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"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, July 06, 2019

Weekly Overseas Health IT Links – 6th July, 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.
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Matthew Gould confirms LHCRE and GDE programmes are here to stay

The CEO of NHSX has confirmed in a blog post that two flagship NHS digitalisation projects are here to stay.
Hanna Couch – 24 June 2019
Published on 24 June, ahead of NHSX’s official launch on 1 July, Matthew Gould, confirmed the Local Health and Care Records Exemplar (LHCRE) and Global Digital Exemplar (GDE) projects will continue.
The LHCRE programme focuses on supporting interoperability and the joining up of data across population and place while the GDE programme focuses on creating sites of digital excellence.
However, the latter, according to Gould will have “more emphasis on the parts of the NHS that need most help”.
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One-click function for SCR introduced for community pharmacists

Community pharmacists can now access patient information more easily after a one-click function was introduced to the Summary Care Record (SCR).
Hanna Crouch – June 25, 2019
The function allows pharmacy professionals logged in on their Smartcard to click straight through to a selected patient’s SCR, without having to log in separately and complete a manual search.
The new functionality is live across Sonar and Pinnacle advanced services systems1.
Pharmacies can access the Summary Care Record to; check allergies to prevent prescribing errors; check current medications prescribed for emergency supply purposes; check eligibility for services such as a free flu jab.
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Best Practices for Your Epic EHR Go-Live

June 27, 2019
The following is a guest blog post by Heather Haugen & Mia Erickson from Atos
Epic continues to gain market share across the healthcare landscape. In 2019, they represent about 33% of the EHR inpatient hospital market share. Many of the largest healthcare organizations have implemented Epic and they remain a strong contender for new implementations and EHR replacements. Epic maintains a reputation for being clinician-centric, dependable and highly referenceable. Despite their impressive reputation and strong market position, however, implementing and maintaining a large comprehensive EHR still requires significant investment from the adopting healthcare organization before, during and after go-live.
We spoke to Mia Erickson to learn more about Epic’s go-live best practices. Mia has 30 years of Epic experience including work with Kaiser Permanente, WellStar Health System, Children’s Healthcare Atlanta, and many other prominent healthcare organizations. Mia also worked for Epic for several years, during which she gained critical insights working for Epic and with healthcare organizations implementing Epic. She also consulted on inpatient, ambulatory, revenue cycle, and community-based Epic implementations.
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Pressure builds to secure health care data

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Momentum is growing on Capitol Hill to provide more protections for personal medical information as lawmakers work on drafting the first national data privacy law.
Recent health data breaches have put a spotlight on the issue, which is likely to grow in importance as medical professionals shift more of their work online and increasingly turn to data and analytics to treat patients.
Key congressional committees including the Senate Commerce Committee and the House Energy and Commerce Committee have been working to put together data privacy legislation since the start of the new Congress, with health data privacy likely to be in the spotlight.
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AHRQ unveils new database of patient safety events reported by PSOs

Anne-Marie Kommers - Print  | 
The Agency for Healthcare Research and Quality has released its new Network of Patient Safety Databases, according to AHRQ's "News Now" newsletter released June 25.
The NPSD is the first public, online resource listing nonidentifiable information on patient safety events gathered by AHRQ-approved Patient Safety Organizations. NPSD data will be used to create dashboards and a chartbook designed to educate providers and others about patient safety events. These resources will include information on incident distribution, near misses, unsafe conditions and ways to reduce patient safety risk and harm across health systems.
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Jun 27, 2019, 09:02am

Artificial Intelligence Makes Boosting ID Theft Protection Critical, House AI Task Force Chair Warns

Ted Knutson
Artificial intelligence is making improving identity theft protections imperative, House Financial Services Committee AI Task Force Chair Bill Foster warned Wednesday.
The Congressman said AI has become an increasingly popular tool for crooks to swipe assets and sensitive financial information from consumers.
AI is being used to help steal Social Security numbers, credit card numbers and other personal identity factors can be stolen and sold on the dark web, or used by criminals for quick and easy profit gain, Foster explained.
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FDA supports open data to improve patient safety

Anne-Marie Kommers -27 June 2019
The U.S. Food and Drug Administration signed a letter of support May 30 for openly sharing data through efforts such as the Patient Safety Movement Foundation's Open Data Pledge, according to an announcement made June 27.
The FDA says open data engages patients in developing and evaluating medical devices, allows for the identification and prevention of adverse events and sheds light on the benefits and risks of healthcare technology. 
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HIT Think How to unlock enterprise-wide value from data and analytics

