Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, April 16, 2024

The CSIRO Looks At AI And Health Care – A Useful Review.

This appeared a little while ago.

AI trends for healthcare

Publisher

Commonwealth Scientific and Industrial Research Organisation

Resources

AI trends for healthcare

 Description

In 2023 artificial intelligence (AI) technologies have started to move into mainstream use. Tools such as ChatGPT have provided a way that almost everyone can start to interact with AI technologies – and many people are finding new and novel ways of using the technology. In many ways this stage of the use of AI in society mirrors the arrival of Google in the late 1990s, which really marked the beginning of widespread use of the internet.

A key difference between the use of AI in healthcare and the use of AI in other industries is where AI provides decision-making for diagnosis, prevention, prediction, prognosis, monitoring or treatment. In these cases, the AI is considered a medical device and is currently regulated as such – ‘software as a medical device (SaMD)’. This feeds into a bigger discussion of the use of AI across healthcare, for clinical and non-clinical purposes, and ensuring Australia is ready for its use. The healthcare consequences of the rise of generative models are rapidly unfolding and the national discussion about how to regulate AI is gaining pace.

Publication Details Copyright:  Commonwealth Scientific and Industrial Research Organisation 2024

License type: All Rights Reserved

Access Rights Type:  Open

Post date:  9 Apr 2024

Here is the link:

https://apo.org.au/node/326297

This 48 page document provides insight into what the CSIRO is up to in the “AI and Healthcare” field and is well worth a browse. I am sure any of the authors would be happy to respond to any queries people have! It is good to know there is practically aimed research happening.

Worth a browse and follow up where desired.

David.

 

Sunday, April 14, 2024

Forces Are Moving In Ways Which Might Severely Damage Our GP Led Health System.

This appeared last week

11 April 2024

Are we heading for a physician associate moment?

By Holly Payne

The AMA and GP colleges have warned that scope-of-practice reforms could result in the kind of implosion seen in the UK health system.

The UK and Canada are valuable case studies for allied health scope of practice – but not for the reason that the scope of practice review commissioners seem to think, the RACGP says.

Commissioned by the Department of Health and Aged Care last year, the Unleashing the Potential of our Health Workforce scope of practice review is set to release its second issues paper in the coming weeks.

The first issues paper was released in January. It was ostensibly a literature review of sorts and only intended to be “a starting point for further discussions”.

Still, it made two key findings: that health professionals working top of scope make for a stronger primary healthcare system and that Australia has a range of barriers to achieving that.

The reviewers specifically noted that “policy and practice examples from the UK and Canada [in particular] were … found to be highly relevant to the Australian context”.

Responding to the issues paper this week, the RACGP said that “Australia should learn from the UK … on what not to do”.

The number of UK doctors working in Australia has doubled over the past decade, and the government’s commitment to expanding the non-doctor physician associate workforce has created a fallout so large it has threatened one of the oldest medical colleges in the world.

“Australia is in the top three health systems in the world, and the NHS is a basket case,” RACGP president Dr Nicole Higgins told The Medical Republic.

“We’ve got NHS doctor refugees and patients who are leaving in droves because it’s a broken system, and Australia can’t afford to go down that pathway.”

The college submission also pointed out that the Canadian province of Alberta, where pharmacists are allowed to prescribe for a variety of conditions, is experiencing an acute doctor shortage.

One board member of the Alberta College of Family Physicians has publicly blamed the workforce issues on a lack of governmental support for primary care.

The RACGP also homed in on something it felt was missing from the first issues paper: recognition of general practice.

“Issues Paper 1 is deafeningly silent on the large body of high-quality evidence for general practice,” it said.

“The review is overlooking the existing broad scope of general practice and the benefits for patients when GPs and their teams are enabled to work at their top of scope.

“Focusing only on increasing the number of access points will not have the same impact.”

Instead of responding to the individual consultation questions put out by the review, the RACGP chose to present lists of recommendations and risks.

High up on its list of recommendations were facilitating general practice-based dispensing, recognising GP advanced skills and increasing funding to support multidisciplinary team care.

This last includes opening MBS rebates for services delivered by practice nurses without direct GP supervision.

The lists of potential risks were equally voluminous. Chief among the college’s concerns were waitlist blowouts should allied health professionals be allowed to refer to specialists, patient confusion about who was a doctor and the increased administrative burden when relying on tools like My Health Record.

