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, June 12, 2018

Weekly Australian Health IT Links – 12th June, 2018.

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

All sorts seem to be going on with most States having some news. Interestingly we are seeing more and more negative commentary regarding the consistency and credibility of the ADHA and the opt-out. They seem to have more than one answer to a lot of questions – not sure why?
-----

Patients are digitally demanding

  • The Australian
  • 11:36AM June 6, 2018

Supratim Adhikari

The Australian healthcare sector is scrambling to meet the digital demands of patients, with a new survey from medical software and information provider MedicalDirector highlighting that more patients want healthcare providers to better use digital tools, mobile technology and the internet to improve their experience.
According to MedicalDirector’s Patient Engagement Survey 2018, conducted in partnership with online appointment and e-health platform, HotDoc, patients are particularly focused on technologies that helps them better manage their appointments, connect with their General Practitioners (GPs) and obtain test results and diagnoses.
Medical Director CEO Matt Bardsley said that building meaningful relationships with their GP is crucial to good patient outcomes.
-----

Bid to give police access to real-time S8 script data

Patient information would help them identify 'criminal entrepreneurs'
6th June 2018
Patient information contained in the upcoming national real-time script monitoring system would be handed to police investigators under a proposal from the criminal intelligence agency.
The system, which will alert doctors about to prescribe S8 drugs of previous scripts, has long been seen as the key to stopping doctor-shoppers and reducing the misuse of addictive medicines. 
The Federal Government announced funding for a national system in July last year.
-----

A third of poll respondents don’t want a My Health Record

More than a third of pharmacies are now registered for My Health Record, according to AJP’s latest poll

A significant minority of AJP readers have enough concerns that they have decided not to have a My Health Record themselves, a small AJP poll shows.
Between 16 July and 15 October 2018, Australians will be able to “opt out” of having a My Health Record.
More than a quarter – 26% at the time of writing (18 votes) – of AJP readers say they will opt out due to privacy concerns.
For article and poll go here:
-----

Australia to create a connected health service through the National Health Interoperability Roadmap

By: Teresa Umali
Published: 4 Jun 2018
Interoperability is an ongoing issue in an individual’s health record information. With the information fragmented across providers, some even stored as hard copies or scanned copies, retrieval of which becomes difficult especially during critical times. With the development of a National Health Interoperability Roadmap by December 2018, this can be solved.
An announcement from the Australian Digital Health Agency highlighted the government’s plan to connect health services all over the country through the National Health Interoperability Roadmap.
The process of easier access to health service records is about to become a reality. The National Health Interoperability Roadmap is on its way.
-----

Health withholds Telstra payments for $220m cancer register

By Justin Hendry on Jun 5, 2018 11:12AM

As go-live milestones missed.

The Department of Health is withholding payment from Telstra for the development of Australia’s national cancer register due to ongoing project delays.
Telstra won the $220 million contract to build and maintain the single national record for the screening of cervical and bowel cancers in May 2016.
The register was meant to replace eight separate cervical cancer screening registers operated by the states and territories and the paper-based national bowel screening register by March 2017.
-----

Queensland digital hospitals boosting outcomes

By Dylan Bushell-Embling
Thursday, 07 June, 2018
The Queensland Government has announced that the first of the state’s digital hospitals are improving patient outcomes and reducing complications.
The government has so far gone live with eight digital hospitals and plans to roll out 27 across the state by 2020.
These hospitals allow clinicians to monitor a patient’s vital signs such as blood pressure, temperature and heart rate in real time through advanced technology, and to access medical records by scanning a unique barcode on the patient’s identity wristband with a handheld device.
-----

Digital health: it’s in our DNA. Queensland Health Minister on the state’s high-tech revolution

Lynne Minion | 08 Jun 2018
As eHealth Queensland celebrated the annual showcase of its nation-leading, state-wide tech transformation, the state’s Minister for Health said, “Digital is no longer seen as a ‘nice to have’, it is now part of Queensland Health’s DNA”.
With eight digital hospitals and 19 more going live over the next three years, and advances in 3D-printed body parts, nanotechnology, robotics and genomics, the Brisbane eHealth Expo gave a capacity crowd in Brisbane a view of the state’s pioneering plans.
“Our goal is to improve the health of all Queenslanders and technology advancements in healthcare is a big part how we will achieve this,” Health and Ambulance Services Minister Steven Miles told Healthcare IT News Australia.
-----

ACT Health lands $40m for core IT upgrades

By Justin Hendry on Jun 5, 2018 6:27PM

All the tech in the ACT Budget.

The ACT government has earmarked more than $40 million in this year’s budget to replace several core IT systems at ACT Health.
The government will provide $18 million, including $6.7 million in capital, to replace the existing ACT pathology laboratory information system over four years.
It will be replaced with a new end-to-end cloud-based system that “will support the entire process of pathology services, from ordering and specimen collection through to testing, validation, reporting and billing”, in a bid to improve efficiency and the patient experience.
-----

Troubled hospital spends $2.3m on paper deliveries

  • The Australian
  • 12:00AM June 4, 2018

Michael Owen

About 2000 medical records are being delivered daily to the new $2.4 billion Royal Adelaide Hospital from a storage site because the “paper-light” design means the hospital’s floors cannot withstand the weight of patient files.
The Australian can reveal the cost of storing and delivering paper records to the new hospital is more than $2.3 million a year.
The former South Australian Labor government designed the hospital, once ranked the third most expensive building in the world, to be run without old-­fashioned patient records and instead to use its computerised Enterprise Patient Administration System, which has been dogged by cost blowouts and time delays.
-----
Adelaide Thursday June 07, 2018

"Cumulative errors" in EPAS procurement, Ombudsman finds

SA Health failed to use proper procurement processes when it acquired controversial electronic health records program EPAS, the State Ombudsman has found.
Bension Siebert
Ombudsman Wayne Lines’ investigation has found “cumulative procedural errors” in SA Health’s original procurement of the Enterprise Patient Administration System, including insufficient detail to justify not going to tender on the project.
But Lines cleared the department and its executives of maladministration and misconduct, according to a two-page summary final report, released on the Ombudsman’s website.
EPAS has come under fire for repeated cost blowouts – its budget is now $472 million – and persistent claims by medical staff that it poses threats to patient safety, despite SA Health data showing a drop in medication errors at sites using the software.
-----

SA Ombudsman finds deficiencies with EPAS procurement

By Justin Hendry on Jun 8, 2018 11:41AM

Did not observe proper practices.

SA Health failed to follow proper procurement processes for the state’s much maligned electronic patient administration system (EPAS), the state’s Ombudsman has found.
Ombudsman Wayne Lines’ probe into the procurement of EPAS implementation lead ZED Business Management identified “cumulative procedural errors in relation to contract execution” by the department.
While noting the department’s attempts to address the “deficiencies”, his “final view was that the failure to observe proper procurement processes was wrong”.
-----

SA Government describes EPAS as a "failure" that is impairing hospital operations

Lynne Minion | 05 Jun 2018
South Australia’s EPAS system has been described as a “failure” by the state government, with Health Minister Stephen Wade claiming the operation of the flagship Royal Adelaide Hospital and other hospitals are being impaired by the long-troubled electronic health record.
The partial EPAS implementation at RAH has led to the latest embarrassing revelation, with The Australian reporting that it is costing the state $192,000 a month to store paper patient records off-site and deliver thousands to the hospital each day.
According to a SA Health spokesperson, the new $2.4 billion hospital’s floors can’t withstand the weight of the paper.
-----

NSW Health rostering system $37m over budget

By Justin Hendry on Jun 7, 2018 3:20PM

But starting to deliver benefits.

