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, August 04, 2018

Weekly Overseas Health IT Links – 4th August, 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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Interoperability now the top priority for NHS IT Leaders

Interoperability has become the highest single priority issue for NHS IT Leaders, according to the findings of the 2018 NHS IT Leadership Survey.
26 July 2018
An overwhelming 82% of respondents said that interoperability that enabled systems and staff to share information on patients was their highest priority. In the 2017 edition of the survey, the figure was just 51%.
The next highest priorities identified were clinical engagement, identified by 76%; moving to paperless working (73%); and ensuring a reliable, resilient, secure infrastructure (67%).
The annual NHS IT Leadership Survey, carried out by Digital Health Intelligence, exclusively surveys the priorities and concerns of NHS digital leaders, including the most senior IT professionals and doctors and nurses working on digital projects.
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NHS England ‘to publish AI code of conduct later this year’

NHS England plans to publish a code of conduct for the use of artificial intelligence (AI) in healthcare later this year.
Hanna Crouch – 19 July, 2018
Harpreet Sood, associate CCIO at NHS England, made the announcement at The King’s Fund’s Digital Health and Care Congress 2018 on 11 July.
When questioned by an audience member about concerns regarding AI use in the NHS, Sood said NHS England was hoping to publish a “basic terminology of what AI means” and a code of conduct later in 2018.
Sood added that the documents will help provide ‘principles’, ‘guidance’ and ‘transparency’ for the use of AI within the NHS.
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IBM’s Watson gave unsafe recommendations for treating cancer

Doctors fed it hypothetical scenarios, not real patient data

By Angela Chen@chengela Jul 26, 2018, 4:29pm EDT
IBM’s Watson supercomputer gave unsafe recommendations for treating cancer patients, according to documents reviewed by Stat. The report is the latest sign that Watson, once hyped as the future of cancer research, has fallen far short of expectations.
In 2012, doctors at Memorial Sloan Kettering Cancer Center partnered with IBM to train Watson to diagnose and treat patients. But according to IBM documents dated from last summer, the supercomputer has frequently given bad advice, like when it suggested a cancer patient with severe bleeding be given a drug that could cause the bleeding to worsen. (A spokesperson for Memorial Sloan Kettering said this suggestion was hypothetical and not inflicted on a real patient.)
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Homeland Security warns of spike in ERP system attacks

The web-based applications are designed to help organizations manage finances, HR issues and more – meaning they contain troves of personal data sought by nation-state hackers and other cybercriminals.
July 26, 2018 03:59 PM

The U.S. Department of Homeland Security is warning organizations across healthcare and beyond of increased nation-state, criminal group and hacktivist activity against enterprise resource planning systems used to manage finances, human resources and other business activities.
The alert comes just two days after two investigative reports on the activity spike by security firms Onapsis and Digital Shadows.
ERPs are web-based applications designed to manage everyday business operations, which means the systems hold a trove of valuable information. According to the report, the increase in zero-day exploits and vulnerabilities are mostly surrounding Oracle and SAP products, the largest providers of cloud-based ERPs.
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Survey finds most practices have portals, but don’t derive benefits

Published July 27 2018, 5:09pm EDT
Most physician group practices offer portals, a recent survey suggests that they’re not getting much value from them.
The survey, by the Medical Group Management Association, found that nine out of every 10 responding practices have a portal in place. The ability for patients to access information electronically is one capability prescribed by the federal Meaningful Use financial incentive program.
However, portal functionality available to patients can vary. While 43 percent of respondents have a portal that accepts patient-generated health data for clinician review, 37 percent don’t have that capability and remaining respondents were not sure if their portal offered it.
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NHS test drones for blood and medical test delivery between London hospitals

Early research says using drones could save $21 billion annually to the broader UK economy.
July 26, 2018 10:28 AM
A fleet of drones flying over London rooftops carrying life-saving blood and medical results between hospitals could be on the horizon, but a UK report has found regulatory and infrastructure obstacles need to be overcome.
The Flying High report by innovation foundation Nesta studied the possible rapid transportation of light medical deliveries between hospitals in the UK’s capital and says the increased speed and reliability could cut costs and improve patient care. But barriers include the need for air traffic control systems to allow drones to operate at scale without interfering with each other or traditional aircraft. 
The project team collaborated with five UK city-regions and experts from the NHS and emergency services, as well as technology experts and regulators, to study use-cases for drones, including when car accidents and fires occur.
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July 25, 2018 / 9:13 PM / 2 days ago

