I Really Do Wonder About These Services That Seem To Be Popping Up All Over!

I noticed this last week:

Hola Health

Health Info | Telehealth

Healthcare When You Can’t Leave Home – Australia’s Telehealth Landscape

Written by Sai Pragna Chagarla, Staff Writer – Hola Health

Digitally connected, the term we commonly use in a range of industries across Australia be it travel, banking, education, government services, food and beverage, ecommerce and more. But, what about healthcare? Can the available technology ease the wait times, bring in consultation services to the remote parts of Australia with a click of a button? Can the health care industry sustain the burden of disease with the growing population? Is telehealth in Australia the answer to contain the spread of various illnesses? 
 
As we ring in the new year of 2024, it is important to understand how telehealth is shaping Australia’s health care system and why it has become a necessity in our daily lives.  

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Usage of digital technology in Australia

As per a report from Australian Communications and Media Authority, 99% Australian adults have internet access post 2022 for work, study, leisure, shopping, and daily activities. Since the outbreak of Covid-19 in 2020, Telehealth has seen a consistent increase in usage due to the restrictions imposed on movement and to mitigate the risk of spreading the disease. Especially the restrictions led people of all ages to get online for tele consults.  

Australia’s healthcare landscape is undergoing a revolutionary transformation, driven by advancements in technology and a growing emphasis on digital solutions. The National Digital Health Strategy is at the forefront of this change, with telehealth emerging as a pivotal component in delivering accessible, efficient, and patient-centric care. 

As per some statistics from Australia’s National Digital Health Strategy, 1 of 20 Australian google searches are health related, 84% of users first go online for health information and 69% of older Australians used Internet to look up health information which shows how digital technology is already a part of our life.

What do Aussies want from Telehealth in Australia?

As per the Australian Digital Health Agency led consultation process in forming the National Digital Health Strategy, it was found that

• 65% of the respondents think that it is difficult to navigate Australia’s healthcare system.
• 45% of the respondents had difficulty in accessing healthcare when they needed it due to location, cost, or wait times.

Here are some key aspects that Australians typically want from telehealth:

• Reduced Travel: Reducing the need for extensive travel, particularly for routine check-ups, follow-up appointments, or minor health concerns is a boon especially for patients who are in older age. 
• 24/7 Access: Many Australians desire round-the-clock access to telehealth services, allowing them to seek medical advice at any time, especially when it comes to urgent situations or child health. 
• Reduced Waiting Times: Australians want telehealth to address the issue of long waiting times for in-person appointments, providing a more efficient and time-sensitive healthcare experience. 
• Professional Expertise: Patients want assurance that telehealth consultations will involve qualified healthcare professionals who can provide the same level of expertise and care as in-person visits. 
• Cost-Effective Services: Australians look for telehealth options that are cost-effective, providing a more affordable alternative to certain types of healthcare services compared to traditional in-person consultations. 
• Remote Monitoring and Follow-Up: Patients with chronic conditions, new mothers, patients with illnesses that could spread appreciate telehealth for remote monitoring and ongoing management, enabling them to receive continuous care without frequent travel. 
• Post-Operative Care: Australians expect telehealth to play a role in post-operative care, offering convenient follow-up consultations and reducing the need for unnecessary hospital visits. 
• Culturally Competent Care: Australians from diverse cultural backgrounds appreciate telehealth services that are culturally sensitive and respectful of their individual needs and beliefs. 

How are Telehealth services such as Hola Health come into the picture?

Telehealth services are the need of the hour, especially with diseases such as Coronavirus and other easily spreadable viruses, we understand the importance of virtual healthcare in our life. Hola Health, one of the best telehealth platforms in Australia, reduced the burden on the Australian Healthcare system by utilizing technology. Many Australians benefit from these services namely:

• People living in remote or rural areas. 
• new mothers 

• older people  
• people who need post-op follow-up 
• People who require a repeat script 
• people who need a medical certificate for a single day or multiple day leaves 
• People who require medicines, test kits, OTC products delivered to home. 
• People who would like to speak to a mental health specialist in anonymity. 
• People who can’t take off work or cannot travel long distances to reach a hospital. 
• People who need a specialist, pathology, radiology referrals quickly so they can have the reports ready for the next appointment. 
• People who require after hours or weekend consultation.  
• People who cannot get an appointment due to long wait times. 
• People who are travelling  
• People who want cost effective health care and who wants to save on travel costs to a hospital. 

