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."

Sunday, August 13, 2023

There Might Be A Lesson Here For Aspiring Digital GP Practices In Australia.

 This appeared a little while ago:

Babylon looks to sell UK business amid bankruptcy fears

Babylon Health is looking to sell its UK business, including its 100,000 patient NHS GP practice, and may fall into administration, the company has announced.

Jordan Sollof


Following the story back in May that shares in Babylon fell sharply on news that the company was being taken private as part of a new debt plan, the firm announced this week that a $34.5m attempt to restructure and return to private ownership fell through.

Babylon GP at Hand, an online-first GP practice with over 100,000 registered NHS patients around London, is the firm’s main remaining NHS service.

The company revealed that it is now “exploring strategic alternatives in order to find the best outcome for its UK business”, which includes the possibility of selling off the UK business. According to HSJ, senior figures in Babylon are confident that its UK business, including the entities that deliver NHS services, will not close.

Last month, the company was delisted from the New York Stock Exchange and has since announced that London-based investment firm AlbaCore Capital are taking over its assets without shareholders’ approval, and that it was calling administrators in the UK.

Babylon said in a statement that it “cannot provide assurance that it will be able to secure sufficient liquidity to fund the operations of the Group’s business”.

“To the extent that Babylon is unable to secure additional funding and complete a Third Party Sale of a particular business, the applicable entities of the Group will file for bankruptcy protection or implement other alternatives for an orderly wind down and liquidation or dissolution,” the firm added.

Babylon Health is a UK AI firm that was promoted as the future of the NHS by the then health secretary Matt Hancock. Founded in 2013 by former UK Iranian banker Ali Parsa, the company claimed its AI could revolutionise healthcare through virtual appointments and diagnostic chatbots such as its GP at Hand.

Despite Babylon winning a number of NHS contracts, thanks in part to Hancock’s promotion of GP at Hand in 2018, experts continuously warned the technology was unproven and overhyped.

The company now faces collapse after losing almost the entirety of its $4.2 billion valuation.

Here is the link:

https://www.digitalhealth.net/2023/08/babylon-looks-to-sell-uk-business-amid-bankruptcy-fears/

It seems to me that radical change is really hard and that Babylon was really trying very hard with a pretty radical agenda – and so demonstrated just how hard that level of change can be!

A salutary tale!

David.

 

AusHealthIT Poll Number 709 – Results – 13 August, 2023.

 Here are the results of the poll.

Have We Reached The Stage Where It Is Impossible To Tell Between Human-Generated Article Content And AI-Generated Articles?

Yes                                                                     10 (28%)

No                                                                      25 (69%)

I Have No Idea                                                     1 (3%)

Total No. Of Votes: 36

A clear outcome suggesting that a majority of readers feel we are not there quite yet!

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

A good number of votes. But also a very clear outcome. 

1 of 36 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.

Sunday, August 06, 2023

I Think This Would Be A Good Time To Rethink The Place And Role Of The AIDH.

The departure a week or so ago of the previous substantive CEO of the AIDH (Dr Louise Schaper) has provided an opportunity to some fundamentals of the Aust. Institute Of Digital Health (AIDH) to be re-examined and questioned.

Among these are:

Is change needed to the structures and functions of the AIDH?

Should the Academic functions and the Conference Organising functions be separated?

Does it make any sense to have two different sets of credentials (CHIA and FAIDH etc)?

How could a purely academic Digital Health group be sustained and supported, if desired?

What should be the functions of the different parts of the AIDH – or should they be totally separate?

Is the AIDH an appropriate organization to be offering credentials like CHIA. FAIDH etc. and, if so, how should they be managed and supported?

How should AI be managed within a Digital Health initiative?

I am sure there a zillions of other questions that should be also considered, as should be a mechanism to reshape the AIDH as members desire!

I hope the AIDH Board can take these issues up and really design a worthwhile way forward for all stakeholders!

What change do you think is needed?

David.

 

AusHealthIT Poll Number 708 – Results – 6 August, 2023.

 Here are the results of the poll.

Are You Satisfied That Patient Safely Can Be Properly Protected In AI Assisted Medical Diagnosis And Consultation?

Yes                                                                     0 (0%)

No                                                                    37 (100%)

I Have No Idea                                                  0 (0%)

Total No. Of Votes: 37

A very clear outcome suggesting in that a vast majority of readers felt we need continued human involvement in diagnosis and treatment!

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

A good number of votes. But also a very clear outcome. 

