Now This Is The Real Bleeding Edge. Fantastic Stuff Out Of Science Fiction!

This stuff seeming almost from the future appeared a little while ago.

Watson joins the fight against cancer

Posted on Oct 18, 2013

By Mike Miliard, Managing Editor

First he won on Jeopardy!, now he's going to try to beat leukemia. The University of Texas MD Anderson Cancer Center announced Friday that it will deploy Watson, IBM's famed cognitive computing system, to help eradicate cancer.

The two organizations will leverage Watson's computing power to help clinicians uncover insights from MD Anderson's vast patient and research databases, officials say. After a yearlong collaboration, the two will showcase a prototype of MD Anderson's Oncology Expert Advisor, powered by Watson.

That technology seeks to integrate the knowledge of MD Anderson's clinicians and researchers, and to advance the cancer center's goal of treating patients with the most effective, safe and evidence-based standard of care available, say officials. Starting with the fight against leukemia, the Oncology Expert Advisor aims to help clinicians develop and fine-tune treatment plans for patients, while helping them recognize adverse events that may occur throughout the care continuum.

"One unique aspect of the MD Anderson Oncology Expert Advisor is that it will not solely rely on established cancer care pathways to recommend appropriate treatment options," said Lynda Chin, MD, professor and chair of genomic medicine and scientific director of the Institute for Applied Cancer Science at MD Anderson, in a press statement.

"The system was built with the understanding that what we know today will not be enough for many patients," she added. "Therefore, our cancer patients will be automatically matched to appropriate clinical trials by the Oncology Expert Advisor. Based on evidence as well as experiences, our physicians can offer our patients a better chance to battle their cancers by participating in clinical trials on novel therapies."

First in Watson's sights: leukemia, which causes nearly one-third of all cancer deaths in children and adolescents younger than 15 years, according to the Leukemia and Lymphoma Society.

The technology is expected to be accessible to the cancer center's network of clinicians through a computer interface and supported mobile devices, say MD Anderson officials. This provides clinicians – and in turn, patients – with immediate, worldwide access to MD Anderson's expertise and resources, and to IBM Watson's technology prowess in quickly extracting crucial insights from large volumes of complex data.

With more than 100,000 patients cared for each year, MD Anderson has amassed a huge trove of clinical oncology data, but extracting usable insights from it all has proven difficult. Watson will try to extract and make sense of crucial information that might be otherwise trapped in databases, or in the electronic medical records of other providers.

Lots more here:

http://www.healthcareitnews.com/news/watson-joins-fight-against-cancer

We also have this from the bleeding edge.

The Rapid Advance of Artificial Intelligence

By JOHN MARKOFF

Published: October 14, 2013

The jubilant and occasionally squealing attendees appeared to have no idea that next door a group of real-world wizards was demonstrating technology that only a few years ago might have seemed as magical.

The scientists and engineers at the Computer Vision and Pattern Recognition conference are creating a world in which cars drive themselves, machines recognize people and “understand” their emotions, and humanoid robots travel unattended, performing everything from mundane factory tasks to emergency rescues.

C.V.P.R., as it is known, is an annual gathering of computer vision scientists, students, roboticists, software hackers — and increasingly in recent years, business and entrepreneurial types looking for another great technological leap forward.

The growing power of computer vision is a crucial first step for the next generation of computing, robotic and artificial intelligence systems. Once machines can identify objects and understand their environments, they can be freed to move around in the world. And once robots become mobile they will be increasingly capable of extending the reach of humans or replacing them.

Self-driving cars, factory robots and a new class of farm hands known as ag-robots are already demonstrating what increasingly mobile machines can do. Indeed, the rapid advance of computer vision is just one of a set of artificial intelligence-oriented technologies — others include speech recognition, dexterous manipulation and navigation — that underscore a sea change beyond personal computing and the Internet, the technologies that have defined the last three decades of the computing world.

“During the next decade we’re going to see smarts put into everything,” said Ed Lazowska, a computer scientist at the University of Washington who is a specialist in Big Data. “Smart homes, smart cars, smart health, smart robots, smart science, smart crowds and smart computer-human interactions.”

The enormous amount of data being generated by inexpensive sensors has been a significant factor in altering the center of gravity of the computing world, he said, making it possible to use centralized computers in data centers — referred to as the cloud — to take artificial intelligence technologies like machine-learning and spread computer intelligence far beyond desktop computers.