Hola health offers a plethora of services including:

• Online General Practitioner (GP) consultation: Hola Health’s telehealth doctors are AHPRA (Australian Health Practitioner Regulation Agency) accredited GPs and can provide a broad range of medical advice including sick children, coughs, cold and flu, heavy congestion, earaches, sore throats, tooth aches, temperatures, and sexual health. Speak to a GP within 15 minutes, 24 hours a day, 7 days a week from anywhere in Australia. 
• Get a Medical Certificate: Whether you need a doctor’s certificate for work, school, or as a carer, Hola Health puts you in control of your medical certificate needs with simple, quick, online certificate requests.  
• Get an online prescription: Cannot get in to see your regular doctor and need a prescription? Select your medication from the provided list and have a short consult with an AHPRA registered medical practitioner within 15 mins 24 hours a day. Approved scripts are sent to your mobile device as an eScript.  
• Get a Mental Health Treatment Plan: If you think you may be experiencing a mental health disorder, and it is not an emergency, you can make an appointment with an AHPRA registered doctor who is trained in mental health assessment. During this appointment, our doctor will assess whether you have a mental health disorder and would benefit from a Mental Health Treatment Plan (formerly known as a Mental Health Care Plan). Appointments are 100% Medicare bulk billed. 
• Get your medicines delivered at home: Getting to the pharmacy to collect your medicines can be time consuming and take you away from the things you should be doing. There is an easier way. Hola Health medicine delivery provides a fast and convenient way to get the medicines you need, now. 

Telehealth is a cornerstone of Australia’s National Digital Health Strategy, representing a transformative shift towards a more accessible, patient-centric, and digitally driven healthcare system. As technology continues to evolve, the integration of telehealth in Australia will play an increasingly crucial role in shaping the future of healthcare, contributing to improved health outcomes for all. 

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Reference

1. Australian Communications and Media Authority – How we use the internet – Key Summary findings: Reference Link

2. Australia National Digital Health Strategy: Reference Link

3. Internet Activity Australia – Australian Bureau of Statistics: Reference Link

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This link shows you the services offered:

https://hola.health/

Having read the sales pitch I would love to hear from people about whether they would use this or a similar service and how useful they would find it to use such services.

I also wonder just how ethical the advertising is. It does seem pretty commercially orientated and you wonder how patients are screened as suitable for on-line care?

All comments can be anonymous and I am sure we would all learn a lot from other people’s experiences!

David.

Some Views On Digital Health Interoperability From One Of Our Experts

This appeared in New Zealand and I felt it needed some OZ exposure:

My View: Interoperability is a team sport

Monday, 19 February 2024  

VIEW - Grahame Grieve, FHIR product director

I started working on FHIR (Fast Healthcare Interoperability Resources) because I believe in better health outcomes and that healthcare has broken processes. As well as being a technical standard, FHIR is a name for a community of people dedicated to solving the challenge of sharing healthcare information, and who participate in an open fashion.

Together we have produced a technical specification that describes how to exchange healthcare information. That API has become transformative and is taking over the world of healthcare.

Open Solutions
Interoperability is not a technical problem, it is about building community knowledge and building community answers at every level.

FHIR is an open community, anybody can join. You do not have to pay or register, you can just be part of the community by spending your time on FHIR. This frees up the community to focus on solving problems.

One of my mantras is that interoperability is a the team sport: people contribute to open knowledge to drive change, and it’s why FHIR being an open community is so important. One outcome of that is that open knowledge lifts the baseline, forcing everybody to get better.

