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."

Sunday, May 13, 2018

The Commonwealth’s Framework To Guide The Secondary Use of MyHR Patient Data – Any Good?

This was announced – as one would expect on Friday (of Budget Week) by Minister Hunt.

Framework to guide the secondary use of My Health Record system data

The Framework to guide the secondary use of My Health Record system data (the Framework) has been developed.
Page last updated: 11 May 2018
The Framework outlines key principles that will be used to establish the governance mechanisms and implement transparent processes that are needed to guide decisions about releasing data to suitable applicants for secondary use purposes.
On the 11th May 2018 the Minister, The Hon Greg Hunt MP Minister for Health announced the release of the Framework.
The development of the Framework was informed by a national public consultation process. A Community Consultation Summary Report was developed to reflect the findings of that process.
An Implementation Plan will be developed during the second half of 2018 by the Department of Health, the Australian Institute of Health and Welfare and the Australian Digital Health Agency in collaboration with key stakeholders and project partners. The Implementation Plan will be published here once it has been completed.

Related Links


Here is the page link:
Most valuable to me is what the consultation found people wanted (Consultation Report – link above):

Executive Summary

HealthConsult, as leader of a Consortium consisting of two commercial Firms and eight subject matter experts, was engaged on 24th June 2016, by the Department of Health (the ‘Department’) to:
“develop a Framework for the secondary use of data in My Health Record system”
A key task in developing the Framework was to design and conduct a consultation process to facilitate a public conversation about the future possible secondary uses of MHR system data (there is currently no secondary use).  Stakeholders engaged strongly with the consultation process, with 714 individuals attending webinars (159), workshops (256), interviews (25), or completing a written survey (274); and 80 organisations/individuals making a written submission.  This document summarises the key themes that emerged under each of the consultation questions (grouped as appropriate).  It is only a report of the consultation process, and it should not be read as the likely content of the Framework.
A thematic analysis of the findings from the consultative process is presented in the Chapters that follow.  Key conclusions that can be drawn from the consultation process are:
·         There is strong support across all stakeholder groups for the secondary use of MHR data, with a common view being that this emerging public asset must be used for public benefit
·         Stakeholders support a wide range of research, policy, program and service development uses, but use for solely commercial or non-health purposes is not supported by the vast majority
·         Stakeholders do not support the secondary use of MHR data for the purposes of remunerating or for audits or other processes aimed at evaluating the performance of clinicians
·         There is some support for secondary use of MHR data by commercial Firms as long as there is a public health benefit, but there are also some who oppose any secondary use by a commercial Firm
·         There is some support for allowing secondary use of MHR data by overseas users (to support international research collaborations), but the prevailing view is that data must be stored in Australia
·         Stakeholders have provided guidance on a wide range of principles to be applied to guide the release of MHR data for secondary use, and strongly advocated drawing from the best of existing approaches
·         There is strong support for an independent body to govern the secondary use of MHR data, but there is also support for governance by the Department of Health, Australian Institute of Health and Welfare (AIHW) and, to a lesser extent, Australian Digital Health Agency (ADHA)
·         Whatever the governance authority, stakeholders want membership of the governance committee to include independent experts, as well as strong consumer and Indigenous representation
·         Most stakeholders believe that ethics approval should be obtained for secondary use of de-identified MHR data, and applications for data access should demonstrate a public benefit
·         In addition, for secondary use of identified MHR data, most stakeholders believe that informed consumer consent should be obtained
·         There is strong support across stakeholders for data linkage of MHR data to other (particularly health) data sets to be done by an Accredited Integrating Authority, to further leverage benefits from the MHR system
·         Stakeholders believe that privacy protection is paramount and a ‘privacy by design’ approach should be adopted in developing the Framework
·         Stakeholders have provided guidance on a wide range of approaches to privacy protection and advocated that a ‘best of breed’ approach is taken in developing the Framework
·         Stakeholders believe that MHR data should be released for secondary use using a variety of mechanisms determined using a risk based approach, ranging from publication of key statistics, through to the release of controlled data (data cubes), through to access to unit record data in a secured environment
·         Stakeholders strongly support a robust range of monitoring and assurance process from users signing confidentiality undertakings through to random audits of users to ensure that any MHR data released for secondary use is only used for the approved purposes
·         Stakeholders have provided guidance on risk mitigation strategies around secondary use of MHR data that includes users meeting minimum standards for data security infrastructure, users being trained and/or accredited, and users providing annual and end-of-project compliance reports
·         Stakeholders strongly support a public register that includes details of requests for access to MHR data for secondary use as well as publications reporting the outcomes of the secondary use
·         Stakeholders have a mixed view of penalties for misuse of MHR data with some considering the existing arrangements adequate and others advocating a stronger penalty regime
·         Stakeholders believe the current policy/legislative environment is complex, and they would like to see changes to harmonise the various polices/legislation to be explicit around secondary use of data
Overall, the stakeholder engagement process has generated considerable and very valuable input into the development of the Framework.  There is a widespread recognition of the public good benefits that can be obtained through the secondary use of MHR data.  There is also a strong understanding of the risks, and it is clear that the initial Framework must take a cautious approach to ensure that the existing social (and cultural) licence to use the MHR data for secondary purposes is not eroded.  Subsequent updates to the Framework may take a more liberal approach, once processes, procedures, mitigation strategies, and so on have been tried, tested and refined.  To this end, an evaluation of the effectiveness and impact of the initial Framework after two years or so of operation would be a very worthwhile endeavour.
The stakeholder engagement process also generated a variety of inputs on the next steps in the Framework development process, which can be summarised as:
·         Stakeholders advocate the release of a draft Framework for further public consultation, and many of them have expressed a desire to be involved in that process
·         Stakeholders advocate much stronger engagement with the Indigenous sector in the development of the Framework, specifically the consideration of a separate Framework and separate governance process for the secondary use of MHR data about Indigenous people
·         There is a widespread view amongst stakeholders that development of the Framework should take into account the Government’s response to the recommendations of the Productivity Commission’s Inquiry into Data Availability and Use (it is understood that this response is not yet available)
·         Stakeholders believe that the question of charges for access to MHR data for secondary use should be directly addressed in the Framework
·         Stakeholders believe that consumers should be offered the opportunity to expressly consent (dynamic consent is preferred) to, or opt out of, the use of their MHR data for secondary purposes, and that implied consent through an opt out process around primary use is inferior
·         A number of stakeholders believe that the final draft Framework should be subject to a full Privacy Impact Assessment
·         Many stakeholders advocate for a communications campaign (with tailoring as required for Indigenous and CALD communities) to make the public aware of the intended use of MHR data for secondary purposes (and the associated benefits).
HealthConsult will proceed to develop the draft Framework with regard to the input generated via the stakeholder engagement process.  Advice on the process issues raised by stakeholders will be appreciated.
----- End Extract:
However what we got from Government does not quite meet what was asked for by the majority in a number of areas:
Here is what came out:

Guiding principles of the Framework

The Framework outlines a series of guiding principles that will be used to guide the release of data for secondary use purposes. Table 1 below contains a summary of the principles that are discussed in more detail throughout the chapters of the Framework.
Table 1:               Summary of guiding principles within the Framework
Chapter 1: Governance model for secondary use of My Health Record system data
1.1       The Australian Institute of Health and Welfare (AIHW) is the Data Custodian for the purposes of the Framework.
1.2       The My Health Record (MHR) Secondary Use of Data Governance Board (the Board) will implement the Framework.
1.3       The Board has no role around primary use of the MHR system data—this is the responsibility of the System Operator.
1.4       The Board will comprise representatives from the AIHW, the Australian Digital Health Agency (as the System Operator) and a range of independent experts, including representatives from population health/epidemiology, research, health services delivery, technology, data science, data governance and privacy, and consumer advocacy.
1.5       The Chair of the Aboriginal and Torres Strait Islander Peoples’ Advisory Panel will be a member of the Board.
1.6       The Board will oversee development and operation of all secondary use infrastructure.
Chapter 2: Consumer control of data in the My Health Record system
1.1       Consumers can opt out of having their MHR data used for secondary purposes.
Chapter 3: Applying to access My Health Record system data for secondary use
3.1       The Board will assess applications primarily based on the use of data, not the user.
3.2       The Board will take a ‘case and precedent’ approach to determining what uses will be permitted and not permitted for secondary use.
3.3       Any Australian-based entity (except insurance agencies) can apply to access MHR system data for secondary use, subject to meeting the criteria set out in this Framework.
3.4       Applicants that are not based in Australia may, in limited circumstances, be involved in the use of MHR system data for secondary purposes.
3.5       The Board will use the ‘Five safes’ principles to assess applications.
3.6       MHR data that has been made accessible for secondary use must not leave Australia; however, there is scope for data analyses and reports produced using MHR system data to be shared internationally.
Chapter 4: Access to, or release of, data for secondary use
4.1       The Board will ensure that, where data is in other public datasets, the principles applied to access are consistent with those applied in the other datasets.
4.2       The Board will use a ‘case and precedent’ approach to determine what is ‘solely commercial use’ of data.
4.3       The Board will give specific consideration to use of data pertaining to Aboriginal and Torres Strait Islander people and communities.
4.4       Where an applicant seeks access to data from another repository—for example, Medicare Benefits Schedule or Pharmaceutical Benefits Schedule data—they will be referred to the data custodian for those systems.
Chapter 5: Process for requesting and accessing data
5.1       For applications involving identified data, subject to the provisions of the My Health Records Act 2012 and the Privacy Act 1988, the Board will require ethics approval to be obtained by the AIHW Ethics Committee before data can be accessed or released.
5.2       For applications involving de-identified data, the Board may require ethics approval to be obtained before data can be accessed or released.
5.3       The Board will work with related government bodies, data custodians and ethics committee(s) that also have an interest in the particular application to minimise as much as is possible unnecessary duplication of effort, additional cost and/or delays in processing an application.
5.4       Prior to data being released, the Board will require the approved applicant to agree to the Conditions of Use Agreement (CUA).
Chapter 6: Data linkage
6.1       The Board can permit the linkage of MHR system data with other data sources once the applicant’s use is assessed to be of public benefit.
6.2       Specific processes will apply for data linkage involving identified data for Aboriginal and Torres Strait Islander people.
Chapter 7: Processes to ensure protection of the privacy of individuals
7.1       De-identification of data is acknowledged to be a dynamic and ongoing process.
7.2       The Board will strive to stay abreast of changes in technology and data science as they evolve so that, as far as possible, it may anticipate new privacy threats and use this knowledge to inform assessment of applications for the use of data.
7.3       Proven methods will be used to reduce the risk of breaching an individual’s privacy to very low levels.
7.4       The Board will regularly reconsider the privacy protection processes around secondary use of MHR system data. Particular consideration will be given to circumstances where there is already data in the public domain about individuals.
7.5       As part of the ongoing process of reviewing the Framework (with the first review occurring after two years of operation), the list of permitted and not permitted uses will be reconsidered and amended with reference to the ‘case and precedent’ experience of the Board (see Chapter 3, ‘Applying to access My Health Record system data for secondary use’).
Chapter 8: Preparing and making data available, and data quality
8.1       The Board will ensure that individuals’ privacy is protected in the processes of preparing and making data available for secondary use.
8.2       The Board will ensure that any data made available is of sufficient quality to expect that the objectives of the project, as stated in the application, can be achieved.
Chapter 9: Monitoring and assurance processes
9.1       The Board will put in place a set of processes to provide assurance to stakeholders and the public that successful applicants use MHR system data only for approved secondary purposes.
9.2       The higher the assessed risk of a project, the more detailed the monitoring activities that will be required in the Conditions of Use Agreement (CUA).
Chapter 10: Risk mitigation strategies and imposed penalties
10.1    The Board will ensure that the risk of a breach of privacy for an individual is reduced to an acceptable level by minimising the risks associated with each application for secondary use and recommending penalties where applicable.
----- End Extract:
The two huge issues I note is that Secondary Use has been made ‘opt-out’ and that there is no recognition of the incompleteness and unknown quality of the data in the myHR to say nothing of how easy it is to access and use.
Of course I am sure that many will think that the whole question is moot as no generalised secondary use of private health data should be permitted at all, except with specific individual consent!
I am sure others will have additional issues so comment away!
David

