Sorry, But These Have Been My Favourite Creatures Since My Early University Days!

This popped up last week:

The Evolution of Stupidity (and Octopus Intelligence)

What we can learn about intelligence, stupidity, and ourselves—from some of the smartest, strangest, alien-like creatures on the planet.

Brian Klaas

Apr 23, 2024

I: “But I wore the juice”

At 2:47pm on January 6, 1995, Clifton Johnson and McArthur Wheeler walked into the Mellon Bank branch in Swissvale, a small suburb of Pittsburgh. One of them pointed a handgun at the teller, demanding cash. The teller, shaking with fear, handed over some money. The robbers ran out.

Unlike most bank robbers, Johnson and Wheeler made no attempt to disguise themselves, nor to obscure their faces with masks. They looked straight into security cameras. This was particularly puzzling because Wheeler, five foot six and 270 pounds, had an easily identifiable physique—and a distinct face. Sure enough, his conspicuousness doomed him. The local news flashed a photo of Wheeler on the 11 o’clock news. An hour later, after tip-offs flooded in, Wheeler was arrested.

“But I wore the lemon juice. I wore the lemon juice,” Wheeler protested as he was taken into custody. When the cops showed him surveillance footage in which he’s clearly visible robbing the bank, Wheeler’s face contorted in disbelief. Something in his ingenious plan, he realized, had gone very wrong.

Somehow—perhaps due to its relation with disappearing ink—Wheeler believed that lemon juice could make human faces invisible to security cameras. So, even though it made his eyes sting, Wheeler slathered on the juice.

But Wheeler was no sheep-like simpleton. He wisely tested the efficacy of the juice before the robbery. He squirted it on his face, then attempted to take a photo of himself with a Polaroid camera. When the image came out, Wheeler was astonished: he wasn’t in the shot. Convinced by his rigorous scientific experiment, he proceeded to rob the bank, protected by the magic juice. (It’s likely Wheeler pointed the Polaroid camera in the wrong direction and just didn’t realize it).1

This story, which inspired the research into what we now know as the Dunning-Kruger Effect, is a testament to the extraordinary power of human stupidity.

Sadly, so much of our discourse around intelligence and stupidity gets hijacked by pseudoscience, racism, and debates over whether arbitrary measurements like IQ are valid. We ignore more interesting questions around intelligence and stupidity that we can learn not from ourselves, but from other species. In particular:

1. What, specifically, does it mean to be “intelligent?” What do we mean when we say that humans and chimps and dolphins and crows are intelligent?

2. Why did some species—including us—become smart, while others didn’t?

3. Why is stupidity still so widespread in humans?

Pondering these questions requires going on a bit of a wild ride, exploring fascinating animal worlds from chimpanzees to cephalopods, as we begin to understand our own cleverness—and stupidity—through the eyes of an octopus, the closest thing to alien intelligence on Earth.2

II: Chimpanzees, Rubik’s cubes, and disappearing ink

“It’s quite common for people [scientists] to talk about intelligence. It’s less common for people to talk about stupidity, though, arguably, it’s more common.” So observes David Krakauer, evolutionary biologist, genius polymath, and president of the world hub of complex systems research, the Santa Fe Institute.

Krakauer has devoted himself to the study of stupidity. In the process, he has made a series of illuminating arguments about how to consider cross-species intelligence, since IQ tests aren’t an effective tool to determine whether an elephant is smarter than a crow.

Krakauer points out that humans and chimpanzees share nearly 99 percent of our genetic code. “Imagine I gave you Hamlet,” Krakauer says, “and I changed less than 1 percent of the text and I said, ‘What’s the play?’ and you said, ‘It’s Hamlet.’ And I said, ‘What have I changed?’ ‘I’m not quite sure…I did see a few typos.’”

Like a few typos in Hamlet, we are divided from chimps by tiny, almost imperceptible variations. So, how can there be this massive chasm in behavioral intelligence and complexity between chimps and humans with such small divergences in genetics? It’s an enduring puzzle; we still don’t have the answers.

But Krakauer distances himself from what he sees as unhelpful debates around IQ and instead focuses on more general ideas around intelligence, ignorance, and stupidity. His definitions have the advantage of applying across diverse species.

· Ignorance is a lack of relevant data; you don’t have the information necessary to solve a problem. It’s about a gap of information, not limited cognition.

· Intelligence is when one can derive simple solutions to complex problems—and make it look effortless. With intelligence, more relevant information helps you solve a problem faster. Intelligence means you will solve a problem at a rate significantly faster than by trying solutions at random.

· Stupidity is when you use a rule, or a system of thought, in which adding more data or information doesn’t make it any more likely that you’ll get the correct answer. In the extremes of stupidity, one would solve a problem more slowly than if that creature just tried solutions derived from random chance.

To illustrate these points more precisely, Krakauer draws on the example of a Rubik’s cube. There are 43 quintillion possible arrangements of the cube. If you were immortal and randomly moved bits of the cube, eventually, you’d solve it—but it would take a ridiculously long time—billions upon billions of years.

A stupid solution would be to simply keep rotating the same face, over and over, even if someone came along and gave you instructions on how to solve it. With that stubbornly stupid strategy, you’d never solve the puzzle.

The intelligent solution lies at the other extreme: the Rubik’s cube world record currently stands at 3.13 seconds, set in July 2023.

However, the record-holder, 23 year-old Max Park, didn’t discover the insights that allowed him to solve the Rubik’s cube. His success was built atop a foundation of accumulated knowledge that mathematicians and puzzle enthusiasts derived—mental algorithms that enable “cubers” to solve the puzzle with lightning speed.

