I Found This Interesting – Will Be Back To Digital Health Next Week!

This appeared last week:

Asteroid dust caused winter that killed dinosaurs: study

By Daniel Lawler

AFP

Updated 5:24PM October 31, 2023, First published at 2:12PM October 31, 2023

About 66 million years ago, an ­asteroid bigger than Mt Everest smashed into Earth, killing off three-quarters of all life on the planet, including the dinosaurs.

This much we know.

But exactly how the impact of the asteroid Chicxulub caused all those animals to become extinct has remained a matter of debate.

The leading theory recently has been that sulphur from the ­asteroid’s impact – or soot from global bushfires it sparked – blocked out the sky and plunged the world into a long, dark winter, killing all but the lucky few.

But new research based on particles found at a key fossil site reasserted an earlier hypothesis: that the winter was caused by dust kicked up by the asteroid.

Fine silicate dust from pulverised rock would have stayed in the atmosphere for 15 years, dropping global temperatures up to 15C, ­researchers report in the journal Nature Geoscience.

Father-and-son scientists Luis and Walter Alvarez in 1980 first proposed that the dinosaurs were killed off by an asteroid strike that shrouded the world in dust. Their claim was initially met with some scepticism, until a decade later when the massive crater of Chicxulub was found in the Yucatan Peninsula on the Gulf of Mexico.

Now, scientists largely agree that Chicxulub was to blame. But the idea that it was sulphur, rather than dust, that caused the impact winter has become “very popular” in recent years, Ozgur Karatekin, a researcher at the Royal Observatory of Belgium, said.

Dr Karatekin, a co-author of the study, said the international team of researchers was able to measure dust particles thought to be from right after the asteroid struck. The particles were found at the Tanis fossil site in North Dakota. Though 3000km away from the crater, the site has preserved several remarkable finds believed to be dated from directly after the asteroid impact in sediment layers of an ancient lake.

The dust particles were bet­ween 0.8 to 8.0 micrometres – just the right size to stick around in the atmosphere for up to 15 years.

Out of all the material that was shot into the atmosphere by the asteroid, the researchers estimated that it was 75 per cent dust, 24 per cent sulphur and 1 per cent soot.

More here:

https://www.theaustralian.com.au/world/asteroid-dust-caused-winter-that-killed-dinosaurs-study/news-story/35135452be436bf4cc4d58ad59eeb592

I do feel rather sorry for all our old mates but something had to give our ancestors a chance to dominate. I wonder what will eventually come along to wipe us off and give another species a chance?

David.

 

Optus CEO Has Arrogance Of A Really Special Level!

 This appeared this morning in the Fin Review

"Optus CEO says ‘no soundbite’ to explain phone outage

Optus boss Kelly Bayer Rosmarin said the cause of a national outage of phone and internet services was too ‘technical’ to explain."

Maybe she should try us as she leaves her job and moves into dishwashing!

There are some pretty smart people out there who I am sure could understand!!!!

What a specially condescending jerk!

Just to prove the point - from the AFR again:

What early signs suggest may have gone wrong at Optus 

 Early indicators point to a problem with the way Optus routes internet traffic from place to place.

John Davidson Columnist

Nov 8, 2023 – 1.37pm

David.

 

I Suppose This Had To Happen – Was Just A Matter of Time!

This appeared last week:

Meet hackers’ favourite new tool: WormGPT

By David Swan

November 3, 2023 — 5.00am

Cybersecurity researchers are sounding an alarm about the hacking community’s answer to ChatGPT, a new generative AI tool dubbed WormGPT, which is being used to create sophisticated attacks on Australian businesses.

WormGPT is being described as similar to ChatGPT, but with no ethical boundaries or limitations, and researchers say hundreds of customers have already paid for access to the tool on the dark web.

A 23-year-old Portuguese programmer, “Last”, describes himself as the creator of WormGPT, and pitches it as a piece of technology that “lets you do all sorts of illegal stuff and easily sell it online in the future”.

