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."

Monday, August 15, 2016

Weekly Australian Health IT Links – 15th August, 2016.

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

Quite a busy fortnight  and lots of headlines to follow up. I hope you enjoy the browse!
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Appointment of CEO for the Australian Digital Health Agency

Minister for Health, Sussan Ley, has announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems.
 Page last updated: 01 August 2016
1 August 2016
Minister for Health, Sussan Ley, today announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety. 
“Most importantly, the new Agency is the system operator for the Government’s recently launched My Health Record System which is a secure, online summary of people’s health information that can be shared with doctors, hospitals and healthcare providers with the permission of patients. This gives people more control of their health and care and with access to new digital apps and online services the Australian community is benefiting from the modern information revolution,” Minister Ley said.
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Can UK digital whizz resurrect eHealth?

By Marie Sansom on August 3, 2016
The new agency responsible for e-health records has secured the services of the man who oversaw the design of a new digital health strategy for Britain’s National Health Service (NHS).
Tim Kelsey, who was the first National Director for Patients and Information in NHS England, will head up the Australian Digital Health Agency (ADHA), which came into being on July 1 this year.
He will lead national digital health in Australia, including resuscitating the troubled My Health Record system, where patient’s health records are shared between doctors, hospitals, healthcare providers and specialists, with permission from patients.
Kelsey’s CV shows a long-term commitment to transparency and forcing up healthcare quality by using data for public good but he has also been embroiled in some controversy in the past.
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Australia hires former head of controversial UK care.data plan

Tim Kelsey to head new Digital Health Agency

3 Aug 2016 at 23:22, Richard Chirgwin
The Australian government's love affair with digitisation experts from the United Kingdom continues, with former National Health Service (NHS) digital head Tim Kelsey made boss of the antipodean Digital Health Agency (successor to the National e-Health Transition Agency).
The leave moves Telstra Health shy a director, since that was Kelsey's destination when he announced his resignation from the NHS in September 2015.
Kelsey quit the NHS after several years in charge of its highly-controversial care.data program, an data sharing operation that was criticised as privacy-invasive.
In 2014, he went on the record saying that “"no one who uses a public service should be allowed to opt out of sharing their records. Nor can people rely on their record being anonymised.”
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Editorial: Census disaster dents trust in digital future

The Editor, The Courier-Mail
August 11, 2016 12:00am
A FUNNY thing about Australians is how cheerfully willing they are to participate in collective governance.
The unfunny thing is when that goodwill is completely shattered by something like the debacle of the 2016 Census.
Despite a slew of conspiracy theories about how our deepest secrets would be stolen by the new computerised Census, millions of people gave up their Tuesday evenings, their dinners, their TV shows, their homework supervision, their bedroom rituals, to sit down and fill in a form. That’s not typical of national responses to bureaucracy – the US has (usually largely ineffectually) to prod its citizens to even vote.
All those Australians trying to participate in the Census were rewarded by hours of frustration and of stress about the consequences of not completing that form.
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#FHIR is 5 years old today

Posted on August 11, 2016 by Grahame Grieve
Unofficial FHIR project historian Rene Sponk has pointed out that it’s exactly 5 years to the day since I posted the very first draft of what became FHIR:
Five years, on August 18th 2011 to be precise, Grahame Grieve published the initial version of FHIR (known as RFH at the time) on his website. The date of the initial version was August 11th – which is the reason for this post today. Congratulations to all involved for helping to create a success – FHIR has gained a lot of interest over the past few years, and a normative version will be published in the near future.
Wow. 5 years! Who would have thought that we’d end up where we are? I really didn’t expect much at all when I first posted RfH back then:
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#GottaCureEmAll – Pokemon GO teaches healthcare a big lesson

August 1, 2016
If we can believe what we are seeing, Pokemon GO is the world’s most effective, and most widespread, population weight loss intervention. Already, its users spend more time on the game than on other wildly popular mainstream social media platforms like Facebook, Snapchat and Twitter. Over the space of a few weeks, it has prompted millions of children and teens to get off the couch, turn off Netflix, leave the laptop in their bedroom, and walk out into the world to breath the fresh air. More than a few adults have done the same.
Healthcare should pay attention. While healthcare researchers are slowly coming to grips with ‘new’ ideas like gamification and social media to defeat obesity, the game industry has jumped the queue and may have already done it. Silicon valley has drawn down on its deep well of expertise in building large and complex software systems, and in embedding such systems into the real world. They have drawn on their deep experience with and understanding of the psychology of online social media, of what makes games ‘fun’, and what makes them ‘sticky’.
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Australia’s digital divide is leaving the rural community behind

JIM GALL, The Weekly Times
August 11, 2016 12:00am
THE recent experience of yet another drawn-out, clunky and non-transparent voting process to decide Australia’s 45th parliament has reminded me just how antiquated this country is in respect to our collection and management of data.
If Australia were run like a commercial business with even a modicum of marketing expertise, the election process would be simple, fast, transparent and educative for both candidates and voters.
The Australian Electoral Commission could send out an Electronic Direct Mail (EDM) to the electorate via their Customer Relationship Management (CRM) database with a live link to the AEC website profiling candidates in every electorate.
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Planning for privacy in health research

Australia August 8 2016
Information is critical to the conduct of health and medical research. Much of the time the information relates to individuals. Higher education institutions regularly collect, use, disclose and hold information, including health information, for research purposes. The richness and availability of information sources for research purposes, including digital data from the public domain, together with the ease with which data can cross jurisdictions, and the ability to mine and analyse it, all require researchers and human research ethics committees (HRECs) to engage directly with a complex range of multi-jurisdictional privacy obligations.
The challenges are even more onerous when health information is involved as it is considered to be more sensitive than other personal information (and is legally defined as such ). It is therefore afforded a higher degree of protection, which means there are more stringent obligations on individuals and entities who collect health information for research purposes. However privacy legislation also makes special provisions to permit the use of personal information in health and medical research where the public interest in the research activities substantially outweighs the public interest in the protection of privacy.
This article provides a recap of the privacy framework that applies to health information that is collected for research purposes and offers some practical insights into preparing for and managing privacy issues.
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11 August, 2016

