This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Saturday, March 05, 2016
Weekly Overseas Health IT Links - 5th March, 2016.
Note: Each link is
followed by a title and few paragraphs. For the full article click on the link
above title of the article. Note also that full access to some links may
require site registration or subscription payment.
Old paper medical
records being trucked to an incinerator blew all over a street in Fort Myers,
Fla., resulting in more than 480,000 individuals being notified that their
protected health information was compromised.
The truck’s driver
failed to secure the container door, and staff and physicians at Radiology
Regional Center spent three days combing the area and retrieving “virtually”
all the records, according to information sent to affected patients.
There is a growing
need to exchange and share imaging studies with outside entities. Hospitals
that have foregone the traditional merger and acquisition route to become
affiliates, for example, have a need to share both individual patient and
population health data, although their modalities for exchange and viewing may
be very different.
transfers—between facilities, specialty and professional consultations, and
even telehealth opportunities—have created a new way of thinking about the
delivery of images between two related, yet independent points of care. CDs,
however, still remain both the most used and one of the largest bottlenecks in
For Ontario Shores
Centre in Whitby, Ontario, the journey to its 2015 Davies Award started with
preparation. A lot of preparation.
Ontario Shores went
shopping for an electronic medical record system in 2007, selected Meditech's
EMR system in 2008, and rolled it out in late 2010. Between the vendor
selection and the go-live date, the institution had to completely rethink its
“We were a purely
paper organization—we didn't have any [electronic] clinical systems for
documentation,” says Sanaz Riahi, the center's director of professional
practice and clinical information. “But we realized we couldn't fit our paper
workflows into this new technology.”
Patient-Centered Outcomes Research Institute announced a plan to make it easy
for individuals to access data in their electronic health records and share it
for research that could improve care for their conditions.
Director Joe Selby, MD, revealed at Thursday’s White House Precision Medicine
Initiative Summit that 20 of PCORI’s Patient-Powered Research Networks have
pledged to help participating patients more readily obtain information from
It took 20 years
for the stethoscope to be widely accepted in clinical practice, but the
industry doesn't have that time to waste before embracing patient-generated
data, Joseph Kvedar, M.D., writes at MedCity News.
Home monitoring and
similar services have shown to be useful in improving outcomes, reducing
mortality and engaging patients in programs to control hypertension and
diabetes. Yet physicians resist efforts to make use of patient-generated data,
and are more willing to base care on information like blood pressure readings
conducted a couple times a year, says Kvedar, vice president of Connected
Health at Boston-based Partners HealthCare.
many of the nation's leading cancer centers, doctors have begun to
sequence the DNA of their patients' tumors to better personalize their
treatments. That information has saved a growing number of lives. It might
tell you, for instance, whether a certain type of chemotherapy may be
extra toxic for a particular individual or if a different drug that
no one ever thought of may be the miracle you were praying for.
The problem is:
This approach doesn’t scale. Today, figuring out
how genetic mutations may impact a patient's response to a
treatment is a time-consuming and manual process. It often involves a team
of a half-dozen or more experts combing through hundreds of journal
articles and consulting with colleagues around the world for a month. Even
then, there's no guarantee that this will lead to useful information for the
National Institutes of Health on Thursday named Verily, formerly Google Life
Sciences, as adviser to Nashville's Vanderbilt University in a pilot program to
launch the Precision Medicine Initiative outlined by President Barack Obama
The pilot program,
which aims to enroll 79,000 U.S. participants by the end of this year, is the
first phase of an ambitious program to mine medical data, including genetics,
environmental factors and lifestyle, to develop better ways to treat or even
prevent a wide range of diseases.
Verily are slated to test approaches for engaging and enrolling volunteers
through a web portal.
A “best practice
advisory” pop-up message in the Epic electronic medical record, combined with
an educational campaign, improved time to antibiotics and other process
measures in sepsis patients.
from electronic medical records systems have obvious promise but can be a
hassle (NEJM JW Emerg Med
Dec 2015 and Ann
Emerg Med 2015; [e-pub]). Investigators compared sepsis process and
outcome measures before (111 patients) and after (103 patients) an emergency
department intervention that involved an educational campaign and a new pop-up
alert in the hospital's Epic electronic medical record system.
