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Health Check: how long should you stay away when you have a cold or the flu?



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Symptoms of the flu generally develop more quickly and are more severe than the common cold.
By txking/Shutterstock

Nadia Charania, Auckland University of Technology

Most adults get around two to three colds a year, and children get even more. In terms of the flu, there are around 3-5 million severe cases of influenza worldwide each year and 290,000 to 650,000 deaths.

The symptoms of a cold and the flu are similar, so it’s hard to tell the difference. But the flu is usually more severe and develops more quickly than a cold.

Colds and flus can be easily passed from person to person through the air, when an infected person coughs or sneezes, and touch, when a person touches an infected surface or object like doorknobs and light switches.

So what’s the difference between colds and flus, and how long should you stay away?

Colds

Cold symptoms include a sore throat, cough, runny or stuffy nose, tiredness and headache.

Most people become contagious with cold symptoms one to two days after exposure to a cold virus. These symptoms usually peak two to four days later. The common cold usually lasts about ten days.




Read more:
I’ve always wondered: why is the flu virus so much worse than the common cold virus?


There is nothing you can take to shorten the duration of a cold, and most people will get better without needing to see a doctor. But some over-the-counter medications can help alleviate the symptoms. These include anti-inflammatories (to reduce inflammation or swelling), analgesics (to reduce pain), antipyretics (to reduce fever) and decongestants (to relieve nasal congestion).

But be careful you follow the instructions and recommended dosage for these medications. A recent study of US adults who used paracetamol, the active ingredient in many cold and flu medicines, found 6.3% of users exceeded the maximum recommended daily dose. This mostly occurred during the cold and flu season.

For your own and others’ health, the best place for you to be when you’re sick is at home.
Shutterstock

Natural products such as vitamin C and echinacea are sometimes recommended to prevent and treat a cold, but there is limited evidence to support their effectiveness.

The flu

Common symptoms of the flu include fever (a temperature of 38°C or higher), cough, chills, sore throat, headache, runny or stuffy nose, tiredness and muscle aches.

An infected person can spread the flu for five to seven days after becoming infected. The infectious period can begin 24 hours before the onset of symptoms. This means you can spread the flu without even knowing you’re sick.

Influenza viruses can cause mild to severe illness in people of all ages. Most people will fully recover within one to two weeks and won’t require any medical attention. Similar to a cold, people can take some over-the-counter medications and other remedies to help alleviate symptoms.




Read more:
Explainer: what’s new about the 2018 flu vaccines, and who should get one?


But some people can become acutely unwell with the flu. They may require antiviral medication and, in severe cases, hospitalisation. Those at high risk include pregnant women, children, the elderly, and people with certain medical conditions such as HIV/AIDS, asthma, diabetes and heart and lung diseases.

The flu virus strains that circulate usually change every year, so the best way to prevent getting the flu is to get the annual flu vaccine. The vaccine is moderately effective and recommended for adults and children over the age of six months. Some common side effects may occur, such as temporary soreness, redness and swelling at the injection site, fever, headache, muscle aches and nausea.

Wash with soap for at least 20 seconds to kill the germs.
Shutterstock/Alexander Raths

Avoid passing it on

If you feel unwell, stay home from work or school and rest (and get plenty of fluids) until you feel better. If you’ve had a fever, stay home for at least 24 hours after the fever has broken.

When you go back to work or school, you may still be infectious, so avoid passing the virus on by:

  • regularly washing your hands with soap and water for at least 20 seconds and drying them properly – if soap and water are not available, use an alcohol-based hand sanitiser

  • practising good cough and sneeze etiquette: cover your mouth and nose with a tissue or your upper shirtsleeve when you cough or sneeze, and throw away used tissues immediately

  • not touching your eyes, nose and mouth

  • The Conversationfrequently cleaning the surfaces and objects you’ve touched.

Nadia Charania, Senior Lecturer, Public Health, Auckland University of Technology

This article was originally published on The Conversation. Read the original article.