NSW Health has spent an extra $37 million on its new state-wide rostering system HealthRoster, putting the project more than 40 percent over budget.
The state’s audit office today released its report on the benefits of the system, which is also “taking six years longer ... to fully implement than originally planned”.
The auditor found that while the system is starting to deliver some benefits to local health districts (LHDs) where it has been implemented, the journey has not been without its problems.
The state government approved $88.6 million back in 2009 to replace NSW Health’s legacy rostering systems, including an out-of-support Kronos system, with a single system that more effectively rosters staff.
-----
  • Updated Jun 6 2018 at 11:00 PM

Big pharma wants to invest more in Australian biotech says Greg Hunt

by Ben Potter
Big US pharmaceuticals companies such as Johnson & Johnson, Pfizer, Merck, AbbVie and Eli Lilly want to invest more in Australia as a result of the Turnbull government's efforts to stimulate the medical tech and biotech sectors, Health Minister Greg Hunt has said.
Mr Hunt said the increased interest was the result of the government's cumulative efforts over several years to turn more of Australia's world-leading medical and pharmaceuticals research into commercial products, starting with the establishment of the $20 billion Medical Research Future fund in the 2014 budget.
The 2018-19 budget's change to the research and development tax incentive to reward greater R&D "intensity" – spend as a share of sales – and carve out clinical trials from new payment caps had added to Big Pharma's interest, as had the $1.3 billion medical industry growth plan which included $248 million to expand clinical trials.
-----

Third of 416 robo-debt claims found to be wrong

One-third of the appeals made by those who were slugged with debts by Centrelink, over what has come to be known as the Federal Government's robo-debt scheme, have been upheld by the Administrative Appeals Tribunal.
Statistics provided during Senate Estimates showed that since the program was launched by the government in mid-2016, 461 cases had been decided by the AAT.
Of these, 265 (63.7%) had been left unchanged, 10 (2.4%) varied from the original estimates, and 141 (33.89%) had been set aside, Australian Greens Senator Rachel Siewert said in a statement.
-----

Lost in transition

Rate of errors are still too high at care transition, and HMR funding caps are not helping: experts

Problems with coordination of care are still leading to an unacceptable level of medication errors, says a team of experts who has highlighted some areas that could improve the situation.
A review article by a multidisciplinary research team has highlighted the scope of the problem and suggested a range of potential solutions, including emphasising the value of medication reviews.
People with complex medication regimens, older people, those with mental health problems, people who are poor or have low literacy, and Aboriginal and Torres Strait Islander and migrant populations are particularly at risk of medication discrepancies, the authors said.
-----

Trembling cursor ‘early sign’ of Parkinson’s

  • Mark Bridge
  • The Times
  • 12:00AM June 5, 2018
Your web searches, mouse movements and even online scrolling speed could be monitored remotely to spot Parkinson’s disease or Alzheimer’s.
Data from millions of users of Microsoft’s Bing search engine revealed a correlation between those with tremulous mouse ­actions and those whose search terms suggested they were ­Parkinson’s patients.
The findings could lead to ­algorithms identifying the onset of the disease sooner but have raised privacy concerns about the extent and power of data harvested by tech companies.
-----

Melbourne children's hospital emergency department gets real-time wait updates

The Royal Children's Hospital Melbourne aims to alleviate crowds at the emergency department with its new wait status dial.
By Jonathan Chadwick | June 7, 2018 -- 03:03 GMT (13:03 AEST) | Topic: Innovation
The Royal Children's Hospital Melbourne (RCHM) has released an online tracker that gives real-time information about wait times in their emergency department (ED) 24 hours a day.
The tracker, unveiled on Thursday by Premier Daniel Andrews and Minister for Health Jill Hennessy, rates activity as normal, very busy, or extremely busy on a dial. The portal is aimed to help parents decide whether to take their children to a local hospital or GP instead of the ED.
According to the Victorian government, data shows over 60 percent of parents currently bypass their local hospital to attend the ED, which can result in crowds and long delays for patients with less serious illnesses or injuries.
-----

Dementia Australia rolling out virtual reality workshops nationwide

Puts participants in the shoes of someone living with dementia
George Nott (Computerworld)
Dementia Australia is rolling out its hugely successful virtual reality based training workshops nationwide.
The EDIE (Educational Dementia Immersive Experience) VR tool has been used as part of workshops run by the charity in Victoria for the past two years. The workshops were held for the first time in New South Wales late last year and in recent weeks have been made available in Queensland and South Australia.
The ‘Enabling EDIE’ workshops use a virtual reality app developed by researchers at Deakin University run on Samsung Gear VR headsets to deliver a training program that helps participants better understand the lived experience of dementia sufferers.
-----

Where's the evidence for prescribing health apps?

7 June 2018

TECH TALK

The hype around mobile health apps in recent years has been almost overwhelming. But the actual evidence? Not so much.
There is, in fact, very little evidence that health apps do anything to help patients, according to a review.
Although many GPs would be unsurprised at this conclusion, the review did throw up some new and surprising stories of exactly how some apps fail to deliver anything useful.
-----

10 ways pharmacies fall victim to cyber criminals

Technology expert shares tips on how to protect yourself
7th June 2018
Training staff to prevent cyber attacks is essential for pharmacies, says MedAdvisor chief technology officer Dr David Chatterton.
As small businesses, pharmacies often don’t have access to proper IT support, he says. It’s very hard to gain back trust once a breach has occurred.
Here are 10 tips based on incidents in pharmacies:
  1. Staff should be trained to avoid using pharmacy computers for personal email and web searches.
  2. Update to Windows 10. Windows XP is not secure and no longer supported by Microsoft. Without an upgrade, pharmacies leave themselves more vulnerable to malware programs and hackers. Cyber criminals are taking advantage of old operating systems used by healthcare providers to install malware to encrypt data. They then demand a ransom be paid in Bitcoin to unlock it.
-----

'White-hot anger': St Vincent's Hospital email gaffe reveals confidential employee details

By Lucy Cormack
8 June 2018 — 4:32pm
Employees at St Vincent's Hospital have expressed "white-hot anger" after more than 200 staff members were accidentally identified in a mass email responding to confidential voluntary redundancy applications.
The privacy breach occurred when an email was sent from the hospital’s human resources department to 220 staff members who had recently applied for a voluntary redundancy.
It is understood all staff were given the opportunity to apply for the non-targeted voluntary redundancy process, which sought 39 members of staff.
-----

Informed consent and internet-based research in epidemiology

Laura Goddard, Fiona J Bruinsma and Graham G Giles
Med J Aust 2018; 208 (10): 424. || doi: 10.5694/mja17.01021
Published online: 4 June 2018
Guidelines are needed for obtaining and storing informed consent in internet-based research
The internet has become an easily accessible resource for conducting epidemiological research, but there are currently no national guidelines for researchers or human research ethics committees which are specific to ethical considerations in internet-based research in Australia.
-----

