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, April 30, 2016

Weekly Overseas Health IT Links - 30th April, 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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Joe’s view: of consent to share

As a stroppy teenager, Joe McDonald didn’t think much of his dad’s idea that the Falklands were “there for the asking but not for the taking.” Now, though, he thinks the idea has lot to recommend it, particularly when applied to sharing patient information.
19 April, 2016
As an adolescent psychiatrist, I frequently deal with the stage of development in which a certain amount of rebellion is quite normal.
Regular readers will know that I have previously referenced Erik Erikson’s stages of development, each of which is typified by what he called a psychosocial crisis.
The successful resolution of the psychosocial crisis allows an individual to progress to the next phase of development. The psychosocial crisis associated with adolescence is that of identity versus confusion.
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Artificial intelligence, cognitive computing and machine learning are coming to healthcare: Is it time to invest?

With Google, IBM and Microsoft all setting sights squarely on healthcare, and analysts predicting 30 percent of providers will run cognitive analytics on patient data by 2018, the risk of investing too late may outweigh the risk of doing so too soon.
April 22, 2016 07:27 AM
The arrival of artificial intelligence and its ilk — cognitive computing, deep machine learning — has felt like a vague distant future state for so long that it’s tempting to think it's still decades away from practicable implementation at the point of care.
And while many use cases today are admittedly still the exception rather than the norm, some examples are emerging to make major healthcare providers take note.
Regenstrief Institute and Indiana University School of Informatics and Computing, for instance, recently examined open source algorithms and machine learning tools in public health reporting: The tools bested human reviewers in detecting cancer using pathology reports and did so faster than people.
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Healthcare wearables to 'flood' market within three years

April 16, 2016 | By Judy Mottl
Healthcare wearables are predicted to become the cornerstone of future digital health strategies--driven by remote patient and population health management--with a big wave of devices hitting in the next two to three years, according to a new Tractica report.
The report predicts that worldwide shipments of wearables will spike from 2.5 million this year to 97.6 million units annually by 2021, according to an announcement.
"Overall we see a flood of healthcare wearable devices entering the market around the 2018 to 2019 timeframe," Tractica Research Director Aditya Kaul told FierceMobileHealthcare in an email. The prediction, however, is based on the industry overcoming two hurdles: federal agency approval and insurance provider approval, according to Kaul.
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CHIME to FDA: Collaboration on med device security between manufactures, providers critical

April 22, 2016 | By Katie Dvorak
The College of Healthcare Information Management Executives lauds the U.S. Food and Drug Administration for its work on medical device cybersecurity in a recent letter, but also says that increased collaboration between manufacturers and providers is critical.
CHIME's comments on the guidance cover the organization's overall reflections, commentary on the postmarket guidance and responses to specific questions from the FDA.
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Machine learning can help detect presence of cancer, improve public health reporting

April 22, 2016 | By Katie Dvorak
To support public health reporting, the use of computers and machine learning can better help with access to unstructured clinical data--including in cancer case detection, according to a recent study. 
Often, the unstructured free text data made available by electronic health records is obtained by means that are "resource intensive, inherently complex and rely on structured clinical data and dictionary-based approaches," according to the authors of the study, published in the Journal of Biomedical Informatics.
The researchers, from the Regenstrief Institute and Indiana University-Purdue University in Indianapolis, used about 7,000 pathology reports from the Indiana health information exchange to attempt to detect cancer cases using already available algorithms and open source machine learning tools.
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HealthTap to certify docs in ‘virtual care’

 Apr 21, 2016 at 6:04 PM
HealthTap, which bills itself as the “world’s first global health practice,” will be offering training and certification in “virtual care,” the Palo Alto, California-based company announced Thursday. The online program is free and eligible for continuing medical education credits.
The certification program is aimed at bringing best practices to virtual care. HealthTap CEO Ron Gutman said that there still is a lack of scientific rigor in this area, which he sees as being much broader than telemedicine.
“There’s a lot of interest in the physician community,” said HealthTap CEO Ron Gutman. “But there’s a lot of confusion” about how to practice medicine in a virtual environment.
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Chicago-area HIE sues IT vendor over shutdown plans

By Joseph Conn  | April 20, 2016
(Story updated at 12:29 p.m. ET)
The hospital association that operates a major Chicago-area health information exchange is suing its health information technology vendor that abruptly announced it will go out of business.
The hospital Metropolitan Chicago Healthcare Council, now merged with the Illinois Health and Hospital Association, operates the MetroChicago HIE that connects more than 30 northeastern Illinois hospitals, according to a membership list on its website.
A suit in U.S. District Court for the Northeastern District of Illinois names as defendants Sandlot Solutions and Santa Rosa Consulting, an owner of the company. The suit alleges that Sandlot breached its agreement “by shutting down the MetroChicago HIE system and denying MCHC's participants access to their client data on the system.”
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Apr 21, 2016, 10.59 AM | Source: PTI

India's healthcare sector poised to grow to $280 bn:

Report The CII-KPMG 'The Indian services sector: Poised for global ascendancy' report launched at the second edition of Global Exhibition on Services (GES) said that healthcare sector is forecast to reach USD 160 billion in 2017, accounting for about 4.2 percent of GDP.
Report The country's healthcare sector is poised to grow to USD 280 billion by 2020 while it is expected to be a leader in e-health by 2019, a new report said. The CII-KPMG 'The Indian services sector: Poised for global ascendancy' report launched at the second edition of Global Exhibition on Services (GES) said that healthcare sector is forecast to reach USD 160 billion in 2017, accounting for about 4.2 percent of GDP. "
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ECRI ranks health IT among the industry’s top safety concerns

