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, January 07, 2019

Weekly Australian Health IT Links – 7th January, 2019.

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

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Another quiet week as we all adjusted to more holidays or a quick return to work….nevertheless the #myHealthRecord continued to make news for all the wrong reasons.
Things will soon start to heat up as we approach the opt-out deadline – which is not a deadline any more as you can have your data deleted at any time – or can you – rumours it may not actually work. Anyone know more……?????
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Wrong medical details entered into My Health Record

Sue Dunlevy, National Health Reporter, News Corp Australia Network
December 30, 2018 9:10pm
Subscriber only
Exclusive: Seventeen people had another individual’s private medical details entered onto in their online My Health Record in a serious glitch that highlights key risks with the controversial $2 billion system.
The inaccurate information could have potentially led to an adverse health outcome if doctors relied on it.
In another stuff up, a child had an incorrect parent or guardian assigned to their My Health Record, the Australian Digital Health Agency has revealed in its annual report.
The records of two people were viewed by fraudsters and suspected fraudulent information was entered into the records of another 22 people.
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Glitches in Qld’s $600m electronic medical records system

Janelle Miles, The Courier-Mail
December 31, 2018 1:00am
Subscriber only
QUEENSLAND Health’s $600 million electronic medical record system rollout continues to be plagued with problems, placing patient safety at risk, frustrated doctors say.
Documents obtained by The Courier-Mail reveal medication errors and test results failing to register in the system are among a litany of complaints.
The incidents include cases of drugs not being administered to patients or incorrect doses being given.
Some medical specialists also complain the process for ordering blood tests is error-prone.
Their concerns are at odds with Queensland Health bureaucrats, who insist patient safety has markedly improved under the integrated electronic medical record, or ieMR, citing a notable reduction in medication mistakes.
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Howard govt feared slow Y2K bug preparations, cabinet documents reveal

By Doug Dingwall
1 January 2019 — 10:26am
Predictions of a chaotic IT collapse brought on by the Y2K bug had the Howard government fearing Australia was unready for the worst, previously classified documents reveal.
As the year 2000 approached, the federal government in 1997 took seriously the warnings that the new millennium's arrival could play havoc with electricity, hospitals and traffic lights.
The "millennium bug", cast by some as a looming apocalypse, brought on hundreds of billions in estimated spending worldwide to avoid catastrophe.
Cabinet documents from 1996-1997, released on Tuesday by the National Archives of Australia, show the federal government feared inaction could expose emergency services, telecommunications and navigation equipment to failure.
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Greg Hunt warns pharmacists and doctors on medicine information

By Dana McCauley
1 January 2019 — 5:15pm
Federal Health Minister Greg Hunt will write to pharmacists and doctors to remind them of their responsibilities, after consumer advocates raised concerns that patients were not being given vital information about medicine interactions and side effects.
The Consumers Health Forum of Australia called on Mr Hunt to step in after receiving complaints that patients were not always being given consumer medicine information documents (CMIs), which pharmaceutical companies are required by law to make available.
In the past CMIs were provided as a leaflet inside prescription medicine boxes but most products now direct patients to read the information online, leaving it to doctors or pharmacists to print off the documents for patients starting new medications.
But consumer advocates say this makes the information inaccessible to many, particularly if busy GPs and pharmacists fail to provide the documents – which experts say are far too difficult to read and understand.
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Qld pharmacy changes could force rural GPs to close

Janelle Miles, The Courier-Mail
January 5, 2019 6:16am
GENERAL practices in rural and remote parts of Queensland risk being forced to close if the State Government accepts a controversial proposal to allow pharmacists to dispense some medications without a prescription, doctors say.
Australian Medical Association Queensland president Dilip Dhupelia yesterday repeated warnings that lives could also be in danger under recommendations to give pharmacists more power, particularly if “live” travel vaccines are given to patients with weakened immune systems.
But the Pharmacy Guild of Australia’s Queensland branch described the concerns as “sensationalist propaganda”.
Dr Dhupelia said Queensland’s rural and remote general practices were already struggling to remain viable on the back of a five-year Medicare Benefits Schedule freeze and the drought. He said creating more competition from local pharmacists would “make them even more marginal”.
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‘Brain pacemaker’ has epilepsy and Parkinson’s in its sights

  • By Chris Smyth
  • The Times
  • 12:00AM January 2, 2019
A “pacemaker for the brain” that could help treat epilepsy and ­Parkinson’s is being developed by scientists.
The implant listens to brain waves and responds to emerging seizures with personalised electrical stimulation, which experts hope could cut attacks and ­improve patients’ lives.
The device has not yet been tested on humans and will need to prove itself in several rounds of trials before being considered for patients.
Tests on macaques have shown that the device could detect when they were preparing to move a joystick and it could ­deliver electrical signals that ­delayed the movement.
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What are the digital healthcare predictions for 2019 (part 2)?