Collectively, humans have produced an extremely intelligent solution to a complex problem—and it’s trillions of times faster than trying random solutions.

This is one of the unique tricks that has allowed humans to collectively become the world’s smartest species. Krakauer refers to this secret weapon as exbodiment, the transfer of knowledge from our brains to external repositories and tools, which can be shared, iteratively improved, and transferred across space and time.

“Most of what happens cognitively doesn’t happen in here [our brains], but out there,” Krakauer explains, “stored in the world—in books, in folklore, in symphonies and so forth.”

We, today, can still gain intelligence from reading Aristotle or Lao Tzu, whereas chimpanzees and octopuses only learn from those who are currently alive.3

This, Krakauer argues, is the critical difference between us and our primate cousins. The ability to accumulate intelligence through cultural transfers is likely the crucial tipping point, or phase transition, that explains how tiny genetic fluctuations could express themselves in wildly different levels of complex cognition. As Krakauer explains:

Imagine that I gave you an ink that was very volatile, such that when you wrote down text you could only transmit it to at most one other individual, and once those people had it—and tried to propagate it—the message will have disappeared.

If we lived in such a world there would be no culture; because we couldn’t transmit across many generations what we had learned in our lifetime. So just by changing the chemical constituents of the ink—one little chemical change—you make the difference between no culture and a culture. And I think that’s what we have to look for. There’s something about the capability of humans to integrate over time what they have acquired and incrementally, and collectively, add to culture.

This logic neatly resolves the paradox of tiny genetic markers producing enormous shifts in cognitive complexity. Of course, the disappearing ink is a thought experiment—not a literal scientific solution. But it helps provide a framework for understanding how little tweaks, evolutionary flukes if you will, can unlock profound improvements in intelligence. In our complex, non-linear world, small changes often produce big effects.

But even if we accept that logic, there’s a deeper, lingering question: why are some species smart and others…not so much? 

III: Cephalopods and the evolution of alien intelligence

In 2008, researchers at a German aquarium grew perplexed: each morning, when they came into work, they found the electricity shut off. With the power shorted out, the filtration pumps turned off, imperiling other animals. Finally, a few researchers volunteered to stay overnight—to figure out what was going on.

To their astonishment, they found the culprit: an octopus named Otto, who was climbing to the rim of his tank and shooting jets of water at an overhead light that was annoying him. He had figured out that several squirts would cause the light to switch off, short-circuiting the electricity in the process. (A similar behavior was observed at the University of Otago in New Zealand, and it was so expensive that they eventually just released the octopus back into the sea).

One intrepid octopus named Inky even managed to permanently escape from his tank. When researchers found he had disappeared, they discovered tracks, showing he walked eight feet across the floor, entered a drainpipe only six inches wide, and proceeded 164 feet to oceanic freedom. (Octopuses4 have soft bodies, so their only limiting factor is their hard beak. They can squeeze through even the smallest cracks. If you haven’t seen this video, watch it).

It’s plausible that Otto’s great escape was the culmination of several reconnaissance missions: at a UK aquarium, one octopus was caught escaping on a nightly basis, exploring to snatch prey from other tanks, then returning back to his own lair, a cephalopod caper worthy of an Arthur Conan Doyle title: The Case of the Disappearing Fish.

Octopuses also seem to take a like or dislike to individual humans, with one feisty octopus squirting water at a particular researcher, but nobody else. Even when researchers wore identical uniforms, the octopus could recognize different faces.

These behaviors are evidence of complex cognition, an advanced level of intelligence few creatures on Earth possess. But what’s most intriguing about octopuses is that they’re so unlike us—and unlike everything else that’s evolved to be a hyper-intelligent species. Other than coleoid cephalopods (octopus, squid, and cuttlefish), all animals with advanced intelligence are vertebrates, from corvids (crows and jays); to cetaceans (whales, dolphins, and porpoises); to primates like ourselves. And birds, great apes, and dolphins are broadly on the same evolutionary lineage, with reasonably similar brain architectures.5

Cephalopods are the only supremely intelligent creatures on the planet that have emerged from the separate evolutionary limb of invertebrates (cold-blooded animals with no backbone that comprise 95 percent of animal species on Earth). But what’s particularly remarkable is how distantly we separated from the octopuses and squid and cuttlefish on the tree of life.

Our last common ancestor was probably a worm-like creature something like 550 million years ago. The mystery of how octopuses evolved complex cognition deepens when we consider that their closest ancestors are species like slugs, snails, oysters, and clams—hardly the kinds of animals we’d choose to invite along to help us win a pub quiz.

With such a distant common relative, it’s no surprise an octopus would be quite unlike ourselves. But the divergences in their brains go well beyond the weird and into the territory of alien-like. An octopus arguably has not one brain, but nine, a hub in its mantle (what we think of as the head) and then eight brains the reside in each of its arms. Approximately three-fifths of the roughly 500 million neurons in an octopus are housed in its arms.6

Even more bizarre, a severed octopus arm can behave similarly whether or not it is attached to the body. For over an hour, the detached arm will still search for food and try to feed a mouth that’s no longer there.7 When the rest of the body of the octopus encounters its own severed arm, it will recognize it as itself—whereas if it’s presented with any other octopus arm, it will realize it is not part of itself. This has raised the possibility that octopuses have several separate hubs of consciousness housed in one body, a profoundly spooky idea that resonates with humans from split-brain experiments.