Published April 21 2016, 6:47am EDT
While information technology has vast potential to improve patient outcomes, the ECRI Institute has ranked a health IT-related issue as the top 2016 patient safety concern facing healthcare organizations.
Heading ECRI’s list of this year’s top 10 patient safety worries is “health IT configurations and organizational workflow that do not support each other.” As ECRI’s report points out, when HIT configuration and workflow clash, communication suffers and can lead to delays in care or even medical errors.
That wasn’t the only patient safety concern with a health IT connection, says Bill Marella, executive director of patient safety reporting systems at ECRI.
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ICIT: Endpoint security crucial to ransomware protection

April 21, 2016 | By Dan Bowman
Endpoint security, while not a "sliver bullet solution" to cybersecurity issues in healthcare and other industries, is a vital component to any multi-layered protection strategy, according to a brief published by the Institute for Critical Infrastructure Technology (ICIT).
Such security, the authors say, instead must be considered as a first line of defense in an ever-evolving threat landscape and organizations must not see it as "static." This is particularly important as ransomware persists as a threat, the authors say, since it is easy and inexpensive to deploy and often targets endpoints.
"If only 1 percent of ... victims pay at least $1, the attacker has likely recovered whatever resources they initially invested in the campaign," the authors write. "Further, even unskilled modern adversaries pose a threat to unprotected organizations."
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Growing number of endpoints raises healthcare vulnerability

Published April 21 2016, 6:51am EDT
The risk of criminal access to networks and cyber attacks is rising because of endpoint vulnerabilities, according to results of a recent survey by the Ponemon Institute.
The survey, conducted by Ponemon on behalf of CounterTack, has significant implications for healthcare organizations, which have seen increased access to networks and information through the use of many kinds of devices, such as laptops and smartphones.
The fact that more devices are in use to access an organization’s network—often in the hands of unsophisticated users who may be careless with security practices—raises the number of ways that networks can be hacked.
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Caldicott and care.data stalled by EU referendum 'purdah'

Daloni Carlisle
21 April 2016
Dame Fiona Caldicott’s most recent review of data sharing will not be published until after the referendum on membership of the European Union, it has been revealed.
The review was commissioned by health secretary Jeremy Hunt in September 2015 and asked Dame Fiona to look at data security, consent and opt-out.
It also asked Dame Fiona to develop standards against which the CQC can carry out inspection of NHS and social care organisations in regard to their use of data.
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Office-Based Physician EHR Use Dips Below 60 Percent

By Kyle Murphy, PhD on April 20, 2016

Office-based physician EHR use decreases between 2015 and 2016; Epic Systems remains on top.

Office-based physician EHR use drops by close to four percent between 2015 and 2016, according to SK&A Market Insights Report on physician office EHR use.
A previous report put the percentage of office-based physician EHR use at 62.8 percent in 2015, but the most recent figure now numbers an even 59 percent. While dips in EHR use were consistent across practices of various sizes, smaller physician practices saw the largest decline year over year.
The survey data come from phone interviews with more than 290,000 medical offices between August 2015 and February 2016.
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HIT Think How to make sure only certified users access patient data

Published April 21 2016, 4:40pm EDT
Failing to certify user access to networks and information can have dire consequences.
A recent example is the recent jury decision to award Epic Systems Corp. $940 million in a trade-secret lawsuit against Tata Consultancy Services Ltd., an Indian multinational IT service, consulting and business solutions company.
The lawsuit alleges that a Tata Consultancy employee, working as a consultant for Kaiser Permanente, downloaded more than 6,000 documents from Epic's UserWeb, a portal through which Epic provides training and manuals to help customers with implementing and maintaining the company's products. The lawsuit also alleges that the Tata consultant gave his access credentials to other Tata employees in India and that the company used the stolen information to advance its own electronic health record software.
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Report to Congress suggests product guidance role for ONC

Published April 20 2016, 6:56am EDT
The Office of the National Coordinator for Health Information Technology has sent Congress a report examining the feasibility of helping providers compare and select certified electronic health records products.
The report was mandated under the Medicare Access and CHIP Reauthorization Act (MACRA), but with the EHR Incentive and Regional Extension Center programs winding down, ONC is examining how providers can continue to receive crucial support with implementing information technology.
Support is still essential, ONC believes, as many providers are upgrading or replacing EHRs they bought to achieve meaningful use, and they’re retooling as they get ready for reforms in healthcare.
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Tips for detecting ransomware and other malware before it cripples your network

CISOs and security analysts from top-tier firms offer highly effective advice and tactics for rooting out and getting rid of malicious code.
April 20, 2016 07:14 AM
Carolinas HealthCare CISO Robert Pierce said that installing security appliances can help detect malicious communications from malware on a network.
Before the prevalence of mobile phones and caller ID, there was an urban legend about a babysitter receiving frightening calls. Long story short: When an operator runs a trace, the babysitter is told to her horror, “The calls are coming from inside the house!”
Such is the case with cybersecurity today. Threats are not just coming from without, they also are coming from within. Cybercriminals might be trying to crack through a healthcare organization’s outer defenses, or, they may already be inside an organization’s network. Either way, the horror they can wreak upon a healthcare organization is considerable, including not just holding data hostage but bringing patient care to a standstill.
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Health IT workflow and patient ID concerns top list of patient safety issues

