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, February 11, 2017

Weekly Overseas Health IT Links – 11th February, 2017.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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HL7, HSPC join forces to solve interoperability challenges

Published February 03 2017, 7:02am EST
Health Level Seven International and the Healthcare Services Platform Consortium have signed a collaboration agreement opening the door for the organizations to undertake joint projects aimed at solving industry-wide interoperability challenges.
The collaborative effort is meant to support the development of HL7’s emerging Fast Healthcare Interoperability Resources (FHIR) standard. HSPC is a group of providers, IT vendors and system integrators that are dedicated to creating an open ecosystem of interoperable applications, content and Service Oriented Architecture (SOA) services, and the organization has been a champion of FHIR for several years.
According to Oscar Diaz, HSPC’s chief executive officer, his organization held the first FHIR summit with Grahame Grieve—architect of the open healthcare data standard—before the Argonaut Project was formed by HL7 to accelerate its development and adoption.
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Cerner president Zane Burke reveals open approach to interoperability

The health IT giant is focusing its $700 million R&D budget on EMR usability, interoperability, revenue cycle management, population health. 
February 02, 2017 09:01 AM
Cerner president Zane Burke said that advancing interoperability is a moral obligation for the healthcare industry. 
Cerner President Zane Burke said the company is continuing to push forward with a focus on overarching trends such as patient identification, population health – and an open philosophy to interoperability.
“It’s one thing to say it, it’s another thing to do it,” Burke said. “It takes significant focus to be both open and interoperable.”
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Secure texting pitfalls can hurt patient care

Feb 3, 2017 12:06pm
A slow connection could cause harmful delays when physicians text critical orders.
Connectivity delays and network latency continue to be significant barriers to secure texting between clinicians, an issue that creates the opportunity for patient harm, according to several IT executives at a Texas health system.
Although text ordering may be convenient for physicians during routine patient care, network connectivity concerns can hamper the immediacy of those orders, creating potential delays for physicians who rely on immediate communication while caring for critically ill patients, executives with Christus Health in Dallas wrote in Perspectives in Health Information Management.
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Blockchain could save healthcare from interoperability woes

Feb 3, 2017 9:35am
The regulatory and innovation climates could set the stage for blockchain in healthcare this year.
Emerging technology—coupled with new IT regulations and Department of Health and Human Services leadership that is keen on improving interoperability while reducing documentation burdens—could give blockchain technology the boost it needs to finally integrate into healthcare.
Although blockchain technology offers tremendous promise regarding both data security and accessibility, practical solutions have yet to make a breakthrough in healthcare. But since interoperability continues to be a chief concern throughout the industry, this may be the year blockchain finally makes its debut in a meaningful way.
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Move to implement patient ‘data lake’ scheme

Ben Heather
30 January 2017
NHS leaders will “rapidly move to implement” a new NHS patient “data lake” scheme after consulting experts and industry, the NHS’ top CIO says.
In a letter, obtained by Digital Health News, NHS England’s chief information officer Will Smart said he had received 45 responses to the proposed scheme.
The responses came from attendees at the Interoperability and Population Health Summit, which Smart convened in December.
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Making the most of electronic health records is easier said than done

EHR optimization is a big challenge. Healthcare's fundamental transition from fee-for-service to a value-based business model is just one major hurdle.
February 01, 2017 10:30 AM
Electronic health records have become an integral part of healthcare delivery over the past decade or so, and for the most part, providers have adapted to using them in varying capacities. Still, there is a sense in the industry that EHRs aren't fulfilling their enormous potential as conduits for personal health information, patient diagnostics and monitoring, point-of-care decision support and as an optimal financial tool.
EHRs definitely need to be optimized, industry analysts say, but going about it brings forth some thorny issues regarding healthcare's changing business model, utilization protocols, definition of purpose and enriching the technical capabilities necessary to give them more functionality.
As for why EHRs haven't yet become a pinnacle of success for the modern age, the menu of reasons is vast.
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Wed Feb 1, 2017 | 5:39pm EST

