Saturday, July 29, 2017

Weekly Overseas Health IT Links – 29th July, 2017.

Here are a few I came across last week.
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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GOP plans Senate health vote with no clear specifics of bill

Published July 21 2017, 4:20pm EDT
Republican Senator Susan Collins of Maine is ready to start over with the healthcare debate. John McCain is back home indefinitely in Arizona fighting brain cancer.
Republicans can only lose two votes and still pass their embattled health bill, with several other Republicans undecided over whether to proceed. Even so, Majority Leader Mitch McConnell of Kentucky says the Senate will vote early next week on, well, something related to health care.
Collins said Thursday she has “no idea” what that will be.
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Nuance struggling to recover after Petya cyber attack

Published July 20 2017, 3:49pm EDT
Many doctors still can’t use a transcription service made by Nuance Communications three weeks after the company was hit by a powerful, debilitating computer attack. 
Integrated delivery systems, including Beth Israel Deaconess in Boston and the University of Pittsburgh Medical Center said eScription, a Nuance product that enables physicians to dictate notes from a telephone, still isn’t functioning. The outage obliterated doctors’ instructions to patients, forcing some to revert to pen and paper. 
The computer virus, called Petya, has sent ripples throughout the healthcare industry, which is frequently targeted by hackers, said Michael Ebert, a partner with KPMG who advises health and life-science companies on cybersecurity. 


Atul Gawande says AI is 'massively far' from taking over medical diagnosis




Atul Gawande says machines like Watson can't account for the variability in patient symptoms the way a doctor can.
Renowned surgeon Atul Gawande hasn’t quite bought into the hype of artificial intelligence in medicine, in part because diagnosing a human being is highly variable.
Speaking with George Mason University economist Tyler Cowen, Ph.D., Gawande balked at the idea that a patient could obtain an accurate diagnosis simply by relaying their symptoms to a program like IBM’s Watson. Healthcare is “massively far” from that type of scenario, he said on Cowen’s podcast Conversations with Tyler.
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More clinicians are texting, but far fewer hospitals offer a secure messaging app

Although most clinicians still use pagers, text messaging is gaining traction despite security concerns.
As more clinicians gravitate toward text messaging to communicate patient information, hospitals aren’t keeping pace with appropriate security protocols.
Pagers continue to be the most popular form of communication among hospital-based clinicians, but more than half are using standard text messaging for patient care-related communication, according to a survey published in the Journal of Hospital Medicine.
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Web-based ICU communication improves patient, provider satisfaction

Jul 18, 2017 | Cara Livernois
Researchers at Brigham and Women's Hospital (BWH) have developed a web-based program that uses team communication and engagement to improve patient experience and outcomes.
The project, called PROSPECT (Promoting Respect and Ongoing Safety through Patient Engagement Communication and Technology), is outlined in the recent issue of Critical Care Medicine. The platform includes shared checklists, health information and goals for the clinician and patient. The project aims to reduce adverse effects such as falls, ulcers and urinary tract infections as well as improving satisfaction rates and customizing care plans.
"Our goal was to shift our clinical thinking from 'What is the matter?' to discovering 'What matters to you?'" said Patricia Dykes, PhD, RN, a senior nurse scientist in the Center for Patient Safety, Research and Practice at BWH and lead author of the paper. "If we can effectively collaborate with our patients and their care partners and engage them in their care, then we have the potential to enhance the care, improve adherence to care plans, positively impact satisfaction rates and reduce healthcare costs."
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Massive Amazon S3 leaks highlight user blind spots in enterprise race to the cloud

Data leaks at Dow Jones, Verizon, and a GOP analytics firm show that companies are forgoing security best practices in order to quickly make it to the cloud.
By Conner Forrest | July 18, 2017, 11:50 AM PST
A recent data breach at Dow Jones exposed data including names, addresses, and partial credit card numbers from millions of customers, according to a Monday report from UpGuard. The reason for the leak? Dow Jones simply chose the wrong permission settings for the Amazon Web Services (AWS) S3 data repository.
By configuring the settings the way it did, Dow Jones essential gave any AWS users access to the data. While this seems like an oversight that would be easily caught by an admin, common sense mistakes are rampant among large companies racing to get their data to the cloud.
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In 'new chapter,' Google's Glass pivots toward healthcare and other industries

