Drones In War And Peace Look To Be Transformational In All Sorts Of Different Domains.

It seems only a few years ago when we were reading about what were essentially ‘toy’ drones doing deliveries of tablets and some limited observation tasks! Well a decade has really wrought change!

The flavour of this article shows just how much movement there has been and how serious drone technology has become!
Eight-year wait for anti-drone solution as radical ideas take flight

EXCLUSIVE

By Ben Packham

Foreign Affairs and Defence Correspondent

Updated 11:40AM February 1, 2024, First published at 9:30PM January 31, 2024

Australian soldiers won’t be protected from killer drones for at least eight years on the army’s current timetable, as Defence takes its time to assess potential options including the use of trained eagles and hawks to attack unmanned aircraft in mid-flight.

An army briefing document obtained by The Australian reveals Defence will spend until the middle of 2028 deciding which counter-drone capabilities are mature enough to be purchased.

Options to be considered in the 4½-year “strategy and concepts” phase include jamming, lasers, ­microwave pulses, projectiles, birds of prey, and nets that can be fired into the air.

A further 2½ years will be spent on risk mitigation and contracting processes before acquisition is scheduled to commence in late 2030.

The approach outlined in the November 11, 2023, document flies in the face of last year’s Defence Strategic Review, which called for Defence to “abandon its pursuit of the perfect solution … and focus on delivering timely and relevant capability”.

According to the unclassified industry briefing document, the army has begun assessing electromagnetic and “kinetic” technologies such as machine guns and missiles to attack incoming drones. It will examine a range of other options this year including directed energy weapons, birds of prey, and “projected netting” rounds being developed by the Canadian military. It will also look at “passive defence” options including camouflage, decoys and “dummies”.

Other countries have used of birds of prey to ­attack enemy drones. India ­revealed just over a year ago it had been training native black kites to prey on Pakistani drones along the countries’ disputed border since 2020. Dutch police also trialled a program in 2015 using eagles trained by a private company to protect airspace over airports and other sensitive areas.

The army document says its project will deliver protection against armed and unarmed drones operating individually and in swarms, and be used to defend troops, vehicles, logistics, airfields, vessels and ports.

The drawn-out process comes despite the success of a number of Australian companies in bringing counter-drone systems to market.

Canberra-based Electro Optic Systems’ Slinger – a radar-guided 30mm canon – is already in service in Ukraine, along with Sydney-based company DroneShield’s electromagnetic drone jammers.

The US is also using a range of technologies including signal disrupters, “spoofers” that manipulate drones’ GPS systems, high-energy lasers and anti-drone guns.

Former Defence official Marcus Hellyer said the ADF was “stuck in a paralysis of indecision” because it feared acquiring something that didn’t meet 100 per cent of its requirements.

“They spend all this time scanning the market, spending little drops of money here and there, doing a little bit of research, which is simply a way of deferring having to make decisions about acquisition,” said the Strategic Analysis Australia research director.

“But of course, the threat is moving just as fast. So by the time you’ve done your strategising and your conceptualising, the world has moved on. The whole thing is kind of ludicrous. The bad guys have been using this stuff for a decade, and we’re still just admiring the problem.”

The army briefing tells potential industry partners that their systems must be low-cost, safe to use, resilient enough for the battlefield, and have a high level of technical readiness.

Despite Defence’s failure so far to select any Australian system on the market, the army briefing note advises firms to “respect the project”, and warns it is “not a BD (business development) contest”.

Dr Hellyer said Defence must “start putting money into industry to start making stuff and giving it to your soldiers”.

The Australian revealed this week that the army’s new $13bn armoured vehicle fleet will be vulnerable to killer drones, requiring major upgrades to protect Australian personnel from the growing battlefield threat.

None of the service’s $5bn Boxer combat reconnaissance vehicles, its new $3bn fleet of Abrams tanks, nor its $4.5bn infantry fighting vehicles have been ordered with specialised counter-drone systems.

But one senior army commander said this week: “I am working with industry to develop a counter-UAS capability that I can fit to any land vehicle that has a remote weapons station.”

