Saturday, November 14, 2015

Weekly Overseas Health IT Links -14th November, 2015.

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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IDC releases top 10 predictions for healthcare and IT is in the driver's seat

Posted on Nov 05, 2015
By Karin Ratchinsky, Level 3
There has never been a more exciting time to be in healthcare IT. There has never been a more pivotal and stressful time to be in healthcare IT. IDC's latest healthcare IT predictions illustrate this and could not ring more true. U.S. healthcare spending as a percentage of GDP is almost double that of any other nation putting continued legislative focus on reforming the system and IT is truly in the driver's seat.
These predictions highlight the multitude of transformational innovations that will help us get to much needed efficiencies through proactive personalized care, intelligence driven protocols, machine to machine learning and scaling to deliver care outside provider settings.
IDC FutureScape: Worldwide Healthcare 2016 Predictions
1.      Downward pressure of the healthcare economy will increase risk based contracting to 50% of provider payments by 2017 resulting in premium increases in the 2% to 3% range.
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Healthcare industry must discover best ways to weigh, combine disparate datasets

November 6, 2015 | By Katie Dvorak
As information flows into the healthcare system from myriad technologies--wearables, apps, social media, online portals, electronic records, etc.--the industry needs to figure out how those types of information can be combined and weighed, according to a paper published this week in Nature.
Not all data can be created equal, say the authors, from medical institutions across the U.S., Canada and Australia; they point out that healthcare data increasingly is coming in from different domains, is generated in many different ways and is store in many different places.
Because of that, "scientists need to work out why, when and how to combine diverse data--for instance, should physical-activity data from clinical records, online questionnaires and wearable devices be combined?" they write.
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Consumer Experience with Health Apps Mixed, Finds Survey

NOV 5, 2015 7:11am ET
In what is being called the most in-depth analysis to date of health-related app use in the United States, a new online national survey of Americans’ health app use shows both positive and negative aspects of mHealth adoption.
The survey results, published in the Journal of Medical Internet Research mHealth and uHealth, and analyzed by researchers at NYU Langone Medical Center, show that 65 percent of respondents indicated that apps improved their health, and a majority had strong faith in the accuracy and effectiveness of the apps.
In addition, 58 percent of the 1,604 adult smartphone users surveyed had downloaded one of the estimated 40,000 available health-related mobile apps, while 42 percent had downloaded five or more.
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EHRs need better workflows, less 'chartjunk'

November 2, 2015 | By Marla Durben Hirsch
Electronic health records currently handle data poorly and should be enhanced to better collect, display and use it to support clinical care, according to a new study published in JMIR Medical Informatics.
The authors, from Beth Israel Deaconess Medical Center and elsewhere, state that the next generation of EHRs need to improve workflow, clinical decision-making and clinical notes. They decry some of the problems with existing EHRs, including data that is not displayed well, under networked, underutilized and wasted. The lack of available data causes errors, creates inefficiencies and increases costs. Data is also "thoughtlessly carried forward or copied and pasted into the current note" creating "chartjunk," the researchers say.
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Data and analytics come to the med school curriculum

Posted on Nov 05, 2015
By Kaiser Health News
Medicine, meet Big Data.
For generations, physicians have been trained in basic science and human anatomy to diagnose and treat the individual patient.
But now, massive stores of data about what works for which patients are literally changing the way medicine is practiced. "That's how we make decisions; we make them based on the truth and the evidence that are present in those data," says Marc Triola, an associate dean at New York University School of Medicine.
Figuring out how to access and interpret all that data is not a skill that most physicians learned in medical school. In fact, it's not even been taught in medical school, but that's changing.
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Three Important Tech Skills That Need To Be Added to Medical School Curricula

by Tim Cannon Friday, November 6, 2015
In June, the American Medical Association adopted a policy for medical students to gain hands-on experience with electronic health record systems while they are in school. The policy encourages medical schools and residency and fellowship training programs to teach students how to use the systems in real-life practice settings.
As EHR systems become more and more important in health care, the move by AMA is an important step toward improving medical education and patient care. But future providers will need to be familiar with more technology than just EHRs. Technology is taking on a larger role in health care and to get the most from these new tools, physicians will need to know how to use them.
The following technologies could have a huge effect on the health care industry, and medical students need immediate training to realize that promise.
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NHS staff asked to rate EPR usability

