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, May 16, 2015

Weekly Overseas Health IT Links - 16th May, 2015.

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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Cerner Q1 Results Fall Short of Analyst Expectations

MAY 8, 2015 7:44am ET
Cerner Corp., which is battling privately-held Epic Systems for supremacy in the electronic health records market, had good revenue numbers in the first quarter of 2015 yet still did not match investment analysts’ expectations.
Quarterly revenue of $996.1 million increased 27 percent over the first quarter in 2014, but was short of the $1.09 billion consensus figure of analysts. “Revenue was below guidance provided by the company due to a combination of lower than expected revenue from our recently closed acquisition of Siemens Health Services, and lower revenue in our existing business,” according to a Cerner statement.
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Surgical robot hacks: Exploring the vulnerabilities

May 8, 2015 | By Susan D. Hall
An engineering team at the University of Washington has been exploring the security vulnerabilities of a surgical robot to determine whether a malicious attack could hijack remotely-controlled operations in the future.
Their research, described in a recently published ArXiv paper, comes at a time when medical robot sales are increasing by 20 percent per year, according to an announcement.
The research was done using the Raven II, a next-generation teleoperated robotic system that is used solely for research and is not FDA approved--not the Da Vinci surgical system in wide use in the U.S. And during the experiments, the robot was merely moving blocks, not actually performing surgery.
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5 ways to close common medical device vulnerabilities

May 8, 2015 | By Brian Eastwood
The U.S. Department of Veterans Affairs is no stranger to cyberattacks. In March, roughly 1.2 billion cyberattacks targeted the VA network, CIO Stephen Warren said at the Medical Informatics World conference in Boston. That's a sharp increase from 330 million attacks in November.
Amid all that activity, the VA saw a sharp drop in protected health information breaches in March, with 383 veterans the victim of a PHI breach in March compared to 891 in February, FierceHealthIT previously reported.
Admittedly, the VA benefits from a level of security that not all healthcare organizations have--namely, the Department of Homeland Security's control points, known as Trusted Internet Connections, as well as advanced security measures that even Warren doesn't know about.
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Fitness and Health Market Opportunities for Wearables

by Harry Wang Thursday, May 7, 2015
Today, roughly 30% of U.S. broadband households own a connected health device, which includes approximately 15 million households that have a connected fitness or wellness device, such as a fitness tracker, a weight scale, or a sports watch with heart-rate/GPS functions. Adoption rates are increasing, particularly among high-income households, where more than one-third own a connected health device, and by 2016, more than 32 million U.S. consumers will actively track their personal health and fitness online or via a mobile device.
The entry of notable consumer-friendly brands such as Apple and Google will spur this growth in particular by driving consumer awareness and the emergence of new products and applications. Apple's new watch -- which the company unveiled in September 2014 and started to take pre-orders on April 10 -- will crush the smart watch sales of its competitors in 2015; however, the entire smart watch industry will benefit from Apple's entry. A complete ecosystem will form around these devices, including support, value-added services and apps, which will create new opportunities for device makers, service providers, and health and technology companies.
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Survey Finds Mixed Nurse Perceptions about EHRs

MAY 7, 2015 7:17am ET
A new survey of more than 600 U.S. nurses finds that a large majority of respondents believe electronic health records can help providers improve patient safety (73 percent) and reduce medication errors (72 percent). And, acute care nurses were even more convinced that EHRs support improved patient safety (82 percent).
However, the survey—conducted by HIMSS Analytics on behalf of EHR vendor Allscripts—also showed
that fewer than half of the nurses surveyed (43 percent) agreed that EHRs eliminate duplicate work, while an even smaller percentage of floor/acute nurses (26 percent) indicated that EHRs reduce duplicate work. Though about a third of nurses (31 percent) agreed that EHRs help them to spend more time with patients, even more (38 percent) said that EHRs in fact reduce the time they can spend with patients.
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IBM's Watson to guide cancer therapies at 14 centers

May 5 (Reuters) - Fourteen U.S. and Canadian cancer institutes will use International Business Machines Corp's Watson computer system to choose therapies based on a tumor's genetic fingerprints, the company said on Tuesday, the latest step toward bringing personalized cancer treatments to more patients.
Oncology is the first specialty where matching therapy to DNA has improved outcomes for some patients, inspiring the "precision medicine initiative" President Barack Obama announced in January.
But it can take weeks to identify drugs targeting cancer-causing mutations. Watson can do it in minutes and has in its database the findings of scientific papers and clinical trials on particular cancers and potential therapies.
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Most health data breaches caused by criminal attacks

