Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Wednesday, January 31, 2018

Talk About A Non-Committal Release From The AMA On The myHR And Digital Healt. I Reckon They Don’t Want A Bar Of It.

This was released a few days ago.

Update From The Australian Digital Health Agency

25 Jan 2018


The Australian Digital Health Agency (ADHA) has provided the AMA with updates relevant to GPs and My Health Record. The ADHA receives considerable input and advice from AMA members.
Former AMA President, Dr Steve Hambleton, has outlined the importance of My Health Record in allowing for the straightforward and secure sharing of information. Up-to-date shared health summaries can easily be accessed by other healthcare practitioners, allowing for patients to receive continuity of care. Read more about Dr Hambleton’s experience and thoughts here.
AMA member and GP representative Dr Chris Moy has outlined the critical role My Health Record plays in improving patient care. His experience with following up on an unwell patient was made all the easier with an up-to-date My Health Record. Read more about his experience here.
My Health Record will be expanded to an opt-out model in 2018 – information on this can be found here and the Department will be providing the AMA with updates, which will be communicated in future articles in GPNN.


Here is the link:
I can see it all now – the ADHA wanting some publicity so saying to the AMA we want a release on what wonderful things are going in Digital Health – a per our Memorandum.
The AMA says OK and adopts the most minimalist of minimalist approaches and you see what comes out!
Barely enough wind to move the curtains!
Love it!
David.

A Very Interesting Survey Of Australians On Digital Health And Other Matters.

This appeared last week:

Most Australians would not sign up to an online health record, survey finds

Lynne Minion | 23 Jan 2018
Almost two-thirds of Australians want their healthcare records to be shared more effectively across healthcare providers but only 38 per cent would consider signing up to a secure online summary of their health information, a new study has found.
As the Australian Digital Health Agency moves towards this year’s creation of a My Health Record for every Australian who doesn’t opt-out, the research into digital technology in healthcare commissioned by GlaxoSmithKline shows that 51 per cent are concerned about the privacy of their online personal information.
“Their hesitation towards embracing electronic health records is largely due to uncertainty around the privacy of data, how securely patient records are stored and even patient attitudes toward the government or EHR provider,” Director of Healthcare Environment at GSK David Herd told Healthcare IT News Australia.
“Privacy and security are, of course, non-negotiable when it comes to patient health data.”
According to the survey, despite the Federal Government committing $374.2 million over two years to the MyHR opt-out roll-out, over 60 per cent of Australians would not consider opting in to a secure online health record platform. This is despite 57 per cent of respondents claiming they want improved sharing of their healthcare records between health providers.
It’s a disconnect that will take careful communicating by the government and healthcare industry to address.
“It is the responsibility of both government and healthcare providers accessing the records to ensure this roll-out is managed carefully, and in a way that gives privacy and security of data a non-negotiable first priority,” Herd said.
More here including comments on clinical engagement and AI.
Here are more details from the press release:

Australians embrace digital health but privacy remains top concern

06 December 2017
Results of a new study commissioned by GlaxoSmithKline Australia (GSK) reveal that Australians are in a bind when it comes to healthcare digitisation - recognising the benefits of healthcare technologies but struggling with anxieties around privacy.
While nearly three quarters (72.8%) of Australians reported using technology in some form to manage their health, more than half (51%) ranked concerns about the security of their personal information as their top reservation about how technology is affecting healthcare.1
“As an industry, we have a role to play in ensuring digital innovation continues to enhance patients’ experiences and that data transparency is done right. Upholding these responsibilities will help build confidence that as increasing digitisation propels healthcare in an exciting direction, the privacy of Australians will continue to be respected and maintained,” said David Herd, Director of Healthcare Environment at GSK.
Technology continues to change the way healthcare services are being delivered and the widespread introduction of electronic health records is just one such change. Although the Federal Government has committed $374.2 million over the next two years to provide every Australian with an electronic health record by default,2 only 38% of those questioned said they would consider signing up to have a secure online summary of their health information, if given the option.1
Despite highlighting a reluctance to sign up to online health records, the survey also found that 57% wished their healthcare records could be more effectively shared digitally across healthcare providers - an output that electronic health systems aim to deliver by better connecting national health systems, resulting in better, faster and more efficient care.1
“The results of this research suggest that greater education is needed to instil trust and understanding of how new healthcare technologies will ultimately benefit the end-patient and our nation as a whole,” said Herd.
While technology is valued as a means of support, many Australians still place their trust in humans over machines, with almost a third (29.9%) of Australians worried about the use of artificial intelligence in place of a person to make decisions about their healthcare.1 Other concerns about the effects of technology on healthcare included being able to find trustworthy and accurate information (34.8%) and a lack of personal contact with healthcare practitioners (31.4%).1
“As the scope of possibility increases with the evolution of health technology, so do patients’ expectations of how services should meet their needs. While algorithms and digitisation will bring welcome efficiencies, it is essential that digital innovations reflect the care and support the needs of patients,” Herd explained.
Moving forward, consumers are still hopeful that healthcare tech will facilitate major gains in the future. According to the survey, these include cheaper, more convenient access to services which are more tailored to the individual as well as services which support filtering accurate, trustworthy and relevant information.1
“Digital technology continues to change the face of healthcare and is rapidly increasing the scope of how we can help Australians better manage their health,” said Herd.
From electronic health records through to wearable health technology, innovation is supporting healthcare to become more personalised, targeted and effective. As a result, Australians are more empowered to take more control of how they manage their health,” he added.
-ENDS-
About the research
GlaxoSmithKline (GSK) commissioned Ipsos to conduct an online survey in August 2017. The research was a nationally representative sample of 1,000 Australian adult respondents (18+), who’s responses were gathered to understand their use of and views towards healthcare technologies.
Here is the link
All in all a useful sounding of public views unfiltered by spruikers and detractors.
David.

