Wednesday, February 10, 2016

Now Here Is An Attempt To Make Us All Obsolete - Exciting Stuff I Reckon?

This popped up a few days ago:

New project aims to 'reverse-engineer' the brain

The goal is to make computers learn the way humans do
Teaching computers to learn the way we do is widely considered an important step toward better artificial intelligence, but it's hard to achieve without a good understanding of how we think. With that premise in mind, a new $US12 million effort launched on Wednesday with aims to "reverse-engineer" the human brain.
Led by Tai Sing Lee, a professor in Carnegie Mellon University's Computer Science Department and the Center for the Neural Basis of Cognition (CNBC), the five-year project seeks to unlock the secrets of neural circuitry and the brain's learning methods. Ultimately, the goal is to improve neural networks, the computational models often used for AI in applications including self-driving cars, automated trading, and facial and speech recognition.
"Today's neural nets use algorithms that were essentially developed in the early 1980s," Lee said. "Powerful as they are, they still aren't nearly as efficient or powerful as those used by the human brain."
A computer might need to be shown thousands of labeled examples in order to learn to recognize an object, for example, while a human would require only a handful.
Trying to figure out why that's so will use a technique called two-photon calcium imaging microscopy. Researchers will record the signaling of tens of thousands of individual neurons in mice as they process visual information.
"By incorporating molecular sensors to monitor neural activity in combination with sophisticated optical methods, it is now possible to simultaneously track the neural dynamics of most, if not all, of the neurons within a brain region," said team member Sandra Kuhlman, assistant professor of biological sciences at Carnegie Mellon and the CNBC.
A massive data set will result, offering a detailed picture of how neurons in one region of the visual cortex behave, she added.
More here:
I guess I won’t see the outcome in my lifetime - but for the first time ever I suspect one of these teams mentioned may actually make some real progress. Time will tell.
David.

This Looks To Be A Very Interesting Step Forward For E-Health In Oz and NZ. It Seems To Be Really Working.

This release appeared a few days ago.
MEDIA RELEASE – FOR IMMEDIATE RELEASE
2 February 2016

HealthLink announces the launch of SmartForms

One of the worst kept secrets in the health IT industry has now been publicly confirmed.  HealthLink’s new SmartForms solution is being implemented across all the major practice management platforms and electronic medical records systems in Australia and New Zealand.  HealthLink already has its eyes firmly on a service launch in British Columbia in the not too distant future. 
HealthLink’s SmartForms solution is currently being rolled out across HealthLink’s 13,500 site network.  Almost all of the major EMR systems across Australia and New Zealand have implemented SmartForms or are in the process of doing so.
·         Best Practice     
·         Cloud Appointments
·         Genie
·         Gensolve
·         Houston Medical
·         IntraHealth (windows and Macintosh)
·         MedTech (Medtech32 and Evolution)
·         Medical Director
·         My Practice
·         Peak Software
SmartForms technology has already been developed and implemented across much of New Zealand’s health system over the past five years.  It is being used for a number of purposes including electronic hospital referrals, specialist and allied health referrals, health insurance forms, as well as pathology and radiology service requesting.  The number of SmartForms being sent each month continues to climb.  In November, General Practices sent 170,000 SmartForms. 
One of HealthLink’s key advantages is a close working relationship with the electronic medical record (EMR) vendor community across Australia and New Zealand.  HealthLink works closely with each of these companies as a neutral party and is therefore able to sort out interoperability issues and problems.  HealthLink also funds some of the EMR vendors’ development activities and works closely with their support teams to develop services collaboratively.”
“We are delighted that Australia and New Zealand’s largest electronic medical records vendors have incorporated SmartForms as a key feature within their latest product releases.”
Key to the steady emergence of SmartForms as a robust and dependable industry solution is the Aduro Interface specification.   Aduro is a standards based framework for exchange of clinical information on a large scale is the objective of the Aduro Alliance which is being set up to promote use of the Aduro specification.  For further information please visit www.aduroalliance.com
----- End Release.
More at http://www.healthlink.net/en_AU/
It is good to know the underlying specs are moving to the FHIR approach - which may well turn out to be a very important way forward in the future.
I look forward to hearing from users about their experiences!
David.

Tuesday, February 09, 2016

It Seems That The Evidence That The PCEHR Is A Dud Is Building. The Waste Continues.

This article appeared last week:

E-health records have few fans, study confirms

1 February 2016
MORE patients than clinicians use My Health Record, and most users – both doctors and patients – are generally negative about the system.
But much of the negativity may be because users don’t understand the system, a new factor analysis of studies shows.
By March 2015, about 9% of all Australians were registered with the My Health Record (MyHR) system, previously known as the PCEHR, with some 5000 GP practices (almost 75% of those eligible) and 11,000 clinicians on board, and 44,000 shared health summaries available.
But the analysis notes that most people viewing the information on the system are consumers, with around 20,000 patient viewings per month.
According to the study, published in the Internal Medicine Journal, the potential reasons for GPs not accessing the system are:
  • Doctors believing they know most of what they need to about their patients.
  • The “clunky” MyHR summary display.
  • The fear of missing important information, placing doctors at risk of litigation.
  • The lack of evidence showing the system helps deliver better patient outcomes.
“These findings suggest that Australian consumer and healthcare providers are generally negative towards the PCEHR [now MyHR],” it says. 
“Participants’ uncertainty appears to stem from not knowing the mechanics of the PCEHR”. 
The analysis found that although most Australians appeared ambivalent or negative about the value of the system, a large minority of 42% seemed positive.
More here:
Here is the abstract.

