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."

Thursday, August 29, 2019

This Rather Has The Look Of A Bit Of A Triumph Of Hope Over Experience.

This appeared last week:

ACT begins search for $70m digital health records platform

By Justin Hendry on Aug 23, 2019 1:53PM

Gets ready to junk legacy systems.

ACT Health is waiting on the arrival of the territory’s new digital health records platform to begin decommissioning as many of its existing clinical systems as possible.
The agency responsible for the health needs of a 400,000-strong population made the declaration in a market approach this week for a provider to deliver the solution.
The solution, which was funded to the tune of $70 million in this year’s budget, will introduce a single health record for every person engaging with the ACT’s public healthcare system.
A central tenet of the ACT government's plan to deliver a “future-focused” public health system, the digital health record will capture all clinical interactions with patients in one central repository.

This includes core, specialty and ancillary patient information, patient administration and management and “sophisticated” analytics and reporting capabilities.
But this is expected to lead to many existing clinical systems within the territory’s “highly fragmented” IT environment being withdrawn over the next four years.
“Currently the territory’s ICT environment is highly fragmented with more than 250 different systems supporting the delivery and management of health care services,” tender documents state.
“The territory will be seeking to decommission as many existing clinical systems as possible, as soon as possible.
“However, it is recognised that it will be necessary to retain some existing clinical systems particularly in early phases of implementation of the digital health record.”
ACT Health said the e-health record would be introduced using a phased approach, the first of which – to take place over the next two years – will cover the design, build and deployment of the solution to the territory’s three primary hospitals.
More here:
From what is said here I am not sure the proponents quite get the complexity or the change management challenge of giving the boot to 250 different systems over just a few years.
Equally moving to a single repository for all clinical and apparently administration as well sounds like something of a challenge.
This will be a project to watch over the next few years….
David.

Wednesday, August 28, 2019

Digital Inclusion Is Getting More And More Air Time It Seems But It Is Not Yet Clear How The Problem Is To Be Solved.

This appeared last week:

APO Digital Inclusion Collection brief: August 2019

22 Aug 2019
Description
This snapshot is inspired by the initiation of the Digital Health Literacy program being piloted for the Australian Digital Health Agency between July and December 2019. This program will deliver training to support people to improve their digital health literacy, including how to find quality, reliable information, as well as understanding how to use and manage their My Health Record.
This snapshot examines the treatment of digital inclusion as a digital health system issue in Australia’s National Digital Health Strategy and the subsequent Framework for Action that details how Australia will deliver the benefits of digitally enabled health and care. It also examines the revised Digital Inclusion Guide for Health and Social Care recently released by the UK National Health Service (NHS). The NHS has long been a leader in addressing digital inclusion as it pursues a digital-first service delivery strategy.
Indeed, the Good Things Foundation, who are piloting Australia’s Digital Health Literacy program, have been delivering a similar Widening Digital Participation program for the NHS since 2013 (see reviews in 2015 and 2016). While the NHS Digital Inclusion Guide points to the importance of skills training (like that offered through the Digital Health Literacy program), it also highlights a broader set of practical interventions necessary to address digital inclusion as a complex multifaceted barrier to equitable digital health outcomes. The guide provides a useful template that could be adapted for use, both in the Australian health sector, and by organisations in other government service sectors undergoing digital transformation.

Here is the link:
Two things flow from this:
First the NHS has produced a very useful document with all sorts of practical ideas, which is linked here:

Digital inclusion guide for health and social care

15 Aug 2019
This guide to digital inclusion is aimed at local health and care organisations to help them to take practical steps increase access to digital services for all in their communities.
It should be relevant to:
  • commissioners of health and care services, including clinical commissioning groups – so they can take into account the needs of local populations who may be digitally excluded
  • integrated care systems – so they can ensure digital inclusion is central to the design of future services
  • providers of health and care services – so they can ensure services delivered digitally are as inclusive as possible
  • local authorities and voluntary organisations – so they can make the most of partnerships with the health and care sector to improve digital inclusion
  • designers of digital health services – so they can take into account the needs of those who might be digitally excluded, and design inclusive and accessible services
The guide is intended to help you understand:
  • what we mean by digital inclusion
  • who is likely to be digitally excluded and the barriers they may face
  • why digital inclusion matters in health and care
  • the benefits of supporting people to get online
  • practical steps you can take to support digital inclusion locally
  • the tools you can use to commission, provide and evaluate digital inclusion support
  • resources for developing digital skills of health and care staff, carers and patients
Publication Details
Copyright: NHS Digital 2019
Language: English
License Type: Open Government Licence v3.0
Published year only: 2019
The link to the resource is here:
Second in the brief proper – as I have remarked often previously - the ADHA in its strategic thinking is way behind the curve in its strategy and Framework for Action:
To quote the brief.
“Overall, discussion of digital inclusion in the Strategy is limited to around half a page (of a total of 63 pages). This discussion is included under the incongruous strategic priority of supporting “[a] thriving digital health industry delivering world-class innovation” (p.47). Here the Agency clearly highlights that “while digital innovation is transforming many aspects of our lives, there is not yet equal opportunity for all to participate, particularly those people who make the greatest use of health services”. Given this acknowledgment and the principle of equity, it is perplexing that the Agency does not consider addressing digital inclusion to be one of the six critical success factors of the Strategy (see pp.52-53).
The Agency does call for some direct action on digital inclusion as part of the Strategy – the convening of “stakeholders across the community to develop comprehensive approaches to digital inclusion, ensuring that actions to address digital literacy are based on high-quality evidence for how best to support people who are currently experiencing digital disadvantage” (p.50, my italics). Whilst this is commendable, in limiting action to digital literacy, it does not engage with the access, accessibility and financial barriers to digital inclusion all clearly identified by stakeholders in the consultation process as highlighted on page 49 of the Strategy.”
And:
“The Framework references a miscellaneous collection of existing government and non-government agencies involved in measuring or responding in some way to digital inclusion, but it is not clear how these initiatives align with each other, the Strategy or the Framework (see p.82).
The Australian Digital Health Agency through the National Digital Health Strategy and Framework for Action clearly outlines the many benefits an Australian digital health system will generate. The Agency acknowledges digital inclusion as a barrier to the equitable distribution of the benefits of such a system—nevertheless, addressing this issue does not feature prominently in the Strategy or Framework. The actions to be pursued also focus largely on digital literacy which is just one aspect of digital inclusion. Perhaps digital inclusion would have received greater attention had the Agency considered it to be one of the critical success factors for the Strategy.”
The last sentence is particularly telling.
The bottom line is that there is vastly more work to do in this area and additionally that it is not actually soluble! There will always be a significant number of the population who are ‘digitally excluded’ for what ever reason. The work needs to be directed as keeping the number as low as possible.

