Saturday, March 24, 2012

Weekly Overseas Health IT Links - 24th March, 2012.

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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Smartphones improve Kenyan disease surveillance

By Mary Mosquera
Created 2012-03-13 09:44
Smartphones show promise in disease surveillance in the developing world because it is faster, cheaper and more accurate than traditional paper survey methods to gather disease information after the initial set–up cost.
Smartphone data was more reliable than paper, according to the findings of the Kenya Ministry of Health and researchers in Kenya for the U.S. Centers for Disease Control and Prevention (CDC).
Survey data collected with smartphones in the study had fewer errors and were more quickly available for analyses than data collected on paper. For example, smartphone data were uploaded into the database within eight hours of collection compared with an average of 24 days for paper-based data to be uploaded, in a study released March 12 by CDC.
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6 keys to developing a BYOD program

By Michelle McNickle, Web Content Producer
Created 03/15/2012
With mobile technology evolving every few months, keeping up with the devices' changing role in the workplace can be tough. Even though their effectiveness is being debated, bring your own device (BYOD) programs are popping up left and right, offering employees the comfort and ease of having their personal mobile devices in the office. 
"Right now in the Xigo universe, we're seeing folks carrying somewhere between three to four devices, on average," said Randy DeLorenzo, chief mobility officer at Dimension Data company Xigo. "They're mobile devices that can be in the form of a smartphone, a wireless modem, an iPad [or] a second smartphone for international travel. And we're definitely seeing the entrance of BYOD on the second, third and fourth screens. ... Particularly in healthcare, security is a huge concern around HIPAA, but they are the most stringent of all our customers – they're very interested in security, digital finger printing, and those types of things."  
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Survey: Most hospitals with EHRs and HIEs plan cloud initiatives

By kterry
Created Mar 16 2012 - 9:55am
Hospitals and healthcare systems are increasingly eyeing the use of cloud-based systems, according to a new survey [1] by Harris Interactive for the Optum Institute. Nearly 60 percent of responding CIOs from organizations that have both an electronic health record (EHR) and a health information exchange (HIE) said they plan to invest in "cloud-based open systems."
Thirty-six percent of these respondents said they planned to use cloud computing for both EHRs and HIEs; 12 percent said they'd use it only to exchange health information; and 11 percent plan to use it only for.
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EHRs Aren't Specialist-Friendly Enough

KLAS survey shows that most electronic health records systems are not tailored to medical or surgical specialties.
By Ken Terry,  InformationWeek
March 15, 2012
Specialists are less satisfied with their electronic health records than primary care doctors are, according to a recent survey by KLAS Research. The survey results underline the difficulties that healthcare organizations encounter in searching for EHRs that meet the needs of all their physicians and that also work well with hospital systems.
KLAS assessed physician satisfaction with the ambulatory-care products of 18 vendors. In a section entitled "Inpatient and large group analysis", it compared the results for Allscripts, Cerner, eClinicalWorks, Epic, GE Healthcare, and NextGen EHRs. These EHRs have a broad coverage of specialties and have either limited or full ability to share data with inpatient systems. AdTech Ad
Across all products, internal medicine and family medicine scored 7.6 and 7.5, respectively, on a scale of 10 in physician satisfaction with EHRs. Pediatrics scored 7.2, ob/gyn 6.8, urology 6.4, and nephrology 6.2. Oncology (5.8) and ophthalmology (5.8) were among the lowest-rated programs.
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Thursday, March 15, 2012

Meaningful Use Stage 2: Raising the Bar With Exchange, Standards, Engagement

On Feb. 23, CMS released the long-awaited notice of proposed rule-making that details Stage 2 of the Electronic Health Record Incentive Program, advancing the next set of criteria that hospitals and health care providers must meet to continue successfully demonstrating meaningful use of EHR systems.
While proposals for the next phase of core and menu set requirements largely mirror the direction set by the Health IT Policy Committee's summer 2011 recommendations, they are, on the whole, more aggressive. This is unsurprising given that everything that is included in the final rule -- due out summer 2012 -- must be initially addressed in the NPRM and vetted in a public comment period.
Stage 1 focused on the adoption and implementation of certified EHR technology and the capture of critical, structured data elements. With Stage 2, CMS aims to advance clinical processes for continuous quality improvement. CMS has retained its basic framework for a core and menu set of measures. While the number of overall objectives does not increase, providers should note that CMS has subsumed a number of Stage 1 measures -- such as the problem list, medication list and medication allergy list -- into other Stage 2 objectives to make room for new requirements.
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Warwick to use iPads for patient records

