Monday, February 20, 2017

Weekly Australian Health IT Links – 20th February, 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

An interesting week with the NBN attracting a lot of news for all the wrong reasons and a lot of private sector activity being announced in the e-Health space.
Additionally the Government is really worrying just why so many projects fail! Enjoy the read.
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Big fix to govt's $6 billion tech woes

Noel Towell
Published: February 17, 2017 - 7:59AM
The federal government is to embark on a massive overhaul of its troubled technology effort, putting more than 100 projects, each worth more than $10 million, under the microscope.
The move looks set to be the biggest ever shake-up of Australian government IT, significantly weakening the grip of Canberra mandarins on the $6.2 billion spent on info tech by the Commonwealth each year.
First to feel the blowtorch will be the $1 billion replacement of Centrelink's automated payment system and Defence's new "enterprise resource planning" project, which also comes with a $1 billion price tag.
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DTA’s command and control begins with review of ICT projects

By Harley Dennett

17.02.2017
Government’s ICT failures will never go away entirely but perhaps they can be mitigated with better oversight, central control and provider diversification — at least that’s the hope.
The next step for the Digital Transformation Agency will be to review all major ICT projects as part of its oversight of the $6.2 billion whole-of-government ICT spend.
Assistant Minister for Digital Transformation Angus Taylor announced the review on Friday declaring it will “provide unprecedented visibility and centralised management of IT projects.”
Details are thin. The review will an internal exercise, conducted by DTA’s newly created Digital Investment Management Office headed by Andrew Woolf, the former assistant secretary at the Department of Finance prior to the machinery of government change in October last year.
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Welfare ‘fraud finder’ among ICT projects in $6bn review

  • The Australian
  • 12:00AM February 17, 2017

Sarah Martin

More than $6 billion spent each year on technology projects will be reviewed by the federal government, including the program being developed to recover welfare overpayments from Centrelink recipients.
Assistant Minister for Digital Transformation Angus Taylor will announce today a government review into all ICT projects worth more than $10 million, including several technology projects worth upwards of $1bn.
Among the projects subject to the review is the Welfare Payment Infrastructure Transformation pro­ject, known as WPIT, which is touted as one of the world’s largest social welfare software systems that will eliminate welfare fraud through data matching with the ATO.
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  • Updated Feb 16 2017 at 11:00 PM

NAB, Westpac back medical start-ups to fix health payments

National Australia Bank and Westpac Banking Corp are attacking the $100 billion national health market by separately investing in two medical technology start-ups which are making it easier for patients to book and pay for allied health services and simplifying financial management for doctors.
Through its corporate venture fund NAB Ventures, National Australia Bank has invested in Medipass Solutions, a new company created from the start-up Localz, which will roll out a customer-facing application for booking health services like optical or therapy.
Westpac, meanwhile, has taken an equity stake in Surgical Partners, which has built middleware for GPs and specialist doctors to help them integrate medical services payments with their own accounting systems.
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NAB-backed start-up to streamline visit to the doctor

By Allie Coyne on Feb 17, 2017 6:15AM

Single online process for everything from bookings to rebates.

National Australia Bank has invested in a new health technology start-up that will create a digital platform to connect doctors, health insurers, and payment providers in order to unify the healthcare process.
NAB has joined with Melbourne-based beacon technology start-up Localz to create a new business, funded in part by an undisclosed equity investment from NAB Ventures, called Medipass Solutions.
Localz won NAB's inaugural Labs hackathon in December 2014, giving it the opportunity to work with the bank on new solutions.
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Talking Teeth: time to catch up on oral health data systems and big-data analysis

Editor: Marie McInerney Author: Marc Tennant, Estie Krugeron: February 15, 2017In: dental care, evidence-based issues
The National Oral Health Alliance (NOHA) last week welcomed news from Health Minister Greg Hunt that the two year cap for subsidised services under the Child Dental Benefits Scheme (CDBS) would remain at $1,000, and not be cut to $700 as the Federal Government had proposed after its decision to retain the CDBS after all.
NOHA had lobbied against the proposal, fearing a reduction in the cap would have led families in greatest need having to refuse treatment because they were unable to meet the additional costs. Spokesman Tony McBride had warned significant numbers of children from rural and remote and Aboriginal communities would have been affected.
Meanwhile, Professors Marc Tennant and Estie Kruger say recent research reports are showing how whole-of-country data systems in countries like Sweden and Denmark are improving the oral health of millions of people.
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Care providers to establish secure messaging service

By Technology Decisions Staff
Monday, 13 February, 2017
Tender seeking partners in industry will need to establish an interoperable and secure electronic messaging service, following a request from the Australian Digital Health Agency.
The objective behind this is to improve ‘point to point’ messaging across care providers and the clinical information systems being used in Australia.
“Currently, we are using pen and paper and fax machines to communicate with each other,” said the chair of RACGP’s e-health committee and co-sponsor of the project, Nathan Pinskier.
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13 February, 2017

Caution urged over emergency doc app

 Posted by ruby Prosser Scully
A new app that promises to save patients a trip to, and a long wait in, the emergency department has prompted concern about fragmentation of care.
My Emergency Dr, an app developed by Sydney Royal North Shore Hospital emergency physician Dr Justin Bowra, promises to give “every Australian urgent video access via your smartphone to an emergency specialist, wherever they live and whenever they call”.
According to trial data from the company, six in 10 patients using the app were able to avoid a visit to the hospital after a video consultation with one of their doctors.
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Epworth Healthcare selects Telstra Health patient management system