This link shows just how hard it can be:

https://theconversation.com/logged-out-farmers-in-far-north-queensland-are-being-left-behind-by-the-digital-economy-121743
If we ever saw any Board Notes from the ADHA maybe we could see if they are now on the job?
David.

I Am Offering A Prize For The First Comment That Explains What This Actually Means.

Health Privacy Issues

Additional treatment information relating to veterans to be included in My Health Record.

On 1 July 2019, a regulatory amendment issued under the My Health Records Act 2012 prescribed that information relating to the provision of healthcare to veterans may in certain circumstances be included in a My Health Record: My Health Records Amendment (Veterans' Affairs Treatment Benefits) Regulations 2019.  The Treatment Benefits (Special Access) Act 2019 provides for medical treatment, through a Department of Veterans' Affairs treatment card (gold card), of members of Australian Civilian Surgical and Medical Teams who provided medical aid, training and treatment to local Vietnamese people during the Vietnam War, and the effect of the amendment is that the My Health Records Regulation 2012 now provides for the inclusion in a My Health Record of healthcare provided under the Treatment Benefits (Special Access) Act.  The Statement of Compatibility with Human Rights which accompanied the amendment observed that "including healthcare information created under the Treatment Benefits (Special Access) Act 2019 will enable eligible Australians to better manage their healthcare information and assist healthcare providers".

Here is the link:
Does anyone know what this means and does it matter?
Thanks
David.

Tuesday, August 27, 2019

Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety And Security Matters. Lots Of Interesting Perspectives - August 27, 2019.

-----
This weekly blog is to explore the larger issues around Digital Health, data security, data privacy and related matters.
I will also try to highlight ADHA Propaganda when I come upon it.
Just so we keep count, the latest Notes from the ADHA Board are dated 6 December, 2018! Secrecy unconstrained! This is really the behavior of a federal public agency gone rogue!
-----

My Health Record Presentation

20, Aug 2019 ADHA Propaganda
Genetic and Rare Disease Network and WA Primary Health Alliance (WAPHA) collaborated in June to bring you an information session to learn about the benefits of My Health Record and how to access the system.
My Health Record is an online summary of your health information. You control what goes into your record, and who can access it. Share your health information with doctors, hospitals and other healthcare providers anywhere, anytime. My Health Record may be a valuable resource for those living with rare disease.
For those of you who were unable to attend the event, WAPHA have been kind enough to share the presentation with us so all of our members can benefit from the information. Please click on the following link to access My Health Record Presentation
-----

How Accenture is making Minority Report a reality

Hettie O'Brien
Aug 23, 2019 — 11.25am
The glossy 2002 film Minority Report is based on a 1956 novel by Philip K Dick, in which three humans with mutant powers, or precognitives – “precogs” – can foresee crimes before they happen. Spotting an opportunity, the PreCrime police department uses the precogs to virtually eliminate crime by identifying people before they break the law. Every so often, though, one of the precogs generates a “minority report” at odds with the predictions of their counterparts. This inconvenient detail is kept a secret. Revealing it would damage the credibility of the machine.
Though intended as a grimly speculative account of the problems of relying on imperfect predictions, the premise of Minority Report is increasingly being used by police in the UK as a blueprint for new technology. Last month, the Home Office pledged £5 million ($9 million) in funding to West Midlands Police to develop a system that will identify individuals at risk of committing future crimes. Elsewhere, Durham police have developed an algorithm for use in custody decisions; Avon and Somerset Police, meanwhile, use predictive technology to map where violent crime might occur.
The West Midlands system, which police are currently developing with the help of private sector consultancy giant Accenture, will use artificial intelligence, statistics and police data to identify future criminals and victims of crime, and pinpoint those who might become an influential “hub” within a wider network of offenders involved in modern slavery. Though still in beta, the system will eventually “help the force … reduce cost across its operations”, “improve effectiveness and increase efficiency” and “reduce future demand for services”, according to Accenture’s website.
-----

How does Inca collect and share health information?

