Quote Of The Year

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

Saturday, August 17, 2019

Weekly Overseas Health IT Links – 17th August, 2019.

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.

AI and the potential liability issues arising from use in a clinical setting

Artificial Intelligence (AI) is intruding more and more into modern life and is seen as a tool which could transform healthcare. But what about the risks that come with it? Andrew Rankin, legal director at DAC Beachcroft LLP who specialises in technology law and related data protection matters, and Christian Carr, is a senior associate, specialising in matters related to regulation of healthcare look the potential legal issues surrounding AI in healthcare.
DHI Admin – August 6, 2019
Artificial Intelligence, or “AI” is a branch of computer science which attempts to build machines capable of intelligent behaviour. If AI can be thought of as the science, then machine learning can be thought of as the algorithms that enable the machines to undertake certain tasks on an ‘intelligent’ basis. So the enabler for AI is machine learning.
AI has become pervasive in our lives, yet we are often blissfully unaware that it is powering a lot of things.  From your smartphone, to Google searches, to your online banking, to Facebook: you may use systems deploying machine learning many times a day without even knowing it.
Outside of consumer use, in many areas of industry, people are excited about the possible applications for AI – arguably no more so than in medicine, which promises to harness its powers to make clinical care better, faster and safer.  Although AI technology is already embedded in many forms of medical technology, its use in front line clinical practice remains limited.

Apple and Eli Lilly are studying whether data from iPhones and Apple Watches can detect signs of dementia

Published Wed, Aug 7 2019 5:16 PM EDTUpdated Wed, Aug 7 2019 6:56 PM EDT

K Points
  • Apple has teamed up with Eli Lilly on new research to detect evidence of brain decline by using data from popular connected devices.
  • The early-stage study took place over 12 weeks, and included both an 82-person healthy control group and 31 individuals with varying stages of cognitive decline and dementia.
  • More than 6 million people in the U.S. live with dementia.
Apple has been adding health features to its iPhone and smartwatch, and is now working with Eli Lilly to see if data from the devices can help spot early signs of dementia.
According to research published this week, the two companies teamed up with health-tech start-up Evidation to find ways to more quickly and precisely detect cognitive impairments like Alzheimer’s disease with the help of popular consumer gadgets.
The study, which will be discussed on Thursday at a conference in Alaska, is the first to publicly link Apple and Eli Lilly. Of the 15 authors of the paper, five work for each company with the other five representing Evidation. It’s the latest sign that Apple’s health team is investing in deep medical research with traditional pharmaceutical players.

Patients trying to access medical records from shuttered, unresponsive clinic

Posted 6:11 PM, August 6, 2019, by Darren Cunningham, Updated at 07:02PM, August 6, 2019
OTSEGO, Mich. — Patients at an Allegan County health clinic are being forced to find a new place to receive treatment and struggling to access their records after it abruptly closed.
Michele Holes went to Monarch Health in Otsego for allergy injections that help with headaches, but now that the clinic closed its doors without notice, just getting her medical records has been an even bigger struggle.
“My medication isn't life-altering. But what if I was an elderly person who had a hard time getting to a new doctor? And getting a new script and they needed it right away?" Holes said.
Holes is speaking up not only for herself but for other former patients of Monarch Health who are unable to gain access to their medical records. As FOX 17 reported in June, the clinic in Otsego shutdown without notice and without explanation.

DirectTrust Surpasses 1 Billion Health Data Exchange Transactions

DirectTrust has experienced continued growth over this time last year, facilitating 397 percent more transactions over the same time last year.
August 05, 2019 - DirectTrust recently reported continued steady growth in the number of participating organizations, patient users, and health data exchange transactions in the second financial quarter of 2019.
The nonprofit healthcare industry alliance supports secure, identity-verified electronic exchanges of protected health information (PHI) between healthcare organizations, providers, and patients to support care coordination.
DirectTrust supported the exchange nearly 251 million messages in the last quarter — a nearly 53 percent increase over the previous quarter and a jump of nearly 397 percent over the same time last year.
HIT Think

