Saturday, June 03, 2017

Weekly Overseas Health IT Links – 3rd June, 2017.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Cedars-Sinai reduces unnecessary care using EHR alerts

Published May 22 2017, 7:12am EDT
Cedars-Sinai Medical Center in Los Angeles has decreased inappropriate or unnecessary care by integrating recommendations from the national Choosing Wisely initiative into its electronic health record system.
Because of the integration, EHR alerts pop up on physicians’ computer screens during patient visits at the 886-bed hospital and multi-specialty academic health science center, advising whether specific care choices are necessary because of patients’ specific medical conditions and medications.
Launched in 2012 by the American Board of Internal Medicine Foundation and Consumer Reports, the Choosing Wisely initiative is based on guidance from dozens of medical specialty societies and has identified nearly 500 common diagnostic tests and procedures that may not have clear benefit for patients and sometimes should be avoided.
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Unreliable wearable data puts physicians in a bind

May 26, 2017 11:56am
Most fitness trackers don't accurately measure calories burned, adding to concerns about the clinical utility of wearables.
A new study shows wearable fitness trackers provide inaccurate measurements, but that’s not stopping patients from asking physicians to integrate that data into their medical care.
Researchers at Stanford reviewed seven wearable fitness trackers, ranging from the Apple Watch to the Fitbit, evaluating each device’s ability to measure heart rate and calories burned. Although most devices were generally more accurate at measuring heart rate, all seven achieved error rates of 20% or more when it came to measuring calories burned, according to the results published in the Journal of Personalized Medicine.
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AHCA uncertainty has some health IT startups drifting away from providers

May 26, 2017 10:57am
Anxiety over the GOP's healthcare bill is prompting some health IT companies to rework their business model. Gage Skidmore / CC BY-SA 2.0
Patients, providers and payers are expected to feel the brunt of the GOP's reform bill. But potential reforms are also generating uncertainty that is trickling down to the health IT industry.
Smaller digital health startups are pivoting toward consumers because the uncertainty surrounding an ACA repeal has left providers hesitant to invest in new technology, according to the Wall Street Journal.
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Sweden struggles to achieve ambitious e-health dreams

The Local Client Studio
26 May 2017
11:23 CEST+02:00
Think a world-class public healthcare system, a stable of leading tech firms, and an impressive track-record of digital innovation make Sweden a shoe-in for the top spot globally in digital healthcare? Think again.
Sweden has long been admired for its comprehensive system of social welfare in which taxpayers fund an impressive range of benefits, with public healthcare provision at its core.
At Sweden is also ranked in several indices rank as one of the world’s most innovative countries, and is home to several successful global firms as well as tech startup scene that’s churning out new firms that have the power to turn traditional industries on their heads.
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Trade groups pan Trump's cuts to health IT

HIMSS, AHIMA, AMIA all say the drastic cuts to ONC and other agencies will hamper patient safety and new cures, send innovation in a downward spiral and slow down work toward a learning health system.
May 23, 2017 03:31 PM
The ONC Town Hall event at HIMSS17 discussed the future health IT policy initiatives. With the release of Trump's new budget, many organizations believe the ONC budget cut will have a negative impact on innovation, among other things.
Healthcare industry associations reacted to the White House’s budget proposal that circulated on Tuesday with strong cautionary tones and a call on Congress to fund the Office of the National Coordinator for Health IT adequately.
“This budget request stops progress in its tracks,” Thomas Payne, MD, board chair of the American Medical Informatics Association, said in a statement.  “The ecosystem that entices young scientists and clinicians to pursue their passion to help patients will be severely damaged, resulting in a downward spiral of innovation, delayed or forgone investment in new treatments, and a stagnant patchwork of IT-enabled patient care.”
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350,000 errors found in child immunisation IT system switchover

Laura Stevens

24 May 2017
Hundreds of thousands of errors have been discovered in a northern trust’s child immunisation IT system, meaning that vaccinations could have been recorded incorrectly.
Pennine Care NHS Foundation Trust have been transferring information from Community Child Health 2000 (CCH2000) to Civica’s Paris system.
During the process 350,000 errors were discovered in CCH2000, a trust spokeswoman confirmed.
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Philips is bringing a “next generation” EPR to Europe

Laura Stevens

18 May 2017
Technology behemoth Philips is launching a”next generation electronic medical record” which combines the clinical and administrative into one system.
Named Tasy, it is a single platform that intends to put the patient at its centre, according to Philips global chief innovation and strategy officer, Jeroen Tas.
Tasy combines patient care, bed management, room scheduling, finance reporting and other medical, organisational and administrational processes.
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Nightmare scenario: Only 5% of hospitals annually test medical device security