At $42.50 per keystroke, ePIP’s EMR incentive might just bite

Posted by Jeremy Knibbs
Medical Director’s ePIP tool simplifies the new ePIP incentive so much you can earn about $42.50 for each tap of your keyboard
According to Medical Director’s Chief Medical Officer Dr Andrew Magennis, it takes only 200  keystrokes  per quarter for a  GP practice to earn the new ePIP incentive using Medical Director’s new ePIP tool.
In May, ePIP switched focus from practices having the communications capability to upload shared health summaries to them actually sending them to the MyHealthRecord (MHR) database. A practice can earn up to $50,000 per year if they send up to 0.5% of their SWPE (standardised whole patient equivalent) count in shared health summaries to the MHR database per quarter over one year.
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Brain-controlled robots and VR help paraplegic patients feel and move limbs again

The team behind the Walk Again Project wanted to teach paralyzed patients how to walk using robotic leg supports, but the results were much better than they expected.
By Kelly McSweeney for Robotics | August 12, 2016 -- 19:01 GMT (05:01 AEST) |
When the Walk Again Project was founded in 2013, an international consortium of scientists had an ambitious goal to teach paraplegic patients to walk using a brain-controlled robotic exoskeleton. But a year into the study, they were surprised to discover that the results were even better than they could have imagined: the patients could feel and move their legs again.
It's hard to say exactly which aspect of the therapy is responsible for the remarkable recovery, because the project involved a combination of three different setups. Additionally, the study only involved a small sample of eight patients. A comprehensive clinical trial will be necessary in the future, but the results are still quite ground breaking nonetheless.
All of the patients had been previously diagnosed as being completely paraplegic, but after long-term therapy with brain machine interfaces (BMIs), they all showed some improvement. After several years of being paralyzed, patients could feel and sometimes even move their limbs again. The treatment also improved bladder and bowel functions. One year after the start of the project, half of the patients recovered enough sensation and muscle control that their doctors upgraded their diagnoses from complete to partial paralysis.
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Webinar: Designing a workflow for registering patients for a My Health Record

Created on Tuesday, 09 August 2016
You are invited to attend a new webinar brought to you by the Australian Digital Health Agency (the Agency), and the Australian Association of Practice Managers (AAPM). This webinar is designed to provide targeted information and training on the My Health Record system to practice staff.
This webinar will take place on Friday 19 August, 1:00pm - 1:45pm AEST.
The webinar will cover the following:
  1. Design a practice system for registering new and existing patients
  2. Share success stories from other practices
  3. Create a practice-specific dialogue for registering patients
  4. Identify privacy and access restrictions for administration staff
  5. Discuss policies, consent, and standards appropriate to My Health Record
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Doctor 'TripAdvisor' bothers AMA

29 July, 2016 
A rate-my-doctor website, dubbed the 'TripAdvisor' of healthcare, has been welcomed by the federal government but met with caution from doctors.
Private health insurers Bupa and HBF have agreed to join the Whitecoat doctor directory and customer review website founded by rival nib - expanding its reach to about six million privately insured Australians.
The health funds say Whitecoat will promote competition and improve transparency among high-charging doctors.
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Hospitals line up to receive notorious SA health software

By Paris Cowan on Aug 4, 2016 12:21PM

Minister reveals future EPAS sites.

South Australia’s Health Minister Jack Snelling has revealed the list of hospitals next in line to receive the notorious EPAS patient records system under the state’s $421 million metropolitan rollout.
Despite the headaches caused by the electronic patient administration system (EPAS) over the past five years, Snelling told budget estimates this week he was confident the installation at the Lyell McEwin Hospital and Flinders Medical Centre in Adelaide’s suburbs would “probably go pretty smoothly”.
His comments come despite a concession that the health department will almost certainly have to go back to the state treasury in coming years to beg for more money to complete the late-running project.
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SA govt settles unlicensed software lawsuit

By Paris Cowan on Aug 4, 2016 4:20PM

Vendor agrees to renew licences rather than go to trial.

The South Australian government has managed to resolve its differences with hospital software provider Global Health, preventing a potentially messy Supreme Court trial set down for the end of this year.
The state has been locked in a legal spat with the Australian distributor of a legacy patient administration solution known as CHIRON since last year, over the health department's refusal to stop using the 1980s, out-of-license software in at least a dozen regional public hospitals. 
SA Health is the only remaining user of the long-unsupported product, and the vendor has complained that the continued installation represents an unwanted drain in its Australian resources.
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MedsASSIST hits two million recorded transactions

Monitoring system for medicines containing codeine has reached a significant milestone

More than two million transactions involving OTC medicines containing codeine have been recorded by pharmacists participating in the MedsASSIST program, reports the Pharmacy Guild of Australia.
And about 65% of community pharmacies have used MedsASSIST since its national roll out in March, says the organisation.
MedsASSIST is a real-time recording and monitoring system for medicines containing codeine, which was developed by the Pharmacy Guild in response to concerns about patient safety.
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What do we do with all this patient-generated health data?

3 August 2016
GEORGE ORWELL would be amused. Modern technology is watching us even more than he predicted — every step we make, every pill we take, every time we wake. And we can’t get enough.
Over one-fifth of Australians now track their health using a wearable device, and almost one-third with mobile phone apps. 
The trend is part of a larger shift towards patients wanting a more collaborative role in their healthcare, says Melbourne GP Dr Nathan Pinskier, who chairs the RACGP’s ehealth expert committee. 
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Outpatients’ telehealth program is saving time and money

on August 8, 2016 at 11:20 am
Senior Physiotherapist, Stephanie Carroll, walks us through the successful trial of a telehealth program being used in the Post Arthroplasty Review (PAR) clinic at St Vincent’s Hospital Melbourne (SVHM).
SVHM is responsible for approximately 700 joint replacements a year with each of these patients requiring routine reviews for up to ten years post surgery. SVHM provides an Elective Surgery Access Service (ESAS) which offers surgery to patients that have endured long wait times elsewhere. Often patients are required to travel long distances to attend their review appointments.
In 2008, a physiotherapy review clinic led by Advanced Musculoskeletal Physiotherapists (AMP) was established to assist with the increasing number of reviews traditionally completed by orthopaedic surgeons.
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MyHealth Record limited by quality of GPs’ e-records

