Security concerns over Australia’s e-health records

Medicos blame NEHTA’s "unreliable performance". But enough with lost data! Let’s criminalise negligent data breaches.

As Australia grinds ever-closer to putting our health records online from (allegedly) 1 July, disturbing news is emerging. US hospitals are seeing more data breaches, and Australian medical experts warn that patient safety could be put at risk.

“It is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not," wrote three experts in the latest subscriber-only Medical Journal of Australia.

According to News-Medical.Net, the new e-health system has been subject to growing criticism based on privacy and security concerns, and that's down to the unreliable performance of the National E-Health Transition Authority (NEHTA).

There are "accusations of ineffective oversight and failure of administrators to acknowledge design flaws" and "warnings that the system will not succeed because its implementation has been ill-considered and rushed," according to the report — although NEHTA has pulled back the pace.

One of the critics is NEHTA's own chief clinical advisor, Dr Mukesh Haikerwal. His co-authors are Enrico Coiera, director of the University of NSW Centre for Health Informatics; and Michael Kidd, executive dean of Flinders University's Faculty of Health Sciences.

I hardly need to tell CSO Online readers that we're still seeing vast amounts of personal and financial data being lost. It's unacceptable. It needs to stop. But when it comes to medical data, the stakes are far higher.

Errors in readings could have life and death implications, Dr Haikerwal reported to have said. Quite.

The medicos’ editorial calls for a national governance regime for e-health clinical safety generally, covering inaccuracies in data as well as security. But will that be enough?

CSO Online understands that industry concerns are less with the NEHTA core stack and more with medical practice management and other third-party software systems that interface with it, and with the quality of their implementation and operation in the more than 10,000 medical practices around the country.

AusCERT general manager Graham Ingram has previously raised concerns about the difficulty of securing end-users' computers.

In the financial sector we have security standards, the best-known of which is the Payment Card Industry Data Security Standard (PCI DSS). Yet investigators tell us that in more than 60 per cent of breaches there was a failure to meet that standard.

One particularly egregious US example was the Stratfor breach. The company didn't merely fail to meet PCI DSS compliance; they didn't even try — with credit card numbers stored unencrypted in a database with no password.

Did Stratfor suffer a penalty for this? As far as we know, no.

Indeed, as far as we know, no Australian organisation has lost its merchant facility for failing its PCI DSS compliance. And why would MasterCard, Visa and the rest cut off their revenue stream?

The rules for medical data are less rigorous. There's industry accreditation by organisations such as the Royal Australian College of General Practitioners, but their infosec standards are... aspirational.

CSO Online understands that GPs don't want to improve their infosec practices, but still want indemnity against data being lost on their watch unless it's proved wilful or negligent — and their staff to sign a code of conduct that covers them against any staff action that leads to data being lost.

Hang on.

"Lost"?

Time to recalibrate, methinks.

How about we stop talking about organisations "losing" personal data like it’s a little bit of a whoopsie. Let’s call it as it is, neglecting to take proper responsibility for that data.

Note: I've deliberately chosen words with strong legal or ethical meaning. Negligence. Impropriety. Irresponsibility.

And while we're at it, let's make it a crime.

When I floated this idea on Twitter yesterday I got immediate support from Leslie Nassar, technology director at digital agency Amnesia Razorfish — although he was clearly speaking in a personal capacity.

"It's galling when Sony loses a massive cache of personal data without penalty, while lobbying for torrents to be criminalised," [[xref: https://twitter.com/#!/leslienassar/status/193900713678618625 |he tweeted|]].

"What are the real-world ramifications of tacitly giving criminals your personal data, versus watching a download of a FTA [free-to air television] show?" he asked.

We know the answer already. Just watch Bennett Arron's? You join the dots.

Yet right now an organisation that's negligent suffers no legal penalty. That's wrong, especially when the fixes are simply ignored.

The Australian Privacy Foundation would agree too.

"We've been laying off these organisations, permitting them to 'self-regulate', ha ha. It is simply inadequate," said Professor Roger Clarke, chair of the Australian Privacy Foundation, in the wake of the Apple iPhone location scandal and the Sony data breaches last year.

"The law has to get to grips with detail now. It's got to be technology-specific, and it's got to create teeth. We've got to have criminal offences for organisations that are insecure."

Agreed. It's time to put a bit of stick about...

Contact Stilgherrian at Stil@stilgherrian.com or follow him on Twitter at @stilgherrian

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