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 28, 2018

Weekly Australian Health IT Links – 28th 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

Well this week was all about the reaction to Tim Kelsey’s evangelical speech at the National Press Club on Wednesday. The Press Club gave him a good hearing but seemed a little sceptical if I read the mood of the reporters correctly. There are links to text and video on the blog if you want to watch / read again.
Also lots of activity on the GDPR which came into effect on May 25, 2018.
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Digital Heath Agency: ‘No conspiracy’ to keep My Health Record opt-out quiet

‘There is no Big Brother’ says CEO Tim Kelsey
George Nott (Computerworld) 24 May, 2018 16:41
The CEO of the Australian Digital Health Agency (ADHA) – the body responsible for implementing and operating the My Health Record – has rejected claims Australian’s right to opt-out of the electronic health record system is not being sufficiently communicated.
Australians will have three months from mid-July to opt out of having a My Health Record automatically created for them. After the opt-out deadline has passed the record cannot be deleted, only made “unavailable” to health providers and individuals, the Department of Health revealed last year.
Speaking at the National Press Club in Canberra today, ADHA chief Tim Kelsey highlighted the clinical benefits of the majority of Australians having electronic health records, and countered claims that the agency was keeping the opt-out right quiet to achieve it.
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Australian Digital Health Agency CEO Tim Kelsey grilled on My Health Record system at National Press Club

Sue Dunlevy, News Corp Australia Network
THERE is no conspiracy to keep Australians in the dark about the new online health record to be given to every Australian at the end of this year, the head of the agency rolling it out says.
Tim Kelsey has confirmed there will be no national radio, television or newspaper advertising campaign informing Australians the record will be created for them at the end of this year unless they opt out.
Households will not even get a letter explaining the new record, the head of the government’s Australian Digital Health Agency says.
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Stay in the network

Pharmacists told to get ready for Australia’s revolutionary new opt-out e-health record network

Pharmacists will need support and education to ensure their patients achieve the optimum benefit from Australia’s soon-to-be implemented opt-out My Health Record system.   
Australian Digital Health Agency CEO Tim Kelsey delivered his Your Health in Your Hands – the Digital Evolution of Health and Care in Australia speech at the National Press Club yesterday and outlined the collaboration needed between governments, consumers and clinicians to make data and technology work better for modern health.
In particular he discussed the importance of the pending shift to an opt-out e-health record and the role of each sector in making this work best to improve health care and decision making. 
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DENHAM SADLER
May 23, 2018

My Health Record an 'abuse of trust'

E-Health
Digital rights advocates are calling on Australians to opt-out of the My Health Record service after labelling the government’s approach to the digital service an “abuse of trust”.
My Health Record is an electronic health record that has been in the works for more than five years. It is currently available as an opt-in service requiring informed consent, with the government claiming that more than five million Australians now having a record.
The government recently announced that it would instead move to an opt-out model due to a low uptake of the service, with Australians given a three-month period to actively remove consent before being given an online record by default.
The three-month opt-out period will begin from 16 July.
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Health report confirms: consumers want control of their own health data

23 May, 2018
Australians want ownership and control of their own health data and want to be asked for consent when their data is used by either government, private companies or researchers.
This stand-out finding was revealed today in the Engaging Consumers in their Health Data Journey Report jointly published by Consumers Health Forum and NPS MedicineWise.
The comprehensive report was generated through qualitative interviews, literature reviews, a round table discussion with key stakeholders and consumer representatives, and a nationally representative survey of 1,013 Australians.
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Privacy concerns over My Health Record system

20 May, 2018 / 04:13
Rev. Bill spoke to Bernard Robertson-Dunn, chair of the Health Committee for The Australian Privacy Foundation, about the My Health Record opt-out function and privacy concerns as healthcare industries sign up to connect with My Health Record.
Download this podcast here
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LETTERS: Keep your health record online for emergencies

25 May 2018, 3:30 a.m.
A PERSON’S life can be saved in an emergency with an online health record.
I urge all country people to ensure they have a My Health Record – an online summary of all their health information.
Country people are more likely to be brought into an emergency department from a heart attack, car accident or diabetic coma. 
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Media release - Nation empowered through improved digital health services

24 May 2018
Digital information is the bedrock of high quality healthcare. Harnessing the power of the modern information revolution is one of the first priorities for governments to improve the safety and efficiency of healthcare through better use of data and technology.
Australian Digital Health Agency CEO Tim Kelsey delivered his Your Health in Your Hands – the Digital Evolution of Health and Care in Australia speech at the National Press Club today and outlined the collaboration needed between governments, consumers, clinicians, and entrepreneurs to make data and technology work better for modern health.
“Australia has one of the best systems in the world – by any measure. We are at the forefront of medical research, we have world-class facilities, and the people that provide care are among the most highly skilled and committed professionals anywhere.
Note – This links to speech transcript and to a list of myHR Supporters so everyone can be assured the myHR is a fabulous idea.
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IT glitch hits Queensland Health, taking down clinical systems

Lynne Minion | 22 May 2018
Queensland Health moved quickly to fix an IT meltdown last week that brought down clinical systems statewide.
Access to patient records, as well as admissions, transfer and medication systems were disrupted by the glitch that hit at about 10am on Thursday.
Department staff worked with the state government's primary ICT services provider CITEC to solve the problems with the online-based systems, and contingency arrangements were activated to minimise any impact on services.
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Should you trust what e-records tell you?

