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, October 29, 2016

Weekly Overseas Health IT Links – 29th October, 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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Information security spending to top $101 billion by 2020

Published October 20 2016, 3:34pm EDT
Worldwide spending on security-related hardware, software and services will grow from $73.7 billion in 2016 to $101.6 billion in 2020, according to new research from International Data Corp.
The rise in expenditures to bolster security represents a compound annual growth rate (CAGR) of 8 percent, more than twice the rate of overall IT spending growth, during the five-year forecast period.
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Curtain up on theatre systems

Running a theatre suite more efficiently can deliver big time, cash, and quality benefits to a hospital. That puts the onus on IT, says Jennifer Trueland.
As a cardiac surgeon, Ben Bridgewater felt at first hand the frustrations of problems in the operating theatre. So perhaps that’s why he is now spending his time trying to make sure that the only thing on the surgical team’s mind is doing the job that they’re there to do.
“It’s wrong to look at the theatre in isolation, because the whole system is involved,” he says. “As a consultant, I’d get in at 8am with the aim of seeing the patient and starting at 8.30am.
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October 18, 2016

IBM Watson, Quest Diagnostics Launch Precision Oncology Service

IBM Watson Health and Quest Diagnostics said today they have launched a new service designed to advance precision cancer treatment by combining cognitive computing with genomic tumor sequencing.
The service—called IBM Watson Genomics from Quest Diagnostics®—will consist of laboratory sequencing and analysis of a tumor’s genomic makeup designed to help reveal mutations associated with targeted therapies and clinical trials. Additional genome sequencing capabilities will be provided by The Broad Institute of MIT and Harvard.
“This is a powerful combination that we believe it will leapfrog conventional genomic services as a better approach for identifying targeted oncology treatments,” Jay G. Wohlgemuth, M.D., CMO and svp of research, development, and medical, Quest Diagnostics, said in a statement.
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Another view: of handling letters

GP Neil Paul wants a better way to deal with the many letters that flow into a GP surgery; one that’s future proof for the coming world of federated, hub and spoke working.
As a practice, we hired a pharmacist to deal with a load of medicines issues and take work load off the GPs. We did this five years ago, and it’s worked well.
Recently, there has been a national scheme encouraging practices to do the same by pump-priming the appointment.
Now, 14 local practices have a pharmacist. One GP told me the other day that his practice’s pharmacist had changed his life for the better. I could have said: “Told you so.”
While I’m naturally very pro GP, if I was to criticise my colleagues, then one of their collective faults - driven partly by the partnership model - is that they can fail to invest in innovation; and often rely too much on new pots of money when they do.
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NHS Digital’s plans for a digital NHS

The NHS is taking another run at digital transformation. At a national level, much of the “heavy lifting” is falling to NHS Digital. Ben Heather talks to three of the new organisation’s leaders about what coming for a digital NHS.
Ben Heather
17 October 2016
When Andy Williams moved from the private sector to become chief executive at the Health and Social Care Information Centre in early 2014, past digital failures were still lingering in the air.
“There was a long shadow caused by NPfIT [the National Programme for IT],” he recalls. “I think it had been slowing things down over the past few years. We have taken a long time to get going again.”
The NHS is still paying for NPfIT, a multi-billion-pound nationwide programme to create national infrastructure, develop national programmes such as e-booking, and roll out electronic patient records to trusts. It largely failed in the last, and most high profile respect. 
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KLAS: Only 6 percent of providers hit interoperability 'home runs'

Oct 19, 2016 12:53pm
Most providers can’t obtain patient information from other providers, let alone use it effectively to improve care, according to a report published this month by KLAS Research.
The 2016 interoperability report found that respondents could reasonably access information from exchange partners on a different electronic health record 28 percent of the time, which KLAS referred to as the “first base” of interoperability. Only 13 percent found those exchanged records easy-to-locate (second base). When adding whether the data received and located was integrated into a clinician’s workflow (third base), only 8 percent of providers answered in the affirmative. Only 6 percent found that the patient data exchanged facilitated improvement of patient care (the “home run”).
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New ONC pilots to focus on use of patient-generated health data

Oct 20, 2016 12:49pm
A pair of recently launched pilot programs spearheaded by the Office of the National Coordinator for Health IT and Accenture Federal Services focus on the use of patient-generated health data (PGHD) by providers and researchers.
In one pilot, Northern California-based Sutter Health and Validic will examine how best to move PGHD from disparate devices into electronic health records or clinical dashboards. Sutter patients with Type II diabetes last month began receiving the health system’s Mpower (Motivating Patients Online with Enhanced Resources) app on their smartphones. The app, via Validic’s digital health platform, can connect securely to medical devices that measure blood glucose, blood pressure, activity levels and weight.
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Smartphone sensor spots cancer in several samples simultaneously

