Saturday, April 23, 2016

Weekly Overseas Health IT Links - 23rd April, 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.
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Health information technology investments rise in first quarter

Published April 15 2016, 7:37am EDT
Two recent reports suggest soaring investor interest in the healthcare information technology sector, citing high growth rates for its companies and rapid transformation in the industry, leaving providers in search of IT solutions.
Investor interest in healthcare information technology is higher than ever, with venture capital funding reaching $1.4 billion in the first quarter of 2016, according to data from Mercom Capital Group.
A recent Mercom report on venture funding and mergers shows that private equity and corporate venture capital in healthcare information technology and digital health sector increased 27 percent, compared with $1.1 billion in investment in the fourth quarter of 2015.
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Virtual reality surgery streamed online

April 15, 2016 | By Susan D. Hall
Surgeon Sahfi Ahmed, who made a name for himself by using Google Glass, performed cancer surgery Thursday using virtual reality that was streamed online.
Medical students around the world and other interested parties could view the Royal London Hospital-based operation--and the whole surgery workflow--using inexpensive Google Cardboard VR glasses paired with the VRinOR app for smartphone or tablet or by watching it online.
Ahmed told The Guardian he believes virtual reality could improve the training of surgeons worldwide. Nicklaus Children's Hospital, part of the Miami Children's Health System, currently uses virtual reality to train employees on procedures such as cardiopulmonary resuscitation (CPR). 
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The doctor's bag is getting a digital makeover

Written by Matthew Driver
Published: Thursday 7 April 2016
As probably the most recognized medical device in history, the stethoscope is a true symbol of modern medicine that can be found in the bags, offices and hanging from the necks of doctors and nurses around the world; yet it is a technology that has remained largely unchanged since its invention in the early 19th century. As the stethoscope marks its 200th anniversary this year, this cornerstone of modern medicine is getting a digital upgrade - and it is not the only technology that is transforming the traditional doctor's bag.
The stethoscope was invented in France in 1816 by René Laennec. His device consisted of a simple wooden tube similar to the common ear trumpet, which allowed him to examine the chests of women without having to press his ear to their bodies - the common method of auscultation used by physicians at that time.
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The government may want a refund for its $30 billion investment in electronic medical records

April 14, 2016 | 11:59 AM
The federal government has invested more than $30 billion in electronic medical records. The idea is that these records will let doctors and hospitals improve patient care – and potentially lower costs – by tracking all the treatment a person receives.
The government may want its money back.
A new report from the Journal of the American Medical Informatics Association finds nearly half of patient face-to-face contact with health care providers — checkups, emergency room stays, even hospital admissions — were missing from their electronic records.
This paper appears to be the first to quantify the problem.
Harvard’s Stephen Soumerai – one of the authors – says inaccurate electronic records like this are a safety threat.
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Spending on software expected to rise 4.2 percent in 2016

Published April 13 2016, 7:36am EDT
Worldwide information technology spending is expected to total $3.49 trillion in 2016, a decline of 0.5 percent, compared with 2015 spending of $3.5 trillion, according to estimates by Gartner Inc. Growth in software spending is expected to show the biggest growth in 2016, rising an estimated 4.2 percent over 2015.
Spending on IT services and data center technology is projected to increase an estimated 2.1 percent, the research firm predicts. At the other end of the spectrum, spending on devices is expected to decline 3.7 percent, while expenditures for communication services is expected to fall 2 percent.
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Birmingham rolls out Your Care Connected

Rebecca McBeth
12 April 2016
A shared patient record scheme is being rolled out across Birmingham, Sandwell and Solihull, using Healthcare Gateway technology.
Your Care Connected will enable healthcare professionals working in secondary care to view information from a patient’s GP record.
The Medical Interoperability Gateway will pull information on up to 1.8 million patients from GP systems Emis Web, TPP SystmOne and INPS Vision.
It will be rolled out to users throughout 2016, becoming available to all of the area's hospitals, as well as Birmingham and Solihull Mental Health NHS Foundation Trust, West Midlands Ambulance Service, out-of-hours GP service providers and every GP practice.
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First Clinical Software Usability Survey reaches milestone