Better health for Australians with My Health Record

My Health Record is a secure online summary of health information which improves access to health information for patients, carers and health providers. You can choose who your record is shared with; who accesses it and what’s stored in it.
The benefits of My Health Record include reducing time spent looking for and carrying health information around; avoiding unnecessary repeated scans and blood tests; and you won’t have to repeat health history to different health providers - which is especially handy for people travelling around Australia.
By the end of 2018, every Australian will have a My Health Record unless they choose not to have one during the three month opt out period that will run from 16 July to 15 October 2018.
For more information visit the My Health Record website.
(Propaganda Alert)
-----

Cancelled My Health Record data to be kept in limbo

Those choosing to opt-out of the My Health Record service will still have their data visible if they reactivate their account.
By Asha McLean | June 5, 2018 -- 03:50 GMT (13:50 AEST)
The federal government is automatically signing people up to its My Health Record scheme, with the goal of having issued a digital medical file to all Australians by the end of this year.
Individuals will have the ability to opt-out of the service; however, the information will not be destroyed as first thought, rather it will be kept in somewhat of a limbo.
Offering further detail on the online record last month, Tim Kelsey, chief executive of the Digital Health Agency (ADHA) -- the agency charged with overseeing the My Health Record and ensuring citizen information is secure -- said that after a record is cancelled, no data will be attributed to it until it's reactivated, at which time two years' worth of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data from that date will be repopulated.
-----
6 June 2018

ADHA reveals MHR information strategy

Posted by Julie Lambert
The Australian Digital Health Agency will use GP clinics, chemist chains and media advertising to sell the public on electronic health records in the three-month opt-out period starting in July.
ADHA CEO Tim Kelsey has confirmed that the agency would rely largely on the 31 Primary Health Networks to run public information campaigns which will begin from the July 16 launch date.
The campaigns would cover the rights and ability of consumers to opt out of the My Health Record scheme, the benefits of staying in, and the possible use of data by third-party organisations.
-----

An important overview of the pros, cons and questions about My Health Record

By the end of 2018, a My Health Record (MHR) will be created for every Australian unless they choose not to have one.
This major development brings potential benefits – but also raises complex questions for individuals to consider, according to Leanne Wells, CEO of the Consumers Health Forum of Australia.
Wells reviews the pros, cons and challenges involved, in the #LongRead below.
-----

My Health Record data could be uploaded without consent

By Justin Hendry on Jun 7, 2018 11:56AM

Risking loss of personal control.

Confidential healthcare data could be uploaded onto a My Health Record unbeknownst to an individual if activated by a clinician, bypassing otherwise stringent mechanisms to ensure the scheme is consent-based.
The potential for two years of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data to be uploaded to e-health records automatically was confirmed by Australian Digital Health Agency chief Tim Kelsey last week.
The scenario could arise where a newly created record is not personally activated following the forthcoming three-month opt-out period between July 16 and October 15.
-----

Going on the record

The 3-month window for opting-out of the My Health Record begins soon. Health bureaucrats gave a Senate hearing the latest on the program, including what pharmacy’s role entails

The My Health Record program was a topic of lengthy discussion and questioning at the recent Senate Estimates Committee hearings in Canberra.
Among the data and opinions presented were many revealing figures on the scale of program, how patients can opt-out, and when. It also covered the number of pharmacies currently involved in the program, and what their role in it actually entails 
-----

Why should GPs care about primary health networks?

5 June 2018

OPINION

One dream scenario is actually a current reality, says Dr Charlotte Hespe.
Imagine it is Monday morning, and Margaret is in the waiting room. She is a 78-year-old widow who is living with poorly controlled diabetes, retinopathy, moderate renal impairment, osteoarthritis, depression and recurrent falls. She has been seeing you, her trusted GP, for the past 15 years.

To add to her current problems, her latest blood test shows iron deficiency anaemia, no doubt related to her polypharmacy and NSAID use.

Kylie, your practice nurse, pops in and says that she is worried about Margaret’s mental health and thinks she needs some extra support. Margaret can’t afford to see a psychologist.

-----

Understanding the digital behaviours of older Australians

1 Jun 2018
Description
This report details findings of a combined quantitative and qualitative study which aimed to understand the current behaviour and perceptions towards digital devices and internet amongst people aged 50 years and over.
The quantitative component involved 3,602 nationwide telephone surveys using a Random Digit Dialling (RDD) approach. The sample achieved delivers a statistically representative sample that provides insight into people aged 50 years and over in terms of their behaviour and attitudes towards digital devices, e.g. smartphone, desktop computers etc., and the internet. Fieldwork was conducted from 25 May 2017 to 26 June 2017 with the results obtained reflecting a baseline measurement of people’s attitudes and behaviour.
-----
Monday 4th Jun, 2018

Millions of older Aussies missing out over ‘fear’ of the internet

Can you believe that a whopping 2.7 million Australians over the age of 50 have no idea how to access the internet, connect to WiFi or even send an email?
A shocking new study has revealed that a huge percentage of Australia’s older generation are missing out on all that the internet has to offer, with the main reasons being fear of the unknown and feeling intimidated by technology.
However, the results also revealed that more than half of over-50s across Australia actually want to get to grips with digital technology, but the main factor holding them back is feeling apprehensive and intimidated when it comes to asking for help, with many unsure about where to look for support in the first place.
-----
  • Updated Jun 4 2018 at 11:00 PM

Scott Farquhar's Skip Capital and AirTree back skin cancer start-up MetaOptima

After a worldwide search for the "best company in the field", Scott Farquhar's Skip Capital and AirTree Ventures have invested $US6.5 million ($8.6 million) in skin cancer detection start-up MetaOptima.
The Canadian company says it has developed the world's most-advanced skin imaging and analytics tool, DermEngine, which uses artificial intelligence to assist in the detection of all types of skin cancer.
​The investment is a personal one for AirTree's Daniel Petre, who told The Australian Financial Review the process began almost four years ago when one of his daughters was diagnosed with melanoma at just 21.
-----

DXC Technology nabs Dr John Lambert as medical director

Dr Lambert moves to the company from eHealth NSW
Byron Connolly (CIO) 05 June, 2018 12:23
IT services company, DXC Technology has appointed former eHealth NSW CIO Dr John Lambert as its first chief medical director in Australia and New Zealand.
Lambert was lured across from the NSW health system, where he has worked as medical doctor for more than 25 years. He was appointed as eHealth NSW’s inaugural chief clinical information officer in July 2014.
He is also a board member of the Health Informatics Society of Australia and a qualified anesthetist and intensivist.
-----

The Aussie Shepherd maps indoor space for visually impaired

Media release | 5 June 2018
When the Aussie Shepherd founder Anna Wright was diagnosed with a rare eye condition and told she would eventually go blind, it not only changed her life but drove her to help others with visual impairment.
With the assistance of a $25,000 Minimum Viable Product grant from the NSW Government-backed Jobs for NSW, Ms Wright developed Banjo Maps, which helps people with visual impairment navigate internal spaces like public buildings and shopping centres.
Deputy Premier and Minister for Small Business John Barilaro said Banjo Maps was a fantastic new technology that had the potential to be exported globally with great positive impacts for the visually impaired.
-----

Waitemata and Counties Manukau DHBs live with Clinical Portal 8

Tuesday, 5 June 2018  
eHealthNews editor Rebecca McBeth
Waitemata DHB and Counties Manukau Health have gone live with Clinical Portal 8, the latest version of Orion’s Concerto platform.
The DHBs launched a single instance of the portal on 18 April, allowing them to share more information across the region. Auckland and Northland DHBs are set to move on to the regional platform in the future.
HealthAlliance, the shared services provider for the four Northern region DHBs, says the new system allows single sign-on for clinicians as well as providing a “highly available, resilient, and scalable platform with faster response times”.
-----

Rigorous new complaints rules set to be imposed on telcos

New telco industry standards designed to give consumers an improved complaints experience when migrating to the national broadband network are about to come into effect, with the regulator acknowledging that “buck-passing” has plagued consumer experiences in the past.
The rules, to take effect from 1 July, can potentially result in the imposition of civil penalties of up to $250,000.for telcos breaching the standards.
The new standards and record-keeping rules were announced on Thursday by the Australian Communications and Media Authority (ACMA), with the Authority chair Nerida O’Loughlin acknowledging that consumers deserve to have better complaints-handling procedures.
-----
Enjoy!
David.