Health Check: should I take vitamin C or other supplements for my cold?



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Once you have a cold, taking vitamin C supplements won’t do anything.
From shutterstock.com

Clare Collins, University of Newcastle

Last week I had a shocking cold. Blocked nose, sore throat, and feeling poorly. This made me think about the countless vitamins and supplements on the market that promise to ease symptoms of a cold, help you recover faster, and reduce your chance of getting another cold.

When it comes to the common cold (also called upper respiratory tract infections) there is no magic cure (I wish) but some supplements may deliver very minor improvements. Here is what the latest research evidence says.




Read more:
Health Check: can you treat the common cold?


Vitamin C

For the average person, taking vitamin C does not reduce the number of colds you get, or the severity of your cold.

In terms of how long your cold lasts, some studies have looked at people taking vitamin C every day, while others have focused on participants taking it once they develop a cold.

In 30 studies comparing the length of colds in people regularly taking at least 200 milligrams of vitamin C daily, there was a consistent reduction in the duration of common cold symptoms.

However, the effect was small and equates to about half a day less in adults, and half to one day less in children. These types of studies also found a very minor reduction in the amount of time needed off work or school.

Among studies where vitamin C was only started once a cold had developed, there was no difference in duration or severity of a cold.

There are some risks to taking vitamin C supplements. They can increase the risk of kidney stones in men, and shouldn’t be taken by people with the iron storage disease haemochromatosis, as vitamin C increases iron absorption.




Read more:
Feeling worn out? You could have iron overload


Special considerations

Although in the general population vitamin C has no impact on the number of colds people get, there is an exception. For people who are very physically active – such as marathon runners, skiers and soldiers exercising in very cold conditions – vitamin C halved their chance of getting a cold.

Many people take vitamin C supplements in hope it will treat their cold.
From shutterstock.com

A few studies have also found some benefit from vitamin C supplements of at least 200 milligrams a day for preventing colds among those with pneumonia.

However, taking vitamin E supplements in combination with a high intake of vitamin C from food markedly increased the risk of pneumonia.

Zinc

A review of studies testing zinc supplements in healthy adults found starting daily supplements of at least 75 milligrams within 24 hours of the onset of a cold shortened the duration by up to two days or by about one-third. It made no difference to the severity of the cold.

There was some variability in the results across trials, with insufficient evidence related to preventing colds. Researchers suggested that for some people, the side effects such as nausea or a bad taste from zinc lozenges might outweigh the benefits.

Take care to stop zinc supplements as soon as your cold resolves because taking too much zinc can trigger a copper deficiency leading to anaemia, low white blood cell count, and memory problems.

Garlic

Only one study has tested the impact of garlic on the common cold. Researchers asked 146 people to take garlic supplements or a placebo daily for 12 weeks. They then tallied the number and duration of their colds.

The group that took garlic reported fewer colds than those who took the placebo. The duration of colds was the same in both groups, but some people had an adverse reaction to the garlic, such as a rash, or found the garlic odour unpleasant.

Because there is only one trial, we need to be cautious about recommending garlic to prevent or treat colds. We also need to be cautious about interpreting the results because the colds were tracked using self-report, which could be biased.




Read more:
Science or Snake Oil: will horseradish and garlic really ease a cold?


Probiotics

In a review of 13 trials of probiotic supplements that included more than 3,700 children, adults and older adults, those taking supplements were less likely to get a cold.

Their colds were also likely to be of shorter duration and less severe, in terms of the number of school or work days missed.

There is some evidence that probiotics, which can be found in yoghurt, may reduce the incidence of colds.
From shutterstock.com

Most supplements were milk-based products such as yoghurt. Only three studies used powders, while two used capsules.

The quality of the all the probiotic studies, however, was very poor, with bias and limitations. This means the results need to be interpreted with caution.

Echinacea

Echinacea is a group of flowering plants commonly found in North America. These days you can buy echinacea products in capsules, tablets or drops.

