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."

Sunday, September 30, 2018

The Father Of The myHR And Ex-CEO of NEHTA Bells The Cat. Basically Its Junk Right Now, And Needs A Decade To Be Fixed If That Is Even Possible!

I was just sent this:

My Health Record – an essential conversation to have in Australia

By Andrew Howard
The recent My Health Record (MyHR) debate has been essential for Australia – across government, technology and health sectors, as well as, with the broader community.  It’s demonstrated how as new technology infrastructures are deployed and technologies evolve, we need to ensure that legislative frameworks keep pace.
And that people, not efficiencies, remain the centre of the system. Because those who engage, support or interact with the MyHR system need to understand it will support their personal health journey now and in the future. 

E-health is changing the health sector

We know that new technologies are rapidly changing Australia’s health system and the way it operates in the future will be vastly different to the way it operates today.  People will receive more health information through technology-enabled systems and devices.  Many consultations will be done virtually, supported by measurement and diagnosis systems that are closer to the consumer’s point of need.  Surgery, too, has already begun to be managed by computers.  In the future many procedures will be monitored by humans – the same way we trust the autopilot in a plane – if we have extraordinarily well-trained pilots.
But it’s not just about technology – it’s also about people. It’s about how, when and where we access the health system. There are periods during our lives where we will rarely see a doctor and other times when we’ll need to access to doctors, specialists and hospitals – and our health records.

My Health Record – one solution to prepare us for the future

The My Health Record database was developed to help prepare for a rapidly changing health system. First deployed in 2012, it was built to be an index service for important health information.  People could opt in to MyHR and control access to their personal health information.  Those with MyHR records could ask their clinicians to upload health information to the record – so that others could access the information.  There were default settings for what was considered sensitive information – such as a prescription for a medication to control an STD.  But in most cases, information would be shared by default.
People could also allow carers and family members access to their medical records through the platform.  They could also control which clinicians could see the information.  An audit trail provided users with a record of the people or  organisations accessing their health data. If an individual accessed the information inappropriately, this would be quickly and easily traced.
Without advertising and government promotion, and limited incentives, the MyHR adoption reached over six million people. Since the MyHR business case, there have been five Health Ministers from both sides of politics who, while needing to re-assess expenditure, agreed that the MyHR is a great initiative and if deployed and managed correctly, will save many lives and reduce the costs of health care delivery.

Privacy and security concerns

The recent decision to move all Australians to MyHR, with the opt out option, raised valid concerns about privacy and security. As pointed out in a Fairfax editorial:
“People who had previously ignored My Health suddenly had to think about the risk that embarrassing, personal information could be hacked and sold or used by governments to persecute or punish. There are precedents including the commercial misuse of social media such as Facebook and a leak of data for 26 million people last year from the British National Health Service.”
In response, Greg Hunt, Minster for Health, announced on 31 July that the MyHR leglisation will be strengthened to match existing Digital Health Agency policy.
This means that a court order is required to release any MyHR information without consent. The amendment will ensure no record can be released to police or government agencies, for any purpose, without a court order.
When it comes to the security of the system, I was directly involved in the designs for defence grade security that was deployed. The security layers were better than the banking sector when it was switched on in 2012.  So, with the ongoing investments in the infrastructure, I am certain that the Australian Digital Health Agency, the Digital Transformation Authority and the Department of Health have maintained an equivalent capability.
There is vastly more here:
Let me pick up a few points:
“Without advertising and government promotion, and limited incentives, the MyHR adoption reached over six million people.”  

No it was all those Aspen Medical staff signing up people in hospital corridors and all those in the opt-out trials they hardly knew about that got to 6 million!
“There are also stringent consumer controls that give Australians control over their medical records.
These controls allow individuals to:
  • apply a record access code to their entire record so that only those healthcare providers with that code can access their record
  • remove documents from their record if they do not want them as part of the record, or apply a limited document access code to restrict access to specific documents, or
  • cancel their record at any time to ensure no one can access the information in the record.”
If they know how, know they have a record and have a computer etc.
"If 97% of Australians adopt the MyHR, this will be a great step forward for the health sector.”

And the evidence for that claim is?

“While the focus has been on encouraging GPs, specialists and hospitals to adopt MyHR, other providers will use the platform as use and acceptance of the system increases. This includes allied health professionals, dentists, aged care facilities, local district nursing services or blood collection services. There are benefits to having a holistic record of a person’s interaction with health or wellness providers.”
I am not sure I want my pathology specimen collector reading myHR – Are you?
“The MyHR was designed on these principles.  It is not a central national database of all health record data.  The MyHR concept of operations stressed the design of an index to the data sources or ‘repositories’ using templates to structure the clinical information on a common terminology and Health Language Seven (HL7) – the international standard for health care interoperability standards.”
So why does the ADHA talk about “all your health information in one place”?
“The current MyHR and the centralised data store of shared health summaries, referrals and diagnostics is a stop gap until FHIR-based clinical systems are brought online.  In five to ten years, the MyHR will likely evolve into an indexing database that accelerates the ability of local systems to interoperate effectively.”
So what we have now is a stop gap system that will evolve over the next decade into what is needed??? What are we to do in the meantime – just put up with a rubbish unusable system?
There is more but it is clear the former NEHTA CEO is not listening to those who wonder what on earth is going on with this program.
Thank you Andrew for explaining all this to us, we really needed the clarity.

