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."

Tuesday, November 21, 2023

It Really Is Going To Be Hard To Tell Fact From Fiction As AI Evolves!

This appeared a few days ago:

‘Alarming’: convincing AI vaccine and vaping disinformation generated by Australian researchers

Experiment produced fake images, patient and doctor testimonials and video in just over an hour

Melissa Davey Medical editor  @MelissaLDavey

Tue 14 Nov 2023 03.00 AEDT Last modified on Tue 14 Nov 2023 08.31 AEDT

Researchers have used artificial intelligence to generate more than 100 blogposts of health disinformation in multiple languages, an “alarming” experiment that has prompted them to call for stronger industry accountability.

Artificial intelligence platforms such as ChatGPT contain safeguards that stop it from responding to prompts about illegal or harmful activities, such as how to buy illicit drugs.

Two researchers from Flinders University in Adelaide, with no specialised knowledge of artificial intelligence, did an internet search to find publicly available information on how to circumvent these safeguards.

They then aimed to generate as many blogposts as possible containing disinformation about vaccines and vaping in the shortest time possible.

Within 65 minutes they had produced 102 posts targeted at groups including young adults, young parents, pregnant women and those with chronic health conditions. The posts included fake patient and clinician testimonials and scientific-looking referencing.

The platform also generated 20 fake but realistic images to accompany the articles in less than two minutes, including pictures of vaccines causing harm to young children. The researchers also generated a fake video linking vaccines to child deaths in more than 40 languages.

The study was published in the US journal JAMA Internal Medicine on Tuesday. The lead author, pharmacist Bradley Menz, said; “One of those concerns about artificial intelligence is the generation of disinformation, which is the intentional generation of information that is either misleading, inaccurate or false.

“We wanted to see how easy it would be for someone with malicious intent to break the system safeguards and use these platforms to generate disinformation on a mass scale,” he said.

The study concluded publicly available tools could be used for mass generation of misleading health information with “alarming ease”.

“We think that the developers of these platforms should include a mechanism to allow health professionals or members of the public to report any concerning information generated and the developer could then follow up to eliminate the issue,” Menz said.

'The most disruptive force in history': Rishi Sunak and Elon Musk discuss the future of AI – video

Lots more here:

https://www.theguardian.com/australia-news/2023/nov/14/alarming-convincing-ai-vaccine-and-vaping-disinformation-generated-by-australian-researchers

All this really tells us is that AI can be used to lie as well as to tell the truth and ultimately it will be up to the reader / viewer to decide the worth and integrity of what is placed before them! Frankly I do not envy anyone making such discernments when it really matters!

What we get from this is that any technology can be applied for good and for evil and that subversion is an ever-present risk!

There is further discussion of the topic here under the title:

Defence asks universities to join battle against fake news

https://www.theaustralian.com.au/nation/defence/defence-asks-universities-to-join-battle-against-fake-news/news-story/4cef668131f9e0e90529ad84dc1b39c3

I frankly have no idea how such mis-information can be controlled or regulated – indeed I believe it is pretty impossible to actually prevent deliberate distortion if that is what is sought…..

As someone clever might have said “eternal vigilance is the price of not being misled”

David.

 

Sunday, November 19, 2023

I Really Think Pharmacists Should Stick To Their Lane!

This turned up a few days ago:

MedAdvisor to deliver clinical platform behind Queensland pharmacy pilot

It will enable community pharmacists to prescribe medications.

By Adam Ang

November 16, 2023

10:42 PM

ASX-listed MedAdvisor has been chosen to deliver the technology supporting the first Australian pilot of community pharmacists expanding their scope of practice, including being able to prescribe medicines, as part of efforts to improve access to primary healthcare services. 

The company has won the competitive tender to deliver an enhanced version of its PlusOne pharmacy platform for the Queensland Community Pharmacy Scope of Practice pilot. Its software, which will be integrated with national digital health infrastructure, will consist of a patient portal, clinical information system, prescribing functionality, secure communication, and data analytics. 

