This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
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
Another really quiet week with the occasional highlights – like the loss of a whole heap of Cabinet Papers! Enjoy!
It turns out the best way to get your hands on secret government documents in Australia is to head down to a furniture store and buy a locked cabinet or two full of them.
This sounds like the plot of a bad sitcom, but thanks to the reporting of Australia's ABC, we know it is the truth.
The gravity of this scenario cannot be overstated. These are some of the most secret documents that the Australian government creates, usually locked up for 20 years before being released to the public due to their sensitively and to put a bit of time between the actors and their actions, yet here they were, up for sale in suburban Canberra.
Consultation has started on the My Health Record Guidelines for Pharmacists developed by the PSA
The Guidelines provide guidance to pharmacists on meaningful clinical use of the My Health Record system.
By the end of 2018, all Australians will have a My Health Record unless they choose not to have one.
Pharmacists have a professional responsibility to review their practice and, where necessary, build on their digital health competency to ensure they are ready to integrate use of the My Health Record system into patient care.
Wild Health Melbourne is a one day Q&A panel style summit bringing together the country’s thought leaders on interoperability and future connectivity in medicine.
Whether you’re a grass roots GP, seeking practical ways to improve patient hours per day via technology, or a ‘GP connectivity guru’ wanting to engage more effectively and network with the country’s top thought leaders ,Wild Health Melbourne, on April 17, at Collins Square in Melbourne, is an important event to get to.
Not your usual talkfest, health experts who will take to the stage include CEOs, CIOs, CMIOs, Clinicians, Innovators and Academics from: The Royal Children’s Hospital, Melbourne Health, Monash Health, Barwon Health, Mater Health, Peninsula Health, Australian Institute of Innovation, Flinders Research Centre, Victoria’s Dept. of Health and Human Services, Western Australia’s Dept. of Health, and the Federal Government’s Australian Digital Health Agency + more.
Wearable technology – is this one of those emerging terms that clearly shows I am not keeping up with the times?
I confess I am no IT junkie and I do know about some of the more contemporary wearable technology including pedometers, smartwatches and Fitbits. But these are just the tip of the iceberg – there is an abundance of wearable technologies, with two examples being the Smart Shoe and the Smart Hoodie.
The “Smart Shoe” provides health analytics, has Bluetooth connectivity to enable personalised messages from a coach, and includes auto lacing and regulated temperature control.
Patients will be able to control who has access to their MHR, and can receive information in real-time about who has accessedtheirinformation.Asat7January 2018,nearly5.5millionAustralianshad aMHR,withabout25%ofpharmacies registeredtoaccessthesystem.
Recently, the Australian Digital Health Agency(theAgency)announcedanumber of partnerships with dispensing software providers to ensure their software is compliantwiththeMHRsovitaldispensing informationisprovidedtoapatient’s MHR which can be utilised by other healthcare professionals in the care of thepatient.Thesepartnershipswillmean theoverwhelmingmajorityofdispensing software providers are able to ensure their customers (pharmacies) can access the MHR system.
The intent of the Board is to publish as many Board documents as is feasible. Information and attachments to Board documents that are draft, not finalised or sensitive will not be published. An exception is made for draft material already in the public domain (in this instance the Board Advisory Committee Charters released on 16 September 2016).
Board Meeting 6 December 2017 - Board Papers (Download)
Embrace My Health Record for simpler, safer care wherever you are
The Hon Ken Wyatt AM, MP
Minister for Aged Care
Minister for Indigenous Health
Member for Hasluck
MEDIA RELEASE
31 January 2018
Embrace My Health Record for simpler, safer care wherever you are
Aged Care Minister Ken Wyatt has called on Australians, especially senior Australians, to embrace the rollout of the My Health Record, for secure, safer, more convenient care.
Joining Australian Digital Health Agency CEO Tim Kelsey for the first community information session for older Australians on My Health Record, Minister Wyatt said the patient-centred digital system helped health professionals deliver the best care.
“My Health Record empowers Australians to take better control of their health and provides secure access to patients’ health information at the point of care,” said Minister Wyatt.
There is no shortage of grey nomads who remain deeply sceptical about the effectiveness of signing up for the Government’s highly-promoted online medical records system.
Common complaints relate to the fact that many doctors haven’t yet ‘bought into’ the system and basically that the reality on the ground simply doesn’t live up to the hype.
The rollout continues nonetheless, and the Digital Health Agency insists that any teething troubles with ‘My Health Record’ will be ironed out. To date, more than five million Australians have signed up to use it and, by the end of the year, every Australian will have a My Health Record unless they make a deliberate decision to ‘opt out’.
Mid North Coast residents, especially seniors, are being encouraged to register online for My Health Record, for secure, safer health care.
Nationals Member for Cowper, Luke Hartsuyker, said the simple system puts local patients at the forefront and can help health professionals do their job faster.
“My Health Record is particularly useful for our many so-called ‘grey nomads’ who travel from the Mid North Coast around our nation,” Mr Hartsuyker said.
A global survey of 800 chief information officers by digital performance management company Dynatrace has found that a little more than three-quarters fear that the complexity of IT setups in organisations would soon make the management of digital performance impossible.
To underline the point about complexity, the survey found that a single Web or mobile transaction was now crossing an average of 35 different technology systems of components compared to 22 five years ago.
