Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, August 22, 2016

Weekly Australian Health IT Links – 22nd August, 2016.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Seems like the recurrent theme is Government IT and the various problems it is having all over the place. The Department of Human Services and Health seem to have pretty frequent issues. The hope is the better governance from ADHA might help.
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My Health Record: Medics speak up

By Marie Sansom on August 15, 2016
My Health Record: Medics speak up
As the new trials of the My Health Record roll out in Queensland, NSW, WA and Victoria, Government News asks clinicians what might help – or hinder – the progress of the revamped national individual electronic health record.
A bit of history
The idea of a national individual electronic health record has been around for decades, routinely popping up in report recommendations from government health agencies.
It was an idea former Prime Minister John Howard helped spread and one the National Electronic Health Transition Authority (NEHTA) was set up to drive in 2005.
Labour introduced the Personally Controlled Electronic Health Record (PCEHR) in 2012 after two years of GP trials.
But from its inception, the electronic health record has been dogged with problems and fraught with complexities and it still has not had the uptake needed to fulfil the vision of a concise patient record available in an emergency.
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My Health Record 'dumb and useless': Australian Privacy Foundation

Forget last week's Census debacle. Far more has been spent on an e-health system with little clinical value and fewer than 17 percent of Australians on board.
By Stilgherrian for The Full Tilt | August 19, 2016 -- 04:59 GMT (14:59 AEST) | Topic: Security
"My Health Record (MHR) is not yet a f*** up because hardly anybody's using it, [but] it's a f*** up in terms of how much money the government has spent, and how little they've got for that expenditure," Dr Bernard Robertson-Dunn, who chairs the health committee of the Australian Privacy Foundation (APF), said.
"It's cost AU$2 billion so far, it's costing over AU$400 million every year, but the government has never told us how it has improved health care or reduced health costs. All it is doing is putting patient data at risk."
With the Census, the Australian Bureau of Statistics (ABS) was trying to do the right thing, but got it "somewhat wrong", Robertson-Dunn told ZDNet earlier this week. However, the Australian Digital Health Agency (ADHA) is trying to make access to MHR easier, the data is far more intrusive, and it's continually collecting data, as opposed to the Census' five-year cycle.
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Porter questions repairs to NDIS bungle

  • The Australian
  • 12:00AM August 20, 2016

Michael Owen

Social Services Minister Christian Porter has criticised the ­National ­Disability Insurance Agency’s handling of a technology bungle that has dented confidence in the government’s ability to smoothly roll out a landmark scheme for the most vulnerable.
This comes as audit firm PwC, hired by the Turnbull government for about $350,000, works to complete a review of the new MyPlace payment portal used by the N­DIA.
The IT system, designed and built in-house by the Department of Human Services, is blamed for some providers being left unpaid and some people being ­unable to access services, sending the $22 billion National Disability Insurance Scheme into disarray.
Mr Porter yesterday said he had commissioned a “short, sharp report” and The Weekend Aus­tralian understands its interim findings suggest the main problems appear to be around communication from the NDIA providing the right information to providers and participants, and offering sufficient help.
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GP gives MyAgedCare's two-calls policy a fail

Antony Scholefield | 19 August, 2016 | 
MyAgedCare staff always ring twice, but only twice, according to a GP who says the call centre’s “two attempts” policy for contacting elderly patients is inadequate.
The MyAgedCare system was lauched last year to improve access to support services for some of Australia's most vulnerable patients.
However, it has been mired in controversy, with claims that web referrals by GPs often go missing, resulting in delays in patients being assessed for the care they need.
It has now emerged that staff make only two attempts to contact each elderly client after a GP referral from an aged care assessment.
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A little more detail could vastly improve health summaries

15 August 2016
MEDICAL specialists, hospital staff­ and others who receive referrals and health summaries from GPs complain that the list of medicines often contains some that the patient is no longer using, and that the indication for each medicine is not stated.
The health summaries produced by most clinical software packages list current medicines alphabetically, which is probably the least useful order, and don’t enable users to include medicines that have been tried or used previously. The Best Practice software package allows past prescriptions to be inserted, but this is a simple chronological list of every occasion on which each of those past medicines was prescribed or re-prescribed, and it does not include medicines for which no prescription was generated within the practice.
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Is this the e-health game-changer GPs are looking for?

Antony Scholefield | 16 August, 2016 |
The Holy Grail of software development for years has been to allow doctors to easily share information between healthcare facilities and systems.
The government has tried to solve the problem with its MyHealth Record scheme, which uses a standardised language called the SNOMED Clinical Terms – Australia (SNOMED CT-AU).  
But another solution is to map existing software interfaces to SNOMED, so doctors can stick with their current software, but still download patient information that was uploaded on different software, with SNOMED acting as a digital translator.
Now MedicalDirector has pledged to map SNOMED onto its next generation practice system software, called Helix.
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  • August 19 2016 - 1:08PM

Doctors warn over diagnosis apps amid Ada launch

Julia Medew

It is marketed as being "smarter than human doctors" and the "world's most accurate health diagnosis service".
It is a medical app on your smartphone that invites you to put in a list of symptoms to find the most likely explanation. According to the company that created Ada, the app includes 10,000 symptoms and diseases and was developed by 100 doctors, making it more knowledgeable than any human brain.  
But for all its promises, leading Australian GPs are urging consumers to be wary of it and other apps that make similar claims. Both the Australian Medical Association and Royal Australian College of GPs said they were concerned about the accuracy of the Ada system, and its potential to either falsely reassure people about their health or alarm them unnecessarily.
Despite a booming market for health apps, including ones that aim to diagnose, research suggests they may not be as reliable as they appear.  
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Talking about the next generation

