This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
Good afternoon. Please see the attached signed decision letter in response
to your FOI request.
Regards,
Cecilia
FOI Officer
FOI Officer, FOI Team
Strategic Service Design and Delivery
Australian Digital Health Agency
Scarborough House, Level 6, 1 Atlantic Street, Woden ACT 2606
Phone [1]+61 22230780
Mobile [2]+61
Email [3][ADHA request email]
Web [4]www.digitalhealth.gov.au
The Australian Digital Health Agency acknowledges the traditional owners
of country throughout Australia, and their continuing connection to land,
sea and community. We pay our respects to them and their cultures, and to
Elders both past and present.
Important: This transmission is intended only for the use of the addressee
and may contain confidential or legally privileged information. If you are
not the intended recipient, you are notified that any use or dissemination
of this communication is strictly prohibited. If you receive this
transmission in error please notify the author immediately and delete all
copies of this transmission.
I have decided that document 1 contains material that is fully exempt from disclosure under section 47E of the FOI Act as set out in the attached schedule.
Sub section 47E(d) of the FOI Act concerns documents that may affect certain operations of agencies and it provides:
A document is conditionally exempt if its disclosure under this Act would, or could reasonably be expected to, do any of the following:
….
(d) have a substantial adverse effect on the proper and efficient conduct of the operations of an agency.
I note that paragraph 6.123 of the OAIC Guidelines state that any predicted substantial adverse effect must ‘bear on the agency’s proper and efficient operations, that is the agency is undertaking its expected activities in an expected manner’.
I have found that the Agency’s operations would be substantially affected if the information in the above document was disclosed. The information regarding the technical operation system for the deletion processes contained in this document is such that, if it were released, the Agency’s My Health Record (MHR) and ICT systems would be vulnerable to potential exploitation and other cyber security risks.
To divulge that level of technical information, would compromise the security and integrity of the MHR system. It would undermine the Agency’s ICT systems control, operations and processes for the management of the MHR and potentially weaken the Agency’s ICT capability into the future. Authors of operational information may limit the detail included in this material to reveal less about the system and the way it operates in case the information is made publicly available.
I am satisfied that the document identified above attracts the subsection 47E(d) exemption because the Agency’s operations would be compromised.
After determining that the documents are conditionally exempt in accordance with subsection 47E(d), I am required to consider the Public Interest test (section 11A(5)).
Public interest considerations
Disclosure of the deliberative material would facilitate the objects of the FOI Act, by providing the applicant with access to information held by the Commonwealth Government (the Government) and increasing scrutiny of the Government’s activities. However, I consider that release of this information could reasonably obstruct the future development of ICT operational systems from being honestly expressed and recorded. It is also of equal importance that a level of integrity and confidence is maintained for the continued free flow of ideas and that operational platforms are protected. It is important that officers are able to give full and uncensored consideration to opinions, advice and outcomes when engaging in operational functionalities. The ability and willingness of officers to thoroughly consider all options would be adversely affected if the document could then be disclosed to the public for debate and comment outside of official operational processes.
Therefore, it is reasonably foreseeable that allowing public access to documents concerning the operations of the Agency would undermine the functioning of the Agency, its ICT systems and its conduct in discharging Commonwealth business.
I consider that, on balance, the public interest factors against disclosure outweigh the factors for disclosure of the exempt material contained in the documents. Therefore, I have decided that it would be contrary to the public interest to release the information considered exempt under section 47E(d) of the FOI Act.
In accordance with section 11B(4) of the FOI Act, I have not taken any irrelevant factors into account when making my decision.
The bottom line here is, as Justin Warren who requested the stuff has pointed out (and big big thanks for the effort), that it is hard to see how a vulnerability could be introduced by knowing how the process worked and that it seems incredible there is only one document on the topic.
Surely the ADHA could have produced a 2 page technical document explaining how it worked with no compromise – but as usual they obfuscate.
Without details no-one would trust they actually do it! And saying if the public knows how things work would discourage discussion internally is bunkum
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.
Hancock calls for NHS clinicians to be able to email patients directly
Matt Hancock is calling for clinicians to be able to directly email information to patients in a bid to increase data security and reduce delays and wastage.
Hanna Crouch 15 February 2019
Speaking at NHS England’s ‘Empowering people in the digital world’ conference on 13 February, the secretary of state for health and social care argued emails are as secure and cheaper than communicating through paper and fax machines.
“There is no reason why a doctor cannot email a patient confidentially, for example with their test results or prescription, rather than make them wait days for a letter or ask them to come into the surgery. The rest of the world runs on email – and the NHS should too.”
