Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Tuesday, January 31, 2017

Is There A Lesson In All This For The Health Sector? - I Suspect So!

Few can be unaware of the issues around the use of data-mining to attempt to identify individuals who have been overpaid from Government coffers.
This is a good summary if you have not been paying attention.

How the Centrelink debt debacle failure rate is much worse than we all thought

Peter Martin
Published: January 24, 2017 - 8:20PM
It has become the most widely cited figure in the Centrelink robo-debt debate: that 20 per cent of the debts identified by its data-matching machine are wrong.
But the figure itself is wrong. The true number of mistakes is almost certainly higher, perhaps as high as 90 per cent.
Twenty per cent has become the accepted truth in part because the figure is big - big enough for critics to use to condemn the data-matching program and big enough for Centrelink to use to fob off requests for the truth.
Even Malcolm Turnbull's disenchanted former digital transformation chief Paul Shelter embraced it.
"All I can say is, if they were a commercial company, you would go out of business with a 20 per cent failure rate, a known 20 per cent failure rate, you would go out of business," he told The Guardian this month.
Labor frontbencher Anthony Albanese backed him up, wrongly saying that "on the government's own figures, 20 per cent of people who've been sent debt letters, often accompanied by threats of debt collection agencies being involved, have been sent them on a false basis".
The 20 per cent isn't the proportion of debt letters sent out that are false. We won't know that for a long time, if ever. Some people have been paying up even when the debt letters are wrong, sometimes because they don't have the records to argue otherwise, sometimes because they trust the government, and sometimes because they can't be bothered dealing with Centrelink.
A Centrelink whistleblower alleges that, disgracefully, staff have been ordered not to use information in Centrelink's possession to correct false debt notices. Another says that of hundreds of debt notices reviewed, only a few dozen turned out to be correct.
Here is where the 20 per cent figure comes from. Between July and December, Centrelink's computer sent out 232,000 letters asking people to log on to a website to confirm or update their income history. Around 169,000 did so. (An email to Fairfax Media from the office of Human Services Minister Alan Tudge implies that none of the 63,000 who did not log on have been issued with debt notices. Their cases are "are still active and in progress or require further review".)
More here:
This is also a good recent summary:

Automated Centrelink a fast track to Turnbull's demise

Ross Gittins
Published: January 24, 2017 - 10:58PM
Of the loads of films I saw last year, the most memorable was Ken Loach's I, Daniel Blake. I go to the movies for escapist entertainment, not to give my emotions a good workout but, even so, it left a lasting impression.
It was the story of a 59-year-old carpenter in Newcastle, England, whose cardiologist told him not to go back to work for a few months after he'd had a heart attack on the job.
What we saw was Blake's mistreatment at the job centre he went to for social security payments at the height of the Cameron government's austerity spending cuts.
It was run like an assembly line, with "clients" processed as fast as possible, with a complete lack of flexibility or consideration.
Nothing Blake said was listened to, but at his first sign of frustration he was rebuked for his utterly unacceptable behaviour and threatened with removal by security guards. He was repeatedly threatened with the "sanction" of having his dole suspended for such crimes as being late for his appointment.
He got nowhere when he visited the centre, had to hang on for ages when he phoned, and was always being told to fill out forms online. Small problem: he didn't have a computer and didn't know how to use one.
Sorry, online forms are "mandatory".
Why would a government treat its citizens so badly? Well, reading between the lines you saw the centre had been handed over to a private business. It probably underquoted to get the contract and had turned the centre into a sausage machine in the hope of saving enough on staff to make a profit.
I thought of Daniel Blake when I read of the way the Turnbull government is using an "automated debt recovery program" to harass former users of Centrelink.
It's using a computer program to go back several years, checking Centrelink benefit payments against records from the Tax Office, to look for apparent overpayments and demand the money be repaid.
Trouble is, the exercise is hugely prone to error. Eligibility for social security benefits is assessed on a fortnightly basis, whereas tax information is annual. The machine merely divides the annual figures by 26 and often gets the wrong answer.
Lots more here:
The simple lesson we can all take from this is that the Government is not over endowed in skills in getting such IT programs to work as desired – and certainly does not seem to grasp the needs for rigorous system design and testing.
With the Department of Health busily trying to gather a large national data-base of patient information we have to assume they have in mind some use for the data. Clearly the clinical utility of the information would not make such an exercise worthwhile – so what are they up to?
Maybe they want to manage fraud, maybe regulate access to services or maybe something else?
Informed speculation more than welcome.
David.

Monday, January 30, 2017

Weekly Australian Health IT Links – 30th January, 2017.

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

General Comment

With a week broken up by Australia Day we don’t seem to have had much going on other than yet another amazingly messy Government IT debacle with Ultranet!
At the same time we still have the Centrelink data mining and letter generation system under more than considerable fire.
Enjoy the browse.
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When it comes to privacy, patients trust e-health more than faxes

23 January 2017
ANALYSIS
Stories about digital health data being compromised, hacked or accidentally leaked seemed to be a theme last year. 
In October, more than 500,000 blood donors had sensitive data, including sexual health details, posted online after a mistake at Australian Red Cross. In the same month, the Federal Department of Health released one million lines of MBS claims data online, not realising it could potentially identify individual doctors.
Concerns have also grown in recent months that the government’s prized MyHealth Record system could suffer a breach. 
However, a new US study says despite the fact digital health data breaches are attracting more and more media attention, patients are not spooked by this.
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25 January, 2017

One step forward then two back for digital health?