July 2019
Precedence Health Care’s Integrated Care Platform (Inca) is a cloud- based network of digital health and wellness services, including MediTracker mobile application services.
It is important that all users of Inca services understand how the network collects and shares health information (“personal information”) and are aware of their responsibilities for gaining informed consent from patients.
To the extent applicable (if at all), the Health Privacy Principles (or equivalent), which operate in some jurisdictions, should guide your actions. In the absence of applicable Health Privacy Principles, you should refer to relevant Commonwealth, State or Territory privacy legislation, and assistance can also be derived by referring to the website of the Office of the Australian Information Commissioner. You should make sure you are familiar with the applicable principles or other relevant guidance, and also with Precedence Health Care’s Privacy Policy.
Inca collects and shares personal information about patients and other persons under care (also called “consumers”) who consent to this information being stored and shared in the network. This information may come from a variety of sources, including the clinical software systems used by GPs (e.g., Medical Director, Best Practice); other members of the patient’s care team (e.g., allied health professionals, medical specialists); the patient themselves; participating health services and pathology services; and the Commonwealth’s My Health Record.
-----
22 August 2019

Your health data being sold online for peanuts

Technology
Posted by Francine Crimmins
Thieves of big data from digital healthcare systems are happy to wait months or even years to re-sell that information on online forums, cyber experts say.
A report recently published by a US-based cyber security company called FireEye, has found that multiple healthcare databases, all of which had encountered historical data breaches, risked that data being sold and resold much later down the track, and often for less than $2000 a time.
The FireEye report is based on an annual investigation into online security and malicious activity against international healthcare systems.
FireEye said the timing of the advertisements for stolen data did not typically correlate with the timing of a reported data breach.
“Many of the observed advertisements were for databases that had been compromised in previous months or years,” FireEye said.
------

APO Digital Inclusion Collection brief: August 2019

22 Aug 2019
This snapshot is inspired by the initiation of the Digital Health Literacy program being piloted for the Australian Digital Health Agency between July and December 2019. This program will deliver training to support people to improve their digital health literacy, including how to find quality, reliable information, as well as understanding how to use and manage their My Health Record.
This snapshot examines the treatment of digital inclusion as a digital health system issue in Australia’s National Digital Health Strategy and the subsequent Framework for Action that details how Australia will deliver the benefits of digitally enabled health and care. It also examines the revised Digital Inclusion Guide for Health and Social Care recently released by the UK National Health Service (NHS). The NHS has long been a leader in addressing digital inclusion as it pursues a digital-first service delivery strategy.
Indeed, the Good Things Foundation, who are piloting Australia’s Digital Health Literacy program, have been delivering a similar Widening Digital Participation program for the NHS since 2013 (see reviews in 2015 and 2016). While the NHS Digital Inclusion Guide points to the importance of skills training (like that offered through the Digital Health Literacy program), it also highlights a broader set of practical interventions necessary to address digital inclusion as a complex multifaceted barrier to equitable digital health outcomes. The guide provides a useful template that could be adapted for use, both in the Australian health sector, and by organisations in other government service sectors undergoing digital transformation.
-----

Inside GCHQ: the art of spying in the digital age

As the centenary of its creation approaches, the UK’s largest intelligence service is rethinking the way it recruits the spies of tomorrow.
David Bond
Aug 22, 2019 — 11.53am
Five years ago, Rob, a 38-year-old father of two, was fitting kitchens and bathrooms for a living. Now he is a digital spy.
As one of Britain's Government Communications Headquarters (GCHQ)’s army of cyber analysts, he monitors global counter-intelligence targets in countries he cannot disclose for national security reasons.
“You’re always looking for that key or that nugget that’s going to really help progress the operation,” he says, before adding proudly that his work often makes the headlines.
-----

Artificial intelligence brings out the information in your voice

Banks are using biometric data to catch scammers trying to imitate their customers on the phone, while doctors are using such data to detect the onset of dementia or depression.
The sound of your voice is becoming a new type of fingerprint.
Increasingly sophisticated technology that detects nuances in sound inaudible to humans is capturing clues about people’s likely locations, medical conditions and even physical features.
Law enforcement agencies are turning to those clues from the human voice to help sketch the faces of suspects. Banks are using them to catch scammers trying to imitate their customers on the phone and doctors are using such data to detect the onset of dementia or depression.
That has created new possibilities for healthcare, finance and criminal justice organisations while also raising fresh privacy concerns as consumers’ biometric data is harnessed in novel ways.
-----
Denham Sadler
August 21, 2019

Use of de-identified data questioned

More significant data breaches are “inevitable” until Australian governments engage in an open discussion about the use of de-identified personal data, according to the University of Melbourne’s Dr Chris Culnane.
Dr Culnane, along with colleagues Professor Vanessa Teague and Professor Ben Rubenstein, recently revealed that data released by the Victorian government from 15 million myki public transport cards could easily be re-identified, potentially allowing for an individuals’ movements over the last four years to be tracked.
Using the dataset the researchers quickly found themselves able to trace their public transport movements. They were also able to find people they had travelled within the dataset, and find a state politician in the dataset by simply matching his tweets with the touch-on and touch-off data.
“Ordinary travellers are very easily and confidently identifiable from the published Myki data," the report said.
-----
Thursday, 22 August 2019 00:02

Warning: Cybercriminals pose threat to Australian, world’s healthcare systems  

Australian and the world’s healthcare systems face a range of security threats due to malicious activity as cybercriminals attempt to access sensitive information stored in the systems.
The warnings on the vulnerability of healthcare systems to criminal activity come from global security firm FireEye in a report just released.
According to FireEye the healthcare vertical in Australia, and worldwide, faces a range of threat actors and malicious activity as, in some cases, criminals seek to monetise personally identifiable information (PII) and protected health information (PHI).
On security incidents occurring in healthcare sectors FireEye reports that between Oct. 1, 2018 and March 31, 2019, its Threat Intelligence systems observed multiple healthcare-associated databases for sale on underground forums, many for under $2000.
“Actors buying and selling PII and PHI from healthcare institutions and providers in underground marketplaces is very common, and will almost certainly remain so due to this data’s utility in a wide variety of malicious activity ranging from identity theft and financial fraud to crafting of bespoke phishing lures,” FireEye’s report notes.
-----

Health Privacy Issues

Additional treatment information relating to veterans to be included in My Health Record.

