Quote Of The Year

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

or

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

Monday, February 01, 2016

Weekly Australian Health IT Links – 2nd February, 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

Well it seems it is well and truly on for one and all with all sorts of things happening. I am amazed how much has happened in the last week.
Enjoy browsing the headlines!
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Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016

- F2016L00070
Rules/Other as made
This rule establishes a corporate Commonwealth entity under section 87 of the Public Governance, Performance and Accountability Act 2013 to be named the Australian Digital Health Agency. Provides functions, governance arrangements, reporting requirements and transitional provisions to transfer assets and liabilities from the National E-Health Transition Authority Ltd.
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Troubled myGov website to be taken from Human Services and given to Digital Transformation Office for streamlining

Date January 28, 2016 - 10:30PM

Noel Towell

Reporter for The Canberra Times

The federal government's troubled myGov website is set to be taken over by the Prime Minister's pet public service project the Digital Transformation Office.
Fairfax understands that moves are already under way for the DTO to take over the management of the web portal from Commonwealth service delivery workhorse the giant Department of Human Services.
MyGov was launched in 2013 and is now used by several million Australians as a portal to access their Centrelink, Medicare, Child Support, Department of Veteran Affairs, e-health, and DisabilityCare accounts. Photo: Screenshot
Neither agency would confirm that a takeover was under way but one government IT expert said the move would be a chance to make a real difference for the digital change project which has so far produced little more than "wishy-washy" statements.
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John Madigan says agency that oversees doctors can't be trusted with metadata

Australian Health Practitioner Regulation Agency previously used doctors’ phone and web data to investigate doctors who have sex with their patients
Independent senator John Madigan says the government agency overseeing doctors, dentists and chiropractors cannot be trusted to gain access to Australians’ phone and web data.
The Australian Health Practitioner Regulation Agency (Ahpra) has previously used doctors’ phone and web data to help it investigate doctors who have sex with their patients.
Ahpra is one of 61 agencies on a list released by the government who have purportedly applied to the attorney general, George Brandis, for ongoing access to be classed as enforcement agencies to gain warrantless access to telecommunications data. Ahpra said it is seeking guidance from the department on whether it would be granted access.
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Prompts would help GPs keep track of patient changes

28 January 2016
THE ISSUE
PATIENTS’ contact details are recorded when they first register at general practices, but these details, as well as patients’ family and social histories, often change. Currently clinical and administrative software packages marketed for use in general practice do not prompt practice staff, GPs or practice nurses to check the currency of any of those details.
Failure to maintain this information can have serious consequences. In a recent MO Update (‘Medico-Legal Risks’, 30 October 2015), the authors advise readers to “make sure contact details are up to date”. However, it is impossible for practice staff, GPs and practice nurses to do this reliably, consistently and thoroughly.
Further, in most clinical software packages, some information, such as family and social history and allergies and intolerances, is recorded only as plain text, without any note of when and by whom that information was last confirmed as current or else updated.
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Australia's first opt-out e-health site to start trials this week

More than 670,000 northern Queenslanders first in line.

By Allie Coyne
Jan 27 2016 6:46AM
One of the two Australian health networks nominated to be the first to trial the government's plans for opt-out medical records will start testing the approach this week.
The Northern Queensland Primary Health Network (NQPHN) was last year named as one of two sites, alongside the Nepean Blue Mountains PHN, to automatically sign locals up for a 'My Health Record'.
Combined, the two trial sites will see the new opt-out approach tested on around one million individuals at a cost of $51 million. Evaluation firm Siggins Miller has been given a $1.4 million contract to review the trials once they are complete.
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E-health warning: cliff edge ahead

When I got back from a family camping trip this month I noticed that, apparently, the government had made important eHealth announcements shortly before Christmas Day. In summary, the news was that the government is going ahead with its plans, despite objections from the RACGP, AMA and others. Hardly surprising, but still disappointing.
Practices will miss out on their IT support payments if they don’t get their doctors to upload patient health summaries to the PCEHR (now called MyHealth Record). These IT support payments were originally introduced to make sure practices have up-to-date computer systems.
The Department must have known that GPs are usually not employed by practices and that most are ‘contractors’. This effectively means that they run their own independent businesses within a practice. Stopping payments to the practice does not directly affect their hip pocket unless they own the practice. So this is bad news for business owners. The strategy could affect the quality, safety and security of the medical IT systems – which is not good for patient care.
The question is: will doctors be using the eHealth system more often as a result of this change?
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PHN goes it alone in setting up e-health network

29 January 2016
EXCLUSIVE
ONE of the 31 new Primary Health Networks is starting its own e-health system independent of the federal My Health Record.
It will allow GPs to view hospital data for patients with chronic multimorbidities. 
The Gold Coast Primary Health Network is joining GPs and the region’s public hospital network, which includes the Gold Coast Hospital, to create its own e-health system for sharing and matching data, MO has learned.
As part of the plan Queensland Health is expected to open up its "Viewer" database — which contains all pathology and clinical imaging — to GPs.
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Pharmacists in new bid to stop codeine prescription push