May 7, 2015 | By Susan D. Hall
Criminal attacks on healthcare organizations have increased 125 percent in the past five years and now are the leading cause of data breaches, according to a new study from the Ponemon Institute.
At the same time, most healthcare organizations are not prepared for the rapidly changing world of cyberthreats, lacking resources and process to protect patient data, according to an announcement.
Small to mid-size organizations especially are vulnerable because they have limited security and privacy processes, personnel, technology, and budgets compared with their larger counterparts, the report notes.
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Rising Cyber Attacks Costing Health System $6 Billion Annually

8:00 PM AEST  May 7, 2015

Recommended

A rise in cyber attacks against doctors and hospitals is costing the U.S. health-care system $6 billion a year as organized criminals who once targeted retailers and financial firms increasingly go after medical records, security researchers say.
Criminal attacks against health-care providers have more than doubled in the past five years, with the average data breach costing a hospital $2.1 million, according to a study today from the Ponemon Institute, a security research and consulting firm. Nearly 90 percent of health-care providers were hit by breaches in the past two years, half of them criminal in nature, the report found.
While intrusions like ones exposing millions of consumers at health insurer Anthem Inc. and hospital operator Community Health Systems Inc. have increased risk awareness, most of their peers are still unprepared for sophisticated data attacks, security experts have said.
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As Data Breaches Spread, Providers and Payers Must Prepare

Lena J. Weiner, for HealthLeaders Media , May 6, 2015

The actions taken by an organization in the days, weeks, and months after a security breach can mean the difference between recovery and organizational failure—whether the breach is a result of criminal activity or "good people doing stupid things."

Three words healthcare executives dread hearing—"we've been hacked"—are reverberating in hospitals, health systems and physicians groups with growing frequency.
Just last week, Boston-based Partners Healthcare notified 3,300 patients that some information including names, addresses, dates of birth, telephone numbers and Social Security numbers and clinical information had been leaked to hackers. In February, the country's largest insurance company, Anthem, announced that 80 million member and employee records had been breached.
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EHI News becomes Digital Health News

4 May 2015   Digital Health News staff
EHI News has changed and become Digital Health News; a new name to reflect the changing face of healthcare IT and digital health and social care.
With the new name comes a new domain, digitalhealth.net. Digital Health brings together EHI News, EHI Intelligence, the CCIO Network and Health CIO Network - to create a new home for UK health IT.
For the next six months, anyone visiting the old ehi.co.uk domain will be taken to a landing page that asks whether they want to proceed to digitalhealth.net. 
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Cancer Centers, Epic to Tap Power of IBM Watson Supercomputer

MAY 6, 2015 7:15am ET
Fourteen major cancer centers will use the cognitive abilities of the IBM Watson Health supercomputer to quickly analyze patients’ DNA, identify cancer-causing mutations and speed identification of personalized treatment options.
Further, Epic Systems Corp. is working with Watson and Mayo Clinic on a proof-of-concept program to match patients to the most appropriate clinical trials.
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3 tips for getting along with Dr. Google

May 4, 2015 | By Debra Beaulieu-Volk
Though they need to better engage patients in their health, physicians often struggle to help patients use medical information they may obtain online in a productive way. Difficulties with patients consulting "Dr. Google" may include misinformation, biased medical suggestions and patients' preconceived ideas about their diagnosis or treatment, Laura Cooley, Ph.D., director of education and outreach at the American Academy on Communication in Healthcare in Lexington, Kentucky, told Medical Economics.
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Legislators grill Karen DeSalvo on interoperability

May 6, 2015 | By Dan Bowman
The issue of poor interoperability between electronic health record systems took center stage at a Senate hearing Tuesday focusing on the promise of precision medicine.
National Coordinator for Health IT Karen DeSalvo was peppered with questions and comments from legislators about the current state of interoperability as it pertains to healthcare in general, President Barack Obama's Precision Medicine Initiative and with regard to the Department of Defense's pending EHR contract.
Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Committee on Health, Education, Labor & Pensions, pointed out that despite $28 billion spent on EHR adoption so far, physicians aren't keen on such systems due to, among other issues, disrupted workflow.
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Karen DeSalvo to step down as ONC head if confirmed for HHS role