AusHealthIT Poll Number 442 – Results – 30th September, 2018.

Here are the results of the poll.

Do You Believe the ADHA Provided Credible, Complete And Accurate Testimony To The Senate myHR Inquiry Last Week?

Yes 0% (0)

No 99% (162)

I Have No Idea 1% (2)

Total votes: 164

This is a totally clear cut with no-one thinking they were honest etc.

If you have not already, don’t forget to come to grips with what we are really facing…..

https://www.youtube.com/watch?v=XlUQMH19BkQ (74,922 views so far!)

This one is also from the same team is also fun!

https://youtu.be/eW-OMR-iWOE (106,483 views so far!)

This time on the planned encryption laws

Any insights on the poll welcome as a comment, as usual.

A really, great turnout of votes!

It must have been an easy question as 2/164 readers were not sure what the appropriate answer was.

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


Saturday, September 29, 2018

Weekly Overseas Health IT Links – 29th September, 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.

System C commits to ‘full FHIR support’ to drive interoperability

System C & Graphnet Care Alliance has announced a commitment to ‘full FHIR support’ for all its shared records, EPR, child health and social care systems.
18 September 2018
The comprehensive commitment is probably the most significant interoperability move yet by a major supplier operating in the UK health and care market.
As well as bolstering the ease with which information can be shared, the move – if successful – potentially positions the company to become a core platform upon which to develop future digital health services.
The FHIR-based APIs are promised across all System C and Graphnet products within two years. The first APIs will be released by the end of the year and are described as extensions of the internal APIs already used by System C and Graphnet.

HIMSS: 4 ways tech can help the opioid crisis

Secure electronic health information can be shared across disciplines to integrate care.
September 21, 2018 03:41 PM
HIMSS on Friday issued a call to the healthcare industry to take action in battling the ongoing opioid crisis in America by using health information and technology.
While reported opioid drug overdoses killed more than 42,000 Americans in 2016 and nearly 48,000 in 2017, both tech and policy must align in the fight.
Specifically, HIMSS recommended four ways:
1. Leverage Prescription Drug Monitoring Programs (PDMPs). A number of states and hospitals are already working on PDMPs to reduce opioid misuse and abuse, beginning with only prescribing opioids when entirely appropriate in the first place. They’re also tracking all prescription data with the aim of preventing avoidable deaths by overdose, allergies or drug-drug interactions.

NHS Digital names first CISO

The National Health Service announced that Robert Coles will serve in the newly created chief information security officer role.
September 21, 2018 01:05 PM
NHS Digital announced that Robert Coles will be its first system-wide Chief Information Security Officer (CISO) starting in October.
Coles spent the last four years as CISO for GlaxoSmithKline and previously held similar roles at National Grid and Merrill Lynch.
The appointment of Coles follows recommendations made by national Chief Information Officer for Health and Care Will Smart in a review looking into last year’s WannaCry cyber-attack.
Sep 21, 2018, 08:30am

Move To Population Health Hits Hospital Finances

Bruce Japsen  
The move to population health and away from fee-for-service medicine is working to the detriment of U.S. hospitals, a new report from Fitch Ratings indicates.
Many would argue that the move to value-based care is a good thing because it’s designed in part to eliminate unnecessary tests, procedures and inpatient hospital admissions long considered a waste when pay is based on volume of care delivered. The Fitch special 2018 report on nonprofit hospitals and health systems shows an industry slow to adapt to these changing reimbursement models.
Sep 21, 2018, 08:30am

Move To Population Health Hits Hospital Finances

Bruce Japsen  
The move to population health and away from fee-for-service medicine is working to the detriment of U.S. hospitals, a new report from Fitch Ratings indicates.
Many would argue that the move to value-based care is a good thing because it’s designed in part to eliminate unnecessary tests, procedures and inpatient hospital admissions long considered a waste when pay is based on volume of care delivered. The Fitch special 2018 report on nonprofit hospitals and health systems shows an industry slow to adapt to these changing reimbursement models.

Many employee work habits seem innocent but invite security threats

Published September 21 2018, 2:28pm EDT
Many employees engage in behaviors that open their organizations to security threats, even though they believe they are risk averse.
A new report from Spanning Cloud Apps, a provider of cloud-based data protection, is based on a survey of more than 400 full-time U.S. employees. It found that more than half (55 percent) admitted to clicking on links they didn’t recognize.
Of survey respondents, 45 percent said they would allow a colleague to use their work computer, and 34 percent were unable to identify an unsecure ecommerce site.

