Quote Of The Year

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

or

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

Saturday, January 30, 2016

Weekly Overseas Health IT Links - 30th January, 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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Ambulatory EHRs fall short, Frost & Sullivan says, but primed to pick up through 2020

On-premise EHR limitations and low returns will spur practices to move toward cost-effective, cloud-based products as they pursue population health goals, according to the report.
January 22, 2016 04:52 PM
While the market for inpatient electronic health records is mature, there's still plenty of upside for ambulatory systems as accountable care organizations and patient-centered medical homes struggle to function seamlessly across the continuum of care, according to a new report by Frost & Sullivan.
In its report, U.S. Ambulatory Electronic Health Record Market: 2015–2020, the research firm sees big changes for the outpatient EHR market in the years ahead, as "value-based reimbursement provisions, payer consolidation and EHR optimization agendas" accelerate adoption among ambulatory practices.
Merger and acquisition activity will continue to gain steam as hospitals and large practices snap up smaller practices to bolster bottom lines and grow market share. Meanwhile, on-premise EHR limitations and low returns on investments will often spur practices to move toward cost-effective, cloud-based products that offer remote access and agile IT upgrades, according to the report.
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Hacktivist vs. cyberterrorist: Understanding the 5 enemies of healthcare IT security

According to Critical Infrastructure Technology report, cyber attackers can be categorized according to their target, tactics, techniques, malware and procedures.
January 22, 2016 04:15 PM
From "script kiddies" to sophisticated nation states, healthcare organizations have to be on the lookout for a variety of dangerous bad actors looking to crack its cybersecurity defenses, according to a recent Institute for Critical Infrastructure Technology report.
The possible impacts from a healthcare security breach are vast. Data from administrative or electronic health record systems can be used to steal the identity of patients and employees, which creates a financial burden and can even lead to legal ramifications.
Furthermore, false information provided by the hacker can also increase the risk of medical complications, according to the report.
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Data mining creates growing unease about patient privacy

January 22, 2016 | By Susan D. Hall
The market for medical information is so opaque that many doctors and patients don't realize data from a lab or electronic health record may be anonymized and sold without their consent, according to an article at Scientific American.
It reports growing unease about the expanding use of data mining by commercial entities not just among privacy advocates but among health industry insiders as well.
While longitudinal studies can be beneficial by providing new insights into the long-term effects of drugs and treatments, the under-the-radar market for medical data, the lack of patient consent and the ease at which patients can be identified even from anonymized data raises concerns.
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Electronic health record now available for 3.6 million south west Ontario residents

HealthPress Release
Over 37,000 health care professionals securely access electronic patient information
London, ON. – Over 37,000 doctors, nurses, therapists, and other health care professionals across south west Ontario (SWO) are now able to securely access electronic patient information from the region’s 67 hospitals, four Community Care Access Centres (CCACs), four regional cancer programs and provincial clinical systems for laboratory tests and results, and diagnostic imaging via the cSWO Regional Clinical Viewer, ClinicalConnectTM.
For the first time, patient health information from across the continuum of care can be accessed by authorized health care professionals to gather essential patient data in seconds from those organizations using ehealth technology. The implementation of an integrated electronic health record (EHR) has been achieved in south west Ontario – from Windsor to Tobermory to Guelph and through Niagara Falls.
The connecting South West Ontario (cSWO) Program, funded by eHealth Ontario, achieved a major milestone in July of 2015, when the final acute care hospital sites were successfully integrated with the regional clinical viewer. ClinicalConnect is a secure, web-based portal that provides authorized physicians and health care professionals with real-time access to their patients’ EHRs. eHealth Ontario and the cSWO Program, in partnership with Local Health Integration Networks (LHINs) and health service providers in south west Ontario, are enabling health care systems to share patient information across the sector and the province.
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Industry Association Seeks Answers to Medical ID Theft

JAN 21, 2016 7:32am ET
Idology, a software vendor enabling providers and insurers to validate the identity of a person not physically present, recently joined the Medical Identity Fraud Alliance, bringing the number of stakeholder and association members to 43 a little more than two years after formation.
John Dancu, CEO at Idology, says he recently became aware of MIFA and wants the company to be part of the collaborative association.
“When you share best practices and fraud trends, it makes the customer stronger,” Dancu notes. Further, making sure a customer is legitimate brings a positive experience to the customer and the healthcare organization, he adds. Idology’s healthcare business has grown quickly in the past three years as the industry awakens to the need for better tools to combat medical identity theft, he says.
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5 steps to designing healthy clinical apps