The survey covered 200 CIOs from the US; 100 each from the UK, France, Germany and China; and 50 each from Singapore, Australia, Brazil and Mexico.
Currently waiting for a response from Department of Human Services, they must respond promptly and normally no later than March 01, 2018 (details).
From: Justin Warren
January 30, 2018
Dear Department of Human Services,
If possible, please treat this as an informal or administrative request. Otherwise, please treat this as a formal request for documents under the Freedom of Information Act 1982.
The nation’s peak medical body has warned work conditions and stress levels in South Australia’s hospitals are at dangerous levels.
The state’s health system is still in crisis despite hospitals, including McLaren Vale, recently receiving a significant investment from the government, the Australian Medical Association (AMA) said.
“We are hearing failure after failure within the health system, and I think there's no doubt that the health system is still in crisis,” William Tam from AMA SA told 9NEWS.
Department for Health and Ageing, eHealth Systems, EPAS Program
Indicative Total Remuneration*: $119,945-$124,662 - ASO8 - Full Time / Term Contract (up to 28 December 2018)
The Manager, EPAS Reporting Services is accountable for managing the program of work associated with the provision of EPAS Reporting Services to satisfy SA Health strategic and operational reporting requirements from data contained within the EPAS database; at the enterprise, health unit, corporate or where appropriate, at the individual levels. The Manager, Reporting Services is required to ensure that an EPAS data dictionary is created and maintained; report coding standards are developed and complied with; and all aspects of report development to deployment are managed in accordance with a focus on robust source control; optimal performance; resource use and compliance with EPAS Change Management processes. The Manager, EPAS Reporting Services directs, leads and coordinates EPAS Report Writers to ensure that reporting requirements are met accurately and in a timely, efficient manner.
Data science and artificial intelligence (AI) represent a significant economic opportunity for the Australian economy, according to a new report released by Innovation and Science Australia (ISA).
ISA was tasked by the federal government with developing a strategic plan for the Australian innovation, science and research system out to 2030.
Australia 2030: Prosperity Through Innovation, released today, argues that the emergence “cyber–physical systems” including the Internet of Things are a strategic opportunity for Australia.
Commonwealth agencies are now encouraged make their own cloud computing plans, according to seven principles set out in the federal government’s new secure cloud strategy, which has been published on the Digital Transformation Agency website.
The Australian Signals Directorate has lost its monopoly on certification of cloud providers and a “layered certification model” has been adopted, according to the new document:
“The certification model creates greater opportunity for agency-led certifications, rather than just ASD certifications. It creates a layered certification approach where agencies can certify using the practices already in place for certification of ICT systems.”
Australian invention set to improve cancer treatment
Ben Grubb
Published: February 1 2018 - 7:13PM
The quality of cancer treatment is set to improve thanks to a new technology developed by an Australian medical start-up that initially started out as a university research project.
Called "Breathe Well", the technology developed by Opus Medical coaches cancer patients to self-regulate their breathing to assist with the accurate targeting of tumours and sparing of healthy tissues during radiation treatment. It is specifically targeted towards breast cancer patients.
According to company co-founder Dr Sean Pollock, one in three breast cancer patients will experience cardiac radiation toxicity from their radiation therapy. Of these patients, 43 per cent will require heart surgery due to their heart being unintentionally blasted with radiation.
Hospitals without patients, NASA-style command centres in healthcare facilities, 3D-printed organs — it sounds like something from a sci-fi novel but it could be part of Australia’s healthcare system in less than 10 years.
With healthcare budgets reaching unsustainable levels as people live longer, using technology better is now at the forefront of innovation in the healthcare sector.
The issue is being tackled globally. Last week at the World Economic Forum in Davos, the chief executive of Nokia, Rajeev Suri, said his vision for the future of medical treatment included remote surgeries, 5G ambulances and miniaturised, wearable scanners.
Transforming healthcare through precision medicine
Alan Finkel and Bob Williamson
Published: January 31 2018 - 12:05AM
Lately we've both been enjoying ITV's drama Victoria. By all accounts Queen Victoria lived well, dying at the age of 81 in 1901. A girl born in Australia in Victoria's reign could expect to live to 51. A girl born in Australia today has a life expectancy approaching 85. That's right: the modern plebeian can expect to live longer than yesterday's queen.
Much of that progress can be attributed to public health interventions: vaccination, flush toilets, better nutrition. But those interventions only take progress so far before we confront the reality of our longer, more comfortable lives: chronic disease. In the 21st century, we'll go beyond, to live healthier, for longer – if we harness the power of two great revolutions.
The first is the genomics revolution. In a decade, the price to sequence a human genome – our unique DNA signature – has plummeted from $US10 million to less than $US1000.That plunge down the cost curve will continue, until genome sequencing is a routine part of care.
Recent technological advances have enabled assembly of a wide range of data about an individual’s genetic and biochemical makeup, as formed by their genes, environment and lifestyle. While medicine has always had personal and predictive aspects, precision medicine allows health and disease to be viewed at an increasingly fine-grained resolution, attuned to the complexities of both the biology of each individual, and the variation among the population.
ACOLA’s precision medicine project explores the current trends in precision medicine technologies and explores the role that a broader implementation of precision medicine capabilities may play in the Australian context.
