Monday, June 26, 2017

Weekly Australian Health IT Links – 26th June, 2017.

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

It seems to be the budget week or two and e-Health seems to have done pretty well. Otherwise a big decision in the NT and a few other things – enjoy the browse!
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NT prepares for mammoth overhaul of health IT

$259 million to be delivered by InterSystems
Rohan Pearce (Computerworld) 23 June, 2017 14:24
InterSystems Australia has been chosen by the Northern Territory government to replace the NT’s key health IT systems.
The $259 million Core Clinical Systems Renewal Program (CCSRP) involves replacing four separate clinical IT systems used by the NT’s health service.
The program was originally expected to cost $185.9 million, but the territory’s government in this year’s budget upped funding for the CCSRP.
The project involves implementing a single end-to-end system for NT public health services as well as a territory-wide, real-time health electronic record system.
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GP support for mandatory 'paperless' prescriptions

Antony Scholefield | 23 June, 2017 |  
A call to phase out paper-based prescriptions has been backed by one of the RACGP's e-Health experts.
Integrated electronic prescriptions should become mandatory for “any prescriber of a PBS-listed medicine, any pharmacist wishing to dispense a PBS-listed medicine”, according to a Federal Government review of the pharmacy industry.
In its interim report, released on Thursday, the review says the current paper-based system is outdated and inconvenient, and increases the risk of adverse medical events.
Instead, paper prescriptions should no longer be the "version of record", and pharmacists should be able to retrieve the electronic prescription without sighting a paper version.
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NSW Budget: Dominello reveals AU$536m for health IT infrastructure

The newly appointed Minister for Finance, Services, and Property said citizens are expecting better government services in the digital age.
By Asha McLean | June 19, 2017 -- 03:11 GMT (13:11 AEST)
New South Wales Minister for Finance, Services and Property Victor Dominello has offered a preview into the state government's 2017-18 Budget, due to be handed down on Tuesday.
Speaking at the opening of enterprise cloud company ServiceNow's new Australian headquarters in Sydney, Dominello said the state is pumping funding into eHealth initiatives as citizens are expecting better services in the digital age.
"We're spending money in relation to digital infrastructure," the minister explained on Monday.
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NSW government earmarks $1 billion for major IT projects

State government splashes out to boost eHealth records system
Rohan Pearce (Computerworld) 20 June, 2017 13:07
The New South Wales government plans to spend close to $1 billion on major ICT and digital projects, the 2017-18 budget reveals.
The budget, handed down today, earmarks $522.5 million for health-related technology projects.
The government plans to spend $236.2 million on its integrated digital patient records program, including the roll out of the electronic medication management system to more NSW public hospitals and linking NSW Ambulance and hospital electronic medical records in “real time”.
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NSW Government to invest AU$536 million over eight years in health IT infrastructure

Investment areas include a central repository for patients’ public hospital pathology results and rollout of the Electronic Medications Management System statewide.

21/06/2017
The NSW Government is going to invest AU$536 million over eight years in IT infrastructure and systems to support the healthcare sector, including:
  • digital infrastructure supporting the clinical and other health-related systems across NS 
  • digital patient records to ensure patient records are easy to read, accurate and instantly accessible whenever needed
  • a central repository for patients’ public hospital pathology results
  • rollout of the Electronic Medications Management System statewide
Health Minister Brad Hazzard said research showed electronic systems can reduce medication errors, which could result in significant patient harm, by over 50 percent.
“Notes might be illegible, errors can be made transcribing medication charts, or charts can be lost but this technology helps ensure patients get the right medication at the right time,” Mr Hazzard said.
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E-health gets $536m in NSW state budget

By Justin Hendry on Jun 20, 2017 2:32PM

While digital transformation remains big focus.

Digital health infrastructure in NSW has received a bumper investment in the state's 2017 budget, with more than $500 million flowing to digital patient records and a system-wide digital platform.
In state budget papers handed down today, the government revealed the full cost of two major NSW Health projects that were first detailed in last year’s budget.
Just over $286.3 million across nine years will "enhance the digital infrastructure that supports clinical and other health-related systems across the state", $16.4 million of which has been allocated in 2017-18.
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20 June 2017

Putting patient data at the centre of care

Posted by Andrew Wilson
Although private-health insurers don’t fund GP consultations, we do play an important role in sharing information with general practitioners, and ensuring we promote and support the important work GPs do in preventative care.
There’s a lot of talk, particularly in Canberra, about the spiralling cost of healthcare. It’s something Medibank has experienced first-hand. Since 2011, the number of hospital admissions per Medibank customer has increased 19%, and the average amount Medibank pays in benefits per admission has increased 10%. These increases have seen average hospital benefits paid per customer increase by 31% in just five years.
This goes to the heart of the challenge Australia’s health system faces. How can we make the best use of our healthcare resources? We know that much can be done, and is being done, to improve Australia’s health outside the hospital walls. Delivering care in an environment that is more comfortable for the patient, in their home or in their GPs’ rooms is a solution that can improve the patient’s experience of care, and help reduce the cost of care. However, we know that investment in, and support of, primary care is vital to allow this model to flourish.
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Coding errors cause 300,000-plus mismatches in South Australian medical imaging data

Brad Crouch, Medical Reporter, The Advertiser
June 20, 2017 7:47am
MORE than 300,000 medical images were wrongly labelled when SA Health moved them to a new computer system, raising the risk of “harm to patients through inaccurate diagnosis”.
The mix-ups include images of wrists being called feet, brains filed as chests and breasts classified as heads.
The Advertiser’s revelation of SA Health’s latest bungle comes amid a billion-dollar, pre-election spending spree on health by the State Government, with Labor MPs making announcements at Flinders Medical Centre, Modbury, Queen Elizabeth and Lyell McEwin hospitals.
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SA Health takes disaster recovery gamble to save money

By Allie Coyne on Jun 20, 2017 5:27PM

Pathology systems overhaul running over time, budget.