Dignity Health, Sutter Health and others say Glass Enterprise Edition – which now features a detachable module that can work with other eyewear – has helped with efficiency and allowed doctors to focus more on patients.
July 19, 2017 12:48 PM
Google announced a new version of its Glass technology on July 18, refocusing on ways it can be deployed in enterprise settings such as hospitals.
Glass didn't end up being the hot consumer gadget the company hoped for when it was unveiled amid much hype in 2013. But it's been finding a foothold as a workplace tool in the years since – not least in healthcare.
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New review highly critical of NHS Digital’s capabilities

Laura Stevens

19 July 2017
A critical internal review of NHS Digital has found the organisation relies on out of date technology, has skill shortages in multiple areas and its data services are operating below expectations.
The report also says it is unclear what NHS Digital’s core purpose is, stating that expectations are ill-defined expectations and uncertain operational boundaries adversely affect NHS Digital’s delivery performance.
NHS Digital responded to the Capability Review findings in its Fit for 2020 report, published 18 July, but has yet to publish the actual full review report.  The review was carried out by consultants Deloitte and Accenture, both organisations have previously worked closely with NHS Digital and have former staff now working as directors at the organisation.
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Confidence in achieving NHS 2020 digitisation targets falls

Jon Hoeksma

18 July 2017
Digital Health Intelligence’s annual survey of NHS IT leaders has found levels of confidence  on achieving national targets on achieving a paperless health service and delivering integrated digital health and care records by 2020 have dropped over the past 12 months.
Uncertainty and delays over promised future national funding for NHS digitisation were cited as the main reasons.
Cyber security is the area that has risen sharply in the priorities of NHS IT leaders in the last 12-months. In 2016, cyber security was a priority for just 23% of NHS IT leaders. But in the 2017 survey, which was carried out before the 12 May Wannacry incident that hit many NHS organisations, it was identified as a priority by 66%.
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Somerset A&E clinicians benefit from electronic patient record

Somerset clinicians providing frontline emergency care now have instant access to GP medical records of half a million patients in the county.

DHI Admin

18 July 2017
More than 500 urgent and emergency care staff working across A&E and other acute medical units in Somerset are using the EMIS Web EPR Viewer, to view crucial information in patients’ GP medical records.
Musgrove Park Hospital A&E clinician Philip Rowburrey said he finds that access to EMIS EPR Viewer saves a lot of time, particularly out of hours.
“I also check a patient’s recent consultations to try and establish if their presenting complaint is acute or something that has previously been investigated by primary care”, Rowburrey said. “It is becoming a ‘must check’ when we see a patient now and I thoroughly recommend that this continues.”
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Frustrated patients tell GAO why they're not looking at their medical records online

Jul 20, 2017 12:30pm
Plenty of patients can access their medical records online, but bad user experience often means they won't. 
The Government Accountability Office interviewed patients who tried to access their own medical information online. Their chief complaint: Wasted time. 
Patients said it takes too much time to set up portals and figure out how each one works. The need to remember multiple passwords also frustrates patients, the agency said in a blog post.
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ONC Stresses Improved Patient Data Access Measures

A recent ONC report explained that improving patient data access measures will benefit both patients and healthcare providers.

July 19, 2017 - Healthcare organizations need to improve their processes for patient data access measures, as this will reduce consumer burden and also help entities coordinate better care, according to an ONC report.
ONC explained in Improving the Health Records Request Process for Patients that HIPAA regulations allow for patients to request access to their own health data. However, patients and caregivers still face challenges in accessing necessary information.
“In the current records request process, patients and health systems are often at odds, as each struggles through an inefficient system to accomplish needed tasks with limited resources,” report authors wrote. “But ultimately, these two user groups have the same goals — and shared needs. That means that improving the records request process is a win-win.”
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Researchers develop lab-on-a-chip for quick sepsis diagnosis

Published July 20 2017, 7:25am EDT
As hospitals continue to struggle with sepsis, a leading cause of death and costly patient readmissions, a rapid and accurate point-of-care device has the potential to help physicians better diagnose this serious medical condition caused by an overwhelming immune response to infection.
A team of researchers from the University of Illinois and physicians at the Carle Foundation Hospital in Urbana, Ill., have completed a clinical study of the sepsis lab-on-a-chip, which counts white blood cells and levels of a protein marker called CD64, which surge as a patient’s immune response increases.
“By measuring the CD64 and the white cell counts, we were able to correlate the diagnosis and progress of the patient—whether they were improving or not,” says Umer Hassan, a postdoctoral researcher at Illinois and the first author of a study published earlier this month in the journal Nature Communications.
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HIT Think How surveillance tools can support staff in improving care

