Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, July 14, 2018

Weekly Overseas Health IT Links – 14th July, 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.

Happy Birthday NHS: A look back at its digital milestones

As NHS celebrates its 70th birthday today, professor Daniel Ray, director of data at NHS Digital, reflects on the three major milestones in data and technology that have  impacted the health service and how digital could transform it still further.
DHI Admin
5 July 2018
I cannot help but turn to the Hospital Episodes Statistics (HES) when I look at how data played a part in shaping the NHS since it was first founded in 1948.
There is no disputing the power of HES as its sheer volume and depth is phenomenal, producing a world-leading, unique, database to support health and care research.
It is, quite simply, unique in the world and has contributed to the advancement of health and medicine across the globe.

NHS Digital launches new de-identification system for sharing patient data

NHS Digital is launching a new de-identification system to anonymise patient data for the purpose of sharing it across various health and care settings.
4 July 2018
The organisation has signed a contract with privacy software company Privitar to deliver the technology, which is designed to prevent an individual’s identity from being connected to their patient data.
The de-identification (De-ID) process will enable NHS Digital to better protect identifiable information in cases where patient data is shared for research and planning purposes, to help deliver a better picture of how care services are delivered across the NHS.
While NHS Digital already employs means of de-identifying data across the NHS, the De-ID system provides a single means of doing so across the organisation’s entire estate.
A procurement notice for the system was put out in February this year.

Next-gen telehealth: AI, chatbots, genomics and sensors that advance population health

Telemedicine platforms and tools will transform virtual care by incorporating emerging technologies and novel uses of data.
July 06, 2018 10:01 AM
While the use of telemedicine systems has been expanding in recent years, especially as more payers have begun reimbursing for some telehealth services, the industry is on the verge of more widespread virtual care.
But what will that ultimately look like? The next generation of tools will feature enhancements ranging from chatbots, machine learning and genomics to remote diagnostic tools and better sensors.
Here’s a look at what to expect in the near future. 

How A Leading Cyber Security Company Uses Blockchain Technology To Prevent Data Tampering

Rachel Wolfson , Contributor
July 3, 2018
While cryptocurrencies remain vulnerable to a number of cyber security attacks, the underlying blockchain technology is being used to protect user data from being modified.
We believe that blockchain technology will be transformative in the tech and IT sector in the coming years, similar to what the internet did for the world back in the 90s and early 2000s,  said John Zanni, President of the Acronis Foundation. We started a few years ago working with the Ethereum blockchain to see how to better protect data. Today, part of our storage and backup software lets users notarize any digital data and put that fingerprint on the blockchain to ensure it can’t be tampered with.
As the physical world meets the digital world, data has become a key player for a number of businesses. Yet ensuring that data remains safe, secure, private and authentic has become an ongoing challenge.

At Northwell Health, IT Leaders are Revamping the EHR with AI, NLP and Voice Tools

July 5, 2018
by Heather Landi
For physicians and clinicians, electronic health record (EHR) usability and the time spent box-checking and on data entry are oft-cited sources of frustration and stress. Numerous studies and surveys indicate widespread dissatisfaction among physicians with the time spent on EHR documentation and the impact on patient interactions.
A study published in the Annals of Family Medicine last fall found that primary care physicians spend nearly two hours on EHR tasks per hour of direct patient care. Another time and motion study published in the Annals of Internal Medicine in October 2016 found that, outside office hours, physicians spend another one to two hours of personal time each night doing additional computer and other clerical work. What’s more, a Mayo Clinic study linked EHRs with physician burnout.
Some of the biggest names in technology are working to tackle this problem, as well as innovative teams at many large health care systems, with a focus on developing “smart” EHRs using artificial intelligence and voice recognition technology. As recently reported by CNBC, Google is exploring ways to use AI and voice recognition to improve patients’ visits to the doctor. CNBC reported that four internal job openings at Google describe building the "next gen clinical visit experience" and using audio and touch technologies to improve the accuracy and availability of care.

