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."

Saturday, September 22, 2018

Weekly Overseas Health IT Links – 22nd September, 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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Government publishes code of conduct for AI and data-driven healthcare tech

The government has published a code of conduct on artificial intelligence and data-driven technologies in healthcare, with a view to creating a “safe and trusted environment in which innovation can flourish”.
Claire Reid – 7 September, 2018
Speaking at this week’s Health and Care Innovation Expo, health minister Lord O’Shaughnessy said AI and machine learning was a field moving “at lightning speed” and with “tremendous potential across the healthcare sector”.
He said the principles in the code would constitute “rules of engagement” between industry and the health and care system as each seeks to realise this potential.
“These principles provide a basis to deepen the trust between patients, clinicians, researchers and innovators,” he told delegates.
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Hancock issues stern warning to health IT suppliers

The Secretary of State for Health and Social Care has issued a stern warning to health IT suppliers that they risk losing business with the NHS if they don’t fully embrace data-sharing by adopting common standards.
Hanna Crouch – 7 September, 2018
In his keynote speech at NHS Expo on 6 September, Matt Hancock said the interest of suppliers “are too often not aligned with the NHS’ interests” and that contracts are “badly managed”, with buyers often being locked-in to long deals that prevent them from shopping elsewhere.
In response, Hancock said he planned to increase the NHS’s in-house capacity to understand the technology behind IT systems, to ensure that staff are able to pick the right functionalities from them by splitting “big contracts into smaller pieces”, with more of a focus on user need.
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EHR interoperability for VA and DoD, who’s responsible? Lawmakers, officials can't agree

The first House VA Subcommittee on Technology Modernization hearing revealed that officials and congressional members are not on the same page when it comes to governance.
September 14, 2018 01:47 PM
The Interagency Program Office (IPO) has not fulfilled its legal mandate to be the single point of accountability between the Department of Defense and Department of Veterans Affairs interoperability efforts. But both officials and lawmakers can’t decide who should reconcile the differences.
The inaugural House Veterans Affairs Subcommittee on Technology Modernization hearing, held on Thursday, revealed, not surprisingly, governance and accountability are still major points of contention for the project.
Government Accountability Office Director of Management Issues Carol Harris testified that while the VA has signed the contract with Cerner, created a program management office and drafted high-level governance plans -- program officials haven’t designated “what role, if any, IPO is to have in the governance process.”
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80% of CMIOs Say Medication Management Boosts Patient Safety

Most health IT leaders think medication management initiatives have improved patient safety, but there are still significant issues to overcome.

September 11, 2018 - More than 80 percent of CMIOs believe medication management initiatives are actively helping to reduce the number of adverse drug events that can threaten patient safety, according to a recent survey from the Association of Medical Directors of Information Systems (AMDIS).
However, these executives also believe that the healthcare industry still has significant work to do in order to create comprehensive medication adherence and management programs that positively impact patient care.
While over 80 percent of leaders believe medication management processes have positively impacted patient safety, the survey found that only half of physician IT leaders reported that they are satisfied with the medication management process, and 12 percent indicated dissatisfaction.
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Risk in the age of automation — new hazards and opportunities for insurers in the internet of things

September 11, 2018
By Alex Sun, president and CEO of Mitchell International
According to the famous futurist Ray Kurzweil, “we won’t experience 100 years of progress in the 21st century — it will be more like 20,000 years of progress.” We are at incredibly important moment in time — one that I believe historians will look back on as a pivotal time in the advancement of technology and in the way humans interact with it.
The world is moving quickly beyond the Age of Information, an incredibly fast-moving period marked by the rise of computing, home computers, the internet, mobile phones and streaming video, collectively placing mass quantities of information at our fingertips. Today, we stand on the precipice of the Age of Automation, a period that takes for granted the advancements in computing power and complexity that were previously the stuff of science fiction: artificial intelligence, virtual reality and a world in which virtually everything has the potential to be connected to the internet.
As we enter the Age of Automation, the nature of risk is changing, both in the world at large and within the property and casualty and collision repair industries. Insurance companies rely on historical records to underwrite risk. In many cases, there are things happening today that we have never seen before: a tightly connected world,
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HHS issues HIPAA waiver for covered hospitals in wake of Hurricane Florence