“Everything blackhat related that you can think of can be done with WormGPT, allowing anyone access to malicious activity without ever leaving the comfort of their home,” Last said in an online post on the dark web, in which he sold access to the tool.

While businesses are still excited about the productivity benefits generative AI can bring, industry figures are warning that the new technology is set to unleash a wave of innovative cyberattacks against businesses and individuals.

Patrick Butler, managing partner at Australian cyber firm Tesserent, said that malicious parties were signing up to criminal forums to rent access to WormGPT and using it to craft convincing phishing emails in different languages, which then allowed them to commit identity theft and compromise systems access.

While phishing emails were often characterised by poor spelling or grammar, generative AI could create emails with impeccable English, Butler said, and tools such as WormGPT could be used by attackers with limited technical skills.

“We’re seeing malicious generative AI being used to create new malware variants that are more difficult for some traditional tools to detect,” Butler said. “These platforms can even assist criminals in exploiting published vulnerabilities.

“While some legitimate AI tools can be used to conduct software code reviews, developers should be discouraged from doing this as their code may be used to train AI models that criminals gain access to, giving them further intelligence into organisational systems.”

Butler said the number of different threat actors would likely escalate as generative AI made it easier for criminals to access cyberattack tools. He said the Tesserent Security Operations Centre had already found an increase in phishing campaigns and malicious email activities targeting Australian organisations, particularly in the months following the emergence of WormGPT and similar tools.

There are now at least six different generative AI tools available to rent or purchase on the dark web, including FraudGPT, EvilGPT, DarkBard, WolfGPT, XXXGPT and WormGPT with more appearing, according to Butler.

“While most lack the large capacity of public-facing tools like ChatGPT and Bard, they are proliferating quickly, which can make them harder to find and take down.”

Scott Jarkoff, director of intelligence strategy, APJ & META, at CrowdStrike, said cybersecurity activity had risen amid the conflict in the Middle East, meaning businesses should be even more vigilant than usual.

He said hacking groups from the so-called “big four” of Russia, China, North Korea and Iran had been using generative AI tools to craft attacks in perfect English.

“The Israel-Hamas conflict is now giving criminals a perfect lure to say ‘hey, visit this site to donate to whichever cause you believe in’, and that means it’s now more important that everyone takes cybersecurity more seriously,” he said.

“We all take safety seriously, why do we not take cyber seriously? We’ve got to get to a point where cyber hygiene is built into everyone’s muscle memory, just as safety is built into everyone’s muscle memory.”

Generative AI is not only being used to create realistic phishing emails. It’s also supercharging social engineering, with bad actors using AI to create realistic fake accounts to spread misinformation, according to Dan Schiappa, chief product officer at cyber vendor Arctic Wolf.

More here:

https://www.smh.com.au/technology/meet-hackers-favourite-new-tool-wormgpt-20231102-p5eh5l.html

Inevitable but pretty sad I reckon. There is always someone around to spoil the party!

The prospect of grammatically perfect phishing e-mails from Iran of all places is just too horrible to contemplate!

Important we all know about the threat – and be bloody careful out there!

David.

 

If You Have Yourself For Your Doctor, You Have A Fool For A Patient!

This saga reminded me forcefully of the above saying, which has more that a grain of truth!

Patient speaks out after online prescribing ‘ordeal’

One Australian woman is warning about the dangers of bypassing a GP, after ineffective medication for a UTI left her fighting for life in hospital.

Michelle Wisbey

03 Nov 2023

When Abbey Smith developed a urinary tract infection (UTI), she thought she would log into an online script service for the first time.
 
Little did she know that just days later, that decision would set off a chain of events that would land her in a hospital bed fearing for her life.
 
The Australian journalist shared her experience in an opinion piece for Yahoo News this week, entitled ‘Getting my prescription online almost killed me’.
 