Jeff Rowe
Apr 20, 2016
What’s the biggest concern healthcare stakeholders have this year when it comes to health IT?
According to a new report from the ECRI Institute, it’s that EHR workflows don’t regularly meet the standard configuration for optimal patient safety. This report, titled Top 10 Patient Safety Concerns for Healthcare Organizations, is the third annual report from ECRI, which it compiles by drawing on its own large databases of reported safety events, in addition to conferring with a range of safety experts.  
The workflow problem stems from the fact that healthcare organizations are constantly updating their EHR systems: adding new modules, changing logic rules in the backend, adjusting data collection methodologies, and switching new features on and off.  
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Report: Providers must adopt sophisticated tech, stronger policies to prevent duplicate patient records

April 20, 2016 | By Katie Dvorak
To improve patient identification matching and lessen the chance of errors, more sophisticated technology will be necessary, according to healthcare experts, but human error will never be fully eliminated.
The authors of a report published recently in Perspectives in Health Information Management examined the causes of such errors, analyzing almost 400,000 records that had duplicates.
They found that the greatest mismatches were due to a field being left blank and the provider entering in a default entry. This happened most with either a person's middle name, a little more than 58 percent of the time, or a Social Security number, about 53 percent of the time.
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3-D Printing Comes Online

Sandra Gittlen, April 18, 2016

Using 3-D printing techniques, complex structures such as heart openings can be designed with such accuracy that implants work better and recovery from surgery is improved.

This article first appeared in the April 2016 issue of HealthLeaders Magazine.
Three-dimensional printing in healthcare has received a lot of attention as a gee-whiz, futuristic technology, with photos of prosthetics for injured soldiers and children. But 3-D printing is about to get a whole lot more personal. Sophisticated imaging and modeling means that complex structures such as heart openings can be designed with such accuracy that implants work better and recovery from surgery is improved.
"3-D printing already is becoming more patient-specific, and that will continue. Instead of having different sizes that you have to fit the patient into, implants will be modeled from the patient's own anatomy," says Joseph Lipman, MS, director of device development at Hospital for Special Surgery in New York City. Physicians at HSS perform more than 29,000 surgical procedures annually.
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Millions of patients to benefit from new digital NHS programme

Article posted on: April 20, 2016
Three million people will be able to access new innovations from a pioneering programme devised by the NHS, which will be exhibited at UK e-Health Week
(London, UK) Patients across the UK have started to log on to new apps, safety devices, online networks, and a host of other new technologies and services during the first nine months of a pioneering NHS programme, and its success so far is on show at UK e-Health Week today.
The NHS Innovation Accelerator programme was launched last year to help introduce new innovations into the NHS. Sixty-eight NHS organisations are using one or more of 17 new innovations which aim to improve care by cutting the number of clinical incidents, helping patients self-care and linking patients up with others or with research schemes.
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Portals, patient photos pose possible security gaps

Published April 18 2016, 7:32am EDT
As the healthcare industry continues to confront cybersecurity threats and seek ways to improve defenses, it must consider every avenue that might lead to access to patient information.
Some potential gaps are not as obvious, and providers must look carefully at any potential gap in their perimeter defenses, says security professional Keith Fricke.
For example, there is a potential security gap within the patient portals that providers are offering to patients as they seek to comply with requirements of the electronic health records meaningful use program, says Fricke, principal consultant at tw-Security in Overland Park, Kan.
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Artificial intelligence aids in Zika, Ebola diagnoses

April 19, 2016 | By Susan D. Hall
Rush University Medical Center is using artificial intelligence technology to alert doctors when a patient might have the Zika virus or Ebola, reports The Chicago Tribune.
The medical center's predictive software, called Guardian, analyzes and learns from data in electronic medical records. If a patient has recently traveled to South American or African countries, that information goes into the EHR and could alert physicians that the patient might have a rare disease, helping them make a diagnosis faster.
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Urgent care provider relies on telemedicine to reduce wait times

April 19, 2016 | By Susan D. Hall
Doctor's Care, a chain of urgent care centers in South Carolina and Tennessee, calls on telemedicine to balance the patient load at its centers and improve patient satisfaction, reports Health Data Management.
The organization found that wait times at some of its sites could last up to three hours or more, while other locations had no wait times. In those situations, it found patients opted to be examined remotely, aided by a nurse or medical assistant at their current location.
As some urgent-care providers see telemedicine siphoning off their business, Doctor's Care decided to embrace the trend.
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Majority of Healthcare Data Breaches Caused by Cyberattacks

By Jacqueline Belliveau on April 18, 2016

According to a recent study, most healthcare data breaches in 2015 were caused by cyberattacks, such as phishing scams and ransomware.

Cyberattacks were the top cause of healthcare data breaches in 2015, according to a recent study by Symantec Corporation on healthcare cybersecurity.
The study showed that providers have shifted their views on healthcare cybersecurity to account for the rise of cyber threats, such as ransomware and phishing scams, and the increasing risk to care delivery and patient safety.
 “For the first time in 2015, criminal attacks are the number one cause of data breaches in the health sector,” stated the study. “Why? Because, the cybercriminals have figured out that health data is deep and valuable, and that healthcare IT infrastructure, from traditional IT systems to connected medical devices, is typically vulnerable and easy to penetrate.”
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HIT Think Profit allure makes hospitals ‘ground zero’ for ransomware

Published April 19 2016, 3:54pm EDT
If you were worried about ransomware two years ago, you were almost certainly either a security specialist or a victim. According to the FBI, U.S. companies paid $25 million in ransom last year, and it expects the 2016 total to be more than $200 million.
What is driving this sudden explosion in what was once a rarely seen Internet crime? Who should be worried? Are the dire predictions likely to come true?
If my experiences during the early years of the phishing epidemic are any indication, the dire predictions will turn out to be wrong—because they weren’t dire enough.
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Home-grown Data Fuels Commercial Software for Better Risk Stratification

Scott Mace, April 19, 2016

How Delaware's Christiana Care Health System leveraged a CMMI grant to build out population health across a variety of patient populations.

