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, July 13, 2020

Weekly Australian Health IT Links – 13 July, 2020.

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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An interesting week as the Government started to try and get the Telehealth frenzy under control and manage the profiteers.

Also interesting that Optus is offering 5G wireless as an alternative to the a fixed NBN connection.

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https://croakey.org/telehealth-and-digital-health-navigators-a-bright-future-for-health-delivery/

Telehealth and digital health navigators – a bright future for health delivery

Editor: Marie McInerneyAuthor: Peter Brooks, Stephen Duckett and Brian Oldenburg on: July 09, 2020In: Coronavirus outbreak 2019-2020, digital technology, general practice, health workforce, Healthcare and health reform, primary health care, Public health and population health, rural and remote health

Introduction by Croakey: The long-awaited access to telehealth consultations in the coronavirus pandemic has been broadly embraced by patients and health care providers, though it is not without concerns.

In the UK, the “telemedicine revolution”, which has come much faster than the NHS Long Term Plan anticipated, has been critical to continuing healthcare provision during the crisis but it has come at a cost for many of experience “digital exclusion”, according to this recent article in the BMJ.

Amid other concerns, the Royal Australian College of General Practitioners (RACGP) last week called for an urgent overhaul to telehealth and telephone consultations to ensure patients “steer clear of corporate telehealth pop-ups which have proliferated” amid the Federal Government’s expansion of Medicare-subsidised telehealth and telephone consultations.

The RACGP had long supported expanded telehealth and telephone consultations, which have helped decrease the risk of spreading COVID-19 to patients and practice staff and made care more accessible for vulnerable patients, said President Dr Harry Nespolon.

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https://www.ausdoc.com.au/news/psr-announces-first-gp-telehealth-investigation

PSR announces first GP telehealth investigation

The watchdog was asked to examine the doctor's MBS claims by the Federal Health Department

9th July 2020

By Geir O'Rourke

The Professional Services Review has announced its first investigation into a doctor suspected of abusing the emergency coronavirus telehealth items.

The Medicare watchdog began auditing the GP late last month following a referral from the Federal Department of Health.

There are few details of the allegations, but Australian Doctor has been told the probe will examine whether face-to-face consultations should have been offered to patients who were seen remotely.

PSR director Professor Julie Quinlivan said there would be concerns about any phone or video consult claimed on Medicare where a physical examination was needed.

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10 Jul 2020 2:18 PM AEST

RACGP welcomes changes to telehealth to ensure high-quality patient care              

The Royal Australian College of General Practitioners (RACGP) has welcomed the Australian Government’s move to only allow patients to access subsidised telehealth and telephone consultations through their usual GP.

The Federal Government expanded Medicare-subsidised telehealth and telephone consultations to all Australians earlier this year in response to the COVID-19 pandemic, to slow the virus spreading and ensure access to care for patients.

Today the government announced restrictions to telehealth and telephone consultations to a patient’s usual GP, starting July 20, with exemptions for infants (under 12 months), people experiencing homelessness, and people in COVID-19 hot spots.

RACGP President Dr Harry Nespolon welcomed the reform as key to ensure the community receives the highest quality care.

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https://www.ausdoc.com.au/news/govt-unveils-restrictions-telehealth

Govt unveils restrictions on telehealth

The MBS items will be restricted to practices who have seen the patient face-to-face in the last 12 months

10th July 2020

By Antony Scholefield

MBS telehealth items will be restricted to GP practices with an existing relationship with the patient, starting 20 July, the Federal Government has announced.  

The change – demanded by the RACGP and AMA to preserve continuity of care – will apply everywhere except Melbourne and the Mitchell Shire, the two areas in Victoria currently under stay-at-home orders.  

The definition of a relationship will be having seen the same GP, or a GP at the same practice, face-to-face in the last 12 months before the telehealth consultation takes place.

The restrictions will apply to all the temporary GP telehealth items introduced in March under the government's COVID-19 measures.

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https://www1.racgp.org.au/newsgp/professional/government-restricts-telehealth-mbs-access-to-pati

Government restricts telehealth MBS access to a patient’s regular GP

Anastasia Tsirtsakis

10 Jul 2020

The RACGP has welcomed the Federal Government’s decision, which comes after months of strong college advocacy.

Patients will now only be able to access telehealth services under the Medicare Benefits Schedule (MBS) through their regular GP or a referred non-GP specialist.
 
RACGP President Dr Harry Nespolon welcomed the reform, which will ensure both convenience and appropriate high-quality care for patients.
 
‘I am very pleased the Government has listened to the concerns of our GPs,’ he told newsGP.
 
‘When the RACGP pushed for telehealth to be funded under Medicare, our intention was always that these services would strengthen the GP–patient relationship – that is, with their regular GP, who can also offer face-to-face consultations when needed – and to ensure continuity of care.’
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https://www.zdnet.com/article/telehealth-accounting-for-20-of-all-medicare-funded-doctor-consultations/

Telehealth accounting for 20% of all Medicare-funded doctor consultations

Australian Medical Association has said the pandemic has shown telehealth works.

By Chris Duckett | July 10, 2020 -- 03:43 GMT (13:43 AEST) | Topic: Coronavirus: Business and technology in a pandemic

After years of people stating that telehealth would be the future of medical care, the Australian Medical Association (AMA) said the coronavirus pandemic has shown it works in Australia, and that it must become a permanent feature of the health system.

Responding to the Senate Select Committee on COVID-19, the AMA said telehealth was now accounting for 20% of all doctor consultations funded by the Medicare Benefits Schedule.

"The AMA has said for many years that telehealth should become a feature of our health system, complementing face to face care," it said.

"We must now turn to the task of fully integrating telehealth into day-to-day medical practice while ensuring continuity of care for patients and that we follow best practice standards."

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https://www.zdnet.com/article/services-australia-among-those-found-breaching-privacy-laws/

Services Australia among those found breaching privacy laws

Complaint against the government department revealed it disclosed bank statements to someone the complainant took a Family Violence Order out on.

By Asha Barbaschow | July 10, 2020 -- 00:58 GMT (10:58 AEST) | Topic: Security

The Office of the Australian Information Commissioner (OAIC) has made available the outcomes of its latest privacy complaint investigations, including a determination made against Services Australia.

In the complaint against the CEO of Services Australia, Australian Information and Privacy Commissioner Angelene Falk found that the federal government department interfered with the complainant's privacy as defined in the Privacy Act 1988 by breaching one of the guiding privacy principles.

Specifically, the department disclosed the complainant's personal information in breach of privacy principle 11.

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https://www1.racgp.org.au/newsgp/clinical/fast-tracked-electronic-prescribing-enters-testing

Electronic prescribing enters testing phase ahead of rollout

Simple, fast and secure – that’s what GPs are hoping for as the new era of electronic prescribing nears.

fast-tracked electronic prescribing system has entered its testing phase ahead of a nationwide roll-out – and many GPs hope it will make life easier for them and their patients.

Doug Hendrie

07 Jul 2020

‘On 6 May 2020, Australia transmitted its first electronic prescription in primary care – end to end, from the doctor to the patient – using a digital token via an encrypted digital exchange to be dispensed by the pharmacist, and then claimed through Services Australia at the other end.
 
‘It was a great outcome.
 
‘There are real live electronic prescriptions taking place in Australia at the moment.’
 
That is Andrew Matthews, director of the Medicines Safety Program at the Australian Digital Health Agency (ADHA), who has worked on Australia’s accelerated push to electronic prescribing.
 
That first electronic prescription took place between Anglesea Medical and Anglesea Pharmacy in Victoria.
 
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https://www.ausdoc.com.au/news/practice-fined-16000-after-sending-hiv-diagnosis-wrong-email-address

Practice fined $16,000 after sending HIV diagnosis to wrong email address

Couple originally wanted $250,000 for the alleged distress caused

6th July 2020

By Antony Scholefield

A GP practice which sent an email revealing a patient and his husband had HIV to the wrong address has been ordered to pay $16,400 in damages.

The couple had taken part in a global study on HIV transmission and the Victorian practice, which specialises in sexual health, was emailing a consent form to take part in a follow-up study.

The form should have been sent to the email addresses of the patient and his husband.

The husband’s email address used his first name, the initial of his middle name, followed by his last name.

But the practice omitted the middle initial, sending the email to an unidentified, unrelated Gmail account.