Medical records don’t always match what patients say

(Reuters Health) - Symptoms that patients describe to doctors may not always be documented in electronic medical records, a small U.S. study suggests.
To test out how well the records match reality, researchers compared symptoms that 162 patients checked off on paper-based questionnaires with the information entered in patients’ electronic charts at eye clinics.
Roughly one-third of the time, data on blurry vision from the paper questionnaires didn’t match the electronic records, researchers report in JAMA Ophthalmology. Symptom information also didn’t match for glare 48 percent of the time and was discordant in 27 percent of cases for pain and 25 percent for redness.
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How to benefit from a data-driven, patient-centered approach to care

Published February 02 2017, 4:13pm EST
The shift to value-based care is moving full steam ahead. Delivering the Institute for Healthcare Improvement’s Triple Aim—higher quality, lower costs and better outcomes—is more important now than ever.
How do we as physicians meet these goals, while most importantly, keep the patient at the center of our model? By encouraging interoperability of systems through open health IT platforms, we can deliver better care to our patients, at a lower cost, and ultimately foster healthier patient populations.
My practice, Holston Medical Group (HMG), now has several years’ experience using open platforms and establishing value-based initiatives. HMG is a multi-specialty physician group that sees an average of 40,000 patients per month across 41 offices in Northeast Tennessee and Southwest Virginia. Physician-owned and physician-led, HMG manages a diversified group of more than 150 primary care physicians, specialists and mid-level providers.
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Under-pressure NHS turns to artificial intelligence for smart patient care

Ellie Burns 2nd February 2017
Business and government are on a mission to deploy and succeed with AI in healthcare – IBM Watson has been drafted in the fight against cancer, while the NHS is trialling an AI app and working with the likes of Google’s Deepmind to improve patient care.
It is easy to see why the UK’s NHS would be rushing to adopt AI, with the over-burdened, costly and complex infrastructure of the NHS a perfect candidate in which to reap the efficiency and productivity benefits of AI.
Although archaic processes still reign supreme in the NHS, new data does suggest that AI is starting to infiltrate and make an impact in trusts around the UK.
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New software aids speed, accuracy of medical image analysis

Published February 01 2017, 6:55am EST
Physicians who spend inordinate amounts of time and effort analyzing medical images may be able to get much-needed relief from new software that is able to quickly and accurately analyze any series of images from MRIs, CT scans, and ultrasounds, among other diagnostic equipment.
Researchers at the University of Missouri-Columbia developed the software, called Tracking Equilibrium and Nonequilibrium shifts in Data (TREND). They contend that the application, available free for academic use, can significantly reduce the cost and time required to conduct image analysis as well as improve the process of diagnosing patients.
Doctors spend hours, days or even weeks analyzing these kinds of images. However, by using TREND, the researchers contend that analysis takes only a few minutes and is more accurate and consistent than if physicians performed the work themselves.
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Emerging FHIR standard just the start of interoperability efforts

Published February 01 2017, 7:00am EST
The lack of a universal terminology standard is a major barrier to communication between different electronic health record systems and the ability to derive clinical meaning from the shared EHR data.
While industry experts are working on ways to overcome this challenge, they disagree on the extent to which stakeholders should try to solve the problem of semantic interoperability.
Disparate EHR systems have their own inherent clinical terminologies. By leveraging common data models and vocabularies, these systems can “talk” to each other in the same “language,” providing the ability to share clinical information and use it meaningfully.
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Epic tops 2017 Best in KLAS awards, securing top spot for 7th straight year; see complete winners

Premier landed four Best in KLAS awards and won the Overall Best in KLAS for Healthcare Management, a new category.
January 31, 2017 10:56 AM
Epic landed the top spot for Overall Software Suite in the 2017 Best in KLAS: Software and Services report, for the seventh consecutive year. The report draws from healthcare provider feedback.
Epic also earned the top Overall Physician Practice Vendor and Best in KLAS awards in eight segments.
Premier scored four Best in KLAS awards and won Overall Best in KLAS for Healthcare Management Consulting Firm, a new category. Optimum Healthcare IT was named top Overall IT Services Firm and earned one Best in KLAS award.
Cerner, Caretech Solutions, MedSys Group and IBM Watson subsidiary Merge each earned two Best in KLAS awards.
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Experts: Personalized medicine, data accessibility will shape the next century in healthcare