Antony Scholefield | 2 August, 2016 | 
We keep hearing about the potential of the Federal Government’s MyHealth Record system, but a GP researcher has warned it will always be limited by the quality of GP software.
According to Dr Graeme Miller (pictured), medical director at the University of Sydney’s Family Medicine Research Centre, MyHealth Record had to be “dropped to the lowest common denominator” to accommodate low-quality systems.
In a bid to boost the system, the Sydney GP is calling for the government or the RACGP to introduce minimum standards for practice-based e-health record systems.
Dr Miller has co-written a policy brief for the Deeble Institute for Health Policy Research — a think tank that aims to develop objective publications on evidence-based health policy for policymakers — advocating the move.
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The “Uber-isation” of healthcare in Australia

  • Martin Kopp
  • The Australian
  • 11:35AM August 3, 2016
Australia’s healthcare industry is on the cusp of its “Uber moment”.
Smartphones, health apps, and wearables empower users to take more control of their health, and make better informed decisions. The days of simply tracking the number of steps taken have been replaced by analysis of blood glucose levels, heart signals, and automated reminders telling us to do more exercise. The list of new capabilities goes on.
Massive change is also underway in the healthcare industry. Vast stores of data can be mined to tailor treatments to better suit individual patients, and in some instances the cost of analysis and care have fallen dramatically. For instance, the cost of sequencing a human genome is US$99 — down from a cost of US$2billion the first time it was achieved.
Among researchers and life sciences companies, the understanding of genetics and genomics — and how they drive health, disease and drug response in each person — is advancing each day. This gives medical professionals insight into better disease prevention and enables more accurate diagnoses, safer drug prescriptions, and more effective treatments.
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Healthcare industry embracing the digital workspace

VMware says the digital workplace, or digital workspace, is making a big impact on the healthcare sector
Stuart Corner (Computerworld) 09 August, 2016 13:17
VMware says the digital workplace, or digital workspace, is making a big impact on the healthcare sector.
The terms ‘digital workplace’ and ‘digital workspace’ might appear synonymous, but Sumit Dhawan, senior VP and GM of desktop products at VMware, makes a very clear distinction. Digital workplace, he says is simply an acknowledgement of the fact that a person’s workplace is no longer a fixed location, but whatever physical location they are working, thanks to digital technology.
Digital workspace, on the other hand, is the umbrella term for all the technologies that make the digital workplace a reality.
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Instant digital medical records for every Australian: the future is almost here

Published: 02 August 2016

It’s the sensible step that will make every visit to the doctor a whole lot easier.

With the aim of no longer having to chase up records or re-order expensive tests, Medicare is looking to have a new online database that that will keep all your health records in one place.
The plan to digitize all medical records for Medicare patients is called My Health Record. It’s seen as a huge leap forward in patient care. Doctors and specialists will be able to access your health information from a single location.
The measure means your complete medical history will be on record, including things like all prescription medications, blood tests, scans results, and organ donor preference.
In an emergency, it could mean doctors will be able to make quick, more accurate decisions based on specific health history, even if the patient is unconscious and there’s not an immediate family member to speak to.
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1 August, 2016

Courses to raise digital awareness for doctors

Posted by julie lambert
The Health Informatics Society of Australia is offering a suite of new, self-paced online training courses for doctors to learn about the rapid technological changes overtaking the profession
Former society chair David Rowlands, who has developed the courses, stressed the goal was digital awareness rather than academic rigour.
“It’s about telling clinicians that they are now in a digital business, and in a hyper-connected world there are things you need to know.  Otherwise, mistakes can proliferate as quickly as good things can,” he told The Medical Republic.
“We are trying to raise awareness of key stumbling points and the critical success factors in digital health.”
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2 August, 2016

Planets start aligning for GP telemedicine

Posted by Jeremy Knibbs  
Telemedicine and tele-consultations might be set for a boom as the technology, commercial interest and doctor acceptance all start to kick in
GPs appear to be shifting their views on  tele-consultations with the technology being identified as the second most important technology that can help them improve patient outcomes in a survey released by Medical Director last week.
The only technology with greater immediate potential, was online booking services and appointment kiosks, with more than 30% of GPs saying this ranked as the No1 technology to engage with, closely followed by telemedicine on 24.65%.
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At $6000 a pair talking glasses give hope to the blind

  • The Australian
  • 12:00AM August 1, 2016

Rachel Baxendale

Retired teacher Harry Simon, 71, is heartbroken that blindness has robbed him of the ability to read to his four grandchildren, but new technology in the form of a ­wearable text-to-speech device may change that.
The OrCam device consists of a tiny camera and speakers attached to a pair of glasses, ­enabling the wearer to recognise faces and banknotes, or read a newspaper or menu simply by pointing a finger.
Mr Simon tried the glasses for the first time last week at the Royal Society for the Blind Canberra’s annual adaptive technology expo. He said they had the potential to significantly improve his life, giving him the freedom to receive information without ­having to go through the cumbersome process of scanning things with a smartphone text-to-audio app, or with a machine he has at home.
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Zebra Technologies: refine traditional asset management to digitise healthcare

  • The Australian
  • 12:00AM August 2, 2016

Supratim Adhikari

Healthcare is shaping up as the next frontier for digital technology, but that doesn’t mean we have to reinvent the wheel, according to Zebra Technologies’ senior technology director Wayne Harper.
While Australian healthcare is making strides towards digitalisation, Mr Harper says there’s room for improvement, especially when it comes to the quality and ­efficiency of patient care.
His solution is to repurpose the concepts refined for traditional asset management and make them applicable to the healthcare sector.
“It’s all technology that exists today, it’s proven and used in the enterprise and can be really useful in the healthcare space,” Mr Harper said.
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Enjoy!
David.

Sunday, August 14, 2016

I Really Think This Is A Major Procedural Error That Needs To Be Fixed With The myHR. What Is Happening Right Now Is Wrong I Believe.

