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
-----
The big news of the week has been that Deloitte has been selected to waste more public money on developing a gateway to the #myHealthRecord!
Otherwise various apps for vaccination records and #myHealthRecord also featured.
Also a few commercial and research projects are on the move!
-----
https://www.itnews.com.au/news/govt-to-build-my-health-record-app-566940
Govt to build My Health Record app
By Justin Hendry on Jul 6, 2021 12:49PM
Moves to improve accessibility.
The federal government will develop its very own mobile application for Australians to access the My Health Record, as the overhaul of the country’s national digital health infrastructure gains speed.
The Australian Digital Health Agency revealed plans for the native iOS and Android mobile app – or set of native apps – this week to improve accessibility to information in the ehealth record.
It closely follows consulting giant Deloitte’s contract to deliver the health information gateway that will replace the Oracle API gateway that underpins the My Health Record.
The deal, which the agency has now revealed will cost just shy of $18 million over three years, represents the first phase of a so-called national infrastructure modernisation program that will upgrade the ehealth record.
-----
Australian Government plans ‘vaccination passport’ app
The smartphone app will store COVID-19 test results and vaccination records as Australia gears up to reopen its borders.
By David Flynn, July 7 2021
The Australian government is planning a 'digital health' smartphone app to help restart international travel by storing digital vaccination certificates along with the results of COVID-19 tests.
According to a new Request for Tender issued by the Australian Digital Health Agency, the app will be available for both Apple iPhone and Google Android devices by December 2021.
It would connect to the government's My Health Record system to provide real-time access to not only COVID-19 vaccination and test data but other immunisations, alerts on allergies and organ donation status.
In addition, a critical requirement of the "digital health mobile channel" project is that it can tap into external systems, which could open the path for interaction with national health databases of other countries.
-----
Deloitte to deliver commonwealth’s ‘pivotal’ digital health technology
Tuesday July 6, 2021
The Australian Digital Health Agency has awarded Deloitte the contract to deliver a secure and scalable platform that will simplify the access and exchange of health information, and support the digitisation of government services.
ADHA CEO Amanda Cattermole on Monday said the modernisation of the national digital infrastructure was the agency’s most important strategic focus for 2021, with Deloitte to deliver the first phase — the Health Information Gateway.
“A connected healthcare system is at the heart of the National Digital Health Strategy and while our national digital health infrastructure has already delivered significant benefits for Australians, it is now time to modernise and unlock the potential that new technologies offer,” she said.
“The new Health Information Gateway will reduce costs and technical and operational complexity often faced by healthcare providers by setting in place a single, consolidated gateway with reusable interfaces available to developers. And it requires fewer connections to be developed between healthcare providers and My Health Record and other digital health products and services. This goes a long way to making the sharing of patient information between healthcare providers easier.”
-----
https://www.mivision.com.au/2021/07/key-step-for-national-digital-health-infrastructure/
Key Step for National Digital Health Infrastructure
The Australian Digital Health Agency has contracted Deloitte Consulting Pty Ltd to deliver the first phase of the modernisation of the national digital health infrastructure.
The contract is for the Health Information Gateway, a pivotal piece of national digital health enabling technology that provides a secure and scalable platform for exchanging and accessing health information, including priority areas such as vaccinations and aged care data.
According to the announcement, the Health Information Gateway is key to the Agency’s future directions for national digital health infrastructure. It unlocks the Agency’s ability to deploy and manage additional health information repositories and health data exchanges in support of national priorities for healthcare delivery and digitising government services, now and into the future.
The national digital infrastructure is the Agency’s most important strategic focus for 2021
The new Gateway will provide improved support for the integration of health information from multiple sources into clinical information systems. All clinicians including general and specialist practitioners, hospital physicians, nurses and allied health professionals will benefit from access to more comprehensive patient information when and where it is needed for the most effective care of patients.
-----
https://www.itnews.com.au/news/deloitte-scores-national-health-api-gateway-deal-566888
Deloitte scores national health API gateway deal
By Justin Hendry on Jul 5, 2021 12:09PM
Solution will replace My Health Record's existing Oracle gateway.
Deloitte has won a major contract with the federal government to build the health information gateway that will replace the My Health Record’s Oracle API gateway.
The Australian Digital Health Agency revealed the deal with the consulting giant on Monday, rounding off a seven month search.