Apple was the most successful early innovator in popularizing what is today described as ubiquitous computing. The idea, first proposed by Mark Weiser, a computer scientist with Xerox, involves embedding powerful microprocessor chips in everyday objects.

Steve Jobs, during his second tenure at Apple, was quick to understand the implications of the falling cost of computer intelligence. Taking advantage of it, he first created a digital music player, the iPod, and then transformed mobile communication with the iPhone. Now such innovation is rapidly accelerating into all consumer products.

“The most important new computer maker in Silicon Valley isn’t a computer maker at all, it’s Tesla,” the electric car manufacturer, said Paul Saffo, a managing director at Discern Analytics, a research firm based in San Francisco. “The car has become a node in the network and a computer in its own right. It’s a primitive robot that wraps around you.”

Here are several areas in which next-generation computing systems and more powerful software algorithms could transform the world in the next half-decade.

Lots more here:

http://www.nytimes.com/2013/10/15/technology/the-rapid-advance-of-artificial-intelligence.html?_r=0

This is really getting just more and more exciting. Both are must reads!

David.

I Think This Is One Of The Most Important Economist Editorials In A Long While. Science May Have Lost Its Way.

This appeared late last week.

How science goes wrong

Scientific research has changed the world. Now it needs to change itself

Oct 19th 2013 |From the print edition

A SIMPLE idea underpins science: “trust, but verify”. Results should always be subject to challenge from experiment. That simple but powerful idea has generated a vast body of knowledge. Since its birth in the 17th century, modern science has changed the world beyond recognition, and overwhelmingly for the better.

But success can breed complacency. Modern scientists are doing too much trusting and not enough verifying—to the detriment of the whole of science, and of humanity.

Too many of the findings that fill the academic ether are the result of shoddy experiments or poor analysis (see article). A rule of thumb among biotechnology venture-capitalists is that half of published research cannot be replicated. Even that may be optimistic. Last year researchers at one biotech firm, Amgen, found they could reproduce just six of 53 “landmark” studies in cancer research. Earlier, a group at Bayer, a drug company, managed to repeat just a quarter of 67 similarly important papers. A leading computer scientist frets that three-quarters of papers in his subfield are bunk. In 2000-10 roughly 80,000 patients took part in clinical trials based on research that was later retracted because of mistakes or improprieties.

What a load of rubbish

Even when flawed research does not put people’s lives at risk—and much of it is too far from the market to do so—it squanders money and the efforts of some of the world’s best minds. The opportunity costs of stymied progress are hard to quantify, but they are likely to be vast. And they could be rising.

One reason is the competitiveness of science. In the 1950s, when modern academic research took shape after its successes in the second world war, it was still a rarefied pastime. The entire club of scientists numbered a few hundred thousand. As their ranks have swelled, to 6m-7m active researchers on the latest reckoning, scientists have lost their taste for self-policing and quality control. The obligation to “publish or perish” has come to rule over academic life. Competition for jobs is cut-throat. Full professors in America earned on average $135,000 in 2012—more than judges did. Every year six freshly minted PhDs vie for every academic post. Nowadays verification (the replication of other people’s results) does little to advance a researcher’s career. And without verification, dubious findings live on to mislead.

----- Lots Omitted

Science still commands enormous—if sometimes bemused—respect. But its privileged status is founded on the capacity to be right most of the time and to correct its mistakes when it gets things wrong. And it is not as if the universe is short of genuine mysteries to keep generations of scientists hard at work. The false trails laid down by shoddy research are an unforgivable barrier to understanding.

http://www.economist.com/news/leaders/21588069-scientific-research-has-changed-world-now-it-needs-change-itself-how-science-goes-wrong

What does this mean for those interested in e-Health. To me the implication of all this means a number of things

First we need assessments of e-Health and publications that are done with a view to being replicable and transparent.

Second we need the end points being examined in the studies to be clinical outcome focussed and to be demonstrably achievable in the real world. The difference between finding an effect with a bespoke hand crafted solution in just one hospital and seeing an improvement in population health based measures related to Health IT is just vast.

Third we need to make sure, as the article points out, that failures are documented to we can be sure lessons learnt are being properly documented and understood.

