Showing posts with label privacy. Show all posts
Showing posts with label privacy. Show all posts

Wednesday, 28 August 2019

Do you know exactly who Medicare, your GP, specialist doctor or local area health service are sharing your personal medical information with?


Electronic Frontiers Australia, media release, 26 August 2019: 

Australia, Melbourne — Monday 26 August 2019 — EFA, Future Wise, Digital Rights Watch and APF today call again for a comprehensive review of privacy provisions for healthcare data. 

 Following the HealthEngine scandal in 2018, and the recent use of Pharmaceutical Benefits Scheme (PBS) data to assist recruitment into research on Bipolar disorder, a Twitter user on Friday 23 August shared a SMS message attempting to recruit him into a clinical trial. 

This appears to have occurred through the use of Precedence Healthcare’s InCa (Integrated Care) health platform. Research by members of digital rights organisations today revealed that sensitive patient details—including contact details, demographics and complete medical histories—can be shared with a wide range of partners, including, it appears, private health insurers. 

Dr Trent Yarwood, health spokesperson for Future Wise and a medical specialist, said “Secondary uses like this are a very ethically murky area. People don’t generally expect to have personal details from their healthcare providers made available to anyone, even if well intentioned.” 

The terms and conditions of the application include access to data from myHealthRecord. “While the My Health Records Act includes privacy provisions, once this data is accessed by an external system, these provisions no longer apply,” continued Dr Yarwood. “I’m very concerned that practices making use of this system are not aware of just how widely this data can be shared—and that they are expected to fully inform patients of the nature of the data use,” he concluded. 

“This kind of barely-controlled data sharing is only possible because of how little privacy protection is provided by the current legislation,” said Justin Warren, Electronic Frontiers Australia board member. 

“People have made it clear time and time again that information about their health is extremely personal, private, and they expect it to be kept secure, not shared with all and sundry,” he said. “What people think is happening is quite different to what actually is, and these companies are risking catastrophic damage to patient trust with their lust for data.” 

“If you found out your doctor was sharing your full medical history with private health insurers, or the police, would you keep seeing them?” he added. 

Robust privacy protections are needed for all Australians, such as by finally giving us the right to sue for breach of privacy, requiring explicit consent for each disclosure of medical or health data to a third party, and proper auditing of record-access that is visible to the patient. It is imperative that the risks of health data sharing receive greater attention. [my yellow highlighting]

Australian Health Information Technology, 25 August 2019: 

This Seems To Be A System Of Sharing Personal Health Information That Is Rather Out Of Control. 

I noticed this last week: How does Inca collect and share health information? 

Updated 1 month ago 

Precedence Health Care’s Integrated Care Platform (Inca) is a cloud- based network of digital health and wellness services, including MediTracker mobile application services. 

It is important that all users of Inca services understand how the network collects and shares health information (“personal information”) and are aware of their responsibilities for gaining informed consent from patients. 

To the extent applicable (if at all), the Health Privacy Principles (or equivalent), which operate in some jurisdictions, should guide your actions. In the absence of applicable Health Privacy Principles, you should refer to relevant Commonwealth, State or Territory privacy legislation, and assistance can also be derived by referring to the website of the Office of the Australian Information Commissioner. You should make sure you are familiar with the applicable principles or other relevant guidance, and also with Precedence Health Care’s Privacy Policy. 

Inca collects and shares personal information about patients and other persons under care (also called “consumers”) who consent to this information being stored and shared in the network. This information may come from a variety of sources, including the clinical software systems used by GPs (e.g., Medical Director, Best Practice); other members of the patient’s care team (e.g., allied health professionals, medical specialists); the patient themselves; participating health services and pathology services; and the Commonwealth’s My Health Record. 

Inca uses this information to provide a range of health care and wellness services to the patient and their care team. 

