Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, October 31, 2017

I Reckon The NBN Jumped The Shark In Its Present Form This Week. The Pressure For Major Change And Improvement Is Enormous.

Rather than bore everyone with a gale of the NBN articles I am going to stick to one which really seems to say it all.

Problems plague transition to NBN for Aussie households: survey

Over one million (45%) Australian households who have connected to the national broadband network experienced issues when transitioning across to the service, according to a newly published research report.
Online comparison website iSelect says a new Galaxy Research study it commissioned to assess the attitudes of Australian households towards broadband services, reveals that 1.3 million Australian households who have connected to the NBN had issues with their transition.
And, according to iSelect, Australians now voice concerns about the speed of their broadband service, not so much about price and data allowance as previously raised.
According to the study, just over a third (36%) of Aussie homes have actually made the move across to the NBN.

And, just 44% of homes with the NBN said their home Internet was meeting their expectations and allowed them to “do everything they want online”, compared to 40% of those using ADSL2+ or other connection types.  
But, once connected, those homes with an NBN connection were slightly more satisfied with their internet service, the research reveals.
iSelect says the research also revealed that many Australians are very confused by NBN speed tiers despite the Australian Competition and Consumer Commission's recommendation for Internet providers to move away from unclear language such as “up to” when describing NBN speeds.
According to Laura Crowden, spokesperson for iSelect, the arrival of the NBN means customers now need to take speed into consideration when choosing the right broadband provider and plan.
“Aussies are used to choosing a home broadband plan based primarily on price and data allowance. For households moving across to the NBN, it can be really confusing to understand what the different NBN speed tiers mean and decide which one is right for them.”  
Crowden welcomed the ACCC’s request for retailers to make it clearer for what speeds customers can expect during peak periods.  
“This is definitely a step in the right direction but there remains a lot of variation between providers in terms of both their speed ranges and the names they use to describe them,” she explained.
“Terms like ‘boost’, ‘max’ or ‘superfast’ do little to clarify what speeds customers can realistically expect during busy times such as evenings.  It’s no wonder that many customers remain bamboozled by what the different NBN speed tiers will actually mean for them in reality.”  
Crowden says Internet providers have designed their plans around the NBN’s four speed tiers (12, 25, 50 & 100 megabits per second) but the NBN Co — the builders of the NBN — “does not consider 12Mbps plans to be superfast broadband”.
And, according to Crowden, many households are automatically opting for the cheaper NBN 12 plans without realising they are likely to be similar – or possibly slower – than what they experienced on ADSL2.  
More here:
The stats cited here are really alarming and if replicated with the rest of the roll out the backlash can be guaranteed to get rid of the present Government quick smart. The Government know that and so must be planning some big improvements – to be announced  I guess  after the Barnaby nonsense is resolved!
To not be seen fix this level of issue and dissatisfaction is electoral suicide in my view! Simply too many of us rely on decent internet these days to make it through the day and mobile won’t be up to the task for a couple of years yet.

Monday, October 30, 2017

Weekly Australian Health IT Links – 30th October, 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

It has all been about the NBN (and Barnaby) during the last week of so… Seems people have noticed it is not turning out as promised. It is actually pretty sad IMVHO.
Lots of other stuff as well.

How big data is shaping the future of general practice

25 October 2017


The GPs at Dr Malcolm Clark’s group practice in suburban Melbourne felt confident in their management of diabetic patients. Then they received a data report that got them thinking.
“When we got the data back we could see this smaller group that we could do a better job with,” Dr Clark says. “We were able to identify patients who were good at dealing with their diabetes and those who were not.”
The data in question was in the form of a report produced by MedicineInsight, a data collection, storage and analysis platform provided by NPS MedicineWise (see How it works).

My Health Record data breaches caused by “fraudulent behaviour or human error”

Lynne Minion | 25 Oct 2017
Fraudulent behaviour or human error were responsible for My Health Record data breaches, the Australian Digital Health Agency has confirmed, following the release of the Australian privacy commissioner’s annual report containing details of the security failures.
"This year we received six data breach notifications from the My Health Record System Operator,” the Office of the Australian Information Commissioner’s annual report says.
“These notifications related to unauthorised My Health Record access by a third party.”

Healthier lifestyles for women recovering from cancer

25th October,2017
Increased physical and emotional health benefit for women recovering from cancer has been the outcome of a Griffith University wellness program which is now set to become widely used across Australia.
Led by Griffith’s Menzies Health Institute Queensland, and timely for Breast Cancer Awareness Month October 2017, the nurse-led study aimed to reduce the significant side effects associated with breast, blood and/or gynaecological cancers, whilst also reducing the risk of developing other chronic health conditions.
As part of the Women’s Wellness After Cancer Program, women aged 18 and over with cancer undertook an evidence-based e-health 12-week lifestyle intervention.

