I Wonder Is The ADHA Going To Send A Team To Help?

This appeared last week:

Pushing for better health care

By Joyetter Feagaimaali’i-Luamanu , 05 January 2018

Timely and quality health information will improve healthcare service delivery and provide routine evidence performance of Samoa’s health services. 

That is according to the Minister of Health, Tuitama Dr. Leao Tuitama, on the Samoa’s Health Sector eHealth Policy and Strategy 2017-2022.  

The vision behind the launching of the Samoa eHealth Policy will guide the Samoa eHealth Strategy implementation.

The report says the Government of Samoa is committed to using eHealth to deliver quality healthcare services to the people of Samoa through the proper use and management of Information, Communications and Technology (I.C.T.).

Tuitama in the report notes the move require a functioning Health Information Systems (H.I.S.) capable of capturing accurate data in order to produce information reports for healthy decision making. 

“It sets the long-term pathway and roadmap in improving, strengthening and incrementally developing the complex and phased approach of Samoa’s Health Sector eHealth planned development system. 

“Samoa’s H.I.S. has been characterized by fragmentation and lack of coordination, prevalence of manual systems and lack of automation, and where automation existed; there was a lack of interoperability connectivity between different systems. 

“This eHealth policy and strategy will be guiding the development of Samoa’s Health Sector H.I.S. from the current status to an integrated and well-functioning national system, based on agreed upon scientific and technological standards for interoperability in combating challenges of improving efficiency of clinical care, produce the indicators required for monitoring and evaluation reporting, facilitate patient mobility and supports healthcare professionals.

 “The architecture of this system will ensure patient and health information confidentiality is maintained to its highest level even when it is enabled to interface with other transversal systems when and if required. 

Lots more here:

http://sobserver.ws/en/06_01_2018/local/28543/Pushing-for-better-health-care.htm

I wonder do the Samoans feel they could use a little help and if so might the ADHA get the gig. After all they are pretty experienced travelers one reads! Would be a nice spot to visit!

David.

It Seems Blockchain For Health Data Ideas Are Popping Up Everywhere. It’s Getting Crowded!

This popped up a few days ago:

• 01.04.18

Can This App That Lets You Sell Your Health Data Cut Your Health Costs?

CoverUS wants to use the blockchain to let healthcare companies reward you for the data they now buy from your insurance company.

By Ben Schiller

Americans could do with new ways to save on healthcare. Obamacare-administered plans are set to get more expensive by up to 50% this year amid uncertainty around federal subsidies that help pay for premiums. The cost of employer-sponsored insurance, meanwhile, continues to jump well above inflation. Many of us are hit with surprise medical bills we can’t afford.

CoverUS, a startup, has one idea: monetizing our health-related data. Through a new blockchain-based data marketplace, it hopes to generate revenue that could effectively make insurance cheaper and perhaps even encourage us to become healthier, thus cutting the cost of the system overall.

It works like this: When you sign up, you download a digital wallet to your phone. Then you populate that wallet with data from an electronic health record (EHR), for which, starting in January 2018, system operators are legally obliged to offer an open API. At the same time, you can also allow wearables and other health trackers to automatically add data to the platform, and answer questions about your health and consumption habits.

A prototype of the app. [Screenshots: CoverUS]Why bother? To create a richer picture of your health than is currently held by the EHR systems, health providers, and data brokerages that buy and sell data from doctors, clinics, pharmacies, and other sources. By collecting all our data in one place, CoverUS wants to give us more autonomy over who uses our personal information and who makes money from it.

“From a moral standpoint, we think people should own their healthcare data. It’s currently being brokered to the tune of hundreds of billions of dollars without most of us knowing that it is happening,” cofounder Christopher Sealey tells Fast Company. “Secondly, we believe that healthcare data is most valuable when it’s in an individual’s hands because your electronic medical records and prescriptions only paint part of the picture. Nobody knows better than you how you are doing.”

The health data brokerage industry includes companies like Iqvia, Cinven, and Veeva. They buy and sell anonymized data under the Health Insurance Portability and Accountability Act (HIPAA), as well as non-anonymous health data not covered by that privacy standard, including what you put into search engines and health websites. Drug companies use this data to develop new products and target treatments to particular doctors and hospitals based on prescribing patterns. The data mining companies are often criticized for being intrusive, but it’s arguable if their profiles are even consistently accurate. When a reporter for The Atlantic downloaded her file last year, she found that the data was missing a good deal of necessary information.

