Wednesday, March 29, 2017

An Interesting Article In The Conversation Asking Why The MyHR is Not Being Used More?

This appeared on the Conversation a few days ago.

Why aren’t more people using the My Health Record?

March 24, 2017 2.49pm AEDT
My Health Records were a big government investment, but they’re just not being used.

Authors

  1. Bronwyn Hemsley  Associate Professor in Speech Pathology, University of Newcastle
  2. Jacqueline Meredith  Research Assistant, University of Newcastle
  3. Shaun McCarthy  Director, University of Newcastle Legal Centre, University of Newcastle
The My Health Record is an online summary of personal health information that patients can share with health providers. As many as one in five Australians have a My Health Record.
But recent statistics show the My Health Record is only being used by a small percentage of consumers, and even then not to its fullest uses. So how can we get a greater return on the estimated A$1.2 billion taxpayer dollars invested in the system?

1. More health professionals need to add information

To date, approved health-care providers in the system have uploaded only about 1.7 million clinical documents, for the 4.6 million Australians who have a My Health Record. Just over one third of these clinical documents are Shared Health Summaries - listing health conditions, allergies, medications, and immunisations.
Information about health-care recipients is also added to the My Health Record from other sources – including Medicare and the Pharmaceutical Benefits Scheme, along with pharmacy medications information and hospital discharge summaries. Some health-care providers might be willing to share clinical documents, but hold concerns about privacy and may be unsure how sharing the information will improve patient care.
The shared health information in the My Health Record could help many patients recall vital health information. It could be particularly useful for those who struggle with medication management, have multiple health conditions, enter hospital frequently, or have multiple health providers.
The main purpose of the My Health Record is to improve the quality, safety and efficiency of patient care. Reducing medical errors related to the poor exchange of health information between patients and their health providers, or across multiple health providers, is a high priority.
We need more health information added into the system before it’s going to be useful for more people in supporting their health-care decisions. Patients prompting their GP or practice nurse to upload a Shared Health Summary at each visit could increase use of the system, which is designed to improve patient control over their health information.

2. We need to add more information ourselves

Many consumers with a My Health Record have only had one since June 2016 through a trial of “opt-out” sites. Lacking experience or guidance in using the My Health Record, they will not know what they can upload or why, or how to use the technology.
Currently, there are only about 80,000 “Consumer Entered Health Summaries” in the My Health Record. These summaries contain emergency contact details and very brief information on allergies and medications. There are also about 35,000 “Consumer Entered Health Notes” – similar to a health journal or diary.
Fewer than 900 people have uploaded a copy of their Advance Care Directive - a critically important document outlining a person’s wishes for future medical treatment - into the My Health Record. As it is the only national online repository for Advance Care Directives that can be accessed anywhere, more legal information websites need to prompt people to store their Advance Care Directive in the My Health Record.
Not knowing how to use computers, navigate the My Health Record, or save and upload documents will prevent many people from taking advantage of the system.

3. More people need to know how to use it

Currently, the My Health Record places high demands on reading and e-health literacy, making it difficult for many people to use. This could be a barrier for a large number of people.
People with low health literacy, people who lack engagement with digital health, people who lack access to a computer and the internet, and people with limited English literacy could struggle with these online records.
Information about the My Health Record needs to be inclusive, easier to read, and translated into many languages – and use pictures and videos – to enable everyone to use the system.

4. The people who need it most need support to use it

As many as one in five Australians have a disability. Anyone with a condition that affects their ability to explain their health history to others might need help to use the My Health Record. This includes people with dementia, stroke, traumatic brain injury, intellectual or developmental disability, autism spectrum disorder, motor neurone disease, Parkinson’s disease, and people with a wide range of social, physical, cognitive, or sensory impairments affecting communication.
People with communication difficulties have three times the risk of preventable harmful adverse events in hospital, relating to their problems communicating their needs to health providers. The My Health Record might be particularly helpful for this group, who are at risk of exclusion because of their communication impairments and low levels of digital inclusion.
While the My Health Record is set up for use by all Australians, people with communication difficulties and their families may need additional information, funding, and other supports to enable their participation. They might also need help to identify who would be their Nominated or Authorised Representative in the system.
Future enhancements of the My Health Record need to take into account the views and experiences of people with multiple health conditions who are engaging with the My Health Record. Gathering their stories of experience could lead to a greater understanding of the types of support needed for more people to use and benefit from this important e-health initiative.
You can find the original article here:
I pass this on in the hope we can start a conversation about what are the other problems with the myHR.
Comments welcome indeed hoped for!
David.

Tuesday, March 28, 2017

The AMA Points Out Some Home Truths On What Is Needed From The National Digital Health Strategy.

This appeared last week.

Don’t-give-us-high-level-give-us-down-earth-ama-says

17 Mar 2017
The proposed national digital health strategy should be a simple, straightforward list of proposed projects and their benefits, rather than a high-level strategy document, Australia’s peak doctors’ body says.
In its submission to the Australian Digital Health Agency (ADHA), the AMA says it has long advocated for a strategic plan for digital health.
But it warns that clinicians must be involved in both the development of the proposed National Digital Health Strategy (NDHS) and its implementation, saying too many e-health projects around the world have failed because they were developed without consultation with the people who had to use them.
“The AMA is aware of the long track record, both locally and internationally, of e-health projects falling over for failing to consider the social aspects of development and implementation,” the AMA says.
“If no other lessons have been learnt from Australia’s approach to e-health, clearly a ‘build it and they will come’ approach, without coalface clinical involvement, will fail.”
Clinician involvement must not stop at the ‘strategy’ level.
“There is a need for co-produced development and operational plans so providers can see where critical services are heading, over what time frame, and what this means for them,” the AMA said.
“Many doctors and other healthcare providers have a level of scepticism about high level strategy documents, preferring instead to have access to a simple, clear, prioritised and costed list of projects, with tangible products and benefits able to be understood by the non-technocrat.”
The AMA also said that the strategy should have a more balanced and complete coverage of all health practitioners’ needs, compared to the historic over-emphasis on patient-controlled health records – the My Health Record (MyHR) - and support for e-health in general practice.
“This must include specific support for medical specialists other than GPs to take up digital health, including but not limited to the MyHR,” it said.
“The NDHS should also clearly acknowledge that digital health has important and direct implications for the way health care is organised, for health financing and funding, and for existing payment models.
More here:
You can read the full submission from this link:
It is really useful to read the AMA’s summary of their seven page submission. The points made on the directional and clinician related aspects seemed pretty good to me, including their point on the rather overbalanced emphasis currently in evidence regarding the myHR. (Comments on the commercial aspects of digital health  I will leave to others).
I also note their frustration as well as the recognition of just how difficult all this all is!
David.