In 2012, Christiana Care Health System, based in New Castle, Delaware received a $10 million grant from CMS's Center for Medicare and Medicaid Innovation. CMMI made the grant to design a new care model harnessing information technology to bridge gaps in coordinate care for chronic heart disease patients.
Recently I found out how this grant has impacted general knowledge of technology-enabled care coordination. I spoke with Terri Steinberg MD, chief health information officer and vice president of population health analytics at Christiana Care.
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Big Data Means Big Potential, Challenges for Nurse Execs

Jennifer Thew, RN, April 19, 2016

To ensure big data is used to influence outcomes that are meaningful to the nursing profession, nurse executives need to act as data visionaries and architects.

Have you ever found yourself poring over stacks of data, feeling more like a statistician than a nurse? If you have, welcome to the world of big data.
"You have all of these different data sources coming at you on a weekly, monthly, quarterly basis. The CFO has a stack of data for you, your productivity-management engineer people have a stack of data for you, HR has a stack of data for you, and then your quality director, your clinical folks, have a stack of data for you," says Jane Englebright, RN, PhD, CEBP, FAAN, chief nursing executive and senior vice president at Nashville, Tennessee-based HCA.
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NIST to release new guidance for strengthening hospital cybersecurity

The imminent set of best practices will help healthcare organizations become more penetration-resistant, more effective at limiting damage attackers can inflict and ultimately better able to withstand cyberattacks. 
April 18, 2016 07:59 AM
NIST fellow Ronald Ross said the agency is gearing up to publish new best practices that help hospitals avoid and withstand cyberattacks. 
The National Institute of Standards and Technology is poised to deliver new cybersecurty guidance, according to NIST fellow Ronald Ross.
NIST offers a security framework that was developed for the federal government that helps organizations understand, select and implement security controls.
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Customer Loyalty to EHR Systems Declines to 75% in 2016

By Jacqueline Belliveau on April 14, 2016

The 2016 Black Book survey on inpatient EHR systems revealed that overall customer loyalty to current EHR vendors has declined since last year.

Loyalty to inpatient EHR vendors decreased from 81 percent to 75 percent in 2016, according to a recent Black Book Inpatient EHR survey.
As the healthcare community seeks new innovations in EHR systems, cloud capabilities, and interoperability, healthcare providers are evaluating their inpatient EHR vendors for technological progress, EHR replacement, and meaningful use requirements.
Black Book surveyed 3,152 hospital EHR users and 640 healthcare IT leaders to find out about customer loyalty to current EHR vendors.
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Study: HIT use aligned with new payment, delivery models supported improved care delivery

April 18, 2016 | By Katie Dvorak
Providers with robust electronic health records who participated in an accountable care organizations or patient-centered medical homes were the most likely to routinely perform certain care processes, according to a study published in The American Journal of Managed Care.
The authors, using data from physicians participating in the 2012 National Ambulatory Medical Care Survey Physician Workflow Survey, also found that organizations using EHRs were more likely to perform such processes compared to those who didn't use the systems. The processes examined for the study included quality measurement, population management, communication and care coordination.
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HIT Think How providers can realize value from their EHRs

Published April 18 2016, 5:56pm EDT
Over the last 10 years, health systems and physicians have invested heavily in the current generation of electronic health records. With three out of four hospitals having at least a basic EHR in place, it is safe to say implementing a system has become a foundational requirement for being in the business of healthcare delivery.
The opportunities EHR offer for improvements in care delivery are promising—they include efficient care team communication, improved clinical outcomes through embedded decision support and standard use of evidence-based protocols, immediate access to patients’ clinical information, increased patient engagement and enhanced revenue cycle. However, achieving improvement has remained elusive.
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Time to Face the Ransomware Crisis in U.S. Healthcare: Industry Experts Speak Out

April 17, 2017
by Mark Hagland, Rajiv Leventhal, and Heather Landi
Industry experts agree it’s time for healthcare IT leaders to meet the ransomware crisis head-on
The ransomware phenomenon is menacing more and more U.S. hospitals and patient care organizations. What does it mean? And what can be done? Part one in a two-part series.
The first nationally reported mainstream media news story in this drama was that around Hollywood Presbyterian Medical Center. On Friday, February 12, NBC4News, the local affiliate of the NBC network in Los Angeles, reported in its noon and evening broadcasts, and then online, this story: “Hollywood Hospital ‘Victim of Cyber Attack.’” As the online version of the story, by Jason Kandel and Robert Kovacik, stated, “A Southern California hospital was a victim of a cyber-attack, interfering with day-to-day operations, the hospital’s president and CEO said. Staff at Hollywood Presbyterian Medical Center began noticing ‘significant IT issues and declared an internal emergency’ on Friday, said hospital President and CEO Allen Stefanek. A doctor who did not want to be identified said the system was hacked and was being held for ransom.”
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Enjoy!
David.

