This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
or
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
The Optus outage cannot be considered a “rare occasion”. Over the past few years, we have witnessed several major outages across the telco networks, making it imperative for us to prepare ourselves for such events. But we have ignored the warnings.
Today, more than 99 per cent of telecoms traffic comprises data. Virtually every organisation and nearly all Australians rely on data services through their phones and fixed-line connections. As we’ve observed, an outage of this magnitude can cause significant disruptions in the economy and people’s private lives. In this case, even the triple-zero emergency service on landlines was disconnected.
These outages are of national interest, and thus, we require national solutions to mitigate the considerable fallout from such events.
What occurred at Optus was likely to have been a software problem. While such issues occur more frequently, most systems recover in seconds or minutes, resulting in minimal disruption. However, in some cases, as appears to have happened this time, a critical fault during a software update can cascade through the computer systems that underpin the network’s operation.
Unravelling, fixing and bringing all these different systems back online can take hours, and sometimes even days. Moreover, not all systems are likely to come back online simultaneously; they need to be restarted one by one, further extending the recovery time.
In the end, this is an infrastructure problem.
There are essentially two long-term solutions. The first pertains to the individual networks of the operators. It is unacceptable for there to be a single point of failure in a network that can bring down an entire country, or as seen before, the entire east coast. With more than 100 years of telecoms experience and a wealth of engineering knowledge and skills, networks can be designed to eliminate single points of failure.
In the event of a disruption, traffic should be rerouted through other network systems. In other words, there should be duplicated, unconnected systems, whereby one can take over from the other in emergencies.
The second solution involves the combined telecoms infrastructure in Australia. In case of an emergency, there should be a “gateway” facility connecting the networks, allowing them to take over traffic from one another. In the case of mobile networks, I have advocated for this for more than 20 years: this solution is called roaming.
After government pressure, an announcement was finally made last week that roaming via mobile networks is now possible in emergencies, such as bushfires or floods. It’s technically feasible, and we should explore its use in other emergency scenarios, such as the one we’ve experienced on Wednesday. So, for example, if you’re an Optus customer and the Optus network is down, your phone finds the Telstra network.
The reason for the delay in implementing this in Australia is the resistance from telco companies. They view the size of their networks as a competitive advantage and question why they should allow others to use their network.
The problem is that these networks aren’t merely commercial operations; they are vital infrastructure for our society and economy. Protecting the national interest in the face of serious network failures is paramount. Implementing such solutions requires the government’s commitment and the regulatory authority’s influence.
However, there is also a responsibility for users, both organisations and individuals, to acknowledge that such disruptions will happen, and they should assess their vulnerability. For example, if a company’s sales or financial systems shut down, or its transport systems don’t work, or its emergency operations fail, it must consider the need for its own solutions. …..
Paul Budde is a leading telecommunications management and business consultant.
Paul really says it all and in essence the story is that it is possible to get to 100% up time but you have to pay for it with pretty full provisioning etc. or you can have the government put in place forced sharing in the event of outages! It really is silly that an outage can persist while excess capacity exists just a switch away!!!!!
With so many problems the Government can’t fix the issue but with this issue there is a simple regulatory fix to get basically 100% up time for everybody. Government should just get on and legislate emergency sharing when needed!
How many decades will it take to actually do it do you reckon?
Asteroid
dust caused winter that killed dinosaurs: study
By Daniel Lawler
AFP
Updated 5:24PM
October 31, 2023, First published at 2:12PM October 31, 2023
About 66 million
years ago, an asteroid bigger than Mt Everest smashed into Earth, killing off
three-quarters of all life on the planet, including the dinosaurs.
This much we know.
But exactly how the
impact of the asteroid Chicxulub caused all those animals to become extinct has
remained a matter of debate.
The leading theory
recently has been that sulphur from the asteroid’s impact – or soot from
global bushfires it sparked – blocked out the sky and plunged the world into a
long, dark winter, killing all but the lucky few.
But new research
based on particles found at a key fossil site reasserted an earlier hypothesis:
that the winter was caused by dust kicked up by the asteroid.