Dr Charlotte Middleton | 31 Dec 2018
MedicalDirector CEO Matthew Bardsley recently shared his top digital healthcare predictions for medical professionals, going into 2019.
From a practitioner’s point of view, here are my insights into the digital healthcare trends that will impact the patient experience – in particular, integrations between the patient’s wellness and health, and the digital devices in their lives.
Virtual care and the future of health
Virtual care and its counterpart, telehealth, will see the delivery of health-related services and information in a space removed from the four walls of a consulting room in 2019. Tapping into technology, virtual care is set to become a core component of a more patient-centric care system, which puts personalised needs above the restrictions imposed by the typical doctor-patient interaction.
Forrester recently named virtual care as a crucial part of patient acquisition and retention, as it is poised to disrupt outpatient visit and chronic disease management. 
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What’s next in hi-tech

  • 12:00AM January 3, 2019
The biggest annual technology event on the planet is poised to reveal how 5G devices will change our lives this year.
The Consumer Electronics Show in Las Vegas next week will include 4500 exhibiting companies and more than 250 conference sessions. About 180,000 tech-minded businesspeople, journalists and market analysts from 150 countries will attend in halls taking up more than 230,000sq m.
The CES focuses on the technology to be introduced around the world in the coming year.
This year, 5G is expected to dominate. We’ll not only see an array of early 5G dev­ices such as 5G-enabled phones and modems, but also new 5G-connected self-driving cars, medical devices, and virtual reality and augmented reality experiences.
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Bones can talk: DNA expert urges national ID centre

  • 12:00AM January 4, 2019
Joyce Baxter went missing in Hobart in 1955. Boys playing on a track on Mount Wellington in 1972 found a skull and some bones.
But a coroner was able to definitively declare Baxter dead only last year after DNA from the stored human remains was compared to a DNA reference sample from her daughter.
NSW forensic DNA specialist Jodie Ward says solving Tasmania’s oldest missing person case raises hopes of a breakthrough in some of Australia’s 2600 other long-term missing person cases.
 “What astounds me is that many of the families with long-term missing loved ones have never donated DNA reference samples,” Dr Ward told The Australian yesterday.
“I would hope in this day and age the families do have awareness of the importance of DNA testing, but I don’t think many do.”
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Australian of the Year: Asylum-seeker a world leader in robotic surgery

  • By Jessica Cortis
  • 12:00AM January 5, 2019
Munjed Al Muderis, who fled Saddam Hussein’s oppressive ­regime in Iraq to become one of Australia’s foremost orthopaedic surgeons, has been nominated for this newspaper’s Australian of the Year award.
“It’s always an honour to be nominated for an award and I do what I do because it is the right thing — life is too short so we have to leave something behind,” he said.
Dr Al Muderis, who specialises in hip, knee, trauma and osseo­integration surgery, spent the holiday period at the operating table giving treatment to 86 soldiers and civilians in Iraq between Christmas and new year.
“They were very complex cases, including blast injuries from bombs, amputees, and significant congenital deformities in children,” he said.
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Who is serving whom?

What are we going to do with the data once we have collected it? Often, when I ask this question, the answer is vague.
In the race for big data the purpose has sometimes been forgotten. It’s like doing research without formulating a question first.
I wonder who is serving whom: Are IT systems supporting health providers or are we increasingly following rigid templates and blindly harvesting information for reasons we often don’t even understand?
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How will we teach the robots to behave themselves?

By Simon Longstaff
04 Jan 2019 — 11:45 PM
The era of artificial intelligence (AI) is upon us. On one hand it is heralded as the technology that will reshape society, making many of our occupations redundant. On the other, it's talked about as the solution that will unlock an unfathomable level of processing efficiency, giving rise to widespread societal benefits and enhanced intellectual opportunity for our workforce.
Either way, one thing is clear – AI has an ability to deliver insights and knowledge at a velocity that would be impossible for humans to match and it's altering the fabric of our societies.
The impact that comes with this wave of change is remarkable. For example, IBM Watson has been used for early detection of melanoma, something very close to home considering Australians and New Zealanders have the highest rates of skin cancer in the world. Watson's diagnostic capacity exceeds that of most (if not all) human doctors.
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How Labor and Telstra's NBN ambitions might merge

By Stephen Bartholomeusz
2 January 2019 — 12:31pm
The future shape of the telecommunications sector is probably going to be determined by the progress Telstra makes this year on its "T22" strategy and the big decisions confronting Labor if, as appears probable, it wins government at the federal election.
The two issues overlap. A key element of the T22 plan is to separate all Telstra infrastructure other than its wireless network – including all of its national broadband network revenues and relationships – within a new Telstra InfraCo.
Telstra has made no secret of its ambitions for that entity. It is positioning it so that it can offer the government a solution to the problem of the ugly economics of the NBN.
As its chairman, John Mullen has said, NBN Co pays Telstra about $1 billion a year for access to its ducts, pits, exchanges, fibre loops and copper and will continue doing so until at least 2046.
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SingTel tech chief cuts through the 5G hype

01 Jan 2019 — 11:00 PM
Talk to Mark Chong, the group chief technology officer at Singapore Telecommunications, and you would be forgiven for thinking the super fast mobile technology called 5G is a little over hyped.
The hype has been building thanks to Telstra's enthusiastic support for making the technology the centrepiece of its 2022 transformation plan.
In some ways 5G is perfect for a bout of irrational exuberance in 2019. After all, it has all of the things that got people excited about technology in 2018 such as internet of things, artificial intelligence and smart cities.
It's a technology that comes with plenty of impressive jargon such as "network slicing" and it has the requisite amount of mind-boggling numbers. For example, did you know that today's 4G network can handle about 10,000 devices per square kilometre while 5G can handle 1 million devices in the same area?
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Telstra chief Andy Penn’s moment of truth

  • 12:00AM January 5, 2019
On the evening of Wednesday, June 20 last year, Andy Penn chose the solitude of his holiday home at Red Hill on Victoria’s Mornington Peninsula to reflect upon the biggest decision of his corporate career: to sack one quarter of his workforce.
After a day of media commitments announcing the plans, the Telstra chief executive took up his seat at the pointy end of the plane on the 4pm Qantas flight from Sydney. An hour-and-a-half minutes later he was met by his driver at Melbourne Airport.
By 730pm, as the chill of a Victorian winter’s evening descended, he was sitting alone outside at what is normally his weekend sanctuary, cradling a class of his favourite Mornington Peninsula Chardonnay.
 “I went down there, I can picture it now, I went down on to my deck and sat there with a glass of wine. Our place is very very quiet,’’ Penn now recalls.
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5G is coming to Australia. Here's what you need to know

