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."

Monday, December 31, 2018

Weekly Australian Health IT Links – 31st December, 2018.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A really quiet week leading up to 2019. However, a few sleeper issues seem to have emerged. Read on….

Happy New Year To All. For the record the Blog started in 2006 - A while ago now!

Data Integration Partnership Australia (DIPA)

Page last updated: 19 December 2018


The documents on this page may not be accessible. If you need help please contact us using the enquiries form.


Data held by Health is a valuable national asset. The use, re-use and sharing of Health data can help us explore the health journeys of Australian citizens. This helps researchers and policy makers to provide better health and wellbeing for all Australians, now and for future generations.

New insights regarding important and complex policy questions can be discovered through data integration and analysis. Health is committed to unlocking the value of health data and better leveraging our infrastructure investments through collaboration across government.

‘Fast-track tool’ to save aged-care sector $250m

  • 12:00AM December 27, 2018
Bureaucrats will enter the homes of older Australians destined for care and separate them into “cost classes” using a one-hour ­assessment tool that will save providers and businesses a quarter of a billion dollars each year.
Documents obtained by The Australian under Freedom of ­Information laws provide the first details of a new funding model being considered by the federal government that would ­replace the Aged Care Funding ­Instrument.
The report from Pioneering Economics reveals that aged-care providers currently spend more than $250 million each year on performing assessments of residents’ care needs, while the federal government spends just $5m to check these claims.
Despite overall savings to the sector, a new system would cost the federal government $145m ­annually. So-called ACFI assessments are the foundation for the basic care subsidies taxpayers provide to the $17 billion aged-care sector each year, but the system is so unwieldy that it has been criticised by providers and government and is due for reform.
In 2016, Scott Morrison as then treasurer cut $1.2bn from the ACFI by freezing indexation rates and changing the scoring matrix for the care subsidies that flowed to providers which has, for the first time in more than a decade, seen rising care costs jump ahead of the amount organisations receive from taxpayers to pay for that care.

Amazon's plan to mine GP data may be Christmas miracle

A new medical machine-learning program 'reads' clinical notes to draw inferences about patient health
Antony Scholefield
18th December 2018
It's that time of year when a certain bloke takes credit for flying millions of presents across the world.
Yes, Amazon CEO Jeff Bezos, the $150 billion man.
His retail mega-corporation is celebrating one year since launching in Australia, but back in the US, it has announced its latest product, called Amazon Comprehend Medical.
It’s a machine-learning program that can supposedly analyse unstructured ­doctors’ notes and extract specific information such as diagnosis, treatment and symptoms.
Amazon says it will help — for a fee — identify patients eligible for clinical trials or build population health databases.

How to fix your family’s tech problems

  • By David Pierce
  • December 25, 2018
If you’re the tech-savvy person in your family, you know what the holidays really mean: getting ambushed by a year’s worth of tech-support questions. Why is everything slow? Where did those icons go? Can you really get an Amazon gift card by clicking on this survey? (Answers: Because, somewhere and NO!)
Since it’s the giving time of year, I present my cheat sheet for solving in-home IT problems. I can’t help with everything, and some issues will unfortunately involve customer-service calls. For that I can only recommend a nice cup of spiked eggnog — or a meditation app.
But most problems, I’ve found, are simpler than they sound. And we can fix ’em before those chestnuts are done roasting. Let’s get into it.

Is Googling Your Symptoms As Bad As Everyone Says?

We’ve all done it – heading online to figure out whether that throat tickle may be something more sinister, or whether the cough you’ve had for weeks could really mean something more. But while using Google as a medical database to look up health issues has been typically discouraged and has generally not been super helpful in specifying actual health concerns in the past, a new study suggests it could actually be helpful in some ways, after all.
While there’s very little actual systematic research on how our relationship with Google might affect real-world interactions with medical professionals, and the medical field as a whole, particularly in fields that impact he emergency department, a new team of Australian health researchers have set out to survey a representative sample of ED patients in two clinics, St. Vincent’s Hospital Melbourne and Austin Health.
The Australian researchers began their study by gathering anonymous data from 400 participants. Unsurprisingly, the researchers discovered that more than one-third of the adults did indeed consult the internet about their medical problem before attending the ED. In fact, 49 percent of the survey participants admitted that they searched for online health information regularly.

All I want for Xmas is a reliable connection': Telco customers irate

By Jennifer Duke
26 December 2018 — 2:20pm
Telstra customers were left irate after a National Broadband Network-related outage caused some Australians to be without internet services late on Christmas Eve and stretching into Christmas Day.
A disruption for some NBN-connected households in Victoria and Tasmania on Monday and Tuesday came at "the worst time of the year" for telecommunications companies and their customers, with network staff at Telstra working through the night on Christmas Eve to get services back up and running.
Global internet measurement company Ookla's Down Detector (also known as Aussie Outages locally) shows the issue was largely kept to the two states, with some complaints from NSW. Some reported their NBN-connected landlines were also not working during the outage.
It's unclear how many customers were affected, with many Telstra customers using a recently introduced smart modem with a 4G back-up that kicks in when there are drop outs or issues. Vodafone Hutchison Australia also offers a 4G option in its modems in case of outages.