0 of 37 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.

 

Monday, July 31, 2023

Dr Louise Schaper Has Left The Aust, Institute Of Digital Health After 13 Years!

 This is all a bit sudden after about 13 years and I am sure many will be wondering why?

There may be more to this story than meets the eye, given how sudden and unheralded the announcement is.

I will leave it to others to assess her legacy and impact.

Here is the announcement e-mail. Dated 31/07/2023 - 5.00 pm

-----

Dear David,


I'm writing to introduce myself in the capacity of Interim CEO of the Australasian Institute of Digital Health.

 

You will probably have seen that Dr Louise Schaper left the position of CEO of the Institute last week after nearly 14 years leading the Health Informatics Society of Australia and later AIDH after its 2019 merger with the Australasian College of Health Informatics. I would like to start by recognising all of Louise’s achievements during that time and her huge contribution to the field of digital health. 

 

I’m a Fellow of AIDH and was a member of HISA beforehand. I’ve seen the Institute go from strength to strength. We have a solid strategy in place, our membership is committed, the digital health community supports our agenda to advance the workforce, and our networking and events program has resumed, mostly in person. On that, the MedInfo 2023 global congress was a great success on all measures and a catalyst for international policy discussion in our sector. Thank you to everyone who attended or contributed to its success. 

 

I am greatly looking forward to working with you in coming months to keep up the momentum of work underway and keep our sights firmly set on the AIDH vision for “healthier lives, digitally enabled”. 

Regards,


Mark Nevin FAIDH

Interim CEO

Australasian Institute of Digital Health

-----

I am sure we will hear more in due course! Extra info. and comments welcome!

David.


Sunday, July 30, 2023

It Looks Like Digital ID Is Really Coming To Australia This Time.

 This appeared a few days ago.

Eight things businesses and customers need to know about digital ID in Australia

Tegan Jones

July 28, 2023

This week has seen a resurgence in discussions around the roll out of a national digital ID in Australia, after Finance Minister Katy Gallagher spoke on the subject at the Australian Financial Review Government Services Summit. This has sparked a fresh round of questions and concerns around digital IDs, including how they would work and if they would be secure.

It’s a big subject that has been kicking around for around a decade. And it’s an important one because a digital ID proposes a great deal of benefits when it comes to convenience and privacy. But with that comes valid concerns around how it would work, availability for people who aren’t digital natives, and security, considering the Australian government’s track record with digital ‘solutions’ such as My Health Record and Robodebt.

With that in mind, we have pulled together answers for some of the most common and pressing questions around an Australian national digital iID.

What is an Australian national ID?

The national digital identity scheme will allow Australians to condense all of their official licenses and forms of identification on a single platform that is regulated by the government.

From there, government departments and third-party organisations — such as a bank, insurance company or even a retailer — could access it to verify your identity

An ideal version of this platform would allow this verification without the need for the third-party to capture personal information, such as your birthdate, address or signature.

Doesn’t the MyGov app already do this?

The MyGov app does already let you store digital versions of Medicare, Centrelink concession and health care cards and your international COVID-19 vaccination certificate in its ‘wallet’.

It also allows you to link up a number of government-related services.

However, not all cards and ID are captured by this service (for example, a digital passport). The government itself says on the MyGov website that there is still a way to go.

“It may take some time before all providers are ready to accept digital cards from the myGov app. It’s a good idea to carry your physical cards with you.”

There’s also the issue of being able to use these digital cards widely and consistently with services outside of the government ecosystem.

“From the everyday person’s point of view, we’ve got the system; it’s just not regulated and not in a shape I think that will allow us to drive it forward and give the interoperability and the economy-wide benefits that come from having a national system, but we’re very committed to it,” Gallagher said this week.

“We want to see an economy-wide system, and in a sense we’ve got that operating now, without regulation. We’ve got some private digital ID providers and then you’ve got myGov.”

Could a national digital ID mean sharing less personal information with businesses?

That’s a strong potential possibility, and one that is being advocated for by the former NSW minister for customer service and digital government, Victor Dominello.

For years he has been pushing for a form of digital identification that doesn’t force Australians to hand over personal information, like birth dates.

Let’s say you are signing for a package, the idea is that you could show your digital ID (which has been verified by the government) to a delivery driver and have it verified without the need for your signature. Or perhaps you want to prove you’re over 18 at a pub. In this case, a national digital ID would prove you are the age you say you are, without revealing your actual birth date.

