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by dibstern 2785 days ago
Dude wtf, we need this data to help treat patients and save lives.
4 comments

Imagine I was running a charity that accepted donations by asking people to post their bank login credentials on a corkboard outside my house.
that's not really secure enough, you should require that they confirm how much they want you to withdraw as a line item next to their password.
Why does the data need to be stored on a centralised database acessibile by 100,000 people and not on individual medicare cards?

Is there some dire pressing need where people are literally dying because doctors can't access prior medical history in time? I've not heard anything of the sort.

Do you think the Australian government is proficient with IT and IT security?

People die when the data isn’t available or wrong.

In the perfect world, you could design an architecture for sharing data, so patients would own some sort of medical card with their history.

In the real world, your doctor and your eye doctor bought different IT systems that can’t share data without someone manually typing them in.

Hell, the hospital probably runs around a thousand different IT systems and maybe two of them have APIs, but one is SOAP and the other is Graphql and there isn’t any middleware to make them speak with eacother. So the hospital can’t share your journal between your ward and the X-Ray room, unless there is a centralised journal.

We’re working toward a better architecture, but it’s not easy, and if only 500 of your 1000 systems adopt it, then you’ll still need a way to handle those 500 systems.

Things are made worse by the political decision organ and it’s variating agendas.

For a decade you may have political leadership that enforces an open architecture in which systems have to be able to share data. And you get maybe 10 major systems build on it, and they work, and you build some middleware and use RPA for some of the other systems.

Then the political landscape shifts, and maybe lobbyists play a part. Because open architecture for data is making companies less money since they can’t sell you data extractions. So they spend money on politics, and the conservative side listens and starts making the open APIs and public ownership and management illegal because it “steals” jobs.

Then you have another decade where you change another 10 major systems, except now they are silos and you fire your local IT developers so you can’t build RPA or middleware.

Then people realise that was stupid, so it shifts back to open architecture. Except now 20 years have passed, so we design a new open architecture that doesn’t fit with the old one. And then we buy another 10 major systems on the new architecture.

Now, after 30 years of good intentions, you still need a centralised way to share patient data, and when it fails, people do die.

I don’t have a horse in this race however:

> Is there some dire pressing need where people are literally dying because doctors can't access prior medical history in time

People definitely do die from that.

Because cards break, are lost and stolen all the time. Moreover, ER patients may not have the card with them when they need it. One would still need a centralized backup.
> Do you think the Australian government is proficient with IT and IT security?

Not to a sufficient level.

This is what I think - I can opt it at any time, and provide my entire medical history, but I can never delete my data.

So I'll opt in when I need to.

Unfortunately the Aust government often seems to incompetently implement their (larger) IT projects.

IF there was a track record of success, then this might be fit for purpose. The chances are extremely low though.