Fourth we need to be sure that whatever is measured in a study is genuinely clinically meaningful.

Last for me we really do need to see publication when it is likely to make a difference rather than just because the publish or perish paradigm is active. I would much rather read 20 quality meaningful publications a year than the zillion abstracts that seem to always be floating around and which make it very hard so see to wood for the trees.

The scientific endeavour has made a great contribution to the world but if don’t focus on quality (and replicability) rather than quantity we may do ourselves enormous harm.

The pressures on Australian Universities at present are pretty extreme and it is important these pressures do not lead to poor quality rushed research.

David.

This Is A Reassuring Finding On Patient Access To Pathology Results. Makes Most Happy Apparently.

The following popped up a little while ago.

Patients like seeing lab results online

October 7, 2013 | By Ashley Gold

Patients able to view their lab results online overwhelmingly reacted positively to being able to do so, according to a new study published in the Journal of Participatory Medicine.

The study conducted an email survey of Kaiser Permanente members who had viewed at least one test result online in the last year, with 1,546 respondents. According to the study, survey participants reported, "high levels" of satisfaction, appreciation, calm, happiness and relief. Few were confused, upset or angry at being able to see lab results online. 

After reviewing results online, the most common actions were discussing results with family and friends, looking up information online or making a graph of results over time. It was also important for doctors to set patients' expectations--in doing so, they were less likely to follow up on test results by calling, emailing or setting up new appointments, according to the study.

"The findings that patients largely react positively to seeing test results online should be reassuring to physician practices that are considering adding a patient portal with PHR to their practice websites," study authors wrote. The study results could serve as a good reason to expand test outcomes online for practices already using patient portals.

…..

To learn more:
- read the study

Lots more here with additional relevant links.

http://www.fiercehealthit.com/story/patients-seeing-lab-results-online/2013-10-07

This is a useful study and is really worth close reading:

The direct link is here:

http://www.jopm.org/evidence/research/2013/10/03/viewing-laboratory-test-results-online-patients-actions-and-reactions/

The full paper is accessible for free.

One worry is that a small but significant minority - considering the number of results that are generated were confused, anxious or angry.

Clearly having the doctor being able to set expectations and to comment directly to the patient are useful features.

David.

Does Anyone Else Find This Rather Confusing? NASH Strikes Again It Would Seem!

The following appeared a little while ago.

NASH PKI certificates

About NASH PKI certificates

Healthcare providers and participating supporting organisations need to have a National Authentication Service for Health (NASH) Public Key Infrastructure (PKI) certificate to access the Personally Controlled Electronic Health (eHealth) Record system.

For example, your organisation needs a NASH PKI certificate to securely access the eHealth record system to add information to your patient's eHealth record.

Depending on the NASH PKI certificate you’re issued with:

• you can access the eHealth record system
• you can identify other healthcare providers and supporting organisations who send health information to you
• any information you send to other healthcare providers is secure and any unauthorised change can be detected, and
• any information you send can be made confidential and can only be opened by the person or organisation it is addressed to

However NASH PKI certificates can't be used to access the Healthcare Identifiers (HI) Service or claim Medicare benefits.

NASH PKI certificates were previously called Department of Human Services eHealth Record Individual or Organisation PKI Certificates. If you currently use an eHealth record PKI certificate and you renew your certificate, you will receive a NASH PKI certificate, and it will be valid for 2 years.

Lots more is found here:

http://www.medicareaustralia.gov.au/provider/vendors/nash-and-human-services-ehealth-record-pki-certificates.jsp

Two things stuck me here.

First NASH now seems to have been implemented as a simply as a name change - so it seems that commentary that NEHTA did not know what they were doing and should have just gone straight to Medicare Australia for help right from the start was close to the truth.

Secondly why are we now expecting people to have different PKI certificates for the IHI Service and Medicare Claiming and for the PCEHR? Why can’t a practice have an organisational certificate for billing and individual certificates for access to the PCEHR?

Here is the page that tells you all about the older system.

http://www.medicareaustralia.gov.au/provider/business/online/register/apply.jsp

Surely there could have been a simpler way that might have made life a lot easier for practices. So much for the Government ambition to reduce red-tape!

David.

Weekly Australian Health IT Links – 21st October, 2013.