By Don Clark
Updated 02 Jan 2019 — 9:13 AM, first published at 9:01 AM
In 2019, a big technology shift will finally begin. It's a once-in-a-decade upgrade to our wireless systems that will start reaching mobile phone users in a matter of months.
But this is not just about faster smartphones. The transition to new fifth-generation cellular networks, known as 5G for short, will also affect many other kinds of devices, including industrial robots, security cameras, drones and cars that send traffic data to one another.
This new era will leap ahead of current wireless technology, known as 4G, by offering mobile internet speeds that will let people download entire films within seconds and most likely bring big changes to video games, sports and shopping.
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NBN upgrade necessary and likely with Labor government

By James Fernyhough
01 Jan 2019 — 11:00 PM
A Shorten Labor government has been tipped to initiate an overhaul of National Broadband Network policy within months or even weeks of a federal election, opting for a more comprehensive fibre-optic cable network than the Coalition's controversial "multi-technology mix".
Although a return to full fibre to the premises is unlikely, experts predict Labor, should it win the election this year, would scrap the Coalition's controversial fibre-to-the-node policy and replace it with "fibre to the curb". This would mean running fibre-optic cable down a residential street to a pit outside the premises, rather than simply to the nearest node cabinet, which on average is about 400 metres away from homes.
"An incoming Labor government would gain access to the inner workings of NBN Co, and over a period of weeks or a few months learn about the current contracts, future commitments, finances and rollout progress," said Mark Gregory, telecommunications expert and associate professor in network engineering at RMIT.
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NASA rings in new year with historic flyby of faraway Ultima Thule

  • AFP
  • 12:00AM January 2, 2019
NASA conducted a fly-by of the farthest, and possibly the oldest, cosmic body explored by humankind — a tiny, distant world called Ultima Thule — in the hopes of learning more about how planets took shape.
“Go New Horizons!” said lead scientist Alan Stern as a crowd including children blew party horns and cheered at the Johns Hopkins Applied Physics Laboratory in Maryland to mark the moment at 12:33am (3.33pm AEDT) when the New Horizons spacecraft aimed its cameras at the space rock 6.4 billion kilometres away in a dark and frigid region of space known as the Kuiper Belt.
Offering scientists the first up-close look at an ancient building block of planets, the fly-by took place about 1.6 billion kilometres beyond Pluto, which was until now the most faraway world visited up close by a spacecraft.
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Chinese moon landing is first step to military muscle in space

By Sarah Knapton & Gordon Rayner
4 January 2019 — 7:00pm
London: The Chinese moon landing shows the emerging superpower is a growing threat to Britain and the world, say military experts and  British government sources.
The China National Space Administration on Thursday confirmed  touchdown on the dark side of the moon – the first time any nation has achieved the feat – and transmitted the first close-range image from its surface.
Such a landing is tricky because one side of the moon always points towards Earth making it impossible to communicate directly from the "dark" half. The Chinese needed to launch a separate satellite to relay signals back to mission control.
While Beijing claimed the landing "opened a new chapter in human lunar exploration", British government sources and experts warned the achievement placed China in a strong position to establish the first manned lunar base and a dominant military position in space.
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Enjoy!
David.

Sunday, January 06, 2019

Another Reason (Or Two) Why The #myHealthRecord Is A Solution Looking For A Problem.

This appeared a day or so ago:
January 4, 2019 / 4:38 AM / a day ago

Most U.S. patients not using online medical portals

 (Reuters Health) - Most people in the U.S. with health insurance don’t use the patient portals that are increasingly provided by doctors for online communication, a new study suggests.
In a nationally representative survey, researchers found that nearly two-thirds of insured participants had not used an online medical portal in the past year.
Disparities among those who said they’d been offered portal use, and among those who chose to use it, suggest this technology can become a source of unequal access to healthcare, the study team writes in Health Affairs.
“Previous research has shown there are real benefits to portal use. Patients become more engaged in their own health and really stick to their treatments,” said senior author Denise Anthony of the University of Michigan in Ann Arbor.
“However, new treatments in health care, and new technologies in general, can end up increasing inequality,” she told Reuters Health by email.
Anthony and her colleagues analyzed data on 2,325 insured patients who participated in the 2017 Health Information National Trends Survey and who had a medical visit during the year before the survey. The researchers wanted to understand the characteristics of portal users and nonusers and the reasons, such as technology issues or security concerns, why many patients don’t use online sites to access their medical records.
Overall, 63 percent of survey participants reported not using a patient portal during the past year, and 60 percent reported not having been offered access to a portal.
Nonusers were more likely to be men, aged 65 or older, to be unemployed, live in a rural location, have public insurance through Medicaid, have a high school diploma or less education and to lack a regular doctor. Similar characteristics, as well as being non-white, were seen among people who said they weren’t offered access to a patient portal.
People who were offered access to a portal and didn’t use it were more likely to have less than a college education, to be insured by Medicaid, to be 65 or older, live in a rural area and to be Hispanic.
Among the reasons participants gave for not using online portals, 25 percent mentioned issues with internet access, 32 percent said they had no online medical record, 70 percent said they preferred to speak directly to the doctor, and 22 percent were concerned about privacy issues.
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Here is the article link:
Here is the abstract from the paper cited:

Who Isn’t Using Patient Portals And Why? Evidence And Implications From A National Sample Of US Adults