14 March 2012   Chris Thorne
South Warwickshire NHS Foundation Trust has signed a five-year contract with Kainos to digitise all of its patient records and make them available to staff on iPads.
The trust hopes to give staff mobile access to its systems by the end of the year, using Apple iPad devices. The iPads will give staff the ability to access and update a patient’s record at the point of care during a clinic, or a visit to a patient’s home.
The trust published an ICT strategy for 2011-14 in June last year, which said it wants to create a paper-light environment and improve mobile working, especially among its community staff.
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March 13, 2012

Stepping Up to the Cloud

There has been a lot of publicity lately about the benefits of cloud computing in healthcare, although hospital systems have been taking a cautious approach when it comes to moving certain applications to a cloud platform.
I recently had a conversation about the cloud with Scott MacLean, deputy CIO of Partners HealthCare in Boston. He says Partners has uses the cloud in a limited way: it hosts its revenue cycle management application with a major software vendor, in what he describes as a private, corporate hosting arrangement; and also has certain software as a service (SaaS), with appropriate business associate agreements in place, at the departmental level, he says.
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Kalorama: EMR market hits $17.9B

Written by Jeff Byers
March 14, 2012
Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of EMRs grew 14.2 percent in 2011, according to medical market research company Kalorama Information.
The New York City-based research company found increasing physician and hospital acceptance, robust competition and growth in EMR budgets; factors culminating in a $17.9 billion market in 2011.
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IBM platform to personalize cancer treatments

By danb
Created Mar 15 2012 - 1:35pm
A new decision support tool from IBM has the potential to personalize treatments for patients suffering from cancer, hypertension and AIDS, the company announced [1] this week.
The tool essentially takes patient data and runs it against de-identified data compiled from similar cases to create a treatment plan. It also would provide hospital administrators with a report on aggregated patient care, according to a ZDNet article [2]. Researchers are optimistic that increased efficiency will improve care and lower costs.
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ONC lays out strategy for health information exchange

By kterry
Created Mar 14 2012 - 5:56pm
The Office of the National Coordinator of Health IT (ONC) lays out its 2012 strategy for health information exchange in a new Health Affairs paper [1].
ONC plans to continue to develop the building blocks required for three types of information exchange: directed exchange, which enables providers to send clinical data to each other electronically; query-based exchange, which permits providers to search for data that could help them diagnose and treat a patient; and consumer-mediated exchange, which gives patients access to their own health information.
"Based on the work of Office of the National Coordinator and its many collaborators over the last year," the ONC paper says, "the building blocks required to initiate all three forms of exchange are complete, tested and available today. These standards are already in use by private networks and electronic health records vendors to exchange documents within their own networks."
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The Robots Are Coming to Hospitals

A New Breed of Blue-Collar Robots is Handling the Dirty Work, Transporting Linens and Laundry

By TIMOTHY HAY

In the next few years, thousands of "service robots" are expected to enter the health-care sector, Timothy Hay reports on digits.
Robots have already staked out a place in the health-care world—from surgical droids that can suture a wound better than the human hand to "nanobots" that can swim in the bloodstream.
But the stage is now set for a different kind of robots, one with a sophisticated brain and an unlimited tolerance for menial tasks.
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Beware virtual keyboards in mobile clinical apps

By: Neil Versel | Mar 14, 2012
Don’t look now, but there’s another report raising safety issues about electronic medical records – and this one is focused squarely on mobile devices.
Remember the problems Seattle Children’s Hospital had with trying to run its Cerner EMR, built for full-size PC monitors, on iPads? The hospital tried to use the iPad as a Citrix terminal emulator, so the handful of physicians and nurses involved in the small trial had to do far too much scrolling to make the tablet practical for regular use in this manner.
Well, there may be a greater risk than just inconvenience when tablets and smartphones stand in for desktop computers. According to a report from the Advisory Board Co., “[A] significant threat to patient safety is introduced when desktop virtualization is implemented to support interaction with an EMR using a device with materially less display space and significantly different support for user input than the EMR’s user interface was designed to accommodate.”
The report actually is a couple months old, but it hasn’t gotten the publicity it probably deserves. We are talking about more than user inconvenience here. There are serious ramifications for patient safety, and that should command people’s attention.
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After Blues HIPAA settlement, more work to do: privacy experts

