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."

Tuesday, March 29, 2016

Dear Oh Dear! There Seems To Be Angst Regarding The SA EPAS Program.

This appeared a few days ago:

No end in sight for loathed electronic record system

18 March 2016
SA HEALTH is ploughing ahead with a much-maligned platform for electronic records that has been blamed for inducing “rage attacks” in clinicians.
Doctors remain concerned that the $422 million Electronic Patient Administration System (EPAS) remains user-unfriendly, despite assurances that bugs have been ironed out.
“The EPAS system will continue to evolve and improve over time and SA Health remains committed to working closely with our clinicians’ support (for) the roll out of EPAS”, SA Health told Medical Observer in a statement.
The Flinders and Far North Doctors Association (FFNDA) wrote to the department in January arguing that the system should be overhauled or junked.
“We would like to remind you again that the overwhelming majority of us work primarily as general practitioners, working in private practices,  that use electronic records 100% of the time,” the letter said. 
“We have for years embraced electronic medical records and their expected efficiencies. EPAS has been extremely disappointing in not delivering these efficiencies as would be expected of a contemporary program.
“Therefore, we ask again – please take EPAS away and completely remodel it into a more user-friendly, efficient and safe interface. Or, if that is not possible please replace EPAS with something much better.”
Earlier, in 2014, the group advised the department that the system caused “rage attacks” among clinicians and some doctors were refusing to work with it.
EPAS has been on trial for more than two years at Port Augusta hospital using consultants from Adelaide and the local GP workforce. 
“It had many teething problems that drove clinicians completely mad,” Dr Peter Rieschbieth, a vice president of the SA Rural Doctors Association tells MO.
“This was relayed to us because rural doctors are contracted to work in hospitals required to work with EPAS.”
The GP says he has not heard one clinician back up the department’s claim that the bugs have been ironed out.
However, senior doctors were reportedly giving their passwords to junior doctors or students, asking them to input data on their behalf.  
“Across the board, clinicians have been saying it’s not user-friendly, it takes much longer to use. Fewer patients are seen at outpatients, fewer patients are being operated on, because you spend so much time on it.” 
More angst outlined here:
What to say? While I am sure there are two sides to this story, at least to some degree, it is clear things are simply not working out with this implementation.
It would be good to see some Government commentary on just where this project is up to and just how the new Royal Adelaide Hospital is going to be provided with working and clinically acceptable IT - along with relevant plans for all the other large hospitals which seem also to now be all that happy.
It’s about time the Minister hopped out of his apparent state of denial and sorted all this out.
David.

Monday, March 28, 2016

Weekly Australian Health IT Links – 28th March, 2016.

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

Quite an interesting week with cyber-threats of all sorts catching the headlines and again some private sector activity.
I hope all enjoyed the Easter break!
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Alert raised over cyber attacks on medical devices

Jo Hartley | 23 March, 2016 | 
The Australian Prime Minister falls to the floor clutching his chest as cybercriminals play power games with his pacemaker. A final flip of the remote and he’s dead.
It makes for gripping TV, but could this Homeland scene really happen?
Yes, says cybersecurity expert Dr Robert Merkel (PhD), an IT researcher at Monash University, Melbourne.
Dr Merkel is speaking with Australian Doctor following the release of a TGA alert advising medical device makers and hospitals to carry out IT assessments to determine the risk of cyber attack.
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US hospital pays $24k ransom after cyber attack locks medical records

Date February 19, 2016

Justin Wm. Moyer

Obama's new budget to fix 'ancient' technology

The eighth and final budget is announced by President Barack Obama, and it includes a $19 billion boost in cyber security funding aimed at replacing insecure and 'downright ancient' systems.
Not too long ago, taking the United States' wild, messy, unreliable system of medical records online seemed like a worthy goal.
"To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America's medical records are computerised," President Obama said. "This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests."
While the shift Obama and many others pushed may have improved care, electronic medical records led to quite the unique hostage situation in Los Angeles this week. There, a hospital fell prey to a cyberattack — and has escaped its plight by paying hackers a $US17,000 ($23,740) ransom.
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Privacy fact sheet 47: Young people and the My Health Record system (Northern Queensland and Nepean Blue Mountains)

Note: This fact sheet applies only to people living in the Northern Queensland and Nepean Blue Mountains areas
March 2016
In June 2016, people whose registered Medicare address is in the Northern Queensland or Nepean Blue Mountains Primary Health Networks will have a My Health Record created for them. This includes young people under the age of 18. This fact sheet explains how young people can take control of and manage their My Health Record, and how an authorised representative (such as a parent) can manage a My Health Record on a young person’s behalf. This includes how to opt a young person out of a My Health Record so that a record is not created for them.
This fact sheet is for people whose registered Medicare address is in the Northern Queensland and Nepean Blue Mountains Primary Health Networks. It should be read together with the OAIC’s Privacy fact sheet 46: My Health Record system – What to expect in Northern Queensland and Nepean Blue Mountains.
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Australian industry lashes out at data breach notification scheme

Businesses complain of unclear obligations, broad scope.

