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."

Monday, November 23, 2015

Weekly Australian Health IT Links – 23rd November, 2015.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

A very quiet week really but some movement in various directions. Good to see there is actually so much to report!
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Re-booting ehealth

Australia November 16 2015

In brief

  • The uptake of eHealth records has been low, with only 10% of Australians having registered, an insufficient population for an effective national system.
  • The ‘re-booting’ of eHealth, announced by Minister Ley in May 2015, has progressed with the passing of the Health Legislation Amendment (eHealth) Bill 2015 (Cth) by both houses of Parliament.
  • The most dramatic reform is a shift from an ‘opt-in’ to an ‘opt-out’ approach to enrolment, which is likely to give the system the necessary ubiquity to drive utilisation and innovation.
  • The regulation of the use of health identifiers and health information has been strengthened as a corollary of the adoption of an ‘opt out’ model.
  • Further reform is expected, with the expansion of the role of the National eHealth Transition Authority under a new structure, to be called the Australian Commission for eHealth.
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Taxpayer records exposed by serious ATO, myGov security flaw

Date November 19, 2015 - 12:00AM

Hannah Francis

Technology Reporter

Australians' private tax records were left unsecured thanks to a serious flaw in how the tax office's online services connect with myGov, in the latest of a series of security bungles related to the federal government's online services.
Experts have raised concerns over the handling of IT security issues by the Australian Taxation Office and the Department of Human Services, which runs the overarching service portal myGov, after a taxpayer who tried to report the issue claimed he was hung up on twice by the agencies' call centre staff.
Sydney IT professional JP Liew recently discovered the flaw when logging into myGov to access his online tax records, only to discover he was looking at his wife's.
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Audit of GP clinics flags patient privacy risks

Tessa Hoffman | 19 November, 2015 | 0 comments Read Later
Lax security measures in GP clinics are putting patients’ electronic records at risk of privacy breaches, a government audit has found.
The Office of the Australian Information Commissioner assessed privacy risks to patient information held by seven practices in Victoria and NSW.
It found the clinics – which had between four and 20 GPs — were at medium to high risk of breaching privacy laws when using IT and the MyHeath Record (formerly PCEHR) system, details of which were released in a reported last month.
Last month, Australian Doctor reported that GPs and practice staff face jail and fines of up to $108,000 for misuse of the e-health system under controversial laws being pushed through the Federal Parliament.
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PANEL: How collaboration on data and technology is making medicine smarter

Chris Pash Today at 9:00 AM
Big data is more commonly associated with helping business make more profit but researchers are reaping enormous benefits benefits in health care and medicine.
The convergence of technology and healthcare is creating opportunities across disciplines, creating partnerships and breakthroughs.
The first step to getting the most out of big data is to get the data itself.
Information and knowledge tends to exist and stay in silos, according to Sean Hogan, global vice president of health for IBM, who spoke at a Business Insider event in Sydney, Health & Technology Frontiers, as a member of a panel of experts.
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E-health key to mental health reform: Ley

Serkan Ozturk | 17 November, 2015 | 
The Federal Government wants digital programs to play a central role in reforming mental health care, despite growing concerns over the efficacy of treatments such as online CBT.
Speaking in Federal Parliament late last week, Health Minister Sussan Ley signalled that the eagerly awaited report into the country's mental health system by her appointed expert reference group would be released before the end of the year.
Foreshadowing the report's contents, Ms Ley told parliament the recommended reforms contained within it would be "significant, far-reaching and very important".  
A key part of that would be the far greater use of online mental health programs, she said.
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Shared Health Summary Versus Event Summary

Created on Tuesday, 17 November 2015
In the eHealth record system, the Shared Health Summary and the Event Summary are two separate clinical documents – you can find the different features of each one here.
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Goodbye PCEHR, hello My Health Record

16 November 2015
THE Personally Controlled Electronic Health Record (PCEHR) will officially be re-branded as My Health Record, following the Senate’s passing of the eHealth bill with Labor and Greens support late last week.
It will also mean the opt-out eHealth trials in northern Queensland and the Nepean and Blue Mountains in NSW, foreshadowed by Health Minister Sussan Ley two weeks ago, will definitely go ahead early next year.
Under the newly passed Health Legislation Amendment (eHealth) Bill 2015, if the regional opt-out trials are successful, they will be rolled out nationally, probably in 2017. 
And while there is change under way, the much-troubled system continues to attract criticism in several reports released this month that focus on its low uptake, privacy and inter-operability issues.
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Treat anonymised data as personal information: Pilgrim

Timothy Pilgrim

Privacy Commissioner warns of modern matching methods.