Prior to contributing a patient’s personal information to be stored in or used by Inca, users must obtain informed consent from patients for the collection and sharing of this information. Ensuring that patients are informed about what will happen with the information that is being shared is a fundamental component of best practice in privacy, so it is important that all Inca users and patients know what information is available on Inca and who has access to that information. 

When a patient’s GP or other person authorised by the GP uses Inca to collect personal information from their general practice clinical system, Inca will extract and share the following information: 

· Patient demographics 
· Alcohol consumption and smoking status 
· Allergies and adverse reactions 
· Family and social history 
· Observations and results 
· Current medications 
· Immunisation history 
· Current and past problems 

If the patient or the GP does not wish to share some of this information, the GP’s clinical system should provide a means for declaring such data “confidential” and thereby preventing it being sent to Inca. 

GPs who do not know how to do this should contact the provider of their clinical software. Inca may also collect and share information obtained from other sources. 

These include: 

· Information that the GP or any member of the care team or the patient themselves adds to the patient record or to any notes concerning the patient’s care using Inca services, web sites or mobile devices. This information may include contact information, measurements, care plans, assessments, referrals, progress notes, appointments, and other related personal and health information. 

· Information from participating Health Services, including discharge summaries and emergency department attendance. 

· Information obtained from My Health Record. This information may include some or all of the data stored in the patient’s My Health Record. 

It is the responsibility of the provider of information stored in or used by Inca, or the person who grants access to such information, to inform the patient of the type of personal information that is so provided or made accessible. 

Inca will provide access to a patient’s personal information with the patient’s GP and care team, the patient (or their carer as authorised by the patient), participating Health Services, and some others as necessary to provide the services of Inca. Precedence Health Care may share de-identified data (that is, data from which it is impossible to ascertain who you are) to persons or organisations who are engaged in research, trials and analyses relating to improvements in health and the management of health services. The way Inca shares and protects this information is described in the Precedence Health Care Privacy Policy. 

It is important that patients understand what information is being shared, who it is being shared with, and for what purpose. It is the responsibility of the persons providing this information to ensure that each patient is aware that their personal and health information is being stored on a computer system hosted on a secure site in Australia, as described in the Precedence Health Care Privacy Policy. 

It is also important for all users of Inca to be aware that this information may not be complete, up to date, or accurate. 

In seeking informed consent to participate, patients should be advised that any measurements or notes that they enter into Inca are not continuously monitored and will be available to members of the patient’s care team only when the provider next logs in to Inca. 

Patients who are concerned about any condition should contact their GP or other health care provider using their normal means (e.g., phone) and should not use Inca for this purpose. 

Please contact Precedence Health Care’s Privacy Officer on (03) 9023 0800 or email privacy@precedencehealthcare.com if you have any questions or concerns about our Privacy Policy, or if you wish to suggest improvements. You may also contact your State’s Privacy Commissioner or Ombudsman to get advice about privacy or make a complaint. 

Here is the link: https://phc.zendesk.com/hc/en-us/articles/360021090952-How-does-cdmNet-collect-and-share-health-information- 

For background Precedence Health run a shared patient data base which is accessible to GPs, Specialists and Allied Health Staff for the purpose of care planning and co-ordinating care. Using their system allows GPs to claim a Medicare Item No for this service. They also provide patient access to the data and have services such as reminders etc in an app. 

All that said this system, on its own statements, just sucks information from everywhere (GP systems, health services and the myHR) and pops it into one database. One user, who is now switching it off, revoking consent and getting out has described to me a collection of erroneous and mis-sorted data on their record. 

More they seem to be happy to hand out the data to others claiming it is de-identified – and we all know how in-effective that can be! 

The rather loose way consent rules for disclosure appear to be enforced is also a worry. 

They even have the legendary myHR disclaimer that “It is also important for all users of Inca to be aware that this information may not be complete, up to date, or accurate.” Doh! 

