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."

Monday, May 07, 2018

Weekly Australian Health IT Links – 7th May, 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

A huge week – read on!
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Vic government to spend $124 million on digital patient records

EMR system to cover four health services
Rohan Pearce (Computerworld) 01 May, 2018 12:32
Victoria’s 2018-19 budget will earmark $124 million for the rollout of electronic medical records at three health services, the state government revealed today.
The Victorian government said that the EMR rollout at the Peter MacCallum Cancer Centre, Melbourne Health and Royal Women’s Hospital will see the records linked to the currently operating EMR system at the Royal Children’s Hospital.
The rollout will reduce avoidable errors and duplications as well as help patients receive faster care, the government said. Once implemented, the measure is estimated to save  $34.1 million a year.
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Vic govt commits $124m to e-health records

By Justin Hendry on May 1, 2018 10:12AM

Three hospitals receive budget windfall.

The Victorian government has set aside $124 million to bring digital health records to three major Melbourne hospitals.
Minister for Health Jill Hennessy and Special Minister of State Gavin Jennings announced the funding ahead of today’s state budget.
The funding will deliver electronic medical records (EMR) to three health services in Melbourne's Parkville Precinct: the Peter MacCallum Cancer Centre, Melbourne Health and the Royal Women’s Hospital.
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Australia to get national data commissioner

By Ry Crozier on May 1, 2018 11:59AM

New custodian part of $65m package.

Australia is set to get its first national data commissioner, in part to build public trust in the government as the custodian of significant data assets.
The creation of the commissioner role is one of a series of measures unveiled by the government today that will collectively cost $65 million over the next four years.
They form the government’s official response [pdf] to a Productivity Commission report into data availability and use that was released a year ago.
Other major initiatives that the government has committed to include:
  • New legislative and governance arrangements to enable better use of data across the economy “while ensuring appropriate safeguards are in place to protect sensitive information”; and
The introduction of a consumer data right, which the government formally committed to at the end of last year
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Government’s $65m plan to establish a ‘National Data Commissioner’

By Stephen Easton • 01/05/2018
A new National Data Commissioner will independently manage the delicate balance between releasing open data from federal agencies for public benefit and risks to individual privacy, taking a lot of curly risk management decisions away from individual agencies.
Today’s announcement is the centrepiece of the Turnbull government’s long-awaited response to the Productivity Commission’s inquiry into Data Availability and Use.
Along with new consumer rights, allowing people to obtain some of their data from private companies, the government response also explains proposed legislation aimed at facilitating more data releases, sharing, integration and analysis.
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Open data: Government to establish a ‘National Data Commissioner’

Unveils $65 million push to make more government data available
Rohan Pearce (Computerworld) 01 May, 2018 10:50
A new position of the ‘National Data Commissioner’ will be established as part of a $65 million, four-year open data push by the federal government.
The creation of the new position is part of the government’s response to the Productivity Commission inquiry into the availability and use of public and private data by individuals and organisations.
The government in November revealed that it would legislate a new Consumer Data Right as part of its response to the PC’s recommendations. The government said that this will allow individuals to access data relating to their banking, energy, phone and Internet usage, potentially making it easier to compare and switch between service providers.
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Tom Burton: Canberra creates a brave new data world

By Tom Burton • 03/05/2018
It is hard to overstate the importance of the federal government’s decision to create a consumer right over the data created about them.
Spurred by various inquiries calling for measures to enable consumers to more easily shop around for their financial and utility providers, federal cabinet has created a right designed to give citizens control over the data that is collected about them. The right will enable consumers to send their usage data to a competitor, to get a better deal based on their actual spending, usage and saving patterns.
The new right is predicated on the view there are enormous economic and societal benefits to better understanding the modern world through shared data. Better competition has been called out, but the benefits in collating and integrating administrative and personal data across virtually every sector in the community, are now obvious to everyone.
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NSW health system could be fully digital in next decade

By Justin Hendry on May 4, 2018 10:30AM

CIO plots road ahead.

eHealth NSW's chief information officer Zoran Bolevich has predicted a “fully digitally-enabled and integrated” healthcare system in the state within as little as eight years.
Speaking at Oracle's CloudWorld event in Sydney this week, Bolevic expressed a desire to make the state's "world class" health system "even betterm smarter and more patient centric in the future".
“We’ve set ourselves an aim that in eight to ten years we will become a fully digitally-enabled and integrated healthcare system that places patients, carers, families at the centre, and consistently delivers great patient experiences and great patient outcomes," he said.
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Digital health in a decade, say NSW eHealth chief

NSW eHealth CEO and CIO outlines his vision digital transformation of NSW’s health system
Stuart Corner (Computerworld) 02 May, 2018 14:15
The CEO and CIO of NSW eHealth, Dr Zoran Bolevich, has outline the goal of the state having a fully integrated digital health service within a decade.
Bolevich is charged with the complete digital transformation of NSW Health. He heads a health IT agency with a team of about 1000 people responsible for planning, implementing and supporting the largest digital health program in Australia.
In a Q&A session with Oracle SVP and CIO Mark Sunday at Oracle Cloudworld in Sydney, Bolevich said NSW had set a goal that, within the next eight to 10 years “we will become a fully digitally enabled and integrated healthcare system that places patients and their carers and families at the centre.”
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A Big Bank has a message for us GPs — should we listen?

4 May 2018
We might not embrace the thought of dedicating more of our time and resources to digital technology, but at some point, we will have to.​
A GP goes to a financial planner at a big bank and asks “How do I go about getting a small business?”
“Easy,” comes the advice. “Borrow enough money to buy a big one and wait.”
This month seems like a dubious time for a bank to be dishing out business advice, but the Commonwealth Bank was perhaps too distracted by the Royal Commission to amend the release date of their report GP Insight: understanding the future of general practice.
This report on patient satisfaction with their GP found a few things wanting. The executive summary describes “a clear divide between patient demands and the services currently offered by practices”.
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ADHA tries to forge greater e-health participation

By Justin Hendry on May 2, 2018 5:29PM

Using a series of digital test beds.

The Australian Digital Health Agency is set to test new models of healthcare that are enabled or enhanced by the forthcoming personal e-health record.
The operator of the record system said it is looking to fund a series of test bed projects in partnership with industry and academia to feed into the creation of digitally-enabled services and new models of healthcare.
It will use the projects both to test digital technologies and to “produce evidence of the positive impact" new services or models of care might provide.
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ATM ID: DH1011