Published September 14 2018, 7:19am EDT
With Hurricane Florence making landfall, Health and Human Services Secretary Alex Azar has waived sanctions and penalties under certain provisions of the HIPAA Privacy Rule.
While the HIPAA Privacy Rule is not suspended during a public health or other emergency, the HHS Secretary may waive certain provisions of the rule under the Project Bioshield Act of 2004 of the Social Security Act.
Azar’s waiver, part of his declaration of a public health emergency in North Carolina, South Carolina and Virginia, applies to provisions that generally require covered hospitals to give patients the opportunity to agree or object to sharing information with family members or friends involved in their care.
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CIOs must take charge in implementing artificial intelligence governance

Published September 14 2018, 4:32pm EDT
The role of many chief information officers is changing, as organization strategies move from data governance initiatives to artificial intelligence governance.
That is placing new pressure on CIOs to take a more advisory role in what is for many is still cutting-edge technology. But this is welcome news and brings new opportunities for those that are successful.
That was the message of Jean-François Gagné, chief executive officer at Element AI, at the Strata Data Conference in New York this week. Gagné spoke on the topic “From data governance to AI governance: The CIO’s new role.”
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Oregon hospital to expand use of control center to head off sepsis

Published September 14 2018, 4:49pm EDT
A control center at Oregon Health & Science University is now focusing attention on improving sepsis care, long a vexing challenge for hospitals.
The centralized control center collects data from the organization’s electronic health record system and other metrics, presents visualizations of patients at risk, and tracks the trajectory of a patient’s progress with built-in clinical decision support alerts.
The center was created in 2017 in an effort to gain better visibility on how to reduce patient transfers in the Portland-based three-hospital delivery system. The “Mission Control Center” from GE Healthcare was launched to understand barriers and bottlenecks that can occur during treatment and have better visualization of which patients need to be treated first.
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Health Information Exchanges Are the Hidden Heroes of Hurricane Season

Jack Murtha
SEPTEMBER 14, 2018
In the sprawling world of health tech, it’s easy for critical but understated technologies and initiatives to get lost in the hype. Health information exchanges (HIEs) fit that description, lacking the publicity power of brand-name wearables and the intrigue of artificial intelligence.

But HIEs provide great resources to healthcare organizations and patients. And as Hurricane Florence begins to strike the U.S. and millions of evacuees spread across the Eastern Seaboard, the significance of HIEs becomes clearer than ever.

These organizations are, in effect, the hidden heroes of hurricane season — and they might just save a few lives or, at the very least, improve outcomes and empower patients and clinicians.
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Healthcare innovation giving rise to the Chief Digital Officer

Pamela Dixon of SSi-Search on the emerging CDO role and how it differs from traditional CIOs, CTOs and other executive positions.
September 13, 2018 08:00 AM
There is no shortage of C-level roles related to IT in healthcare today. There’s the chief information officer, of course, the chief technology officer, chief innovation officer, chief medical informatics officer, to name some of the most common. And there’s a new one gaining traction: chief digital officer.
Healthcare information and technology pros might know one, or have heard of the prominent CDOs. But what, exactly, does the CDO do?
The Chief Digital Officer is “a strategic, business minded leader using technology as a key lever to rethink operations,” according to Pamela Dixon, managing partner of SSi-Search, a recruiting firm that specializes in CMIOs, CHIOs and, of course, CIOs.
Dixon enlightened us about the emerging role, the “shape-shifting” among CIOs and CTOs, and what the future holds for chief data officers.
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Ransomware attack on fetal diagnostic lab breaches 40,800 patient records

The Fetal Diagnostic Institute of the Pacific was able to restore data from backups, and with help from a cybersecurity firm wipe the virus from the infected server.
September 13, 2018 02:42 PM
The Fetal Diagnostic Institute of the Pacific was hit by a ransomware attack on June 30 that potentially breached the data of 40,800 patients.
According to the notice, hackers breached FDIP servers in June, which included some patient records. Officials took immediate action to contain the incident and enlisted a cybersecurity firm. They were able to successfully remove the virus, clean the system and confirm no malware remained.
The cybersecurity firm also installed further protections to better prevent future incidents. Fortunately, officials said FDIP had backups in place that they maintained for contingency and were able to restore the impacted data. Officials did not name the ransomware type behind the infection.
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Biometric fingerprinting tool could help securely identify infants and children

The technology, developed at UC San Diego, could enable accurate ID to help kids in situations such as disaster relief, migration and refugee settlement.
September 13, 2018 01:39 PM
University of California San Diego researchers have created a new biometric technology they say could help securely identify children and even newborns with just the wave of a finger.
The tech, funded in part by the Bill and Melinda Gates Foundation, is not yet commercially available, but UC San Diego researchers hope it will be within a year. They say it could be a help in many different scenarios: tracking vaccinations, delivering care during natural disasters, helping prevent human trafficking, resettling refugees and reuniting migrant children with their families.
The portable device, called ION, is a non-contact optical scanner. It enables imaging of fingers and palms, stored scanned prints as encrypted templates that can then be shared securely with laptops and mobile devices.
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Many healthcare organizations lack confidence in disaster preparedness, survey finds