The ultimate goal of FHIR is to make the platform public property, so that commercial organisations make money by providing services, not by owning the platform.

If we can solve community problems in an open way, we share the technical base at multiple levels. This solves another key problem with healthcare, which is scale.

Making interoperability worthwhile
The accepted definition of interoperability is the ability of two or more systems to exchange data and make use of the data, so it is a very data centric view of the world. But what if we automate our existing processes, and they are not very good?

You can easily create worse processes with digital, so the real challenge with interoperability is to make it worthwhile.

I prefer to use this definition of clinical interoperability; ‘the ability of two or more clinical teams to transfer patients and provide seamless care’.

The idea is not to automate existing bad practices, but to build new ones that allow us to transform healthcare outcomes.

Institutions tend to keep records and share them for institutional purposes, rather than to serve the patients their families. This means the systems serve our institutions, they do not serve us – where us is either the individuals providing care, the individuals receiving care, or their families.

Our call in the FHIR community is to refocus not on interoperability that automates our existing walls and features, but on processes that break down the walls and allow us to create new kinds of workflows, as it is through those new kinds of workflows that change happens.

For example, using FHIR to provide access to fluid patient summaries that are widely available to create virtual workflows. Virtual Emergency Departments and early discharge services that keep people connected through FHIR and interoperability to hospital systems are truly transformative.

Join the community
In my experience, interoperability happens slowly and gradually and then suddenly you realise that you now totally depend on it.

We set out to disrupt healthcare by significantly reducing the cost of data exchange, principally through making it scalable, easy and natural to use. But of all the things we did, it is the open community that truly changed the game.

I encourage you to join our community and build interoperability that serves clinical health outcomes and helps to build a public treasure that we all benefit from.

This View is a summary of Grieve's presentation at Digital Health Week 2023, if you attended the conference you can access his and all other presentations online.  

If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.

More here:

https://www.hinz.org.nz/news/665386/My-View-Interoperability-is-a-team-sport-.htm

Some good thoughts here. Interesting to see how widely FHIR is now adopted and used. Suggests it has a lot right!

I hope at least a few might give thought to joining the FHIR community to add to its progress and success.

David.

The ADHA Has Released A New Digital Health Strategy – Oh Whoopdy Do!

I noticed this press release last week announcing a new Digital Health strategy:

Digital health: focus on interoperability, collaboration bolstered with national strategy

Friday, 23 February, 2024

The Australian Digital Health Agency has launched the National Digital Health Strategy 2023–2028 and the accompanying Strategy Delivery Roadmap that set out a vision and pathway for the country’s digital health future.

The five-year strategy plan is aimed at achieving four key outcomes for digital health: digitally enabled — health services are connected, safe, secure and sustainable; person-centred — Australians are empowered to look after their health and wellbeing, with the right information and tools; inclusive — equitable access to health services, when and where they are needed; data-driven — readily available data informs decision-making at the individual, community and national level, contributing to a sustainable health system.

Australian Digital Health Agency CEO Amanda Cattermole PSM said the Strategy and Delivery Roadmap were the result of a productive collaboration between federal, state and territory governments and shaped through extensive consultations with consumers, carers, healthcare providers, research organisations and technology innovators.

“In an age of precision medicine, characterised by healthcare innovations like wearable technology and AI-driven genomic research, we are witnessing a paradigm shift towards personalised and preventative health care. The National Digital Health Strategy is essential to support this shift while fostering a connected, secure, inclusive and ethical healthcare system, backed by robust legislation,” Cattermole said.

“The Strategy captures areas of reform that require a nationally co-coordinated effort across all jurisdictions to drive transformation in digital health. The powerful partnerships behind this Strategy and Roadmap will ensure that no matter what corner of the country they call home, Australians can reap the benefits of digital health care that is tailored to their unique circumstances.”

Agency Chief Clinical Advisor Dr Steve Hambleton said advances in technology are already improving health outcomes and reducing waste. Clinical benefit and consumer engagement can only get better as programs such as sharing diagnostic tests to My Health Record by default roll out.