Positive beliefs and privacy concerns shape the future for the Personally Controlled Electronic Health Record

  1. E. C. Lehnbom1,*,
  2. H. E. Douglas2 and
  3. M. A. B. Makeham2
Article first published online: 27 JAN 2016
DOI: 10.1111/imj.12956

Abstract

The uptake of the Personally Controlled Electronic Health Record (PCEHR) has been slowly building momentum in Australia. The purpose of the PCEHR is to collect clinically important information from multiple healthcare providers to provide a secure electronic record to patients and their authorised healthcare providers that will ultimately enhance the efficiency and effectiveness of healthcare delivery. Reasons for the slow uptake of the PCEHR and future directions to improve its usefulness is discussed later.
Paid access to the rather short article is found here:
(Note: The article was submitted in April 2015 and is actually a re-analysis of a study which was actually published in 2014.
“A more recent study sought to survey the Australian general public’s perceptions of having a PCEHR and found that the perceived value and risk associated with the PCEHR were the two most important variables explaining attitudes.7 This survey used questionnaires borrowed from consumer acceptance of interactive communication technology studies, which were not specifically developed for the PCEHR; therefore, its use in examining the attitudes towards the PCEHR is limited. To establish what constituted the key attitudes towards PCEHR in Australia, we performed a factor analysis on previously published data.9”
Here are the 2 references cited
7. Andrews L, Gajanayake R, Sahama T. The Australian general public’s perceptions of having a personally controlled electronic health record (PCEHR). Int J Med Inform 2014; 83: 889–900.
9. Lehnbom EC, Brien JE, McLachlan AJ. Knowledge and attitudes regarding the personally controlled electronic health record: an Australian national survey. In- tern Med J 2014; 44: 406–9.)
This said, it is hard to argue with the concluding recommendations:
“Future efforts to improve to uptake and usability of the PCEHR should focus on alternative structures to present in- formation to enable healthcare providers to find quickly the information they are looking for; evaluate the impact of PCEHR on healthcare delivery and patient outcomes to provide evidence that having a PCEHR makes a difference and track the awareness and knowledge of consumers and healthcare providers of the PCEHR’s potential  benefits.”
I have a sense hell may freeze over before we see these recommendations actually implemented - time will tell I guess.
I do wonder just why these publication are not available without paid subscriptions. DoH should be making them available!
David.

Senate Estimates - E-Health Hearing Tomorrow Late Afternoon (Feb 10, 2016)

 Here is the listing


 Community Affairs (PDF 80KB)
Health: Wednesday, 10 February 2016        
E-Health Section
4:45pm – 5:55pm
Outcome 7: Health System Capacity and Quality
Program 7.1: e-Health Implementation
Program 7.2: Health Information
Program 7.3: International Policy Engagement
Program 7.4: Research Capacity and Quality

Select Program here to watch

http://www.aph.gov.au/News_and_Events/Watch_Parliament

Enjoy 

David.


Monday, February 08, 2016

Weekly Australian Health IT Links – 9th February, 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

A really quiet week indeed with little happening - other than some new research suggesting the PCEHR needs a great deal more work.
-----

GPs shun new e-health system

1 February, 2016  
More patients than clinicians use My Health Record, and most users – both doctors and patients – are generally negative about the system.
But much of the negativity may be because users don’t understand the system, a new factor analysis of studies shows.
By March 2015, about 9% of all Australians were registered with the My Health Record (MyHR) system, previously known as the PCEHR, with some 5000 GP practices and 11,000 clinicians on board.
-----

E-health records have few fans, study confirms

1 February 2016
MORE patients than clinicians use My Health Record, and most users – both doctors and patients – are generally negative about the system.
But much of the negativity may be because users don’t understand the system, a new factor analysis of studies shows.
By March 2015, about 9% of all Australians were registered with the My Health Record (MyHR) system, previously known as the PCEHR, with some 5000 GP practices (almost 75% of those eligible) and 11,000 clinicians on board, and 44,000 shared health summaries available.
But the analysis notes that most people viewing the information on the system are consumers, with around 20,000 patient viewings per month.
-----

Positive beliefs and privacy concerns shape the future for the Personally Controlled Electronic Health Record

  1. E. C. Lehnbom1,*,
  2. H. E. Douglas2 and
  3. M. A. B. Makeham2
Article first published online: 27 JAN 2016
DOI: 10.1111/imj.12956

Abstract

The uptake of the Personally Controlled Electronic Health Record (PCEHR) has been slowly building momentum in Australia. The purpose of the PCEHR is to collect clinically important information from multiple healthcare providers to provide a secure electronic record to patients and their authorised healthcare providers that will ultimately enhance the efficiency and effectiveness of healthcare delivery. Reasons for the slow uptake of the PCEHR and future directions to improve its usefulness is discussed later.
-----

The Coalition is stuck in ‘Yes Minister’ mode

  • Business Spectator

Robert Gottliebsen

I find it stunning that so many Coalition politicians are advocating an increase to the GST when there is a multitude of government spending areas that could be slashed without any effect on services.
Longer term, as our population ages, we may need to increase the GST to pay for the additional outlays required. But there should be no GST increases while lazy politicians pander to the public service.
The two most obvious areas of substantial expenditure cuts that don’t reduce services are in none other than health and education. These are exactly the areas where higher-GST advocates plan to spend the money.
When the Coalition government campaigned to replace Kevin Rudd back in 2013, one of its linchpin policies was to end the massive sums being wasted in health and education, plus other areas, through Commonwealth-state duplication.
-----

Melbourne Health still grappling with Qbot malware

Virus mutations make it hard to contain.

By Allie Coyne
Feb 2 2016 4:59PM
Melbourne Health is still working to contain a dangerous strain of malware that attacked its systems more than two weeks ago due to the virus' ability to mutate and hide itself from discovery.
On January 18 the health network revealed malicious software had infected Windows XP computers through Royal Melbourne Hospital's pathology department.
The malware downed the hospital's pathology systems and forced staff into manual workarounds.
It made its way into the health department through an unnamed zero-day exploit in Windows XP computers, past the agency's full enterprise antivirus suite.
-----

Malware attacks a Melbourne hospital’s outdated IT system

Australia February 2 2016
Don’t say we (and Microsoft) didn’t warn you, a prominent Melbourne hospital’s IT system that runs on an outdated and unsupported Windows operating system, Microsoft XP, was hacked last week.
Microsoft recently activated the end-of-life phase for Windows 8, 9 and 10 and encouraged users to transition to the company’s supported operating systems in order to prevent security incidents. The same process was undertaken for Microsoft XP in 2014; however the hospital continued to use the platform in some departments.
-----

“Health IT – to lead or be led” seminar & workshop

EHRs – today’s reality…

  • Lack of clinician engagement with eHealth
  • Silos of data
  • Fragmentation of eHealth activities and clinical data
There is increasingly awareness of the need for use of clinical data to support high quality healthcare delivery.  Yet it has traditionally been difficult for clinicians to engage and participate in influencing the quality of the data that they need to support their care of patients, for research and analysis, to underpin clinical decision support and exchange with other healthcare providers.
Momentum is now gathering in Australia and a number of international eHealth programs to change this, using a new clinician-led approach which involves standardisation and sharing of  high quality, computable clinical  data specifications.
-----