EHR vendor selection process is fraught with risks in alienating docs

Published September 21 2018, 2:16pm EDT
Healthcare organizations that don’t maintain and optimize their electronic health record systems risk having unhappy and unproductive physicians.
That can have catastrophic effects, as some of those clinicians may decide to leave and go elsewhere to practice. This happens more often than many stakeholders might expect, says Jay Anders, MD, chief medical officer at Medicomp Systems, a vendor of software to enhance documentation and streamline workflows.
If an organization asks doctors and other clinicians what they want, many will say that the current documentation setup is backwards to how they actually document, notes Anders, a physician for 20 years before going into administrative posts.

HIT Think How value-based care may provide an answer to addiction treatment

Published September 21 2018, 2:00pm EDT
The shift to value-based care is impacting every aspect of healthcare. As has been well documented in many places, value-based care is built upon the concept of driving enhancements to the quality of care while taking focus away from quantity or volume.
Information technology and care coordination are often seen as the keys to success with value-based care, and now, the approach is being studied in care areas that are challenging the nation’s health systems.
While value-based care is often touted as intended to change the entire healthcare system, most of the efforts have focused on traditional medicine and perceived high-cost aspects of care. For example, bundled payments are often centered around surgical episodes of care, and accountable care organizations ostensibly place primary care at the center.

Lessons From Florence: Set Up Advance HIE Connections

By Mandy Roth  |   September 20, 2018

With proper disaster prep, Health Information Exchanges play key role in transmitting patient data.


Integrate HIEs into disaster preparedness plans.
Think beyond your immediate geographic region.
Establish and test connections before disaster strikes.
Natural disasters, like Hurricane Florence, present challenges to health systems and providers not only in areas directly impacted, but also to those in neighboring regions who treat patients displaced by the catastrophe. One of the greatest issues: access to patient records.
Health Information Exchanges (HIEs), play a critical role in making these records available. But there's a catch. Electronic connections must be set up in advance by HIEs in the impacted areas and in locations where patients may migrate. And, health systems and providers on both sides of the disaster must participate in an HIE and be connected to a data-sharing network for the data transfer to occur.

What if healthcare is not broken? And what if we're actually winning the opioid battle?

Dave Chase puts forth those contrarian viewpoints in his new book, and predicts that millennials will redirect the future of healthcare – which is a good thing.
September 20, 2018 09:00 AM
Here comes a counterargument to two widely held opinions: that the U.S. healthcare system is broken, and that we are losing the battle against the opioid crisis.
Instead, Dave Chase says, healthcare is already fixed because solutions exist to the industry’s biggest dysfunctions – and he has specifics to prove it, such as places in the U.S. that are turning around the opioid problem around entirely.
Chase, co-founder of Health Rosetta, is the author of the new book, The Opioid Crisis Wake-Up Call. And while there are bound to be plenty of skeptics to his argument, there’s also a lot to learn from considering his counterpoint to such widely-held perceptions.

IBM launches cloud tool to detect AI bias and explain automated decisions

Natasha Lomas@riptari / 19 September, 2018
IBM has launched a software service that scans AI systems as they work in order to detect bias and provide explanations for the automated decisions being made — a degree of transparency that may be necessary for compliance purposes not just a company’s own due diligence.
The new trust and transparency system runs on the IBM cloud and works with models built from what IBM bills as a wide variety of popular machine learning frameworks and AI-build environments — including its own Watson tech, as well as Tensorflow, SparkML, AWS SageMaker, and AzureML.
It says the service can be customized to specific organizational needs via programming to take account of the “unique decision factors of any business workflow”.

Fitbit Launches a Connected Health Platform for mHealth Coaching

Fitbit has unveiled Fitbit Care, a connected health platform designed to give healthcare providers, businesses and health plans a telehealth resource for managing remote monitoring and health and wellness programs.

September 19, 2018 - Fitbit is launching a telehealth platform designed to offer coaching and support for healthcare providers, employers and others using mHealth devices in connected health programs.
With the launch of Fitbit Care, the California-based developer of fitness wearables and smartwatches looks to stake its claim as a telehealth company linking consumers and their care providers. Company officials say the new, subscription-based offering can either be a stand-alone solution or wrapped around an existing health and wellness program.

How AI Can Help Stop Cyberattacks

As hackers get smarter and more determined, artificial intelligence is going to be an important part of the solution

By  Adam Janofsky
Sept. 18, 2018 10:09 p.m. ET
As corporations struggle to fight off hackers and contain data breaches, some are looking to artificial intelligence for a solution.
They’re using machine learning to sort through millions of malware files, searching for common characteristics that will help them identify new attacks. They’re analyzing people’s voices, fingerprints and typing styles to make sure that only authorized users get into their systems. And they’re hunting for clues to figure out who launched cyberattacks—and make sure they can’t do it again.
“The problem we’re running into these days is the amount of data we see is overwhelming,” says Mathew Newfield, chief information-security officer at Unisys Corp. UIS -0.99% “Trying to analyze that information is impossible for a human, and that’s where machine learning can come into play.”

