AusHealthIT Poll Number 706– Results – 23 July, 2023.

 Here are the results of the poll.

Do You Find You Personally Get A Reasonable Amount Of Value From Conferences Like Medinfo etc. For The Expense And Time Involved?

Yes                                                                26 (60%)

No                                                                 15 (35%)

I Have No Idea                                                 2 (5%)

Total No. Of Votes: 43

A pretty clear outcome suggesting in that a majority of readers felt conferences were a useful way to spend time.

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes. Also a pretty clear outcome.  

2 of 43 who answered the poll admitted to not being sure about the answer to the question!

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

David.

The Pace Of Change Is Really Quite Scary!

 It rather looks like AI in Healthcare is already very much on the move!

Opinion

The AI revolution in health care is already here

By Leana S. Wen

Contributing columnist

July 11, 2023 at 2:56 p.m. EDT

 

Pay attention to the media coverage around artificial intelligence, and it’s easy to get the sense that technologies such as chatbots pose an “existential crisis” to everything from the economy to democracy.

These threats are real, and proactive regulation is crucial. But it’s also important to highlight AI’s many positive applications, especially in health care.

Consider the Mayo Clinic, the largest integrated, nonprofit medical practice in the world, which has created more than 160 AI algorithms in cardiology, neurology, radiology and other specialties. Forty of those have already been deployed in patient care.

To better understand how AI is used in medicine, I spoke with John Halamka, a physician trained in medical informatics who is president of Mayo Clinic Platform. As he explained to me, “AI is just the simulation of human intelligence via machines.”

Halamka distinguished between predictive and generative AI. The former involves mathematical models that use patterns from the past to predict the future; the latter uses text or images to generate a sort of human-like interaction.

It’s that first type that’s most valuable to medicine today. As Halamka described, predictive AI can look at the experiences of millions of patients and their illnesses to help answer a simple question: “What can we do to ensure that you have the best journey possible with the fewest potholes along the way?”

For instance, let’s say someone is diagnosed with Type 2 diabetes. Instead of giving generic recommendations for anyone with the condition, an algorithm can predict the best care plan for that patient using their age, geography, racial and ethnic background, existing medical conditions and nutritional habits.

This kind of patient-centered treatment isn’t new; physicians have long been individualizing recommendations. So in this sense, predictive AI is just one more tool to aid in clinical decision-making.

The quality of the algorithm depends on the quantity and diversity of data. I was astounded to learn that the Mayo Clinic team has signed data-partnering agreements with clinical systems across the United States and globally, including in Canada, Brazil and Israel. By the end of 2023, Halamka expects the network of organizations to encompass more than 100 million patients whose medical records, with identifying information removed, will be used to improve care for others.

Predictive AI can also augment diagnoses. For example, to detect colon cancer, standard practice is for gastroenterologists to perform a colonoscopy and manually identify and remove precancerous polyps. But some studies estimate that 1 in 4 cancerous lesions are missed during screening colonoscopies.

Predictive AI can dramatically improve detection. The software has been “trained” to identify polyps by looking at many pictures of them, and when it detects one during the colonoscopy, it alerts the physician to take a closer look. One randomized controlled trial at eight centers in the United States, Britain and Italy found that using such AI reduced the miss rate of potentially cancerous lesions by more than half, from 32.4 percent to 15.5 percent.

Halamka made a provocative statement that within the next five years, it could be considered malpractice not to use AI in colorectal cancer screening. But he was also careful to point out that “it’s not AI replacing a doctor, but AI augmenting a doctor to provide additional insight.” There is so much unmet need that technology won’t reduce the need for health-care providers; instead, he argued, “we’ll be able to see more patients and across more geographies.”

Generative AI, on the other hand, is a “completely different kind of animal,” Halamka said. Some tools, such as ChatGPT, are trained on un-curated materials found on the internet. Because the inputs themselves contain inaccurate information, the models can produce inappropriate and misleading text. Moreover, whereas the quality of predictive AI can be measured, generative AI models produce different answers to the same question each time, making validation more challenging.

At the moment, there are too many concerns over quality and accuracy for generative AI to direct clinical care. Still, it holds tremendous potential as a method to reduce administrative burden. Some clinics are already using apps that automatically transcribe a patient’s visit. Instead of creating the medical record from scratch, physicians would edit the transcript, saving them valuable time.

Though Halamka is clearly a proponent of AI’s use in medicine, he urges federal oversight. Just as the Food and Drug Administration vets new medications, there should be a process to independently validate algorithms and share results publicly. Moreover, Halamka is championing efforts to prevent the perpetuation of existing biases in health care in AI applications.

