Quote Of The Year

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

Saturday, December 08, 2018

Weekly Overseas Health IT Links – 8th 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.
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IT investment in China’s hospital system estimated to reach 65.7 billion yuan in 2022

Beijing-based research consultancy Analysys’s report also notes that China’s medical system will shift its focus from basic digitalisation to patient-centric clinical digitalisation in the future.
November 30, 2018 01:51 AM

A recent article from China Daily stated that IT investment in the country’s hospital system will reach 65.7 billion yuan ($9.47 billion) in 2022, surging 53.5 percent from 2017 and boosting the digitalisation of the Chinese medical system, based on a forecast report by Analysys. The Beijing-based research consultancy’s report also noted that the Hospital Information System has almost achieved full coverage in China’s tertiary hospitals, which is the largest in the country’s three-tier system.
Coverage in primary and secondary hospitals, the lowest two tiers, is currently at 80 percent.
Statistics from the Chinese Hospital Association indicated that in 2017, hardware investment accounted for 44 percent of total hospital digitalisation investment, while spending on software and services represented 56 percent. Chen Qiaoshan, a medical analyst at Analysys said that software and services as the core of hospital digitalisation will a have higher growth potential than compared to hardware.
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Alert fatigue: Are clinical surveillance tools making it any better?

KLAS sized up 10 vendors and found that the technologies are maturing and improving clinician’s workflow.
November 30, 2018 11:40 AM
A new KLAS study of 10 vendors who provide clinical surveillance tools, with alerts, found that the technology can save lives, prevent readmissions and improve workflow.
That is at least one small piece of welcome news for IT shops and the clinicians they support, who are widely understood to be overrun by medical alerts.
WHY IT MATTERS
Embedded alerts have created a state of alert fatigue for many users — but these new findings make it evident that the risk of alert fatigue might be worth it.
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System C & Graphnet using FHIR to integrate with new National Record Locator Service

System C & Graphnet Care Alliance has completed the initial phase of integrating  CareCentric with a new information sharing setup from NHS Digital, the company has announced.
Owen Hughes – 29 November, 2018
The National Record Locator Service was launched by NHS Digital earlier this week, and is intended to improve sharing of key patient data between clinicians.
In the first instance, it will allow paramedics and mental health nurses to easily find out if the patient they are attending has a mental health crisis plan.
System C & Graphnet Care Alliance’s initial deployment adds locator records for patients who have been referred to Cheshire and Wirral Partnership NHS Foundation Trust.
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Vitality’s Apple Watch initiative leads to sustained physical activity increase

A large-scale study of an Apple Watch incentive programme from insurer Vitality, covering 400,000 people, has recorded sustained 34% increases in physical activity.

Jon Hoeksma - 30 November 2018
The study points to the effectiveness of wearable tech, linked to goal-orientated incentives and behavioural change programmes to achieve significant increases in physical activity in all population segments, not just the already active.
The international longitudinal study of the impact of behavioural tech by Rand Europe found Vitality’s Active Rewards programme has resulted in a sustained 34% increase in people’s physical activity.
Rand said this equates to almost a week of extra activity per month – which could result in two extra years of life per person.  The 34% increase was recorded in people who had already enrolled in the Vitality Active Rewards Programme.
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John Hancock's Vitality platform sees big user growth

By Tim Sandle     Nov 28, 2018 in Business
Insurance company John Hancock and behavior change platform Vitality have released data that shows those who wear an Apple Watch and participate in the Vitality Active Rewards program take part in increased physical activity.
John Hancock recently entered into a partnership with Vitality to integrate life insurance with a comprehensive healthy living program for U.S. consumers. The aim of the program is to offer potential for savings on annual insurance premiums, plus discounts and rewards from leading retailers, to those taking out health or life insurance. The program also intends to encourage policyholders to take small steps to improve their health.
As Digital Journal reported earlier, there are two tiers of insurance on offer. The first is the basic Vitality GO scheme, which provides fitness and nutrition advice and resources. Through these, as people hit goals and milestones they will be rewarded through discounts at "major outlets." The second tier is Vitality PLUS. Here those taking out insurance can be awarded up to a 15 percent discount on premiums, together with rewards for exercising, eating healthy and getting regular check ups.
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FDA Foresees Few Patient Safety Issues with Data from Rx Apps

Data-driven applications that pose few patient safety risks for users of prescription drugs will likely avoid intense scrutiny, the FDA says.