Octopus camouflage—and that of cuttlefish—is so magical that it’s difficult to believe. And using a special trick from a part of their anatomy known as photophores, many cephalopods can even emit light in a technique known as counter-illumination, matching the exact light intensity of the stars or moonlight from the sky above the ocean, so they won’t cast a conspicuous silhouette that a predator could see from below.

But my favorite cephalopod behaviors are their unique form of sexual mimicry, in which males of a species of cuttlefish are able to make the top of its body look sexy and masculine, while making the bottom of its body mimic the appearance of a female. That way, its potential mate will see the enticing bits, while a rival male looking up from below will think it’s just two females hanging out and won’t interfere. Similarly, when a lady of the opalescent squid variety (Doryteuthis opalescens) wants to rid herself of a pestering male, she’s able to flash a white stripe down her body that appears to be the testes of a male squid—an extreme, clever form of sexual rejection. (Quite an escalation from a woman at a bar giving out a fake phone number).

Many of those examples are evolved traits of strange bodies, not necessarily evidence of advanced cognition. But octopuses are absurdly smart, embodying the Krakauer definition with elegance, as they solve complex problems but make it look easy. They use tools: one has been filmed carrying coconut shells, an exercise that shows a trait of advanced cognition called mental time travel, in which they plan for an unforeseeable future moment when sharks may arrive, hiding their entire body in a bit of brown, hairy, impenetrable armor.

Mimic octopuses are routinely filmed masquerading as flounders, adjusting their body shape, undulating across the ocean floor in convincing cosplay, making it less likely that a predator will nip at one of their vulnerable arms, tucked behind them as they glide across the sea floor.

In another study, octopuses were presented with two similar shells and one odd one. If they grabbed the odd one, they were given a food reward. Soon, they transferred that learning to a more general rule, identifying the odd item out in sets they hadn’t seen previously. Cuttlefish have also passed the marshmallow test.

An octopus may not challenge Max Park for the Rubik’s cube world record, but carrying around foraged body armor in the ocean depths and inferring rules and categories to extract rewards? That is seriously smart.

 IV: Live slow and social, die smart?

Yet, octopus intelligence poses a tricky puzzle. For every vertebrate with complex cognition, two main theories of intelligence help explain how it emerged.

1. The Ecological Intelligence Hypothesis: intelligence emerges to help creatures find food in difficult environments.

2. The Social Intelligence Hypothesis: creatures that live in social groups require complex cognition to cooperate, deceive, form social bonds, and learn from one another.

The latter, in particular, makes sense if you’re planning to stick around for a while, learn smarter strategies for survival, and teach your young how to behave. These theories match the vertebrate data really well: crows, dolphins, and primates (including us) all have long lives (a minimum of 15+ years); take care of their offspring; and are capable of reproducing multiple times in one lifespan.

By contrast, most cephalopods live alone, survive for between six months and two years; don’t take care of their offspring, and produce children just once, then die.

Researchers have recently proposed that the evolution of advanced cephalopod cognition emerged when they were forced to become more adaptable, and jettisoned their hard shells (which persisted in cousin species like nautiluses). This had a major advantage—flexibility in habitat—which is why cephalopods are found pretty much everywhere in oceans. But it came with a cost: without a shell, they faced an abrupt surge in predators eating them, which required a get-smart-quick scheme, a pressure that led to advanced cognition. The puzzle persists, however. After all, many animals get devoured; few become brainiacs.' We don’t have the answers.

Why, other than the fact that octopuses are stupefyingly interesting, should we care about this? Because it implies a profound idea: there are multiple evolutionary pathways and biological architectures that create intelligence. The study of cephalopods can yield new ways of thinking about artificial intelligence, consciousness, and plausible imaginings of unknown alien intelligence.

V: Why we are uniquely stupid

But there’s another lesson we can learn from cephalopods about our own stupidity. What an octopus lacks—which we have in spades—is rigid, stubborn ideology. Our unique ability to reason with generalized concepts, to imagine worlds that don’t exist, to conjure up distorted mental models of how we think reality functions—from outlandish conspiracy theories, to religious and political zealotry—can blind us to obvious truths.

In Fluke, I mention Alfred Wegener, the balloonist who proposed that the continents must have drifted, given how clearly their coastlines fit together like a jigsaw puzzle. Blinded by scientific precepts, what is now plainly obvious to any child who glances at a map of South America and Africa, was resisted—for vast stretches of time—by the world’s smartest thinkers.

Or, more prominent today, consider a conspiracy theorist or political ideologue who will never change their mind, no matter the evidence. That’s a uniquely resilient form of stupidity, more familiar to Marjorie Taylor Greene than to, say, the average porpoise. After all, an octopus or squid may not solve a Rubik’s cube, but cephalopods are unlikely to resist relevant, useful information simply because the data doesn’t match its ideology about how the world should work.

Humans, therefore, arguably possess the widest spectrum of behaviors along the Krakauer definition of intelligence. We are capable of the most astonishing feats of cognition, externalized outside our minds across vast stretches of time and space. But we are also capable of breathtaking stupidity, imagining that it’s a good idea to turn over a nuclear arsenal to Donald Trump, or, at the delightful pinnacles of human beclowning, that we can camouflage ourselves by making our faces invisible with lemon juice.

If you enjoy my writing, or learn something new from it, consider an exbodiment of your intelligence, by doing the smart thing and upgrading to a paid subscription for the low, low price of just $4 per month. Or, you can show off your advanced cognition by doing something no octopus can: buy and read my new book, FLUKE.