Data breach notification: Senate calls for government to explain delays

Senate calls on Attorney-General George Brandis to clarify the government’s intentions
The Senate yesterday backed a motion introduced by Greens Senator Scott Ludlam that called on the government to explain delays in introducing a mandatory data breach notification scheme.
The introduction of a data breach notification regime formed part of the government’s response to the report of the parliamentary inquiry into the data retention.
The report of that inquiry had recommended the creation of such a scheme.
-----

Mandatory reporting of data breaches coming

The Australian Government has proposed that companies with a turnover of $3 million or more must notify people whose personal information may have been exposed in a serious data breach.
The draft bill  is open for submissions until 4 March 2016 but it is understood that it is generally equitable.
LogRhythm, a leader in security intelligence and analytics has joined with IPSec, one of Australia’s leading specialists in information protection to launch IPSecGuard to enable Australian organisations of all sizes to leverage the benefits of a 24/7 fully manned security operations centre (SOC) solution.
-----

Former NAB exec to lead billion-dollar Centrelink IT overhaul

John Murphy to WPIT.

By Paris Cowan
Feb 1 2016 10:00AM
The Department of Human Services has hired a former NAB banking executive to lead its billion-dollar welfare payments infrastructure transformation (WPIT) project.
John Murphy will start work at the department on 22 February, after being appointed to a new deputy secretary-level role created to lead the mammoth replacement of the mainframe-based system currently used to calculate and pay welfare entitlements across the country.
Murphy joins the DHS from the National Australia Bank, where he currently serves as executive general manager of deposits and transaction services, his seventh executive job title with the financial institution, according to his Linkedin profile.
-----

Barwon Health appoints health veteran as CIO

Fills vacancy created by the departure of Ann Larkins.

By Andrew Sadauskas
Feb 1 2016 2:23PM
Victorian state-owned public health operator Barwon Health has promoted Sharon Hakkennes to the role of chief information officer, filling a vacancy left by the departure of Ann Larkins last year.
Hakkennes has worked in the healthcare industry for more than 20 years and has served in numerous roles since joining Barwon Health in March 2014. Her previous roles for the organisation include director of health informatics and information management officer.
Outside of Barwon Health, Hakkennes is a director of the Kids Plus Foundation, an organisation that delivers multi-disciplinary therapy programs for young people with neuro developmental disabilities, and a member of the department’s clinical informatics reference group.
-----

Mobile Health Solutions to use Optus satellite

  • 03 February 2016
New Zealand health care provider Mobile Health Solutions will use Optus Satellite services to deliver health education via videoconferencing.
Mobile Health Services has entered a deal with New Zealand ISP Wireless Nation for satellite-based mobile videoconferencing services. Wireless Nation uses satellite capacity provided by Optus.
Mobile Health will use the link to deliver health education sessions from its van to rural parts of the country.
-----

New section for pharmacists on the NEHTA website

Created on Wednesday, 03 February 2016
NEHTA has published a new section specifically for pharmacists wanting to use eHealth.
Pharmacists can find a range of helpful information on eHealth benefits, how to use the My Health Record system in their pharmacy and how to promote their pharmacy as eHealth capable. We have also provided a list of helpful contacts, frequently asked questions by pharmacists and additional information around policies, procedures, processes, and guides.
For help, call 1300 901 001 or please email the NEHTA Help Centre at help@nehta.gov.au.

Webinar slides now available for 'Connecting your software to the My Health Record system'

Created on Friday, 05 February 2016
The presentation webinar slides for the Connecting your software to the My Health Record system webinar are now available for download.
The webinar took place on Wednesday 3 February 2016 and follows on from the first webinar Introduction to the national My Health Record system and will outline the steps for software developers to connect your system to the My Health Record system. It also covers the resources available to support your implementation.
-----

Telehealth solutions from real world learnings

Delivering and bringing scale to telehealth and telemedicine along with practitioner and user experiences of implementations rather than pilots are among the key themes of this year’s Australian Telehealth Conference (ATC) program, which has just been launched.
Confirmed speakers at ATC 2016 include Associate Professor Francesco Paolucci from Murdoch University who will advise delegates on how to remove barriers and bring scale to telehealth services.
Andrew Slater from Homecare Medical in New Zealand will talk about healthcare professionals and organisations already delivering change while Dr Andrew Lin, the founder and CEO of home health technology developers CliniCloud, is presenting on home medical devices moving telemedicine into the mainstream.
-----

Can Malcolm Turnbull’s pet project fix myGov?

Starts at Sixty Writers
Could Australia’s most frustrating website be saved by the Prime Minster? If so, he will be remembered for doing a great thing for society.
Fairfax media is reporting that management of the myGov website will be taken away from the Department of Human Services and passed over to the Digital Transformation Office.
The DTO is was established  in July 2015 and is part of the Prime Minister’s portfolio. According to the department’s website, its mission is to lead the transformation of government services to deliver a better experience for Australians.
“In any given month, one in eight Australians aged 14 and over will look up government information and services online, totalling around 324 million transactions a year. Of these people, more than half will experience a problem.
Meeting this challenge is vital to our success as a government, and as a nation.”
-----

ACT government defends seeking access to Canberrans' metadata

Date February 1, 2016 - 12:00AM

Tom McIlroy

Legislative Assembly reporter at The Canberra Times

The ACT government has defended its right to seek access to Canberrans' private phone and internet records without a warrant, in moves designed to assist law enforcement and anti-tax evasion efforts.
Among dozens of federal, state and territory agencies which have sought access to citizens' metadata for criminal investigations or protection of government funds are the ACT Revenue Office and the Access Canberra agency, which sits as part of Chief Minister Andrew Barr's Treasury and Economic Development Directorate.
Last month, the federal government issued a list of 61 non-law enforcement agencies that had applied for the right to access metadata. Australia Post, the Australian Taxation Office, the RSPCA, seven federal departments and local councils are included on the list.
-----

