I Suppose This Had To Happen – Was Just A Matter of Time!

This appeared last week:

Meet hackers’ favourite new tool: WormGPT

By David Swan

November 3, 2023 — 5.00am

Cybersecurity researchers are sounding an alarm about the hacking community’s answer to ChatGPT, a new generative AI tool dubbed WormGPT, which is being used to create sophisticated attacks on Australian businesses.

WormGPT is being described as similar to ChatGPT, but with no ethical boundaries or limitations, and researchers say hundreds of customers have already paid for access to the tool on the dark web.

A 23-year-old Portuguese programmer, “Last”, describes himself as the creator of WormGPT, and pitches it as a piece of technology that “lets you do all sorts of illegal stuff and easily sell it online in the future”.

“Everything blackhat related that you can think of can be done with WormGPT, allowing anyone access to malicious activity without ever leaving the comfort of their home,” Last said in an online post on the dark web, in which he sold access to the tool.

While businesses are still excited about the productivity benefits generative AI can bring, industry figures are warning that the new technology is set to unleash a wave of innovative cyberattacks against businesses and individuals.

Patrick Butler, managing partner at Australian cyber firm Tesserent, said that malicious parties were signing up to criminal forums to rent access to WormGPT and using it to craft convincing phishing emails in different languages, which then allowed them to commit identity theft and compromise systems access.

While phishing emails were often characterised by poor spelling or grammar, generative AI could create emails with impeccable English, Butler said, and tools such as WormGPT could be used by attackers with limited technical skills.

“We’re seeing malicious generative AI being used to create new malware variants that are more difficult for some traditional tools to detect,” Butler said. “These platforms can even assist criminals in exploiting published vulnerabilities.

“While some legitimate AI tools can be used to conduct software code reviews, developers should be discouraged from doing this as their code may be used to train AI models that criminals gain access to, giving them further intelligence into organisational systems.”

Butler said the number of different threat actors would likely escalate as generative AI made it easier for criminals to access cyberattack tools. He said the Tesserent Security Operations Centre had already found an increase in phishing campaigns and malicious email activities targeting Australian organisations, particularly in the months following the emergence of WormGPT and similar tools.

There are now at least six different generative AI tools available to rent or purchase on the dark web, including FraudGPT, EvilGPT, DarkBard, WolfGPT, XXXGPT and WormGPT with more appearing, according to Butler.

“While most lack the large capacity of public-facing tools like ChatGPT and Bard, they are proliferating quickly, which can make them harder to find and take down.”

Scott Jarkoff, director of intelligence strategy, APJ & META, at CrowdStrike, said cybersecurity activity had risen amid the conflict in the Middle East, meaning businesses should be even more vigilant than usual.

He said hacking groups from the so-called “big four” of Russia, China, North Korea and Iran had been using generative AI tools to craft attacks in perfect English.

“The Israel-Hamas conflict is now giving criminals a perfect lure to say ‘hey, visit this site to donate to whichever cause you believe in’, and that means it’s now more important that everyone takes cybersecurity more seriously,” he said.

“We all take safety seriously, why do we not take cyber seriously? We’ve got to get to a point where cyber hygiene is built into everyone’s muscle memory, just as safety is built into everyone’s muscle memory.”

Generative AI is not only being used to create realistic phishing emails. It’s also supercharging social engineering, with bad actors using AI to create realistic fake accounts to spread misinformation, according to Dan Schiappa, chief product officer at cyber vendor Arctic Wolf.

More here:

https://www.smh.com.au/technology/meet-hackers-favourite-new-tool-wormgpt-20231102-p5eh5l.html

Inevitable but pretty sad I reckon. There is always someone around to spoil the party!

The prospect of grammatically perfect phishing e-mails from Iran of all places is just too horrible to contemplate!

Important we all know about the threat – and be bloody careful out there!

David.

 

If You Have Yourself For Your Doctor, You Have A Fool For A Patient!

This saga reminded me forcefully of the above saying, which has more that a grain of truth!

Patient speaks out after online prescribing ‘ordeal’

One Australian woman is warning about the dangers of bypassing a GP, after ineffective medication for a UTI left her fighting for life in hospital.

Michelle Wisbey

03 Nov 2023

When Abbey Smith developed a urinary tract infection (UTI), she thought she would log into an online script service for the first time.
 
