Wearable Technology Seems To Have A Major Future In The Medical Domain.

This appeared last week:

6 wearable technologies doctors need to know about

John Kron | 14 October, 2016 | 

The explosion in wearable technology in recent years may be a commercial fad but many believe it will benefit doctors in treating patients. Australian Doctor takes a look.

Basic is probably the word that best describes the technology used in most pedometers back in the 1990s.

The device attached to your belt. A sensor counted up the steps and, well, that was about it.

Now, compare this with the Samsung belt launched in January.

Yes, it counts steps, but the sensors also measure distance travelled, activity and sedentary time, calories burned, waistline size based on belt tension. Then it sends the data to a smart phone app that suggests how best to manage your weight.

The only flaw is its name — the “welt”. Apparently nothing to do with skin lesions but a play on the words ‘belt’ and ‘wellness’.

There is now a wearable for just about every part of the body — smart watches for the wrist, smart glasses for the face, sensors to access pelvic floor muscles for the vagina and hearing aids incorporating health-tracking features for the ear.

All these devices are designed to capture various physiological data from physical activity and body temperature to electrodermal activity and glucose levels.

And all this information can be beamed, in theory, directly to a patient’s doctor.

Despite the hype that accompanies most modern things that go ping, there’s something serious happening and the hope is that this technology as it evolves can soon be integrated into general practice.

One example of a clinically useful wearable device becoming commonplace soon is the continuous glucose monitoring (CGM) device according to Professor Tim Usherwood from the department of general practice at the University of Sydney.

He says it already allows diabetes patients to generate reports on their glucose levels so that their GP can use the data to identify, for instance, “a need to increase morning insulin because they can see regular glucose peaks at 11am”.

Another example in clinical trials in the UK involves a wearable device to measure physical activity, but in a way that users can input subjective information about how they’re feeling as well.

“The activity and subjective data are collected and analysed to generate patient prompts such as ‘if you’re feeling low and haven’t been active much today, consider booking an appointment with your GP’,” says Professor Usherwood.

“I laugh when people say that doctors hate technology,’ says Dr Louise Schaper, CEO of the Health Informatics Society of Australia.

“Doctors love technology. Just look at their uptake of smart phones. What doctors don’t like, however, is poorly designed technology that doesn’t enhance workflows, or improve decision-making and efficiency.”

As wearable technology moves forward, she stresses that the devices will have to move beyond capturing data.

“We’ll need to develop effective and useful data analytics,” she says. “And it has got to be integrated into GP IT systems.

“The GP opens up the medical record and sees a dashboard of clinically useful highlights which can be talked about with the patient on the spot.”

It’s a lot to achieve. But the first measured steps are being taken.

Read the list with in-depth descriptions here:

http://www.australiandoctor.com.au/news/news-review/6-wearable-technologies-for-doctors

Really well worth a browse!

David.

The Push To Exploiting Health Information Seems To Be Building A Head Of Steam. It Is Not All Good News.

This appeared last week:

• Chanticleer
• Updated Oct 21 2016 at 8:58 AM

Top scientist wants to bring big data analysis to healthcare

by Tony Boyd

A day after winning the Prime Minister's Innovation Prize, Mike Aitken, was busy pressuring federal and state governments, health funds, hospitals and doctors to begin a mammoth big data exercise in healthcare.

Aitken, who is chief executive of the Capital Markets Co-operative Research Centre, says there is an opportunity to save up to $20 billion a year from leveraging the power of personal health data.

His urgent call for action is timed to coincide with the publication of the first of three reports by CMCRC on the multiple silos of data in the health system.

The first report is called Flying Blind – Australian consumers and digital health.
Aitken says it "chronicles the opportunity loss to Australia from a failure to integrate more than 50 sources of health data in Australia".

The report was sent to federal and state health ministers this week.

It concludes that Australia has high-quality healthcare data in digital form. This could support real-time personalised healthcare.

Too fragmented

But the fragmentation of the data from multiple sources means it is almost impossible to prepare consistent healthcare consumer identifiers.

Instead we have multiple health information coding systems and multiple points in the chain where consumers hand over the same data given to someone else in the system.

A symbol of the dysfunction is the sight of people carrying hard copies of medical documents and radiology images.

The report says administrative data collections contain incomplete filtered and filleted data that limit their usefulness for planning and managing the health system. The same weaknesses work against the efficient monitoring of the quality of health services.

Consumers are the biggest losers from the failure to centralise and share personal data.

Lots more here:

http://www.afr.com/brand/chanticleer/top-scientist-wants-to-bring-big-data-analysis-to-healthcare-20161020-gs6yzx

I thought it would be useful to have a look at the report.