Clinicians need better opioid data within their workflows, says EHRA
The HIMSS Electronic Health Record Association's Opioid Crisis Task Force has created what it calls "ideal minimum data set" to get physicians the right information to enable safer EPCS.
The HIMSS Electronic Health Record Association says it's working toward policies and procedures that will allow physicians better visibility for opioid data in the EHR.
"We were surprised to find that there was no comprehensive source for the state-specific policies and standards surrounding prescription drug monitoring programs and electronic prescribing of controlled substances," write David Bucciferro and Katelyn Fontaine of the task force in a blog post this week. "So, we set out to create our own."
WHY IT MATTERS
The EHR Association looked at state-by-state data to gain insights on an array of key factors: how long it took providers to report controlled substance prescriptions to prescription drug monitoring programs, what data is collected, who is able to access PDMP information, whether and when such data can be shared across states and how retention of that prescribing data might be limited within an EHR.
The new initiative is set to displace local drug disposal locations on Google Maps year-round.
The hope is that users can easily type in queries like "drug drop off near me" or "medication disposal near me" and Google Maps will automatically display where permanent disposal locations are nearby so people can quickly and safely discard of unneeded medication.
IBM Watson Health Teams Up with Hospitals for AI, EHR Research
IBM Watson Health is investing in new partnership that will focus on the intersection between artificial intelligence, EHR data, and the user experience.
February 20, 2019 - IBM Watson Health has announced a ten-year, $50 million investment in artificial intelligence (AI) research partnerships with Brigham and Women’s Hospital (BWH) and Vanderbilt University Medical Center (VUMC).
The two collaborations will explore how to use artificial intelligence to improve EHR usability, support precision medicine, bolster patient safety, and foster health equity across communities.
“Building on the MIT-IBM Watson Lab announced last year, this collaboration will include contributions from IBM Watson Health's longstanding commitment to scientific research and our belief that working together with the world's leading institutions is the fastest path to develop, advance, and understand practical solutions that solve some of the world's biggest health challenges,” said Kyu Rhee, MD, MPP, vice president and chief health officer at IBM Watson Health.
While artificial intelligencepromises to create actionable insights for clinicians to make better care decisions for patients, the regulations and standards for evaluating AI-based algorithms are lacking.
That’s the contention of Ravi Parikh, MD, a fellow in hematology and oncology at the University of Pennsylvania’s Perelman School of Medicine, and two colleagues.
Writing in the February 22 issue of the journal Science, they make the case that evaluations of AI-based algorithms are not held to traditional clinical trial standards—and, as a result, there has been little prospective evidence that predictive analytics improve patient care.
Patrik Sundström, program manager of e-Health SALAR, discusses how Sweden is using technology to move healthcare from the hospital to the patient, in line with the ambitious Vision for eHealth 2025 national strategy.
AI platform can identify, predict cancer development
It's being touted as the first use of network analysis as a method to examine the relationships between common symptoms suffered by a large group of cancer patients undergoing chemotherapy.
A team of scientists from the University of Surrey and the University of California have used artificial intelligence networks to help identify and analyze the symptoms of cancer patients.
A new study, published by Nature Scientific Reports, describes how researchers used network analysis to examine the structure and relationships between 38 common symptoms reported by over 1300 cancer patients receiving chemotherapy.
WHY IT MATTERS
This represents the first use of network analysis as a method of examining the relationships between common symptoms suffered by a large group of cancer patients undergoing chemotherapy, researchers say. The NA allowed the team to identify nausea as central, impacting symptoms across all three different key networks.
The development and use of AI is growing rapidly is the medical field, specifically in diagnostics and treatment management.
People as individuals and human beings are regaining an appropriate central focus in healthcare. The shift in thinking of putting relationships front and center was especially evident during the annual mass gathering of the healthcare information technology sector at the HIMSS Annual Conference.
Without a so-called blockbuster announcement, this arguably most important element of healthcare was able to permeate all levels of discussion.
The focus on individuals was evident in a variety of venues—from the government dropping a long-anticipated regulation just as HIMSS19 started, to the way in which companies framed their offerings, to the gathering of different communities. Being able to consider how best to enhance the relationship between clinicians, patients and other stakeholders was a refreshing change from chasing the latest shiny object, which was often the feeling in the past.
The healthcare industry is moving toward consumer-centered, patient-driven care. The consumer and patient perspective is becoming central to how healthcare is delivered, reimbursed and evaluated by regulators and other stakeholders.