AusHealthIT Poll Number 422 – Results – 13th May, 2018.

Here are the results of the poll. To the question below the responses were:

Has The ADHA Lost It?

Yes 94% (157)

No 4% (7)

I Have No Idea 2% (3)

Total votes: 167

A huge vote of no confidence I would suggest on a very large number of votes. Also, I have to say the comments regarding the ADHA never having it to loose did bring a small smile to my face. It really is the comments that make this so much fun!

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 3/167 readers were not sure what the appropriate answer was.

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

David.

Saturday, May 12, 2018

Weekly Overseas Health IT Links – 12th 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.
-----

Dimec allows patients to choose pick-up point for prescriptions

A pharmacy app has announced it is the first service in the UK to allow patients to choose any high street pharmacy to collect their prescription.
Hanna Crouch – 3 May 2018
Dimec works by linking a patient’s phone directly to their NHS GP and pharmacy and then letting them pick where to collect medicines from at the touch of a button.
Prior to this, patients were required to contact their GP or Pharmacist to request to alter their pharmacy.
The update to the app means patients can now view and select high street pharmacies based on their current location their home address or scroll around the integrated map.
-----

Hunt: IT error ‘could have cut short the lives of up to 270 women’

An IT error may have been the reason why the lives of up to 270 women in England were shortened after they failed to receive their final routine breast cancer screening invitation, Jeremy Hunt has told MPs.
Hanna Crouch – 2 May 2018
Speaking in the House of Commons on Wednesday, the Health and Social Care Secretary said the affected group of women were not sent invitations before their 71st birthday because “there was a computer algorithm failure”, which dated back to 2009.
He added: “Latest estimates I have received from Public Health England (PHE) is that as a result of this, between 2009 and the start of 2018, an estimated 450,000 women aged between 68 and 71 were not invited to their final breast screening.
-----

The tech revolution is coming, and the NHS needs to be ready

As Dr Eric Topol commences his review into the training needs of NHS staff and how can they leverage artificial intelligence, genomicsotics and other technologies to improve care, Stephen Barclay, minister of state for Health and Social Care, says it is important that NHS is “future-fit” to embrace the technological revolution.
DHI Admin – 30 April, 2018
Aided by the rapid advance of new technologies, there is something profound happening within modern medicine – we are starting to digitise the science of human health. Sophisticated smartphone apps are being used to continuously monitor a patient’s vital signs, opening up new ways of managing long term conditions such as diabetes.
Artificial intelligence is revolutionising diagnostics, with machine learning technologies set to improve the accuracy and speed of diagnosis, as is already underway at Moorfields Hospital.
-----