Study warns of rising hacker threats to SAP, Oracle business software

LONDON (Reuters) - At least a dozen companies and government agencies have been targeted and thousands more are exposed to data breaches by hackers exploiting old security flaws in management software, two cyber security firms said in a study published on Wednesday.
The Department of Homeland Security issued an alert citing the study by security firms Digital Shadows and Onapsis that highlights the risks posed to thousands of unpatched business systems from software makers Oracle (ORCL.N) and SAP (SAPG.DE).
These can enable hackers to steal corporate secrets, the researchers said.
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2 UN agencies create focus group for AI in global healthcare

Written by Anuja Vaidya (Twitter | Google+)  | July 25, 2018 | Print  | Email
Two United Nations specialized agencies — the International Telecommunication Union and the World Health Organization — established the ITU Focus Group on AI for Health.
The focus group will develop an international standards framework for the way AI is used in the healthcare sector. It will engage experts, including researchers, engineers and policy makers, to create guidelines steering the creation of national policies around the safe and appropriate use of AI in healthcare. It will also identify use cases of AI in the health sector that can be scaled globally.
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Verma: Many providers are holding patient medical records hostage

Published July 26 2018, 7:35am EDT
Many healthcare providers are holding medical records hostage by denying patients access to their own health data.
That’s the message CMS Administrator Seema Verma delivered on Wednesday in a speech at The Commonwealth Club of California in San Francisco.
“The use of electronic health records has merely replaced paper silos with electronic ones, while providers—and the patients they serve—still have difficulty obtaining health records,” Verma told the audience.
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HIT Think Cloud vs. data center—how to make the best decision

Published July 26 2018, 5:21pm EDT
It’s hard to get by without some kind of formal data management system. If an organization isn’t collecting and actively using data that’s been collected on patients and customers, it may not be able to reach them; and if it isn’t using data to optimize operations, it will be working at less-than-peak efficiency indefinitely.
However, data storage and management bring a new web of complexity to an organization. It can try to handle it all itself by investing in a data center and recruiting the right people to handle its management, or it can pay money to an outside firm to handle those responsibilities.
Each approach comes with its share of advantages and disadvantages, so HIT executives should make the decision that’s right for their organizations.
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Blockchains for biomedicine and health care are coming. Buyer: be informed

By Andy Coravos and Noah Zimmerman
July 25, 2018
Dom Smith/STAT
In a First Opinion piece on how blockchain technologies could affect health care and the life sciences, its landscape map included 48 projects covering areas like decentralized health records and data marketplaces. Just six months later, the map has tripled in size, covering nearly 150 projects that have raised more than $660 million in private and blockchain-funded (crypto) markets.
While a blockchain health care unicorn has yet to be crowned, the health care industry has seen substantial interest from developers and investors. The dizzying pace has made it difficult to assess what is going on in this space. That’s why Elektra Labs, a startup backed by the National Science Foundation I-Corps, joined forces with the newly-formed Center for Biomedical Blockchain Research at the Icahn School of Medicine at Mount Sinai to create a dataset and accompanying framework for understanding and tracking developments in health care and biomedical blockchains.
At its core, a blockchain is a digital ledger (similar to a spreadsheet) in which transactions are recorded chronologically and openly. The ledger is decentralized, with multiple copies stored across a large network of computers. It does not rely upon a central authority, like a bank or broker, to verify transactions. Participants who update the ledger can be paid for their work using a digital currency or token, like Bitcoin, Ethereum, or a specialty token customized for a specific project.
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How an academic medical center integrated AI into its Epic EHR to improve diagnoses