22 May 2018

TECH TALK

GPs are repeatedly told that electronic medical records will fix the problems of faulty memories, illegible hospital handover notes and patients who aren’t faithful to one GP (but don’t tell you). But do you trust what your computer says?
Researchers from Perth read the electronic patient records of almost 1000 patients and then checked with the real-life patient if they were accurate.
The results focused on whether patients had received their flu vaccination or not. These searches found that, in 84% of cases, the electronic records and the patients’ memories were the same. However, in 16% of cases, the computer said no but the patient said yes — or the other way around.
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Queensland needs real-time prescription monitoring 'urgently', coroner says, amid opioid deaths

21 May, 2018
A prescription monitoring system to prevent "doctor shopping" in Queensland is needed urgently within the next two years, rather than the state waiting for a national scheme to come online, an inquest into four opioid deaths has found.
Coroner James McDougall examined the deaths of William House, Jodie Anne Smith, Vanessa Joan White and Daniel Keith Milne between 2012 and 2014.
Medical bodies including the Australian Medical Association and the Pharmacy Guild have repeatedly called for a real-time monitoring system to be introduced in Queensland to prevent addicts from visiting different doctors to collect multiple opioid prescriptions.
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‘Urgency’ to implement real-time script monitoring: coroner

An inquest into four deaths related to opioid prescribing and doctor shopping has highlighted the urgent need for real-time monitoring

A joint inquest into four recent deaths was recently held in the Coroners Court of Queensland with the aim to consider the issues associated with misuse of opioid prescription medication in Queensland and, more broadly, Australia.
Coroner James McDougall explored the circumstances surrounding the deaths of William House, 30 years old at the time of his death; Jodie Anne Smith, 41 years old at the time of her death; Vanessa Joan White, 38 years old at the time of her death; and Daniel Keith Milne, 40 years old at the time of his death.
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Australia’s My Health Record to include diagnostic imaging reports and assist in better palliative care

Teresa Umali
21 May 2018
Australians will receive improved diagnostic imaging reports after Perth Radiological Clinic (PRC), NSW Health and Mater Group announce connections to My Health Record. At the same time, the My Health Record system also caters to the complex needs of palliative care patients.
Having a My Health record is important because it provides an online summary of a person’s key health information, which is controlled by the individual, allowing access to health care providers involved in a person’s care in order to deliver better health outcomes for patients.
An announcement by the Australian Digital Health Agency discussed how Australians will receive improved diagnostic imaging reports after Perth Radiological Clinic (PRC), NSW Health and Mater Group announce connections to My Health Record. An enhanced access to diagnostic imaging reports will be granted to Australians living in Western Australia, New South Wales and Queensland after the Perth Radiological Clinic (PRC), NSW Health, and the Mater Group, respectively, have all announced connections to My Health Record.
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It’s time to put consumers in the driver’s seat in Big Data economy

By Lauren Solomon • 21/05/2018
If the public doesn’t feel it can say no, all the privacy policies and terms and conditions can’t solve society’s data governance woes.
The Australian government has allocated $44.6 million over four years in this year’s budget to establish the new Consumer Data Right (CDR). This investment is slated to support the ACCC, OAIC and CSIRO to establish appropriate rules and standards and to ensure the impacts of the CDR are consistent with the Privacy Act.
This is a welcome step, because our latest research uncovers the yawning gap between public expectation and current practices when it comes to data collection, sharing and use.
In a survey of 1004 Australians conducted for the Consumer Policy Research Centre by Roy Morgan Research from March to April this year, 94% of those surveyed did not read the privacy policies or terms and conditions for all the products they signed up to in the past 12 months.
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  • May 20 2018 at 8:38 PM

Government orders report into AI dangers

The government will spend almost half a million dollars researching the risks of artificial intelligence and the internet of things.
Two reports will be produced by the Australian Council of Learned Academies (ACOLA) to look at how Australia can maximise the benefits of the new technologies, but avoid negative impact on the economy and individuals.
General Manger of ACOLA, Dr Angus Henderson, said a lot of countries had been quicker off the mark with artificial intelligence, including near neighbours such as Singapore. He said Australia had plenty of AI and Internet of Things capability in the shape of companies such as Siemens, GE and CISCO which had big operations in the here.
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Australian ​Department of Health using blockchain for medical research records

Australian secure cloud provider Vault Systems and blockchain startup Agile Digital have combined forces to provide the department with an immutable record for tracking health data research.
By Asha McLean | May 20, 2018 -- 22:00 GMT (08:00 AEST) | Topic: Innovation
The Australian Department of Health is working on a proof of concept that uses blockchain to record who is accessing its medical data.
Teaming up with secure cloud provider Vault Systems to host the data, and local startup Agile Digital for its distributed ledger technology, the department is exploring blockchain as means to prove who is accessing medical data, why they're accessing it, and to securely record research queries.
Speaking with ZDNet about the project, Agile Digital executive director David Elliot said the department was seeking a platform that supports research on health data, while maintaining privacy on citizen data.
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4 ways scammers target GPs — and how to protect yourself

24 May 2018

SPECIAL FEATURE

Some criminals see doctors as rich pickings
Like other small businesses, general practices are vulnerable to being cheated because they don’t always have the resources or systems to detect security breaches. There’s also a perception that GPs can afford to pay up and that makes them attractive targets.
Here’s a look at the four scams directed at general practices and some tips to prevent them: 

1: Cybercrime 

Dr Nathan Pinskier, the chair of the RACGP Expert Committee on eHealth & Practice Systems, says while there aren’t any meaningful statistics, there’s anecdotal evidence that general practices are being targeted more frequently by cyberattacks. The
major threats include: 
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Is health care ready for virtual medicine?

Authored by Hugo Wilcken
IN AUSTRALIA, where communication between doctors is still regularly done by post and fax, medicine using virtual reality (VR) technology may seem a bit like science fiction. But according to a Perspective published in the MJA, “virtual medicine” could transform the way we treat patients in the future.
In his article, Dr Brennan Spiegel, director of health research at Cedars-Sinai Medical Center in Los Angeles, California, says that research into the health benefits of VR – where users wear goggles with interior screens that immerse them in a lifelike, three-dimensional world – has been ongoing for years, but that implementation has been stymied by the high cost of the technology. However, recent advances have driven down those costs dramatically, making it feasible for virtual medicine to enter into the medical mainstream.
Dr Spiegel focuses on three areas where virtual medicine has the most potential. The first is distraction therapy for pain. For example, VR has been found to be effective in lessening pain during bandage changes for severe burns, as well as during routine procedures such as intravenous line placements or dental procedures. Although it’s not fully understood how VR reduces pain, simple distraction is likely to be key.
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Family Planning’s epic security fail

  • Michael Connory
  • The Australian
  • 9:23AM May 21, 2018
It seems ANZAC Day 2018 will be remembered by 8000 New South Wales women as more than just Australia’s National Day of mourning to honour the sacrifice of the fallen in conflicts of theatre Australia has been engaged in.
For them, April 25, will have an equally different side to it. It will be remembered as the day, Family Planning NSW, failed to protect their privacy and health details.
ANZAC Day shouldn’t be thought of as a day when hackers were able to crack through Family Planning NSW’s security, it has greater prominence of elevation in our minds, but for 8000 women, it will have a different meaning now.
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Grieving mum calls for hospital records overhaul after teen daughter's suicide

