This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
PATIENTS at a recently-closed Hervey Bay medical practice will still be able to access their medical record.
In December, administrators were appointed for Ranveer Medical Practice Group, which traded as Drs on Main.
Several former patients raised concerns about medical record access with Hinkler MP Keith Pitt, who said anyone who sought access to medical records could send a request to ranveer@svp.com.au.
Other medical practices are also able to request records.
"Some people have very complex health conditions and it's important they have access to their medical records if they need to change doctors, for whatever reason," he said.
The Federal Government announced the creation of a "My Health Record" to begin nationally in 2018. My Health Record is a secure online summary of an individual's health information.
Mr Pitt said details about My Health Record and what individuals need to do, and by when, if they do not want a record automatically created for them, will be announced in the coming months.
Go to myhealthrecord.gov.au. for more information about My Health Record.
Just how allowing people who attended a defunct GP practice, which was hardly likely to be a big myHR user, will benefit from being told about getting their own myHR I struggle to understand.
Getting their paper records from the administrator to take to their new doctor would be a much more useful activity I believe!
There can be benefits from the ‘sharing’ (distribution) of health and other personal information among health care professionals and researchers. Any such ‘sharing’ must, however, be based on an understanding of potential risks. It must only occur within an effective legal framework, and controls appropriate for those risks. A ‘Trust me, I’m from the government!’ approach is a recipe for pain. So is sharing such sensitive data with government without full openness, transparency and a legal framework that prevents them from misusing it out of the public eye.
The inadequacy of Australia’s current health data privacy framework – inadequate risk assessment, inadequate law, inadequate enforcement – was demonstrated recently by a major independent study from Chris Culnane, Benjamin Rubinstein and Vanessa Teague at Melbourne University, released in the last days of 2017. [1]
In 2016 the Australian government released a large-scale data set relating to the health of many Australians, under the fashionable rubric of ‘Open Data’. [2] This 10% sample included all publicly reimbursed medical and pharmaceutical bills for selected patients spanning the thirty years from 1984 to 2014. The data as released was meant to be ‘de-identified’, meaning that it supposedly could not be linked to a particular individual: and since it would thus raise no privacy issues, it could be released ‘into the wild’, without controls.
Unfortunately, the government got it wrong: this weak protection can be breached. The IT security researchers demonstrated that this sensitive health data can be reidentified: with minimal effort it may be possible to get a picture of the health of prominent Australians, or of you and your neighbours. The research follows similar studies in the United States and Europe demonstrating the unreliability of existing ‘de-identification’ techniques in the face of rapidly-evolving artificial intelligence ‘machine learning’, and Big Data tools. It must be taken seriously.
In response to that earlier study, the Office of the Australian Information Commissioner’s Office (OAIC), the national privacy watchdog formerly known as the Privacy Commissioner, announced that it is “investigating the publication of the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) datasets”. OAIC has been investigating since September 2016, after the same researchers initially revealed problems with the data by demonstrating it was possible to re-identify practitioner records. [3]
More than a year later, in 2018 the OAIC is still investigating.
There has been no public report, nor warning about the bug in ‘Open Data’.
There is no indication of when the report will be released.
There has been no indication of whether the report will be released in full rather than in the usual redacted version.
There has been no requirement to reconsider the misplaced trust in ‘deidentification’ of ‘Open Data’ in the face of evidence of its unreliability.
You should be able to trust governments to care for sensitive personal data about yourself and your family. Clearly some of those who are handling this data either lack expertise, or are careless: it appears that ‘Open Data’ protections can be breached.
The Health Department and its Minister should be held to account. Overseas governments have responded effectively to similar problems: for example, the major Caldicott reports in the UK saw the end of the ‘Care.Data’ plan to sell the health records of most people in Britain. (The architect of that plan is now the CEO of the Australian Digital Health Agency.)
The OAIC should also be held to account. The delay of more than a year is unacceptable. So is the fact there is no end in sight, and the fundamental, controversial flaw in the rhetoric about the claimed safety of ‘Open Data’ remains unrecognised.