The department of emergency medicine at the University of Maryland uses imaging-oriented technology as a virtual specialist in the ER.
July 25, 2018 09:26 AM
Emergency room physicians are almost always asking themselves, “What’s in front of me right now? Is this independent from the problem the patient has or is it part of the problem?” To answer these questions effectively, the physicians must know a lot about many different diseases.
“To master skin diagnoses, for example, I read a lot of atlases and earlier books from dermatologists, but the problem myself and my colleagues would run into is that we had the information available but not the visual component to answer the question, ‘What is it I’m looking at?’” said Brian Browne, MD, chair of the department of emergency medicine at the University of Maryland.
To overcome these challenges, Browne and his team deployed an imaging-based, artificial intelligence-powered clinical decision support tool from vendor VisualDx. The tool uses more than 100,000 medial images, available through a desktop or a smartphone.
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A CIO's take on EHR optimization: Engaging clinicians via many methods is critical to understanding their needs

Penn Medicine’s Mike Restuccia explains why instituting an end user survey is such an important, and eye-opening, step to take.
July 25, 2018 10:02 AM
We’ve officially entered into the “dog-days” of summer here in the mid-Atlantic states. When I think back to the biting cold wintertime in January it seemed that summer would never appear, yet it has arrived in full force. I use this metaphor because it closely resembles the electronic health record (EHR) optimization challenges that many of us face. 
After years of toiling, building and deploying, users are asking for more out of their EHR; and rightfully so! Industry statistics indicate that users in all industries tend to use between 50 percent and 60 percent of the functionality provided in their core application suite. 
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RDP backdoors cost just $10 on dark web: How to avoid getting hacked

With access to hacked machines cheaply available and thousands of new ports being added daily, it’s imperative to shore up this preventable threat.
July 25, 2018 09:08 AM
Over the last six months, brute force attacks on Remote Desktop Protocols have become a common headline. Consider the cases of LabCorp, the city of Atlanta, multiple health systems, Colorado Department of Transportation and others.
Most recently, in fact, Cass Regional Medical Center’s EHR went down for a week after a brute force attack on its RDP. The recent attack on LabCorp was reportedly caused by an RDP attack using the notorious SamSam ransomware.
While officials have yet to confirm the cause of the system outage, RDP attacks are a common method for the SamSam virus. And just this year, SamSam took down Allscripts for a week, again, officials did not confirm the hacker’s entry point.
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Google Cloud joins NIH initiative to create a biomedical database

Jul 25, 2018 1:40pm
Google Cloud is the first to join a new initiative by the National Institutes of Health (NIH) to create a biomedical database, the agency announced on Tuesday.
Google will provide cloud computing services as part of NIH’s Science and Technology Research Infrastructure for Discovery, Experimentation and Sustainability (STRIDES) Initiative, which aims to give researchers access to biomedical data sets. The agency’s initial focus is to make “high-value data sets more accessible through the cloud” as well as incorporate artificial intelligence and machine learning to optimize research.
As part of its agreement, more than 2,500 academic institutions will be able to use Google Cloud’s storage, computing and machine learning capabilities.
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7 Ways to Better Secure Electronic Health Records

Healthcare data is prime targets for hackers. What can healthcare organizations do to better protect all of that sensitive information?
7/24/2018
11:00 AM
January was not a particularly bad month for electronic health record (EHR) breaches. Still, in just those 31 days, nearly a half-million records were exposed to unauthorized viewers.
According to the HIPAA Journal, the top four breaches in January were all the result of hacking or an IT incident, exposing more than 387,000 records. While these numbers pale in comparison to the tens of millions of records involved in recent credit bureau and social media hacks, the sensitive nature of the records amplify the damage done.
What's more, the number of records lost to hacking or IT incident has steadily increased year over year since 2009 (though authors of the "January 2018 Healthcare Data Breach Report" note that at least some of that increase could be due to a lack of reporting in earlier years). 
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Senate confirms Robert Wilkie to head VA, will prioritize EHR project

After months without a permanent leader, Wilkie will be tasked with ‘righting the ship’ and is set to focus on the Cerner EHR project, already underway.
July 24, 2018 10:42 AM
Robert Wilkie, a Department of Defense under secretary was confirmed as Department of Veterans of Affairs Secretary on Monday, giving the troubled agency a permanent leader for the first time since March.
The vote of 86-9 makes Wilkie the first VA Secretary to not be unanimously confirmed. Nine Democrats and Bernie Sanders, I-Vermont, dissented. Sanders expressed concern that Wilkie would align with the Trump administration to privatize VA healthcare.
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HIT Think How incentives and deadlines could accelerate interoperability