Australian Privacy Commissioner Timothy Pilgrim has warned businesses that de-identifying datasets will not absolve them of the need to meet the stringent information protection demands of the Privacy Act.
Speaking to the International Association of Privacy Professionals today, Pilgrim said even anonymised datasets should be treated the same as personally identifiable information to future-proof organisations against increasingly sophisticated data matching efforts.
“The current challenge facing all organisations that handle large data sets is that data sets of ‘anonymous data’ are fast becoming identifiable'" he told the conference. 
“Personal information is not just that which does identify you, but that which may."
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Releasing anonymised data creates a future technical debt: APF

Australian Privacy Foundation (APF) has come out today in support of the push to treat ‘anonymised data’ as personal information.
Yesterday Australian Privacy Commissioner Timothy Pilgrim called for anonymised datasets to be treated the same as personally identifiable information, which can then be protected by the Privacy Act.
The APF chair, Dr. Bernard Robertson-Dunn agrees. He said, “We are creating a technical debt into the future by releasing whole data sets of 'anonymised' personal information under the brand 'open data'."
A couple of years ago the Federal government decided to encourage most of its publications—for example, River Flow Heights, Rainfall—to be made publicly available under open content licences.
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Phone abortion service proves popular

Alice Klein | 20 November, 2015 | 
A telephone abortion service that allows women to bypass their GP has been inundated with thousands of requests since its launch in September.
The Tabbot Foundation received more than 2500 enquiries in the first two days after launching, says medical director Dr Paul Hyland.
And the service continues to receive about 50 enquiries a day, with the number steadily growing.
The foundation, which mails out mifepristone (RU486) and misoprostol to eligible women, has been clamouring to hire more staff in order to respond to the demand.
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Doctor-shopper's death throws spotlight on prescribing monitor

19 November 2015
STATE and territory governments are under increasing pressure to implement real-time monitoring of prescription services following the death of a Sydney mother who visited six GPs within 10 days before fatally overdosing on prescription drugs.
NSW deputy coroner Carmel Forbes made no recommendations when she handed down her finding into the death of Christine Drinnan from what Ms Forbes said was “multidrug toxicity” by “misadventure”.
But Ms Forbes had already called for a real-time prescription monitoring service following inquests last year into the deaths of three people from overdoses of prescription drugs.
Ms Drinnan’s inquest would have been held concurrently with the other three but was suspended when Ms Forbes referred the matter to the office of the Director of Public Prosecutions, which decided earlier this year that no proceedings would be pursued.
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Connecting online can help prevent social isolation in older people

18 November 2015, 20:10 CET
Social technologies could provide valuable opportunities for isolated older persons to stay connected to the world. shutterstock

Author Jenny Waycott

Lecturer in the Department of Computing and Information Systems, University of Melbourne
John*, a widower, is a retired engineer aged in his 90s. He lives alone in the family home and has struggled with loneliness and depression since his wife passed away. He feels frustrated that as he gets older he can no longer do many of the things he used to enjoy, which exacerbates his sense of feeling alone in the world.

Social isolation in old age

In Australia, one-quarter of people aged 65 and above live alone. Some older people, like John, will be vulnerable to social isolation, which occurs when people have limited opportunities for human contact and become disconnected from society.
Not all older people who live alone are socially isolated. And social isolation is certainly not limited to old age. But social isolation in old age is a significant concern. It is linked to a range of health problems and, in extreme cases, can lead to people growing old and dying alone.
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Do teleoncology models of care enable safe delivery of chemotherapy in rural towns?

Bryan A Chan, Sarah L Larkins, Rebecca Evans, Kerrianne Watt and Sabe Sabesan
Med J Aust 2015; 203 (10): 406.
doi:  10.5694/mja15.00190
Abstract
Objectives: To compare the dose intensity and toxicity profiles for patients undergoing chemotherapy at the Townsville Cancer Centre (TCC), a tertiary cancer centre in northern Queensland, with those for patients treated in Mount Isa, supervised by the same medical oncologists via teleoncology.
Design: A quasi-experimental design comparing two patient groups.
Setting: TCC and Mount Isa Hospital, which both operate under the auspices of the Townsville Teleoncology Network (TTN).
Participants: Eligible patients who received chemotherapy at TCC or Mt Isa Hospital between 1 May 2007 and 30 April 2012.
Intervention: Teleoncology model for managing cancer patients in rural towns.
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Rural teleoncology works

Nicole MacKee
Monday, 16 November, 2015
HIGH-quality cancer care can be delivered to patients in rural settings with the support of medical oncologists via teleoncology, according to Australian researchers.
A 5-year comparison study, published in the MJA this week, found no difference in the dose intensity and toxicity profiles for patients undergoing chemotherapy in the Townsville tertiary cancer centre, and those treated via teleoncology at the rural Mount Isa Hospital with supervision from a medical oncologist. (1)
Professor Sanchia Aranda, Cancer Council Australia CEO, welcomed the findings. She said the teleoncology model, developed by James Cook University’s Associate Professor Sabe Sabesan, had effectively removed the barriers to the delivery of chemotherapy in small communities and was helping to build the capacity of local health services.
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BaptistCare hunts for new CIO

Former CIO George Lymbers has left the organisation to pursue new opportunities
Not-for-profit organisation BaptistCare NSW & ACT is searching for a new CIO after George Lymbers left the organisation this month.
A BaptistCare spokesperson said Lymbers had left to pursue other interests. The CIO had been in the role for over three years. Lymbers declined to be interviewed on his current plans.
According to the job advertisement on Seek, the CIO will provide strategic and operational direction to the IT unit to meet the organisation's technology objectives and the successful delivery of organisation-wide,hardware, systems, communications and business applications that support and enable the business.
“This position is an opportunity for a CIO to lead the organisation with inspirational leadership that thrives on a challenge, is innovative in their approach and is an outstanding influencer of new ideas,” the ad states.
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Stakeholders gear up on real-time codeine monitoring

The deferment of a final decision on the upscheduling of codeine-containing OTCs is very good news, but stakeholders now need to get moving quickly on the proposed real-time monitoring system for the medicines, they say.

