Monday, April 07, 2014

Weekly Australian Health IT Links – 7th April, 2014.

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

Suddenly the PCEHR seems to have one of its core underpinnings - the use of CDA for clinical document exchange and presentation seems to have a few exploitable security holes. Guess there is some work going on in the background to fix this!
Other than that we have some system issues from Victoria, lack of interest in disclosure of the PCEHR review and ongoing recruitment for PCEHR registrations which seem not to be being used.
The back to the future changes to Windows 8 seems to suggest Microsoft essentially got their interface wrong. Those pesky and change resistant consumers again!
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Security vulnerabilities in C-CDA Display using CDA.xsl

Apr04
TL;DR: If you’re using XSLT stylesheets to render C-CDAs in your EHR, make sure you understand the security implications. Otherwise you could be vulnerable to a data breach.
This blog post describes security issues that have affected well-known 2014 Certified EHRs. Please note that I’ve already shared this information privately with the Web-based EHR vendors I could identify, and I’ve waited until they were able to investigate the issues and (if needed) repair their systems.
Last month I observed a set of security vulnerabilities in XSLT “stylesheets” used to display externally-supplied C-CDA documents in many EHRs. To be specific: the CDA.xsl stylesheet provided by HL7 (which has been adopted by many EHR vendors) can leave EHRs vulnerable to attacks by maliciously-composed documents.
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CDA Use in the PCEHR: Lessons learned

Posted on April 4, 2014 by Grahame Grieve
I wrote an article for the latest edition of Pulse IT (page 53) called “CDA Use in the PCEHR: Lessons learned”:
One of the key foundations of the PCEHR is that the CDA (Clinical Document Architecture) is used for all the clinical documents that are part of the PCEHR. This article describes the lessons learned from using CDA for the PCEHR.
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CDA Security Issues and implications for FHIR

Posted on April 5, 2014 by Grahame Grieve
Overnight, Josh Mandel posted several security issues with regard to CDA:
This blog post describes security issues that have affected well-known 2014 Certified EHRs. Please note that I’ve already shared this information privately with the Web-based EHR vendors I could identify, and I’ve waited until they were able to investigate the issues and (if needed) repair their systems.
Josh identified 3 issues:
  1. Unsanitized nonXMLBody/text/reference/@value can execute JavaScript
  2. Unsanitized table/@onmouseover can execute JavaScript
  3. Unsanitized observationMedia/value/reference/@value can leak state via HTTP Referer headers
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“No public interest” in PCEHR review release

news The Department of Health has stated it does not believe there is a public interest case for the Federal Government’s review of the troubled Personally Controlled Electronic Health Records project to be released publicly, despite the fact that Health Minister Peter Dutton has stated the document contains “a comprehensive plan for the future of electronic health records in Australia”.
The PCEHR project was initially funded in the 2010 Federal Budget to the tune of $466.7 million after years of health industry and technology experts calling for development and national leadership in e-health and health identifier technology to better tie together patients’ records and achieve clinical outcomes. The project is overseen by the Department of Health in coalition with the National E-Health Transition Authority (NEHTA).
However, in July the Government revealed it had failed to meet it initial 500,000 target for adoption of the system, with only close to 400,000 Australians using the system at that point.
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Medicare Local keen to get patients used to e-health system

Posted Mon 31 Mar 2014, 2:00pm AEDT
Educating patients about new electronic health services in South Australia's north and west is the next big task for Medicare Local Country North SA.
E-health allows GPs to update patient records stored on a central database.
The e-health system gives GPs, hospitals and pharmacists access to detailed and accurate patient records.
Medicare Local's Sarah Wiles says most GPs are prepared.
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Hospital in chaos over new booking system