May 6, 2015 | By Dan Bowman
President Barack Obama late Wednesday announced his intent to nominate current National Coordinator for Health IT Karen DeSalvo for Assistant Secretary for Health at the Department of Health and Human Services.
As DeSalvo's confirmation is pending, she will continue to serve both as head of ONC and as Acting Assistant Secretary for Health, according to an email sent to staffers by HHS Secretary Sylvia Mathews Burwell that was shared with FierceHealthIT. Once confirmed by the Senate, however, DeSalvo will step down as National Coordinator, HHS confirmed.
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HDM May Feature: The Portal Outlook is Cloudy

MAY 5, 2015 7:32am ET
Engaging patients through the use of health information technology has been a growing challenge for healthcare organizations, and it's one that's expected to loom even larger in years to come.
Patient portals, as the acknowledged leading patient engagement tool, so far have been disappointing in satisfying the needs of both patients and providers. While portals typically enable patients and families to view health and billing information and perform simple requests, such as schedule appointments, consumer uptake has been minimal.
That's a worry for providers, which are on the hook for consumer use of engagement technology. Objectives for Stage 2 of the federal meaningful use program were the first to set out a requirement for consumer connection to clinical information. While that level of engagement was set low, many healthcare organizations reported problems in getting consumers to participate.
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Telemedicine Reimbursement and Licensure Expands in State Regulations

Scott Mace, for HealthLeaders Media , May 5, 2015

At its annual meeting, the American Telemedicine Association reports that 24 states now require that healthcare received via telemedicine be paid the same as in-person services.

Over just six months, state regulating bodies show moderate improvement in telemedicine policies and laws, the American Telemedicine Association reports this week.
At its annual meeting in Los Angeles this week, the ATA reported that 24 states and Washington, D.C., now have enacted parity laws requiring comparable coverage of and reimbursement for services delivered via telemedicine as is available for in-person services, by state-approved private insurance plans, state employee medical plans, and Medicaid. Three more states than had such laws in effect last September.
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Telemedicine Reimbursement and Licensure Expands in State Regulations

Scott Mace, for HealthLeaders Media , May 5, 2015

At its annual meeting, the American Telemedicine Association reports that 24 states now require that healthcare received via telemedicine be paid the same as in-person services.

Over just six months, state regulating bodies show moderate improvement in telemedicine policies and laws, the American Telemedicine Association reports this week.
At its annual meeting in Los Angeles this week, the ATA reported that 24 states and Washington, D.C., now have enacted parity laws requiring comparable coverage of and reimbursement for services delivered via telemedicine as is available for in-person services, by state-approved private insurance plans, state employee medical plans, and Medicaid. Three more states than had such laws in effect last September.
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Technology and the Patient Experience

Scott Mace, for HealthLeaders Media , May 5, 2015

In addition to cutting-edge tools and devices, some healthcare leaders are finding that even putting consumer feedback on a website can play a role.

This article appears in the April 2015 issue of HealthLeaders magazine.
All too often, technology manages to get in the way of superior patient experiences in healthcare. Despite the benefits technology brings to healthcare, it also can intrude on doctor-patient communications. Too much gathered information remains locked up, unavailable to the public. But at more and more healthcare organizations, attention is shifting to leveraging technology to make the healthcare experience better and more transparent.
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Interoperable Medical Device Safety Standards Making Headway

MAY 4, 2015 7:15am ET
It may be a stretch to compare the medical device market of the early 21st century to the market for electrical wiring and appliances in the early 20th century, but the goal of Underwriters Laboratories is essentially the same in both instances.
"Our goal is public safety. People recognize our brand because of our focus on that," said Anura Fernando, principal engineer for eHealth Medical Systems Interoperability and mHealth at UL. "In some cases, like electrical safety, people often don't even notice the UL mark on the back of products. In some respects it becomes very much taken for granted. But regardless of public perception and branding and so forth, we try to find areas where we can continue to grow and evolve the mission."
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Healthcare security: Adapt or die

Posted on May 04, 2015
By Erin McCann, Managing Editor
This is Part III of our April Cover Story on healthcare IT's tall to-do list. Part I focused on interoperability. Part II focused on analytics
"It is not the strongest or the most intelligent who will survive but those who can best manage change" – a quote, often attributed to Charles Darwin, (turns out it was actually a paraphrase by some accounts), but that aside, a lesson in evolutionary biology turns out to be incredibly useful in the realm of healthcare security.
When examining the rapid speed at which the threat landscape for healthcare is changing and combining it with the traditionally slow-to-adapt nature of the healthcare industry in general, the problem's pretty clear.  

