AusHealthIT Poll Number 714 – Results – 17 September, 2023.

Here are the results of the poll.

Do You Believe Developments In Generative AI Will Lead To Major Job And Workforce Changes Over the Next Decade?

Yes                                                                      30 (71%)

No                                                                       12 (29%)

I Have No Idea                                                    0 (0%)

Total No. Of Votes: 42

A clear outcome! A good majority think generative AI will matter and lead to considerable change!

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 42 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.

 

Are Pharmacists Really Just Shopkeepers With A Strong Line In Pills?

This appeared last week:

Chemists protest medicine rule change in angry walk out

Tom McIlroy Political correspondent

Sep 4, 2023 – 5.37pm

Pharmacists have staged an angry walk-out of federal parliament, protesting the Albanese government’s moves to allow more than 4 million consumers to buy two months’ worth of medicine for the price of a single prescription.

Hundreds of pharmacists were in Canberra for a protest on Monday morning, and many pharmacists attended question time in white uniforms, jeering as Prime Minister Anthony Albanese defended Labor’s consultation over the plan.

In an already rowdy question time, Speaker of the House of Representatives Milton Dick warned people in public galleries that they were present as observers, not participants, in parliamentary proceedings and should refrain from interjecting.

But hostilities escalated dramatically when members of the group loudly exited the chamber, with many yelling at MPs on the chamber floor below in a co-ordinated exit.

Some shouted “lies” and at least one pharmacist raised his middle fingers as he walked out. The sitting was disrupted for a few minutes.

The guild said in a statement it was not involved in the chamber ruckus and wanted to resolve its differences with the government as quickly as possible.

New funding deal

Health Minister Mark Butler told question time the government had agreed to bring forward negotiations on a new funding agreement for community pharmacies. A deal could be agreed by March 1.

He said Labor MPs had met members of the profession “time and time again” to discuss the changes and criticised the opposition for not considering the cost-of-living benefits for consumers.

“That commitment was contingent upon a decision by the guild to stand down their campaign against this measure” he said.

“A reasonable person in this building might question whether that commitment is being delivered upon.”

For months, Labor has stuck to its plan to move to 60-day dispensing rules. The change came into force on September 1, after the Coalition pulled out of an attempt in parliament to stop the regulation going into effect.

Change affects common medicines

More than 320 common medicines are covered by the change, including medication for high blood pressure and cholesterol, diabetes, depression and anxiety, osteoporosis, epilepsy and Parkinson’s disease.

More here:

https://www.afr.com/politics/federal/chemists-protest-medicine-rule-change-in-angry-walk-out-20230904-p5e1wg

Back when I was a boy if a dispute arose between the Pharmacists and the Government the Pharmacy Guild would sort it all out behind closed doors with more than often a Government backdown to what was then a very powerful lobby. No fuss and no unseemly protest!

It looks like all has changed and that the Guild has been de-fanged, or lost control.  with this latest white-coat outburst! I wonder what has happened for the Guild to be essentially ignored? I guess we will hear in time!

A very interesting change….

David.

 

I Think We Need Careful Balance In Medical Outcome Reporting To Actually Mean Much.

This appeared last week and made some good points:
Flip the script: When medicine keeps us sick

Prescription drugs are being doled out with alarming regularity. Dubious surgeries are on the rise. Now there’s a growing push-back against overdiagnosis, overprescription and overtreatment.

By Natasha Robinson

September 9, 2023

It’s a paradox of modern medicine that many of today’s most prevalent health conditions are capable of being fixed by measures other than pharmaceuticals, yet the rate of prescription of drugs is climbing exponentially.

Scripts are doled out with alarming regularity for conditions that are likely to get better simply with the passage of time and circumstance. The tendency towards overtreatment is reflected in high rates of dubious surgeries, too, with tens of thousands of patients every year going under the scalpel for orthopaedic procedures that lack evidence of efficacy and frequently cause harm.

And patients with chronic metabolic diseases often are simply told to pop pills to manage blood sugar and insulin, when dietary interventions have the capacity to reverse diseases such as Type 2 diabetes completely.

“Overall, it has been consistently estimated that around 60 per cent of medical care is effective, 30 per cent is of little or no value and a further 10 per cent is harmful,” says Ian Harris, an orthopaedic surgeon and co-author of the book Hippocrasy: How Doctors are Betraying Their Oath.