Date April 1, 2014

Julia Medew

Health Editor

EXCLUSIVE
Staff at one of Melbourne's largest hospital networks say a new computerised booking system has wreaked havoc over the past year, causing untold distress for vulnerable people and putting lives at risk.
Senior Austin Health employees have told Fairfax Media that the new Patient Choice Booking service at the Austin Hospital and Olivia Newton-John Cancer and Wellness Centre has caused scores of patients to miss crucial appointments with specialists responsible for their care.
This included seriously ill patients, such as organ transplant recipients, cancer patients and those with infectious diseases such as TB and HIV who needed to be seen at particular times to receive continuing tests, medications and other treatment.
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Austin Hospital booking system brings grief to cancer sufferer

Date April 2, 2014

Julia Medew

Health Editor

Until May last year, Kevin Biaggini had no reason to doubt his care at the Austin Hospital. In November 2012, the Ivanhoe father was treated there for liver cancer and thought the medical and administrative staff were excellent.
But when the hospital introduced its new ''Patient Choice'' booking system in May last year, Mr Biaggini said things started to deteriorate. After having a routine MRI scan on May 15 to check his liver was clear of cancer, he received an unexpected phone call 10 days later. The nurse wanted to know why he had not attended an appointment that week.
''Straight away I knew what was in the wind,'' he said.
The nurse went on to tell him the MRI had found more cancer and that he had been scheduled for treatment that week.
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Startup's stethoscope adapter gets to the heart of the matter

Doctors can add the device to their stethoscopes and send heartbeat data to their phones
Seeing the latest smartphone makes some people's hearts beat faster. Now there's an app that can hear them.
The app, from a company called Eko Devices, works with a device that attaches to a standard analog stethoscope. Via the Bluetooth Low Energy protocol, the Eko adapter sends the audio from the stethoscope to the doctor's phone or tablet for recording, viewing, analysis and sharing. The six-person company demonstrated its product at the Demo Enterprise conference in San Francisco Thursday.
Digitizing the heart and lung sounds that a stethoscope picks up allows doctors to view them as waveforms, giving them another tool to detect potential ailments. Digital stethoscopes have been on the market for years, but Eko's accessory allows doctors who prefer traditional analog devices to bring them into the digital age.
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Dan Munro, Contributor
3/30/2014 @ 10:28PM

Setting Healthcare Interop On Fire

There’s a new software standard for sharing health data that’s gaining a lot of interest and support. Still in “prototype” format, it’s called Fast Health Interoperable Resources or FHIR (pronounced ‘fire’) and the early interest is more than just curiosity. Several high profile projects ‒ including the new CommonWell Health Alliance ‒ are actively testing the new software framework.
The reason for all the excitement is relatively easy to understand ‒ even if you don’t care to understand anything about software in healthcare. In a nutshell, many of the “behind‒the‒scenes” software standards and techniques that we all take for granted as part of our online web experiences (like shopping, travel and banking) are making a kind of formal debut in healthcare.
FHIR is the “HTML” of healthcare. It’s based on clinical modeling by experts but does not require implementer’s to understand those details. Historically healthcare standard were easy for designers and hard for implementor’s. FHIR has focused on ease of implementation. John Halamka ‒ CIO at Harvard and Beth Israel Deaconess Medical Center
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GS1 Recallnet Healthcare goes live to streamline total recall process in the Australian Healthcare Industry

Created on Tuesday, 01 April 2014
The recall process for therapeutic goods in the Australian healthcare sector is set to become streamlined with GS1 Recallnet Healthcare going live on Tuesday 1 April 2014.
 Developed over four years by GS1 Australia in association with the National E-Health Transition Authority (NEHTA), the Therapeutic Goods Administration (TGA), state and territory health departments and a number of medical device and pharmaceutical suppliers and industry associations, GS1 Recallnet Healthcare is an electronic product recall notification management system for therapeutic goods.
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Net’s forever: protect your integrity