Digital health chiefs demonstrate joined-up thinking as they hold summit in Leeds

Published: 13:12 Wednesday 25 October 2017
Leaders in the digital health field from opposite sides of the world shared their expertise at a summit meeting in Leeds. NHS Digital hosted a delegation from the Australian Digital Health Agency (ADHA) for the talks on how technology can improve health and care.
During the two-day event at NHS Digital’s head office in Leeds, executives from the two organisations discussed topics including cyber security, the NHS’s national digital systems and how to better involve patients in their own health and care.
Officials from NHS England and the Department of Health also attended. Sir Ian Andrews, non-executive director at NHS Digital and co-chair of the summit, said: “This was a really exciting opportunity to explore ways in which we can learn from each other’s experience and to identify opportunities for future collaborative working. It is clear that we face many of the same challenges.”

Government cancer screening register delayed again: Labor

The Australian government's cancer-screening register will not be operational until March 2018, Labor has said, with Telstra again delaying the service to be delivered under its AU$220 million government contract.
By Corinne Reichert for Mobile Platforms | October 27, 2017 -- 01:42 GMT (12:42 AEDT) | Topic: Mobility
Australia's Shadow Minister for Health and Medicare Catherine King has accused Telstra of delaying the National Cancer Screening Register again, claiming the register will not be fully operational until March next year.
"The government said that this register and test would prevent around 140 cases of cervical cancer every year -- now it has been delayed by almost 12 months, they need to come clean about the deadly toll of this delay," King said.
"The national register will not be able to send cervical screening histories to pathology laboratories until March 2018 at the earliest, with laboratory staff concerned about the 'serious implications for patient safety'."

Vale pharmacy as we know it: technology will “inevitably” change pharmacists’ role and lead to job losses

Lynne Minion | 27 Oct 201
Game changing technology will force dramatic shifts in pharmacy practice at a pace faster than lobby groups prefer or policy can keep up with, according to a new Productivity Commission report, ending the current retail model.
The ‘Shifting the Dial: 5 year productivity review’ studied factors likely to affect Australia's medium term economic performance, and predicted that technology will lead to increased mechanisation and job losses for pharmacists.
“Disruption and automation appears likely to produce job losses for some health occupations, notwithstanding growth in the healthcare sector,” the review found.

Guild “strongly commends” real-time monitoring system

The Victorian Branch of the Pharmacy Guild has praised the state government for passing bill in Parliament last week

The Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017 enables the rollout of SafeScript, which will monitor all Schedule 8 medicines such as morphine and oxycodone – which carry the highest risk of misuse – and other high-risk medicines, including all benzodiazepines such as diazepam.
Once fully implemented, it will be mandatory for prescribers and pharmacists to check the system before writing or dispensing a prescription for a high risk medicine.

New medication app for staff working with people with dementia

Dementia Training Australia has released a new mobile app to assist staff involved in medication management to provide quality use of medicines for people living with dementia.
The Medication Management app is based on popular hard copy quick reference cards that were also developed by DTA.
DTA is funded by the Australian Government to provide dementia education and training across Australia.
The Medication Management app has two sections. The first provides information on the optimal use of antipsychotic medications for responsive behaviours; this includes medication management plans, monitoring, and side effects.

Cochlear launches ‘world first’ Made for iPhone implant in Australia

Inventor of the bionic ear and hearing solutions company Cochlear has developed a “world first” Made for iPhone implant sound processor which it claims will significantly improve hearing for users in Australia.
Dubbed the “smallest and lightest” behind-the-ear cochlear implant sound processor available on the market, Cochlear says for the first time people living in Australia with severe to profound hearing loss can now reach the highest level of hearing performance with the Nucleus 7 Sound Processor, streaming sound directly from a compatible iPhone, iPad and iPod Touch to their sound processor.
The Nucleus 7 sound processor is 25% smaller and 24% lighter than the previous generation Nucleus 6 Sound Processor.

Smartglasses help the hearing-impaired enjoy theatre

London's National Theatre is testing Epson Moverio BT-300 AR smartglasses to enable deaf and hearing-impaired people to read subtitles in their field of vision when they are watching any performance.
The National Theatre is one of the three most prominent publicly funded performing arts venues in the UK.
The BT-300 smartglasses feature Epson's silicon-based OLED digital display technology, enabling mobile augmented reality experiences. They are also the lightest binocular see-though smartglasses to date.

Apple and Cochlear launch product that streams calls straight to implant in ear

Esther Han
Published: October 25 2017 - 12:15AM
When Julia Sattout had a Cochlear device implanted in her head five years ago, it didn't just restore her ability to hear again, it saved her career as a lawyer.
But there was one anxiety-inducing problem. Despite using the latest accessories, the simple task of picking up a call on her mobile phone often proved difficult.
"At one point I had a double adaptor, so I had a coil hooked over my right ear and an audio cable I had to plug into my sound processor," said Ms Sattout, 45 of Concord West.
23 Oct 2017

HICAPS Go set to improve cost transparency for patients

Patients can now locate a practitioner, get a quote, pay for their consultation and claim their private health insurance benefit using a new one-stop healthcare app.
HICAPS Go, which has launched in Melbourne, provides patients with a simple and transparent experience which gives them more visibility on their out of pocket expenses before they see their healthcare practitioner and facilitates a completely digital process to pay their bill.
The app also and makes it easy for patients to locate, book and manage a health practitioner appointment.