Here is the link:

https://www.forkingpaths.co/p/the-evolution-of-stupidity-and-octopus

I hope you enjoyed the read!

David.

This Is A Really Useful Discussion Of The Vagaries Of The Private Hospital Sector

 I found this a useful summary of the current situation.

Productivity link a solution to private hospital red ink

John Durie

1:52PM April 26, 2024

The first two rules of insurance are don’t pay and don’t rush. But if you are a private hospital and your financial survival depends on insurance payments, the tensions are somewhat greater.

Covid-19 flipped the balance between private hospitals and insurance, and the latter enjoyed a resurgence in profit margins – it seems at the expense of the hospitals.

Patient numbers crashed during Covid-19 and are still to return, while insurers with high reserves were able to return funds to members.

Conversely NIB chief executive Mark Fitzgibbon is also clear, telling The Weekend Australian that “without private hospitals there is no private health insurance”.

Worse, if private hospitals fail, the pressure increases on the public sector; and in the past five years 71 private hospitals have closed as health costs increase, to take more than 10 per cent of the national income.

Federal Health Minister Mark Butler and some state colleagues are acutely aware of the problems and Butler is considering some sort of inquiry by the ACCC or Senate to look at the plight of the sector.

Insurers like Fitzgibbon says there is no need as “there is no evidence of market failure”.

The private hospitals would welcome an inquiry to prove their case but are also aware that government inquiries are a delaying mechanism by politicians wanting to be seen to be doing something without actually doing anything.

The fact is the market has long failed and governments have been knee-deep in the mess as they attempt to resurrect the private hospital sector over recent decades, moving from crisis to crisis – with the latest spots mental health and pregnancy.

Private health insurance is now relatively healthy. About 55 per cent of the population has some sort of insurance, up from 29 per cent in the mid 1990s.

The industry has lifted its game but government regulations were the key to the market share increase, including rebates and rules imposing penalties on those who don’t join at a set age.

Insurers naturally would prefer us to all stay healthy and out of hospital as they pocket your premiums, but few people would credit their insurer as the reason for their good health. Ultimately it’s the doctors who call the shots and direct the flow of funds.

They have proved unreliable sources of supply, in part because they may be linked to multiple hospitals, are increasingly building their own hospitals and, post Covid-19, have also learned the lifestyle benefits of working less.

Doctors, just like Qantas learned, understand the laws of economics when it comes to restricting supply to drive prices higher.

Insurer Medibank is in the same game with its own day hospitals.

The solution is for the insurers to pay the hospitals more but it’s way more complex than that simple metric and much of it is out of the hospitals’ control.

For a start neither the hospital nor the insurer owns the patient and while everyone talks about consumer benefits at the end of the day it’s the doctor who controls the supply chain.

The doctor decides when surgery will happen and at what facility.

The increasing financial plight of the sector means it is looking to insolvency practitioners for assistance, such as Arnold Bloch’s Leon Zwier.

Two out of five hospital admissions are to private hospitals which do two out of three elective surgeries.

State and federal governments pay $5.6bn a year to the sector and the other $11.5bn comes from private health funds.

Governments spend in total $60bn on public health services, but less than 10 per cent of which goes to private hospitals that account for 40 per cent of admissions.

The insurers say they have rationalised and it’s time for the hospitals to do likewise.

NIB, by way of example, used to have 80 retail shopfronts. It now has zero.

They have also invested in technology while the hospitals lag on this score.

The health funds tend to compare themselves to general insurers and claim to return 86 per cent of premiums against 65 per cent for general insurers.

They claim an average management expense ratio of 10.8 per cent against general insurers at 22.6 per cent.

They also say are now paying for two thirds of all elective surgery procedures in Australia, including more than 80 per cent of hip and knee replacements and more than 70 per cent of cataract surgery in the private sector.

These claims depend on which side of the fence you sit.

Their premiums are set by government which this year approved a 3.03 per cent increase compared with sector increases of 16 per cent.

No one disputes the financial pain, and the big five hospital groups last year lost $553m on $11.2bn in revenues.

By way of example, the Bermudan-based fund Brookfield paid $4.4bn for Healthscope in 2019 with $1.6bn in debt.

It collects about $2.3bn in revenues against which staff costs total $1.1bn, medical and consumables $290m, prosthetics $302m, occupancy costs of $195mn and debt service of $230mn.

The industry like everyone else has had to cope with higher energy costs, a rising wages bill and staff shortages.

The big trend in the industry is shorter stays, more day surgeries and more care from home, which everyone supports.

But obviously a private hospital geared to longer stays is going to need to change its cost base.

Estimates put savings in hospital from home at $1.3bn.

The debate is over how much is covered by the insurer and the hospitals want a default benefit which is a multiple of what the insurers say they should pay. The default is based on a set amount depending on the procedure.

Prosthetics is another perennial but the immediate debate is not over tungsten or ceramic hips but the long list of what are called general use items like gauze and staples.

The prosthetic list has long been debated about the hefty cost differential paid for replacement hips in Australia compared with offshore.

The everyday list is a bit more basic and arguably important but the insurers oppose the inclusion of some items.

They are due to drop off what is known as the “prescribed list” in July, subject to what the government says.

This debate highlights what happens between the two as the insurers are trying to exclude some items and the hospitals want more covered.