My way or the Huawei: Chinese firm deserves inclusion in 5G network

By Clive Williams
29 December 2018 — 12:00am
Much of the recent media reporting about the potential security threat posed by Huawei telecommunications and networking equipment, and Huawei consumer electronics products, is poorly informed and smacks of hysteria.
Huawei (meaning “Splendid Act” or “Able China”) was started in China in 1987 by Ren Zhengfei a former People’s Liberation Army engineer. He started by developing phone switches, but soon realised that future success in the electronics industry required advanced research. Some of Huawei’s early research knowledge may have come from China’s global industrial espionage program.
Although China has managed to shortcut research across the board through industrial espionage, I suspect China's advanced IT capabilities largely came about because the US leaked like a sieve during a critical period of IT development.

Hold the phone. A 5G future is still quite far away

By James Fernyhough
27 Dec 2018 — 11:00 PM
Around this time next year the first 5G smartphones will have started to hit the shelves, and already the buzz around this fifth generation of mobile technology is getting deafening.
When you ask experts what 5G is, the conversation quickly descends into futuristic discussions of smart cities, with cars that drive themselves and fridges that do your shopping for you.
But the question most consumers will want to know is: How will it change what I can do with my smartphone? The answer lands with a disappointing thud: It probably won't change much, at least initially.
That's because 4G technology is already more than capable of doing what we demand from our phones.That has led analysts and commentators to warn consumers are unlikely to pay a premium to access a service they don't need.

Pluto explorer ushering in new year at more distant world

By MARCIA DUNN 28 December, 2018
CAPE CANAVERAL, Fla. (AP) — The spacecraft team that brought us close-ups of Pluto will ring in the new year by exploring an even more distant and mysterious world.
NASA’s New Horizons spacecraft will zip past the scrawny, icy object nicknamed Ultima Thule (TOO-lee) soon after the stroke of midnight.
One billion miles beyond Pluto and an astounding 4 billion miles from Earth (1.6 billion kilometers and 6.4 billion kilometers), Ultima Thule will be the farthest world ever explored by humankind. That’s what makes this deep-freeze target so enticing; it’s a preserved relic dating all the way back to our solar system’s origin 4.5 billion years ago. No spacecraft has visited anything so primitive.

Dark liquid: Radical new model of the universe revealed

Annual Report Alert: The ADHA Has Published Its 2017-2018 Annual Report

Here is a link from which to download the .pdf.


You can play the "seek out all the spin" game and you will score pretty highly. There is a fair bit to be found!


Sunday, December 30, 2018

I Reckon This Is Just A Taster For What The Department Of Health Plans With The #myHealthRecord Data In Time.

This popped up as the silly season got properly underway, and I almost missed it!

Data Integration Partnership Australia (DIPA)

Page last updated: 19 December 2018


The documents on this page may not be accessible. If you need help please contact us using the enquiries form.


Data held by Health is a valuable national asset. The use, re-use and sharing of Health data can help us explore the health journeys of Australian citizens. This helps researchers and policy makers to provide better health and wellbeing for all Australians, now and for future generations.

New insights regarding important and complex policy questions can be discovered through data integration and analysis. Health is committed to unlocking the value of health data and better leveraging our infrastructure investments through collaboration across government.

Connected Health Data (CHD) Program

Health, through the DIPA initiative, has established the Connected Health Data (CHD) Program to:
  • Build a safe and secure platform for managing data access through Health’s existing Enterprise Data Warehouse (EDW)
  • Expand and enhance health and aged care data to unlock the value of this information
  • Make health and aged care data assets available more widely within government for policy development, program evaluation and research


Health is partnering with the Australian Institute of Health and Welfare (AIHW) and the Australian Bureau of Statistics (ABS). Data sets will be added to Health’s EDW with trusted users able to access the data within a secure environment.

Case Studies

Identifying Adverse Events Associated with Medicines

Through the Data Integration Partnership for Australia (DIPA), the Social, Health and Welfare Analytical Unit supported Health to run a pilot project. This analysed Pharmaceutical Benefits Scheme (PBS) data to identify adverse events associated with medicines.

The pilot analysed 684 medicines looking for an association with heart failure as an adverse event. One hundred and twenty-two medicines already known to be associated with heart failure as an adverse event were successfully identified. Five new medicines were shown to be potentially associated with heart failure.

The following link provides a
flyer outlining this work - PDF 607 KB

National Integrated Health Services Information (NIHSI) Analysis Asset (AA)

Health is working with the Australian Institute of Health and Welfare (AIHW) and state and territory health authorities to add National Integrated Health Services Information (NIHSI) Analysis Asset (AA) data to Health’s Enterprise Data Warehouse. It can be used to derive insights into a wide variety of situations ranging from healthcare in the home and management of chronic disease to the use of opioids.
Here is the link:
The associated flyer reveals this is not a trivial program.
Here is a quote:
“The Data Integration Partnership for Australia (DIPA) is a three- year $130.8 million investment.”
That is not a small sum I would suggest – like say 1/3-1/2 of the ADHA Budget.
What is missing from all this is that there is no mention of consent, de-identification, privacy and security details and so on.
In other words they are just sucking data-sets from wherever and using them how they choose, with their ‘trusted partners’, in total secrecy from the data subjects!
I bet the plan is, once the opt-out barrier is cleared, is to have all sorts of data sets extracted by the ‘trusted partners’ in secret as is the form to date.
Does anyone disagree and if so we would love to see your working – Secondary Use Framework of myHR Data or not!

AusHealthIT Poll Number 455 – Results – 30th December, 2018.

