Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, July 04, 2015

Weekly Overseas Health IT Links -4th July, 2015.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Nurse Smartphone Ownership, App Use Eclipses that of Docs

JUN 26, 2015 7:32am ET
According to a new survey, 95 percent of nurses own a smartphone and 88 percent of them use smartphone apps in their daily work to improve patient care—a higher percentage than physicians.
The survey of 241 nurses, conducted by market research firm InCrowd, found that bedside access to drug interactions and clinical data were the most popular uses of smartphones by nurses.
“Nurses reported using their smartphones for fast access to patient care information across a wide range of daily nursing tactics, from receiving patient photos of a rash to setting a timer for meds administration,” stated InCrowd. 
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How can hospitals protect their medical equipment from malware?

Posted on Jun 26, 2015
By Adam Winn, OPSWAT
The challenges in protecting hospitals from cyber attacks are very similar to those faced in ICS and SCADA environments; the equipment used in hospitals is not user-serviceable and therefore often running out-of-date software or firmware. This creates a dangerous situation where:
The devices have known vulnerabilities that can be easily exploited by bad actors
Administrators are not likely to notice malware running on the device as long as nominal operation is maintained
The end goal of bad actors infecting a medical device is to use it as an entry and pivot point in the network. Valuable patient records are not likely to be present on the medical devices, but those devices often have some level of network connection to the systems that do contain patient records.
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Report: Telehealth Video Visits to Reach 158M by 2020

Telhealth video visits will increase from 19.7 million in 2014 to 158.4 million per year by 2020, according to a new report from Tractica. The report, “Telehealth Video Consultations“, examines the telehealth market and technology issues surrounding telehealth video visits for both clinical and non-clinical applications. The firm also predicts that, while clinical consultations currently constitute more than three-quarters of the market, growth over the next several years will be especially strong in non-clinical settings. Tractica forecasts that non-clinical video consultations will outnumber clinical consultations by 2019.
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Why nursing homes should embrace HIEs

June 26, 2015 | By Susan D. Hall
Inefficient and unclear communication between hospitals and nursing homes can complicate care, so researchers are looking to health information exchanges to change that, according to research published at Applied Clinical Informatics.
Researchers from the University of Missouri undertook a project--using a $14.8 million grant from the Centers for Medicare & Medicaid Services--aimed at reducing avoidable re-hospitalizations among nursing home residents, according to an announcement.
In assessing the HIE readiness of 16 nursing homes, they found that while many used electronic record-keeping internally to support patient care tasks most of the technology was not used to communicate externally, such as with hospitals or off-site pharmacies. In additon, tracking patients' medications or scheduling appointments often was done using separate systems.
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Internet of Things just the beginning of disruptive healthcare innovation

June 26, 2015 | By Alok Saboo
By John DeGaspari
The proliferation of Internet-connected devices is changing healthcare delivery, said panelists at last week's 2015 BIO International Convention in Philadelphia. And there's much more disruptive tech in the industry's future. 
Brandon Staglin, director of marketing communications at the One Mind Institute, discussed the role of digital therapeutics in the treatment of neurological disorders, according to an article in Bioscience Technology.
Staglin, who was diagnosed with schizophrenia in 1990, spoke of the healing potential of wearable sensors, saying they could help monitor his thoughts, set schedules and help with medication adherence.
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American Patients Want To Chat With Their Doctors Over Facebook or Email

By Andrea Alfano, Tech Times | June 25, 3:25 PM
House calls are mostly a thing of the past, at this point. Today's patients are looking for Facebook calls.
A national survey of over 2,000 American customers of a retail pharmacy found that many patients want more online resources. More than a third of the patients surveyed had contacted their doctor via email in the past six months, and 18 percent sought medical help via Facebook, according to the study, which was published in the Journal of General Internal Medicine.
As many as 57 percent of the patients who participated in the survey expressed that they wanted to be able to use their physicians' websites to access their medical information. That seems completely reasonable in this day and age. Why wouldn't it be possible to access your own health information on the Internet? 
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Epidemic of Healthcare Cyberattacks Requires Action, Says WEDI

JUN 25, 2015 7:54am ET
The Workgroup for Electronic Data Interchange has released a “primer” addressing some of the challenges that healthcare organizations face in defending themselves against the epidemic of cyberattacks and how to counter them.
According to WEDI, the frequency, scope and sophistication of cyberattacks on healthcare organizations are growing at an alarming rate. It estimates that between 2010 and 2014 about 37 million healthcare records were compromised in data breaches. However, in the first four months of 2015 alone, more than 99 million healthcare records have already been exposed through 93 separate attacks.
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HIEs evolving as demand increases

June 19, 2015 | By Marla Durben Hirsch
Both health information exchanges (HIEs) and providers' needs regarding them have evolved since HIEs were first launched, according to a new report from NORC at the University of Chicago researchers for the Office of the National Coordinator for Health IT.
The report, released June 19, examined HIEs from March through May 2014 in six states: Iowa, Mississippi, New Hampshire, Utah, Vermont and Wyoming. The researchers found that providers' HIE needs have moved beyond simply connecting disparate electronic health record systems and the need to meet Meaningful Use requirements into more of a desire for information at the point of care to improve healthcare delivery. For instance, some of the priority items providers are pursuing or would like to see include admission, discharge and transfer alerts, care coordination and interstate data sharing.
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Not all vendors take EHR usability seriously