Monday, June 11, 2018

HealthEngine Comes Out Of The Bunker And Apologises Unreservedly.

This appeared a little while ago:

HealthEngine chief 'unreservedly apologises' for editing patient reviews


The chief executive of HealthEngine, the online GP booking business at the centre of a review-tampering controversy, has apologised for the company's actions and announced a sweeping review of its "aspirational review system".
Fairfax Media revealed exclusively on Sunday that 53 per cent of the 47,900 "positive" patient reviews on HealthEngine had been edited in some way, with many turned from tepid or negative to "positive customer feedback".
Initially, HealthEngine's head, Marcus Tan, defended the company's review policies, saying it published only positive reviews because it wanted to celebrate high-performing GP practices.
But in a letter published on HealthEngine's home page on Monday, Dr Tan, himself a GP, said the company did not mean to mislead readers and had realised it could do things better.
"User trust is paramount to us at HealthEngine and we are conducting an internal and external review of the HealthEngine Practice Recognition System to ensure clarity, compliance and best practice regarding the way in which we review and publish patient comments," he wrote.
"We have removed all customer feedback from our site until further notice pending the results of our review."
In a separate comment on social media, he said he recognised the way that the review moderators worked had caused some "unintended confusion" and "unreservedly apologised" for this.
HealthEngine said previously it did not publish negative comments because it ran an "aspirational" review system and it edited out identifying details and clinical information to comply with laws and Australian Health Practitioner Regulation Agency's (AHPRA) guidelines.
After scrutinising both the original reviews and edited versions, Fairfax Media found numerous examples where relevant but negative points had been deleted to the point at which what was published no longer reflected the patients' opinions.
Lots more here:
Looks like they are sensibly in full crisis response mode – driven by the commercial partners no doubt.
Now we just await the scale of the damage to become clear.
David.

A Pair Of Nice Long Reads On The myHR To Assist In Opt-Out Decision Making.

Given it is a holiday weekend I thought I would have a little break and let two other authors discuss the issues.
First we have Leanne Wells writing on Croaky.

An important overview of the pros, cons and questions about My Health Record

By the end of 2018, a My Health Record (MHR) will be created for every Australian unless they choose not to have one.
This major development brings potential benefits – but also raises complex questions for individuals to consider, according to Leanne Wells, CEO of the Consumers Health Forum of Australia.
Wells reviews the pros, cons and challenges involved, in the #LongRead below.

Leanne Wells writes:

After years of uncertainty about the future of a nationally effective eHealth system, Australia is now preparing for the biggest step yet towards a near-universal scheme with the expansion of the My Health Record’s (MHR) reach to all people – except those who choose to opt out.
So the crunch questions about the pros and cons of MHR now take on a more immediate and direct import for the majority of Australians who have so far not signed up.
The Consumers Health Forum has strongly supported MHR and the change to an opt-out approach because we believe that, for the majority of Australians, the potential individual and national health benefits outweigh the risks that it may pose to privacy and security.
In simple terms, the more Australians who use MHR, the more use it will be to Australians.
Going for opt out makes it much more likely that MHR will become effectively universal with all the benefits of scale, interconnected care and potential for transformational change that this offers for patients and for the health system.
It should not be seen as a revolutionary or final version that solves all our problems and that never changes – it is an evolutionary step that will only get to where it needs to be with use by, and engagement of consumers and health professionals.
A common complaint of the current level of MHR information is that often it is too meagre to be of much use and that too many health providers are reluctant to use it for cost, efficiency, and change-resistant reasons.
Consumers have also regarded it as clunky, although improvements are underway.
Yet opt-out stands to bring us much more quickly to an inflection point where, for the first time, consumers en masse will have access to their records – and to personally control who sees them and under what conditions.
Here is the link:
To be fair Ms Wells presents a pretty balanced view and makes it very clear that the myHR is no unalloyed good and that there are all sorts of issues which one needs to reflect on before deciding to just let opt-in happen.
A rather more negative and again long read is here:

Why and how to opt out of My e-Health Record

After the article “My Health Record gets one million more reasons to sign up” was published on health.gov.au, it seems only fair that someone should mention at least a few reasons to opt out.
By “one million”, the Department of Health meant a million of Australians chosen to be Guinea pigs in the new e-Health trial where online heath records were created for each of them without them asking. The trial is touting its success saying that only 2% opted out of My Health Record (MyHR). However, the low opt out rate could easily be down to the fact that the trial participants were only sent glossy brochures plastered with photos of smiling people and outlining only the benefits of having an online health record, without mentioning any risks, disadvantages and implications. Just like it is done in other medical “information” booklets: pick up any pro-screening brochure at your doctor's office and compare the length of text urging you to screen and the text honestly disclosing risks of misdiagnosis, over-treatment and other harms. The situation with MyHR can hardly be expected to be any different.
Every person needs to know all pros and cons before making an informed decision. We all heard about the promised benefits of having an online medical record. Here is a small list of reasons on

Why opt out

The laws and legislation governing and protecting My Health Record can be changed at any time to suit the political agenda of the day.

It already happened once: the parliament passed a bill specifically to enable the creation of trial online health records for one million people who never asked for it. Back then the need to obtain consent was a big legal obstacle — so this was removed. Now the law does not require your consent for your health data to be collected and stored. At the moment, the e-Health scheme allows to opt out, but there is no guarantee that opting out won't be stopped or made excessively difficult in the future. There is also no guarantee that one day some budget genius won't come up with an idea to start selling health record data to private corporations, insurance companies, pharmaceutical giants, marketing researches or anyone else. It will be simply a matter of another bill hastily passed through.
Eventually, all the health information may be stored in a large database where it can be used for purposes other than health care and matched against other databases. Australian Bureau of Statistics already announced its plans to link census data with medical records. The Australian Taxation Office is also pushing for increased sharing and use of Government held personal data.
Vastly more here:
Both these are well worth the time to read and I reckon at the end of that process you will be pretty clear as to what course suits you!
All will be aware that my view is to stay well away and to opt-out unless there are circumstances the myHR seems to provide something you believe you need despite all the potential downsides.
David.

Sunday, June 10, 2018

Let’s Call A Spade A Spade! On The Face Of It This Is Misleading And Deceptive Conduct Isn’t It?