Posted by Jeremy Knibbs
Spare a thought for Tim Kelsey and his new, and, so far, tightly knit, team at the Australian Digital Health Agency (ADHA).
Faced with an almost impossible task of re-igniting a spark under our digital health agenda, his group had, by year’s end, done an amazing job of re-enlisting large numbers of a mostly disenfranchised and cynical healthcare community into a rebooted crusade for digital change.
Since assuming the top job at the ADHA in mid-August, Kelsey travelled much of Australia, listening to patients, clinicians and regulators at the coalface, and quickly decided on a new team. This team included selected ex NEHTA staff who could provide valuable corporate memory and experience, and had done much of the key initial work required to deliver a cohesive, workable and believable new digital healthcare strategy.
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New ePIP deadline looms for practices

Antony Scholefield | 25 January, 2017 | 
GP practices have until 31 January to meet Federal Government targets for uploading shared health summaries to the MyHealth Record system.
Under the e-health Practice Incentives Program, clinics will have to ask their GPs to upload the summaries for at least 0.5% of the clinic’s patient list or face losing an average of $25,000.
The original deadline for the uploads was 31 July 2016, but it emerged in August that about 1500 practices had not met the target and would have to repay the ePIP cash.
In response, the original deadline was pushed back six months to January.
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Slick, misleading YouTube clips pose health threat

24 January, 2017 Rachel Worsley 
Parents should be advised to avoid YouTube for medical information because it is packed with slickly produced but ultimately misleading video clips, child health researchers warn.
UK paediatricians who reviewed 400 patient-uploaded clips of children with croup or dehydration found just 15 provided good clinical examples.
Worryingly, misleading clips were often more technically accomplished than reputable ones.
Even paediatricians find it laborious to track down good-quality child health videos on YouTube, the authors say, and it is likely even harder for parents to separate the helpful from the harmful.
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Senior citizen walkers drawn to fitness tracking devices

Seniors and baby boomers have joined the younger, healthy set in using fitness tracking devices, according to new research which shows that the older brigade in Australia are emerging as a major market for fitness tracking devices as they take up health technology and devices as rapidly as young people.
The survey of 1000 Australians by data insights and programmatic media company Pureprofile reveals that walkers over the age of 60 make up the largest number of users of fitness devices, such as smartphone apps and wrist bands.
According to Pureprofile, walking is by far the most popular activity, with an average of 53% of survey respondents claiming it is their main fitness activity, followed by gym/workouts (17%), running (9%) and swimming (5%).
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My Health Record

My Health Record is the name of the National digital health record system. Having a My Health Record means your important health information like allergies, medical conditions and treatments, medicine/prescription details, blood test results and scans as well as hospital discharges can be shared.
You control what goes into it, and who is allowed to access it. Your eHealth record allows you and your doctors, hospitals and other healthcare providers to view and share your health information from anywhere they need to, like in an accident or emergency.
After you create your Electronic Health Record ask your GP at Hornsby Fountain Medical Centre to upload your medical file. You can go through with the GP and see/choose what you would like shared or not.
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Advance notice: Plan to call for Expressions of Interest for secure messaging proof of concept projects

Created on Tuesday, 24 January 2017
The Australian Digital Health Agency (Agency) is providing advance notice to jurisdictions, industry and the healthcare sector that it plans to call for Expressions of Interest as part of its secure messaging program.
Proposals will be sought from industry secure messaging suppliers, clinical information system/applications suppliers and end users to collaborate on implementation projects to prove the concept and demonstrate a working model going forward for three key use cases to support the adoption of secure messaging capabilities across the health sector:
  1. General Practice referral to Specialist
  2. Allied Health message to General Practice or Specialist
  3. Hospital Discharge Summary to General Practice and/or other Provider
The EOI will seek consortiums of suppliers and users (possibly organised through a healthcare organisation or group such as a PHN or LHD)  to respond with written fixed-price proposals from supplier/s who can collaborate with other suppliers, and end user sites who demonstrate the ability to implement secure messaging capabilities.
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FHIR Product Roadmap January 2017

R3 plans
The FHIR project is presently finalising “STU3” (Standard for Trial Use, release 3). This 3rd major milestone is currently close to completion. We’ve been meeting in San Antonio this week to finalise ballot reconciliation, perform testing and quality activities, and we are now focusing on preparing the final publication package. Following our publication plan we expect to be publishing release 3 on or about Mar 20.
R4 plans
Once R3 is published, we will start working on release 4. The various committees that manage the different parts of Release 4 have been discussing their scope of work for R4, and planning their engagement and implementation activities to support that this week.
Some of the major things under consideration for Release 4:
  • Improvements across all domains
  • Cds-hooks integrated in FHIR Specification
  • Query language framework
  • Support for integrating research and clinical practice
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Initial foundations for clinical workflow

Posted on by wolandscat
Over the last 6 months or so I have been working on two projects, but one theme: implementing computable clinical workflow. For as long as I can remember, ‘workflow’ and ‘process’ are the main words that excite most clinical professionals in health informatics. They get mildly enthused about data, modelling tools, and applications, but what they really want is for the IT layer to help them work with other clinicians and the patient through time. From my point of view, they’ve always been right, but I’ve also thought we needed to get something working in the data layer to even have a chance at solving process.
Today I think we have enough going in terms of a semantic health data platform in openEHR, and some of the smarter EMR systems, such as at Intermountain, Kaiser etc to consider the next layer. Serendipitously, I’ve recently had the chance to concentrate on the process question.
Making workplace processes computable is a huge challenge, and it would be difficult to over-estimate the effort that has gone into it over some decades. There are dozens of process languages and workflow tools, and endless reams of research to cover. In some industries, notably manufacturing, there have been successes, but creating similar solutions for healthcare seems endlessly elusive. Intuitively, it’s not hard to understand why. Most workflow solutions are based on the idea of modelling deterministic processes that can then be performed by agents, i.e. humans, robots, or other devices. This can work well in e.g. car manufacturing, where there are very few unknowns (the amount of time for specialist human welders to finish a weld will vary somewhat for example).
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IBAC finds disastrous Ultranet project for schools was a 'corrupt' shambles