June 9, 2015 | By Marla Durben Hirsch
Electronic health record vendor commitment and understanding of the need for usable EHRs varies significantly, according to a new study published in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from District of Columbia-based MedStar Health and elsewhere, noted that poor EHR usability increases provider frustration, can hinder adoption of the systems and leads to errors that can jeopardize patient safety. The problem is so acute that the Office of the National Coordinator for Health IT's 2014 certification criteria includes a requirement that vendors attest that they use user centered design (UCD) processes and report the results of usability testing.
However, most usability studies focus on providers, not on EHR developers. To learn more about vendor views regarding usability, the researchers visited 11 unidentified EHR vendors to analyze their UCD processes and determine what challenges vendors face in integrating usability with EHR development.
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NATO takes a look at Avera's telemedicine program

June 23, 2015Eric Wicklund - Editor, mHealthNews
Avera Health's telemedicine platform may be going global.
The South Dakota-based health system, long praised for delivering healthcare to remote locations across the Midwest and West, is hosting NATO officials who are looking at different methods for responding to global disasters, ranging from armed conflicts to tsunamis and earthquakes.
"This project is aiming at the creation of the multinational capacity in responding to major situations, disasters (and) civil emergencies, in countries where we would send our teams and they may need to consult experienced physicians at a distance from where they are," Romanian interior ministry official Raed Arafat, the NATO director for the project, told the Associated Press.
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Pharmacists given access to SCR

23 June 2015   Lyn Whitfield
Community pharmacists are to be given access to the NHS Summary Care Record, the Health and Social Care Information Centre has announced.
The move, which follows a long campaign for access by pharmacists, and a pilot at 140 sites, will be backed by £7.5 million of investment in training, and will start this autumn.
In a statement, the new minister of state for community and social care, Alistair Burt, said: “Pharmacists are an untapped resource in our health service – as experts in medicines, they can help people to manage their conditions and take some of the pressure off our GPs.
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How long do physicians spend charting on EHRs each day?

Written by Akanksha Jayanthi (Twitter | Google+)  | June 24, 2015
A common clinician complaint regarding EHRs is the interruption in workflow and productivity. A recent survey conducted by the Physicians' Alliance of America sought to determine how much additional time using EHRs adds to clinicians' work days.
The survey gathered responses from more than 250 clinicians nationwide.
The majority of respondents (34 percent) said they spend less than 30 minutes per day charting, followed by 23 percent who spend between 30 and 60 minutes and 17 percent who spend between 60 and 90 minutes. Nine percent of respondents indicated spending more than 120 minutes per day on charting.
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NASA's 1st humanoid robot in space will aid with medical tasks

Written by Akanksha Jayanthi (Twitter | Google+)  | June 24, 2015
Astronauts sometimes need medical care, too, and NASA has developed a robot to administer such care.
The Robonaut 2, a second generation humanoid robot developed by the space agency, lives on the International Space Station. It is the first humanoid robot in space.
In addition to assisting astronauts on missions and, for example, providing an extra pair of ambidextrous hands, R2 is undergoing testing for its telemedicine capabilities.
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Google develops mHealth wristband

June 24, 2015 | By Judy Mottl
Google is developing a mHealth wristband for pharma clinical trials and drug tests to provide research teams with real-time data on patient vital signs, from pulse and heart rates to light exposure and noise level monitoring.
While the device will be used by patients and lab research participants, it will not be sold directly to consumers, according to Bloomberg. 
"Our hope is that this technology could unlock a new class of continuous, medical-grade information that makes it easier to understand these patterns and manage serious health conditions," Andy Conrad, head of the life sciences team at Google, told CNN.
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Machine training future of health IT

June 25, 2015 | By Susan D. Hall
In the next three years, the healthcare industry will have to focus as much on training machines as on training people, according to a new report from Accenture.
Eighty-four percent of healthcare executives agree or strongly agree that their industry will need to focus on using algorithms, intelligent software and machine learning as well as human workforce training. Eighty-three percent foresee provider organizations needing to manage intelligent machines to keep up with the surge in clinical data, according to an announcement.
Intelligent machines will also manage data from various disparate sources, such as diagnostic tests, Internet-connected devices, genomics and medical records. Forty-one percent of those polled said their data volume has grown more than 50 percent in the past year.
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University of Oregon Sexual Assault Case Sheds Light on Medical Privacy Limitations

by Kate Ackerman, iHealthBeat Editor in Chief Thursday, June 25, 2015
A recent University of Oregon sexual assault case highlights a potential legal loophole when it comes to students' medical privacy.
A UO student -- known only as Jane Doe in court documents -- last year said she was raped multiple times by three members of the men's basketball team. Although the Lane County district attorney declined to prosecute the men, the university found the players responsible and dismissed them from the team and school.
It later was discovered that one of the players was suspended from a previous college team over sexual assault allegations. In January, Doe filed a lawsuit against the university and its head basketball coach for "deliberate indifference" in recruiting a player with an alleged sexual assault history.
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Online health info balances power between patients, docs

June 24, 2015 | By Susan D. Hall
Online health information can empower patients and even shift the balance of power between patients and their doctors, according to an article at the Journal of Medical Internet Research.
The study is based on focus groups with 32 participants recruited from an arthritis research center in British Columbia, Canada. Participants were asked to talk about the types of online health sites they visited as well as how the information they gleaned affected their relationships with their doctors.
The participants looked to sites that include university and medical webpages, as well as social media sites (Twitter and Facebook), chat rooms and other sites for information on research and treatment options, medication self-management strategies and resources.
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How hospital IT teams maintain continuity amid chaos

