Saturday, May 28, 2016

Weekly Overseas Health IT Links - 28th May, 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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Google using self-designed AI processors

Published May 19 2016, 2:42pm EDT
Google has begun to use computer processors its engineers designed to increase the performance of the company’s artificial intelligence software, potentially threatening the businesses of traditional chip suppliers such as Intel Corp. and Nvidia Corp.
During the past year, Google has deployed “thousands” of these specialized artificial intelligence chips, called TensorFlow Processing Units (TPUs), in servers within its data centers, said Urs Holzle, the company’s senior vice president of infrastructure, Wednesday at the company’s developer conference. Google declined to specify precisely how many of the chips it’s using, but stressed the company continues to use many typical central processing units and graphics processing units made by other companies.
 “If you use cloud voice recognition, then it goes to TPU. If you use Android voice recognition, then it goes to TPUs,” Holzle said. “It’s been in pretty widespread use for about a year.”
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HHS Office for Civil Rights to release guidance for dealing with ransomware attacks

The cyber-threats are increasingly hitting healthcare organizations with great effectiveness, and the OCR is preparing to assist executives seeking to better protect their data and systems.
May 20, 2016 11:17 AM
The U.S. Department of Health and Human Services Office for Civil Rights is working on official guidance to help healthcare organizations formulate plans to bolster against ransomware attacks and to figure out effective ways to react to such attacks, according to the Bloomberg Bureau of National Affairs.
Deven McGraw, deputy director for health information privacy at OCR, first discussed the ransomware guidance at a recent cybersecurity panel event held by Politico. According to a new report from the Ponemon Institute, ransomware, denial-of-service attacks and malware are the top threats facing healthcare organizations today.
The OCR guidance additionally will look to shed light on when a ransomware attack is considered a breach, thus requiring healthcare organizations to inform the OCR and patients, according to Bloomberg BNA. To date, healthcare organizations have not been reporting ransomware attacks as breaches.
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How to Protect Your Entity from Healthcare Phishing Attacks

By Lysa Myers of ESET on May 19, 2016

It is becoming more common for data breaches to be triggered through healthcare phishing attacks, which are not always easy to protect against.

We read with horror about healthcare organizations getting hacked, spilling personal health details that no one wants to find dumped out onto the public internet. The origins of these attacks are all-too-frequently healthcare phishing attacks, stemming from emails that a staff member has unwisely opened.
While in theory, the obvious advice to give is that one should not click on strange links in email, that directive may not be as easy to follow as one might hope.
Phishing emails are becoming increasingly convincing, in part by targeting specific individuals via “spear phishing.”
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Only three states require e-prescribing of narcotics despite its benefits

Jayne O'Donnell, USA TODAY 9:39 a.m. EDT May 19, 2016
Electronic prescribing of controlled substances reduces fraud and keeps patients from getting multiple prescriptions for the same drug, but only three states require it and one doesn't even enforce its law.
As much of the country struggles with record overdose deaths, often from opioid painkillers, industry officials say this legislative lapse needs to be remedied as part of a broad drug control policy.
Although paper prescriptions were once considered safer, all states now allow e-prescribing for drugs, including opioid painkillers and other controlled substances. Still, only 7% of doctors do so, according to Surescripts, which links doctors with pharmacies for e-prescribing.
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Healthcare IT budgets expected to rise, but demands even more so

May 19, 2016 | By Susan D. Hall
A majority of healthcare executives expect IT budgets to increase in the next two years, but doing more with less remains a major reality, according to a survey from Peak 10.
The poll of 157 C-level executives and healthcare IT pros found staffing a major worry, whether in dealing with increasing security threats or the increasing need for a data-savvy workforce.
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World Privacy Forum questions adequacy of PMI privacy principles

May 19, 2016 | By Katie Dvorak
The World Privacy Forum says privacy principles set forth for the Precision Medicine Initiative "lack detail and fail to address underlying legal requirements and protections." 
In a research paper published this week, the organization notes that the HIPAA Privacy Rule will not apply to the research, and that the principles "appear to be voluntary and lack important legal and administrative details."
The current privacy principles in place for the initiative were created by the White House with help from experts working both inside and outside the government. They include categories such as transparency to participants and the public; respect for participant preferences; and appropriate data sharing, access and use.
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ICO 'aware' of Google DeepMind and Royal Free app concerns