What possibilities would a national digital ID have for businesses?

There are plenty of ways in which a digital identity could affect businesses.

For example, it could be an alternative to the controversial proposals to roll out facial recognition in pubs and clubs to identify people who have been banned.

There are also arguments for it improving user experience for customers when logins are simpler and removing time-consuming manual labour.

And as there is a push for stricter privacy laws around how long businesses hold onto customer records, a digital identity could mitigate this issue. Businesses won’t need to spend the time or storage on holding onto records that they don’t need.

Deloitte also states that it could mean increased customers and revenue for businesses, especially those that adopt early, due to the ease of use, efficiency, and how it will position a brand as one that values the privacy of its customers.

Would I have more control over my digital ID than the government?

That’s certainly the theory, and one that has been pushed for by Dominello.

“You hold the golden keys,” he said at a Tech Council of Australia event in March.

“So the customer genuinely – not just in language – informs the centre of [this] rather than rather than governments and banks.”

While we don’t yet know exactly how a nationwide digital identity would play out in practice, Katy Gallagher did reflect a similar perspective when questioned about it this week.

“It’s really about you having control as citizens; control of their information that allows them to access government systems in a very easy, secure, voluntary and efficient way. But you know, I’m going in with my eyes open that there’s a fair bit of work to do on this, and hopefully bipartisan support.”

While some states in Australia already offer digital driver’s licenses (as well as trials around digital work credentials), they’re more of a stepping stone towards an eventual national digital ID.

Some scenarios still don’t allow for digital drivers licenses to be used as ID, and at the present time they’re all state-based. The digital ID of the future would be nation-wide, meaning it would work and be accepted across all of Australia — and hopefully overseas as well.

As an example, on a recent trip to the US, a colleague found that bars would not accept a New South Wales digital license as a form of ID but would accept a physical one.

From Dominello’s perspective, digital drivers licenses are a “crude defacto” and reveal too much information.

“Fit for purpose digital ID would give more control to the individual on what information they share and for how long,” Dominello said on LinkedIn.

Are there privacy and security concerns around a national digital ID?

Absolutely.

The ethos behind digital IDs is improved privacy and security for individuals through minimising how many companies and institutions have access to their information.

This has become of particular concern over the last 12 months in the wake of major breaches from Optus, Medibank and Latitude, especially because Australia lacks specific data privacy laws.

These are all great arguments for a national digital ID.

However, the federal government has an extremely poor record when it comes to implementing digital systems. The two biggest in recent years have been the catastrophic results of Robodebt, as well as the rushed rollout of My Health Record despite glaring privacy concerns. This included the inability of many Australians to opt out after discovering records had already been automatically made for them.

Australians can’t be blamed for being wary of government infrastructure being relied upon for something as important as a central point of digital identification.

Just this week it was revealed that scammers have gotten away with over $500 million in an ATO fraud due to a flaw in the MyGov system.

So the fact that Gallagher has pencilled in mid-2024 as a possibility for roll out is understandably concerning for some.

When will national digital ID launch in Australia?

There is no firm timeline right now, but at the AFR‘s summit this week, finance minister Katy Gallagher said the government has cabinet approval to release an exposure draft “hopefully by September”, which she hopes to then get into Parliament by the end of the year.

More here:

https://www.smartcompany.com.au/startupsmart/startupsmart-technology/what-businesses-customers-digital-id-australia/

It is true to say there have been more than more that one false dawn on this and also that it is a complex implementation to get right with many, many stake-holders.

That said many other nations have succeeded so it is about time we wound up with a simpler and more trusted system in OZ. The time has well and truly passed for success to be achieved, given the benefits that are possible and the ultimate simplicity and security that can be achieved.

The health sector can be made both safer and more efficient with a national ID I believe.

David.

 

AusHealthIT Poll Number 707– Results – 30 July, 2023.

 Here are the results of the poll.

Do You Think The Catastrophic Heat Waves Seen In This European Summer Bode Ill For Australia In A Few Months Time?

Yes                                                                28 (80%)

No                                                                   7 (20%)

I Have No Idea                                                  0 (0%)

Total No. Of Votes: 35

A pretty clear outcome suggesting in that a majority of readers felt we are in for a very hot summer!

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

A good number of votes. But also a pretty clear outcome. 

0 of 35 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.

 

Sunday, July 23, 2023

I Am Not Sure How Important It Is We Don’t Fully Understand Some AI Systems.