Jon Hoeksma
14 April 2016
Digital Health Intelligence has completed phase one of the first, national, comparative Clinical Software Usability Survey, cSUS.
During the initial phase, which opened in November 2015 and closed on 31 March, more than 1,300 clinicians from across all parts of the NHS provided detailed usability ratings data on the clinical systems they use most often to care for patients.  
Ratings data has been submitted on 101 clinical systems in use across the UK, covering hospitals, mental health, community services and general practice. The survey has also covered services for which clinical software rarely gets wider attention, such as ambulances and community dentistry.
The data will now be analysed to provide comparisons between different areas of care, different regions of the NHS, and different categories of clinical IT systems. The analysis will also examine how NHS usability scores compare to those in other industries.
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Kaiser Permanente: Patient portal support improves care but can create e-health disparities

April 11, 2016 | By Marla Durben Hirsch
Patient portals have great potential to improve care by better engaging patients in their own health and supporting better care delivery--if only more providers gave consumers the opportunity--according to a recent Health Affairs Blog post.
The blog post, written by trio of Kaiser Permanente employees, notes that consumer expectations and Meaningful Use requirements both call for increased use of user-friendly technology such as ATMs and Uber.  However, only 10.4 percent of U.S. hospitals in the first half of 2015 had met the Meaningful Use requirement that patients be able to electronically view, download and transmit their records. Another study showed that only 15 percent of consumers had access to email their providers, many physicians simply didn't offer email or other electronic tools such as online appointment reminders.
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Data gaps in EHRs a 'widespread problem'

April 14, 2016 | By Marla Durben Hirsch
Electronic health records are missing a "substantial" amount of data, which could have "profound" implications for clinical care, medical research and public health, according to a new study in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from Harvard Medical School and Harvard Pilgrim Health Care Institute, reviewed the EHRs of 5,500 patients diagnosed with either depression or bipolar disorder who were insured by a major insurer and who receive their primary care from the leading area multi-specialty group, Harvard Vanguard Medical Associates. The EHRs were compared to the insurance claims data.
The researchers found that the EHRs were missing a lot of data. For instance, about one-fourth of the depression and bipolar diagnoses and more than half of behavioral health visits were not recorded in the EHR. Almost 90 percent of acute psychiatric services at hospitals also were not in the primary care provider's EHR.  
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Mismatch of HIT and workflow tops list of patient safety concerns

April 14, 2016 | By Susan D. Hall
A disconnect between health IT configurations and organizational workflow topped the ECRI Institute's 2016 list of top 10 patient safety concerns.
When a health IT system is implemented, organizations need to tailor the configuration to the workflow and vice versa, but this often doesn't happen. When health IT configuration and workflow clash, communication suffers, the organization says in an announcement.
In its third annual list, the institute focused on concerns that are happening, but not necessarily those that are most frequent or severe. "We're trying to pick out the things that are relatively novel or that are not necessarily new but are manifesting themselves in a new way because of changes in the healthcare system," executive director Bill Marella says.
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Interoperability Under MACRA Must Provide Standard HIE Tools

By Sara Heath on April 13, 2016

According to Dr. Larry Garber, HHS must define interoperability under MACRA in such a way that individual providers would have access to standardized HIE tools.

National interoperability frameworks are necessary before providers can fully improve electronic health information exchange (HIE) in support of federal regulations, including the upcoming Medicare Access and CHIP Reauthorization Act (MACRA), says Dr. Larry Garber, medical director for informatics at Reliant Medical Group.
Republished in a blog post by Beth Israel Deaconess’s CIO John D. Halamka, MD, Garber urges the Department of Health & Human Services (HHS) to reconsider the framework for health IT interoperability, saying that in order for all members of the healthcare industry to fully support interoperability, they must have access to a national framework.
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Kaiser Permanente collecting patient data for DNA Research Bank

Participants will provide access to their electronic health records, offering data that can inform studies into genetic and environmental factors.
April 14, 2016 11:51 AM
Kaiser Permanente this week launched a new database that enables researchers to examine participants' DNA in conjunction with environmental and behavioral health.
Kaiser members across eight states and the District and Columbia can participate in the research bank, which aims to spur new diagnoses and treatment plans. The goal, officials say, is to gather data from 500,000 participants across Kaiser's seven regions – creating one of the biggest and most diverse repositories of genetic, environmental, and health data in the world.
To date, more than 220,000 members from four geographic regions have enlisted with KP's biobank initiatives.
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Big data analytics, telemedicine, wearables rank high among $1.4B worth of health IT investments in 2016