Lorraine Chapman, director of healthcare user experience for the global software and design firm, will discuss at HIMSS16 how to leverage user-centric design.
January 21, 2016 02:28 PM
The problem with many health apps often comes down to design, creating “a mismatch between what the app is trying to do and what the end users are trying to do,” said Lorraine Chapman, director of healthcare user experience for the global software and design firm Macadamian.
At HIMSS16, Chapman and Jeff Belden, MD, a practicing physician and professor of clinical family and community medicine at the University of Missouri – Columbia, will share five tips for making user-centric design part of your organizational DNA to enable more effective clinical apps.
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Epic, athenahealth, other EHR vendors sign on for Carequality Interoperability Framework

EHR heavy-hitters to be first class of vendors to implement data exchange principles set by The Sequoia Project.
January 21, 2016 04:30 PM
Barely a month after its launch, the Carequality Interoperability Framework devised by The Sequoia Project has already signed up five health IT heavy-hitters to be the first to implement its data exchange principles: athenahealth, eClinicalWorks, Epic, NextGen Healthcare and Surescripts.
The vendors – at least two of whom have verbally sparred in recent years over their willingness to play ball with interoperability – have agreed to provide health information exchange services for their customers under the Carequality Framework: legal terms, policies, technical specs and processes meant to enable another step forward for nationwide health information exchange.
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More 'vulnerable' patients still not embracing portals

January 19, 2016 | By Marla Durben Hirsch
Primary care providers have mixed views on patient portals, and aren't seeing their vulnerable patients using them much, according to a new study in the Journal of Medical Internet Research.
The researchers, from Wake Forest School of Medicine and elsewhere, conducted in-depth interviews with 20 clinical personnel in four North Carolina counties between October 2013 and June 2014. All of the providers served a lower income population.
They found that the main motivator of implementing a patient portal was external pressure, mainly from the Meaningful Use program, which requires more patient engagement. The providers acknowledged the potential benefits of portals, including:
  • Improved office efficiency
  • Fewer phone calls
  • Immediate access to patient electronic requests
  • Easier patient access to information
  • Better patient care management
  • More patient satisfaction
  • Improved information with other providers
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Pew study: Online access to records increasingly 'acceptable' for Americans

January 19, 2016 | By Marla Durben Hirsch
More Americans are in favor of online access to their medical records, so long as they believed that the site was secure, according to a new study by Pew Research Center.
The study, part of a larger study on privacy and information, surveyed 461 U.S. adults and conducted nine online focus groups of 80 people. It found that 52 percent of respondents were in favor of an online website where they could view their medical records and schedule appointments where the doctor "promises" that it's a secure website. Only 26 percent found that scenario unacceptable.
Patients ages 50 and older were more likely to find such access acceptable than those ages 18 to 49 (62 percent v. 45 percent); those with some college education also were more in favor of such access than those who did not have such education (59 percent v. 44 percent). Those in favor noted that the added convenience and ease would be appealing, although some said that it depended on how secure the website was, who would access the data and whether the respondent in general trusted his or her doctor.
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Loss of life, liability top cybersecurity fears for health IT leaders

January 21, 2016 | By Katie Dvorak
Losing patients due to malicious actors gaining access to systems or hacking medical devices is the top fear for healthcare leaders when it comes to cybersecurity, according to the results of a new survey.
For the survey, conducted by HIMSS on behalf of application security company Veracode, executives also cite damage to their brand, enforcement by government agencies and post-breach costs as major concerns in an environment where breaches are growing in frequency and breadth.
Of more than 200 hospital and health system IT leader participants, 28 percent said their top threat concern is the ability of hackers to take advantage of vulnerabilities in Web- and cloud-based tools such as electronic health record systems and clinical applications.
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How a hospital CIO turns patient feedback into healthy outcomes

Yale New Haven Hospital is using feedback software and tablets to help bolster patient satisfaction and, ideally, outcomes, says CIO Lisa Stump.

CIO | Jan 20, 2016 9:50 AM PT
It might seem strange to compare a patient’s hospital stays to a consumer indulging in the extravagances of a four-star hotels. Yet Yale-New Haven Health System is improving its healthcare services based on real-time patient feedback, collected via tablets, about anything from the cleanliness of rooms to the friendliness of nurses.
Consumers choose hotels based on their reputations for comfort, dining and other amenities. Similarly, patients have several options for healthcare providers, says Lisa Stump, CIO of Yale-New Haven Health System. And in an age where Yelp and Twitter can make or break reputations, hospitals must deliver the best experiences to make patients prefer their facilities. "We give you back some control in an experience where you don't have a lot of control because you're stuck in a hospital bed," Stump says.
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3 Ways Telemedicine is Changing Healthcare

Lena J. Weiner, for HealthLeaders Media , January 21, 2016

From increasing access to influencing better patient outcomes, health systems are recognizing the benefits of virtual patient visits and remote monitoring—and finding ways to mitigate the costs.