Friday, April 29, 2016

This Can't Be Good News! Healthcare The Biggest Target Of Security Issues

This appeared last week

Healthcare Data Breaches Top Reported Data Security Incident

By Jacqueline Belliveau on April 12, 2016

A recent study revealed that healthcare data breaches accounted for 39 percent of data breaches in 2015.

Healthcare data breaches were the most common type of data security incident reported in 2015, according to a recent study by Symantec Corporation.

Researchers found that approximately 39 percent of breaches during the year occurred in the health services sub-sector.

 “This comes as no surprise, given the strict rules within the healthcare industry regarding reporting of data breaches,” explained the authors of the study. “However, the number of identities exposed is relatively small in this industry. Such a high number of breaches with low numbers of identities tends to show that the data itself is quite valuable to warrant so many small breaches.”

There were 120 healthcare data breaches reported in 2015, which was the largest number of data breaches across all industries studied. The next leading industries for data breaches (business and education) only reported 20 incidents each.
Despite the prevalence of healthcare data security events, the study reported only 1 percent of incidents led to exposure of identities. That still accounted for nearly four million individuals who had their identities exposed as a result of a healthcare data breach.

The study attributes the growing volume of data breaches across all industries to a shift in how cybercriminals operate.

Researchers found that more cybercriminals used more zero-day attacks, including phishing scams and ransomware, in 2015.

The number of zero-day vulnerabilities in 2015 increased by 125 percent from a year ago. Meanwhile, 430 million new malware variants were found in 2015.

“Advanced criminal attack groups now echo the skill sets of nation-state attackers. They have extensive resources and a highly-skilled technical staff that operate with such efficiency that they maintain normal business hours and even take the weekends and holidays off,” said Symantec Security Response Director Kevin Haley. “We are even seeing low-level criminal attackers create call center operations to increase the impact of their scams."

Even though cyberattacks are becoming more sophisticated and business-like, the healthcare sub-sector is not being targeted as frequently as other industries.
The study reveals that, in the healthcare field, about 54.1 percent of emails are spam. Cybercriminals typically use spam to execute more advanced cyberattacks.

However, the phishing ratio in the healthcare field was only 1 out of 2,711 emails, which was the second lowest ratio across all industries.

The healthcare industry was also one of the least likely sectors to be targeted for spear-phishing attacks, the study confirmed.

Additionally, the healthcare sector was the least likely to encounter an email containing a virus. The virus ratio was 1 out of every 396 emails.

Here is the link:

http://healthitsecurity.com/news/healthcare-data-breaches-top-reported-data-security-incident

There is really little to add. Clearly everyone handling health information needs to be careful given they have a great big target on their back!

David.


Thursday, April 28, 2016

The Macro View - General And Health News Relevant To E-Health And Health In General.

April 28  Edition
The macroeconomic stresses seem to have eased a little more with markets rising or stable around the world.
With Budget Night now May 3 we won’t have long to wait to see what is happening. The Budget now seems to now be very minimalist with any major reform seemingly off the table. It seems there is going to be some exciting political times until we get there!
Given it is only 1-2 weeks away I guess we just wait and watch. Is seems sin-taxes are also back on the agenda!
Interestingly we are now seeing any changes to Negative Gearing being ruled out and a new Dental Funding Scheme being announced. We also saw a lot of news related to the Big Banks with things becoming rather more political than makes sense.
You can expect many more leaks over the next week or so - and it is probable we will know most of the details well before the actual Budget Speech!
The biggest thing last week was a speech from Glenn Stevens - where he made it clear we are not out of the woods - just yet,

Reserve Bank governor Glenn Stevens warns that low rates come at high cost to retirees

By AM business editor Peter Ryan
The Reserve Bank governor Glenn Stevens has warned that today's world of ultra-low interest rates is putting increasing pressure on returns for superannuation funds.
Mr Stevens said record low interest rates are "a big problem" for savers and that many stand to be "disappointed" about the direction of their retirement nest eggs.
Speaking in New York, Mr Stevens told a conference that low yields for investors pose a problem for both defined benefits and accumulation funds, with the "whole set of assumptions" for retirement income plans is being called into question.
"Increasingly we are hearing commentary about the difficulty or impossibility of defined benefit pension plans making good on their promises with long term rates of return being so low," Mr Stevens said.
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Here is a summary of interesting things up until the end of last week:
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General Budget Issues.

Treasurer Scott Morrison reveals little 'integrity' as budget approaches

Date April 18, 2016 - 6:58AM

Jessica Irvine

Senior Writer

In a quiet courtyard of Parliament House, close to the Press Gallery, grows a magnificent maple tree that erupts annually in fiery autumnal splendour in the lead-up to the federal budget.
It's been nicknamed the "budget tree", and your scribe has been admiring it for more than a decade now on my annual pilgrimage to the federal budget lock-up.
But this year, my spies tell me, the budget tree is still green. Nary a tinge of colour, as this column went to print.
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Scott Morrison needs to lift taxes to pull the budget into shape

Date April 18, 2016 - 12:15AM
EDITORIAL
Scott Morrison has a regrettable tendency to resort to loud bluster and swollen rhetoric when he is questioned about the government's economic strategy. That makes it doubly difficult for those whose sorry task it is to disentangle the government's important intentions from Mr Morrison's near-incessant polemic.
Moody's Investors Service is one organisation that is trying to do just that, and it does not like what it is hearing. On Thursday, Moody's warned that unless the Turnbull government came up with measures to raise revenue in the budget, then government debt would continue to rise and that would put the nation's AAA credit rating at risk.
The ratings agency contends that unless the government lifts taxes, or other forms of revenue, it will miss its self-imposed deadline of 2020-21 for balancing the budget.
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Morrison (sort of) reveals the budget strategy: bracket creep