Tuesday, January 30, 2018

This Has To Be A Real Step Forward And May Even Save A Few Lives!

This appeared last week:

How the ACT is eliminating hospital errors

By Justin Hendry on Jan 22, 2018 6:00AM

New systems cross-reference patient with process.

ACT Health has embarked on a clinical systems transformation that will see patients electronically cross-referenced with pathology orders and medication at their bedside in an effort to eliminate errors at the point of care.
The territory's health directorate has completely overhauled how it interacts with patients to banish the paper-based records and processes that are the traditional causes of mixed up blood samples and medications in hospitals.
Despite having made a significant effort to strengthen these processes in recent years, ACT Health wasn't getting the reduction in avoidable errors it wanted. 
So it starting looking at electronic tools to eliminate transcription mistakes.
Chief information officer Peter O'Halloran and team decided to take the bold step of equipping Health's electronic record systems with identification standards.
Patient wristbands and staff ID cards were upgraded to include GS1 compliant barcodes, as were clinical note labels and specimen labels.
It required modifications to eight separate IT systems provided by different vendors to get them to accept the GS1 barcodes.
Now, when a clinician takes a blood sample, they are required scan both their own and the patient's barcodes at the outset, before the specimen label can be scanned and printed. A computer on wheels kitted out with the barcode scanners is used by the patient's bedside.
It means a pathology specimen label can only be printed in the presence of the patient, reducing the risk that the label will be incorrect or misapplied.
"Electronic ordering and collection has eliminated paper order readability and transcription incidents," O'Halloran said.
More here:
While hardly earthshattering it is these sort of initiatives that incrementally improve the outcomes provided by the health system and overall can make hospitals safer places to the cared for within.
More of this sort of initiatives and less crusading against the fax machine makes pretty good sense to me – not that we should not be able to both walk and chew gum!
David.

It Looks Like The Big IT Of The DHS Are Struggling Again With The Little Things.

This appeared last week:

DHS offers one-time passcodes for myGov login

By Allie Coyne on Jan 23, 2018 2:52PM

Updated: But early reviews aren't good.

Australians can now continue using two-factor authentication on their myGov accounts when overseas or out of mobile range through new one-time access codes.
But early reaction to the service has not been as positive as the Department of Human Services might have hoped.
The myGov Access mobile app - available on Android and iOS as of last month - replaces the SMS code or secret questions and answers that have until now been required with a person's username and password to log into the online service portal.
The one-time codes address an issue with SMS two-factor authentication that meant users who were unable to receive an SMS based on their network coverage faced being locked out of their myGov account.
DHS previously advised users in such situations to switch off two-factor SMS authentication prior to entering an SMS dead zone. Login then reverts to requiring responses to security questions.
Once a person has been locked out of their account, they have no option but to create a new one - MyGov does not offer an account recovery feature - which has led to people operating multiple myGov accounts under the same name. 
The new myGov Access app is "ideal for people going overseas or where mobile reception is poor," according to the department.
The app creates a six-digit one-time code that can be used alongside a username and password to sign into myGov. A new code is created every 30 seconds and is valid for a maximum of 60 seconds.
The app can, however, only be used on one mobile device.
"If you change your device or want to delete the app, you must first go to your myGov account settings and change your sign in options," DHS says.
Uninstalling the app risks locking the user out of their account.
More of the gory details here:
You really would think they would sort all this out before releasing it on an unsuspecting public.
Note, of course, that this gateway is the path to the myHR….
More work needed it would seem!
David.

Monday, January 29, 2018

Weekly Australian Health IT Links – 29th January, 2018.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Another really quiet week with the occasional highlights. Enjoy!

On another matter congrats to Dr Mukesh Haikerwal on his AC. One of the very few to honestly call the faults with NEHTA, the PCEHR and myHR. While making no claims to technological genius he could see clearly what was working and useful and what was not!
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Most Australians would not sign up to an online health record, survey finds

Lynne Minion | 23 Jan 2018
Almost two-thirds of Australians want their healthcare records to be shared more effectively across healthcare providers but only 38 per cent would consider signing up to a secure online summary of their health information, a new study has found.
As the Australian Digital Health Agency moves towards this year’s creation of a My Health Record for every Australian who doesn’t opt-out, the research into digital technology in healthcare commissioned by GlaxoSmithKline shows that 51 per cent are concerned about the privacy of their online personal information.
“Their hesitation towards embracing electronic health records is largely due to uncertainty around the privacy of data, how securely patient records are stored and even patient attitudes toward the government or EHR provider,” Director of Healthcare Environment at GSK David Herd told Healthcare IT News Australia.
“Privacy and security are, of course, non-negotiable when it comes to patient health data.”
-----

Apple can win electronic medical record game with Health Records in iOS 11.3: Here's 7 reasons why

Apple's enterprise footprint, approach to privacy and partnerships will give it an edge with Health Records, a feature in iOS 11.3 to position the company in medical health records.
By Larry Dignan for Between the Lines | January 25, 2018 -- 12:10 GMT (23:10 AEDT) | Topic: Digital Transformation
Apple's next update of operating system for iPhones and iPads will include a feature called "Health Records" that may ultimately be best positioned to aggregate electronic medical records for individuals.
The move to electronic medical records and the patient portals that go with them has been underway for years. There are multiple players in the space and tech giants such as Microsoft and Google and now Apple have been inserting themselves into the health care market.
Meanwhile, wearable device companies can also be players in the patient data game. Fitbit and Apple have been partnering with medical device makers and that data can ultimately be rolled up into a portal and health record.
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23 January 2018