25 May, 2018
"Rani was a really beautiful soul who unfortunately just got caught up in some really bad situations."
Those are the words of grieving mum Kerrie Stanley, and already you know how this story ends.
It's a painful one. And familiar.
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eHealth program targets young people’s ‘big six’ behaviours to reduce chronic disease risk

Friday, 25 May 2018
University of Newcastle researchers have collaborated on a world-first eHealth initiative aiming to target young people’s ‘big six’ behaviours to help reduce their chronic disease risk.
Associate Professor Frances Kay-Lambkin and Professor David Lubans are part of the online Health4Life Initiative, launched today at UNSW Sydney.
Led by UNSW’s Professor Maree Teesson AC, the project aims to help to help thousands of young Australian high school children reduce their chance of developing chronic diseases, including heart disease and mental health disorders, by preventing and modifying lifestyle risk behaviours that commonly emerge in adolescence.
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My Health Record Data for ´Research and Public Health Purposes´

PulseLine is pleased to report last week the Federal government announced that Australians who don’t want a personal electronic health record will have three months from July 16 to October 15 to opt-out of the national scheme. Under the framework, medical information would be made available to third parties for public health and research purposes from 2020 unless individuals opted out.
The Medical Technology Association of Australia (MTAA) welcomes the release of the framework to guide the secondary use of My Health Record system data. The guiding principles within the framework align with MTAA´s position to allow third parties access the data for public health and research purposes.
To inform on how data on the My Health Record system can be used for research and public health purposes while preserving privacy and security of data in the system, the Australian government developed the framework in consultation with key stakeholders.
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Govt's high-risk IT project watchlist falls to 14

By Justin Hendry on May 23, 2018 9:30AM

DTA drops four, adds two.

The number of federal government IT projects considered high-risk by the Digital Transformation Agency has fallen to 14 after four projects were downgraded and one was cancelled.
The DTA has been keeping tabs on high-risk projects since it was tasked with identifying all government IT projects valued at more than $10 million in early 2017.
It looked to categorise projects as part of its digital investment review by confidence of delivery, with the most high-risk ones assigned an ‘engage’ classification.
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GDPR: data protection in an uncertain and insecure cyber world, says top lawyer

The biggest change in laws governing data protection is due to take effect in the European Union on 25 May and a seasoned practitioner of the law in the UK says the most important part of the General Data Protection Regulation is the overall protection of data in what is an "uncertain and insecure cyber world".
Rashda Rana, a state counsel in the UK, told iTWire in a detailed interview that management consulting firm Oliver Wyman had estimated that the EU would reap about US$6 billion in fines from organisations that were not in compliance during the first year of the GDPR. This, despite all parties having had two years to fall in line with the regulation.
A high-profile lawyer in the UK, Rana has also had extensive experience in international commercial litigation and arbitration as counsel and arbitrator in other jurisdictions including Australia, New York, Paris, Milan, Brazil, Hong Kong, Singapore, Malaysia and China.
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Data sharing can cost you a pretty penny

  • Tim Ebbeck
  • The Australian
  • 12:00AM May 22, 2018
At the end of 2017, Australia’s Actuaries Institute surveyed the chief risk officers of APRA-regulated institutions.
Among other things, the risk officers were asked to name the top three risks facing their businesses in the coming year. The results were hardly surprising given the current environment. In first place was regulatory and legislative change, followed by increased competition and therefore lower profits, and in third, cyber risks.
To be clear, I don’t think any business should see these as separate risks given the growing pressure on the heads of risk to safeguard their data. The European Union’s General Data Protection Regulation standards take effect on Friday, May 25, and any Australian firm that sells products and services in the EU, or monitors the behaviour of individuals there, will have to fall in line with these stricter privacy laws.
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Some firms apprehensive, others see opportunity as GDPR date approaches

With just a few days to go before the European Union's General Data Protection Regulation comes into effect, companies are scrambling to be compliant.
A great many organisations are unlikely to meet the deadline, with an estimate made by management consulting firm Oliver Wyman had estimated that the EU would reap about US$6 billion in fines from organisations that were not in compliance during the first year.
Below are some comments from companies as they try to get ready for what is the biggest change in laws governing personal data anywhere in the world.
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Microsoft to extend GDPR rights to users worldwide

Microsoft will extend the same rights that are at the heart of the European Union's General Data Protection Regulation to all its users worldwide, the company has announced.
A blog post by corporate vice-president and deputy general counsel, Julie Brill, also praised the "strong leadership by the European Union on these important issues".
Outlining Microsoft's support for the GDPR since it was first proposed in 2012, Brill said: "That’s why today we are announcing that we will extend the rights that are at the heart of GDPR to all of our consumer customers worldwide.
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Why you should read all those GDPR privacy policy updates

By Brian X Chen
24 May 2018 — 9:01am
You have probably noticed a flood of emails and alerts from companies in the past few weeks informing you about changes to their privacy policies.
Don't ignore them.
Yes, there is a lot of legalese to wade through. But resist the temptation to immediately delete those emails or close the alerts right away. They may contain important information about managing your digital privacy at a time when it's become clear that our online data is far from safe.
From emails to pop-ups, companies are coming up with various ways to get your 'consent' and comply with the new laws.
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Attention Aussie businesses: you’re not immune to GDPR

  • Scott Leader
  • The Australian
  • 10:07AM May 24, 2018
On a global stage, instances of data misuse and breaches are becoming all too familiar to businesses, and you needn’t look far to find examples.
Security breaches send a sobering message to any business or individual with data online; you are not immune. While digital platforms such as Facebook are moving swiftly to respond by educating their customers on revised data collection and privacy policies — and many other businesses are following suit — it’s surprising to learn how complacent the majority of individuals and businesses remain when it comes to data security.
In Australia, we’ve recently seen the Data Breach Notification Laws come into effect, with many organisations left underprepared and unaware of both their obligations to comply and the consequences for failing to do so. Sixty data breaches were reported in the first six weeks of the law coming into effect, with a majority of these breaches due to human error. As we continue to conduct business in a globalised world, we are likely to see many more policies and regulations come into force to keep us protected and these policies will increasingly cross borders.
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Optus fined $1.5m for forcing HFC customers onto NBN

By Ry Crozier on May 23, 2018 8:37AM

Chasing migration payment 'bounty'.

