Quote Of The Year

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

or

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

Saturday, January 28, 2023

Weekly Overseas Health IT Links – 28th January, 2023.

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://www.digitalhealth.net/2023/01/how-trust-leaders-can-leverage-their-electronic-patient-record-systems/

How trust leaders can leverage their electronic patient record systems

Dr Victoria Betton, associate at Public Digital and director of PeopleDotCom, looks at how leaders of NHS trusts can leverage their electronic patient record systems.

It started with unintended consequences

DHI News Team – 19 Jan, 2023

When I worked in an NHS trust, my colleagues and I had to make a 5% cut to our annual departmental budgets each year.

There was little discussion about the implications for patients, intended or unintended consequences for clinical services, nor modelling of the impacts. All that mattered was that I had to find a way to cut my budget and hit the cost improvement target.

I wish I had fully appreciated then, what I know now about complex systems – that each division and function is a subset of a wider whole and that a change in one has an impact on the other.

A complex adaptive system

Too often digital teams are dealing with their own resource challenges in a departmental silo. As I interviewed CIOs, CCIOs and other digital health practitioners for the new NHS Providers’ guide, Making the most of your electronic patient record system, many told me how they are grappling with the challenge of continually improving and adapting their EPR so that it creates genuine value. They are doing this within the context of NHS trusts fighting for their lives amid a workforce crisis and unprecedented demand. The context could hardly be more challenging.

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https://www.digitalhealth.net/2023/01/2023-predictions-digital-health-leaders-on-what-lies-ahead/

2023 predictions: Digital health leaders on what lies ahead

After another significant year in the digital health space, we asked some digital health leaders what they think is in store for 2023. Here is what they predict:

Jordan Sollof – 18 January, 2023

Saffron Cordery, interim chief executive of NHS Providers

“Next year will continue to be challenging for the NHS, and in the digital space funding will remain constrained. Despite this, NHS board leaders will continue to look to digital ways of working to address some of the big strategic challenges the sector faces.

“Through our existing Digital Boards programme, delivered in partnership with Public Digital, and supported by HEE and NHS England, we know that trust leaders endeavour to expand and evolve their digital capabilities to meet current and future operational demands and rise to heightened expectations of patients and staff. Where possible, this will mean investing in digital teams, but will also include upskilling existing staff.

“For those with electronic patient care records (EPRs) already in place, ‘optimisation’ will be at the forefront of their strategic thinking, while consideration will be needed on alignment or even convergence with system partners. And for those who have secured funding for their EPR programmes, procurement and implementation will dominate the board’s agenda.

“Our new Digital ICS programme, delivered in partnership with the NHS Confederation and Public Digital, and supported by HEE and NHS England, will help the new ICS leadership use digital to drive their system ambitions, including digital’s role in reducing health inequalities. We look forward to working alongside integrated care boards over the course of 2023 to further realise these digital opportunities.”

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https://www.digitalhealth.net/2023/01/google-research-and-deepmind-develop-ai-medical-chatbot/

Google Research and DeepMind develop AI medical chatbot

Google Research and DeepMind have developed a large language model for the medical community, which could generate safe and helpful answers using datasets covering professional medical exams, research and consumer queries.

Cora Lydon – 18 Jan 202

The AI-powered chatbot, MedPaLM, combines HealthSearchQA, a free-response dataset of medical questions found online developed by Google and DeepMind, with six existing open-question answering datasets.

The six other datasets come from MedQA, MedMCQA, PubMedQA, LiveQA, MedicationQA and MMLU.

MedPaLM addresses multiple-choice questions and answers posed by both medical professionals and non-professionals.

Large language models (LLMs), such as MedPaLM, are designed to understand queries and generate appropriate responses in plain language. To do this they draw information from large datasets.

The technology is benchmarked with MultiMedQA, an open-source medical question-answering benchmark. Testing into the new open-source Google LLM involved evaluating its performance by studying its responses for factuality, precision, conceivable harm and bias.

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https://mhealthintelligence.com/news/telehealth-gave-orgs-economic-boost-cut-carbon-footprint

Telehealth Gave Orgs Economic Boost, Cut Carbon Footprint

Recent research found that telehealth led to the saving of over 53 million miles in travel distance and over $22 million in travel costs.

By Mark Melchionna

January 18, 2023 - A recent study from UC Davis Health found that the uptake of telehealth during the first two years of the COVID-19 pandemic improved patient outcomes and led to noticeable financial and environmental benefits , largely due to the cut in carbon footprint associated with virtual visits.

As telehealth became more widely used throughout the COVID-19 pandemic, researchers focused on its effect on various aspects of healthcare.

The study from UC Davis Health aimed to gather further information regarding the carbon footprint occupied by telehealth. Researchers gathered data from five University of California healthcare systems from during the initial two years of the pandemic. They then analyzed various components related to travel distance, time, and costs.

“Our study documented the many benefits of utilizing telehealth for ambulatory visits,” said Sristi Sharma, a UC Davis preventive medicine physician and lead author of the study, in a press release. “It is the first, large-scale study to evaluate the round-trip distance, time, and cost-saving, and greenhouse gas emissions prevented from telehealth use during the pandemic.”

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https://www.csoonline.com/article/3685488/how-ai-chatbot-chatgpt-changes-the-phishing-game.html#tk.rss_all

How AI chatbot ChatGPT changes the phishing game

The Microsoft-backed free chatbot is improving fast and can not only write emails, essays but can also code. ChatGPT is also polyglot and that could facilitate and increase exponentially phishing attacks.

Contributing writer, CSO | 16 January 2023 21:00 AEDT

ChatGPT, OpenAI’s free chatbot based on GPT-3.5, was released on 30 November 2022 and racked up a million users in five days. It is capable of writing emails, essays, code and phishing emails, if the user knows how to ask.

By comparison, it took Twitter two years to reach a million users. Facebook took ten months, Dropbox seven months, Spotify five months, Instagram six weeks. Pokemon Go took ten hours, so don't break out the champagne bottles, but still, five days is pretty impressive for a web-based tool that didn't have any built-in name recognition.

There are so many good reasons to be panicking about OpenAI's ChatGPT right now. It writes better essays than the average high school or college student. It can write and debug code.