Published July 25 2018, 5:48pm EDT
Earlier this year, the ONC released the Trusted Exchange Framework and Common Agreement (TEFCA), which responds to a mandate included in 2016’s 21st Century Cures Act and lays out principles, terms and conditions on which to base an interoperability framework that healthcare organizations can embrace.
“Patients who have received care from multiple doctors and hospitals should have their medical history electronically accessible on demand by any other treating provider in a network that signed the Common Agreement,” noted National Coordinator for Health IT Donald Rucker in a recent blog post.
To achieve that goal, TEFCA is divided into two parts—Part A, or the principles ,and Part B, the terms and conditions, which is also where the rubber meets the road for many who live in the healthcare IT world.
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NHS to bolster hospital IT with $540 million in new spending

The UK's new Secretary of State for Health and Social Care says tech transformation is coming to the National Health Service as he pledges big investments.
July 23, 2018 03:32 PM
In his first major speech since becoming the new Health and Social Care Secretary, Matt Hancock has put information technology atop his list of priorities for improving the National Health Service.
And he's backing his words with big money – the UK will invest around $540 million for hospital IT, according to reports, with another $98 million earmarked to help those trusts who still rely on paper make the move to electronic health records.
Hancock said his top three priorities for the NHS were "workforce, technology and prevention," and he said the millions in new funding were needed to boost the efficiency and morale of providers and the engagement of patients.
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Medical errors reported during computer conversion at Banner Health's Tucson facilities

Jul 23, 2018 Updated Jul 23, 2018
Banner-University Medical Center’s nine-story tower, 1501 N. Campbell Ave., will cost $426.7 million and cover 670,000 square feet. It is to be finished in April.
There were “numerous” reports of medical errors after Banner Health’s conversion to a new computer system at its Tucson facilities late last year, state records show.
Records of an Arizona Department of Health Services investigation into complaints about Banner’s computer conversion released to the Star after a public-records request were heavily redacted.
But the records indicate Banner’s Oct. 1 switch adversely affected patients and caused a high level of frustration among some staff members.
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Calculator can predict heart age, risk for heart disease

By Allen Cone  |  July 23, 2018 at 10:47 AM
July 23 (UPI) -- A new online health calculator is available that can predict a person's heart age and risk for heart disease based on a variety of factors.
Researchers developed and validated the Cardiovascular Disease Population Risk Tool, or CVDPoRT, based on data from the Canadian Community Health Surveys of 104,219 Ontario residents, who were between age 20 and 105. The surveys also included data from 2001 to 2007 of hospitalizations and deaths.
The tool was published Monday in Canadian Medical Association Journal and is available online.
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EXCLUSIVE Survey: Industry Execs Express Confidence in Interoperability Advancements

July 23, 2018
by Rajiv Leventhal
New research from Healthcare Informatics asks leading industry organizations their perceptions on key health IT issues
A survey of 459 leading health IT executives reveals that many industry stakeholders see themselves as far along on their interoperability journeys, but less advanced in their value-based care and risk-based contracting progressions.
The research, conducted this summer by Healthcare Informatics, generated 459 responses from healthcare stakeholders spanning various types. Entities such as ACOs (accountable care organizations) and health information exchanges (HIEs) were the highest-volume responders (43 percent of the total), while healthcare providers (25 percent) ranked next highest in response rate. Additional respondents included vendors, payers, teaching universities, and associations, among others.
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Health Data Breach Tally: Lots of Hacks, Fewer Victims

Bigger Organizations 'Have Invested Wisely' in Breach Prevention. What About Smaller Ones? Marianne Kolbasuk McGeeJuly 23, 2018
Hacker attacks are still dominating the data breaches added to the official federal tally so far this year. But compared to the mega-breaches of past years, this year's biggest hacks have been relatively small.
As of Monday, some 199 breaches affecting 3.9 million individuals had been added to the Department of Health and Human Services' HIPAA Breach Reporting Tool website, commonly called the "wall of shame." The website lists health data breaches affecting 500 or more individuals.
By comparison, the 2015 cyberattack on Anthem Inc. affected nearly 79 million individuals. Plus, 2015 attacks against Premera Blue Cross, Excellus BlueCross BlueShield, and UCLA Health affected many millions more.
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Deep learning can be useful in screening for pulmonary diseases