Little did she know that just days later, that decision would set off a chain of events that would land her in a hospital bed fearing for her life.
 
The Australian journalist shared her experience in an opinion piece for Yahoo News this week, entitled ‘Getting my prescription online almost killed me’.
 
Ms Smith’s story began around a year ago when she developed a UTI. Feeling the ‘familiar sting’ she simply jumped online, paid her $17.50, and a script soon arrived in the mail.
 
‘I dropped into my local chemist on the way to work and was only asked if I’d used the antibiotic before and whether I needed to be instructed on its use,’ she said.
 
‘I declined and off I went thinking how quick and easy the process was and how I’d use it again.’
 
But after a few days, Ms Smith could not keep warm – she was so cold her lips were turning blue.
 
She went to the emergency department but after an eight-hour wait and multiple blood tests, was sent home.
 
‘Just 24 hours later, after I experienced rigours, a fever and hallucinations of my deceased nanna, pop and first boyfriend, my housemate rushed me to the emergency room where I was told I was turning septic,’ she said.
 
‘The infection had spread to my blood, and I was admitted to hospital on the spot.
 
‘Before I was discharged a doctor explained the bug in my system was E. coli, a common cause of UTIs which is resistant to the antibiotic I was given.’
 
One year on and Ms Smith wrote she is only now starting to bounce back, and has vowed never to use an online prescription service again.
 
‘Since my ordeal, I’ve spoken to several other women who have been through the same thing as me, or know someone who has,’ she said.
 
‘My experience has stopped me from using online prescription services altogether.
 
‘These days, if I’m feeling unwell, I book into my local GP and take the time to go over my medical history.’
 
Ms Smith’s terrifying tale comes amid a rise in telehealth and online prescribing services.
 
In June, the Medical Board of Australia released new telehealth guidelines designed to clamp down on asynchronous prescribing services.
 
The new Guidelines: Telehealth consultations with patients took effect in September, and state ‘prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board’.
 
RACGP Expert Committee – Quality Care member Associate Professor Magdalena Simonis told newsGP Ms Smith’s story is proof of how ‘inefficient and potentially dangerous’ online prescribing can be.
 
‘Online prescribing is not as safe a method of treating medical problems as using telehealth or face to face with the patient’s regular GP,’ she said.
 
‘Online tick-box prescribing without a real-time, patient–doctor consultation fragments care and is not founded on the basis of an ongoing therapeutic relationship, and the flow on from this is that it is not good medical practice.
 
‘It is a warning to policymakers and politicians that fragmentation of care which does not take into account the differential diagnoses, the patient’s response to the treatment, and the need to review the patient by an expert in health such as a GP, poses a risk.’
 
In October, the RACGP urged governments to bolster telehealth access as part of its updated position statement, ‘The use of telehealth in general practice’.
 
It said telehealth must be of the highest quality, led by a GP, and thought of as complementary to face-to-face care, rather than a substitute.
 
Above all, it should be delivered by a trained healthcare professional, it said.
 
Associate Professor Simonis said the verbal and nonverbal exchange which occurs between a patient and a doctor who is familiar with them will often provide key information about the complaint.
 
‘It is not unusual for a person to associate their symptoms with what they already have had in the past, even if there might be a difference,’ she said.
 
‘UTIs are a classic example of this, where a patient might have dysuria and frequency but in fact has an STI or an undiagnosed pregnancy.
 
‘The need to come back or call for review “if things don’t improve, or new symptoms develop”, is key to preventing such unfortunate and potentially lethal outcomes.’ 
More here:

https://www1.racgp.org.au/newsgp/clinical/patient-speaks-out-after-online-prescribing-ordeal

Given this article comes from the GP College it is easy to suggest they are ‘talking their own book’ but they do have a point.

There is a reason one spends many years to becoming a doctor so one can prescribe and that it that you understand the risks of just this sort of scenario where the patient is not seen initially and then followed up while on the treatment!

As my old professor used to say “You rarely get into clinical trouble if you actually see the patient”!

A safe health system has necessary costs and protocols for a reason and if these are ignored problem will ensue.

I am not sure we have the on-line prescribing rules and regulations fully right just yet and I am sympathetic to calls for regular reviews of how things are working along with an effective system to identify when things go wrong.

David.

 

Artificial Intelligence Has Certainly Become A Global Focus This Last Year!