Published June 28 2019, 2:51pm EDT
Does your healthcare organization spend loads of time and money collecting and analyzing data without ever seeing the expected return?
Some 60 percent of data and analytics projects fail to meet their objectives. Part of the problem is that you can now track just about anything, which has caused our appetite for data to grow exponentially—often beyond what enterprise organization’s data and analytics teams can handle. Too often, talented people with the right tools can’t create meaningful outcomes because of cultural or organizational challenges.
Here are some telltale signs that your data resources are being wasted.
  • Road to nowhere: When data and analytics teams are seen as order-takers, it can lead to a one-way stream of requests that overload resources and don’t reflect strategic needs.
  • Garbage in: A lack of standards around how data requests are made leads to disorder and inefficiency.
  • Static data in a dynamic world: Data is treated as a retrospective recording of historical measurements with little ability to draw insights or solve problems.
  • Data distrust: Data silos lead to a lack of transparency around who is producing data, what data is actually being used and how they’re doing it. Over time, this can make business leaders start to doubt the accuracy of their own organization’s information.
In this environment, employees often try to satisfy their own data needs outside the company’s defined channels, which worsens the problem by creating more internal customers for the centralized data analytics team.
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Ransomware hits Romanian hospitals, disrupts operations

The Romanian national cybersecurity and incident response team cautioned that no money should be paid to the ransomware hackers.
June 27, 2019 01:25 PM
At least four hospitals in Romania were hit by ransomware last week in attacks the Romanian Intelligence Service said it suspected were launched by Chinese hackers.
The agency, known as SRI, told Healthcare IT News that a team from the National Cyberint Centre – SRI's cyberintelligence centre – was asked to go to Victor Babeș, an infectious and tropical disease hospital in Bucharest, the capital, to "pick up hard disks and evaluate the attacks" on 20 June.
Details are unclear, but three other facilities are also said to have been affected: a hospital in Huși, Vaslui county, in eastern Romania, one in Dorohoi, Botoșani county, also in the eastern part of the country, and one in Câmpeni, Alba county, in Transylvania.
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Large health systems better prepared on security, says CHIME Report

While most orgs surveyed said they have network access solutions to monitor devices connected to the network, fewer than half of small providers use network segmentation to control the spread of infections.
June 28, 2019 10:47 AM
The majority of health organizations are following cybersecurity practices recommended by a federally convened task group, according to a new study organized by the College of Healthcare Information Management Executives and KLAS Research.
WHY IT MATTERS
The recommendations in the CHIME report include a host of cybersecurity policies including email and endpoint protection systems, data protection and loss prevention, network and vulnerability management, incident response and medical device security.
Although most of the organizations surveyed said they have network access solutions to monitor devices connected to the network, less than half of small organizations use network segmentation to control the spread of infections.
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The potential of healthcare tech – human-centric AI, meaningful applications and the future

A diverse panel consisting of healthtech start-ups, government and medical representatives discussed the possibilities of healthcare tech at the Innofest Unbound conference held in Singapore.
June 28, 2019 04:44 AM
Buzzwords like Artificial Intelligence (AI) and machine learning are commonly heard at conferences and industry events and they often conjure up images of robots or killing machines from the Terminator. However, panelists from the Innofest Unbound conference in Singapore all felt that technologies such as AI should not replace humans as it is commonly imagined – rather, they should augment the work of clinicians and hopefully, even enhance the patients’ interactions with their doctors.
Human-centric AI
A medical doctor by training and also the founder of MEDGIC, a startup which utilises AI to detect skin conditions, Dr Reid Lim feels that the use of AI should always involve doctors and not replace them.
“Healthcare systems are becoming unsustainable and we need AI to help automate some things and to help alleviate the burden on doctors. AI is not new and it seems strange that some people are only beginning to grasp the use AI.”
“A lot of radiologists are already using Computer Aided Diagnosis (CAD) for mammography and it has been happening for some time. So the idea is for us as a tech startup to pursue what we call human-centric AI. We try to make AI as explainable as possible and we always want humans to be involved in the whole process,” he added.
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FDA Says Medtronic Insulin Pumps Pose Cybersecurity Risk

Hackers could potentially connect wirelessly to a nearby insulin pump to change settings or control insulin delivery

By  Thomas M. Burton
June 27, 2019 6:18 pm ET
WASHINGTON—The Food and Drug Administration warned that certain insulin pumps made by Medtronic PLC have cybersecurity vulnerabilities and could be manipulated by hackers, causing danger to diabetes patients.
Medtronic began notifying patients about the issue Thursday, saying a hacker could potentially connect wirelessly to a nearby insulin pump to change settings or control insulin delivery.
But the company said the likelihood of such a danger from hackers is small, and that the unauthorized person would need to be in fairly close proximity to the person with the insulin pump—several feet away, or potentially at a house next door, depending on the hacking equipment being used.
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Creating Healthcare Access In Rural Communities

June 26, 2019
The following is a guest article by Christopher Caggiano, MD, FACP, Solutions Director at Allscripts.
Some 58% of adults in rural areas say access to high-speed internet is a problem for them, including 24% who say the problem is major, according to 2018 data from Pew Research Center. Healthcare providers, who are especially concerned with costs, may also not know which affordable services they can offer patients from afar and how to best use these to actively engage with patients themselves.
Because a single hospital may serve a large and loosely connected area, providers find it difficult to manage resources efficiently among the population. At the same time, patients may lack convenient or affordable access to the care they need. Due to distance from a facility, rural patients may often miss routine appointments or, when they do need immediate care, have few options other than the emergency department (ED).  In these communities, alternate forms of access are key to saving resources and ensuring viable patient options.
As a result, providers and patients in rural communities face several unique challenges in giving and receiving healthcare. Recently, one of my emergency department patients was seen at his primary care  office and had radiology tests  performed at the local critical access hospital. The result would be available later in the day. The patient then went to work. After finishing his evening work shift, he was unable to view his test results via  patient portal, as had no internet access from home. The usual public access internet sites, such as the library and local restaraunts, were closed by that time.
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How the VA uses algorithms to predict suicide