November 28, 2018 - The FDA is suggesting a hands-off approach to reviewing prescription drug applications that present data with low risks to patient safety, the agency said in a request for comments published in the Federal Register.
The solicitation for industry opinions is part of the process of establishing a framework for managing the emerging market for digital health tools that can monitor medication adherence, provide data about utilization, or help maintain correct usage of prescription substances.
While tools and apps that act as companions for prescription drugs are likely to be valuable assets for drug manufacturers and patients, they are also generally expected to pose little safety risk, the FDA noted.
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Patient-led portal aggregates crowdsourced data to accelerate cancer cure

Published November 30 2018, 7:48am EST
HealthTree.org, a new patient-led online portal, is aggregating crowdsourced data to accelerate a cure for Multiple Myeloma, a cancer with 30,000 new diagnoses annually that affects bone marrow.
The portal aggregates patient-contributed and de-identified data, helps patients find treatment options relevant to them in their specific stage of disease, and connects patients with clinical trials they are eligible to join.
In addition, the platform enables patients to track all of their myeloma lab values in one place, and allows patients to view collective reports that provide analysis of treatments based on their success.
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EHRA offers implementation guide for CDC opioid recommendations

Published November 30 2018, 7:28am EST
The Electronic Health Record Association has released a new implementation guide for incorporating the CDC’s recommendations for prescribing opioids into EHRs.
In 2016, the agency developed and published the CDC Guideline for Prescribing Opioids for Chronic Pain including 12 recommendations to improve communication between providers and patients about the risks and benefits of opioid therapy.
According to EHRA, the CDC’s 12 recommendations for prescribing opioids for chronic pain—outside of active cancer, palliative, sickle cell disease and end-of-life care—apply primarily to physician, physician assistant, as well as advanced practice nurse prescribers of opioids who are making treatment decisions.
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HIT Think How to stay ahead of cyber threats to IoMT devices

Published November 30 2018, 2:30pm EST
Recent years have seen dramatic growth in the use of connected medical devices, collectively called the internet of medical things. From MRIs to heart monitors to insulin pumps, medical devices are increasingly communicating with each other, with networked hospital systems, with electronic medical record operations and with other agents via the internet.
U.S. hospitals are already using an average of 10 to 15 connected medical devices per bed. In total, Forbes reports, some 3.7 million connected devices are in use today. By 2020, there will be 20 billion to 30 billion such devices in use, according to a projection from Frost & Sullivan.
The rapid uptake of these technologies is not surprising: device connectedness has the potential to transform medicine by allowing for better patient and health monitoring. But along with IoMT’s transformative potential comes a host of new cybersecurity risks. By virtue of their connectivity (for example, trusted internal network access), these devices are exposed to the larger IT environment. The FDA has reported that an average of 164 cyber threats are detected per thousand IoMT devices. Vulnerabilities are multiplying as more IoMT devices are being granted authorized-user access to hospital networks.
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U.S. indicts Iranian hackers responsible for deploying 'SamSam' ransomware

WASHINGTON (Reuters) - The United States on Wednesday indicted two Iranians for launching a major cyber attack using ransomware known as “SamSam” and sanctioned two others for helping exchange the ransom payments from Bitcoin digital currency into rials.
The 34-month long hacking scheme wreaked havoc on hospitals, schools, companies and government agencies, including the cities of Atlanta, Georgia, and Newark, New Jersey, causing over $30 million in losses to victims and allowing the alleged hackers to collect over $6 million in ransom payments.
The deployment of the SamSam ransomware represented some of the highest profile cyber attacks on U.S. soil, including one in 2016 that forced Hollywood Presbyterian Hospital in Los Angeles to turn away patients and one last year that shut down Atlanta courts and much of its city government.
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HHS drafts strategy to reduce EHR 'burden' on clinicians: 4 things to know

