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."

Sunday, July 31, 2022

They Say Insanity Is Doing The Same Thing Over And Over And Expecting A Different Outcome!

This release appeared a few days ago.

Strengthening Medicare Taskforce Communiqué

All Australians deserve equitable access to affordable quality primary care.

Today, the Strengthening Medicare Taskforce held its inaugural meeting on the land of the Gadigal people of the Eora Nation.

The Strengthening Medicare Taskforce members are health leaders, representing a cross section of perspectives on the primary care system.

At today’s meeting, all members undertook to work together in the best interests of the health of Australians and the Australian health system. I was delighted with the spirit of partnership and collaboration.

The Australian Government established this Taskforce to identify the highest priority reforms in primary care.

There is no doubt primary care around the country is in a parlous state.

The Government is committed to ensuring Australians get the care they need, when they need it and without worrying about the cost.

The Taskforce will develop recommendations to achieve this through five focus areas to achieve concrete results for patients:

·         a reliable training and development pipeline, to build a strong and vibrant primary health care workforce

·         increased access to multidisciplinary care, harnessing the full skills of nurses, pharmacists and allied health professionals

·         new models of care and stronger relationships between patients and practices, to better respond to today’s health needs, including older Australians and those with complex and chronic conditions

·         ensuring access to care is modern, patient-centred and easy, harnessing the power of technology, and

·         providing universal health care and access for all through health care that is inclusive and reduces disadvantage.

Taskforce members had the opportunity to discuss the reform journey to date from the co-chairs of the former Primary Health Care Reform Steering Group, who guided the development of the Primary Health Care 10 Year Plan 2022-2032.

Members also had the opportunity to share their priorities for reform.

The Government has committed $750 million in the Strengthening Medicare Fund to turn proposals into concrete actions for a person-centred primary health care system.

The Taskforce agreed to develop a forward work program, focusing on immediate priorities to deliver better health care for all Australians. The Taskforce will report to Government at the end of 2022 and will meet again in August.

Chair

The Minister for Health and Aged Care, the Hon Mark Butler MP

29 July 2022

Sydney

The Strengthening Medicare Taskforce is chaired by the Minister for Health and Aged Care, the Hon Mark Butler MP. The Membership is set out below.

Member

Organisation

Dr Omar Khorshid

President, Australian Medical Association

Adjunct Professor Karen Price

President, Royal Australian College of General Practitioners

Dr Sarah Chalmers

President, Australian College of Rural and Remote Medicine

Ms Leanne Wells

Chief Executive Officer, Consumer Health Forum of Australia

Dr Dawn Casey PSM

Deputy Chief Executive Officer, National Aboriginal Community Controlled Health Organisation

Mr Anthony Nicholas

Board Chair, Allied Health Professionals Australia

Ms Karen Booth

President, Australian Primary Health Care Nurses Association

Ms Annie Butler

Federal Secretary, Australian Nursing and Midwifery Federation

Dr Ruth Stewart

National Rural Health Commissioner

Ms Amanda Cattermole PSM

Chief Executive Officer, Australian Digital Health Agency

Associate Professor Learne Durrington

Chief Executive Officer, WA Primary Health Alliance

Dr Nigel Lyons

Deputy Secretary, NSW Health (state and territory representative)

Professor Adam Elshaug

Director, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne

Professor Stephen Duckett

Honorary Enterprise Professor, Melbourne School of Population and Global Health, The University of Melbourne

Dr Steve Hambleton AM

General Practitioner

Dr Walid Jammal

General Practitioner

Here is the link:

https://www.health.gov.au/resources/publications/strengthening-medicare-taskforce-communique-29-july-2022

As I read through this I had 3 main thoughts.

First in the thirty or so years I have been watching Government Policy on General Practice we seem to be seeing pretty much to same outcome over and over – as represented here!

Second the make-up of the taskforce is exactly what you would select if you wanted the status quo. All those selected have been at this and similar games for years with no discernible change in outomes and just the typical ‘word salad’ outcomes!

Third was the glacial pace at which anything was planned to happen. All the issues are well known and it hardly takes six months to write them down.

As this article points out GP is bleeding

Health Minister to focus on ‘terrifying trend’ of GP shortfall

The new federal health minister has identified the looming shortage of general practitioners as the most pressing medium to long-term challenge in the health system.

Health Minister Mark Butler, speaking at the Australian Medical Association’s national conference on Saturday, said the low number of medical graduates applying to specialise in general practice was “the most terrifying statistic” in health care. 

“It’s hard enough to get a GP right now and we know that the current generation of older GPs are pretty exhausted, particularly over the last 2½ years, and we just do not have the pipeline coming through,” Butler said. “It is probably the most terrifying trend that I see in primary care.” 

Royal Australian College of General Practitioners president Dr Karen Price told The Sun-Herald and The Sunday Age that 16 per cent of medical graduates had applied to specialise in general practice in 2022, up slightly from the 15.2 per cent reported last year but “not enough”. 

The Herald and The Age have previously reported on the falling enrolments in general practice training and the looming shortfall of nearly 10,000 doctors by 2030. Doctor shortages are most acute in rural and regional areas.

Butler said the issue had been discussed in the first meeting of the Strengthening Medicare Taskforce on Friday, and he was told that several decades ago more than half of all graduates had applied for general practice.

Australian Medical Students Association president Jasmine Davis, who said her desire to become a rural GP made her unusual among her peers, asked Butler what his government would do to make general practice a career of choice.

Butler said fixing the GP pipeline was a long-term project and there was “no silver bullet for cities, let alone rural and regional Australia” but his government was exploring alternative models, such as the trial of the single employer model in the Murrumbidgee region started by the former government.

Under this system, general practice trainees remain employed by NSW Health, allowing easy transition between hospital and community-based general practice training placements, and portability of entitlements such as annual leave. Several trainees at the conference praised the program and Davis told The Sun-Herald and The Sunday Age it was helpful because losing entitlements by switching employers “definitely turned students off and significantly impacted women, who were more likely to be GPs”.