Published July 20 2017, 3:58pm EDT
With patient care, circumstances can change in an instant. The complexity is compounded for hospital nurses, who typically have several patients to care for at a time—thus, prioritizing care and managing patient populations can become rather difficult.
This is where surveillance comes in. A surveillance tool works in the background of an EHR, and gives clinicians real-time, meaningful information to evaluate and interpret whether a patient experiencing shortness of breath may meet the criteria for sepsis, chronic heart failure, pneumonia or any other condition.
This information is pushed to clinicians as an early warning system, enabling them to quickly identify patients that may be trending toward a bad outcome. Being able to have crucial information sent to staff enables them to save time and intervene earlier in patient care.
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How to stop ransomware: It's really not that complicated

Security basics go a long way to protecting patient data against even scary-looking attacks.
July 18, 2017 02:22 PM
Ransomware. The word itself is scary enough, let alone the glimpse of just how damaging such attacks could be that the world saw in WannaCry and NotPetya during May and June. But cybersecurity experts counter that ransomware shouldn’t actually be so overwhelming to information security professionals -- if they adhere to simple best practices. 
For starters, backup files are crucial and those should be both encrypted and kept offline -- separate from the main network, according to Engin Kirda, professor of electrical and computer engineering and computer and information science at Northeastern University.
Lee Kim, HIMSS’ director of privacy and security said the real problem is that hospitals are often stuck running outdated, legacy systems. And even keeping pace with software patches is not always completely effective. Both NotPetya and WannaCry, for instance, leveraged vulnerabilities in these legacy systems.
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Petya attacks now appear to be causing permanent damage

After a hospital had to replace infected IT systems, now FedEx is the second organization to admit the drastic impact of the wiper malware.
July 18, 2017 12:18 PM
When the Petya attack struck Princeton Community Medical Hospital in West Virginia, the system had to replace infected computers. A community hospital is one thing, but then FedEx on Monday admitted that some of the damage Petya wreaked on its networks may be permanent. 
FedEx’s Ukrainian division was hit by the initial attack on June 28, which spread to more of the company’s systems. Officials said the majority of the affected computers were on the TNT Express network, an international transportation, delivery and freight transportation company owned by FedEx.
FedEx officials told the U.S. Securities and Exchange commission in its annual 10-L filing that no data was stolen from the company’s network, but operations and communications were significantly affected.
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4 reasons patients value access to visit notes in the EHR

Jul 19, 2017 10:43am
A new study looks at what patients like about having access to visit notes in the EHR.
There are four primary reasons patients like having access to the notes doctors and other clinicians write after a visit and include in their electronic health record, according to a new study.
With an increasing number of healthcare organizations offering patients access to their EHRs, including visit notes, via patient portals, researchers at OpenNotes and Beth Israel Deaconess Medical Center in Boston wanted to know what patients value about the process. They reported their findings in a study in the Journal of Medical Internet Research.
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791 data breaches so far in 2017: 6 things to know

Written by Julie Spitzer | July 18, 2017 | Print |
There have been 791 data breaches tracked in the first half of the year, a record high, according to an Identity Theft Resource Center report obtained by Becker's.
For the report, ITRC gathered and analyzed data breach information from public notices in the U.S. The report, sponsored by CyberScout, comprises five industries: financial, health/medical, government/military, education and business.
Here are six things to know.
1. The health/medical industry experienced 179 breaches in the first half of the year, accounting for 22.6 percent of all U.S. data breaches.
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What’s next after the GOP health plan collapse

Published July 18 2017, 3:43pm EDT
Senate Majority Leader Mitch McConnell’s new proposal to simply repeal the Affordable Care Act appears to already be dead, less than 24 hours after he dropped his replacement plan for lack of support among fellow Republicans.
A handful of Republican lawmakers, including Sens. Susan Collins (Maine), Shelley Moore Capito (W.Va.) and Lisa Murkowski, (Alaska), said Tuesday that they would oppose the repeal-first strategy. The dissention eliminates hope that the approach will gain traction in the near term, despite calls for action on Monday night from President Trump and Majority Leader Mitch McConnell.
So what’s next?
Even with the GOP’s failed effort, there may be additional opportunities for employers to gain relief from ACA requirements in coming months. However, for the healthcare industry, next steps are a bit vague.
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Artificial intelligence is transforming radiology, but it still can't make human judgment calls