Agency: Australian Digital Health Agency

Category: 80141500 - Market research
Close Date & Time: 6-Jun-2018 2:00 pm (ACT Local Time)
Description:
Tasked with improving health outcomes for Australians through the delivery of digital healthcare systems and the National Digital health Strategy (Strategy) for Australia. The Australian Digital Health Agency is responsible for national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety including coordinating and providing input into the Strategy. Our focus is on putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them.
This is REI process is intended to enable the Agency to establish test bed projects that will produce evidence of the positive impact of new digitally-enabled services and models of care, and demonstrate that they are sustainable and scalable.
The Agency’s overarching business objectives are to:
1. promote innovation and create new digitally-enabled services and models of care that focus on priority health areas;
2. accelerate realisation of benefits attributable to digital health;
3. generate evidence to secure ongoing investment in digital health;
4. instigate sustainable and viable partnerships with industry and other organisations; and
5. inform the development of test bed framework for the enhanced models of care pillar in the National Digital Health Strategy.
The Agency is seeking Submissions to engage Respondents to provide services to establish geographical or health sector-based test beds. These test beds require a collaborative model of delivery and are intended to be partnerships  between industry, government and other organisations. The Agency is seeking proposals by Respondents that use new approaches and demonstrate outcomes (e.g. by creating a new digitally-enabled model of care, or by generating robust evidence of the impact of an existing digitally-enabled service) that can be scaled nationally, and provide further business opportunities for partners.
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Digital health leaders meet in United States to forge global plans

Digital health leaders from 16 countries, Hong Kong SAR and the World Health Organization (WHO) are participating in the Global Digital Health Partnership (GDHP), which has held its second Summit hosted in Washington DC on April 24-25.
Participants discussed approaches to global collaboration in a range of topics related to the delivery of digital health services and associated policy priorities.
The GDHP is a collaborative of governments, territories, government agencies, and the World Health Organisation to support effective implementation of digital health services. It was initiated in February 2018 in Canberra, Australia.
Argentina, Australia, Austria, Republic of Belarus, Canada, Hong Kong SAR, India, Republic of Indonesia, Italy, Republic of Korea, New Zealand, Kingdom of Saudi Arabia, Singapore, Sweden, the Ukraine, the United Kingdom, United States, and the World Health Organization (WHO) are participating in the GDHP.
The GDHP is a platform for international healthcare leaders to share best practice in the use of data and technology to advance health and care, said Tim Kelsey, CEO of the Australian Digital Health Agency, which hosts the GDHP secretariat.
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What was the government’s response to the King Review?

Health Minister confirms the government has rejected proposals of generic medicines tendering and machine dispensing, but has not ruled out keeping the $1 discount or abolishing HMR caps as yet

In a highly anticipated move, Health Minister Greg Hunt today announced the Federal Government has released its response to the Review of Pharmacy Remuneration and Regulation.
The Pharmacy Guild of Australia welcomed the response, saying pharmacists “appreciated the positive tone of the Minister’s approach to the Review and to the future of pharmacy”.
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My Health Record storing health information online

Posted on: Fri 4 May 2018
My Health Record is a means for people to have a summary of their health information stored online, for easy personal access.
Individuals control what goes into and who can access the record, including doctors, hospitals and other healthcare providers.
Wills Logue, Regional Communications Coordinator for My Health Record, speaks to Small Change’s Lisa Burns.
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Experts call for GPs to be more educated about data sharing

Call for more initiatives to educate GPs on tech literacy and avoid accidental data sharing
27th April 2018
Medical Director says it's being as “open as possible” about its plan to share GPs' de-identified patient data, after some doctors complained they had signed up without realising.
The company, which provides practice software to 45% of Australia's GPs, is asking for permission to extract information — including prescriptions and immunisation records of all their patients — as part of its latest program update.
Dubbed MD Heart, the scheme will allow GPs who agree to the handover to compare their activity with other doctors.
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UK’s NHS in breast cancer bungle that could cost 270 women their lives

  • The Australian
  • 6:38AM May 3, 2018
Up to 270 women may have died after a NHS computer error failed to invite around 450,000 of them to breast screenings
Britain’s Health Secretary has apologised for what he called a “serious failure” that resulted in the mistake, which he said appeared to be the result of a “computer algorithm failure” dating back to 2009.
Jeremy Hunt said about 450,000 women aged between 68 and 71 weren’t given a chance to have a mammogram. Of those women, he said experts estimated up to 270 might have died prematurely.
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30 April 2018

I couldn’t afford an EMR, so I bought a robot instead

Posted by Jeremy Knibbs
Something is definitely rotten in the state of Denmark (Australia) when a manager running a major Australian hospital’s information systems looks at buying a hospital-wide electronic medical records (EMR) system then decides instead to buy a surgical robot for one of their busy theatres.
 The most obvious “wrong” here is that the robot is winning in the return on investment stakes against an EMR.
You might question the competence of such a manager given the supposedly vital role EMRs promise in terms of both both safety and hospital efficiency.
But you’d have to think again.
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Be prepared for the expansion of My Health Record in 2018

What is My Health Record?
My Health Record is a secure online summary of an individuals key health information such as  medical history, medicines, allergies and adverse reactions, immunisations, discharge summaries,  and test and scan results.
For  Aboriginal and Torres Strait Islander peoples and communities, it means  their important health  information is kept together in one place that is accessible anytime by the ir authorised healthcare  providers, including in a medical emergency.
Who gets a record?
Currently, more than 1 in 5 Australians have a My Health Record. Later this year, the program will be  expanded to an ‘opt -out’ model, whereby every Australian will have a My Health Record created for them unless they choose not to have one.
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Wanting more for less: You can’t have your cake and eat it too

Dr Edwin Kruys 30/04/2018 3:19:56 PM
The Practice Incentive Program is shrinking, but the Government expects new quality improvement systems and GPs’ data, Dr Edwin Kruys writes for newsGP.
Dr Kruys believes the Federal Government is seemingly making ‘policy on the run’ in addressing changes to the Practice Incentive Program.
Most GPs were underwhelmed, to say the least, when they heard about the changes (read: cuts) to the Practice Incentive Program (PIP). Cutting the funding for nursing home visits is a hard sell for the Department of Health and the Federal Health Minister.

This is the wrong message at a time when there are more elderly people with complex chronic health problems in need of appropriate medical care, preferably in the community.
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G Medical's new e-store lets consumers buy Prizma medical smartphone case direct

Want to turn your smartphone into a 21st century medical monitor, akin to an early form of Star Trek medical Tricorder? Now you can.
Back on 26 October 2017, I conducted a video interview with Dr Yacov Geva, chief executive of G Medical Innovations, a man with decades of experience in business, life, success and the medical realm.
His company, G Medical Innovations, is based in Israel, but has since listed on the ASX, and was one of the reasons why Dr Geva was in town last year.
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When it comes to drug compliance, apps are no quick fix

3 May 2018
There’s a mountain of medical apps out there. But are they really any good? Can they prove their clinical worth in rigorous trials?
Researchers from the US took it upon themselves to find out by investigating the medication adherence app most highly rated for usability. That app is Medisafe, which promises to improve drug compliance by sending smartphone alerts if a patient doesn’t take their medicine on time.
In addition to alerts, it provides weekly adherence reports and allows users to set up a ‘Medifriend’, who receives alerts on their own smartphone if their friend doesn’t take their medicine, presumably so they can berate them about it. Sounds like a perfect combination of prompts to boost drug adherence in, say, people with poorly controlled hypertension.  
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ACRRM secures GP remuneration review in 'compact' with government

The deal echoes those agreed in secret by the RACGP and AMA last May
3rd May 2018
The Federal Government is promising to review the pay and incentives of rural doctors as part of a 'compact' signed with ACRRM ahead of next week’s federal budget.
It has also pledged to urgently finalise all outstanding legislative amendments required to grant the college full recognition as a certifier of specialist GPs.
The compact, made public on Wednesday, echoes those agreed in secret by the RACGP and AMA last May.
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Government denies ASD has plans to spy on Australians