June 24, 2015 | By Dan Bowman
The following is an excerpt from an article published in FierceHealthcare's eBook "Hospital Disaster Recovery." Download the eBook here to read more.
In the midst of disaster, hospitals often serve as a refuge, a place of comfort for those in need of care or shelter. But even hospitals aren't immune to chaos, as electronic health record systems, network connections and even whole power grids can be rendered useless in the blink of an eye.
Response to and recovery from IT outages are critical, as UC Irvine Health's Charles Podesta knows all too well. Prior to accepting a role as chief information officer for the Orange, California, health system in September 2014, he served for five years in the same capacity for University of (Burlington) Vermont Medical Center (then known as Fletcher Allen Health Care). A little more than one year into his tenure—and roughly one month after completing implementation of a brand new electronic health record system—the 562-bed hospital suffered a freak power outage that left its EHR system out of commission for nearly half a day.
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Slow progress

The mental health systems market isn’t changing quickly as National Programme for IT contracts come to an end, but it is changing. Kim Thomas reports.
Mental health trusts in London and the South are now coming to the end of the contracts negotiated under the National Programme for IT, under which local service provider BT supplied them with the RiO electronic patient record. Next year, it will be the turn of trusts in the North East, East and Midlands.
It should be a time of frenetic activity in the market – but that hasn’t been the case. In London, many trusts have opted to stay with RiO, entering into direct contracts with the supplier Servelec. A few have gone elsewhere – Advanced Health and Care, for example, has won five of the former BT contracts.
The NME trusts seem to be biding their time, says Jim Chase, managing director of Advanced Heath and Care. “It is strangely quiet in many respects because, given that people have to look at their requirements, look at what the market has to offer, go through a procurement process and then do a system implementation, there is not a lot of time left.”
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Survey: HIOs Split in Cost-Benefit Analysis of Direct

June 23, 2015
Health Information Organizations (HIOs) using Direct Messaging technologies are split down the middle as to whether the benefits of the technology outweigh the costs.
This was one of the findings of a survey from the Healthcare Information and Management Systems Society (HIMSS) Interoperability and HIE Committee’s on Direct Messaging. The HIMSS Interoperability and HIE Committee surveyed 75 HIOs across 27 states on how they are using Direct. Fifty-one percent agreed the cost of using Direct was worth the benefit of information exchange. A larger percentage of HIOs, 67 percent, openly supported Direct as a method in exchanging data.
HIMSS posted the results on a blog. Most of the respondents were from Health Internet Service Providers (HISPs).
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Direct Messaging Has Value, But Not Without Challenges

JUN 23, 2015 7:38am ET
A survey of 75 health information organizations in 27 states finds that two-thirds support Direct messaging protocols as the method of choice for exchanging data via secured messaging software.
In the 2015 Direct Messaging Survey, 51 percent agreed that the cost of using Direct was worth the benefit of health information exchange. The survey, conducted by the HIMSS Interoperability and HIE Committees, was designed to provide visibility on the use and value of Direct messaging for increasing interoperability and facilitating information exchange.
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House FY16 Funding for ONC Flat, Proposes AHRQ Termination

JUN 23, 2015 7:26am ET
Congress increasingly is talking a good game about the need to significantly enhance interoperability of health information technology systems, but the funding purse remains closed for now.
For two years, the Obama administration has shot for the moon with its budget request for the Office of the National Coordinator for Health Information Technology—including a whopping $91.8 million for FY 2016. And for the third year, the initial budget proposal for ONC from the House is flat, about $63.387 million.
The House, where budgets originate although the Senate surely will have its say as well, also proposes termination of the Agency for Healthcare Research and Quality, effective October 1, 2015, when the federal FY16 budget year starts. However, agencies may after Oct. 1, with conditions, carry out activities of AHRQ that already are in progress, including activities in ONC and patient safety activities in the HHS Office of the Assistant Secretary for Health.
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5 health IT trends set to shake up industry

Posted on Jun 23, 2015
By Erin McCann, Managing Editor
For those healthcare providers still resistant to technology, you've got a problem on your hands: You're going to be left behind. This is where healthcare it going – with or without you.
That's according to a new Accenture report, Healthcare Technology Vision 2015, which lays out five key trends in the industry that show adaptation might be the best business model.
First, Accenture analytics are calling it the "platform revolution" – that is the ever-increasing ubiquity of mobile and cloud platforms that far surpass merely the ability to track in real-time a patient’s health. Rather, this is a platform that addresses interoperability, "that captures the data from disparate sources such as wearables, phones and glucometers, and pulls it all together to give a patient and caregiver a holistic and real-time view of the patient's health," they write.
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Infographic: Direct messaging trends

Posted on Jun 23, 2015
By Mike Miliard, Editor
The 2015 HIMSS HIE and Direct Messaging Survey published this week, conducted jointly by HIMSS' Health Information Exchange and Interoperability & Standards Committees, polled accountable care organizations, health information exchanges, hospitals, policymakers, vendors and other stakeholders in 27 states about how the state of Direct messaging, and how its doing when it comes to facilitating HIE.
Five years since its launch, how much impact has the secure messaging tool, developed via a unique partnership – "a classic, fantastic, soon-to-be-legendary example of how the public and private sectors can come together in a collaborative, entrepreneurial explosion of mojo to improve and advance healthcare in America," in the immortal words of former HHS CTO Todd Park – had on the improving ease and efficacy of healthcare data exchange?
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Study: Tablet, app use does not improve patient knowledge of care

June 22, 2015 | By Judy Mottl
Supplying patients with tools such as tablets and patient portal apps does not have a great impact on their understanding of their care and treatment, according to a study published in the Journal of the American Medical Informatics Association.
Originally, the authors thought that the tablet and app "would result in greater knowledge of team members' names and roles, planned tests and procedures, medications and higher patient activation."
They handed out the tools to 100 patients at Chicago's Northwestern Memorial Hospital to be used for the duration of the patients' stay. The researchers then looked at patient use and satisfaction with the portal through questions specifically created for the study. The goal was to evaluate how such tools can help patients become more involved in and aware of care activity, from knowing physicians' names to procedures being ordered.
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NASA refines robot for medical tasks