October 19th, 2016
Researchers at WSU have developed a portable spectrometer, which works with a smartphone to analyze multiple samples at once for signs of cancer(Credit: Washington State University)
The continuing miniaturization of electronic devices has allowed sensors previously confined to a laboratory to shrink down to a portable size, with previously bulky equipment now able to fit in a briefcase or even a needle. Now a team from Washington State University (WSU) has developed an inexpensive spectrometer that connects to a smartphone and can spot cancer biomarkers in several samples simultaneously, thereby taking lab-like accuracy out into the field.
While existing smartphone biosensors can only deal with one sample at a time, the WSU team's device can scan up to eight at once, measuring the light spectrum to detect traces of specific chemicals in a sample. In this case, the spectrometer is searching for the presence of human interleukin-6 (IL-6), which can act as a red flag for liver, lung, prostate, breast and epithelial cancers.
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Application security remains 'troubling' in healthcare

Oct 20, 2016 6:36am
A lot of software in use, particularly related to the healthcare industry, has not been through a formal security improvement process, according to a new analysis by application security vendor Veracode.
In its report, Veracode compared applications’ compliance with the Open Web Application Security Project (OWASP) and SANS Top 25 standards, which are built around slightly different sets of threats.
Examining compliance pass rates for first-time scans, only government (25 percent) fared worse than the healthcare industry (33 percent). The report notes, however, that every industry sector except financial services improved slightly from last year.
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Biden report identifies data as key to breakthroughs in Cancer Moonshot

Published October 18 2016, 6:48am EDT
An unprecedented volume and diversity of data have the potential to enable the Obama administration’s Cancer Moonshot to meet its goal of achieving a decade’s worth of progress against the disease in just five years. However, if the initiative is to succeed, there are significant barriers that must overcome.
That’s the central message of a new report sent to President Barack Obama by Vice President Joe Biden, who is spearheading the Cancer Moonshot.
In the document, Biden notes the abundance of data “being generated daily through genomics, family history records, lifestyle measurements, and treatment outcomes,” with the opportunity to discover “new patterns of causes, earlier signs of cancer, and successful treatments of cancer.” And, thanks to advances in supercomputing power, he contends that researcher now have the ability to “analyze enormously complex and large amounts of data to find answers we couldn’t just five years ago.”
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How telehealth can enable declines in readmission rates

Published October 20 2016, 4:13pm EDT
High readmission rates are a $17 billion problem across the U.S. for hospital administrators. What’s even more alarming is that a portion of 30-day readmissions are preventable.
According to a recent University of California-San Francisco (UCSF) study published in the New England Journal of Medicine, 27 percent of readmissions could be avoided. This study shows that hospitals must improve communications between patients, physicians, hospitals and primary care providers, while providing better post-discharge resources.
Upon discharge, if a patient is readmitted within 30 days, the Center for Medicare and Medicaid Services (CMS) requires payment from the hospital because of the guidelines of the Affordable Care Act (ACA), which penalizes preventable readmissions. However, the burden of keeping abreast of each patient’s unique recovery isn’t an easy task for both providers and hospitals.
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e-Discharges will soon be made available to GPs

October 20, 2016 by William Bourke
GPs will shortly have access to e-Discharges, through which they will be informed when a patient is out of hospital and also receive the patient’s notes, the Minister for Health has pledged.
Minister Simon Harris has criticised the extent to which paper files are still being used and stored in hospitals. “There are warehouses full of paper files. GPs have proven they can grapple with the eHealth agenda and they are doing it. We now have e-referrals in place where many GPs, at the click of a button, are able to refer a patient onto an outpatient waiting list.
“Previously the referral would have passed through 16 pairs of hands before the referral was made,” said Minister Harris, adding that three would be an individual health identifier and, ultimately, an electronic health record in place by 2020.
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Patient records deleted in ransomware attack

Published October 18 2016, 3:13pm EDT
A ransomware attack in early August has resulted in the loss of patient data at three-site Rainbow Children’s Clinic, which delivers care in the Arlington and Grand Prairie region of Texas.
The attack affected an estimated 33,698 affected individuals who have received care from the provider.
As the attack started encrypting data on servers, the computer system was shut down to prevent further loss of data, according to a notice on the practice’s web site. However, some patient records were “irretrievably deleted,” the notice states.
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EHR systems critical to U.S. response to spread of Zika virus