This appeared earlier today:

'Very poor': GP booking service HealthEngine sanitises patient reviews

By Esther Han
10 June 2018 — 12:00am

In numbers

·         "Positive customer feedback" of GPs on HealthEngine's website. 47,900
·         Reviews that have been edited. 53%
·         Medical practices listed on the website that have reviews. 1840
Australia's largest online GP booking business HealthEngine has been caught dramatically altering negative patient reviews and publishing them as "positive customer feedback", potentially misleading users.
A Fairfax Media analysis of the 47,900 "positive" patient reviews of 1840 medical practices on HealthEngine found 53 per cent had been changed in some way. HealthEngine says it only publishes positive reviews.
After scrutinising both the original reviews and edited versions, Fairfax Media found numerous examples where relevant but negative points had been deleted to the point that what was published no longer reflected the patient's opinion.
One patient originally wrote: "The practice is good. All the doctors I've seen there are good apart from [doctor's name] ... she genuinely comes across like you are wasting her time". This was whittled to "The practice is good. All the doctors I've seen there are good" and posted on the clinic's webpage.
Another submitted: "I will use this practice if I have no other option. Receptionist was lovely but the wait and then the doctor checking text messages and not seeming connected with us was disappointing". This was published as "Receptionist was lovely".
The Australian Competition and Consumer Commission (ACCC) said selectively editing reviews could mislead customers, especially if the total body of reviews doesn't reflect the writers' opinions. An ACCC spokesman said it couldn't comment on a specific business.
The Australian Health Practitioner Regulation Agency (AHPRA) said a person who advertises a regulated health service or business in a way that is "false, misleading or deceptive or is likely to be misleading or deceptive" is in breach of the law. They also couldn't comment on HealthEngine's practices.
The start-up company's conduct is worthy of scrutiny as it is forging a digital path for the healthcare sector that's largely been reluctant to be compared and rated by health consumers.
Lots more here:
Reading through the examples captured this is just fraud, pure and simple, as far as I can tell. It’s really sad that this is happening and the site has just blown its credibility and become yet another example of why one has to be so careful to check out carefully what you see on-line.
Does anyone have a believable explanation as to why this would happen, other than just greed (and maybe stupidity)?
Another possible blow to the credibility of Digital Health maybe? I am not sure but doubt it, but surely a serious blow to the commercial backers who I suspect will be furious!
I also suspect the Financial Services Royal Commission would point out this sort of behaviour falls far below community expectations!
All rather a pity I reckon, assuming the report is true, which I have no reason to doubt..
David.

Update - 9:57 Mon 11, 2018

HealthEngine have just tweeted that their practice recognition system was well intentioned but didn't quite work out - to paraphrase the tweet.

Feature withdrawn and full review underway.

D.

 

AusHealthIT Poll Number 426 – Results – 10th June, 2018.

Here are the results of the poll.

Does The ADHA Have The "Social License" (Public Support, Confidence, Trust, Understanding etc.) To Introduce The Near Universal myHR?

Yes 3% (5)

No 97% (160)

I Have No Idea 0% (0)

Total votes: 165

As clear cut as it gets – the view among our readers is that the ADHA has not earned to trust it needs!

Any insights welcome as a comment, as usual.

A really, great turnout of votes!

It must have been a very easy question as just 0/165 readers were not sure what the appropriate answer was.

Again, many, many thanks to all those that voted!

David.

Saturday, June 09, 2018

Weekly Overseas Health IT Links – 9th June, 2018

Here are a few I came across last week.
Note: Each link is followed by a title and 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.
-----

Breast cancer screening error ‘may have affected thousands more’

The breast cancer screening error may have affected thousands more women across England, one researcher at Kings College London has claimed.
Hanna Crouch – 31 May 2018
Jeremy Hunt told MPs in May that a “computer algorithm failure”, which dated back to 2009, meant a group of women were not sent routine screening invitations before the cut off point of their 71st birthday.
Hunt said initial estimate by Public Health England (PHE) predict that up to 450,000 women may have been affected by the glitch, which dates back to 2009.
However Professor Peter Sasieni, a cancer screening and prevention researcher at King’s College London, has claimed the error could date back to early as 2005.
-----

Orion Health cuts 177 jobs and posts $40m loss

30 May 2018
New Zealand clinical integration and population health specialist Orion Health has posted losses of  NZD $40m (£20.9m) and revealed 177 jobs have been cut internationally.
Orion Health’s chairman also confirmed the company is continuing to work on, but has not yet been able to complete, a “strategic review”, likely to include a partial sale of the business.
The most recent job losses have included staff in the UK, and come at the same time as new government investment is being committed to regional interoperability initiatives.
-----

Updated: IBM Watson slashed workforce this week

With one employee describing the layoffs as a cost-cutting measure, estimates say Big Blue may have cut as much as 70 percent of its employees.
June 01, 2018 09:06 AM
After multiple press reports said IBM Watson laid off 50-70 percent of its workforce, a research note published by investment banking company Morgan Stanley on May 31 pushed back on that percentage. IBM, for its part, said the layoffs were small.
“First, any layoffs come on the back of IBM’s reported $613 million restructuring announced on the April 17th earnings call – of which, about $100 million related to the Cognitive business division,” according to Morgan Stanley. “IBM management, as recently as the March 8th, 2018 investor day, discussed aggressive hiring in strategic areas, including Oncology within Watson Health.”
“IBM is continuing to reposition our team to align with our focus on the high-value segments of the IT market,” the company said in a statement. “We’re not discussing specific numbers of employees affected, but it’s a small percentage of our global Watson Health workforce, as we move to more technology-intensive offerings, simplified processes and automation to drive speed.”
-----

Catching up with recent moves in EHR, interoperability initiatives

Apple, Allscripts, athenahealth, Cerner and others made noteworthy moves in the last few weeks.
June 01, 2018 09:29 AM
May might be the month for flowers but hospitals and other healthcare organizations have hardly slowed down to smell them if EHR implementations and interoperability work are any indication.
Instead, it’s been another busy one, not altogether unlike April before it. 
The biggest event, of course, came when the U.S. Department of Veterans Affairs, after much delay and the public firing via Twitter of Secretary David Shulkin, MD, officially signed the modernization contract with Cerner.
VA inked that pact as Cerner’s work with the Defense Department came under fire from an audit report for being “not operationally suitable,” after which Cerner President Zane Burke responded by suggesting that was fake news possibly.
-----

Prescription drug monitoring program use continues to rise

Published June 01 2018, 7:24am EDT
Physician use of state-run prescription drug monitoring programs is dramatically increasing while doctors have decreased opioid prescribing nationwide for the fifth consecutive year.
That’s among the findings of a new report released on Thursday by the American Medical Association, which the organization says shows progress toward reversing the U.S. opioid epidemic.
According to the AMA, the number of opioid prescriptions decreased by more than 55 million—a 22.2 percent decrease nationally—between 2013 and 2017, with a 9 percent decrease—more than 19 million fewer prescriptions—between 2016 and 2017. In fact, all 50 states have seen a decrease in opioid prescriptions over the last five years, notes the report.
-----