As I thought about the following article it seemed clear that there are many situations where we receive value but are not sure how exactly it was achieved. What, for example, do we really know of the details of the art of writing a novel or a symphony?

Here is the article:

Even the scientists who build AI can’t tell you how it works

 “We built it, we trained it, but we don’t know what it’s doing.”

By Noam Hassenfeld Jul 15, 2023, 7:00am EDT

Artificial intelligence systems like ChatGPT can do a wide range of impressive things: they can write passable essays, they can ace the bar exam, they’ve even been used for scientific research. But ask an AI researcher how it does all this, and they shrug.

“If we open up ChatGPT or a system like it and look inside, you just see millions of numbers flipping around a few hundred times a second,” says AI scientist Sam Bowman. “And we just have no idea what any of it means.”

Bowman is a professor at NYU, where he runs an AI research lab, and he’s a researcher at Anthropic, an AI research company. He’s spent years building systems like ChatGPT, assessing what they can do, and studying how they work.

He explains that ChatGPT runs on something called an artificial neural network, which is a type of AI modeled on the human brain. Instead of having a bunch of rules explicitly coded in like a traditional computer program, this kind of AI learns to detect and predict patterns over time. But Bowman says that because systems like this essentially teach themselves, it’s difficult to explain precisely how they work or what they’ll do. Which can lead to unpredictable and even risky scenarios as these programs become more ubiquitous.

I spoke with Bowman on Unexplainable, Vox’s podcast that explores scientific mysteries, unanswered questions, and all the things we learn by diving into the unknown. The conversation is included in a new two-part series on AI: The Black Box.

This conversation has been edited for length and clarity.

Noam Hassenfeld

How do systems like ChatGPT work? How do engineers actually train them?

Sam Bowman

So the main way that systems like ChatGPT are trained is by basically doing autocomplete. We’ll feed these systems sort of long text from the web. We’ll just have them read through a Wikipedia article word by word. And after it’s seen each word, we’re going to ask it to guess what word is gonna come next. It’s doing this with probability. It’s saying, “It’s a 20 percent chance it’s ‘the,’ 20 percent chance it’s ‘of.’” And then because we know what word actually comes next, we can tell it if it got it right.

This takes months, millions of dollars worth of computer time, and then you get a really fancy autocomplete tool. But you want to refine it to act more like the thing that you’re actually trying to build, act like a sort of helpful virtual assistant.

There are a few different ways people do this, but the main one is reinforcement learning. The basic idea behind this is you have some sort of test users chat with the system and essentially upvote or downvote responses. Sort of similarly to how you might tell the model, “All right, make this word more likely because it’s the real next word,” with reinforcement learning, you say, “All right, make this entire response more likely because the user liked it, and make this entire response less likely because the user didn’t like it.”

Noam Hassenfeld

So let’s get into some of the unknowns here. You wrote a paper all about things we don’t know when it comes to systems like ChatGPT. What’s the biggest thing that stands out to you?

Sam Bowman

So there’s two connected big concerning unknowns. The first is that we don’t really know what they’re doing in any deep sense. If we open up ChatGPT or a system like it and look inside, you just see millions of numbers flipping around a few hundred times a second, and we just have no idea what any of it means. With only the tiniest of exceptions, we can’t look inside these things and say, “Oh, here’s what concepts it’s using, here’s what kind of rules of reasoning it’s using. Here’s what it does and doesn’t know in any deep way.” We just don’t understand what’s going on here. We built it, we trained it, but we don’t know what it’s doing.

Noam Hassenfeld

Very big unknown.

Sam Bowman

Yes. The other big unknown that’s connected to this is we don’t know how to steer these things or control them in any reliable way. We can kind of nudge them to do more of what we want, but the only way we can tell if our nudges worked is by just putting these systems out in the world and seeing what they do. We’re really just kind of steering these things almost completely through trial and error.

Noam Hassenfeld

Can you explain what you mean by “we don’t know what it’s doing”? Do we know what normal programs are doing?

Sam Bowman

I think the key distinction is that with normal programs, with Microsoft Word, with Deep Blue [IBM’s chess playing software], there’s a pretty simple explanation of what it’s doing. We can say, “Okay, this bit of the code inside Deep Blue is computing seven [chess] moves out into the future. If we had played this sequence of moves, what do we think the other player would play?” We can tell these stories at most a few sentences long about just what every little bit of computation is doing.

