Thread by @stilgherrian

This is about 10 minutes away. I’ll be watching, and may tweet a few random bits and pieces. #MyHealthRecord

https://twitter.com/stilgherrian/status/1041512421142085632

I can hardly wait. #MyHealthRecord

The problem with watching on Parlview is that it’s a few minutes behind real time, because of the cleverness. The direct stream at aph.gov.au/Watch_Read_Lis… is less bad, but doesn’t have the cleverness. #MyHealthRecord

Here we go. First up is @paul_shetler, former head of the Digital Transformation Office (DTO). He’s been critical of the whole thing. innovationaus.com/2018/07/Shetle… #MyHealthRecord

@paul_shetler Shout-out to @trentyarwood’s FOI request. #MyHealthRecord

@paul_shetler Shetler is speaking very confidently on why people are being “dragooned” into using MHR. Because nobody wanted it. If it were something people wanted it, they’d flock to it. #MyHealthRecord

Senator Singh is asking Shetler about doctors being paid. She is clearly unaware of the eHealth Practice Incentives Program (ePIP). en.wikipedia.org/wiki/Personall… #MyHealthRecord

Shetler: “It is shocking how bad the access control is” on My Health Record. Gosh. #MyHealthRecord

Next up: Consumers Health Forum of Australia, with CEO Leanne Wells and Digital Health Adviser Dean Hewson. #MyHealthRecord

Wells is repeating the usual anecdata about people finding MHR useful, but dismisses concerns for misuse as “potential”. Says that on balance it’s of benefit for the community, but doesn’t explain how that balance was calculated. #MyHealthRecord

Wells asks for every household be sent a letter outlining the benefits and privacy controls of MHR. [Why wouldn’t it also explain the risks, so they can make an informed choice?] #MyHealthRecord

Senator Martin is all about the dixers. #MyHealthRecord

Wills is “quietly confident” that there’s enough privacy protection and sanctions against misuse, but again she’s not saying how she’s reaching that conclusion. I assume it’s because there’s a high enough count of reassuring words. #MyHealthRecord

Senator Keneally is exploring the Forum’s contractual arrangements with ADHA, which I’ll have to re-listen to later because it strikes me as quite curious. #MyHealthRecord

Wills describes as “unfortunate” the “public discourse” that ended up being about privacy concerns. Curious language. #MyHealthRecord

Thanks for the details. #MyHealthRecord

https://twitter.com/pagedaemon/status/1041581246319538176

Bells for a Senate division! Committee adjourned for a few minutes. #MyHealthRecord

And we’re back. #MyHealthRecord

Senator Keneally asks about privacy and controls re 14–18yos. Wills says the Forum hasn’t been tracking that, and is now waffling some generalities. #MyHealthRecord

Next up is @GrahameGrieve of Health Intersections Pty Ltd. His submission is interesting. He’s calling for a different kind of system. healthintersections.com.au/?p=2850 #MyHealthRecord

Grieve is basically saying that MHR is the state of the art from some years back, and that it hasn’t kept up with what consumers now expect, e.g. Apple's use of the health info framework. Access controls are “poor”. #MyHealthRecord

Grieve has been calling for a federated framework based on more recent technical standards. He’s now explaining that to the committee chair. #MyHealthRecord

Important clarification here. Omitting mention of the risks was just an impromptu slip by Wills. The submission has it right. #MyHealthRecord

https://twitter.com/deanhewson/status/1041586896676184064

He’s struggling with it. I don’t envy him having to explain federated services to the senators. #MyHealthRecord

Senator Gichuhi is now asking questions about the federated structure. This is all a bit of a mess now. No one is the wiser. #MyHealthRecord

Senator DiNatale asks whether protecting privacy is the main reason for going federated. Grieve is saying his main concern is that it’s a better platform for building services. He’s losing his audience here. #MyHealthRecord

Oh dear God. DiNatale is asking whether 2-factor authentication would help here. Grieve is not clarifying things. Everything is now terrible. #MyHealthRecord

AAAAARRRRGGGHHHH!!! #MyHealthRecord

Next up, for reasons that are not entirely clear to me, a bunch of unionists. #MyHealthRecord

Ah, amongst other things, ACTU is concerned about how employer-nominated doctors might access data, and a bunch of other issues related to individual privacy. HSU same. ETU same. #MyHealthRecord