Ms Smith’s story began around a year ago when she developed a UTI. Feeling the ‘familiar sting’ she simply jumped online, paid her $17.50, and a script soon arrived in the mail.
 
‘I dropped into my local chemist on the way to work and was only asked if I’d used the antibiotic before and whether I needed to be instructed on its use,’ she said.
 
‘I declined and off I went thinking how quick and easy the process was and how I’d use it again.’
 
But after a few days, Ms Smith could not keep warm – she was so cold her lips were turning blue.
 
She went to the emergency department but after an eight-hour wait and multiple blood tests, was sent home.
 
‘Just 24 hours later, after I experienced rigours, a fever and hallucinations of my deceased nanna, pop and first boyfriend, my housemate rushed me to the emergency room where I was told I was turning septic,’ she said.
 
‘The infection had spread to my blood, and I was admitted to hospital on the spot.
 
‘Before I was discharged a doctor explained the bug in my system was E. coli, a common cause of UTIs which is resistant to the antibiotic I was given.’
 
One year on and Ms Smith wrote she is only now starting to bounce back, and has vowed never to use an online prescription service again.
 
‘Since my ordeal, I’ve spoken to several other women who have been through the same thing as me, or know someone who has,’ she said.
 
‘My experience has stopped me from using online prescription services altogether.
 
‘These days, if I’m feeling unwell, I book into my local GP and take the time to go over my medical history.’
 
Ms Smith’s terrifying tale comes amid a rise in telehealth and online prescribing services.
 
In June, the Medical Board of Australia released new telehealth guidelines designed to clamp down on asynchronous prescribing services.
 
The new Guidelines: Telehealth consultations with patients took effect in September, and state ‘prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board’.
 
RACGP Expert Committee – Quality Care member Associate Professor Magdalena Simonis told newsGP Ms Smith’s story is proof of how ‘inefficient and potentially dangerous’ online prescribing can be.
 
‘Online prescribing is not as safe a method of treating medical problems as using telehealth or face to face with the patient’s regular GP,’ she said.
 
‘Online tick-box prescribing without a real-time, patient–doctor consultation fragments care and is not founded on the basis of an ongoing therapeutic relationship, and the flow on from this is that it is not good medical practice.
 
‘It is a warning to policymakers and politicians that fragmentation of care which does not take into account the differential diagnoses, the patient’s response to the treatment, and the need to review the patient by an expert in health such as a GP, poses a risk.’
 
In October, the RACGP urged governments to bolster telehealth access as part of its updated position statement, ‘The use of telehealth in general practice’.
 
It said telehealth must be of the highest quality, led by a GP, and thought of as complementary to face-to-face care, rather than a substitute.
 
Above all, it should be delivered by a trained healthcare professional, it said.
 
Associate Professor Simonis said the verbal and nonverbal exchange which occurs between a patient and a doctor who is familiar with them will often provide key information about the complaint.
 
‘It is not unusual for a person to associate their symptoms with what they already have had in the past, even if there might be a difference,’ she said.
 
‘UTIs are a classic example of this, where a patient might have dysuria and frequency but in fact has an STI or an undiagnosed pregnancy.
 
‘The need to come back or call for review “if things don’t improve, or new symptoms develop”, is key to preventing such unfortunate and potentially lethal outcomes.’ 
More here:

https://www1.racgp.org.au/newsgp/clinical/patient-speaks-out-after-online-prescribing-ordeal

Given this article comes from the GP College it is easy to suggest they are ‘talking their own book’ but they do have a point.

There is a reason one spends many years to becoming a doctor so one can prescribe and that it that you understand the risks of just this sort of scenario where the patient is not seen initially and then followed up while on the treatment!

As my old professor used to say “You rarely get into clinical trouble if you actually see the patient”!

A safe health system has necessary costs and protocols for a reason and if these are ignored problem will ensue.

I am not sure we have the on-line prescribing rules and regulations fully right just yet and I am sympathetic to calls for regular reviews of how things are working along with an effective system to identify when things go wrong.