Date January 30, 2016 - 11:00AM

Adam Gartrell

National Political Correspondent

Pharmacists are rolling out a new reporting system for codeine-based painkillers such as Panadeine and Nurofen Plus in a fresh bid to convince drug regulators there is no need to make them prescription-only.
The Therapeutic Goods Administration made an interim decision last year to make about 150 codeine products available only to people with a prescription, amid concerns the drugs are being misused and abused.
The change was supposed to take effect in June this year but the TGA delayed the move after being inundated with negative feedback. It now plans to make a final determination later this year with the change expected to come into force in 2017.
The Pharmacy Guild of Australia, which has been a leading opponent of the TGA's plan, argues a national real-time reporting system would be a more sensible and cost-effective solution to the problem of codeine abuse.
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January 29, 2016

Online Insomnia Program Improves Depression Symptoms

By Amy Orciari Herman
A fully automated online intervention can reduce depressive symptoms in adults with insomnia, according to a Lancet Psychiatry study.
Over 1100 adults in Australia who screened positive for insomnia and depressive symptoms (but not major depression) using online tools were randomized to the Internet-based SHUTi program or a control program for 6 weeks. SHUTi used cognitive behavioral therapy and focused on stimulus control, cognitive restructuring, sleep hygiene, and relapse prevention, while the control program simply offered health information.
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How the Qbot malware downed Melbourne Health's systems

Got in through Windows XP zero-day.

By Allie Coyne
Jan 22 2016 3:50PM
Melbourne Health's networks were attacked earlier this week by a new variant of the Qbot malware, which infiltrated its systems via a zero-day exploit in the Windows XP operating system.
Late on Monday the health department discovered malicious software had infected Windows XP computers through Royal Melbourne Hospital's pathology department.
The malware downed the hospital's pathology systems and forced staff into manual workarounds to process blood tissue and urine samples.
The health IT team has since managed to restore services to the pathology unit, but was forced to fastrack its in-train operating system upgrade after the malware killed its Windows XP computers.
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App provides a clear guide to diagnosing Marfan syndrome

29 January 2016
MARFAN DX aims to help clinicians from various specialities, including general practice, determine whether the signs noted in their patient add up to a diagnosis of Marfan syndrome.
The app, produced by the Marfan Foundation, uses the criteria for diagnosis found in the 2010 Revised Ghent Nosology.
The home page details the aims of the app. Information on the cardinal features of Marfan syndrome – aortic root aneurysm and ectopia lentis, presence of FBN1 mutation and family history – are included. 
The main feature of the app is the Systemic Calculator, which walks the user through the lesser features which can be used to confirm a diagnosis in the absence of all cardinal features. 
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Aussie pharmacies test real-time monitoring of codeine sales

Industry lobby fights against prescription-only plans.

By Allie Coyne
Jan 28 2016 2:19PM
Pharmacies across Australia will soon embark on a large-scale pilot of real-time monitoring of over-the-counter sales of medicines containing codeine, in bid to stop the government reclassifying the pills as prescription-only.
The Pharmacy Guild of Australia last month commenced user testing of the prototype "MedsASSIST" real-time monitoring tool with around 30 pharmacies in the Newcastle area of NSW.
The system records purchases and allows pharmacies to review a customer's recent purchases from other pharmacies to identify patients who are at risk of codeine dependence. 
Customers need to consent to have their details recorded, but will not be supplied the codeine product unless consent is given.
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Jay spruiks local tech company snubbed by SA Health

It's the company the Health department rejects that the Premier likes the best.
Adelaide Thursday January 28, 2016
Premier Jay Weatherill says relatively inexpensive e-health software developed by SA firm Alcidion – which was rejected by SA Health in 2014 in favour of the embattled, $422 million electronic health records system EPAS – is “a thing of the future”.
Weatherill delivered a glowing keynote address to mark the listing of local health informatics company Alcidion on the ASX yesterday, whose “leading product, called Miya” – the one snubbed by SA Health – was “creating a great deal of interest”.
 “This innovative technology was the key reason for Alcidion receiving the 2015 Impact Award,” Weatherill said.
Last year, Alcidion co-founder and former head of the Health Commission (now called SA Health) Ray Blight told InDaily he had pitched Miya to the department, whose senior staff conceded the merits of the technology but suggested EPAS would eventually have the same capabilities.
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Pharmacy 'pick-up lines' plan attacked

Paul Smith | 28 January, 2016 |
A leading GP has savaged a push by pharmacy owners to boost sales of schedule 2 and 3 medications by using so-called “pick-up lines” on patients.
Dr Evan Ackermann (pictured), chair of the RACGP’s standing committee on quality care, said the pharmacy industry was attempting to plug financial losses from ongoing PBS cuts.
He said educational courses aimed at maximising pharmacists’ revenue were encouraging sales tactics using pick-up lines to trigger consultations about minor ailments.
The Pharmacy Guild of Australia ran what it described as an “all-business-no-clinical-content-conference” in Melbourne in 2014, where delegates were asked to share their best “S3 pick-up line”.
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Warning against giving AHPRA access to metadata

Paul Smith | 22 January, 2016 | 
A leading indemnity insurer is warning against giving AHPRA warrantless access to doctors' phone and web metadata, saying the watchdog is not a "criminal law enforcement agency".
Earlier this week, it was revealed that AHPRA was on a list of 61 organisations that had apparently written to the Federal Government wanting warrantless access to phone and internet metadata
Such data includes call records, assigned IP addresses, contact information and location information.
Other applicants included the Federal Health Department; the Health Care Complaints Commission in NSW; and the Department of Human Services, which runs Medicare.
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Investment in GP2U to deliver 'better health care’ says HCF

