Monday, December 11, 2017

Weekly Australian Health IT Links – 11th December, 2017.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a 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.

General Comment

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A really big week with the regulations to enable myHR opt-out gazetted and now in operation with various start up dates and implications.
Otherwise the wind down to Christmas seems to be rapidly taking over!
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Federal Government authorises itself to collect Australians’ health information

Lynne Minion | 05 Dec 2017
The Australian Digital Health Agency has been given the authority to collect the health information of Australians in the My Health Record system, including for those who have not signed up and prior to the availability of an opt-out function.
The Federal Health Minister has registered the legal instrument required to switch My Health Record to opt-out, allowing for all Australians to be signed up to the national repository for individuals’ medical information unless they choose to be excluded.
“Consumers support the concept of an opt-out model for the My Health Record system,” Minister Greg Hunt’s explanatory statement to the My Health Records (National Application) Rules 2017 says.
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Online consults result in more work, not less

5 December 2017

TECH TALK

What lessons can we draw from an experiment in the UK?
The idea of offering online consultations might be total anathema to some GPs. But if anything could persuade you that they really are the future, how about the idea they would save that most valuable commodity: time?
For example, what if the patient could fill out an online questionnaire with plenty of room to detail their complaint, which was then printed and delivered to you by your staff?
Voila, no face-to-face appointment required and time saved. Of course, there may be some medicolegal issues to contend with.
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6 December 2017

Wild Health: Pay GPs to create health record

Posted by TMR Staff
My Health Record won’t take off without economic incentives for GPs to use the system, says Dr Tony Sara, the medical adviser at the South Eastern Sydney Local Health District.
“We all want it to work,” Dr Sara told The Medical Republic at the Wild Health Summit.
“Given that there is no fundamental economic model, then my sense is that there needs to be some sort of payment to incentivise GPs to create the record.”
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8 December 2017

Wild Health: Is AI making headway in medicine?

Posted byTMR Staff
AI has crept into many areas of medicine already, says Professor Enrico Coiera, the director at the Centre for Health Informatics at Macquarie University’s Australian Insititute of Health Innovation.
“AI has been with us for 20 years or more,” Professor Coiera told The Medical Republic at the Wild Health Summit.
“We don’t even know that behind the scenes we’ve got intelligence algorithms doing everything from interpreting our blood tests [to] helping radiologists look at CT scans,” he said.
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Pharmacy boost for My Health Record

Thursday, December 7, 2017 - 16:23
Every Australian pharmacy will be able to use My Health Record, with the final software provider about to connect to the system, reports industry newspaper Pharmacy News.
Corrum point of sale (POS) and script dispensing software, which is used by 1000 pharmacies nationally, will connect to the system next year.
Pharmacy uptake has also been boosted by Chemist Warehouse, which says it plans to roll out My Health Record in all of its pharmacies.
There are reportedly just over five million Australians with a My Health Record, and nearly 13 million prescriptions and dispensing records have been added to the system.
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This suicide prevention app is a good idea, but needs work

5 December 2017

APP REVIEW

Product: My Coping Plan 
Price: Free 
Pros: Simple and easy to use, would remind some patients what to do when it becomes difficult to cope
Cons: Unlikely to garner enough interest to regularly use and therefore may be forgotten when needed 
Verdict: ★★★☆☆
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1 December 2017

Mind the private and public procedures health gap

Posted by Jeremy Knibbs
The days of angry private health patients blaming their GP for sending them to hospital only to discover they have an out-of-pocket fee in the many thousands many be nearing an end.
If you’re a privately insured patient about to undergo a hospital procedure, one of three things can happen. Your specialist can be participating with one of the insurers in a “no gap” or a “known gap” scheme, or they can be non-participating.
Depending on the specialist you are directing a patient to, even the clinical aspects of your referral can be overridden by the financial settings if they are dire, which sometimes they can be.
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CSIRO’s start-up accelerator selects AI, virtual reality and genomics health innovations

Lynne Minion | 08 Dec 2017
AI for gut disorders, virtual reality aids for carers, and genomics to develop drugs faster are among the emerging technologies selected for the latest intake of CSIRO’s sci-tech accelerator ON.
A fast-track to market, ON brings together researchers, entrepreneurs and mentors, and the new batch of innovators are tackling some of Australia's greatest challenges in energy, food and agriculture, water quality, wildlife conservation and health, according to CSIRO Chief Executive Dr Larry Marshall.
“Establishing ON was about bringing the Australian research sector closer to Australian industry – creating a pathway to help our scientists turn their excellent science into real-world solutions,” Marshall said.
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  • Dec 6 2017 at 6:26 PM

Doctors asked to not include ‘grief reactions’ in medical records

Doctors say patients are asking them to exclude "ordinary grief reactions" from medical records because they don't want this information passed onto insurers as the insurance industry seeks to deal with what it describes as a 'tsunami' of mental health related claims.
The president of the peak body for general practitioners, Dr Bastien Seidel, said patients asking doctors to omit instances of grief, anxiety and other mental health information from their medical record is "not an issue for insurers" but is a significant problem for GPs.
With the banking royal commission likely to investigate cases relating to discriminatory practices in insurance cover, including the denial of cover and denial of claims, and a spike in mental health claims risking the sustainability of the sector, insurers are being forced to look at the quality of their risk profiling, as well as their underwriting and claims processes.
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8 December 2017

Where are we at with real-time monitoring?