It represents the first phase of the national infrastructure modernisation program that will refresh the ehealth record, which is currently operated and managed by Accenture.
Accenture has held the lucrative national infrastructure operator deal for the system since 2011, when My Health Record was known as the personally controlled electronic health record (PCEHR).
-----
https://www.miragenews.com/contract-awarded-for-modernisation-of-national-590016/
July 5, 2021 8:04 am AEST
Contract awarded for modernisation of national digital health infrastructure
Australian Digital Health Agency
The Australian Digital Health Agency today announced that Deloitte Consulting Pty Ltd has been awarded the contract to deliver the first phase of the modernisation of the national digital health infrastructure.
The contract is for the Health Information Gateway, a pivotal piece of national digital health enabling technology that provides a secure and scalable platform for exchanging and accessing health information, including priority areas such as vaccinations and aged care data.
The contract was awarded following a competitive tender process to secure a supplier to support the Agency’s consumer-centric approach.
The Health Information Gateway is key to the Agency’s future directions for national digital health infrastructure. The new Gateway unlocks the Agency’s ability to deploy and manage additional health information repositories and health data exchanges in support of national priorities for healthcare delivery and digitising government services, now and into the future.
-----
https://www.governmentnews.com.au/deloitte-consulting-to-deliver-new-digital-health-gateway/
Deloitte to deliver digital health gateway
5 July, 2021
Deloitte Consulting has won the contract to deliver the government’s new health information gateway.
The Australian Digital Health Agency says the gateway, the first phase in a large-scale digital health infrastructure modernisation program, will open the door to a simplified, future-ready health ecosystem.
The gateway will provide a scaleable platform for exchanging and accessing health information such as vaccination and aged care data and will connect healthcare providers to My Health Record and other digital products and services.
ADHA says the gateway will be based on modern standards for health information exchange and clinical terminologies, such as Fast Healthcare Interoperability Resources (FHIR), meaning it will be able to interact with health information exchange technologies used by the medical software industry, as well as state and territory health departments.
-----
https://www.zdnet.com/article/deloitte-scores-australian-health-information-gateway-contract/
Deloitte scores Australian health 'information gateway' contract
The consultancy firm will be delivering the first phase of the modernisation of the national digital health infrastructure project underway by the Australian Digital Health Agency.
By Asha Barbaschow | July 6, 2021 -- 02:01 GMT (12:01 AEST) | Topic: Innovation
Deloitte has scored a contract with the Australian Digital Health Agency (ADHA), the system administrator of the contentious My Health Record.
Deloitte Consulting will be delivering the first phase of the modernisation of the national digital health infrastructure project underway by the ADHA.
The contract is for the "health information gateway", which the agency described as a "pivotal piece of national digital health enabling technology that provides a secure and scalable platform for exchanging and accessing health information, including priority areas such as vaccinations and aged care data".
"The new gateway unlocks the agency's ability to deploy and manage additional health information repositories and health data exchanges in support of national priorities for healthcare delivery and digitising government services, now and into the future," it said.
-----
ADHA awards contract to develop Australia's Health Information Gateway
Adam Ang | 05 Jul 2021
The Australian Digital Health Agency has chosen Sydney-based business consulting firm Deloitte to build its Health Information Gateway after a competitive tender process.
WHAT IT'S ABOUT
According to ADHA, the single, consolidated Gateway will provide a secure and scalable platform for exchanging and accessing health information, including vaccination records and aged care data. It is based on modern web services and standards for health information exchange (HIE), such as Fast Healthcare Interoperability Resources (FHIR).
It will enable the agency to deploy and manage additional health information repositories and health data exchanges. Moreover, it will support the integration of health data from multiple sources into clinical information systems.
WHY IT MATTERS
In a media release, ADHA CEO Amanda Cattermole claimed that the gateway will reduce costs and technical and operational complexities for healthcare providers as it features reusable interfaces for developers, requiring "fewer" connections between providers and My Health Record and other digital health products and services.
-----
https://www.innovationaus.com/deloitte-to-lead-govts-digital-health-project/
Deloitte to lead govt’s digital health project
Denham Sadler
Senior Reporter
5 July 2021
The federal government has awarded Deloitte a significant contract to develop the “foundational capability” for Australia’s future national digital health ecosystem.