Butler said the results of the single employer model in the Murrumbidgee would inform a possible further trial in South Australia.

Lots more here:

https://www.smh.com.au/healthcare/health-minister-to-focus-on-terrifying-trend-of-gp-shortfall-20220730-p5b5vc.html

All I can say is that GP is the core of our health system and it really is time for some radically new thinking to move forward! A little more money into the hands of he GPs might be a good first step!

The inertia seen here reminds me powerfully of what we see in Federal Digital Health Policy where simply no one can figure out that we need to give up (after a decade) on the #myhealth record and start doing things differently, It looks rather like even a change of Government cannot “unstick” the glued down policy wheels and all the vested interests!

David.

 

AusHealthIT Poll Number 642– Results – 31st July, 2022.

Here are the results of the poll.

Should The Federal Government Stick To Policy Issues And Funding In Digital Health And Leave Actual Delivery Of Solutions To The Private Sector?

Yes                                            52 (95%)

No                                              3 (5%)

I Have No Idea                           0 (0%)

Voters: 55

A very clear cute vote with most feeling tech delivery is just too hard for the Federal Government.

Any insights on the poll are welcome, as a comment, as usual!

A fair number of votes. and a very balanced outcome. 

0 of 55 who answered the poll admitted to not being sure about the answer to the question!

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

David.

 

Saturday, July 30, 2022

Weekly Overseas Health IT Links – 30th July2022.

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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https://ehrintelligence.com/news/internal-email-outlines-changes-to-oracle-cerner-ehr-business-unit

Internal Email Outlines Changes to Oracle Cerner EHR Business Unit

Upon its acquisition, the Cerner EHR business is now called Oracle Health, one of Oracle’s global industry units (GIUs).

By Hannah Nelson

July 22, 2022 - An internal email from an Oracle executive shared on Reddit describes significant changes in the former Cerner EHR business that is now owned by Oracle.

The email notes that the business is now called Oracle Health, one of Oracle’s global industry units (GIUs). According to HIStalk, the post was confirmed by Oracle as authentic by the Kansas City business paper.

“Oracle Health brings together Cerner’s portfolio with Oracle’s technologies for healthcare to help us achieve our mission of enabling better outcomes for patients and providers while reducing administrative workload and overall healthcare costs,” Mike Sicilia, executive vice president of Oracle’s global business units, wrote in the email.

Sicilia said that former Cerner president and CEO David Feinberg, MD, MBA will become chairman of Oracle Health. Further, former chief client and services officer Travis Dalton, MPA, who led Cerner Government Services, will take on the role of Oracle Health’s general manager.

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https://healthitsecurity.com/news/nist-updates-healthcare-cybersecurity-hipaa-security-rule-guidance

NIST Updates Healthcare Cybersecurity, HIPAA Security Rule Guidance

NIST issued a new draft publication on healthcare cybersecurity and implementing HIPAA Security Rule requirements.

By Jill McKeon

July 22, 2022 - The National Institute of Standards and Technology (NIST) issued updated healthcare cybersecurity and HIPAA Security Rule guidance to aid organizations in safeguarding protected health information (PHI). NIST is seeking comments on the draft publication until September 21.

“One of our main goals is to help make the updated publication more of a resource guide,” Jeff Marron, a NIST cybersecurity specialist, said in an accompanying press release.

“The revision is more actionable so that health care organizations can improve their cybersecurity posture and comply with the Security Rule.” 

The original guidance was published in 2008, and the updated guidance is meant to fit seamlessly into the NIST Cybersecurity Framework and other resources that were developed after the original guidance. It is important to note that the HHS Office for Civil Rights (OCR) is the office that enforces HIPAA compliance. NIST’s publication is simply additional guidance on implementing HIPAA’s provisions.

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https://www.healio.com/news/infectious-disease/20220720/toolkit-helps-identify-and-respond-to-monkeypox-exposures-among-health-workers

July 20, 2022

Toolkit helps identify and respond to monkeypox exposures among health workers

Massachusetts General Hospital developed a toolkit that can help identify and respond to potential monkeypox exposures among health care personnel, researchers reported in Infection Control & Hospital Epidemiology.

The toolkit uses an enhanced version of REDCap, a web-based software platform that supports survey and data collection.

“They say necessity is the mother of invention and that’s absolutely true in this case,” Erica S. Shenoy, MD, PhD, associate chief of the infection control unit at Mass General, told Healio.

Shenoy noted that clinicians at the hospital identified the first U.S. case of monkeypox in the current outbreak.

“We had to respond quickly to identify potentially exposed health care personnel, patients and visitors,” Shenoy said.

Shenoy and colleagues quickly developed and deployed an enhanced version of REDCap in the hospital.

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https://ehrintelligence.com/news/ehnac-releases-new-criteria-for-health-it-accreditation-programs

EHNAC Releases New Criteria for Health IT Accreditation Programs

The updated health IT accreditation criteria was revived to align with federal regulations such as HIPAA/HITECH, 21st Century Cures Act, and TEFCA.

By Sarai Rodriguez

July 21, 2022 - The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit health IT data standards development organization, has released the finalized criteria for its three accreditation programs.

The enhanced criteria programs include the Trusted Dynamic Registration & Authentication Accreditation Program (TDRAAP-Basic and TDRAAP-Comprehensive) and the Trusted Network Accreditation Program (TNAP-QHIN).

The EHNAC criteria for its three accreditation programs aim to create foundational requirements that measure an organization’s ability to meet federal and state healthcare regulation like HIPAA/HITECH, the 21st Century Cures Act, Trusted Exchange Framework and Common Agreement (TEFCA), and other mandates that focus on privacy, security, cybersecurity, breach handling, confidentiality, best practices, procedures, and asset management.