Written by Kelly Gooch | September 12, 2018 | Print  | Email
A number of healthcare organizations said they don't believe they have a comprehensive disaster recovery plan implemented, even though disasters remain prevalent in the U.S., according to a survey from DrFirst, a provider of e-prescribing and medication management solutions.
The survey, conducted in August, involved 109 healthcare professionals in acute, ambulatory, hospice and home care.
Five findings:
1. Most respondents (68 percent) reported they were affected by two or more natural and/or man-made disasters over the last five years.
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Stakeholders join to find ways to improve medical diagnoses

Published September 13 2018, 5:37pm EDT
More than 40 organizations have launched ACT for Better Diagnosis, an effort to improve diagnostic processes and their resulting accuracy.
The organizations—representing providers, specialty societies, federal agencies, patients, policymakers and other groups—believe that as many as 80,000 patient deaths annually can be attributed to inaccurate or delayed diagnosis, and that the use of information technology can play a key role in reducing mortality.
“This is a campaign to mobilize and motivate public stakeholders, policy makers, informaticists and data vendors,” says David Newman-Toker, MD, a professor of neurology, ophthalmology and otolaryngology at Johns Hopkins Medicine.
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How to incorporate social determinants of health data into EHRs

September 11, 2018
Potential ways to include social determinant of health data, such as inadequate physical activity or food insecurity, were recently published in Annals of Family Medicine.
“Numerous health care systems are exploring how to incorporate social needs documentation and intervention into routine care,” Rachel Gold, PhD, MPH, of the Kaiser Permanente Center for Health Research in Oregon, and colleagues wrote.
 “These efforts are based on strong evidence that patients’ social and economic contexts (their social determinants of health) shape health, and on nascent evidence that clinic-based [social determinants of health] screening and intervention can improve health,” they wrote.
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20+ healthcare companies create the Da Vinci Project to advance data sharing

Written by Anuja Vaidya (Twitter | Google+)  | September 11, 2018 | Print  | Email
Twenty-plus healthcare companies have joined together to form the Da Vinci Project, a private sector initiative focused on leveraging HL7 Fast Healthcare Interoperability Resources to improve data sharing.
The project's participants will work together to define a common set of interoperability standards that can be implemented nationally. The project identified two initial test use cases that it will focus on — one is centered on 30-day medication reconciliation and the other on requesting and receiving health plan coverage requirements at the point of care.
The project's participants include Epic, Allscripts, Cerner, Blue Cross Blue Shield Association, Cognosante, Humana and Optum. They have established a governance model that is built on both steering and operating committees.
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Different usability standards are needed for pediatric electronic health records

by Tina Reed 
Sep 11, 2018 7:21pm
When it comes to medicine, children are not just little adults—and that premise extends to the electronic health records their clinicians rely on, according to a new viewpoint published in JAMA Pediatrics this week.
"There are unique usability and safety challenges for our pediatric populations," said Raj Ratwani, Ph.D., a researcher with the National Center for Human Factors in Healthcare at Columbia, Maryland-based MedStar Health, in an interview with FierceHealthcare.
For example, he said, when a doctor is giving a medication to a child, they have to take the child's weight into consideration for dosing.
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Apple gets FDA approval for new watch, touts health gains

Published September 12 2018, 5:30pm EDT
Apple unveiled the most-significant upgrades to the Apple Watch since it first went on sale in 2015, enabling it to monitor users’ health.
The new version, called Apple Watch Series 4, has larger screens that fit into the same overall watch sizes, and new health sensors and apps such as an electrocardiogram monitor. It also includes a faster dual-core processor called the S4, Apple said. The new smartwatch line was introduced Wednesday at its headquarters by Chief Operating Officer Jeff Williams.
Williams described the latest Watch as an "intelligent guardian of your health," noting that Apple got clearance for the ECG app from the Food and Drug Administration, the first of its kind.
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Apple adds heart monitoring to Apple Watch