“This means that around 40 per cent of what doctors do is overtreatment and overdiagnosis: treatments and tests that don’t actually help people but often cause harm.

“Research has also shown that doctors consistently over-estimate the benefits and underestimate the harms of their interventions. This is a driver of overtreatment and overdiagnosis because when a doctor recommends a treatment or a test, they are basing the recommendation on the balance of benefits and harms, but their estimate of that balance is skewed.”

Around the world there is a growing push-back against what some have labelled the “medico-industrial complex” that drives trends of overdiagnosis, overprescription and overtreatment. Blockbuster antidepressant medications are a major focus, with Britain leading the world in a “deprescribing” movement that aims to educate patients on symptoms that commonly come with withdrawal from psychoactive drugs.

The deprescribing movement is also challenging notions of the degree of efficacy of selective serotonin reuptake inhibitors, or SSRIs, emphasising that alternative interventions such as exercise and psychotherapy are often just as effective as antidepressant drugs, and that the medications are not designed to be taken for years on end.

An astonishing one in seven people in Australia was taking an SSRI in 2021, the latest figures from the Australian Institute of Health and Welfare show. That’s the second highest rate of prescribing in the world.

“I think there is an increasing biomedicalisation of human experience in Western societies,” Victorian psychiatrist William Lugg says. “The old adage of a pill for every ill seems to be quite true. And so we do have a tendency to biomedicalise distress.”

Lugg, a public hospital consultant psychiatrist, is leading a team that is piloting Australia’s first psychotropic medication deprescribing program, working with GPs in Melbourne and a community health service. It’s designed to provide a framework for people to safely taper down their medication, giving them a better understanding of withdrawal symptoms and how to manage them.

“I’m of the view, as is my team, that stopping people’s dependence on these medications is as important as helping people to go on them,” Lugg says.

“I think there’s been a longstanding underappreciation to the degree to which people develop physiological dependence on these drugs.”

There are divergent views among psychiatrists as to the true efficacy of SSRIs, but it seems apparent that in many cases the medication is prescribed inappropriately for mild depression that would resolve on its own or could be addressed effectively through lifestyle and social interventions.

One recent reanalysis published in the journal BMJ Open of a widely cited systematic review found it was “unclear whether antidepressants are more efficacious than placebo”. Other recent studies have indicated exercise may be as effective or even more effective than antidepressant medication.

That’s no surprise to proponents of what has become known as lifestyle medicine, a growing and increasingly organised movement aimed at preventing and treating – through non-pharmaceutical methods – chronic, complex and lifestyle-related conditions including depression and anxiety and other diseases with environmental, societal and behavioural causes such as Type 2 diabetes, obesity and cardiovascular disease.

Treatments under the umbrella of lifestyle medicine include the formal evidence-based application of nutrition, fasting, movement, sleep, mind-body practices including mindfulness, and stress management.

The movement also focuses on reduced substance use and pathological screen use, social connectedness and connection with the natural world. It uses health coaching, new models of care and digital health to prevent and treat disease.

The evidence is growing that such lifestyle approaches should be frontline treatments in chronic disease, but gaining traction is a battle against powerful vested interests that tend to drive medicine’s mainstream emphasis on surgery and drugs.

“I think one of the problems with medicine is that there are such powerful lobby groups that really divert us away from the things that we know are the best, lowest cost interventions – primary care and preventive care,” former deputy chief medical officer Nick Coatsworth says.

This week Coatsworth gave the opening address at the Lifestyle Medicine Better Health for All international conference presented by the Australasian Society of Lifestyle Medicine in Melbourne, where practitioners received high-level training in the application of lifestyle medicine.

ASLM is a not-for-profit organisation working towards improved prevention, management and treatment of chronic, complex and lifestyle-related conditions.

“Everybody knows that primary care and preventive care are where the healthcare dollar needs to go,” Coatsworth says.

“What that means is that you have to be able to take on the medico-industrial complex in a way that no government has done before. I don’t think any government has ever had a serious attempt to exercise the regulatory power to rein in the costs of the medico-industrial complex.”

One of the examples of what Coatsworth calls the medico-industrial complex is the inflated cost of medical devices in Australia. It’s common for medical device sales reps to be in the operating theatre side-by-side the surgeon, ostensibly to deliver education. Critics are alarmed by the practice, which raises significant issues of device company influence on the doctor’s choice of prosthetic and also the potential for unjustified excess use of glues and consumables, which all must be paid for by private health funds.