Photoacoustic CT offers quicker way to scan for breast cancer

Published July 06 2018, 7:28am EDT
Researchers at the California Institute of Technology in Pasadena and Washington University in St. Louis have discovered a way to make scanning breast tissue for cancer a lot easier.
In a single breath-hold, with the woman lying in a prone position without painful compression of the breast, an accurate scan is now available, they say in a paper on their findings, published June 15 in Nature Communications.
According to lead researcher Lihong Wang, professor of medical engineering and electrical engineering at CalTech, the single-breath-hold photoacoustic CT (SBH-PACT) could be available relatively soon. “A company called CalPACT has licensed our IP,” he says. “Depending on the clinical testing and regulatory approval process, commercial availability is expected to take a few years.”

The Spotify/iTunes Model For AI In Health Care

Brigham Hyde
CEO and Founder of Precision Health AI.Partner at the Symphony AI Venture Fund.
July 5, 2018
Artificial intelligence (AI) in health care has become the subject of both great promise and great hyperbole. Beyond buzzwords and a plethora of venture capital investments, AI and other mathematical techniques are beginning to emerge in a second wave of domain-specific systems of intelligence. The key missing factor has been a business model in the payer-and-provider community that enables the “best” (aka: most validated, most clinically proven, most workflow-integrated) models to drive an economic value both to the care paradigm and to the cost centers of health care data storage and analytical processing.
Cloud Vendors Are Beginning To Create A Model For Performance-Based AI In Health Care
As the cloud storage wars have entered health care, a question has emerged: Beyond security and the improved economics of cloud storage versus physical storage, what will drive revenue for cloud vendors? Furthermore, how will horizontal cloud vendors prove the validity of AI offerings to impact the business needs of providers and payers such as improved quality, decreased workload and better outcomes? From IBM Watson to Microsoft, a Symphony AI partner, as well as Amazon and Google, the question of how AI practically affects care is critical for most health care players.

CMS Administrator Seema Verma presses for remote monitoring of patients

She says redesign of the home health payment system would encourage value over volume.
July 03, 2018 03:05 PM
The Centers for Medicare and Medicaid Services is promoting the idea of paying home health agencies for monitoring patients remotely.
Remote monitoring enables the collection of patients’ health data, such as vital signs, weight, blood pressure, blood sugar, blood oxygen levels, heart rate and electrocardiogram readings.
In a statement Monday, CMS Administrator Seema Verma said more use of remote monitoring would allow doctors more time with their patients. At the same time, home health agencies would be able to leverage innovation to drive better results.

Dell to go public once again - what that could mean for healthcare

After an eventful few years in which it was taken private, made the biggest tech acquisition in history and retooled itself for the new century, Dell is expected to return to the market in a $21.7 billion deal next week.
July 03, 2018 01:26 PM
Michael Dell is ready to return his company to the public stock market, five years after taking it private with help from investment firm Silver Lake.
The New York Times reports that Dell could go public again as early as next week, in a complex $21.7 billion stock buyout deal it says will enable the company to make investments in its future with the founder and CEO firmly in control.

Using mHealth as a Care Management Tool for Bariatric Patients

New York's Icahn School of Medicine at Mount Sinai has launched an NIH-funded study examining how mHealth can help bariatric surgery patients with care management.

July 03, 2018 - Healthcare providers are studying whether a mobile health platform can help patients who have undergone bariatric surgery in managing their weight and addressing mental health issues that sometimes appear after the operation.
In a study funded by the National Institutes of Health, researchers at New York’s Icahn School of Medicine at Mount Sinai are working with Noom’s mHealth platform to create a digital health care management program that targets the 20 percent of bariatric patients who regain the weight they’d lost and the 30 percent who develop mental health-related side effects.  
Dr. Andreas Michaelides, a Bronx-based psychologist and Chief Psychology Officer for Noom, is the lead researcher on the project. mHealthIntelligence recently spoke to him about the project, as well as the promise of and challenges in working with mHealth.

Algorithm can find patients likely to benefit from aggressive BP treatment

Published July 05 2018, 7:35am EDT
Researchers at UT Southwestern in Dallas are using machine learning to predict which patients will benefit most from intensive high blood pressure treatment.
The decision tree algorithm they developed combines three simple variables routinely collected during clinic visits to identify adults with hypertension who are at the highest risk for early major adverse cardiovascular events, such as death, heart attack or stroke.
Patient data from two large clinical trials that tested intensive vs. standard blood pressure lowering—Systolic Blood Pressure Intervention Trial (SPRINT) and Action to Control Cardiovascular Risk in Diabetes (ACCORD)—were leveraged to identify patients for whom the benefits of intensive therapy outweigh the risks.