  • 24 January 2016
Australian not-for-profit health fund, HCF, has invested in telehealth start-up GP2U, taking a 15% stake in the business.
HCF Sheena Jack, HCF Chief Strategy Officer Sheena Jack said the investment in GP2U demonstrated “HCF's commitment to supporting innovation to deliver better health care to all Australians”.
“Telehealth has the ability to dramatically improve the convenience and accessibility of health care. We are delighted to be a part of GP2U and have been impressed with both the end-to-end technology platform and the team behind it.”
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HCF snaps up stake in telehealth technology start-up

  • The Australian
  • January 28, 2016 12:00AM

Damon Kitney

Members of the nation’s largest not-for-profit health fund will be able to have their GP prescriptions sent directly to Terry White and Priceline pharmacies for collection following a consultation after HCF struck an equity deal with telehealth start-up GP2U.
HCF has taken a 15 per cent stake in GP2U, whose speciality is allowing for remote medical consultations using videoconferencing. But the start-up also allows messages on prescriptions from GPs to be sent directly to Terry White and Priceline pharmacies, owned by Australian Pharmaceutical Industries.
HCF joins listed diagnostics company Sonic Healthcare as a shareholder in GP2U, which is majority-owned by its founder, James Freeman.
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Press release:

YOUNG DOCTORS ‘APPY’ TO HELP CANCER PATIENTS

Sydney: Young doctors are pushing cancer care into the smartphone age, with a landmark new app to provide personalised cancer information to patients.
CancerAid enables doctors to “prescribe” the correct information to the patient, including details on their disease, treatments and possible side-effects.
Patients and their caregivers can use the app to navigate their entire cancer journey and share important details with clinicians and family.
29-year-old radiation oncology trainee, Dr Nikhil Pooviah of Sydney’s Chris O’Brien Lifehouse, designed CancerAid after observing many patients experienced “information overload”.
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E-health unlikely to be ready for new Royal Adelaide Hospital

Troubled $422 million electronic health records system, EPAS, is unlikely to be fully functional at the new Royal Adelaide Hospital when it opens later this year, InDaily can reveal.
Bension Siebert
Adelaide Thursday January 28, 2016
An internal SA Health memo, obtained by InDaily, suggests only the administrative functions of the embattled IT program, and some clinical functions, will be activated when the multi-billion-dollar hospital opens late this year.
An internal newsletter, sent to Central Adelaide Local Health Network staff from CEO Julia Squire, says EPAS is only expected to be fully functional at the new hospital by May 2017 – or “earlier if possible”.
“It is expected that the new RAH will use the full administrative and clinical EPAS functionality for all new admissions by May 2017 and earlier if possible,” the note says.
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Queensland nurses go after new triage algorithm

Doctor Data will see you now.

By Paris Cowan
Jan 28 2016 11:26AM
Queensland Health is hunting for a new algorithm-based system that will help its registered nurses deliver advice to patients over the phone, based on details like their age, sex, health conditions and proximity to a health facility.
The state health authority is looking to replace the decision making support system used by its 30-seat teletriage service, a public hotline that allows Queenslanders to call in and get advice on whether to see a medical professional based on their symptoms.
The old decision support system has reached its tenth birthday, and the state is looking for new technology to see it through the next decade.
It wants an algorithm-based solution that will use patient data, teamed with clinical decision making processes, to automatically guide the nurses though a call based on the information a patient shares with them.
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PowerHealth Solutions has entered the Canadian healthcare market by partnering with change capability and management consultants Canadian Healthcare Management. PowerHealth Solutions (PHS) is a healthcare administration software vendor, which has been specialising in patient costing and decision support for 20 years. Their award-winning PowerPerformance Manager (PPM) system is the leading patient costing solution in Australia and New Zealand - adopted across all public hospitals by the majority of Australian State Health Departments and the largest District Health Boards in New Zealand.
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Orion Health, a leading population health management and healthcare integration company, has announced the release of Rhapsody Integration Engine Version 6.2. The new version of Rhapsody delivers a number of customer focused innovations to help users work smarter. Plus, it builds on the FHIR capabilities introduced in Rhapsody 6.1, the first integration engine to implement the new HL7® Fast Healthcare Interoperability Resources (FHIR®) standard. The Rhapsody dashboard has been enhanced to provide at-a-glance monitoring via multiple channels such as a tablet, smart phone, and monitor.
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Aliens are not coming, scientists say, because they’re all dead

  • The Australian
  • January 26, 2016 12:00AM

John Ross

The paper offers a third explanation for the apparent absence of extraterrestrial life.
Scientists have a new explan­ation as to why the search for alien life has drawn a blank: the aliens are all dead.
Australian astrobiologists ­believe lifeforms have emerged on countless worlds but quickly died off as water on host planets either froze or boiled away.
The only evidence of alien life is likely to be microscopic fossils or “isotopic anomalies” in four-billion-year-old rocks. “The vast majority of life in the universe is either young and microbial or extinct,” the researchers argue in the journal Astrobiology.
The paper offers a third explanation for the apparent absence of extraterrestrial life. The dominant theories are that it never emerged in the first place, or it eventually self-destructed. Co-author Charles Lineweaver, a planetary scientist at the Australian National University, said early life’s fragility triggered its rapid demise.
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Enjoy!
David.

Sunday, January 31, 2016

Some More Details On The PCHER Opt-Out Trials Very Interesting Indeed. What A Shonk!