Monday, March 27, 2017

Weekly Australian Health IT Links – 27th March, 2017.

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 really quiet week until the Council of Australian Governments leapt in and decided we are all going to  be given a myHR. Time will tell how that works out.
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Don’t-give-us-high-level-give-us-down-earth-ama-says

17 Mar 2017
The proposed national digital health strategy should be a simple, straightforward list of proposed projects and their benefits, rather than a high-level strategy document, Australia’s peak doctors’ body says.
In its submission to the Australian Digital Health Agency (ADHA), the AMA says it has long advocated for a strategic plan for digital health.
But it warns that clinicians must be involved in both the development of the proposed National Digital Health Strategy (NDHS) and its implementation, saying too many e-health projects around the world have failed because they were developed without consultation with the people who had to use them.
“The AMA is aware of the long track record, both locally and internationally, of e-health projects falling over for failing to consider the social aspects of development and implementation,” the AMA says.
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Design Aid program to help make Diabetes finger pricking a thing of the past

We’re proud to announce that Deakin University’s non-invasive smart solution for blood glucose monitoring project will be the first recipient of our Design Aid program.
The Design Aid program is part of our mission to give underfunded digital health projects access to world class design.
The winning project is specifically looking to design and implement a state-of-the-art smartphone-based non-invasive glucose monitoring solution using terahertz technology. The project is based on years of collaboration between Australia, the United States and Canada and is about to enter the Visualisation and Prototyping phase of the project – ideally suited to our user experience design expertise in the health sector.
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Why aren’t more people using the My Health Record?

March 24, 2017 2.49pm AEDT
My Health Records were a big government investment, but they’re just not being used.

Authors

  1. Bronwyn Hemsley  Associate Professor in Speech Pathology, University of Newcastle
  2. Jacqueline Meredith  Research Assistant, University of Newcastle
  3. Shaun McCarthy  Director, University of Newcastle Legal Centre, University of Newcastle
The My Health Record is an online summary of personal health information that patients can share with health providers. As many as one in five Australians have a My Health Record.
But recent statistics show the My Health Record is only being used by a small percentage of consumers, and even then not to its fullest uses. So how can we get a greater return on the estimated A$1.2 billion taxpayer dollars invested in the system?

1. More health professionals need to add information

To date, approved health-care providers in the system have uploaded only about 1.7 million clinical documents, for the 4.6 million Australians who have a My Health Record. Just over one third of these clinical documents are Shared Health Summaries - listing health conditions, allergies, medications, and immunisations.
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Illawarra cancer network investigates HoloLens’ potential

Microsoft’s mixed-reality headset could deliver training for nurses at ISCaHN as part of a broader mobility program at the cancer network
Rohan Pearce (Computerworld) 21 March, 2017 08:40
Microsoft’s mixed-reality HoloLens headset will be used for nurse training by the Illawarra Shoalhaven Cancer and Haematology Network (ISCaHN) if a proposal currently under consideration goes ahead.
Kenneth Masters, Illawarra Shoalhaven Local Health District’s oncology information system manager, said the purchase of two headsets has already been approved by ISCaHN’s IT steering committee and directors and was just awaiting a final sign-off from finance.
The initial use for the headsets would be training for nurses in the patient care environment. The headset could allow virtual assets to be set up in a critical care environment, displaying patient information at a bedside and making that same information visible to different nurses.
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Gene therapy: What personalized medicine means for you

From CNET Magazine: What if the next pill you took were tailored to your genetic makeup? That day is almost here.
Sci-Tech
by Marguerite Reardon March 22, 2017 5:30 AM PDT @maggie_reardon
Thuy Truong thought her aching back was just a pulled muscle from working out. But then came a high fever that wouldn't go away during a visit to Vietnam. When a friend insisted Truong, 30, go to an emergency room, doctors told her the last thing she expected to hear: She had lung cancer. Back in Los Angeles, Truong learned the cancer was at stage 4 and she had about eight months to live.
"My whole world was flipped upside down," says Truong, who had been splitting her time between the San Francisco Bay Area and Asia for a new project after selling her startup. "I've been a successful entrepreneur, but I'm not married. I don't have kids yet. [The diagnosis] was devastating."
Doctors at the University of Southern California took a blood sample for genetic testing. The "liquid biopsy" was able to detect tumor cells in her blood, sparing her the risky procedure of collecting cells in her lungs.
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Contractor army wanted for Qld Health's middleware overhaul

By Allie Coyne on Mar 23, 2017 10:24AM

Getting into meaty part of big transformation.

Queensland Health has put a call out to the market for an army of IT contractors it can turn to for help with its long-running middleware overhaul.
In late 2015 the department revealed its intention to incrementally replace its massive legacy environment by implementing new plumbing between the systems.
Addressing the middleware means the agency can overhaul small pieces at a time without impacting stability of other systems and applications.
Later that year it chose Fujitsu to help it implement Orion Health's integration software into its sprawling environment.
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Opportunities for providers as seniors adopt digital healthcare

By Natasha Egan on March 24, 2017 in Technology
A majority of Australian seniors are using digital devices to manage their health, signalling a critical role for consumer-focused technologies in aged care, new report finds.
The report draws on Accenture’s 2016 survey of 7,840 consumers in seven countries – including 241 Australians aged over 65 – and their views on health and healthcare technology.
With a majority of older people reporting they use technology to manage their health at least monthly, the analysis concluded there were many opportunities for aged care providers to offer digital services to Australia’s four million seniors.
Lead author and Accenture Australia principal director – healthcare Ian Manovel said more seniors were using digital health technology than they had been expecting.
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Government cracks down on fake doctors after NSW doctor is impersonated

