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"

or

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

Tuesday, September 27, 2022

Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety, Social Media And Security Matters. Lots Of Interesting Perspectives - September 27, 2022.

This weekly blog is to explore the news around the larger issues around Digital Health, data security, data privacy, AI / ML. technology, social media and any related matters.

I will also try to highlight ADHA Propaganda when I come upon it.

Just so we keep count, the latest Notes from the ADHA Board were dated 6 December, 2018 and we have seen none since! It’s pretty sad!

Note: Appearance here is not to suggest I see any credibility or value in what follows. I will leave it to the reader to decide what is worthwhile and what is not! The point is to let people know what is being said / published that I have come upon, and found interesting.

-----

https://www.innovationaus.com/no-proof-covidsafe-app-developers-were-delivering/

No proof COVIDSafe app developers were delivering

Joseph Brookes
Senior Reporter

21 September 2022

The government agency responsible for outsourcing the development of the failed COVIDSafe app did not monitor the developer’s performance or consider value for money as the contract more than doubled to $6 million.

The Digital Transformation Agency (DTA) also failed to notice multiple overpayments to the company totaling nearly $400,000, which have not been paid back six-months after being identified. The agency was made responsible for Australia’s controversial contact tracing app early in the pandemic.

According to a scathing new review of the DTA’s ICT procurement, agency officials decided to “bypass the usual process” to select the developers of COVIDSafe because it was related to the pandemic.

They would later fail to notice overpayments or properly monitor exactly what the company was delivering.

COVIDSafe was officially scrapped last month by the new Labor government, which called it a “colossal waste of more than $21 million of taxpayers money” after it discovered just 17 unique close contacts in the two years despite millions of downloads.

-----

https://www.innovationaus.com/govt-handpicked-deloitte-for-mygov-upgrade/

Govt handpicked Deloitte for myGov upgrade

Justin Hendry
Editor

21 September 2022

Deloitte was the only supplier approached for a major overhaul of the myGov platform that has netted the consulting giant more than $45 million so far, a scathing audit of the Digital Transformation Agency’s procurement practices has uncovered.

Concerns have also been raised with a similar approach used to source a funding case for a future stage of the myGov update, with the subsequent contract with Nous Group increasing to “40 times its original value” in two years after a procurement process that fell short of “ethical behaviour requirements”.

Both procurements were probed by the Australian National Audit Office (ANAO) in its audit released on Wednesday, which revealed the DTA failed to follow the Commonwealth Procurement Rules (CPRs) on nine key procurements worth almost $55 million.

Deloitte was contracted to deliver “enhancements to the myGov portal” under the ‘myGov Upgrade Horizon 1’ procurement in March 2020, having initially handed it $1 million to develop a prototype for a new government digital experience platform, dubbed GovDXP.

-----

https://www.croakey.org/digital-technologies-in-mental-healthcare-creating-opportunities-for-better-care-or-a-new-form-of-asylum/

Digital technologies in mental healthcare: creating opportunities for better care, or a new form of asylum?

·         Alison Barrett

·         Piers Gooding and Simon Katterl

·         Wednesday, September 21, 2022

Introduction by Croakey: With a rapid increase in the use of digital technology in healthcare, it is critical the technologies are implemented in a careful and safe way, particularly in the area of mental healthcare.

While digital technology provides some benefits for mental healthcare, such as anonymous help-seeking, some challenges exist in establishing these benefits, according to Dr Piers Gooding and Simon Katterl, co-authors of a new report.

Below, Gooding and Katterl outline some of the challenges including privacy and surveillance concerns, whether users are able to provide meaningful consent, and the immense influence of Big Tech interests, including Elon Musk and Meta/Facebook.

They argue for stronger protection of users’ privacy and human rights, accountability and the inclusion of people with lived experience of mental health and healthcare into all stages of development.

“When people use digital mental health technologies, they should be safe and secure,” they write.


Piers Gooding and Simon Katterl write:

Mental healthcare is becoming increasingly digital, giving rise to competing visions for the future of our mental health systems.

In one world, new technologies help expand our best responses to mental distress and crises, with digital technologies selectively introduced to augment care in genuinely helpful ways.

In another future, the worst features of the current system are expanded by new technological possibilities, to create a kind of digital asylum for the 21st century, based on control and surveillance.

