More unexpected fax to consider
Seven years after it was first encouraged to consider changing its laws to permit real-time monitoring of prescriptions, Queensland has finally come to the party and amended its poisons and medicines act and its therapeutic goods regulations to pave the way for a RTPM system to be introduced next year.
There's no word as yet on exactly which system the Sunshine State plans to introduce, but it has a couple of options it can look into, including following Victoria's lead by rolling out a system like SafeScript, or Tasmania and the ACT which use Tasmania's DORA system. South Australia signalled a while back that it planned on introducing a similar system and all states and territories now have access to a federally funded data exchange built by Fred IT as well as a licence to the original ERRCD software.
NSW has been dragging the chain somewhat and ordered reviews from Deloitte and the Australian Digital Health Agency and the other jurisdictions don't seem to be in much of a hurry either despite constant criticism from various state coroners, allied to federal health minister Greg Hunt's promise to have a national system in place by last December.
Besides warnings from drug and alcohol groups in Victoria that more support is needed for patients, we have not heard much criticism of SafeScript, which monitors a lot more than just schedule 8 drugs and covers a very large jurisdiction. If you have heard otherwise, let us know.
The big story this week however was a curious one from The Age, about a man in Melbourne who has owned a fax machine for 22 years. That in itself is weird but what is weirder is that for the last two years, he has been erroneously receiving referrals from a general practice in Coburg about patients with postnatal depression.
That medical records are being faxed to the wrong number doesn't come as a surprise to our industry and we are all trying to do something about it through encouraging the uptake of secure messaging, but we have to admit that the reaction of the unintended recipient (UR) is a new one.
Rather than ring the clinic and tell them they had the wrong fax number, the UR instead decided to hope for the best, telling The Age he was prepared to wait for the situation to resolve itself and he didn't want to alarm anyone. We believe a missing referral for something as serious as postnatal depression is a bit more alarming than a breach of confidentiality, but each to their own.
It reminds us of the Canadian woman who received faxed referrals for a decade, but who tried her utmost to put a stop to it. Still, the faxes kept coming. It's also worth pointing out that while secure messaging means Joe Public won't see an errant record, secure messages are misdirected all the time.
Also this week was a story from US not-for-profit investigative outfit ProPublica and German public broadcaster BR concerning millions of medical images being available on the open internet through unsecured PACS servers, which are easily accessible with a DICOM image viewer.
This is not a new problem – this research from German firm Greenbone (PDF) which prompted the story states that frankly – but it is a large and widespread problem, Unsecured systems were found in dozens of countries, with six systems in Australia holding 50,000 data sets and 2.6 million images discovered.
A lot of this problem is down to older PACS systems, often bespoke, that have been around for a long time and responsibility for their security is passed around. One US IT consultant mentioned in the ProPublica story was just gobsmacked that his clients' servers could be accessed as he was not “even aware that there was a possibility that could even happen”.
This is the healthcare industry so of course it can, just as medical records can be faxed to private homeowners for several years without anyone raising a peep.
That brings us to our poll question for the week: do you think secure messaging is really more reliable than fax?
Last week, we asked: If you could curate your medical record on your phone, would you? Most said yes – 70 per cent to 30 per cent in the negative.