Feb 1, 2017 10:04am
Experts say genomics and data will improve patient engagement and alter care in the next 100 years.
Health IT experts believe the rise of genomics and personalized medicine will pave the way for healthcare’s transition to a more patient-centered approach to care over the next 100 years.
In particular, advancements in genetic testing will provide physicians with a more complete picture of each patient's risk for complex diseases, experts told Elsevier as part of the organization’s 100th anniversary celebration of its Medical Clinics journal.
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Elon Musk wants to turn humans into bionic hybrids

DNA Web Team | Mon, 30 Jan 2017-05:15pm , Mumbai , DNA webdesk
The Tesla founder isn’t the only one looking to this path, other companies are also researching cybernetic augments for the human mind
Last week, Elon Musk made an announcement to the world, that he would be providing updates on his neural lace project in February. This particular piece of technology is the iconic entrepreneur’s attempt at improving the capability of the human mind with cybernetic augmentation.
In the race to perfect neural networks, Artificial Intelligence systems have already surpassed humans in many ways. They can beat us at complex games like poker and Go, identify disease markers more accurately than humans, drive our cars better than we do, and in some cases even teach other AI. Thanks to these developments, a few tech leaders have been worried about humanity’s place in a machine-driven world, and the potential catastrophic fallout that could result from a rogue AI.
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Forrester predicts breaches as big as Anthem will become commonplace in 2017

The research firm offers five cybersecurity predictions for 2017, ranging from Internet of Things devices to Trump facing a cyber-crisis.
January 31, 2017 07:06 AM
Healthcare breaches will become as large and common as retail breaches, and the 2015 breach of Anthem that affected as many as 80 million patients will become commonplace in the future, predicts Forrester Research.
That is one of five predictions in its “Predictions 2017: Cybersecurity Risks Intensify,” which includes warnings about President Trump facing a cyber-crisis, the talent gap in cybersecurity, a Fortune 1000 company failing because of a cyber-breach, and a major Internet of Things devices security crisis.
On the healthcare note, as a result of mergers, acquisitions and other partnership arrangements, large healthcare insurer and provider conglomerates are only increasing in size, as is the critical patient information they store, the report said. 2017 represents a turning point for healthcare providers because the consolidation of providers leaves security fragmented with varying security levels and because patient data carries tremendous unique, permanent information, such as genetic markers, and biometric data, such as fingerprints, Forrester said.
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Use cases will demonstrate progress in information exchange

Published February 01 2017, 1:39pm EST
Data exchange among healthcare organizations has achieved increased importance as many in the regulatory sphere now recognize the importance of ensuring the free flow of information among all constituents.
Pressure is rising to ensure that the industry is not engaged in blocking information, either because of competitive pressure or technical issues.
This year’s progress in achieving interoperability will be on display at HIMSS17, where 34,000 square feet of floor space will be used to show industry progress in exchanging information among various partners in healthcare.
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Why 2017 will be a pivotal year in advancing interoperability

Published February 01 2017, 3:38pm EST
With January barely behind us and new occupants in the White House, perhaps it’s a good time to set aside what might change for a moment and focus on what must change.
Interoperability is a more urgent concern in 2017 because of the goals established last year by the Office of the National Coordinator (ONCHIT) and the passage of the 21st Century Cures Act, which legally requires healthcare IT interoperability by the end of the current calendar year.
The Interoperability Standards Advisory for 2017, released by ONCHIT in December, is an effort to facilitate interoperability by releasing “essential standards and implementation specifications” determined in dialogue with public and private sector partners. These partners include healthcare IT vendors with products installed in 90 percent of U.S. hospitals that have also made a public commitment to the ONCHIT-created Interoperability Pledge and its essential elements:
1. Use standardized APIs.
2. Make it easier for patients to access data.
3. Don’t block information exchange.
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Macedonian miracle as eHealth system ends hospital waiting lists