“My Health Record is not a clinical record; it is a summary of patient encounters,” the RACGP said.

“It is not sufficient to provide good patient care … [and] is also reliant on patients choosing not to opt out, which many did when the tool was first launched.”

The GP college also took issue with several of the definitions used by the review team, including one reference to the “acute health system”.

“Does ‘acute health system’ translate only to hospitals?” the RACGP wrote.

“GPs provide care of acute problems, such as lacerations or pneumonia, and should therefore be considered part of the acute care system.”

Although the AMA has not publicly released its submission yet, it told TMR that it would not be supporting “shortcuts” to tackling GP shortages.

“Our members have raised a number of concerns and it’s critical the scope of practice review provides a process to genuinely address the AMA’s concerns,” a spokesman said. 

“The AMA also rejects suggestions that all identified ‘barriers’ are obstacles that should be removed, because some of the so-called barriers provided safeguards.”

ACRRM’s submission to the consultation, while acknowledging the opportunity it presented for rural generalists, was similarly scathing.

“We are disappointed that the initial analysis and evidence review appears to have concluded that broadening of scope of practice would have virtually universal positive outcomes without any reference to potential risks or unintended costs,” the rural college said.

More here:

https://www.medicalrepublic.com.au/are-we-heading-for-a-physician-associate-moment/106634

There is some nonsense being sprouted by Government here!

First it is important to see clearly, as identified above, that the myHealth Record is basically an administrative tool that has little intention or capability to actually support clinical care delivery.

The second is the ongoing bureaucratic attempt from the Department of Health to blur the distinction between medical practitioners and ancillary care providers, and to claim some equivalence between these roles – where there is none. Carers are either doctors or they are not!

We have a very good health system and part of its quality is due to the GP-led nature of the way it is organized. Mess with that at your peril is my view!

David.

AusHealthIT Poll Number 742 – Results – 14 April, 2024.

Here are the results of the poll.

Do You Believe The Cost Of Comprehensive Private Health Insurance Has Become Essentially Unaffordable?

Yes                                                                             21 (81%)

No                                                                                4 (15%)

I Have No Idea                                                            1 (4%)

Total No. Of Votes: 26

People seem to think that Private Health Insurance has really gone over the top!

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

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

1 of 26 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.

Friday, April 12, 2024

It Might Be That Our Understanding Of Dark Energy is Improving – Or Not!

2 related articles appeared last week:

First we had this:

Astronomers may have got dark energy all wrong. It’s great news for the universe

By Dennis Overbye

April 5, 2024 — 3.30pm

New York: On Thursday, astronomers who are conducting what they describe as the biggest and most precise survey yet of the history of the universe announced that they might have discovered a major flaw in their understanding of dark energy, the mysterious force that is accelerating the expansion of the cosmos.

Dark energy was assumed to be a constant force in the universe, both currently and throughout cosmic history. But the new data suggest that it may be more changeable, growing stronger or weaker over time, reversing or even fading away.

“As [Joe] Biden would say, it’s a BFD,” said Adam Riess, an astronomer at Johns Hopkins University and the Space Telescope Science Institute in Baltimore, referring to the US president’s “big f-—ng deal” expression. Riess shared the 2011 Nobel Prize in physics with two other astronomers for the discovery of dark energy, but was not involved in this new study. “It may be the first real clue we have gotten about the nature of dark energy in 25 years,” he said.

That conclusion, if confirmed, could liberate astronomers – and the rest of us – from a long-standing, grim prediction about the fate of the universe. If the work of dark energy were constant over time, it would eventually push all the stars and galaxies so far apart that even atoms would be torn asunder, sapping the universe of all life, light, energy and thought, and condemning it to an everlasting case of the cosmic blahs. Instead, it seems, dark energy is capable of changing course and pointing the cosmos towards a richer future.

The keywords are “might” and “could”. The new finding has about a 1-in-400 chance of being a statistical fluke, a degree of uncertainty called three sigma, which is far short of the gold standard for a discovery, called five sigma: 1 chance in 1.7 million. In the history of physics, even five-sigma events have evaporated when more data or better interpretations of the data emerged.

This news comes in the first progress report, published as a series of papers, by a large international collaboration called the Dark Energy Spectroscopic Instrument, or DESI. The group has just begun a five-year effort to create a 3D map of the positions and velocities of 40 million galaxies across 11 billion years of cosmic time. Its initial map, based on the first year of observations, includes just 6 million galaxies. The results were released on Thursday at a meeting of the American Physical Society in Sacramento, California, and at the Rencontres de Moriond conference in Italy.

