Monday, October 31, 2016

Weekly Australian Health IT Links – 31st October, 2016.

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

General Comment

This week has essentially been ‘stuff-up’ central with all sorts of bad things happening all over!
Additionally we have the pharmacists saying the myHR is hardly up to scratch and hospitals blowing poor patients up with oxygen connected to the wrong tubes….heavens above….
Read and be amazed!
Thank heavens for some apparently good news on secure messaging!
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Why pharmacists are saying no to the e-health system

25 October, 2016 Tessa Hoffman 
The government’s $1 billion e-health record system could be heading for white-elephant status in community pharmacy – with fewer than 5% using it in any given week.
Only about 1250 pharmacies are registered for the system, previously known as PEHCR and now called My Health Record. And only 20% of these view or upload information in any seven-day period, according to the department of health.
It says that once fully rolled out, the system will enable automatic uploading of dispensing information to a patient’s e-record. Pharmacists will be able to view a patient’s medical history – including shared health summaries and hospital discharge documents.
This would improve efficiency and reduce the risk of medicines misadventure, says the health department. But it admits that only 45% of pharmacies have software that’s compatible with the system.
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  • October 28 2016 - 9:30PM

Red Cross data leak: personal data of 550,000 blood donors made public

Tom McIlroy
Fergus Hunter
Rania Spooner
The private lives of half a million Australians – including sexual and medical histories – have been made public in what could be one of the country's largest data breaches.
Australian Red Cross Blood Service staff are contacting more than 550,000 blood donors whose personal information was contained in a file accidentally placed on an unsecured, public-facing part of their website.
The information relates to donors from 2010 to 2016 and includes names, addresses and dates of birth as well as sensitive donation eligibility questions concerning sexual activity, drug use, weight and medical conditions.
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Australia's biggest data breach sees 1.3m records leaked

By Allie Coyne on Oct 28, 2016 12:00PM

Medical data exposed.

More than one million personal and medical records of Australian citizens donating blood to the Red Cross Blood Service have been exposed online in the country’s biggest and most damaging data breach to date.
A 1.74 GB file containing 1.28 million donor records going back to 2010, published to a publicly-facing website, was discovered by an anonymous source and sent to security expert and operator of haveibeenpwned.com Troy Hunt early on Tuesday morning.
The database was uncovered through a scan of IP address ranges configured to search for publicly exposed web servers that returned directory listings containing .sql files.
The contents of the 'mysqldump' database backup contains everything from personal details (name, gender, physical and email address, phone number, date of birth and occasionally blood type and country of birth) to sensitive medical information, like whether someone has engaged in at-risk sexual behaviour in the last year.
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Contractor behind Australia's biggest-ever data breach revealed

By Allie Coyne on Oct 28, 2016 4:25PM

Exclusive: How human error exposed 550,000 donors.

Over four frantic days that must have felt like mere minutes, the Red Cross Blood Service has been battling to deal with a data breach that exposed the sensitive personal and medical records of 550,000 of its donors online.
An anonymous individual stumbled across the 1.74GB file containing 1.28 million records while scanning IP address ranges for publicly exposed web servers containing .sql files.
The Red Cross Blood Service became aware of the blunder on Tuesday morning through a chain of communications that included security researcher Troy Hunt and Australia’s computer emergency response team AusCERT.
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Veteran's Affairs races to stave off IT catastrophe

By Paris Cowan on Oct 25, 2016 10:53AM

Overhaul to cost 'hundreds of millions'.

Department of Veteran’s Affairs boss Simon Lewis says his agency’s pending IT transformation is expected to cost “hundreds of millions” of dollars, as the department races to get its IT shop in order before legacy applications collapse.
DVA is currently working with PriceWaterhouseCoopers on a business case to convince cabinet to fund the overhaul, which it estimates will take around five years.
The $8 million paid to the consultants comes out of $24.8 million DVA got in the last budget to fund a blueprint for its “veteran-centric reform”, to be underpinned by a fundamental modernisation of the department’s IT systems and business processes.
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Are GPs ready to embrace ultrasound technology?

Antony Scholefield | 28 October, 2016 | 
Due to ultrasound's shrinking price and size, the technology is being touted as a good option for general practice. But is real change afoot?
Some machines that go ‘ping' have proven revolutionary in medicine, and perhaps none more so than the ultrasound.
Ultrasound's first use on patients came via 1940s' quackery — ultrasonic energy administered as a therapy for a variety of common ailments, from arthritis, eczema and asthma to haemorrhoids and urinary incontinence.
But scientists in Europe at the time were also recognising its possibilities as a diagnostic tool, with early experiments attempting to locate exudates and abscesses, and even brain tumours although this was less successful.
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Thodey, Bassat back UHG health info bridge technology

  • The Australian
  • 12:00AM October 25, 2016

Damon Kitney

Seek chief executive Andrew Bassat and former Telstra CEO and now CSIRO chairman David Thodey have taken strategic stakes in a Melbourne health technology company allowing corporations, doctors and insurers to share medical records online.
Unified Healthcare Group, whose “medEbridge’’ online platform is used to send requests for medical reports and files from insurers to doctors, is now preparing to launch a multi-million-dollar capital raising to bankroll its growth plans after securing the support of Mr Bassat and Mr Thodey.
In June the company secured the exclusive support from the Royal Australian College of GPs for the exchange of health information from GPs to businesses and government agencies.
“The support of the RACGP, the peak body representing the 30,000-plus GPs, is very important for UHG to achieve its objectives to improve the interactions between businesses and healthcare providers,’’ said UHG chief executive Brandon Carp.
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HFC Catalyst health-tech accelerator programme returns