You can see the Privacy Policy here if you wish! https://phc.zendesk.com/hc/en-us/articles/360021091012-Privacy-Policy- 

Don’t know about you but none of my information would go anywhere near this if I could help it! It looks like a serious unthought through shambles to me. 

What do you think? 

David.  [my yellow highlighting]

Sunday, 11 August 2019

Alleged data theft by HealthEngine leaves hundreds of thousands of Australians vulnerable


Perhaps now is the time for readers to check who owns the company they might use to make medical appointment online.

ABC News, 8 August 2019: 

Australia's biggest medical appointment booking app HealthEngine is facing multi-million-dollar penalties after an ABC investigation exposed its practice of funnelling patient information to law firms. 

The Australian Competition and Consumer Commission has launched legal action against the Perth-based company in the Federal Court, accusing it of misleading and deceptive conduct. 

In June last year, the ABC revealed HealthEngine was passing on users' personal information to law firms seeking clients for personal injury claims. 

The details of the deal were contained in secret internal Slater and Gordon documents that revealed HealthEngine was sending the firm a daily list of prospective clients at part of a pilot program in 2017.



The ACCC has also accused the company of passing the personal information of approximately 135,000 patients to insurance brokers in exchange for payments.


"Patients were misled into thinking their information would stay with HealthEngine but, instead, their information was sold off to insurance brokers," ACCC chairman Rod Sims said in a statement.

The information sold included names, phone numbers, dates of birth and email addresses.

The ACCC has not said how much money the company earned form the arrangement.

The ABC revealed last year that HealthEngine had also boasted to advertisers that it could target users based on their symptoms and medical conditions. 

HealthEngine has also been accused of misleading consumers by manipulating users' reviews of medical practices. 

"We allege that HealthEngine refused to publish negative reviews and altered feedback to remove negative aspects, or to embellish it, before publishing the reviews," Mr Sims said. 

Among a range of examples, the ACCC alleges that one patient review was initially submitted as: "The practice is good just disappointed with health engine. I will call the clinic next time instead of booking online." 

But when that review was made public, it was allegedly changed to simply read: "The practice is good." 

HealthEngine is facing a fine of $1.1 million for each breach of the law, but the ACCC has yet to determine how many breaches it will allege....

Wednesday, 22 May 2019

The Abbott-Turnbull-Morrison Federal Government still hasn't made personal health data secure


Since about 2014 it has been known that the personal details of Medicare cardholders has been for sale on the dark web.

Despite an April 2014 report by the Australian National Audit Office that the Consumer Directory - which contains all Medicare customer records - was not secure and that cardholder details were for sale, the federal Liberal-Nationals Coalition Government does not appear to have comprehensively acted act on the issue of database security.

It was not unknown that Medicare cardholder details were being used fraudulently.


When contacted by the mainstream media in July 2017 the Liberal MP for Aston and then Minister for Human Services Alan Tudge denied any prior knowledge of cardholder details being offered for sale.

It was not reported that at the time if he was asked about instances of Medicare cardholder details being used to commit fraud or identity theft.

In August 2017 eHealth Privacy Australia was telling the Senate Finance and Public Administration Committee that:

• There are fundamental weaknesses in both the HPOS (Medicare card data) and My Health Records systems, which make them vulnerable to illegal access.

• Those weaknesses mean that fraudulent users of the systems can assume the identity of legitimate users to gain illegal access.

• It is not sufficient to mitigate these weaknesses in the My Health Records system.

By 1 January 2019 IT News was reporting that Medicare cardholder details fraudulently obtained had been used to access an individual’s My Health Record:

The number of data breaches involving the My Health Record system rose from 35 to 42 in the past financial year, new figures show.

The Australian Digital Health Agency (ADHA) said in its annual report [pdf] that “42 data breaches (in 28 notifications) were reported to the Office of the Australian Information Commissioner” in 2017-18.

As with previous years, the agency said that “no purposeful or malicious attacks compromising the integrity or security of the My Health Record system” were reported in the period.