Posted by Julie Lambert
GPs will play a central role in the first serious attempt to stop doctor shopping and illicit use of pharmaceutical drugs on the Australian mainland.
Under legislation passed on October 19, Victoria will have the distinction of becoming the first state to impose a mandatory real-time prescription monitoring regime, giving doctors, pharmacists and nurse practitioners ready access to a patient’s prescription history.
The initiative rides on the back of Tasmania’s successful DORA monitoring system, which has been in place since 2011. But the challenge for Victoria is to cover a population 12 times larger, and an expanded list of medications. Not to mention the problem of bordering jurisdictions that have yet to get on board with real-time monitoring.
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Depression and mental health apps: How to tell the good from the bad

RN
Posted Wed at 11:12am
There are currently more than 10,000 depression and anxiety-related self-help apps available to download, the American Psychiatric Association estimates. But less than 1 per cent have been professionally evaluated.
Cause for concern? Well, yes. But not a cause for depression, says Harvard Medical School's John Torous, who leads the association's working group on smartphone app evaluation.
In fact, he sees great promise in digital mental health technologies.
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GPs: Install the latest version of clinical information systems (CIS) to get the most of out of My Health Record

5 December, 2017
Dr John Aloizos AM shares his views on how digital health benefits him as a GP, plus how important it is to ensure clinical information systems (CIS) are updated to get the most out of My Health Record.
As a GP, I often find myself in conversation with colleagues who are in general practice about My Health Record and initiatives that the Australian Digital Health Agency is leading to connect other parts of the sector in the lead up to national opt-out.
One of the frequent comments I hear is:
I’ve tried using the My Health Record in my CIS but it’s too cumbersome to locate useful information. We were told usability improvements had been made – but I’m not seeing them! When will the My Health Record be fixed? When will the usability issues be fixed?’
In response, my question is: ‘When did you last upgrade your practice CIS?’
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Ethics, regulation and the medical devices boom

Editor: Amy Coopes Author: Amy Coopes on: December 04, 2017
In an era of medical apps, remote-controlled biomedical devices and 3D printing, regulatory and quality-control challenges will enter unprecedented territory, the latest Consumers Health Forum journal explores.
In a special edition of Health Voices on medical devices, the ethical, practical and personal dimensions of this runaway industry’s frenetic expansion comes under the spotlight.
Australia has seen a number of scandals involving implants in recent years, including metal-on-metal hip replacements, breast inserts and, perhaps most famously of late, trans-vaginal mesh, which is the focus of a paper by Health Issues Centre chief Danny Vedasz.
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Queensland research into hospital digital systems finds the benefits outweigh the risks

Lynne Minion | 04 Dec 2017
Ehealth technologies can improve patient care, lower costs, increase efficiency and prevent duplicated tests in Australian hospitals but they risk causing “alert fatigue” and prescription errors, according to new research published in Australian Health Review.
 Conducted by a team of authors involved in the digitisation of Brisbane’s Princess Alexandra Hospital, Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice claims ehealth systems can improve healthcare processes and patient outcomes but much is still to be learned about best practice design and use.
The study by PAH and Queensland’s Metro South Hospital and Health Service evaluated recently published research reviews of electronic medical records, electronic prescribing, computerised decision support systems and computerised physician order entry technologies, and found the benefits outweighed the risks.
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Digital platform GoShare rolls out in NSW health service to help chronic patients help themselves

Lynne Minion | 05 Dec 2017
Reassuring patients they are not alone and providing resources for them to better manage their conditions are among the aims of the Western Sydney roll-out of a digital platform designed to help the chronically ill.
WentWest and Western Sydney Local Health District have signed up the patient education tool GoShare to provide multimedia guidance for people living with chronic disease, with the view to improving health outcomes, preventing complications and reducing avoidable hospitalisations.
Following a successful 12-month pilot with WentWest, this new agreement will allow all healthcare professionals across the continuum of care in the region to use GoShare with patients, including those requiring cardiac rehab.
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It’s time to talk about who can access your digital genomic data

December 4, 2017 6.18am AEDT

Authors

  1. Caitlin Curtis  Honorary Research Fellow, The University of Queensland
  2. James Hereward  Post  Doc Ecological and Evolutionary Genetics, The University of Queensland
We are approaching a time when you might be too scared to have your genome sequenced.
Only last week, a US senator called for an investigation into the privacy policies of direct-to-consumer DNA companies. But this is only one piece of a puzzle that is about to get much more connected.
As with any kind of personal data there are a number of concerns regarding collection, transmission, storage and use. But unlike most other data, your genome reveals intimate information about not only you, but also the people to whom you are related.
It’s time to talk about who can access that data, how, when and why.
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Avatars put a face to schizophrenic voices