"It allows people with zero coding and development knowledge to be a developer," says Sergey Shykevich, threat intelligence group manager at Check Point Software Technologies. Shykevich, who is based in Israel, has been monitoring the chatter on the dark web.

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https://fedtechmagazine.com/article/2023/01/federal-officials-urge-healthcare-industrys-adoption-fhir-interoperability

Jan 19 2023

Federal Officials Urge Healthcare Industry’s Adoption of FHIR for Interoperability

The Department of Defense, among others, is already using the data standard to streamline health information exchange, expedite scientific discoveries and ensure health equity.

Dave Nyczepir is a Senior Editor for Manifest.

The best way to ensure electronic health record systems can share data interoperably is for industry to adopt the Fast Healthcare Interoperability Resources standard, or FHIR, say federal officials.

While the deployment of a single, consolidated electronic health record, called the Military Health System GENESIS, has the Department of Defense on a path to interoperability, the FHIR data standard that serves as its backbone isn’t congressionally mandated.

FHIR application programming interfaces streamline health information exchange by standardizing data and eliminating the need for sharing agreements, which is why the government required certified EHR vendors to make the APIs available to customers by the end of 2022. Still, unlike credit card companies, which have accepted data standards industrywide, the healthcare industry hasn’t fully rallied behind FHIR.

“We probably need to get the Chief Data Officers Council to make sure that it covers all the agencies. Congressional mandate, law is another tool,” said Ken Johns, CTO for the Defense Healthcare Management Systems Program Executive Office, at the AFCEA Bethesda Health IT Summit 2023 on Tuesday. “Probably what will be most successful is for industry to agree to standardize.”

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https://www.healthcareitnews.com/blog/perspective-physicians-should-be-sole-decision-makers

Perspective: Physicians should be sole decision-makers

Predictive analytics in EHRs aren't yet effective enough for clinical decision support at the point of care.

By Joyoti Goswami

January 20, 2023 10:19 AM

We often hear about various reports on the inefficacy of machine learning algorithms in healthcare – especially in the clinical arena. For instance, Epic's sepsis model was in the news for high rates of false alarms at some hospitals and failures to flag sepsis reliably at others. 

Physicians intuitively and by experience are trained to make these decisions daily. Just like there are failures in reporting any predictive analytics algorithms, human failure is not uncommon. 

As quoted by Atul Gawande in his book Complications, “No matter what measures are taken, doctors will sometimes falter, and it isn’t reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.” 

Predictive analytics algorithms in the electronic health record vary extensively in what they can offer, and a good percentage of them are not useful in clinical decision-making at the point of care.

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https://venturebeat.com/ai/federated-learning-ai-model-could-lead-to-healthcare-breakthrough/

Federated learning AI model could lead to healthcare breakthrough

The potential for artificial intelligence (AI) and machine learning (ML) to improve human health cannot be understated, but it does face challenges. 

Among the big challenges is dealing with siloed data sources, so researchers are not able to easily analyze data from multiple locations and initiatives, while still preserving privacy. It’s a challenge that can potentially be solved with an approach known as federated learning.

Today in a research report first published in Nature Medicine,  AI biotech vendor Owkin has revealed just how powerful the federated model can be for healthcare. Owkin working alongside researchers at four hospitals in France was able to build a model with its open source technology that it claims will have a significant impact on the ability to help effectively treat breast cancer. The Owkin AI models were able to identify accurately novel biomarkers that could lead to improved personalized medical care.

“Owkin is an AI biotech company and we really have this ambitious goal, which is to cure cancer,” Jean du Terrail, senior machine learning scientist at Owkin, told VentureBeat. “We are trying to leverage the power of AI and machine learning, in addition to our network of partners, to move towards this goal.”

Owkin is one of the hottest biotech startups in the market today. The company raised $80 million in funding back in June 2022, from pharmaceutical giant Bristol Myers Squibb, bringing total funding to the unicorn startup, over $300 million since the company was founded in 2016.

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https://ehrintelligence.com/news/interoperability-data-quality-leads-the-way-as-top-exec-priorities

Interoperability, Data Quality Leads the Way as Top Exec Priorities

Healthcare systems and hospital executives are focusing on interoperability initiatives as they seek to improve data quality and information sharing challenges in 2023.

By Sarai Rodriguez

January 19, 2023 - While the healthcare industry is turning its attention to interoperability, a new survey found that barriers such as poor data quality and information sharing remain challenging to over 60 percent of healthcare executives.

In Health Gorilla’s 2023 State of Interoperability report, responses from nearly 130 executive healthcare decision-makers were collected to evaluate new opportunities and challenges for healthcare interoperability as the new year continues.

The survey, conducted in collaboration with Flexpa and the Health Management Academy, found that health systems will be ramping up their interoperability investments by 5 to 20 percent in 2023.

Additionally, the survey discovered that health system executives had mixed reviews about the quality of the data received through health information exchanges.

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https://patientengagementhit.com/news/patient-data-access-is-insufficient-for-60-of-healthcare-consumers

Patient Data Access is Insufficient for 60% of Healthcare Consumers

A new survey shows that most consumers want health systems to provide them with timely access to their medical records, but nearly three-fifths lack immediate patient data access.

By Sarai Rodriguez

January 19, 2023 - Providing patients with easy access to their health information can improve patient engagement. Yet, recent findings revealed that 60 percent of consumers don’t have adequate patient data access, according to a survey conducted by Propeller Insights on behalf of Carta Healthcare, which was obtained via email.

The survey of a little more than 1,000 United States patients showed that patients have a strong interest in their own medical records and prioritize providers that offer greater patient data access.

Under HIPAA, patients have an inherent right to access their own health information. Accessing records can enable active participation in patient care, helping patients ensure that their provider has complete information.

Healthcare providers who have offered patient portals and clinical note access have seen a difference in their behaviors. Past studies have highlighted that patients with access to health information will later mention the notes during clinical encounters, highlighting gains in patient engagement and activation.

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https://healthitsecurity.com/news/hc3-warns-healthcare-of-ais-use-in-malware-development

HC3 Warns Healthcare of AI’s Use in Malware Development

In its latest brief, HC3 details how artificial intelligence (AI) can be used by threat actors to aid in malware development, forming a serious threat to healthcare cybersecurity.

