Quote Of The Year

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

or

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

Tuesday, May 24, 2016

Here Is The Approach That Is Going To Make The myHR Totally Obsolete - And Soon.

This release appeared a few days ago:

MedicalDirector Helix: The new cloud-based platform for Australian medical practices

Australia’s largest medical software and information provider, MedicalDirector, has announced its next generation cloud-platform, MedicalDirector Helix, delivering a new approach for patient-centred care.
“The Australian health sector is on the cusp of major change as it moves to using cloud-based software. We have developed MedicalDirector Helix to help practices adapt to this anticipated change, and with this platform we aim to transform their everyday patient and clinical interactions,” says Phil Offer, Executive Director at MedicalDirector.
“We’ve listened to clinicians and designed the new platform from the ground up to provide world-class useability and agility, while ensuring efficacy, patient safety and privacy,” Mr Offer says.
The new platform reflects a simple principle to let doctors be doctors and spend more time with patients during consultation. It will cover the needs of the entire practice, enabling significantly faster performance of recurrent clinical processes.
“Good technology allows practitioners to focus more on the patient and deliver more directed care. Through MedicalDirector Helix, all aspects of the patient’s interaction with the practice, from booking to consultation, to payment, will be integrated,” Mr Offer says.
According to Mr Offer the agility of the new platform will provide doctors with unprecedented flexibility in their work.
“Using the new system, a clinician can see a patient in their practice and update that patient’s record through a web browser on their desktop computer. Another patient might be seen in an aged care facility, with their records updated using a mobile device or tablet. The clinician could later be at home reviewing urgent results from laboratories and specialists,” he added.
With security of patient data the organisation’s highest priority, MedicalDirector has used world-class bank-grade security and advanced levels of threat management to ensure data is protected. All data will be stored and backed up in Australia and will be encrypted using the highest levels of data encryption.
The platform will provide seamless practice management support; with automatic software updates taking the hassle and worry away regarding server storage and backups.
Moving forward, customers will have a choice of using the current on-site version or MedicalDirector Helix. Existing MedicalDirector customers will easily be able to migrate to the new platform. MedicalDirector Helix will be previewed at this month’s General Practice Conference & Exhibition in Sydney (May 20-22).
For more information or to register your interest in the new platform and be one of the first to participate in the first release program visit www.medicaldirector.com/helix.

The release is found here:
There is commentary on all this found here:
19 May, 2016

Let the cloud games begin!

Posted by Jeremy Knibbs
Medical Director has declared itself a starter in the race for the future of the connected health ecosystem
The company, one of the country’s major patient management system providers, announced today that they are going to launch a “cloud” version of their iconic desktop management system – Medical Director Helix.
If it is a properly architected cloud version they intend to launch – truly non-device dependent, mobile and with seamless communication and data exchange features though a secure cloud environment – then Medical Director is putting a stake in the ground that indicates an intent to take on disruptive cloud patient-management start-ups head on, and in the very near future.
The timing of the announcement, at the precise date of the formal launch of much mooted cloud based start-up, MediRecords, at GPCE today, is not likely to be a co-incidence. It looks targeted directly at their customer base to at least put some doubt in the minds of anyone who is thinking of switching to the MediRecords system in the near term.
MediRecords, which has had been secretly building their system with a development team of over 30 people for the past three years, has a sophisticated cloud offering which they claim has all the functionality of both Medical Director and Best Practice, plus a swathe of new features associated with its key differentiating feature – it’s connectivity. It also has a fully integrated back-office billing system.
It’s a high-risk strategy on the part of Medical Director to announce they, too, have a cloud version, but one that they probably needed to pursue. By declaring they have a cloud version, they are going to need to deliver that product quickly to their customers or face the sort of cynicism and backlash that affected the long-standing market leader in the SME accounting software market MYOB, when they were caught off guard by the launch of XERO, a fully functional cloud offering for small business.
Lots more here:
Additionally we have this provider of health cloud based services:
With all this activity we will surely see a market shake-out as well as seeing that once you have your records in the cloud it is possible to make the records accessible for the individual patient - as is happening in the UK. With the appropriate controls agreed with the patient just where does myHR fit?
And of course, once this happens why would anyone - other than the Government - need the myHR.
This is especially so when you consider the money being spent on the myHR and the model being used to implement it - brute force.
Times are changing and the myHR is looking more and more like a ‘white elephant’.
David.