Cloud still hangs over patient data sovereignty concerns

While our cybersecurity columnist Davey Winder has no problem with his data being held in the cloud, he is worried about this recent push to off-shored cloud services and the possibility of NHS patient data being stored outside the UK.
May 4, 2018
The debate surrounding security and the cloud has, for the most part, long since been settled: it’s not insecure by design. Of course, that doesn’t mean there aren’t security issues as far as cloud-based storage is concerned – just that they tend to be like the threats that are prevalent across the enterprise storage space.
But that didn’t stop 61% of NHS trusts responding to a freedom of information request earlier in the year citing security and compliance as being the biggest barriers to cloud adoption.
Practically speaking, the security concerns surrounding the cloud tend to be issues such as vulnerabilities in web applications. According to Alert Logic there has been a 300% increase in such attacks since 2014 and 75% of all ‘events’ logged by the cloud security specialists during the last 18 months involve them in one way or another.
-----

Apple Watch Alerts Users to Seek Medical Attention, Saving Lives

Doctors say alerts from the smartwatch urging users to seek medical attention saved their lives.
By Alexa Lardieri, Staff Writer May 3, 2018, at 11:31 a.m.
The Apple Watch is credited with saving two lives in April by alerting users to immediately seek medical attention.
William Monzidelis received this notification on his smartwatch when he was working at his family's bowling alley in New York. The 32-year-old began feeling dizzy and went to the bathroom, where he began bleeding. When he returned to tell his mother he wasn't feeling well, she said he "looked like a ghost," NBC New York reported.
After receiving the alert to seek medical care immediately, Monzidelis and his mother rushed to the hospital.
-----

FDA on the hunt for its own EHR system

By Rachel Z. Arndt  | May 3, 2018
The Food and Drug Administration is looking for a "large electronic medical record system" to conduct research about adverse drug reactions.
The FDA's Bioinformatics and Biostatistics Division will use the EHR to look into the "safety and surveillance of FDA regulated products," according to the request for quote the agency posted earlier this week. Specifically, researchers will analyze VA data to look for adverse side effects from medications. It will use the EHR to develop "novel data mining and data visualization" to apply to the data.
Right now, those data exist in different versions of VistA, the VA's home-grown EHR.
-----

Allscripts Acquires HealthGrid to Enhance Patient Engagement Tools


The EHR vendor will absorb HealthGrid's patient engagement tools such as the patient portal.
May 04, 2018 - EHR vendor Allscripts has acquired HealthGrid, a provider of enterprise patient engagement solutions that help connect patients with their providers.
The acquisition, which should be complete by the end of the second quarter of 2018, will allow Allscripts to absorb HealthGrid’s offerings into the Allscripts patient portal tool, FollowMyHealth. Currently, FollowMyHealth allows patients to utilize traditional patient portal functions including patient data access and secure messaging.
-----

Feds issue guidance on substance abuse confidentiality law

Published May 04 2018, 7:28am EDT
The Office of the National Coordinator for Health IT and the Substance Abuse and Mental Health Services Administration have issued guidance to help providers apply Title 42 of the Code of Federal Regulations Part 2 to healthcare settings, including the electronic exchange of health information.
42 CFR Part 2, which protects the confidentiality of substance use disorder patient records, was passed by Congress in 1975 because of concerns about the potentially negative consequences that could come from disclosing such information.
However, much has changed since the law governing the confidentiality of substance use disorder records went into effect, including the widespread adoption of electronic health records by providers. And, with the opioid epidemic continuing to take a toll on the lives of Americans, ONC and SAMHSA contend that it is critical for individuals with substance use disorders to get the safest and most effective treatment possible.
-----

HIT Think How computational modeling and simulation could benefit care delivery

Published May 04 2018, 5:54pm EDT
It currently takes more than $100 million and eight years to bring a new high-risk medical device to market. These numbers are growing every year, but what if those numbers could be cut in half? What if medical devices could be designed and safely tested in the virtual world before ever being used on a real person?
Researchers, pharmaceutical manufacturers, scientists, doctors and other industry leaders are turning to virtual worlds and computational modeling and simulation (CM&S) software to answer this exact question.
-----

Amazon, Apple only part of 'seismic change' coming to healthcare

More than 80 percent of the Fortune 50 already have a presence in the market, so here’s what hospital IT shops should be thinking about as they digest that reality.
May 01, 2018 04:10 PM
Health executives know about Amazon, Apple, Google, IBM and Microsoft making moves into the healthcare industry but there are far more Fortune 50 companies that already have a foot in the space. 
Translation: Healthcare is even more ripe for disruption than it presently appears. And that means it’s time to act fast or face irrelevancy. 
Here’s a look at what hospital IT shops should be doing now to prepare for the future. 
-----

Blockchain for healthcare – closer than we think?

Big opportunities, and challenges, ahead for the distributed ledger, from EHRs to supply chain and security.
May 03, 2018 09:30 AM
Blockchain holds big potential for overcoming issues of trust and ironing out technology wrinkles in the sharing of clinical and financial data in healthcare. While that is becoming increasingly widely discussed, it’s also true that the distributed digital ledger technology is still somewhat shrouded in mystery and has that futuristic feel about it. 
There’s little questioning the road ahead will be long but new evidence is emerging that perhaps practicable uses of blockchain are closer than many health IT and security professionals currently think. 

