CHOICE membership

MyHealth Record - Coming to Us Like it or Not


#201

In reference to assertions that the number of registrations for MyHealthRecord is impressive, somebody’s been watching: http://mailman.anu.edu.au/pipermail/link/2018-July/105457.html

I track the daily rate of many of the items they report on, the most relevant are # registrations/day and #Shared Health Summaries uploaded/day

A visual inspection of registrations/day seem to be following a gradual decline over the past year.

SHS/day have a very definite three month cycle which match exactly the ePIP, the Practice Incentives Program, which is the incentive paid to GPs to upload myhr data. GP’s get paid I think $33k/period if they meet a certain upload number abased upon a % off their patients. Some GPs have had to pay money back

https://www.myhealthrecord.gov.au/for-healthcare-professionals/practice-incentives-program
https://ama.com.au/gp-network-news/pip-ehealth-incentive-targets-–-what-happens-if-you-fall-short

So registrations were declining. Explains the desperation. Can’t afford to have such an expensive program wither & die.


#202

The Myhealth initative has or had bipartisan support. In it’s first form it was kicked off in the last term of the Gillard - Rudd government. Later adopted by the Libs, the Nats and their bastardised oneness the LNP.

Might limit the options?
Although there is a possibility both the major political parties might change position in unison and come to a new but shared common position.

MyHealth mk2 any one?
Fit for purpose, secure, privacy assured.


#203

The “fit for purpose” bit is most interesting to me. What was the purpose, exactly?

It seems to me that there were initially two aims:

  1. Save money and;
  2. Be seen to be “doing something”.

As the project progressed, functions were added. Mostly, they involve surveillance and law enforcement. Neither public nor individual health seem to have been substantial considerations in the design of the system.

From a national and individual health perspective, what should be the purpose? To my mind:

  1. Bring together individuals’ information from all health providers and;
  2. Build a national population health database to provide policy guidance.

Of course, the mere existence of such a target poses risks. Whether we want to take the risk is up to each of us.

Meanwhile, back in the real world:

What could possibly go wrong?


#204

This whole mess is rather sad as, if done right, medical records being made accessible through proper use of tech will improve and has improved health outcomes. It isn’t just the extreme case of the person with serious allergies who, being comatose, cannot inform a new doctor. There are less threatening cases where improved communication and record keeping is a big benefit.

Consider the case I had several years ago when my GP had to ask me what the specialist had said as the GP couldn’t get a report. I recently had a scan and the results were on line and accessible within a hour.


#205

“save money” itself could mean different things.

The government saves money relating to its direct costs?

Health providers save money relating to the inefficiencies and overheads of doing business (not directly to do with the government)?

This is not a purpose in its own right though. In isolation that is really an anti-purpose. :slight_smile:

The purpose should have been improvements in individual health and improvements in population health (as you may have implied). The latter would presumably also save money.


#206

At present, an individual’s records are in multiple locations. A treating medical professional needs access to all of them. Missing a vital detail will at best lead to less than optimal outcomes and could be fatal. Even the patient doesn’t necessarily know where all their records are.


#207

That’s true. It doesn’t follow though that the only solution is to centralise the information (and if it is centralised, there would be choices about where). Multiple locations isn’t necessarily a problem, providing that a) information can be found, and b) information can be accessed.

I can understand why government took the “easy” solution of centralising the information within the government - but that doesn’t deal with the reasons not to do that.


#208

There are always options. For the individual, there’s no need to centralise the information. A central access-point would probably be sufficient to make access to the whole more reliable (hopefully reliable enough). The caveat is that every point of communication between systems opens up security holes and points of potential failure.

From a public health perspective, leaving information spread all over the map is going to make analysis and data mining more difficult and less reliable - if it can be done at all. Most of the potential benefit and savings are at the population level, not the individual.

To find out exactly what the term means in this context, you’ll need to read the Deloitte report.


#209

“It’s not surprising that the number of people opting to use these privacy settings is “fewer than 2 out of every 1000 individuals registered,” according to the ADHA.”

I expect that to get much worse once most Australians are default opted in when we get to October.
Basically every record will be wide open. It’s just a question of how many 9s.

“Privacy to pry, however, is assured for the 900,000 people who will have access to your My Health Record. Their names won’t be logged and audited when accessing your record, only their institution’s name.”

These are just the “authorised” people, not the hackers referred to in the article title.


