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."

Wednesday, January 14, 2015

Here Is Another One That Seems To Have Slipped Out When No One Was Watching!

This appeared late last week.

Personally Controlled Electronic Health Record (PCEHR) January 2015 Release 5 available for download

Created on Friday, 09 January 2015
NEHTA has released new specification sets and conformance requirements to enable Pathology and Diagnostic Imaging Reports to be uploaded to the Personally Controlled Electronic Health Record (PCEHR) by Pathology and Diagnostic Imaging service providers. These specifications support new capabilities in the PCEHR.
The Pathology and Diagnostic Imaging Reports can be used to share information about Pathology tests and Diagnostic Imaging examinations via an individual's PCEHR. These reports include a PDF which contain one or more examinations that are uploaded by the pathology or diagnostic imaging provider to the individual's PCEHR.
An additional new feature is the ability to download the Health Record Overview which can be displayed in local clinical information systems in whole or part. 
Presentation and Data Usage guidance documents have been developed for vendors presenting the Pathology Report, Diagnostic Imaging Report views and also the Health Record Overview in clinical information systems.
NEHTA has also updated a number of technical specifications to support the new capability:
The specification sets can be downloaded from the NEHTA website:
For more detailed information, please refer to the following release notes. Download:
Here is the link to the relevant page:
What surprised me with all this was that I had not, to date, seen minutes that confirm that all the stakeholders involved in results upload and use had agreed how it is to work.
Has anyone seen the final view from Government in all this?
If it does not exist one wonders how such specifications can be finalised.
Isn’t it also wonderful to see that in NEHTA’s view the PCEHR is going to become a large collection of .pdfs. Talk about back to the future.
David.

It Looks Like The Government Will Need A Plan C on The Medicare Co-payment.

Read all about it here:

www.smh.com.au/federal-politics/political-news/majority-of-senators-commit-to-scrapping-new-20-gp-fee-20150114-12nxvy.html

I wonder how far down the alphabet we will go before they realise this is not a good idea?

As we can see from this article from the OZ today there are plenty of other more sensible and less destructive options:

http://www.theaustralian.com.au/national-affairs/health/health-eyes-15bn-payoff-from-war-on-waste/story-fn59nokw-1227183948925

David.

Tuesday, January 13, 2015

A Belated Welcome To 2015. I Wonder How It Will Play Out In E-Health? I Am Not All That Confident For Now.

Over the holiday break I was challenged to suggest what might be needed to make a positive difference in e-Health.
What I suggested then were that five actions were needed. These were:
“Action One:
Recognise that there are two distinct clients for e-Health systems and services and that their needs are not by any means the same - meaning that different systems are required for each. The professional clients (doctors, nurses, allied health etc.) need systems that enhance their clinical capabilities, improve record keeping and facilitate their secure sharing of clinical information to improve patient care and safety.
The consumers need systems to allow them to record their own information while at the same time having access  to, ideally, the live clinical systems so they can better engage with and understand and contribute to their care.
It is obvious the present PCEHR does neither of these things well.
Action Two:
We need to recognise we don’t need a single monolithic System but that we need an e-Health ecosystem where health information flows efficiently, accurately, securely and privately between appropriately credentialed actors within the health system and to and from consumers.
Action Three:
We need an updated National E-Health Strategy that consults all stakeholders properly and provides the  governance, leadership, strategic technical, standards and managerial pathways to actually achieve the goals cited by the CHF for this domain. We then need the Strategy properly funded and led - as did not happen with the 2008 version.
Action Four:
Before anything more is done or spent actually undertake a proper in depth peer-reviewed evaluation of what e-Health in all its guises has achieved in Australia and what has been achieved in the rest of the world that might be applicable to Australia. This research should inform what comes next.
Action Five:
We need to understand that no-where in the world has a transition to e-Health been easy, uncomplicated, pain free or without missteps. As we increasingly realise, getting this right is a very considerable and some might suggest near impossible challenge that takes lots of time, lots of money and dedication - as well as quality leadership and governance for success. E-Health is not something for generalist bureaucrats and technicians to have repeated goes at and repeatedly fail at!”
Most who commented rather liked what I had suggested but still seemed rather pessimistic about the next decade or so. I think, on reflection, that what I missed in my post was that these five actions need to be seen as an integrated package. All five areas need to be properly, openly and transparently addressed. You, for instance, can’t develop a quality strategy and then not fund it - as happened in 2008 - and you can’t change management without making sure they have a clear strategy, commitment and real funding.
There is no doubt that 2015 will be a pretty interesting year with a new Federal Health Minister who has the PCEHR ‘hot potato’ placed right in the middle of her desk and who lacks any apparent expertise, right now, in the Health or E-Health sector. Deciding what to do with the PCEHR is going to be one of the most difficult parts of the portfolio, if we ignore the extreme difficulty of sorting out what to happen with the Plan B Medicare Co-payment - now that the AMA and the RACGP are now running public campaigns against the plan.
To me if the PCEHR is a ‘hot potato’, the co-payment is a grenade with the pin removed!
The old curse of ‘May You Live In Interesting Times’ is more that apposite and the times may indeed turn out to be more than challenging!
David.