“So far we’re seeing basic agreement with our best model of the universe, but we’re also seeing some potentially interesting differences that could indicate that dark energy is evolving with time,” Michael Levi, the director of DESI, said in a statement issued by the Lawrence Berkeley National Laboratory, which manages the project.

The DESI team had not expected to hit pay dirt so soon, Nathalie Palanque-Delabrouille, an astrophysicist at the Lawrence Berkeley lab and a spokesperson for the project, said in an interview. The first year of results were designed to simply confirm what was already known, she said: “We thought that we would basically validate the standard model.”

But the unknown leaped out at them.

When the scientists combined their map with other cosmological data, they were surprised to find that it did not quite agree with the otherwise reliable standard model of the universe, which assumes that dark energy is constant and unchanging. A varying dark energy fit the data points better.

“It’s certainly more than a curiosity,” Palanque-Delabrouille said. “I would call it a hint. Yeah, it’s not yet evidence, but it’s interesting.”

But cosmologists are taking this hint very seriously.

Wendy Freedman, an astrophysicist at the University of Chicago who has led efforts to measure the expansion of the universe, praised the new survey as “superb data”. The results, she said, “open the potential for a new window into understanding dark energy, the dominant component of the universe, which remains the biggest mystery in cosmology. Pretty exciting.”

Michael Turner, an emeritus professor at the University of Chicago who coined the term “dark energy,” said in an email: “While combining data sets is tricky, and these are early results from DESI, the possible evidence that dark energy is not constant is the best news I have heard since cosmic acceleration was firmly established 20-plus years ago.”

Dark energy entered the conversation in 1998, when two competing groups of astronomers, including Riess, discovered that the expansion of the universe was speeding up rather than slowing, as most astronomers had expected. The initial observations seemed to suggest that this dark energy was acting just like a famous fudge factor – denoted by the Greek letter Lambda – that Albert Einstein had inserted into his equations to explain why the universe didn’t collapse from its own gravity. He later called it his worst blunder.

But perhaps he spoke too soon. As formulated by Einstein, Lambda was a property of space itself: The more space there was as the universe expanded, the more dark energy there was, pushing ever harder and eventually leading to a runaway, lightless future.

Dark energy took its place in the standard model of the universe known as LCDM, composed of 70 per cent dark energy (Lambda), 25 per cent cold dark matter (an assortment of slow-moving exotic particles) and 5 per cent atomic matter. So far that model has been bruised but not broken by the new James Webb Space Telescope. But what if dark energy were not constant as the cosmological model assumed?

At issue is a parameter called w, which is a measure of the density, or vehemence, of the dark energy. In Einstein’s version of dark energy, this number remains constant, with a value of -1, throughout the life of the universe. Cosmologists have been using this value in their models for the past 25 years.

But this version of dark energy is merely the simplest one. “With DESI we now have achieved a precision that allows us to go beyond that simple model,” Palanque-Delabrouille said, “to see if the density of dark energy is constant over time, or if it has some fluctuations and evolution with time”.

The DESI project, 14 years in the making, was designed to test the constancy of dark energy by measuring how fast the universe was expanding at various times in the past. To do that, scientists outfitted a telescope at Kitt Peak National Observatory with 5000 fibre-optic detectors that could conduct spectroscopy on that many galaxies simultaneously and find out how fast they were moving away from Earth.

As a measure of distance, the researchers used bumps in the cosmic distribution of galaxies, known as baryon acoustic oscillations. These bumps were imprinted on the cosmos by sound waves in the hot plasma that filled the universe when it was just 380,000 years old. Back then, the bumps were 500,000-light-years across. Now, 13.5 billion years later, the universe has expanded a thousandfold, and the bumps – which are now 500-million-light-years across – serve as convenient cosmic measuring sticks.

The DESI scientists divided the past 11 billion years of cosmic history into seven spans of time. (The universe is 13.8 billion years old.) For each, they measured the size of these bumps and how fast the galaxies in them were speeding away from us and from each other.

When the researchers put it all together, they found that the usual assumption – a constant dark energy – didn’t work to describe the expansion of the universe. Galaxies in the three most recent epochs appeared closer than they should have been, suggesting that dark energy could be evolving with time.