  • Apple launched a new Apple Watch with a completely revamped design.
  • The screen is 30 percent larger, and the speaker is 50 percent louder, the company said.
  • It also added a new health sensor that lets you take an electrocardiogram, or ECG, that measures the heart's rhythm, not just the heart rate.
Published 8 Hours Ago Updated 1 Hour Ago
Apple just announced a new Watch called Apple Watch Series 4.
The new Apple Watch comes with a larger, edge-to-edge screen, giving it the biggest facelift since its launch in 2014. The screen is 30 percent larger than the previous version, while the device itself has become thinner.
But the bigger focus was put on the new Watch's ability to play the role of a medical device. The new Watch comes with a new health sensor that lets you take an electrocardiogram, or ECG, that measures the heart's rhythm and notifies you if it detects the presence of atrial fibrillation. It is now able to detect falls and automatically initiate an emergency call, as well.
"The Apple Watch has become an intelligent guardian for your health," Apple COO Jeff Williams said.
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Machine learning helps UI Health Care reduce surgical site infection by 74%, save $1.2 million

And that's not counting the value-based savings for reducing those infections, says the machine learning co-developer the University of Iowa Hospitals & Clinics.
September 10, 2018 12:31 PM
Imagine knowing, in real time, whether a patient will suffer a surgical infection as a surgeon closes up a wound. That's the kind of clinical situation that machine learning is enabling at the University of Iowa Hospitals & Clinics.
To date, the health system's innovation with AI analytics has led to a 74 percent reduction in surgical site infection over a three-year period, which at scale is a $1.2 million cost savings – not including savings from value-based purchasing because of the reduced surgical site infection rate.
Iowa’s work with comes as more and more hospitals and tech vendors are undertaking innovative initiatives with machine learning and artificial intelligence. Johns Hopkins for instance, is using deep learning to improve how it handles pancreatic cancer and Amazon Web Services is harnessing machine learning to enable customers to better treat depression.
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AI predicts risk of death from heart disease more accurately than experts

The machine learning model uses 600 variables with patient's data whereas human-constructed models made predictions based on 27, researchers say.
September 11, 2018 04:17 PM
Scientists have designed a model using Artificial Intelligence that can predict risk of death in patients with coronary heart disease (CHD) better than expert-constructed models.
According to a new study published in PLOS One, scientists from the Francis Crick Institute, working with University College London Hospitals NHS Foundation Trust and the Farr Institute of Health Informatics Research, developed the AI model using the data of 80,000 patients, available for researchers through UCL’s CALIBER platform, which links four sources of electronic health data in England.
The model that the AI one was compared to made predictions based on 27 variables chosen by medical experts, while the Crick team got their AI algorithms to train themselves, look for patterns and select the most relevant variables from a set of 600.
Both machine learning and AI are picking up steam in healthcare, with hospitals testing or deploying the tech for a range of use cases from treating patients with pancreatic cancer to reducing surgical site infections while experts are saying the next generation of clinical decision support tools will include AI in workflow to improve diagnostics, imaging, radiology and pathology, among other functions.
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EHR investments slowing down as hospitals cite high costs, study finds

The expense of software and implementation, as well as concerns about data security, are slowing growth in a global market moving toward $33 billion.

Jeff Lagasse, Associate Editor
Hospitals spent nearly $25 billion globally on electronic health records in 2017 and that is projected to increase to $33 billion by 2023 but signs are also emerging EHR spending is starting to slow down, according to a report from Allied Market Research.
Specifically, the cost of software and implementation are inhibiting growth from being more robust. There has also been an increase in concerns related to the safety and security of the data contained therein.
Still, growth is happening, led by an upsurge in the adoption of cloud-based EHR software, a rise in the incidence of chronic diseases and a larger aging population. The potential to cater to untapped markets could provide opportunities for future growth, the report found.
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Many Opportunities for Doctors Using Twitter
Twitter can be used to build networks and find potential research partners; learn about research
MONDAY, Sept. 10, 2018 (HealthDay News) -- Doctors can use Twitter to build networks and learn more about research in real time, according to a blog post published by Penn Medicine News.
According to the report, finding an audience is a universal challenge, and doctors using Twitter suggest interacting with your institution or specific center. To find a specific niche, doctors need to decide who to follow and prioritize their tweets.
Doctors on social media have the opportunity to share ideas, including direct interaction with leaders in the field. Early-career scientists are encouraged to be more active as a way of gaining visibility within a field. Twitter allows users to connect, even if they are not in physical proximity, enabling networking with a range of others. In addition, Twitter provides an opportunity to keep up with the latest research, learning things from friends and coworkers, with commentary as well as just the research highlights. While academic writing takes time to be published, Twitter is real time and provides an opportunity for academics to engage. Twitter also helps doctors find potential partners for collaboration.
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AMIA voices support for CMS' plan to reduce EHR burdens on physician

