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"


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

Monday, December 30, 2013

Is This Not Misleading Advertising? - Seem To Me The LMMMS May Be Making False Representations.

This popped up a few days ago.

Bendigo makes the most of eHealth records


BENDIGO health professionals are embracing the eHealth record initiative.
The federal government initiative is a secure online summary of your health information designed to enable doctors, hospitals and other healthcare providers to view and share your health information to provide patients with the best possible care.
Loddon Mallee Murray Medicare Local has teamed up with St John of God Hospital Bendigo to help people register their eHealth records.
LMMML trained 11 of the hospital’s volunteers to help staff, patients and visitors register for an eHealth record.
LMMML eHealth co-ordinator Katrina Law commended St John of God Hospital Bendigo for embracing the eHealth initiative.
“We have been working closely with the hospital to develop a whole of hospital approach to the eHealth program - volunteer eHealth assistants are vital to this vision," she said.
“As more people register and organisations join the eHealth record system, the better connected our health system with become.
"Being a volunteer eHealth assistant allows the St John of God volunteers to become involved in various capacities across the hospital.
"This keeps role of volunteering meaningful interesting and fulfilling."
Ms Law said the partnership was in its infancy but had already been well-received.
"We are hoping that registrations will increase once information has been sent out in a pre-admission kit," she said.
"The eHealth record is a Commonwealth program, completely free of charge and completely voluntary.
More here:
What is going on here? The PCEHR is under review, the Budget is about to be slashed and money which might be spent elsewhere is being spent on a program which may have a life measured in weeks.
I am surprised the Medicare Local thinks it is OK to just press on and continue spending when it is clear there is likely to me major changes if not outright cancellation.

It will hardly be a good look if the volunteers discover they have been conned and wasted their time on a program the new Government has decided to cancel. This outcome has to be an even chance I would reckon.

Also I really do not like the idea of enthusiastic volunteers signing people up to anything when they typically have something rather larger on their mind - like an upcoming operation. Not the time to be at your most clear about what you are agreeing to!
Oh well.

Sunday, December 29, 2013

It Will Be Interesting To See Where This Is Heading. Looks Important And Not Good!

Sorry to interrupt the Summer of cricket but this might be pretty important.
This popped up on the weekend.

Government puts key talks on health reform on hold for six months

FEDERAL, state and territory health ministers earlier this year resolved to have a high-level advisory committee explore "possible future directions for future reform of Australia's health system".
The committee was to look at how this could be done through a closer working relationship between GPs and hospitals, better e-health solutions and improved co-ordination of care for people with chronic and complex conditions, including cancer.
The NSW government was then tasked with reporting on the progress of the existing National Health Reform Agreement, including the performance of various bodies established by the Rudd and Gillard governments, and with developing a framework and timeline for further reform work.
The much-anticipated blueprint was not delivered at last month's meeting of the Standing Council on Health as expected, and documents obtained by The Weekend Australian under Freedom of Information laws show it was deliberately deferred.
A briefing paper for federal Health Minister Peter Dutton shows the federal government wanted to delay the blueprint presentation until the council meets next May, to allow further budget cuts and governance changes to be detailed.
"We do not currently have a clear indication of the government's inclination to support further health reform," the paper said.
There was also some concern that preparation of a blueprint "may initiate reform proposals from the states and territories that the commonwealth does not support" whereas "deferral will allow more time to ensure the proposed work aligns with the commonwealth government health priorities".
More here:
The delay is clearly to allow the present Government to absorb and develop responses to the Medicare Locals Review, the PCEHR Review and the Commission of Audit - all of which seem likely to be responded to in the May Budget.
One has to imagine that the deferral means there is going to be budget action one way or another in these areas. I would lay ‘London to a brick’ that funding increases are not actually being seriously considered. I think you can also be sure the Health Sector overall is going to take some sort of hit in May!
Back to the restful quiet summer now!

AusHealthIT Poll Number 198 – Results – 29th December, 2013.

Do You Believe The PCEHR SHOULD Be Closed Down?

Yes 69% (36)

No 23% (12)

I Am Undecided 8% (4)

Total votes: 52

Again, it seems that the review should recommend ending the suffering and stop wasting everyone’s time and money.

Again, many, many thanks to those that voted!


Wednesday, December 25, 2013

For The Record - Australasian College Of Health Informatics Responds To Medicare Locals Review

You can download a copy - only a few short pages with 15 recommendations - from this link:


In summary I think it is fair to say that ACHI sees Medicare Locals (ML) as very much a work in progress that really need a great more clarity on what they should do and what is the evidence supporting the various current and proposed ML activities and associated spending.

Have a quick read to find out more.

I would be interested in links to other submissions people know about - other than the AMA submission which was covered earlier on the blog.

See here:



Tuesday, December 24, 2013

Happy Christmas And A Great 2014 To All!

Thanks for reading during the year.

All the best to you and yours!

Will be back, fate and God willing,  January 6, 2014 to do it all again!

I wonder what the Minister for Health has been told about PCEHR? Inside information in the comments welcome!

Now we know what has been said, it is really astonishing that the Minister can think a worthwhile review could be done in the six to seven weeks.

Certainly all the commenters picked up on this:

1 – 3 of 3
Anonymous Anonymous said...
"Their report provides a comprehensive plan for the future of electronic health records in Australia." Wow! Now we have the record system, let's develop the plan. Does the plan include a Tardis? I do hope they publish this report and let us all in on the plan.
12/23/2013 10:01:00 PM
Anonymous Anonymous said...
Maybe the plan is to have another review and then develop a plan to replace the plan they never had in the first place.....
12/24/2013 06:32:00 AM
Anonymous Anonymous said...
If its true that they produced a "comprehensive plan" then their lack of insight into their limited knowledge is worse than I thought. Perhaps those with deep knowledge of eHealth could be employed producing comprehensive plans for education or defense spending as it seems in this new order having experience in anything just clouds your judgement. My confidence in western civilization is waning... Perhaps we should begin stockpiling guns, ammo and canned food?
12/24/2013 12:33:00 PMDelete
 ----- End Comments.

