Monday, July 25, 2016

Weekly Australian Health IT Links – 25th July, 2016.

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

Finally we seem to have settled who is the Government and who is in that Government. Mr Ley comes back as Health Minister and I am sure will continue on as expected. Whether we see some improvements in the e-Health domain we need to just wait and see!
Other than this there is quite a bit going on so it is worth scanning down the headlines.
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Appointment as Minister for Health, Aged Care & Sport

It is an honour to be reappointed as Minister for Health, Aged Care and Sport.
Page last updated: 19 July 2016
18 July 2016
It is an honour to be reappointed as Minister for Health, Aged Care and Sport.
The Turnbull Government has developed a bold and ambitious health reform agenda needed to deliver a first-class, universal health system and I thank the Prime Minister for the opportunity to continue this important work.
This includes protecting the future of Medicare and ensuring it remains universally accessible to all Australians, as well as tackling the growing burden of chronic disease through our Health Care Homes.
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Terror review to consider giving spy agencies access to mental health records, Malcolm Turnbull says

July 22, 20169:53am

Man under guard after police station attack

PRIME Minister Malcolm Turnbull has confirmed he’s considering giving Australia’s spy agencies access to mental health records to help curb terrorism.
But he claims any such move would be carefully considered, acknowledging it would be a huge change to our mental health privacy system.
Mr Turnbull has asked counter-terrorism co-ordinator Greg Moriarty to conduct a review into what further measures Australia can take to protect itself in the wake of the deadly Nice attack, The Herald Sun has revealed.
Speaking to 3AW today, the Prime Minister said allowing spy agencies, including ASIO, to access mental health records was being looked at.
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Ready or not here comes telehealth

Walid Jammal
Monday, 18 July, 2016
ON a recent visit to the US, it was brought home to me again how technology is transforming medical practice in a way that would have been unimaginable only a few years ago.
Colleagues, professional associations and indemnity providers I spoke to were grappling with the provision of health care via telehealth and the changes that are being embraced by patients.
Imagine being able to communicate directly with patients via a secure patient portal, or electronically writing repeat prescriptions which are transmitted direct to the pharmacist. Imagine also doing a “virtual” home visit, and using a device which can transmit heart and breath sounds, and looking into the patient’s ears and throat using an adaptor attached to a smartphone.
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Telehealth might be great, but you may need a soundproof room

Antony Scholefield | 19 July, 2016
The upgrade of a mental health telehealth system in SA has highlighted the reality of technology in everyday general practice; better tech is great but it may not solve all perceived problems, and may even create a few extra ones along the way.
In 2012, Country Health SA, invested $5 million to upgrade its 15-year-old analog teleconsult service that links rural patients to city-based psychiatrists.
It then asked Flinders University to investigate the benefits of the new Digital Telehealth Network (DTN) system, located in local hospitals that GPs can refer to.
The research, based on interviews and focus groups with more than 40 health worker users, found the upgrade had boosted the quality of teleconsults as it allowed for better video and audio, fewer dropouts and less lag.
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Digital health: Priorities for the new ADHA

VIC
Jul 25
The new Chair for the Australian Digital Health Agency, Jim Birch AM will discuss the operation, governance as well as responsibilities and priorities for the new agency in bringing our health system into the digital century.

Speakers

Jim Birch AM, Chair, Australian Digital Health Agency  
 Trustee only
 25/07/2016
 NAB Boardroom, VIC
 Health/Ageing
 Lunch (12:00pm to 2:00pm)
    Contact us

Event overview

The new Australian Digital Health Agency was formed by the Australian Government to lead and provide direction in developing digital health. The agency formally opened on 1 July 2016 and will replace the National E-Health Transition Authority (NeHTA).
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A suggestion to improve the tracking of stray medicines

19 July 2016

The issue

MANY patients are using medicines for which no prescription has been written within the practice.  
These might include S3, S2 and non-schedule  medicines that the GP advised the patient to use, medicines prescribed or advised outside the practice, and medicines being taken as part of a clinical trial.  
All of these types of medicines should be added to the patient’s list of current medicines to have as complete a record as possible and to facilitate quality use of medicines.  
Patients often stop taking long-term medicines for which no prescription was written.
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Vic Health using Defence algorithm to predict flu outbreaks

By Paris Cowan on Jul 18, 2016 6:43AM

Fresh application for anti-bioterrorism tool.

An analytics tool developed by the Department of Defence's science and technology branch to guard against bioterrorism has found a new home in public health, thanks to a collaboration between its creators and Victoria’s health department.
EpiDefend is an algorithm created by Defence scientist Tony Lau and his team. It uses a ‘particle filtering’ technique of statistical analysis to crunch through historical data on lab-confirmed flu cases, anonymised patient data from GPs, and collections of environmental data records to predict the spread of naturally occuring influenza.
Up until now it has been used to identify organic disease outbreaks in order to differentiate them from more sinister causes, such as maliciously distributed viruses or bioterrorism.
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New National Clinical Terminology Service website

Created on Thursday, 21 July 2016
The new website for the National Clinical Terminology Service (NCTS) is scheduled to launch early August 2016 and will be available at www.healthterminologies.gov.au.
The NCTS, operated by the Australian Digital Health Agency, is responsible for managing, developing and distributing national clinical terminology solutions such as SNOMED CT-AU and the Australian Medicines Terminology (AMT).
The NCTS also provides a range of tools and services to support the digital health requirements of the Australian healthcare community in their adoption, use and maintenance of terminology.
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Reality check - reliable national data from general practice electronic health records