South Australia's Health department has decided not to implement a secondary site for disaster recovery with its new state-wide pathology system in an effort to save costs from a project that is running late and over budget.
In late 2015, the state's audit office looked into SA Health's enterprise pathology laboratory information system (EPLIS) overhaul and warned it was likely to run out of money before it was complete.
The project was funded from a 2012, $30.4 million investment to replace two ageing and incompatible Cirdan Ultra instances and as many as 30 smaller pathology systems across in labs and hospitals across the state.
SA Health in 2014 signed a contract with Cerner to introduce its Millennium suite of pathology lab information modules, signalling the start of the transformation.
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My Health Record Update - Release 8

22 Jun 2017


The Australian Digital Health Agency (ADHA) has recently released an update to the MyHealth Record that it says is designed to improve its usability.
According to the ADHA, in addition to a number of cybersecurity and back end system improvements, changes have been made to the front end portals for both clinicians and consumers as part of this release.
The next time clinicians access a My Health Record, among a number of changes, they will notice a new Medicines Information view, which will sort and display medicines information held in the patient’s My Health Record documents in date or alphabetical order. This view can also be found in most clinical information systems (CIS) under the OTHER DOCUMENTS LIST.
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Microsoft believes it can change how Australian GPs work

20 June 2017
Sixty Australian practices are about to test a video-based consultation process, writes Neil Bramwell.


A 1925 cover of Science and Invention magazine featured a drawing of an imaginary medical device, the teledactyl.
The magazine’s publisher, Hugo Gernsback, predicted the device would use the new medium of radio communication to allow a doctor to view their patients on a screen and touch them with spindly remote-controlled robotic arms by the year 1975.
Technology hasn’t quite caught up with Gernsback’s imagination, but the development of telemedicine or telehealth or virtual health — call it what you will — is in overdrive.
Couple this proliferation of technology with the political will to harness the apparent efficiencies and it’s clear that telemedicine will become an integral part of primary care.
To date, however, there has been little clarity on how to make commercial sense of the expansion of telemedicine services in primary care.
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NSW appoints full-time privacy commissioner

By Allie Coyne on Jun 22, 2017 2:02PM

Brings in health privacy executive.

The NSW government has made the role of state privacy commissioner a full-time position with the appointment of Samantha Gavel.
Gavel takes over from Elizabeth Coombs, who has been acting in the position part-time, or three days a week, for the past five years. Her term finished last November.
The state government indicated at the time that it intended to employ Coombs' replacement on a full-time basis following complaints by Coombs about resourcing.
Gavel is currently the national health practitioner ombudsman and privacy commissioner. She previously served as the private health insurance ombudsman for six years.
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Extension of EOI deadline to Friday 7 July, 5pm for diagnostic imaging and pathology services offers

The Australian Digital Health Agency (the Agency) has amended the diagnostic imaging and pathology services offers in response to recent feedback from industry representatives to ensure we can help as many organisations as possible to take advantage of the offer. We will therefore extend the deadline for lodging EOIs by two weeks to Friday 7 July at 5pm (AEST).
We expect to publish the updated offer documents on Monday 26th June. If you are planning to submit an EOI by the original deadline, please wait until we publish the updated offer, so that you can consider your response in light of the updates.
The Agency has contacted all organisations who have already submitted EOIs and advised them that they have until Friday 7 July to amend, withdraw, or keep unchanged their EOI in light of the updated offer. All EOIs received will be evaluated after the new offer close date of Friday 7 July.
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My Health Record System News

Pathology and Diagnostic imaging update
Recently some health services have started to use the capability to upload patient pathology and diagnostic imaging reports to the My Health Record system.
The Australian Digital Health Agency has taken another step towards having a more integrated health industry by announcing that more organisations, both public and private, have begun uploading pathology and diagnostic reports during June.
The benefits of receiving, viewing and storing a patient’s test results in the one place are significant for both the patient and their treating healthcare providers as it enables patients to share their test results with any number of treating providers. Clinicians will also benefit from having access to their patient’s results in circumstances where they did not initiate the requests.
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A new Medicines Information view in the My Health Record

New improvements to the My Health Record System

Over the past year, the Agency has worked with valued partners and the industry in order to deliver value in My Health Record and realise benefits of digital health in Australia. The Agency have incorporated public contributions in crafting the release by consulting over 140 Clinicians and 220 Consumer in order to deliver the best possible outcome.
1) New Medicines Information view
The next time you access a patient’s My Health Record, you may notice the new Medicines Information view.
The Medicines Information view can quickly sort and display medicines information held in a patient’s My Health Record documents in date or alphabetical order. The medicines information is gathered from:
  • the patient’s most recent (and up to two years’) Prescription and Dispense records and other PBS claims information
  • the patient’s most recent Shared Health Summary and Discharge Summary
  • recent Event summaries, Specialist Letters and e-Referral Notes uploaded to the patient’s record since their latest Shared Health Summary, and
  • the patient’s Personal Health Summary that may include any Allergies or Adverse Reactions and other key information
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Register to flag ADF suicide risk