On 1 July 2019, a regulatory amendment issued under the My Health Records Act 2012 prescribed that information relating to the provision of healthcare to veterans may in certain circumstances be included in a My Health Record: My Health Records Amendment (Veterans' Affairs Treatment Benefits) Regulations 2019.  The Treatment Benefits (Special Access) Act 2019 provides for medical treatment, through a Department of Veterans' Affairs treatment card (gold card), of members of Australian Civilian Surgical and Medical Teams who provided medical aid, training and treatment to local Vietnamese people during the Vietnam War, and the effect of the amendment is that the My Health Records Regulation 2012 now provides for the inclusion in a My Health Record of healthcare provided under the Treatment Benefits (Special Access) Act.  The Statement of Compatibility with Human Rights which accompanied the amendment observed that "including healthcare information created under the Treatment Benefits (Special Access) Act 2019 will enable eligible Australians to better manage their healthcare information and assist healthcare providers".
-----

Aussie banks warn customers after fresh PayID data breach

By Ry Crozier on Aug 21, 2019 10:28AM

'Client-side technical issue' blamed for latest disclosure.

Banks have started warning customers of a fresh data breach involving PayID records that was reported to new payments platform overseer NPP Australia late Friday.
NPP Australia said that an undisclosed number of PayID records “and associated data in the Addressing Service were exposed by a vulnerability in one of the financial institutions sponsored into the NPP by Cuscal Limited.”
“Cuscal has confirmed that the client-side technical issues underlying the exposure were identified and resolved immediately,” it said in an advisory.
“The affected data included PayID name and account numbers. 
-----

HealthEngine: The intersection of privacy and consumer protection

The Australian Competition & Consumer Commission (ACCC) announced on 8 August 2019 that it had commenced legal proceedings in the Federal Court against the online platform, HealthEngine Pty Ltd (HealthEngine) alleging that a number of its practices constitute misleading and deceptive conduct in breach of the Australian Consumer Law.
HealthEngine is an online platform that enables Australians to book healthcare providers online. Until this practice ceased in June 2018, patient reviews of member health care providers were also published on HealthEngine’s site.
Reviews and ratings
The first aspect of the ACCC’s claim is that HealthEngine did not publish negative patient reviews, manipulated the patient reviews that it did publish (creating a misleading impression) and also that it misrepresented why ratings were not published for some health practices. In that respect, the case is unremarkable and is similar to other cases that the ACCC has instituted in the past, including in relation to Meriton serviced apartments. In that case, Meriton was ordered by the Federal Court to pay penalties of $3 million for manipulating client feedback to stop negative reviews of its properties being published on TripAdvisor.
-----

VICBAR: Subpoenas for production of documents in the My Health record system

The Australian Digital Health Agency has contacted the Bar requesting we draw to our members’ attention the provisions of section 69 of the My Health Records Act 2012 (Cth) and the limited circumstances in which the Agency can be required to disclose health information included in a healthcare recipient’s My Health Record to a court or tribunal or coroner (02 August 2019). More...
-----

Taming the technology tsunami

Christian von Reventlow
The next great wave of truly ­disruptive technology is looming on the horizon, bringing with it dramatic changes that will reverberate across transportation, medicine, education, communication, and virtually every other aspect of our lives.
In this ultra-digitised, ultra-connected world, your driverless car will receive and instantly ­respond to information from the driverless cars around it to create a seamless, safe traffic flow.
The members of your global team will come together in one room as holograms, interacting with one another just as they would in person. The “tactile internet” will ­enable a virtual merging of human and machine capabilities, so that a surgeon can manipulate a robotic tool with the same sensitivity she’d have if she were holding the scalpel in her own hands.
As dramatically different as the future will be, it’s clear that most of us have ­already taken our first steps into that digitised world. And while we may have some misgivings, it’s also clear that we want what that future promises to offer.
-----

Rod Sims is right about the spy in your kitchen

John Davidson Columnist
Aug 20, 2019 — 12.00am
Smart speakers from the likes of Google and Amazon, which customers control with their voice, are "horrifying" and a "time bomb waiting to go off", data privacy experts have warned.
Not only are devices such as Google Home and Amazon Echo a "ripe target" for hackers and for government-led surveillance, the very way they're used by the companies that make them should be enough to scare off anyone thinking of buying them, the experts say.
The warnings come in the wake of comments from the chairman of the Australian Competition & Consumer Commission, Rod Sims, who is set to announce landmark lawsuits against Big Tech companies for large-scale privacy breaches, and who said last week he would never have a Google Home in his own house.
-----

'Shocking': Sydney has more CCTV than Moscow

Lucas Baird Reporter
Aug 19, 2019 — 4.35pm
Sydney is the 15th most-surveilled city in the world, new research has found, and the nation's capital, Canberra, also ranked highly.
The report by the UK-based firm Comparitech ranked cities based on the number of CCTV cameras per 1000 people. That placed Sydney place higher than Russian capital Moscow and Baghdad in Iraq.
These results can tell a lot about the society you live in, said Privacy Foundation chairman David Vaile, and did not reflect well on the NSW capital.
"It's a bit of a wake-up call ... it's a bit shocking," he said of the 60,000 cameras Comparitech recorded in Sydney. "It's a high number that puts us just a tier or two behind the big Chinese cities."
China had eight of its largest cities rank within the 10 most surveilled cities, according to the report. Mr Vaile said this was likely due to the ruling Chinese Communist Party's Orwellian social credit system.
-----

