I Find This A Rather Compelling Case For Not Being A TikTok User And Encouraging Others To Be The Same!

This appeared a few days ago:

TikTok made me write this – and it’s time for it to go

Tiktok’s influence on young Australians goes beyond free speech and into sinister realms of undue influence.

The Parrhesian Columnist

Mar 15, 2024 – 11.56am

This week the US House of Representatives voted in favour of a bill banning TikTok in the US unless Chinese parent company ByteDance divests the app.

India banned TikTok in 2020. TikTok is also inaccessible in China, along with Facebook, Instagram and Google.

It’s time for Australia to join the bans, too. Every month, there are 8.5 million Australians active on TikTok, who spend an average 58 minutes per day on the platform, which is higher than for any other country.

This skews towards young people who use it as a source of entertainment, news, advice, and commercial recommendations. It is designed to be addictive, with algorithms that feed people more and more of what they crave.

#TikTokMadeMeBuyIt is a trend where young people justify purchases – from the latest haircare products to trips to Bali – based on the influence of TikTok.

The app’s powerful algorithm identifies the most compelling and sensational content, and surfaces it with a frequency and reach that make its recommendations very hard to resist. TikTok says four in 10 users buy a product after seeing it on TikTok, boasting that “investment can be instant with 41 per cent of users immediately purchasing a product after discovering it on TikTok. 

Skews viewers to a Communist Party agenda

“The user shopping experience doesn’t stop at purchase with 79 per cent of users creating videos ... This triggers more users to shop with 92 per cent saying they take action after watching a TikTok video.”

Those numbers are staggering if you compare them with any other form of promotional content whose response, recall, let alone action rates are much lower and 2 per cent to 5 per cent would be considered outperformance.

More than a third, or 34 per cent, of Gen Z also say they get their news from TikTok (it’s unclear if the other 66 per cent get it elsewhere or just do not care to read news at all).

With this level of pervasiveness and persuasiveness, are we doing enough to understand the real influence this platform and its algorithms have on young Australians?

Anthony Goldbloom is an Australian data scientist living in Silicon Valley who founded Kaggle and sold it to Google, and who formerly represented Australia in sailing and worked for the Reserve Bank of Australia.

TikTok is not available in China

He has written an analysis of TikTok’s algorithms that proves the app does not reflect prevailing attitudes of its users but skews viewership to suit what he argues is a Communist Party agenda.

The analysis shows that content consistent with Chinese geopolitical goals, for example #StandWithKashmir, which could undermine stability in India, is amplified relative to other platforms, while content unfriendly to the Chinese agenda, for example #FreeTibet, #FreeUighurs and #FreeHongKong, is disproportionately suppressed.

Another example is that despite an evenly split opinion on the Israel-Hamas war in the US, #FreePalestine content outweighs Israel-supportive content by 80 to 1.

Goldbloom has also exposed how many posts and comments are generated by bots that originate in other countries, such as Indonesia, Malaysia, Pakistan, Egypt and Saudi Arabia, which begs the question whether our children are being unknowingly influenced by an imported worldview or hidden agenda.

It is telling that the TikTok we see in the West is not available in China itself, so one could argue the Chinese are serving Western kids addictive, digital heroin they wouldn’t serve up to their own children.

In the US, with the experience of Russian Facebook influence in a prior election, and an impending one, this topic is the subject of urgent debate.

In Australia, are we just too happy that our kids are safe in their rooms spending hours scrolling what, we believe, are harmless dance videos to pay attention to the real data and demand action?

Even if you set aside the arguments about China dictating content about how our young people engage and what they buy as mere conspiracy theories, it is still problematic that silent bot armies with unknown foreign agendas produce content that normalises ideas in ways that go far beyond free speech.

This is moving into undue influence. And how much concentration of power should one platform have when it commandeers so much time and has demonstrated much higher levels of addictiveness and persuasion than other forms of media and influence that have preceded it?

According to the eSafety Commission, a high proportion of young people in Australia have encountered inappropriate or hateful content online, 57 per cent have seen real disturbing violence, and 33 per cent have seen images or videos promoting terrorism.

There are big questions to be considered. How does a country protect its sovereignty when it comes to values, ideals and culture? And what about safeguarding our children?

We have strict regulations about how sensitive topics, such as violence and death, are depicted and referenced in traditional media, and codes of conduct governing news reporting accuracy and truth in advertising, but none of those seem to apply to the 8 million hours a day Australians are on TikTok.

The fine lines between truth and propaganda, influence and credibility, reality and deep-fakes blur more each day. And the algorithms determining what to serve up are opaque, designed for addiction, and controlled by a non-Australian organisation, possibly influenced by foreign entities who aren’t even willing to consume that content themselves. That doesn’t sound like a recipe that bodes well for Australia’s future.

Are we in the Orwellian fog of 1984 where we are so mollified by the screens that entertain us and tell us how wonderful life is with just one more product and one more like-minded opinion, that we are happy to ignore a future reality where the opinions that form the basis of our social fabric, and the values and ideals of future generations may look very different from what we anticipate?

Or like Winston’s act of rebellion in the book, must we be compelled to say “DOWN WITH TIKTOK”?

Australia cannot ignore the data that has emerged, especially when we spend more time on the platform per person than any other country.

We may not have an immediate election to protect, but we do have our children and our future to consider, and for them TikTok may be a ticking time bomb.

So tick-tock, tick-tock, it’s time for real debate on calling time on TikTok.

