This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
Move aside Apple. If you haven’t heard of computer chipmaker and market rock star Nvidia, you haven’t been paying attention.
It is big enough to be its own stock market index. If it were an economy, Nvidia would kick France off the seventh spot in world GDP rankings. As an investment, it has spawned countless millionaires and billionaires in a few short years and is likely to deliver an even bigger crop in the months ahead.
Nvidia has now become the third member of the most exclusive of clubs – companies whose stock market value has topped $US3 trillion (that’s $4.5 trillion Australian dollars) – and pressed ahead of Apple to be just whisker shy of the top spot, currently occupied by Microsoft.
Even James Packer has become a latter-day Nvidia disciple – having doubled down on his investment in recent months.
But despite its size and meteoric rise in the market, Nvidia is hardly a household name. Most of us still don’t even know how to pronounce it. For those who want to sound informed at dinner parties, “in vidia” is its phonetic spelling – and it’s derived from the Latin word for “envy”. How appropriate.
With Nvidia’s chief executive and co-founder Jensen Huang getting mobbed by tech groupies at public events, what is the company’s secret superpower?
This company makes best-in-class computer chips – a vital ingredient for data processing. The recent boom in its earnings and value comes off the back of the excitement around the next iteration of artificial intelligence, generative AI, which requires an exponential lift in processing power.
If, as they say in business parlance, chipmakers are the picks and shovels of the AI explosion, then Nvidia is an earthmover.
Huang recently declared AI was the beginning of the next industrial revolution and that Nvidia would turn data centres into AI factories.
There are a few other players in this market (AMD, Intel) and while their share prices have also been on a tear, there is daylight between Nvidia and the rest of the pack.
Demand for Nvidia’s top-of-the-line processors is far outstripping supply as Microsoft, Meta Platforms and Google parent Alphabet race to expand their AI computing capabilities and dominate the emerging technology.
The recent explosion in Nvidia’s share price – which increased its market capitalisation by more than $US1 trillion in six weeks – is what has investors’ heads swivelling.
Over those six weeks, Nvidia’s market capitalisation has grown by more than four times the market value of BHP.
The company more than doubled sales to US$61billion in the year that ended in January 2024. That number is poised to nearly double again to over US$110 billion by January 2025. That is an 11-fold increase in sales (along with gross margin expansion) compared with the numbers in 2020.
Such breathtaking speed has naturally drawn the ire of sceptics who suggest caution about Nvidia’s ability to continue expanding its business and its share price at warp speed. Overtaking Apple on the trillionaires chart will add more fuel to that fire, but can Nvidia really deliver a repeat performance as far as its share price is concerned?
Nvidia’s stock price necessitates sustained double-digit revenue growth off its new US$110 billion base – and this is certainly possible. But there are investors who suggest that Nvidia’s outsized share price returns would imply revenue growth even greater than double digits.
Nvidia’s stock is responsible for a third of the S&P500’s gains this year, but the question is whether maintaining this breakneck pace of growth is realistic.
Nvidia doesn’t trade in a vacuum. Its share price performance will be influenced by broader market sentiment. And this calendar year, that sentiment has gone in the share market’s favour – particularly for the “growth” technology stocks (that typically populate the US Nasdaq Index).
Nvidia is part of the Nasdaq and S&P500 index and has been a large contributor to the overall positive performance of both. So for now, it looks like the tail is wagging the dog with Nvidia calling the shots.
I have to say I suspect we at peek ‘hype cycle’ here and that while the company has grown amazingly the share price and market value are really not presently reflecting reality and will be seen – a year or two from now – to have got ahead of themselves!!
It will be fascinating to see how sustainable the share price rise turns out to be!
Get back to me a year from now but I really suspect the rise is grossly overdone…
‘A case of when rather than if’: Why are hospitals
becoming more of a target for ransomware attacks?
Lauren Chadwick
·5-min read
‘A
case of when rather than if’: Why are hospitals becoming more of a target for
ransomware attacks?
A
ransomware attack against a lab provider disrupted several hospitals and
primary care doctors in London this week, delaying operations and blood tests.
The
attack had a “significant impact,” with the lab provider Synnovis stating it
was a “harsh reminder that this sort of attack can happen to anyone at any
time,” but the NHS does not know the full impact on data at this point.
“All
urgent and emergency services remain open as usual and the majority of
outpatient services continue to operate as normal,” an NHS spokesperson said on
Thursday.
“Unfortunately,
some operations and procedures which rely more heavily on pathology services
have been postponed, and blood testing is being prioritised for the most urgent
cases, meaning patients have had phlebotomy appointments cancelled”.