EHR Top Priority When Developing Value-Based IT Competencies

By Jonathan Bees  |   July 05, 2018

Having a seamlessly integrated EHR environment is one of the keys to successfully implementing value-based care at healthcare organizations.

Providers are especially focused on EHR capabilities as they work to improve their IT competencies in preparation for value-based care, given the critical role the EHR plays within healthcare organizations.
According to the 2018 HealthLeaders Media Value-Based Readiness Survey, for example, the top three IT competency items are all EHR related: enhancing provider efficiency through EHR usability (57%), EHR standardization among care partners (49%), and EHR interoperability (46%).
Having a seamlessly integrated EHR environment is one of the keys to successfully implementing value-based care, and it is no surprise that providers are concentrating on this area.

HIT Think 5 reasons why big data will become everyone's job

Published July 05 2018, 5:52pm EDT
Big data was once a responsibility reserved for data analysts and technical experts, but we’re entering an era where everyone is, in some ways, required to use data in their roles.
Business intelligence software that enables staff and clinicians to access valuable insights without SQL knowledge or other IT skills is already emerging, and soon, some element of data collection, organization or management may be a part of every department.
So why is this change happening, and what will the healthcare world look like once it manifests?

Special Report: Observations and vital signs

In December last year, the Royal College of Physicians released an updated version of the National Early Warning Score – NEWS 2. It is now being mandated by the government that all acute and ambulance trusts align with NEWS 2 – or risk losing income. With 20% of hospitals still not using the national early warning scoring, how difficult will it be to implement the new system? And how can technology help? Maja Dragovic reports.
In 2015, there were about 60 early warning score systems used in hospitals across the UK. The systems are designed to help staff identify a patient whose condition is deteriorating – the higher the score, the sicker the patient. But the variation in systems is such that a patient’s score in one place might be different in another.
In the West of England region alone, all of their six hospitals used to use different scores.

‘Minor’ Errors In Medical Records Can Have Major Consequences

Guest Writer
Courtesy Abby Norman While reviewing my medical chart before a routine appointment, I was asked about my eight sisters, all of whom were listed as in good health. I don’t have any sisters.
“Quality” is a buzzword in many industries ― but in health care, it’s lumped in with “safety,” since poor quality can lead to much more than just customer dissatisfaction.
Medical errors are the third leading cause of death in the U.S., according to Johns Hopkins University School of Medicine researchers: Each year, approximately 250,000 patients in the U.S. die due to such errors. But more often than not, medical errors hurt patients in unobvious ways, just as an illness doesn’t always present itself clearly and instead takes root perniciously, over time and under the radar. They’re a sign of a much more severe ailment that plagues our entire health care system.

How disparate EHR systems, lack of interoperability contribute to physician stress, burnout

The evolution of the patchwork EHR landscape has been complex, and one expert traces the problem back to meaningful use.
July 02, 2018 11:48 AM
Physician burnout is an increasingly common issue in healthcare, and there are a lot of factors that can contribute to it. Long hours, paperwork and the burden of administrative tasks all play a part. But electronic medical records can also contribute to burnout, largely because each system is different. With disparate electronic health record systems comes an added hardship for physicians, affecting their work -- and their reimbursement.
Compounding the issue is that many physicians are no longer limited to just one facility. Many handle rounds at multiple hospitals and/or practices, and if each has its own EMR system that doesn't necessarily communicate with the others, it can be a growing headache.
Niki Buchanan, general manager of population health management at Philips Health, said the lack of interoperability is taking a toll.

Cleveland Clinic puts EHR data onto iPhone with Apple Health Records

In combination with the Epic MyChart app, patients can now access lab results, meds, vitals and more.
July 03, 2018 10:00 AM
Cleveland Clinic announced Monday that its patients can now access their personal health data on their iPhones with the Health Records feature.
That, together with Cleveland Clinic's version of the Epic MyChart app, offers patients more comprehensive mobile access to their own health data and a way to manage appointments, message their physicians and more, officials said.
"Access to one's own medical records is a crucial part of the digital transformation taking place in healthcare today, and enhances our relationship with our patients," Peter Rasmussen, MD, a neurosurgeon and medical director of digital health at Cleveland Clinic, said in a statement.