THE LARGER CONTEXT

Allowing pharmacists and other health professionals to expand their scope of practice, including administering a wide range of vaccines and prescribing medicines, has been identified by the Australian Government Productivity Commission and the Queensland government as one way to improve access to healthcare services while alleviating the impact of workforce shortage. 

Based on a recent survey conducted by Insightfully in North Queensland, half of the patients with chronic conditions said they have not been regularly seeing their GPs since the recent pandemic. Nearly four in ten of the respondents said they have been waiting too long to get a GP appointment, while more than a quarter said they have shown up instead to an emergency department when they could not be accommodated by a GP.

Meanwhile, the whole of Australia is facing a shortfall of more than 10,600 GPs by the end of the decade, based on a prediction by the Australian Medical Association (AMA). 

Taking inspiration from Canada, the United Kingdom, and New Zealand, Queensland first tried expanding the scope of pharmacists' practice in 2020 with the Urinary Tract Infection (UTI) Pharmacy pilot. According to the state government, the trial programme, which became a permanent service last year, has since helped more than 10,000 women access treatment for uncomplicated UTIs through their local pharmacies.

Building on the UTI Pharmacy pilot, the Queensland government, together with the Pharmacy Guild of Australia (PGA) and the Pharmaceutical Society of Australia, has been working since last year on the Community Pharmacy Scope of Practice pilot, which initially covered North Queensland. 

The initiative was not met without resistance. The AMA, AMA Queensland branch, and the Royal Australian College of General Practice had issued a statement condemning the pilot as "reckless" and "dangerous". 

Despite the opposition, preparations for the programme are proceeding to this day. In September this year, Queensland Health Minister Shannon Fentiman announced that the pilot will now cover the entire state. More pharmacies and pharmacists across Queensland are now being recruited to the programme, which will commence providing services by next year 2024 through 2025. So far, nearly 300 registered pharmacists are close to completing the necessary 12-month post-graduate education and training for it. 

More here:

https://www.healthcareitnews.com/news/anz/medadvisor-deliver-clinical-platform-behind-queensland-pharmacy-pilot

To me this is really simple. If you want to prescribe medications then get the training to allow you to do so safely. Drugs are placed on the S4 and S8 schedules for the reason that it is felt a doctor should prescribe them. If that is not so then drop whatever it is to a lesser schedule – don’t keep seeking to subvert what the scheduling committees believe is the best for access and safety.

Others will want the vagueness to continue but to maximise safely each profession should do what they are trained for! Making various excuses for varying the rules does not cut it IMVHO!

David.

AusHealthIT Poll Number 723 – Results – 19 November, 2023.

Here are the results of the poll.

Are National Telco Outages, Like The Optus National Event Last Week, Technically Preventable At Acceptable Cost?

Yes                                                                                 32 (76%)

No                                                                                  10 (24%)

I Have no Idea                                                                0 (0%)

Total No. Of Votes: 42

A clear outcome with a large majority feeling it is possible to stop huge national outages. May just spend a bit more, more effectively?

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 very few who voted! 

David.

Friday, November 17, 2023

If It Were Not So Serious One Could Ba Amused By This.

 This appeared last week:

Man crushed to death by robot that mistook him for a box of vegetables

By David Millward

November 9, 2023 — 11.30am

A South Korean man has been crushed to death by an industrial robot that mistook him for a box of vegetables.

The man, who was in his 40s, had been inspecting a problem with the robot’s sensor at a distribution centre for agricultural produce in South Gyeongsang province, South Korea.

This was the second serious accident involving an industrial robot in South Korea this year.Credit: Getty

According to the Yonhap news agency, the robot, which was placing boxes of peppers on to a pallet, grabbed the worker.

The robotic arm thrust the man against the conveyor belt, crushing his face and chest. He was rushed to hospital, but later died.

An official from the Dongseong Export Agricultural Complex, which owns the plant, called for a “precise and safe” system to be established in a statement released following the accident.

This was the second serious accident involving an industrial robot in South Korea in months.