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https://www.itnews.com.au/news/medicare-to-reuse-centrelinks-new-payments-calculator-550174

Medicare to reuse Centrelink's new payments calculator

By Justin Hendry on Jul 7, 2020 6:34PM

Pegasystems platform to be utilised across Services Australia.

The payments calculation engine currently being developed by Infosys to work out the eligibility of Centrelink recipients looks set to replace the country’s legacy Medicare payments system.

Government Services Minister Stuart Robert revealed the new entitlements calculation engine (ECE) would be reused across Services Australia during a National Press Club address on Tuesday.

It ends two years of uncertainty over the future of the legacy Medicare payments processing system that began when the government dumped its procurement of a cloud-based replacement.

The ageing platform – also known as the health and aged care payments system – is currently used to deliver Medicare, Pharmaceutical Benefits Scheme, veterans and aged care payments.

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https://www.hinz.org.nz/news/515758/National-Contact-Tracing-Solution-expanded-to-support-border.htm

National Contact Tracing Solution expanded to support border

Sunday, 5 July 2020  

eHealthNews.nz editor Rebecca McBeth

The National Contact Tracing Solution (NCTS) has been expanded to support the Covid-19 border process with National Health Index numbers now being matched or assigned to all new arrivals.

Deputy director-general data and digital Shayne Hunter says the solution being rolled out to managed isolation and quarantine facilities also captures facility and room registration, day 3 and day 12 test requirements, daily health checks and the day 14 final release decision. 

The Ministry’s databases for storing information about people in isolation facilities came under scrutiny last month when director general of health Ashley Bloomfield was unable to say how many people had left managed isolation without receiving a Covid-19 test. This was despite it being policy for a negative test to be returned before they were allowed to leave.

Bloomfield revealed at a media stand-up that the problem was there had been two databases operating, one for people in managed isolation facilities and quarantine and the other for medical information such as test results.

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https://www.theweeklysource.com.au/telstra-health-claims-it-is-back-after-nearly-flaming-out-in-2017/

Telstra Health claims it is back after nearly flaming out in 2017

Published on July 7, 2020

In 2013 Telstra Health announced it was going to be the gorilla in the health IT sector, including the aged care sector. By 2017, after investing $200 million in 18 acquisitions, but little enthusiasm from customers, it was forced to pull back from the market.

Now, three years later and with COVID, Mary Foley – the ex-National Head Practice Leader for PwC and ex-lead of St Vincent’s and Mater Health Sydney – in the Telstra Health leadership role, they have found their niche.

They were ideally placed for telehealth and they have led the introduction of remote electronic scripts. At the beginning of May, FRED IT, a joint venture partner of Telstra Health, successfully delivered the first paperless script transaction between a GP and a pharmacy.

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https://itwire.com/security/third-batch-of-toll-documents-leaked-online-after-windows-ransomware-attack.html

Saturday, 04 July 2020 13:00

Third batch of Toll documents leaked online after Windows ransomware attack

By Sam Varghese

Cyber criminals who attacked Australian logistics and transport provider Toll Group in May have now released a third batch of documents which they exfiltrated from the company's website during the attack.

Toll was attacked using the Nefilim ransomware that runs only on Windows systems.

Among the documents, released as one text file and one zipped file, are many files dealing with compliance requirements for other countries, financial documents, tax invoices and the like.

Toll announced on 5 May that it had been compromised by the ransomware. This was the second attack on Toll this year, with the first in February being through use of the Mailto ransomware.

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https://thesector.com.au/2020/07/06/allergypal-wins-innovation-challenge-to-support-children-with-food-allergies/

AllergyPal wins innovation challenge to support children with food allergies

by Freya Lucas

July 06, 2020

​The Australian Digital Health Agency has announced five winners of the $50,000 Innovation Challenge championing digital health innovation to provide a healthier future for Australians through connected healthcare, including AllergyPal, a digital management platform for children with food allergy. 

Developed by an MCRI-based team AllergyPal was designed to support families in managing their child’s food allergy.

AllergyPal provides ready access to a child’s allergy plan, interactive guidance on how to manage allergic reactions in an emergency and a way for parents to leave individualised instructions on their preferred approach to allergen avoidance. 

The app also has a share function which allows parents to give other carers direct access to all of the features of AllergyPal when leaving their child with friends and family or in education and care settings. 

Anyone caring for a child can then use AllergyPal to help recognise the signs of an allergic reaction and seek appropriate help.

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https://www.hospitalhealth.com.au/content/technology/news/project-irad-to-expand-in-sw-sydney-region-1066573139

Project iRAD to expand in SW Sydney region

Tuesday, 07 July, 2020

South Western Sydney Primary Health Network’s (SWSPHN) iRAD (Integrated Real-time Active Data) interoperability project has successfully concluded its 12-month pilot phase. The innovative solution enables healthcare organisations to share patient-consented health records across the continuum of care.

The initiative — driven by Allscripts’ dbMotion Solution — demonstrated its practicality during the COVID-19 pandemic by activating COVID-19 Risk Notifications and Dashboards to enhance patient and staff safety.

iRAD went live with general practices last year and exchanges data in real time between primary care sites, healthcare organisations and hospitals. SWSPHN has recruited and extended the platform to additional general practices and the federally funded COVID-19 respiratory clinics, assisting clinicians to provide continuity of care as patients visit an array of health services.

Allscripts Australia and New Zealand Director of Business and Partnerships Dani Arousi said that healthcare organisations around the globe continue to prioritise staff safety during the COVID-19 pandemic and that iRAD contributed to the successful management of the pandemic.

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https://www.itnews.com.au/news/govcms-withstands-massive-covid-traffic-spikes-550324

GovCMS withstands massive COVID traffic spikes

By Justin Hendry on Jul 10, 2020 11:02AM

Health Department stands up to a 760 percent increase.

Government websites using the hosting and content management system GovCMS withstood record traffic during the height of COVID-19, as Australians scrambled to find reliable sources of information.

At the peak of the public health response, the open source Drupal-based platform, which government agencies are increasingly using for their web channels, handled as many as 100,000 pageviews each minute and up to 187,000 concurrent users at a time.

The most visited page was understandably the health.gov.au website, which experienced a 760 percent increase in traffic, and on one day - likely when the government ramped up its public health response in March - recorded six million visits.

Despite the huge spike in traffic, which heath.gov.au technical product owner Danni Marlow said was “typically … up to 20,000 concurrent users”, the GovCMS site managed to keep page load time under 2.7 seconds.

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https://www.hospitalhealth.com.au/content/clinical-services/news/stimulating-device-now-an-option-for-chronic-back-pain-841934266

Stimulating device now an option for chronic back pain

Nevro
Friday, 03 July, 2020

Medical professionals can now access a TGA-approved device to treat patients with chronic back pain, which affects 3.24 million Australians.

The Senza Omnia Spinal Cord Stimulation System from Nevro delivers treatment for chronic back pain using frequency technology to stimulate the spinal cord and is reported to be the only product of its kind that can deliver all frequencies, between two and 10,000 HZ.

The device offers a waveform pioneered by Omnia — the HF10 — which was found to reduce pain across two 24-month trials. In the SENZA-EU study, a multicentre back pain study conducted in Europe, the average opioid intake of the patients was decreased by nearly 70% and the percentage of patients not taking opioids by two years had tripled (from 14% to 42%).

Nevro Chief Commercial Officer Niamh Pellegrini said the product will be available to medical practitioners across Australia from 1 July, following successful launches in the United States and Europe.

“Omnia was developed as a result of extensive feedback from physicians to provide a versatile solution to help more patients with chronic pain,” Pellegrini said.

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https://itwire.com/sponsored-announcements/tasmania-health-services-delivers-real-time-data-with-qlik-to-fight-coronavirus-90771.html

Friday, 26 June 2020 11:49

Tasmania Health Services Delivers Real-Time Data with Qlik to Fight Coronavirus

By David Deacon

David Deacon is State Manager, Clinical Financial Analytics Unit (CFA) of the Tasmania Health Service (THS). David shares how THS has incorporated data into its strategy to battle the pandemic.

Tasmania Health Service in Australia has embraced the use of data and analytics to stay ahead of the curve and formulate its response to COVID-19. Over the past 18 months, the Health Service has been developing a suite of near real-time operational focus boards together with key stakeholders, which they were then able to build on when the outbreak occurred.

Meet SIMON

The Statewide Information Management Operation Node (SIMON) is a centralized informational portal built on Qlik that supports both transactional input and output functions. The portal is alert oriented and provides enough detail to inform effective clinical decision-making, which enhances safe patient flow throughout the hospital.