Genomes, blockchains, bitcoins and the bottom line

Posted by The Conversation
Did you know that when you take certain genetic tests, the company can make money by on-selling your data to other businesses?
Now new blockchain-based marketplaces could give individuals control over access to their encrypted DNA data, and the ability to sell it to research companies for their own profit.
Consumer DNA testing saw unprecedented public demand in 2017. By one estimate, 10 million genetic tests were conducted on individuals by companies such as AncestryDNA.
People using these services may not realise that the real money for some of these companies could lie in the sale of genetic data to third parties for medical research. A 23andMe board member reportedly explained this in 2013:
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How online repeat prescriptions can improve patient satisfaction

By HealthEngine | 17 Jan 2018
More than 74 million prescriptions were dispensed in Australia last year alone. With 46 per cent of patients reporting that they require routine medication to manage their health, it’s clear that repeat prescriptions are an integral part of the wellbeing of many Australians. 
Patients need to ensure they obtain a repeat prescription before their current one runs out. How do GPs handle patient requests for ongoing medication? Do patients have a good experience with their practice when they need such medication?
We surveyed more than 2000 patients and 27 GPs to find out.
Just over 90 per cent of patients said they need to make an appointment for repeat prescriptions of their regular medication, yet 80 per cent of doctors believe there are circumstances where they could safely prescribe repeat prescriptions without a face to face consult.
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How the ACT is eliminating hospital errors

By Justin Hendry on Jan 22, 2018 6:00AM

New systems cross-reference patient with process.

ACT Health has embarked on a clinical systems transformation that will see patients electronically cross-referenced with pathology orders and medication at their bedside in an effort to eliminate errors at the point of care.
The territory's health directorate has completely overhauled how it interacts with patients to banish the paper-based records and processes that are the traditional causes of mixed up blood samples and medications in hospitals.
Despite having made a significant effort to strengthen these processes in recent years, ACT Health wasn't getting the reduction in avoidable errors it wanted. 
So it starting looking at electronic tools to eliminate transcription mistakes.
Chief information officer Peter O'Halloran and team decided to take the bold step of equipping Health's electronic record systems with identification standards.
-----

Update From The Australian Digital Health Agency

25 Jan 2018


The Australian Digital Health Agency (ADHA) has provided the AMA with updates relevant to GPs and My Health Record. The ADHA receives considerable input and advice from AMA members.
Former AMA President, Dr Steve Hambleton, has outlined the importance of My Health Record in allowing for the straightforward and secure sharing of information. Up-to-date shared health summaries can easily be accessed by other healthcare practitioners, allowing for patients to receive continuity of care. Read more about Dr Hambleton’s experience and thoughts here.
AMA member and GP representative Dr Chris Moy has outlined the critical role My Health Record plays in improving patient care. His experience with following up on an unwell patient was made all the easier with an up-to-date My Health Record. Read more about his experience here.
-----

Scientists 'walk' through cancer cells using virtual reality

Friday, 12 January, 2018
Researchers are using groundbreaking virtual reality technology that allows multiple scientists to see inside a human cell at the same time, giving them a three-dimensional tool to improve doctor interaction and help analyse how cancer drugs work.
UNSW Art & Design’s Associate Professor John McGhee is working with Professor Maria Kavallaris, from UNSW Medicine and Children’s Cancer Institute, in the second phase of the Journey to the Centre of the Cell project, a major initiative that combines scientific data, microscopy images and animation to create a virtual reality (VR) world of cells and blood vessels that can be seen through headsets.
“I saw we could do so much more with VR than selling products and superheroes,” said McGhee. “We have amazing gaming technology and we can use it to benefit patients and specialists. The inner workings of the body can often get lost in specialist data and this makes the process democratic.”
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Vax reminders effective

Sending vaccination reminders to patients can increase immunisation rates by up to 8%, depending on the target population, a Cochrane review has concluded. The analysis of data from 75 studies found that letters and text messages were both effective, but a simple phone call was the best. The evidence was strongest for childhood and adolescent vaccinations, the authors said. There was also good evidence suggesting that centralised recall systems, not just local ones from individual practices, boosted immunisation rates.
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DHS offers one-time passcodes for myGov login

By Allie Coyne on Jan 23, 2018 2:52PM

Updated: But early reviews aren't good.

Australians can now continue using two-factor authentication on their myGov accounts when overseas or out of mobile range through new one-time access codes.
But early reaction to the service has not been as positive as the Department of Human Services might have hoped.
The myGov Access mobile app - available on Android and iOS as of last month - replaces the SMS code or secret questions and answers that have until now been required with a person's username and password to log into the online service portal.
The one-time codes address an issue with SMS two-factor authentication that meant users who were unable to receive an SMS based on their network coverage faced being locked out of their myGov account.
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Lysn up: mental telehealth online platform expands nationwide with low tech option for poor internet areas

Thea Cowie | 24 Jan 2018
An Australian mental health startup that has developed an algorithm to pair patients with a psychologist nationwide who best suits their needs is expanding its online therapy service and going old school with the addition of telephone sessions for those in remote regions with poor internet coverage.
Lysn aggregates the qualifications and specialties of hundreds of Australian psychologists and matches them with people seeking telehealth counselling sessions.
“When patients sign up, they complete a questionnaire that profiles their specific needs to best match them with the right psychologist using Lysn’s proprietary algorithm,” said Dr Jonathan King, founder of the startup with the motto: You talk, we lysn.
“This means that patients in both metropolitan and rural regions can now have access to a wide range of psychologists specialising in a field that best suits their requirements.”
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How a single app cut the load on Catholic Healthcare's call centre

By Justin Hendry on Jan 23, 2018 12:00AM

Using OAuth to do without login credentials.

