Quote Of The Year

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

Saturday, May 12, 2018

Weekly Overseas Health IT Links – 12th May, 2018

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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Dimec allows patients to choose pick-up point for prescriptions

A pharmacy app has announced it is the first service in the UK to allow patients to choose any high street pharmacy to collect their prescription.
Hanna Crouch – 3 May 2018
Dimec works by linking a patient’s phone directly to their NHS GP and pharmacy and then letting them pick where to collect medicines from at the touch of a button.
Prior to this, patients were required to contact their GP or Pharmacist to request to alter their pharmacy.
The update to the app means patients can now view and select high street pharmacies based on their current location their home address or scroll around the integrated map.
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Hunt: IT error ‘could have cut short the lives of up to 270 women’

An IT error may have been the reason why the lives of up to 270 women in England were shortened after they failed to receive their final routine breast cancer screening invitation, Jeremy Hunt has told MPs.
Hanna Crouch – 2 May 2018
Speaking in the House of Commons on Wednesday, the Health and Social Care Secretary said the affected group of women were not sent invitations before their 71st birthday because “there was a computer algorithm failure”, which dated back to 2009.
He added: “Latest estimates I have received from Public Health England (PHE) is that as a result of this, between 2009 and the start of 2018, an estimated 450,000 women aged between 68 and 71 were not invited to their final breast screening.
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The tech revolution is coming, and the NHS needs to be ready

As Dr Eric Topol commences his review into the training needs of NHS staff and how can they leverage artificial intelligence, genomicsotics and other technologies to improve care, Stephen Barclay, minister of state for Health and Social Care, says it is important that NHS is “future-fit” to embrace the technological revolution.
DHI Admin – 30 April, 2018
Aided by the rapid advance of new technologies, there is something profound happening within modern medicine – we are starting to digitise the science of human health. Sophisticated smartphone apps are being used to continuously monitor a patient’s vital signs, opening up new ways of managing long term conditions such as diabetes.
Artificial intelligence is revolutionising diagnostics, with machine learning technologies set to improve the accuracy and speed of diagnosis, as is already underway at Moorfields Hospital.
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Cloud still hangs over patient data sovereignty concerns

While our cybersecurity columnist Davey Winder has no problem with his data being held in the cloud, he is worried about this recent push to off-shored cloud services and the possibility of NHS patient data being stored outside the UK.
May 4, 2018
The debate surrounding security and the cloud has, for the most part, long since been settled: it’s not insecure by design. Of course, that doesn’t mean there aren’t security issues as far as cloud-based storage is concerned – just that they tend to be like the threats that are prevalent across the enterprise storage space.
But that didn’t stop 61% of NHS trusts responding to a freedom of information request earlier in the year citing security and compliance as being the biggest barriers to cloud adoption.
Practically speaking, the security concerns surrounding the cloud tend to be issues such as vulnerabilities in web applications. According to Alert Logic there has been a 300% increase in such attacks since 2014 and 75% of all ‘events’ logged by the cloud security specialists during the last 18 months involve them in one way or another.
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Apple Watch Alerts Users to Seek Medical Attention, Saving Lives

Doctors say alerts from the smartwatch urging users to seek medical attention saved their lives.
By Alexa Lardieri, Staff Writer May 3, 2018, at 11:31 a.m.
The Apple Watch is credited with saving two lives in April by alerting users to immediately seek medical attention.
William Monzidelis received this notification on his smartwatch when he was working at his family's bowling alley in New York. The 32-year-old began feeling dizzy and went to the bathroom, where he began bleeding. When he returned to tell his mother he wasn't feeling well, she said he "looked like a ghost," NBC New York reported.
After receiving the alert to seek medical care immediately, Monzidelis and his mother rushed to the hospital.
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FDA on the hunt for its own EHR system