By Sarai Rodriguez

January 19, 2023 - Artificial intelligence (AI) tools play an increasingly important role in cybersecurity. AI models can be leveraged to defend the healthcare sector against cyber threats. On the other hand, AI’s capabilities could also be used for malware development to harm the healthcare sector, a Health Sector Cybersecurity Coordination Center’s (HC3) analyst note suggested.

“Artificial Intelligence (AI) has most notably been applied to the defensive side of cybersecurity. It has been used to detect threats, vulnerabilities, and active attacks and to automate security tasks,” the analyst note stated.

“However, because of its known defensive use and because threat actors in cyberspace are known to be highly creative and well-resourced, concerns have been raised in the cybersecurity community about the potential for artificial intelligence to be used for the development of malware.

AI works 24 hours per day, seven days per week. The constant monitoring means that the tools can quickly process large quantities of data and detect threats, making it an ideal cybersecurity measure for healthcare facilities.

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https://www.healthcareitnews.com/news/regenstrief-develops-framework-assess-patient-matching-accuracy

Regenstrief develops framework to assess patient matching accuracy

Patient identity is a great weakness in healthcare infrastructure, according the physician informaticist who led the algorithm research, which is aimed at boosting interoperability and patient safety.

By Mike Miliard

January 18, 2023 10:02 AM

Regenstrief Institute announced this week that some of its researchers have developed an eight-point framework designed to assess the validity and accuracy of algorithms to match patient medical records.

WHY IT MATTERS
Accurate patient matching across the care continuum is essential for quality and safety. It's also key to driving down healthcare costs by reducing the ordering of duplicative medical tests. But without a national patient identifier – the United States, Regenstrief points out, is the only developed nation not to use one – that goal has been elusive for years.

Given the lack of a national patient ID, in the U.S., linking patient records is often dependent on algorithms designed by technology vendors or healthcare researchers.

Regenstrief vice president for data and analytics Dr. Shaun Grannis led a team of research scientists to create an eight-point framework for evaluating the performance of those patient-matching algorithms.

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https://healthtechmagazine.net/article/2023/01/4-tips-improve-data-loss-prevention-healthcare

Jan 17 2023

4 Tips to Improve Data Loss Prevention in Healthcare

Here’s how healthcare organizations can improve their approach to managing critical data.

Mike Chapple is associate teaching professor of IT, analytics and operations at the University of Notre Dame. 

Healthcare providers store, handle and transmit some of the most sensitive information a person can possess, from personal health data to Social Security and credit card numbers.

Meanwhile, data loss incidents are on the rise, and they happen 38 times more frequently than leaders estimate, according to a 2021 Tessian report. Remote work is also affecting data security, according to that report: Half of all employees reported that they feel “less secure” when working outside of the office, and 42 percent said that they are “less likely to follow safe data practices when working remotely.”

Data loss prevention (DLP) solutions help IT leaders get better control over their data by identifying and stopping potential data leaks before they occur.

1. Strengthen DLP System Visibility

DLP technology only works when it can see the data it needs to protect. In an ideal environment, this means combining endpoint DLP agents with network-based DLP sensors and cloud-focused DLP enforcement points. The greater visibility that DLP has into your enterprise IT environment, the more likely it will be to spot and stop a potential leak.

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https://www.propublica.org/article/websites-selling-abortion-pills-share-sensitive-data-with-google

Websites Selling Abortion Pills Are Sharing Sensitive Data With Google

Some sites selling abortion pills use technology that shares information with third parties like Google. Law enforcement can potentially use this data to prosecute people who end their pregnancies with medication.

Jennifer GollanJan. 18, 5 a.m. EST

Online pharmacies that sell abortion pills are sharing sensitive data with Google and other third parties, which may allow law enforcement to prosecute those who use the medications to end their pregnancies, a ProPublica analysis has found.

Using a tool created by the Markup, a nonprofit tech-journalism newsroom, ProPublica ran checks on 11 online pharmacies that sell abortion medication to reveal the web tracking technology they use. Late last year and in early January, ProPublica found web trackers on the sites of at least nine online pharmacies that provide pills by mail: Abortion Ease, BestAbortionPill.com, PrivacyPillRX, PillsOnlineRX, Secure Abortion Pills, AbortionRx, Generic Abortion Pills, Abortion Privacy and Online Abortion Pill Rx.

These third-party trackers, including a Google Analytics tool and advertising technologies, collect a host of details about users and feed them to tech behemoth Google, its parent company, Alphabet, and other third parties, such as the online chat provider LiveChat. Those details include the web addresses the users visited, what they clicked on, the search terms they used to find a website, the previous site they visited, their general location and information about the devices they used, such as whether they were on a computer or phone. This information helps websites function and helps tech companies personalize ads.

But the nine sites are also sending data to Google that can potentially identify users, ProPublica’s analysis found, including a random number that is unique to a user’s browser, which can then be linked to other collected data.

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https://www.marketwatch.com/amp/story/teladoc-to-cut-300-jobs-or-about-6-of-its-workforce-in-restructuring-01674044659

Teladoc to cut 300 jobs or about 6% of its workforce in restructuring

Published: Jan. 18, 2023 at 7:24 a.m. ET

By   Ciara Linnane

Teladoc Health Inc. TDOC said Wednesday it is planning a restructuring that will eliminate about 300 jobs, or about 6% of the telehealth company’s overall workforce. In a regulatory filing, the company said it expects to book pretax charge of about $4.4 million in the fourth quarter of 2022 and pretax charges of about $17 million in 2023. Those are split between about $9 million related to employee transition, severance payments and other benefits, and about 8 million of exit costs related to office space reductions that are expected to occur by the second quarter. Chief Executive Jason Gorevic said the move was necessary to allow the merged organization to operate as one Teladoc Health. “Second, as we’ve discussed over the past several months and seen across our industry, businesses like ours must transition to more balanced growth of revenue and profitability. At this stage in both our evolution as an enterprise and given the challenged economic environment, we believe that balanced growth is the right step for us as a well-run company,” he said in a letter to employees released with the filing. The stock was up 1% premarket but has fallen 63% in the last 12 months, while the S&P 500 SPX has fallen 13%.