Written by Jessica Kim Cohen | November 28, 2018 | Print  | Email
HHS released a draft of a new strategy Nov. 28 designed to reduce administrative and regulatory burdens placed on clinicians by inefficient health IT processes.
Here are four things to know about the draft strategy:
1. The ONC partnered with CMS to create the draft strategy, as required under the 21st Century Cures Act. "Information technology has automated processes in every industry except healthcare, where the introduction of EHRs resulted in additional burden on clinicians," said ONC head Don Rucker, MD.
2. To develop the draft strategy, ONC and CMS hosted listening sessions and solicited written feedback from clinical stakeholders, including clinicians, about regulatory and administrative burden associated with health IT. Much of the feedback focused on EHRs, with clinicians voicing concerns that documentation requirements have led them to spend significant time entering data into these systems.
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ONC makes awards in Easy EHR Issue Reporting Challenge

Published November 29 2018, 7:23am EST
The Office of the National Coordinator for Health IT has announced the winners of its challenge to identify potential solutions for helping providers report on the usability or safety of their EHR systems.
ONC’s Easy EHR Issue Reporting Challenge was a call to industry to create software tools to make it easier for clinicians to efficiently and effectively report concerns about the usability or safety of EHRs.
“Improving the safety of health IT remains an important priority,” said Andy Gettinger, MD, ONC chief clinical officer. “We believe that making it easier for end users to report will help in that goal.”
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Smartphones remain communications concern for clinicians

Published November 29 2018, 5:37pm EST
Concerns persist among clinicians about the sending of unsecured text messages via their smartphones.
Virtually every provider in a healthcare organization, along with researchers, administrators and anyone else in an authorized position that may possess patient information, has a smartphone with them at all times.
These phones offer great convenience for clinicians who can communicate quicker than they had been able to do just a few years ago—and, much of that communication is through texting.
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10 ingredients making VA’s e-health record program sick

The House Veterans Affairs Subcommittee on IT Modernization recently held a hearing on the Department of Veterans Affairs electronic health record modernization (EHRM) program to assess progress to date. The hearing was remarkable on several levels but perhaps the most remarkable was the bipartisan and positive support for this program from both sides of the aisle. Congress clearly wants this program to succeed and wants to be as helpful as possible.
Despite this positivity, every member of the committee raised serious concerns about this 10-year, $16 billion program which is now in its 18 month. The chairman of the subcommittee, Rep. Jim Banks (R-Ind.), questioned how a program that has not yet reached a single major milestone could now be $350 million over its approved budget. He raised an alarm about Cerner’s current inability to deliver community care interoperability and the lack of a VA plan to achieve it.
Rep. Phil Roe, (R-Tenn.), a physician, warned repeatedly about the significant impact a project of this scale and scope would have on patient care under the best of circumstances. Rep. Conor Lamb (D-Pa.) gently probed how workflow issues were going to be dealt with by the VA, and whether or not the concerns expressed by the VA workflow councils made up of Defense Department and VA clinicians would be resolved, and by whom.
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Verma says interoperability rule is coming, backs data sharing as a Medicare requirement

Nov 28, 2018 11:51am
A much-anticipated proposed rule on interoperability should be coming “shortly,” according to a top Trump administration official.
“Hopefully in the next couple of weeks we’ll have some more clarity,” Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma told reporters on Tuesday.
A rule titled “Interoperability and Patient Access” is still under review by the Office of Management and Budget. The proposal, deemed “economically significant,” vaguely says it will “move the health care industry toward a more accessible and interoperable health care ecosystem.”
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New HHS recommendations focus on freeing clinicians from EHR burdens