Monday, January 12, 2015

Weekly Australian Health IT Links – 12th January, 2015.

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

Welcome to 2015.
Judging from the news 2015 will be all about Telstra and e-Health, the fate of the PCEHR, safety and Health IT, FHIR and wearable technology.
Enjoy the ride!
-----

Clinical safety of England's national program for IT: a retrospective analysis of all reported safety events 2005 to 2011

Received: March 26, 2014; Received in revised form: September 15, 2014; Accepted: December 28, 2014; Published Online: January 03, 2015
Publication stage: In Press Accepted Manuscript

Highlights

  • All known safety problems with national scale IT systems in England were examined.
  • National IT implementation was associated with problems on a large scale impacting on care delivery.
  • Problems encountered are not unique, but are well-understood challenges of IT implementation.
  • Human factors were four times as likely to result in reported patient harm than technical problems.
-----

Telstra Health picks up cloud medicine

5 January, 2014
Telstra has added further capabilities on the eHealth front with the acquisition of Australian eHealth cloud software developer Cloud9 and an Indian health software developer, IdeaObject.
The deals are designed to bolster the portfolio of integrated eHealth solutions held by Telstra Health, which was officially hived off as a stand-alone unit by the telco in October last year.
The Telstra Health division, running under the auspices of Shane Solomon - a former CEO of the Hong Kong Hospital Authority - aims to provide the connective tissue that brings patients, healthcare professionals, health funds and healthcare infrastructure (pharmacies and hospitals) together.
-----

What CEOs expect in 2015

Tony Boyd and Michael Smith
Captains of industry from banking, resources, media, property, insurance, infrastructure and retail give their insights on tough questions for the new year. Here’s a selection:
…..

David Thodey, Telstra

2: Up until recently I would have said the biggest threat was complacency, but following the B20 and G20 I think there is now a shared realisation within government and business that we need to take urgent action in some critical areas. Infrastructure investment is high on the list. There is currently a huge shortfall worldwide in the investment needed to meet the demands of the growing global population and to provide the platform needed to take advantage of innovative technologies. Digital solutions and new business models are disrupting every sector in the community. From a Telstra perspective, this technology disruption is obviously having a profound impact on our industry and the services we offer – cloud, mobility, the internet of things – and we aim to be a leader in these fields just as we were with our core business.
We’re also keenly aware of the disruption technology is causing in adjacent industries and looking to see where we can add value. The e-health industry is one we are very active in, and where we believe technology can fundamentally improve the system for all Australians.
-----

Indian HIS developer, IdeaObject, acquired by Telstra Health

IdeaObject will be integrated into Telstra Health, Australia’s largest telecom and tech firm
The business of Indian- based health software developer IdeaObject has been acquired by Telstra Health, the eHealth business unit of Australia’s largest telecom and technology company.
The IdeaObject business along with the business of Cloud9, an Australia-based eHealth cloud software developer which has also been acquired by Telstra Health, will be integrated into Telstra Health, with this work commencing immediately.
Jim Flynt, currently Telstra Health’s General Manager of Health Applications, has been appointed CEO of Cloud9, while the existing Indian executive management team will continue to have responsibility for the day-to-day operations and product development activities, as C-HIS is integrated into the broader Telstra Health strategy.
-----