Posted: March 14, 2012 - 1:00 pm ET
The first-ever penalties stemming from enforcement of the HITECH Act's breach-notification rule are drawing mixed reviews from data-privacy advocates, who say federal regulators' $1.5 million settlement with Blue Cross and Blue Shield of Tennessee seems unlikely to halt healthcare companies' lax treatment of patient data.
"This is not about breach notification, it's about security," said Twila Brase, a registered nurse and president of the Citizens' Council for Health Freedom in St. Paul, Minn. "The settlement brings this up into the news so people understand that we have a problem with security of private health data. But I just don't think that the fines are necessarily going to solve the problem."
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Healthcare groups team to promote PHRs

Posted: March 14, 2012 - 12:00 pm ET
Hoping to encourage adoption and use of personal health records "by showing consumers how they can use PHRs to store vital health information such as medical conditions, allergies, medications, and doctor or hospital visits in one convenient and secure place," several healthcare organizations have collaborated on brochures that explain the reasons for using a PHR.
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CCIO on NHS CB “jolly good idea”

9 March 2012   Lyn Whitfield
Health secretary Andrew Lansley has said a chief clinical information officer on the new NHS Commissioning Board would be a “jolly good idea.”
Responding to a question at the launch of the EHI CCIO Leaders Network in London yesterday, Lansley stressed that he was reluctant to “recommend” that the board in Leeds should appoint a CCIO.
The whole point of his Health and Social Care Bill, he insisted, was to give NHS organisations – including the powerful board headed by Sir David Nicholson – the freedom to run their own affairs.
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Global telemedicine market to reach $27B by 2016

By sjackson
Created Mar 14 2012 - 2:10pm
The healthcare industry is banking on telehealth to reduce healthcare costs and provide significant savings on health services worldwide. So much so, in fact, that the market is expected to grow more than 130 percent over the next four years--to a whopping $27.3 billion. That's an annual growth just shy of 20 percent per year. 
The report [1] from Wellesley, Mass.-based BCC Research breaks the telehealth industry down in an interesting way--comparing "telehospital/clinic" providers (hospitals that sponsor and run telehealth sessions from their facilities) "telehome" providers (which use telehealth to monitor and track patients in their homes).
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Health IT spending more efficient in Canada than in the U.S.

By danb
Created Mar 14 2012 - 2:18pm
Providers at Canadian hospitals could be using health technology resources more efficiently than their U.S. counterparts, according to a study published this week [1] in the Journal of the American Medical Association. The study examined rates of mortality, readmissions and cardiac events at hospitals throughout Ontario from 1998 to 2008 and found that hospitals that spent more money reported better outcomes.
While the study's true aim was to determine whether patients received better care at hospitals that spent more money--particularly in a universal healthcare system--the researchers also compared some of their statistics to data for hospitals in the U.S.
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Scientific proof of health IT benefits lacking: So what?

By gshaw
Created Mar 14 2012 - 1:15pm
As evidenced by the not-very-pretty online tit-for-tat between researchers who say there's evidence that electronic health records systems will increase costs [1] and the National Coordinator for Health IT who says the study was flawed [2], there's still plenty of room for debate over the benefits of electronic health records and other types of clinical IT.
But there is plenty of evidence. The only problem? None of it is conclusive.
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Chicago hospital doctors say iPads raise their efficiency

Mon, Mar 12 2012
By Genevra Pittman
NEW YORK, March 12 (Reuters Health) - When doctors-in-training at the University of Chicago were given iPad tablet computers to use on their rounds, they found that using the device helped them be more efficient at ordering tests and procedures for their patients.
The study from the university program, published Monday in the Archives of Internal Medicine, tracked 115 residents who received devices purchased by the hospital. There was no funding reported from Apple Inc, which makes the iPad.
Most residents who used the devices to access patient records and coordinate their care said they cut about an hour per day off their workload. Researchers also found that the internal medicine trainees tended to put in orders for patient procedures earlier than before they got an iPad.
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Posted: Tue, Mar. 13, 2012, 6:47 AM

Health-record privacy impeding medical research

Kathryn Segesser says she believes the current thinking about eating disorders may be wrong.
Segesser suspects that for centuries, anorexia and bulimia have afflicted both men and women. She would like to challenge the popular theory that blames modern cultural pressures and unrealistic images of beauty projected by lollipop-thin models.
"I'm trying to see if, in the 18th century, people understood that there was some psychological reason that people decided not to eat," Segesser said.
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Electronic Submission of Medical Docs Trial Goes Live

James Carroll, for HealthLeaders Media , March 13, 2012

This is part one in a series covering various topics in the world of recovery auditors. Part one focuses on CMS's esMD (Electronic Submission of Medical Documentation) program.
A year ago this month, CMS announced its esMD tool, which is an option for providers to electronically send medical documentation that is requested of them by recovery auditors and other government entities contractors. 
Phase 1 of esMD kicked off on September 15, 2011. During this period, providers will still receive medical documentation requests via paper mail, but will have the option to electronically send their documentation to the requesting review contractor.
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HIMSS on HIE formation: Why are you doing this?