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

Well, quite an interesting week with the peak GP body coming out and wanting some PCEHR improvements and or changes. Will be interesting to see if there is any response.

As far as I can tell we have had no substantive health policy of any sort announced since the election. Going to ground hardly describes just how quiet the Ministers have been since the election. Either they have nodded off or there is a lot of paddling happening under the apparently serene swan on the surface.

Time will tell.

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http://www.australianageingagenda.com.au/2013/08/16/doctors-ready-to-pull-plug-on-ehealth/

Doctors ready to pull plug on eHealth

By Australian Ageing Agenda on August 16, 2013 in Government, Industry, Technology

By Julian Bajkowski 

Australia’s long and troubled efforts to create a functioning national system of electronic health and medical records system is once more close to collapse.

The Australian Medical Association has expressed serious concerns over clinician input into the project following the shock resignation of highly respected clinical representative Dr Mukesh Haikerwal from the National eHealth Transition Authority (NeHTA) this week.

Other crucial clinical advisors, including Dr Nathan Pinksier and other clinical leads are also understood to have quit signalling a severe breakdown in relations between doctors and Department of Health and Ageing.

A loss of confidence by doctors in either DoHA or or NeHTA would, in practical terms, shut-off political life support for the circa $1 billion Personally Controlled Electronic Health Record (PCEHR) project because the scheme cannot work unless doctors voluntarily agree to use it.

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http://www.medicalobserver.com.au/news/concerns-over-clinical-use-of-ehealth-records

Concerns over clinical use of e-health records

16th Oct 2013

Byron Kaye

GENERAL practice leaders have called on the federal government to address concerns about the clinical use of the personally controlled electronic health record (PCEHR) after the project’s most senior leaders quit en masse.

In August, five of the top National E-Health Transition Authority (NEHTA) clinical leads, including the project’s most vocal proponent, Dr Mukesh Haikerwal, resigned amid reports of souring relations between the advisers and the Department of Health and Ageing because of claims the department was taking an increasingly central role in the rollout.

Today, United General Practice Australia (UGPA) – the umbrella group comprising the AMA, the RACGP, the RDAA and others – said the government, which is now the PCEHR operator, must make an “urgent priority” of addressing “significant clinical utility issues” associated with it.

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http://www.itwire.com/it-policy-news/govenrment-tech-policy/61924-gps-raise-concerns-over-e-health-record-system

GPs raise concerns over e-health record system

• 16 October 2013
• By  Peter Dinham

Australia’s general practice (GP) leaders are calling on the federal government to heed what they say are concerns raised by GPs regarding the “significant clinical utility issues” associated with the Personally Controlled eHealth Record (PCEHR) system.

The GPs, through the United General Practice Australia (UGPA) – the overarching organisation comprising a number of Australia’s medical bodies- say the government needs to give urgent priority to addressing the issues with the PCEHR system.

According to the UGPA, its members meeting in Canberra unanimously agreed that the focus of the PCEHR needs to be redirected to clinical utility and standardisation to ensure seamless clinical adoption.

-----

http://www.dailyliberal.com.au/story/1837672/dubbo-trailing-on-ehealth-uptake/?cs=112

Dubbo trailing on eHealth uptake

By PHILIP LY

Oct. 14, 2013, 4 a.m.

PEOPLE of Dubbo have been slow to take up the federal government's eHealth record system rolled out more than a year ago.

According to a spokesperson for the Australian Government Department of Health, there are around 1000 residents who have registered for the personally controlled eHealth record system (PCEHR) in Dubbo, which stores all medical records to make receiving the right treatment faster, safer and easier.

"In Dubbo, the Western NSW Medicare Local (WML) is supporting the uptake of consumer education and registration for the PCEHR... which currently has one million patients nationally," the department spokesperson said.

eHealth gives individuals the power to determine what records go into a secure online summary of personal medical information.

-----

http://www.pharmacynews.com.au/news/latest-news/guild-seeks-e-script-incentive-confirmation

Confirmation needed on e-script incentive

16 October, 2013 Nick O'Donoghue

The Pharmacy Guild of Australia is seeking urgent confirmation that the new Federal Government will deliver the Electronic Prescription Scanning Incentive, which was announced by Labor before the recent election.

Under the proposal by the previous government, pharmacists would be eligible to claim up to $2000 per pharmacy if they use electronic prescription scanning systems, as reported by Pharmacy News.