By Rachel Z. Arndt  | May 3, 2018
The Food and Drug Administration is looking for a "large electronic medical record system" to conduct research about adverse drug reactions.
The FDA's Bioinformatics and Biostatistics Division will use the EHR to look into the "safety and surveillance of FDA regulated products," according to the request for quote the agency posted earlier this week. Specifically, researchers will analyze VA data to look for adverse side effects from medications. It will use the EHR to develop "novel data mining and data visualization" to apply to the data.
Right now, those data exist in different versions of VistA, the VA's home-grown EHR.
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Allscripts Acquires HealthGrid to Enhance Patient Engagement Tools


The EHR vendor will absorb HealthGrid's patient engagement tools such as the patient portal.
May 04, 2018 - EHR vendor Allscripts has acquired HealthGrid, a provider of enterprise patient engagement solutions that help connect patients with their providers.
The acquisition, which should be complete by the end of the second quarter of 2018, will allow Allscripts to absorb HealthGrid’s offerings into the Allscripts patient portal tool, FollowMyHealth. Currently, FollowMyHealth allows patients to utilize traditional patient portal functions including patient data access and secure messaging.
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Feds issue guidance on substance abuse confidentiality law

Published May 04 2018, 7:28am EDT
The Office of the National Coordinator for Health IT and the Substance Abuse and Mental Health Services Administration have issued guidance to help providers apply Title 42 of the Code of Federal Regulations Part 2 to healthcare settings, including the electronic exchange of health information.
42 CFR Part 2, which protects the confidentiality of substance use disorder patient records, was passed by Congress in 1975 because of concerns about the potentially negative consequences that could come from disclosing such information.
However, much has changed since the law governing the confidentiality of substance use disorder records went into effect, including the widespread adoption of electronic health records by providers. And, with the opioid epidemic continuing to take a toll on the lives of Americans, ONC and SAMHSA contend that it is critical for individuals with substance use disorders to get the safest and most effective treatment possible.
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HIT Think How computational modeling and simulation could benefit care delivery

Published May 04 2018, 5:54pm EDT
It currently takes more than $100 million and eight years to bring a new high-risk medical device to market. These numbers are growing every year, but what if those numbers could be cut in half? What if medical devices could be designed and safely tested in the virtual world before ever being used on a real person?
Researchers, pharmaceutical manufacturers, scientists, doctors and other industry leaders are turning to virtual worlds and computational modeling and simulation (CM&S) software to answer this exact question.
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Amazon, Apple only part of 'seismic change' coming to healthcare

More than 80 percent of the Fortune 50 already have a presence in the market, so here’s what hospital IT shops should be thinking about as they digest that reality.
May 01, 2018 04:10 PM
Health executives know about Amazon, Apple, Google, IBM and Microsoft making moves into the healthcare industry but there are far more Fortune 50 companies that already have a foot in the space. 
Translation: Healthcare is even more ripe for disruption than it presently appears. And that means it’s time to act fast or face irrelevancy. 
Here’s a look at what hospital IT shops should be doing now to prepare for the future. 
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Blockchain for healthcare – closer than we think?

Big opportunities, and challenges, ahead for the distributed ledger, from EHRs to supply chain and security.
May 03, 2018 09:30 AM
Blockchain holds big potential for overcoming issues of trust and ironing out technology wrinkles in the sharing of clinical and financial data in healthcare. While that is becoming increasingly widely discussed, it’s also true that the distributed digital ledger technology is still somewhat shrouded in mystery and has that futuristic feel about it. 
There’s little questioning the road ahead will be long but new evidence is emerging that perhaps practicable uses of blockchain are closer than many health IT and security professionals currently think. 

Blockchain: healthcare to benefit from financial services early work

New research from Deloitte and Chilmark offer a real-world look at what’s happening in blockchain today. 
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Machine Learning Can Quiet “Building Crescendo” of EHR Dissatisfaction

Allscripts CEO Paul Black sees a bright future for electronic health records as machine learning matures into a valuable tool to reduce EHR dissatisfaction.