The Australian Government has been quick to deny a story that the Australian Signals Directorate is trying to extend its spying powers to Australian citizens.
Foreign Minister Julie Bishop told reporters in Cairns: "The current laws safeguard the privacy of Australians but also provide us with an opportunity to keep Australians safe."
The story ran in Sunday editions of News Corp newspapers and cited correspondence between the head of the Department of Home Affairs, Mike Pezzullo, and Defence Secretary Greg Moriarty.
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Privacy Foundation expresses alarm over ASD report

The Australian Privacy Foundation says it is "seriously alarmed" about the weekend's report that the Australian Signals Directorate is trying to extend its powers to spy on Australian citizens.
The story ran in some News Corporation newspapers on Sunday and both the government and the secretaries of the two departments concerned, Home Affairs and Defence, were quick to deny that any such plans existed.
Adam Molnar, the co-chair of the APF's Surveillance Committee, said the move was "a dangerous precedent that would remove an already inadequate oversight mechanism that our nation’s top foreign intelligence agency has in relation to the rule of law and democratic accountability".
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Facebook: a canary in the data goldmine

  • Yohan Ramasundara
  • The Australian
  • 12:00AM April 24, 2018
Seeing Facebook’s Mark Zuckerberg face the Senate hearing in the US last week showcased something that we don’t get to see that often: a company, and its CEO, held accountable.
The furore over the revelations that Cambridge Analytica harvested data on 87 million users — including some 300,000 Australians — via an app that tied into Facebook and slurped up data without permission isn’t all that surprising: Facebook, YouTube, Twitter and others have built their business on user-generated data.
Cambridge Analytica caused such a backlash because it harvested this data without permission, and not only of Facebook users but also of ­people who have never used Facebook, thanks in part to “shadow profiles” gleaned from personal data.
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No need to fret, CBA says of mammoth data breach

Confirms data relating to 19.8 million customer accounts may have been misplaced
Rohan Pearce (Computerworld) 03 May, 2018 09:07
The Commonwealth Bank says there is “no evidence of customer information being compromised or suspicious activity” as a result of copies of financial data relating to some 19.8 million customer accounts being misplaced in 2016.
The bank confirmed a May 2016 incident when it was unable to confirm the scheduled destruction of two magnetic tapes with customer statements. The tapes included customer names, addresses, account numbers and transaction details from 2000 to early 2016, CBA said.
BuzzFeed News’ Paul Farrell broke the story, revealing that the incident took place when Fuji Xerox was decommissioning a CBA data centre.
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Be alert but not alarmed about mammoth CBA breach, say experts

By Ben Grubb
3 May 2018 — 5:10pm
Commonwealth Bank customers should be “alert but not alarmed” about a mammoth data breach in 2016, which the bank chose to keep private, Australia’s former privacy commissioner, Malcolm Crompton, says.
As the scandal-plagued bank faces the fallout from this latest incident — which has prompted the privacy regulator to re-look at how the bank handled it — privacy experts said even if a similar breach happened again, the bank might not be required to disclose it under new notification laws.
Yet another scandal plagues Australia's largest bank, with the Prime Minister Malcolm Turnbull labeling it an "extraordinary blunder".
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Health data governance enforceable undertaking for reidentification of MBS/PBS data

Australia, USA May 3 2018
In brief
The Australian Information Commissioner has concluded an investigation into the re-identification of Medicare service provider data within the de-identified Medicare Benefits Schedule and Pharmaceutical Benefits Schedule data published by the Commonwealth Department of Health on data.gov.au in 2016. Background and further information about the data published can be found in a LegalTalk Alert which was distributed on 11 May 2017. In the investigation, the Commissioner found that the Department of Health failed to take reasonable steps to protect personal information and to implement practices, procedures and systems to ensure compliance with Australian privacy laws.
The Department of Health provided the Commissioner with an undertaking, which included a requirement to establish an external review and audit into departmental policies and procedures for the release of data based on personal information.
The incident in 2016 has provided a valuable learning experience for Government agencies as they explore how to best realise the value of public data sets. Importantly, the Commissioner observed that the risk of re-identification may require limiting the sharing of some types of data to trusted recipients, and/or using secured environments to share information, rather than simply relying on de-identification techniques.
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New Zealand underinvesting in health IT

Wednesday, 2 May 2018   (0 Comments)
eHealthNews editor Rebecca McBeth
An investigation by eHealthNews has uncovered a low level of spending by DHBs on information technology, putting existing systems at risk and inhibiting the transformational change needed.
 New Zealand’s district health boards are spending around 2.3 per cent of their annual budgets on information technology, which is half the global average.
 Experts spoken to by eHealthNews say 2.3 per cent is barely enough to keep the legacy systems running and does not allow for investment in the transformational change that the health system requires.
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Answer: Telehealth. So what was the question?

…How can we transform healthcare?

Report by HISA’s Nigel Chartres and Dr Josie Di Donato

Genuine intent and achievement to transform care virtually, in a connected and codesigned way amplified the theme of the 2018 Australian Telehealth Conference in Sydney.

From Start-Up to Scale-Up

Opportunities for using technology that enables virtual, connected care were more and more apparent at this year’s Australian Telehealth Conference (ATC). Telehealth is no longer videoconferencing alone. It is no longer on the periphery and exclusive technology for the supported care of people living in the remotest parts of the world. Telehealth has stood the test of time and broadened the frame for healthcare delivery no matter where you live and no matter how far the nearest healthcare provider is located.
Telehealth has emerged beyond the veil of pilot and demonstration projects, as a key tool for achieving virtualised and connected care.
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Outgoing head of the Garvan talks about the rapid, inevitable transformation of the “last of the great cottage industries”

Lynne Minion | 02 May 2018
Within two years it will be unacceptable for cancers to go unsequenced and genomics analysis will be the standard of care for rare and undiagnosed severe disability, according to the outgoing head of Australia’s prestigious Garvan Institute, as healthcare transforms from the “last of the great cottage industries”.
A pioneer, soothsayer and pied piper: meeting Professor John Mattick it’s easy to see why he is described as a man on the vanguard of transforming clinical care through genomics.
A precision medicine evangelist, he is preoccupied with placing its diagnostic and curative powers – once the stuff of science fiction and the high-tech province of medical research – into doctors’ hands.
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Labor reiterates commitment to fibre in NBN rollout

The Australian Labor Party says it is committed to fast, reliable and affordable Internet for the country, and that means more fibre in whatever remains of the NBN rollout after the next election which it expects to win.
The party's acting shadow minister for communications, Stephen Jones, told iTWire in response to a query that work was continuing on the party's broadband policy for the next election.
In its draft policy for the next election, the word "fibre" has been left out, raising questions in some quarters that the party was planning to follow the current rollout policy for the national broadband network.
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Are unlimited 4G and future 5G plans the death knell for the NBN?

