Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

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

Tuesday, January 23, 2024

Job Opportunity - Board Members – Australian Digital Health Agency

This appeared recently:

Board Members – Australian Digital Health Agency

  • National

The Australian Government is inviting expressions of interest to fill future board member positions on the Australian Digital Health Agency (Agency) Board. We are seeking a broad range of candidates with diverse professional and lived experiences from across Australia to enrich the Agency’s knowledge and capacity to deliver its objectives.

The Agency commenced operations as a Commonwealth Corporate entity in July 2016 to lead the digital transformation of healthcare and create a more connected health system for all Australians. The Board is the key decision-making body and is accountable to the Commonwealth Minister for Health and Aged Care. The work of the Agency is supported by all Australian Governments.

The Board maintains a watching brief over internal and external environments and is responsible for overseeing the Agency’s performance, governance, and resource allocation as custodians of Commonwealth and state and territory funding.  It is critical that the Agency is guided by a strong, diverse, high-performing Board that can set the strategic direction, objectives, and policies to ensure proper and efficient performance of organisational functions.

The Agency is charged with implementing an ambitious national agenda to connect Australia’s digital health system to support our world class health system. Candidates who have strategic senior leadership and board experience, possess subject matter expertise in the relevant fields outlined in Subsection 19(3) of the Agency Establishing Rule and have a deep understanding of digital transformation in a complex sector are encouraged to apply.

Key skill areas include but are not limited to digital innovation and transformation, informatics, technology standards and information management in large scale settings, delivery of health services, consumer health advocacy, risk and governance, financial management and legal services.

The Australian Government is committed to open and transparent recruitment processes for public sector board appointments. To ensure the Boards composition meets diversity requirements, gender balance and geographic diversity will be considered for future appointments. Applications from people with a diversity of skills, perspectives, abilities, cultures, life experience and backgrounds are encouraged to apply.

 For further information on the roles, please contact Amanda O’Rourke Executive Search at admin@amandaorourke.com.au quoting Ref. No. 1124 in the subject line for an Information Pack.

 Applications close at 11:59pm AEDT on Sunday, 18 February 2024.

Here is the link:

https://www.themandarin.com.au/careers/jobs/237695/board-members-australian-digital-health-agency/ 

It's fun to think how many of the present Board are qualified against this requirement!

Make a difference!

David.

There Is Some Serious Effort Now Being Directed To AI In The Health Sector.

This appeared last week:
 Artificial intelligence 'facing barriers' in our health system

Authored by Sam Hunt

Issue 1 / 15 January 2024

Barriers abound in implementing artificial intelligence across Australia’s health care systems, with Queensland researchers calling for more government funding to take advantage of this emerging technology.

Australia’s health care system has been described as “impervious” to the alure of artificial intelligence (AI), with a lack of clinician trust and data privacy the main barriers to adopting the technology in clinical settings.

Other main concerns preventing the greater rollout of AI-related technology in Australian clinical settings include health inequity concerns due to possible biases in underlying data and not enough government regulation, according to a Perspective published in the Medical Journal of Australia.

“Across a network of clinicians in a national AI working group, only one hospital was known to have an AI trial underway,” Dr Anton Van Der Vegt and his colleagues wrote.

“As far as we are aware, there is no clinical AI implemented across Queensland Health despite having Australia’s largest centralised EMR system, which could make large-scale AI feasible.

“In stark contrast to the number of implemented AI systems, AI research abounds, with nearly 10 000 journal articles published each year across the world.”

Dr Van Der Vegt, a mechanical engineer by background, is an Advanced Queensland Industry Research Fellow with the Centre for Health Services Research at the University of Queensland Faculty of Medicine.

The WHO urges caution

The World Health Organization (WHO) last year called for caution in the use of AI in medicine.

“[The] growing experimental use [of AI] for health-related purposes is generating significant excitement around the potential to support people’s health needs,” the WHO said.

“It is imperative that the risks be examined carefully when using [large language model tools (LLMs)] to improve access to health information, as a decision-support tool, or even to enhance diagnostic capacity in under-resourced settings to protect people’s health and reduce inequity.”

Data used to train AI may be biased, “generating misleading or inaccurate information that could pose risks to health, equity and inclusiveness,” it said.

“LLMs may be trained on data for which consent may not have been previously provided for such use, and LLMs may not protect sensitive data (including health data) that a user provides to an application to generate a response.”

Government response

There is currently no specific AI legislation in place in Australia.

The Australian Government last year consulted on the potential risks of AI and how they can be mitigated, releasing this discussion paper.

The Department of Industry, Science and Resources, which ran the consultation, is using the 150 responses from industry and the community to inform the “appropriate regulatory and policy responses” (here).