Henrietta Cook, Benjamin Preiss, Timna Jacks
Published: January 27, 2017 - 5:10PM
Education Department officials wasted up to $240 million of taxpayers' money during a corrupt tender process for a school IT project, Victoria's anti-corruption watchdog has concluded.
The officials could now faces criminal charges over the "appalling waste" following a lengthy investigation by the Independent Broad-Based Anti-Corruption Commission.
The Ultranet project promised to deliver an online platform that connected teachers, parents and students, but was plagued by technical issues and rarely used after its rollout by the former state Labor government in 2010.
In a long-awaited report tabled in state parliament on Friday, IBAC found that department officials purchased shares in CSG – the company awarded the Ultranet project – influenced the tender process and accepted inappropriate gifts from suppliers including flights and lavish dinners.
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Corruption claims over failed $240m Ultranet project

Inquiry finds evidence of process corruption, improper diversion of funds, conflict of interest and mismanagement
George Nott (Computerworld) 27 January, 2017 15:00
The launch was extravagant. Dancers and singers were hired to perform a specially choreographed musical number. A bespoke stage was constructed to look like a giant laptop. Kindles and iPads were given away as spot prizes.
A branded bus ferried then Victorian education minister Browyn Pike and special guests to the ‘Big Day Out’ event at Melbourne Convention and Exhibition Centre. Today, they would launch Ultranet, a virtual learning portal that promised to ‘revolutionise learning’ for every Victorian school pupil.
Poised at their computers in schools across the state, teachers readied themselves to log-on to the system as it went live. It crashed. The million-dollar event was a damp squib. And so was Ultranet.
Three years later, in 2013, plagued by limited functionality and declining student take-up from an already pitiful base of 10 per cent, the Ultranet project was abandoned. Although the exact cost is unknown, estimates go as high as $240 million.
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Director Enterprise Patient Administration System (EPAS) Clinical Delivery

  • Central Adelaide Local Health Network, Royal Adelaide Hospital
  • Temp F/T (up to 1/3/2019) – SAES Level 1
You will be accountable to the Chief Executive Officer, Central Adelaide Local Health Network (CALHN), through the Executive Director new Royal Adelaide Hospital (RAH) Activation, for managing the delivery of the Enterprise Patient Administration System (EPAS) across CALHN to achieve successful and sustainable implementation. Working with the CALHN Executive and EPAS Leadership, you will provide authoritative advice, leadership, oversight and management for the coordination of the operational outcomes for the EPAS Program implementation. This will include planning, leading, coordinating, controlling and managing timely, high quality and cost effective projects and providing expert advice and consultancy services. Overseeing operational changes required across all EPAS-live sites in CALHN, you will deliver recommendations regarding resource allocation and changes to key workflows and business processes. You will also act as the overall site lead during EPAS activation at the new RAH, providing direction, coordination leadership and single point of liaison with the EPAS Team during this period.
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Complex algorithms can use a little of that human touch

  • Anthony Wong
  • The Australian
  • 12:00AM January 24, 2017
Recent publicity over Centrelink’s automated debt recovery program has reignited the debate on how algorithms and data matching are used to inform decisions, in both the public and private sectors, and the need to ensure that human judgment continues to play a role.
The use of complex algorithms to automate processes might reduce costs, but ICT professionals need to ensure that appropriate checks are in place to achieve the desired result. No one would argue the government’s right and indeed responsibility to protect public moneys by ensuring that welfare recipients receive their exact entitlements and no more.
The government has clarified its approach, while making adjustments to soften the impact and ensure that recipients under the debt recovery program understand what steps are available to them and how to exercise their rights.
Labor is pushing ahead with calls for a Senate inquiry and demanding that Centrelink’s data matching system be suspended until a comprehensive review has taken place. The Commonwealth Ombudsman is conducting his own investigation after receiving a series of complaints.
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Centrelink staff speak out against DHS over data matching bungle

By Allie Coyne on Jan 25, 2017 11:11AM

Claim the department ignored warnings.

Unionised Centrelink staff have banded together to speak out against the Department of Human Services' botched data matching system, claiming the agency refused to listen to warnings that it was problematic.
The Community and Public Sector Union - representing "thousands" of unionised departmental staff - today published an open letter to Centrelink customers acknowledging the 'unfairness' of the automated debt notice system.
"We need to tell you that we see your pain and acknowledge your fear. We know you are angry and we are too. We know that the people of Australia deserve better," the open letter states.
"We know that the automated debt notices are unfair, unjust and callous. We acknowledge that in a great many cases, they are not your debts.
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Using genomics to predict heart risk

Authored by Charlotte Mitchell
THE clinical application of genomic risk scores for coronary heart disease (CHD) has been debated by experts, after new research finds that genetic variants can be more predictive of disease than traditional clinical risk scores.
Lead authors of the research from the University of Melbourne, Dr Gad Abraham and Associate Professor Mike Inouye, told MJA InSight that current clinical approaches for detecting increased heart disease risk were “severely” limited because they depended on elevated levels of known risk factors, while ignoring the substantial genetic component of the disease.
“Consequently, a large number of individuals who will experience myocardial infarction cannot be detected ahead of time.
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1stGroup rebrands health portal as MyHealth1st

Australian online heath portal group 1st Group has rebranded its health portal to MyHealth1st from 1stAvailable.
1st Group managing director Klaus Bartosch said the new brand made it clear that the company is a “consumer-centric health portal which brings a more accessible, less intimidating way for people to connect with their preferred healthcare providers”.
He said the new name conveyed that the portal and related apps delivered a “simple connection to better health and wellbeing”.
Bartosch said the portal had transitioned from being a free online appointment booking platform for healthcare appointments to a platform with significantly expanded scope and functionality. “The MyHealth1st portal today enables access to a much broader range of products that leverage the booking platform, supporting an expanded range of healthcare services.”
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Pioneering medical research institute seeking CIO