If you are a health entrepreneur, expert or specialist, the HFC Health-tech programme may help start-ups and others to accelerate their use of technology in the healthcare industry.
HFC’s Catalyst programme has returned for a second year, building on the success of the pilot programme developed with Slingshot last year. iTWire has a report on its launch here and the results here.
HCF Catalyst is now accepting applications from health entrepreneurs, experts, and other specialists to participate in a 12-week structured programme designed to develop compelling business models and secure the traction, viability, and investment needed to succeed.
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Disease threat unchecked as School vaccination register faces a delay

Sue Dunlevy, National Health Reporter, News Corp Australia Network
October 30, 2016 12:00am
VITAL immunisation information that will help prevent killer disease outbreaks may not be available because of a delay in awarding a tender for the new Australian School Vaccination Register.
Two months before it’s due to start the federal government has yet to award a tender for the register that will remind high school students about key school based vaccines and identify areas with low immunisation.
The $26.4 million program was meant to begin on January 1 2017 and is a fundamental part of the government’s No Jab No Play policy introduced in response to News Corp’s campaign to improve immunisation rates.
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SA Health’s EPAS record ‘confusing’, could damage coronial inquests, State Coroner says

Andrew Hough, The Advertiser
October 24, 2016 8:55pm
THE state’s controversial new electronic patient medical system is “confusing” and its complex hard copy records almost indecipherable, the State Coroner has warned.
Mark Johns on Monday raised concerns about the potential negative impacts the Enterprise Patient Administration System could have on important coronial inquests.
The Coroners Court heard that among medical blunders was the contentious EPAS system failing during critical moments.
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Former Socceroo Stephen Herczeg died after oxygen tube connected to catheter caused bladder to burst, coroner hears

A former Socceroo died in an Adelaide hospital last month after his oxygen supply was connected to his catheter causing his bladder to burst and lungs to collapse, a coronial inquest hears.
Stephen Herczeg, 72, was South Australia's first World Cup qualifying Socceroo in 1965, but his death on September 19 this year at the Queen Elizabeth Hospital is now the subject of a coronial inquest.
The inquest, being held before State Coroner Mark Johns, also heard hospital staff could not access Mr Herczeg's resuscitation status because of problems with SA Health's new electronic records system, EPAS.
The court heard Mr Herczeg suffered from a number of health problems, including lung disease, and had a catheter in place due to urinary retention problems.
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No access to records as Socceroo was dying

- on October 28, 2016, 3:12 pm
A former Socceroo who suffered an agonising death in an Adelaide hospital had a "not for resuscitation" status but medical staff had trouble accessing his records and attempted CPR, a nurse says.
Steve Herczeg died in the Queen Elizabeth Hospital on September 19 because his urinary catheter had somehow become attached to an oxygen supply, bursting his bladder and collapsing his lungs.
Enrolled nurse Kayla Woodward has told an inquest that medical staff performed CPR for about 13 minutes before she gained access to the electronic patient records, and efforts to revive Mr Herczeg were stopped.
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How rural health practitioners are using e-health for palliative care

27 October, 2016 Carmel Sparke  
Rural health practitioners are using Skype to care for terminally ill patients who wish to die at home.
The innovative palliative care scheme in Queensland aims to provide rural patients with the same quality of care they would receive in the city, says Olivia Carey, clinical nurse manager of the medical palliative care unit at St Andrews Hospital, Toowoomba.   
Ms Carey set up the program two years ago and presented details on more than 20 case studies at the Rural Doctors Association of Australia annual conference in Canberra last week.  
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Google just made GP-led telehealth a whole lot easier

Antony Scholefield | 25 October, 2016 | 
Some GPs wish there was a magic word that could dispel all the technical issues that are preventing telehealth from taking off. Could that magic word be “gRPC 1.0”?
GP and software developer Dr Joe Logan has helped develop a telehealth system called Air Health — a system that is sold as more secure than Skype.
He says a big positive during its development was when Google released open-source software called gRPC 1.0 so that anybody could work with it.
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Digital Health Agency responds to calls to fix electronic messaging

Created on Wednesday, 26 October 2016
The Australian Digital Health Agency is launching a major program with the medical software industry and healthcare providers to realise the direct benefits for providers and their patients of using secure, electronic messaging for communicating with other health professionals.
"I have been listening to key partners in the community on their aspirations for the Digital Health Agency and ways it can support key health priorities in Australia," CEO Tim Kelsey said.
"I have had hundreds of conversations with patient and public advocates, leaders in public and private health services, the clinical community, industry, peak bodies and innovators. I have met with frontline professionals and service-users who have taken me through ways in which digital technology can support them better.
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28 October, 2016

Secure messaging: the great leap forward?

Posted by Julie Lambert
A team of outsiders, led by Melbourne GP Dr Nathan Pinskier, will oversee the development of secure electronic messaging for the medical profession so that doctors can finally set a bonfire of the faxes.
Australian Digital Health Agency chief Tim Kelsey said interoperable secure messaging was the top digital-health priority to permit healthcare professionals to communicate with each other easily, safely and routinely.
“Many of the problems we have to resolve are not straightforward ones.  I think we all have recognise this is going to be small steps, small steps to build confidence,” Kelsey told the RACGP eHealth Forum last week.
He acknowledged a “history of disappointment” in digital health in Australia, saying he worried that people were fatigued by the overselling of the digital technology in healthcare.
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24 October, 2016

Can one bloke change the fate of Australian health?

