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scruffy1

don't want to make you paranoid, but...

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Posted (edited)

"The Australian Government is expanding My Health Record for all Australians in 2018.

By the end of 2018, a My Health Record will be created for every Australian unless they choose not to have one."

 

up till november, the program will have been opt in

 

then :

Minister makes Rules that apply opt-out model nationally (to begin on a date to be prescribed)Minister makes notifiable instrument before September 2018 prescribing date Part 3 of Rules commences – opt out begins on that dateOpt-out period Begins on 16 July 20183 monthsOpt-out period Ends on 15 October 20184 week Reconciliation PeriodMy Health Records created for all eligible individuals who did not opt-out on 13 November 2018

what does this mean for citizens ?

 

if you don't say no, you said yes - that seems about right, like it works for sexual assault... oh, wait... that isn't how that works these days

 

 

still, if the government wants to fuck you, better bend over

 

 

the feds have spent a lot of money on setting this up, and the public uptake was, to be generous, colder than lukewarm

 

so rather than admit it was less than a great idea, make it 100% popular by default

 

 

 

what are the consequences ?

 

here's the positive spin :

https://www.myhealthrecord.gov.au/for-you-your-family/what-is-my-health-record

 

it has some obvious benefits, although as the "customer" can refuse to have some information uploaded, the record will as a result be less than reliable for health care providers - think : HIV status, drug dependency, STI, mental illness

 

 

here's the clause that makes me worry, which will affect everyone that hasn't consciously said no before the cut off date of 15 october this year, because after that, "you can check out any time you like, but you can never leave" :

 

What happens when you cancel a My Health Record?

When you cancel your record, it means that:

  • Healthcare providers will not be able to upload documents to the record, or access the record - even in an emergency.
  • You, or your representative can only access the record by making a request to us.
  • Once your record is cancelled, it will be retained for a period of 30 years after your death or, if the date of death is unknown, for a period of 130 years after the date of your birth.
  • Your My Health Record may be accessed by us for the purposes of maintenance, audit and other purposes required or authorised by law.

 

especially the underlined bits

 

wow ! just, wow....

 

i note the feds haven't made a lot of noise about the pending change in opt in status (but maybe my lack of tv and radio intake has left me uninformed)

is there any general information being put out ?

 

 

will this include laws yet unimagined ? i'd love to believe their intent is benign, but mr potato head makes me paranoid

 

 

 

so, the choice is yours

 

in a benevolent world populated by rainbows and unicorns, the concept has great promise

 

but in a less perfect world, that promise has about as much reliability as "i won't come in your mouth"

 

 

 

 

 

consider yourselves informed; what you do about the information is your choice, but there is a window, and it will be closed like the ones in an airconditioned government building, before summer

 

this might be worth subscription : https://www.myhealthrecord.gov.au/for-you-your-family/howtos/opt-out

Edited by scruffy1

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This stuff has actually been a long time coming. I went for a job interview probably around the mid 2000s with HIC and they were going on about how it was intended to have everyone's history put online.

 

In theory it should be fairly secure and private - a lot of access is just in the name of generating metadata.

But yeah, in theory as well it could be open to all sorts of abuse like say a prospective employer filtering out appicants who've had certain conditions.

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given my faith in the feds abilities to maintain any coherent level of "privacy", and my increasing suspicion that they will use information to their benefit rather than the public's, there's a lot of potential for misuse

 

this would be the same federal people who were quite willing to put the whole e-contact business of the tga (therapeutic good administration) in the hands of an american firm, until i eventually had them fold after repeated "enlightenment" that they were also placing the opportunity for harvesting quite valuable data in the hands of american isp's, given the then recent rulings over there about "privacy" (or actually lack thereof

 

had they gone ahead, and privacy issues would be only answerable by turning up in person in a local court in bumfuck, illinois (from memory), and under u.s. jurisdiction, at personal expense of the plaintiff