By Allie Coyne
Mar 23 2016 10:02AM
Australian businesses say they are not sold on the government's proposed mandatory data breach notification scheme, with some even going so far as to call for it to be abandoned.
Late last year the government released an exposure draft of its long-awaited bill for the scheme, outlining what it considers a serious breach and the steps an organisation must take in response to one. 
It defines a serious breach as unauthorised access to, disclosure or loss of customer information which generates a real risk of serious harm to individuals.
After an entity is aware or "ought to have been aware" a serious breach has occured, it must notify customers, the Privacy Commissioner, and potentially the media "as soon as practicable".
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Mixed reception for data breach notification scheme

Case for scheme has not been made, some industry orgs argue
There has been a mixed reception from business to a draft government bill that would implement a mandatory data breach notification scheme.
The government in in December released an exposure draft of a bill to implement a data breach notification regime.
The government had committed to the introduction of such a scheme as part of its response to concerns about the mandatory data retention scheme for telcos, which began operation in October.
The release of the exposure draft late in the year represented backtracking by the government, which had originally committed to legislating a scheme in 2015.
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One million South Island electronic referrals

Health Minister Jonathan Coleman says one million electronic referrals to specialists have been successfully processed in the South Island.
The South Island Electronic Request Management System allows general practice teams to submit requests for specialist advice direct to a secure database of over 700 specialists.
“More than a million South Islanders have had access to timely specialist advice as a result of the eReferrals system,” says Dr Coleman.
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IT bungles cost taxpayers hundreds of millions

Benjamin Preiss state political reporter
Published: March 21, 2016 - 3:29PM
Bungled IT systems that were scrapped before launching, or introduced with major flaws, have cost taxpayers almost $900 million.
The splurge by government departments on faulty projects comes despite repeated warnings in recent years about substandard commissioning processes.
Earlier this month Victoria's financial watchdog issued another scathing report on six information communications technology (ICT) projects in the public sector.
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Delays to NBN rollout could hinder new health services

21st Mar 2016 6:00 AM
QUEENSLANDERS are embracing new telehealth services enabled by better access to fast broadband to better manage family health from home, according to a new report released today.
The NBN Digital Health At Home Report, shows 72 per cent of respondents living in regional or rural Australia have delayed a visit to a GP, with reasons for this including to prevent wasting time, losing money and having to take days off work.
With a number of regional Queenslanders having to travel significant distances for specialist healthcare, the research highlights how access to fast broadband and telehealth services (such as GP video conferencing and in-home monitoring for the elderly) can help time-poor Aussies manage family health from home.
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How to improve the recording of requested appointments

23 March 2016
To improve clinical software, we look at recording the requested appointment and provide two vendor responses.
THE ISSUE?
PATIENTS usually have preferences about when they wish to be seen at the practice and by whom. General practices currently have no way to monitor how well they are satisfying those wishes, because their electronic appointment systems record only the appointment that was given and not the appointment that was requested.
PROPOSED SOLUTION
The patient should be asked to state their ‘ideal appointment’ — the one that would best suit their needs and preferences.
To achieve this, the practice’s appointment software should prompt the receptionist, or the patient who is using the practice’s online appointment system, for answers to as many of the following questions as matter to the patient
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Australian Doctor launches online dermatology hub

Guest writer | 22 March, 2016 | 
Sponsored
With one in 10 patient consultations related to a skin complaint and one third of the general population suffering with a skin ailment within the past fortnight, the demand among GPs for quality independent dermatology information has never been so great.
To keep GPs abreast of the latest clinical developments, Australian Doctor has launched a new website, ‘Clinical Hub’ focussing initially on all things skin.
The hub, which has been unlocked for doctors with an unconditional educational grant from Bayer, delivers a range of content – from in depth clinical articles on diagnosis and treatment to practical patient case studies, videos and quizzes to test your clinical knowledge.
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ASX-listed 3D Medical makes AU$60m hospital data play