CMS Needs To Beef Up Risk Management for Medicare Database

The Centers for Medicare and Medicaid Services needs to improve its risk management oversight and security controls to ensure the availability of the Medicare enrollment database, concluded the HHS Office of Inspector General.

September 19, 2018 - The Centers for Medicare and Medicaid Services (CMS) needs to improve its risk management oversight and security controls to ensure the availability of the Medicare enrollment database (EDB), concluded an HHS Office of Inspector General (OIG) audit released Sept. 18.
EDB is the primary source of Medicare enrollment information for the entire population of beneficiaries. It estimated that it would cost CMS $47 million per day if a cyberattack shut down the EDB.

Europol Warns Nation-States Behind More Ransomware Attacks

The European law enforcement agency Europol is warning that nation-states are increasingly behind ransomware attacks, such as the 2017 WannaCry campaign.

September 19, 2018 - The European law enforcement agency Europol is warning that nation-states are increasingly behind ransomware attacks, such as the 2017 WannaCry campaign.
The WannaCry ransomware targeted medical devices and caused widespread problems for healthcare organizations, including UK's National Health Service. It cost organizations worldwide $4 billion. 
Europol warned in its Internet Organised Crime Threat Assessment 2018 report that, although there are fewer ransomware attacks this year than last, ransomware remains a grave threat to organizations.

Early warning system to speed patient care at Children’s Health

Published September 20 2018, 4:04pm EDT
Children’s Health in Dallas has selected Royal Philips as its technology partner to enhance their existing patient monitoring and PACS systems.
The delivery system, which has a service area that encompasses nearly one million patients in North Texas, also will standardize additional patient monitoring initiatives using the Philips Intellivue X3 patient monitor to enable staff to track patient vital signs during transport and at the bedside.
The 15-year, $75 million agreement gives Children’s Health access to other Philips patient monitoring systems, including the IntelliVue Guardian early warning system to quickly identify patients who may need an intervention, and IntelliVue Mobile Caregiver, which offers a suite of mobile apps for monitoring patient data via smartphones and other mobile devices.

Interoperability needs an architecture in addition to APIs, HIMSS CTIO Steve Wretling says

And there’s already one in the JASON Report from 2014 that was eclipsed by the industry’s excitement about open APIs.
September 19, 2018 08:00 AM
Interoperability: There’s a lot happening right now. FHIR, as in Fast Healthcare Interoperability Resources. Open APIs. Blue Button 2.0. Carequality and CommonWell reaching a milestone this summer in terms of exchanging Continuity of Care Documents.  
At the same time, however, a thorny reality persists: The average hospital has 16 disparate EMRs in place among its affiliated outpatient practices. Look more broadly at integrated health systems, and that number bumps up to 18.
So where is it all going? And what will it take to get to the point where interoperability, though perhaps not 100 percent solved, will be a less pressing issue for hospitals, EHR vendors and tech startups?
I spoke with HIMSS Chief Technology and Innovation Officer Steve Wretling about what the industry needs to achieve interoperability, his advice to aspiring entrepreneurs and the innovation that has surprised him most.

Trump's tariff threats on China could hit hospital IT shops

Prices could go up on tech from vendors such as Cisco, Dell, HP and others as well as makers of consumables, pacemakers and MRI machines.
September 19, 2018 05:23 PM
President Trump on Wednesday threatened to add new import taxes on an additional $257 billion of Chinese goods to the $200 billion established on Monday. This was in response to China on Tuesday announcing plans to impose new tariffs on $60 billion in U.S. exports.
Even though it’s only a threat at this point, rather than brush it off, hospital IT executives would be smart to monitor the developments because further tariffs could bring higher prices on everyday technologies, such as computer hardware and software, not to mention consumables, pacemakers, MRI Machines and other medical equipment manufactured in China.
Hospital supply chain directors, in fact, “are appropriately paranoid but cautiously optimistic,” said Peter Allen, executive vice president of sourcing operations at Vizient, which is a member of the Healthcare Supply Chain Association.

How's your cybersecurity posture? Answer these 5 crucial security questions

Drafted by the U.K. National Cyber Security Centre, the guidance provides insight into preventing phishing attacks, bolstering third-party management and other security threats.
September 19, 2018 01:13 PM
A new study finds one in every hundred emails sent around the globe has malicious intent.
Nearly 70 percent of board members from the largest U.K firms reportedly have received no training to deal with cyber incidents, and 10 percent don’t have a cyber-response plan, according to a report from the U.K. National Cyber Security Centre.
Those numbers are noticeably poor even in comparison to the U.S. healthcare system where less than half of IT professionals feel confident in their organization’s overall level of cybersecurity.
It’s well known that an organization’s cybersecurity posture needs to start in the boardroom to build a cybersecurity posture that can be translated all the way down to clinicians. As insiders overwhelmingly cause the most breaches, those boardroom conversations are crucial.