“Patch work” of regulations


The Australian Human Rights Commission has described Australia’s AI regulations as a “patchwork”, saying that if the technology is not developed and deployed safely, it can threaten human rights.

“AI operates in a regulatory environment that is patchwork at best,” the Commission said.

“This has allowed AI to proliferate in a landscape that has not protected people from human rights harms.

“The Commission is especially concerned about emerging harms such as privacy, algorithmic discrimination, automation bias, and misinformation and disinformation.”

Algorithms “developed separately”

AI algorithms are typically developed and evaluated on different datasets to the ones at hospital sites, Dr Van Der Vegt and colleagues wrote.

This means that changes to clinical workflows, presenting patient conditions, data quality levels and patient demographic distributions can significantly affect algorithm performance.

“For example, AI algorithms developed on large city populations may perform poorly for hospitals in rural and remote areas, further perpetuating poor health outcomes for underserved and marginalised patient cohorts,” they wrote.

“Without this evaluation checkpoint, the AI remains untested. We argue this is one of the major reasons for the slow or absent uptake of AI within Australian hospitals today.”

AI may assist with diagnosis and treatment

Australian Medical Association President, Professor Steve Robson, said artificial intelligence has the potential to transform medicine.

“This will be just as big a culture shock for doctors as it will be for their patients,” Professor Robson said.

“The most advanced AI that most doctors use at the moment is often Siri, or their Netflix preference guides.”

The first doctors to embrace the potential of AI have been radiologists, Professor Robson said.

“For several years now, AI software applications have been introduced to assist with image recognition and, increasingly, with decision-support,” he said.

“Interpreting medical scans can be challenging for even the most experienced specialists, and the stakes are high. Missing an important diagnosis, such as an early cancer or a subtle bone fracture, can have serious consequences for patients.

“The use of AI to assist radiologists as they work to read multiple images has been shown to enhance accuracy and improve outcomes for patients.

“AI is so powerful in its capabilities that it may detect subtle changes in human tissues that elude the human eye.”

The technology also has the potential to change pathology services, such as the diagnosis of cancer, he said.

“At a time when the pathology workforce is under great pressure, the introduction of AI technologies that act as a co-pilot and assist the pathologist in dealing with high workloads will be attractive to health services,” Professor Robson said.

Call for AI funding

Public funding outside of health care organisations’ budgets is required to develop this infrastructure, Dr Van Der Vegt and his colleagues argue.

More here:

https://insightplus.mja.com.au/2024/1/artificial-intelligence-facing-barriers-in-our-health-system/

This is a useful summary of the issues. It is interesting to see that the AMA is also very much on board:
Artificial intelligence has the potential to transform medicine

Published 18 January 2024

The MJA this week looks at the future role for AI in Australia’s healthcare.

The AMA’s journal — the Medical Journal of Australia (MJA) — this week looks at the barriers and possibilities for artificial intelligence (AI) in Australia’s healthcare system.

AMA President Professor Steve Robson told the MJA artificial intelligence has the potential to transform medicine.

“For several years now, AI software applications have been introduced to assist with image recognition and, increasingly, with decision-support,” Professor Robson said.

“Interpreting medical scans can be challenging for even the most experienced specialists, and the stakes are high. Missing an important diagnosis, such as an early cancer or a subtle bone fracture, can have serious consequences for patients.

“The use of AI to assist radiologists as they work to read multiple images has been shown to enhance accuracy and improve outcomes for patients. AI is so powerful in its capabilities that it may detect subtle changes in human tissues that elude the human eye.”

“The technology also has the potential to change pathology services, such as the diagnosis of cancer. At a time when the pathology workforce is under great pressure, the introduction of AI technologies that act as a co-pilot and assist the pathologist in dealing with high workloads will be attractive to health services,” Professor Robson said.

In other recent media on AI Professor Robson warned that “we are about to see the start of a quiet revolution that will, in the long run, be almost as transformative as the introduction of technologies such as antibiotics, blood banking and safe anaesthesia”.

“If we are to harness its power for the greatest good, then we need to ensure it is a safe and trustworthy co-pilot in human health care, and never takes over the controls.”

Last August, the AMA published its first position statement on AI, outlining the need for regulation to be put in place before the widespread use of the technology in healthcare.

Read the position statement

Here is the link:

https://www.ama.com.au/ama-rounds/19-january-2024/articles/artificial-intelligence-has-potential-transform-medicine

All I can really suggest is watch this space or better still get a job in the area and make a contribution.

David.

 

Sunday, January 21, 2024

Now We Know Why We Don’t Know What Is Going On In The Health Sector.