“Our industry is experiencing change at a rapid pace, and we must be ready to meet these new requirements as they arise, while holding security, confidentiality, integrity, and efficiency at the forefront when electronically exchanging healthcare data,” Lee Barrett, executive director and CEO of EHNAC, said in the press release. “EHNAC’s three newly enhanced accreditation programs are designed to ensure compliance and stakeholder-trust while mitigating risk as organizations address these ever evolving legislative and regulatory revisions.”

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https://healthitanalytics.com/news/ai-tool-can-identify-sepsis-within-12-hours-of-hospital-admission

AI Tool Can Identify Sepsis Within 12 Hours of Hospital Admission

An artificial intelligence-based tool developed by University of Florida and University of Washington researchers can identify a patient’s likelihood of developing sepsis within 12 hours of admission.

By Shania Kennedy

July 21, 2022 - A new study published in JAMA Network Open assesses an artificial intelligence (AI) tool that can predict the likelihood of patients developing sepsis and the severity of the infection as quickly as 12 hours after hospital admission.

According to the Centers for Disease Control and Prevention (CDC), 1.7 million adults in the US develop sepsis in a typical year, and 270,000 die. One in three patients who die in the hospital has sepsis, but the condition, or the infection that causes it, starts outside the hospital in 87 percent of cases. Some patients who survive sepsis also develop permanent organ damage and, as a result, have a higher risk of other medical conditions for several years after recovering.

Identifying the risk of sepsis quickly is key to reducing serious adverse outcomes such as septic shock, which can result in multiple organ failures and death. But recognizing and managing sepsis early remains a challenge.

“There is no consistent way of recognizing and triaging critically ill patients when they’re admitted to the ICU,” said Lyle L. Moldawer, PhD, director of the University of Florida’s Sepsis and Critical Illness Research Center and emeritus director of the Laboratory of Inflammation Biology and Surgical Science, in the press release. “While this may not pose a problem at large academic institutions with dedicated specialists, it can be harder for places where tertiary care is less developed.”

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https://mhealthintelligence.com/news/most-americans-support-expansion-of-asynchronous-telehealth-options

Most Americans Support Expansion of Asynchronous Telehealth Options

A new survey shows that a majority of Americans support legislation that would expand asynchronous telehealth, thereby increasing access to care, particularly mental healthcare.

By Mark Melchionna

July 21, 2022 - Two-thirds (69 percent) of Americans are in favor of legislation to expand access to asynchronous telehealth, according to a new survey.

Telehealth company Hims & Hers Health worked with polling firm Public Opinion Strategies to conduct a survey of 1,301 US adults between Feb. 13 and 17. The results indicate that optimizing telehealth and changing policies are critical.

The COVID-19 pandemic significantly affected healthcare overall, resulting in an increased need for care, especially for behavioral healthcare.

The survey found that only 38 percent of respondents reported having good mental health, which was lower than the 52 percent who said the same in February 2021.

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https://www.fiercehealthcare.com/payers/doj-charges-36-series-phony-telehealth-claim-fraud-schemes

DOJ charges 36 over $1.2B in phony telehealth claim fraud schemes

By Robert King

Jul 21, 2022 06:40am

Federal prosecutors charged 36 defendants with committing a variety of alleged schemes to bilk Medicare using telehealth, as regulators continue to tinker with how to make the COVID-19 telehealth boom permanent.

The Department of Justice (DOJ) announced Wednesday that the defendants allegedly engaged in a series of actions that led to $1.2 billion in medical fraud, with much of that coming from phony telehealth claims for advanced genetic testing and unnecessary medical equipment.

“Fraudsters and scammers take advantage of telemedicine and use it as a platform to orchestrate their criminal schemes,” said Luis Quesada, assistant director in the FBI’s Criminal Investigative Division, in a statement. “This collaborative law enforcement action shows our dedication to investigating and bringing to justice those who look to exploit our U.S. health care system at the expense of patients.”

Under one of the alleged schemes, a collection of clinical laboratories would offer $16 million in kickbacks to telemedicine companies, call centers and doctors for genetic testing orders and the documentation needed to submit the claims to Medicare for reimbursement, according to a federal indictment. But the genetic testing was not medically necessary. 

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https://www.healthdatamanagement.com/articles/progress-report-integrating-genetic-data-with-ehrs

Progress report: Integrating genetic data with EHRs

Foundation Medicine is working with software vendors and healthcare providers to automate ordering tests and obtaining results.

Jul 19 2022


Howard Anderson

Contributing Editor, HDM

Foundation Medicine, which provides genomic profiling tests for patients with advanced cancer, is working with several electronic health record vendors and healthcare providers to further automate the ordering of tests and receiving of results within EHRs.

In one of the most recent initiatives, Foundation Medicine worked with University of Missouri Health Care to develop an HL7 interface to enable the electronic ordering of tests and obtaining a PDF of the results via its EHR system, Oracle Cerner’s PowerChart. The provider organization has a strategic partnership with Cerner – the Tiger Institute for Health Innovation – that runs much of its IT operations and coordinated the interface initiative, explains Katie Wilkinson, a senior director at the institute.

Previously, the health system relied on submitting paper orders and receiving results via fax and then manually scanning the information into the record, says Richard Hammer, MD, professor of pathology at the MU School of Medicine and vice chair of clinical affairs in the Department of Pathology and Anatomical Sciences.

“Our clinicians now have the ability to seamlessly integrate this new tool into our workflow,” Hammer says. “We can order the patient testing and receive the results within the EHR, and an email will notify us when the information is available. It speeds up the entire process.”

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https://www.healthdatamanagement.com/articles/a-physician-who-became-cio-reflects-on-important-lessons-learned?id=130611

A physician who became CIO reflects on important lessons learned

Despite the emphasis on technical acumen, success in healthcare IT is all about people. ‘If we don’t get this right, everything else falls apart.’

Jul 21 2022


Lee Milligan, MD

On June 12, 2000, I started working at Asante Health System as an emergency department doctor.

My wife and I had just gotten married three months prior. She was two months pregnant. And I was a week out from finishing my emergency medicine residency at UCLA. 