Deloitte was awarded the deal by the Australian Digital Health Agency (ADHA) on Monday to develop the Health Information Gateway, which will be a “secure and scalable platform for exchanging and accessing health information”, including vaccinations and aged care data.
This will see the redevelopment of a key component of the controversial My Health Record in the programming interface gateway, which was previously managed by Accenture on a contract worth well over $550 million.
While the ADHA announced the contract on Monday, the details of it do not have to be made public on AusTender for another 42 days, and the agency declined to reveal the value of it.
-----
Deloitte wins $18m My Health Record contract
Edmund Tadros Professional services editor
Jul 6, 2021 – 3.20pm
Deloitte has won an $18 million contract to create a platform that will allow developers to build apps and software to link into the government digital health system My Health Record.
The three-year contract is with the Australian Digital Health Agency, the body that runs the My Health Record system for the federal government.
The new communication system, known as the Health Application Programming Interface Gateway, “will be a single point of access into the [My Health Record] system and other digital health products and services over time,” an agency spokeswoman said.
“The Health API Gateway will be used by authorised software developers of clinical information systems and mobile apps for the integration and exchange of health information, including the My Health Record.
-----
Webinar on driving to connected care: What is next in health and aged care?
Jul 5, 2021 | Aged care, AIDH news
Those of us working in healthcare for many years have known the opportunities, benefits, and challenges of connecting care through digital health – whether using interconnected systems across providers, better use of telehealth and virtual care, leveraging mobile technologies and consumer apps, or applying data analytics.
A webinar on the application of digital health and the progress of driving to a nirvana of connected care this week heard from a panel of health tech and aged care leaders who were told: “Aged care is an edge case for health: It acts as the canary in the coal mine for broader aspects of skillsets and connected care.”
The webinar heard the report from the Royal Commission into Aged Care highlighted several key gaps in service delivery and connecting care which are mirrored across healthcare generally. We have made a lot of progress in applying digital health across healthcare. However, we still have some way to go, as the Royal Commission report highlighted.
-----
Indigenous bush medicine gets official recognition
8:25PM July 4, 2021
For more than two decades, Linc Walker has been spruiking the secrets of bush medicines.
Now the traditions that have served Indigenous communities for millennia are about to become part of the nation’s digital health records.
Whether it’s mullet soup washed down to soothe aching joints, ground hibiscus leaves to ease an upset stomach or even beach lettuce squeezed over irritated eyes and skin, Mr Walker says there’s a lot we can learn from Indigenous Australians about bush medicine.
“I’ve always loved guiding people around my home and educating them about the different bush medicines that can be extracted from the natural environment … And I enjoy the reaction when you explain that goanna’s fat is good protein or tell them to lick the behinds of green ants because their great for vitamin C.”
Mr Walker, who founded Kuku Yalanji Cultural Habitat Tours in 1999, has been a custodian of Indigenous bush medicines since the region’s elders introduced them to him as a young boy.
-----
Aged care, community groups in Canberra receive funds for tech upgrades
Adam Ang | 07 Jul 2021
The Australian Capital Territory government has awarded a total of AU$478,000 ($358,200) in grant funding to 37 community groups and organisations to foster digital connection and boost technology access in Canberra.
WHY IT MATTERS
Christian non-profit group Anglicare Aged Care & Community Services is among the recipients of the ACT government's inaugural Technology Upgrade Fund. It will use the grant to purchase laptops and Apple iPads to facilitate client outreach and improve service delivery to a large group of vulnerable people, such as those with disabilities and mental health issues.
The non-profit group Migrant And Refugee Settlement Services Australia also obtained funds to buy laptops and audio-visual equipment to deliver, among others, a digital carer support programme to seniors from a culturally and linguistically diverse background.
Charity organisation Stride Mental Health will be using the government funds to acquire eight Apple iPads and a desktop computer to support its participants in undertaking telehealth appointments and accessing a range of digital mental health and wellness apps.
------
https://www.ausdoc.com.au/news/racgp-warns-practices-are-being-shortchanged-govts-arbitrary-pip-rule
RACGP warns practices are being shortchanged by govt's 'arbitrary' PIP rule
Telehealth consults shouldn't be ignored by officials when assessing a practice's patient workload, says college president Dr Karen Price
6th July 2021
The RACGP has accused the Federal Government of short-changing GP practices by applying “arbitrary” rules to the $350 million PIP scheme with no consultation or warning.