#210

If they’re not tracking activity down to the level of individual operatives, then the system should not be operating. The weakest link is most often the human element.

Ronald’s terrified ex-wife, referred to as “Julie” in this report, was forced to relocate and go into hiding after police officer Senior Constable Neil Punchard accessed the confidential police database, QPRIME, and texted her address to her former husband.


#211

Oops. OK, it’s not the most reputable of sources.


#212

This timely article: http://www.abc.net.au/triplej/programs/hack/privacy-breach-revealed-nsw-health/10062426


#213

“military-grade security” - sorry - it’s on the Internet … it is by definition not military grade … people can spout all the stories they like, but its all b/s - military grade comes nowhere near the Internet, that’s a significant part of the many facets of that level of security …


#214

Shows that, no matter how good they start out, people get lazy. Sadly, MyHealthRecord started out badly.

But the Minister said … :face_with_raised_eyebrow:


#215

The first and most reliable clue about peak dodgy!


#216

The purpose of this system is positive, but those who say the privacy issues are “a storm in a teacup” are not thinking about how the world really works. Criminals are in it for the money. It’s a business. It’s not personal (generally – unless you are someone famous), it’s a matter of return on investment.

Sure, health records are currently held by each and every medical practitioner. So, if you are running a criminal hacking organisation, you would need to hack hundreds of thousands of systems to obtain everyone’s health records. That would cost you a fortune, especially as many of them would sensibly not be on the internet at all, so you would have to physically break in to offices all over the country. Now, you only need to hack one central system. It may not even need to be an external hack. Just find an employee with, say, massive gambling debts, and bribe them to access the system. It’s absolutely worth it for crime syndicates to pour massive resources into penetrating such a system.

I also don’t understand why there is such an obsession with identity theft. Anyone who is paying attention to their credit scores and bank accounts will spot identity theft quickly and have it dealt with. Health records may have way more valuable information. This system never deletes anything until 30 years after your death. You can mark an uploaded item as not to be shared, but you can never actually delete it. Incorrect diagnoses. Incurable diseases. Genetic abnormalities. Mental illnesses. Available in the system for your whole lifetime with no option to delete them.

I opted out on the first day it was possible.


#217

Perhaps you don’t fully appreciate the risks.

Identity theft is not limited to finances. Even there, how do you keep an eye on a bank account or loan that you don’t even know about? There is no limit to what a criminal will do with your life.

Spotting identity theft is one thing; dealing with it is quite another. Even when identity theft is proved, a ruined credit record or reputation won’t necessarily recover - ever. Once the information is in the criminal world, attacks are likely to continue - possibly beyond the grave.

To save a bit of time:




Then, of course, there’s the disturbingly common crime of taking control of property and selling out from under the legitimate owner:




Examples are practically endless, but that’s probably enough for now.


#218

An analogy someone made on another forum relating to the NBN probably seems relevant here, where the initial idea and goal is good, but the implementation is poor.

‘Your boss on the farm you work at says we will get more done if we add another vehicle to the fleet, “tomorrow I’ll go spend 100k on a new Landcruiser”. Tomorrow comes and the boss rolls up with 20 yo Corolla saying he only paid 80k and got a towbar thrown in’.


#219
  1. I totally appreciate the risks. My point was that the levels of damage possible with health records includes identity theft, but also even worse personal risk to some people, so why just concentrate on the (less significant, but still major) identity theft issue. If someone’s identity is used, it’s usually for financial gain and money can be recovered (in many cases). If someone’s health condition is made public, that can never be undone.

  2. I’m not going to read through all your examples, but the Canberra property scam one I’d already read about. She’d been living outside Australia for 12 years and leaving management of her property to a company which she wasn’t in regular contact with. That’s totally within the realm of not paying attention to her finances.


#220

There have been other property scams where you simply go away on holidays for a few weeks.

While away on holidays, someone shows prospective buyers through your house, sells it, and exfiltrates the proceeds from Australia.

The money won’t ever be “recovered”. In the meantime both you and the buyer have a claim on your house. Have fun sorting it out.

I can’t see what steps you can take while on holidays to pay attention to your finances that would avoid this.

Alarms and surveillance cameras in your house perhaps? Is that what My Health Record is bringing us to?

We don’t have to argue about which is the greater damage. It will vary from individual to individual. Both are very unwelcome.