I have to say I really do enjoy all the comments. It is great to have so many different slants on things!

Do have a good one!


Monday, December 23, 2013

As We Always Suspected The E-Health Review Will Be Secret For A While! And It Won’t Help Either!

This has just appeared.


20 December 2013

E - Health Record Review

The review of the Personally Controlled Electronic Health Records (PCEHR) system has been completed.
Health Minister Peter Dutton today received the report from the review team headed by the Executive
Director of the UnitingCare Health Group, Mr Richard Royle.
The review looked into significant concerns about the progress and implementation of the PCEHR.
Mr Royle was assisted by AMA President Dr Steve Hambleton and Australia Post CIO Andrew Walduck.
Their report provides a comprehensive plan for the future of electronic health records in Australia.
Mr Dutton said the Government would now take time to c onsider the review recommendations and would respond in due course.
“I sincerely thank the members of the review panel for their work on this matter.”
Media Contact: John Wiseman
0401 776 108
Clearly Mr Dutton has no idea what a real plan would actually look like as it is impossible to develop anything remotely that in a few weeks.
Sorry to provide such nonsense just before Christmas.

Weekly Australian Health IT Links – 23rd December, 2013.

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

There seemed to be enough news to make a summary worthwhile.
So have a good one in a day or two.

NSW launches eHealth Blueprint

Health Minister Jillian Skinner spoke to ehealthspace.org today following the launch of A Blueprint for eHealth in NSW at Parliament House this morning.  The Blueprint formalises the establishment of eHealth NSW as a separate entity.
The Minister said that part of the rationale behind introducing this structural change now was the departure of former HealthShare NSW head Mike Rillstone and CIO Greg Wells who both joined FACS in October.
“We are using this as an opportunity to split the two areas, to give greater focus to both, although they will still be working very closely together,” she said.

Super-CIO, new tech body to lead NSW e-health drive

Minister brings health IT higher up the food chain.

An IT leader with freshly expanded authority, a clinical technology champion and a brand new strategic health organisation will form the foundation of the NSW government’s new blueprint for e-health.
The five year roadmap, formally launched today by health minister Jillian Skinner, makes good on a 2011 commitment to establish a standalone IT body that will oversee the strategic direction of e-health across hospitals and health districts.
Speaking to iTnews, NSW Health director-general Dr Mary Foley said the new eHealth NSW body would be formed from a lift and shift of IT staff out of the department’s current corporate support agency Healthshare NSW. 

NSW govt touts e-health future

Government introduces new blueprint for services delivery across the state and will soon appoint chief executive of eHealth NSW, and chief CIO
The NSW government has unveiled its Blueprint for eHealth in NSW, aimed at improving collaboration between agencies and the development of a strategy to provide services to rural and remote areas.
The blueprint – announced today by health minister Jillian Skinner – outlines a framework for enhanced collaboration between eHealth NSW, the NSW Ministry of Health and the Local Health Districts.
The blueprint formalised the establishment of eHealth NSW, the minister said. The government will appoint an inaugural chief executive of eHealth NSW by April, as well as a chief CIO to engage clinicians on eHealth.

E-health software risk flagged

6 December, 2013 Paul Smith
The software GPs use when accessing the PCEHR is not clinically safe, the RACGP warns.
In a highly critical submission to the Federal Government's review of the billion-dollar system, the college said there were serious failures in the project's rollout, fuelled by a failure to consult with doctors.
Vendors upgraded their GP software systems earlier this year, allowing doctors to access patient information held on the PCEHR.
But the college said: "The views provided through the various vendor desktop systems are not standardised, safe or intuitive.
"The individual desktop systems each display different documents and are not searchable.

QLD's ban on IBM stays put as state government sues for damages

Published on Mon, 09/12/2013, 04:56:23
By Julian Bajkowski
Queensland premier Campbell Newman has confirmed that a ban on IBM securing new public sector business in the state is still standing after the government commenced legal action for damages late last week in the Supreme Court of Queensland.
A spokesman for the Premier told Government News that there has been “no change in position” in relation to the ban that was put in place in August this year following the release of findings from a special Commission of Inquiry into the $1.2 billion Queensland Health Payroll software disaster that labelled the incident as possibly the worst IT project failure Australia has ever seen.
Technology industry sources outside IBM have told Government News they believe that the ban appears aimed at giving the Newman government better leverage in terms of attempting to force IBM to the table to come to a financial settlement.

Fujitsu Enables a Winning Solution for Healthshare NSW

Enterprise Imaging Repository scoops Premier’s Award for developing the first state-wide medical imaging repository in Australia

Sydney, 13 December, 2013
Fujitsu announces that HealthShare NSW1 has won a prestigious NSW Premier's Award for the pioneering Enterprise Imaging Repository (EIR). Presented at a gala ceremony in Sydney on November 13, the award honours the significant achievements and collaborative efforts of the HealthShare NSW and Fujitsu Australia teams, which are implementing the EIR at more than 220 public hospitals across the state’s 15 Local Health Districts.
A NSW Health2 initiative, the EIR is based on a leading patient-centric management and distribution solution. In an Australian first, the new scalable medical imaging exchange will make a significant difference to patient care, especially for people who need treatment in multiple hospitals and also for those who live in rural and regional areas.

Who will be iTnews' Healthcare CIO of the year?

Benchmark finalists revealed.

Three CIOs incredibly passionate about their jobs -  down to the impact that they have at the patient bedside - have been shortlisted as finalists for Healthcare CIO of the Year at this year's iTnews Benchmark Awards.
David Johnston, who during 2013 was CIO of the South Australian Department of Health, Greg Wells, who served as CIO of NSW Health, and Glenn Payne, CIO at aged care provider Feroscare, make up the select group.
In terms of the total submissions, we can say with confidence that 2013 was the year of the electronic health record. Two of our finalists - and several other high scoring entries - have created platforms that allow their state-based medical record systems to interface with the national Personally Controlled Electronic Health Record (PCEHR), a project which aims to usher in a new era of clinical collaboration.