Last month, Australian Doctor revealed that health officials were ignoring millions of patient consult done via telehealth when calculating practices’ patient workloads, defined by Standardised Whole Patient Equivalents (SWPEs).
As a result, PIP payments fell $1.5 million nationally in the May quarter — or an average of $200 per practice.
The Department of Heath said it had made the move because it wanted to encourage face-to-face care and it did not regard telehealth as a “full substitute”.
-----
Australia’s vaccine passport could be on phones by December
The Federal Government has called for tenders to develop a vaccine passport app that could land on our phones by December.
July 8, 20212:39pm
The Federal Government is forging ahead with plans for a vaccine passport app that would store vaccination details of Australians, enabling the eventual return of international travel.
Travel Daily reports the Australian Digital Health Agency has issued a request for tender for the development of a “digital health mobile channel” — a smartphone app that will store the user’s Covid vaccination certificate and test status.
It is expected to be available for iPhone and Adroid users by December this year.
As well as providing real-time access to Covid-related information, the app will also store immunisation data against other diseases, including yellow fever, as well as allergy alerts and organ donation status,Executive Traveller reports.
-----
https://www.itnews.com.au/news/nsw-education-department-hit-by-cyber-attack-567046
NSW Education department hit by cyber attack
By Justin Hendry on Jul 8, 2021 2:47PM
Just days before school term resumes.
The NSW Department of Education has suffered a cyber attack just days before the school term resumes and students in Greater Sydney are forced to rely on remote learning.
The department said in a statement on Thursday that the attack had forced it to deactivate “a number of internal systems as a precaution” late on Wednesday.
Online portals used by both staff and students are both impacted, as is email and the staff intranet.
NSW Education Secretary Georgina Harrisson said the decision was made as a precaution while it investigates the incident, with the security of student and staff data the first priority.
-----
HotDoc launches vaccination booking projects with major hospitals
Friday, 02 July, 2021
Patient engagement platform HotDoc is working with two of the biggest hospitals in Australia to allow for the safe COVID-19 and influenza vaccination of staff and patients.
Starting this week, the Austin Hospital in Melbourne will be provided with a complete scheduling solution, eligibility screening and stock management for AstraZeneca and Pfizer COVID-19 vaccinations, as well as booking online or via call centre. Austin is expecting to work through approximately 1000 COVID-19 vaccination appointments each day through the HotDoc system.
HotDoc CEO Ben Hurst said it was great to see a major hospital utilising the HotDoc vaccine booking solution.
“The HotDoc COVID-19 vaccine solution has been used to book in over 2.5 million Australians at our GP network across the country, and our hospital solution will only help to speed up the rollout of COVID-19 vaccinations in Victoria. Having a booking system that is a great experience for patients, allowing for the bookings of the first and second dose, is key to an efficient rollout of the COVID-19 vaccine,” he said.
-----
https://www.innovationaus.com/deloitte-given-further-5m-for-mygov-work/
Deloitte given further $5m for myGov work
Denham Sadler
Senior Reporter
7 July 2021
The federal government has handed Deloitte a further $5 million to continue the redevelopment of myGov, with the multinational consulting giant now being paid nearly $40 million since early last year for work on the government services platform.
It’s already been a bumper month for Deloitte, with the firm also recently awarded a $18 million contract for a significant piece of work around Australia’s digital health infrastructure.
Services Australia is leading the project to create an “enhanced” version of myGov, after taking control from the Digital Transformation Agency late last year.
The project involves a complete revamp of the myGov platform to bring the user experience more into line with offerings from the private sector, along with a number of other redevelopments.
-----
Accenture, IBM, Arq Group round out myGov system integrator panel
By Justin Hendry on Jul 7, 2021 7:04AM
As Deloitte starts building a myGov mobile app.
Services Australia has settled on the four systems integrators that will carry out its $200 million myGov rebuild, as Deloitte gets to work developing a new mobile application to access the government services platform.
The agency has revealed that IT giants Accenture and IBM, as well as local player Arq Group, have joined Deloitte on the multi-vendor panel arrangement that will be invited to bid for the integration work.