New healthcare app helps claim private insurance benefit online

The National Australia Bank and tech start-up Medipass have launched a health app that enables consumers to locate a practitioner, obtain a quote, pay for consultation and claim private health insurance benefits.
Known as HICAPS Go, the app has launched in Melbourne. It leverages the current NAB-owned HICAPS payment/claiming terminal system.
“We have re-imagined the user experience for a digital age and built an Uber equivalent for Australia’s healthcare ecosystem,” NAB chief operating officer Antony Cahill said.

My Health Record security recommendations

The Australian Digital Health Agency recommends:
We all understand the importance of health prevention activities – it is much better to avoid illness than have to cure it. It’s just the same with information technology (IT) – it is much better to secure your IT rather than deal with the consequences of not having done so. 
There are a number of things we can do to help secure the health information we handle, and at the same time help to protect against reputational and financial loss associated with cyber security threats.

Simple steps to protect small healthcare businesses

23 October, 2017
The Information Security Guide for Small Healthcare Businesses (the Guide) is a simple tool produced by the Australian Digital Health Agency for every business to take simple steps to better protect their information.
The Guide, which was developed in partnership with the Australian Government's Stay Smart Online program, provides simple guidance for non-technical health professionals regarding issues such as privacy, passwords, software updates, back-ups and staff security awareness.
Healthcare providers are, rightly, focussed on providing quality care and patient outcomes, and sometimes information security can seem like an overly complicated and technical task.
- ----

#FHIR and R (Stats / graphing language)

Posted on October 27, 2017 by Grahame Grieve
I’ve spent the last 2 days at the 2017 Australian R Unconference working on an R client for FHIR.
For my FHIR readers, R is a language and environment for statistical computing and graphics. (Having spent the last couple of days explaining what FHIR is to R people).  My goal for the 2 days was to implement a FHIR client in R so that anyone wishing to perform statistical analysis of information available in R could quickly and easily do so. I was invited to the R Unconference by Prof Rob Hyndman (a family friend) as it would be the best environment to work on that.
My work was a made a lot easier when Sander Laverman from Furore released an R package to do just what I intended to do earlier this week. We started by learning the package, and testing it.

HISA joins digital health showcase HealthHorizon

MTPConnect – the Medical Technologies and Pharmaceuticals Industry Growth Centre – today announced it will provide a proposed $100,000 provisional funding to a National MedTech, Pharmaceutical and Digital Health Showcase over one year, with proposed matched funding of $100,000 coming from the sector. The funding will allow the project to catalogue and track the progress of health innovations under development in Australia and make the information accessible to all on a public online platform.
The project consortium is led by Canberra-based start-up Health Horizon, and includes national organisations like Medical Technology Association of Australia (MTAA), Health Informatics Society of Australia (HISA) and Medical Software Industry Association (MSIA). Industry members of the consortium include ANDHealth (Australia’s only national mid-stage digital health integrator and accelerator), hospital and health services intellectual property management company Hospital and Health Services IP Ltd and Novartis Pharmaceuticals Australia. The academic consortium members include the Melbourne Academic Centre for Health and influential health innovation groups from QUT and the University of Newcastle.

openEHR Task Planning – heading for implementation

Posted on by wolandscat
We’ve made a lot of progress since my last post on this topic. We have published a 1.0.0 version of the openEHR Task Planning specification, which will go into implementation immediately in the City of Moscow e-health project. The current version will certainly be changed by that experience, but we believe is good enough for use in implementation, having been reviewed and worked on by our development team, including people from Marand (provider of the Moscow EHR platform implementation), DIPS (largest EMR vendor in Norway) and others from Tieto (Finland) and Moscow.
We are currently looking at creating a visual language for it, of which the above diagram contains initial ideas for the TP conditional structures on the left, with BPMN equivalents on the right.

Ipsos Global Advisor survey finds Australia ranks lowest for broadband satisfaction

Matt Wade
Published: October 25 2017 - 10:00AM
Australia has been ranked last out of 28 countries when it comes to broadband satisfaction, a new international poll shows.
Just 32 per cent rated the quality of Australia's broadband fairly or very good which was down 6 percentage points compared with a year ago and much lower than the international average of 56 per cent.
There were only two other nations in the international survey where fewer than four in ten respondents rated broadband as good - Italy (35 per cent) and Brazil (37 per cent).

Problems plague transition to NBN for Aussie households: survey

Over one million (45%) Australian households who have connected to the national broadband network experienced issues when transitioning across to the service, according to a newly published research report.
Online comparison website iSelect says a new Galaxy Research study it commissioned to assess the attitudes of Australian households towards broadband services, reveals that 1.3 million Australian households who have connected to the NBN had issues with their transition.
And, according to iSelect, Australians now voice concerns about the speed of their broadband service, not so much about price and data allowance as previously raised.
  • Oct 23 2017 at 11:16 AM

Time for government to act on NBN mess

Interviews with National Broadband Network chief executive Bill Morrow published on Monday show that the controversial project to bring Australia's telecommunications infrastructure into the modern age is a mess.
Pure and simple … from whichever way you look at it, it is a disaster both politically and for the hapless Australian population being told to accept second (or third or fourth) best internet speeds simply because we happen to live in a large, sparsely populated land mass … the unlucky country eh?
The way the NBN has been set up it has two main criteria by which it should be judged – is it providing Australians with world class broadband? And is it a successful business?