 

eventually they cancelled the idea, but it was almost a year before they did, and despite repeated requests for progress information, i only found out belatedly 2nd hand from another interested party who supported my dissent with the assistance of hs local federal member (mine is tony abbott - say no more as to his usefulness)

 

 

 

i was a member of the original working group on core data set last century, and even back then it was obvious that the concept was complicated; the uk has recently lost interest in their version after several billion pounds went nowhere in making it useful; nz has a workable system using a similar idea, but they don't have state entities to run the public arm of the health system, and i daresay their government is vastly more representative of the populace than the idiots we seem to promote here

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Overall statistical data is not really any problem - it can even lead to beneficial results like deciding which successful new drugs to go on the PBS, and whether to buy more of certain types of equipment.

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what's to say the 'solid' info of someone's health records gained, is actually factual ? What company is gonna be responsible for the gathering of data ? The same one that did the census and centrelink ?

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The data is already there... the nightmare would be getting it in one place in digital form.

 

The thing I'm curious about though is how the hell OCR or humans are going to recognise 10 year old scribble. I suspect old paper records will just be stored as bitmaps.

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They create this myhealth, suck everyone into the system and then ...sell it for a fortune.

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"The thing I'm curious about though is how the hell OCR or humans are going to recognise 10 year old scribble."

 

That'll go in the too hard basket and be determined unnecessary ;)

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Posted (edited)

very few practices still use paper

 

i can admire the virtue of digital records; we use one of the better options, and even that is remarkably clumsy unless you are either totally ocd , or have a good memory for your patients

 

 

i'm pretty ocd (most successful clinicians are), but i have an excellent memory for trivia

 

sadly tough, i am into visual recognition, so names on files mean very little to me until i view the subject's face most times, then i can usually recall most of the back story

 

 

 

an online record will have some useful thing - allergies / medications / important past illnesses, but because it is still at the patient's discretion what goes in, it will be haphazard

 

and because it is a true g.i.g.o. system, it will be bloated with lots of useless shit too

Edited by scruffy1

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My doc up here uses paper. I would suppose a digital record also, but paper files are fully in evidence across the whole wall behind the receptionist.

 

" but because it is still at the patient's discretion what goes in, it will be haphazard " << is what I had in my mind, and given the general incompetence of bureaucracy I'd say there's a good chance the facts of the recordings

will be questionable to say the least.

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12 months ago i would be paraniod and not want my data stored

now though, it is easier fir me if each clinic i attend has the information in front of them

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i agree it has merit as a pure idea

 

i myself have enough medical background to have some benefit in keeping the information collated for future reference

 

 

but in an increasingly fascist environment, knowledge is power, and my faith in the "goodness" of government is pretty jaded

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The concept is fine, but what they (our Ze government) do with that information is completely different matter.

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The data is already there... the nightmare would be getting it in one place in digital form.

 

The thing I'm curious about though is how the hell OCR or humans are going to recognise 10 year old scribble. I suspect old paper records will just be stored as bitmaps.

 

Documents like this already are.

I'm not one for those 'when I was working here' type stories, but I actually have one :)

 

When I was working for a government agency, one area I had to help out was Adoption Services.

Without bothering to go into detail on the odd security that was;

"blur the screen please" *turns dial* when looking at scans, "This security guard will escort you" when walking through the building... etc (Treasury, and Dept Child Safety was less secure!)

What I was there for, was to try and fix (and i did! :D) a Microfilm scanner.

 

This thing was neat, it had it's own SCSI card, and dumped massive (99% quality) JPEG's, at the rate of literally hundreds per second.

You'd load up the microfilm.

You'd select the Baud Rate that the SCSI and Scanner could both manage.

You'd look up the human, and get a reference number.

You'd load up that roll of film, and turn the dial for "start" and "end" frame, of the film.

And you'd click 'scan'.

 

Before I knew how to limit it, I'd scanned a roll in like 35 seconds flat.

