Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, October 12, 2013

Weekly Overseas Health IT Links - 13th October, 2013.

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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Athenahealth to monitor flu activity during government shutdown

October 4, 2013 | By Susan D. Hall
During the government shutdown, health IT vendor athenahealth plans to monitor flu activity and issue updates accordingly.
Such activity normally is conducted by the Centers for Disease Control (CDC), which had to furlough nearly 9,000 workers during the budget fight in Washington. CDC normally issues a weekly flu report, and the media help announce disease outbreaks and launch public awareness campaigns. Without those reports, detection of flu trends could be delayed.
Thanks to its database built on cloud-based architecture, Watertown, Mass.-based athenahealth has the ability to report data in real time. Its client physicians also are dispersed around the country with good statistical representation across practice types and sizes, Iyue Sung, director of core analytics, says in a blog post.
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Medical device security efforts ramp up

Posted on Oct 04, 2013
By Eric Wicklund, Editor, mHealthNews
A non-profit organization focused on Internet security is looking to develop a set of benchmarks to protect medical devices from potentially fatal cyber attacks.
Officials with the Center for Internet Security said the benchmarks would help device manufacturers and healthcare providers protect such devices as insulin pumps, pacemakers and defibrillators from being hacked or damaged by malware.
"The technological advancements that enable healthcare providers to embed life-saving devices and treat patients remotely are tremendous. We must do everything we can to protect those devices and the patients who rely on them," said William F. Pelgrin, CIS' president and CEO, in a news release.
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AMDIS: Using HIE for hospital alerts could save millions in readmissions

Beth Walsh
Oct 02, 2013
BOSTON—One in three Rhode Islanders are participating in the state’s health information exchange (HIE)—CurrentCare—which makes it a good testing site for new processes, said Jonathan Leviss, MD, chief medical officer of the Rhode Island Quality Institute, at the AMDIS Fall Symposium.
Leviss discussed the organization’s experience in improving care coordination through the HIE. The state’s practices and accountable care organizations have a vested interest in knowing when their patients are admitted, discharged or seen in the emergency department of a hospital. “If providers know when their patients are admitted and discharged, they know what to do. By connecting the pieces, maybe we can reduce readmissions.”
They began an alert process where primary care providers are alerted, if the patient consents, about hospital care so they could follow up appropriately. Once they started, the providers said the messages weren’t helpful because they weren’t getting useful information.
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Epocrates Launches First App As athenahealth Company

Written by Helen Gregg (Twitter | Google+)  | October 03, 2013
At the 7th Annual Health 2.0 Conference in Santa Clara, Calif., Epocrates and athenahealth jointly announced the launch of Epocrates' first app since the mobile health company was purchased by athenahealth in March.
Epocrates Bug + Drugs app aims to provide clinicians with up-to-date information about bacteria types and resistance patterns to support their antibacterial prescribing. The app draws data from athenahealth's cloud-based electronic health record database, which has information on more than 15 million patients across the country.
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Healthcare Providers Face Tougher HIPAA Rules

Scott Mace, for HealthLeaders Media , October 4, 2013

More stringent privacy regulations now in effect mean hospitals and medical practices can expect random audits, higher fines, and a surge in formal complaints from patients who ask for, but do not receive their medical records in a timely fashion.

This article appears in the September issue of HealthLeaders magazine.
Spurred by stricter and closer regulation and enforcement, healthcare providers spent the summer scrambling to update their ability to abide by the federal privacy, security, and breach notification rules of the Health Insurance Portability and Accountability Act .
The new rules kick in on September 26, 2013. Providers can expect random audits, fines that now rise based on the number of records compromised, more frequent and sterner communications from HHS' Office for Civil Rights, and a surge in formal complaints from patients who ask for, but do not receive in a timely fashion, their medical records upon request.
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Google Glass gets healthy push

Posted on Oct 03, 2013
By Diana Manos, Senior Editor
Royal Philips and Accenture announced Thursday they will partner to study the creation of a proof-of-concept demonstration that uses a Google Glass™ head-mounted display for researching ways to improve the effectiveness and efficiency of performing surgical procedures. 
The demonstration connects Google Glass to Philips IntelliVue Solutions and proves the concept of seamless transfer of patient vital signs into Google Glass, potentially providing physicians with hands-free access to critical clinical information.
The new concept demonstration depicts how a doctor wearing the display could simultaneously monitor a patient's vital signs and react to surgical procedural developments without having to turn away from the patient or procedure. A physician could also monitor a patient's vital signs remotely or enlist assistance from doctors in other locations.
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6 tactics for boosting EHR usability

Posted on Oct 03, 2013
By Tom Sullivan, Editor, Government Health IT
EHR usability is among the greatest barriers to digitizing America’s healthcare system. Electronic health records present a push toward modernization – transformation even –  but to fulfill the promise, industry insiders say, the clunky technology has to be made easier for doctors to use. EHRs must be more elegant and more interoperabile.
“Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care,” Sue Bowman, AHIMA’s senior director of coding policy and compliance, wrote in an article of AHIMA’s Perspectives in Health Information Management. “These unintended consequences also may increase fraud and abuse and can have serious legal implications."
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Secure cloud could resolve interoperability issues

October 3, 2013 | By Julie Bird
Secure cloud collaboration can help solve interoperability issues as it links mHealth and other applications among healthcare providers, TechCrunch reported.
In an article focusing on Box, which recently launched a healthcare line of business, TechCrunch reports the company wants to improve collaboration among providers by investing in startups developing mobile electronic health record solutions and "connect each of these apps in a way that allows it to power collaboration, file transfer and secure, HIPAA-compliant sharing."
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Glasgow hit by IT failure

2 October 2013   Lis Evenstad
An “unprecedented IT issue” has forced NHS Greater Glasgow and Clyde to postpone more than 500 patient appointments over the past 36 hours.
The issue relates to the health board’s network, which means staff are struggling to connect to clinical and administrative systems.
The health board’s chief executive, Robert Calderwood, said in a statement at lunch time today that the problem, which occurred yesterday morning, is not yet resolved.
This has meant that over the past 36 hours 564 patients have had their treatment or appointment postponed.
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Infographic: Recent IT hiring numbers

Posted on Oct 02, 2013
By Healthcare IT News Staff, New Gloucester, Maine
The recently released HIMSS Workforce Survey came with an infographic showing growth in hiring among healthcare provider organizations even as outsourcing continues to rise.
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Finding EHR Problems Before They Fester

