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, October 14, 2019

Weekly Australian Health IT Links – 14th October, 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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Another week that has seen much emphasis on cyber-security as well as the usual discussions on what is new and might make a difference. The ADHA has continued to keep secret what it is doing. Do you think they are doing anything other than spruiking the #myHealthRecord and does it matter anyway?
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Victorian hospitals slowly restoring systems after cyber attack

By Justin Hendry on Oct 11, 2019 1:00PM

Some systems still offline.

Regional Victorian hospitals and health services hit by a ransomware attack last week are slowly restoring their IT systems after a forced shutdown was required to isolate the infection.
But many systems, including internet and email, remain offline following the cyber security incident, with some systems expected to remain that way until at least early next week.
As mop up efforts continue across the Gippsland Health Alliance and South West Alliance of Rural Health (SWARH), manual workaround are still being used for systems still yet to be restored.
The attack, which occurred on September 30, blocked access to several major systems across hospitals and health services, including financial management, after being infiltrated.
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9 October 2019

Telehealth gets a green light for the bush

Posted by Francine Crimmins
Farmers on isolated and drought-stricken properties will now be able to consult their GP via video chat with no out-of-pocket fees, the Rural Doctors Association of Australia (RDAA) says.
The details of 12 new telehealth item numbers on the MBS were announced this week by the Department of Health. The tele-consultations will allow patients living in the two most remote classification areas (MMM 6 and 7) to access GP and allied health services from November 1 this year.
The decision was made after significant pressure from the RDAA and other key rural health stakeholders.
RDAA President Dr Adam Coltzau said the new items would make a real difference to the healthcare available to Australia’s most remote residents.
“We know there is a group of patients out there in remote Australia, busy farmers for example, who are struggling to keep their farms afloat, who simply don’t have the time to get to town and see their doctor in person,” he said.
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Disruptive digital design could help health services reach vulnerable

October 7, 2019 — 4.05am
No doubt many of us are very fortunate to live productive and engaged lives in this very ancient land. For those who do enjoy a rich state of mental health and wellbeing, Prime Minister Morrison’s catch-cry of “How Good’s Australia!”, is easy to endorse. During Mental Health Week, however, a more serious question we need to face is this: “How good is Australia’s mental health and wellbeing?"
Recently, the Australian Bureau of Statistics released its 2018 data on Causes of Death. Suicide rates in Australia now stand at 12.1 in 100,000 people, up from 10.7 in 2009 and 11.1 in 2013. Suicide is the leading cause of death in those aged 15-44 years, resulting in 105,630 years of life being lost prematurely in 2018.
While suicide, intentional self-harm and related accidents (such as deaths due to single-car accidents) are complex, ABS notes that 44 per cent are linked to mood disorders, 22 per cent to other emotional states, 18 per cent to anxiety, 29 per cent to psychoactive substance use and 22 per cent to alcohol and other drugs.
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9 October 2019

AI and Teledermatology: An Unexpected Alliance

It’s no secret: medical professionals are overworked. Extreme fatigue, long patient wait times, and an undersupply of specialists add up to stressful conditions that risk compromising the quality of care professionals can provide. With skin cancer rates on the rise, affecting 2 out of every 3 Australians in their lifetime, patients need access to care. In fact, they need it yesterday.
Teledermatology Reimagined
Enter teledermatology, an innovative solution providers are adopting to connect them with their colleagues and patients alike for streamlined referral workflows. Already a welcome solution, pioneering doctors are taking this vision a step further by teaming up with the other most talked about innovation in dermatology: artificial intelligence.
Rather than telling you (the medical professional) what it can do, intelligent dermatology software like DermEngine are being actively molded to fit the needs of Australia’s rapidly evolving dermatology ecosystem. What does this look like? Let’s break it down to the three basics of your daily practice:
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Fascinating cases from far-off places: App