“Immediate access to critical diagnostic information wherever requested is a quantum leap forward in supporting clinicians to make the best decisions for the patient.

“Digital tools will never replace doctors but doctors who use digital tools will likely replace doctors who don’t,” Hambleton said. 

The roadmap initiatives are based on some key principles to guide partners and collaboration:

• Digital health solutions support a person-centred health and wellbeing system.
• Digital health is integral to care delivery and complements in-person care.
• Solutions are co-designed to reduce rather than create access barriers and to be fit for purpose and accessible.
• Solutions are developed to make information discoverable and accessible.
• Digital solutions are interoperable, reusable, coordinated, efficient and supported by the use of national healthcare identifiers.
• Governance, use and management of data is respectful, culturally responsive, meaningful and appropriate.
• Data and information are shared in accordance with jurisdiction and partnership actions under the National Agreement on Closing the Gap.
• Initiatives are developed and implemented with respect to consumer rights on access, safety, respect, partnership, information, privacy and feedback.

Here is the link:

https://www.hospitalhealth.com.au/content/technology/news/digital-health-focus-on-interoperability-collaboration-bolstered-with-national-strategy-828235392

Here is the official link:

National Digital Health Strategy

About the strategy and roadmap

Australia's National Digital Health Strategy is a 5-year plan that sets the vision and pathway for our digital health future.

It builds on the achievements of the previous National Digital Health Strategy released in 2017 and acknowledges the efforts, planning and investment to date towards digital enablement and the uplift in digital health maturity.

The strategy places people at the centre of a connected and digitally enabled healthcare system. It seeks to achieve 4 key health system outcomes that will improve the wider Australian health system by creating a more connected, person-centred digital health system and by realising the benefits digital technology offers consumers and carers, health care providers, the wider community, governments, industry and providers.

The strategy is supported by a Strategy Delivery Roadmap which sets out the implementation pathway over the 5 years.

"This next phase of digital transformation will drive information sharing and advance real time data exchange to make information available when and where it’s needed, in line with consumer consent and strong privacy and cyber security standards."

National Digital Health Strategy

The strategy and roadmap have been collaboratively produced and agreed by the Australian, state and territory governments and informed through detailed consultations with patients, consumers, carers, healthcare providers, industry, organisations and innovators.

The Australian Digital Health Agency is the custodian of the strategy, with its role being to evolve national digital health capability by innovating, collaborating and leading.

Download the strategy and roadmap

The strategy and roadmap have been produced collaboratively and agreed by the Commonwealth, state and territory governments.

The documents have been informed through detailed consultations with patients, consumers, carers, healthcare providers, industry, organisations and innovators.

Here is the link:

https://www.digitalhealth.gov.au/national-digital-health-strategy

It is worth scanning these documents, if only to be amazed at how much is to happen and just how busy the ADHA will be delivering all the various components – if they actually do!

I have seen many plans like this over the years and I am not sure just how much has actually been delivered. Change is hard and I suspect the real purpose of all this documentation is to paint a set of objectives that can be approached as the resources and skills are available.

There is no doubt that progress can happen in the directions laid out but I sense it takes a good deal longer than suggested above. It is sensible to have stretch targets and as I read, while awed by the scope, the broad directions seem sensible.

You only have to think of things like secure messaging and electronic prescribing to understand that they are happening, just not at the pace originally suggested. For how long have we been talking about electronic prescribing? How fully adopted is it now?

Still some progress is better than none – so it’s sensible to just sit back and watch as it happens, with the odd comment if things are too slow or go off the rails!

It is a worry just how slow progress seems to be and I really wonder how much of what is happening is actually due to the ADHA. They cost a fair bit each year so it would be good to see them really moving things along!

Have you noticed progress in your city or town with new services becoming available?

The other point to make is that as far as I can recall the 2017 ADHA Digital Health Strategy really was not that much different from the 2024 one. Not much strikes me as very new or very unexpected, That probably says something!