Nov 28, 2018 2:10pm
It’s no secret that physicians are bogged down by EHRs. Now, the federal government says it has some solutions.
A new draft strategy issued by the Department of Health and Human Services (HHS) on Wednesday details three overarching goals to reduce clinician burden revolving around entering information into the EHRs, meeting regulatory requirements and improving EHR ease of use. In several recommendations, the agency vowed to continue is work stripping down regulations and working with the industry to find solutions to growing problems. 
“When using their EHRs, clinicians increasingly rely on checkboxes, templates, cut-and-paste functionality, and other workarounds that may counter the intended benefits of EHRs,” senior officials with the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services (CMS) wrote in a blog post. “We have heard from many clinicians that they continue to spend more time entering data, leaving less time for patient interaction.”
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UnitedHealth rolls out beta individual health record to 3 ACOs, touts promising early results

Nov 27, 2018 3:00pm
Shortly after announcing it would make a new in-house medical record available to 50 million members by the end of next year, UnitedHealth is already testing it out on select providers.
The company released a beta version of its new individual health record (IHR) to three accountable care organizations (ACOs) in early November, and the results so far have been promising, UnitedHealth CEO David Wichmann said during the company’s investor conference on Tuesday.
In the first week, the IHR “positively altered the course of treatment” for two patients, possibly saving their lives, he said.
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November 28, 2018 / 9:28 AM

Telemedicine surging in US but still uncommon

 (Reuters Health) - Although telemedicine visits have increased sharply in the U.S. in recent years, the vast majority of American adults still receive care from doctors in person rather than via remote technology, a new study suggests.
The goal of telemedicine is to help improve access to specialty care, particularly in rural, underserved areas of the country, researchers note in JAMA. As of 2016, 32 states have passed so-called “parity” laws requiring insurance coverage and reimbursement for telemedicine visits.
To see whether these laws translate to more use of telemedicine, researchers examined private health insurance claims data from 2005 to 2017 from OptumLabs Data Warehouse.
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Amazon launches NLP service to process unstructured text

Published November 28 2018, 7:15am EST
A new machine learning service from Amazon Web Services is being offered to process unstructured medical text and identify information such as patient diagnosis, treatments, dosages, and symptoms.
Amazon Comprehend Medical is being touted as a natural language processing service that makes it easy to use machine learning to accurately and quickly extract relevant information from unstructured text, such as medical notes, prescriptions, audio interview transcripts, as well as pathology and radiology reports.
“There are no servers to provision or manage—developers only need to provide unstructured medical text to Comprehend Medical,” wrote Amazon’s Taha Kass-Hout, MD, former FDA chief health informatics officer, and Matt Wood, general manager for deep learning and AI, in a blog post on Tuesday.
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EHRs help identify patients at greatest risk of dying from sepsis

Published November 28 2018, 7:07am EST
Drexel University researchers have developed an analytical model for detecting early warning signs of sepsis that can predict those patients at the greatest risk of dying from the life-threatening condition.
Leveraging EHR data from more than 210,000 hospital visits between 2013 and 2016, researchers have used their model to analyze the relationship between in-hospital mortality and sepsis symptoms with seven organ systems—cardiovascular, gastrointestinal, hematopoietic, metabolic, nervous, renal, and respiratory—in order to determine which organ dysfunctions resulted in deaths.
“The integration of analytics and clinical, translational research provides insight into developing smart and connected systems that support data-driven and personalized management of sepsis,” said Muge Capan, co-principal investigator of the study and an associate clinical professor at Drexel's LeBow College of Business.
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Data breach at Atrium Health impacts more than 2.6M records

Published November 28 2018, 7:32am EST
A major cyber event at Atrium Health, an expansive delivery system with more than 40 hospitals and 900 care locations, could affect more than 2.6 million patient records.
Included in that total are about 700,000 affected individuals whose Social Security numbers were compromised and are being offered credit monitoring services from Kroll.
“It is very important to understand that the data was accessed but not downloaded in this incident,” according to an Atrium Health spokesperson. “Our forensic reports indicate they were not able to actually download or remove the files.”
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HHS pledges to reduce health IT regulatory burdens on clinicians