PUBLISHED:  

Patient portals that provide secure online access to medical record information and provider communication can improve health care. Yet new technologies can exacerbate existing disparities. We analyzed information about 2,325 insured respondents to the nationally representative 2017 Health Information National Trends Survey to examine characteristics of portal nonusers and reasons for nonuse. Sixty-three percent reported not using a portal during the prior year. In multivariable analysis, we found that nonusers were more likely to be male, be on Medicaid, lack a regular provider, and have less than a college education, compared to users. Similar disparities existed in who reported being offered access to a portal, with nonwhites also less likely to report being offered access. Reasons for nonuse included the desire to speak directly to providers and privacy concerns, both of which require recognition of the important role of provider communication and patient-provider relationships.
Here is the abstract link:
This article is about the use of portals by patients who have at least some association with the portal provider and know, if and when they check, there will be information accessible that is likely to come directly from their carers and will be up-to-date and relevant to their care.
This is of course to be compared with the myHR portal which may, or may not, have any relevant information, may or may not be current and may or may not contain anything useful.
Again in this study the effects of education, health literacy, digital literacy, age and so it goes on. Sadly the ADHA seems to think that, when they suddenly give people a myHR they citizen will miraculously know how to both access and use it – which is clearly fantastical nonsense.
The bottom line is that few will bother with the myHR portal and those that do are likely to be overwhelmed by complexity and underwhelmed by the functionality and utility they are offered.
The public is simply not ready for delivery of health information digitally as pretty much the sole mode of access – and many probably never will be.
This really is not thought through about how the ADHA is going about its mandate of delivering Digital Health for all. There are going to be many left by the wayside I am sure – and that is just plain wrong.
David.

AusHealthIT Poll Number 456 – Results – 6th January, 2019.

Here are the results of the poll.

Do You Trust The Government To Use Personal Health Information They Hold On You (MBS, PBS Data etc.) Responsibly, Respectfully, Ethically And Securely?

Yes 9% (10)

No 91% (101)

I Have No Idea 0% (0)

Total votes: 111

What an amazing poll. A very large majority do not trust the government to do the right thing with their private health information.

Any insights on the poll welcome as a comment, as usual.

A really, great turnout of votes for the time of the year!

It must have been a very, very easy question as only 0/111 readers were not sure what the appropriate answer was.

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

David.

Saturday, January 05, 2019

Weekly Overseas Health IT Links – 05th January, 2019.

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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Patient experience: Where your hospital needs to be five years from now

Here’s a look at what experts are saying hospital business decision makers should be doing today to prepare for the future.
December 28, 2018 09:16 AM
Healthcare C-suites are very concerned with how patients experience their organizations and the care delivered within. The patient experience is a factor that has grown in importance over the years. And forward-looking provider organizations are branching out by doing such things as signing agreements with Uber and Lyft to transport patients to appointments.
A big question today is what should the patient experience look like tomorrow? And in five years? But to understand where the patient experience should go, healthcare C-suites need to know where the patient experience is right now, and how health IT can help. CIOs and similar executives have a lot to say on the subject.
Looking for new methods
Children’s Hospital of Alabama has systems in place for doing things like measuring patient satisfaction and reporting patient satisfaction and things that show follow-through, according to CIO Bob Sarnecki. From an IT perspective, the organization is trying to find ways besides just logging satisfaction.
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Why Cybersecurity Remains a Top C-Suite Concern

UPMC CISO John Houston Discusses Top Cyber Challenges for 2019
December 26, 2018
Healthcare C-suite executives shouldn't have to worry about cybersecurity, contends John Houston, CISO and chief privacy officer at Pittsburgh-based integrated health delivery network UPMC. Nevertheless, for the second year in a row, cybersecurity was named the top priority for senior executives in a survey of 40 U.S. health systems.
The study was conducted by the Health Management Academy and the Center for Connected Medicine, which is jointly operated by UPMC, GE Healthcare and Nokia.
Among those surveyed for the Top of Mind for Top Health Systems in 2019 study were CIOs, chief medical informatics officers, chief nursing informatics officers as well as CEOs and chief operating officers.
"It's troubling that cybersecurity remains a high priority for those individuals," Houston says in an interview with Information Security Media Group. "It's also sad because those individuals shouldn't be worried about cybersecurity. They should be worried about things like improving quality of care and [patient] outcomes.
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SRTI, WebMD team on study to better understand pregnancy health

Published December 28 2018, 7:10am EST
The Scripps Research Translational Institute has partnered with WebMD on a smartphone-based platform to recruit pregnant women to participate in a study aimed at better understanding pregnancy.
The study’s platform—built on Apple’s ResearchKit framework—has been embedded into the WebMD Pregnancy App, which offers physician-approved content and tools. The goal is to recruit a large and diverse population of pregnant women to participate in the research that includes surveys and sensor-collected data measuring activity, blood pressure, heart rate, and sleep.
“We’re looking at many different factors during pregnancy and being better able to understand what’s normal during pregnancy, and to provide women with more individualized feedback and information about what is typical for women with their individual characteristics,” says Jennifer Radin, an epidemiologist and digital medicine expert at SRTI. “We’re hoping this will be a multi-decade research project.”
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HIT Think 7 best practices for combating cybersecurity risks

Published December 28 2018, 5:13pm EST
In 2018 alone there have been more than 600 cybersecurity data breaches, exposing more than 22 million records, with no clear end in sight.
Despite the massive number of breaches, Deloitte recently found that only 25 percent of organizations are scenario planning to defend against these attacks. With consumer and employee displeasure with corporate leaders only continuing to grow and calls for regulation coming from elected officials, it is crucial that leaders begin to regulate themselves by prioritizing cybersecurity to make their business stronger.
As we approach the end of the year and move forward into a year with new cyber risks, here are seven tips to avoid and combat cybersecurity risks.
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Doctors are asking Silicon Valley engineers to spend more time in the hospital before building apps