Please note: for more information and to access content relating to this report, please visit the ACOLA page here (link is external)
One of the biggest challenges in medicine is how to offer hope without hype. Designing personalised treatments based on the science of the human genome will doubtless bring benefits, particularly for those with rare genetic conditions. But overpromoting the promise risks a tsunami of unwarranted diagnoses and unnecessary treatment. Without rigorous evaluation, widespread premature implementation of this costly new approach threatens human health and health system sustainability.
The influential Australian Council of Learned Academies published an upbeat report this week on the future of precision medicine, where scientists work to determine the genetic and biochemical makeup of an individual, and doctors use that information to tailor personalised treatments or prevention strategies.
The report intended to examine the opportunities and challenges posed by precision medicine in Australia but it makes only passing reference to the potential harms of screening and diagnosing the genes of healthy people. The very real risk of widespread overdiagnosis is not mentioned once in its 200 pages.
The new mental health texting service could be useful to groups dealing with cyber-bullying and veterans managing post traumatic stress disorder, as well as rural people isolated from help.
Aussie Helpers is launching a mental health texting service on Thursday morning that it expects will be a lifesaver in rural Australia.
The brainchild of Zimbabwean expat, Dervla Loughnane, the Virtual Psychologist business is already connecting rural people with mental health professionals in a way that offers anonymity, convenience and an instant response.
All-digital governing to save billions and lift online access
The Australian
12:00AM February 1, 2018
Simon Benson
A cabinet sub-committee will be established to secure billions of dollars in savings as part of a strategy to digitise data across all federal departments and agencies and a push to increase online access to a range of government services.
Mass data currently “hoarded” by government departments will also be made accessible to business under the digital transformation and public sector modernisation committee, to be chaired by Michael Keenan, the Human Services Minister and Minister Assisting the Prime Minister for Digital Transformation.
The technology driven savings will also include cloud-based travel expense management for all government departments. This alone would save more than $55 million in costs around information and communications technology, or ICT.
A cabinet committee will focus on ways to further digitise government services and move towards “a 24/7 government that everyone can access from anywhere,” while a new strategy will help further public sector adoption of secure cloud services, according to Michael Keenan who today made his first major address as the minister overseeing digital transformation efforts.
Keenan, who late last year was appointed human services minister and minister assisting the prime minister for digital transformation, revealed details of the initiatives in remarks prepared for the Indonesia–Australia Digital Forum.
Cabinet’s new Digital Transformation and Public Sector Modernisation Committee will be chaired by the minister.
Later today, at the Indonesia–Australia Digital Forum in Jakarta, the cabinet minister Michael Keenan will offer the first look at his digital transformation priorities since picking up responsibilities in the latest ministerial reshuffle.
In his own words, what’s coming is a 24/7 government that everyone can access from anywhere: “We are going to improve the experience of people dealing with government and modernise the Australian Public Service by using technology to help people.”
A new sub-committee of Cabinet — the Digital Transformation and Public Sector Modernisation Committee — has been created to achieve this. Keenan will chair.
In his new role as Minister Assisting the Prime Minister for Digital Transformation, Keenan has four key priorities:
Politicians warned to use higher-level security on social media accounts
The Australian
9:36PM January 29, 2018
Rosie Lewis
Federal politicians and their staffers have been advised to take steps to reduce the risk of their Twitter profiles being hacked by a “malicious” new campaign after the accounts of two cabinet ministers “liked” pornography tweets.
In an e-mail sent to MPs and staff today from two of Parliament House’s top technology and cyber security experts, the politicians were told there was “no evidence” the building’s occupants had been targeted.
But the Department of Parliamentary Services said it had become aware of a “significant recent increase” in the hacking of public figures as attackers tricked people into revealing their Twitter passwords.
The use of external advisers, driven in part by on-going caps on the size of the public service, that have helped Australia become the most attractive consulting market in the world for professional service firms.
A Joint Committee of Public Accounts and Audit has made it plain that there is a perception these firms have had it too good for too long in Canberra and they are going to have to seriously prove their worth if they want too avoid getting booted off the gravy train.
The committee called for the inquiry after seeing the findings of a first-of-its-kind analysis of government procurement contracts by the Australian National Audit Office which highlighted the big taxpayer dollars at stake and how little the government knows about how money is being spent across the departments.
A Queensland-based healthtech startup is looking to raise over $150 million via an initial coin offering to help medical patients secure their medical records and fetch second opinions from medical professionals.
DHealthNetwork launched a pre-sale for its token at the end of last week. The startup has an ambitious goal of selling 60 million of its DHT tokens by February 9, followed by two more tranches of 60 million tokens to be sold by March 9. These tokens can be purchased for a price of between 2000 to 1350 DHT per Ether contributed, leading to a potential total raise value of more than $150 million at current prices.
So far, the company has raised just $142 at time of publication, according to the company’s funding contract listed on its website.
Australian Government response to the Joint Standing Committee on the National Broadband Network report: The rollout of the National Broadband Network: 1st Report of the 45th Parliament
The Australian Government notes the report by the Joint Standing Committee on the National Broadband Network (the Committee) into the rollout of the National Broadband Network (NBN).