More here:

https://www.theaustralian.com.au/nation/defence/eightyear-wait-for-antidrone-solution-as-radical-ideas-take-flight/news-story/827452b3e87a466d7fdc9a92734b2a50

You only have to look to the other side of the world and the Ukraine – Russia war to see just how central drone technology has become in war and you can be sure that applications of a more preaceful nature will follow on behind.

Where these technologies lead no one can be sure but the peaceful applications in health care and other domains are surely coming as well

It is hard to fathom just how stupid and obtuse our defense planners are to not see the implication of what is going on globally and get organized swiftly, for all our sakes. That the Army is not full bottle and well equipped in this vital are just defies belief! - what is it they say about Generals always fighting the 'last war'?

Sometimes you really have to wonder!

David.

AusHealthIT Poll Number 732 – Results – 04 February, 2024.

Here are the results of the poll.

Medicare Is Now 40 Years Old. Overall, Has It Been A Success?

Yes                                                                         36 (96%)

No                                                                            1 (2%)

I Have No Idea                                                        1 (2%)

Total No. Of Votes: 38

As clearer outcome as you can get. It seems most think that overall Medicare has been a success with pretty strong views on the fact it is a work in progress with a lot more to do!

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

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

1 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.

This Should Mean We In OZ See Some Digital Health Related AI In Action Soon.

This appeared last week:

24 January 2024

Epic’s generative AI goes live

Wendy John

The EHR maker has made good on its promise, but what does that mean for Aussie health data?

The NSW government’s future electronic health record now has the possibility of using generative AI, but whether or not it will be included is anyone’s guess. 

Epic announced last week that its promised generative AI is now fully embedded in its electronic health record. It is being used by more than 150 hospitals and health systems across the US but NSW Health cannot, at this stage, reveal if it will be a part of the state’s new EHR. 

Epic’s new feature is provided by Microsoft’s Nuance Dragon Ambient eXperience (DAX). DAX combines Nuance’s conversational and ambient AI – which engages with speech and sensor information – with the problem-solving power of the GPT4 AI model. 

The feature will enable clinicians to draft notes automatically from the exam room, or via telehealth, for quick clinical review and completion after each patient visit. 

Brent Lamm, CIO at UNC Health, said that DAX enhances the Epic EHR by making clinical documentation “intuitive and straightforward”.  

“Patients also say how much they value the conversational interactions they have with their providers and how they truly feel seen and heard during visits while DAX Copilot unobtrusively takes care of the clinical documentation,” he said at the announcement. 

However, there is controversy over how far AI should assist with diagnosis. Using AI to assess imaging, and offer diagnoses, is becoming more widespread and some clinical AI tools, both local and from abroad are now assisting doctors with diagnosis during face-to-face-consultations.  

Epic came under fire last year after Mayo Clinic published research that spotlighted the poor results of Epic’s AI-based algorithm for predicting the onset of sepsis. Epic’s sepsis AI tool failed to identify two-thirds of the patients who went on to develop sepsis. 

Dr John Halamka, president of Mayo Clinic Platform, said those kind of findings “amplify the reservations many clinicians have about trusting AI-based clinical decision support tools”. 

eHealth NSW has not yet shared which Epic features are to be included in its contract with the global behemoth but advised in October last year that “work is now starting on the initial design and build of this next generation system”. 

An eHealth spokesperson said last year that the new EHR will enable clinicians to access a patient’s clinical records quickly, securely, and safely, regardless of their location.  

“The SDPR will also provide simplified clinical workflows in an intuitive, user-friendly system with streamlined technical support,” said an eHealth NSW spokesperson. 

The Epic rollout across NSW Health hospitals is expected to take six years with the Hunter New England Local Health District to be the first LHD to go live with the new platform in 2025-26. 

More here at this link:

https://www.medicalrepublic.com.au/epics-generative-ai-goes-live/104521

We can only hope it does not turn out to be an expensive add-on NSW Health baulks at!

Sounds like it will be interesting to watch progress.

David.

It Is Hard To Believe There Is Not A Serious Lesson Here….

This appeared last week:

Google’s termination of Appen contracts big ‘wake up call’ for tech workers, Alphabet Workers Union warns

By Joseph Lam

Reporter

11:34AM January 26, 2024

Appen’s multimillion-dollar contract loss should be “a wake-up call for workers” as artificial intelligence is increasingly eating into the roles of some of the tech industry’s most vulnerable, a major union has warned.