A
ransomware attack is one in which malware prevents people from accessing files
to force the victim to pay for access.
It
reflects what experts have called a growing trend of cyber incidents in the
health sector.
European healthcare sector ‘increasingly targeted’
“The
healthcare sector has been increasingly targeted as digitalisation has expanded
the attack surface and giving rise to increased phishing and ransomware
attacks,” Laura Heuvinck, a spokesperson at the EU Agency for Cybersecurity
(ENISA), told Euronews Health.
An
ENISA report published last year found that ransomware attacks represented 54
per cent of cyber incidents in the sector from January 2021 to March 2023, with
this type of attack being named a “prime threat in the health sector”.
Yet
just 23 per cent of health sector organisations had a dedicated ransomware
programme in 2023, the agency said.
The
report, which covered part of the COVID-19 pandemic era where the health sector
was a primary target, found that most of those behind the ransomware attacks
were driven by financial gain.
“Attacks
mostly target patients' data such as electronic health records which are then
used for example for fraud, identity theft or use sensitive data for
extorsion,” the agency spokesperson added.
EU
healthcare providers and hospitals were particularly affected by the incidents
compared to health authorities and the pharmaceutical industry.
A
French Digital Health Agency report last month noted a “persistence of
incidents of malicious origin” in 2023, with 581 reports of cyberattacks in
healthcare, at least half of which were malicious.
But
they also noted that the year was marked by a “significant reduction in major
incidents and stability in the number of incidents that had an impact on
patient care”.
Some
53 per cent of structures said that a cyber incident had no impact on their
functioning, and analysts said proactive monitoring of information systems had
helped make cyberattacks less effective.
There
was, meanwhile, an increase in ransomware attacks targeting US hospitals in
2023, according to a report this year from the software
company Emsisoft.
Ransomware
attacks affected 46 US hospital systems spanning more than 140 hospitals last
year, and at least 32 hospital systems had protected health data stolen,
Emsisoft said.Why would criminals target
the healthcare sector?
Alan
Woodward, a computer security expert at the University of Surrey in the UK,
said hospitals may be at risk as they “aim to communicate between a lot of
different providers,” making their systems more “open”.
“It's
one of those things where the more connectivity there is, the attack surface
grows, so that there's going to be more opportunity for criminals to get in,”
said Woodward.
“Just
imagine the number of emails going backwards and forwards to a hospital and all
the people in the hospital every day…You only need one to get through with a
bit of malware in it; it spreads”.
An
example of this was the 2017 global WannaCry ransomware attack which impacted
80 hospital trusts in England.
One
analysis from Imperial College London put the cost of the massive cyberattack
at nearly £6 million (€7 million) for the NHS due to appointment cancellations
and delays to life-saving care for patients.
“The
bottom line is criminals don't care. They really don't care who they hit, and I
think some of the thinking probably in their mind is if we attack things that
are critical, people might be more likely to pay up because they’ve just got to
have it,” he added.
Hospitals
are also already stretched resource-wise.
“IT
isn't their core business, but they are very dependent on it,” he added, so
“finding time and resources to make sure you've got the latest software, the
latest versions of things that are not vulnerable, it's difficult”.
What can hospitals do to prevent attacks?
“Most
hospitals now are prepared for the fact that it’s a case of when rather than if
they’re going to be attacked,” said Woodward.
People
need to know who to call and what actions to take in the event of a cyberattack
as part of their incident response plan.
But
overall, ransomware typically gets into a system “by fooling somebody,” says
Woodward.
“One
should never ever victim blame when it comes to cybersecurity. But what
organisations should do is repeatedly run awareness education of how this could
happen, you know what to look out for,” he said.
All
logins should also have multi-factor authentication, he added, and education
should include password hygiene.
Experts
say that the key is also to not pay the ransom, with some pushing for an
international ban on these payments.
A
2022 Sophos survey
across 31 countries found that the healthcare industry was the most likely to
pay ransom but also paid the least amount.
“The
only solution is to financially disincentivise attacks by completely
prohibiting the payment of demands. At this point, a ban is the only approach
that is likely to work,” said Emsisoft threat analyst Brett Callow in a blog
post earlier this year.
“The
advice always is please don't pay up because A. you just embolden the criminals
and B. you guarantee nothing. You don't guarantee getting your data back,”
Woodward added.
Updated 6:46PM May 30, 2024, First published at 11:27AM May 30, 2024
Power usage in India’s capital surged to a record high on Wednesday as residents of the sprawling megacity struggled to keep cool during a crushing heatwave, with temperatures sizzling above 45C.