Fine silicate dust
from pulverised rock would have stayed in the atmosphere for 15 years, dropping
global temperatures up to 15C, researchers report in the journal Nature
Geoscience.
Father-and-son
scientists Luis and Walter Alvarez in 1980 first proposed that the dinosaurs
were killed off by an asteroid strike that shrouded the world in dust. Their
claim was initially met with some scepticism, until a decade later when the
massive crater of Chicxulub was found in the Yucatan Peninsula on the Gulf of
Mexico.
Now, scientists
largely agree that Chicxulub was to blame. But the idea that it was sulphur,
rather than dust, that caused the impact winter has become “very popular” in
recent years, Ozgur Karatekin, a researcher at the Royal Observatory of
Belgium, said.
Dr Karatekin, a
co-author of the study, said the international team of researchers was able to
measure dust particles thought to be from right after the asteroid struck. The
particles were found at the Tanis fossil site in North Dakota. Though 3000km
away from the crater, the site has preserved several remarkable finds believed
to be dated from directly after the asteroid impact in sediment layers of an
ancient lake.
The dust particles
were between 0.8 to 8.0 micrometres – just the right size to stick around in
the atmosphere for up to 15 years.
Out of all the
material that was shot into the atmosphere by the asteroid, the researchers
estimated that it was 75 per cent dust, 24 per cent sulphur and 1 per cent
soot.
I do feel rather sorry for all our old mates but something
had to give our ancestors a chance to dominate. I wonder what will eventually
come along to wipe us off and give another species a chance?
Cybersecurity researchers
are sounding an alarm about the hacking community’s answer to ChatGPT, a new
generative AI tool dubbed WormGPT, which is being used to create sophisticated
attacks on Australian businesses.
WormGPT is being
described as similar to ChatGPT, but with no ethical boundaries or limitations,
and researchers say hundreds of customers have already paid for access to the
tool on the dark web.
A 23-year-old
Portuguese programmer, “Last”, describes himself as the creator of WormGPT, and
pitches it as a piece of technology that “lets you do all sorts of illegal
stuff and easily sell it online in the future”.
“Everything
blackhat related that you can think of can be done with WormGPT, allowing
anyone access to malicious activity without ever leaving the comfort of their
home,” Last said in an online post on the dark web, in which he sold access to
the tool.
While businesses
are still excited about the productivity benefits generative AI can bring,
industry figures are warning that the new technology is set to unleash a wave
of innovative cyberattacks against businesses and individuals.
Patrick Butler,
managing partner at Australian cyber firm Tesserent, said that malicious
parties were signing up to criminal forums to rent access to WormGPT and using
it to craft convincing phishing emails in different languages, which then
allowed them to commit identity theft and compromise systems access.
While phishing
emails were often characterised by poor spelling or grammar, generative AI
could create emails with impeccable English, Butler said, and tools such as
WormGPT could be used by attackers with limited technical skills.
“We’re seeing
malicious generative AI being used to create new malware variants that are more
difficult for some traditional tools to detect,” Butler said. “These platforms
can even assist criminals in exploiting published vulnerabilities.
“While some
legitimate AI tools can be used to conduct software code reviews, developers
should be discouraged from doing this as their code may be used to train AI
models that criminals gain access to, giving them further intelligence into
organisational systems.”
Butler said the
number of different threat actors would likely escalate as generative AI made
it easier for criminals to access cyberattack tools. He said the Tesserent
Security Operations Centre had already found an increase in phishing campaigns
and malicious email activities targeting Australian organisations, particularly
in the months following the emergence of WormGPT and similar tools.
There are now at
least six different generative AI tools available to rent or purchase on the
dark web, including FraudGPT, EvilGPT, DarkBard, WolfGPT, XXXGPT and WormGPT
with more appearing, according to Butler.
“While most lack
the large capacity of public-facing tools like ChatGPT and Bard, they are
proliferating quickly, which can make them harder to find and take down.”