Garvan Institute of Medical Research looking for experienced IT chief
George Nott (Computerworld) 20 January, 2017 15:46
The Garvan Institute of Medical Research – home of Australia’s first clinical whole-genome sequencing service – is seeking a new CIO.
A major focus of the role will be “bringing business discipline to the way IT is used within the organisation”, a job listing noted.
The successful candidate would be “commercially astute” and have experience in driving transformation change.
The CIO will lead the institute's IT department and report to Chief Operating Officer Philip Knox, formerly CFO of broadcaster Austrar.
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Federal Court erred in Grubb metadata ruling

The Australian judicial system has usually proved itself to be one that applies the common sense principle when confronted by technological cases. But in the case of the recent ruling on what is, and what is not, personal information, the Federal Court has erred and badly too.
Over the years, the court system has handled the Kazaa case, the Sony case, the iiNet case, the Dallas Buyers Club copyright case and more recently the copyright case involving Foxtel and Village Roadshow.
In every case, the judges have shown that despite fears to the contrary, they have a more than adequate understanding of technological detail to make an informed judgment.
Over and above this, they have always shown that they are worldly-wise and aware of the extent to which some entities try to use scare tactics to frighten members of the public.
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Future shocks: beyond drones, driverless cars and 3-D printing

Sophisticated artificial intelligence could ultimately decide it can run things better than humans.
  • The Australian
  • 12:00AM January 28, 2017

Graham Lloyd

It is fitting the future has come first to fashion. Buying shoes will never be the same again. Customers can simply scan their feet with a smartphone and use the digital file to 3-D print a bespoke, perfect pair. It is a future that has already arrived.
Soon, customers will be able to instruct a personal robot to summon a battery-powered driverless transportation pod. This will be when the “internet of things” (when everything is connected) gets really interesting.
Driverless vehicles will all but eliminate car ownership — and accidents. Roads will be freed up, cutting insurance rates to shreds.
Alternatively, a drone can whiz the new shoes to the buyer’s hands using enhanced geo-satellite tracking that has mapped the physical world to the square millimetre.
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Enjoy!
David.

Brief Report On The ADHA Consultation Webinar Conducted 30 January, 2017

The discussion and questions ran for 1.5 hours.

The most interesting thing I gleaned was that the emphasis of the new - approximately 5 year - Strategy would be to get what Tim Kelsey referred to as the 'foundations' in place and that the foundations now included the myHR - along with SMB etc. (So this is really an admission that from 2008 (The old Strategy) to 2016 we were spinning our wheels and now is the time to move boldly forward.)

The process will be that now we have all been consulted  (ends tomorrow) there will be the creation of a Strategy, this will be approved by the COAG health ministers and then will be made public along with a four year work plan and, presumably, some funding.

Interestingly it seems the opt-out evaluations are virtually complete - and have apparently been successful - and that the new Strategy will be focused on the collection of evidence of benefit of all this new investment going forward. Apparently no evidence has been gathered of benefit to date - or at least it was not mentioned that I heard.

I guess we all just wait and see what happens next.

David.



Sunday, January 29, 2017

I Think There Are Some Lessons Here For All Who Want To Be Digital Change Agents.

This appeared over the weekend.
  • Updated Jan 27 2017 at 4:00 PM

Why Malcolm Turnbull's digital transformation guru Paul Shetler had to quit


by Jenny Wiggins
Lunch with Paul Shetler starts with a technological hitch. He doesn't receive the email I sent him changing our date to meet at Café Sydney. So I text to ask if I have the wrong address. He replies straight away. "No that's correct. Not sure why I didn't get it but thanks! Looking forward to it :)"
If anyone knows how to track down a missing email, it should be the self-described "technologist". The American was headhunted from his executive job in London with Britain's Government Digital Service in 2015 by Malcolm Turnbull – then communications minister – to run Australia's new Digital Transformation Office (DTO), which was set up with the laudable goal of making it easier for people to find and use government services online.
But Shetler was sidelined in October 2016 when the DTO was transmogrified into the Digital Transformation Agency (DTA) under Angus Taylor, who became Assistant Minister for Cities and Digital Transformation early last year. Less than two months after being moved out of the chief executive role into the job of chief digital officer, he quit.
We've taken a table on the terrace, preferring to be outside even as Sydney Harbour shimmers in the summer heat, paper fans helpfully placed alongside the cutlery. The waitress suggests "a nice cold beer" to Shetler. "Maybe a glass of red wine," he replies. 
Shelter, who lives near the Harbour in Sydney's Elizabeth Bay, is in no hurry to leave Australia. "It's such a beautiful place, it just seems kind of crazy not to savour it," he tells me, gesturing to our view over Circular Quay, where a cruise ship, the Carnival Legend, nestles in front of the Harbour Bridge. 
Talent shortage: 'it's a vicious circle'
But are there enough opportunities to tempt him to stay? Shetler grew up in Ohio's Cleveland Heights, a quiet university town, but has lived and worked in some of the world's greatest cities, including New York, Rome, London and Amsterdam, and has Russian and Lithuanian ancestry.
Yes, there's "definitely possibilities", although he agrees Australia does have difficulties retaining talent. When Shetler arrived in Sydney in mid-2015, it was hard to find skilled people working in digital product development. "It's sort of a vicious circle – there's not much talent, there's not much demand for it, so people don't go into it and those who do get the jobs get snapped up by a Google or by an Apple and then they go overseas."
For Australia to "thrive and not just survive" in a digital economy, it needs people with the skills to create products it can sell, Shetler explains as the sommelier comes over to discuss pinot noirs, recommending he tries a glass of the Moorooduc Estate from the Mornington Peninsula. A tempranillo rosé sounds more appealing to me as the temperature soars, and I choose La Linea from the Adelaide Hills. 
Vastly more here: 
http://www.afr.com/business/turnbulls-digital-public-service-appointee-paul-shetler-on-what-went-wrong-20170124-gtxhjd

Towards the end of the article he makes some useful points about just how hard change is and that for success the whole system (all of the web-sites, processing and information) need to be fully managed and made coherent.