This is a cautious and thoughtful approach. Just like any tool, AI must be studied rigorously and deployed carefully, while heeding the warning to “first, do no harm.” Nevertheless, AI holds incredible promise to make health care safer, more accessible and more equitable.

 Here is the link:

 https://www.washingtonpost.com/opinions/2023/07/11/ai-health-care-revolution

 If the penetration and use of AI at the Mayo Clinic is anything to judge by its all over bar the declaration of victory. It really feels that things are running too fast for all our benefit! Those asking for a short pause may not be that wrong!

Is you head spinning or are you relaxed at the pace of progress?

David.

AusHealthIT Poll Number 705– Results – 16 July, 2023.

Here are the results of the poll.

Should There Be An Inquiry Into The Failure, Harm, Waste And Mismanagement Surrounding The #myHR Program?

Yes                                                                26 (68%)

No                                                                 19 (42%)

I Have No Idea                                                0 (0%)

Total No. Of Votes: 45

A pretty clear outcome suggesting in that a majority of readers felt a close look may be a good idea.

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes. But also a pretty clear outcome. Not sure why so many wanted to give a free pass to ADHA and the Government!

0 of 45 who answered the poll admitted to not being sure about the answer to the question!

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

David.

 

I Reckon This Is A Little Hard To Prove And Is Really Just A Troll!

Australia must look to Canada for world’s best-practice in digital health

Orion Health

 Wednesday, 12 July, 2023

 

Australia’s federal and state governments should look to Canada as the template for how best to implement a successful digital health strategy, CEO of the world's number one health data platform provider, New Zealand’s Orion Health, Brad Porter said in Sydney today.

 

Mr Porter was speaking on the sidelines of the MedInfo23 conference in Sydney, where Orion Health provided an overview of its central role in the roll out of the highly successful Digital First for Health strategy in Canada’s most-populous province, Ontario, and its work delivering integrated patient-family community-centred care in the province of Alberta.

 

“I have publicly praised the Albanese Government’s healthcare funding initiatives in the May Budget as an example of what New Zealand’s political parties should be promising ahead of the 14 October election.

 

“Australia’s States and Territories are also committed to implementing digital health initiatives but like their federal counterparts, and New Zealand, they need to be bolder and move faster.

 

“Australian governments are investing many hundreds of millions of dollars in digital health, strengthening Medicare - which they should - but if they want to see a real return on investment, they need to look at proven market disruption that has made an impact - that’s Canada.”

 

Mr Porter said governments shouldn’t be seeing digital as 'just another IT project' but rather a way of transforming care delivery, relieving pressure on GPs, Emergency Departments (EDs) and workers in acute settings by triaging needs and directing people to the care they need rather than funnelling through ED waiting rooms - so straight to radiology or a virtual nurse consult. 

 

Examples north of the 49th parallel include the successful use of Orion Health’s Health Information Exchange in the Canadian province of Alberta, which has led to:

 

·         A reduction in Hospital wait times of up to 90 per cent.

·         A reduction in in-person patient visits - in 42 per cent of cases, full in-personal referral appointments were avoided.

·         Clinicians having vastly improved visibility on referral status and waiting times, enabling appropriate triaging and patient expectation management.

·         Configurable referral templates with required fields to eliminate incomplete referrals and clerical issues.

 

Mr Porter has spent much of the past year on the road meeting with Orion Health’s customers across the world. He has road tripped from Texas to Oklahoma to Albuquerque. 

He attended major healthtech events in Nashville, Chicago and Boston and spent time in the Middle East visiting cutting edge ‘Virtual Hospitals’ and the rollout of the world’s largest ever Health Information Exchange. He has spent time in Scotland, Northern Ireland and England seeing first hand the NHS in action. 

 

“Canada boasts bold approaches like Ontario’s Digital First Healthcare transformation - which has seen Orion Health deliver its world first at scale Digital Front Door solution to a population of 15 million - as well as Alberta and other provinces rolling out seamless shared care records and province-wide Health Information Exchanges. 

 

“The Canadian approach has put interoperability at the heart of digital health, and they are now seeing the benefits.

 

Australia should look at how Ontario Health Teams are being introduced to organise and deliver care that is more connected to patients in their local communities, Mr Porter said. 

 

“There are 54 Ontario Health Teams across the province that have been approved through a standardised intake and assessment process.”