It may be that the OAIC lacks expertise and other resources. That is no excuse. (Extensive research work done by NICTA, and by independent university researchers like those at Melbourne and other institutions internationally, identifies the growing risks to ‘de-identification’ as a safe basis for the release of data derived from personal information into a hostile global environment. Efforts by proponents of ‘Open Data’ to promote the safety of de-identification must be met with a more sceptical view.)
It is time for the new Attorney General to provide adequate resources for the national privacy watchdog, so Australians can expect them to investigate the fundamental risks in ‘Open Data’ properly, independently, and promptly.
The OAIC should act like a watchdog, not like a rather timid snail.
The Australian Privacy Foundation wants the government to develop security controls around sharing open data and provide the agency charged with investigating data misuse with 'adequate' resources.
By Asha McLean | January 8, 2018 -- 02:03 GMT (13:03 AEDT) | Topic: Security
The Australian Privacy Foundation (APF) has called out the federal government and the Office of the Australian Information Commissioner (OAIC) after failing to publish a report on the September 2016 incident that revealed Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data was not encrypted properly.
The dataset was found by a team of researchers from the University of Melbourne and was subsequently pulled down by the Department of Health.
At the time, the OAIC announced it was investigating the publication of the datasets, however more than 12 months later, it is still investigating.
Of concern to the APF is that there has been no public report, nor warning about the bug in open data; no indication of when the report will be released; and no requirement to reconsider the misplaced trust in the de-identification of open data.
"You should be able to trust governments to care for sensitive personal data about yourself and your family. Clearly some of those who are handling this data either lack expertise, or are careless: It appears that 'Open Data' protections can be breached," a statement from the APF reads.
While the APF agrees there can be benefits from the sharing of health and other personal information among health care professionals and researchers, it said the sharing must be based on an understanding of potential risks.
"It must only occur within an effective legal framework, and controls appropriate for those risks," the APF continued.
"A 'Trust me, I'm from the government!' approach is a recipe for pain. So is sharing such sensitive data with government without full openness, transparency, and a legal framework that prevents them from misusing it out of the public eye."
Consumers want greater control over and better outcomes for their health, and healthcare providers want access to the right information when and where they need it. Digital health technologies contributes to improving health care quality and outcomes through facilitating effective information management, communication, decision making, and better care coordination and continuity of care.
The Australian digital health environment incorporates several digital infrastructure and technologies at national, state, regional and organisation levels. Brisbane South Primary Health Network’s Digital Health team is continually striving to support the improvement of the efficiency, effectiveness and quality of health services by facilitating the adoption these technologies, providing digital health education and supports to, and fostering collaborations among the health professionals in the region.
My Health Record
The My Health Record is an online summary of an individual’s health information that can be shared securely between the patient and authorised healthcare providers involved in their care.
The web-site is still a bit rocky with some links not quite working but the broad coverage of topics and especially support of data quality and clinical care quality and review is especially welcome.
More emphasis in area other than the myHR is very welcome indeed and offers hope to us all I reckon.
You are now able to interact with your My Health Record using mobile apps. This means that with your permission information uploaded by you, your healthcare providers, or by Medicare could be accessed with an app.
The My Health Record system is committed to strong security and safeguarding your privacy. We require apps to obtain your informed consent before accessing your My Health Record. You can set access controls in your My Health Record to remove apps if you no longer wish for them to access your data.
You will need to have a My Health Record before you use apps that connect to your record. If you don’t have a My Health Record, visit our Registration page to register.
Apps that are authorised to connect to your My Health Record:
1. HealthEngine
HealthEngine Pty Ltd
Features
Booking your next health appointment is quick and easy with HealthEngine. With doctors, dentists, physiotherapists, chiropractors, and many more listed around Australia, HealthEngine connects you with health practitioners when you need it most. HealthEngine also securely connects with your My Health Record, allowing you to view your important health information such as allergies, current conditions, and medications, and pathology/imaging reports.