PA Hospital Cuts Opioid Scripts, Looks At New Ways To Ease Pain

Eric Scicchitano | Daily Item Jul 2, 2018
The culture of clinicians treating pain as a fifth vital sign, targeting pain-free living through a prescription regimen, is acknowledged as a driving factor behind the rise of opioid addiction.
The American Society of Addiction Medicine found 4 in 5 new heroin users began by abusing prescription painkillers.
Geisinger Health System took efforts to change that culture internally, slashing by half its opioid prescriptions and focusing instead on a regimen of pain management combining physical therapy with changes in diet and behavior.

GAO: VA spent $3B on VistA EHR since 2015

Written by Jessica Kim Cohen | July 02, 2018 | Print  | Email
The Government Accountability Office released a report June 26 on the U.S. Department of Veterans Affairs' impending transition to a Cerner EHR.
VA Secretary David J. Shulkin, MD, revealed plans to replace the agency's homegrown EHR VistA with a Cerner system in June 2017. The GAO's report, part of an ongoing review, highlights its preliminary observations regarding the VA's preparation for the Cerner EHR transition.
Here are three insights from the report:
1. The GAO noted the VA has begun preparation for its transition to a new EHR, including clarifying its approach to interoperability and establishing governance for the new program. The VA is also developing a framework for joint governance with the U.S. Department of Defense, which has already begun deploying Cerner.

California law introduces new data concerns for healthcare organizations

By Rachel Z. Arndt  | July 2, 2018
California legislators are giving companies dealing in personal data—including some health information—yet another set of restrictions to contend with thanks to a new broad privacy law passed last week.
The California Consumer Privacy Act of 2018 gives consumers more control over the personal data that businesses collect. Companies have to tell people what data they've collected, what they're using the data for, and which third parties they've given access to the data, among other requirements.
Although healthcare companies already comply with HIPAA, the new state law will create another layer of compliance when it goes into effect in a year and a half.

AHA to CMS: Industry needs more secure mobile apps

Published July 03 2018, 3:56pm EDT
The American Hospital Association, in comments sent to the Centers for Medicare and Medicaid Services relating to the Hospital Inpatient Prospective Payment System for FY 2019, is calling attention to CMS on the need for more secure mobile apps.
There is a lot of information that regulators and hospitals need to know about the current data security status of mobile apps and while AHA asserts the importance of data exchange, much of its comments are sober.
“Hospitals and health systems believe that securely sharing health information is central to providing high quality coordinated care, supporting new models of care and engaging patients in their health, according to the association. New tools and technologies, including APIs and apps, will allow for more convenient and flexible access to health information and new ways for individuals to engage in their health.”

HIT Think How clinician alert systems need to become smarter

Published July 03 2018, 3:28pm EDT
Electronic medical records systems are causing a lot of challenges for clinicians. Of all the issues with usability, data quality, communication and more, one of the biggest challenges with the systems is alert fatigue, and the complaints have merit.
The number of alerts constantly interrupting workflow, although intended to be helpful, are on the rise as technologists abuse the ability to fit more messages on a screen. This precious real estate is being devalued, as alerts are ignored, studies show. This is obviously not what health IT envisioned for the system, and as physician burnout reaches an all-time high, it is a pressing problem technologists must solve.
The solution lies in giving clinicians more control over their workspace—that can reduce the burden of the system on the user to make it more useful, applicable to them personally, and insightful about a patient—possibly even more pleasant to have to use in the first place. Consider the smartphone and how it’s used by millions as their workspace every day. Users control the apps that are installed on their phones, where they are placed on the screen and the alerts that are received.

3 Questions You Must Ask Before Investing in AI

By Mandy Roth  |   July 03, 2018

Eager to experience the advantages artificial intelligence promises to deliver, healthcare executives may leap before looking into issues that could create future liabilities.

As artificial intelligence (AI) makes deeper inroads into healthcare, health systems may embrace innovation without knowing what questions to ask to protect against potential liability and patient care issues that may occur down the road.
A new report from Accenture indicates, "As AI continues to play a greater role in decision-making, four-fifths (81%) of health executives said they are not prepared to face the societal and liability issues that will require them to explain their AI-based actions and decisions." In addition, 86% "have not yet invested in capabilities to verify data sources across their most critical systems."