June 22, 2015 | By Susan D. Hall
NASA has a humanoid robot aboard the International Space Station that might one day help the agency by performing medical tasks in space, guided by human hands on Earth, reports Quark.
It's the second iteration of the Robonaut 2, known as R2. It's made up of multiple component technologies and systems--vision systems, image recognition systems, sensor integrations, tendon hands, control algorithms and more, NASA says on its website.
Working with private-sector partners, NASA has been exploring how the robot could help reduce fatigue and prevent stress injuries, provide assisted walking in rehab scenarios and use telemedicine to perform an ultrasound scan of a medical mannequin and to use a syringe as part of a procedure, according to a NASA announcement.
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Docs Seen as Key Driver for Patient mHealth Adoption

JUN 22, 2015 7:38am ET
Despite the explosion of mobile healthcare technology available to consumers, just 15 percent of physicians are discussing wearables or health apps with their patients as tools for achieving wellness, according to market research firm MedPanel.
At the same time, the firm found that physicians at accountable care organizations are more than twice as likely to discuss wearables or apps compared to physicians not part of an ACO.
In a separate survey of 500 medical professionals by Research Now, 86 percent of providers said they have a better understanding of a patient’s medical condition with the help of mHealth apps, while 76 percent reported that they believed apps helped patients manage chronic conditions. And, 46 percent of those surveyed thought that apps can make patient transitions from hospitals to home-based care easier.
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Telemedicine may support flexible work-life balance, survey finds

Written by Akanksha Jayanthi (Twitter | Google+)  | June 22, 2015
More than half of physicians would be willing to conduct video consultations with patients, largely to help improve work-life balance, according to a survey conducted by telemedicine platform provider American Well.
In collaboration with QuantiaMD, American Well surveyed more than 2,000 primary care physician on their perceptions of video consultations.
Fifty-seven percent of primary care physicians said they would be up for telemedicine consultations, 12 percent said they were unwilling to have a video visit and 31 percent said they were uncertain.
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Data Independence is Up to Patients Now

Scott Mace, for HealthLeaders Media , June 23, 2015

For patients to get the medical data they deserve in a way the HIPAA Omnibus law says they deserve it, they need to demand that providers cut the red tape. Whether they will do so remains to be seen.

When former national coordinator of healthcare IT, Farzad Mostashari MD, stood on stage at the annual HIMSS conference in April and called for a national day of action on July 4 for patients to request their medical records, headlines followed.
But now that the headlines have died down, and the date is approaching, I wonder just how big a day it will turn out to be.
Russ Branzell, president and CEO of CHIME, expressed sympathy about patients' difficulty in obtaining their records. But CHIME still supports the gutting of Meaningful Use requirements that providers prove actual patient viewing/downloading/transmitting of their data, a decision now in ONC's hands.
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Google Reveals Health-Tracking Wristband

June 23, 2015 — 11:30 PM AEST
Google Inc.’s life sciences group has created a health-tracking wristband that could be used in clinical trials and drug tests, giving researchers or physicians minute-by-minute data on how patients are faring.
The experimental device, developed within the company’s Google X research division, can measure pulse, heart rhythm and skin temperature, and also environmental information like light exposure and noise levels. It won’t be marketed as a consumer device, said Andy Conrad, head of the life sciences team at Google.
“Our intended use is for this to become a medical device that’s prescribed to patients or used for clinical trials,” Conrad said in a telephone interview.
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‘No-Brainer’ System Improves Infusion Safety at Vermont Hospital

JUN 22, 2015 7:23am ET
It is a simple safety technology that most hospitals should be able to implement without much difficulty. That’s the message Charles Still, senior systems analyst at 99-bed Southwestern Vermont Medical Center in Bennington, Vt., wants to send colleagues about a cheap and easy way to increase the safety of infusions.
At SVMC, there are up to 19 unique data elements on a patient infusion label and different departments in the hospital have different needs for their labels. Pharmacy technicians, Still notes, are concerned with IV component drug and concentrations while nurses focus on the correct patient name and drug.
Like many other hospitals, SVMC has used plain black and white labels for infusion orders. However, during the past 14 months the hospital has phased in a new type of label, with oncology/chemotherapy on board for the past four months. These labels are the same size as previous labels but are far easier to pick out the most critical information.
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Hospital employee indicted for fraud after swiping data of 12K

Posted on Jun 22, 2015
By Erin McCann, Managing Editor
A former employee at a major New York health system has been indicted, along with seven others, for stealing personal data of 12,000 patients, enabling more than $50,000 in fraud.
Manhattan's district attorney last week announced the indictment of Monique Walker, 32, a former assistant clerk at the eight hospital Montefiore Health System, for swiping patient data and supplying it to an identity theft ring. Walker, who had access to patient names, Social Security numbers, dates of birth, among others, reportedly printed the records of as many as 12,000 patients and supplied them to seven other individuals who used the data to make multiple purchases from department stores and retailers.
Walker, according to the New York County’s District Attorney’s office, sold the patient records for as little as $3 per record. Co-conspirators were able to open credit cards and make several unauthorized big ticket purchases at Barneys New York, Lord & Taylor and Bergdorf Goodman, among others. Defendants have been charged with grand larceny, unlawful possession of personal identification information, identity theft and criminal possession.
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EXTREME essentials for interoperability