SEP 24, 2013 10:12pm ET
How can you recognize early on that an electronic health records implementation project is in trouble? That’s the subject of an educational session during the MGMA 2013 Annual Conference, Oct. 6-9 in San Diego.
Carolyn Hartley, president and CEO at consultancy Physicians EHR Inc. in Cary, N.C., will describe the seven symptoms that you have a problem and what to do. The symptoms cover such functions as new patient registration, rooming the patient, charting and documentation capture, computerized physician order entry, messaging and triaging incoming calls, night clinics and walk-ins, and patient portals/patient engagement.
Take rooming the patient, for instance. In a paper world, the nurses and physicians have difference processes. One physician may want a nurse to capture most of the routine information of an office visit, while another physician may say “check blood pressure and I’ll do everything else.” But in the electronic world, that means data is being inconsistently entered into the EHR, and it gets worse if one nurse is substituting for another that usually works with a specific physician. Consequently, practices going electronic need standard processes. “Without internal governance standards, the EHR will be a mess,” Hartley says.
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Healthcare Providers and Health Information Technology Infographic

Read how America’s healthcare providers are now using EHRs and Health IT to achieve meaningful use and help to improve their patients’ care and health.
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HDM Feature: Assembling an Analytics Team

OCT 1, 2013 4:06pm ET
Analysis is nothing new in the science and data-heavy health care field, but what used to be a couple guys crunching numbers for Excel sheets and calling it "analytics" has become a high-profile, risky and expensive adventure aimed at the heart of the business of health care organizations. If you don't know your data in this stupendously complex market, you don't know your business. And enormous changes in payments and clinical quality standards mean organizations that don't know their business are at real of risk of not having one.
Intense, enterprise analytics has come about suddenly; most providers that have assembled analytics teams have done so recently, and in that quick ramp-up have learned some hard lessons about how to put together the structure and staff they need to provide actionable intelligence to financial and clinical business owners.
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Unencryption at core of HIPAA breach

Posted on Oct 02, 2013
By Erin McCann, Associate Editor
The San Jose, Calif.-based Santa Clara Valley Medical Center is notifying 571 patients that their protected health information has been compromised after an unencrypted laptop was stolen from the hospital's audiology department. 
Patient names, medical records numbers, dates of birth, ages, sex, dates of service and brainwaves from testing were all included on the laptop, according to the Sept. 27 notification letters mailed to patients. 
The theft was discovered Sept. 16.
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Military Health System examines privacy, identity challenges

October 2, 2013 | By Susan D. Hall
As the U.S. Department of Defense and Veterans Affairs work toward an effective electronic exchange of healthcare records, issues of patient privacy and identity management remain.
As part of that process, the Military Health System undertook a literature review to identify data-integration processes as well as the related techniques and standards necessary for a shared EHR that also exchanges data with civilian healthcare providers, reports Health IT Security.
These parameters need to be in place for the data-sharing, along with the interoperability to make it happen, speakers told the recent HIMSS Privacy and Security Forum.
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Wearable device revenues to grow to $6B in 2018

By: Aditi Pai | Oct 1, 2013
Wearable connected device revenues will grow to more than $6 billion in 2018, according to new findings from ABI Research. The survey tracked four areas: sports, fitness and wellness; home monitoring devices; remote patient monitoring; and professional (on-site) healthcare.
Of the four markets, sports, fitness and wellness was the largest, always producing at least half the revenue over the forecast period. Within this category heart rate monitors are the shipment leader today, although by 2017, ABI Research predicts activity trackers will grow at a 40 percent compound annual growth rate and overtake heart rate monitors.
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Mobile Health Holds Promise for Improving Care of Homeless Patients

by Kate Ackerman, iHealthBeat Editor in Chief Wednesday, October 2, 2013
People who are homeless have poor access to primary care and often experience high levels of unmet health needs. As a result, it's not surprising that the homeless make up a disproportionate share of emergency department patients. But a new study suggests that mobile health has great potential to increase communication within that patient population, boost preventive care, and ultimately improve health outcomes and lower costs.
Researchers at the Yale School of Medicine's Department of Emergency Medicine studied the prevalence and types of "new media" use among ED patients who experience homelessness.
Lori Ann Post -- lead author of the study and an associate professor of emergency medicine and research director at the Yale School of Medicine -- said, "It's really important to us because we're the emergency department, and we treat so many people experiencing homelessness," adding, "I wanted to take the opportunity to identify how new media can transcend health care barriers, and I can't think of a better population than people experiencing homelessness."
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HDM Feature: Why EHRs Won’t Reduce Your Malpractice Premiums

SEP 30, 2013 3:42pm ET
You're dozing off in front of late-night TV. An insistent voice jerks you awake. "Have you been injured because of your doctor or hospital's use of electronic health records?" asks the TV lawyer. "Call the number on your screen to see if you may be eligible to receive a monetary award!"
Nightmare or tomorrow's reality? EHRs, properly implemented, are generally considered a boon to care quality and safety, with their reminders, care protocols, and readability. EHRs can help providers avoid making the types of mistakes that can land them in court.
But experts say those characteristics won't automatically translate into fewer malpractice claims, easier defenses, or lower malpractice insurance premiums. In fact, EHRs may make malpractice claims more expensive to defend, and obscure the very facts they're supposed to confirm.
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Asia-Pac catches case of 'cloud fever'

Posted on Oct 01, 2013
By Mike Miliard, Managing Editor
The market for software-as-a-service and infrastructure-as-a-service technologies is set to explode in Asia in the next half-decade, growing at a compound annual rate of 22.3 percent between now and 2018.
"Healthcare providers are cognizant of the long term cost benefits of cloud solutions," said Natasha Gulati, connected health industry analyst, Frost & Sullivan Asia-Pacific, in an Oct. 1 news release. "What they are looking for now, are reliable technology partners who can address their concerns over data privacy and security."
While many healthcare IT vendors emphasize the enhanced security and back-up support provided by cloud technologies, the message has not successfully reached hospital CIOs yet, according to Frost & Sullivan. This is why healthcare continues to invest in private clouds while other industries are rapidly moving to public or hybrid cloud models.
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Insurance exchanges open for business