“No doctor gets an invitation from a pharma company for the box to watch the Wallabies any more, whereas that was happening in the 1990s,” Coatsworth says.

“There has been some curtailing of pharma influence. It’s not clear that the medical device companies are subject to the same regulation.”

Harris says there is a significant amount of overservicing in orthopaedic surgery, with people regularly given knee replacements for mild or moderate osteoarthritis, when the pain could have been largely alleviated through the lifestyle intervention of weight loss.

Even more concerning, however, is the performance of spinal fusion surgery for back pain, which has no evidence of efficacy and is associated with frequent poor outcomes and disability. Such surgery leads to often huge claims on health funds and pushes up the cost of premiums.

One health fund had to pay out $309,900 for spinal fusion surgery for a member last year.

“I think people just generally don’t understand the benefits of lifestyle modification over surgery,” Harris says. 

”If you have a patient with osteoarthritis, and they’re obese, not only will weight loss potentially help their knee pain but it will also ameliorate or reverse their diabetes, it’ll decrease their risk of heart disease. And by better controlling their diabetes, they’re less likely to develop eye disease, peripheral vascular disease and kidney disease.

“You could treat many people a lot better just with weight loss, but people just say: can’t you just replace the knee? Isn’t that easy?”

Lots more here:

https://www.theaustralian.com.au/inquirer/australians-seem-all-too-ready-to-pop-pills-when-lifestyle-changes-could-stop-disease-in-its-tracks/news-story/dc25e627349e48f622989e6513e542c5

The problem with all this perfectly true reporting is its confusion of the outcomes at various levels.

Look at one example – my, now infamous, Rt. Coronary Artery Stent. On the evidence of my eyes it was both justified and appropriate for my clinical situation and I am very happy to have it – and to take the pills to keep it open and working by thinning my blood a little.

My stent was strongly indicated because of my heart attack but in others one may be needed but a few extra are added for less clear cut reasons. Overservicing or caution?

So many other treatments have equally complex stories so judgement intrudes and is vital. The problem is to know which individual interventions are life-saving and which were unnecessary! Lots of stories can be written that really don’t get us anywhere as judgement by a single clinician is what determines what happens in each case – and is swayed by experience, marketing and who knows what else! An who counts what each does?

So Natasha, great story, which really gets us not very far for our patients I am afraid. What and how much for each is as hard as ever......! Remember there are risks in undert-reatment etc as well.

David.

I Have The Sense The Next Few Years Are Going To See All Sorts Of Impacts From AI Emerge

These two articles have caught my attention  in the first few days of September.

First we have:

‘I hope I’m wrong’: the co-founder of DeepMind on how AI threatens to reshape life as we know it

David Shariatmadari

From synthetic organisms to killer drones, Mustafa Suleyman talks about the mind-blowing potential of artificial intelligence, and how we can still avoid catastrophe

Sat 2 Sep 2023 18.00 AEST Last modified on Sat 2 Sep 2023 23.23 AEST

Halfway through my interview with the co-founder of DeepMind, the most advanced AI research outfit in the world, I mention that I asked ChatGPT to come up with some questions for him. Mustafa Suleyman is mock-annoyed, because he’s currently developing his own chatbot, called Pi, and says I should have used that. But it was ChatGPT that became the poster child for the new age of artificial intelligence earlier this year, when it showed it could do everything from compose poetry about Love Island in the style of John Donne to devise an itinerary for a minibreak in Lisbon.

The trick hadn’t really worked, or so I thought – ChatGPT’s questions were mostly generic talking points. I’d asked it to try a bit harder. “Certainly, let’s dive into more specific and original questions that can elicit surprising answers from Mustafa Suleyman,” it had trilled. The results still weren’t up to much. Even so, I chuck one at him as he sits in the offices of his startup in Palo Alto on the other end of a video call (he left DeepMind in 2019). “How do you envision AI’s role in supporting mental health care in the future,” I ask – and suddenly, weirdly, I feel as if I’ve got right to the heart of why he does what he does.

“I think that what we haven’t really come to grips with is the impact of … family. Because no matter how rich or poor you are, or which ethnic background you come from, or what your gender is, a kind and supportive family is a huge turbo charge,” he says. “And I think we’re at a moment with the development of AI where we have ways to provide support, encouragement, affirmation, coaching and advice. We’ve basically taken emotional intelligence and distilled it. And I think that is going to unlock the creativity of millions and millions of people for whom that wasn’t available.”

