The Productivity Commission Administers A Swift Kick Up The Backside Of The ADHA For Financial Waste!

This appeared last week.

Report finds My Health Record ‘plagued’ with poor usability

Chelsea Heaney

---

16 May 2024

It also found automation of simple tasks could free up to 30% of clinicians’ time, and data sharing could save $5.4 billion.

A new Productivity Commission report has revealed that investment into digital technology in healthcare and improving the management of My Health Record (MHR) could save more than $5 billion a year.  
 
Increased data sharing in healthcare could save $355 million from fewer duplicated tests alone, it found.
 
The report states that while nine out of 10 GPs now practice digitally, with no paper records, progress is ‘more mixed when it comes to realising the gains of digital information sharing’. 
 
With around 7000 accredited GP clinics and 700 public hospitals in Australia, the report said there is a lag in information access between acute and community care. 
 
‘These providers have invested in different digital systems, each with their own data structures, clinical terminology and standards,’ it states. 
 
‘MHR was intended to be a solution to this siloed data structure, providing a central access point for a patient’s most important health data.  
 
‘But despite an investment of more than $2 billion, it continues to be plagued by incomplete records and poor usability.’ 
 
Repairing this ‘disconnected information management and sharing landscape’ will be challenging, the report highlights, but overall would result in ‘significant payoffs’. 
 
‘In addition to the substantial cost savings it could provide, better data also lays the foundation for other digital health applications, such as remote care and AI,’ it reads. 
 
RACGP Expert Committee – Practice Technology and Management Chair Dr Rob Hosking said GPs often get frustrated when they find key information missing from MHR. 
 
‘It’s a bit of a vicious cycle because once you look a few times and there’s nothing there, you stop looking,’ he told newsGP.  
 
‘But every now and again, there’ll be more information. 
 
‘What will probably eventually drive more uploads is more utilisation by the patients, when they are reviewing their own records and realise that the records are incomplete.’ 
 
The Productivity Commission found data sharing across healthcare providers can also reduce the incidence of adverse events.  
 
‘When GPs do not receive hospital discharge summaries, the risk of an individual being readmitted to hospital within seven days increases by 79%,’ the report reads. 
 
It also says there are major issues in MHR that have created gaps in the system. 
 
‘Consumers need to link their MHR through MyGov to access their records,’ it states.  
 
But as of March 2024, less than one-third, or 6.7 million had done so. 
 
The report also highlights that despite almost all GPs being registered on the system, they can also choose not to enter patient data into MHR, even for individuals that have opted in, meaning ‘the amount of detail contained within an individual’s record varies’. 
 
The report has put forward making MHR uploading mandatory for GPs, but states that ‘getting the information onto the system is only half the challenge – clinicians also need to draw on this valuable information’. 
 
If this is to occur, the Productivity Commission says mandatory uploading will need to be accompanied by ‘changes that allow practitioners to efficiently search large volumes of data and display reports in a way that is easy to read and accessible’. 
 
Commission estimates suggest that around 2% of documents uploaded by healthcare providers are viewed by other healthcare providers. 
 
But Dr Hosking says it is too early to mandate GPs to upload to MHR and adding extra upload times to GPs’ hours would be ‘unacceptable’. 
 
‘At the moment, we are rewarded [through the Practice Incentives Program eHealth Incentive] for uploading a small percentage of our patients’ summaries to MHR, so it’s a carrot rather than a stick,’ he said. 
 
‘If it’s an upload, it’s going to add extra time, if it’s automated, that’s a different story.’ 
 
Dr Hosking said it will become mandatory for pathology and diagnostic imaging to be uploaded onto MHR if legislation passes by the end of the year. 
 
‘That’s going to make a huge difference,’ he said. 
 
Additionally, the Commission says surveys show that administrative tasks are consuming too much of healthcare workers time and should be taken over by AI. 
 
‘AI technology based on large language models has been developed that can transcribe notes during a consultation, draft referral letters and care plans and complete other forms of documentation,’ the report said. 
 
‘AI can also automate labour-intensive tasks such as clinical coding of data, with a recent pilot finding that processing time for a full-time equivalent worker improved by 30% using AI.’ 
 
Dr Hosking agrees that AI can be used efficiently to transcribe consults but is not ready to be used in clinical decision making. 
 
‘Transcription of notes is time consuming for clinicians and GPs, so that’s one area that it can work really well,’ he said. 
 
‘If software is functioning as a medical device it needs to be registered with the Therapeutic Goods Administration (TGA) and it has to undergo specific testing and safety clearance.  
 
‘At the moment that’s what the TGA is currently grappling – how to regulate it and make sure that those tools are safe.’ 
 
AI and digital technology for general practice is set to be a talking point at the RACGP 2024 Practice Owners Conference next week. 
 
Log in below to join the conversation. 

Here is the link:

https://www1.racgp.org.au/newsgp/professional/report-finds-my-health-record-plagued-with-poor-us

I wonder when the PC is just going to admit the myHR is just a silly, obsolete idea and close the whole thing down, spending the money saved on something more useful?

We can dream I guess….

David.