As regular readers will know I spent a much too exciting few days in the Royal North Shore Hospital earlier this week!

I escaped a few days ago and yesterday decided to have a look at my My Health Record to see if anything had been uploaded as I result of my admission.

To my surprise, and with no discussion with me, I found a very detailed 8 page Discharge Summary had been uploaded to the My Health Record by not the clinical team but a Hospital Pharmacist.

What I don’t understand is, while the GP is meant to discuss what will be uploaded to a Shared Health Record with the patient there seems to be no such process for Discharge Summaries.

I am not all that concerned that this happened but I suspect that at least 2 patients I shared a room with for a while (one of each had a potentially stigmatising family undisclosed illness and the other of which may have disclosed to their clinicians some potentially problematic past history – and yes I am being vague deliberately) may have hoped for the opportunity to discuss the contents of the upload before it happened.

To me when a hospital pharmacist takes it upon themselves to upload such material with no discussion or warning, and with no consideration of material that might be reasonably be excluded, to avoid possible discrimination or embarrassment, we have moved a little over the top!

I don’t see the Government as being entitled, of right, to all this information without some discussion or consent with the patient.

When a person is mentally competent I see no reason for the upload not to be reviewed by the patient before it is uploaded – even if to allow them to know what is happening and block access later should they choose to. At the very least the patient should be told so they can review what has been uploaded – should they desire. I would have had no idea what had gone one had I not checked.

Much better to have an upload to the nominated GP and not indirectly to some monolithic Government system. Even more so after the Census debacle!

David.

AusHealthIT Poll Number 331 – Results – 14th August, 2016.

Here are the results of the poll.

Have You Noticed Real Progress Being Made In Public Hospital Clinical Computing In Your State? (Please leave comments in last poll comment section)

Yes 17% (12)

No 53% (37)

I Have No Idea 30% (21)

Total votes: 70

It seems the improvement I found at RNSH might be a bit isolated!

A good turnout of votes.

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

David.

Wednesday, August 10, 2016

Observations On A New Hospital EMR At RNSH From The Point Of View Of A Curious Patient!



Note: All these notes are based on discussions with a range of staff at various levels from Consultants to Ward Porters – overall probably chatted with 10-15 different people.

Was good to see pretty strong privacy focus – to the extent of taking some fast talking to get to be able to access my record!

All this is E&OE as I may or may not have accurately grasped what I had been told. (I was a might sick for a good part of the time!)

Key Points.

Initial Implementation was in A&E and have managed to become paperless with clinical charting, patient records, results (image integrated with text etc.). Implementation in the wards is quite recent (months)

Screens are impressively clear and high resolution – and speed is really good.

System works by selecting ward census then patient and then has lots of tabs down left side to move into different functionality.

I was easily able to look up my new results with no training at all so it works pretty intuitively!

The COWs are a feature. Residents and registrars glide them around and make notes and place orders as they see patients. Battery powered and fully secured with scrub-able illuminated keyboards and full size high-res screen on really secure trollies. (COW = Computer On WheelS)

WiFi for the computer system is everywhere and fast!

There appear to be secure Wi-Fi points for clinicals, byod, mob-xray, and data. As well an open guest account I assume I was not meant to use!

Acceptance of the system is broadly aged based and seems also very much related to the level of typing skills.

Was interesting to note placing a ‘request on the system’ was almost seen as having done what was requested and needed. The workload communication was widely used.

Negatives:

Some staff worried about privacy of the large screen census boards on the wards.

Senior staff can find navigation (menus can be rather deep) and system freezes frustrating.

Was a bit sad to see observations which were gathered by superb and very smart trollies being manually typed into the system rather than being interfaced!

Lessons:

Where possible specific tasks for senior staff might be set up as scripts.

It is important to minimise system unresponsiveness as this can frustrate staff.

Organisation of free text information is still a challenge. Reports are fine and findable – progress notes seem to be a different story – suffer rather from the PCEHR pile of notes issue.

It was not clear just how useful the search functions were.

Technology:

All the Clinical Ward PCs run an enterprise level version of Win 7 – but I did spot the odd Win XP screen in radiology.

Each PC is named and has a unique IP address and while many are wired at desks – the COWs all run wi-fi in the Hospital.

The number of terminals / COWS seems nicely over-provisioned – there is access everywhere that seem reasonable.

Security:

Log on is username / password to the relevant domain.

Once logged on the username does not expire but password does pretty quickly.

(user name is 8 or 10 digit staff number)

Home Nursing Service – Remote Visit Support:

Using a laptop the initial admission to the APAC Service was done on line to another copy of Cerner Millennium – over a remote WiFi link.

The laptop provided access to all information held in my record within the hospital – and worked well.

Overall:

This implementation is clearly a very complex EMR with very rich functionality that is really working pretty well indeed. I have often wondered would I ever see at least some of the potential I knew was possible actually delivered but this is not bad at all! It works, is capturing rich information and has essentially got rid of paper notes – except at present for medication charts.

What is now in place is clearly a key part of the nervous system of the Hospital.

Once the more advance information management issues are solved there is the basis of a really useful and important system here that will in all likelihood make a very positive difference to care. This is all much better than I dared hope!

Well done to all those involved in getting to this point!

David.

Sunday, August 07, 2016

AusHealthIT Poll Number 331 – Results – 7th August, 2016.

Here are the results of the poll.

The ADHA Is Apparently Planning 'Compulsory Health Records for all Australians' According To A Slide From HIC 2016. Do You Agree?

Yes 9% (9)

No 87% (88)

I Have No Idea 4% (4)

Total votes: 101

Seems that idiotic idea gets the big thumbs down!

A great turnout of votes.

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

David.

Blog Alert For When I Escape The Ancient And Honourable St Leonards By The Railway (RNSH)

I have been using my stay to have a lot of chats with the staff using the NSW Health EMR at Royal North Shore.

A lot of the feedback has been really, really encouraging indeed.

Summary: I think this system is really working and making positive difference!

Sure there are gripes and grumbles, but overall high marks indeed.

Lots more when I escape!!!

David.