Both device manufacturers and providers lack confidence that devices are secure and most won’t get a bigger budget to protect them until a breach strikes, Ponemon Institute says.
May 25, 2017 10:58 AM
Pretty much anyone in the health IT or hacker communities could tell you that medical devices are security sieves and potential nightmares for hospitals. But new research paints an even bleaker picture.
“Only 9 percent of manufacturers and 5 percent of users say they test medical devices at least annually,” according to the report, Medical Device Security: An Industry Under Attack and Unprepared to Defend, conducted by the Ponemon Institute.  
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MGH doctor: To make EHRs less burdensome, focus on value-based payments

May 25, 2017 11:34am
Physicians are in "EHR purgatory," according to a Massachusetts physician. Value-based payments will get them out.
Widespread implementation of EHRs has left the majority of physicians spending more time at a keyboard than with patients. A massive shift toward paying for value over volume could relieve that burden.
Physicians are stuck in “EHR purgatory,” writes Allan H. Goroll, M.D., an internal medicine physician at Massachusetts General Hospital (MGH) in Boston, in a perspective for the New England Journal of Medicine. Although physician practices and hospitals have turned to several short-term solutions—including voice-recognition software and medical scribes—Goroll argues that a significant shift toward value-based payments will force EHRs to evolve to a more patient-centered tool.  
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We're not getting Luke Skywalker's prosthetics any time soon

You've got about as good a chance inventing a lightsaber.

05.23.17 in Medicine
In 1937, robot hobbyist "Bill" Griffith P. Taylor of Toronto invented the world's first industrial robot. It was a crude machine, dubbed the Robot Gargantua (PDF, Pg 172) by its creator. The crane-like device was powered by a single electric motor and controlled via punched paper tape, which threw a series of switches controlling each of the machine's five axes of movement. Still, it could stack wooden blocks in preprogrammed patterns, an accomplishment that Meccano Magazine, an English monthly hobby magazine from the era, hailed as "a Wells-ian vision of 'Things to Come' in which human labor will not be necessary in building up the creations of architects and engineers."
In the 80 years since, Gargantua's progeny have revolutionized how we work. They're now staples in agriculture, automotive, construction, mining, transportation and material-handling. According to the International Federation of Robotics, the United States employs 152 robots for every 10,000 manufacturing employees -- though that lags behind South Korea's 437, Japan's 323 and Germany's 282.
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Report Targets Health IT-Related Patient Safety Problems

A recent Bipartisan Policy Center report outlines ways policymakers, providers, and developers can improve patient safety with health IT.

Source: Thinkstock

Kate Monica

May 24, 2017 - The Bipartisan Policy Center (BPC) yesterday released a report exploring the relationship between patient safety and health IT and ways providers, policymakers and health IT developers can improve it.
The organization outlined the progress made thus far in the healthcare industry to improve health IT-related patient safety, as well as policy recommendations to spur the implementation of a health IT framework centered on patient safety and innovation.
“Numerous studies have shown that health IT reduces medication errors, improves quality outcomes, and reduces the cost of care,” wrote authors. “However, there are instances in which health IT has the potential to create harm if not effectively developed, implemented, or used.”
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HIT Think How big data can improve clinical research initiatives

Published May 25 2017, 4:32pm EDT
We have made enormous strides in the care of patients with disabling and deadly cardiovascular disease, but despite improved therapies and new clinical approaches, it still remains the No. 1 cause of death in the United States.
The collective mission to reduce death and disability from cardiovascular disease (CVD) has advanced over the past few decades, yet much more needs to be done. New approaches are necessary, and improved information is needed to build on current data, and then to enable clinicians to use information technology to anticipate incidents and intervene in real time.
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Not so fast, Congress: VistA is more interoperable than you think

While Congress has long-spurned DoD and Veterans Affairs for failing to become interoperable, the VA isn’t necessarily to blame.
May 22, 2017 03:22 PM
The Department of Veterans Affairs has been under fire for years for its electronic health record VistA and the lack of interoperability with the Department of Defense’s EHR and other systems.
But while VistA may have its flaws, the VA and others insist that interoperability is not one of them.
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Under Trump’s budget, ONC would eliminate health IT adoption programs, shift priorities