15 August, 2016 
Posted by julie lambert
Healthcare technologies that seamlessly connect devices and data in secure networks are closer than we think
China, Apple, Google and the most plugged-in patients in history are racing towards a new day where medical devices can speak to one another in an “internet of things”, pick up clinical errors and feed data into health records.
Doctors and health IT experts are also looking forward to a better time – one where someone comes up with a plan for assuring the safety and security of the data-driven, interconnected, tech-heavy health system we have today.
Todd Cooper, an international authority on health IT, says rapid advances in connectivity are being driven by pressure from manufacturers in China and India, plus a surge of activity in Big Data and analytics, with IBM, Apple and others entering the fray.
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Australia to play role in IBM cognitive eye health project

By Ry Crozier on Aug 19, 2016 6:56AM

Interns recruited into global effort.

Researchers at IBM Australia will play a role in building a “cognitive assistant” the IT giant hopes will help ophthalmologists diagnose eye conditions from medical image data.
The company recruited a batch of research interns to lend their expertise to the project via the IBM Australia research lab in Melbourne. The interns were slated to begin work last month.
“IBM research is building the next generation cognitive assistant with advanced multi-media capability for early detection and management of diseases that can affect both the eyes and overall health of a person,” the firm said in a now closed advertisement.
“We are building the image-guided informatics system that acts as a filter to extract the essential clinical information ophthalmologists need to know about a patient for diagnosis and treatment planning.
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  • Updated Aug 19 2016 at 6:17 PM

He makes 3D skull and bone implants but now he's in pain

A pioneering maker of 3D printed skull and bone implants held up as a beacon of innovation by Prime Minister Malcolm Turnbull says the government's actions don't match its rhetoric and are blocking his company's growth.
Melbourne neurosurgeon Paul d'Urso founded Anatomics 20 years ago to make customised 3D print cranial implants. With the advent of new, stronger materials such as powdered titanium Anatomics he has expanded the range to load bearing spinal, heel and ribcage implants, hips and shoulders. 
The company now exports to 30 countries. It made a custom sternum and ribcage for a cancer patient in Salamanca, Spain, last year and created a heel implant to save the leg of a cancer patient. Its implants are distributed in Germany by B Braun. 
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ResMed launches app for CPAP users to track sleep apnea treatment

August 18, 2016
For those who wear continuous positive airway pressure (CPAP) masks -- which help people with sleep apnea maintain steady, regular breathing while asleep – a new app is designed to help support device users and improve adherence. With myAir, an offering from medical device company ResMed, CPAP users can now track their treatment via an iOS app, giving users access to their daily sleep patterns and coaching tips.
The app provides contextual information-based coaching on how to improve their therapy through videos, emails and encouragement along the way. A user would put on the CPAP mask at night, then log in to the app the next morning to get their “myAir score”, based on a scale of one to 100, that comprises different elements of therapy – how long they slept on CPAP, how many apneas (pauses in breathing) they had per hour and how well their CPAP mask fit.
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19 Aug 2016 - 5:40pm

No halt to Medicare outsource work issued

No action has been taken to stop a Medicare outsourcing project, the health department has revealed in reply to a freedom-of-information request.
Source:  AAP 19 Aug 2016 - 5:40 PM  UPDATED YESTERDAY 5:40 PM
A private firm has not been told to stop work on a $5 million taxpayer-funded contract to manage the outsourcing of the Medicare payments system.
Labor leader Bill Shorten campaigned heavily during the election on the issue of Turnbull government plans to "privatise" Medicare.
Labor's claim was based on several factors, including a contract given to PriceWaterhouseCoopers (PWC) to oversee the outsourcing of the $50 billion-a-year payments system.
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Digital Advisory Board replaces National Health IT Board

Ministry of Health creates Digital Advisory Board
The Ministry of Health has scrapped it National Health IT Board, replacing it with a Digital Advisory Board.
The NHITB web site says the DAB held its first meeting on 12 August, where governance arrangements, terms of reference and the future of the advisory groups that currently support the NHITB were among the items considered.
The DAB will provide strategic direction, monitor the overall portfolio of sector IT investments, review significant business cases and assess new technologies.
“We will be updating the NHITB website to reflect our new direction. In the interim, we will continue using this website to provide updates and information on the Ministry’s digital health work programme and the single electronic health record,” the site said.
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Digital lives of older Australians

4 August 2016
Source: 
Owning Institution: 
This research snapshot aims to explore the levels of online engagement of older Australians (those aged 65 and over). It examines various measures of digital engagement, including internet access, frequency and location of internet use, as well as the devices used to access the internet and the activities undertaken online. This snapshot also discusses differences in demographic profiles of older internet users and non-users.
The importance of the digital literacy of older Australians has been recognised by the Australian Government. The Government has committed to invest $50 million to ensure that senior Australians will be equipped with the skills and knowledge to improve their safety online and allow them to participate in the modern digital economy.
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15 August 2016

Privacy is for doctors too

Authored by Dr Aniello Iannuzzi
PRIVACY is a paradox of modern society, which is immersed in more information than ever before.
While millions of us appear to be addicted to sharing personal information online, the concept of privacy is still closely guarded. Technology and the law have had to erect privacy walls to protect us from ourselves. There are even international conferences on privacy.
Three topics in our professional lives brought home to me how important privacy has become for practising doctors.
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17 August, 2016

Communication as medicine

Posted by Julie Lambert
A US trial of sharing notes online with patients has evolved into a national movement
US experiment in doctors sharing visit notes with patients via an online portal suggests transparency is very good medicine – and not just for well-informed, tech-savvy white folks.
Like many Australian GPs eyeing the arrival of patient-controlled electronic health records, the American primary-care doctors participating in the OpenNotes program had a host of reservations, mainly about the impact on work flow.
But while their misgivings were borne out in just a handful of cases, the benefits were consistently strong, according to Dr Sigall Bell, the program’s director of discovery and patient safety, who presented the findings at last month’s Health Informatics Conference in Melbourne.
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Govt releases billion-line 'de-identified' health dataset

By Paris Cowan on Aug 15, 2016 12:26PM

Medicare claims dating back to 1984 available online.