WannaCry, Petya 1 year later: The good, the bad and the ugly

Healthcare providers are investing more in cybersecurity, but an increase in threat sophistication and threat actors mean the industry is still not ready for the next big global cyberattack.
June 29, 2018 01:19 PM
It's been about a year since the WannaCry and Petya cyberattacks ravaged IT systems around the world, crippling hospitals and technology vendors alike. The healthcare industry is still unprepared for the next big attack.
In May 2017, the WannaCry ransomware attack hit more than 300,000 computers and knocked hundreds of businesses offline, including the U.K. National Health Service. Just one month later, hackers struck again with Petya wiper malware, which permanently damaged the IT systems of its victims, including two U.S. health systems and FedEx.
What's most concerning is that these attacks are seen by many in the security field as poorly executed test attacks – but still their victims were unprepared for the major damage they caused.

Mining EHR data could help physicians uncover signs of dementia earlier

Written by Julie Spitzer | June 28, 2018 | Print  | Email
Mining unstructured notes in the EHR could help physicians and nurses more easily recognize signs and symptoms of Alzheimer's disease and other kinds of dementia, according to a new study published in the Journal of the American Medical Informatics Association.
Andrea Gilmore-Bykovskyi, PhD, RN, an assistant professor at the University of Wisconsin–Madison School of Nursing, led a team of researchers from UW-Madison, the William S. Middleton Memorial Veterans Hospital in Madison and Penn State University in State College, Pa., which combed through unstructured progress notes from the EHRs of 343 patients diagnosed with dementia.
The team was specifically looking for words and phrases that could be indicative of a cognitive dysfunction, like "forgetful at times, "increased confusion in the evening," "disoriented and agitated," "limited by confusion" and "finding it hard to find words."
Health Care Technology Impacts Younger Patient Satisfaction
Younger health care consumers are dissatisfied with technology capability of health care organizations
THURSDAY, June 28, 2018 (HealthDay News) -- Health care communication technology is a determinant of patient satisfaction in younger patients, according to a report published by Black Book Market Research LLC.
Black Book collected over 57,000 viewpoints on information technology and outsourced vendor performance and provided interested sectors of the clinical technology industry with comprehensive comparison data.
According to the report, 89 percent of health care consumers younger than 40 polled in the survey reported being unsatisfied with the technology capabilities of the health care organizations with which they seek services. Most (84 percent) reported wanting the most technologically advanced and electronically communicative medical organizations available. Higher expectations were reported by younger health care consumers, who are more dissatisfied with their inpatient provider experience where complete medical records and telehealth options were not offered (92 and 85 percent dissatisfied, respectively).

AMIA Notes Health IT Safety Considerations to FDA in EHR Use

Using health IT to support quality improvement in primary care is an EHR use excluded from the definition of device in the Cures Act, the association explained.

June 29, 2018 - There are key considerations within EHR use related to health IT safety, AMIA explained in response to FDA’s request for input on health IT benefits and risks associated with the software functions excluded from the 21st Century Cures Act device definition.
FDA requested feedback on its approach to adhering to the Cures Act, specifically with regard to non-device software functions and assessing the impact that such software functions have on patient safety.
“The Cures Act amended the Federal Food, Drug, and Cosmetic Act to exclude certain medical software functions from the definition of a medical device,” FDA explained in a May 2018 blog post. “Under the Cures Act, Congress excluded specific types of software from FDA regulation, including general wellness software products, electronic patient records and more.”

6 Themes Driving Healthcare Leaders to Change

By Philip Betbeze  |   June 28, 2018

A report featuring leaders of 24 healthcare organization in a variety of positions shows that high prices and costs continue to fuel big changes that will require collaboration and innovation.

A report featuring candid conversations with 24 industry leaders from a variety of healthcare subsectors shows broad agreement on six themes that should drive healthcare convergence and an improvement of the patient experience.
To win, these subsectors must learn to collaborate, says the report. Authored by by privately held real estate firm Transwestern and IMEG, a design and consulting firm, the report features collected responses from a discussion among thought leaders at 24 healthcare-related organizations.

Digital health funding shows no signs of tapering off with $3.4B invested in first half of 2018

Jul 2, 2018 3:17pm
For the second straight year, more than $3 billion flowed into digital health companies during the first half of the year.
Investors sunk $3.4 billion into digital health companies during the first six months of 2018, nearly matching the record-setting $3.5 billion during the first half of 2017, according to data released by Rock Health. The average deal size of $17.9 million was the highest it's been since the group began tracking funding data in 2011.
Last year, the industry saw record-breaking funding totals reach $5.8 billion.

