Liberals in turmoil:

James Burke writes: Re. “Libs search for their dreamtime martyrs” (Friday). For a while I’d been nursing an idea for a book to be titled Fools on the Hill: The Search For Australia’s Stupidest Federal Parliamentarian. After much procrastination, I spiked the project only days ago, having decided that it would be unfair and distasteful to pick on the apparent frontrunner, now that he had paraded his traumatic history of learning difficulties and sexual abuse before the public.

I was then amazed to see the shortlist so dramatically showcased by the series of dummy-spits (pun intended) that has been unleashed on Malcolm Turnbull in the past week. Joyce, Tuckey, Mirabella, Jensen, Schultz, McGauran, Bernardi, Ferravanti-Wells … these are some of the biggest dills and dolts in the current or, indeed, any parliament.

I only wish that some of the dear departed  could be here to share in this mass outbreak of feral idiocy (De-Anne Kelly, Ross Lightfoot, Jackie Kelly, Mal Colston, Santo Santoro, Pauline Hanson, Graeme Campbell: gone but not forgotten). OK, some of the dummy-spitters (Abbott, Minchin, Abetz) are more in the category of Crazed Meanies than Feral Dummies, but all up it is a remarkable demonstration of how far the Right of politics has deteriorated, intellectually and morally, into little more than an alliance between the greediest, most vicious and most ignorant members of society.

The Turnbulls of tomorrow are unlikely to look to such a degenerate mob to further their political careers.

Jacqueline Kent writes: Malcolm Turnbull is obviously hoping for a Maurice Sendak-led recovery. From WHERE THE WILD THINGS ARE:

They roared their terrible roars and gnashed their terrible teeth and rolled their terrible eyes and showed their terrible claws till [he] said, “Be still!” and tamed them with the magic trick of staring into all their yellow eyes without blinking once and they were frightened and … made him king of all wild things.

And if that doesn’t work, he can always get into his private boat and sail home.

Ray Quigley writes: I am worried. Politicians, to my eye, are generic egotists. So when our current supreme leader, Kevin Rudd, is confronted by “nothing” his egomania will expand in a commensurate way. Why am I worried?  All Government’s need an organised opposition, or they will ride roughshod over us all, and we ain’t got one.

John Shailer writes: Many commentators maintain the Libs face electoral oblivion, if they don’t pass the ETS.   However support for the ETS is declining rapidly, as evidenced by a string of current polls – Galaxy poll (60% for delay); Roy Morgan (47% against, 37% for); Lowy Institute’s annual poll (a 23% drop in support since 2006); and Nielsen poll (18% drop since July 2008).

It  will decline further as the voting public overcomes the conspiracy of silence by Kevin Rudd  and his media cheer squad, and they becomes aware that the ETS is simply an Extra Tax Scheme, equivalent to increasing the GST from 10%  to 12.5 % on nearly everything.

If Kevin Rudd wants to force an early election on his flawed ETS, bring it on!

Grant Corderoy writes: Please ask Bernard Keane or Guy Rundle to delve into the Nick Minchin files. Or maybe Stephen Mayne to provide a critique on his performance as Minister for Finance and Administration in the previous government. Why?

Because they will confirm by way of quality journalism and research what we suspect — that this apologist for the Howard Government who  has never ventured outside the “safe haven” of the party machine and then the senate has no credibility nor role in any public debate about important social and economic issues.

Martin Gordon writes: Re. “So how come an ETS was OK under John Howard? Ask the oldies” (Friday). It astounds me that people if the opinion polls are to be believed don’t understand what an emissions trading scheme means.

Kevin was elected by many of these people now they claim they don’t understand it means higher prices. That’s it. It’s about changing our behaviour by changing prices, all the happy talk about saving the Barrier Reef is fluff.

I support action but people must be foolish that action is costless.

Angus Sharpe writes: Re. “No party lasts forever: split happens” (Friday). Great Article from Greg Barns, who asks: “But who would vote for a genuine liberal party that stood for action on climate change, market-driven economic policies, and new thinking on issues such as drugs, gay marriage and indigenous self-empowerment and refugees?”

I would.

Climate change:

Steve O’Connor writes: Re. Tamas Calderwood (Friday, comments). I’m not a climate scientist, but this is my understanding:

  1. You quote a different set of temperature records than the IPCC report uses.
  2. Your (Uni of Alabama) records are satellite, not ground measurements.
  3. Satellite measurements need a fudge factor applied to transform them to ground records

From what I can see, there seems to be ongoing dispute what the correct fudge factors are, so ground measurements are much more reliable (and applicable, as most people don’t live in the troposphere.)

In regard to IPCC author Kevin Trenberth and his leaked email, he was referring to his recent paper, and the travesty that scientists don’t have enough measuring devices to adequately monitor the heat flux as it distributes throughout different systems of the earth (e.g., into the oceans etc).

Perhaps someday soon you will experience your own “oh sh*t” moment.

Ken Lambert writes: “Sexing up” a graph to create false certainty is scientific dishonesty. Trenberth, Mann, Briffa and Co are people endlessly quoted in the IPCC Reports and references as *the* authorities on proof for AGW via the CO2 GHG mechanism. Discovery of collusion to “sex-up” the data, or privately disclose their profound doubts about the observations matching their theories has dealt a huge blow to their credibility.

There is no doubt that the ructions in the Liberal Party over the CPRS and ETS, has been fueled in recent days by these revelations of scientific ‘clay feet’ on the part of leading proponents of alarmist AGW. I believe the email traffic on this matter to politicians involved has been stupendous.

What does Tim Flannery say to a bewildered politician ringing for climate science advice? … “I don’t know what’s going on mate.”