This is at the centre of the hospital-at-home debate whereby insurers and hospitals are at opposite ends of the spectrum on the cost of the procedure and hence amount of funds to pay for the service.

The list is much longer and, given the size of the sector, the solutions hold many of the keys to the drive for productivity reform in Australia.

Here is the link:

https://www.theaustralian.com.au/business/productivity-link-a-solution-to-private-hospital-red-ink/news-story/cc94d3423e72fa407d1feedee0b83021

Well worth a read to catch up on what has been going on!

David.

I Wonder How This System Is Being Evaluated? It Sounds Too Good To Be True!

 This appeared last week:

NIB unleashes AI-powered symptom checker to slash hospital wait times

EXCLUSIVE

By Jared Lynch

Technology Editor

Updated 1:12PM April 26, 2024, First published at 1:15PM April 25, 2024

Health insurer NIB has developed what it says is almost the equivalent of a triage nurse that can fit inside people’s pockets, thanks to artificial intelligence.

The ASX-listed company has partnered with Polish software company Infermedica, which uses AI to deliver “efficient, safe and reliable care” to patients. In NIB’s case, it is a “symptom checker” available via the health insurer’s app.

It works by asking a series of questions about a person’s symptoms, then directs them to the health service that best suits their needs, whether that is a GP, hospital emergency department or home monitoring.

NIB chief medical officer Rob McGrath said the AI-powered symptom checker worked in “many ways” like a triage nurse.

“It’s kind of a new approach on the traditional decision tree algorithms. It’s much more probabilistic modelling,” Dr McGrath said.

“There’s an inference engine which kind of changes the next question based on previous questions and risk factors and demographics and those types of things. And it’s much more nuanced to the individual. And it’s a little bit more dynamic, which is kind of the way doctors and nurses work inherently, so it tends to be shorter and more focused and post traditional kind of decision tree algorithms.”

The deployment of AI systems is aimed at helping combat spiralling health care costs, which become a hot topic of dispute in funding negotiations between hospitals and health insurers. Private hospital operators have been calling for a greater share of health insurer profits as they continue to deal with pandemic-era restrictions on elective surgeries – their main revenue driver.

It’s a problem shared with the public system, with NSW health department data revealing almost one in 10 patients are waiting up to 11 hours in emergency departments. To help reduce time blowouts, the NSW government is encouraging people with non-urgent issues to call the federal Healthdirect helpline instead of triple-0.

Dr McGrath said the AI ‘symptom checker’ has achieved accuracy of 97.2 per cent, which is “pretty high for these types of digital triage tools”.

“In fact, there was a study in the Medical Journal of Australia in 2020, which cited 36 online symptom checkers and this platform outperformed all of those for every measure. So it’s, really accurate and it just improves over time as more people use the platform.”

NIB quietly launched the symptom checker in February and said it has already been accessed more than 5000 times. Of those who completed an assessment, 64 per cent were referred to a GP, 15 per cent were directed to a hospital emergency department, and 21 per cent were advised to monitor their symptoms carefully from home.

“What we’d like to do is preserve some of those precious resources in emergency departments, in general practices, so they can focus on those patients that really need the support,” Dr McGrath said.

“We’re seeing some really good results in the early data. The hope is that it can create some efficiency and ideally a better experience for our members, so they’re not sitting in emergency departments waiting for hours on end.”

Dr McGrath said the health sector was “just at the beginning” of exploring AI. Pathology providers have been among the earliest adopters. Sonic Healthcare backed AI start-up Harrison.ai’s $129m Series B funding round in 2021, acquiring a 20 per cent interest in the group and forming a separate joint venture called franklin.ai.

It is using AI to support a “more effective and efficient diagnosis of patients in anatomic pathology and laboratory medicine by providing pathologists with ‘a second set of eyes’.”

Australia’s second biggest private hospital group Healthscope is also using AI to better gauge patients’ emotions and improve their quality of care. It partnered with Adoreboard – a tech company spun out of Queen’s University Belfast – to analyse patient surveys, eliminating the need to manually read each comment.

Healthscope completed a three-year study into the AI platform and said it could spark a 13.9 per cent in how patients rate their care and treatment. CSL, Cochlear, and ResMed are also. all exploring or using AI.

“Obviously, there needs to be some guardrails around the adoption of AI tools to support clinical care, but I think we’re just at the beginning of that journey,” Dr McGrath said.

“As resources become more and more strained, these tools can help create efficiency and triage as well as navigation through the system and supporting clinicians to be more efficient.”

The symptom checker is available to all NIB members in Australia and is aimed, in particular, at international students and workers, offering guidance on where and how to seek treatment while in Australia. NIB’s international inbound health insurance business covers over 200,000 international students and workers.

Here is the link:

https://www.theaustralian.com.au/business/nib-unleashes-aipowered-symptom-checker-to-slash-hospital-wait-times/news-story/eab338602c971113a301d647b66b4a93

This is surely an innovation to keep a close eye on!

Reports from the field encouraged! Have you used to system?

David.

Some How I Think This Lot Are On The Losing Side, And Are Probably Worried About Pretty Much Nothing!

This popped up last week

US nurses protest against the use of AI in hospitals

Cora Lydon

---

26 April 2024

 

Hundreds of nurses gathered at Kaiser Permanente’s San Francisco Medical Center this week to protest against the use of artificial intelligence (AI) in healthcare.

The demonstration was organised by the California Nurses Association, who believe the hospital industry is rushing to implement AI technology that is untested and unregulated – and could harm patients.