Too many healthcare
organizations are focused on securing the wrong assets, leaving them vulnerable
to cyberattacks and putting patients at risk, a new report from Independent
Survey Evaluators claims.
leaders focus primarily on protecting patient data, they often fail to address
actual cybersecurity threats that directly affect patient health, the report
said. So if an active medical device or electronic work order were infiltrated
by cybercriminals, the patient could be directly affected. On the other hand,
an electronic health record is secondary – it requires a provider to alter the
data before it could potentially harm a patient.
Recent studies have
provided conflicting information about whether or not EHRs improve patient
safety. One study, conducted by the Agency for Healthcare Research and Quality
(AHRQ) and published in the Journal of
Patient Safety found that fully electronic health records
(their definition for fully electronic health records is records that include
physician notes, nursing assessments, problem lists, medication lists,
discharge summaries and provider orders are electronically generated) lead to
fewer adverse events such as hospital acquired infections. However, an analysis of a large
malpractice claims and suits database maintained by CRICO, an
evidence-based risk management group of companies owned by the Harvard medical
community, found that there were 248 malpractice cases showing serious
unintended consequences from the use of EHRs.
with the introduction of the Epic electronic patient record at Cambridge
University Hospitals NHS Foundation Trust led to a catastrophic loss of
confidence in the system that took months and a “huge amount of effort to
rebuild”, the president of the Royal College of Surgeons has said.
Clare Marx, who is
also chair of the strategic clinical advisory group to the National Information
Board, was speaking about a visit to Cambridge at a Westminster Forum on
electronic patient records this month.
Cambridge went live
with Epic in October 2014 as part of a £200 million eHospital programme. It is
the first and only trust in the country to have deployed the EPR, which is
widely used in the US.
University Hospitals NHS Foundation Trust went live with its Epic electronic
patient record as part of a £200 million eHospital programme in October 2014.
Sixteen months later, Digital Health News editor Rebecca McBeth gets an inside
perspective on the system, its deployment, and outstanding issues.
words “disaster” “chaos” and “confusion” feature strongly in reactions from
staff to Cambridge University Hospitals NHS Foundation Trust’s implementation
of a new electronic patient record in 2014.
Acute Hospitals Branch joint communications officer Carole Proctor found a
number of staff willing to answer questions from Digital Health News about the
trust’s implementation of Epic 16 months ago.
While most of the
clinical and administrative staff that she spoke to say things are much
improved and benefits are starting to be realised, Proctor herself describes
the period immediately after deployment as “pretty chaotic”.
There's been little
fanfare about this week's survey
results from global physician social network SERMO regarding the
apparently different views American and European doctors have about electronic
health records and patient safety. More than half of the European doctors
polled viewed EHRs as improving patient safety; just 11 percent thought that
EHRs negatively impacted patient safety.
were much more doom and gloom, with only 27 percent believing that EHRs
improved patient safety, and 39 percent saying that they worsened it.
In a post to The CMS Blog Feb. 24,
Slavitt (pictured) touts the effort put forth by CMS and the industry at large
to make the shift, although he stops short of calling it a win.
implementation, we never declare victory, and are still at the ready to
continually improve," Slavitt says. To that end, he says, "Y2K
fears" never materialized, and the transition was one that most outside of
the healthcare industry weren't even aware of.
HHS’s Office of the
National Coordinator for Health Information Technology has launched a new site
to spread the gospel of interoperability and its developing projects.
The ONC, which is
tasked with helping update the nation’s health IT infrastructure network,
debuted its Interoperability
Proving Ground on Feb. 24 as a network to share and
update stakeholders about ongoing interoperability projects.