Here is the link:

https://flyingblind.cmcrc.com/

Here is the Executive Summary:

EXECUTIVE SUMMARY

The Australian health system records sufficient high quality data in digital form to support consistent and targeted, real-time, personalised healthcare for each Australian. While, at a whole- of-population level, Australians enjoy high quality healthcare, our study shows that the acute level of data fragmentation creates an environment in which individual consumers, their next of kin and their service providers are flying partially or completely blind. The problem then extends to those charged with policy, resourcing, management and funding decisions in the public, private and non-government organisation (NGO) sectors, as well as health and medical researchers whose work is vital to the future health of consumers and the financial health of the country.

The fragmentation is the result of a number of key factors. Health services are delivered across a myriad of primary, secondary, hospital and allied healthcare settings, by a combination of private, public and  NGO providers,  many  of which  are  regarded as independent businesses. These are, in turn, funded and paid in many different ways and through different channels by consumers, state, territory and federal governments, and a wide range of insurers and related schemes. That each key player may use one  or more of a diversity of consumer identifiers and, in some cases, different health information coding schemes for their records, adds a lost in translation twist that further exacerbates effective use of data, even where this is brought together. Of equal significance are the multiplicity of state and federal laws and regulations that deal directly or indirectly with health data governance. While undoubtedly well intentioned, many present, or are interpreted as presenting,  significant,  and,  in some cases, insuperable  obstacles to rational combinations of health data. When viewing health as a market we have a clear case of market failure, a point   that is made directly and indirectly in recent submissions to the Productivity Commission’s inquiry into data availability and use.

The current situation does not result from a lack of goodwill or investment. Governments, universities and research bodies and service provider collectives (for example, doctors, hospitals, insurers) have made significant investments in improving health data collection and linkage over the past two decades.

However, these efforts have been largely focused around assembling fit-for-certain-purposes datasets that are generally de-identified, geographically bounded and do not contain complete health data even for the populations they are  seeking to study. Indeed, much cost and effort is often incurred in attempting to detour around the many barriers and data weaknesses that are described in more detail in our report.

In relation to consumer-centric health data initiatives, most effort has been directed towards what is now termed My Health Record. This initiative has been underway in various guises for almost two decades, but has yet to gain significant traction amongst consumers and health service providers.

Commentators have noted that tapping into complete, current and ‘fast flowing’ datasets of healthcare providers is an alternative model that delivers more comprehensive and ‘real-time’ benefits to consumers and their carers as well as providing the richest possible environment to support system planning and management, and  research.

We are effectively in the fifth decade of the digital era. Today, the power of data-and-evidence-driven product and service delivery   is taken for granted across many aspects of our lives. It is therefore ironic, that the most intrinsic and important aspect for each of us, namely our healthcare, remains such a significant outlier.

The perceived wisdom that continues to mitigate against joining up personal data to improve health is today significantly outof step with consumers increasing demand for instantaneous, personalised service delivery and their understanding of the social-contract necessary to achieve this. Generally, consumers have confidence that secure information processing regimes can deliver the benefits while mitigating the risks.

It is important to note that a range of other countries have tackled this situation boldly and have environments that leverage the power of health data for both preventive and curative healthcare.

This report is intended as an urgent call to action for the nation. While the notion of data may well be unexciting,    the power of complete, quality data to dramatically improve the fortunes of all health market stakeholders, particularly consumers, is assured. The knock-on benefits to burgeoning health budgets is an important by-product.

The time for piecemeal data initiatives is long since passed.   The nation must embrace an initiative that is truly transformative. This requires that we start from the perspective that data recorded at the point-of-service is the richest, most accurate and most current resource we have and that we should seek to capture once and use many times. It goes without saying that using state-of-the-art techniques to assure security and privacy are intrinsic to any solutions approach, but we must not let these issues deflect, hamper and ultimately defeat the initiative as has happened too often in the  past.

To succeed, such an initiative must be representative of key stakeholders, with consumers, clinicians and other health services providers determining the health outcomes required and policy makers, funders and researchers driving the what, when and how. Whilst acknowledging that government is a key stakeholder, this initiative should be driven as much by non-government stakeholders. The mission and funding of the initiative must be independent of electoral and government funding cycles. It must also be freed from the constant changes in stakeholder and management groups that are the characteristic of many national initiatives. We should adopt  an iterative, lightly engineered approach that will deliver immediate benefits and avoid costly mistakes and dead-ends.

At a detail level, we will need to adopt persistent identifiers  for consumers and providers, and consistent health information coding schemes as well as addressing legislative and  regulatory barriers that unnecessarily hamper consumer and community sanctioned collection and use of health data.