Published November 28 2018, 4:02pm EST
Providers are spending too much time entering data into electronic health records, leaving less time to interact with patients, while having difficulty finding relevant patient information to effectively coordinate care.
That’s the contention of the Department of Health and Human Services, which issued a draft strategy on Wednesday—required by the 21st Century Cures Act—to reduce administrative and regulatory burdens on doctors.
“Health IT tools need to be intuitive and functional so that clinicians can focus on their patients and not documentation,” said Don Rucker, the National Coordinator for HIT. “This draft strategy identifies ways the government and private sector can alleviate burden. I look forward to input from the public to improve this strategy.”
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HIT Think 5 steps organizations can take to thwart insider security threats

Published November 28 2018, 2:33pm EST
A few years ago, if someone had asked me to talk about insider threats, I might have been less than excited about the subject.
We all hear news about credit card or healthcare data being stolen, or lately, election-related hacking. Images come to mind of darkly clothed people sitting in the shadows somewhere far away—perhaps working with a foreign government or a sophisticated cybercrime group. Few of us consider that the person sitting in the cubicle down the hall could be a cyberattacker.
But in my recent conversations with security leaders, the subject of insider threats has been voiced as a top reason that organizations are seeking new approaches to cybersecurity. Among our customers, we have also seen an increase in the number of actual malicious insider events.
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A CIO's guide to AI dashboards

Some forward-looking CIOs are putting together AI dashboards, or beginning to think about such dashboards and what would make them useful tools.
November 27, 2018 08:56 AM
The presence of artificial intelligence-powered IT is growing in healthcare. More and more CIOs and caregivers are finding new uses for powerful AI to help its human users in the delivery of care, both behind the scenes and at the point of care.
Dashboards are popular tools for healthcare executives and caregivers to use to track and measure technologies in action. And AI is no different in this respect, though it is very different from other technologies in its complexity. So some forward-looking CIOs are putting together AI dashboards, or beginning to think about such dashboards and what would make them useful tools.

What AI dashboards track

So what would an AI dashboard track? To some extent, this is going to depend on what a hospital is hoping to accomplish with its deployed AI. For example, are the use-cases targeting inpatient or outpatient metrics, operational functions or clinical.
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Samsung applies AI to medical imaging

Samsung Electronics has applied its artificial intelligence (AI) algorithms to its imaging devices that will assist diagnosis of radiologists.
By Cho Mu-Hyun | November 26, 2018 -- 01:37 GMT (12:37 AEDT) | Topic: Samsung
Samsung Electronics has applied its AI algorithms to its imaging devices, the company announced.
The South Korean tech giant, together with its medical device affiliate Samsung Medison, showcased various types of diagnostic imaging software at the Radiological Society of North America 2018 Annual Meeting (RSNA 2018) in Chicago.
Offerings include those for ultrasound, digital radiography, computed tomography, and magnetic resonance imaging (MRI).
Samsung's S-Detect for Breast, which analyses for breast lesions using ultrasound images, and provides standardized reports and classifications, was showcased at RSNA 2018.
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Building a better patient portal

By Rachel Z. Arndt  | November 24, 2018
You hear the complaints often: Electronic health records are difficult to navigate. Information is incomplete or hidden. And they don't actually save time.

Think these are complaints from providers? Think again—they're from patients. It's easy to forget there are two sides of the EHR: one for providers, one for patients.

Meaningful use dollars—$35 billion through May 2016—were supposed to result in EHRs that make data move not only among providers but also between providers and patients. But the stodgy software continues to pose problems.