Optus has been fined $1.5 million by the federal court for trying to force customers off its HFC network and onto the NBN in a bid to fast-track migration payments from NBN Co.
The penalty amounts to around double what Optus is said to have made from the initiative, which was found to have misled customers over their rights.
The Australian Competition and Consumer Commission (ACCC) said Optus told around 14,000 of its HFC customers that their services would be disconnected - “in as little as 30 days in some cases” if they did not move to the NBN.
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Optus fined $1.5 million for misleading customers over NBN transition

Optus has been fined $1.5 million in the Federal Court for misleading customers by telling them their services would be disconnected if they did not move from its HFC network to the National Broadband Network (NBN).
Optus told 14,000 of its customers, during the period from October 2015 to March 2017, that their internet services would be disconnected - in as little as 30 days in some cases - unless they transitioned to an NBN plan.

Optus took the action despite the fact that under the terms of its contract it could not force disconnection within the timeframe it claimed.
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NBN Co ditches 100/40Mbps wireless plans

National Broadband Network provider NBN Co has killed off plans to offer a 100/40Mbps fixed-wireless service, with NBN Co chief Bill Morrow confirming the decision in a Senate Estimates committee hearing.
There are widespread media reports this morning, including  by the ABC, that Morrow told the committee  yesterday “we killed it”, basing the decision on economic grounds.
According to the ABC report Morrow said consistently achieving 100mbps would cost "billions and billions of dollars" — a taxpayer spend he described as "outrageous".
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Enjoy!
David.

Sunday, May 27, 2018

Is Tim Kelsey Telling An Untruth Here Or Am I Missing Something?

At the National Press Club last week Mr. Kelsey said the following in his prepared speech:
----- Begin Extract.
Tim Kelsey:                         My Health Record has a range of protocols which mean that all instances of access by a clinician are attributable directly to that person and recorded in real time. Unauthorised access is subject to a custodial prison sentence of up to two years. Trust is the essence of medicine. Digital services can support confidentiality and not undermine it. My Health Record operates to the highest cyber security standards in Australia, and is independently audited on that basis by a number of organisations, including the Australian Signals Directorate. The agency has set up a national cyber security centre to ensure constant multi-layered surveillance of My Health Record. Since the system was launched in 2012, there has been no breach. But, real time vigilance, of course, remains our highest priority. People are quite rightly concerned about the security of their privacy information, and that's why they have a right to make a choice. That's why the Australian government was absolutely right to introduce opt-out into this measure.
----- End Extract.
Here we have the Office of The Australian Information Commissioner (OAIC) Report for 2016-17.

Annual report of the Australian Information Commissioner’s activities in relation to digital health 2016–17

Part 1: Executive summary

From 1 July 2016, national digital health governance arrangements and My Health Record system operations transitioned from the Department of Health and the National E-Health Transition Authority to a new body, the Australian Digital Health Agency (the Agency).
This annual report sets out the Australian Information Commissioner’s digital health compliance and enforcement activity during 2016–17, in accordance with s 106 of the My Health Records Act 2012 (My Health Records Act) and s 30 of the Healthcare Identifiers Act 2010 (Cth) (HI Act), as outlined in the 2016–17 memorandum of understanding (MOU) between the Office of the Australian Information Commissioner (OAIC) and the Agency.
The report also provides information about the OAIC’s other digital health activities, including its assessment program, development of guidance material, provision of advice, and liaison with key stakeholders.
More information about the MOU is provided below in section 2 of this report. The MOU can also be accessed on the OAIC’s website www.oaic.gov.au.
This was the fifth year of operation of the My Health Record system and the seventh year of the Healthcare Identifiers (HI) Service, a critical enabler for the My Health Record system and digital health generally.
The management of personal information is at the core of both the My Health Record system and the HI Service (collectively referred to as ‘digital health’ in this report). In recognition of the special sensitivity of health information, the My Health Records Act and the HI Act contain provisions that protect and restrict the collection, use and disclosure of personal information. The Australian Information Commissioner oversees compliance with those provisions and is the independent regulator of the privacy aspects of the My Health Record system and the HI Service.
The My Health Record system commenced in 2012 as an opt-in system where an individual needed to register in order to get their My Health Record. In March 2016, the Australian Government commenced a trial of opt-out system participation in Far North Queensland and in the Nepean Blue Mountains region of New South Wales. A My Health Record was created for each individual living in those areas, unless the individual chose to opt-out of participating in the trial.
Changes to the My Health Records Act introduced by the Health Legislation Amendment (eHealth) Act 2015 enabled the trial to be undertaken. That amendment Act also introduced a number of other changes across digital health legislation and the Privacy Act 1988 (Privacy Act), including streamlining the personal information handling authorisations, and introducing additional civil and criminal penalties for privacy breaches. An independent evaluation of the trials commissioned by the Department of Health was conducted to look at the outcomes from these trials.
In the May 2017 Budget, the Australian Government announced the creation of a My Health Record for every Australian to begin nationally from mid–2018.
In 2016–17, the OAIC received 35 mandatory data breach notifications. These notifications recorded 140 separate breaches affecting a total of 152 healthcare recipients, 144 of whom had a My Health Record at the time of the breaches. Five of these notifications remain open at the end of the reporting period. The OAIC received two complaints regarding the My Health Record system and no complaints relating to the HI Service. In addition to handling data breach notifications, the OAIC carried out a full program of digital health-related work, including:
  • commencement of one privacy assessment and completion of two assessments from the previous year
  • liaising with the Agency and the Department of Health on the decision for national expansion of My Health Record in 2018
  • making submissions to various stakeholders on matters directly related to or associated with the My Health Record system. This included a submission to the Agency on the development of the National Digital Health Strategy
  • providing advice to stakeholders, including the Agency, on privacy related matters relevant to the My Health Record system
  • developing, revising and updating guidance materials for a range of audiences, including the development of My Health Record related multimedia resources for healthcare providers
  • participation in the Privacy and Security Advisory Committee, one of the advisory committees established by the Agency to support the Agency’s Board
  • monitoring developments in digital health, the My Health Record system and the HI Service.
----- End Extract.
Here is the link:
I am unable to reconcile the two bolded sentences and would be interested to know how they can be reconciled (channeling Rowena Orr QC of the Royal Commission). When is a breach not a breach etc?
Interestingly there were similar findings the previous year:
“In 2015–16, the OAIC received 16 mandatory data breach notifications. These notifications recorded 94 separate breaches affecting a total of 103 healthcare recipients, 98 of whom had a My Health Record at the time of the breaches.”
Here is the link:
I look forward to views on this repeated claim (of a breach free system)  which must make us wonder what else we are told we can take as the full and precise truth?
David.