-----

https://www.theaustralian.com.au/business/technology/hacked-optus-data-goes-back-five-years/news-story/8528e08701c90e7d466c1a180699bae4

Hacked Optus data goes back five years

David Swan

David Ross

6:15AM September 24, 2022

Hackers have obtained personal customer data dating back as far as five years, the Optus chief executive has revealed, as she delivered an emotional mea culpa for a massive data breach that has affected up to 10 million customers.

Kelly Bayer Rosmarin said on Friday that current and former customers from 2017 have been caught up in the cyber attack, which has been linked to hackers using European IP addresses.

The hackers have stolen the passport, driver’s licence and phone numbers of up to 2.8 million customers – most of whom are yet to be contacted – in one of the largest data breaches in the nation’s history. Up to another seven million Optus users had their dates of birth and email addresses stolen.

The executive was on the verge of tears when asked how she felt about the data breach occurring under her leadership.

-----

https://www.news.com.au/technology/online/hacking/cyber-expert-explains-how-optus-users-will-know-theyve-been-hacked/news-story/bdeca08f7f6a185ca3f2107992b75904

Cyber expert explains how Optus users will know they’ve been hacked

A cyber expert has explained how Optus customers will know they’ve been hacked, after the telco suffered a major cyber attack that left millions compromised.

Anton Nilsson and Adelaide Lang

September 24, 2022 - 8:58AM

Whether it’s an email from Optus or a flurry of spam from fraudsters, anyone caught up in the telco’s cyberattack should find out soon enough.

Millions of Australians may have had their personal information stolen and sold by the cybercriminals behind this week’s massive attack against Optus.

People’s names, dates of birth, phone numbers, and email addresses have been exposed, Optus has confirmed.

Some current and former customers have even had their passport or driver’s licence numbers compromised.

The people worst affected are likely to hear from Optus first, the telco’s chief executive said on Friday.

-----

https://www.smh.com.au/national/now-you-know-tiktok-is-bombarding-our-teenagers-with-fake-news-20220920-p5bjms.html

Now you know: TikTok is bombarding our teenagers with fake news

Kerri Sackville

Columnist

September 24, 2022 — 5.00am

The other day my teenager told me an interesting story.

“Kids in the US are barking in class,” she said, “and the teachers aren’t allowed to discipline them because they have to respect their gender identity as animals.”

I frowned. The story sounded fake. “Where did you learn this?” I asked.

“Online,” she said cheerily.

I hit Google and did some research. The story wasn’t true. It was born of a fake news item on YouTube, clearly designed to send the message that “gender politics has gone mad!”

But my daughter didn’t see the story on YouTube, or even Facebook, those bastions of misinformation. She saw it on TikTok.

I have long been aware of the dangers of TikTok. Its parent company is ByteDance, whose major stakeholder is the Chinese Communist Party. There have been repeated calls for TikTok to be banned in Western countries, due to privacy and data sharing concerns.

But until recently the content on TikTok seemed relatively benign. Sure, there were the odd dangerous “challenges” (Tide Pods, anyone?) but with its dance routines, comedy videos, makeup tutorials and Booktoks, for the most part, it was innocuous fun.

-----

https://www.afr.com/technology/optus-ceo-gets-on-the-front-foot-in-a-no-win-situation-20220923-p5bkgf

Optus CEO gets on the front foot in a no-win situation

Optus boss Kelly Bayer Rosmarin fronted a media pack keen to get details on a hugely damaging cyber attack, even though she openly had no idea what all the answers should be.

Paul SmithTechnology editor

Sep 23, 2022 – 12.50pm

Optus chief executive Kelly Bayer Rosmarin found herself in an unenviable position on Friday morning after a significant cyber breach of the telco’s systems caused panic among many of its 11 million customers.

Morning TV news shows went big on the story on Friday, introducing commentators to warn punters – of varying degrees of tech-savvy – that they need to be vigilant in checking that their various accounts are not being ripped off.

How they do that is another matter, of which nobody has any fool-proof answers.

In that context, Bayer Rosmarin made a courageous and correct call to get in front of the media in a video call that felt strangely intimate and completely open.

Journalists’ questions were in plain view in a text box, meaning she could not dodge the tricky ones. She made no attempt to hide the fact that this was a mess, and that she did not have many answers about how it all happened.

