Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


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

Sunday, July 05, 2020

It Seems We Have A Mini #myHealthRecord Being Grown In NSW – Who Knew? It Seems Your Health Data Is Going All Over, Apparently Often Without Specific Consent!

I noticed this brochure a few days ago.

The Sydney Children’s Hospital Network


We follow strict government standards regarding the secure storage of your child’s health information in all formats.

We regularly enhance and audit our systems in order to protect your child’s information from unauthorised access, loss or other misuse.

NSW public health services hold health information in paper records, on local electronic medical record systems and the NSW HealtheNet.

HealtheNet is a secure state-wide electronic record used by the NSW public health service.

HealtheNet contains a summary of your child’s health information, for example, your child’s discharge summaries, pathology and diagnostic test results and medication information.

If your child attends a public health service anywhere in NSW, in most cases this summary information will be available to your child’s treating clinical staff via HealtheNet.


My Health Record is Australia’s national digital health record system. All Australians have a My Health Record, unless you choose not to have one.

If your child has attended a NSW public health service, a summary of their health information will be sent to your child’s My Health Record. NSW public health staff may also view, and send information to, your child’s My Health Record.

If your child has a My Health Record, but you do not wish for your child’s information from a particular doctor’s appointment or hospital visit to be included in their My Health Record, you must inform the health provider at the beginning of your child’s visit. For further information about My Health Record, telephone 1800 723 471, or visit myhealthrecord.gov.au.


Young people are able to make decisions about their health if medical staff think they are mature enough to fully understand their health problems and the treatment options. There is no fixed age for this, but it is usually about 14 years of age.

In most circumstances, medical staff will encourage young people to involve their parent or carer. Children aged 16 years and over have the right to ask for their information independently.

Here is the link:


A search finds this basic description of what HealtheNet is and what is does. Dated Sep 2019.

What is HealtheNet?

HealtheNet is a NSW Health state-wide information-sharing platform, accessed via the hospital’s electronic Medical Record(eMR). It connects multiple systems allowing NSW Health clinicians with secure and immediate access to a patient’s medical information from across all NSW Local Health Districts.

HealtheNet also shares patient information with General Practitioners (GPs)via secure messaging and sends and retrieves key clinical information to the national My Health Record (MHR) system, if the patient has one; enabling patients and Primary Healthcare providers access to key clinical information.

What documents are sent directly to GPs?

Currently HealtheNet electronically sends discharge summaries to a patient’s nominated GP (via secure messaging). GP practices receive discharge summaries when:

1.Patient’s nominated GP details is stored in eMR

2.A hospital clinician electronically signs the discharge summary;and

3.The patient is discharged.

What clinical information does NSW Health share to a consumer’s MHR?

HealtheNet sends and retrieves patient related clinical information with the MHRsystem.

Currently, NSW is sharing the following clinical document types to MHR:

1.Discharge summaries

2.NSW Health pathology results*

3.Diagnostic imaging reports

4.Dispense medication records at discharge

NSW Health is currently uploading information from Inpatient and Emergency encounters. Work is underway to include information from Outpatient encounters.*

All NSW Health Pathology networks are planned to be contributing to HealtheNet and MHR by late2019.

Note: GPs will still receive pathology reports from NSW Health Pathology laboratories through their existing channels.

Here is the link:


It is interesting what information is not sent on to the #myHealthRecord.

---- Begin extract

What information does NSW Health NOT share with a patient’s MHR?

Pathology test results identified as sensitive (at NSW state level) are not sent to the patient’s MHR. These include: (i) HIV tests and HIV Drug Assays (ii) Sexually Transmitted Infections (STIs) tests (iii) Genomics tests (iv) Pregnancy related tests in minors(under 16yrs)(v) Drug and Alcohol tests (vi) ABO typing paternity group, (vii) MCS tests (genital), and (vii) Autopsy tests.

▪ Pathology tests ordered by GPs and processed by NSW Health Pathology are not displayed in HealtheNet Clinical Portal nor uploaded to the patient’s MHR

Pathology results and imaging reports from public hospitals that use a private pathology/imaging lab may not be sent to the patient’s MHR.

Dispensed medication at discharge that are classified as sensitive drugs are not shared with MHR, these include but not limited to HIV medications.

IMPORTANT: Patients have the right to request that information not be sent to their MHR and NSW Health is obliged to comply with this request. In NSW Health a request not to send information to a MHR will apply to all clinical information created for that hospital encounter.

Note: Pathology test results and diagnostic imaging reports shared with the MHR system are accessible to healthcare providers immediately however they cannot be viewed by the patient for seven days.

----- End extract

How decent of them!

So it seems we have a mini, duplicate and partial #myHealthRecord being created in NSW totally under the radar (for me at least) if not for most of the public!

I wonder what steps have been taken to obtain any form of consent for passing this information to the federal system and making the information accessible all over NSW.

It seems that if the bureaucrats get hold of any of your health information they are overwhelmed by a desire to send it off far and wide – without actually asking you – but seemingly assuming you will be perfectly happy for that to happen.

It seems eHealthNSW noticed the opt-in / out debate and decided to fly under the radar!

What other States are up to this sort of covert program I wonder? Queensland perhaps.


AusHealthIT Poll Number 534 – Results – 5th July, 2020.

Here are the results of the poll.