India’s government-run weather bureau said a station reading showing a potentially record-breaking temperature in the capital may have been due to an “error” in the measuring equipment.
As people sought relief from scorching temperatures, the electricity grid groaned under a record peak power demand of 8302 megawatts, according to official data.
The India Meteorological Department, which reported “severe heat-wave conditions”, this week issued a red alert health notice for Delhi’s estimated 30 million people, and authorities on Wednesday warned of dire water shortages and ordered teams to clamp down on wastage.
The weather bureau also said it had sent a team to investigate a staggeringly high reading at an automatic weather station.
“Mungeshpur reported 52.9C as an outlier compared to other stations,” the bureau said, referring to a station in a Delhi suburb.
“It could be due to error in the sensor or the local factor.”
The bureau’s multiple other sites recorded a maximum temperature over Delhi on Wednesday that “varied from 45.2C to 49.1C”.
Bureau meteorologist Soma Sen Roy said officers were “checking out” whether the station had recorded it correctly.
On Tuesday, two Delhi stations – at Mungeshpur and at Narela – posted readings of 49.9C.
In 2022, Delhi temperatures were recorded to have hit 49.2C.
In 2016, 51C was recorded in Phalodi on the edge of Rajasthan’s Thar Desert, the highest confirmed temperature in India.
I find this utterly incredible. I have no idea how anyone could survive temperatures like this! No matter what the actual reader was, it was clearly lethally hot!
If this is even half true I am very glad I am in the second half of my life and not the first. It looks like things are going to get pretty terrible as we move forward!
New prescribing powers for NSW pharmacists allowing them to treat women who present with uncomplicated urinary tract infections (UTIs) have come into effect today. Bypassing the need for a GP appointment, women aged 18 to 65 can pay for a private consultation with a pharmacist trained specifically to deal with UTIs, to be prescribed antibiotics.
In a 12-month clinical trial led by the University of Newcastle, 1000 participating pharmacies provided 17,000 consultations.
The trial results have yet to be released, raising concerns among GPs that the prescribing powers have been implemented prematurely, risking misdiagnosis and ineffective use of antibiotics.
Hailing the trial as successful, Pharmacy Guild New South Wales branch president David Heffernan said he was aware of only one adverse event. A patient’s UTI was so advanced she needed intravenous treatment after oral antibiotics proved ineffective.
“I’m very proud of the trial – it was robust, and we worked with GPs in a professional and collaborative way,” he said.
“It’s a very positive thing – there’s one disease state out of thousands that we’ve had red tape removed to treat. It’s about opening up options for patients.”
During the trail, Heffernan said, on average one woman presented to a participating pharmacy each week, meaning many still chose their GP for treatment.
However, Royal Australian College of General Practitioners NSW and ACT chair Dr Rebekah Hoffman said she was concerned about the powers being made permanent before the release of the trial results.
“The trial [is being] used as a rationalisation after the fact rather than a genuine evaluation … We still have genuine concerns about the lack of supporting evidence for patient safety given the potential for adverse events, as well as cost-effectiveness, and appropriate communication back to the GP,” she said.
Hoffman said she was also concerned about antibiotics being prescribed inappropriately, or pharmacists misdiagnosing UTIs instead of more serious health problems.
In a similar trial in Queensland, two patients were misdiagnosed with UTIs. One had chlamydia and another had a 15-centimetre pelvic mass.
“Pharmacists aren’t [adequately] trained to diagnose a UTI and this doesn’t change that, it just puts the cure before a diagnosis,” Hoffman said.
A spokesperson for NSW Health said the trial was under evaluation.
“[The evaluation includes] a review of service satisfaction levels, how often antibiotics were supplied, how often women were referred to other services and what, if any, medical and pharmacy services the trial participants required after the consultation,” the spokesperson said.
NSW Health Minister Ryan Park said similar trials and models has been implemented in Queensland and Victoria.
“Empowering pharmacists to expand their scope of practice is critical to relieving pressure on our GPs, and improving timely access to care,” he said.
The number of GPs in Australia has been declining since 2018. There were about 9550 GPs in the 2022-23 financial year, down from 10,062 the year before.
Blooms The Chemist health programs pharmacist Alex Elia said pharmacists’ response to the policy was overwhelmingly positive, as it was from patients who said they had struggled to book a GP appointment.
“As pharmacists, we are healthcare providers and provide medication, counselling, information … but sometimes in those conversations you fall short of being able to help customers,” she said.
The government had paid pharmacists $20 a consultation during the trial, but pharmacies can now set their fee, to be covered by the patient.
A separate trial allowing pharmacists to treat impetigo (school sores) and shingles is under way.