A review of echinacea products found they provide no benefit in treating colds. However, the authors indicated some echinacea products may possibly have a weak benefit, and further research is needed.

Chicken soup

Yep, I’ve saved the best until last.

In a novel experiment on 15 healthy adults, researchers measured the participants’ nasal mucus flow velocity – our ability to break down and expel mucus to breathe more clearly. They tested how runny participants’ noses were after sipping either hot water, hot chicken soup or cold water, or sucking them through a straw.

Sipping hot water or chicken soup made participants’ noses run more than cold water, but sipping chicken soup worked the best. The researchers attributed this to the chicken soup stimulating smell and/or taste receptors, which then increased nasal mucus flow.

Another study on chicken soup found it can help fight infection and recovery from respiratory tract infections.

The ConversationOther researchers have shown comfort foods, such as chicken soup, can help us feel better.

Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle

This article was originally published on The Conversation. Read the original article.

A strong immune system helps ward off colds and flus, but it’s not the only factor



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Winter bugs are impossible to escape.
Shutterstock

Hui-Fern Koay, University of Melbourne and Jesseka Chadderton, University of Melbourne

It’s peak flu season. You’re cold, rugged up and squashed on public transport or in the lift at work. You hear a hacking cough, or feel the droplets of a sneeze land on your neck. Will this turn into your third cold this year?

No matter how much we try to minimise our exposure to respiratory viruses, it’s far more difficult in winter when we spend so much time in close proximity to other people.

On top of this, viruses tend to be more stable in colder and drier conditions, which means they stick around longer.




Read more:
Health Check: how long should you stay away when you have a cold or the flu?


The common cold is caused by more than 200 different viruses, the most common of which are rhinoviruses (rhino meaning nose). Rhinovirus infections tend to be mild; you might get a sore throat and a head cold lasting just a few days.

Influenza, or the flu, is generally caused by type A or B influenza viruses. The flu is far more aggressive and often includes a fever, fatigue and body aches, in addition to all the classic cold symptoms.

The flu tends to be more severe than the common cold.
healthdirect

When it comes to getting sick, there’s always an element of bad luck involved. And some people, particularly those with young children or public transport commuters, are likely to come into contact with more viruses.

But you may have noticed that illness often strikes when you’re stressed at work, not sleeping properly, or you’ve been out partying a little too much. The health of our immune system plays an important role in determining how we can defend against invading cold and flu viruses.

How the immune system fights viruses

Your skin and saliva are key barriers to infection and form part of your immune system, along with cells in every tissue of your body, including your blood and your brain.

Some of these cells migrate around to fight infection at specific sites, such as a wound graze. Other cells reside in one tissue and regulate your body’s natural state of health by monitoring and helping with the healing process.

The cells that make up your immune system need energy too, and when you’re low on juice, they’ll be on low-battery mode. This is when our natural immune defences are weakened and normally innocuous bugs can begin to cause strife.

Our immune system requires a lot of energy to defend our bodies. Feeling tired and achy, overheating, and glands swelling are all signs that our immune system is busy fighting something.




Read more:
Explainer: how does the immune system work?


Boosting our natural defence system

Our immune system has evolved to naturally detect and eliminate viral infections. And we can actively strengthen our immunity and natural defences by looking after ourselves. This means:

  • getting adequate sleep. Sleep deprivation increases the hormone cortisol, which suppresses immune function when its levels are elevated

  • exercising, which helps the lymphatic system, where our immune cells circulate, and lowers levels of stress hormones

  • eating well and drinking enough water. Your immune system needs energy and nutrients obtainable from food. And staying well hydrated helps the body to flush out toxins

Good food feeds your immune system.
Anna Pelzer
  • not smoking. Smoking, or even secondary smoke, damages our lungs and increases the vulnerability of our respiratory system to infection.



Read more:
Health Check: should I take vitamin C or other supplements for my cold?


