Saturday, July 30, 2016

Weekly Overseas Health IT Links – 30th July, 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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Portals linked to lower rates of hospitalization, readmission

Published July 21 2016, 4:40pm EDT
Research still underway shows that congestive heart failure patients using a patient portal offered by a hospital or physician practice have higher engagement rates, lower hospitalization and readmission rates, and higher outpatient visit rates.
Use of portals is associated with 20 percent lower hospital admissions and a similar lower rate of readmissions, said Indranil Bardhan, a professor at the University of Texas at Dallas, during a session at Health Data Management’s Healthcare Analytics Symposium in Chicago.
The higher rate of outpatient visits is a positive sign, Bardhan adds. While utilization grows, patients who get more outpatient treatment are less likely to have hospitalizations or readmissions.
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AHA finds patient access to medical records higher than ever

The American Hospital Association found that providers are enabling patients to conduct more tasks online, including paying bills, contacting their provider, and scheduling appointments.
July 22, 2016 09:09 AM
More than 90 percent of hospitals across the country make patients’ medical record available online, according to a new report from the American Hospital Association.
Most of them also make it possible for patients to perform related tasks, such as download information, request changes and send referral summaries to third parties.
AHA found progress in these realms. The 92 percent hospitals that make it possible for patients to view medical records, in fact, more than doubled since 2013, when 43 percent of hospitals offered that capability.
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HIT Think Why those studying CPOE usability are asking the wrong questions

Published July 22 2016, 2:25pm EDT
Healthcare IT has caused angst among physicians for decades. The evidence bombards us:
  • The American Medical Association has mounted a campaign to bring physicians’ complaints to the attention of healthcare policy makers.
  • A survey on physician use of electronic health record systems found that more than half of all respondents reported their EHR system had a negative impact on costs, efficiency or productivity.
  • Now another study from the Mayo Clinic reports the use of EHR systems and computerized physician order entry (CPOE) reduces physician satisfaction and contributes to higher rates of burnout.
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Health IT rethink needed amid "colossal" financial challenge

Lyn Whitfield
19 July 2016
Sir David Dalton has called for a radical shake-up in the way that NHS IT is bought and deployed in a health select committee report that warns the NHS is facing a "colossal" financial challenge.
As part of an inquiry into the impact of last year’s spending review on health and care, MPs visited Salford Royal NHS Foundation Trust, where chief executive Sir David told them that technology was a “key enabler of successful transformation”.
Salford deployed the Allscripts electronic patient record in 2013, in support of its ambition to be “the safest hospital in the NHS”. Sir David told the committee it had enabled the trust to standardise care pathways and to link acute to primary care, “reducing variation in care standards and achieving economies of scale”.
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Editor's Corner: Too soon to tell if EHRs provide good ROI

Jul 20, 2016 11:35am
There’s been a lot of hoopla about the role of electronic health records in patient safety, Meaningful Use, data sharing and security.
But the elephant in the room is always "do EHRs provide a good return on investment? Will EHR users make more money?" It seems, based on recent research, that the answer might be yes.
First, there’s the study that EHRs are adept at increasing a provider’s charge capture. By using their EHR’s automation and enhanced coding capability, pediatric primary care physicians saw an $11.49 increase on average, per-patient collections and an $11.09 increase on average, per-patient charges, as well as an improvement in collection ratios. The researchers determined that the increases were due to more orders for ancillary services, improved documentation, forced completion of records and reduced coding errors. They concluded that the investment in EHRs would be recouped.
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Ransomware: 4 steps to resist and recover

Researchers propose tactics for preventing ransomware attacks and learning from them when they do occur, based on NIST’s cybersecurity framework. 
July 21, 2016 10:57 AM
The threat of ransomware attacks on health care facilities is greater than ever as cybercriminals see the opportunity to make money by encrypting health data in EHRs and demanding payment to unlock it.
CIOs and CISOs, meanwhile, understand that security tools are only one piece of the puzzle when it comes to safeguarding patient data. Another critical aspect not to overlook, of course, is user training.
“While preventing all ransomware attacks is not possible, there are a number of steps healthcare organizations can take to reduce their risk as well as mitigate potential harm,” according to Dean Sittig and Hardeep Singh, MD.
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Federal health IT spending sees 'astonishing growth,' says new report

