Health Informatics History, Challenges & Opportunities

In this article, i’ll try to illustrate some of the historical factors that continue to influence health informatics systems & the challenges that exist to fix them.

The article has been authored as a consequence of questions being raised by Healthcare Industry applications of the work i’ve been doing over many years on semantic systems (that are used by healthcare today) and the knowledge-banking work i’ve been seeking to bring together into a next stage of growth.

Parts of the international leadership groups, whom i’ve been working closely with over many years, have already started work on solutions for healthcare.

Indeed there are many old examples of where the works relate to healthcare systems already in place.

Yet i have reservations and a series of considerations that relate to a particular approach that i believe is more likely to result in better patient / healthcare outcomes, overtime once established and resilient foundations are produced.

Whilst perhaps this is about focus,..

This article seeks to communicate those considerations and related historical contexts that in-turn associate to how it is causality led me to writing this document in support of works that relates to verifiable claims. Therein it is important to note that i’m Australian and that the work of others have some different qualities to my own, noting also that the issues experienced by those who live elsewhere may be different to the ‘social characteristics’ & concerns applicable to health systems, as illustrated below.

Another of the families boats, now so many years ago…

BACKGROUND: Some Personal History

It’s hard to connect works that relate to systems to support health, without illustrating aspects that relate to my life personally.

Part of my family have played a significant role in the Australian Medical Industry, whereby my Grandfather grew overtime, with others, a substantive pathology company that is now well known; now forming part of one of Australia’s largest companies, where family have worked for sometime.

My Grandfathers cousin won a Nobel prize in how synapses work, as is discussed in other articles. My mother, amongst her many talents; first obtained nursing qualifications and the healthcare industry has in-turn played a significant role in my life since birth.

I’m now 41. I grew-up with early computers from a young age, and what i remember growing-up, about the pathology systems was that there were very old computing systems that were used and relied upon to record, manage and communicate critical healthcare information between the lab and doctors.

I remember my grandfather had a camera on his microscope on his desk; in an environment that i think was very much about solving clinical puzzles.

As the eldest of his grandchildren, i was fortunate enough to spend a lot of time with my grandfather. We repaired a boat together when i was in my twenties, and in my younger years, I was able to enjoy an involvement with the Couta Boats, of which the family owned two.

My ‘work experience’ spent down the beach, learning how to build boats.

More broadly however, my mothers work in aged care homes. I visited at times, playing piano for its residents’ and later, going to the pathology where my mother worked; running specimens up to the different departments whilst doing my homework.

I remember some of the first practice management software applications used by general practices; had as part of their branding the pathology logo.

The reason why these systems were first needed, from my recollection; they were first produced to improve the means to distribute vitally important & private healthcare information from the pathology lab, to clinicians waiting for results ASAP.

Since then; healthcare informatics has become big business, in much the same way as pathology services developed over a similar timespan.

The puzzle solving is seemingly now closely linked to a medicare billing IDs, whilst the records management systems that evolved from the early ones for clinical records; continue to exhibit many problems — that are all too often considered ‘inconvenient’ to talk about.

In my life, i’ve maintained an interest in health systems & solutions; which has in-turn led to an involvement in many extreme circumstances relating to health, healthcare and a moral attitude seeking to be of assistance to those in need.

Yet this has not always ‘gone well’. In one case, i asked about a brain tumour relating to a person; and was told by a family authority, that what i was told was nonsense. Later, the tumour had returned & grown leading to death. Nothing could then be done, but this wasn’t the answer sought of me then.

In another example; I had cause in my life, in past, to go about seeking the Convention of the Rights of the Child to be incorporated into Australian Law.

At the time, it wasn’t there, and i was told the human rights of children, don’t matter; Indeed i was told i was ‘tilting at windmills’ as i raised my concerns.

I considered the situation to be entirely unacceptable, and decided it was of great moral importance to address the issue; without victimising those involved, who moreover as abusers and participants in a broken system, weren’t really able to do anything about it…

Overtime, i found myself supporting a commission endorsed by Australia’s governor general to teach kids about our system of democracy, supported with materials such as this short video, that brought tears to my eyes…

The situation was very upsetting for me, disaffecting my wellbeing & health. yet my studies led me to learn that i should not take it personally, as it was a societal wide problem; that by comparison to all too many, i was coping with (surviving) relatively well given the circumstances.