Educating our immune system

Natural defences aren’t always enough to keep us safe and we need the help of flu vaccinations.

Vaccines are designed to educate an army of B and T cells which make up your adaptive immune system. This arm of your immune system learns by exposure and provides long-term immunity.

These T and B cells need a bit of time from the initial influenza exposure before they can be activated. This activation lag time is when you feel the brunt of the flu infection: lethargy, body aches, extreme fatigue and unable to get off the couch for a day or two.

To overcome this delay and protect people before they are exposed to potentially harmful flu strains, flu vaccination introduces fragments of the influenza virus into the body, which acts like prior exposure to the bug (without actual infection).

You can still get the flu if you’ve been vaccinated but you might not get as sick.
VGstockstudio/Shutterstock

Seasonal vaccines are designed to match currently circulating strains and target those strains before you’re infected.

You can still catch the influenza virus if you are vaccinated. But because of this pre-education, the symptoms will likely be milder. The immune system has been trained and the army of B and T cells can move into action quicker.

Already have a cold or the flu?

If you’ve been sniffling and sneezing your way through winter, be comforted by the fact that these bugs are strengthening your immune system. Our body remembers the particular strain of rhinovirus or influenza we get, so it can recognise and mount a stronger defence if we encounter it again.


The Conversation


Read more:
Explainer: what’s new about the 2018 flu vaccines, and who should get one?


Hui-Fern Koay, Research Fellow in Immunology, University of Melbourne and Jesseka Chadderton, PhD Candidate, University of Melbourne

This article was originally published on The Conversation. Read the original article.

‘Use this app twice daily’: how digital tools are revolutionising patient care



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New electronic devices are being used by people of all ages to track activity, measure sleep and record nutrition.
Shutterstock

Caleb Ferguson, Western Sydney University; Debra Jackson, University of Technology Sydney, and Louise Hickman, University of Technology Sydney

Imagine you’ve recently had a heart attack.

You’re a lucky survivor. You’ve received high-quality care from nurses and doctors whilst in hospital and you’re now preparing to go home with the support of your family.

The doctors have made it clear that the situation is grim. It’s a case of: change your lifestyle or die. You’ve got to stop smoking, increase your physical activity, eat a healthy balanced diet (whilst reducing your salt), and make sure you take all your medicine as prescribed.




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But before you leave the hospital, the cardiology nurse wants to talk to you. There are a few apps you can download on your smartphone that will help you manage your recovery, including the transition from hospital to home and all the health-related behavioural changes necessary to reduce the risk of another heart attack.

Rapid advancements in digital technologies are revolutionising healthcare. The benefits are numerous, but the rate of development is difficult to keep up with. And that’s creating challenges for both healthcare professionals and patients.

What are digital therapeutics?

Digital therapeutics can be defined as any intervention that is digitally delivered and has a therapeutic effect on a patient. They can be used to treat medical conditions in a similar way to drugs or surgery.

Current examples of digital therapeutics include apps for managing medications and cardiovascular health, apps to support mental health and well being, or augmented and virtual reality tools for patient education.

Paper-based letters, health records, prescription charts and education pamphlets are outdated. We can now send emails, enter information into electronic databases and access electronic medication charts.

And patient education is no longer a static, one-way communication. The digital revolution facilitates dynamic and personalised education, and a two-way interaction between patient and therapist.

How do digital therapeutics help?

Digital health care improves overall quality of care, even in cases where a patient lives hundreds of kilometres away from their doctor.

Take diabetes for example. This condition affects 1.7 million Australians. It’s a major risk factor for developing cardiovascular disease and stroke. So it’s important that people with diabetes manage their condition to reduce their risk.

A recent study evaluated a team-based online game, which was delivered by an app to provide diabetes self-management education. The participants who received the app in this trial had meaningful and sustained improvements in their diabetes, as measured by their HbA1c (blood glucose levels).

App based games of this kind hold promise to improve chronic disease outcomes at scale.