It’s not what I was expecting – AI as BFF – but it’s all the more startling because of what Suleyman has already told me about his background. Born in 1984 in north London to a Syrian father and English mother, he grew up in poverty and then, when he was 16, his parents separated and both moved abroad, leaving him and his little brother to fend for themselves. He later won a place at Oxford to study philosophy and theology, but dropped out after a year.

“I was frustrated with it being very theoretical. I was an entrepreneur at heart. I was running a fruit juice and milkshake stall in Camden Town while I was at Oxford. So I was coming back through the summer to make money because I was completely skint. And I was also doing the charity at the same time.” (Suleyman, although a “strong atheist”, was helping a friend set up the Muslim Youth Helpline, designed to make counselling and support available to young Muslims in a culturally sensitive way.) “So it was kind of three things simultaneously. And it just felt like I was doing this ivory tower thing when really I could be making money and doing good.”

Now 39, he’s still not in touch with his dad, and lives alone in California. Reflecting on what he hopes AI can offer – “a boost to what you can do, the way that you feel about yourself” – he says: “I certainly didn’t have that. And I think that many don’t.” But is interaction with a chatbot a realistic replacement for companionship, support, even love? It’s hard not to find the idea a bit chilling. “It’s not intended to be a substitute. But that doesn’t mean it’s useless. I think it can fill in the gaps where people are lacking. It’s going to be a tool for helping people get stuff done. Right? It’s going to be very practical.”

This is one aspect of the sunlit uplands of AI; the shadow side is largely what preoccupies Suleyman in his new book, written with the researcher Michael Bhaskar and ominously titled The Coming Wave. Even if you have followed debates about the dangers of artificial intelligence, or just seen Black Mirror, it’s a genuinely mind-boggling read, setting out the ineluctable forces soon to completely transform politics, society and even the fabric of life itself over the next decade or two. I tell Suleyman that it’s “sobering”. “I mean, that’s a polite way to put it,” he says. “And, you know, it was hard to write – it was gut wrenching in a way. And it was only because I had time to really reflect during the pandemic that I mustered the courage to make the case. And, obviously, I hope I’m wrong.”

Me too. The Coming Wave distils what is about to happen in a forcefully clear way. AI, Suleyman argues, will rapidly reduce the price of achieving any goal. Its astonishing labour-saving and problem-solving capabilities will be available cheaply and to anyone who wants to use them. He memorably calls this “the plummeting cost of power”. If the printing press allowed ordinary people to own books, and the silicon chip put a computer in every home, AI will democratise simply doing things. So, sure, that means getting a virtual assistant to set up a company for you, or using a swarm of builder bots to throw up an extension. Unfortunately, it also means engineering a run on a bank, or creating a deadly virus using a DNA synthesiser.

The most extraordinary scenarios in the book come from the realm of biotech, which is already undergoing its own transformation thanks to breakthroughs such as Crispr, the gene-editing technology. Here, AI will act as a potent accelerant. Manufactured products, Suleyman tells us, could one day be “grown” from synthetic biological materials rather than assembled, using carbon sucked out of the atmosphere. Not only that, but “organisms will soon be designed and produced with the precision and scale of today’s computer chips and software”. If this sounds fanciful, it’s just a bit further along a trajectory we’ve already embarked on. He points out that companies such as The Odin are already selling home genetic engineering kits including live frogs and crickets for $1,999 (£1,550). You can even buy a salamander bioengineered to express a fluorescent protein for $299 – though when I visit the website, they’re out of stock.

Glow-in-the-dark pets aside, many of these developments hold enormous promise: of curing disease, charting a way through the climate crisis, creating “radical abundance”, as Suleyman puts it. But four aspects of the AI revolution create the potential for catastrophe. First, the likelihood of asymmetric effects. We’re familiar with this in the context of warfare – a rag-tag band of fighters able to hamstring a powerful state using guerrilla tactics. Well, the same principle will apply to bad actors in the age of AI: an anonymous hacker intent on bringing down a healthcare system’s computers, say, or a Unabomber-like figure equipped with poison-tipped drones the size of bees.

Second, there’s what Suleyman terms hyper-evolution: AI is capable of refining design and manufacturing processes, with the improvements compounding after each new iteration. It’s incredibly hard to keep up with this rate of change and make sure safeguards are in place. Lethal threats could emerge and spread before anyone has even clocked them.