Deeble Institute Issues Brief No. 18
14 July 2016
Since 1998, data about general practice activity in Australia has been collected, analysed and disseminated through the Bettering the Evaluation and Care of Health (BEACH) program. BEACH has provided valuable information about how general practice has changed over time, the impact of policy on practice and general practitioner (GP) professional development, and is the most reliable national source of data on GP activity. However, its cross-sectional design precludes comparison of outcomes of different approaches to care.
It is estimated that 96% of GPs currently use computers for clinical purposes. However, some GPs only use Electronic Health Records (EHR) for part of their clinical work, such as prescribing or ordering pathology tests. Others are paperless and only use EHRs, but even in these circumstances the EHRs themselves lack the structure to reliably link management actions to a patient problem. There are at least eight EHRs used in general practice, each developed independently and structured differently.
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GPs double e-record uploads after PIP changes

18 July, 2016 Tessa Hoffman 
The stick-over-carrot plan to save the MyHealth Record system appears to have resulted in twice as many practices uploading shared health summaries since new e-health PIP incentives were brought in.
In April, a month before practices were required to upload shared health summaries for 0.5% of their full-time equivalent patient workload, 798 practices uploaded almost 11,000 of the documents.
In May, this had almost doubled to 1520 practices uploading some 23,000 summaries.
Dr Chris Pearce, vice-president of the Australasian College of Health Informatics (pictured), said most of these documents would be coming from GPs uploading the summaries for the first time.
Last month, the AMA called for the e-health requirements to be shelved, saying that they were an unfair impost on GPs.
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From wearable technologies to digitised dissection on the internet: so many questions

Editor: Melissa Sweet Author: Deborah Lupton on: July 20, 2016In: digital technology, health and medical education
What are the implications for culturally and linguistically diverse communities of the burgeoning range of activity trackers, smart watches, health apps, and personal heart rate monitors?
These and related questions will be discussed at a seminar and consultation on Thursday, July 28, to be held in Melbourne by the Centre for Culture, Ethnicity and Health, the Research Unit in Public Cultures, School of Culture and Communication at University of Melbourne and the Better Health Channel.
Journalist Marie McInerney will cover the seminar for the Croakey Conference News Service; please join her about 2pm today for a preview via a Periscope interview with Dr Ruth De Souza, the Stream Leader, Research, Policy and Evaluation at the Centre for Culture, Ethnicity & Health.
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My Health Record Statistics – at 17 July 2016

Published 17 July 2016
Over 3.9 million people have a My Health Record, with an average of 1 new record being created every minute
A further 1 million people have had a My Health Record automatically created for them during the participation trials.
Over 4 million prescription and dispense records have been uploaded.
Over 8,800 healthcare providers are connected, including GPs, hospitals, pharmacies, aged care residential services, allied health.
Over 744,000 clinical upload documents.

Dashboard display of My Health Record statistics

This page contains My Health Record statistics to 17 July 2016.
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Media release
Monday, 18 July 2016

Medicare: time for positive reform free of hip pocket pain

The Consumers Health Forum of Australia congratulates the Coalition Government on its re-election and welcomes the re-appointment of Sussan Ley as Minister for Health.  
“We are encouraged by Prime Minister Turnbull’s commitment to Medicare.  But we urge the Government not to shy away from the reasonable reforms needed to ensure Australia’s universal health system is sustainable in the 21st century,” the CEO of the Consumers Health Forum, Leanne Wells said.
“In responding to the “Mediscare” campaign, the Prime Minister has said that consumers will not pay more to see their GPs because of the freeze on Medicare benefits.  He has reaffirmed ‘the faith of the Australian people in our commitment to health and to Medicare’. And a government spokesperson has also said that a GP co-payment will not be put back on the table.
“These are signals the Consumers Health Forum warmly welcomes.
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Researchers more than double the number of identified brain regions with 'HD' scan

July 21 2016 - 10:37AM
·         Amy Ellis Nutt
​Scientists like to say the human brain is the most complex object in the universe — a kilogram and a half of fluid and tissue, about which we understand only a fraction.
That fraction just grew dramatically.

97 new regions of the brain discovered

Researches in the US have released the most detailed map of the human brain.
In a study published online in Nature, a team of researchers more than doubled the number of distinct areas known in the human cortex, from 83 to 180. This new map of the brain combines data from four different imaging technologies to essentially bring high-definition to brain scanning for the first time.
The immediate implications, say those familiar with the results, include the possibility of identifying biological markers for a host of neurological diseases and mental illnesses, and the new knowledge may aid neurosurgeons who need to know exactly what sort of tissue they are operating on.
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No body-worn cameras for Qld paramedics

By Paris Cowan on Jul 19, 2016 11:50AM

Ambulance workers prioritise patient privacy.

Queensland Health has no plans to equip the state’s paramedics with body-worn video cameras despite serious concerns about increasing violence against ambulance workers, health minister Cameron Dick has revealed.
The Ambulance Service’s stance on the technology is in contrast to its colleagues in the Queensland Police, who are in the midst of a force-wide rollout intended to provide cops evidence gathering benefits while also discouraging violence against officers.
In an answer to a question on notice, the health minister said the technology had been investigated by a paramedic safety taskforce formed to come up with practical strategies to reverse an increase in attacks on ambulance workers, but decided against it.
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How the ABS plans to use your Census name data

By Allie Coyne on Jul 22, 2016 6:43AM

Linking datasets for better policy-making, but is it legal?