Increasing frequency of cyberattacks

It's a different threat world nowadays. Think about it. Every 60 seconds, 232 computers are infected with malware; 12 websites are successfully hacked, with 416 attempts; more than 571 new websites are created; 204 million emails are sent, and 278,000 tweets are sent out into the twittosphere – all in a single minute. Combine this with the fact that on the black market, medical records are worth $60, compared to credit card data, which typically sells for $20. So, what are the implications for a healthcare security professional?
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Regenstrief gives clinicians CDS control

Posted on May 04, 2015
By Bernie Monegain, Editor-at-Large
When in comes to clinical decision support, clinicians often have to go through a lengthy process to get specific warnings or reminders added to the electronic medical record system.
But, Regenstrief Institute aims to change all that by making it possible for the clinicians to write decision support rules based on personal experience with their patients.
RAVE, a new distributed approach to clinician decision support rule authoring  developed by Regenstrief, is "personalized" to patient population, location and time, developed. RAVE, ann acronym for Rule Authoring and Validation Environment, was tested at Eskenazi Health, one of the nation's largest safety net hospital systems.
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Big data's biggest healthcare challenge: Making sense of it all

May 4, 2015 | By Katie Dvorak
Collecting healthcare data on patients and populations will soon be easier than ever for the industry, it's making sense of all the information that will be the biggest challenge, Drew Harris, M.D., director of health policy at Thomas Jefferson University's School of Population Health in Philadelphia, writes at the Wall Street Journal.
The most significant change will come when data systems are merged; when electronic health records can link people who live, work and commute together, according to Harris.
"This information can be used to inform your care from knowing which bacterial strains are circulating in your network to what ideas about health and health behavior are influencing you," he writes.
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Nurses Develop RNSafe to Verify Bedside Dosing

May 4, 2015
Several nurses at Boston Children’s Hospital have banded together to develop RNSafe, a prototype mobile system designed to help verify bedside medication and doses, taking advantage of an Innovation Acceleration Program grant.
Hospital rules stipulate that when a nurse delivers a complex medication, another nurse must be present to observe and verify the dose. However, retrieving a second nurse on a hectic hospital floor can pose a challenge, which can be further compounded when the nurse has to wear protective gear because the patient’s room contains infection control precautions.
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Researchers Take Most Clinical Data Registries to Task

May 1, 2015
Most clinical data registries on patient outcomes are substandard and lack critical features to make them useful, say researchers at Johns Hopkins University School of Medicine. 
The researchers looked at 153 U.S. clinical registries containing health service and disease outcomes data to determine how effective they were at tracking outcomes. They created a registry of registries to study how healthcare measures its performance. What they found was that poor data monitoring and reporting were ensuring these registries were not aiding the patients, providers, policymakers, and researchers that needed them for guidance. 
A strong majority of registries (more than 75 percent) did not adjust results for differences in disease complexity, which researchers say leads to misinterpretation. An even greater number did not include independently entered data, which is supposed to mitigate the bias of self-reported data. Also, they found that most registries did not share their data publicly and a majority of U.S. recognized medical specialties had no national clinical registries.
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Teleburn Aids in Burn Diagnosis, Treatment

by Rebecca Vesely, iHealthBeat Contributing Reporter Monday, May 4, 2015
Teleburn, an emerging telemedicine specialty that links hospitals and clinics to specialty burn centers, is filling a gap in diagnosis and treatment of burns as burn centers have become more consolidated into regional centers of excellence over the past 15 years.
"There are fewer and fewer burn centers, and the expertise is hard to duplicate," Daniel Caruso, chief of burn services at the Arizona Burn Center at Maricopa Integrated Health Center in Phoenix, said. "Burn care is really amenable to telehealth."
Advances in digital and smartphone cameras today are making teleburn possible because of the low cost and the high quality of images outlying centers can send to specialists to accurately diagnose burns and recommend treatment, Caruso said.
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The Reality of Virtual Care

Scott Mace, for HealthLeaders Media , May 4, 2015

Telemedicine is removing geographical boundaries and bringing patients and providers together.