This Sort Of Outage Affecting So Many Really Should not Happen,,,,

This broke last week:

Data deleted: UniSuper outage raises lockout fears

By David Swan

May 18, 2024 — 12.05am

For more than a week in early May, more than half a million Australians were unable to access their superannuation funds – more than $130 billion worth – and were left wondering if their balances had been wiped out or taken by hackers.

One of the nation’s largest superannuation funds, UniSuper, succumbed to a technical glitch, which knocked its services offline and left each one of its 600,000 customers – this reporter included –locked out of their accounts.

The root cause? The fund’s cloud computing provider, US tech giant Google, had accidentally erased UniSuper’s Google Cloud account.

Normally that would be easy enough to come back from, given UniSuper typically has duplication in place across two geographies, so if one service goes down it can be restored from the other. However, the deletion hit UniSuper’s account across both geographies, part of what the companies now call an “unprecedented sequence of events” and an isolated, one-of-a-kind occurrence.

But far from being a one-of-a-kind occurrence, outages and disruptions are the unfortunate new reality of our digital era, exacerbated by what some see as an overreliance on a handful of giant companies.

That such a seemingly innocuous error could affect billions of dollars and cause such widespread frustration among the public has raised questions about the degree to which the Australian economy relies on an increasingly small number of US-based tech giants for their computing services.

Just three American companies – Amazon, Microsoft, and Google – command about two-thirds of Australia’s cloud infrastructure.

When UniSuper picked up the issue, the company mobilised a team of more than 100 people from both UniSuper and Google Cloud, who worked 24/7 in shifts to try and fix it.

A day after the outage started, it issued a statement assuring members the incident was not a cyberattack and that no personal information or funds were compromised.

“We drew on every resource we had to get these systems online again for our members,” a UniSuper spokesman told this masthead.

“It was an isolated, ‘one-of-a-kind occurrence’ that should not have happened, as Google Cloud has confirmed.”

The spokesman said that UniSuper had backups in place with both Google and another unnamed provider, improving its ability to restore services.

Handing over the keys

The problem with cloud services is that the businesses using them have little or no control over the infrastructure and its security.

There are great benefits to using the cloud. By using third-party cloud providers like Google Cloud, Amazon Web Services or Microsoft Azure, businesses often have reduced infrastructure costs and scale resources up or down automatically based on demand. Using the cloud often means hiring less in-house IT staff, and therefore significantly reduced costs, and often higher levels of security and reliability.

Nearly half a million companies globally rely on Google’s ‘platform-as-a-service’, while an increasing number of Australian public sector departments use its technology. Australia Post, the CSIRO, the NSW Department of Customer Service and the Australian Department of Health and Aged Care are all Google Cloud customers.

Australia’s banks are also moving their infrastructure to the cloud: NAB signed a multimillion-dollar, long-term deal with Amazon Web Services in 2022, while CBA boss Matt Comyn has led a five-year cloud transition since 2020.

UniSuper shifted a significant portion of its operations to Google Cloud last year. The process involved transferring all non-production tasks, including 1900 virtual machines, across to Google, work that was previously spread across Microsoft’s Azure cloud platform and two of its data centres.

A UniSuper executive not authorised to speak publicly said that the company’s membership levels haven’t been affected by the outage and that members continue to join the fund.

So what lessons can we take from the incident?

One obvious solution is for companies to stop using the cloud so much, and instead return to how computing looked in the 1990s. That was a more decentralised model in which companies ran their own servers and were responsible for their own infrastructure.

US-based technology executive Lisa Rehurek is the founder and CEO of The RFP Success Company. Rehurek says a hybrid architecture – a combination of on-premise and cloud infrastructure – would have greatly reduced the chance of a single mistake causing such widespread problems.

“What the incident highlights is the potential risks of vendor lock-in,” she said. “Cloud providers offer many benefits but relying too much on one can increase an organisation’s vulnerability ... Keeping a hybrid set-up can help lower this risk.”

Transparency and communication were also issues during the outage, according to Rehurek. “There were concerns about the lack of clear and timely info from Google Cloud about the cause and fixes. Clear and prompt communication keeps trust and lets customers choose.”

Analyst firm Telsyte’s managing director Foad Fadaghi said firms are increasingly spreading their computing workload across multiple providers, rather than relying on just one.

Telsyte’s research shows that Amazon Web Services has a commanding share of Australia’s $4.3 billion infrastructure-as-a-service market, accounting for 42 per cent of the market, with Microsoft Azure at 27 per cent and Google Cloud at 13 per cent.

“Ironically, Google has benefited from being the second or third choice cloud provider in Australia,” he said.

“Google increased its market share in 2023 as Australian businesses look to de-risk and use multiple providers.”

For Gartner vice president and analyst Michael Warrilow, UniSuper did the right thing. “Failures at cloud mega vendors are rare. And they are typically the result of software bugs rather than hardware because of the cloud-native architecture that’s used,” he said.

“For every cloud outage there are many more outages with traditional IT environments. UniSuper showed best practice for cloud by having a backup in another provider,” Warrilow said.

“Other examples of best practice include monitoring, problem/incident and change management. [Using the] cloud doesn’t obviate the need to continue these disciplines.”

Most UniSuper customers – and members of the public more broadly – don’t care where the computing power is occurring, they just want it to work.