Written by Julie Spitzer | September 10, 2018 | Print  | Email
The American Medical Informatics Association submitted comments on CMS' recent efforts to reduce documentation burden for physicians, largely praising the agency's work.
In June, CMS released several new proposals aimed at reducing documentation burden by reforming evaluation and management visit level guidelines, increasing the use of virtual care codes, and streamlining participation in Medicare incentive programs, including its "promoting interoperability program," formerly known as meaningful use.
Here are four highlights from AMIA's comments:
1. AMIA recommended CMS provide resources to support their proposed E&M reforms, such as emerging technologies and tools like natural language processing, medical device data, voice recognition software and the use of sensors to capture clinical activity.
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New PCORI Policy Has Data Rules In Line with HIPAA Regulations

A new data sharing policy adopted by the Patient-Centered Outcomes Research Institute stipulates that all personally identifiable health information must be deidentified in accordance with HIPAA regulations.

September 10, 2018 - A new data sharing policy adopted by the Patient-Centered Outcomes Research Institute (PCORI) stipulates that all personally identifiable health information must be deidentified in accordance with HIPAA regulations.
On Sept. 7, the PCORI board approved the new policy, which requires researchers who receive PCORI funds to share their data sets and documentation for reanalysis and reuse. The Washington, D.C.-based non-profit was created by Congress in 2010.
Informed consent obtained from study participants must be sufficiently broad to permit future research by other researchers. Requests to access data and documents in the repository will be reviewed based on the scientific merit of the request and on the qualifications of the requestors, PCORI explained in a press release.
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A look inside Epic, Cerner and Allscripts app store programs

Executives explain how the developer initiatives work and why they’re fueling innovation and shaping future direction of their platforms.
September 10, 2018 10:28 AM
Major electronic health record systems vendors are pretty innovative companies when it comes to keeping their products up to date with the changing requirements of delivering healthcare at health systems, hospitals and group practices.
But there is only so much big companies can do, and further, sometimes the perspective from an innovative upstart developer can shed light on new features and processes not previously considered.
This is why EHR vendors like Epic, Cerner and Allscripts in recent years have opened their products to third parties in the form of app stores, where smaller IT players can create and offer apps that integrate easily with the respective EHRs, performing tasks that the EHR alone does not offer.
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IBM is betting big on blockchain technology. Is it worth the risk?

Ahiza Garcia  @ahiza_garcia September 6, 2018: 5:19 PM ET

IBM is betting heavily on blockchain technology revolutionizing everything from shipping to banking.

Industry watchers say it's a risky move, given the relative novelty of the technology and the hype surrounding it, but say IBM is well positioned to make it pay off.
For the uninitiated, the blockchain is essentially a shared digital ledger. Once entered, transactions cannot be changed, creating an immutable record. The technology is most associated with cryptocurrency, but several companies, including Microsoft (MSFT), JPMorgan Chase (JPM), and American Express (AXP), are exploring its use in other areas.
IBM (IBM) has 1,500 employees working on more than 500 blockchain projects in industries like shipping, banking, healthcare and food safety. It also has forged partnerships with the likes of Columbia University to develop still more uses for the tech.
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Are you at risk of diabetes? Chinese AI system could predict disease 15 years in advance

Technology firm working with Shanghai hospital says system had an 88pc accuracy rate in tests on information from 170,000 people
UPDATED : Friday, 07 September, 2018, 3:33pm
1 Sep 2018
Doctors at a hospital in Shanghai are hoping a new artificial intelligence system will help them to identify patients at risk of developing diabetes up to 15 years in advance.
In tests the model, known as Ruining Knows Sugar, or Ruining Zhitang in Chinese, achieved an accuracy rate of 88 per cent, according to 4 Paradigm, the Beijing-based company that developed the software and which has been working with medical staff at Ruijin Hospital in Shanghai since last year.
According to Tu Weiwei, a machine learning specialist at the tech company, the system was designed to identify those most at risk of developing type 2 diabetes – the most common form of the chronic disease – within the next three years.
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Epic EHR Now Includes Nuance Voice-Enabled Clinical Workflows

Epic EHR users can use voice-enabled clinical workflows to conversationally access schedules, patient health data, and lab results.