New project aims to 'reverse-engineer' the brain

The goal is to make computers learn the way humans do
Teaching computers to learn the way we do is widely considered an important step toward better artificial intelligence, but it's hard to achieve without a good understanding of how we think. With that premise in mind, a new $US12 million effort launched on Wednesday with aims to "reverse-engineer" the human brain.
Led by Tai Sing Lee, a professor in Carnegie Mellon University's Computer Science Department and the Center for the Neural Basis of Cognition (CNBC), the five-year project seeks to unlock the secrets of neural circuitry and the brain's learning methods. Ultimately, the goal is to improve neural networks, the computational models often used for AI in applications including self-driving cars, automated trading, and facial and speech recognition.
"Today's neural nets use algorithms that were essentially developed in the early 1980s," Lee said. "Powerful as they are, they still aren't nearly as efficient or powerful as those used by the human brain."
-----

NBN research: fibre to node satisfies as much as fibre to home

  • The Australian
  • February 5, 2016 12:00AM

Annabel Hepworth

NBN research has found fibre-to-the-node technology as satisfactory as fibre to the home.
Homes with the fibre-to-the-node technology at the heart of the Coalition’s National Broadband Network policy are re­porting the same levels of satisfaction as those with the all-fibre model favoured by Labor, ­research suggests.
The Australian can reveal that initial research finds that both homes getting the NBN over FTTN technology — which uses the century-old copper network for about the last 350m to homes — and those with fibre to the premises are scoring their satisfaction at 7.7 out of 10.
The government-owned company building Australia’s largest infrastructure project will point to the findings today when it delivers its half-year results in Melbourne.
-----

Good riddance to the Java plugin

Date February 3, 2016 - 8:10AM

Brian Krebs

Java is installed on roughly 850 million computers worldwide.
Good news: Oracle says the next major version of its Java software will no longer plug directly into the user's web browser. This long overdue step should cut down dramatically on the number of computers infected with malicious software via opportunistic, so-called "drive-by" download attacks that exploit outdated Java plugins across countless browsers and multiple operating systems.
According to Oracle, some 97 per cent of enterprise computers and a whopping 89 per cent of desktop systems in the US run some form of Java. This has made Java JRE (the form of Java that runs most commonly on end-user systems) a prime target of malware authors.
"Exploit kits," crimeware made to be stitched into the fabric of hacked and malicious sites, lie in wait for visitors who browse the booby-trapped sites. The kits can silently install malicious software on computers of anyone visiting or forcibly redirected to booby-trapped sites without the latest version of the Java plugin installed. In addition, crooks are constantly trying to inject scripts that invoke exploit kits via tainted advertisements submitted to the major ad networks.
-----
Enjoy!
David.

Sunday, February 07, 2016

Article Draft: E-Health in 2016. What Can You Expect For This Year? It Will Be One to Watch!

As this is the first article for 2016 I thought it might be useful to lay out some expectations for the rest of the year ahead in National E-Health.
I think it would be fair to say that 2015 wrapped up quietly with those interested in the e-Health domain expecting a lot of back-room activity to be happening after the passage of new PCEHR (now officially called My Health Record (mHR after Jan 16, 2016) legislation causing waves in 2016.
This legislation, among other things, has enabled the conduct of trials of an ‘opt-out’ approach to your personal information being held in the Government mHR system and has enabled a new Australian Digital Health Agency (previously the ACeH) to replace some Department of Health functions and the National EHealth Transition Authority (which is seen as having lost clinician and technical confidence).
The mHR change was seen as necessary by the Department because, after two years, clinician and consumer interest and use in the PCEHR was very low with less than 10% of the population having a record and very few patients or clinicians actually accessing the record. The change was seen as the last throw of the dice to have the system become relevant and useful. If the change is seen as successful, the legislation authorises extension of the record to the whole population.
At the time of writing we have seen the expected activity begin to  manifest. The present announced plan is that there will be two trials of the ‘opt-out’ consent approach conducted. The first will involve about half a million people in Far North Queensland and the second trial will be conducted in Far Western Sydney and the adjacent Blue Mountains.
What the trials will involve is the creation of a health record for each individual with the record then being populated with data held in the Medical Benefits and PBS systems for the individual concerned.
So far there have been consultations with a variety of different health professionals (GPs, Allied Health etc.) where the Government’s plans have been outlined, as discussed above. It is planned that over the next period there will be an educational program conducted to inform the relevant populations of what is happening and to offer anyone who is concerned to not have their record made accessible - although a record will apparently still be created.
Clearly before any trial can begin it will be necessary for GPs, Allied Health and Hospitals to have access to systems where the records are integrated into their present  systems.
If there is no slippage in the time-table (which seems pretty unlikely) it is intended that the records of those who have not opted out will be made available to the individual, so they can set up the access controls they desire for their mHR and then the system will be made available for access by clinicians - around the end of June 2016.
An evaluation team has been funded ($1.4M) until the end of November 2016, which seems to be an extremely short time to complete an evaluation and report on the trial(s).
There have been no criteria made public as to how success of the trials will be determined and, as it is clear that the Department wants to develop a clinical database for additional research purposes rather than direct patient care and safety, it seems likely the system will just proceed - useful clinically or not. The Government has invested close to a $1.0Billion in the system which has so far failed - and committed an additional $0.4Billionover the next few years - so simply walking away - sadly - seems unlikely.
The new Australian Digital Health Agency is intended to commence operations on July 1, 2016 and is the other major e-Health activity for 2016 that we are presently aware of.
The functions of the Agency - as set out in the enabling regulations, is as follows:
(a) to coordinate, and provide input into, the ongoing development of the National Digital Health Strategy;
(b) to implement those aspects of the National Digital Health Strategy that are directed by the Ministerial Council;
(c) to develop, implement, manage, operate and continuously innovate and improve specifications, standards, systems and services in relation to digital health, consistently with the national digital health work program;
(d) to develop, implement and operate comprehensive and effective clinical governance, using a whole of system approach, to ensure clinical safety in the delivery of the national digital health work program;
(e) to develop, monitor and manage specifications and standards to maximise effective interoperability of public and private sector digital health systems;
(f) to develop and implement compliance approaches in relation to the adoption of agreed specifications and standards relating to digital health;
(g) to liaise and cooperate with overseas and international bodies on matters relating to digital health;
(h) such other functions as are conferred on the Agency by this instrument or by any other law of the Commonwealth;
(i) to do anything incidental to or conducive to the performance of any of the above functions.
Essentially the Agency is to become the Operator of the mHR and the co-ordinator and facilitator of national e-Health initiatives.
As with all entities of this type, the selection of the CEO and Board and the quality of those appointed to the various advisory committees which will cover clinical and technical issues, privacy and security issues, consumer issues and jurisdictional issueswill determine how likely success is. One key concern is all the activity on the opt-out trials etc before the agency responsible even exists. One can’t but wonder how sensible this is.
Left out of this discussion is the very wide range of State and private sector initiatives, some of which seem to me to show very considerable promise. They will have to form the basis of a future article.
All in all, 2016 looks to be a pretty big year in National E-Health. At this point it is impossible to know how things will turn out and if the public will receive value for the money being spent. Nevertheless it will be fun to watch!
-----
Comments welcome!
David.