3 keys to protecting patient data from common threats

August 09, 2019, 3:49 p.m. EDT
In the spring of 2018, cybercriminals attacked a multi-specialty practice, a lab-testing company and an electronic health records developer in just a few weeks. In the most alarming example, they infected a Missouri clinic with multiple types of malware. Then, as the hackers made their exit, they also infected the clinic with ransomware to cover their tracks.
The diagnosis is clear: Healthcare is under attack from hackers, and no one is exempt or immune. The cost of a data breach is also rising, with each record lost now costing healthcare organizations $408, compared with $380 a year ago. Even worse, healthcare faces a higher cybersecurity liability than any other industry—nearly three times higher than the average for all other industries ($158).
Hackers target the healthcare industry because even the smallest providers have valuable data, even though they often do not have strong cyber protections in place. In yet another example, hackers gained access to the consumer portal for Humana health insurance. The damage could have been limited if someone had noticed and acted quickly. Instead, the problem went unnoticed for almost four months, during which time hackers stole names, addresses, policy information and partial Social Security numbers. Unfortunately, this kind of slow response is all too common.

ID theft stings, but it’s hard to pin on specific data hacks

August 4, 2019
NEW YORK (AP) — Equifax 2017. Marriott 2018. Capital One 2019.
Data breaches through hacking attacks are distressingly common these days, and personal details about you can lead to identity theft, such as credit cards and loans in your name. But it’s hard to pin the blame on any specific hack, as the most sophisticated criminals combine data from multiple attacks to better impersonate you.
“That’s why fraud can be emotionally challenging,” said Kyle Marchini, a specialist in fraud management at the financial research group Javelin. “It just comes out of the blue, and there’s no way to identify where it came from or what I could have done to prevent that.”
While the number of reported breaches decreased slightly last year to 1,244, according to the nonprofit Identity Theft Resource Center, the total number of records exposed more than doubled to 447 million. That suggests hackers are focusing on larger organizations with bigger payoffs. Last year’s figures include data on about 383 million . Marriott guests in a breach that investigators suspect was tied to the Chinese government.

The Cybersecurity 202: Hackers are going after medical devices — and manufacturers are helping them

August 8
LAS VEGAS — Ten of the nation’s top medical device companies will give hundreds of ethical hackers free rein this weekend to poke and prod their pacemakers, drug infusion pumps and other devices — and look for bugs that could hurt people or even end their lives if they're exploited by criminals. 
And the hacks will take place out in the open — in a realistic hospital replica here at the Planet Hollywood Casino that includes hospital rooms, a lab for bloodwork, and neonatal and intensive care units. 
“Medical devices are lifesaving and life preserving, but they also can have flaws that could put someone’s life at risk,” Beau Woods, who organized the Medical Device Lab at this year’s Def Con cybersecurity conference, told me. “So, we’re trying to create a safe space to bring security researchers and medical device manufacturers together.” 
That marks a massive shift since 2011, when cybersecurity researcher Jay Radcliffe first demonstrated how he could hack his own implantable insulin pump at Def Con's sister conference Black Hat.
Overlake Medical Center & Clinics has, among other things, embedded state prescription monitoring program database access into the EHR, changed the Epic nursing workflow sheet for pain management, and revised the text in the after-visit summary.

An in-depth look at how one health system customized its Epic EHR to fight the opioid crisis

August 09, 2019 11:43 AM
The opioid crisis is not news to most in this country. But the way Overlake Medical Center & Clinics in Bellevue, Washington, is customizing its Epic electronic health record to combat the opioid crisis is.
Multidisciplinary teams have customized the EHR to include: tracking when a patient agreement goes into Epic; tools for assessing risk of diversion or addiction; the state provider database; and more.
“The opioid epidemic obviously has myriad contributing causal factors,” said Dr. Tom Miller, medical director, quality and safety, at Overlake Medical Center & Clinics. “As our community’s healthcare convener, we developed a plan to address some of these factors we could influence from our vantage point.”

Experian acquires MyHealthDirect, strengthening leadership position in patient access and engagement

August 9, 2019
MyHealthDirect digital care coordination platform and Experian’s data and analytics capabilities will work together to streamline healthcare administration
Experian, the global information services company, announced today that it has signed a definitive agreement to acquire MyHealthDirect, which offers a digital care coordination platform that optimizes scheduling for providers, payers, and consumers. This acquisition further solidifies Experian’s position as a leading provider of solutions that simplify the financial and administrative aspects of healthcare—making tasks like scheduling, registration and check-in smoother, cost estimates more accurate, and insurance coverage easier to verify.
“Experian Health’s mission is to use data-driven insight to connect and simplify healthcare for all,” said Jennifer Schulz, Experian Group President overseeing Experian Health. “Joining with MyHealthDirect will further propel how we deliver on that mission, giving us the potential to evolve our front-end patient access and patient engagement capabilities by creating solutions that improve consumer convenience while optimizing care across healthcare providers.”