World Congress Tackles Diabetes Management with Technology

Posted: Tuesday, December 17, 2013 - 09:43
Young global diabetes advocates joined forces to help design a sophisticated eHealth app for diabetes prevention and management, expected to assist more than a million Australians living with diabetes.
As part of the recent World Diabetes Congress program in Melbourne, Nigerian Prince and International Diabetes Federation Young Leader, Prince Ikenna Nwaturuocha, joined 170 Young Leaders representing 69 countries to solidify the group’s vision for a world-leading digital platform.
The output will directly feed the development of Diabetes Australia’s eHealth app, supported by a donation of up to $1 million through the 2013 eftpos Giveback campaign.

MLs review timetable and terms of reference announced

16th Dec 2013
THE future of Medicare Locals may be decided early next year following a review being led by former Commonwealth Chief Medical Officer Professor John Horvarth.
The review, a promise made by Health Minister Peter Dutton prior to the Coalition’s election victory in September, is to report by March next year and will examine whether MLs are enhancing clinical services, and what bureaucratic impact they have had.
Stakeholders have been invited to make submissions to the review discussing issues such as the extent to which general practice has been maintained “as the cornerstone of primary care in ML functions and governance structures”, as well as MLs' management of after-hours services.

Medicare Locals review

Australia’s former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government’s review of Medicare Locals.

Page last updated: 16 December 2013
16 December 2013
Australia’s former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government’s review of Medicare Locals.
Prof Horvath is a distinguished doctor, researcher and health adviser and served as the nation’s CMO from 2003 to 2009.
Health Minister Peter Dutton has announced details of the review which was a Coalition election commitment.

MLs not delivering: AMA review submission

19th Dec 2013
MEDICARE Locals do not communicate effectively with GPs, do not understand their own roles and have disenfranchised those previously involved in after-hours care according to the AMA.
The association’s latest critique of the organisations, which also included a renewed call for the ‘Medicare Local’ moniker to be replaced with a less misleading name, came in its submission to an ongoing review of the MLs program being headed up by Professor John Horvarth.
Along with its submission the AMA also released the results of a recent survey it had conducted of 1212 GPs which found that almost half (48.9%) of respondents believed they had not been kept informed of the work being done by their ML.

Submission: AMA submission to the Australian Government Review of Medicare Locals

The AMA has made a submission to the Australian Government Review of Medicare Locals.  Former Chief Medical Officer, Professor John Horvath will oversee the Review.
 The AMA submission is supportive of a network of Primary Health Care Organisations (PHCO), but highlights significant problems in the design and implementation of Medicare Locals.  The AMA submissions calls for fundamental changes to the model implemented by the former Government so that a future PHCO structure is
  • GP-led and locally responsive;
  • focused on supporting GPs in caring for patients, working collaboratively with other health care professionals;
  • not overburdened by excessive paperwork and policy prescription
  • focused on addressing service gaps, not replicating existing services; and
  • better aligned with Local Hospital Networks, with a strong emphasis on improving the primary care/hospital interface.

Medicare Locals slammed by AMA

19 December, 2013 Jo Hartley
A radical overhaul of Medicare Locals - including ditching the meaningless name - should be a key priority for the Abbott government, according to the AMA.
In its submission to the Federal Government’s review of the program, the AMA says the Medicare Locals model is a failure and no better than its predecessors, the GP divisions.
Medicare Locals had systematically failed to engage GPs in their work, with notifications of meetings often given at short notice and arranged during working hours.
Instead many had used  “high-cost consultancy” firms with no understating of local health needs to determine service provision – often resulting in duplication, the submission reveals.
AMA president, Dr Steve Hambleton, said: "The performance of Medicare Locals against their objectives has been patchy, and there is little evidence of improvement over the divisions of general practice structure they replaced – despite additional funding."

Public hospital boards struggle with patient care and safety, study finds

Date December 20, 2013

Julia Medew

Health Editor

Some Victorian public hospital boards and executives are struggling to deal with quality of care and patient-safety issues despite the buck stopping with them if things go wrong, according to a study published in an international journal.
A survey of 233 board members from 82 Victorian public hospitals has revealed wide variation in engagement with quality-of-care matters such as monitoring death and injury rates that might be caused by errors or systemic negligence.

Companies not ready for privacy laws

AT least half of corporate Australia will not be compliant with new privacy laws when they come into effect in March next year, according to a legal expert.
DLA Piper intellectual property and technology partner Alec Christie said there was little understanding of what businesses had to change in order to be compliant.
"My feel is 50 to 60 per cent of corporate Australia will not be compliant by March 12 and either it is a hangover from not taking the previous law that seriously, because there weren't penalties and fines, or it is just not on their to-do list," he said.

Wearables tipped to power next wave of gadgets

Date December 17, 2013 - 12:15AM

Stuart Corner

The pundits are in agreement: 2014 will be the year that the market for wearable devices takes off.
But if you think wearable devices are limited to things like the popular Nike FuelBand and the much publicised Google Glass, think again. Californian software developer EyeMynd claims to have developed a "Brain Operating System" that, it says, "allows anyone to interact with their electronic device just by thinking what they want to occur".
According to founder and chief executive, Dan Cook, it will soon be possible to use EyeMynd's technology to control your computer by thought alone.

No way to future proof NBN: Switkowski

James Hutchinson
Ziggy Switkowski concedes Australia’s biggest infrastructure project, the national broadband network, could become obsolete in decades, overtaken like the once-promising networks built by Telstra and Optus he is negotiating to take over.
In an interview with The Australian Financial Review, the new executive chairman of NBN Co says the danger of obsolescence is a key factor behind the radical redesign of the network that will combine cutting-edge fibre optics with century-old copper wiring.
Central to the new strategy are ­Telstra and Optus’s existing copper and cable networks. Once at the forefront of communications and now-fading assets, Dr Switkowski predicts he will get both at no extra cost to NBN Co, a coup for him and his boss, Communications Minister Malcolm Turnbull.

NBN alternatives: fibre to the node or HFC cable?