Unlimited 4G data plans for mobile phones have arrived in Australia at long last, and truth be told, unlimited 4G was actually launched long ago by VividWireless, but is this the end for the NBN?
COMMENT: Has the NBN been turned into the EndBN? Is it all over for Kevin Rudd and Stephen Conroy's dream of a national broadband network, since destroyed, as ordered by former prime minister Tony Abbott, and carried out by current Prime Minister Malcolm Turnbull's spectacularly inept handling of the NBN fiasco?
Given the fact that a robust, wired, nationwide fibre network is required for robust handling of the massive traffic volumes that today's 4G network and tomorrow's 5G networks require, it's easy to see that the answer is no.
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Morrow says copper is slower than fibre. And in other news, the sun rose in the east...

NBN chief executive Bill Morrow has given the clearest indication yet that he plans to continue working in Australia after he leaves the company at the end of the year, issuing a six-page "white paper" last week in which he acknowledged that the multi-technology mix NBN has suffered in speed terms due to the abundance of copper.
This acknowledgement has been interpreted in varied ways by people, with some saying he was criticising the federal government, others saying he was being frank about the problems posed by copper, and yet others saying he had finally seen the light.
But what Morrow did is common among people who are perceived by the public as having screwed up in style and want to make amends so that they continue in some other public role without looking too much like dunderheads.
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NBN Co chief gets frank about copper's problems

By Ry Crozier on Apr 27, 2018 1:24PM

Helped quicken the rollout but caused ongoing issues.

NBN Co’s outgoing CEO Bill Morrow has issued a frank assessment of how increased use of copper in the network has caused both the company and its customers problems.
Morrow stopped short of criticising the technology switch from majority fibre to a mix of access technologies - which happened under a change of government.
He still believed that reusing the copper and HFC networks was required to meet the expected pace of the rollout.
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  • Apr 30 2018 at 2:21 PM

Needless Bill Morrow NBN essay an effort in legacy building and blame dodging

In what has become a ridiculously regular occurrence, the construction of the National Broadband Network was again plunged into furious political debate at the end of last week, when departing chief executive Bill Morrow published a "position paper," laying out a range of historic and existing issues with the project.
The essay covered a perspective on the original need for improved broadband, a potted history of the countless funds it has had to give to Telstra for its existing infrastructure and a factual breakdown of why the copper used in the fibre to the node heavy rollout, mandated by Malcolm Turnbull, was slower and more prone to problems than the fibre to the premise (FTTP) model used by the previous Labor government.
He then concluded that, despite all of these problems, the government's approach was essentially correct in the context of building the NBN faster and cheaper than Labor's model, and providing a service that is good enough for now.
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Turnbull sabotaged NBN: Shorten

  • The Australian
  • 3:09PM April 27, 2018

David Swan

Supratim Adhikari

Opposition leader Bill Shorten says Malcolm Turnbull has sabotaged the NBN, following The Australian’s report that the head of NBN Co, Bill Morrow, had highlighted the Coalition’s multi-technology approach as source of customer confusion.
“Malcolm Turnbull has absolutely given Australia a second-rate NBN and even his outgoing CEO has confirmed that fact,” Mr Shorten said at a Melbourne press conference.
“Turnbull has stuffed up the NBN because he backed in a cheaper technology which is now going to deliver sub optimal outcomes.
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Enjoy!
David.

Sunday, May 06, 2018

The Signs Of Incompetence and Chaos Just Keep Piling Up Around The ADHA, But They Have Really Excelled Themselves This Week!

The bad week began early in the week when all sorts of comments appeared on the blog making it clear that announcements on the Secondary Use of myHR data and the opt-out process were coming soon.
The stage was being set for opt-out to start with events such as an address to the National Press Club on May 24 and so on.

Tim Kelsey

Chief Executive Officer, Australian Digital Health Agency
'Your Health in Your Hands – the Digital Evolution of Health and Care in Australia'
Thursday, 24 May 2018
Arrive from 11.30am, lunch 12 noon, speaker 12.30 concludes 1.30pm
Canberra - 16 National Circuit, Barton ACT 2600
Here is the link:
This was then followed by a blog post from fellow blogger Dr. Edwin Kruys letting us all know – from the inside – that it was soon to be on for one and all.

It has begun: Australians will soon have a digital health record

By the end of the year Australians will have an online digital health record, unless they opt out of the system. The details of the move towards opt-out will be released soon.

The Australian Digital Health Agency (ADHA) is ramping up its activities to prepare for the change to opt-out. The large-scale operation will involve extensive stakeholder engagement, a nation-wide communication and advertising campaign and increased support for consumers and clinicians.
For consumers who have not opted out at the end of the defined three-month period later this year, a My Health Record (myHR) will be created. The record will be activated when used for the first time by consumers or clinicians.

A clean slate

ADHA has opened a new call centre, launched a revamped website myhealthrecord.com.au and is now present on Twitter (@MyHealthRec).
Staff levels of the call centre – transferred from the Department of Health to ADHA – will increase from thirty to two hundred and will operate around the clock during the opt-out period.
The record will initially be empty apart from two years worth of retrospective MBS and PBS data. Consumers have the option to remove this data.
Pathology and imaging reports are uploaded into the MyHR one week after the test date. Some sensitive tests, such as HIV, may not be automatically uploaded depending on the various State or Territory legislation.
Clinicians and consumers will have the opportunity to stop the upload of results and other reports if desired. Consumers can restrict access to or remove reports from their MyHR.
There is a great deal more here:
This paragraph – since modified – tells us Secondary use is on the way too!

Risks and challenges

The MyHR offers clear benefits as clinicians will have increased access to information such as shared health summaries, discharge summaries, prescription and dispense records, pathology reports and diagnostic imaging reports.
However, every digital solution has its pros and cons. It has been decided that the risks associated with the MyHR will not be explicitly discussed on the website.
Behind the scenes however, risk mitigation has been one of the priorities of ADHA. This obviously includes the risk of cyber attacks and public confidence in the security of the data.
Many consumers and clinicians regard secondary use of the MyHR data as a risk. The MyHR will contain a ‘toggle’, giving consumers the option to switch secondary use of their own data on or off.
----- End Extract.
We can assume this is authoritative info given the author:
“Edwin Kruys is a member of the My Health Record expansion program steering group.”
 And finally it was all brought together beautifully here:

New My Health Record opt out and secondary use details leak, as announcements loom

Lynne Minion | 04 May 2018
Weeks before the anticipated announcement of the My Health Record opt out period, an insider’s leak has claimed the Australian Digital Health Agency has decided to not explicitly inform consumers of the risks associated with My Health Record, such as those relating to cybersecurity and the “secondary use” of the clinical data collected within it.
As the ADHA heads towards the imminent announcement of the three-month window in which Australians will be able to opt out of My Health Record before being signed up to the online health information repository, the agency was caught by surprise today when details emerged in a blog post by GP and member of the steering group for the national expansion of MHR, Dr Edwin Kruys.
Kruys wrote that MHR offers “clear benefits” to healthcare through providing clinicians with greater access to discharge summaries, pathology and diagnostic reports, prescription records and more, but said “every digital solution has its pros and cons” and behind-the-scenes risk mitigation has been one of the priorities of the ADHA. However, he claimed Australians may not be made aware of the risks involved in allowing their private medical information to be shared via the Federal Government’s system.
“It has been decided that the risks associated with the MyHR will not be explicitly discussed on the website,” Kruys wrote.
“This obviously includes the risk of cyber attacks and public confidence in the security of the data.”
The most contentious contribution in the post related to the secondary use of Australians’ health information, the framework of which has yet to be announced by Health Minister Greg Hunt.
Vastly more here:
Additionally the Board has not posted its notes in 5 months and Tim Kelsey was in the US when last heard of on International Digital Health Business.
Worse still the system still seems to need lots of rest – especially when it might be most useful!
See here:
Of course, as well, we still have the ongoing issues around the myHR’s compulsion, fitness for purpose, cost, usefulness, reliability, privacy, security and data quality to say nothing of its basically flawed initial design and the open secret that it is intended to monitor GP performance for Government rather that assist clinical care.
Its really sad how so much initial hope has given way to frustration and annoyance.
David.