In just over two weeks, Australia’s citizens will once again pick up their pens to enter their personal details in the country’s national headcount, except this time, things will be a little bit different.
For the 2016 Census on August 9, the Australian Bureau of Statistics has reversed its long-held policy not to use people’s names and addresses for the datasets it produces from the count in the hope it will be able to better inform national policy-making and decisions.
The move was met with concern by privacy advocates after it was quietly announced late last year, with even the ABS’ former statistician Bill McLennan labelling the plan “the most significant invasion of privacy ever perpetrated on Australians by the ABS” [pdf].
But despite the pushback from sections of the community, the ABS is persevering.
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Calls to put specialist fees on public website

Clare Pain | 22 July, 2016 | 
The Federal Government is sitting on masses of Medicare data that would show patients and GPs the out-of-pocket fees charged by specialists.
There are growing calls for specialist fees to be made available on a public website, as some GPs say they are battling to care for patients who cannot find specialists willing to bulk-bill or reduce out-of-pocket costs.
Former secretary of the Department of Health Dr Stephen Duckett (PhD) says it would be a simple matter for Medicare to produce a website that lists individual fees. 
“All that is required is an administrative decision to make that information available,” says Dr Duckett, who is now health program director at the Grattan Institute in Melbourne.
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3 reasons Telstra Corporation Ltd shares could move higher

By Robert Stephens - July 19, 2016 | More on: TLS
Telstra Corporation Ltd’s (ASX: TLS) share price performance in 2016 has been somewhat disappointing. It is up by 2.5%, which is the same amount as the ASX, while other blue-chips such as Suncorp Group Ltd (ASX: SUN) have risen by over 6%. However, I believe that there is better performance ahead for Telstra’s investors for these three key reasons.
Healthcare expansion
Since it launched Telstra Health in 2014, Telstra is no longer a pure play telecoms company. This provides it with greater diversification which in my view could lead to an increase in its intrinsic value as its risk profile and discount rate is lowered.
Further, Telstra is leveraging its existing strengths in connectivity to create new solutions in the healthcare space which I believe could act as a positive catalyst on its earnings and share price. Telstra has quickly gained a foothold in the ehealthcare space thanks to an M&A programme which has included analytics firm Dr Foster, aged care software vendor iCare Health and hospital software vendor Emerging Systems. This ‘buying in’ of growth should mean that Telstra’s investment payback period in ehealthcare is reduced somewhat and that the division has a greater impact on Telstra’s bottom line.
Additionally, those three acquisitions themselves have huge potential in my opinion to benefit from a demographic tailwind. People are living longer and technology is becoming an increasingly important part of all of our lives. Therefore, they and Telstra’s other investments in ehealthcare could produce a favourable growth curve for the company.
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NSW Health renews clinical contract with MedicalDirector

This month, NSW Health extended its current contract with MedicalDirector until 2018 for the Clinical Information Access Portal (CIAP).
CIAP provides evidence-based clinical decision support resources to assist NSW public healthcare practitioners make the right decisions at the point of care. Clinical resources now include UpToDate and a broad range of resources covering clinical areas, including aged care, emergency care, maternity, mental health, oncology, pharmacy, paediatrics, and rehabilitation.
“We are extremely pleased that our partnership with NSW Health and CIAP will continue. Over the past 20 years we have worked with NSW Health to provide the best available clinical information resources via CIAP and we look forward to continuing to provide NSW health practitioners with key resources that can assist them in their profession”, said Ms Allison Hart, MedicalDirector’s Manager of Publishing and Knowledge.
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Meridian IT deploys Lenovo servers for eHealth NSW

By Samira Sarraf
Jul 18 2016 5:30AM
Managed services provider Meridian IT has been selected to provide eHealth NSW with Lenovo servers in a contract worth $847,000.
Meridian IT will deploy Lenovo x3850 X6 rack servers, originally part of IBM's System x range, to the NSW Government Data Centres.
The recently updated NSW Data Centre Reform Strategy, first adopted in December 2013, dictates a consolidation of all NSW government agencies' data centres into the Government Data Centres' two facilities in Silverwater and Wollongong. This plan supports the delivery of as-a-service adopted across the agencies.
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NBN HFC network rollout buys tick of approval from Ovum

NBN Co is standing tall on the rollout of its HFC network, which will ultimately deliver broadband services to more than three million premises across Australia, after commissioning an endorsement of HFC by global analyst firm Ovum.
Ovum’s endorsement of HFC as part of the technology mix — “NBN Co and Australia’s broadband users can have great confidence that as broadband requirements continue to grow, the HFC network will be more than capable of meeting expectations” — is an attempt by NBN Co to answer the constant criticism and concerns about which technologies will deliver not only the best quality services, but also very high speeds.
However, many of NBN Co's detractors are likely to be sceptical of the paid report.
The analyst firm was commissioned by NBN Co to provide it with an overview of global hybrid fibre coaxial (HFC) evolution, the market environment and technology enhancements.
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CIO Explainer: What is Artificial Intelligence?

Wide-scale adoption by business may be approaching, with important implications for how people live and work.