If ever there was a case of wait and see how it works this has to be it. I only hope our systems are good enough to detect if there is a real excess of patient problems as the approach is rolled out.
I think that this change should not result in major harm but I hope it is not seen as a way to go further in expanding the pharmacist scope of practice beyond what is sensible.
There’s a war raging about the future of artificial intelligence – the technology that is already disrupting our economy, our jobs, and our social media feeds – and Melbourne-born Helen Toner is at its centre.
Toner, who grew up in Southeast-Melbourne, was ousted as a board member of ChatGPT maker OpenAI last year after an unsuccessful attempt to force out its chief executive Sam Altman.
At the crux of the bloodletting is a war over AI safety and ethics – as well as a clash of personalities – that will shape the future of the generative AI sector as well as society more broadly.
Helen Toner in May cautioned against over-relying on AI chatbots, saying there was “still a lot we don’t know” about them.
AI’s promise is magical, offering massive benefits in productivity, efficiency and creativity. But its potential pitfalls are just as severe. Some Australians are already losing their jobs to AI, with workers in data input and sales among the most affected. Others are using the technology to be more efficient. And the nation’s parliamentarians and regulators are being left in the dust.
Toner believes that AI’s roll-out should not be left to private technology companies like OpenAI, the company that released the wildly popular chatbot ChatGPT less than two years ago.
“It would be a mistake to rely on corporate self-governance structures to handle all the challenges of AI,” Toner said in an interview with this masthead.
“The challenge with AI and making policy for it is that it’s a general-purpose technology. It can be used in literally every sector, for literally everything ... But AI systems are already causing harm. Robodebt is an example of an extremely basic system that caused a lot of harm to a lot of people.
“Personally, I am pretty worried about some of the worst cases from AI. But I also worry they’re so sexy and attention-grabbing that they end up sucking all the oxygen and not leaving room for all the other issues.”
And there are plenty of issues, for a technology that has raced into our workplaces, newspapers, songs and movies seemingly in the blink of an eye.
Toner, who is in her early 30s and is an AI policy researcher, graduated from Melbourne Girls Grammar with a perfect VCE score. She joined OpenAI’s board in late 2021 after stints in China, where she studied its AI industry, and Washington DC, where she helped form Georgetown’s Centre for Security and Emerging Technology, a think tank focused on AI and national security, where she still works today.
Her subsequent departure from OpenAI’s board was widely characterised at the time as a showdown between ethics and profits. Between slowing down or speeding up.
Instead, Toner says there was board mistrust and that Altman had created a toxic atmosphere; claims that Altman and board chair Bret Taylor have denied.
For Toner, it is critical that governments – including Australia’s – play an active role and tech companies not be left to their own devices or trusted to self-regulate what’s quickly becoming a massively important sector.
It’s unpredictable technology that clearly isn’t ready for prime time, but it doesn’t matter.
We’re quickly entering an era in which technology companies - predominantly US-based heavyweights like Google, Meta, Nvidia and OpenAI - are racing to build generative AI into every product and service we use, even if the results are wrong or nonsensical.
Companies like Google and Meta are hoping generative AI will supercharge their platforms, making them far more engaging – and useful – than they were before. And there’s a lot of money at stake: it is estimated generative AI will be a $2 trillion market by 2032.
Most of Google’s billions of global users may not have used a chatbot before, but will soon be exposed to AI-generated text in its answers. Similarly, many of the images you scroll through on Facebook, or see in the pages of The Daily Telegraph, are now generated by AI.
This week, an image spelling out “All Eyes on Rafah” was shared by more than 40 million Instagram users, many of whom would have had no idea it was likely generated by artificial intelligence.
AI’s rapid ascent into the zeitgeist is reminiscent of bitcoin’s rise five years ago. As with bitcoin, everyone is talking about it, but no one really understands how it works. Unlike bitcoin, however, generative AI’s potential, as well as its impact, is very real.
According to Toner, no one truly understands AI, not even experts. But she says that doesn’t mean we can’t govern it.
“Researchers sometimes describe deep neural networks, the main kind of AI being built today, as a black box,” she said in a recent TED talk. “But what they mean by that is not that it’s inherently mysterious, and we have no way of looking inside the box. The problem is that when we do look inside, what we find are millions, billions or even trillions of numbers that get added and multiplied together in a particular way.
“What makes it hard for experts to know what’s going on is basically just, there are too many numbers, and we don’t yet have good ways of teasing apart what they’re all doing.” How AI works
The deep neural networks are complex systems that power large language model chatbots like ChatGPT, Gemini, Llama and Lamda.