Some patients are harder to reach than others.
Refusing to turn on his webcam, one telemedicine patient insisted on communicating only using the chat box on his provider's mobile app. Eventually, he admitted that he suffered from agoraphobia, germophobia, and social anxiety. This was the only way he felt comfortable seeking care.
Once the realm of science fiction, telemedicine has become a reality of care—and an option for patients that might once have been difficult to reach, including rural patients, professionals with busy schedules, and patients unable or uncomfortable seeking care in person.
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Report: Healthcare the least prepared sector against cyberattacks

January 20, 2016 | By Susan D. Hall
Healthcare is the most targeted yet least prepared sector in the U.S. when it comes to cyberattacks, according to a report from the Institute for Critical Infrastructure Technology. 
"Both providers and payers devote the majority of their resources to fulfilling their mission," the report's authors say. "Sadly, attackers have seen this selfless dedication to human life as sign of weakness."
Government and healthcare organizations manage complex infrastructure that has many layers that leave gaps, which allows hackers access to sensitive data, according to the authors. What's more, many times, manufacturers no longer support their technology, which creates even more vulnerability. One example of how malicious actors took advantage of this is the Office of Personnel Management hack, which put information of about 4 million federal employees at risk.
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Seek and treat

Central initiatives, from the plans in the ‘Five Year Forward View’ to clinical commissioning group scorecards, are driving the use of data and analysis in healthcare.
But it is using data to find patients at risk and then to tailor appropriate interventions for them that could really drive change in health and social care, Kim Thomas discovers.
All too often, chronic kidney disease is diagnosed too late – but could there be a way of picking it up earlier?
Using tools from Emis, NHS Camden Clinical Commissioning Group now carries out central searches of GPs’ patient records to identify those patients who might be at risk.
The GPs are informed, and the patient, with their consent, is given a virtual referral to a hospital specialist, who reviews the records and decides on one of three courses of action: that the patient attends the hospital renal clinic, is managed under the care of their GP, or is attended by a community nurse.
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With iPhone apps, your doctor can read your bathroom scale

January 19, 2016
Lane Turner/The Boston Globe

Pulse of Longwood takes you inside one of the nation’s largest hubs of hospitals and biomedical research.

Patients with heart failure could soon start beaming their body weight from bathroom scales right to their doctor’s office, as Beth Israel Deaconess Medical Center joins a growing number of hospitals experimenting with mobile technologies to track patients’ health at home.
In doing so, the 672-bed teaching hospital in Boston’s Longwood Medical Area joins the first wave of health care providers using Apple’s HealthKit software to tap into the stream of health information that patients are already collecting on their iPhones.
Since patients are already using smartphones to track how much they step, eat, sleep, and snore, hospitals now want to seize on that data to forge a new type of remote health care that they hope will drive down costs and help people manage chronic diseases.
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CHIME Launches $1M National Patient ID Challenge

January 19, 2016
by Heather Landi
National Coordinator for Health IT Karen DeSalvo, M.D., applauds the patient identification challenge as an example of private sector leadership with developing national standards and health IT innovation
The College of Healthcare Information Management Executives (CHIME) announced today a National Patient ID Challenge, a $1 million crowdsourcing competition to incentivize the private sector to develop a fail-safe patient identifying solution that links patients to their medical records.
Partnering with HeroX, a crowdsourcing innovation platform, on the initiative, CHIME aims to encourage innovators to help solve the complex problem of patient misidentification There is currently no universal standard to 100 percent accurately identify patients and match them to their medical records. And, since 1999, the federal government is prohibited from spending public funds on the development of a national patient identifier.
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Data Sharing

Dan L. Longo, M.D., and Jeffrey M. Drazen, M.D.
N Engl J Med 2016; 374:276-277January 21, 2016
DOI: 10.1056/NEJMe1516564
The aerial view of the concept of data sharing is beautiful. What could be better than having high-quality information carefully reexamined for the possibility that new nuggets of useful data are lying there, previously unseen? The potential for leveraging existing results for even more benefit pays appropriate increased tribute to the patients who put themselves at risk to generate the data. The moral imperative to honor their collective sacrifice is the trump card that takes this trick.
However, many of us who have actually conducted clinical research, managed clinical studies and data collection and analysis, and curated data sets have concerns about the details. The first concern is that someone not involved in the generation and collection of the data may not understand the choices made in defining the parameters. Special problems arise if data are to be combined from independent studies and considered comparable. How heterogeneous were the study populations? Were the eligibility criteria the same? Can it be assumed that the differences in study populations, data collection and analysis, and treatments, both protocol-specified and unspecified, can be ignored?
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The Impact of Technology Resistance on Information Exchange