The PCEHR / #myHealthRecord Has Just Had Its Eighth Birthday With The Overall Project Cost Now Being More Than $2 Billion. In Your View Has The Project Been Clinically Worthwhile And Good Value For Money?

Yes 1% (1)

No 99% (114)

I Have no Idea 0% (0)

Total votes: 115

Very clear cut poll that makes it clear that the readers here think we have been sold a very poor system and have not got value for money. It is clear the myHR is just another failed Commonwealth Government mega IT project.

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

A good number of votes.

It must also have been a very easy question with 0/115 readers were not sure how to respond.

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


Saturday, July 04, 2020

Weekly Overseas Health IT Links – 04 July, 2020.

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.



NAO report highlights “complexity of the NHS digital landscape”

The team behind a troubling report into digital transformation across the NHS in England have said they think it highlights the “complexity of the NHS digital landscape”.

Hanna Crouch – 25 June, 2020

Published in May, the National Audit Office’s (NAO) report concluded that local NHS organisations are facing “significant challenges” when it comes to working towards digital transformation.

Prior to the Covid-19 pandemic, the NAO looked into the state of digital services across the NHS in England and its readiness to deliver digital transformation, focusing on plans, governance arrangements, resources and technical challenges.

The report also concluded that while the main bodies plans for digital transformation are “ambitious”, the track record in the NHS has been “poor”.



Lack of ‘robust’ digital systems is pilling pressure on GPs

A lack of robust digital systems and sustainable plans is leading to extra work for GPs, a British Medical Association (BMA) survey has revealed.

Hanna Crouch – 24 June, 2020

Due to reduced numbers of patients attending hospital because of the coronavirus pandemic, family doctors across the country are now expected to perform blood tests for hospital outpatients, prescribe medication that would normally be given in secondary care, and complete tests before making a possible cancer referral, which could lead to delays in treatment.

This is often due to a lack of digital solutions to enable hospital doctors to do this, as well as a lack of planning for alternatives in the community, the BMA found.

In fact, half of the 7,497 doctors who responded to the survey said that they were having to now provide care that would normally be delivered by secondary care colleagues.

And a further 81% said they had been asked to carry out new investigations and manage ongoing care, which would also usually be done in hospitals, further adding to GPs’ growing workload.



How VA drastically expanded telehealth during the pandemic

By Nicole Ogrysko @nogryskoWFED

As the Department of Veterans Affairs canceled and postponed in-person medical appointments, the agency moved mountains to quickly expand its telehealth capacity during the coronavirus pandemic.

The numbers tell most of the story.

VA conducted about 2,500 telehealth video sessions daily at the beginning of March. Today, VA is conducting nearly 25,000 sessions — a 1000% increase.

The department also boosted bandwidth for concurrent video sessions up by factor of five during the pandemic.



June 26, 2020 / 2:22 AM / a day ago

Coronavirus may have infected 10 times more Americans than reported, CDC says

Steve Holland

WASHINGTON (Reuters) - Government experts believe more than 20 million Americans could have contracted the coronavirus, 10 times more than official counts, indicating many people without symptoms have or have had the disease, senior administration officials said.

The estimate, from the Centers for Disease Control and Prevention, is based on serology testing used to determine the presence of antibodies that show whether an individual has had the disease, the officials said.

The officials, speaking to a small group of reporters on Wednesday night, said the estimate was based on the number of known cases, between 2.3 million and 2.4 million, multiplied by the average rate of antibodies seen from the serology tests, about an average of 10 to 1.

“If you multiply the cases by that ratio, that’s where you get that 20 million figure,” said one official.



AI used to rank NHS patients in order of urgency to clear COVID-19 backlog

NHS hospitals are using AI to prioritise urgent appointments with a scoring system, as number waiting for treatment could reach 10 million by Christmas.

By Sara Mageit

June 26, 2020 06:06 AM

With a large backlog of appointments caused by coronavirus, some hospitals in England and Wales have started using algorithms to prioritise patients most urgently in need of care and to help clear the mounting numbers.

Multiple companies are vying to get into this space from Babylon's AI services which provide health information, to DrDoctor, which recently released a new AI software adopted to collate and automatically rate patient’s responses with digital questionnaires.

DrDoctor’s software assesses the urgency of a patient's illness with a traffic light scoring system, giving patients either a green, amber or a red score.

Tom Whicher, CEO of DrDoctor estimates that if every hospital in the country adopted his technology, the time needed to get through the backlog would be dramatically reduced from four years to ten months.



The successes – and pitfalls – of using telehealth for home-based primary care

Although providing services to patients virtually can improve provider efficiency, it's important to consider individual technological capabilities.

By Kat Jercich

June 26, 2020 03:00 PM

Home-based primary care allows individuals with chronic conditions – especially older people – to stay in their homes longer, so reducing hospitalization rates and improving quality of life. As the COVID-19 crisis has made evident, telehealth can be a useful tool to help connect patients with services remotely. 

However, experts say it is vital to consider the capabilities of patients when trying to implement an at-home care model – and the capabilities of their caregivers.

"It wasn't perfect, but we did learn a lot," said Rachael-Linn Spooner, vice president of clinical transformation at Northwell Health, in an American Telemedicine Association 2020 deep-dive session on employing telehealth for primary care.