May 24, 2017 10:28am
Under Trump's budget, the ONC would do away with several programs died to health IT adoption and shift its focus to policy.
President Donald Trump wants to trim nearly $22 million from the Office of the National Coordinator for Health IT (ONC) next year, a move that would eliminate several programs and significantly realign the agency's priorities in the coming years.
Working with less than two-thirds of the funding that it’s had in years past, the ONC would focus most of its efforts on policy, governance and standards, and do away with programs that focus on health IT adoption, care transformation, usability and privacy and security.
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Using AI for diagnosis raises tricky questions about errors

May 24, 2017 11:54am
Would IBM take the fall for a diagnostic error by Watson?
Artificial intelligence is changing the way physicians treat patients by using massive amounts of data to make faster and more accurate medical diagnoses.
But what happens when the machine is wrong?
That inevitable scenario raises a host of thorny questions, according to an article in Quartz that looks at who might take the blame for a computer’s mistake.
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AMIA sees internet access as a social determinant of health

May 24, 2017 4:29pm
In a letter to the FCC, AMIA said access to broadband should be considered a social determinant of health.
Education, socioeconomic status, housing insecurity and education are among the well-established social determinants of health. One informatics association believes internet access should be included as well.
In a letter (PDF) to the Federal Communications Commission, the American Medical Informatics Association (AMIA) said it “believes that access to broadband is, or soon will become, a social determinant of health,” and urged the federal agency to take steps to improve internet access for certain populations to allow for widespread use of health technology.
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InterSystems, Epic land more global business than any other EHR vendors

KLAS report found InterSystems appealed to many providers for its lower cost structure than Epic.
May 23, 2017 01:32 PM
On the EHR world stage, InterSystems and Epic won more new hospital contracts in 2016 than any of their rivals, according to a new KLAS report: “Global EMR Market Share 2017.”
The two companies broke ahead of both their multiregional and regional competitors.
“In addition to cost, many other factors were important in providers’ decisions,” said KLAS, which added that many EHR vendors recorded strong years.
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HIT Think How healthcare organizations can use data unification to find insights

Published May 22 2017, 4:01pm EDT
Even as organizations increasingly turn to data preparation to feed their analytics tools and create better data-driven intelligence, they are encountering difficult challenges in terms of how many data sources they can handle.
Useful data comes in all forms and from a wide range of sources, and that’s particularly true in healthcare organizations, which gather patient data from a variety of systems. But at the same time, many organizations are experiencing a fundamental limitation with their traditional data preparation tools.
This problem is particularly acute for larger, mature organizations that have been accumulating data in separate systems for a number of years. They may have several ERP and CRM systems, or they may have acquired or merged with other organizations that have collected information in their own data silos for a number of years.
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Trump budget proposal cuts billions and would 'devastate' healthcare programs

May 23, 2017 11:40am
If enacted, President Trump's 2018 proposed budget will slash billions from the National Institutes of Health and the Centers for Disease Control and Prevention. (Gage Skidmore / CC BY-SA 2.0)
Despite criticism over his initial proposal in March that included huge cuts to the Department of Health and Human Services, National Institutes of Health and Centers for Disease Control and Prevention, President Trump’s fleshed-out 2018 budget will slash billions from those health programs in order to spend more on the military and cover planned tax cuts.
The full budget plan is due to be released this morning at 11 a.m., but the White House administration inadvertently posted the section (PDF) that dealt with cuts to the HHS late Monday before it quickly took it offline.
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Putting A Lid On Waste: Needless Medical Tests Not Only Cost $200B — They Can Do Harm

By Chad Terhune May 19, 2017
It’s common knowledge in medicine: Doctors routinely order tests on hospital patients that are unnecessary and wasteful. Sutter Health, a giant hospital chain in Northern California, thought it had found a simple solution.
The Sacramento-based health system deleted the button physicians used to order daily blood tests. “We took it out and couldn’t wait to see the data,” said Ann Marie Giusto, a Sutter Health executive.
Alas, the number of orders hardly changed. That’s because the hospital’s medical-records software “has this cool ability to let you save your favorites,” Giusto said at a recent presentation to other hospital executives and physicians. “It had become a habit.”
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49% of Orgs Report File Sharing Data Breach in Past 2 Years

A recent Ponemon/Metalogix report indicates that healthcare entities should be mindful to avoid a potential file sharing data breach.