Deloitte was the first of three systems integrators to be named on the panel in February after scoring a $4.6 million contract relating to the work, which will involve developing an integration layer that sits over the existing myGov system.
The consulting giant had already been heavily involved in the development of a Facebook-inspired myGov Beta platform, otherwise known as the government digital experience platform (GOVDXP).
-----
Thursday, 08 July 2021 22:44
How to make the ultimate comeback from a lower leg injury with revolutionarily simple smart medical tech
Ukranian medtech startup ComeBack Mobility has raised US $1M for its "Smart Crutch Tips" - an ingeniously simple yet sophisticated piece of tech that attaches to regular crutches, and pairs with a smartphone app and web service - to heal faster from lower leg injuries than ever before.
ComeBack Mobility. It has created “Smart Crutch Tip” orthopaedic devices that work together with an app, shared by a patient and a doctor, bringing the lower limb rehabilitation industry to a whole new level.
So, why are Smart Crutch Tips revolutionary?
Well, it's because weight bearing (WB) in rehabilitation is essential for bone healing in patients with fractures and when following orthopaedic surgery, and it's well known that low-intensity weight bearing exercise has been shown to be beneficial in bone healing over non-weight bearing exercises.
-----
InterSystems Launches TrakCare® 2021 as a Foundation for Virtual Care Innovation
TrakCare 2021 responds to growing demand from patients and healthcare professionals for telehealth and virtual care in a healthcare environment shaped by COVID-19
Sydney, Australia, July 5, 2021 – InterSystems, a creative data technology provider dedicated to helping customers solve the most critical scalability, interoperability and speed problems, has announced the availability of the latest version of its TrakCare® Unified Healthcare Information System, T2021.
This version of TrakCare includes new features inspired by the rapid response of healthcare organisations around the world to the challenges of the COVID-19 pandemic.
The latest TrakCare update responds to the increasing demand for telehealth and virtual care with the introduction of integration with InterSystems HealthShare® Personal Community, a comprehensive, cross-EMR patient portal. This integration enables new features including outpatient bookings and the synchronisation of third-party app data integrated into patient records. The tool is also configurable, enabling further innovation in remote monitoring and patient engagement for TrakCare users around the world.
-----
Monday, 05 July 2021 11:36
InterSystems updates its healthcare information system to improve telehealth and virtual care services
Technology provider InterSystems introduces new updates to its TrakCare Unified Healthcare Information System to better serve patients and healthcare professionals.
InterSystems launches the latest version of its TrakCare Unified Healthcare Information System, T2021.
InterSystems says the new version of TrakCare was inspired by the rapid response of healthcare organisations globally to COVID-19 pandemic.
The TrakCare update integrates with InterSystems HealthShare Personal Community, a cross-EMR patient portal.
-----
Thursday, 08 July 2021 10:57
RMIT, St Vincent’s Hospital Melbourne team up to develop new AI tech for early detection of prostate cancer
RMIT University and St Vincent’s Hosital Melbourne have collaborated on the development of an artificial intelligence (AI) program for early detection of prostate cancer.
The tech, developed by RMIT in collaboration with clinicians at St Vincent’s Hospital, works by analysing CT scans for tell-tale signs of prostate cancer, something even a well-trained human eye struggles to do.Prostate cancer is the most diagnosed cancer and a leading cause of death by cancer in Australian men and early detection is key to successful treatment but men often dodge the doctor, avoiding diagnosis tests until it’s too late.
CT imaging is not suitable for regular cancer screening because of the high radiation doses involved, but RMIT and St Vincent’s Hosital say the AI solution could be used to run a cancer check whenever men have their abdomen or pelvis scanned for other issues.
RMIT’s Dr Ruwan Tennakoon said CT scans were great for detecting bone and joint problems but even radiologists struggled to spot prostate cancers on the images.
-----
https://www.innovationaus.com/aussie-ai-takes-on-radiology-diagnostics/
Aussie AI takes on radiology diagnostics
James
Riley
Editorial Director
5 July 2021
An Australian healthcare joint-venture between artificial intelligence startup Harrison.ai and local radiology company I–MED Radiology Network has launched a chest X-ray diagnostic tool on the same day a peer-reviewed diagnostic accuracy study of the product was published by The Lancet Digital Health.