The Department of Health has released a huge tranche of de-identified Medicare and PBS claims dating back to 1984, in an effort to help researchers identify pain points in the public health system.
The dataset, which is made up of 1 billion lines of historical data dating back over 30 years, records claims made for visits to doctors, pathologists, imaging services and allied health professionals, and covers about 10 percent of the national population (3 million people).
It is now available to download from the data.gov.au website.
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Medicare, PBS data release a healthy step says Consumers Health Forum

16 August 2016Media release
The release of de-identified health data offers great potential to advance research showing how Australia can deliver better health care more cost effectively, the Consumers Health Forum says.
The Department of Health has released one billion items of Medicare and Pharmaceutical Benefits Scheme records which will facilitate research into the performance of the health system.  The release will enable researchers to study linkages between Medicare and PBS claims for a random 10 per cent sample of Australians.
“The data recorded by Medicare and the PBS represent a treasure trove of information that has previously been difficult for researchers to access.   When these de-identified records of both medical services and medicine prescriptions are linked they can yield a population-wide picture of what care has been delivered, patterns of service provision and  the relationship between medical services provided and medication utilisation,’’ the CEO of the Consumers Health Forum, Leanne Wells said.
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19 August, 2016

One billion lines of historical health data released

Posted by Felicity Nelson
The Department of Health’s release of a billion lines of de-identified historical health records has generated much excitement but also some concern within the medical profession
The records, released online on 1 August, include linked, individual Medicare and PBS claims relating to approximately three million Australians.
The data has been drawn from a random sample of 10% of Australians and date from 1984 to 2014 for Medicare data and 2003 to 2014 for PBS data.
The linked data will allow researchers to track the drugs obtained by individuals and follow medical services accessed by those same individuals over time.

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You could be Qld Health's first-ever digital strategy chief

By Allie Coyne on Aug 17, 2016 4:46PM

Two new deputies to report into CIO.

The technology arm of Queensland's Health department has put out the call for its first-ever chief digital strategy officer, one of two new deputies that will report into acting CIO Mal Thatcher.
The new eHealth Queensland executive will "drive and optimise digital strategy" and will be responsible for "enterprise information assets," according to a job ad.
"eHealth Queensland is going through significant organisational change. This is a new role and one that will be drawing together functions from across the organisation," it said in a job ad.
"The CDO champions the use of digital solutions in business model design, and all aspects of the business to create business success."
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Why this year’s Census might still be a privacy nightmare

The Australian 2016 Census has sparked consternation among privacy advocates
Nikolai Hampton (Computerworld) 12 August, 2016 09:39
The 2016 Census has made headlines this week for all the wrong reasons. But the inability of the Australian Bureau of Statistics and its tech partner, IBM, to keep the website online is not the only controversy surrounding this year's Census, explains security researcher Nikolai Hampton.
The Australian 2016 Census has sparked much debate and consternation among privacy advocates and security professionals alike. At the core of these concerns is a move by the Australian Bureau of Statistics (the ABS) to link census records to other data.
The mechanism proposed for linking records and data is a 'random looking' Statistical Linkage Key. We have been told that the linkage key is secure and will be 'hashed' to make it irreversible — but what exactly does that mean, and how does it secure your data?
Statistical Linkage Keys or SLKs have been used frequently by people doing data research, it provides some very basic anonymity, and a sanity check on the data while retaining a way of identifying an individual throughout a study.
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Far reaching consequences of ABS/IBM census debacle: analysts

16 August 2016
Source: 
Owning Institution: 
Investigations are continuing into what went wrong at the Australian Bureau of Statistics over the botched online census. But there's fresh scrutiny of the computer giant IBM, which has been blamed for failing to take adequate pre-emptive steps to deal with the denial of service attack. IT industry analysts say the fallout from the census debacle will be far reaching, and could open up the field for tech providers vying for lucrative government contracts.
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  • August 16 2016 - 7:17AM

Virtual reality trip inside cancer cells can help design better chemotherapy drugs

Marcus Strom
Gaming technology is allowing cancer researchers to imagine – and interact with – cells in a mind-blowing new way.
In a fantastic voyage to the scale of a single cell, scientists can now observe the virtual interaction of therapeutic drugs as they penetrate the very membranes of those cells.
"As well as the obvious educational role this can play, it has the potential to allow cancer researchers to see their data in a new way, which can help them design better nanotherapies," said John McGhee​ at the University of NSW.
Dr McGhee is director of the 3D Visualisation Aesthetics Lab at UNSW's school of art and design in Paddington. He has harnessed the data from a high-resolution scan of a breast cancer cell to construct a virtual world using technology straight from the gaming industry. He took the data from a University of Queensland scan and built it into a 3D mesh where designers in his lab added colour, lighting, texture and animation.
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  • August 16 2016 - 7:53AM

Putting a computer in your brain is no longer science fiction

Elizabeth Dwoskin

Like many in Silicon Valley, technology entrepreneur Bryan Johnson sees a future in which intelligent machines can do things like drive cars on their own and anticipate our needs before we ask.
What's uncommon is how Johnson wants to respond: Find a way to supercharge the human brain so that we can keep up with the machines.
KerNEL's chip will work by predicting the memory recall function a healthy brain would make and replicating it inside a damaged or diseased brain. 
From an unassuming office in Venice Beach, his science-fiction-meets-science start-up, KerNEL, is building a tiny chip that can be implanted in the brain to help people suffering from neurological damage caused by strokes, Alzheimer's, or concussions. The team of top neuroscientists building the chip — they call it a neuroprosthetic — hope that in the longer term, it will be able to boost intelligence, memory, and other cognitive tasks.
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Enjoy!
David.