CoverUS, which plans to launch in the first quarter of 2018, will pay for the data we gather in the form of a fixed-price cryptocurrency called CoverCoin. Users generate coins by signing up and then sharing their data. The startup then hopes users will be able to spend the coins on services that improve their health (like gym memberships) or deposit them in a health savings account where the coins can be exchanged for insurance plan savings. Sealey says it’s in discussions with several providers.

More here:

https://www.fastcompany.com/40512559/can-this-app-that-lets-you-sell-your-health-data-cut-your-health-costs

I was instantly reminded of this article just a week or so ago:

Rebuffed by the ADHA, E-Nome looks to GP and hospital systems to enable people to access their health information and sell it on

Lynne Minion | 19 Dec 2017

The Australian Digital Health Agency has denied claims by technology start-up E-Nome that patients will be able to access their My Health Record and sell their medical data to researchers, governments, pharmaceutical companies and insurers via the company’s upcoming app.

But head of E-Nome Nick Curtis has told Healthcare IT News Australia the My Health Record data isn't crucial to the success of the company's platform, with plans to integrate into GP, hospital, allied health services and wearables systems, enabling people to trade their most private of information, including genomes.

The Daily Telegraph reported on Monday that E-Nome was seeking investors to fund the development of its online platform.

According to the company's Position Paper, the app will allow individuals to share their de-identified health data with whomever they choose.

“E-Nome’s business is about providing a platform by which the consumer is empowered to be placed in the middle of a global market worth billions of dollars a year trading their data,” E-Nome’s position paper says.

“Current data collection and transfer is managed by major corporate intermediaries. These corporate intermediaries profit directly from the inefficiency and constraints in data collection. E-Nome is seeking to disintermediate data transfer in the health sector.”

The company is seeking to raise revenue by offering a new crypto-currency called Nomes for sale and hopes a two-stage investment process raises up to $60 million to fund the development of the “E-Nome Ecosystem”, including the E-Nome App, E-Nome Research Portal, E-Nome Medical Practitioners Portal, E-Nome Electronic Data Warehouse and the E-Nome Core.

Vastly more is found here:

http://www.healthcareit.com.au/article/rebuffed-adha-e-nome-looks-gp-and-hospital-systems-enable-people-access-their-health

It rather looks like there are a few players emerging in this domain. I wonder is the ADHA considering blockchain technology as part of the “replatforming” efforts?

That would move them to the bleeding edge!

David.

Post script:

Steve Wilson has tweeted a useful link as a bit of an antidote to all this:

http://lockstep.com.au/library/ehealth/how-healthy-is-blockchain

Thanks Steve.

David

It Seems Portals Allowing Access to Health Information Do Not Make Much Of A Clinical Difference.

This appeared last week:

Study shows patient portals have no impact on hospital readmissions or mortality

by Evan Sweeney 

Jan 3, 2018 10:33am

Previous research has have tackled patient portal usability and satisfaction among users, but few studies have looked at the impact of portals on hospital outcomes.

A new study out of the Mayo Clinic Hospital in Jacksonville, Florida, does just that with relatively uninspiring results.

Researchers found that 30-day readmissions, inpatient mortality and 30-day mortality were virtually the same when comparing hospitalized patients that used portals versus those that did not, leading them to conclude that patient portals may not ultimately improve hospital outcomes. The results were published last week the Journal of the American Medical Informatics Association.

But that doesn’t mean patient portals are entirely worthless. The researchers noted that of the 44% of patients that registered for a portal account, just 20.8% accessed it while they were hospitalized. Therefore, higher adoption rates could have a bigger impact on outcomes. 

Portal usage may also be more impactful for patients managing chronic diseases rather than an acute illness. Several other factors including mobile device availability, education and real-time access to physician notes could also have a positive influence on engagement and perhaps tip the scales when it comes to outcomes.

More here:

https://www.fiercehealthcare.com/mobile/patient-portal-study-outcomes-mortality-readmissions-mayo-clinic

Yet another reason to be a little skeptical of the various claims of benefit that are made for the myHR portal.

It would be really good to see some real evidence of significant benefit flowing from the myHR. Thus far there has been little credible evidence of benefit I have seen.

David.