This popped up a few days ago as emblematic of the trend:

Summit warns about dangers of artificial intelligence influence

By Jacquelin Magnay

5:41PM November 2, 2023

Industry and Science Minister Ed Husic has warned artificial intelligence-generated misinformation is “the big thing” that could influence the way people make future decisions, including at elections.

He said governments had adopted a “comfortable, helpful helplessness” when it comes to technology because it was previously “all too hard”.

But he warned: “I think there’s a dawning realisation on governments, you can’t have that (attitude), you need to shake that off.”

US Vice-President Kamala Harris, speaking separately at the US embassy in London, warned AI has the potential to cause profound harm.

“From AI-enabled cyber attacks at a scale beyond anything we have seen before to AI-formulated bioweapons that could endanger the lives of millions of people. These threats are often referred to as the ‘existential threats of AI’ because of course they could endanger the very existence of humanity.

“These threats without question are profound and they demand global action. But let us be clear, there are additional threats that also demand our action.”

She said the US situation concerning voluntary commitments with technology companies were an “initial step’’, saying there will be more to come “because as history has shown in the absence of regulation and strong government oversight, some technology companies choose to prioritise profit over the wellbeing of their customers”.

Mr Husic, on the sidelines of the British-organised two-day AI summit at Bletchley Park, England, attended by governments and tech titans including Elon Musk, said the application of generative AI and language models “is not so much ‘will the robots take over?’ but ‘will AI-generated disinformation do that?’”

He said disinformation would guide the way people make decisions, not just governments, and impact on the broader public reaction to things that might influence the way governments or businesses respond.

He said Australia was looking to the AI policy models proposed by others, such as the United States, the European Union and the United Kingdom, because going one-out was too difficult.

On Wednesday, the summit issued the Bletchley declaration, signed by 28 countries,which recognised that there was potential for “serious, even catastrophic, harm, either deliberate or unintentional, stemming from the most significant capabilities of these AI models”.

The declaration, signed by Australia, said: “Substantial risks may arise from potential intentional misuse or unintended issues of control relating to alignment with human intent. These issues are in part because those capabilities are not fully understood and are therefore hard to predict. We are especially concerned by such risks in domains such as cybersecurity and biotechnology, as well as where frontier AI systems may amplify risks such as disinformation.”

Musk: ‘Hope for the best but prepare for the worst’ with AI

More here:

https://www.theaustralian.com.au/nation/politics/summit-warns-about-dangers-of-artificial-intelligence-influence/news-story/f1898a89cef5d4c55b35d80603fbe65c

I think this is very important stuff but that it is important to preserve perspective as we navigate a very interesting near future,

My perspective is that much of the work in AI is really fascinating and potentially very impactful but that right now we have a world grappling with a number of equally complex issues cantered around poverty, war, mistrust and hate etc. that we need to navigate and that having the necessary bandwidth to handle it all is a rather daunting ask!

It seems at present we are just managing to ‘walk and chew gum’, as they say, but I wonder just how much energy we need to allocate to the current crop of apparently existential threats which desire our attention to keep the balls safely in the air! More than we have I suspect,,,,

AI has the potential to solve many problems and we need to be sure we direct it onto the important biggies as best we can!

As I, and others, often say ‘I am just a very old man on many drugs’ but I hope I can last long enough to see at least the outline of where this coming revolution is leading because matter it really does IMVHO and I am sure it will be very interesting indeed!

David.

AusHealthIT Poll Number 721 – Results – 05 November, 2023.

Here are the results of the poll.

Do You Believe Implementation Of Artificial Intelligence Technologies Will Significantly Reduce The Clinical Documentation Workload Over The Next 5-10 Years?

Yes                                                                               15 (45%)

No                                                                                18 (55%)

I Have no Idea                                                              0 (0%)

Total No. Of Votes: 33

A mixed outcome with a bare majority feeling AI will reduce the workload a little.

Any insights on the poll are welcome, as a comment, as usual!

A fair number of votes. But also a very vague outcome! 

0 of 33 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those very few who voted! 

David.

OAIC Reveals What It Has Done In Digital Health For The Year.

We noted this a few days ago:

Annual report of the Australian Information Commissioner's activities in relation to digital health 2022–23

Published: 20 Oct 2023

Executive summary

Download the Annual report of the Australian Information Commissioner's activities in relation to digital health 2022–23

This annual report sets out the Australian Information Commissioner’s digital health compliance and regulatory activity during 2022–23, in accordance with section 106 of the My Health Records Act 2012 (My Health Records Act) and section 30 of the Healthcare Identifiers Act 2010 (HI Act).