-----

https://www.smh.com.au/technology/what-we-know-about-the-optus-hack-so-far-and-what-customers-should-do-20220923-p5bkfc.html

What we know about the Optus hack so far - and what customers should do

By Nick Bonyhady

September 23, 2022 — 10.06am

What has happened?

Optus detected a cyberattack on its systems on Wednesday. Hackers accessed the data of up to 9 million people, including names, addresses, phone numbers and email addresses for many along with driver’s license numbers and passport numbers for a smaller group. The hack was disclosed on Thursday afternoon. The hackers’ access has been removed but just how much data was stolen and why is not yet known.

What is Optus doing about it?

Its chief executive Kelly Bayer Rosmarin has apologised to customers and said she was “devastated” by the attack. It has shut down the hackers’ access and called in the Australian Cyber Security Centre, a government agency that works with the nation’s top online spies, to help assess the hack and trace its source. The federal police, privacy regulators and banks have also been notified. SIM card swaps, replacements and ownership changes have been paused online for Optus customers. They can only be done in store as a precaution against fraud.

Should Optus customers change their passwords or credit card details?

So far, there is no indication from Optus that password or financial data was compromised. Instead, users should be vigilant about requests that they don’t recognise to change those details because it could be an indication someone is impersonating them with data that was stolen.

What should customers do?

Be wary. Keep an eye out for offers, customer support calls or even scam warnings that ask for approvals or passwords. Even if these use your real name or phone number and appear to come from a company that isn’t Optus, they could be exploiting data from the hack. Verify any communications by independently contacting the company that appears to have sent them. Never click on suspicious links. Do not give out passwords.

-----

https://www.afr.com/politics/federal/meet-the-woman-remaking-a-government-mega-agency-20220919-p5bjam

Meet the woman remaking a government mega-agency

After reaching a low with robo-debt, Services Australia is being reborn with a powerful new tech platform and a focus on being a trusted provider of services.

Tom Burton Government editor

Sep 22, 2022 – 10.38am

The night of Sunday, September 4, was a make or break moment for Services Australia chief executive Rebecca Skinner.

After years of planning, brand research and $200 million of technical development, the myGov accounts of 24 million Australians were due to be transferred to a new service portal.

Following almost a decade of derision, the clunky, “work horse” green myGov website was finally being retired, in favour of what Skinner describes as a bright fresh blue for Australia’s largest authenticated website. Beyond the paint job, the myGov site, which brings together a diaspora of high-volume government services such as Centrelink, Medicare, the Australian Taxation Office and personal health records, received a massive technological overhaul.

Built on mainframe technologies, the old site was well past its technical use-by date. Too often it had been overwhelmed, most recently in March 2020 when nearly 90,000 people tried to access the site after national cabinet suddenly shut the country down to stop the spread of COVID-19.

-----

https://www.itnews.com.au/news/optus-attack-exposes-customer-information-585567

Optus attack exposes customer information

By Ry Crozier on Sep 22, 2022 2:51PM

Personal details of 1.1 million customers purportedly offered for sale.

Optus has suffered a cyber attack and data breach involving the details of potentially millions of customers, with “a subset” having their identity documentation exposed.

The Australian reported Thursday that “about 2.8 million” customers had personal details exposed in the attack, though Optus has not put any numbers out publicly on the impacted cohort.

Early on Friday, Emsisoft threat analyst Brett Callow posted a screenshot on Twitter that purported to show a database of 1.1 million Optus customers' details, comprising names, email addresses and mobile numbers.

It had been offered for sale since September 17. 

An Optus spokesperson declined to confirm the number to iTnews, saying an investigation is still underway.

-----

https://www.jmir.org/2022/9/e35772

Digital Health Literacy as a Predictor of Awareness, Engagement, and Use of a National Web-Based Personal Health Record: Population-Based Survey Study

Digital Health Literacy as a Predictor of Awareness, Engagement, and Use of a National Web-Based Personal Health Record: Population-Based Survey Study

Authors of this article:

Christina Cheng 1  ;  Emma Gearon 2  ;  Melanie Hawkins 1  ;  Crystal McPhee 3  ;  Lisa Hanna 4  ;  Roy Batterham 5  ;  Richard H Osborne 1 

Abstract

Background: Web-based personal health records (PHRs) have the potential to improve the quality, accuracy, and timeliness of health care. However, the international uptake of web-based PHRs has been slow. Populations experiencing disadvantages are less likely to use web-based PHRs, potentially widening health inequities within and among countries.