By  Steven Norton
Jul 18, 2016 7:32 pm ET
Artificial intelligence is approximating human reasoning more and more closely all the time. Wide-scale adoption by business may be approaching, with important implications for how people live and work.
AI is paving the way for new business models and raising questions about how people and machines can best work together. Now, thanks in part to cheaper and faster computing power, intelligent machines help doctors comb through troves of medical images to identify diseases early, allow manufacturers to predict when their machines will break (and fix them before that happens), and provide the “brains” behind increasingly autonomous vehicles. It’s also playing a central role in the consumer market, powering the latest virtual assistant, for example, or the engine that matches Airbnb guests with the housing they want.
International Data Corp. predicts the worldwide market for cognitive software platforms and applications, which roughly defines the market for AI, to grow to $16.5 billion in 2019 from $1.6 billion in 2015 with a CAGR of 65.2%. The market includes offerings from both established tech giants and AI startups.
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Nano solution to information overload

  • The Australian
  • 1:00AM July 19, 2016

John Ross

Scientists have fashioned the world’s smallest hard disk, ushering a new era of data storage in which every book ever written could be contained on a gadget the size of a 20-cent piece.
Dutch and Portuguese researchers say their “kilobyte atomic memory”, revealed in the journal Nature Nanotechnology, could solve the storage problems posed by the generation of more than a billion gigabytes of new information every day.
The rewritable device stores the equivalent of a news story in a space one-thousandth the size of a needle tip. Pound for pound, it can hold around 1000 times as much information as current hard disks and flash drives.
“In theory, this storage density would allow all books ever created to be written on a single post stamp,” said team leader Sander Otte of Delft University of Technology in The Netherlands.
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Enjoy!
David.

Magical Thinking And The Search For Relevance - Ms Ley And The myHR.

This appeared today.

Malcolm Turnbull to meet key health bureaucrats

  • The Australian

Sean Parnell

Prime Minister Malcolm Turnbull will today meet with health department officials for the first time since the Coalition’s re-election bid for was almost derailed by Labor’s so-called ‘Mediscare’ campaign.
…..
Ms Ley will also tell a Health Informatics Society conference almost four million Australians have an electronic My Health Record.
“In order to make our Health Care Homes work, we need innovative digital health ideas to help PHNs and primary health professionals to better co-ordinate and manage chronic disease,” Ms Ley will say.
“We need these ideas to link into the My Health Record and we need them to engage with the patient, so they can better self-care.”
The fate of the Medicare payments system — already holding back reform and compliance measures — is unclear, with Labor’s claim it would be privatised or sold prompting Mr Turnbull to rule out outsourcing in favour of an internal upgrade.
Lots more here:
So someone else needs to be very clever and innovative to sort out and make useful the hopeless myHR initiative!
Implication – we are out of ideas so please help us to not waste a fortune!
Great and true admission!
Just astonishing!
David.

Sunday, July 24, 2016

I Am Not Quite Sure This Is The Way I Had Hoped The ADHA Starting. I Hope All This Is Not An Omen.

I spotted this last week:

Digital health: Priorities for the new ADHA

VIC
Jul 25
The new Chair for the Australian Digital Health Agency, Jim Birch AM will discuss the operation, governance as well as responsibilities and priorities for the new agency in bringing our health system into the digital century.

Speakers

Jim Birch AM, Chair, Australian Digital Health Agency  
 Trustee only
 25/07/2016
 NAB Boardroom, VIC
 Health/Ageing
 Lunch (12:00pm to 2:00pm)

Event overview

The new Australian Digital Health Agency was formed by the Australian Government to lead and provide direction in developing digital health. The agency formally opened on 1 July 2016 and will replace the National E-Health Transition Authority (NeHTA).
Chair Jim Birch AM will discuss the operation, governance as well as responsibilities and priorities for the new agency in bringing our health system into the digital century.
This briefing is by invitation only to CEDA Trustees. Trustees are senior leaders nominated by CEDA member organisations. At CEDA boardroom briefings our Trustees hear from an informed, expert guest speaker in a private, small group setting. Invitations to boardroom briefings are a valued benefit of a CEDA membership. The Chatham House Rule applies.

Meet the speaker

Jim Birch AM
Chair, Australian Digital Health Agency
Jim is a former EY Partner in the Government and Public Sector practice having previously been the Global Health Care Leader, the Oceania Government and Public Service Leader and the inaugural Leader of the Health and Human Services Practice for Asia Pacific.
Jim has over thirty five years of experience in planning, leading and implementing change in complex organisations such as Health Care, Justice and Human Services. Jim has been a Chief Executive of a Human Services and Health Department (South Australia), Deputy Chief Executive of Justice and Chief Executive of major health service delivery organisations, including teaching hospitals.
Here is the link:
A few days later we see Mr Birch scheduled to speak for a half hour at the HISA conference in Melbourne on Wednesday 27 July.
9:10 am
Australia’s National Digital Health Strategy
Jim Birch Chair, Australian Digital Health Agency

So we have a briefing for the big end of town on a non-disclosure basis followed by a short session at HISA on the National Digital Health Strategy when there is not any disclosure of the strategy on the ADHA web site.
Without wishing to be too picky, Mr Birch should hardly be talking where the is no disclosure of what was said and hardly talking about Strategy when, as far as I know, none such exists – except the abortive draft produced by DoH which is yet to be repaired and re-released post consultation.
If a new document exists it would be very good to have it see the light of day! Given a new draft has not even been circulated we can all just watch, wait and maybe be surprised – in a less than ideal way.
I wonder how the search for a CEO is going – I have heard a few rumours and now that Ms Ley is back in the saddle this should be soon sorted. Maybe announced at HISA? Again we can watch and wait!
I have always had a hope ADHA would be a totally different beast to NEHTA in terms of consultation and openness. Thus far the signs are not great! I hope this changes…..
David.

AusHealthIT Poll Number 329 – Results – 24th July, 2016.

Here are the results of the poll.

Are The Current Efforts With SNOMED-CT and The Aust. Medicines Terminology (AMT) Actually Making A Positive Difference In Australian Health IT?

Yes 8% (8)

No 62% (63)

I Have No Idea 30% (30)

Total votes: 101

It seems most are pretty unimpressed with the terminology efforts of NEHTA / ADHA so far. We have to hope this will improve!