Blockchain: healthcare to benefit from financial services early work

New research from Deloitte and Chilmark offer a real-world look at what’s happening in blockchain today. 
-----

Machine Learning Can Quiet “Building Crescendo” of EHR Dissatisfaction

Allscripts CEO Paul Black sees a bright future for electronic health records as machine learning matures into a valuable tool to reduce EHR dissatisfaction.

May 02, 2018 - The notion that electronic health records are difficult to work with and cumbersome to use has become a worryingly common theme across the healthcare industry. 
Providers working in organizations of all sizes, settings, and specialties have experienced, or know someone who has experienced, some sort of issue, glitch or hiccup with their EHRs – and these problems can sometimes drastically impact patient care.
It’s easy to assume that frustration has always been and will always be the default emotion tied to EHR use.
-----

Ransomware targets healthcare industry the most: 4 things to know

Written by Julie Spitzer | May 02, 2018 
For the second consecutive year, healthcare was the sector hardest hit by cyberattacks, according to Cylance's 2017 Threat Report released May 1.
For its report, Cylance — a cybersecurity firm that uses artificial intelligence to protect against threats — reviewed attacks that affected its global customer base, which spans multiple industry sectors, in 2017.
Here are four report insights.
-----

More than 347k HITECH breaches since 2009 — What gives?

Written by Julie Spitzer | May 02, 2018 |
Since the Health Information Technology for Economic and Clinical Health Act was implemented in 2009, HHS' Office for Civil Rights has received a total of 247,090 breaches of patient data, according to Health Information Privacy/Security Alert.
Roughly 344,823 of those breaches affected fewer than 500 patients each, but 2,267 of them appeared on OCR's "Wall of Shame" — a publicly accessible data breach portal that displays HIPAA violations affecting more than 500 individuals.
-----

Poor data hygiene a leading cause of insider data breaches

Published May 03 2018, 7:28am EDT
Although insider threats have been a concern in cybersecurity for years, relatively little has been done to address the leading cause—poor data hygiene, says Larry Ponemon, chairman and founder of the Ponemon Institute.
Insider threats occur when employees intentionally or unintentionally misuse access to confidential information that compromises the safety of an organization’s information systems.
The total average cost among 3,269 insider threats over the past year was $8.76 million, according to a new report for which the Ponemon Institute interviewed 717 IT and IT security practitioners in 159 organizations in North America, Europe, the Middle East, Africa and Asia-Pacific. The firm completed the interviews in January.
-----

HIT Think How providers can implement the NIST cybersecurity framework

Published May 03 2018, 5:37pm EDT
The use of cybersecurity frameworks is becoming more prevalent because of pervasive threats and attacks across the healthcare industry. Large organizations are now especially motivated to adopt a framework and implement tighter, more consistent controls.
The NIST Cybersecurity Framework is designed to help organizations establish the minimum viable policies, procedures and practices to safeguard against theft of data or attacks on their systems. And, while organizations are not required to use the NIST Cybersecurity Framework, or report on the type of framework in place, they must at the very least comply with the HIPAA Security Rule, which has been crosswalked to the NIST Cybersecurity Framework.
Here are some fundamental questions and recommendations for instituting a cybersecurity framework based largely on the NIST model.
-----

Algorithm as accurate as radiologists in assessing breast density, cancer risk

Published May 03 2018, 7:34am EDT
Software that assesses breast density is just as accurate in predicting women’s risk of breast cancer as a typical evaluation of images conducted by radiologists, according to researchers at UC San Francisco and the Mayo Clinic.
In the largest study of its kind to date, researchers pitted automated breast density software from New Zealand’s Volpara Solutions against Breast Imaging Reporting and Data System (BI-RADS) density categories estimated by radiologists.
What they found was that automated and clinical BI-RADS evaluations “similarly predict interval and screen-detected cancer risk, suggesting that either measure may be used to inform women of their breast density.” The results of the study were published May 1 in the Annals of Internal Medicine.
-----

NIH to start national enrollment for PMI cohort on May 6

Published May 02 2018, 7:04am EDT
The National Institutes of Health will officially begin national enrollment on May 6 for the Precision Medicine Initiative’s All of Us research program, an effort to recruit a million or more participants to contribute their physical, genomic and electronic health record data.
On Sunday, NIH will hold community launch events in seven U.S. cities—including Birmingham, Chicago, Detroit, Kansas City, Nashville, New York and Pasco, Wash.—as well as an online event to start enrolling volunteers with the goal of creating one of the largest and most diverse biomedical datasets of its kind for medical research.
According to NIH, the EHR data leveraged by the All of Us program will “offer useful information related to medical histories, side effects and treatment effectiveness” to more precisely prevent and treat a variety of health conditions.
-----

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.
-----

3 ways to guard against distracted doctoring even as digital devices add to the problem

May 2, 2018 5:17pm
Everyone has heard about the problem of distracted driving and, even, districted walking. But what about distracted doctoring?
It's a problem that can endanger patients and increase medical liability, according to Shelley Rizzo, patient safety risk manager at physician-owned medical malpractice insurer The Doctors Company.
When a doctor takes attention away from a patient, it increases the potential for a serious patient safety event, Rizzo said in an interview with FierceHealthcare. 
-----

SamSam Ransomware Attacks Focus on Victims Who Will Pay Up

Cybercriminals carrying out SamSam ransomware attacks, which are targeting healthcare organizations this year, focus on victims that are most likely to pay to get their data back, according to an analysis by security firm Sophos.