Saturday, August 06, 2016

Weekly Overseas Health IT Links – 6th August, 2016.

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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EHRs help improve the quality of inpatient nursing care

Jul 28, 2016 2:31pm
The use of electronic health records by hospital bedside nurses can improve the quality of care provided without increasing direct costs, according to a new study in the Journal of Nursing Administration.
The researchers conducted a retrospective analysis in a 431 bed urban hospital with 10 medical/surgical units and two critical care units. They measured the impact of implementing an integrated EHR on the quality of nursing care--reviewing hospital-acquired falls, hospital-acquired pressure ulcers, ventilator associated pneumonia (VAP), central line associated blood stream infections (CLABSI) and catheter associated urinary tract infections (CAUTI).
They found that EHR adoption had an overall positive effect without increasing costs. The rates for falls, CAUTI and CLABSI fell; for instance, the rate of falls declined 15 percent. The ulcer and VAP rates saw negative results at implementation but then followed with a significant rate reduction that surpassed the rate in the preimplementation period. Moreover, the costs were initially negatively impacted but returned to the baseline. 
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Patients who discuss treatment online are more satisfied

Jul 29, 2016 11:00am
Patients who seek information online and discuss their healthcare treatment choices via email and on social media platforms feel better about their decisions, according to research published in JAMA Oncology.
Researchers analyzed a sample of 2,460 women recently diagnosed with breast cancer. They found 41 percent of the women responded to their diagnosis by discussing it through e-mail, text messages, Facebook, Twitter and online support groups, to determine the best treatment options and their therapeutic value.    
The study found a relationship between those patients who used online communication the most and those who weighed their treatment decisions with more care as well as reported greater satisfaction after making that decision.
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Congress offers glimmer of hope for patient matching

Jul 29, 2016 11:06am
An industry trade group sees signs of hope that Congress will help move patient matching efforts forward--but they're also keeping an eye on the 2016 elections.
In a report accompanying a fiscal 2017 funding bill, the House appropriations committee directed HHS to provide technical assistance to private-sector-led patient-matching initiatives.
"AHIMA is very encouraged," Lynne Thomas Gordon, CEO of the American Health Information Management Association, said in an interview at Healthcare Info Security.
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EHRs and digital health tools 'dramatically transforming' care experience, patients say

A new study found that patients of all ages, with Baby Boomers leading the charge, are interested in accessing medical records online and tapping into portals to book appointment, pay bills, and refill prescriptions. 
July 29, 2016 09:28 AM
Nearly 75 percent of patients expressed a high level of interest in accessing their electronic medical records, according to new research, and 33 percent indicated that EHRs have already changed their experience for the better.
"The patient experience is dramatically transforming,” CareCloud CEO Ken Comee said in a statement. “Patients of all ages are actually embracing digital online patient engagement tools from scheduling appointments to accessing their medical records and making online payments."
Contradicting stereotypes that millennials are the leading technology adopters, a CareCloud survey of 1,443 patients determined that Baby Boomers (51-65 years of age) are the group most likely to use healthcare tools.
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Cleveland Clinic slashes unplanned ICU transfers, patient length of stay with population health and remote monitoring tools

The health system is using eHosptial and eCMU to create command centers where clinicians gather to keep an eye on the sickest patients and, in turn, more effectively handle rapid response calls. 
July 27, 2016 07:08 AM 
BOSTON — While electronic health records have had many positive effects on medicine, like many technologies EHRs also come with certain tradeoffs.
The demise of a single chart for each patient – and the need for multiple members of a care team to share it – removed a point of community and collaboration from care teams.  
Now Cleveland Clinic is looking for ways to use technology to bring that collaboration back, according to Associate CIO William Morris.
"You would all fight for the one chart. And you’d fight for it, but it would force these conversations. Five, 6, 7 years ago any nurse’s station was Grand Central Station. It was a packed resource, everyone jockeying for that one chart,” Morris said at the mHealth and Telehealth World Congress here. “But now it’s become a ghost town. You miss this natural collaboration. This is why we feel like there’s opportunities to bring that back to the nurse’s unit and actually use visualizations in population health, to bring these collaborations."
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Brain Training Protects Against Cognitive Decline, Dementia

Megan Brooks
July 25, 2016
TORONTO ― A cognitive training program targeting speed of processing in healthy elderly adults cut the risk for dementia nearly in half over a 10-year period in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study.
"We believe this is the first time a cognitive training intervention has been shown to protect against cognitive impairment or dementia in a large, randomized controlled trial," Jerri Edwards, PhD, of the School of Aging Studies and Byrd Alzheimer's Institute, University of South Florida, in Tampa, said in a statement.
Dr Edwards presented 10-year results from the ACTIVE study here at Alzheimer's Association International Conference (AAIC) 2016.
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Four Technologies You Should Be Using in Your Practice

July 28, 2016
Physicians and their practices are becoming pretty comfortable using technology, according to the data from Physicians Practice's 2016 Technology Survey, which features 1,568 respondents from across the country. Apart from EHRs, which have made significant inroads into independent medical practice, there are a plethora of other technologies that can make a physician's life just a little bit easier and are increasingly being adopted into their practices.
Not surprising, a clear majority (78 percent) of practices say they use billing and coding software. Far more interesting, from our perspective, is that roughly a third of respondents say they use technology to conduct data analytics (33 percent) and manage their revenue cycle (29.4 percent), and 16 percent use technology to facilitate patient check-in and registration ( a 2 percent increase over 2015). While small, this number is significant given the fact that every dollar counts in medical practices, especially so for the smaller groups. In fact, when asked "What is your most pressing information technology problem?" after citing EHR-related problems, 8 percent of survey respondents said, "Costs to purchase and implement other technologies."
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Viewpoint | July 28, 2016

What Happens When Underperforming Big Ideas in Research Become Entrenched?