AusHealthIT Poll Number 306 – Results – 7th February, 2016.

Here are the results of the poll.

Overall, Now It Is Being Wound Up, How Would You Rate NEHTA's Performance Over The Last Decade?

Great 2%

Good 1%

OK 10%

Not Much Good 45%

Pretty Bad 15%

Just Awful 26%

I Have No Idea 1%

Total votes: 92

A really decisive poll. 86% said NEHTA’s performance was Not Much Good or worse. The message is clear - they have been a decade long failure.

Good turnout of votes!

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

David.

Saturday, February 06, 2016

Weekly Overseas Health IT Links - 6th February, 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.
Note: A very sad week with the closure of the iHealthBeat.org website. An invaluable resource for a very long time!
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Do you know where your hard drives are?

Published  January 28 2016, 2:54pm EST
There’s no shortage of memory media at healthcare organizations; maintaining control of their whereabouts is a significant challenge for IT staff.
Even hard drives, which are wired into computing devices, can be hard to track when they’re removed. Centene, a health insurer offering coverage through the Medicaid, Medicare and health insurance exchange markets, recently announced that it could not account for six hard drives after it conducted an inventory of its information technology assets. Those hard drives contained personal health information or other data from about 950,000 individuals.
The company will offer protective services and is reviewing its IT asset management procedures. However, it isn’t alone in the struggle to track IT assets, says Tom Walsh, president and CEO at tw-Security, a healthcare consultancy. “It’s almost impossible to have true accountability of media in an organization,” he notes.
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The doctor will see you now—on your phone

Published January 29 2016, 5:45am EST
TouchCare, a Durham, N.C.-based telehealth company founded in 2013, is striving to make telehealth more intimate.
“Most third-party telehealth services assign patients to random doctors they don’t know,” says Dov Cohn, TouchCare’s senior vice president of products. “We focus on connecting patients with their own doctors and healthcare providers. Our approach builds on existing relationships, trust and access to previous health records. Those things are all shown to improve health outcomes.”
TouchCare offers more than just connectivity to patients; it helps doctors connect with each other, too. Providers to conduct HIPAA-compliant video consults with each other, talking face-to-face privately or sitting alongside a patient to present the case to a specialist anywhere in the world.
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National patient identifier: Exploring the pros and cons

January 29, 2016 | By Katie Dvorak
The debate about creating a national patient identifier is a contentious one--some think it can help protect privacy, others think it won't bring any added benefits to healthcare.
A national patient ID could help alleviate worries patients have about the security of their health information, Douglas Fridsma, M.D., Ph.D., president and CEO of the American Medical Informatics Association, tells STAT.
He adds that the conversation has been too focused on how it will help the American health system, and not Americans themselves.
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How to design a hospital with health IT in mind

January 29, 2016 | By Susan D. Hall
Building a new all-digital hospital in Los Angeles county required creating a vision, selecting technologies that supported that vision and staying laser-focused on the goal, according to an article at Healthcare Dive.
The 131-bed Martin Luther King, Jr. Community Hospital opened last July to serve a population of 1.3 million residents in the area, many of whom were low-income and lacked insurance. Of the $158 million budget provided to build the hospital, nearly half--$70 million--was devoted to IT.
The facility boasts smart beds that track patients' movements, a patient interactive system and phones that allow doctors and nurses to communicate and share patient information on a secure internal network even outside the hospital, according to the article.
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Fear of lost privacy costs lives

  • By Joy Hwang, Peter L. Levin
  • Jan 28, 2016
Avoidable medical errors -- so-called preventable adverse events, or PAEs -- contribute to the deaths of approximately 400,000 Americans each year. That makes PAEs the third leading cause of fatalities in the United States, behind heart disease and cancer. They are responsible for four times as many deaths as the number of people who perish from gun violence, breast cancer and automobile accidents combined.
We think that personal electronic health records, sometimes called PHRs, are an underutilized antidote to this problem; and that a perceived barrier to their adoption is a disproportional fear -- actively and cynically promoted in some circles -- that patients are at great risk of losing their privacy if their records are electronic, interoperable, accessible and shared.
Unfortunately, the discussion about poorly digitized medical practices and their contribution to the demise of nearly half a million lives annually is confined within the walls of hospitals, research institutions and the merchants of electronic medical records. And the first defense of inaction raised is almost always the well-flogged piñata of lost privacy.
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How healthcare systems can become digital-health leaders

The potential of digitization is well understood, yet healthcare systems are struggling to convert ambition into reality. Here’s what we recommend.