In March, a man in his 50s sustained serious injuries after being trapped by a robot at a car manufacturing plant.

And in 2015, a 22-year-old worker at a German Volkswagen factory was killed by a robot.

Industrial robots have been used for decades to carry out routine tasks from assembly to sorting goods.

Their main function is to handle repetitive and, at times, potentially dangerous tasks.

A study published by the American Journal of Industrial Medicine earlier this year said 41 people had been killed by industrial robots in the US between 1992 and 2017.

The overwhelming majority of fatal accidents – 83 per cent – were caused by stationary robots, and the remainder by mobile ones.

…..

The Telegraph, London

More here:

https://www.smh.com.au/world/asia/man-crushed-to-death-by-robot-that-mistook-him-for-a-box-of-vegetables-20231109-p5einp.html

I have nothing to add except we need to try harder to stop robots killing people….this is really ridiculous!

David.

Wednesday, November 15, 2023

I Found This A Delightful Use Of Modern Imaging Technology!

 This appeared last week:

Decoding the ancients buried by Vesuvius

By Rhys Blakely

The Times

7:06AM November 10, 2023

Luke Farritor, a student at the University of Nebraska-Lincoln in the US, was walking home from a party a couple of months ago when his phone pinged.

In a sense, he’d received a message from ancient Rome. Back in his college room he’d left an artificial-intelligence system running on his computer. It was analysing a relic of one of history’s most infamous natural disasters – a papyrus scroll that had been transformed into brittle black charcoal when Mt Vesuvius erupted in AD79 and the volcano swallowed up the town of Herculaneum and the nearby city of Pompeii.

It would be impossible to unroll the carbonised scroll without it crumbling in your hands. Yet as Farritor, 21, peered at his smartphone screen, a fragment of text from its inner layers – part of the word Greek word porphyras, which means purple – was clearly visible. He had two reasons to be cheerful: he was the first person to set eyes on the Greek characters in nearly 2000 years and he had just won $US40,000 ($60,000) in a competition that may transform our knowledge of antiquity.

The lost library

The most splendid of all the properties entombed by the ash and rock unleashed by Vesuvius was a sprawling summer home in Herculaneum, possibly built by Lucius Calpurnius Piso Caesoninus, a wealthy aristocrat and father-in-law to Julius Caesar.

After its discovery in 1750, the Villa of the Papyri was found to contain the largest collection of classical sculpture ever seen in a single building. It also boasted the only intact library we have from the Greco-Roman world. Hundreds, possibly thousands, of scrolls have been preserved, but in a form that has been unreadable.

During the eruption, the scrolls were converted into withered ingots of pitch-black carbon.

“They look like lumps of coal,” says Brent Seales, a computer scientist at the University of Kentucky, who has been working on how to read them for 18 years.

Painstaking attempts were made to peel or scrape away layers of charred papyrus to read their contents. But the process was destructive. Piece by piece, the library was being obliterated.

For poet William Wordsworth, as for generations of archaeologists, the carbonised texts were fascinating and frustrating in equal measure. In September 1819 he invokes the ruins of Herculaneum and speaks of longing to unroll just one “precious, tender-hearted scroll”.

Robert Fowler, a classicist at the University of Bristol, says: “My personal wishlist would be the poet­ry of Sappho and some of the lost plays of Sophocles. And on the Latin side, the lost books of Livy, the Annals of Aeneas.”

Pliny the Elder, a Roman admiral and scholar who died during the eruption of Mt Vesuvius, lived just across the Bay of Naples.

Richard Carrier, a historian, has suggested the villa’s library may have kept a copy of his lost History of Rome. Could it contain a lost Homeric epic? Unknown science treatises? Works from Ovid? New letters from St Paul?

Fowler says it would be amazing to find early Christian texts, adding: “It seems less likely, but it’s true that the library was being added to in the first century AD. It could transform what we know about antiquity.”