Wednesday, 06 December, 2017
Therapy using avatars appears to help reduce auditory hallucinations for people with schizophrenia.
An experimental therapy which involves a face-to-face discussion between a person with schizophrenia and an avatar representing their auditory hallucination may help reduce symptoms when provided alongside usual treatment, according to a study published in The Lancet Psychiatry.
The randomised controlled trial compared the avatar therapy to a form of supportive counselling (adapted specifically for the study). It found that avatar therapy was more effective at reducing hallucinations at 12-week follow-up, and had a large effect size.
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Consumer-centred digital health on the horizon

Thursday, 07 December, 2017
The Australian Digital Health Agency and Consumers Health Forum of Australia have signed a memorandum of understanding to ensure that digital health solutions are consumer centred.
It is hoped that the ongoing development of My Health Record will enable improved safety and quality of patient care.
“Our unique partnership with the Australian Digital Health Agency will ensure health consumers have a real voice in developing Australia’s digital health capability,” said CHF CEO Leanne Wells.
“Importantly, the MoU supports the national effort to promote increased use of the My Health Record system by consumers and carers.”
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Consumers’ voice drives digital health

7 December 2017Media release
Health consumers are central to the design and delivery of a digital transformed health sector and the ongoing development of My Health Record, a digital system that enables improved safety and quality of patient care.
A Memorandum of Understanding signed between the Australian Digital Health Agency and the Consumers Health Forum of Australia (CHF) will ensure that digital health solutions are consumercentred and advance the efficiency, quality, and delivery of healthcare in Australia.
“Our unique partnership with the Australian Digital Health Agency will ensure health consumers have a real voice in developing Australia’s digital health capability. “Importantly, the MoU supports the national effort to promote increased use of the My Health Record system by consumers and carers,” CHF CEO Leanne Wells said.
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Senior Telstra executive Cynthia Whelan to depart

  • The Australian
  • 12:47PM December 8, 2017

Supratim Adhikari

Telstra has lost another senior executive, with group executive of its new business division, Cynthia Whelan, leaving the telco.
Ms Whelan, who has headed Telstra’s new business portfolio since 2015, is also the chairman of Foxtel and a director on Telstra Ventures and Telstra Health.
At Telstra (TLS), Ms Whelan has had responsibility for driving growth initiatives into new markets.
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Freedom of information: Australians are losing the battle against government secrecy

Richard Mulgan
Published: December 5 2017 - 12:15AM
The information commissioner survived abolition but FOI remains nobbled.
Government policy on freedom of information remains in limbo. In 2014-15, thanks to resistance from the Senate, prime minister Tony Abbott and his Attorney-General, George Brandis, failed in their initial aim of fully abolishing the Office of the Australian Information Commissioner. But they certainly succeeded in reducing its resources and public standing.
Though the office's statutory functions were later fully restored under the leadership of the privacy commissioner, Timothy Pilgrim, who took on the extra role of information commissioner, funds available for FOI functions remain well below former levels. Throughout this period, the office has kept a low profile on FOI issues while concentrating more on privacy and access to government data.
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This GP isn't slowing down in his specialist fee crusade

7 December 2017

ANALYSIS

Earlier this year, we wrote about Dr Richard Zhu, the revolutionary Sydney GP on a mission to list the fees of every specialist in Australia.
His resulting website, SeekMedi.com.au, made national media headlines with praise from both GPs and patients for fighting for greater fee transparency.
What has happened since? Do doctors and patients use it? Is it making a difference? 
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How much is too much information? The dose response curve of informed consent

Australia November 9 2017
“While the over-informed person is inconvenienced, the under-informed has his/her autonomy violated.” – United States Medical Ethicist, Robert Veatch.
“A patient may make an unbalanced judgment because he is deprived of adequate information. A patient may also make an unbalanced judgment if he is provided with too much information and is made aware of possibilities which he is not capable of assessing because of his lack of medical training, his prejudices or his personality.” - Lord Templeman in Sidaway[1] (1985)).
It has now been 25 years since the High Court of Australia[2] decided the case of Mrs Whitaker – the unfortunate lady who developed sympathetic ophthalmia in her left eye following an operation on her right eye. The High Court held that the surgeon, Dr Rogers, was liable for failing to warn Mrs Whitaker specifically about this rare, but devastating, risk of the procedure.
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Google and others lead AI revolution in machine learning

  • The Australian
  • 12:00AM December 7, 2017

Chris Griffith

We’ve seen the beginnings of artificial intelligence in the world around us. But AI could also reside inside us. The idea ­exists that microscopic nano­machines could be injected into our bloodstream, scouting for ­disease and repairing cells through the use of artificial intelligence, within 20 years.
Senior inventor John McNamara discussed the idea at a British House of Lords AI committee meeting in October, so I was keen to hear the views of another of the world’s most eminent AI experts about the concept during an interview last week.
Jeff Dean is senior fellow at Google and last week was key speaker at Google’s AI conference in Tokyo. The conference revealed a plethora of AI projects that ­Google, Dean and the company’s engineers are involved with.
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HFC network will need work to be fit for NBN: experts