Dr Park is a GP on the Sunshine Coast, Queensland.
9th October 2019
This app is really quite puzzling.
In fact, it’s an app where healthcare professionals can share their images and clinical stories and get multiple opinions from experts in a multitude of fields on how they would diagnose and manage presentations.
The app is freely available from app stores and is easy to log in to with an email address.
You can then click through either body parts, pathological systems or ‘follow’ specific experts to review case images and histories.
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Monday, 07 October 2019 11:20

La Trobe Uni students pilot digital tech learning for anatomy studies

Anatomy students at La Trobe University are putting aside their text books and piloting the use of digital technologies - Augmented Reality (AR) and Virtual Reality (VR) - to learn about the human body, with the university conducting the pilot program to teach the second-year anatomy subject.
The university says use of the technology is designed to help improve spatial awareness, explorative learning and accessibility.
The University has also made the technology available for all other Year 2 and 3 anatomy students at its Melbourne (Bundoora), Bendigo and Albury-Wodonga campuses, including students studying Allied Health and Science degrees such as physiotherapy, orthotics, prosthetics, podiatry and biomedicine.
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La Trobe Uni ditches anatomy textbooks for VR

By Matt Johnston on Oct 8, 2019 1:15PM

Adds AR app for 24/7 access.

La Trobe University is trialling augmented and virtual reality (AR/VR) in its anatomy courses as a replacement for textbooks to improve accessibility and students’ spatial awareness.
The technology is currently being piloted with second and third-year anatomy students from Allied Health and Science degrees including physiotherapy, orthotics, prosthetics, podiatry and biomedicine.
Dr Aaron McDonald, head of the Anatomy Discipline at La Trobe, said AR in particular gives students affordable and convenient access to highly detailed imagery through their phones, tablets or computers at any time of day.
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myGovID goes live on Android OS

By Justin Hendry on Oct 9, 2019 7:09AM

Android 7 or later supported.

Australians can now use both Android and Apple iOS devices to create a myGovID digital identity to access government services online.
The digital equivalent of the 100 point ID check quietly launched on the Google Play store late last week ahead of the Australian Taxation Office’s planned ramp of the credentialing application.
But only users with Android 7 (Nougat) or later (Oreo, Pie) will be able to use the application, potentially locking out Australians still using older versions of the Google operating system.
Android’s distribution dashboard puts the percentage of users with Nougat, Oreo and Pie at just under 58 percent.
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Victoria named nation's cybercrime hotspot

By Tate Papworth
October 6, 2019 — 11.30pm
Australians are reporting incidents of cybercrime about every 10 minutes, according to statistics released by the nation's cyber security watchdog.
More than 13,500 reports of cybercrime have been received by the Australian Cyber Security Centre since July.
Victoria made up the bulk of those reports at 26 per cent (3,027 reports), followed by NSW with 25 per cent (2,922).
The most-common type of cybercrime reported to the ACSC is online fraud, closely followed by identity-related offences.
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Monday, 07 October 2019 23:48

MedAdvisor raises $17 million in new funding

Australian-listed digital medication company MedAdvisor has successfully completed a $17 million capital raising ahead of planned global expansion, initially in the US market.
The capital raise- which  MedAdvisor says received strong demand - involved a placement of 340,000 fully paid ordinary sharers with MediAdvisor (ASX:MDR) to use the funds to execute identified opportunities in each market and to move to cash flow break even.
The capital raising also sees US healthcare analytics and technology business HMS take a pivotal cornerstone position of A$11.0 million alongside Australian institutional investors.
And MediaAdvisor says use of the funds will include continued investment in its technology, sales and support to drive success in the US and the UK and support the Zuellig joint venture in South East Asia.
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AI exoskeleton helps quadriplegic to walk by reading his brain