Here is the link:

https://www.smh.com.au/technology/data-deleted-unisuper-outage-raises-lockout-fears-20240516-p5je2m.html

I have to say I am still wondering how this sort of failure can be so prolonged given the infrastructure UniSuper is using, but I guess you do rather shoot yourself in the foot with big deletions!

David.

This Rather Has The Feel of A Bullett Dodged!

This appeared a day or so ago:

Aussie cops probe MediSecure's 'large-scale ransomware data breach'

Throw another healthcare biz on the barby, mate

Jessica Lyons

Fri 17 May 2024 // 23:31 UTC

Australian prescriptions provider MediSecure is the latest healthcare org to fall victim to a ransomware attack, with crooks apparently stealing patients' personal and health data.

"While we continue to gather more information, early indicators suggest the incident originated from one of our third-party vendors," the e-script provider said in a statement on Thursday. 

MediSecure did not indicate how many individuals were affected by the incident, but promised to "provide further updates via our website as soon as more information becomes available." It also said it is working with Oz's National Cyber Security Coordinator to "manage the impacts of the incident," and has notified regulatory agencies including the Office of the Australian Information Commissioner.

Australia's federal police are investigating the intrusion, which the National Cyber Security Coordinator described as a "large-scale ransomware data breach incident." 

In a separate statement on Thursday, the country's top cybersecurity chief said the Australian government "continues to assist MediSecure," and that it's "still working to build a picture of the size and nature of the data that has been impacted by this data breach."

The statement continued:

From the information that is currently available to the government, no current ePrescriptions have been impacted or accessed. The Department of Health has confirmed there has been no impact to the ePrescription services currently in use.

On the basis of technical advice from MediSecure to date, the original compromise has been isolated and there is no evidence to suggest an increased cyber threat to the medical sector.

We are looking closely at any evidence about whether identity documents have been compromised in the breach, and are working with MediSecure, Services Australia, and state and territory credential issuing bodies to build a full picture of the impacted dataset.

We have not seen evidence so far to suggest that anyone needs to replace their Medicare card. If our investigation turns up any evidence to suggest Australians' identities are at risk and they need to replace their documents, we will let them know. 

The government is also briefing health sector industry groups about the digital intrusion and response, including the Australian Medical Association, the Pharmacy Guild of Australia, and "major private hospital providers."

The MediSecure incident is yet another indication of ransomware crews increasingly targeting the healthcare sector as these organizations are responsible for safeguarding very sensitive medical and personal information belonging to millions. 

• Australia imposes cyber sanctions on Russian it says ransomwared health insurer
• London Drugs closes all of its pharmacies following 'cybersecurity incident'
• UnitedHealth's 'egregious negligence' led to Change Healthcare ransomware infection
• Ransomware negotiator weighs in on the extortion payment debate with El Reg

Data thieves know this means the victim orgs are more likely to pay ransom demand — as we saw with the massive Change Healthcare attack in America with that company paying the criminals $22 million. Despite paying the extortion demand, more ransomware crooks reportedly started leaking sensitive data and extorting the company for even more money.  

In late 2022, Australian health insurer Medibank fell victim to a ransomware attack with data of almost 10 million customers leaked.

Stolen info included medical treatment details belonging to about half a million Medibank customers, along with names, dates of birth, addresses, phone numbers and email addresses of 9.7 million individuals.

The now-defunct REvil crime gang was blamed for this attack, and Australian authorities accused Russia of harbouring the group.

Here is the link:

https://www.theregister.com/2024/05/17/medisecure_ransomware_attack/

Here is the  Government’s response:

MediSecure cyber security incident

​​​​​​​​​​​The Australian Government is working with former prescription delivery service provider MediSecure to respond to a cyber incident affecting the company.

This service enabled prescriptions to be delivered from prescribers to a pharmacy of an individual’s choice (for paper and electronic prescriptions). Until late 2023, MediSecure was one of two prescription delivery services operating nationally.

In May 2023 the Australian Government finalised a tender for this service, awarded exclusively to another company, Fred IT Group’s eRx Script Exchange (eRx).

The national prescription delivery service, eRx, is not affected by this cyber incident. Consumers can continue to access medicines safely, and healthcare providers can still prescribe and dispense as usual.

The National Cyber Security Coordinator is working with agencies across the Australian Government, as well as states and territories to coordinate a whole-of-government response to this incident.

We are in the preliminary stages of our response to the incident.

​​What data has been compromised?

What should I do if I think my data has been compromised?

I am a general practitioner, pharmacist or other medical professional. What advice should I give to my patients who may be impacted?

I am a general practitioner, pharmacist or other medical professional. What action should I take if I think my Medicare Provider Number (MPN) or PBS prescriber number has been impacted?

Is there a risk my other medical records have been accessed?

How can I protect my information online?

More Information

---

What data has been compromised?

A MediSecure database containing the personal and limited health information of individuals relating to prescriptions, as well as healthcare provider information has been affected by this cyber security incident.

The affected data relates to prescriptions distributed by MediSecure’s systems up until November 2023.

Technical and forensic investigations are ongoing. Updates will be provided as those investigations progress.

What should I do if I think my data has been compromised?

Prescriptions continue to work as normal. People should keep accessing their medications and filling their prescriptions. This includes prescriptions (paper and electronic) that may have been issued up until November 2023.