06/25/2019 04:48 PM EDT
The Department of Veterans Affairs is using artificial intelligence to figure out which veterans are in critical need of mental health treatment as part of a massive effort to stem suicide in its ranks, a top priority of President Donald Trump and his VA leadership.
A computer program scours millions of records for medications, treatment, traumatic events, overall health and other information, and based on prior experience, it plucks out the names of veterans most likely to die by suicide in the next year. Clinicians then reach out to them directly, sometimes before the patient has expressed suicidal thoughts to anyone.
The VA believes that its algorithms have reduced suicides by vulnerable veterans. Since the VA adopted the technology in 2017, about 250 fewer veterans have died by suicide than the would have been expected based on the previous rate, according to VA estimates. It's not clear how big a role the algorithms played in the apparent decline. A 2018 VA report shows veteran suicides decreased from 6,281 in 2015 to 6,079 in 2016.
Still, about 20 former and current service members die by suicide each day, about six of whom have been in VA health care, according to the Department. The veteran suicide rate is about 22 percent higher than that of the general population.
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June 26, 2019 04:02 PM

There's a push to slow down required EHR-PDMP integration

Health IT groups were generally supportive of revised information technology provisions proposed in the CMS' annual update to the inpatient prospective payment system, but urged the agency to slow potential requirements related to integrating outside programs with electronic health record systems. The public comment period for the CMS' IPPS proposal, which the agency released in April, closed Monday.
Now the CMS is tasked with sifting through more than 2,000 comments from providers, vendors and trade groups offering feedback on the agency's plan to update inpatient hospital reimbursements for federal fiscal 2020.
The EHR Association expressed support for keeping the reporting period for the use of EHRs to any continuous 90-day period, a provision hospital groups were successful in lobbying for in a previous IPPS update, and encouraged the agency to go one step further—instituting the time frame as a permanent fixture.
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AI presents host of ethical challenges for healthcare

Published June 27 2019, 4:01am EDT
While artificial intelligence has tremendous potential for revolutionizing healthcare delivery, there are many possible pitfalls and ill-intended uses of this powerful technology.
That’s the contention of Georgia Tourassi, director of the Health Data Sciences Institute at the Department of Energy’s Oak Ridge National Laboratory.
“With the great promise of AI comes an even greater responsibility,” Tourassi testified on Wednesday before a House committee hearing on AI’s societal and ethical implications. “There are many ethical questions when applying AI in medicine.”
With respect to ethics, she observed that the massive volumes of health data being leveraged by AI must be carefully protected to preserve privacy.
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Standards efforts aim to improve ability to exchange images

Published June 27 2019, 3:36pm EDT
Current work on standards aims to facilitate the exchange of images, or better integrate diagnostic patient views with other clinical systems.
While much progress has been made on the separate fields of data exchange standards and image standards, more attention is turning to enabling the integration of images into electronic medical records, as well as their increased accessibility from other clinical systems.
Several presenters at the annual conference of the Society for Imaging Informatics in Medicine highlighted progress being made in imaging exchange this year through several organizations promoting relevant standards.
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Ethical worries may cloud use of SDOH data, eHealth Initiative says

Published June 27 2019, 4:06pm EDT
While social determinants of health can greatly impact the effectiveness of healthcare delivery, they also pose ethical dilemmas for healthcare organizations.
The eHealth Initiative, which convenes stakeholders to identify and share best practices to improve care delivery through IT and promote data sharing, summarized its take on these issues through a white paper on guiding principles for ethical use of SDOH data.
During the past decade, research has shown SDOH significantly influence health, and providers and insurers are now considering how to use of SDOH data to identify patients with social needs and facilitate interventions to improve care.
“Because of the sensitive nature of this consumer data, we felt it was critical to put a stake in the ground around the ethical use of this data,” says Jennifer Covich Bordenick, CEO of eHealth Initiative. “Lots of industry groups are publishing papers and producing research, but there is not a lot of direction about how to use this data.”
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Survey: Privacy and security are barriers to Interoperability

Published June 27 2019, 4:18pm EDT
A recent survey finds that privacy and security concerns continue to hamper the increasing interoperability of healthcare systems.
The research, based on a survey from the Trusted Network Accreditation Program (TNAP), found that survey respondents overwhelming indicate that improving the electronic movement of health information will improve patient care, notes Lee Barrett, CEO at the Electronic Health Network Accreditation Commission (EHNAC), which accredits organizations for meeting best practices for electronic data exchange.
EHNAC created the TNAP a year ago in collaboration with WEDI, SAFE-BioPharma Association, the eHealthcare Initiative and the eP3 Foundation, a community of nonprofits, standards organizations, industry leaders, researchers and government agencies working to improve health, education and wellness.
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What the U.S. Medical System Can Learn From Estonia