Partners HealthCare taps AI to bring ultrasound to point of care

August 08, 2019, 12:05 a.m. EDT
Boston-based Partners HealthCare is teaming with FUJIFILM SonoSite to enhance ultrasound technology with artificial intelligence for use at the point of care.
Under the partnership with Seattle’s FUJIFILM SonoSite, the first area of focus will be on some of the more complex emergency medicine procedures using AI-enabled portable ultrasound.
“Allowing for even greater integration of ultrasound into our healthcare delivery system requires smarter machines,” says Keith Dreyer, chief data science officer at Partners HealthCare. “In emergency settings, the efficiency and cost-effectiveness of portable ultrasound makes it a critical companion to other imaging modalities.”

Transitions hampered by info exchange between venues of care

August 08, 2019, 4:25 p.m. EDT
Transitions in care between providers offering different levels of care are still mired in manual processes that hampers the ability to coordinate care.
A new survey examines the processes of how patients are being transitioned from acute-care providers to the long-term and post-acute care treatment environments. The research suggests that the difficulties in moving patients from one setting to another may grow as a problem as Baby Boomers begin to enter into hospitals and post-acute care facilities in record numbers.
Combine that with a nursing shortage, razor-thin margins, the need to reduce readmissions and ever-increasing federal regulations, and it is imperative that the long-term market automate to deliver best practices for improving long-term care, says B.J. Boyle, vice president at PointClickCare, a vendor of platforms to eliminate data silos and enable collaboration and insights among various types of providers.

Pittsburgh Health Data Alliance, AWS join on machine learning effort

August 08, 2019, 12:19 a.m. EDT
A consortium of three Pittsburgh institutions, focused on turning big data into better health, is joining forces with Amazon Web Services as part of a machine learning research sponsorship.
The Pittsburgh Health Data Alliance, which includes Carnegie Mellon University, the University of Pittsburgh and UPMC, will leverage AWS machine learning services to improve patient care through cancer diagnostics, precision medicine, voice-enabled technologies and medical imaging.
“New machine learning technologies and advances in computing power, like those offered by Amazon SageMaker and Amazon EC2, are making it possible to rapidly translate insights discovered in the lab into treatments and services that could dramatically improve human health,” according to PDHA’s announcement.

Telehealth use jumps at inpatient settings



Aug. 6, 2019

Dive Brief:

  • The use of telehealth services has surged in inpatient settings but remains relatively flat for outpatient locations, according to a pair of surveys released Tuesday by data and analytics company Definitive Healthcare.
  • Providers in both care settings are planning to invest in the technology going forward, with 90% slated to do so in the next 18 months, according to the surveys.
  • Cost is the primary barrier to adoption for inpatient providers. One in five outpatient respondents also cited "satisfaction with the practice's current solutions and services" as a primary obstacle to adoption.

Dive Insight:

Telehealth adoption has held promise for years, but adoption has been relatively slow. A recent survey found uptake has been highest among providers outside hospitals.

In Health Tech, Beware of Getting Exactly What You Want

August 8, 2019
Last night, I watched a video about the rise and fall of disgraced biotech startup Theranos, which claimed to have invented technology that would dramatically change clinical blood testing worked.
Though it apparently never came close to delivering what it promised, Theranos managed to raise more than $700 million in investments over the course of its lifetime. Not only that, it struck huge deals with a number of high-profile customers, including Walgreens, which agreed to bring Theranos technology into its stores without even testing it.
The spectacular flameout of Theranos has generated not only tons of news coverage, but also a book, a podcast, an HBO special and even a movie. Even so, I think there’s still one lesson to be drawn from the Theranos debacle that hasn’t come up much. It reminds us to beware of being presented with something that’s too good to be true.

Industry Voices—Removing ban on nationwide unique patient identifier would save lives, money

Aug 7, 2019 10:32am
Jane Doe receives Joan Doe’s cataract lens implantation.
One elderly Cantonese-speaking woman admitted to a hospital for a broken hip lies in pain overnight after being misidentified as her roommate, also an elderly Cantonese-speaking woman.
A delayed cancer diagnosis because of an identification mix-up, opioids being prescribed to a patient with a history of addiction, babies given incorrect milk—the list goes on. Those are but a few real-life examples of what can go wrong when patients are misidentified.
The statistics show that patient misidentification is common and can involve some of our most vulnerable people.