May 01, 2018 - Cybercriminals carrying out SamSam ransomware attacks, which have been identified by HHS as posing a significant threat to healthcare organizations this year, focus on victims that are most likely to pay to get their data back, such as hospitals, according to an analysis by security firm Sophos.
The SamSam cybercriminals use two methods to get access to their target organization: they either exploit system vulnerabilities to gain access to the target’s network or they launch brute-force attacks against weak passwords of the remote desktop protocol (RDP) function.
Once cybercriminals have penetrated the target organization’s network, they look for more victims through network mapping and stealing credentials, according to Sophos. They then manually deploy the SamSam ransomware on selected systems using PSEXEC and batch script tools.
-----

Full ONC SAFER Guide Implementation Low, EHR Safety Can Improve

A study determined that new national policy initiatives could help stimulate ONC SAFER guide implementation and improve EHR safety and usability.

May 01, 2018 - Healthcare organizations looking to improve EHR safety and usability can look toward ONC SAFER Guides that were updated in 2017. However, a recent study found that adherence to recommended EHR safety practices is low, even with recommendations on how to improve EHR use being widely available.
Healthcare organizations are more likely to follow technical recommendations with EHRs than those that “require workflow and process enhancements related to clinical areas of concern or recommendations to use technology to reduce safety concerns,” according to Sittig, et al.
“Uptake of the remaining SAFER recommendations will likely increase as organizations become more confident in their abilities to develop new policies, procedures, clinical workflows, and configure and maintain their EHR implementations,” researchers continued. “Finally, full implementation of the SAFER recommendations will require organizational prioritization, resource allocation, policy changes, and vendor participation.”
-----

NIH’s All of Us Program Hits Milestone with National Enrollment to Launch May 6

May 1, 2018
by Heather Landi
The All of Us Research Program has enrolled 45,000 participants during the beta phase, with 27,000 individuals completing the entire enrollment protocol.
The National Institutes of Health’s “All of Us” Research Program, an unprecedented effort to advance precision medicine, has hit a significant milestone as the enrollment beta phase is ending and the program’s open national enrollment will launch May 6.
The All of Us Research Program, established by the White House in 2015, aims to advance precision medicine by studying the health data of 1 million diverse Americans over the next five years. The official launch date, which is this Sunday, will be marked by community events in seven cities across the country as well as an online event, according to NIH officials. Volunteers will join more than 25,000 participants already enrolled in All of Us as part of a year-long beta test to prepare for the program’s national launch. The overall aim is to enroll 1 million or more volunteers and oversample communities that have been underrepresented in research to make the program the largest, most diverse resource of its kind.
“The idea of bringing together 1 million people from all walks a life to partner in the research process might have seemed like a pipe dream 15 years ago, but today it’s a reality,” Francis Collins, NIH director, said, during a media briefing announcing the official national enrollment launch date. “It’s ambitious” Collins said, adding, “The ‘All of Us’ research program is among the most ambitious research efforts that our nation has ever undertaken.”
-----

Fitbit, Google to support wearables in care coordination

Published May 01 2018, 7:26am EDT
Fitbit, a major vendor of fitness software to help individuals track their activity and exercise levels, has teamed up with Google to accelerate innovation in the healthcare wearables market to better manage chronic care and improve collaboration among patients’ healthcare providers.
Company executives say they are exploring opportunities to develop digital consumer and enterprisewide healthcare solutions. However, beyond the initial announcement of the partnership, the companies are not providing any additional details.
The core idea is to give patients and providers a better view of a patient’s health, which can lead to a personalized care plan, according to the companies.
-----

Mayo Clinic CIO Christopher Ross on breaking the $1 billion EHR and IT modernization rollout barrier

Ross explains tactics for managing a project of this scope, as well as challenges, possible pitfalls, and why Mayo focused on user experience and optimization before the deployment not after -- which is all too common.
May 01, 2018 10:21 AM
Mayo Clinic is on the cusp of one of the biggest and most expensive EHR go-lives in history. 
When the health system replaces Cerner and GE software with Epic’s electronic health record on May 5, at its Rochester, Minnesota,  headquarters, the go-live will be the most critical piece of a massive technology project dating back to 2013. But it won’t the last: Launches in Arizona and Florida are scheduled for October 2018. 
Cost of the total project, which includes several pieces in addition to the EHR: $1.5 billion
-----