Malcolm Turnbull says the NBN was a mistake and may never make money

James Massola
Published: October 23 2017 - 11:11AM
Prime Minister Malcolm Turnbull says that, in hindsight, the National Broadband Network project was a mistake and blamed the former Labor government for setting up a new government company to deliver the mammoth infrastructure project.
And Mr Turnbull, who was previously the Communications Minister in the Abbott government, admitted the giant project might never make back the money invested by taxpayers.
Despite this, the Prime Minister said his government had no plans to impose a levy or penalty on people who connect to the internet using mobile data connections, rather than the fixed line network.

NBN CEO casts doubt on ability to turn profit

By Ry Crozier on Oct 23, 2017 6:55AM

Analysis: Your move, government.

NBN Co CEO Bill Morrow has confirmed what the industry has been saying for years: that the network builder’s economic model is broken and that - under current conditions - it may never turn a profit.
In a sensational interview with Fairfax Media pre-empting a damaging 4Corners investigation to be aired on Monday night, Morrow effectively laid out an ultimatum to the government: ditch the idea of making a return on taxpayers’ investment, or face more politically unpalatable options.
The NBN model has always been predicated on it generating an internal rate of return (IRR) on the $29.5 billion taxpayer investment in the project.

Like it or not, you’re getting the NBN, so what are your rights when buying internet services?

October 23, 2017 6.03am AEDT
When buying internet services it pays to read the fine print. Dave Hunt/AAP

Author Jeannie Marie Paterson

Associate Professor, University of Melbourne
Most Australians will be forced to move onto the NBN within 18 months of it being switched on in their area, and that means navigating what can be confusing new contracts.
So, what are your rights regarding landline and internet connections?


Many consumers can and do manage without a landline. But particularly for those without a reliable mobile service, a landline can be essential. It is included in many phone and internet “bundles” offered by internet service providers.
  • Oct 23 2017 at 12:00 PM

If Wi-Fi is KRACK-ed what can you do to keep safe(ish)?

by Peter Moon
The news that most of the planet's Wi-Fi networks are at risk of being hacked has shocked the business world. Just search "WPA2" for a litany of reports that researchers have uncovered a gaping hole in the current standard for wireless security.
In brief, everything passing over most Wi-Fi networks is probably open to interception.
At times like this, grey hairs come into their own. We looked up a couple of tech veterans for their take on the nightmare news. They don't disagree for a moment that the threat is real.

Sunday, October 29, 2017

Somehow Even The August Productivity Commission Has Been Drinking The Kool-Aide!

Early last week – before the High Court upended things a bit – we had a new major report released by the Productivity Commission.

Shifting the Dial: 5 year productivity review

Inquiry report

This report was sent to Government on 3 August 2017, then tabled in Parliament and publicly released on 24 October 2017.
This is the first document of its kind for the Productivity Commission — a look out across the landscape of factors and influences that may affect Australia's economic performance over the medium term, in order to offer advice on where our priorities should lie if we are to enhance national welfare.

Download the report

Here is the link to the Report page.
Health was a major focus in the report:

Healthcare fault lines ‘risk patients, funds’

  • The Australian
  • 12:00AM October 25, 2017

Sean Parnell

Australian doctors may be less inclined than their overseas counterparts to put patients at the centre of decision-making, and the primary care, public and private hospital sectors do not collaborate enough to improve healthcare, a review has found.
In an inaugural review to be repeated five-yearly, the Produc­tivity Commission has questioned the lack of integration and informed decision-making in health. Not only do these “fault lines” lead to substandard care and inequality, they waste hundreds of millions of dollars each year.
The findings yesterday prompted Treasurer Scott Morrison, who commissioned the review, to link the economic benefits of future health reform to better outcomes for patients.
“The pathway of patient care in Australia is all too often fragmented and plagued by poor or non-existent communication between different parts of the health system,” he said. “This veil of ignorance, where a doctor may not even be aware of significant health issues affecting their patient, can slow down the process of care, put the patient at risk, and lead to unnecessary procedures.”
The commission recommended funds be diverted to funding pools for primary health networks and local hospital networks to target problems at a local level. It also wants the Australian Commission on Safety and Quality in Health Care to drive better performance monitoring, data collection and reporting to aid transparency.
While Mr Morrison has talked up the Coalition’s healthcare homes trial and a move to electronic health records, the commission had reservations. It suggested the homes trial was underfunded and should be better connected to local hospital networks to support people with chronic illness.
It said low public awareness of My Health Records pointed to a deeper problem: “Quite apart from the structural and attitudinal changes needed to the health system ... there is a glaring gap in peoples’ capabilities for exercising more control — a lack of health literacy. The majority of Australians have inadequate health literacy, and the share is greatest for those with chronic conditions. Even 40 per cent of people with a qualification related to health have inadequate health literacy.”
More here:
I thought it was important to see what the PC actually said about the myHR.
Here it a summary… (Page 68 of the main report)