Americans waste time and money filling out paperwork and repeating tests in the doctor’s office. A small Baltic nation has found a better way.
Olga Khazan
Jun 25, 2019
The scene: a doctor’s office. You: frustrated, on your lunch break from work, just wanting to get in and get out. It’s probably not your first visit to that provider. It might not even be your second or third. And yet there you are, filling out byzantine papers attached to a clipboard, promising to pay if your insurance doesn’t, providing your Social Security number for the kajillionth time, and trying to remember your insurance group number, which is not the same as the ID number.
“Every time I go to the doctor, I spend the first half hour filling out pages of information. Why isn’t that traveling with me?” asked a cancer survivor in the audience of a recent talk by Eric Topol, the chair of innovative medicine at Scripps Research, at Aspen Ideas: Health, co-hosted by the Aspen Institute and The Atlantic.
“It’s so real that you have to fill out the same forms all the time,” Topol responded. The American medical system is atrocious at keeping track of the stuff it does. According to Topol, 10 percent of all scans in the United States are repeated unnecessarily simply because patients can’t get hold of their past records and scans. It amounts to billions of wasted dollars.
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The Nationwide Interoperability Roadmap And The ONC’s And CMS’s Proposed New Regulations: Are We Halfway There Yet?

Five years into the nation’s 10-year interoperability roadmap, where do we stand? For new draft regulations just out from the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS), what is our polestar? Are we halfway there yet? 
In 2015, the ONC’s Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap outlined the steps necessary to implement a nationwide “learning health system” by 2024. This system would be capable of improving individual and population health, empowering consumers, driving innovation, addressing health disparities, advancing precision medicine, and supporting value-based care and reimbursement. The 21st Century Cures Act—bipartisan congressional legislation passed in 2016—reinforces the aims of the roadmap by requiring, for example, that application programming interfaces (APIs) allow complete access, exchange, and use of all electronically accessible health information on a national scale. The 21st Century Cures Act made interoperability and patient access national imperatives and targets improving the quality and coordination of health care, population health, health disparities, and health information technology to enable care and monitoring in homes and communities. 
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Is the EMR Implementation Market Dead?

June 25, 2019
I’ve been thinking a lot about the EMR implementation market lately. Looking at the market, you see a lot of mixed signals about what’s happening. Take for example a comment that was recently shared on the HIStalk blog:
“Re: KLAS doing research on consulting firms. We had been ranked by KLAS for multiple years, but we’re no longer ranked in our category and KLAS can’t get us back up to the minimum number. Our category used to have 35-40 consulting firms ranked and now there are only 11.”
We’ll leave the specific comments about KLAS alone for now, but know that we’ve talked about how you do well in KLAS rankings and how you ensure you get a high number of ratings so you’re ranked in our healthcare marketing community. This piece aside, it’s kind of astounding to think that where they’re used to be 35-40 EHR consulting firms there are now only 11. That’s quite amazing attrition for a section of the market that was so hot for many years.
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AHIP19: A Kaiser Permanente Ventures investor's view of health tech's future

Jun 25, 2019 3:33pm
NASHVILLE, TENNESSEE—Buzz-generating new technologies from health startups are a dime a dozen.
Want to stand out from the pack? Prove you've not only got a great idea, but that consumers will actually use your product, a Kaiser Permanente investment director told a crowd at the AHIP Institute & Expo last week.
Speaking at the annual gathering of payers and providers, Liz Rockett, director of Kaiser Permanente Ventures, said the secret ingredient is to think of how technology will fit into the spectrum of a patient's care rather than a static point in the care journey. They also need to make sure they've got something patients will intrinsically want to use. 
One of the key concerns with new technologies is that patient uptake is slow, so looking at these options from a broader perspective can give patients or members a reason to care. 
“Folks need to see proof that it works,” Rockett said. 
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Report: 5G has the potential to revolutionize robotic-assisted surgery, improve availability of healthcare

Jun 26, 2019 11:03am
Many predict 5G will be game-changing for healthcare, providing organizations with more connection power and faster broadband speeds.
One area where 5G could be especially groundbreaking: remote robotic-assisted surgery.
With the technology, surgeons could potentially perform remote, across-the-globe procedures that are impossible today, according to a report from Fitch Solutions Macro Research, a unit of Fitch Group. Robot-assisted surgery remains a popular alternative to traditional surgery, providing better accuracy and precision.
There also is a growing demand from patients and clinics for minimally invasive surgery coupled with improving procedure rates more generally, which can be provided by surgical robots. This can, in turn, reduce pressure on healthcare systems, according to Fitch Solutions.
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Circling closer to a federal privacy law, Congress has introduced 7 privacy bills this year