Sue Dunlevy, National health reporter, News Corp Australia Network
March 24, 2017
FAKE doctors will face longer jail sentences and tougher financial penalties under a crackdown agreed by state and federal ministers after a recent NSW case.
And every Australian will be given an e-health record unless they take action to opt out under a change that could have major privacy implications.
A major overhaul of the regulation of medical practitioners was agreed by state and federal ministers meeting in Melbourne on Friday.
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NSW hospital patients not told their medical records were found in public areas

20 March, 2017
NSW hospital patients have had their confidential details compromised on multiple occasions, including medical records being found in a public carpark.
Many of the most serious privacy breaches have been reported in the Central Coast Local Health District, which runs Gosford and Wyong hospitals.
In 2015, a patient's emergency assessment paperwork was discovered on the ground near Gosford Hospital.
However, the patient concerned was never informed because the Health District said there was not a "serious risk of harm".
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Patients should be able to add notes to their clinical record

20 March 2017
THE ISSUE
Patients have their own agenda for what they plan or hope to do in a consultation, but most clinical software packages don’t provide any means for them to enter this into their clinical record.
Instead, for most clinical software systems, GPs and practice nurses act as the patient’s scribe, with an attendant likelihood of errors, bias, mis-emphasis and selective recording tailored to fit with the GP’s or practice nurse’s agenda.
Sometimes the patient’s agenda or reason for consultation is not recorded at all.
The Health Engine online appointment system allows patients to add notes to their booking with their reason(s) for making the appointment, but those notes do not automatically become part of the patient’s clinical record. As with all communications with or about patients, they should.
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Govt to launch mass data-harvest on Australia's pensioners

Noel Towell
Published: March 23, 2017 - 5:16PM
The federal government is to begin the mass-harvesting of financial information on hundreds of thousands of Australian pensioners as it steps up the "automation" of the nation's welfare system.
Centrelink is to be given the power to force superannuation funds and other sources of income for retirees to hand over the details of payments made to their members.
The move is expected to save up to $38 million each year in reduced administration for Centrelink and fewer overpayments of the age pension.
The welfare reform bill that passed late on Wednesday night contained the clause empowering Centrelink to demand the information, which is expected to be in the form of data-sets, from super funds and other "income stream" providers.
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Balancing act on the right to use, access and protect data

  • Anthony Wong
  • The Australian
  • 12:00AM March 21, 2017
In today’s digital and connected economy, data has become a vital resource that, when combined, could unlock new forms of value, connect previously unseen linkages and provide insights to stimulate growth and innovation in the digital economy.
Organisations of all sizes are taking steps to exploit the competitive advantage that big data, social media and the Internet of Things offer in profiling and analysing customer buying patterns.
Data drives revenue
Facebook reportedly generates 96 per cent of its revenues through targeted advertising that leverages user data, while Google’s sophisticated search capabilities attracted advertising revenues of more than $US57 billion last year. Between them, the two companies accounted for over 70 per cent of digital advertising, creating a global duopoly.
In this data-driven world, however, it’s often the case that the people who generated the data have little or no control over what happens to it once it has been captured. Even our ability to access data relating to personal transactions in areas such as banking, telecommunications and health has become more challenging in our increasingly paperless environment.
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Angus Taylor: we’re delivering on digital projects and promises

  • Angus Taylor
  • The Australian
  • 12:00AM March 21, 2017
Earlier this month the member for Chifley, Ed Husic, published an opinion piece in this paper highlighting the purported weaknesses of the Coalition’s digital strategy. Unfortunately, the piece was a masterclass in why Labor will never truly understand how to lead.
Given that it rather conveniently forgot to address the years of underinvestment in IT and digital under Labor’s watch, it’s perhaps pertinent to look at the transformative work going on inside government to remedy the past mistakes.
As the Assistant Minister to the Prime Minister for Cities and Digital Transformation, I see every day how this government is delivering on its promises — from infrastructure development to industrial relations reform to energy security. In my own portfolio I’m proud of how the Digital Transformation Agency is delivering real reform through an unprecedented government- wide overhaul that the Labor Party didn’t bother to pursue when it had the chance.
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Digital healthcare ‒ addressing cyber security risks for medical devices in the digital age

Australia March 16 2017
Addressing cyber security threats in medical devices proactively will help mitigate the risks associated with the rise of these technologies.
Healthcare, as with most sectors, is becoming increasingly digitised in the modern age. This presents both opportunities and risks for healthcare systems ‒ in particular, the cyber security of medical devices that employ wireless technologies and software.
Recently, the Australian Therapeutic Goods Administration (TGA) and the United States Food & Drug Administration (FDA) have actively addressed this issue. The TGA had previously noted the possibility of unauthorised users gaining remote access to Hospira's Symbiq Infusion System and LifeCare PCA3 and PCA5 Infusion Pump Systems, while both regulatory bodies have turned their attention to potential vulnerabilities in implantable cardiac devices.
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Automated patient check-in for Gold Coast Health

By Australian Hospital + Healthcare Bulletin Staff
Tuesday, 21 March, 2017
Gold Coast Health has launched an automated patient check-in system across its five busiest departments at the Gold Coast University Hospital (GCUH). The check-in system is part of the Q-Flow patient optimisation framework that includes a series of kiosks that patients use to register their presence on arrival, as well as a backend patient management system that organises patient records.
Demand for Gold Coast Health’s services is only increasing, with growth in the number of total patients being seen in clinics across the city going from 699,000 in 2014–15 to 835,000 in 2015–16.
Gold Coast Health has partnered with patient flow management software specialist NEXA to integrate Q-Flow with GCUH’s core systems. The system is helping to eliminate patient queues, while capturing critical performance data from many of the hospital’s departments.
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Government pushes ahead with work on Centrelink payment system