HHS and VA have made huge investments in infrastructure and cybersecurity. With its massive EHR modernization project the DHA is also opening its purse strings.
July 21, 2016 11:14 AM
A new analysis of information technology spending at the U.S. Department of Health and Human Services, Department of Veterans Affairs and Defense Health Agency shows that, even despite sequestration, IT services for federal health agencies are up 27 percent annually.
HHS – most notably the sprawling Centers for Medicare and Medicaid Services – was far and away the biggest spender, doling out some $13 billion in prime contract obligations between fiscal years 2011 and 2015, according to a report by market research firm Govini.
The Defense Health Agency is also making waves, of course, with its mammoth electronic health record modernization program, which awarded an initial $4.3 billion contract to Leidos, Cerner and Accenture almost exactly a year ago.
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Open-source competitors must 'break open' patient health data

Jul 21, 2016 10:21am
A movement is needed to “break open” how patient data can be collected and used, and patients can no longer be passive players when it comes to their personal information, according to John T. Wilbanks and Eric Topol.
Silicon Valley’s role in healthcare is changing rapidly, and more healthcare experts are moving out West to bring their expertise to companies like Google and IBM. These companies can collect giant amounts of data in minutes, and can control how that data is used, Wilbanks, M.D., chief commons officer at Sage Bionetworks, and Topol, a cardiologist and director of the Scripps Translational Science Institute, write in a commentary for Nature.
That, they say, can cause digital profiling, which could increase pre-existing biases.
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Wed Jul 20, 2016 8:51am EDT
Related: Health

Your inhaler's watching you: drugmakers race for smart devices

LONDON | By Ben Hirschler
Makers of inhalers to treat asthma and chronic lung disease are racing to develop a new generation of smart devices with sensors to monitor if patients are using their puffers properly.
Linked wirelessly to the cloud, the gadgets are part of a medical "Internet of Things" that promises improved adherence, or correct use of the medication, and better health outcomes. They may also hold the key to company profits in an era of increasingly tough competition.
Drugmakers believe giving patients and doctors the ability to check inhaler use in this way could be a big help in proving the value of their medicines to governments and insurers, though they need to tread carefully on data privacy.
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Advanced EHR Use Shows Potential to Lower Patient Costs

By Sara Heath on July 20, 2016

Research shows that patients at advanced EHR use hospitals cost on average $730 less than those at other hospitals.

Advanced EHR use may lead to significant per patient savings, showing promise for an eventual return on investment, shows a study published in the American Journal of Managed Care.
The study included a retrospective analysis of the National Inpatient Sample (NIS) and the HIMSS Annual Survey to examine patient costs and rates of advanced EHR use.
For the purposes of the study, the researchers defined advanced EHR use as meaningful use. Those that achieved the benchmarks set forth by the Centers for Medicare and Medicaid Services’ EHR Incentive Programs were categorized as advanced EHR users.
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HIT Think Why IT must play a role in solving the mental health crisis

Published July 21 2016, 4:23pm EDT
Chances are good someone close to you is suffering from a mental health disorder right now. You may not know it.
Chances are also good that you don't have the knowledge or resources to deal with an extended bout of mental illness suffered by a family member. This was a primary concern in the recent passage by the House of the Helping Families in Mental Health Crisis Act, which seeks to overhaul the American mental health care system and awaits companion Senate legislation.
New laws that fund more treatment will be helpful, to be sure, but the Helping Families Act will probably be more initial salvo than decisive blow, given what the nation is up against when it comes to mental illness. The Centers for Disease Control estimates that 25 percent of Americans have a mental illness, and almost 50 percent will face at least one mental health challenge at some point in their lives. The Department of Health and Human Services says 8 percent of Americans could benefit from drug or alcohol treatment.
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The Secret Documents That Detail How Patients’ Privacy is Breached

ProPublica, July 21, 2016

Thousands of times a year, the Office for Civil Rights of the U.S. Department of Health and Human Services resolves complaints about possible violations of the Health Insurance Portability and Accountability Act quietly, outside public view.