This well researched report appeared a few days ago:

Australia's first opt-out e-health site to start trials this week

More than 670,000 northern Queenslanders first in line.

By Allie Coyne
Jan 27 2016 6:46AM
One of the two Australian health networks nominated to be the first to trial the government's plans for opt-out medical records will start testing the approach this week.
The Northern Queensland Primary Health Network (NQPHN) was last year named as one of two sites, alongside the Nepean Blue Mountains PHN, to automatically sign locals up for a 'My Health Record'.
Combined, the two trial sites will see the new opt-out approach tested on around one million individuals at a cost of $51 million. Evaluation firm Siggins Miller has been given a $1.4 million contract to review the trials once they are complete.
Residents of the two locations will have My Health Record accounts set up for them by default using names, addresses and health identification numbers pulled out of the Medicare database.
On Wednesday and Thursday this week, Department of Health and NQPHN officials and staff from Siggins Miller will visit Cairns and the Tablelands to begin the first stage of public consultation on the implementation plan.
“These sessions with the Department of Health’s digital health division will be an opportunity for health industry experts and community members to share their valuable insight and feedback about our region’s needs and ways in which allied health can interact with My Health Record," NQPHN chairman Trent Twomey said in a statement.
“Their feedback will directly inform the implementation plan and delivery of My Health Record.
More here:
The report provoked me to do a little more research.
First the evaluation tender. Here is the summary.

Opt out trial program review and evaluation

CN ID                               CN3316597
Agency                            Department of Health
Publish Date                    21-Jan-2016
Category                          Information technology consultation services
Contract Period                24-Dec-2015 to 30-Nov-2016
Contract Value (AUD)       $1,429,230.25
Description                      Opt out trial program review and evaluation
Procurement Method      Open tender
SON ID                             SON2647271
Confidentiality - Contract No
Confidentiality - Outputs No
Consultancy                     No

Supplier Details

Name               SIGGINS MILLER CONSULTANTS PTY. LTD
Postal Address 
Town/City        KENMORE
Postcode          4069
State/Territory QLD
Country            Australia
ABN                  56 076 986 500

Agency Details

Contact Name           BMU
Contact Phone          02 6289 1555
Division                    EHealth
Office Postcode        2606
Agency Reference ID 4500118987
Now the company that has been selected to evaluate the opt-out trial - Siggins Miller:
Here is the link:
The areas of expertise are listed on the home page as:
Consulting Service
The areas they have looked at in our domain are as follows (according to the site are)

Telehealth and e-health

Development of qualitative and quantitative evaluation methodologies for the assessment of the costs and benefits of multidisciplinary team meetings for cancer care which brought together rural and regional clinicians together with city based specialists, reducing professional isolation, providing secondary consultations on clinical matters and improving patient outcomes, convenience and continuity of care
Designed and managed consultations in rural and remote Australia for Health Workforce Australia to develop the National Rural and Remote Health Workforce Innovation and Reform Strategy and for the Department of Health and Ageing’s Rural and Remote Health Strategic Framework. In both these projects we gathered detailed information and developed a deep understanding  about the need for e-health solutions to:
·       address the tyranny of distance
·       assist with closing the gap in outcomes between rural and remote and Aboriginal and Torres Strait Islander and urban populations
·       improve the retention of health workers
·       support students on rural and remote placements
·       improve quality through increasing access to CPD, point of care resources and secondary consultations.
A long history of conducting system wide, multi layered evaluations of national capacity building efforts. We are used to working in complex field settings, managing multiple stakeholders and conducting large system wide consultations cost effectively. Our evaluations have included e-health related components, assessing the contribution of initiatives at the personnel, organisational and system level to overall outcomes and assessing the impact of the broader environment enablers and barriers on the achievement of hoped for outcomes
We are also skilled at working with those designing interventions or rolling out innovation to assess their readiness for implementation in a way that builds in evaluative thinking from the beginning, suggests monitoring and evaluation methods, and maximises chances of avoiding implementation failures by thinking things through in detail before launch.
Examples of our work in this area have included:
·         A 6 year longitudinal evaluation and support service to Cancer Australia between 2006 and 2012. This evaluation included evaluation of on line CPD and point of care resources, evaluation of multidisciplinary team meetings via telehealth, provision of secondary consultations and virtual teams including economic evaluation, on line directories of services and  the convening of national teleconferences and workshops to reduce duplication of effort, advise on change management and speed the uptake of innovation
·         A 3 year longitudinal evaluation of all aspects of Canteen and the DoHA YCNF to improve outcomes for adolescents and young adults with Cancer, including web based interventions, the use of social media and online resources for health professionals
·         Development of an evaluation framework for the Royal Australasian College of Physicians to monitor and evaluate its educational program including those elements based on lecture series based on video conference capacity
·         Design of an evaluation framework and implementation of the evaluation of telehealth mediated Aboriginal and Torres Strait Islander patient navigator program in Far North Queensland for Queensland Health
·         Development and implementation of an evaluation framework for an innovative pilot of a telehealth mediated Aboriginal and Torres Strait Islander Care Coordinator role in Far North Queensland
·         A two year evaluation of the National Drug Strategic Framework for the Department of Health and Ageing  including the evaluation of information systems to assist pharmacists to prevent illicit use of pharmaceuticals
·         Development of an evaluation framework and conduct of the first two years of an evaluation of AusAID funded capacity building in the health system in PNG which included building communication capacity in a developing country context.
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In last week's blog we noted that there was planned to be consultation with all the professional groups and no consumer consultation. I assume that comes later.
See here:
So $1.4M for an evaluation that ends, apparently in less than a year, for a project that probably won’t even actually be live until June or so!
I look forward with breathless anticipation to the valuable evaluation that will flow after less than 6 months experience of opt-out and all its ramifications!
What a duplicitous farce on the part of DoH. A set up of the first water to me!
David.