Of the 42 breaches, one was the result of “unauthorised access to a My Health Record as a result of an incorrect Parental Authorised Representative being assigned to a child”, the agency reported.

A further two breaches were from “suspected fraud against the Medicare program where the incorrect records appearing in the My Health Record of the affected individual were also viewed without authority by the individual undertaking the suspected fraudulent activity”, ADHA said.

In addition, 17 breaches were the result of “data integrity activity initiated by the Department of Human Services to identify intertwined Medicare records (that is, where a single Medicare record has been used interchangeably between two or more individuals)”, the agency said. [my yellow highlighting]

Despite this knowledge the Abbott-Turnbull-Morrison Government has still not grasped the nettle, because on 16 May 2019 The Guardian reported:

Australians’ Medicare details are still being illegally offered for sale on the darknet, almost two years after Guardian Australia revealed the serious privacy breach.

Screenshots of the Empire Market, provided to Guardian Australia, show the vendor Medicare Machine has rebranded as Medicare Madness, offering Medicare details for $US21.

Other vendors charge up to $US340 by offering fake Medicare cards alongside other fake forms of identification – such as a New South Wales licence.

The Medicare Madness listing suggests the Medicare details “of any living Australian citizen” have been available since September 2018.

Guardian Australia first reported patient details were on sale in July 2017, verifying the listing by requesting the data of a Guardian staff member and warning that Medicare card numbers could be used for identity theft and fraud.


The report did not identify the source of the Medicare data leak but suggested that people could use publicly available information about healthcare providers – including their provider number and practice location – to pass security checks and obtain a Medicare card number through the Department of Human Services provider hotline.

The review panel warned the “current security check for release of Medicare card information provides a much lower level of confidence than the security requirements” for Health Professional Online Services, the portal that allows providers to make rebate claims.

An IT industry source, who refused to be named, said the re-emergence of the data breach brings into question government assurances around the privacy of medical data “when those responsible cannot even manage the security of Medicare cards”.

The source said there is a “concerted effort at the moment by law enforcement to curtail darknet market activity”.

“In reality the darknet markets, while disrupted momentarily when their sites are brought down, easily relocate and continue business.”

Darknet markets can simply private message existing clients with a new link to resume business elsewhere. [my yellow highlighting]

Thus far the federal government has failed to recognise where Medicare cardholder details may be being accessed unlawfully, as this 2 August 2018 ABC online article indicates:

Privacy experts have warned that the system opens up health records to more people than ever before, thereby increasing the threat surface — the number of vulnerabilities in a system — dramatically.

Dr Bernard Robertson Dunn, who chairs the health committee at the foundation, says once the data is downloaded into the health system, the My Health record system cannot guarantee privacy.

"Once the data has been downloaded to, for instance, a hospital system, the protections of the hospital system apply, and then the audit logs apply to the hospital system — not to My Health record.

"So there is no way the Government would know who has accessed that data, and it is untraceable and untrackable that that access has occurred."

Thursday, 2 May 2019

Dozens of Centrelink clients have had their names published on Facebook by a Commonwealth-funded work-for-the-dole provider



ABC News, 26 April 2019:

Dozens of Centrelink clients have had their names published online in what has been described as a "shocking" abuse of privacy.

A Commonwealth-funded work-for-the-dole provider uploaded lists of people who were required to attend client meetings to a public Facebook page.

"We are at a loss as to why anyone would post about workers' appointments online," union official Lara Watson said.

"We were shocked at the publication of names on a social media platform."

The incidents are the latest to emerge from the Government's flagship remote employment scheme, the Community Development Programme (CDP).

Nearly 50 people from the Northern Territory community of Galiwinku, located 500 kilometres east of Darwin, were affected.

The job service provider, the Arnhem Land Progress Association (ALPA), established the social media page apparently with the intention of uploading such lists.