Scott Jarkoff,
director of intelligence strategy, APJ & META, at CrowdStrike, said
cybersecurity activity had risen amid the conflict in the Middle East, meaning
businesses should be even more vigilant than usual.
He said hacking
groups from the so-called “big four” of Russia, China, North Korea and Iran had
been using generative AI tools to craft attacks in perfect English.
“The Israel-Hamas
conflict is now giving criminals a perfect lure to say ‘hey, visit this site to
donate to whichever cause you believe in’, and that means it’s now more
important that everyone takes cybersecurity more seriously,” he said.
“We all take safety
seriously, why do we not take cyber seriously? We’ve got to get to a point
where cyber hygiene is built into everyone’s muscle memory, just as safety is
built into everyone’s muscle memory.”
Generative AI is
not only being used to create realistic phishing emails. It’s also
supercharging social engineering, with bad actors using AI to create realistic
fake accounts to spread misinformation, according to Dan Schiappa, chief
product officer at cyber vendor Arctic Wolf.
Ms Smith’s story began around a year ago when she developed a UTI. Feeling the
‘familiar sting’ she simply jumped online, paid her $17.50, and a script soon
arrived in the mail.
‘I dropped into my local chemist on the way to work and was only asked if I’d
used the antibiotic before and whether I needed to be instructed on its use,’
she said.
‘I declined and off I went thinking how quick and easy the process was and how
I’d use it again.’
But after a few days, Ms Smith could not keep warm – she was so cold her lips
were turning blue.
She went to the emergency department but after an eight-hour wait and multiple
blood tests, was sent home.
‘Just 24 hours later, after I experienced rigours, a fever and hallucinations
of my deceased nanna, pop and first boyfriend, my housemate rushed me to the
emergency room where I was told I was turning septic,’ she said.
‘The infection had spread to my blood, and I was admitted to hospital on the
spot.
‘Before I was discharged a doctor explained the bug in my system was E. coli, a
common cause of UTIs which is resistant to the antibiotic I was given.’
One year on and Ms Smith wrote she is only now starting to bounce back, and has
vowed never to use an online prescription service again.
‘Since my ordeal, I’ve spoken to several other women who have been through the
same thing as me, or know someone who has,’ she said.
‘My experience has stopped me from using online prescription services
altogether.
‘These days, if I’m feeling unwell, I book into my local GP and take the time
to go over my medical history.’
Ms Smith’s terrifying tale comes amid a rise in telehealth and online
prescribing services.
The new Guidelines:
Telehealth consultations with patients took effect in September, and
state ‘prescribing or providing healthcare for a patient without a real-time
direct consultation, whether in-person, via video or telephone, is not good
practice and is not supported by the Board’.
RACGP Expert Committee – Quality Care member Associate Professor Magdalena
Simonis told newsGP Ms Smith’s story is proof of how ‘inefficient and
potentially dangerous’ online prescribing can be.
‘Online prescribing is not as safe a method of treating medical problems as
using telehealth or face to face with the patient’s regular GP,’ she said.
‘Online tick-box prescribing without a real-time, patient–doctor consultation
fragments care and is not founded on the basis of an ongoing therapeutic
relationship, and the flow on from this is that it is not good medical
practice.
‘It is a warning to policymakers and politicians that fragmentation of care
which does not take into account the differential diagnoses, the patient’s
response to the treatment, and the need to review the patient by an expert in
health such as a GP, poses a risk.’
It said telehealth must be of the highest quality, led by a GP, and thought of
as complementary to face-to-face care, rather than a substitute.
Above all, it should be delivered by a trained healthcare professional, it
said.
Associate Professor Simonis said the verbal and nonverbal exchange which
occurs between a patient and a doctor who is familiar with them will often
provide key information about the complaint.
‘It is not unusual for a person to associate their symptoms with what they
already have had in the past, even if there might be a difference,’ she said.
‘UTIs are a classic example of this, where a patient might have dysuria and
frequency but in fact has an STI or an undiagnosed pregnancy.
‘The need to come back or call for review “if things don’t improve, or new
symptoms develop”, is key to preventing such unfortunate and potentially lethal
outcomes.’ More here:
Given this article comes from the GP College it is easy to
suggest they are ‘talking their own book’ but they do have a point.