AusHealthIT Poll Number 424 – Results – 27th May, 2018.

Here are the results of the poll.

Is The ADHA Doing Enough (Media, Mail-outs etc.) To Alert The General Public Of The Opt-Out Period For The myHR And Its Implications?

Yes 16% (32)

No 71% (144)

I Have No Idea 13% (28)

Total votes: 204

A considerable vote of no confidence I would suggest on a very large number of votes. It seems there is little confidence the ADHA is doing enough.

Any insights welcome as a comment, as usual.

A really, really great turnout of votes!

It must have been a really hard question as just 28/204 readers were not sure what the appropriate answer was.

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

David.

Saturday, May 26, 2018

Weekly Overseas Health IT Links – 26th 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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EHR market revenues approach $30B in 2017, Kalorama reports

Published May 18 2018, 6:02pm EDT
The electronic health records market reached $29.7 billion in annual revenue 2017 and will rise to $39.7 billion by 2022, according to a new annual report from Kalorama Information, a research firm.
The EHR market includes computerized physician order entry systems and services such as installation, training, servicing and consulting. Picture archiving and communication systems and hardware are not included in Kalorama’s market projections.
“We believe adoption and upgrading activities will still be stimulating growth in 2017-2022,” says Mary Ann Crandall, author of the report.
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Critical-Care Group Updates TeleICU Standards

Jennifer Thew, RN, May 18, 2018

The American Association of Critical-Care Nurses' consensus statement reflects current evidence and best practices in TeleICU nursing.

Telehealth is a growing segment in the healthcare industry, thus providing nurses with new settings and opportunities in which to practice. The American Association of Critical-Care Nurses recognized the need for guidance in this area and issued the first authoritative document to define practice guidelines specifically for the emerging telenursing practice in critical care in 2013
Telehealth continues to evolve and so must nursing practice standards.
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Sutter Health back online after 24 hours of systemwide EHR outage

The activation of a fire suppression system of one of the health system’s data centers on Monday shut down its Epic EHR and other information systems.
May 16, 2018 01:21 PM
Sutter Health faced more than a day of downtime of its Epic EHR and an outage of internal communications this week after the activation of a fire suppression system in one of its data centers, officials said.
All systems currently are back online.
The outage began late Monday night and impacted all 24 hospitals in the California-based health system, according to an internal memo obtained by the Press Democrat. The outage affected certain information systems, the service desk and some of its phone systems.
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Johns Hopkins unveils new computational method for precision oncology

Hospitals could use the math-based technique to make it easier to tailor treatments for patients.
May 17, 2018 10:06 AM
One of the ongoing dilemmas faced by provider organizations with precision medicine is that for all the advances made in genomic research, sometimes it can still be hard to translate into routine clinical practice: Physicians don't always know how best to turn genetic-based data into appropriate treatments.
A key challenge for clinicians is that each primary form of cancer, such as breast or prostate, may have multiple subtypes, each of which responds differently to a given treatment.
Healthcare IT News is reporting this week from the HIMSS Precision Medicine Summit in Washington, D.C. Also this week, researchers at nearby Johns Hopkins announced what they say is a new computational strategy that can help translate complex precision medicine data into a more simplified format that keeps the focus on patient-to-patient variation in the molecular signatures of cancer cells.
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CMS Accepting New Promoting Interoperability Measure Proposals

CMS will accept proposals from stakeholders for new Promoting Interoperability measures until June 29.

May 16, 2018 - CMS recently announced it is accepting proposals for new measures stakeholders would like to see included in the Medicare Promoting Interoperability (PI) program.
The federal agency will accept proposals until June 29.
CMS is encouraging stakeholders to submit measure proposals as part of its annual call for measures for eligible hospitals and critical access hospitals (CAHs) participating in the newly-minted PI program — formerly known as meaningful use. Submitted measures will be considered for inclusion in 2019 rulemaking.
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VA finally pulls trigger and awards Cerner $10B EHR contract

Published May 17 2018, 6:24pm EDT
After nearly a year of negotiations with Cerner, the Department of Veterans Affairs on Thursday finally awarded the vendor a $10 billion electronic health record modernization contract to replace the VA’s decades-old legacy EHR system.
“I am pleased to announce we have signed a contract with Cerner today that will modernize the VA’s healthcare IT system and help provide seamless care to veterans as they transition from military service to veteran status, and when they choose to use community care,” said Robert Wilkie, the VA acting secretary. “This is one of the largest IT contracts in the federal government, with a ceiling of $10 billion over 10 years. And with a contract of that size, you can understand why former Secretary Shulkin and I took some extra time to do our due diligence and make sure the contract does what the President wanted.”
In June 2017, then-VA Secretary David Shulkin announced his decision to award a sole-source contract to Cerner in order to replace the legacy Veterans Health Information Systems and Technology Architecture with a single common EHR system with the Department of Defense based on Cerner’s Millennium platform. However, President Trump’s recent firing of Shulkin and the resignation of the VA’s acting chief information officer Scott Blackburn cast doubt on the agency’s EHR efforts.
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Why EHR data interoperability is such a mess in 3 charts

Hospitals have a complex web of electronic health record vendors but once data sharing broadens it will open the door to innovation.
May 16, 2018 10:07 AM
The thorny matter of interoperability in healthcare, as it is or has historically been in other industries, is almost all-consuming among technology vendors and their clients. 
Indeed, a big part of the problem is exactly how many EHR companies are out there and, more specifically, the average number of platforms hospitals are running today.
It’s 16. That’s right: 16 distinct electronic health records platforms, according to statistics HIMSS Analytics pulled from its Logic database looking at 571,045 providers affiliated with 4,023 hospitals.
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Cyberattackers Exploiting Weaknesses in Healthcare Data Security

Cyberattackers are exploiting inherent weaknesses in healthcare data security, making the sector the most targeted industry in the first quarter of 2018, according to Rapid7’s quarterly threat report.