June 25, 2019 by Tim Peterson
Congress has stated its intention to pass a federal privacy law. For more than a year following Facebook’s Cambridge Analytica controversy, various committees within the House of Representatives and the Senate have held hearings to figure out the composition of a comprehensive federal privacy law.
Members of Congress have introduced several privacy bills this year that aim to regulate companies’ collection and/or use of people’s personal information (privacy bills introduced last year, such as the CONSENT Act, never passed into law and died when Congress reset after last year’s mid-term elections). None of these bills introduced this year have yet to be put to a vote, and if previous efforts are any indication, none are likely to pass into law. However, taken together they paint a picture of what a federal privacy law would likely cover, especially if Congress were to cherry-pick their various provisions and combine them into an omnibus bill. They also indicate Congress members’ differing stances on what a federal privacy law should require of companies. Those latter complications could require Congress to compromise on a federal privacy law’s scope in order to ensure its passage into law, especially if Congress intends to try to pass a federal privacy law before California’s privacy law takes effect in January 2020.
Based on the bills, members of Congress appear to agree that companies need to provide people with better insight into and control over the information that companies collect from them and share with others, in response to Facebook’s Cambridge Analytica scandal. They also appear to agree that the Federal Trade Commission should be responsible for enforcing any federal privacy law. However, they don’t see eye to eye on everything, such as whether consent should be opt-in or opt-out, what qualifies as personal information and whether or not a federal privacy law should preempt states’ own privacy laws, which may be more stringent than a national law but present companies with a compliance nightmare.
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New med school curriculum to emphasize patient safety

Published June 26 2019, 5:24pm EDT
The Patient Safety Movement Foundation is creating a curriculum for persons going into medical school, as well as other healthcare professionals, to teach patient safety across the education process from freshman year through residency.
The goal is to reduce preventable patient deaths, and multiple schools already have committed to the curriculum. They include Chapman University School of Pharmacy, Universidad Autonoma de Mexico School of Medicine, San Diego State University School of Nursing and Geisinger Commonwealth School of Medicine.
More organizations are joining daily, says Steven Scheinman, MD, president and dean at Geisinger Commonwealth School of Medicine.
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HIT Think 3 security plans in which organizations must have complete confidence

Published June 26 2019, 1:58pm EDT
With the number of cyberattacks focusing on healthcare—for purposes ranging from destruction of data to impersonating a physician or other clinician to just taking data—it is truer than ever that a successful attack is only a matter of time.
A common threat is ransomware, which aims to lock an organization out of its data and require payment of a ransom to potentially get full access to that data.
If threats are real and commonplace, what can be done? First of all, taking threats seriously is important. In the past (but hopefully not currently), many organizations would use an argument that they were too small to attract the notice of attackers or that the threat only applied to someone else.
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Implementation best practices: Giving medical devices, IoT special attention

Three medical device technology experts from GE Healthcare, BioSig Technologies and Advantech offer comprehensive advice on best practices for healthcare organizations launching new medical devices.
June 26, 2019 03:32 PM
Medical devices are key pieces of the health IT puzzle, technology that helps deliver patient care at one of the most critical junctures.
There are many types of medical devices. And the number is increasing as the Internet of Things proliferates, adding more and more connected devices to a provider organization’s IT infrastructure.
Especially because of that explosion of IoT devices, implementing medical device technology at hospitals and health systems has become a delicate and important process that must be done correctly. Here, three medical device technology experts offer advice and tips on how to best implement medical devices at a healthcare provider organization.
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Promoting an overdue digital transformation in healthcare

18 Jun 2019
For all the ways that technology is transforming the way people shop, bank, and travel, it has yet to make major inroads into how they receive healthcare. The adoption of digitally enabled tools for diagnosis, treatment, and management, for example, has been modest. Electronic medical records are still not a part of routine care. According to the Electronic Medical Record Adoption model, adoption ranges from just 3 percent in Europe to 35 percent in the United States.
Technology itself isn’t the problem. Many healthcare tasks have been automated or digitally enhanced for decades. And evidence of further potential is compelling. This includes, for example, preventing up to 95 percent of adverse drug events, saving lives by improving compliance with care recommendations, and reducing the number of duplicate diagnostic tests and reducing costs by 7 to 11 percent.
Instead, the barriers to a digital transformation in healthcare are often decidedly nontechnological. In a recent interview, Harold F. Wolf, president and CEO of the Healthcare Information and Management Systems Society (HIMSS), considers a change of culture to be the biggest hurdle in the industry’s digital transformation. Similarly, our McKinsey colleagues found that the three barriers to digital most mentioned by leaders in the pharmaceutical and medical-technology industry were culture and mind-set, organizational structure, and governance.
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Special Report: Medicines Management

Various national figures have put a very strong focus on e-prescribing with former health secretary Jeremy Hunt pledging financial support to hospitals to implement such a system. But has that perhaps limited an understanding of the full breadth of areas in which digital can make a difference when it comes to medicines management and optimisation? Maja Dragovic reports.
Atif Ishaq is far from ungrateful for the £75m pledged nationally back in February 2018 for the acceleration of e-prescribing. He feels the money – promised by then-health and social care secretary Jeremy Hunt – served to put the focus on electric prescribing and medications administration (EPMA) and on the reality that trusts need it.
But Ishaq, solutions and technical director at Dedalus UK, fears the way the funding was focused might have limited the ability to see where there are broader opportunities for change.
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DHS CISA warns of Iranian hackers' habit of deploying data-wiping malware