Michael J. Joyner, MD1; Nigel Paneth, MD, MPH2; John P. A. Ioannidis, MD, DSc3
JAMA. Published online July 28, 2016. doi:10.1001/jama.2016.11076
For several decades now the biomedical research community has pursued a narrative positing that a combination of ever-deeper knowledge of subcellular biology, especially genetics, coupled with information technology will lead to transformative improvements in health care and human health. In this Viewpoint, we provide evidence for the extraordinary dominance of this narrative in biomedical funding and journal publications; discuss several prominent themes embedded in the narrative to show that this approach has largely failed; and propose a wholesale reevaluation of the way forward in biomedical research.
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HIT Think Five key privacy weak spots in healthcare facilities

Published July 29 2016, 3:35pm EDT
Amid all the efforts to protect digital data in the healthcare industry, it can be easy to overlook the importance of protecting data in its physical or visual state.
Healthcare organizations continue to invest in and improve their cyber defense, forcing hackers seeking patient information to evolve their tactics in acquiring it. One of those tactics is visual hacking, which is the viewing or capturing of sensitive, confidential or private information for unauthorized use.
Healthcare organizations have an obligation to take all reasonable measures to protect sensitive data in this era of data breaches. This includes protecting patients’ personal demographic, health and financial information.
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Worries about data quality put pressure on IT pros

Published July 27 2016, 4:06pm EDT
Data quality issues continue to plague the large majority of organizations, according to a new report from research firm TDWI.
The study found that 86 percent of the 411 organizations it surveyed are not fully satisfied with the quality of their data, and 94 percent are not very satisfied with their processes for addressing data duplication.
That puts a broad array of IT executives and professionals—including business and data analysts, line-of-business and departmental directors—under pressure to reduce the time needed to extract meaningful insights from data. As a result, more than 80 percent are evaluating self-service data preparation and infrastructure changes to accelerate information-driven decision-making.
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Twelve million records shared in Merseyside

Ben Heather
28 July 2016
More than 12 million records have been shared across Merseyside, as an increasing number of health and social services sign-up to share information.
At the iLinks Innovations conference in Liverpool earlier this month, it was revealed that record sharing in the North Merseyside health economy has continued to grow, albeit at a slower rate.
Nearly 6 million records were shared in 12 months to July, compared to 5.5 million the year before.
The drive to share is part of the region’s iLinks transformation programme, which aims to improve patient pathways and outcome through improved use of technology.
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Special report: radiology information systems

Increasingly, trusts need to collaborate on reporting on images to cope with demand. Is that best done using a RIS or another core IT system? Kim Thomas reports. are now well established at many trusts; and the quest is on to extend them to new areas. Daloni Carlisle reports.
The National Programme for IT formally ended earlier this month. Apart from a few stragglers, such as the handful of London trusts running RadCentre, trusts have replaced their radiology information systems or, in most cases, upgraded their existing one.
Some trusts that opted for tactical extensions to their existing contracts may go out to tender within the next year or two, while Scotland has issued a prior information notice and is expected to replace its existing RIS within the next year (currently, Scottish boards are using either Carestream or HSS RIS.)
The push for collaboration
Vendors agree that the main driver for new RIS and picture archiving and communications system procurements is the need for trusts to collaborate. The shortage of radiologists, combined with an increase in the number of images, has led to some trusts using expensive outsourcing companies to report on images.
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Switching EHRs has no impact on patient safety or mortality rates, Harvard researchers say

Despite what appear to be common industry fears about new electronic health records having adverse effects on care delivery, Harvard’s School of Public Health officials said recent research should be encouraging to doctors.
July 28, 2016 11:09 AM
A Harvard study found that switching to a new electronic health record platform has no effect on patient safety or mortality rates.
"Physicians' tremendous frustration in switching to new electronic health records can spill over into concerns that patient care is actually worse because of these systems," said Harvard assistant professor Michael Barnett, who led the study. "Happily, our results suggest that switching to a new system is a challenge that hospitals are prepared to handle safely."
Researchers from Harvard Medical School and the Harvard T.H. Chan School of Public Health, in fact, considered the short-term impact of implementing EHR systems nationally, and identified 17 hospitals that went live in one day. 
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Are EHR vendors poised to extinguish public HIEs?

With the number of health information exchanges declining since 2012, and EHR makers creating their own exchanges, the latter might just be a more effective way to share patient data. 
July 28, 2016 07:12 AM
The longevity of public health information exchanges has long been obscured with questions of financial sustainability and the viability to provide services hospitals cannot undertake on their own.
This month researchers at the University of Michigan found an 11 percent drop in the number of state and community exchanges between 2012 and 2014 from a total of 119 HIEs down to 106 — and perhaps the more telling discovery is that all are facing barriers to success while only half of those reported financial stability.
"Our results suggest early signs of a shakeout as these efforts try to prove they are creating value," University of Michigan’s Schools Public Health Assistant Professor Julia Adler-Milstein said in a statement.
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Connected health advances care across the globe

Connected health - technology-enabled care solutions that facilitate communication between patients, providers and caregivers - is becoming more prevalent in the United States and spreading across the globe.
July 28, 2016 08:15 AM 
By Chris Edwards, Chief Marketing Officer, Validic
Connected health – technology-enabled care solutions that facilitate communication between patients, providers and caregivers – is becoming more prevalent in the United States. But, this idea of improving outcomes and patient experience with digital-health technologies is also spreading across the globe. There are a number of examples of countries and companies abroad launching successful and innovative strategies.
For example, an African governmental body recently provided residents of a remote village with smartphones that enable them to monitor their vital signs. Patients are then able to supply that information, which includes blood pressure and heart rate data, to doctors and caregivers – who, in turn, can respond with treatment advice. Connected technology makes it possible for this population to receive much-needed clinical care remotely, which saves the men, women and children from walking for days to visit the nearest healthcare facility.
In the United Kingdom, clinicians are monitoring patient’s lifestyle data – such as sleep, exercise, diet, weight, blood pressure and blood-glucose levels – to then leverage real-time video consultations with patients. And, in Australia, a company is leveraging digital-health devices to monitor and manage the health, wellness and nutrition of members of the Australian Rugby team in an effort to ensure that these elite athletes are in top physical condition for key competitions.
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President signs order to improve cyber attack responses