3D Medical has acquired US diagnostic image management company Mach7 Technologies in a AU$60 million deal that will see the Australian company take on the global hospital market.
By Asha Barbaschow | March 22, 2016 -- 04:58 GMT (15:58 AEDT) | Topic: Big Data Analytics
Australian Securities Exchange (ASX)-listed 3D Medical has scooped up US-based Mach7 Technologies in a bid to bolster the global presence of its vendor neutral diagnostic technology.
According to Dr Nigel Finch, chairman of the Melbourne-based 3D printing firm, the AU$60 million acquisition gives 3D Medical monopoly of the global marketplace, with hospitals previously locked into sticking with a single vendor for their diagnostic machines.
Finch said that within a hospital, there is a rich set of Digital Imaging and Communications in Medicine (DICOM) data, which is stored as its own file format. This DICOM data is created each time an X-ray, magnetic resonance imaging (MRI), or computerised axial tomography (CAT) scan is performed, with Finch saying this data is often completely siloed.
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GP2U: Smartphone app brings the doctor to your phone

  • The Australian
  • March 24, 2016 12:00AM

Chris Griffith

A new kid on the block in telehealth medicine is sailing in uncharted waters.
Fire up a smartphone app and you’re on your way to visiting a virtual clinic, even waiting in a virtual waiting room, before your appointment with a GP or specialist possibly thousands of kilometres away.
GP2U is one of a new breed of GP online clinics that offers this. Telehealth is a well-established practice for healthcare in remote locations. Now it’s available to city folk, too.
Being able to videoconference with your doctor on your smartphone or via a weblink is of obvious value to immobile people, those without transport, the elderly and parents facing logistic difficulties getting kids to the doctor.
But does this compromise medicine delivery?
For younger, tech-savvy generations, it’s about convenience and saving time. This is new age medicine for the millennials and gen Y parents. Squeezing in an online consultation during a busy workday without leaving the office, or on the phone in the train, has its appeal.
This new era of mobile and PC-connected consultations goes further than video chat. It takes in patients using blood pressure dev­ices capable of uploading data to the doctor. And there are apps that help patients take photos of their skin for uploading to a skin cancer specialist.
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Illusion or reality? Does SMS messaging really help the medicine go down?

March 24, 2016 2.40am AEDT

Author David Glance

Director of UWA Centre for Software Practice, University of Western Australia
Mobile health solutions or mHealth encompasses all of the technology and software that combined with mainly smartphones, provide individuals to measure, record, monitor, analyse and report the state of their health. The ultimate aim of course is to keep people well and to help them to get better in the event of illness.
It is easy with mHealth to confuse the enormous potential for technology to bring about change, with its actual ability to do so. Whilst the advances in connected devices and the promise of technology such as Google’s smart contact lenses that will monitor blood sugar levels of diabetics, there is very little evidence that these devices will bring about significant changes in the outcomes that matter, namely an improvement in the health of the person using the device.
The problem with research in this area is that mHealth is such a broad area, covering such a large range of technologies that are applied to a large range of uses. Whilst it is entirely possible that an app on a mobile phone could help in the management of a very specific condition, being able to determine this experimentally is very difficult. There are few rigorous “randomised controlled trials” involving mHealth and those that have been conducted confirm the difficulty of drawing definite conclusions from the promise of this technology.
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Electronic Medication Management

The Commission focuses on the electronic future for medicines management. It makes available a range of resources to assist health service organisations and health professionals safely implement and use electronic medication management.

National guidelines for on-screen display of clinical medicines information

The Commission has worked with the National eHealth Transition Authority (NEHTA) and the Australian Government Department of Health to develop national guidelines for standardised presentation of on-screen medicines information to ensure benefit from investments in e-health initiatives and to maximise patient safety.
The guidelines provide an evidence-based approach to on-screen presentation of medicines information, incorporate Australia’s National Tall Man Lettering, and build on Australia’s Recommendations for terminology, abbreviations and symbols used in the prescribing and administration of medicines.
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NBN launches Digital Diagnosis, releases telehealth report

Respondents to an NBN survey have said that access to telehealth would be convenient, save money and time, and provide more options for those living in regional areas.
By Corinne Reichert | March 21, 2016 -- 01:24 GMT (12:24 AEDT) | Topic: NBN
The company responsible for rolling out the National Broadband Network (NBN) across Australia has released a research paper on e-health, spruiking the benefits of using high-speed broadband for monitoring health and conducting telehealth conferences with doctors.
NBN's guide to health in the home: How fast broadband is helping to connect us to anytime, anywhere healthcare [PDF] was commissioned by NBN and conducted by market research agency Colmar Brunton.
The report was released as part of NBN's new Digital Diagnosis program, which exists primarily to push broadband -- or, more specifically, the NBN -- as a health enabler.
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GPs warned about privacy risks with patient images

21 March 2016
GPs who email images of patients' conditions to specialists to seek a better diagnosis have been warned of significant privacy and legal risks.
The practice, known as store-and-forward, is becoming increasingly popular particularly with dermatologists, say research assistant Paul Stevenson and colleagues from the University of Queensland and Brisbane's Princess Alexandra Hospital.
They say doctors should obtain informed patient consent, explaining how the images will be used, applying appropriate digital security to prevent unauthorised access and deleting pictures after saving them to patient health records.
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Transforming Health blueprint defended by Minister Jack Snelling amid Opposition criticism

Critics of a wide-ranging plan to transform health services in South Australia to tackle rising costs and forecast patient growth have not put any better proposal to the State Government, Health Minister Jack Snelling says.