The role of My Health Record

An effective My Health Record is an important foundation for an integrated health system. The introduction of an opt-out system (compared with the initial opt-in approach) will lead to nearly universal coverage of Australians, as very few people in the trial opt-out sites chose to opt out. Given high take-up by providers, there is some promise that My Health Record can provide a central, lifelong depository for each patient’s medical records, regardless of provider, in an electronic format accessible by providers and patients.
There are compelling grounds to use My Health Record as a platform for providing clinically-proven advice to patients, rather than just as a method for collecting data for clinicians. For example, a person might be reminded of the potential need to have a vaccination or a screening test, such as a check for osteoporosis for post-menopausal women. The Australian College of Nursing supported a role of My Health Record as a source of information for self-care. The form of the advice that has the highest degree of compliance could readily be tested — the right words and the right technology (smart phone app, SMS, email, letter) — geared to the traits of the person. The clinician would ultimately be the decision maker (and their decision could be undertaken remotely in many cases). General practice could also receive online reminders. Currently, 56 per cent of Australian GPs say they routinely receive computerised reminders for guideline-based intervention or screening tests — though how often they act on these is not known.
There is some evidence of a lack of awareness by people of the potential uses of the Record. For example, only 971 people (0.002 per cent of registered users) had used My Health Record to lodge an Advance Care Planning Document, despite the relevance of such a document to all Australians. Clearly, communication of opportunity in data systems for patients is currently failing. This and other barriers will need to be overcome (section 3.2 of SP 5).
----- End Extract.
So they are pretty keen – especially for patient use of the record – which we all know has been pretty abysmal to date.
But then you find this under the heading (Page 109 of Section 5)  “Things that Work”.
Integrated ICT: shared electronic health record, linked clinical and financial measures
“What it means for Australia”.
1. Invest in information technology and software for information flows throughout the system (Great idea)
2. Use My Health Record as the key patient record (WTF!)
That is all you need to read  – use of the myHR as the key patient record is just rubbish. It is not and was never intended to be the ‘key patient record’.  Sorry guys back to the drawing board – the Kool-Aide has got you!
Again we see bureaucratic lust for data and control overwhelm common sense. Pity about that because there is a lot in the rest of the report on pharmacy, integrated care and the like that is pretty good.
Again so called experts have gone ‘off the reservation’ on expectations for Digital Health!

AusHealthIT Poll Number 394 – Results – 29th October, 2017.

Here are the results of the poll.

Do You Agree With Grahame Grieve (And Your Humble Pollster) That The myHR Is Architecturally Fundamentally Badly Flawed And That This Needs Correction If The myHR Is To Succeed?

Yes 99% (146)

No 0% (0)

I Have No Idea 1% (1)

Total votes: 147

I think this is the clearest vote ever! The myHR needs architectural change to succeed. Tinkering around the edge is an expensive waste of time and money!

Any insights welcome as a comment, as usual, especially regarding what might be done to fix things?

I begin to wonder who the single clueless person is who just likes to vote for the sake of voting?

A really great turnout of votes!

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


Saturday, October 28, 2017

Weekly Overseas Health IT Links – 28th October, 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.

71% of providers say interoperability not attainable by 2020

Published October 20 2017, 7:08am EDT
Less than a third of provider organizations believe that current federal policies, committees and regulations are sufficient to help the country attain meaningful health IT interoperability by 2020.
That’s among the findings of the eHealth Initiative’s just-released 2017 Survey on Access to Patient Information.
Researchers conducting the survey say the lack of confidence in the nation achieving interoperability over the next few years does not bode well for the healthcare industry as it transitions from fee-for-service to value-based care.

Clinic pays ransom to recover from a hacking attack

Published October 18 2017, 4:20pm EDT
Namaste Healthcare, a small primary care clinic in Ashland, Mo., suffered a data breach on August 12 and 13 when a hacker remotely accessed the practice’s file server and potentially viewed protected health information.
On August 14, when the practice opened, data on the file server was found to be encrypted.
The practice disabled the unauthorized user’s access, took computers offline and with help from its technology contractor terminated further remote access. However, the data was still encrypted by the hackers, and the practice was forced to pay an undisclosed ransom to get the decryption key and restore the encrypted data, according to a notification letter mailed to affected individuals.

Epic Named Best EDIS Enterprise Vendor in Overall Satisfaction

A recent KLAS report showed organizations using Epic as their EDIS system report significantly higher rates of overall satisfaction.

October 17, 2017 - The September 2017 KLAS report for emergency department information system (EDIS) usability showed provider leadership at organizations using Epic EHR have significantly higher rates of overall satisfaction than those using other enterprise vendor systems.
KLAS researchers attributed this success to the health IT company’s excellent support, relationships, and general experience.
However, Epic users reported lower rates of workflow satisfaction and usability compared to best-of-breed customers.
 “Several Epic customers report excessive and repetitive clicking, back-and-forth navigation, and upgrades that create additional clicks; at the same time, users admit that these steps/clicks have helped improve patient safety, and respondents report that the vendor delivers more information at-a-glance,” wrote KLAS researchers in the report.

UVA Researchers Recommend Using EHRs for Reduced Medical Testing

Researchers at UVA recommend suggest using EHRs for reduced medical testing, such as limiting repetitive lab test ordering.