All too many were being paid knowingly harming children, whilst being labelled societally as people who are ‘mentally well’… in utility of funding from Government..

The Hut i lived in whilst commencing my Human Centric Web works, whilst forced to live in poverty.

The circumstances put upon many, had the effect of weaponising children and were empowered through various government funded programs who leveraged children, for personal income. This had the effect of formatting punitive socioeconomic conditions, that i’m now advised ‘have been reviewed’, changing policies whilst many issues still remain.

One important fact that caused serious repercussions was the practice of placing an income restraints (circa $400PW only, for no less than 12 weeks) on people seeking legal help and their practice method for doing so was to state this as a requirement over the phone; which in-turn had the effect of harvesting slavery enhancing circumstances (whilst ‘saving money’), as is in-turn used to prosecute inhumane practice methods as prosecuted by other ‘agencies’ and ‘programs’ independently employed by government, to great expense for all, overall…

In reality, i ended-up living on much less as a consequence of these organised systemic abuses were put upon my life, leading me to take-up the commission from the GG, and to do the work needed to build the information systems required to better support our societal values; rather than aiding and abetting those who through the plurality of institutional agencies act as to systemically abuse them.

Whilst this had a pronounced impact on my mental health; no-one questioned theirs. When changes occurred, they said it was because they needed more funding, when the facts are that the cost of their activities is far too expensive.

The illustrative example of how some policies are employed upon civilians, is known to relate to death, injury, and other severe impacts upon many.

Whilst the actions, in the real-world: formed agendas, that were mobilised and set-out as to effectively set aside circumstances, where civilians were harming, decisions were then made to even make statistics less available than was earlier the case.

I found it impossible to endorse the opinion that this was intentionally designed by our societal leaders.

Yet, on one very difficult day i went to the doctor who asked if i was ok seeing a student; which i said was fine. I then discussed the problem with her, and she wrote in my medical record words to the effect of suggesting i thought WHO, the world-health organisation, was out to get me. Which was entirely false as the fact was that i was talking about the UN rights of the child works.

Her problem seemingly was that she didn’t understand who the UN was.

The young doctor didn’t understand what human rights charters were, or what their meaning was; As a consequence, her actions, in a manner that is virtually impossible to do anything about. The systems as employed today, seek to protect her privacy and capacities to perform acts of clinical negligence; as is considered, by systems employed to protect the legal interests of medical practices, to be most important.

Now, even though the laws subsequently changed 2 years after i commenced my efforts to ensure the changes were brought about; now that record misleads people in a way that is threatening and indeed quite harmful to my health, and capacity; both, to get appropriate healthcare; and, my ability to initiate positive relationships with clinicians, who may easily start with false assumptions.

Later, building upon these wrongful acts by others; similar yet worse examples were forcefully illustrated to me as i sought attention and illustrated to clinicians that i worked on important global projects without being paid by them to do so; with the likes of Tim Berners-Lee. This led to false assumptions, abuse & wrongdoings; to which clinicians responding once alerted to their mistakes by seeking impunity;

most often, for their colleagues, as the clinicians who identified the wrongdoing did good, but did act in a manner that suggested they were concerned about the repercussions of better blowing the whistle;

overall leaving my records sullied, the lives of myself and others around me harmed without lawful remedy. So i started the call for a royal commission..

Severe burn caused due to an accident (car blew-up) due to poverty (couldn’t afford to get it serviced). It later required skin-graft surgery ( i think they said it was a 3rd degree burn, post surgery); but upon first presentation, it took quite some time to get pain medication for it… not that i can do much about that…

The consequences put upon me by others, as a consequence of playing a vital role in the development of critical technologies for the future of our socioeconomic environment have been extraordinarily punitive. Whilst the above listed video of Tim Berners-Lee speaking of his project shows me as one our of about 250m million people on the planet identified to be involved at that stage; the consequential medical industry ‘tall poppy’ tactics have been shown to me, to be consistent with that which may be considered criminal.

As privacy means so much less than dignity, the actions exhibited by government sponsored agents is all too often, truely shameful. The tears of social workers i was asked to accept as my personhood be diminished; facilitated harms over an extended periods of time, and their tears, followed by silence — doesn’t help.

Whilst it is posited to me, that this be an acceptable cost of being an Australian. I objectionably disagree and have suffered for doing so.