At the time, we didn’t know much about Oregon or Asante, other than the space is beautiful and the people are gold. We were in for an adventure. Over time, we were blessed to have four children born at our flagship hospital – two requiring NICU care – and raise them in the beautiful Rogue Valley.

My career eventually shifted from working in the system to working on the system, most recently serving as senior vice president and CIO.   

Now comes another adventure. After working for Asante for 22 years, I have left to start a new role.

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https://www.reuters.com/technology/apple-outlines-health-technology-strategy-new-report-2022-07-20/

Apple outlines health technology strategy in new report

By Stephen Nellis

July 20 (Reuters) - Apple Inc (AAPL.O) on Wednesday released a report outlining a two-pronged strategy in digital health markets, courting consumers with health and fitness features on one hand while engaging with traditional healthcare systems on the other.

Spearheaded by Apple's chief operating officer, Jeff Williams, the report is the first time Apple has offered a comprehensive view of its approach to healthcare markets in the eight years since it began releasing health features such as a medical records storage system on iPhones. It has also started partnering with institutions such the Stanford University School of Medicine to conduct large-scale formal medical studies.

Much of the work has centered around the Apple Watch, a device that Williams played a key role in bringing to market and which contains sensors for heart health and other functions.

In the report, Apple said its focus for consumers is on providing a secure place for users to store their health and medical information on iPhones while using tools like the Apple Watch to warn and nudge users toward better health. The device can alert people to heart irregularities and detect when a person takes a hard fall to alert an emergency contact, among other features. Apple said its system can now store 150 different types of health data that is encrypted so that only users, not Apple, can access it.

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https://www.healthcareitnews.com/news/amazon-makes-further-healthcare-inroads-39b-one-medical-deal

Amazon makes further healthcare inroads with $3.9B One Medical deal

The merger agreement with the IT-driven primary care company aims to make healthcare more "accessible, affordable and even enjoyable" with in-person and virtual care services.

By Mike Miliard

July 21, 2022 10:46 AM

Amazon and One Medical announced their plans to merge on Thursday morning, in a $3.9 billion mega deal that would see the retail giant continue its ambitious string of healthcare acquisitions.

Under terms of the merger agreement, which is subject to customary closing conditions, Amazon will acquire One Medical for $18 per share in an all-cash transaction. 

San Francisco-based One Medical is a technology-focused primary care organization offering in-person, digital and virtual care services that it says are designed to improve the healthcare experience for its customers.

"The opportunity to transform health care and improve outcomes by combining One Medical’s human-centered and technology-powered model and exceptional team with Amazon’s customer obsession, history of invention, and willingness to invest in the long-term is so exciting," said One Medical CEO Amir Dan Rubin, who will remain in that role, in a statement. 

He said the deal represents an opportunity to help build a primary care experience with Amazon that's "more accessible, affordable, and even enjoyable for patients, providers, and payers."

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https://www.healthcareittoday.com/2022/07/21/securing-the-internet-of-medical-things-10-effective-ways/

Securing the Internet of Medical Things: 10 Effective Ways

July 21, 2022

The following is a guest article by Vinugayathri Chinnasamy from Indusface.

The Internet of Medical Things (IoMT) is revolutionizing the healthcare industry by creating a connected infrastructure of medical systems and services that are helping enhance patient outcomes. But they come with newer security risks too. 63% of healthcare organizations in 2019 faced security incidents owing to the insecure and unmanaged Internet of Medical Things. Given the increasing costs of data breaches, IoT security in healthcare is indispensable.

Continue reading to find out more about IoMT and powerful insights on securing the Internet of Medical Things.

What is IoMT?

The Internet of Medical Things (IoMT) is the amalgamation of medical devices and applications that use networking technologies to connect to healthcare IT systems. The IoT in healthcare is helping improve patient outcomes and enhancing patient experiences, optimizing costs, enabling quicker, more accurate diagnosis, enabling effective remote monitoring of chronic diseases, and bettering drug management, among others.

Why is IoT Security in Healthcare Necessary?

Today, a hospital has an average of 15-20 medical devices such as smart beds, ventilators, insulin pumps, IV pumps, etc. If any of these devices have vulnerabilities or security weaknesses such as unpatched software or outdated OS, attackers can easily breach them and access the connected devices.

Attackers could weaponize these devices and cause harm to patients. Or they could orchestrate a ransomware attack to extort huge sums of money from healthcare organizations. Given the criticality of these devices to patient safety and life, organizations may end up paying the ransom.

Healthcare organizations collect, store, and transmit a large volume of sensitive patient data using these connected devices. So, unprotected Internet of Medical Things pose a threat to data security and attracts huge penalties if a breach occurs.

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https://www.healthleadersmedia.com/telehealth/feds-list-7-characteristics-fraudulent-telehealth-arrangement

Feds List 7 Characteristics of a Fraudulent Telehealth Arrangement

Analysis  |  By Eric Wicklund  |   July 21, 2022

The characteristics are part of a Special Fraud Alert issued by the Health and Human Services Department's Office of the Inspector General, and give healthcare organizations an idea of what to look out for in dealing with telehealth companies.

Federal officials have issued a Special Fraud Alert targeting contracts with telehealth companies and offered seven characteristics of an arrangement that could be illegal.

The notice, issued by the Health and Human Services Department's Office of the Inspector General, follows several recent investigations into companies claiming to offer what they define as telehealth services, but which often constitute illegal marketing schemes.

"While the facts and circumstances of each case differed, often they involved at least one practitioner ordering or prescribing items or services for purported patients they never examined or meaningfully assessed to determine the medical necessity of items or services ordered or prescribed," the OIG notice reads. "In addition, telemedicine companies commonly paid practitioners a fee that correlated with the volume of federally reimbursable items or services ordered or prescribed by the practitioners, which was intended to and did incentivize a practitioner to order medically unnecessary items or services. These types of volume-based fees not only implicate and potentially violate the federal anti-kickback statute, but they also may corrupt medical decision-making, drive inappropriate utilization, and result in patient harm."