By Henry Bodkin
October 7, 2019 — 10.12am
A quadriplegic man can walk again thanks to a breakthrough computer that can read his mind.
The Frenchman, who has been paralysed for four years after falling from a nightclub roof, was strapped into an exoskeleton driven by a computer able to read signals from his brain.
Named only as Thibault, the 30-year-old optician successfully walked nine metres and performed a series of complex arm movements using the futuristic machine.
While powered exoskeletons have been a staple of Hollywood sci-fi films for decades, appearing in movies such as the Iron Man franchise, this is the first real-world example of one being used to help such a badly injured patient.
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Anatomics reinvents car factory for tech growth

Medical device manufacturer ­Anatomics will push into the US market after moving to a new ­facility, repurposed from the ashes of the car manufacturing industry, as it looks to spearhead a hi-tech sector for the region.
Health Minister Greg Hunt on Thursday will officially open the Melbourne site, which will manufacture some of the most advanced medical implants in the world, including human tissue scaffolds made of a plastic polymer known as StarPore, developed by Anatomics and the CSIRO.
Paul D’Urso, founder and executive chairman of Anatomics, said the site — an old brake factory in Bentleigh East — had space for future expansion and provided the region with a new ­industry to develop hi-tech jobs. “We can set up training and education for the next generation of students to enter the 3D printing and biomedical engineering space,” Dr D’Urso said.
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Taxpayer money at risk from special needs loophole

Aged-care providers can tick a box on the My Aged Care website that nominates them as specialists in servicing clients with special needs such as foreign language or LGBTQI, with no proof of qualification, the aged-care royal commission heard on Wednesday.
By promising to support special needs clients, they are favoured in the allocation of funded aged-care places, but the government has never checked whether providers do what they said they would after the aged-care place was secured, the commission heard.
The evidence prompted royal commissioner Lynelle Briggs to warn that the current arrangements risked a “serious misallo­cation of a lot of government money”.
Counsel assisting the commission, Peter Gray QC, asked federal Department of Health official Jaye Smith whether an aged-care provider needed to prove actual expertise before delivering ser­vices to groups with special needs.
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Cyberattack prompts national review of health systems security

Sunday, 6 October 2019  
eHealthNews.nz editor Rebecca McBeth
The Ministry of Health is working with primary health organisations and district health boards to check the security of their systems following revelations that health data on more than 900,000 patients may have been illegally accessed by hackers.    
PHO TÅ« Ora Compass Health had its website defaced in August 2019 during a widespread global cyber incident, prompting the organisation to take its server offline and strengthen IT security.
TÅ« Ora immediately informed the Ministry and an investigation has since revealed evidence of four attacks by cyber criminals dating back to 2016.
TÅ« Ora says data may have been accessed on more than 900,00 people from the greater Wellington, Wairarapa and Manawatu regions and could include data going back to 2002.  
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Middleware enabling safe electronic transfer of patient information

Tuesday, 8 October 2019  
eHealthNews.nz editor Rebecca McBeth
Ryman Healthcare is working with Canterbury and Auckland District Health Boards to deliver ‘transfer of care packs’ electronically when residents are transferred to hospital.
The aged care provider recently built and implemented its own electronic care record, myRyman, that runs on 3600 tablets deployed in residents’ rooms across its 33 residential villages.
Ryman operations clinical and quality manager Karen Lake says the development of myRyman means nurses can see all of a resident’s care record in one place, including diagnosis, current care plan and progress notes.
Having an electronic patient care record has enabled the development of a middleware option to allow the safe transfer of patient information to acute hospital services and general practitioners.
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Labor questions ACCC's judgment on TPG-Vodafone

Oct 10, 2019 — 12.00am
Labor communications spokeswoman Michelle Rowland has questioned the competition watchdog's decision to block the merger between TPG and Vodafone Hutchison Australia, saying the mobile market is already highly competitive.
In a speech at the CommsDay conference in Melbourne on Thursday, Ms Rowland will say the more-the-merrier view of competition is "an overly simplistic view of what is a more complex world".
"It is not always the number of competitors, but the right type of competition that is critical," the former communications lawyer will say.
Her comments come a little over a week after the end of the Vodafone-TPG Federal Court hearings into the Australian Competition and Consumer Commission's decision to block the $15 billion merger. A decision is expected in February.
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Mobile competition good for NBN, says Paul Fletcher