Key points:

  • Some critics had their names used without permission, Health Minister says
  • Opposition says original Transforming Health promises had changed
  • Minister Jack Snelling says Government listening to clinicians' views
The Minister told 891 ABC Adelaide that doctors who were vocal opponents of the Transforming Health blueprint were far from representative of all who worked in the state public health system.
"These are not the only medical voices out there, there are in fact medical voices who are supporting the changes we're making," he said.
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National burns registry desperate for funding

Charlotte Mitchell
Monday, 21 March, 2016
FUNDING is urgently needed to keep the Burns Registry of Australia and New Zealand (BRANZ) up and running because experts say it is the “foundation stone” for excellence in burns injury care.
Winthrop Professor Fiona Wood, director of the Burns Service of Western Australia, told MJA InSight that “continuously improving outcomes for those unfortunate in suffering burn injury is now possible, but it hinges on the continuation of this data registry”.
She said that thanks to BRANZ, researchers and clinicians have been able to identify key attributes of quality care and transfer this knowledge across the whole country.
However, there is no guaranteed source of funding to preserve and develop this valuable resource.
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Diagnosis by unsecured smartphone risks patient confidentiality: researchers

Date March 21, 2016 - 1:03AM

Lisa Yallamas

Doctors who photograph skin conditions using unsecured, personal mobile phones could be breaching patient privacy, new Queensland research warns.
In an article in the Medical Journal of Australia, researchers from the University of Queensland and Princess Alexandra Hospital, led by Paul Stevenson, say using telemedicine for diagnosing dermatological conditions was popular because it sped up treatment and improved patient outcomes, particularly in regional areas where there are few specialists.
However doctors and medical institutions endangered patient privacy, as well as their own indemnity insurance and confidentiality clauses of their employment contracts, if they failed to protect confidential patient records by using unsecured mobile phones and emails.
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Half of dermatology discharge summaries inaccurate

Alice Klein | 18 March, 2016 | 
About half of discharge letters from dermatologists omit important information or contain incorrect diagnoses and spelling errors, new research suggests.
The accuracy rate of dermatology discharge summaries is only 55%, according to a retrospective analysis of 219 dermatology inpatient discharge summaries at St George Hospital, Sydney, in 2013.
About 30% of summaries failed to report whether a skin biopsy had been performed, 40% did not document the diagnosis, and more than 60% failed to report differential diagnoses.
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Enjoy!
David.

Sunday, March 27, 2016

Now This Is Pretty Ominous News But I Am Not Sure What We Can Do About It!

This appeared a little while ago:

Thousands of medical devices are vulnerable to hacking, security researchers say

The security flaws put patients' health at risk
Next time you go for an MRI scan, remember that the doctor might not be the only one who sees your results.
Thousands of medical devices, including MRI scanners, x-ray machines and drug infusion pumps, are vulnerable to hacking, creating significant health risks for patients, security researchers said this week.
The risks arise partly because medical equipment is increasingly connected to the Internet so that data can be fed into electronic patient records systems, said researcher Scott Erven [cq], who presented his findings with fellow researcher Mark Collao [cq] at the DerbyCon security conference.
Besides the privacy concerns, there are safety implications if hackers can alter people's medical records and treatment plans, Erven said.
"As these devices start to become connected, not only can your data gets stolen but there are potential adverse safety issues," he said.
The researchers located medical devices by searching for terms like "radiology" and "podiatry" in Shodan, a search engine for finding Internet-connected devices.
Some systems were connected to the Internet by design, others due to configuration errors. And much of the medical gear was still using the default logins and passwords provided by manufacturers.
The researchers studied public documentation intended to be used to set up the equipment and found some frighteningly lapse security practices.
The same default passwords were used over and over for different models of a device, and in some cases a manufacturer warned customers that if they changed default passwords they might not be eligible for support. That's apparently because support teams needed the passwords to service the systems.
The researchers focused on equipment from GE Healthcare, but they said they could have picked any company. GE is "one of the more progressive" vendors and responded quickly when the flaws were pointed out, they said.
…..
On the plus side, there was no evidence the hackers had targeted the devices specifically because they looked like medical systems, Collao said, but they're still being targeted.
"Next time you're in a hospital getting hooked up to a machine and you see an Ethernet cable going to the wall, it makes you think twice."
More here:
Love the last paragraph - but I am not sure just what the patient can do. Clearly it is the equipment manufacturers are the ones who need to save us from all the risks here. A few news stories of things going wrong will be the best tool to foster change and our safety.
David.