New electronic devices are also being used by people of all ages to track activity, measure sleep and record nutrition. This information provides instant and accurate feedback to individuals and their therapists, allowing for adjustments where necessary. The logged information can also be combined into large data sets to reveal patterns over time and inform future treatments.




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Digital therapeutics are spawning a new language within the healthcare industry. “Connected health” reflects the increasingly digital ways clinicians and patients communicate. A few examples include text messaging, telehealth, and video consultations with health professionals.

There is increasing evidence that digitally delivered care (including apps and text message based interventions) can be good for your health and can help you manage chronic conditions, such as diabetes and cardiovascular disease.

But not all health apps are the same

Whilst the digital health revolution is exciting, results of research studies should be carefully interpreted by patients and providers.

Innovation has led to 325,000 mobile health apps available in 2017. This raises significant governance issues relating to patient safety (including data protection) when using digital therapeutics.

A recent review identified that most studies have a relatively short duration of intervention and only reflect short-term follow up with participants. The long-term effect of these new therapeutic interventions remains largely unknown.

The current speed of technological development means the usual safety mechanisms face new ethical and regulatory challenges. Who is doing the prescribing? Who is responsible for the efficacy, storage and accuracy of data? How are these technologies being integrated into existing care systems?

Digital health needs a collaborative approach

Digital health presents seismic disruption to patient care, particularly when new technologies are cheap and readily accessible to patients who might lack the insight required to recognise normality or cause for alarm. Technology can be enabling and empowering for self management, however there’s a lot more needs to be done to link these new technologies into the current health system.

Take the new Apple Watch functionality of heart rate notifications for example. Research like the Apple Heart Study suggests this exciting innovation could lead to significantly improved detection rates of heart rhythm disorders, and enhanced stroke prevention efforts.

But when a patient receives a high heart rate notification, what should they do? Ignore it? Go to a GP? Head straight to the emergency department? And, what is the flow on impact on the health system?




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Many of these questions remain unanswered suggesting there is an urgent need for research that examines how technology is implemented into existing healthcare systems.

The ConversationIf we are to produce useful digital therapeutics for real-world problems, then it is critical that the end-users are engaged in the process. Patients and healthcare professionals will need to work with software developers to design applications that meet the complex healthcare needs of patients.

Caleb Ferguson, Senior Research Fellow, Western Sydney University; Debra Jackson, Professor, University of Technology Sydney, and Louise Hickman, Associate Professor of Nursing, University of Technology Sydney

This article was originally published on The Conversation. Read the original article.

My Health Record: Deleting personal information from databases is harder than it sounds



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Federal Health Minister Greg Hunt has announced that the My Health Record system will be modified to allow the permanent deletion of records.
Shutterstock

Robert Merkel, Monash University

Since the period for opting out of My Health Record began on July 16, experts in health, privacy and IT have raised concerns about the security and privacy protections of the system, and the legislation governing its operation.

Now federal health minister Greg Hunt has announced two key changes to the system.

First, the legislation will be amended to explicitly require a court order for any documents to be released to a law enforcement agency. Second, the system will be modified to allow the permanent deletion of records:

In addition, the Government will also amend Labor’s 2012 legislation to ensure if someone wishes to cancel their record they will be able to do so permanently, with their record deleted from the system.

But while this sounds like a simple change, permanently and completely deleting information from IT systems is anything but straightforward.




Read more:
My Health Record: the case for opting out


Systems designed for retention, not deletion

The My Health Record database is designed for the long-term retention of important information. Most IT systems designed for this purpose are underpinned by the assumption that the risk of losing information – through a hardware fault, programming mistake, or operator error – should be extremely low.

The exact details of how My Health Record data is protected from data loss are not public. But there are several common measures that systems like it incorporate to greatly reduce the risks.

At a most basic level, “deletion” of a record stored in a database is often implemented simply by marking a record as deleted. That’s akin to deleting something on paper by drawing a thin line through it.