Additionally his discussion of just how the public service can resist change makes for good reading!

Well worth a careful read.

David.

Alert For ADHA Webcast Tomorrow – Will Be Fascinating I Am Sure!

This is happening tomorrow afternoon.

Q&A Webcast - Australian Digital Health Agency

Created on Monday, 19 December 2016
The Australian Digital Health Agency are hosting a Q & A Webcast on Monday 30 January 2pm – 3:30pm AEDT.
This is an open Q & A webcast for the general public and healthcare professionals to have a voice and shape the future of how data and technology can be used to create happier and healthier lives.
From Monday 30 January 2pm – 3:30pm AEDT, tune in to the open Q & A webcast at the following link:

How to Register

In the link above, make sure you follow the steps below:
  1. Click to 'Register Your Interest' for the Q&A Webcast and fill out your details.
  2. Go to http://livestream.education.gov.au/digitalhealth/30January2017/ to set up your account.
Have your say on shaping the Australian Digital Health Strategy!

Your health. Your say.

Visit conversation.digitalhealth.gov.au to take the survey on the national digital health strategy, and more ways on how you can help shape the future of digital health.
REMINDER: If you have gone directly to the Event page on conversation.digitalhealth.gov.au, please go to http://livestream.education.gov.au/digitalhealth/30January2017/ to set up your account to watch the webcast!
For any further questions, please email us at yoursay@digitalhealth.gov.au or call the Australian Digital Health Agency Help Centre on: 1300 901 001.
Here is the link:
This will be very interesting and the first serious occasion for us to all hear what has been happening with the consultation process and where things are planned to head.
Providing a reminder seems the most useful thing I can do with today’s blog as like many others, I am sure, it had slipped my mind!
David.

AusHealthIT Poll Number 355 – Results – 29th January, 2017.

Here are the results of the poll.

Should The New Health Minister Undertake A Major Review Of E-Health Policy And Direction?

Yes 61% (73)

No 21% (25)

I Have No Idea 18% (21)

Total votes: 119

It seems readers are pretty keen to see the new Federal Health Minister undertake a review at the policy level.

A good turnout of votes.

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

David.

Saturday, January 28, 2017

Weekly Overseas Health IT Links – 28th January, 2017.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Tom Price takes aim at the inefficiencies of meaningful use, questions how to pay for precision medicine

The HHS nominee decries a law that has turned physicians "into data entry clerks." Meanwhile, genomics represents a "brave new world," he said – but "the challenges of how we afford to be able to make that available to our society are real."
January 19, 2017 10:52 AM
Rep. Tom Price, MD, the Georgia Republican tapped by President-elect Donald Trump to be the next U.S. Secretary of Health and Human Services, spent four hours testifying before the Senate Health, Education, Labor and Pension Committee on Jan. 18.
Most of the hearing focused on the expected topics: the future of the Affordable Care Act, the scope of Medicare and Medicaid, Price's questionable investments in medical device and drug companies.
But toward the end of the testimony, Republican Louisiana Senator Bill Cassidy, MD, asked Price to weigh in on health information technology.
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Machine learning could turn a patient's voice into a diagnostic tool

Jan 20, 2017 11:59am
Machine learning could help physicians detect a range of illnesses that can't be diagnosed with more traditional tests, such as post-traumatic stress disorder, according to MIT Technology Review.
It might be easy to diagnose a cold based on a patient’s hoarse voice, but researchers believe subtle vocal changes undetectable to the human ear can identify or predict certain difficult-to-diagnose diseases.
That’s where machine learning could step in, helping physicians detect a range of illnesses that can't be diagnosed with more traditional tests, such as post-traumatic stress disorder, according to MIT Technology Review.
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EHRs can reduce unnecessary care; best approach unclear

Jan 20, 2017 11:20am
The ability for EHRs to collect data and intervene with automated alerts offers tremendous potential.
EHRs can be a critical tool in deterring physicians from ordering unnecessary tests. Unfortunately, researchers say the ideal approach is still unclear.
Movements such as the Choosing Wisely campaign have highlighted the impact of unnecessary testing and procedures, although research shows it has not decreased the number of unnecessary tests ordered by physicians.
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Scientists use heartbeat to access electronic health records

Researchers have developed a new technology that could use a person's heartbeat as a password to access health records.
By Amy Wallace   |   Jan. 18, 2017 at 12:30 PM
Zhanpeng Jin, an assistant professor in the Department of Electrical and Computer Engineering at the Thomas J. Watson School of Engineering and Applied Science at Binghamton University, has developed a method to use a person's heartbeat as a password to access electronic health data. Photo by Binghamton University
Jan. 18 (UPI) -- Researchers at Binghamton University have created a new method to use a person's heartbeat to access their electronic healthcare records in an effort to protect personal information.
"The cost and complexity of traditional encryption solutions prevent them being directly applied to telemedicine or mobile healthcare," Zhanpeng Jin, assistant professor in the Department of Electrical and Computer Engineering at the Thomas J. Watson School of Engineering and Applied Science at Binghamton University, said in a press release. "Those systems are gradually replacing clinic-centered healthcare, and we wanted to find a unique solution to protect sensitive personal health data with something simple, available and cost effective."
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How new security threats will buffet healthcare in 2017