Here are the results of the poll.

Have The Large Number Of Health Information Data Leaks And Trust Abusive Actions By The Likes Of Facebook and Google Recently Meant That Centralised Projects Like #myHealthRecord Are No Longer Seen Positively By The Public In General?

Yes 99% (79)

No 1% (1)

I Have No Idea 0% (0)

Total votes: 80

What an amazing poll. Just a single respondent thinks that programs like the myHR are seen positively in the way they may have been a few years ago.

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

A really, great turnout of votes for the time of the year!

It must have been a very, very easy question as only 0/80 readers were not sure what the appropriate answer was.

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


Saturday, December 29, 2018

Weekly Overseas Health IT Links – 29th December, 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.

NICE publishes standards to help improve NHS technology uptake

Hanna Crouch 13 December, 2018
Requirements for developing digital health technologies for the NHS have been published by the National Institute for Health and Care Excellence (NICE).
The public body has created a set of standards to help developers and investors understand what evidence is required to introduce their product for use in the NHS.
Working collaboratively, NHS England, NICE, NHS Digital, MedCity, Public Health England and DigitalHealth. London have been engaging with industry, commissioners and innovators to understand what is required for health technology to thrive in the UK.

Clinical triage system cuts appointment wait time at London GP surgery

Hanna Crouch 17 December, 2018
A new online triage system introduced by Egton, which is part of EMIS Group, has allowed a GP practice in east London to reduce admin and cut the time that patients wait for an appointment from up to four weeks to just one day.
The GP IT software supplier introduced clinical triage as well as video consultations to its Patient Access system earlier this month.
However, GPs at Stratford Village Surgery in east London had earlier access to a pilot version of the programme and has been using it since August.

3 charts show where artificial intelligence is making an impact in healthcare right now

HIMSS Media research uncovered the key areas where hospitals say AI and machine learning are already delivering value.
December 21, 2018 08:58 AM

Artificial intelligence is so hyped that it might be tempting for top health executives to presume it’s just the domain of technologists, or so far off that they might be wiser waiting for others to move first.
Instead, it’s smart to consider where rival healthcare organizations are investing today. We surveyed 142 qualified professionals working in IT, business, informatics and clinical roles within hospitals, health insurers and pharmaceutical companies.
The findings show that artificial intelligence and machine learning are already delivering value in specific areas. Respondents have big hopes for AI and ML in clinical settings for chronic conditions in particular. The 77 percent of survey-takers who say they’re using AI to support clinical decisions represent the most common use case being tested – but not the only one by far.

NIST releases Risk Management Framework 2.0 to combine privacy, security and supply chain into one

RMF 2.0 includes seven objectives and adds a preparation step.
December 21, 2018 02:27 PM
The National Institute of Standards and Technology posted the newest update to its Risk Management Framework.
“RMF 2.0 is the first framework in the world to address security, privacy, and supply chain risk in an integrated manner — at the organization, mission/business process, and system levels,” NIST Fellow Ron Ross wrote in a Twitter post.
RMF 2.0’s full name is the NIST Special Publication 800-37 Revision 2, Risk Management Framework (RMF) for Information Systems and Organizations: A System Life Cycle Approach for Security and Privacy.

HIMSS Analytics identifies top trends, challenges and priorities in European health IT

Findings from a European annual survey point to an acceleration in the shift toward patient empowerment becoming a core part of the eHealth agenda.
December 21, 2018 10:00 AM
From Google hiring Geisinger Health CEO David Feinberg to drive its health care initiatives, then moving DeepMind’s Streams team under his supervision, to Apple getting its first FDA clearance for an atrial fibrillation-detecting algorithm and an ECG built into its Watch, it seems that big tech companies have been making significant strides during the past year in paving the way toward disrupting health care.
In Europe, findings from an annual HIMSS Analytics survey, included in a recent report, indicate that patient empowerment will become the "key focus" in eHealth, with "patient-generated data" - through wearables and other gadgets aimed at consumers - and "patient/ consumer-owned health records" seen as some of the core trends changing the delivery of care as we currently know it.

70% of Hospitals Participated in Nationwide HIE Networks in 2017

A new ONC data brief offers insight into the state of HIE adoption, health data exchange, and interoperability among acute care hospitals.
December 20, 2018 - About 70 percent of acute care hospitals participated in at least one health information exchange (HIE) network with nationwide scope in 2017, according to a new ONC data brief evaluating methods used to enable interoperability among non-federal acute care hospitals.
ONC used data from a nationally representative 2017 American Hospital Association (AHA) IT Supplement survey to identify methods hospitals use to exchange summary of care records. The federal agency also offered insight into hospitals’ rates of participation in HIE networks and variations in the ways hospitals share data.
“Hospitals’ electronic exchange of information is a complex process involving a variety of methods,” wrote report authors. “Although a majority of hospitals used more than one electronic method to send and receive summary of care records, most hospitals still used both paper-based and electronic methods.”

