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, June 18, 2019

Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety And Security Matters. Lots Of Interesting Perspectives - Week 48.

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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How artificial intelligence uses chaos theory to predict death

6th June 2019
How does artificial intelligence make its decisions? What is the nature of its rational thought?
It’s a question that bamboozles even developers. The unknowable nature of artificial intelligence (AI) has led to its decision-making processes being called ‘the black box’.
You feed it masses of data, somehow it learns and out come the predictions.
A new study in Lancet Digital Health has found that AI can predict in-hospital, 30-day and 90-day mortality for ICU admissions with greater accuracy than even the best formulas used by human doctors.
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Email concerns for Australian IT chiefs amid deluge of malicious spam

By Ben Grubb
June 14, 2019 — 2.07pm
If your email inbox has been harder to sift through than usual, this might be why: seven in 10 emails in Australia were spam last month.
That's according to security and networking equipment manufacturer Cisco, which provides services that monitor and filters corporations' emails to weed out security threats and spam.
While some spam is caught by filters, it can still get through, and some contain security threats.
Last month, the Australian Competition and Consumer Commission (ACCC) warned that Australian businesses lost an estimated $7.2 million to email scammers last year. However, the number is likely to be much higher, as most email scams aren't reported.
The same report from the ACCC also pointed to a 53 per cent jump in business email compromise in the same year and said that Australian consumers reported losing $107 million to agencies that monitor fraud, which include Scamwatch and the Australian Cybercrime Online Reporting Network.
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Intelligence agency could be used for 'offensive cyber' operations in Australia

By David Wroe
June 15, 2019 — 12.00am
Australia's electronic intelligence agency could smash the computer networks of criminals domestically using "offensive cyber" operations presently confined to overseas targets under proposals being discussed among national security officials.
The Australian Signals Directorate (ASD) could also sit within the networks of major Australian power, water, telecommunications and other critical infrastructure companies to help defend them against foreign cyber attacks.
The Sydney Morning Herald and The Age can reveal that a greater domestic role for the ASD remains a live consideration for the Morrison government despite the political firestorm that has erupted since police raided a journalist's home to investigate a top-secret leak of the ASD proposals.
Senior officials have repeatedly stated that the proposal never amounted to spying on Australians - a position strenuously underscored by multiple sources in recent days.
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My Health Record: learning opportunity for PAs

Pharmacy assistants play an important role in helping customers obtain the medicines they need, and part of that process is using My Health Record in the supply of medicines and advice to customers.
Often pharmacy assistants have well established relationships with customers, based on familiarity, time and the previous high-quality service they have provided.
With the introduction of My Health Record, pharmacy assistants now have an opportunity to develop those relationships through helping pharmacists and customers get the greatest benefit from the system.
In recognising that the My Health Record system makes it easier and safer for pharmacists, doctors and other health professionals to provide care to customers, Guild Learning and Development has partnered with the Australian Digital Health Agency to develop an online module titled Introducing My Health Record.
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Future of warfare in the cyber grey zone

  • 12:00AM June 14, 2019
Defence Force chief Angus Campbell has warned the West must come to terms with new forms of “political warfare” being waged by totalitarian states seeking to subdue, disrupt and overpower ­Australia and its allies.
In a speech last night on the sort of war Australia might have to fight in 2025, General Campbell said the nation’s “worst nightmare” of armed conflict would emerge from “the grey zone” — ­information campaigns, cyber operations, theft of intellectual property, coercion and propaganda.
“Grey-zone operations that subvert, erode and undermine, breaking international rules and norms but ones that, in the eyes of the targeted state, fall short of ­requiring a war response,” he said.
General Campbell warned totalitarian states were masters of political warfare, naming Russia but not China as perpetrators, ­despite Beijing’s well-documented political coercion and offensive hacking operations.
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Doctor, just how safe is your patient data, really?