Published Fri, Dec 28 2018 • 9:38 AM EST | Updated Fri, Dec 28 2018 • 12:43 PM EST





Key Points
  • Richard Zane, an emergency room physician, developed a program so that engineers can understand the clinician’s workflow before they build their products
  • RxRevu is one start-up that shadows Zane on the job.
  • In the Bay Area, it’s become common for doctors to invite technologists from Google and elsewhere to follow them on the job.
As an emergency room physician, Richard Zane often considers how software can help him with patients. The problem is that engineers and doctors are from different worlds.
Zane, who’s also the chief innovation officer at UCHealth in Colorado, said that most technologists he’s met have never seen the inner workings of a hospital and don’t have a deep understanding of what doctors want and need.
“We found that tech companies more often than not had a preconceived notion of how health care worked,” Zane told CNBC. They’ve “gone very far down the path of building a product” without that input, he said.
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How a government shutdown affects America’s cybersecurity workforce

America’s federal cybersecurity workforce will see sharp reductions if Congress fails to pass a spending bill to keep the government open, according to planning documents from federal agencies.
If a new budget is not signed by midnight Dec. 21, roughly 800,000 federal government workers will be affected by a shutdown, according to the White House.
Among the heaviest hit agencies would be the National Institute of Standards and Technology, which would have 85 percent of its staff furloughed. Only 435 employees are considered “essential,” according to a planning document from the Department of Commerce.
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InterSystems exec on distributed, data-intensive, rapidly changing world of health IT

The health IT vendor is also concentrating on AI and FHIR heading into HIMSS19.
December 26, 2018 09:16 AM
There are three primary factors driving health IT today: It is distributed, it is information-intensive, and it is changing rapidly, said Kathleen Aller, director of market strategy for healthcare at InterSystems.
The vendor will be focusing on these and other health IT trends, including FHIR and AI, at HIMSS19 in February in Orlando.
“The distributed nature of it means that patients are seeking care from all points of the healthcare ecosystem, and the data from these points of care – social, outpatient, inpatient, specialty clinics, etc. – have to be aggregated into a unified patient record,” Aller explained.
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A C-suite guide to telemedicine

NewYork-Presbyterian, UPMC and Thibodaux executives discuss the advantages and imperatives of creating wide-ranging telehealth programs.
December 27, 2018 09:02 AM
Telemedicine is much more than two video cameras, two screens, a doctor and a patient. Telemedicine is a major change in the way healthcare is delivered, and an opportunity for healthcare provider organizations to expand the geography and range of patients they serve.
From the business point of view, there are a variety of things a hospital or health system C-suite should be prepared for when it comes to launching and maintaining telemedicine programs.
We interviewed top telehealth leaders at NewYork-Presbyterian, UPMC and Thibodaux Regional Medical Center about how they have instituted successful telemedicine tools and programs, what works well, and other considerations for healthcare business decision makers.
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Stanford sees healthcare democratization a big trend for 2019 and beyond

A new report from the university says intelligent computing and data sharing advances spurred by companies such as Apple are reshaping old ways of doing business.
December 27, 2018 10:50 AM
With the extreme proliferation of data comes the opportunity to further democratize healthcare, according to Stanford University School of Medicine's 2018 Health Trends Report.
The university found that the influx of data was taking healthcare by storm and that technologies that were old hat in other industries  are still in their infancy in the healthcare. The barriers to this data are falling fast, however, and the report identifies three main trends in technology that are driving remarkable change in how physicians, researchers and patients all share information.
Intelligent computing. Physicians will be able to use new computing power to develop tailored treatment plans based on the complex interplay of health data that is a patient. Greater insight into patient data, along with being able to utilize a much wider range of trial-based information gathered and presented by intelligent computing could help reduce healthcare spending by billions in only a manner of years.
Data sharing. The report notes that "democratization necessitates openness," and that all of the computing and insights in the world will not amount to much unless the data is shared between all stakeholders. Interoperability is still a great challenge but technologies like APIs, which standardize how applications communicate with one another, promise to help improve the exchange of data. Much of this is being driven by companies new to healthcare, like Lyft or Apple.
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HIT Think Three key trends that will change cybersecurity strategies in 2019

Published December 27 2018, 2:59pm EST
Look back at 2018 and you’ll see how turbulent of a year it was for the security industry. Unprecedented data breaches from the likes of Facebook and Marriott, among many more, prove that organizations and security professionals must do a better job at proactively protecting sensitive information.
In 2018 we also saw governments step in and enforce new security regulations to protect consumers. It’s safe to say security policies and reporting will both undergo major updates over the next 1-2 years. And as security infrastructures evolve as a result, it is certain that new attack vectors and vulnerabilities will emerge, and security teams will need to be able to identify and prioritize the mitigation actions needed to prevent more breaches of this scale.
As we approach 2019, here are three major shifts that security teams and organizations alike can expect.
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Chuck Norris laments serious problems for patients: physician burnout