“I think this is a win for everybody – for pharmacists, for consumers, for industry,” Deon Schoombie, CEO of the Australian Self-Medication Industry, told the AJP. “In terms of the principles of enhancing and supporting self care with the involvement of health professionals, this is the right way to go.
“It’s a great opportunity to demonstrate the role of pharmacists in Quality Use of Medicines.
“There’s a lot of pharmacists doing excellent work in this, and this is an opportunity to make it more consistent and universal, and raise the standard for everybody, bearing in mind that pharmacy overall is doing a great job.”
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Boost for rural hospitals as NZ broadband rollout finishes

“Faster broadband enables healthcare to be delivered in new and innovative ways."
All rural public hospitals and integrated family health centres now have access to high speed broadband across New Zealand, as revealed by Health Minister Jonathan Coleman and Communications Minister Amy Adams.
According to Dr Coleman, the 39 hospitals and integrated family health centres identified by DHBs as candidates for the government’s Rural Broadband Initiative are now all able to connect to fibre capable of peak speeds of at least 100 Mbps.
“Faster broadband enables healthcare to be delivered in new and innovative ways,” Dr Coleman adds.
“These e-Health solutions offer better, safer, more efficient healthcare closer to home.
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Tech meets health as Wellington patients access hospital records on mobile phones

Patients of GPs in Wellington’s Compass Primary Health Organisation (PHO) are the first to get to secure access to their health records via their mobile phones.
Patients of GPs in Wellington’s Compass Primary Health Organisation (PHO) are the first to get to secure access to their health records via their mobile phones.
A mobile app for ManageMyHealth has been launched for both Apple and Android devices, designed to enable Compass patients in the Wellington region to communicate with their doctors in real time and to download personal health information.
ManageMyHealth is a secure personal health portal created by New Zealand-based health IT company Medtech Global, which allows healthcare providers to help individuals take a more active role in the management of their health and wellbeing.
Individuals can, for example, access appropriate patient medical records online, see health results such as lab tests, and engage electronically with their health care providers to support positive lifestyle changes.
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Hefty medical handbook now an app

16 November 2015
THE Oxford Handbook of Clinical Medicine was one of a handful of books I dragged everywhere with me in my intern days.
It pains me to admit that my internship was so long ago that there were no smartphones and definitely no app versions of popular medical textbooks. 
All that has changed, and lightened the load of doctors everywhere.
While some textbooks don’t successfully make the transition to an app version, the Oxford handbook is among those that do. 
All the information from the book is contained in the app, and while there is often some clicking involved to get through to the details you want, this is a minor point.
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Plan to tie MyHealth record-use to e-health PIP slammed

Serkan Ozturk | 18 November, 2015 |
The RACGP has slammed planned changes to tie e-health Practice Incentive Program payments to the mandatory uploading of clinical notes to the national e-health records system, calling them "superficial". 
College president Dr Frank Jones (pictured) has written to Federal Health Minister Sussan Ley calling on her to drop the proposal, which was set out in a discussion document on the newly renamed MyHealth record system.
The RACGP's main concerns centre around online privacy and security, which the college says makes the scheme unsafe for pateints and GPs.
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Microsoft releases encryption tech for bioinformatics

Allows researchers to work on data securely.

By Juha Saarinen
Nov 16 2015 6:54AM
Microsoft has released tools that allow bioinformatics researchers to work on genome data sets securely to protect privacy.
Genomic data is becoming available in increasing amounts as gene sequencing becomes easier, cheaper and faster, and is used for several new applicaitons such as predicting the occurrence and survival of cardiovascular disease.
Hospitals, clinics, companies and other insitutions are faced with handling large amounts of such data securely, to ensure the privacy of subjects, but this carries risks.
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Millions of sensitive records exposed by mobile apps leaking back-end credentials

Developers have hard-coded credentials for back-end services into thousands of mobile apps, researchers found
Thousands of mobile applications, including popular ones, implement cloud-based, back-end services in a way that lets anyone access millions of sensitive records created by users, according to a recent study.
The analysis was performed by researchers from the Technical University and the Fraunhofer Institute for Secure Information Technology in Darmstadt, Germany, and the results were presented Friday at the Black Hat Europe security conference in Amsterdam. It targeted applications that use Backend-as-a-Service (BaaS) frameworks from providers like Facebook-owned Parse, CloudMine or Amazon Web Services.
BaaS frameworks offer cloud-based database storage, push notification, user administration and other services that developers can easily use in their apps. Their goal is to minimize the knowledge needed to maintain the back-end servers of an application.
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DTO snubs advice from peak industry bodies