The ASX-listed data processing company “had no prior knowledge” that Google would abruptly dump its contracts over the weekend, which were responsible for $US82.8m ($125m) in revenue in 2023.

The Alphabet Workers Union has warned the decision will have a “devastating impact” including some lay-offs on at least 2000 contracted Alphabet workers across the US and Canada who had worked on Google’s Bard AI product and search engine through Appen.

The company’s global contractor base, including workers who providing ratings on Google products including YouTube, expands much further across over 170 countries.

The AWU described Google contractors as a “canary in the AI coal mine” who are often “stuck between large language models and their users”.

‍“This news should be a wake-up call for workers in the tech industry and anyone concerned about the impacts of AI on working people,” said Toni Allen, AWU executive board secretary. “As subcontractors for Google we have been a canary in the AI coal mine calling out the precarious labour conditions we face being the human workers standing between large language models and their end users.”

Appen told investors on Monday it was completely in the dark on Google’s move, and that it would “immediately adjust its strategic priorities following the notification of the Google contract termination and provide further details in its FY23 full year results on 27 February 2024”.

Ms Allen said the situation was a symptom of how tech industry workers were being treated across the board in the wake of the mass adoption and integration of AI.

“This is what AI work looks like when workers have no say in the process. It is time that the world heard our voices before this situation repeats itself far and wide,” she said.

More here:

https://www.theaustralian.com.au/business/technology/googles-termination-of-appen-contracts-big-wake-up-call-for-tech-workers-alphabet-workers-union-warns/news-story/1536a7e274d09d259c631f583d858646

Reading between the lines this really seems to be an example of an AI being developed to repace a manual rating system with obvious cost savings and human pain!

“The thin end of the wedge” is the description that comes to mind as well as the “canary in the coal mine” allusion!

Others have suggested that about 40% of present workforces may be vulnerable to this sort of change, and I sadly have to say that feels to be no exaggeration to me! 

This is a serious harbinger of things to come to me!

What do others think?

David.

This Is Really Not A Happy Piece Of News – The Alert Level Needs To Be Raised!

is appeared last week:

Cybercriminals having ‘field day’: Credential stuffing attacks set to soar

January 28, 2024 — 6.00am

Cybersecurity professionals are bracing for a surge in attacks where hackers use stolen passwords to make fraudulent purchases online, saying recent data breaches mean more businesses will join The Iconic, Dan Murphy’s and Event Cinemas in suffering financial losses.

Industry insiders told this masthead that cybercriminals are having a field day with Australian usernames and passwords, which are being bought and sold on the dark web after being stolen in data breaches.

The warnings come amid calls for passwords to be abolished altogether, as technology firms start to roll out other forms of authentication, such as via fingerprint ID, facial ID or a PIN entered via a smartphone.

As first reported by this masthead, a fast-growing number of customers of the country’s biggest fashion, fast food and entertainment companies have been victims of a brazen hacking scheme known as “credential stuffing”, in which scammers access their online accounts and make fraudulent transactions.

The Iconic, Dan Murphy’s and other websites weren’t directly breached. Instead, cyber criminals used previously stolen passwords to log in and make purchases, with some victims losing thousands of dollars as a result. The attacks assume that people use the same passwords for a number of different websites, which is often correct.

Peter Maloney, chief executive of Australian cybersecurity provider AUCloud, has issued a warning on what he sees as an alarming trend.

“We are issuing a stern warning on the escalating trend of credential stuffing attacks amidst a surge of hacks and cyberattacks only days into 2024,” Maloney said.

“The alarming trend is straightforward, but poses a significant risk to individuals and organisations across the country. Australians need to take notice.

“Many people use the same username and password combinations across multiple online platforms... It only takes one of these to be breached for your details to be exposed.”

Maloney said hackers were having a field day given the sheer amount of Australian login information available for purchase. There are some 24.6 billion username and password combinations circulating on dark web marketplaces, according to recent research from software provider Digital Shadows.

‘We would never use the same key to access every building we enter: home, office, garage, safe. The same thinking should apply to online passwords.’