Then there’s the fact that AI is “omni use”. Like electricity, it’s a technology that does everything. It will permeate all aspect of our lives because of the benefits it brings, but what enables those benefits also enables harms. The good will be too tempting to forgo, and the bad will come along with it.

Finally, there’s “autonomy”. Unique among technologies so far in human history, AI has the potential to make decisions for itself. Though this may invoke Terminator-style nightmares, autonomy isn’t necessarily bad: autonomous cars are likely to be much safer than ones driven by humans. But what happens when autonomy and hyper-evolution combine? When AI starts to refine itself and head off in new directions on its own? It doesn’t take much imagination to be concerned about that – and yet Suleyman believes the dangers are too often dismissed with the wave of a hand, particularly among the tech elite – a habit he calls pessimism aversion.

He likes to think of himself as someone who confronts problems rather than rationalising them away. After he left Oxford he worked in policy for the then mayor of London Ken Livingstone, before helping NGOs arrive at a common position during the Copenhagen climate summit. It wasn’t until 2010 that he got into AI, creating DeepMind with the coding genius Demis Hassabis, the brother of a school friend, and becoming chief product officer. DeepMind’s mission was to develop artificial general intelligence, AI with human-like adaptability. Four years later it was acquired by Google for £400m, making Suleyman and his colleagues unimaginably rich.

For a while DeepMind’s efforts seemed nerdy and abstract. It tried to beat people at board games. Among its achievements was using AI to thrash the champion Go player Lee Se-dol. But it was always about more than that (Hassabis recently said: “I’ve always been interested in the nature of the universe, nature of reality, consciousness, the meaning of life, all of these big questions. That’s what I wanted to spend my life working on”). In 2020, it unveiled a program that could figure out the structure of proteins, one of the most fiendish problems in science. Painstaking research over many decades had described the shape of about 190,000 of these complex molecules – which include insulin and haemoglobin – information that’s vital for understanding how they function, and coming up with targeted drug treatments. By 2022 DeepMind had worked out another 200m.

The rest is here:

https://www.theguardian.com/books/2023/sep/02/i-hope-im-wrong-the-co-founder-of-deepmind-on-how-ai-threatens-to-reshape-life-as-we-know-it

Also we have:

Sunday, 03 September 2023 22:30

Generative AI set to disrupt 25% of the Australian economy, Deloitte says

By David M Williams

New research by Deloitte indicates more than a quarter of the Australian economy will be rapidly and significantly disrupted by generative AI or almost $600 billion of economic activity.

The findings are part of a new report Generation AI: Ready or not, here we come! co-developed by Deloitte Access Economics and the Deloitte AI Institute to provide insights for Australian C-suite executives on Generative AI (or Gen AI) and its increasing popularity with students and employees. As well as conducting economic research, 2,550 individuals were surveyed including 2,000 current employees from across 18 industries and 550 students.

The report examines which sectors face the biggest and most imminent disruption and who is using Gen AI already. It also shares seven ‘no regret’ moves organisations can make to ensure they disrupt with, rather than get disrupted by Gen AI.

Deloitte Australia CEO Adam Powick said, “Leaders like me need to accept that this technology is real and recognise that our role is to harness and guide the responsible application of generative AI, rather than turning a blind eye or resisting change by banning its use. We need to rapidly educate ourselves on the potential and implications of generative AI in our settings and actively encourage adoption, innovation and the sharing of ideas and concepts across our organisations.”

Deloitte Access Economics Lead Technology Partner John O’Mahony said, “Our inaugural Gen AI survey revealed students are almost twice as likely to use Gen AI than current employees. That’s why we named the report Generation AI: Ready or not, here we come! It speaks volumes – businesses need to prepare for this new generation of AI users – tech-savvy young people who are using Gen AI regularly to study, live and work better. They will no doubt change the way work gets done and test how emerging technology can transform businesses from within.”

Deloitte Australia Lead Strategy & Business Design Partner and AI Institute Lead Dr Kellie Nuttall said: “Individuals naturally embrace tech faster than business – but Gen AI has seen this happen faster than ever before, broadening the gap between a business and its workforce. Yes, this leads to a disruptive threat; but it leads to an even bigger opportunity. Let’s not forget businesses are made up of lots of individuals, each with the power to disrupt.”