“And we do see, indeed, a hint that the properties of dark energy would not correspond to a simple cosmological constant” but instead may “have some deviations,” Palanque-Delabrouille said. “And this is the first time we have that.” But, she emphasised again, “I wouldn’t call it evidence yet. It’s too, too weak.”

Time and more data will tell the fate of dark energy, and of cosmologists’ battle-tested model of the universe.

“LCDM is being put through its paces by precision tests coming at it from every direction,” Turner said. “And it is doing well. But, when everything is taken together, it is beginning to appear that something isn’t right or something is missing. Things don’t fit together perfectly. And DESI is the latest indication.”

Riess of Johns Hopkins, who had an early look at the DESI results, noted that the “hint,” if validated, could pull the rug out from other cosmological measurements, such as the age or size of the universe. “This result is very interesting and we should take it seriously,” he wrote in his email. “Otherwise why else do we do these experiments?”

This article originally appeared in The New York Times.

Here is the link:

https://www.smh.com.au/world/north-america/astronomers-may-have-got-dark-energy-all-wrong-it-s-great-news-for-the-universe-20240405-p5fhq0.html

and second we have this:

Space

New 3D cosmic map raises questions over future of universe, scientists say

Researchers say findings from map with three times more galaxies than previous efforts could challenge standard idea of dark energy

Nicola Davis Science correspondent

Fri 5 Apr 2024 02.00 AEDTLast modified on Fri 5 Apr 2024 07.07 AEDT

The biggest ever 3D map of the universe, featuring more than 6m galaxies, has been revealed by scientists who said it raised questions about the nature of dark energy and the future of the universe.

The map is based on data collected by the Dark Energy Spectroscopic Instrument (Desi) in Arizona and contains three times as many galaxies as previous efforts, with many having their distances measured for the first time.

Researchers said that by using this map, they have been able measure how fast the universe has been expanding at different times in the past with unprecedented accuracy.

The results confirm that the expansion of the universe is speeding up, they added. However, the findings have also raised the tantalising possibility that dark energy – a mysterious, repulsive force that drives the process – is not constant throughout time as has previously been suggested.

Dr Seshadri Nadathur, a co-author of the work and senior research fellow at the University of Portsmouth’s Institute of Cosmology and Gravitation, said: “What we are seeing are some hints that it has actually been changing over time, which is quite exciting because it is not what the standard model of a cosmological constant dark energy would look like.”

Prof Carlos Frenk, from Durham University and a co-author of the research, said that if dark energy was indeed constant in time, the future of the universe was simple: it would expand on and on, for ever. But if the hints found in the map stood up, that would be called into question.

“Now all of that goes out the window and essentially we have to start from scratch, and that means revising our understanding of basic physics, our understanding of the big bang itself, and our understanding of the long-range forecast for the universe,” he said, adding that the new hints left open the possibility that the universe might undergo a “big crunch”.

The research, which has been published in a series of preprints – meaning it has yet to be peer-reviewed – reveals how the team first created the 3D map, then measured patterns in the distribution of galaxies that relate to sound waves that occurred in the early universe, known as baryon acoustic oscillations.

As the size of these patterns is known to be regular, the team was able to calibrate the distances to different galaxies in the map, allowing them to work out how fast the universe has been growing over the last 11bn years, with a precision better than 0.5% over all times, and better than 1% between 8bn and 11bn years ago.

Frenk said the precision itself of the measurements was notable given that galaxies could be billions of light years away, and billions of years old. “It’s mind-boggling that we can measure anything to a precision of 1%, which is precision you get in the laboratory in physics for high-precision measurements,” he said.

Andrew Pontzen, professor of cosmology at University College London and author of the book The Universe in a Box, who was not involved in the work, said Desi was one of a slew of exciting new astronomical surveys cataloguing the night sky, with one of the primary goals being to measure the rate at which our expanding universe has speeded up.

“Like measuring the acceleration of a car, charting the universe’s expansion tells us about the ‘engine’ powering cosmic acceleration. That engine is known as dark energy,” he said.

However, Pontzen noted that our knowledge of how dark energy operates was limited. “The new data, when combined with existing measurements, would seem to contradict the simplest possible explanations for dark energy,” he said.

“At face value, that’s an exciting step forward. But as the team themselves caution, there is a huge amount still to understand about this data and early results should be taken with a healthy grain of salt.”