A royal commission was later announced as an election promise in 2018..

In my experience which in the interests of ‘privacy’ of others, are not fully explained; there are many examples (that i can demonstrate, if forced to), well known to clinical practitioners, of errors made, then wilfully kept secret, “covered up”, that have caused injury and could easily end-up killing a patient.

This is not the intended moral purpose of privacy considerations.

The consequence of one act of protected misgendered violence, has consequence in reality as is termed ‘causality’. Whether that acts as to cause harm by a thousand cuts, by a multitude of actors; who each in-turn built upon the records produced by others, in systems designed to necessarily inhibit testing the validity of ‘claims’; or even notifying the patient of considerations relating to the contents of them, or being precluded from the capacity to evaluate important facts sourced from other fiduciary agencies.

Whether it is one critical and seemingly innocuous event or the accumulation of many as a consequence; fiction can changes the lives of human beings, forever.

Clinical systems do not easily support evaluation as to identify when it is the case that the clinical fraternity themselves have caused injury; nor, consequentially, does it support their responsibility to remedy the consequences of their mistakes.

Anecdotally, it is not uncommon for medical industry & related professionals to abuse (pharmaceutical) drugs; which indicates that despite the suggestion employees are always ‘mentally well’, this is likely to be a flawed assumption.

Yet, it is common-place for medical industry professionals to protect one-another even though they know their actions cause injury to those clinical professionals within that sector have historically been sworn to serve.

This is not a problem that is specific to the medical industry, as it is a problem that is widespread across all parts of society. The difference in this sector is,

the old form oath “I will abstain from all intentional wrong-doing and harm”

When considering ‘healthcare systems’ there are added levels of complication.

Compounding issues;

Healthcare industry workers (inclusive to related industries) often do not have highly developed computing skills. (whilst this is changing overtime)

Today, many mistakes can be made due to this underlying literacy problem the availability and use of specialist ICT professionals is not common-place for the operational staffing requirements retained by the vast majority of medical industry practices.

Consequentially, what is now becomes increasing alarming; is the manner through which records systems are now being repurposed for use with AI. I’ve been made aware of AI mental health projects, built out of universities, in circumstances where there were not even guidelines on AI Ethics…

Kids, seemingly a ‘softer target’ to obtain funding for experiments…

In my own works with the clinical industry, i’ve helped senior expert practitioners as they’ve climbed under tables pointing, asking ‘is this the router’, It is not at all uncommon for medical workers to have poor ICT skills and then seek to defend acts that cause others injury due to these problems…

Certainly, trying to explain what i have been doing has been lost on most.

Another series of issues is that there are significant; real-world issues, both within clinical environments and outside of them.

Clinical providers are not able to support patients needs beyond their scope of practice expertise as clinicians themselves depend upon trusted communities.

Sometimes;

• Issues are difficult to properly diagnose due to scientific factors & circumstances; in other cases,
• proper treatment of an underlying issue may, due to a confluence of other factors, be reasonably impossible to get right.

In yet other types of circumstances;

If a patient (or clinician) is unduly influenced by circumstances relating to others; sometimes an incorrect diagnosis might be safer for the patient than could be achieved. If a clinical practice method would otherwise led to powerlessly leaving a patient in a circumstance of greater harm, due to acts and/or negligence relating others, the underlying principles seek to act in a manner that would do less harm, where it is otherwise the case harm be done.

Whilst seeing a terrible doctor would most often be considered generally better than seeing none at all… That shouldn’t be a choice that’s offered to the needy, in circumstances without a practical availability of alternatives…

One way or another means to ensure societal measures to bare witness to harms done, becomes an intrinsic part of what it is health-records system, should do.

This in-turn links across to relationships with law enforcement and many other areas; that are overall, not within the capacity of clinicians to do much about; but rather within the powers of government — where all too often, systems are broken.

What’s the point of a correct diagnosis if better treatment options are available for a similar yet incorrect diagnostically engineered circumstance.

There is a correct and appropriate role for legal representation to support the needs of people who’ve been subjected to wrongful practices that may-by-many means, be inclusive to records systems that curate stories of life, costs & impacts.

Considerations of liability as to only consider probable threats; Without support for access to justice can only lead to the poor and vulnerable being more easily prayed upon, without consideration by way of law or policy innovation. As becomes the implication, outcomes worsen economic productivity and costs.