Accenture gets lead systems integrator role on first phase of WPIT
Rohan Pearce (Computerworld) 22 March, 2017 13:31
Accenture has been chosen as the lead systems integrator for the first part of a program to overhaul Centrelink’s payment system.
Human services minister Alan Tudge said that the selection of the company as preferred tenderer for systems integrator services on the first phase of the Welfare Payment Infrastructure Transformation (WPIT) Program was still subject to commercial negotiations.
DHS is currently planning a range of WPIT-related projects including a new online user interface for welfare payments, a new payment utility to deliver payments faster, and work on designing an end-state technology solution for future phases of WPIT.
The government said in October that Capgemini and Accenture were shortlisted for the role.
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Codeine handling ‘suboptimal,’ says study

Newly published research has shown that in roughly a quarter of direct product requests for non-prescription combination analgesics containing codeine, pharmacists weren’t involved

Researchers from LaTrobe University conducted 145 covert pharmacy visits in which one of two scenarios took place, each of which involved a direct product request for Nurofen Plus.
The scenarios involved identical reasons for use, symptoms and medical history but varied previous product use: one involved a first-time user while the other had used the products regularly for the past month.
The research was undertaken between July and August 2015, well before the Pharmacy Guild’s MedsASSIST program began to roll out in March 2016. The product category is to be upscheduled to prescription-only on 1 February 2018.
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National Clinical Terminology Service: Website User Survey

Created on Monday, 20 March 2017
In October 2016, the Australian Digital Health Agency launched the National Clinical Terminology Service (NCTS) website www.healthterminologies.gov.au to provide our customers with a one-stop shop to access our terminology products, tools, applications and supporting resources. We are conducting a survey to seek your feedback on the website and to help identify future improvements to the service.
Click on the link below to start the survey. You have until Thursday 13th April 2017 to complete it. Thank you for your participation!
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National Product Catalogue Data Quality in Health Program

Created on Friday, 24 March 2017
GS1 Australia and the Australian Digital Health Agency (the Agency), in partnership with the Healthcare Industry, are continuing to implement the National Product Catalogue Data Quality Improvement Program to address healthcare industry concerns relating to data quality within the National Product Catalogue (NPC).
Key highlights include new data quality reporting passing the pilot phase of the project with reports now scheduled to be released to the Healthcare Industry by July 2017. This is a significant step forward to improved medical product data being available across healthcare systems via the National Product Catalogue.
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Digital Health in an Era of Precision Medicine — The Genome Generation

Thursday, 23 March 2017
As the Chief Medical Adviser for the Australian Digital Health Agency (the Agency), I'm privileged to have the opportunity to meet with many inspiring people – clinicians, health consumers, researchers and innovators who help us think about the way our organisation can best serve Australians to get a good deal out of our investment in digital health services and technologies. We are delivering key services at the Agency that will enable our health system to remain world-leading in its innovation and ability to support a high standard of health and well-being for our citizens. Our continued efforts to improve and expand our understanding of how our services underpin and interrelate to the broader health and care ecosystem depends upon us continually looking outwards, reflecting and learning about future directions for health and care clinical priorities, as well as focussing on striving for internal excellence in our organisation.
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Enjoy!
David.

Sunday, March 26, 2017

Is It Possible To Really Believe Anything We Hear From Government Regarding The myHR? Are They Really Ignoring Their Own Legislation?

Towards the end of 2015 modified update legislation relating to the then PCHER was passed through the Commonwealth Parliament.
This legislation was triggered in response to the earlier Royle Review of the PCEHR commissioned by Minister Dutton when the Abbott Government was elected.
Here is a link that covers the outcome of that review from late 2014 – including a link to the actual report.
The summary of the 2015 legislative outcome is as follows.

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.
Most interesting are the comment on the recently approved opt-out approach to the myHR.
Here it is as part of a much fuller review.

“Adoption of an ‘opt out’ enrolment model

The most substantive change introduce by the Bill is an amendment to the MHR Act to allow the creation of a ‘My Health Record’ for an individual unless they opt out.
The Bill requires that a trial of the ‘opt out’ model must first be undertaken to determine whether the change in model leads to participation in the system at a level that ‘provides value to users of the system’ before the model can be adopted throughout Australia.
The requirement for a trial is an unusual approach; it suggests a degree of uncertainty as to whether the poor take up of the PCEHR is explained by personal choice or apathy. It is also unclear whether anything short of an overwhelming level of ‘opt out’ in the trial would influence the Commonwealth to abandon the rollout, given the clear imperative to establish a functioning eHealth record system in Australia.
Here is the link to the legislative review:
This was the state of play till Friday when this was sprung on the unsuspecting public.

COAG Health Council Communique - 24 March 2017

The Federal and state and territory Health Ministers met in Melbourne at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by the Victorian Minister for Health, Jill Hennessy.
Page last updated: 24 March 2017
24 March 2017
The Federal and state and territory Health Ministers met in Melbourne today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy.
Health Ministers welcomed the Hon Dr Jonathan Coleman, the New Zealand Health Minister, the Australian Capital Territory Health Minister, Meegan Fitzharris MLA, the New South Wales Health Minister, the Hon Brad Hazzard, the Commonwealth Health Minister, the Hon Greg Hunt and the Hon Roger Cook, the new Health Minister from Western Australia, to their first COAG Health Council meeting.
Major items discussed by Health Ministers today included:

Health Practitioner Regulation National Law Amendment Law 2017

Advancing the clinical trial environment

Expiring National Partnership Agreements (NPAs)

Update on medical research at Commonwealth and state level

Pre-exposure prophylaxis for the prevention of HIV

Meningococcal W

Ear disease and hearing loss in Aboriginal and Torres Strait Islander children

Other items

Ministers considered a number of other important national health matters, noting ongoing cooperation and work on issues including long term health reform, digital health, childhood obesity, the implementation of the Health Care Homes program, end of life care and the medicinal cannabis.
Ministers agreed that the Fifth National Mental Health Plan will re-emphasise its objective of Suicide Prevention and will therefore become the Fifth National Mental Health and Suicide Prevention Plan.
Ministers agreed to a national opt out model for long term participation arrangements in the My Health Record system.
Here is the link to the full communique with the comments on all the earlier matters included.
Note the bold text in the last 2 lines – seemingly meant not to be noticed or commented upon! This rather reminds us all of a Department getting out the controversial / bad news late on a Friday afternoon in the hope it is not noticed!
So we are left with 2 choices – either there is a secret evaluation report of opt-out but we have not been shown it or a decision has been taken ignoring the legislated requirement of a trial and presumably a report on said trial(s).
Either way it looks to me the Health Department and the ADHA would appear to be trying to reduce our confidence in the transparency and proactivity of their communication.
We really need to see better than this for the sake of both the e-Health community and the public. Observing co-design in actuality as well as in announcements  would be really good as no-one wins if things are done like has just been done here!
David.