Hixny Extends Health Data Exchange Services to 9 New NY Counties

Providers in nine counties will now have the opportunity to utilize health data exchange services through the New York-based HIE.

September 18, 2018 - New York-based Hixny will now provide health data exchange services to nine additional counties as it expands its territory over an 18-month period.
The health information exchange (HIE) is one of New York’s eight qualified entities (QE) part of the Statewide Health Information Network for New York (SHIN-NY). SHIN-NY functions as a network of networks overseen by the New York State Department of Health.
“The success of the SHIN-NY hinges on meeting the needs of providers based on complete, accurate and up-to-date data,” said Hixny CEO Mark McKinney. “At Hixny we've demonstrated the effectiveness of our model – and want to do the same for the providers and patients in our neighboring regions.”

HHS Makes a Pitch for Telemedicine in Substance Abuse Treatment

HHS officials are worried that healthcare providers are too reluctant to use telemedicine in Medication Assisted Treatment (MAT) therapy for Opioid Use Disorder (OUD). So they're putting out the word on available resources.

September 18, 2018 - The Health and Human Services Department wants to remind everyone that telemedicine can be an important tool in treating people with addiction and substance abuse issues.
In a blog timed to coincide with Prescription Opioid and Heroin Epidemic Awareness Week, Assistant Health Secretary Adm. Brett P. Giroir, MD, noted that healthcare providers can use connected care platforms to improve Medication Assisted Treatment (MAT) therapy for people struggling with Opioid Use Disorder (OUD).
“HHS is committed to improving access to MAT for OUD and is working on a variety of strategies to improve access to this life saving treatment through increased funding to states and communities, payment policy changes, and education, training and technical assistance,” he wrote. “One such area is to help providers understand how telemedicine can be used, in certain circumstances, to expand access to buprenorphine-based MAT.”

Healthcare Workers Uninformed About Cybersecurity Best Practices

Forty percent of healthcare workers would allow a colleague to use their work computer, displaying a disturbing lack of knowledge about cybersecurity best practices.

September 18, 2018 - Forty percent of healthcare workers would allow a colleague to use their work computer, displaying a disturbing lack of knowledge about cybersecurity best practices.
Surprisingly, healthcare workers performed better than government workers, 60 percent of whom would allow a colleague to use their work computer, according to a survey of more than 400 US workers by Spanning Cloud Apps.
Other industries included in the study were banking and finance, construction, education, information technology, manufacturing, and retail.

Speech-enabled EHRs poised for growth as physician adoption expands

Sep 19, 2018 2:17pm
The majority of doctors now use speech-recognition software to interact with EHR systems, according to a new report.
But as accuracy and integration improve, some signs suggest the market may still have substantial room to grow.
While sexier technologies like telemedicine and artificial intelligence grab most of the attention for their potential to disrupt the healthcare space, speech-recognition technology has steadily gained traction without much fanfare. Survey results included in a report from Reaction Data show 62% of participants from a variety of physician specialties using speech recognition with their current EHR solution. Another 15% reported they were either in the process of implementing the technology or planning to implement it within the next two years.
It’s no surprise that doctors have gravitated toward speech-recognition technology to streamline their workflow, according to Jeremy Bikman, CEO of Reaction Data.

Tech company’s app brings docs info on patients, treatment options

Published September 19 2018, 5:21pm EDT
Northwestern Memorial Hospital is using a mobile app that gives mobile physicians secure access to detailed patient information.
The just-released app enables physicians to access patient records, structured clinical information, potential therapies, relevant clinical trial options, and it also gives a view of patients’ molecular alterations.
“As an oncologist, I spend most of my time traveling between patients in a busy clinic,” says Shikha Jain, MD, a hematologist and oncologist at Chicago-based Northwestern’s Robert Lurie Comprehensive Cancer Center. “This app is easy to navigate and puts my patients’ pertinent information at my fingertips, allowing me to quickly access and review the results immediately prior to walking into the room, and share the results with the patient.”

HIT Think Why IT is crucial for tracking social determinants of health

Published September 19 2018, 5:36pm EDT
Each visit to a physician involves data collection. From the moment patients walk in the door, data is collected by registration, the billing department, the provider and in other areas. These data pieces all converge to become part of the whole view of the patient.
In the past, data collected was more focused on past medical history, disease states and strictly medical issues. In recent years, however, the realization that social determinants of health are critical indicators of a patient’s success or failure to comply with a treatment plan is finally gaining acceptance in the healthcare industry – especially for at-risk populations.
These factors help providers gain deeper insights into a patient’s background so they can tailor healthcare services directly to their individual circumstances, ultimately reducing costs through care coordination and preventative care.