The first quarter of this year saw a 27 percent spike in health IT venture capital and the most M&A activity in a single quarter, according to a report from Mercom Capital Group.
April 13, 2016 03:41 PM
The first quarter of 2016 saw $1.4 billion in venture capital funding and the most merger and acquisitions transactions in a single quarter to date, according to Mercom Capital Group.
The top health IT areas of investment were: wearables at $260 million, analytics at $197 million, telemedicine at $171 million, mHealth apps at $120 million and consumer health information/education with an even $100 million.
Those numbers include private equity and venture capital, according to Mercom, and the $1.4 billion total represents a 27 spike over the last quarter of 2015.
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HIT Think 5 steps providers can take to reduce security risks

Published April 12 2016, 4:49pm EDT
Realizing the true value of information governance requires ongoing collaboration, monitoring, assessment and education to promote process improvement. Organizations guided by successful IG programs are well poised to drive process improvement across the entire enterprise—one project at a time.
The first step is to recognize problems and then carefully analyze organizational data—from all data sources—to achieve change. This article explores how one health system used data analysis in conjunction with IG to turn potentially damaging privacy and security incidents into mission-critical process improvement initiatives.
Part of any solution is knowing the right questions to ask, and engaging the right partners. This is true for any type of negative event, trend or outcome.
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Providers need new tools to make sense of unstructured data

Published April 13 2016, 7:16am EDT
Healthcare is being inundated with a deluge of big health data, 80 percent of which are invisible to current computing systems because the data are unstructured, according to Ginni Rometty, chairman and CEO of IBM.
New cognitive systems will enable the industry to “see” unstructured health data that previously has been hidden from sight.
Traditional structured health data, which “fits into rows, columns and tables,” is visible, but the vast majority of big data—consisting of doctors’ notes, wearables, X-rays, social media, the weather, sensors and sound—is unstructured and invisible to healthcare organizations, Rometty said In her keynote address Tuesday at the World Health Care Congress in Washington, DC.
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Special report: Voice Recognition

Feature
Voice recognition is steadily becoming accepted as a way to interact with electronic patient record systems. Now, suppliers and trusts are thinking about how natural language processing can be used to make sure that EPRs deliver quality benefits. Lawrie Jones reports.
In December, Great Ormond Street Hospital for Children NHS Foundation Trust released an electronic patient record tender. Voice recognition was a key component.
The tender confirms a long-term trend that means that, for some trusts at least, voice recognition is no longer something that is confined to the pathology department or to speeding up the production of letters on which the government has put targets.
It also underlines the extent to which trusts have realised that they need good infrastructure and good user interfaces to support their EPRs: the days when a core software system could be rolled out to a couple of PCs per ward are going, if not quite gone.
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Medi-Cal ditches $179M IT modernization project

April 13, 2016 | By Susan D. Hall
California has decided to scrap a $179 million computer modernization project for its Medi-Cal program and start over, reports California Healthline.
It reached a legal settlement Monday in which project contractor Xerox Corp. will pay the state approximately $120 million. The state had paid Xerox $9 million so far, $8.1 million of it with federal funds.
Xerox, however, will continue to operate the patched-together legacy system until 2019.
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Moving from Hacker to Attacker: Intermountain CIO Marc Probst on Healthcare's Increasing Data Security Challenge