When the pandemic was declared in March 2020, the COVID-19 Focus Board was created using SIMON and deployed within days at Emergency Command Centers. The emergency dashboard, designed to monitor the status of patients across emergency departments in Tasmania’s four major hospitals, was the first application to launch. Later, other dashboards were created, including those concerning critical care, emergency surgery, ambulance movement, occupancy and admission rates.

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https://itwire.com/sponsored-announcements/how-peninsula-health-transitioned-to-secure-remote-working-fast-with-tdl-and-citrix-202006230714.html

Tuesday, 23 June 2020 17:08

How Peninsula Health transitioned to secure remote working fast with TDL and Citrix

VENDOR NEWS:  As businesses emerge from the COVID-19 lockdown, we’re starting to hear stories of organisations that thrived and those that struggled to adapt to a predominantly remote workforce. One example of a business that got it right is Peninsula Health, which covers a number of health facilities and hospitals in the Frankston and Mornington Peninsula areas of Victoria.

With 1,000 back-office staff that needed to transition to remote working urgently, Peninsula Health enlisted TDL and Citrix to help. With no real history of remote working at an organisational level, and a high need to maintain data security, Peninsula Health sought to balance the requirement to move fast with the need to get the right remote working solution in place.

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Monday July 6, 2020

SOCIAL ROBOTS - A NEW TOOL IN HEALTH CARE THAT MAY BE AS EFFECTIVE AS A HUMAN CLINICIAN

A Monash Researcher has found that small interactive robots are proving useful in helping people develop and implement healthy lifestyle plans, showing they can support weight loss and healthy habits

The research trial, led by Dr Nicole Robinson, placed 26 social robots with participants to deliver a multi-session behaviour change treatment program around diet and weight reduction.

The robots interact with users and guide them through their program by providing audible prompts.   

Results found the robot-delivered program helped people to achieve more than 50 per cent snack episode reduction and 4.4kg average weight loss.

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https://www.itnews.com.au/news/sydney-unis-brain-and-mind-centre-scores-7m-for-ai-projects-550226

Sydney Uni's Brain and Mind Centre scores $7m for AI projects

By Matt Johnston on Jul 9, 2020 6:42AM

For neurological and mental health disorders.

Two multidisciplinary projects at the University of Sydney are set to share in over $7 million to develop technologies for mental health and neurological disorders using artificial intelligence.

The two projects from the university’s Brain and Mind Centre received the funding as part of the federal government’s Medical Research Future Fund.

A shade over $4 million will go towards a project led by professor of neurology Michael Barnett and the the Sydney Neuroimaging Analysis Centre (SNAC).

They will investigate how AI can be combined with medical imaging technologies to improve diagnoses, monitoring and treatment of diseases like multiple sclerosis (MS).

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https://itwire.com/reviews-sp-288/networking/optus-5g-home-internet-is-an-nbn-killer.html

Thursday, 09 July 2020 15:43

Optus 5G home Internet is an NBN killer

By Sam Varghese

For a while now, there have been mutterings here and there that the NBN Co's vain attempts to raise its average revenue per user — which has the fancy acronym ARPU — will face a real challenge once 5G gets a foothold in the community and retail service providers decide to use it to challenge the government monopoly.

That day seems to have arrived. I've just been playing around with one of the very real challengers, one that would definitely give the good folk at NBN Co some sleepless nights. Singtel Optus has started selling a service it calls Optus 5G home Internet – and, believe me, it is a real NBN killer. I can judge because in a few months' time I would have been on the NBN for three painful years.

Optus' solution to the bandwidth problem — which the NBN has illustrated in black and white — is simplicity itself. A 5G Nokia modem, in pristine white and looking every bit Scandinavian, is the only thing that's needed, along with a connector, of course. (This is what is meant by plug-and-play - though with Microsoft, which invented the term, it was always plug and pray.)

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https://itwire.com/telecoms-and-nbn/telsoc-says-sacking-staff-a-%E2%80%98misstep%E2%80%99-by-nbn-co.html

Thursday, 09 July 2020 11:00

TelSoc says sacking staff a ‘misstep’ by NBN Co

By Peter Dinham

Australia’s telecoms industry association, the Telecommunications Society (TelSoc), has raised serious concerns over the planned sacking of hundreds of employees by NBN Co, describing the move as a “misstep” by the company.

TelSoc vice-president Laurie Patton said the “massive” staff cuts was exactly what NBN Co - the operators of the National Broadband Network - should not be doing, and called instead for the company to begin “the replacement of millions of inferior connections”.

“They need to retain staff to do this,” Patton said in a statement issued on Thursday.

As iTWire reported, as the COVID-19 pandemic surges again, NBN Co has announced it would be sacking 800 employees before the end of the year, telling its staff on Wednesday that numbers would fall from 6300 to 5500.

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https://www.itnews.com.au/news/nbn-co-to-cut-800-staff-by-end-of-2020-550223

NBN Co to cut 800 staff by end of 2020

By Ry Crozier on Jul 8, 2020 4:00PM

Unveils plans for post-build internal restructure.

NBN Co is set to cut around 800 staff by the end of the year as part of a broader post-rollout restructure of the company.

CEO Stephen Rue said that the company would slim down the size of its direct workforce from around 6300 employees to “around 5500 people by the end of this calendar year.”

“As we have approached the final stages of the initial build, we have talked about changing the size and shape of the organisation and we are now preparing for the next phase of the company’s evolution,” Rue said.

Rue said NBN Co had paused the majority of internal restructuring activities over the past six months, in part to stay resourced enough to meet “data and operational demands brought on by the COVID-19 crisis.”

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https://itwire.com/telecoms-and-nbn/nbn-co-turfs-out-800-staff-as-covid-19-surges-again.html

Thursday, 09 July 2020 05:22

NBN Co turfs out 800 staff as COVID-19 surges again

By Sam Varghese

As the COVID-19 pandemic surges again, the company that is rolling out Australia's broadband network has announced it would be sacking 800 employees before the end of the year.

NBN Co told its staff on Wednesday that numbers would fall from 6300 to 5500.

Chief executive Stephen Rue said in an email sent to staff: "With the initial network build complete and as we embark on our customer-led transformation in earnest, I would like to announce a series of changes to our operating model and executive management structure, as we align ourselves for the future.

He also said in another statement: "As we have approached the final stages of the initial build, we have talked about changing the size and shape of the organisation and we are now preparing for the next phase of the company's evolution."

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https://www.itnews.com.au/news/nbn-cos-final-build-push-includes-25k-premises-that-fell-through-the-cracks-550217

NBN Co's final build push includes 25k premises that fell through the cracks

By Ry Crozier on Jul 8, 2020 1:25PM

Due to overlap in responsibilities with Telstra.

NBN Co has revealed 25,000 premises in smaller new housing developments remain unconnected to the NBN after June 30 due to an apparent mix-up in the implementation of government policy.

The network builder provided an update earlier this week on the status of 109,000 premises whose connections were deemed too complex to be completed as part of the main “volume” build.

Cryptically, NBN Co said the 109,000 included “an additional 25,000 premises in new development sites”, without elaborating.

iTnews can now reveal that these are premises that Telstra deployed telecommunications infrastructure for in its role as an infrastructure provider of last resort (or IPOLR) under the government’s telecommunications in new developments (TIND) policy.

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https://itwire.com/telecoms-and-nbn/nbn-co-%E2%80%98proudly%E2%80%99-declares-nbn-construction-targets-achieved-or-%E2%80%98exceeded%E2%80%99.html

Monday, 06 July 2020 11:51

NBN Co ‘proudly’ declares NBN construction targets achieved or ‘exceeded’

By Peter Dinham

NBN Co says it has achieved or exceeded its National Broadband Network construction targets for 25 consecutive months by more than 230,000 premises, making 11.73 million premises ready to connect by 30 June this year.

The company building the network also touts the fact that in the last three months alone, it has made it possible for customers living and working in more than 500,000 premises throughout Australia to order an NBN service via their preferred service provider, exceeding its corporate plan 2020-23 and FY20 build target.

NBN Co said in a statement on Monday that during the three months to 30 June 2020, approximately 375,000 Australian homes and businesses have connected to the NBN, and the company “continues to activate around 30,000 additional premises every week”.

“More than 1.7 million additional premises have connected to the NBN in the last 12 months and by 30 June 2020, more than 7.26 million premises were connected to the NBN.”