Facial recognition is now rampant. The implications for our freedom are chilling

This new technology is being secretly used on streets and in shopping centres across Britain, making potential suspects of us all
Last week, all of us who live in the UK, and all who visit us, discovered that our faces were being scanned secretly by private companies and have been for some time. We don’t know what these companies are doing with our faces or how long they’ve been doing it because they refused to share this with the Financial Times, which reported on Monday that facial recognition technology is being used in King’s Cross and may be deployed in Canary Wharf, two areas that cover more than 160 acres of London.
We are just as ignorant about what has been happening to our faces when they’re scanned by the property developers, shopping centres, museums, conference centres and casinos that have also been secretly using facial recognition technology on us, according to the civil liberties group Big Brother Watch.
But we can take a good guess. They may be matching us against police watchlists, maintaining their own watchlists or sharing their watchlists with the police, other companies and other governments. Our faces may even be used to train the machine-learning algorithms deployed by oppressive regimes such as China, which uses facial recognition technology to monitor and control its people, particularly its Uighur Muslims, more than a million of whom are interned in concentration camps.
-----

Logged out: farmers in Far North Queensland are being left behind by the digital economy

August 16, 2019 6.00am AEST
Author :  Amber Marshall - Research fellow, Queensland University of Technology
Farming families and communities in Queensland’s remote north are being left behind by the digital economy, putting them at significant social and economic disadvantage.
Our report, launched in Cairns today, details the impacts of low levels of “digital inclusion” among farmers in Far North Queensland (FNQ), for whom reliable internet connection is not a given.
People in rural and remote areas – including Indigenous communities – score much lower than urban Australians on the Australian Digital Inclusion Index. This index – which measures access to technology, affordability of connections, and digital ability – shows that North West Queensland (which includes FNQ grazing lands) is one of the least digitally included regions in Australia.
-----

Could big tech companies be holding the keys to our thoughts?

By Paul Biegler
August 18, 2019 — 12.00am
Neuralink CEO Elon Musk says his company is working to connect the human brain with a machine interface before the end of the year. He claims the micro processor chips will allow humans to connect with artificial intelligence.
In an unnamed primary school classroom in China the lesson is all about colours. But the colours aren’t on the blackboard. They are lighting up on the kids' foreheads.
The children are part of a trial, reported earlier this year, in which each is fitted with a brainwave-reading headset, made by Boston-based startup BrainCo, that measures how focused they are on their school work. A small light on the device tells the teacher if those young minds are straying. Blue means relaxed, yellow means focused and red means very focused.
Neat. And maybe the headband, which is called Focus 1, is a useful teaching tool. But the experiment also has a darker side.
-----

Digital inclusion guide for health and social care

15 Aug 2019
This guide to digital inclusion is aimed at local health and care organisations to help them to take practical steps increase access to digital services for all in their communities.
It should be relevant to:
  • commissioners of health and care services, including clinical commissioning groups – so they can take into account the needs of local populations who may be digitally excluded
  • integrated care systems – so they can ensure digital inclusion is central to the design of future services
  • providers of health and care services – so they can ensure services delivered digitally are as inclusive as possible
  • local authorities and voluntary organisations – so they can make the most of partnerships with the health and care sector to improve digital inclusion
  • designers of digital health services – so they can take into account the needs of those who might be digitally excluded, and design inclusive and accessible services
The guide is intended to help you understand:
  • what we mean by digital inclusion
  • who is likely to be digitally excluded and the barriers they may face
  • why digital inclusion matters in health and care
  • the benefits of supporting people to get online
  • practical steps you can take to support digital inclusion locally
  • the tools you can use to commission, provide and evaluate digital inclusion support
  • resources for developing digital skills of health and care staff, carers and patients
-----
Comments more than welcome!
David.

Monday, August 26, 2019

Weekly Australian Health IT Links – 26th August, 2019.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

-----
All in all a seemingly quiet week with the odd bit of excitement with some tech improvements.
-----

ACT begins search for $70m digital health records platform

By Justin Hendry on Aug 23, 2019 1:53PM

Gets ready to junk legacy systems.

ACT Health is waiting on the arrival of the territory’s new digital health records platform to begin decommissioning as many of its existing clinical systems as possible.
The agency responsible for the health needs of a 400,000-strong population made the declaration in a market approach this week for a provider to deliver the solution.
The solution, which was funded to the tune of $70 million in this year’s budget, will introduce a single health record for every person engaging with the ACT’s public healthcare system.
A central tenet of the ACT government's plan to deliver a “future-focused” public health system, the digital health record will capture all clinical interactions with patients in one central repository.
-----

Sigma enters into tele-health

Carrie LaFrenz Senior Reporter
Aug 19, 2019 — 12.00am
Sigma Healthcare has entered the tele-health market after making a small investment into Doctors on Demand, which offers professional online consultation and advice from Australian-registered doctors inside pharmacies.
This new online general practitioner service will initially focus on rural locations in Australia where there is a pharmacy but the local community has limited access to healthcare services.
So far 23 pharmacies across the Amcal, Guardian and Discount Drug Store banners are participating.
The drug wholesaler's boss Mark Hooper said this investment is a way to broaden the pharmacy healthcare offering.
-----

First pharmacy Telehealth service launches

Sigma Healthcare and its branded pharmacies have launched a partnership with Doctors on Demand called InClinic, which it says is Australia’s first Telehealth service in pharmacies

InClinic provides patients with timely access to professional online consultation and advice from an Australian registered doctor, inside a pharmacy.
This new InClinic online General Practitioner service will focus on locations in Australia where there is a pharmacy, but the local community has limited access to GP healthcare services.
 To launch this partnership, 23 pharmacies across Australia will initially participate in the GP InClinic service.
A range of Amcal, Guardian and Discount Drug Store pharmacies will now be able to offer a secure and private link to the Doctors on Demand online platform in a professional consulting suite.
-----

Medicare confirms validity of electronic referrals

A six-month push for information has provided clarity on the previously murky area of Medicare rebates derived from electronic referrals.
Is it sufficient for an email referral to simply state that it is ‘signed electronically’.