A great turnout of votes.

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

David.

Saturday, July 23, 2016

Weekly Overseas Health IT Links – 23rd July, 2016.

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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Healthcare industry is among the top users of encryption

Published July 14 2016, 3:06pm EDT
The biggest users of data encryption for security are companies in the healthcare and pharmaceuticals, financial services, and technology and software industries, according to a new report by the Ponemon Institute.
The study, sponsored by security company Thales, is part of an annual survey of more than 5,000 individuals covering 14 industry sectors and 11 countries. It focuses on how encryption is being used in conjunction with business applications in order to protect data.
Companies reporting extensive use of encryption rose 7 percentage points from the previous year to a total of 41 percent, the largest increase in the 11-year history of the report. Databases, Internet communications and laptop hard drives consistently top the list of areas where encryption is most frequently used.
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Privacy, security concerns continue to cloud mHealth’s future

Published July 15 2016, 6:48am EDT
Mobile health apps are emerging as disruptive technologies with the potential to shake up the healthcare industry with both benefits and risks for consumers. But mHealth privacy and security safeguards must be addressed immediately.
That’s the consensus of lawmakers and witnesses who appeared at a July 13 hearing of the House Subcommittee on Commerce, Manufacturing, and Trade.
With about 165,000 mHealth apps currently available on the market, the data generated by these apps shows promise in changing patient behaviors, which could improve outcomes.
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Editor's Corner: EHR copy, paste could land you in hot water

Jul 13, 2016 8:50am
We knew this day would come. Those handy electronic health record cut, copy and paste features can cause a provider to be in violation the False Claims Act.  
Louisville, Kentucky-based home healthcare provider MD2U Holding Company and its related entities have agreed to pay $3.3 million plus a percentage of net income to settle allegations that they violated the False Claims Act by taking advantage of the cut, copy and paste function of its EHRs to submit false Medicare bills to the government. Evidently MD2U cut, copied and pasted notes from visits that occurred weeks, months and even years before the current encounter, creating the illusion that clinicians were performing a “significant” amount of work when they really weren’t.
This manipulation was part of the company’s overall scheme to obtain more money than to which it was entitled, including upcoding and billing for medically unnecessary services.
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GAO: Full interoperability of VA, DoD health record systems 'years away'

Jul 14, 2016 11:43am
The Department of Veterans Affairs' approach to addressing its electronic health record needs is “uncertain” and full interoperability with the Department of Defense is “years away,” according to a new Government Accountability Office (GAO) report.
In testimony before a Senate subcommittee this week, Valerie Melvin, the GAO’s director of information management and technology resources issues, said concerns have been raised about the VA’s efforts regarding its EHR system, VistA. Those include questions about its interoperability goals and measures as well as issues with unnecessary duplication of the Department of Defense’s EHR modernization efforts. The two agencies abandoned their efforts to create a combined EHR system in 2013.
Melvin noted that since the GAO last released a report on its concerns, the VA has developed some plans to modernize the system, including standardizing systems to improve interoperability and creation of a roadmap to be deployed through fiscal year 2018. However, long delays have caused VistA to become outdated, and the modernization program is running into risks and technical issues, she said.

How ‘digitizing you and me’ could revolutionize medicine. At least in theory

Dr. Eric Topol is a big believer in the power of precision medicine.
July 15, 2016
There’s a whole lot of hype around precision medicine.
Proponents — up to and including President Barack Obama — predict a revolution that will bring us medical treatments as precisely tailored as a bespoke suit: Drug doses adjusted to your genome. Chemotherapy customized to your tumor’s DNA. Diets adapted perfectly to your risk for diabetes.
To propel research, Obama has proposed spending a $215 million on a Precision Medicine Initiative. The first step: Rally 1 million volunteers (or even more) to give up a slew of intimate details about their health, medical history, diet, lifestyle, genetics — and even the granular details of the bacteria that line their guts.
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FDA touts 3D printing in personalized medicine

By Christine Ayala - 07/14/16 04:22 PM EDT
The FDA touted the potential of 3D-printed medical devices and drugs Thursday, releasing regulatory science research on devices already cleared and approved by the agency. The FDA issued draft guidance on 3D-printed devices in May, which is currently open for comment until Aug. 8.
James Coburn, the principal investigator for the FDA’s Center for Devices and Radiological Health, highlighted the potential for advancements in personalized medicine through 3D printing, also called additive manufacturing.
“With patient-specific devices, there are a lot of areas where people have been thinking about doing this, but it’s been cost prohibitive or technologically prohibitive, and 3D printing has opened up a lot of those doors,” Coburn said.
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National Programme for IT ends, but not for everyone

Ben Heather
11 July 2016
The National Programme for IT has finally come to an end, although the bill for the enormously expensive and controversial project will continue to be paid for years to come.
The deadline to exit NPfIT national contracts in the North, Midlands and East passed on 7 July, marking the end of the final chapter of the £12.7 billion attempt to bring the NHS into the digital age.
Trusts in these regions should have now signed new local contracts but most have opted to simply stick with those services that were deployed under the national contracts with United States-based company CSC.
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Lorenzo: the end of the beginning