This story first appeared July 22, 2016 on the Charles Ornstein ProPublica website.
When the federal government takes the rare step of fining medical providers for violating the privacy and security of patients' medical information, it issues a press release and posts details on the web.
But thousands of times a year, the Office for Civil Rights of the U.S. Department of Health and Human Services resolves complaints about possible violations of the Health Insurance Portability and Accountability Act quietly, outside public view. It sends letters reminding providers of their legal obligations, advising them on how to fix purported problems, and, sometimes, prodding them to make voluntary changes.
Case closed.
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ONC takes aim at health data outside scope of HIPAA

Published July 20 2016, 6:45am EDT
The Office of the National Coordinator for Health IT has sent a report to Congress detailing the lack of clear guidance around the privacy and security of electronic health information collected, shared, and used by entities not currently covered by HIPAA.
Developed in coordination with the Department of Health and Human Services’ Office for Civil Rights and the Federal Trade Commission, the ONC report focuses on mobile health technologies and health social media that are outside the scope of HIPAA.
The report identifies key gaps in oversight that exist between HIPAA regulated and non-regulated entities when it comes to health data, and recommends filling those gaps in a way that protects consumers “while leveling the playing field for innovators inside and outside of HIPAA.”
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Doctor devises new database methodology to thwart hackers and end big data breaches

William Yasnoff, MD, has developed a personal grid format that can prevent hackers from accessing an entire database full of patient records. Hospitals or IT vendors can use the tactic – for free – to force cybercriminals to decrypt one record at a time.
July 20, 2016 07:17 AM
Longtime healthcare and technology veteran William Yasnoff, MD, has created a personal grid tactic for tuning relational databases to make it harder for hackers to steal large sets of medical records.
And Yasnoff, a managing partner at NHII Advisors, said that hospital CIOs and CISOs or technology vendors can use the personal grid approach for free. It’s not a product but, rather, a methodology for organizing data within a traditional relational database management system.
“Large-scale security problems – Anthem and Premara and so on – concern the loss of an entire data set with one intrusion,” said Yasnoff, also an adjunct professor of health sciences informatics at Johns Hopkins University and a member of the team that led the work at the Department of Health and Human Services that resulted in the executive order creating the Office of the National Coordinator for Health Information Technology.
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AHA: Most hospitals offer patients access to their EHRs

Jul 20, 2016 10:40am
Hospitals are doing a better job than ever of providing patients with the ability to access their electronic records, according to a new report from the American Hospital Association (AHA).
Almost all hospitals (92 percent) offered patients the ability to view their EHRs in 2015, up from 43 percent in 2013. Eighty-four percent allowed patients to download data from their EHR, up from 30 percent in 2013, while more than two-thirds (70 percent) allowed an electronic referral summary to be sent to a third party, an increase from 13 percent in 2013. 
Additionally, 63 percent of hospitals had the capability to enable patients to message their providers online, an increase of eight percentage points from 2014. Thirty-seven percent were able to let consumers submit patient-generated data to the hospital, up from 14 percent in 2013.
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Data-driven parameters can help reduce alarm fatigue

Jul 20, 2016 10:44am
New research finds that use of data-driven parameters to modify and reduce alarm limits is one viable option for cutting alarm fatigue, which regularly is cited as a top healthcare hazard.
The study, published in the Journal of Hospital Medicine, focuses on alarm use for hospitalized children at Lucile Packard Children’s Hospital Stanford.
The facility’s electronic health record system was accessed to find vital sign measurements for heart rate (HR) and respiratory rate (RR) for patients. The researchers then analyzed rapid response team and cardiorespiratory arrest events over the course of a year, using HR and RR values before the event to find the number of patients with out-of-range vitals.
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74% of physicians say they haven't seen a return on EHR investment

Written by Erin Dietsche (Twitter | Google+)  | July 19, 2016
Physicians Practice recently released its annual Technology Survey, which surveyed physicians about their health IT use.
As part of the Technology Survey, Physicians Practice analyzed the responses of more than 1,500 physicians and practice managers across the nation.
Here are four things to know about the survey.
1. Approximately 74.3 percent of respondents said they haven't noticed a return on EHR investment.
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Can Automated Prompts Reduce Surgical Site Infections?