We are confident from our extensive interactions with stakeholders across the health market that there is broadly based support for such an initiative. As one stakeholder put it: “At the end of the day, our health is all we   have”.

----- End Executive Summary.

I have to say – having read this two or three times I am still wondering just what the group is really on about. The whole effort could really have benefited from some input from some e-Health experts who had some ‘on the ground’ experience. It is by no means clear to me just who is the intended target for the information etc. and just how issues of consent and privacy are to be addressed. I am also by no means convinced that the authors have a good feel for the complexity of health information and how deep the understanding of health data meaning is.

On a related topic I spotted this last week as well.

Can big data research lead to useful medical insights?

Antony Scholefield | 18 October, 2016 |

Many doctors have heard the phrase ‘big data’.

In fact, some might be tired of it already. There’s no perfect definition, but it usually describes huge datasets that reveal patterns of behaviour.

The Federal Department of Health has started to focus on using big data for medical research, and recently released a dataset based on anonymised Medicare data from 10% of patients.

It’s also working on a framework for secondary uses of MyHealth Record data, which will probably include using it for research.

But some UK and US researchers argue that big data will not lead to useful medical insights.

The rise of big data has come about because digital technology has made it easy to collect and store data.

One of the study authors, Dr Roger Highfield (PhD), director of external affairs for the Science Museum Group, UK, wrote an explanation of the paper for the website Wired.

He described big data research as being able to “take the ever expanding ocean of data [and] send a torrent of bits and bytes into a great hopper”.

“Then crank the handles of huge computers that run powerful statistical algorithms to discern patterns where science cannot.”

It’s the type of research that can tell doctors which demographics are more likely to be vaccinated, and who is more susceptible to developing kidney disease or catching a cold.

However, Dr Highfield and his co-authors warn that it’s the type of research that could also encourage people to incorrectly draw links between autism rates and vaccinations rates.

More here:

http://www.australiandoctor.com.au/news/latest-news/can-big-data-research-lead-to-useful-medical-insig

Good to see a healthy level of scepticism as to just what is possible and useful. Well worth a read:

Here is the full reference:

Philosophical Transactions of the Royal Society A 2016; online.

David.

I Wonder Just What This Sort Of Disruption To The Global Internet Might Have On E-Health.

It was a bad day for the Global Internet last Friday.

Here is a report:

After massive cyberattack, shoddy smart device security comes back to haunt

Almost everyone affected by the cyberattack had a part to play — from shipping shoddy devices to a consumer apathy towards security.

By Zack Whittaker for Zero Day | October 22, 2016 -- 18:49 GMT (05:49 AEDT) | Topic: Security

Friday morning saw the largest internet blackout in US history. Almost every corner of the web was affected in some way -- streaming services like Spotify, social sites like Twitter and Reddit, and news sites like Wired and Vox appeared offline to vast swathes of the eastern seaboard.

After suffering three separate distributed denial-of-service (DDoS) attacks, Dyn, the domain name system provider for hundreds of major websites, recovered and the web started to spring back to life.

The flooding attack was designed to overload systems and prevent people from accessing the sites they want on a scale never seen before this.

All signs point to a massive botnet utilizing the Internet of Things, powered by malware known as Mirai, which allows the botnet's operator to turn a large number of internet-connected devices -- surveillance cameras, smart home devices, and even baby monitors -- against a single target.

In this case, it was Dyn's servers.

"We're seeing attacks coming from an Internet of Things botnet that we identified called Mirai, also involved in this attack," said Dale Drew, chief security officer at Level 3, in a live stream on Friday, during a time where information about the attack was still scarce.

Level 3 and other firms, including Sophos, said that only a fraction of the half-a-million devices in the botnet were used in the attack, suggesting it could be far more powerful if used again.

Chester Wisniewski, principal research scientist at security firm Sophos, said that this demonstrates "incredible power wielded by just one type of device," and argued that harnessing the power of tens of millions of insecure smart devices "could cause incredible disruptions."

Lots more here:

http://www.zdnet.com/article/blame-the-internet-of-things-for-causing-massive-web-outage/

Almost prophetically we say this a day or so earlier.

Australian IoT industry told to put security first

The director of the Australian Centre for Cyber Security at UNSW in Canberra has delivered a scathing attack on the IoT industry

Stuart Corner (Computerworld) 18 October, 2016 09:31

Professor Jill Slay, the director of the Australian Centre for Cyber Security at UNSW in Canberra, has delivered a scathing attack on the IoT industry for failing to design in security, on the vendor community for peddling false promises, and bemoaned what she sees as a general lack of leadership in cyber security.