HIT Think Why provider IT systems aren’t ready to capitalize on patient data

Published June 01 2018, 3:44pm EDT
Value-based care is bringing about a shift in patient empowerment, forcing changes in their relationships with healthcare organizations, which now have to provider greater value, a better experience, accountability and transparency.
New technologies also are empowering patients, who are able to see benefits from the personal use of wearable devices, remote health monitoring and online diagnostic tools, health apps and telemedicine. These technologies can provide physicians with important insights to track, monitor and measure a patient’s progress. Engaging patients in this way will also reduce time in clinics, connect the circle of care and better deliver the quality of care that best suits them.
Factoring in the impact of artificial intelligence, predictive analytics and sensors, it’s clear that the vast amount of data now available to the provider community represents a challenge to manage. Using all this data to maximize the potential benefits also has to be balanced with maintaining patient privacy and trust—all the while not overwhelming physicians and clinicians with data that is not meaningful.
-----

Skyping the doctor? Poll shows it's not just for the young

  • By Lauran Neergaard and Emily Swanson, Associated Press
WASHINGTON — May 31, 2018, 1:40 PM ET
Every morning, 92-year-old Sidney Kramer wraps a blood pressure cuff around his arm and steps on a scale, and readings of his heart health beam to a team of nurses — and to his daughter's smartphone — miles from his Maryland home.
Red flags? A nurse immediately calls, a form of telemedicine that is helping Kramer live independently by keeping his congestive heart failure under tight control.
"It's reassuring both psychologically and physically. The way he's put it to me, it's like having a doctor appointment every morning," said Miriam Dubin, Kramer's daughter.
-----

How using blockchain in the supply chain could democratize innovation itself

The distributed ledger technology could help increase transparency, adding visibility and improving supply chain economics.
By Conner Forrest | June 1, 2018 -- 14:58 GMT (00:58 AEST)
Opinions about the business value of cryptocurrency are mixed, but the blockchain technology that underpins it has emerged as one of the potential next big things in enterprise technology. Organizations are just beginning to dip their toes in the blockchain waters, but a few industries have emerged as ripe for blockchain disruption.
Chief among those: Supply chain.
For the uninitiated, blockchain is a decentralized, distributed ledger technology that maintains transactional records known as blocks. The blocks are cryptographically secured and are immutable, making it easier for members of a given blockchain network to track the transaction history of a given asset and confirm its provenance. So, it's pretty clear why this would work so well for a supply chain.
-----

AI outperforms dermatologists in diagnosing skin cancer

Published May 30 2018, 7:22am EDT
Dermatologists are no match for artificial intelligence when it comes to diagnosing skin cancer, according to a new study by researchers in the United States, France and Germany.
The international team trained a convolutional neural network (CNN) to identify skin cancer by showing it more than 100,000 images of malignant melanomas as well as benign moles.
Specifically, they trained and validated Google’s Inception v4 CNN architecture using dermoscopic images at a 10-fold magnification and corresponding diagnoses. Then, they compared its performance with that of 58 international dermatologists from 17 countries—including 30 experts with more than five years of experience.
-----

Seniors Slow to Embrace Online Access to Doctors

WEDNESDAY, May 30, 2018 (HealthDay News) -- Many doctors have internet portals to help patients manage their care. But that doesn't mean older folks will use them.
A University of Michigan poll found only about half of patients 50 to 80 years old have set up an online account with their health care provider.
"The health care system has provided patient portals as an efficient way for patients to communicate with their providers. But many older adults are uncomfortable with electronic interactions substituting for a phone call or in-person conversation," co-associate poll director Sarah Clark said in a university news release.
-----

FDA launches innovation challenge to help stem opioid crisis

The contest aims to offer unique approaches to detecting, treating and preventing addiction, Food and Drug Administration officials said.
May 30, 2018 01:23 PM
The U.S. Food and Drug Administration on Wednesday announced an innovation challenge to address the national opioid epidemic. 
Specifically, FDA is looking to the developer community to build digital health technologies, such as medical devices, diagnostic tests and mobile apps to help stem the opioid crisis. The intent is to provide unique approaches to detecting, treating and preventing addiction, addressing diversion and treating pain.
As of March 2018, the most recent statistics on opioid use from the National Institute on Drug Abuse showed that 115 people in the U.S. die every day after overdosing on opioids. According to the latest statistics, opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states. In the Midwest, opioid overdoses increased 70 percent from July 2016 through September 2017.
-----

Kaiser to advance use of AI to personalize care interventions

Published May 31 2018, 4:55pm EDT
Kaiser Permanente is teaming with machine learning vendor Medial EarlySign on an initiative to use artificial intelligence to identify which Kaiser patients are most likely to respond to care interventions.
Kaiser has previously worked with the vendor in a project to identify patients with the highest risk of having undiagnosed colorectal cancer while in the early stages of the disease.
Now, Kaiser will use Medial EarlySign’s AlgoAnalyzer platform to stratify populations. It will enable the use of multiple sets of different types of algorithms that can help clinicians, care managers and population health managers predict risk in a population or an individual.
-----

Is your hospital ready for the many challenges of precision medicine?

There are big and complex questions as genomics moves into general practice, but they're ones providers who want to stay competitive will have to grapple with soon.
May 30, 2018 09:30 AM
If your hospital or health system hasn't yet started thinking about how to handle the fundamental changes soon to arrive thanks to precision medicine, now is the time.
Before long, care and treatment based on genetic sequencing and other omic factors will become the standard of care, says one informaticist, and providers will need to be ready to compete.
"My prediction is that genomic medicine will move from a specialty that did not even require an MD degree, to become an integral part of practice that's required of everyone with an MD degree," Nephi Walton, MD, assistant professor of genomic medicine at Geisinger, said at the HIMSS Precision Medicine Summit in Washington, D.C. this month. 
-----

5 critical factors for a successful telehealth program

Written by Jessica Kim Cohen | May 29, 2018 
Three-quarters of U.S. hospitals either have consumer telehealth services in place or plan to implement the capability by the end of 2019, according to Teladoc's second annual state of consumer telehealth benchmark survey.
During a May 15 webinar, sponsored by Teladoc and hosted by Becker's Hospital Review, Alan Roga, MD, president of Teladoc's hospital and health systems division, presented key findings from the company's annual survey. Teladoc, the nation's leading telehealth solutions company, works with health systems, employers and insurers providing virtual care delivery services to more than 23 million members. The company's dedicated business unit for hospital and health system clients offers services including account management, marketing and technology support.
For the survey, Teladoc partnered with Becker's in 2017 to poll nearly 300 C-suite executives and directors from hospitals of various sizes across the U.S. about their experiences with telehealth and priorities for the next year. Nearly half of the hospitals represented — 45 percent — first implemented their telehealth program one to three years prior to the survey.
-----

Feds Need to Do Better Job With EHR Data Security, Privacy

The US federal government needs to do a better job at EHR data security and privacy, concluded a recent federal IT systems audit by GAO.