Previously, individual patients reported on their health to their individual clinicians, with little opportunity for the quantitative and qualitative data to be aggregated and mobilized at a population level. Alternatively, patients had to participate in clinical registries or studies to provide their data to the health system for research purposes only.
In recent years, however, many new patient- and consumer-directed tools and platforms have become available. The new tools and platforms—like the Apple Health Kit, Apple Watch and FitBit—have enabled patients to report on their health outcomes to their healthcare providers and insurers, and to gather their health data for their own personal use.
Keeping up with the latest version of HL7’s Fast Healthcare Interoperability Resources standard is a challenge that the Office of the National Coordinator for Health IT says it is up to meeting.
In its proposed rule released last week, the agency—for the first time—has said that it intends to make FHIR a requirement for developers participating in the ONC Health IT Certification Program.
Specifically, ONC’s proposal seeks to make FHIR Release 2 a requirement. However, last month HL7 published FHIR Release 4—the normative version of the interoperability standard.
Whether you’re working to improve patient experience, engagement or activation, the range of technologies for communicating with patients is expanding, which can make it harder to pick the most effective one.
So, here’s a tip. Physicians and the IT shops that support them might consider messaging alternatives to meet consumer preferences for communicating via text messaging.
WHY IT MATTERS
The vast majority (91 percent) of 200 U.S. respondents would like the ability to communicate with their loved one's care team via text messaging, according to a DrFirst survey.
Just 10 percent of patients surveyed said they prefer to receive physician communications through patient portals, but nearly twice that many (19.6 percent) said they favor receiving information through secure text messages if in-person visits or phone calls are not possible.
Info-blocking ruled the day, while APIs, FHIR, artificial intelligence and virtual reality were also prominent themes at this year’s Global Conference.
I went to HIMSS19 last week, like a whole lot of other people. As Healthcare IT News is a HIMSS Media publication, we actually start covering the conference well in advance and this time around that meant a first article way back in August, believe it or not, about the new HIMSS Circles communities.
Fast forward to late Friday before the Global Conference and word got out that the Office of Management and Budget finished work on the eagerly-anticipated information blocking rule — thereby signaling the possibility that it would bring the new rule to Orlando.
And while the rule dominated the discourse from the opening panel to Friday morning keynotes, plenty more happened at the show.
Innovation and emerging technologies were all over the show floor, in fact, including artificial intelligence, blockchain, IoT and virtual reality wares.
An aging demographic, a strong economy driving a tight job market, and increases in the costs of medical goods and services are key reasons for spending growth.
KEY TAKEAWAYS
·Healthcare's share of the GDP will rise from 17.9% in 2017 to 19.4% by 2027, reaching nearly $6 trillion.
·Government is projected to pay for 47% of national healthcare spending.
·Hospital spending growth will average 5.6% through 2027, while physician and clinical services spending growth will average 5.4% per year over the same span.
·National health expenditure growth is expected to average 5.5% annually through 2027, reaching nearly $6 trillion and consuming nearly 20% of the economy by then, according to federal actuaries.
The projections, issued Wednesday by the independent Office of the Actuary at the Centers for Medicare & Medicaid Services and published in Health Affairs, anticipate that growth in national health spending will outpace projected growth in Gross Domestic Product by 0.8 percentage points over the coming decade.
Because of that, the actuaries project that healthcare's share of the GDP to rise from 17.9% in 2017 to 19.4% by 2027.
HONG KONG: Chinese investment in the U.S. biotechnology industry presents a risk to national security, potentially giving China’s government access to patient data that could be used to blackmail Americans, according to a report for a Congressional advisory commission.
Biotech companies in China have access to technology and data through investments in U.S. companies, partnerships with American universities and recruitment of U.S.-trained researchers, the report for the U.S.-China Economic and Security Review Commission said.
“Chinese biotechnology companies are acquiring technologies crucial to advancement in the field as well as amassing large collections of clinical and genetic data on U.S. residents,” the report published Feb. 14 said. -----
Customized drug alerts protect patients from medication errors, study finds
Megan Knowles - Friday, February 15th, 2019 Print | Email
Researchers from Memphis, Tenn.-based St. Jude Children's Research Hospital used a comprehensive method to reduce drug interaction alerts clinicians receive, improving EHRs to lower alert fatigue and boost patient safety, according to a study published in Pediatrics.
"In some instances, clinicians are getting a constant stream of alerts that aren't appropriate for their patient, leading them to disregard the alerts," said senior author James Hoffman, PharmD, St. Jude's chief patient safety officer. "This type of alert fatigue can lead to patient safety concerns."