Published July 27 2016, 6:42am EDT
President Obama has released Presidential Policy Directive/PPD 41, establishing principles to govern responses to major federal and private sector cyber attacks.
Although not specifically focused on cyber incidents at healthcare organizations, the directive does recognize the serious impact that such incidents can have on “public health and safety.”
“While the vast majority of cyber incidents can be handled through existing policies, certain cyber incidents that have significant impacts on an entity, our national security or the broader economy require a unique approach to response efforts,” according to the directive. “These significant cyber incidents demand unity of effort within the Federal Government and especially close coordination between the public and private sectors.”
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AHA lauds growth in patient access to electronic records

Published July 26 2016, 4:41pm EDT
Prodded by requirements in the Electronic Health Records Incentive Program, hospitals are increasingly making it easier for patients to access their medical records, according to data collected by the American Hospital Association.
Last year, 92 percent of hospitals could let patients view their records online, more than double the percentage that were able to do so in 2013, when only 43 percent of hospitals could deliver that information to patients, the industry’s trade organization for hospitals said in a report released last week.
Other results quantifying the increasing ability of hospitals to communicate with patients are just as striking, the AHA report said.
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Researchers leverage EHR data to reduce alarm fatigue

Published July 27 2016, 6:32am EDT
Hospitals are places where clinicians are typically bombarded with a variety of alarms sounding from medical devices. However, the noise has become a serious distraction for clinicians who are being bombarded daily with thousands of alarms—the vast majority of which are false or not clinically actionable. All that noise is impacting patient safety, critics say.
Not surprisingly, providers have become desensitized to these alarms, a phenomenon known as alarm fatigue. To help address the problem, a 2014 Joint Commission National Patient Safety Goal urged hospitals to prioritize alarm system safety and to develop policies and procedures to manage alarms and alarm fatigue. Yet, progress has been slow.
“There are tens of thousands of alarms that go off every single day at individual hospitals, and providers are expected to triage all of those stimuli on a moment-to-moment basis when they’re trying to care for patients,” says Veena Goel, MD, a pediatric hospitalist for the Palo Alto Medical Foundation and adjunct clinical assistant professor at Stanford Medicine.
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Emisoft unveils free ransomware decryptor to unlock your own data

The anti-malware vendor said that hospitals hit by a Stampado ransomware attack can download their software to gain back access to locked data.
July 27, 2016 07:06 AM
Anti-malware software maker Emisoft has posted a free decryptor that hospitals and other organizations hit by the ransomware strain Stampado can use to unlock their data.
Stampado, which is being aggressively advertised on the dark web for $39 in Bitcoin, boasts similar functionality to Cryptolocker and other ransomware strains.
First discovered by Heimdal Security firm, Stampado is fully-functional and when installed it encrypts the victim’s files using AES encryption. From there, the code demands a ransom to decrypt files, according to malware removal and computer forensics specialist Lawrence Abrams, who founded the tech support site BleepingComputer.com. 
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Canadian clinicians report 'positive' experience with interoperability

Jul 27, 2016 8:44am
Most Canadian healthcare professionals are enjoying a positive experience with information sharing, according to a study published this month in BMC Medical Informatics and Decision Making.
The clinical components of interoperable electronic health records (iEHRs) are at varying levels of availability across Canada. All provinces and territories have at least two of four clinical components (diagnostic imaging, lab test results, dispensed drugs and clinical reports/immunizations) available; five provinces/territories have all four components available. About half of healthcare professionals (250,000) in the country indicate that they electronically access data from outside their main practice settings.
The researchers, affiliated with Canada Health Infoway, which tracks EHR use in Canada, conducted a series of surveys of 2,316 iEHR users in six Canadian provinces and territories between 2006 and 2014 to determine what iEHR users thought of their experiences with data exchange. They found overwhelmingly positive results.   
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Report: Healthcare tops for ransomware incidents in Q2

by Dan Bowman 
Jul 27, 2016 11:32am
The healthcare industry, far and away, led all others in volume of ransomware detections in the second quarter of 2016, according to a recent security firm report.
Roughly 88 percent of all ransomware detected was discovered in healthcare, while the next most targeted industry was education at 6 percent, according to the report, published by Solutionary. One reason? Its stakeholders often pay hackers.
The report, which examined “information through the research of significant events identified through global visibility” of a company’s client base, also points to “an abundance of systems and devices” as pathways for hackers. It also notes that ransomware detections between March and May of this year increased by 11 percent per month. The report highlights that, according to the FBI, since October 2013, business email compromise scams have resulted in more than $3 billion lost for more than 22,000 victims.
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ONC releases data for top vendors used in EHR Incentive Program

Published July 26 2016, 1:01pm EDT
The Office of the National Coordinator for Healthcare Information Technology has released its data for top vendors used by providers participating in the EHR Incentive Program. Data is based on 2015 information compiled by the agency.
The Quick Stats split out the total number of providers that reported using a vendor's certified technology by the technology's certification edition, either the 2011 or 2014 edition.
The top 10 certified health IT vendors for hospitals include Cerner, 1,029; Meditech, 953; Epic Systems, 869; Evident, 636; McKesson, 462; MEDHOST, 359; Allscripts, 235; Sunquest Information Systems, 200; FairWarning Technologies, 172; and Iatric Systems, 161.
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CMS fraud prevention efforts save $42 billion

Published July 26 2016, 6:30am EDT
The Centers for Medicare and Medicaid Services has embraced a multifaceted, proactive approach to preventing fraud, using a heavy investment in analytics and enforcement agency resources to save $42 billion in fiscal years 2013 and 2014.
CMS highlighted the importance of the savings in preventing fraud in order to ensure sustainability of the Medicare program and making sure beneficiaries have future access to care.
In CMS’ annual report to Congress on the effectiveness of the Recovery Audit Program—a strategy to combat fraud, waste and abuse at a federal level—that was released last week, the agency reported $24.8 billion of the $42 billion recovered came from prepayment review that employed advanced analytics.
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The simple concept behind cloud's benefit to hospitals

by Matt Kuhrt 
Jul 26, 2016 4:30pm
Editor's note: The following is an excerpt from FierceHealthIT's eBook, Hospitals in the Cloud: How the technology is helping executives boost quality and cut costsYou can download it for free
The use of cloud technology in hospitals has accelerated in recent years, leading to an increasing variety of solutions and a growing awareness of the value such tools unlock in organizations. Among other benefits, cloud technology can help hospital executives save money, improve efficiency and reduce administrative overhead.
As with any technology, however, a cloud-based solution only offers benefits if it is implemented appropriately and measured accurately. The cloud is already reshaping the role of healthcare IT departments, shifting their focus from installing and running systems to coordinating and managing a growing suite of services. This trend is likely to continue as hospitals find new ways to use the cloud to improve their operations.
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Hospitals 'largely' addressing HIPAA requirements for EHR contingency plans