This popped up last week
More than 900 parliamentary questions on health and aged care unanswered

By Olivia Ireland

January 14, 2024 — 5.06pm

More than 900 questions from the Senate about the health and aged care portfolio have been left unanswered since October, as crossbench and opposition members accuse the government of having “contempt for transparency”.

As of January 12, data collated from the Senate community affairs committee found only 62 questions on notice were answered for the health and aged care portfolio since the supplementary budget estimates on October 26, with 931 unanswered.

In comparison, the social services portfolio has published 339 answers to questions on notice with 19 outstanding. Similarly, the Services Australia portfolio has answered all 362 questions with none outstanding.

While more than 900 questions on notice would be a lot for the department to get through, says former secretary of the Health Department Stephen Duckett, answering only 62 after months highlights possible management problems.

“Questions on notice are a really important part of the democratic process. Senate estimates should be about finding out what the facts are, they should be about looking at issues that might not yet be in the public domain,” he said.

“It is really important I think that there is this accountability, that when members of parliament and senators are seeking information, that we deal with that seriously and answer the questions as quickly as possible.”

‘It is disappointing that this government’s commitment to transparency is clearly only measured by what they think they can get away with.’

Previously, an answered question on notice in 2019 revealed the percentage of bulk billing attendances by electorate, which Duckett said was the first time the data had been conveyed in that way and gave important context on the distribution of health services.

In the lead up to parliament’s first sitting week in February, Liberal senator Jane Hume has submitted a notice of motion that asks the Senate to provide a statement on the number of total unanswered questions on notice and an explanation for why they have not been answered.

Hume, who asked 667 questions of the health and aged care portfolio during the last round of Senate estimates hearings, was unapologetic about the number, saying the Coalition would never apologise for holding the government to account.

“It is disappointing that this government’s commitment to transparency is clearly only measured by what they think they can get away with,” Hume said.

“Questions put to departments that are not answered will be pursued, regardless of whether the government thinks it can hide this information.”

Examples of outstanding questions on notice range from updates to election commitments such as the $39 million pledge to expand the newborn bloodspot screening program to detect up to 50 conditions and whether an interim Australian Centre for Disease Control will begin on January 1.

Health Minister Mark Butler declined to comment, while the Department of Health and Aged care stated it was working to finalise outstanding responses as soon as possible.

Opposition health spokesperson Senator Anne Ruston, who has asked 96 questions to the committee, condemned the delay in answering the questions, arguing the responses were in the public interest.

“These questions … pertain to important issues including the aged care taskforce, medicine listings, general practice grants and the prime minister’s broken election commitment of newborn blood spot screening,” she said.

“This government’s contempt for transparency is a concerning trend and reflects their attitude towards openness and honesty.”

ACT senator David Pocock was also critical on the delay, saying he recognised the work of the public service required time, but it was important it get adequate resources.

“Since entering parliament, I’ve found the estimates process a really important tool to help to hold the government accountable on behalf of our community,” he said.

“Transparency is key to a healthy democracy and providing timely responses to questions on notice is part of that. I am still waiting for answers to questions on notice from May last year.”

Pictures etc. here:

https://www.smh.com.au/politics/federal/more-than-900-parliamentary-questions-on-health-and-aged-care-unanswered-20240112-p5ewx1.html

No wonder the ADHA just does what ever it likes and we are still spending a fortune on that hopeless myHR! No one is even seeing the questions!

David.

AusHealthIT Poll Number 730 – Results – 21 January, 2024.

 Here are the results of the poll.

Are You Concerned About A New Outbreak Of COVID-19 In The Next Few Weeks?

Yes                                                                         14 (44%)

No                                                                          18 (56%)

I Have No Idea                                                        0 (0%)

Total No. Of Votes: 32

It looks like many are a bit concerned but rather more feel we are over the hump!

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

A great number of votes. But also a very clear outcome! 

0 of 32 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.

Thursday, January 18, 2024

The ADHA Releases Its Annual Report For 2022-23 And Pushes on With The myHR.

The new Annual Report arrived recently:

Here is the link:

https://www.transparency.gov.au/publications/health/australian-digital-health-agency/australian-digital-health-agency-annual-report-2022-2023

Whatever is contained in the report the front page is totally amazing claiming that “Our work means so much to so many” Certainly they are pretty full of their own importance!

Part 1 of the Report has some useful facts!

Information about this Part

Part 1 provides a view of the Agency at a glance – an overview of the Agency’s purpose, role, strategy and functions and an outline of the path ahead.

The Agency at a glance

Purpose

Better health for all Australians enabled by connected, safe, secure and easy-to-use digital health services.