AusHealthIT Poll Number 421 – Results – 6th May, 2018.

Here are the results of the poll.

Is It Possible To Create A Digital Health System That Is Optimally Useful And Functional For Both Clinicians And Patients?

Yes 42% (63)

No - Each Group Has Different Requirements 56% (85)

I Have No Idea 2% (3)

Total votes: 151

Looks like a little over half agree that you can’t serve two masters optimally. It was interesting that the poll result changed slowly over the week with the ‘no’ vote rising steadily over the week.

Any insights welcome as a comment, as usual.

A really, really great turnout of votes!

It must have been a really easy question as just 3/155 readers were not sure what the appropriate answer was.

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

David.

Saturday, May 05, 2018

Weekly Overseas Health IT Links – 5th May, 2018

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

April 26, 2018

In 1997, health information technology and digitial health pioneer Warner Slack wrote his bold and prophetic book, Cybermedicine: How Computing Empowers Doctors and Patients for Better Care.  Slack argued that “the electronic digital computer, with its capacity to hold large amounts of data and to execute multiple complex instructions and accuracy would…find an important clinical role in both diagnosis and treatment.”
While the digitization of health information has solved many problems in American medicine — particularly, helping to reduce medical errors by enhancing clinical decision support — it has inevitably created many new ones. Clinician-oriented solutions such as electronic health records (EHRs) are contributing to physician burnout instead of facilitating patient care. Many anticipated that health information technology would reduce costs by limiting the duplication of tests and studies, but there is little evidence that it has accomplished this. And while patient-oriented digital solutions have proliferated in number, their clinical impact has been limited. Slack anticipated a world in which patient access to records would enhance “patient power” — yet many patient-oriented solutions have little relevance in the clinical exam room.
Yet there are rays of light, each of which shares a common denominator: a rigorous focus on the specific needs of the end user, be it patient or clinician. When creative health systems consider and engage the end user of the digital technology as the “customer” of that technology, adoption levels are high and so, too, is the impact. Two CareMore Health initiatives serve as examples: One provides patients with non-emergency transportation, and the other is a new secure platform for clinical team communication and collaboration.
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Succeeding in sepsis: The transformation with mobile technology continues

25 April 2018
Improving outcomes for patients with sepsis is a major NHS priority. The condition, which annually costs the NHS an estimated £2.5 billion, claims at least 44,000 lives in the UK each year. Around 14,000 of these deaths are preventable.
Despite concerted efforts to accelerate the identification and treatment of patients with sepsis, County Durham & Darlington NHS Foundation Trust recognised it needed to do more to help its clinical teams drive quality improvement in this area of high NHS priority.
The subsequent deployment of mobile technology to help expedite diagnosis and escalate treatment pathways has transformed sepsis care across the integrated organisation. County Durham & Darlington is now among the best performing trusts in England in its identification and treatment of patients with sepsis.
This is their story.

Read the full case study

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Plymouth plans to go live with OpenEHR in next six months

26 April 2018
The CIO at University Hospitals Plymouth NHS Trust has said the organisation is planning to go live with an open source electronic health record (EHR) “some time between June and October” this year.
Andy Blofield confirmed his trust was plans to initially go live with an open-standards based electronic prescribing module, on a single pilot ward.
He added that he doesn’t have “all the information” as the technology is still “very new”. The trust is thought to be the first to go live with OpenEPR, the open standards electronic health architecture which is supported by Slovenian company Marand.
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HIT Think How EHRs can help in the battle against the opioid crisis

Published April 27 2018, 5:51pm EDT
There are distressing similarities between what the United States faced with HIV/AIDS in the 1980s and the current opioid epidemic. Most people have a personal story related to the harm that can be associated with opioids, and the numbers of opioid deaths and people suffering from substance use disorder has reached staggering proportions.
Many smart and influential people are working hard to address the issues from multiple fronts, lift the stigma and put improvements in place, such as the following:
  • The U.S. omnibus spending bill, passed in March, includes $4 billion to address the opioid crisis.
  • All the key federal agencies under Health and Human Services (CDC, NIH, FDA, SAMSHA) are mobilized.
  • Both the Senate and House are actively working on numerous bills that will direct actions related to preventing and treating opioid addiction.
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Partnership Working – Advisory Series, April 2018

By Maja Dragovic – Digital Health
Digital’s ability to support greater partnership working in healthcare has been frequently touted. But, as Maja Dragovic reports, it’s also increasingly proving the means or motivator for initiatives which extend partnerships beyond health and into broader care.
As regions across the country bid for national investment in shared health and care records, the potential for digital to help forge collaborations within and beyond the NHS has once again been highlighted. Local Health and Care Record Exemplars (LHCREs) will initially be focused on developing shared care records, but the intention is that – in the longer term – they will open up possibilities for greater collaboration and integration across a local care landscape.
But LHCREs aren’t the only national initiative with digitally-supported partnership working as a stated aim. Venture into the local government sector, and you’ll uncover the Social Care Digital Innovation Programme. Developed in collaboration with NHS Digital, the programme sees the Local Government Association (LGA) award funds to councils developing digital technology projects to improve social care.
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5 Ways Healthcare Can Defend Itself Against Orangeworm

Jack Murtha
APRIL 25, 2018
By now, you’ve heard of the enigmatic hacker group Orangeworm and how it has blasted healthcare over the past few years. Its Kwampirs malware might be simple and messy, but it has proved effective in stealing patients’ protected health information. So, what can healthcare organizations do to prevent—or respond to—an Orangeworm attack?
To answer this question and more, Healthcare Analytics News™ reached out to John Nye, senior director of cybersecurity research and communications for CynergisTek, a security and information management firm with deep roots in healthcare. Nye understands how malicious actors operate because, well, that’s his job. He’s been a penetration tester for years, meaning companies have retained him to break into the very networks they want to protect. So, when news of Orangeworm broke, he began analyzing the cyberattacks and what went wrong.
Right off the bat, he lists 2 notable things about the Orangeworm hacks: For one, it’s unlikely that a nation-state (like China, Russia, or North Korea) is behind this. Second, although the group has mostly targeted healthcare, it has also terrorized businesses, like information technology companies, that are linked to healthcare.
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FDA requests $100M to tap EHRs for evaluating medical products