Here is the link:

https://www.theguardian.com/science/2024/apr/04/biggest-ever-3d-map-universe-dark-energy-data-scientists

I think Joe Biden is right that what we a dealing with here is a Big F…king Deal as it really goes to our understanding (or not) of the history and fabric of the cosmos. Doesn’t matter for tonight’s dinner but for where, over time, our overall understanding of the universe winds up!

All we can do is sit back and watch as the story unfolds, and keep our sense of awe and wonder alive.

David.

Thursday, April 11, 2024

I Suspect We Need To Be A Bit Wary Of Some Excessive Hype But Things Are Happening!

This appeared last week:

03 April 2024

Australia entering ‘extraordinary epoch’ of AI in healthcare

By Harriet Grayson

AI apps could transform clinical workflows and patient outcomes across aged care, disability, radiology and primary care, according to the CSIRO.

The rise of natural language processing and generative language models across AI applications in healthcare has taken Australia’s health sector into an “extraordinary epoch”, according to a new report from the CSIRO.

The AI Trends for Healthcare report highlighted numerous opportunities and challenges to further integrating AI technologies in healthcare, including several initiatives being led by the CSIRO to implement AI across aged care, disability, medical imaging and clinical decision support.

One example included using natural language processing alongside the GPT-3 generative language model to build a natural language interface, OntoGPT, designed to streamline how users navigate information stored on SNOMED CT.

According to the report, the rise of natural language interfaces and generative language models presenting the opportunity to strengthen clinical decision-making and reduce administrative workloads for clinicians as well as improving patient outcomes

“These technologies represent an extraordinary epoch in medicine, where machines will be able to lighten the administrative load for clinicians, offer therapeutic support through chatbots that can take histories and offer education to patients, and enable improved clinical decision making,” the authors said.

“This, together with their ability to enhance patient care when they are linked to electronic records via SMART on FHIR represents a potentially rich and impactful research and implementation opportunity for CSIRO.”

Other CSIRO-led AI initiatives included developing smart homes integrated with mobile health apps and clinician platforms to support chronic conditions, improving preventative risk management such as falls prevention and enhancing eye health diagnosis and prevention.

While the significant increase in computational power in the last decade was the “biggest contributor” driving recent advances in machine learning, the substantial investment required to support the computer servers hosting AI networks could create inequity of access among medical researchers, the report warned.

Key barriers to introducing AI into aged care included the lack of rigorous evidence supporting AI-enabled products and services and limited education regarding how to safely and effectively engage with AI tools among older Australians living in residential aged care or within their communities.

Alongside working to develop and integrate AI tools across various clinical settings, greater attention needed to be paid to strengthen the digital capabilities of Australia’s health workforce, the report said.

The authors identified a number of initiatives led by the AHERC to improve digital health education among health workers nationwide, including work with the university sector to provide FHIR training courses, as well as developing opportunities with health bodies such as Queensland Health to develop staff on FHIR-aligned activities

“While the operationalisation of the existing frameworks is not landed yet, it is important to create inclusive, interdisciplinary, and ongoing discussions across sectors to shape the regulatory processes and to size the potential of AI in a safe way,” the report said.

“To harness the capabilities already at our disposal within the health ecosystem appropriately and responsibly – it is critical that our workforce (from clinicians, scientists, system administrators etc) are equipped to identify both the opportunities, challenges, and potential pitfalls as we navigate these new paths together.”

Here is the link:

https://www.medicalrepublic.com.au/australia-entering-extraordinary-epoch-of-ai-in-healthcare/106397

Here is a summary of the report:

New report says healthcare is a winner when it comes to AI

March 27th, 2024

Our new report AI Trends for Healthcare  released today, shows that healthcare is set to be the big winner in the artificial intelligence stakes.

The recent explosion in AI for healthcare has resulted from a rapid increase in compute power, as well as the availability of AI tools being developed by research centres like AEHRC in collaboration with industry.

This is not unlike many sectors where AI is taking hold. But healthcare is unique because the safety and success of the technology can mean life and death, health or disease.

We published our first AI report in 2020, at the height of the pandemic and at an epoch which will undoubtedly be remembered as the tidal wave for digital health

This report leans to some extent on the first edition especially in that we explain some of the terms and language around health AI.

What’s new is a challenges and opportunities section and a case studies section where we reveal the latest research using AI for health.

This report is not to be missed if you’re interested in how AI will be used in the future of diagnosis, treatment and management of disease.