Epworth HealthCare is to deploy Telstra Health’s Patient Flow Manager platform to improve efficiency in managing bed occupancy and movement at Epworth Hospital in the Melbourne suburb of Richmond.
One of Australia’s largest not-for-profit private healthcare providers with more than 140,000 patient admissions and 90,000 surgeries annually, Epworth Health will utilise the Telstra Health solution to gain greater visibility of key data from multiple hospital IT systems in order to improve patient movement within the hospital.
Epworth Richmond executive director, Nicole Waldron, says that Telstra Health’s solution would help staff to have a complete view of patient flow information in near real-time, enabling them to plan patient movement and flow more efficiently across the organisation.
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Telstra Health provides patient movement system for Epworth Richmond Hospital

Telstra Health's Patient Flow system will allow the hospital to glean near real-time information on bed capacity and patient movement, allowing for more accurate forecasting of demand.
By Corinne Reichert | February 13, 2017 -- 05:49 GMT (16:49 AEDT) | Topic: Telcos
Telstra Health has another win under its belt after being selected by non-profit private healthcare provider Epworth HealthCare to provide its Patient Flow Manager system for Epworth Richmond Hospital in Melbourne.
Telstra's system provides near real-time information on bed occupancy and patient movement throughout the hospital, enabling more efficient planning than via the manual, paper-based system that is still being used.
"The current process for managing bed flow across the sites is manual and relies on a series of meetings and conversations between staff about planned or potential discharges. The flow of information can be time consuming, reactive, subject to individual interpretation and sensitivity," Epworth Richmond executive director Nicole Waldron said.
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Australia finally gets data breach notification laws at third attempt

Twice-stranded laws have finally succeeded in making passage through the Australian Parliament.
By Chris Duckett | February 13, 2017 -- 02:08 GMT (13:08 AEDT) | Topic: Security
At the third time of asking, Australia will have data breach notification laws.
The passage of the Privacy Amendment (Notifiable Data Breaches) Bill 2016 through the Senate on Monday means Australians will in the near future begin to be alerted of their data being inappropriately accessed.
The legislation is restricted to incidents involving personal information, credit card information, credit eligibility, and tax file number information that would put individuals at "real risk of serious harm".
"It is not intended that every data breach be subject to a notification requirement. It would not be appropriate for minor breaches to be notified, because of the administrative burden that may place on entities, the risk of 'notification fatigue' on the part of individuals, and the lack of utility where notification does not facilitate harm mitigation," the explanatory memorandum for the Bill states.
Notification laws would only apply to companies covered by the Privacy Act, and would exempt intelligence agencies, small businesses with turnover of less than AU$3 million annually, and political parties from needing to disclose breaches. E-health providers are still subject to the mandatory data breach notification scheme under the My Health Records Act.
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What does data breach notification mean for you?

By Allie Coyne on Feb 14, 2017 11:06AM

All you need to know for your business.

The Australian senate yesterday passed new laws that will require businesses and government agencies to notify the Privacy Commissioner and customers if they have experienced a data breach.
It brought an end to five years of uncertainty as both sides of politics made attempts to get a mandatory data breach notification scheme up and running.
But what does the Privacy Amendment (Notifiable Data Breaches) Bill 2016 mean for your business, and what constitutes a breach? 
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Australia's privacy regulators are under siege

By Paris Cowan on Feb 15, 2017 6:45AM

[Blog post] Why do our governments fear a well-resourced watchdog?

If Australia’s privacy regulators had a dollar for every time a politician or senior official insisted citizens’ privacy is their number one priority, they might have enough funding to actually carry out their duties.
But instead - in the upside down world of pollie doublespeak - such pledges actually translate into a gradual, persistent, behind-the-scenes undermining of these statutory offices, in what has turned the bulk of Australia’s personal information regulators into agencies under siege.
In Australia, Commonwealth privacy law - which governs all organisations turning over more than $3 million a year, and all federal agencies - is enforced by the Office of the Australian Information Commissioner.
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17 February, 2017

Data penalties ‘may cripple practices’

Posted by Felicity Nelson
General practices will face hefty fines for failing to notify patients of data breaches under legislation that passed both houses of parliament this month.
The Senate passed the Privacy Amendment (Notifiable Data Breaches) Bill 2016 on 13 February.
Under the new law, businesses that handle sensitive information, including all general practices, are required to disclose serious data breaches or face fines of $360,000 for individuals and $1.8 million for organisations.
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Problems with premium payments hit Medibank customers, reveals ombudsman

Esther Han
Published: February 16, 2017 - 2:38PM
Medibank policyholders should check there are no problems with their automatic payment set-ups, with many complaining about incorrect or irregular direct debits.
The latest quarterly bulletin from the Private Health Insurance Ombudsman shows the biggest cause of complaints in the three months to December was problems with premium payments, and Fairfax Media can reveal it largely related to one insurer: Medibank.
"[Premium payment problems] predominantly concerned direct debits from bank accounts and credit cards, such as incorrect debit amounts or irregular debits, or the accidental cessation of direct debit arrangements," the ombudsman said.
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Medibank's troubled IT overhaul is starting to stabilise

By Allie Coyne on Feb 17, 2017 10:45AM

SAP system 'on track' for full operation.