January 2016 | byGerardo Aue, Stefan Biesdorf, and Nicolaus Henke
Health systems around the world clearly recognize the potential of digital health: over the past decade, they have invested heavily in national e-health programs. Yet most have delivered only modest returns when measured by higher care quality, greater efficiency, or better patient outcomes. And in some cases, e-health projects have been cancelled due to significant cost overruns and delays, such as the National Program for IT in the United Kingdom’s National Health Service (NHS).1 That’s because such ambitious information-technology initiatives—with a clear focus on IT support for clinical professionals—are typically beyond the core mission of healthcare systems, which also often struggle with legacy systems that impede data integration.
At the same time, the advent of smartphones, cloud computing, and global connectivity has created a universe of consumers accustomed to everything from checking bank balances, making purchases, and watching movies on mobile devices. Increasingly, those consumers wonder why health systems cannot provide similar service innovations. In that respect, digital-health companies would appear to be best positioned: innovation is in their DNA, they have attracted billions of dollars in venture capital, and they have the flexibility to design applications that cater directly to patient groups. Yet digital-health companies have been impeded by a lack of access to health data along with uncertainty about how to distribute the economic benefits generated by smartphone apps.
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Naming the Best in KLAS for HIT software and services

Published January 28 2016, 12:35pm EST
Vendor research firm KLAS Enterprises is out with its annual Best in KLAS awards for health information technology software vendors and service firms. Epic Systems is the top overall vendor for the 6th consecutive year and Impact Advisors is the No.1 IT services firm for the fourth straight year.
KLAS rankings, measuring satisfaction rates, are based on thousands of interviews with hospitals and physician practices during the past year. Health information exchange vendor Medicity scored 20 points higher than it did a year ago, making it the most improved vendor. Vendors with multiple top honors include Epic, Impact Advisors, Merge Healthcare, Athenahealth, CareTech Solutions, CureMD and Galen Healthcare. Here are the Best of KLAS winners:
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New code for open source EHR released

Rebecca McBeth
27 January 2016
IMS Maxims has released the latest version of its open source electronic patient record, including all of the enhancements made for Taunton and Somerset NHS Foundation Trust.
Taunton was the first trust to go live with openMaxims in September last year and has been working closely with the company on developing new functionality, which is now available on the open source website GitHub.
New features of openMaxims 10.5 include; clinical triage of referrals; elective list management; clinical coding; appointment outcomes; and pre-operative assessment for theatres.
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Texas hospital's EHR system suffers ransomware attack

January 27, 2016 | By Marla Durben Hirsch
Mount Pleasant Texas-based Titus Regional Medical Center (TRMC) is the latest victim of a cyberattack of its electronic health record system, with ransomware making it inaccessible, according to an article in The Daily Tribune.
The ransomware virus has encrypted files on several of TRMC's data base services, blocking TRMC's ability to enter or retrieve patient data in EHR. TRMC has implemented a conditional Hospital Incident Command System, and brought in a forensic specialist to deal with the problem. However, there was no indication if or when the virus neutralized. It also was not revealed how much money was demanded in ransom in order to unlock the cyberthief's encryption.
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Despite repeated warnings, pervasive EHR fraud vulnerabilities remain

January 25, 2016 | By Evan Sweeney
The push for healthcare providers to adopt electronic health records (EHRs) has been fueled by promises of improved efficiency and usability, greater accessibility to health information, and in some cases, better patient care.
But the implementation of EHRs has produced mixed results. Despite repeated warnings from government watchdog agencies, vulnerabilities within EHR systems continue to provide a conduit to improper billing and sometimes shockingly brazen fraud schemes.
This is not a new issue. For years, researchers and experts have been pointing to vulnerabilities with EHRs that could contribute to upcoding or facilitate outright fraud. A 2012 report by the Center for Public Integrity found that the rapid implementation of EHRs led to aggressive billing by providers. That same year, a New York Times article revealed similar concerns about a rise in Medicare payments from providers that adopted EHRs.
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CDC: Almost three-fourths of docs using certified EHRs

January 28, 2016 | By Marla Durben Hirsch
The percentage of office-based physicians implementing certified electronic health records climbed to 74.1 percent in 2014, up from 67.5 percent in 2013, according to a new data brief published this week by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).
The data brief, based on the National Electronic Health Records Survey, found that EHR adoption varied widely by state, with 58.8 percent of physicians in Alaska using the systems, but 88.6 percent of those in Minnesota doing so, exceeding the national average. Other states where adoption was greater than the national average included Iowa, North Carolina, Oregon, Vermont and South Dakota.
Primary care physicians were more likely to use the EHRs (72.1 percent in 2013 and 78.6 percent in 2014) compared to specialists, with adoption rates of 63.1 percent in 2013 and 70.3 percent in 2014, respectively.
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Telemedicine market value to rocket to $35B value by 2020

Written by Carrie Pallardy | January 27, 2016
The global telemedicine market was valued at $14 billion in 2014, but as adoption continues to increase, this value is projected to grow at a compound annual growth rate of 14 percent until 2020.
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Major health IT groups to partner on cyber defense

Published January 27 2016, 2:45pm EST
As cyber attacks increasingly buffet the healthcare industry, two prominent organizations are coming together to facilitate the sharing of threat data.
The National Health Information Sharing and Analysis Center has aligned with the Electronic Healthcare Network Accreditation Commission, which certifies healthcare vendors and business associates for meeting best business practices, will harmonize efforts to reduce the growing threat of HIPAA breaches, incidents and cybersecurity attacks.
The agreement was formalized through a memorandum of understanding, says Denise Anderson, president of NH-ISAC. The collaboration is significant, because there’s growing need for healthcare organizations to share threat level data; this information has been ineffectively shared in the past because of competitive pressures and the disjointed nature of the industry. As cyber attacks rise against healthcare organization, it will become increasingly important for threat information to be shared quickly and widely.
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10 trends in cyberattacks in healthcare, other industries, new survey shows

This year the top motivation wasn’t hacktivism or vandalism, but 'criminals demonstrating attack capabilities,' Arbor Networks report claims.
January 27, 2016 04:25 PM
Cyberattacks around the world are growing in size and complexity, according to Arbor Networks 11th Annual Worldwide Infrastructure Security Report, released January 26 by Arbor Networks, the security division of NETSCOUT.
For the first time, nearly half of the respondents were from enterprise, government and educational organizations, with service providers at 52 percent. Healthcare is one of the verticals included in the enterprise category.
The survey garnered 354 responses, up from 287 received last year, from a mix of Tier 1 and Tier 2/3 service providers, hosting, mobile, enterprise and other types of network operators from around the world.
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5 health technologies poised for triple-digit growth in 2016, HIMSS Analytics says