We're talking GB's of data, countless images, all in near full quality JPEG (as full quality as JPEG gets, you CAN select bitmap, but it was unneeded)

 

These scans were all the signed documents from dropping off\picking up people in the adoption service.

All hand written, all in various states of neat vintage paper rot, but all more than readable at what I could only describe as "Fuck off, that's a lot!" DPI, at 99% quality.

 

I was amazed by how cool microfilm was!

 

Also, tldr;

Yes, they'll number you and scan all your doctor scribble.

Gotta remember; 'Stored Digitally' does not inherently, mean 'Searchable'.

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This system is still haphazard and will be for a long time. Not only were they having massive problems getting customers/patients to opt in, but most surgeries, GPs, medical practices and pathology services's computer systems still aren't compatible with it so that data remains individual to the particular address it was generated at.

 

I used to go to four separate GPs, two near work and two near home. Plus we moved house 4 times in the last 3 years so I went to 3 more GPs either for myself or someone in the fam. So a few years ago I opted in, but pretty much the ONLY of my data uploaded into the system were bits of info pertaining to Medicare payments. If I had a test that was paid for by Medicare, that test and the treating doc's name were uploaded. As for the rest of my medical records: Nup, there are still at least 8 sets of them in 8 separate locations.

 

So as far as functioning for what it's intended for, the system is still near useless.

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They have to start somewhere - like I said, it's been in the pipeline a real long time. It's probably only recently that it's actually viable to store massive amounts of un-OCR'd scanned documents.

A kludge for sure since you can't do a text search or use them very well for statistics but still way easier than having to get physical records sent or faxed from one place to another.

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Oh don't get me wrong, I think there's a net benefit in the system, as long as identifiable data doesn't get turned over to third parties like other government departments, private insurers or employers. But it's taking AAAAGGGESSSS to get a usable amount of data into the system or a decent amount of providers or patients on board.

 

A couple of my friends actually made decent money literally just walking around and signing people up to opt in by explaining what it is and what the benefits are. If they made their quota of 100 paper applications per day they go a bonus. That was years ago and it's STILL not big enough to be useful.

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Oh don't get me wrong, I think there's a net benefit in the system, as long as identifiable data doesn't get turned over to third parties like other government departments, private insurers or employers. But it's taking AAAAGGGESSSS to get a usable amount of data into the system or a decent amount of providers or patients on board.

 

A couple of my friends actually made decent money literally just walking around and signing people up to opt in by explaining what it is and what the benefits are. If they made their quota of 100 paper applications per day they go a bonus. That was years ago and it's STILL not big enough to be useful.

 

Yeah but if you've worked government, you'd know security is not the best.

 

2nd story time, and I swear 100% true.

I was helping someone in the Treasury, lets call her 'Anne'.

 

Anne was in her 70's, and about 10 years ago she ticked "Save My Password" in the custom Treasury software.

She had denied all PC updates, as she only used ONE application, and this one "had all her passwords on it".

As Windows XP moved away for windows 7 (non-optional) she had to change PC's.

 

I found her in tears, because she was unable to work; she didn't know any of her logons. (FUCK! This is going to be a drama.)

So I call the Treasury Support line (we were simply contracted to help).

 

"Hi, My name is MS, I'm here with Anne, and she's forgotten all her passwords. What do you need to reset those? Supervisor request? Photo ID? She's upset and I want to get this sorted for her"

"Hi MS, just hold on for one minute."

....one minute passes...

"Ok, Her passwords are cat, dog, mouse" (not literally, but they were basic non-secure words).

"Neat, thank you, and she'll have to change those?"

"No, those are what they were"

........Oh.....

 

So now we know 3 things.

1. They just gave someones high level access passwords to someone on the phone, who has not proven their identity.

2. They do NOT require any sort of password length or complexity.

3. The passwords are stored in plain text because he was able to read them back to me!!!!

 

Good god.