Digital Health News staff
3 November 2015
NHS clinicians have been asked to rate the usability of their main IT system in a survey launched by Digital Health Intelligence and the CCIO Leaders Network.
The first Clinical Software Usability Survey is intended to provide a better understanding of how easy a piece of clinical software is to use; according to the doctors, nurses and staff who use it on a regular basis.
The ultimate aim is to create a site similar to travel review site 'TripAdvisor' so that clinicians and NHS managers can see reviews of medical software and discuss professional experiences of different systems. This site is planned for launch in autumn 2016.
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Digital doctor to review NHS tech

Thomas Meek
30 October 2015
Health secretary Jeremy Hunt has announced that a best-selling US digital health author is to lead a review of the digital future of the NHS.
Dr Robert Wachter, author of 'The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age' and professor at University of California, San Francisco, will “conduct a review for the NHS on the critical lessons we need to get right as we move to a digital future,” said Hunt, who was speaking at an HSJ event.
Wachter, who Hunt described as a “world expert on the promise and pitfalls of new IT systems”, has become an influential figure in healthcare IT since the publication of his book.
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Interest high in investing in digital healthcare

November 5, 2015 | By Susan D. Hall
Nine out of 10 technology and life sciences companies in a new survey say digital healthcare plays an important role in their overall business strategy, but they face myriad challenges.
The survey report, from global law firm White & Case LLP and Mergermarket, forecasts growth over the next two decades for remote monitoring and mHealth, with Generation Xers (those born between 1965 and 1981) the most likely adopters in the next five years.
Of the 120 executives polled, 92 percent from life sciences companies and 96 percent from technology companies said their organizations plan to increase investment in digital healthcare over the next 18 months, according to an announcement.
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Q&A: HL7’s Charles Jaffe on Latest Progress with FHIR

NOV 4, 2015 7:42am ET
Charles Jaffe, M.D., Ph.D., has led HL7 as its CEO since 2007. The organization is on the leading edge of standards development, and is working on refining its Fast Healthcare Interoperability Resource (FHIR) standard. The platform uses coding and URL calls to facilitate the exchange of healthcare information. It’s attracting a lot of attention, and organizations are using the current version of FHIR to enable healthcare information exchange that was previously difficult to achieve.
As HL7 continues to develop and evolve the standard, Jaffe took time to answer some questions about the current status of the FHIR standard, the development work that is ongoing, and the role FHIR can play in improving information exchange within healthcare.
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OpenNotes shows success with medication adherence

Posted on Nov 03, 2015
By Jessica Davis, Associate Editor
Patients with online access to doctors' notes are more likely to adhere to their medication regimens, a two-year Geisinger Health System study reports.
This is the first large-scale study to reveal how doctors' notes affect patients when it comes to taking their prescriptions, researchers say.
Geisinger has been involved with the OpenNotes initiative, first conceived at
Beth Israel Deaconess Medical Center in Boston, since 2010. The program directly connects patients to their physician's notes through an online portal.
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Is health data privacy even possible in the social media age?

Posted on Nov 03, 2015
By Jack McCarthy, Contributing Writer
The healthcare industry is only just beginning to understand how much we lack control over personal data and, at the same time, Americans are putting more and more data onto social networks, making it that much harder to know how best to protect it.
"People are becoming more concerned about privacy," said Jennifer Golbeck, an associate professor with the College of Information Studies at the University of Maryland. "Many are frequent social media users, but see they are losing control of data in a lot of ways they don't like, so I think we are starting to engage in a big debate."
Golbeck, a leader in creating human-friendly security and privacy systems, as well as in social media research and science communication, will explore that topic during her presentation "Your Weakest Security Link? The Answer Will Surprise You," at the HIMSS and Healthcare IT News Privacy & Security Forum.  
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Need for mental health apps is not being met