By Laura Kolkman and Bob Brown
Created 2012-03-12 09:28
After all the time and effort you’ve expended so far in forming your HIE, two reasonable questions to ask are, “What’s your objective?” and, “What’s in it for you?” But don’t answer yet. We’ll come back to those questions—and give you our opinion—at the end of this month’s column.
First, let’s look at what others might say about the journey you’re on.
Some would say it’s simply about standing up an organization that can serve the needs of your community. When it’s operational, your HIE will have the requisite business plan, policies, governance model, leadership, technical architecture, procedures and staff to get the job done. You’ll have built the organizational engine that will enable the exchange of patients’ health information in a safe and secure manner. But is that all?
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Q&A: CEO Charles Jaffe on broadening HL7's horizons

By Tom Sullivan, Editor
Created 2012-03-08 10:19
HL7 – not just for IT anymore. That thinking is the catalyst behind a triptych of recent moves designed to open the standards process to more health professionals, notably caregivers.
Ideally, pulling in a new group of professionals will open the feedback loop, particularly to those concerned with usability and workflow, but by no means limited to that. According to Charles Jaffe, HL7 CEO, tapping into their minds and, indeed, day-to-day work experiences will also yield specialist knowledge that bolsters decision support.
Government Health IT Editor Tom Sullivan spoke with Jaffe about those initiatives, very positive initial reactions, and what the future holds for HL7. Hint: Genomics, and mobile health.
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5 best practices for HIPAA security

By Michelle McNickle, Web Content Producer
Created 03/12/2012
The risk of protected health information being breached has grown dramatically within the past few years, and to combat the threat, the HIPAA Security Rule was created to provide organizations with administrative, physical, and technical guidelines to safeguard their electronic PHI.  
"The guidelines underscore a higher goal of the HIPAA Security Rule: helping organizations maintain their data’s confidentiality, integrity, and accessibility," said Mahmood Sher-Jan vice president of product management at ID Experts. "Understanding the guidelines and their greater goal can help organizations implement best practices to better protect their ePHI."
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By Joseph Conn

Post-acute sector could use some government IT help

When is it appropriate for government to get involved in a task?
I'll give you one example. It's appropriate when something needs to be done collectively, as opposed to individually, and can be done most efficiently and expeditiously through a public, rather than a private, initiative.
A story I wrote this week for Modern Healthcare was, ostensibly, about how health information exchange can be extended to nursing homes, home health, acute long-term care and behavioral-health providers, all of which lag behind other enterprises in health information technology adoption.
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Doctors, Patients Can Spur HIE Progress, Feds Say

National HIT coordinator Mostashari calls on clinicians and patients to demand more data at point of care. This will help drive development of health information exchanges, he says.
By Neil Versel,  InformationWeek
March 12, 2012
National health IT coordinator Dr. Farzad Mostashari is challenging clinicians and patients alike to create demand for health information exchange by asking that pertinent information be available whenever and wherever healthcare decisions need to be made.
"No investment in standards or infrastructure for information exchange will rapidly mobilize information sharing if the underlying demand for the shared information is low. Demand for information is the business driver for health information exchange," Mostashari and colleagues in the Office of the National Coordinator for Health Information Technology (ONC) wrote in an article published in Health Affairs that outlined a new national HIE strategy. AdTech Ad
"Sharing information to coordinate care--where information is sent and received between providers, such as a referral from a physician to a specialist--can build demand for, and trust required to support, other exchange models that involve aggregating and finding patient data," ONC officials added. "The goal of health information exchange is for information to follow patients, wherever and whenever they seek care, in a private and secure manner so that teams of doctors, nurses, and care managers can provide coordinated, effective, and efficient care."
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Meaningful Use is indispensable to healthcare reform

By kterry
Created Mar 12 2012 - 11:24am
The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the 2009 stimulus legislation, authorizes the Department of Health and Human Services (HHS) "to establish [1] programs to improve health care quality, safety, and efficiency through the promotion of health information technology (HIT), including electronic health records and private and secure electronic health information exchange."
Judging by that description, the Meaningful Use EHR incentive program was always about more than just ensuring that the federal government spent its money wisely on HIT. Congress' real objective was to reshape the healthcare delivery system. To be sure, provisions of the Patient Protection and Affordable Care Act (PPACA) are also directed to the same end. These include sections that authorize HHS [2] to promote accountable care organizations (ACOs), bundled payments, medical homes and value-based purchasing. Nevertheless, none of these PPACA provisions has yet affected as many providers as the Meaningful Use program has. Moreover, the success of these care delivery innovations will depend in large part on how well the EHR incentive program works.
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Start-ups want to help hospitals harness big data