According to a video posted by the San Francisco Chronicle to X, nurses brandished signs reading ‘Trust Nurses Not AI’ and chanted “AI has got to go!”

The association is calling for nurses and all union members to be involved in the decision-making process for the deployment of AI in “every step”, with Kaiser Permanente an early adopter of AI and other data-driven technologies.

A statement from Michelle Gutierrez Vo, BSN, RN, registered nurse at the Kaiser Permanente Fremont (Calif.) Medical Center and president of the California Nurses Association, reads: “It is deeply troubling to see Kaiser promote itself as a leader in AI in healthcare, when we know their use of these technologies comes at the expense of patient care, all in service of boosting profits.

“Nurses are all for tech that enhances our skills and the patient care experience. But what we are witnessing in our hospitals is the degradation and devaluation of our nursing practice through the use of these untested technologies.”

Cathy Kennedy, RN, a nurse at Kaiser Permanente Roseville (Calif.) Medical Center and a president of the state nursing association, agreed, stating: “Human expertise and clinical judgment are the only ways to ensure safe, effective, and equitable nursing care.

“We know there is nothing inevitable about AI’s advancement into healthcare. No patient should be a guinea pig and no nurse should be replaced by a robot.”

In response to the action, Kaiser Permanente released the following statement: “Kaiser Permanente is empowering nurses with state-of-the-art tools and technologies that support our mission of providing high-quality, affordable health care to best meet our members’ and patients’ needs.

“We have consistently invested in and embraced technology that enables nurses to work more effectively, resulting in improved patient outcomes and nurse satisfaction, and we will continue to do so.

“At Kaiser Permanente, AI tools don’t make medical decisions, our physicians and care teams are always at the center of decision making with our patients. We believe that AI may be able to help our physicians and employees, and enhance our members’ experience. As an organisation dedicated to inclusiveness and health equity, we ensure the results from AI tools are correct and unbiased; AI does not replace human assessment.”

The US took an aggressive stance on the topic of AI safety last year. October 2023 saw President Biden issue an executive order aimed at protecting Americans from potential risks of the technology.

Here in the UK, following the AI Safety Summit in November last year, the Medicines and Healthcare products Regulatory Agency set out new plans in January this year to protect patients while enabling access without delay to innovative new medical technologies, including AI.

A thought leadership report from 2022 from DAC Beachcroft revealed that trust in AI among both patients and healthcare staff will improve with regulation. Exactly what that regulation will look like remains to be seen.

Here is the link:

https://www.digitalhealth.net/2024/04/us-nurses-protest-against-the-use-of-ai-in-hospitals/

I really struggle to understand what the problem is. No one is planning mass sackings, rather they are planning to use AI to improve the consistency and quality of care – which to me has to be a good thing!

I suspect KP will be able to ride this one out and those who are worried will survive the transition and wonder later what the fuss was all about!

David.

I Suspect The Social Media Giants Are Slowly Loosing The Social License To Operate.

 This appeared a few days ago:

Surge of violence tests policy tolerance of social media

The Coalition in particular has to ask tricky questions of when enough is enough on social media platforms.

Laura Tingle Columnist

Apr 26, 2024 – 5.16pm

It has become a standard, if unfortunate, part of Australian politics in recent years for politicians to pick up and run with some incident to crystallise public sentiment on an issue and let the media debate rage on it.

Think African gangs, needles in strawberries, Woolworths not selling enough Australia Day merchandise.

You might notice that these have tended to be the preserve of the Coalition side of politics more than the Labor side.

That Labor doesn’t do it so much may be testament to their better angels, or to the fact they have just never been good at the particular style of politics.

But we now face a perfect firestorm of issues that challenge our community cohesion and present us with Australian society in all its ugliness.

It is a particularly complex set of issues that cannot be untangled from each other.

That makes this particular modus operandi dangerous for both those who might be tempted to practice it, and for the rest of us.

We all know social media has become an unwieldy force in politics around the globe. But our political leaders are now being forced to confront, in very specific terms, the really difficult questions thrown up about when enough is enough with social media.

A debate that has largely been framed in terms of freedom of speech has become conflated with a whole range of issues that now challenge us: from social cohesion, to terrorism, to domestic violence.

The killings, predominantly of women, at Bondi Junction and the stabbing attack on a bishop in the western Sydney suburb of Wakeley have come at a time of horrendously relentless killings of women, and amid heightened tensions provoked by the Gaza conflict.

Social media is a thread that has run through all these stories: from the misinformation and disinformation spread about the Bondi attacker while the attacks were still underway; to the livestreaming of the bishop’s church service and subsequent misinformation that led to a violent riot; to questions about the growing aggression of misogynistic online content directed towards young men; to online abuse and threats of violence levelled at anyone on either side of the Gaza conflict.

This week, the e-safety commissioner, Julie Inman Grant, took on X and Elon Musk in the Federal Court seeking to force X to take down 65 postings of graphic footage of the knife attack on the bishop in western Sydney.

She is seeking to do that under the powers the parliament granted her – under the Morrison government – in the Online Safety Act in 2021.

There are now two mighty struggles going on about how we communicate and debate each other in future.

While there had been a lot of political noise made in the wake of the Bondi attacks 48 hours earlier about dealing with the disinformation and the misinformation that had circulated at the time, the social media platforms are currently subject only to voluntary codes of conduct about removing inflammatory commentary and misinformation.

Legislation dealing with these issues is currently being considered, as are changes to the Online Safety Act – which was already under review before these attacks all happened.