David.

 

Artificial Intelligence Has Certainly Become A Global Focus This Last Year!

This popped up a few days ago as emblematic of the trend:

Summit warns about dangers of artificial intelligence influence

By Jacquelin Magnay

5:41PM November 2, 2023

Industry and Science Minister Ed Husic has warned artificial intelligence-generated misinformation is “the big thing” that could influence the way people make future decisions, including at elections.

He said governments had adopted a “comfortable, helpful helplessness” when it comes to technology because it was previously “all too hard”.

But he warned: “I think there’s a dawning realisation on governments, you can’t have that (attitude), you need to shake that off.”

US Vice-President Kamala Harris, speaking separately at the US embassy in London, warned AI has the potential to cause profound harm.

“From AI-enabled cyber attacks at a scale beyond anything we have seen before to AI-formulated bioweapons that could endanger the lives of millions of people. These threats are often referred to as the ‘existential threats of AI’ because of course they could endanger the very existence of humanity.

“These threats without question are profound and they demand global action. But let us be clear, there are additional threats that also demand our action.”

She said the US situation concerning voluntary commitments with technology companies were an “initial step’’, saying there will be more to come “because as history has shown in the absence of regulation and strong government oversight, some technology companies choose to prioritise profit over the wellbeing of their customers”.

Mr Husic, on the sidelines of the British-organised two-day AI summit at Bletchley Park, England, attended by governments and tech titans including Elon Musk, said the application of generative AI and language models “is not so much ‘will the robots take over?’ but ‘will AI-generated disinformation do that?’”

He said disinformation would guide the way people make decisions, not just governments, and impact on the broader public reaction to things that might influence the way governments or businesses respond.

He said Australia was looking to the AI policy models proposed by others, such as the United States, the European Union and the United Kingdom, because going one-out was too difficult.

On Wednesday, the summit issued the Bletchley declaration, signed by 28 countries,which recognised that there was potential for “serious, even catastrophic, harm, either deliberate or unintentional, stemming from the most significant capabilities of these AI models”.

The declaration, signed by Australia, said: “Substantial risks may arise from potential intentional misuse or unintended issues of control relating to alignment with human intent. These issues are in part because those capabilities are not fully understood and are therefore hard to predict. We are especially concerned by such risks in domains such as cybersecurity and biotechnology, as well as where frontier AI systems may amplify risks such as disinformation.”

Musk: ‘Hope for the best but prepare for the worst’ with AI

More here:

https://www.theaustralian.com.au/nation/politics/summit-warns-about-dangers-of-artificial-intelligence-influence/news-story/f1898a89cef5d4c55b35d80603fbe65c

I think this is very important stuff but that it is important to preserve perspective as we navigate a very interesting near future,

My perspective is that much of the work in AI is really fascinating and potentially very impactful but that right now we have a world grappling with a number of equally complex issues cantered around poverty, war, mistrust and hate etc. that we need to navigate and that having the necessary bandwidth to handle it all is a rather daunting ask!

It seems at present we are just managing to ‘walk and chew gum’, as they say, but I wonder just how much energy we need to allocate to the current crop of apparently existential threats which desire our attention to keep the balls safely in the air! More than we have I suspect,,,,

AI has the potential to solve many problems and we need to be sure we direct it onto the important biggies as best we can!

As I, and others, often say ‘I am just a very old man on many drugs’ but I hope I can last long enough to see at least the outline of where this coming revolution is leading because matter it really does IMVHO and I am sure it will be very interesting indeed!

David.

AusHealthIT Poll Number 721 – Results – 05 November, 2023.

Here are the results of the poll.

Do You Believe Implementation Of Artificial Intelligence Technologies Will Significantly Reduce The Clinical Documentation Workload Over The Next 5-10 Years?

Yes                                                                               15 (45%)

No                                                                                18 (55%)

I Have no Idea                                                              0 (0%)

Total No. Of Votes: 33

A mixed outcome with a bare majority feeling AI will reduce the workload a little.