Delivering a speech at the Everything IoT conference in Sydney, Slay opened her presentation by telling the audience: “I am the person who is going to pour cold water on all your enthusiasm.”

Of her role, and that of other security researchers she said: “We have hacked every kind of device you can imagine. We walk a few steps behind you agile people who adopt new things. Then we attack them and tell you why you shouldn’t use them. That is who we are. … Our mantra is: ‘Don’t bolt on the security afterwards, build it in at the beginning.’ Security by design. Hack it to death yourself.”

She called on all involved in IoT in Australia to develop a culture of security as a matter of urgency. “The Internet of things has a bright shiny future, but we are way past the beginning already. We need to build in the security now. “I commend you all for your excitement and I trust you will secure everything. Let us develop a culture of security as we develop a culture of agility.

Meanwhile she accused vendors of making unrealistic promises about their technologies. “I live in Canberra. What I see is the vendor solution to everything. It would appear that we just have to buy the right tool and the right vendor training for the tool and then we will see a system that is secure. If anybody promises you that, it is just not true.”

Lots more here:

http://www.computerworld.com.au/article/608686/australian-iot-industry-told-put-security-first/

There is little doubt this was one of the largest disruption to the Internet in the US that has been seen in a good while.

Reading about this it seems to me that the classical medical approach of ‘prevention is better than cure’ is even truer than ever! This is an issue that is of rather larger scope than e-Health!

For e-Health clearly the risk in all this is a prolonged inability to access information which is held on the web or in the cloud.

It makes sense that, when planning to use remote services, at least some questions are asked of prospective service providers as to the mechanisms steps they have in place to mitigate risk from Denial of Service attacks and so on.

It was also really interesting to see just how quickly the attacks became major news. There is a lot of dependency on the net these days!

David

Weekly Australian Health IT Links – 24th October, 2016.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

The biggest news this week was the huge cyber-attack against the Internet last Friday. As we get the facts about this I am sure there will be lessons that e-Health can take about securing both devices and software.

Lots of other headlines to browse as well..

-----

http://www.zdnet.com/article/blame-the-internet-of-things-for-causing-massive-web-outage/

After massive cyberattack, shoddy smart device security comes back to haunt

Almost everyone affected by the cyberattack had a part to play — from shipping shoddy devices to a consumer apathy towards security.

By Zack Whittaker for Zero Day | October 22, 2016 -- 18:49 GMT (05:49 AEDT) | Topic: Security

Friday morning saw the largest internet blackout in US history. Almost every corner of the web was affected in some way -- streaming services like Spotify, social sites like Twitter and Reddit, and news sites like Wired and Vox appeared offline to vast swathes of the eastern seaboard.

After suffering three separate distributed denial-of-service (DDoS) attacks, Dyn, the domain name system provider for hundreds of major websites, recovered and the web started to spring back to life.

The flooding attack was designed to overload systems and prevent people from accessing the sites they want on a scale never seen before this.

-----

http://www.computerworld.com.au/article/608760/government-pushes-ahead-medicare-payment-system-overhaul/

Government pushes ahead with Medicare payment system overhaul

Seeks solution “based on existing commercial technology”

Rohan Pearce (Computerworld) 19 October, 2016 09:19

The government has confirmed that it will overhaul the aging health and aged care payments system.

The current system is three decades old.

A statement from health minister Sussan Ley and human services minister Alan Tudge said the government "has commenced today to identify solutions for this new payments system, which will be based on existing commercial technology".

A consultation on the design of the new system is expected to be finalised in January next year.

-----

http://www.9news.com.au/national/2016/10/19/10/18/outside-help-needed-for-medicare-update

10:15am October 19, 2016

Outside help 'needed' for Medicare update

By AAP

The federal health department admits it will need outside help to update the Medicare payments system but is adamant it will continue to be operated by the federal government.

Department secretary Martin Bowles on Wednesday denied there was ever a plan to privatise the system, as claimed by Labor in the lead-up to the July 2 election.

The 30-year-old payments system was in "urgent" need of updating and the department began looking for solutions in 2014, with outsourcing just one option.

Mr Bowles says the system will continue to be owned and operated by the federal government as promised by Prime Minister Malcolm Turnbull during the election campaign.

-----

http://www.itnews.com.au/news/health-surges-toward-medicare-payments-system-tender-439682

Health surges toward Medicare payments system tender

By Paris Cowan on Oct 19, 2016 11:26AM

Govt commits to replacing legacy tech itself.

The Department of Health hopes to have a tender to market for its controversial Medicare payments gateway by early next year after it completes a four-month co-design process to nut out the core requirements of a modern infrastructure.