Think about access by doctors chosen by WorkCover insurers, or about pre-employment health checks. #MyHealthRecord

Trevor Gauld, National Policy Officer of the Electrical Trades Union, is quite well briefed on this, and is putting his case well. #MyHealthRecord

Senator Martin asks how they know the Healthcare Identifiers Act wouldn’t prevent this sort of thing. HSU rep says “It’s happening now.” There follows an interesting discussion on how this sort of dodginess is done. #MyHealthRecord

A lot of the answers to at least some of these concerns seems to be just writing the restrictions into black-letter law,. There are certainly gaps here. I look forward* to hearing from the lawyers after the dinner break. #MyHealthRecord

The discussion is digging down into the weeds of what constitutes consent to access a record, and what is “work related”, and so on. #MyHealthRecord

The Senate committee has adjourned for a 30-minute dinner break. Back at 1900 AEST. #MyHealthRecord

I should mention again that I’m tweeting the Senate Community Affairs References Committee’s hearing on the My Health Record system. Program at aph.gov.au/Parliamentary_…. Two hours left, from 1900 to 2100 AEST, with some of the best to come. #MyHealthRecord

When I say “best”, I say so in the way that connoisseurs of Senate committee hearings tend to view things. #MyHealthRecord

Meanwhile, I’m enjoying the Senate’s lovely Aussie on-hold music, aph.gov.au/Watch_Read_Lis… #MyHealthRecord

Senator Siewert is waiting for quorum. Some senators are a bit slow getting back from dinner, it seems. #MyHealthRecord

Next up, a bunch of lawyers. Names are not all as advertised. Check Hansard later. #MyHealthRecord

Tom Ballantyne is outlining concerns similar to those the unions outlined before dinner. Say the law as written does not restrict access as it should. #MyHealthRecord

Thanks to the ParlAV team for getting the names of the Law Council representatives up nice and quickly. #MyHealthRecord

Balies is reading a prepared statement. I’ll grab a copy from @thelawcouncil in the morning. Plenty of commentary on the problematic definition of “parental responsibility”. #MyHealthRecord

@thelawcouncil A full submission is yet to come from @thelawcouncil. #MyHealthRecord

@thelawcouncil A lot seems to hinge on section 14 of the Healthcare Identifiers Act 2010. austlii.edu.au/cgi-bin/viewdo… #MyHealthRecord

Oops. Earlier up I may have attributed some of Senator Watt’s comments to Senator Martin. #MyHealthRecord

As you might expect, this is quite a technical discussion about legislation. Although as noted here it’s straying from where it should be focused. #MyHealthRecord

https://twitter.com/quarterpipe/status/1041621673873555456

Next up, the government representatives. And there’s quite a few, from Dept Health, ADHA, and OAIC. #MyHealthRecord

Senator Siewert vs the assembled witnesses. #MyHealthRecord

Hmmm. Falk is reading out a prepared statement, which so far is a bunch of background that has already been widely reported. #MyHealthRecord

Senator Watt starts off by asking ADHA how many people have opted out. They don’t have all the numbers, because some are on paper, but... #MyHealthRecord

Kelsey: As of 12 Sept, the opt-out by internet or call centre is around 3%, which translates to around 900,000 individuals. This does not include paper opt-out forms. #MyHealthRecord

Kelsey says this is [my paraphrase] in line with expectations and international experience, e.,g. UK and Austria. #MyHealthRecord

ADHA says so far 830 public hospitals are connected, and will have 75% by end of Sept, and all but Vic and SA completed by end of year. As for private, 178 are connected, that’s around 50%. Some of those include multiple facilities. #MyHealthRecord

The difference? Public hospitals started investing earlier. Private hospitals generally started around two years ago, the tipping point being the change to opt-out. #MyHealthRecord

Discussion now as Senator Watt tries to understand what that 3% is of. Anyone eligible for a Medicare card, which is citizens and some resident and the like. A total of $28 million, says Kelsey. #MyHealthRecord

On access controls, 16,848 record access codes have been set, and 4,109 limited document access codes. Sign-ups for email or SMS notification when documents are accessed is 136,644. #MyHealthRecord