Objective: With limited understanding of the predictors of community uptake and use of web-based PHR, the aim of this study was to identify the predictors of awareness, engagement, and use of the Australian national web-based PHR, My Health Record (MyHR).

Methods: A population-based survey of adult participants residing in regional Victoria, Australia, was conducted in 2018 using telephone interviews. Logistic regression, adjusted for age, was used to assess the relationship among digital health literacy, health literacy, and demographic characteristics, and the 3 dependent variables of MyHR: awareness, engagement, and use. Digital health literacy and health literacy were measured using multidimensional tools, using all 7 scales of the eHealth Literacy Questionnaire and 4 out of the 9 scales of the Health Literacy Questionnaire.

Results: A total of 998 responses were analyzed. Many elements of digital health literacy were strongly associated with MyHR awareness, engagement, and use. A 1-unit increase in each of the 7 eHealth Literacy Questionnaire scales was associated with a 2- to 4-fold increase in the odds of using MyHR: using technology to process health information (odds ratio [OR] 4.14, 95% CI 2.34-7.31), understanding of health concepts and language (OR 2.25, 95% CI 1.08-4.69), ability to actively engage with digital services (OR 4.44, 95% CI 2.55-7.75), feel safe and in control (OR 2.36, 95% CI 1.43-3.88), motivated to engage with digital services (OR 4.24, 95% CI 2.36-7.61), access to digital services that work (OR 2.49, 95% CI 1.32-4.69), and digital services that suit individual needs (OR 3.48, 95% CI 1.97-6.15). The Health Literacy Questionnaire scales of health care support, actively managing health, and social support were also associated with a 1- to 2-fold increase in the odds of using MyHR. Using the internet to search for health information was another strong predictor; however, older people and those with less education were less likely to use MyHR.

Conclusions: This study revealed strong and consistent patterns of association between digital health literacy and the use of a web-based PHR. The results indicate potential actions for promoting PHR uptake, including improving digital technology and skill experiences that may improve digital health literacy and willingness to engage in web-based PHR. Uptake may also be improved through more responsive digital services, strengthened health care, and better social support. A holistic approach, including targeted solutions, is needed to ensure that web-based PHR can realize its full potential to help reduce health inequities.

J Med Internet Res 2022;24(9):e35772

doi:10.2196/35772

-----

https://www.lexology.com/library/detail.aspx?g=929715c2-8a1f-4550-a4aa-0ed0b6b02a80

Genetic information - global privacy considerations - an Australian and UK perspective

DLA Piper - Eliza SaundersJames ClarkSarah Birkett and Senal Premarathna

Australia, European Union, United Kingdom September 20 2022

Introduction

The benefits of using genetic information for research purposes are clear, especially as the technology underpinning medical research continues to advance at such a rapid pace. Outside of research and clinical development, the number of organisations which use blood and saliva samples and other genetic information for diagnostic and treatment purposes, as well as ancestry research, has exponentially increased.

When an individual provides a genetic sample, whether as part of a medical treatment, a clinical trial or in connection with ancestry research, what regimes are in place to protect his or her privacy?

In this article we examine, by way of example, the differing regimes in place in Australia and the UK.

-----

https://wildhealth.net.au/the-future-will-see-you-now/

21 September 2022

The future will see you now

AI

By Fran Molloy

Artificial intelligence (AI) is making inroads across most fields of medicine, and its inevitable use in rheumatology heralds the potential for more widespread access and reduced workloads for specialists, along with improved screening, diagnosis and treatment for patients.

However, the use of AI in clinical practice also raises many legitimate concerns, from the risks of relying on an often-opaque decision-making process, to the potential for AI to magnify incorrect assumptions and biases, and the concerns of patients about its safety.

Rheumatologist and ARA spokesperson on technology, Professor Rebecca Grainger, says that while many clinicians may be understandably apprehensive about the introduction of AI, she sees it as another very useful tool to help understand disease.

She says that AI’s role in practice will provide similar utility to that of peer-reviewed clinical studies.