  • The Australian
  • 12:00AM June 19, 2017

Sean Parnell

Australian Defence Force personnel and veterans may be ­singled out in an electronic health record system being rolled out across Australia, as authorities look to reduce the number of military suicides.
With My Health Records set to go national next year on an opt-out basis, automatically registering people unless they say otherwise, the departments of health and defence are discussing how best to support ADF personnel and veterans.
In 2014, before the decision to make records opt-out, the Department of Veterans’ Affairs ­negotiated the inclusion of an ADF indicator on the My Health Record, allowing individuals to self-identify their military status.
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My Health Record registrations up

More than 20% of Australia’s population is now registered for a My Health Record, according to the Department of Health.
Over 4.91 million people (out of Australia’s 23.8 million) now have a My Health Record, with an average of one new registration being created every 38 seconds.
Of the registrants, 54% are female and 46% male, while there are 9,879 connected healthcare providers including GPs, hospitals, pharmacies, aged care residential services and allied health providers.
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Inquiry calls for Centrelink ‘robo-debt’ system to be put on hold

Report highlights ‘procedural fairness flaws’
Rohan Pearce (Computerworld) 22 June, 2017 06:30
The report of a Senate inquiry has recommended that Centrelink pause its automated data-matching program designed to claw back welfare overpayments.
The system has been criticised both for its accuracy and the impact on welfare recipients. The report of the Senate’s Community Affairs Reference Committee, tabled last night, recommended that the so-called Online Compliance Intervention (OCI) “should be put on hold until all procedural fairness flaws are addressed” and a range of other recommendations implemented.
The committee’s report said that Between November 2016 and March 2017, at least 200,000 people received notices under the OCI relating to potential welfare overpayments.
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Woolworths CTO quits for healthcare

By Allie Coyne on Jun 19, 2017 5:43PM

Change of scenery.

Woolworths chief technology officer Ryan Fahy has left the retailer for the healthcare sector, taking on the chief information officer role at Primary Health Care.
Fahy had spent around two-and-a-half years at Woolworths as its CTO, including a brief period as its acting chief information officer after Clive Whincup resigned this time last year.
Since November Fahy has been working under replacement Woolworths CIO John Hunt, who came over from Woolworths South Africa.
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Medical Must-See: Meet the colonoscopy worm-bot

Sophie Attwood | 23 June, 2017 |  
Although the prospect of a worm robot inching its way through your colon may be a touch disconcerting, it could actually be a safer and more comfortable alternative to traditional colonoscopies.
Scientists from the University of Colorado in the US have created a worm-like device that can cleverly navigate the human colon, collecting images along the way.
The latest in the field of robotic aides, the 13cm-long ‘worm’ is made up of three flexible sections and nine shape-memory alloy springs, which convulse in a peristaltic motion mimicking that of the gut.
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1ST Group Launches MyHealth1st TV & Health Guide

Provides the MyHealth1st community with comprehensive and trusted Australian online health content
HIGHLIGHTS
  • Signing of a powerful advertising and health content partnership between MyHealth1st and an Australian leading health advertising and content provider, Tonic Health Media
  • Supports MyHealth1st’s preventative care and health education strategy
  • Tonic Health Media sales, advertising expertise and content syndication platform to drive MyHealth1st advertising revenues
  • Enables consumer access to over 700 health videos and 1,000 articles through the MyHealth1st platform
  • Tonic’s content syndication platform will continue to grow with premium content partners such as Health& joining the network
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NBN withholds individual internet speeds

  • The Australian
  • 8:00PM June 20, 2017

Anthony Klan

The National Broadband Network has details of the achievable internet speeds for every home it has connected but refuses to release the information despite widespread confusion among consumers seeking to connect.
The fact NBN Co has both “theoretical” speeds — the speeds it expects homes not yet connected will achieve — and actual speeds post-connection also raises questions as to the necessity of a $7 million federal government program to monitor connection speeds in 4000 homes.
Industry experts interviewed by The Australian have raised concerns NBN Co has widespread detailed net speed information and is not releasing it publicly but only to retail telco providers, who may have financial incentives to suppress the information.

Govt goes ahead with broadband tax bill

By Ry Crozier on Jun 22, 2017 11:43AM

Reiterates assertion that NBN customers won’t pay more.