1st Apr 2014
THE pace of technological advancement in healthcare has been phenomenal in my professional lifetime.
I am not just talking about PET scans, MRI and robotic surgery, but the everyday accessible desktop-type technology that has transformed clinical practice and practice management. Being a reasonably early adopter, I remember the installation of our new state-of-the-art fax machine.
For the first time, with this magical technology we could instantly send and receive letters and results over the phone. What we did not realise was that the images on thermal paper faded within a few years and so faxes were useless as a long-term record and we would need a more durable format.
I also remember the first computers we installed in the clinic. Our secretaries loved them because they no longer had to bend and stretch to retrieve and file those heavy paper folders and managing the appointments became much simpler.
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Paraplegic walks tall with bionic backpack

Date April 1, 2014 - 3:42PM

Kate Hagan

Radi Kaiuf was confined to a wheelchair for 20 years after being shot in the spine while fighting for the Israeli army in Lebanon in 1988.
But a chance meeting with Israel computer scientist Amit Goffer at a rehabilitation centre in Tel Aviv changed all that.
Dr Goffer, who became a quadriplegic in a car accident in 1997, asked Mr Kaiuf if he'd like to try something new - a bionic walking machine that he had developed.
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Analytica delivers positive usability trials for e-health treatment system

Monday, March 31, 2014 by Proactive Investors
Analytica has successfully completed phases 1 to 3 of the usability trials for the PeriCoach system.
Analytica's (ASX: ALT) shares are expected to open firmer this morning following the successful completion of phases 1 to 3 of the usability trials for the PeriCoach system.

PeriCoach is an e-health treatment system for women who suffer Stress Urinary Incontinence, which is a very large market considering 1 in 3 women worldwide are affected.

The incontinence pad market in the U.S. is $5 billion, and forecast to grow to $7 billion by 2017.

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Fiona Coote celebrates life 30 years since her first heart transplant

Date April 4, 2014

Rachel Browne

Social Affairs Reporter

When Fiona Coote had a heart failure in 1984, a transplant was the only option. Three decades later, one of the surgeons who operated on the teenager believes heart transplants will soon be a thing of the past.
The director of heart-lung surgery and transplantation at St Vincent's Hospital, Phillip Spratt, says technological advances in artificial heart pumps will make transplant surgery redundant.
Almost 40 per cent of patients at the hospital's heart-lung transplant unit have the devices implanted, which keep them alive for years, in some cases until they undergo surgery.
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Windows 8.1 Update: Microsoft Hits Reverse, Adds Windows 7 Features

With its Windows 8.1 Update, announced today, MicrosoftMSFT -0.17% is looking in the rearview mirror—and putting the car in reverse. But for all the people who have wanted Windows 8 to work more like Windows 7, that’s the right direction.
On April 8—coincidentally the same day that Microsoft cuts off Windows XP support—a free Windows 8.1 Update will bring mouse and keyboard users some much needed relief with some small but useful system tweaks.
“Our goal is to bring back the familiar,” Chaitanya Sareen, Microsoft Principal Program Manager Lead on Windows, told me as he demonstrated some of the new features last week.
There are three that I think will significantly aid people making the transition from a traditional version of Windows, including XP or 7, to Microsoft’s now slightly-less-brave new world.
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Microsoft unveils Cortana digital assistant, reinstates Start menu

Date April 3, 2014

Dina Bass, Ian King

  • Windows 8.1 reinstates the Start menu
  • Windows Phone gets Siri-like assistant
  • Windows Phone free to handset makers
Microsoft has renewed its push to catch up with Apple and Google in mobile devices, unveiling updated Windows Phone software with voice-search features and offering it for free to makers of smartphones and tablets.
Microsoft, which previously charged a licensing fee of $5 to $15 per device, will offer it without charge to makers of smartphones and smaller tablets with screens of less than nine inches, the company revealed at its Build developers conference in San Francisco on Wednesday (Thursday morning Australian time).
The new Windows Phone 8.1 software for smartphones and tablets includes a voice-controlled digital assistant called Cortana, similar to Apple's Siri, and will be rolled out to existing Windows Phone 8 users over the coming months.
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Enjoy!
David.

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