Medical Records Systems can be used an an ‘informatics weapon’, used upon all involved in the ecosystem of clinical services. As this does not appear to be properly acknowledged; the worst part of it, is that today — there isn’t a solution that can adequately supports the needs of mental health.

The underlying business systems that are pragmatically problematic today, feature traits that extend into considerations supporting the suggestion that medically relevant materials; including clinical notes, imaging, pathology records and a great deal more; be considered property of the health providers.

‘Consumer’ accessible to these records can be made by consumers via Freedom of Information requests or similar. This in-turn (legally) means instrumental information required for purposes of safety may not be made available for months, which doesn’t fit with the needs of a person surviving an emergency.

The inferred position, of these health-business practitioners lack consideration of the beneficial use of knowledge for patients; and as such, undermine health care options for civilians, as an implication of protections furnished for improper functional attributes that in-turn relate to the healthcare business.

Whilst some may quip that this is the best way to protect against the fools operating within the medical sector; the reality becomes an inability to discern easily, between the good actors and the far worse ones; as protections are levied to protect the bad, at great cost to others.

Humility

Part of the underlying problem is that even the best of clinicians can and will make mistakes; as is part of our human condition. Yet this is a distinct concept to the reality of designing clinically employed tools; as does in-turn support industrialised, organised, protections for professional malpractice, yielding in-turn, government sponsored (via medicare, etc.) human misery.

The intention of health is to support the means for human beings to strive to engage in society to their fullest potential, as to yield maximum socioeconomic benefits as fit and healthy persons.

Yet the way technology has been implemented generally throughout society, most disaffects healthcare and the means to make use of ‘patient records’ tools to support clinical practices as to reliably support meaningfully positive healthcare outcomes.

The idea that people suffer from unfair and wrongful acts by others, and are considered in-turn to be ‘mentally unwell’ if they don’t cope with it, without access to justice, without being able to resolve a real-world problem; isn’t actually a set of problems that can be addressed directly via the medical industry. Practice methods seeking to do so are rather misusing the medical industry, and its funding pools to in-turn employ it as a nuanced form of insurance, protecting others who are unlikely to feature in any AI Readable format on patient records.

ICT and technology advancement generally, have led to many significant and very positive advancements throughout the field of health sciences.

When i was 3, my right eye was biopsied for something that is now treatable.

But overall; the type and size of participants who are seemingly in-control of defining how health informatics systems work for civilians, are generally enormous & operating in a manner i’d suggest lacks the basic properties required for good moral grammar that are commercial in nature.

No-matter the circumstances as to why, it’s hard to accept they’d be happy with the results that have been brought about without a functional capacity to support the means for patients (citizens, natural persons) to be provided greater means to be granted the opportunity to support, their own healthcare with Internet Tools.

My considerations have in-turn garnished support, as works on mental health industry issues - led to a royal commission, which is amongst the many outcomes that may not adequately act to triage the underlying problems risking harm and injury in an unmanageable way, to us all.

Considerations about Solutions.

So, when people have asked me how i’d approach the problems, which has been a longer-term high-stakes use case, from many years ago…

My view on it; is that, I thought it would be better to first focus on producing a system from the ground-up that is designed, amongst other things, to tend to mental health needs, overall.

Around 2012, i tried to build an implementation for historical communities, but that didn’t work out so well as the problems there, were all too hard…

Since then global works have developed significantly; and now, they’re far more developed and in the process of becoming implemented, world-wide.

Its fundamentally impossible to do the right thing when explaining the underlying nature of experiences relating to these concepts; as to tell the truthful story, that doesn’t further injure the vulnerable who’ve already been disaffected and is in-turn employed by bad actors, to further pursue wrongs.

This in-turn illustrates the manifest nature of organisationally poor mental health faculties relate to the manner through which people, get paid to do a job.