JAN 19, 2016 4:44pm ET
Commentary: Thanks to the Affordable Care Act and new care delivery models, provider compensation is increasingly being tied to quality outcomes and cost-effective care. To achieve quality and cost objectives, patient care must be well-coordinated in order to accelerate the delivery of care, reduce wasteful duplicate testing, and minimize the risks and costs associated with missed or delayed diagnosis, medication errors and hospital readmissions.
To effectively and efficiently coordinate care, providers need access to a patient’s complete health record, including details on medications, previous test results and medical history. Initiatives such as the Meaningful Use program and the Direct Project initiative seek to promote the fast and secure exchange of clinical patient information.
However, many organizations have yet to adopt new technologies to facilitate the electronic exchange of health data. In many cases, perceived high implementation costs are to blame. More commonly, the biggest barrier is provider unwillingness to disrupt existing workflows in favor of new processes.
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FDA posts cybersecurity guidance for medical device manufacturers

In addition to incorporating controls in device designs, makers must also consider ongoing improvements because risks could occur over the device's lifecycle.
January 19, 2016 03:04 PM
The Food and Drug Administration has issued draft guidance outlining steps medical device manufacturers should take to counter cybersecurity threats.
The agency offers advice on monitoring, identifying and addressing cybersecurity vulnerabilities in medical devices once they have entered the market.
The draft guidance, published Jan. 15, is part of the FDA's effort to ensure the safety and effectiveness of medical devices at all stages in their lifecycle, officials said. They note that in addition to incorporating controls in the design of the device, makers must also consider improvements during maintenance because risks could occur over the device's lifecycle.
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FireEye exec to probe why hackers see healthcare data as such a lucrative target

Providers and payers need to protect their security, shoring up third-party relationships with official business associates, Dan McWhorter to discuss in HIMSS16 keynote.
January 19, 2016
03:40 PM
Cyber-criminals continue to pose major threats to healthcare information technology departments, and experts say it’s the lure of electronic protected health information that keeps them coming.
“In the last two years, healthcare providers and insurers have been hit by some of the most severe network intrusions ever observed, exposing millions of patient records and costing victim organizations tens of millions of dollars,” said Dan McWhorter, vice president of global threat intelligence and strategy at FireEye, an IT security vendor.
McWhorter will deliver a keynote address at HIMSS16 on the importance of health data security in his presentation, “Emerging Threats: Why is ePHI a Target?”
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How prying eyes put PHI at risk

January 19, 2016 | By Katie Dvorak
Healthcare organizations need to not only worry about patient data being compromised by outside sources, but also because of prying eyes within their walls.
Snooping and spying is human nature, Kate Borten, president and founder of The Marblehead Group, tells HealthITSecurity.com. And as personal health information is increasingly viewed on computer screens, tablets and mobile phones, the ability for someone to see data they shouldn't grows.
A screen facing out into a hallway or waiting area could mean people catching glimpses of very private information, but a solution could be as simple as re-angling the screen, Borten says.
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AMIA Study Examines the Impact of Health IT on Patient Consultations

January 15, 2016
by Heather Landi
There is growing concern about the impact of health information technology (IT) on patient-clinician communication, yet a study by the American Medical Informatics Association (AMIA) finds that the use of health IT can affect consultations in positive or negative ways depending on a number of factors.
Recent studies have linked high computer use by clinicians with lower patient satisfaction. According to AMIA, the purpose of it study, which was published in the Journal of the American Medical Informatics Association, was to review the current literature on health IT use during the clinical encounter to update best practices and inform the continuous development of health IT policies and educational interventions.
For the study, researchers conducted a literature search of four databases and analyzed about 50 articles and then used a qualitative thematic analysis to compare and contrast the findings across the studies.
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Meaningful Use Lives On

by Brian Ahier Tuesday, January 19, 2016
On Oct. 6, 2015, CMS and the Office of the National Coordinator for Health IT released the final rules for Stage 3 of the Electronic Health Record Incentive Program and the 2015 Edition Health IT Certification Criteria. Through this rulemaking, the agencies hoped to simplify requirements and add some new flexibilities for providers. They moved from fiscal year to calendar year reporting for all providers beginning in 2015, and they offered a 90-day reporting period for all providers in 2015, for new participants in 2016 and 2017, and for any provider moving to Stage 3 in 2017. They reduced the number of Stage 2 meaningful use objectives from 18 to 10 in 2015-2017, with no change in clinical quality measures. For Stage 3, there will be eight meaningful use objectives (with about 60% of them requiring interoperability).
They also requested additional feedback about Stage 3 of the EHR Incentive Program going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System (MIPS) and consolidated certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework. They plan to use this feedback to inform future policy developments for the EHR Incentive Program, as well as consider it during rulemaking to implement MACRA, which is expected to take place in the spring of 2016.
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Meaningful Use 'Bombshell' Leaves Nary a Mark

Scott Mace, for HealthLeaders Media , January 19, 2016

Andy Slavitt throttles back his forecast for the end of meaningful use as we know it, disappointing many, but proving that government reform is coming… at its own excruciating pace.