May 02, 2018 - The notion that electronic health records are difficult to work with and cumbersome to use has become a worryingly common theme across the healthcare industry. 
Providers working in organizations of all sizes, settings, and specialties have experienced, or know someone who has experienced, some sort of issue, glitch or hiccup with their EHRs – and these problems can sometimes drastically impact patient care.
It’s easy to assume that frustration has always been and will always be the default emotion tied to EHR use.
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Ransomware targets healthcare industry the most: 4 things to know

Written by Julie Spitzer | May 02, 2018 
For the second consecutive year, healthcare was the sector hardest hit by cyberattacks, according to Cylance's 2017 Threat Report released May 1.
For its report, Cylance — a cybersecurity firm that uses artificial intelligence to protect against threats — reviewed attacks that affected its global customer base, which spans multiple industry sectors, in 2017.
Here are four report insights.
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More than 347k HITECH breaches since 2009 — What gives?

Written by Julie Spitzer | May 02, 2018 |
Since the Health Information Technology for Economic and Clinical Health Act was implemented in 2009, HHS' Office for Civil Rights has received a total of 247,090 breaches of patient data, according to Health Information Privacy/Security Alert.
Roughly 344,823 of those breaches affected fewer than 500 patients each, but 2,267 of them appeared on OCR's "Wall of Shame" — a publicly accessible data breach portal that displays HIPAA violations affecting more than 500 individuals.
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Poor data hygiene a leading cause of insider data breaches

Published May 03 2018, 7:28am EDT
Although insider threats have been a concern in cybersecurity for years, relatively little has been done to address the leading cause—poor data hygiene, says Larry Ponemon, chairman and founder of the Ponemon Institute.
Insider threats occur when employees intentionally or unintentionally misuse access to confidential information that compromises the safety of an organization’s information systems.
The total average cost among 3,269 insider threats over the past year was $8.76 million, according to a new report for which the Ponemon Institute interviewed 717 IT and IT security practitioners in 159 organizations in North America, Europe, the Middle East, Africa and Asia-Pacific. The firm completed the interviews in January.
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HIT Think How providers can implement the NIST cybersecurity framework

Published May 03 2018, 5:37pm EDT
The use of cybersecurity frameworks is becoming more prevalent because of pervasive threats and attacks across the healthcare industry. Large organizations are now especially motivated to adopt a framework and implement tighter, more consistent controls.
The NIST Cybersecurity Framework is designed to help organizations establish the minimum viable policies, procedures and practices to safeguard against theft of data or attacks on their systems. And, while organizations are not required to use the NIST Cybersecurity Framework, or report on the type of framework in place, they must at the very least comply with the HIPAA Security Rule, which has been crosswalked to the NIST Cybersecurity Framework.
Here are some fundamental questions and recommendations for instituting a cybersecurity framework based largely on the NIST model.
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Algorithm as accurate as radiologists in assessing breast density, cancer risk

Published May 03 2018, 7:34am EDT
Software that assesses breast density is just as accurate in predicting women’s risk of breast cancer as a typical evaluation of images conducted by radiologists, according to researchers at UC San Francisco and the Mayo Clinic.
In the largest study of its kind to date, researchers pitted automated breast density software from New Zealand’s Volpara Solutions against Breast Imaging Reporting and Data System (BI-RADS) density categories estimated by radiologists.
What they found was that automated and clinical BI-RADS evaluations “similarly predict interval and screen-detected cancer risk, suggesting that either measure may be used to inform women of their breast density.” The results of the study were published May 1 in the Annals of Internal Medicine.
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NIH to start national enrollment for PMI cohort on May 6

Published May 02 2018, 7:04am EDT
The National Institutes of Health will officially begin national enrollment on May 6 for the Precision Medicine Initiative’s All of Us research program, an effort to recruit a million or more participants to contribute their physical, genomic and electronic health record data.
On Sunday, NIH will hold community launch events in seven U.S. cities—including Birmingham, Chicago, Detroit, Kansas City, Nashville, New York and Pasco, Wash.—as well as an online event to start enrolling volunteers with the goal of creating one of the largest and most diverse biomedical datasets of its kind for medical research.
According to NIH, the EHR data leveraged by the All of Us program will “offer useful information related to medical histories, side effects and treatment effectiveness” to more precisely prevent and treat a variety of health conditions.
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Patients prefer the doctor without the computer, MD Anderson researchers find