Technical experts who have closely followed the rollout of the NBN say Telstra's HFC network will need considerable work done on it to meet the needs of NBN customers.
Last week, NBN Co, the company rolling out the national broadband network, said that network issues would mean a delay in HFC connections of anything from six to nine months.
Dermot Cox, an HFC expert and business consultant, told iTWire the HFC platform was fine, but "running out of capacity, yes. In need of field workforce training, yes; in need of robust NBN Co workforce craft practices, yes".
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NBN Co will have to maintain HFC network no matter what

The NBN Co will have to continue maintaining the Telstra HFC cable network even if the condition of the cable network makes it impossible to be used for the national broadband network.
This is one of the conditions of the deal which NBN Co signed with Telstra for use of its HFC network, the Australian Financial Review reported.
NBN Co is paying Telstra $5 billion in infrastructure payments, $4 billion in disconnection payments and $2 billion in Commonwealth agreements for the HFC network.
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Alan Kohler: how to fix the NBN

  • The Australian
  • 6:32AM December 4, 2017

Alan Kohler

Last week NBN Co took its first faltering step towards some kind of adulthood. There’s a long way to go.
The decision to delay HFC cable connections so the technology could be fixed was its first assertion of independence from the government, which is on the hook politically for a quick rollout of the network. That’s because speed of rollout was part of the reason given for downgrading it, the real reason being that it had to be different from the ALP’s idea.
Actually, the press release last Monday was a pretty phony piece of spin, and was rightly described as “glitter on a turd” by journalists the next day.
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Enjoy!
David.

Sunday, December 10, 2017

I Am Getting The Feeling Things Are Not Going Well With The Roll-Out Of The myHR and The ADHA.

Why do I think this?

First the poll published earlier today makes it pretty clear that the confidence of the savvy audience in this blog that the myHR will be a success has pretty much evaporated.
See here:
Second we are seeing furious defensive reactions of the ADHA CEO to critical articles in the popular press, which are based on interviews with AHDA staff, being published. I am told this correspondence is being circulated to virtually every editor in the country while some odd claims are being made.
See here:
The letter does not seem to me to be 100% accurate.

As an example of probable error, from the letter:
“My Health Record requires each clinical professional to have unique identity credentials as well as conformant clinical software to open a My Health Record. This is not available to any medical receptionist. “
Last time I looked many practices used practice wide certificates that allow virtually all practice staff access to the myHR and that the Department has no real way of knowing who in a particular practice is accessing the myHR via that credential.
This is confirmed here:
Yes. The staff at your Healthcare Provider Organisation can access My Health Records as long as they are authorised users, even if they do not have an Healthcare Provider Identifier-Individual (HPI-I) identifying them as a healthcare provider. The My Health Record system entrusts a participating organisation to grant access to ‘authorised users.’ An authorised user must be an employee who has a legitimate need to access the My Health Record system as part of their role in healthcare delivery. When authorised users without a HPI-I access the My Health Record system, they are only permitted to access the records of patients with whom they are involved in delivering healthcare services. All access to the My Health Record system is with the patient’s initial consent and is audited. Authorised users without an HPI-I cannot be listed as the author of a clinical document submitted to the My Health Record system.”
Here is the link:
So anyone a practice authorises can access relevant records.
Also note that the myHR is internet connected (be it open or closed – whatever that means) and is so subject to breach – security experts say when not if. I tend to agree with the experts.
As for this:
“My Health Record places Australians in control of their healthcare and gives authorised healthcare providers secure digital access to key health information at the point of care, wherever that may be. Benefits include reduced hospital admissions, reduced duplication of tests, better coordinated care, and better informed treatment decisions.”
We have been waiting for evidence that this is true for 5 years and just saying it does not make it so!
Third was are seeing all sorts of non-technical people lined up to assist with getting more users.

Consumers’ voice drives digital health

7 December 2017Media release
Health consumers are central to the design and delivery of a digital transformed health sector and the ongoing development of My Health Record, a digital system that enables improved safety and quality of patient care.
A Memorandum of Understanding signed between the Australian Digital Health Agency and the Consumers Health Forum of Australia (CHF) will ensure that digital health solutions are consumercentred and advance the efficiency, quality, and delivery of healthcare in Australia.
“Our unique partnership with the Australian Digital Health Agency will ensure health consumers have a real voice in developing Australia’s digital health capability. “Importantly, the MoU supports the national effort to promote increased use of the My Health Record system by consumers and carers,” CHF CEO Leanne Wells said.
More here:
Note the sentence I have bolded.
Fourth there is increasing recognition that the current myHR is close to being past its use by date in its present form and will either need to be expensively re-developed / replaced or abandoned.
Last it is becoming clear that the roll-out of opt-out is only likely to be completed around the same time as there are cheaper and better ways to provide patient access to their data in the next 2-3 years rendering the entire effort redundant. (Think maybe the NBN and 5G). Also think the movement of GP Systems to the cloud.
To me the myHR is an idea (now 7 years old) whose time has passed.
What do you think?
David.