Posted by Jeremy Knibbs
With barely two months under his belt, but a tonne of kilometres already clocked up running around the country listening to stakeholders from all walks of the health spectrum, the new head of the Australian Digital Health Agency (ADHA), Tim Kelsey, is charged up and ready to fire the starting gun on what might be a new beginning for Australia’s health future – one with some semblance of sensible and practical digital health strategy development and execution.
If he could wrangle even half of the  herd of cats that has wandered our digital health landscape in the last few years – the federal regulators, software vendors (eg, patient management systems and secure messaging vendors), health service providers (eg, pathology labs), state government health department empires, the politicians, the GP and specialist lobby groups and the media –  it would be a promising start.
Today he announced the appointments of Associate Professor Meredith Makeham as the Chief Medical Advisor to the ADHA and Dr Steve Hambleton, a key player and digital health influencer and a past AMA president, as the “Senior Responsible Owner” for a number of high-priority clinical digital programs for the ADHA.
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Clinical experts join new digital health agency

By Andrew Sadauskas on Oct 24, 2016 6:27PM

Researcher, former AMA president claim posts.

The federal government has recruited two leading medical professionals to senior roles at the Australian Digital Health Agency to help oversee the revised implementation of personal electronic health records in Australia.
Macquarie University associate professor Meredith Makeham has been appointed as ADHA’s chief medical adviser. The new role is responsible for engaging with researchers in the design, build and evaluation of digital health services.
Makeham is a member of the WHO safer primary care working group and a member of the representative expert committee for e-health and practice systems with the Royal Australian College of General Practitioners.
Separately, Steve Hambleton has been named the first in a series of non-executive ‘senior responsible owners’ who will lead clinical priority programs within the agency, with additional SROs expected to be appointed over the coming weeks.
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https://www.digitalhealth.gov.au/news-and-events/news/1173-clinical-leaders-to-join-digital-health-agency

Clinical Leaders to join Digital Health Agency

Created on Monday, 24 October 2016
The Australian Digital Health Agency has today announced the appointments of Associate Professor Meredith
 Makeham and Dr Steve Hambleton.
Leading patient safety advocate Associate Professor Meredith Makeham takes on the role of Chief Medical 
Adviser in which she will lead the development of initiatives to ensure that digital health services are designed
, built and evaluated in partnership with the research community in Australia and internationally.  
 Associate Professor Makeham, a practising GP, will be a member of the Australian Digital Health Agency’s
 executive leadership team and will provide advice in her areas of expertise including patient safety, 
clinical governance, risk management, and digital health and safety research.
“It’s a great honour for me to join the Australian Digital Health Agency.  As a clinician and a researcher,
 I see first-hand the immense value that digital health technologies can offer people and their care 
professionals, and their fundamental importance in our aims to deliver better health outcomes to Australians”, 
she said.
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Real-time prescription monitoring can’t work alone

Authored by Nicole MacKee
A LEADING addiction specialist has warned that introducing the proposed Commonwealth developed and funded Electronic Recording and Reporting of Controlled Drugs (ERRCD) system across Australia, without improving access to addiction services and agreement on the “flags” of misuse, has the potential to do more harm than good.
In September 2016, at a Council of Australian Governments Health Council meeting, Federal Health Minister Sussan Ley urged all state and territory Health Ministers to adopt a national real-time prescription monitoring system that alerts doctors and pharmacists to people who are misusing prescription drugs by doctor or pharmacy shopping.
However, Professor Nick Lintzeris, Clinical Professor, Discipline of Addiction Medicine at the University of Sydney, said that prescription monitoring was an important component in a response to prescription opioid misuse in Australia, but warned: “On its own – don’t do it.”
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EPAS Program Manager

  • Department for Health & Ageing, Adelaide CBD
  • Indicative Total Remuneration: $126,911 – Temp F/T (up to 29/12/2017) – MAS3
You will be directly responsible for managing the delivery of specific projects that relate to critical Enterprise Patient Administration System (EPAS) priorities and goals. You will be required to plan, lead, coordinate, control and manage timely, high quality and cost effective projects and provide expert advice and consultancy services. You will also be required to lead, manage and monitor staff as required such as IT contractors, suppliers and consultants. As the Program Manager, you will provide authoritative advice, leadership, and manage the coordination of the operational outcomes for the EPAS Program, including management of outcomes, milestones and associated documents required to successfully complete this project of work. This position provides the critical conduit to enable and facilitate high level communication channels, collaboration and coordination of functional and operational streams within SA Health, as well as providing the key interface between SA Health and Allscripts.
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HaBIC Seminar Series 2016

A big-bang EMR implementation at RCH

The Health and Biomedical Informatics Centre is pleased to invite you to this seminar on EMR implementation. RCH was the first hospital in Australasia to implement the Epic system and went live with this fully integrated EMR across the entire hospital in April 2016. We will present details of what was delivered and the implementation process.
Program
Prof Mike South - Chief Medical Information Officer, The Royal Children's Hospital Melbourne
Jackie McLeod - EMR Project Director, The Royal Children's Hospital Melbourne
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Magnetic field to help detect deadly disease

  • The Australian
  • 12:00AM October 28, 2016

Paige Taylor

Researchers from Western Australia, Queensland and Brazil have collaborated to invent a simple and cheap prototype that detects the early stages of a globally devastating parasitic disease considered second only to malaria.
The syringe-like device uses a magnetic field to detect tiny amounts of the parasite eggs that cause schistosomiasis in humans.
Schistosomiasis may initially have no symptoms but eventually causes debilitating organ damage and can be deadly if left untreated. It affects 250 million people a year and is most prevalent in poorer and rural parts of Africa, Asia and the Middle East. However, it is curable if detected early.
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  • October 26 2016 - 9:37AM

Census debacle laid bare: Malcolm Turnbull to decide which heads will roll

Peter Martin
Stephanie Peatling
The Prime Minister's special adviser on cyber security has told the Senate the denial of service attacks on the census website were small and predictable and should not have brought it down on census night.
Malcolm Turnbull now has the report Alastair MacGibbon conducted on behalf of the Prime Minister to determine "which heads will roll and when" as a result of the the debacle.