Date December 21, 2013 - 10:17AM

Adam Turner

A third of Australian homes will connect to the internet via pay TV cables under the latest national broadband network proposal.
After scrapping the plan to run fibre to 93 per cent of premises, the government initially proposed switching many homes to fibre to the node – using the copper phone lines to cover the last few hundred metres. Now it supports a multi-technology mix with roughly an even split between fibre to the premises, fibre to the node and the existing hybrid fibre-coaxial (HFC) pay TV cable.
Fibre to the node will struggle to offer more than 50 megabits-per-second (Mbps) in the near future but could eventually reach 100 Mbps, depending on the condition of your copper line. Cable already offers the 100 Mbps speeds promised by fibre to the premises. Unfortunately cable is highly susceptible to congestion and regularly grinds to a halt for some users.

CryptoLocker still a danger

·  Chris Griffith
·  December 16, 2013 12:00AM
NETWORK security engineers have had limited success disabling devastating malicious software that encrypts all files on a user's computer.
The malware, CryptoLocker, uses sophisticated 256-bit encryption which makes it virtually impossible for the encryption code to be cracked by accident. Affected users are forced to pay hundreds, sometimes more than $1000 to obtain a "private key" -- a special string of digits and letters needed to decrypt their files.
The only hope for defeating CryptoLocker is when users have offline backups of their data before their computer is infected. The Trojan horse malware will also try to encrypt files on USB external hard drives and even network attached storage -- so as to make it hard for users to recover data without paying up.

Microsoft likely to bring back Start menu in future Windows update

If rumors are right, Redmond will mimic Stardock's tools that already offer Start menu and 'Metro' apps on the desktop
Microsoft will bring back the Start menu to Windows 8 and let users run "Metro" apps inside windows on the desktop, restoring traditional elements to its newest operating system, according to a report by a long-time Microsoft watcher.
Paul Thurrott, citing anonymous sources, claimed Monday that the next update for Windows, which other pundits have pegged for the spring of 2015, will offer options for both a Start menu and on-desktop execution of the touch-centric "Modern," nee "Metro," apps.
In October, Microsoft restored a pseudo-Start button in Windows 8.1, and gave users the option of circumventing the tile-style Start screen by booting directly to the conventional desktop. However, it declined to reinstate a Start menu.

Sunday, December 22, 2013

I Suspect None Of Us Are Taking This Seriously Enough. Get Caught And It Could Be Very Bad.

About a year ago we had this appear.

Practice won’t pay for ransomed records

9 January, 2013 Kate Newton
A Gold Coast medical practice whose patient records were hacked and encrypted by foreign cyber criminals will not pay a $4000 ransom, instead choosing to recreate the records bit by bit.
GPS at Miami Family Medical Centre discovered last December that their server had been hacked and all 15,000 patient files encrypted, making them unusable.
The hackers, believed by Queensland police to be operating from eastern Europe, did not steal any patient details but demanded a ransom of $4000 to decrypt the files.
The practice was able to recover some patient details through referrals, pathology reports and other outside health services, but had to rely on handwritten notes and appointment books for several days to ensure patient care was not disrupted.
Before Christmas, the practice was seriously considering paying the ransom. However, practice co-owner David Wood, whose wife is a GP at the clinic, said they had now decided against it.
"It's not that simple to pay anyway. You have to give photo ID and all sorts of things to a faceless website, so you just add another problem to the mix of potentially having your identity stolen," he said.
Instead, the practice was piecing together a new set of patient records.
More here:
This then appeared last week:

CryptoLocker still a danger

·         Chris Griffith
·         The Australian
·         December 16, 2013 12:00AM
NETWORK security engineers have had limited success disabling devastating malicious software that encrypts all files on a user's computer.
The malware, CryptoLocker, uses sophisticated 256-bit encryption which makes it virtually impossible for the encryption code to be cracked by accident. Affected users are forced to pay hundreds, sometimes more than $1000 to obtain a "private key" -- a special string of digits and letters needed to decrypt their files.
The only hope for defeating CryptoLocker is when users have offline backups of their data before their computer is infected. The Trojan horse malware will also try to encrypt files on USB external hard drives and even network attached storage -- so as to make it hard for users to recover data without paying up.
Once the encryption process finishes, it tells users to pay a ransom, which so far has been $100, $300 or two bitcoins, currently worth about $1950.
CryptoLocker was first detected in September. Since then, it has infected mainly Windows-based computers in Britain and USA with devastating results. As The Australian recently revealed, there are now confirmed cases of CryptoLocker infecting computers locally.
A number of antivirus suites will detect and disable CryptoLocker malware, which enters computers disguised as attachments on fake emails purportedly from companies such as courier companies FedEx and UPS, and antivirus firm Symantec.
However antivirus suites that disable and remove CryptoLocker can render it impossible for users to get their files back. Victims wanting to decrypt their files have been forced to reinstall the malware and apply the criminal-supplied private key.
Network security firms however have been investigating ways to render CryptoLocker harmless on networks before the malware gets the chance to encrypt any files on a user's computer.
Lots more here:
Given none of the security firms (Symantec etc.) seem to have the problem beaten it is clear that prevention is way better than cure.
See here for very recent Symantec article:
Short summary - once encrypted - files that are not backup up safely are gone for all practical purposes.
There is a useful Computerworld article here:
So what to do:
1. Take the threat seriously - pretty obvious.
2. Make sure your anti-virus and anti-malware scanners are current and active.
3. Make sure you and all who access your network are aware of the risks associated with opening attachments that are not from trusted sources and expected. If at all unsure just delete!
4. Make sure you have current data backups that are not network accessible (switched off drives, detachable drives that are detached, non-mapped drives to your NAS, backups that are encrypted etc.)
5. You may want to check out CryptoPrevent.
Seems like a useful way of adding some protection. Near 100,000 downloads seems to mean others think so. This is the only blocker I have found so far.
Hope this helps…If just one person is saved it will be a very good thing!

AusHealthIT Poll Number 197 – Results – 22nd December, 2013.

A special week with 2 polls!

Do You Think The Consent Model For The PCEHR Should Be Changed From Opt-In To Opt-Out. i.e. The Population Should All Be Enrolled In The PCEHR Unless They Actively Decline To Be Enrolled?