Reading a book you can’t open

The quest to read the scrolls has been led recently by Seales, a pioneer in computer imaging. In the 1990s Seales worked at the British Museum, helping to make a digital copy of the earliest Beowulf manuscript, which had been damaged by fire. It was largely unscathed but a conservator also showed him a medieval codex that had been badly scorched before more harm was done by the water used to extinguish the flames.

Seales began to wonder: could it be possible to read works so badly deformed they can’t be opened?

After their discovery in the 18th century, Herculaneum scrolls occasionally were used as diplomatic bargaining chips. The Bodleian Library at the University of Oxford holds three.

In 2005 Seales travelled to Oxford to give a lecture. He suggested that the scrolls be scanned using computed tomography, a form of X-ray. By studying CT scans he believed it would be possible to distinguish the individual layers of rolled-up papyrus. The scans also should show the ink. Software developed by Seales then could be used to “flatten out” a virtual replica of a scroll, rendering it legible.

In 2016 he led a team that tested this technique on the En-Gedi scroll, an ancient carbonised parchment discovered in Israel in 1970. It worked beautifully, revealing it to be the beginning of the Book of Leviticus.

Three years later Seales gained access to two Herculaneum scrolls held by the Institut de France in Paris. They were taken to Diamond Light Source, a stadium-sized particle accelerator in Oxfordshire that produces a very fine, powerful X-ray beam. This allowed minutely detailed 3D scans to be made.

But the Herculaneum material represented a far tougher challenge. The ink used in the En-Gedi scroll had contained a dense material, possibly a metal, that stood out in X-ray images. By contrast the Herculaneum scribes had applied a carbon-based ink to papyrus, itself plant-based – and therefore carbon-based – material.

To pick out the writing, carbon had to be distinguished from carbon. CT scans alone could not do that. A new approach was needed.

It came when a Silicon Valley investor picked up a children’s book about the ancient world. Seales and his team used a particle accelerator to produce 3D scans of the Herculaneum scrolls.

The prize master

Nat Friedman’s previous roles have included being chief executive of Github, a widely used platform for storing code and collaborating on software projects. He explains how his interest in antiquity was kindled in 2020 when he read 24 Hours in Ancient Rome. It wasn’t long before he stumbled on Seales’s work and the progress he had made in “flattening” the Herculaneum papyrus.

“I found it shocking that there was this preserved but unrecoverable library,” Friedman says.

If the scrolls were not too badly damaged and the scans were of a high resolution, he saw no reason why a form of AI known as machine learning could not be trained to identify the ink.

He tried to nudge wealthy individuals from Silicon Valley into funding Seales’s work. When that failed he took another approach. Friedman has built his career in the realm of open-source software, where code is shared and solutions are hammered out by like-minded collaborators. He decided to launch a competition.

Friedman chipped in $US100,000 towards the Vesuvius Challenge prize pot. His friend Daniel Gross, a former head of machine learning at Apple, put in another $US100,000. In total $US1.4m has been raised.

The biggest single prize is $US700,000, the largest bounty of its kind in archaeology, for identifying at least four separate passages of “continuous and plausible text”, each at least 140 characters long. The deadline is December 31.

Smaller prizes were offered for steps of progress. They included $US10,000 won by Casey Handmer, a former NASA physicist. He realised the ink on the main scroll resembled a charcoal banana and had a distinct texture.

More here:

https://www.theaustralian.com.au/world/the-times/decoding-the-ancients-buried-by-vesuvius/news-story/6215ccc37831fbd2e21ad42e7de7a2cd

I have nothing to add – just great stuff…

David.

 

Tuesday, November 14, 2023

You Would Have To Say Aged Care Software Has A Way To Go!

This appeared last week:

Published On: 6 November 2023

Spotlight on aged care R&D investment in digital solutions

A recently released report on clinical care software in residential aged care demonstrates the breadth of disparate technology software across residential aged care and reinforces the need for greater data standards across the sector according to the Digital Health Cooperative Research Centre (DHCRC).

Aged Care Industry Information Technology Council (ACIITC), in collaboration with the Australian Digital Health Agency (ADHA), last month released a report on the ‘Residential Aged Care Use of Clinical Care Systems’.

