usual.

A more than reasonable turnout of votes for a holiday shortened week!

It must have been a fairly easy question as only 1/108 readers were not sure what the appropriate answer was.

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

David.