John Commins, July 20, 2016

More than 90% of patients surveyed followed preoperative protocols to prevent surgical site infections. Researchers believe this inexpensive strategy will reduce SSIs.

A common sense-based by medical students at Washington University School of Medicine in St. Louis provides a good example of the benefits of patient engagement.
The research, led by second-year students Michelle Keyin Lu and Christopher Chermside-Scabbo, looked at patient engagement as a tool in reducing surgical site infection. It is the third most common healthcare-associated infection, adversely affecting more than 500,000 patients each year.
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Telehealth at a tipping point for changing healthcare delivery

Published July 19 2016, 6:02am EDT
Fueled by three important trends, the time has come for healthcare to embrace telehealth as a technology platform for achieving increased industry efficiencies and providing greater patient access to care.
So argue Eric Topol, MD, director of the Scripps Translational Science Institute in La Jolla, Calif., and Ray Dorsey, MD, director of the Center for Human Experimental Therapeutics at the University of Rochester Medical Center in Rochester, N.Y.
Writing last week in the New England Journal of Medicine, Topol and Dorsey contend in a review article that telemedicine has reached a tipping point and has the potential to dramatically transform the delivery of healthcare for millions of Americans. Thanks to three trends, the authors make the case that the widespread adoption of telehealth is rapidly approaching, especially given the ongoing doctor shortage and the industry’s growing burden of managing chronic diseases.
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Precision Medicine Initiative a 'turning point' for healthcare, Eric Topol says

by Dan Bowman 
Jul 19, 2016 12:59pm
The Precision Medicine Initiative is “unprecedented” and represents “a turning point in medicine,” according to cardiologist Eric Topol.
In a recent interview with STAT, Topol, who serves as director of the Scripps Translational Science Institute (STSI), says the data will help to improve prevention and treatment efforts on a much more personalized level. He calls current testing “a profound waste” that proliferates “one-size-fits-all” efforts.
“This is a new day,” Topol says. “This is a reset, a reboot of what we thought about medicine, and it’s all predicated on what we know about individual people.”
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ONC names first winners of data sharing app challenges to leverage FHIR for easier patient and provider access

The Consumer Health Data Aggregator and Provider User Experience challenges focus on easing access to information for consumers and clinicians, respectively.
July 19, 2016 11:07 AM
"The apps that these challenges will produce have the potential to spur real-world improvements for individuals and clinicians throughout the health system," said Principal Deputy National Coordinator Vindell Washington, MD.
The Office of the National Coordinator for Health Information Technology announced Monday the Phase 1 winners of two app challenges that aim to make it easier for patients and providers to access and share healthcare data.
Applicants were tasked to use HL7's Fast Healthcare Interoperability Resources specification and open application programming interfaces to develop apps that enable more robust data sharing than exists in most electronic health records.
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AMIA Challenges FDA over EHR Data Quality Claims

By Kyle Murphy, PhD on July 18, 2016

Concerns over EHR data integrity and reliability stem from lack of standardization, certification of health information technology.