AusHealthIT Poll Number 305 – Results – 31st January, 2016.

Here are the results of the poll.

Guest Question: Should Australia invest in the development of a secure, trusted, functional, integrated network of health service providers which is designed to support and encourage the seamless exchange and sharing of current, accurate health record information that is quickly and easily accessible, accurate and relevant, and able to be relied upon by all health service providers to support patient care?

Yes 21% (16)

Probably 54% (41)

Neutral 17% (13)

Probably Not 5% (4)

No 3% (2)

I Would Have No Idea 0% (0)

Total votes: 76

Again a pretty decisive poll. 75% think this is a reasonable direction for investment as opposed to what we have going on at present.

Good turnout for the silly season!

Again, many, many thanks to all those that voted in such a quiet week!

David.

Saturday, January 30, 2016

Weekly Overseas Health IT Links - 30th January, 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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Ambulatory EHRs fall short, Frost & Sullivan says, but primed to pick up through 2020

On-premise EHR limitations and low returns will spur practices to move toward cost-effective, cloud-based products as they pursue population health goals, according to the report.
January 22, 2016 04:52 PM
While the market for inpatient electronic health records is mature, there's still plenty of upside for ambulatory systems as accountable care organizations and patient-centered medical homes struggle to function seamlessly across the continuum of care, according to a new report by Frost & Sullivan.
In its report, U.S. Ambulatory Electronic Health Record Market: 2015–2020, the research firm sees big changes for the outpatient EHR market in the years ahead, as "value-based reimbursement provisions, payer consolidation and EHR optimization agendas" accelerate adoption among ambulatory practices.
Merger and acquisition activity will continue to gain steam as hospitals and large practices snap up smaller practices to bolster bottom lines and grow market share. Meanwhile, on-premise EHR limitations and low returns on investments will often spur practices to move toward cost-effective, cloud-based products that offer remote access and agile IT upgrades, according to the report.
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Hacktivist vs. cyberterrorist: Understanding the 5 enemies of healthcare IT security

According to Critical Infrastructure Technology report, cyber attackers can be categorized according to their target, tactics, techniques, malware and procedures.
January 22, 2016 04:15 PM
From "script kiddies" to sophisticated nation states, healthcare organizations have to be on the lookout for a variety of dangerous bad actors looking to crack its cybersecurity defenses, according to a recent Institute for Critical Infrastructure Technology report.
The possible impacts from a healthcare security breach are vast. Data from administrative or electronic health record systems can be used to steal the identity of patients and employees, which creates a financial burden and can even lead to legal ramifications.
Furthermore, false information provided by the hacker can also increase the risk of medical complications, according to the report.
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Data mining creates growing unease about patient privacy

January 22, 2016 | By Susan D. Hall
The market for medical information is so opaque that many doctors and patients don't realize data from a lab or electronic health record may be anonymized and sold without their consent, according to an article at Scientific American.
It reports growing unease about the expanding use of data mining by commercial entities not just among privacy advocates but among health industry insiders as well.
While longitudinal studies can be beneficial by providing new insights into the long-term effects of drugs and treatments, the under-the-radar market for medical data, the lack of patient consent and the ease at which patients can be identified even from anonymized data raises concerns.
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Electronic health record now available for 3.6 million south west Ontario residents

HealthPress Release
Over 37,000 health care professionals securely access electronic patient information
London, ON. – Over 37,000 doctors, nurses, therapists, and other health care professionals across south west Ontario (SWO) are now able to securely access electronic patient information from the region’s 67 hospitals, four Community Care Access Centres (CCACs), four regional cancer programs and provincial clinical systems for laboratory tests and results, and diagnostic imaging via the cSWO Regional Clinical Viewer, ClinicalConnectTM.
For the first time, patient health information from across the continuum of care can be accessed by authorized health care professionals to gather essential patient data in seconds from those organizations using ehealth technology. The implementation of an integrated electronic health record (EHR) has been achieved in south west Ontario – from Windsor to Tobermory to Guelph and through Niagara Falls.
The connecting South West Ontario (cSWO) Program, funded by eHealth Ontario, achieved a major milestone in July of 2015, when the final acute care hospital sites were successfully integrated with the regional clinical viewer. ClinicalConnect is a secure, web-based portal that provides authorized physicians and health care professionals with real-time access to their patients’ EHRs. eHealth Ontario and the cSWO Program, in partnership with Local Health Integration Networks (LHINs) and health service providers in south west Ontario, are enabling health care systems to share patient information across the sector and the province.
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Industry Association Seeks Answers to Medical ID Theft

JAN 21, 2016 7:32am ET
Idology, a software vendor enabling providers and insurers to validate the identity of a person not physically present, recently joined the Medical Identity Fraud Alliance, bringing the number of stakeholder and association members to 43 a little more than two years after formation.
John Dancu, CEO at Idology, says he recently became aware of MIFA and wants the company to be part of the collaborative association.
“When you share best practices and fraud trends, it makes the customer stronger,” Dancu notes. Further, making sure a customer is legitimate brings a positive experience to the customer and the healthcare organization, he adds. Idology’s healthcare business has grown quickly in the past three years as the industry awakens to the need for better tools to combat medical identity theft, he says.
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5 steps to designing healthy clinical apps

