Surprisingly for some, Telstra was recently awarded a $220 million contract from the government to construct and maintain an electronic cancer register. Prior to Telstra winning the contract, the process was far less efficient. Cervical cancer screening had been run by eight separate state and territory based cancer registries, for example. Screening for bowel cancer by one central body that mostly relied on postal reminders, as ABC reported. Telstra’s on a mission.
How Telstra Sees the Cancer Register
Managing Director of Telstra Health, Shane Solomon, says Telstra will bring several benefits to the screening register: “The advantage of having it under one roof is, first of all, having the data [so] we can follow up [with] people, and secondly it makes the whole system more efficient.” Solomon also mentioned the relative ease of tracking patients for follow-up, should they move to a different state.
Yet the cancer register is only part of what Telstra Health department envisions. Telstra wishes to use their technological advantage in “creating a unified operating system for care delivery” to “enable a seamless experience across the entire care continuum. This strategic platform opens the door to a new era of personalized evidence-based medicine, with the patient at the centre of everything we do.”
Their website goes further, “We’ve seen what the digital technology revolution has done to meet challenges in other industries. We believe Australia’s healthcare system can benefit significantly from a successfully implemented, connected eHealth system, reducing the reliance on multiple face-to-face interactions and removing an often siloed approach to care.”
Telstra’s Philanthropic Gains
Would Telstra profit from all this philanthropy? Of course it will. Telstra has a responsibility to shareholders to make as much money as possible and this is an ajascent market which could make it a lot. The telco giant is not new to the concept of healthcare or technology. Using the motto, “Technology to the Rescue,” Telstra Health:
- Builds apps for hospitals, pharmacies, general practitioners and senior care
- Provides development, support and content management services to the National Health Services Directory
- Offers services to electronically transfer patient referrals and prescriptions
- Operates Australia’s largest online booking system and health directory provider
- Assists remote patient monitoring and does telephone and video support for remote GP visits
- Aggregates medical intelligence for facility use
Telstra offers services in other industries besides health and government, including education, financial services, insurance, manufacturing, media, mining, public safety, retail, transport, logistics and utilities.
In core telco, Telstra provides mobile solutions, i.e. the basics such as business apps and messaging to other companies as most phone companies do. In addition, they provide cloud services, like video and web conferencing. The telco helps support various industries with:
- Customer contact centres, allowing other companies to outsource their customer service needs to Telstra
- Internet security services that include phishing protection, anti-virus software, firewalls and the like
- Digital publishing and marketing services across devices
- Vehicle fleet tracking and monitoring
- Satellite services
- Network management
Given all this, it really is no surprise that Telstra is growing its health records segment. It’s just one more piece of the Telstra pie.
Health Data Collection in Australia
The collection of electronic health data began when the government allocated $467 million in 2010 towards the start of the personally controlled electronic health record (PCEHR) system that’s now known as My Health Record. As the original name still indicates, the records are “personally controlled” by patients, and both consumers and healthcare professionals alike can opt in or out of the program. It is non-binding.
While patient consent is generally needed for any institution that holds health information (such as Telstra holding a cancer register) to do things other than store it, there are exceptions when it comes to research.
According to the Office of the Australian Information Commissioner (OAIC),
“In certain circumstance[s], the Privacy Act permits the handling of health information and personal information for health and medical research purposes, where it is impracticable for researchers to obtain individuals’ consent. This recognizes the need to protect health information from unexpected uses beyond individual healthcare [and] the important role of health and medical research in advancing public health.”
The Privacy Commissioner approved the guidelines that direct the handling of health information for the purposes of medical research when there is no patient consent. They also mandated that “public interest in the research activities substantially outweighs the public interest in the protection of privacy.”
According to the OAIC, these guidelines – the details of which are contained in Section 95A of the Privacy Act 1988 (difficult reading at best) – assist Human Research Ethics Committees in deciding whether to approve research applications from registries like Telstra Health.
Telstra Conducts Research with Public Health Records
The Sydney Morning Herald reports Telstra’s cancer register is “part of the Coalition’s plan to ensure Australia remained a world-leader in cancer research, prevention and treatment.”
The Herald quotes Minister for Health Sussan Ley as saying,
“This national register will do everything from sending patients reminders they’re due to undergo cancer screening all the way through to ensuring their doctor knows the results, as well as helping researchers find the cures of tomorrow.”
Whether or not the plan was announced for Telstra Health to conduct research using the cancer register, the fact that it is handling a specific set of data clearly indicates this and has set off a wave of privacy concerns.
Executive Director of the University of New South Wales Cyberspace Law and Policy Centre, David Vaile, talked to ABC about his concerns: “Those existing registries [who, prior to Telstra Health’s contract, conducted cervical and bowel cancer screening] were pretty trustworthy. They may not get it right all the time, but it’s relatively straightforward they don’t have a built-in conflict of interest.
“Telstra on the other hand is a strong proponent of big data, of open data. They’re obviously a commercial operation. They’re often seeking to use personal information for uses beyond what it was originally collected for and to push the limits of privacy and data protection law.”