The Government is disappointed that after considering 191 submissions; holding 15 public hearings; receiving testimony from 179 witnesses; and undertaking three site visits, the Committee’s majority report and recommendations indicates a failure to understand the fundamentals of the NBN. While it does not agree with all of the conclusions and recommendations contained in the majority report, the Government does however note that the report highlights the consumer experience and acknowledges that improving consumer experiences during connection and use of the NBN is an important priority. The Government fully supports the dissenting report given by the Chair of the Committee.
A document outlining the key points for the Rudd government’s 2009 announcement that it would fund the rollout of a national fibre network and a second document outlining a strategy for negotiating with Telstra and other potential investors in NBN Co are among those released by the ABC.
The ABC today published ‘The Cabinet Files’ — a trove of cabinet-in-confidence documents obtained from locked filing cabinets sold at a Canberra second-hand store — as well as a number of accompanying articles based on the files.
Among the leaked documents is one titled ‘NBN financing options and borrowing and budget impacts’ (PDF). The un-dated document details the Rudd government’s proposed financial commitment to the National Broadband Network including related measures to be included in the 2009-10 budget.
The Labor Government in 2009 appears to have considered Telstra its main obstacle to setting up a company that would build a national broadband network for the country.
Tactics discussed during planning in 2009 before setting up the NBN Co have been revealed in documents that were found in two old locked cabinets.
The ABC obtained the documents from the person or persons who bought these cabinets at a second-hand shop. The broadcaster has made select documents available on its website, presumably the pick of the crop.
The UK has achieved 95% provision of superfast broadband coverage to its residents, reports from a broadband comparison website and the government claim.
The comparison site, thinkbroadband, said that this did not mean that all areas had 95% coverage - in some. like Epson and Ewell, Tamworth, Worthing and Watford, the coverage was higher at 99%.
But in some other areas, like the City of London (50.3%), Orkney Islands (66.8%), Western Isles (71%) and Kingston Upon Hull (71.7%) the figure was lower.
Mobile speeds in Australia will comfortably outstrip those available over the National Broadband Network by the time the network is fully rolled out in 2020, raising the prospect of consumers choosing to give the $50 billion network a miss altogether.
5G, or “5th generation mobile”, is the next telecommunications standard that will power mobile networks, catering for more devices connected to the internet, faster data transfer speeds and cutting the time needed for connected devices to speak with each other.
While much of the conversation on 5G has been mostly theoretical, telcos are working hard to take the technology out of the labs. Singtel Optus is looking to start connecting customers to 5G services by next year, becoming the first Australian mobile operator to set a date on when it starts offering plans.
Documents published by the ABC have shown what the Australian government was expecting in terms of NBN funding arrangements and negotiations with Telstra back in 2009.
By Corinne Reichert | January 31, 2018 -- 06:35 GMT (17:35 AEDT) | Topic: NBN
Australian Cabinet-in-Confidence documents published by the ABC on Wednesday have shown what the National Broadband Network (NBN) funding and negotiation plans looked like back in 2009.
Two of the documents -- which the ABC obtained after someone purchased a filing cabinet during an ex-government sale that had the papers locked inside -- detailed the government's position on negotiating with Telstra and other potential investors in the project, and with the funding and rollout plans.
Consultation begins on My Health Record Guidelines
January 29, 2018
Consultation has started on the My Health Record Guidelines for Pharmacists developed by the peak national body for pharmacists, the Pharmaceutical Society of Australia (PSA).
The Guidelines provide guidance to pharmacists on meaningful clinical use of the My Health Record system.
By the end of 2018, all Australians will have a My Health Record unless they choose not to have one.
Pharmacists have a professional responsibility to review their practice and, where necessary, build on their digital health competency to ensure they are ready to integrate use of the My Health Record system into patient care.
During the public consultation, PSA welcomes comments from interested individuals and organisations including members of the pharmacy profession as well as consumers, other health professional groups and practitioners, educators, researchers and government bodies.
The consultation paper can be accessed at the PSA website. Please review the consultation paper first then provide feedback through the consultation survey.
Consultation will be open until Tuesday 20 February 2018.
This document has been created with funds from and assistance from the ADHA.
What I found most interesting is that there is no real discussion of the workload using the myHR will impose on pharmacists. It seems to me even if only 10% of patient records are reviewed there will be a lot of time consumed given the granular nature of myHR records (you have to access them serially etc.) No mention of how this will be paid for that I noticed. In places like Chemist’s Warehouse this time loss may really matter.
There is discussion of security and privacy but who at an outlet will have access to the myHR and what they need to do in the case of sensitive information is not clear. More work on looking at real pharmacist workflows and how it actually will fit is needed I suspect.
Here is the executive summary:
Executive summary
The My Health Record has been designed to allow the secure sharing of patient health information via an electronic platform. [1]
From the pharmacist’s perspective, this greater access to patient health information may:
·enable more efficient and effective medication reconciliation
·enhance their contribution to the quality use of medicines
·improve continuity of patient care.
The ability for pharmacists to contribute patient health information to the My Health Record (i.e. dispensing records) may also enhance communication with other healthcare providers caring for their patients, and improve health outcomes.
These Guidelines do not replace the need for pharmacists to exercise professional discretion and judgement when using the My Health Record. These Guidelines do not include clinical information or detailed legislative requirements. At all times, pharmacists delivering these programs must comply with all relevant Commonwealth, State and Territory legislation, as well as program-specific standards, codes, and rules.
