Melbourne Law School - Research Publications
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ItemImpact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review(JMIR PUBLICATIONS, INC, 2022-05-04)BACKGROUND: The adoption of electronic health records (EHRs) and electronic medical records (EMRs) has been slow in the mental health context, partly because of concerns regarding the collection of sensitive information, the standardization of mental health data, and the risk of negatively affecting therapeutic relationships. However, EHRs and EMRs are increasingly viewed as critical to improving information practices such as the documentation, use, and sharing of information and, more broadly, the quality of care provided. OBJECTIVE: This paper aims to undertake a scoping review to explore the impact of EHRs on information practices in mental health contexts and also explore how sensitive information, data standardization, and therapeutic relationships are managed when using EHRs in mental health contexts. METHODS: We considered a scoping review to be the most appropriate method for this review because of the relatively recent uptake of EHRs in mental health contexts. A comprehensive search of electronic databases was conducted with no date restrictions for articles that described the use of EHRs, EMRs, or associated systems in the mental health context. One of the authors reviewed all full texts, with 2 other authors each screening half of the full-text articles. The fourth author mediated the disagreements. Data regarding study characteristics were charted. A narrative and thematic synthesis approach was taken to analyze the included studies' results and address the research questions. RESULTS: The final review included 40 articles. The included studies were highly heterogeneous with a variety of study designs, objectives, and settings. Several themes and subthemes were identified that explored the impact of EHRs on information practices in the mental health context. EHRs improved the amount of information documented compared with paper. However, mental health-related information was regularly missing from EHRs, especially sensitive information. EHRs introduced more standardized and formalized documentation practices that raised issues because of the focus on narrative information in the mental health context. EHRs were found to disrupt information workflows in the mental health context, especially when they did not include appropriate templates or care plans. Usability issues also contributed to workflow concerns. Managing the documentation of sensitive information in EHRs was problematic; clinicians sometimes watered down sensitive information or chose to keep it in separate records. Concerningly, the included studies rarely involved service user perspectives. Furthermore, many studies provided limited information on the functionality or technical specifications of the EHR being used. CONCLUSIONS: We identified several areas in which work is needed to ensure that EHRs benefit clinicians and service users in the mental health context. As EHRs are increasingly considered critical for modern health systems, health care decision-makers should consider how EHRs can better reflect the complexity and sensitivity of information practices and workflows in the mental health context.
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ItemStrengthening Australia’s cybersecurity regulations and incentives: Response to the Department of Home Affairs Discussion Paper( 2021)The development of the regulatory and incentives framework is a key opportunity to align Australian enterprises’ cybersecurity practice with latest research, particularly on consumer protections, and emerging cyber threats and security challenges. The Australian Government has an essential role in establishing incentives to encourage best practice and consequences to combat poor practice. It will be increasingly important for government at all levels to act as a role model, by following best practice in the conduct of its public business.
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ItemNo Preview AvailableThe Hidden Harms of Targeted Advertising by Algorithm and Interventions from the Consumer Protection Toolkit(National Law School of India, 2021-01-01)Developments in pervasive data collection and predictive data analytics are allowing firms to target consumers with increas ingly precise personalisedbehavioural and contextual advertising. These techniques give rise to new risks of harm in the attention economy by unduly influencing or manipulating consumers' deci sions and choices, and by narrowing the product options visible and available to them. In many countries, the legal response to concerns about targeted advertising by algorithm has been focused on privacy protection and data rights. These are important initiatives. However; consent-based data rights are unlikely to provide a comprehensive or even adequate response to the risks of harm to consumers occasioned by the kinds of algo- rithmically targeted advertising that are now possible. This paper suggests that a suite of responses from the consumer protection toolkit are required to address the different and potentially harm ful manifestations of algorithmic ally targeted advertising. These include bans and warnings as well as making use of standard safe- ty-net prohibitions on misleading and unconscionable/unfair con duct already in place in many jurisdictions.