SDOH Affect Patient Health Literacy, Knowledge About COVID-19

Research shows disparities in health literacy and knowledge about COVID-19 among people of color, men, and younger individuals.

By Sara Heath

June 25, 2020 - Patient health literacy and knowledge about the COVID-19 pandemic falls along sociodemographic lines, further evidence of the fact that the social determinants of health (SDOH) dictate an individual’s ability to be and stay healthy, according to new research from the Harvard Kennedy School.

More specifically, individual knowledge about COVID-19 and health behaviors were dependent upon individual race, sex, and age.

Black people, males, and individuals younger than age 55 were less likely to know how the novel coronavirus spreads and the key symptoms of the disease.

Additionally, individuals in those populations were less likely to engage in key healthy behaviors known to prevent COVID-19 spread, including regular handwashing and adherence to stay-at-home or better-at-home orders, the researchers found.



How to defend against a ransomware attack

Patrick Hopkins

June 24, 2020

It’s Monday morning. SmartBrief on Cybersecurity arrives in your inbox. You open it, wondering who’s been hit recently and for how much money or data.

The brief includes news about four breaches. If malware is involved in all four, there’s a 27% chance one of them is a ransomware attack. If so, the criminals have probably struck a hospital, a school, a city government or a manufacturing plant, and they might get paid a sizable ransom.

The entity that was struck probably had insurance. ProPublica reported that “[o]ne cybersecurity company executive said his firm has been told by the FBI that hackers are specifically extorting American companies that they know have cyber insurance.” That insurance probably paid out because paying is cheaper than trying to reconstruct everything, when reconstructing is even possible.

What is ransomware, and how does it work?

You might not have heard much about ransomware, which accounts for less than 1 in 20 cyberattacks. But it’s so well-known in the cybersecurity world that Merriam Webster has gone through the trouble of defining it: “Malware that requires the victim to pay a ransom to access encrypted files.” If the encrypted files are the files your business uses to make money, you may have just lost everything.



Study: Online trackers follow health site visitors

By Melanie Lefkowitz  

Internet trackers are more likely to follow people who visit popular health sites, such as WebMD.com and mayoclinic.org, to other types of sites, a Cornell Tech study has found – suggesting that advertisers might be more likely to target people based on sensitive health information than previously understood.

A visualization of one of the researchers’ experiments, browsing from health to news to educational contexts, which shows particularly dense connections of user IDs between health care and news websites.

The study examined how the order in which users visit 15 major health, education and news sites affects the way third-party trackers follow them around the internet. Although the health sites may have fewer trackers than other types of sites, the researchers found, those trackers are more persistent in following page visitors.

“The health care context is really appealing to advertisers, since it’s such sensitive data that allows advertisers to know a lot about you, or even manipulate you to click on an ad that relates to your health problem,” said Ido Sivan-Sevilla, a postdoctoral fellow at Cornell Tech’s Digital Life Initiative and first author of “Unaccounted Privacy Violation: A Comparative Analysis of Persistent Identification of Users Across Social Contexts.”



Massachusetts eHealth Collaborative is calling it a day

After 15 years as health IT innovation leader, the nonprofit MAeHC will be winding down operations in 2020, with many of its assets transferred to other like-minded organizations.

By Mike Miliard

June 25, 2020 03:56 PM

The Massachusetts eHealth Collaborative says it is winding down its operations, having made big progress over the past decade and a half enabling technology-driven healthcare improvements in Massachusetts and beyond.

Founded in 2005 with the mission of boosting the safety, quality and cost-effectiveness of healthcare with technology and data analytics, MAeHC has helped hospitals, practices and others across the state hone their clinical and operational efficiencies over the years.

It has also modeled health IT best practices, policy innovation, interoperability standards development and thought leadership nationwide.

Now, MAeHC officials say the group will distribute many remaining assets to other "like-minded local nonprofits" around Massachusetts.



Are Digital-Only Health Systems On The Horizon?

June 25, 2020

Anne Zieger

Over the past few years, health systems have made increasingly large bets on digital health and telemedicine applications. The question is, now that COVID-19 has forced many of them to beef up their digital capabilities dramatically, can they leverage this experience to deliver virtual care more effectively?

To be sure, some are already making big bets on digital care management and delivery. High-profile efforts we’ve covered in Healthcare IT Today include the Mercy Virtual Care Center, a “hospital without beds” which focuses exclusively on telemedicine and remote monitoring, and the hybrid model rolled out by LifeBridge Health, whose virtual hospital service integrates with brick-and-mortar services by both treating patients online and routing them to appropriate levels of in-person care.

That being said, until recently few systems have followed in their footsteps, if for no other reason than, getting there isn’t cheap. (For example, Mercy apparently spent $54 million to launch its virtual hospital project in 2015.)



What is Social Recruiting and Why Should I Care?

June 25, 2020

Erin Kennedy

Recruiters and hiring managers want to know about you before they offer an interview invitation. And in today’s technological age, they can find out about you easy enough…just go online and “google” you. They look at your social networks to get a picture of who you are. Too many executives believe they don’t need an online presence since the experience on their resume speaks for itself. However, sometimes not having an online presence at all is perceived as being just as bad as having a negative presence. At the very least, it’s important to work with a LinkedIn profile service to develop a profile you can point to online for recruiters. Here’s what you need to know about social recruiting today.

 What is Social Proof?