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

A fair number of votes. But also a very vague outcome! 

0 of 33 who answered the poll admitted to not being sure about the answer to the question!

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

David.

OAIC Reveals What It Has Done In Digital Health For The Year.

We noted this a few days ago:

Annual report of the Australian Information Commissioner's activities in relation to digital health 2022–23

Published: 20 Oct 2023

Executive summary

Download the Annual report of the Australian Information Commissioner's activities in relation to digital health 2022–23

This annual report sets out the Australian Information Commissioner’s digital health compliance and regulatory activity during 2022–23, in accordance with section 106 of the My Health Records Act 2012 (My Health Records Act) and section 30 of the Healthcare Identifiers Act 2010 (HI Act).

Digital health is an increasingly significant part of the healthcare system, and while the use of digital health information continues to grow, it is it is critical that privacy measures are upheld.

The Australian Government has established two key services to underpin digital health in Australia: the Healthcare Identifiers Service (HI Service), and the My Health Record system. Both involve the management of personal information – and for the purposes of this report, we refer to them collectively as ‘digital health’.

Healthcare identifiers are assigned to individuals, healthcare providers, and healthcare provider organisations. They help healthcare providers communicate accurately with each other and identify and access patient records in the My Health Record system.

The My Health Record system is an online summary of an individual’s health information, including their medicines, immunisations, allergies and medical history. Registered healthcare providers, including doctors, nurses and allied health professionals involved in their care can view and add information to it, subject to legislative obligations and any individual access controls.

Following the earlier establishment of the HI Service, the My Health Record system commenced in 2012 as an opt-in system: people needed to register in order to establish and share their record. In 2017, the Australian Government announced the creation of a My Health Record for every Australian. Following an opt-out period that ended on 31 January 2019, a My Health Record was created for everyone who had not opted out of the system.

Privacy is critical to ensuring trust in digital health, and the legislation establishing the My Health Record system and HI Service include important privacy provisions which are regulated by the Office of the Australian Information Commissioner (OAIC). These provisions recognise the special sensitivity of health information, and protect and restrict its collection, use and disclosure. We work to ensure that healthcare providers understand and comply with their privacy obligations.

This report provides information about digital health activities undertaken by the OAIC, including our assessment program, handling of My Health Record data breach notifications, development of guidance material, provision of advice and liaison with key stakeholders.

In 2022–23, the OAIC received 10 privacy complaints relating to the My Health Record system with 11 complaints ongoing at the end of the reporting period, including 6 complaints received in previous reporting periods. We finalised 8 My Health Record system complaints, including 3 complaints from previous reporting periods.

We received 5 new privacy complaints relating to the HI Service in 2022–23, of which we finalised 1, as well as another 7 complaints from the previous year.

Over the reporting period, the OAIC has continued its focus on regulatory policy work in relation to the HI Service and continued to handle complaints and enquiries about healthcare identifiers. These complaints and enquiries primarily concerned the inclusion of Individual Healthcare Identifiers (IHIs) on COVID-19 digital vaccination certificates (vaccination certificates). On 3 December 2022, IHIs were removed from vaccination certificates and we updated our published privacy guidance to assist entities and individuals who had collected vaccination certificates containing an IHI.

We received 10 data breach notifications during the reporting period in relation to the My Health Record system and closed 10 notifications.

We also carried out other digital health-related work including:

• commencing one assessment regarding the My Health Record system and finalising 2 further assessments as part of the My Health Record access security policy assessment program
• providing advice to stakeholders, including the Australian Digital Health Agency (ADHA), Services Australia and the Department of Health and Aged Care about privacy-related matters relevant to the My Health Record system and HI Service
• developing and promoting guidance materials, including publishing a template for healthcare providers to help them comply with security and access policy requirements under the My Health Records Rule 2016 and updating our My Health Record emergency access function guidance
• engaging with the Department of Health and Aged Care regarding the proposed amendments to the Healthcare Identifiers Regulations 2020 and the HI Act , and
• monitoring developments in the My Health Record system and the HI Service.