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https://www.itnews.com.au/news/nbn-co-will-have-22000-premises-still-awaiting-infrastructure-after-this-year-550110

NBN Co will have 22,000 premises still awaiting infrastructure after this year

By Ry Crozier on Jul 6, 2020 11:32AM

Increases its focus on hard-to-connect sites.

NBN Co is now forecasting it will only have around 21,800 brownfields premises unable to connect to its network post-2020.

The company today provided more detail about the estimated 100,000 premises that it deemed too difficult to complete the build for by the end of June this year.

The number is now closer to 109,000, but NBN Co is now forecasting build completion for “approximately 80 percent of these premises” by the end of 2020.

The 109,000 comprises three tranches of work.

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Enjoy!

David.

Sunday, July 12, 2020

The Horrible Fiasco With COV-19 In The USA Can't Go Unremarked...

As I watch my Twitter feed it is becoming clear that a full-blown humanitarian disaster is unfolding in the South West of the US, while Florida Disneyland is reopening for heaven's sake!

We are seeing NY like scenes of hospitals failing to cope and death rates spiraling out of control. As of today only 7 of the 50 States are seeing the virus spread slowing (r <1.0).

The fault for this catastrophe can be laid squarely at the feet of a narcissistic President and a hopelessly divided polity where it seems most of the nation's leaders have forgotten what they are meant to do if disaster threatens - and it is not to continue to make a political issue of mask wearing and ignoring good science!

(In passing terrible leadership has also led to catastrophe in Brazil. Otherwise a number of countries are also looking at risk but they won't have the impact of the disaster that seems to be unfolding in the US. One commentator described it as a 'Category 6, slow moving hurricane'. Sounds about right.)

The USA has been in serious decline pretty much since the fall of the Berlin Wall triggered by totally excessive hubris on the part of its leaders - but, unless a major course change is executed, we may see a descent into anarchy and civil war among a population which has more guns than citizens. Scary what?

Australia has serious skin in this game and we should fervently hope sanity prevails and the worst scenarios to not eventuate. We are desperately vulnerable in a world that is becoming more unstable and dangerous by the month. One has to wonder how bad it has to get for the US to ease up on the silliness and get its act together - if it still can!

Back to Digital Health...

David.

This Is Really A Fascinating Story Of How Intelligence Of Disease Outbreaks Can Be Gleaned.

This appeared a day or so ago.

A chance to get smarter in cyber space of intelligence

In mid-November last year, WeChat users in China started discussing a new virus spreading in Wuhan.

Words and phrases such as SARS, coronavirus, novel coronavirus, Feidian (the Chinese equivalent of SARS), shortness of breath, dyspnoea and diarrhoea all began to increase in use across China’s most popular messaging app. As the virus spread, volunteer open-source researchers in China began collecting and archiving online material, including through GitHub, a Microsoft-owned coding and collaboration platform, to protect and preserve information at risk from China’s internet censors. Later, some of these open-source researchers, web archivists and citizen journalists would be detained, their online projects shut down.

We will never know how many governments were monitoring and collecting these early signs of COVID-19, and we will hear only snippets about what they found. Like advice from public health agencies and diplomatic cables, intelligence provides another source of information for governments. And for those intelligence agencies that pivoted quickly as the virus spread around the world early this year, online open-source collection, including data scraped from Chinese social media networks, blogs and archived databases, had the potential to alert them to the seriousness of what was to come.

On January 6, eight days before the now notorious tweet by the World Health Organisation announcing that Chinese authorities had “found no clear evidence of human-to-human transmission of the novel #coronavirus”, cyber-espionage actor APT32 was on the hunt, trying to find out more about the unnamed virus spreading in Wuhan and beyond. APT32 (also known as OceanLotus), long believed by cyber-security researchers to be operating on behalf of the Vietnamese government, used COVID-19 themed malicious email attachments in an attempt to compromise the professional and personal email accounts of officials working for the government of Wuhan and China’s Ministry of Emergency Management. We don’t know how successful APT32’s attempted cyber intrusions were, or what prompted this operation.

But we do know that Vietnam — like Australia — acted quickly, closing its 1400km border with China on February 1. By the end of April, the Vietnamese government had reported no deaths and fewer than 300 cases of COVID-19.

Alongside most industries, intelligence agencies — including Australia’s — will be assessing whether the global disruption caused by COVID-19 will change the way they operate. Will it accelerate evolutions in tradecraft? Will the expectations and priorities of intelligence customers shift as these types of global events become more frequent?

They will need to take stock of their response. As the virus began its rampant spread, were they set up and resourced to respond in a timely fashion? Crucially, as other sources of information signalled danger, were they able to move fast to collect information, much of which, in the early stages at least, was not necessarily “secret”?

For governments wrestling with difficult decisions such as border closures and public safety measures, having accurate data about the virus and its spread was essential. But responding quickly isn’t always easy because intelligence collection is challenging, labour-intensive and complicated.

Agencies can’t ordinarily pivot quickly between targets. In China, which has invested heavily in sophisticated surveillance and public security technologies to monitor and control its population, collecting on-the-ground human intelligence is becoming more dangerous and expensive.

The demands of dealing with, and protecting, sources means human intelligence may not be easily redirected. Signals intelligence also needs time to change course; penetrating a network requires figuring out a way in, and exploitable vulnerabilities are hard to find. Only certain intelligence collectors, such as those working in open-source and geospatial information gathering, can manoeuvre more readily.

Intelligence collection during the early months of COVID-19 would have required agencies to work creatively and flexibly. They would have had to gather information, much of which existed only in, for example, municipal and provincial medical circles, high-resolution satellite imagery or archived online databases and Chinese social media channels.

This would have raised another challenge for intelligence agencies: as the data poured in, were they able to quickly process and analyse what they had?

But the most important questions are the ones that can’t be answered yet. With nations still emerging from this crisis, intelligence communities need to forecast what a world after COVID-19 abates will look like. Because they need to make decisions now about how they will operate in this new environment.

…..

Danielle Cave is deputy director of the Australian Strategic Policy Institute’s International Cyber Policy Centre. This is an edited extract of her essay, Data Driven, in the new issue of Australian Foreign Affairs, Spy v Spy, published on Monday.

More here:

https://www.theaustralian.com.au/inquirer/a-chance-to-get-smarter-in-cyber-space-of-intelligence/news-story/4736134c3ef2c1dd0bc987284f515c6a

Here is a link to the relevant section of the ASPI Web-site.

https://www.aspi.org.au/program/international-cyber-policy-centre

Here is the link to the issue of the magazine.

https://www.australianforeignaffairs.com/essay/2020/07/spy-vs-spy

I find this interesting in the sense that it seems at least Vietnam (and certainly Taiwan) were more than aware that something serious was happening in Wuhan at least a week before the WHO said there was a problem and were acting to control the virus entry into their country.

I wonder how many stories of other really smart people figuring out what was going on – using public information – long before China fessed up!

David.

AusHealthIT Poll Number 535 – Results – 12th July, 2020.

Here are the results of the poll.

Does The Lack Of A CEO Appointment For The ADHA For Now Longer Than Six Months Suggest Serious Problems With The Organisation's Culture And Future?

Yes 92% (97)

No 8% (8)

I Have No Idea 1% (1)

Total votes: 106

Very clear cut poll that makes it clear that the readers here think the lack of a CEO appointment is a sign of considerable issues with ADHA. The other possibility is that anyone who is suitable for the CEO role knows what a poison chalice it would be being stuck with supporting the #myHealthRecord and the various other failed ADHA initiatives!

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

A good number of votes.  

It must also have been a very easy question with 1/106 readers were not sure how to respond.

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

David.

Saturday, July 11, 2020

Weekly Overseas Health IT Links – 11 July, 2020.

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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https://www.digitalhealth.net/2020/07/experts-react-to-governments-u-turn-on-contact-tracing-app/

Experts react to government’s U-turn on contact-tracing app

The government should ensure ethics and privacy are “correct by design” in its new contact-tracing app, industry leaders have said.

Andrea Downey – July 2, 2020

Following the government’s decision to abandon its contact-tracing app in favour of Apple and Google’s technology, Digital Health News asked a number of experts what they thought of the U-turn.

The decision to switch to a decentralised model, working with Apple and Google to develop a companion style app, was largely seen as an opportunity for NHSX to get the design of its new app right.