Protecting my medical identification

Services Australia advises those who are concerned about healthcare card identifier details (such as Medicare, Pensioner Concession, Healthcare Concession, and Commonwealth Seniors), that your Medicare account cannot be accessed with your Medicare card number alone. Unlike a scan or copy of a Medicare card, a Medicare card number by itself cannot be used as proof of identity.

Services Australia advises that individuals do not need to take any action related to their Medicare, Pensioner Concession, Healthcare Concession, and Commonwealth Seniors cards.

Services Australia is examining other potential impacts to individuals’ identity security associated with breached card numbers.

More information about how Services Australia protects information in the event of data breaches is available on the Services Australia website.

Protecting my personal information

In any data breach involving sensitive personal information, it is essential that individuals can find proper support. The Office of the Australian Information Commissioner (OAIC) provides data breach support and resources on the OAIC website.

The IDMatch, a joint Australia, state and territory government initiative, provides guidance on how Australians can protect and remediate identity information. You can find clear, consistent guidance on how to protect identity information, how to minimise the likelihood and consequences of identity crime, and the steps to take to remediate compromised identities at the IDMatch website.

Identifying and reporting scams

The Australian Competition and Consumer Commission has established the National Anti-Scam Centre, to coordinate government, law enforcement and the private sector to combat scams. It operates Scamwatch, a service to support individuals to recognise, avoid and report scams.

Individuals can report suspected scams through to the National Anti-Scam Centre via Scamwatch through the National Anti-Scam website.

This website also hosts information to support individuals to protect themselves from scams and recognise the signs of a scam.

Identifying and reporting cyber security incidents

The Australian Signal’s Directorate’s Australian Cyber Security Centre (ASD’s ACSC) provides technical incident response advice and assistance to Australian organisations that have been impacted by a cyber security incident.

Cyber security incidents can be reported to the ASDs ACSC via the Australian Cyber Security Centre Hotline on 1300Cyber1 (1300 393 371) or online at ReportCyber.

I am a general practitioner, pharmacist or other medical professional. What advice should I give to my patients who may be impacted?

If you have a patient concerned that their information has been breached, direct them to this information page. We also ask you to advise your patients they can – and should – continue to fill their electronic and paper prescriptions and access their medications. The current prescription delivery service is not affected, and health care providers can still prescribe and dispense as usual.

I am a general practitioner, pharmacist or other medical professional. What action should I take if I think my Medicare Provider Number (MPN) or PBS prescriber number has been impacted?

MPNs and PBS prescriber numbers are already publicly available numbers that are printed on invoices, health certificates and patient referrals.

An MPN and PBS prescriber numbers is not enough information for a third party threat actor to access Medicare records or claiming systems. These claiming systems include security measures to prevent unauthorised access. Online channels and our telephony channels are protected by proof of record ownership processes.

If a health professional is notified that their MPN or PBS prescriber number has been exposed, they don’t need to request a new one.

Using the Health Professional Online Services (HPOS) system provides an additional measure of security if a healthcare provider needs to update their details, such as the address recorded against their MPN and PBS prescriber number, and banking details.

Is there a risk my other medical records have been accessed?

There is no risk to the current national prescription delivery service, eRx.

Additionally, digital systems supporting the Pharmaceutical Benefits Scheme, Medicare, Real Time Prescription Monitoring and My Health Record have not been impacted by this cyber security incident.

The impact of this incident is isolated to MediSecure’s systems only.

There is no evidence to suggest there is an increased cyber threat to the medical sector.

How can I protect my information online?

As an individual there are steps you can take to protect your personal information and online accounts, particularly if you think any of your information, such as logins or passwords, have been caught in a data breach.

Three simple steps you can take to be more secure online are:

·         Set up multi-factor authentication to add an extra layer of security to your online accounts.

·         Create strong and unique passphrases of 14 or more characters long for every account.

·         Install software updates regularly to keep your devices secure.

By incorporating these simple steps into your daily online activity, you can significantly improve your personal cyber security.

Learn the basic steps to protect yourself online at cyber.gov.au, the Australian Government's trusted source of cyber security advice, and where you can receive the latest cyber information and advisories.

More Information

For more information regarding the cyber security incident impacting MediSecure, please visit MediSecure’s website.

Here is the link:

https://www.homeaffairs.gov.au/cyber-security-subsite/Pages/nat-cyber-security-coordinator/medisecure-cyber-security-incident.aspx

It looks to me that, as the service was no longer in use, that there is not a great amount of harm done – other than to remind system owners that they need to be alert of issues all the time!

The incident has been reported on globally and has been a wake-up call all over!

Another learning experience I guess!

David.

It Looks Like It Is ‘Coming, Ready Or Not’ With Google Answers!

I am pretty sure this is actually ‘very big news’! Read on to discover why.

Google search is becoming Google answers. That is bad news for media

In a world where AI can browse the internet and paraphrase what it sees, users may find they never click on links again. That is an existential problem for many publishers.

Kevin Roose

May 19, 2024 – 9.52am

San Francisco | For the past year-and-a-half since ChatGPT was released, a scary question has hovered over the heads of major online publishers: what if Google decides to overhaul its core search engine to feature generative artificial intelligence more prominently – and breaks our business in the process?