Siobhan is a reporter with Australian Doctor Group.
14th June 2019
A team of auditors recently hacked a number of health services and accessed sensitive patient records to make a point about data security complacency.
Their findings, published in a Victorian Auditor-General’s report last month, showed just how easily patient data could be stolen or altered.
The main targets were Barwon Health in Geelong, and the Royal Children’s Hospital and the Royal Victorian Eye and Ear Hospital, both in Melbourne.
The most common problems were weak passwords, inadequate access control, limited network monitoring and poor staff knowledge.
But the report also highlighted the techniques they used to infiltrate a hospital system — and none of these techniques required a cybercrime mastermind as you might imagine.
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Study highlights e-prescribing errors

Pharmacies are being left out of pocket, say researchers
13th June 2019
The increasing use of electronic scripts has been linked with a number of dispensing errors and pharmacy frustration, a US study has found. 
Researchers from the pharmacy colleges at the universities of Cincinnati and Arizona analysed 589 voluntary reports to an e-prescribing error portal made over a four-year period. 
They found problems with patient directions (210) were the most common issue, and 10% of mistakes were not picked up before reaching the patient. 
Errors with the drug quantity (158 cases) and drug selection were the next most common mistakes, with 20% reaching the patient, the researchers reported in Applied Clinical Informatics
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My Health Record CPD Accredited Course for Nurses Now Available

The Australian Digital Health Agency has partnered with the Australian College of Nursing (ACN) to develop a self-paced online course tailored to the nursing role in any healthcare setting. This course is eligible for CPD points. It will ensure nurses are supported to confidently use My Health Record.
The course contains five modules:
  • Module 1 – An Introduction to My Health Record
  • Module 2 – Clinical Documents and Patient-Entered Information
  • Module 3 – Accessing, Viewing and Uploading to My Health Record
  • Module 4 – My Health Record Privacy, Security and Consent
  • Module 5 – Supporting Patients’ Use of My Health Record
Dr Helen Almond, Specialist General Practice Nurse and Lecturer in Digital Health said the new module is the latest in a series of initiatives conducted by the Agency and the ACN to ensure nurses are intrinsic in the use of My Health Record.
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CFEH Integrate with My Health Record

12 June, 2019
The Centre for Eye Health (CFEH) has commenced posting all patient reports and associated images to My Health Record files, in order to help improve the quality of patient care for people who have, or at risk of, developing eye disease and vision loss.
CFEH is the first in the eye care industry to integrate with the new system, and aims to focus on the early detection and management of eye disease and the development of innovative referral pathways to allow timely access to affordable eye care.
uploading patient information to My Health Record will help facilitate better inter-disciplinary communication and represents a great step forward
“Nine out of 10 Australians now have a My Health Record. Secure electronic communication pathways between optometrists and ophthalmologists as well as with other health professionals involved with our patients’ care such as GPs, public eye clinics and other specialists are currently somewhat fragmented,” said Michael Yapp, CFEH Head of Clinical Operations and Teaching.
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The ethics of artificial intelligence: laws from around the world

In this article, we examine the creation of frameworks for the ethical use of AI in Australia and globally.
Key takeouts
AI offers significant potential as well as risks.
In Australia, CSIRO's Data61 has proposed a framework for managing the ethics of AI which appears to be developing similarly to efforts in Europe.
There is growing consensus on these issues and serious consideration of AI ethics and best practice globally by the tech industry.
The use of artificial intelligence and machine learning (AI) driven solutions is becoming increasingly common in Australian businesses. By processing enormous amounts of information in a very short time, AI can minimise human intervention in decision making processes, and allow organisations to optimise their operations. The Minister for Industry, Science and Technology, Karen Andrews has commented that "AI has the potential to provide real social, economic, and environmental benefits – boosting Australia's economic growth and making direct improvements to people's everyday lives".
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Damned lies and statistics: how to 'unspin' medical news

Antony is a medical reporter with a special interest in technology and pharmacy.
12th June 2019
At the risk of having to plead the fifth, let’s talk about the failings of health journalists.
In a novel series of randomised controlled trials, published recently in BMC Medicine, researchers tried to quantify the effect on readers of misleading ‘spin’ in health news stories.
As they noted, spin can have real-world consequences. In 2008, coverage of a mouse study evaluating lithium for motor neurone disease led many patients to try it, they say. Subsequent research showed the treatment was ineffective in humans.
For the BMC Medicine study, US and French teams, including epidemiologists and journalism academics, read 30 news stories, including one from Australia’s own Herald Sun newspaper, and attempted to unwind the spin by adding appropriate scientific cautions to see how the change would be received by readers.
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09 - Graham Grieve

Pete chat's with the "Father of FHIR" Graham Grieve about the motivations and drivers behind the plumbing of healthcare data.  Check out the FHIR community at www.fhir.org
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Jeremy Lee v Superior Wood: biometric data, the Privacy Act, and the employee records exemption