Published April 26 2018, 7:07am EDT
The Food and Drug Administration is asking for $100 million in its Fiscal Year 2019 budget request for a new initiative aimed at better utilizing electronic health record data to help streamline clinical development as well as inform the safe and effective use of medical products.
FDA Commissioner Scott Gottlieb, MD, told a Senate appropriations subcommittee on Tuesday that the funding for the initiative would create the capability to “conduct near-real-time evaluation down to the level of individual electronic health records for at least 10 million individuals from a broad range of healthcare settings.”
Currently, the FDA’s active post-market data monitoring systems—the National Evaluation System for health Technology (NEST) for medical devices and Sentinel system for drugs and biologics—depend largely on the secondary use of claims data.
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How ‘-omics’ data can revamp treatment of diseases

Published April 26 2018, 5:16pm EDT
Healthcare professionals can draw lifesaving conclusions from omics data sets—molecular data from genomics, proteomics and metabolomics—to help inform their clinical decision-making and improve patient care.
What distinguishes omics data from previous molecular biology research is the ability to express all of a cell’s proteins, rather than a single protein, says Mark Depristo, head of deep learning for genetics and genomics at Google. “You collect a lot of data very quickly because you're not selecting for specific proteins you want to cite,” Depristo noted.
Depristo and Anthony Philippakis, MD, the chief data officer of the Broad Institute, a Harvard and MIT biomedical and genomic research center, will be among the experts discussing this topic at the HLTH session “Discovering Meaning From Massive Omics Data Sets” scheduled to begin at 3:20 p.m. on Tuesday, May 8, at the Aria in Las Vegas.
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mHealth Apps With CDS Can Help Doctors Make Quicker, Better Decisions

An analysis of an mHealth app developed by the CDC finds that it - and other properly evaluated apps - can help physicians make better decisions on ordering diagnostic and lab tests. And they can do it quicker and with more confidence.

April 24, 2018 - mHealth apps for clinical decision support can help clinicians make better and quicker decisions about ordering diagnostic and lab tests, according to a recent study by researchers at the Baylor College of Medicine and the Centers of Disease Control and Prevention.
But those apps, researchers said, have to be evaluated and approved, so that doctors know which of the ever-growing number of mobile health apps are reliable. That’s particularly important when physicians report that they’re uncertain about what tests to order for one of every seven patients.
In their study, recently highlighted in the Journal of the American Medical Informatics Association, experts from Baylor and the CDC evaluated the effectiveness of one particular app, PTT Advisor, against typical decision support tools, including online and text resources. The app, developed by the CDC’s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC), offers guidelines for diagnostic and test ordering decisions for certain coagulation and bleeding disorders.
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Study: 9 in 10 Clinicians to Use Mobile Devices at Bedside by 2022

April 24, 2018
by Heather Landi
A recent study indicates a rising adoption in clinical mobility, such as the use of mobile devices like handheld mobile computers, tablets, cordless barcode scanners and mobile printers, in hospitals and clinicians increasingly see mobile devices as improving the quality of patient care and helping to reduce medication administration errors.
Nine in 10 clinicians expect to use a mobile device at the bedside by 2022, according to Zebra Technologies’ 2022 Hospital Vision Study. Zebra Technologies, a mobile device solutions company, surveyed 1,500 nursing managers, IT decision-makers and patients and the survey compiles the feedback from respondents across the United States, Brazil, China, United Kingdom, Saudi Arabia, Kuwait, Qatar, and United Arab Emirates.
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CMS floats proposal tying medical records sharing to Medicare participation

Apr 25, 2018 1:20pm
Buried underneath changes to the Meaningful Use program, a newly proposed hospital payment rule includes the possibility of more stringent federal requirements that would force providers to share data to participate in Medicare and Medicaid.
That approach, which involves revising Conditions of Participation (CoPs), would allow the Centers for Medicare & Medicaid Services to wield a far heftier regulatory stick and offer a clear-cut business case for interoperability. 
The 1,880-page rule (PDF) released by the Centers for Medicare & Medicaid Services (CMS) on Tuesday includes what the agency dubbed as an “overhaul” of the Meaningful Use program, now known as Promoting Interoperability. As part of that change, the agency shaved down number or measures hospitals are required to meet from 16 to six and revamped the program to a points-based scoring system.
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HIT Think Meaningful Use changes are only part of CMS’ proposed rule

Published April 26 2018, 5:55pm EDT
This week, CMS released its Inpatient Proposed Rule for Fiscal Year 2019. Early reactions from stakeholders have been varied, with some healthcare stakeholders bemoaning "the death of Meaningful Use" while others praised the triumph of "Patients Over Paperwork" and the clear influence such efforts have played in this year's proposals.
In keeping with stated goals of the current administration, one aspect of the 1,882-page regulation is undeniably clear: CMS is intently focused on reducing administrative burden for providers. While CMS anticipates that its proposals to eliminate some reporting requirements will save hospitals many hours, providers shouldn't assume that the net effects of these proposals will automatically lead to more favorable financial impacts than in the past, especially because some of the proposed changes are to the pay-for-performance programs.
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Patients prefer the doctor without the computer, MD Anderson researchers find

Apr 24, 2018 9:15am
Take the computer out of the exam room and patients perceive the doctor as more compassionate and professional, with better communication skills.
That’s the finding of a study by researchers at the University of Texas MD Anderson Cancer Center in Houston, published in JAMA Oncology.
The researchers conducted the randomized clinical trial to assess patients’ perception of doctors who use a computer in the examination room.
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CMS overhauls meaningful use EHR program, removes redundancies

Administrator Seema Verma said changes to the program eliminate 25 measures and ultimately save hospitals over 2 million hours of work.
April 24, 2018 06:08 PM
Centers for Medicare and Medicaid Services Administrator Seema Verma on Tuesday announced changes to overhaul the meaningful use EHR incentive program, including equipping patients with access to their electronic health records on the day they leave the hospital.
Indeed, it starts with a new moniker: meaningful use is being renamed “Promoting Interoperability.”
The proposed rules and request for comment are a follow up to Verma’s March announcement during HIMSS18 in Las Vegas for better interoperability between providers and for patients.
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HIT Think How healthcare organizations can become information-driven

Published April 25 2018, 5:35pm EDT
Over the last several years, data analytics has become a driving force for organizations wanting to make informed decisions about their operations and their patients.
With further advancements in open source analytic tools, faster storage and database performance and the advent of sensors and IoT, IDC predicts that the big data analytics market is on track to become a $200 billion industry by the end of this decade.
Many organizations now understand the value of extracting relevant information from their enterprise data and using it for better decision-making, superior customer service and more efficient management. But to realize their highest potential in this space, organizations will have to evolve from being "data-driven” to being “information-driven.” While these two categories might sound similar, they’re actually quite different.
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APIs: A Path to Putting Patients at the Center