AusHealthIT Poll Number 363 – Results – 26th March, 2017.

Here are the results of the poll.

Innovation and Science Australia Chair Bill Ferris says the Health Department's myHR "can become a valuable resource for better service delivery, prognosis, diagnosis and the basis for a whole pile of new business applications, including precision medicine." (AFR Mar 16, 2017) Do You Agree?

Yes - Its a great innovation 3% (6)

No - He's on the Kool Aide 84% (147)

I Have No Idea 13% (23)

Total votes: 176

I think it would be fair to say readers believe Mr Ferris should stick to talking about what he has expertise in.

A really great turnout of votes!

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

David.

Saturday, March 25, 2017

Weekly Overseas Health IT Links – 25th March, 2017.

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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Adventist Health’s trigger tool uncovers thousands of additional harm occurrences

Mar 17, 2017 10:21am
After several years of using manual methods to identify and track patient harm, a real-time alert system helped Adventist Health System uncover thousands of additional instances of harm.
Over an 11-month period, an automated trigger tool uncovered nearly 2,700 instances of patient harm stemming from incidents both inside and outside the health system, according to a study published in The Joint Commission Journal for Patient Safety. Comparatively, the system’s manual method uncovered just 132 instances of patient harm during an 11-month period two years prior.
A major reason for the increase was the sheer number of records that the automated system could process through Adventist Health System's Patient Safety Organization. The trigger tool combed through more than 40,000 records compared to just 440 that were reviewed in the manual process.
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Data breach fear for 26m GP records

Nadeem Badshah
March 18 2017, 12:01am, The Times
An investigation has been launched into the security of a computer system that holds 26 million patients’ records.
The Information Commissioner is looking into a potential breach involving 2,700 GP surgeries. It centres on SystmOne, which is used by family doctors. When GPs switch on “enhanced data sharing” so that records can be seen by a hospital, they also can be accessed by thousands of staff even if there is no medical reason to do so.
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GAO details weaknesses in federal push to share patient data

By Joseph Conn  | March 16, 2017
A federal watchdog group said HHS isn't doing enough to measure how much patients are using their medical records. The Government Accountability Office also found patients aren't accessing their medical records because they can't aggregate all of their information into one medical record, underscoring the need to streamline and standardize systems.
Patients often have to go through different portals for each provider, the GAO said, adding that patients generally have to manage separate login information for each provider-specific portal.
Personal health record technology is available to collect the records, but these systems “are not widely used,” a 55-page GAO report stated.
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DeepMind's first deal with the NHS has been torn apart in a new academic study

  • Mar. 16, 2017, 8:07 AM
A data-sharing deal between Google DeepMind and the Royal Free London NHS Foundation Trust was riddled with "inexcusable" mistakes, according to an academic paper published on Thursday.
The "Google DeepMind and healthcare in an age of algorithms" paper — coauthored by Cambridge University's Julia Powles and The Economist's Hal Hodson — questions why DeepMind was given permission to process millions of NHS patient records so easily and without patient approval.
"There remain many ongoing issues and it was important to document how the deal was set up, how it played out in public, and to try to caution against another deal from happening in this way in the future," Powles told Business Insider in Berlin the day before the paper was published.
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Half of Medication Errors Involve CPOE, Data Shows

Alexandra Wilson Pecci, March 17, 2017

Computerized prescriber order entry systems and pharmacy systems are the most commonly reported factors contributing to medication errors in Pennsylvania healthcare facilities, data shows.

Although health IT tools can help prevent patient safety problems, they can also lead to significant patient safety errors if they're not used correctly, finds research from the Pennsylvania Patient Safety Authority.
Between January 1 and June 30, 2016, Pennsylvania healthcare facilities reported 889 medication-error events that indicated health IT as a contributing factor.
The most frequently reported errors included dose omission, wrong dose or overdosage, and extra dose. The most commonly reported systems involved in the errors were computerized prescriber order entry systems (CPOE) and the pharmacy systems.
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Poorly implemented IT systems lead to medication errors

Mar 17, 2017 10:58am
IT systems designed to streamline medication ordering and administration can contribute to medication errors.
Health IT systems designed to improve prescription ordering and medication administration can just as easily contribute to medical errors.
That’s according to a study released by the Pennsylvania Patient Safety Advisory (PPSA), which found that computerized prescriber order entry (CPOE) systems, pharmacy IT systems and electronic medication administration tools were frequently to blame for medication errors. Nearly 70% of those errors reached the patient.
Last year, researchers at Johns Hopkins published a study indicating that medical errors are the third-leading cause of death in the U.S., a study that drew harsh criticism from many physicians. Some have warned that digital prescription systems miss potential drug errors, and the Office of the National Coordinator for Health IT has called on vendors and providers to reduce the number of “pick list” medication errors.
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Top 10 patient safety concerns for 2017, according to ECRI

A new report says poor information management and faulty CDS implementation pose risks to patients. It also raises concerns about patient identification and process improvement activities.
March 14, 2017 01:10 PM
Health information technology holds enormous potential for improving patient safety, but only when implemented and used correctly. A new study from ECRI Institute spotlights EHR information management practices and clinical decision support as two areas of particular concern.
"The 10 patient safety concerns listed in our report are very real," says Catherine Pusey, RN, associate director, ECRI Institute Patient Safety Organization. "They are causing harm – often serious harm – to real people."
This list for 2017, which derives from PSO event data, focuses on concerns raised by provider organizations and ECRI experts.
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Health IT coalition seeks scrutiny of ONC's regulatory role