The Government’s much vaunted Digital Transformation Office (DTO) closed door policy is rankling peak industry bodies that want access to the agency.
Laurie Patton, CEO Internet Australia (IA), the peak body representing Internet users claims a number of civil society and industry groups are apparently finding the door to the DTO firmly shut or are being left out of the loop when it comes to stakeholder engagement.
“We asked for a meeting and were told to come back next year”, Patton said. “They said they were too busy to see us”.
He believes the Australian Communications Consumer Action Network (ACCAN), the peak body representing all consumers on communications issues, also had appointments ‘bumped’ to next year because the DTO is “too busy”.
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Media consultants paid big money to train bureaucrats for Senate hearings

Date November 22, 2015 - 12:15AM

Adam Gartrell

National Political Correspondent

Exclusive
Federal government departments have paid external media consultants hundreds of thousands of dollars to train bureaucrats how to "perform" in Senate estimates hearings.
The consultants, who can be paid up to $30,000 a month, insist the training is not aimed at teaching public servants how to spin or avoid scrutiny – but some senators are not so sure.
While a search of government contracts suggests departments have spent about $160,000 on the training in recent years, the true cost is believed to be much higher but concealed through a sometimes opaque tender process.
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Enjoy!
David.

Sunday, November 22, 2015

NEHTA Reveals Just How Clumsy The PCEHR Will Always Be. It Is Just Going To Be An Ever Bigger Pile Of Separate Documents.

NEHTA published this little piece of ‘news’ last week.

Shared Health Summary Versus Event Summary

Created on Tuesday, 17 November 2015
In the eHealth record system, the Shared Health Summary and the Event Summary are two separate clinical documents – you can find the different features of each one here.
Link is here:
Here is the main contents of the document
Shared Health Summary
What is it?
Represents a patient’s health status at a point in time. This will include known information in 4 key areas: patient’s medical conditions, medicines, allergies/adverse reactions and immunisations.
A patient has only one current Shared Health Summary at a time.
Who can create and upload?
Shared Health Summaries are prepared and uploaded by a patient’s Nominated Healthcare Provider – the patient’s regular provider.
They can be either a:
• Medical practitioner registered with the Australian Health Practitioner Regulation Agency (AHPRA)
• Nurse registered with AHPRA
• Aboriginal and Torres Strait Islander health practitioner registered with AHPRA.
When to create?
Examples include:
• When completing a patient health assessment (e.g. GP Management Plan, 75+ Assessment, child health check)
• Significant changes to a patient’s health status in any of the 4 key areas: patient’s medical conditions, medicines, allergies/adverse reactions or immunisations.
The Shared Heath Summary should be created in consultation with the patient.
How to create?
Software demonstrations can be found here:
Where to go for more details?
http://www.nehta.gov.au/using-the-ehealth-record-system/how-to-use-the-ehealth-record-system/ uploading-a-shared-health-summary
Event Summary
What is it?
Captures key health information about a significant healthcare event that is relevant to the ongoing care of the patient, e.g. indicating a clinical intervention, improvement in a condition or treatment has been started or completed.
Who can create and upload?
Event Summaries are intended for healthcare providers who are not the patient’s regular provider/ Nominated Healthcare Provider.
They can be created and uploaded by any healthcare provider with a Healthcare Provider Identifier – Individual (HPI I) who is working at a participating healthcare organisation and involved in the patient’s care.
When to create?
Examples include:
• Patients visiting an after-hours medical service
• Holidaying patients
• Patients visiting from another area
• Patients receiving an immunisation or flu vaccine.
Generally, an Event Summary is used when it is not appropriate for the healthcare provider to create and upload any of the following:
• Shared Health Summary
• Discharge Summary
• Specialist Letter.
How to create?
Software demonstrations on uploading an Event Summary will be available soon. Check the NEHTA website for details.
Where to go for more details?
http://www.nehta.gov.au/using-the-ehealth-record-system/how-to-use-the-ehealth-record-system/ uploading-an-event-summary
Sources:
NEHTA website http://www.nehta.gov.au/get-started-with-ehealth/what-is-ehealth/ features-of-the-ehealth-record-system/clinical-documents
NEHTA guide https://www.nehta.gov.au/using-the-ehealth-record-system/ehealth-training-resources/guides/704-ehealth-guide-for-general-practice
----- End Extract.
So what the patient record will be is a single summary and then an ever increasing pile of unco-ordinated event summaries.
Given the event summaries will just pile up in some random temporal (not clinical) order it is hard to be sure just what value all of these documents will add and how useful they will be - rather like last week’s newspaper.
If you are looking to provide clinical utility for most of the stated purposes of the PCEHR all that is needed is the Shared Summary. Of course you can create a huge pile of results and prescriptions but how often, if ever, is anyone going to actually wade through all the junk to find something relevant, rather than just ring the relevant provider etc?
The only reason a national system would want the results of billions of blood test results has to be for some - unannounced - data mining project or the like.
Without a clear plan as to how the information will be managed and organised within the PCEHR - which at present seems to be a ‘State Secret’ - the system is a joke. Take it from me DoH and NEHTA have no clue on this. They seem to think we will aggregate and you (the GP) will hunt through - with the clumsiest interface imaginable!  They are dreaming!
David.