Published January 20 2017, 3:45pm EST
It’s worth remembering that 2016 was dubbed the “year of data security” after 90 percent of healthcare providers suffered data breaches in the previous two years. In particular, the Anthem breach of late 2014 and early 2015 got everyone’s attention for the sheer magnitude of the hack—estimated at nearly 80 million records.
Looking back, we can say 2016 lived up to its name as the number of records accessed was significantly lower than the year prior. But IT security is a game of whack-a-mole, so if fewer patient records were lost, malevolent forces simply found other ways to make the lives of healthcare CIOs very difficult.
Ransomware, for example, became the dominant security issue of 2016 and made everyone aware that hackers can always just hold your files hostage if they can’t steal them.
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UCHealth offers patients enterprise-wide access to physician notes

Published January 19 2017, 7:07am EST
The University of Colorado Health has given patients online access to the clinical notes physicians write at its five hospitals and 350 clinics. However, it hasn’t been an easy path to becoming a transparent healthcare organization, according to C.T. Lin, MD, UCHealth’s chief medical information officer.
UCHealth is part of a growing nationwide movement among providers—called OpenNotes—designed to enhance patient-physician communication by sharing clinicians’ notes with patients and to make their medical records fully transparent. The goal is to bolster overall safety and quality of care by ensuring the accuracy of clinician note-taking, while reducing medical errors and improving medication adherence.
Lin contends that UCHealth is the only provider of OpenNotes in the state of Colorado, and boasts that it is the health system that has adopted the concept more broadly than any other in the country. Last year, he says that the healthcare organization “turned on” OpenNotes for all of UCHealth’s medical and surgical specialties, primary care practices, as well as hospital discharges.
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Obama: Health IT interoperability 'harder than expected'

Jon Hoeksma
17 January 2017
It’s not just NHS IT leaders, even the outgoing President Barack Obama has struggled with the thorny problem of healthcare interoperability.
During an interview on Obamacare with new services Vox earlier this month, the commander-in-chief said achieving progress on healthcare interoperability had been frustratingly slow during his presidency.
Obama said the US$27 billion (£23 billion) his government had spent on Meaningful Use since 2009, a programme designed to accelerate digitalisation of the US healthcare system, has delivered mixed success.
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New national NHS patient "data lake" proposed based on STPs

Ben Heather
18 January 2017
NHS officials have met with IT suppliers, including Google Deepmind, to discuss a national patient data collection service that will make both pseudonymised and identifiable patient data available for research.
A draft summary of the Interoperability and Population Health Summit in December last year, outlined plans to make NHS regional organisations, likely based on the 44 Sustainability and Transformation Plans (STPs), responsible for gathering and controlling patient data. NHS England chief information officer Will Smart convened the event and wrote the summary.
The document said this data will then be fed into a new national “data lake” that will link data sets to one another and make  available either “pseudonymised of identifiable” for research purposes.
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Recent Study Identifies How EHR Use Could Increase Spending

While proponents of EHR use tout its ability to decrease healthcare spending for hospitals and clinicians, a recent study suggests otherwise.

January 18, 2017 - A recent study of physician EHR use found that the technology could be responsible for increasing spending in a hospital setting.
Since EHR technology has the potential to benefit the healthcare system overall, the healthcare industry has steadily sought technological advancement and optimization over the past several years. The Health Information Technology for Economic and Clinical Health Act (HITECH) in 2009 accelerated the effort in the area of EHR implementation by introducing incentive payments as motivation for individual providers and hospital systems to demonstrate meaningful use of EHR systems prior to the advent of the Quality Payment Program. An estimated $30 billion was allotted to this incentive program.
In 2005, RAND predicted EHR implementation would save the healthcare industry $81 billion a year.
However, researchers in 2012 reassessed the financial benefits of EHR implementation and reported instead an adverse effect on healthcare costs totaling $800 billion. This realization does not counteract the projected benefits of EHRs, but it does raise some doubts as to the true cost benefits possible through EHR adoption.
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Phoenix Children’s uses big data to eliminate pediatric medication errors

Jan 18, 2017 12:10am
Phoenix Children's CIO David Higginson explains how the hospital used big data to eliminate dosing errors.
Using data analytics to comb through eight years of patient records, Phoenix Children’s Hospital has eliminated all overdosing medication errors among pediatric patients for the last six years.
By analyzing more than 750,000 patient records and identifying specific dosage thresholds, the hospital developed an automated alert system that informed clinicians when a dose is too high, according to an op-ed by David Higginson, chief information officer at the Phoenix Children’s Hospital in Healthcare IT News, a HIMSS publication.
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Tom Price weighs pros, cons of electronic health records at Senate HELP Committee hearing

Jan 18, 2017 3:55pm
Rep. Tom Price, Trump’s choice for Health and Human Services secretary, went before the Senate Health, Education, Labor and Pensions Committee on Wednesday.  
Debate over the value of electronic health records arose at a meeting between legislators and Donald Trump’s choice for Health and Human Services secretary, Rep. Tom Price. 
 “I’m skeptical about electronic health records and their negative impact on productivity,” said Republican committee member Sen. Bill Cassidy of Louisiana at the Senate Health, Education, Labor and Pensions (HELP) Committee on Wednesday.
Price agreed that electronic health records can hurt productivity.
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How Laboratorians Can Lead With Information Technology to Improve Patient Safety