Digital health is an increasingly significant part of the healthcare system, and while the use of digital health information continues to grow, it is it is critical that privacy measures are upheld.

The Australian Government has established two key services to underpin digital health in Australia: the Healthcare Identifiers Service (HI Service), and the My Health Record system. Both involve the management of personal information – and for the purposes of this report, we refer to them collectively as ‘digital health’.

Healthcare identifiers are assigned to individuals, healthcare providers, and healthcare provider organisations. They help healthcare providers communicate accurately with each other and identify and access patient records in the My Health Record system.

The My Health Record system is an online summary of an individual’s health information, including their medicines, immunisations, allergies and medical history. Registered healthcare providers, including doctors, nurses and allied health professionals involved in their care can view and add information to it, subject to legislative obligations and any individual access controls.

Following the earlier establishment of the HI Service, the My Health Record system commenced in 2012 as an opt-in system: people needed to register in order to establish and share their record. In 2017, the Australian Government announced the creation of a My Health Record for every Australian. Following an opt-out period that ended on 31 January 2019, a My Health Record was created for everyone who had not opted out of the system.

Privacy is critical to ensuring trust in digital health, and the legislation establishing the My Health Record system and HI Service include important privacy provisions which are regulated by the Office of the Australian Information Commissioner (OAIC). These provisions recognise the special sensitivity of health information, and protect and restrict its collection, use and disclosure. We work to ensure that healthcare providers understand and comply with their privacy obligations.

This report provides information about digital health activities undertaken by the OAIC, including our assessment program, handling of My Health Record data breach notifications, development of guidance material, provision of advice and liaison with key stakeholders.

In 2022–23, the OAIC received 10 privacy complaints relating to the My Health Record system with 11 complaints ongoing at the end of the reporting period, including 6 complaints received in previous reporting periods. We finalised 8 My Health Record system complaints, including 3 complaints from previous reporting periods.

We received 5 new privacy complaints relating to the HI Service in 2022–23, of which we finalised 1, as well as another 7 complaints from the previous year.

Over the reporting period, the OAIC has continued its focus on regulatory policy work in relation to the HI Service and continued to handle complaints and enquiries about healthcare identifiers. These complaints and enquiries primarily concerned the inclusion of Individual Healthcare Identifiers (IHIs) on COVID-19 digital vaccination certificates (vaccination certificates). On 3 December 2022, IHIs were removed from vaccination certificates and we updated our published privacy guidance to assist entities and individuals who had collected vaccination certificates containing an IHI.

We received 10 data breach notifications during the reporting period in relation to the My Health Record system and closed 10 notifications.

We also carried out other digital health-related work including:

• commencing one assessment regarding the My Health Record system and finalising 2 further assessments as part of the My Health Record access security policy assessment program
• providing advice to stakeholders, including the Australian Digital Health Agency (ADHA), Services Australia and the Department of Health and Aged Care about privacy-related matters relevant to the My Health Record system and HI Service
• developing and promoting guidance materials, including publishing a template for healthcare providers to help them comply with security and access policy requirements under the My Health Records Rule 2016 and updating our My Health Record emergency access function guidance
• engaging with the Department of Health and Aged Care regarding the proposed amendments to the Healthcare Identifiers Regulations 2020 and the HI Act , and
• monitoring developments in the My Health Record system and the HI Service.

---- End Summary

Here is the link:

https://www.oaic.gov.au/about-the-OAIC/our-corporate-information/digital-health-annual-reports/annual-report-into-the-australian-information-commissioners-activities-in-relation-to-digital-health-202223

I was going to comment on the detail but it seems the Information Commissioner’s site is down on Sun at 4:30pm.

Try later

David.

 

What Can We Make Of This Latest Plan For Re-Structuring And Sharing

This popped up last week….

Sharing by default: delivery of health interoperability plan in full swing

25 October 2023

By Kate McDonald

The Australian Digital Health Agency (ADHA) will release quarterly updates on the ambitious goals of the national healthcare interoperability plan following the recent creation of the independent Council for Connected Care (CCC), and in light of the federal government’s commitment to a “share by default” policy on health information sharing.