While some are still playing meaningful use catch-up, many other hospitals are charging ahead with new IT buys, with big increases in purchasing plans this year.
January 27, 2016 04:55 PM
Electronic data interchange and in-house transcription are just two of the five emerging health IT applications that will surge in 2016, according to a new report by HIMSS Analytics.
Simply put, there's "tons and tons of activity" forecast for the year ahead as hospitals look to install or upgrade technologies, said Matt Schuchardt, HIMSS Analytics' director of market intelligence solutions sales.
The report examines the tech that will be shaping hospitals' buying plans in 2016, with these five technologies poised for growth of 200 percent or more compared with 2015.
Clinical data warehousing/mining (500 percent more hospitals with plans this year than last year). The huge increase indicates that a critical mass of providers are now moving to the next phase of IT maturity, understanding that electronic medical records are just the basic building blocks for care improvement.
"EMR systems are, at a very base level, sophisticated billing systems," said Schuchardt. "They capture a lot more data and allow you to bill more effectively. But they're just the very beginning of what the big data revolution is going to do to health. Hospitals are starting to realize that: The EMR is not the end of the transformation but the very, very beginning."
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The sharing economy

Joining up healthcare services and integrating with social care is now a major focus for national policy; but the IT architecture and the systems needed to do it are still being developed.
Fiona Barr hears about the growing sophistication of information and record sharing models, and about some of the different systems that are being put through their paces by vanguards and pioneers.
The desire to deliver integrated care has been around for a long time. In 2016, however, the pace of change is accelerating as it becomes a focus for national policy.
And while integrated care is far more than an IT system, record sharing capability is an essential component. Choosing the right model may not be easy, however, when it can sometimes feel as if everybody claims to have the answer – and all the answers are subtly different.
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Digital healthcare: from revolution to evolution

Alex Pelletier
Jan 27, 2016
Galvanized in large in part by the Affordable Care act and payment reform from fee for service to value based payment, provider organizations are reacting and preparing for seismic change. Everyone agrees these changes must happen in order to ‘bend the cost curve’ and provide better outcomes for the cost of care being delivered.
The hope, of course, is that  the churn of patients entering and exiting the system will no longer be profitable to provider organizations. Instead, they will be incentivized to provide the quality care patients demand.
As healthcare costs continue to rise, patients’ wallets are being hit with high deductible insurance plans and rising out of pocket costs. What’s emerging is an active healthcare consumer actively assessing the value and cost of medical care. Quality care will be just one facet that determines value for patients in the value-based era.
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athenahealth joins early adopters of data sharing framework

Jeff Rowe
Jan 26, 2016
Prospects for nationwide interoperability got a big boost last week when five leading health IT organizations announced they will implement the interoperability framework launched in December by the health health information network collaborative known as Carequality.
Under the framework – which consists of legal terms, policy requirements, technical specifications, and governance processes – the new partners have agreed to provide health information exchange services for their customers. The five companies include athenahealth®, eClinicalWorks, Epic, NextGen Healthcare and Surescripts.
"The adoption of the Carequality Framework represents a major leap forward for nationwide interoperability," explained Dave Cassel, director of Carequality, in a statement at the time of the announcement. "By these organizations committing to unified Rules of the Road, they are simplifying system-to-system connections to make data exchange easier for a significant portion of the healthcare ecosystem.”
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Intermountain 's March Probst: Take thoughtful approach to national patient ID

January 27, 2016 | By Susan D. Hall
A national patient ID could improve privacy and security, but if a person is linked to the wrong records, the outcomes could be very serious, Marc Probst, CIO of Intermountain Healthcare, said in an interview at HealthcareInfoSecurity.
The issue led to a congressional ban of creating a national patient ID, said Probst, a member of the Office of the National Coordinator for Health IT's HIT Policy Committee and CHIME board chair. However, the sentiment in changing, he added.
Just the other day, the College of Healthcare Information Management Executives (CHIME) launched a  $1 million challenge to find innovative ways to match patients to their records. In addition, draft legislation in the U.S. Senate's Health, Education, Labor & Pensions (HELP) Committee would require the Government Accountability Office to conduct a study reviewing patient matching methods.
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DARPA Challenges Researchers to Link Human Brains With Computers

By Richard Adhikari
Jan 26, 2016 7:00 AM PT
The United States Defense Advanced Research Projects Agency, or DARPA, last week announced a new program that aims to build a connection between the human brain and the digital world.
To achieve the goals of the Neural Engineering System Design program, DARPA has invited proposals to design, build, demonstrate and validate a human-computer interface that can record from more than 1 million neurons and stimulate more than 100 thousand neurons in the brain in real time.
The interface must perform continuous, simultaneous full-duplex interaction with at least 1,000 neurons -- initially in regions of the human auditory, visual, and somatosensory cortex.
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What’s the real value of EHRs?

Published January 26 2016, 5:31am EST
Adoption of electronic health records since 2009 has been rapid and pervasive in the healthcare industry. Using meaningful use as a barometer, 95 percent of all eligible hospitals and 54 percent of office-based physicians have installed the systems to an extent enough to qualify for incentive funding under the federal EHR Incentive Program.
But there’s mixed opinion on whether those systems have delivered real value. Much depends on the measuring stick that researchers hold against EHRs.
For example, the ability to derive value from the systems has been limited by ease of use issues, contends the American Medical Association. The national professional association for physicians is becoming more vocal in its message that the very incentives intended to drive widespread adoption of EHRs have exacerbated and, in some instances, directly caused usability issues.
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NHS eyes modern tech to help patients stay healthy at home

January 26, 2016 | By Susan D. Hall
Britain's National Health Service has announced pilot projects in seven locations to test how technology can help monitor people with long-term conditions, according to an article in The Telegraph.
Introducing the trials, NHS England Chief Executive Simon Stevens said: "Over the next decade, major health gains won't just come from a few 'miracle cures,' but also from combining diverse breakthroughs in fields such as biosensors, medtech and drug discovery, mobile communications, and AI computing.
"Our new program aims to cut through the hype and test the practical benefits for patients when we bring together some of these most promising technologies."
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AHRQ urged to consider more studies on telehealth's benefits

January 26, 2016 | By Susan D. Hall
HIMSS and the Personal Connected Health Alliance are urging the Agency for Healthcare Research and Quality (AHRQ) to consider conducting additional studies that provide more data on the benefits of telehealth and remote patient monitoring.
In a letter, the two organizations provide comments to an AHRQ technical brief on telemedicine issued in December. That effort, based on 44 systematic reviews and interviews with key stakeholders, determined telehealth interventions produced "positive results," primarily through improved communication, but called for more research on its effectiveness in chronic disease management.
Sens. Bill Nelson (D-Fla.) and John Thune (R-S.D.), in December 2014, had asked AHRQ to review the value of telehealth and remote patient monitoring, particularly for the chronically ill.
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How Public / Private Accelerators are Fostering eHealth Innovation

Scott Mace, for HealthLeaders Media , January 26, 2016

It is no surprise that a growing number of healthcare institutions are seeking partnerships to fund and nourish innovative startups. Massachusetts and New York are at the forefront of fostering such relationships.