Some Extra Questions and Thoughts On Re-Platforming From Grahame Greive

Here is the post: 
Australian Digital Health Strategy Question

Posted on January 8, 2018 by Grahame Grieve

On the subject of replatforming the MyHR, the Australian Digital Health Strategy has this to say:
Every healthcare provider will have the ability to communicate with other professionals and their patients via secure digital channels by 2022. Patients will also be able to communicate with their healthcare providers using these digital channels. This will end dependence on paper-based correspondence and the fax machine or post.
I’m doing some consulting to the Agency around Secure messaging, and I’m thinking about this. I haven’t heard any discussion about this anywhere – what would it look like?

• Would patients have to communicate through a MyHR portal? Or could they choose to use their normal Email? Or should there stringent security requirements?
• Would doctors ask patient’s for the email id? or would the register it via their MyHR?
• Would patients get a Doctor’s email from their website? Or would they look it up in the national healthcare directory?
• What kinds of workflows would you build on top of that? Care plans? Scheduling?

Obviously this is all just idle speculation. Surely there’ll be formal consultation and design and so forth later. But maybe we can toss around some ideas now…

Here is the link:

http://www.healthintersections.com.au/?p=2772

Looking forward to some useful comments.

As an opening question where will technology be in 5 years and what sort of impact will that evolution of tech have on any imagined futures? 2022 is a fair way off in technological terms I reckon? 

David.

It Seems Health Information Exchange and Record Location Without A Central Data Base Is Practical and Useful!

This appeared last week:

Strategic Health Information Exchange Collaborative launches new initiative to share patient records nationally

by Evan Sweeney 

Jan 5, 2018 10:01am

SHIEC's new initiative lays the foundation for interoperability between regional HIEs.

A national trade association for health information exchange organizations has launched a new initiative that allows regional HIEs to share patient medical records across the country.

The Patient Centered Data Home (PCDH), launched by the Strategic Health Information Exchange Collaborative (SHIEC) on Thursday, expands several smaller regional implementations designed to allow HIEs to synchronize patient records and notify physicians when their patient experiences a health event away from home.  

“The HIEs working together to create PCDH built a powerful foundation for interoperability between HIEs—and we managed to do it using our current technologies,” Dan Porreca, executive director for HEALTHeLINK, Western New York's HIE, and chair of the SHIEC board of directors, said in an announcement. “We also created and agreed to a national, legally-binding agreement, which laid the foundation for HIEs sharing data with each other across state lines and throughout communities.”

The national initiative lays the groundwork for medical records to follow patients across the 60 HIEs that make up SHIEC’s membership. When a patient visits a medical facility away from the area where they live, the provider generates an admissions message that includes the patient zip code. Using that information, PCDH notifies the treating physician that previous medical records for that patient are housed in another HIE. Likewise, the system can alert the patient's regular physician that a new record has been generated through a distant HIE.

More here:

https://www.fiercehealthcare.com/ehr/strategic-health-information-exchange-collaboration-patient-records-hie-interoperability

Here is the full release with more details:

SHIEC’s Patient Centered Data Home™ Initiative Launches Nationally

Nationwide Expansion of PCDH Lays Foundation for HIEs to Support Better Patient Care by Making It Possible to Share Patient Medical Records Across Geographies

January 04, 2018 09:30 ET | Source: Strategic Health Information Exchange Collaborative (SHIEC)

GRAND JUNCTION, Colo., Jan. 04, 2018 (GLOBE NEWSWIRE) -- The Strategic Health Information Exchange Collaborative (SHIEC), a national collaborative representing health information exchanges (HIEs), today announced the organization’s Patient Centered Data Home™ (PCDH) initiative is now live and serving tens of millions more patients through the network. PCDH is a secure health data exchange system that helps patients by proactively alerting their providers when they have a health event away from home.

The PCDH network makes this possible by synchronizing patient identity records among the several HIEs whose participants are caring for the patient, and it provides detail about where the patient record is located for easier, faster query and response. For patients, this provides reassurance they can receive high-quality, personalized care regardless of where they are in the country.

This national launch unifies three smaller regional implementations in which 17 HIEs worked together to prove the concept of inter-HIE information sharing and notification. Based on the success of the implementations, the participating HIEs have each agreed to a common, national agreement for participation, which set the stage for connecting the regional implementations together and rolling out the full-scale, national implementation.