The software can be programmed to ignore any such deleted records, but the underlying record is still present in the database – and can be retrieved by an administrator with unfettered permissions to access the database directly.

This approach means that if an operator error or software bug results in an incorrect deletion, repairing the damage is straightforward.




Read more:
My Health Record: the case for opting in


Furthermore, even if data is actually deleted from the active database, it can still be present in backup “snapshots” that contain the complete database contents at some particular moment in time.

Some of these backups will be retained – untouched and unaltered – for extended periods, and will only be accessible to a small group of IT administrators.

Zombie records

Permanent and absolute deletion of a record in such a system will therefore be a challenge.

If a user requests deletion, removing their record from the active database will be relatively straightforward (although even this has some complications), but removing them from the backups is not.

If the backups are left unaltered, we might wonder in what circumstances the information in those backups would be made accessible.

If, by contrast, the archival backups are actively and irrevocably modified to permit deletion, those archival backups are at high risk of other modifications that remove or modify wanted data. This would defeat the purpose of having trusted archival backups.

Backups and the GDPR’s ‘right to be forgotten’

The problem of deleting personal information and archival backups has been raised in the context of the European Union’s General Data Protection Regulation (GDPR). This new EU-wide law greatly strengthens privacy protections surrounding use of personal information in member states.

The “right to erasure” or “right to be forgotten” – Article 17 of the GDPR – states that organisations storing the personal information of EU citizens “shall have the obligation to erase personal data without undue delay” in certain circumstances.

How this obligation will be met in the context of standard data backup practices is an interesting question, to say the least. While the legal aspects of this question are beyond my expertise, from a technical perspective, there is no easy general-purpose solution for the prompt deletion of individual records from archived data.

In an essay posted to their corporate website, data backup company Acronis proposes that companies should be transparent about what will happen to the backups of customers who request that records be deleted:

[while] primary instances of their data in production systems will be erased with all due speed … their personal data may reside in backup archives that must be retained for a longer period of time – either because it is impractical to isolate individual personal data within the archive, or because the controller is required to retain data longer for contractual, legal or compliance reasons.

Who might access those backups?

Data stored on archival backups, competently administered, will not be available to health professionals. Nor will they be available to run-of-the-mill hackers who might steal a practitioner’s credentials to gain illicit access to My Health Record.

But it’s not at all clear whether law enforcement bodies, or anyone else, could potentially access a deleted record if they are granted access to archival backups by the system operator.

Under amended legislation, such access would undoubtedly require a court order. Nevertheless, were it to be permitted, access to a deleted record under these circumstances would be contrary to the general expectation that when a record is deleted, it is promptly, completely and irrevocably deleted, with no prospect of retrieval.




Read more:
Opting out of My Health Records? Here’s what you get with the status quo


Time required to work through the details

In my view, more information on the deletion process, and any legislative provisions surrounding deleted records, needs to be made public. This will allow individuals to make an informed choice on whether they are comfortable with the amended security and privacy provisions.

Getting this right will take time and extensive expert and public consultation. It is very difficult to imagine how this could take place within the opt-out period, even taking into account the one-month extension just announced by the minister.

The ConversationGiven that, it would be prudent to pause the roll-out of My Health Record for a considerably longer period. This would permit the government to properly address the issues of record deletion, as well as the numerous other privacy and security concerns raised about the system.

Robert Merkel, Lecturer in Software Engineering, Monash University

This article was originally published on The Conversation. Read the original article.

What could a My Health Record data breach look like?



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Health information is an attractive target for offenders.
Tammy54/Shutterstock

Cassandra Cross, Queensland University of Technology

Last week marked the start of a three-month period in which Australians can opt out of the My Health Record scheme before having an automatically generated electronic health record.

Some Australians have already opted out of the program, including Liberal MP Tim Wilson and former Queensland LNP premier Campbell Newman, who argue it should be an opt-in scheme.

But much of the concern about My Health Records centres around privacy. So what is driving these concerns, and what might a My Health Records data breach look like?