Jul 18, 2017 11:53am
Automation is expected to replace millions of jobs in the coming years, but it’s not just blue-collar workers in the crossfire. Technology is changing the way some doctors work, and that could result in lower demand for some specialties.
As artificial intelligence expands into healthcare, radiologists will be among the first doctors who will have to adapt.
That’s because AI can help read the medical images that radiologists use to diagnose and treat patients, providing better services at lower costs by, for instance, improving the analysis of an MRI. "This is going to be transformational," Keith Dreyer, D.O., vice chairman of radiology computing and information sciences at Massachusetts General Hospital, told CNN.
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My Changing Relationship with Technology in Medicine

Now that I am in a different style of practice, technology has been a great help rather than a hindrance. I'm surprised at the fact I currently interact with patients due to technology, something I couldn't have imagined before.
My new EHR has a fully functioning portal. It has been great to quickly exchange information with patients, much faster than a phone call. While my patients get an email stating that they have a portal message, the only way I know a patient sends me a message is when I log into the EHR system. I wish the system would send me an email or text to let me know there's a new communication for me. So, I've developed a workaround where I give my cell phone number to my patients and they let me directly they sent a question, usually with a text to my cell phone.
I've been very clear that text and regular email are not HIPAA compliant and I cannot send private medical information through these channels. Thus far, I can say patients have not abused my private number (and after 25 years of having my house phone listed, there is only one time a patient called my home). They respect my time and privacy and so far, only contact me when they are having a crisis.
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July 17, 2017 / 2:22 PM / 2 days ago

Global cyber attack could spur $53 billion in losses: Lloyd's of London

 (Reuters) - A major, global cyber attack could trigger an average of $53 billion of economic losses, a figure on par with a catastrophic natural disaster such as U.S. Superstorm Sandy in 2012, Lloyd's of London said in a report on Monday.
The report, co-written with risk-modeling firm Cyence, examined potential economic losses from the hypothetical hacking of a cloud service provider and cyber attacks on computer operating systems run by businesses worldwide.
Insurers are struggling to estimate their potential exposure to cyber-related losses amid mounting cyber risks and interest in cyber insurance. A lack of historical data on which insurers can base assumptions is a key challenge.
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Only Half of Healthcare Professionals Report Their IT Infrastructure Is Safe from Cyber Attacks

July 17, 2017
by Heather Landi
According to the Medical Group Management Association’s (MGMA) most recent MGMA Stat poll, only 55 percent of healthcare professionals said they believe that their organization’s information technology (IT) infrastructure is secure against attacks.
Meanwhile, 15 percent of healthcare professionals responded they do not think their information technology infrastructure is secure, and another 15 percent responded that they are working on securing their information technology infrastructure.
What’s more, a final 15 percent said that they were unsure of their IT infrastructure’s security against an attack.
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Six million Belgians authorize data exchange by electronic means

Tuesday, 18 July 2017 12:07
More than six million Belgian have given their consent for the secure exchange of medical data between healthcare providers.
The Minister for Health, Maggie De Block indicated this on Monday in a communiqué. This consent enables providers to access the most recent medical data, in particular the results of the most recent blood test or the medicines prescribed.

The eHealth platform counter recorded precisely 6,000,333 consents on Monday, compared to 35,000 at the beginning of the parliament at the end of 2014, according to the eHealth platform. The number of consents reached the bar of one million at the end of May 2015 and exceeded 5 million at the beginning of this year.
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Ministers could miss target of allowing patients to book GP appointments online

MINISTERS are on course to miss their own target for expanding schemes which allow patients to book their GP appointments and order repeat prescriptions online.

PUBLISHED: 00:01, Tue, Jul 18, 2017
90 per cent of surgeries are supposed to offer a digital service for patients by the end of the year
Under the Scottish Government’s flagship eHealth Strategy 90 per cent of surgeries are supposed to offer such digital services by the end of this year.
But new research has revealed just four health boards have reached the goal despite pledges to use technology to bolster frontline care.
Think-tank Reform Scotland found only a quarter of NHS Highland practices offer online appointments booking and/or repeat prescribing.
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AI can speed up precision medicine, New York Genome Center-IBM Watson study shows

Researchers said Watson provided actionable insights within 10 minutes, compared to 160 hours of human analysis and curation typically required to reach similar conclusions.
July 14, 2017 01:15 PM
The potential for artificial intelligence in precision medicine is big, according to conclusions of a new study by the New York Genome Center and IBM.
The results, published in the July 11 issue of Neurology Genetics, a journal of the American Academy of Neurology, showed that researchers at the New York Genome Center, Rockefeller University and other institutions – along with IBM – verified the potential of IBM Watson for Genomics to analyze complex genomic data from state-of-the-art DNA sequencing of whole genomes.
 “This study documents the strong potential of Watson for Genomics to help clinicians scale precision oncology more broadly,” Vanessa Michelini, Watson for Genomics Innovation Leader for IBM Watson Health, said in a statement. “Clinical and research leaders in cancer genomics are making tremendous progress towards bringing precision medicine to cancer patients, but genomic data interpretation is a significant obstacle, and that’s where Watson can help.” 
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Survey: More than half of patients prefer telehealth visits to in-person care