What are we to make of CMS Acting Administrator Andy Slavitt's pronouncement last week that meaningful use is "effectively over" and that it "will be replaced with something better"?
As of this morning, my take on things is that Slavitt said disappointingly little that was truly new, and various journalists, myself included, jumped to conclusions when we characterized his remarks as a bombshell.
The evidence for this appeared just this morning, as Slavitt himself, in this blog post with Karen DeSalvo, head of the Office of the National Coordinator, basically throttled back his prediction of the end of meaningful use as we know it in 2016.
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5 healthcare imperatives as patients demand more personalized treatment

EMC survey finds bulk of consumers want faster access, digital connectivity and more integrated devices.
January 18, 2016 04:15 PM
Eight-nine percent of healthcare providers say technology has changed patient expectations, according to a recent EMC report.
Respondents to the survey, which polled 236 healthcare leaders from 18 countries, said more than half of their patients wanted faster access to services. 45 percent wanted 24/7 access and connectivity and 42 percent wanted access on more devices. Another 47 percent said they wanted "personalized" experiences.
"Consumers buy across a spectrum of principles," Dave Dimond, chief technology officer of EMC said. Millennials buy on price. The Baby Boomer generation buys on cost and quality, and the builder generation buys based on quality and trust."
But "across the spectrum," he said, "they're interested in convenience."
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Enjoy!
David.

Friday, January 29, 2016

I Wonder Who Was Really Accountable For This Debacle. There Are A Few Possibilities.

I Wonder Who Was Really Accountable For This Debacle. There Are A Few Possibilities.
This little problem got a good deal of mainstream and technical coverage last week.

Royal Melbourne Hospital attacked by damaging computer virus

Date January 18, 2016 - 10:18PM

Julia Medew

Health Editor

The health network's website is not working and says it is "currently under maintenance".
A virus has attacked the computer system of one of Melbourne's largest hospital networks, causing chaos for staff and patients who may face delays as a result.
Staff at Melbourne Health - the network which runs the Royal Melbourne Hospital - are urgently trying to repair damage to its IT system after a virus infected Windows XP computers.
An email sent to staff today said the virus had hit Melbourne Health's pathology department, causing staff to manually process specimens such as blood, tissue and urine samples instead of computers aiding the registration, testing and entry of results.
While the Blood Bank is still operating for the hospital, the email said only urgent pathology specimens would be processed due to delays involved in "manual work-arounds" and that staff needed to send faxes to the pathology department if they required urgent results.
"Critically abnormal" haematology and biochemistry results are being telephoned to staff on wards including the intensive care unit and emergency department.
"Please note that there will be delays in the processing of Microbiology and Anatomical Pathology specimens," said the email sent this afternoon by Associate Professor Denise Heinjus, Executive Director Nursing Services and Allied Health.
The email said the hospital's food service was working with nurses to ensure that the right meals continue to be delivered to the right patients.
"IT is currently implementing a network-wide solution to this virus. This will take some time so staff must not attempt to fix the problem themselves," the email said.
It also warns staff whose computers are on and working not to switch them off. The email said staff should not log in to any password protected sites such as bank, Gmail or Facebook accounts. Staff whose computers are off are being warned not to switch them on.
More here:
Among other coverage we also had this:

Royal Melbourne Hospital hit by Windows XP virus

Work at the pathology department of the Royal Melbourne Hospital has been hit for several days by a virus which has infected computers running Microsoft's Windows XP operating system.
The processing of blood, tissue and urine samples has been done manually due to the infection, causing massive delays, according to reports on a number of websites, with The Age leading the way.
These reports were confirmed by the hospital when it issued a terse media release on Tuesday afternoon.
In it, the hospital, one of the largest in Melbourne, said: "Melbourne Health would like to reassure all of our patients and community that there are minimal disruptions to patient services today (Tuesday).
"Elective surgery and our Emergency Department are operating as normal. There have been a very small number of outpatient cancellations.