The American Medical Informatics Association (AMIA) is raising concerns over EHR data quality in current systems in comments on draft guidance issued by the Food & Drug Administration (FDA) for the use of EHR data for clinical investigations.
 “As a picture of the future state, this guidance provides an important window into how interoperable EHRs and electronic data capture systems or electronic case reporting forms could be leveraged to simplify data collection, reduce errors and provide healthcare professionals new opportunity to treat emerging issues that arise as part of investigations,” writes AMIA President & CEO Doug Fridsma, MD, PhD, and Board Chair Thomas Payne, MD. “However, we strongly caution FDA from assuming that most EHRs are readily configurable for clinical investigations, even among more advanced institutions.”
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AMIA questions whether EHR data can be used for research

Published July 19 2016, 6:13am EDT
The use of electronic health records for clinical research offers great opportunities to facilitate medical research but there’s a long road ahead before digital records can reliably used for that purpose.
That’s the warning of the American Medical Informatics Association (AMIA), which yesterday filed comments responding to the Food and Drug Administration’s proposed guidance on using EHRs for research purposes.
Both hospitals and physicians are gathering large amounts of information through the electronic records systems they’ve installed in recent years, AMIA noted. But the professional association, which represents the nation’s leading biomedical and clinical informaticians, said it doubted whether those systems contain data of high enough quality that could support randomized controlled trials.
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Ransomware Attacks Can't Hide from HIPAA Anymore

Scott Mace, July 19, 2016

Hospital and health system executives are on notice: Come clean about ransomware attacks as early as possible or be prepared to face sanctions.

Ransomware, the scourge of healthcare IT for much of 2016, is no longer something healthcare executives can try to sweep under the rug.
A pronouncement  from CMS last week clarifies that any ransomware attack is also likely a data breach which must be reported like any HIPAA violation.
This puts healthcare executives on notice that they must come clean about ransomware attacks as early as possible or potentially face sanctions.
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OpenAPI is the first to be certified using FHIR standard for Stage 3 MU

Published July 15 2016, 3:01pm EDT
The first open application programming interface (API) software platform has been certified using HL7’s emerging Fast Healthcare Interoperability Resources (FHIR) standard to meet Stage 3 Meaningful Use interoperability requirements.
This distinction belongs to OpenAPI from Carefluence, a Michigan-based company that offers software solutions and technology integration services to electronic health record vendors and healthcare providers.
Drummond Group, which is authorized by the Office of the National Coordinator for Health IT to test software for compliance with Meaningful Use interoperability requirements, has certified that the Carefluence OpenAPI software module can be deployed alongside existing EHR systems, providing functionality that enables open access to EHRs and lets providers receive incentive payments from the federal government.
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Ponemon: 79 percent of security professionals lack consistent tools to identify and mitigate cyberthreats

The firm's new report, Security Beyond the Traditional Perimeter, found an acute need for both expertise and technology for safeguarding IT networks and protected health information.
July 18, 2016 09:46 AM
Ponemon Insitutue founder Larry Ponemon said that even though leaders understand threats, hospitals continue to struggle with implementing effective defenses. 
Top executives in charge of cybersecurity at health systems across the country are painfully aware of the costs of unchecked external Internet attacks. Even still, many lack the expertise and technology to stop them, according to a new Ponemon Institute study.
For the report, “Security Beyond the Traditional Perimeter,” commissioned by BrandProtect, Ponemon garnered responses from 505 companies representing a wide range of industries. Ponemon said the number of responses makes it one of the most comprehensive investigative surveys to date on external threat awareness, costs, preparedness and mitigation. 
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Health IT investment: 2016 gets off to lackluster start

Jul 15, 2016 10:32am
U.S. capital markets were relatively flat for health IT and related sectors during the first half of 2016, according to a report from Healthcare Growth Partners, which provides investment banking and advisory services.
It counted197 venture capital deals, compared with 215 transactions during the first half of 2015. Deal sizes also were down.
The report also tracked stock indices for seven sectors when evaluating the performance of publicly traded companies: health IT, HIT services, pharmacy benefit management, healthcare services, contract research organizations, payers and payer services.
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Study: Vulnerable patient populations find apps close to useless

by Judy Mottl 
Jul 18, 2016 7:44am
Low-income patients are eager to embrace mobile healthcare apps, but the majority say the tools are frustrating and nearly useless, finding data entry burdensome and gaining little use from the apps.
A new UC San Francisco study, published in the Journal of General Internal Medicine, revealed nearly every participant who used health apps could not get to a productive point. The respondents also were able to complete just 51 percent of data entry tasks and just 43 percent of them could access data from the tools.
The research involved patients at The Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), a UCSF partner hospital. Most were managing diabetes or depression, while come serve as caregivers.
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Study finds demographic differences in portal access