Sunday, August 21, 2016

Why Is The Government So Hopeless In IT Delivery? Wish I Knew….

This popped up in my scans yesterday.

NQ Primary Health Update

My Health Record latest news

Did you know that an individual needs to have a myGov account to access My Health Record? People can either log in via their existing account and link their My Health Record to their myGov, or they can take a few moments and create their own MyGov account.
There is a simple step by step guide at www.myhealthrecord.gov.au/stepbystep to support people to register or access their My Health Record for the first time.
Even though there are several Government services are on myGov, such as Medicare and the Australian Tax Office, it is only registered healthcare providers involved in a patient’s care who can access the My Health Record system.
For GPs who are using Best Practice and Medical Director software, we have been aware that they are undergoing some upgrades which is resulting in some error messages when accessing the My Health Record system. If you are receiving error messages, please contact your clinical software provider for assistance.
There is a huge amount extra found here:
I noted two things – First, from August this year, it does still seem myHR integration with GP practice systems is having a few issues.
Second, while reading I noticed the comment on MyGov. This prompted me to recount the silliness I encountered just yesterday trying help here to use MyGov to claim a small Medicare refund.
She was not enrolled in MyGov so the process of signing up was its usual intrusive self.
Once in we linked Medicare and found a range of extra details were needed including my birthday etc. as my name is the first entry on our family Medicare Card.
Once finally in we started the process to claim back our $50.
We entered the various details (Provider Number, Date of Service, Amount Paid, Medicare Item No etc.) thinking we must be getting close given we had provided all the banking details for the deposit etc.
We were also told to scan the bill, as we would need to upload the .pdf etc. (What do you do if you don’t have a scanner etc.?)
We hit complete and were then told that for this item number we could not claim via MyGov but had to use the Express Plus Medicare Billing App.
Here is the website for these marvels.
Well talk about customer hostile nonsense. Just what do you do if you don’t have a smartphone or can’t seemingly get it installed as the phone is demanding an Apple ID and password that my wife never uses and has probably been lost!
You are told to call a number and hope for a better outcome!
So the bottom line is the Medicare Offices have basically gone and the replacement assumes you have a smartphone and know all about how to use the App Store etc. etc.
What a massive fail at so many levels. Who would voluntarily get a myHR if you had experienced the Census or this sort of nonsense!
David.

AusHealthIT Poll Number 332 – Results – 21st August, 2016.

Here are the results of the poll.

Should The Patient Be Required To Review And Approve A Discharge Summary Before It Is Uploaded To The myHR?

Yes 76% (68)

No 15% (13)

I Have No Idea 9% (8)

Total votes: 89

It seems the great majority do not support the current practice with discharge summaries just being tossed into the huge myHR abyss.

A great turnout of votes.

Again, many, many thanks to all those that voted!

David.

Saturday, August 20, 2016

Weekly Overseas Health IT Links – 20th August, 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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VA seeks information on EHR replacement for VistA

Published August 12 2016, 7:04am EDT
The Department of Veterans Affairs has issued a request for information seeking industry feedback on how the VA might transition from its legacy electronic health record system to a commercial EHR.
While it continues to modernize the decades-old Veterans Health Information Systems and Technology Architecture (VistA) system, the VA is having second thoughts about whether the legacy EHR is able to meet its needs going forward.
“Over the years and due to local customization, there are few standard data elements, a variety of complex algorithms and heterogeneous mix of legacy hardware and software supporting 130 unique VistA instances across the VA enterprise, making modernization and standardization efforts extremely complicated, expensive and time consuming,” states the VA’s request for information.
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Automated detection tools reduce adverse drug events, curb alert fatigue

Aug 12, 2016 10:05am
Automated electronic detection tools can help providers to reduce medication errors and improve patient safety, according to a new study published in the Journal of the American Medical Informatics Association.
The researchers, from Cincinnati Children’s Hospital Medical Center and elsewhere, note that such programs have proven successful in the past, but wanted to see if they could use electronic health records to create an algorithm that would automatically detect overdoses and adverse drug events, as well as lessen the number of medication alerts.
Fatigue from too many alerts and alarms, FierceHealthIT has previously reported, is a pressing problem at hospitals today.
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Brain-robot training triggers improvement in paralysis

  • 11 August 2016
In a surprise result, eight paraplegic people have regained some sensation and movement after a one-year training programme that was supposed to teach them to walk inside a robotic exoskeleton.
The regime included controlling the legs of a virtual avatar via a skull cap, and learning to manipulate the exoskeleton in the same way.
Researchers believe the treatment is reawakening the brain's control over surviving nerves in the spine.
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Employer Health Plans May be 100% Telemedicine-enabled by 2020

Gregory A. Freeman, August 10, 2016

The great appeal of telemedicine is that it comes at a lower cost than other care access points, and payers have exhausted other cost efficiencies on the front end.