 

The Ontario Digital First for Health strategy provides:

 

·         More virtual care options: Expanded availability of video visits and other virtual care tools such as secure messaging. Additionally, providers can use a variety of virtual care technologies that best meet the needs of their patients.

·         Expanded access to online appointment booking: Patients can book appointments that best meet their needs.

·         Greater data access for patients: More patients can review their secure health record online, give providers all the information they need wherever they need it and make informed choices about their care.

·         Better, more connected tools for frontline providers: More providers can access patient records stored across multiple health service providers to provide better, faster care.

·         Data integration and predictive analytics: Providers face fewer barriers to integrating and using secure health information to manage health resources and improve patient care. This has led to improvements such as earlier intervention and better management of chronic disease, and reduced the cost of healthcare

“Digital First for Health is central to the government’s efforts to transform the health care system so that it is integrated, sustainable and patient-centred,” Mr Porter said.

 

“Strong digital capabilities are a critical enabler for system integration and information sharing within health teams and the healthcare system so that patients have a choice on how they engage with the healthcare system and receive seamless care.”

About Orion Health
Orion Health is a leading global technology company that develops software to support the delivery of optimised healthcare. We provide flexible technology solutions that bring together all types of health data to support the management of individualised patient care across a health system. With 30 years’ experience, Orion Health has the global healthcare experience and capabilities to help organisations realise value quickly, without compromising on the local touch required for successful delivery and support. Find out more at www.orionhealth.com.

 Media contacts:

More information: Benjamin Haslem - benjamin.haslem@iconagency.com.au ; 0408 887 742

 

-----

 

Here is the link:

 

https://www.hospitalhealth.com.au/content/technology/article/opinion-australia-must-look-to-canada-for-digital-health-best-practice-1563538329

 

What do others think? Masters of exaggeration or realists? Are there 2 Orions given the comments??

 

David 

The Robo-Debt Saga Has Some Interesting Parallels For The myHR.

For those who came in late Robo-Debt programme was at its core a plan to use technology to control financial waste in the Social Services department that used a flawed algorithm to identify that waste / debt and to then demand some half million people pay back money they did not owe.

The myHR was a plan to use inadequate and flawed technology at a national scale to store patient clinical records with no clear plan or purpose for their use and any real idea what value these records would deliver.

In both cases we see an unevaluated, poorly designed and flawed system pushed on the unsuspecting citizenry with minimal consultation and no care for the harm that might be caused.

Of especial concern is the following:

Robo-debt bureaucrat on leave amid doubts over her $900k job

By Anthony Galloway

Updated July 8, 2023 — 11.00pmfirst published at 5.05pm

Former top public servant Kathryn Campbell went on leave from her $900,000 a year job with the Defence Department last week – a day before the robo-debt royal commission made damning findings against her.

There are now doubts within Defence over whether Campbell will return from leave after the royal commission made a range of scathing findings including that she repeatedly failed to act when the scheme’s flaws and illegality became apparent.

Pressure is also mounting on former prime minister Scott Morrison with Prime Minister Anthony Albanese on Saturday accusing his predecessor of failing to show any contrition despite the royal commission ruling he had allowed cabinet to be misled over the legality of the scheme.

In an interview with this masthead, Government Services Minister Bill Shorten said he didn’t want to comment on specific individuals in the public service as that would be dealt with by “other jurisdictions and other people”.

But Shorten said he understood “the general sense of the anger” from robo-debt victims.

“They feel that people have got away with it,” he said. “I just want to assure them that they haven’t got away with it.”

Government Services Minister Bill Shorten has addressed the findings of the robodebt royal commission report.

Senior Defence sources confirmed that Campbell was on leave from her role with Defence on Thursday and Friday as the damning findings were handed down by royal commissioner Catherine Holmes, SC.

Campbell served as secretary of the Department of Human Services between 2011 and 2017, the period in which the illegal income averaging scheme was introduced.

The royal commission found that Campbell kept the true nature of the income-averaging scheme secret when advising cabinet because she knew then-social services minister Morrison wanted to pursue the program.

Much more here:

https://www.smh.com.au/politics/federal/robo-debt-public-servant-on-leave-amid-doubts-over-whether-she-will-stay-in-900k-job-20230707-p5dmn4.html

Basically it is clear that the politicians and bureaucrats knew Robo-debt was a pile of harmful abusive crock but just let it run. Same goes for the useless and wasteful myHR. They know it is a waste of space and money but just press on.

In both cases we must ask WHY?