Jeff Rowe
Nov 02, 2015
Consider a few facts about mental illness: According to the National Alliance on Mental Illness (NAMI), one in four Americans experiences mental illness in a given year. Meanwhile, the National Institutes for Mental Health (NIMH) measure healthcare costs attributed to mental illness measure in the trillions of dollars. And NIMH also says the World Economic Forum considers mental health the world’s largest driver of overall health costs.
And, yet, for all the buzz about mHealth, mental health stakeholders lament the lack of attention still being paid by health IT developers to mental health patients. One of those stakeholders is Deborah Estrin, a computer science professor at Cornell University and one of the founders of Open mHealth, a non-profit start-up focused on bringing “clinical meaning to mobile health data.”
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Patients lack access to, knowledge of digital health communication tools

November 4, 2015 | By Dan Bowman
Many Americans lack access to and knowledge of digital tools such as text and email reminders that can boost communication efforts with their healthcare providers, a new survey by the Council of Accountable Physician Practices (CAPP) and the Bipartisan Policy Center finds. What's more, few primary care doctors even recommend such technology options, consumers who responded to the survey say.
For the survey, unveiled Nov. 4, Nielsen Strategic Health Perspectives last summer polled 5,014 U.S. residents over the age of 18; in addition, 626 doctors also were surveyed.
Just 29 percent of consumer respondents said they receive electronic reminders for appointments, refills or suggested care; 14 percent said they have the ability to conduct online checks of their medications. Fifteen percent of respondents said they use email to communicate with their provider.
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20 schools join AMA effort to bring medical education into the future

November 4, 2015 | By Katie Dvorak
Harvard Medical School, Emory University School of Medicine and Rutgers Robert Wood Johnson Medical School are among 20 new institutions joining the American Medical Association's effort to create innovative ways to improve medical education.
The AMA's Accelerating Change in Medical Education Consortium started in 2013 to bring medical education into the 21st century and ensure when students enter the workforce they can hit the ground running, Susan E. Skochelak, M.D., AMA Group Vice President for Medical Education, said in a press call Wednesday.
The initiative originally included 11 medical schools charged with the task of evolving curriculum to better prepare physicians for changes in the healthcare landscape.
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How to maintain privacy during genomic data-sharing

November 4, 2015 | By Susan D. Hall
Two Stanford University researchers have demonstrated a technique to better maintain privacy during genomic research data-sharing.
The work, published in The American Journal of Human Genetics, seeks to balance the quest to make genomic data-sharing easier for researchers, but harder for patient data to be re-identified.
The research focuses on a network of genomic data sets on servers, or beacons, organized by the Global Alliance for Genomics and Health that allows researchers looking for a particular genetic variant in a multitude of genomic databases to determine whether there's relevant data in a particular database there before applying for access. It also allows researchers investigating the same topic to find each other and collaborate, according to an announcement.
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Want to reach your doc? Many Americans would use email or text — but can’t

Lena H. Sun November 3, 2015
The digital technology that many Americans use in often very busy lives -- in banking, shopping, traveling, communicating -- still plays but a bit role when it comes to their health care.
According to a Nielsen survey released Tuesday, most people can't use email, texting and other tools to share medical information with their doctors, much less receive the same, because many providers don't offer such access.
The survey, conducted on behalf of two health policy groups, polled more than 5,000 Americans ages 18-65 on their attitudes and use of technology to manage their medical care. Only 21 percent have access to online appointment scheduling with their doctors; just 15 percent use email to communicate with their provider; only 9 percent receive reminders by text.
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Anti-Vaccination Websites Use 'Distorted' Science, Researchers Find