David Quilty, Guild executive director, said the incentive was fully funded under the Fifth Community Pharmacy Agreement, and was “a critical step along the road towards a paperless script environment”.

“We have no reason to believe that the new Minister [for Health, Peter Dutton] is not committed to this incentive,” he said in the Guild’s Forefront newsletter today.

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http://www.fool.com.au/2013/10/15/telstra-sees-growth-in-asia-e-health-nas-and-connectivity/

Telstra sees growth in Asia, e-Health, NAS and connectivity

By Owen Raskiewicz - October 15, 2013

Today Telstra (ASX: TLS) shareholders went to company’s AGM armed with over 1,600 questions on the NBN, remuneration, dividends and redundancies.

Chair Catherine Livingstone and CEO David Thodey passed briefly over redundancies and dividends, telling shareholders the telco has performed well and they expect dividends to be reviewed on a six-month basis in 2014. The future of the NBN remains largely unknown as a result of ongoing reviews within the NBN Co.

Telstra also defends its position on offshoring as the dynamics of the industry change, allowing more customer service online whilst improved standards means overseas call centres have no excuses regarding poor service. In addition Mr Thodey said, “Ultimately, our aim is to keep creating new jobs that are sustainable in an increasingly digital, mobile and global world, and that’s what we’re doing.”

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http://www.australianageingagenda.com.au/2013/09/18/health-information-technology-wa-hitwa-2013/

Health Information Technology WA (HITWA) 2013

By Australian Ageing Agenda on September 18, 2013 in Conferences & Events

HITWA 2013 – WA’s premier e-health and health informatics event

•Friday, 8 November at the Perth Convention and Exhibition Centre

Don’t miss this unique opportunity to attend the only dedicated event that deals specifically with the unique challenges and opportunities for e-health in Western Australia. You will hear from and network with national leaders and experts.

This year’s conference theme, “The Road to Reform: Challenges, Innovations and Success” brings together a diverse range of industry professionals and academics to share their knowledge and stories.

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http://www.racgp.org.au/your-practice/business/tools/support/qualityhealthrecords/

Quality health records in Australian primary healthcare - A guide

Quality health records in Australian primary healthcare: A guide was developed by an inter-professional Advisory Group in consultation with colleagues across the Australian primary healthcare sector. The guide is:

• designed to assist health professionals produce, manage and use high quality health records that are fit for a range of purposes including safe clinical decision making, good communication with other health professionals, trustworthy partnerships with patients and effective continuity of patient care.
• applicable to all health professionals operating in the Australian primary healthcare sector whether as solo practitioners, members of single-discipline practice teams, members of multidisciplinary practice teams or members of larger organisations.
• comprehensive in covering electronic health record systems, paper-based health record systems and hybrid health record systems and describes a set of core principles and practical examples to illustrate particular principles in day-to-day clinical practice. 

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http://www.smh.com.au/digital-life/digital-life-news/older-people-net-savvy-but-web-costs-can-leave-them-lonely-20131014-2viv5.html

Older people net savvy but web costs can leave them lonely

Date  October 15, 2013

Kate Hagan

Older Victorians with home internet are more connected to their families and communities but cost is a major barrier, leaving many isolated.

A VicHealth survey of 25,000 Victorians has highlighted a digital divide that is having a detrimental effect on the health and wellbeing of those aged 65 years and older.

The survey showed that use of the internet at home declined with age, with 98 per cent of 18 to 24-year-olds having home access compared with 43 per cent of those older than 75.

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http://www.cio.com.au/article/529054/slow_nbn_rollout_contributing_digital_literacy_deficit/?fp=16&fpid=1

Slow NBN rollout contributing to digital literacy deficit

"If you don't have the NBN, you won't generate the digital literacy to maximise the use of it," says Flinders University's associate head of ICT

• Rebecca Merrett (CIO)
• 15 October, 2013 16:02

The slow roll out of the National Broadband Network is contributing an ongoing digital literacy deficit across Australia, especially in telehealth, according to speakers at the Connected Australia event in Sydney.

“There's a lot of up-skilling to do, in particular at the home end or recipient end of healthcare. There's a notion of build it and they will come: If you don't have the NBN, you won't generate the digital literacy to maximise the use of it. So it's a little like chicken and egg,” said Professor Colin Carati, associate head of ICT at Flinders University.