The National Programme for IT in the NHS came to an end in the North, Midlands and East last week. Its flagship electronic patient record was Lorenzo. After ten years trying, and millions of pounds of investment, how are recent deployments going, and what legacy will it leave? Ben Heather reports.
Peruse the board papers of Norfolk and Suffolk NHS Foundation Trust and it soon becomes clear that it’s been a rough year on the IT front.
The trust deployed CSC’s Lorenzo as its electronic patient record on 20 May last year. It was hoped the new system would turbocharge Norfolk and Suffolk into the digital age, replacing paper and ageing, clunky software with a slick, adaptive platform. It hasn’t quite worked out that way, at least not yet.
In October last year, the Care Quality Commission warned the trust it needed to get Lorenzo in order, but as recently as June the trust’s board was still being told “performance issues” with the EPR were an “outstanding risk”.
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Jeremy Hunt retains post as health secretary

Lyn Whitfield
14 July 2016
Jeremy Hunt has retained his post as health secretary in the re-shuffle triggered by Theresa May’s appointment as Prime Minister, following the Brexit vote and David Cameron’s departure.
The news is likely to disappoint medics who took to Twitter to celebrate Hunt's departure from Richmond House following false reports that he had been sacked on Thursday morning. 
Staff took to the social media platform to claim there had been cheering in their hospitals when the news filtered through, and to post jokes about how he would now be able to enjoy his weekends.
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How telehealth is shaping the future of healthcare

Jul 14, 2016 11:35am
Telehealth has the potential to greatly expand the reach of medicine, not only in remote areas around the globe, but also for various socio-economic groups, according to an article in The New England Journal of Medicine.
Technology has the potential to disrupt established patterns of care and address ongoing concerns about the distribution of providers, according to the authors, E. Ray Dorsey, M.D., of the University of Rochester Medical Center, and Eric Topol, M.D., with the Scripps Research Institute.
They point to three trends shaping telehealth: a shift in focus from increasing access to convenience and lower costs; expansion beyond addressing acute conditions such as stroke to wider uses including chronic care management; and the movement away from hospitals and clinics to patient homes and mobile devices.
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Electronic hand-hygiene monitoring cuts MRSA rates by nearly half

Jul 14, 2016 11:17am
Electronic monitoring of healthcare workers’ hand-washing habits cuts Methicillin-resistant Staphylococcus aureus (MRSA) infection rates by 42 percent, according to a study published in the American Journal of Infection Control.
Researchers at Greenville (South Carolina) Health System analyzed hand- hygiene compliance data from an electronic monitoring system in 23 inpatient units between July 2012 and March 2015. They found that under the system, in addition to a 42 percent drop in MRSA infection rates, compliance rates increased by 25.5 percent. Furthermore, the organization saved approximately $434,000 in "avoided care" costs that it would have provided to patients who contracted a hospital-acquired infection because clinicians failed to wash their hands. 
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Google Cardboard saved their baby's life

By Elizabeth Cohen, Senior Medical Correspondent
Updated 1528 GMT (2328 HKT) July 13, 2016
(CNN)In the past six months, Cassidy and Chad Lexcen have been too busy to look at the Google Cardboard images that saved their baby's life.
During that time they had to tend to their daughter, Teegan, who teetered on the brink of life and death at Nicklaus Children's Hospital in Miami, plus they had to fly back and forth to care for their other three children in Chaska, Minnesota.
But CNN recently brought the images of Teegan's heart to the Lexcens, and seeing them for the first time brought on deep emotions -- both happy and sad.
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Why 55% of health IT professionals are constantly stressed: 7 survey findings

Written by Akanksha Jayanthi (Twitter | Google+)  | July 13, 2016
More than half of health IT professionals report being frequently or constantly stressed, and it is taking a toll on their physical and mental wellbeing, finds a new survey from HealthITJobs.com.
The survey gathered responses from nearly 500 health IT professionals in April 2016. Here are seven key findings from the survey.
1. Fifty-five percent of health IT professionals reported being frequently or constantly stressed, 38 percent said their stress is high or extremely high, and 45 percent said their stress occurs on a frequent or constant basis.
2. Key factors correlating with higher frequency of stress include working in management roles, spending more than 11 hours in meetings each week, working more than 51 hours each week, having little control over deadlines, being given an unrealistic amount of work to complete in a certain time and exercising no more than one day per week.
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Mobile Devices Speed and Streamline Pre-hospital Care

Tinker Ready, July 14, 2016

Mobile devices allow telemedicine providers to virtually assess patients, and have the potential to improve stroke care and reduce emergency department traffic.

Smartphones and tablets often come with the promise that advanced technology and more powerful cellular networks will lead to better connections and faster streaming video.
But those promise could mean a lot more in a medical emergency.
Clearer pictures and reliable connectivity are making telemedicine more mobile and more reliable. The result: better tools for pre-hospital providers and the emergency department teams they work with.
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How the NHS got it so wrong with care.data 

Sarah Knapton
7 July 2016 • 12:29pm
In early 2014 the health press were invited for a briefing on the NHS’s new project 'care.data' - a vast database which would include the records of everyone in Britain.
It was a public relations masterpiece. NHS England wheeled out the great and the good of academia as well as the medical directors some of Britain’s biggest charities such as Cancer Research UK and the British Heart Foundation to back the scheme.
The UK’s leading doctors told us how access to so many NHS records would help them understand the causes of disease, quickly spot the side-effects of new drugs and detect outbreaks of infectious diseases.
They showed us a slick advert in which cancer survivor Richard Stephens described how his life had been saved because of big data, and called on Britain to ‘do their bit’ in allowing their medical notes to be shared.
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FBI sees rising cyber threats to healthcare