Agata Blaszczak-Boxe, Contributing Writer   |   November 03, 2015 02:37pm ET
Many websites that promote unscientific views about vaccinations use pseudoscience and misinformation to spread the idea that vaccines are dangerous, according to a new study.
For example, of the nearly 500 anti-vaccination websites examined in the study, nearly two-thirds claimed that vaccines cause autism, the researchers found. However, multiple studies have shown that there is no link between vaccines and autism.
About two-thirds of the websites used information that they represented as scientific evidence, but in fact was not, to support their claims that vaccines are dangerous, and about one-third used people's anecdotes to reinforce those claims, the scientists found.
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2015 Edition Certification Rule Criticized for Immature Standard

NOV 3, 2015 7:42am ET
A standard to address the legal and technical complexities of electronically exchanging behavioral health data has gained some traction with its inclusion in the 2015 Edition Health IT Certification Criteria final rule released last month. However, critics say the Data Segmentation for Privacy (DS4P) standard is not ready for prime time.
Behavioral health data requires additional protections beyond HIPAA, including adherence to federal law 42 CFR Part 2, which limits disclosure of identifiable information by a federally-assisted substance abuse treatment program to any entity, even for treatment, without signed consent from the patient, with limited exceptions. It also restricts re-disclosure of data by the receiving entity for any purpose without consent.
DS4P seeks to overcome barriers to secure electronic exchange of behavioral health data by applying a set of metadata and encryption onto a clinical document, enabling a provider to send it to a receiving system with technology to recognize the data is from a behavioral health or substance abuse program and to segregate it.
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See the highest-rated EHRs for usability

Posted on Nov 02, 2015
By Mike Miliard, Editor
The American Medical Association, alongside MedStar Health's National Center for Human Factors in Healthcare, has launched a new framework to rank electronic health records according to their user-centered design, of UCD.
The aim, according to AMA and MedStar, is to spotlight the importance of UCD -- something officials call "an essential component in improving patient safety and the satisfaction of physicians, patients and medical professionals who use EHRs."
Too many vendors - even those certified by the Office of the National Coordinator for Health IT - still don't feature best UCD practices, they point out. Vendors must only report on the UCD processes they followed for the eight capabilities deemed critical to patient safety by ONC, which doesn't use UCD best practices as a basis for certification.
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OIG 2016 work plan heightens, refines EHR scrutiny

November 2, 2015 | By Marla Durben Hirsch
The Department of Health and Human Services' Office of Inspector General (OIG) continues to focus on electronic health records and health IT, adding two EHR-related issues to its new 2016 work plan.
In the plan, published Nov. 2, OIG says for the first time that it will review the U.S. Food and Drug Administration's oversight of medical devices networked to EHRs.
"We will examine whether FDA's oversight of hospitals' networked medical devices is sufficient to effectively protect associated electronic protected health information [ePHI] and ensure beneficiary safety," the plan says. "Computerized medical devices, such as dialysis machines, radiology systems and medication dispensing systems that are integrated with electronic medical records and the larger health network, pose a growing threat to the security and privacy of personal health information."
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EHRs, Patient Portals, and the "Four P's"

Patient portals are an underutilized resource for a population hungry for health information, according to the results of recent survey.
Craig Kemp, leader of innovative partnerships for Merck Vaccines, sums up the current thinking of many pharmaceutical executives when it comes to patient portals.
“Health technologies such as EHRs now manage the clinical workflow,” he said. “Patient engagement through health technology such as patient portals is rapidly increasing. Our industry's services and solutions that help patients access appropriate therapies and use them correctly can dramatically improve health outcomes. Figuring out how to deliver these services and solutions through health technology is one of the great challenges our industry faces.”
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3D Printing Breakthrough Could Change Healthcare