"Our staff have worked tirelessly over the past couple of days to maintain patient safety and ensure minimal disruption.
More here:
It seems to me there are a few possibilities.
1. The technical people looking after the affected systems not being aware of the risks of running Win XP - very unlikely.
2. An outside provider providing a Win XP based package and not updating it as needed - again not all that likely.
3. Senior IT Management at the hospital not knowing that XP was still being used - possible - but not working to fix the issue - unlikely.
4. Hospital Senior Management - saw the cost of replacement and decided it could wait - ignoring requests from below…not at all unlikely.
Who would you surmise is likely to be the real culprit? I reckon No 4 is looking good! If you work there let us all know the truth! I have to say this recent article leaves the whole thing rather up in the air - but maybe we know a little more!

http://www.itnews.com.au/news/how-the-qbot-malware-downed-melbourne-healths-systems-414041
 
David.

Thursday, January 28, 2016

The Macro View - General And Health News Relevant To E-Health And Health In General.

January 28 Edition
Here is some other of the recent other news and analysis.
Clearly the big news in the last few weeks has been macroeconomic with oil slipping to be worth less than $US30 a barrel, sinking global share markets, Chinese manipulation of the yuan, falling bond yields and a gentle uptick in the price of gold.
On Friday last week, someone seems to have said enough is enough, and things have steadied. By the time you read this we will know if the fix is in - or not!
Here is a summary up until the end of last week:

ASX's bear market likely to be Gummy, not Grizzly: Credit Suisse

Friday, 22 Jan 2016 | 12:18 AM ET
Australia's shares are set to enter a bear market, but there's a two in three chance investors who buy in will emerge with a profit if they hang on for a year, Credit Suisse said.
So far, Australian stocks have avoided bear territory, but just by the skin of their teeth; at Friday's close, the S&P ASX 200 was down around 18 percent from its 52-week high of 5,982.69, set in April 2015, despite posting a 1.07 percent rally for the day.
Credit Suisse expects that could change at any time.
But if it does, it's likely to be a Gummy bear that grips equities, not a Grizzly, the bank said in a note on Thursday, after examining the past 12 bear markets Down Under. That's a nod to a popular sticky, bear-shaped candy.
In a Grizzly bear market, the index falls by a further 20 percent, while under the Gummy scenario, the benchmark would rally by an average 24 percent over the next 12 months, Credit Suisse said.
"Grizzly bears are associated with deeper profits recessions and higher starting valuations. Our forecast of flat EPS (earnings per share) and reasonable starting valuations (as measured by cyclically adjusted price-to-earnings ratios) suggests the potential upcoming bear market in Australia will be of the Gummy kind," Credit Suisse said.

Thursday Update: Nothing has really improved - most markets and oil still in a funk!
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General Budget Issues.

Income growth lowest in 50 years

  • The Australian
  • January 18, 2016 12:00AM

David Uren

Australia faces its slowest income growth in more than 50 years as the downturn in China hits wages and profits while sparking fears of a new global downturn.
With the Australian sharemarket facing the prospect of steep falls today, a new report by Deloitte Access Economics identifies Australia’s poor income growth as a “worry”, even though the latest figures on the national economy, including strong jobs growth, have pointed to reasonable growth.
“Weak incomes today are a risk to growth down the track.” the report says, noting that poor income growth erodes business investment and household spending.
The report comes as world markets face renewed pressure this week amid doubts about the strength of the economies of China and the US.
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Economy is OK, budget isn't: economist

AAP – 2 hours 31 minutes ago
Treasurer Scott Morrison faces the tricky task of explaining the budget is in trouble even though the economy is doing okay, economist Chris Richardson warns.
It comes as a Deloitte Access Economics report warns Australia faces its slowest income growth in more than half a century.
"You have a treasurer who has to explain to Australia genuinely, the economy is okay but the budget is not," Mr Richardson told ABC radio on Monday.
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Australian economy very sound: Morrison

AAP
January 18, 2016, 8:42 am
Treasurer Scott Morrison has reassured Australians the economy remains "very sound" despite global volatility, with more than 300,000 jobs created in the past year.
Mr Morrison says the government's plan "is exactly as we need it to be" in the face of volatility in financial markets and a slowdown in the Chinese economy.
The Chinese slowdown was not unanticipated and the government was focused on boosting business and jobs while reducing expenditure to get the budget back on track.
The treasurer's comments came as a Deloitte Access Economics report warned Australia faces its slowest income growth in more than half a century.
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Treasurer Scott Morrison calls cool heads over volatile Chinese economy