"Welcome to our Facebook page where we will be posting appointments, courses and CDP information," it wrote last month.

The two sheets of names were posted to the Galiwinku CDP page on March 11 and 12.

Both images were shared to another local Facebook group titled Elcho Island Notice Board, which has more than 2,000 members.

One CDP insider denounced the online uploads, saying they were unprecedented and could have placed job seekers at risk.

"If a person has a family violence order in place to protect them, then perhaps the perpetrator would know where she was," said the source, who requested anonymity.

"It advertised that a person is accessing welfare services, and unfortunately in Australia there's discrimination against people accessing welfare services.

"People can be bullied for being unemployed."

The Galiwinku CDP page appears to have since been removed from the internet but the organisation denied any wrongdoing.

"We do not believe that this is a breach of confidentiality," an ALPA spokeswoman said.....

"All ALPA CDP participants give … media consent when they commence as a participant."......

Wednesday, 1 May 2019

Facebook spends more than a decade expressing contrition for its actions and avowing its commitment to people’s privacy – but refuses constructive action



“It is untenable that organizations are allowed to reject my office’s legal findings as mere opinions. Facebook should not get to decide what Canadian privacy law does or does not require.[Canandian Privacy Commissioner  Daniel Therrien, 25 April 2019]

Facbook Inc. professes that it  has taken steps to ensure the intregrity of political discourse on its platform, but rather tellingly will not roll out transparency features in Australia that it has already rolled out in the US, UK, Eu, India, Israel and Ukraine.

The only measure it commits to taking during this federal election campaign is to temporarily ban people outside Australiabuying ads that Facebook determines are “political”.


So it should come as no surprise that Canada issued this three page news release…….

Office of the Privacy Commission of Canada, news release, 25 April 2019:

Facebook refuses to address serious privacy deficiencies despite public apologies for “breach of trust”

Joint investigation finds major shortcomings in the social media giant’s privacy practices, highlighting pressing need for legislative reform to adequately protect the rights of Canadians

OTTAWA, April 25, 2019 – Facebook committed serious contraventions of Canadian privacy laws and failed to take responsibility for protecting the personal information of Canadians, an investigation has found.

Despite its public acknowledgement of a “major breach of trust” in the Cambridge Analytica scandal, Facebook disputes the investigation findings of the Privacy Commissioner of Canada and the Information and Privacy Commissioner for British Columbia. The company also refuses to implement recommendations to address deficiencies.

“Facebook’s refusal to act responsibly is deeply troubling given the vast amount of sensitive personal information users have entrusted to this company,” says Privacy Commissioner of Canada Daniel Therrien. “Their privacy framework was empty, and their vague terms were so elastic that they were not meaningful for privacy protection.

“The stark contradiction between Facebook’s public promises to mend its ways on privacy and its refusal to address the serious problems we’ve identified – or even acknowledge that it broke the law – is extremely concerning.”

“Facebook has spent more than a decade expressing contrition for its actions and avowing its commitment to people’s privacy,” B.C. Information and Privacy Commissioner Michael McEvoy says, “but when it comes to taking concrete actions needed to fix transgressions they demonstrate disregard.”

Commissioner McEvoy says Facebook’s actions point to the need for giving provincial and federal privacy regulators stronger sanctioning power in order to protect the public’s interests. “The ability to levy meaningful fines would be an important starting point,” he says.

The findings and Facebook’s rejection of the report’s recommendations highlight critical weaknesses within the current Canadian privacy protection framework and underscore an urgent need for stronger privacy laws, according to both Commissioners.

“It is untenable that organizations are allowed to reject my office’s legal findings as mere opinions,” says Commissioner Therrien.

In addition to the power to levy financial penalties on companies, both Commissioners say they should also be given broader authority to inspect the practices of organizations to independently confirm privacy laws are being respected. This measure would be in alignment with the powers that exist in the U.K. and several other countries.