Researchers at Carnegie Mellon have used a new technique to print soft tissue an off-the-shelf 3D printer, and hope to use the method to make hearts.
11/2/2015 01:26 PM
A new 3D printing technique developed at Carnegie Mellon will allow the printing of soft living tissue like that of our own organs. The most amazing part is that Carnegie Mellon has done this with off-the-shelf 3D printers that cost about $1,000.
Up until now, 3D printing was mostly done using rigid materials like plastics, resins, and metal. Until this process, 3D printing of soft tissue required special artificial frameworks or lattices to hold together the organs. Otherwise, if you try to print softer materials in air, they cannot support their own weight as you add layers of material. If an organ can’t hold its shape while you add to it, it is useless. However, the frames had a potential for increasing rejection rates. They made the whole process more complicated and expensive.
The technique developed by Carnegie Mellon researchers uses a gel to support the organ as it is being built. The printer injects the new materials inside the gel, and once the organ is complete and can support itself, the outer gel can be melted away in warm water, leaving behind the perfectly formed organ.
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Building the Data Analytics Team

Scott Mace, for HealthLeaders Media , November 3, 2015

Leaders are finding that recruitment from the outside can be useful but difficult, and that internally, talent can be developed to support analytics efforts.

This article appears in the October 2015 issue of HealthLeaders magazine.
Healthcare's many imperatives, including population health, require keen analytical resources coupled with a deep understanding of clinical systems and the obstacles that face healthcare's march to achieve the triple aim.
Finding and training talented staff—from line analysts all the way up to visionary chief medical information officers and chief information officers—remains a tall order. By and large, however, analytics team leaders find it is easier to train clinicians in the art and science of analytics than it is to find, hire, and train data analysts from outside of healthcare.
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Paying for Telemedicine

September 3, 2015
In April, Congress passed the “doc fix” bill with strong bipartisan support (92 to 8 in the Senate; 392-37 in the House), avoiding a scheduled 21.2 percent cut in payments to physicians who treat Medicare patients and fundamentally reforming how Medicare pays providers for in-person care. While passage of this legislation represents a major shift in physician payment policy, the doc fix didn't address how to pay for a relatively new method of delivering care: telehealth.
Telehealth, also often called telemedicine or virtual care, involves delivering health services and information via technology like voice and video. It can include telephone calls, videoconferencing, and remote monitoring (patient measures blood pressure or glucose at home and physician monitors changes remotely), and can be conducted in real time, such as in a live video, or asynchronously, for example when a photograph or radiograph is taken, and an expert, at a different location, later reads and interprets it.
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CMS Issues ICD-10 Progress Report

OCT 30, 2015 7:25am ET
For the first time since the ICD-10 compliance deadline went into effect Oct. 1, the Centers for Medicare and Medicaid Services on Thursday released data indicating that the code transition is going smoothly for those providers that have submitted claims to CMS.
The agency made public metrics detailing Medicare fee-for-service claims from Oct. 1-27. Over the nearly four-week period, CMS reported that 2 percent of total claims submitted were rejected due to incomplete or invalid information—the same rejection rate according to the historical baseline.
In addition, CMS revealed that 0.09 percent of total claims submitted during that timeframe were rejected due to invalid ICD-10 codes, compared to 0.17 percent of total claims rejected based on CMS end-to-end ICD-10 testing conducted last year. The agency also disclosed that 0.11 percent of total claims submitted were rejected due to invalid ICD-9 codes versus0.17 percent of total claims rejected based on end-to-end testing.
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Halamka: Stage 3 Meaningful Use Should Be Eliminated

NOV 2, 2015 7:47am ET
John Halamka, M.D., chief information officer of Boston’s Beth Israel Deaconess Medical Center, was a critic of the Stage 3 electronic health records Meaningful Use program, even before it was finalized. Now with the final rule out, he would like to see Stage 3 eliminated altogether.
Speaking as a healthcare CIO and not as co-chair of the Health IT Standards Committee that advises the government, Halamka contends that Stage 3 is not only generally unhelpful but downright counterproductive.
“Walk inside a hospital, talk to the IT people and the providers. Everyone has the Meaningful Use hangover. We’ve been drinking Meaningful Use and boy do we have a headache,” he exclaims. “Stage 2 hasn’t even been optimized and now layering on the requirements for Stage 3 is too much, too fast. It’s not that I oppose the further adoption of IT and innovation but only 12 percent of doctors have made it over the Stage 2 finish line and now we’re going to make it even harder. Does that make sense?”
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FHIRWorks rocks the Epic campus