IBM and ABS share census blame

The cyber attacks on census night were minor and should have been easily repelled, says the Prime Minister's cyber security adviser.
"They were indeed small attacks," Mr MacGibbon told a Senate committee on Tuesday. "The attacks were around three gigabits per second. To have some comparison, it's not uncommon now to see attacks of 100 gigabits per second, and some of the attacks against some of the internet infrastructure such as domain name servers are up to 1000 gigabits per second.
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Global IT spending projected to grow 2.9 percent to US3.5 trillion in 2017

October 24, 2016
Gartner forecasts worldwide IT spending to total $3.4 trillion in 2016, a0.3 percent decline from last year. In 2017, global IT spending is projected to grow 2.9 percent and reach $3.5 trillion. Analysts said this growth will be driven by the software and IT services segments. Worldwide spending on software is projected to grow 7.2 percent, and IT services 4.8 percent. Software and IT services will be key to the development of the civilization infrastructure.
Peter Sondergaard, senior vice president and global head of Research, said that this civilization infrastructure will be the most important thing IT accomplishes in the next decade. “Civilization infrastructure will forever change the way people engage socially, digitally, and physically through connected sensors and digital intelligence”, Mr. Sondergaard said.
This civilization infrastructure will be a new digital platform that extends beyond traditional IT infrastructure using new technologies not familiar to the typical IT department. “Your new digital platform will allow you to participate in the evolving world of business, government, and consumer ecosystems because ecosystems are the next evolution for digital. It’s how you compete at scale”, Mr. Sondergaard said.
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Australian IT spending to hit $85b in 2017: Gartner

Growth in the software and IT services market is driving up IT spending in Australia to a forecast total spend of almost $85 billion in 2017 on the back of organisations undertaking major digital platform transformations.
According to Gartner, the forecast figure of $85 billion (A$) represents a 2.8% increase in spending from this year.
Gartner revealed the forecasts for the Australian market at its Symposium/IT Expo on the Gold Coast on Tuesday, while reporting that global IT spending, also driven by growth in software and IT services revenue, is forecast to reach US$3.5 trillion in 2017, up 2.9%  from 2016 estimated spending of $3.4 trillion.
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Enjoy!
David.

Sunday, October 30, 2016

It Seems The Pharmacists Are Not All That Keen On The myHR – What A Surprise!

This appeared a few days ago.

Why pharmacists are saying no to the e-health system

25 October, 2016
The government’s $1 billion e-health record system could be heading for white-elephant status in community pharmacy – with fewer than 5% using it in any given week.
Only about 1250 pharmacies are registered for the system, previously known as PEHCR and now called My Health Record. And only 20% of these view or upload information in any seven-day period, according to the department of health.
It says that once fully rolled out, the system will enable automatic uploading of dispensing information to a patient’s e-record. Pharmacists will be able to view a patient’s medical history – including shared health summaries and hospital discharge documents.
This would improve efficiency and reduce the risk of medicines misadventure, says the health department. But it admits that only 45% of pharmacies have software that’s compatible with the system.
The Pharmacy Guild is not opposed to the system, but its King Review submission suggests that the government pays pharmacies to participate.
Currently only general practice is incentivised to use the system.
Kos Sclavos, the Guild’s Queensland vice president, says: “Doctors are getting paid, and pharmacists are saying why should we do anything? We’re not getting paid.
“There needs to be some consistency across the health professions, if they (the government) see pharmacy playing a role,” says Mr Sclavos, who was part of the original consultation group on the system.
He says participation costs pharmacies time, money and effort, and many resent the expectation they will do it for free.
He says pharmacy banner groups are discouraging members from participation until the issue of payments is sorted out, something which they deny.
Terry White Chemists has a policy of neither encouraging nor discouraging participation.
Spokesman Jeff McEvoy says that without payments it would be “very hard” to promote.
“We fully support the Guild’s stance on funding,” he says.
“No one can expect someone to do more for less.”
Health informatics experts say it would make sense to pay pharmacists to use the system if it was working, but it’s a moot point because it is not.
Dr David Glance, director of University of West Australia’s Centre for Software Practice, says despite hefty investment the system has “failed since its inception” and does not enjoy support from GPs or patients.
More here:
This is all a little confusing I must say. Readers will recall that there are two electronic prescription exchanges (Medisecure and eRX) that have been operational for a few years and which, if used, create a record that goes to the myHR.
There is heaps of information here:
and here:
Under the 5th and 6th Pharmacy Agreements there is funding for scanning printed e-prescriptions that is paid to pharmacists and the ePIP incentives are linked to e-Prescribing as well.
Additionally we have automatic feeds of e-prescription information to the myHR where an e-prescription is used.
So it rather seems we have the situation where heaps of information is flowing into the myHR from the PBS System and the e-Prescribing systems but that it is partial and incomplete, and of little apparent use.
Yet again it seems to e-Health ecosystem, centred around the myHR is not seemingly delivering as it was intended.
I wonder might the ADHA stand back for a moment – and map out the e-Health information flows and work out where value can actually be found – and work those conclusions into the planned new National E-Health Strategy.
There have been all sorts of new actors emerge in the private sector that will eventually need to be recognised and integrated practically and functionally for the benefit of patients and clinicians. One recent announcement is here – and it is just one of many:

Thodey, Bassat back UHG health info bridge technology

  • The Australian
  • 12:00AM October 25, 2016

Damon Kitney

Seek chief executive Andrew Bassat and former Telstra CEO and now CSIRO chairman David Thodey have taken strategic stakes in a Melbourne health technology company allowing corporations, doctors and insurers to share medical records online.
Unified Healthcare Group, whose “medEbridge’’ online platform is used to send requests for medical reports and files from insurers to doctors, is now preparing to launch a multi-million-dollar capital raising to bankroll its growth plans after securing the support of Mr Bassat and Mr Thodey.
In June the company secured the exclusive support from the Royal Australian College of GPs for the exchange of health information from GPs to businesses and government agencies.
“The support of the RACGP, the peak body representing the 30,000-plus GPs, is very important for UHG to achieve its objectives to improve the interactions between businesses and healthcare providers,’’ said UHG chief executive Brandon Carp.
“We are confident with our strategy and vision to be the go-to platform connecting businesses and healthcare providers.
“And to accelerate the growth we will be raising a multi-million-dollar sum to drive increased sales into new business sectors, expand the healthcare provider marketplace and potential ­bolt-on acquisitions.” An information memorandum for the issue will be distributed to potential investors in the coming months.
 “This is a classic two-sided marketplace, the more traction you have with healthcare providers, the more opportunities there are with businesses and vice versa. There is a real network effect that operates here,” Dr Carp said.
More here:
The need for a rational well-thought out and well consulted strategy could not be greater – before we wind up with an ill co-ordinated and overlapping collection of only partially useful systems.
If this is co-ordinating role is not taken seriously and undertaken sensibly and fairly we are at risk of having more failures and bankruptcies than is reasonable.
David.

AusHealthIT Poll Number 342 – Results – 30th October, 2016.

Here are the results of the poll.

Should The Government Be Planning To Outsource The Development And Delivery Of The New Medicare Payments System?

Yes 84% (124)

No 13% (19)

I Have No Idea 3% (5)

Total votes: 148

A large majority seem to think the Government have got is right on this one!

A very large turnout of votes.

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

David.

Saturday, October 29, 2016

Weekly Overseas Health IT Links – 29th October, 2016.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Information security spending to top $101 billion by 2020

Published October 20 2016, 3:34pm EDT
Worldwide spending on security-related hardware, software and services will grow from $73.7 billion in 2016 to $101.6 billion in 2020, according to new research from International Data Corp.
The rise in expenditures to bolster security represents a compound annual growth rate (CAGR) of 8 percent, more than twice the rate of overall IT spending growth, during the five-year forecast period.
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Curtain up on theatre systems

Running a theatre suite more efficiently can deliver big time, cash, and quality benefits to a hospital. That puts the onus on IT, says Jennifer Trueland.
As a cardiac surgeon, Ben Bridgewater felt at first hand the frustrations of problems in the operating theatre. So perhaps that’s why he is now spending his time trying to make sure that the only thing on the surgical team’s mind is doing the job that they’re there to do.
“It’s wrong to look at the theatre in isolation, because the whole system is involved,” he says. “As a consultant, I’d get in at 8am with the aim of seeing the patient and starting at 8.30am.
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October 18, 2016

IBM Watson, Quest Diagnostics Launch Precision Oncology Service

IBM Watson Health and Quest Diagnostics said today they have launched a new service designed to advance precision cancer treatment by combining cognitive computing with genomic tumor sequencing.
The service—called IBM Watson Genomics from Quest Diagnostics®—will consist of laboratory sequencing and analysis of a tumor’s genomic makeup designed to help reveal mutations associated with targeted therapies and clinical trials. Additional genome sequencing capabilities will be provided by The Broad Institute of MIT and Harvard.
“This is a powerful combination that we believe it will leapfrog conventional genomic services as a better approach for identifying targeted oncology treatments,” Jay G. Wohlgemuth, M.D., CMO and svp of research, development, and medical, Quest Diagnostics, said in a statement.
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Another view: of handling letters

GP Neil Paul wants a better way to deal with the many letters that flow into a GP surgery; one that’s future proof for the coming world of federated, hub and spoke working.
As a practice, we hired a pharmacist to deal with a load of medicines issues and take work load off the GPs. We did this five years ago, and it’s worked well.
Recently, there has been a national scheme encouraging practices to do the same by pump-priming the appointment.
Now, 14 local practices have a pharmacist. One GP told me the other day that his practice’s pharmacist had changed his life for the better. I could have said: “Told you so.”
While I’m naturally very pro GP, if I was to criticise my colleagues, then one of their collective faults - driven partly by the partnership model - is that they can fail to invest in innovation; and often rely too much on new pots of money when they do.
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NHS Digital’s plans for a digital NHS

The NHS is taking another run at digital transformation. At a national level, much of the “heavy lifting” is falling to NHS Digital. Ben Heather talks to three of the new organisation’s leaders about what coming for a digital NHS.
Ben Heather
17 October 2016
When Andy Williams moved from the private sector to become chief executive at the Health and Social Care Information Centre in early 2014, past digital failures were still lingering in the air.
“There was a long shadow caused by NPfIT [the National Programme for IT],” he recalls. “I think it had been slowing things down over the past few years. We have taken a long time to get going again.”
The NHS is still paying for NPfIT, a multi-billion-pound nationwide programme to create national infrastructure, develop national programmes such as e-booking, and roll out electronic patient records to trusts. It largely failed in the last, and most high profile respect. 
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KLAS: Only 6 percent of providers hit interoperability 'home runs'