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This does not add much rather is notable for the uncertainty in the benefits flowing from use of the myHR.
The expectation of changes of practice in the absence of some decent trials using the working system to see what it adds would have to be worthwhile – but don’t seem to be contemplated. I wonder why?
The PSA’s National President is a very strong advocate for the my HR and that may be related:
More haste, less speed and a bit more evidence might be a good idea in my view. The Guidelines still need some work and to address some of the more difficult issues head on.
Patients should also be rather wary of random pharmacists in the big chains just opening their myHR’s willy-nilly. I reckon and to me this is another reason to consider opting out.
Are You Expecting An Exodus Of Senior Federal E-Health Bureaucrats Over The Next Year Or Two?
Yes 9% (14)
No 9% (14)
They Will Just Be Shuffled Around. 78% (115)
I Have No Idea 3% (5)
Total votes: 148
This is a fun poll with bureaucratic shuffling seen as the anticipated outcome. It does not suggest we are going to see much change or progress with all that hunkering down.
Any insights welcome as a comment, as usual.
A really great turnout of votes!
It must have been a fairly easy question with just 3% not sure what the correct answer was.
Chaos as IT systems in two NHS health areas are brought down by technical problems
Lynne Minion | 25 Jan 2018
Technical issues have been blamed for a ‘major incident’
that caused outages across NHS systems in Wales and Manchester
yesterday, with doctors and hospital staff unable to access online
clinical systems.
As healthcare providers struggled to continue services without access
to electronic records, patients were urged to attend emergency
departments only for serious or life-threatening emergencies.
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NICE recommends app for depression should be trialled on the NHS
Hannah Crouch
25 January 2018
A new online and mobile app for depression should be trialled on the NHS, according to the National Institute for Health and Care Excellence (NICE).
The organisation believes Deprexis could help adults with depression get faster access to care.
The app, which was developed in Germany, uses cognitive behavioural therapy (CBT) to help people assess their own situation and find effective ways of coping.
It can be used on any device that has internet access including smartphones, tablets and desktops.
Patient survey reveals preference for digital communications
Hannah Crouch
22 January 2018
A study has suggested that more than two-thirds of patients prefer digital communications from their healthcare provider over those sent via post.
The independent survey, commissioned by Healthcare Communications, involved questioning 2,000 patients about their appointment habits.
Over two thirds of patients showed a preference for digital communications, with 68% stating they would prefer to manage medical appointments online or via a smartphone.
In this second article, Shreshtha Trivedi looks at how primary care and urgent care sector are using digital to respond to these pressures, what is working and how can we accelerate the transformation agenda for next winter.
As acute trusts struggle to cope with wider problems facing the NHS and social care, it all comes back to oft-asked question: how can we keep patients out of hospital in the first instance?
January 24, 2018 - Whether healthcare providers are working to prepare for potential natural disasters like hurricanes or manmade cybersecurity issues (i.e., ransomware attacks, insider data breaches) having a disaster recovery plan is essential.
Entities of all sizes must ensure that patient care is not compromised during periods of downtime, and also that EHR security is never put at risk.
Having a current and comprehensive backup plan and contingency plan are also federal requirements under the HIPAA Security Rule.
Oscar, Cleveland Clinic use FHIR to streamline data exchange
Oscar Health and the Cleveland Clinic are using a high-tech data exchange standard to improve the customer experience for members of their new co-branded insurance plans.
The standard, called Fast Healthcare Interoperability Resources (FHIR), is intended to help promote interoperability between the healthcare industry’s largely siloed electronic health records systems.
For their first project using FHIR, the Cleveland Clinic and Oscar have integrated it into a tool that allows members to select a primary care physician (PCP) through a mobile or web app, according to a post on Medium.
Yale New Haven Hospital has launched a command center that provides real-time data analytics so the healthcare organization can better manage patient capacity, operational processes and other critical decision making at the facility.
Developed jointly with electronic health record vendor Epic, the new center includes dashboards for clinicians and administrators with metrics such as bed capacity, bed cleaning turnaround time, patient transport times, delays for procedures and tests, as well as ambulatory utilization and quality and safety indicators.
The real-time dashboards—which are visible on the command center screens and are accessible to other staff—build on existing functionality in the Epic EHR, says Ohm Deshpande, MD, director of utilization review and clinical redesign at Yale New Haven Health System. He adds that the center is part of an ongoing initiative over the past five years to help Yale New Haven become a “high-reliability” organization.
Every organization needs ready access to timely and trustworthy information, and more healthcare organizations are realizing that their strategic initiatives can’t succeed without a base level of data quality and the ability to understand and manage a rapidly growing volume of business information.
These capabilities are the province of data governance—a discipline that leverages the business value of data by improving its availability, usability, integrity and security.
Data governance has a reputation for being a daunting task that is prone to delays and failure. Surveys report that as many as two-thirds of all initial data governance efforts die on the vine. The major reason is that many well-intentioned efforts mushroom into such complexity during the planning and design phases that they are abandoned before they have the chance to deliver any value.
A new alliance launched by Health IT Now features providers, technology startups and medical associations geared towards leveraging data and technology to combat the opioid epidemic.