Having previously toyed with the idea of outsourcing the operation of the payments engine to a private sector provider, the Turnbull government was forced to backtrack on the proposal in the lead-up to the July election after the plan was attacked as a threat to the Medicare safety net.

The prime minister has since promised that any replacement to the 30-year-old legacy system, which crunches rebate payments according to the Medicare and pharmaceutical benefits system, will be fully owned and operated by the government.

It has been described as an IT project on a scale comparable to the $1.5 billion Centrelink payments system replacement also currently underway, albeit slightly less complex.

-----

http://www.australianageingagenda.com.au/2016/10/21/sector-welcomes-replacement-troubled-aged-care-payments-system/

Sector welcomes replacement of troubled aged care payments system

By Natasha Egan on October 21, 2016 in Government, Industry

Aged care sector representatives have welcomed the government’s move to replace the outdated system for aged care payments, which continues to cause major challenges for providers.

Minister for Aged Care Sussan Ley and Minister for Human Services Alan Tudge announced on Wednesday that the Federal Government would replace the 30-year-old system with a new platform to deliver health, aged care and veterans’ payments.

Aged care systems for online claiming, payments and income and asset testing have been causing major problems for aged care providers on an ongoing basis for more than two years resulting in lengthy delays for payments, inaccuracies along with demands for compensation and apologies.

Ms Ley confirmed the new system would be government owned and operated and said that the process to find a solution based on existing commercial technology had begun.

-----

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2016-ley076.htm

Digital payments IT system replacement

The Australian Government will replace the IT system to deliver reliable and accurate health, aged care and veterans’ payments.

Page last updated: 19 October 2016

PDF printable version of Digital payments IT system replacement - PDF 298 KB

Joint Media Release

The Hon Sussan Ley MP
Minister for Health and Aged Care
Minister for Sport

The Hon Alan Tudge MP
Minister for Human Services

19 October 2016

The Australian Government will replace the IT system to deliver reliable and accurate health, aged care and veterans’ payments.

Australia’s existing health and aged care payments system is 30-years-old and is now obsolete.

The new system will support the Australian Government continuing to own, operate and deliver Medicare, PBS, aged care and related veterans payments into the future.

-----

http://www.medicalrepublic.com.au/where-to-now-for-the-myhr/

17 October, 2016

Where to now for the MyHR?

Posted by julie lambert

The government has dodged a major embarrassment by dropping its threat to punish general practices for not meeting initial upload targets for the My Health Record system.

After a series of backflips and retreats on health policy, from the failed GP co-payments scheme to the damaging pre-election brawls over bulk-billing incentives, the Coalition is desperate to avoid another humiliation, and the MyHR system is ripe for attack.

For now, Health Minister Sussan Ley has agreed only to shift the deadline for GPs to upload 0.5% of their patients’ health summaries to the MHR system to January 31, after a large proportion missed the August cut-off for the first quarter despite the threat of financial pain.

Speaking at the RACGP’s annual conference on September 29, Minister Ley said the move was evidence of the government’s flexible approach to general practice and its willingness to listen.

-----

http://www.medicalobserver.com.au/professional-news/whole-of-life-immunisation-register-cranks-up-ahead-of-shingles-vax-roll-out

Whole-of-life immunisation register cranks up ahead of shingles vax roll-out

Rada Rouse

18 October 2016

GPs are being urged to ensure practice software updates are installed to obtain new vaccine codes and facilitate lodging adult vaccinations in the new Australian Immunisation Register (AIR).

The former Australian Childhood Immunisation Register became a whole-of-life vaccination record this month ahead of the 1 November roll-out of the national shingles vaccination program.

According to the Department of Human Services, 13,759 immunisations have been recorded for adults aged 20 and older recorded since 30 September.

“GPs should be checking for updates from their general practice software provider [which] enable transmission of the data from their general practice to the register,” says immunisation specialist Associate Professor Kristine Macartney.

-----

http://www.medicalrepublic.com.au/doctors-still-smarter-average-machine/

19 October, 2016

Doctors still smarter than the average machine

Posted by Felicity Nelson

Many patients use apps and websites to arrive at their own diagnosis before stepping foot in a GP clinic. But, as GPs may have suspected, the diagnostic skills of doctors far surpass those of computers – and a recent study proves it.

Research published in JAMA Internal Medicine showed doctors were more than twice as accurate as web-based systems when it came to diagnosis.

Websites and apps (known as “symptom checkers”) picked the correct diagnosis in a dismal 34% of cases, whereas physicians got it right 72% of the time.

“In what we believe to be the first direct comparison of diagnostic accuracy, physicians vastly outperformed computer algorithms,” the authors said.