The federal government has made good on its promise to introduce broadband tax legislation before parliament wraps up for the winter.
Minister for Urban Infrastructure Paul Fletcher introduced a pair of telecommunications bills today that set NBN Co as the new default fixed-line operator in Australia, and paved the way for a broadband tax to cover future fixed wireless and satellite costs.
The broadband tax converts an “opaque” internal NBN cross-subsidy of regional and rural connections into a “transparent” monthly charge of $7.10 per premises served by FTTx and HFC technologies.
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Three charts on: the NBN and Australia’s digital divide

Editor: Melissa Sweet Author: Ashley Schram, Fran Baum, Matt Fisher, Patrick Harris, Sharon Friel and Toby Freeman on: June 21, 2017
Let’s spend billions of dollars widening the social, economic and health gap between people who are already quite privileged and those who are not so well off.
Is that what we’re doing with the National Broadband Network (NBN)?
OK, that may be a touch hyperbolic but the article below suggests there is mounting evidence that the NBN rollout is more likely to exacerbate than alleviate health inequities.
And there are other reports of variable access to the NBN within regions (see the tweet below from former MP Tony Windsor about differential access in regional NSW, responding to these concerns about inequitable access in Bendigo, relative to other regional centres in Victoria).
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ACCC seeks volunteers for NBN speed tests

The competition regulator has invited Australians to join a new programme that will measure and compare broadband speeds across the country.
Under the programme, which aims to find out if issues relating to poor speeds at peak times are caused by the NBN Co's performance or network management decisions made by ISPs, hardware devices will be installed in about 4000 homes for four years.
The ACCC said the aim was to get about 2000 volunteers in the first year. The devices will carry out remote tests to determine typical speeds on fixed-line NBN services throughout the day.
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Enjoy!
David.

Sunday, June 25, 2017

I Believe They Are Getting A Little Ahead Of Themselves With This One. Needs A Bit More Planning.

This article appeared a day or so ago.

GP support for mandatory 'paperless' prescriptions

| 23 June, 2017
A call to phase out paper-based prescriptions has been backed by one of the RACGP's e-Health experts.
Integrated electronic prescriptions should become mandatory for “any prescriber of a PBS-listed medicine, any pharmacist wishing to dispense a PBS-listed medicine”, according to a Federal Government review of the pharmacy industry.
In its interim report, released on Thursday, the review says the current paper-based system is outdated and inconvenient, and increases the risk of adverse medical events.
Instead, paper prescriptions should no longer be the "version of record", and pharmacists should be able to retrieve the electronic prescription without sighting a paper version.
Dr Oliver Frank, a member of the RACGP expert committee for e-Health and Practice Systems, says many GPs are uploading electronic prescriptions to exchange software such as eRx or MediSecure already.
 “If it makes the system better and saves paper, do it."
He says the only difference in moving to a completely paperless system would be to the legal significance of the paper prescription.
At the moment, pharmacists must still scan a paper barcode to access the electronic prescription, which downloads the prescription information to the pharmacist’s dispensing software.
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More Information:
The full article is found here:
Now it is hard to suggest that in principle this is not a great idea. A lot of paper does get shuffled around and much of that is surely un-necessary.
There are however a few practicalities around issues like needing access to a computer system at difficult moments such a home visits at 3 a.m. and so on. There are also security issues that would need careful review if ‘on the move’ prescribing was to be agreed.
However the real issue is going to be to have the pharmacists be confident the doctor can’t direct a script to a particular pharmacy – so called ‘script-channeling’.  The way this is prevented at present is by handing the paper script to the patient – and having the patient decide where to take it for dispensing. The paper has a barcode which allows the pharmacist to access a script exchange to avoid typing and to provide accuracy.
The parallel system we have now seems to be the way to keep pharmacists happy while ensuring accuracy, ease of use etc.
Frankly I would like the doc to be able to ask the patient where they want to pick up the medicine and then to have the script go there with no paper. It can also be ready as soon as you go to pick it up – as in the USA. Great idea but the pharmacists hate it – and they are a powerful lobby!
I suspect the present system works well enough to ensure that change will be very slow to come!
David.

AusHealthIT Poll Number 376 – Results – 25th June, 2017.

Here are the results of the poll.

The myHR Has Been Operational For 5 Years. How Do You Rate It So Far?

A Great Success Saving Many Lives 1% (2)

So So 0% (0)

Could Have Done A Lot Better 4% (7)

An Expensive Disaster 94% (176)

It Is Still Too Early To Tell 1% (2)

I Have No Idea 1% (1)

Total votes: 188

The numbers speak for themselves. The vast majority think the myHR is presently an expensive disaster. Hard to disagree.

The real question now is, given right now it is clearly a disaster, can something clinically useful and worthwhile be salvaged from the present mess? Vote on the current poll to express your view!

A really great turnout of votes!

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

David.

Saturday, June 24, 2017

Weekly Overseas Health IT Links – 24th June, 2017.

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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Supercomputers help mine cancer data to identify risk factors

Published June 15 2017, 7:12am EDT
For researchers exploring the complexity of cancer genomes linked to mutations that carry increased risks for the disease, it can be like searching for a proverbial needle in a haystack.
However, supercomputers at the Texas Advanced Computing Center in Austin, given their ability to manage and analyze massive datasets, are helping to find correlations between chromosomal rearrangements—one of the hallmarks of cancer genomes.
“One of the things we’d like to understand in a predictive sense is where mutations are likely to occur, because mutations can lead to cancerous outcomes,” says Matt Vaughn, director of life sciences computing at the University of Texas at Austin’s TACC.
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Special Report: E-prescribing