Lyn Whitfield
17 May 2016
The Information Commissioner’s Office has confirmed that it is “aware” of concerns about a trust’s collaboration with Google DeepMind on an AKI alert system.
Google announced that its artificial intelligence offshoot, DeepMind, had launched a new division to work with NHS clinicians on developing technology to improve patient care in March.
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Integrated care pioneers 'struggling and facing IT issues'

Lyn Whitfield
16 May 2016
The government’s integrated care pioneers have made little progress and are struggling with IT and information governance issues, an official evaluation has shown.
The Integrated Care and Support Pioneer Programme was an initiative championed by Liberal Democrat care minister Norman Lamb during the last Parliament.
It was seen as leading the charge for the kind of ‘whole system’ working that policy makers hope will deliver significant efficiency savings.
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Mayo Clinic: Remote monitoring of low-risk pregnancies boosts patient satisfaction

May 18, 2016 | By Susan D. Hall
Women with low-risk pregnancies reported improved satisfaction with a program called OB Nest that combined a reduced number of in-person prenatal visits with in-home monitoring, according to a presentation this week at the Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists.
Researchers from the Mayo Clinic compared usual care that involves 12 to 14 visits with an obstetrician to the OB Nest program, in which patients had eight in-person appointments and six "virtual care" visits with a trained nurse by phone or email. Participants also used home monitoring equipment for fetal heart rate and maternal blood pressure. In addition, they could be part of an online community of OB Nest participants and nurses, according to an announcement.
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Researchers: Portals should be more personal, interactive

May 18, 2016 | By Susan D. Hall
Patient portals need to provide more personalized, direct communication with providers and interactivity to fully engage patients, according to research published at the Journal of Internet Medical Research.
The researchers found that portals haven't been as widely adopted as hoped, and sought to find contributing factors to that. They conduced 31 patient interviews, two clinician focus groups and reviewed 142 incidents involving portal use, 102 negative and 40 positive.
They noted a "pronounced" difference in expectations, with providers using the portal to educate and motivate patients for preventive screenings and patients seeking to organize their healthcare overall.
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Business continuity crucial for healthcare IT execs facing rising threats

Published May 18 2016, 2:56pm EDT
Healthcare is becoming increasingly reliant on digital technology and the data it generates. Technology is now integrated into operations at virtually every level—handheld diagnostic tools, tablet-based consultation reports, electronic medical records, automated reconciliation, billing and payment and more. IT is how healthcare works, competes and manages the efficiency and effectiveness of each organization.
As a result, the potential impact of IT outages has increased exponentially. And that makes the discipline of business continuity an imperative for healthcare executives. One clear, simple example of the gravity of this issue: A business continuity plan is required to comply with HIPAA regulations.
But in the course of providing IT managed services to healthcare clients, there is often a lack of clarity and understanding of business continuity in general. So, let’s begin this discussion by defining business continuity in healthcare terms.
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38% of execs want telemedicine programs built onto their EHRs; 6 other survey takeaways

Written by Max Green | May 17, 2016
There are a number of ways for hospitals to implement telemedicine programs. Many systems are beginning to dabble with the technology to determine what works best for them and their patient population, but a new survey suggests that many executives — 38 percent — would prefer a rolling out a telehealth option that could be built out of their existing EHR.
Here are six additional findings from Avizia's "Closing the Telehealth Gap" report.
  • Of respondents, 63 percent say their organization uses telehealth.
  • Of hospitals, 72 percent or healthy systems say they use telehealth. That number drops to 52 percent for physician groups and clinics, and 36 percent for other types of providers.
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Telemedicine's Explosive Growth Rate Belies its Penetration

John Commins, May 18, 2016

Telemedicine has grown tremendously in the past five years in some rural areas. Yet barriers remain, and only a fraction of the population has access.