AusHealthIT Poll Number 400 – Results – 10th December, 2017.

Here are the results of the poll.

Do The Recent Additions Of Many New Clinical Information Feeds For The myHR Persuade You The System Has A Bright Successful Future Ahead?

Yes 1% (1)

No 97% (142)

I Have No Idea 2% (3)

Total votes: 146

Any insights welcome as a comment, as usual, especially regarding where it should go from here? It certainly seems there is definite belief among readers that the myHR is not the way to go and really does not have much of a future.

A really great turnout of votes that was almost unanimous!

Again we note three respondents who are clueless!

Again, many, many thanks to all those that voted! Hard to believe there have been 400 polls!

David.

Saturday, December 09, 2017

Weekly Overseas Health IT Links – 9th December, 2017.

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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NHS England backs 11 new innovative technologies

Hannah Crouch

27 November 2017
A device which spots early signs of Sepsis is among the 11 new innovations NHS England is promoting.
The projects are being backed as part of the NHS Innovation Accelerator (NIA) programme which is designed to encourage innovative technologies in the NHS.
One of them is RespiraSense, a wireless device which measures breathing and abdomen movements to help detect early signs of sepsis, pneumonia and cardiac arrest.
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Safety group urges doctors to stop texting medical orders

Dec 1, 2017 12:13pm
The Institute for Safe Medication Practices urges doctors to stop texting medication-specific orders.
While it may be convenient for doctors and other clinicians, texting medical orders creates serious patient safety issues and must be stopped, according to the Institute for Safe Medication Practices.
In a safety alert, the nonprofit organization said the healthcare industry must ban the texting of medication-specific orders until it identifies and resolves those safety concerns. The Joint Commission this year also reaffirmed its ban on texting orders.
A survey of 778 healthcare professionals identified a number of problems with texting medical orders, including abbreviated language, improper autocorrection and orders without full patient names and a second unique identifier to offset data security concerns, the ISMP said.
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New platform lets patients sell their health data

By Rachel Z. Arndt  | November 30, 2017
There's a new app available for healthcare patients to make some money off their medical data.
Falls Church, Va.-based healthcare IT company Health Wizz has created a patient-data-aggregation platform that allows patients to trade and sell their data to pharmaceutical companies, researchers and other organizations.The platform, which was previously available in beta and was relaunched Thursday, runs on a mobile app through which patients can aggregate their health records.
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HIT Think 3 ways providers can help clinicians gain timely access to data

Published December 01 2017, 4:21pm EST
In healthcare, access to actionable data is mission critical. But while physicians don’t need the skills of an undercover agent to pull actionable intelligence from their systems, obtaining the right data at the right time is often challenging—particularly in large health systems, such as integrated delivery networks.
Across the country, large health systems have spent millions of dollars on electronic health records (EHRs) and other systems that hold the promise of connecting physicians and hospital leaders to comprehensive patient, financial and administrative data that can better inform approaches to care and revenue cycle processes. In this case, data is shared internally, across facilities and, ideally, with other organizations across the care continuum.
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AMIA seeks better standards testing, update to interoperability map

Published December 01 2017, 3:17pm EST
The nation needs a more robust and modern way of testing healthcare information technology standards, as well as an update to plans for the interoperability “roadmap” it’s following to improve the exchange of medical information.
Those suggestions are among several offered by the American Medical Informatics Association (AMIA) in a comment letter sent this week to the Office of the National Coordinator for Health Information Technology.
AMIA, in responding to a request for comments on ONC’s Interoperability Standards Advisory (ISA), went beyond merely discussing provisions of the advisory to add the organization’s thoughts on the direction of interoperability within the healthcare industry.
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Blockchain in healthcare: From possible to probable

The tech’s appeal lies in its digital ledger of transactions and healthcare is on the precipice of adoption to grow networks of secure data.
November 29, 2017 03:04 PM
Blockchain is the digital ledger of transactions that anyone on the network can see — and no one on the network can alter that information. Tracing information back to its original source and every detail in-between is the key to the technology. Healthcare is interested in this idea to change the way we think about data interoperability and security. There are many more applications for the idea that aren’t just about EHRs and money but about patient engagement as well. Read this primer and the 3 basic principles to understand the tech if you are still trying to figure out blockchain and its value to grow networks of secure data in healthcare.
Here are some of the latest developments happening related to blockchain right now.
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Newly-Designed Physician EHR Notes May Improve EHR Usability

Researchers redesigned physician EHR notes to reduce information overload and emphasize clinically relevant information.