Kathy Farndon, Vice-President of BCS, The Chartered Institute for IT, said: “A majority of BCS members reported in our May survey that they did not believe the proposed model would work as intended and had concerns about the reliance on a centralised database.

“The government now has the opportunity to work collaboratively, communicate clearly and show that ‘ethical and correct by design, and privacy by default’ values will be integral to any new version put before the public.”

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https://www.healthcareitnews.com/news/europe/autonomous-robot-targeting-covid-19-virus-unveiled-bahrain

Autonomous robot targeting COVID-19 virus unveiled in Bahrain

The smart device, a prototype by Fab Lab Bahrain, reportedly uses UV-C light that kills or inactivates a range of microorganisms by disrupting their DNA or RNA.

By Ahmed El Sherif

July 03, 2020 09:30 AM

A “coronavirus-fighting” robot that has the ability to work autonomously around public spaces has been unveiled in Bahrain.

Designed by Fab Lab Bahrain – in collaboration with the country’s Ministry of Youth and Sports Innovation Centre – the machine reportedly uses ultraviolet germicidal irradiation (UVGI) to disinfect commonly used areas, such as an office space, for example.

UVGI is a known disinfection method that utilises short-wavelength ultraviolet C (UV-C) light to kill or inactivate a range of microorganisms by disrupting their DNA or RNA. This leaves them unable to perform vital cellular functions.

Coronaviruses are enveloped, single-stranded RNA viruses.

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https://ehrintelligence.com/news/how-a-hospital-optimized-its-ehr-dashboard-to-combat-covid-19

How a Hospital Optimized its EHR Dashboard to Combat COVID-19

A regional hospital in New Hampshire was able to work with its EHR dashboard vendor to successfully track COVID-19.

By Christopher Jason

June 30, 2020 - When Concord Hospital implemented its EHR system in 2017, Paul Clark, MD, faced a challenge that disrupted the way the providers were getting patient information and ultimately patient care. Information overload clogged up the EHR dashboard, pushing Clark to consider EHR optimization.

“Providers were struggling a little bit to find information,” said Clark, who is the chief medical information officer at Concord Hospital. “They were jumping around to a lot of screens to get the information. So, we were trying to optimize the EHR system. But what became clear to us is that we would like something that was a little bit more agile in terms of making changes to deliver information to providers so it was more meaningful.”

In other words, Clark’s interactions with his EHR vendor weren’t quick enough, keeping the hospital from being able to pivot to different EHR optimization projects.

Once COVID-19 hit New Hampshire, Clark and Concord Hospital had a difficult time figuring out how they were going to track patients and the pandemic. Initially, the health IT team thought they would have to suffer through the previous burdensome, manual process to track patients.

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https://ehrintelligence.com/news/new-data-shows-heavy-ehr-adoption-investment-prior-to-hitech-act

New Data Shows Heavy EHR Adoption Investment Prior to HITECH Act

Researchers went back to the time the HITECH Act was passed to figure out whether or not the reported 9 percent EHR adoption rate painted the complete picture at the time.

By Christopher Jason

July 01, 2020 - A new report published in the Journal of Informatics in Health and Biomedicine (JAMIA) is challenging the statistic that only 9 percent of hospitals had completed a basic EHR adoption by 2008, a key figure on which the 2009 HITECH act hinged.

In fact, 73 percent of hospitals had started EHR adoption in 2008, and the majority of hospitals had implemented six of the 10 basic EHR components. This mean, the number of hospitals beginning their EHR journey was far greater than the 9 percent figure that has been the original baseline for “basic” EHR adoption when crafting HITECH, the study authors argued.

More specifically, 30 percent of hospitals may have adopted a “basic” EHR and 58 percent of hospitals were on their way toward “basic” EHR adoption.

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https://patientengagementhit.com/news/why-epic-systems-says-patient-portal-will-be-key-in-virtual-care

Why Epic Systems Says Patient Portal Will Be Key in Virtual Care

Epic Systems predicts more health IT tools — especially the patient portal — will be integral as COVID-19 continues to revolutionize healthcare.

By Sara Heath

June 30, 2020 - When you drive up to your local CVS drive-thru window to get a COVID-19 test, the process is fairly simple. You fill out a quick registration page, receive your test, and get an activation code for the Epic Systems MyChart patient portal — if you aren’t already set up on the technology, that is.

The system is fairly elegant, helping to connect patients to the care and testing they need, keeping them distanced and out of the clinic, and delivering those crucial results as soon as possible on an easy-to-access format.

That’s not exactly par for the course in healthcare. Limited interoperability between EHR or patient portal systems have stunted efforts to coordinate care across different medical providers. Siloed healthcare can be frustrating for patients, not to mention fragmentation limits health outcomes.

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https://ehrintelligence.com/news/considering-ehr-documentation-strategies-in-pediatric-care

Considering EHR Documentation Strategies in Pediatric Care

Health IT developers are working on EHR documentation tools to decrease pediatrician burden and enhance patient care.

By Christopher Jason

July 02, 2020 - Clinical documentation in pediatric care has changed dramatically since EHRs became more prevalent, leading to pediatrician burden, according to a study published in the Journal of the American Academy of Pediatrics.

Clinical EHR documentation was initially designed to record clinical information as provider notes in real-time during a consultation, assessment, imaging, or treatment, ultimately to share patient information among health providers.

While the transition from paper to EHR documentation has allowed for more accessible and legible notes, it is a primary cause of clinician burden due to information overload and larger amounts of text that is not always relevant to patient care.

EHR documentation tools force or send alerts to the clinician about required or forced fields. These interventions can result in clinician burden by increasing the length and decreasing the effectiveness of the notes, while also increasing the occurrence of inaccurate documentation.

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https://www.healthcarefinancenews.com/news/telehealth-important-tool-rural-hospitals-treating-covid-19-research-shows

More on Telehealth

Telehealth is an important tool for rural hospitals in treating COVID-19, research shows

Despite the benefits, barriers remain in place, preventing the widespread, long-term use of the service.

Jeff Lagasse, Associate Editor

Rural hospitals are more likely than urban facilities to have access to telehealth, a once-underused service that now is playing a key role in treating COVID-19 patients, according to research by two health administration professors in Florida Atlantic University's College of Business.

Drs. Neeraj Puro and Scott Feyereisen say the research can help U.S. hospitals understand the extent to which they are prepared for another wave of the pandemic.

Having telehealth provides hospitals the ability to expand their service offerings in multiple ways. It has the potential, for example, to improve outcomes for high-risk obstetric patients in rural communities. And telehealth facilitated the use of antimicrobials in rural areas where infectious disease physicians were not available. 

Still, barriers such as insurance restrictions and technology limitations remain in place, for now preventing the widespread, long-term use of the service. The Centers for Medicare and Medicaid Services has issued temporary waivers to ease some of these restrictions, but these waivers are expected to expire once the public health crisis has passed, with Congressional action required to enshrine more permanent change.

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https://www.healthcareitnews.com/news/europe/new-zealand-s-covid-crushing-effort

New Zealand’s COVID-crushing effort

The response by the New Zealand government to the COVID-19 pandemic has brought the crisis there under control. HIMSS Insights spoke to Shayne Hunter, deputy director general of data & digital at the New Zealand Ministry of Health, about their strategy.

By Lynne Minion

July 02, 2020 01:28 AM

On 8 June, as most nations continued to grapple with COVID-19, Prime Minister Jacinda Ardern announced New Zealand no longer had any active cases of the virus. The country had recorded a total of 1,154 confirmed cases, including nine deaths, before it had eliminatedthe disease.

How vital has technology been in New Zealands response to COVID-19?

We have been able to maintain services while the bulk of the workforce is working and collaborating from home. This would not have been possible otherwise. Had this occurred five years ago it would have been a different story. We did have Skype but the advent of tools like Zoom and Teams, and the investment in moving to Cloud services along with high-speed internet, have been significant enablers.

Data was vital to supporting the management of COVID-19, be it in modelling, reporting, surveillance and contact tracing, etc.

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https://www.healthcareittoday.com/2020/07/02/health-data-integration-must-be-for-the-whole-clinic/

Health Data Integration Must Be for the Whole Clinic

July 2, 2020

Andy Oram

As health clinics, dentists, and specialists gradually reopen during what we hope is a reprieve from the first COVID-19 wave, lapses in effective data sharing come into glaring view. For instance, some friends told me that when they arrived at a clinic, the receptionist handed them paper forms and pens. The receptionist would say, “Just keep the pen. We don’t want it back–we’d just have to resanitize it.” And I thought, “Is this necessary in the year 2020?”