When the opportunity arises to build a medical platform solution, considerations are that the best way to approach it is for mental health. As such, and in seeking to support healthcare cases in reality (rather than some distorted version of it); whilst there are many reasons for my triage method & assessment; therein, i’ll go through and illustrate a few,

1. Much of the modern workforce are no-longer involved in physical activities that have traditionally incorporated threats of physical injury. As such, there is an increasing volume of activities by people where mental health injury is of greatest concern; and with that, physical health issue can be brought about, but may often consequentially be a secondary comorbidity.
2. Where people are subjected to activities by others that have legal considerations (wrongs); in-turn impacts mental health; which in-turn has a series of implications on a persons capacity to participate in society and more legally relevant socioeconomic factors become relevant; alongside physical health.
3. Poor physical health leads to symptoms that impact mental health. Social factors beyond the capacity for a patient to deal with in a vacuum (as to suggest any one person can solve all problems without anyone else); impacts mental health.
4. Broken Clinical systems impact the mental health; of healthcare workers. without the means to identify underlying issues, problems only worsen.
5. The impacts of untimely death (particularly where it may have been avoidable) has an enormous ripple effect that both features intergenerational attributes alongside widespread social ones. Whilst records pertaining to physical health may be considered proprietary property of a provider; the cost implication can be better evaluated through mental health cost ecologies. Today there is a movement led by our prime-minister to address suicide; yet perhaps, it’s better to start with addressing considerations that may lead a person approach how it is they’re able to address problems before such pathways, be deemed best.
6. There are a number of operational issues relating to the practice methods employed with medical records for physical health issues; it’s fairly reasonable to consider that the utility of mental health records would likely not be subject to commercialities in a similar way to those about other diagnostic records; that people, no-matter their role; care about agency; even if, the case is today that they’ve struggled to figure it out in the roles they’ve facilitated with respect to physical health industries.
7. The ecosystem for supporting mental health necessarily incorporates the need to review how (AI) systems deal with physical health support solutions.
8. The Health Records systems have seemingly always sought to serve a particular set of stakeholders; on a commercial basis. Compounding this problem health related failings can be used by criminals to support crime. To Fix this, it would be better to make use of the tools available, to build a better system from the ground up. In doing so, for mental health, the stakeholders that did exist; such as the pathology and diagnostics industries, aren’t relevant to begin with; as the practice method focuses firstly on mental health service needs and the needs of mental health practitioners to do their job, well. Consequentially, a system that is ‘fit for purpose’ can be designed, tested and made operational; later becoming equipped to take a greater role in areas that existing clinical systems fail.

Yet, this is in every possible way a very high-stakes application of ICT. Whilst something is better than nothing, it’s a questionable endeavour to seek to first address, even if the right systems framework has been fostered to do so.

The issues that are engendered upon vulnerable persons (patients) through the misuse of practice management — patient records technology, is arguably higher-stakes than any underlying related systems such as criminal records.

Whilst law enforcement records are amongst the other areas of problematic enterprise systems; sharing similar traits in some ways, to patient records; the facts of a circumstance overtime is more likely to be tracked via patient records over a longer-period of time; than it is law enforcement records, whilst the two forms of social-systems do indeed, interrelate.

The greatest problem about building systems that relate to the well-being of a natural person; as communicated through institutional systems, beyond the traditional nature of issues relating to insurance and related factors; is that of defining what it is be defined, for mental health purposes; ‘normal’ or unwell.

There are life factors that happen to people, for no fault of their own; and this in-turn forms an array of implications upon their being, their personhood; their perception of what is normal, what is within their comfort zone; and what is not; whether or not, those evaluations made in minds are good or bad.

The clinical fraternity despite best efforts do not really know how entirely, the manifestation of consciousness actually works. Whilst my studies suggest quantum mechanics, not only has something to do with it; but is influenced by the design implications (use of) informatics systems; this isn’t understood.

Causality makes sense, just don’t ask someone about it when its inconvenient for them to consider how their role may be presented as a bad actor, as applied to situational awareness support (ICT) systems…

There appears, overall, to be a nonsensical fear of systems that present reality, as a threat; & not as may otherwise be considered, an enormous opportunity.

The reality more-broadly is however; that the confluence of information being produced and stored on AI Assistants in homes, social networks and in connection to mobile devices such as phones and health sensors; will end-up providing rich analytical environments that are made useful, for courts.

The Opportunity

There are countless opportunities that could be brought about if an agenda were set-out to provide systems that supported digital agency of natural persons, by way of systems akin to my ‘knowledge banking’ works; and for those systems, to in-turn be applied to the problem-space of mental health.

What this in-turn means; is a nuanced form of precision medicine, that is not simply about genetically targeted treatment methods, but moreover the capacity to make use of the best technology has to offer; to assist in overall well-being as is able to be attributed to the stated desires outlined by patients.