AusHealthIT Poll Number 313 – Results – 27th March, 2016.

Here are the results of the poll.

Do You Believe The Government Can Be Trusted To Properly Protect And Secure The Private Health Information Of Citizens In The mHR?

Yes 5% (7)

No 95% (138)

I Have No Idea 1% (1)

Total votes: 146

A really decisive poll. Again it seems there is a considerable lack of trust in the DoH to keep our information safe and secure.

Again Ms Ley should take careful notice!

Really great turnout of votes!

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

David.

Saturday, March 26, 2016

Weekly Overseas Health IT Links - 26th March, 2016.

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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Project uses EHR data to cut heart disease risks

Published March 17 2016, 2:58pm EDT
De-identified electronic health records data is being used in a small Minnesota town to monitor the heart health of its population and to reduce risk factors for cardiovascular disease.
In 2009, Minneapolis Heart Institute Foundation, along with Allina Health, New Ulm Medical Center and the community of New Ulm, began a 10-year population health research project to learn if heart attacks and heart disease risk factors could be decreased through collaborative efforts.
Called the Heart of New Ulm Project, it focuses on reducing factors known for increasing heart attack risk, including high cholesterol, high blood pressure, uncontrolled glucose, obesity, tobacco use, physical inactivity, low fruit and vegetable intake, as well as medication underutilization and non-adherence.
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HIT Think How to give physicians some relief from distracting alerts

Published March 17 2016, 3:05pm EDT
Clinical information systems now produce great quantities of data. That can be both blessing and curse.
Perhaps no one knows this better than physicians, who are looking for help in separating important information from that which is not. Systems that can’t help them with that process can impede their ability to provide effective care.
Alert notifications have been often cited as culprits in this gush of information. Intended to let physicians know when patient conditions merit their attention, the ability of systems to crank out alerts at a dizzying pace has had the opposite effect, at times.
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Epic round-up: seven stories worth another read

Rebecca McBeth
17 March 2016
Articles involving US software company Epic really seem to get our readers going and have been the most read on Digital Health over the past year. We’ve decided to recap our coverage for anyone who missed it, or who wants to jog their memory.
The EpicCare electronic patient record, which is in widespread use in the US, entered the UK market when it went live at Cambridge University Hospitals NHS Foundation Trust in 2014, following a high-profile and closely fought procurement. The implementation has since been revealed to have been problematic.
Only now are some of the details about where the deployment went wrong becoming clear. Our most recent coverage includes comments from the president of the Royal College of Surgeons Clare Marx.
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CIT: Ransomware will 'wreak havoc' in 2016; healthcare already 'relentlessly' targeted

March 18, 2016 | By Katie Dvorak
Ransomware in 2016 will "wreak havoc on America's critical infrastructure community," and the healthcare industry is already seeing an influx of such attacks, according to a recent Institute for Critical Infrastructure Technology report on the threat.
In addition to an increase of new ransomware attacks, older vulnerabilities that were exploited last year will allow malicious actors to "capitalize upon positions that they have previously laid claim," the authors write.
The report points to the healthcare industry, which has previously been off-limits, as one that now is "brutally" and "relentlessly" targeted. The authors say healthcare organizations may have escaped these attacks previously because shutting down systems could endanger the lives of patients, but that mentality is changing.
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Google, Harvard team up for better insights into health IT

March 18, 2016 | By Susan D. Hall
A new executive education program brings Google staff to Harvard Medical School in an attempt to help them better align technology with the needs of healthcare.
It's not about learning what the liver is and how it works--you can Google that; rather, the course's fundamental premise focuses on teaching how doctors think, according to an article.
The course looks at how diagnoses are made, how data drives healthcare and how healthcare delivery can vary geographically and demographically in the hope that Google tech experts can create better tools for the industry.
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University of Buffalo researchers develop necklace that tracks food intake by listening

March 17, 2016
Researchers at the University of Buffalo have developed a necklace that could help passively track nutrition by listening to the sound of the wearer chewing.
University at Buffalo computer scientist Wenyao Xu is developing the wearable, called AutoDietary, with a small microphone on the back that records the sound of people eating food. The sounds are sent to a smartphone via Bluetooth and compared against a database of chewing and swallowing sounds for different foods, including cookies, peanuts, and apples. 
“There is no shortage of wearable devices that tell us how many calories we burn, but creating a device that reliably measures caloric intake isn’t so easy,” Xu said in a statement.
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HIT Think In light of pervasive security threats, why not encrypt everything?