Elizabeth Snell

May 22, 2017 - With more healthcare organizations looking to cloud computing and file sharing options, PHI privacy and security cannot be overlooked. Failing to account for how these tools interact with sensitive data or work to keep that data secure could lead to a data breach.
Just under half of surveyed organizations – 49 percent – stated they had at least one confirmed file sharing data breach in the last two years, according to a Ponemon Institute and Metalogix report.
Approximately 1,400 respondents were interviewed for Handle with Care: Protecting Sensitive Data in Microsoft SharePoint, Collaboration Tools, and File Share Applications.
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On seeing the future of health IT for myself

Persistent infrastructure and talent acquisition concerns render the industry not-quite-ready to embrace the next generation of health IT. But we’re getting close.
May 23, 2017 11:22 AM
SAN FRANCISCO — EHRs are everywhere … no, wait, you already know that. What’s more elusive, though, is exactly what the next generation of health IT will look like. But I caught a glimpse last week at the Healthcare IT News Big Data and Healthcare Analytics Forum.
The usual suspects were on hand: population health and precision medicine, predictive and prescriptive analytics, even natural language processing and, not coincidentally, big data itself.
Some new-ish faces showed up as well. Artificial intelligence, cognitive clinical science and machine learning, for instance, and then there was “targeted learning” a fresh idea for many in healthcare brought to the conference by Maya Petersen, MD, an associate professor of biostatistics and epidemiology at the UC Berkeley School of Public Health.
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Trump's budget slashes ONC by more than a third

The President’s proposal instructs the Office of the National Coordinator for Health IT to prioritize interoperability and EHR usability with $22 million less than ONC had in years’ past.
May 23, 2017 10:47 AM
Mick Mulvaney, Office of Management and Budget Director, spoke last week at the White House. On Monday, he briefed reporters off-camera about the FY18 budget.
President Trump’s budget proposal, released Tuesday, allocates $38 million to the Office of the National Coordinator for Health IT for 2018. That’s $22 million, or 37 percent, less than the $60 million ONC had in previous years.  
In other words: ONC is now charged with doing almost everything it already was but with considerably less in the way of financial resources.
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HIT Think How to build portals that entice patients to use them

Published May 23 2017, 4:09pm EDT
There will always be a segment of your patient population that just isn't interested in using a patient portal. But, over time, most people will want to electronically communicate with their healthcare provider—and they will want an engaging and useful online experience.
So what does a patient portal need to succeed?
Over time, a portal should become the foundation for more extensive electronic communications between patient and provider—a tiny seedling that will hopefully blossom into a collaborative relationship. So, what functionalities should patient portal tools have to succeed?
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Lab Results Delivered by Push Alert Speed ER discharge

Alexandra Wilson Pecci, May 23, 2017

Chest pain patients were discharged 26 minutes quicker when doctors final troponin lab results via push notification to their smartphones.

Delivering lab results to ED physicians via their smartphones can help discharge patients from the emergency department faster, data shows.
The study, published online inAnnals of Emergency Medicine, found that chest pain patients in the ED whose attending emergency physicians received lab results delivered directly to their smartphones spent about 26 minutes less waiting to be discharged than patients whose lab results were delivered to the electronic patient record on the hospital computer system.
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Healthcare Among Industries Most Vulnerable to Cyberattack

Alexandra Wilson Pecci, May 23, 2017

Simultaneous attacks on multiple organizations are likely in 2017, according to an AIG report.

"Is cyber risk systemic?"
That's the question that was posed to experts in a new American International Group (AIG) report, and if recent events are any indication, the answer is yes.
The United Kingdom's National Health Service was crippled this month when a global ransomware attack—dubbed "WannaCry"—forced appointments and operations to be cancelled, hospitals to disconnect from email, IT systems to be shut off, and some facilities to turn patients away.
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Favorable CBO score gives boost to Medicare telehealth bill

Published May 19 2017, 7:00am EDT
Legislation designed to give Medicare Advantage plans and accountable care organizations greater flexibility in providing telehealth services to patients with chronic conditions got a major boost this week from the Congressional Budget Office, which gave the Senate bill a favorable score.
Previously, the CBO has expressed concerns that changing Medicare reimbursement policy regarding telemedicine could dramatically increase healthcare spending.
However, on Tuesday the office released a preliminary cost estimate of the CHRONIC Care Act, which includes four provisions expanding telehealth coverage under Medicare: nationwide coverage for telestroke, home remote patient monitoring for dialysis therapy, enhanced telehealth coverage for ACOs, and more flexibility for telehealth coverage under Medicare Advantage plans.
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Patients ready for AI and VR in healthcare; legal and regulatory challenges ahead