Notes doctors seldom have time to address health-behavior links due to job stress
22 December, 2018
Last month, I reported on vitamin and mineral supplements that roughly half of all Americans routinely take and are said to make up 5 percent of all grocery sales in the United States. When faced with more than 90,000 dietary supplement products for sale, it is important to choose your sources carefully and with expert help.
Commercially available vitamins, minerals and herbs are all lumped together as supplements and are not regulated by the Food and Drug Administration. You can be assured of a product’s dosage, the correctness of its ingredients and that it does not contain toxins or contaminating organisms if the label shows it is certified as tested by independent labs such as U.S. Pharmacopeia, Consumer Lab or NSF International. Such certification will be visible on the product’s label.
I also tried to make clear that our bodies prefer naturally occurring sources of vitamins and minerals. Studies consistently show that people who eat diets rich in fruits, vegetables, nuts, whole grains and fish consume high levels of vitamins and minerals from them. As a result, they have a lower risk of many diseases, including heart disease, stroke, diabetes and cancer.
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3 ways AI will improve healthcare in 2019

by John Stevens — 22 December, 2018 in Contributors
In a recent piece, I explained why AI’s complexity shouldn’t be a deterrent for its adoption. In fact, I went as far as stating that artificial intelligence will be just as disruptive as the internet was. This is a view I am doubling down on.
As far as artificial intelligence is concerned, one industry most likely to be most disrupted is the healthcare industry. Why will AI have such an impact on the healthcare industry? Facts like the ones below are why:
  • Hospital error — which can be significantly addressed and prevented by AI — is the third leading cause of patient death
  • Depending on what source you pay attention to, up to 440,000 Americans die annually from preventable medical errors
  • According to data from the National Safety Council, 2016 was the deadliest year on American roads in a decade — with 40,000 deaths. This means preventable hospital deaths due to hospital error are 11 times the number of road accidents in the United States
  • 86 percent of mistakes in the healthcare industry are purely administrative and preventable
  • Effective application of AI is projected to result in annual savings of $150 billion in the US healthcare industry
  • The AI health market is projected to grow more than 10 times within the next five years
When we look at both the physical and economic implications, the healthcare industry is one industry that is very much in need of an artificial intelligence disruption. That said, there are certain key healthcare AI trends to pay attention to in 2019:
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Five innovation trends that will impact the healthcare industry in 2019

The behavioral health epidemic, artificial intelligence and more procedures being done in outpatient settings are some the key 2019 trends that will determine how decision makers purchase technology.

Dec 25, 2018 at 2:00 PM
What role will technology play in the healthcare industry in the next year?
For venture capitalists and others with interests in the healthcare industry, being able to anticipate industry innovations is critical. However, it isn’t enough to simply study emerging technology.
While understanding current innovations is important, we also need to study the underlying challenges they aim to solve. A solid grasp of how care delivery is changing provides deeper insights into how new technologies can advance care or resolve real industry problems.
To help you navigate the next year of healthcare changes, here are five health innovation trends that will impact the industry in 2019 and how you can prepare for them:
Behavioral Health Epidemic
There is little denying that the United States is in the throes of a serious opioid epidemic. Currently, over 130 people die each day from opioid-related drug overdoses. A full 80 percent of heroin users report misusing prescription opioids prior to moving on to using heroin.
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Med school platform puts knowledge in computable format

Published December 26 2018, 7:43am EST
Health information technology is enabling healthcare organizations to analyze the data they generate during the process of taking care of patients to create new “local” evidence to improve outcomes.
Combining this locally generated evidence with evidence from peer-reviewed medical literature is critical to creating a learning health system that can continuously study and improve itself while rapidly integrating this knowledge into best practice models, moving research out of journals and into the clinical environment.
So says Charles Friedman, chair of the University of Michigan Medical School’s Department of Learning Health Sciences and the Josiah Macy Jr. Professor of Medical Education.
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Providers turning to health IT to combat the opioid crisis

Published December 26 2018, 7:49am EST
Providers have begun to harness technology to improve their management of opioids and avoid misuse.
It’s not a moment too soon. The Centers for Disease Control and Prevention’s most recent reports, released in November, confirm that the opioid crisis is worsening. The number of drug overdose deaths in the United states in 2017 was 9.6 percent higher than in 2016. The rate of drug overdose deaths involving natural and semisynthetic opioids like oxycodone and hydrocodone has risen steadily since 1999. The rate of drug overdose deaths involving synthetic opioids such as fentanyl, which individuals frequently turn to when they can no longer obtain prescribed opioids, increased 45 percent between 2016 and 2017.
One of the key components to reversing these trends is to keep people from becoming addicted in the first place, says Jim Turnbull, CIO of University of Utah Health and Co-chair of the College of Healthcare Information Management Executives (CHIME) Opioid Task Force. Providers are uniquely positioned to address this problem because they are the ones prescribing the drugs.
“We want to make sure we’re not contributing to addiction. We don’t want to be the source of people getting addicted,” Turnbull adds.
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Enthusiasm for AI is outpacing adoption, study finds

Published December 26 2018, 4:50pm EST
Artificial intelligence and machine learning have become essential for organizations to stay competitive. But adoption is lagging, even among key decision-makers championing change.
That is the finding of a new survey by the RELX Group, a global provider of information and analytics. The company surveyed 1,000 U.S.-based senior executives across government, healthcare, insurance, legal, science/medical and banking in September, and the research found that 88 percent agree that AI and machine learning will help their organizations be more competitive.
While the value of the technologies is clear to executives, only 56 percent of organizations use machine learning or AI. In addition, only 18 percent of those surveyed plan to increase investment in these technologies.
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A retrospective look at the work of HIMSS Communities in Europe in 2018

European HIMSS Communities collaborate to advance the development of a digital health ecosystem.
December 26, 2018 07:19 AM
This is the time of the year when we take a moment to look back at the work of our HIMSS communities in Europe during the past 12 months and create new goals for the year to come. For a number of reasons, 2018 has made us proud and energized to make 2019 the best it can be. 