Published March 18 2016, 4:23pm EDT
In healthcare, we all know what a breach is. Generally, it’s an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of protected health information.
We all know what protected health information is, or at least we should, by this late date. The requirement has been around since 2009: it is personal health information that is not rendered unusable, unreadable or indecipherable.
Further, information released to unauthorized persons may be rendered unusable, unreadable or indecipherable through the use of a technology or methodology specified by the Secretary in guidance, such as encryption for electronic PHI.
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Parkland doctor hoping his Dallas health care software startup can ease other doctors’ headaches

Melissa Repko Email mrepko@dallasnews.com
Published: March 17, 2016 3:11 pm
A software platform for health care that began under Parkland Memorial Hospital has spun off into a Dallas-based tech startup and raised $21.6 million from venture capital firms, Dallas investors and hospital systems.
Dr. Ruben Amarasingham said he hopes his software brings joy back to the practice of medicine by eliminating some of the paperwork and giving doctors and nurses more time to build relationships with patients.
Pieces Technologies announced today that it has become a health information technology company. It raised millions in a Series A funding round to create a sales and marketing team, invest in cloud-based infrastructure and add more features to its software, said Dr. Ruben Amarasingham, its founder and CEO.
He hopes to see his company’s software used by hospitals and health care systems around the world.
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Report: Fewer docs using ambulatory EHRs than last year

March 14, 2016 | By Marla Durben Hirsch
Physician use of ambulatory electronic health records has dropped in the past 12 months, according to a report from SK&A.
The new market insights report of physician office usage of EHR software, based on telephone interviews with 290,155 medical offices, found that overall office adoption and use decreased from 62.8 percent in January 2015 to 59 percent in January 2016.
Usage also dropped from 54.5 percent to 50 percent for solo practitioners, from 73 percent to 70.5 percent for groups of three to five physicians, and from 77.2 percent to 75.6 percent for groups of 26 or more physicians.
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'Community' HIEs may need help to compete with 'enterprise' models

March 14, 2016 | By Marla Durben Hirsch
"Community" and "enterprise" health information exchanges (HIEs) have different priorities and goals, and while they could be complementary, currently they compete with each other, according to a new report in Milbank Quarterly.
HIEs are a major focus of data exchange and the Meaningful Use program. The researchers--from Indiana University School of Public Health and Texas A&M Health Sciences Center--wanted to determine why some health systems join community HIEs, which bring in a broad spectrum of participating providers, and why others create their own enterprise HIEs.
The authors conducted semi-structured interviews with 40 HIE leaders, policy makers and healthcare executives from 19 different organizations. They found that health systems that create enterprise HIEs of affiliated desired trading partners do so to as a "stepping stone" to leverage their own data and technology for their strategic goals, such as to participate in accountable care organizations and other payment reforms. 
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EHR notification overload costs doctors an hour a workday, JAMA says

Primary care doctors are subject to twice as many notifications as specialists, researchers found, but both are facing information overload.
March 17, 2016 08:37 AM
Primary care doctors now lose more than an hour a day to sorting through approximately 77 electronic health record notifications, researchers at Baylor University found.
“Information overload is of concern because new types of notifications and ‘FYI’ (for your information) messages can be easily created in the EHR (vs in a paper-based system),” the researchers wrote in the Journal of the American Medical Association  Internal Medicine.     
Making the workload harder to endure, reading and processing these messages is uncompensated in an environment of reduced reimbursements for office-based care, according to the study.
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PCAST touts telehealth, wearable sensors as key to keeping aging population connected

Report to President Obama claims remote monitoring technologies, robust Internet are essential as Americans live longer.
March 17, 2016 11:39 AM 
A new report from the President’s Council of Advisors on Science and Technology claims technologies such as telehealth and wearable sensors should be put to work to help more elderly Americans stay healthy and connected as they age.
The report by PCAST, an advisory group of scientists and engineers appointed by President Barack Obama to make policy recommendations related to technology and science, found these types of technologies can help elderly Americans face challenges tied to social connectivity, emotional health and cognitive and physical ability.
"With many Americans wishing to live in their homes and communities for as long as possible, technology such as prosthetics, wearable sensors, and other tools for daily living can make that possible," said PCAST members Christine Cassel and Ed Penhoet.
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Surrey and Sussex trust to use PKB with 3,200 IBD patients