A recruiter will still want you to have a stellar resume, but you have to back it up with social proof. Employers want to be able to validate who you say you are from your resume and learn more about your life in general. They will look at your LinkedIn profile, Twitter, Facebook, and any other profiles you have to gather this information. They aren’t necessarily stalking you, but rather, they just want to be sure you are who you say you are before they make an investment in hiring you.



Big Data Analytics Dashboard Shows Greatest Risk Factors for COVID-19

The dashboard leveraged big data analytics tools to reveal that social deprivation is a leading factor in determining COVID-19 risk.

By Jessica Kent

June 23, 2020 - Parkland Center for Clinical Innovation (PCCI) has developed a big data analytics dashboard to accurately identify communities at high risk for COVID-19 infection.

The PCCI COVID-19 Vulnerability Index incorporates socioeconomic, clinical, mobility, and demographic risk factors. The index showed that social deprivation is a leading factor in determining an individuals’ risk for COVID-19 and is the primary reason for racial and ethnic disparities in COVID-19 risk – more so than age, race, or comorbidity rates.

The Vulnerability Index determines communities at risk by examining comorbidity rates, including chronic illnesses like hypertension, cancer, diabetes, and heart disease; areas with large density of populations over the age of 65; increased social deprivation such as lack of access to food, medicine, employment, and transportation.

The index also evaluates communities’ levels of mobility by modeling the rate at which individuals are able to observe stay-at-home and social distancing measures. Historical racial and ethnic disparities are also seen with COVID-19, with African American and Hispanic neighborhoods at greatest risk.



4 Key SDOH Impeding Chronic Disease Management

Geography, income, educational attainment, and housing security are key SDOH that affect chronic disease management and engagement.

By Sara Heath

June 23, 2020 - Meaningful chronic disease management is a key aspect of value-based healthcare. After all, a sizeable portion of healthcare spending can be attributed to a small share of the nation’s sickest patients, underscoring the need to manage illness.

But with this shift comes a growing realization that care management is more than just medical practice; it’s an acknowledgment that the social determinants of health (SDOH) impact chronic disease.

These factors that determine a patient’s ability to obtain wellness can keep patients from engaging in healthy behaviors, accessing healthcare, and keeping their disease state of symptoms under control.

Below, PatientEngagementHIT outlines the key social determinants of health that affect chronic disease management and how the healthcare industry has begun to address them.



Pandemic Forced Insurers To Pay For In-Home Treatments. Will They Disappear?

Julie ApplebyJune 23, 2020

After seven days as an inpatient for complications related to heart problems, Glenn Shanoski was initially hesitant when doctors suggested in early April that he could cut his hospital stay short and recover at home — with high-tech 24-hour monitoring and daily visits from medical teams.

But Shanoski, a 52-year-old electrician in Salem, Massachusetts, decided to give it a try. He’d felt increasingly lonely in a hospital where the COVID pandemic meant no visitors. Also, Boston’s Tufts Medical Center wanted to free up beds for a possible surge of the coronavirus.

With a push from COVID-19, such “hospital-at-home” programs and other remote technologies — from online visits with doctors to virtual physical therapy to home oxygen monitoring — have been rapidly rolled out and, often, embraced.

As remote visits quickly ramped up, Medicare and many private insurers, which previously had limited telehealth coverage, temporarily relaxed payment rules, allowing what has been an organic experiment to proceed.



Bungled Lancet study casts shadow over health data industry

Retracted paper linking hydroxychloroquine to increased deaths in Covid-19 patients relied on reams of suspect data.


06/24/2020 09:53 AM EDT

Health data has long been touted as the key to a revolution in medical research, fueled by billions of dollars from tech investors and Silicon Valley giants eyeing new markets.

But in the wake of a botched study on the benefits of an anti-malarial drug against Covid-19, leading academics warn that big sets of health data need to be treated with caution — and can by no means replace tried-and-true scientific methods in the search for medical treatments.

The study, published in leading medical research journal the Lancet in May, linked the use of hydroxychloroquine to increased deaths in patients infected with Covid-19. It immediately led the World Health Organization to pause its own trial on the drug, while some countries went so far as to ban its use as a treatment for the coronavirus.

Yet as questions emerged over the quality of the data used to support the study's conclusions, the authors withdrew their support and the journal took the rare step of yanking the paper.



CMS creates new Office of Burden Reduction and Health Informatics

In addition to reducing the hours and costs clinicians and providers incur for CMS-mandated compliance, the office will also focus on how health data can be harnessed for more efficient healthcare and improved patient experience.

By Mike Miliard

June 24, 2020 11:13 AM

"The work of this new office will be targeted to help reduce unnecessary burden, increase efficiencies, continue administrative simplification, increase the use of health informatics and improve the beneficiary experience," said CMS Administrator Seema Verma.

The Centers for Medicare and Medicaid Services has formed the new Office of Burden Reduction and Health Informatics – an outgrowth of its Patients over Paperwork Initiative whose mission is eliminating red tape in healthcare documentation and, officials say, "permanently embeds a culture of burden reduction across all platforms of CMS agency operations."

The new office is meant to bolster CMS's efforts to decrease the hours and costs clinicians and providers incur for CMS-mandated compliance.

Across Medicare, Medicaid, the Children's Health Insurance Program and the Health Insurance Marketplace, the agency will take a more proactive approach to reducing provider burden, officials said, as new regulations are rolled out.