David.

It Seems There Are Some Encouraging Signs Coming From The Gene Therapy Arena.

This appeared a few days ago

‘Years my kids didn’t have’: Boost to Australian gene therapy development

February 24, 2024 — 10.00pm

 

When Megan Maack’s two children were diagnosed with a rare genetic condition causing childhood dementia in 2013, research teams overseas had a drug that could dramatically slow the disease’s progress.

But it took years for the drug to be developed to a clinical grade, and it is extremely difficult to enrol in trials of such drugs when they are held abroad.

“They were years my kids didn’t have,” said Maack, who is now CEO of the Childhood Dementia Initiative, a group advocating for the 2800 children born with conditions causing childhood dementia in Australia each year, including her children Isla, 14, and Jude, 12, who have Sanflippo syndrome.

“We need to get these drugs to kids when they are young. Once they hit a point of decline, the drug is just not effective,” she said.

“Unfortunately, at the moment, there’s just not the capability in Australia to develop clinical trials locally. It is more about developing small batches to test on mice.”

But Maack is optimistic about the future of treatment in Australia, with major investment in gene therapy in NSW that could see life-changing drugs for rare childhood diseases being produced and trialled in Sydney as early as 2025.

A $134.5 million world-leading “viral vector” manufacturing facility in western Sydney is expected to be fully operational by the end of this year.

Viral vectors – microscopic tools which deliver genetic material into cells – are providing hope in the treatment of rare genetic diseases and cancers through gene therapy, an area of medicine which has progressed rapidly in the past five years.

“It’s just unbelievable what’s evolving: the way we can fix genes is now more precise,” said Professor Ian Alexander, head of the gene therapy research unit at Sydney Children’s Hospital.

“Instead of putting an extra copy of a healthy gene in, we can go in and fix ‘spelling errors’ in existing genes.”

A recent success story has been the treatment of spinal muscular atrophy (SMA), a rare condition causing muscle wastage which is the leading cause of infant death.

An international trial of gene therapy for the condition, which involved babies treated at Sydney Children’s Hospital, was so successful that since 2022 NSW has funded free screening for the disorder in a baby’s first three days of life, to ensure early access to treatment.

Maack said this would be an ideal outcome for therapies developed for conditions causing childhood dementia. Like SMA, she said, parents are unlikely to know if their child is at risk, and early genetic treatment, before a child’s decline, is critical.

“Both parents need to have a mutation in the same gene, so you can’t look at your family history,” she said.

“The majority of families will be completely blindsided by the diagnosis.”

The state government announced today it had created a new company, registered as Viral Vector Manufacturing Facility Pty Ltd, to manage operation of the Westmead plant as it manufactures the therapies on a commercial scale, managing relationships between research teams, universities, hospitals, pharmaceutical companies and other stakeholders.

“My priority as health minister has been to embrace innovative initiatives in improving health outcomes for our community,” Ryan Park said.

“These therapies are expanding rapidly, targeting more and more genetic diseases, cancer and infections, significantly increasing the number of patients who can and will benefit from viral vectors.

More here:

https://www.smh.com.au/national/nsw/years-my-kids-didn-t-have-boost-to-australian-gene-therapy-development-20240223-p5f7dg.html

It really must be one of the worst outcomes people can have to find their nipper(s) have a genetic flaw that will lead to disability, suffering or worse.

What is proposed here is clearly complex and expensive work with no guarantee of success and all most of us can do is watch and wait as the experts do their work and progressively more young lives can be saved / improved!

It’s good to see funding and effort are going to these endeavours. It is hard to see the rewards won’t be pretty large over time! I sure hope so….

David.

AusHealthIT Poll Number 735 – Results – 25 February, 2024.

Here are the results of the poll.

Do You Think The Next Decade Will See A Major Evolution Of Social Media Functionality And Use?

Yes                                                                           7 (31%)

No                                                                          15 (65%)

I Have No Idea                                                        1 (4%)

Total No. Of Votes: 23

A split vote with a majority not holding out much hope for improvement in social media!