Having squeezed all they can out of health plan design, employers are now pinning their hopes on telemedicine as the way to bring down their health insurance costs.
Telemedicine is growing rapidly and within a few years will be a routine part of healthcare plans offered by employers, according to the president and CEO of the National Business Group on Health (NBGH), a non-profit association of 425 large employers.
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Half a billion images migrated at Oxford acute trust

Laura Stevens
8 August 2016
One of the largest data migrations in the UK has been successfully undertaken at the Oxford University Hospitals NHS Foundation Trust, as part of a move to a new digital imaging system.
More than 100 terabytes of historical data was transferred by Insignia Medical Systems ahead of the trust’s go-live with the company’s InSight picture and archiving communications system. The PACS went live 10 July, four months after the start of the migration.
The move to Insignia’s PACS will also give the trust the opportunity to share images with neighbouring trusts, support home reporting and merge images from other departments.
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Attorneys outline next steps for closing healthcare privacy gaps

Aug 11, 2016 9:32am
The United States must answer three important questions as it moves forward to protect patient data, according to attorneys with the healthcare group at law firm Crowell & Moring.
In a report published by Bloomberg BNA, Jodi Daniel, Elliot Golding and Jennifer Williams address the next steps necessary for following up a recent report from the Office of the National Coordinator for Health IT outlined gaps between HIPAA protections and mHealth technologies
Questions that must be asked, they say, include:
  • Why develop standards and requirements?
  • What should those standards be and who should develop them?
  • How should organizations be held accountable?
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Data theft rises sharply, insiders to blame

A new study suggests many data breaches are caused by insider threats -- whether through malice or accident.
By Charlie Osborne for Zero Day | August 10, 2016 -- 08:03 GMT (18:03 AEST) | Topic: Security
A new survey exploring the main causes of corporate data breaches suggests that three out of four organizations in the US have been hit with the loss or theft of sensitive data in the last two years -- and insiders are usually the ones at fault.
According to the researchers involved in the study, rising data breach and information loss is often due in part to compromised employee accounts, which is further exacerbated by staff and third parties having access to more sensitive information than they need.
In addition, the "continued failure" by businesses to properly monitor access and activity around email and file systems is to blame.
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DeSalvo to step down from top position at ONC

Published August 11 2016, 3:35pm EDT
Karen DeSalvo, national coordinator for health information technology, will be leaving her technology office position, to be replaced by Vindell Washington, MD, currently serving as the principal deputy national coordinator at ONC.
Sylvia Burwell, secretary of the Department of Health and Human Services, made the announcement today, indicating that the transition of responsibilities would begin on Friday, August 12.
DeSalvo, who has filled the lead role for two and a half years, will continue to serve as acting assistant secretary for health. Named to that position in late 2014, industry observers long expected that she would gravitate toward the HHS post.
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Karen DeSalvo through the years: A look back at her ONC tenure

DeSalvo made her way from New Orleans to Washington and while serving as National Coordinator, she realigned ONC and delivered visionary strategic plans for interoperability and health IT, before President Obama nominated her to a key HHS post.
August 12, 2016 11:24 AM
When Karen DeSalvo, MD, became the fifth National Coordinator for Health IT in January 2014, she took charge of ONC at a critical time for the industry, as four years of momentum spurred by meaningful use started to pay exciting dividends – but also sowed frustrations as many healthcare providers struggled with burdensome federal requirements.
She also had some big shoes to fill. Her two immediate predecessors,  David Blumenthal, MD, and Farzad Mostashari, MD, had helped conceive and implement Stage 1 and Stage 2, respectively, of the transformative EHR incentive programs – setting the stage for widespread uptake of basic IT systems, then dramatically raising expectations about how hospitals and practices should put them to work.
But DeSalvo was the right person for the job, at the right time. Her public health bona fides – honed in her hometown of New Orleans, first in the wake of Hurricane Katrina as Vice Dean Community Affairs and Health Policy at Tulane University and later as New Orleans Health Commissioner – made her the ideal national coordinator for a period that saw the building blocks of basic EHRs mature into interoperable networks focused on improved population health.
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Geisinger, KeyHIE bolster clinician productivity an hour a day with patient alerts

In conjunction with the Keystone Health Information Exchange, Geisinger Health System sends clinicians push HL7 ORU messages in a population health management program to identify at-risk patients and reduce readmissions.
August 10, 2016 07:48 AM
Kim Chaundy, an IT director at Gesinger and director of operations at Keystone Health Information Exchange, said that sending real-time notifications prevented nurses from traveling to see patients who where not there. 
The Keystone Health Information Exchange, also known as KeyHIE, a collaborative HIE that includes Geisinger Health System, employs what it calls the Information Delivery Service “push” messaging technology designed to enable proactive care with real-time delivery of alerts, notifications and critical patient information to clinicians and care managers across the community.
The Information Delivery Service’s centralized aggregation technology brings all of a patient’s data into a single record. The system identifies chronically ill and at-risk patients and consolidates a community’s health data in one place to help care managers and accountable care organizations manage diverse population groups. And clinicians can customize their subscriptions to important alerts, notifications and patient information updates.
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On paper, IT contingency plans a must for hospitals

Aug 10, 2016 10:40am
As part of its contingency plan for IT emergencies, Boston Children's Hospital has developed what it calls a "downtime cart," according to an article published in Bloomberg BNA.
The cart, the article notes, contains all the paper forms and instructions doctors and nurses need to do their jobs should computer systems fail, whether for a power outage or a cybersecurity incident. The number of employees who don’t know how to fulfill their functions without electronic systems was an eye-opener for MedStar Health, which took all systems down for about five days earlier this year due to a ransomware attack.
A ransomware attack at Hollywood Presbyterian Medical Center also left staffers working with paper and faxes for more than a week.
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Health IT costs top $32K per doctor per year

Aug 10, 2016 11:21am
High tech means high costs for physician practices.
Keeping up in the digital age is proving to be a continuing expense for physician practices, with the cost of health information technology reaching more than $32,500 per doctor annually, according to a new analysis from the Medical Group Management Association.
That figure reflects a continued rise in costs, as physician-owned multi-specialty practices spent more than $32,500 in 2015 for each full-time doctor on health IT equipment, staff, maintenance and other related costs, the MGMA said in an announcement.
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Health IT Standard FHIR Ready to Advance Interoperability

By Kyle Murphy, PhD on August 09, 2016

FHIR is a draft health IT standard and API, but that doesn't mean it's not ready for primetime.