Omron's smartwatch blood pressure monitor cleared by FDA, launches in January

The HeartGuide watch uses a flexible synthetic band to inflate and maintain its shape to comfortably take an oscillometric wrist blood pressure on the fly.
December 20, 2018
This morning, Omron Healthcare announced that the HeartGuide wristwatch — a wearable oscillometric wrist blood pressure monitor unveiled earlier this year at CES 2018 — has received FDA clearance and will be available at retail on January 9, 2019. The device is currently available for preorder for $499.
The key feature of the product is a flexible synthetic band that is designed to inflate and maintain its shape when taking a blood pressure reading, yet remain comfortable on the wrist. According to the company, more than 80 patents were filed directly relating to band and other components required when designing the new device.
Alongside the blood pressure feature, which can also be programmed to take a reading during the night, the HeartGuide tracks other metrics of health including daily steps and sleep quality. Also to be released in January is a free-to-download companion mobile app that will look to better educate wearers on their health readings while offering personalized recommendations for improving their health.

HIT Think How machine learning can better inform a health plan’s decisions

Published December 21 2018, 3:37pm EST
If you are an executive of a health plan, better analytics to improve decision-making is at the top of your wish list for your organization. As the cost of healthcare has risen, health plans have seen a growing need to proactively manage members’ health. The proactive part of that is the rub—it’s far easier to react to an event than to anticipate the likelihood of an event and act to prevent it.
That’s where analytics becomes valuable. Most health plans have much of the data they need to predict health events, particularly those related to chronic disease. But getting accurate insights from that data, particularly predictive insights, has, until recently, been expensive, complex and time-consuming.
Hence the wish list is topped by more useful analytics. It’s the one capability that can truly transform a health plan’s business model, if it could only be adopted in a way that is fast, agile and affordable.

Survey: Physician Sentiment Mixed on Benefits of Data, Analytics Tools

December 19, 2018
by Heather Landi, Associate Editor
A new research report reveals physicians’ continuing dissatisfaction with electronic health records (EHRs) and this frustration with EHRs may slow physicians’ immediate acceptance of new data and analytics tools.
More than half of surveyed physicians say the introduction of EHRs has had both negative and positive impacts. Similarly, 57 percent of doctors say the "introduction of advanced data and analytics tools, population health software and data registries has been a positive and a negative development for practicing physicians."
Across the board, as physicians become active users of population health tools, they report an increasingly positive outlook toward these tools and the value they bring, according to a report by Geneia, a Harrisburg, Pa.-based healthcare analytic solutions and services company.

HIT Think How to create EHRs that doctors don't hate

Published December 20 2018, 5:02pm EST
It may be difficult to recall now, what with the ongoing Cerner deployment and recent challenges that had little to do with technology, but there was a time when the Department of Veterans Affairs was considered the gold standard for healthcare IT.
VA was out front with the initial development in the 1970s of the VistA system, which would come to be widely recognized and frequently honored. Indeed, when VA was overhauled in the 1990s, VistA was the primary tool that enabled the success of new policies.
Without question, much of the effectiveness and durability of VA’s VistA can be attributed to the way it was developed, specifically to the collaboration between technologists and clinicians that defined the process.

How to explain the real cost of cloud computing to your C-suite

The benefits are well known yet some IT leaders still have a hard time convincing CEOs, CFOs and COOs to fund cloud projects. Here’s expert advice on breaking it down in a way they can understand.
December 20, 2018 08:54 AM
If a CIO cannot successfully communicate something IT to the rest of the C-suite, that’s a problem.
As it turns out, 56 percent of CIOs say it is very difficult to explain to C-suite peers capital expenditure or operational expenditure ins-and-outs when vying for IT budgets and approvals, according to Black Book’s 2018 Health IT Trends report. That could be bad news for cloud computing, a technology that holds much promise in healthcare.
CIOs encounter difficulties working with the rest of the C-suite on CapEx versus OpEx because by making comparisons between the cost of running an on-premise data center versus the cost of moving to the cloud, communication and overall understanding can get misconstrued, said Michael Archuleta, CIO and HIPAA and information security officer at Mt. San Rafael Hospital in Trinidad, Colorado.
“Unless the cloud numbers are significantly higher, there are many beneficial aspects to cloud economics that would cause the remaining C-suite to view it as a very strategic approach,” he said. “In my opinion, a much better strategy would be to identify decision criteria for determining whether a given app should be hosted on-premise or could be moved to the cloud.”

How top healthcare executives can use IT to stem the opioid crisis

Properly configured EHRs are a start. From there, top leadership can employ several tactics to address the difficult and complex challenge.
December 19, 2018 09:27 AM
The sheer scope of America’s opioid crisis—more than 40,000 opioid overdose deaths just in 2017, and more than 2 million addicted—almost defies comprehension. Many of us know one or more of the people that those horrifying numbers represent. We all want to help.
While fewer than half of those deaths were due directly to prescribed painkillers, according to the National Institute on Drug Abuse, the role that prescription medication plays in the overall crisis is significant and complex. The pain is real: more than one in ten U.S. adults live with chronic pain. But so is the abuse: 11.5 million Americans over 12 reported misusing prescription opioids in 2016.  

Ransomware attacks more rampant than many hospitals might think, Kaspersky says

New research showed that organizations don’t always learn their lesson the first time around, with 33 percent of survey respondents saying ransomware attacks happened more than once.
December 18, 2018 03:38 PM
According to a new report from Kaspersky Lab, healthcare employees in the U.S. and Canada not only admit their organizations have fallen victim to ransomware cybersecurity attacks, they also claim it wasn’t a one-time occurrence.
The report, titled “Cyber Pulse: The State of Cybersecurity in Healthcare,” stems from a survey conducted by research firm Opinion Matters that included 1,758 healthcare employees in roles ranging from doctors and surgeons to administration and IT staff. All were located in the United States and Canada.
The findings expose a “continuous pattern of ransomware cybersecurity attacks plaguing organizations” in the healthcare industry. It also shed light on employee perceptions and behaviors.