April 24, 2018, 8:42 am / Don Rucker M.D. / National Coordinator for Health Information Technology
I remember when visiting a city required paper maps and often actual guidebooks. Today, I tap on a map app on my phone, enter my destination, and review options for getting from point A to point B. In recent years, these applications have expanded to integrate ride-sharing, bike-sharing, and public transit information. Map apps provide two key real-time data points to help me compare the different options: the time it will take to get to my destination and the cost.
Behind those data points are elegant algorithms that analyze traffic patterns and conditions, as well as the real-time data exchange between multiple apps through modern, Representational State Transfer (RESTful) application programming interfaces (APIs). What makes our smartphones so powerful is the multitude of apps and software programs that use open and accessible APIs for delivering new products to consumers and businesses, creating new market entrants and opportunities. There is nothing analogous to this app ecosystem in healthcare.
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EHR Capabilities Impact Patient Satisfaction Levels, Report Finds

April 23, 2018
by Rajiv Leventhal
Electronic health record (EHR) technology and the ways that providers use it to communicate with their colleagues and with patients is affecting how satisfied consumers are with their hospital organizations, according to a new Black Book market research.
The insight is revealed within the eighth annual Black Book industry surveys of inpatient EHR users including hospital staff, managers, networked physicians and patient panels. The data revealed that 89 percent of healthcare consumers under 40 years old, who were polled in this year's survey on hospital provider technologies, disclosed they are unsatisfied with the technology capabilities of the healthcare organizations with which they seek services. And 84 percent asserted they are seeking the most technologically advanced and electronically communicative medical organizations available for their healthcare alternatives.
“Involvement with healthcare consumers through technologies is proving to be a significant element of patient satisfaction," said Doug Brown, managing partner of Black Book Research. "Healthcare consumers more frequently interact through electronic media in 2018, and while they value contact with their providers, they don't have the patience for lacks in hospital interoperability, incorrect billing and access to scheduling and results."
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36% of administrators continue to struggle with EHR interoperability

April 23, 2018 | Cara Livernois
As a result of the implementation of varying electronic health record (EHR) systems, 36 percent of medical record administrators struggle with the exchange of patient health records with providers with differing EHR platforms. Findings were published April 20 in a report by Black Book Market Research.
The report included responses from 3,040 hospital EHR users.
Key findings included:
  • 36 percent of medical record administrators struggled with the exchange of patient health records to other healthcare providers with differing EHR platforms, a slight improvement from 41 percent in 2016.
  • 24 percent of administrators were unable to use meaningful patient data they received electronically from outside sources not within a siloed EHR system.
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Medical Device Security Should Be Focus for Healthcare Providers

While ransomware attacks on hospitals have caught the headlines, medical device security and supply chain risk should be of greater concern to healthcare providers, according to a recent report by Trend Micro and HITRUST.

April 23, 2018 - While ransomware attacks on hospitals have caught the headlines, medical device security and supply chain risk should be of greater concern to healthcare providers, according to a recent report by Trend Micro and HITRUST entitled Securing Connected Hospitals.
Researchers at Trend Micro analyzed internet-connected medical devices and systems using the Shodan search engine and found many that were viewable publicly.
Hospitals and clinics leave devices and systems exposed online because they incorrectly configure infrastructure, internet connection is a requirement for the device or system to function, and/or remote access enables remote troubleshooting or remote operations.
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HIT Think Why consumers are casting a wary eye at Terms of Use

Published April 24 2018, 5:12pm EDT
Many websites, mobile applications, software solutions and similar solutions are offered for “free.” The services are free from the perspective that there is no cost to acquire or use the service.
However, as the famous saying used commonly by the author Robert Heinlein goes, “There ain’t no such thing as a free lunch.” While a user may believe there is no cost, the provider of the service will seek to obtain a benefit in some manner.
In the context of a mobile app or software, how does that happen? The data entered into the services is where the value lies. From this perspective, understanding the Terms of Service, Terms of Use or other similar document is important. And after the recent debacle at Facebook regarding user information and privacy concerns, consumers of healthcare services are among those paying more attention to these stipulations.
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CMS issues proposed rule to revamp Meaningful Use

Published April 24 2018, 5:05pm EDT
The Center for Medicare and Medicaid Services Tuesday proposed broad changes in the way it handles providers’ efforts to implement electronic health records systems, as well as the ways in which those systems support changes in patient care.
CMS released its proposed rule to implement its MyHealthEData initiative to strengthen interoperability and change the rules of the Medicare and Medicaid Electronic Health Record Programs, commonly called the Meaningful Use program.
CMS officials say they intend to rename the Meaningful Use program “Promoting Interoperability” to emphasize that measures in the policies will “require the exchange of health information between providers and patients.”
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Changing the game: Machine learning in healthcare

When EHRs can learn – gather and remember – what works best for each user, they can attain maximum efficiency.
April 20, 2018 02:16 PM
As we live in the new world of quality, value-based care, we must be able to draw more insights and conclusions from ever-increasing amounts of information. We have the data, now we must put it to work. When we combine all of this data with machine learning, we are equipped to make smarter decisions. We have the power to transform healthcare – from the way we use electronic health records to the way we predict and deliver care.

A game changer for EHRs

Most EHRs are built on technology that is 20 or 30 years old. Generally, EHRs have kept up with rapid changes in healthcare by making incremental improvements over time. But it is challenging to retrofit EHRs to take full advantage of new innovations.
EHRs must do more than store data. They should be smart enough to deliver the right information at the right time, at the point of care. When an EHR is powered by machine learning, it can pre-populate information based on usage patterns and deliver preference reminders, constantly surveilling trends by user and organization to create opportunities for more effective care.
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Comcast partners with Independence Health to create digital health company

Companies say the cross-sector partnership will create open source platform that it hopes other tech companies will use to innovate.
April 20, 2018 11:22 AM
Independence Health Group, one of the biggest Blue Cross insurers in the country, is working with Comcast on a consumer-focused healthcare platform designed to improve the efficiency and experience of care delivery.
The plan is that the patient-centered technology and communications platform will provide patients with access to data about their healthcare journey, according to officials. Comcast and Independent Health plan to make the platform available nationwide on a range of devices and distribution channels.
"Rapid technological advances in recent years have changed the expectations consumers have about accessing and using goods and services,” Independence CEO Daniel Hilferty said in a statement. “Healthcare is no exception.”
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AI: A data scientist explains how deep and shallow learning can work together to create cost savings

Nationwide Children’s Hospital Chief Research Information Officer Simon Lin says applying artificial intelligence to patient data enables efficiencies and better outcomes for its Medicaid patients.
April 23, 2018 08:54 AM
For all the hype and excited pronouncements about the impacts it can have driving healthcare efficiencies, artificial intelligence is still not deployed as widely (or wisely) as it could be.
But many health systems are working in earnest to roll out AI-driven analytics projects – even if their particular payoff isn't quite yet in sight – with the understanding that the technology is evolving at a dizzying pace, and big improvements could be just around the corner.
That's the case at Partners for Kids, an accountable care organization affiliated with Nationwide Children's Hospital in Columbus, Ohio. As one of the largest pediatric ACOs in the country, PFK has a big opportunity to enable big savings by bettering the health of its Medicaid patients.
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House committee to examine cybersecurity risks of legacy technology in healthcare