They’re effectively computer programs that have been trained on huge amounts of texts from the internet, as well as millions of books, movies and other sources, learning their patterns and meanings.
As ChatGPT itself puts it, first you type a question or prompt into the chat interface. ChatGPT then tokenises this input, breaking it down into smaller parts that it can process. The model analyses the tokens and predicts the most likely next tokens to form a coherent response.
It then considers the context of the conversation, previous interactions, and the vast amount of information it learned during training to generate a reply. The generated tokens are converted back into readable text, and this text is then presented to you as the chatbot’s response.
Apart from the war over ethics and safety, there is another stoush brewing over the material used to train the likes of ChatGPT. Publishers like News Corp have signed deals to allow OpenAI to learn from its content, while The New York Times is suing OpenAI over alleged copyright infringement.
For now, the chatbots are working with limited datasets and in some cases faulty information, despite rapidly popping up in every classroom and workplace.
A recent RMIT study found 55 per cent of Australia’s workforce are using generative AI tools like ChatGPT at work in some capacity. Primary school teachers are creating chatbot versions of themselves to work with students, and ad agency workers are using ChatGPT to create pitches in minutes, work that would have taken hours.
Parliamentarians are wondering how to react. Some 20 years after Mark Zuckerberg invented Facebook, the Australian parliament is grappling with the prospect of enforcing age verification for social media. Decades into the advent of social media we are still coming to terms with its effects and how we might want to rein it in.
People close to the technology, including Toner, are warning governments to not make the same mistake with AI. They say there’s too much at stake.
Some argue the nation’s parliament is also already years behind grappling with artificial intelligence. Science and industry minister Ed Husic says he is keenly aware of the issue: he’s flagged new laws for AI use in “high-risk” settings and has appointed a temporary AI expert group to advise the government.
Researchers and industry members say those efforts have lacked urgency, however. A senate committee on the adoption of the technology in May heard that Australia has no laws to prevent a deepfake Anthony Albanese or Peter Dutton spouting misinformation ahead of the next federal election.
“I’m deeply concerned at the lack of urgency with which the government is addressing some of the risks associated with AI, particularly as it relates to Australian democracy,” independent senator David Pocock told this masthead.
“Artificial intelligence offers both opportunities and huge risks.”
Pocock wants specific laws to ban election-related deepfakes while others, including Australian Electoral Commission chief Tom Rogers, think codes of conduct for tech companies and mandatory watermarking would be more effective.
Either way, there’s a broad consensus that Australia is far behind other jurisdictions when it comes to grappling with both the risks and opportunities presented by AI. Simon Bush, chief executive of peak technology lobby group AIIA, fronted the Senate hearings and pointed out that Australia ranks second-largest globally in adopting AI across the economy according to several surveys.
“The rest of the world is moving at pace,” he said. “This is a technology that is moving at pace. We are not.”
The most recent federal budget allocated $39 million for AI advancement over five years, which Bush says is a negligible amount compared to the likes of Canada and Singapore, whose governments have committed $2.7 billion and $5 billion respectively.
For Bush, the narrative around fear and Terminator-esque imagery has been too pronounced, at the expense of AI adoption. He wants Australia to help build the technology its citizens will inevitably end up using.
“Australians are nervous and fearful of AI adoption, and this is not being helped by the Australian government running a long, public process proposing AI regulations to stop harms and, by default, running a fear and risk narrative,” he told the senate committee hearing.
Toner says, however, that Australia, as with other countries, should be thinking about what kind of guardrails to put around these systems that are already causing harm and spreading misinformation. “These systems could change pretty significantly over the next five, 10 or 20 years, and how do you get ready for that? That’s definitely something we need to grapple with.”
While Australia dithers, the tech is moving forward whether we like it or not.
Toner wants us to not be intimidated by AI or its developers, and says our collective involvement is crucial in shaping how AI technologies are used. “Like the factory workers in the 20th century who fought for factory safety, or the disability advocates who made sure the World Wide Web was accessible, you don’t have to be a scientist or engineer to have a voice.”
The very first step, for Toner, is to start asking better questions. “I come back to this question of, ‘is it just hit the accelerator or the brakes’. Or you know, are we thinking about who is steering? How well does the steering work, and how well can we see out of the out of the windscreen? Do we know where we are, do we have a good map?
“You know, thinking about all these kinds of things, as opposed to just floor it and hope for the best.”
I have to say that what I see here is what I would expect as powerful and complex technologies are rolled out and we have contention between those who want to rush forward and those who are keen on a slower, safer and steady path. We have to hope somehow the balance will be found where the pace of progress is measured but rapid enough!