Roy Monaghan, national telehealth delivery officer at the National Aboriginal Community Controlled Health Organisation (NACCHO), agreed, saying the lack of reliable broadband in remote and rural Australia has contributed to a digital divide.

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http://www.theaustralian.com.au/business/in-depth/conroy-root-cause-of-nbn-woes/story-e6frgaif-1226739889457

Stephen Conroy 'root cause' of NBN woes

• Anthony Klan and Annabel Hepworth
• The Australian
• October 15, 2013 12:00AM

FORMER communications minister Stephen Conroy was the "root cause" of Labor's "abysmal" handling of the National Broadband Network, according to construction industry heavyweight David Chandler.

Mr Chandler, who was the deputy chairman of Labor's $14 million inquiry into the school buildings stimulus scheme, said Senator Conroy's attempt to blame NBN delays on contractors was an "awful attempt to rewrite history".

Addressing an Australian Computer Society event in Sydney on Friday, Senator Conroy cited a "failure of the construction industry to mobilise resources" for the NBN's woes.

But Mr Chandler said the NBN delays were a result of a lack of skills within the former communications department and an "arrogant indifference" from Senator Conroy's office regarding solving problems when they arose.

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http://www.theaustralian.com.au/technology/fibre-backers-admit-labor-nbn-failures/story-fn4htb9o-1226739835930

Fibre backers admit Labor NBN failures

• Chris Griffith
• The Australian
• October 15, 2013 12:00AM

SUPPORTERS of a fibre-to-the-home National Broadband Network agree that Labor's targets for the NBN were flawed and "overly ambitious".

Speaking at an Australian Computer Society luncheon last week, former communications minister Stephen Conroy admitted it was "undeniable" that NBN Co had failed to meet its targets and said he would not be barracking for his old job back on the opposition frontbench.

He said the fibre rollout was "significantly lagging due to the failure of the construction industry to mobilise resources" and nominated two major decisions that had impeded the NBN rollout.

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http://www.computerworld.com.au/article/528974/queensland_health_seeks_servers_unix_hardware_replacement_project/

Queensland Health seeks servers for UNIX hardware replacement project

Invitation for offer covers four buildings and has expected contract period of five years.

• Adam Bender (Computerworld)
• 14 October, 2013 10:52

The Queensland Department of Health has invited bids to install servers for a UNIX hardware replacement project.

The UNIX project aims to upgrade the ICT powering healthcare services in the state, prioritising “critical failing or at capacity UNIX hardware” across the department, according to an invitation to offer dated 11 October.

Under the invitation, the department seeks a single supplier who can provide four SPARC T4-1 and eight SPARC T5-2 servers, Oracle standard system installation services and Oracle premier support. The tender covers four of the department’s buildings in the state and has an expected contract period of five years.

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http://www.computerworld.com.au/article/529006/obamacare_portal_suffers_from_common_e-health_government_disorders/

Obamacare portal suffers from common e-health government disorders

The Affordable Care Act site has malfunctioned due to scalability issues, political squabbling and unreasonable deadlines

• Mikael Ricknäs (IDG News Service)
• 14 October, 2013 15:06

The U.S. governments healthcare portal is under emergency care, afflicted by ailments that have sickened many government IT health systems worldwide.

Two weeks after it opened, users still struggle to gain access and sign up for insurance under the terms of the Affordable Care Act, President Barack Obama's signature legislation.

Financial, technical and managerial missteps caused the crisis, and fixing the US$400 million system could take up to two months, the New York Times wrote on Sunday.

The causes for the fiasco are varied and include unfeasible deadlines, scalability issues and bickering politicians.

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https://www.mja.com.au/insight/2013/39/suzanne-robinson-healthy-change

Suzanne Robinson: Healthy change

Suzanne Robinson

Monday, 14 October, 2013

AUSTRALIA’S new federal government has a lot to do to improve population health and maintain Australia’s place as a high performing health care system.

Existing primary care services are fragmented and focused largely around general practice, hospital services are costly and overutilised, and the system fails to seriously focus on disease prevention and health promotion activity. There are also gaps and inequities in access to services and variations in health outcomes between different population groups.