October 18, 2017 - Researchers at the University of Virginia (UVA) Health System and other universities have developed a plan to cut unnecessary medical testing in an effort to save money and improve patient safety, satisfaction, and health outcomes in part by using EHRs.
Hospital staff frequently perform routine lab tests on hospitalized patients. However, researchers suggest automatically testing patients is wasteful and potentially threatening to patient safety when medical testing is not a necessary part of treatment.
For example, researchers pointed out that excessive blood testing can lead to hospital-acquired anemia, increased medical costs, and additional unnecessary testing.

Hospitals provide guidelines for eliminating unnecessary medical tests

Published October 19 2017, 7:12am EDT
Researchers have developed evidence-based guidelines intended to help hospitals eliminate unnecessary medical testing, and are developing an approach to deliver the guidelines to clinicians through electronic health records.
In addition to limiting unnecessary tests, the initiative intends to give providers real-time feedback on their ordering patterns with anonymized comparative data.
The guidelines, published this week in JAMA Internal Medicine, were developed by researchers at Johns Hopkins University, the University of Michigan, University of Pennsylvania, University of Toronto and the University of Virginia—all members of the High Value Practice Academic Alliance, a coalition of more than 80 academic medical centers working to improve healthcare by eliminating waste.

Report: Insider Threats to Patient Data Remain Unnoticed

October 18, 2017
by Heather Landi
Of the reported healthcare data breach incidents that occurred in September, it took an average of 387 days for healthcare organizations to discover a breach had occurred, according to a report from cybersecurity software company Protenus.
There was a substantial uptick in the number of breach incidents reported in the month of September, with almost half a million patient records compromised, according to the report. There were 46 incidents in September, compared to 33 in August, 36 in July and 52 in June. The Protenus Breach Barometer is a monthly snapshot of reported or disclosed breaches impacting the healthcare industry, with data compiled and provided by DataBreaches.net. The report includes breach incidents either disclosed to the U.S. Department of Health and Human Services (HHS) or to the media in the past month.
For the 42 incidents for which Protenus had numbers, 499,144 patient records were affected. The largest single incident for which Protenus had numbers involved 128,000 patient records in a hacking incident that involved ransomware. Reports did make it clear that this patient data was made inaccessible by the hacking.

Machine learning helps Mass General predict cancerous breast lesions

Published October 18 2017, 7:06am EDT
Researchers at Massachusetts General Hospital, working with MIT’s Computer Science and Artificial Intelligence Laboratory, have developed a machine learning tool to identify high-risk breast lesions that are likely to develop into cancer.
By accurately predicting which biopsy-diagnosed, high-risk lesions are likely to become cancerous, the technology has the potential to reduce unnecessary surgeries by nearly one-third in this specific patient population. That’s the finding of a new study published online in the journal Radiology.
“This study is our proof of concept that we can actually change the way we’re managing our patients through machine learning algorithms,” says Constance Lehman, MD, senior author of the study and director of breast imaging at Massachusetts General Hospital.

Regular Employee Training Essential in Healthcare Cybersecurity

How do employee training programs help protect against evolving healthcare cybersecurity threats and reinforce HIPAA compliance?

October 16, 2017 - Healthcare cybersecurity threats are constantly evolving, forcing covered entities and business associates to subsequently adjust their privacy and security measures to keep PHI secure. A key aspect to data security though is regular employee training.
Health IT executives are increasingly concerned over their employees having a proper grasp of cybersecurity measures. The 2017 Level 3 Healthcare Security Study found that 80 percent of HIT leaders list employee security awareness as their top healthcare data security worry.
Sixty-nine percent of respondents said exposure from partners or third-parties was their top concern, followed by securing wireless or BYOD devices (54 percent) and a lack of actionable intelligence (36 percent).

41% of Health Data Breaches Stem from Unintended Disclosure

The leading cause of health data breaches in 2017 so far are from unintended disclosure, followed by hacking or malware.

October 17, 2017 - Unintended data disclosure, such as emails containing PHI sent to the wrong recipient or servers left publicly accessible, accounted for 41 percent of reported health data breaches the first nine months in 2017, according to research from Beazley.
The second most common issue was from hacking or malware incidents (19 percent), followed by insider incidents (15 percent), and physical loss (8 percent).
Organizations need to understand the underlying causes of data breaches so necessary mitigation and management techniques can be put in place, Beazley Breach Response Services Global Head Katherine Keefe explained.
 “All organizations face the reality that data breaches have become inevitable,” Keefe said in a statement. “And the stakes are high: they hold personal data on trust for customers, employees and patients. The volume of protected health information maintained by healthcare organizations and the digitization of electronic health records have increased the vulnerability for large breaches.”

Fighting physician burnout: How tech can undo the damage done by EHRs

Solutions should reduce the burden of repetitive data input that now takes place and enable seamless ways for clinicians to talk to each other, experts say.
October 16, 2017 10:39 AM
When it comes to doctor burnout, technology is both the problem and a potential solution.
“Let’s not dance around it – we all know how much the electronic health record has contributed to the physician burnout epidemic,” said Bridget Duffy, MD, chief medical officer at Vocera, co-founder of the Experience Innovation Network and former chief experience officer at the Cleveland Clinic.
“Physicians who once were absorbed in speaking with and examining their patients found themselves spending more time clicking through screens and pecking away at a keyboard.”
The widespread frustration felt by doctors wrangling with kludgy interfaces, interminable sign-ins and so many clicks is well-trodden at this point. Perhaps less understood, however, is how technologies including EHRs can be tuned to make physicians more efficient — and more happy.