Get Healthi: Advance your family’s health with a summary of recent healthcare visits, allergies and medications. See what’s in your My Health Record: prescriptions, lab test results, imaging reports and hospital discharge summaries.
Talk to a doctor any time and schedule consultations by phone with specialists, mental health professionals and more. You can view your My Health Record, find emergency care nearby, and store and share important care contacts. HealthNow connects you with the information that’s vital for managing your health.
In-app support: Settings > Under Settings > Contact Us (9:00am - 5:00pm AEST)
4. My Child's eHealth Record
The Australian Digital Health Agency
Features
The free My Child's eHealth Record app is a simple way of keeping track of your child’s health information, development and immunisations- all in the one place.
Before you use this app register for or sign in with your MyGov account to set up access and link to your child’s My Health Record.
Tyde is an application that puts you at the centre of your health, securely consolidating all your health information in one place, giving you secure fingerprint access to all your records. Tyde allows you to create your very own ‘personal health journal’, so no details are lost along the way.
Help
For app support:
Call: Help line on 1300 546 126 (9:00am - 5:00pm AEST)
So I stupidly thought I would try an app from my iPhone 8 despite being the most hopeless typist known to man on these devices.
Sadly it was a rather painful experience given my typing prowess!
Once I was registered with HealthNow (with typing complex passwords many times till I got them matching) the thrill was then to log on to myGov – more complex passwords to type – and to make it to myHR.
Once I got there it was really just a small and less easy to read version of the myHR I know on / from the web. (Indeed the display was simply in the Safari Browser)
What can I say other than the view was more cramped, less easy to navigate, slower and complex document were either in tiny type of needed a lot of scrolling around to be read.
The level of concession to the mobile environment was minimal to zero and the PC based web really is more user friendly. Interestingly the app seemed to remember the myGov login and went straight to the record - so there is only one password on the app that controls access once set up - or so it seemed.
Maybe this is version 1.0 and we will see innovation flow from now – as it has not to date. Just what you would really do with this rather eludes me at present.
Others can try the other apps and let us know via comments maybe?
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
Again a quiet week with little going on as the summer daze rolls on and on. This week may see a bit more activity.
With the Guild’s system to be shut down from the night of 31 January, what is the outlook for real-time prescription monitoring across the country?
MedsASSIST – the real-time recording system developed by the Pharmacy Guild of Australia to help reduce misuse of over-the-counter combination analgesic medicines containing codeine – will be discontinued nationally from the night of 31 January 2018, the Guild has announced.
“The reason for the shutdown is that all of the medicines recorded in MedsASSIST will be up-scheduled to prescription only from 1 February, and the system will become redundant at that time,” says the organisation.
“MedsASSIST was designed specifically to record over-the-counter medicines containing codeine. MedsASSIST was not designed to record prescription medicines.”
Payday lenders are asking applicants to share their myGov login details, as well as their internet banking password — posing a security risk, according to some experts.
It also goes against the advice of the government website.
As spotted by Twitter user Daniel Rose, the pawnbroker and loan provider Cash Converters asks people receiving Centrelink benefits to provide their myGov access details as part of its online approval process.
PATIENTS at a recently-closed Hervey Bay medical practice will still be able to access their medical record.
In December, administrators were appointed for Ranveer Medical Practice Group, which traded as Drs on Main.
Several former patients raised concerns about medical record access with Hinkler MP Keith Pitt, who said anyone who sought access to medical records could send a request to ranveer@svp.com.au.
Other medical practices are also able to request records.
Alfred Health now uploading discharge summaries to My Health Record
Alfred Health have now commenced uploading discharge summaries for inpatient episodes to My Health Record.
From November 27th, patients who have registered for the My Health Record and are discharged from Alfred Health will have their discharge summaries uploaded, unless the patient has withdrawn consent for this to occur.
The discharge summary will be uploaded to My Health Record when the discharge summary is sent to the patient’s nominated GP.