The question speaks to one of the most fragile dependencies in today’s online media ecosystem.

Most big publishers, including The New York Times, receive a significant chunk of traffic from people going to Google, searching for something and clicking on articles about it.

That traffic, in turn, allows publishers to sell ads and subscriptions, which pay for the next wave of articles, which Google can then show to people who go searching for the next thing.

The whole symbiotic cycle has worked out fine, more or less, for a decade or two. And even when Google announced its first generative AI chatbot, Bard, last year, some online media executives consoled themselves with the thought that Google wouldn’t possibly put such an erratic and unproven technology into its search engine, or risk mucking up its lucrative search ads business, which generated $175 billion in revenue last year.

But change is coming.

At its annual developer conference last week, Google announced that it would start showing AI-generated answers – which it calls “AI overviews” – to hundreds of millions of users in the United States this week. More than 1 billion users will get them by the end of the year, the company said.

The answers, which are powered by Google’s Gemini AI technology, will appear at the top of the search results page when users search for things like “vegetarian meal prep options” or “day trips in Miami”. They’ll give users concise summaries of whatever they’re looking for, along with suggested follow-up questions and a list of links they can click on to learn more. (Users will still get traditional search results, too, but they’ll have to scroll farther down the page to see them.)

The addition of these answers is the most significant change that Google has made to its core search results page in years, and one that stems from the company’s fixation on shoving generative AI into as many of its products as possible. It may also be a popular feature with users – I’ve been testing AI overviews for months through Google’s Search Labs program, and have generally found it to be useful and accurate.

But publishers are right to be spooked. If the AI answer engine does its job well enough, users won’t need to click on any links at all. Whatever they’re looking for will be sitting right there, on top of their search results. And the grand bargain on which Google’s relationship with the open web rests – you give us articles, we give you traffic – could fall apart.

Google executives put a positive spin on the announcement on Tuesday, saying that the new AI overviews would improve the user experience by “taking the legwork out of searching”.

But that legwork pays for a lot of journalism, and many other types of online media (fashion blogs, laptop reviews, restaurant listings) without which the internet would be far less useful. If Google’s AI overviews starve these websites of traffic, what will happen to them? And if big chunks of the web were to vanish altogether, what would be left for the AI to summarise?

Google clearly anticipated these fears, and its executives had responses prepared.
More searches, more diversity

In a briefing this week before Google’s developer conference, they said that the company’s tests had found that users who were shown AI overviews tended to conduct more searches, and visited a more diverse set of websites. They also said that the links that appeared in AI overviews got more clicks than the links that were displayed on traditional search results pages.

Liz Reid, vice president of search at Google, said in a blog post on Tuesday that the company would “continue to focus on sending valuable traffic to publishers and creators”.

But parse these responses carefully, and you’ll see that Google is not saying that publishers’ overall search traffic won’t decline. That’s because Google can’t really predict what will happen once it starts showing AI-generated overviews in billions of search results a day, and how users’ behaviour may change as a result.

Earlier this year, I wrote about Perplexity, an AI-powered “answer engine” that shows users a concise summary of a topic they’re researching rather than handing them a list of websites to visit. The experience, I believed, was clearly better than a traditional search engine for some types of searches, and usually gave me more useful information faster.

But I was also nervous because during my own testing of Perplexity, I basically stopped clicking any links at all. In a world where AI can browse the internet for me and paraphrase what it sees, I found that I just didn’t need them. And I worried about what would happen if Perplexity users were all like me and got in the habit of relying on AI-generated summaries rather than on original sources. 

Concerns on vastly different scale

I have the same concerns about Google’s new AI overviews, but on a vastly different scale.

Perplexity is tiny – just 10 million monthly users, as of February. Google, by contrast, has billions of users and represents more than 90 per cent of the global search market. If it makes a change to its search engine that reduces outgoing traffic by just a few percentage points, every publisher will feel it.

It’s unclear how big the effects of Google’s AI overviews will ultimately be. One analyst firm, Gartner, has predicted that traffic to the web from search engines could fall by 25 per cent by 2026. And many publishers are bracing for double-digit declines in traffic this year.

Maybe these fears are overblown, and publishers have been worrying over nothing. But after Tuesday’s announcement, Google has made it clear that they’re about to find out either way.

This article originally appeared in The New York Times.

Here is the Australian link:

https://www.afr.com/technology/google-search-is-becoming-google-answers-that-is-bad-news-for-media-20240519-p5jerg

It is hard to imagine just how such a change to the user search results will impact things but it seems to me that people will now, do a search, read the resulting summary and for most things go away satisfied with what they are given.

It is well above my pay grade to figure out just how this will all change the use of search and what follows but I am sure the effect will be pretty consequential – and unpredictable as yet.

The old certainties of Google searching are about to be ‘blown up’ I suspect and I am not sure where all the pieces will fall!

More interesting times acoming!

David.

AusHealthIT Poll Number 747 – Results – 19 May, 2024.

Here are the results of the poll.

Do You Agree With The Productivity Commission Report That Suggests We Are Currently In A Digital Health "Black Hole" And Need To Do A Lot Better?