ONC ‘hard at work’ on standards for big-picture data about U.S. health care

Carten Cordell
It’s often said that data is the new oil of the age, and Donald Rucker wants the health care industry, with help from the federal government, to start taking better advantage of it.
The head of the Office of the National Coordinator for Health Information Technology (ONC) says his team is in the “early stages” of developing health care data standards for population-level data to help make it more shareable across electronic health records (EHR) systems.
“There is no broad-based computable standard to look at the care that American providers provide,” he said April 27 at the AcademyHealth Health Datapalooza. “Think about that for a second: There is no computable accountability of the care that we are providing. That’s a pretty stunning type of thing to say in 2018.”
-----

Top 12 Ways Artificial Intelligence Will Impact Healthcare

Artificial intelligence is poised to become a transformational force in healthcare. How will providers and patients benefit from the impact of AI-driven tools?

April 30, 2018 - The healthcare industry is ripe for some major changes.  From chronic diseases and cancer to radiology and risk assessment, there are nearly endless opportunities to leverage technology to deploy more precise, efficient, and impactful interventions at exactly the right moment in a patient’s care.
As payment structures evolve, patients demand more from their providers, and the volume of available data continues to increase at a staggering rate, artificial intelligence is poised to be the engine that drives improvements across the care continuum.
AI offers a number of advantages over traditional analytics and clinical decision-making techniques.  Learning algorithms can become more precise and accurate as they interact with training data, allowing humans to gain unprecedented insights into diagnostics, care processes, treatment variability, and patient outcomes.  
-----

VA Tool Improves Patient Access to Health Data, Medical Images

The tool will allow patient access to health data and medical images over the veteran patient portal.

April 30, 2018 - The VA has launched a new system for patient access to health data and medical images, thus allowing patients to stake a larger claim in their own healthcare.
The system, called the VA Medical Images and Reports, will be embedded in veteran patient portals using VA’s My HealtheVet. Patients may view, download, or share their radiology studies, X-rays, mammograms, MRIs, and CT scans. All of this data will also be stored in the patient’s EHR file.
The VA Medical Images and Reports comes as a part of VA’s efforts to improve patient engagement and veteran access to their own health data, as first espoused in VA’s Blue Button initiative, according to acting VA Secretary Robert Wilkie.
-----

Opioid epidemic: Why aren't prescription drug monitoring programs more effective?

Every state outside of Missouri already has a PDMP in place, but issues with data standardization and differences in regulations inhibit their potential.
April 30, 2018 03:59 PM
Long before the opioid epidemic was thought to be a public health emergency, prescription drug abuse and misuse were steadily increasing in the U.S. 
To combat this, states and hospitals have been building technological platforms to enable prescription drug monitoring programs that can the track habits of both prescribers and patients. But use of PDMPs varies by state, with some states mandating its use and others merely recommending that hospitals and medical groups opt-in. 
With the Trump administration saying it will crack down on opioid abuse, it begs the question: Could these data-heavy platforms make a dent in the crisis?
-----

FDA chief sees big things for AI in healthcare

Scott Gottlieb, MD, is bullish on the opportunities artificial intelligence could bring to EHRs, decision support and more.
April 30, 2018 08:51 AM
At AcademyHealth’s 2018 Health Datapalooza on Thursday, the U.S. Food and Drug Administration offered a vote of confidence for artificial intelligence in healthcare, promising more refined strategies for regulation, touting its tech incubator for AI innovation and announcing a new machine learning partnership with Harvard.
"We’re implementing a new approach to the review of artificial intelligence," said FDA Commissioner Scott Gottlieb, MD. As one example, he pointed to the agency's approval earlier this year of a new clinical decision support software that uses AI algorithms to help alert neurovascular specialists of brain deterioration faster than existing technologies.
"AI holds enormous promise for the future of medicine, and we’re actively developing a new regulatory framework to promote innovation in this space and support the use of AI-based technologies," said Gottlieb. "So, as we apply our Pre-Cert program – where we focus on a firm’s underlying quality – we’ll account for one of the greatest benefits of machine learning – that it can continue to learn and improve as it is used."
-----

ONC Working with Health IT Innovators to Improve Interoperability

ONC is encouraging health IT innovators to develop APIs that improve interoperability and health data access.

April 27, 2018 - ONC is currently working with health IT innovators to spur the development of application programming interfaces (APIS) that improve interoperability and patient health data access, according to a recent Health IT Buzz blog post by National Coordinator for Health Information Technology Don Rucker, MD.
“As part of ONC’s role in coordinating health information technology (health IT) nationally, we are working with innovators to develop modern APIs that support the use of mobile apps to help individuals manage their own health or the health and care of a loved one,” Rucker wrote.