In Jeremy Lee v Superior Wood Pty Ltd, the Full Bench of the Fair Work Commission (FWC) considered the lawfulness of an employer directing an employee to provide their biometric data.
In this case, Mr Lee objected to his employer’s direction to use a fingerprint scanner to sign in and out of his work site, under Superior Wood’s Site Attendance Policy (Policy). Mr Lee argued that he owned the biometric data contained within his fingerprint, and that as ‘sensitive information’ under the Privacy Act 1988 (Cth) (Privacy Act), his employer was not entitled to require he provide this information.
Following the implementation of the Policy, Mr Lee was provided with verbal and written warnings, directing him to adhere to the Policy and provide his fingerprint. After Mr Lee’s continued refusal, his employment was terminated for failing to follow a lawful and reasonable direction to comply with the Policy.
At first instance, Commissioner Hunt held that the direction to provide the fingerprint scan was both lawful and reasonable. The Full Bench of the Fair Work Commission quashed this decision, finding Superior Wood’s direction to be unlawful, as it breached the Australian Privacy Principles (APP) in the Privacy Act, specifically, APP 3.
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How hackers can permanently lock you out of your accounts

Some hackers use malicious code, but most just hide in plain sight. It can be devastatingly effective
When their computer or social media account is hijacked by an unknown entity, most people probably picture something like this: a faceless man hunched over a sleek laptop in an abandoned building, eyes darting to and fro, hands dancing across a mechanical keyboard. Green ciphers wash down his screen faster than the eye can track until … ping! your face pops up on the screen. He just cracked your Facebook account, and now this digital mastermind is going to message all your friends asking for money. Jackpot.
This only happens in movies, of course, and while a minority of “hackers” do write Trojan horses, viruses and other malicious code, most just hide in plain sight and exploit human psychology to gain entrance. Social engineering can take many forms, including “tailgating” – following someone through a turnstile or into an elevator to access restricted floors; showing up at a restricted site disguised as an IT contractor; or the infamous SIM-swapping hack in which the hacker simply calls T-Mobile’s customer service, pretends to be you, perhaps gives your home address or SSN, and asks to port your number to a new SIM card, bypassing any two-factor authentication you have. This isn’t particularly difficult; the data needed to pretend to be you can be easily gleaned from the hundreds of data breaches that occur every year. Most often, hackers enter through the front door.
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City of Perth rolls out new facial recognition CCTV cameras, but is it surveillance by stealth?

Updated Sat at 2:21pm
The activation of new facial recognition camera systems in Perth and Brisbane has raised concerns about how the technology is being quietly introduced by Australian governments as a way of monitoring their citizens.

Key points:

  • Facial recognition technology will be trialled by the City of Perth for 12 months
  • If successful it could be expanded to all 480 CCTV cameras in the city's network
  • But legal experts question whether it is an effective crime reduction tool
The technology was recently rolled out on the west and east coasts with little, if any, consultation with the public the government plans to watch.
Legal experts now say the public must be engaged in a debate about whether they want this powerful technology and how it could affect them in their day-to-day lives.
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Comments welcome!
David.

Monday, June 17, 2019

Weekly Australian Health IT Links – 17th June, 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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A very news free week other than for the sad demise of Bridget Kirkham – always a driver of Digital Health activity for good.
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Paramedics to transfer medical records en route to hospital

Sunday, June 16, 2019

Do You Remember When The ADHA Regulations Were Changed To Allow Shop Assistant Access To The #myHealthRecord?

I spotted this last week:

My Health Record: learning opportunity for PAs

Pharmacy assistants play an important role in helping customers obtain the medicines they need, and part of that process is using My Health Record in the supply of medicines and advice to customers.
Often pharmacy assistants have well established relationships with customers, based on familiarity, time and the previous high-quality service they have provided.
With the introduction of My Health Record, pharmacy assistants now have an opportunity to develop those relationships through helping pharmacists and customers get the greatest benefit from the system.
In recognising that the My Health Record system makes it easier and safer for pharmacists, doctors and other health professionals to provide care to customers, Guild Learning and Development has partnered with the Australian Digital Health Agency to develop an online module titled Introducing My Health Record.
This is the first of two modules to be launched on this topic, written especially for pharmacy assistants and dispensary assistants. The second module will be launched in July.
This first module examines how My Health Record works, and explores the information stored in the My Health Record system. On completing this module, pharmacy assistants and dispensary assistants will have learned how they can support their pharmacy to use My Health Record when supplying medicine and advising customers.
To enrol in this course, visit guilded.guild.org.au or contact Guild Learning and Development on 03 9810 9930 or email learninganddevelopment@guild.org.au for more information.
Here is the link:
Let us be quite clear here – these “pharmacy assistant” are not registered clinicians in any sense but my have received training from the Pharmacy Guild in store front operations and so on. Basically they are just shop assistants.
Here is the advertisement for a training session.