By Rachel Z. Arndt  | March 14, 2017
Health IT Now is asking Congress and the Trump administration to examine the role the Office of the National Coordinator for Health Information Technology plays in regulating health IT and how that role relates to other regulatory agencies.
Not-for-profit advocacy group Health IT Now wrote in a letter Monday to HHS Secretary Tom Price that the coalition worries that recent ONC actions could raise costs and slow product development by going beyond what the Health Information Technology for Economic and Clinical Health Act allows the ONC to do.
Under the ONC's "enhanced oversight and accountability" final rule, the office is allowed to review products directly for patient safety concerns. According to the rule, direct review “will promote health IT developer accountability for the performance, reliability and safety of health IT.”
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5 big challenges to utilizing genomic data for precision medicine

Two Advisory Board research leaders discuss the current state of precision medicine – and what it will take for genomics to become part of routine care.
March 14, 2017 05:18 PM
Precision medicine holds the key to better health. And as the industry moves more toward value-based care, its evidence-based principles can help providers ease into the transition.
"It's a big step to go from trial-and-error medicine to evidence-based medicine," said Jim Adams, executive director of research at The Advisory Board. "Even for evidence-based care and precision medicine, genomics data is really important. But it's not one-to-one.
"You can get to precision medicine without genomics data," he added. "There's a lot of work that can be done without the genomic data to achieve precision medicine while we wait for the technology and industry to catch up."
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Do we need to certify digital health Leaders?

James Freed, CIO Health Education England and Andy Kinnear, chair of BCS Health and Care, ran a workshop at the recent Digital Health Leadership Summit on the case for certifying digital leaders, here they summarise what attendees said.
There has been much talk about certification, registration and regulation of digital health leaders, in particular CIOs and CCIOs, in recent (and not-so-recent) years, but this debate seems to be gathering pace since September last year.
That was when Secretary of State for Health Jeremy Hunt, following a key recommendation of the Wachter Review of NHS IT, announced plans for the development of a ‘Digital Academy’ to ensure CIOs and CCIOs, and aspirants to those hallowed positions, are as good as they can be.
Cue much discussion on ‘what good looks like’, and the validity of another NHS University. Indeed, we have written in the past about the role and duty, of CIOs in particular, to demonstrate their ability and their drive.
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3 ways Trump’s FDA nominee could reshape digital health

Mar 16, 2017 11:37am
Under Scott Gottlieb, the FDA could see a subtle policy shift that loosens regulations for the digital health industry, observers tell FierceHealthcare.
President Donald Trump’s nominee to lead the Food and Drug Administration is a strong proponent of deregulating the drug industry, an approach that could be equally beneficial for the digital health industry that has occasionally butted heads with the federal agency.
Last week, Trump announced his intent to nominate Scott Gottlieb, M.D., a resident fellow at the conservative-leaning American Enterprise Institute and a former deputy commissioner for medical and scientific affairs at the FDA during the George W. Bush administration. Gottlieb, who has close ties to the pharmaceutical industry and has been vocal about the need for a new, streamlined approach to drug approvals, was applauded by PhRMA, the industry’s leading lobbying group.
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Despite federal push to offer EHR access, patient engagement is low

Mar 16, 2017 11:50am
A new GAO report says HHS needs to improve the way it measures patient access to EHRs.
Although the vast majority of hospitals and physicians provided access to EHRs in 2015, very few patients took advantage, calling into question the effectiveness of efforts led by the Department of Health and Human Services.
Just 15% of hospital patients electronically accessed their medical records despite 88% of hospitals offering access, according to a report released by the Government Accountability Office (GAO). Nearly one-third of patients accessed EHRs offered by physician practices.
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Study: Patients Typing Visit Agendas into EHRs Improves Communication with Physicians

March 15, 2017
by Rajiv Leventhal
Patients attending a safety-net primary care clinic in Seattle were interested and able to type their agenda into the electronic health record (EHR) visit note, and as a result, both patients and clinicians felt improved communication, according to new research in the Annals of Family Medicine.
More than 100 patients and clinicians at Seattle’s Harborview Medical Center (HMC) participated in the study, which took place in 2015. As the researchers stated, “existing OpenNotes research shows enthusiasm among both patients and clinicians, but this is the first Open-Notes study of cogeneration of clinic notes. Allowing patients to type their agenda into their clinic note before a visit may facilitate communication of health concerns,” they said.
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CHIME Advises HHS Improve Interoperability, Standardization

Recommendations submitted to the Department of Health & Human Services last month prioritize industry-wide standardization to improve health data exchange and interoperability.

March 13, 2017 - The College of Healthcare Information Management Executives (CHIME) recently submitted a list of recommendations to Department of Health & Human Services (HHS) Secretary Thomas Price, MD, on ways to improve patient care delivery in several areas, including interoperability.
In an effort to maintain momentum in improving interoperability, reducing stringent regulations on providers, and streamlining the transition to value-based care, CHIME submitted seven suggestions regarding steps HHS should consider when drafting future legislation.
“CHIME members have moved beyond adopting information technology and to pursuing strategies that promote population health, patient engagement and value-based payment,” members wrote. “However, significant barriers remain to harnessing the full power of these systems. Below are a set of priority areas and recommendations which, we believe, could propel us toward greater innovation in care delivery.”
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More Than 300 Data Breaches to Date in 2017

The latest count from the Identity Theft Resource Center (ITRC) reports that there have been 312 data breaches recorded this year through March 14, 2017, and that over 1.3 million records have been exposed since the beginning of the year.
VisionQuest Eyecare in Indiana reported a data breach on March 2 that affected some 86,000 individual records. This was the largest incident reported so far in 2017, but the company has not revealed any further details about the event.
At the U.S. Department of Health and Human Services (HHS) breach portal, there is an entry for Commonwealth Health Corporation (Kentucky) indicating nearly 700,000 individuals have been affected by a theft of data, but no additional details are available for this incident.
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March 16, 2017

Star Trek's Tricorder a sign of health care to come

"Take two apps and I'll call you in the morning": Game-changing technology puts data in hands of patients