I am stu…d if I know!

David.

 

AusHealthIT Poll Number 704 – Results – 09 July, 2023.

Here are the results of the poll.

Are You Expecting The National Health Interoperability Plan From The ADHA To Make A Significant Positive Difference To Information Handling In Australia?

Yes                                                                0 (0%)

No                                                               36 (100%)

I Have No Idea                                              0 (0%)

Total No. Of Votes: 36

A pretty clear outcome suggesting that most readers are not seeing much value in the Jnterop. Plan

Any insights on the poll are welcome, as a comment, as usual!

An OK number of votes. But also a pretty clear outcome. 

0 of 36 who answered the poll admitted to not being sure about the answer to the question!

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

David.

AusHealthIT Poll Number 703– Results – 02 July, 2023.

Here are the results of the poll.

Is Having The MyHealthRecord Sort Of Operational In Australia A Help Or Hindrance To Digital Health Progress Nationally?

A Help                                                                    1 (2%)

A Hindrance                                                        47 (98%)

I Have No Idea                                                       0 (0%)

Votes: 48

A pretty clear outcome suggesting that most readers think the MyHealthRecord is not much help

Any insights on the poll are welcome, as a comment, as usual!

A good count of votes. But also a pretty clear outcome. 

0 of 48 who answered the poll admitted to not being sure about the answer to the question!

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

David.

The ADHA Is Having Another Try At Extracting Value From Siloed Clinical Data.

 This appeared a few days ago.

ML project to unlock siloed data on chronic diseases

The project will "bring machine learning to data" while protecting privacy and integrity.

By Adam Ang

June 30, 2023 03:02 AM

A new project led by the University of Queensland seeks to create a national data network that will support the development of novel solutions for managing chronic diseases.

Recently, the National Infrastructure for Federated Learning in Digital Health (NINA) project secured A$6 million ($3.9 million) funding from the federal government's Medical Research Future Fund. It also received an additional A$7.7 million ($5 million) in contributions from UQ, Monash and Macquarie universities, and the Queensland Cyber Infrastructure Foundation.

WHAT IT'S ABOUT

According to a media release, the five-year project will enable researchers to use machine learning to access siloed information on debilitating chronic diseases, such as diabetes, rheumatoid arthritis and osteoarthritis. It will prepare and harmonise the data to global standards while protecting individual privacy. Analyses will also be generated and shared across health organisations and states.

UQ will collaborate with 23 Australian and global partners to co-design the conceptual framework for NINA and speed up the translation and adoption of the data model at a national scale. 

WHY IT MATTERS

Researchers across Australia find it difficult to access health databases and move their research forward on digital health. 

"Australia has excellent digital health records, but data is siloed across health systems, preventing talented researchers from accessing millions of records about treatments and trends in crippling chronic conditions," noted Clair Sullivan, associate professor at UQ’s Queensland Digital Health Centre.

Chris Bain, Professor of Practice in Digital Health at Monash University Faculty of IT, said various privacy and data sharing restrictions hinder the meaningful use of such databases. 

"This has ultimately led to an almost insurmountable divide across healthcare sectors, including a lack of data connectivity across primary, secondary and tertiary care," he said in a separate statement.

The NINA project intends to "put data to work" to find solutions for better managing chronic conditions. "Rather than attempting to merge different data sets to enable machine learning centrally, the project will bring machine learning to the data," Sullivan added.

THE LARGER TREND

Despite having the will to pursue digital transformation using data and analytics, most healthcare organisations across Australia and New Zealand lack the ability to share real-time data and integrate disparate systems, according to a recent study commissioned by InterSystems. They are also analysing a limited number of data despite having tons of it as multiple datasets are not interoperable.

Nevertheless, most providers wanted a standardisation of data exchange. The Australian Digital Health Agency is helping fulfil this through its National Healthcare Interoperability Plan, which envisions a more connected Australian health system by 2027. 

As part of this endeavour, the agency recently partnered with Health Level Seven Australia to promote the consistent adoption of FHIR standards in the country. It also tied up with CSIRO's Australian e-Health Research Centre to create the National Clinical Terminology Service, which will provide terminology services and tools that will enable connectivity across the health system.

Here is the link:

https://www.healthcareitnews.com/news/anz/ml-project-unlock-siloed-data-chronic-diseases

This is surely a project to watch to see what value is obtained for the $12 million being spent. I really struggle to bring to mind any similar data aggregation projects in OZ that have provided some significant value.

Let me know of any you are aware of!

David.