“Previously, we’ve used statistical methods in academic studies to help us understand patterns and associations around disease, and to consider how the findings might apply to our own setting.

-----

https://www.hospitalhealth.com.au/content/technology/news/new-wearable-device-monitors-tumour-size-1042936061

New wearable device monitors tumour size

Wednesday, 21 September, 2022

Engineers at Stanford University have created a small, autonomous device with a stretchable and flexible sensor that can be adhered to the skin to measure the changing size of tumours below. The non-invasive, battery-operated device is sensitive to one-hundredth of a millimetre (10 micrometres) and can beam results to a smartphone app wirelessly in real time with the press of a button.

In practical terms, the researchers say, their device — termed FAST for ‘Flexible Autonomous Sensor measuring Tumours’ — represents a new, fast, inexpensive, hands-free and accurate way to test the efficacy of cancer drugs. On a larger scale, it could lead to promising new directions in cancer treatment. FAST is detailed in a paper published in Science Advances.

FAST’s sensor is composed of a flexible and stretchable skin-like polymer that includes an embedded layer of gold circuitry. When stretched the layer of gold develops small cracks that change the electrical conductivity of the material. Stretch the material and the number of cracks increases, causing the electronic resistance in the sensor to increase as well. When the material contracts, the cracks come back into contact and conductivity improves.

This sensor is connected to a small electronic backpack designed by former postdocs and co-authors Yasser Khan and Naoji Matsuhisa. The device measures the strain on the membrane — how much it stretches or shrinks — and transmits that data to a smartphone. Using the FAST backpack, potential therapies that are linked to tumour size regression can quickly and confidently be excluded as ineffective or fast-tracked for further study.

-----

https://wildhealth.net.au/winning-wearables-trump-style-over-stigma/

21 September 2022

Winning wearables trump style over stigma

Interoperability Technology

By Wendy John

Health tech designer Associate Professor Leah Heiss took out the Australian Women in Design trophy at Friday’s Good Design Awards 2022. 

The Monash University Professor has designed a portfolio of human-centred wearables including jewel-like hearing aids, ornate necklaces that monitor cardiac status and chic diabetes jewellery to administer insulin.  

Although she draws from fields such as nanotechnology and manufacturing, Professor Heiss fundamentally takes a co-design approach that leverages the patient’s lived experience.  

This ethos also informs her work with the World Health Organisation (WHO) to improve the uptake and implementation of WHO guidelines, particularly in developing nations. 

“My practice is focused on the lived experience of health systems, services and technologies. And I do feel like at some point those things will converge, for example in how the big systems work and the wearables work. We’re not quite there yet. But we’re getting pretty close,” Professor Heiss said. 

-----

https://www.hospitalhealth.com.au/content/design-in-health/article/health-tech-innovator-bags-design-award-581247690

Health-tech innovator bags design award

Tuesday, 20 September, 2022

Leah Heiss, a health-tech innovator and Associate Professor, Monash University, has been awarded the 2022 Australian Women in Design Award at this year’s Good Design Awards for her work across wearable health technologies and healthcare co-design.

Heiss is currently working on redesigning the experience of health care in Australia as a part of the Future Hospital Future Health Initiative. She is working with the World Health Organization to improve the uptake and implementation of WHO guidelines, particularly in developing nations. Her wearable health technologies include a jewel-like hearing aid, jewellery to administer insulin, jewellery to monitor cardiac events, swallowable devices to detect disease and emergency jewellery for times of medical crisis.

The award recognises women at the top of their field and seeks to encourage a more diverse and equal representation in design and creative industries, where women account for less than 17 of executive leadership roles.

Heiss said she was honoured to receive the award that seeks to address the gender imbalance within leadership roles in the design industry.

-----

https://www.smh.com.au/technology/facebook-pulls-out-all-stops-to-delay-cryptocurrency-scam-case-20220919-p5bj8c.html

Facebook pulls out all stops to delay cryptocurrency scam case

By Nick Bonyhady

September 19, 2022 — 7.45pm

Facebook owner Meta’s attempt to suppress documents from the consumer watchdog’s litigation over cryptocurrency investment scams has run into turbulence, but it has made a fresh attempt to delay proceedings in the Federal Court.

