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Australia's new e-health platform crashes as people rush to opt-out

zdnet.com

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Re: Australia's new e-health platform crashes as people rush to opt-out

#31

Post by systoll »

ekianjo wrote: post #3
TheSpiceIsLife wrote: post #2

The Australian government is paying doctors to upload patient records to a centralised government controlled database. The Australia government is incentivising doctors to sell client data to the government . What part of this is ok in any sense?

how is that compatible with doctor patient confidentiality?

The federal law says you can't upload data if the patient tells you not to. Max penalty for that seems to be 2 years imprisonment, though I doubt we'll see that. Some states have further restrictions which expand the scope of this -- for instance, in NSW, uploading anything about HIV would be illegal, even with patient consent.

The Australian Medical Association has said that the interaction of the MHR system with their code of ethics implies that doctors must get positive consent from patients.

In practice, your new patient registration forms are getting another checkbox.

Re: Australia's new e-health platform crashes as people rush to opt-out

#32

Post by lbriner »

auslander wrote: post #14
danieltillett wrote: post #4

Anyone know who is the contractor running this fiasco?

Dunno, but I shuddered to find "...the creation of a new government agency - Service NSW - supported by the Salesforce Service Cloud. ..." https://www.salesforce.com/au/customer-success-stories/servi... I trust government with my private data, not Salesforce or any other corporation.

Governments don't store private data, corporations do!

The only difference between government-fronted storage and direct-to-the-corporation like Salesforce is that corporations are mostly driven by profit and have slightly stronger reasons for protecting data to avoid losing your trust and money. Government motivation is mixed and changes over time.

Re: Australia's new e-health platform crashes as people rush to opt-out

#33

Post by lbriner »

megaman22 wrote: post #12
danieltillett wrote: post #4

Anyone know who is the contractor running this fiasco?

Are there any of them that actually are any good? You read these stories, and deal with a few different ones personally, and the whole sector quickly starts to look like a barely competent disorganized mess.

Most of them are very good but the assumption that there is a mythical 100% good system or company would assume that requirements are reasonable, unchanging and that the time and money to build it well are all present undermines everything. Even a simple application will quickly unwind when the whims of the customer change 10 times quicker than it takes to build something (same in most other industries).

Re: Australia's new e-health platform crashes as people rush to opt-out

#34

Post by kirrent »

rjvbk wrote: post #19

Having a centralised system with health records is bad? I've had that since I was born in my country and I think it's useful and handy. Something happens to you, they know what could've been, if you're on meds, what things and meds you're allergic to, etc. I guess the outrage makes sense when looked from an American point of view where you distrust the government by principle?

I've been bothering my doctors to actually check my E-health record for years. Sure, one specialist and a GP can communicate fine, but add on a couple of different specialists and it turns into a nightmare to get everyone the information that they need. Even in its current form, without mandatory use by doctors its been useful to me. I'm looking forward to having a proper record of my healthcare as opposed to the fragmented buy in there is now.

But that's mostly convenience for me. My wife worked as a doctor in emergency for a while. The only way to get a new patient history including all the information you've said is to call their doctor or ask them. Many patients can't give a full medical history and very few can do so in detail when it's complex. Many doctors aren't at work 24/7 when you want to call them. An E-health record is better.

Re: Australia's new e-health platform crashes as people rush to opt-out

#35

Post by pimmen »

jopsen wrote: post #15
TheSpiceIsLife wrote: post #13

Earlier quoted context omitted.

C) the database never gets hacked, or leaked, or otherwise exfiltrated

Even if there is a risk of this. It might be a risk worth taking. Edit: I don't know the specifics, but I sometimes wonder what good stats on more health records could do for future treatments.

I agree. In the US, the equivalence of a packed Boeing 747 of people die every day because of medical mistakes. It's the third leading cause of death. If you could reduce that number by 1% through this policy, that would mean thousands of people saved every year.

In my opinion, the risk-reward analysis is clearly in favor of a centralized system.