Jul 17, 2017 11:17am
Patients value the convenience of telehealth as more physicians are using the technology to treat minor ailments.
As telehealth technology continues gaining momentum, patients are realizing the value of virtual care options—even preferring it to in-person care in some instances.
More than half of patients surveyed by the Health Industry Distributors Association (HIDA) indicated they were “very satisfied” with a telehealth visit in the last year, and 54% said the experience was better than a traditional office visit.
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Beware of These Top 10 Phishing Emails. Would You Fall for Them?

Jul 14, 2017
One hazard of being a cybersecurity reporter is that attackers send phishing emails to my inbox on a daily basis.
If you don't believe me, ask the security team at Time Inc., Fortune's parent company.
Truth is, anyone online can be a target for hackers, spies, and cybercriminals. You might not think you're that interesting, but the funny thing about networks is that even if you are boring (surely, you mustn't be, given that you're a Fortune reader), hackers may still aim to A) profit from your misfortune, and B) use you as stepping stone to get at someone else.
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Study: Cybersecurity attacks pose manipulation risk for medical, device data

Cybersecurity attacks are becoming more common in the healthcare industry, and new attacks could manipulate patient and device data in a way that would have immediate, potentially life threatening results, according to a new study.
The study, published this month in the New England Journal of Medicine, acknowledges the damage of previous attacks like the WannaCry ransomware attack, but calls to attention the potential damage that could be done in future attacks where disruption and stolen patient data aren’t the central target.
The study implied that while attacks which result in breaches of protected health information were dangerous, it said that manipulation of patient data could be “even more damaging.”
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Why technology isn’t solving patient appointment issues

Published July 17 2017, 4:16pm EDT
Information technology is playing an increasing role in enabling faster patient scheduling for physician appointments, but a recent study suggests that other human factors intervene, actually slowing down the process.
The findings suggest that workflow and attitude adjustments also are important in speeding the appointment process, which is likely to become more important as providers take on more risk for patient care—treatment delayed, in many cases, is believed to drive up care expenses as the conditions of patients worsen over time.
An article in the New England Journal of Medicine concludes that information technologies, such as scheduling applications, secure messaging and telehealth visits, can play a role in speeding up appointments. However, other factors, including old-school physician beliefs, can contribute to long waits by patients, who may suffer physically and emotionally from delays.
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HIT Think 4 big takeaways from the revised Senate health bill

Published July 17 2017, 4:03pm EDT
Last week, Senate GOP leaders released a revised version of their potential healthcare reform bill, the Better Care Reconciliation Act (BCRA) of 2017.
Although multiple factions within the GOP pressured Senate Majority Leader Mitch McConnell to make changes to the bill, the revised version largely retains the BCRA's original framework. An updated CBO score, with revised estimates of the bill's implications for insurance coverage and affordability, is expected this week and will help set the stage for continued debate.
In the meantime, here are our top four takeaways on the updated bill and its implications for providers:

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Bupa employee stole half a million customers’ health insurance data

 

Laura Stevens

19 July 2017

A rogue Bupa employee has stolen personal customer data from the health insurance giant, leaving more than half a million people compromised.

Bupa Global revealed that one of its staff members had taken international health insurance information affecting 547,000 people.

On 13 July, Sheldon Kenton, managing director of Bupa Global released a statement saying an employee had “inappropriately copied and removed some customer information from the company”. 

https://www.digitalhealth.net/2017/07/new-data-standards-will-underpin-safe-information-sharing/

New data standards will underpin safe information sharing 

Dan Taylor 

17 July 2017 


As head of data security at NHS Digital, people think my job is about systems and technology. It isn’t. My job is about building public trust, and about supporting others within health and care to do the same.

I am unrelenting in my belief that one way we can improve patient outcomes is through digital patient information. This move to digital, which is happening across all aspects of our lives, can help to transform health and care, but it needs to have the right safeguards and controls in place.
I am here to put patient care first, just like frontline organisations who deliver that care, and I would urge every organisation I work with to focus widely on building and maintaining public trust, rather than solely on security.

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Enjoy!
David.



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