The Opioid Safety Alliance, which includes Intermountain Healthcare, Walgreens, the Association of Behavioral Health and Wellness, IBM and the National Council for Prescription Drug Programs, to name a few, plans to focus on “advancing technology-enabled solutions to combat the scourge of opioid misuse,” Health IT Now announced on Thursday.
Among the group's key focus areas: reforming federal regulations that limit substance abuse data sharing between clinicians, leveraging telehealth and digital tools to expand substance use disorder treatment options and advocating Congress to make “smart, targeted investments” in technology to enhance prescription drug monitoring programs (PDMP).
Solving the long-standing puzzle that is lack of interoperability among electronic health records (EHRs) requires computer system savvy as well as knowledge about improving patient care.
The Office of the National Coordinator for Health Information Technology (ONC) may, then, have the right person to guide it in Don Rucker, MD. Rucker, named to the post in March 2017, is skilled in informatics, board certified in emergency and internal medicine and built an early version of an EHR nearly two decades ago.
Medical Economics spoke with Rucker at the ONC’s recent annual conference in Washington, D.C. about his vision for healthcare IT and how to address his peers’ frustrations with EHRs, among other topics.
The cost, flexibility and scalability advantages of the cloud are impossible to ignore, and today many healthcare organizations are moving not only business data to the cloud, but also clinical data.
A variety of cloud initiatives are surging in popularity, including the adoption of cloud-based Software as a Service (SaaS) applications, moving data backup to public cloud services such as AWS or Microsoft Azure, and the use of these same cloud services as their primary location for the storage of business or clinical data.
Three cloud initiative best practices are emerging as crucial for healthcare IT executives:
Evaluating the potential problems associated with any cloud initiative.
Developing a strong data management strategy that addresses these problems.
Vetting and partnering with vendors that can fully support a data management strategy.
A new program at the National Human Genome Research Institute within the National Institutes of Health hopes to increase adoption of genome editing technologies for treating disease, with up to $190 million available to researchers over six years.
Genome editing is a molecular approach to make precise changes to the sequence of DNA, which is the hereditary material inside live cells. Editing can change who DNA interacts with RNA, which carries instructions from DNA to control proteins.
The new sequence can change the course of a disease in a person who inherited a disease. For example, a particular sequence in a patient with brain degeneration could slow the degeneration over time.
Chatbot campaign for flu shots bolsters patient response rate by 30%
Brett Swenson, MD, deployed a chatbot to improve engagement from EHRs to triage and found real success in reaching patients with information about flu shots.
Communicating with patients can be tough. Reminder pamphlets often go straight into the rubbish and emails are deleted before they are read. But one doctor found that chatbots could be a key to patient outreach.
Brett Swenson, MD, is no stranger to digital health. He runs a concierge practice in Arizona and started working with EMRs about 20 years ago when they were first introduced. He said he is a keen adopter of new technology.
So when he heard about using chatbots at a conference a little over a year ago he decided to dig a little deeper. A number of vendors are offering chatbots for healthcare, notably Babylon Health Buoy Health, Catalia Health, Florence, Memora Health, SapientX, SimplifiMed and Your.MD, among others.
Artificial intelligence is starting to have a transformative impact on many industries, healthcare included, as it moves beyond the theoretical and into common practice.
"We are no longer on the brink of change resulting from AI — we are already immersed in a world with software-driven machines learning to process unstructured information in meaningful ways, something that until relatively recently was the domain of humans alone," Infosys researchers wrote in a report released this week at the World Economic Forum in Davos, Switzerland.
It's clear that something that seemed sci-fi even five years ago is already changing the landscape in a real and profound way, the study "Leadership in the Age of AI," suggested and include workforces alongside the technology.
There’s little doubt that many hospitals are going to start moving more and more of their technological infrastructure and software into the cloud.
As that happens, consultancies such as IDC are predicting the cloud model will effectively change the way IT shops typically operate. Instead of performing many of the tasks historically considered to be information technology, for instance, hospital tech departments will become more akin to lines of business that acquire those functions, IDC’s projection suggests.
But how can hospitals considering tapping into more cloud services or even embarking on a cloud-first mindset begin?
Former pharma executive Alex Azar has a new title: secretary of Health and Human Services.
The Senate voted 55-43 to confirm the nomination of Azar, the former head of pharmaceutical giant Eli Lilly’s U.S. operations, to serve in the role vacated by Tom Price, M.D.
Price, a former congressman, resigned in September after eight months on the job due to controversy over use of private planes for government travel using taxpayer money. President Donald Trump soon tapped Azar to fill the role, saying he would be “a star for better healthcare and lower drug prices!”
2017 Breach Report: 477 Breaches, 5.6M Patient Records Affected
January 23, 2018
by Heather Landi
Although 2017 saw fewer massive health data breaches when compared to 2016, there was still an average of at least one health data breach per day throughout the entire year, according to a year in review report from cybersecurity software company Protenus.
Progress is being made, but there is still much that healthcare organizations must do in order to ensure that the patient data entrusted to them is properly secured, Protenus' Breach Barometer 2017 year-in-review report states.
In 2017, there were 477 healthcare breaches reported to the U.S. Department of Health and Human Services (HHS) or the media, and information available for 407 of those incidents, which affected a total of 5.579 million patient records, according to Protenus, which tracks disclosed breaches impacting the healthcare industry, with data compiled and provided by DataBreaches.net.