A Samsung tablet equipped with the OAuth authorisation protocol has drastically reduced the volume of calls to Catholic Healthcare's call centres and handed control back to its elderly clients.
Since this time last year the not-for-profit aged care and retirement provider has been giving tablets running the Breezie aged care interface to its home care customers.
The not-for-profit operates 51 residential aged care and retirement living communities, but a growing number of its clients choose to remain in their own home.
These clients rely on regular visits made by Catholic Healthcare's carers, but previously visibility for these customers into when - and who - would be making these visits was limited.
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Citadel Group reveals IT and cloud wins with Victorian Health, Melbourne City Council, Queensland transport and others over six months

ASX-listed Citadel Group has secured a slew of contract wins over the past six months including new government deals and 17,000 new cloud services customers.
In a letter to investors, the managed services provider gave an update on some $62 million worth new contracts and renewals signed since mid-2017. Among the successes it highlighted are a multi-site pathology laboratory information system for Victoria, enterprise collaboration provisioning for Melbourne City Council and a transport deal with the Queensland government.
The company’s Victorian pathology laboratory information system deployment was completed recently, with care providers Austin Health, Peter MacCallum Hospital and Melbourne Health all now live on Citadels lab information system, called Evolution, as of 20 January. The company also signed Eastern Health in Victoria onto the Evolution system in a $1.7 million-per-year contract until 2023.
“Together, over 4000 staff across Australia are now using our LIS solutions and we hope to be able to back up these successes with further roll-outs across Victoria, New South Wales and South Australia as opportunities arise,” Citadel chief executive Darren Stanley said.
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M3DICINE's Stethee stethoscope adds connected analytics, ditches the tubes

January 25, 2018
Brisbane, Australia-based M3DICINE is the latest device maker looking to distance physicians from their signature rubber-tubed stethoscopes. Today, the company announced the launch of Stethee, a wireless, artificial intelligence-boosted stethoscope that pairs with an iOS or Android app to quickly capture and analyze heart and lung data.
“This most iconic and enduring symbol of healthcare is now reinvented, into an intelligent and sophisticated medical device — a powerful diagnostic assistant that becomes more intelligent the more it is used,” Dr. Nayyar Hussain, founder and CEO of M3DICINE, said in a statement. “The complementary Stethee Apps bring the power of machine learning and deep neural networks to health professionals worldwide who can use this data not only to monitor the progress and health of individual patients, but collectively to uncover new patterns and trends to help in the fight against heart and lung disease globally.”
Stethee, which was cleared by the FDA late last year, filters and amplifies the sounds of a patient’s heart or lungs before sending the audio to a user’s connected headphones via Bluetooth. A copy is also made on the Stethee app, which can display the audio file as a continuous phonocardiograph or calculate heart rate. The device includes a Beat Finder feature to help determine the optimal location for it to be held, and collects the data needed to make its analyses within 20 seconds. 
The platform’s AI engine, named “Aida,” automatically tags geolocation, patient position, and environmental data — such as humidity, temperature, or pollen count — when making its analyses. These data points are encrypted and anonymized, and can be reported back or shared with practitioners as quantitative reports.
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EPAS Senior Business Analyst, Reporting (Multiple Vacancies)

  • Department for Health and Ageing, eHealth Systems, EPAS Program
  • Indicative Total Remuneration*: $96,599-$102,467 - ASO6 - Full Time / Term Contract (up to 28 December 2018)
Accountable for providing high level analysis, expertise and advice into the identification and organisation of data elements required to facilitate strategic and operational reporting from data captured and managed within EPAS. Identify how reporting requirements can be met; from existing or modified standard EPAS reports or the specification of new reports that address the needs of SA Health; at the enterprise, corporate health unit and, where appropriate, at the individual level.
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Health records firm badly hit by Windows ransomware

A billion-dollar electronic health records company in Chicago is struggling to recover from an attack of a variant of the SamSam Windows ransomware.
Allscripts was hit on Thursday by an attack through data centres in Raleigh and Charlotte in North Carolina. The company has 180,000 doctors across nearly 45,000 ambulatory facilities, 2500 hospitals and 17,000 post-acute organisations on its client register.
A report from CSO Online said Jeremy Maxwell, the company's director of information security, had told customers on Saturday that its PRO EHR and Electronic Prescriptions for Controlled Substances services were the worst affected.
On Sunday, the company told customers that they would have to be prepared for issues to continue through the week, as it continued to use back-ups to restores files that had been encrypted.
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Tax office computer system flaws revealed

  • The Australian
  • 7:38 AM January 25, 2018

Robert Gottliebsen

The Inspector-General of Taxation Ali Noroozi has underlined a number of the dangerous Australian Taxation Office practices that are damaging the small business community in Australia.
And his revelations confirm why the current draft bill to give the ATO even greater powers must be amended or abandoned.
At its essence the ATO is a massive computer systems operation and we have seen lots of anecdotal cases where these systems are not working properly.
The Inspector-General of Taxation helps explain the breakdowns by revealing that the ATO uses two separate accounting systems to administer its PAYG operation.
Not surprisingly this is causing taxpayers to either not receive correspondence or receive correspondence that makes no sense. It also seems that in many cases these systems have to be reconciled manually.
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Is NBN Co planning to drop HFC from rollout plans?

Is the NBN Co, the company rolling out Australia's national broadband network, planning to drop HFC altogether from its multi-technology mix that it adopted after 2013 for the network?
At least two suburbs in Melbourne have been switched from HFC to other technologies in the wake of the company's announcement in November that technical issues were bedevilling the use of the technology.
At that time, NBN Co announced that houses and businesses slated to receive the NBN over HFC would have to wait between six and nine months longer for connections.
Under the revised rollout plan, put in place after the Coalition Government came to power in 2013, the NBN Co planned to use both the Telstra and Optus HFC networks as a means of delivering the NBN, in order speed up the rollout.
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Monkeys cloned from tissue cells amid warnings of opening the door to cloning humans

Sarah Knapton
Published: January 25 2018 - 11:30AM
London: The first monkeys cloned in the same way as Dolly the sheep have been born, raising concerns that it may soon be possible to clone humans.
Chinese scientists at the Chinese Academy of Sciences on Wednesday announced the births of Zhong Zhong and Hua Hua, a pair of healthy macaques that are genetically identical.
The infants are being bottle fed and are said to be growing normally compared with monkeys their age. More cloned births are expected this year.
Previously scientists have "cloned" primates by splitting an embryo in half, but the process is essentially just artificial twinning rather than true cloning.
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Enjoy!
David.