Macedonia Gary Finnegan
An online booking system has helped Macedonia abolish waiting lists. The European Consumer Health Index shows Serbia is set to do the same - and others may follow
Macedonia’s online appointment-making tool has dramatically slashed waiting times for patients, prompting neighbours to adopt the system wholesale and pushing the former Yuogoslav republic up to 20th position of the 35 countries in the 2016 European Consumer Index, despite being among the poorest in the region.
“Macedonia is the biggest success story we’ve seen since launching the Index over 10 years ago,” said Arne Björnberg Chair of the Health Consumer Powerhouse, which compiles the ranking. “They have rocketed up the scoreboard since introducing the system in 2013 and have now eliminated waiting lists altogether.”
The system allows GPs to make appointments for their patients with hospital consultants or to book slots on diagnostic scanners such as MRI and X-ray machines. This significantly reduces the amount of downtime for specialists and fills up timeslots where expensive imaging machines would otherwise lie idle.
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Jonathan Bush: Time for a health IT arms race

athenahealth’s CEO said that hospital executives should stop tolerating software that users hate and, instead, demand a new set of core competencies from their technology vendors. And he pointed to Waze, Google and Kayak as examples to emulate.
January 30, 2017 12:35 PM
New technologies in consumer markets (travel, shopping, social/networking with friends, etc…) are continually drawing in people, creating new demand curves, while healthcare – with its faxes, beepers, legacy system software – remains comfortably and obstinately entrenched in its frozen time bubble. In short, we haven't seen any 'break all the laws' bids in healthcare – like what Uber did with ride sharing or Amazon for shopping. 
That said, I'm an optimist. Despite the glacial-like pace of groundbreaking health information technology to date, I predict that in 4 to 6 years we'll see an explosion of networked-backed health services that come with a loyal commitment and proven ability to chip away at our industry's massive cost overrun and inefficiency issues. If they're going to stick, however, they'll need the right adoption incentives and network from which to grow. 
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Trump’s two-for-one regulation order: Its potential impact on healthcare

Jan 31, 2017 11:47am
President Donald Trump’s new executive order aimed to reduce the number of federal regulations could be good for the healthcare industry.
President Donald Trump’s new executive order aiming to reduce the number of federal regulations could be good for the healthcare industry, according to health policy experts interviewed by FierceHealthcare.
The order is designed to cut federal regulations by requiring departments and agencies to eliminate two existing regulations for every new rule they introduce.
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Study: Docs spend more time with computers than patients

Jan 31, 2017 12:11pm
Docs spend an increasing amount of time with computers instead of patients, according to a new study.
Doctors may spend up to three times as much time with computers as they do with patients, according to new research. 
The study, conducted at a Swiss hospital, found that residents at the facility spent nearly half their day on computers. The docs, on average, spent about 1.7 hours a day with patients and 5.2 hours on computers, with about 13 minutes spent doing both.
"That so much of residents' time is spent on the computer, rather than on direct patient care and interaction, suggests we need to rethink how residents' time is allocated to achieve a more reasonable balance," Nathalie Wenger, M.D., a researcher at the University Hospital of Lausanne where the study was conducted and its lead author, told Medscape Medical News (reg. req.).
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Handheld healthcare: Mobile apps spread around the globe

Jan 30, 2017 | Cara Livernois
Mobile access to healthcare, through apps or telemedicine, will continue to grow in the coming years. A new report from SA-Business Research & Consulting Group, "Global Smart Phone Enabled Healthcare Diagnostics Market Assessment & Forecast: 2016 - 2020," shows the most potential growth in rural countries and those offering care otherwise unavailable.
The report outlines the growth of smartphone healthcare products and differing capabilities from regions around the world. With more than 550 million people using smartphones for health-related purposes, the market continues to expand.
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More on Population Health

Black Book ranks top population health vendors

The firm also found that while population health management is top of mind for healthcare providers many still lack a clear strategy.

Population health management is one of the fastest growing areas in healthcare IT, in the realm of about $8 billion in spending, according to Black Book's most recent survey, released January 30.
So it's no surprise that many electronic health record vendors and pure-play population health companies are making big moves in the space.
Black Book, in fact, ranked Allscripts, Cerner and Epic as the top three core EHR/PHM vendors. The research firm pointed out a measurably higher satisfaction with Allscripts and Cerner because they are vendor-agnostic to other EHRs in the PHM process. 
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73% of organizations increase cybersecurity spending in 2017: 4 things to know

Written by Jessica Kim Cohen | January 30, 2017 |
At the start of 2016, 58 percent of organizations anticipated their IT security spending would increase by the end of the year, according to a Thales report. In 2017, this number has grown to 73 percent.
Here's what you need to know.
  • The top two spending priorities are network (62 percent) and endpoint (56 percent) protection. The least common spending priority organizations reported was data-at-rest encryption (46 percent).
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Mobile App Reduces Alarm Fatigue

Scott Mace, January 31, 2017

A mobile app that integrates clinicians' phone with infusion pump alerts is reducing alarm fatigue among staff at a small Wyoming hospital.