Apr 24, 2018 9:15am
Take the computer out of the exam room and patients perceive the doctor as more compassionate and professional, with better communication skills.
That’s the finding of a study by researchers at the University of Texas MD Anderson Cancer Center in Houston, published in JAMA Oncology.
The researchers conducted the randomized clinical trial to assess patients’ perception of doctors who use a computer in the examination room.
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3 ways to guard against distracted doctoring even as digital devices add to the problem

May 2, 2018 5:17pm
Everyone has heard about the problem of distracted driving and, even, districted walking. But what about distracted doctoring?
It's a problem that can endanger patients and increase medical liability, according to Shelley Rizzo, patient safety risk manager at physician-owned medical malpractice insurer The Doctors Company.
When a doctor takes attention away from a patient, it increases the potential for a serious patient safety event, Rizzo said in an interview with FierceHealthcare. 
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SamSam Ransomware Attacks Focus on Victims Who Will Pay Up

Cybercriminals carrying out SamSam ransomware attacks, which are targeting healthcare organizations this year, focus on victims that are most likely to pay to get their data back, according to an analysis by security firm Sophos.

May 01, 2018 - Cybercriminals carrying out SamSam ransomware attacks, which have been identified by HHS as posing a significant threat to healthcare organizations this year, focus on victims that are most likely to pay to get their data back, such as hospitals, according to an analysis by security firm Sophos.
The SamSam cybercriminals use two methods to get access to their target organization: they either exploit system vulnerabilities to gain access to the target’s network or they launch brute-force attacks against weak passwords of the remote desktop protocol (RDP) function.
Once cybercriminals have penetrated the target organization’s network, they look for more victims through network mapping and stealing credentials, according to Sophos. They then manually deploy the SamSam ransomware on selected systems using PSEXEC and batch script tools.
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Full ONC SAFER Guide Implementation Low, EHR Safety Can Improve

A study determined that new national policy initiatives could help stimulate ONC SAFER guide implementation and improve EHR safety and usability.

May 01, 2018 - Healthcare organizations looking to improve EHR safety and usability can look toward ONC SAFER Guides that were updated in 2017. However, a recent study found that adherence to recommended EHR safety practices is low, even with recommendations on how to improve EHR use being widely available.
Healthcare organizations are more likely to follow technical recommendations with EHRs than those that “require workflow and process enhancements related to clinical areas of concern or recommendations to use technology to reduce safety concerns,” according to Sittig, et al.
“Uptake of the remaining SAFER recommendations will likely increase as organizations become more confident in their abilities to develop new policies, procedures, clinical workflows, and configure and maintain their EHR implementations,” researchers continued. “Finally, full implementation of the SAFER recommendations will require organizational prioritization, resource allocation, policy changes, and vendor participation.”
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NIH’s All of Us Program Hits Milestone with National Enrollment to Launch May 6

May 1, 2018
by Heather Landi
The All of Us Research Program has enrolled 45,000 participants during the beta phase, with 27,000 individuals completing the entire enrollment protocol.
The National Institutes of Health’s “All of Us” Research Program, an unprecedented effort to advance precision medicine, has hit a significant milestone as the enrollment beta phase is ending and the program’s open national enrollment will launch May 6.
The All of Us Research Program, established by the White House in 2015, aims to advance precision medicine by studying the health data of 1 million diverse Americans over the next five years. The official launch date, which is this Sunday, will be marked by community events in seven cities across the country as well as an online event, according to NIH officials. Volunteers will join more than 25,000 participants already enrolled in All of Us as part of a year-long beta test to prepare for the program’s national launch. The overall aim is to enroll 1 million or more volunteers and oversample communities that have been underrepresented in research to make the program the largest, most diverse resource of its kind.
“The idea of bringing together 1 million people from all walks a life to partner in the research process might have seemed like a pipe dream 15 years ago, but today it’s a reality,” Francis Collins, NIH director, said, during a media briefing announcing the official national enrollment launch date. “It’s ambitious” Collins said, adding, “The ‘All of Us’ research program is among the most ambitious research efforts that our nation has ever undertaken.”
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Fitbit, Google to support wearables in care coordination