The ground has now shifted under the political debates about the specifics of both those legislative developments.

But in the meantime, there are now two mighty struggles going on about how we communicate and debate each other in future.

One concerns the fight in the courts with Musk and his assertion that, in trying to force his company to take down the posts, the Australian government is not only hindering free speech, it is over-reaching into an attempt to dictate what can be seen online outside Australia’s borders.

The second struggle concerns the general position of our politicians about if, and how, we reset the terms of social media’s social contract. 

Dutton’s dilemma

The political leader in the more difficult position on this is the opposition leader, Peter Dutton, who not only faces divisions on this in his party – and in the conservative base – but also the problem of reconciling those divisions with his own strong views about social media when it comes to issues like law and order and child abuse.

It is instructive to look at comments Dutton made on April 8, before the Sydney attacks, about social media and its role in facilitating things like young people posting crimes like house-breaking or car theft online.

The social media companies, he said, have to “make sure that they take content down so that these young offenders don’t get the publicity that they’re seeking”.

The Coalition’s private members bill would set up the power to do this, he said.

“Because at the moment, a lot of people are living in fear and they’re worried about whether they’re going to be broken into again. It’s devastating, it’s confronting to have somebody coming into your bedroom or coming into your living area, particularly when you’ve got young children.”

In the wake of the Bondi and Wakeley attacks, Dutton told the ABC’s Insiders on Sunday that there was “no question at all [that tougher action needed to be taken against social media companies] and I think there’s a bipartisan position in relation to this”.

“We know that the companies – and we’ve seen some of the comments from Elon Musk overnight – they see themselves above the law. The Australian law here should apply equally in the real world as it does online ... you would be sued for defamation and you would be taken before the courts under various acts for publishing some of that which freely flows on the internet.

“They’re allowing paedophiles to distribute through their networks, images and videos of children being sexually abused, they’re impeding the investigations of the police.”

This issue of removing explicit content is the same one Inman Grant is trying to deal with over the bishop’s stabbing.

For some, including Senate crossbenchers Pauline Hanson and Ralph Babet, and the Institute of Public Affairs, this amounts to an attack on free speech.

Dutton also faces questions about his approach from some in his own ranks.

But he can’t really go too far on the question of removing violent content given his position on things like kids posting themselves breaking the law or child exploitation.

The fact that the Australian Federal Police and ASIO emerged this week to explicitly link the violent content with terror threats also highlights the difficulties for Dutton, given his tough line on national security.

Our national security officials told us the Wakeley footage could be used just as footage of the Christchurch terror attacks had been used by Isis as part of their recruitment of young men.

And we subsequently saw the arrest of five teenagers linked to the Wakeley attacker, some of whom we were told had just graphic content on their phones.

The even more difficult question becomes how parliaments and governments deal with misinformation and disinformation since it involves not just removing graphic images but people’s opinions and, therefore, becomes a much clearer debate about censorship and free speech.

When the government put up some draft laws to deal with this last year, the Coalition howled it down.

You would have to think the optics and the policy imperatives have changed.

Who wins and loses in the Federal Court is just one aspect of the battle ahead.

Here is the link:

https://www.afr.com/politics/federal/surge-of-violence-tests-policy-tolerance-of-social-media-20240422-p5fll7

Social media can be a force for both good and evil. For good it can educate and inform as well as assist people stay in contact and feel valued and supported.

For evil it is now clear social media can assist in radicalization as well as assist in the organization of malign forces and entities.

Frankly I think the time has now come for a great deal more responsibility to be attached to social media and for accountability to be demanded for dangerous and divisive social media activity.

On another tack there is also a problem with data-encryption and how it is used. It is clearly good when used to protect commercial transactions and the like – but maybe not so good when facilitating secret malign plotting and scheming!

I am presently not sure just how well those responsible for keeping ordinary citizens safe understand some of the malign forces circulating in our community and how they can lead to the attacks and stabbings seen recently.

There seems to be a well of psychopathy and distress that the community is yet to fully understand and come to grips with. There seems to be rather too many alienated and disenchanted souls out there we need to work harder as a community to reach and support.

Right now I am not all that sure social media is adding much to community health and cohesion – commercially driven as it is!

How do readers assess all this at present?

David.

AusHealthIT Poll Number 744 – Results – 28 April, 2024.

Here are the results of the poll.

Do We Still Need Specialised Clinics To Manage People Suffering From The Effects Of Prolonged COVID-19 Disease?

Yes                                                                              19 (54%)

No                                                                               16 (46%)

I Have No Idea                                                             0 (0%)

Total No. Of Votes: 35

An almost perfectly split vote with just a tiny vote in favour of specialised clinics

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

A good number of votes.  

0 of 35 who answered the poll admitted to not being sure about the answer to the question!

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

David.

Anxiety With The Potential Capabilities Of AI Is Certainly Rising!

This appeared last week:

Where do we draw the line on using AI in TV and film?

Recent controversies, including Civil War posters and altered photos in a Netflix documentary, have led to concern over the growing use of artificial intelligence on screen

Adrian Horton

Sat 20 Apr 2024 17.12 AEST  Last modified on Sat 20 Apr 2024 17.13 AEST

Though last year’s writers’ and actors’ strikes in Hollywood were about myriad factors, fair compensation and residual payments among them, one concern rose far above the others: the encroachment of generative AI – the type that can produce text, images and video – on people’s livelihoods. The use of generative AI in the content we watch, from film to television to large swaths of internet garbage, was a foregone conclusion; Pandora’s box has been opened. But the rallying cry, at the time, was that any protection secured against companies using AI to cut corners was a win, even if only for a three-year contract, as the development, deployment and adoption of this technology will be so swift.