I Strongly Favour Opt-Out 14% (11)

I Favour Opt-Out 8% (6)

I Favour Opt-In 4% (3)

I Strongly Favour Opt-In 71% (56)

I Have No Idea 4% (3)

Total votes: 79

Opt-In is certainly the favoured approach on this blog.

Should The PCEHR Review Recommend That The PCEHR Program Be Cancelled?

Definitely 70% (55)

Probably 11% (9)

Possibly 3% (2)

Definitely Not 16% (13)

I Have No Idea 0% (0)

Total votes: 79

It seems that the review should recommend ending the suffering.

Again, many, many thanks to those that voted!


Saturday, December 21, 2013

Weekly Overseas Health IT Links - 21st December, 2013.

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.

Healthcare turns to big data analytics for improved patient outcomes

Summary: Analytics platforms and new healthcare-specific solutions together are offering far greater insight and intelligence into how healthcare providers are managing patient care, cost, and outcomes.
By Dana Gardner for BriefingsDirect | December 12, 2013 -- 23:53 GMT (10:53 AEST)
Listen to the podcast. Find it on iTunes. Read a full transcript or download a copy. Sponsor: HP.
Analytics platforms and new healthcare-specific solutions together are offering far greater insight and intelligence into how healthcare providers are managing patient care, cost, and outcomes.
Based on a number of offerings announced this week at the HP Discover Conference in Barcelona, an ecosystem of solutions are emerging to give hospitals and care providers new data-driven advantages as they seek to transform their organizations.

Sleeker Sepsis Plan Shortens Time to Rx

Published: Dec 13, 2013
By Sarah Wickline , Contributing Writer, MedPage Today
ORLANDO -- Reductions in time to treatment followed the development of more efficient treatment protocols for sepsis, but not after Computer Physician Order Entry (CPOE) systems were put in place, researchers reported here.
A combination of procedural updates, including Code Sepsis and nursing staff alerts, shortened the time between diagnosis and administration of antibiotics by 64% in non-ICU sepsis patients, Tram Cat, PharmD, BCPS, of Cedars-Sinai Medical Center in Los Angeles, Calif., and colleagues reported at the midyear meeting of the American Society of Health-System Pharmacists.
Previous research has shown that time to treatment is crucial for successful management of sepsis. A delay of more than 1 hour from the time a patient develops hypotension to the administration of antibiotics can lower the rate of survival by 8% each hour of delay for the 6 hours following onset of symptoms.

ONC Meeting to Cover Matching Patients to Their Data

DEC 12, 2013 3:14pm ET
The Office of the National Coordinator for Health Information Technology invites stakeholders to an open meeting in Washington on Dec. 16 to unveil findings of an initiative to improve patient matching efforts.
Space on the premises is limited and participation also will available via the Web. Those who wish to come in person must register as soon as possible.

Healthcare about to turn on its head

Posted on Dec 13, 2013
By Bernie Monegain, Editor
Most people are optimistic about technology innovations advancing healthcare, are willing to participate in virtual healthcare visits with their doctor, and would use health sensors in their bodies and even their toilets, according to a new study commissioned by Intel Corporation.
The "Intel Healthcare Innovation Barometer," conducted across eight countries by Penn Schoen Berland, found the majority of people also believe that technology innovation holds the best promise for curing fatal diseases – more than increasing the number of physicians or additional funding for research. The survey was conducted online in Brazil, China, France, India, Indonesia, Italy, Japan and the United States from July 28 to Aug. 15, 2013, among a representative sample of 12,000 adults, 18 and older.

CommonWell EHR Interoperability Pilot Announced

Scott Mace, for HealthLeaders Media , December 12, 2013

The electronic health record vendors in the first series of CommonWell Alliance pilots include Allscripts, Athenahealth, Cerner, CPSI, Greenway, McKesson, RelayHealth and Sunquest. Testing will begin January 1.

CommonWell Alliance announced Wednesday three regions in Illinois, North Carolina, and South Carolina where pilot testing of its cross-vendor EHR interoperability services will commence January 1.
Participating providers include Lake Shore Obstetrics & Gynecology in Chicago; Hugh Chatham Memorial Hospital in Elkin, N.C.; Maria Parham Medical Center in Henderson, N.C., and Midlands Orthopaedics and Palmetto Health, both of Columbia, S.C.

Mobile Apps Can Save Billions in Health Costs

Published: Dec 12, 2013
By David Pittman, Washington Correspondent, MedPage Today
NATIONAL HARBOR, Md. -- If Omri Bob Shor's father doesn't take his diabetes medication or accidentally takes too much insulin, Shor gets an alert to his phone telling him so.
MediSafe, the system Shor uses and the company he helped found, is like most other medication management applications that have sprung up in recent years with the proliferation of smartphones in that it sends alerts reminding patients to take their medication.
Shor said medication adherence with his app is 86%. He called it a media platform linking various devices with family members and communication lines such as phone calls, emails, and text messages. "MediSafe is the first app to [notify] family members in real time," he told MedPage Today.

E-Prescribing: Inpatient Results Disappointing

Published: Dec 12, 2013
By Sarah Wickline , Contributing Writer, MedPage Today
ORLANDO -- Electronic prescription order entry and medication reconciliation reduced some errors in hospital settings but increased others, and did not meet overall expectations, researchers reported here.
After implementation of a computerized prescriber order entry (CPOE) system, one hospital experienced a 29.2% increase in medication dispensation errors American Society of Health-System Pharmacists.

Allscripts, Cerner, McKesson & Others Launch Interoperability Service

DEC 11, 2013 3:54pm ET
CommonWell Health Alliance, which seven health information technology companies formed in early 2013 to cooperate on systems interoperability issues, will launch initial services in early 2014 in four regions.
The alliance, which continues to welcome other vendors to join, will start with specific provider organizations in Chicago, the cities of Elkin and Henderson in North Carolina, and Columbia in South Carolina. These regions were selected because of strong market share that alliance members have within them.
Founding members of the alliance are Allscripts, athenahealth, Cerner, CPSI, Greenway, McKesson and Sunquest, with McKesson’s RelayHealth unit providing the health information exchange platform. These members, according to the alliance, represent 42 percent of the acute care electronic health records market and 23 percent of the ambulatory market.