Other key report findings include:

• With 58% of students already using Gen AI, this group is almost twice as likely as employees to use this new tech
• 32% of employee survey respondents use some form of Gen AI for work purposes, but about two-thirds of people using it believe their manager doesn’t know about it
• 75% of employees are concerned with Gen AI’s use of personal, confidential or sensitive information
• Australia ranks second-last out of 14 leading economies on its deployment of Gen AI according to one international study
• 26% of the economy will be rapidly disrupted by Gen AI – including finance, ICT and media, professional services, education and wholesale trade
• So far only 9.5% of large Australian businesses (those employing over 200 employees) have officially adopted AI in their business. This drops to 1.4% among all businesses in Australia

Gen AI is exploding around the world and here in Australia. There are now more than 3,000 Gen AI tools available. The amount invested annually in AI by Australian businesses is expected to be seven times what it is today by 2030 and the number of daily users is expected to double in the next five years.

Here is the link:

https://itwire.com/business-it-news/data/generative-ai-set-to-disrupt-25-of-the-australian-economy-deloitte-says.html

As I read through this, and others in the same domain, I really do just wonder how all this will play out and what the impact will be, especially on those whose employment is more labour intensive. We are going to make sure there are few left behind in what will be a dramatic transformation in all aspexts of work (and play), over the coming decade.

The feeling ‘we ain’t seen nothing yet!’ pervades I believe.

David.

 

AusHealthIT Poll Number 713 – Results – 10 September, 2023.

Here are the results of the poll.

Are You Expecting Any Major Positive Impact From The Just New, Just Announced Intergovernmental Agreement On National Digital Health 2023-2027?

Yes                                                                      0 (0%)

No                                                                      35 (100%)

I Have No Idea                                                   0 (0%)

Total No. Of Votes: 35

A totally clear outcome! Seems there is zero faith in Government making any impact!

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 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.

 

Technological Progress Is Really Off And Rolling At An Amazing Pace!

 

Last week I had the misfortune to have what I have been led to believe was a small myocardial infarction, which I am happy to report I have apparently survived.

In true doctor fashion I had been ignoring some minor chest discomfort until last Sunday week when a doctor friend insisted I go an be assessed at the local teaching hospital (RNSH) at which I had worked decades ago. My, have things changed!

Once I confessed to the emergency doctor that I had some chest discomfort things rolled on fast.

From 6:30pm to 7:30 I was examined, blood tests done and some potent analgesics were given while a cardiograph was done and assessed. – till now much as I expected might happen.

Then things ramped up a notch as I swiftly found myself in a catheter lab surrounded by huge TV screens as various lines were inserted into arteries and veins, and a team of experts assembled. (In the dark, surrounded by screens, the staff looked quite ghost-like!)

Despite the powerful ‘happy juice’ I recognised the screens were now filled with images of my heart and my coronary arteries – with the right one being apparently blocked part way down.

No worries – soon artery was dilated and a stent (tiny tube) was put where the block has been.

More pictures to ensure all of the heart was now supplied with blood.

An hour later (9:30) back in my more comfortable bed – the others in the cath are bloody hard – and very comfortable with no chest pain and the knowledge that all of my heart now has plenty of blood to keep on pumping with!

48 hours later I has kicked out of hospital, with some new tablets, to check in with my cardiologist in 4-6 weeks and to stay in touch with my GP!

So here I type to you – gentle reader – amazed at the tech in the catheter lab, the catheters and the stents – all of which are so new and so powerful in the hands of our experts we are really lucky. We all know just how much work has gone into developing all this and proving it up, but I reckon it was worth it.

All this ignores  the amazing advances I witnessed during my stay in the use of ultrasound to image almost anything from eyes to prostates - just saying nothing of MRI and all the other innovations!

Well, I for one, is grateful, as is my 75 year old ticker, for all these advances! They all really seem to work and keep us going! (I remember the days when the "heart attack" was 2 weeks rest and 2 weeks light duties! - times have really changed.)

Thanks to all for the apparent miracles!

David.

 

I Suppose This Is Big News – But It May Just Be Another Damp Squid!

This appeared last week:

30 August 2023

Lift-off: governments sign digital health deal

Government Interoperability

By Cate Swannell

Reform of Australia’s healthcare system is on the way. See what's in the fine print.

---

The new Intergovernmental Agreement on National Digital Health 2023-2027 has been signed by the Commonwealth and all eight states and territories, and quietly released into the world. 