Infosec pros rank malware as their top concern

Also of concern in a new vendor survey are in-network incidents and increasing time to detection.
December 19, 2018 11:30 AM
The vast majority (91 percent) of cybersecurity experts are concerned about malware and ransomware, according to a new survey by Attivo Networks.
On top of that, cyberattackers are becoming more and more sophisticated, and are continually bypassing perimeter security.
Attivo sells security technologies so the results should be taken with a grain of salt. That said, the findings align with other security research of late. The Center for Connected Medicine, for instance, found cybersecurity is a high priority in its 2019 Top of Mind survey.
Attivo, for its part, surveyed more than 450 cybersecurity professionals and executives from around the world and healthcare was the most represented industry.

9 things physicians hate about medicine

Dec 18, 2018 3:23pm
You might have guessed it. Paperwork and administrative burdens is the number one issue that frustrates doctors, according to a new poll.
This year when Medical Economics polled its physician readers, it asked them “What’s ruining medicine for physicians?”
Some 44% said paperwork and administrative burdens, according to the publication (PDF). That’s typical. For instance, the American Academy of Family Physicians called reducing the administrative burden weighing down doctors the "most pressing priority" for its physicians and earlier this year adopted a host of principles aimed at correcting the problem.
Here are the other top issues that doctors said frustrate them and get in the way of treating patients and running their practices:

Most hospitals still use mail or fax to exchange data

Dec 19, 2018 12:46pm
Health systems use numerous methods to exchange patient medical records, but providers continue to rely heavily on the old-fashioned approach of mail or fax, according to new federal data on interoperability.
Nearly three-quarters of non-federal acute care hospitals routinely use fax or mail to receive summary of care records from providers outside their system, according to new data released by the Office of the National Coordinator for Health IT. Two-thirds of health systems use fax or mail to send records.
Paper-based methods outpaced electronic transmission, particularly in receiving records. More than 4 in 10 systems said they “often” use mail or fax while 27% said they often use a standalone health information service provider like DirectTrust.

This app tells your doctor if you have malaria

By Thomas Lewton and Alice McCool, for CNN
Updated 1452 GMT (2252 HKT) December 14, 2018
Kampala, Uganda (CNN)Only a few spare seats remain in the crowded waiting room at Kiruddu General Hospital, overlooking Lake Victoria on Kampala's southern tip.
Doctors in white coats walk quickly past tired patients clothed in bright, patterned kitenge fabrics.
Upstairs, lab technicians tackle a mounting pile of slides for microscopic examination - staring through the eyepiece at blood samples suspected of containing malaria parasites or the bacteria that causes tuberculosis. It's a time consuming process, with each slide finely adjusted by hand around 100 times before a confident diagnosis can be given.
Upstairs, lab technicians tackle a mounting pile of slides for microscopic examination - staring through the eyepiece at blood samples suspected of containing malaria parasites or the bacteria that causes tuberculosis. It's a time consuming process, with each slide finely adjusted by hand around 100 times before a confident diagnosis can be given.
But this is changing. Uganda's first Artificial Intelligence (AI) lab, at Makerere University, has developed a way to diagnose the blood samples using a cell phone.

Healthcare providers: The route to digital transformation success

By Mark E. Gilbert, Senior Director, Analyst at Gartner . Dec 17, 2018, 5:25AM
Imagine the following situation: The CIO of a hospital group has been asked, by the CEO, to develop a digital care business case to improve the lives of patients with chronic conditions. This will impact the way the hospital delivers ambulatory, inpatient, outpatient and day surgery services; patient record access; and virtual care. Although a growing number of clinicians and managers support the idea, there’s no overall strategy or plan for a future of digital care delivery.
This is a typical scenario for many healthcare providers, and business leaders are looking to CIOs for ways to increase the success rate of innovation and business transformation initiatives.
Providers recognise the health and business benefits of delivering care digitally, yet a significant gap exists between their digital business goals and their ability to execute, particularly from a workforce skills perspective.

Biometric data predicted to be at risk for cyberattacks

Judy Greenwald
12/17/2018 2:39:00 PM
Cyberattacks will zero in on biometric hacking and exposure vulnerabilities in touch identification sensors, facial recognition and passcodes in 2019, Experian Data Breach Resolution predicts in a report issued Monday.
“Organizations need to ensure their biometric systems are secure in all layers,” says the report by Data Breach Resolution, a unit of Costa Mesa, California-based Experian Information Systems Inc., in its report, Data Breach Industry Forecast 2019.
“Biometric data should be encrypted and stored in secure servers,” says the report.

HIT Think Why careful planning is key in building a mobile strategy

Published December 19 2018, 4:48pm EST
Deploying shared smartphones across an enterprise is a major decision that has implications on finance, productivity and even patient safety. According to a 2018 Spyglass Consulting Group survey, it’s also a common decision, as 90 percent of hospitals are making significant investments in smartphones and unified mobile communications platforms.
Organizations once considered smartphones a security risk. Now, they are providing them to enable mobile communications across teams, send critical notifications from legacy systems and replace outmoded communication options like pagers, land lines and overhead broadcasts.
For example, the Hospital for Special Surgery in New York, New York, a 2018 HIMSS Davies Award of Excellence Winner, implemented a standardized clinical care communications platform to address escalating frustration with pagers and answering services.