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https://ehrintelligence.com/news/the-sequoia-project-releases-tefca-flow-down-resource

The Sequoia Project Releases TEFCA Flow-Down Resource

New resources from The Sequoia Project outline TEFCA flow-down provisions and the kinds of entities that can be participants or subparticipants in TEFCA.

By Hannah Nelson

July 20, 2022 - The Sequoia Project, selected by ONC as the Recognized Coordinating Entity (RCE) for the Trusted Exchange Framework and Common Agreement (TEFCA), has released a new resource to help healthcare organizations comply with the Common Agreement’s flow-down obligations.

The “Informational Resource for Flowing Down Common Agreement Provisions Into Framework Agreements” (TEFCA Flow-Down Resource) aims to help qualified health information networks (QHINs), participants, and subparticipants in compliance with the Common Agreement’s required flow-down obligations.

Required flow-down provisions ensure that QHINs legally bind TEFCA participants to specific terms and conditions of the Common Agreement. Flow-down requirements also ensure that participants and subparticipants, and subparticipants and downstream subparticipants, are legally bound by these same terms and conditions of the Common Agreement.

The resource is divided into two parts. First, it outlines general information regarding each section of the Common Agreement and its impact (or lack thereof) on Participant-QHIN Agreements.

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https://ehrintelligence.com/news/onc-releases-united-states-core-data-for-interoperability-version-3

ONC Releases United States Core Data for Interoperability Version 3

United States Core Data for Interoperability Version 3 (USCDI v3) includes a new data class, Health Insurance Information, to support the interoperability of health insurance data.

By Hannah Nelson

July 20, 2022 - ONC has released the United States Core Data for Interoperability Version 3 (USCDI v3), which expands upon USCDI v2 by adding new data classes and elements.

ONC received more than 800 public comments on data classes and elements after the publication of Draft USCDI v3 in January 2022.

Building on USCDI v2, USCDI v3 added 24 data elements across the following classes: health insurance information, health status/assessments, laboratory, medications, patient demographics/information, and procedures.

Health Insurance Information Data Elements

USCDI v3 includes a new data class, Health Insurance Information, which allows health IT (not just EHR systems) to capture and share healthcare insurance coverage information in a standardized way.

This data class includes seven new elements: Coverage Status, Relationship to Subscriber, Member Identifier, Subscriber Identifier, Payer Identifier, Group Identifier, and Coverage Type.

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https://mhealthintelligence.com/news/klas-broad-remote-patient-monitoring-vendors-most-used-considered

KLAS: Broad Remote Patient Monitoring Vendors Most Used, Considered

Broad vendors — vendors that monitor many conditions using many devices — were the most used and considered in the RPM arena, new data from KLAS shows.

By Mark Melchionna

July 20, 2022 - Broad remote patient monitoring (RPM) vendors, that is, companies that monitor a wide array of clinical conditions, were most commonly used or considered by healthcare organizations, with Health Recovery Solutions (HRS) and Vivify Health being two vendors that stood out, according to a recent KLAS report.

As RPM use continues to grow, KLAS researchers are determining how solutions can be used to produce effective interventions, which can lead to improved outcomes and lower costs. During this process, they sought insight into the workings of the RPM landscape.

The KLAS report examined several vendors, along with the various types of services they offer. It also noted the plans of each organization regarding potential expansion efforts.

The report found that HRS and Vivify Health were the most widely used and considered RPM vendors. HRS achieved an overall performance score of 91.9, while Vivify Health received a score of 86.7.

Regarding types of vendors, researchers found that broad RPM was the most widely used, with 33 organizations currently using it and 35 considering it. A distant second was focused RPM vendors that monitor a single use case or condition. Nine organizations presently use focused RPM vendors, and two are considering it.

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https://www.healthcareitnews.com/news/debunking-some-healthcare-s-biggest-blockchain-myths

Debunking some of healthcare's biggest blockchain myths

An expert in distributed ledger technology dives deep into how blockchain can best be used in healthcare – and dispels some stubborn misconceptions that might be hindering its wider acceptance.

By Bill Siwicki

July 20, 2022 10:41 AM

Although not yet widely implemented in healthcare, blockchain technology has tremendous potential and could be transformational by providing increased security, transparency and integrity.

However, some common myths around blockchain may be slowing its acceptance.

Kali Durgampudi is chief technology officer at Zelis, a healthcare payments company. He is a blockchain expert, which is why Healthcare IT News sat down with him – to discuss how blockchain can be used in healthcare, those stubborn myths and blockchain's transformational potential in the industry.

Q. What are the primary use cases for blockchain in healthcare?

A. Some of the biggest issues we have in healthcare are privacy and data security. Cyber-risk continues to grow exponentially as the industry moves toward digitizing and eliminating archaic paper-based processes.

Blockchain technology has the potential to alleviate many of these concerns. For those who are not familiar with it, blockchain is essentially a system of tracking and recording information. "Blocks" of data, or encrypted information, are widely distributed across a peer-to-peer network.

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https://www.healthleadersmedia.com/technology/acep-launches-digital-data-platform-emergency-care-services

ACEP Launches Digital Data Platform for Emergency Care Services

Analysis  |  By Eric Wicklund  |   July 19, 2022

The American College of Emergency Physicians is partnering with PA Consulting on a new platform aimed at helping emergency care providers access data and resources to improve services and outcomes and reduce administrative burdens.

The American College of Emergency Physicians (ACEP) is launching a digital platform aimed at helping healthcare organizations improve their emergency care services.

ACEP will partner with PA Consulting on the platform, which will form the foundation for ACEP's newly launched Emergency Medicine Data Institute (EMDI).

“The ACEP Emergency Medicine Data Institute will transform information that physicians and others can rely on to support clinical innovation and patient management,” ACEP President Gillian Schmitz, MD, FACEP, said in a press release. “We are very excited to launch a resource with the potential to transform care delivery and empower clinicians at the bedside with analytics from emergency departments around the country.”