Garrett O’Hara, Mimecast senior director

“The dark web and various hacking communities provide a marketplace for stolen login credentials obtained from data breaches; from here, cyber criminals can easily purchase or acquire these stolen credentials, and gain access to other accounts using these details,” Maloney said.

“The compromise of a single set of credentials can have a cascading effect, jeopardising the security of numerous accounts and platforms linked to the affected user.”

Nigel Phair, professor of cybersecurity at Monash University, said the rise in credential stuffing attacks was due to the sheer scale of breaches targeting high-profile companies, affecting millions of Australians.

Tens of millions of Australians have been caught up in recent breaches including customers of Optus, HWL Ebsworth, Latitude Financial, Medibank, DP World and Dymocks, in what’s being dubbed a “new normal” of consistent attacks.

“This is a direct consequence of those cyberattacks. This is what happens with the data that is taken,” Phair said.

“Once personal data, logins and passwords have been taken in a data breach, that information could be available for cybercriminals to access easily, instantly, and forever.”

Garrett O’Hara, senior director at Mimecast, said attackers were looking for where they can easily make the most money.

With the huge number of breaches that have happened in recent years – combined with many people who still use the same password for many accounts – attackers now have both a massive availability of username and password combos and huge computer power to automate credential stuffing many sites, he said.

“Compared to the effort involved in novel or sophisticated breaches, credential stuffing is technically very simple, making it available to more attackers,” O’Hara said.

“It’s preventable – we don’t need to see these stories hit the news.

“We need a population that is better aware of the dangers of reusing passwords. For obvious reasons we would never use the same key to access every building we enter: home, office, garage, safe. The same thinking should apply to our online passwords.”

O’Hara said consumers should use a password manager, turn on multifactor authentication and check websites such as haveibeenpwned.com to see if they have been caught up in previous data breaches.

One person who claimed to have direct knowledge of The Iconic cyber incident said the people responsible did not execute the data breaches themselves, but instead had their own suppliers carry out the breaches who then on-sold the accounts.

The person, speaking anonymously to protect their identity, said the hackers used scripts to automatically input the purchased logins into websites. The scripts then categorise whether the login was successful, and what data is linked to the account, including credit card information, for example.

More here:

https://www.smh.com.au/technology/cybercriminals-having-field-day-credential-stuffing-attacks-set-to-soar-20240118-p5eyer.html

There sure is a lesson here and that to me is that where-ever you access any important web site – i.e. ones with any financial or identity risk – you must use a unique name / password combo.

It is a pain in the butt and I have no idea why the whole issue was not solved, and a solution adopted decades ago – but here we are and, frustratingly, we all have to do our bit!

Multiple factor id. is a pain but really it is the only way to go. I just wish there was a better way around all this!

David.

I Think There Is Little Doubt That, After 40 Years, Medicare Is An Overall Success.

This article is a great summary of a major innovation which, despite some false starts and ongoing issues, overall has been a success. It has genuinely become part of the fabric of Australian life and it is hard to find a better national health system anywhere on the globe! This fact is something we should all celebrate!

 Mind the gap: At 40, Medicare feels the pain of age as patients pay more

Universal health care was a proud Labor achievement. At 40, Medicare is in better shape than its US and UK peers, but there are cracks in the ageing edifice.

By Deborah Snow

January 28, 2024

In 2016, three years before his death, Bob Hawke was growing frailer. But the Labor titan was able to perform one last service for his party.

Wielding every ounce of his still considerable authority, the then 86-year-old starred in a series of prime-time ads warning Australians that the Liberal Party was out to privatise and destroy that most cherished of Labor’s reforms, Medicare.

Hawke’s warnings carried particular weight – he was, after all, the prime minister who’d launched Medicare three decades earlier, in 1984.

The 2016 “mediscare” campaign, as it was soon dubbed, had tenuous foundations. Labor weaponised a Coalition plan to investigate outsourcing the scheme’s back office payment functions – hardly a wholesale dismantling. Even so, the campaign was stunningly successful, nearly carrying then opposition leader Bill Shorten into the Lodge.