See original version of this story

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https://www.healthcareitnews.com/news/ransomware-stakes-are-life-or-death-says-ponemon-report

Ransomware stakes are life-or-death, says Ponemon report

The institute examined the continued impact of ransomware attacks on patient care and asked healthcare IT professionals to evaluate their use of benchmarking in making their cybersecurity program decisions.

By Andrea Fox

January 19, 2023 08:44 AM

Nearly half of healthcare provider respondents (45%) said ransomware attacks increased complications from medical procedures, according to a new study from the Ponemon Institute. That's up from 36% in 2021.

WHY IT MATTERS

For the report, "The impact of ransomware on patient safety and the value of cybersecurity benchmarking," which was sponsored by Censinet, Ponemon researchers surveyed 579 healthcare IT professionals at healthcare-delivery organizations in the fourth quarter of 2022 in order to understand how ransomware continues to impact patient care, and to determine the value of cybersecurity benchmarking in reducing impacts.

Like the first study, "The impact of ransomware on healthcare during COVID-19 and beyond," Ponemon found that more than one in five respondents indicated that ransomware attacks had an adverse impact on patient mortality rates.

The most prevalent impact identified was an increase in patients transferred or diverted to other facilities, reported by 70% of those surveyed, up from 65% in the previous study. 

More organizations experienced ransomware attacks, with an increasing number caused by poor cybersecurity controls and third-party technology vulnerabilities – and more of these organizations are paying the ransom.

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https://www.healthcareitnews.com/news/deep-dive-endpoint-security-healthcare

Deep dive: Endpoint security in healthcare

A healthcare infosec expert talks why CISOs and CIOs should prioritize unified endpoint management, what a UEM strategy looks like and much more.

By Bill Siwicki

January 19, 2023 11:20 AM

Remote healthcare certainly has gained traction via the pandemic. As a result, some healthcare information security experts contend a unified endpoint management system has become a top priority for provider organizations conducting telehealth.

Remote healthcare facilities can be a breeding ground for security breaches, which can pose a tremendous threat – especially if sensitive patient information is exposed. Additionally, with healthcare taking a digital shift, tablets and smartphones have become accessories to enable better and faster patient care.

This means an increased dependence on technology and a resulting IT overload, said Apu Pavithran, CEO and founder of Hexnode, vendor of a unified endpoint management (UEM) platform housed by Mitsogo.

Healthcare IT News sat down with Pavithran to discuss the digital shift in healthcare and what that means for security, why CISOs and CIOs should prioritize endpoint management, what a UEM strategy looks like and why CISOs and CIOs should consider one, and more.

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https://www.healthcareittoday.com/2023/01/19/a-look-at-the-21st-century-cures-act-with-micky-tripathi/

A Look at the 21st Century Cures Act with Micky Tripathi

January 19, 2023

John Lynn

One of the biggest pieces of legislation to hit healthcare IT since the HITECH Act is the 21st Century Cures Act.  While it doesn’t have the same stimulus money as the HITECH Act, it’s possible that it will have even more impact on healthcare organizations and patients.  This is particularly true when it comes to sharing health information between healthcare organizations and with patients.

To better understand everything that’s happening with the 21st Century Cures Act and how it will impact healthcare organizations, I sat down with Micky Tripathi, National Coordinator for Health IT at HHS.  I start off by asking Tripathi to share how he sees the state of electronic health information sharing and interoperability today.  Then, I ask him where he sees the 21st Century Cures Act making an impact for good on patients and clinicians and what other things they can expect to impact them as the regulation takes effect.

I also ask Tripathi what he thinks is the most misunderstood part of the 21st Century Cures Act.  Plus, he highlights what areas of the Cures Act are going to be the hardest for healthcare organizations to implement.

I couldn’t resist asking him about TEFCA and QHINs as well which seem to be the hottest healthcare interoperability topic right now.  Needless to say, he sees a lot of promise and potential with what’s happening with these two important efforts.  Finally, I ask him to share his overarching vision for ONC.

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https://www.healthleadersmedia.com/technology/home-medical-device-safety-tops-ecris-list-healthcare-technology-hazards

Home Medical Device Safety Tops ECRI's List of Healthcare Technology Hazards

Analysis  |  By Eric Wicklund  |   January 19, 2023

Recalls of home-based medical devices and defective single-use devices are the top two concerns on the Pennsylvania-based non-profit's top 10 technology hazards for 2023.


KEY TAKEAWAYS

·         For 16 years, ECRI has listed the top 10 technology hazards in the healthcare space, highlighting issues that can affect care delivery and even harm patients.

·         This year's list highlights the growth of home-based and patient-centered healthcare, with recalls of home-based devices and a large number of defective single-use products coming in first and second.

·         The organization is urging healthcare organizations to be diligent in emphasizing safety protocols and asking the medical device to do a better job with device manufacture and safety requirements.

The growing popularity of smart home technology and home-based healthcare, including remote patient monitoring programs, means there are more medical devices in the home to oversee, either by the care team or the patent. That could lead to problems if the devices aren't working.

The challenge of identifying recalls for at-home medical devices tops the Top 10 Technology Hazards for 2023, an annual report issued by ECRI, a Pennsylvania-based non-profit focused on safety, quality, and cost-effectiveness in healthcare. Now in its 16th year, the report highlights the problems associated with healthcare technology, and spots trends in care delivery that might be catching both providers and patients by surprise.

With at-home medical devices, ECRI notes that patients using those devices at home might be the last to hear of a recall, and they might not understand what the recall means or how the address one.

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https://ehrintelligence.com/news/directtrust-releases-tnap-version-2.0-criteria-for-tefca-participants

DirectTrust Releases TNAP Version 2.0 Criteria for TEFCA Participants

The DirectTrust TNAP-Participant accreditation program demonstrates stakeholder compliance with TEFCA Participant requirements.

By Hannah Nelson

January 18, 2023 - DirectTrust, a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information, has released the TNAP version 2.0 criteria for TEFCA participants.

The TNAP-Participant program version 2.0 criteria is available for public comment through March 20, 2023. The Trusted Network Accreditation Program (TNAP) provides third-party accreditation for healthcare exchange entities such as qualified health information networks (QHINs), participants, health information exchanges (HIEs), accountable care organizations, and data registries.