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https://www.healthleadersmedia.com/technology/marrying-precision-medicine-ehrs-priority-uh-cleveland

Marrying Precision Medicine to EHRs is a Priority at UH Cleveland

Analysis  |  By Scott Mace  |   July 20, 2022

University Hospitals Cleveland's technology platform is a key part of a long-term strategy to improve clinical outcomes.


KEY TAKEAWAYS

·         The approach helps providers develop therapeutic strategies for patients, including depression treatments.

·         Shortcomings of EHRs and data interoperability remain unsolved challenges.

·         Anticoagulation and genetic counseling initiatives are also benefitting from related technology.

Healthcare organizations can make patient genomic data actionable, incorporating it into the EHR.

So says Maulik Purohit, MD, associate chief medical information officer at University Hospitals Cleveland, a 25-hospital system with 6,000 affiliated providers covering northeastern Ohio.

In this interview with HealthLeaders, Purohit describes ways to evaluate organizational information technology and clinical readiness for strategic precision medicine programs, moving genetic information from tests to the lab to the EHR and then to the patient. This interview has been edited for brevity and clarity.

HealthLeaders: What kind of problem will this solve?

Purohit: Precision medicine is about using large sets of data to understand pathophysiology solutions, diagnoses, and treatments, and how they affect the patient. We have a lot of potential, where nearly everybody is on electronic records of some type, in converting that data to knowledge and using that, with the hope of improving care for patients. How did each individual do? Did the individual have side effects? Did the individual get the same level of improvement as somebody else? Those are questions that research studies couldn't answer because they're done on a population level.

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https://www.cnet.com/health/apple-discusses-the-future-of-health/?ftag=CAD090e536

Apple Discusses the Future of Health

A new report aims to define the company's philosophies. Apple VP Sumbul Desai talks to CNET about where things go from here.

Scott Stein

July 20, 2022 5:00 a.m. PT

Apple's Health app keeps evolving, with the company aspiring to offer a combination personal data archive, medical liaison and insight engine. iOS 16 and WatchOS 9 are adding medication management and multistage sleep tracking to a growing list of features. But what comes next?

Apple just published a multipage Health report, which aims to detail where the company sees its health focus heading on the iPhone and the Apple Watch. The report covers the app, research studies and initiatives with medical organizations.

As Google prepares to release a Pixel Watch that will connect to Fitbit's features and services, Apple looks to be strengthening its position by expanding beyond the watch to a larger spectrum of health services. Already, Apple Health and Fitness Plus are evolving into services you don't need an Apple Watch to use.

But will Health start become an extension of how I connect with my own doctors? Will sleep tracking offer a doorway to other health insights? And why doesn't Apple have its own equivalent of the "readiness score" used by Fitbit and Oura?

Apple's vice president of health, Dr. Sumbul Desai, spoke with CNET about the goals of Apple Health and where goals are being set next. She sees the blend of lifestyle with clinical data, medication data and an increasing number of metrics in one place as helping future insights in other health measurements over time. 

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https://mhealthintelligence.com/news/data-inconsistencies-provide-blurry-picture-of-audio-only-telehealth-use

Data Inconsistencies Provide Blurry Picture of Audio-Only Telehealth Use

According to Harvard and RAND Corp. researchers, challenges in data analysis of audio-only telehealth make it hard to assess the use of the care modality. 

By Mark Melchionna

July 19, 2022 - In a piece published in Health Affairs, researchers from Harvard Medical School and RAND Corporation wrote that predicting the future of audio-only sources is hard, mainly due to the common difficulties in data analysis and the lack of clarity regarding reimbursement.

Throughout the rapid uptake and high use of telehealth during the COVID-19 pandemic, many payers, including Medicare, began reimbursing for audio-only and video-based telehealth services at the same rate as in-person services. Although this and other regulatory flexibilities will remain active throughout the remainder of the pandemic, there are difficulties in predicting the future of virtual care use.

To determine the rate of use and efficacy of telehealth, groups such as government agencies and payers use surveys, claims, and her data.

The authors of the Health Affairs article used this type of information to identify 25 different telehealth visit estimates. Across these, the proportion of audio-only telehealth visits spanned from 9 percent to 98 percent.

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https://patientengagementhit.com/news/telephone-patient-outreach-effective-for-smoking-cessation-quit-rates

Telephone Patient Outreach Effective for Smoking Cessation, Quit Rates

Consistent smoking cessation treatment provided through a telephone patient outreach model improved quit rates two-fold in comparison to patients who received minimal counseling.

By Sarai Rodriguez

July 19, 2022 - Offering smoking cessation treatment through a telephone patient outreach model may be an effective way to engage patients and help them quit smoking, according to a recent study published in the Journal of the National Cancer Institute.

“Quitting smoking is very difficult, and people who seek medication and support are more successful than those who try to quit on their own,” Kathryn L Taylor, PhD, professor in the Department of Oncology at Georgetown University and corresponding author of the study, said in the press release. “Importantly, making a quit attempt while undergoing lung screening may provide a boost to one’s motivation to stop smoking.”

People with a long-term smoking history are at high risk for lung cancer.

According to CDC data, cigarette smoking is linked to about 80 percent to 90 percent of lung cancer deaths. In addition, people who smoke cigarettes are nearly 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke.

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https://patientengagementhit.com/news/waning-public-trust-in-healthcare-poses-medical-misinformation-threat

Waning Public Trust in Healthcare Poses Medical Misinformation Threat

Community health partnerships with entities that have gained public trust could help clinicians combat a medical misinformation threat.

By Sara Heath

July 19, 2022 - The number of patients saying they trust their healthcare providers has decreased since pre-pandemic times, posing a threat of further medical misinformation problems already beleaguering the healthcare industry, according to new data from Harris Poll, a Stagwell company.

The dampening of public trust in the medical establishment, paired with increased trust in non-medical sources to answer healthcare questions, just might open the door for pervasive medical misinformation.