Yes                                                                               32 (91%)

No                                                                                  3 (9%)

I Have No Idea                                                              0 (8%)

Total No. Of Votes: 35

A clear cut vote suggesting we need a good deal more effort in the Digital Health space!

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

A very good voting turnout. 

0 of 35 who answered the poll admitted to not being sure about the answer to the question!

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

David.

It Seems Some Are Not Sure If The NBN Offers The Best Value for Money, Which Really Matters These Days!

This appeared a few days ago

National broadband network (NBN)

Price, speed and Elon Musk: why some Australians are ditching the NBN

While politicians argue over who to blame for a decline in Australia’s broadband uptake, customers are seeking more affordable ways to get online

Josh Taylor

Sun 12 May 2024 06.00 AEST Last modified on Sun 12 May 2024 11.23 AEST

Tens of thousands of Australians are abandoning the national broadband network for 5G mobile and other ways of accessing the internet with experts saying three main factors are driving people away: price, speed and Elon Musk.

Despite the NBN being only a few years past completion, between the end of June 2022 and the end of April 2024 the number of customers in the most common category of services declined by more than 65,000.

This category, also known as brownfields, covers 7.1m active NBN broadband services to homes and businesses that existed before the NBN was built and is a mix of fibre-to-the-premises-type connections as well as connections made under the Coalition’s revised plan that used existing copper and cable connections (which predated the NBN and was used mostly for pay TV).

The Coalition’s communications spokesman, David Coleman, said this month the decline was a “troubling sign” for the company and the government had questions to answer. But others blame the Coalition itself.

In February, the company’s outgoing chief executive, Stephen Rue, told Guardian Australia those shifting away from the NBN were largely customers on fibre-to-the-node – the Abbott-Turnbull-era technology that uses legacy copper phone lines, where speed and quality decreases the further away your home is from the node.

“The main reason for that is service and a desire for faster speed … customers who are at the end of the FttN line ... they get 25 megabits per second, but they can’t experience a faster speed and obviously there are some copper lines that have unreliability,” he said.

NBN has embarked on a massive full-fibre upgrade to premises in the fibre-to-the-node “footprint” – effectively rebuilding most of the network to the type planned by the former Rudd Labor government in 2009 before changes made under the Coalition after 2013.

The company has projected that 5m premises will be upgraded by the end of 2025. Over 200,000 premises have already been upgraded in these parts of the network to improve speeds and to keep customers on board, but the effort has not yet halted the decline in customers.

Associate Prof Mark Gregory, of RMIT’s school of engineering, said the “copper debacle” was the cause of the company’s woes but more attention needed to be paid into what the company is offering to keep customers and how.

Cost seemed to be a major factor moving customers away, he said. “The current NBN charges are too high and this means that customers are looking for alternatives.”

Aiding customers hunting to reduce their internet bill are cut-price 5G home internet plans, which some retailers market at a lower cost to their own NBN plans. They are able to do this due to the lower cost in supplying internet over mobile, compared with the wholesale prices NBN charges.

This is reflected in recent financial statements from the two biggest retailers, Telstra and TPG. Both companies admit a customer decline in fixed-line services; TPG reported losing 109,000 NBN customers in its last financial results, while Telstra reported losing 58,000 in the first half of the 2023-2024 financial year.

Both said the losses were offset in part by gains in fixed wireless, suggesting some of their customers are giving up the NBN for a 5G alternative.

It is understood Vodafone’s parent company, TPG, has been steering customers who might otherwise choose a lower-speed NBN plan to its 5G home internet product because the margins are better using TPG’s mobile network and customers can get more for less. For example, Vodafone’s 5G home internet plan is $55 a month for 100Mbps, while Vodafone’s NBN 25Mbps plan is $70 a month and the 100Mbps plan is $80 a month.

In 2023, TPG grew its fixed wireless business by 56,000 customers, for a total of 227,000 on the technology.

Dr Gareth Downing, acting CEO of the Australian Communications Consumer Action Network (ACCAN), said it wasn’t surprising Australians were ditching the NBN for more affordable options.

“4G and 5G wireless technologies can in some cases provide faster internet speeds than the NBN, particularly in areas with limited NBN infrastructure or where the NBN connection speeds are slow due to congestion or distance from the node,” he said, adding that the mobile services could also be more affordable.

Downing said ACCAN had long suggested a cheaper price plan for households receiving government financial support.

The other factor is the arrival of Elon Musk’s Starlink low-earth-orbit (LEO) satellite internet service in Australia. Although more expensive than the NBN options, the speeds are much faster and customers in regional and remote parts of Australia have taken to it in droves.

The company posted on Musk’s social media platform X in March that it now had 200,000 customers in Australia.

“The cost of LEO products such as Starlink is prohibitive for some consumers,” Downing said. “Competition may drive prices down as new offerings such as Amazon’s Project Kuiper enter the Australian market.”

Gregory said the trend to satellite alternatives could continue with retailers signing deals with LEO companies like Starlink and could make NBN an irrelevancy in regional and remote parts of the country.

“The large telcos have already reached agreements with one or more LEO provider and they will aggressively push LEO as an alternative to NBN. This will increase when mobile is added to the suite of offerings provided through LEO.”