The proposed methodology sought to achieve this outcome; seeks to attend to the needs of the poor, of the vulnerable; much like it was the case in the era my grandfather was brought-up in, as his aunts and sisters were involved in the churches, still today so highly involved in the delivery of welfare and health solutions for our communities both in Australia, and abroad.

By forming an industrial approach for the treatment of mental illness as to manage mental health; as is defined to make distinct, those two terms…

The capacity to better manage healthcare delivery & services could in-turn be far better democratised, delivering better outcomes for patients and societies; particularly those whose services are attributed to a medicare billing code, one way or another. Poor social behaviours, shouldn’t be funded via medicare.

Poor social behaviours leading to inflated medicare expenses, shouldn’t be hidden for reasons of convenience to others; as a technically employed and nuanced form of wrong, that would otherwise hold attributes relating to the meaningful utility of human rights and in-turn, considerations of the Hippocratic Oath and what it is that defines a successful clinicians character.

Clinical systems today, do not take into account the large volume of personally produced & attributable information or data; that may relate to a vast array of activities & interactions in the real-world.

Proper use of these datasets can vastly improve the means for the medical industry to better to its job.

The means to do so, is not better equipped by subservience of personal agency as to provide the complete datasets to a practices business & ICT systems.

Rather, the better approach, to address how to do so is by providing the ‘inferencing’ (AI) capabilities to the patients own systems, that are in-turn made to work interoperable with the clinicians systems, as to improve upon the information that may otherwise be provided by the patient verbally and/or with physical documents.

Therein; the systems would not-only take into account the positional considerations relating to the patient; but also, those relating to the clinician.

If a clinician doesn’t understand some sort of complex concept raised by the patient; these systems would protect both the patient, and the clinicians who become involved.

If there is a set of discernible trends relating to the patient that are not brought-up; inclusive to those relating the patient to their interactions with others in their lives, there are means to use information systems to see any related trends overtime and use that for clinical evaluations and treatment.

If there are systemic failures that are exhibited throughout society that the clinician is unable to do anything about; they’re no-longer made to be the victim of others, who may suggest it was their fault more was not done.

The mental health services sector has a direct attribution to a large number of broader, societal inter-dependencies which attributes to billions in expenditure; both in terms of the costs put upon society by poor practices and the defence of any such morally indefensible practices, causing pain & injury.

There is an enormous opportunity to stem the flow of these costs; but it will not come about without consequence, which is all too often, considered inconvenient.

There are many real-world stories of horrors put upon members of our society which has caused enormous injury to them, and their capacities to more meaningfully participate in society.

There are examples of fairly hectic issues that are built into the business systems of how some industries operate that both engender serious mental health risks & concerns; but are hard to talk about, indeed often its taboo.

The issues that exist within existing clinical systems that are not designed to address mental health; pale by comparison to the risks and opportunities of redesigning those systems, by creating something else for mental health.

Yet the problem is most likely to be; that vendors, working with government and other group agents will make best endeavours to define such systems as to suit themselves; without undergoing the relative inconvenience of seeking to enshrine both in industry and by law; personal agency over the informatics systems used to define a person as to protect their needs; when inconvenient for ecosystem participants of a group nature who are involved, regardless.

The underlying challenge gets to the heart of ‘reality check: tech’, and whether it is the case, or not, that our society is advanced enough to care.

Weaponisation of Health on the Poor & Invested

The underlying consequential nature of how these systems are currently put to use; as is distinct to how they COULD BE refactored to be made useful; is that mental health today is employed, as to justify slavery related work conditions and other horrible acts put upon people, who should therefore be reasonably provided protection when seeking help.

One of the very old methods used to suggest someone who has worked on something valuable for a long-period of time; should not be paid or involved with the economic production activities relating to their work, is in consideration of health.

Incorporated to that consideration should be one where clinicians and society considers the impacts upon persons who work over long-periods of time making investments; in things that can be commercialised and life aspects that have nothing to do with money; and the way mental health can be weaponised by attackers who seek to take from others, without consideration, compensation or any reasonable practice method that should relate to moral equity and fairness.

A person who is considered mentally unwell, can also be considered unfit to be a director of a company or sufficiently ‘of sound mind’ to be heard by a court of law which undermines the capacity for a victim of these sorts of attacks to have any rights, whether grounded in human rights principles or otherwise.