The full article is here:

https://www.afr.com/politics/federal/tiktok-made-me-write-this-and-it-s-time-for-it-to-go-20240312-p5fbnv

All this makes me feel we would all be better off without this particular app in our lives, but then I would say that given my dislike of the present array of social media which all seem way too exploitative for my liking. The days of simplicity have really passed with the current generation of social media all working hard to exploit us all. As has often been said if the product is free it is you who are the price being paid!

David.

It Seems This Has Become A Complex Public Health Emergency Under Our Very Noses.

This appeared last week and frankly reveals a public health disaster…. 

The vape ban has utterly failed. What now?

Vaping rates have exploded, organised crime controls the trade, and Australia stands on the brink of a public health disaster. Is it time we followed New Zealand’s lead?

By Natasha Robinson

March 15, 2024

Australia stands on the brink of a public health disaster. The failure to regulate vaping in the past three to four years has created an illicit disposable vapes market that is rampant and looks to be impossible to stamp out. Vaping rates have exploded despite disposable vapes being made illegal. Organised crime controls the trade, lured by massive profits.

The federal government has embarked on a mammoth effort to kill the illegal trade and slash vaping rates via the toughest policies in the world that ban the importation, sale and personal use of nicotine vapes unless they are obtained by prescription – something no other country has attempted.

If the prescription model fails, as it has so far, such a policy comes close to amounting to prohibition. Prohibition has never worked at any point in history for any other illicit substance.

“This is a public health menace, particularly impacting younger Australians,” federal Health Minister Mark Butler said when he announced the tough vaping policies that formed part of a renewed attack on tobacco smoking in Australia, casting the tobacco industry as the driver of an insidious vaping threat to teenagers. “It is a deliberate strategy, I think, of Big Tobacco to create a new generation of nicotine addicts, and we simply can’t stand by and let that happen. It’s hooking our kids to nicotine and providing a gateway to cigarette smoking for them.”

There’s little doubt that vaping is harmful. How harmful the practice is, is contested. The long-term effects will be seen only in decades to come. The Cancer Council of NSW lists an alarming suite of health impacts, including lung inflammation and scarring caused by chemical inhalation, cell death and DNA damage. It points to the toxic chemicals contained in vapes, including chlorine, formaldehyde, the bug spray benzene, mercury, arsenic and acrolein, a substance found in weed killer.Vapes are technically illegal in Australia - but the colourful devices are still more present than ever.

These are the substances highly likely to be found in the illegal disposable vapes that have flooded the Australian market and account for at least 90 per cent of the e-cigarettes most of the nation’s 1.7 million vapers are smoking. People have no way of knowing whether these harmful products are in the vape they’re smoking because unlike New Zealand, Britain, Canada and many other countries, we do not have a highly regulated market that aims to deliver some measure of quality control.

The public health sector has lined up almost universally behind Butler’s quest to stamp out vaping. While the National Health Service in Britain distributes posters telling the public that e-cigarettes are “95 per cent less harmful to your health than normal cigarettes” and promotes a vaping-to-quit smoking policy, and the foremost institute, Public Health England, states expert reviews have found “there is no evidence so far that e-cigarettes are acting as a route into smoking for children or nonsmokers”, Australian public health leaders remain sceptical.

‘Shop owners are being stood over by gangsters telling them to sell these products or we’ll firebomb your shop.’

Public Health Association of Australia chief executive Terry Slevin says the possibility that the harms from vaping that emerge in coming decades could be as significant as those of smoking cannot be dismissed. “That’s entirely within the realms of possibility,” Slevin says. “I can’t tell you that with certainty, but anybody who dismisses that possibility is doing so naively.”

A war over statistics is playing out over the impact of rising vaping rates on smoking reduction and the true position on the connection between vaping uptake and transition to tobacco smoking. Butler cites research that indicates vapers are three times more likely to transition to tobacco smoking.

Yet the recent publication of the National Drug Strategy Household Survey 2022-23 – the most comprehensive Australian source of information on smoking and vaping, among other substances – showed a 25 per cent decline in daily smoking in the past four years, a drop four times faster than the historic average. Adult daily smoking rates now sit at 8.9 per cent, down from about 20 per cent about 20 years ago, and the rate is 0.9 per cent among 14 to 17-year-olds, down from 1.9 per cent in 2019.

At the same time, vaping rates tripled across the population. One in five people aged 14 and older in Australia reported having used e-cigarettes at least once in their lifetime. That figure was 49 per cent among 18 to 24-year-olds and 28 per cent in 14 to 17-year-olds. But only 3.5 per cent of those youth reported vaping daily. Proponents of vaping as an alternative to tobacco smoking point to the inverse relationship between declining smoking rates and rising vape use as probably causative.

“There are now more young adults using vapes almost entirely illegally than smoking cigarettes. And from a public health point of view, that’s a big win,” says University of Melbourne tobacco control researcher Ron Borland, a previous Cancer Council Nigel Gray Distinguished Fellow in Cancer Prevention. “Now, some people claim that just because they’re going in opposite directions, it’s not necessarily causation. And that’s absolutely true. But there’s lots of other evidence that it’s likely to be causative. The fact that the big wins in smoking reduction have been gained by people having to behave illegally is somewhat ironic.”

While other countries have moved to regulate the vaping industry via networks of specialised vape retailers and imposing standards on products those outlets are able to sell, Australia four years ago made the importation of nicotine vapes and liquid nicotine illegal, and legislated a medical model in which nicotine vapes only could be prescribed by a doctor and supplied at a pharmacy. The subsequent uptake of prescription vapes was low, with GPs shunning the program, and an illicit trade flourished as organised crime stepped in to supply consumer demand.