NBN Co’s own satellite customer base has dropped to 87,000, from a peak of 111,000 in 2021, partially driven by customer frustration at the service but also partially due to NBN Co moving some customers onto its fixed wireless service as upgrades have been made. NBN Co has also been offering improved speeds and download capacities on the satellite service in recent months.

NBN Co has argued overall the number of connections on the NBN is going up – 95,000 net gains in the same period, but this is largely due to close to 170,000 new connections to newly established premises (greenfields) in that time. The company has pointed to the upgrade plans for how it will manage customer retention.

“Our network upgrade program is supporting customers to meet their desired broadband internet speeds, performance and reliability needs,” a spokesperson said.

“The reduction in brownfield sites represents only 0.76% of our base of 8.6m premises. We are pleased to see many NBN customers seeing the value in a full fibre connection with around 6,000 customers per week, on average, placing orders and receiving full fibre upgrades.”

Rue announced on Monday he would leave NBN Co to become the CEO of Optus in November and a replacement has not yet been announced.

Here is the link:

https://www.theguardian.com/technology/article/2024/may/12/australia-nbn-usage-declining-5g-mobile-network-speeds

It seems that the inevitable competition to the NBN is starting. Not before time I reckon! I look forward to some great offers over the next year or so!

David.

This Is Not Good News!

This just appeared

Federal agencies convene after cyber attack on healthcare data service MediSecure

• By jared lynch
  
  Technology Editor
  
  and joseph lam

  Reporter 

   
• Updated 3:16PM May 16, 2024, First published at 1:49PM May 16, 2024

An Australian healthcare information service which provides electronic prescriptions and a prescription monitoring service has become the latest victim of a large scale data breach that has sent shockwaves across the nation.

The attack on MediSecure, which the company claims may have come through a third-party service, has seen cyber security agencies at the highest level convene to investigate and respond to the issue.

The eHealth business claims it is the only Australian electronic prescription service to be accredited by national eHealth infrastructure and the Personally Controlled Electronic Health Record service. It also provides software for healthcare providers to use while providing services.

Medisecure said it was made aware of a breach as early as Monday, and it began working with federal agencies including the Office of the Australian Information Commissioner.

“MediSecure has identified a cyber security incident impacting the personal and health information of individuals. We have taken immediate steps to mitigate any potential impact on our systems,” the company said in a statement.

“While we continue to gather more information, early indicators suggest the incident originated from one of our third-party vendors.

MediSecure takes its legal and ethical obligations seriously and appreciate this information will be of concern. MediSecure is actively assisting the Australian Digital Health Agency and the National Cyber Security Coordinator to manage the impacts of the incident. MediSecure has also notified the Office of the Australian Information Commissioner and other key regulators.”

The data breach, which officials said they were made aware of on Wednesday afternoon, is being dealt with at the highest levels of government, with the Australian Federal Police, The Australian Signals Directorate and the Australian Cyber Security Centre all working together on the response.

But unlike high profile cyber assaults on Medibank and Optus, the Australian Signals Directorate and Australian Cyber Security Centre did not name the organisation.

“Yesterday afternoon I was advised by a commercial health information organisation that it was the victim of a large-scale ransomware data breach incident,” National Cyber Security Coordinator Michelle McGuinness said in a statement.

“I am working with agencies across the Australian Government, states and territories to co-ordinate a whole-of-government response to this incident. The Australian Signals Directorate Australian Cyber Security Centre is aware of the incident and the Australian Federal Police is investigating,” LtGen McGuinness said.

When The Australian contacted the Department of Home Affairs for further information in the early afternoon on Thursday, it was told the department was unable to share further information at this time.

“We are in the very preliminary stages of our response and there is limited detail to share at this stage, but I will continue to provide updates as we progress while working closely with the affected commercial organisation to address the impacts caused by the incident,” LtGen McGuinness said.

MediSecure’s website and phone lines were down on Thursday afternoon. Around 2.30pm, it updated its website to acknowledge a breach had taken place.

“MediSecure understands the importance of transparency and will provide further updates as soon as more information becomes available. We appreciate your patience and understanding during this time,” the company said.

Online, the company claims its electronic prescription service “gives doctors and pharmacists the certainty of clinical integrity and data security and can help reduce errors in the prescribing and dispensing of medicines”.

Cyber Security Minister Clare O’Neil also said she was aware of the incident and is understood to be assisting.

“I have been briefed on this incident in recent days and the government convened a National Coordination Mechanism regarding this matter today,” she said.

Ms O’Neil had asked that people refrain from speculating on which organisation was affected by the breach. “Updates will be provided in due course. Speculation at this stage risks undermining significant work underway to support the company’s response,” she said.

The attack comes as industry experts criticised the Albanese government’s lack of cyber security investment in the federal budget on Tuesday night.

Chris Sharp, Asia Pacific chief executive of cloud marketplace Pax8, said a lack of attention to cyber defences “sleepwalks over the financial challenges of our small to medium businesses”.

The MediSecure cyber incident comes as a recent US cloud software service Rubrik report found that the typical healthcare organisation has 42 million sensitive data records. Sensitive data in healthcare organisations jumped by 63 per cent in 2023 as the medical professional increasingly digitises patient records and use software services, including AI-powered diagnosis services.