-----

http://www.itnews.com.au/news/govts-data-breach-notification-bill-enters-parliament-439693

Govt's data breach notification bill enters parliament

By Ry Crozier on Oct 19, 2016 12:48PM

Expands on actions that could reduce need to notify.

The federal government has introduced mandatory data breach notification laws into parliament after missing a self-imposed deadline to have a scheme up and running before the end of last year.

The substance of the proposed laws – and the process for declaring a breach – is largely unchanged from an exposure draft published by the Attorney-General last December. The government spent until March this year consulting with industry on the proposed changes.

However, the government has heeded calls from industry to edit the language of the bill to remove the requirement for notification if an organisation "ought to have been aware" a breach had occurred.

Under the bill, organisations that determine they have been breached or have lost data will need to report the incident, and notify customers that are directly impacted or “at risk”. Those that don’t face a range of penalties, including fines of $360,000 for individuals and $1.8 million for organisations.

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http://www.itwire.com/data/75297-racgp,-ibm-watson,-health-collaborate-on-health-data-initiative.html

RACGP, IBM Watson, Health& collaborate on health data initiative

• 18 October 2016
• Written by  Peter Dinham

The Royal Australian College of General Practitioners (RACGP) is collaborating with Health&, a new Web portal, and IBM Watson, to provide all Australian general practitioners and their patients access to the latest health and data technologies.

The Health& online proactive health management tool, supported by the RACGP, offers a secure place for individuals and their families to store their health data plus an easy-to- use library of health information approved by the Health& Medical Advisory Board, and made “easy to understand” with IBM Watson.

“Providing easy access to health information is the key to good health for all Australians,” said David Yip, Health Industry technical director, IBM Australia.

-----

http://www.adelaidenow.com.au/news/south-australia/doctors-union-warns-queen-elizabeth-hospital-patients-at-risk-from-epas-electronic-health-record-system/news-story/c06ae204c47aa8d3462564477d0521ab

Doctors’ union warns Queen Elizabeth Hospital patients ‘at risk’ from EPAS electronic health record system

Brad Crouch, Medical Reporter, The Advertiser

October 21, 2016 10:30pm

CRITICALLY ill patients are being placed in “dangerous environments” and there is a “high risk” clinicians are missing vital medical information following introduction of the controversial electronic health record system at the Queen Elizabeth Hospital, doctors warn.

In a letter to SA Health interim chief executive Vickie Kaminski, obtained by The Advertiser, the SA Salaried Medical Officers Association warned workloads had risen since the Enterprise Patient Administration System was rolled out in June and registrars were taking double the time to do ward rounds.

However, Mrs Kaminski said the rollout had “significantly improved patient safety” with a marked reduction in medication errors thanks to the automatic safety net built into the EPAS.

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http://www.theaustralian.com.au/news/world/the-times/stroke-victims-to-be-treated-with-electric-shocks/news-story/924d841d88c2efeca994855740b571a5

Stroke victims to be treated with electric shocks

Stroke patients could recover the use of their hands with a device that triggers their nerves through a series of clicks and electric shocks.

• Oliver Moody
• The Times
• 12:00AM October 20, 2016

Stroke patients could recover the use of their hands with a device that triggers their nerves through a series of clicks and electric shocks.

Each year millions of people around the world suffer strokes, in which part of the brain is damaged because its blood supply is cut off.

About half of those who survive the attacks are left with a disability, which often takes the form of a persistently clenched fist.

Scientists from Britain’s University of Newcastle believe they can teach patients how to loosen their hands by changing the wiring through which the brain sends messages to limbs.

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https://www.digitalhealth.gov.au/news-and-events/news/1158-digital-health-space-blog-leading-voices-in-health-and-care

Digital Health Space blog: Leading voices in health and care

Created on Monday, 17 October 2016

The Australian Digital Health Agency has launched the Digital Health Space, a blog where stories across Australian health and care are told and shared. Leading voices across peak bodies, healthcare advocates, along with emerging and established health and technology professionals will share their stories on the future of digital health and care.

CEO Tim Kelsey tells his story on his visits to the Northern Territory, where he spoke to pharmacists and patients on the transformative power of digital services and the crucial role people play in realising its potential. Recently, Mr Kelsey also visited Perth, Western Australia where the extraordinary story of Fiona and her husband Peter showed how important easier access to health information is in order to help patient care and improve patient outcomes.

The latest blog post by Vanessa Halter, senior privacy specialist at the Australian Digital Health Agency, highlights the crucial role of privacy in building confidence in digital health and driving its adoption across a range of health and care providers.