An Interview with Eugenio Zabaleta, PhD

Author: Jaime Noguez, PhD  // Date: JAN.3.2017  // Source: Clinical Laboratory News
Jaime Noguez, PhD, of the CLN Patient Safety Focus editorial board conducted this interview. 
Physicians have always strived to provide individualized and safe care for their patients. But today’s healthcare environment increasingly makes it difficult for them to do so at the level necessary to prevent errors and adverse events. Clinical laboratories are in a unique position to help reduce this risk and use the power of technology to streamline care, catch and correct errors, enable a more rapid response to adverse events, and assist with clinical decisions. 
However, many laboratorians are not sure where to start. In this interview, Eugenio Zabaleta, PhD, provides practical examples of how labs can use technology to enhance the value of laboratory results and improve patient care. Zabaleta is a clinical chemist at OhioHealth Mansfield and Shelby Hospitals. 
How have you used information technology (IT) to improve patient safety? 
Leadership at OhioHealth Mansfield and Shelby Laboratories understand that our laboratory has to play a more decisive role by providing clinical decision support (CDS) for laboratory orders and results. This not only contributes to patient safety but also makes the lab a critical part of the healthcare team. 
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Digital transformation forces businesses to rethink cybersecurity

Enterprises are increasingly bringing together security professionals with operations teams and developers.

Senior Writer, CIO | Jan 16, 2017 7:22 AM PT
Seeking to maintain competitive advantage, gain market share and satisfy evolving customer demands, businesses around the globe are pursuing digital transformation. And that digital transformation is forcing reevaluation of cybersecurity strategies, according to a new study by BMC and Forbes Insights.
One of the more significant changes, says Brian Downey, senior director of Product Management, Security Operations and Automation at BMC, is that operations are increasingly being held accountable for security — the study found 52 percent or respondents indicated that accountability for security breaches had increased for their operations teams.
"When I look at it, I think that given the amount of risk out there in the world today and the amount of angles they're getting attacked from, businesses are demanding an increasing level of accountability," Downey says. "In my mind, the operations team is the one that has control over shutting and locking the windows. That's their role. More and more customers feel that way."
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How to become a digital champion in the internet of things in healthcare

Guest Contributor
T-Systems
Published: 17 Jan 2017
It is the Internet of Things, but with an enterprise angle. Take that to mean industry vertical applications, development ecosystems, product design, hardware, deployment and more.
Healthcare costs continue to climb around the globe. The advent of the internet of things has the potential to revolutionize the traditional paper-based healthcare treatment through the access of real-time patient data and remote patient monitoring. Connected healthcare, particularly for chronic sufferers, enables improved patient care and encourages patient self-management while at the same time lowering costs.
Consequently, the global IoT market in healthcare was valued at $60.4 billion in 2014, and is estimated to more than double and reach $136.8 billion by 2021.
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Top 10 cybersecurity must-haves for 2017

We talked to four security experts to garner insights on changes that must be made within the healthcare industry to avoid repeating 2016's cybersecurity mishaps.
January 16, 2017 12:07 PM
It's not as easy as just pressing a button. But partnering with other organizations on risk analysis, testing, incident response, and activity monitoring can help better position providers for data security in the year ahead.
The healthcare industry was riddled with cybersecurity issues in 2016 as ransomware, human error, IoT flaws and hacking attempts were some of the biggest problem areas.
The good news is that it appears the industry is taking notice and attempting to secure its vulnerabilities. The bad news? There is still a long way to go to protect valuable patient data and keep it out of cybercriminals' hands.
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In fight against superbugs, old technology is new again

Spectrometry, developed in the 1940s, has been re-engineered and is back in the spotlight with new uses.
January 16, 2017 12:03 PM
Mass spectrometry, which once entailed breaking up samples into tiny particles and then measuring how they formed and moved, was used in the lab to identify different types of carbon. Today, the technology has been re-engineered for diagnosis of patients at risk for severe infections and to fight superbugs.
Spectrometry represents a billion-dollar market, according to a new report from research firm Kalorama Information's, Mass Spectrometry in Clinical Applications.
The technology has been enhanced with lasers, and can be used for protein analysis, using complicated histograms of the intensity of charges and mass ratios to definitively identify a substance.
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Experts face off over the potential impact of ECHO

Jan 17, 2017 12:09pm
ECHO has gained widespread support over the years, but is it living up to its hype?
Is the hype surrounding Project ECHO shrouding the limitations of the program, or are we just beginning to see its true impact? That depends on who you ask.
One of the developers of the Expanding Capacity for Health Outcomes (ECHO) model, designed to virtually connect primary care providers with specialists to improve treatment of complex health conditions, defended the program against criticism that the evidence supporting ECHO’s framework had been outpaced by the early enthusiasm, and that it may not have a substantial impact on specialized care.
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Patients Harbor Little Concern for EHR Security Events

By Sara Heath on January 16, 2017

As EHR use becomes ubiquitous, providers and patients alike grapple with the security risks. However, research shows EHR security events don't deter patients from digitally sharing their health data.

EHRs have become a ubiquitous fixture in doctor’s offices and hospitals nationwide, with adoption levels reaching nearly 90 percent. With that surge comes an increase in EHR security events during which patient data may be put at risk for breach.
In a recent study published in the Journal of Medical Internet Research, a team of investigators sought to determine how this relationship affects patients and their willingness to contribute their data to the digital tools.
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Mercom: healthcare IT funding reached $5B in 2016

January 16, 2017
Last year set some new records for healthcare IT funding, with VC investments reaching over $5 billion and mobile health funding hitting an all-time high, according to a new report from Mercom Capital Group.
In their annual Healthcare IT/Digital Health Funding and M&A Report, the market intelligence firm tracked $5.1 billion in VC funding across 622 deals in 2016, compared with $4.6 billion in funding across 574 deals in 2015.
Since 2010, VC funding towards healthcare IT has risen to $18.5 billion across 2,672 deals, and Mercom identified several notable funding rounds in 2016: China’s Ping An Good Doctor’s $500 million round, Flatiron Health’s $175 million and Jawbone’s $165 million.
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At Boston Children's Hospital, an Interoperability Win is Imminent

Scott Mace, January 17, 2017

The hospital runs Cerner, but its affiliated physicians organization is implementing Epic, so new connections are arriving just in time.