Health insurer Medibank expects to exit "hyper-care" of its new SAP-based core platform in the next few months as it stabilises the system following a difficult implementation.
Medibank has been working to embed its new, single software suite for customer, policy, premium and product management systems with the help of IBM since data migration issues arose last July.
'Project DelPHI' is the final and core component of Medibank's $150 million overhaul of its policy and customer relationship management systems.
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Medibank software deal to keep experts honest on big gap fees

  • The Australian
  • 12:00AM February 17, 2017

Sean Parnell

Australia’s largest health fund will take a harder line on out-of-pocket expenses, signing a deal with a clinical software provider that will allow GPs to identify specialists who leave patients with significant gap fees.
Amid ongoing concern over rising costs, the new arrangement between Medibank and Healthshare will make financial considerations a factor in traditionally sacrosanct conversations between GPs and their patients about referrals.
Medibank chief customer offic­er David Koczkar said the software — accessible by 85 per cent of GPs — would identify specialists who had participated in the insur­er’s “no gap” or “known gap” schemes in the previous 12 months. “We talk to our customers all the time and we know that they have a very high desire to use the schemes so they have certainty over their out-of-pocket costs,” Mr Koczkar said.
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Hospital pharmacy makes changes to reduce readmissions

The Pharmacy Department at Wollongong Hospital has made several key changes following the release of new research

The study, undertaken by researchers from the University of Wollongong, is hoped to improve patient health outcomes following their discharge from hospital.
Dr Carl Mahfouz from UOW’s Graduate Medicine, began working on an 18-month study into how hospital discharge summaries could be improved to better suit the needs of the GPs and the discharge information they require to optimally address the health care needs of their patients.
“I noticed inconsistencies on the discharge summaries of some of my patients, which prompted me to investigate whether this was a common problem,” he says.
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Why keeping a digital health record is important

15th February 2017 7:35 AM
Pilot and farmer, Ian Gillies, has registered with My Health Record.
KEEPING your health records in the digital age is easy, and can be very important should an emergency occur, a spokesperson from the North Coast Primary Health Network said.
Registrations for My Health Record - a digital health record containing important information which can be easily accessed in an emergency - are steadily increasing.
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Lockheed CISO hired to protect Australian health records

By Paris Cowan on Feb 16, 2017 12:30PM

As crunch time nears.

Infosec veteran Anthony Kitzelmann has been lured back into the public sector to head up the Australian Digital Health Authority’s security centre.
The ADHA was formed to operate Australia’s billion-dollar electronic health records scheme, which is due to ramp up dramatically as the government nears a final decision on whether it will set up accounts for citizens by default.
Pilots of opt-out My Health Record have seen an average of just two percent of participants elect not to have a record created for them. A change in approach on a nationwide scale would produce records for the vast bulk of Australians.
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Access you My Health Record on your mobile, android or tablet!

Consumers can now access and view their My Health Record on mobile devices with the soft launch of the Healthi app, the first authorised consumer app to link to the national system since the My Child’s eHealth Record app was released back in 2013.
Healthi does not retain any information from the records, instead storing the information on the device temporarily while it is being viewed and removing it when the app is closed. It has PIN code and encryption key security.
The app includes a summary screen, two searchable document screens, as well as allergies and medications data, including prescriptions and PBS items. It also allows users to access the records of children or other family members who have given authorised or nominated representative consent, with a function allowing easy movement between each family member’s records.
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The Future of Digital Health

Created on Friday, 17 February 2017
On Monday 13 February, more than 1,000 people tuned in to the Australian Digital Health Agency national webcast on the future of digital health.
Facilitated by Ellen Fanning, the webcast marked the final stage of the consultation towards a co-produced National Digital Health Strategy, due for delivery to the Australian Government in mid-2017.
Panellists included:
  • Mr Martin Bowles PSM, Secretary of the Australian Department of Health
  • Professor Brian Schmidt AO, Vice Chancellor of the Australian National University
  • Mr Adrian Turner, Chief Executive Officer of Data61
  • Mr Barry Sandison, Director of the Australian Institute of Health & Welfare (AIHW)
  • Mr Tim Kelsey, Chief Executive Officer of the Australian Digital Health Agency
  • Clinical Professor Meredith Makeham, GP and Chief Medical Adviser of the Australian Digital Health Agency.
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National Digital Health Strategy consultation: Emerging themes on the future of digital health

Created on Tuesday, 14 February 2017
What are we hearing from the Australian community on what makes the ideal health service? What are the key priorities we should focus on?
Over 1,000 people completed our online survey and sent us submissions, along with over 3,000 attended workshops, meetings, town halls, forums, and webcasts to share with us their thoughts on where they see the future of health and care.
Watch the video below to see what the Australian community have been saying!
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Clinical Informatics Unit Announcement: Participation Data Specification Release

Created on Wednesday, 15 February 2017
The Clinical Informatics unit is pleased to announce the latest release of the Australian Digital Health Agency's Participation Data Specification (v3.3).
You can download the full release file bundle from the following location on the Agency website:
The accompanying release note outlines changes in the Participation Data Specification and the triggers for the changes.
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Is NBN Co’s CEO right that Australians aren’t interested in ultra-fast broadband?

February 10, 2017 6.51pm AEDT

Author David Glance Director of UWA Centre for Software Practice, University of Western Australia

Whilst announcing NBN Co’s 2017 half year results, CEO Bill Morrow stated that there was little market demand for faster broadband speeds than the 100 Mbps being currently offered on the NBN.
Morrow made the remarks after being asked when Internet Service Providers (ISPs) would offer internet connection speeds of 1 gigabit per second (1 Gbps).
Morrow replied that there are currently 1.5 million homes that can have 1 Gbps connections and that although a “couple of the retailers have signed up for a trial” of these speeds, nobody as yet has offered the service to consumers. Morrow presumed “it is because there isn’t that big of a demand out there to actually develop a product to sell to those end users”.
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NBN switch will cost users up to 20% more

The NBN is starting to make inroads into the capital cities, with construction in Sydney, the nation­’s biggest consumer market, to begin later this year.
  • The Australian
  • 12:00AM February 13, 2017