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https://www.digitalhealth.gov.au/about-the-agency/digital-health-space/item/3-privacy-enabling-trust-and-confidence-in-digital-health

Privacy – enabling trust and confidence in digital health

Monday, 17 October 2016

What’s the collective noun for a group of healthcare providers? A horde? A congregation? Certainly not a gaggle. I think it should be an orchestra – just as an orchestra is made up of distinctive yet harmonious sections, so too is the healthcare industry.

Recently, at the Sydney North PHN workshop, an orchestra of healthcare providers watched expectantly, waiting for me to pick up my baton, set the tempo and begin:

“The vast majority of people in this room did not get into the healthcare industry to work with computers. Your priority is your patient. Am I right?”

The pharmacists nod their heads, the general practitioners give a bit of a chuckle, and the practice nurses smile. Good, we’re in agreement.

I’ve been a privacy advisor for digital health for five years, and no presentation I make is ever the same. Yet, there is one consistent element with every audience: privacy is a priority. I see that as one of the reasons why some providers have not dived head first into adopting digital health. Those providers want to be absolutely sure that the trust their patients already have in them to uphold privacy is not eroded.

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http://www.wapha.org.au/my-health-record-clinical-engagement-medicines-integration/

My Health Record Clinical Engagement: Medicines Integration

Posted on 20 October 2016 | Category: Digital Health, My Health Record

The Australian Digital Health Agency wants to improve access to medicines, allergies and adverse reactions information in the My Health Record system, to better support medicines reconciliation processes and reduce adverse events.  To do this, the agency will be undertaking a research study in October and November of 2016, engaging with a range of healthcare providers to understand how the design of medicines information in My Health Record system could be optimised for use.

The research will seek to deepen understanding how the Agency should evolve the design of medicines related data in the My Health Record system, sensitive to this complex context, and so improve how users interact with, consume and contribute to consumer medicines related data.

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http://www.australiandoctor.com.au/news/news-review/6-wearable-technologies-for-doctors

6 wearable technologies doctors need to know about

John Kron | 14 October, 2016 |  

The explosion in wearable technology in recent years may be a commercial fad but many believe it will benefit doctors in treating patients. Australian Doctor takes a look.

Basic is probably the word that best describes the technology used in most pedometers back in the 1990s.

The device attached to your belt. A sensor counted up the steps and, well, that was about it.

Now, compare this with the Samsung belt launched in January.

Yes, it counts steps, but the sensors also measure distance travelled, activity and sedentary time, calories burned, waistline size based on belt tension. Then it sends the data to a smart phone app that suggests how best to manage your weight.

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http://www.australiandoctor.com.au/news/latest-news/can-big-data-research-lead-to-useful-medical-insig

Can big data research lead to useful medical insights?

Antony Scholefield | 18 October, 2016 

Many doctors have heard the phrase ‘big data’.

In fact, some might be tired of it already. There’s no perfect definition, but it usually describes huge datasets that reveal patterns of behaviour.

The Federal Department of Health has started to focus on using big data for medical research, and recently released a dataset based on anonymised Medicare data from 10% of patients.

It’s also working on a framework for secondary uses of MyHealth Record data, which will probably include using it for research.

But some UK and US researchers argue that big data will not lead to useful medical insights.

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http://www.afr.com/brand/chanticleer/top-scientist-wants-to-bring-big-data-analysis-to-healthcare-20161020-gs6yzx

• Chanticleer
• Updated Oct 21 2016 at 8:58 AM

Top scientist wants to bring big data analysis to healthcare

by Tony Boyd

A day after winning the Prime Minister's Innovation Prize, Mike Aitken, was busy pressuring federal and state governments, health funds, hospitals and doctors to begin a mammoth big data exercise in healthcare.

Aitken, who is chief executive of the Capital Markets Co-operative Research Centre, says there is an opportunity to save up to $20 billion a year from leveraging the power of personal health data.

His urgent call for action is timed to coincide with the publication of the first of three reports by CMCRC on the multiple silos of data in the health system.

The first report is called Flying Blind – Australian consumers and digital health.
Aitken says it "chronicles the opportunity loss to Australia from a failure to integrate more than 50 sources of health data in Australia".

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http://www.medicalobserver.com.au/professional-news/bacchus-marsh-baby-deaths-australia-should-learn-from-the-uk-and-publish-clinician-performance-data

Bacchus Marsh baby deaths: Australia should learn from the UK and publish clinician performance data

The Conversation

20 October 2016

By Andrew Street, University of York

The United Kingdom has been where the Victorian government is now. After a review confirmed 11 newborn and stillborn deaths at Victoria’s Bacchus Marsh hospital were potentially avoidable, the state is set to overhaul its health services.