No, handing pens to patients shouldn’t be necessary. Digital data integration is crucial, not just to quash infections–because keypads are also a major vector for transmitting bugs–but to make sure that a prescription is ready when the patient leaves the office and walks to the pharmacy, and to prevent errors when a technician transfer vital signs from a monitor to the patient’s health record (EHR).

Health IT vendors, particularly since the passage of the 2009 HITECH Act, focus on integrating EHRs. But integration should really extend to every system in the clinic or hospital: billing, pharmacy, practice and workforce management, biometric stations that authenticate staff, and so on. As Josh Douglas, CTO of Bridge Connector, points out, the time spent by a patient in the doctor’s office is only a tiny part of their interaction with the entire health care system.

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https://healthitanalytics.com/news/predictive-analytics-tools-forecast-covid-19-surges-globally

Predictive Analytics Tools Forecast COVID-19 Surges Globally

Using data collected from around the world, researchers have built predictive analytics models that can track COVID-19 surges in different countries.

By Jessica Kent

June 29, 2020 - Researchers from Binghamton University, State University of New York have developed several predictive analytics models to examine COVID-19 trends and patterns around the world.

The machine learning algorithms analyze trends from the 50 countries that have the highest COVID-19 rates, including the US, and can often predict within a ten percent margin of error what will happen for the next three days based on data from the past 14 days.

“We believe that the past data encodes all of the necessary information,” said Anand Seetharam, assistant professor in the department of computer science at Binghamton University.

“These infections have spread because of measures that have been implemented or not implemented, and also because how some people have been adhering to restrictions or not. Different countries around the world have different levels of restrictions and socio-economic status.”

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https://www.fiercehealthcare.com/tech/investors-double-down-health-technology-as-funding-reaches-9-1b-2020

Investors double down on health technology as funding reaches $9.1B in 2020

By Heather Landi 

Jul 1, 2020 3:10pm

While the financial markets have taken a hit during the COVID-19 pandemic, the health technology market continues to thrive.

After a record-breaking first quarter in digital health investment, the strong performance continued in the second quarter with investors sinking $4.2 billion into digital health, according to a report from investment firm Startup Health.

Total health innovation funding for the first half of 2020 hit $9.1 billion, up nearly 19% compared to $7.7 billion invested during the same period in 2019, the firm reported.

Startup Health looked at publicly available data through June 30 on seed, venture, corporate venture and private equity funding.

Funding in the second quarter of 2020 was down slightly compared to $4.4 billion in the second quarter of 2019. The first half of 2020 was buoyed by a surge in funding in January, which hit $2.2 billion before the COVID-19 health crisis impacted the U.S.

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https://www.infosecurity-magazine.com/news/cybersecurity-standard-iot-etsi/

30 Jun 2020 News

New Cybersecurity Standard for IoT Devices Established By ETSI

James Coker Reporter

A new standard for cybersecurity in the Internet of Things (IoT) has been unveiled today by the ETSI Technical Committee on Cybersecurity. It establishes a security baseline for internet-connected consumer products and for future IoT certification schemes. It is hoped the standard, titled ETSI EN 303 645, will help prevent large-scale, prevalent attacks taking place against smart devices.

Developed in collaboration with industry, academics and government, the standard aims to restrict the ability of cyber-criminals to control devices across the globe and launch DDoS attacks, mine cryptocurrency and spy on users in their own homes. This has become a major concern for the cybersecurity industry due to the growing prevalence of smart devices in households, many of which have security weaknesses.  

Earlier this month, for example, an investigation by Which? found that 3.5 million wireless indoor security cameras across the world potentially have critical security flaws that make them vulnerable to hacking.

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https://ehrintelligence.com/news/orgs-with-high-opioid-prescribing-rates-lack-pdmp-ehr-integration

Orgs with High Opioid Prescribing Rates Lack PDMP EHR Integration

Only 22 percent of prescribers located within a high opioid prescribing area had PDMP EHR integration that allowed efficient prescribing oversight.

By Christopher Jason

June 30, 2020 - Hospitals located in areas with high rates of opioid prescribing were less likely to have prescription drug monitoring programs (PDMPs) integrated into the EHR, which limits the impact of PDMPs in these vital areas of the country, according to research published in JAMA Network Open.

A PDMP that is implemented into the EHR can decrease the strenuous process of checking the PDMP, which as a result, can reduce the cognitive workload and clinician burden.

However, EHR-integrated PDMPs are not particularly widespread.

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https://www.healthcareitnews.com/news/asia-pacific/overview-malaysia-s-digital-health-landscape

An overview of Malaysia’s digital health landscape

Digital health tools and investments offer great opportunity for efficiency improvements and better health outcomes in the country.

By Dean Koh

July 01, 2020 10:26 PM

Malaysia has a dual-tiered system of healthcare services: one led by the government and funded by taxpayers, and the other provided by the private sector. Like many other countries, the growing burden of non-communicable diseases is one of the most prominent threats to the financial sustainability of the current healthcare system.

As such, digital health tools and investment in digital solutions could help address some of the challenges of maintaining and growing Malaysia's healthcare services and ensuring quality, affordable and patient-centric healthcare.

Government and private initiatives

Launched in 2017 by the Ministry of Health, the Malaysian Health Data Warehouse (MyHDW) is a national healthcare information gathering and reporting system covering all government and private healthcare facilities and services. MyHDW includes a patient treatment information system (SMRP) and patient registry information system (PRIS). 

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https://www.healthcareittoday.com/2020/07/01/securing-medical-devices-and-iot/

Securing Medical Devices and IoT

July 1, 2020

John Lynn

I know it’s easy to be distracted by COVID-19 right now, but it’s important to remember that many of the challenges we faced pre-COVID-19 are still around and need to be managed effectively even as we deal with the pandemic.  One of those ongoing challenges is properly securing medical devices and IoT.

In fact, one could argue that this challenge has become even harder amidst COVID-19 as more IoT devices are being implemented in healthcare and the risk surface is increasing as we add more and more endpoints that can be exploited.  Plus, it’s no news to anyone in healthcare that many medical and IoT devices weren’t designed with security in mind.

In order to better understand this problem and how a healthcare organization should be approaching it, we sat down with Renee Tarun, Deputy CISO at Fortinet and Michael Archuleta, CIO at BridgeCare Health Network – Mt San Rafael.

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https://patientengagementhit.com/news/why-have-covid-19-racial-health-disparities-emerged

Why Have COVID-19 Racial Health Disparities Emerged?

COVID-19 racial health disparities are the result of a near-century of institutional health inequities.

By Sara Heath

June 29, 2020 - The racial health disparities that have emerged throughout the COVID-19 pandemic can be boiled down to three root causes: structural racism affecting patient access to care, high occurrence of chronic disease, and economic inequalities leading marginalized populations to work high-risk jobs, according to Patrice Harris, MD, the immediate past president of the American Medical Association (AMA).

During a recent hearing on health and wealth inequality in American, held in the US House of Representatives, Harris joined other health and economic experts to outline how stark racial health disparities came to the forefront during the pandemic.

“As our nation confronts the dual crises of a deadly pandemic that has triggered joblessness unseen since the Great Depression, the pandemic has revealed starkly the disproportionate impact of the virus on minoritized and marginalized communities,” she said in her testimony.

“While the data remains incomplete, the data that have emerged on the racial and ethnic patterns of the COVID-19 pandemic show that the virus has clearly disproportionately affected Black and Latinx, American Indian/Alaska Native—particularly in the Navajo nation—Asian-American, and Pacific Islander communities.”

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https://ehrintelligence.com/news/ehr-usability-impacts-fellowship-education-clinician-burnout

EHR Usability Impacts Fellowship Education, Clinician Burnout

Just over half of physicians who are studying to become kidney specialists said EHR usability has had a positive impact on their education.

By Christopher Jason

June 25, 2020 - EHRs aid physicians who are training to become kidney specialists from an educational standpoint. However, EHR time demands and data entry lead to physician burden for fellows, according to a study published in the Clinical Journal of the American Society of Nephrology (CJSON).

Over the past decade, EHRs have shown to be a vital and volatile addition to healthcare systems across the country. But while there are a handful of benefits for EHR adoption and use, there is also a list of negatives that highly impact users and their relationships with patients.