Fast Healthcare Interoperability Resources (FHIR) remains a draft standard and application programming interface, but that status doesn't mean this health IT resource is not ready for the big time, according to the head of Health Level Seven (HL7) International.
"There's this tension between making FHIR, which is not a normative standard identified in regulation and predicated for use, and a recognition that FHIR is evolving very, very quickly — sometimes nightly — and getting better with each iteration," HL7 CEO Charles Jaffe, MD, PhD, told HealthITInteroperability.com.
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August 8, 2016

Lessons learned from EHR-related medical malpractice cases

Richard L. Oken, M.D., FAAP
The physician’s pen has been replaced by the electronic health record (EHR) resulting in improved medical record documentation and legibility. The EHR also has been heralded as the best tool to help physicians achieve the triple aim of better care, better population health and lower health care costs per capita. However, malpractice insurers report that EHRs can be a source of medical liability.
A national medical liability insurer’s recent review of EHR-related malpractice claims revealed that 42% were derived from system errors and 64% were from user factors (see table).
Becoming aware of and preventing potential and real risks of EHR errors is the best policy.
The following factors can play a role in EHR liability.
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'DarkOverLord' ransomware accounts for nearly 30 percent of health data breaches in July

Among the breaches revealed last month, the average time to report incidents was a surprising two years.
August 09, 2016 02:27 PM
Cybercriminals launching ransomware attacks – and one hacker in particular known as TheDarkOverLord – represented nearly 30 percent of the 39 data breaches in July. The average time an attack went unreported, meanwhile, was a whopping two years.
That’s according to the July Breach Barometer from Databreaches.net and security specialist Protenus.  
Protenus CEO Robert Lord said that the amount and variety of attacks hackers perpetrate against healthcare organizations suggest that July’s findings may persist into the foreseeable future. 
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OSU Center for Health Systems Innovation launches new Center for Predictive Medicine

Posted: Tuesday, August 9, 2016 12:01 am
Oklahoma State University’s Center for Health Systems Innovation announced the launch of its Center for Predictive Medicine on Tuesday.
The center will use the largest clinical database in the country to develop and implement information-technology tools designed to improve patient care.
The HIPAA-compliant health-care database, which documents the clinical information of 63 million patients, was donated to OSU in 2014 by Cerner Corp. founder Neal Patterson.
The data comes from more than 850 facilities across the United States and includes more than 75 million clinical event encounters collected over the last 16 years.
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OpenNotes hits 10 million patient milestone

OpenNotes Executive Director Catherine DesRoches said the growing number of patients able to access their medical records online is advancing the shift toward transparency between doctors and patients.  
August 08, 2016 03:15 PM
Ten million U.S. healthcare consumers now can read their medical records securely online through efforts by the OpenNotes initiative.
OpenNotes advocates for a fully transparent record, including the notes physicians, nurses and other clinicians write after a visit. The Department of Veterans Affairs and 50 health systems in 35 states now share notes online using secure patient portals, and OpenNotes is actively working with healthcare organizations moving toward implementation in a majority of the remaining 15 states.
“The results of the OpenNotes study involving 105 primary care doctors and 20,000 of their patients were shared in the Annals of Internal Medicine in 2012 – just four years later, we’re seeing the culture shift toward transparency in the patient and provider relationship really take hold, and we’re beginning to understand the benefits that openness brings to everyone in the healthcare delivery system,” said Catherine DesRoches, DrPH, OpenNotes executive director and a caregiver at Beth Israel Deaconess Medical Center.
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HIT Think Why providers can’t let up on security training

Published August 08 2016, 3:39pm EDT
Peter Singer, director of the Brookings Institution’s Center for 21st Century Security and Intelligence and co-author of the book “Cybersecurity and Cyberwar: What Everyone Needs to Know,” was quoted in Fortune as saying “Stop looking for others to solve it for you, stop looking for silver bullet solutions and stop ignoring it.”
The “it” healthcare management professionals must address is cybersecurity; the art and science of proactively and reactively protecting your hospital’s data, especially patient health information (PHI).
There’s a saying in IT security circles about how organizations acknowledge the ever-present threat of unauthorized intrusions into their information infrastructures. Basically, it notes at least 95 percent of public and private sector entities admit to have been hacked, while the other 5 percent are liars. Singer suggests 97 percent of all such institutions have been attacked and the remaining 3 percent don’t know it.
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Study: Continuous Patient Monitoring Could Save Healthcare $15B

Continuous contact-free patient monitoring can save the US healthcare system up to $15 billion annually, according to peer-reviewed paper published in Critical Care Medicine.  Conducted by researchers from Harvard School of Medicine, and a new Frost & Sullivan report, Finding Top-Line Opportunities in a Bottom-Line Healthcare Market, each hospital bed monitored with EarlySense enables hospitals to achieve a cost savings of approximately $19,940.
The cited cost savings are attributed to clinical outcome improvements published by hospitals implementing EarlySense. The technology has been proven to assist clinicians in earlier detection of patient deterioration, helping to reduce patient length of stay, minimizing ICU utilization, reducing falls and pressure ulcers, and avoiding cardiac and respiratory arrests.
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OpenNotes' benefits extend to care partners