September 07, 2018 - Providers using Epic EHR will now have access to voice-enabled clinical workflows powered by Nuance virtual assistant technology for faster, more efficient data access.
The voice-enabled clinical workflows are now commercially available to Epic users through the health IT company’s clinical documentation and barcode validation app Epic Rover.
At Epic’s 2018 Un-Users Group Meeting, Nuance and Epic discussed plans to help providers streamline clinical documentation and patient health data access through conversational virtual assistant functionality powered by artificial-intelligence (AI.)
The pair’s newest venture is a commercially-available offering that will allow users of Epic mobile apps to conversationally access patient schedules, lookup patient health information, and view lab results, medication lists, and visit summaries.
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Healthcare Data Presents Lucrative Target for Cyberattackers

The healthcare industry will remain one of the most targeted sectors by cyberattackers because of its valuable healthcare data, judged a report published Sept. 6 by Marsh & McLennan Companies' Global Risk Center.

September 07, 2018 - The healthcare sector will remain one of the most targeted industries by cyberattackers because of its valuable healthcare data, judged a report published Sept. 6 by Marsh & McLennan Companies' Global Risk Center.
In fact, more than one-quarter of healthcare organizations reported they had been victims of a cyberattack. This is more than financial institutions (20 percent) and nearly twice the rate in the communications, media and technology sector (14 percent).
The report’s data is taken from a survey of 1,312 senior executives conducted by Marsh in partnership with Microsoft.
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AI algorithm predicts aneurysm risk from EHR, genetic data

Published September 10 2018, 7:33am EDT
Stanford researchers are able to predict the risk of abdominal aortic aneurysm by using an artificial intelligence algorithm that combines genome-sequence information and electronic health record data.
A new study from the Stanford University School of Medicine, published September 6 in Cell, is good news for the millions of people who are afflicted each year with the often fatal cardiovascular disease—abdominal aortic aneurysm (AAA)—that rarely shows symptoms.
“No one has ever set up a predictive test for it and, just from a genome sequence, we found that we could actually predict with about 70 percent accuracy who is at high risk for AAA,” says Michael Snyder, professor and chair of genetics at Stanford, who noted that when other details from EHRs were added—such as whether a patient smoked and his or her cholesterol levels—the accuracy of the machine-learning algorithm increased to 80 percent.
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Blue Cross Blue Shield Association supports member FHIR adoption

Published September 10 2018, 5:01pm EDT
Health insurers are joining the ranks of providers and vendors adopting HL7’s emerging Fast Healthcare Interoperability Resources standard for sharing information.
Blue Cross Blue Shield Association, a federation of 36 independent U.S. health insurance companies providing coverage to more than 100 million Americans, has selected IT vendor Edifecs to support the rapid deployment of FHIR data standards by BCBSA’s members.
“As we seek to drive more coordinated, higher quality and affordable healthcare across the country, FHIR adoption is a key component for BCBS companies,” says David Corso, executive director of PlanConnexion at Blue Cross Blue Shield Association. “Many BCBS companies are shifting toward value-based models that put patients at the center of care. FHIR standards advance interoperability of both clinical and financial data, and help BCBS companies to turn this data into actionable intelligence to enhance the customer experience.”
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HIT Think 3 ways machine learning could immediately aid healthcare organizations

Published September 10 2018, 5:42pm EDT
Machine learning (and its close cousin, artificial intelligence) are hot buzzwords on the healthcare landscape right now. But below the surface, it often seems there is more theoretical discussion than practical application.
The core idea is simple. Machines are really, really good at poring over massive amounts of data and picking out patterns and anomalies within them. They can do it far better and faster than humans can.
Cognitive learning is an area that’s taking off, but it’s still in its infancy and is limited in not being able to infer the meaning of those patterns and anomalies. It’s still up to humans to determine whether those patterns are an indication of an issue that must be addressed immediately, a topic for discussion at the next executive or departmental meeting, or merely something to make you say “hmmm” before moving on.
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How to plan a healthcare technology innovation initiative

Before investing in and implementing a new technology initiative, healthcare CIOs should first diagnose the condition they want to solve. Then they can research possible cures.

Biz Technology Solutions
Whether an organization wants to improve patient care or gain new efficiencies, few healthcare CIOs are given extra funding to implement or develop new technology initiatives. But despite this lack of capital, health IT leaders are under constant pressure to deliver healthcare technology innovation programs to address the many challenges facing hospitals today.
Much of the innovation adopted by healthcare organizations comes from ready-to-go software or hardware that can uniquely address one or more challenges. Examples include hospitals using collaboration platforms to support care team collaboration, the use of analytics tools alongside electronic health record data to gain new patient insights, and the use of wearable devices to track patients' vitals once they leave the hospital. 
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Citizen-centric digital systems, a story of e-government from Estonia

Update: September, 09/2018 - 09:00
By Hồng Minh
Karim Heredia, a software engineer from Guatemala, moved to his wife’s homeland Estonia some 10 years ago in search of better work opportunities than in crisis-hit Ireland.
However, after some time living and working in the Estonian capital Tallinn, Karim discovered a few other good things he had not seen outside the small Baltic state. He is living in the digital future.
“When you are a foreigner and get your Estonian ID, you are also getting your electronic identity. With that, you can file taxes online, access information about property, bank accounts, mobiles, whatever services you need,” he shared his experiences on Quora.com.
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Enjoy!
David.