Date January 18, 2016 - 9:22AM

Judith Ireland

National political reporter

US stocks take another beating

Equities face relentless selling pressure amid ongoing worries about falling oil prices and weakness in China.
Treasurer Scott Morrison has broken his holiday silence to call on people to keep a "cool head" about the Chinese economy, saying Australia was in a solid position despite recent global turmoil.
In his first major interview for 2016, Mr Morrison said doubts about the Chinese economy - which have seen the Australian stock market plunge to a two-and-a-half-year low -  were "not unanticipated". 
"This is a time for just being, I think, very cautious," he told Sky News on Monday. 
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Morrison rejects gloom in face of budget woes

18th Jan 2016 6:55 PM
TREASURER Scott Morrison has rejected doom-and-gloom reports of China's impact on Australia, urging people to have "cool heads" in the face of a two-year low in the stock market.
Mr Morrison told Sky News on Monday that people needed to be "cautious" about reports of global volatility and defended the economy as "very sound".
A Deloitte Access Economics report released on Monday found growth in the United States was countering some effects of China's slowdown.
But Deloitte's Chris Richardson also described the combined effects of low commodity prices and the China slowdown as "a wrecking ball for the tax take".
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IMF warns global growth could be 'derailed' over the next two years

Date January 20, 2016 - 5:54AM

Gareth Hutchens

Global growth will disappoint in 2016 and the outlook for the medium-term has deteriorated, the head of the IMF, Christine Lagarde announced late last year.
Global growth could be "derailed" over the next two years if key transitions in the world economy are not successfully navigated, the International Monetary Fund has warned.
This coming year is going to be a year of great challenges and policymakers should be thinking about short-term resilience and the ways they can bolster it 
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Queensland taxes: Federal government offers deal to cut state taxes

January 24, 2016 1:00am
Renee Viellaris The Sunday Mail (Qld)
THE Federal Government is expected to offer state treasurers a deal to abolish stamp duty and payroll tax in a bid to get the economy moving.
The deal, which would see Canberra replace the money states take from the two taxes with a bigger slice of income tax receipts, would come at the expense of the Budget bottom line but government sources say they will make it up through extra economic activity.
A spokesman for Treasurer Scott Morrison said “everything is on the table’’.
It comes as Queensland and Victoria continue to publicly dismiss any increase or broadening of the GST.
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  • Jan 20 2016 at 4:53 PM

Kelly O'Dwyer says tax changes will be 'clear' before next election

by Joanna Mather
The Turnbull government will clearly spell out its tax changes before the next election, and doesn't feel it is running out of time to hold meaningful consultations about contentious changes such as increasing the GST or curbing superannuation tax breaks, Assistant Treasurer Kelly O'Dwyer says.
"We're going to take any tax reform package to the election and the election's not until later in the year," she told ABC radio.
"We are going to be very clear with the Australian people where we stand on tax reform."
Before that, Prime Minister Malcolm Turnbull and Treasurer Scott Morrison will face their first major test – the May federal budget. 
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Scott Morrison: Too much economic 'volatility' for an early election

Date January 21, 2016 - 8:16PM

Fergus Hunter

Reporter

Treasurer Scott Morrison has linked the timing of this year's federal election to market "volatility", declaring the Turnbull government would go full term as it puts forward its solutions for economic uncertainty.
He also reaffirmed his government's intention to institute tax reform, including cuts to income and company taxes. 
The Treasurer insisted that rumours of an early election are wrong.
"The Prime Minister has said the government will go full term and that's what we'll be doing," Mr Morrison told business channel Bloomberg on Thursday.
"And the reason for that is, right now, certainly there is volatility.
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Empty promises and false starts limit budget repair

  • The Australian
  • January 23, 2016 12:00AM
In this election year there is a temptation to think of the Turnbull administration as a new government, preparing to deliver its first budget and outline its taxation and other reform plans before going to the people.
Yet Malcolm Turnbull and his Treasurer, Scott Morrison, have been in cabinet for more than two years and, with that cabinet, have endorsed two budgets. What is more, when it comes to international markets, financiers, investors and creditors there is only one Australian government, a constant no matter whether Labor or Liberal, Kevin Rudd, Julia Gillard, Tony Abbott or Mr Turnbull is in charge. The fact is that eight years have passed since the federal budget dipped deep into deficit and despite repeated promises and forecasts, few inroads have been made. Deficits stretch still, as far as we can see.
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Coalition fixed the budget in 1996: it can be done again

  • Peter Costello
  • The Australian
  • January 23, 2016 12:00AM
Anyone can spend money they don’t have if someone is prepared to lend it to them. When governments do that the cost of the borrowing becomes a charge against future taxes. Future taxpayers have just that little bit less of their own taxes to pay for services ­because a component must go off to service the cost of previous ­consumption.
Maybe they will decide to send the cost on to the next generation and add in a little bit of their own overconsumption as well. Soon the debt and debt-servicing cost begins to accumulate. Soon future generations have less money to spend on their own needs because they are paying the cost of previous decisions.
Personal debts die with the person who incurred them. Governments do not die, and their debts continue down to successive generations. Their flexibility and their options begin to narrow.
One of the things I am proud of in my time in government is that we bequeathed no debt to future generations. And we cleared the debts of all the governments that went before it. Never had the ­financial position of the federal government been stronger. It was an important time to be strong, given the gyrations in the international financial system in 2008.
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How is Scott Morrison performing as Treasurer?