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

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

1 of 23 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.

It Seems AI Is Really Making An Impact At The ‘Top-End’ Of Town!

This appeared last week.

CBA racks up "50-plus" GenAI use cases across the bank

By Ry Crozier

Feb 14 2024 2:02PM

Via experimentation environment set up last May.

Commonwealth Bank created 50-plus generative AI use cases using a safe environment it set up for experimentation in May last year.

The bank revealed the large-scale growth and usage in ancillary slides [pdf] accompanying its half-year results presentation, though did not directly address the success.

CBA said that it had practiced “responsible scaling of AI, resulting in [the] 50-plus generative AI use cases to simplify operational processes and support our frontline to serve customers” materialising between June and November last year.

These use cases, it said, were generated out of CommBank Gen.ai Studio, an H2O.ai powered environment aimed at enabling safe experimentation with large language models (LLMs).

The bank said it had also “upskilled over 500 staff on AI tools to democratise the responsible use of AI”.

In addition, CBA suggested that generative AI is enabling it to experiment more with its long-running next best conversation (NBC) engine, known as the customer engagement engine or CEE.

The CEE is used to personalise conversations and offers to customers - CEO Matt Comyn told financial analysts that, for example, the bank had recently used CEE to make “personalised pricing offers” to home loan customers coming off a fixed-rate loan.

Though somewhat cryptic, CBA indicated it had seen a “30x increase in experimentation capability within an NBC compared to [the] current CEE A/B testing framework with GenAI.”

iTnews has contacted a CBA spokesperson to clarify the findings.

Tech drives up OpEx

CBA said that continued insourcing of IT capabilities and cloud contributed to higher operating expenses in the back half of last year, but these were “more than offset” by productivity benefits.

The company’s half-year results for the six months ended December 30 showed a familiar pattern of IT and cloud’s contribution to the bank’s operating expenses.

More here:

https://www.itnews.com.au/news/cba-racks-up-50-plus-genai-use-cases-across-the-bank-605089

I guess the CBA is the toppest ‘top end of town’ you can find. AI has clearly hit the big time as a technology to be considered and reviewed!

David.

This Really Does Seem To Be A Considerable Leap Forward.

 This appeared last week.

Best Practice will use AI assistant to draft GP patient notes by ‘listening’ to consults

Best Practice is integrating an AI assistant for note-taking.

Heather Saxena

14 February 2024

Major GP software maker Best Practice is integrating a note-taking AI assistant to its desktop software.

The tool was built by Lyrebird Health, an Australian company founded eight months ago and will be fully integrated into the software which is used by around 25,000 doctors.

Best Practice claims it will save GPs who choose to use it between 60-90 minutes of note-writing every day.

How does it work, how was it tested and are there potential medico-legal risks?

Danielle Bancroft, the company’s chief product officer, answers AusDoc’s questions.

---

AusDoc: The Lyrebird tool is meant to write up clinical notes based on ‘listening’ to the consultation. How does it know what’s important to record? 

Danielle Bancroft: The tool is already programmed to know what is clinical information and reject ‘chit chat’. 

That process has improved as the database of doctors with access to the system has increased.  

If the occasional non-clinical line creeps in, and the GP deletes it from the consultation notes, the system will ‘learn’ not to include similar data in the future. 

When I first had it demonstrated to me, we were in a room with 5000 people. 

We talked about all kinds of things including the weekend footy with the kids.

It managed to remove all of that. 

AD: Does Lyrebird keep all the recordings from GP consults to ‘teach’ the AI based on real patients? 

Ms Bancroft: No, the tool captures what is said and immediately removes any identifying patient information from the audio stream while it’s being processed, as consultation notes are generated and displayed for the doctor to review. 

Each recording is only available for 24 hours after the consultation before it’s deleted. 

It’s purely there for the clinician to check against and validate the notes in that period of time.

It won’t be stored forever.  

The tool is really just short-cutting the manual part of typing up the initial notes.  