The CCC was announced at the MedInfo conference in July (pictured), to provide strategic advice to ensure implementation of the national health interoperability plan, which was also launched at the conference.

Chaired by Australian Institute of Health and Welfare CEO Rob Heferen, the CCC had its third meeting recently, concentrating on standards. Attendees included representatives from the Australian Commission on Safety and Quality in Health Care, Department of Health and Aged Care, the CSIRO, Standards Australia, HL7 Australia, GS1 Australia, Integrating the Healthcare Enterprise (IHE) and the AIHW.

An update was provided by ADHA’s standards advisory group, chaired by University of Melbourne associate dean of digital health and informatics Wendy Chapman.

The meeting also discussed the new Sparked program, a FHIR accelerator the has brought together the CSIRO’s Australian eHealth Research Centre, the Department of Health and Aged Care, the Australian Digital Health Agency, CSIRO, and HL7 Australia to develop an Australian core dataset for interoperability and FHIR.

ADHA CEO Amanda Cattermole said the council was designed to be as broad a stakeholder engagement group and an advisory and stewardship group as possible.

“The way that it’s framed is that each meeting will be a deep dive on one domain that is going to drive change under the plan,” Ms Cattermole said.

More here:

https://www.pulseit.news/australian-digital-health/share-by-default-delivery-of-health-interoperability-plan-in-full-swing/

We now have the first quarterly progress report on the national healthcare interoperability plan and it is  is available from ADHA.

The report is a nice 25 slides. The summary of progress is as follows (Page 4).

“Key progress towards a better-connected healthcare system for all Australians includes:

• Establishing strong governance – the Council for Connected Care and the Australian Digital Health Standards Advisory Group – and developing a communication and engagement plan for collaboration and transparency.

• Sharing resources in central locations – the Agency’s Online Interoperability Toolkit and Digital Health Developer Portal – for collaboration and to build the knowledge base.

• Developing roadmaps for healthcare identifiers and the Fast Health Interoperability Resources (FHIR) Accelerator program and commencing consultations with jurisdictions on the National Health Information Exchange Architecture and Roadmap.

• Developing guidelines for ICT procurement and a framework for conformance.

• Publishing guiding principles for digital health standards, developing a standards gap analysis tool and designing a community platform for a standards catalogue that will bring resources together in one place.

• Building the digital health capability of the workforce through assessment tools and training on FHIR and healthcare identifiers.

• Measuring maturity through the 2022 Interoperability Benchmark Survey, identifying appropriate maturity models and monitoring progress against the actions in the Interoperability Plan.”

Why do I get the feeling I need to come back in 5 years time to see if anything much has changed. Right now all we seem to have guidelines and wish-lists!

The more closely I read these seven points the stronger my sense of déjà vu! If I tried I reckon I could find you similar documents from the 1990’s. Will someone please tell me where the hard evidence of real progress resides and send me a copy! Is that too much to ask?

David.

 

I Have To Say I Did Not Know eConsults Were A Thing Until Now!

This popped up a few days ago.

EConsults? Show me the time and money

By Laura Woodrow

27 October 2023

Broad structural change is necessary if this model is ever to take off in Australia.

EConsults could increase access to specialist care and improve GP-physician relationships, if implemented well – but structural change is needed to allay concerns over remuneration and time allocation, say Australian specialists.

With a 13% rise in referrals from GPs to non-GP specialist over a decade (2006-07 to 2015-16) and 28% of patients waiting more than four weeks for non-GP specialist care, there is a growing need for easy access to timely specialist advice.

EConsults, in which GPs securely share case information with non-GP specialists for advice and support, rather than referring, have been successfully incorporated internationally as a means of asynchronous health provision.

But while the concept of an efficient platform for GP and non-GP specialist communication may appeal, concerns remain over implementation, according to a study recently published by the Australian Journal of Primary Health

The study investigated what 14 RACP fellows, across a range of specialties, genders and ages, thought of implementing eConsults, with a 72-hour turnaround time, in Australia.

According to the study, specialists generally felt this model would improve access to specialist advice and could be of “considerable benefit” for non-urgent consultations.

“RACP fellows agreed this could improve access to timely specialist advice, place downward pressure on outpatient face-to-face clinic waiting times and reduce unnecessary patient travel.”

The fellows interviewed felt that these asynchronous consultations might provide opportunity for ongoing GP education and reduce the need for future referrals or non-GP specialist advice.