The Morrison government is open to the idea of 5G mobile services competing directly with the National Broadband Network, with Communications Minister Paul Fletcher saying the NBN shouldn’t be protected from competitive forces.
At the CommsDay Melbourne Congress on Wednesday, Mr Fletcher said consumers should have more broadband options available to them.
Both 4G and 5G mobile networks offered a viable alternative to the NBN, he added.
 “I want to make it clear that the government welcomes the fact that the mobile networks provide competition to the NBN.
“In New Zealand, mobile operator Spark is using mobile data services to compete against fixed-broadband services; we may see more of that in Australia over 4G or 5G networks.”
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NBN Co reinvents broadband speed test rankings

By Ry Crozier on Oct 11, 2019 1:16PM

"Debunks" other league tables, creates its own.

NBN Co will launch its own broadband speed ranking system - while “debunking” existing ones - in Amsterdam next week, escalating a long-running beef over third-party rankings that place Australia’s internet speeds alongside those of developing countries.
The company is understood to have commissioned local advisory firm AlphaBeta to produce the ‘global broadband speed report’, which it will launch at Broadband World Forum on Wednesday.
The report “debunks popular speed test rankings with unrepresentative samples that produce unreliable and unrealistic results, and offers an alternate methodology that ranks countries based on the average broadband speeds available to all citizens – a key factor in delivering social and economic benefits,” according to a blurb sighted by iTnews.
An NBN Co spokesperson declined to comment ahead of the announcement.
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Government hints at radical NBN shake-up

Oct 9, 2019 — 3.42pm
Communications Minister Paul Fletcher has encouraged mobile players to develop 5G alternatives to the national broadband network, saying competition would force the NBN to improve its products and prices.
The minister also hinted he was looking at ways to open up the fixed line market to competition, in what would be a radical shift from Labor's original plan to create a regulated wholesale monopoly.
Speaking at the CommsDay conference in Melbourne on Wednesday, the former Optus executive said he did not expect 5G to replace NBN completely, saying the two technologies were "complementary".
"But I want to make it clear that the government welcomes the fact that the mobile networks provide competition to the NBN," he said.
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The end is nigh for Telstra's 3G network; termination set for 2024

By Adam Turner
October 9, 2019 — 12.44pm
As Telstra ramps up its 5G rollout, the telco has announced plans to kill off its ageing 3G network in 2024.
While some remote areas of Australia still rely on 3G coverage, Telstra has committed to upgrading and expanding its 4G coverage over the next four years to a "materially equivalent size and reach" to its 3G footprint. Currently, 0.3 per cent of the population has 3G-only coverage.
The 850MHz spectrum currently used for the 3G network, and before that 2G CDMA, will be re-purposed to expand the 5G network. Telstra 5G is currently available in 10 cities across Australia, with plans to add another 25 cities over the next year.
Telstra was the first Australian telco to shut down its 2G network back in 2016, with Optus and Vodafone following the next year, but Telstra's rivals are yet to announce 3G shutdown plans.
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Vocus calls for rewrite of NBN statement of expectations

By Ry Crozier on Oct 10, 2019 11:58AM

To curb bad business market behaviour.

Vocus chief executive Kevin Russell has called on the government to issue a new statement of expectations for NBN Co on how it should behave in the enterprise market.
Russell told the CommsDay Summit in Melbourne that an “updated statement of expectations should lay out some clear ‘rules of engagement’ for NBN in enterprise.”
The comments come less than a day after NBN Co was formally warned by the Australian Competition and Consumer Commission (ACCC) for treating some of its telco partners more favourably than others - in breach of its non-discrimination obligations - for the purpose of selling enterprise services.
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Wednesday, 09 October 2019 11:35