Senate passes sweeping opioid response bill with eRx, EHR, PDMP provisions

The landmark legislation would disburse nearly $8 billion to HHS, CMS, CDC and state governments, with big goals for population health, care coordination and patient safety.
September 18, 2018 12:31 PM
With a rare near-unanimous vote, the United States Senate passed The Opioid Crisis Response Act of 2018 on Monday evening. It's a massive bill comprising a wide array of proposals drawn from five Senate committees, and has many implications for the use and funding of health IT.
Senate Majority Leader Mitch McConnell, R-Kentucky, called the bill – drawn up using input from more than 70 senators and passed by 99-1 vote – a "landmark" piece of legislation meant to combat the nationwide opioid epidemic from all angles.
The legislation comes amid an ongoing opioid crisis in the U.S. as policymakers and technology vendors are working to address the issue, while hospitals are piloting apps to find blindspots in prescription drug monitoring programs and using mobile technologies to write fewer prescriptions.

NHS hospital kicks off Axe the Fax initiative

Countries around the globe are dealing with legacy fax machines and the UK organization is looking to get rid of its devices by 2019.
September 18, 2018 12:33 PM
Leeds Teaching Hospitals NHS Trust is pledging to remove nearly all of its fax machines by 2019 amid increasing criticism over the NHS’s heavy reliance on outdated technology.
Legacy fax machines and the privacy, security and patient safety issues they potentially represent are not just a problem in the UK, either. In the U.S., Centers for Medicare and Medicaid Services Administrator Seema Verma last month called on hospitals and other healthcare providers to strive to be fax-free in two years, meaning by 2020. And in Australia, Queensland Health is amid efforts to eradicate fax machines, though a recent development in which Ipswich Hospital mandated that clinicians use only fax machines for urgent referrals shows how tricky eliminating fax machines altogether will be.
In the UK, Recent research released by the Royal College of Surgeons (RCS) found NHS hospitals trusts in England owned more than 8,000 fax machines, prompting calls to modernise the IT infrastructure of the health service as figures provided by the RCS indicated that only ten organisations included in the analysis did not own any of the outdated gadgets.

Are Healthcare Providers Getting Comfortable With Telehealth?

Recent research indicates that healthcare providers are diagnosing and treating patients with telehealth as well as - or even better than - they're doing in person. Does this mean virtual care technology has reached maturity?

September 17, 2018 - While research has long suggested that telehealth can be more cost-effective than the in-person visit, new studies are suggesting that doctors who use connected care technology are also becoming better care providers.
A year-long telehealth study by Humana found that physicians using a virtual care platform prescribe less antibiotics than they do for in-office visits and are more discerning about tests and follow-ups, resulting in more effective treatment.
Oh – and those telehealth visits only cost an average of $38, compared to an average of $114 for a visit to the doctor’s office.

Interoperability marks top EHR improvement physicians want, survey finds

Written by Jessica Kim Cohen | September 17, 2018 | Print  | Email
The majority of physicians agree interoperability is the top concern they'd like to address when it comes to EHRs, according to a Deloitte report.
Deloitte surveyed 624 primary care and specialty physicians for its poll on attitudes toward EHRs. The poll was conducted as part of the Deloitte 2018 Survey of U.S. Physicians, which is designed to be representative of the American Medical Association Masterfile with respect to years in practice, gender, geography, practice type and specialty.
Here are the most common improvements physicians said they would want to make to EHRs:

Lack of EHR Interoperability, API Use Hinder Value-Based Care

The current state of EHR interoperability is insufficient to support healthcare’s transition to value-based care, according to industry leaders.

September 17, 2018 - Almost a decade after healthcare organizations across the country began investing in EHR technology, problems with EHR interoperability still obstruct care coordination, health data exchange, and clinical efficiency.
Consistent, widespread application programming interface (API) implementation and use may help to overcome existing barriers to interoperability and accelerate the transition to value-based care, according to testimony from Adventist Health Chief Transformation Officer and Population Health Services Chief Medical Officer Nishant Anand, MD at a September 13 hearing for the House Energy and Commerce Subcommittee on Health.
“There are real challenges that we face regarding interoperability, sharing enabling technology with our physicians, and navigating the care of our patients,” said Anand in written testimony.

HHS lacks standardized framework for interagency data sharing

Published September 18 2018, 7:19am EDT
The Department of Health and Human Services lacks a consistent, transparent and standardized framework for interagency data sharing, according to the HHS Office of the Chief Technology Officer.
A report, written by the Office of the Chief Technology Officer and released on Monday, identified key challenges that impede the sharing of restricted and nonpublic data among HHS agencies.
“For the first time in the department’s history, a systematic examination of data sharing practices was undertaken across its agencies including CMS, FDA, CDC, NIH, AHRQ and others,” wrote HHS Chief Data Officer Mona Siddiqui, MD, who led the study, in a September 17 blog. “The findings describe processes that lack transparency and reliability, a regulatory landscape that is difficult to navigate, technical barriers that prevent ease of information sharing, and resource constraints that inhibit data sharing from becoming a programmatic priority.”