The profits on offer are enormous. Most of the disposable vapes in Australia – many of which deliver a high concentration of nicotine – come out of Shenzhen in China, and are sold to wholesale suppliers here for about $5 or $6 a device. Retailers pay the wholesalers about $20 a vape and sell them to consumers for about $38.

“This is now a vast, vast network,” says Louis Upton, sales director at Sydney vape manufacturer Oceania Liquid Labs, one of a dwindling network of nicotine-free vape suppliers that set up in Australia about a decade ago expecting nicotine-containing e-cigarettes to eventually become a regulated industry. Upton’s laboratory operates to high standards and produces products with ingredient labels. The legitimate vape industry in Australia is being squeezed into non-existence by the black market.

“The volume of illegal vapes coming into this country is a tsunami,” Upton says. “This can’t be stopped by the government saying they are banned because they’ve always been banned. These organised crime groups are not going to stop. Shop owners are being stood over by gangsters telling them to sell these products or we’ll firebomb your shop. That’s how lucrative it is. It is terrifying. And that’s happening every day in Australia.”

The Australian Border Force has told the government frankly that it cannot stem the tide of illegal vapes at the border. The prospect of policing vape sales at every convenience store in the country appears a herculean task beyond the capacity of health authorities and not a job that state police forces have the resources to incorporate into their purview.

The Australian National Advisory Council on Alcohol and Other Drugs told the government before the vape ban legislation that a policy of prohibition would make the problem only worse. Its members were scathing that the Therapeutic Goods Administration appeared unwilling to consider harm or demand reduction strategies, and raised concerns that young people would end up being criminalised.

Butler has stated that is unequivocally not the aim, yet a few weeks ago a 13-year-old boy in the NSW country town of Deniliquin who was vaping in a supermarket on a shopping trip with his mum was approached by police and violently tackled to the ground when he refused to hand over his vape.

Nicole Lee from the National Drug Research Institute is a member of the advisory council. She predicts the prohibitionist stance taken by Butler – who nominated vape control as his hoped legacy as a health minister – will fail.

“In general, with any drugs or essentially banned substances, the more restrictive you are with access, the more likely people will go to the black market, and the less control you have over anything,” Lee says. “We’re the only country in the entire world that is going in this direction. In terms of regulation, the problem we’re going to encounter with the prescription route is that GPs are already overstretched. And people don’t want to have to pay $100 to go to their GP to get a prescription for vapes.

“So what they do is just go around that system and go to the black market. I think in terms of the black market, the whole horse has already just kind of bolted. If you take illicit drugs, for instance, we spend an enormous amount of policing and customs time and effort and money to try to stamp out that market. And it’s made absolutely no difference whatsoever.

“When we take a law enforcement approach rather than instituting a public health response, there’s a high risk that the response will be disproportionate to the harms that the drug causes.

“Meanwhile, we see that black markets thrive and serious crimes are committed. And once we’ve got a black market thriving, kids have much better access. So if we’re trying to restrict access to children, then regulation for adults is the way to do that.”

Deakin University senior lecturer in criminology James Martin agrees. “Supply-side restrictions in any illicit market are difficult to pull off, and nearly impossible to pull off when they’re already established and when they exist in the context of strong demand,” he says.

“Drug trafficking syndicates see these policies as a business opportunity. And frankly, the stiffer the penalties, as long as the demand and the supply is there, the more profitable business opportunity is.

“And when you have a situation where you can go into any corner store or supermarket and purchase cigarettes but you need a prescription to purchase vapes that are a less harmful alternative, that seems to defy logic.”

Australia’s close neighbour New Zealand has taken a diametrically opposite approach. The New Zealand government began to heavily regulate the vaping industry in 2020. A legal industry was required to comply with a notified products register and a Vaping Regulatory Authority was established and tasked with approving specialised vape retailers, which must be bricks-and-mortar stores that could not be located within 300m of a school. A regime of compliance was instituted.

In the past four years New Zealand has recorded a 40 per cent decline in smoking rates. Its smoking rate is now just under 7 per cent. Smoking rates in Maori women have dropped from 40 per cent four years ago to 18 per cent. Australian Indigenous smoking rates have fallen substantially in recent years but still sit at a devastating 37 per cent and much higher in remote areas.

“We’ve got quite an interesting natural experiment going on between Australia and New Zealand, whereby our laws on cigarettes and tobacco are pretty much identical, but the only real difference is that New Zealand’s had a legal, permissive approach to vaping,” says longtime tobacco control campaigner Ben Youdan, director of the New Zealand independent campaign organisation Action for Smokefree 2025, which aims to eliminate the death and harm caused by tobacco.

Youdan recently visited Australia and briefed parliamentarians on New Zealand’s approach and outcomes. “Vaping has been unbelievably disruptive to smoking rates in countries which have had permissive approaches, in the UK and New Zealand, even in the US. And actually, weirdly, it appears to be the case even in Australia through the illicit market as well. That’s an awful lot of people who are not going to die as a result of smoking.

“Putting vapes in a situation where they’re through prescription, where there’s prohibition, doesn’t make any sense when smoking is overwhelmingly in the lower socio-economic populations, marginalised populations, Indigenous populations, populations who don’t have fair access to health systems, populations who face multiple systemic barriers in accessing GPs and healthcare. And those are the folks who just are not going to be able to get their hands on vapes to help them stop smoking.

More here:

https://www.theaustralian.com.au/inquirer/australias-vape-ban-has-utterly-failed-what-now/news-story/d4eedd2321c647a841d4e5e46c628077

Ms Robinson has outlined a real ripper of a dilemma here!