Babylon Health hits back at claims its AI isn't up to the job

UK startup and NHS partner urges a bit of common sense is needed

  • 18 December 2018
BABYLON HEALTH has become one of the breakout stars of the current class of UK tech start-ups, but several insiders have suggested that things aren't what they seem.
The company, which has contracts to provide NHS services in the UK, uses, amongst its real-life medical staff, an AI chat-bot to do initial triage and basic diagnosis with patients, in an attempt to get quick results to simple cases.
One current and one former member of Babylon staff have gone on record with Forbes, claiming that it misses 10-15 per cent of warning signs of serious conditions, and that a group of clinicians had gone straight to Ali Parsa, founder and CEO as recently as last Friday in an attempt to stall a planned software drop.
But Babylon isn't taking things lying down and has hit back strongly at the claims that the Forbes article "used a distorted lens to magnify the views of a few anonymous individuals whilst ignoring the findings from multiple government regulators, dismissed the integrity of the hundreds of doctors who work with us and ignored the lengths we have gone to as we have shared our science with the world."
EDITOR'S PICK Dec 17, 2018, 06:00am

This Health Startup Won Big Government Deals—But Inside, Doctors Flagged Problems

Parmy Olson
AI, robotics and the digital transformation of European business.
Late one Friday evening in December 2017, a group of worried Babylon Health doctors sat down for a meeting with Ali Parsa, the 53-year-old founder of the London-based healthcare app maker. Parsa, an Iranian-born ex-banker who had run a troubled hospital project, had raised $85 million for Babylon largely on the strength of the company’s highly rated app, which allowed British patients to quickly videoconference with a doctor. That’s a game-changer in a country where state-run healthcare has brought high-quality medical services to every citizen, but at the cost of long waits (think weeks, not days) for clinic visits. Now Parsa, who spoke of cracking the U.S. market someday, was looking to further increase efficiency and reduce costs by adding an artificially intelligent chatbot that promised to give diagnostic advice on common ailments, without human interaction. The new bot would go to Babylon’s own app users that December, then to patients of Britain’s National Health Service sometime in the future. The problem was, according to some of the doctors in his office, the bot’s advice was often wrong.
To prove their point, the doctors had spent about a day carrying out an audit on their own initiative, according to one current and one former staff member, who asked not to be named for fear of legal repercussions. They found that around 10% to 15% of the chatbot’s 100 most frequently suggested outcomes, such as a chest infection, either missed warning signs of a more serious condition like cancer or sepsis or were just flat-out wrong, according to one insider. The clinicians had gone directly to Parsa that Friday in the hope of stalling the new release. They made their case, and after some negotiation he agreed to delay the rollout. 

Where is the Information Blocking Rule? Health IT Now Criticizes Missed Deadline

December 17, 2018
by Heather Landi, Associate Editor
Industry group Health IT Now, a coalition of healthcare and technology companies, responded today to the Trump Administration's latest missed deadline for publication of a proposed information blocking rule as required under the 21st Century Cures law.
The proposed rule was sent by the Office of the National Coordinator for Health IT (ONC) to the Office of Management and Budget (OMB) on September 17, 2018, setting off a 90-day timeline for the agency to complete its review; a period which was now expired without publication of a proposed rule, according to Health IT Now.
The onus to publish the regulation falls on ONC, the health IT branch of the federal government that is tasked with carrying out specific duties that are required under the 21st Century Cures Act, which was signed into law in December 2016. Some of the core health IT components of the Cures legislation include encouraging interoperability of electronic health records (EHRs) and patient access to health data, discouraging information blocking, reducing physician documentation burden, as well as creating a reporting system on EHR usability.

Survey: One-third of clinicians say e-prescribing systems give incorrect warnings

Published December 18 2018, 7:24am EST
Electronic prescribing systems send physicians automated warnings when a potential problem with a prescription is detected. Yet, the accuracy of these decision support algorithms is being questioned.
A new survey of members of the American Society of Clinical Psychopharmacology finds that one-third of those surveyed believe their e-prescribing system has provided erroneous warning information—with one-third of this group indicating that the alerts were inaccurate 50 percent or more of the time.
Specifically, the categories of information in e-prescribing alerts that clinicians considered inaccurate were dosing range (54.2 percent), drug interactions (50 percent), contraindications (41.7 percent), dosing frequency (37.5 percent), dosing time (12.5 percent) and indications (12.5 percent).

Open Door wins second HIMSS Davies Award for use of HIT

Published December 18 2018, 4:48pm EST
Open Door Family Medical Center has won its second HIMSS Davies Award for excellence in the use of health information technology.
Open Door is a federally qualified health center with six sites and seven school-based health centers in the New York Hudson Valley Region.
The award recognizes use of IT to improve clinical outcomes, and Open Door demonstrated impressive improvements in technology-supported asthma care in school environments as well as advancements in colorectal screening at community health centers, according to HIMSS.