Patient access to e-notes may become 'standard of care'

December 12, 2013 | By Marla Durben Hirsch
Allowing patients access to physicians' electronic notes is becoming more popular, and is influencing the content of the notes themselves, according to a new op-ed article in the New England Journal of Medicine.
The article, written by several participants in the OpenNotes experimental program, states that while the initiative has been welcomed by both patients and physicians, it has changed their approach and drafting of the notes.
Patients are now more careful about what they share with physicians and desire more control over the information. The clinicians are wary about how they phrase notes, particularly about sensitive medical conditions.

Survey ranks EHR vendors on technology, functionality and interoperability

December 11, 2013 | By Marla Durben Hirsch
EHR vendors tout the importance of their systems' technology when they market their products, but providers were more concerned about vendors' ability to deliver functionality than the particular technology the system used, according to a new study by KLAS Research.
In a survey of 117 organizations, mainstream technology such as Oracle, .Net or SQL were a strong driver in the selection of EHR vendors AllScripts, Cerner, McKesson and Siemens. AllScripts rated highest for programmability and accessibility of data; Cerner rated highest for interoperability and configuration.
"It is easier to access data and modify EMRs that have mainstream technologies at their cores…lower ratings for Epic and Meditech were influenced by a perception of design complexity, vendor protectiveness and scarcity of skilled staff," the researchers found. Epic and Meditech use Cache and MAT technologies.

Barts clinicians view GP data in Cerner

12 December 2013   Rebecca Todd
Barts Health NHS Trust is using Cerner’s Health Information Exchange to view a summary of patients’ GP records, embedded within its Millennium electronic patient record system.
Hospital clinicians can see GP data showing the patient’s problems, diagnoses, recent medications and recent diagnostic tests.
Patients must give explicit consent for staff to view their 'community record', though there is an exception in emergency situations.

IMS Offers M-Heath App Ratings

12/10/2013 02:50 PM
Health tech firm offers prescription infrastructure for healthcare providers, along with consumer health app rankings.
IMS Health, a major healthcare research and technology firm, is offering healthcare providers and payers an "mHealth prescribing solution" that can help create "formularies" for physicians who prescribe mobile-health apps to their patients.
While few doctors are currently doing this, IMS Health is entering a crowded field, which already includes Happtique, HealthTap, Cigna, and Partners Healthcare's Center for Connected Health. But only IMS Health claims to provide a comprehensive ranking of m-health apps, coupled with a full-blown m-health prescribing system.

CMS Releases Security Risk Analysis Tip Sheet

Written by Akanksha Jayanthi (Twitter | Google+)  | December 11, 2013
Hospitals in stage 1 or stage 2 of The Centers for Medicare and Medicaid Services' electronic health record incentive programs can download a free tipsheet to help conduct a security risk analysis to meet the meaningful use requirements and protect the security and privacy of patients' health information.
The tipsheet offers steps for conducting a security risk analysis, tips on how to create an action plan, an outline of security areas to be aware of and myths and facts regarding security risk analysis.

Supervising IT security across a large healthcare network

Author Name Patrick Ouellette   |   Date December 10,
The shift from a training message that is solely tied to HIPAA regulations to a substantial patient care and safety focus is easier said than done. Despite the challenge involved with this type of undertaking, Jim Noga, Vice President and CIO of Partners Healthcare, and CISO Jennings Aske have seen success in concentrating on why they’re securing patient data, as opposed to only a strict regulatory approach.
Noga said that resonates this type of message resonates with staff members because they can identify with moving from a regulatory discussion toward reminding them that the conversation is about providing better patient care and protecting them as members of our staff, not just arbitrary rules meant to complicate clinical processes.
Dr. Gary Gottlieb [President and CEO of Partners HealthCare] talked during Privacy and Security week at Partners about the importance of patient privacy and security and how it needs to become part of our culture. In addition to all the technology, people need to think about it. No matter how you batten down the hatches in healthcare, the unencrypted laptop makes the press. And a lot of that is based on people’s personal behavior.

Medical IT: Physician Practices Now Spend Over $19k Per FTE Physician

Written by Laura Miller | December 11, 2013
The MGMA Cost Survey Report: 2013 Report Based on 2012 Data shows that medical practice expense per full-time equivalent physician for information technology has climbed to $19,439.

PwC survey reveals the top health industry trends of 2014

December 12, 2013 | By Ilene MacDonald
The Affordable Care Act isn't the only major concern facing the healthcare industry in 2014. PwC's Health Research Institute's Top Health Industry Issues for 2014 report reveals the upcoming year will force hospitals and health systems to become more retail-focused as they respond to consumer demand for greater price transparency and cost savings.
"While health insurance exchange implementation is driving headlines today--in reality the next 12 months will be marked by how well the industry addresses a range of core business challenges," said Kelly Barnes, PwC's U.S. health industries leader, in the report announcement. "Businesses must address rapid innovation and competition from non-traditional players, but above all they must respond to empowered consumers as customer-centric transformation sweeps healthcare."

Blue Button gets more powerful

Posted on Dec 11, 2013
By Frank Irving, Editor, Medical Practice Insider
The Office of the National Coordinator for Health IT has big plans for Blue Button, the mechanism that enables consumers to securely download their health information, as part of an overarching effort to enhance patient engagement.
"Providers who engage patients create an environment in which patients feel a partnership," said Ellen Makar, senior program analyst at ONC. "These providers are assisting patients in accessing their own data, and making them feel that they can own their treatment options and share in decision-making."
The EHR meaningful use program is important in this area, Makar explained Tuesday during an ONC-led town hall session at the mHealth Summit in National Harbor, Md. Stage 2 of MU calls for patients to be able to view, download and transmit their information, and Blue Button — while not the only way to give patients those capabilities — is certainly a very recognizable and increasingly popular means to that end.