Data breaches

Data breaches exposing individuals’ private information are becoming increasingly common and can include demographic details (name, address, birthdate), financial information (credit card details, pin numbers) and other details such as email addresses, usernames and passwords.

Health information is also an attractive target for offenders. They can use this to perpetrate a wide variety of offences, including identity fraud, identity theft, blackmail and extortion.




Read more:
Another day, another data breach – what to do when it happens to you


Last week hackers stole the health records of 1.5 million Singaporeans, including Prime Minister Lee Hsien Loong, who may have been targeted for sensitive medical information.

Meanwhile in Canada, hackers reportedly stole the medical histories of 80,000 patients from a care home and held them to ransom.

Australia is not immune. Last year Australians’ Medicare details were advertised for sale on the dark net by a vendor who had sold the records of at least 75 people.

Earlier this year, Family Planning NSW experienced a breach of its booking system, which exposed client data of those who had contacted the organisation within the past two and a half years.

Further, in the first report since the introduction of mandatory data breach reporting, the Privacy Commissioner revealed that of the 63 notifications received in the first quarter, 15 were from health service providers. This makes health the leading industry for reported breaches.

Human error

It’s important to note that not all data breaches are perpetrated from the outside or are malicious in nature. Human error and negligence also pose a threat to personal information.

The federal Department of Health, for instance, published a supposedly “de-identified” data set relating to details from the Medicare Benefits Scheme and the Pharmaceutical Benefits Scheme of 2.5 million Australians. This was done for research purposes.

But researchers were able to re-identify the details of individuals using publicly available information. In a resulting investigation, the Privacy Commissioner concluded that the Privacy Act had been breached three times.

The latest data breach investigation from US telecommunications company Verizon notes that health care is the only sector where the threat from inside is greater than from the outside. Human error contributes largely to this.

There are promises of strong security surrounding My Health Records but, in reality, it’s a matter of when, not if, a data breach of some sort occurs.

Human error is one of the biggest threats.
Shutterstock

Privacy controls

My Health Record allows users to set the level of access they’re comfortable with across their record. This can target specific health-care providers or relate to specific documents.

But the onus of this rests heavily on the individual. This requires a high level of computer and health literacy that many Australians don’t have. The privacy control process is therefore likely to be overwhelming and ineffective for many people.




Read more:
My Health Record: the case for opting out


With the default option set to “general access”, any organisation involved in the person’s care can access the information.

Regardless of privacy controls, other agencies can also access information. Section 70 of the My Health Records Act 2012 states that details can be disclosed to law enforcement for a variety of reasons including:

(a) the prevention, detection, investigation, prosecution or punishment of criminal offences.

While no applications have been received to date, it is reasonable to expect this may occur in the future.

There are also concerns about sharing data with health insurance agencies and other third parties. While not currently authorised, there is intense interest from companies that can see the value in this health data.

Further, My Health Record data can be used for research, policy and planning. Individuals must opt out of this separately, through the privacy settings, if they don’t want their data to be part of this.

What should you do?

Health data is some of the most personal and sensitive information we have and includes details about illnesses, medications, tests, procedures and diagnoses. It may contain information about our HIV status, mental health profile, sexual activity and drug use.

These areas can attract a lot of stigma so keeping this information private is paramount. Disclosure may not just impact the person’s health and well-being, it may also affect their relationships, their employment and other facets of their life.

Importantly, these details can’t be reset or reissued. Unlike passwords and credit card details, they are static. Once exposed, it’s impossible to “unsee” or “unknow” what has been compromised.

Everyone should make their own informed decision about whether to stay in My Health Record or opt out. Ultimately, it’s up to individuals to decide what level of risk they’re comfortable with, and the value of their own health information, and proceed on that basis.


The Conversation


Read more:
My Health Record: the case for opting in


Cassandra Cross, Senior Lecturer in Criminology, Queensland University of Technology

This article was originally published on The Conversation. Read the original article.