This article appears in the April 2015 issue of HealthLeaders magazine.
Virtual care is not a new idea. Videoconferencing dates back several decades. Remote monitoring in ICUs began more than a decade ago. Telestroke and remote behavioral health programs have been on the radar in many settings for years.
But two major factors have given virtual care a big boost in the past year. Healthcare's notorious inefficiency is pushing health systems to balance workloads and workflows, erasing distance and time as limiting factors on the provision of care—using virtual care to do much of the balancing. Second, telemonitoring technology is providing improved ease of use and simplicity, while more attractive price points and performance capabilities are driving virtual care innovation into all of healthcare's costly nooks and crannies.
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Use of mHealth can reduce the impact of demographic change

Written by Anne-Sophie Parent on 4 May 2015 in Opinion
Tackling privacy and security issues is key to empowering old people to part manage their own health and wellbeing, says Anne-Sophie Parent.
A question certain to be raised at this year's eHealth week is whether mobile health can provide an answer to the increasing needs of Europe's ageing population.
The event, held in Riga, is set to focus on the main conclusions from the European commission's public consultation on mobile health, or mHealth as some call it. 
eHealth is a generic term covering all ICT-enabled health services and devices that are used by health professionals, carers, funders and patients. 
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Patent Trolls Are Everywhere

Consumer personal health record vendor LMG 3 Marketing and Development Corp. sues Apple, claiming that its Health and HealthKit apps violate its patents for technologies that it claims to have licensed to retailers such as Target. I found the original 2012 patent, which is a vague and seemingly unrelated description of a personal health record on a thumb drive. The primary inventor is Mike Lubell of Raleigh, NC, who developed MyPMR in 2000 while creating an EMR/PM business unit  for Canon Business Solutions. LMG 3 apparently offers sells MyPMR for $34.95.
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Enjoy!
David.

Friday, May 15, 2015

We Really Do Need To Be Paying More Attention To The HIT Safety Issues.

I spotted this from one of our local experts this week.

In Conversation with…Enrico Coiera, MB, BS, PhD

Editor's note: Enrico Coiera, MB, BS, PhD, is a professor and director of the Centre for Health Informatics (Australian Institute of Health Innovation) at the University of New South Wales. Dr. Coiera has researched and written about clinical communication processes and information systems. We spoke with him about how interruptions and distractions in the clinical environment influence patient safety.
 This interview can be heard by subscribing to the AHRQ WebM&M Podcast (.MP3 | 11.9 MB | 8 minutes, 40 seconds)
Interview
Dr. Robert Wachter, Editor, AHRQ WebM&M: How big a problem are interruptions and distractions in the world of patient safety?
Enrico Coiera: Interruptions happen every day to every clinician, nurse, and doctor. It's become clear over the last decade that in some clinical settings, not only are interruptions frequent but they're also a patient safety risk. We're not saying every interruption is a bad interruption, but we do know that for certain places and times, they can lead to significant patient risk.
RW: Which areas have the highest risk?
EC: The challenge is in understanding why interruptions can cause harm. They essentially disrupt working memory with the consequence that you can forget to do what you're about to do or, very oddly, repeat the task you've already done. For example, you might have administered a medication to a patient and then been interrupted, but because you do the task so often any individual act is not particularly memorable, and you give the same dose again.
An interruption can also result in the interrupted task being incorrectly executed. My classic example is driving to the shops on a Saturday morning, when the cellphone goes off. By the time you've finished your call, you don't find yourself at the shops but instead in the car park at work. The call has occupied your attention and because you are distracted, you follow an initially similar, but ultimately wrong plan, which dominated because it is well rehearsed and easily enacted.
Psychology tells us certain variables predict higher risk of memory disruption. Probably the most important is working memory load, which is governed by many things you have to remember at any one time, and how complicated each is. If a task involves mental calculation or many steps, then your working memory load will be high and thus put you at more risk of disruption by interruption. Another issue is if the interrupting task is very similar to what you're currently doing, this also increases the risk that it will lead to memory disruption.
Another variable is the interruption modality—is the interrupting task visual or auditory for example? Those modalities are processed differently in the brain. It's quite possible to be talking about one thing and looking at a something different, to multitask. If the interruption uses the same modality however, like two visual tasks, then you have more chance of one disrupting the other. The final variable is how good you are at the task you're doing. If you have a lot of practice and experience, your opportunity to do well with interruption increases.
So, the kinds of clinical tasks that we worry about include administering medications, preparing injectable chemotherapy and IVs, induction of anesthesia, or putting a central line in. They're all tasks for which cognitive and task variables suggest that they are at risk of disruption by interruption.
Lots more here:
Well worth a listen!
David.