Posted on Oct 01, 2013
By Anthony Brino, Editor, HIEWatch
Even amid the government shutdown, the new online insurance marketplaces -- known as health insurance exchanges -- were up and running today. There were early reports of computer glitches across several states. Some states, with large numbers of uninsured, are dealing with problems of a different sort.
In the states with largest uninsured populations, the stakes are high for this fall’s insurance exchange enrollment — the difference between the healthcare status-quo and improvements in healthcare access and sustainability.   
Some 5.7 million Texans, almost 25 percent of the population, are estimated to be uninsured, contributing to about $5.5 billion in uncompensated hospital care annually, according to the Texas Hospital Association. But with state leaders declining to expand Medicaid, a number of those uninsured may remain without coverage, caught in an eligibility “donut hole” — too rich for Medicaid but too poor for federal premium assistance, which starts at 133 percent of the federal poverty level under the Affordable Care Act.
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GP appointments auto-cancelled via text

25 September 2013   Rebecca Todd
GP practices are using new iPlato functionality to allow patients to automatically cancel GP appointments via their mobile phone.
The new feature, available for Enterprise and Pro users, means appointments can be cancelled without intervention by practice reception staff.
The Hammersmith Surgery has trialled the functionality.
Practice manager Lesley Kenny said: “Whilst eliminating effort for practice staff to deal with incoming cancellation requests from patients, this new feature has significantly sped up the process of making short term appointments available for other patients.
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Digital care plans by 2015

25 September 2013   Rebecca Todd
Everyone with a long-term condition or disability must have a digital personalised care plan accessible online or via a mobile phone app by 2015, under a package of measures launched today by NHS England.
Transforming Participation in Health and Care is online guidance to commissioners that promotes the use of technology to put patients and their carers at the centre of treatment decision making.
The NHS Mandate set an objective that everyone with a long-term condition will be offered a personalised care plan. The new guidance says this must be digitally accessible.
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  • September 27, 2013, 5:30 PM ET

Hospital Testing Tablets to Boost Patient Care, Lower Costs

Hospitals are turning to technology to help patients manage their care. Some patients at New York-Presbyterian Hospital are using tablet computers to call for nurses and view their health records. The hospital says the switch away from nurse page buttons will make care more efficient and eliminate the need to spend millions to replace an aging call system.
And with health insurance marketplaces set to launch nationwide on Tuesday, NY-Presbyterian says the program helps meet new federal guidelines requiring hospitals to demonstrate “meaningful use” of electronic health records. Hospitals will receive a one-time bonus payment for showing that 5% of annual patients access their health information online by 2014. Such regulations are spurring hospitals to boost their information technology infrastructure.
NY-Presbyterian is testing tablets running Microsoft Corp.’s Windows 8 software with a select number of patients, with plans to roll the program out hospital-wide by next year. Upon admittance, patients receive a tablet tethered to a bedside hospital cart. Patients can use the tablet to call or text their nurse to request water or notify them that they are in pain. CIO Aurelia Boyer says today’s hospital staffs are more mobile and the program routs calls and texts to PCs at the nurse’s station as well as to the nurse’s mobile phone.
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Q&A: Mostashari Reflects as He Prepares to Exit ONC

Scott Mace, for HealthLeaders Media , October 1, 2013

In the second part of a two-part interview, departing National Coordinator for Health IT Farzad Mostashari, MD, discusses EHRs and quality measures, Regional Extension Centers, and VDT requirements.

In the second half of my exit interview with outgoing National Coordinator Farzad Mostashari, MD, of the federal Office of the National Coordinator, we discussed the evolution of electronic health record systems and concerns over quality measures. Part I of the interview is here.
HLM: Some argue that HITECH has funded the purchase of EHR software which is really not suited to the emerging value-based care system, that today's EHRs are overwhelmingly designed for fee-for-service and maximization of revenue.
Mostashari: I would say that their views are exactly correct, but a little outdated. When I testified before Congress seven years ago, that's what I said, and I said that EHRs today don't let you make a list. They don't let you measure quality. They don't collect smoking status, or blood pressure, in standardized ways. They don't offer decision support.
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Do patients even want digital health records?

By Mike Miliard, Contributing Editor
While the federal government is incentivizing healthcare providers to implement and use electronic health records systems, and ramping up patient engagement efforts, the question of how many patients actually want to use digitized health data remains.
Indeed, majorities of Americans are concerned about the security of their electronic data, according to a new poll, and more than two-thirds of respondents indicated that their physicians have not adequately explained the switch to digital records.
As physicians race to adopt EHRs and collect federal incentive payments, a survey sponsored by Xerox suggests they need to do a better job educating their patients about the implications of digitized health information.
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Disasters happen: Best to be ready

Posted on Sep 30, 2013
By John Andrews, Contributing Writer
On any given day, a disaster occurring somewhere in the country is making news – whether it’s wildfires out West, floods in the heartland, a major tornado in Oklahoma or a ferocious storm like Hurricane Sandy hitting the East Coast. And while the focus is (rightly) on the human toll and physical destruction these events cause, little attention is paid to how important data and IT infrastructure is lost to provider organizations in the danger zones.
Perhaps that lack of publicity is why putting a disaster recovery plan in place hasn’t been a high priority for a number of healthcare providers. Vendors report that many of those who do have a backup plan are still using antiquated tape and that adoption of more sophisticated disaster recovery programs remains at a low level.
“Despite the critical importance of keeping data safe, not enough organizations are taking it seriously,” says Steve Deaton, vice president at Garner, NC-based Viztek. “Either they don’t want to spend the money on it or lack the desire to figure it out.”
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Patients still ill-informed about EHRs

Posted on Sep 30, 2013
By Mike Miliard, Managing Editor
Large majorities of Americans have concerns about the security of their electronic health records, and more than two-thirds of patients say their physicians have not adequately explained the switch to digital records, a new poll shows.
As physicians race to adopt EHRs and collect federal incentive payments, a survey sponsored by Xerox suggests they need to do a better job educating their patients about the implications of digitized health information.
The fourth annual EHR survey polled more than 2,000 U.S. adults and found that just 29 percent have even been informed by their doctor that their medical records will be converted to digital format.
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New Nonprofit Dedicated to Healthcare Interoperability

September 27, 2013
A newly formed nonprofit organization called the Center for Medical Interoperability has gotten off the ground thanks to grant funding, personnel, and royalty-free technology licensed from The Gary and Mary West Health Institute., a nonprofit dedicated to lowering health costs.
The nonprofit will aim to drive rapid, widespread and sustained interoperability of medical technology to improve patient safety and lower healthcare costs, and will be led by hospitals and health systems. It will be dedicated to enabling standards-based technical solutions to drive adoption of medical interoperability.
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IBM uses big data to predict outbreaks of dengue fever and malaria