---- End Summary

Here is the link:

https://www.oaic.gov.au/about-the-OAIC/our-corporate-information/digital-health-annual-reports/annual-report-into-the-australian-information-commissioners-activities-in-relation-to-digital-health-202223

I was going to comment on the detail but it seems the Information Commissioner’s site is down on Sun at 4:30pm.

Try later

David.

 

What Can We Make Of This Latest Plan For Re-Structuring And Sharing

This popped up last week….

Sharing by default: delivery of health interoperability plan in full swing

25 October 2023

By Kate McDonald

The Australian Digital Health Agency (ADHA) will release quarterly updates on the ambitious goals of the national healthcare interoperability plan following the recent creation of the independent Council for Connected Care (CCC), and in light of the federal government’s commitment to a “share by default” policy on health information sharing.

The CCC was announced at the MedInfo conference in July (pictured), to provide strategic advice to ensure implementation of the national health interoperability plan, which was also launched at the conference.

Chaired by Australian Institute of Health and Welfare CEO Rob Heferen, the CCC had its third meeting recently, concentrating on standards. Attendees included representatives from the Australian Commission on Safety and Quality in Health Care, Department of Health and Aged Care, the CSIRO, Standards Australia, HL7 Australia, GS1 Australia, Integrating the Healthcare Enterprise (IHE) and the AIHW.

An update was provided by ADHA’s standards advisory group, chaired by University of Melbourne associate dean of digital health and informatics Wendy Chapman.

The meeting also discussed the new Sparked program, a FHIR accelerator the has brought together the CSIRO’s Australian eHealth Research Centre, the Department of Health and Aged Care, the Australian Digital Health Agency, CSIRO, and HL7 Australia to develop an Australian core dataset for interoperability and FHIR.

ADHA CEO Amanda Cattermole said the council was designed to be as broad a stakeholder engagement group and an advisory and stewardship group as possible.

“The way that it’s framed is that each meeting will be a deep dive on one domain that is going to drive change under the plan,” Ms Cattermole said.

More here:

https://www.pulseit.news/australian-digital-health/share-by-default-delivery-of-health-interoperability-plan-in-full-swing/

We now have the first quarterly progress report on the national healthcare interoperability plan and it is  is available from ADHA.

The report is a nice 25 slides. The summary of progress is as follows (Page 4).

“Key progress towards a better-connected healthcare system for all Australians includes:

• Establishing strong governance – the Council for Connected Care and the Australian Digital Health Standards Advisory Group – and developing a communication and engagement plan for collaboration and transparency.

• Sharing resources in central locations – the Agency’s Online Interoperability Toolkit and Digital Health Developer Portal – for collaboration and to build the knowledge base.

• Developing roadmaps for healthcare identifiers and the Fast Health Interoperability Resources (FHIR) Accelerator program and commencing consultations with jurisdictions on the National Health Information Exchange Architecture and Roadmap.

• Developing guidelines for ICT procurement and a framework for conformance.

• Publishing guiding principles for digital health standards, developing a standards gap analysis tool and designing a community platform for a standards catalogue that will bring resources together in one place.

• Building the digital health capability of the workforce through assessment tools and training on FHIR and healthcare identifiers.

• Measuring maturity through the 2022 Interoperability Benchmark Survey, identifying appropriate maturity models and monitoring progress against the actions in the Interoperability Plan.”

Why do I get the feeling I need to come back in 5 years time to see if anything much has changed. Right now all we seem to have guidelines and wish-lists!

The more closely I read these seven points the stronger my sense of déjà vu! If I tried I reckon I could find you similar documents from the 1990’s. Will someone please tell me where the hard evidence of real progress resides and send me a copy! Is that too much to ask?

David.