HIT Think Why advanced visualization is on the rise in radiology

Published December 18 2018, 3:49pm EST
With healthcare IT becoming increasingly enterprise across departments and sites, advanced visualization as well as PACS, is commonly a strategic obstacle because of its often standalone workstation-based nature.
The wish for diagnostic viewing integrated into the healthcare enterprise with multiple access points, has given new hope for the more lightweight universal viewers (UV) and increased demand for UV with diagnostic tools. The UV market is still small compared with the more mature advanced visualization (AV) market, but after years of relying on superior diagnostic features alone, AV vendors are now realizing AV needs to change to remain as the primary diagnostic tool.
Just like PACS, AV cannot continue to be a disconnected island within hospital informatics. And what do you do when you realize you are being sidetracked? You integrate. RSNA this year testified to this realization with AV showcases and announcements focusing on AV integrating more tightly in the workflow pre- and post-diagnosis, as well as new developments with AI assisted image analysis.

We’re Finally Learning the Lesson of Y2K — and It’s Too Late

It’s time to question our faith in the machine
Dec 6, 2018
 In a welcome anticlimax to two years of dire warnings, the new millennium arrived over the weekend without a computer-driven meltdown of the globe’s electronic infrastructure.” So began a New York Times editorial on January 3, 2000, reflecting a collective sigh of relief that immediately followed the clocks turning over from 1999 to 2000.
New Year’s Eve 1999 was supposed to be like no other. In the months leading up to the start of the new millennium, panic rose over a programming error lodged within computers all over the world. The so-called Y2K bug was a problem with internal clocks in computers and software — they only counted years as two digits. And so, nobody was quite sure what would happen when they all went from 99 to 00. Panic rose. What would the computers do, faced with a theoretical year double-zero? Would bank machines work? Would planes fall out of the sky? Would nuclear missiles be accidentally deployed?

Evidence standards framework for digital health technologies

As digital health technologies develop at an increasing pace, we've worked with partners to develop standards that ensure new technologies are clinically effective and offer economic value.
The aim of these standards is to make it easier for innovators and commissioners to understand what good levels of evidence for digital healthcare technologies look like, while meeting the needs of the health and care system, patients, and users.
We've created these standards as part of a working group led by NHS England. The group also includes:
  • Public Health England
  • MedCity
  • DigitalHealth.London.

Checklist: 10 steps for future-proofing ambulatory EHRs

Action items to help make the most of whichever electronic health record platform you’ve chosen.
December 17, 2018 08:08 AM
Following are insightful tips from ambulatory EHR experts on how best to prepare today for the ambulatory EHR technology of tomorrow.
1. Healthcare organizations need to mitigate physician frustration and simplify the EHR. “For many years, the focus in EHR development was on meeting regulatory requirements, which meant users had to adapt to less-than-optimal solutions,” said Allscripts CEO Paul Black. “That comes at a cost: When provider wellness suffers, it can negatively affect decision making and patient safety.” User-centered design principles must be employed to create more intuitive systems, overcome workflow challenges and make EHRs smarter to give users the right information at the right time, he said.
2. Providers must prepare for the growth in Millennials. That’s because they’re digital natives willing to harness tech tools to play a greater role in their health and bringing new expectations to the system. “Consumers are viewing health solutions in terms of overall wellness, patient experience and outcomes, an indication that patient-centric solutions will become the norm for all aspects of healthcare,” Black said. Many pediatric practices are discovering that Millennials have different expectations for their children’s healthcare than previous generations, so services such as online scheduling and e-mail appointment reminders have become an expectation for the generation that grew up with the internet, he added.

What to know before purchasing a next-gen ambulatory EHR

Executives from Epic, Allscripts, athenahealth, eClinicalWorks and Greenway reveal what business decision makers should expect from their forthcoming software and cloud-based services.
December 17, 2018 08:35 AM
Electronic health record systems are the backbone of ambulatory practices today and need to be designed and tailored to meet the specific needs of physicians. Ambulatory EHRs are tasked with streamlining workflows, improving care and helping to trim costs. And like every technology, ambulatory EHRs are evolving, changing in different ways to meet the constantly transforming healthcare marketplace.
It’s up to physician group practices, health systems that own numerous group practices, and other ambulatory healthcare organizations to stay abreast of change to make sure they are getting the most out of their EHRs, and to make sure that they don’t fall behind technologically in a highly competitive industry.
Ambulatory EHR experts at both provider and vendor organizations have a wide variety of informed opinions and helpful insights as to where the technology is headed next so that ambulatory healthcare provider organizations can best prepare for where they need to be in the years ahead. And they share their expertise here, as well as in a checklist of both evolutionary changes coming soon and ways organizations can future-proof in advance of such changes and in a case study of an ambulatory EHR in action.

Using AI to Improve Electronic Health Records

December 13, 2018
Electronic health record systems for large, integrated healthcare delivery networks today are often viewed as monolithic, inflexible, difficult to use and costly to configure. They are almost always obtained from commercial vendors and require considerable time, money, and consulting assistance to implement, support and optimize.
The most popular systems are often built around older underlying technologies, and it often shows in their ease of use. Many healthcare providers (including the surgeon and author Atul Gawande) find these systems complex and difficult to navigate, and it is rare that the EHR system is a good fit with their preferred care delivery processes.
As delivery networks grow and deploy broad enterprise EHR platforms, the challenge of making them help rather than hinder clinicians is increasing. Clinicians’ knowledge extends far beyond their clinical domain — care procedure knowledge, patient context knowledge, administrative process knowledge — and it’s rare that EHRs can capture all of it efficiently or make it easily available. What’s more, in the U.S., regulatory, billing and revenue cycle requirements add additional complexity to the electronic healthcare workflow and further reduce the time clinicians have to engage with patients.