Surely This Is Shuffling The Deck Chairs On The Titanic!

This appeared a little while ago.

Immigration CIO leaves to join Health


Paul Madden takes over e-health drive.

The Department of Immigration's chief information officer Matt Yannopoulos will leave the agency to take over as CIO at the federal Department of Health.
Yannopoulos will end an almost two-year stint as Immigration's top tech chief in July to take on a position held by former Health CIO Paul Madden, as first reported by Intermedium.
Madden was moved into a new special adviser role at Health - responsible for strategic health systems and information management - as the result of an internal restructure several months ago.
His remit includes the agency's e-health initiatives.
Following Madden's promotion, Bettina Konti was placed into the role of CIO.
She will now move into the department's e-health division under Madden to deliver the switch from opt-in to opt-out for the national myHealth Record (formerly PCEHR).
Yannopoulos will take on the title of CIO and responsibility for the systems that support the Department’s operations.
More details here:
Given that according to the Budget Papers there is no National E-Health Strategy or plan one can only wish them some luck and hope they are very good at making it up as they go along!
One would have to think maybe Bettina has been given a poisoned chalice! We can all watch on with interest…..
This really has the feel of a disaster in the making, not because of the people but because of the bizarre way they are apparently being forced to proceed.
David.

Thursday, May 14, 2015

The Privacy Act and The Rules Will Suddenly Get More Attention If An Opt-Out PCEHR Is Implemented!

There were a couple of articles appeared last week.
First we had this:

Privacy complaints leap as companies struggle with compliance

Date May 4, 2015 - 3:09PM

Hannah Francis

Technology Reporter

More than half of all major Australian companies recently examined by Australia's Privacy Commissioner have failed to comply with privacy rules.
Privacy Commissioner Timothy Pilgrim said that 55 per cent of the 20 top websites run by the companies examined published inadequate privacy policies, while privacy-related complaints had leapt 43 per cent in the year since the nation's privacy laws were revamped.
The companies surveyed included the "big four" Australian banks; social media sites Instagram, LinkedIn and Twitter; the Department of Human Services; and major media outlets including news.com.au, ninemsn.com.au, The Guardian Australia, Yahoo!7 and The Sydney Morning Herald, owned by Fairfax Media, publisher of this article.
Government agencies performed the best out of 11 industry sectors when it comes to handling users' personal data and privacy.  
A separate report from Deloitte Australia, also launched on Monday to coincide with Privacy Awareness Week, found more than a third of consumers had experienced privacy "issues" with Australian companies.
The findings come just over a year after the Office of the Australian Information Commissioner (OAIC) introduced revamped privacy rules for government agencies and businesses, as well as increased powers for the Privacy Commissioner.
More here:
Second we have this.

NSW Privacy Commissioner calls for mandatory data breach notification

State privacy act needs an overhaul
NSW Privacy Commissioner Doctor Elizabeth Coombs has called for amendments to be made to the state's Privacy and Personal Information Protection (PIPP) Act from 1998 to bring it in line with 21st Century privacy concerns.
A report (PDF) was tabled in state parliament which outlined a number of recommendations.
These include:
  • The PPIP Act to be amended to provide mandatory notification of serious breaches of an individual’s privacy by a public sector agency.
  • Access to and amendment of personal information to be governed solely by the PIPP Act and access to non-personal government information to be governed by the Government Information Public Access (GIPA) Act
  • All NSW state owned corporations should be covered by privacy legislation
  • Principle of anonymity and pseudonymity where lawful and practicable
  • Coombs to prepare guidance for agencies on the use of surveillance technologies such as CCTV
  • The PPIP to include privacy by design
  • ISO/IEC 27018 standard covering privacy, security and cloud services to be considered for inclusion in the NSW government’s information security management systems policy
  • A Code of Practice to be developed to enable information sharing for planning and policy analysis purposes between agencies.
More here:
Lastly we have this:

Nearly half of employees inadequately trained on Privacy Act compliance

Only 54 percent of workers believe their employers have given them adequate training about how to preserve the privacy of customers' personally identifiable information (PII), a new survey has found as privacy authorities spruik a new privacy management framework designed to help Australian organisations improve privacy compliance efforts that have been slammed as inconsistent and unbelievable by consumers.
Released by the Office of the Australian Information Commissioner (OAIC) to mark the 2015 Privacy Awareness Week – an annual awareness exercise run by the Asia Pacific Privacy Authorities (APPA) forum – the new Privacy management framework is designed to help organisations boost employee awareness of privacy responsibilities.
Specific recommendations are intended to inform organisations' privacy response along four key steps: embedding a culture of privacy, establishing robust and effective privacy processes, evaluating privacy processes to ensure continued effectiveness, and enhancing organisations' response to privacy issues.
“Privacy management is an obligation that is continuous and proactive and for it to be successful, it must have support from an organisation's leadership team,” Australian privacy commissioner Timothy Pilgrim said in a statement.
More here:
While the Government agencies typically do a good job of protecting personal information their responsibility rises dramatically with a compulsory opt-out system.
It seems to be certain new legislation will be required with the change to opt-out as we believe is the case - so we will need to wait and see just how it is framed - especially as the Privacy Commissioner would seem to be at least partially defunded!
There are some serious issues to be sorted out - and these will need to be sorted before the trials commence.
David.

Wednesday, May 13, 2015

The Budget Has Some Pretty Tough Details For The Health Sector. Rises Are Less Than Health Inflation.

This appeared yesterday and highlights the bigger picture.

Federal budget 2015: Nearly $2 billion in cuts to health system

Date May 12, 2015 - 8:41PM

Amy Corderoy, Dan Harrison

The Abbott government will cut nearly $2 billion from the health system over the next five years, while pushing ahead with controversial changes to the way it funds state-run public hospitals.
After angering voters last year with proposals for a Medicare co-payment, Health Minister Sussan Ley has looked for savings from a range of little-known programs, including grants for preventative health research, chronic disease prevention and rural outreach. 
Ms Ley says the budget still represents a "sensible and moderate" increase in funding – to more than $69 billion next financial year. Health spending is projected to increase by 3.2 per cent in real terms over the next four years.
The government is proceeding cautiously on Medicare reform, allocating $34 million to support the work of taskforces which will examine elements of the system and present reform blueprints to the government by the end of the year.
But it has not retreated on its plans to cease funding hospitals based on the services they provide and shift to a new model based on population growth and inflation, which will leave states and territories $57 billion worse off over 10 years.
The Australian Medical Association has said this "will fall well short of the funding needed to position public hospitals to meet the increasing demand", locking them in to having inadequate capacity to give people the treatment they need.
Patients will welcome $1.6 billion in new drug listings, including medicines for melanoma and bowel cancer.
A number of services will be added to Medicare, including a new treatment for early-stage breast cancer, while a new cervical cancer test will mean women will only need to get a pap smear every five years instead of every two.
More here:
The really bad bit of this is the pressing on with the huge cuts to the Public Hospital Sector. You can be sure that the Premiers on either side of politics are going to become increasingly noisy regarding this issue.
Also we still don’t quite know where Pharmacy and Drug costs will land as the Agreement with the Pharmacy Guild is still unresolved - and looks like taking a few more weeks. It is good to see that some additional drugs are added to the PBS - but speaking today Mr Hockey confirmed the Government is still pushing up the PBS Co-Payment by $5.00 per prescription. That will be a big hit to some.
We will need a few more details for the full extent of what has been added and what has been removed to become totally clear.
One additional bit of good news is a new MBS item for Telehealth in ophthalmology in remote areas in 2015-16. Small but sensible I reckon.

The AMA reaction to what they saw in Health was less than keen.

See here:

https://ama.com.au/media/spectre-2014-budget-overshadows-modest-measures-2015-health-budget

What was particularly odd was this comment:

"A/Prof Owler said it was evident tonight that the health sector was not impressed with the withholding of Budget detail in the Health Budget lock-up.
“It was insulting to have the leaders of Australia’s health organisations locked in a room with no Budget detail,” A/Prof Owler said.
The AMA will make a more detailed response when full details of the health Budget are made available."

I wonder what was going on there? I also wonder of the AMA has thought through its comments on the e-Health reboot?

David.

Here Are The Main Details Of The E-Health Area Of The Budget For 2015-16. Very, Very Interesting!

This is the detail.
Programme 7.1: eHealth
Programme Objectives

Redevelop and operate a national shared eHealth record system

The report from the Review of the Personally Controlled Electronic Health Record, released in May 2014, made recommendations aimed at improving the operation of the system and increasing use by healthcare providers and individuals. In 2015-16, the Government will work with stakeholders to implement key recommendations from the review including: usability improvements; renaming the system as My Health Record; revised incentives; and education and training for healthcare providers. The Government will also commence trials of new participation arrangements, including an opt-out system recommended by the review, to inform future strategies for increasing uptake and meaningful use of the My Health Record.