How telemedicine can help close the maternal health gap

A number of pregnancy-related services, including lactation support, at-home monitoring and mental healthcare can be provided virtually.

By Kat Jercich

June 24, 2020 09:32 AM

In 2012, there were fewer than 1,400 maternal-fetal medicine specialists in the United States, and 98% resided in metropolitan areas.

This left pregnant patients in rural areas without the ability to access care, especially if travel was not an option. 

Today, telehealth can be used to fill that gap – but providers still may face challenges in ensuring patients get the services they need.

As Dr. Craig Sable, associate division chief of cardiology at Children's National Hospital in Washington, D.C., noted during a virtual ATA2020 session Tuesday, the COVID-19 pandemic has only clarified the potential usefulness of telehealth for expectant parents.



ARM Yourself – A Healthcare CIO’s Introductory Guide to Apple Silicon

June 24, 2020

Mitch Parker, CISO

For the first time in 15 years, Apple has announced a major architecture change for the Macintosh platform.  They are moving their primary processor from Intel to ARM-based Apple Silicon using the same architecture that powers the iPhones, iPads, and iPod Touch.  Apple has grown to be one of the largest suppliers of electronic devices in healthcare.  Their use by medical staff is indispensable and has enabled significant innovation.  The 21st Century CURES Act Final Rule also provides for their use by applications so patients can retrieve and use their information to improve their care via FHIR 4.0.1 APIs.  The Apple Watch and HealthKit have provided significant benefit to organizations.

Don’t Panic!

The first thing to remember is not to panic over this and make technology decisions that will have negative repercussions down the line because of initial thoughts.  Apple has switched processor architectures three times.  Microsoft has made epochal changes to their technology stack several times as well.  Yet we didn’t throw out Microsoft when XP had massive security issues, or when they twice laid turkeys with Vista and 8 (although some will argue that maybe we should have).  There’s been a lot of people who have voiced initial thoughts of dumping Apple because of a processor switch.  This is not something to panic over.  This is something a CIO or IT Director manages.

This article is going to go over several steps you can take as a CIO or IT Director now to more effectively manage what you have and set yourself up for success with Apple Silicon in your environment.  Our end goal here is for you to avoid the major pitfalls that beset your predecessors during the 68K to PowerPC and PowerPC to Intel transitions, specifically with legacy applications.  We want you to be able to meet customer demand and use these devices as part of a good long-term healthcare technology strategy that supports and reinforces the organization’s.



NIH to Collect Patient Data with New COVID-19 Analytics Platform

The COVID-19 analytics platform will leverage patient data from the medical record to support research efforts around understanding the disease and finding treatments.

By Samantha McGrail

June 19, 2020 - The National Institutes of Health (NIH) recently launched a new COVID-19 analytics platform that will provided a centralized, secure enclave to analyze medical record data from coronavirus patients to understand the disease and develop effective COVID-19 treatments.

The study is part of an effort called the National COVID Cohort Collaborative (N3C), which aims to transform clinical information needed to identify health risk factors that indicate better or worse outcomes of COVID-19. 

The initiative will combine information into a standard format and make it available for researchers and healthcare providers to find potentially effective COVID-19 treatments.



Majority of COVID-19 Contact Tracing Apps Lack Adequate Security

Guardsquare analyzed 17 global government COVID-19 contact tracing apps, including those from the US, finding most lacked sufficient security and pose a serious hacking risk.

By Jessica Davis

The vast majority of government COVID-19 contact tracing apps from across the world, including the US, don’t employ sufficient security protections, making the apps easy targets for hackers, according to a report from Guardsquare.

Guardsquare assessed 17 Android mobile contact tracing apps from 17 different countries, including Europe, the Americas, and Asia-Pacific, using static and dynamic analysis. All apps were built by government entities, some supported by third-party contractors. Researchers noted it was not an exhaustive list, but designed to shed light into security flaws of these apps.

In the US, Google and Apple recently released a contact tracing API designed to support government agencies in creating their own contact tracing apps. The American Civil Liberties Union, a group of 200 scientists, Congress, and the Electronic Frontier Foundation have all warned of potential privacy and security issues posed by these apps.



What Makes a Patient Choose Telehealth Care Access?

A new study looks at different factors influencing whether a patient would choose in-person or telehealth care access, using pre-COVID data.

By Sara Heath

June 22, 2020 - Patients facing care access barriers but no technology limitations are more likely to opt for a telehealth visit with their providers, compared to those with limited access barriers or challenges with technology, according to new data published in JAMA Network Open.

This data, while collected prior to the COVID-19 pandemic, could have implications for healthcare organizations leaning on telehealth to expand patient access to care while cutting the risk for COVID spread in the office.

Even before the outbreak of the novel coronavirus, telehealth presented key opportunities for patient care access. The technology allowed patients to visit with their medical providers without having to travel into the clinic, posing a serious convenience factor that could boost patient engagement and satisfaction.

But telehealth access does not come without its challenges. The technology relies on strong broadband and internet signal, something of a threat in rural areas or for families in low-income neighborhoods where access is typically limited.



Big Data Analytics Dashboard Shows Greatest Risk Factors for COVID-19

The dashboard leveraged big data analytics tools to reveal that social deprivation is a leading factor in determining COVID-19 risk.