Published July 24 2018, 7:26am EDT
Computer-aided review of X-rays can help diagnose people with lung illnesses such as tuberculosis and pneumonia.
Such review, augmented by deep learning, can help lead to earlier detection and treatment of these conditions, especially in remote areas where specialists are typically in short supply, according to new research.
About one third of people in the world may be infected with tuberculosis. In 2016, there were more than 10 million cases of active tuberculosis, resulting in 1.3 million deaths. It’s the No. 1 cause of death for an infectious disease, and more than 95 percent of these deaths occurred in developing countries. Pneumonia is also prevalent, affecting 450 million people a year around the world, resulting in about 4 million deaths annually.
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Portal to make largest Alzheimer's genetic database available to researchers

Published July 24 2018, 7:11am EDT
Researchers will soon have access to the largest genetic database on Alzheimer’s disease through a new portal designed to make large-scale DNA sequence data available to qualified investigators.
The portal for the National Institute on Aging Genetics of Alzheimer's Disease Data Storage Site (NIAGADS) is currently undergoing beta testing involving a small number of investigators, with broader access slated to begin next month.
Whole-genome sequence data for 5,000 subjects, including Alzheimer's cases and cognitively normal controls, are being made available to researchers. An additional 20,000 subjects will become available next year to the research community as part of the Alzheimer's Disease Sequencing Project, a National Institute on Aging initiative to fully sequence the DNA of as many as 25,000 individuals.
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AI scours 1.2 million appointments to cut doc office wait times

Published July 24 2018, 4:11pm EDT
A Quebec tech company said it can cut wait times in doctors’ offices to less than 20 minutes and save patients 6.5 million hours a year in the Canadian province alone.
Bonjour Sante, which manages bookings for more than 300 clinics in Quebec, teamed up with Montreal’s flagship AI lab to create an algorithm predicting delays. The model looks at tens of thousands of past appointments through 1,900 parameters—from the weather to the type of medical-file software the doctor uses. Two hours before the scheduled time, patients receive a text estimating when the doctor will actually see them.
The service is currently offered at 10 clinics in the Bonjour Sante network at no additional charge. Founder Benoit Brunel said potential paying clients include hospitals and eventually, other industries struggling with needless waits.
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HIT Think How bad data is worse than no data at all

Published July 24 2018, 12:49pm EDT
Accurate and reliable data can bring context to research studies, help people understand trends, aid executives in knowing what’s working well for achieving organizational goals and much more.
However, data discernment is crucial. Bad data can completely negate all the positive factors of trustworthy information.
Some glaring imperfections in data can be spotted right away. For example, those working closely with healthcare data might find various misspelled names or cases in which an entry appears two or more times in a list but should only be there once or date-related inaccuracies.
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Hackers breach 1.5 million Singapore patient records, including the prime minister's

In what officials say was a "deliberate," highly targeted attack, cybercriminals repeatedly targeted Singapore Prime Minister Lee Hsien Loong’s personal records.
July 20, 2018 12:45 PM
Hackers breached the Singapore government’s health database with a “deliberate, targeted and well-planned” cyberattack, accessing the data of about 1.5 million patients, including Prime Minister Lee Hsien Loong, for almost a full week.
The cybercriminals initially breached a front-end workstation to gain privileged account credentials to obtain privileged access into the database. Officials said they detected unusual activity on July 4, but the hack began on June 27.
The investigation found the hackers didn’t tamper with the records, rather they exfiltrated the data. Officials said the attack was well-planned, and it wasn’t the work of “casual hackers or criminal gangs.”
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Here's what cybersecurity professionals at companies actually do, and why they're so vital