May 29, 2018 - The US federal government needs to do a better job at EHR data security and privacy, concluded a federal IT systems audit by the Government Accountability Office (GAO) released May 23.
The federal government also must ensure privacy is guaranteed when facial recognition systems are used and better protect the privacy of users’ data on state-based health insurance marketplaces, GAO concluded.
To accomplish these goals and improve lax federal cybersecurity in general, agencies should implement the information security program mandated by the Federal Information Security Management Act (FISMA)
-----

EHRs exacerbate the pen and paper problems they were meant to solve: study

May 30, 2018
by John R. Fischer , Staff Reporter
The current set-up of EHRs has led to greater physician work load, higher risk for burnout and an increase in other challenges it was meant to fix.
That is what researchers at Penn Medicine argue in a new study, referring to EHRs as mere digital remakes of pen and paper files, and opting for a system that enables physicians to "subscribe" to patients, receiving push notifications on real-time updates for when action is required, as they do on social media and news app feeds.
"I think that firms have created platforms that focus almost entirely on the technical task of making medical records digital and not the design task of making them useful," senior author David Asch, executive director of the Penn Medicine Center for Health Care Innovation, told HCB News. "You end up creating something that looks very much like a paper chart. If you focus on the task of making electronic records more useful and think about what people really want from them, you can create something even better.”
-----

HIT Think How social determinants of health and analytics can aid suicide prevention

Published May 30 2018, 3:45pm EDT
There’s growing urgency around the need to take proactive steps to prevent suicides by veterans. An average of 20 Veterans per day committed suicide in 2014, according to the Department of Veterans Affairs. Veterans, who constitute 8.5 percent of the U.S. population, accounted for 18 percent of all suicide deaths.
Despite the obvious challenge and risk of mortality, suicide prevention for veterans is a challenging service to provide. However, emerging interest in new types of social data—paired with medical information contained in veterans’ health records—holds new promise in assisting clinicians to find those who are at risk. And the increased use of analytics also may be able to sift through mounds of seemingly unrelated medical data to find crucial correlations that may identify suicide risks that warrant intervention.
Many behavioral experts say data is crucial in understanding the risks of suicide, and anticipating and intervening before something dire happens. The difference between an individual falling victim to suicide or not often is whether someone can intervene and prevent that individual from taking the ultimate step.
-----

EHR vendors target small hospitals as market tightens

May 30, 2018 1:46pm
EHR vendors are finding some success among smaller hospitals even as many of those hospitals are being bought up by larger systems and forced to integrate onto a single platform.
Several vendors—including Athenahealth and Meditech—have found a groove in a post-Meaningful Use marketplace where the number of systems inking new EHR contracts has declined over the last three years, according to an annual report by KLAS that analyzes EHR market share.
Last year, 216 acute care hospitals with fewer than 200 beds signed a new EHR contract, accounting for 80% of deals throughout 2017.
-----

Health IT, mental health groups back bill to eliminate telehealth restrictions for opioid treatment

May 30, 2018 3:52pm
Nearly a dozen healthcare groups are voicing their support for legislation that would allow providers to utilize telehealth to treat substance abuse.
In a letter to lawmakers last week, 11 groups—including the College of Healthcare Information Management Executives, HIMSS and the American Telemedicine Association—urged lawmakers to include the Expanding Telehealth Response to Ensure Addiction Treatment Act (eTREAT) Act in efforts to address the opioid crisis. The bill, introduced by a bipartisan group of senators earlier this month, would waive site restrictions on Medicare reimbursement for telehealth treatment for substance abuse disorders.
The health IT groups were joined by the Association for Behavioral Health and Wellness, the National Alliance on Mental Health and Mental Health America.
-----

Clinical decision support benefits radiology trainees, significantly improves appropriateness scores

May 25, 2018 | Melissa Rohman
University of Virginia researchers found that radiology trainees benefit the most from a commercially available clinical decision support (CDS) program being implemented into an electronic health record, which overall improves the appropriateness scores of ordered imaging studies significantly.  
The study was published May 25 in the Journal of the American College of Radiology.  
Designed around the American College of Radiology (ACR) Appropriateness Criteria, CDS helps health care providers choose appropriate imaging studies at the time of order entry, wrote led author Timothy Huber, MD, and colleagues.  
-----

How Amazon’s digital health moves could affect providers

Published May 29 2018, 7:33am EDT
Amazon this year has made a number of significant moves that are fueling speculation about what the online giant’s ambitions might be in the healthcare sector—and what impact such a push by the company might have on traditional providers.
Employers, federal and state governments and consumer groups have expressed frustration for years about the healthcare industry’s 18-percent-plus share of the GDP and the failure of myriad reform efforts to significantly change the industry’s cost structure or create a truly patient-focused approach to care. Many healthcare experts believe that Amazon might be getting ready to step in with alternative solutions.
-----

HIT Think Why preparation is crucial to success in data analytics

Published May 29 2018, 5:34pm EDT
Preparation is critically important to any initiative, but let’s be clear about something—it is not easy. We have all participated in projects or initiatives that lacked proper planning or preparation, and we’ve experienced the fallout from those poorly planned initiatives.
Value-based care, and the associated requirements, has wrung all of the wiggle room out of strategic initiatives. Provider organizations are under enormous pressure to create efficiencies from EHR investments in preparation for value-based care. These organizations are about as well prepared to take on the risk of patient care as they are to start a casino.
Organizations may have a deluge of data, but without having data structured or related to care-based decisions, organizations are, in essence, flying blind.
-----

Clinical decision support in EHR helps reduce low-value imaging

Published May 29 2018, 3:03pm EDT
The use of clinical decision support software can help young physicians more appropriately order imaging studies, reducing the number of studies they order that have minimal benefit to the treatment process.
In a recently published study, medical residents and fellows benefitted the most from the use of clinical decision support in ordering imaging examinations, said researchers from the University of Virginia.
Providers who followed the criteria on the appropriateness of imaging requests—guidance on which was integrated into the organization’s electronic health records system—ordered 50 percent fewer “low utility” studies that would not aid clinicians in diagnosing conditions. On the plus side, the rate of ordering appropriate imaging studies rose to more than 80 percent. Results of the study were published in the May 25 online version of the Journal of the American College of Radiology.
-----

Health reforms to enable sharing of patient data

Future Health Summit took place at the Convention Centre Dublin on Tuesday

29 May, 2018
The Department of Health will introduce new regulations to enable patient data to be shared, including for research, ahead of the rollout of electronic health records in the coming years.
Muiris O’Connor of the department told the Future Health Summit at the Convention Centre Dublin on Tuesday that it was putting in place regulations in line with the new EU General Data Protection Regulation (GDPR), which became enforceable from May 25th.
He said money would be coming from the Government from next year onwards to help drive the transformation of the health service.
At present, he said information within the Health Service Executive (HSE) went into “its own little pockets” and that e-health was a “critical enabler”.
-----

How Blockchain Could Help Lower Health Costs

The digital ledger could replace fragmented data systems, simplifying record-keeping and improving care

By Tomio Geron
May 28, 2018 10:04 p.m. ET
In the continuing push for affordable health care, one of the biggest stumbling blocks is still the confused and error-filled manner in which electronic data is shared among doctors, insurers, hospitals and patients.
One solution could be blockchain technology.
In the current tangle of incompatible records systems that typifies U.S. health care, incorrect information can creep in when patient data gets re-entered multiple times by doctors’ offices, insurers and hospital staff. Big errors can seriously affect the quality of care that patients receive, small discrepancies can result in wrongful denials of insurance coverage, and errors of all types add to the system’s cost.
-----
Enjoy!
David.

Friday, June 08, 2018

AI Continues To Break Out All Over And So Do Its Implications.