And while providers have to use that software to meet federal requirements, patients don't. As of 2017, just 28% of patients accessed their health records online in the previous year, according to the Office of the National Coordinator for Health Information Technology. Of those patients, the majority viewed their records just one time. Barely half of providers even offered online access in the first place.
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Federal cybersecurity center to issue guidelines on remote patient monitoring systems

Written by Jessica Kim Cohen | November 26, 2018 | Print  | Email
The National Cybersecurity Center of Excellence at the U.S. Department of Commerce's National Institute of Standards and Technology proposed a project to address security and privacy risks that healthcare delivery organizations face when offering remote patient monitoring services.
Remote patient monitoring services pose a challenge for healthcare providers, since equipment is deployed in a patient's home, rather than in controlled environments such as the hospital setting. These services also tend to rely on third-party video conferencing, cloud computing and internet technologies — the security of which may not be regulated outside of the hospital.
To address the risks inherent in these services, the NCCOE outlined a reference architecture to help healthcare organizations secure their remote patient monitoring ecosystem and proposed a project to assess its feasibility.
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Ransomware Attack Prompts Ohio Hospitals to Enter EHR Downtime

An Ohio hospital and medical center are experiencing EHR downtime and diverting patients following a ransomware attack.

November 26, 2018 - East Ohio Regional Hospital (EORH) and Ohio Valley Medical Center (OVMC) have voluntarily initiated a period of EHR downtime after a ransomware attack hit the hospital’s network on Friday, November 23.
The hospitals are diverting emergency squad patients away from their facilities due to the cyberattack, according to The Times Leader.
EORH and OVMC Director of Marketing and Public Relations confirmed the attack to the Times on Saturday morning. Emergency squads began transporting patients to other local hospitals after receiving notification of the full diversion.
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Combined PET, X-ray CT offers ability to scan body in 3-D

Published November 20 2018, 7:28am EST
A medical imaging scanner that combines positron emission tomography and X-ray computed tomography is able to capture a 3-D image of the human body.
The combined technology has produced images far more quickly than currently used technology, according to those developing it at UC Davis.
Called Explorer, the machine captures radiation far more efficiently than other scanners, producing an image in as little as one second. In addition, over time, it can be used to produce movies that can track specially tagged drugs as they move around the entire body.
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Feds sanction provider who shared patient information with reporter

Published November 27 2018, 4:08pm EST
A three-doctor medical practice in Connecticut will pay a $125,000 fine to the HHS Office for Civil Rights after a patient had a dispute with one of the physicians who spoke to a local TV reporter.
Although the exact nature of the dispute between the patient and the doctor at Allergy Associates of Hartford was not made public, OCR investigated the incident and determined that the doctor’s conduct demonstrated a reckless disregard for the patient’s privacy.
The disclosure occurred after the physician was told by the privacy officer at Allergy Associates to not either respond to the media or respond only with “no comment.”
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HIT Think How telehealth gets to far-flung residents in Alaska

Published November 27 2018, 2:30pm EST
Most people know Alaska’s state nickname is “The Last Frontier,” but how many know its motto is “North to the Future”? We all may be surprised at how relevant that motto may become for health systems in the Lower 48. Odd as it may sound, Alaska could offer a future model for delivering care for all U.S. health systems, especially those focused on value-based care built upon digital health.
Telehealth has become an emphasis for even urban health systems seeking to deliver digitally enabled care and wellness programs to individuals and populations with equal ease, efficiency and quality across cities or wide regions. It has no better testing ground than Alaska. In essence, if it can play in Kodiak or Sitka, it can play anywhere.
Ranked first among the 50 states in area at just over 663,000 square miles, Alaska ranks 48th in population with about 740,000, more than a third of whom live in Anchorage. It’s like taking a medium-sized city and distributing its population over an area three and a half times the size of the Midwest.
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Amazon Starts Selling Software to Mine Patient Health Records

The move is the latest by a technology company to tap the health-care market

By Melanie Evans and Laura Stevens
Nov. 27, 2018 3:55 p.m. ET
Amazon.com Inc. AMZN 0.01% is starting to sell software to mine patient medical records for information that doctors and hospitals could use to improve treatment and cut costs, the latest move by a big technology company into the health-care industry.
The software can read digitized patient records and other clinical notes, analyze them and pluck out key data points, Amazon says. The company announced the software, which was first reported by The Wall Street Journal, on Tuesday.
Amazon Web Services, the company’s cloud-computing division, has been selling such text-analysis software to companies outside medicine for use in areas such as travel booking, customer support and supply-chain management. The technology’s health-care application is the newest effort by Amazon to tap into the lucrative market.
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Check Your Medical Records For Dangerous Errors