  • Cybersecurity headlines can be interpreted by looking at them as from the viewpoint of a chief information security officer or CISO.
  • The title, referring to the top cyber executive at a company, was first used at Citigroup in the mid-90s, when the bank hired Steve Katz to set up a new kind of security office.
Published 9:09 AM ET Sat, 21 July 2018 
Stephen Katz is the first person to take on the role of chief information security officer.
There's so much cybersecurity news these days, from elections integrity to stolen credit reports to the latest cybersecurity start-up, sometimes it feels like you need a decoder ring to make sense of it all.
One way to start breaking through the jargon and intrigue is to try viewing these issues through the lens of the Chief Information Security Officer (CISO), typically the top cybersecurity executive at a company.
The CISO role dates back to 1994, when banking giant Citigroup (then Citi Corp. Inc.) suffered a series of cyberattacks from a Russian hacker named Vladimir Levin. The bank created the world’s first formal cybersecurity executive office, and hired Steve Katz to run it.
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US health care companies begin exploring blockchain technologies

July 19, 2018 8.42pm AEST

Author Ana Santos Rutschman

Assistant Professor of Law, Saint Louis University
The sprawling U.S. health care industry has trouble managing patient information: Every doctor, medical office, hospital, pharmacy, therapist and insurance company needs different pieces of data to properly care for patients. These records are scattered all over on each business’s computers – and some no doubt in filing cabinets too. They’re not all kept up to date with current information, as a person’s prescriptions change or new X-rays are taken, and they’re not easily shared from one provider to another.
For instance, in Boston alone, medical offices use more than two dozen different systems for keeping electronic health records. None of them can directly communicate with any of the others, and all of them present opportunities for hackers to steal, delete or modify records either individually or en masse. In an emergency, doctors may not be able to get crucial medical information because it’s stored somewhere else. That can result in direct harm to patients.
There might be a way out, toward a health care system where patients have accurate and updated records that are secure against tampering or snooping, and with data that can be shared quickly and easily with any provider who needs it. In my work on health care innovation at the Center for Health Law Studies, at Saint Louis University School of Law, I have been following the rise of a technology that may help us address the weaknesses in today’s health care record-keeping: blockchain.
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Study finds EHR implementation still taking too much time, causing serious errors

Jul 23, 2018 3:48pm
While physicians have long complained about the administrative burden of EHRs, a new study quantifies some of those concerns and shows how even commonly used platforms can complicate simple tasks.
The study, published last week in the Journal of the American Medical Informatics Association (JAMIA), suggests wide variability in the usability and safety of EHRs.
Researchers observed how long it took four groups of physicians and residents to complete common tasks—like ordering an X-ray or prescribing Tylenol—using EHR platforms made by two major vendors, Epic and Cerner. They also measured how many errors the providers made.
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FDA issues guidance on how to use EHR data in clinical studies

Published July 23 2018, 7:02am EDT
The Food and Drug Administration has issued guidance to industry on using electronic health record data in clinical investigations including those involving human drugs and biological products, as well as studies conducted in clinical practice settings.
“EHRs may have the potential to provide clinical investigators and study personnel access to real-time data for review and can facilitate post-trial follow-up on patients to assess long-term safety and effectiveness of medical products,” the FDA’s guidance states. “In addition, there are opportunities for long-term follow up of large numbers of patients, which may be of particular importance in studies where the outcome of interest occurs rarely, such as in prophylaxis studies.”
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HIT Think Why patient matching needs a dual-track approach

Published July 23 2018, 12:50pm EDT
Patient matching with records affects all of us, most of the time without our knowledge.
Whether it is the receptionist at a doctor’s office asking for your date of birth or someone on a care team pulling records from a Health Information Exchange, one of two things is happening behind the scenes. An identifier is establishing your identity across different silos of information, or some kind of statistical matching is being performed.
The identifier is a simple solution, but historically has not been viable. Despite this, our current technology landscape offers two tools to make a universal patient identifier (UPI) practical—the advent of big data and the ubiquity of smartphones.
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Opioid prescribing principles can help doctors fight the epidemic

Published July 23 2018, 4:45pm EDT
The opioid epidemic has become an unprecedented crisis, says Dr. Halee Fischer Wright, president and CEO at MGMA. “Through our research, we’ve put forward both current best practices for, and barriers to, preventing prescription opioid abuse and treating addiction,” she adds.
The association suggests three ways to support development of an effective opioid prescription policy:
* Lines of communication must be open and clear between all parties, including patients, providers, staff members and pharmacists. This helps ensure all parties understand proper use of opioids and can recognize potential misuse.
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Enjoy!
David.

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