21 Aug 2019
The Medicare benefit payable is dependent on a referral from another practitioner for certain services provided by specialists and consultant physicians.

Confusion has existed for years regarding the ‘acceptable evidence’ required if the referral is sent electronically; in particular, what constitutes a signature on these documents.

However, GP and digital health expert Dr Oliver Frank,
a leading advocate for the digitisation of healthcare in Australia, believes he has finally found the answer to this long vexing question.

‘Medicare says if a specialist has received a referral and is going to claim at the higher rate, that referral must be signed,’ he told newsGP.

‘My question to Medicare was, “GPs are already sending referrals by the secure messaging systems but there is no actual legally valid signature on it. Does that matter?”’

-----

The ADHA is simplifying its clinical terminology database with AWS

The National Clinical Terminology Service has been re-engineered to reduce complexities and costs.
By Aimee Chanthadavong | August 20, 2019 -- 03:16 GMT (13:16 AEST) | Topic: Cloud
The Australian Digital Health Agency (ADHA) is currently in the final phase of testing before going live with version 2.0 of the National Clinical Terminology Service (NCTS).
The NCTS, which is operated by the ADHA and was built together with the Commonwealth Scientific and Industrial Research Organisation (CSIRO), is a cloud-based software service that provides healthcare professionals access to an up-to-date one-stop shop national standardised terminology database.
While the original NCTS was built on Amazon Web Services (AWS), ADHA director Dion McMurtrie said it was built as a traditional microservices-based infrastructure-as-a-service application, which presents several complexities.
"The current system may not look it but it's quite complicated from an operation use. There are a number of different services that are operating and are configured and glued together." he said, presenting at the AWS Public Sector Summit on Tuesday.
-----

How the ADHA is working to keep Australia's clinical systems talking

By Justin Hendry on Aug 21, 2019 7:18AM

Redevelops national terminology service.

The Australian Digital Health Agency is preparing to rollout the latest version of the national service used to keep clinical systems terminology consistent across healthcare providers.
The agency best known for the My Health Record has been busy rebuilding the cloud-based national clinical terminology service (NCTS), which was first introduced in 2016.
A lynchpin for ensuring heath data interoperability in Australia, the database helps to keep the mishmash of systems used by healthcare professionals up-to-date and communicating in the same language.
It does this by making clinical terminology solutions such as the international recognised terminology standard SNOMED available through a centralised repository, with systems vendors able to integrate directly using APIs.
-----

Smartphones fight killer bacteria

Monday, 12 August, 2019
A combination of off-the-shelf quantum dot nanotechnology and a smartphone camera could soon allow doctors to identify antibiotic-resistant bacteria in just 40 minutes, potentially saving patient lives, Australian scientists believe.
Macquarie University and University of New South Wales researchers say they have developed a cheap and rapid way to identify antibiotic-resistant golden staph (MRSA).
Their findings were published in the journal Sensors and Actuators B: Chemical.
Staphylococcus aureus (golden staph) is a common form of bacterium that causes serious and sometimes fatal conditions such as pneumonia and heart valve infections. Of particular concern is a strain that does not respond to methicillin, the antibiotic of first resort, and is known as methicillin-resistant S. aureus, or MRSA.
-----
SNAC plans to integrate its analysis tools with systems already used by clinicians, so that once a scan is taken, it is automatically routed to a server and processed.

Australia’s SNAC develops AI tools to improve brain scan analysis

August 21, 2019 03:17 AM
Sydney Neuroimaging Analysis Centre (SNAC), an Australian company co-located with the University of Sydney’s Brain and Mind Centre, is building AI tools to automate laborious analysis tasks in their research workflow, such as isolating brain images from head scans and segmenting brain lesions.
Additional algorithms are in development and being validated for clinical use. One compares how a patient’s brain volume and lesions change over time. Another flags critical brain scans, so radiologists can more quickly attend to urgent cases. The researchers develop their algorithms using the NVIDIA Clara suite of medical imaging tools, as well as cuDNN libraries and TensorRT inference software.
WHAT’S THE IMPACT
SNAC analyses patient MRI and CT scans acquired at clinical sites around the world. With a training dataset of more than 15,000 three-dimensional CT and MRI images, SNAC is building its deep learning algorithms using the PyTorch and TensorFlow frameworks.
-----

Sydney brain scanners speed up analysis with AI

By Matt Johnston on Aug 23, 2019 6:55AM

Increasing accuracy with automation.