In 1993, then-prime minister Paul Keating, had made similar mincemeat out of then opposition leader John Hewson, when Hewson proposed dismantling key elements of Medicare as part of his much-maligned Fightback! package.

“Universal health insurance was really the defining fault line in Australian politics for 25 years at least, from the time that Gough Whitlam first proposed it [in the ’70s] until the time that the Liberal Party raised the white flag after the 1993 election,” federal Health Minister Mark Butler recalls.

“Establishing Medicare and firmly implanting it as part of Australia’s social fabric was a long, long fight for Labor – and one we are very proud of.”

As Medicare approaches its 40th anniversary on February 1, the scheme’s political potency endures, much to the astonishment of Dr Neal Blewett, the health minister under Hawke who oversaw its introduction.

“We had no expectation [at the time] that it would survive so long,” the now 90-year-old recalls. “We hoped it would, but we didn’t expect it given the Liberals were so clearly out to destroy it if they got back into power. Today I look back with a sense of amazement that it’s still there as the basic health system of this country.”

Dr Rachel David, the CEO of Private Healthcare Australia, describes Medicare as “by far the most popular brand that any political party in Australia has ever associated itself with, more popular than the age pension” – a telling observation from a body that represents the private health funds, once among the most vociferous opponents of the scheme.

To mark the 40th anniversary, Prime Minister Anthony Albanese and Butler will use the resumption of parliament on February 6 to open an exhibition on the scheme’s history, which will tour halls and libraries around the country.

Yet, there are cracks in the ageing edifice – and they are starting to widen, raising fears it’s increasingly becoming a two-tier scheme, especially for those who do not have concessional status.

AMA federal president Professor Steve Robson likens it to a “cherished family home that’s in need of a reno; I think it’s still liveable, but it’s been neglected”.

John Menadue, who was Gough Whitlam’s chief aide and later head of his department, believes “the ALP has been living off the legacy of Medicare for 40 years – and after 40 years, everything needs change and reform”.

Menadue was privy to the earliest discussions inside Labor that eventually led to the first iteration of Medicare, dubbed Medibank, in 1974-75, developed by then social security minister Bill Hayden. Medibank replaced a hodgepodge of private insurance arrangements and a ragged government safety net which had left many Australians without medical cover.

(Despite the yearnings of some in the party, there were constitutional obstacles against setting up a British-style nationalised health service here.)

But Medibank didn’t survive the ousting of the Whitlam government by Malcolm Fraser in 1975, and by the time Hawke came to power, the Fraser government had largely dismantled it. Some 2 million Australians were again living without protection against the potentially devastating financial consequences of ill health.

Hawke was in a tearing hurry to get the new Medicare scheme up and running after his election in 1983, Blewett recalls. “He wanted it within a year because it was part of the accord with the unions – in return for wage restraint he’d promised them the social wage, and the most important feature of the social wage for unions at that stage was Medicare.”

The 1984 scheme, rising phoenix-like from the ashes of its 1975 predecessor, built on the key features of the original: universal, compulsory, funded by a taxpayer levy, with a single payer (the federal government). Doctors were offered incentives to charge standard fees across the system and minimise out-of-pocket costs to patients by “bulk-billing” (also known as direct billing) – that is, charging government directly for consultations, and accepting that as full payment, rather than leaving patients to seek refunds.

Not only would Medicare offer the fairest form of health cover, its designers hoped, but it would be cheaper too. While medicos would not be obliged to keep their fees to the level the government was prepared to reimburse (the so-called “scheduled fee”), it was thought many would do so because of its administrative simplicity.

An important aspect of Medicare, the PHA’s David points out, was that it allowed the private sector to find a complementary place in the overall scheme, particularly on private hospital cover and a range of ancillary services.

And the public hospital systems benefited from the extra funds the Hawke government poured in under new agreements with the states.

The speed with which Medicare was set up in 1984 was breathtaking, recalls Bill Bowtell, then the chief aide to Blewett.

“From September 1983 there was a huge campaign to enrol people and give them a Medicare card – we had over 90 per cent of the population enrolled by the following February. It was a remarkable achievement.”

Today the opposition’s health spokesperson, Anne Ruston, says the Coalition has a “steadfast commitment to ensure the ongoing sustainability” of the scheme, while the original hostility of the doctors’ groups to the scheme has long since evaporated.