Enabling the Clinical Use of My Health Record in Pharmacy       

With 9 out 10 Australians now having a My Health Record (MHR), this important session for community pharmacies will provide an update on privacy and security obligations for pharmacy as well as introduce a new pharmacy clinical document for the MHR.
Open to all pharmacy staff, this workshop will expand upon participants' knowledge of MHR and will explore its features, functionalities, benefits and uses as they relate to pharmacy practice. Participants will be asked to participate in an extensive case study group discussion and will have the opportunity to discuss the MHR system.
Here is the link:
Note  the workshop is open to all staff:
“Who can attend: All pharmacy staff including proprietors, pharmacists and pharmacy assistants.”
So what training do these PAs have?

Pharmacy Assistant Training

Pharmacy Assistant Training is supported by Guild Learning and Development and delivered by your local Guild Training Team. The Pharmacy Guild has been delivering training to Pharmacy Assistants for over 15 years, longer than any other provider.

The Guild offers training in the following accredited qualifications for Pharmacy Assistants:

SIRCIND002 Support the supply of Pharmacy Medicines and Pharmacist Only Medicines (S2S3)

This unit will give your pharmacy assistants the knowledge and skills to support supplying S2 and S3 medicines to your customers. Accredited training can help you ensure your customers receive the best advice, care and health solutions.

SIR20116 Certificate II in Community Pharmacy*

The Certificate II in Community Pharmacy is your first step in a career in pharmacy. This qualification will provide you with basic pharmacy and retails skills. Expanding your skills provides career growth and opportunities, helping you to secure your future.

SIR30116 Certificate III in Community Pharmacy*

Comprehensive product knowledge and health information including cough and cold, analgesic and anti-inflammatory and allergies management. Grow and specialise your career with key pharmacy roles: health conditions, front of shop operations, merchandising and display, marketing, stock control, dispensary operations and key product and health categories.

SIR40116 Certificate IV in Community Pharmacy*

This qualification will benefit experienced pharmacy assistants who are looking to expand their skills to become a senior pharmacy assistant or front-of-shop manager. Senior pharmacy assistants are often responsible for the management of particular functions in the pharmacy, the management of a range of health categories or for the supervision of pharmacy staff.

SIR40216 Certificate IV in Community Pharmacy Dispensary

This qualification will benefit experienced pharmacy assistants who are looking to expand their skills in the area of dispensary. Dispensary assistants work with the pharmacist to provide prescription medicines to pharmacy customers. Under the supervision of the pharmacist, dispensary assistants maintain customer records, select and label medicines and process claims.
*Jobs and Skills WA funding may be available and is dependent on eligibility criteria.
** If enrolling person was not born in Australia
Here is the link:
Here is another useful link:
Does anyone think these unregistered staff should be anywhere near #myHR data.
AFAIAK it is not what the law says and these non-registered staff a committing a crime, in terms of the relevant act, accessing and using the #myHR. If indeed a pharmacist can authorise shop staff to access the #myHR then all the protections are a bigger farce than most of us thought.
What do you think?
David.

AusHealthIT Poll Number 479 – Results – 16th June, 2019.

Here are the results of the poll.

Given The Recent Serious Cyber Attacks On Australia (ANU, Parliament House etc.) Are You Concerned About The Vulnerability Of The Australian Health Sector - Including GP and the #myHR?

Yes - Much More Needs To Be Done 96% (89)

No - It Is All Under Control 4% (4)

I Have No Idea 0% (0)

Total votes: 93

Well that was pretty clear – most think we need to lift our game.

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

A more than reasonable turnout of votes.

It must have been a really easy question as 0 /93 readers were not sure what the appropriate answer was.

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

David.