For the study, the researchers collected input on the EHR's drug interaction alerts from three sources: a validated survey instrument, an advisory group of St. Jude clinicians and data within the EHR that captured which alerts clinicians most often ignored or overrode.
An independent report authored by a US government auditing agency has recommended that Congress develop internet data privacy legislation to enhance consumer protections, similar to the EU's General Data Protection Regulation (GDPR).
The 56-page report was put together by the US Government Accountability Office (GAO), a bi-partisan government agency that provides auditing, evaluation, and investigative services for Congress. Its reports are used for hearings and drafting legislation.
The House Energy and Commerce Committee, which requested the GAO report two years ago, has scheduled a hearing for February 26, during which it plans to discuss GAO's findings and the possibility in drafting the US' first federal-level internet privacy law.
The healthcare industry is getting closer to a clearer definition of what the blocking of electronic health information is and what it is not, according to the Department of Health and Human Services.
Section 4004 of the 21st Century Cures Act authorizes HHS to identify reasonable and necessary activities that do not constitute information blocking.
Toward that end, the Office of the National Coordinator for Health IT last week made public its long-awaited proposed rule implementing the information blocking provisions of the Cures Act, while including seven exceptions to the definition of information blocking.
The adoption of artificial intelligence tools is rapidly growing in the workplace. But to take full advantage of AI’s opportunities, organizations must understand and overcome lingering doubts from patients and clinician users, among others.
That is one of the key findings in new research from professional services firm Genpact. For its study, Genpact commissioned Wakefield Research to survey 500 C-level and other senior executives in the United States, United Kingdom, Australia, and Japan, in November and December. Wakefield also conducted an online survey of 4,000 consumers in the same countries.
One of the most important shifts during the past year is the nature of adoption, with organizations moving from using AI at the fringe of their operations in 2017 to starting to deploy it in their core processes.
A recent survey conducted by Siemens Healthineers queried hospital and laboratory senior executives as well as lab directors on the future of artificial intelligence in the in vitro diagnostic lab.
The result: 69 percent of respondents expect widespread adoption will occur within four years, and 88 percent identify AI as important for the lab. The survey was sponsored by Siemens Healthineers and conducted by ReRez Research of Dallas last May. It was completed by 200 health system and in vitro diagnostic laboratory senior leaders.
How can laboratories prepare for this significant technological shift? What challenges might labs face, and where will AI be most useful? Let’s review how lab leaders expect AI to change the clinical lab.
Added value of AI
AI is expected to have a broad impact across healthcare in general, as confirmed by 92 percent of respondents. Focusing specifically on the IVD lab, survey participants identified several key areas where they expect AI will be of most value.
HIMSS Stage 7 makes for happier physicians, says KLAS
Hospitals that reach the pinnacle of the HIMSS Analytics' EMR Adoption Model have more satisfied docs, more widespread personalization of EHRs and better teamwork between clinicians, according to a new survey with HIMSS Analytics.
Achieving Stage 7 on the HIMSS Analytics EMR Adoption Model is a tall order. It demands that hospitals have totally transcended the paper chart, are using data warehousing and advanced analytics, are able to share clinical information readily with an array of outside entities and are in strict compliance with a range of other exacting requirements for enterprise-wide IT deployment.
WHY IT MATTERS
It's worth the effort, as a new report from KLAS, done in cooperation with HIMSS Analytics, shows. Not just for the clinical and operational gains that can be accomplished with that level of technology maturity, but for generally higher levels of physician satisfaction.
At a time where EHR-exacerbated physician burnout is being discussed more than ever, those are interesting findings – suggesting that it's the way technology is deployed, rather than the mere fact of it, that might have the most beneficial impact on doctor productivity and patient care.
AI algorithms can quickly detect and localize wrist fractures in X-ray images, which can augment the work of harried emergency physicians and radiologists.
Missing a fracture on an emergency department radiograph is one of the most common causes of diagnostic errors and subsequent litigation. Such errors are due to clinical inexperience, distraction, fatigue, poor viewing conditions and time pressures.
The study authors, from the National University of Singapore, hypothesized that automated analysis using artificial intelligence (AI) would be “invaluable” in reducing these misreadings and that an object detection convolutional neural network (CNN) would work better than other CNNs.
The Mayo Clinic has added its first-aid voice application to Google Assistant and voice-powered web chat.
The Mayo Clinic earlier added the Mayo First Aid skill to Amazon's Alexa. To access the information on Google Assistant, a consumer would say “Hey Google, talk to Mayo First Aid.”