The joint-venture – Annalise.ai – unveiled its chest X-ray AI solution Annalise CXR, which detects 124 clinical findings and is a decision support tool for radiologists and clinicians. The next most comprehensive CXR AI product detects just 75 clinical findings, with most CXR AI products limited to fewer than 15 findings.
The study published in The Lancet Digital Health found that when used as an assist device, Annalise CXR significantly improved the ability for radiologists to perceive 102 chest X-ray (CXR) findings in a non-clinical environment, was statistically non-inferior for 19 findings, and no findings showed a decrease in accuracy.
The study also assessed the standalone performance of the model in a non-clinical environment against radiologists in identifying chest x-ray pathology, as well as investigating the effect of model output on radiologist performance when used as an assist device.
-----
Take control of identity security to protect critical health assets
CyberArk
Software Inc.
By
Thomas Fikentscher, Regional Director, ANZ at CyberArk
Monday, 05 July, 2021
Australia’s healthcare industry is undergoing dramatic digital transformation, in terms of both digital care and the digitisation of business activities. While this transformation is absolutely necessary, it also makes the industry a prime target for cybercriminals due to the sensitive data collected by healthcare providers, as well as their increased reliance on cloud-based services and telehealth.
Cyberattacks have the potential to interfere with the delivery of health services and the supply of critical products to those in need, which could have serious consequences. Attacks can also cause significant reputational and financial damage to healthcare organisations.
According to data from the Australian Cyber Security Centre (ACSC), reported cybersecurity incidents relating to the healthcare sector increased almost 85% in 2020. The government agency states that this is likely a result of increased targeting of the health sector due to COVID-19, with incidents primarily reported by healthcare providers, as well as customers falling victim to health-related scams or data breaches. And these are just the incidents that were reported.
-----
Friday, 09 July 2021 10:08
NBN and Jawun collaborate to champion reforms and deliver opportunities for indigenous communities
NBN collaborates with non-for-profit Jawun to carry out its commitment of strengthening relationships and creating opportunities for indigenous people. It also laid out its ongoing commitments and remaining projects for the year.
NBN is working on a new three-year collaboration with Jawun, a non-for-profit improving the capacity of indigenous leaders, organisations, and communities to achieve their own development goals.
The collaboration will see up to 12 NBN employees endorsed into indigenous organisations in Australia, using their knowledge to help communities enhance their digital capability.
The collaboration extends a week of NAIDOC celebrations for NBN, centred around stories of First Peoples history, culture, and excellence. It highlights NBN’s commitment to strengthening relationships and creating opportunities for indigenous people and their communities.
-----
NBN Co to change the way it expands and upgrades its wireless network
By Ry Crozier on Jul 8, 2021 7:01AM
Stands up a new panel of partners.
NBN Co is setting up a panel of partners that it will ask to handle fixed wireless upgrades and new site builds.
The change was revealed in a since-removed recruitment advertisement last week, which suggested that “a significant project is currently underway in the FWSAT [fixed wireless and satellite] team, which will see the establishment of a new multi-delivery partner model, which will include new delivery partners, systems, tools and processes.”
While the phrasing of “multi-delivery partner model” is somewhat open, it is believed this does not mean that NBN Co might try to source future fixed wireless services from third-party cellular operators in future and rebrand those services as ‘NBN’.
Such an operating model has previously been flagged as a possibility in the satellite footprint, and local infrastructure players have expressed interest in facilitating ground connections if NBN Co does go down that path.
-----
NBN Co to offer temporary discount for every active 250Mbps-plus customer
By Ry Crozier on Jul 5, 2021 12:31PM
As six-month 'focus on fast' campaign nears end.
NBN Co is set to rebate retail service providers between $3 and $7 a month for every 250Mbps and above customer they have on their books from the start of next month.
The ‘superfast plus rebate’, which was first reported by CommsDay late last week, comes into effect on August 1 and runs for between six and 12 months, according to an update to NBN Co’s discount list last week. [pdf]
Clarification on the duration was being sought at the time of publication.
Under the rebate, retail service providers (RSPs) would receive a $3 a month rebate for every ‘superfast’ - 250Mbps - residential customer they have, and a $7 a month rebate for every ‘ultrafast ‘ - up to gigabit - residential customer.
-----
Enjoy!
David.