After many months of rumors, Apple announced that it is launching a personal health record (PHR) feature with iOS 11.3, the beta of which launched Wednesday to users in Apple's iOS Developer Program. The feature, called Health Records, will aggregate existing patient-generated data in the Health app with data from a user's electronic medical record — if the user is a patient at a participating hospital. At launch, Apple is working with 12 hospitals across the country, including Penn Medicine, Cedars-Sinai in Los Angeles, Johns Hopkins, and Geisinger Health System.
“Our goal is to help consumers live a better day," Apple COO Jeff Williams said in a statement. "We’ve worked closely with the health community to create an experience everyone has wanted for years — to view medical records easily and securely right on your iPhone. By empowering customers to see their overall health, we hope to help consumers better understand their health and help them lead healthier lives.”
The feature will use HL7's FHIR (Fast Healthcare Interoperability Resources) specification. Users will be able to see things like allergies, medications, conditions, and immunizations, as well as the sort of things they might check an EHR patient portal for, such as lab results. They can be notified when the hospital updates their data. The data will be encrypted, and users will need to enter a password to view it.
While the use of electronic health records by providers is nearly universal, it has resulted in major challenges in managing EHR documentation by doctors, who are more likely to include inaccurate, inconsistent and excessive information in progress notes on patients.
The phenomenon is known as “note bloat,” a moniker for the trend describing how physician notes contain multiple pages of nonessential information, according to Neveen El-Farra, MD, associate clinical professor of medicine and associate dean for curricular affairs at UCLA’s David Geffen School of Medicine.
“The electronic health record makes it so easy to import all this data,” adds El-Farra, who is also a hospitalist in the Department of Medicine and associate program director of the internal medicine residency program. “EHRs were supposed to be the best things ever, but they have a lot of issues and are the No. 1 cause of burnout among physicians.”
Deep learning’s pre-eminence to the enterprise today is significant for two reasons. It represents the ultimate expression of machine learning’s advanced capabilities and, as such, has become virtually synonymous with artificial intelligence because of its progressive learning prowess.
Deep learning is at the core of the most intricate AI capabilities including speech recognition, image and video recognition, speech generation and aspects of robotics. It’s unparalleled at swiftly analyzing data at scale in accordance with the differentiation characteristic of big data.
In considering the massive influx of unstructured data besieging enterprises such as healthcare organizations, the ascending interest in AI, and the pivotal context with which deep learning purveys nearly any use case, it’s clear 2018 is the year this technology’s utility will finally supersede classic machine learning’s.
A slightly higher percentage of physician practices are offering telemedicine services to patients in the coming year, but the majority are still wary of virtual services, according to a new poll.
The portion of physician practices currently offering telehealth services increased three percentage points compared to last year, according to a poll by Medical Group Management Association. Of the nearly 1,300 respondents, 26% said they are offering telemedicine to patients this year.
But just 15% of practices plan to offer telemedicine services in 2018, down from 18% in last year's survey. And despite telemedicine’s growing popularity throughout 2017, most providers haven’t been persuaded to implement programs: 39% said they would not provide care via telehealth and 20% were still unsure.
Technological innovations are transforming medical training and could help ease a global shortage of healthcare professionals.
One leader in the effort is Shafi Ahmed, a British colorectal surgeon, who last year used Snap Inc.’s high-tech spectacles and the Snapchat photo-sharing app to broadcast a real-time hernia operation to doctors and millions of curious viewers, according to Bloomberg Technology.
Ahmed, who connected with more than two million viewers for that Snapchat surgery, sees the social media platform as a promising way to help train the next generation of doctors, according to the article. And such efforts could help ease a projected global shortage of 15 million healthcare workers by 2030.
Reducing diagnostic errors is a crucial component of improving care quality, but current methods of monitoring such mistakes may be time consuming. Now, researchers at Johns Hopkins have developed a strategy that uses big data to speed up the process.
David Newman-Toker, M.D., director of the Center for Diagnostic Excellence at Johns Hopkins' Armstrong Institute for Patient Safety and Quality, and his team developed a new approach called SPADE (Symptom-Disease Pair Analysis of Diagnostic Error) to allow providers to harness databases instead of having staff members comb medical records for more information, according to a study published in BMJ Quality & Safety.
SPADE uses statistical analyses to find and flag patterns that can predict diagnostic errors. It mines available databases for common symptoms that lead patients to visit a doctor and then compares those data with diseases that are often misdiagnosed.
VA Patient Data Disclosure to HIEs Permitted in Proposed Rule
A recently proposed federal rule would permit the VA to allow patient data disclosure to HIEs even if there is not a physical copy of written patient consent.
January 19, 2018 - The Department of Veterans Affairs (VA) published a proposed rule that would amend its current regulations on allowing patient data disclosure to health information exchanges (HIEs). The updated rule would permit VA to release a patient’s medical records to an HIE even if there is not a physical copy of the patient’s written consent.
“This proposed rule would be a reinterpretation of an existing, long-standing regulation and is necessary to facilitate modern requirements for the sharing of patient records with community health care providers, health plans, governmental agencies, and other entities participating in electronic HIEs,” the rule summary stated.