One really is left wondering what next for this mess. We have a legal and very harmful product (cigarettes) and an illegal but much safer alternative that it might be a very bad idea to promote – for its long term harm.

Frankly this is a really crazy mess now – we have a legal very harmful product and an illegal but much less harmful one that can replace it. It is hard to think just what move the Government can make to sort out the mess and eventually reach the desired state: i.e. minimal to no use of nicotine products – which, given how addictive they are, has to be very unlikely!

What would you do in this situation as Health Minister? I am rather short of realistic suggestions!  I am also pretty worried about the organised crime links - not good!

David.

AusHealthIT Poll Number 738 – Results – 17 March, 2024.

Here are the results of the recent poll.

Is The Proportion Of The Overall Number Of GP Consults Presently Being Undertaken Via Telehealth About Right?

Yes                                                                             9 (27%)

No – Too Many                                                         2 (6%)

No – To Few                                                            18 (55%)

I Have No Idea                                                          4 (12%)

Total No. Of Votes: 33

People seem to think we are not using telehealth enough I would say!

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

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

4 of 33 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 Seems Like A Real “Boots-and All” Trial Of Microsoft Copilot.

I noticed this a few days ago:

06 Mar 2024 10:16 am AEDT

APS Tests Generative AI for Government Use Safety

DTA

Canberra, Australia - Over 50 Australian Public Service (APS) agencies have commenced a 6-month trial of Copilot for Microsoft 365. Participating agencies are trialling new ways to enhance productivity and develop skills, capabilities, and preparedness for generative artificial intelligence (AI). Over 7,400 public servants are participating in the trial.

The trial runs from January to June 2024, coordinated by the Digital Transformation Agency (DTA). It allows APS staff and agencies to innovate and explore how generative AI might support routine, day-to-day tasks - such as meeting summaries and action items, internal correspondence, or presentation outlines - to free more of the day for detailed, substantive work that people do best.

Chris Fechner, Chief Executive Officer for the DTA, says that the government is committed to embracing AI in a safe, ethical and responsive way, and fostering an innovative culture in the APS.

"Government should be an exemplar in transparency, risk management and governance of emerging technologies such as generative AI".

"By having agencies with different types of work participate - from the Department of Industry, Science and Resources to the Department of Finance and the National Disability Insurance Agency - the Australian Government will better understand how to harness generative AI in a safe, ethical and responsible way."

A complete list of participating agencies is available below.

Guidance for participating agencies

"The DTA, in partnership with the AI in Government Taskforce, is leading the evaluation of the trial," Mr Fechner explains.

Participating agencies are rolling out the generative AI tool according to their own circumstances and requirements, including their security and technical readiness.

Participating staff are required to undertake learning module and knowledge assessment specific to the trial. Both of the learning tools build upon the existing Interim guidance for agency use of generative AI that offer direction through the application of golden rules, tactical guidance, use cases, and five principles in practice:

1. Accountability. APS staff-members must be able to explain, justify, and take ownership of any advice or decisions that where generative AI tools were used to assist the process.
2. Transparency and explainability. Agencies should consider appropriately marking where generative AI was used, and any information generated must be critically examined.
3. Privacy protection and security. The government should not use public generative AI tools with any classified, personal, or sensitive information and should follow the relevant laws and policies.
4. Fairness and human-centred values. The government should avoid biases in generative AI tools that can harm some groups and should involve relevant communities in decision-making.
5. Human, societal, and environmental wellbeing. The government should use generative AI tools in a way that improves the wellbeing of the community, respects right holders, as well as carefully considering Indigenous data sovereignty and governance.

These five principles in practice expand on Australia's 8 AI Ethics Principles, a voluntary framework to reduce the risk of negative impact by maintaining safe, reliable, and fair outcomes for Australians.

Australia's data and digital approach

This trial continues the Australian Government's commitment to improve how the APS adopts and uses data and digital technologies as outlined by the Digital and Data Government Strategy (the Strategy). This strategy identifies several areas of improvement, including enhancing service delivery, advancing interoperability, replacing outdated technologies, exploring the use of new technologies, updating legislation, and leading by example.

Mr Fechner links this latest generative AI trial, as driven by the Strategy, to Australia's recent recognition as a world leader in digital government. Australia debuted at 5th in the Organisation for Economic Co-operation and Development's (OECD) Digital Government Index for 2023.

"The APS and the DTA will keep looking for opportunities to lift our Digital Government performance as evidenced by our inaugural OECD ranking and strive to improve on it in future years for the benefit of all Australians," says Mr Fechner.

"These goals go hand in hand with the Government for the Future mission that strives to take advantage of emerging technologies to deliver secure, ethical, and modern data and digital technologies by 2030."