The Senate Seems To Have Flushed Out A Few New ADHA Papers - Not Before Time!


It seems a little Senate scrutiny has flushed out some new Board Papers after 10 months.

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Board Papers

The intent of the Australian Digital Health Agency Board (Board) is to publish as many Board documents as is feasible. Generally Board papers are published after the minutes for that meeting have been accepted. This is usually at the next Board meeting. When clarification or correction of the minutes is required, publication of the Board papers may be delayed.
Board documents that are draft, not finalised or sensitive will not be published.

Board Meeting 18-19 April 2018 – Board Papers (Download)

Board Meeting 15 February 2018 – Board Papers (Download)

Hardly complete or timely - but just better than nothing..

David.

Friday, September 21, 2018

I Wonder What Gives Between The ADHA And The Digital Health Initiatives Of The CSIRO.

This article appeared last week.

CSIRO lays out action plan for Australia’s digital health future

Staff writer | 12 Sep 2018
Consumer distrust in data sharing, poor digital health literacy and system interoperability problems are major challenges to the effectiveness and sustainability of Australia’s healthcare system, according to a new CSIRO report aimed at highlighting solutions.
Released on Wednesday, the Future of Health: Shifting Australia’s focus from illness treatment to health and wellbeing management report is aimed at shaping future investments in the health system to help shift the focus on illness treatment to health and wellbeing management within the next 15 years.
“While there has been a broad social shift, purposefully and inadvertently, to sharing personal information in other sectors, consumer trust can be rapidly eroded if the confidentiality, integrity, or availability of their information is threatened,” the report’s authors stated.
“In a survey of over 300 Australian health professionals, only 3 per cent said they trust data sharing in the medical industry.”
CSIRO recommended five actions to help overcome barriers to data sharing:
  •  Build on existing initiatives to develop frameworks for improved health and medical data-sharing, with a focus on privacy-preserving techniques for patient data.
  • Improve healthcare networks and infrastructure, such that all new systems and upgrades are secure by design, promoting safe and effective information exchange.
  • Develop incentives for competing healthcare providers to collaborate on building cyber resilience into their systems, such as medical indemnity incentives or education credits for health professionals.
  • Facilitate data sharing by clearly outlining to consumers why, how and when personal health data is being collected, and what the intended outcome is (i.e. the value to the consumer who owns the health data).
  • Ensure comprehensive consultation of Australian stakeholders and communities in developing laws and guidelines around the ownership, sharing, and management of health data to account for ethical and cultural diversity.
Increasingly, digital and health literacy are becoming vital for patients to be able to access the best healthcare available, the report found.
“Almost 60 per cent of Australians aged 15–74 have a health literacy level that is considered inadequate,” CSIRO found.
“This challenge is compounded by a lack of digital literacy, with approximately 40 per cent of Year 6 and 10 students failing to meet a proficient standard of ICT literacy.”
Among the solutions CSIRO has proposed is to ensure AI-backed digital health initiatives use input data that is relevant to the intended target demographic.
“Most health apps in the market are designed for the masses and their underlying algorithms can be biased by incomplete training data that does not reflect minority groups,” the report states.
“Ensuring the design of these tools considers contextual information specific to the demographic it is applied to is essential.”
While acknowledging current efforts to develop national interoperability standards, the report stresses this is not enough.
“While Australia is not large enough to significantly impact international interoperability standards, it is important that governments, researchers, and businesses participate in discussions to ensure national planning and investment is aligned with global needs,” it states.
“Ensuring new health software adheres to standards around language, terminology, openness, and data security and privacy will help facilitate the effective and safe sharing of individual health data across Australian service providers as well as with international organisations.”
As well as highlighting the rapid global uptake of the Australian-developed FHIR, the report suggested three enabling actions on interoperability:
  • Invest in digital and data infrastructure to ensure digital health data can be transferred quickly and securely between and within health organisations.
  • Ensure Australian representation in international discussions around the global harmonisation of interoperability standards.
  • Develop strategies at the healthcare organisation level for a hybrid standards environment – aggregating data from a variety of systems.
More here:
Three comment on the myHR struck me:
First – Page 11:
Attempts have been made to link systems through My Health Record. While the program has had limited adoption to date, improvements may arise from the recent move to an opt-out model, with more data increasing the potential value. All initiatives designed to link existing and emerging sources of health data will need to carefully consider data privacy, access, and handling arrangements, as well as the communication of these protocols to all relevant stakeholders.
 Second – Page 32