Human Services urged to hang up on Telstra outsourcing deal

Date January 8, 2015 - 11:30PM

Noel Towell

Reporter for The Canberra Times

More than 6500 Centrelink and Medicare public servants have made a last-ditch appeal for their bosses to abandon an outsourcing deal that would have Telstra workers answering phones at the agencies' call centres.
The employees of the giant Department of Human Services say the proposal poses an unacceptable risk to the confidential information of millions of Australians.
The signatories to a union-organised petition say Human Services' troubled customer service performance could get even worse with inexperienced Telstra workers answering the phones.
But the department, which also runs the Child Support Agency and administers some Veterans Affairs and Pharmaceutical Benefits Scheme payments, said it had  not made a decision on whether to proceed with the deal.
-----

The Silicon Valley doctor who never sleeps

More than 10 million people visit the HealthTap website every month, where they can ask medical questions for free, or – for $US99 a month – talk immediately with a licensed doctor at any time of day or night. 
James Hamblin
What if you could text a doctor with a medical question at any time of day and get a quick, thoughtful response? No more haphazard googling (“swollen feet allergies”; “tick stuck in ear access to brain?”). No more sifting through message boards. No more algorithms suggesting a stomach ache might be the first sign of a terminal skin disorder.
As a patient, I’d say that sounds great. As a doctor, I’d say that sounds at best unsustainable, and at worst disastrous. The average primary-care physician has about 2300 patients. He or she would never sleep.
But Ron Gutman, a Silicon Valley entrepreneur, would say that’s a business opportunity. Since he founded HealthTap four years ago, the website has grown into an interactive community of more than 60,000 licensed US physicians, who answer user questions for free. More than 10 million people visit the site every month.
-----

Medical diagnosis at the touch of a button

Monday 29 December 2014 6:46AM
A mental healthcare provider in regional Victoria has introduced interactive software that allows patients to enter their details, medical preferences, and symptoms online to provide faster access to treatment.

Guests

Caroline Byrne
-----

Privacy will be considered a luxury in 2025: experts

Date December 21, 2014 - 5:34PM

Hannah Francis

Technology Reporter

Experts believe the exchange of personal data for online conveniences will soon erode today's notions of privacy.
Today's notions of privacy will be eroded significantly within the next decade as growing reams of personal data are willingly exchanged for the convenience of living our lives online.
That's the prevailing view among the more than 2500 industry experts from around the world - including academics, legislators and staff at global companies such as Google, Microsoft and Yahoo - who were quizzed on the future of privacy and security.
Respondents to the study from the Pew Research Center in the US, in conjunction with North Carolina's Elon University, said they believed living a public life online would be the new default by 2025.
-----

#FHIR for Laboratory Integration

Posted on January 9, 2015 by Grahame Grieve
As the FHIR project has progressed, many organizations are starting to face the difficult question: when should we think about using FHIR for our production interfaces?
Making this kind of evaluation depends on the technical merits of the various possible alternative standards, the existing ecosystem and how much is already invested in alternative approaches, and what kind of maturity rating is appropriate for the standard.
With regard to the last, see  Dixie Baker’s JAMIA paper, “Evaluating and classifying the readiness of technology specifications for national standardization”, but note that what kind of maturity is best for a project depends on that nature of the project and it’s participants. National regulations need something different than smaller projects with a shorter time line.
-----

How to salvage a (nearly) hopeless software project

Faulty foundations, AWOL contractors, bugs piling up -- here's what to do before taking a sledgehammer to a faltering pile of code
Like a carpenter called in to salvage a home repair gone wrong, developers who've been around the block are used to seeing a handful of the same problems. The code gets creaky; bug reports file at an ever-increasing clip; the time spent maintaining the project surpasses any ability to add features to it. At a certain point, the question arises: Can you rehab the code, or should you scrap it and rebuild from the ground up?
We talked with seasoned pros for insights on how they have addressed the most common types of software projects on the brink: Projects with runaway costs, poorly architected projects, ones that simply no longer work.
-----