Penn State's solution for addressing forensic examiner shortage: Telehealth

Aug 7, 2019 12:00pm
Since Cindy Forbes, R.N., became a sexual assault forensic nurse examiner seven years ago, she has been the only specialized examiner in her rural community of Lakeport, California.
"If my victims aren't getting rape exams here, they aren't getting rape exams," said Forbes, an emergency department nurse at Sutter Lakeside Hospital, in a video for the National TeleNursing Center.
Lakeport is not unique.
Nurses that are trained to provide expert care to sexual assault victims are a highly valuable resource—they have specialized training in forensic examination and understand best practices in evidence collection. There are too few of these nurses, called Sexual Assault Nurse Examiners (SANE), nationally and many communities have no access to such expertise.

AI Ethics Guidelines Every CIO Should Read

You don't need to come up with an AI ethics framework out of thin air. Here are five of the best resources to get technology and ethics leaders started.
Technology experts predict the rate of adoption of artificial intelligence and machine learning will skyrocket in the next two years. These advanced technologies will spark unprecedented business gains, but along the way enterprise leaders will be called to quickly grapple with a smorgasbord of new ethical dilemmas. These include everything from AI algorithmic bias and data privacy issues to public safety concerns from autonomous machines running on AI.
Because AI technology and use cases are changing so rapidly, chief information officers and other executives are going to find it difficult to keep ahead of these ethical concerns without a roadmap. To guide both deep thinking and rapid decision-making about emerging AI technologies, organizations should consider developing an internal AI ethics framework. 
The framework won’t be able to account for all the situations an enterprise will encounter on its journey to increased AI adoption. But it can lay the groundwork for future executive discussions. With a framework in hand, they can confidently chart a sensible path forward that aligns with the company’s culture, risk tolerance, and business objectives.
HIT Think

Solving identifiers is key to address interoperability roadblocks

August 07, 2019, 4:44 p.m. EDT
In late June, in the course of voting on the Labor-HHS appropriations bill, House members passed an amendment offered by Representative Bill Foster (D-Ill.) and Representative Mike Kelly (R-Pa.) to H.R. 2740, the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act of 2020.
The Foster-Kelly amendment strikes Section 510 of the Labor-HHS Appropriations bill, which currently prohibits HHS from spending any federal dollars to promulgate or adopt a national patient identifier.
Removing this decades-old ban on a national patient identifier—or universal patient identifier (UPI)—addresses a major policy roadblock to interoperability that has cost American taxpayers, the federal government and hospitals, millions of dollars—not to mention jeopardized lives and resulted in mistakes that have caused deaths. By finally facilitating positive patient identification, we deliver on the promise of a person accessing or transporting their records in an increasingly mobile world.

State AGs ask Congress to replace law on substance use disorder records

August 07, 2019, 12:27 a.m. EDT
The National Association of Attorneys General wants the U.S. Senate and House of Representatives to get rid of decades-old regulations preventing doctors from knowing patient addiction treatment histories.
In a letter to congressional leaders, 39 state AGs called on Congress to “replace the cumbersome, out-of-date, privacy rules contained in 42 CFR Part 2 with the effective and more familiar privacy rules contained in the Health Insurance Portability and Accountability Act.”
Congress passed 42 CFR Part 2 more than 40 years ago out of concern about the potentially negative consequences—including discrimination—that could come from disclosing the patient records of individuals with substance use disorders.
However, the AGs contend that the antiquated law prevents lifesaving medical care for patients in trying to recover from addiction.

Mr Fax goes to Washington D.C.

By John Nebergall | August 5, 2019
eFax® advocates on Capitol Hill
Recently, I had the honor of travelling to Washington D.C. to speak on behalf of a substantive and important policy issue, digital cloud fax technology (DCFT) and interoperability in the health care industry.
Federal officials are on a mission to create a seamless exchange of personal health information (PHI) and electronic health records (EHR). That's the layman's definition of interoperability.
Although I am a layman on Capitol Hill, J2 Global Inc (J2), a provider of eFax Cloud Services remains a champion for DCFT. We are a key player in the field and we used our influence to educate federal officials about an issue that is extremely important to us and to our customers.
(Fax fight back??)