Opting out of My Health Records? Here’s what you get with the status quo



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Most hospitals have a mix of paper and digital records.
Shutterstock

Peter Bragge, Monash University and Chris Bain, Monash University

Australians have just under three months to decide whether they want a My Health Record, which would allow the various health professionals who look after them to access and share their health information. From October 15, those who haven’t opted in or out will have a record automatically generated.

In emergency situations, access to information from My Health Records about allergies, medicines and health conditions can save lives. Day to day, it will provide benefits such as reminding us when we last had a tetanus shot, or allowing a back-up GP to access the results of a recent blood test so we don’t need another.

Efficiencies generated by My Health Records, including reduced duplication of tests, are projected to save more than A$300 million over three years.

Most arguments for opting out revolve around the security of health data in centralised record systems. But if you’re opting out of My Health Records, you’re opting in to “business as usual”. So it’s important to know what the current system looks like.




Read more:
What could a My Health Record data breach look like?


As you read this, reams of medical data are being sent between health professionals in the mail, through conversations (on the phone or in person), and in small pockets of secure messaging. This includes emails, text messages and faxes.

In 2016, the Royal Australian College of General Practitioners recommended ceasing the use of fax machines within three years, noting that slow communication between health providers could result in significant medical errors.

Tragically, ten months earlier, Victorian man Mettaloka Halwala died after his cancer test results showing signs of potentially fatal lung toxicity were faxed to the wrong number.

This underlines the limitations of paper records as a method of storing and communicating medical information. There are numerous examples of paper medical files being found in bins and inadequately disposed of, including examples of records being found by complete strangers.

This is in part a function of their enormous physical volume. To give you an idea of the scale, in 2016, the Royal Adelaide Hospital faced the challenge of moving an estimated 400,000 paper records from the previous two years alone to a new site.




Read more:
My Health Record: the case for opting in


Health services and systems have long known the limitations of paper records – which is why you already have several electronic medical records.

When you visit your GP, your consultation data will typically be stored electronically in a GP computer practice system such as Medical Director.

Any prescriptions will be stored on another computer system at your local pharmacy. Data on all dispensing transactions is also sent to higher-level government repositories.

If you are unwell enough to need a visit to hospital, more of your health data will be stored in another separate hospital system. This system may be mainly paper, fully electronic, or somewhere in the middle, which is the situation for most hospitals across most of Australia. Only three Australian hospitals have highly automated medical records.

In hybrid paper-electronic systems, paper documents may be scanned into your electronic record – creating two copies of the same information and thus doubling the opportunity for data breaches.

Many people would assume that these software systems are in some way compatible. They’re not. There isn’t even one software platform for each of these parts of the health-care system; there are multiple platforms available to GPs, pathology labs, hospitals and other practices.

Your My Health Record will contain summaries and subsets of all these types of data that are critical to your health care – if you maintain the general setting – as well as more detailed sources of the electronic data that already exists today in multiple locations.




Read more:
My Health Record: the case for opting out


Australians are understandably concerned about hackers breaching the government’s aggregated data system. But there is comparatively little concern about their local GP clinic, pharmacy, imaging centre or hospital being hacked. Yet these systems have far less financial investment, no overarching governance authority and, at times, limited IT support.

True, each of these systems contains only a piece of your medical history. This means that if any one of them were to be hacked, you wouldn’t have all of your medical information accessed. But any argument about vulnerabilities in My Health Record data security can be more convincingly made for the present system.

The ConversationIt’s important to have all the facts about the status quo of health records, and what might be lost or gained through My Health Record, before deciding whether to opt in our out. If the considerable investment in My Health Record comes to nothing, the opportunity to address the limitations of the current system will have been lost.

Peter Bragge, Associate Professor, Healthcare Quality Improvement (QI) at Behaviour Works, Monash University and Chris Bain, Professor of Practice in Digital Health, Monash University

This article was originally published on The Conversation. Read the original article.