Wearables expand to waistline, feet and fingers

One company says its "smart belt" can track a wearer's health
The Ring can let you remotely control your smartphone by making finger gestures.
Wearables for the wrist are all the rage at this year's International CES show, but companies are also coming up with devices meant to be worn on your waist, your feet and your index finger.
Enter Belty, a smart belt developed by French firm Emiota. When you put it on, the mechanical belt buckle will tighten around you automatically for a comfortable fit. It will then adjust the waist size automatically when it appears you're sitting down or standing up.
Emiota designed the smart belt as a way to track the health of the wearer. It does this by measuring changes in the user's waistline, which can be used to predict a person's diabetes risk, said Carine Coulm, the company's co-founder.
-----

Security bolstered on myGov website after dire warnings

Date January 2, 2015

Ben Grubb

Deputy technology editor

Your highly personal government records are now just that little bit safer.
The federal government's online myGov portal – which allows millions of Australians to access their private government tax, health and other records — has finally introduced a long-awaited security measure experts have previously said was urgently required.
The measure, implemented more than 30 months after launching the service, is called two-factor authentication. The process requires users to put in an optional token, or code, sent to their mobile phone before they are allowed access to their account.
Quietly launched in early December by the Department of Human Services, users are now being prompted to take up the new measure — described as an "enhanced security" mechanism to protect user accounts – when they next sign in.
-----

Safety in E-Health

E-Health programs have the aim of improving the quality of health care. The main elements of Commission’s Safety in E-Health program are:
  • Optimising safety and quality within the rollouts of clinical systems, with an initial focus on discharge summary and hospital medications management programs
  • Using E-Health initiatives to improve the safety and quality of health care
  • The secondary use of information agenda – optimising reuse and analyses of safety and quality data available from clinical systems, to further drive improvements in safety and quality
The Commission works in collaboration with jurisdictions, the private hospital and primary care sectors, NEHTA, the National Health CIO Forum, and other national bodies to promote the safety and quality agenda within national E-Health programs.
…..

Clinical safety audit program for the Personally Controlled Electronic Health Record (PCEHR)

The Commission has established an independent Clinical Governance Advisory Group (CGAG) and a clinical safety audit program for the Personally Controlled Electronic Health Record (PCEHR).
This national clinical governance function complements and strengthens the work being performed by the National E-Health Transition Authority in assuring the safety and quality of the standards and specifications supporting the PCEHR and will provide external assurance on PCEHR clinical safety issues.
The CGAG meets quarterly to consider the clinical safety audits of the PCEHR and other clinical safety issues relating to the PCEHR and provide advice to the Department of Health and Ageing. The CGAG comprises experts from across Australia, and is chaired by the Chief Medical Officer Professor Chris Baggoley.
-----

Personally Controlled Electronic Health Record (PCEHR) January 2015 Release 5 available for download

Created on Friday, 09 January 2015
NEHTA has released new specification sets and conformance requirements to enable Pathology and Diagnostic Imaging Reports to be uploaded to the Personally Controlled Electronic Health Record (PCEHR) by Pathology and Diagnostic Imaging service providers. These specifications support new capabilities in the PCEHR.
The Pathology and Diagnostic Imaging Reports can be used to share information about Pathology tests and Diagnostic Imaging examinations via an individual's PCEHR. These reports include a PDF which contain one or more examinations that are uploaded by the pathology or diagnostic imaging provider to the individual's PCEHR.
An additional new feature is the ability to download the Health Record Overview which can be displayed in local clinical information systems in whole or part. 
Presentation and Data Usage guidance documents have been developed for vendors presenting the Pathology Report, Diagnostic Imaging Report views and also the Health Record Overview in clinical information systems.
-----

Professor Graeme Clark Wins Prestigious US Bioengineering award

on January 8, 2015 at 1:00 am
Professor Graeme Clark AC from the University of Melbourne is the first Australian to receive the US Russ Prize for an outstanding achievement in bioengineering innovation that is in widespread use to improve health and well-being: the cochlear implant.
The US National Academy of Engineering and Ohio University announced the winners of the biennial prize of US $500,000 today and recognised Professor Clark’s pioneering role in the development of the multi-channel cochlear implant for people with severe-to-profound deafness. 
Professors Clark, Ingeborg and Irwin Hochmair from Austria and Michael Merzenich and Blake Wilson from the US are the pioneers in developing the multi-channel cochlear implant for giving
-----

New antibiotic ‘just the tip of the iceberg’ in beating resistance

  •  The Times
  • January 09, 2015 12:00AM
SCIENTISTS are hailing a poten­t­ially huge advance against ­antibiotic resistance with the ­devel­opment of what could be the first new class of the drugs in 25 years.
If approved for use in humans, teixobactin promises to combat pathogens that are resistant to today’s antibiotics. The way teixobactin was discovered also opens a mechanism by which scientists can search for other antibiotics.
The discovery, published in the journal Nature, comes after British Prime Minister David Cameron warned that the world could be “cast back into the dark ages of medicine” unless action was taken to combat resistance to antibiotics.
-----

The 8080 chip at 40: What's next for the mighty microprocessor?