The AMA’s Robson says, “Medicare is embedded in the national psyche; the current generation of medical practitioners have grown up with it and have a sense that it has delivered for Australia in a way that we have not seen in countries like the UK and US.”

Yet for many Australians, Medicare is no longer delivering on the rosy promise of the early days, when Hawke promised that “all are guaranteed, as a basic right, protection against the financial impact of essential medical and hospital treatment”.

Cost pressures and a six-year freeze on Medicare scheduled benefits prior to 2019 have eroded the willingness or ability of GP practices to bulk-bill regular (that is non-concessional) patients, millions of whom are struggling with their own cost-of-living pressures.

The Australian Patients Association reports that only 10 per cent of the 9000 people it surveyed recently said their regular GP was fully bulk billing. Nearly two-thirds reported shelling out between $21 and $60 out of their own pockets, and 73 per cent said the cost of living, combined with rising gap fees, was affecting their health care decisions.

In November, a start-up called Cleanbill asked around 6300 GP practices around the country how many were bulk-billing every patient who walked through their door. Only 24.2 per cent said they were.

The Royal Australian College of General Practitioners reported that the proportion of GPs bulk-billing all their patients halved from 24 per cent in 2022 to 12 per cent last year.

And while the most recent federal health department data records that 76.5 per cent of GP services were still being bulk-billed, that’s not the same as the proportion of patients always bulk-billed by their GPs. Nationally, the department put that figure at 51.6 per cent in 2022-23, down sharply from 64.3 per cent the previous year.

Meanwhile, co-payments for basic scans are also rising. Only 67.9 per cent of ultrasounds are now fully covered by Medicare, down 10 per cent in three years.

The Consumers Health Forum’s head of advocacy, Melissa Le Mesurier, says: “We are certainly hearing from some consumers that out-of-pocket costs mean they are either delaying or not accessing that initial health care, which is a concern for them and for the system as whole because it just pushes the problem down the road where it gets more complex and more expensive.”

Private Healthcare Australia says it has evidence that some doctors are also still charging fees while bulk-billing, which is forbidden by law (if a medico bulk-bills for a service, they should not also be charging a patient a fee for that service). It recently had an anonymous letter from an office administrator in Victoria, alleging that every one of the 25 surgeons in that practice were charging patients as well as bulk-billing them, or lodging “no gap” claims with private health funds despite gap payments being sought.

“A lot of patients don’t realise its illegal, some doctors don’t realise its illegal,” the PHA’s David warns. “It’s one of those things that’s not measured or policed, and I think it’s one of the many aspects of Medicare that the department needs to get on top of. They can’t just rely on the stats that come through Services Australia and the card-swipe machines. It’s a consumer issue that really needs to be investigated.” (The department says it doesn’t use the terminology “illegal” because the issue has yet to be tested in the courts.)

Butler acknowledges that bulk-billing “has been in sharp decline whatever measurement you use”. He says the challenges facing Medicare stem not just from years of near-frozen rebates (the Gillard government put a temporary freeze on them in 2013, and the Coalition extended that for several years) but also the changes over time in the pattern of illness.

Once most GP visits were of an “episodic” nature, say an infection, or a broken bone. Today, there’s a far heavier burden of chronic disease – diabetes, obesity and mental health most prominently – driven by lifestyle and an ageing population.

“Medicare has not been redesigned to reflect that change; it’s not well set up to deliver wraparound, multidisciplinary continuous care,” Butler concedes.

Recently, he’s launched three key measures aimed at stemming the slide in bulk-billing rates.

The first has been the establishment of 58 “urgent care” clinics across the country, all of which will eventually operate for extended hours seven days a week. Primarily they’re intended to take pressure off nearby hospital emergency rooms, but they’ll also bulk-bill anyone who walks in. However, they are only financially viable because of the generous extra subsidies they receive from the federal government.

Both the AMA and the Royal College of Australian General Practitioners have given the urgent care clinics a cool reception, fearing they will drain staffing and resources from existing general practices, and introduce more inequality in the health system (those for whom the clinics are geographically accessible versus those for whom they are not).