April 11, 2016
by Rajiv Leventhal
Shared security operations center in the works for Intermountain
At the World Health Care Congress 2016, Marc Probst, notable vice president and CIO of Salt Lake City, Utah-based Intermountain Healthcare, discussed the continual—and increasing— threat that the healthcare industry is facing when it comes to protecting data.
During his case study presentation, "Avoid Data Breaches and Strengthen Health Information Security" at the Marriott Wardman Park Hotel in Washington D.C., Probst reflected on when he first started working at Intermountain 12 years ago. Back then, he recalled, IT security consisted of just passwords and usernames. There wasn't anything close to the chief information security officer (CISO) that you see all across patient care organizations today, but just someone who ran the data center and was mostly concerned about locking doors and changing passwords. "Physicians would get ticked off every five years when we asked them to change their passwords. Yes, every five years," Probst said, partly facetious. 
Probst further looked back at one of the first data breaches at Intermountain since he was there, involving  a lost laptop which was unencrypted and had a lot of behavioral health data on it. "We spent tens of thousands of dollars investigating it, and we did recover it. We had poor security on it and no way to track it. It woke us up," he admitted. He additionally recalled another incident at the nearby University of Utah Health Care involving records stored on backup security tapes being stolen from an employee's car overnight. It cost the healthcare organization about $2 million, and Intermountain, having learned from the incident, began encrypting their tapes two weeks later, Probst said. 
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Healthcare Data Breaches Top Reported Data Security Incident

By Jacqueline Belliveau on April 12, 2016

A recent study revealed that healthcare data breaches accounted for 39 percent of data breaches in 2015.

Healthcare data breaches were the most common type of data security incident reported in 2015, according to a recent study by Symantec Corporation.
Researchers found that approximately 39 percent of breaches during the year occurred in the health services sub-sector.
 “This comes as no surprise, given the strict rules within the healthcare industry regarding reporting of data breaches,” explained the authors of the study. “However, the number of identities exposed is relatively small in this industry. Such a high number of breaches with low numbers of identities tends to show that the data itself is quite valuable to warrant so many small breaches.”
There were 120 healthcare data breaches reported in 2015, which was the largest number of data breaches across all industries studied. The next leading industries for data breaches (business and education) only reported 20 incidents each.
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ICD-10 brings both complexity and opportunity

Jeff Rowe
Apr 13, 2016
Of all the changes that have transformed the healthcare sector, in recent years, none may have been more anticipated – or dreaded, depending on one’s perspective – than the transition to ICD-10.  But while many stakeholders will at least concede that the transition has gone much more smoothly than anticipated, others argue that, in fact, the precision in analytics presented by ICD-10 makes the new system a potential ally in increasing revenue.
According to Tracy Dean, business office director for OrthoTexas Physicians and Surgeons, for example, since the ICD-10 transition her organization does not assume any denial is a one-time, isolated event. "We are working the claims and looking at denials,” Dean recently told HealthcareIT News. “Nothing is too small not to have a conversation with the team.”
In other words, providers facing the need to adjust to correctly report the data required by ICD-10 can also adjust to analyze that data for potential revenue.
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Why organizations fail to successfully deploy big data

Published April 13 2016, 2:44pm EDT
More than one recent big data study has labeled 2016 as the year of action, a time to actually act on the insights that data analytics can provide. That theme was echoed at the recent Strata & Hadoop World conference in San Jose, Calif.
David Weldon, editor of Information Management (a sister publication to Health Data Management) spoke with Ash Parikh, vice president of data integration, data security and big data at Informatica for his take on what this new focus means.
What are the most common themes that you are hearing and how do those themes align with what you expected?
The Big Data space has been evolving gradually over the last few years, reflecting the level of maturity in real customer projects. A few years ago, if you were to attend any of the major Big Data events, road shows or conferences, you would walk away extremely excited about the buzz, the giveaways, the myriad technologies mushrooming by the minute, and the newness of the space in general.
We are starting to see a shift—there is more awareness in general that it is a nightmare to keep up with all the new technologies being introduced and ones that are fast becoming outdated in such a short time.
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How CMS wants to see IT used to improve primary care

Published April 11 2016, 4:04pm EDT
In an effort to unlock healthcare data and move to value-based payment models, the Centers for Medicare and Medicaid Services today launched what it is calling its largest-ever initiative to transform and improve primary care in the United States, potentially impacting more than 20,000 clinicians and 25 million patients nationwide.
Called the Comprehensive Primary Care Plus (CPC+) model, CMS says the new initiative is meant to improve healthcare quality and cost, while enabling physicians and patients to have more control over care delivery. Specifically, the five-year CPC+ model is aimed at providing better health outcomes and paying doctors for achieving those results.
As many as 5,000 primary care practices will participate in one of two tracks, with incrementally advanced care delivery requirements and payment options. Healthcare information technology will play an integral role in both tracks, which are designed to give patients 24-hour access to care and health information.
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CPOE use nearly universal, but hospitals at risk for drug errors