Oct 19, 2016 12:53pm
Most providers can’t obtain patient information from other providers, let alone use it effectively to improve care, according to a report published this month by KLAS Research.
The 2016 interoperability report found that respondents could reasonably access information from exchange partners on a different electronic health record 28 percent of the time, which KLAS referred to as the “first base” of interoperability. Only 13 percent found those exchanged records easy-to-locate (second base). When adding whether the data received and located was integrated into a clinician’s workflow (third base), only 8 percent of providers answered in the affirmative. Only 6 percent found that the patient data exchanged facilitated improvement of patient care (the “home run”).
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New ONC pilots to focus on use of patient-generated health data

Oct 20, 2016 12:49pm
A pair of recently launched pilot programs spearheaded by the Office of the National Coordinator for Health IT and Accenture Federal Services focus on the use of patient-generated health data (PGHD) by providers and researchers.
In one pilot, Northern California-based Sutter Health and Validic will examine how best to move PGHD from disparate devices into electronic health records or clinical dashboards. Sutter patients with Type II diabetes last month began receiving the health system’s Mpower (Motivating Patients Online with Enhanced Resources) app on their smartphones. The app, via Validic’s digital health platform, can connect securely to medical devices that measure blood glucose, blood pressure, activity levels and weight.
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Smartphone sensor spots cancer in several samples simultaneously

October 19th, 2016
Researchers at WSU have developed a portable spectrometer, which works with a smartphone to analyze multiple samples at once for signs of cancer(Credit: Washington State University)
The continuing miniaturization of electronic devices has allowed sensors previously confined to a laboratory to shrink down to a portable size, with previously bulky equipment now able to fit in a briefcase or even a needle. Now a team from Washington State University (WSU) has developed an inexpensive spectrometer that connects to a smartphone and can spot cancer biomarkers in several samples simultaneously, thereby taking lab-like accuracy out into the field.
While existing smartphone biosensors can only deal with one sample at a time, the WSU team's device can scan up to eight at once, measuring the light spectrum to detect traces of specific chemicals in a sample. In this case, the spectrometer is searching for the presence of human interleukin-6 (IL-6), which can act as a red flag for liver, lung, prostate, breast and epithelial cancers.
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Application security remains 'troubling' in healthcare

Oct 20, 2016 6:36am
A lot of software in use, particularly related to the healthcare industry, has not been through a formal security improvement process, according to a new analysis by application security vendor Veracode.
In its report, Veracode compared applications’ compliance with the Open Web Application Security Project (OWASP) and SANS Top 25 standards, which are built around slightly different sets of threats.
Examining compliance pass rates for first-time scans, only government (25 percent) fared worse than the healthcare industry (33 percent). The report notes, however, that every industry sector except financial services improved slightly from last year.
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Biden report identifies data as key to breakthroughs in Cancer Moonshot

Published October 18 2016, 6:48am EDT
An unprecedented volume and diversity of data have the potential to enable the Obama administration’s Cancer Moonshot to meet its goal of achieving a decade’s worth of progress against the disease in just five years. However, if the initiative is to succeed, there are significant barriers that must overcome.
That’s the central message of a new report sent to President Barack Obama by Vice President Joe Biden, who is spearheading the Cancer Moonshot.
In the document, Biden notes the abundance of data “being generated daily through genomics, family history records, lifestyle measurements, and treatment outcomes,” with the opportunity to discover “new patterns of causes, earlier signs of cancer, and successful treatments of cancer.” And, thanks to advances in supercomputing power, he contends that researcher now have the ability to “analyze enormously complex and large amounts of data to find answers we couldn’t just five years ago.”
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How telehealth can enable declines in readmission rates

Published October 20 2016, 4:13pm EDT
High readmission rates are a $17 billion problem across the U.S. for hospital administrators. What’s even more alarming is that a portion of 30-day readmissions are preventable.
According to a recent University of California-San Francisco (UCSF) study published in the New England Journal of Medicine, 27 percent of readmissions could be avoided. This study shows that hospitals must improve communications between patients, physicians, hospitals and primary care providers, while providing better post-discharge resources.
Upon discharge, if a patient is readmitted within 30 days, the Center for Medicare and Medicaid Services (CMS) requires payment from the hospital because of the guidelines of the Affordable Care Act (ACA), which penalizes preventable readmissions. However, the burden of keeping abreast of each patient’s unique recovery isn’t an easy task for both providers and hospitals.
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e-Discharges will soon be made available to GPs

October 20, 2016 by William Bourke
GPs will shortly have access to e-Discharges, through which they will be informed when a patient is out of hospital and also receive the patient’s notes, the Minister for Health has pledged.
Minister Simon Harris has criticised the extent to which paper files are still being used and stored in hospitals. “There are warehouses full of paper files. GPs have proven they can grapple with the eHealth agenda and they are doing it. We now have e-referrals in place where many GPs, at the click of a button, are able to refer a patient onto an outpatient waiting list.
“Previously the referral would have passed through 16 pairs of hands before the referral was made,” said Minister Harris, adding that three would be an individual health identifier and, ultimately, an electronic health record in place by 2020.
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Patient records deleted in ransomware attack

Published October 18 2016, 3:13pm EDT
A ransomware attack in early August has resulted in the loss of patient data at three-site Rainbow Children’s Clinic, which delivers care in the Arlington and Grand Prairie region of Texas.
The attack affected an estimated 33,698 affected individuals who have received care from the provider.
As the attack started encrypting data on servers, the computer system was shut down to prevent further loss of data, according to a notice on the practice’s web site. However, some patient records were “irretrievably deleted,” the notice states.
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EHR systems critical to U.S. response to spread of Zika virus