Where poverty ensues due to what is in-effect, organised human rights abuses; there is no legal representation available for poor people; so, a commercial method employed by organised bad actors can be to exploit these factors, as its known to be all too inconvenient for the organisations responsible to protect citizens, to address the manifest reality that these practices are now widespread.

One of the most significant aspects associated to slavery practices, is poor mental health of the enslaved.

The practice of reviewing policies that contribute to this form of miserable conduct is likely to be inconvenient. It is likely to change public perceptions about some ‘leaders’, as other factors become more clearly able to be understood and both medically & socioeconomically provided meaningful treatment & support.

The alternative seems to be, an under-class of civilians who do not really have rights, serving those who do…

They can work, in nominated environments of gainful employment but are made subservient to an elite group of persons whose mental health as exhibited by the influence of their choices affecting others, not be questioned.

Part of the problem may be the implications of works that can address the issues.

The problem with acceptance of the ‘status quo’ approach; is that society will loose the meaningful equity of kindness, and moral grammar.

Endorsing insanity in the hope that it will underpin & support economic growth is a self-determinate endeavour. Wealth, in a manner that will engender outcomes where fewer opportunities for lawful socioeconomic participation alternatives are allowed to exist, undermines human dignity.

This sort of problem can arguably be illustrated within the university sector, as the economic frameworks use to provide tertiary education are linked to significant proportionate numbers of young women engaging in new forms of sex work as to support (the university & societal) needs of getting an academic qualification / ‘education’; where it is reported in Australia that there are 200k accounts and in the UK 475K accounts representing in both regions a significant proportion of students overall; yet it seems to be suggested that mental health has anything to do with it?

Neither as a check they are ok, or to ensure that any otherwise secretive experiences can be discussed when in fact it may be as important as an STD Check. Whereas a mental health system, might provide credentials, for both.

The inference may be made that leaders, directing the sector, must be considered to have ‘good mental health’ whilst so highly involved in economic modelling built upon the utility of these income streams by key stakeholder, who are involved because they are seeking a ‘good education’ upon fair terms…

The dignity i saw in my grandfather (indeed both, in different ways) was that his pursuits were about solving puzzles that materially helped people. I question whether the practice method use of medicare billing-codes help others do so in a similar manner today, but there’s more at stake today than what could otherwise be illustrated to be a clinical version of ‘fake news’.

So, what are the grass roots of what upsets me about it all?

People don’t do their own clinical pathology assessments. I’ve survived so many bad commercial actors whilst working on something that’s led to one wild experience — yet without valuing human dignity, the qualities embodied within the method of availability of services, arguably won’t matter any more.

Their may be one group, who got crispr engineered children on a long-term contract that links reoccurring revenues to social status, life and opportunity; and another group, who are considered foolish to care about the biosphere and an array of otherwise important considerations relating to life, that exists in it.

The distinctions between the two; depend upon our concept of mental health and how it is as a society we best serve those in need.

Today, our systems are broken as institutions seek to own and clip the ticket on what they say is our digital identity. If that reality is raised to others as a problem, it’s all too easy for astonishing forms of attacks to be made without consequence; and if, the alternative is the case, its proposed a few ‘secret’ tears should be enough. That reality, has absolutely nothing to do with gov expenditure and in utility of that mantra — it is considered best, to start on health systems.

Whist it may be argued that the experiences i’ve had should have reasonably been avoided by simply ‘getting a job’, that’s not really the case. Furthermore, the international technologies produced with my help (and that of a few others globally) would not have occurred if i didn’t do the work to bring it about and the circumstances in which i did so, were similar to the others elsewhere, overseas.

This sort of wrongful positioning taken by those seeking to take advantage must be addressed by our societal systems that will support what it is their ethical frameworks are designed to support.

I think these systems are broken, many consider they’re working perfectly fine for them; which seems to me to be wilfully nonsensical and overwhelmingly, short-term and/or ignorantly self serving.

In reality, if the systems were working well today, statistics generated in relation to societal interactions with them would be promoted; rather than what is the case today, as the statistics are all too often made to be unavailable.

This in-turn reflects a mental health attributable standing of decision makers. Whether they believe themselves to be forced to take this approach or otherwise; the reality is that it takes effort to do anything, they’ve not done it.

So, whilst there’s lots of socioeconomic opportunities, i’m doubtful its safe to address the underlying pragmatic opportunity to define solutions given the inferences one can exhaustively illustrate of the moral relationship to money.