The clinician is in control of what is actually saved. 

AD: What happens during that 24-hour period? 

Ms Bancroft: During a consult, all audio is transcribed in real-time on Lyrebird Health’s Australian servers. 

At no point in time are audio files saved or permanently stored.

The audio stream from the consultation is completely encrypted and securely transferred to the servers.  

What this means is that by the time a consult is finished, all audio has already been converted to text and there is no audio remanence of the conversation. 

Even if accessed, it can’t be tied back to the individual GP or patient.

After 24 hours it is removed. 

Ensuring the recording does not persist or contain personal information minimises the risk of breach or data spill.  

AD: What about for the individual GP, the AI ‘learns’ what they want and don’t want in their notes? 

Ms Bancroft: As an example, the system generates consultation notes with default sub-headings — symptoms, observations and the like.   

If a GP removes certain subheadings they don’t use, or add new subheadings in, the notes will eventually reflect the doctor’s usual note-taking format. 

But these changes are specific to that doctor. 

Other GPs won’t find their consultation notes changing as a result. 

The tool is an enhancement to provide a more detailed base to start from for the consult note.  

It does not replace the clinician’s involvement or responsibilities.  

AD: If Lyrebird notes down something incorrectly, and there are consequences, who is held responsible? 

Ms Bancroft: The integration workflow ensures that draft consult note produced is checked by the clinician first before saving/writing to the database. 

There is a confirmation box that prompts users to double-check and confirm the accuracy of their records before they are able to export it to Best Practice. 

Lyrebird worked with medicolegal documentation experts when developing the tool. 

One described the depth of information it generates as being 3-4 times greater than what they would ordinarily write.  

Crucially, through work with doctors who specialise in the quality of records, there has been a significant increase in documentation quality when compared with notes manually recorded by a GP.

On average, less than 3% of the output text that Lyrebird generates is being edited. 

The responsibility is still on the clinician to ensure the clinical notes are accurate prior to saving, just as it is today.  

They have an opportunity to change or add to the notes before saving. 

Lyrebird consulted directly with medical defence organisations when developing the tool. 

AD: Given it’s based on what’s said aloud during the consultation, will GPs need to tweak their style? For example, if they’re taking blood pressure and both the GP and the patient can view the reading, will they need to announce it out loud? 

Ms Bancroft: In that example, GPs will have to say the blood pressure reading [out loud]. 

There’s also a little bit of change required during examinations, with GPs maybe having to pronounce what they are doing, rather than just chit-chat while they check.

AD: What if a GP or patient has a strong accent? 

Ms Bancroft: [We’ve done work] concentrating on different accents.

The more people who use the system the better that is going to get as well. 

It also gets to know the individual clinician: how they speak, how they interact with their patients and their approaches. 

AD: Will GPs need to secure patient consent specifically to use Lyrebird for note-taking? 

Ms Bancroft: When GPs hit record at the start of the consultation, a prompt will ask if they have obtained patient consent and will record whether the patient has said ‘yes, just for this consult’ or ‘yes for all consults’ or ‘no’. 

We are working on a workflow that will allow clinics to send out a SMS with a link so patients can be informed and consent before they get to the clinic at reception. 

AD: Has a system similar to this been used anywhere else by doctors and in what context? 

Ms Bancroft:  Yes, one example being clinical decision support tools that process information about the patient, their history and risk factors and measures it against known information and trends to provide prompts and suggestions back to the doctor.  

MIMS is another example.  

That information is provided based on certain triggers and known trends but ultimately the clinician is the one who takes in the information and decides next steps. 

AD: Have GPs tested the system ahead of its release? 

Ms Bancroft: Yes.  

We have a number of beta testers currently in the process of testing the integration of Lyrebird with Best Practice in advance of the Orchid Sp2 release in a few weeks.  

The metrics we use include user experience, efficiency, accuracy and future workflow enhancement.  