Giving the federal Commissioner order-making powers would also ensure that his findings and remedial measures are binding on organizations that refuse to comply with the law. 

The complaint that initiated the investigation followed media reports that Facebook had allowed an organization to use an app to access users’ personal information and that some of the data was then shared with other organizations, including Cambridge Analytica, which was involved in U.S. political campaigns.

The app, at one point called “This is Your Digital Life,” encouraged users to complete a personality quiz. It collected information about users who installed the app as well as their Facebook “friends.” Some 300,000 Facebook users worldwide added the app, leading to the potential disclosure of the personal information of approximately 87 million others, including more than 600,000 Canadians.

The investigation revealed Facebook violated federal and B.C. privacy laws in a number of respects. The specific deficiencies include:

Unauthorized access

Facebook’s superficial and ineffective safeguards and consent mechanisms resulted in a third-party app’s unauthorized access to the information of millions of Facebook users. Some of that information was subsequently used for political purposes.

Lack of meaningful consent from “friends of friends”

Facebook failed to obtain meaningful consent from both the users who installed the app as well as those users’ “friends,” whose personal information Facebook also disclosed.

No proper oversight over privacy practices of apps

Facebook did not exercise proper oversight with respect to the privacy practices of apps on its platform.  It relied on contractual terms with apps to protect against unauthorized access to user information; however, its approach to monitoring compliance with those terms was wholly inadequate.

Overall lack of responsibility for personal information

A basic principle of privacy laws is that organizations are responsible for the personal information under their control. Instead, Facebook attempted to shift responsibility for protecting personal information to the apps on its platform, as well as to users themselves.

The failures identified in the investigation are particularly concerning given that a 2009 investigation of Facebook by the federal Commissioner’s office also found contraventions with respect to seeking overly broad, uninformed consent for disclosures of personal information to third-party apps, as well as inadequate monitoring to protect against unauthorized access by those apps.

If Facebook had implemented the 2009 investigation’s recommendations meaningfully, the risk of unauthorized access and use of Canadians’ personal information by third party apps could have been avoided or significantly mitigated.

Facebook’s refusal to accept the Commissioners’ recommendations means there is a high risk that the personal information of Canadians could be used in ways that they do not know or suspect, exposing them to potential harms.

Given the extent and severity of the issues identified, the Commissioners sought to implement measures to ensure the company respects its accountability and other privacy obligations in the future. However, Facebook refused to voluntarily submit to audits of its privacy policies and practices over the next five years.

The Office of the Privacy Commissioner of Canada plans to take the matter to Federal Court to seek an order to force the company to correct its privacy practices.

The Office of the Information and Privacy Commissioner for B.C. reserves its right under the Personal Information Protection Act to consider future actions against Facebook.  

Related documents:

* Note: my yellow highlighting

Nor should this alleged 'mistake' made by Facebook cause surprise.......

The New York Times, 25 April 2019:

SAN FRANCISCO — The New York State attorney general’s office plans to open an investigation into Facebook’s unauthorized collection of more than 1.5 million users’ email address books, according to two people briefed on the matter.

The inquiry concerns a practice unearthed in April in which Facebook harvested the email contact lists of a portion of new users who signed up for the network after 2016, according to the two people, who spoke on condition of anonymity because the inquiry had not been officially announced.

Those lists were then used to improve Facebook’s ad-targeting algorithms and other friend connections across the network.

The investigation was confirmed late Thursday afternoon by the attorney general’s office.

“Facebook has repeatedly demonstrated a lack of respect for consumers’ information while at the same time profiting from mining that data,” said Letitia James, the attorney general of New York, in a statement. “It is time Facebook is held accountable for how it handles consumers’ personal information.”…

Users were not notified that their contact lists were being harvested at the time. Facebook shuttered the contact list collection mechanism shortly after the issue was discovered by the press…..

Facebook Inc's rapacious business practices has been the death of online privacy and now threatens the democratic process.