The benefits of e-prescribing have long been emphasised, and uptake is increasing – albeit very slowly. The next step: harnessing the growing functionality and increasing intelligence that such systems can offer. Claire Read reports.
You’ll have heard about the potential benefits of e-prescribing. Perhaps it was from Tim Kelsey, the former national director for patients and information, who was fond of citing it as an example of the sort of technology the NHS should get on and adopt so as to save lives. Or maybe you’re aware of Lord Carter recommending its uptake in his review of NHS productivity.
Perhaps you remember the flurry of attention e-prescribing received when it was announced the entirety of the first tech fund was going to go towards funding the implementation of such systems. (Spoiler alert: that’s not quite what happened.)
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Portals – Advisory Series, June 2017

By Claire ReadDigital Health
In the second of Digital Health Intelligence’s new advisory series, Claire Read looks at how sustainability and transformation plans are embracing portals – and considers how the concept is evolving.
It’s a simple word, but ‘portals’ has a remarkable ability to polarise opinion in health IT. It’s fair to say Ciaron Hoye isn’t a big fan. “I absolutely hate the term,” admits Hoye, who is head of digital at Birmingham CrossCity Clinical Commissioning Group. He fears it is a “very vanilla description” which immediately conjures up an outdated understanding of its meaning.
“A lot of people when you say ‘portal’ think, ‘oh, right, a web page’,” he argues. “Well, no. That’s a very nineties and noughties idea of a portal.”
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DOCAPOST and Tactio Announce Strategic Partnership to Accelerate the Development of eHealth in France

PARIS, June 16, 2017 /PRNewswire/ DOCAPOST, a subsidiary of LeGroupeLaPoste, andTactioHealth Group, theworldleaderin mobilehealthsystems, have teamed up to speed up the development ofeHealthin France.
This partnership is supported byDOCAPOST'sindustrial capabilities in the health prevention andtelehealthsectors in France.Tactiobrings its genuine technological expertise and business savvy in mobile and connected health, developed in the Canadian and American markets to grow new and innovative practices in these sectors in France.
The expected synergies will provide a complete end-to-end digital healthsolution covering 2 areas:
  • A technological partnership which will lead to a close collaboration between the two companies on new telemedicine and eHealth projects in France in order to promote the large-scale development of eHealth solutions in France;
  • A business partnership which will lead DOCAPOST to incorporate Tactio solutions into its offering portfolio in France, also combined with DOCAPOST's Internet of Things (IoT) and healthcare solutions.
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The drones are coming, and they’re here to help with medical emergencies


Drones might replace ambulances to deliver emergency care to disaster victims.
In the not-too-distant future, drones equipped with medical supplies might replace ambulances that are slow to respond to emergencies following a natural disaster.
Four years after Hattiesburg, Mississippi was hit with a tornado that injured at least 80 people, Italo Subbarao, M.D., the associate dean of William Carey University College of Osteopathic Medicine, has built three drone prototypes designed to provide medical care in the event of a large-scale disaster, according to a report by Pew Charitable Trusts.
Some have predicted that drones could be used in healthcare, particularly for remote regions of the country, but there have few real-world applications to date.  
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Report: 19% of business passwords 'easily compromised'

Nearly one in five enterprise users have passwords that are weak or shared, putting their business at risk for cyber attack, according to a new report from Preempt.
By Alison DeNisco | June 14, 2017, 6:21 AM PST
Despite high profile breaches continuing to make headlines, weak passwords remain an issue for enterprises worldwide, leading to breaches and other security issues. An average of 19% of enterprise professionals use poor quality passwords or shared passwords that make their accounts "easily compromised," according to a new report from security firm Preempt.
Some 7% of enterprise users use an "extremely weak" password that has appeared on lists of previous password breaches—think using the word "password" or "123456." Meanwhile, about 13% of business professionals use passwords that they share with other users and teams, and between different accounts.
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What Health Systems, Hospitals, and Physicians Need to Know About Implementing Electronic Health Records

June 15, 2017
A decade ago, Kaiser Permanente installed the nation’s most comprehensive electronic health record (EHR). The decision was made by the health plan and medical group together. Due to the large size of our organization, implementation was challenging and expensive: The process took two years, and the cost at the time was estimated to be around $4 billion. But there is no question that the price tag and the effort required to train and motivate physicians and staff were worth it. The information the EHR provided, combined with our data analytics and integrated medical care delivery system, has helped us save countless lives.
Across the United States, few physicians have access to a comprehensive EHR that contains all of a patient’s medical information (regardless of how many doctors have provided care) and communicates care gaps and potential medical errors before they happen. As difficult and expensive as it may be to integrate this kind of system across a community, doing so is the best way to maximize quality of care for all patients. For health systems that want to make the investments in time and capital needed, here are some important lessons our experience taught us.
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FDA Pilot to Sign Off on Low-Risk Digital Health Products Without Premarket Review

US Food and Drug Administration (FDA) Commissioner Scott Gottlieb on Thursday announced an upcoming pilot program that would create a third-party certification program under which lower-risk digital health products could be marketed without FDA premarket review and higher-risk products could be marketed with a streamlined FDA review.
The pilot, part of a new approach to regulating digital health tools, would help to certify, according to Gottlieb, whether a company "consistently and reliably engages in high quality software design and testing (validation) and ongoing maintenance of its software products. Employing a unique pre-certification program for software as a medical device (SaMD) could reduce the time and cost of market entry for digital health technologies."
FDA also will provide guidance clarifying its stance on products that contain multiple software functions and which currently fall outside FDA regulations.
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NHS Digital on cyber-attack: “We can be better prepared”