Chris Griffith

Supratim Adhikari

Households face a price hike of nearly 20 per cent on internet servic­es, on average, as they are required to sign up to the National Broadband Network when it arrives in their neighbourhood and the ­existing service is switched off.
The NBN is starting to make inroads into the capital cities, with construction in Sydney, the nation­’s biggest consumer market, to begin later this year.
Until now the more than 70 per cent of NBN’s rollout happened in regional and rural areas, but the switch to the metro will gather pace this year, especially if the company rolling out the network, NBN Co, wants to hit its target of having 5.4 million premises ready to receive a service by June 30.
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Morrow admits NBN can’t deliver affordable superfast broadband

NBN Co chief Bill Morrow has admitted that the National Broadband Network cannot deliver an affordably priced superfast broadband product to Australians. However, he claims we don't need it anyway and wouldn't use it even if it was free.
Morrow, in a blog on the NBN Co website, says that NBN cannot deliver 1Gbps broadband at a comparable price to that on offer in Singapore and other countries where 1Gbps superfast broadband costs less than $50 a month.
Morrow says in a blog published today that if NBN Co was in a position to deliver 1Gbps for $49/month, as they do in Singapore, “then we would do it – but we are simply not in that position from an economic point of view.”
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Bill Morrow's 'alternative facts' about the NBN

Australia is unique in many ways but today one more attribute of this country now falls into that class: we are the lone nation to be building a broadband network that cannot give us affordable super-fast connections.
Yes, you heard right. And you can't question the source, for these words come from the chief of NBN Co, Bill Morrow, the man who earns $3.3 million an annum (that's $9041 a day, a little less in leap years) to push the build of the National Broadband Network that has become both a joke and a national shame.
After Morrow suffered from an attack of loose lips and told a crowd at the release of NBN Co's half-yearly results last week that Australians, bunch of chumps that they are, did not want super-fast broadband even if it came gift-wrapped and hand-delivered with no money asked, he must have felt some amount of blowback.
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Google finds networks became ‘highly aggressive’ in competition

  • Mark Bridge
  • The Times
  • 12:00AM February 18, 2017
A Terminator scenario where ­artificial intelligence goes rogue and seeks to destroy its human creators is looking a bit more plausible.
Researchers at Google’s DeepMind, its artificial intelligence division, found neural networks trained to learn from experience and pursue the most efficient strategies became “highly aggressive” in competition. When the networks — computer systems modelled on the human brain — were tasked to collect apples, they co-operated as long as the fruit was plentiful. Once the supply decreased, they turned nasty, blasting their opponents with ­lasers and temporarily putting them out of action.
Joel Leibo, one of the ­researchers, wrote in a blog post: “We let the agents play this game many thousands of times and let them learn how to behave rationally using deep multi-agent reinforcement learning. Rather naturally, when there are enough apples in the environment, the agents learn to peacefully coexist and collect as many apples as they can; however, as the number of apples is reduced, the agents learn it may be better for them to tag the other agent to give themselves time alone to collect the scarce apples.”
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Enjoy!
David.

Sunday, February 19, 2017

I Wonder Will This Review Cover A Very Obvious Target – The myHR?

This appeared a few days ago

Government will review all major ICT projects

Release Date: 
17 February 2017
Media release
The Commonwealth Government will review all significant government technology projects.
Assistant Minister for Digital Transformation Angus Taylor said the review would provide greater transparency and oversight of Government’s $6.2 billion annual ICT spend.
"We need to make sure we’re delivering what the public needs, we’re avoiding duplication, and we have the right processes in place to minimise disruption to public services," Assistant Minister Taylor said.
A new investment management office within the Digital Transformation Agency (DTA) will provide a comprehensive picture of ICT and digital technology investments. Government will be able to see the costs, benefits, risks and status of these initiatives.
"The DTA will ensure we’re investing in the right technology projects, we can track their  implementation, and know they will deliver on the public policy benefits they promise.
"This is more than a review, it’s ongoing oversight, and it will provide unprecedented visibility and centralised management of IT projects."
One of the key capabilities of the expanded DTA will be to target technology assistance to government departments and agencies, and remediate projects.
"We can always do better - better impact for government by doing more with every dollar and better impact for citizens by providing easier-to-use services."
The review will include all non-corporate Commonwealth entities and all active projects over $10 million in value or those that engage a large number of Australians.
The review is expected to report to Government by mid-2017.
There is some additional coverage and background here:

DTA’s command and control begins with review of ICT projects

By Harley Dennett

17.02.2017
Government’s ICT failures will never go away entirely but perhaps they can be mitigated with better oversight, central control and provider diversification — at least that’s the hope.
The next step for the Digital Transformation Agency will be to review all major ICT projects as part of its oversight of the $6.2 billion whole-of-government ICT spend.
Assistant Minister for Digital Transformation Angus Taylor announced the review on Friday declaring it will “provide unprecedented visibility and centralised management of IT projects.”
Details are thin. The review will an internal exercise, conducted by DTA’s newly created Digital Investment Management Office headed by Andrew Woolf, the former assistant secretary at the Department of Finance prior to the machinery of government change in October last year.
The scope is any project valued over $10 million or provides a service affecting a significant number of Australians — so about as broad as it gets. Corporate entities like the NBN and Australia Post will be exempt.
The review will look for inefficiencies, mismanagement and duplication, opportunities through scale, and where skills support is most needed. The findings are likely to be embarrassing to those currently working on the projects, so there is no expectation they will be published when the review reports back to government in mid-2017.
Taylor says the goal is better bang for taxpayer’s buck, better outcomes for suppliers and better outcomes for users, especially Australians using government’s front-end systems.
“This review will give DTA genuine oversight, a view of what’s going on inside each major project in government and also a role in approving future investments and major procurement decisions,” Taylor told The Mandarin.
“DTA’s second role is a service delivery role. It can inject skills into projects … the combination of that oversight and the ability to work closely with agency that need support, is the model that will have the impact.”
Lots more here:
This quote from the release suggest the myHR will be reviewed – as the ADHA is an agency not a corporate I believe.
“The review will include all non-corporate Commonwealth entities and all active projects over $10 million in value or those that engage a large number of Australians.”
However this is a pretty big worry from the Mandarin report.
“The review will look for inefficiencies, mismanagement and duplication, opportunities through scale, and where skills support is most needed. The findings are likely to be embarrassing to those currently working on the projects, so there is no expectation they will be published when the review reports back to government in mid-2017.”
So the findings will be secret. We will obviously have to hope for leaks, whistle-blowers and so on or maybe an FOI request would work!
Of course we also still need the Auditor General to have a look at the whole project.
Dream on David I guess.
David.