The Electronic Healthcare Network Accreditation Commission (EHNAC) governs DirectTrust's accreditation and certification programs.

Stakeholders revised the TNAP-Participant accreditation program to address the Trusted Exchange Framework and Common Agreement (TEFCA) Recognized Coordinating Entity (RCE) requirements that Participants and Subparticipants must meet to participate with a QHIN. TEFCA aims to establish a floor of universal interoperability across the country through a network of QHINs.

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https://healthitanalytics.com/news/ai-education-needed-to-prepare-medical-students-for-clinical-practice

AI Education Needed to Prepare Medical Students for Clinical Practice

Researchers argue that artificial intelligence must be taught “as a fundamental toolset of medicine” for medical students to be successful when they begin to practice.

By Shania Kennedy

January 18, 2023 - In a recent commentary published in Cell Reports Medicine, University of Michigan researchers argued that the lack of education on healthcare artificial intelligence (AI) in medical school leaves students underprepared for future clinical practice.

The researchers stated that AI is transforming the practice of medicine and becoming ubiquitous in clinical care with the advent of AI-based systems assessing chest radiographs, pathology slides, and early warning systems embedded in EHRs. However, they noted that medical students have minimal exposure to these technologies and the concepts needed to effectively evaluate them.

This leaves students underprepared for future clinical practice in a world where healthcare AI is becoming increasingly common. The authors argued that remedying this requires educators to bolster undergraduate medical education (UME) on the topic of AI.

Specifically, the authors proposed that medical educators should treat AI as a critical component of medical practice to be introduced early and integrated with the other core components of medical school curricula. By equipping graduating medical students with this knowledge, educators will help ensure that students possess the skills to solve challenges at the intersection of AI and medicine, they stated.

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https://healthitsecurity.com/news/how-healthcare-cybersecurity-benchmarking-can-help-sector-enhance-security-efforts

How Healthcare Cybersecurity Benchmarking Can Help Sector Enhance Security Efforts

Healthcare cybersecurity benchmarking can help health IT experts establish cybersecurity program goals and improve decision-making, a new survey from Censinet and Ponemon Institute suggests.

By Jill McKeon

January 18, 2023 - Healthcare cybersecurity benchmarking data can help health IT experts make data-driven decisions, evaluate program effectiveness, and improve their organization’s overall security posture, a new report commissioned by Censinet and conducted by Ponemon Institute suggested.

Ponemon Institute surveyed 579 IT and IT security professionals at healthcare organizations, asking them a series of questions about the value of cybersecurity benchmarking and their experiences with ransomware attacks.

As ransomware increasingly becomes recognized as a patient safety issue, healthcare organizations need to make informed, risk-based security decisions more than ever. The report suggests that peer benchmarking is a key step toward helping the sector mitigate risk effectively.

Ransomware is a Patient Safety Issue

Nearly half of respondents reported experiencing a ransomware attack in the past two years. The survey results supported existing data that show an increase in third-party data breaches and ransomware attacks, as well as a hike in ransomware payment demands.

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https://www.healthdatamanagement.com/articles/january-2023-coverstory

January 2023 COVERstory

January 2023 takes a deep dive into federal health and IT policy and features insights from National Coordinator Micky Tripathi, a recap on the evolution of the ONC, and a look into the future of interoperability.

Jan 17 2023


From the Editor:

For nearly two decades, the Office of the National Coordinator for Health Information Technology has been moving the health industry to digitize health records and demonstrate a baseline of capabilities with information systems. 

Now, the federal agency is embarking on new initiatives that seek to help the industry achieve benefits from information technology, facilitate the exchange of health information to improve patient care, and support health-related initiatives of other federal agencies. 

This series of articles, based in part on an in-depth interview with Micky Tripathi and Steve Posnack of ONC, aims to give the industry insight into ONC’s current and future role, and can help organizations better understand the arc of emerging federal policy. 


Key Takeaways

As you dive into this COVERstory, we hope you find it becomes a reference helping you: 

  • 1. Gain a historical perspective of how the ONC is responding to the current state of federal regulations and its growing authority.
  • 2. Understand the coming attractions driving the ONC to become more proactive and aligned with the industry and other federal agencies.
  • 3. Place within historical context the reasoning behind federal incentives and how this ties into the current state of interoperability and the new TEFCA initiative.
  • 4. Connect the dots between the many acronyms and acts that have been created over the last decade. 21st Century Cures, TEFCA, MU/Promoting Interoperability, FHIR, USCDI, and many more.
  • 5. Understand how key leaders perceive the current alignment between the ONC and the industry.
  • 6. Learn some approaches that will help your organization better anticipate and respond to the ever-evolving landscape of federal regulations.

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https://www.fiercehealthcare.com/health-tech/jpm23s-health-tech-tidbits-talkspace-plots-path-profitability-babylon-ceo

JPM23's Health Tech Tidbits: Talkspace plots path to profitability, Veradigm invests in analytics company and Babylon CEO pushes back

By Heather Landi

Jan 16, 2023 07:45pm

The 41st annual J. P. Morgan Healthcare Conference came to a close Thursday in San Francisco, the first in-person event after three years.

It was a week packed with rainstorms, meetings, presentations and long lines for elevators and coffee.

On the healthcare side, the biggest news might have been the weather, with intense downpours, hail and lightning.

Many executives attending JPM last week noted it was relatively quiet, from a news perspective, with the exception of CVS Health. The retail drugstore giant backed three funding rounds: Carbon Health's $100 million series D, $25 million for Array Behavioral Care and Monogram Health's hefty $375 million round. And there were rumors about a potential $10 billion deal to buy Medicare-focused primary care player Oak Street Health.

What you didn't hear at JPM was the typical buzz around new fundraising (except Carbon Health) and big M&A deals. The relative quiet reflects the current down market, many JPM attendees told Fierce Healthcare, as venture capital dollars are harder to come by and many startups are taking a back-to-basics approach.

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https://www.healthcareittoday.com/2023/01/18/shortening-hospital-discharges-technical-and-workflow-solutions/

Shortening Hospital Discharges: Technical and Workflow Solutions

January 18, 2023

Andy Oram

An earlier article, “Why Hospital Discharges Take So Long—And What We Can Do To Shorten Them,” explored the complexities of discharging and how hospitals are re-evaluating their workflows to get patients out faster. This article looks at some technical solutions.