There is a reason one spends many years to becoming a doctor
so one can prescribe and that it that you understand the risks of just this sort
of scenario where the patient is not seen initially and then followed up while
on the treatment!
As my old professor used to say “You rarely get into clinical
trouble if you actually see the patient”!
A safe health system has necessary costs and protocols for a
reason and if these are ignored problem will ensue.
I am not sure we
have the on-line prescribing rules and regulations fully right just yet and I
am sympathetic to calls for regular reviews of how things are working along
with an effective system to identify when things go wrong.
This popped up a few days ago as emblematic of the trend:
Summit warns about dangers of artificial intelligence influence
By Jacquelin Magnay
5:41PM November 2, 2023
Industry and Science Minister Ed Husic has warned artificial intelligence-generated misinformation is “the big thing” that could influence the way people make future decisions, including at elections.
He said governments had adopted a “comfortable, helpful helplessness” when it comes to technology because it was previously “all too hard”.
But he warned: “I think there’s a dawning realisation on governments, you can’t have that (attitude), you need to shake that off.”
“From AI-enabled cyber attacks at a scale beyond anything we have seen before to AI-formulated bioweapons that could endanger the lives of millions of people. These threats are often referred to as the ‘existential threats of AI’ because of course they could endanger the very existence of humanity.
“These threats without question are profound and they demand global action. But let us be clear, there are additional threats that also demand our action.”
She said the US situation concerning voluntary commitments with technology companies were an “initial step’’, saying there will be more to come “because as history has shown in the absence of regulation and strong government oversight, some technology companies choose to prioritise profit over the wellbeing of their customers”.
He said disinformation would guide the way people make decisions, not just governments, and impact on the broader public reaction to things that might influence the way governments or businesses respond.
He said Australia was looking to the AI policy models proposed by others, such as the United States, the European Union and the United Kingdom, because going one-out was too difficult.
On Wednesday, the summit issued the Bletchley declaration, signed by 28 countries,which recognised that there was potential for “serious, even catastrophic, harm, either deliberate or unintentional, stemming from the most significant capabilities of these AI models”.
The declaration, signed by Australia, said: “Substantial risks may arise from potential intentional misuse or unintended issues of control relating to alignment with human intent. These issues are in part because those capabilities are not fully understood and are therefore hard to predict. We are especially concerned by such risks in domains such as cybersecurity and biotechnology, as well as where frontier AI systems may amplify risks such as disinformation.”
Musk: ‘Hope for the best but prepare for the worst’ with AI
I think this is very important stuff but that it is important to preserve perspective as we navigate a very interesting near future,
My perspective is that much of the work in AI is really fascinating and potentially very impactful but that right now we have a world grappling with a number of equally complex issues cantered around poverty, war, mistrust and hate etc. that we need to navigate and that having the necessary bandwidth to handle it all is a rather daunting ask!
It seems at present we are just managing to ‘walk and chew gum’, as they say, but I wonder just how much energy we need to allocate to the current crop of apparently existential threats which desire our attention to keep the balls safely in the air! More than we have I suspect,,,,
AI has the potential to solve many problems and we need to be sure we direct it onto the important biggies as best we can!
As I, and others, often say ‘I am just a very old man on many drugs’ but I hope I can last long enough to see at least the outline of where this coming revolution is leading because matter it really does IMVHO and I am sure it will be very interesting indeed!
Do You Believe Implementation Of Artificial Intelligence Technologies Will
Significantly Reduce The Clinical Documentation Workload Over The Next 5-10 Years?
Yes15 (45%)
No18 (55%)
I Have no Idea0 (0%)
Total No. Of Votes: 33
A mixed outcome with a bare
majority feeling AI will reduce the workload a little.
Any insights on the poll are
welcome, as a comment, as usual!
A fair number of votes. But
also a very vague outcome!
0 of 33 who answered the poll
admitted to not being sure about the answer to the question!
Again, many, many thanks to
all those very few who voted!