September 29, 2013 9:01 PM
IBM has teamed up with university researchers to use big data and analytics to predict the outbreak of deadly diseases such as dengue fever and malaria.
The research is aimed at understanding the spread of diseases in real-time in order to better deploy public health resources, said James Kaufman, public health manager at IBM Research in the IBM Almaden Research Center in San Jose, Calif.
But rather than just predicting the spread of a disease, the researchers at IBM, Johns Hopkins University, and the University of California at San Francisco are applying analytics from large data sets to see how changes in rainfall, temperature, and even soil acidity can dramatically affect the populations of wild animals and insects that carry the diseases. They’re also merging that information with other data, like airport and highway traffic, to further understand outbreaks.
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Mobile Apps May Expand Dermatology Practice

Last Updated: September 27, 2013.
Mobile apps may offer an opportunity to expand delivery of dermatological care, according to research published online Sept. 25 in JAMA Dermatology.
FRIDAY, Sept. 27 (HealthDay News) -- Mobile apps may offer an opportunity to expand delivery of dermatological care, according to research published online Sept. 25 in JAMA Dermatology.
In an effort to determine the number, type, and price of dermatology-related mobile apps, Ann Chang Brewer, M.D., from the University of Arizona in Phoenix, and colleagues queried dermatology-related search terms in online app stores of the most commonly used mobile platforms developed by Apple, Android, Blackberry, Nokia, and Windows.
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Physicians Spend More Time on EMRs Than With Patients in ED

Susan London
Sep 27, 2013
Emergency medicine physicians spend nearly half their time entering data into electronic medical records (EMRs), according to a study conducted in a community hospital in Pennsylvania.
Robert G. Hill Jr, MD, from St. Luke's University Health Network, Allentown, Pennsylvania and colleagues analyzed time use in their emergency department and found that physicians spent 43% of their time, on average, performing data entry, or roughly twice as much as that spent on direct patient care. Their study was published online September 23 in the American Journal of Emergency Medicine.
During a busy 10-hour shift, their calculations suggested that a physician might perform a finger-numbing 4000 mouse clicks entering data.
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Patient Portal Market Expected to Reach $900M by 2017

September 27, 2013
The total U.S. patient portal market for hospitals and physicians earned revenue of $279.8 million in 2012, and is expected to increase steadily, reaching $898.4 million in 2017—representing a 221.1 percent increase—according to new research from consulting firm Frost & Sullivan.
According to the analysis, "U.S. Patient Portal Market for Hospitals and Physicians: Overview and Outlook, 2012–2017," the majority of revenue will primarily result from increased demand driven by myriad forces, including the need to meet Stage 2 meaningful use requirements, the growing move to clinical integration and accountable care, and increasing consumer demand for health information technology.
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Intermountain signs sweeping EHR deal

Posted on Sep 30, 2013
By Bernie Monegain, Editor
Intermountain Healthcare, a healthcare system known for its leadership and attention to quality, has signed a multi-year contract with Cerner to deploy Cerner’s electronic medical record and revenue cycle technology across all of Intermountain’s hospitals and clinics.
Intermountain is known around the world for its laser focus on care quality and its pioneering work with data analytics.
The IDN’s choice of an EMR vendor in a field where only two companies – Epic and Cerner – seem to be in competition for the large and complex deployments, the selection is bound to garner attention.
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Enjoy!
David.

Friday, October 11, 2013

Oh Dear! This Sounds Like Another Bad Example Of E-Health Governance Failure.

This appeared a little while ago.

National vision for digitizing health records has failed as each province does its own thing

By Jules Knox, Special to The Province September 25, 2013
While banking and other industries completed their entry into the digital age years ago, the health-care system is still scrambling to make the transition.
Billions of taxpayer dollars have been spent on digitization but governments continue to struggle to address the diverse needs of health-care practitioners. The vision of a pan-Canadian electronic health record for each patient, which once seemed so important, is now further off than ever.
When the federal government realized a national strategy was needed, it created Canada Health Infoway, a not-for-profit corporation that has received $2.1 billion since its founding in 2001 to invest in provincial electronic health projects and set pan-Canadian standards for interoperability.
There is a reluctance within the field to speak out on the record, but this organization is widely perceived to be a federal boondoggle that has failed to produce results. That’s largely because health care is a provincial responsibility and Canada Health Infoway’s interoperability standards aren’t binding. It received no new funding in 2013.
Provinces have adapted the Infoway standards to suit their own environments and to work with old computer systems that are already in place, says Bill Pascal, chief technology officer at the Canadian Medical Association. “But as soon as you start to adapt a standard, they don’t line up,” he says.
Software vendors have to customize their electronic medical records to meet each province’s individual requirements.
“Because each electronic system needed to be specifically certified in that particular province, it created 10 different marketplaces instead of a countrywide market,” says Dr. Alan Brookstone, a physician and health-care information technology consultant. “And this slowed down overall adoption rates.”
While more than 90 per cent of family doctors in the U.K. and Australia use electronic medical records, Canada has an adoption rate of only about 57 per cent.
More here:
There is further commentary here:

Provincial tweaking of interoperability standards impedes Canadian EHR network

September 24, 2013 | By Marla Durben Hirsch
The U.S. is not alone when it comes to road bumps toward a national electronic health record system: Canada also is struggling to create a nationwide interoperable EHR network, according to an article published this week in British Columbia's The Province.
The non-profit Canada Health Infoway, which provides funding for EHR projects throughout Canada, has set Pan-Canadian standards for EHR interoperability. However, the standards are not binding, and the provinces have adopted the standards in different ways for their own benefit, meaning they no longer line up to share data. 
Moreover, EHR vendors have had to customize their products to meet the different requirements, making interoperability even more elusive.
"Because each electronic system needed to be specifically certified in that particular province, it created 10 different marketplaces instead of a countrywide market," Alan Brookstone, a physician and healthcare information technology consultant, told The Province. "And this slowed down overall adoption rates." 
More here:
In Australia, of course, NEHTA has a similar brief but the problem with here has been that the jurisdictions have essentially not taken all that much notice of what is being said as they are simply working with the systems they have purchased which all come with different basic Standards assumptions.
Of course in GP land we have only limited interoperability between systems as well as rather limited messaging interoperability actually being used.
Just as in Canada we have a little way to go!
David.