Ali Parsa, CEO and founder of Babylon, an AI and digital health platform, says discharge planning doesn’t require “massive amounts of technology” or “rocket science”; just good planning from the beginning of the stay. Indeed, one research study (suggested to me by Dr. Geoffrey Rutledge, Chief Medical Officer and co-founder of HealthTap) achieved a significant time saving through low-tech measures such as checklists.

Other respondents, however, reported that their solutions were making a difference in discharges.

Weaknesses of Current Technology

With modern databases, it’s ridiculous for many care managers to be checking the availability and services of nursing facilities manually. They should be able to draw up a list of suitable facilities quickly and transfer data from the patient’s electronic record to a corresponding record at the chosen facility. And why can’t patients and caregivers have instant access to pictures, CMS ratings, and other information about the facility they’re considering?

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https://www.healthleadersmedia.com/telehealth/will-your-smartphone-be-next-doctors-office

Will Your Smartphone Be the Next Doctor's Office?

Analysis  |  By Kaiser Health News  |   January 17, 2023

Using smartphones as diagnostic tools is a work in progress.


KEY TAKEAWAYS

·         Although doctors and their patients have found some real-world success in deploying the phone as a medical device, the overall potential remains unfulfilled and uncertain.

·         Smartphones can help assess people for concussions, watch for afib, and conduct mental health wellness checks, to name the uses of a few nascent applications.

·         Companies are tapping into modern phones' built-in cameras and light sensors; microphones; accelerometers, which detect body movements; gyroscopes; and even speakers.

·         The apps use AI software to analyze the collected sights and sounds to create an easy connection between patients and physicians.

·         Earning potential and marketability are evidenced by the more than 350,000 digital health products available in app stores.

By Hannah Norman

The same devices used to take selfies and type out tweets are being repurposed and commercialized for quick access to information needed for monitoring a patient's health. A fingertip pressed against a phone's camera lens can measure a heart rate. The microphone, kept by the bedside, can screen for sleep apnea. Even the speaker is being tapped, to monitor breathing using sonar technology.

In the best of this new world, the data is conveyed remotely to a medical professional for the convenience and comfort of the patient or, in some cases, to support a clinician without the need for costly hardware.

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https://ehrintelligence.com/news/covid-19-sparks-health-it-market-growth-in-telehealth-ehr-integrations

COVID-19 Sparks Health IT Market Growth in Telehealth EHR Integrations

Telehealth EHR integrations were twice as likely to contain specialized capabilities for COVID-19 response compared to all apps listed in EHR app galleries.

By Hannah Nelson

January 17, 2023 - The health IT market experienced a rapid increase in telehealth EHR integrations following the onset of the COVID-19 pandemic in March 2020, according to a study published in AJMC.

Researchers collected data from Boston Children’s Hospital’s SMART (or Substitutable Medical Apps and Reusable Technologies) and four EHR vendors’ public app galleries: Allscripts, Athenahealth, Cerner Corporation, and Epic Systems Corporation.  

The number of telehealth-related apps doubled from pre-pandemic levels to 87 apps by June 2021. Compared with all apps listed in the EHR app galleries, these apps were two times more likely to contain specialized capabilities for COVID-19 response, such as secure messaging, vaccine administration, and laboratory testing.

HHS temporarily issued several measures to make it easier for patients to receive care through telehealth during the COVID-19 public health emergency. For instance, HHS gave healthcare providers and patients the flexibility to use video communication apps that did not comply with Health Insurance Portability and Accountability Act (HIPAA) regulations for telehealth purposes.

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https://ehrintelligence.com/news/onc-releases-draft-us-core-data-for-interoperability-version-4

ONC Releases Draft US Core Data for Interoperability Version 4

ONC encourages the public to submit comments on the Draft United States Core Data for Interoperability (USCDI) v4 until April 17.

By Hannah Nelson

January 17, 2023 - ONC has released the Draft United States Core Data for Interoperability (USCDI) Version 4, which proposes to add 20 data elements across a new data class and eight existing data classes.

The new data class is “Facility Information,” which includes the data elements facility identifier, facility type, and facility name.

If finalized, USCDI v4 would have 112 data elements organized in 19 data classes.

The v4 submission cycle ended on September 30, 2022. ONC received approximately 150 submissions for new data elements and almost 350 comments on previously submitted data elements. ONC applied prioritization criteria discussed in Standards Bulletin 2022-2 to develop the final list of proposed new data elements for Draft USCDI v4.

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https://healthitsecurity.com/news/cisa-reflects-on-past-year-upcoming-critical-infrastructure-security-priorities

CISA Reflects on Past Year, Upcoming Critical Infrastructure Security Priorities

CISA’s 2022 Year in Review outlines the four-year-old agency’s top accomplishments of the past year and hints at upcoming critical infrastructure security priorities.

By Jill McKeon

January 17, 2023 - The Cybersecurity and Infrastructure Security Agency (CISA) released its 2022 Year in Review, in which the agency reflected on what it accomplished in 2022 and what it hopes to achieve in 2023.

The four-year-old agency was established to lead the United States’ efforts to protect its 16 critical infrastructure sectors from relentless cyber threats through public-private partnerships as well as the creation of useful cyber resources and tools.

“Protecting our nation’s critical infrastructure is foundational to our national security. That critical infrastructure includes everything from healthcare, water, and education to chemical, transportation systems, telecommunications, energy, and much more,” the Year in Review document stated.

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https://www.healio.com/news/ophthalmology/20230116/specialist-debunks-common-cyber-security-myths-for-practice-owners

January 15, 2023

Specialist debunks common cyber security myths for practice owners

By Anthony DeFino

Fact checked byPatricia Nale, ELS

KOLOA, Hawaii — Specialists are responsible for protecting their practices from cyber attacks and should not rely solely on standard cyber security measures, according to a presentation at Hawaiian Eye 2023.

To help practice owners become more prepared for potential cyber security issues, Renee Bovelle, MD, debunked myths surrounding how practices should approach protecting themselves, which included combatting an overreliance on cybersecurity insurance as well as the incorrect assumption that third party electronic health record vendors are responsible for making their products compliant with HIPAA privacy and security rules.