  • The Australian
  • April 18, 2016 7:49AM

Alan Kohler

Treasurer Scott Morrison laid out the government’s budget strategy the other day.
Morrison was a resounding success as immigration minister through the unusual, for a politician, tactic of saying nothing. As Treasurer, he feels the other extreme is the way to go.
In the midst of a frenzied, convoluted attempt to turn Moody’s criticism of Australia’s feeble budget efforts in recent years into an attack on Labor, Morrison explained his plan and gave a preview of the May budget.
“Revenue will rise to the long-run average of 24.1 per cent. On the current estimates, revenue is forecast to rise over the next three or four years. … our plan is to see revenue rises through growth and ensuring a better targeted tax system. So our revenue measures that we announce in the Budget and the redeployment of that revenue to easing the tax burden where you can foster investment is the way we believe that you can drive growth and jobs in this economy.”
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Australian Budget Talk: Experts Say Scott Morrison Should Lift Taxes For Good Budget

19 April, 2016 / By Kalyan Kumar / In Australia,Business,Financial
The upcoming Australian budget will risk Australia’s credit ratings if it fails to raise taxes and shore up revenue, warned rating agency Moody’s. The agency predicts that the credit rating will nosedive if the budget lacks substance. It called for concrete revenue-raising steps, including new taxation plans.
Moody’s said Malcolm Turnbull government is yet to show up tangible measures in revenue-yielding plans and warned that the government would be caught in a debt trap.  The current Triple A (AAA) credit rating of the country will be put at risk.
Prior to Moody’s caution, the Commonwealth Bank, NAB and J.P. Morgan also raised similar concerns, reports The Age.
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19 Apr 2016 - 8:44am

Labor criticises govt's post-budget ads

The federal opposition has criticised leaked advertising showing the government's budget will include changes to super and multinational tax.
Source:  AAP
19 Apr 2016 - 8:44 AM  UPDATED 25 MINS AGO
Labor has seized on leaked advertising highlighting changes to superannuation tax concessions and multinational tax arrangements due to be aired after the federal budget.
Sky News says it's seen the key statements of a script for the government's taxpayer-funded television and radio advertisements, which have already been filmed.
The statements include $16 billion in savings over the four years under changes to super and multinational tax.
Opposition finance spokesman Tony Burke says the post-budget ads are part of the coalition's re-election strategy because none of the measures will have been implemented before parliament is dissolved.
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Government refuses to comment on 'humiliating' leak of core budget details, ad campaign

By political reporter Tom Iggulden
The Government is refusing to comment on what Labor is calling a "humiliating" leak of core budget details.
Sky News last night revealed purported key points of a script for a radio and television ad campaign to be rolled out after the May 3 budget.
Presenter Paul Murray told viewers the ads would boast of $16 billion worth of budget savings over four years, including crackdowns on superannuation tax concessions and multinational tax avoidance.
"The Government doesn't respond to speculative reports," a spokesman for Treasurer Scott Morrison told the ABC.
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Federal budget 2016: Advertising 'leak' shows $16 billion in savings: report

Date April 19, 2016 - 8:56AM

Michael Koziol

National political reporter

Turnbull's winter election gamble

The ABCC legislation didn't pass the Senate so we're going to the polls on July 2 - that's a 75 day election campaign.
The Turnbull government will reportedly spruik $16 billion in savings over four years in the federal budget, as it prepares for an all-but-certain double dissolution election on July 2.
Sky News reported on Monday night that the government would pursue changes to superannuation concessions and multinational tax avoidance to reach the savings figure.
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Federal budget 2016: Coalition plans tougher crackdown on super to outflank Labor

Date April 20, 2016 - 5:04AM

Peter Martin

The Coalition is set to reveal on budget night, a superannuation tax plan that will rake in more money than Labor's will.
The Turnbull government is preparing to trump Labor in the budget by cracking down harder on high-income superannuation tax concessions to raise four times as much as the opposition's policy.
Labor has promised to cut the income threshold for more heavily taxing contributions from $300,000 to $250,000. The Coalition now plans to cut it to $180,000.
The change, to be unveiled on budget night, will tax more highly the super contributions of an extra 244,000 Australians and will net $2 billion a year, compared with Labor's $500 million a year.
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Federal budget 2016: Superannuation backlash might not stem savings

Date April 20, 2016 - 12:15AM

Sally Rose

Markets reporter

Government's big super plan

The Coalition is set to reveal on budget night, a superannuation tax plan that will rake in more money than Labor's will.
If the Turnbull government follows through with leaked plans to slash superannuation tax breaks for high income earners in the upcoming federal budget it will be a bold move that risks angering many of its supporters.
But it won't necessarily stop them pouring money into super, some analysts say.
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Federal budget 2016: Scott Morrison to give extra $120m to corporate regulator ASIC

Date April 19, 2016 - 11:04PM

James Massola

Chief political reporter

Turnbull confirms he wants July 2nd poll

There will be a double-dissolution election, says Malcolm Turnbull, and he intends holding it on July 2nd. Courtesy ABC News 24.
Treasurer Scott Morrison will announce at least $120 million in additional funding for corporate regulator ASIC as part of a suite of measures to be unveiled on Wednesday, after he and Prime Minister Malcolm Turnbull were challenged by the Coalition backbench on the need to crack down on bank behaviour.
The announcement will come a day after Mr Turnbull confirmed Australians will go to the polls in a double dissolution election to be held on July 2 and is designed to blunt the political impact of Labor's push for a banks royal commission.
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Turnbull Government expected to crack down on superannuation