Texas Children’s doctor says artificial intelligence requires physicians to redefine their role in medical care

Oct 17, 2017 11:11am
Doctor's need to stop thinking of themselves as "victims of the machine," and decide which parts of their job are better left to computers.
To coexist with machines, one physician says doctors will need to delegate parts of their job to algorithms that are better equipped to support patient care.
Arguing that physicians are headed to “evolution, not extinction,” Bryan Vartabedian, M.D., an assistant professor of pediatrics at Baylor College of Medicine and an attending physician at Texas Children’s Hospital, said physicians need to redefine themselves not as “victims of the machine,” but participants in reshaping the future of medical care.

Proposed bill calls for a national breach notification standard

Published October 17 2017, 4:03pm EDT
In the wake of the Equifax data breach that may have affected more than 143 million individuals, Rep. Jim Langevin (D-Rhode Island) has reintroduced legislation previously proposed to establish a single national breach notification standard, along with establishment of a federal regulator that would ensure information on a breach quickly reaches affected individuals.
The bill is H.R. 3806, entitled the Personal Data Notification and Protection Act. Alabama and South Dakota are the only states that don’t currently have a state breach notification law.
“There is much still to learn about the Equifax breach and its ramifications,” says Langevin in a statement. “What is abundantly clear, however, is that consumers are still not sure whether they were affected and what information was stolen.”

EHRs Play Role in More Malpractice Claims

Alexandra Wilson Pecci, October 17, 2017

There was a continuous increase over the past decade in malpractice claims in which the use of EHRs contributed to patient injury, says a new study.

As EHR usage grows more widespread, so too does the technology’s role in malpractice claims, finds a new study.
The Doctors Company, a physician-owned medical malpractice insurer, found a continuous increase over the past decade in malpractice claims in which the use of EHRs contributed to patient injury.

EHR-related malpractice claims are rising, and risk-mitigation strategies more important than ever

System factors in the EHR itself – poor integration, suboptimal design and UX, failures of alerts and alarms – were up 8 percent since the last time The Doctors Company did a similar report.
October 17, 2017 04:11 PM
Malpractice claims for errors caused, all or in part, by electronic health records have risen significantly, according to a report from The Doctors Company, a physician-owned malpractice insurer. The study offers some useful tips to help providers protect against that risk.
There were just two claims for which EHRs were either the cause or (more likely) a contributing factor between 2007 and 2010, according to report. From from 2011 through the end of 2016, however, there were 161.
The new study examined more than five dozen of those claims and found a wide array of factors – some related to technology and system design (drop-down menus, templates, alerts) and some having to do with human error (lack of training, inappropriate use of copy-and-paste) – contributing to the alleged medical errors.

What hospitals should consider when choosing AI tools

AI and machine learning are augmentative tools, size matters among data sets, real-world applicability is a must, and tools must be validated, experts say.
October 13, 2017 11:25 AM
Some healthcare organizations are turning to artificial intelligence and machine learning because of the enhancements these advanced technologies can make to patient care, operations and security. But assessing the promises of the technologies can be difficult and time-consuming, unless you’re an expert.
Two such experts weigh in with insights hospitals should understand when both planning and purchasing AI tools. 
Raj Tiwari is chief architect at Health Fidelity, which uses natural language processing technology and statistical inference engines, mixed with analytics, to identify and correct compliance risks, and Brent Vaughan is the CEO of Cognoa, a company that develops AI tools for diagnosing medical conditions.

Epic's rival EHR vendors say they too are making the 'CHR' switch

Cerner, athenahealth and eClinicalWorks said they are incorporating new data types, such as social determinants, population health and precision medicine to make EHRs more “comprehensive.”
October 13, 2017 11:00 AM
Epic Systems CEO Judy Faulkner drove a stake into the ground when she said the company is transforming today’s EHR into a Comprehensive Health Record, a.k.a CHR.
But health and IT executives should take note: The new moniker does not mean that Epic has intrepidly moved into undiscovered country. Instead, rival EHR makers are already taking a similar tack. It’s just that no one has publicly attempted such a bold rebranding of the category.
“We’ve been discussing longitudinal health records that include social determinants and other relevant data for at least two years now, and there are more than 100 clients today using Cerner’s population health management platform (including many Epic EHR clients),” Cerner President Zane Burke said. “We’ve worked with these clients to develop solutions like HealtheIntent that are EHR-agnostic and aggregate data from multiple, disparate sources outside the four walls of the hospital or clinic.”