The first aid feature, created with Mayo Clinic and Orbita, a provider of a HIPPA-compliant platform for voice, provides answers questions such as how to treat a sunburn, animal bite or a black eye.
HIMSS participants share insights about what technological developments will change healthcare.
KEY TAKEAWAYS
·AI will have widespread impact, particularly by influencing clinical decision-making.
·Telehealth and devices that facilitate the transition to home-based care will change the dynamics of healthcare delivery.
·Platforms to manage data and the ability to exchange and interpret data are foundational to innovation.
Last week the world of healthcare information technology gathered in Orlando, Florida, for the HIMSS 2019 annual conference. There were 42,595 people, 1,300 exhibitors, and more than 300 educational sessions.
For a few days, the Orange County Convention Center became the epicenter of healthcare technology brain power, with many on a quest for the best ideas that will help transform healthcare.
As HealthLeaders' innovations editor, I was interested in what innovation participants thought will have the greatest impact on health systems, I asked that question to nearly everyone I encountered during interviews, at exhibit booths, and while networking. The responses were diverse, but the most common answer involved some form of artificial intelligence (AI).
Greg Yap is a venture capitalist looking for the next big thing in digital health. At age 45, he's also the father of young kids and the son of an aging mother, who lives nearby in an independent living facility.
On days he can't visit his mom and doesn't hear from her, he still wants to know how she's doing. So he's combining his personal concerns as a son with his job as an investor and experimenting with new technologies that can give him some peace of mind without invading his mother's privacy.
Beyond mainstream devices like Amazon's Echo, which can set medication reminders, Apple's smartwatch with fall detection and the Nest thermostat's motion sensors, Yap has been trying new products specifically designed to monitor aging parents. One example is Silver Mother, which incorporates sensors on pill boxes, front doors and mattresses for remote monitoring of health, safety and sleep.
"I've been trying a few sensors out to approximate this monitoring function," Yap said. "The technology is not yet idiot-proof though."
And they don't even do a release to announce they are lumping millions of people with a useless Secondary Data Record for them to store YOUR Health Information! I wonder might that be because they don't want to remind their victims what they have done so close to a Federal Election?
The computer networks of Australia’s major political parties have been the subject of a cyber-attack by a “sophisticated state actor”, the Prime Minister has told Parliament.
The news comes after the attempted hack of Australia’s parliamentary network in early February.
“Members will be aware that the Australian Cyber Security Centre recently identified a malicious intrusion into the Australian Parliament House computer network,” Mr Morrison said in a national security statement in the House of Representatives.
“During the course of this work, we also became aware that the networks of some political parties, Liberal, Labor and Nationals have also been affected.
“Our security agencies have detected this activity and acted decisively to confront it.
“Our cyber experts believe that a sophisticated state actor is responsible for this malicious activity.”
Previously Australia has blamed China and Russia for cyber-attacks.
Mr Morrison said there is no proof cyber-attacks have led to electoral interference, but the Australian Electoral Commission is being briefed and any political party will be provided support.
LandMark White has claimed that the data inadvertently leaked by the property valuation firm and subsequently posted on a ‘darkweb’ forum is “relatively benign”.
Earlier this month the ASX-listed company revealed details of a data breach. It subsequently entered a trading halt to assess the impact on its business, after major banks paused their use of its services.
The leaked dataset “was limited to property valuation and some personal contact information of borrowers, lenders, homeowners, residents, and property age,” the company said in a statement released today.
“The type of information present in the dataset varies from person to person and includes some or all of the following: first and last name, residential and/or business address, email address and contact telephone number. The dataset also includes commentary about the property, relevant to its overall valuation.”
The Melbourne Heart Group, a medical unit located at Cabrini Hospital in the Melbourne suburb of Malvern, has been hit by a Windows ransomware attack that has resulted in about 15,000 patients being locked.
The incident, which occurred some three weeks ago, has been reported to the Australian Cyber Security Centre. It was first reported by Nine Entertainment.
An ACSC spokesperson told iTWire that it had been recently alerted to a cyber security incident by the MHG.
"[We] provided cyber security advice and assistance to MHG," the statement added. "As the matter is ongoing, it is not appropriate to comment further."
Cyber attackers have hit Melbourne’s Catholic Archdiocese, demanding a ransom from the church and paralysing its computer system for days, while Australia's biggest corporate superannuation fund, TelstraSuper, has admitted it has also been targeted.
Car maker Toyota has also been hit by a cyber attack in Australia, with employees locked out of their emails for days. Toyota Australia's servers were targeted on Tuesday and an investigation involving federal authorities is under way into who was behind the potentially malicious cyber attack.
