Category Archives: Empowerment

Artificial Intelligence (AI) and Machine Learning (ML) Hype or Help for medical professionals?

The answer is both.

The diagnostic performance of deep learning models is impressive.

However, we must acknowledge AI and the more advanced ML in healthcare are tools. The correct term is Augmented Intelligence (AugI).

AugI in medicine is an approach focusing on AI’s assistive role, emphasizing the fact that technology is designed to enhance human intelligence not replace it.

The aforementioned is illustrated in an excellent 09/25/19 review article in The Lancet:  “A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis”

“Our review found the diagnostic performance of deep learning models to be equivalent to that of healthcare professionals,” write Livia Faes, MD, of Cantonal Hospital Lucerne in Switzerland, and colleagues.

Diagnosis of disease using deep-learning algorithms “holds enormous potential,” they conclude. “From this exploratory meta-analysis, we cautiously state that the accuracy of deep-learning algorithms is equivalent to healthcare professionals while acknowledging that more studies considering the integration of such algorithms in real-world settings are needed.”


Michael Horsch Fizz

11/09/2020 Zoom’s Meeting Platform security crisis continues. 07/13/2020 Wants to share calls with the police!

11/09/2020 – Update

FTC Requires Zoom to Enhance its Security Practices as Part of Settlement.
Commission alleged that the company deceived users about the level of security for Zoom meeting platform and unfairly undermined a browser security feature.

“Zoom has agreed to a requirement to establish and implement a comprehensive security program, a prohibition on privacy and security misrepresentations, and other detailed and specific relief to protect its user base, which has skyrocketed from 10 million in December 2019 to 300 million in April 2020 during the COVID-19 pandemic.”

07/25/2020 – UPDATE

From all the external pressures – ZOOM reversed its decision to make end-to-end encryption a paid feature. Privacy and Security MUST be the default in technology, not a paid luxury!
ORIGINAL 07/13/2020 POST: 

This is outrageous. Zoom made significant and commendable strides forward to finally address security flaws in 2020. However, IMO this latest policy change puts them back into the dog house. Zoom just announced that they will NOT offer end to end encryption to users with free accounts, because they want to give the police and FBI access to calls.

If paid subscribers do have end to end encryption this “policy” is a blatant strategy to simply generate revenue.

Sign the petition to tell Zoom: “Keep people safe by implementing default end to end encryption for all video, audio, and text chat.”

Tell Zoom to implement end to end encryption for all users.

“This threatens protesters who are using Zoom to coordinate demonstrations and have confidential discussions about necessary reforms. By giving cops these sensitive conversations, Zoom puts activists at risk. The police can use the information gathered to disrupt protests and even arrest the people involved.”

“As activists demand justice, accountability, and freedom from police violence, Zoom fuels the very police oppression the protesters are fighting against.1

“This is a decisive moment of change. The need for safety both on and offline has never been greater. Now more than ever companies must take action for our security, not expose us to more danger.”

Tell Zoom to keep all users safe.

“Eric Yuan, Zoom’s CEO, believes limiting encryption to paying customers is necessary because “some people use Zoom for bad purposes.” Not only does Yuan show disturbing bias in drawing a connection between free users and criminals, but he’s making a ridiculous argument. People with bad intentions will just pay to secure their calls, which means there’s literally no reason not to offer end to end encryption to free account holders other than to do law enforcement a favor.2,3

Eric Yuan, CEO Zoom

And while bad actors and corporations pay for safety, users who can’t afford paid accounts will be left vulnerable to cyber-criminals, stalkers, and governments around the world can access calls with full cooperation from Zoom.4

This sets an extremely dangerous precedent. This is what law enforcement wants and why they’re pressuring facebook to not roll out end to end encryption on messenger. By doing this Zoom is reinforcing a dangerous lie that widespread availability of end to end encryption is inherently dangerous, which is just nonsense.5

Tell Zoom to make all user accounts safe and secure with end to end encryption.

1. The Guardian:
2. CNET:
3. Schneier on Security:
4. Tech Crunch:
5. The Verge:

Reliable resources and patience during COVID-19

“Be patient so you don’t become one.”
1990 PostMedCare / MHF

During these times of increased anxieties, the aforementioned holds true as it did when first coined in the early 90s.

I understand how you may be feeling.  Anxious for the most current accurate information.  So many have felt and are feeling the same.  What many have found to counter the negative is to stay informed by utilizing credible resources. No one has all the answers.  However, the below resources can help us all to be informed and significantly reduce risk.

Get the latest public health information from the CDC:

Get the latest research from NIH:

Medical professional resources all can tap into:

March 18

JAMA held a live interview with NIAID Director Anthony Fauci, MD, about updates on the coronavirus.

March 17

—AMA has designed a quick guide to support physicians and practices in expediting the implementation of telemedicine.

—CDC held its latest webinar: Coronavirus (COVID-19) Update and Information for Long-term Care Facilities

—The CDC updated guidelines on cruise ship travel to include additional pre-travel advice about in-cabin isolation if patients become sick during a cruise and a 14-day quarantine following completion of any cruise. 

—New CDC interim guidance released on March 16 for discontinuation of home isolation for persons with COVID-19 as well as new FAQ for Healthcare Professionals released March 17 that provides additional knowledge regarding  COVID-19 at this time.

March 16

—AMA issued a letter to the White House to express the urgent need to resolve the mounting problems being raised by the nation’s frontline caregivers with respect to the COVID-19 pandemic.

—New CDC guidance recommends all persons defer any travel on cruise ships and river boats worldwide and provides recommendations to clinicians and state and local health departments to provide patients with pre- and post-travel advice to reduce risk of COVID-19 transmission.