Eric Topol draws line in sand: Patients own their medical data

The renowned author and physician-scientist highlights the hurdles to sharing data with patients and asserts that giving patients their records could save lives.
October 13, 2017 12:50 PM
In a firm, bulleted-list, notable author and physician-scientist Eric Topol, MD, sparked a Twitter debate on his insights about the barriers to giving patients their medical record -- and why the shift needs to happen.
“Hospitals won’t or can’t share your data… Your doctor (more than 65 percent) won’t give you a copy of your office notes,” Topol tweeted. “Access or ‘control’ of your data is not enough.”
The tweet has been shared about 775 times and liked by more than 1,200 users.

Athenahealth, Cerner, Epic see wide adoption of population health platforms

But KLAS analysis suggests that what providers want in a PHM solution going forward is likely to evolve.
October 13, 2017 01:35 PM
While much of the population health management work hospitals are undertaking today relies on EHRs, new research from KLAS uncovered a crop of technology companies gaining purchase in the realm: IBM Watson Health, Philips Wellcentive and HealthEC. 
EHR vendors athenahealth, Cerner and Epic are still seeing stronger deployment of their pop health tools than these third-party vendors, KLAS noted. 
Research firm BlackBook said over the summer that Epic, Cerner and Allscripts are poised to dominate the population health market as a wave of mergers, acquisitions and consolidation is coming. 

AMA Launches Integrated Healthcare Big Data Analytics Platform

The physician-led Integrated Health Model Initiative aims to bring standardized healthcare big data analytics to the care continuum.

October 16, 2017 - The American Medical Association is working to develop an integrated big data analytics and clinical informatics platform that will offer a common data model for organizations seeking to deliver the highest possible quality of coordinated care.
With initial partners including Cerner Corporation, IBM, Intermountain Healthcare, PCORI, AMIA, and SNOMED, the Integrated Health Model Initiative (IHMI) will prioritize a collaborative approach to better chronic disease care and population health management.
“We spend more than three trillion dollars a year on health care in America and generate more health data than ever before. Yet some of the most meaningful data – data to unlock potential improvements in patient outcomes – is fragmented, inaccessible or incomplete,” said AMA CEO James L. Madara, MD.

Virtual interviewers may help soldiers speak up about PTSD

October 12, 2017
Service members unwilling to open up about their PTSD in person may be more likely to speak with computer-generated virtual interviewers, newly published research suggests.
Due to their anonymity and rapport-building capabilities, these virtual interviewers could be uniquely positioned to break through soldiers’ fears of discrimination and career-affecting stigma and improve mental health care, Gale M. Lucas, senior research associate at the University of Southern California’s Institute for Creative Technologies, and colleagues wrote.
“We envisioned a technology system – a virtual human interviewer – whereby military service members can get feedback about their risk for PTSD in a safe place without stigma,” Lucas told MobiHealthNews in an email. “Our prior research has shown that, because its ‘just a computer’ (therefore safe and anonymous), this virtual human interviewer helps people to feel safe discussing sensitive issues like mental health symptoms.”

Quality Issues for Both Paper-, Electronic-Based Health Records

Study affirms poor quality of nursing documentation, as well as lack of knowledge and skills
FRIDAY, Oct. 13, 2017 (HealthDay News) -- Both paper-based and electronic health records (EHRs) have shortcomings in terms of quality of content, process, and structure, with poor quality of nursing documentation seen for both methods, according to a study published online Oct. 5 in the Journal of Clinical Nursing.
Laila M. Akhu-Zaheya, Ph.D., R.N., from Jordan University of Science and Technology, and colleagues compared the quality of paper-based and electronic-based health records according to content, documentation process, and structure in a retrospective descriptive study. A total of 434 paper-based records and EHRs were audited using the Cat-ch-Ing Audit Instrument.
The researchers found that in terms of process and structure, EHRs were better than paper-based health records. Paper-based records were better than EHRs in terms of quantity and quality content. Poor quality of nursing documentation was affirmed in the study, as was nurses' lack of knowledge and skills in the nursing process and its application in both paper-based and EHR systems.

HIT Think How tinkering with the ACA puts health IT investment at risk

Published October 16 2017, 3:30pm EDT
Laws put in place over the past 70 years typically are done so with a delicate balance in mind—a bull in a china shop approach can do much damage in often unforeseen ways.
However, it’s apparent that recent events portend myriad challenges for providers throughout the country, and risk negating some of the benefits the country had hoped to derive from efforts to implement health information technology in the last 10 years.
For example, in 1946, the 79th Congress passed and President Truman signed the Hill-Burton Act, a federal law that required any facility receiving federal funds to treat any person with life-threatening injuries without concern for their ability to pay. Although rarely enforced for almost 30 years, the law was amended in the 1970s to include provisions to test compliance and impose penalties when indicated.

Has somebody shared your 'anonymised' health data? Bad news

Harvard boffins unmask 100% of 'encrypted' S Korean records

By Alexander J Martin
Researchers from Harvard University have published a paper claiming a 100 per cent success rate in de-anonymising patients from their supposedly anonymised healthcare data in South Korea.
The study, which bears the ronseal title of "De-anonymizing South Korean Resident Registration Numbers Shared in Prescription Data", was published this week in Technology Science.
Two de-anonymisation experiments were conducted in the study on prescription data from deceased South Koreans, with encrypted national identifiers - Resident Registration Numbers (RNN) - included.