Last month's announcement that Carequality and CommonWell are connecting their networks has apparently caught the imagination of health IT leaders at providers across the country.
Perhaps no organizations stand to benefit more in the immediate term than Boston Children's Hospital and its affiliated Pediatric Physicians Organization at Children's Hospital (PPOC). The hospital is running Cerner's EHR, and PPOC is going live on Epic's EHR at 80 practices representing 400 providers this March.
Moreover, the hospital actually runs Epic as well, to manage its revenue cycle.
Such a mixed bag of EHRs is practically a poster child for the need for CommonWell and Carequality to connect, which will first occur via pilots beginning in the first half of this year.
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Organizational complexity is the greatest threat to cybersecurity

Published January 16 2017, 6:57am EST
Some 83 percent of organizations believe they are most at risk for cyberattack because of organizational complexities, according to a new survey of organizations by the Ponemon Institute.
“Employees are not following corporate security requirements because they are too difficult to be productive, plus policies hinder their ability to work in their preferred manner,” the study noted. “It is no surprise that shadow IT is on the rise because employees want easier ways to get their work done.”
The study, which was sponsored by Citrix, finds that employees are increasingly putting data on their personal devices, meaning key organization information is accessible from any laptop, phone or tablet left sitting at a desk or coffee shop. And data assets are increasing, putting more information at risk, according to 87 percent of survey respondents.
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EHRs help ensure proper patient use of blood thinners

Published January 16 2017, 6:35am EST
Medication adherence is critical for patients, especially when it comes to blood thinners prescribed after they leave the hospital. In particular, electronic health records have demonstrated value in assisting with anticoagulation therapy between outpatient and inpatient settings and across multiple providers.
That’s the finding of a study from the University of Missouri Health Care, which found that using EHRs can improve the care of patients on warfarin, a commonly prescribed blood thinner used to prevent harmful clots, as well as eliminate potential confusion among providers and pharmacists.
Margaret Day, MD, a primary care physician and medical director at MU Health Care’s Family Medicine-Keene Clinic, contends that the use of warfarin can be “potentially very complicated and dangerous,” and that’s borne out by the fact that adverse effects of the drug accounts for 33 percent of annual emergency hospitalizations for patients 65 or older in the United States.
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Healthcare industry looks to future of APIs

Jan 16, 2017 11:40am
Across the healthcare sector, enthusiasm is building for application programming interfaces (APIs) to improve organizational performance and provide a better patient experience. Overwhelmingly, clinical and other leaders see APIs as technology-enablers of process change and evolving care models.
That’s the conclusion of a new report from Chilmark Research, which found that providers expect the digital revolution spawned by APIs in consumer apps and in other industries to spread to the healthcare realm. There’s “broad consensus” that the largest health information technology vendors and their large provider clients must lead the way to develop APIs, according to the report.
Many small healthcare companies have had trouble accessing and using API data from larger, more established electronic health record vendors, as FierceHealthcare has reported. But Chilmark predicts the technology will eventually trickle down. It notes that smaller healthcare organizations are dealing with the “tyranny of the moment,” and are still waiting for proof of the utility and efficacy of an API-based infrastructure.
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Jan 12, 3:02 PM EST

Testing wearable sensors as 'check engine' light for health

By LAURAN NEERGAARD
WASHINGTON (AP) -- A next step for smart watches and fitness trackers? Wearable gadgets gave a Stanford University professor an early warning that he was getting sick before he ever felt any symptoms of Lyme disease.
Geneticist Michael Snyder never had Lyme's characteristic bulls-eye rash. But a smart watch and other sensors charted changes in Snyder's heart rate and oxygen levels during a family vacation. Eventually a fever struck that led to his diagnosis.
Say "wearables," and step-counting fitness trackers spring to mind. It's not clear if they really make a difference in users' health. Now Snyder's team at Stanford is starting to find out, tracking the everyday lives of several dozen volunteers wearing devices that monitor more than mere activity.
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2016 averaged 1 healthcare data breach per day

Written by Erin Dietsche (Twitter | Google+)  | January 12, 2017 | Print | Email
There was an average of one health data breach per day in 2016, according to the Protenus Breach Barometer, which utilizes information from DataBreaches.net.
Protenus recently collaborated with DataBreaches.net to publish the "Breach Barometer Report: Year in Review."
Here are eight additional findings from the analysis.
1. There were 450 total breach incidents in 2016. The analysis is based on 450 incidents either reported to HHS or disclosed to the media throughout the year. Information was available for 380 of the incidents.
2. More than 27 million patient records were breached in 2016. The breaches resulted in 27,314,647 affected patient records.
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When medical records can’t be shared, we all lose

Updated: January 16, 2017 — 11:55 AM EST
Richard Schlisky, MD, Chief Medical Officer of the American Society of Clinical Oncology.
by Richard L. Schilsky, M.D.
You only have to look as far as your smartphone to appreciate how electronic information, and the ability to share it, has improved nearly every aspect of our modern lives. What used to take hours or days can now be done in seconds through a few taps on our phones—from communicating with friends and family to accessing real-time weather forecasts and traffic, to shopping online. Unfortunately, health care has not kept pace with this progress because many electronic health record (EHR) systems cannot “speak” to each other. 
When EHRs can share information – called interoperability – doctors can more effectively diagnose patients and reduce medical errors, doctors and patients communicate more easily and effectively, and care becomes more coordinated and efficient. 
Today, more than 80 percent of all doctors use EHRs, but different healthcare providers and hospitals use different  software platforms that cannot communicate with each other. In fact, not even all EHR systems built on the same platform are interoperable, because these systems are so highly customized.
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Enjoy!
David.