Here is the link:

https://aehrc.csiro.au/new-report-says-healthcare-is-a-winner-when-it-comes-to-ai/

It is well worth downloading the 48 page report to see the details of what the CSIRO is up to!

They have a serious number of people (150+) and serious funding to progress some quite important work, that we don’t seem to hear all that much about – which is a pity!

David.

 

Wednesday, April 10, 2024

I Think It Is Probably Wise To Wait A Few Years Before Trusting AI Health Advice!

This appeared a few days ago

Why you shouldn’t ask ChatGPT for medical advice

By Angus Thomson

April 4, 2024 — 6.00am

If you asked a doctor whether to use ice to treat a burn, they would quickly advise you to run it under cold water instead. Even “Dr Google” will tell you that extreme cold constricts the blood vessels and can make a burn worse.

But what happens when you ask ChatGPT the same question? The chatbot will tell you it’s fine to use ice – so long as you wrap in a towel.

The question is one of a hundred common health queries that Australian researchers used to test the chatbot’s ability to provide medical advice.

They found the software was fairly accurate when asked to provide a yes or no answer, but became less reliable when given more information – answering some questions with just 28 per cent accuracy.

Co-author Dr Bevan Koopman, CSIRO principal research scientist and associate professor at the University of Queensland, has spent years looking at how search engines are used in healthcare.

He said people were increasingly using tools such as ChatGPT for medical advice despite the well-documented pitfalls of seeking health information online.

“These models have come on to the scene so quickly ... but there isn’t really the understanding of how well they perform and how best to deploy them,” he said. “In the end, you want reliable medical advice … and these models are not at all appropriate for doing things like diagnosis.”

The study compared ChatGPT’s response to a known correct response for a set of questions developed to test the accuracy of search engines such as Google.

It answered correctly 80 per cent of the time when asked to give a yes or no answer. But when provided with supporting evidence in the prompt, accuracy was reduced to 63 per cent, and fell to 28 per cent when an “unsure” answer was allowed.

Inverting the prompts to frame the question as a negative also reduced the accuracy of its answers – from 80 per cent to 56 per cent for the yes/no option, and from 33 per cent to just 4 per cent when it was given a third option of “unsure”.

Koopman said large language models such as ChatGPT were only as good as the information they were trained on, and hoped the study would provide a stepping stone for the next generation of health-specific tools “that would be much more effective”.

A national road map for artificial intelligence (AI) in healthcare, released last year, recommended the government “urgently communicate the need for caution” when using generative AI that is untested and unregulated in healthcare settings.

Professor Enrico Coiera, the director of Macquarie University’s Centre for Health Informatics and one of the authors of the road map, said some doctors were using large language models to help them take patient notes and write letters, but these had so far avoided the regulation and testing hurdles that every other health technology has to go through.

“In Silicon Valley they say, ‘move fast and break things’. That’s not a good mantra in healthcare where the things you might break are people,” he said.

Large language models construct sentences by assessing a huge database of words and how often they appear next to each other. They are chatty and easy to use but “don’t know anything about medicine”, Coiera said, and therefore should be supported by another kind of AI that can better answer health-related questions.

Dr Rob Hosking, a GP and the chairman of the Royal Australian College of General Practitioners’ technology committee, said there was a place for large language models in healthcare “if it’s trained on medical quality data, and supervised by a clinician who knows how to understand the data”.

“It’s really no different from our perspective – people come in with information they’ve got from friends, family or the internet,” he said. “It’s a bit like the move from using pen and paper to using a word processor – it’s a tool. We can’t take it as gospel.”

Here is the link:

https://www.smh.com.au/national/why-you-shouldn-t-ask-chatgpt-for-medical-advice-20240327-p5ffkp.html

At this point I reckon we should seek health advicr from a human who is backed up by a computer to fill in the blanks and details.

I am sure many would be re-assured if the advice from the doctor is confirmed by the computer but I think I want the human touch for now! 10 years on who knows?

What do you think?

David.

Tuesday, April 09, 2024

This Sounds Like A Good Step Forward In The Further Evolution Of FHIR.

This appeared last week:

03 April 2024

FHIR independent watchdog established

By Staff Writers

A committee consisting of reps from DoHAC, CSIRO, ADHA, MSIA and HL7 has convened to oversee the development of the first national FHIR standards.

An independent committee has been established to oversee the development and implementation of FHIR standards, with FHIR founder Grahame Grieve appointed committee chair. 