May 15, 2018 - Cyberattackers are exploiting inherent weaknesses in healthcare data security, making the sector the most targeted industry in the first quarter of 2018, according to Rapid7’s quarterly threat report released May 15.
The Rapid7 research found that the leading attack vectors in healthcare were remote access, such as  suspicious logins, access attempts from disabled accounts, and account leaks, as well as phishing and ransomware.
There are several factors that attract attackers to the healthcare sector, according to researchers.
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State health departments face government barriers to interoperability, report says

May 16, 2018 1:10pm
State health departments can harness data analytics to inform policy and improve outcomes for large populations—but there are a number of hurdles to fully taking advantage of the technology, according to a new report. 
Researchers at Leavitt Partners interviewed officials at state health departments in Utah, Oklahoma, Washington, Colorado and Idaho to gather a cross-section of states at different points in the journey to a robust and interoperable analytics program. 
Through those interviews, the authors were able to identify several pain points for health officials looking to expand their abilities to gather and use data. In particular, governance and legal challenges, such as the Health Insurance Portability and Accountability Act (HIPAA), pose a significant barrier to data sharing for these agencies. 
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New program aims to ensure identities in exchanging health data

Published May 16 2018, 7:21am EDT
The Electronic Healthcare Network Accreditation Commission, which accredits industry stakeholders for meeting best business practices that include privacy and security protections, now is focusing on a new accreditation program to ensure identity verification and authentication of stakeholders conducting health information exchange, as well as supporting blockchain and cloud hosting services.
Organizations collaborating with EHNAC to develop the new Trusted Exchange Accreditation Program include the Workgroup for Electronic Data Interchange, SAFE-BioPharma Association, eHealth Initiative and the EP3 Foundation which facilitates secure identity to support data sharing for research and clinical trials without revealing personal or sensitive information.
The goal of Trusted Exchange is to offer the industry third-party accreditation for a wide range of healthcare entities.
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$148 for a PDF? Patient Access to Medical Records Hit or Miss

Steven Porter, May 16, 2018

A watchdog agency cites egregious cases as the federal government promotes interoperability of health data.

The fees patients pay for copies of their own medical records vary drastically, sometimes running afoul of the restrictions written into federal law, according to a Government Accountability Office report released this week.
The watchdog agency's report provided a list of egregious cases, including one in which a patient was charged $148 for a digital copy of her medical record. Two others were charged more than $500 apiece for a single request, the report said, citing an unnamed patient advocacy organization.
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GAO: Patient access to medical records remains a challenge

Published May 15 2018, 7:20am EDT
Despite the widespread adoption of electronic health records by providers, patients continue to face challenges in accessing their healthcare information, according to a new audit by the Government Accountability Office.
Under HIPAA, consumers have the right to inspect, review and receive a copy of their medical records, while providers are authorized to charge a reasonable cost-based fee when patients request copies of their medical records or request that their records be forwarded to another provider or entity, such as an insurer or lawyer.
However, according to the GAO, the fees for third-party requests are generally higher than the fees charged to patients—which can vary significantly across states—while high fees can adversely affect patients’ access to their medical records.
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Precision medicine: 'We want to make sure people feel respected,' clinical ethicist says

As hospitals collect patient data they must characterize it well, apply new technologies – and practice what Cleveland Clinic’s Paul Ford calls "human medicine."
May 14, 2018 11:44 AM
While precision medicine continues picking up momentum it’s going to change many aspects of healthcare, notably shared decision making in the doctor-patient relationship, confidentiality and data privacy.
Managing those is going to require a human touch. If physicians and caregivers just focus on genetics and genomics without taking into account who the patients are as people to better understand their activity and behavior then they will be missing a big part of what drives an individual’s health.
“We want to make sure that precision medicine continues to be human medicine – person-centered – as in treating the whole person,” said Paul Ford, a clinical ethicist and Director of the Center for Bioethics at the Cleveland Clinic Foundation. “We want to make sure people feel respected. In some ways, making things personalized – tailors it, makes them feel less like a whole mass.”  
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Cerner has almost double EHR global market share of closest rival Epic, Kalorama says

But Epic leads in the physician office sector, according to the new report, and GE is now among the top four electronic health record vendors.
May 15, 2018 09:32 AM
Cerner leads the worldwide EHR market with Epic taking the second spot, Allscripts in third and GE Healthcare at fourth. 
“In the competition for large healthcare systems, it's the top four EHR companies mainly participating with some exceptions,” Mary Anne Crandall, a senior analyst at Kalorama Information, wrote in the firm’s annual report on the state of EHRs.
For 2017, Cerner earned 17.3 percent market share, while Epic has 8.8 percent. 
Allscripts, thanks to mergers and acquisitions of Misys and Eclipsys, rose to 6.1 percent. 
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Large hospitals more likely to use Cerner, small hospitals opt for Epic: 4 report insights

Written by Julie Spitzer | May 14, 2018 |
With 17 percent of the global market share, Cerner is the most used EMR, according to Kalorama Information's annual EMR industry report.
For its report, EMR 2018: The Market for Electronic Medical Records, Kalorama analyzed the global EMR market and the trends affecting it through a statistical review of industry influences, demographics, life expectancy and company strategies.
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One Hospital's $1M Savings in CDI Transcription Costs

Alexandra Wilson Pecci, May 15, 2018

Phoenix Children's CMIO reveals the IT-clinical collaboration behind its ambulatory disease-specific clinical documentation templates.