Posted on Nov 02, 2015
By Bernie Monegain, Editor-at-Large
There's nothing like a developer event to get the crowd fired up. At least that's how the hosts and the keynote speaker at the FHIRWorks' event at the Epic campus last week described it.
About 5,000 people, among them Epic employees, developers and users, turned up for the happening last week on the Epic headquarters in Verona, Wis., a small town, about 10 miles from Madison.
The developers accounted for the smallest group, about 75 of them, but they generated the most excitement.
It's the first time Epic invited users to the campus for this type of event, Epic President Carl Dvorak told Healthcare IT News.
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How data from health records, social media streams improves flu predictions

November 2, 2015 | By Susan D. Hall
By combining data from social media and other sources, researchers were able to more accurately predict incidence of flu, according to a study published last week in PLoS Computational Biology.
Computational epidemiologists at Boston's Children Hospital first compiled predictive models from five sources: near real-time records from medical practices managed by athenahealth; Google Trends, which notes search volumes for specific queries; flu-related Twitter posts; FluNearYou, a participatory flu-surveillance system; and Google Flu Trends.
With help from the Centers for Disease Control, Google is revamping its flu-prediction models after over-predicting the illness last year.
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Exemptions enable hacking of med devices for safety

November 2, 2015 | By Susan D. Hall
The Library of Congress has granted several exemptions to copyright rules that in effect mean it's OK to sometimes hack medical devices in search of security and design flaws.
The exemptions were granted last week to Section 1201 of the Digital Millennium Copyright Act (DMCA), which prohibits the circumvention of technological methods used to protect copyrights--think jailbreaking a smartphone, an exemption that was renewed.
The exemptions allow "good-faith security research" to be performed on computer programs that run on cars, implanted medical devices and a host of other things including voting machines.
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Patients prefer password-protected portals for most sensitive test results

November 2, 2015 | By Katie Dvorak
Most patients prefer receiving results from medical tests--especially ones containing highly sensitive information--through password protected patient portals or websites, according to a recent study.
Researcher at Georgetown University Medical Center surveyed 409 patients to see if they better liked getting test results through email, mailed letters, text message, fax, phone call or portals, according to an announcement.
While many preferred the portal, respondents also didn't mind obtaining results for tests like blood cholesterol through text, email or voicemail. When it came to results for tests on sexually transmitted diseases or genetic tests, however, patients preferred a more secure form of communication.
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87% of consumers believe cloud-based apps can be hacked: 5 things to know

Written by Carrie Pallardy | October 30, 2015
Mobile app use is incredibly popular, but consumer attitudes toward data security reveal some concerns over how these apps store and protect information.
Here are five things to know from radware's Mobile Application Security: Consumer Perspectives and Organizational Implications report.
1. More than half of Americans aged 18 to 34 report using cloud-based apps. Fifteen percent of Americans aged 65 and over report using cloud-based apps.
2. The most popular types of apps include:
•    Fitness apps: 16 percent
•    Food ordering services: 10 percent
•    Transportation and financial services: 8 percent
•    Healthcare: 7 percent
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Feds Look To Improve Broadband Access Amid Health IT Boom

by Heather Drost, iHealthBeat Editor Friday, October 30, 2015
The health care industry's increasing use of health IT tools and Wi-Fi-enabled medical devices has renewed the conversation around broadband access in the U.S.  
Earlier this year, the Broadband Opportunity Council -- an interagency council created by President Obama -- published a request for comment seeking ideas from stakeholders on ways the government can better support broadband adoption.
Separately, the Federal Communications Commission in February adopted new rules for regulating the Internet that will increase oversight of mobile and fixed broadband providers. In addition, FCC currently is looking at ways to reform and modernize programs under the universal service, which aims to ensure all Americans have access to communications services, such as broadband.
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Enjoy!
David.

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