“One unintended consequence is a potential deleterious effect on physician training, including limiting time with patients and mentors; perpetuation of erroneous information (data obfuscation) via pre-population, checkboxes, and copy forward; and superficial discussions and analysis of patient problems,” wrote the study authors.

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https://healthitsecurity.com/news/riskiest-healthcare-devices-pacs-hl7-gateway-radiotherapy-systems

Most At-Risk Medical Devices: PACS, HL7 Gateway, Radiotherapy Systems

Forescout finds 35 percent of healthcare workstations operate on unsupported versions of Windows, with PACS, HL7 Gateway and Radiotherapy Systems as some of the riskiest devices in the sector.

By Jessica Davis

June 25, 2020 - More than 35 percent of the workstations used in healthcare are operating on unsupported versions of Windows, with Picture Archiving and Communication Systems (PACS) and HL7 gateway among the riskiest devices in the sector, according to a new Forescout Research Labs report.

The report comes on the heels of several Department of Homeland Security alerts regarding Ripple20 vulnerabilities in millions of medical devices, as well as critical flaws found in six medical device platforms.

For its Enterprise of Things Security Report, researchers assessed the risk posture of over 8 million devices across five sectors, healthcare, government, manufacturing, financial services, and retail using defined metrics and data from Forescout’s Device Cloud, one of the largest repositories of connected enterprise device data.

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https://www.zdnet.com/article/ransomware-attacks-that-start-with-phishing-emails-are-suddenly-back-in-fashion-again/

Ransomware: Attacks that start with phishing emails are suddenly back in fashion again

Email was once the main method for delivering ransomware. Now familiar and new forms of ransomware are using it again.

By Danny Palmer | June 29, 2020 -- 12:03 GMT (22:03 AEST) | Topic: Security

Ransomware attacks via email are on the rise again, with several new and familiar forms of ransomware recently being distributed with the aid of malicious payloads in phishing messages.

Email used to be the most prolific way to infect victims with ransomware, but in recent years, attackers have successfully pivoted to using remote ports, insecure public-facing servers and other vulnerabilities in enterprise networks to encrypt entire networks – often demanding hundreds of thousands of dollars in payment to release the data again.

However, in recent weeks, researchers at Proofpoint have seen a rise in the number ransomware attacks being distributed by email – including one from a ransomware that hasn't been active in years – with crooks sending out hundreds of thousands of messages every day. The email attacks use a variety of lures to trick people into opening them, including subject lines related to coronavirus.

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https://hbr.org/2020/06/where-telemedicine-falls-short

Where Telemedicine Falls Short

June 30, 2020

Telehealth use has surged during the coronavirus pandemic, with the technology spreading far and fast. Doctors and patients alike must be wondering if this is the beginning of a whole new kind of doctor–patient relationship, one that might totally transform our health care system.

I’m not convinced, and Americans may not be either as the initial telehealth surge appears to be leveling off.

I am not skeptical because of the technology: I am a strong supporter of health information technology and believe new IT holds huge benefits for patients and their caregivers. Years ago, I helped lead the federal government’s effort to get hospitals and doctors to adopt electronic health records. Indeed, virtual care would be much less valuable if it weren’t for electronic records that enable doctors to access patients’ health histories remotely.

But I am also a primary care physician. I know that trusting relationships between patients and clinicians can be a boon to giving and receiving care. And that trust — the kind that lets anxious patients return to sleep at night, the kind that settles the stomach of a new mother with a sick baby — grows fastest and strongest through in-person relationships.

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https://www.healthcareitnews.com/news/europe/uk-rolls-out-ai-based-cancer-detection-nhs-patients

UK rolls out AI-based cancer detection for NHS patients

Ibex Medical Analytics and LDPath announce UK’s rollout of clinical grade AI applications for cancer detection in pathology.

By Sara Mageit

June 30, 2020 04:34 AM

Leader in AI-powered cancer diagnostics, Ibex Medical Analytics and provider of digital pathology services in the NHS, LDPath, have announced the UK’s first rollout of clinical grade AI application for cancer detection in pathology.

This platform will support pathologists in enhancing diagnostic accuracy and efficiency.

WHY IT MATTERS

Over the years, a global increase in cancer cases has coincided with a decline in the number of pathologists around the world.

Traditional pathology involves manual processes that have remained the same for years. These processes involve slides to be analysed by pathologists using microscopes, and reporting is often carried out on pieces of paper.

The limited availability of pathologists has required couriers to transport glass slides containing tissue samples between different locations to access expert opinions. 

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https://www.healthcareitnews.com/news/europe/flattening-curve-virtual-care-australia

'Flattening the curve' with virtual care in Australia

When Paul Roseworn flew out on holiday to Ireland and the UK in February to watch the Six Nations Rugby, he didn’t realise he would be caught up in a global pandemic. But by the time he’d arrived back in Australia 3 weeks later, he'd contracted COVID-19.

By Lynne Minion

June 30, 2020 07:01 AM

I just had an inkling. It felt like a cold but slightly worse. There was something a bit off about it,” Roseworn told HIMSS Insights.

The 52-year-old company director was tested a day later and spent the next three and a half weeks hospitalised” in his home thanks to the remote care provided by one of the nations major health facilities, Royal Prince Alfred Hospital (RPA) in Sydney.

There were a few days there where it felt like I had a weight sitting on my chest. I wasnt wheezing, it just felt hard to expand my chest for a few days,” Roseworn, who is asthmatic, said. And I had a pretty bad dry cough so it sounded antisocial.”

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https://www.healthcareittoday.com/2020/06/30/telehealth-only-doctors-and-medical-practices/

Telehealth Only Doctors and Medical Practices

June 30, 2020

John Lynn

The evolution and adoption of telehealth these past few months has been fascinating to watch.  It illustrated many of the built in biases many healthcare organizations had towards in person visits.  It also highlighted times when an in person visit is far superior to an online visit.  While we’re starting to see a roll back to more in person visits with new social distancing, COVID-19 has certainly thrown the doors open to telehealth in a way that could have never been imagined possible 6 months ago.

Even before COVID-19, there were a number of direct to consumer telehealth companies who were offering telehealth options for a special set of visits.  No doubt that’s exploded in the current environment and in many ways has started to compete with health systems for visits.  I expect we’ll continue to see this area of telehealth to continue to grow as these direct to consumer companies can create a really convenient patient experience.  Plus, we’ve got at least another year or more until people feel really comfortable going back to in person visits.

Along with these direct to consumer telehealth models, a massive number of telehealth companies are providing the tools and technology needed to provide doctors the opportunity to do telehealth on top of their existing medical practice.  We’ve written a lot about this as many were forced to convert their scheduled appointments to online telehealth visits.

While both of these areas of the video telehealth visit are interesting, I wonder if there’s an opportunity here that I haven’t really seen before.  Will we start to see telehealth only doctors and medical practices?

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https://www.healthcareittoday.com/2020/06/30/consumers-see-remote-monitoring-tech-positively/

Consumers See Remote Monitoring Tech Positively

June 30, 2020

Anne Zieger

A new survey has concluded that the vast majority of patients believe that remote monitoring of their condition can make a difference in their overall health.

The research was conducted by Sony’s mSafety Wearable Platform Division, whose mSafety platform helps healthcare organizations build remote monitoring applications. (For more background on the platform, check out this interview my colleague Andy Oram did with Sony Network Communications Europe’s Arnol Rios, who’s with subsidiary Takeoff Point Inc.)

To conduct the survey, Sony researchers reached out to more than 2,000 patients diagnosed with chronic conditions in the US.

The study found that one in three chronically ill patients responding to the survey have trouble tracking important health measurements such as vital signs. It also found that one in three felt stressed about the need to keep up with such efforts as well as the possibility of misreporting such statistics.

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https://healthitanalytics.com/news/over-50-of-leaders-underwhelmed-by-population-health-management-tech

Over 50% of Leaders Underwhelmed by Population Health Management Tech

A survey revealed that healthcare leaders want analytics and care coordination functionalities embedded in their population health management solutions.

By Jessica Kent

June 25, 2020 - Fifty-six percent of healthcare leaders say their current population health management solution doesn’t meet their needs, according to a survey from Persivia and commissioned by Sage Growth Partners.

Just 38 percent of respondents rated their population health solution as eight, nine or ten on a scale of one to ten, while 24 percent rated it a seven and 37 percent judged their solution to be a six or less.

The survey of 224 healthcare leaders was conducted in April 2020. Researchers found that only 41 percent are using a population health management (PHM) solution or participating in value-based care at all. The 59 percent not using PHM platforms or participating in value-based care were screened out of the remaining survey questions.