Judith GrahamNovember 21, 2018
When Liz Tidyman’s elderly parents moved across the country to be closer to their children and grandchildren years ago, they carried their medical records with them in a couple of brown cardboard folders tied with string.
Two days after their arrival, Tidyman’s father fell, which hadn’t happened before, and went to a hospital for an evaluation.
In the waiting room, Tidyman opened the folder. “Very soon I saw that there were pages and pages of notes that referred to a different person with the same name — a person whose medical conditions were much more complicated and numerous than my father’s,” she said.
Tidyman pulled out sheets with mistaken information and made a mental note to always check records in the future. “That was a wake-up call,” she said.
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Game-changing initiative to boost eHealth Interoperability Conformity Assessment in Europe

Experts meet in Brussels to discuss an EU project aiming to promote the adoption and take-up of interoperability testing of eHealth solutions against existing industry standards and profiles.
November 26, 2018 04:19 AM
Key European eHealth interoperability experts gathered in Brussels, Belgium, last week to discuss a multi-stakeholder initiative that could allow a one-time interoperability testing of eHealth products with mutual recognition across the EU and beyond.
New usages, new technologies, an ageing population and many other factors have contributed to a change in healthcare, leading to more connectivity between systems and an increasing need for interoperability.
Organised by the EURO-CAS project partners under the Horizon 2020 European research and innovation programme, including, among others, Integrating the Healthcare Enterprise Europe (IHE Europe), Agence eSanté Luxembourg, the European Institute for Biomedical Imaging Research (EIBIR) and Personal Connected Health Alliance (PCHAlliance), attendees looked at the potential use and scale of introducing a Conformity Assessment Scheme for Europe (CASforEU) based on existing well-used norms and standards to overcome interoperability challenges in the healthcare sector.
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Malaysia to implement EMR at 145 hospitals nationwide in the next three years

Health Minister Datuk Seri Dr Dzulkefly Ahmad also said in a recent HIMSS TV interview that even if an organisation has a good programme and system in place, digitising healthcare will not succeed if there is no clinical buy-in underpinned by training.
November 25, 2018 10:34 PM
 “In order to improve the country's health service to a better level, the Ministry of Health is committed to ensuring that the electronic medical record system (EMR) can be realised within three years at 145 hospitals nationwide,” said Malaysian Health Minister Datuk Seri Dr Dzulkefly Ahmad.
He spoke to the media after the Luncheon Talk at Menara Razak, Universiti Teknologi Malaysia (UTM) on 8 November 2018. Dr Dzulkefly added that 20 percent of the hospitals in Malaysia already have the EMR system in place, including Selayang Hospital and Ampang Hospital in Selangor but it is still not fully operational.
“We want to follow the best examples, such as in Turkey that have end-to-end solutions, good hospital information, and efficient track and trace for medicines that they have zero counterfeit (medicines).”
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Two cybersecurity policies, one clear new objective

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The views expressed by contributors are their own and not the view of The Hill
In the wake of countless cyberattacks, two federal cybersecurity policies are providing much-needed guidance to improve the defense of our nation’s cyber infrastructure, networks and data, setting a clear roadmap on how we can best protect the country. However, the work is not done yet. With a new set of legislators freshly elected, additional steps must be taken to ensure critical cyber policies remain a top priority.
This year, President Trump officially signed the new National Institute of Standards and Technology (NIST) Small Business Cybersecurity Act into law, and the Trump Administration announced the new National Cyber Strategy for United States of America — an effort the Administration said was the first of its kind in 15 years.
The National Cyber Strategy outlines the government’s multi-agency mission to secure critical infrastructure, combat cyber crime, foster a stronger cybersecurity workforce, promote responsible behavior between nation states and prevent malicious “information campaigns,” among a dozen more publicized items. 
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Report: Apple in Talks with VA to Provide Veterans Access to EHRs