CISA also warns against other Iranian hackers' favorite techniques: password spraying, credential stuffing, spear-phishing.
By Catalin Cimpanu for Zero Day | June 23, 2019 -- 08:15 GMT (18:15 AEST) | Topic: Security
The Department of Homeland Security's cyber-security agency is warning of increased cyber-activity from Iranian hackers, and urging US companies to take protective measures against these hacker groups' most common practices -- the use of data-wiping malware, credential stuffing attacks, password spraying, and spear-phishing.
The warning was published in a tweet by the Cybersecurity and Infrastructure Security Agency (CISA) Director Christopher Krebs.
The CISA alert comes as Iranian hackers launched new waves of cyber-attacks against US targets following escalating tensions between the US and Iran, according to a CBS News report.
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INSIGHT: Minimizing Litigation, Reputational Risk in the Data Breach Age

David Solomon - GLG Law
June 20, 2019
Experience a data breach? Learn from previous multimillion-dollar cases, writes David Solomon, with GLG Law, and take steps to minimize both reputational damage and financial cost of breaches and resulting litigation.
Perhaps you get the news by phone, or possibly in an email. Your heart sinks. Somehow, you thought it wouldn’t happen to your business. Hadn’t legal, compliance, and IT taken all the necessary steps to protect your data?
Spoiler alert: it wasn’t, and now your company is exposed to substantial and costly litigation risk, not to mention a public relations nightmare.
Over the past few years, litigators—and the public at large—have watched some of the world’s most recognized companies fall victim to breaches of their confidential data. First came the public excoriation, and inevitably, the lawsuits.
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Study: Increased use of patient portals leads to uptick in outpatient visits

Jackie Drees – 24 June, 2019
Access to a patient portal through the EHR can help improve patients' self management of healthcare services, resulting in increased outpatient appointments and reduced emergency room visits and hospitalizations, according to a recent study published in PLOS One.
Oakland, Calif.-based Kaiser Permanente researchers analyzed the rates of outpatient office and ER visits as well as hospitalizations among 165,447 of the health system's patients. The study participants were split between individuals who have diabetes and those who have diabetes plus one of the following additional chronic conditions: asthma, congestive artery disease, congestive heart failure or hypertension.
The study examined both patients who had access to an electronic portal and those who did not have access from January 2006 to December 2007. The patient portal allows individuals to complete functions such as view lab results and visit summaries, message their providers and request medication refills.
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Healthcare Overconfident in Privacy Maturity, As Breach Rate Rises

An Integris report takes pulse of the industry’s data privacy maturity, finding that while healthcare was one of the most breached sectors in 2018, its leadership is overly confident in their privacy policies.

June 21, 2019 - The majority of healthcare leadership is overly confident in their data privacy maturity, despite failing to keep an accurate pulse on the data it maintains, transmits, and acquires, according to a recent Integris Software report.
Integris researchers surveyed 258 top business executives and IT decision makers from mid- to large-sized organizations to determine where the healthcare sector stands with data privacy maturity.
The researchers found most organizations were overly confident in their technical maturity, with 70 percent of respondents reporting they were very or extremely confident in knowing exactly where sensitive data resides.
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Smart speakers serve as cardiac arrest detection system

Published June 25 2019, 12:01am EDT
Researchers at the University of Washington have developed a tool that monitors people at home for cardiac arrest while they’re sleeping by capturing audio samples.
The tool, which uses smart speakers such as Amazon Alexa and Google Home, is trained to detect agonal respiration, an abnormal pattern of breathing associated with about half of people who experience cardiac arrests.
“A lot of people have smart speakers in their homes, and these devices have amazing capabilities that we can take advantage of,” says Shyam Gollakota, an associate professor in the UW’s Paul G. Allen School of Computer Science and Engineering. “We envision a contactless system that works by continuously and passively monitoring the bedroom for an agonal breathing event and alerts anyone nearby to come provide CPR. And then, if there’s no response, the device can automatically call 911.”
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AI, mammograms and EHRs can predict early breast cancer

Published June 25 2019, 12:01am EDT
An algorithm that integrates machine and deep learning with a linked set of digital mammography images and electronic health records detected early breast cancer as well as radiologists.
The finding from a study of the capability opens the door to the use of the tool as a second reader in clinical settings.
Breast cancer is the second leading cause of cancer-related deaths, and the most commonly diagnosed cancer in women throughout the world. Digital mammography is the primary imaging modality of breast cancer screening in asymptomatic women.
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Trump administration updates AI strategy, with emphasis on transparency, data integrity