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https://mhealthintelligence.com/news/cms-moves-to-make-covid-19-home-health-telehealth-expansion-permanent

CMS Moves to Make COVID-19 Home Health Telehealth Expansion Permanent

The Centers for Medicare & Medicaid Services is proposing to make telehealth coverage enacted during the COVID-19 crisis permanent for home health care providers - though providers still won't be reimbursed.

By Eric Wicklund

June 26, 2020 - Federal regulators are moving to permanently expand telehealth coverage for home health care services.

In a June 25 notice, the Centers for Medicare & Medicaid Services unveiled a proposed rule to make permanent emergency rules enacted on March 30 to address the coronavirus pandemic. The proposed rule will be published in the Federal Register on June 30.

In response to the COVID-19 crisis, CMS enabled home healthcare providers to use connected health platforms to provide more services as long as those services are part of the patient’s care plan and they don’t replace needed in-person visits as ordered in the original care plan.

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https://www.aappublications.org/news/2020/06/29/edocumentation062920

Electronic documentation guidance aims to prioritize values, reduce burden

Heather C. O’Donnell, M.D., M.Sc., FAAP

·         AAP Policy

·         AAP Technical Report

Much has changed in the way pediatricians document care, including the transition to electronic health records (EHRs) and the changing stakeholders, policies and regulations regarding clinical documentation. For many, these shifts have altered the content, structure and even the perceived purpose of clinical documentation.

While electronic documentation has improved information availability and legibility, new problems have been introduced, including documentation burden, “note bloat” and information overload. These issues have necessitated reexamining documentation priorities and requirements.

Pediatrics is a unique specialty in many ways, involving both patients and their families. Additional stakeholders in clinical documentation include schools, as teachers and school nurses serve as important caregivers for children and adolescents. In some states, teens have the right to consent to their own care in certain situations and might want to keep that information confidential from parents or guardians.

Thus, a new AAP policy statement and technical report provide guidance that aims to drive electronic documentation improvement initiatives. The goal is to maximize the benefits of electronic documentation and functionalities while mitigating their potential negative aspects.

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https://www.medscape.com/viewarticle/933065

Outpatient Diagnostic Delays Linked to EHR Usage, Design Flaws

Ken Terry

June 26, 2020

Health information technology (HIT) is implicated in many of the missed test result follow-ups that lead to outpatient diagnostic delays, according to a new study of root cause analysis (RCA) data from the US Department of Veterans Affairs (VA). Such delays have been shown to threaten patient safety by causing the treatment of serious conditions such as lung and breast cancer to be postponed.

Whereas computer hardware and software issues were responsible for some of these errors, most safety concerns involved "sociotechnical factors" associated with people, workflow and communication, and a poorly designed human-computer interface.

The five key high-risk areas for diagnostic delays were managing electronic health record (EHR) inbox notifications and communication, clinicians gathering key diagnostic information, technical problems, data entry problems, and the failure of a system to track test results.

Lauren Powell, MD, MBA, and colleagues published findings from their retrospective cohort study online June 25 in JAMA Network Open.

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https://www.healthcareitnews.com/news/ucsf-pays-114-million-decrypt-files-after-ransomware-attack

UCSF pays $1.14 million to decrypt files after ransomware attack

The medical school was hit by an opportunistic malware attack on June 1, and the encrypted data was "important to some of the academic work we pursue as a university serving the public good," officials said.

By Mike Miliard

June 29, 2020 04:02 PM

UCSF on Friday announced that it had "made the difficult decision" to pay a $1.14 million ransom and unlock the important data that had been encrypted in a ransomware attack earlier this month.

WHY IT MATTERS
On June 3, IT staff at UCSF School of Medicine detected a security incident that had occurred two days earlier, said school officials in a statement.

"We quarantined several IT systems within the School of Medicine as a safety measure, and we successfully isolated the incident from the core UCSF network. Importantly, this incident did not affect our patient care delivery operations, overall campus network, or COVID-19 work," officials noted.

Even as that attack was stopped, however, the perpetrators launched a malware program that encrypted some servers. UCSF officials note that IT and security staff have been working with an outside consultant and hope to restore access to the servers and shore up its defenses in general.

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https://www.healthcareitnews.com/news/after-initial-spike-telehealth-visits-are-decline-report-finds

After initial spike, telehealth visits are on the decline, report finds

Data from 50,000 healthcare providers suggests that ambulatory practice visits have not rebounded to pre-pandemic levels.

By Kat Jercich

June 29, 2020 01:50 PM

A new report from the Commonwealth Fund found a "plateau" in the growth of telemedicine visits, accounting for a relatively small percentage of rebounding ambulatory care services.

As states experiment with reopening – and re-closing – their economies in response to concerns around coronavirus, continuing attention has been paid to skyrocketing rates of telehealth visits.   

But the report found that telemedicine visits have actually been declining since April, suggesting that health providers are still finding the best ways to provide virtual services.  

"Telemedicine cannot replace all types of visits – for instance, in-person visits are still necessary to diagnose and test certain complex conditions," said Commonwealth Fund SVP for policy and research Dr. Eric C. Schneider and VP for delivery system reform Tanya Shah in a blog post accompanying the report. 

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https://histalk2.com/2020/06/26/weekender-6-26-20/

Weekly News Recap

  • Kaufman Hall spins off its enterprise performance management software division as Syntellis Performance Solutions.
  • Public health officials in Austin, TX blame COVID-19 case counts that vary wildly by day on labs that are sending test results by fax.
  • The American Hospital Association loses its bid to stop the federal government from requiring hospitals and insurers to publish their negotiated prices, but will appeal.
  • Massachusetts eHealth Collaborative shuts down after 15 years.
  • CMS begins publishing a monthly Medicare COVID-19 Data Snapshot.
  • CMS announces the creation of CMS’s Office of Burden Reduction and Health Informatics.
  • Russian President Vladimir Putin calls for the healthcare system there to roll out out digital systems and to use artificial intelligence.

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Enjoy!

David.

Friday, July 10, 2020

It Seems Governments All Over Need To Work Harder To Have Us Trust Them With Our Personal Information.

This appeared last week.

70 per cent don’t trust govt on personal data

29 June, 2020

Seventy per cent of Australians have limited or no trust in the government to safely handle their personal data.

An international survey has found Australians are highly distrustful of government surveillance and data collection, especially in relation to COVID-19.

Cloud software vendor Okta commissioned an online survey of over 12,000 people between the ages of 18 and 75 in Australia, France, Germany, the Netherlands, the UK, and the US.

It found seventy per cent of Australians were uncomfortable with the government handling their data, and it also found Aussies are “shockingly unaware” of how much their data is collected.

“From Cambridge Analytica to the news that Australia’s My Health Record has suffered two potential data breaches, a never-ending list of controversies have shed a light on consumers’ shrinking levels of privacy,” the report, The Cost of Privacy, says.

“Yet our data shows that many consumers are not aware of the routine tracking and data harvesting that takes place daily.”

But it also found that Australia isn’t alone and distrust in government is high around the world, although social media companies ranked lowest in the trust stakes.

Trust in the age of coronavirus

When it came to the Coronavirus pandemic, a third of Australians said they felt less comfortable with the idea of data tracking if the government was involved.

However concern was higher among Americans, with 45 per cent of US respondents expressing similar concerns.

Almost 80 per cent of Australians believe personal data collected for COVID-19 will be used for more than the stated public health purpose, with 63 per cent worried it will be accessed for law enforcement purposes.

“Australians show widespread discomfort with the idea of their data being collected to aid the containment of COVID-19,” the report says.

Aussies were slightly more comfortable with medical data being collected for this purpose.

“While the public health benefits of collecting data to track the spread of COVID-19 are clear, consumers in every country surveyed are worried about privacy,” the report concludes.

Across Australia, the UK, the US and Germany respondents report significantly higher trust in their workplace to handle their personal data than the government.

More here:

https://www.governmentnews.com.au/70-per-cent-dont-trust-government-on-personal-data/

I have to say the ADHA have a difficult gig here with their total lack of openness and transparency to convince pretty much anyone that they will treat your information with honesty and transparency and not cause you any surprises!

Maybe offering more honest and better explained usage statistics for the system could be a good start?

Actually explaining in lay terms what the data breaches were really all about might also be helpful.

The ADHA could also publish proper Board Minutes – but I suspect hell will freeze over first!

David.