The system is often criticised for being provider-centric rather than patient-focused.

There have also been some whisperings around the fate of Medicare Locals under a Coalition government.

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http://www.theaustralian.com.au/technology/bionic-man-lives-with-artificial-parts/story-e6frgakx-1226739459063

Bionic man lives with artificial parts

• AP
• October 14, 2013 10:07AM

A TEAM of engineers has assembled a robot using artificial organs, limbs and other body parts that comes tantalizingly close to a true "bionic man."

The parts hail from 17 manufacturers around the world. This is the first time they've been assembled together, says Richard Walker, managing director of Shadow Robot Co. and the lead roboticist on the project.

"(It's) an attempt to showcase just how far medical science has gotten," he says.

The term "bionic man" was the stuff of science fiction in the 1970s, when a popular TV show called "The Six Million Dollar Man" chronicled the adventures of Steve Austin, a former astronaut whose body was rebuilt using artificial parts after he nearly died.

Walker says the robot has about 60 to 70 per cent of the function of a human. It stands six-and-a-half feet tall and can step, sit and stand with the help of a Rex walking machine that's used by people who've lost the ability to walk due to a spinal injury. It also has a functioning heart that, using an electronic pump, beats and circulates artificial blood, which carries oxygen just like human blood.

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http://www.smh.com.au/digital-life/computers/microsoft-releases-windows-81-a-year-in-the-making-20131017-2vnyf.html

Microsoft releases Windows 8.1, a year in the making

Date October 17, 2013 - 12:10PM

Ryan Nakashima

Microsoft is releasing its long-awaited Windows 8.1 upgrade as a free download starting Thursday night.

It addresses some of the gripes people have had with Windows 8, the dramatically different operating system that attempts to bridge the divide between tablets and PCs.

Windows 8.1 still features the dual worlds that Windows 8 created when it came out last October.

On one hand, it features a touch-enabled tile interface resembling what's found in tablet computers.

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Enjoy!

David.

I Fear The GPs Are Not Ambitious Enough In Demanding Changes In The PCEHR Program. It Needs A Major Rethink.

The following Press Release appeared this week.

UGPA calls on Government to address clinical utility of the PCEHR as an urgent priority

Australia’s general practice (GP) leaders are calling on the Government to heed concerns raised by GPs regarding the significant clinical utility issues associated with the Personally Controlled eHealth Record (PCEHR) system and address them as an urgent priority.

At a recent United General Practice Australia (UGPA) meeting in Canberra, representatives of the GP sector unanimously agreed that the focus of the PCEHR needs to be redirected to clinical utility and standardisation to ensure seamless clinical adoption.

Significant issues have been identified and currently there is no alignment between consumer registration and meaningful use through engagement of the clinical community and assurance of improvement of patient health outcomes.

In August 2013 a number of key clinical leads resigned from National E-Health Transition Authority (NEHTA). This was amidst ongoing concerns and requests for NEHTA and the Department of Health and Ageing (DoHA) to review the PCEHR development cycle and re-establish meaningful clinical l input.

Since August, DoHA has become the PCEHR system operator and opportunities for clinical engagement have been less clear.

UGPA is calling on Government to implement strategies to ensure the PCEHR is best structured to improve the health outcomes of all Australians. The process should be profession led and include:

• GP input at every level of the PCEHR development life cycle; including planning through to implementation
• Ensuring the system is clinically safe, usable and fit for purpose
• Supported by an acceptable, and robust  legal and privacy framework
• Secure messaging interoperability is a critical dependency priority.

E-health and the PCEHR have the potential to transform Australia’s health system and provide superior, safer and more efficient healthcare to all Australian patients. UGPA members believe that this potential will only be fully realised if there is meaningful clinical engagement at a grassroots level.

The Government has announced it will review implementation of the PCEHR. UGPA supports the review and look forward to contributing to the review and expect that the clinical voice and the concerns raised will be heard.

ENDS

UGPA comprises the Royal Australian College of General Practitioners (RACGP), the Australian Medical Association (AMA), the Australian Medicare Local Alliance (AMLA), the Australian General

Practice Network (AGPN), General Practice Registrars Australia (GPRA), the Australian College of Rural and Remote Medicine (ACRRM), and the Rural Doctors Association of Australia (RDAA).