But remuneration and time allocation were a recurring concern among study participants.

“It is clear from our work that Australian physicians require reassurance that they will not be pressured to add this work to existing consultation numbers and demand without support,” the researchers said.

“They also did not see the model as workable if it intruded into out-of-work time.” 

According to the researchers, for primarily public health physicians the concerns centred around time constraints.

“Without dedicated time, participants were concerned that uptake would be low among their colleagues, and that the 72-h turnaround time would not be feasible, which in turn, would reduce the effectiveness of the model,” they said.

But for private physicians, concerns were around matching existing consulting rates to face-to-face consultation rates.

Ultimately, the RACP fellows felt broad structural change would be necessary to make the model viable across Australia.

“All participants viewed the success of a future eConsult model as contingent on the formal structures that would be required to underpin it.

“They were of the opinion that eConsults would represent a fundamental change to the primary–secondary care interface, and as such, would require a proper administrative and governance structure.”

The change would require incorporating suitable and safe technology, ensuring indemnity was addressed with providers and administrative support.

“All participants viewed a formal administrative structure as essential to the success of the eConsult model of care,” said the researchers.

“An informal or haphazard approach would result in low provider satisfactions and low uptake among both GPs and non-GP specialists.”

Speaking to The Medical Republic, dermatology specialist and associate professor at the University of Queensland Jim Muir discussed an educational and resourcing platform, Tele-Derm, that facilitates advice exchange between dermatology specialists and other doctors and is currently up and running in Australia.

Professor Muir is one of four moderators of the Tele-Derm service that is provided through ACRRM, alongside Dr Dan Kennedy, Dr Rachael Foster and Dr John Bingley.

The Tele-Derm online service offers free advice and education, contributing to CPD point, to all rural doctors, whether they are ACRRM members or not, and now has around 4000 doctors registered on the platform.

Tele-Derm combines hundreds of case studies, videos, how-tos with telemedicine platform to bolster specialist advice with educational support, allowing 80% of the cases received to be managed locally by GPs, said Professor Muir.

More here:

https://www.medicalrepublic.com.au/econsults-show-me-the-time-and-money/101370

Now I understand, what we have here is really just a new name for electronically enabled joint consultation!

It seems to me there are lots of circumstances where such a care model makes perfect sense and equally some where it my not be appropriate.

I reckon it is up to each clinician how they wish to proceed with remote consultation and to go from there. There are certainly a lot of consults where virtual – especially when video-enabled -consults are totally fine – and to have two doctors involved is hardly a stretch!

What do others think?

David.

 

I Am Not Really Sure Just Why This Is Happening.

This was announced last week:

Epic to supply NSW patient record system

Technology

By Amanda Sheppeard

23 October, 2023

The worst-kept secret in digital health is finally confirmed with news global health software giant Epic has signed up to deliver the NSW government’s promise of a single digital patient record. 

The government’s eHealth NSW department announced late last week that the contracts had been finalised to form the partnership for the project that will be rolled out over the next six years. 

“The contract signing marks an important milestone with work now starting on the initial design and build of this next generation system,” the statement said. 

Epic will work closely with local health districts, specialty health networks and other NSW Health organisations, facilitated by eHealth NSW and NSW Health Pathology. 

“Hunter New England Local Health District (HNELHD) will be the first LHD to go live with the new platform in 2025,” said eHealth NSW. 

“The sequencing of other local health districts is currently being considered, with a readiness assessment underway.” 

The single digital patient record (SDPR) will deliver a state of the art, secure digital record-keeping platform that will transform the digital systems that NSW Health staff use every day to deliver care, according to the statement. 

“For the first time, our healthcare teams will have access to an integrated all-in-one electronic medical record system, patient administration system and pathology laboratory information system,” said eHealth NSW. 

“Having one statewide system will support consistency and continuity of care for all patients, while also streamlining the way clinicians work.” 

Clinicians will be able to access a patient’s clinical records quickly, securely, and safely, regardless of their location. The SDPR will also provide simplified clinical workflows in an intuitive, user-friendly system with streamlined technical support. 

“Patients will benefit from a better, more consistent experience no matter where they seek care,” said eHealth NSW. 

“Having confidence that their healthcare team will have all the relevant information at their fingertips.” 

The NSW government’s decision to partner with Epic Systems followed a procurement process that took more than two years and involved over 350 clinical and technical experts from across the system. 