Published October 18 2016, 6:56am EDT
As the Zika outbreak continues to spread in the continental United States and territories, electronic health records are going to be essential to tracking the virus within patient populations, according to Laurie Garrett, senior fellow for global health at the Council on Foreign Relations.
“One of the huge problems we have with Zika is that we don’t have great diagnostics, and so we have to be able to scour for symptoms,” Garrett told an audience during Monday’s general session at the AHIMA conference in Baltimore. “We need some kind of record keeping that keeps track of mobile populations that move around from place to place.”
That’s where EHRs come into play by helping public health officials and providers identify patients who might be at risk of infection, said Garrett.
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Why the most valuable security assets are human, not technical

Published October 19 2016, 3:39pm EDT
You already know that the biggest threat to healthcare IT security is the human element. But if human beings are the greatest vulnerability, that also makes them the strongest asset. Here’s why.
According to the 2016 HIMSS Cybersecurity Survey, the two primary healthcare IT security concerns among provider organizations (hospitals and physician practices) are phishing attacks (most pressing concern for 77 percent of respondents) and viruses/malware (67 percent). Both events require a responsive actor on the organization side of the transaction for hackers to access patient data.
It may seem like this is a rather straightforward problem to resolve—just make sure clinicians and staff have the requisite knowledge and are savvy enough to not get duped, and all is good. In reality, especially among larger organizations with hundreds of potential points of entry, turning human beings into alert sentries is a constant human behavioral challenge.
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Merck Manuals’ Robert Porter: Mobile tech a ‘must have’ for docs

by Judy Mottl 
Oct 18, 2016 9:08am
A new Merck Manuals survey reveals nearly three-quarters of physicians view themselves as tech-savvy. Two-thirds (66 percent) say they are using a mobile device to access data in the professional setting more than 10 times a day, with 80 percent stating that mobile data plays a role in diagnosis or treatment. Eighty-one percent of respondents say they believe mobile tech has changed the office visit dynamic.
To gain deeper insight on the survey findings, and the impact mobile technology is having on the physician-patient experience, FierceMobileHealthcare reached out to Robert Porter, editor-in-chief of the Merck Manuals. Porter views mobile technology as an enhancement of, but not a replacement for, the patient-doctor relationship.
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Human body, smartphone passcode may forge better mHealth security

by Judy Mottl 
Oct 18, 2016 9:31am
A human body passcode created via wireless data transmission using a smartphone fingerprint reader may provide stronger security for mHealth devices and wearables.
The system could potentially replace today’s password approach that uses data encryption, creating a new physical security layer impenetrable to outside attack, according to new research from the University of Washington’s Networks and Mobile Systems Lab.
The system can send a 256-bit key via the body to a wearable device from a fingerprint sensor in under 15 seconds, according to researchers, and the device can acknowledge key acceptance using Wi-Fi or Bluetooth over the smartphone. That eliminates the need for manually entered passwords.
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Despite healthcare success, IBM's Watson efforts no small expense

Oct 18, 2016 11:19am
While IBM has invested heavily in Watson, and the artificial intelligence technology is paying off in innovations within healthcare and other sectors, it's performing less brilliantly for the company’s bottom line, at least so far.
“IBM has pursued big, bespoke moonshot initiatives that can take years and are extremely expensive,” Gartner research fellow Tom Austin told The New York Times. "It seems like they’re swimming upstream with that."
According to the article, the company believes more lucrative times lie ahead. IBM points to a collaboration announced Oct. 18 with Quest Diagnostics, Memorial Sloan Kettering Cancer Center and the Broad Institute of MIT and Harvard as an example. The parties will combine cognitive computing with genomic tumor sequencing as a cloud service available to doctors and patients across the country.
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Oct 17, 2016 @ 07:30 AM 17,259 views The Little Black Book of Billionaire Secrets

White House To Announce Big Push For Cancer Blood Tests

I cover science and medicine, and believe this is biology's century.
The White House, as part of the Cancer Moonshot effort being run by Vice President Joe Biden, is announcing a major push to develop blood tests that can detect and monitor cancer, that aims to unite makers of diagnostic tests, drugs, and other cancer-related products.
“If you think about somebody who is at risk of cancer, or has been diagnosed with cancer, through the rest of life there is this question: Where is the cancer, what does the cancer look like? And what is going to happen next?” says Peter Kuhn, the Dean’s Professor of Life Sciences at the University of Southern California, which is participating in the effort.
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Six tips to help practices adapt to a new EHR