ACCC warns NBN Co over playing favourites with RSPs

The Australian competition watchdog has warned NBN Co, the company rolling out broadband in the country, about discriminating between retail service providers when it comes to supplying upgraded infrastructure to business customers.
In a statement on Wednesday, the Australian Competition and Consumer Commission said NBN Co had accepted a court-enforceable undertaking, which included a pledge not to indulge in such activity again.
The ACCC said from at least January 2018, NBN Co had offered differing commercial terms to different RSPs as upgrades were being made to support business-grade services.
Additionally, the watchdog said, one RSP had been given indicative pricing information for the new Enterprise Ethernet service, months before other RSPs were provided the same information.
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NBN pinged by competition watchdog for discriminating between telcos

By Jennifer Duke
October 9, 2019 — 11.27am
The National Broadband Network has been pinged by the competition watchdog for allowing one telecommunications company to see sensitive details about pricing months ahead of its rivals and discriminating between providers.
The taxpayer-funded NBN Co, which has a monopoly on fixed-line internet services, has been given a formal warning and accepted a court-enforceable undertaking requiring the $51 billion business to put in place checks and balances to stop any discrimination between its commercial customers.
The NBN Co is a wholesaler of internet products and sells to telcos which directly provide the different plans to households and businesses when they are able to connect.
The Australian Competition and Consumer Commission found that from January 2018 the NBN Co offered materially different terms to telcos as it upgraded its network to provide business-grade internet. There was no finding that these actions had caused any harm or detriment to competition.
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NBN Co wants to fix your home wi-fi

By Ry Crozier on Oct 9, 2019 7:06AM

Using a "tool, firmware agent, or feature" added to your wi-fi gateway.

NBN Co is hoping to add a “tool, firmware agent, or feature” to wi-fi gateways in selected people’s homes to collect telemetry that can help it troubleshoot the in-home portion of internet connections.
The trial is set to last between two and three months, according to an NBN Co spokesperson, and could involve upwards of 5000 users.
It is being officially called the ‘Managed Wi-Fi trial’, suggesting that it could ultimately be packaged up as a service and used more broadly throughout the NBN footprint.

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Telcos prepare for 5G health backlash

Oct 7, 2019 — 12.00am
The mobile phone industry is taking on growing community concerns about the potential health risks of 5G with a campaign backing the safety of the latest generation of mobile technology.
Chris Althaus, chief executive of the Australian Mobile Telecommunications Association, said the industry was taking "some significant steps to ramp up its education initiatives", mainly by engaging media, governments and local councils.
"We are very concerned about the level of misinformation that is out there. There is a great deal of churn, particularly on social media, that are reiterating and repeating points of view in relation to 5G that are simply untrue.
"After decades of research, there's not been any adverse health linkage identified [to mobile technology] so people should be confident in that.
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Telstra cuts uplink speeds early in NBN fixed wireless shift

By Ry Crozier on Oct 8, 2019 1:15PM

Won't wait until 2020 to max out at 10Mbps.

Internet providers are starting to move 151,000 users from the old NBN 50Mbps fixed wireless product to a new “best effort” service, but some customers will get more constrained uplink speeds from day one.
The removal of the current 25-50 (download)/5-20 (upload) speed tier product for NBN fixed wireless was first reported by iTnews in August 2018, and then announced publicly by NBN Co six months later.
The network builder said its existing 25-50/5-20Mbps product would be cut “by the end of 2019” and replaced with a new ‘best-effort’ product called Fixed Wireless Plus (formerly MAX) that was intended to launch in mid-2019.
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NBN Co rezones businesses for cheaper pricing

By Ry Crozier on Oct 8, 2019 6:55AM

Concerted effort to draw 600k businesses off residential connections.