Lorraine Chapman, director of healthcare user experience for the global software and design firm, will discuss at HIMSS16 how to leverage user-centric design.
January 21, 2016 02:28 PM
The problem with many health apps often comes down to design, creating “a mismatch between what the app is trying to do and what the end users are trying to do,” said Lorraine Chapman, director of healthcare user experience for the global software and design firm Macadamian.
At HIMSS16, Chapman and Jeff Belden, MD, a practicing physician and professor of clinical family and community medicine at the University of Missouri – Columbia, will share five tips for making user-centric design part of your organizational DNA to enable more effective clinical apps.
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Epic, athenahealth, other EHR vendors sign on for Carequality Interoperability Framework

EHR heavy-hitters to be first class of vendors to implement data exchange principles set by The Sequoia Project.
January 21, 2016 04:30 PM
Barely a month after its launch, the Carequality Interoperability Framework devised by The Sequoia Project has already signed up five health IT heavy-hitters to be the first to implement its data exchange principles: athenahealth, eClinicalWorks, Epic, NextGen Healthcare and Surescripts.
The vendors – at least two of whom have verbally sparred in recent years over their willingness to play ball with interoperability – have agreed to provide health information exchange services for their customers under the Carequality Framework: legal terms, policies, technical specs and processes meant to enable another step forward for nationwide health information exchange.
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More 'vulnerable' patients still not embracing portals

January 19, 2016 | By Marla Durben Hirsch
Primary care providers have mixed views on patient portals, and aren't seeing their vulnerable patients using them much, according to a new study in the Journal of Medical Internet Research.
The researchers, from Wake Forest School of Medicine and elsewhere, conducted in-depth interviews with 20 clinical personnel in four North Carolina counties between October 2013 and June 2014. All of the providers served a lower income population.
They found that the main motivator of implementing a patient portal was external pressure, mainly from the Meaningful Use program, which requires more patient engagement. The providers acknowledged the potential benefits of portals, including:
  • Improved office efficiency
  • Fewer phone calls
  • Immediate access to patient electronic requests
  • Easier patient access to information
  • Better patient care management
  • More patient satisfaction
  • Improved information with other providers
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Pew study: Online access to records increasingly 'acceptable' for Americans

January 19, 2016 | By Marla Durben Hirsch
More Americans are in favor of online access to their medical records, so long as they believed that the site was secure, according to a new study by Pew Research Center.
The study, part of a larger study on privacy and information, surveyed 461 U.S. adults and conducted nine online focus groups of 80 people. It found that 52 percent of respondents were in favor of an online website where they could view their medical records and schedule appointments where the doctor "promises" that it's a secure website. Only 26 percent found that scenario unacceptable.
Patients ages 50 and older were more likely to find such access acceptable than those ages 18 to 49 (62 percent v. 45 percent); those with some college education also were more in favor of such access than those who did not have such education (59 percent v. 44 percent). Those in favor noted that the added convenience and ease would be appealing, although some said that it depended on how secure the website was, who would access the data and whether the respondent in general trusted his or her doctor.
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Loss of life, liability top cybersecurity fears for health IT leaders

January 21, 2016 | By Katie Dvorak
Losing patients due to malicious actors gaining access to systems or hacking medical devices is the top fear for healthcare leaders when it comes to cybersecurity, according to the results of a new survey.
For the survey, conducted by HIMSS on behalf of application security company Veracode, executives also cite damage to their brand, enforcement by government agencies and post-breach costs as major concerns in an environment where breaches are growing in frequency and breadth.
Of more than 200 hospital and health system IT leader participants, 28 percent said their top threat concern is the ability of hackers to take advantage of vulnerabilities in Web- and cloud-based tools such as electronic health record systems and clinical applications.
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How a hospital CIO turns patient feedback into healthy outcomes

Yale New Haven Hospital is using feedback software and tablets to help bolster patient satisfaction and, ideally, outcomes, says CIO Lisa Stump.

CIO | Jan 20, 2016 9:50 AM PT
It might seem strange to compare a patient’s hospital stays to a consumer indulging in the extravagances of a four-star hotels. Yet Yale-New Haven Health System is improving its healthcare services based on real-time patient feedback, collected via tablets, about anything from the cleanliness of rooms to the friendliness of nurses.
Consumers choose hotels based on their reputations for comfort, dining and other amenities. Similarly, patients have several options for healthcare providers, says Lisa Stump, CIO of Yale-New Haven Health System. And in an age where Yelp and Twitter can make or break reputations, hospitals must deliver the best experiences to make patients prefer their facilities. "We give you back some control in an experience where you don't have a lot of control because you're stuck in a hospital bed," Stump says.
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3 Ways Telemedicine is Changing Healthcare

Lena J. Weiner, for HealthLeaders Media , January 21, 2016

From increasing access to influencing better patient outcomes, health systems are recognizing the benefits of virtual patient visits and remote monitoring—and finding ways to mitigate the costs.