"Soccer is America's sport of the future," so that old joke goes, "and it always will be."
I am reminded that of that chestnut every four years as I follow the World Cup misfortunes of the U.S. men's team, and whenever the subject turns to telemedicine.
For so many years we've been talking about the potential of telemedicine, how it can improve population health and access and contain costs, particularly in rural America. Still, we've yet to achieve the sort of widespread utilization and population health benefits that many advocates have envisioned.
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Cybersecurity special report: Ransomware will get worse, hackers targeting whales, medical devices and IoT trigger new vulnerabilities

Cybercriminals have set their sights on healthcare. Ransomware is the new normal. And many providers are approaching security all wrong. CIOs, CISOs, ethical hackers and other experts point the way forward. 
May 17, 2016 07:07 AM
Boston Children's CIO Daniel Nigrin, MD said that in the past he thought about cybersecurity related to health IT as safeguarding data. But experience, particularly the Anonymous attack, has since taught him that it is much more than that. 
When it comes to digital security, healthcare provider organizations have the wrong mission and are using outdated approaches, generally failing at securing their organizations from today’s increasingly sophisticated cybercriminals.
That’s according to “Hacking Hospitals,” a two-year study by Independent Security Evaluators of 12 healthcare facilities, two healthcare data facilities, two healthcare technology platforms and two medical devices.
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FDA issues draft guidance on use of EHRs in clinical investigations

May 16, 2016 | By Marla Durben Hirsch
The U.S. Food and Drug Administration has released draft guidance regarding the collection and use of electronic health record data in clinical trials.
The draft guidance is an effort to modernize and streamline clinical investigations, and its goals are to "facilitate use of EHR data in clinical investigations and promote the interoperability of EHRs and electronic systems supporting the clinical investigation."
The FDA notes that EHRs may enable researchers to more easily combine, aggregate and analyze data, both in real-time and longitudinally, as well as facilitate post trial follow ups. The FDA's acceptance of such data depends on the FDA's ability to verify its quality and integrity.
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How to prevent ransomware attacks

Published May 16 2016, 8:32pm EDT
By this time last year, 105 healthcare breaches had been reported to the U.S. Department of Health and Human Services (HHS) for a total of over 92 million lost records, compared with “only” 81 breaches and 3.5 million records so far in 2016. Good news, right? Well, sort of.
Unfortunately, this seemingly positive trend does not reflect the actual threat landscape in the healthcare industry. Ransomware is a type of malware that restricts access to files or systems with encryption until the victim (the hospital) pays the ransom for the key to unlock them.
As a former security operations lead for a hospital network, I responded to numerous ransomware infections following targeted phishing campaigns against the hospital. The incident response team followed the same procedure for each incident: isolate the infected PC and restore the corrupted (encrypted) files on the department shared drive from backup. In such isolated instances, there was no impact to clinical operations and patient care. However, the story would have been different in the case of widespread infection on the network.
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Is ONC putting too much hope on the cloud?

Published May 13 2016, 1:27pm EDT
The Office of the National Coordinator for Health Information Technology (ONC) is pinning its latest hopes for interoperability on the cloud, namely with application programing interfaces, or APIs. But is this hope realistic?
Experts feel it will be a close call to get the API standards ready in time for requirements found in the April 27 release of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) proposed rule. The rule makes it a national objective to achieve health data interoperability by December 31, 2018.
A measure in the MACRA proposal called, “View, Download, Transmit (VDT),” calls for eligible clinicians to help patients:
  • view, download or transmit their health information to a third party;
  • access their health information through the use of an API; or
a combination of both
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Survey: No slowdown in healthcare breaches

Published May 16 2016, 4:09am EDT
Nearly 90 percent of healthcare organizations were the victims of a data breach in the past two years, and 45 percent had more than five data breaches during that same time period.
Criminal attacks are the leading cause of these health data breaches, with 50 percent of healthcare organizations and 41 percent of business associates reporting such attacks, while employee mistakes, third-party snafus, and stolen computer devices are the cited reasons for the other breaches.
Those are among the findings of a new study by the Ponemon Institute, sponsored by software and services vendor ID Experts, in which denial-of-service attacks, ransomware, malware, and phishing are listed as the top cyber threats facing healthcare organizations and business associates.
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5 health issues presidential candidates aren't talking about but should be

Long-term care, out-of-pocket spending and even dental care are among the challenges America faces in the next few years. But Bernie Sanders, Donald Trump and Hillary Clinton are not saying nearly enough about their intentions in those areas. 
May 16, 2016 10:22 AM
References to the Affordable Care Act — sometimes called Obamacare — have been a regular feature of the current presidential campaign season.
For months, Republican candidates have pledged to repeal it, while Democrat Hillary Clinton wants to build on it and Democrat Bernie Sanders wants to replace it with a government-funded “Medicare for All” program.
But much of the policy discussion stops there. Yet the nation in the next few years faces many important decisions about health care — most of which have little to do with the controversial federal health law. Here are five issues candidates should be discussing, but largely are not:
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MACRA focus should be patient outcomes, not 'unnecessary burdens,' John Halamka says