Facilitating Electronic Health Record Engagement

Whether it be the national My Health Record or smaller‑scale solutions, having accessible electronic health records (EHRs) will be key to unlocking many of the holistic, preventative, and precision health offerings of the future. EHRs can improve health outcomes by enabling safer medicines management, improving care coordination, and helping inform treatment decisions.95
Successful EHR platform roll-outs require five things:
  • Clear value communication – The value must be understood by the consumer, the health professional, and any other parties involved to ensure uptake and engagement. This includes clearly articulating what the platform will and will not do.
  • Ease of use – Data entry and management needs to be simple enough so that its use is not a significant change in the daily activities for health professionals or consumers. The scope could initially be limited to a simple data repository of metrics that rarely change (e.g. allergies, blood type, medical history, lifestyle habits) – those deemed most useful and time saving for health professionals and consumers alike. Expansion to more complicated data collection can evolve once health professional and consumer behaviours begin to accept the new norm.
  • KPIs around usage – The success of the record system needs to be measured based on outcomes such as health professional and consumer engagement and health decisions that have been informed by the collected data, not registration numbers that can give a false indication of usage.
  • Interconnectivity – A range of service providers must be able to securely share certain data points in order to provide the most impactful and efficient health solutions.
  • Effective education and training programs – As with any new tool, those using it will require education and training to become familiar with the process of uploading data, data handling protocols, and how the tool can and cannot be used. This is required for both consumers and health professionals.
To ensure these five characteristics are met, large scale digital infrastructure programs could leverage elements of successful international systems and be developed in conjunction with the market; for example, through Public‑Private Partnerships.
Third – Page 34

Ensuring Interoperability

Interoperability is the ability for different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Interoperability is critical to unlocking the value inherent in pooling different data sets together for new and consumer-centric health services. At present, the fragmented Australian system has various regions adopting different systems from a range of technology providers using different standards.
In addition to assisting the sharing of information between healthcare providers within existing systems of information exchange (e.g. My Health Record), interoperability can also unlock completely new and more personalised structures for health data sharing that give consumers the choice to manage their health information the way they want to. This consumer-centric structure of data sharing is already present in the banking sector which will be further bolstered by Open Banking; the first implementation of the Consumer Data Right.
----- End quotes.
I have to say it really rather feels that the CSIRO and the ADHA have different views on that is important an what should be being progressed. The ADHA Strategy seems hardly to be mentioned in the CSIRO report.
CSIRO also seems to be suggesting the myHR is way off track in all sorts of ways as far as the second quote is concerned!
David.

Thursday, September 20, 2018

We Have Not Seen The Details Yet - But The ADHA and Tim Kelsey Really Felt The Heat This Evening In The Senate.

Questions for Mr Kelsey from the Senate Committee which is to report on the myHR Program on October 8, 2018 tonight (among other things) on:

1. The care.data Program led by Tim Kelsey in the UK and what it means for us in Australia.

2. Paid spruikers. (Some docs got $1.1M over 2 years) - was mostly for advocacy of the myHR +++ for $$$$ - and really not for design help (The myHR remains a rubbish system and all involved know it.) No neutral views really provided at all.

3. Journalistic suppression / bullying. There has been serious distortion of the right to public information by the ADHA and there is good reason to hold them to account. Mr Kelsey himself is not apparently totally innocent in all this - as was put to him by Senator Singh.

4. Dodgy usage stats for the myHR - and what is means for care and how much the system is actually used.

5. Failure to separate the UK SCR and what it does from the myHR - He knows it is very different! One is an updated mini-record for emergency use and the other is a pile of ageing .pdfs etc.

6. The biased nonsense run out from paid PHN's etc on the joys and zero risk of the myHR.

7. A total brief that talks of little else but benefit - but ignores risks.

I don't think this lack of honesty and mega-spin can end well. We will see.

Also interesting were questions about just where control of the ADHA lies and who makes up all this stuff. The answer - like many others - seemed pretty waffly and vague.

As a colleague just said, with a Labor Government a racing certainty to win the next general election, I would reckon the ADHA should change leader and develop the capacity to listen real fast now to even survive.  What do others think?

David.