Sunday, January 28, 2018

It Really Looks Like The Department of Health Has Given Digital Health The Boot. It’s Gone Who Knows Where?

The organizational chart which we discussed a day or so ago is very interesting with respect to Digital Health.

What is clear from this link is that the part of the org chart in the lower left that had Paul Madden and Bettina Konti has gone, with her moving to a purple box a half way across the new chart and he vanishing.

Here is the link:

http://health.gov.au/internet/main/publishing.nsf/Content/24BEDAF18381C86ACA257BF0001E0193/$File/Departmental%20Structure%20Chart%20-%2019%20Jan%2018.pdf

Here is a link from the NLA Wayback Machine for almost 6 months ago (August 1, 2017) when all was in place:

http://webarchive.nla.gov.au/gov/20170816053652/http://www.health.gov.au/internet/main/publishing.nsf/Content/health-struct.htm

So we seem to have a pretty major un-announced, as far as I know, change in Digital Health responsibility and coverage.

I think what we need to know is the fate of the senior officers and the projects that they were looking after. The ADHA does not publish a detailed org. chart but what is there has not changed. Has it been a merger, a takeover or outsourcing or are we just not understanding the new chart?

A thorough independent assessment of the before and after suggests:

- The loss of a Dep. Sec. Position and 2 actual individuals at this level.

- The loss of over 25% of the SES Staff in total heads

- The loss of the PIP Program as best I can tell.

I am sure some who read here will know he ins and outs of what has / is going on!

Always fun to start the new working year with a shakeup and a little mystery!

David.

AusHealthIT Poll Number 407 – Results – 28th January, 2018.

Here are the results of the poll.

Will The myHR Ultimately Become A Really Important And Useful System To Support Safe And High Quality Clinical Care - As Originally Intended?

Yes 2% (3)

No 96% (150)

I Have No Idea 2% (3)

Total votes: 156

Any insights welcome as a comment, as usual.

This is as clear cut a poll as we ever see and the implications, at least to me, are pretty obvious.

A really great turnout of votes!

It must have been an easy question with just 2% not sure what the correct answer was.

Again, many, many thanks to all those that voted!

David.

Saturday, January 27, 2018

Weekly Overseas Health IT Links – 27th January, 2018

Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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FDA approves clinical platform that predicts patient deterioration

Published January 19 2018, 7:24am EST
The Food and Drug Administration has approved a clinical monitoring platform that alerts hospital staff in near real time of a patient’s deteriorating condition using a predictive algorithm.
The WAVE Clinical Platform from Excel Medical acts as an early warning system that automatically calculates the risk of patient deterioration about six hours before the patient actually worsens, enabling clinicians to take corrective action before it’s too late to intervene.
According to Mary Baum, chief strategy officer for Excel Medical, WAVE is designed to eliminate unexpected deaths in U.S. hospitals which take the lives of more than 400,000 Americans each year and is the country’s third-leading cause of death.
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Allscripts hit with a ransomware attack affecting a 'limited number' of applications

Jan 18, 2018 4:12pm
This story has been updated to include comments from Northwell Health. 
Allscripts is investigating a ransomware attack impacting a "limited number" of applications, according to a company spokesperson.
“We are working diligently to restore these systems, and most importantly, to ensure our clients’ data is protected,” Allscripts spokesperson Concetta Rasiarmos said in an email to FierceHealthcare. “Although our investigation is ongoing, there is currently no evidence that any data has been removed from our systems. We regret any inconvenience caused by this temporary outage.”
Rasiarmos did not respond to questions about what specific applications were impacted.
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Can mHealth Make the Connection Between Providers and Minorities?

Two new studies report that minorities are much more likely to access mHealth information on smartphones.This may be the link doctors need to create effective population health outreach.

January 18, 2018 - Healthcare providers looking to connect with minorities should develop an mHealth strategy that focuses on the smartphone.
That’s the takeaway from a pair of studies published this month in the American Journal of Managed Care. The studies – one focusing on the variation of devices used to access patient portals and the other examining mobile access to personal health records – found that black and Hispanic populations use smartphones far more often than non-Hispanic whites to access mHealth data, and in many cases  that’s the only device they use.
The studies offer guidance on how to reach underserved populations, as well as offering a warning that mHealth programs now in place may be missing their target patients.
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EHR Data Useful for Measuring Low-Value Clinical Service Overuse

Research shows analyzing EHR data can help identify the prevalence of unnecessary or low-value testing and clinical services.

January 19, 2018 - EHR data can be useful for accurately measuring overused clinical services and low-value testing, according to a recent study published in the American Journal of Managed Care (AJMC).
A research team led by Thomas Isaac, MD, extracted performance information on 13 healthcare services. The services were identified by the Choosing Wisely campaign using EHR data at a large physician practice group from 2011 to 2013. The Choosing Wisely campaign identifies health services that are frequently ineffectual to help providers cut back on unnecessary testing.
In addition to using EHR data to measure rates of clinical services overuse, researchers also manually reviewed charts for 200 cases of overuse for each measure to see if tests had been ordered due to clinical risk factors.
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Report: Best practice programs foster better physician notes

Written by Julie Spitzer | January 18, 2018 | Print  |
Physicians take higher-quality and more efficient notes when they receive education and guidelines that emphasis note-taking best practices, according to a UC-Los Angeles study.
For the study, Neveen El-Farra, MD, and Daniel Kahn, MD, distributed note-taking templates that incorporated best practices at four academic internal medicine residency programs. Residents received both a brief educational conference and the electronic progress note template, which included an inpatient checklist for documenting patient concerns, quality measures and discharge planning. The template offered physicians a way to minimize the use of common efficiency tools — including the auto-population of notes — and instead, encourage them to enter only relevant information.
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EHR Use, Administrative Burden Accelerating Physician Burnout

A response to a recent study of family physician burnout points the finger at increased EHR use and administrative burden.