May 16, 2016 | By Dan Bowman
Beth Israel Deaconess Medical Center CIO John Halamka believes that less could be more when it comes to physicians transitioning to the new programs outlined under the Medicare Access & CHIP Reauthorization Act (MACRA).
For clinicians, he says in a post to his Life as a Healthcare CIO blog, less focus on striving toward multiple quality indicators and more emphasis on an important but select few could lead to improved outcomes quality. The post is a follow-up to his earlier commentary on the MACRA proposed rules, which he calls overly complex and burdensome.
He notes, for instance, that forcing doctors like his ophthalmologist to record smoking statuses or send secure messages to patients is not as vital to better care as actually ensuring medications are administered and eyesight does not worsen.
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Telecom companies lag behind Google, Apple in digital health space

May 16, 2016 | By Katie Dvorak
As Apple and Google take a greater role in healthcare innovation, telecom companies fall short of success in the industry, according to a Bloomberg report.
As early as 2009, AT&T, Verizon and similar companies had their sights set on digital health, but according to the report weren't able to obtain the same foothold or put in the same amount of time and money into transforming healthcare as other tech giants.
While the companies had the technical capability to create necessary networks, they weren't able to make the headway as that Google and Apple have with their tools and devices. Hospitals wanted services and devices that would improve workflow, Lee Schwamm, medical director of telehealth at Massachusetts General Hospital, says in the article.
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Boston Children's Hospital creates mHealth development guide

May 15, 2016 | By Judy Mottl
Boston Children's Hospital researchers have created a 14-point mobile app development guideline for bring-your-own-device hospital environments to help developers with system integration, compliance adherence and software deployment strategies.
Once the Mobile Application Development guideline was developed, BCH researchers built the TaskList app, which is aimed at helping medical residents capture, monitor, create and share daily collaborative patient-focused tasks. The guideline's 14 recommendations cover four categories, from authentication and data management to secure app environments and remote enforcement, according to a report detailing the guideline's development, published in the Journal of Medical Internet Research.
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Study of Telemedicine Finds Misdiagnoses of Skin Problems

Online medical services are booming, but physicians remain concerned

By Melinda Beck
Updated May 15, 2016 4:40 p.m. ET
Researchers posing as patients with skin problems sought help from 16 online telemedicine companies—with unsettling results.
Some of the online doctors misdiagnosed syphilis, herpes and skin cancer, and some prescribed medications without asking key questions about patients’ medical histories or warning of adverse effects, the researchers found. Two sites linked users with doctors located overseas who aren’t licensed to practice where the patients were located, as required by state law.
“The services failed to ask simple, relevant questions of patients about their symptoms, leading them to repeatedly miss important diagnoses,” said Jack Resneck, a dermatologist with the University of California, San Francisco, and lead author of the study, published online in JAMA Dermatology on Sunday.
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Prevent Data Breaches with Strong Medical Device Security

With cybersecurity attacks becoming more complex, strong medical device security is an essential aspect when it comes to preventing data breaches.

Patients come to your healthcare facility with a whole host of expectations.
They want personalized, quality care delivery. They want strong medical device security, knowing that all equipment is reliable, effective and safe.
They’re placing an incredible amount of trust in you and your facility. Their health and wellbeing is entirely in your hands.
Patients are also trusting your equipment, systems, and staff to keep their personal health information safe from cyberattacks.
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ONC Task Force: No ‘Show-Stopping’ Barriers to API Requirements

May 15, 2016
by David Raths
Calls existing standards, infrastructure and identity-proofing processes adequate to support patient-directed access via APIs
A task force of the Office of the National Coordinator for Health IT (ONC) has prepared a series of recommendations to address privacy and security concerns around application programming interfaces (APIs), technology that allows one software program to access the services provided by another software program. The task force said it did not identify any “show-stopping” barriers that would prevent the deployment of APIs within the timelines ONC has set for 2015 certification criteria or Meaningful Use stage 3.
 In its 2015 Edition of Health IT Certification Criteria (2015 CHIT), ONC established three new criteria that requires certified health IT to demonstrate the ability provide a patient-facing app access to the Common Clinical Data Set via an API. In parallel, CMS included two objectives in MU Stage 3 that reference the use of APIs involving patient electronic access to health information and coordination of care through patient engagement.
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Enjoy!
David.

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