Alarm fatigue is a common condition among clinical staff in hospitals. Symptoms of the affliction may include sensory overload, desensitization, and missed alarms.
Now mobile apps that can pre-empt alarms and improve workflow are being tested as possible remedies.
An 88-bed hospital in tiny Sheridan, WY, (population 17,828) is a beta site for one such app.
Sheridan Memorial Hospital has integrated its infusion pump technology with Cerner's CareAware Connect app residing on clinicians' mobile phones. As a result, nurses, physicians, and pharmacists at the hospital can now track the progress of infusions using the same interface they use to securely communicate with each other.
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FHIR expected to supplement, not replace, other standards

Published January 30 2017, 6:49am EST
While Health Level Seven International’s Fast Healthcare Interoperability Resources (FHIR) application programming interface holds great potential for the interoperable exchange of health information, the emerging standard will not replace older HL7 standards.
That’s the contention of Russell Leftwich, MD, senior clinical advisor for interoperability at software vendor InterSystems and assistant professor of biomedical informatics at Vanderbilt University School of Medicine.
Leftwich believes that by leveraging RESTful application programming interfaces, the latest web standards that are the basis of Google and Twitter, FHIR has tremendous potential to serve as the core functionality to support data access in healthcare enabling health information exchange.
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Not easy for practices to perfect patient followup

Jan 30, 2017 11:37am
Procedures to follow up with patients need improvement.
Procedures to follow up with patients either after an office visit or after a visit to the emergency room or a hospital stay need improvement.
Current procedures aren’t working in his own patient-centered medical home, writes Fred N. Pelzman, M.D., of Weill Cornell Internal Medicine Associate, on MedPage Today.
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Most docs say health wearables provide little helpful data

Jan 30, 2017 10:41am
So far, wearables aren't providing doctors with useful patient data.
When Permanente Medical Group president and CEO Robert Pearl, M.D., spoke before a healthcare conference last fall, he got a laugh when he joked that doctors make use of Fitbits when they need to buy a Christmas or Hanukkah present for that person on their list who has everything.
In fact, for the majority of doctors the data that Fitbits and other wearable devices can currently track isn’t very helpful, according to Wareable.com, a website that reports on wearable technology.
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How technology can help sustain rural providers

Published January 30 2017, 2:57pm EST
As 2017 begins, around 81 percent of Americans live in urban areas, up from 79 percent in 2000. At the same time, urban and suburban areas where vacant land exists (so, not you, San Francisco) have been expanding, redefining what used to be rural.
With this demographic shift comes a transition of resources and tax bases that leave rural areas and rural services, including healthcare, struggling to survive.
Indeed, we can learn a lot about the state of rural healthcare from several access-related statistics:
  • As of last year, more than 70 rural hospitals had closed since 2010 and 673 were vulnerable to closure, of which 68 percent were critical access.
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Ransomware: What to Do When Your Systems are Hijacked

BlogJanuary 26, 2017Billing Compliance, Compliance, HIPAA
Electronic healthcare security systems were put to the test in 2016, as record numbers of hospitals, facilities and physician practices fell victim to ransomware attacks.  The increasing number of ransomware attacks on providers is particularly troublesome because hackers can essentially lock out users from their EHR systems.  Once a system is infected, providers feel compelled to pay the ransom rather than sustaining an interruption to patient care.  For these reasons, providers should learn about the risks of ransomware and develop strategies to prevent and manage such malicious cyber-attacks. 
Ransomware refers to malicious software that attempts to deny access to a user's data, usually by encrypting the data in a way that prohibits access until a ransom is paid.  Computer systems affected by ransomware will see ominous messages, indicating that their computer is essentially locked out, except for a web-link that directs the user to pay a ransom to a hacker.  The ransom is usually demanded in Bitcoin or other cryptocurrency and requires the user to access the "dark web" to make the payment.  Hackers promise that upon payment they will release a decryption key, which will restore the user's system.  However, there have been instances where hackers do not honor their promises and instead demand more money.    
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HIMSS Analytics sees longer-term growth for telemedicine, biometric security and many more