FDA commissioner: mHealth requires scientific evidence

December 11, 2013 | By Ashley Gold
FDA Commissioner Margaret Hamburg began her keynote on the final day of the mHealth summit in Washington, D.C., by joking about her qualifications to speak: She only got an iPhone two weeks ago, she said. 
"I may be a late adopter, but I recognize that the world is transforming," said Hamburg (pictured right). "Certainly, the FDA has understood the value of scientific computation to support our mission and the advancement of health."
The FDA supports the growing complexity of products that come before them for review, Hamburg said. And as a physician, she "certainly appreciates" the promise of mHealth.

Structured reporting could save lives

3 December 2013   Kim Thomas
Structured reporting in radiology could save lives, a meeting at the Radiological Society of North America annual conference heard on Monday.
The claim was made by Curtis Langlotz, professor of radiology at the University of Pennsylvania, in a debate called ‘Is structured reporting the answer?’
Langlotz argued that the unstructured, free-text reports currently used by radiologists could be ambiguous and unclear. As an analogy, he cited an air traffic accident in Tenerife in 1977, which had been caused by a mismatch in the terminology used by a KLM pilot and the terminology used by the control tower.

Fraud-Wary Feds to Regulate EHR Copy-and-Paste Function

Robert Lowes
December 10, 2013
The Centers for Medicare & Medicaid Services (CMS) is going to regulate the controversial copy-and-paste capability of electronic health record (EHR) systems in its campaign against billing fraud.
CMS made its intentions known in response to a report released online today by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). In a survey of 864 hospitals, OIG found that only one fourth had policies governing the use of EHR copy-and-paste functions. And only 44% had EHR audit logs that record the method of data entry, whether it is copy-and-paste, voice recognition, or keyboarding.
OIG said that the ability to "clone" chart notes from a previous patient encounter to help document the next one can help physicians work more efficiently, but also invite fraud, especially if no one edits the cloned information to make sure it's accurate and up to date. Government officials are worried that many physicians bill for higher levels of evaluation and management (E/M) services than warranted by cloning dense blocks of old patient information. For example, a physician may bring forward a diagnosis from an earlier visit — an infection, for example — that no longer applies.

The spectre of flawed IT ought to scare us all

I am worried that most of my companies are not tech-savvy enough. Despite our bias towards sectors such as hospitality, technology needs to be front and centre in our thinking. From mobile meal ordering to digital menus to social media wizardry, the eating experience is being reinvented by technology. In the years ahead, any business that fails in its IT strategy will surely go broke.
A few years ago I backed an ailing retail chain with the hope of turning it round. After I invested, I discovered the core reason it was in decline: its technology strategy was deeply flawed and it suffered from a huge under-investment in systems. It had not built its own ecommerce platform. It totally lacked any form of digital marketing presence. Its electronic point of sale systems were useless; its stock-keeping and logistics software and hardware were redundant; its management accounting was in disarray. Unsurprisingly my investment was a write-off.

mHealth forecast wows audience

Posted on Dec 10, 2013
By Bernie Monegain, Editor
There it was – the clear-as-a-bell prediction about mobile health. Call it the "wow factor."
"I will predict 85 percent of healthcare will be done in the home in the next five or six years," Andrew Watson, MD, told an audience here at an mHealth Summit breakfast meeting Dec. 9. You could hear the hushed "wow" rippling across the room.
"I don’t know the boundaries of this; I don’t think we’re going to know for four or five years," Watson said.
But, if it turns out that his assertion about the changing venue for healthcare is incorrect, he said: “We’ve got to push harder.”

GP indicators added to NHS Choices

10 December 2013   Rebecca Todd
Forty indicators about GP practice standards and performance have been added to the NHS Choices Accountability Tool.
The indicators are designed to give people a comprehensive view of practice performance across a range of quality and clinical indicators and cover things such as: early diagnosis of cancer; cervical smears; asthma diagnosis; and flu vaccination levels.
Data about GP, hospital and clinical commissioning croup outcomes as well as local authority health information has been brought together in the new easily-navigable tool on the NHS Choices website.

mHealth13: Patient-centered care will drive mobile adoption

December 10, 2013 | By Ashley Gold
Mobile technology may be the future of patient-centric care, but better evidence is needed to take it to the next level, according to a panel of experts speaking Tuesday morning at the mHealth Summit in Washington, D.C., at FierceMobileHealthcare's executive breakfast panel "mHealth's Role in Patient Engagement."
Cleveland Clinic Chief Medical Information Officer David Levin (pictured second from right) said that while he's devoted most of his career in bringing technology to healthcare, it's mainly been a failure and there's much more to do. Technology shouldn't put more space between the provider and the patient, but all too often, he said, it does.
The question Levin said he's been asked repeatedly: "Why is it going be different this time?" His response: It's a perfect storm now, and it's become about value-based, patient-centric care. Results, he stressed, are really going to matter.

Telehealth improves home management of chronic disease

December 10, 2013 | By Julie Bird
A pair of separate studies recently published out of northern Canada and Taiwan indicate that telehealth is an effective tool in self-management of chronic disease, including diabetes.
The study from Taiwan, published in the Journal of Medical Internet Research, focused on diabetes self-management. Results indicated "sophisticated technological design" improved five of seven self-care behaviors, resulting in better blood glucose control and glycemic control. While improved self-care resulted in better outcomes, the "changes in behavior required time to show effects," researchers found.

Diabetes Data Beamed to Your Phone

Walt Mossberg Reviews Two New Meters From iHealth and LifeScan

By  Walter S. Mossberg
Updated Dec. 10, 2013 9:04 p.m. ET
Two companies, iHealth Lab and LifeScan, have brought diabetic glucose monitoring to the smartphone age with bluetooth devices and apps. Walt Mossberg reviewed these and gives his us his take. (Photo: iHealth Labs/LifeScan)
Home medical devices, as opposed to fitness products like activity-measuring wrist bands, have too often been stuck in the past, even as smartphones have zoomed ahead on hardware and software.
Katie Boehret reviews a peer-to-peer backup system called Space Monkey is a less-costly alternative to many hard-drive and cloud solutions. Full review

Sharecare goes mobile with health advice app, AskMD

By: Aditi Pai | Dec 9, 2013
Atlanta-based online health advice website Sharecare has launched a free app, AskMD, that is meant to help users keep track of their symptoms and put them in contact with doctors and hospitals.
Launched by WebMD Founder Jeff Arnold, Sharecare is an online portal that connects healthcare professionals and patients. It offers a question and answer service for patients to connect with experts and health systems, a portal to connect with other patients dealing with health issues and a 16-week program to help users get fit. Sharecare also has a “RealAge Test” for users to find the true age of their body, which the company says has been taken by more than 30 million people since the test was first launched.