By Jessica Kent

June 23, 2020 - Parkland Center for Clinical Innovation (PCCI) has developed a big data analytics dashboard to accurately identify communities at high risk for COVID-19 infection.

The PCCI COVID-19 Vulnerability Index incorporates socioeconomic, clinical, mobility, and demographic risk factors. The index showed that social deprivation is a leading factor in determining an individuals’ risk for COVID-19 and is the primary reason for racial and ethnic disparities in COVID-19 risk – more so than age, race, or comorbidity rates.

The Vulnerability Index determines communities at risk by examining comorbidity rates, including chronic illnesses like hypertension, cancer, diabetes, and heart disease; areas with large density of populations over the age of 65; increased social deprivation such as lack of access to food, medicine, employment, and transportation.

The index also evaluates communities’ levels of mobility by modeling the rate at which individuals are able to observe stay-at-home and social distancing measures. Historical racial and ethnic disparities are also seen with COVID-19, with African American and Hispanic neighborhoods at greatest risk.



Microsoft Azure and Johns Hopkins Medicine have partnered to accelerate precision medicine

Erum Ahmed

23 June, 2020

Johns Hopkins Medicine (JHM) and Microsoft Azure have teamed up in a five-year deal in which JHM will leverage Microsoft's AI and analytics tools to facilitate precision medicine breakthroughs. This partnership will expand on JHM's Precision Medicine Analytics Platform — which was built in 2019 in collaboration with Microsoft to facilitate data collection and analysis and help providers improve patient care plans.

AI could help unlock the full potential of precision medicine to improve health outcomes by accelerating providers' ability to sift through data to tailor treatment options for patients. For context, precision medicine uses genetic and molecular testing to better predict which particular disease treatment will work best for each patient — instead of using a blanket approach to treatment by recommending therapies that don't take a patient's unique biology into account. For example, UCSF experts note that precision medicine will take into account factors like genetic predisposition, ethnicity, sex, and age. But in order for precision medicine to be effective, researchers need to be able to sift through and analyze large sets of data.



DHS CISA: Serious Vulnerabilities Found in 6 Medical Device Systems

System vulnerabilities found in medical devices from Baxter and Biotronik could allow an attacker to compromise patient information and alter system configurations if exploited.

By Jessica Davis

22 June, 2020

The Department of Homeland Security Cybersecurity and Infrastructure Security Agency issued alerts for vulnerabilities found in six different medical devices manufactured by Biotronik, Baxter, and BD Alaris.

If exploited, some of these flaws could enable a hacker to launch a DDOS attack or alter system configurations or device data, as well as compromise patient information.

Four of the six flaws are found in Baxter medical devices: ExactaMix, PrismaFlex and PrimsaMax, Sigma Spectrum Infusion Pumps, and Hemodialysis Delivery System. The vulnerabilities were identified by the the manufacturer and reported to CISA.

The flaws in the PrismaFlex and PrimsaMax devices pertain to the system’s method of cleartext transmission of sensitive data, along with hard-coded passwords and improper authentication. If a hacker successfully exploited the flaw with network access, they could view and change device data.



Telehealth: ATA president says 'we have a lot more work to do'

Video-based real-time services are just the beginning, said American Telemedicine Association President Dr. Joe Kvedar during his keynote for the virtual ATA2020 conference.

By Kat Jercich

June 23, 2020 09:56 AM

"Telehealth is now a household world," said American Telemedicine Association president Dr. Joe Kvedar during his keynote address Monday, the first day of the virtual ATA2020 conference.

For the past 25 years, Kvedar said he's been explaining to people what he does for a living, working to advance virtual care.

Kvedar, who has run the Center for Connected Health at Boston's Partners HealthCare since 1995, has been a self-described "telehealth evangelist" over those decades. Now, technology and policy have finally aligned to show virtual care's promise on a large scale, even if it took a crisis to force the issue.

After decades of under-fulfilled promise for telehealth, "we have successfully brought the doctor's office into the home," said Kvedar.



Screeners, navigators and nudgers: The future of conversational AI in healthcare

By limiting medical jargon and concentrating on closed-ended questions, chatbots can reduce clinical workload and make patient care more efficient – and maintain empathy in the process.

By Kat Jercich

June 23, 2020 12:38 PM

Using virtual agents to offload human work and support customers' needs is nothing new. Think of the process of calling your cable company to inquire about service outages: You will almost certainly be met with an automated number-based menu, along with the invitation to "listen carefully, as our options have changed."

The difference today, say experts, is that the agents are often conversational. Using natural language processing, they're intended to bring much more of an empathetic – some might even call it human – model to customer service.

"The commerce world has been doing this for a while," said Nathan Treloar, president and cofounder of conversational AI vendor Orbita, during an ATA2020 virtual presentation Monday.

In the healthcare industry, he said, the potential for a virtual agent to support a patient seeking services through basic triaging is "pretty obvious."



Telehealth Features – What’s Required?

June 23, 2020

John Lynn

As the telehealth adoption wave continues in healthcare, we thought we’d take the time to do a series of articles on a number of aspects of telehealth.  In this first series we’re going to look at various Telehealth features.  We’ll talk about whether those features should be considered essential.  We’ll evaluate nuances of when a feature might be nice to have and in other cases where it’s a deal breaker.  Hopefully, we’ll expose you to the best telehealth options out there.