Thursday, October 10, 2013

The Most Recent Update I Have Seen On PCEHR Usage - A Way To Go Yet.

This appeared a few days ago.

Little interest in eHealth system

By CLARE COLLEY

Oct. 1, 2013, 4 a.m.
ONLY 1178 residents in Orange have signed up for the federal government’s eHealth record system giving them, their doctor, pharmacist and other healthcare providers online access to their health information, despite it being up and running for more than a year.
Since August 12, health department staff have signed up 1100 residents for the optional service at the Orange Medicare Office.
The eHealth record system was rolled out in July 2012 to allow any registered healthcare provider including general practitioners (GP), pharmacists, and allied health professionals to access a patient’s eHealth record.
As a privacy measure, it is up to the individual to choose who can access their information.
“You control what goes into it, and who is allowed to access it,” a health department spokesman said.
“Your eHealth record allows you and your doctors, hospitals and other healthcare providers to view and share your health information to provide you with the best possible care.”
Although users of the eHealth system use the same myGov account login to access other federal government services such as Centrelink, Veterans Affairs and Child Support, the eHealth records are kept separate, according to the department spokesman. 
In NSW, more than 1950 healthcare providers use the system and 270,000 residents are registered for an eHealth record.
Australia-wide 924,623 residents have signed up as of last Wednesday.
More here:
This amounts to 3.98% of the population of 23.238 million after 15 months of operation.
It is really going to have to start to move up more quickly to reach its targets and more importantly to actually be useful.
Of course - as usual - we don’t seem to have any data on the levels of regular use and the numbers of real clinical documents held in the system so far.
Time for a bit better disclosure I think.
David.

Wednesday, October 09, 2013

Medical App Regulation Looks To Have Really Become A Hot Topic In The Last Little While.

A few articles appeared in the last week or so.
First we had this.

Is there a medical app for that? TGA issues guidance on medical software and apps

On 13 September 2013, the Therapeutic Goods Association (TGA) published guidance about Australia's regulatory arrangements for medical software and mobile medical 'apps' on its website.
The TGA first undertook to regulate medical software and apps in 2011, after the United States Food and Drug Administration released draft guidelines on the issue.  This is the first time that the TGA has published formal regulatory guidance about medical software and medical apps. 
WHAT MEDICAL SOFTWARE DOES THE TGA REGULATE?
Medical software is regulated by the TGA as a “medical device” under Chapter 4 of the Therapeutic Goods Act 1989 (Cth) (the Act).
Generally, medical device software that is intended to control a device, or influence the functions of a device will fall into the same classification as that device itself. 
However, the TGA’s guidance about in vitro diagnostic medical devices (published online on 19 September 2013) clarifies that medical software will be a distinct medical device if:
  • it is software that is provided separately to a medical device (such as hardware) but which is intended to operate, or influence the operation of, the hardware; or
  • it is intended to be used to provide diagnostic or therapeutic information but it is not intended to drive or influence medical hardware (that is, standalone software).
This means that medical software available for use by consumers through smart phones, tablets or computers are likely to be distinct medical devices if the relevant software is intended to be used for a therapeutic purpose such as diagnosing or treating a disease, injury or disability, or for the purpose of controlling conception.  
In contrast, software that is limited to merely collating and presenting medical information would not be a medical device and would not fall within the ambit of the TGA’s regulatory mandate.
Lots for here:
Second we have this.

Medical apps a health gamble

Cate Swannell
Monday, 30 September, 2013
NEW guidelines from the Therapeutic Goods Administration and the US Food and Drug Administration will do little to slow the proliferation of medical smartphone applications if the “app” retailers ignore them, say concerned Australian experts.
The sale and use of apps and attachable devices for smartphones by doctors and patients is a “huge grey area” and “fraught with traps”, the AMA’s dermatology spokesman Professor Stephen Lee told MJA InSight.
The AMA is so alarmed at the explosion of medical apps, they have fast-tracked discussions on the issue in time for the November Federal Council meeting, Professor Lee, of the University of Sydney, said.
He said the use of apps, particularly by patients looking for a quick diagnosis or risk assessment, was “fraught with traps”.
“For example, [melanoma] apps rely on the patient taking a photo of the right lesion, or the right part of the lesion”, he said. “Is the resolution good enough? If not, then the image could be misleading.”
Research into dermatology apps, published in JAMA Dermatology, found that, as of July this year, there were 229 available, with 51.1% aimed at patients, 41.0% aimed at providers and 7.9% aimed at both. (1)
“The widespread variety and popularity of mobile apps demonstrate a great potential to expand the practice and delivery of dermatologic care”, the authors concluded.
An accompanying invited commentary went further, saying if dermatologists were not using such apps it represented “a practice gap”. (2)
Professor Peter Soyer, a clinical adviser with the Australasian College of Dermatologists, said using such medical apps could be like “playing with dice”.
Much more here with references.
Last (for now) we have.

Regulation gaps for medical apps under scrutiny

Last week, another smartphone-enabled medical device, an asthma wheeze monitor, was launched by Australian medical technology company iSonea Limited, backed with a high-profile ad campaign featuring Australian Olympian Cathy Freeman.
The company claims the digital device is a world-first for monitoring wheeze via smartphone technology, and with an estimated 2.3 million Australians with asthma, it’s likely to be a commercial success.
The user holds the AirSonea device against their throat to record breathing sounds, which the smartphone app then transmits to a cloud-based site for analysis by proprietary wheeze detection algorithms and software – a far simpler process than the peak-flow monitors traditionally used to monitor asthma through forced breathing.
The device sounds like a great application of mobile technology to a clinical need, and the company has registered it with Australia’s Therapeutic Goods Administration (TGA) and will seek FDA approval before launching in the US.
The Airsonea joins a rapidly-growing technology niche; according to a Deloitte report, an estimated 247 million people downloaded a health app in 2012, up from 124 million in 2011.
It’s the tip of a growing medical app iceberg, and regulators are trying to get some control back, with the TGA coming out earlier this month [http://www.tga.gov.au/industry/devices-software-mobile-apps.htm ] with clarification on the types of medical apps that could be classified as medical devices.
The statement issued noted that software that manages and presents information, like dosage calculators, would usually be exempt, but apps that incorporate a therapeutic or diagnostic function, such as one analysing clinical data like blood test results, could be considered to be medical devices and would be subject to TGA regulation.
More here:
To me, given the scale of the app market, this area can only become more and more complex, especially as the device manufacturers add additional sensors to the various devices.
I would argue that the key to what should be regulated revolves around what potential harm can result either from the app misleading or confusing the user or the app not performing in a reliable trustworthy and transparent way.
To achieve this outcome is by no means easy - as you have to recognise that 50% or people are below average - and being sure the app is safe and reliable in the hands of pretty much all users is a more than considerable challenge.
Developers need to apply the classical ‘first do no harm’ mantra in all they offer the public and to think laterally regarding all the possible risks they need to ensure they address!
David.