Boris Johnson announces £1.8bn cash boost to upgrade NHS facilities and equipment

Hospital trusts will use part of the funding towards tech projects such as developing integrated digital health services and creating a new laboratory management system.
August 07, 2019 03:51 AM
Hospital trusts will use part of the funding towards tech projects such as developing integrated digital health services.
The government announced that 20 hospitals will benefit from £850m (€925m) some of which will go towards digital projects.
South Yorkshire and Bassetlaw will use part of its £57.5m (€62.5m) funding towards joining up local services and “therefore improving the use of digital in primary care,” its website states. This will include developing a fully integrated digital service to enable patients to access their health care records and data, support clinical and strategic decision-making and improve system-wide IT services.

Epic’s Struggle Highlights Issues In Sharing Patient Information Datasets

August 7, 2019
In recent times, Epic has expanded its vision from being merely an EHR vendor to offering access to a gigantic patient health dataset culled from a broad range of providers. However, getting there is proving to be tougher than the company expected.
According to John Moore of Chilmark Research, who attended Epic’s 2018 UGM conference, CEO Judy Faulkner spoke there of building “One Virtual System Worldwide.” This virtual system, Faulkner told attendees, will help researchers generate clinical science breakthroughs drawing on the de-identified data of all of Epic’s clients.
One core element of Epic’s emerging virtual system is the Cosmos platform, a hosted data warehouse built on the Caboodle stack, which comes with a hosted version of its Slicer-Dicer analytics tools. Epic’s broader enterprise analytics and population health offering includes its Cogito Analytics Suite, AI and machine learning capabilities and its Healthy Planet population health platform.

At Vanderbilt, Electronic Health Records Are Beginning To Talk Back

Blake Farmer August 6, 2019
Electronic medical records are starting to talk back to doctors at Vanderbilt University Medical Center. The hospital is test-piloting a system where computers can analyze patient health data and spit out a brief summary.
Vanderbilt has been developing this digital assistant for the exam to solve a real sore spot across the health care system — distracted doctors.
Yaa Kumah-Crystal, a pediatric endocrinologist who specializes in clinical data, is leading the creation of VEVA, Vanderbilt's EHR Voice Assistant. And the hope is that physicians will actually look up from their laptops and really pay attention to the person in front of them.
"What I would love is to be hands-free, taking care of the patient, maintaining eye contact, having a conversation," Kumah-Crystal says. "Then just shouting out to the air, 'Oh, can you refill this patient’s medication?' And not have to kind of break away and just stare at the computer screen the entire time."

Model predicts patients at risk for Alzheimer’s 2 years in advance

August 06, 2019, 11:19 a.m. EDT
MIT researchers have developed a machine learning model that forecasts the cognitive decline of patients at risk for Alzheimer’s disease by predicting their cognition test scores as much as two years in advance.
Researchers, who will present a paper later this week at the Machine Learning for Health Care conference at the University of Michigan, contend that experiments indicate that accurate Alzheimer’s predictions can be made looking six, 12, 18 and 24 months in advance.
At the Machine Learning for Health Care conference, researchers will discuss how their model could be used for clinical trials to improve the selection of candidate drugs and participating patients who are in the disease’s early stages—before symptoms are evident and when treatment has the best chance of being effective.

Why Doctors Should Organize

Meeting the challenges of modern medicine will require more than seeing patients.

Many doctors feel despair about their appalling working conditions and the deteriorating doctor-patient relationship. But there have been no protest marches or social-media campaigns. Why not?
In the fall of 2018, the American College of Physicians published a position paper on gun violence. “Firearm violence continues to be a public health crisis in the United States,” its authors wrote, in the journal Annals of Internal Medicine. The report argued that assault weapons should be banned and that “physicians should counsel patients on the risk of having firearms in the home.” When it was published, the National Rifle Association responded with a tweet: “Someone should tell self-important anti-gun doctors to stay in their lane.”
The N.R.A.’s tweet provoked an unprecedented response from the medical profession. Using the hashtag #ThisIsMyLane, emergency-room physicians, trauma surgeons, pediatricians, and pathologists, all of whom are involved in the care of patients with gunshot wounds, posted images of shooting victims and bloodstained hospital floors. Some shared selfies in which they were splattered with blood. “Do you have any idea how many bullets I pull out of corpses weekly? This isn’t just my lane. It’s my fucking highway,” Judy Melinek, a forensic pathologist, tweeted. Melinek’s tweet went viral. Doctors appeared on television and wrote op-eds expressing their disgust with the N.R.A.