“This revision would ensure that more community health care providers and other HIE community partners can deliver informed medical care to patients by having access to the patient's VA medical records at the point of care.”
Oneview's technology is in use at a number of facilities around the world, including UCSF.
How it works
Oneview's personalized hospital bedside tablets or monitors allow patients to communicate directly with their care team, select and order meals, set and track recovery goals, Skype with family during a clinical consultation, play video games, watch movies, receive patient education, and other functions.
FHIR transformative, blockchain overhyped, CIOs say
Innovation was the largest divergence among results with only 14 percent having a dedicated innovation center and a third with no innovation plans in the next 24 months.
HL7's FHIR specification was seen as the one with the most potential to have an impact in the next two years.
Innovation is something everyone in healthcare is after. But not everyone is approaching it the same way – and not everyone is able to prioritize it in the ways they'd prefer. That's according to a new survey of CHIME member CIOs from Impact Advisors.
The poll finds significant divergence across health systems with regard to innovation efforts, and an uneven pace of change as certain IT leaders are freer to innovate than others, with the budgets, staff resources and leadership support to put technology to work in envelope-pushing ways.
Allscripts is still working to bring its cloud-hosted services back online after a ransomware attack took down several applications, prompting an outcry from physicians who lost access to their EHR and appointment systems.
In a notice to Allscripts clients early Monday morning, the company said its Electronic Prescriptions for Controlled Substances (EPCS) had been restored, but the company is still working to restore cloud-hosted services like Allscripts PM and its Professional EHR. Those outages are becoming increasingly frustrating for smaller physician practices that have resorted to pen and paper after having no access to medical records, scheduling or payment systems for the last five days.
“Allscripts has totally dropped the ball in downplaying what is going on and not coming forward with exactly what is happening,” Mansoor Ahmed, the office manager for Capital Internal Medicine, a single-physician practice in Raleigh, North Carolina, told FierceHealthcare. “All the stuff they have brought back up are secondary services.”
Will 2018 be better or worse than 2017? Current trends and future predictions.
I think it's fair to say, 2017 wasn't a great year for cyber-security. We saw a large number of high-profile cyberattacks; including Uber, Deloitte, Equifax and the now infamous WannaCry ransomware attack. Despite the constant flow of security updates and patches, the number of attacks continue to rise.
This raises the question…will 2018 be better or worse than 2017? Let’s take a look at some of the current trends and future predictions.
1. AI-powered attacks
AI/Machine Learning (ML) software has the ability to "learn" from the consequences of past events in order to help predict and identify cybersecurity threats. According to a report by Webroot, AI is used by approximately 87% of US cybersecurity professionals. However, AI may prove to be a double-edged sword as 91% of security professionals are concerned that hackers will use AI to launch even more sophisticated cyber-attacks.
RIGA - Latvia should consider creating a single government agency employing highly skilled and well-paid professionals to oversee implementation of all major e-projects, said Edgars Tavars, the board chairman of the Latvian Green Party which is a member of the ruling Greens/Farmers bloc.
He said that people with special competences were required for implementation of nationwide e-projects and there were few such people in the Latvian public administration, each working for a different agency.
Following the troubles with implementation of the e-health project, it is time to consider creating a single government agency employing highly skilled and well-paid professionals to handle all major e-projects, Tavars suggested.
Patients payments for healthcare services now represent about 35 percent of the healthcare spend. As a consequence, they’re expecting more value for their money.
From the payer perspective, their value proposition now includes providing adequate coverage while controlling overall costs. Policy administration, however, is not an easy task. In fact, it’s one of the areas in which costs have spiraled out of control.
Consequently, policy administration is an area in which intermediaries could benefit most from blockchain technology. It can simplify tasks related to claims, fraud and verification, enabling payers to direct more time and funds to providing better, more affordable coverage for policyholders.
Concerns about non-use of evaluations have plagued the profession since it emerged in the 1960s to guide government decision-making about social policies and programs. While there is a substantial body of empirical and theoretical literature about evaluation use, this literature does not identify the factors that are considered most important to facilitating evaluation use or the pathways to evaluation use. Additionally, much of the literature is from North America and Europe and there has been no large-scale study of evaluation use in Australia. This study aimed to identify Australasian Evaluation Society (AES) members’ perceptions of the levels of use of evaluation and the factors associated with use, as well as how evaluators overcome barriers to use. It used a questionnaire of AES members and in-depth interviews with evaluators. The AES members who responded perceive both demand-side factors, particularly leadership commitment and individual receptiveness to evaluation, and supply-side factors, particularly involvement of stakeholders in identifying the evaluation purpose and effective communication of findings, as important to evaluation use. Evaluators employ a range of utilisation-focused strategies and have some success in negotiating the barriers they encounter to use. Evaluators’ experience reflects that the factors that are most important to use and the pathways to use differ by context, suggesting that existing theoretical models of evaluation use could be strengthened through recognition of context-based pathways.
Essentially what the paper points out is that the key barriers to evaluation are (what a surprise) politics, resourcing and leadership. Despite the barriers I would have to suggest for the vast majority of the time evaluation is important and necessary if we are not to just blunder uselessly around!
I rather suspect the author has it right on the bassiers! How to fix things? Another story I fear.