Published October 18 2016, 6:56am EDT
As the Zika outbreak continues to spread in the continental United States and territories, electronic health records are going to be essential to tracking the virus within patient populations, according to Laurie Garrett, senior fellow for global health at the Council on Foreign Relations.
“One of the huge problems we have with Zika is that we don’t have great diagnostics, and so we have to be able to scour for symptoms,” Garrett told an audience during Monday’s general session at the AHIMA conference in Baltimore. “We need some kind of record keeping that keeps track of mobile populations that move around from place to place.”
That’s where EHRs come into play by helping public health officials and providers identify patients who might be at risk of infection, said Garrett.
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Why the most valuable security assets are human, not technical

Published October 19 2016, 3:39pm EDT
You already know that the biggest threat to healthcare IT security is the human element. But if human beings are the greatest vulnerability, that also makes them the strongest asset. Here’s why.
According to the 2016 HIMSS Cybersecurity Survey, the two primary healthcare IT security concerns among provider organizations (hospitals and physician practices) are phishing attacks (most pressing concern for 77 percent of respondents) and viruses/malware (67 percent). Both events require a responsive actor on the organization side of the transaction for hackers to access patient data.
It may seem like this is a rather straightforward problem to resolve—just make sure clinicians and staff have the requisite knowledge and are savvy enough to not get duped, and all is good. In reality, especially among larger organizations with hundreds of potential points of entry, turning human beings into alert sentries is a constant human behavioral challenge.
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Merck Manuals’ Robert Porter: Mobile tech a ‘must have’ for docs

by Judy Mottl 
Oct 18, 2016 9:08am
A new Merck Manuals survey reveals nearly three-quarters of physicians view themselves as tech-savvy. Two-thirds (66 percent) say they are using a mobile device to access data in the professional setting more than 10 times a day, with 80 percent stating that mobile data plays a role in diagnosis or treatment. Eighty-one percent of respondents say they believe mobile tech has changed the office visit dynamic.
To gain deeper insight on the survey findings, and the impact mobile technology is having on the physician-patient experience, FierceMobileHealthcare reached out to Robert Porter, editor-in-chief of the Merck Manuals. Porter views mobile technology as an enhancement of, but not a replacement for, the patient-doctor relationship.
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Human body, smartphone passcode may forge better mHealth security

by Judy Mottl 
Oct 18, 2016 9:31am
A human body passcode created via wireless data transmission using a smartphone fingerprint reader may provide stronger security for mHealth devices and wearables.
The system could potentially replace today’s password approach that uses data encryption, creating a new physical security layer impenetrable to outside attack, according to new research from the University of Washington’s Networks and Mobile Systems Lab.
The system can send a 256-bit key via the body to a wearable device from a fingerprint sensor in under 15 seconds, according to researchers, and the device can acknowledge key acceptance using Wi-Fi or Bluetooth over the smartphone. That eliminates the need for manually entered passwords.
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Despite healthcare success, IBM's Watson efforts no small expense

Oct 18, 2016 11:19am
While IBM has invested heavily in Watson, and the artificial intelligence technology is paying off in innovations within healthcare and other sectors, it's performing less brilliantly for the company’s bottom line, at least so far.
“IBM has pursued big, bespoke moonshot initiatives that can take years and are extremely expensive,” Gartner research fellow Tom Austin told The New York Times. "It seems like they’re swimming upstream with that."
According to the article, the company believes more lucrative times lie ahead. IBM points to a collaboration announced Oct. 18 with Quest Diagnostics, Memorial Sloan Kettering Cancer Center and the Broad Institute of MIT and Harvard as an example. The parties will combine cognitive computing with genomic tumor sequencing as a cloud service available to doctors and patients across the country.
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Oct 17, 2016 @ 07:30 AM 17,259 views The Little Black Book of Billionaire Secrets

White House To Announce Big Push For Cancer Blood Tests

I cover science and medicine, and believe this is biology's century.
The White House, as part of the Cancer Moonshot effort being run by Vice President Joe Biden, is announcing a major push to develop blood tests that can detect and monitor cancer, that aims to unite makers of diagnostic tests, drugs, and other cancer-related products.
“If you think about somebody who is at risk of cancer, or has been diagnosed with cancer, through the rest of life there is this question: Where is the cancer, what does the cancer look like? And what is going to happen next?” says Peter Kuhn, the Dean’s Professor of Life Sciences at the University of Southern California, which is participating in the effort.
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Six tips to help practices adapt to a new EHR

October 17, 2016
Adopting a new electronic health record (EHR) system doesn’t end with the software implementation. Instead, physicians should be prepared for at least several months of adjusting their day-to-day practices once the software in place.
Although doctors (and their patients) frequently report frustration as everyone adjusts to the new software, physicians can better manage the time immediately following the software upgrade with these key strategies:
Sell the upgrade
It’s important to let people know that there’s an adjustment period, said Scott Jacobs, vice president of community outreach services at The HCI Group, a Jacksonville, Florida, firm providing healthcare IT services. He said physicians should not only tell those in the practice about the upgrade, they should sell their patients and partners on the change, too. “Tell them, ‘We’re increasing our capabilities. Your data is going to be safer now.’ And if you’ve gotten an EHR integrated (with the local hospital), that’s a huge benefit. I’d let them know that you’ll have all their records—everything [that happened at the] hospital you will know about—and vice versa. That’s a big selling point,” he said.
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How HIPAA enables progress in healthcare innovation

Published October 18 2016, 3:54pm EDT
Many in healthcare blame difficulties over creating new solutions or trying to ease workflow burdens on HIPAA. The litany of issues that HIPAA is blamed for include contentions that it prevents the ability to share information with patients or even other providers; it overly restricts how information can be stored or transmitted; and it does not allow any information about an individual to be disclosed under any circumstances without the impacted individual’s consent.
It is unclear whether such excuses are used because of an honest misinterpretation of HIPAA, laziness or some other reason. Regardless of the cause, HIPAA is the easy out utilized because it remains misunderstood.
Despite HIPAA being enacted in 1996 and the primary components of both the privacy and security rules being in place since the early 2000s, a pervasive belief remains that HIPAA does not address and apply to modern technology. An oft-repeated argument is that the law and regulations pre-date modern solutions, such as cloud storage and social media, which prevents innovation in these areas.
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ONC Chief Talks MACRA, Meaningful Use

Scott Mace, October 18, 2016

Under MACRA, improvements to meaningful use will continue, as will opportunities for information exchange, predicts the National Coordinator for Health Information Technology.