 The Australian FHIR Coordination Committee was designed to maintain transparency and integrity throughout the development of FHIR standards, in accordance with the recently drafted Australian FHIR management framework outlining governance arrangements for FHIR standards development. 

Former HISA chair David Rowlands was appointed deputy chair of the committee, with other members including representatives from Oracle Health, MSIA, DoHAC, the ADHA and CSIRO, as well as members from HL7 Australia’s FHIR work group and technical services group. 

All representatives would operate independently from their respective organisations while on the committee, Mr Grieve said. 

We are transparent, we keep good records, and everybody knows that even if they don’t like the outcomes, they were heard, and that no underhanded stuff going on,” he said.  

“If the government is going to make this kind of investment in the community, then they have a legitimate concern – as does the rest of the community – in how does that trust and integrity get built in. 

“The drive for me, which comes out of my experience in international standards, is having an independent watchdog with a nominated watchdog role.” 

Funding for the coordination committee and FHIR management framework arose out of the 2023-24 budget, with money allocated by the federal government for the CSIRO to work with the states and territories, the Australian Digital Health Agency and software vendors to develop and adopt national standards, according to HL7 Australia board chair Isobel Frean. 

Here is the link:

https://www.medicalrepublic.com.au/fhir-independent-watchdog-established/106399

It is especially good to see there is at least some funding allocated to support the effort

Personally I would like the see Grahame get rich out of his efforts – but I fear the Standards Gods don’t run to that!

David.

Sunday, April 07, 2024

The Flogging Of This Dead Horse Is Really Getting Silly!

This appeared last week:

CareVision Working to Integrate My Health Record for NDIS Aged Care and Community Care

Apr 4, 2024 | Company News, Home Care Software, Home Care Technology

The Australian government recommends the universal adoption of My Health Record by the aged care sector. My Health Record provides authorised healthcare professionals with access to a patient’s key health information. CareVision is working towards integrating My Health Record as it provides many benefits:

  •                Saves time in the transfer of care especially in emergencies
  •     Quick and reliable verification and validation of clinical information
  •     It helps in avoiding the duplication of tests as well as diagnostic imaging
  •    Improves the continuity of patient or client care

The information included in My Health Record is uploaded by healthcare professionals, including doctors and pharmacists. Some of the clinical documents that will be accessed include:

  •                shared health summaries
  •   vaccination and immunisation information
  •     prescription and dispense records
  •   discharge summaries
  •    transfer of care information
  •    radiology and pathology results.

It is also possible for the actual patients or their family members and carers to upload advanced care documents.

Here is the link:

https://carevision.com/carevision-working-to-integrate-my-health-record-for-ndis-aged-care-and-community-care/

The real question here is just what is the actual usage level on the myHR and how many GPs are actually filling it in as each patient visits.

It is now a little over a year since this commentary appeared, and it appears usage has rather flatlined or worse since then.

My Health Record is meant to empower patients – but with little useful information stored, is it worth saving?

Published: March 3, 2023 6.08am AEDT

Author

  1. Megan Prictor

Senior Lecturer in Law, The University of Melbourne

Australia’s My Health Record is a national, integrated electronic record, intended to overcome the problem of having personal health information “siloed” in different systems.

People can access their own My Health Record via MyGov or an app. Any of their treating health professionals can access it, too.

My Health Record can hold various past information, including a shared health summary, records of health conditions, allergies and medications, summaries of cancer treatment, test and scan results, hospital discharge notes, vaccination records, organ donation choices, and notes entered by patients themselves.

But is the system actually being used? Why is it, when people access their My Health Record, they often find little helpful information? Earlier this year, Health Minister Mark Butler promised an overhaul as part of the Strengthening Medicare Taskforce. But what needs to happen for it to be finally fit for purpose?

Lots more here:

https://theconversation.com/my-health-record-is-meant-to-empower-patients-but-with-little-useful-information-stored-is-it-worth-saving-199508

The current usage statistics are found here:

https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record/statistics

You will note there has been no update since January, 2024 and that people looking at their information has basically flatlined or dropped since January 2023. Practitioner usage also seems to have flatlined or also declined.

As far as I can tell active usage by GPs of the myHR is stable to declining and the huge pile of historical documents (many years old) just pile up! Any sign of the promised improvements?

It is of note that even the ADHA has stopped updating the stats in the last 3 months – what does that tell you?

The huge “white elephant” status of the myHR seems to be confirmed.

David.