“At ONC, we are
focused on providing you with the chance to inspire colleagues, share
experiences, and describe lessons learned when it comes to interoperability,”
said Steven Posnack, ONC’s director of the Office of Standards and Technology,
in a post announcing the Interoperability Proving Ground.
Users of Facebook,
LinkedIn and other social media applications are often amazed by how omniscient
the technology seems to be. How do a bunch of algorithms know, out of billions
of users, who you might consider a friend, or which videos you should consider
watching just because you liked “The Dark Knight”?
A big part of the
answer is a core social media technology that holds great promise for transforming
healthcare by making true interoperability at last possible.
It’s called the
graph database. Designed specifically to interpret relationships between
different sets of data, the graph database is the foundational technology that
lets social media applications, as well as companies like Amazon, build
sophisticated social networks around each account owner. For instance, it’s
what enables us to look at our friends’ friends and navigate through their
interests and connections.
The refresh of picture
archiving and communications systems triggered by the end of national contracts
is almost at an end.
Trusts are now turning
their attention to sharing images with different ‘ologies’, with different
trusts and – shortly – other services, such as primary care. Kim Thomas reports
on some of the different approaches that trusts are taking.
The dust has almost settled
on the refresh of picture archiving and communications systems occasioned by
the end of the contracts negotiated under the National Programme for IT.
and awareness are healthcare organizations' greatest defenses against
ransomware, attorney Mary Ellen Callahan advises in an AHA Newsarticle.
The malware in such
an attack usually infects a network through a phishing scam, though unlike
those that hit Magnolia
Health Corp. in California and more recently St. Joseph's
Healthcare System in New Jersey, the hackers aren't interested in identity
theft, but in collecting a ransom.
Presbyterian Medical Center in Los Angeles, whose computer systems were offline
for a week in a ransomware attack, decided
to pay about $17,000 in the cybercurrency Bitcoin to the
hackers. However, law enforcement officials advise against paying ransom.
There's no guarantee you'll get your data back or that hackers, now knowing
you'll pay, won't subject you to ransomware again.
ORLANDO -- Google
Glass didn't exactly take the world by storm, as tech prognosticators told us
it would, but the technology could end up playing an important role in bridging
the information gap between first responders and hospital-based medical
personnel, a well-known critical care specialist said here Sunday.
technology is being used experimentally in several
sites in and outside of the U.S. to facilitate live-streaming of videos from
paramedics caring for patients en route to hospitals to the clinicians who will
treat them once they arrive.
ORLANDO, Florida — Using
telemedicine to provide remote support from critical care specialists to
community hospitals reduces mortality, the number of patients needing to be
transferred to tertiary care hospitals, and costs, new research shows.
"One year after we
started our telecritical care program for community hospitals caring for
acutely ill patients, mortality rates in the intensive care units and in the
hospital were both decreased by almost 40%," said William Beninati, MD,
from Intermountain Healthcare in Salt Lake City.
"There was also a
small decrease in ICU costs," he said here at the Society of Critical Care
Medicine's 45th Critical Care Congress.
organizations need to do a better job encrypting sensitive personal information
such as medical records and Social Security numbers, according
to a report by California Attorney General Kamala
In 2015, the
records of 24 million Californians were breached, up from 4.3 million in 2014.
The cyberattack on health-care insurer Anthem Inc. accounted for 10.4 million
records and another attack on UCLA Health compromised 4.5 million records.
About 55% of
compromised records in the health-care sector are the result of a failure to
encrypt data, as opposed to just 16% of breaches in other sectors, according to
the California Data Breach Report, released February 16.If companies encrypt
information like Social Security numbers and other personally identifiable
information, it’s not considered
a breach under state law. “The industry appears to be improving in
its use of encryption to protect data on laptops and other portable devices,
but there is still a long way to go in addressing this preventable type of
breach,” according to the report.
Last week we all
read another sobering account of the disruption that cyber incidents can cause.
The ransomware attack at Hollywood Presbyterian Medical Center was despicable
in its nature and alarming in it what it says about the overall preparedness of
healthcare to deflect these threats.