Posted on Jun 22, 2015
By Mike Miliard, Editor
Writing in the Journal of the American Medical Informatics Association this past week, two health IT researchers put forth five use cases that help define what an "open" electronic health record should really look like.
Dean F. Sittig, professor of biomedical informatics at the University of Texas Health Science Center at Houston, and Adam Wright, medical informatics researcher in the Department of General Internal Medicine, Brigham & Women’s Hospital, use the term EXTREME – it stands for EXtract, TRansmit, Exchange, Move, Embed – to shape a definition of useful interoperability.
  • An organization should be able to securely extract patient records while maintaining granularity of structured data.
  • An authorized user can transmit all or a portion of a patient record to another clinician who uses a different EHR or to a personal health record of the patient’s choosing without losing the existing structured data.
  • An organization in a distributed/decentralized health information exchange can accept programmatic requests for copies of a patient record from an external EHR and return records in a standard format.
  • An organization can move all its patient records to a new EHR.
  • An organization can embed encapsulated functionality within their EHR using an application programming interface. Goals: access specific data items, manipulate them, and then store a new value.
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Healthcare cybersecurity primer outlines defensive strategies

June 22, 2015 | By Alok Saboo
By John DeGaspari
A new primer on cybersecurity outlines the challenges that healthcare organizations face and steps they can take to defend themselves against cyberattacks.
The Workgroup for Electronic Data Interchange's (WEDI) "Perspectives on Cybersecurity in Healthcare" covers three prime areas of cybersecurity: the lifecycle of cyberattacks and defense; the anatomy of an attack; and building a culture of prevention.
To build that culture of prevention, the report recommends a strong cyberdefense strategy that addresses how to prepare for and monitor attacks and recover from breaches.
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How Much Should Cancer Drugs Cost?

Memorial Sloan Kettering doctors create pricing calculator that weighs factors such as side effects, extra years of life

By  Peter Loftus
June 18, 2015 11:21 a.m. ET
One of the nation’s top cancer hospitals is challenging the pharmaceutical industry to adopt a more rational approach to drug pricing.
Memorial Sloan Kettering Cancer Center in New York has created an interactive calculator that compares the cost of more than 50 cancer drugs with what the prices would be if they were tied to factors such as the side effects the drugs produce, and the amount of extra life they give patients. In many cases, the website calculates a price that is lower than the drug’s market price.
The project, led by Peter Bach, a physician and director of the hospital’s Center for Health Policy and Outcomes, is the latest salvo from doctors and others against the escalating costs of cancer drugs, which increasingly carry price tags of $100,000 or more per patient for a year or a course of treatment. A colleague of Dr. Bach’s at Memorial Sloan Kettering recently blasted cancer drug prices as excessive in a speech before thousands of cancer doctors at a meeting in Chicago.
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A Digital Divide Between Homo Informaticus and the U.S. Health Care System

by Jane Sarasohn-Kahn Monday, June 22, 2015
The American patient is a consumer looking for uber-satisfying customer experiences from the U.S. health care system. Legacy stakeholders -- doctors, hospitals and pharma -- best listen to the voice of this customer. If not heeded, health care consumers will increasingly patronize health services through pharmacies, retail stores and digital offerings untethered from traditional health care. This could result in continued fragmentation of a consumer's health and wellness data, quite separate from the patient's clinical data in electronic health records and insurance claims systems.
Two forces are underneath the phenomenon of consumers' adoption of retail health services and products: The emergence of homo informaticus and people's search for trust and transparency in health care as out-of-pocket payments grow.
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Enjoy!
David.

Friday, July 03, 2015

Some More Thinking Regarding Just Where The Value Lies In Health IT. We Need To Keep Value In Mind.

This appeared a little while ago

Industry professionals create framework for measuring HIT value

January 29, 2015 | By Katie Dvorak
Healthcare professionals have created a framework for measuring health information technology with a goal of making "HIT evaluations more relevant to the current needs of the healthcare system," according to a paper published at the American Journal of Managed Care.
In the paper, sponsored by the Office of the National Coordinator for Health IT, the researchers--from RAND Health, Harvard Medical School and Brigham and Women's Hospital--say that HIT should take into account three principles.
Those principles are:
  • Value includes costs and benefits: Value cannot be found through cost analysis alone, the report's authors say. While costs are important, they do not reveal what the health benefit to patients may be nor do they assess the potential benefits of the technology or system. Studies must be sure to measure both, they say.
  • Value accrues over time: New tools have short-term costs and long-term costs, and the same holds true for the benefits they provide. While capturing the impact of technology over the long term is not "feasible for any study," the authors say, a study must allow for enough time to show the upside of having the new tool compared to not having it.
  • Value depends on stakeholder's perspective: Perception varies from person to person and practice to practice, the authors say. This must be a consideration because differing opinions could impact conclusions about the value of the study. "Ideally, all evaluations of HIT would take the perspective of all relevant stakeholders," according to the paper.
Lots more (with links) here:
Here is a link to the full paper with a .pdf also available :
Here is the introduction to the paper:

The Value of Health Information Technology: Filling the Knowledge Gap | Page 1

Published Online: January 26, 2015
Robert S. Rudin, PhD; Spencer S. Jones, PhD; Paul Shekelle, MD, PhD; Richard J. Hillestad, PhD; and Emmett B. Keeler, PhD
In 2010, the United States Congress enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act, thereby dedicating roughly $27 billion to eligible healthcare providers who demonstrate “meaningful use” of health information technology (HIT). This action motivated the purchase and installation of tens of thousands of HIT products across the US healthcare system and placed a national spotlight on HIT. The HITECH Act was justified, in part, by early studies that documented positive effects on healthcare quality, safety, and efficiency at a subset  of institutions that were early to implement HIT, and by policy analyses that extrapolated the implications of these potential benefits throughout the US healthcare system.1,2 These studies suggested that HIT had the potential to create enormous value by facilitating improvements in the quality of healthcare and reductions in costs.