“You may say, ‘I have a cybersecurity policy, so I don't have to worry if anything happens.’ Well, that is not the case,” she said.

Cyber security companies want their clients to have methods in place to prevent any breaches in cybersecurity; if practice owners cannot show evidence that they have met their cyber insurance company’s policies, their claims may be rejected, according to Bovelle.

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https://www.mobihealthnews.com/news/qa-former-va-secretary-shulkin-digital-health-refining-patient-first-care

Q&A: Former VA Secretary Shulkin on digital health refining patient-first care

Former VA Secretary Dr. David Shulkin discusses how his experiences in healthcare shaped his digital health platform for chronic pain patients.

By Jessica Hagen

January 13, 2023 10:41 am

Dr. David Shulkin has had a decades-long career in healthcare, from working at the higher echelons of the private healthcare sector to being appointed by President Barack Obama as undersecretary for health at the U.S. Department of Veterans Affairs in 2015. Two years later, Shulkin was confirmed as the ninth secretary of the Department of Veterans Affairs under President Donald Trump. 

Shulkin spoke with MobiHealthNews about how the healthcare industry has changed throughout his career and how he's using lessons from his time in public service to develop his chronic pain management startup Override

MobiHealthNews: What kind of changes have you seen within the healthcare industry over the course of your career?

Dr. David Shulkin: Wow. Well, that's a big question. Mostly what I've seen is a transition from when there was complete professional autonomy, where the provider used to be the one that would control what was happening. That meant the provider would determine the price, the provider would give the advice and expect people to follow it, and the provider really was able to determine the course of treatment. 

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https://www.healthcareittoday.com/2023/01/17/why-hospital-discharges-take-so-long-and-what-we-can-do-to-shorten-them/

Why Hospital Discharges Take So Long—And What We Can Do To Shorten Them

January 17, 2023

Andy Oram

Anyone who has had the misfortune to land in the hospital, or care for a relative in one, knows the following frustrating experience: The doctor comes during morning rounds and says the patient is good to go…and hours later, you’re still waiting for the paperwork to get done.

I decided to unpack this experience. During conversations with about 20 experts, I learned about the complex plans that go into the simple act of getting a patient out of the hospital. This article discusses some organizational and workflow measures that hospitals are taking to shorten discharge times, saving money along the way. A subsequent article will chime in with some technologies that help.

Factors Delaying Discharges

Where to begin? So many hospital activities were cited by respondents to my question that I can hope at best to summarize the most salient of them. I’ll run through the observations quickly in order to get to solutions, which boil down to “Think about what you’re doing.”

First, according to Donna Pritchard and Joy Avery of CipherHealth, a company with a communications platform for healthcare, discharge may take time because a lot of important procedures lie between the doctor’s proclamation and the actual discharge. The patient might need some physical therapy, more tests to prove they are free of disease, a dose of antibiotics, etc. Lisa Weber, Director, Healthcare Industry Practice at UiPath—a company that automates elements of the workflow in healthcare and other industries—offers a partial list of people who participate in discharging the patient: the patient themselves, patient caregivers, charge nurse, doctor, therapists, and care manager.

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https://www.healthcareittoday.com/2023/01/17/where-are-ehrs-headed-in-2023/

Where are EHRs headed in 2023?

January 17, 2023

Colin Hung

Electronic Health Records (EHRs) are the central technology pillar for healthcare organizations. EHRs are vital to both clinical and administrative operations. Because of that, we wanted to dedicate an entire article to where EHRs are headed in 2023.

We connected with MEDITECH, Epic, eClinicalWorks, ModMed, NextGen Healthcare, athenahealth, and Elation Health. We asked them all the same 2 questions:

  1. What can customers expect from you in 2023?
  2. What is your prediction for the EHR market in 2023?

Here are their responses.

MEDITECH – Leah Farina, Vice President of Client Services and Carol Labadini, Vice President of Meditech-as-a-Service

In 2023 our MEDITECH acute care users can expect more focus on EHR optimization. As organizations continue to deal with workforce challenges, they are looking to their technology partners to help ease the burden on staff. This means optimizing the EHR so that it fits more seamlessly into their daily routines and helping customers take advantage of underutilized technologies like surveillance-based toolkits as well as patient portals.

Our ambulatory users can expect more functionality for specialty clinics, like infusion clinics, dialysis, and pain management in 2023. We are also planning to continue enhance our Expanse Now mobile physician app which allows clinicians to practice more efficiently.

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https://www.healthleadersmedia.com/technology/duke-evidation-team-target-health-equity-digital-health-studies

Duke, Evidation Team Up to Target Health Equity in Digital Health Studies

Analysis  |  By Eric Wicklund  |   January 17, 2023

The two are joining forces to create analytical technology that would help digital health studies attract a more diverse and representative patient population.


KEY TAKEAWAYS

·         Racial and ethinc minorities account for 28% of the US population but only 6% of clinical trial participants.

·         Digital health programs are often developed to improve access to care for underserved populations, but they struggle to overcome social determinants of health and other non-clinical factors that hinder access to care.

·         Duke University's BIG IDEAs Lab and Evidation will develop technology that would allow these programs to identify and track study participation, adherence, and retention across racial and demographic lines.

Duke University is joining forces with a California-based digital health firm to develop technology to measure health equity in clinical studies.

The North Carolina university's BIG IDEAs Lab is partnering with Evidation to create "an analytic structure to better predict study participation, adherence, and retention across racial and demographic lines," according to a press release.

While the COVID-19 pandemic saw a huge increase in the use of telehealth and digital health to boost access to care for underserved populations, it also trained the spotlight on social determinants of health and other barriers to care experienced by those groups.

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https://www.healthleadersmedia.com/clinical-care/telehealth-saves-time-travel-and-money-patients-cancer-researchers-find

'Telehealth Saves Time, Travel, and Money for Patients,' Cancer Researchers Find

Analysis  |  By Christopher Cheney  |   January 17, 2023

Increasing the number of telehealth visits for cancer patients could reduce the financial toxicity of oncology services.


KEY TAKEAWAYS

·         Based on two cost models for telehealth visits, the mean total saving in indirect costs ranged from $147.4 to $186.1 per visit.