AusHealthIT Poll Number 358 – Results – 19th February, 2017.

Here are the results of the poll.

What Do You Think Of The ADHA's Plans For Further Development Of The myHR System?

They Are Great 2% (3)

They Are OK 1% (2)

Neutral 16% (23)

They Are Not Much Good 27% (40)

They Are Hopeless 34% (50)

What Plans? 18% (26)

I Have No Idea 1% (2)

Total votes: 146

While 18% had no idea about the plans those that did were apparently rather less than impressed overall.

A great turnout of votes!

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

David.

Saturday, February 18, 2017

Weekly Overseas Health IT Links – 18th February, 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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Top 5 ways to bring doctors to the EHR optimization table

With barely one-third of physicians saying they're satisfied with their electronic health records, its time their voices were heard.
February 09, 2017 11:14 AM
While some speak optimistically about the "post-EHR era," electronic health records are still very much a going concern – and will be of great interest to many of the 45,000 or so attendees at the 2017 HIMSS Annual Conference & Exhibition later this month.
There will be education sessions on topics ranging from enabling EHR analytics to resolving usability issues that could impact patient safety to better integrating genomics data into clinical workflows. There's even a half-day User Experience Forum at HIMSS17 –  a major theme of which will be the ways UX can be improved for care teams to create a more transparent, intuitive way of care delivery.
Long story short: For all their ubiquity, EHRs still have a lot of improving to do.
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Cleveland Clinic’s IT expansion seen as critical to operations

Published February 10 2017, 6:56am EST
As one of America’s top hospitals, the Cleveland Clinic sees more than 4 million patients annually from all 50 states and 180 countries. The not-for-profit multispecialty academic medical center also has a global footprint that requires the health information technology infrastructure to support it.
Access Anytime Anywhere is the tagline on the healthcare organization’s website. In addition to its locations in northern Ohio, Weston, Fla., and Las Vegas, the health system has a presence in Abu Dhabi and Toronto, and it has started to develop a facility in London.
“We have various operating models in different regions, but ultimately, technology plays an important role in every single one of them,” says Doug Smith, the Cleveland Clinic’s interim chief information officer. “The key is design for scale. We can’t continue to create a new blueprint every time we deploy a hospital. We have this construct where we’re able to grow and deploy this global footprint while allowing for local tweaks and preferences.”
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Scientists use computer to predict outcomes in AML

Study uses the first computer machine-learning model to predict outcomes in acute myelogenous leukemia.
By Amy Wallace   |   Feb. 9, 2017 at 12:19 PM
Feb. 9 (UPI) -- Researchers from Indiana University - Purdue University Indianapolis School of Science have used a computer machine-learning model to accurately predict which patients with acute myelogenous leukemia, or AML, will relapse or go into remission.
"It's pretty straightforward to teach a computer to recognize AML, once you develop a robust algorithm, and in previous work we did it with almost 100 percent accuracy," Murat Dundar, associate professor of computer science in the School of Science at Indiana University - Purdue University Indianapolis and senior author of the study, said in a press release.
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Patient portals boost efficiency, engagement, but getting patients and physicians on board a challenge

Feb 10, 2017 11:49am
Patient portals can increase a practice's efficiency.
Many practices have implemented a patient portal, but a big challenge remains: getting patients and doctors to actually use it.
Practices use portals for a variety of reasons. They can allow patients to schedule visits, pay bills, request prescription refills, check test results and communicate with physicians and staff. That convenience put online portals at the top of a list of patient engagement strategies in a recent survey.
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Tom Price confirmed as HHS secretary, industry reacts

Feb 10, 2017 10:59am
As expected, the Senate voted along party lines this morning and confirmed Rep. Tom Price, R-Ga., as secretary of the Department of Health & Human Services. (http://tomprice.house.gov)
As expected, the Senate voted along party lines this morning to confirm Rep. Tom Price, R-Ga., as secretary of the Department of Health and Human Services.
The vote, 52 to 47, took place at around 2 a.m., after Democrats ran the clock out with 30 hours of debate. The confirmation required only a simple majority to vote for him, so in order to block the nominee, Democrats needed to convince a few Republicans to join them. They didn’t succeed.
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Why practices are struggling to exchange records

Published February 10 2017, 3:42pm EST
Medical record administrators are continuing to have difficulties exchanging patient records with other providers.
Data exchange is particularly difficult when receiving providers are not on the same electronic health record as the sender, according to results of a survey conducted in January by Black Book Research, which found that more than 40 percent of responding administrators admitted to record exchange challenges.
Those mixed results come even though vendors of EHRs are reconfiguring systems to better enable data exchange. The survey also measured how well respondents’ electronic health records vendors are optimizing EHRs, including the use of the emerging FHIR interoperability standard, to better support HIE.
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How 4 key practices can prevent ransomware incidents