However, systematic reviews of HIT have found that the evidence for value is inconclusive and that existing studies suffer from major limitations.3-6 This finding is true even of the most recent literature reviews, despite a greatly increasing number of studies evaluating HIT.6 In this paper, we suggest a way to overcome these deficiencies and make HIT evaluations more relevant to the current needs of the healthcare system, by presenting a conceptual framework for measuring the value of HIT, examining how a sample of published HIT articles report the information needed to make meaningful assessments of value, and proposing a set of criteria for future evaluations that would make them more useful for policy makers.

This paper was sponsored by the Office of the National Coordinator for Health Information Technology, which otherwise had no role in the conduct or writing of the paper or the decision to publish it.
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This is really useful as it attempts to show how we might assess how well we are going with our e-Health efforts. We must do better in this area otherwise funding will gradually evaporate!
You can’t keep just spending without being able to prove you are making a positive difference - especially in these restrained times!
David.

Thursday, July 02, 2015

2016 Budget - Lots Of Money Saved Towards Budget - But Hospital Funding Still A Bone Of Huge Contention!

July  2  Edition
Budget Night was May 12, 2015.
Parliament has risen - the Government is very happy how things have gone so all is well with the world.
Sadly some global authorities are suggesting we lurk in a fool’s paradise. Others disagree so I guess only time will tell!
In reading about the state of our country one of the best places to start is the IMF who spend 2-3 weeks meeting with all sorts of experts, the Treasury and so on - off the record - and then report what they find - often to the annoyance of the Treasurer!
See here:

What the Treasury, not the Treasurer, really thinks

Date June 26, 2015

Michael Pascoe

BusinessDay contributing editor

Joe Hockey promised in the budget last month that we'd be roaring back to 3.25 per cent growth in 2016-17 and even stood by the silly assumption that we'd do 3.5 per cent for the two years after that. Photo: Andrew Meares
Ask not what the International Monetary Fund recommends for Australia, but what Australia recommends the IMF recommends. That was the most important aspect of an IMF official's sombre warning for our economy this week. It's a chance to find out what the Treasury and Reserve Bank really think.
Despite the attention we sometimes give the IMF, it doesn't give us much. Australia is not one of the countries it worries about – it doesn't devote many resources to guessing what's going on here because it largely trusts what the RBA and Treasury tell it. Note that's "Treasury", not "Treasurer".
To remain a high-growth country, to be the high-wage, high-productivity nation we can and should be, we'd have to become a lot smarter about what we do and perhaps bolder in how we go about it. 
What tends to happen for the IMF review of Australia's performance is someone visits for a couple of weeks, talks on a background basis to the Treasury and RBA boffins, as well as a few trusted souls from the states and private sector, and subsequently produces a report that doesn't stray far from the official family's view - especially if the official family first gets to review said report.
Colleague Peter Martin this week reported what the IMF visitor had to say after his fortnight of Down Under economist hobnobbing and before he writes the report. At least as important as what the IMF regional assistant director thinks of us is the extent to which his views are formed by what Treasury and the RBA really think.
Here is some of the recent other news and analysis.

General Budget Issues.

Abbott: Hockey is doing a great job selling the Budget

Chris Calcino | 22nd Jun 2015 6:05 AM
PRIME Minister Tony Abbott has praised his Treasurer Joe Hockey for his handling of the Federal Budget despite a recent spate of criticism.
"Now, Joe has copped a lot of crap lately, but since the budget, hasn't it changed!" Mr Abbott told the NSW Liberal Party state council conference," he said.
"Because what Joe has done is brought down the best budget ever for the small businesses of Australia - and didn't the small businesses of Australia finally deserve some recognition and reward.
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CBA: The budget stimulus is working to lift business spending

Greg McKenna Jun 23, 2015, 9:29 AM
The Commonwealth Bank has just released its latest Business Sales Indicator (BSI) and says there are early signs that Joe Hockey’s small business stimulus plan is working.
The bank said that the BSI, “which includes businesses such as Office Furniture, Commercial Equipment, Electrical Parts and Computers, and Computer Equipment and Software, recorded spending growth of 1.9 per cent in trend terms in May – the biggest rise since May 2012“.
In trend terms the move was a more reserved 0.8% in May, which is in line with the gains in March and April. But that still means “annual sales growth stood at 7.5 per cent, well above the decade average of 5.3 per cent,” the bank said.
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Joe Hockey putting Australia at risk: IMF

6:08pm, Jun 25, 2015
James Fernyhough
 Money Editor
The world’s neoliberal policeman has its doubts about Joe Hockey’s economic policy.
Joe Hockey has got it all wrong.
Rather than obsessing over getting back to surplus as soon as is humanly possible, he should be borrowing more money, raising the GST, and cutting tax concessions to the rich.
That, at least, is the view of the International Monetary Fund, the body that acts simultaneously as the world’s insurance policy and its economic policeman.
Following an official visit to Australia, the IMF said on Wednesday: “Australians have enjoyed exceptionally strong income growth for the last couple of decades. But the waning of the resource investment boom and the recent sharp fall in the terms of trade have brought this to a halt.”
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Anxiety rises despite friendly budget

The Abbott Government's attempt at a friendlier budget appears to be easing consumer anxiety around government policy, but has failed to offset growing fears about job security, according to a fresh data from National Australia Bank.
Consumer anxiety rose in the second quarter of the year as worries over job security and cost of living increased, offsetting falling concerns surrounding government policy after Joe Hockey handed down his second Federal Budget, NAB said.
The bank's consumer anxiety index increased to 63.5 points in the second quarter, up from a result of 6.18 in the first quarter, with anxiety levels rising in all surveyed categories except government policy.
NAB chief economist Alan Oster said Australians had responded positively to May's Federal Budget, with "a significant fall" in anxiety levels related to government policy.
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Job concerns and living costs dampen mood