January 16, 2018 - In response to a new study about high levels of physician burnout among family physicians, Ohio State University Wexner Medical Center family physician Donald O. Mack, MD, suggested the recent transition to a value-based care system and increased EHR use may have augmented the problem.
“Burnout is associated with lower patient satisfaction and care quality, higher medical error rates and malpractice risk, higher physician and staff turnover, physician substance abuse/addiction, and physician suicide,” he wrote.
“The causes are numerous, and in many cases physicians point to the increasing demands of electronic medical records, quality metrics, administrative tasks such as prior authorization, and value-based payment requirements, which take time away from direct clinical care,” Mack continued.
Mack’s commentary came in response to a recent study by Hansen et al. that showed levels of physician burnout vary significantly between states, with Michigan and Minnesota physicians reporting the highest rates of exhaustion.
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Cloud use spurs concerns about data security, access and complexity

Published January 18 2018, 4:22pm EST
Security, management and compliance challenges are impacting the benefits that organizations are receiving from using the cloud, as their infrastructures become more complex, according to a report by WinMagic, a data security provider.
Some 39 percent of respondents surveyed for the research reported that their infrastructure was more complex since they began using the cloud. More than half—53 percent—spend more time on management tasks than they have done previously.
WinMagic surveyed 1,029 IT decision makers in the U.S., U.K., and Germany in November, and found that the vast majority of the organizations (98 percent) reported using the cloud, with an average 50 percent of their infrastructure now in the cloud. One third reported that data is only partially encrypted in the cloud, and 39 percent admitted to not having unbroken security audit trails across virtual machines in the cloud, leaving them exposed.
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ONC: Rise of Alexa, frustrations with legacy systems giving healthcare AI a boost

But the advisory group says acceptance in clinical practice, the ability to leverage personal devices and the availability of quality data are still challenges.
January 17, 2018 02:49 PM
Artificial intelligence has been hyped as much, if not more, than just about any other major technological advancement in recent history — and that is at least as true in healthcare today as it is elsewhere.
But is this time different for AI or will the hype fade away again in the near future?
“The use of artificial intelligence in health and healthcare is promising – and doable,” officials wrote on ONC’s HealthITBuzz blog. 
That’s the conclusion to come out of a new report posted by the Office of the National
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Scientists say artificial intelligence will deliver results in healthcare

Published January 17 2018, 4:46pm EST
Artificial intelligence is starting to play a transformational role in the healthcare industry, even if opportunities for using it are just beginning to be explored.
That’s an initial finding of a new report from JASON, an independent group of scientists advising the federal government on science and technology issues. The Department of Health and Human Services and the Robert Wood Johnson Foundation commissioned the report; the names of the scientists who developed the report are not being released.
Computers can match human competence in image recognition and, in some studies, can make diagnostic decisions on medical images that match or exceed the ability of clinicians. Technology is also getting better at speech recognition and natural language processing.
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Medical Boards Prioritize Opioids, Telemedicine

John Commins, January 17, 2018

Telemedicine, physician burnout, medical marijuana, and interstate medical licensure top the list of concerns for the nation’s state medical boards.

Opioid prescribing and telemedicine are the most important regulatory issues for state medical boards, according to an annual survey by the Federation of State Medical Boards.
"Our member boards play a central role in providing guidance to policymakers and healthcare professionals on how to navigate some of our nation's most pressing medical issues," said Humayun J. Chaudhry, DO, president and CEO of the FSMB.
"Anticipating these trends will help the FSMB provide boards with resources they need to address these challenges and continue their mission," Chaudhry said.
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Canadian Cerner EHR investigation finds install was mismanaged, underfunded

The Ministry of Health's second investigation into Nanaimo's EHR project found that managers failed to leverage advice that could have helped prevent some of those issues.
January 15, 2018 03:46 PM
The Vancouver Island Health Authority's electronic health record implementation has been fraught with controversy since its launch in March 2016. And the latest investigation, by British Columbia's Ministry of Health, stands by provider complaints: The Cerner project was mismanaged – neither properly planned nor implemented.
In fact, the report found that had officials leaned on advice or experiences from other Canadian EHR installs, many of the problems could have been prevented.
The Cerner project went live in March 2016 at Nanaimo Regional General Hospital, Dufferin Place Residential Care Centre in Nanaimo and Oceanside Health Centre in Parksville. But the launch was quickly denounced by many providers -- some even refused to use the technology. This led to Island Health creating some stiff enforcement policies.
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Study shows wearables lack clinical impact, but researchers haven’t lost hope

Jan 16, 2018 8:57am
New research shows that wearables and remote patient monitoring technology have a limited impact on clinical outcomes. But digital health researchers aren't ready to abandon the promise of mobile technology. 
A literature analysis published in the new Nature Partner Journal (npj) Digital Medicine reviewed 27 randomized control studies focused on wearable biosensors and found no statistically significant impact on factors like body mass, waist circumference, body fat percentage, and systolic and diastolic blood pressure. The study adds to a growing body of research indicating that clinical evidence has struggled to keep pace with the hype surrounding wearables.
However, digging into 16 “high-quality” remote patient monitoring studies, the researchers, from Cedars-Sinai Medical Center in Los Angeles, found pockets of promising evidence for certain conditions like obstructive pulmonary disease, Parkinson’s, hypertension and lower back pain. Even more specifically, interventions that use validated health behavior models and tailored coaching saw the highest success rates. In one study, monitoring technology had a significant impact on blood pressure for adults 55 and older.
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Study shows little evidence that wearable biosensors aid clinical outcomes