Published February 10 2017, 3:57pm EST
You're the CIO of a major healthcare provider. You log in to your computer and see a strange page with a ticking clock and a message that says that your files have been encrypted. You try to open some of your files, but they all appear to be gibberish. And then it hits you: Your hospital has been infected by ransomware.
Ransomware is a form of malware that targets your critical data and systems for extortion. Typically, ransomware encrypts data with a key known only to the attacker until a ransom (usually in a cryptocurrency such as Bitcoin) is paid. After the ransom is paid, the attacker will sometimes provide a decryption key.
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DOD launches new EHR system; House committee wants quarterly updates from the VA

Feb 9, 2017 11:42am
Lawmakers have asked the VA to provider quarterly reports on IT modernization efforts.
After a four-year buildup, the Department of Defense has officially gone live with an upgraded EHR system at an Air Force Base in Washington.
Technical issues forced the Pentagon to push back the rollout of the new system that was expected to launch at Fairchild Air Force Base and Naval Hospital Oak Harbor in December. The new system is now live at Fairchild and running as expected, officials told FCW.
Implementation of the new system was led by Leidos and Cerner, which secured a $4.3 billion contract in June 2015. Even before that contract was awarded, some health IT experts warned that the modernization efforts were “doomed to fail." 
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Wearables And Health: Where Do They Intersect?

02/07/2017 By Brian Thomas
Brian Thomas, VP & CIO, Swope Health Services
In the last entry, we talked about what to watch for in the way of wearable technology this year. Now we’ll discuss how this innovative form of technology can be used to promote a healthier population. We all know that health insurance payers give incentives to providers for healthy patients; to obtain these incentives, providers must gather more data, communicate more effectively with their patients, and get them engaged in managing their own health. Why not use technology to automatically gather this data and send it back to the patient’s medical record? This method ensures accuracy, efficiency, timeliness, and accountability — things that can be sorely lacking in today’s healthcare management system.
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3 emerging technologies that will impact healthcare

Published February 09 2017, 4:34pm EST
If you read my previous article concerning the progress we have made in health information technology adoption and the development of digital health tools, yo. I believe we have made significant progress in many areas, but there are also some places where we have a long way to go.
I am optimistic that if we unleash the creativity of entrepreneurs and innovators, we can solve some big problems society is facing and certainly build a better healthcare system. Things are changing quickly and the policy landscape is shifting under our feet (often feeling like quicksand). There is confusion and sometimes chaos in the uncertain future of federal policy, yet this also creates opportunity for those bold enough to charge ahead.
There are going to be some big changes coming to healthcare, driven by these new policies and a different kind of leadership in Washington, but technology will still play a key role in transforming the healthcare system, creating change on a monumental scale. This massive change will occur because of the exponential growth of information technology, and this will impact all emerging technologies—robotics, automation, 3D printing, quantum computing, virtual and augmented reality, nanotube electronics, sensors, mobile technology, artificial intelligence, machine learning, natural language processing, cloud storage, big data analytics, the Internet of Things, and much more.
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Tapping into the EHR data flow to improve patient care

Elizabeth Meyers, RN, PhD(c), CPHIMS, February 8, 2017
Each time a patient is admitted to the hospital, a tiny message is generated to let every software system know the patient has arrived. Similar messages are sent as the patient is transferred from department to department during their stay, and when they are discharged. Other messages carry lab results, vital signs, and medication orders from system to system. The more technology is employed by a hospital, the larger the interface web becomes. Until, volumes and volumes of data are streaming behind the scenes, making modern patient care possible.
These connections do a great job serving their primary purpose – getting data from one place to another to enable continuity of excellent patient care.  But, what if we could tap into those data feeds in real time?  What things could be improved if this engine suddenly became aware of the meaning of the data flowing through it?
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Interoperability reality check: FHIR, population health and the patient experience

Experts from the Advisory Board weigh in on progress made during the last 12 months, take a look at how widespread health data exchange can enable hospitals to better serve patients and address lingering questions about interoperability. 
February 06, 2017 04:19 PM
The year 2016 was a big one for interoperability — particularly FHIR (Fast Health Interoperability Resources) development and the implications the emerging standard has for EHRs, health information exchange and population health. Even still, hospital CIOs and IT executives face a number of pressing questions.
"The major EHR and interoperability vendors embraced FHIR with enthusiasm, and many are now delivering working technology previews," said Greg Kuhnen, senior director of research at Advisory Board. “That’s remarkable progress for a standard that has no regulatory mandate or direct financial incentive.”
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How hospitals put predictive analytics into action

Feb 7, 2017 4:53pm
Predictive data analytics has a lot of value to providers seeking to better understand trends in their facilities, but applying that information for change may be more complicated.
Predictive analytics can tell healthcare leaders a lot about trends in their facilities, but turning that information into action is a bigger challenge. 
Just over 30% of hospitals have used some type of predictive data analytics for a year or longer, according to an article from Hospitals & Health Networks, and the vast majority of healthcare executives (80%) say they think the technology can improve patient care.
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VA admits past IT failures, turns to commercial solutions

Feb 8, 2017 11:13am
VA officials testified Tuesday that they are in the process of purchasing commercial IT products, shifting from its previous in-house approach.
Officials with the Department of Veterans Affairs repeatedly told lawmakers that the agency is moving on from its failed approach of building in-house IT systems, and is instead seeking commercial, off-the-shelf options to improve scheduling, EHR interoperability, and billing and claims processing.
In a hearing before the House Committee on Veterans’ Affairs on Tuesday, Rob Thomas, acting assistant secretary for information technology and CIO for the Office of Information and Technology at the VA, acknowledged previous failures in the agency’s attempt to modernize IT systems, but noted that it is no longer trying to build systems from the ground up.  
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Feds: Provider-owned devices affected by St. Jude cybersecurity vulnerability