NBN Co is hoping to encourage more businesses to switch to its enterprise products by lowering their connection costs from Wednesday this week.
The network builder said in a retail service provider (RSP) bulletin last week that it would update the way businesses are zoned for pricing purposes from October 9.
The price of NBN Co Enterprise Ethernet varies depending on where a business customer is located.
Premises are divided into four ‘UNI zones’: a CBD zone, which is the cheapest, and then zones 1 to 3, with the latter being the most expensive.
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Enjoy!
David.

Sunday, October 13, 2019

The ANAO Audit On The #myHealthRecord Is Coming Soon!

I checked in today.

Found this.

Report Status - Report preparation

Contribution has closed


Due to table: October, 2019

Portfolio Health

Entity Australian Digital Health Agency; Department of Health

Contact Please direct enquiries through our contact page.

Sector Health

Here is the link:

https://www.anao.gov.au/work/performance-audit/my-health-record

I am sure it will be interesting to say the least. I am sure there is a big effort on from the ADHA to suppress any critical comments. I am pretty sure that will not work!

David.

I Wonder Why The Government Is So Secretive With Clinical Usage Statistics For The #myHealthRecord?

As far as I know there are two public sources of data.
First we have the information found here:

My Health Record statistics

The Australian Digital Health Agency publishes a range of statistics about how My Health Record is being used by healthcare provider organisations and consumers. The statistics include information about registrations, document uploads and prescription/dispense documents being recorded. 


These are the most interesting from my perspective:

Clinical document uploads

Total number of clinical documents in the My Health Record system.
Document type
Count
Shared health summary
3.1 million
Discharge summary
4 million
Event summary
1.1 million
Specialist letter
160,000
eReferral note
170
Pathology report
16 million
Diagnostic imaging report
3.1 million
TOTAL
28 million
Note no mention of access of use of any of the documents.
Second we have this:

Digital Health Data

Page last updated: 15 May 2019

Who is using digital health?

The Australian Digital Health Agency publishes information about which public and private hospitals are using digital health as well as the latest software products.

My Health Record statistics by Primary Health Network (PHN)

My Health Record is a secure online summary of a consumer’s health information. It allows consumers, doctors, hospitals and other healthcare providers to view and share health information to provide consumers with the best possible care.

The index below outlines the data that is currently contained within the Primary Health Network (PHN) - My Health Record Statistics report.
Consumer registration by PHN
Provider registration by PHN
Providers uploading by PHN
Provider document uploaded by PHN

Reports 2018-19

Reports 2017-18

Reports 2016-17

Reports 2015-16

Here is the link:

I have extracted a few figures from this on Shared Health Summary (SHS) Uploads:

June 2017 No 66,256 4-25 June.
June 2018 No 80,984 3-24 June.
December 2018 No 72,087 2-30 December.
January 2019 No 72,581 6-27 January.
May 2019 No 150,895 5-26 May.

The statistics from both sources stop in June and May 2019 respectively - now 4-5 months ago with zilch explanation!

Amazingly at 150,000 SHSs per month uploads to give everyone a summary will take 11 years assuming a total population of about 20 million. It will be worn out by then!

So even useless statistics have stopped, and the #myMHR is empty of Share Health Summaries largely, and those that are there are already mostly very old. This is because to get to the claimed 3.1 million at 150,000 a month  (the fastest rate) would have taken at least 20 months! A lot of the SHSs must be ancient history.

Easy to understand the bureaucratic secrecy and obfuscation. It’s a dud!

David.

AusHealthIT Poll Number 496 – Results – 13th October, 2019.

Here are the results of the poll.

If The Australian National University And The Federal Parliament Can Be Infiltrated By "Foreign Actors" Are You Confident The #myHealthRecord Can Be Really Secured Against Cyber Attack - Especially Given All The Personal Data It Holds?

Yes 2% (2)

No 97% (85)

I Have No Idea 1% (1)

Total votes: 88

Well that was pretty clear. The vast majority think the #myHealthRecord would not be secure against a sophisticated attack were it to happen.

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

A very reasonable turn out of votes.

It must have been a fairly easy question as only 1/88 readers were not sure what to respond.

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

David.