“A robust health app ecosystem can lead to disease-specific apps and allow patients to share their health information with researchers working on clinical trials to test a drug or treatment’s efficacy, or monitoring outcomes like those in the National Institutes of Health’s All of Us Research Program,” he continued.
-----

HIT Think Eight steps for overcoming data risks posed by third parties

Published April 30 2018, 6:20pm EDT
Third-party risk management is becoming increasingly top-of-mind for organizations as they attempt to protect their privacy and confidential data and improve their security and risk exposure as part of the overall health of their organization.
High-profile breaches in the healthcare industry continue to bring to the forefront the risks third parties can introduce to an organization. As the cloud has increasingly become mainstream, an entirely new set of external risks has been introduced to our environment.
Most organizations today rely on several—if not dozens—of external/SaaS applications to run their business, not to mention cloud-based infrastructure and platform offerings. Data ranging from employee vacation time to business documentation to confidential customer information now resides in the cloud, creating a new frontier of risk with which organizations must now contend.
-----

Family physicians considering staging new protests over problems with e-health system

  • 2018-04-29
  • LETA/TBT Staff
RIGA - Family physicians are running out of patience over the continuing glitches in the e-health system, and some of them have been urging the Latvian Family Physicians' Association to organize a protest, the association's president Sarmite Veide told LETA.
She added that staging a protest could be considered during the Family Physicians Association's general meeting on June 8.
Family physicians have been using the e-health system to issue electronic sickness leaves and prescriptions since the beginning of the year. Although four months have passed since using the system became mandatory, various glitches in the system have not been fixed yet, and the system continues to be very slow, stressed Veide.
-----
Enjoy!
David.

The ADHA Board Has Now Officially Moved Into Its Sixth Month Of Radio Silence!

The arrogance is just breathtaking! That they treat their major stakeholder (the public) like this shows how worried we should all be about their opt-out and secondary use plans.

They are managing to well and truly confirm the result of this week's poll!

Pretty pathetic!

David.

Friday, May 11, 2018

The Luddites At The Pharmacy Guild Are Really Obstructionist Pains In The Bum!

This popped up a few days ago:

Dimec allows patients to choose pick-up point for prescriptions

A pharmacy app has announced it is the first service in the UK to allow patients to choose any high street pharmacy to collect their prescription.
Hanna Crouch – 3 May 2018
Dimec works by linking a patient’s phone directly to their NHS GP and pharmacy and then letting them pick where to collect medicines from at the touch of a button.
Prior to this, patients were required to contact their GP or Pharmacist to request to alter their pharmacy.
The update to the app means patients can now view and select high street pharmacies based on their current location their home address or scroll around the integrated map.
Chief technical officer and co-founder, Andrew Bailey, said: “We’ve been working exceptionally hard with our team, NHS Digital and GP system suppliers to get this new feature live.
More here:
So in the UK – and in the US of course – you can direct where your pre-prepared meds will be waiting.
In Australia you can’t because the Pharmacy Guild wants us to have to select our pharmacy go in with our script and wait while they do the work – worried that if we could say where we want to pills to be waiting the nasty doctors might favour one pharmacy over another.
So nation-wide we have a zillion hours of waiting by the public to sooth Pharmacy Guild paranoia.
And to further reveal the professionalism of pharmacies we have this:

Pharmacies avoid homeopathy ban as government parks recommendations

By Kate Aubusson
3 May 2018 — 6:50pm
Homeopathic products will continue to be sold in Australian pharmacies, despite a long-awaited review warning the government the practice could compromise the health of consumers.
The federal government has accepted just three of the 45 recommendations made by the review of Pharmacy Remuneration and Regulation delivered to Health Minister Greg Hunt in September.
Releasing the final report and its response on Thursday, the government outright rejected three recommendations and merely “noted” more than 30, including restrictions on the sale of complementary medicines and reforms to pharmacy location rules.
A national real-time electronic drug monitoring system was one of three recommendations accepted. Another five recommendations were accepted “in principle”.
Chair of the review, Monash University economics Professor Stephen King, said he was pleased the government had accepted the e-records recommendation, saying it would bring Australian pharmacy into the 21st century.
But he was disappointed it had rejected or "not taken more action" on the bulk of the recommendations aimed at protecting consumers and ensuring fairer access to vital medicines.
The government did not accept a recommendation to ban the sale of homeopathic products, despite the review panel warning consumers could forego evidence-based medicines in favour of the products, “which may further compromise their health”.
The review also recommended complementary medicines be sold in a separate area from other medicines where pharmacists can provide information to consumers about the extent, and limitations, of the evidence of their efficacy.
Among the bulk of recommendations not accepted and merely “noted” were reforms to pharmacy location rules aimed at preventing local monopolies that stifle competition and hike up prescription prices.
It also noted a recommendation that would have banned pharmacies from raising or lowering the price of PBS medicines beyond the co-payment set by the government.
“Currently consumers are engaged in prescription lottery,” Professor King said.
“Depending on where you live and how many pharmacies there are, you will pay very different prices for the same medicines … we didn’t think this was fair.”
More here showing how patient convenience comes a long second for the Guild lobbyists! 
https://www.smh.com.au/national/pharmacies-avoid-homeopathy-ban-as-government-parks-recommendations-20180503-p4zd94.html
The response to the report has the Guild’s fingerprints all over it and while they behave like this they are just overqualified shopkeepers I reckon.
David.