Global May 10 2017
Emerging technologies, from artificial intelligence (AI) to virtual reality (VR), are rapidly redrafting the healthcare industry landscape and are thus poised to become a hive of legal activity in the years ahead.
In a recent report published by PwC based on a survey over 11000 people across 12 EMEA countries, a majority of respondents (over 55%) declare to be in favour to receive healthcare from AI technology and robotics in order to answer health questions, perform tests, make a diagnosis or recommend treatment (with respondents from emerging countries showing more preference towards AI than those from well-established countries). Access to quality and affordable healthcare (36%) as well as speed and accuracy in the diagnosis and treatment (33%) constitute primary factors favouring the use of AI in healthcare, while mistrust in AI and robots as healthcare decision-makers (47%) and the lack of “human touch” (41%) constitute primary factors against it (with respondents showing far more willingness to use AI in minor than in major surgical procedures). The report also provides next steps for public and private stakeholders to advance towards this new healthcare reality (setting appropriate regulatory frameworks, understanding how AI and robotics may interact with professionals and patients, etc.).
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Academic medical centers team up with Google to bolster machine learning and predictive analytics

May 22, 2017 10:25am
Three large academic medical centers have announced partnerships with Google to advance machine learning.
Several large academic medical centers are teaming up with one of the country's largest consumer tech companies to provide a boost to healthcare analytics.
The University of Chicago Medicine recently announced a new partnership with Google aimed at using machine learning to predict hospitalizations and identify instances where a patient’s health is declining, according to the Chicago Tribune. Google analysts will use data in the medical center’s EHR system to build on the hospital's internal algorithm called eCART that predicts whether a patient is at risk for cardiac arrest.
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FDA’s Bakul Patel envisions a new regulatory approach to digital health

May 22, 2017 9:59am
A new digital health unit will change the FDA's approach to innovative technology.
As digital health innovation has outpaced the FDA’s regulatory structure, the agency’s top official wants to overhaul the approval process for new technology.
That overhaul comes by way of a new Medical Device User Fee Agreement (MDUFA) that is making its way through Congress despite some recent pushback from Department of Health and Human Services Secretary Tom Price. A portion of the four-year agreement includes the creation of a central digital health unit within the FDA’s Center for Devices and Radiological Health.
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Exclusive Report: What Can U.S. Healthcare IT Leaders Learn, in the Wake of Wanna Cry?

May 17, 2017
by Mark Hagland and Heather Landi
What can U.S. provider leaders learn from the Wanna Cry cyberattack crisis?
What emerged on Friday morning, May 12, European time, and quickly spread across the world as one of the most intensive and extensive ransomware-based attacks to date, affecting organizational operations of all kinds in approximately 150 countries, seemed to have gotten somewhat under control by early this week, even as the attack has jolted the information technology world across the planet.
Variously known as the Wanna Cry or Wanna Decryptor ransomware virus, the phenomenon on Friday virtually shut down several dozen regional health authorities within the National Health Service of the United Kingdom, while simultaneously impacting the operations of such diverse entities as Spain’s national telephone service, La Telefónica; Germany’s railway system, Deutsche Bahn; automotive plants of the French car manufacturer, Renault; the Russian Interior Ministry; and universities in China and Taiwan.
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mHealth Apps Aid Remote Monitoring of Elderly Patients

The use of mHealth apps has strong potential to mitigate health risks of elderly patients through remote monitoring

Thomas Beaton

May 17, 2017 - mHealth apps designed at the University of Alabama Huntsville (UAH) may soon provide remote monitoring solutions that can provide better care choices for treating elderly patients.
Using a smartphone secured to the patient with a chest strap, the software uses CDC standardized tests for mobility and is able to record movement data that is uploaded to an elderly patient’s EHR.
Over time, the data in the EHR would allow physicians to detect patterns in patient mobility at such a detailed level that providers could even predict when patients will fall or when they are likely to experience a stroke.
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HHS updates ransomware guidance for healthcare organizations

Written by Jessica Kim Cohen | May 17, 2017 | Print | Email
HHS on May 15 released a third update for its "International Cyber Threat to Healthcare Organizations" guidance.
The new guidance — which is updated from its second version, which was released May 13 — includes links to additional cybersecurity resources. It also details how IT personnel in healthcare organizations can apply to InfraGard, a nonprofit affiliated with the FBI, to receive healthcare intelligence. InfraGard oversees the Cyber Health Working Group, which enables health IT personnel to collaborate to exchange threat information.
The document also restates its existing guidance on how an organization can request a scan of its public IP address from the National Cybersecurity Assessment & Technical Services, a program of the Department of Homeland Security's U.S. Computer Emergency Readiness Team. The scan assesses an organization's operational and business networks for external vulnerabilities and configuration errors to reduce cybersecurity risk.
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Enjoy!
David.

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