Foundations

The Agency was established on 30 January 2016 and began operations on 1 July 2016, with a vision of improving health outcomes for Australians through the delivery of digital innovation, health systems and services.

Enabling legislation

The Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (Agency Rule) 1 created the Agency and governs its operations. The Rule was made by the Minister for Finance under Section 87 of the PGPA 2 that allows for the establishment of corporate Commonwealth entities. The Agency was the first in the Commonwealth to be established by Section 87 of the PGPA Act.

Products and services

The Agency has a lead role in stewarding, operating and developing the national digital health infrastructure that underpins the delivery of digital health in Australia. This vital infrastructure is an enabler for digital health foundations including:

  • My Health Record system
  • Healthcare Identifiers (HI) Service
  • National Authentication Service for Health (NASH)
  • Secure messaging delivery
  • National Clinical Terminology Service (NCTS) including SNOMED CT-AU and Australian Medicines Terminology (AMT)
  • Clinical content specifications based on Clinical Document Architecture (CDA) and Fast Healthcare Interoperability Resources (FHIR®)
  • Provider Connect Australia (PCA)
  • Vaccine Clinic Connect Finder.

Governing, operating and maintaining this infrastructure is a core activity for the Agency and ensures that Australian healthcare consumers and healthcare providers can be confident they are using clinically safe systems to support their health and care needs. Part 1 provides further detail on this activity. 

Delivery priorities for 2022–23

Over the course of 2022–23, the Agency led the way in advancing and expediting digital innovation as part of the broader national health agenda. The Agency’s Corporate Plan 2022–23 championed 3 strategic areas of focus:

  • Infrastructure solutions and initiatives
  • Interoperability supporting connected health and care
  • National digital health initiatives.

Performance against each priority area is captured in Part 2 of this report. 

Governance structure

The Agency is a corporate Commonwealth entity, established by a rule under the PGPA Act. Information about our governance, management and accountability framework is covered in Part 3 of the report.

Board as the accountable authority

A Board, chaired by Dr Elizabeth Deveny, is the Agency’s accountable authority. As the accountable authority, the Board sets the objectives, strategies and policies 3 for the Agency and is responsible for the proper and efficient performance of the Agency’s functions. 4

Advisory committees

The Board is supported in the performance of its functions by advisory committees. Four standing advisory committees are established under the Agency Rule:

  • Clinical and Technical Advisory Committee
  • Jurisdictional Advisory Committee
  • Consumer Advisory Committee
  • Privacy and Security Advisory Committee.

The Agency also has an Audit and Risk Committee, as required under the Public Governance, Performance and Accountability Rule 2014.

Intergovernmental

The Agency operates under an Intergovernmental Agreement between the Commonwealth and state and territory governments. Under this agreement, the Agency works closely with the states and territories to transform how health information is used to deliver better healthcare and implement a world-class digital health capability in Australia.  

Portfolio and ministerial oversight

The Agency sits within the Health and Aged Care portfolio and is accountable to the Ministers of the Health and Aged Care portfolio:

  • The Hon Mark Butler MP, Minister for Health and Aged Care
  • The Hon Anika Wells MP, Minister for Aged Care and Minister for Sport
  • The Hon Ged Kearney MP, Assistant Minister for Health and Aged Care
  • The Hon Emma McBride MP, Assistant Minister for Mental Health and Suicide Prevention and Assistant Minister for Rural and Regional Health
  • Senator the Hon Malarndirri McCarthy, Assistant Minister for Indigenous Health.

Our people and their location

At 30 June 2023, the Agency had 412 permanent staff with offices in Brisbane, Sydney and Canberra.

Funding

The Agency is jointly funded by the Commonwealth ($229.5 million) and the states and territories ($32.25 million), reflecting the commitment at all levels of government to the delivery of digital health reform.

Financial outcome

  • Operating loss: $32.8 million
  • Operating revenue: $255.9 million
  • Operating expenses: $288.7 million

The Agency’s financial performance and the Australian National Audit Office’s (ANAO) audited financial statements are presented in Part 4 of this report.

---- End Section

The Corporate Plan can be accessed from this link:

https://previewapi.transparency.gov.au/delivery/assets/80a82ed1-3e33-027b-b7e0-6493f97f18f8/f802dc8b-2e84-43a4-822b-ffbf7a38db4a/adha_cp_2022-23.pdf

It is 54 pages and says that the Agency is funded until June 30, 2023.

There are pages and pages of measures as to how the ADHA is going but no results for any of these measures.

I wonder how anyone actually knows who is doing what for whom.

Surely with $250M + and 400+ staff there should be progress reports and outcome measures!!!

Can someone send me some?

David.