AusHealthIT Poll Number 297 – Results – 22nd November, 2015.

Here are the results of the poll.

Do You Believe NEHTA Is Now 'Very Good At What It Does' As Claimed In The 2014-2015 Annual Report? (Page 5)


Yes 5% (5)

No 92% (93)

I Have No Idea 3% (3)

Total votes: 101

This time a very decisive poll. It would seem NEHTA’s view of itself is not actually attached to reality!

Good to see such a great number of responses!

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

David.

Saturday, November 21, 2015

Weekly Overseas Health IT Links -21st November, 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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Patient data breaches widespread, beyond healthcare

Posted on Nov 13, 2015
By Jessica Davis, Associate Editor
It's not just hospitals. Or even payers. Some 392 million health records have been accessed in 1,931 protected health information breaches across a staggering 90 percent of industries, according to preliminary findings from a new Verizon report.
These industries, across 25 countries, have seen health insurance information, personnel files or other data outside of traditional healthcare settings or industries stolen, the study shows.
Indeed, of the 20 industry sectors examined in the study, only utility and management industries were free from reported PHI breaches.
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The path forward for meaningful use

Posted on Nov 11, 2015
By John Halamka, Beth Israel Deaconess Medical Center
Below is my assessment of the current meaningful use program and a proposal to better serve the needs of stakeholders. I'm likely going to violate many rules with this post. First, it's over 1500 words, which is not ideal for social media. Second, there are many who will find my conclusions politically unpopular. I'm not criticizing people, I'm just commenting on ideas. Finally, many of these topics do not have black and white answers. I hope my suggestions improve upon our current trajectory. 
Where We Are
1. I believe that the meaningful use programs have served their purpose. 
Stage 1 created a foundation of functionality for everyone. That was good. Stage 2 tried to change too much too fast and required an ecosystem of applications and infrastructure that did not exist. Clinicians struggled to engage patients and exchange data because they could send payloads but there were few who could receive them. Stage 3 makes many of the same mistakes as Stage 2, trying to do too much too soon. It requires patient accessible Application Programming Interfaces (APIs) without specifying any standards. It requires sending discharge e-prescriptions although pharmacies cannot widely support the cancel transaction that is essential to discharge medication management workflow. It requires public health transactions but CMS has no authority to require public health authorities to standardize the way they receive data.   
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FDA a 'toothless dragon' on med device security, researchers say

November 13, 2015 | By Susan D. Hall
Security researchers accuse the U.S. Food and Drug Administration of being "a toothless dragon" in dealing with medical device vulnerabilities, according to a Bloomberg Business article.
In the report, hacker Billy Rios recounts how the Mayo Clinic, in 2013, engaged him and other "white hat" hackers and set them off in teams in an effort to exploit about 40 different medical devices.
"Every day, it was like every device on the menu got crushed," Rios tells Bloomberg. "It was all bad. Really, really bad."
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EHR Adoption Comes at Expense of Doctor-Patient Relationship

NOV 12, 2015 7:45am ET
The healthcare system is too focused on technology-based checklists and protocols requiring data entry by physicians, leaving less time for patients and getting in the way of productive doctor-patient relationships.
So argues Douglas Wood, M.D., medical director of the Mayo Clinic’s Center for Innovation. Speaking earlier this week at the HIMSS Connected Health Conference in Washington, D.C., Wood asserted that with the advent of electronic health record systems and the ubiquitous presence of computers in examination rooms something tangible has been lost in the practice of medicine.  
“Patients are afraid of the complexity of the system because they’ve learned that oftentimes they’ll tell us their story—sometimes in great detail—but we fail to listen and to synthesize the details of that story into something that we can use to really make them better,” he observed. “Think if we stopped paying for healthcare in terms of office visits, with all of the inputs like ‘did I do all of the bullets of the history and examination’ and really started listening.”
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Rise of the Medical Robot

NOV 12, 2015 2:44am ET
Use of a pillcam, a swallow-able capsule with a tiny video camera that lets physicians examine the colon, is common today. But what about a pillcam that actually can do a procedure, such as attach a surgical clip to stop bleeding?
Researchers at Vanderbilt University’s School of Engineering have built early versions of this surgical clip capsule as well as about two dozen other function-specific capsules—called medical capsule robots—that collect biopsies, screen for colorectal cancer with a magnet outside the body manipulating a magnet in the capsule to get better views, screen for stomach cancer with tiny jets of water moving the capsule to places of interest, or check PH levels in the gastrointestinal tract, among other uses.
These and other first-generation capsules won’t be ready for human testing for about five years, but they are real and could be in widespread use in a decade, says Pietro Valdastri, assistant professor of mechanical engineering at Vanderbilt who did early work on the capsules with Akos Ledeczi, associate professor of computer engineering at the university, along with other team members.
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Senators question HHS on efforts to curb medical identity theft