November 29, 2017 - Showing less data in physician EHR notes may produce more benefits for physician productivity, according to a recent study published in the Journal of the American Board of Family Medicine (JABFM).
The study by Jeffery Beldon, MD et al. compared different physician EHR note designs to see which design physicians found most efficient, accurate, and usable when attempting to obtain information for ambulatory chronic disease care.
Researchers devised four physician note designs and tested the designs on 16 primary care physicians in random order. Physicians were instructed to find key information in the EHR notes during timed tasks.
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Security researchers discover vulnerability in OpenEMR that potentially compromises 90M health records

Written by Julie Spitzer | November 29, 2017 | Print | Email
Researchers at Risk Based Security are warning healthcare providers using OpenEMR to a vulnerability in its configuration that may expose the system to a complete compromise, the firm wrote in a blog post. 
OpenEMR is an open-source EHR management application used in thousands of physician offices and small healthcare facilities around the world, and it hosts data on more than 90 million patients. In the U.S., it is estimated there are more than 5,000 installations of OpenEMR in physician offices, serving more than 30 million patients. It is a PHP-based web application that fully integrates with EHRs and practice management, scheduling and electronic billing. 
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Care planning software helps doctors make the right treatment call

Published November 30 2017, 4:50pm EST
Abington Jefferson Health in Pennsylvania is using care planning software, embedded with guidelines, to deliver guidance on treatment directly to clinicians at the patient’s bedside for more than 200 conditions.
The two-hospital delivery system with six clinics, anchored by 665-bed Abington Hospital, is moving away from a paper-based process of monitoring patients by adopting an electronic decision support documentation process that lets clinicians better understand patient needs and implement appropriate intervention programs.
The goal is to have internal professional teams of clinicians all documenting together the same way and expanding documentation to more deeply cover potential patient problems, educational needs of patients and families and interventions specific to the reason for admission, explains Diane Humbrecht, chief nursing informatics officer.
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Your Apple Watch Could Tell You When You’re Having a Stroke

A new app combines health tech with artificial intelligence that can warn when danger is imminent.
By Michelle Cortez
November 30, 2017, 9:00 PM GMT+11 Updated on December 1, 2017, 6:15 AM GMT+11
A device that’s embedded in a new wristband for the Apple Watch marries two existing features—the heart rate monitor and activity sensors—and takes them to a new level using artificial intelligence.
The KardiaBand from AliveCor uses a neural network to predict and analyze the wearer’s heart rate based on his or her history and a trove of cardiovascular data from both sick and healthy people. The device measures the heart rate every five seconds and tells users when it’s out of their expected range. It doesn’t apply a generic range—instead, it determines what’s abnormal for you.
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Apple's Heart Study app can identify irregular heart rhythms

The app uses Apple Watch's sensor to calculate heart rate and rhythm, and can notify users who might be experiencing atrial fibrillation.
November 30, 2017 8:40 AM PST
Your Apple Watch can now tell you if you have an irregular heart rhythm.
Apple launched its Heart Study app on Thursday, which uses the Apple Watch's heart rate sensor to collect data on a wearer's heart rhythms and then notify them if they might be experiencing atrial fibrillation, or AFib.
Using the Apple Watch, the Heart Study app can notify users if they have irregular heart rhythms. 
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EHRs in the cloud: Why smaller healthcare providers are making the leap

Providers say flexible platforms help them to prepare for population health management and value-based care.
November 28, 2017 09:25 AM
Add one more to the growing list of healthcare providers moving their EHRs into the cloud. Coastal Orthopedics in Conway, South Carolina, consolidated its legacy electronic health records and practice management systems into the cloud and is seeing tangible results already. 
Hospitals of various sizes, including University of California San Diego and UC Irvine Health just this month, have opted for cloud-based EHRs recently. On the smaller end of the provider scale, Lost Rivers Medical Center in Arco, Idaho, and Faith Community Hospital in Jacksboro, Texas, have also moved their EHR and related software into the cloud. 
While UCSD and UC Irvine Health are running Epic’s EHR in a private cloud on the vendor’s campus, Coastal Orthopedics went with athenahealth. 
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Meaningful Measures specifics emerge: CMS program will track 18 areas

The aim of the core measures is to refocus the agency's regimen of quality metrics on high-quality healthcare and meaningful outcomes for patients, according to the agency.
November 28, 2017 03:52 PM
The Centers for Medicare and Medicaid Services on Tuesday offered further insight into how the Meaningful Measures program works. In a webinar, Jean Moody-Williams, RN, deputy director of CMS' Center for Clinical Standards and Quality, said the initiative to streamline quality reporting was launched in recognition that "there's a fine line between being helpful and being a hindrance."
CMS has heard the feedback from industry stakeholders that there are too many often-overlapping quality measures, and that it's often difficult to see how they relate to each other and how tracking and reporting them is meant to further common goals, said Moody-Williams.
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If confirmed, HHS secretary nominee Alex Azar plans to take on EHRs, care delivery reforms

Nov 29, 2017 10:00pm
Though much of the discussion during Alex Azar's confirmation hearing for secretary of the Department of Health and Human Services centered on his ties to the pharmaceutical industry, a Senate panel also grilled Azar on payment reforms, the Affordable Care Act and electronic health records. 
If confirmed, Azar told the Senate Health, Education, Labor and Pensions Committee that he'd want to delve into the regulations and the role that EHRs plays to contribute to the administrative burdens that are at the top of physicians' complaints.
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HHS nominee sees potential of big data, pitfalls of EHRs