States set differing rules for use of PDMP data in opioid fight

August 06, 2019, 11:08 a.m. EDT
Prescription drug monitoring programs, state-run electronic databases, are on the frontlines of fighting America’s opioid crisis but have different requirements for prescribers to review the PDMP information.
The Department of Health and Human Services’ Office of Inspector General took a close look at of eight states—Nebraska, Nevada, New Hampshire, Tennessee, Texas, Utah, Washington and West Virginia—to assess their oversight of opioid prescribing and their monitoring of opioid use.
What the OIG found was that all eight states have laws, regulations or policies related to opioid prescribing—as well as to using PDMP data—and also perform data analytics.
 “The states are using opioid-related data to perform data analytics, as well as performing outreach to providers and patients,” according to the report, which notes that the states are analyzing data to determine the number of opioid prescriptions written by providers to detect high-prescribing providers.

NHS Patient Data Could Generate Billions For UK, But Is It OK To Go Down That Road?

August 5, 2019
I don’t know about you, but I don’t like the idea of governments selling off patient healthcare data. Still, given the financial benefits it could generate, I’m not surprised that people are still kicking around the idea, which is what makes the following article to be so interesting.
In her recent piece, EY global health sciences and wellness and life science industry leader Pamela Spence speculates about the potential value of the health data assets held by the United Kingdom’s National Health Service.
As some readers may know, the NHS is the single largest integrated health provider in the world, and maintains patient records on the entire UK population from birth to death. That puts it in control of about 55 million patient records, along with 23 million episodic specialty care patient records and 100,000 DNA records for patients with cancer, rare diseases and infectious diseases.

Babylon Health confirms $550M raise at $2B+ valuation to expand its AI-based health services

Babylon Health, the U.K.-based startup that has developed a number of AI-based health services, including a chatbot used by the U.K’.s National Health Service to help diagnose ailments, has confirmed a massive investment that it plans to use to expand its business to the U.S. and Asia, and expand its R&D to diagnose more serious, chronic conditions. It has closed a $550 million round of funding, valuing Babylon Health at more than $2 billion, it announced today.
This is the largest-ever fundraise in Europe or U.S. for digital health delivery, Babylon said.
“Our mission at Babylon is to put accessible and affordable healthcare into the hands of everyone on earth,” said Dr Ali Parsa, founder and CEO of Babylon, in a statement. “This investment will allow us to maximise the number of lives we touch across the world. We have a long way to go and a lot still to deliver. We are grateful to our investors, our partners and 1,500 brilliant Babylonians for allowing us to forge ahead with our mission. Chronic conditions are an increasing burden to affordability of healthcare across the globe. Our technology provides a solid base for a comprehensive solution and our scientists, engineers, and clinicians are excited to work on it. We have seen significant demand from partners across the US and Asia. While the burden of healthcare is global, the solutions have to be localised to meet the specific needs and culture of each country.”
Before today’s announcement, the investment — a Series C — had been the subject of a lot of leaks, with reports over recent days suggesting the investment was anywhere between $100 million and $500 million.

Norton lowers opioid prescriptions by over 50% through data analysis, education

By Boris Ladwig | August 2, 2019 5:45 am
Norton Healthcare has lowered its opioid prescriptions by more than half since 2014 through data analysis and further educating its doctors and their patients.
Norton in 2013 created an opioid task force to monitor, analyze and decrease the number of opioids its patients were receiving. Prompted in part by state legislation, the system previously had begun providing continuing medical education about opioids to its staff.
“When we started this, you would not believe the averages of pills per script that physicians around the country and our doctors were prescribing,” said Dr. Joshua Honaker, chief medical administrative officer of Norton Medical Group.
Despite an electronic health records system, tracking information about opioid prescriptions initially was tough, Honaker said.

Insider threats cause many of the most damaging security incidents

Published August 05 2019, 5:08pm EDT
Insiders continue to pose a serious and growing threat to data security at many organizations, according to a new survey by Cybersecurity Insiders, an online community for information security professionals and vendors, and security company Nucleus Cyber.
The companies surveyed cyber security professionals in the 400,000-member Cybersecurity Insiders community, and found that 70 percent of organizations are more frequently seeing insider attacks and 60 percent experienced one or more within the last 12 months. More than two thirds (68 percent) feel “extremely to moderately” vulnerable to these attacks.
The report showed that today’s most damaging security threats often don’t originate from outsiders or malware, but from trusted insiders, said Holger Schulze, CEO and founder of Cybersecurity Insiders.