There have been all sorts of articles on AI appear this week that are worth noting.
First we have Henry Kissinger…
  • Jun 1 2018 at 9:00 AM

Human society isn't ready for artificial intelligence

Is it possible that human history might go the way of the Incas, faced with a Spanish culture incomprehensible and even awe-inspiring to them? Were we at the edge of a new phase of human history?  
by Henry Kissinger
Three years ago, at a conference on trans-Atlantic issues, the subject of artificial intelligence appeared on the agenda. I was on the verge of skipping that session – it lay outside my usual concerns – but the beginning of the presentation held me in my seat.
The speaker described the workings of a computer program that would soon challenge international champions in the game Go. I was amazed that a computer could master Go, which is more complex than chess. In it, each player deploys 180 or 181 pieces (depending on which colour he or she chooses), placed alternately on an initially empty board; victory goes to the side that, by making better strategic decisions, immobilises his or her opponent by more effectively controlling territory.
The speaker insisted that this ability could not be preprogrammed. His machine, he said, learned to master Go by training itself through practice. Given Go's basic rules, the computer played innumerable games against itself, learning from its mistakes and refining its algorithms accordingly. In the process, it exceeded the skills of its human mentors. And indeed, in the months following the speech, an AI program named AlphaGo would decisively defeat the world's greatest Go players.
As I listened to the speaker celebrate this technical progress, my experience as a historian and occasional practising statesman gave me pause. What would be the impact on history of self-learning machines – machines that acquired knowledge by processes particular to themselves, and applied that knowledge to ends for which there may be no category of human understanding? Would these machines learn to communicate with one another? How would choices be made among emerging options? Was it possible that human history might go the way of the Incas, faced with a Spanish culture incomprehensible and even awe-inspiring to them? Were we at the edge of a new phase of human history?
Aware of my lack of technical competence in this field, I organised a number of informal dialogues on the subject, with the advice and co-operation of acquaintances in technology and the humanities. These discussions have caused my concerns to grow.

Age of Reason

Heretofore, the technological advance that most altered the course of modern history was the invention of the printing press in the 15th century, which allowed the search for empirical knowledge to supplant liturgical doctrine, and the Age of Reason to gradually supersede the Age of Religion. Individual insight and scientific knowledge replaced faith as the principal criterion of human consciousness. Information was stored and systematised in expanding libraries. The Age of Reason originated the thoughts and actions that shaped the contemporary world order.
But that order is now in upheaval amid a new, even more sweeping technological revolution whose consequences we have failed to fully reckon with, and whose culmination may be a world relying on machines powered by data and algorithms and ungoverned by ethical or philosophical norms.
The internet age in which we already live prefigures some of the questions and issues that AI will only make more acute. The Enlightenment sought to submit traditional verities to a liberated, analytic human reason. The internet's purpose is to ratify knowledge through the accumulation and manipulation of ever expanding data. Human cognition loses its personal character. Individuals turn into data, and data becomes regnant.
Users of the internet emphasise retrieving and manipulating information over contextualising or conceptualising its meaning. They rarely interrogate history or philosophy; as a rule, they demand information relevant to their immediate practical needs. In the process, search-engine algorithms acquire the capacity to predict the preferences of individual clients, enabling the algorithms to personalise results and make them available to other parties for political or commercial purposes. Truth becomes relative. Information threatens to overwhelm wisdom.
Inundated via social media with the opinions of multitudes, users are diverted from introspection; in truth many technophiles use the internet to avoid the solitude they dread. All of these pressures weaken the fortitude required to develop and sustain convictions that can be implemented only by travelling a lonely road, which is the essence of creativity.
The impact of internet technology on politics is particularly pronounced. The ability to target micro-groups has broken up the previous consensus on priorities by permitting a focus on specialised purposes or grievances. Political leaders, overwhelmed by niche pressures, are deprived of time to think or reflect on context, contracting the space available for them to develop vision.
The digital world's emphasis on speed inhibits reflection; its incentive empowers the radical over the thoughtful; its values are shaped by subgroup consensus, not by introspection. For all its achievements, it runs the risk of turning on itself as its impositions overwhelm its conveniences.
Science fiction has imagined scenarios of AI turning on its creators. More likely is the danger that AI will misinterpret human instructions due to its inherent lack of context.
Vastly more here:
Additionally we have this interesting view:

Rule by AI? There’s too much legacy stupidity

  • Allan Waddell
  • The Australian
  • 12:00AM May 29, 2018
Elon Musk can’t be wrong about artificial intelligence, can he? Well, actually, yes he is wrong.
The idea behind the existential threat of AI is alternatively called the “singularity” or the “intelligence explosion” and it’s gaining some serious momentum. There are more transistors today than there are leaves on all the trees in the world, more than four billion alone in the smartphone you carry. Is digital eclipsing the “real” world?
A little history about this idea of our impending extinction at the hands of our silicon creations. Princeton’s flamboyant and brilliant John von Neumann coined the term “singularity” in terms of AI in the 1950s. The term “intelligence explosion” might have come from mathematician I.J. Good in 1965. In Advances in Computers, vol. 6, Good wrote of an ultra-intelligent machine that could design even better machines, creating an “intelligence explosion” that would leave the intelligence of man far behind. He warned, “the first ultra-intelligent machine is the last invention that man need ever make”.
Ray Kurzweil, a futurist and inventor who pops an endless regime of vitamins so he will stay alive long enough to upload himself into the cloud and is also director of engineering at Google, says human-level machine intelligence might be just over 10 years away. He predicts 2029 for the year an AI passes the Turing test and marked 2045 as the date for the singularity. Computer scientist Jurgen Schmidhuber, whom some call the “father of artificial intelligence”, thinks that in 50 years there will be a computer as smart as all humans combined. And Musk, technology ringmaster extraordinaire of PayPal, SpaceX, Tesla and, recently, OpenAI, while not quite as prone to specific-date-prophesying, calls artificial intelligence a “fundamental existential risk for human civilisation”.
Much more here:
And for some good news we had this:

Kaiser to advance use of AI to personalize care interventions

Published May 31 2018, 4:55pm EDT
Kaiser Permanente is teaming with machine learning vendor Medial EarlySign on an initiative to use artificial intelligence to identify which Kaiser patients are most likely to respond to care interventions.
Kaiser has previously worked with the vendor in a project to identify patients with the highest risk of having undiagnosed colorectal cancer while in the early stages of the disease.
Now, Kaiser will use Medial EarlySign’s AlgoAnalyzer platform to stratify populations. It will enable the use of multiple sets of different types of algorithms that can help clinicians, care managers and population health managers predict risk in a population or an individual.
More here:
and this:

AI outperforms dermatologists in diagnosing skin cancer

Published May 30 2018, 7:22am EDT
Dermatologists are no match for artificial intelligence when it comes to diagnosing skin cancer, according to a new study by researchers in the United States, France and Germany.
The international team trained a convolutional neural network (CNN) to identify skin cancer by showing it more than 100,000 images of malignant melanomas as well as benign moles.
Specifically, they trained and validated Google’s Inception v4 CNN architecture using dermoscopic images at a 10-fold magnification and corresponding diagnoses. Then, they compared its performance with that of 58 international dermatologists from 17 countries—including 30 experts with more than five years of experience.
Results of the study, published this week in the Annals of Oncology, show that the CNN missed fewer melanomas and misdiagnosed benign moles as malignant less often than the group of experienced dermatologists.
More here:
So much going on, so little time to catch up with it all!
David.