According to Dan Porreca, executive director for HEALTHeLINK and chair of the SHIEC board of directors, “The HIEs working together to create PCDH built a powerful foundation for interoperability between HIEs – and we managed to do it using our current technologies. We’re very proud of this accomplishment and the milestone we’ve achieved. We also created and agreed to a national, legally-binding agreement, which laid the foundation for HIEs sharing data with each other across state lines and throughout communities.”

SHIEC’s launch of PCDH marks an important milestone in making it possible to achieve health episode notification and efficient data sharing across the country.

What is PCDH?

At its core, PCDH is an inter-HIE notification and data sharing system that allows a patient’s records to follow them wherever they seek care. Because patients are unrestricted by geographic boundaries when they seek care, it is common for a person to be treated by a doctor, clinic or hospital a distance from where they live. Frequently the “away” treatment facility is not a part of the same HIE in which the patient’s “home” doctors participate. As a result, there is a higher risk that the clinician treating them will not have access to the patient’s full medical records to support diagnoses and treatment plans.

To more quickly alert the treating physician that there are medical records available for access from the patient’s doctors at home, and to provide a specific query location to retrieve those records, HIEs worked together to create the technical ability for HIEs to automatically notify each other regarding the existence of a patient’s medical records and to synchronize the patient’s identity among the HIE systems.

The mechanism that makes this work is very straightforward. When a patient presents at a medical facility away from home, that facility will generate an Admission, Discharge, Transfer (ADT) message. This message includes demographics about the patient; information such as the patient’s name, the patient’s location in the hospital, his or her address, phone number, gender, etc. By including ZIP Code information in the ADT, PCDH can automatically detect when a patient is being treated within a ZIP code outside of their normal home area.

When these events occur, the “away” HIE alerts the HIE in the patient’s home area, and that home HIE, known as the patient’s “data home,” automatically lets the treating HIE know they have records for the patient so the treating HIE can generate a query to access those records. Once the treatment encounter concludes, PCDH also makes it possible for the “away” HIE to alert the patient’s home HIE that there are new records for their patient that the home HIE providers can access in order to better care for the patient on an ongoing basis. This new capability makes it possible for a patient’s comprehensive medical history to follow them wherever they seek treatment.

National Approach for Triggering Effective Data Sharing Built on Regional Collaboration

To prove the viability of the PCDH model, SHIEC set up three regional implementations: the western implementation, the heartland implementation and the central implementation. Each of these regional implementations involved coordination among multiple HIEs – which collectively spanned geographic areas and states. The trial implementations were constructed this way to prove the concept worked with multiple different HIE systems.

With the successful completion of the trial implementations and the creation of SHIEC’s national legal framework, PCDH is now being rolled out on a national level. With the implementation of the national agreement, SHIEC has connected the three regional networks into a nationwide network for securely sharing patient information when and where it is needed most to improve health and save lives.

About SHIEC

SHIEC is the national collaborative of health information exchanges (HIEs) and strategic business and technology partners. As the unbiased data trustees in their communities, the 60 member HIE organizations manage and provide for the secure digital exchange of data by medical, behavioral, and social service providers to improve the health of the communities they serve. Collectively, SHIEC members serve almost 75 percent of the U.S. population. For more information about SHIEC, visit info@strategichie.com and follow us on Twitter at @SHIEClive.

Here is the link:

https://globenewswire.com/news-release/2018/01/04/1283449/0/en/SHIEC-s-Patient-Centered-Data-Home-Initiative-Launches-Nationally.html

I am sure there are some wrinkles in all this but it does rather seem to be a much better way architecturally to solve the mobile patient problem and avoid a great big vulnerable database.

The myHR is looking more like yesterday’s idea as each day goes by!

David.

Weekly Australian Health IT Links – 8th January, 2018.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Again a very quiet week with little going on as the summer daze rolls on.

Enjoy the quick read!

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http://www.couriermail.com.au/news/opinion/opinion-amaq-calls-for-realtime-monitoring-for-codeine-prescriptions-to-tackle-addiction/news-story/2a7aaca15a67ce04a66809f3127c4174

Opinion: AMAQ calls for real-time monitoring for codeine prescriptions to tackle addiction

Richard Kidd, The Courier-Mail

January 2, 2018 1:00am

A FEW months ago President Donald Trump told a crisis meeting at the White House that the US’s opioid drug epidemic was a “national emergency”.