Along the way, our goal is to help you get a better understanding of what features are possible with telehealth as you evaluate which telehealth company is best for you organization.  Yes, I’m sure you’ve all done some sort of telehealth implementation already, but did you implement the right telehealth software?  Are there better software out there?  Are there features on this list that other telehealth vendors have that make you want to switch telehealth companies?  Can you use the features on this list to drive your telehealth vendor to add new features?

A big thank you to Jim Tate, Chief Product Officer at MediVisum Telehealth Solutions, for writing this article which inspired and started as the seed topic for this list.  As he aptly pointed out, we learned during EHR adoption was that many were looking for a list of features that an EHR platform should include.  The same is true as healthcare organizations select a telehealth platform.  Regardless of what you’ve implemented already, you want a “complete” solution as Jim Tate described.



Chronic Disease Management Projects Leverage AI, Data Analytics

Howard University College of Medicine is partnering with AARP to improve chronic disease management using artificial intelligence and data analytics.

By Jessica Kent

June 18, 2020 - Howard University College of Medicine’s 1867 Health Innovations Project and AARP Innovation Labs will leverage artificial intelligence and data analytics to boost chronic disease management in medically underserved communities.

The partnership will examine age-tech solutions to expand healthcare access for people with chronic conditions, and will focus on developing new models of care.

AARP and Howard University will conduct two clinical pilot projects to improve diabetes management and medication adherence. The first is a proactive voice-technology that uses facial recognition to remind individuals to take their medication.

The second project will launch a digital online health community that connects individuals to others with similar health challenges. The collaboration will aim to develop additional pilot projects to address health conditions such as hypertension, cardiovascular disease, genetic disorders, cancer, and neurodegenerative diseases.

AARP Innovation Labs will provide Howard University researchers with cutting-edge technologies and resources like design thinking training to improve the health of adults 50 and older.



Machine Learning Tracks EHR Data to Predict Disease Risk

A machine learning technique can track patients’ EHR data over time to predict their risk of developing different diseases.

By Jessica Kent

June 19, 2020 - A new sequential approach uses machine learning to connect patients’ EHR data, including medications and diagnoses, to quantify disease risk, according to a study published in Cell Patterns.

While EHRs contain important information about patients’ health conditions and the care they receive, these records are not always precise. EHRs may not be direct indicators of patients’ true health states at different points in time, but rather reflect clinical processes, patients’ interactions with the system, and the recording process.

Researchers from Massachusetts General Hospital developed a strategy that uses machine learning to collect information on patients’ diagnoses and medications over time, rather than from independent health records.



Patients on board with health trackers but don't trust consumer wearables, survey finds

By Heather Landi

Jun 22, 2020 2:30pm

Patients who manage chronic conditions are eager to use a monitoring device to manage their health. But consumer smartwatches might not be the answer.

Three in four patients say they would wear a specialized monitoring device only used for their specific condition if prescribed by their doctor, a survey from electronics company Sony found.

Nearly 90% of those surveyed believe they could better manage chronic conditions with a health monitoring device. More than half of patients said they would potentially switch doctors if another doctor prescribed a specialized device, according to the survey of 2,000 people conducted by Sony.

However, while consumer-facing companies like Apple and Fitbit offer wearables with health tracking capabilities, only 28% of patients would trust a consumer device to help manage their chronic condition and 45% said they were unsure, according to the survey.



Ransomware operators lurk on your network after their attack

By  Lawrence Abrams

·         June 21, 2020 12:28 PM

When a company suffers a ransomware attack, many victims feel that the attackers quickly deploy the ransomware and leave so they won't get caught. Unfortunately, the reality is much different as threat actors are not so quick to give up a resource that they worked so hard to control.

Instead, ransomware attacks are conducted over time, ranging from a day to even a month, starting with a ransomware operator breaching a network. 

This breach is through exposed remote desktop services, vulnerabilities in VPN software, or via remote access given by malware such as TrickBot, Dridex, and QakBot.

Once they gain access, they use tools such as Mimikatz, PowerShell Empire, PSExec, and others to gather login credentials and spread laterally throughout the network.



TikTok joins the EU’s Code of Practice on disinformation

Natasha Lomas @riptari / 9:34 pm AESTJune 22, 2020

TikTok is the latest platform to sign up the European Union’s Code of Practice on disinformation, agreeing to a set of voluntary steps aimed at combating the spread of damaging fakes and falsehoods online.

The short video sharing platform, which is developed by Beijing based ByteDance and topped 2BN downloads earlier this year, is hugely popular with teens — so you’re a lot more likely to see dancing and lipsyncing videos circulating than AI-generated high tech ‘deepfakes’. Though, of course, online disinformation has no single medium: The crux of the problem is something false passing off as true, with potentially very damaging impacts (such as when it’s targeted at elections; or bogus health information spreading during a pandemic).

The EDiMA trade association, which counts TikTok as one of a number of tech giant members — and acts as a spokesperson for those signed up to the EU’s Code — announced today that the popular video sharing platform had formally signed up.



COVID-19 tracing apps in Bahrain, Kuwait and Norway spark privacy concerns

In a new investigation by Amnesty International, the two Gulf states and Norway have released apps that reportedly operate as mass surveillance tools.