Federal Health Minister Mark Butler was the first to sign, on 31 May, and WA’s Minister for Health Amber-Jade Sanderson was the last, on 26 July. This locks every government into a commitment to make interoperability across sectors and healthcare jurisdictions a reality. 

The signatories have committed to an overall financial contribution of $64.5 million per annum split via a cost-shared formula agreed to by the Health Chief Executives Forum in 2022-23. 

The Commonwealth will bear 50% of the cost, currently $32.25 million per annum, with the rest split between New South Wales (15.71%), Victoria (12.73%), Queensland (10.22%), WA (5.36%), South Australia (3.51%), Tasmania (1.11%), the ACT (0.88%) and the Northern Territory (0.48%).  

Funding for the ADHA and the operation of the MHR will be met by the Commonwealth.  

The parties to the agreement are now formally committed to developing and providing the following services: 

• Healthcare Identifiers Service – a national system that assigns a unique 16-digit number to people, healthcare providers and healthcare organisations, allowing electronic systems across the national healthcare system to identify them correctly, and associate information with the right patient and provider at the point of care. The Healthcare Identifiers Act 2010 and the Healthcare Identifiers Regulations 2020 set the framework and rules for the HI Service. 
• The modernisation of My Health Record. 
• Implementation of the National Healthcare Interoperability Plan. 
• Updating and modernising the National Health Services Directory 

• Standards and informatics – the Australian Digital Health Agency’s work on standards and informatics for key products and services to support interoperability, connectivity and solutions for information exchange’. 
• ePrescribing comprised of three software components: practice software used to generate the prescription; prescription delivery service (PDS), which incorporates a prescription exchange (PE) and holds the prescription; and pharmacy software that retrieves the e-prescription and is used to dispense the prescription. 
• Real Time Prescription Monitoring – a nationally implemented system designed to monitor the prescribing and dispensing of controlled medicines with the aim of reducing their misuse in Australia. 
• National Authentication Service for Health – makes it possible for healthcare providers and supporting organisations to securely access and exchange health information, using public key infrastructure certificates. 
• National Clinical Terminology Service – easier, consistent and more meaningful use of clinical terminologies in healthcare. It is responsible for managing, developing and distributing national clinical terminologies and related tools and services to the Australian healthcare community to support their adoption, use and maintenance of terminology. 
• New standard-related services. 
• Healthcare Information Provider Service – a middleware product offering seamless integration with systems including patient administration systems, clinical information systems; laboratory and radiology information systems; aimed primarily at supporting large-scale digital health environments typically found in organisations such as hospitals and diagnostic service providers. 
• National Secure Messaging Network – will define a national standard for a messaging solution that can be implemented by clinical information and secure messaging systems to enable secure, reliable and interoperable exchange of messages including text-only messages, stand-alone clinical documents or messages containing text and clinical documents between Australian healthcare providers. 
• Provider Connect Australia connects healthcare organisations with their business partners (such as Primary Health Networks, Medicare and health services directories) to streamline updates of the services they provide and the practitioners providing them. 

Three specific delivery partners have also been “invited to participate in the governance arrangements to support collaboration and implementation of the Agreement” – the Australian Digital Health Agency, Services Australia, and Healthdirect Australia. Other delivery partners, as identified by the parties to the agreement, can also be invited to participate. 

More here:

https://www.medicalrepublic.com.au/lift-off-governments-sign-digital-health-deal/97850

I Have to say this seems like a pretty big agenda and a look back a few years hence will be interesting to see how much progress has been made.

It seems to me there is a layer of practicality and hard work here which suggests those doing the work will need all the time they are allocated!

It needs to be pointed out that there is very little new here and what is evident is continuation of work, some of which has been underway for many years. The NASH has been evolving and emerging since Adam was a nipper in short pants!

Does anyone actually remember one of these actually reaching finality?

David.

 

AusHealthIT Poll Number 712 – Results – 03 September, 2023.

Here are the results of the poll.

Should Australia Be Legislating Against Disinformation / Misinformation Or Trusting Citizens To Know / Tell The Difference Between Truth And Falsehood?

Yes – We Need Laws                                                     21 (54%)

No – Rely On People Who Know The Difference      15 (41%)

The Answer Is Far Above My Pay Grade                       2 (5%)

Total No. Of Votes: 38

A mixed outcome suggesting that a small majority of readers feel laws are needed but many are not sure!

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

A good number of votes. But also a rather mixed outcome. 

2 of 38 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.