Unusually for President Trump, his comments did not attract controversy.

That’s because fatal drug overdoses in the US hit 59,000 last year – a massive jump from the 1990s when the annual toll was under 10,000.

It is no longer heroin that is America’s drug scourge, but powerful prescription opioid drugs such as oxycodone.

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http://www.afr.com/technology/apps/babyglimpse-dna-testing-app-affords-couples-a-look-into-their-babys-future-20171219-h07d4s

• Updated Jan 3 2018 at 12:15 AM

BabyGlimpse DNA testing app affords couples a look into their baby's future

by Allison Eatough

What will my baby look like?

It's a question expectant parents have had for centuries as they await the birth of their little one. Now, a new app co-founded by Calvert County, Maryland resident Jennifer Lescallett is offers an answer.

BabyGlimpse uses a couple's individual DNA to explore everything from a baby's potential hair and eye colour to whether it will be lactose intolerant, prefer sweet or salty snacks or sneeze when it looks towards the sun. It's one of the latest examples of a growing direct-to-consumer genetic testing industry, where companies market genetic tests to consumers and then work with labs to sequence, analyse and interpret the customer's DNA.

"BabyGlimpse is sort of like the bright side of genetics," said Lescallett, a mother of three and former genetics research associate. "We've coined it sunshine science. You get to look at the fun part of your potential future baby versus some of the scary stuff."

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https://chf.org.au/media-releases/consumer-health-care-priorities-2018

Consumer health care priorities for 2018

MEDIA RELEASE Thursday 4 January 2018

In this new year, the Federal Government should look to harness the forces transforming the health system and recognise the contribution health makes to national productivity, the Consumers Health Forum says.

“The internet-enabled consumer power that has transformed people’s interaction with the economy in areas such as banking, travel and telecommunications is rapidly creeping into the tradition-bound world of health care,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“The dynamics of health are shifting towards a stronger role for consumers.  With the right support through self-management programs and services, many of which can be digitally enabled and delivered, and roles leading and shaping health care policy, consumers are better placed than ever to drive innovation and improvement in health care.  In 2018, developments on a variety of health fronts will reinforce this trend.

“The gradual roll-out of consumer-centred primary care, the critical need to put in place community-based alternatives to hospital care, expansion of the My Health Record and proposals for a database where patients can check their surgeons’ fees and performance records when taking up a referral, exemplify the changing influences in health.

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https://ama.com.au/media/transcript-dr-gannon-6pr-dr-google

03 Jan 2018

Transcript: AMA President Dr Michael Gannon, 6PR, Breakfast with Lisa Barnes and Geof Parry, Wednesday 3 January 2018

Subject: Dr Google

LISA BARNES:   The Australian Medical Association President, Michael Gannon, joins us now. Good morning, Michael.

MICHAEL GANNON:   Good morning, Lisa.

LISA BARNES:   I'm not sure if you heard that call then with Judy, but it seems she had a good experience in using Dr Google yesterday. Is that what you're finding among other patients as well?

MICHAEL GANNON:   I think there'd be plenty of patients who would have positive experiences, and there'd be plenty of patients that are led down the garden path. I think that if you put into a search engine the basic symptoms, in my experience most patients end up diagnosing themselves with either leukaemia or a brain tumour. But if you ask for something very specific, there's some very credible and very useful health information that gives patients an idea how to proceed.

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http://www.dailymail.co.uk/news/article-5229967/AMA-boss-says-patients-Google-symptoms.html

So, it IS okay to Google your symptoms: AMA chief says patients can seek credible advice about their health online

• AMA boss Michael Gannon said patients Googling symptoms was beneficial
• Research enabled them to have 'more informed conversations' with doctors
• But patients shouldn't substitute the internet for doctors visits 

By Nic White For Daily Mail Australia

Published: 10:19 AEDT, 3 January 2018 | Updated: 10:26 AEDT, 3 January 2018

Australian Medical Association president Michael Gannon said doctors should not be annoyed if patients sought information from 'credible sources' on the internet

Patients looking up their symptoms online before going to a doctor could be beneficial, Australia's top doctor advised.

Australian Medical Association president Michael Gannon said doctors should not be annoyed if patients sought information from 'credible sources'.