Using one of the worst passwords of 2018 is a great way to get hacked

December 13th, 2018 at 6:15 PM
No matter how much we read about hacks and data breaches and the importance of taking solid security precautions, one of the unchangeable truths of the world is that people on average are absolutely terrible when it comes to choosing passwords. We use the same ones over and over, to the delight of hackers, and the ones we come up with tend to be pathetically easy so that we’re able to remember them.
SplashData is out with its eighth annual compilation of the Worst Passwords of the Year, a ranking it produces after evaluating more than 5 million passwords that have been leaked on the Internet. If you use any of these, we can’t stress this enough. As SplashData puts it themselves, anyone using any of these passwords is putting themselves “at substantial risk of being hacked and having their identities stolen.”
A few notes about this list: 2018 was the fifth straight year that saw these passwords in the Number 1 and 2 spots for being the absolute worst: “123456,” and “password.” The five worst passwords after those 2? They’re all just numerical strings.

Texas judge strikes down ACA as unconstitutional, but long legal path remains

Dec 14, 2018 10:45pm
Industry groups were quick to criticize the judge's ruling, as President Trump called it "great news for America." (Getty/Ellenmck)
A federal district judge struck down the Affordable Care Act on Friday evening, ruling the entire law is unconstitutional and setting up a lengthy legal battle that could ultimately bring the law back to the Supreme Court once more. 
U.S. District Judge Reed O'Connor of the Northern District of Texas sided with 20 attorneys general in their lawsuit against the Affordable Care Act, ruling that the individual mandate is "essential to and inseverable from the remainder of the ACA."
"Congress stated many times unequivocally—through enacted text signed by the President—that the Individual Mandate is 'essential' to the ACA," O'Connor wrote in a 55-page decision (PDF). "And this essentiality, the ACA’s text makes clear, means the mandate must work 'together with the other provisions' for the Act to function as intended."

Docs don’t routinely report patient symptoms in EHRs

Published December 17 2018, 7:24am EST
Primary care physicians do not routinely put patient-reported symptoms regarding sleep, pain, anxiety, depression and low energy or fatigue into electronic health record systems.
That’s among the findings of a study published in the December issue of the peer-reviewed journal Quality of Life Research.
In addition, most EHR systems are not designed to include patient-reported symptoms, according to Regenstrief Institute investigator Kurt Kroenke, MD, senior author of the study.

Decision support tool helps City of Hope docs find answers quicker

Published December 17 2018, 4:25pm EST
City of Hope has adopted an evidence-based clinical decision support platform to aid oncologists in selecting optimal precision medicine treatments.
The Duarte, Calif.-based organization, which is an independent cancer research and treatment provider, is moving to the approach to find best treatments for each patient at the point of care.
The platform is Trapelo from software vendor Intervention Insights, which also offers order management and results reporting for molecular testing, appropriate workflows and collaboration between providers, laboratories and insurers.

HIT Think Why cybersecurity should focus on preparing for the unknown

Published December 17 2018, 4:55pm EST
This past July was the worst month on record for healthcare data breaches, according to the Department of Health and Human Services’ Office for Civil Rights. Records show that data breaches put 858,411 individuals at risk.
These numbers follow unsettling figures from the first half of 2018—Protenus Breach Barometer reported 3.15 million patient records were compromised in breaches during the second quarter alone. While certainly unwelcome, this news doesn’t come as a shock to the healthcare industry.
However, it does serve to raise the anxiety level, especially for provider organizations that hold troves of sensitive, personal data, such as Social Security numbers, addresses, credit cards and personal health information (PHI). A single breach can expose thousands of patient records, which puts individuals at risk of having their personal information exposed or used fraudulently. It also results in significant financial and reputational consequences for providers.

Interoperability Issues? Most Blame EHR Integration and Lousy Addresses for Physicians

By Mandy Roth  |   December 17, 2018

ONC report highlights interoperability progress and where health systems should focus.

Interoperability remains one of the greatest challenges in health information technology, and resolving these issues holds great promise to enhance innovation. As we move into a new year, a recent report by the Office of the National Coordinator (ONC) for Health Information Technology sheds light on the state of interoperability and where health systems should focus to make continued progress.
Where do the biggest problems lie? The most common reason for not using information received electronically from outside the hospital system is difficulty integrating information into the EHR. The  greatest barrier to sending information via electronic exchange is difficulty locating providers’ addresses.
The ONC study, "Variation in Interoperability Among U.S. Non-federal Acute Care Hospitals in 2017," indicates hospitals made significant progress between 2016 and 2017. Yet challenges still exists. Among the barriers to health information exchange, nearly six in 10 hospitals reported challenges exchanging patient health information across different vendor platforms, up from five in 10 in 2016.

Experts sought to take part in new ‘consent’ committee for health research

Researchers will be able to apply in exceptional circumstances to use personal data without consent

16 December, 2018
Purpose of the regulations is to ‘support health research and promote enhanced public confidence in such research’.
Members of the public and experts in the areas of health, research, ethics and technology are being invited to express an interest in sitting on a committee that will play a key role in overseeing new health research regulations.
The committee will have the power to grant health researchers an exemption in certain circumstances from obtaining “explicit consent” from individuals to using their personal data in their research.
Known as the Consent Declaration Committee, it will be appointed by Minister for Health Simon Harris under new health research regulations signed by him in August.