Published April 11 2016, 7:44am EDT
Despite widespread adoption of computerized provider order entry, tests of those systems found a significant potential for adverse drug events.
In recent tests of hospital CPOE systems, 39 percent of potentially harmful drug orders were not flagged to alert clinicians to potential errors, and 13 percent of potentially fatal errors failed to trigger an alert, according to the Leapfrog Group.
Results of the study, based on data from 1,750 hospitals in 2015, showed little improvement for comparable data in 2014, which measures the ability of hospitals’ information systems to flag potential errors. The Leapfrog Group said the ability to catch errors improved by only 1 percent between 2014 and 2015.
Leapfrog, a coalition of large employers working to improve care quality, pulled CPOE data from its 2015 annual survey of hospitals covering a range of issues. Castlight Health, which offers a software platform to help employees make better healthcare decisions, provided analysis support.
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Docs in Brazil turn to telehealth to treat Zika cases

April 12, 2016 | By Katie Dvorak
The challenge of Zika in Brazil is a complicated one: the country is large, infrastructure is poor and many people who need care live far from the specialists who can help them. But doctors are turning to health IT to meet those challenges head on. 
A telehealth program for pediatric cardiology care created by Sandra Mattos, M.D., a pediatric cardiologist, is now being used by the state of Paraiba to help infants with possible Zika-related birth problems, according to a NPR report.
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How healthcare organizations can function amid looming security threats

April 12, 2016 | By Susan D. Hall
Just as you'll never be able to rid your body of all viruses and bacteria, healthcare organizations must learn to live with the reality of malware and cyberattacks, Kevin Fu tells HealthcareInfoSecurity.com.
While medical device makers are becoming more vigilant about security, it will take time for those measures to reach the marketplace, says Fu, who directs the Archimedes Research Center for Medical Device Security at the University of Michigan. In the meantime, hospitals must press their vendors to provide more meaningful security, he says.
To that end, Fu says, such security must be measurable. As he's said previously, some organizations are wielding the "power of the purse," making security requirements part of the procurement process.
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Health organizations team up to thwart cyberattacks

April 12, 2016 | By Susan D. Hall
Hospitals and medical schools across the U.S. are teaming up in their quest to thwart cyberattacks.
Security teams from the University of Maryland, Baltimore and its related hospitals, medical school, physicians' offices and academic health programs are meeting monthly to learn from each other about how to stave off infiltration of their electronic systems, reports The Baltimore Sun.
The facilities are putting emphasis on educating staff, students and others how to recognize a potential problem and what to do if an issue arises. In addition, beyond education and working to keep systems updated, they organizations are focusing on making their systems perform better overall.
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Black Book names Cerner top open system HIE vendor

Written by Carrie Pallardy | April 11, 2016
Black Book Research has released its 2016 HIE User Survey, and for the fourth year running Cerner has claimed the top spot.
Cerner's solution is used to exchange millions of patient records. For example, Columbia, S.C.-based Palmetto Health used its health information exchange solution to connect to the Georgia Regional Academic Community Health Information Exchange. As part of the HIE, Palmetto Health is connected to a platform exchanging more than 2.2 million patient records in South Carolina and Georgia.
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Kaiser to use database to find cures for disease

The Baltimore Sun
April 11, 2016
Kaiser to use data bank to find cures for disease
Kaiser Permanente is expanding a database of DNA and other medical information donated by patients to use in research it hopes will lead to groundbreaking cures and treatments for some of the most common chronic diseases.
The health system, which started collecting data from patients in California in 2008, said it now will track patient data from members across the country, including those it treats in Maryland. It believes the national Kaiser Research Bank could become one of the country's largest and most diverse repositories of health data.
"There is such power in numbers," said Cabell Jonas, regional operational leader of the Kaiser Research Bank. "The more data we have coming from different communities, the more representative the bank will be and allow us to look at all kinds of diseases. We have such a diversity of members in Kaiser that we hope the bank will reflect the population."
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Ransomware Threat Levels: Elevated. Executives, are You Listening?