Special edition of AMA Journal of Ethics Ethics Talk: Editor-in-chief, Audiey Kao, MD, discusses the ethical challenges, including resource scarcity and medical worker obligations, that arise during pandemics with public health expert Dr Matthew Wynia.


JAMA / Humana – Waste in the US Health Care System Estimated Costs and Potential for Savings

William H. Shrank, MD, MSHS1Teresa L. Rogstad, MPH1Natasha Parekh, MD, MS2

The estimated total annual costs of waste were $760 billion to $935 billion and savings from interventions that address waste were $191 billion to $282 billion.


Abstract / Synopsis

Donald M. Berwick, MD, MPP, discuss the findings and their implications for the US health care system.
Watch the VIDEO – Donald M. Berwick, MD, MPP, discuss the findings and their implications for the US health care system.

Importance  The United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health care spending may be considered waste. Despite efforts to reduce overtreatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains.

Objectives  To estimate current levels of waste in the US health care system in 6 previously developed domains and to report estimates of potential savings for each domain.

Evidence  A search of peer-reviewed and “gray” literature from January 2012 to May 2019 focused on the 6 waste domains previously identified by the Institute of Medicine and Berwick and Hackbarth: failure of care delivery, failure of care coordination, overtreatment or low-value care, pricing failure, fraud and abuse, and administrative complexity. For each domain, available estimates of waste-related costs and data from interventions shown to reduce waste-related costs were recorded, converted to annual estimates in 2019 dollars for national populations when necessary, and combined into ranges or summed as appropriate.


Findings  The review yielded 71 estimates from 54 unique peer-reviewed publications, government-based reports, and reports from the gray literature. Computations yielded the following estimated ranges of total annual cost of waste: failure of care delivery, $102.4 billion to $165.7 billion; failure of care coordination, $27.2 billion to $78.2 billion; overtreatment or low-value care, $75.7 billion to $101.2 billion; pricing failure, $230.7 billion to $240.5 billion; fraud and abuse, $58.5 billion to $83.9 billion; and administrative complexity, $265.6 billion. The estimated annual savings from measures to eliminate waste were as follows: failure of care delivery, $44.4 billion to $93.3 billion; failure of care coordination, $29.6 billion to $38.2 billion; overtreatment or low-value care, $12.8 billion to $28.6 billion; pricing failure, $81.4 billion to $91.2 billion; and fraud and abuse, $22.8 billion to $30.8 billion. No studies were identified that focused on interventions targeting administrative complexity. The estimated total annual costs of waste were $760 billion to $935 billion and savings from interventions that address waste were $191 billion to $282 billion.

Conclusions and Relevance  In this review based on 6 previously identified domains of health care waste, the estimated cost of waste in the US health care system ranged from $760 billion to $935 billion, accounting for approximately 25% of total health care spending, and the projected potential savings from interventions that reduce waste, excluding savings from administrative complexity, ranged from $191 billion to $282 billion, representing a potential 25% reduction in the total cost of waste. Implementation of effective measures to eliminate waste represents an opportunity reduce the continued increases in US health care expenditures.


They will bypass your best computer security system in ten minutes.

Social Engineering
The Evil Art of Human Hacking

Social engineering is a technique hacker’s use to take over an account by persuading or psychologically manipulating people to divulge confidential information. This is usually the first step within a more complex scheme. Social engineering uses “confidence building” techniques to set the victim at ease and convince him or her that the attacker is legitimate and presenting a valid scenario.

Social engineering is very common and occurs regularly; it is so pervasive, in fact, that two prominent internet companies, GoDaddy and PayPal, recently fell for a carefully crafted social engineering attack. This attack enabled unauthorized parties to hijack the account of a significant user and, through that breach, to access other confidential accounts. Cases like this “should have thrown up red flags for any Internet company dealing in identity,” reports “These are not new tactics and they should be guarded against as a very basic precaution.”

More alarming than the frequency of social engineering attacks is the relatively low risk for the attacker, who can disengage at any time simply by hanging up the phone or deleting the address used to send fraudulent emails. When this low risk is combined with the inviting ratio of success to failure, social engineering becomes an attractive alternative to much riskier fraud that requires facing your victim.

The means to defeat social engineering, however, are relatively simple if you understand what social engineering is: social engineering is a con. It relies on the victim’s reluctance or inability to question the authenticity of the attacker. Once that authenticity is questioned, the attacker must deviate from their “script” and flounder to avoid being discovered. The more you drive the attacker off the script, the more information you can gain; proportionally, this increases the risk to the attacker. Five simple steps can help you avoid becoming a victim of social engineering:

  • Question the authenticity of every communication. This is especially true if you are asked for information such as usernames, passwords, or other sensitive data.
  • Do not be afraid to validate the caller. Advanced social engineers will set up “bounce” numbers; these are phone numbers that are answered by co-conspirators who serve to falsely validate the authenticity of the caller. You can avoid this trap by instead calling a number you know to be legitimate, such as the published number for a company or the internal extension for the employee’s supervisor.
  • Insist on two-way validation. If someone asks you for your information, ask them for their information about you. For example, if a caller identifying himself as an IT technician asks for your information, ask what equipment his database reports for you. Then request from him his supervisor’s name, which you can validate in an employee directory, and call that supervisor to validate his request.
  • If you have identified a social engineering attempt, be sure to communicate your finding to management; news of this attempt should then be shared companywide to limit the attacker’s possible success.
  • Validate through testing. Every organization should, as one component of a thorough penetration test, evaluate employee readiness for social engineering attempts. A firm well versed in social engineering testing will go beyond mere phone calls, employing a multitude of techniques to perform extensive tests in this discipline.

Originally released in part by VIMRO,
Larry Boettger
Michael Horsch Fizz

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