Apr 23, 2018 11:05am
An influential House committee is taking a deeper dive into the cybersecurity risks associated with legacy technology throughout the healthcare industry and asking for stakeholders to help policymakers establish possible solutions moving forward.
Calling healthcare cybersecurity a “complex, nuanced challenge with many different contributing factors,” lawmakers zeroed in on legacy devices as the “root cause” of many security incidents, according to a request for information (PDF) issued by the Energy and Commerce Committee last week.
The request acknowledged the simplest recommendation is to replace legacy technology with updated equipment. But the healthcare industry finds itself in a predicament with no easy solutions. Medical technology is more specialized with fewer replacement options for legacy devices. The cost of replacement is much higher than that of consumer technology, and for hospitals with thin operating margins, updating equipment often means sacrificing another portion of its budget.
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Wearables Can Enhance Practice, But Questions Remain

Marcia Frellick
April 22, 2018
NEW ORLEANS — Wearable technology — such as fitness trackers, sensors, and monitors — can build patient engagement, save time on office visits, and add real-time data points, according to physicians speaking here at the American College of Physicians Internal Medicine Meeting 2018.
And starting this year, the Centers for Medicare and Medicaid will reimburse physicians for time spent analyzing data the devices collect, as part of improvements to the Merit-Based Incentive Payment System.
"This is an area where there is a lot of focus from health systems so that they can actually bill for care coordination," said Priya Radhakrishnan, MD, from the HonorHealth Medical Group in Scottsdale, Arizona. "The caveat is that 20% has to be borne by the patient" under the Medicare rules of reimbursement.
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Pew: 5 ways EHRs contribute to patient harm — and 2 ways to fix it

Written by Jessica Kim Cohen | April 20, 2018 |
The Pew Charitable Trusts outlined how EHR usability issues may contribute to patient harm and provided two suggestions on how to solve these safety issues in an April 17 infographic.
Here are five ways the Pew Charitable Trusts said EHR usability issues may harm patients.
1. Alert fatigue
2. Customization that hasn't undergone rigorous testing
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Hacker group targets healthcare organizations through supply chain

Published April 23 2018, 1:27pm EDT
Data security vendor Symantec is warning of a new and significantly dangerous hacker ring targeting large healthcare organizations in the United States, Europe and Asia.
“Symantec has identified a previously unknown group called Orangeworm that has been observed installing a custom backdoor called Trojan.Kwempirs,” the vendor notes.
Orangeworm is looking for targets to engage in corporate espionage in healthcare and other industries. Targets are chosen carefully and deliberately with extensive planning before an attack is made, Symantec experts contend.
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Why providers need IT to achieve a ‘whole person' approach

Published April 23 2018, 5:17pm EDT
Chronic diseases are responsible for seven out of 10 deaths in the United States each year, according to the U.S. Centers for Disease Control and Prevention. Many think a key to reducing chronic disease deaths is personalizing the information sent to each patient, to increase their chances of better managing their health.
Glen Tullman, chairman and CEO of Livongo, will speak at a panel called “Tech-Enabled Services Supporting Chronic Populations” at the upcoming HLTH conference on May 7. Tullman, a former CEO of EHR software company Allscripts, recently spoke with Health Data Management on the role analytics can play in managing chronic conditions. An edited version of the interview follows.
HDM: Livongo Health’s stated mission is to help people with chronic conditions using a “whole person” approach. Tell us about that.
Tullman: Livongo has traditionally been known as a company that helps people with diabetes. But if you look at our vision statement, we talk about empowering people with chronic conditions to live better and healthier lives. And the reason our statement doesn't mention diabetes is because we have always understood that you can't treat people in silos. We've always realized that we had to treat the whole person because that's who we are as people. We're not a disease. We're not a diabetic. We're not a heart patient. We have to look at the whole person. We have to have that kind of approach.
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Telemedicine is getting trendy, but doctors may not be keeping up

April 22
For years, doctors have been told to look at the patient — not the computer — when providing medical care. What we haven’t been told is what to do when there’s only a computer.
Telemedicine is perhaps the most rapidly evolving area in health care. About 15 million Americans receive some form of remote medical care every year. Investment in on-demand health-care services is estimated at $1 billion annually, according to Accenture Consulting. Kaiser Permanente, the nation’s largest integrated delivery system, provides more visits virtually than it does in person.
All of which raises an important but overlooked question: Do doctors know how to use telemedicine?
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Enjoy!
David.

The Question We Must All Now Ask Is "Has The ADHA Board Died"?

Captured today!

"Australian Digital Health Agency Board

Download the latest Board Meeting - 6 December 2017 - Board Papers"

Captured 5 May 2018 - 14:34

Seems that they are so busy they have no time to tell their customers what they are doing. They are behaving in the same arrogant way as the Big Banks and AMP as far as I can tell! We all know how that is turning out!

It's been five months now - are they trying for six do you reckon?

David.

Friday, May 04, 2018

ADHA Can’t Even Say What They Mean As Far As myHR Availability Is Concerned?

This appeared last week:

My Health Record – the connection to accessible information at any time

Hospital pharmacist Leonie Abbott discusses the benefits of My Health Record.
This article originally appeared on Australian Association of Practice Management (AAPM).
By the end of this year, every Australian will have a My Health Record unless they decide they do not want one – and all healthcare providers need to be prepared, wherever they are.
Already 5.5 million Australians – more than 20% of the population – have a My Health Record.
Almost 1,000 public and private hospitals around Australia have connected to the My Health Record system via their electronic medical record systems. Across Australia, 72% of public hospitals are connected to My Health Record – covering approximately 81% of available beds nationally.
Hospital pharmacist Leonie Abbott from the University Hospital Geelong, at Barwon Health in Victoria, has been uploading records to, and using My Health Record, since 2013.
She said having My Health Record accessible ‘24/7’ is an extremely useful benefit of the system.
“Within a busy emergency department, being able to access information at any time is essential. Patients come in at any time of the day or night with emergencies, and often they have little healthcare information with them, including knowledge of their medicines.
“My Heath Record is a summary of multiple clinical information software all in one record. It gives some preliminary information that may allow you to identify which healthcare practitioner in the community to call. This avoids unnecessary phone calls, or faxes and time wasted,” Ms Abbott said.
Lots more here:
When you go to the new website what you find is this:

Service availability

There is currently no planned outage to the My Health Record system
So knowing how, in the past weekends have been favoured for downtime, and reading here that there can be planned, as well as obviously unplanned, outages the 24/7 has not in the past been true and won’t be in the future.
Here is a recent example:

My Health Record system Release 9.2

Created on Tuesday, 16 January 2018
Release 9.2 of the My Health Record system is a technology release which will improve some functionality for both individuals and healthcare providers. There will be minor visible changes to the user experience, mainly to improve access on mobile devices.
Release 9.2 is scheduled to go live on Monday 22nd January 2018.
There will be a planned outage from 8pm Friday 19th January to 6am Saturday 20th January.
Here is the link:
That is 14 hours off-line – not really 24/7 I would say – and not really fit for the purpose claimed – isn’t Friday night the busiest time in ED? Great for planed downtime!
More proof it is not a clinically focused clinical system but a useless data pile.
Might be good to get the story straight. Anytime is not all the time, but when it suits us and we have not had an unexpected outage!
David.