The setback comes as Meta battles a similar claim in Western Australia from Australia’s richest man, mining magnate Andrew Forrest. The social media giant has previously alleged that the WA state court had “no jurisdiction” to adjudicate on the matter.

A Federal Court judge is yet to rule on Meta’s latest claim, but has already partially rejected an attempt by the company to have court documents in the ACCC case kept secret.

In a September 9 ruling, Justice David Yates described aspects of Meta’s tactics as “strange” and “unfortunate” and said its claim that the state case was outside jurisdiction conflicted with its other claim that documents should be kept from public view to avoid prejudicing a potential trial.

Forrest announced in February he had taken the rare step of launching a private criminal case in the WA Magistrates’ Court against Meta for allegedly failing to stop cryptocurrency investment scams that used his name and image. The Federal Court has been told a trial could be two and a half years away.

-----

https://www.computerworld.com/article/3673249/as-telehealth-use-plummets-the-healthcare-industry-faces-a-crossroads.html

As telehealth use plummets, the healthcare industry faces a crossroads

COVID-19 forced many medical providers to roll out telehealth technology to handle remote. But as the pandemic has waned, so has the use of virtual care, leaving the healthcare industry to decide whether to fall back on old methods or move forward.

By Lucas Mearian

Senior Reporter, Computerworld | 12 September 2022 20:00 AEST

After reaching historically high adoption rates during the height of the COVID-19 pandemic, the use of telehealth services has plummeted since the beginning of the year.

Experts say that places the healthcare industry at a fork in the road, where providers, payors, and tech companies must choose whether to embrace an effective and convenient healthcare medium or be left behind as telehealth marches forward.

The road toward adoption of telehealth — the use of electronic communications to provide care and other services — has been long. Before the COVID-19 pandemic took hold in 2020, the adoption rate in the US, nearly 60 years after telehealth technology was first introduced, was just 0.9% of outpatient visits.

In first few weeks of the pandemic, however, the percentage of virtual healthcare visits jumped to 52%, according to Mark Gilbert, senior director analyst for Healthcare Strategy at research firm Gartner. “In that five weeks, there was no time for strategic planning or business cases; there were no time for [requests for proposals], or any of that stuff that goes into normal procurement process of a technology platform,” Gilbert said. “It was just, ‘Get it done. Make it happen.’”

-----

https://itwire.com/it-people-news/education/cypher-learning,-drone-operations-partner-on-drone-training-for-schools.html

Monday, 19 September 2022 12:51

Cypher Learning, Drone Operations partner on drone training for schools

By Staff Writer

Intelligent learning platforms for schools, universities and organisations provider Cypher Learning has announced the successful implementation of its MATRIX learning platform for Australian schools drone training provider Drone Operations .

The Gold Coast-based training organisation Drone Operations provides specialised drone training in private and public schools across Australia in the Civil Aviation Safety Authority (CASA) Excluded Category, which includes under 2kg remote piloted aircraft (RPA). 

Cypher Learning says the partnership empowers schools with state of the art learning materials, as students work towards obtaining the AVI30419 Certificate III in Aviation (Remote Pilot) - MW training RTO: 2510 using Drone Operations resources to deliver and assess all learners. 

“Drones offer a different perspective for the pilot and opens up a new realm of possibilities in disaster response, meteorology, science & research, even film and video,” said Graham Glass, CEO and Founder of Cypher Learning. “We’re excited to be such an integral part of the journey with Drone Operations to bolster its offerings, as Australia becomes one of the leading cradles for drone applications and development.”    

-----

David.

 

4 comments:

Anonymous said...

According to the LinkedIn site, there are 21 current job openings at ADHA, all less than 2 weeks old.

Seems very strange to me.

Anonymous said...

Known for a high turn over of staff - you will probably find 90% are just a process thing and will be filled internally - see how many are in “acting” roles. It’s sad as they waste peoples time who apply but will never get the job.

Anonymous said...

In my view, the government's policy of advertising jobs when a department/agency has an incumbent earmarked or otherwise knows who will get a position is cruel and should be abolished, especially by a Labor government. Job seekers put time into applications and many genuinely want or need a position. It's a terrible system.

Anonymous said...

If the 21 jobs will be filled by internals, then there will still be 21 vacancies.

Strange way to run a government agency.