Londoners are suspicious of sharing information outside the NHS, study finds

Research commissioned by the OneLondon LHCRE highlights the need for greater engagement with the public to improve trust about how data is shared.
August 05, 2019 04:47 AM
Londoners are sceptical about how patient data is shared by the NHS, according to a study commissioned by the OneLondon Local Health and Care Record Exemplar (LHCRE).
The independent report, ‘Understanding public expectations of the use of health and care data’, collated existing knowledge about people’s expectations and attitudes to the use of health and care data.
It found a strong public expectation that patient information would be shared among clinicians to support individual care, but a lack of confidence about data being shared for the purpose of research and improving services.
Researchers identified a lack of public understanding about the role of bodies outside the NHS and suspicion about their involvement in secondary uses of data. People were more likely to support data-sharing when they could see a clear public benefit.  

DirectTrust sees huge growth in exchange transactions

Use of Direct messaging increased by more than 50 percent over the previous quarter and nearly 400 percent since last year.
August 05, 2019 12:07 PM
DirectTrust says it has seen "explosive growth" in the number of Direct exchange transactions so far this year, as providers make use of the simple and secure means of data interoperability.
During the second quarter of 2019, the nonprofit alliance – which was launched to promote secure, electronic exchanges of protected health information between providers and between providers and patients – tracked nearly 251 million messages sent and received through the DirectTrust network
That's an increase of nearly 53%, compared with the previous quarter – and nearly 397% over the same period last year, the group says, noting that the cumulative total of Direct exchange transactions since 2014 has surpassed a billion.

DirectTrust hits milestone of 1B messages exchanged; developing instant messaging standard

Aug 5, 2019 7:49am
DirectTrust, a nonprofit association of providers and IT vendors, announced a milestone on Monday: 1 billion messages exchanged.
During the second quarter of 2019, the organization reported that Direct message transactions increased nearly 53% over the prior quarter, 397% over the same period a year ago, and outpaced total 2018 transactions by more than 51%. Direct is a technical standard to exchange patient data. 
There were nearly 251 million messages sent and received through the DirectTrust network during the second quarter of 2019, an increase of almost 87 million messages from the previous quarter. More than 1 billion messages have been exchanged since 2014.
The lack of interoperability in healthcare, which makes it difficult for providers to share information with each other and with patients across disparate technology platforms, is one of the industry’s biggest challenges. Direct messaging is a cost-effective and uncomplicated way to exchange health information, said Scott Stuewe, president and CEO of DirectTrust.

Implementation best practices: Getting pop health off the ground

Four experts in population health management offer wide-ranging technology guidance and best practices for healthcare provider organizations launching pop health initiatives
August 05, 2019 02:48 PM
Increasingly, healthcare provider organizations across the country are launching population health management programs to improve health, enhance care delivery, trim costs and contend with the growing demands of value-based care.
But healthcare leaders cannot begin to get into population health without their CIOs and other health IT professionals effectively deploying information technology to support these programs. There’s a lot of EHR data that’s needed to successfully pull off population health, and analytics technology is key to making sense of it all.
Four experts in population health IT spoke with Healthcare IT News, offering comprehensive advice and best practices for launching systems that will support successful population health programs.

Weekly News Recap

  • The VA opens director and deputy director positions to oversee its Cerner implementation.
  • Meditech reports lower quarterly revenue and earnings.
  • Cerner signs a partnership deal with Amazon Web Services.
  • The country’s biggest technology companies reaffirm their commitment to healthcare interoperability.
  • CMS announces a pilot project to display a patient’s claims data to Medicare fee-for-service providers.
  • Surescripts says Amazon-owned mail order pharmacy PillPack accessed its patient prescription records without authorization and will turn the issue over to the FBI.
  • Bain sells a majority stake in Waystar.
  • Meditech celebrates the 50th anniversary of its founding this week.
  • Kaiser Permanente hires its first chief digital officer.

Friday, August 16, 2019

NSW May Be Heading Down A Very Dangerous Rabbit Hole. I Hope They Stop Soon.

This appeared last week:

NSW seeks better analytics, consistency with digital health record initiative

NSW Health seeks input on Single Digital Patient Record
Rohan Pearce (Computerworld) 09 August, 2019 10:22
NSW Health has launched a formal market engagement process to as it seeks to boost the capabilities of the state’s electronic medical record system.
“NSW Health is considering a range of options to enhance its electronic medical record capability into the future,” an eHealth NSW spokesperson told Computerworld.
A Single Digital Patient Record (SDPR) “will provide a holistic, state-wide view of a patient’s health care information,” states a request for information (RFI) document released this week by NSW Health.
“The SDPR will support safe, high-quality healthcare for patients and a more consistent ICT user experience for healthcare providers.”