Shireen Khalil

14 June 2017
NHS Digital admits the organisation could have done better during the global cyber-attack that crippled parts of the NHS last month.
Speaking at NHS Confed ’17 on Wednesday, NHS Digital’s acting chief executive, Rob Shaw said that better communications could have been provided earlier.
There is a lot of negative press and publicity against us but in my opinion we did really, really well and the local organisations coped really well…but we can be better prepared and we can also make sure we in the centre, provide better communications earlier and make sure we give advice.”
Addressing the audience of industry professionals in Liverpool, Shaw spoke about NHS Digital’s role in cybersecurity, services they provide on this front and the importance of communication, education and training healthcare staff.
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CIOs and CCIOs urge greater clarity on shared records and data protection

Claire Read

15 June 2017
Current data protection guidance and regulations are contradictory and not conducive to effective patient care according to a new discussion paper published by the independent CCIO and Health CIO networks.
The CCIO and Health CIO Networks discussion paper:’data sharing and data protection in healthcare’, considers the sensitive issue of the use of patient information, and was initially written in response to recent controversies over the data sharing model in TPP’s widely used SystmOne software.
The Information Commissioner’s Office in March announced an investigation into the TPP model over concerns it may contravene principles 1 and 7 of the Data Protection Act.
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HIT Think Why slow and steady IT development will best support value-based care

Published June 15 2017, 4:48pm EDT
Recently, my son has been listening to an adaptation of the classic story—the tortoise and the hare, a parable that supports the notion that slow and steady wins the race.
What does this story have to do with shifting healthcare to a value-based care system? Expectations and hype (the hare) cannot be allowed to overcome practical, thoughtful adoption (the tortoise). No change, especially fundamental change, can be expected to occur overnight. It takes time for reform to seep in, be implemented and be refined. And, we’re finding out, that it takes time for information technology tools to mature and provide the exact kind of support that providers will need to succeed.
A recent joint survey by Quest Diagnostics and Inovalon shows slow, but growing acceptance and recognition that value-based care is here to stay in healthcare. In comparison to the 2016 version of the survey, more physicians (and health plan executives) see that the technology tools are in place for value-based care.
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Video Call May Be as Good as Doctor Visit for Headache

Telemedicine offers a convenient alternative for sufferers, study authors say
WEDNESDAY, June 14, 2017 (HealthDay News) -- Seeing a neurologist via video conference may be as effective as an in-person visit for people with headaches, researchers say.
The new study included just over 400 headache patients in Norway who were referred by their primary care doctor to see a neurologist.
Half of the patients had an in-person appointment with a neurologist, while the others consulted with the specialist via video conference -- also known as "telemedicine."
At the study's start, three months later and again after a year, the patients completed surveys about their pain and the impact of their headaches on daily life. No differences were found between people who had traditional office visits and those treated through video, the researchers said.
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Hospitals overpay for health IT when systems don't connect

Jun 14, 2017 11:43am
To ensure that technologies and data can be used effectively in patient care, providers should invest in systems management.
Healthcare organizations can end up significantly overpaying for new healthcare technologies when they don't have integrated systems such as electronic health records, according to experts at Johns Hopkins.
The U.S. spends more on health IT than many other countries. Meanwhile, attitudes about interoperability are mixed. One recent survey found most providers (75%) think integrated systems are valuable, but that's lower than in other countries, which average out at 88%. 
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Why doctors hate electronic records — and what could change that

June 12, 2017 Updated: June 12, 2017 3:19pm
The health care industrial complex has spent billions of dollars and untold amounts of time trying to make medical records as flexible, invisible and unobtrusive as possible for patients and clinicians alike.
The results will be well worth the expense, the thinking goes, if the records — tracking patients in the vast and complicated health care system — could help clinicians spend more time caring for people and less on paperwork.
But after nearly two decades of concerted innovation, amid a push to do away with paper records, many physicians say they’re still hamstrung by issues that have dogged them for years. We’ve replaced the medical chart with a patchwork of systems that impose on doctors’ precious time and have yet to deliver clear improvements.
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ONC Releases C-CDA “Checkup” Tool for Healthcare Providers

A simple Direct message with a C-CDA attached can give healthcare providers insight into how to improve these critical data packets.

Jennifer Bresnick

Director of Editorial
jbresnick@xtelligentmedia.com
June 13, 2017 - Organizations that aren’t sure if their Consolidated Clinical Document Architecture (C-CDA) formatting and presentation are up to snuff can now get a simple numerical quality score from a new online ONC tool. 
The One Click Scorecard allows users to see how their electronic health record systems generate C-CDA documents, giving providers a glimpse into how they can improve this foundational summary of patient care.
“This benchmarking tool is the health IT equivalent of an internet speed test and is specially designed with health care providers in mind – to give them visibility into the quality of the C-CDAs their health IT generates,” explained Steven Posnack, MS, MHS, Director of the ONC Office of Standards and Technology, in a blog post.
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HIT Think Why IoT may be the next big target for ransomware attacks