November 12, 2015 | By Susan D. Hall
Four senators are asking the Department of Health and Human Services what it's doing to prevent data breaches at provider and payer organizations.
In a letter to Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services, and Jocelyn Samuels, director of the HHS Office for Civil Rights, the senators point to five major breaches in the past year--Anthem, Premera, Carefirst, Excellus and UCLA Health--that have affected up to 105 million people.
The danger of medical identity theft increases with the proliferation of breaches, they note. The authors include Lamar Alexander, chairman of the Senate Committee on Health, Education, Labor and Pensions (HELP); Patty Murray, ranking member of the HELP committee; Orin Hatch, chairman of the Senate Finance Committee; and Ron Wyden, the finance committee's ranking member.
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NHS IT needs £8 billion - McKinsey

Thomas Meek
10 November 2015
The NHS needs to spend an additional £7.2 billion to £8.3 billion on digital technology over the next five years in order to achieve savings of between £8.3 billion and £13.7 billion, according to a report by management consultancy firm McKinsey.
If the McKinsey investment case was funded and the projected savings were subsequently fully achieved, the report suggests they could account for up to a quarter of the £30 billion shortfall in NHS finances projected by 2020-21.
A copy of a PowerPoint presentation of the report, which underpins NHS England’s bid to the Treasury spending review, has been sent to Digital Health News by pressure group Spinwatch, which obtained it via a Freedom of Information Act request.
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Can the NHS bank on IT for productivity gains?

NHS England is bidding for billions of IT investment to improve NHS productivity. If it succeeds, a McKinsey presentation obtained by Digital Health News shows that it will be required to deliver on a scale never before achieved, argues editor Jon Hoeksma.
Against the background of one of the toughest spending reviews ever, the Treasury is being asked to consider a multi-billion pound investment in NHS IT.
A report from management consultancy McKinsey, obtained via the Freedom of Information Act by Spinwatch, argues that this would drive health service productivity.
If agreed, it would certainly demonstrate a strategic commitment to NHS modernisation and sustainability. However, if the Treasury were to commit anything like the additional £3.3 billion to £5.2 billion, the NHS would be required to deliver.
The report suggests this investment – which, with training, adoption and running costs could reach £7.2 billion to £8.3 billion over five years – should deliver efficiency savings of between £8.3 billion and £13.7 billion.
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Prediction: Health app market to top $31B by 2020, driven by hardware sales

By: Aditi Pai | Nov 11, 2015        
The health app market, currently valued at $10B, will grow at a compound annual growth rate of 15 percent to reach $31 billion by 2020, according to a report from research2guidance.
Although the health app market has seen significant growth, Zuzana Vranova, a senior research analyst at research2guidance, said that app developers are still trying to find effective monetization strategies. Existing app revenue sources, for example advertising and paid downloads, that developers in other industries use, are not sufficient for monetizing health apps, she added.
One strategy that health app developers have found is to use the apps to sell connected devices, like activity trackers and glucometers.
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EHRs, Alarm Fatigue Remain Top ECRI Patient Safety Concerns

By Jennifer Bresnick on November 11, 2015

Workflow woes, data integrity concerns, and EHR alarm fatigue are still tops on ECRI's watch list of dangerous healthcare technologies for 2016.

EHRs may be changing the healthcare industry at a lightning pace, but it appears that the patient safety downsides of health IT, including alarm fatigue and workflow struggles, remain sadly the same.  These issues, along with patient monitoring and surveillance shortfalls, have consistently camped out on the annual ECRI Institute Top 10 Health IT Hazards list, and are likely to continue to plague the industry in 2016.
"With all of the issues that hospital leaders are dealing with, technology safety can often be overlooked," says Anthony Montagnolo, chief operating officer at the ECRI Institute. "Based on our experience with independent medical device testing in our laboratory, accident investigations, and reported events, we're very aware of serious safety problems that occur."
After a shocking series of patient deaths due to improperly cleaned reusable endoscope devices, the difficult-to-clean equipment snagged the unenviable top spot on this year’s hazards list.  Insufficient staff education or haphazard processing before reuse can contribute to the spread of deadly carbapenem-resistant Enterobacteriaceae (CRE) infections, the list warns.
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It’s Way Too Easy to Hack the Hospital

Firewalls and medical devices are extremely vulnerable, and everyone’s pointing fingers

By Monte Reel and Jordan Robertson | November 2015

from Bloomberg Businessweek

In the fall of 2013, Billy Rios flew from his home in California to Rochester, Minn., for an assignment at the Mayo Clinic, the largest integrated nonprofit medical group practice in the world. Rios is a “white hat” hacker, which means customers hire him to break into their own computers. His roster of clients has included the Pentagon, major defense contractors, Microsoft, Google, and some others he can’t talk about.
He’s tinkered with weapons systems, with aircraft components, and even with the electrical grid, hacking into the largest public utility district in Washington state to show officials how they might improve public safety. The Mayo Clinic job, in comparison, seemed pretty tame. He assumed he was going on a routine bug hunt, a week of solo work in clean and quiet rooms.
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Q&A: Epic President Carl Dvorak