Healthcare is one
of our most critical infrastructures and important to every American. The CEO
for this institution eventually opted to pay the ransom to return his
institution's systems back to service. A decision only he and the leadership of
that hospital could make and one I'm sure not easily arrived at.
In most instances
the majority of security and law enforcement professionals would advise against
paying the hackers, because, 1) there is no guarantee you will get the
decryption key, and 2) there is the fear that it will encourage others to
follow suit. I would argue that is easy advice to give if you are not the one
looking down the barrel of the ransom note. Until you have walked in those
shoes you don't really know what you will do.
The technical and regulatory pathway to consumer-mediated sharing is
clear. From here, patients must demand that providers enable them to authorize
who can and cannot access their health information.
February 23, 2016 09:00 AM
This time of year, millions
of Americans file taxes. We are required to move sensitive financial data from
employers and banks to the Internal Revenue Service. In the old days, we waited
for paper W2’s and bank statements to arrive by mail and then spent hours with
pencils and stacks of paper. But now tax preparation software enables automatic
retrieval and upload of data in seconds and without error. Why is this
possible? Because each of us controls our own financial data.
Now imagine that we
want our sensitive health records transferred to a new doctor. We fill out
paper forms, mail or fax them, pay fees, and if we are lucky a stack of printed
paper records arrives by fax or mail at our new doctor’s office weeks or months
later. Weeks after that they might be scanned into an electronic health record
as images but, even then, they can’t be searched easily.
While some people
working in healthcare say electronic health records have slowed digitization in
the industry, two former federal IT officials believe that there are other
factors preventing a digital health revolution.
M.D., former National Coordinator for Health IT, and Aneesh Chopra, former U.S.
chief technology officer, in a Harvard
Business Reviewpost, defend the
estimated $31 billion the federal government has spent on pushing the adoption
of electronic health records.
the challenges facing the digital health revolution are economic and social
issues that must be addressed if the potential value of electronic records is
to be realized," they say.
The Office of the
National Coordinator for Health IT is embarking on a new initiative to help
healthcare organizations "adapt and evolve ONC's standards and technology
The ONC Tech Lab
"will provide internal and external stakeholders with common connection
points to ONC's standards and technology efforts," Steven Posnack,
director of the agency's Office of Standards and Technology, writes for the agency's Health IT Buzz blog.
Royal Philips plans
to introduce medical-grade, wearable biosensors for monitoring at-risk patients
in low-acuity hospital settings.
measures vital signs and transfers data to a clinical decision support software
application that can be set up to automatically notify the caregiver or
Philips says it
expects to unveil a portfolio of solutions that will connect to analysis tools
and dashboards — all with an eye toward improving patient care and lowering
healthcare costs. — Anisa Jibrell
Most CIOs and
health IT leaders see security, business intelligence/big data and mobility as
the top areas impacting their organizations in 2016 and initiatives related to
mobile health and patient engagement are likely driving these IT priorities,
according to a survey conducted by TEKsystems.
IT staffing and
services firm TEKsystems surveyed healthcare IT leaders, including CIOs, IT
vice presidents, IT directors and IT hiring managers, as part of its annual IT
forecast and the survey results indicate that 45 percent of IT leaders expert
their organization’s IT budget to stay the same this year. Only 41 percent of
health IT leaders expect their budgets to increase this year, which represents
the lowest percentage expecting budget increases in the past four years. And 14
percent of respondents expect their budgets to decrease.
Scott Mace, for
HealthLeaders Media , February 23, 2016
associated with a Tom Cruise movie to identify hospital patients is an
actuality at one Louisiana hospital, where it saves time at check-in, reduces
chances for patients to receive the wrong care, and has already paid for
At Terrabonne General Medical
Center, a 325-bed acute care hospital in Houma,
Louisiana, patients check in by having their photo taken by a greeter at the
door to the waiting room.
the scenes scans the unique markings on each patient's irises, matches these
patterns up to previous registration data, or flags the patient as being new.