Published May 01 2018, 7:26am EDT
Fitbit, a major vendor of fitness software to help individuals track their activity and exercise levels, has teamed up with Google to accelerate innovation in the healthcare wearables market to better manage chronic care and improve collaboration among patients’ healthcare providers.
Company executives say they are exploring opportunities to develop digital consumer and enterprisewide healthcare solutions. However, beyond the initial announcement of the partnership, the companies are not providing any additional details.
The core idea is to give patients and providers a better view of a patient’s health, which can lead to a personalized care plan, according to the companies.
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Mayo Clinic CIO Christopher Ross on breaking the $1 billion EHR and IT modernization rollout barrier

Ross explains tactics for managing a project of this scope, as well as challenges, possible pitfalls, and why Mayo focused on user experience and optimization before the deployment not after -- which is all too common.
May 01, 2018 10:21 AM
Mayo Clinic is on the cusp of one of the biggest and most expensive EHR go-lives in history. 
When the health system replaces Cerner and GE software with Epic’s electronic health record on May 5, at its Rochester, Minnesota,  headquarters, the go-live will be the most critical piece of a massive technology project dating back to 2013. But it won’t the last: Launches in Arizona and Florida are scheduled for October 2018. 
Cost of the total project, which includes several pieces in addition to the EHR: $1.5 billion
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ONC ‘hard at work’ on standards for big-picture data about U.S. health care

Carten Cordell
It’s often said that data is the new oil of the age, and Donald Rucker wants the health care industry, with help from the federal government, to start taking better advantage of it.
The head of the Office of the National Coordinator for Health Information Technology (ONC) says his team is in the “early stages” of developing health care data standards for population-level data to help make it more shareable across electronic health records (EHR) systems.
“There is no broad-based computable standard to look at the care that American providers provide,” he said April 27 at the AcademyHealth Health Datapalooza. “Think about that for a second: There is no computable accountability of the care that we are providing. That’s a pretty stunning type of thing to say in 2018.”
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Top 12 Ways Artificial Intelligence Will Impact Healthcare

Artificial intelligence is poised to become a transformational force in healthcare. How will providers and patients benefit from the impact of AI-driven tools?

April 30, 2018 - The healthcare industry is ripe for some major changes.  From chronic diseases and cancer to radiology and risk assessment, there are nearly endless opportunities to leverage technology to deploy more precise, efficient, and impactful interventions at exactly the right moment in a patient’s care.
As payment structures evolve, patients demand more from their providers, and the volume of available data continues to increase at a staggering rate, artificial intelligence is poised to be the engine that drives improvements across the care continuum.
AI offers a number of advantages over traditional analytics and clinical decision-making techniques.  Learning algorithms can become more precise and accurate as they interact with training data, allowing humans to gain unprecedented insights into diagnostics, care processes, treatment variability, and patient outcomes.  
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VA Tool Improves Patient Access to Health Data, Medical Images

The tool will allow patient access to health data and medical images over the veteran patient portal.

April 30, 2018 - The VA has launched a new system for patient access to health data and medical images, thus allowing patients to stake a larger claim in their own healthcare.
The system, called the VA Medical Images and Reports, will be embedded in veteran patient portals using VA’s My HealtheVet. Patients may view, download, or share their radiology studies, X-rays, mammograms, MRIs, and CT scans. All of this data will also be stored in the patient’s EHR file.
The VA Medical Images and Reports comes as a part of VA’s efforts to improve patient engagement and veteran access to their own health data, as first espoused in VA’s Blue Button initiative, according to acting VA Secretary Robert Wilkie.
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Opioid epidemic: Why aren't prescription drug monitoring programs more effective?