If we can’t even figure out how to enable civilians a means to store their retail tax receipts; or the many other ‘low stakes’ use cases more easily done today, why is it that people today think that the first use case that’s achievable is within the field of healthcare.

We can’t even give people needing lawful remedy access to the records and a court of law with them, as to preserve life. So, how should we expect doctors to help?

The issue with the healthcare business is not technology, its moral equity.

They’ve long-decided to sell it down the river and money isn’t going to help. It would have been better to see our brightest minds all marching down the street, but that’s not happened. I suspect many are frightened to make mistakes and the stakes are high, but the reality is that the healthcare business is different from healthcare.

If a change is going to be made, natural persons must have a place to store the information that is important to them as constituent pieces of information about our lives.

There appears to be a very low appetite to do this and there are enormous commercial interests wanting to make money by ensuring any such option is not made able to occur or if it does, it is bound to off-shore owned operators.

How to think about Knowledge Banking as a solutions framework

What most would understand as the ‘world wide web’ today (cyber); is like a world, before banking; where people have no right to an account or the personal ownership of wealth.

In this world of AI, to start with healthcare without a good plan, backed by law to protect peoples rights as a person from the indefensible acts of others; recorded in institutional systems, that can be edited, changed, updated to suit the needs of legal personalities no-matter the relationship to reality…

Without seeking to future institutionalise the right to life, and human rights.

I am not an advocate of starting with high-stakes environments like Medical Records; whilst it has been instrumental to my works over many many years, to get to a point where there is a practical and safe solution, for them & for us.

Where there are all so many people totally willing to completely fuck-over a person as to cause enormous injury to their lives, for money; they’re different to people like me who saw how medical results aided the attacks and were not adequately remedied even after circumstances were made clear.

The way to resolve the problems as to define solutions for healthcare, is by first working on solutions that are meaningfully useful for a persons life.

Around the Christmas table as a child we were taught values different to those exhibited to me by commercially motivated adversaries. Yet today, it seems preferentially sought to protect wrongdoers no matter the costs; This is illustrated by the lack of support for human beings records, of all forms, particularly those that by ‘truth telling’ as would protect a person (and indeed also others) in a court of law. If those in control of that circumstantial situation are unable to be addressed from a mental health perspective, it is unlikely that any solution defined as to support their needs would be about health, rather than reinforcement infrastructure supporting monetised illness.

Any plan that seeks to address this underlying issue with high-stakes data, is IMHO dangerous; There’s alot to consider, and it all relates to reality and aspects to how this is all made to work, is far more important than money.

One way or another, we’ll be engineering AI systems that’ll curate the vast majority of interactions with others, telling them who we are, defining us.

If we want to do a good job at defining how it is these systems, work, it’s important to ensure natural persons have their own ‘inforgs’ or ‘knowledge banking accounts’ (and related informatics infrastructure solutions.

It is no where near as difficult or expensive to achieve than the first trip to the moon. The problem is not about expenses or cost (or benefit) but rather choices.

So, in consideration — ask yourself at least this one of these critical questions.

• if they’re not designed to serve you, the natural person who in life, often in critical life events — may be labelled a ‘patient’,
• who are these systems designed to serve? and why is that a good thing?
• In those circumstances, are their needs, more than your own?

If you have no (timely) access to records, perhaps no memory of the events, perhaps no comprehension about what might have been or what to do about it,

• What is the potential impact upon you and your loved ones?
• Should you need to talk about the details publicly, to do anything about it?

There is an approach some may call ‘privacy preserving’, and others that may better protect human dignity including (but not limited to) confidentiality.

It’s undignified to be unwell, and there are many undignified experiences people all too often get, when seeking help.

As a mental health system should be supportive of reality, the first problem that needs to be address as to make health records systems that can work; is how to clinically address reality & not some false version of it, that suits them.

As a means to do so, in an effort that is so very much related to my hopes that we can indeed deliver solutions that vastly improve health-outcomes, i note again — it is my firm belief, that it’s best to start with a Trust Factory and here is a link to the note that describe how it is i think that might best be done.

Therein, whilst the practice method ends-up creating solutions for health; the means to address the socio-political and economic barriers, has its nuances that I believe will end-up with an outcome that clinicians would support and be better able to make great use of in their efforts to do their jobs, for us all.