With these neural networks [e.g., the type of AI ChatGPT uses], there’s no concise explanation. There’s no explanation in terms of things like checkers moves or strategy or what we think the other player is going to do. All we can really say is just there are a bunch of little numbers and sometimes they go up and sometimes they go down. And all of them together seem to do something involving language. We don’t have the concepts that map onto these neurons to really be able to say anything interesting about how they behave.

Noam Hassenfeld

How is it possible that we don’t know how something works and how to steer it if we built it?

Sam Bowman

I think the important piece here is that we really didn’t build it in any deep sense. We built the computers, but then we just gave the faintest outline of a blueprint and kind of let these systems develop on their own. I think an analogy here might be that we’re trying to grow a decorative topiary, a decorative hedge that we’re trying to shape. We plant the seed and we know what shape we want and we can sort of take some clippers and clip it into that shape. But that doesn’t mean we understand anything about the biology of that tree. We just kind of started the process, let it go, and try to nudge it around a little bit at the end.

Noam Hassenfeld

Is this what you were talking about in your paper when you wrote that when a lab starts training a new system like ChatGPT they’re basically investing in a mystery box?

Sam Bowman

Yeah, so if you build a little version of one of these things, it’s just learning text statistics. It’s just learning that ‘the’ might come before a noun and a period might come before a capital letter. Then as they get bigger, they start learning to rhyme or learning to program or learning to write a passable high school essay. And none of that was designed in — you’re running just the same code to get all these different levels of behavior. You’re just running it longer on more computers with more data.

So basically when a lab decides to invest tens or hundreds of millions of dollars in building one of these neural networks, they don’t know at that point what it’s gonna be able to do. They can reasonably guess it’s gonna be able to do more things than the previous one. But they’ve just got to wait and see. We’ve got some ability to predict some facts about these models as they get bigger, but not these really important questions about what they can do.

This is just very strange. It means that these companies can’t really have product roadmaps. They can’t really say, “All right, next year we’re gonna be able to do this. Then the year after we’re gonna be able to do that.”

And it also plays into some of the concerns about these systems. That sometimes the skill that emerges in one of these models will be something you really don’t want. The paper describing GPT-4 talks about how when they first trained it, it could do a decent job of walking a layperson through building a biological weapons lab. And they definitely did not want to deploy that as a product. They built it by accident. And then they had to spend months and months figuring out how to clean it up, how to nudge the neural network around so that it would not actually do that when they deployed it in the real world.

Noam Hassenfeld

So I’ve heard of the field of interpretability. Which is the science of figuring out how AI works. What does that research look like, and has it produced anything?

Sam Bowman

Interpretability is this goal of being able to look inside our systems and say pretty clearly with pretty high confidence what they’re doing, why they’re doing it. Just kind of how they’re set up being able to explain clearly what’s happening inside of a system. I think it’s analogous to biology for organisms or neuroscience for human minds.

But there are two different things people might mean when they talk about interpretability.

One of them is this goal of just trying to sort of figure out the right way to look at what’s happening inside of something like ChatGPT figuring out how to kind of look at all these numbers and find interesting ways of mapping out what they might mean, so that eventually we could just look at a system and say something about it.

The other avenue of research is something like interpretability by design. Trying to build systems where by design, every piece of the system means something that we can understand.

But both of these have turned out in practice to be extremely, extremely hard. And I think we’re not making critically fast progress on either of them, unfortunately.

Noam Hassenfeld

What makes interpretability so hard?

Sam Bowman

Interpretability is hard for the same reason that cognitive science is hard. If we ask questions about the human brain, we very often don’t have good answers. We can’t look at how a person thinks and explain their reasoning by looking at the firings of the neurons.

And it’s perhaps even worse for these neural networks because we don’t even have the little bits of intuition that we’ve gotten from humans. We don’t really even know what we’re looking for.

Another piece of this is just that the numbers get really big here. There are hundreds of billions of connections in these neural networks. So even if you can find a way that if you stare at a piece of the network for a few hours, we would need every single person on Earth to be staring at this network to really get through all of the work of explaining it.

More here:

https://www.vox.com/unexplainable/2023/7/15/23793840/chat-gpt-ai-science-mystery-unexplainable-podcast

I found the issues raised here fascinating and clearly above my pay pay-grade, but nevertheless important to wonder about.

My guess is that it is the complexity of these systems that allow them to work and to be so hard to really understand. Given the importance of the tasks AI is now addressing it is important to have some idea of what is actually going on!

Other thoughts welcome!

David.