Provide national eHealth leadership

The Australian Government will continue to lead the national roll out of eHealth technology and services, and work with the States and Territories to support eHealth foundations, and finalise a national eHealth strategy. This strategy will identify the priorities for future Commonwealth and jurisdictional investment in eHealth.
In 2015-16, an Implementation Taskforce will be established to oversee and manage the transition of governance arrangements and eHealth operations from the National eHealth Transition Authority and the Department of Health to the Australian Commission for eHealth. This Commission will assume responsibility for the governance, operation and ongoing delivery of all eHealth across Australia, including the My Health Record from 1 July 2016.

In 2015-16, the Practice Incentives Programme (PIP) eHealth Incentive will be reviewed with the aim of encouraging general practices to contribute to and use the My Health Record system to improve clinical decision-making and the continuity of care for their patients.

Programme 7.1 is linked as follows:
·           This Programme includes National Partnership payments for:
-    Tasmanian electronic patient information sharing.
National Partnership payments are paid to State and Territory Governments by the Treasury as part of the Federal Financial Relations Framework. For Budget estimates relating to the National Partnership component of the programme, refer to Budget Paper No. 3 or Programme 1.9 of the Treasury’s Portfolio Budget Statements.
·           The Department of Human Services (Services to the Community – Health Programme 1.2) to support operation of the My Health Record.
·           The Department of Industry and Science (Business and Market Development – Programme 3.2) to expedite clinical trial reform in Australia.
Programme 7.1: Expenses

Table 7.2: Programme Expenses

2014-15 Estimated actual
$'000
2015-16 Budget

$'000
2016-17 Forward Year 1
$'000
2017-18 Forward Year 2
$'000
2018-19 Forward Year 3
$'000
Annual administered expenses





Ordinary annual services
135,221
135,981
129,963
120,944
5,062
Non cash expenses1
18,309
18,309
18,308
-
-
Programme support
23,127
20,829
10,515
10,577
10,830
Total Programme 7.1 expenses
176,657
175,119
158,786
131,521
15,892
1    “Non cash expenses” relates to the depreciation of computer software.

Programme 7.1: Deliverables

Qualitative Deliverables for Programme 7.1
Redevelop and operate a national shared eHealth record system
Qualitative Deliverables
2015-16 Reference Point or Target
Good practice principles and methods are applied to the operation and support of the My Health Record system.
The My Health Record system operations and practices are regularly reviewed to improve performance and usability.
Trials of new participation arrangements are undertaken, including for an opt-out system.
Trials to commence in 2016.
Provide national eHealth leadership
Qualitative Deliverable
2015-16 Reference Point or Target
New eHealth governance arrangements are implemented, including establishment of the Australian Commission for eHealth.
The Commission is operational from 1 July 2016.
Programme 7.1: Key Performance Indicators
Qualitative Key Performance Indicators for Programme 7.1
Redevelop and operate a national shared eHealth record system
Qualitative Indicator
2015-16 Reference Point or Target

Participation trial findings inform future planning to increase participation in, and meaningful use of, the My Health Record.
Trials to commence in 2016.



Quantitative Key Performance Indicators for Programme 7.1
Redevelop and operate a national shared eHealth record system
Quantitative
Indicator
2014-15 Revised Budget
2015-16 Budget
Target
2016-17 Forward
Year 1
2017-18 Forward
Year 2
2018-19 Forward
Year 3
System availability
99% of the time (excluding planned outages)
99% of the time (excluding planned outages)
99% of the time (excluding planned outages)
99% of the time (excluding planned outages)
N/A

The amazing details are as follows:

1. They don’t actually have a National -Health Strategy at present.

2. They will establish the usual task force in 2015-16 to implement the changes - presumably after some planning!

3. They will begin trial of Opt-Out in 2016 - so hardly likely to see much actually until 2017.

4. ePIP will be fiddled with again to increase pressure to use the system.

5. The funding allocated is hardly more than was already planned - if at all!

6. And in the notes we see this:  The Government has agreed to continue and improve the operation of eHealth records for three years, ending 30 June 2018. The funding largely stops at that date.

The suggestion that this is all just a holding action to keep things ticking over while actually doing a new Strategy and working out what to do is looking better and better!

More comments later.

David.