Vanderbilt leverages blockchain, FHIR for secure sharing of medical records

Published July 02 2018, 7:08am EDT
Engineers at Vanderbilt University say they have successfully developed and validated the feasibility of a blockchain-based architecture that leverages HL7’s Fast Healthcare Interoperability Resources standard for secure and confidential sharing of patient medical records.
Called FHIRChain, the technology meets the Office of the National Coordinator for Health IT’s technical requirements for sharing clinical data between distributed providers, according to Vanderbilt researchers, who developed it in collaboration with radiation oncology treatments and software maker Varian Medical Systems.
Specifically, FHIRChain uses FHIR data elements in conjunction with a token-based design to exchange data resources in a decentralized and verifiable manner without actually moving the data.

HIT Think 6 ways an analytics platform can help execs make strategic decisions

Published July 02 2018, 5:41pm EDT
During the past year, a great deal of attention has been paid to the physical expansion of the healthcare industry. Kettering Health Network announced it will soon begin construction of a $70 million, five-story tower at Soin Medical Center in Beavercreek, Ohio. Phoenix-based Banner Health currently has 386 active construction projects across its markets, totaling $1.7 billion. And Jersey Shore University Medical Center is close to completing its $265 million outpatient tower.
The expectation is that these new facilities and expansions will drive revenue for hospitals through the delivery of new, high-quality services, as well as increase volume for existing services.
However, building new physical capacity or starting a new service line isn’t always the right approach to strategic revenue growth. First, this approach might not be financially viable for many hospitals and health systems. Second, and potentially more important, it might not be necessary. The opportunity for growth may be hidden, lying dormant across existing resources and services.


Trevor3130 said...

A paper at WEIS2018 (pdf) looked at Underground Trade in Code Signing Certificates. Does anyone know if this aspect of security is relevant to MyHR?

Anonymous said...

Thanks Trevor that was a heavy but interesting read for a Sunday morning. I don’t have an answer but I do wonder what the implications might be in the secure messaging area? After all there appears to be an acceptance to allow vendors to use their own proprietary PKI.

Andrew McIntyre said...

The article is about code signing certificates, which are used to trace executables back to a legitimate company and you virtually need this in todays IT landscape or anti-virus will prevent your applications running. If there is a leak here it is a concern as it makes it easier to run malicious software on your computer.

In the matter of PKI infrastructure for healthcare, I would much prefer a official certificate as issuing a certificate does need to be well validated and this does run against the "get it up and running quickly" with a minimal of fuss that is the reality of the messaging world.

Its a telling indictment of the lack of ability of our national eHealth bodies to get this up and running after > $2 Billion spend over 15 years. IBM were given $24 Million to do it at some stage but nothing was ever seen and Medicare have done it, but never in a timely or scaleable way. Renewals for example were via post!

I would be much happier to send clinical data off to "wherever" if I knew it was encrypted by a reliable certificate and received messages were signed by a reliable certificate. I suspect the government also wants to duck this responsibility and in the end you have to ask what the $2Billion spend has actually delivered, I struggle to name anything that is workable.

If there is one thing that a national eHealth authority should deliver its a PKI infrastructure and its failure to do that suggests you have to take any of their security claims with a grain of salt.

Anonymous said...

Sounds as though faxes are safer until the government gets its act together.

Anonymous said...

Just to put this in a real world context - https://www.okta.com/security-blog/2018/06/issues-around-third-party-apple-code-signing-checks/

I recall ADHA published something on code Cerys a few years back, probably a reissue of nehta, however when I went looking I got a rather blunt/rude - access denied- you must register. I appreciate it is a developer site, but registration should be voluntary and serve a purpose other than preventing access to guidance paid for by the general public.


Anonymous said...

1:53 PM. That is just how things are with ADOHA. You need to say the secret password ‘I love what you doing, you are an inspiration and strategic gift from god’

Anonymous said...

@12.09 PM - you have to take any of their security claims with a grain of salt.

Quite agree, especially they way the seem to think the minimum security requirements for a system are somehow beyond the call of duty. They do have something in common with the banking industry...