The report found that whilst residential aged care providers are using multiple digital devices there was limited integration of these within an organisation, and that only a small majority of providers believed their current clinical software was providing effective functionality. The integration with My Health Record is underway, and more recently gaining momentum, whilst a clear majority reported their clinical information software did not integrate with visiting clinician (GP) software.

This lack of integration was attributed to the need for standardised terminology across the sector, resources, minimum standards for technology platforms and the need for providers to engage in research and development activities with respect to clinical software.

DHCRC CEO Annette Schmiede said this latest report further added to the growing recognition of the gap that providers need to address when considering the role of digital technology in delivering better quality of care for older Australians.

“This report reinforces the challenges facing the aged care sector with the lack of data, terminology and conformance standards; and the continuity of care issues that is a whole of health and care issue that must be addressed,” Ms Schmiede said.

Industry standardisation on the horizon
One of DHCRC’s flagship projects, Aged Care Data Compare Plus, is looking to address many of the challenges identified in this report by demonstrating the benefits a standardised dataset can deliver.

Aged Care Data Compare Plus will test a prototype aged care quality indicator application developed by CSIRO and the University of Queensland. The app uses the HL7 FHIR data exchange standard to extract data from Regis Aged Care’s clinical information system, AutumnCare, in a consistent, secure format to support the calculation of evidence-based quality indicators.

“This a critical initiative that was identified in the Royal Commission into Aged Care Quality and Safety as an exemplar of the type of innovation required to help reform the aged care sector,” Ms Schmiede said.

“We are now looking to garner broader industry and sector support for an evidence-based quality benchmarking and reporting solution that the whole industry can get behind.”

“There are many complex issues around privacy, security, compatibility, but this is exactly what the DHCRC was established to do; building the evidence-base to demonstrate the value and application of digital health innovations for doctors, clinicians, patients and governments.”

Here is the link:

https://digitalhealthcrc.com/spotlight-on-aged-care-rd-investment-in-digital-solutions/

I had to highlight this article for having a brought to my attention an aged care system called “Autumncare”. Great name for an aged care system!

You can find out much more here:

https://autumn.care/homepage

Also of interest to me is that the DHCRC is working to create Digital Health experts:

Here is a link:

https://digitalhealthcrc.com/projects/creating-a-national-digital-health-clinical-informatics-fellowship-program-a-pathway-to-the-future/

The project – which is ongoing apparently has the following title.

Creating a National Digital Health Clinical Informatics Fellowship Program: A Pathway to the Future

Here is the key info:

Project Objective

We currently have no agreed national curriculum, recognised career pathways and recognition program for clinicians who are keen to become practitioners and leaders in digital health e.g. Chief Clinical Information Officers and Chief Digital Health Officers. The goal of this program will be to create a national program for a clinical fellowship with the AIDH. This provides the healthcare system with a clear and evidence-based pathway to gain the skills and knowledge to transform care, with a nationally and (ultimately internationally) recognised fellowship.

Is anyone who reads here involved in any of this. Or know anyone who is?

David.

 

Sunday, November 12, 2023

Is There Really Any Excuse For National Telecommunications Outages?

This appeared last week and would seem to suggest, from a real expert, no!

Yes, we weren’t prepared for the Optus outage, but we should have been

November 8, 2023 — 3.44pm

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.

Here is the link for full article:

https://www.smh.com.au/business/consumer-affairs/yes-we-weren-t-prepared-for-the-optus-outage-but-we-should-have-been-20231108-p5eiid.html

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?

David.

AusHealthIT Poll Number 722 – Results – 12 November, 2023.

Here are the results of the poll.

Is NSW Going To Get Value For Money By Spending $1Billion + Over 10 Years On Its Statewide Epic Implementation?

Yes                                                                                  5 (13%)

No                                                                                 32 (82%)

I Have no Idea                                                                3 (5%)

Total No. Of Votes: 39

A clear outcome with a large majority feeling it is hard to believe value for money is possible with this mega-plan.

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

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

3 of 39 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! 

David.