Opinion Best practices for defending against emerging email threats

Published September 18 2018, 5:08pm EDT
Research done by Intel revealed that 97 percent of computer users cannot identify phishing emails. When the phishing attack comes from a trusted coworker, users are often defenseless on their own.
Protecting against insider email threats presents a significant challenge for security operations teams, and the increasing popularity of Microsoft Office 365 has deepened cyber vulnerability because of the architectural limitations of traditional cloud email security gateway products.
Phishers know their audience—predatory emails tend to look like any other email a user might receive. As researchers at Carnegie Mellon University noted in a recent study, “Users who share similar interests belong to a specific user segment and are susceptible to a specific type of attack.”

The New Apple Watch Shows the Money Big Tech Sees in Health

Silicon Valley is ramping up its health-care ventures to profit from a vast and fast-growing part of the economy.
Zachary Tracer Spencer Soper Gerrit De Vynck  and Dina Bass
September 15, 2018, 1:35 AM GMT+10
Apple Inc.’s new watch is the latest proof: Big Tech is trying to remake health care in its own image.
The device, introduced at a splashy launch event this week, can call for help after a fall. It can monitor heartbeats for dangerous conditions. It can do an electrocardiogram, a test that monitors for a common abnormal heart rhythm and is usually done by a doctor.
For the iPhone maker, it’s the boldest foray so far into personal health. Apple has already pushed the use of its mobile devices for health tracking and medical research, and recently added a feature that can connect to some hospital medical-records systems.

HIMSS CEO Hal Wolf: Every hospital has to innovate for Silver Tsunami

The aging population is becoming more educated and driving transformational change, Wolf said at Health 2.0.
September 17, 2018 03:26 PM
SANTA CLARA, CALIFORNIA — The worldwide challenge of treating aging populations is driving the healthcare industry toward innovation, according to HIMSS CEO Hal Wolf.
Speaking at the Health 2.0 conference here Monday, Wolf said that in the U.S., 49 percent of healthcare costs are covered by the government, yet as the ‘Silver Tsunami’ continues, that cost is expected to leap to 53 percent. But the problem isn’t just money, it is also the lack of manpower and skilled providers to take care of the aging population. Currently there is a gap of 7 million healthcare professionals, but that gap is only expected to grow, he said.
“That is why purely and simply … every healthcare system in the globe is trying to figure out how they are going to use innovation to take all of this disparate and disconnected components [and] bring it back together, so we can deliver care to rising populations, that are going to be sicker,” Wolf said. “That is what is siting behind the rising investment digital health. It is not something that is going to easily burst because the drivers that sit behind it are not the evaluations themselves as much as the socioeconomic drivers.”

Microsoft launches 3D audio app for blind people in Australia

Software giant’s artificial intelligence research team has been collaborating with Vision Australia to test.
September 17, 2018 09:57 AM
Microsoft and Vision Australia unveiled a new 3D audio app designed to give blind and vision impaired people greater independence to explore the world around them.
Dubbed Soundscape, the software enables users to set audio beacons at destinations and landmarks, and through a stereo headset the 3D audio is perceived as coming from the point of interest as they walk, allowing them to build a mental image of what’s around from the acoustic environment.
The app also calls out roads, intersections and landmarks, and was designed to be used in addition to mobility aids such as guide dogs and canes.

CEO Power Panel: Health systems focus on patient-centered care as consumerism takes hold

By Maria Castellucci  | September 15, 2018
Market forces are pushing health systems to rethink their approach to defining and encouraging patient-centered care.

The term patient-centered care, first coined by the Institute of Medicine in 2001 and defined as ensuring patients guide their own clinical decisions, has become commonplace in healthcare. But CEOs of top health systems say the term and approaches to providing it need a revamp in order to address evolving consumer expectations.

According to results from Modern Healthcare's most recent CEO Power Panel Survey, nearly 65% of the healthcare executives have changed how they define patient-centered care over the past five years, and they overwhelmingly assign multiple components to the definition. Most CEOs responded that the term means more than just involving patients in their care decisions. It includes ensuring patients have access to services, care is coordinated and patients are provided education materials and resources.

Two-Thirds of Physicians Left Out of EHR Optimization Efforts

A new survey revealed only one-third of healthcare organizations requested feedback from physicians to inform EHR optimization projects.

September 13, 2018 - Many healthcare organizations are missing a valuable opportunity to boost EHR usability, physician satisfaction, and clinician engagement by leaving physicians out of the EHR optimization process.
This finding comes from a recent 2018 Deloitte survey exploring physician interactions with EHR technology that revealed 66 percent of surveyed physicians were not asked to provide feedback to inform EHR optimization decisions.
Deloitte gathered responses from 624 primary and specialty care physicians across the country to gain insight into clinicians’ opinions about interoperability, clinical workflows, EHR optimization, and clinical documentation.