Published July 13 2016, 7:11am EDT
The Federal Bureau of Investigation sees increasing pressure from hackers trying to access patient information from providers.
Recent events suggest that the pressure may be rising, as offers to sell patient records with protected health information on the “Dark Web” market represent a new level of threat for healthcare organizations trying to protect health information.
In late June, a hacker known as “The Dark Overlord” reported the theft of nearly 10 million patient medical records from providers and a major insurer and put them on the Dark Web market where hackers conduct buy and sell data taken from a variety of sources. As of this writing, the records have not been sold, and the seller may be having trouble selling the treasure trove of protected health information.
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Appropriations says HHS can 'examine' national patient ID

Jul 13, 2016 10:06am
The College of Healthcare Information Management Executives (CHIME) “applauds” the House Appropriations Committee for acknowledging issues surrounding the lack of a unique patient health identifier.
In its Labor, Health and Human Services and Education appropriations report, the committee says it is “aware” that without a national patient data matching strategy, barriers to health information exchange persist. While it will continue to prohibit the use of funds by HHS to adopt any standards for a patient ID, the “limitation does not prohibit HHS from examining the issues around patient matching.”
Unique patient identifiers were required by the 1996 Health Insurance Portability and Accountability Act (HIPAA), but in 2000 Congress prohibited not only the identifier but also any testing of one.
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ONC certifies first open API for Stage 3 meaningful use interoperability requirements

Carefluence OpenAPI proved to be compliant with Office of the National Coordinator criteria by using the FHIR standard. The application programming interface also can used with EHRs for open access.
July 13, 2016 10:40 AM
The Office of the National Coordinator has awarded its first Stage 3 meaningful use certification for interoperability requirements using the FHIR (Fast Healthcare Interoperability Resources) standard to Carefluence, for its open application programming interface platform, the company announced on July 12.
Carefluence OpenAPI is a plug-and-play software platform compliant with the FHIR standard, which provides insights on datasets to support health information exchange across disparate EHR systems. As a result, any EHR vendor will be able to license Carefluence OpenAPI and offer it to customers, with the knowledge it’s compliant with meaningful use.
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Special report: e-observation and vital signs systems

Charting a new future
E-observations are now well established at many trusts; and the quest is on to extend them to new areas. Daloni Carlisle reports.
The image of the nurse with her hand on the patient’s wrist, her eye on the watch dangling from her top pocket, and her other hand reaching for a pen to make a note on a bedside chart is history.
Today’s nurse will be wheeling a small trolley full of the machines that she will need to make observations and frequently will be using a tablet or smartphone to record them. Welcome to the brave new world of e-observations.
Achieving scale
There are now a number of hospitals that have rolled out e-observations at scale. Nottingham University Hospitals NHS Trust has placed more than 4,000 mobile devices in clinicians’ hands, for example.
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Report: Healthcare Analytics Market Expected to Reach $43B by 2024

The global healthcare analytics market is expected to reach $42.8 billion by 2024, according to a new report by Grand View Research, Inc. 
Growth in the healthcare analytics market is largely being driven by:
– providers ability to identify clinically meaningful outcomes in relation to costs through the investigational mining of EMRs to identify inherent medical inaccuracies in the system to provide cost effective patient treatment
– accelerated adoption of big data that enables informed patient decision-making, allowing patients to take better control of their health as well as to receive customized care
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Telemedicine Enables 'Skip the Trip' to the ER Option

HealthLeaders Media News, July 13, 2016

Patients connect with hospital staff via its website, which promises to provide speedy diagnoses for common ailments for a set fee.

St. Vincent's Medical Center in Bridgeport, CT has launched an online diagnosis and treatment service with the hopes that the technology will free up its clinicians. The hospital is promoting the service by telling patients to "skip the trip!" to the ED.
The website connects patients with St. Vincent staff and promises to provide speedy diagnosis and treatment for common ailments, such as colds, conjunctivitis, eczema, and bladder infections.
"With Myvirtualcare.com, patients can skip the trip to the doctor's office and still get the care they need, when and how they need it," Dianne Auger, senior vice president and chief strategy officer for St. Vincent's Medical Center, told local media.

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ONC seeks proposals for using blockchain in healthcare

Published July 12 2016, 6:51am EDT
A federal agency wants to take a closer look at proposals to use blockchain technology in healthcare.
To solicit potential uses for blockchain, the Office of the National Coordinator for Health Information Technology is sponsoring a challenge that’s seeking ideas for the use of the advanced IT technology.
In the challenge, announced last week, ONC is soliciting white papers on the technology and its potential use in health IT “to address privacy, security and scalability challenges of managing electronic health records and resources.”
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Mandatory e-prescribing could solve opioid abuse problem

Jul 12, 2016 11:05am
Most of the conversations around the growing opioid abuse problem in the United States are missing one important element: E-prescribing.
That’s according to Devon Herrik, Ph.D., a senior fellow for the National Center for Policy Analysis, who writes that e-prescribing is a common sense solution that is basically being ignored.
“Mandatory e-prescribing of controlled substances adds electronic checks and balances to an existing system,” he writes.
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OCR’s HIPAA guidance on ransomware puts pressure on providers

Published July 12 2016, 4:24pm EDT
With the healthcare industry increasingly coming under attack from ransomware gambits, the Department of Health and Human Services’ Office for Civil Rights has released new HIPAA guidance on the risks of being victimized by file-encrypting malware.
The OCR’s guidance underscores the serious nature of ransomware and providers’ responsibility in preventing and recovering from such attacks.
“This document describes ransomware attack prevention and recovery from a healthcare sector perspective, including the role the Health Insurance Portability and Accountability Act has in assisting HIPAA covered entities and business associates to prevent and recover from ransomware attacks, and how HIPAA breach notification processes should be managed in response to a ransomware attack,” states OCR.
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HHS Office for Civil Rights releases ransomware guidance