By gshaw
Created Mar 13 2012 - 12:12pm
As the healthcare industry wakes up and smells the potential of big data, hospitals are experimenting with ways to harness it--and two new start-ups want to help them do so.
Charité University of Medicine Berlin, Europe's largest university hospital, is using increasingly large stores of complex information not only to improve quality and aid clinicians and researchers but also helps improve senior management processes, according to a case study [1] in Forbes magazine.
Deputy CIO Martin Peuker told Forbes that more than 700 hospital employees have access to a central data warehouse that holds both financial and operational information. Every senior manager has ready access to data about operations, scheduling, patient care, and patient records. The entire repository of information stored by the hospital exceeds 1.6 petabytes.
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At SXSW, Hipsters Look for Healthcare Tech Tipping Point

Scott Mace, for HealthLeaders Media , March 13, 2012

South by Southwest, the conference that made Twitter a household word, now has its sights set squarely on the business of healthcare.

In other words, get ready for more technology-fueled disruption than ever before. At the expanded three-day health track at the annual three-ring film/music/tech circus in Austin, TX, healthcare payers were front and center this week, clamoring for change—or at least trying to get in front of the parade of patients.
"We have good doctors, and we have insurance companies that want to fund the right thing, but it's not working, and all the trends are going in the wrong direction," says Michael Golinkoff, executive vice president of specialty programs at Aetna.
In the current atmosphere of fear and loathing existing between payers, providers, and patients, Golinkoff and a small army of other speakers urge big and little actions to create an atmosphere of trust.
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Walgreens taps Surecripts to send patient data to docs

By Bernie Monegain, Editor
Created 03/12/2012
DEERFIELD, IL – Walgreens will use e-prescribing network Surescripts' Clinical Interoperability services to electronically deliver patient data directly to primary care providers. The intent, say Walgreens officials, is to improve the coordination of care.
In the coming months, all 7,800 Walgreens and Duane Reade pharmacies and 350 Take Care Clinics nationwide will use the Surescripts network to deliver immunization records to the patients' primary care providers. Later this year, Walgreens will also use the Surescripts network to provide immunization reporting to state and local public health agencies, and Take Care Clinic patient summaries to the patients' primary care providers.
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AHRQ hopes to help hospitals with health IT project workflow

By gshaw
Created Mar 12 2012 - 12:13pm
The Agency for Healthcare Research and Quality [1] hopes to address one of the most challenging aspects of big health information technology projects: workflow design. The federal agency announced [2] it is seeking feedback on a proposed Workflow Assessment for Health IT Toolkit.
"Understanding clinical work practices and how they will be affected by practice innovations such as implementing health IT has become a central focus of health IT research," the agency wrote in the March 9 Federal Register.
"While much of the attention of health IT research and development had been directed at the technical issues of building and deploying health IT systems, there is growing consensus that deployment of health IT has often had disappointing results, and while technical challenges remain, there is a need for greater attention to sociotechnical issues and the problems of modeling workflow."
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President Obama appoints Todd Park nation's CTO

By Bernie Monegain, Editor
Created 03/09/2012
WASHINGTON – Todd Park will take over as assistant to the President and U.S. Chief Technology Officer (CTO), filling a vacancy created by last month's departure of Aneesh Chopra, the nation's first CTO.
Park has served as CTO of the Department of Health and Human Services since August 2009, where he gained a reputation as an energetic agent for change. Hired as the department’s “entrepreneur-in-residence,” Park has been helping HHS harness the power of data, technology and innovation to improve the health of all Americans, the announcement from the White House said.
The President has asked him to bring that same approach to a broader mission – helping to replicate those and other best practices across government and bring them to scale.
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Monday, March 12, 2012

Security Risk Assessments Gaining Traction in Health Care

Security risk assessments are gaining a higher profile in the health care field as providers look to prevent data breaches, prepare for government audits and qualify for meaningful use incentive dollars.
A security risk assessment takes stock of an organization's data protection policies and procedures, with an eye toward identifying weakness and establishing an improvement regimen. This aspect of IT security, although not entirely unknown in health care, has been more prevalent in other regulated industries such as financial services. However, a number of factors are driving interest in risk assessments among hospitals, medical practices and other covered entities under HIPAA. 
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Enjoy!
David.

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