Published January 17 2018, 7:32am EST
While wearable biosensors have the potential to gather health data to support remote patient monitoring, there is a lack of medical evidence that these devices improve clinical outcomes.
Researchers at Cedars-Sinai Medical Center in Los Angeles note the popularity of wearable biosensors for health and fitness applications such as activity trackers, blood pressure monitors and sleep assessment. But, as Michelle Keller, clinical research specialist at the Cedars-Sinai Center for Outcomes Research and Education, contends, “There is a big difference between using these sensors to track sleep for self-betterment and using them to make medical decisions.”
While their analysis found that the wearable biosensors did show early promise in improving outcomes for certain conditions, including obstructive pulmonary disease, Parkinson's disease, hypertension and low back pain, researchers revealed that remote patient monitoring with these devices had no statistically significant impact on any of six reported clinical outcomes—body mass index, weight, waist circumference, body fat percentage, as well as systolic and diastolic blood pressure.
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Hospital pays $55,000 ransom; no patient data stolen

By Samm Quinn -

1/15/18 11:27 PM
GREENFIELD — Hancock Health paid a $55,000 ransom to hackers to regain access to its computer systems, hospital officials said.
Part of the health network had been held hostage since late Thursday, when ransomware locked files including patient medical records.
The hackers targeted more than 1,400 files, the names of every one temporarily changed to “I’m sorry.” They gave the hospital seven days to pay or the files would be permanently encrypted, officials said.
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Speech recognition for insulin bolus calculator improves postprandial glycemia

January 15, 2018
Patients with type 1 diabetes on insulin pump therapy who used an automatic bolus calculator designed to recognize voice descriptions of meals were more likely than those without the technology to have 2-hour postprandial glucose levels within the target range, according to findings reported in the Journal of Diabetes.
The VoiceDiab system consists of an Android-system smartphone with an app that communicates with a set of three servers, according to Piotr Foltynski, PhD, of the Nalecz Institute of Biocybernetics and Biomedical Engineering at the Polish Academy of Sciences in Warsaw, and colleagues. The servers are responsible for automatic speech recognition and transformation of the verbal description of meals into text, analysis of the textual description of the meal to determine its composition (ie, amount of protein, fat and carbohydrate), and calculation of the insulin dose compensating the meal, according to an algorithm.
“The primary reasons for the use of software applications in bolus calculation are technological opportunities and the reduction of errors in dose calculation by patients using bolus calculators,” Foltynski and colleagues wrote. “Low numeracy is associated with poor diabetes control; therefore, the use of bolus advisors may bring benefits to the patients.”
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AI-based computer model accurately analyzes kidney biopsy images

Published January 16 2018, 1:28pm EST
Boston University School of Medicine has developed computer models based on artificial intelligence that significantly improve the analysis of routine kidney biopsy images.
BU researchers, who conducted a proof-of-principle study on kidney biopsy sections, contend that their AI-based models have both diagnostic and prognostic applications and could lead to the development of software for diagnosing kidney disease as well as predicting kidney survival.
In the study, images processed from renal biopsy samples were collected on 171 patients treated at the Boston Medical Center and were analyzed by convolutional neural networks (CNN) models and nephropathologists, who specialize in the analysis of kidney biopsy images.
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'Explainable AI' Could Reduce Readmissions (and Win Clinicians' Trust)

Alexandra Wilson Pecci, January 16, 2018
This technology can accurately predict 30-day readmissions and clarify the AI process for clinicians.
Artificial intelligence (AI) has the potential to change the healthcare industry, but gaining the trust of clinicians to use it can be a barrier to adoption.
"A lot of the resistance from clinicians … is because people don't quite understand how [AI analytics] work," says Kamal Jethwani, MD, MPH, senior director of Connected Health Innovation at Partners HealthCare.
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In-Depth: News and views from CES 2018

January 12, 2018
Las Vegas was once again host to the annual CES conference (formerly known as the Consumer Electronics Show), and digital health players came out in force. Along with a roundup of all the device launches and announcements that caught our eye, MobiHealthNews has put together a primer on the biggest news and discussion points that came out of the trade show and its Digital Health Summit.
Big brands talk healthcare consumerization
Unsurprisingly, several of the conference’s participants were eager to talk about the impact consumerization has had on the industry. For certain companies, like Johnson & Johnson, that means creating health products and services that aren’t just useful, but also easy to stomach.
“It goes beyond just the care itself, which may be top quality, but all the pre- and post-care, administrative, and other aspects of it just feel like they are 100 years behind, where the rest of the economy isn’t,” Marc Leibowitz, global head of health technology and Johnson & Johnson, said during a roundtable session. “As leaders in the healthcare field, our mission is to borrow from the successful work that has been done in retail and other areas, and apply those in healthcare to enhance the overall experience.”
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Healthcare at CES 2018: Blockchain, Blue Button and interoperability among hot topics

Health data sharing, telemedicine, even federal value-based payment plans were all part of the excitement at the Consumer Electronics Show in Las Vegas.
January 12, 2018 02:23 PM
LAS VEGAS -- The tech world descended upon Las Vegas this week for the annual Consumer Electronics Show, and plenty of health IT’s biggest players were in attendance. While much of the discussion was on consumer-friendly health tools and novel digital interventions, there were still a handful of products and discussions between executives and entrepreneurs focused on healthcare’s largest roadblocks — namely, data management and analytics.
“Everyone loves playing in their own sandbox. How does it get to the point of sharing that data? How do we have EMRs being shared across systems today?” Pat Keran, VP of innovation and R&D at Optum Technologies, said during a roundtable discussion at CES’ Digital Health Summit. “I think data sharing is first and foremost, but even for the data that we have, how do we effectively analyze that today? How do we use artificial intelligence, deep learning, those types of things that are starting to evolve right now into being a lot more effective for where we’re at today?” 
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Doctors must stop blaming EHRs for clinical documentation shortcut failures