Date June 25, 2015 - 3:21PM

Jason Cadden

Concerns about job security, health and spending power are now the main factors dampening confidence, and will likely drag down spending in the coming months, NAB chief economist Alan Oster said. Consumers are growing more anxious but this time it's not the government's fault.
Worries about job security and the cost of living are overshadowing a positive response to this year's business-friendly federal budget.
National Australia Bank's consumer anxiety index rose 1.7 points to 63.5 points in the June quarter, with anxiety up in all categories except government policy.
A year ago it was Joe Hockey's harsh spending cuts and charges such as the $7 Medicare co-payment fee that weighed on consumer confidence and spending.
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Hockey exhorts SMEs to “have a go” at the $20,000 asset write-off, as Gerry Harvey spruiks it as “Boxing Day sale” equivalent

Friday, 26 June 2015 2:05
Eloise Keating
Treasurer Joe Hockey is urging small businesses to open their wallets before next Tuesday in order to take advantage of his government’s $20,000 asset write-off scheme by the end of the financial year.
Hockey told Parliament during question time yesterday the government has so far saved the budget bottom line $14.2 billion as a result of passing a number of its budget measures through the House of Representatives and the Senate.
He said the progress means “small business can go out, have a go and give their employees a fair opportunity to participate in … wealth creation”. And Hockey said this weekend is the perfect time to have that go.
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Health Budget Issues.

3:42pm June 23, 2015

Abbott defends hospital reform proposal

Prime Minister Tony Abbott has called for a mature debate on the future of health system funding after a federal government discussion paper flagged handing responsibility for public hospitals to the states.
The option contained in a leaked document on Federation reform, held by the prime minister's office, has been slammed by state premiers.
It comes after other options to change school funding were leaked and then swiftly ruled out by the federal government on Monday.
Mr Abbott said officials in state and federal government departments had for months been discussing ideas for reform and many things would be considered and rejected during this process.

States blast leaked proposal for federal government to exit hospital funding

Discussion paper on federation reform raises option to leave $18bn in public hospital funding responsibilities to states
The states have slammed reports the federal government is considering leaving the funding of public hospitals to the states.
The option, contained in a leaked discussion paper on federation reform, could cost the states and territories $18bn a year.
It also comes after options to change school funding, including a means test on public school education, were leaked and then swiftly ruled out by the federal government.
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Private patients caught off guard with cheaper packages

Complaints about the private health insurance industry have been rising as customers are ­increasingly drawn to cheaper, basic-level policies, often unaware that they are not covered for a growing list of procedures.
Insurers including Medibank Private, HBF and NIB have ­recently launched new products that, with various exclusions and restrictions, appear to be tailored towards budget-conscious customers.
While the trend appears to be driven by rising premiums and government policy designed to encourage participation, private hospital operators are becoming concerned about its impact.
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Pharmacy Issues.

The price of Australia's most common medicines could soon be halved

Olivia Chang Jun 21, 2015, 10:58 AM
Australians could soon see the prices of some of its most common medicines halved under a new generic drug deal.
Pressure is mounting on the Senate to pass the legislation this week after Federal Health Minister, Sussan Ley, signed an $18.9 billion deal with the Pharmacy Guild and Generic Medicines Industry Association which could drop the prices of over 2,000 common prescription medicines.
Ley said that the focus should be on having “more affordable medicines for consumers” especially since “so many Australians now are suffering from chronic diseases”.
In particular, Ley pointed to medication for cholesterol and heart conditions which could drop to $10 per script for general patients.
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How Australia could save $320m a year on prescription drugs

Date June 22, 2015

Dan Harrison

Health and Indigenous Affairs Correspondent

Taxpayers could save $320 million a year by only paying for the best-value drug when cheaper drugs work just as well as more costly ones, according to a report by a former federal health department head.
The Grattan Institute report, by health program director and former top bureaucrat Stephen Duckett and Grattan health fellow Peter Breadon, evaluates the effectiveness of therapeutic price premiums, a policy which is supposed to make patients pay the difference between an expensive drug and its cheaper equivalent. One aim of the policy is to put pressure on drug companies to drop their prices to reduce the risk of patients switching from their drug to a less costly equivalent.
But the pair argue that while the idea behind the policy is good, it is "broken" in Australia because the scheme covers too few drugs, premiums charged are too small, and patients are often unaware of whether their drug attracts a premium.
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PBS reforms passed by Senate

23 June, 2015 Chris Brooker
It’s all systems go for the Sixth Community Pharmacy Agreement after the Senate today passed the government’s PBS reform package.
The government had tied the 6CPA to the passage of its reform bill, meaning it needed to be passed by 30 June – the expiry date of the Fifth Agreement.
The reform bill passed today, with two more sitting days left before that date, after the Greens and Labor supported the bill.
While key CPA items like location rules are now protected for the life of the agreement, the controversial ‘optional’ pharmacy co-payment discount of up to $1 per script is also now law.
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Pharmacy deal clears parliament

  • AAP
  • June 23, 2015 5:45PM
Some medicines could become cheaper after the government's multi-billion dollar deal with pharmacists cleared parliament.
A bill to implement the sixth community pharmacy agreement passed the Senate with Labor and Greens support on Tuesday, seven days before the previous five-year agreement ran out.
The $18.9 billion deal, signed off with the Pharmacy Guild of Australia in May, allows 5450 community pharmacies to continue dispensing medicines under the Pharmaceutical Benefits Scheme.
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Ley abandons strategic agreement, Medicines Australia disappointed

Medicines Australia says it is “extremely disappointed” with a last-minute decision by Health Minister Sussan Ley to abandon a Strategic Agreement, which it says casts a shadow over the future stability of the local medicines industry and also puts patient safety at risk.