April 20, 2016 8:16am
Charis Chang and AAPnews.com.au

Turnbull superannuation overhaul plan exposed

THE Turnbull government is ready to outdo Labor and will reportedly crack down harder on high-income superannuation tax concessions.
Superannuation has been a hot topic of debate with experts suggesting that loopholes in the system cost the Federal Budget about $30 billion a year in lost revenue.
Richard Denniss, from progressive think tank the Australia Institute, told news.com.au last year that the key issue was that rich people got lucrative tax concessions that were not offered to low-income earners.
“There’s a very clear problem at the moment: tax concessions go disproportionately to rich the wealthy. We could fix that and save the Budget a lot of money,” Mr Denniss said.
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Banks still haven't got the message that bad behaviour is not on

Date April 19, 2016 - 10:58PM

Ross Gittins

The Sydney Morning Herald's Economics Editor

The Federal Opposition tries to turn up the heat on the Government to hold a banking royal commission.
Is there any justification for a royal commission into the conduct of the banks? Is it just a political stunt? All royal commissions are called for political reasons and many are stunts, in the sense that their primary objective is just to bring particular issues into the public spotlight.
To me, the best justification for an inquiry into the banks is that they still don't seem to have got the message. They've been caught treating their customers badly, but so far they've shown little sign of contrition - sorry about the few bad apples, but I didn't know - and little willingness to make amends.
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Budget 2016: Malcolm Turnbull’s $10bn spree since coup

  • The Australian
  • April 22, 2016 12:00AM

David Uren

The budget will have to find savings to cover more than $10 billion of fresh spending since Malcolm Turnbull gained power last September, before being able to fund any election promises or new budget commitments.
Although Scott Morrison has declared that his main goal in the lead-up to the May 3 budget is stopping new spending, the government has made as many new commitments in the seven months since the change of leadership as were contained in last year’s budget.
The Treasurer has made a target of reducing government spending from the 25.9 per cent of GDP reported in the mid-year budget update and has promised to cover the cost of new spending with fresh savings measures.
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  • Apr 22 2016 at 12:15 AM

Tricks and fudges to look out for in budget 2016

by Richard Holden
Policies in the federal budget, to be handed down on May 3, will affect the personal finances of households around the country. It will also set the scene for much of the upcoming election battle.
Amid a sea of statistics, slogans, and spin, what are the key takeaways for you? Here's what to look for on May 3.

Forecasts

Both government revenue and expenditure going forward depend on macroeconomic factors. Expenditures depend importantly on inflation, since many welfare and other benefits, as well as payments to government employees, are inflation indexed. On the revenue side, tax receipts depend on nominal gross domestic product growth, and the composition of it, which determines who is in which tax bracket.
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Federal budget 2016: We need more tax

Date April 20, 2016 - 1:56PM

Peter Martin

Economics Editor, The Age

Another leak for team Turnbull?

If the leak is genuine, the post-budget advertisement says the government will save the budget $16 billion over four years. Vision Sky News & ABC 24.
Never before has a budget advertisement been prepared ahead of the budget itself. In fact, rarely before has a budget needed an advertisement.
The leaked script read on Sky News is a bit like something for Seinfeld in that it is a script about nothing. All previous budget advertising campaigns have been about something specific, such as small-business tax breaks.
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Federal Budget set to deliver relief to middle-income wage earners

April 22, 2016 9:24pm
ELLEN WHINNETT Herald Sun
PERSONAL income tax cuts will be included in the Federal Budget, with middle-income wage earners winning tax relief.
The Herald Sun can reveal those earning slightly more than $80,000 will get a tax cut, as the Turnbull Government tries to relieve the burden of bracket creep on middle-income earners.
The beneficiaries will be those paying 37c in the dollar tax because they are earning more than $80,000 a year, or who are due to go up into that tax bracket.
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Federal election 2016: Home ownership an election issue as Government takes reform off table

April 24, 2016 4:30am
Samantha Maiden EXCLUSIVE Herald Sun
THE Turnbull government has officially placed negative gearing reforms off-limits in the Budget, which will make home ownership the key election battleground.
Prime Minister Malcolm Turnbull will announce the Budget policy today in response to Labor proposals to remove negative gearing on existing properties from 2017.
Warning a Labor election victory would drive up rents and reduce home values, Mr Turnbull said families face a clear choice at the election.
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Health Budget Issues.

Bulk billing incentives for pathologists to be scrapped on day before election, Sussan Ley says

By political reporter Caitlyn Gribbin
Federal Health Minister Sussan Ley says she will not give into a "scare campaign" against a policy to scrap bulk billing incentives for pathologists — even if the plan is due to come into effect the day before the July 2 election.
The Opposition and pathologists are fighting against the Federal Government's policy to cut bonus payments it offers for pathology services to bulk bill.
But Ms Ley looks set to push on with the changes, despite them being flagged to kick in on July 1.
"The Government's made announcements and we'll stick with those announcements," Ms Ley said.
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Malcolm Turnbull to announce revamp of dental policy in first budget