By Adam Rubenfire  | February 7, 2017
Cybersecurity vulnerabilities in a St. Jude Medical cardiovascular device extend to a piece of equipment that is used within healthcare facilities, according to an update from the U.S. Department of Homeland Security.
DHS and the Food and Drug Administration said that hackers could deplete the battery of a St. Jude cardiac device or send inappropriate shocks to a patient by exploiting vulnerabilities in Merlin@home, a device that transmits device data to clinicians. In an update Tuesday, DHS released details on which Merlin models are affected by the vulnerability, including those used by clinicians.
Merlin transmitters used in medical offices have a MerlinOnDemand capability, which allows them to gather data from multiple implants within patients who are being seen by clinicians. These transmitters are deployed across the industry, but represent only 0.1% of all transmitters worldwide, according to the alert.
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Cancer survivors find telehealth services useful, study shows

Written by Anuja Vaidya (Twitter | Google+)  | February 06, 2017 | Print | Email
Researchers from United Kingdom-based University of Surrey found that the majority of cancer survivors report that the use of telehealth is a positive and worthwhile experience.
The researchers examined studies which reported cancer patients' direct views on their experience of telehealth.
Overall, cancer survivors who had used telehealth for meetings and follow-up consultations with their providers appreciated the flexibility and convenience of the program. Additionally, the research shows that telehealth provides a perceived anonymity that reduces cancer survivors' sense of vulnerability and allows them to voice concerns they may not have voiced face-to-face.
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The age of the BIONIC BODY: From robot hands controlled by your mind to electronic eyeballs, experts reveal 6 medical marvels introduced by new technology

  • While bionic limbs once belonged in science fiction, today it is less extraordinary
  • Last week, paralysed former policewoman Nicki Donnelly walked on robotic legs
  • Today, experts reveal six other robotic limbs that may change medicine for ever
When The Six Million Dollar Man first aired in the Seventies, with its badly injured astronaut being rebuilt with machine parts, the TV show seemed a far-fetched fantasy.
But fast-forward 40 years and the idea of a part-man, part-robot doesn't seem so extraordinary after all.
Today, the idea of a part-man, part-robot doesn't seem so extraordinary after all. For example, robotic arms controlled by thought are now being developed in Britain 
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EHRs are everywhere: Now what?

Now that the healthcare industry is essentially digitized, analytics are moving to the fore for population, risk-sharing and value-based care, according to Geneia CTO Fred Rahmanian.
February 06, 201709:16 AM
Since meaningful use incentivized what has become near-ubiquity of electronic health records, hospitals and providers are looking at what they can do on top of the digitized platform.
“The EHR market has commoditized now and the healthcare domain is coming into an era where most other domains, like the financial domain, have been for a long time – understanding risk, identifying and mitigating risk, and finding tools to do so,” said Fred Rahmanian, chief technology officer at Geneia, a vendor of population health, remote patient monitoring and analytics systems. “One reason people will see a lot of activity here is because of the ability to ingest a lot of data and extract insights from that data. Healthcare analytics is front and center now.”
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Wearable device market expected to nearly triple by 2021

Published February 07 2017, 3:33pm EST
The global wearable devices market was valued at more than $2 billion in 2016 and is expected to reach almost $6 billion by 2021, according to a new report from Technavio Research.
In developed regions, including North America and Western Europe, the demand for and shipment of smart wearable devices— smartwatches, wearable bands, wristbands, medical devices and the like—has increased recently, the report said. The decline in the cost of these products is a major driving force behind the adoption of wearable devices, it said.
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E-pills that can monitor patient health in the offing

The device may offer a safer and lower-cost alternative to the traditional batteries now used to power such devices, researchers said.PTI  |  February 07, 2017, 13:34 IST
Boston, Feb 7: MIT scientists have developed a small battery that runs on stomach acids and could power next-generation ingestible electronic pills which may monitor patient health or treat diseases by residing in the gastrointestinal tract for extended periods of time.
The device may offer a safer and lower-cost alternative to the traditional batteries now used to power such devices, researchers said.
"We need to come up with ways to power these ingestible systems for a long time," said Giovanni Traverso, from Massachusetts Institute of Technology's (MIT) in the US.
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Study: Can EMRs streamline care in mental health facilities?

Written by Jessica Kim Cohen | February 06, 2017 | Print | Email
A study in Journal of Medical Internet Research: Medical Informatics investigated whether using an EMR in a mental health facility would lead to quality improvement outcomes.
A tertiary-level mental health facility in Ontario, Canada, implemented an EMR, which included workflow and documentation tools for point-of-care staff. Over two years, the number of restraint incidents decreased 19.7 percent, representing cost savings of more than $1 million.
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Lingering obstacles block the path to interoperability

A host of challenges – technological, financial, even cultural – are stymieing the goal so many stakeholders say they want.
February 06, 2017 01:28 PM
Acknowledgement of the value of interoperability – and the desire to implement it – are seemingly widespread in healthcare. So why is the industry still so short of achieving it? For many reasons – technology, financial or logistical obstacles, a lack of standardization, fear of new procedures, or data gaps in EHR systems – the goal of being able to easily and securely exchange accurate patient data across healthcare providers remains elusive.
Technology isn't enough
Getting a handle on advancing interoperability requires that technical and business process/policy challenges are addressed together, instead of in isolation, so that there's an integration of technology and policy workflows and scaling. "Simply putting the technology in peoples' hands isn't enough," said Steven Posnack, director of the Office of Standards and Technology for the Office of the National Coordinator in the U.S. Department of Health and Human Services.
"There need to be business agreements in place and, in many cases, a business model around exchanging information that impacts the delivery of care." Whatever the intention is – e.g., sending a patient for a referral, requesting information from a patient or sending an electronic prescription -- the training and workflow implementation involved with interoperability technology must make it a more usable and seamless part of the health information technology and patient care delivery infrastructure.
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Top News