Every state outside of Missouri already has a PDMP in place, but issues with data standardization and differences in regulations inhibit their potential.
April 30, 2018 03:59 PM
Long before the opioid epidemic was thought to be a public health emergency, prescription drug abuse and misuse were steadily increasing in the U.S. 
To combat this, states and hospitals have been building technological platforms to enable prescription drug monitoring programs that can the track habits of both prescribers and patients. But use of PDMPs varies by state, with some states mandating its use and others merely recommending that hospitals and medical groups opt-in. 
With the Trump administration saying it will crack down on opioid abuse, it begs the question: Could these data-heavy platforms make a dent in the crisis?
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FDA chief sees big things for AI in healthcare

Scott Gottlieb, MD, is bullish on the opportunities artificial intelligence could bring to EHRs, decision support and more.
April 30, 2018 08:51 AM
At AcademyHealth’s 2018 Health Datapalooza on Thursday, the U.S. Food and Drug Administration offered a vote of confidence for artificial intelligence in healthcare, promising more refined strategies for regulation, touting its tech incubator for AI innovation and announcing a new machine learning partnership with Harvard.
"We’re implementing a new approach to the review of artificial intelligence," said FDA Commissioner Scott Gottlieb, MD. As one example, he pointed to the agency's approval earlier this year of a new clinical decision support software that uses AI algorithms to help alert neurovascular specialists of brain deterioration faster than existing technologies.
"AI holds enormous promise for the future of medicine, and we’re actively developing a new regulatory framework to promote innovation in this space and support the use of AI-based technologies," said Gottlieb. "So, as we apply our Pre-Cert program – where we focus on a firm’s underlying quality – we’ll account for one of the greatest benefits of machine learning – that it can continue to learn and improve as it is used."
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ONC Working with Health IT Innovators to Improve Interoperability

ONC is encouraging health IT innovators to develop APIs that improve interoperability and health data access.

April 27, 2018 - ONC is currently working with health IT innovators to spur the development of application programming interfaces (APIS) that improve interoperability and patient health data access, according to a recent Health IT Buzz blog post by National Coordinator for Health Information Technology Don Rucker, MD.
“As part of ONC’s role in coordinating health information technology (health IT) nationally, we are working with innovators to develop modern APIs that support the use of mobile apps to help individuals manage their own health or the health and care of a loved one,” Rucker wrote.

“A robust health app ecosystem can lead to disease-specific apps and allow patients to share their health information with researchers working on clinical trials to test a drug or treatment’s efficacy, or monitoring outcomes like those in the National Institutes of Health’s All of Us Research Program,” he continued.
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HIT Think Eight steps for overcoming data risks posed by third parties

Published April 30 2018, 6:20pm EDT
Third-party risk management is becoming increasingly top-of-mind for organizations as they attempt to protect their privacy and confidential data and improve their security and risk exposure as part of the overall health of their organization.
High-profile breaches in the healthcare industry continue to bring to the forefront the risks third parties can introduce to an organization. As the cloud has increasingly become mainstream, an entirely new set of external risks has been introduced to our environment.
Most organizations today rely on several—if not dozens—of external/SaaS applications to run their business, not to mention cloud-based infrastructure and platform offerings. Data ranging from employee vacation time to business documentation to confidential customer information now resides in the cloud, creating a new frontier of risk with which organizations must now contend.
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Family physicians considering staging new protests over problems with e-health system

  • 2018-04-29
  • LETA/TBT Staff
RIGA - Family physicians are running out of patience over the continuing glitches in the e-health system, and some of them have been urging the Latvian Family Physicians' Association to organize a protest, the association's president Sarmite Veide told LETA.
She added that staging a protest could be considered during the Family Physicians Association's general meeting on June 8.
Family physicians have been using the e-health system to issue electronic sickness leaves and prescriptions since the beginning of the year. Although four months have passed since using the system became mandatory, various glitches in the system have not been fixed yet, and the system continues to be very slow, stressed Veide.
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Enjoy!
David.

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