The state government’s 10-year eHealth strategy, launched in 2016, called for NSW Health to “continue its journey toward an integrated digital patient record so patients have consistent health and wellbeing engagement no matter when or where they interact with it.”
 “This includes developing enhanced functionality and integration of core clinical information systems across care settings, clinical specialties, NSW Health Organisations, Jurisdictional Health Organisations, and private care providers,” the document stated.
The NSW Treasury in 2006-07 funded the initial tranche of work on the state’s Electronic Medical Record (eMR) system.
The SDPR initiative “aims to build on current EMR capabilities and harmonise approaches to create greater consistency across the state,” the eHealth NSW spokesperson said.
eHealth NSW expects a range of benefits from the SDPR, including improved safety and quality in the continuity of patient care, a consistent patient experience, and a “consistent and enhanced clinician experience” with electronic medical record systems.
The SDPR is expected to be easier to integrate with community-based and private healthcare providers, the spokesperson said. In addition, it’s expected to make it easier to implement consistent data analytics and clinical decision support.
More here:
There is also coverage here:

NSW to consider opening ehealth records to patients

By Justin Hendry on Aug 9, 2019 12:12PM

As part of system upgrade proposal.

NSW Health has begun considering what the state's future electronic medical record might look like, including whether to give patients access to their clinical information.
Last week the department's digital arm eHealth NSW approached the market to inform its plan to develop a single digital patient record (SDPR).
The SDPR is pitched as “a holistic, state-wide view of a patient’s health care information” that will “support safe, high quality healthcare for patients”.
The project is expected to build on the state’s existing electronic medical record (eMR2), which is currently found in more than 90 percent of public hospitals.

Last year eHealth NSW's chief information officer Zoran Bolevich said more than 50,000 clinicians were using the EMR everyday as part of their work.
But NSW Health is planning to shift to an increasingly integrated and digitally-enabled healthcare system over the next nine years, according to Bolevich.
It follows a $500 million funding injection in digital patient records and a system-wide digital platform in the state’s 2017 budget.
A spokesperson for eHealth NSW told iTnews the SDPR initiative would “enhance” and “harmonise” the existing ehealth record to provide greater consistency across public hospitals.
More here:
Here is how the Tender is described:

NSW Health / RFI NSW Health - Single Digital Patient Record - RFT-10025641

RFT ID RFT-10025641
RFT Type Notice
Published 1-Aug-2019
Closes 16-Aug-2019 5:00pm
Covered Procurement Yes
Category (based on UNSPSC)
81160000 - Information Technology Service Delivery
Agency HealthShare NSW
Contact Person
Justin Pleass
Phone: 02 8644 2000

Tender Details

The eHealth Strategy aims to create ‘a digitally enabled and integrated system delivering patient-centred health experiences and quality health outcomes’ in NSW.
NSW Health is considering options to develop a Single Digital Patient Record (SDPR), which will provide a holistic, state-wide view of a patient’s health care information. The SDPR will support safe, high-quality healthcare for patients and a more consistent ICT user experience for healthcare providers. 
To support development of this strategic initiative, eHealth NSW is now seeking to engage the market through an open Request for Information (RFI).  This will help to inform any future business case development and enable industry to offer valuable input into the SDPR initiative. 
The RFI will outline the current NSW Health electronic medical record (EMR) landscape and overall vision for the SDPR.  This will also include key considerations for future directions and options. 
NSW Health is seeking input regarding solutions, services, and experiences that your organisation can provide to support this direction.  This is expected to include key products, services, approaches, costs, options and lessons learnt from previous experiences.
Here is the link:
The good thing about this is that this is really a ‘fishing expedition’, and an attempt to gain free consulting perspectives on what might be considered to further integrate the Health IT used in NSW Health to improve health care delivery. As far as it goes that is great, BUT all this about a single digital patient record (unless a really virtual one) needs to be taken with a huge ‘grain of salt’.
If what we are seeking is easier access to records held all over the state on the same patient that is both sensible and would be useful – but let’s be careful to avoid expensive overreach! I am sure the eHealth NSW team know how sensible it is to hasten slowly!