Daloni Carlisle
16 March 2016
Surrey and Sussex Healthcare NHS Trust is to offer patient-controlled electronic records to more than 3,200 people with inflammatory bowel disease.
A pilot study funded by pharmaceutical company Janssen (part of Johnson and Johnson) has already seen more than 400 patients with IBD use the Patients Know Best system.
The solution is integrated with the hospital’s Cerner Millennium electronic patient record, allowing the patient record to augment the hospital record.
Dr Azhar Ansari, project lead and consultant gastroenterologist at Surrey and Sussex Healthcare said: “By using Patients Know Best, the patient can self manage their condition far more effectively and warn us before problems occur.
“In many cases we can avoid A&E visits and that’s good news for the patient – and for our hospital.”
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E-discharge: standard clinical headings required by Dec

Rebecca McBeth
14 March 2016
All NHS providers must send digital discharge summaries to GPs using standard clinical headings by December this year, the new draft NHS standard contract says.
The contract, which is out for consultation, also encourages providers to adopt structured messaging for discharge summaries, but this will not become a formal requirement until next year’s contract, NHS England head of enterprise architecture Inderjit Singh told Digital Health News.
The new General Medical Services contract will also make it a requirement for GPs to be able to receive discharges electronically from next month.
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HIT Think Breach notification planning should include the consumer angle

Published March 16 2016, 4:10pm EDT
Customer-facing breach notification and response should be a part of a healthcare organization’s incident response plan, but it’s often not top-of-mind when the worst happens for a healthcare organization.
Federal and state laws often dictate specific steps healthcare organizations need to take, particularly when they are victimized by large breaches. There are many steps to be taken, including public notification and release of information to the media in the event of large breaches.
However, that doesn’t replace the need to handle notifications to people whose information may have been compromised, communicate to employees and the public about what happened, and otherwise set the tone for recovery. It's more art than science, with different factors that influence what and how you do the notification and response.
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Hospital exec quits, compares $764M upgrade to Challenger disaster

A senior official was so worried a new $764 million medical records system for the municipal hospital system was launching too early that he resigned, comparing it to the disastrous space shuttle Challenger launch in 1986.
In a “resignation and thank-you” email last week, Dr. Charles Perry urged colleagues at NYC Health + Hospitals — formerly the Health and Hospitals Corp. — to sound the alarm and press for an “external review” to stop the system from going live next month.
Perry was chief medical information officer of Queens and Elmhurst Hospital Centers, the first scheduled to get the new electronic medical data system.
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HIE use sees 'considerable growth,' but only in a few states

March 16, 2016 | By Katie Dvorak
Health information exchange adoption and use continues to see "considerable growth," but is driven only by a small number of states, according to a new report from NORC at the University of Chicago researchers.
Examining the State HIE Cooperative Agreement Program, NORC found that from 2011 to 2013, directed transactions increased more than threefold and patient record queries increased more than fourfold. However, the authors note that those numbers do not reflect high participation from all states, but only from a select few.
For example, in the second quarter of 2012 Indiana, Colorado and New York accounted for more than 85 percent of transactions, while in Q3 of 2013, Michigan, Colorado, Indiana, New York and Vermont accounted for more than 85 percent of the total.
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Cyber threats multiply as foreign 'hacktivists' set sights on healthcare data

Jeff Rowe
Mar 15, 2016
Until recently, the idea of health data being the target of international cyber criminals would have been considered the stuff of science fiction, or at least the very distant future. 
But the future began back in 2012, writes our colleague Tom Sullivan over at HealthcareIT News, when organized criminals “found that stealing patient data enabled them to monetize that information in a number of ways. Since then attacks have grown increasingly sophisticated ever since. And attackers are launching attempts now than ever.”
He cites a study from the Ponemon Institute, which found that healthcare organizations have been hit by one hack per month during the last year. “Ponemon questioned 535 IT security professionals working at public, private and government healthcare organizations and found that the most common threat is attackers exploiting existing software vulnerabilities that are more than three months old. Newer vulnerabilities and spearphishing -- sending targets an email aiming to get them to click on an executable or other malicious code -- ranked second and third, respectively.”
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NQF identifies key health IT patient safety issues

Jeff Rowe
Mar 16, 2016
While issues surrounding cybersecurity may currently be top of mind for a majority of health IT stakeholders, concerns surrounding patient safety are bound to grow as EHRs and other IT systems continue to spread across the sector.
With that concern in mind, the National Quality Forum (NQF) has issued a report that identifies and addresses what the forum considers the key issues for stakeholders to understand.  To be sure, the report, "Identification and Prioritization of Health IT Patient Safety Measures," notes that with proper design, implementation and use, healthcare organizations can reduce medical errors and improve care quality, but it also discusses the potential for new hazards.
”HIT will fulfill its potential only if the risks associated with its use are identified and a coordinated effort is developed to mitigate those risks," the report argues. "Accordingly, there is a need for measures to help identify the nature, scope, and prevalence of HIT-related safety issues and to assess how well providers, vendors, and others are preventing or mitigating HIT-related safety concerns.”
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ONC Report on Health IT Details Barriers to Interoperability

HCPro Staff, March 16, 2016

Although some progress has been seen, a lack of health IT vendor transparency and cooperation have been named as barriers to interoperability in the ONC’s annual report.