The veteran doctor said Googling their symptoms would enable people to have 'more informed conversations' with medical practitioners.

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http://www.heraldsun.com.au/news/victoria/hospital-discharge-letters-too-slow-say-frustrated-gps/news-story/10065b1d23abd2971519af132b5d03bb

Hospital discharge letters too slow say frustrated GPs

Grant McArthur, Herald Sun

January 3, 2018 8:30pm

PATIENTS’ lives are being risked daily because of hospitals’ and specialists’ failure to provide timely discharge letters, frustrated GPs say.

The lack of instructions for patients and their family doctors after operations and other hospital stays are leading to thousands of costly readmissions to hospital, and a worsening of Victorians’ health, the Royal Australian College of General Practitioners says.

The problem has also increased pressure on state and federal governments to roll out electronic hospital records.

A State Government spokeswoman said health services were expected to provide GPs with timely patient discharge summaries, and the Commonwealth was encouraging more clinics to adopt technology to receive the information from hospitals.

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http://www.adelaidenow.com.au/news/opinion/the-advertiser-letters-to-the-editor-january-2-2018/news-story/24324a381f7b1140d6a2982fc302e968

The Advertiser Letters to the Editor, January 2 2018

The Advertiser

January 2, 2018 1:00am

Costly mistake

THE “motherhood” vision offered by AMA President William Tam for our health care prospects in the year ahead (The Advertiser, 29/12/17) avoids the harsh reality of the parlous state of our health and hospital systems.

The downgrading and fragmentation of hospital services with Transforming Health has resulted in serious problems in equity and access to health care. These problems must be addressed urgently in 2018 and beyond.

Remediation of the system requires administrative reform. SA Heath is beset with governance problems, inefficiencies and a lack of continuity in senior management; it presides over a toxic culture with poor staff morale.

A new overarching executive body should be established, with significant input from clinicians, and professional and industrial organisations, to provide an effective bridge between government, the bureaucracy and health workers.

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http://www.afr.com/technology/apps/tobi-pearce-and-kayla-itsines-100m-netflix-of-health-and-fitness-20171220-h08civ

• Updated Jan 1 2018 at 11:30 AM

Sweat: Tobi Pearce and Kayla Itsines' $100m 'Netflix of health and fitness'

by John Stensholt

Tobi Pearce compares the Sweat health and fitness global empire he has built from Adelaide with his fellow Young Rich List member Kayla Itsines to a software business or Netflix.

And following in those footsteps, with 28-minute workouts, dietary advice, yoga and post-pregnancy plans all tailored to women aged 20-35 around the world, is how Pearce says Sweat will maintain its relevance and keep growing in 2018 and beyond.

Sweat has a huge presence around the world and has hit upon the magic formula of combining fitness, the endless search for ways to lose weight and maintain a healthy diet with a huge social media presence.

The secret, according to Pearce, has been to harness his and Itsines' passion for workouts with tech savviness and pinpointing exactly what their consumers what via relentless data mining and consumer research.

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http://www.dailymail.co.uk/wires/aap/article-5227633/Flying-Doctor-Service-looks-future.html

Flying Doctor Service looks to the future

By Australian Associated Press

Published: 16:00 AEDT, 2 January 2018 | Updated: 16:00 AEDT, 2 January 2018

With 69 planes covering seven million square kilometres, the Royal Flying Doctor Service has come along way from one plane on loan from Qantas.

Best known for medical retrievals of Australians in some of the most remote parts of the continent, the service will mark its 90th year in 2018.

And as it does, it will continue to evolve and innovate, bringing Australians a broader range of services.

"We want to ensure we take the right services to the right people at the right time, that's the ambition," RFDS chief executive John Lynch says.

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http://www.theaustralian.com.au/life/personal-technology/living-with-robots-expect-evolution-at-home-in-ai-social-vr-and-ar/news-story/accce8e4b4ee4aead3dc85984e9fe461

Living with robots: expect evolution at home, in AI, social VR and AR

• The Australian
• 12:00AM January 4, 2018

Chris Griffith

They say all roads lead to Rome, but this year all technology roads lead to human-like robots. Better sensor technology, computer vision, object recognition, speech, voice recognition, artificial intelligence and unnervingly human facades will see the mechanical species increasingly viable.