Click here for more information for health care providers about My Health Record.
ScalaMed, founded by Australian doctor and former pharmaceutical executive Tal Rapke, allows patients to receive prescriptions directly from their clinician to their mobile phones.
“The only person in common at the hospital, the pharmacy, the GP or the specialist is the patient. There's not necessarily any shared data across all of those locations,” Rapke said.
“But if you can get the patient in the middle of their healthcare journey with their data, engaged with the right kind of algorithmic or AI support behind them, then you truly start creating a new healthcare future that's oriented towards the patient.”
My Health Record Expansion Programme Deputy Chair Dr Steve Hambleton discusses My Health Record.
Created on Tuesday, 9 January 2018
Now that I have the ability to easily and securely share information on the My Health Record, my understanding of the purpose of my notes and in particular my health summary has changed from an aide memoire for myself to a collection of information that can benefit my patient as they touch other parts of the health system. An up-to-date shared health summary can be rapidly accessed by the other healthcare practitioners my patients encounter to help them make much more informed decisions to maximise benefits and minimise misadventure.
A key recent enhancement to the My Health Record is the Medicines View. The Agency has used the smarts of the computer systems to collect medicines information from many different places within the My Health Record and display it all on a single page. I can see what has been dispensed and what has been prescribed by other doctors with links to the original documents. Allergies from all sources are there, patient recorded information is there as well as information from the discharge summary if the patient has recently spent time in hospital.
Are you an App developer? Visit the App developer page for more information.
You are now able to interact with your My Health Record using mobile apps. This means that with your permission information uploaded by you, your healthcare providers, or by Medicare could be accessed with an app.
The My Health Record system is committed to strong security and safeguarding your privacy. We require apps to obtain your informed consent before accessing your My Health Record. You can set access controls in your My Health Record to remove apps if you no longer wish for them to access your data.
You will need to have a My Health Record before you use apps that connect to your record. If you don’t have a My Health Record, visit our Registration page to register.
MEDIA RELEASE: ‘Open Data’: Too much sharing, too little care? Who’s reading your health information now?
There can be benefits from the ‘sharing’ (distribution) of health and other personal information among health care professionals and researchers. Any such ‘sharing’ must, however, be based on an understanding of potential risks. It must only occur within an effective legal framework, and controls appropriate for those risks. A ‘Trust me, I’m from the government!’ approach is a recipe for pain. So is sharing such sensitive data with government without full openness, transparency and a legal framework that prevents them from misusing it out of the public eye.
The inadequacy of Australia’s current health data privacy framework – inadequate risk assessment, inadequate law, inadequate enforcement – was demonstrated recently by a major independent study from Chris Culnane, Benjamin Rubinstein and Vanessa Teague at Melbourne University, released in the last days of 2017. [1]
In 2016 the Australian government released a large-scale data set relating to the health of many Australians, under the fashionable rubric of ‘Open Data’. [2] This 10% sample included all publicly reimbursed medical and pharmaceutical bills for selected patients spanning the thirty years from 1984 to 2014. The data as released was meant to be ‘de-identified’, meaning that it supposedly could not be linked to a particular individual: and since it would thus raise no privacy issues, it could be released ‘into the wild’, without controls.
Director, Research Ethics & Compliance Support, UNSW
Imagine this scenario: you’re a recently graduated doctor working at a medical clinic in rural Australia. A person presents with a bite of what seems to be a poisonous spider - but you’re not sure. You take a photo of the skin lesion on your phone, and post it in a social media group to source swift advice from more experienced experts.
Digital image capturing devices like smartphones have enormous potential to facilitate communication for time critical medical interventions. And, as a society, we all seem to be part of a contract where we tacitly consent to immediate, mass distribution of images depicting us.
But there’s a catch: image capture and storage may fail to comply with current legislative frameworks for privacy, with significant ethical, legal and security implications.