Earlier this month, I attended CES 2016 (formerly known as the Consumer Electronics Show) in Las Vegas, walking aisle upon aisle of digital health technology offerings. I do this every couple of years to take the pulse of a consumer phenomenon that continues to attract millions in venture capital funding: mobile health and wellness trackers, sensors, monitors, appliances, and personal medical devices.
I'm mindful that every time I attend, there will be plenty of new startups, but scant clinical evidence to support the worthiness of their efforts, and often not a trace of the promising startups that made the trek to Vegas just two years prior.
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HIT Think A stubborn problem: How to increase patient access to health data

Published January 22 2016, 4:22pm EST
There’s a debate raging in healthcare about whether patients should have control over their own health data. It’s the kind of transformational discussion upon which the future of medicine depends.
Proponents argue that patients must be empowered with information if they are ever to manage their own health and if the industry is to truly realize the Triple Aim of improving patient experience, improving population health and reducing the per capita cost of care.
However, patient-controlled data remains an elusive goal—at least in the current healthcare environment dictated by the information hegemony of providers. As pressures grow on healthcare organizations to optimize care, CIOs and other HIT executives will be involved in data ownership debates within organizations, and then face the challenge of executing each organization’s strategy.
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The key ingredient to cybersecurity: Layers

January 25, 2016 | By Katie Dvorak
As cyberthreats grow, the best way for providers to ensure their systems are as secure as possible is to implement multiple layers of protection.
In addition, according to an article in Health Data Management, those layers of tools must also be backed by systems that can detect hackers before they break into the system.
It's not just enough to have firewalls; providers should also have intrusion detection and prevention inside those firewalls, especially for specific servers, David Reis, vice president of IT governance and security at Lahey Health, Burlington, Massachusetts, tells HDM.
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Market for connected health to hit $117B by 2020

January 4, 2016 | By Judy Mottl
The next four years will bring a seismic shift in connected healthcare technology, with an increased emphasis on chronic condition management, personal fitness and wellness and remote patient monitoring, according to a new report.
What's more, the market is projected to hit $117 billion by 2020 and 86 percent of clinicians believe mobile apps will be central to patient health in that time frame, according to the newly released "State of the App Economy," report from ACT | The App Association.
"Over the next few years, there will be a transition to much more focused products in this space," ACT Executive Director Morgan Reed tells FierceMobileHealthcare in an interview.
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Study: mHealth impact negligible on healthcare costs, patient benefits

January 24, 2016 | By Judy Mottl
A research trial evaluating mobile healthcare technology versus traditional disease management reveals "little evidence" digital medicine intervention reduces healthcare costs or drives greater consumer healthcare interest, though some improvement in health self-management was reported.
The six-month Scripps Translational Science Institute trial provided 160 participants managing hypertension, diabetes and/or cardiac arrhythmia with iPhone-enabled biosensors, blood pressure monitors, blood glucose meters or a mobile ECG device. Participants were provided data aggregation and visualization tools to track and view data via an online dashboard accessible to caregivers. The goal was to ascertain if mHealth utilization impacted healthcare insurance claims.
"Overall we found little in terms of differences in health insurance claims between individuals enrolled in the control and monitoring arm," the Scripps researchers said, noting that they expected a moderate impact--approximately a doubling of insurance claims dollars. "This suggests that while there may be small, short-term increases in healthcare utilization as a result of mobile health monitoring, there is likely not a major effect. "
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Meaningful use declaration mixed among rural healthcare providers, Health Affairs finds

Study finds 38 percent of rural providers skipped at least one year after initial meaningful use achievement, compared to 34 percent of urban counterparts.
January 25, 2016 04:36 PM
While rural providers have adopted health IT at the same time or at greater rates as their urban counterparts, meaningful use varies dramatically among them, according to a recent HealthAffairs study.
About 97.2 percent of rural hospitals with fewer than 100 beds initially achieved meaningful use; a rate consistent with larger hospitals with more than  400 beds, at about 97.4 percent. Critical access hospitals had slightly lower meaningful use achievement rates at about 92 percent.
However, many rural providers failed to continue achieving meaningful use after the initial year, which leads to a greater financial disadvantage.
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Cybersecurity Sector Will See Huge Growth in 2016

By Sephi Shapira Follow | 01/22/16 - 08:51 AM EST
Some big names, including Donald Trump and Ashley Madison, fell victim to cybercrime in 2015, along with hundreds of millions of individuals and organizations. A single attack on insurer Anthem left almost 80 million customers and employees exposed. An attack on The United States Office of Personnel Management resulted in 18 million U.S. citizens' records and 5.6 million sets of fingerprints being stolen.
"Given the ongoing, evolutionary nature of cyber attacks, coupled with the relatively low share of total IT spend security accounts for, we believe industry growth rates will remain stronger than industry forecasts," said the investment bank Columbia Threadneedle Investments. Those rates are 10%-to-15% over the next three to five years, according Columbia Threadneedle, or 8%-to-10%, according to industry analysts at Gartner.
In a $75 billion market, growth rates such as these create immense opportunities for innovative cybersecurity companies, as well as potentially outsized investment returns for those capitalizing on market demand. 
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Targeting EHR Workarounds

by Bonnie Darves, iHealthBeat Contributing Reporter Monday, January 25, 2016
Many in the health IT sector and the health professional community view electronic health records as both a blessing and a curse. EHRs have significantly improved documentation and dissemination of patients' clinical information, streamlined certain tasks and improved safety in areas such as medication management. But EHRs also have made some aspects of health care providers' workload more time consuming than in the "paper" days and sometimes compromise patient safety.
EHRs' negative effect on workflow is a chief reason why clinical users are tempted to devise and use workarounds to simplify or expedite task completion.
Those workarounds, depending on the system and the user, might be harmless in some cases but potentially dangerous in others.
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Enjoy!
David.