Published November 30 2017, 7:15am EST
President Donald Trump’s nominee to head the Department of Health and Human Services contends that by harnessing the power of big data and predictive analytics, the healthcare industry can be made more efficient and lead to better patient outcomes.
Alex Azar told a Senate committee on Wednesday that Medicare must “shift the focus in our healthcare system from paying for procedures and sickness to paying for health and outcomes.”
Azar testified that if he is confirmed to serve as HHS secretary, one of his four critical priorities at the agency will be to “better channel the power of health information technology and leverage what is best in our programs—and in the private competitive marketplace—to ensure the individual patient is the center of decision-making, and his or her needs are being met with greater transparency and accountability.”
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Survey: Financial Costs of a Cyber Attack Increasing Year over Year

November 28, 2017
by Heather Landi
Enterprise organizations that have been impacted by cyber breaches report that monetary losses from cybersecurity events have increased year over year, according to the 2017 U.S. State of Cybercrime survey.
Looking at the financial ramifications of cyber attacks, the survey notes that there are many metrics to measure the impact of an attack, both hard costs and time as well as reputation. One thing that cannot be disputed is the financial costs of a cyberbreach. The survey found that 21 percent of enterprises report that monetary losses from cybersecurity events have increased year over year. In fact, enterprise organizations estimate financial losses at an average of $884,000, compared to estimates of $471,000 from the previous year.
The survey aims to provide a look into the state of U.S. cybersecurity, revealing how security and business leaders are defending their organizations, the top threats they are facing as well as ramifications when an attack occurs. The survey is a collaborative effort between CSO, the CERT Division of the Software Engineering Institute at Carnegie Mellon University, the U.S. Secret Service and Forecepoint. The survey was published by IDG Communications.
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Prescription monitoring programs crucial to fighting opioid epidemic

Published November 29 2017, 7:47am EST
Electronic databases that help states track controlled substance prescriptions are critical to reducing opioid prescribing, according to New Jersey Gov. Chris Christie, chairman of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
Testifying before a House committee hearing on Tuesday held in Baltimore regarding the Commission’s recent findings and recommendations, Christie told members of Congress that prescription drug monitoring programs (PDMPs) are among the most promising state-level interventions for flagging suspicious prescribing activities.
Christie said that PDMPs are not only effective law enforcement tools but are also aid physicians who can use the databases to see if a patient has opioid prescriptions from other doctors and “stop adding to the problem” of overprescribing of opioids.
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HIT Think Why a National Patient Identifier won’t solve matching concerns

Published November 29 2017, 4:43pm EST
Hope for a national patient identifier suffered a blow recently when the College of Healthcare Information Management Executives announced it was pulling the plug on its highly publicized National Patient ID Challenge.
For years, the question of how to accurately identify individuals in a complicated healthcare ecosystem has been a perplexing one for healthcare IT leaders.
Data creation in healthcare has accelerated from torrential to a veritable tsunami, bringing with it many challenges in the identification and reconciliation of patient records because of the various ways systems classify, store and protect information. As data sharing proliferates and the bar for better coordination across the continuum is raised, resolving patient record matching issues grows especially complex—and increasingly urgent.
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Hospitals Must Decide on Most Effective IT Spend as Costs Add Up

Gregory A. Freeman, November 27, 2017

After rising in past years, IT budgets are showing signs of flattening out for some hospitals. Health leaders will have to decide whether their goals require spending more.

Health system IT budgets are beginning to settle down after significant increases in the past decade, driven largely by the adoption of electronic medical records and concerns over cyber security, but 2018 could require even more funding for hospitals that want to be cutting edge.
That isn’t the only path, however. Hospital leaders will have to consider the role of IT innovation in their missions and budget accordingly.
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Is health IT really ready for a FHIR takeover?

Sponsored Content
The full value of FHIR is still years in the making, says one expert.
November 21, 2017 09:01 AM
Thirty years ago, interoperability was a lot simpler. If you could exchange data between two IT systems, you had interoperability. But in the three decades since, the amount of data and the number of sources of data for an individual or a population have both increased exponentially.
Now interoperability is about accessing data across many systems, both inside and outside the organization, as a single, concordant view, and presenting it to clinicians in a way that is usable and actionable in their workflows. 
FHIR (HL7 Fast Healthcare Interoperability Resources) is quickly becoming the foundation for the future of interoperability. The FHIR standard has the ability to provide vastly simplified, accelerated and effective clinical information sharing between systems, and it’s creating opportunities for tremendous innovations in the healthcare IT industry.    
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Opinion The 3 most important data metrics for retaining customers

Published November 28 2017, 2:45pm EST
Nearly everything in modern business, including healthcare organizations, is measurable, but often companies are relying on legacy data that can obscure the truth about what is happening in the business.
Some time ago, broad quantitative metrics were enough to shape the strategy of the business and were often focused on acquiring new customers. But with time, global markets, including hospital markets, have become increasingly competitive and acquiring new clients has become harder and more expensive. Thus, businesses have transformed their operational models to building continuous relationships with customers.
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Algorithm outperforms radiologists in diagnosing pneumonia