To be clear, patient trust hasn’t gone away entirely. In Harris Poll’s 2022 Health Information Trends Survey, 78 percent of the more than 2,000 adult patient respondents said they trust their primary care providers.

But that trails trust levels of merely three years ago when Harris Poll’s 2019 iteration of the survey revealed 83 percent of adult patients trust their primary care providers.

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https://healthitsecurity.com/news/health-sector-suffered-337-healthcare-data-breaches-in-first-half-of-year

Health Sector Suffered 337 Healthcare Data Breaches in First Half of Year

Providers accounted for the highest number of healthcare data breaches so far this year, followed by business associates and health plans.

By Jill McKeon

July 19, 2022 - Fortified Health Security’s mid-year report on the state of healthcare cybersecurity observed slight shifts in healthcare data breach trends in the first half of 2022. The HHS Office for Civil Rights data breach portal showed that there have been 337 healthcare data breaches impacting more than 500 individuals each in the first half of this year, signifying a slight decrease from 368 at this time last year.

“While the number of healthcare cybersecurity reported breaches has leveled off after meteoric rises over the past several years, hospitals and health systems still cannot breathe a sigh of relief,” the report stated.

“The percentage of healthcare breaches attributed to malicious activity rose more than 5 percentage points in the first six months of 2022 to account for nearly 80 [percent] of all reported incidents.”

Fortified Health Security studied incident response, cyber program effectiveness, the MITRE ATT&CK framework, and the growing prevalence of artificial intelligence (AI) in cybersecurity to inform its mid-year report.

In its analysis of the OCR data breach portal, the organization found that healthcare providers accounted for 72 percent of the healthcare data breaches in the first half of the year, followed by business associates at 16 percent and health plans at 12 percent.

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https://www.medscape.com/viewarticle/977395

Data Exchange Among Doctors Widespread, but Challenges Remain: Report

Ken Terry

July 18, 2022

Nearly two thirds of office-based physicians are engaged in some form of electronic health information exchange (HIE), and three quarters of those who exchange data say they have experienced improvements in quality of care, practice efficiency, and patient safety as a result, according to a new study from the Office of the National Coordinator for Health IT (ONC).

The data analysis from an annual survey by the Centers for Disease Control and Prevention (CDC) also showed that the percentage of physicians electronically finding or querying patient information reached 49% in 2019, a 40% increase from 2015.

But other domains of interoperability did not grow much, if at all.

“The progress of interoperability is still incremental,” commented Julia Adler-Milstein, PhD, professor of medicine at the University of California San Francisco and director of its Center for Clinical Informatics and Improvement Research, in an interview with Medscape Medical News. “Every year, things are getting better on both the ambulatory practice and the hospital side, but it’s not dramatic progress. We have to just keep chipping away at the facets of this problem.”

Overall, 65% of physicians either sent, received, or queried health information with providers outside of their organization in 2019. The other physicians used only mail, fax, or e-fax to exchange patient information with other providers.

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https://www.healthleadersmedia.com/technology/opinion-physicians-need-use-smarter-safer-ehrs

Opinion: Physicians Need to Use Smarter, Safer EHRs

Analysis  |  By Scott Mace  |   July 19, 2022

A JAMA article penned by two doctors builds upon a recent CMS final rule calling on health systems and vendors to work together to improve EHRs.

New guidelines are needed to minimize the cognitive load imposed by electronic health records, according to a physician-written proposal published last week in JAMA Network Open.

Making Electronic Health Records Both SAFER and SMARTER states that a recent final rule issued by the Centers for Medicare & Medicaid Services should stimulate shared responsibility between EHR vendors and health systems to improve EHRs by reducing the cognitive load on clinicians and making EHRs more readable.

"Cognitive attention of the clinical team is a scare resource – one that is essential for quality health care," say Kevin B. Johnson MD, MS, of the department of biostatistics, epidemiology, and informatics at the University of Pennsylvania, and William W. Stead, MD, who served as chief strategy officer for Vanderbilt University Medical Center from 2010 to 2020.

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https://healthitanalytics.com/news/ml-analysis-of-handgun-purchases-can-forecast-suicide-risk

ML Analysis of Handgun Purchases Can Forecast Suicide Risk

New research shows that administrative data on handgun transactions, analyzed using machine-learning techniques, may predict firearm suicide risk and provide insights to inform prevention strategies.

By Shania Kennedy

July 18, 2022 - A new study published in JAMA Network Open indicates that machine-learning (ML) models designed to analyze handgun transaction data can accurately forecast firearm suicide risk, resulting in insights that could inform targeted interventions for suicide prevention.

According to the study, research suggests that limiting access to firearms among individuals at high risk for suicide is an effective method for suicide prevention, but accurately identifying them to initiate an intervention is a challenge. The authors of the study hypothesized that firearm purchasing records might offer a large-scale and objective data source for developing tools to predict firearm suicide risk.

To test their hypothesis, the researchers used California’s Dealer’s Record of Sale (DROS) database, which consisted of 4.9 million handgun transaction records from 1.9 million individuals between Jan. 1, 1996, and Oct. 6, 2015. The DROS records include purchaser identifiers, addresses, dates and times of the transaction, identifiers for the seller, and firearm calibers, types, makes, and models.

They fed this data into an ML-based model designed to predict suicide risk based on 41 factors pulled from the DROS data. The researchers also pulled California death records from 1996 to 2016 to measure rates of firearm suicide within one year of firearm transactions, as defined by the ICD-9 and ICD-10 code sets. They identified firearm suicide deaths by linking purchasers in DROS to the California Department of Public Health’s Death Statistical Master File, using probabilistic matching on name, date of birth, and gender/sex.

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https://healthitsecurity.com/news/ocr-settles-11-hipaa-right-of-access-cases

OCR Settles 11 HIPAA Right of Access Cases

OCR announced the resolution of 11 HIPAA Right of Access cases to reinforce patient health record access under the HIPAA Privacy Rule.