Here is the link:

 https://www.theaustralian.com.au/business/technology/federal-agencies-convene-after-cyber-attack-on-healthcare-provider/news-story/ed65a0cd87c7670a92eece345d618187

Not good at all!

David!

This Is A Really Hard One To Solve Fairly I Believe. What Do Others Think?

This appeared last week:

Insurance (Australia)

Some say it’s ‘genetic discrimination’, but insurance companies are fighting for access to these test results

‘I’m being discriminated against purely based on the genes I was born with’, says a Queensland man who couldn’t update his life insurance policy

Andrew Messenger

Sun 12 May 2024 10.00 AEST Last modified on Sun 12 May 2024 11.24 AEST

Hereditary bowel cancer claimed the lives of three women in Dwayne Honor’s family. They had Lynch syndrome, a genetic condition that increases the chances of certain cancers developing. But he never expected it to affect his insurance.

For years the Bundaberg resident and members of his family participated in university research to help understand and deal with the common condition. About one in 280 people are believed to have it.

As genetic testing becomes more accessible, more people are taking action to detect Lynch syndrome and similar diseases, but insurance companies can sometimes also get the same information.

Honor says despite a moratorium preventing insurers from requesting genetic data for claims under $500,000, one of his family members was denied life insurance in 2023. He worries his children will have the same problem and he’s been unable to update his own life insurance policy, which predates genetic testing.

Honor, who has never been tested for Lynch syndrome but who undertakes regular screenings for bowel cancer, feels he’s “being discriminated against purely based on the genes I was born with”.

“I can’t choose my genetic makeup, so why should any financial service provider be able to discriminate against me?”

Paediatrician and chair of parliament’s health committee, Mike Freelander, agrees it’s a form of discrimination. The committee has recommended the insurance industry be banned from accessing people’s genetic testing results as part of a crackdown against the discriminatory use of health data.

But the life insurance industry is fighting a total ban and instead wants a financial cap on insurance policies offered without disclosure.

According to a 2023 Treasury report, there are more than 5,000 health conditions known to be caused by genetic variations.

Freelander says “genetic discrimination” – where life insurers charge extra or deny coverage to people who have a proven genetic risk – is discouraging people from testing in the first place.

“We really are now at a tipping point where we need to decide who should have that information, and how it should be used,” he says.

“Some businesses – insurance companies in particular – really want to get hold of this information because it makes it easier for them to pick and choose who they provide services to.”

Freelander prefers a simple ban on access to genetic information. He says there’s just no responsible way to regulate a private company into behaving responsibly with it.

The UK and Canada imposed total bans in 2001 and 2017, respectively. Under the Canadian ban, information can only be submitted voluntarily by a person seeking to prove they do not have a condition that runs in their family.

Jane Tiller, a Monash University researcher who has led the campaign for reform, is concerned the insurance industry is trying to persuade the federal government to adopt a false compromise.

Since a 2019 moratorium, insurers have only been allowed to ask for genetic data under certain circumstances, including if a client wants more than $500,000 worth of coverage. In its submission to the Treasury inquiry, the industry asked for the cap to remain, at a $1m limit.

In its submission to the Treasury review, the Council of Australian Life Insurers warned a total ban would create the potential for “adverse selection,” which is when a person is “more likely to purchase insurance, insure themselves for larger amounts and to claim but because the insurer is unaware of this, it cannot appropriately price the person’s individual risk”.

The council claims this would increase overall life insurance bills.

Instead, the industry supports what it calls a “near-total ban,” with a $1m limit on claims before a person can be required to provide genetic testing information.

It also wants the government to maintain “the principle that insurers can ask people to disclose, and use as part of the underwriting process, any diagnosis of a condition, even if the diagnosis resulted directly or indirectly from a genetic test”.

Council of Australian Life Insurers CEO, Christine Cupitt, says most people who disclose the results of a genetic test to a life insurer see no result on their final underwriting decision.

But Tiller says any exceptions or limitations would be unacceptable for consumers.

Freelander has had “extensive discussions with the ministers responsible” and is “very hopeful of a positive outcome for patients”.

Support for reform crosses partisan lines, with Liberal MP Warren Entsch and independent senator David Pocock among the many calling for change.

Entsch says “insurance companies, even though they scream poverty, are doing exceptionally well, their profit margins are quite extraordinary”.

“You don’t want them to go through a process where they can eliminate all risk before they take a policy, which is money for jam.”

Pocock is calling for “a full ban, no exemptions, no caps and no loopholes”.

“We can’t replace a patchy code with patchy legislation and say it’s fixed. We need strong laws that provide certainty for people that they can have a genetic test and never be penalised for the results.”

Here is the link:

https://www.theguardian.com/australia-news/article/2024/may/12/life-insurance-industry-customers-genetic-tests-ban

I find this very hard to work out what is a fair thing but I lean towards being able to insure yourself normally if you are truly not aware of any specific genetic marker you carry that increases your risk. Penalties have to apply for not telling the truth when asked!

If you are aware of a specific risk then I reckon  this should be disclosed and let the chips fall where they may. What do you think of the idea of a cap in the value of policies where no disclosure will prejudice cover?

Can anyone suggest a fairer approach?

David.