Some patients are harder to reach than others.
Refusing to turn on his webcam, one telemedicine patient insisted on communicating only using the chat box on his provider's mobile app. Eventually, he admitted that he suffered from agoraphobia, germophobia, and social anxiety. This was the only way he felt comfortable seeking care.
Once the realm of science fiction, telemedicine has become a reality of care—and an option for patients that might once have been difficult to reach, including rural patients, professionals with busy schedules, and patients unable or uncomfortable seeking care in person.
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Report: Healthcare the least prepared sector against cyberattacks

January 20, 2016 | By Susan D. Hall
Healthcare is the most targeted yet least prepared sector in the U.S. when it comes to cyberattacks, according to a report from the Institute for Critical Infrastructure Technology. 
"Both providers and payers devote the majority of their resources to fulfilling their mission," the report's authors say. "Sadly, attackers have seen this selfless dedication to human life as sign of weakness."
Government and healthcare organizations manage complex infrastructure that has many layers that leave gaps, which allows hackers access to sensitive data, according to the authors. What's more, many times, manufacturers no longer support their technology, which creates even more vulnerability. One example of how malicious actors took advantage of this is the Office of Personnel Management hack, which put information of about 4 million federal employees at risk.
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Seek and treat

Central initiatives, from the plans in the ‘Five Year Forward View’ to clinical commissioning group scorecards, are driving the use of data and analysis in healthcare.
But it is using data to find patients at risk and then to tailor appropriate interventions for them that could really drive change in health and social care, Kim Thomas discovers.
All too often, chronic kidney disease is diagnosed too late – but could there be a way of picking it up earlier?
Using tools from Emis, NHS Camden Clinical Commissioning Group now carries out central searches of GPs’ patient records to identify those patients who might be at risk.
The GPs are informed, and the patient, with their consent, is given a virtual referral to a hospital specialist, who reviews the records and decides on one of three courses of action: that the patient attends the hospital renal clinic, is managed under the care of their GP, or is attended by a community nurse.
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With iPhone apps, your doctor can read your bathroom scale

January 19, 2016
Lane Turner/The Boston Globe

Pulse of Longwood takes you inside one of the nation’s largest hubs of hospitals and biomedical research.

Patients with heart failure could soon start beaming their body weight from bathroom scales right to their doctor’s office, as Beth Israel Deaconess Medical Center joins a growing number of hospitals experimenting with mobile technologies to track patients’ health at home.
In doing so, the 672-bed teaching hospital in Boston’s Longwood Medical Area joins the first wave of health care providers using Apple’s HealthKit software to tap into the stream of health information that patients are already collecting on their iPhones.
Since patients are already using smartphones to track how much they step, eat, sleep, and snore, hospitals now want to seize on that data to forge a new type of remote health care that they hope will drive down costs and help people manage chronic diseases.
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CHIME Launches $1M National Patient ID Challenge

January 19, 2016
by Heather Landi
National Coordinator for Health IT Karen DeSalvo, M.D., applauds the patient identification challenge as an example of private sector leadership with developing national standards and health IT innovation
The College of Healthcare Information Management Executives (CHIME) announced today a National Patient ID Challenge, a $1 million crowdsourcing competition to incentivize the private sector to develop a fail-safe patient identifying solution that links patients to their medical records.
Partnering with HeroX, a crowdsourcing innovation platform, on the initiative, CHIME aims to encourage innovators to help solve the complex problem of patient misidentification There is currently no universal standard to 100 percent accurately identify patients and match them to their medical records. And, since 1999, the federal government is prohibited from spending public funds on the development of a national patient identifier.
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Data Sharing

Dan L. Longo, M.D., and Jeffrey M. Drazen, M.D.
N Engl J Med 2016; 374:276-277January 21, 2016
DOI: 10.1056/NEJMe1516564
The aerial view of the concept of data sharing is beautiful. What could be better than having high-quality information carefully reexamined for the possibility that new nuggets of useful data are lying there, previously unseen? The potential for leveraging existing results for even more benefit pays appropriate increased tribute to the patients who put themselves at risk to generate the data. The moral imperative to honor their collective sacrifice is the trump card that takes this trick.
However, many of us who have actually conducted clinical research, managed clinical studies and data collection and analysis, and curated data sets have concerns about the details. The first concern is that someone not involved in the generation and collection of the data may not understand the choices made in defining the parameters. Special problems arise if data are to be combined from independent studies and considered comparable. How heterogeneous were the study populations? Were the eligibility criteria the same? Can it be assumed that the differences in study populations, data collection and analysis, and treatments, both protocol-specified and unspecified, can be ignored?
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The Impact of Technology Resistance on Information Exchange

JAN 19, 2016 4:44pm ET
Commentary: Thanks to the Affordable Care Act and new care delivery models, provider compensation is increasingly being tied to quality outcomes and cost-effective care. To achieve quality and cost objectives, patient care must be well-coordinated in order to accelerate the delivery of care, reduce wasteful duplicate testing, and minimize the risks and costs associated with missed or delayed diagnosis, medication errors and hospital readmissions.
To effectively and efficiently coordinate care, providers need access to a patient’s complete health record, including details on medications, previous test results and medical history. Initiatives such as the Meaningful Use program and the Direct Project initiative seek to promote the fast and secure exchange of clinical patient information.
However, many organizations have yet to adopt new technologies to facilitate the electronic exchange of health data. In many cases, perceived high implementation costs are to blame. More commonly, the biggest barrier is provider unwillingness to disrupt existing workflows in favor of new processes.
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FDA posts cybersecurity guidance for medical device manufacturers