·         For more than 11,000 cancer patients in the study, about 3,790,000 roundtrip miles were avoided, which generated more than 75,000 hours of savings in total driving time.

·         The mean driving cost savings per telehealth visit ranged from $83.2 at $0.56 per mile of travel to $122.0 at $0.82 per mile of travel.

Telehealth visits generate significant cost savings for adult cancer patients younger than 65, according to a new research article.

Cancer is among the most expensive medical conditions to treat in the United States, according to the National Cancer Institute (NCI). Direct costs include multiple types of treatments such as surgery, chemotherapy, and radiation therapy. Indirect costs include travel expenses and lost employment productivity for clinical visits.

The new research article, which was published by JAMA Network Open, examines indirect cost savings for more than 11,000 patients with more than 25,000 telehealth visits at Moffitt Cancer Center, the only NCI-designated Comprehensive Cancer Center in Florida. The telehealth visits were conducted from April 1, 2020, to June 30, 2021.

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https://www.independent.ie/irish-news/health/senior-hse-exec-says-he-was-absolutely-horrified-by-hospital-overcrowding-as-he-resigns-42290621.html

Senior HSE exec says he was ‘absolutely horrified’ by hospital overcrowding as he resigns

Professor Martin Curley said the HSE is not fit for purpose

Eoghan Moloney

January 16 2023 04:41 PM

The HSE’s head of digital transformation, Professor Martin Curley, has resigned, saying that administrators being so resistant to change, that would have reduced hospitalisations and improved patient outcomes, was a “big part” of his decision to leave.

Prof Curley said he was “horrified” by the overcrowding seen in Irish hospitals in recent weeks and said technologies are available to ease this, but there must be a “concerted effort to scale them” across the health service.

Asked on RTÉ’s Drivetime programme whether the HSE is fit for purpose, Martin said: “I’ll be very honest, no it’s not”.

He said that working with the HSE has been “difficult and the system has been very slow to respond”.

“The HSE is not the solution, the HSE is the problem. There are a lot of things going right in Ireland...but we’re really challenged in our healthcare system.”

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https://ehrintelligence.com/news/reduction-in-ehr-inbox-notifications-not-enough-to-cut-clinician-burnout

Reduction in EHR Inbox Notifications Not Enough to Cut Clinician Burnout

Collaboration between health system leaders and primary care providers is necessary to address clinician burnout brought on by EHR inbox notifications.

By Hannah Nelson

January 16, 2023 - Reducing EHR inbox notifications in the primary care setting did not have a measurable effect on clinician burnout, according to a study published in AJMC.

In 2017, the Veterans Health Administration (VHA) led an initiative to reduce low-value EHR inbox notifications. Each facility formatted its EHR to include a mandatory set of notifications based on VHA and facility priorities and trained PCPs in EHR customization of optional notifications.

Researchers estimated the share of PCPs experiencing clinician burnout using VHA All Employee Survey responses before and after the initiative in 2016 and 2018. The study aggregated survey responses from 6,459 PCPs at 138 VHA facilities.

The VHA initiative resulted in increases and decreases in notification volumes for PCPs. In both instances, there was not a measurable impact on clinician burnout.

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https://healthitsecurity.com/news/ransomware-operators-continue-to-aggressively-target-us-healthcare-sector

Ransomware Operators Continue to Aggressively Target US Healthcare Sector

HC3’s latest brief highlights the tactics and capabilities of Royal ransomware and BlackCat ransomware, two groups that are known to target the healthcare sector.

By Jill McKeon

January 16, 2023 - The Health Sector Cybersecurity Coordination Center’s (HC3) latest brief outlines the tactics and exploitation techniques used by Royal ransomware and BlackCat ransomware, two threats that ransomware operators have been using to aggressively target the US healthcare sector.

HC3 has previously warned the sector about both Royal and BlackCat in previous briefs and analyst notes, but its latest brief dives into more detail regarding their past activity and impact on the healthcare sector.

ROYAL RANSOMWARE

HC3 described Royal ransomware as a “relatively new, but highly capable” threat to the healthcare sector. First observed in 2022, Royal is the ransomware of choice for some experienced operators, including those who previously took part in Conti ransomware operations.

oyal is written in C++ and targets Windows systems. Notable attacks for the group include an attack against Silverstone Circuit, a popular racing circuit in the UK, and one against an unnamed US telecom organization in December 2022. The December attack resulted in compromised employee passports and driver’s licenses.

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https://partner.sciencenorway.no/artificial-intelligence-e-health-research-health/artificial-intelligence-interprets-your-medical-record/2139588

Artificial intelligence interprets your medical record

The system will automatically propose condition codes for patients' discharge summaries.

Hasse Berntsen Communications Adviser
Presented by: Norwegian centre for E-health research

monday 16. January 2023 - 04:30

Healthcare professionals have to deal with an international system with over 30,000 codes for various diseases. It is easy to make mistakes. Researchers are now developing a computer program so that practitioners can be assisted by artificial intelligence.

Because in the healthcare system, a lot of manual and time-consuming work takes place to document a patient's care.

After each patient contact, the practitioner must write a discharge summary and record one or more condition codes that describe the type of examination or treatment the patient has received.

A discharge summary is a written summary of the examination or treatment of a patient, based on medical records.

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https://washingtontechnology.com/contracts/2023/01/gao-rules-booz-allen-has-no-conflict-860m-va-award/381764/

GAO rules Booz Allen has no conflict in $860M VA award

By Nick Wakeman,
Editor-in-chief

January 12, 2023

This is the second time in 12 months that protestors unsuccessfully raised conflict-of-interest allegations against Booz Allen over a large Veterans Affairs win.

The Government Accountability Office’s decision on Tuesday to deny a pair of protests has cleared the way for Booz Allen Hamilton to continue its role supporting the Veterans Affairs’ electronic health record modernization project.

In September 2022, Booz Allen won the $860 million task order that extends its work for another five years as program manager for the VA’s massive program to implement Cerner's electronic health record. The company first won that role in 2017 through a $750 million task order awarded in 2017.

The VA competed both orders through its Transformation Twenty-One Technology Next Generation vehicle known as T4NG.

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Enjoy!

David.

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