For many years, the ambulatory clinics at Phoenix Children's Hospital lagged in their EHR use.
"The ambulatory was a little step behind," says Vinay Vaidya, MD, vice president and chief medical information officer at Phoenix Children's. "Everything was on paper or dictation."
Now, the clinics not only use a clinical documentation platform in all 30 divisions of its ambulatory clinics, but the organization is in the process of building disease-specific templates that are part of a larger quality improvement initiative for chronic diseases.
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Cybersecurity: Nightmare scenarios and guiding principles

From legacy infrastructure to potential medical device hacks, some of the industry’s leading voices opened up about how the industry can begin to combat the inevitable breach.
May 11, 2018 03:07 PM
Some clinicians share their passwords with nurses in order to complete charts with the idea of “a care efficiency: rather than a risk.
By now, the healthcare sector is fully aware of the looming target placed on its back by hackers. The issue is that legacy infrastructure, staffing shortages and insider threats can make it tough to tackle these issues.
The biggest threats lie within the legacy infrastructure of healthcare itself. This includes medical devices operating on outdated platforms, along with IoT devices. We have not have seen it happen frequently but, if those devices are hacked cybercriminals can actually put patient lives at risk.
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New cloud-based machine learning tools offer programmatic approach to security

After years of wariness from healthcare providers about off-premise data, new AI capabilities from Amazon, Google, IBM and Microsoft could make cloud storage easier and more trustworthy than ever.
May 14, 2018 08:40 AM
For years, many healthcare organizations tended to be skeptical and resistant (if not outright hostile) to the idea of storing their data, particularly protected health information, in the cloud. IT and security decision-makers had deep reservations about stashing such sensitive data anywhere but their own on-premises servers, safe under their own watchful eyes.
But not too long ago that changed, and seemed to change quickly. To the surprise of many, over the past few years, it appears that many healthcare providers have been getting markedly more comfortable putting their trust in the cloud.
"If you had asked me in 2011, I would have predicted that healthcare would still be one of the slower moving industries," said Jason McKay, chief technology officer of Logicworks, a managed hosting company that helps organizations in many sectors build and manage cloud infrastructure. "We were surprised at the uptake."
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Next-gen analytics: Here's what's coming in the future

Hospitals should expect orders of magnitude more data – but will also see emerging tools such as artificial intelligence and 5G connectivity helping to put both structured and unstructured information to work.
May 14, 2018 09:11 AM
The healthcare analytics market is booming and will be worth close to $54 billion worldwide by 2025, according to a March 2018 report from Grand View Research.
Given the need to achieve the Triple Aim, along with the rise of precision medicine and the move toward value-based care, data analytics have never been more important to healthcare provider organizations.
As the technology continues to grow and mature, here's the pressing question for healthcare and IT leaders: How will analytics tools evolve – and what should they expect to come next?
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Cerner EHR Ranked Highest for 3rd Year in Nursing EHR Satisfaction

Black Book research showed that nursing EHR satisfaction levels continue to rise, with the majority of nurses not wanting to return to paper records.

May 11, 2018 - There has been a definite shift in nursing EHR satisfaction levels over the past few years, showing the perceived value in EHRs in delivering higher quality care, according to recent Black Book research.
Cerner EHR received top rankings from a nursing functionality and usability perspective for the third consecutive year, with a mean satisfaction ranking of 93 percent, the poll found. MEDITECH and Allscripts both had mean satisfaction rankings of 88 percent, while McKesson had an 85 percent mean product satisfaction ranking.
Approximately 15,000 registered nurses from 40 states were interviewed for three separate surveys, discussing how they implemented hospital EHRs over the past four years.
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HIT Think How telehealth can improve medication management and patient safety

Published May 11 2018, 5:47pm EDT
Medication errors account for at least one death each day and injuries to an estimated 1.3 million people annually. But while implementing new workflows can put a dent in this problem, making a significant impact requires a huge dedication of resources.
What’s not typically part of the discussion? How telehealth can improve medication safety.
While telehealth’s power to enhance acute-care programs is undisputed, its ability to improve the less-prominent (but equally important) medication reconciliation and safety processes is largely untested, and potentially eyebrow raising.
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'Stigmatizing' language in EHRs may negatively affect patient care for years

Written by Jessica Kim Cohen | May 12, 2018 | Print  |
Including nonessential, "stigmatizing" notes in a patient's health record may lead them to receive inadequate care in the future, according to a study out of Baltimore-based Johns Hopkins University School of Medicine and published in the Journal of General Internal Medicine.
For the study, the researchers developed a series of chart notes, half of which employed "neutral language," and half of which employed "stigmatizing" language. The researchers enrolled 413 medical students and internal and emergency medicine residents to review these notes and suggest next steps, in an effort to assess whether stigmatizing language affected providers' attitudes toward patients.
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FDA Turns to AI and Digital Health, So Why Are There Still Fax Machines?

MAY 10, 2018
Recently, FDA Commissioner Dr. Scott Gottlieb, spoke discussed how he sees digital health playing out and where the agency stands in a speech titled "Transforming FDA's Approach to Digital Health." Some things he said are worth exploring in more depth.
Gottlieb started out by saying that the digital health space has really matured and is the time for regulation.
"Digital health tools have vast potential improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual, making medical care truly patient centric -- empowering the individual," Gottlieb said.
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DOD report blasts MHS Genesis rollout, citing inaccurate patient information and safety concerns

May 14, 2018 3:42pm
A scathing report from the Department of Defense says its MHS Genesis EHR is “neither operationally effective nor operationally suitable,” highlighting concerns that the system’s failures jeopardize patient safety.
The April 30 report (PDF), released by the DOD last week, describes a system rife with critical problems impacting patient care and clinical usability. Robert Behler, the DOD’s director of operational test and evaluation, reviewed the Cerner implementations at three facilities in Washington state and found that 156 incident reports were of “critical deficiencies” that included potential patient safety concerns.
The report was released shortly after Politico reported that the system was riddled with errors that could lead to patient deaths.
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U.S. doctors’ clinical notes 4 times as long as those in other countries

May 10, 2018 1:40pm
Regulations that require doctors to document patient care may be responsible for the fact that U.S. physicians’ clinical notes are, on average, four times as long as those in other countries.
Those regulations may be causing U.S. physicians, who commonly complain about the time they spend on electronic health records (EHR), to overdocument when compared to their overseas counterparts, according to an opinion piece in the Annals of Internal Medicine.
"Documentation in other countries tends to be far briefer, containing only essential clinical information," the authors said. "It does not contain much of the compliance and reimbursement documentation that commonly bloats the American clinical note."
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DoD rollout of Cerner EHR deemed not operationally effective or suitable