The White House wants "explainable" systems for healthcare, not black boxes, and wants research into new technologies that are "reliable, dependable, safe, and trustworthy."
June 24, 2019 04:32 PM
In its update to its National Artificial Intelligence Research And Development Strategic Plan, the White House's Office of Science and Technology Policy has set new objectives for federal AI research.
WHY IT MATTERS
The strategic plan boils down to eight strategies for how government can better enable development of safe and effective AI and machine learning technologies for healthcare and other industries.
  • Make long-term investments in AI research, prioritizing next-generation applications that can help "drive discovery and insight and enable the United States to remain a world leader in AI."
  • Develop more effective strategies for human-AI collaboration, with a focus on AI systems that "effectively complement and augment human capabilities."
  • Understand and address the "ethical, legal, and societal implications of AI" and how they can be addressed through the technology.
  • Work to ensure AI systems' safety and security, and spread knowledge of "how to design AI systems that are reliable, dependable, safe, and trustworthy."
  • Create high-quality, shared public datasets and environments for AI training and testing.
  • Measure and evaluate AI with standards and benchmarks, eventually arriving at a broad set of evaluative techniques, including technical standards and benchmarks.
  • Better understand the workforce needs of AI researchers and developers nationwide, and work strategically to foster an AI-ready workforce.
  • Expand existing public-private partnerships, and create new ones to speed advances in AI, promoting opportunities for sustained investment R&D and for "transitioning advances into practical capabilities, in collaboration with academia, industry, international partners, and other non-Federal entities."
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White House Wants Transparency in Healthcare Artificial Intelligence

The White House is calling for more transparency and “explainability” in healthcare artificial intelligence.

June 25, 2019 - The White House is calling for more transparency and “explainability” in healthcare artificial intelligence.
Currently many algorithms are opaque to users, which creates problems for their use by doctors, who need transparency to justify their diagnoses or treatment.
This is one argument made by the National Artificial Intelligence Research and Development Strategic Plan: 2019 Update released June 21 by the National Science and Technology Council in the Executive Office of the President.
 “AI techniques such as decision-tree induction provide built-in explanations but are generally less accurate. Thus, researchers must develop systems that are transparent, and intrinsically capable of explaining the reasons for their results to users,” particularly in healthcare, the plan argued.
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Hackers are taking cities hostage. Here’s a way around it.

June 23
HACKERS ARE taking cities hostage, and some cities are paying ransom to the criminals. That needs to change.
Ransomware attacks on municipalities are on the rise. Last year, it was Atlanta, which spent $2.6 million to recover rather than pay the demanded $51,000. Before that, it was suburbs of Dallas and of Birmingham, Ala., and localities in North Carolina and New Mexico. Last month, hackers crippled Baltimore, which is still working to restore its systems without paying the $100,000 or so the hackers demand. And then there are places that decide to pay, such as the Florida town that decided to fork over a whopping $600,000 to the bad guys last week, desperate to de-paralyze its computer systems and restore essential services to its residents.
The numbers may seem to make the case for giving hackers what they want. But that’s the point of ransomware: It is designed to convince victims that complying is cheaper and easier than the alternative. The argument for refusing to put taxpayer money into malicious actors’ coffers is stronger. Morally, taxpayer money should not be used to reward criminal enterprises. Practically, if cities collectively stop providing that reward, hackers may pack up their keyboards. Every dollar — or, more accurately, every bitcoin — that cities turn over to cybercriminals encourages them to continue attacking, and it also gives them the resources to do so more effectively and more often.
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HIT Think Why SDOH buzz is becoming a roar among health plans

Published June 24 2019, 2:46pm EDT
There was nary a session at the annual conference of America's Health Insurance Plans that did not include a mention social determinants of health.
Whether it was from the stage or on the show floor, there was widespread acknowledgement that these determinants are crucial factors in achieving the best health of a wide variety of individuals.
It's not that SDOH is completely new to health plans. Several have been working on projects to address how these factors--whether it is lack of transportation, inability to access high-quality food, socioeconomic factors, or challenges such as social isolation and loneliness--impact health.
And it’s certainly not that there hasn't been inordinate buzz at a healthcare conference before, and buzz can lead to over-the-top hype, and thence on to hyperbole. But my sense was that this was something different.
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Digitally-supported ageing takes off in Germany

German care-tech provider Media4Care wants to simplify access to the digital world for older people, their carers and relatives.
June 24, 2019 05:24 AM
Tablets for senior citizens and nursing staff are increasingly being used in the home care sector and in nursing homes in Germany. The aim is for tablet-based assistance systems to support people with dementia and provide help against cognitive decline and social isolation.
German care-tech provider Media4Care has now announced that the digital care of senior citizens using tablets has already been deployed in every third home for senior citizens in Germany. Worldwide, 40,000 senior citizens are already using the so-called Digital Health Start-Up service.
WHAT HAPPENED
The 60+ generation is often reluctant to use smart devices. Media4Care has therefore set itself the goal of providing tablets suitable for senior citizens that simplify use and access to the digital world for older people and their carers and relatives.
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Vietnam to deploy EHR nationwide in July