Jul 18, 2016 10:58am
While a majority of consumers say it’s important to have online access to their health information, a new survey finds racial and demographic differences effects who is offered such access.
In the study of 3,677 respondents, published in the Journal of the American Medical Informatics Association, 92 percent considered online PHI access important, but just 34 percent were offered that access by a healthcare provider, and only 28 percent had accessed online PHI through a secure website or phone app.
While the researchers found no demographic differences in interest in online access, respondents reported it was offered less often to people who were older, non-white, Hispanic, less educated or had lower incomes. Geographic differences were also noted; groups living in nonmetropolitan areas and in the Northeast or South reported being offered portal access less often.
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Patients accessing medical records online more than ever

Written by Akanksha Jayanthi (Twitter | Google+)  | July 15, 2016
With the adoption of EHRs and patients' growing demand for access to information, the rate at which hospitals are offering electronic capabilities — and that patients are using them — has skyrocketed in the past three years. Where patients previously had to submit a formal request to a hospital's medical records department for a paper copy, patients are now taking advantage of the digitization of healthcare. For example, in 2015, 92 percent of hospitals offer patients the ability to view their medical records online, a significant increase from the 43 percent who offered the ability in 2013, according to an American Hospital Association report.
In other examples, 30 percent of hospitals allowed patients to download information from their medical record in 2013. That increased to 80 percent in 2014 and 84 percent in 2015. Thirty-five percent of hospitals allowed patients to request changes to medical records in 2013, growing to 71 percent in 2014 and 78 percent in 2015.
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Should you pay a hacker’s ransom?

It's like negotiating with terrorists. (Reuters/Kacper Pempel)
Written by
Carl Herberger Vice president of security solutions, Radware
July 14, 2016
If someone locked down your pacemaker, what would you pay to regain control? If hackers took over a cockpit or locomotive, what would you pay for restitution?
This is the future of ransomware that we’ll almost certainly see if the evolution of these threats holds course. Any time human safety enters the mix, it’s a ripe opportunity to extort money. As more ransomware victims pay, the kind of threats that put lives at risk will be even more incentivized.
For now, though, it’s computers, data centers, and entire IT environments that are held hostage. While these threats are certainly not as grave as those against human lives, they can cripple businesses, health care facilities, and even government operations.
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Mercom: Healthcare IT Funding Soars $1.6B in Q2 2016

Healthcare IT funding reached $1.6B in 140 deals in the second quarter of 2016, representing a 33% increase compared to the $1.4B raised during the same period in 2015, according to a new report from Mercom Capital Group. Mercom’s comprehensive report covers healthcare IT and digital health deals of all sizes across the globe.
So far in the first half of 2016, close to $3 billion has been raised in 286 deals, a 50 percent increase compared to nearly $2 billion raised during the same period in 2015.  The numbers are similar to the digital health funding reported by StartUp Health last week. 
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Healthcare and pharma least prepared for external cyber threats

Published July 18 2016, 3:33pm EDT
Only 16 percent of healthcare and pharmaceutical organizations have a formal process for monitoring the Internet and social media for external cyber threats.
In addition, just 26 percent of respondents in the healthcare and pharmaceutical industry believe they have the tools and resources to analyze and understand external threats; 29 percent say they have the tools and resources to mitigate such threats; and 34 percent indicate that they have the tools and resources to monitor these threats.
Those are among the findings of a new survey conducted by the Ponemon Institute and sponsored by cybersecurity vendor BrandProtect. Specifically, respondents were surveyed about external cyber threats—those that arise outside an organization’s traditional firewall and security perimeter, and use online channels and use email, social media, mobile apps, or domains as their primary attack technology.
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Enjoy!
David.

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