Epic Systems is a world-leading software company specialising in the design and delivery of electronic medical records systems and associated technologies.  

Its software is currently being used in the ACT and in hospitals in Melbourne, as well as offshore in health services in the UK and the US. 

The SDPR program is working towards the following timeline: 

• Finalise contract negotiations: 2023. 
• Design and build: 2024–2025. 
• Lead site deployment in Hunter New England LHD: 2025-26 
• Statewide rollout in remaining LHDs/SHNs: 2026–2029/30 
• NSW Health Pathology adoption: 2026–2029/30 

A website has been set up to provide more information about the SDPR program. 

The NSW government yesterday announced the planned overhaul, describing the state’s current health records system as “complex, cumbersome and outdated”. 

“Currently we have nine systems used for electronic medical records, 10 patient administration systems and five pathology laboratory information manage systems in use across NSW Health,” the government said in a statement. 

“Currently, these systems are not connected statewide. Data is routinely collected but is often unable to be shared or integrated in real time. This can create duplicative data collection or create information gaps in decision making.  

“As a result, patients may have to recall and repeat complex medical information when they’re feeling unwell. Often this is when patients are receiving care at different locations or from separate treatment teams and impacts the experience of care they receive.” 

New chief executive of NSW Health Pathology, Vanessa Janissen, told Health Services Daily a statewide pathology laboratory information management system would a key component of the single digital patient record (SDPR) and would improve pathology service delivery. 

“A statewide record keeping system will support consistency and continuity of care for all patients, including providing enhanced analytics, tools and reporting to support patient safety, and streamlining ways of working for our public health professionals,” she said. 

More here:

https://www.medicalrepublic.com.au/epic-to-supply-nsw-patient-record-system/101054

In recent weeks I have been in and around the Health System and have been quite impressed to see the level of communication and information access available both in and out of Hospital.

Here we have the announcement that all this is going to be replaced with an Epic based system over the next few years. What is not made clear is just why, having got lots of stuff working, a new transition is required for what must be pretty incremental gains, and enormous cost.

Here is how NSW Health sees the problem:

“The Challenge

Clinical information is captured in many different systems across NSW Health. Currently, healthcare teams must access several platforms to get a comprehensive patient history. These include various electronic medical record systems, patient administration systems and laboratory information management systems. This makes it difficult to quickly access comprehensive information about a patient.

Some of these systems are also not connected statewide. This means different care teams must manually request patient information from other local health districts if a patient is visiting multiple health services. Data is routinely collected but is often unable to be shared or integrated in real time. This can create data duplication or information gaps that could affect providing the best patient care possible.

To solve these challenges, a single source of clinical information is needed.”

The Plan is outlined here:

“The SDPR program will transform the digital systems NSW Health staff use every day to deliver care. All NSW Health care teams, no matter where they work, will securely access the same information about a patient in real time from one source.

The SDPR will replace several existing systems that are widely used across NSW Health services. This includes 228 public hospitals, 600+ community health centres, 60 pathology laboratories and 150+ pathology collection centres. The highly secure system will house medical, pathology and administration records all in one place.

The SDPR will be delivered collaboratively and in partnership with local health districts (LHDs), specialty health networks (SHNs) and other NSW Health organisations, facilitated by eHealth NSW and NSW Health Pathology. Input will be sought from clinicians, consumers, patients and technical experts. Epic Systems, a world-leading software company specialising in the design and delivery of electronic medical records systems and associated technologies, has been contracted to supply the technology platform for the SDPR.

SDPR will first be available in the Hunter New England LHD, followed by a phased rollout throughout NSW. The rollout schedule for the SDPR will be planned in consultation with LHDs, SHNs, and other partners.

The overall implementation timeline is anticipated to be 6 years (2023-2029/30). This includes the design and build of the system, and statewide rollout.”

It seems to me this is a HUGE project that is going to have all areas of NSW in various states of disruption for the next 6 years (if it goes on time) while all this happens and at the end of ti we wind up with a single centralised system with all the risks that brings

I bet the Business Case of this project is not disclosed but one can be sure it will be costing a fortune and that one installed it will be moving towards obsolescence! I have no idea what the disruption that will be caused will cost!

I may be wrong but this seems just too big and too centralised a project to be sensible! Empire building on a grand scale!

What do others think?

David.