Published November 28 2017, 7:28am EST
Stanford University researchers have developed a deep learning algorithm that analyzes chest X-rays and can diagnose pneumonia better than expert radiologists.
While chest X-rays are currently the best available method for diagnosing pneumonia, interpreting these images is very challenging because the appearance of the condition in these images is often vague, overlaps with other diagnoses and mimics benign abnormalities.
However, the algorithm—called CheXNet—outperformed four Stanford radiologists in terms of pneumonia diagnoses for both sensitivity and specificity.
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Does it matter which EHR your health system uses? This study says yes

Written by Julie Spitzer | November 27, 2017 | Print | Email
Although the goal of the federal EHR certification process is to create a level playing field for quality in support of the meaningful use program, some EHR vendors consistently outperform others, according to a study published online in the Journal of the American Medical Informatics Association.
A team of researchers, led by Jay Holmgren, a doctoral student in the health policy management track at the Boston-based Harvard Business School, examined national hospital data on EHR products used for meaningful use attestation provided to ONC, and compared those measures against EHR incentive program data reported to CMS. The study was limited to hospital performance on six meaningful use stage two criteria.
Here are the six criteria.
1. Availability of medication computerized physician order entry
2. View, download and transmit technology availability
3. Whether VDT can be used by patients
4. Medication reconciliation capabilities
5. Ability to provide summary of care records
6. Ability to electronically send summary of care records
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Judge: Doctor who doesn’t use computer can’t regain license

November 27
CONCORD, N.H. — A New Hampshire judge has denied an 84-year-old doctor’s request to regain her license to practice, which she had surrendered partly over her inability to use a computer.
The state challenged Dr. Anna Konopka’s record keeping, prescribing practices and medical decision making. It said her limited computer skills prevent her from using the state’s mandatory electronic drug monitoring program, which requires prescribers of opioids to register in an effort reduce overdoses.
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Using Personal Financial Data to Improve Healthcare

Alexandra Wilson Pecci, November 28, 2017

Using such data as a source of social determinants of health information can boost the accuracy of population risk predictions.

 It’s no surprise when your mailbox is full of credit card offers or coupons and catalogues from your favorite stores. After all, it’s fairly common knowledge that credit reporting agencies like Experian and Equifax (which recently made headlines for a massive data breach) provide your purchasing data to companies for direct marketing purposes.
But what if healthcare providers could tap into that data too? How might it be added to claims and clinical data to better predict population health risk?
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The biggest interoperability holdup? There's no business case for it

Although many organizations claim interoperability is a major focus, progress is slow, at best. For HL7 CEO Charles Jaffe, the reason is a lack of financial reward, as for-profit vendors can’t be expected to “connect everyone on their own dime.”
November 27, 2017 08:48 AM
The healthcare industry has struggled to figure out the right way to make interoperability happen for years. Seen as the holy grail for the sector, nationwide interoperability, while touted as a major focus for many, is elusive.
In fact, a Rand report in Health Affairs 12 years ago, praised interoperability for its cost-saving capabilities and safety benefits. But the only way to reap those benefits is with an interconnected system.
Providers also see the benefit. A recent National Health Information Exchange and Interoperability Landscape report found that 80 percent of providers saw increased efficiency and 89 percent saw improved care quality by using electronic data exchanges.
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Cerner reportedly finalizing a new partnership with Amazon’s cloud service

Nov 27, 2017 11:57am
One of the nation’s largest EHR developers is planning to announce a new partnership with Amazon’s cloud computing platform.
The new partnership with Cerner is scheduled to be unveiled this week by Amazon Web Services CEO Andy Jassy at the company’s annual conference, according to a report by CNBC, citing sources familiar with the matter.
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Surprising Number of Conditions Linked to Celiac Disease

Damian McNamara
November 21, 2017
ORLANDO — Celiac disease is associated with a wide range of medical conditions, including liver disease, glossitis, pancreatitis, Down syndrome, and autism, according to a database study of more than 35 million people.
The rate of celiac disease is almost 20 times higher in people with autism than in those without, reported lead investigator Daniel Karb, MD, a second-year resident at University Hospitals Case Medical Center in Cleveland.
"If you have a patient who is autistic and they have all these unusual symptoms, you might want to screen them for celiac disease," he said here at the World Congress of Gastroenterology 2017.
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HIT Think How healthcare organizations can reap value from vast stores of data

Published November 27 2017, 3:00pm EST
The healthcare industry is finally nearing the end of the task of digitizing health records. It has been an arduous and necessary journey worth celebrating. Now, however, healthcare organizations are faced with two major challenges.
First, many organizations are struggling to deliver a reasonable payback on their investments. And second, advances in scientific computing and analytics—things like next-generation electronic health records, genomic sciences, precision medicine, predictive analytics and machine learning, the enterprise imaging revolution, advances in electron microscopy (including cryo-EM), exploring unstructured data such as digital notes and more—have resulted in an unbounded data explosion.
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Enjoy!
David.