Tuesday, October 08, 2013

Will Mr Dutton Be A Health Minister We Can Have Some Confidence In? At Least He Talks The Talk!

It really is interesting times in the Federal Health sector. The only words to come from the Federal Minister in public seems to be an interview on ABC’s Life Matters.
25/09/2013
Transcript of interview of Minister Dutton on Radio National by Natasha Mitchell on the Life Matters program.

Transcript of Interview on Radio National

Transcript of interview of Minister Dutton on Radio National by Natasha Mitchell on the Life Matters program.

Page last updated: 25 September 2013
25 September 2013
Topics: Mental Health, Priorities for Government
Natasha Mitchell: It's been a big first week for Australia's new Prime Minister, Tony Abbott, and the federal government. His new ministers were officially sworn in last week. Peter Dutton was the Shadow Minister for Health and Ageing for five years while in opposition. Now he takes the posts of both the Minister for Health and for Sport. This means that he's effectively responsible for what were three separate roles under the Rudd Government. You'll recall that mental health was a separate portfolio as well.
Now, health is always near the top of Australians' list of priorities. The minister certainly has a complex job ahead and a significant recent legacy of national health reform to pick up on, and so what are the minister's priorities for your health? What will stay, what will go, and what might be new? Peter Dutton joins us on the line from Canberra.
Thank you very much for joining us on Life Matters, Minister.
…… (Lots omitted).
Peter Dutton: Well let's again look at the facts Natasha. I mean the Government imposed the so called alcopops tax. In actual fact the consumption of spirits has gone up since the introduction of that tax. What we've said is that we're very keen to pursue evidence based policies and ideas that can work, but we don't think for argument sake that prohibition would work in terms of alcohol or tobacco. I think if we're starting with a clean slate and we're having a discussion about the federation today and we were starting fresh as a country I'm sure that we would approach things differently both in terms of the way in which regulation's imposed at a state and federal level, but also in relation to tobacco for argument sake. I mean I think wherever we can discourage the take up of tobacco we should because we know of the health outcomes, we should do whatever we can [indistinct].
Natasha Mitchell: [Talks over]Do you acknowledge though, Minister, that regulation has a place in targeting some of those powerful vested interests that contribute significantly to poor outcomes? So, the tobacco industry, the alcohol industry, the junk food industries, who are in our face with their products in a major way and target young people too?
Peter Dutton: Well let's again take, sort of, a factual case study into consideration. When Tony Abbott was the Health Minister, we introduced the graphic warnings onto cigarette packaging. Now, that has had the greatest impact in terms of the reduction of smoking rates in addition to the increase in excise. In Opposition, I proposed an increase in the tobacco excise, and the Rudd Government eventually took it up. They announced increase in tobacco excise, again during the course of the last couple of months we adopted that same policy.
So, we're happy to adopt measures that have proven to be successful and an increase pricing around tobacco has been part of the reason that we've been able to reduce smoking rates in this country to some of the lowest in the western world. Part of the tobacco problem, that I don't think we've concentrated on, to be frank, is in indigenous communities, or in the take up around young women and young men, for arguments sake. And I think that part of our focus going forward really needs to be about how we can reduce smoking rates in indigenous communities. I think that is a national shame, the smoking rates within indigenous communities at the moment. And I think we can start to target some effort in those areas and I think, frankly, that would be a great and positive outcome for our country if we could start to target more those indigenous smoking rates.
Natasha Mitchell: Okay.
Peter Dutton: So we're not opposed to evidence based, but the only point that I'd make here…
Natasha Mitchell: Good to hear.
(More omitted)
-----
The full transcript is here:
(Italics and emphasis is mine.)
So Mr Dutton says he wants to be evidence based in making policy. That is just great but what does it mean for e-Health?
To me the first thing he needs to do is access and release and evidence base on which the design and implementation of the NEHRS / PCEHR is based ad facilitate and expert review of the evidence to understand just how justifiable and evidence based the whole program is.
Without trying to prejudice the outcome of the review I have to say that at present I can find no publicly available evidence backing the architecture, design and implementation approach of the PCHER. This is especially true of one is looking for evidence of improved clinical outcomes based on such an implementation.
Indeed it is very hard to find good evidence supporting improved clinical outcomes from national Shared Electronic Health Records Systems - for example the UK NHS Shared Care Record Program.
There are a number of evaluation studies that have been conducted on the UK system.
Here are some links:
A defence of summary care records - Mark Walport [Wellcome Trust]
These links are taken from an excellent article which is important reading.

Trisha Greenhalgh on Summary Care Record - where does the truth lie?

Ted Ritter
Found here:
So Mr Dutton’s challenge is really pretty simple. First to test the evidence that shows worthwhile clinical utility from the e-Health program as it presently is and then to reshape it based on what proper sound evidence actually shows.
We can all wait and watch!
David.

Monday, October 07, 2013

Weekly Australian Health IT Links – 7th October, 2013.

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

A quiet week on the surface but it does seem that Telstra is up to something with all these purchases recently. One has to wonder just how successful it will be and just how these various bits and pieces are to be formed into a coherent offering - or is that not the plan? Hard to know what else could make these purchases actually provide a real return on their cost.
Otherwise we find the new (now rather less new) Government is very, very, very quiet on e-Health!
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Little interest in eHealth system

By By CLARE COLLEY

Oct. 1, 2013, 4 a.m.
ONLY 1178 residents in Orange have signed up for the federal government’s eHealth record system giving them, their doctor, pharmacist and other healthcare providers online access to their health information, despite it being up and running for more than a year.
Since August 12, health department staff have signed up 1100 residents for the optional service at the Orange Medicare Office.
The eHealth record system was rolled out in July 2012 to allow any registered healthcare provider including general practitioners (GP), pharmacists, and allied health professionals to access a patient’s eHealth record.
As a privacy measure, it is up to the individual to choose who can access their information.
“You control what goes into it, and who is allowed to access it,” a health department spokesman said.
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John Wilson: Digital inevitability