October 17, 2016
Adopting a new electronic health record (EHR) system doesn’t end with the software implementation. Instead, physicians should be prepared for at least several months of adjusting their day-to-day practices once the software in place.
Although doctors (and their patients) frequently report frustration as everyone adjusts to the new software, physicians can better manage the time immediately following the software upgrade with these key strategies:
Sell the upgrade
It’s important to let people know that there’s an adjustment period, said Scott Jacobs, vice president of community outreach services at The HCI Group, a Jacksonville, Florida, firm providing healthcare IT services. He said physicians should not only tell those in the practice about the upgrade, they should sell their patients and partners on the change, too. “Tell them, ‘We’re increasing our capabilities. Your data is going to be safer now.’ And if you’ve gotten an EHR integrated (with the local hospital), that’s a huge benefit. I’d let them know that you’ll have all their records—everything [that happened at the] hospital you will know about—and vice versa. That’s a big selling point,” he said.
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How HIPAA enables progress in healthcare innovation

Published October 18 2016, 3:54pm EDT
Many in healthcare blame difficulties over creating new solutions or trying to ease workflow burdens on HIPAA. The litany of issues that HIPAA is blamed for include contentions that it prevents the ability to share information with patients or even other providers; it overly restricts how information can be stored or transmitted; and it does not allow any information about an individual to be disclosed under any circumstances without the impacted individual’s consent.
It is unclear whether such excuses are used because of an honest misinterpretation of HIPAA, laziness or some other reason. Regardless of the cause, HIPAA is the easy out utilized because it remains misunderstood.
Despite HIPAA being enacted in 1996 and the primary components of both the privacy and security rules being in place since the early 2000s, a pervasive belief remains that HIPAA does not address and apply to modern technology. An oft-repeated argument is that the law and regulations pre-date modern solutions, such as cloud storage and social media, which prevents innovation in these areas.
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ONC Chief Talks MACRA, Meaningful Use

Scott Mace, October 18, 2016

Under MACRA, improvements to meaningful use will continue, as will opportunities for information exchange, predicts the National Coordinator for Health Information Technology.

October 14—the day the MACRA final rule was released—found Vindell Washington, MD, head of the HHS Office of the National Coordinator, in San Francisco briefing the Association of Health Care Journalists.
In between other national briefings, I had 20 minutes to interview Washington one-on-one about the impact of the final rule and the road ahead for healthcare and healthcare IT. This transcript below has been lightly edited.
HLM: What do you say to hospital executives in particular now? They weren't so much addressed by MACRA, but they still face rule upon rule still with meaningful use. Is this going to continue to work for hospitals?
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Healthcare's worst security weakness?

Hint: It’s not the steady stream of data breaches. But the two are walking the same tightrope.
October 17, 2016 06:29 AM
Healthcare attorney Pam Hepp said that hackers are always one step ahead of healthcare organizations and providers are so dependent on data that it makes protecting information that much harder.
It seems like health data breaches will never stop. In the first half of 2016 alone, the healthcare industry experienced 263 incidents, comprising 27 percent of the total breaches in all industries, according to a report from digital security firm Gemalto.
What’s more, the number of breaches in the third quarter of 2016 outpaces those in the first two, the Protenus Breach Barometer found. And research from Ponemon Institute and Trend Micro rank healthcare as the sector with more breaches than all others.
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CMS launches initiative to reduce physician paperwork

Oct 17, 2016 11:56am
A big complaint among physicians is the amount of time they spend on paperwork.
Responding to that concern, the Centers for Medicare & Medicaid Services has launched an initiative that will allow physicians to spend more time on patient care and less time on paperwork. As a first step, CMS announced a medical review reduction program to ease the reporting burden for physicians.
An 18-month pilot program will relieve doctors who participate in specified advanced alternative payment models (APMs) from additional scrutiny under certain Medicare medical review programs, CMS said. The agency identified APMs for the pilot because participating clinicians share financial risk with the Medicare program.
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Accuracy varies among wrist-worn heart rate monitoring wearables

Oct 17, 2016 10:44am
In a new study comparing the accuracy of four wristband heart rate monitoring wearable devices, the Apple Watch proved more accurate than the Fitbit Charge HR, the Mio Alpha and the Basis Peak, Cleveland Clinic researchers said. 
For the study, published in JAMA Cardiology, the researchers also compared the devices to two traditional chest-band electrode systems. Fifty healthy adults underwent various physical activities while wearing the devices
The wearables all revealed variable accuracy, the authors said, who noted that further research on different types of exercise and other devices is necessary. The Watch hit about 90 percent accuracy while the other wearables were in the low 80s, study author Gorgon Blackburn told Time.
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Health data breaches in Q3 2016 outpace first two quarters