April 23, 2016 12:00am
Sue Dunlevy National Health Reporter News Corp Australia Network
EXCLUSIVE
Every Australian child will get government-subsidised dental care including braces under a major revamp of dental policy to be announced in Malcolm Turnbull’s first budget.
The current means tested Child Dental Scheme (CDBS) which provided care to three million kids will be axed and replaced by a scheme providing dental cover for every child — 5.3 million kids.
The current $1,000 cap on government funded dental care will be scrapped under the new Child and Adult Public Dental Scheme (caPDS) scheme that will even pay for braces, crowns and implants if they are clinically necessary rather than cosmetic.
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Budget 2016: healthcare waste costs $20bn a year

  • The Australian
  • April 23, 2016 12:00AM

Adam Creighton

Sarah-Jane Tasker

Australians are forking out at least $20 billion a year in higher taxes and insurance premiums to cover entrenched waste and anti-competitive practices in the healthcare sector — equivalent to extending the GST to fresh food, health and education.
As the government and Labor debate proposals to increase tax to plug the $38bn budget deficit, health insurance chiefs and the head of the government’s Health Safety and Quality Commission, Debora Picone, have told The Australian improving health ­efficiency could knock 15 per cent off the $150bn national health bill.
“Falling-off-a-log type reforms could save that amount every year with no reduction in actual outcomes,” said Australian Unity chief executive Rohan Mead, pointing to overservicing and lack of competition among hospitals and doctors.
Health insurer NIB chief Mark Fitzgibbon said attacking the “low hanging fruit” of waste in the system — ensuring prices for devices on the prostheses list is the same for private and public hospitals — would mean up to a 4.5 per cent drop in insurance premiums.
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Budget 2016: super tax reform pitched at battlers

  • The Australian
  • April 23, 2016 12:00AM

David Crowe

The Turnbull government is preparing to blunt Labor’s pitch to ordinary workers by preparing superannuation reforms in the May 3 budget that help those on low incomes at the expense of those earning more than $180,000 a year.
Malcolm Turnbull and Scott Morrison are turning their sights on the barriers facing the “battlers”, as part of a package that will ensure there are winners as well as losers from the super tax overhaul.
The move comes as a new report from Industry Super Australia highlights the impact on average workers from the existing super rules, which give wealthier Australians more than six times the tax breaks on their retirement savings.
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Universal health care must not penalise the sick

22nd Apr 2016 4:52 PM
Caroline Hutchinson
IS IT just me or is everyone looking for a good excuse to avoid a pap smear?
I was a kid when Medicare was introduced so it is the only system I have ever known.
Being the robust country girl I am, I haven’t been a great burden on the health system but I’ve been the grateful recipient of three healthy babies and the very relieved young wife of a cancer survivor.
The times I have needed the system most were the times I could afford it least.
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Health Insurance Issues.

Doctors’ fees ‘real villain’ for health insurance funds

  • The Australian
  • April 18, 2016 12:00AM

Sean Parnell

Health funds would have more say over the specialists members are referred to as well as the ­hospitals to which they are ­admitted under a proposal from a former insurance industry regulator concerned at unrestrained doctors’ bills.
Shaun Gath, who was chief executive of the Private Health Insurance Administration Council for seven years, believes competition has failed to keep costs down and that the Constitution prevents governments dealing with the “real villain” of doctors’ fees and charges.
“In the 1946 referendum, we gave the parliament power to make a range of social security payments, including hospital and medical benefits,” Mr Gath writes in The Australian today.
“But the section also stops the parliament from controlling what doctors charge. So one step in that direction and it’s off to the High Court.”
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Private health insurance may be broken, but it can be fixed

  • Shaun Gath
  • The Australian
  • April 18, 2016 12:00AM
The three day moral panic that passes for serious debate around our private health insurance system has come and gone again. Premium increases can do that to you. And obviously getting hit up for an extra 5, 6, or 7 per cent is ­nobody’s idea of fun.
Most of the media advice, by design, has a short shelf life. The issue will be back next year and the same games will play all over again.
So, here’s a crazy idea … what if we actually did something to try and fix the problem?
But before rushing off, let’s at least give private health insurance its due. It’s been a pillar of our health system for over 150 years. Over that time lot of people in real need have been helped. That remains true today.
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  • Apr 21 2016 at 12:15 AM
  • Updated Apr 21 2016 at 12:15 AM

Can Medibank's health deliver free-kick for Drummond?

If Medibank's loyalists and share price are to be believed, one of Craig Drummond's first acts as chief executive at Medibank Private will be an earnings upgrade.
In January the private health insurer upgraded its 2015-16 health insurance profit by $100 million to more than $470 million due to weak claims growth, tougher hospital contracting, and an ongoing crackdown on improper claims.
Medibank said at the time that its targets "anticipate that the second operating half profit will be lower than the first half due to increased marketing and brand investment, and some moderation of the recent slowdown in the growth of hospital utilisation rates".
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Surgeon cracks down on NIB’s low payments

April 24, 20167:29am
Sue Dunlevy News Corp Australia Network
EXCLUSIVE.
Australia’s fourth largest health fund NIB pays doctors so little a surgeon is urging his patients to switch their cover because he can no longer afford to take part in its gap cover scheme.
NIB pays just $2,014 for knee replacement surgery, 40 per cent less than the AMA fee of $3,600.
Dr Hardeep Salaria has written to his patients warning them NIB is “paying significantly less to doctors under the Gap Cover arrangements than almost all other funds”.
And he is urging them to choose another health fund which is not for profit such as HCF or one of the AHSA funds.
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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites are still being flown - although narrowing it seems to be largely focussed on Super! Enjoy. Less than two weeks to the Budget!
David.