Its advice includes ways to prevent and contain malware threats; OCR officials stress that these viruses are considered security incidents under HIPAA.
July 12, 2016 11:18 AM
"One of the biggest current threats to health information privacy is the serious compromise of the integrity and availability of data caused by malicious cyberattacks on electronic health information systems, such as through ransomware," said OCR Director Jocelyn Samuels.
The U.S. Department of Health and Human Services Office for Civil Rights has released its guidance to help healthcare organizations handle ransomware attacks, including prevention methods, a detailed description of ransomware and advice on how to respond to a ransomware threat.
One important highlight is the reiteration that both malware and ransomware constitute a security incident under HIPAA. Therefore, any affected organizations must initiate security incident response and reporting procedures.
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Behind the Expansion of Home Dialysis, Rigorous Training and Texting

Scott Mace, July 12, 2016

More training and the use of timely communication are helping home dialysis patients overcome some of the workflow problems they face there.

Home-based kidney dialysis remains a relative rarity, with only one in ten U.S. patients able to receive peritoneal dialysis and hemodialysis at home, according to national averages.
But driven by the staggering cost of outpatient dialysis treatments and improvements in home dialysis technology, one chain of dialysis clinics has been able to double that average. And it aims to double it again through an innovative program involving feedback from patients as well as nephrologists and payers.
The costs paid by Medicare tell the tale: While dialysis patients represent less than 1% of the Medicare population, they also represent 6% to 7% of the total cost of Medicare.
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Active market for healthcare records looms as newest cyber threat

Published July 11 2016, 6:31am EDT
Offers to sell patient records with protected health information on the “Dark Web” market represent a new level of threat for healthcare organizations trying to protect health information, offering further monetary inducement to hackers trying to access records.
The addition of a new potential for profiting from hacking could increase the “demand” side of the equation for records, increasing the likelihood of attacks and the need for healthcare organizations to stiffen defenses.
In late June, a hacker known as “The Dark Overlord” reported the theft of nearly 10 million patient medical records from providers and a major insurer and put them on the Dark Web market where hackers conduct buy and sell data taken from a variety of sources. As of this writing, the records have not been sold, and the seller may be having trouble selling the treasure trove of protected health information.
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Buyers Guide to intrusion detection and prevention tools

Amid the evolving cybersecurity threat landscape peppered with hackers, ransomware, nation-states gunning for coveted PHI, hospitals must safeguard against attempts to penetrate their networks. Here's a roundup of the top IDS and IPS tools for doing that.
July 11, 2016 08:07 AM
To help Healthcare IT News readers put up a stronger defense, we created this guide to Intrusion Detection Systems and Intrusion Prevention Systems software with details on the leaders in the field and the products they offer. 
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Rush OB/GYN residents to practice surgical skills using virtual reality

Jul 11, 2016 10:09am
Obstetrics and gynecology residents at Rush University Medical Center in Chicago will begin using a virtual reality system later this summer to practice surgical procedures, reports the Chicago Sun-Times.
The VR system will allow students to practice standard procedures on the uterus, ovaries and fallopian tubes using a joystick or other surgical tool while viewing a virtual patient on a screen.
The students will be able to practice on their own time without supervision and gain confidence in doing the procedures. The VR technology will alow them to practice as many times as it takes to get it right.
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Cybersecurity, telehealth top of mind for 'Most Wired' hospitals

Jul 11, 2016 10:53am
The major healthcare breaches of 2015 and recent ransomware attacks have put cybersecurity at the forefront for 2016's "Most Wired" hospitals.
More than 680 providers, who represent more than 2,146 hospitals, responded to the survey about their IT use. The report is sponsored by the American Hospital Association’s Health Forum and publlished at Hospitals & Health Networks.
In addition to defensive measures, such as intrusion detection systems, and employee education on security risks, 67 percent of the Most Wired hospitals are using pattern detection to prevent automated logins, up from 48 percent in 2013.
Telemedicine is another area these organizations are giving a lot of attention.
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Dr. John Halamka proposes alternate IT certification plan

Written by Akanksha Jayanthi (Twitter | Google+)  | July 08, 2016
In his perfect world, John Halamka, MD, CIO of Boston-based Beth Israel Deaconess Medical Center would reduce or eliminate the 2015 EHR Certification Rule and instead require just five elements for health IT certification.
He wrote in a post on "The Health Care Blog" that the technical requirements of the Medicare Access and CHIP Reauthorization Act are overly restrictive and place a significant burden on developers.
While MACRA intends to provide flexibility for providers by offering them a choice of metrics to meet, it means developers have to design products meeting every single standard. "For vendors, every 'OR' means an 'AND' — developers must implement everything in the rule because some stakeholder will demand every transaction in the regulation," Dr. Halamka wrote. "There was little curation in the rule and most of the HIT Standards Committee recommendations to limit scope were ignored."
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Prescription-drug monitoring saves lives, could save more

(Reuters Health) - State programs that monitor narcotic prescriptions help prevent 10 opioid-overdose deaths a day in the U.S., yet improvements could save another two people a day, a new study finds.
States with the most robust programs - ones that tracked a greater number of potentially addictive medications and updated their databases at least weekly - saw the biggest drops in overdose deaths, the research showed.
Implementing drug monitoring in all states and strengthening weaker programs could prevent another 600 opioid-overdose deaths this year, researchers calculated.
“Prescription drug-monitoring programs are a public health tool to ensure that we’re using opioids appropriately but limiting the negative health impacts we see in almost every community in the United States,” lead author Dr. Stephen W. Patrick said in a phone interview.
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Enjoy!
David.