In addition to incorporating controls in device designs, makers must also consider ongoing improvements because risks could occur over the device's lifecycle.
January 19, 2016 03:04 PM
The Food and Drug Administration has issued draft guidance outlining steps medical device manufacturers should take to counter cybersecurity threats.
The agency offers advice on monitoring, identifying and addressing cybersecurity vulnerabilities in medical devices once they have entered the market.
The draft guidance, published Jan. 15, is part of the FDA's effort to ensure the safety and effectiveness of medical devices at all stages in their lifecycle, officials said. They note that in addition to incorporating controls in the design of the device, makers must also consider improvements during maintenance because risks could occur over the device's lifecycle.
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FireEye exec to probe why hackers see healthcare data as such a lucrative target

Providers and payers need to protect their security, shoring up third-party relationships with official business associates, Dan McWhorter to discuss in HIMSS16 keynote.
January 19, 2016
03:40 PM
Cyber-criminals continue to pose major threats to healthcare information technology departments, and experts say it’s the lure of electronic protected health information that keeps them coming.
“In the last two years, healthcare providers and insurers have been hit by some of the most severe network intrusions ever observed, exposing millions of patient records and costing victim organizations tens of millions of dollars,” said Dan McWhorter, vice president of global threat intelligence and strategy at FireEye, an IT security vendor.
McWhorter will deliver a keynote address at HIMSS16 on the importance of health data security in his presentation, “Emerging Threats: Why is ePHI a Target?”
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How prying eyes put PHI at risk

January 19, 2016 | By Katie Dvorak
Healthcare organizations need to not only worry about patient data being compromised by outside sources, but also because of prying eyes within their walls.
Snooping and spying is human nature, Kate Borten, president and founder of The Marblehead Group, tells HealthITSecurity.com. And as personal health information is increasingly viewed on computer screens, tablets and mobile phones, the ability for someone to see data they shouldn't grows.
A screen facing out into a hallway or waiting area could mean people catching glimpses of very private information, but a solution could be as simple as re-angling the screen, Borten says.
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AMIA Study Examines the Impact of Health IT on Patient Consultations

January 15, 2016
by Heather Landi
There is growing concern about the impact of health information technology (IT) on patient-clinician communication, yet a study by the American Medical Informatics Association (AMIA) finds that the use of health IT can affect consultations in positive or negative ways depending on a number of factors.
Recent studies have linked high computer use by clinicians with lower patient satisfaction. According to AMIA, the purpose of it study, which was published in the Journal of the American Medical Informatics Association, was to review the current literature on health IT use during the clinical encounter to update best practices and inform the continuous development of health IT policies and educational interventions.
For the study, researchers conducted a literature search of four databases and analyzed about 50 articles and then used a qualitative thematic analysis to compare and contrast the findings across the studies.
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Meaningful Use Lives On

by Brian Ahier Tuesday, January 19, 2016
On Oct. 6, 2015, CMS and the Office of the National Coordinator for Health IT released the final rules for Stage 3 of the Electronic Health Record Incentive Program and the 2015 Edition Health IT Certification Criteria. Through this rulemaking, the agencies hoped to simplify requirements and add some new flexibilities for providers. They moved from fiscal year to calendar year reporting for all providers beginning in 2015, and they offered a 90-day reporting period for all providers in 2015, for new participants in 2016 and 2017, and for any provider moving to Stage 3 in 2017. They reduced the number of Stage 2 meaningful use objectives from 18 to 10 in 2015-2017, with no change in clinical quality measures. For Stage 3, there will be eight meaningful use objectives (with about 60% of them requiring interoperability).
They also requested additional feedback about Stage 3 of the EHR Incentive Program going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System (MIPS) and consolidated certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework. They plan to use this feedback to inform future policy developments for the EHR Incentive Program, as well as consider it during rulemaking to implement MACRA, which is expected to take place in the spring of 2016.
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Meaningful Use 'Bombshell' Leaves Nary a Mark

Scott Mace, for HealthLeaders Media , January 19, 2016

Andy Slavitt throttles back his forecast for the end of meaningful use as we know it, disappointing many, but proving that government reform is coming… at its own excruciating pace.

What are we to make of CMS Acting Administrator Andy Slavitt's pronouncement last week that meaningful use is "effectively over" and that it "will be replaced with something better"?
As of this morning, my take on things is that Slavitt said disappointingly little that was truly new, and various journalists, myself included, jumped to conclusions when we characterized his remarks as a bombshell.
The evidence for this appeared just this morning, as Slavitt himself, in this blog post with Karen DeSalvo, head of the Office of the National Coordinator, basically throttled back his prediction of the end of meaningful use as we know it in 2016.
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5 healthcare imperatives as patients demand more personalized treatment

EMC survey finds bulk of consumers want faster access, digital connectivity and more integrated devices.
January 18, 2016 04:15 PM
Eight-nine percent of healthcare providers say technology has changed patient expectations, according to a recent EMC report.
Respondents to the survey, which polled 236 healthcare leaders from 18 countries, said more than half of their patients wanted faster access to services. 45 percent wanted 24/7 access and connectivity and 42 percent wanted access on more devices. Another 47 percent said they wanted "personalized" experiences.
"Consumers buy across a spectrum of principles," Dave Dimond, chief technology officer of EMC said. Millennials buy on price. The Baby Boomer generation buys on cost and quality, and the builder generation buys based on quality and trust."
But "across the spectrum," he said, "they're interested in convenience."
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Enjoy!
David.