Best Practice clinical adviser Dr Fabrina Hossain also utilised the tool within her travel medicine clinic and focused on efficiency in terms of time saved through the day, on average 60-90 minutes per day, through not running late or staying back to flesh out and record consult notes. 

More here:

https://www.ausdoc.com.au/news/best-practice-will-use-ai-to-draft-gps-patient-notes-by-listening-to-consult/

We need to wait for the reports from the field to see how it actually performs in practice. Exciting times!

David.

This Looks Like Rather Good News On The Cancer Front!

This encouraging report appeared a few days ago.
Australian researchers unlock the secret to a future cancer vaccine

Exclusive

By Natasha Robinson

Health Editor

3:00AM February 15, 2024

Australian researchers have unlocked a crucial key to future ­cancer vaccines in a world-first discovery set to fast-track RNA-based therapeutics.

Vaccine technology took a giant leap forward with the advent of Covid-19, when mRNA vaccines proved successful and were administered to hundreds of millions of people worldwide.

But while mRNA vaccines are effective at inducing an immune response in viral disease, the technology has major challenges in its application for other diseases such as cancer, because the genetic ­material is breaks down quickly in the body and is therefore difficult to apply to other diseases.

Now scientists at the Peter MacCallum Cancer Centre in Melbourne have made a major discovery in the study of another, more robust form of RNA that could underpin the next generation of RNA-based therapeutics.

They studied a type of genetic material called circular RNA (circRNA), and discovered for the first time exactly how this compound is actively transported out of the nucleus of cells to their site of action in the body of the cell.

The discovery means that scientists will now be able to progress with harnessing circRNA in vaccines and other injectable drugs to fight cancer and other diseases.

“It’s the linear shape of mRNA that makes it relatively unstable and lack durability inside the body and this has been a limiting factor in the potential application of RNA-based therapeutics for diseases such as cancer,” explains Dr Vi Wickramasinghe, senior author on a scientific paper reporting the discovery published on Thursday in the journal Nature.

“For this reason, there’s a rising interest and excitement about another more robust form of RNA – known as circular or circRNA – which has the shape of a closed loop of genetic material, making it much more durable. However, key features of how circRNA operates within cells has remained a mystery – until now.

“Our discovery shows that these circular RNAs, which are actually made in the nucleus, they actually function in the cell’s cytoplasm,” Dr Wickramasinghe said. “Essentially, we discovered this pathway of how they get exported, or how they move from the nucleus to the cytoplasm to perform their functions. And the reason that’s important is because knowing these pathways, we can then use that information to help make the next generation of these RNA therapeutics more efficient.”

The scientists’ discovery that circRNAs are transported out of the cell in a similar way to some proteins, rather than in the same way as other types of RNA, sheds light on a mystery that many scientists around the world had been trying to unlock. There has been much scientific interest in circRNAs, particularly since the Covid vaccine revolution, but exactly how they functioned in the body has been little understood and scientifically contentious.

“This further cements evidence these circular RNAs … are made to carry out important functions in the cell – a contention that has been unclear for most of the circular RNAs discovered to date,” Dr Wickramasinghe said.

“Now this molecular mechanism is worked out, it opens up possibilities for manipulating it for beneficial outcomes such as disease therapies.”

Dr Wickramasinghe said it was now becoming clear that mRNA vaccines were “just the tip of the iceberg” in terms of the potential of gene-based therapies.

“We will look back on this in 10 years and say, ‘these RNA therapeutics have transformed medicine’, that’s how impactful it is.”

Australia has moved to set up manufacturing and research facilities to support the development of mRNA therapeutics since the pandemic, and the circRNA discovery cements the Peter MacCallum Centre as a leader in the devel­opment of RNA therapeutics.

More here:

https://www.theaustralian.com.au/science/australian-researchers-unlock-the-secret-to-a-future-cancer-vaccine/news-story/ca3be130e1f68163aaf2489d415aff11

It is really good to see the promise of RNA being realised and making it slowly to the clinic and into people’s arms! One can only hope there is lots of promise and little hype in the report!

David.