Ontario startup CloudDX has created Vitaliti, a virtual doctor based on Star Trek’s tricorder device, one of several promising new technologies transforming health care. March 8, 2017
Richmond Hill Liberal
A trip to the doctor can be an ordeal.
Take time off work, drive to the health clinic, sit in the waiting room until the doctor can see you, have your throat swabbed or ear examined or head over to the medical lab for blood tests or imaging, then wait some more for the results, for the follow-ups, for the prescriptions ...
Dr. McCoy had a better way. The Star Trek doctor simply pulled out his trusty Tricorder and within seconds, you were diagnosed and on your way to better health.
Soon, you too may boldly go where science fiction has gone before.
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Why telehealth study may underestimate the technology's benefits

Published March 15 2017, 4:51pm EDT
A new study published recently in Health Affairs cuts against the conventional wisdom on one of the biggest trends in healthcare: the increased use of direct-to-consumer telehealth services.
The study found that while these services increase patients' access to care, they also may increase overall healthcare spending—contrary to the widespread expectation that direct-to-consumer telehealth would cut costs.
But if you dig a little deeper, you'll find the study's takeaways aren't nearly as clear as they may seem.
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GOP health plan to boost uninsured by 24 million, CBO says

Published March 13 2017, 6:19pm EDT
About 24 million more people would be uninsured under the Republican plan to replace Obamacare, according to the nonpartisan Congressional Budget Office, creating a daunting political impediment for a proposal that would reduce the deficit by more than $300 billion.
The coverage estimate is a setback for President Donald Trump, who promised that “insurance for everybody” would replace Obamacare, which used government subsidies and an expansion of Medicaid to bring coverage to 20 million people. But Republicans trying to pass the legislation without Democratic support argued that any reduction in the rolls of the insured isn’t as important as what they say will be cheaper coverage.
The CBO, the official scorekeeper of the budgetary effects of proposed legislation, said the GOP proposal would reduce the deficit by $337 billion over 10 years. Trump touted the plan Monday before the CBO score was released.
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Hospital datacenters: Extinct in 5 years?

Prominent healthcare executives are predicting a drastic shift from on-premise IT infrastructure into the cloud. That includes electronic health records, clinical decision support and analytics.
March 13, 2017 09:22 AM
Richard Stroup of Children's Mercy in Kansas City joked that the datacenter of the future will have very few on-site employees. 
Every time Carolinas HealthCare System gets rid of server or storage hardware, someone in the IT department takes out a roll of red tape. They cut off two pieces and lay those down on the floor in the shape of an X, as in: Do not put any new hardware here. 
"I used to be so proud of my datacenter," Carolinas Chief Information and Analytics Officer Craig Richardville said. "Now I just can't wait to get rid of my datacenter." 
Other healthcare executives are of a similar mind. Count Beth Israel Deaconess Medical Center CIO John Halamka, MD, among those. 
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EHR management tops ECRI’s list of patient safety concerns

Mar 14, 2017 10:31am
Two health IT systems—EHR management and clinical decision support systems—are among the top three patient safety concerns facing hospitals in 2017.
Information management within EHRs topped the annual list published by the ECRI Institute, which identified the top ten patient safety concerns through a review of the ECRI’s incident reporting database, member root-cause analyses, a member survey and input from an expert panel.
ECRI’s report urged hospitals to “approach health IT safety holistically” by including IT management professionals and encouraging users to report concerns about EHR usability.
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Apple's ResearchKit generates reliable health data — at least for asthma patients

Good news, since there are so many smartphones

by Angela Chen@chengelaMar 13, 2017, 12:08pm EDT
Health data collected entirely from smartphones can be reliable, research from Mount Sinai Hospital claims. The researchers involved found that Apple’s ResearchKit platform and an app for asthma were fairly accurate when compared to existing patient studies.
Finding and recruiting participants is a big hurdle for medical studies. In recent years, people have started collecting health data from smartphones, which seems sensible given how common smartphones are. But this raises questions about whether data gathered this way can be trusted. Today’s study, published today in the journal Nature Biotechnology, suggests that health care apps may be reliable, at least in regards to asthma. This is good news since smartphone usage is only increasing — there are supposed to be 6 billion smartphones used worldwide by 2020 — and collecting reliable health data from them could be very good for research.
Apple launched ResearchKit, a software medical platform, in 2015. It helps researchers recruit participants for studies; participants can enroll in trials and take surveys or provide other data. Early research partners included big names like the University of Oxford, Stanford Medicine, and the Dana-Farber Cancer Institute. The asthma mobile app from today’s study was one of the five disease-specific apps that Apple launched with the initial release of ResearchKit.
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Artificial intelligence could create smarter EHRs

March 16, 2017
Intermountain Healthcare has approximately 150 protocols built into its electronic health record (EHR) system, alerting clinicians when the patient information they enter indicates certain conditions and then guiding them through further examinations and potential treatments.
A 12-member team of doctors, nurses and analytics experts takes upwards of a year to analyze data and build each protocol, said Marc Probst, the chief information officer at the not-for-profit health system based in Salt Lake City.
Recently, though, Intermountain teamed with a company that uses artificial intelligence (AI) to do the same work. But AI works faster and more thoroughly, taking just 10 days to develop a protocol that included additional data points not previously identified, Probst said.
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Genomics, patient generated health data to be top information sources in five years, survey finds

The lack of adequate EHR interoperability continues to hinder healthcare organizations ability to use patient data in care delivery, the report’s author said.
March 13, 2017 09:42 AM
The importance of genomic and patient-generated data will increase dramatically in the next five years as healthcare managers gain control of Big Data to develop precision medicine.
Forty percent of respondents to a new survey, in fact, said genomic data will become one of the most useful data sources in five years, up from just 17 percent today. And forty percent said patient-generated data will be a top source of data in five years, opposed to 30 percent listed it as a top source today.
“The landscape is shifting from one of despair over the unfulfilled promises of big data to a more realistic vision of what sophisticated analytics can do to transform care delivery,” wrote Amy Compton-Phillips MD, chief clinical officer for Providence St. Joseph Health, who authored the report for NEJM Catalyst
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State Opioid Database Links with EHR in Pilot Program

Alexandra Wilson Pecci, March 14, 2017

In an effort to encourage physicians to use the databases, a pilot program has linked the Colorado Prescription Drug Monitoring Program with the University of Colorado Hospital's EHR/EMR.