But an elegant walking, talking robot is a way off. While AI is developing at an astonishing rate, the one area holding back robots is the mechanics of movement. They may move around on rollers but you struggle to find one that can walk gracefully, dexterously stack the dishwasher or clear the dinner table.

The beginnings of robots in the home are humble. We have Google Home, a speaker device you can talk to and request information such as the weather and news and speak commands to control your home.

This year Google Home will connect with an increasing number of Australian businesses and services. Already you can contact Officeworks, Optus and eBay, and Uber is coming.

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http://www.smh.com.au/business/it-will-take-decades-if-ever-to-recoup-cost-of-the-nbn-telstra-20180104-p4yy8u.html

It will take decades ‘if ever’ for cost of NBN to be recouped: Telstra

Jennifer Duke

Published: January 5 2018 - 12:15AM

NBN Co’s business model has been slammed by major telecommunications providers, which say the government needs to reconsider whether the company should have to fully recoup its investment costs.

In public submissions made in response to an Australian Competition and Consumer Commission review of the communications sector, Optus, Telstra and other leading retail service providers said a review of NBN's costs and pricing was needed sooner rather than later.

The government requires the $49 billion NBN to recover the cost of its rollout around Australia, which directly affects the prices it charges telcos for access to its network, which they pass on to consumers.

The ACCC's draft report, released in October, included a proposed recommendation that the government consider whether the NBN should continue to be obliged to recover these costs.

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http://www.smh.com.au/technology/technology-news/what-you-need-to-know-about-the-big-chip-security-problem-20180104-h0ddw8.html

What you need to know about the big chip security problem

Ian King

Published: January 4 2018 - 2:24PM

Intel Corp has said that most of the processors running the world's computers and smartphones have a feature that makes them susceptible to attack. The largest chipmaker is working with rivals and partners on a fix, but the news sparked concern about this fundamental building block of the internet, PCs and corporate networks.

What's the problem?

Modern processors guess what they'll have to do next and fetch the data they think they'll need. That makes everything from supercomputers to smartphones zippy. Unfortunately, as Google researchers discovered, it also provides a way for bad actors to read data that had been thought to be secure. In a worst-case scenario that would let someone access your passwords.

How bad is it?

This won't stop your computer working and doesn't provide an avenue for hackers to put malicious software on your machine. There's been no report so far of anyone's computer being attacked in this manner, but in theory this puts important data at risk. Hardware and chip-level security has long been pushed by the industry as more tamper-proof than software. Those claims may have been overstated.

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http://www.theaustralian.com.au/business/technology/what-you-can-do-to-protect-against-chip-flaw/news-story/9b1b1bf091ddd513be58a9d6a2564399

What you can do to protect against chip flaw

• Jay Greene
• Dow Jones
• 3:32PM January 5, 2018

While tech giants grapple with the chip security flaws disclosed this week, there are steps people can take now to mitigate potential harm to their iPhones, Windows PCs, Android devices and other gadgets.

The most important is ensuring software on any device is up to date.

Apple acknowledged today that its mobile devices and computers — even the Apple TV — are affected by one of the vulnerabilities, called Meltdown, but said it already issued updates to fix the problems.

For iPhones and iPads, iOS version 11.2 released last month includes the latest fix. You can update via the settings app.

For Macs, Apple pushed out version 10.13.2 to its High Sierra operating system last month. Users can find the update by clicking “About this Mac” under the Apple icon.

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Enjoy!

David.

It Looks Like Health Information Exchange Can Be Done Well With A Proper Interoperability Framework Like That Provided By ONC in the US.

This appeared last week:

ONC releases its Trusted Exchange Framework establishing a single ‘on ramp’ for interoperability

by Evan Sweeney

Jan 5, 2018 1:14pm

After several months of public meetings and industry input, the Office of the National Coordinator for Health IT has released its Trusted Exchange Framework and Common Agreement designed to improve data sharing between health information networks.

The framework (PDF), mandated by the 21st Century Cures Act, provides the policies, procedures and technical standards necessary to exchange patient records and health information between providers, state and regional health information exchanges and federal agencies.

It also aims to eliminate the burdens of costly point-to-point interactions that healthcare organizations currently face by creating a common set of practices to allow providers, patients, payers and health IT vendors to securely communicate with one another.