The Australian Privacy Foundation wants the government to develop security controls around sharing open data and provide the agency charged with investigating data misuse with 'adequate' resources.
By Asha McLean | January 8, 2018 -- 02:03 GMT (13:03 AEDT) | Topic: Security
The Australian Privacy Foundation (APF) has called out the federal government and the Office of the Australian Information Commissioner (OAIC) after failing to publish a report on the September 2016 incident that revealed Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data was not encrypted properly.
The dataset was found by a team of researchers from the University of Melbourne and was subsequently pulled down by the Department of Health.
At the time, the OAIC announced it was investigating the publication of the datasets, however more than 12 months later, it is still investigating.
AMA submission to the National Health Genomics draft implementation plan
11 Jan 2018
The AMA considers the COAG draft implementation plan for a coordinated national health genomics approach in the public sector is a good first step in moving forward. However the plan would be strengthened if it recognised the potential contribution of the private sector. The AMA also cautions on the secondary use of personal data.
Microsoft is adding an end-to-end encryption option, powered by Signal, to Skype.
‘Private Conversations’ are powered by the Signal Protocol, which is already being utilised by WhatsApp, Facebook Messenger, and Google Allo among others.
“At Signal, our goal is to make private communication simple and ubiquitous,” Signal’s Joshua Lund wrote in a blog post.
“With hundreds of millions of active users, Skype is one of the most popular applications in the world, and we’re excited that Private Conversations in Skype will allow more users to take advantage of Signal Protocol’s strong encryption properties for secure communication.”
Australian minnow Pro Medicus has muscled its way into the US, beating global giants to secure sought-after contracts in a health technology industry that boss Sam Hupert says Australia could learn a lot from.
Dr Hupert, who started the Australian-listed company in the early 1980s, said the past four years had been transformational for Pro Medicus, driving the share price from below $1 to more than $8.
Melbourne-based Pro Medicus, which also has offices in Berlin and San Diego, makes software that allows large healthcare institutions to store and transport images.
Dr Hupert said the “step change” in the company started to take shape in late 2007 when he decided to target a company that did digital imaging.
The Orderly module of Oncall System’s proprietary clinical messaging technology, Smartpage, has gone live at North Shore and Waitakere public hospitals in Auckland
Oncall Systems has recently entered into a definitive acquisition agreement with Alcidion
Smartpage’s Clinical and Orderly modules are now installed at 4 large public hospitals across New Zealand, and the Clinical module is in the process of being rolled out at the first Australian location via Monash Health
Strong market demand exists for reliable and proven communication technology solutions in hospital settings, providing strong strategic rationale for the acqusition of Oncall Systems
Adelaide, South Australia, 10 January 2018 – Alcidion Group Limited (ASX:ALC) today announced that Oncall Systems Limited (“Oncall”), the company which is currently the subject of a definite acquisition agreement with Alcidion, has gone live with the Orderly module of its clinical messaging technology, Smartpage, at North Shore and Waitakere Hospitals, in Auckland, New Zealand.
Ingestible electronics are giving their first full tours of the gas in people’s guts.
Newly constructed capsules, described online January 8 in Nature Electronics, sense various gases while traveling through a person’s digestive tract, revealing how the gut’s chemical composition reacts to factors like diet.
What exactly each person’s gut gas could reveal about his or her health “is still to be determined,” says William Bentley, a bioengineer at the University of Maryland in College Park. But using capsules to gather gas fingerprints of many people with different diets or disorders could help researchers better characterize gut problems and improve disease diagnoses as well as boost monitoring of the effects of dietary or medication changes.
Kourosh Kalantar-Zadeh, an engineer at the Royal Melbourne Institute of Technology in Australia, and his colleagues built plastic capsules about 2.5 centimeters long — about as long as a Jolly Rancher hard candy — that sniff out carbon dioxide, hydrogen and oxygen gas molecules in the gut. Such molecules are primarily generated when microbes feast on undigested food. These battery-powered capsules continuously relay gas updates to a smartphone until expelled from a person’s body.