Despite the growing number of online prescription drug databases that aim to counter the misuse of opioids and other controlled substances, many physicians don't use them.
In an effort to encourage physicians to use the databases, a pilot program at the University of Colorado Anschutz Medical Campus has linked the Colorado Prescription Drug Monitoring Program (PDMP) with the University of Colorado Hospital's EHR/EMR.
PDMPs are state-run databases to track information related to a patient's controlled substance prescription history and are used to monitor suspected abuse or diversion, according to the CDC.
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Telemedicine OK for ICU Coma Assessment, Researchers Say

Alexandra Wilson Pecci, March 14, 2017

Assessments of coma severity were similar when conducted remotely and in person, Mayo Clinic researchers found.

Telemedicine is a reliable way to assess comatose patients, according to new research. Stroke assessments via telemedicine have been studied before, but research conducted at the Mayo Clinic Hospital in Arizona and published in Telemedicine and e-Health is the first to look specifically at using telemedicine for patients in a coma.
The study was conducted over a 15-month period and included 100 patients who were randomly assigned two Mayo Clinic physicians, one who conducted their assessments at the bedside and another who assessed patients via a desktop workstation on another floor in the same hospital.
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EXCLUSIVE: 'Scotland as a leader in digital health and care'

Article posted on: March 14, 2017
Author: Dr Pieter van de Graaf, eHealth Clinical Strategy Team Leader, Scottish Government
The above may seem ambitious, but it’s exactly the challenge set earlier this month by Scotland’s Cabinet Secretary for Health and Sport, Shona Robison MSP, at a major conference in Edinburgh. It’s a challenge that the Scottish Government is looking forward to meet in close partnership with colleagues across NHS Scotland, local authorities, Third Sector, academia and industry.
The Digital Health and Care Scotland conference, organised by Holyrood Events, saw around 300 delegates from across health and social care sharing and reflecting on achievements to date, exploring current issues and challenges, and discussing future priorities.
The Cabinet Secretary’s message that, in health and social care, like other aspects of everyday life, digital is no longer an ‘add-on’ was recognised by many delegates. Digital is increasingly central to everything we do and every decision we make, whether as a clinician, a carer or a patient.
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ECRI's top 10 patient safety dangers for 2017

Mar 14, 2017 12:17pm
Providers should be aware of these 10 patient safety dangers in 2017.
ECRI Institute has identified its 10 greatest patient safety dangers for 2017. Among them: antibiotic stewardship and identification errors.
The list is compiled each year to help providers identify areas for improvement and innovation. The ECRI report also includes strategies that hospitals and other providers can use to address these concerns in their own facilities.
"The 10 patient safety concerns listed in our report are very real," Catherine Pusey, R.N., the associate director of ECRI Institute’s patient safety organization said in announcement. "They are causing harm—often serious harm—to real people."
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Poll: Where readers stand on artificial intelligence, cloud computing and population health

Healthcare IT News conducted a post-HIMSS17 survey to gauge real implementations of the conference’s big buzzwords. Respondents also revealed their favorite part of this year’s conference.
March 10, 2017 01:53 PM
The showroom floor came in tops as favorite part of HIMSS17.
When IBM CEO Ginni Rometty delivered the opening keynote at HIMSS17 she effectively set the stage for artificial intelligence, cognitive computing and machine learning to be prevalent themes throughout the rest of the conference.
Other top trends buzzed about in Orlando: cloud computing and population health.
Healthcare IT News asked our readers where they stand in terms of these initiatives. And we threw in a bonus question to figure out what their favorite part of HIMSS17 was.
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Safety huddles offer a pathway to address EHR failures

Mar 13, 2017 11:49am
Daily safety huddles offer an opportunity to address EHR patient safety concerns.
A group of Texas informatics researchers are urging hospitals to utilize daily safety huddles to identify EHR shortcomings that impact patient care.
Widely adopted on the clinical side, hospitals and health systems have used daily safety huddles to identify patient safety concerns and discuss medical errors. But a one-year review of patient safety huddles in a midsized tertiary care hospital found those huddles frequently included discussions related to EHRs, according to a study published in the Journal of the American Informatics Association.
Researchers at the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety and Baylor Scott and White Health found that safety huddles spanning 249 days identified 245 EHR-related safety concerns, representing 7% of all safety concerns addressed in the huddles. Two-thirds of the concerns were traced back the EHR system either working incorrectly or not at all.
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Big EHR vendors set their sights on smaller targets

Mar 13, 2017 11:16am
Looking for new customers, electronic health record companies are turning their attention to physician practices and small hospitals.
Electronic health record system vendors are turning their attention to an untapped market: Physician practices and small and rural hospitals.
Those healthcare settings present an opportunity for new sales of EHR systems, according to a report by Healthcare Dive.
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Some docs skeptical of house call apps

Mar 13, 2017 9:52am
Some patients are adopting apps that allow them to summon a doctor for a house call.
Apps that allow patients to summon a doctor for a house call may be the way of the future, but many physicians are skeptical of the trend.
Docs that participate in such programs like that it allows them to get back to the basics of medicine, according to an article from MedPage Today. But some physicians have expressed concerns that certain apps may lead to subpar care, as docs treat conditions they’re not trained to handle.
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42% of providers set to deploy digital transformation projects

Written by Jessica Kim Cohen | March 10, 2017 | Print | Email
Ten percent of providers and payers are currently working on digital transformation projects, but this number is expected to increase throughout 2017, according to an IDC report.
For the report, titled Payer and Provider Investment Plans for Digital Transformation, IDC Health Insights surveyed providers and payers to better understand their investment plans related to clinical communication, connected health, Internet of Things and value-based care.
Here are four things to know.
1. The majority of current digital transformation projects are still in their pilot or research phases.
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Enjoy!
David.