John Wilson
Monday, 30 September, 2013
IT is encouraging that recent research in the MJA and a subsequent news story in MJA InSight have created so much interest in the value (or otherwise) of telehealth.
What should be our priority in pursuing telemedicine — to enhance clinical care, achieve cost–benefit advantage or to meet society’s needs?
There is no doubt that digital solutions do not always have instant acceptance. One prime example is the personally controlled electronic health record (PCEHR), which has been contentious more for its promise to deliver than its potential value.
Few will argue that the internet has changed "the way we live, work and play”. There is universal acceptance of digitally recorded, formatted and communicated information in all aspects of life. It is a sequitur that digital electronic health records will achieve acceptance with one format eventually emerging above others to serve medical needs.
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Telstra buys 50% stake in Fred IT

Telstra has further bolstered its positioning in the healthcare technology space buying a 50 per cent stake in health technology provider Fred IT Group.
Fred IT provides eHealth solutions (IT services, medical dispensing software) to GPs and pharmacists and Telstra’s Head of Health, Shane Solomon said the investment was part of Telstra’s ongoing focus on building capability in the health sector.
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Telstra Health grabs slice of Fred IT

1 October, 2013 Chris Brooker
Telstra Health has announced it is making a “significant investment” in Fred IT Group, in a move welcomed by the Pharmacy Guild of Australia.
The telco’s health arm is “taking a 50 per cent interest in Australia’s leading provider of IT services and dispensing software to pharmacies”, according to a release. 
The strategic partnership between Fred and Telstra Health reinforced Fred’s commitment to providing IT innovation and leadership for pharmacy and pharmacy customers long term, the Guild has said.
“The investment will position Fred to continue to invest strongly in e-Health and IT solutions which are vital in improving patient health and safety, creating new ways for community pharmacy to service customers and manage businesses”.
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Telstra takes stake in Fred IT

  • Australian IT
  • October 01, 2013 3:21PM
TELSTRA has expanded its focus on the health sector by acquiring a 50 per cent stake in software firm Fred IT Group, which provides IT services and dispensing software to pharmacies.
The undisclosed investment follows Telstra's acquisition of healthcare software company DCA and investments in e-health record player IPHealth and online health appointment booking company Health Engine.
"We are excited by the opportunities this investment presents and we will work with the Fred IT Group to build on the great foundations they have established," Telstra head of health, Shane Solomon, said.
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Telstra finalises pharmacy software company investment

Telstra has finalised its investment in the Fred IT Group, taking a 50% interest in Australia’s leading provider of IT services and dispensing software to pharmacies.
The investment in the Fred group follows Telstra’s acquisition of healthcare software company DCA eHealth Solutions and more recent investments in electronic health record specialist IPHealth and one of Australia’s leading online health appointment booking companies, Health Engine.
Telstra’s Head of Health, Shane Solomon said the investment was part of Telstra’s ongoing focus on building capability in the health sector.
“Community pharmacies play a vital role in providing services and advice to millions of Australians and Fred IT Group is at the leading edge of companies offering eHealth solutions to the community, GPs and pharmacists.
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Medical apps a health gamble

Cate Swannell
Monday, 30 September, 2013
NEW guidelines from the Therapeutic Goods Administration and the US Food and Drug Administration will do little to slow the proliferation of medical smartphone applications if the “app” retailers ignore them, say concerned Australian experts.
The sale and use of apps and attachable devices for smartphones by doctors and patients is a “huge grey area” and “fraught with traps”, the AMA’s dermatology spokesman Professor Stephen Lee told MJA InSight.
The AMA is so alarmed at the explosion of medical apps, they have fast-tracked discussions on the issue in time for the November Federal Council meeting, Professor Lee, of the University of Sydney, said.
He said the use of apps, particularly by patients looking for a quick diagnosis or risk assessment, was “fraught with traps”.
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Is there a medical app for that? TGA issues guidance on medical software and apps

On 13 September 2013, the Therapeutic Goods Association (TGA) published guidance about Australia's regulatory arrangements for medical software and mobile medical 'apps' on its website.
The TGA first undertook to regulate medical software and apps in 2011, after the United States Food and Drug Administration released draft guidelines on the issue.  This is the first time that the TGA has published formal regulatory guidance about medical software and medical apps. 
WHAT MEDICAL SOFTWARE DOES THE TGA REGULATE?
Medical software is regulated by the TGA as a “medical device” under Chapter 4 of the Therapeutic Goods Act 1989 (Cth) (the Act).
Generally, medical device software that is intended to control a device, or influence the functions of a device will fall into the same classification as that device itself. 
-----

Regulation gaps for medical apps under scrutiny

Last week, another smartphone-enabled medical device, an asthma wheeze monitor, was launched by Australian medical technology company iSonea Limited, backed with a high-profile ad campaign featuring Australian Olympian Cathy Freeman.
The company claims the digital device is a world-first for monitoring wheeze via smartphone technology, and with an estimated 2.3 million Australians with asthma, it’s likely to be a commercial success.
The user holds the AirSonea device against their throat to record breathing sounds, which the smartphone app then transmits to a cloud-based site for analysis by proprietary wheeze detection algorithms and software – a far simpler process than the peak-flow monitors traditionally used to monitor asthma through forced breathing.
-----

From September the NSW Health Clinical Portal now connects to the National eHealth Record (PCEHR)

If a patient has an eHealth Record a clinician will be able to view their information in the NSW Health Clinical Portal.
This will deliver the benefits of improving information sharing between hospitals, community health, general practitioners (GPs) and consumers – closing the loop between primary and acute patient care.
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Why healthcare interoperability standards aren’t perfect