Published May 14 2018, 7:22am EDT
While the Department of Defense contends that its initial deployment last year of MHS GENESIS—a new Cerner electronic health record system—at four military sites in the Pacific Northwest was a success, the EHR is “neither operationally effective nor operationally suitable,” according to a new report from DoD’s director of operational test and evaluation.
DOT&E’s initial test and evaluation report, dated April 30 and released by DoD on Friday, is based on an assessment of three of four military sites in Washington State that were part of the rollout.
“MHS GENESIS is not operationally effective because it does not demonstrate enough workable functionality to manage and document patient care,” wrote Robert Behler, director of operational test and evaluation, in a letter to senior Pentagon officials accompanying his report. “Users successfully performed only 56 percent of the 197 tasks used as measures of performance. MHS GENESIS is not operationally suitable because of poor system usability, insufficient training and inadequate help desk support. Survivability is undetermined because cybersecurity testing is ongoing.”
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FHIR information exchange capability now coming of age

Published May 14 2018, 7:31am EDT
2018 is shaping up as a pivotal year for Health Level 7 International’s Fast Healthcare Interoperability Resources application programming interface. Significant momentum continues to build as a growing number of use cases indicate FHIR has reached a tipping point as a mature standard for the electronic exchange of health information.
In March, Apple launched an enhancement to its Health app—which leverages FHIR—enabling patients at 39 participating U.S. healthcare organizations to view their medical records on their iPhones after updating to the iOS 11.3 mobile operating system.
The enhanced Health Records section within the Health app allows patients to see medical data— encrypted and protected with their iPhone passcodes—gathered from various institutions and presented in a single, aggregated view. Patients also receive electronic notifications when their records are updated by providers.
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HIT Think Why it's important to give nurses the data they need

Published May 14 2018, 5:49pm EDT
Florence Nightingale, widely recognized as the founder of the nursing profession, could also be considered the first informatics nurse. The definition of nursing informatics is drawn from the IMIA Special Interest Group on Nursing Informatics, which uses this description: "The science and practice [that] integrates nursing, its information and knowledge, with information and communication technologies to promote the health of people, families, and communities worldwide."
A study completed by Nightingale, done on note cards, used a huge set of data collected between 1854-1855 that changed our knowledge of—and had an enormous impact on—hospital sanitation. Her insights were based on detailed analyses of the cause of death of the British soldiers stationed in Crimea.
She used data to identify trends that allowed her to look at the root cause of the deaths, and from that insight, suggested changes in care. Her reforms in Crimea, including the introduction of mandatory hand-washing, cut the death rate in military hospitals from 42 percent to 2 percent. We still leverage that knowledge and advice on patient care, which remains relevant for hand hygiene protocols in hospitals globally.
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Electronic medical records are a burden or the future, depending on who you ask

BY JON O'CONNELL, STAFF WRITER / Published: May 13, 2018
Dr. Kevin Olsen spends up to 12 hours most weekends hunched over a laptop doing something he hates.
The Scranton cardiologist updates his patients’ electronic medical or health records, often called EMRs or EHRs.
They’re made to reduce redundancy and errors and give doctors a complete picture of care for each patient by showing them how other doctors are treating them.
On the flip side, independent doctors like Olsen, who have small staffs and who have practiced medicine using paper records for decades, are duly burdened by them.
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Foreign experts find error slowing down e-health system in Latvia

BC, Tallinn, 14.05.2018.
International experts have found the main error in one of the e-health system's modules that was slowing down the entire system, Health Minister Anda Caksa (Greens/Farmers) told Latvian Television this morning, cites LETA.
Caksa did not specify how much repairing the system would cost, she only said that the Health Ministry's budget section for the e-health system would not be exceeded, and that the experts were paid on an hourly basis.
According to Caksa, it became clear in two or three months after the launch of the e-health system that something was slowing it down each day around noon. International experts were hired to find out what was wrong, and last week they found the main error in one of the e-health system's modules that was slowing the system down. The experts said that repairing the system would take two months.
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Foreign experts find 'bug' in national "e-health" system

Today, 11:29 | Health Authors: eng.lsm.lv (Latvian Public Broadcasting)
International experts probing the country's "e-health" system have found a bug that had caused it to slow down. It should be fixed within two months, said Latvia's Health Minister Anda Čakša, reported LTV May 14.
"We found, after it had been working for two to three months, that there are slow-downs...especially during midday when there's a peak in the number of active users. 
"Understanding there's an error somewhere in the core [of the code], we invited international experts who have identified the main problem," she said.
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Vietnam to issue electronic health insurance cards

It is expected to help boost supervision and avoid fraudulent activities in medical examinations and treatment under the health insurance policy.

Devdiscourse News Desk 13 May 2018, 03:27 AM Vietnam
Vietnam’s insurance sector will issue electronic health insurance cards in 2018 to facilitate the management of information regarding medical examinations and treatment.
According to the Vietnam Social Security (VSS), people with e-cards visit health facilities for examinations and treatment or visit relevant agencies to solve their social insurance interests, their information can be clearly displayed by using card reader chips.
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Enjoy!
David.

Friday, May 25, 2018

Are We Seeing The Bipartisan Support For The myHR Begin To Fracture?

This appeared last week:

 ‘This is a Government with a woeful track record on IT security and privacy.’

Catherine King, Shadow Minister for Health

Catherine King has challenged the Turnbull Government on whether it can roll out the My Health Record system without getting it wrong

It’s been heralded as a “game changer” by the PSA’s Shane Jackson and “strategically very valuable” for pharmacy by the Guild’s David Quilty… but the Shadow Minister for Health and Medicare has suggested that the Government may not be able to implement the system with effective privacy controls in place.
This week the Health Minister, Greg Hunt, announced that Australians who want to opt out of having a My Health Record can do so between 16 July and 15 October 2018.
Ms King says that Labor supports e-health: “Implemented by a competent Government, e-health could deliver tangible health care improvements and save the health system up to $7 billion a year through fewer diagnosis, treatment and prescriptions errors,” she said.
“But given this is the same Government that gave us census fail, stuffed up robodebt, and allowed Australians’ Medicare data to be sold on the darkweb, we have concerns about their ability to properly implement this reform.
“Put simply, this is a Government with a woeful track record on IT security and privacy. And now they’re asking all Australians to trust them with their most personal information.”
Ms King also accused the Government of making “no real effort” to explain the opt out process to the community.
More here:
Since the PCEHR / myHR was a Labor idea (in 2009-2010) it is interesting to see only luke warm support, even though they still seem to think it is a good idea in general and are probably just trying for a political point or two.
Time will tell where they land as the election approaches.
David.