That was no bluster. In the mere months since the writers’ and actors’ guilds made historic deals with the Alliance of Motion Picture and Television Producers (AMPTP), the average social media user has almost certainly encountered AI-generated material, whether they realized it or not. Efforts to curb pornographic AI deepfakes of celebrities have reached the notoriously recalcitrant and obtuse US Congress. The internet is now so rife with misinformation and conspiracies, and the existence of generative AI has so shredded what remained of shared reality, that a Kate Middleton AI deepfake video seemed, to many, a not unreasonable conclusion. (For the record, it was real.) Hollywood executives have already tested OpenAI’s forthcoming text-to-video program Sora, which caused the producer Tyler Perry to halt an $800m expansion of his studios in Atlanta because “jobs are going to be lost”.

In short, a lot of people are scared or at best wary, and for good reason. Which is all the more reason to pay attention to the little battles over AI, and not through a doomsday lens. For amid all the big stories on Taylor Swift deepfakes and potential job apocalypse, generative AI has crept into film and television in smaller ways – some potentially creative, some potentially ominous. In even just the past few weeks, numerous instances of AI legally used in and around creative projects are testing the waters for what audiences will notice or take, probing what is ethically passable.

There was a small social media flare-up over AI-generated band posters in the new season of True Detective, following some viewer concern over similarly small AI-generated interstitials in the indie horror film Late Night With Devil. (“The idea is that it’s so sad up there that some kid with AI made the posters for a loser Metal festival for boomers,” the True Detective showrunner, Issa López, said on X. “It was discussed. Ad nauseam.”) Both instances have that uncanny lacquer look of AI, as in the AI-generated credits of the 2023 Marvel show Secret Invasion. Same, too, with promotional posters for A24’s new film Civil War, depicting American landmarks destroyed by a fictional domestic conflict, such as a bombed-out Sphere in Las Vegas or the Marina Towers in Chicago, with trademark AI inaccuracies (cars with three doors, etc).

There’s been blowback from cinephiles over the use of AI enhancement (different from generative AI) to sharpen – or, depending on your view, oversaturate and ruin – existing films such as James Cameron’s True Lies for new DVD and Blu-ray releases. An obviously and openly marked AI trailer for a fake James Bond movie starring Henry Cavill and Margot Robbie – neither of whom are part of the franchise – has, as of this writing, over 2.6m views on YouTube.

And arguably most concerning, the website Futurism reported on what appear to be AI-generated or enhanced “photos” of Jennifer Pan, a woman convicted of murder-for-hire of her parents in 2010, in the new Netflix true crime documentary What Jennifer Did. The photos, which appear around the film’s 28-minute mark, are used to illustrate Pan’s high school friend Nam Nguyen’s description of her “bubbly, happy, confident, and very genuine” personality. Pan is laughing, throwing up the peace sign, smiling widely – with a noticeably too long front tooth, oddly spaced fingers, misshapen objects and, again, that weird, too-bright sheen. Film-maker Jeremy Grimaldi neither confirmed nor denied in an interview with the Toronto Star: “Any film-maker will use different tools, like Photoshop, in films,” he said. “The photos of Jennifer are real photos of her. The foreground is exactly her. The background has been anonymized to protect the source.” Netflix did not respond to a request for comment.

Grimaldi does not explain which tools were used to “anonymize” the background, or why certain features of Pan look distorted (her teeth, her fingers). But even if generative AI was not used, it’s still a troubling disclosure, in that it suggests a muddling of truth: that these are old photos of Pan, that there is a visual archive that does not exist as such. If it is generative AI, that would tip into straight-up archival lie. Such use would go directly against a suite of best-practice guidelines just put forth by a group of documentary producers called the Archival Producers Alliance, which rules in favor of using AI to lightly touch up or restore an image but advises against new creation, altering a primary source, or anything that would “change their meaning in ways that could mislead the audience.”

It’s this final point – misleading the audience – that I think is the growing consensus on what application of AI is or is not acceptable in TV and film. The “photos” in What Jennifer Did – absent a clear response, it’s unclear with what tools they were altered – recall the controversy over bits of Anthony Bourdain’s AI-generated voice in the 2021 documentary Roadrunner, which overshadowed a nuanced exploration of a complicated figure over an issue of disclosure, or lack thereof. The actual use of AI in that film was uncanny, but revivified evidence rather than created it; the issue was in how we found out about it, after the fact.

And so here we are again, litigating certain small details whose creation feels of utmost importance to consider, because it is. An openly AI-generated trailer for a fake James Bond movie is strange and, in my opinion, a waste of time, but at least clear on its intent. Creation of AI posters in shows where an artist could be hired feels like a corner cut, an inch given away, depressingly expected. AI used to generate a fake historical record would clearly be ethically dubious at best, truly manipulative at worst. Individually, these are all small instances of the line we’re all trying to identify, in real time. Collectively, it makes finding it seem more urgent than ever.

Here is the link:

https://www.theguardian.com/culture/2024/apr/20/artificial-intelligence-ai-movies-tv-film

This article makes a very good point that the capacity for deception and illusion has progressively amped up and we are now at a stage where the logical progression of what is being do is the cause for more than a little concern.

Just how all this will be managed in the future is very hard to predict but I fear it is not going to be easy or straightforward!

What do you think?

David.