A National Academy of Sciences article describes a reusable, inkjet-printable lab-on-a-chip for point-of-care diagnostics that costs just $0.01.
Heading the NIH-funded project is Stanford Genome Technology Center’s Rahim Esfandyarpour, PhD, an engineering associate who says inexpensive diagnostics could improve low survival rates in developing countries of conditions such as breast cancer, malaria, tuberculosis, and HIV.
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Timeline is uncertain for release of normative version of FHIR

Published February 06 2017, 7:10am EST
As the healthcare industry eagerly awaits a normative version of Health Level Seven International’s Fast Healthcare Interoperability Resources data exchange standard, the timeline for realizing a stable version remains murky, with HL7 executives offering different opinions.
Work is continuing to advance FHIR, and it's being used by some large vendors in an increasing number of situations. But many vendors are waiting for HL7 to get farther along in its standard-setting process before investing in the development needed to incorporate FHIR into their products. A significant milestone for any standard is when it reaches a normative version--that is, a mature standard that works in most cases and most industry participants accept as essential to use.
FHIR continues to mature as an open standard for exchanging healthcare data between information systems. According to FHIR Product Director Graham Grieve, STU3 Standard for Trial Use, release 3 (STU3)—the third major milestone for the initiative—is expected to be published in late March.
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Claims that mHealth can save costs may miss the mark

Feb 6, 2017 11:22am
mHealth research doesn't always offer a comprehensive account of the economic impact.
Proponents of mHealth apps often say the tools can help hospitals cut patient treatment costs by streamlining care. But a more detailed look shows there's often inadequate evidence to support those assertions.
Although almost all studies address the economic factors of an mHealth intervention, including cost savings tied to improved outcomes, many of those studies fail to consider a range of factors that could influence the economic impact, according to a study published in PLOS One.
Researchers with the University of Washington and Columbia University reviewed 39 studies spanning several mHealth interventions—including behavioral health and text messaging—and found that most do not account for all of the Consolidated Health Economic Evaluations Reporting Standards (CHEERS) developed by the International Society for Pharmacoeconomics and Outcomes Researcher (ISPOR), which include a broad spectrum of economic factors.
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NIST review confirms copy-and-paste safety concerns

Feb 6, 2017 12:01pm
Copying ad pasting text into EHRs is a safety concern.
New evidence supports fears that a common physician documentation shortcut can jeopardize patient safety. When docs copy and paste template text into a patient's electronic health record. 
Clinicians reported that while copying text from a template and pasting it into a patient's electronic health record streamlined workflow, it also created the potential for inaccurate information and made it difficult to parse out new relevant patient information, according to a report from the National Institute of Standards and Technology (NIST). 
The results of the study aligned with recommendations by the Partnership for Health IT Patient Safety that called on hospitals to make copy-and-paste material easy to differentiate and offer staff training on the appropriate use of the function.
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How Kaiser cut the clinical decision support noise

Published February 06 2017, 12:37pm EST
To improve drug-disease interaction clinical decision support, the Northern California region of Kaiser Permanente worked with content vendor First Databank to develop a scoring tool to indicate if a particular procedure or drug should be used in the treatment of a patient.
The product is the Disease Interaction Scoring Tool, which Jeff Bubp, PhamD, manager of the decision support group at First Databank; and Brian Hoberman, MD, a physician leader at Kaiser, will explain during an education session at HIMSS17.
The idea, Bubp says, was to develop a standard way to evaluate drug disease clinical support to identify the most appropriate disease alerts. For example, with a new drug order for a patient, the electronic health record checks the order against patient problems to decide if the drug is appropriate.
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Why the pressure’s rising for EMRs to make an impact

Published February 06 2017, 2:44pm EST
As the country wonders about the next iteration or obliteration of the Affordable Care Act, the 1996 movie Jerry Maguire starring Tom Cruise and Cuba Gooding, Jr., provides all the information needed to prepare for changes in the healthcare marketplace in 2017. Cruise plays sports agent Jerry Maguire who represents Rod Tidwell, a fictional Arizona Cardinals wide receiver played by Gooding.
In one poignant scene, Rod chastises Jerry in an effort to motivate him to work harder to secure a more valuable contract for Rod’s services to the Cardinals. Through the repetitive mantra “Show me the money, Jerry,” Rod makes it clear to his agent that only the monetary value of the contract matters.
After spending more than $30 billion on incentive payments, many in and outside government wonder what value that investment in electronic medical records (EMR) delivers to patients. Similarly, many hospital boards of directors, provider organization leadership groups and physicians in private practice wonder what type of return on investment they are receiving from implementing these healthcare information technology (HIT) systems.
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Cybercriminals deploy malware for half of successful cyberattacks, IBM study finds

Breaches rose in number last year and continued causing operational, financial and reputational damage to healthcare organizations.
February 02, 2017 09:05 AM
Forty eight percent of successful healthcare cyberattacks result from a criminal gaining access to a system or data by injecting malicious content. Such attacks include injecting unexpected items into a system database or through the host operating system running a website that then tells the system how to act, a new report from IBM Managed Security Services found.
What’s more, 19 percent of successful healthcare cyber-attackers gain unauthorized access through the manipulation of system data structures, according to the new report entitled “Security Trends in the Healthcare Industry.” Here, a hacker leverages vulnerabilities in data processing to alter the execution path of a process and then takes over.
The report also found that 9 percent of healthcare cyber-attackers attempt to manipulate or corrupt the availability or aspect of a resource’s state (i.e. files, applications, libraries, infrastructure, etc.). Successful attacks here enable an attacker to cause a denial of service, as well as execute arbitrary code on a target machine.
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Enjoy!
David.