Posted on Nov 11, 2015
By Skip Snow, Contributing writer
Epic President Carl Dvorak wrote much of the original code in the system and made some of the enduring architectural decisions empowering its growth. With the company since 1987, he is often referred to as the technology brains of the organization.
Healthcare IT News had an opportunity to speak with Dvorak about Epic's approach to population health. Here's what he had to say.
Epic's DNA is population health management-centric
"We are making significant investments in research and development around the broader issues relating to population health. Our history with population health goes way, way back to our very earliest
electronic health records systems. In the early days of electronic health records, managed care organizations that jumped in first and because of that the core Epic system have just an absolute wealth of population health management features built in. Think of it as our healthcare operating system.
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How popular will wearables ultimately be?

Jeff Rowe
Nov 09, 2015
However much FitBits, Jawbones and Apple Watches have been embraced by the usual “early adoption” suspects, there’s disagreement among some fairly prominent stakeholders about whether the masses, so to speak, will end up following the enthusiasts.
In a keynote address at the recent 12th annual Connected Health Symposium in Boston, Dr. Ezekiel Emanuel, vice provost for global initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, made his feelings quite clear when he said, “I think you can forget about wearables for the masses. Investing in them is not going to pay off.”
He explained that wearables enthusiasts “tend to be young, rich, healthy and connected,” then pointed out that 60 percent of healthcare spending comes from the 10 percent of the population that is older, has multiple chronic conditions and is often poorer then the average citizen.
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Privacy principles set for Precision Medicine Initiative

November 11, 2015 | By Susan D. Hall
The White House has released a set of privacy principles to govern the Precision Medicine Initiative.
The administration worked with experts from inside and outside government, who crafted the principles after analyzing bioethics literature and privacy policies for large biobanks and research cohorts as well as taking into account more than 100 comments on their draft suggestions.
The comments emphasized the importance of engaging participants as collaborators and the need for a robust data security framework, according to an announcement about the initiative.
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Boston Children's Hospital partners with digital health company Grand Rounds to offer expert 2nd opinions

Written by Max Green | November 10, 2015
Boston Children's Hospital and San Francisco-based Grand Rounds are joining up to offer pediatric patients and their parents online-based second opinions for medical diagnoses and treatments.
When pediatric patients or their parents request a second opinion online, Grand Rounds aggregates the patient's medical records electronically and prepares them for review. Along with imaging and test results, Grand Rounds prepares all of the necessary information for review before matching the patient with a Boston Children's specialist who provides a detailed second opinion within days.
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Industry Uses De-Identification To Protect Health Data, but Privacy Risks Remain

by Nicole Lewis, iHealthBeat Contributing Reporter Wednesday, November 11, 2015
As health care organizations increasingly share patient data with public health entities and use patients' information for big data analytics and precision medicine initiatives, the consensus is that de-identification will become a more important tool for health care researchers and academics to minimize privacy risk.
However, an October report from the National Institute of Standards and Technology raises concerns about the practice, noting that "de-identification approaches based on suppressing or generalizing specific fields in a database cannot provide absolute privacy guarantees, because there is always a chance that the remaining data can be re-identified using an auxiliary dataset."  
The report bemoans the fact that "after more than a decade of research, there is comparatively little known about the underlying science of de-identification."
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Why Interoperability Efforts are Heating Up

NOV 11, 2015 7:53am ET
In recent weeks, participation in interoperability initiatives has been growing from different constituencies within the healthcare industry. Most striking has been an influx of interest from groups that have not been at the table before, such as professional groups and the pharmaceutical industry.
Input and assistance by provider organizations gives added impetus to ongoing efforts of standards groups, hospital information system vendors and a few select provider organizations that have taken on interoperability as a mission.
These new participants in the interoperability movement say changes in reimbursement approaches are driving the new interest. Value-based care is a key component of the Department of Health and Human Services to rein in healthcare costs. HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.
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Software Reduces Catastrophic Care Events, Provides Lessons Learned

NOV 11, 2015 3:15am ET
When a “never event,” a catastrophic failure of care resulting in significant harm or death to a patient occurs, a hospital may focus on capturing and analyzing data on the event and classifying it. But how often does a hospital translate findings into actionable and measurable programs to improve safety?
When a critical incident occurs, the first step is to assess what happened, says Andy Weissberg, senior vice president at Quantros, a vendor of safety software supporting analytics, incident response and clinical quality reporting. Then, a hospital will conduct investigations and analyses then check off the appropriate compliance and peer review boxes on a form.
However, what Quantros and its competitors often see missing is a third process to really learn and make improvements, Weissberg laments. “There seems to be a gap in learning from mistakes; that 360-degree view is really lacking.”
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Boston Children's, IBM Watson take on rare diseases