Date January 22, 2016 - 5:50PM

Gareth Hutchens and Fergus Hunter

When Malcolm Turnbull challenged Tony Abbott for the leadership of the Liberal Party, he said the government desperately needed a different leadership style.
Australia is facing huge economic challenges and needs a new leadership team that can explain those challenges clearly and sensibly, he said.
He replaced Treasurer Joe Hockey with Scott Morrison and set about rebuilding the government's economics team.
But how well is Scott Morrison doing as Treasurer? Is he doing a better job than Hockey? We asked some senior economists and strategists for their views.
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Health Budget Issues.

Sussan Ley under fire over pathology comments

Date January 17, 2016 - 6:56PM

Jane Lee

Health Minister Sussan Ley's office has come under fire for saying patients should be "suspicious" of pathologists' estimates of how much patients would have to pay for pap smears and blood tests to recover planned federal cuts.
The Turnbull government plans to cut bulk-billing incentives for pathology and diagnostic imaging services, saving about $650 million over four years. Pathology providers have indicated that they will pass any losses on to patients through a co-payment.
Ms Ley's spokesman has repeatedly said that patients are "rightly suspicious" of pathologists' claims they would charge patients about $30 for pap smears and more than $400 up-front for diabetes monitoring tests, to make up lost funding worth between $1.40 and $3.40.
Lawyer Margaret Faux, who is doing a PhD on Medicare compliance, rejected this, saying it would be illegal to both bulk-bill and charge a fee to cover the loss of the payments.

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Bundled hospitals payments plan for maternity and stroke care

  • The Australian
  • January 20, 2016 12:00AM

Sean Parnell

Maternity care, stroke treatment and joint replacements in public hospitals are set for a shake-up as authorities seek new funding mechanisms and different models of care that can deliver savings to the health system.
The Independent Hospital Pricing Authority is consulting interest groups on a landmark shift to bundled pricing, whereby certain conditions would be covered under a package deal rather than payment for each episode of care.
The authority has highlighted the first three conditions because, clinically, they are relatively straightforward and, financially, any changes could deliver impressive returns to governments.
The high costs in stroke treatment would allow for changes to deliver “potentially significant savings” while uncomplicated ­maternity care involves “high-­volume services, meaning that small improvements in service ­delivery can result in significant savings to the health system”.
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Pharmacy Issues.

Reconsider Panadol Osteo delisting in light of risks: Painaustralia

The PBS delisting of Panadol Osteo needs to be reconsidered in the light of cost and clinical safety implications, says Painaustralia.

The organisation has highlighted the risk of adverse clinical events resulting from chronic pain sufferers switching from Panadol Osteo following its delisting with Health Minister Sussan Ley.
In a letter to the Minister, Painaustralia CEO Lesley Brydon said the group has concerns that patients currently on Panadol Osteo might seek alternative PBS-subsidised therapies with poorer safety profiles, such as NSAIDS or opioids.
“Such a move by patients would clearly add to the complexity of their condition and negate any potential cost savings to government and the consumer,” Brydon says.
“Painaustralia is also concerned about the increased costs for patients arising from the delisting of Panadol Osteo which is currently the recommended first-line treatment for people suffering pain secondary to osteo-arthritis.”
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Minor Ailments Scheme just a drug sales push: GP

The proposed Minor Ailments Scheme based in pharmacy is just “a push by the pharmaceutical industry and pharmacy business to increase drug sales under the guise of health innovation,” according to a prominent GP.

Writing in MJA Insight, Evan Ackermann, a GP at the University Medical Centre, Southern Cross University, Gold Coast, Queensland, and the chair of the Royal Australian College of General Practitioners National Standing Committee – Quality Care, says that while a formal trial to investigate the feasibility of such a Scheme is necessary, a trial should also examine whether further regulatory measures are needed to protect patients.
“Unless integrity within the pharmacy industry is improved, MAS programs will simply become another mechanism to increase drug use in the community,” Dr Ackermann says.
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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites being flown! Enjoy.
David.