Jul 25, 2016 4:56pm
Hospitals are doing a fairly good job at protecting their electronic health record data as required by the HIPAA security rule, according to a new report from the Department of Health and Human Services’ Office of Inspector General (OIG).
The OIG sent a questionnaire to a sample of 400 hospitals that had received Medicare incentive payments for using a certified EHR pursuant to the Meaningful Use program as of September 2014. It also conducted site visits at six hospitals.
The survey found that 95 percent of the hospitals had a written EHR contingency plan, and more than two-thirds (68 percent) reported that their plan addressed the four HIPAA requirements that the OIG reviewed: having a data backup plan; having a disaster recovery plan; having an emergency mode operations plan; and having testing and revision procedures.
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Medical students track former patients' electronic health records, study says

Although most students follow patient treatment outcomes after they are no longer involved with their care, ethical questions about the practice are raised in a recent study.
By Stephen Feller   |   July 26, 2016 at 9:51 AM
CHICAGO, July 26 (UPI) -- Although it is suspected to be largely for educational purposes, researchers in a recent study say the following of patient electronic health records as part of training poses ethical questions for the handling of those records.
A majority of medical students reported they find it beneficial to follow patient medical histories by accessing electronic health records, but some are checking cases they are not involved with out of curiosity -- which may not pose an actual problem, but poses an ethical one, say researchers at Northwestern University.
Some doctors have complained that electronic records, considered essential for better coordination of patient care and improvement of precision medicine, is too significant a burden on their time.
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OIG: 60 percent of hospitals reported unplanned EHR disruption - before rise of ransomware

The Office of the Inspector General posted research from 2014 so there’s reason to believe the proliferation of cyberattacks and malware could create even more downtime. OIG recommended that hospitals institute and continuously update contingency plans.
July 25, 2016 01:01 AM
Nearly 60 percent of hospitals have experienced an EHR outage. According to a new report from the Health and Human Services Office of the Inspector General, in fact, 25 percent of those that have had EHR downtime said it delayed patient care. 
Put another way: 15 percent of hospitals have had a dysfunctional EHR negatively impact their ability to treat patients and 9 percent were forced to reroute patient care. What’s more, 20 percent of the outages lasted more than eight hours.
OIG found that the top cause of EHR outages is attributable to hardware malfunctioning, internet connectivity problems, power failures, natural disasters and it’s worth noting that hacking attacks only accounted for 1 percent of EHR downtime incidents. 
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ONC seeks info sharing organization to help health sector thwart cyberattacks

Jul 25, 2016 11:32am
Visibility of cybersecurity threat detection and response is one way to thwart evolving attacks on the healthcare industry. With that in mind, the Office of the National Coordinator for Health IT today announced two funding opportunities for an Information Sharing and Analysis Organization (ISAO) that wants to help.
ONC, along with the Assistant Secretary for Preparedness and Response (ASPR), is searching for an existing ISAO to help the sector by providing information on the types of threats impacting the industry, expanding education to healthcare entities on cybersecurity awareness, helping stakeholders use that education and information in practice and sharing information throughout the industry.
“In short, the ISAO will create a more robust cyber information sharing environment, especially for smaller entities that may not have the resources to access such information on their own, by leveraging existing relationships,” National Coordinator for Health IT Karen DeSalvo wrote in a blog post.
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Andy Slavitt: Health IT must 'wrap around' needs of patients, clinicians

Jul 25, 2016 10:41am
The purpose of the Medicare Access and CHIP Reauthorization Act, according to Andy Slavitt, is to “return the focus to patient care, not spend time learning a new program.”
Slavitt, acting administrator for the Centers for Medicare & Medicaid Services, spoke to the American Osteopathic Association late last week about all the possibilities the program holds, as well as its many pitfalls--which he said the agency is working to address.
Those include many issues on the technology side, including making sure that IT use wraps “around the needs of patients and clinicians and how they use the healthcare systems, not residing in the silos of health IT companies.”
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Kaiser Permenente testing novel hospital IT tools

Jul 25, 2016 9:38am
In a 37,000-square-foot warehouse near Oakland, California, Kaiser Permanente is trying to re-imagine healthcare of the future and technology’s role in it, reports BloombergBusinessweek.
It’s outfitted a model apartment filled with sleep monitors, fall detectors and a smart fridge for a patient of the future named Leo. In one scenario, the 68-year-old retiree develops arrhythmia while shopping and a driverless car filled with diagnostic gear is dispatched to determine whether he needs to go to the hospital.
Rather than relying on existing offerings, it wants to direct the development of new hardware and software.
“It frees us up so we don’t get so stuck on the realities of today,” Kaiser CEO Bernard Tyson says.
The warehouse also includes mock hospital rooms, an operating room, and a neonatal intensive care unit where staff can practice new procedures.
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HIT Think How IoT will affect information governance

Published July 25 2016, 3:06pm EDT
Malcom Gladwell popularized the phrase “the tipping point” in his best-selling book that highlighted how a series of events over time can lead to a moment when massive growth and expansion materializes.
Often, the triggers that drive these significant tipping point events are obscure and have enough latency that they may not be recognized or understood until after the fact. In other words, grasping the isolated multiple threads for a trend—whether societal, fashion or product related—that actually contribute to a tipping point event are a challenge.
Technological innovation is one area where we have no shortage of visionaries that conjure up the what, when and how technology will change the paradigm in which we live and work. We have a world of microprocessors powering billions of devices connected in the cloud.
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Enjoy!
David.