Portfolio	Entity
Agriculture, Fisheries and Forestry	Cotton Research and Development Corporation Department of Agriculture, Fisheries and Forestry Fisheries Research and Development Corporation Grains Research and Development Corporation Regional Investment Corporation Rural Industries Research and Development trading as AgriFutures Australia
Attorney-General's	Australian Criminal Intelligence Commission Australian Federal Police Australian Financial Security Authority Office of the Commonwealth Ombudsman
Climate Change, Energy, the Environment and Water	Australian Institute of Marine Science Australian Renewable Energy Agency Department Of Climate Change, Energy, Environment and Water Bureau of Meteorology
Education	Australian Research Council Tertiary Education Quality and Standards Agency
Employment and Workplace Relations	Comcare Department of Employment and Workplace Relations Fair Work Commission Office of the Fair Work Ombudsman
Finance	Commonwealth Superannuation Corporation Department of Finance Parliamentary Workplace Support Services Digital Transformation Agency
Foreign Affairs and Trade	Australian Centre for International Agricultural Research Australian Trade and Investment Commission Department of Foreign Affairs and Trade Tourism Australia
Health and Aged Care	Australian Digital Health Agency Australian Institute of Health and Welfare Australian Radiation Protection and Nuclear Safety Agency Department of Health and Aged Care (incl TGA and OTA) Health Direct Australia National Health and Medical Research Council
Home Affairs	Department of Home Affairs (Immigration and Border Protection)
Industry, Science and Resources	Australian Building Codes Board Australian Nuclear Science and Technology Organisation Commonwealth Scientific and Industrial Research Organisation Department of Industry, Science and Resources Geoscience Australia IP Australia
Infrastructure, Transport, Regional Development, Communications and the Arts	Australian Transport Safety Bureau Infrastructure Australia
Parliamentary Departments (not a portfolio)	Department of Parliamentary Services Parliamentary Budget Office
Prime Minister and Cabinet	Australian National Audit Office Office of the Official Secretary to the Governor-General
Social Services	Australian Institute of Family Studies National Disability Insurance Agency
Treasury	Australian Prudential Regulation Authority Australian Reinsurance Pool Corporation Australian Securities and Investments Commission Australian Charities and Not-for-profits Commission Australian Taxation Office Department of the Treasury Productivity Commission Tax Practitioners Board

/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.

Here is the link to the release:

https://www.miragenews.com/aps-tests-generative-ai-for-government-use-1188177/

I have to say I wondered at this rather ‘big-bang’ approach to the introduction of this technology. You have to wonder just how the various targets for trial were selected.

Whatever the reasons it will be interesting to see just how the results of the trial are reported and what learnings emerge. (Let me know if you spot any outcome reports!)

Ai certainly seems to be flavour of the month at present!

David.

I Am Not Sure How To Put This Criticism Nicely But Really Something Needs To Be Said.

This appeared last week:

My Health Record: Enhancing Aged Care Practice

About the event

Are you an Aged Care Nurse interested in exploring more about how My Health Record can help you in caring for your patients? Or are you currently using My Health Record and would like to share your experiences around how you are utilising the My Health Record system within Aged Care?

We are excited to host an upcoming webinar in partnership with the Australian Digital Health Agency (ADHA) on 'My Health Record: Enhancing Aged Care Practice'. This webinar will be an opportunity for nurses to connect with a representative from ADHA and share your views and thoughts, as well as ask questions around how My Health Record can help you within Aged Care and how it could make your job easier.

Key Learning Objectives 

• Recognise the significance of integrating My Health Record into aged care facilities to enhance the quality of care provided to elderly residents.
• Understand how access to comprehensive health information through My Health Record improves medication management, reduces medical errors, and enhances coordination among healthcare professionals in aged care settings.
• Learn how My Health Record promotes resident-centered care by empowering elderly individuals and their families to actively engage in managing their health information and facilitating communication with healthcare providers.

Speaker

Alicia is a Digital Health Educator at the Australian Digital Health Agency. She has 8 years’ experience in the healthcare industry, in pharmacy as a dispensary Technician/ Pharmacy assistant and in medical practice as a senior receptionist. She is passionate about healthcare and how the digital tools can improve patient care and help healthcare providers streamline their approach.

When: Monday, 18 March 2024 5:00 pm AEDT to 6:00 pm AEDT

Cost: Free

Form: Webinar

TO REGISTER

Sign in or create an account to secure your place today.

ACN members

Please log in to your membership account using the My ACN drop down box on our website.

Non members

If you have never enrolled into one of our online courses, you will need to “create a new account” following the prompts.

If you have previously enrolled, you can log on using your previous username and password.

By registering for the short course you are agreeing to the registration Terms and Conditions.

Here is the link:

https://members.acn.edu.au/EventDetail?EventKey=ADHA200324

I really wonder what is going on at the ADHA that Alicia is the most qualified / suitable person who can be offered to conduct this session. I am just not sure, given the nursing audience, how this can be seen as fair to either audience or speaker.

I am in no way critical of Alicia but I do wonder why the ADHA chose her for this role.

What do others think?

David.

 

This Seems To Me To Be A Pretty Good Announcement – I Hope It Is True!

 This appeared last week:

NBN set to become five times faster ‘at no extra cost’

By David Swan

March 5, 2024 — 8.51am

Broadband speeds are set to skyrocket for some 9 million Australians, with NBN Co launching a proposal to make its most popular plan five times faster at no extra cost amid an explosion in demand for data.

In a move the company says is to meet unprecedented usage of high-definition streaming and remote work, NBN Co announced plans to raise its 100/20 Mbps Home Fast product to 500/50 Mbps and triple its Home Superfast product from 250/25 Mbps to 750/50 Mbps.

The accelerated speeds would be made available by the end of the year and apply to the 9 million broadband customers who have access to a fibre-to-the-premises (FTTP) or hybrid fibre coaxial (HFC) NBN connection, which is the majority of Australians. Customers served by other technologies would also have the ability to upgrade.

Critically, the accelerated speeds would come at no added wholesale cost to retailers, and therefore likely no extra cost to consumers. The move could signal an end to the ongoing “price wars” between NBN Co and retailers like Telstra, Optus and TPG, who have been at odds for years on pricing and access terms.