Currently, there are 24 provinces implementing EHRs in Vietnam, of which 6 are officially considered as the 'piloting EHR provinces'.
June 24, 2019 03:06 AM
During the ‘Promoting the implementation of electronic health records’ Seminar that took place in Ho Chi Minh City, Vietnam last week, the Ministry of Health announced that Electronic Health Records (EHRs) will be deployed nationwide from July this year.
WHAT’S THE IMPACT
“The collection of health information will help the Vietnamese manage their health better. This will also raise their self-awareness of disease prevention and the potential risk of diseases affecting health and life,” emphasised Nguyen Truong Son, Deputy Minister of Health, Vietnam.
From the doctors’ and caregivers perspectives, the deployment of EHRs will be an important tool in the prevention and treatment of diseases for the community. The availability of EHRs will also prove invaluable in helping the decision-making processes of doctors, especially during emergency cases in which time is of the essence.
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The Economic Value of Digital Identity

By  Irving Wladawsky-Berger
Jun 21, 2019 12:08 pm ET
Identity plays a major role in our everyday life. It’s the key that determines the particular transactions in which we can rightfully participate as well as the information we’re entitled to access. Think about going to an office, getting on a plane, logging on to a website or making an online purchase. We generally don’t pay much attention to the management of our identity credentials unless something goes seriously wrong.
For much of history, our identity systems have been based on face-to-face interactions and on physical documents and processes.  But the transition to a digital economy requires radically different identity systems. In a world that’s increasingly governed by digital transactions and data, our methods for managing digital identities, security and privacy are proving inadequate.
Data breaches, large-scale fraud and identity theft have become more common. In addition, a significant portion of the world’s population lacks the credentials needed to participate in the digital economy.
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From e-health to digital Health: Telemedicine, Electronic Healthcare File, Artificial Intelligence

In the last five decades we have been assisting on the digitalization of society and consequently of the healthcare sector; we have been using terms such as eHealth, medical informatics, health informatics, telemedicine, telehealth and mHealth, depending on the available technologies and accessibility of the baseline infrastructure.
These terms have been used to describe the application of information and communication technologies (ICTs) to areas of health, health care and wellbeing.
More recently, with the introduction of Artificial Intelligence, we have been assisting with the transition from eHealth to Digital Health that is flexible enough to foster diversity of purposes, technologies and other specificities.
The World Health Organization stated that: “Moving from eHealth to Digital Health puts more emphasis on digital consumers, with a wider range of smart-devices and connected equipment being used, together with other innovative and evolving concepts as that of Internet of things (IoTs) and the more widespread use of artificial intelligence (AI), big data and analytics. Digital Health is changing the way health systems are run and health care is delivered[1].
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#eHealth – First electronic health records of patients exchanged between EU countries

EU Reporter Correspondent | June 24, 2019
First health records of patients have been exchanged in the EU thanks to the cross-border electronic health services. As of now doctors in Luxembourg will be able to receive digital Patient Summaries of travellers coming from Czechia. These Patient Summaries provide background information on important health-related aspects such as allergies, current medication, previous illness, surgeries, etc., making it digitally accessible in case of a medical emergency visit in another country. It is a summary of a patient’s health data stored in electronic format.
Also, as of this week, Finland and Croatia are exchanging ePrescriptions: Finnish citizens can now retrieve in Croatian pharmacies the medicines prescribed electronically by their doctor in Finland. Since January this year, over 2,000 Finnish patients have already been able to get their medicines in Estonia.
Health and Food Safety Commissioner Vytenis Andriukaitis said: “I congratulate Czechia, Luxembourg and Croatia for taking their steps in eHealth cooperation, and I hope other countries will follow soon. Sharing Patient Summaries and ePrescriptions is important for patient safety as it can help doctors to understand better the patient’s medical history, can reduce the risks of incorrect medication and can contribute to better care. In an emergency situation, this can save lives. The Commission will continue its support to expand better care for citizens around the EU.”
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Weekly News Recap

  • A private equity firm acquires EHR/PM vendor Nextech for $500 million.
  • A group of health and technology organizations develops open source cancer data standards and specifications that can be incorporated into EHRs via FHIR.
  • Drug maker Sanofi and Google announce plans to for a virtual innovation lab that will use analytics to study disease and patient treatment response.
  • Change Healthcare increases the amount of its IPO again, this time to $1.2 billion.
  • Accumen acquires Halfpenny Technologies.
  • A 23-bed critical access hospital says it paid a hacker’s unspecified ransomware demand, all but $10,000 of which was covered by cyberinsurance.
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Bill Would Regulate Handling Of Consumer-Generated Health Data

June 21, 2019
Call it a HIPAA reboot for the wearables age. A pair of senators have filed a bill which would impose new regulations on how companies manage data generated by consumer technologies such as health apps, wearables and direct-to-consumer genetic tests.
The Protecting Personal Health Data Act, which was filed by Sen. Amy Klobuchar (D-MN) and Sen. Lisa Murkowski (R-AK), is designed to strengthen privacy protections for consumers’ personal health data.
In their announcement, the Senators note that when HIPAA was enacted in 1996, wearable devices, apps, social media networks and consumer DNA testing companies either didn’t exist or were at a primitive stage. As these technologies have matured, app developers have begun selling the consumer data generated by their users to third parties, including not only marketers but also other parties.
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Enjoy!
David.

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