It came out in 1974 and was the basis of the MITS Altair 8800, for which two guys named Bill Gates and Paul Allen wrote BASIC, and millions of people began to realize that they, too, could have their very own, personal, computer.
It came out in 1974 and was the basis of the MITS Altair 8800, for which two guys named Bill Gates and Paul Allen wrote BASIC, and millions of people began to realize that they, too, could have their very own, personal, computer.
Now, some 40 years after the debut of the Intel 8080 microprocessor, the industry can point to direct descendants of the chip that are astronomically more powerful (see sidebar, below). So what's in store for the next four decades?
For those who were involved with, or watched, the birth of the 8080 and know about the resulting PC industry and today's digital environment, escalating hardware specs aren't the concern. These industry watchers are more concerned with the decisions that the computer industry, and humanity as a whole, will face in the coming decades.
-----
Enjoy!
David.

Sunday, January 11, 2015

The Holiday Period Has Seen Some Pretty Dodgy Documents Released When We Were All Distracted.

The following appeared just before Christmas.

Safety in E-Health

E-Health programs have the aim of improving the quality of health care. The main elements of Commission”s Safety in E-Health program are:
  • Optimising safety and quality within the rollouts of clinical systems, with an initial focus on discharge summary and hospital medications management programs
  • Using E-Health initiatives to improve the safety and quality of health care
  • The secondary use of information agenda – optimising reuse and analyses of safety and quality data available from clinical systems, to further drive improvements in safety and quality
The Commission works in collaboration with jurisdictions, the private hospital and primary care sectors, NEHTA, the National Health CIO Forum, and other national bodies to promote the safety and quality agenda within national E-Health programs. Five E-Health projects are reported here:
The last one was this:

Clinical safety audit program for the Personally Controlled Electronic Health Record (PCEHR)

The Commission has established an independent Clinical Governance Advisory Group (CGAG) and a clinical safety audit program for the Personally Controlled Electronic Health Record (PCEHR).
This national clinical governance function complements and strengthens the work being performed by the National E-Health Transition Authority in assuring the safety and quality of the standards and specifications supporting the PCEHR and will provide external assurance on PCEHR clinical safety issues.
The CGAG meets quarterly to consider the clinical safety audits of the PCEHR and other clinical safety issues relating to the PCEHR and provide advice to the Department of Health and Ageing. The CGAG comprises experts from across Australia, and is chaired by the Chief Medical Officer Professor Chris Baggoley.
The documents are all dated some time in December 2014 - but were actually created during 2013 - and have clearly been kept secret for over a year.
There were 3 Audits of the Clinical Safety of the PCEHR (February, June and December 2013) and interestingly the first two were done by KPMG and the third was done by PWC.
Also it is notable that all three reports are 10-15 page summaries not the full reports.
This few paragraphs show just how much progress has been made - or not.
“The Third Clinical Safety Review of the Personally Controlled Electronic Health Record (the Third Review) was conducted in the period October to December 2013.
The key findings and recommendations presented in this report are based on the analysis of the qualitative and quantitative data collected throughout the audit across the three key review areas.
Within the three key review areas there were a total of 15 findings. The findings have been classified according to the risk ratings developed for the first two audits (a rating scale of critical, major, moderate, minor, minimum). Within the three key review areas there were 1 Critical, 4 Major, 6 Moderate, 2 Minor and 3 Minimum findings. The findings have been classified according to the risk ratings developed for the first and second audits. The 15 key findings resulted in 15 recommendations for consideration. The key findings and recommendations are detailed below.”
So after 2 audits and responses to them we still have extant 1 critical and 4 major issues outstanding.
No information is provided for 2014 so we have no idea what the present status us.
Reading the reports and the responses is it clear there is no properly developed clinical incident reporting system for the PCEHR and that, at the same time there are real issues.
Contrast this with what is reported regarding the UK National E-Health Program:

Clinical safety of England's national program for IT: a retrospective analysis of all reported safety events 2005 to 2011

Received: March 26, 2014; Received in revised form: September 15, 2014; Accepted: December 28, 2014; Published Online: January 03, 2015
Publication stage: In Press Accepted Manuscript

Highlights

  • All known safety problems with national scale IT systems in England were examined.
  • National IT implementation was associated with problems on a large scale impacting on care delivery.
  • Problems encountered are not unique, but are well-understood challenges of IT implementation.
  • Human factors were four times as likely to result in reported patient harm than technical problems.

Abstract:

Objective

To analyse patient safety events associated with England's national program for IT (NPfIT).

Methods

Retrospective analysis of all safety events managed by a dedicated IT safety team between September 2005 and November 2011 was undertaken. Events were reviewed against an existing classification for problems associated with IT. The proportion of reported events per problem type, consequences, source of report, resolution within 24 hours, time of day and day of week were examined. Sub-group analyses were undertaken for events involving patient harm and those that occurred on a large scale.

Results

Of the 850 events analysed, 68% (n = 574) described potentially hazardous circumstances, 24% (n = 205) had an observable impact on care delivery, 4% (n = 36) were a near miss, and 3% (n = 22) were associated with patient harm, including three deaths (0·35%). Eleven events did not have a noticeable consequence (1%) and two were complaints. (More details at site on statistics)

Conclusion

Events associated with NPfIT reinforce that the use of IT does create hazardous circumstances and can lead to patient harm or death. Large-scale patient safety events are a new phenomenon that have the potential to affect many patients and clinicians, and this suggests that addressing them should be a priority for all major IT implementations.
Here is the link:
There is little doubt those responsible for the PCEHR simply failed in their duty to institute a proper Clinical Safety Monitoring System from Day 1, have no idea what is going on presently and that this omission is recognised as bad enough that what limited information has been created is being kept secret for as long as possible.
This is a travesty of mismanagement and incompetence in my view. You really need to read the documents to see what an obfuscatory and ignorant joke they are!
David.

AusHealthIT Poll Number 252 – Results – 11th January, 2015.

Here are the results of the poll.

Holiday Poll: What Do You Think Will Be The Fate Of The PCEHR By The End Of 2015

It Well Be Humming Along, Making A Difference and Much Used 13% (9)

It Will Still Be Struggling To Reach Lift Off With More Being Spent On It 58% (39)

It Will Be Withering On The Vine Slowly 15% (10)

It Will Be Being Actively Wound Down But Slowly 4% (3)

It Will Have Been Shut Down With A New Plan Adopted 0% (0)

It Will Just Be Shut Down 3% (2)

I Have No Idea 0% (0)

Something Else - Leave Comment On Last Week's Poll 6% (4)

Total votes: 67

A pretty clear response with large majority believing the PCEHR is essentially going to struggle or fail over the next year.

Good to see a clear outcome with a lot of responses over the time of the holidays.

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

David.

Sunday, January 04, 2015

AusHealthIT Poll Number 251 – Results – 4th January, 2015.

Here are the results of the poll.

Holiday Poll: How Optimistic Are You That There Will Be Real Progress In E-Health In Australia In 2015?

Extremely 3% (3)

Quite 4% (4)

Neutral 1% (1)

Not Really 54% (52)

Very Pessimistic 38% (37)

I Have No Idea 0% (0)

Total votes: 97

A pretty clear response with large majority believing there is little to be optimistic about in 2015.

Good to see a clear outcome with a lot of responses over the time of the holidays.

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

David.

Thursday, January 01, 2015

Happy New Year And All The Very Best For 2015

It just struck me that the current poll might give people a chance to say what they really think about the prospects for e-Health in 2015 and provoke some commentary.

Well here is the chance to respond to the poll and be heard by at least 100 or so other readers! (Google reckons 500 or so!)

Go for it!

HNY and stay safe!

David.

Just an update on blog spam:

Some 3000 people have tried to add links for them and their clients to the blog. Sadly all have failed and those paying them have lost their money. Both the SEO's and their clients are unethical idiots. Enough said!

D.