Scott Mace, April 12, 2016

Have executives run out of excuses to postpone increasing security awareness, employee training, and overall IT security budgets? Based on events of the past two months, one could make a pretty compelling case.

I saw a CNBC news story on April Fool's Day that I had to read three times to make sure it wasn't a hoax.
A survey of 1,530 nonexecutive directors and C-level executives in the US, UK, Germany, Japan, and Nordic countries, conducted by Nasdaq and Tanium, found that 40% of executives said they do not feel responsible for the repercussions of criminal hackings.
"I think the most shocking statistic was really the fact that the individuals at the top of an organization, executives like CEOs and CIOs, and even board members, didn't feel personally responsible for cybersecurity or protecting the customer data," said Dave Damato, chief security officer at Tanium, speaking on CNBC's Squawk Box that same day.
Have executives run out of excuses to postpone increasing security awareness, employee training, and overall IT security budgets? Based on events of the past two months, in the healthcare industry anyway, I could make a pretty good case:
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Ontario has ‘dropped ball’ on e-health records, now a national ‘laggard’

Smiths Falls Record News
When it comes to e-health records, Ontario is lagging behind other provinces – including tiny Prince Edward Island.
“Ontario should be front and centre,” said Gary Dickson, Saskatchewan’s first Information and Privacy Commissioner, during the Probus Club of Perth’s monthly meeting at the Perth Royal Canadian Legion hall on Wednesday, April 6. In his native Alberta, “you can go in (to the computer), and electrically see all your health information.” The system, he said, is already “up and running,” while, next door, in Saskatchewan, a similar system is nearing completion.
He attended a conference recently where most of the provinces were represented, including Ontario – though the Ontario delegation had little to add to the discussion.
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HIT Think Providers turning to analytics to protect patient data

Published April 08 2016, 4:21pm EDT
I recently attended the annual RSA conference and it reaffirmed my belief that 2016 is the year of big data and analytics, across all industries and especially in healthcare.
I honestly lost track of the number of companies on the expo floor at RSA who focused on user behavior analytics, That said, the capacity of leveraging UBA to identify the presence of “threat actors” in the IT environment, and to report those threats in visual dashboards of increasing sophistication, further proves we are at an exciting time in our industry.
There is virtually no room for error when it comes to serious cyber threats, particularly when patient privacy or life and death decisions are at stake. In February, Hollywood Presbyterian Medical Center in Southern California fell victim to ransomware and ended up paying roughly $17,000 to get the decryption key so it could regain control of its files and data.
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Why Hospital Boards Must Understand Healthcare Cybersecurity

By Elizabeth Snell on April 08, 2016

Healthcare cybersecurity is no longer just an IT issue, and management, as well as hospital boards need to know the deeper issues.

As healthcare cybersecurity continues to evolve and become more intricate, hospital boards should ensure that they have a comprehensive understanding of the necessary data breach prevention measures.
One of the important things that hospital boards need to understand is what exactly their role is when it comes to cybersecurity, according to Kurt Salmon Director of Technology Services Gerard Nussbaum.
 “Each of the members of the board of directors has a fiduciary duty to work in the best interests of the organization,” Nussbaum explained. “Board members are there to assure that there is an appropriate system of controls with respect to cybersecurity and that system of controls is working appropriately.”
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HIT Think Ransomware: What providers should do now

Published April 11 2016, 4:18pm EDT
Last month, a U.S. hospital’s IT system was held hostage by a ransomware attack that demanded payment to unlock access to the network. The system was down for two weeks, forcing administrators to redirect patients to other hospitals and clinicians to revert to recording patient information on paper.
Hospitals are often more vulnerable to ransomware and other cyber attacks than businesses in other industries like financial services. Their digital transformation came late, and the simple reality is that many IT systems weren’t installed with cybersecurity in mind. Healthcare cyber attacks are occurring on almost a weekly basis, and experts expect those attacks to increase and grow more sinister.
What’s a hospital to do? Expect to get hit, and know how you’ll respond.
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Enjoy!
David.

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