The whole iris-matching process takes a couple of seconds. Even identical twins
have unique patterns, and the whole thing works with patients as young as nine
2015 was marked by
far too many digital security breaches, a trend that every organization hopes
to see reversed in the coming year. Unfortunately, it is unlikely that we’ll be
able to stop them all. In this digital era, security breaches are part of the
So what should you
do when facing a security breach? The most important thing that you can do is
stay calm. If you keep your wits about you, you will be better able to approach
the problem and implement a solution to protect your organization. Here is how
to move forward in the face of a digital security breach.
Plan ahead. While you may not
be able to plan for the exact details of a security breach – if you could, then
you could prevent it from happening – what you can do is prepare a preliminary
plan of action for any future breach. Write out a general timeline for what
actions need to take place and in what order. This way, when something does
happen, you do not lose any time giving direction. All you need to do is to
fill in the specifics of the event.
A mobile tool that
helps physicians predict the risk of heart disease for their patients is
expanding its abilities and now can interface with electronic health record
Cardiovascular Disease (ASCVD) Risk Estimator, developed by the American
College of Cardiology, uses "multiple algorithms within one analytic"
to determine 10-year and lifetime risks for ASCVD, according to an announcement; the tool is
available on Android and iOS devices, as well as via the Web. Now, through a
partnership with health analytics company Apertiva, the tool can integrate with
a provider's EHR.
industry is moving to free the data and allow physicians and patients to be
able to integrate it with other tools," ACC CIO Dino Damalas recently toldHealth Data Management.
Damalas added in the announcement that the partnership will broaden the
availability of the decision support-tool, which already has been downloaded
more than 250,000 times.
For executives in
charge of mobile device and network security at hospitals and health systems,
many factors must be taken into consideration. Employees increasingly are
bringing in their own mobile devices, tools that can get lost or stolen, and
hackers continue to find new ways to illegally access systems.
especially, worries Tom Barnett, vice president for health information
technology at NorthShore University HealthSystem.
Big data must be
coupled with rigorous observational methods to prevent grave errors in
assumptions, according to an article published at
the American Journal of
Austin B. Frakt,
Ph.D., health economist with the Department of Veterans Affairs, and Steven D.
Pizer, Ph.D., director of healthcare financing and economics at the VA Boston
Healthcare System, note that for every 5 million packages of x-ray contrast
media distributed to healthcare facilities, about six people die from adverse
With big data,
those deaths can be found to be highly correlated with things like electrical
engineering doctorates awarded and per-capita mozzarella cheese
Communications, Inc. will showcase the Vocera
Communication Platform at the 2016 HIMSS Conference and Exhibition in Las
Vegas, Feb. 29 through March 4, 2016.
enterprise-grade solution enables HIPAA-compliant communication via voice and
secure text messaging on a variety of mobile devices. The Vocera Communication
Platform also integrates with more than 70 clinical systems, including
electronic health records, nurse call, and physiologic monitoring systems.
Vocera arrives at
HIMSS16 with strong momentum after recently announcing the selection of its
communication solutions at Franciscan Alliance and Massachusetts General
Hospital. That energy will continue at HIMSS16 with two Vocera customers
sharing their success stories at the health IT event.
American a unique patient identifier could reduce errors in retrieving their
medical records while improving data sharing and security. A national
identifier could also help protect patient privacy, or at least not further
erode it. Those are key conclusions from Identity Crisis, a RAND study I
coauthored several years ago…
The remainder of
this commentary is available at statnews.com.
When I showed up at
the obstetrical urgent care unit at Brigham and Women's Hospital, the care I
received was swift and appropriate. I saw a nurse quickly and a doctor soon
after. They asked relevant questions and immediately put a plan for further
evaluation in place. Only then did the nurse turn to the computer to enter everything
into the electronic record. As she worked her way through the required
documentation, she asked several more questions. Any allergies that weren't
already in the system? Surgeries she should note? And, of course, importantly,
had I been to an Ebola-infected country recently?