The voluntary framework is also an attempt to resolve some of the nagging issues inhibiting data sharing across the industry, including inconsistencies within the terms and conditions of health information networks. Genevieve Morris, principal deputy national coordinator for health information technology at ONC, compares those variations to the early days of cell phones when texting over different networks was not yet possible.

“This is just the floor of what those required terms and conditions are,” she told FierceHealthcare. “We all just have to agree to the same terms in order for that exchange to happen.”

The draft framework is broken into two sections. Part A provides guardrails and standards to “engender trust between health information networks,” addressing issues around transparency, security, patient safety, and data-driven accountability.

Part B outlines a minimum set of terms and conditions addressing authentication, trusted exchange rules and core operational policies.

More here:

https://www.fiercehealthcare.com/regulatory/onc-genevieve-morris-trusted-exchange-framework-common-agreement-interoperability

There is more coverage here:

ONC releases draft Trusted Exchange Framework to aid interoperability

By Greg Slabodkin

Published January 05 2018, 3:59pm EST

The Office of the National Coordinator for Health IT on Friday released a draft Trusted Exchange Framework to enable interoperability across disparate healthcare information networks nationally, as directed by the 21st Century Cures Act.

The draft framework is designed to support nationwide interoperability by outlining a common set of principles, as well as minimum terms and conditions for trusted data exchange. According to ONC, the document focuses on policies, procedures and technical standards that build from existing HIN capabilities and enables them to work together to provide a “single on-ramp” to patient information regardless of the HIT vendor they use or the health information exchange (HIE) with which they contract.

“Currently, there are more than 100 regional HIEs and multiple national level organizations that support exchange use cases,” states ONC’s draft Trusted Exchange Framework. “While these organizations have expanded interoperability within their particular spheres, the connectivity across all or even most of them has not been achieved. This has limited the patient health information that a provider or health system has access to, unless they join multiple networks.”

According to ONC, the proposed Trusted Exchange Framework supports the agency’s goals of achieving nationwide interoperability by—among other capabilities—having “open and accessible application programming interfaces (APIs) to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record (EHR) usability.”

National Coordinator for HIT Donald Rucker says provisions of the Cures Act seek to advance the interoperable exchange of electronic health information, and the agency’s draft Trusted Exchange Framework will help guide the country toward interoperability.

 “It’s a national challenge—it hasn’t been easy,” said Rucker. “Folks have made some great progress, but obviously there’s a lot of work to be done. One of the approaches that ONC is taking is exactly this Trusted Exchange Framework…the very specific request of Congress.”

Genevieve Morris, ONC’s principal deputy national coordinator, said the draft document is in part the product of three public listening sessions with industry stakeholders.

After a 45-day public comment period and refinements to the draft document, a final Trusted Exchange Framework will be implemented by ONC in collaboration with a Recognized Coordinating Entity—to be selected through a competitive process—which will use the policies, procedures, technical standards, principles and goals to develop a single common agreement that qualified health information networks and their participants will voluntarily agree to adopt.

…..

In addition, ONC has released a User’s Guide to Understanding the Trusted Exchange Framework and the US Core Data for Interoperability (USCDI) Glide Path to identify a roadmap for broadening the data that can be exchanged via the TEFCA. The agency is also seeking public comment on the USCDI Glide Path.

The full article is here:

https://www.healthdatamanagement.com/news/the-framework-is-designed-to-support-nationwide-interoperability

I have to say this all looks like a rational approach to getting health information to be available to all who need it. (patient, provider and payer) and it does indeed do sensible things like avoid a great big vulnerable centralized database.

You can download the 48 page Draft framework from the links provided in the text.

The ADHA might usefully have a very close look at the document to see how some / many of the ideas may assist in Australia. Does anyone know just where the ADHA is up to with their Framework – has been pretty quiet recently?

I particularly like the approach to the private sector reflected here.

David.

AusHealthIT Poll Number 404 – Results – 7th January, 2018.

Here are the results of the poll.

Overall, How Would You Assess The Progress Made In 2017 In Australian Digital Health?

Great 1% (2)

Minor 27% (58)

Non Existent 56% (121)

Gone Backwards 17% (36)

I Have No Idea 0% (0)

Total votes: 217

Any insights welcome as a comment, as usual. It really seems that in the eyes of those that read here 2017 did not go all that well for the ADHA.

A really great turnout of votes!

We note there were no respondents who were clueless, but two seemed a little confused!

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

David.