It also took the deaths or serious injury of babies and children to change things in England. The General Medical Council’s 1998 inquiry into the deaths of 29 babies undergoing heart surgery in the 1980s and early 1990s at the Bristol Royal Infirmary concluded that there had been serious professional misconduct by three doctors. In response, the UK government decided to publish hospital death statistics.

The Victorian government’s review was chaired by Stephen Duckett, director of the health program at Grattan Institute. Its report into the safety of care in Victorian hospitals, released last week, concluded that the potentially avoidable deaths were the result of a series of catastrophic clinical and governance failures.

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http://www.australiandoctor.com.au/news/latest-news/telstra-run-national-cancer-register-voted-in

Telstra-run national cancer register voted in

Paul Smith and AAP | 14 October, 2016 | 

The ALP has failed in its initial attempts to stop Telstra running the new national cancer screening register, amid concerns that sensitive medical information would be handed to the private sector.

From 1 May, the national register will hold patient data on the revamped cervical cancer screening program, along with the bowel cancer screening program.

Despite Opposition claims the government was treating the register like a guinea pig by giving sensitive patient data to Telstra, the bill to establish the register passed the House of Representatives and the Senate last week.

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http://www.itnews.com.au/news/can-an-app-identify-autism-as-well-as-a-doctor-439774

Can an app identify autism as well as a doctor?

By Ry Crozier on Oct 21, 2016 6:42AM

La Trobe to test app coded for free by Salesforce.

Autism researchers from La Trobe University are about to test whether a smartphone app can identify potential signs of autism as accurately as healthcare professionals.

Salesforce earlier this year contributed a team of its engineers, developers and designers to researchers from the Olga Tennison Autism Research Centre (OTARC) to convert their work into code.

The result was ASDetect, an app available for iOS and Android. It has garnered 10,000 downloads in the first six months of availability, 75 percent from Australia. The researchers used Salesforce’s Dreamforce conference this month to officially launch the app in markets outside of Australia.

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http://www.healthlink.net/en_NZ/

HealthLink is 50% of the way to Meeting its Australian SmartForms Platform Establishment Target

Implementation of HealthLink’s SmartForms’ service is dependent upon establishment of the Aduro Interface, a standards based interface that enables a GP or Specialist’s electronic medical record (EMR) system to communicate with a centrally hosted forms server.  It is the Aduro Interface that automatically pulls information out of the EMR in order to populate the eReferral or service order form prior to its being sent. 

As of 1 October HealthLink was 50% of the way to implementing the Aduro interface across Australia’s main EMR systems.  With 4,300 sites now installed, HealthLink expects to reach the full 8,000 target sites by the end of 2016, with use of SmartForms applications ready to commence on a production basis early in 2017.  More than 95% of New Zealand General Practice sites have been installed and development by Incisive Software, New Zealand’s largest specialist EMR company is now underway.

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http://www.theaustralian.com.au/business/wall-street-journal/the-natural-side-of-artificial-intelligence/news-story/75006cebe88115d9e8626297bfc91520

The natural side of artificial intelligence

• Ginni Rometty
• The Wall Street Journal
• 2:23PM October 19, 2016

The rise of artificial intelligence has inspired both fascination and fear of the world to come. Some tech prophets envision a “singularity,” in which advances in AI trigger drastic technological growth, while others imagine that autonomous machines will someday turn on their creators and destroy us.

But when you’re engaged in the science of machine intelligence, you understand that this is a false set of choices shaped by a misleading phrase.

The term “artificial intelligence” was coined in 1955 to convey the concept of general intelligence: the notion that all human cognition stems from one or more underlying algorithms, and that by programming computers to think in the same way, we could create autonomous systems modelled on the human brain.

At the same time, other researchers were taking a different approach. Their method — which worked bottom up to find patterns in growing volumes of data — was called IA, short for “intelligence augmentation.”

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http://www.itwire.com/business-it-news/business-intelligence/75327-microsoft-cracks-the-code-on-speech-recognition-%E2%80%93-as-good-as-humans.html

Microsoft cracks the code on speech recognition – as good as humans

• 19 October 2016
• Written by  Ray Shaw

Microsoft has “cracked the code” achieving computer speech recognition on parity with humans for conversational speech.

This has long been the goal – a computer than can recognise conversational language with human accuracy. It is defined as Word Error Rate and humans generally get about 5.9% wrong. Microsoft says it is the lowest recorded against the industry standard Switchboard speech recognition task.

Suffice to say the researchers at Microsoft AI are chuffed and have published the paper in the Cornell University Library.

The abstract says, “The key to our system's performance is the systematic use of convolutional and LSTM neural networks, combined with a novel spatial smoothing method and lattice-free MMI acoustic training.” 

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Enjoy!

David.