Aug 8, 2016 10:07am
The ability to view doctors’ notes electronically benefits not only the patients, but their care partners as well, according to research published in the Journal of the American Medical Informatics Association.
Geisinger Health System surveyed adults before and after 12 months of exposure to OpenNotes, a service to allow patients to see all clinician notes from their care visits. That transparency was found to improve the doctor-patient relationship in previous research.
Geisinger’s portal, MyGeisinger, allows patients to designate care partners who also can view medical records. The health system polled 323 patients and 389 care partners in a baseline survey and 184 patients and 252 care partners again at 12 months.
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IBM Watson, in minutes, solves patient care problem that stumped doctors for months

Aug 9, 2016 10:07am
Doctors in Japan were perplexed for months over the case of a woman with leukemia who did not take to any of the treatments prescribed to her--then IBM’s Watson took over and solved the mystery in minutes.
The artificial intelligence system was able to conclude that the patient did not have the form of leukemia with which she initially was diagnosed, a form that required a different course of treatment, according to an article at the International Business Times.
The solution was discovered by the machine after it analyzed the patient’s medical information and cross-referenced it with millions of oncological records that doctors uploaded to its system from the University of Tokyo's Institute of Medical Science.
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IBM Watson pinpoints rare form of leukemia after doctors misdiagnosed patient

The supercomputer identified a different type of cancer than the one doctors were currently treating for a patient in Japan.
August 08, 2016 10:58 AM
University of Tokyo doctors report that IBM Watson spotted a 60-year-old woman's rare form of leukemia – a diagnosis that had eluded her doctors for months.
Physicians had judged the woman’s leukemia to be another type, and were treating her accordingly, but having little effect.
Watson compared the patient's genetic changes with a database of 20 million cancer research papers, according to reports. The supercomputer’s diagnosis led to the right treatment for the patient.
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Patient eReferrals produce few adverse outcomes

Published August 08 2016, 6:48am EDT
An electronic referral and consultation system at Zuckerberg San Francisco General has been shown to improve communication between referring and specialty providers, replacing an inefficient paper-based approach.
According to a study published in the August issue of The Joint Commission Journal on Quality and Patient Safety, the infrastructure of specialty referral systems in primary care is “deeply flawed” and paper referral syste “unreliable, wait times can be long, and information flow is limited.” As a result, its authors assert that there is the potential for “safety problems leading to missed and delayed diagnoses.”
However, a web-based referral and consultation system—called eReferral—has been integrated into Zuckerberg San Francisco General’s electronic health record system enabling referring providers to enter relevant clinical information via an online interface, ensuring that referrals do not fall through the cracks and are optimized.
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First patient facing app to get GP system approval

Ben Heather
1 August 2016
The first patient facing app is expected to get approval to integrate with a GP primary system this week, after years of development.
PAERs’ is one of three patient facing subsidiary suppliers, along with iPlato and Wiggly Amp, that has been going through the long and sometimes arduous process of pairing with primary systems.
Brian Fisher, co-director of PAERs, said the company’s iPatient product was being piloted in five GP practices using the Emis Health primary system and he expects to get approval for full roll-out across every Emis GP site in the country imminently.
“It has taken an unbelievably long time but we think what we have to offer is going to change how we do health care,” he said.
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Campaigners fear care.data plans still live

Ben Heather
4 August 2016
Parts of the controversial care.data programme could live on but with fewer options for patients to opt-out, MedConfidential has warned.
Last month the government “closed” the care.data national data collection and sharing programme. The decision was made public on the same day the National Data Guardian, Dame Fiona Caldicott’s report on data security, consent and opt-outs was released.
But Phil Booth, co-founder of privacy campaign group medConfidential, said many recommendations in the report would see the care.data programme continue in another guise; with the extraction of a new GP dataset set to go ahead.
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Digital health 'not reaching' seniors

Aug 3, 2016 11:26am
Patients over the age of 65 are often the sickest and most expensive to treat--yet despite the advantages health IT holds for them, the number adopting digital health tools remains low, according to a research letter published in the Journal of the Medical Association.
The research is based on the National Health and Aging Trends Study, which asked 4,355 seniors about their use of technology yearly from 2011 to 2014.
Although 76 percent of the respondents used cellphones and 64 percent used computers in 2011, only 16 percent obtained health information online. In addition, far fewer used digital health tools to fill prescriptions (8 percent), contact clinicians (7 percent) and handle insurance claims (5 percent).
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Provider Directory Data Accuracy in CA Law's Crosshairs

Scott Mace, August 9, 2016

Inaccurate provider directories are a hurdle to consumers seeking healthcare, but a California law is pushing providers and technology professionals to make improvements.