“Alone we can do so little; together we can do so much," Helen Keller

This quote encapsulates best the drive behind the work of our Nordic community. We started with small steps in March during the Nordic Workshop at HIMSS18, discussing ownership and use of data within national health systems. The more we deep-dived into the philosophical questions of who owns the data and what the greater good (or threat) would be from its use – the more we realised that we are hitting nails while trying to drive down the road.
The rhetoric shifted a few months later during the HIMSS Europe annual conference in Spain – from the ever-pressing “how” to “why” we need interoperability and what’s in for the patient. We “brought to life” patient Julie and Julie’s story of shuffling between Nordic countries all while trying to live a normal life as a young student diagnosed with diabetes Type 1. By looking into how we can help Julie and her condition, a momentum for the Nordics to step up as a region in view of EU Strategy for a Pan-European exchange of health data came to the surface. 
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5 blockchain developments in 2018

Amazon, Change Healthcare and Walmart all made moves worth watching as we head into 2019.
December 26, 2018 11:44 AM
Blockchain moved from mostly hype in 2017 to early technological developments, proofs-of-concept and pilot projects during the last 12 months.  
Deloitte, in a late summer report, predicted a breakout moment for the distributed ledger technology is approaching as almost 75 percent of research respondents see a compelling business case for DLT.  
So it’s no surprise that major tech vendors are embracing Blockchain. Here are five such moves made in 2018.
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Clock is Ticking on Watch that Could Predict Illness

By Mandy Roth  |   December 21, 2018

HHS awards research funds to help Israeli company further develop technology; more funding opportunities are available.

Wristwatches for telling time are so old school. Devices adorning tomorrow's wrists might alert those wearing them that they've been exposed to a pathogen, they're contagious, and the clock is ticking before they begin feeling sick.
Biobeat Technologies of Israel aims to do just that, and a division of the U.S. Department of Health and Human Services (HHS) is betting the company can, investing nearly $600,000 to further develop Biobeat's existing technology. If perfected, such a device could play a role in health systems' chronic disease management programs, readmission prevention efforts, or population health initiatives by delivering care and medications soon after an individual's exposure to reduce the impact of illnesses. 

Watching for Signs of Illness
 

The project will employ Biobeat’s wrist watch, an FDA-cleared monitoring device that continuously measures blood pressure, heart rate, heart rate variability, oxygen saturation, respiratory rate, stroke volume, cardiac output and index, systemic vascular resistance, sweat, skin temperature, and more. The new funding will be used to further develop its technology to track bodily changes that signal the user potentially has been exposed to an influenza virus or other pathogen.
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New Healthcare Trends in 2019

Indian Healthcare sector is evolving rapidly after the introduction of new age technologies. The time has gone when the healthcare industry was just based on doctor and patient interaction and has now reached at the real time engagement without any geographical limitation, writes Kunal Kishore Dhawan, CEO, Navia Life Care, for Elets News Network (ENN).
With advances in technology in the healthcare industry, public is becoming more aware and smart to lead a healthy life. The consciousness of people especially for their health is resulting in the acceptance of more efficient and innovative systems along with hospitals and other healthcare service providers. With the continuous adoption of new age technologies, the healthcare industry is going through a major transformation and likely to move towards “Value-Based Care”.
In the upcoming year, there will be a huge impact on healthcare sector with two of the most talked about technologies – Artificial Intelligence (AI) and Blockchain.
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3D-printed electronic pill can wirelessly dispense medicine from inside stomach

A customizable electronic pill capable of delivering medication via wireless commands from inside the body has been developed by researchers at MIT, Draper, and Brigham and Women’s Hospital, all in Massachusetts. As described in a paper published in the December 13, 2018 issue of Advanced Materials Technologies, this ingestible device could provide a system of monitoring and treating medical conditions typically requiring injections or strict dosing regiments such as HIV and malaria. Early signs of disease or adverse reaction could be also detected with onboard sensors in at-risk patients, such as those receiving chemotherapy or immunosuppressants, and medicine dispensed accordingly. Tests of similar devices have begun using pigs, and the researchers estimate human trials to start in about two years.
The electronic pill is a Y-shaped compartmented device whose legs have been folded into a smooth capsule that dissolves once swallowed. After the legs unfold again, it lodges into the stomach where it remains for approximately one month before being broken down and fully digested. The scientists in the study anticipate that the pill’s compartments could be designed to be opened using low-energy wireless communication technology such as Bluetooth to release specified amounts of medication. Further, sensors in the pill could connect to other wearable devices, creating an all-in-one communication tool and treatment system connecting the patient’s health data to theirs or their doctor’s smartphone.
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Innovation in Healthcare Technology Changing the Game

Panelists at the recent RealShare Healthcare conference agree that new tech advances will create efficiency but will not take away from the real estate.

By Natalie Dolce | December 20, 2018 at 05:00 AM
SCOTTSDALE, AZ—Innovation in healthcare technology has changed the rules of the game for hospitals and healthcare centers. It has and continues to do so. As in other industries, healthcare will be disrupted by advancements in technology like telemedicine and virtualized care programs, which are already rising in popularity with patients. But how will it impact brick-and-mortar space?
Panelists at the recent RealShare Healthcare conference here in Scottsdale, AZ, said that telemedicine will not replace the need for office visits. “I will not take away from the real estate,” panelists said.
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Vendors team to try to reduce patient data snooping