Physician Groups Ask Congress to Curtail Appropriate Use Criteria Law

September 13, 2018
by David Raths, Contributing Editor
Groups call stand-alone AUC reporting program ‘burdensome, duplicative and costly’
Although implementation of a law to require clinical decision support (CDS) use involving diagnostic imaging orders was pushed back from 2018 to 2020, medical organizations are asking Congress to consider modifications to reduce the burden on clinicians.  
In 2014 Congress passed the Protecting Access to Medicare Act (PAMA), which will require referring providers to consult appropriate use criteria (AUC) prior to ordering advanced diagnostic imaging services for Medicare patients. If the ordering provider does not consult AUC rules via clinical decision support before the order is placed, CMS will not pay the for the imaging. 

Report: HHS needs consistent data-sharing protocol

Sep 17, 2018 2:38pm
Despite being under the same agency umbrella, the 11 HHS sister agencies face significant hurdles sharing data among one another.
HHS wants to do something about the problem, officials said on Monday as they published a comprehensive report detailing the data-sharing environment within HHS.
The Office of the Chief Technology Officer found significant deviations in data governance among HHS agencies—including major players such as the Centers for Medicare & Medicaid Services, the Food and Drug Administration and the Centers for Disease Control and Prevention—but also a cultural reluctance to share data on a regular basis.
The report (PDF), conducted by HHS Chief Data Officer Mona Siddiqui, M.D., and a small team of HHS staff, was light on recommendations but asserted how much value could be created by opening up silos of data within the agency.

Survey: Per-employee healthcare costs expected to increase 4.1% in 2019

Sep 14, 2018 12:52pm
Although estimated cost trends showed large single-digit increases in employer-sponsored health plan costs over the past decade, adjustments to those plans—which often shifted costs to employees—kept the actual rate increases lower. (Mercer National Survey of Employer-Sponsored Health Plans)
Costs in employer health benefit plans are projected to increase by 4.1% in 2019, according to early data from the Mercer National Survey of Employer-Sponsored Health Plans.
The increase is on par with this year's growth of 4.2% and generally in line with the low single-digit increases employers have seen over the past decade.
As Mercer noted, those increases could have been higher had employers not shifted costs to their employees through high-deductible plans."The things you can do to get a short-term, you know, a quick-hit improvement in your medical trend, usually involve what we call cost-shifting," said Beth Umland, director of research for health and benefits at Mercer, in an interview with FierceHealthcare.

Health IT Roundup—Minnesota hospital filmed patients without consent; Are providers ready for the death of faxes?

Sep 17, 2018 2:12pm

Is health IT staff ready for the death of the fax machine?

Seema Verma, administrator at CMS, has called on doctors' offices to eliminate the use of fax machines by 2020. While this might seem like common sense for people outside the industry, providers today are still protective of their fax machines. The near-obsolete solution allows providers to retain control of their records and transfer those records, when necessary, in a HIPAA-compliant way.
Yet the world is changing, and CMS is intent on moving providers away from faxes and toward interoperable EHRs. But before offices can make that jump, health IT staff have some work to do. (Forbes article)

Lack of EHR, data interoperability holding back value-based care

Published September 17 2018, 7:36am EDT
The lack of electronic health record interoperability and sharing of patient data continue to be major barriers to value-based care in Medicare.
That’s the consensus of healthcare stakeholders who testified late last week before the House Energy and Commerce Health Subcommittee.
Nishant Anand, MD, chief medical officer for Adventist Health System, said that about two thirds of the physicians that his organization works with across its ACOs and clinical integrated networks are independent—and, as a result, operate more than 30 different EHR platforms.

FDA comes under fire for rapid Apple Watch approvals

Published September 17 2018, 7:27am EDT
The Food and Drug Administration’s quick approval of new mobile medical apps designed for the Apple Watch is raising eyebrows among FDA observers who say the tech behemoth got preferential treatment.
Last week, the FDA granted—in two separate letters dated September 11—two different “de novo decisions” in Apple’s favor, according to Bradley Merrill Thompson, an attorney at Washington-based law firm Epstein Becker Green who counsels medical device companies on regulatory issues.
What’s remarkable about the letters, says Thompson, is that Apple apparently filed its electrocardiogram (ECG) clearance application on August 14 and the Irregular Rhythm Notification Feature application on August 9.
Thompson points out that these requests are for first-of-a-kind devices and as a result typically take longer to approve than a follow-on device cleared through the 510(k) process.


Health secretary Matt Hancock endorses untested medical app

Billy Kenber | Kat Lay, Health Correspondent
September 17 2018, 12:01am, The Times
The health secretary has provoked a row with doctors after calling for the nationwide introduction of a health app despite fears that it fails to spot serious medical problems.
Matt Hancock said the app, which is being trialled in London, was “brilliant for so many patients”, adding that he wanted to it to be “available to all, not based on their postcode”.
The app, called GP at Hand, uses artificial intelligence to assess symptoms and offers video and telephone consultations with GPs. It is available at present to patients in central London, with more than 30,000 signing up. Doctors have criticised it, however, for allegedly failing to spot the onset of serious problems.