The NBN has long also served as a political football, with the Coalition government under former prime minister Tony Abbott scrapping Labor’s full-fibre rollout in 2013 in favour of a cheaper mix of technologies. Abbott said at the time: “[We] are absolutely confident that 25 megs is going to be enough, more than enough, for the average household.”

The network build is effectively now complete, with the focus shifting towards speed upgrades. The company is in the midst of a multi-year project to eliminate ageing copper infrastructure and replace it with fibre.

Broadband retailers have until April 19 to comment on the proposals.

Data demand and usage has doubled in the last five years, with the average household now consuming 443 gigabytes per month across 22 devices, with the likes of Fortnite, Netflix and Stan fuelling demand. NBN Co expects this to grow to 40 devices per household by the end of the decade.

“Despite this explosion in data usage, many customers have remained on the same broadband plan for years,” NBN Co chief customer officer Anna Perrin said.

“Our network monitoring suggests that some customers are potentially hitting their maximum speed on a regular basis. These customers may enjoy a better internet experience on a faster speed tier.

“And, most importantly, we are proposing to deliver these accelerated speeds at no extra wholesale cost to internet retailers. By working together with the industry, we hope to deliver these accelerated services to customers later this year or early next year,” Perrin said.

The company launched an industry consultation paper on Tuesday and said it is seeking input on introducing the changes sooner than planned, if possible.

Communications Minister Michelle Rowland said on Tuesday that: “Reliable, quality, high-speed internet is not a luxury or nice-to-have: it is essential 21st century infrastructure.

“NBN Co’s proposal is consistent with the Albanese Labor government’s objectives and will deliver turbo-charged speeds that would deliver significant benefits for businesses and households alike. The government expects NBN to consult closely with its retail partners and work with them to enable these speed enhancements to be available for consumers as soon as practical.”

More here:

https://www.smh.com.au/technology/nbn-to-become-five-times-faster-at-no-extra-cost-20240305-p5f9vh.html

This seems to be unequivocally good news to me! Well done NBN to have this happen!

David.

A Useful Summary Of The Players In The OZ HealthTech Space.

 This, really useful, summary article appeared last week:

06 March 2024

Our top 30 most valuable healthtech companies

By Jeremy Knibbs

Investing in the sector feels like a mug’s game post-ZIRP and covid but some groups are defying negative sentiment.

A few ground rules to keep in mind should you decide to have a go at reading this.

I did a version of this a few years back – Our 11 most valuable digital health companies – which taught me a bit, largely through all the things I got wrong (which was quite a bit, especially on the private groups).  

I’m likely to get as much wrong this time in relative terms despite what I’ve learned so keep that in mind (another way of saying that if you took any of this as advice you might need your head read after the fact).

Some ground rules:

• Private company valuations are based on information and intel that runs from pretty good to pretty bad.
• I’ve extracted a few interesting companies out of larger holding companies to feature because they are important for market context when trying to understand what is creating value – for example, InstantScripts, which is now owned by Wesfarmers or Genie which is owned by Citadel.
• Some companies in the list are tech companies and direct healthcare providers with employed or contracted doctors as well but the ones on this list, usually telehealth companies, are substantively providing care via platforms, usually telehealth.
• I’m a non-executive director of MediRecords so I don’t include this company in the list, but I discuss what is publicly known about the group because it’s relevant to understanding value.
• A lot of these companies have at one time or another paid the company that owns our sister publication Health Services Daily money in the form of sponsorship, advertising and delegate and subscription revenue. I list them at the end for transparency.
• I know I’ve missed some companies, so if you are one and you are annoyed at not being in here, let me know.

Here’s the basic league table to get things started:

Who survived from the top 11?

Readers might find who remains from the original 11 list interesting as some sort of starting point.

A lot of them made the new list, but only because we extended it out to 30 from 11. Others didn’t make it to this year’s list at all – you can work out which ones.

Only Telstra Health, Best Practice and Genie Solutions actually stayed in the top 11.

Each of these companies is platform-based, has a lot of share of healthcare providers, good long-term market brands (eg, Medical Director inside Telstra Health), access to capital and a strategy that either has them moving fast already or on a path to transitioning their old server-bound platforms and products to being cloud and FHIR-enabled.

Platforms, cloud and FHIR, combined with existing market position, make up some obvious themes on value, but there is a fair bit more going on.

The first thing to note with this list is that a post-covid and ZIRP (zero interest rate policy – or near zero) environment hasn’t been kind to tech companies across the board in terms of valuation and share price (if they are public), but especially so to health tech companies.

Not to pick on anyone in particular, but as an example, Alcidion, which is an interesting company with a hand in data analytics, clinical workflow, EMR integrations and AI, had a share price of around 13c as covid started, 44c at the peak of covid, and now it’s hovering around 5.4c. That’s despite landing the odd good overseas and local contracts and continuing to increase its revenue base robustly.

It’s a similar picture for many of the smaller cap public digital health companies in terms of share price and market cap.

Beamtree is another interesting example.

Putting aside its controversial (mainly to me, it seems) but clever virtual takeover of not-for-profit hospital performance data group Health Roundtable, this group hasn’t done much wrong in terms of building out revenue, a customer base and evolving its strategy through and post-covid. But the market isn’t buying it much. It had a pre-covid price of 15c, it got to a dizzy 66c mid-covid and today it’s struggling to stay at 22c.

Investors clearly got seduced by covid and lots of cheap money but they’re definitely not feeling that love now.

The bigger problem for many of the smaller cap publicly listed groups is valuation multiples, which mid-covid tended to be measured in multiples of revenue of anything from six to 12 times.