A version of this article originally appeared on HCPro.com
The Office of the National Coordinator of Health IT has published its annual report to Congress detailing the ups and downs of health IT in 2015 and plans for 2016. The report summarizes actions taken by various government agencies to advance health IT, such as the Department of Health and Human Services’ Federal Health IT Strategic Plan, the ONC’s Interoperability Roadmap, and CMS’s EHR Incentive Programs, and touches on the pivotal role private-sector industry plays in realizing the goals outlined in the report. 
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Epic, InterSystems take top spots for HIE and interoperability in new KLAS rankings

A new report based on customer scores found that the two companies outperformed other EHR-dependent and EHR-independent vendors.
March 15, 2016 10:54 AM
Epic Systems and InterSystems earned the highest performance scores in the field of health information exchange and interoperability in the latest study from independent research firm KLAS.
A primary question KLAS asked providers was, “Will your vendor be able to meet your interoperability needs in the next few years?"
KLAS ranked Epic the highest customer score (91.3 out of 100) among electronic health records-dependent vendors – and among all vendors. InterSystems was given the highest customer score (87.1) in the EHR-independent category.
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How a hospital's analytics department helps clinical staff build data skills

March 15, 2016 | By Susan D. Hall
The homegrown data analytics department at Medical Center Health System (MCHS) in Odessa, Texas, aims to help clinicians drill down into data and answer the question of "why," according to an article at HealthData Management.
"Our goal is to supply them with the tools so they can answer those questions themselves," says Alan Snider, senior decision support data analyst in the department.
In setting up the department nearly three years ago, leaders at the 402-bed regional medical center combined decision support and analytics into one department because they believed implementing an electronic medical record and leaving analytics at the department level would have little effect on outcomes and wouldn't allow the organization to tie process metrics to outcomes.
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The 4 big trends of the information economy

Written by Carrie Pallardy | March 14, 2016
The information economy is comprised of "a community of digital citizens living in a global network, always connected with the world's information at our fingertips," according to a "The Information Generation Transforming the Future, Today" report from EMC.
The information economy is driven by using data to identify new opportunities, innovative products, transparency, desire for a personalized experience and 24/7 availability. The four big trends of this economy include:
1. Big data. In healthcare big data is being looked at to better understand populations and drive improvements in patient care.
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HIT Think New standard can ‘FHIR up’ precision medicine

Published March 15 2016, 2:29pm EDT
On February 25, President Obama at the White House celebrated the one year anniversary of his announcement of the Precision Medicine Initiative. The Initiative, first announced in the President’s State of the Union Address last year, initially invested $215 million in this research approach.
Most medical treatments are designed to treat the average patient. This broad approach fails to account for the differences in genetics, physiology, environments and lifestyles that greatly affect the effectiveness of therapies. Precision medicine works to overcome these shortcomings by conducting research into the efficacy of the available treatments in different patients using these and additional factors.
For example, Warfarin is a drug used in anticoagulation therapy for patients who need to prevent blood clots from forming (for example, patients with implanted heart valves or who recently suffered a stroke), and it showcases the value of precision medicine research.
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Dashboards Make Sense of Scattered EHR Data

Scott Mace, March 15, 2016

Savvy health IT customers understand that business intelligence tools are needed to leverage electronic health records data to the fullest.

Sometimes, we are at the mercy of technology.
Some years back, I was helping a nonprofit understand its customer relationship management system, as part of its intent to migrate from one CRM to another. In my naiveté, I sought to understand the underlying data structure of the CRM, which would help us figure out where the data lived, which data we had to move, and how best to arrange it after the move.
But the nonprofit's CRM, like the average CRM, and for that matter, like the average EHR, was populated with thousands of tables. Nine thousand tables.
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Can IT help better manage chronic pain?

Published March 14 2016, 7:34am EDT
New research starting at the Indiana University School of Public Health seeks to develop information technology tools to support the care of patients with chronic pain, as well as educate patients on the benefits of permitting their electronic health records data to be used for research purposes.
Researcher Christopher Harle has received a $1.1 million grant from the Agency for Healthcare Research and Quality to develop technology tools, and a $1.9 million grant from the National Institutes of Health to build software that helps patients through the process of sharing their data for research.
“It is fair to say the typical EHR doesn’t provide decision support content that fully recognizes the complexity of chronic pain and that patients often also have multiple other conditions,” Harle says.
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Enjoy!
David.