November 21, 2018
by Heather Landi, Associate Editor
Tech giant Apple is in talks with the U.S. Department of Veterans Affairs (VA) to provide portable electronic health records (EHRs) to military veterans, according to a Wall Street Journal report published Tuesday.
According to people familiar with the effort and emails reviewed by WSJ, under the plans being discussed Apple would create special software tools allowing the VA’s estimated nine million veterans currently enrolled in the system to transfer their health records to iPhones and provide engineering support to the agency, the article says.
In January, Apple announced that it was launching a feature that allows consumers to see their medical records right on their iPhone and began testing the Health Records feature out with 12 hospitals, inclusive of some of the most prominent healthcare institutions in the U.S. Since that time, more than 100 new organizations have joined the project, according to Apple.
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FDA plans ‘generational’ overhaul of medical device approvals to make way for new technology

Nov 26, 2018 12:47pm
The Food and Drug Administration (FDA) is preparing to implement changes to its medical device clearance process that would rely far less on older predicate devices and offer a modernized pathway for high-tech medical innovations.
The changes, outlined by the agency’s top officials on Monday, represent a significant shift in the way the FDA approves devices for marketing in the U.S., a process first introduced more than 40 years ago. Specifically, the agency plans to change the 510(k) pathway required for new medical devices to account for advances in medical technology, FDA Commissioner Scott Gottlieb, M.D., and Jeff Shuren, M.D., director of the Center for Devices and Radiological Health, said in joint statement.
In 2017, 82% of all medical devices were cleared through the 510(k) pathway. The officials said they are "seizing the chance to make a generational change in the framework for 510(k) reviews."
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FDA seeks $46M to fund National Evaluation System for Health Technology

Published November 26 2018, 6:40am EST
The Food and Drug Administration is seeking $46 million in its fiscal year 2019 budget request to better enable its active post-market data monitoring system to gather real-world evidence for medical devices.
The National Evaluation System for health Technology (NEST), which leverages data from patient registries, Medicare claims, and electronic health records, is meant to provide critical information for assessing the safety and effectiveness of medical devices using real-world evidence.
The new funding for NEST will help to “advance a more rapid build-out” of the system, according to the FDA, providing the ability to more rapidly detect “emerging safety signals through active surveillance, supporting timely evaluation of these signals to determine if they represent a real risk to patients, and ensuring timely responses to new and increased risks.”
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Study: Optimal use of EHRs result in faster hospital discharges

Published November 26 2018, 3:00pm EST
Hospitals with the highest use of electronic health records discharge their patients quicker.
That’s the finding of a new study from Case Western Reserve University in Cleveland.
According to researchers, hospitals that meet federal standards for Meaningful Use of EHRs discharge patients about four hours earlier— which equates to a 3 percent reduction in the average five-day hospital stay.
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Bypassing GPs ‘could help to diagnose cancer sooner’

Chris Smyth, Health Editor
November 26 2018, 12:01am, The Times
Patients may need to bypass their GPs for urgent cancer checks because the family doctor system contributes to patients dying early, a review has concluded.
Ways of getting scans and blood tests more quickly must be tried out to help to close a persistent gap in survival rates between Britain and other countries, Professor Sir Mike Richards, the former national cancer director, has concluded. Action to spot cancer more quickly is expected to be at the centre of a ten-year plan for the NHS due within weeks, after Theresa May promised changes that would mean three quarters of tumours being diagnosed early enough for a cure, up from half.
In a review for the Health Foundation think tank to be published tomorrow, Sir Mike argues that when treatment does start it is largely as good in Britain as elsewhere, but that a key problem remains in getting a diagnosis early enough to allow surgery or radiotherapy to cure the disease. Writing in Red Box on the Times website Sir Mike said that these delays “relate to the way our health system is set up. The NHS in England operates a very tight gatekeeper model where GPs have responsibility for providing patients with access to diagnostics and hospital care.”
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Enjoy!
David.

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