In June 2021 Alcidion had a market cap of over $400 million on revenues of just $26 million (a revenue multiple of over 15 times). In 2023 the group reported a very respectable story of growth with revenues just over $40 million but its market cap today is only $76 million, a revenue multiple of less than two.

What is going on there?

One question I have (as a novice) about these sorts of drops in valuation is this:

With the federal government hot-to-trot on moving the dial on interoperability across health through its program of “sharing by default”, and its newly released Digital Health Blueprint and Action Plan 2023–2033, are groups like Alcidion and Beamtree simply undervalued by an investor community that has over-reacted to the tightening money environment? Is the investor community not really understanding the bigger picture emerging around government intent and policy in digital health and the inevitable emergence of the cloud and AI in healthcare in Australia?

I don’t have shares in either of those companies in case you’re wondering about that.

Because of my interest in MediRecords – I am a non-executive director and small shareholder – I have not included them in the list above as I’m not actually allowed to use the information I know about them which is not publicly available – if I gave you revenue and market cap, I would not be guessing.

I will, however, provide this quick short advertisement for them, because the nature of this particular company is relevant to the context of value of most other companies on the list.

MediRecords is a group that, from its starting point, had cloud tech as its baseline. It started about 10 years ago and, in retrospect, its reading of how fast cloud would be adopted in Australia was probably way too optimistic, so it struggled early on to get traction.

MediRecords gets cloud and cloud-based connectivity and that is not actually that common among some of the major established health tech platform groups in Australia over the last 10 years.

That’s because we have had government policy which did not encourage the sort of innovation you’ve seen with cloud in healthcare in the UK, Europe and the US.

In fact, at times government policy, both state and federal, has tended to reinforce large tech platforms that are server-bound, can’t easily communicate with other systems and can result in forms of information-blocking across providers and to patients.

An example would be state-based secure messaging contracts which still have years to run and tend to lock in all the old tech platform vendors.

But that is now changing at speed, which is why MediRecords would make this list if I was allowed to put it in. It is sitting dead-centre of where technology around cloud-based connectivity is heading, and it is attractive technology for any provider who needs to connect providers and patients virtually and who want to futureproof for interoperability around technologies like FHIR.

Suffice to say anyone who knows how to develop sophisticated provider-based solutions technology using cloud architecture and who has a longer-term skillset in technologies like FHIR, are companies to start watching carefully.

It’s still going to take us 5-10 years to get cloud-based provider platforms rolled out and connected, but Australia, which has been way behind in building out such technology, is now on that journey and the government is fully behind it, having got its head around how much improvement the same technology has created in the US and the UK.

If you want the obvious other two trends to watch over cloud and interoperability capability, it’s AI and analytics.

But let’s shift a bit and look at a large cap which is shooting the lights out and see if there is anything that gives us some insight into what is going on.

Pro Medicus is by a mile our most valuable and successful healthtech company, private or public, at a valuation today of over $10 billion. Here is its10-year share price chart. It’s very un-healthcare like.

So, $20 just as covid started with a market cap of $2.75 billion give or take on revenues of about $57 million (revenue multiple of 48-ish), to a $100 share price and a $10 billion market cap on revenues of $125 million (a revenue multiple of about 80).

Possibly Pro Medicus is so big it’s dangerous trying to learn anything from it about most of the other companies on our list, which are, except for Telstra Health, all valued at a long way under $1 billion. But the obvious things that stand out is access to very big overseas markets in a very big and lucrative existing sector – imaging – with cool platforms, data, AI and cloud-based technology thrown in.

It ticks a lot of boxes, but 80 times revenue does seem high given that globally this is now a very competitive sector.

When you read the list some of the small caps that are ticking a few of the same boxes that Pro-Medicus does – apart from them not being in imaging and don’t have global footprints – and their valuations are well under five times revenue, it’s hard to understand what is happening.

It feels like investors are confused post-covid.

In order to get some more insight on what might be happening in terms of value I’ve  

split the companies on the list into broad categories of technology in play. Breaking the list into baskets of like companies makes it easier to see how value is getting attached to a sector according to different business models.

In order of multiples of revenue to market cap from top to bottom, the sectors are imaging, telehealth, AI/analytics (but non-imaging), patient management and other provider platforms moving to cloud (eg, Best Practice, Genie Solutions, Healthshare), and patients apps.

Imaging

Imaging is quite simply a very high-volume huge global market where AI and analytics are increasing the value on the volume significantly because they are data intensive technologies.

Australian companies doing well in the list are Pro Medicus, Harrison AI, Volpara Technologies, 4D Medical Limited and Enlitic.

Enlitic has a revenue multiple to market cap of 95 times revenue. That feels crazy but as I keep saying I’m a novice.

The average of the basket of imaging groups in multiple of revenue to market cap is just over 37 which is so far off the average of every other identified sector it may just be a market way off on its own. Which doesn’t help us understand much of what else is going on in the core healthtech companies in Australia.

Telehealth

Telehealth is the next most valued sector and an interesting one because the current market darling driving the average valuation of telehealth groups is Eucalyptus, which is not so much a health platform as a marketing platform.

The thing about the telehealth category from the get-go is that there isn’t any tech being put in play that is particularly clever, is very healthcare specific in IP terms, or has much of a barrier to entry.

That leads to speculation that most of the current value is around a potential land grab of patients and consolidation, not actual IP in technology.

Eucalyptus is a marketing machine being driven by management who aren’t health professionals at all but are more retail and tech entrepreneurs applying all the digital platform marketing tricks that we’ve seen in big global platform groups like Uber, AirBnB, even Facebook and Google.