From revenue cycle management to precision medicine, its newest report projects hospital demand for more than 80 health IT applications over the next 24 months
January 26, 2017 03:55 PM 
HIMSS Analytics' newest Essentials Brief offers a look back at health IT market trends in 2016 – and ahead to the rest of this year and beyond, projecting purchasing demand for 81 different applications in 2017 and 2018.
In examining areas such analytics, telehealth, precision medicine and population health, the aim is to gauge hospital technology needs in the next 12 to 24 months, said HIMSS Analytics Director of Research, Brendan FitzGerald.
"Given everything that's occurred from an adoption standpoint since 2008 and 2009, where are organizations going?" he said. "Where do they still need IT help to deliver on their vision?"
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19% of healthcare cyberattacks caused by hacks, malware in 2016, down from 2015

Written by Jessica Kim Cohen | January 26, 2017 
The incidence of ransomware attacks is expected to double in 2017, according to a Beazley analysis of 2016 data.
For the report, Beazley — a London, U.K.-based cybersecurity insurance company with offices in Asia, Australia, Middle East, South America and the United States — analyzed ransomware attacks it has handled over the past few years. The company found ransomware has more than quadrupled in 2016 compared with 2015, with almost half of 2016 attacks taking place in the healthcare sector.
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Enjoy!
David.

Friday, February 10, 2017

I Reckon It Is Really Hard To Disagree With This Sentiment!

This appeared last week.

Jonathan Bush: Time for a health IT arms race

athenahealth’s CEO said that hospital executives should stop tolerating software that users hate and, instead, demand a new set of core competencies from their technology vendors. And he pointed to Waze, Google and Kayak as examples to emulate.
January 30, 2017 12:35 PM
New technologies in consumer markets (travel, shopping, social/networking with friends, etc…) are continually drawing in people, creating new demand curves, while healthcare – with its faxes, beepers, legacy system software – remains comfortably and obstinately entrenched in its frozen time bubble. In short, we haven't seen any 'break all the laws' bids in healthcare – like what Uber did with ride sharing or Amazon for shopping. 
That said, I'm an optimist. Despite the glacial-like pace of groundbreaking health information technology to date, I predict that in 4 to 6 years we'll see an explosion of networked-backed health services that come with a loyal commitment and proven ability to chip away at our industry's massive cost overrun and inefficiency issues. If they're going to stick, however, they'll need the right adoption incentives and network from which to grow. 
Back in the day, health IT vendors were king if they could convince potential buyers that they had mastered the meaningful use game. With MACRA and MIPS, not much has changed; vendors still remain on the hook for helping provider organizations report against government programs. This is the easy stuff, as evidenced by the massive glut of government certified solutions.
But as reimbursement models, both public and private, shift to demand quality beyond just reporting, so too does the job of health IT. I find it satisfying that the playing field will no longer be defined just by "check the regulatory box" systems, but will become an arms race to determine which health IT partners will play the most meaningful role in driving actual performance. A definite sorting of the wheat from chaff. 
As such, it's time for health IT buyers to start the arms race, to demand a new set of core competencies from health IT systems and the vendors who sell them that work in service to the organizations that use them. Some of the most successful companies in their respective industries like Waze, Google and Kayak, tap into the power of networks to deliver valued results to their users. Shouldn't health IT systems follow suit?
If healthcare operated off of a networked infrastructure, data would be stored holistically, rather than trapped in silos at individual organizations. Data could be viewed comparatively so insight into clinical, financial, and operational performance is not limited to a single site, but could be benchmarked across an entire network of peers. Bright spots could be found. Best practices identified. Inefficiencies corrected at scale.
More here:
I wonder what Mr Bush (and yes he is from that famous family) would think about the extreme user hostility of the myHR? I suspect he would want to see some work on that too!
David.