Published June 13 2017, 4:17pm EDT
Ransomware has become one of the most serious cyber threats plaguing organizations. Today, healthcare and other types of organizations are trying to protect themselves from encryption viruses.
But so far, not a lot of attention has been paid to the next wave of ransomware attacks, which many expect to be aimed at encrypting IoT devices. These attacks can be much more dangerous because of the omnipresent and extremely diverse nature of the Internet of Things.
Quite simply, there are some differences that make IoT ransomware more dangerous than the already widespread extortion viruses for desktops and smartphones. Here are some ways in which ransomware attacks on IoT devices pose huge challenges for healthcare organizations.
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HIT Think Why healthcare information still doesn’t flow freely

Published June 14 2017, 4:50pm EDT
A recent University of Michigan survey asked health information exchange (HIE) professionals about their experience with information blocking. Respondents clearly indicated that information blocking is real and is practiced by both health systems and EHR vendors.
“Half of respondents reported that EHR vendors routinely engage in information blocking, and 25 percent of respondents reported that hospitals and health systems routinely do so,” write professors Adler-Milstein and Pfeifer in their report. “Among EHR vendors, the most common form of information blocking was deploying products with limited interoperability. Among hospitals and health systems, the most common form was coercing providers to adopt particular EHR or HIE technology.”
The survey results are especially incriminating for EHR vendors—researchers contend that they either “routinely” or “occasionally” engage in information blocking, according to 88 percent of respondents. Hospitals and health systems fared better, but 59 percent of survey participants still used “routinely” and “occasionally” to describe information blocking behavior.
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Caldicott: 'Data security will become main priority for new government'

Article posted on: June 5, 2017
“I think what’s happened is that the technology and the drive to improve our services of health and care have proceeded at a pace where we haven’t really caught up with in terms of keeping the public informed on what is happening with their information,” Dame Fiona Caldicott said at the Hay Festival in Wales this weekend
The government has not yet issued a response to the National Data Guardian’s review of data security, consent and opt-outs
[London, UK] Dame Fiona Caldicott, National Data Guardian for Health and Care, has said at the Hay Festival in Wales on Friday that data security will be ‘at the top of the agenda’ for the new government that will come into power after the 8 June general election.
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Will healthcare IT go blockchain?

Article posted on: May 15, 2017
Blockchain might not be the newest kid on the IT block but its growing appeal as a potential framework for secure data sharing across the healthcare spectrum signifies a new wave of interest among technology strategists. And this is being driven by a range of pilots and research initiatives now bearing fruit around the globe.
The quest for technology that solves the perennial need in healthcare for a secure, collaborative information exchange model, cutting through the age-old challenges of interoperability and accessibility, has been long and fraught. But the potential of blockchain as a viable proposition for the management of decentralised healthcare data is rapidly gaining momentum across the sector, despite early nervousness about its enabling role in the rise of controversial cryptocurrencies such as bitcoin.
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Widespread precision medicine is still years away, experts say

While the industry is rapidly making progress on precision medicine, cultural, policy and regulatory changes are limiting momentum, industry leaders said at the Precision Medicine Summit on Monday.
June 12, 2017 02:15 PM
BOSTON -- While the Office of the National Coordinator believes the dawn of precision medicine has started, when pressed on the current state of the innovative technology, technology leaders say that the industry is still years away from full utilization.
In fact, on a scale of one to 10, most would place precision medicine at a three in terms of progress.
“The landscape is changing so quickly and things [in the industry] have changed so much already,” University Of California, San Francisco Director of Research Strategy and Associate Director of Precision Medicine India Hook-Barnard said at the HIMSS Precision Medicine Summit in Boston on Monday.
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Digital biomarkers are the new ‘digital divide’ for the mental health app industry

Jun 13, 2017 12:13pm
Access to mental health apps is no longer a concern. Now researchers are focused on identifying useful digital biomarkers.
Smartphones and health apps are emerging as a new and potentially beneficial resource for those with mental health conditions. But so far, little is understood about how that data can guide treatment.
Mobile apps addressing mental health conditions are still in their infancy, but many see the information that is collected through those apps as a new resource for clinicians to better understand various disease states. While access to mobile apps focusing on mental health is no longer a concern, the digital biomarkers collected through those apps offer a new “digital divide,” researchers from Beth Israel Deaconess Medical Center and Harvard Medical School wrote in the journal Digital Biomarkers.
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Software proves as effective for treating depression as drugs

Published June 12 2017, 7:17am EDT
A cognitive-emotional treatment for depression, using software developed by researchers at Mount Sinai Health System, has proven to be as effective as antidepressant drug therapy.
The digital therapeutic, Emotional Faces Memory Task (EFMT), a form of psychological test to ascertain the subject's emotional well-being, was tested in a trial at Mount Sinai that resulted in a significantly greater reduction of major depressive disorder (MDD) symptoms compared with a control group, according to initial clinical results presented last month at the Society of Biological Psychiatry Annual Scientific Convention in San Diego.
In the six-week trial involving 51 patients, the web-based intervention reduced MDD symptoms by 42 percent in the experimental group of 28 patients, versus 15.7 percent in the control group of 23 patients.
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Arizona State using big data in hunt for cancer cure