With copy and paste rampant, UW Health chief medical information officer Shannon Dean says toolkits and vendors can help, but physicians need to take responsibility for proper clinical documentation.
January 12, 2018 04:11 PM
Overuse of copy and paste in electronic health records is a problem. Sure, it's convenient. And it's entirely understandable why it's a common shortcut used by scores of physicians. But it often results in note bloat – unwieldy patient records overflowing with repetitive documentation – that can potentially lead to serious safety risks.
"Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error," wrote researchers in a 2017 study in Journal of the American Medical Association.
The practice of copy and paste has to be reigned in, and one chief medical information officer, writing for the Agency for Healthcare Research and Quality, says that has to start with the physicians themselves.
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Connecticut Supreme Court allows patients to sue providers for HIPAA violations

Jan 15, 2018 10:58am
Add Connecticut to the list of states that allow patients to sue providers for unauthorized disclosure of their medical records.
The Connecticut Supreme Court ruled last week that patients have the right to bring legal action against a provider. Other courts throughout the state have ruled that although HIPAA allows the federal government to issue penalties for violating patient confidentiality, the federal law does not provide a private right of action for patients to collect damages.
The high court's ruling establishes a new legal precedent for the state, falling in line with other jurisdictions that allow patients to sue providers for damages tied to confidentiality violations.
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  • 01.11.18

Having A Heart Attack? This AI Helps Emergency Dispatchers Find Out

The time between calling 911 and the ambulance arriving can be critical for saving heart attack victims, but the person on the phone may not know what’s happening: this AI parses non-verbal clues to help diagnose from a distance.

When someone goes into cardiac arrest outside of a hospital, time is critical: The chance of survival decreases about 10% with each minute. The first step–recognizing that it’s cardiac arrest, when your heart fully stops–is challenging for emergency dispatchers on the phone, who have to make sense of symptoms relayed by a panicked friend or relative.
In Copenhagen, dispatchers now have help from AI. If you call for an ambulance, an artificially intelligent assistant called Corti will be on the line, using speech recognition software to transcribe the conversation, and using machine learning to analyze the words and other clues in the background that point to a heart attack diagnosis. The dispatcher gets alerts from the bot in real time.
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Strong Growth Forecast for Telemedicine

John Commins, January 15, 2018

The industry is riding sustained tailwinds that will push growth of 30% to more than 40% in coming years. Factors include a growing dearth of clinicians, an aging population, and technological innovations that will improve patient access and experience.

If Teledoc, Inc. is a bellwether for the telemedicine industry, the outlook is bright.
Jason Gorevic, CEO of the Purchase, NY-based telemedicine provider, called 2017 "a landmark year as we redefined the virtual care delivery landscape with our acquisition of Best Doctors."
"Through rapid integration, Teladoc has brought to market innovation that gives members a single point of access for a wide array of medical needs. We are seeing a tremendous reception from both clients and prospects to this unique, comprehensive solution," he said.
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6 digital health predictions for 2018

  • The IPO market won't open up in 2018, but expect plenty of M&A.
  • Artificial intelligence will be used in unsexy ways before it disrupts clinical workflows.
  • Tech companies will make big moves in the space.
Steve Kraus, Bessemer Venture Partners
Published 2:16 PM ET Sun, 14 Jan 2018
Steve Kraus, one of the most active health-tech investors in the industry, gave his predictions for 2018, following the J.P. Morgan Healthcare Conference this week in San Francisco.

Don't expect IPOs

I think the public markets will remain closed in 2018 for health-tech companies. However, I do expect 2019 and the years beyond that to start to look more fruitful for initial public offerings, as well-funded start-ups like Health Catalyst, Flatiron Health, Welltok, Grand Rounds Health and others start to scale beyond $100 million in revenue and some of them start to reach positive EBITDA levels.
Healthcare mergers and acquisitions will remain robust but will focus more around health-care service businesses — many of which may be tech-enabled — rather than pure health-care IT companies.
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Part 1: How can NHS use technology to reduce winter pressures?
18 January 2018
As the NHS grapples with a winter crisis, can technology help in alleviating some of the pressures? In this first article of two-part series, we look at how some of the global digital exemplars are using digital to address the demands on the health service. 
As more reports emerge about accident and emergency departments in England missing waiting targets, doctors warning about dying patients and hospitals cancelling elective operations until 31 January 2018, the NHS winter crisis shows no sign of abating.
Amid calls for additional money, more resources for social care and increase in staffing levels, an important point that has been missing in most of these discussions (at least in the mainstream media), is the role of technology in alleviating winter pressures.
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Overcoming the barriers to greater use of mobile technology in healthcare
19 January 2018
For many of us, the idea of navigating daily life without a smartphone or tablet computer has become unthinkable. And yet, while on the up, such technology has not yet achieved ubiquitous status in healthcare settings. Claire Read reports on new Digital Health Intelligence research exploring why that is, and how barriers to greater use of mobile technology in healthcare might be overcome.
You’re walking down the street and spy someone coming towards you, but it’s very clear they haven’t spied you. Their eyes are cast downwards, at a shiny rectangular object in their hand. And they can’t even hear your footsteps, what with the music blaring from the distinctive white earbuds dangling from their ears.
If it feels like the vast majority of the people you encounter are obsessed with their phone, then that’s because they probably are. According to research by UK telecommunications regular Ofcom, three quarters of UK adults now own a smartphone, and almost 60% have a tablet computer. And that near-ubiquity of mobile devices is, undoubtedly, impacting healthcare.
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Enjoy!
David.