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presently medical records have a mandatory retention of 7 years, or for minors, 7 years after then become majors, which is defined as 18 years old

 

thereafter, paper records were routinely purged, and even records only a few years old were moved to storage, which was often at a different physical location

 

 

 

despite the feds enthusiasm, no-one has educated us (the interface) with where the info will actually "happen"

 

equally, from a medico-legal standpoint, as the receivers of information, we are supposed to instantaneously "know" the content and thus take on the responsibility for any failure in assimilating it into a current issue, even though it may be from years ago and not actually ever told to us personally

 

 

 

thus we are currently not inclined to have patients hand us an old pile of notes should their previous gp retire, or they simply choose us - either it's a simple summary (which might be the myhealth idea), or we require them to sit in on a paid consult to sift through wheat is often a large amount of mostly irrelevant data

 

 

like other paperwork, the insinuation that "well, can't you do that in your spare time" neglects the reality that as a busy gp, i don't have spare time, and if i do, it's MY time, not for more unpaid workload, of which there is already plenty (checking results, reading replies to referral letters and formulating a plan for care)

if people complain, i usually check their occupation, and suggest that they might barter - "oh, i see you're a senior chef... i'll do it while you rip round to my place and prepare dinner for me..."

 

 

 

when we were first dong work on the "core data set", it was clear that the useful things would be - age / sex / names / allergies / current (and past) medication / known illness / surgical procedures / injuries / any old pathology and investigations (pure data, not rambling notes) / concise reports from senior parties

 

even wrt pathology - numerous providers mean comparison of cumulative numbers is nigh on impossible - the data isn't granular or even often showing prior results from the same lab on the current sheet

 

 

all that stuff WOULD be useful, and even moreso if the medical record in the gp rooms was a standardised interface - which it isn't; swap practice and you may have a whole new system to comprehend - not unlike windoze . mac . linux... not dissimilar, but nothing like "the same"

 

 

enough ! it's my day off, and i don't really need the aggravation of a reasonable concept delivered with all the rationality of a tony abbott speech

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I was amazed by how cool microfilm was!

Film in general is pretty awesome.

 

Kodachrome-64 colour slide film is estimated to yield something like 50MP of resolution, and archival microfilm goes well beyond that.

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I was amazed by how cool microfilm was!

Film in general is pretty awesome.

 

Kodachrome-64 colour slide film is estimated to yield something like 50MP of resolution, and archival microfilm goes well beyond that.

 

 

I'd believe that.

 

We had A4 paper blown up to what must be bilboard size by default (accidentally), and it was clear as anything!

Just, my god!

I haven't seen a SCSI card for years.....

 

Yeah, it was amazingly cool to see such fast data transfer on such archaic hardware. I'd never have expected it.

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So now we know 3 things.

1. They just gave someones high level access passwords to someone on the phone, who has not proven their identity.

2. They do NOT require any sort of password length or complexity.

3. The passwords are stored in plain text because he was able to read them back to me!!!!

 

Good god.

 

 

That's insane. I mean I know a lot of support people are just too lazy/bored/untrained to withstand some of the more sophisticated social engineering tactics, but that's just INSANE.

 

all that stuff WOULD be useful, and even moreso if the medical record in the gp rooms was a standardised interface - which it isn't; swap practice and you may have a whole new system to comprehend - not unlike windoze . mac . linux... not dissimilar, but nothing like "the same"

 

 

Come to think of it, it sounds like they should have set interface standards for retail medical record software before they tried to implement the MyHealth system. Otherwise, what's the point?

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Come to think of it, it sounds like they should have set interface standards for retail medical record software before they tried to implement the MyHealth system. Otherwise, what's the point?

 

 

 

 

 

 

aye, there's the rub

 

but that's like telling macs amd windoze and linux and android (add any o.s. you like) to co-operate

 

the differences between systems are their sales point, and like the white world of i-things, the idea is to lock you into a system that isn't easily swapped, without impossible extra expense

 

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