By Jill McKeon

July 18, 2022 - The HHS Office for Civil Rights (OCR) announced 11 HIPAA Right of Access resolutions. OCR created the HIPAA Right of Access Initiative in 2019 to support patients' right to timely and cost-effective access to their health records.

"It should not take a federal investigation before a HIPAA covered entity provides patients, or their personal representatives, with access to their medical records," Lisa J. Pino, OCR's director, said in a press release

"Health care organizations should take note that there are now 38 enforcement actions in our Right of Access Initiative and understand that OCR is serious about upholding the law and peoples' fundamental right to timely access to their medical records."

Each settlement involved a settlement payment to resolve allegations of HIPAA Privacy Rule violations, and most required the covered entities to undertake standard corrective action plans. None of the settlements equate to an admission of guilt by the impacted parties.  

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https://fcw.com/it-modernization/2022/07/unknown-queue-va-health-software-led-patient-harm-watchdog-says/374502/

Routing gap in VA health software led to patient harm, watchdog says

By Adam Mazmanian,
Executive Editor

July 14, 2022

An oversight report claims a confusing routing process in the new electronic health record system being fielded by the Department of Veterans Affairs contributed to nearly 150 adverse patient events.

The Oracle Cerner software being installed by the Department of Veterans Affairs as part of a $21 billion-plus technology refresh has flaws that are directly leading to patient harm, according to a report from the agency's Office of Inspector General.

The OIG report focuses on the "unknown queue," which is used by the Oracle Cerner health record system to capture clinical orders that have incomplete routing information. The report covers events at Mann-Grandstaff VA Medical Center, the initial go-live site for the new software.

According to the report, the health record software did not alert clinicians that orders didn't reach their intended destination. From the time the software went live in October 2020 to June 2021, more than 11,00 clinical orders were routed to the unknown queue. According to the report, 8,500 were radiology orders and 2,500 involved other clinical services.

The OIG report concluded that the unknown queue "ultimately led to thousands of orders for medical care not being delivered to the requested service, placed patients at risk for incomplete care, and caused multiple events of patient harm." The report also noted that, "Oracle Cerner failed to inform VA end-users of the existence of the unknown queue and put the burden on VA to identify and address the problem."

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https://www.healthcareitnews.com/blog/seeing-through-security-illusion

Seeing through the security illusion

As an industry we've bought into the idea for too long that we can simply buy some cybersecurity tools and be safe.

By Christopher Frenz

July 18, 2022 10:49 AM

In recent years, a disturbing trend should have come to light to anyone closely following the security industry. We have seen a large uptick in investment in security tools by organizations, but we have not observed a decrease in breaches and ransomware attacks.

In fact, the number of data breaches and ransomware attacks are still arguably increasing despite this increased level of investment in security tooling. This should be raising a serious question among security leaders as to what we as an industry are strategically doing wrong. Why are we not getting improved outcomes against attackers with all of this increased investment?

In the realm of application security, it has long been known – and is an oft repeated mantra – that you must build security in and not bolt it on later as having an application that is secure by design and that has various security controls like input validation, escaping, etc. built into it will lead to far better security outcomes than just sticking a poorly designed application behind a firewall or CASB.

There is a huge body of evidence to support this mantra on the app sec side of the house and it should be viewed as a mantra that as security professionals we all take to heart, whether we work in app sec or not. If it's well established that we can't bolt security on later, then on the larger healthcare delivery organization network scale why do we as an industry often just invest in tools and then assume we are safe?

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https://www.healthleadersmedia.com/innovation/david-danhauer-looks-back-his-career-cmio

David Danhauer Looks Back on His Career as a CMIO

Analysis  |  By Eric Wicklund  |   July 18, 2022

David Danhauer, MD, is retiring after 37 years in healthcare, the last decade spent as cheif medical information officer at Kentucky-based Owensboro Health. He talks to HealthLeaders about the challenges and successes and his role as an enabler for innovation.

After a 37-year career in healthcare, David E. Danhauer. MD, is retiring.

Danhauer has served as chief medical information officer and senior vice president at Kentucky-based Owensboro Health for more than a decade. While with the health system, he oversaw the implementation of an electronic health record platform, supported the growth of an ambulatory care group that now comprises 180 providers in 30 locations, and helped design a $500 million, 450-bed regional hospital.

Prior to that, he was a pediatrician, first running a solo practice for 11 years, then as part of Owensboro Pediatrics.

Danhauer recently spoke about his experiences in an e-mail Q&A with HealthLeaders.

Q: How has the role of Chief Medical Information Officer changed over the years?

Danhauer: CMIO roles have been evolving from an EHR enabler to a strategic clinical IT leader/expert. This transition has required the development of skill sets in leadership/management, project management, and contracting, as well as the ability to network at regional and national levels. The need to stay current with evolving technologies and trends is critical to the success of any CMIO.

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https://www.independent.ie/irish-news/health/lost-decade-in-digital-health-a-big-part-of-chronic-illness-backlogs-that-mounted-during-covid-41845503.html

‘Lost decade in digital health’ a big part of chronic illness backlogs that mounted during Covid

Ireland has experienced “a lost decade in digital health” that is partly to blame for the rising backlog in the treatment and diagnosis of cancer and other serious and chronic conditions that mounted up during the pandemic, according to the HSE’s director of digital transformation.

Speaking to the Sunday Independent, Professor Martin Curley said the HSE “needs to start from scratch” where digital healthcare is concerned, and “create a national digital health agency which can transform care, keep more people cared for in their homes using digital monitoring, dramatically improving healthcare outcomes”.

If such an agency had existed before the pandemic, patient monitoring could have allowed earlier intervention, resulting in fewer people requiring more complex care being on waiting lists, he said.

Prof Curley also blamed a “tendency to do nothing instead of doing no harm”, of some in senior HSE roles, as well as the prolific use of management consulting firms, for the lost decade.

Figures provided last month by the HSE to Sinn Féin health spokesman David Cullinane showed 1.3 million people — almost a quarter of the population — are on some form of waiting list, for hospital, therapy or diagnostics.

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Enjoy!

David.