By Ahmed El Sherif

June 19, 2020 09:00 am

Bahrain and Kuwait are using their COVID-19 contact tracing apps as mass surveillance tools, it has emerged. According to a new report released by Amnesty International, the two Gulf states, along with Norway, have released “some of the most invasive COVID-19 contact tracing apps around the world, putting the privacy and security of hundreds of thousands of people at risk.”

In its investigation, Amnesty’s Security Lab reviewed apps released in Europe, the Middle East and North Africa, focusing on 11 products from Algeria, Bahrain, France, Iceland, Israel, Kuwait, Lebanon, Norway, Qatar, Tunisia and United Arab Emirates. According to the NGO, Bahrain’s ‘BeAware’, Kuwait’s ‘Shlonik’ and Norway’s ‘Smittestopp’ emerged as the “most alarming mass surveillance tools” with the three reportedly carrying out live or near-live tracking of users’ locations by frequently uploading GPS coordinates to a central server. Most contact-tracing apps rely solely on Bluetooth signals.

“Bahrain, Kuwait and Norway have run roughshod over people’s privacy, with highly invasive surveillance tools which go far beyond what is justified in efforts to tackle COVID-19,” stated Claudio Guarnieri, head of Amnesty International’s Security Lab. “Privacy must not be another casualty as governments rush to roll out apps.” 



A new COVID-19 wave is coming – how can health systems prepare?

Two potential areas to consider are supply chain management and telehealth tool selection.

By Kat Jercich

June 22, 2020 04:23 PM

Epidemiologists have warned that a second wave of COVID-19 is on its way. In fact, in some countries, it's already here.

When coronavirus cases begin to grow in early spring, health systems were forced to pivot quickly – sometimes within a matter of days – to allocate scant resources and implement new technologies and workflows. Now, experts say administrators have the chance to start preparing for the next spike.

Manage supply chains effectively

"COVID has taught us a lot, particularly around bandwidth and supply chain," said Gordon Krass, CEO of inventory-management-system vendor IntelliGuard.

"We learned how fragile the supply chain is, particularly for critical items like personal protective equipment and ventilators," Krass continued. 



Epic Partners With Health Insurer To Make Two-Way Data Exchange Possible

June 22, 2020

Anne Zieger

Historically, health insurers have relied on one form of patient data, while providers operated in a different world.

Because it lines up with how they do business, health insurance companies have focused on analyzing patient care using claims data. Providers, of course, are far more focused on the contents of medical records, which offer a depth process and decision-making-related data that doesn’t show up in a claim.

However, over time both sides of come to realize that they need to speak in each other’s data language more fluently. In particular, providers are more likely to be successful at value-driven care if they can reap the benefits of both clinical and initiative/claims data.

In that spirit, health plan operator Health Care Service Corporation has struck a deal with Epic in which the two will allow providers using its EHR to engage in two-way information change. HCSC operates health plans in Illinois, Montana, New Mexico, Oklahoma and Texas, and has almost 16 million members across the five states.



Racial Health Disparities by Age Paint Starker Picture of COVID-19

When adjusted by age, racial health disparities run deeper than previous reports, underscoring the rampantness of chronic illness in underserved populations.

By Sara Heath

June 18, 2020 - New data confirms the stark racial health disparities for COVID-19 health outcomes. When adjusted for age, black patients are dying at a rate 3.6 times that of their white peers, according to data from the Brookings Institution. For Hispanic patients, that number comes in at 2.5 times the death toll of white patients.

The COVID-19 pandemic has shone a glaring light on racial health disparities that have plagued the US health system for decades. Per the Brookings Institution report, black patients are overall twice as likely to die from COVID-19, and Hispanic patients are equally as likely to die from the condition as their white peers.

Most experts agree this is not because people of color are predisposed to contract COVID-19; the virus is an equal opportunity illness that does not know race or ethnicity. Instead, years of structural inequity in the healthcare system have made it more likely a black patient will develop a chronic illness. And while COVID-19 may not know race, it does affect those with comorbidities more than generally healthy patients.




21 Jun, 03:43

Putin calls for artificial intelligence to be used in healthcare

To date, 576,952 coronavirus cases have been confirmed in Russia, with 334,592 patients having recovered from the disease

NOVO-OGAREVO, June 20. /TASS/. Russian President Vladimir Putin has ordered to roll out digitalization and phase in artificial intelligence (AI) technology in the healthcare sector.

"Unconditionally, we should provide broad digitalization and the application of artificial intelligence technology at the all-level medical institutions," he said at a video conference with health workers on Saturday.

"Now, we must move on relying on the experience gained during the fight against coronavirus, honestly analyzing both achievements and unsolved issues," the president added, emphasizing that not only was he talking about the fight against epidemics, but also about an increase in the reliability of the entire system.



Weekly News Recap

  • Health Care Service Corporation, the country’s fifth-largest insurer, will create a Payer Platform to connect its health plans to Epic-using health systems.
  • Epic cancels UGM 2020.
  • Proteus Digital Health, once valued at $1.5 billion, files Chapter 11 bankruptcy.
  • Walmart acquires the technology assets of online pharmacy CareZone for a rumored $200 million.
  • Surgisphere, the tiny company whose questionably sourced aggregated EHR data was responsible for two major research article retractions, appears to have shut down.
  • Milliman acquires Wisconsin-based employee health monitoring technology vendor Healthio.