These figures are as of 9 Sept. #MyHealthRecord

Kelsey says that since the start of the opt-out period, 181,000 have opted IN. ADHA was expecting more people to opt out than actually are. #MyHealthRecord

While I wouldn’t characterise it as “fear-mongering”, it’s certainly fair to say that either the lobbyists didn’t reach the audience they’d hoped, or didn’t persuade. #MyHealthRecord

https://twitter.com/KateMcDawdle/status/1041628202517450753

Mind you, they don’t have millions of dollars for advertising. #MyHealthRecord

Kelsey and his team are giving a bunch of data about awareness of MHR, and the privacy settings. Will go through that tomorrow, because it’s a bit confusing right now. Questions in the survey will be tabled. #MyHealthRecord

In amongst that, Kelsey is trying to emphasises that AHDA is listening to the criticisms and suggestions. Am I correct in thinking he sounds less combative than previously? #MyHealthRecord

Details of the communications campaign have just been given. Check the recording from, say, 2010 AEST. #MyHealthRecord

Oops. My livestream just shat itself. #MyHealthRecord

Here we go. I missed a bunch of stuff about access controls there in response to questions from Senators Watt and DiNatale, #MyHealthRecord

Senator DiNatale is persisting with questions about the privacy defaults and the move to opt-out, and how the results of the original MHR trial are perhaps not relevant given the landscape has changed. #MyHealthRecord

Senator SIngh is trying to dig out whether Dept Health prepared a business case for MHR. It”’s being deflected as a cabinet thing. Singh has learned there’s a “work plan” for ADHA. #MyHealthRecord

We have established that there is not a document with the title “Business Case”. There is a work plan called the Work Plan in some way. It has been agreed to by the COAG health council. #MyHealthRecord

I’m not sure where this is going. #MyHealthRecord

OK, Singh is putting it bluntly. Is there a current business case for My Health Record? No, apparently. Senator Gichuhi is trying to run interference but Singh is batting her down. #MyHealthRecord

Kelsey says a blunt “No” in response to whether there’s any commercial arrangements for the use of data, or even any enquiries about commercial use. #MyHealthRecord

This discussion of the Secondary Use Framework is curious. The governance processes won’t be in place to at least 2020, it’s all “We expect” and ”It is not envisaged”. But the Framework is just a policy document. #MyHealthRecord

BELLS! They’ll extend past 2100 AEST to take account for the time of this Senate division. #MyHealthRecord

Yes, this took WAY longer than it should have. #MyHealthRecord

https://twitter.com/KateMcDawdle/status/1041635768811216896

We’re back. We’re extending to 2108 AEST. #MyHealthRecord

The “no commercial use” restriction is being misrepresented. It’s that it can’t be used PRIMARILY for commercial use. #MyHealthRecord

Senator Watt is exploring this. The response does point to the process in the Secondary Use Framework. #MyHealthRecord

How can they confidently talk about it being a “rigorous framework” when the processes and the data governance board won’t even be in place until 2020? #MyHealthRecord

More easy questions from Senator Steve ‘Dixer’ Martin (Nationals, Tasmania). #MyHealthRecord

Finally some numbers! From ADHA: Each year there’s some 2000 deaths due to [was it?] lack of information on medications and allergies. [Check this!] Also some mention of evidence from Austria. #MyHealthRecord

The Privacy Commission is now running through some stats on notifiable data breaches. I won’t tweet the numbers, they’re coming a bit fast, and I’ll have to check against previously released numbers. Tomorrow. #MyHealthRecord

In response to a Q from Senator Gichuhi, there’s nothing authorising ADHA to charge for secondary use of data. “Nothing has been envisaged or ever been discussed” in relation to that. #MyHealthRecord

Senator Watt is digging into the secondary use restrictions. Now he’s referring to @VTeagueAus’s research on re-identifying medical data. #MyHealthRecord

@VTeagueAus ADHA has batted them away, or tried to. They’e changed the way they do it, and in any event it “wasn’t easy” to re-identify. Uhuh. #MyHealthRecord

And after a quick CORRECTION from Kelsey on the budget for the ADHA comms spend, that’s it. Thank you, linesmen. Thank you, ball boys. There ends the Senate Community Affairs References Committee for tonight. My report at @zdnetaustralia tomorrow some time. #MyHealthRecord

@zdnetaustralia Whisky now. #MyHealthRecord