The multiple of Eucalyptus is 26 and the average multiple for the basket of telehealth companies in the top 29 is just over 16.

This group of companies is easier to understand in terms of value than the imaging companies.

Almost all the imaging companies have elements of AI and analytics in them which do add value but also tend to make investors speculate in a sometimes silly manner.

The business mode of telehealth has none of the mystery and possible magic of AI and analytics. It is not rocket science, doesn’t really have huge barriers to entry, isn’t scalable in health like other markets such as media and finance, and most of all, is seriously fraught with day-to-day and patient-to-patient regulatory risk.

Just last year Eucalyptus and Instant Scripts faced off in a regulatory adjustment moment that might have been within a hair’s breadth of catastrophe. The Medical Board of Australia decided that asynchronous consulting (via text or email mostly), which most of these fast service telehealth consulting groups were practising at scale, was not safe enough. They had to stop it and make sure that real doctors contacted each patient at least by phone for at least one consult before they were sent “the pills”.

This created a giant extra cost for all these groups and was a clear warning that regulation can kill single model businesses in health pretty quickly. It could have been much worse.

This particular incident might have slowed their growth and valuations down a little, but at the same time it was happening, so was Ozempic, a reasonably new weight-loss drug which came complete with “miracle drug” pre-marketing overseas by Hollywood stars.

It was manna from heaven, particularly for the marketing gurus at Eucalyptus.

But Ozempic points to a pretty big problem for some of these telehealth companies, most of whom only concentrate on high-volume single condition services (although they don’t market themselves this way) such as weight loss, or, increasingly, prescribed versions of cannabis.

Both weight loss and what is effectively recreational legal cannabis are at this point of time, land grabs.

How many patients in Australia want postal order Ozempic or cannabis without the fuss of facing off their GP?

It’s probably a lot but, like Foxtel subscribers, there is a limit and when the natural limit is reached, it’s hard to see what is beyond it. Because, no matter what some of these single condition-focused telehealth groups like to tell us, they aren’t about looking after a patient properly longitudinally for all their complexity (mental health, weight, cardio, diabetes, RA, and so on infinitum) because that simply is not profitable.

That job is being left to GPs.

The plan for these companies is to corner as many of these high-volume single indication, “miracle drug direct” markets they can get, not just weight loss.  

But really, weight loss and possibly recreational cannibis is it.

Erectile dysfunction and hair loss are already pretty crowded markets with very little margin in them.

The other problem with telehealth as a sector is what happens when big “other” companies that have a deep existing relationship with the customers of these telehealth groups, a lot of capital and a lot more data, decide they need to add the same direct online services to their portfolio of other online services?

Amazon is coming and Wesfarmers (I love Bunnings, so they have my data and brand vote to send me any of these drugs) already owns Instant Scripts.

Eucalyptus may have already started showing the potential strain of facing off this possible strategic challenge.

It is now starting to market a “high end” concierge style version of their product for the ego-driven and rich end of its current database.

“We’ve identified you as a winner, and special, so we’re going to offer you a whole lot of personalised services with an elite club feel to it, so go ahead, make our day and pay us a premium for something that exists everywhere already (seductive brands you pay for to show people what you’re about).”

Not their marketing words, my translation.

And my response, so far at least:

“No thanks, just the quick and easy Ozempic please, and can you make it a lot cheaper because if I go to my GP and ask them for it, it’s like 50% less for me to get it.”

By the way, my GP seems to actually really know me and like me … hmmm.

An exclusive “rich person’s brand” health club?

That feels very old, not new and innovative: an admission perhaps that there isn’t much left in what really is a very basic mass-marketing platform business model.

But who knows.

I’m not saying these companies aren’t going to grow further or aren’t clever at getting people to part with their money based on ego or insecurity or both, and won’t succeed building a high-end, high-paying database of rich health seekers.

I’m just saying that if you look at the risk profile (health is a terrible market for regulation and government interference), the competition coming and the fact that what’s on offer is really just convenient Ozempic or cannabis, maybe the current valuations are more about these groups’ sharp marketing teams than the business model itself.

AI and analytics

AI and analytics in health have explosive potential upside so it’s not surprising that we have a few candidates on the list.

But if you look at what is going on generally in AI investment you know that there’s quite a bit of FOMO going on, which means you have to really do your homework and understand what the AI proposition is, how it will fit into inevitable regulatory frameworks (they’re coming) and what size of market it will  apply to.

Most of the imaging companies in the top sector have AI and analytics as a core part of what they do and we know that the AI in these systems is working and adding a lot of value in a high-volume scalable market.

We haven’t included any of the imaging companies in our AI and analytics top 30 basket.

The multiple of what’s left is nearly eight which seems low but remember we aren’t including any of the imaging and radiology companies in the basket. Most of the ones on the list are either emerging or adapting older business models to leverage of AI hype.

A big part of AI emerging in Australia, which is so far unregulated, is the assessment and recording of patient consults into notes, and then sometimes, the development of things like automated care plans from these consults.

Such technology has massive potential to reduce administrative burden on groups like GPs and specialists and potentially generate new areas of income.

But it’s also fraught with danger.

Currently GPs do take patient notes manually and even put them in their patient management systems. Recording a patient and what they say, then interpreting it with AI might end up as legal dynamite. All these new apps say that the notes or plans generated are always designed for review by the doctor post the consult. But will that end up making more work or less?

AI in EMRs looks like it has quite a way to go.

Lots more here:

https://www.medicalrepublic.com.au/our-top-30-most-valuable-healthtech-companies/105683

Thanks Jeremy for such a detailed and comprehensive review!

David.