Butler’s second measure has been to treble the financial incentives doctors receive from government to bulk-bill concessional patients – pensioners, health care cardholders, and under 16-year-olds – with an extra loading for those in remote and regional areas. While this will support the 11 million Australians in those categories, it won’t help people like the 21-year-old apprentice who recently walked through the door of AMA NSW president Michael Bonning’s practice. The apprentice was earning $28,000 a year but did not fall into any concessional group. (Bonning has chosen to bulk-bill the young man anyway.)

Butler is hoping the new incentives will arrest a further slide in bulk-billing for the most vulnerable. “It was becoming clear to me that there were a whole lot of practices right at the end of their tolerance and, if we didn’t do something, there would be an avalanche [of practices abandoning bulk-billing],” he tells the Herald.

Ruston says she has “little confidence” the extra incentives will arrest the trend, but doctors’ groups have welcomed the enhanced bulk-billing incentives as a significant injection of funds, albeit not enough to compensate for what they say is years of government under-investment in the scheme.

Butler’s third measure is a foray into teams-based care for people with multiple or chronic conditions. Launched under the banner of MyMedicare, and still in its infancy, the scheme will encourage high-needs patients to register with a single practice that can then access better funding for the delivery of multidisciplinary care.

More text and pictures here:

https://www.smh.com.au/politics/federal/mind-the-gap-at-40-medicare-feels-the-pain-of-age-as-patients-pay-more-20240120-p5eytd.html

There is little doubt that Medicare is still a work in progress and far from perfect. Its systems are slow showing their age and probably could do with a total re-vamp!

It seems to me what is needed now is a reshaping of the way services are delivered with a strengthening of the link between patients and practices which are supported to deliver as fuller range of services as possible.

In some areas acute care clinics and their private equivalents and doing a pretty good job of reducing hospital demand and providing a level of care just above the basic GP capability.

The emergence of services specifically focused on selling expensive medications to more well-off patients on perhaps less specific clinical need is worrying at present but may, or may not, be a lasting trend.

Digital Health in the GP arena is well served with a number of software solutions well tailored to the needs of local GPs and delivering reasonable functionality for clinical info. recording, referrals, electronic prescribing, billing and so on.

The last decade has seen the emergence of useful analytic packages of practice performance and increasingly clinical outcomes etc.

The demand from Government for improved reporting has been a driver here!

No coverage of OZ Digital Health can ignore the central Medicare computing capability which processes billions of dollars week and supports some pretty useful analytics which sadly are not as widely shared as they should be!

These systems support on of the most cost-efficient disbursement systems globally as well as being a user of some pretty large IBM mainframes to cope with the huge transaction volumes.

The bottom line is that Medicare as we know it would simply not the possible without a range of very significant computing and technology grunt!

David.

AusHealthIT Poll Number 731 – Results – 28 January, 2024.

 Here are the results of the poll.

Is The Public Getting Value For Money From The $288 Million Spent Each Year On The ADHA?

Yes                                                                          0   (0%)

No                                                                          38 (100%)

I Have No Idea                                                       0 (0%)

Total No. Of Votes: 38

As clearer outcome as you can get. The ADHA is not delivering in the eyes of those who read here! (More than a few HIT Experts I reckon!)

It would be nice to get a comment from the ADHA CEO on how she explains this result and what she plans to do to remedy the issue. Pretty sure we will get crickets!

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

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

0 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.

America Now Seems To Use Oxygen Deprivation To Execute People.

 The news from the NY Times

BREAKING NEWS

Alabama executed a man using nitrogen gas, becoming the first state in the U.S. to use the previously untested method.

Thursday, January 25, 2024 9:46 PM ET

The condemned prisoner, Kenneth Smith, 58, was one of three men convicted in the 1988 murder of a woman whose husband, a pastor, had recruited them to kill her. The Supreme Court allowed the execution to move forward over the objections of its three liberal justices and concerns from death penalty opponents. ----- I hate the death penalty and this just seems to make it just that much worse. Call this for what it is - "state sanctioned murder" and we all understand what has gone on here. The Bible they use in the USA says "thou shall not kill" and :vengeance is mine saith the Lord". Good enough for me.  Glad I don't live there! David.