Professor Jon Patrick and the NSW Health:

Jon Patrick, Chair of Language Technology, University of Sydney, writes: As a regular reader of Crikey I am happy to be able to clarify some of the misconceptions present in the comments made by an anonymous tipster in Friday’s “Tips and rumours”. The “tip” began with: “Standby for a Stoush between the University of Sydney’s health informatics researcher Professor Jon Patrick and the NSW Health…”.

“Anonymous” refers to an article of mine published on my laboratory’s website “that has raised concerns about Cerner’s eMRs being rollout in NSW.” If Anonymous had read the essay they would have known that it is not about eMRs but about a single clinical information system called Firstnet, provided by Cerner. Readers can find the article and assess it for themselves.

Anonymous would have been able to establish that the essay covers the roll out of a state wide use of Firstnet only since 2006 in which NSWHealth is endeavouring, according to clinicians and nurses, to bludgeon unwilling clinical staff into using it, which they say makes their work inefficient, harder to care for patients, and a risk to patient safety.

Readers will find all this substantiated by the quotations from clinicians reproduced in the essay. Readers of the essay will also see a discussion of the systemic issues that have contributed to the failure of this piece of technology, deployment and its serious consequences for many aspects of care in Emergency Medicine. They will notice that Anonymous’s selective choice of content from Garling’s report fails to give attention to his comments that effective clinician engagement is important. This is something the physicians say has failed in the Firstnet roll out, and they have emphasized by voting with their feet by refusing to use it.

Anonymous asserts about me that  “What Professor Patrick does not mention in his essay is that he and his department are developing an alternative electronic medical record system using open source software.”

My research is well published on the web site where the essay described by Anonymous is also published. Any reader who has to go through the web site to get to the essay has the opportunity to study all the different types of research we do in our Laboratory. This of course is one of the reasons the essay is only provided as a download. Furthermore the link in Anonymous’s article does not point to a description of my work as they purport but rather points to a general article in which I am a commentator on the value of open source software.

If Anonymous had perused my web site with even a modicum of effort they would have discovered that my research is directed to the use of natural language processing (NLP) to improve the speed of retrieving semantic content from clinical notes in order to assist clinical staff to work more efficiently.

Concomitantly, we research how an NLP paradigm might change the way we design clinical information systems. EMRs are a different technology and I have never written about them.

The possibility that our language processing research might one day be used in a commercial clinical system is an aspiration we have, but suggesting that we can produce a comprehensive hospital wide EMR system is a flight of fancy.

Anonymous accuses me of attending a conference junket. Readers might be interested to know what this conference entailed. I flew out of Sydney on a weekday evening and for the 13 hour flight I spent about 10 hours editing the first 180 pages of a draft thesis of one of my PhD students. I find the time on airflights quite useful for completing a lengthy piece of work like this that requires continued concentration. Having left on a weekday evening, I arrived on a morning of the same day so I felt the University had a got a free day’s work out of me. I proceeded to the location of a pre-conference workshop where on the next day I presented a paper to a group of specialist researchers on how we might identify the ideal development environment for engineering clinical information systems. I presented my ideas on my principle of Ockham’s Razor of Design and explained how it represented a different paradigm that had natural language processing as the centrepoint of design of these systems.

On the following day I discussed my ideas with researchers from Europe, and the USA along with their own offerings. Oh, I also turned down an offer for a job with a New York research group. On the following day I went to another workshop where I delivered a paper on the methods we used for extracting relevant content from clinical notes.

Oh, I almost forgot to mention, at the same time I also received the winner’s award for building the most accurate system for this year’s international challenge for information extraction from clinical notes, beating 20 other international competitors, including esteemed institutions and recognised leaders in the field, such as the National Library of Medicine, Vanderbilt University, Manchester University, Humboldt University, and the Mayo Clinic.

It seems it might just be that we are the best in the world at it. On the fourth day, after listening to paper sessions, I attended the meeting of two Working Groups of the American Medical Informatics Association, namely Clinical Information System WG and the Ethics, Legal and Social WG. The former group gave me a copy of the new book just published on clinical information system failures, and the second group had arranged for me to speak to them on the pertinent issues that arose both from the contents of my essay and the University’s withdrawal of it after a “complaint” from NSWHealth.

On the fifth day I presented a poster on the work we are doing in our Laboratory on a Clinical Data Analytics Language (CliniDAL). This is a technology that enables a clinician to ask any ad hoc question using their own clinical dialect and jargon that can be answered from content within the clinical information system, and produce an answer even if it has to access multiple information systems and the answer is buried within the prose of the clinical notes. Three organisations (2 from USA and 1 from Canada) discussed my poster in sufficient detail for us to set in train a process of collaboration.

On the sixth day I was engaged in discussion with a number of people about the contents of my essay, using their experience to edit the essay, and collecting more information to verify the international issues in it. I also responded to a request from the US Senate, Finance Committee for a copy of my essay, that had been triggered from my discussions with other interested delegates, who like me lamented the very poor state of the software engineering of clinical information systems.

On the seventh day I must admit to doing no more but having meetings with fellow members of the World Health Organisation’s (WHO) Committee for the design of the International Classification of Diseases (ICD), Version 11, which we expect to roll out in 2012. Version 10 is the basis of most health statistics compiled in Australia and more than 150 other countries around the world.

I also met with fellow members of the International Health Terminology Standards Development Organisation (IHTSDO), which has the international responsibility of managing SNOMED CT, the new clinical terminology adopted by all Australian Governments for the future formal recording of clinical notes.

Subsequently, I flew home on my own time on Saturday and Sunday so that I would be able to get back to my Laboratory by Monday morning, but during which time I completed the editing of my student’s thesis.

I leave it to the reader to judge my efforts.

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Peter Fray
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