When it comes to cutting edge technology, ironies can sometimes be sublime.
The machines humans devised to imitate our brains through the development of artificial intelligence (AI) are now being deployed to analyse and identify how our brains work.
It's a growing market, because while we know some things about how brains operate at a physical level there still a lot we don't. And it's moving fast.
The Sydney Neuroimaging Analysis Centre (SNAC), which last year won a federal grant to enhance brain scans using AI, is now branching out and validating its algorithms for use in clinical settings.
-----

Hearts and minds behind brainchild to follow up the bionic eye

By Stuart Layt
August 22, 2019 — 9.33pm
An organisation being launched on Friday will enable researchers in bionic medicine to co-ordinate their efforts as they work on groundbreaking health projects.
Hear and Say Centre speech pathologist Dimity Dornan founded Bionics Queensland as a hub for collaboration in the bionics research sector.
Dr Dornan said Australian researchers were working on the bionic eye, the bionic heart and even the bionic pancreas, and Bionics Queensland would ensure similar advances were made in the future.
“Bionics Queensland will help fast-track other similar innovations and pave the way for cross-border partnerships, product development and commercialisation,” she said.
-----

Australia’s digital health players to present at RACGP eHealth forum

Digital health records, informatics, privacy and security. There is much to discuss in the eHealth space.


23 Aug 2019
Speakers at the forum, to be held on Thursday 29 August, include Australian Digital Health Agency (ADHA) CEO Tim Kelsey and chief information security officer Tony Kitzelmann, CSIRO product and program lead Kate Ebrill, and Health Informatics Society of Australia’s chief health informatician David Rowlands.

The RACGP’s digital health advocates will be well represented, with Chair of the RACGP Expert Committee – Practice Technology and Management (REC–PTM) Dr Rob Hosking and Chair of the Expert Committee – Quality Care (REC–QC) Associate Professor Mark Morgan also set to present.

The forum will include updates from the ADHA, which is responsible for My Health Record and work to improve secure messaging in healthcare, and the CSIRO’s efforts to improve data quality in primary care.
-----

National Clinical Terminology Service – Online tool demonstrations

Created on Thursday, 15 August 2019
15 August 2019: The National Clinical Terminology Service (NCTS) at the Australian Digital Health Agency has published recordings about online tools that help you browse through and map to SNOMED CT-AU and the Australian Medicines Terminology (AMT).
Webinars include:
Shrimp terminology browser – searching SNOMED CT-AU A webinar (approx. 25 mins) that demonstrates a popular terminology browser and gives tips and hints on how to search for SNOMED CT-AU content, including the AMT.
Snapper:Map – creating maps to SNOMED CT-AU A webinar (approx. 35 mins) that demonstrates a tool that enables the creation of simple maps between SNOMED CT-AU (including the AMT) and other data sources.
-----

Doctors may face prosecution for discussing euthanasia with patients over phone, computer

23 August, 2019
Doctors fear they could face criminal prosecution under WA's proposed voluntary assisted dying laws if they discuss euthanasia with patients electronically due to differences between state and Commonwealth law.

Key points:

  • Concerns centre on discussions via phone calls, emails or telehealth
  • WA's Health Minister concedes there are no guarantees for doctors
  • Victoria has told doctors to limit non face-to-face conversations on euthanasia
The WA Government is seeking assurances doctors will not be placed at risk after concerns from medical groups that doctors who discuss voluntary euthanasia by phone, email or telehealth could fall afoul of Commonwealth laws that prohibit using a carriage service "for suicide related material".
The issue is being taken sufficiently seriously that Victoria has instructed doctors to limit discussions about voluntary assisted dying (VAD) to face-to-face conversations.
-----

NOS programme cut back and renamed

Monday, 19 August 2019  
eHealthNews.nz editor Rebecca McBeth
 The National Oracle Solution programme has been scaled down and renamed after work on the project was suspended in September last year.
The Ministry of Health says NOS has been superseded by the Health Finance, Procurement and Information Management System. A new business case for the FPIM was endorsed by all 20 DHBs and approved by Cabinet in June 2019.
While NOS was intended to replace all 20 DHB’s finance and procurement systems, FPIM will be delivered to 11 DHBs, with four already live.
-----

National Screening Solution delayed

Wednesday, 21 August 2019  
eHealthNews.nz editor Rebecca McBeth
The roll-out of the National Screening Solution has been delayed to early 2020.
Whanganui and Mid-Central District Health Boards were due to go live with the National Bowel Screening Programme using the new NSS this October and November, but will now go live with the interim IT solution, BSP+.
The Ministry of Health signed with Deloitte in January 2019 for the build and operation of the NSS on Salesforce technology and the system was due to be operational by October this year.
National Bowel Screening director Stephanie Chapman says that “since signing the agreement Deloitte and Ministry have mobilised the project team, established the technology environments required to support the build of the NSS and started to build the IT system”.
-----

Chinese stealing health and medical research data: report

Hackers have been putting stolen medical records up for ransom.
The global healthcare sector, including Australia, faces increasing cyber threats and malicious activity from Chinese groups, a new report warns, with medical research a key target.
FireEye, a global intelligence-led security company with a Sydney base, has released a report outlining three of the most commonly used threats against healthcare organisations: data theft, cyber espionage and disruptive and destructive threats.
One key finding of the report is that Chinese groups feature prominently in these attacks.
 “Since 2015, we have observed China-based threat actors conducting intrusions into healthcare organisations to steal patient personal information, likely to identify, track, and potentially exploit targeted individuals of interest to the Chinese government,” Charles Carmakal, vice president and CTO strategic services at FireEye, said.
-----

Questions emerge regarding new SA bid to ease ED strain

Ambulances have begun taking some patients to GP-led priority care centres in an effort to relieve Adelaide’s strained hospital network.


21 Aug 2019
Patients with simple fractures, cuts and abrasions, sports injuries and respiratory-tract infections will be among those who may be taken to the new priority care centres instead of overcrowded emergency departments (EDs), as part of a new South Australian trial.

The clinical decision to recommend patients go to the new centres – based in GP clinics – rather than EDs will be made by the attending ambulance paramedic in consultation with a senior medical officer in the call centre.