Re: Australia's new e-health platform crashes as people rush to opt-out

#36

Post by auslander »

lbriner wrote: post #32
auslander wrote: post #14

Earlier quoted context omitted.

Dunno, but I shuddered to find "...the creation of a new government agency - Service NSW - supported by the Salesforce Service Cloud. ..." https://www.salesforce.com/au/customer-success-stories/servi... I trust government with my private data, not Salesforce or any other corporation.

Governments don't store private data, corporations do! The only difference between government-fronted storage and direct-to-the-corporation like Salesforce is that corporations are mostly driven by profit and have slightly stronger reasons for protecting data to avoid losing your trust and money. Government motivation is mixed and changes over time.

> ... stronger reasons for protecting data to avoid losing your trust and money

Well, I'm not a customer to Salesforce, so they have no incentive to keep my trust and they get no money from me, but they can make money on my data, and likely would, why not?

Re: Australia's new e-health platform crashes as people rush to opt-out

#37

Post by Avamander »

lbriner wrote: post #30

There are problems with paper-based systems but they don't affect everyone to the same extent: * I visit another doctor when on holiday - they don't have my records * Certain treatments need the approval of my home doctor, it talkes longer than it should * Harder to collate statistics that are supposed to show the state of the nation's health But there are problems with an electronic system: * A single point of attac…

* A single point of attack

Totally the same with your data in that one primary doctor's office or whatever

* No way to assure people it is ultimately secure, because it can never be

Totally same with your paper records, someone could walk in and steal your data, imagine that.

* Creeping requirements mean that a few years later, the government might change what they can use it for.

Just like paper records, you can't say what they will use them for in the future.

Re: Australia's new e-health platform crashes as people rush to opt-out

#38

Post by pimmen »

vertex-four wrote: post #25
jopsen wrote: post #15

Earlier quoted context omitted.

Even if there is a risk of this. It might be a risk worth taking. Edit: I don't know the specifics, but I sometimes wonder what good stats on more health records could do for future treatments.

I wouldn’t intentionally place my health records out of my own control, because I have significant risk to my life if those records become public. Having certain illnesses and medical history is inherently political in 2018 - being trans can result in violence against you, talking to your doctor about STIs - even just prevention - can get you kicked out of your home, having medicated/treated schizophrenia will result…

But you also have a significant risk to your life if your doctor can't get to them and orders the wrong treatment. The risk of that happening to you is actually significantly higher than dying from a lot of pretty common illnesses.

Re: Australia's new e-health platform crashes as people rush to opt-out

#39

Post by TheSpiceIsLife »

auslander wrote: post #20
dav43 wrote: post #10

As part of my work, I've had to read a fair amount of the legislation and reports coming out in this sector and also the "Consumer Data Rights" legislation (similar to the UK's open banking scheme. What I found was a massive difference in policy coming out from the same government but in two seperate streams of work. A) Consumer Data Right (legislation being built into Australia Privacy Act) focusing on banking, ener…

> ... focusing on banking... - yeah. Commonwealth Bank Privacy Policy: 5. Who do we share your information with? - Service providers — for example, mortgage insurers, loyalty program partners and our product distributors - Businesses who do some of our work for us — including direct marketing, statement production, debt recovery and IT - support - Organisations involved in our funding arrangements — like loan purchas…

Yeah, how would they delete data they’ve already sold?

Re: Australia's new e-health platform crashes as people rush to opt-out

#40

Post by dav43 »

auslander wrote: post #14
danieltillett wrote: post #4

Anyone know who is the contractor running this fiasco?

Dunno, but I shuddered to find "...the creation of a new government agency - Service NSW - supported by the Salesforce Service Cloud. ..." https://www.salesforce.com/au/customer-success-stories/servi... I trust government with my private data, not Salesforce or any other corporation.

ASide note: they are using the google recaptca on the opt out site shows they have no idea about privacy for a government agency.

So now google know everyone opting out I assume?

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