The purpose of the Agreement was to provide a level of stability and clarity for the local medicines industry in return for supporting a $6.6 billion savings package of which $4.2 billion was to directly impact its members, Medicines Australia says.
Medicines Australia put forward a proposed Strategic Agreement which met all aspects of the Letter of Intent signed by the Health Minister on 27 May.
Medicines Australia says it had also offered to work with the Government on patient safety concerns which will allow the substitution of biosimilar medications by pharmacists without, it says, appropriate evidence that this is safe and without the consent of a patient’s GP or clinician.
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7 things you need to know about the new PBS bill

24 June, 2015 Michael Woodhead
The Senate has passed a PBS bill that promises to reduce the price of some medications and lock in the agreements for the 6th Community Pharmacy Agreement.
Here are some of the main points of the National Health Amendment (Pharmaceutical Benefits) Bill 2015:
1.       A 5% price cut for patented (F1) medicines from 1 April 2016
2.       Extension of price disclosure to further drive down price of medications from 1 October 2016
3.       Pharmacists allowed to discount PBS co-payment by $1 from 1 Jan 2016 (Patients take longer to reach PBS safety net)
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Australians forced to wait 15 months for new drugs vs US & Europe: Report

Australian patients are being forced to wait up to 15 months longer to access the latest breakthrough medicines than in the US or Europe because drug companies are delaying bringing them down under, a new landmark report has revealed.
25 June 2015

Australian patients are being forced to wait up to 15 months longer to access the latest breakthrough medicines than in the US or Europe because drug companies are delaying bringing them down under, a new landmark report has revealed.

The independent review of the Therapeutic Goods Administration’s (TGA) medicines and medical devices regulatory framework – released today – finds Australia’s safety regulator had one of the most efficient and consistent approval processes in the developed world.
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Reforms to fast-track access to new drugs

Sean Parnell

Australians would have faster access to certain new drugs and devices under a reform blueprint that would require local regulators to focus more on post-market monitoring and surveillance.
A government-commissioned review has found the Therapeutic Goods Administration was well-regarded internationally — more so for its handling of drugs than devices — but in need of reforms to cope with the “rapid pace of innovation and change”.
A three-speed regulatory system has been proposed to ensure new drugs with sufficient overseas approvals, or unique requirements, are fast-tracked on to the Australian market. The channels for generic drugs and biosimilars — which have a different composition than patented drugs but similar effects — would be two-speed, again with those products sufficiently assessed overseas given expedited approval.
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Drug regulation overhaul

A government-appointed review panel has recommended sweeping changes to the TGA, including fast-tracking authorisations for some drugs and rubber-stamp approval for those approved in similar jurisdictions.
The Review of Medicines and Medical Devices Regulation examined the TGA’s regulatory framework and processes with a view to identifying areas of unnecessary red tape and opportunities to streamline the regulatory framework.
The reviewers say the TGA generally works well and does not suffer from excessive red tape by international standards.
It takes 391 days to approve a new drug on average, compared with 478 days for EU regulators and 304 days for the FDA.
Among its 32 recommendations, the review panel suggests that new drugs and generics be given automatic TGA approval — subject to local conditions — if the manufacturers could show they had already gained approval in a similar jurisdiction.
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It is going to be very interesting to see what happens to the polls and consumer confidence over the next 2-3 months - especially if we see the Senate continuing to knock back some saving as is seeming likely!
Enjoy.
David.

Wednesday, July 01, 2015

This Can Only Be Good News For Those Who Hope E-Health Can Make A Widespread Difference!

This appeared last week.

The rise of the ‘GranTechie’: closing the generational gap

June 22, 2015
nbn research reveals 35 per cent of grandparents use video calling apps to keep in-touch with their grandchildren. Move over Millennials and watch out GenZ, Aussie grandparents are some of the fastest growing tech users in the country.
Latest research, commissioned by nbn, the company building Australia’s broadband network, identifies a new wave of ‘GranTechies’ – grandparents who are embracing fast broadband and smart devices to form deeper connections with their family and loved ones.
Key findings include:
  • The majority of Aussie grandparents surveyed, use the internet to connect with their children (76 per cent), grandchildren (59 per cent) and other family members (72 per cent).*
  • Grandparents are increasingly using high-bandwidth video calling applications such as FaceTime or Skype to stay in-touch with their grandchildren (35 per cent), while more than half are using Facebook (61 per cent) and email (90 per cent) to connect with their children.*
  • Over two thirds (84 per cent) of grandparents who are using the internet to communicate with their family are doing so on a weekly basis.
  • Smartphone users aged 55 and over are the fastest growing segment in Australia, increasing by 28 per cent in the last 12 months. Similarly, tablet users aged 65 and over are the second fastest growing demographic and have increased by 46 per cent in the last 12 months.
  • More than half of grandparents surveyed (62 per cent) agreed using the internet has made them feel more connected, helping them overcome feelings of loneliness and social isolation (41 per cent).
Nan Bosler, President of the Australian Seniors Computer Clubs Association said: “We are seeing more and more Aussie Grandparents embrace social media and video calling applications to be present for special family milestones, such as a grandchild’s first steps or distant relative’s birthday.
More here:
Note: I assume nbn is what we all still know as the NBN!
Now if we can only fix the retirement income system so they can all afford the Internet at reasonable speeds we will be almost there!
David.