Consumer frustration with inadequate provider directories may finally be getting the attention it deserves.
At next month's innovation-focused Health 2.0 conference, the Robert Wood Johnson Foundation and ProPublica will announce the $50,000 first-prize winner of their Finding the Right Provider Challenge.
The winner will demonstrate a tool letting consumers experience searching for and finding the right provider, considering factors such as cost, hours and location, participation with insurance plans, and feedback from other consumers.
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Hospital eases patient navigation with software

Published July 29 2016, 3:21pm EDT
Here is Health Data Management’s weekly roundup of health information technology contracts and implementations:
* Mission Hospital in Mission Viejo, Calif., will implement navigation software that enables patients to use their smartphone to find their way through the 509-bed facility, and find the best parking location based on where they are going. Mission Hospital is the pilot site, and over time the software from Connexient will be rolled out at its Laguna Beach campus. The software gives turn-by-turn indoor navigation with position accuracy of one to two meters, along with navigation cues and visual landmarks.
* Covenant Health serving eastern Tennessee has chosen electronic health records, financial management and population health management software from Cerner across its 10 hospitals and nearly 100 ambulatory sites. The vendor’s predictable total cost of ownership was a factor in the decision, according to Jim Vandersteeg, president and CEO at Covenant Health. Cerner will host the software at its data center.
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Patients suffering from schizophrenia utilize mHealth program

by Judy Mottl 
Aug 1, 2016 12:44pm
A mobile phone intervention program can prove useful for patients with schizophrenia-spectrum disorders by engaging them during high-risk periods--though further study is needed to assess the tool's impact on reducing relapse outcomes.
A research study published at the Journal of Medical Internet Research Mental Health shows that the program, FOCUS, provides automated real-time and real-place illness management support and is built for patients dealing with psychotic disorders.
Looking also at a research report on FOCUS from 2014, the researchers said the findings show that "the FOCUS mobile phone program may be a useful method to reach a clinical population that is typically difficult to engage in clinic-based services during high-risk periods. The system-initiated mHealth functions led to proportionally more exposure to treatment content than on-demand tools."
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Why a health IT safety center is vital in the age of ransomware

Aug 1, 2016 10:51am
The rise in ransomware underscores the need for a national health IT safety center to help healthcare organizations learn to better protect themselves, say patient-safety advocates Dean Sittig and Hardeep Singh in a Health Affairs Blog post.
The Office of the National Coordinator for Health IT created a five-year plan for such a center and made a $5 million request in the 2017 budget for it. And the American Medical Association voted at its annual meeting to support that plan.
Such a center could dispatch teams in health IT, cybersecurity, clinical informatics and patient safety to sites to determine how ransomware attacks took place and create best practices for mitigating future attacks, Sittig and Singh say. It also could help develop and disseminate information on strategies to reduce risk proactively, and work with institutional and government leaders to ensure these strategies are used to their fullest impact.
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Glaxo, Alphabet Form Venture to Make Bioelectronic Medicines

August 1, 2016 — 4:37 PM AEST Updated on August 1, 2016 — 7:01 PM AEST
  • Companies to invest 540 million pounds over seven years
  • Bioelectronics could be used to treat arthritis, diabetes
GlaxoSmithKline Plc, the U.K.’s biggest drugmaker, is forming a joint venture with Google parent Alphabet Inc.’s life-sciences business to explore using electrical signals to treat diseases.
Glaxo will hold a 55 percent stake in the venture, called Galvani Bioelectronics, and Alphabet’s Verily Life Sciences LLC will hold 45 percent, according to a statement on Monday. The companies will invest up to 540 million pounds ($715 million) over seven years if the research and development efforts meet certain goals.
Glaxo is seeking new sources of revenue growth as its blockbuster respiratory treatment Advair faces the threat of competition from generics in the U.S. Bioelectronic medicine is a new field that aims to tackle chronic diseases using miniature, implanted devices that modify electrical signals that pass along nerves in the body. Glaxo’s researchers are betting conditions like arthritis, diabetes and asthma could be treated using these devices, and the first such medicine may be ready within a decade.
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Do no harm: an oath for health IT developers

The risks for enterprises when security in health IT lags behind

CSO | Aug 1, 2016 6:30 AM PT
As health professionals, nurses, doctors, and even pharmacists are held to a high standard of making sure everything they do is above board. They can lose license for failing to comply with ethical guidelines. Even though software engineers in health IT have a far greater reaching impact on patients, no equivalent code of conduct exists for developers.
The National Institute of Health (NIH) recently granted the Mayo Clinic $142-million to create a biobank as part of the Precision Medicine Initiative Cohort Program. Aiming to enroll at least a million volunteers willing to share their health data in order to advance precision medicine, the program serves as a reminder of the security risks is health IT yet security in the health care sector continues to lag behind.
Collecting health data is moving fast, which begs the question should health IT programmers working on similar projects be held to the same ethical standards as doctors and other medical professionals? 
In order to prioritize security in health IT, programmers  should be required to take the Hippocratic oath just as health professionals do, especially as more biobanks are created.
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Artificial Intelligence’s Long-Term Impact on Jobs: Some Lessons From History

By Irving Wladawsky-Berger
Jul 29, 2016 10:14 am ET
Artificial intelligence has been making extraordinary progress in the past few years. It’s ironic that after years of frustration with AI’s missed promises, many now worry that its mighty power is now upon us while we still don’t know how to properly deploy it. Some fear that at some future time, a sentientsuperintelligent general AI might pose an existential threat to humanity.But while being dismissive of such dire concerns, many experts worry that the real threat is that AI advances could lead to widespread economic dislocation.
What impact will AI have on jobs? Could our smart machines lead to mass unemployment? What will life be like in such an AI future?  “After 200 years, the machinery question is back. It needs to be answered,” notes The Economist in a special report on AI in the June 25 issue. What can we learn from history that will help us better respond to AI’s technological advances?
People have long worried about the impact of technology on society, be it railroads, electricity, and cars in the Industrial Age, or the internetmobile devices and smart connected products now permeating just about all aspect of our lives. The Economist reminds us that these worries have been with us ever since the advent of industrialization two centuries ago. Eminent English economist David Ricardo first raised the machinery question in 1821, that is, the “opinion entertained by the labouring class, that the employment of machinery is frequently detrimental to their interests”.
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Enjoy!
David.