Why must our governments be so incompetent at IT?

Ross Clark
If supermarkets and airlines can do it, so should civil servants
The next time I hear a government minister telling us how important it is to improve our computer literacy I am going to scream. Most of us came to terms with the computer age years ago; it is just the government that has been left behind.
Yesterday we learnt of yet another IT fiasco: the Department for Work and Pensions has written off £40 million spent on a non-functioning IT system to administer Universal Credit. The best that Iain Duncan Smith could say was that it wasn’t as bad as Labour’s IT system for the NHS, which has so far cost taxpayers £9.8 billion — for a system dismantled in 2011 after nine years’ of failed development.

Direct Protocol May Favor Large Providers and Vendors

Scott Mace, for HealthLeaders Media , December 10, 2013

A medical group's call for allowing licensed physicians, without vendor interference, to designate any recipients or senders of messages using the Direct protocol puts a spotlight on nagging EHR interoperability issues.

If 2013 has taught us anything, it's that eventually, every area of healthcare IT becomes enmeshed in politics sooner or later.
This week, speculation is bubbling that the low-cost interoperability promised by the Direct protocol is the latest vehicle for the continuation of expensive, business-as-usual interfaces between different healthcare IT vendors' systems.

Gov’t Health IT Report Expected in Early 2014 

By David Pittman, Washington Correspondent, MedPage Today
NATIONAL HARBOR, Md. -- A strategy for promoting innovation in health information technology -- due from three federal agencies -- should come out early next year, a government official said Monday.
The FDA, Office of National Coordinator of Health IT (ONC), and the Federal Communications Commission have been working on a report outlining strategies and recommendations on the issue as mandated by the FDA Safety and Innovation Act, which Congress passed last summer, explained Jodi Daniel, JD, MPH, director of ONC's Office of Policy and Planning. Daniel was speaking at the mHealth Summit here, hosted by the Healthcare Information and Management Systems Society (HIMSS).

Surgeon gives TED talk on using Google Glass in the OR

December 9, 2013 | By Ashley Gold
Google Glass can help surgeons avoid wrong-side surgery, a surgical "never-event," according to Rafael Grossmann, M.D., from Caracas, Venezuela, a general, trauma, advanced laparoscopic and robotic surgeon who practices in Maine, and who recently delivered a TED talk on the use of Google Glass in the operating room. Care coordination software can make HIE more valuable, giving it more currency to help providers track and manage patients as they move through the delivery system, including: dynamic management of care transitions, care planning, referral management, clinical decision support and medication reconciliation. Here’s how:
  1. It applies clinical relevance and workflow context to the information: Care coordination software condenses and reconciles the data from different sources and formats into customized summaries that each provider sets up, presenting the details most relevant to their role as a care manager, primary care physician, specialist and other team members. Behind the scenes, the platform automatically applies logic to the information and feeds it to the relevant applications and users in support of care coordination. For example, a primary care physician is alerted to hospital discharge and can immediately view/update a care plan, manage referrals, reconcile medication list and initiate additional services or communications with other providers. 

Patients want technology to provide personalized care

December 9, 2013 | By Susan D. Hall
People believe technology innovation holds the best promise for curing fatal diseases--more so than increasing the number of doctors or funding for research, according to a new survey from Intel.
The survey of 12,000 people found that most are open to virtual doctor visits and to the use of health sensors in their bodies--sometimes, even their toilets. What they want most of all, it found, is personalized care.
"This survey indicates very high willingness of people to become part of the solution to the world's healthcare problems with the aid of all sorts of technologies," Eric Dishman, Intel fellow and general manager of the company's Health and Life Sciences Group, said in an announcement.

RWJF Releases Tools for Using Data in Local Settings

Written by Ellie Rizzo (Twitter | Google+)  | December 06, 2013
The Robert Wood Johnson Foundation has released resources to help local healthcare practices leverage physician-level data for quality improvement.

Frost & Sullivan names mHealth as top 2013 trend

By: Jonah Comstock | Dec 6, 2013
Research firm Frost & Sullivan listed mHealth among the top three hot topics in healthcare in 2013, garnered from a global survey of 1,835 executives, about 260 of whom worked in the healthcare industry.
Fifty-one percent of respondents nominated mobility in healthcare, or mHealth, as a top trend for the year. The runners up were cloud computing, at 45 percent, and regulatory environments, at 44 percent. They beat out topics like remote monitoring (38 percent), patient engagement (32 percent), and electronic health records (31 percent).
“mHealth expansion has been fueled by the unprecedented spread of mobile technologies, as well as advancements in their innovative application to address health priorities,” the company wrote in a press release. “It is largely supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs) and other wireless devices.”

Public Health Departments Use Social Media for Education and Monitoring

by Lisa Zamosky, iHealthBeat Contributing Reporter Monday, December 9, 2013
Social media platforms have garnered growing interest as a tool for public health communications. Increasingly, Twitter, Facebook and YouTube and other platforms are being incorporated into public health campaigns to increase health awareness, encourage behavior change and inform the public about medical outbreaks and natural disasters.
These platforms have become an integral part of societal communication and their utility is widely recognized. Their use in the realm of health care communication has grown steadily over the past few years, and many organizations are using these tools to both study and make an impact on public health.
"The criticisms about Facebook or Twitter being just a place where people describe the mundane, like, what people ate for breakfast, can be turned into something powerful. For example, if many people in a metro area are using social networks to report symptoms of a rare flu, that's important public health data,"  John Novack -- communications director at Inspire, a company that builds and manages online patient support communities -- said.