Last Updated:
Wednesday, October 16, 2013

The release is here:

http://www.gpra.org.au/ugpa-calls-on-government-to-address-clinical-utility-of-the-pcehr-as-an-urgent-priority

This release got a lot of coverage with this also being useful.

Doctors ready to pull plug on eHealth

By Australian Ageing Agenda on August 16, 2013 in Government, Industry, Technology

By Julian Bajkowski 

Australia’s long and troubled efforts to create a functioning national system of electronic health and medical records system is once more close to collapse.

The Australian Medical Association has expressed serious concerns over clinician input into the project following the shock resignation of highly respected clinical representative Dr Mukesh Haikerwal from the National eHealth Transition Authority (NeHTA) this week.

Other crucial clinical advisors, including Dr Nathan Pinksier and other clinical leads are also understood to have quit signalling a severe breakdown in relations between doctors and Department of Health and Ageing.

A loss of confidence by doctors in either DoHA or or NeHTA would, in practical terms, shut-off political life support for the circa $1 billion Personally Controlled Electronic Health Record (PCEHR) project because the scheme cannot work unless doctors voluntarily agree to use it.

The urgent warning from the AMA in the wake of the clinicians’ walk out now puts substantial pressure on DoHA’s high profile secretary, Jane Halton, to personally intervene to get the project back on track.

Questions are already swirling around Canberra as to how DoHA managed to shatter the support of the medical lobby on a project that has bi-partisan support during the delicate pre-election caretaker period.

One possible trigger for the breakdown is what appears to be a bureaucratic power grab by DoHA in a ham fisted bid to gain central control over the complex and difficult eHealth project.

It has been reported that a DoHA spokesperson issued a statement that said the department would be “taking the lead” from NeHTA in dealing with medical and health technology interests and would take “a fresh look at the design of the PCEHR system.”

However AMA president Dr Steve Hambleton said he still had confidence in Ms Halton, but called for swift action.

“Jane’s got some good credentials on the board over her time in [DoHA] but she may have to make this a personal focus of hers,” Dr Hambleton told AAA sister publication Government News.

Even with support, Dr Hambleton is not mincing words about how much support from doctors has evaporated.

“It’s really undermining confidence in the profession that one of our senior leaders can’t continue,” Dr Hambleton said of Dr Haikerwal’s resignation.

Lots more here:

http://www.australianageingagenda.com.au/2013/08/16/doctors-ready-to-pull-plug-on-ehealth/

To me this understates what is needed. We have a PCEHR and an associated program that was designed in an environment that bordered on clinician free. Most of the way through, with the design largely set, they got a collection of clinicians to get involved  (The Clinical Leads) . The clinicians were paid for commentary and for support and even with all that they eventually bailed out realising the dog they had been given.

Worse there was no real business case done on the actual final design to assess just how well the PCEHR would deliver clinical outcomes and benefits and fit with our future needs.

Tweaking around the edges will not result in outcomes that are needed - let alone genuine clinical utility where the PCEHR will actually add seamlessly to the present capabilities of current and future GP systems.

There is a really simple question to be addressed here in my view. This is: “Is the money being spent to revamp and possibly improve the PCEHR well spent on this or would it be better spent improving the quality and utility of the present GP Clinical Systems and in improving the information exchange between them via secure messaging as is happening to a large degree already but could be enhanced?”  To me the answer comes down very clearly on the latter - if we are to see real clinical benefits flow from the investment.

Someone needs to tell the bureaucrats in Canberra that the concept of a large centralised national  e-record system is a dud and that the time has come to put a very bad idea out of its misery as it simply can’t be fixed in its present form. It is only with a change of Government will it be possible to have a review with all options, including just scrapping the PCEHR, on the table.
They also need to be told that while e-Health may help the quality and safety of the health system, and save some money, it is not going to be anywhere near the panacea for rising health costs as described in the Intergenerational Report. Much more fundamental changes will be needed to keep the total costs of healthcare in Australia to under 10% or so of GDP.

If we can’t be swiftly shown a detailed costed plan for e-Health and the PCEHR that takes what now is toward something that will meet what clinicians need now and into the future - as well as improving patient engagement with their care - then we need to start again and utterly re-consider what we are doing. It really is as simple as that. To just keep ticking / stumbling along, based on little more than hope, would be very, very sad indeed.

David.