But RACGP SA&NT Chair, Dr Zakaria Baig, told newsGP he feels the 16-week trial will be challenged by funding issues and duplication of existing GP services.

The SA model is understood to be loosely based on Western Australia’s
urgent care clinics, which the RACGP has previously questioned.
-----

Hackathon won by team aiming to improve healthcare communication

One GP’s frustration with communication in antenatal care may lead to a tech solution.


22 Aug 2019
For 16 years, Dr Bambi Markus has been stymied by one particular problem.

Now she’s taken the first step to solve it – and her team has won the RACGP’s first ever Hackathon to boot.

After thinking about the problem of communication in the antenatal space for years, Dr Markus finally had a chance to tackle it directly.

At the RACGP’s inaugural Hackathon held in Melbourne on 10 August, 35 participants shared ideas that might improve practice management or patient experience, aided by tech gurus.
-----

HIMSS Australia Digital Health Summit 2019

About this event

The HIMSS Australia Digital Health Summit 2019 will provide a critical platform for healthcare leaders to discuss "The Now and Next of Digital Health".
Exchange best practices and discuss the latest developments, challenges and to network, learn and explore solutions that leverage information and technology to improve patient safety, quality and efficiency to attain better clinical outcomes.
Event run by:
Information about third party events has been provided by the organiser or sourced from the event website. Inclusion in the events calendar should not be construed as endorsement of the event by the Agency. Information is provided as a service to the digital health developer community, and all event arrangements may be subject to change and should be confirmed with the event organiser.
-----

Morrison vows to tame Centrelink IT "beast"

By Julian Bajkowski on Aug 19, 2019 1:40PM

Says $1bn WPIT overhaul must deliver for customers, not just bureaucrats.

Prime Minister Scott Morrison has singled-out Centrelink’s $1 billion core system replacement as crucial for rebuilding the confidence of everyday Australians dealing with government online, warning public servants it must deliver improvements for customers, not just bureaucrats.
In his first major public address to the federal bureaucracy at Parliament's Great Hall on Monday, the former social services minister demanded “a step change in service delivery” from agency chiefs, warning them that the creation of Services Australia was not a “fancy rebranding exercise.”
Morrison’s tough talk is the strongest signal yet that he is personally prepared to come down hard on persistent customer experience issues across the former Human Services portfolio that range from ham fisted Robodebt calculations to unacceptable call-centre waiting times.
“The process we have been going through with WPIT now for some time is the biggest ICT program we have seen in the public service. It is a beast of a thing to accomplish. It has been going for many years and I think we are making extraordinary progress,” Morrison said before putting bureaucrats on notice.
-----

NIB touts tech rehab as financial restorative

By Matt Johnston on Aug 20, 2019 1:00PM

For better cost management.

Newcastle-based health insurer nib has touted digital technologies and data science-enabled personalisation as the “bedrock” of its business strategy in its full-year results on Monday.
The company, which flagged a $149.3 million post-tax annual profit, said in its results the personalisation push would impact its relationships with members, its products and services, and the information provided to doctors and clinicians.
It's not a bad performance considering Australians are gradually abandoning private health cover in droves, with other insurers sure to be looking for lessons in what went right for nib.
Nib revealed its tech overhaul and cloud push in iTnews in Fberuary last year. 
-----
Wednesday, 21 August 2019 02:03

Booming North American wearables market hits US2 billion for quarter

The value of the North American wearables market reached US2.0 billion in Q2 2019, with shipments up 38% at 7.7 million units, according to a new report.
The report by global analyst firm Canalys reveals that, driven by booming smartwatch sales, North America remains the world’s most valuable wearable band market, despite being second to Greater China in terms of unit sales.
And in Q2 2019, more than 60% of Apple’s 4.7 million global watch shipments were into North America – with Fitbit coming second overall, with shipments up 18% due to it pushing more basic bands into the channel - but failing to ship as many smartwatches as in Q2 last year.
Canalys says that Apple and Samsung contributed most of the region’s value gains.
-----

NBN Co's FTTC and HFC build costs rise again

By Ry Crozier on Aug 19, 2019 1:40PM

Civil works blamed.

NBN Co has seen further increases in its build cost-per-premises in the fibre-to-the-curb (FTTC) and hybrid fibre coaxial (HFC) footprints, which it attributes to civil works and other causes.
In its FY19 results handed down late last week, NBN Co revealed that FTTC cost-per-premises (CPP) had risen from $3058 at the end of 2018 to $3129 by the end of June this year.
“The increase is due to greater civil works required in the build and higher customer connection costs,” chief financial officer Philip Knox said on an earnings call.
FTTC costs have now risen from $329 per premises since early trials of the technology. 
-----

Contract Notice View - CN3621779

AusTender holds Contract and Standing Offer Notices for the 07/08 financial year forward. For information related to previous years, please refer to https://data.gov.au/dataset/historical-australian-government-contract-data
Subcontractors:  For Commonwealth contracts that started on or after 1 December 2008, agencies are required to provide the names of any associated subcontractors on request.  Information on subcontractors can be sought directly from the relevant agency through the Agency Contact listed in each Contract Notice.
Labour Hire
Agency Details
Contact Name: Australian Digital Health Agency
Office Postcode: 2606
CN ID: CN3621779
Agency: Australian Digital Health Agency
Publish Date: 22-Aug-2019
Category: Temporary personnel services
Contract Period:
12-Aug-2019 to 30-Jun-2020
Contract Value (AUD): $141,357.61
Description: Labour Hire
Procurement Method: Open tender
ATM ID: DH2228
-----
Enjoy!
David.