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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

#81

Post by vertex-four »

jbob2000 wrote: post #73
michaelt wrote: post #61

Earlier quoted context omitted.

But you also have a significant risk to your life if your doctor can't get to them and orders the wrong treatment. Don't you think I'm in a better position to make that decision than a central government bureaucrat, given that I have my medical records and an incentive to protect my own privacy, and he has neither?

It's not good public policy for millions of people to make individual decisions about this. It's expensive for the healthcare system when there are a million different ways for it to access your data; some people bring in papers, some papers are on the other side of the country, some people have a USB stick, oh granny lost hers in a fire here's a photocopy from 10 years ago. It's just much more effective to manage th…

So in my country, records are kept by the individual clinics, where I have GDPR rights over them and there isn’t a direct mechanism by which anybody but the clinic can access them. If I move clinic, there’s a process by which those records get moved with my consent.

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

#82

Post by vertex-four »

pimmen wrote: post #71
vertex-four wrote: post #62

Earlier quoted context omitted.

Unless I’m unconscious, I can give my doctor permission to access my medical history from where it’s kept under my control, and give them a quick run-down in the meantime if necessary. I feel that I should have a right to choose between the risk of death when both myself and my emergency contact are unable to provide medical information to a doctor, and the risk of my medical history becoming publicly available - or…

And it would be much simpler if all you had to do was give them that authorization and they could retrieve your medical records in an instant, in the correct format for them to work quickly. If they have to order your medical journal from a completely separate jurisdiction, in a completely different format, and then import it that would take longer. If you require specialist care which is not available in your area t…

All at the low, low risk of creating e.g. a centralised Government database of trans people, or people with HIV, or whatever the next big scare is.

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

#83

Post by TheSpiceIsLife »

jazoom wrote: post #21
msamwald wrote: post #7

Earlier quoted context omitted.

It seems overall okay if you accept the premises that A) A centralized health record system can do substantial good by improving effectiveness and transparency of healthcare processes, and enabling medical progress through data re-use. B) Doctors won't lift a finger to do extra work if they have no selfish incentive for doing so.

It's really not that much money as an incentive. Doctors won't do it unless they believe it's a good thing. Source: I'm an Australian doctor.

What are you doing, and what is your professional organisation (the AMA) doing, to counter long wait times for doctors visits?

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

#84

Post by jazoom »

TheSpiceIsLife wrote: post #83
jazoom wrote: post #21

Earlier quoted context omitted.

It's really not that much money as an incentive. Doctors won't do it unless they believe it's a good thing. Source: I'm an Australian doctor.

What are you doing, and what is your professional organisation (the AMA) doing, to counter long wait times for doctors visits?

I dunno man. I'm not a member of the AMA and I've always run pretty well on time unless I get bowled a bouncer.

I used to get frustrated with doctors running late, until I became one. It's the patients that come before you that largely determine how late the doctor is. If someone might be having an MI but only came in to discuss "reflux" the doctor is going to run behind.

What would you do about it?

Though, I'm not sure why you're asking me this since it has nothing to do with this thread.

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

#85

Post by RichEO »

TheSpiceIsLife wrote: post #83
jazoom wrote: post #21

Earlier quoted context omitted.

It's really not that much money as an incentive. Doctors won't do it unless they believe it's a good thing. Source: I'm an Australian doctor.

What are you doing, and what is your professional organisation (the AMA) doing, to counter long wait times for doctors visits?

So much entitlement in this post

Never the less, I’ll bite because this is a topic of interest to me. What kind of wait times are you talking about?

Emergency room? Public non-emergent and elective surgery? Private practice specialists? Bulk billing or private billing general practice?

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

#86

Post by RichEO »

TheBeardKing wrote: post #76

I get that there's benefit to a centralized health database if you're in a country with socialized medicine, but if dealing with private doctors, why not let the market provide this capability? My primary GP uses one version [1], and I get that there would be several competing others until some convergence happens. But at least with these private providers, if one fails or falls out of trust, patients and doctors can…

You haven’t established that the government is less trustworthy than the private providers?

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

#87

Post by pjc50 »

Avamander wrote: post #58
pjc50 wrote: post #44

Earlier quoted context omitted.

This is true "on paper", but in practice our whole industry is built on the fact that electronic records behave qualitively differently from paper records because they're so much easier to handle. You can't steal everyone 's paper records all at once in the way you can with electronic records, for example.

> You can't steal everyone's paper records all at once in the way you can with electronic records, for example. You're assuming you can steal the entire database at once which most certainly will also be noticed and stopped swiftly.

History is full of massive data breaches which were only noticed when the dump turned up being sold. Few places have decent exfiltration detection on their IDS.

Or there's the classic "health records left on train" incident: http://news.bbc.co.uk/1/hi/uk/7449927.stm

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

#88

Post by jbob2000 »

vertex-four wrote: post #81
jbob2000 wrote: post #73

Earlier quoted context omitted.

It's not good public policy for millions of people to make individual decisions about this. It's expensive for the healthcare system when there are a million different ways for it to access your data; some people bring in papers, some papers are on the other side of the country, some people have a USB stick, oh granny lost hers in a fire here's a photocopy from 10 years ago. It's just much more effective to manage th…

So in my country, records are kept by the individual clinics, where I have GDPR rights over them and there isn’t a direct mechanism by which anybody but the clinic can access them. If I move clinic, there’s a process by which those records get moved with my consent.

Yep, works like this in Canada. The problem is that each clinic implements a different record system, so someone needs to undergo effort to translate them when you switch systems.

Also, I worked with OSCAR, one of Canada's biggest EMRs. It is written by a bunch of academics at a local university and is individually deployed on under-the-desk computers at clinics. It is full of security holes, the whole process of managing this system is.

I get why you want rights over the medical records. You can still have those on a centralized system. Google and facebook are centralized and you have rights over them (in some jurisdictions anyways).

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

#90

Post by SyneRyder »

deevus wrote: post #53

This is a problem every time the government launches a new service. They always have "an unexpected amount of traffic". The last time we had a census the "census night" was totally bust since the majority of Australian internet users tried to use the online form and hardly anyone succeeded. They tried to blame it on "hackers". Leading up to census night there were threats of fines if you didn't submit on time, but du…

The census fiasco was a truly special kind of incompetence. The best inside analysis was from the folks behind the Risky Business infosec podcast:

https://risky.biz/censusfail/

Summary: The project was outsourced to IBM (that alone probably says it all), who didn't purchase any DDoS protection. A small attack crashed the first firewall, and the backup firewall didn't have rules loaded. That caused IBM's monitoring tools to flag system logs as exfiltration, so they called in the Australian Signals Directorate (ie national security) and turned everything off until intelligence agencies completed an investigation of the false positive.

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