Posted on Nov 10, 2015
By Bernie Monegain, Editor-at-Large
IBM Watson and Boston Children's Hospital are taking on rare children's diseases that are hard to diagnose and treat. First up is a rare form of kidney disease.
The giant computing firm and the renowned hospital announced the collaboration on Monday at the Global Pediatric Innovation Summit + Awards in Boston.
Their first project will focus on kidney disease. Watson will analyze the massive volumes of scientific literature and clinical databases on the Watson Health Cloud to match genetic mutations to diseases and help uncover insights that could help clinicians identify treatment options.
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Lack of adherence sinks UCLA remote monitoring study

November 10, 2015 | By Susan D. Hall
Telemonitoring failed to improve readmission rates for heart failure patients in research from the University of California-Los Angeles.
A major problem was that 43 percent of patients dropped out of the study.
"There are individuals who do seem to benefit from these type of approaches, and then identifying [those who will adhere] to these interventions is probably the key issue in terms of use of these type of devices," lead author Michael K. Ong, M.D., told MedPage Today.
The study, known as BEAT-HF, aimed to catch problems early before they led to readmission. After discharge, patients were directed to measure and transmit their weight, blood pressure, heart rate and whether they were taking their medications. They used a Bluetooth-enabled digital scale and automated blood pressure machine with texting capabilities to transmit the data via a cellular transmitter to a central call center at UCLA. They also received regularly scheduled phone calls with a registered nurse, explains an article from the American Heart Association.
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Majority of healthcare institutions aren't using HIPAA-compliant mobile messaging services: 6 findings

Written by Kelly Gooch | November 09, 2015
Only 8 percent of healthcare institutions prohibit consumer messaging apps for employee communication, according to a study released today by Infinite Convergence Solutions.
Additionally, of the healthcare institutions using an official mobile messaging platform, only one in four are using an internal, company-authorized app, the study found. The rest are recommending or using consumer-facing messaging apps and services that fail tot provide the enterprise-grade security needed to comply with regulations like HIPAA.
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Cybercrime is the new healthcare crisis

The scale and intensity of healthcare related cybercrime is a critical and growing threat to the U.S. medical system. In the past year, organizations such as UCLA Health Systems, Anthem, Premera, and CareFirst have announced major breaches, bringing the five year total of compromised patient records to over 143 million or 45 percent of the U.S. population, according to data from the U.S. Department of Health and Human Services. When nearly half of the U.S. population has been a victim of a data security breach, it is an epidemic that can and will hit any healthcare provider.
To put it simply: Cybercrime is the new healthcare crisis.
The reported figures likely understate the severity of the problem, as some organizations may not yet be aware they have been breached and others may not have reported the incident. According to the Health Information Management Society (HIMSS), 2015 Cybersecurity Survey, 64 percent of healthcare organizations have experienced an external cyber-attack during the last twelve months. The Identity Theft Resource Center, which tracks data breaches across industries, reports that more data breaches happen in the medical and healthcare industry now than in any other sector, accounting for 46 percent of the reported breaches in 2014.
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Doctors Prescribe New Apps to Manage Medical Conditions

Patients record symptoms and communicate back to their doctor

By  Laura Landro
Nov. 9, 2015 1:40 p.m. ET
Your doctor may soon prescribe you a smartphone app in addition to drugs and physical therapy.
Hospitals are developing new mobile apps to help patients manage serious medical conditions and feed information back to their doctors between visits, often in real time.
The new apps aim to help with highly specific issues such as recovering from surgery and managing cancer-related pain. Because they are prescribed by physicians and used under medical supervision, researchers say, they stand a better chance of being integrated into patients’ daily routines, compared with health apps that consumers download and use without their doctors’ involvement.
Researchers are conducting clinical trials to test apps that help patients adhere to HIV medications, manage the symptoms of inflammatory bowel disease and asthma, and prevent repeat heart problems after a cardiovascular rehabilitation program. In addition to sending messages, reminders and instructions, the apps can alert providers to developing problems before they become a crisis. Researchers say their use could help reduce costly emergency room visits and hospitalizations.
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Marc Benioff-backed Gobiquity launches children’s vision screening app for pediatricians

By: Aditi Pai | Nov 6, 2015
Gobiquity Mobile Health (formerly iCheck Health Connection), has officially launched its vision screening smartphone app, called GoCheck Kids.
The company began rolling out the product to pediatric practices at the end of last year on handheld devices that were issued to practices, but has since added more functionality and released it on the Apple App Store. Now, physicians have the option to download the app on their own iPhone or use it on a preloaded handheld device.
GoCheck Kids screens for amblyopia, a functional disorder of the eye that typically comes from squinting and can lead to severe visual impairment.
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Performance is the top priority for 53% of healthcare CIOs: 9 insights into CIO perspective

Written by Carrie Pallardy | November 06, 2015
Deloitte’s CIO Program has released its 2015 global CIO survey, which includes insight from 1,200 CIOs and senior IT executives from across the world. 
Here are the nine top priorities for healthcare CIOs.
1. Healthcare services performance: 53 percent
2. Growth: 52 percent
3. Innovation: 48 percent
4. Global cost: 45 percent
5. Customers: 41 percent
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Enjoy!
David.