Some 118 security incidents were either reported to the Department of Health and Human Services or first disclosed in the media in Q3 2016, compared with 89 in Q2 and 63 in Q1, a Protenus report finds.
October 14, 2016 07:03 AM
More data breaches happened in the third quarter of 2016 than in the year’s first two quarters.
That’s according to the Protenus Breach Barometer, which found that 118 security incidents either reported to the Department of Health and Human Services or first disclosed in the media or other sources in the third quarter compared with 89 in the second quarter and 63 in the first quarter, according to the Protenus Breach Barometer, a monthly snapshot of reported or disclosed healthcare breaches with data compiled and provided by DataBreaches.net.
For 37 data breaches in September, the number of patients affected was available for 32 and totaled 246,876 records, according to Protenus, a healthcare cybersecurity firm. While the first six months of 2016 averaged 25.3 breaches per month, the second half thus far has had an average of 39.3 incidents per month, a 55 percent increase. September’s largest single incident involved a ransomware hit that affected 58,000 records.
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Wynne vows no sell-off of eHealth records system

Premier Kathleen Wynne says her privatization czar is only looking at ways to improve eHealth Ontario, not sell off the electronic health records system.
By Robert Benzie
Mon., Oct. 17, 2016
Premier Kathleen Wynne says her privatization czar is only looking at ways to improve eHealth Ontario, not sell off the electronic health records system.
“There is no possibility of the sale or the commercial use of people’s health information,” Wynne said Monday, seeking to allay concerns about her business guru’s upcoming appraisal of eHealth.
“Ed Clark did an assessment of the LCBO. There are changes that are being made to the liquor laws in this province. There are changes that have come about as a result of the work that Ed Clark did. But there is no sell-off of that asset,” the premier said.
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E-health programme brings patient records online

‘Nearly 50% of Kingdom’s public, military health facilities now connected to Hakeem’
By Khetam Malkawi - Oct 15,2016 - Last updated at Oct 15,2016
AMMAN — The health records of over 3 million Jordanians are now accessible in any public or military health facility connected to the e-health programme “Hakeem”.
Electronic Health Solutions (EHS), the company which is implementing the programme, said almost 50 per cent of the Kingdom’s public and military health facilities are currently connected to Hakeem.
EHS CEO Feras Kamal said 100 hospitals and primary and comprehensive healthcare centres are currently connected to the system, and that two major hospitals — Al Bashir Hospital and King Hussein Medical Centre — will be automated in the middle of next year.
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Enjoy!
David.

Friday, October 28, 2016

SA Health Is Still Finding The Doctors Are Revolting And Not Happy With ePAS.

This appeared last week:

Doctors’ union warns Queen Elizabeth Hospital patients ‘at risk’ from EPAS electronic health record system

Brad Crouch, Medical Reporter, The Advertiser
October 21, 2016 10:30pm
CRITICALLY ill patients are being placed in “dangerous environments” and there is a “high risk” clinicians are missing vital medical information following introduction of the controversial electronic health record system at the Queen Elizabeth Hospital, doctors warn.
In a letter to SA Health interim chief executive Vickie Kaminski, obtained by The Advertiser, the SA Salaried Medical Officers Association warned workloads had risen since the Enterprise Patient Administration System was rolled out in June and registrars were taking double the time to do ward rounds.
However, Mrs Kaminski said the rollout had “significantly improved patient safety” with a marked reduction in medication errors thanks to the automatic safety net built into the EPAS.
SASMOA is demanding an urgent meeting to discuss their concerns, which also include claims members who complain are branded “technophobic”.
SA Health has agreed to a meeting in the next fortnight.
The QEH is the largest hospital to use the new system – which was designed to switch hospitals from paper to electronic records. EPAS is earmarked for the new RAH but the system is years behind schedule and the cost has doubled to $422 million, with predictions of more rises.
Use at Noarlunga, the Repatriation General and Port Augusta hospitals have all prompted staff complaints.
More here:
I wonder why it is that problems keep emerging with these implementations despite the number of years this has been going on and the depth of experience with the system that must now exist within the SA Health System.
Someone is not doing their job properly and making sure the roll out is being optimally managed one must begin to think – assuming, of course, that the software being implemented is up to scratch!
The persisting problems must also call that into question.
David.