Posted on October 2, 2013 by Grahame Grieve
Referring to HL7 and other SDO’s, Tim Cook writes:
“Such consensus groups gather political power from their expertise on healthcare IT standards, but they are seldom aware of all the problems real software companies dealing with real customers are facing. After many months or years, and hundreds or millions of dollars or euros spent, this little group of experts define a data model, a message or a schema, and they want to enforce it on everybody. Your customer gets frustrated, because that seldom matches the way clinical practictioners want their data collected, because the conventional top-down standards are much more concerned about the information needs of central governments or large medical hardware corporations than with the routine clinical documentation, which is the essence of medical decision making that really impacts on patient outcomes.”
This is both true and false. I can’t decide which it’s more of. I’ll confine my comments to HL7, which is where I can speak with some knowledge.
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Electronic Health Record Initiative Covers Municipalities in the 6th Regional Healthcare District of Passo Fundo and Will Benefit Thousands of People by the End of 2014
SYDNEY, Aust. -- September 24, 2013 -- After implementing a project for public healthcare informatics for the Government of the Federal District, which has become a model in Brazil and other countries, InterSystems, a global leader in software for connected care, has extended its Brazilian government relationships with a new implementation of InterSystems TrakCare® , an Internet-based unified healthcare information system, for an electronic health record system for the State Government of Rio Grande do Sul.
Called SIGS (Sistema Integrado de Gestão em Saúde), the implementation covers municipalities in the 6th Regional Healthcare District of Passo Fundo. By providing the municipalities with a complete information technology infrastructure, including world-class software systems and a new data centre, the Government of Rio Grande do Sul plans to modernise the public healthcare network to improve services to the community. The new infrastructure provides access to clinical information stored in TrakCare via a cloud computing platform, allowing healthcare teams including physicians, community health workers, nurses and dentists to share information such as a patient’s medications.
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Why big data has so far failed medicine

Summary: How will machine learning help healthcare? Hint: It's not through electronic medical records.
By Audrey Quinn | October 4, 2013 -- 14:55 GMT (00:55 AEST)
YORKTOWN HEIGHTS, NY – Can big data improve human decision-making? That was the question that MIT's Irving Wladawsky-Berger put to a panel of IBM clients at the company's research colloquium on cognitive computing Wednesday. The meat of his discussion focused on Douglas Johnston, a surgeon with the Cleveland Clinic. We'll share their interchange here.
“I think that what's happening now with data science,” said Wladawsky-Berger, “is we can now turn these microscopes on ourselves, systems where the critical components are people, communities, and organizations, and get a level of understanding we didn't have before.”
 “In healthcare in general we’ve been applying data science poorly,” admitted Johnston. “We have a medical literature that is contradictory, and we are relying on 100 year old transcription technology for our records. We still have to dig through those records to get the data. I see the results are failing because it's garbage in and garbage out.”
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Disadvantaged and disconnected in a digital divide

Date October 1, 2013

Daniella Miletic

Michael Dalli's old black Nokia mobile is ringing, so the 42-year-old excuses himself to answer it. Softly spoken, the wheelchair-bound father of one politely tells the caller he is busy and to ring back in half an hour. Then he apologises for taking the call. ''It's a pre-paid phone and I try not to exceed $50 a year,'' he explains.
To avoid using his credit, he always answers his mobile. He has no voicemail, does not text and saves calls ''just for emergencies''. In the age of smartphones, he also does not have mobile access to the internet. More pressingly, there is no internet connection in his Sunshine West home - he can't afford it.
''It's almost like I have a double disability,'' he said. ''I have multiple sclerosis, I'm confined to a wheelchair, but I feel like my other senses are also being denied because I don't have access to the internet.''
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Strap on your computer, wearable technology is taking off

Date October 2, 2013

Martha Mendoza

The digital domain is creeping off our desktops and onto our bodies, from music players that match your tunes to your heart beat, to mood sweaters that change colour depending on your emotional state – blue for calm, red for angry.
There are vacuum shoes that clean the floor while you walk and fitness bracelets, anklets and necklaces to track your calorie burning.
We're talking about paradigm changing devices, capabilities that people haven't thought of before. 
"Everyone agrees the race is just beginning, and I think we're going to see some very, very big leaps in just the next year," said tech entrepreneur Manish Chandra at a wearable technology conference and fashion show in San Francisco Monday that was buzzing with hundreds of developers, engineers and designers.
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Adobe hit with cyber attack

Software company says 2.9 million customer details accessed
Cyber criminals have accessed information about 2.9 million Adobe customers including names, encrypted credit card numbers and expiration dates. The attackers also took customer IDs and encrypted passwords.
According to Adobe CSO Brad Arkin, the cyber criminals did not remove decrypted credit or debit card numbers from its systems.
“We deeply regret that this incident occurred and we’re working with law enforcement to address the incident,” he wrote in a blog post.
The company is resetting customer passwords to prevent unauthorised access to Adobe ID accounts.
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Enjoy!
David.

Sunday, October 06, 2013

It Seems Some Who Probably Need A NEHRS Record Are Really Going To Struggle To Get To First Base.

This appeared last week.

Disadvantaged and disconnected in a digital divide

Date October 1, 2013

Daniella Miletic

Michael Dalli's old black Nokia mobile is ringing, so the 42-year-old excuses himself to answer it. Softly spoken, the wheelchair-bound father of one politely tells the caller he is busy and to ring back in half an hour. Then he apologises for taking the call. ''It's a pre-paid phone and I try not to exceed $50 a year,'' he explains.
To avoid using his credit, he always answers his mobile. He has no voicemail, does not text and saves calls ''just for emergencies''. In the age of smartphones, he also does not have mobile access to the internet. More pressingly, there is no internet connection in his Sunshine West home - he can't afford it.
''It's almost like I have a double disability,'' he said. ''I have multiple sclerosis, I'm confined to a wheelchair, but I feel like my other senses are also being denied because I don't have access to the internet.''
Each week, Mr Dalli makes a trip to his brother's house at Caroline Springs to use his computer to find and apply for jobs. A new Anglicare Victoria report finds Mr Dalli is not alone - and that a lack of access to the internet is exacerbating the gap between the haves and the have-nots. Surveying more than 300 people who needed emergency relief and financial counselling services, the researchers found nearly half (49 per cent) did not have an internet connection and more than half (56 per cent) did not have access to a mobile phone.
Lots more with some useful statistics.
This is a quite sad article I believe. The people who might just benefit from the PCEHR and people who really will struggle to access the PCEHR as sadly likely to be the very same.
Have we reached the stage where provision of basic internet services should be treated as a community right? We must be getting close to taking that step if we hope to make our country one where everyone can access the electronic services they need from Government.
What do you think?
David.

AusHealthIT Poll Number 186 – Results – 6th October, 2013.

The question was:

Do You Believe Australian E-Health Will Be Significantly Improved By The End Of The First Term Of The Abbott Government?

For Certain 2% (1)

Probably 7% (4)

Probably Not 54% (31)

No Chance At All 30% (17)

I Have No Idea 7% (4)

Total votes: 57

Well it seems those who read here have very low confidence in the new Government making a difference in the next three years.

Again, many thanks to those that voted!

David.