Published June 12 2017, 7:08am EDT
Looking for a cancer-causing variation requires the examination of literally millions of different spots within the human DNA in thousands of individuals—a seemingly overwhelming amount of information. In fact, until recently it was so much data that the storage and processing capacities of computing platforms couldn’t efficiently handle the loads, which limited the work of scientists searching for cures.
The researchers at Arizona State University, however, thought big data computing could be just the tool they needed to start making some serious breakthroughs.
ASU is the largest public university by enrollment in the United States, with more than 83,000 students and 3,300 faculty members. The university’s charter is based on a “New American University” model that encourages teaching and research. A program launched under that model is ASU’s Complex Adaptive Systems Initiative (CASI), which aims to tap different departments across the university to develop new technologies and solutions to the immense challenges the world faces in health, sustainability, security and education.
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ONC shifting focus from EHR adoption to usability, interoperability, Rucker says

The ONC chief told a Washington gathering the time is right to address the ‘angst’ over EHR design and moving medical records.
June 09, 2017 01:56 PM
When it comes to the focus of the work of the Office of the National Coordinator for Health IT, adoption is out and usability and interoperability are in as health IT becomes more fully developed and new healthcare laws take full effect, ONC chief Donald W. Rucker, MD, said at a meeting in Washington Friday morning.
The 2009 HITECH Act has thus far provided about $36 billion to incentivize the adoption of electronic health records. And a significantly increasing number of healthcare organizations have been deploying the technology. Now, the 2015 Medicare physician payment law and the 21st Century Cures Act emphasize the free flow of medical records between systems and organizations.
"There's been a lot of angst out there about moving medical records," Rucker told attendees at the Direct Exchange Workshop, according to Politico. Rucker added that improving usability is too complex for government alone to solve. "I've never felt that kind of stuff works." 
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Oscar launches machine learning tool to put relevant clinical insights in front of physicians

Jun 12, 2017 9:23am
A new analytics tool from Oscar aims to give physicians patient data they can act on.
A common complaint among physicians is that they are inundated with a deluge of patient data. Oscar is looking to solve that problem by using analytics to distill data into useful clinical insights.
The five-year-old insurance company has taken its lumps over the past several years, including more than $200 million in losses in 2016, but the company is still betting on its data-driven approach to health coverage.
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Audit estimates CMS issued hundreds of millions of dollars' worth of incorrect EHR incentive payments

Jun 12, 2017 10:57am
The HHS Office of Inspector General estimates that CMS erroneously paid $729 million in EHR incentive payments to eligible healthcare professionals.
As part of a program to encourage providers to shift to EHRs, the federal government incorrectly paid hundreds of millions of dollars in incentive payments to healthcare professionals who did not actually meet Meaningful Use requirements.
The Department of Health and Human Services Office of Inspector General estimates that inappropriate payments to eligible professionals totaled $729 million between May 2011 and June 2014, according to a newly released audit (PDF).
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What Do Informatics Nurses Do?

Interviewer: Susan B. Yox, RN, EdD; Interviewee: Joyce Sensmeier, RN-BC, MS
June 07, 2017
We wanted to learn more about what informatics nurses do and review some of the highlights of the recent workforce survey done by Healthcare Information and Management Systems Society (HIMSS). So Susan B. Yox, RN, EdD, of Medscape spoke by telephone to Joyce Sensmeier, RN-BC, MS, vice president of informatics at HIMSS, to learn more.
Medscape: Would you tell our readers a bit about your background?
Ms Sensmeier: I'm vice president of informatics at HIMSS, and my background is nursing. Specifically, my specialty is nursing informatics. But my role at HIMSS goes beyond that, which probably is typical for many informatics nurses.

I oversee interoperability and standards activities at HIMSS, as well as the clinician community—nurse informaticists—of which we have about 8000 at HIMSS. I also oversee the physician community, pharmacy, and clinical engineering as well. And we're beginning to work more with the enterprise imaging professionals [medical imaging and information technology (IT)]. So those are my overarching areas of responsibility.
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Feds ID $729M in Improper EHR Payments

John Commins, June 12, 2017

Audit estimates that 12% of the $6 billion in electronic health record incentive payments made to hospitals, physicians and other “eligible professionals” under the HITECH Act did not comply with federal regulations.

Federal auditors say that $729.4 million in Medicare payments to incentivize rapid adoption of electronic health records did not comply with requirements for attesting meaningful use.
The Department of Health and Human Services’ Office of the Inspector General is urging the Centers for Medicare and Medicaid Services to conduct a thorough review of the incentive program that was created under 2009’s Health Information Technology for Economic and Clinical Health Act (HITECH Act) and attempt to recover improper payments.
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Monday Morning Update 6/12/17

June 11, 2017 News No Comments

Top News

Cork University Maternal Hospital and University Hospital Kerry in Ireland report significant added expense as a result of their implementations of the nation’s first Maternal and Newborn Clinical Management System. The initial $39.2 million price tag has increased by $785,000 in Deloitte consultancy fees, with millions more expected as 17 additional hospitals prepare to go live on the Cerner-powered system over the next several years. Ireland’s Health Service attributes the over-budget, delayed implementations to a lack of expertise on the part of its clinical and business staff.
Ireland experiences similar woes with its eHealth project, which is “not in a good place,” according to Chief Scientific Adviser Mark Ferguson, adding that the project is moving forward with several initial pilots to help alleviate patient concerns about  the digital storage of PHI. The project will ultimately include the launch of a nationwide EHR, unique identifiers for patients, and capacity for genome-sequencing.
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Enjoy!
David.