October 14—the day the MACRA final rule was released—found Vindell Washington, MD, head of the HHS Office of the National Coordinator, in San Francisco briefing the Association of Health Care Journalists.
In between other national briefings, I had 20 minutes to interview Washington one-on-one about the impact of the final rule and the road ahead for healthcare and healthcare IT. This transcript below has been lightly edited.
HLM: What do you say to hospital executives in particular now? They weren't so much addressed by MACRA, but they still face rule upon rule still with meaningful use. Is this going to continue to work for hospitals?
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Healthcare's worst security weakness?

Hint: It’s not the steady stream of data breaches. But the two are walking the same tightrope.
October 17, 2016 06:29 AM
Healthcare attorney Pam Hepp said that hackers are always one step ahead of healthcare organizations and providers are so dependent on data that it makes protecting information that much harder.
It seems like health data breaches will never stop. In the first half of 2016 alone, the healthcare industry experienced 263 incidents, comprising 27 percent of the total breaches in all industries, according to a report from digital security firm Gemalto.
What’s more, the number of breaches in the third quarter of 2016 outpaces those in the first two, the Protenus Breach Barometer found. And research from Ponemon Institute and Trend Micro rank healthcare as the sector with more breaches than all others.
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CMS launches initiative to reduce physician paperwork

Oct 17, 2016 11:56am
A big complaint among physicians is the amount of time they spend on paperwork.
Responding to that concern, the Centers for Medicare & Medicaid Services has launched an initiative that will allow physicians to spend more time on patient care and less time on paperwork. As a first step, CMS announced a medical review reduction program to ease the reporting burden for physicians.
An 18-month pilot program will relieve doctors who participate in specified advanced alternative payment models (APMs) from additional scrutiny under certain Medicare medical review programs, CMS said. The agency identified APMs for the pilot because participating clinicians share financial risk with the Medicare program.
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Accuracy varies among wrist-worn heart rate monitoring wearables

Oct 17, 2016 10:44am
In a new study comparing the accuracy of four wristband heart rate monitoring wearable devices, the Apple Watch proved more accurate than the Fitbit Charge HR, the Mio Alpha and the Basis Peak, Cleveland Clinic researchers said. 
For the study, published in JAMA Cardiology, the researchers also compared the devices to two traditional chest-band electrode systems. Fifty healthy adults underwent various physical activities while wearing the devices
The wearables all revealed variable accuracy, the authors said, who noted that further research on different types of exercise and other devices is necessary. The Watch hit about 90 percent accuracy while the other wearables were in the low 80s, study author Gorgon Blackburn told Time.
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Health data breaches in Q3 2016 outpace first two quarters

Some 118 security incidents were either reported to the Department of Health and Human Services or first disclosed in the media in Q3 2016, compared with 89 in Q2 and 63 in Q1, a Protenus report finds.
October 14, 2016 07:03 AM
More data breaches happened in the third quarter of 2016 than in the year’s first two quarters.
That’s according to the Protenus Breach Barometer, which found that 118 security incidents either reported to the Department of Health and Human Services or first disclosed in the media or other sources in the third quarter compared with 89 in the second quarter and 63 in the first quarter, according to the Protenus Breach Barometer, a monthly snapshot of reported or disclosed healthcare breaches with data compiled and provided by DataBreaches.net.
For 37 data breaches in September, the number of patients affected was available for 32 and totaled 246,876 records, according to Protenus, a healthcare cybersecurity firm. While the first six months of 2016 averaged 25.3 breaches per month, the second half thus far has had an average of 39.3 incidents per month, a 55 percent increase. September’s largest single incident involved a ransomware hit that affected 58,000 records.
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Wynne vows no sell-off of eHealth records system

Premier Kathleen Wynne says her privatization czar is only looking at ways to improve eHealth Ontario, not sell off the electronic health records system.
By Robert Benzie
Mon., Oct. 17, 2016
Premier Kathleen Wynne says her privatization czar is only looking at ways to improve eHealth Ontario, not sell off the electronic health records system.
“There is no possibility of the sale or the commercial use of people’s health information,” Wynne said Monday, seeking to allay concerns about her business guru’s upcoming appraisal of eHealth.
“Ed Clark did an assessment of the LCBO. There are changes that are being made to the liquor laws in this province. There are changes that have come about as a result of the work that Ed Clark did. But there is no sell-off of that asset,” the premier said.
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E-health programme brings patient records online

‘Nearly 50% of Kingdom’s public, military health facilities now connected to Hakeem’
By Khetam Malkawi - Oct 15,2016 - Last updated at Oct 15,2016
AMMAN — The health records of over 3 million Jordanians are now accessible in any public or military health facility connected to the e-health programme “Hakeem”.
Electronic Health Solutions (EHS), the company which is implementing the programme, said almost 50 per cent of the Kingdom’s public and military health facilities are currently connected to Hakeem.
EHS CEO Feras Kamal said 100 hospitals and primary and comprehensive healthcare centres are currently connected to the system, and that two major hospitals — Al Bashir Hospital and King Hussein Medical Centre — will be automated in the middle of next year.
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Enjoy!
David.