'Swarm' cyber attacks, crypto-currency stealing malware predicted for 2018
Ben Grubb
Published: January 8 2018 - 11:15AM
2018 will be the year malicious software becomes smarter and cyber criminals increasingly chase crypto-currencies like bitcoin, according to predictions from computer security companies.
It will also be the year ransomware — software designed by hackers that locks up computer systems until a fee is paid — will become more targeted and prevalent among big business, where ransom demands are often much higher in dollar value due to businesses having more money to divulge than consumers, according to computer security firm Fortinet.
Derek Manky, global security strategist at Fortinet, says that although the threat magnitude of ransomware has grown by 35 times over 2017 with "ransomworms" and other types of attacks, there is more to come.
Security researchers revealed disastrous flaws in processors manufactured by Intel and other companies this week. The vulnerabilities, which were discovered by Google's Project Zero and nicknamed Meltdown and Spectre, can cause data to leak from kernel memory -- which is really not ideal since the kernel is central to operating systems and handles a bunch of sensitive processes.
Intel says that it's working to update all of the processors it has introduced in the last few years. "By the end of next week, Intel expects to have issued updates for more than 90 per cent of processor products introduced within the past five years," the company said in a statement today.
Unfortunately, Meltdown and Spectre impact a ton of different products -- cloud services, computers, phones, and browsers. Luckily, in many cases, consumers won't have to do much to secure their devices and services; they will just need to keep an eye out for updates and install them when they become available. In some cases, you may simply be out of luck.
The rollout of commercial 5G networks could begin in 2019 if standardisation and technologies are set during 2018, Telstra CEO Andy Penn has said, adding that Telstra is a world leader in the space.
5G will be the watchword of 2018, with Telstra CEO Andy Penn telling ZDNet at CES 2018 that this year will bring further standardisation, spectrum allocation, and wide-scale trials across the globe.
According to Penn, Telstra has only physical implementation and chipset aspects remaining in its preparation work for the extensive 5G trial on the Gold Coast that will take place during the Commonwealth Games in April.
"We've orchestrated the spectrum availability; we have effectively signed up the arrangements with the equipment manufacturer, which is Ericsson that we're trialling it with, and so it's pretty well advanced," he told ZDNet during CES.
Cheaper prices, higher speeds on offer as telcos pass on NBN price cut
Jennifer Duke
Published: January 9 2018 - 4:00PM
Telecommunications companies have reduced their prices, with some customers saving an average of $120 a year, following last month's national broadband network wholesale price cuts.
Most major NBN providers have announced cheaper prices for plans with speeds of 50 Mbps or more and some smaller players are planning to introduce a 50 Mbps product in coming months.
Amid spiralling complaints about broadband speeds, NBN Co slashed the wholesale cost of its 50 Mbps plans in December.
NBN Co predicts pick-up as Australia loses places in internet speed rankings
The Australian
12:00AM January 8, 2018
Anthony Klan
The nation has fallen two places in global internet speed rankings and despite the $49 billion National Broadband Network Australia is now in 55th place — between Kazakhstan and the United Arab Emirates.
According to the Speedtest Global Index, the average Australian internet connection last month delivered speeds of 25.88 megabits per second, below the average of 40.71Mbps for the 129 countries surveyed and well below Singapore at a rocket-fast 161Mbps.
An NBN Co spokesman said the lacklustre performance was because only about three million Australians were connected to the NBN, with many homes able to do so yet to make the switch.
Australia’s fixed broadband has fallen below Kazakhstan on a global ranking of internet speeds, with performance continuing to be below the global average.
The Ookla Speed Test Global Index ranked Australia as 55th in the world for fixed broadband in December, with an average download speed of 25.88 Mbps.
Globally, the average download speed is 40.71 Mbps, pushing Australia behind countries including Austria, Slovenia, the Czech Republic and Russia.
Singapore had the fastest fixed broadband, with average downloads of 161.21 Mbps.