Published December 21 2018, 3:18pm EST
Two health IT vendors are developing a service to enable providers to establish and maintain an effective privacy monitoring program.
CynergisTek is a cybersecurity and information management consultancy with expertise in the optimization of privacy programs and its partner, Protenus, offers technology to monitor health professionals’ behaviors using analytical and artificial intelligence technologies.
Key to their efforts are enabling providers to better monitor their staffs.
Most healthcare providers, staffers and other persons who have access to medical records strive to protect the privacy of patients, but there are those who will go snooping in a record they should not be accessing or are in a location that is inappropriate for the work they are supposed to be doing.
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6 key areas that will separate the AI leaders from laggards

Published December 24 2018, 1:42pm EST
What’s on the horizon for artificial intelligence in 2019? There are certainly of theories floating about, but consulting firm PwC predicts that organizations that focus on six key areas will become AI leaders.
Here are the areas companies need to focus on in 2019 to be ahead of the competition when it comes to AI, according to the firm:
Organize for return on investment (ROI) and momentum
Pressure will increase to scale up AI in 2019 to enhance decision-making and provide forward-looking intelligence for users in every department and function. Having the right AI governance model enables companies to develop use cases that create quick wins.
Teach AI citizens and specialists to work together
AI is being democratized, but is still so complex that even trained business specialists can make mistakes. Organizations need to develop the right mix of citizen users, citizen developers, and data scientists, and give them the tools, training, and incentives to help them work collaboratively.
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HIT Think AL and ML choices can dramatically improve data security

Published December 24 2018, 1:47pm EST
As networks have advanced in complexity, so have the tools and tactics of cybercriminals. Organizations increase their cybersecurity budgets and teams, yet breaches keep occurring. In the fight for stronger security, vendors are offering up AI and machine learning as a Holy Grail. But do these technologies actually deliver?
Frequent headlines make it clear that cybercriminals are currently are winning battles regularly. A successful intrusion attempt need only find a single flaw in an enterprise defense, while security teams are dealing with the increasing complexity of more instrumentation, tools, data and alerts that add to the attack surface.
The increased attack surface just increases alert fatigue and distracting noise, leaving organizations looking for a better solution. Vendors tout AI and machine learning as that better solution, but the reality is that they could actually exacerbate the existing problems and perpetuate the disadvantaged posture of security teams today.
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How Intermountain Saved $1.2M With Neonatal Telehealth Program

By Christopher Cheney  |   December 21, 2018

Avoiding air medical transfers of newborns from community hospitals to tertiary hospitals saves an average of $18,000 per flight.


KEY TAKEAWAYS

Ten percent of newborns require breathing assistance and 1% need resuscitation.
Intermountain Healthcare's neonatal telehealth service enables participating community hospitals to avoid transferring some critically ill newborns.
Averting transfers cuts costs and avoids clinical risks such as handoff communication errors.
Intermountain Healthcare's neonatal telehealth service has improved quality of care at community hospitals and reduced risky transfers of critically ill newborns, recent research published in Health Affairs shows.
Earlier studies have shown that 10% of newborns require breathing assistance, and 1% need resuscitation. Although hospital-based clinicians who care for newborns attend biannual newborn resuscitation programs, researchers have found key skills decline within months of course attendance.
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Original Investigation
Health Policy
December 21, 2018

Feasibility of Reidentifying Individuals in Large National Physical Activity Data Sets From Which Protected Health Information Has Been Removed With Use of Machine Learning

Author Affiliations Article Information
JAMA Netw Open. 2018;1(8):e186040. doi:10.1001/jamanetworkopen.2018.6040
Key Points
Question  Is it possible to reidentify physical activity data that have had protected health information removed by using machine learning?
Findings  This cross-sectional study used national physical activity data from 14 451 individuals from the National Health and Nutrition Examination Surveys 2003-2004 and 2005-2006. Linear support vector machine and random forests reidentified the 20-minute-level physical activity data of approximately 80% of children and 95% of adults.
Meaning  The findings of this study suggest that current practices for deidentifying physical activity data are insufficient for privacy and that deidentification should aggregate the physical activity data of many people to ensure individuals’ privacy.
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Enjoy!
David.

Friday, January 04, 2019

Surely This Is Much Too Obvious To Be News In Late 2018 - Seems Not!

This appeared last week:

Doctors are asking Silicon Valley engineers to spend more time in the hospital before building apps

Published Fri, Dec 28 2018 • 9:38 AM EST | Updated Fri, Dec 28 2018 • 12:43 PM EST





Key Points
  • Richard Zane, an emergency room physician, developed a program so that engineers can understand the clinician’s workflow before they build their products
  • RxRevu is one start-up that shadows Zane on the job.
  • In the Bay Area, it’s become common for doctors to invite technologists from Google and elsewhere to follow them on the job.
As an emergency room physician, Richard Zane often considers how software can help him with patients. The problem is that engineers and doctors are from different worlds.
Zane, who’s also the chief innovation officer at UCHealth in Colorado, said that most technologists he’s met have never seen the inner workings of a hospital and don’t have a deep understanding of what doctors want and need.
“We found that tech companies more often than not had a preconceived notion of how health care worked,” Zane told CNBC. They’ve “gone very far down the path of building a product” without that input, he said.
Zane decided one way to bridge the gap was by inviting in developers from companies to see how he works. For now, that involves monitoring how he uses computers and other software tools to document and make decisions, but keeping them out of the operating environment and away from patient information.
However, “if there were a good reason to do it, like we wanted to build a surgical tool, we would ask patients for their consent,” Zane said.
Across the country, as more funding than ever pours into digital health, technologists are realizing that selling to doctors is more challenging than they expected. So spending time with clinicians by observing medical procedures and sitting in on consultations are some of the ways they’re getting up to speed.
Lots more here:
All I can say this seems to me to be about two decades late, but who’s counting.
Just amazing!
David.