Monday, May 23, 2016

Weekly Australian Health IT Links – 23rd May, 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

Another quiet week with the very long election campaign just dragging on. Pity the myHR isn’t an issue that can be raised and then hopefully fixed. Right now it is a financial black hole as well as a project of totally unproven benefit.
-----
  • May 20 2016 at 12:58 PM
  • Updated May 20 2016 at 12:58 PM

Telstra-backed haptic medical robots transmit doctors' touch from city to country

Robots are on the verge of bridging the gap between the city-based doctors and regional patients.
Robots with a sense of touch, known as haptically enabled, developed by Deakin University's Institute for Intelligent Systems Research (IISRI), with funding and technical support from Telstra, could bring ultrasound patients up to 1000 kilometres away into the offices of medical professionals in city centres.
The remote technology will allow practitioners to conduct abdominal ultrasound imaging to look at patients' kidneys, gall bladder, liver, spleen, pancreas, abdominal aorta and blood vessels.
It can also alert the medical professionals who are operating the equipment hundreds of kilometres away to patient discomfort, and assess tenderness in the examination area.
-----

Deakin Uni, Telstra create remote ultrasound robot

Can check a patient's organs from far away.

By Andrew Sadauskas
May 20 2016 12:13PM
Deakin University has developed a robotics technology with force feedback that can allow clinicians to remotely create ultrasound images of their patients.
The HER (haptically-enabled robotics) technology was developed by Deakin University’s Institute for Intelligent Systems Research and Innovation (IISRI), and received funding and technical support from Telstra’s research partner program.
The use of haptics allows medical professionals to remotely monitor patient discomfort by probing an examination area, which can be collected and compared to historical data.
-----

WA govt launches hospital waiting times app for Perth

Enabled by open data.

By Juha Saarinen
May 16 2016 6:06AM
Perth residents now have the option to use an app on their Apple iOS and Google Android devices to check which hospital has the shortest waiting times.
The WAED app collects Perth hospital emergency department waiting times published by the Department of Health, along with traffic data, device geolocation, and local maps to give app users an estimate of travel time and the ability to identify which nearby hospital can see them sooner.
The app is hosted on Microsoft's Azure cloud computing platform and covers hospitals including the Sir Charles Gairdner, Rockingham, Royal Perth, Armadale, King Edward Women's, Princess Margaret Children's, and Fiona Stanley.
-----

Fears practices will lose e-PIP payments

Tessa Hoffman | 19 May, 2016 | 
Around 100 practices are at risk of losing e-PIP payments worth thousands of dollars due to confusion over upgrades to practice software.
Under rules introduced this month, practices have to upload a set number of health summaries to the MyHealth Record system  to receive ehealth Practice Incentives Program payments.
There are more than 4870 practices signed up to the incentive which is worth up to $50,000 a year.
However, there are fears a small number of practices could miss out follownig a recent Microsoft Security upgrade that had rendered software unable to upload, or download documents from the MyHealth Record.
-----

Ventura Health and Fred IT Group join forces

Retail pharmacy specialist Ventura Health and Fred IT are partnering to implement the Fred NXT cloud solution nationally, providing Ventura with long term competitive gains while also catering to the individual needs of its pharmacies.

As a multi-brand pharmacy resource centre, Ventura Health supports the diverse retail management and technology needs of more than 80 pharmacies, including Cincotta Discount Chemist, Mega Save Chemist, You Save Chemist, Max Value Pharmacy, Better Buy Pharmacy, and My Medical Pharmacy.
According to Mario Capanna, CEO, Ventura Health, the group embarked upon the partnership to embrace digital changes in retail pharmacy.
“Our partnership with Fred was driven by the need for greater flexibility and future-proofing. We wanted to match the contemporary landscape facing pharmacy and provide much greater flexibility and individualised support for our pharmacies,” Capanna says.
-----

The human factor: the untold impact of data breaches

Tracking the data from Australia’s iDcare.

By Allie Coyne
May 17 2016 11:00AM
Eighteen months on from the establishment of Australia’s national identity theft support service, the country is for the first time starting to get a picture of the impact data breaches have on their victims.
The not-for-profit iDcare was formally established in October 2014 to offer those affected by data breaches practical response plans to mitigate the effect of a compromise.
The joint government-industry organisation splits itself down two lines. Specialists and counsellors within its case management centre build a tailored response for people who have had their personal details stolen. The centre operates online and phone-based contact services, and national reporting mechanisms like ACORN and ScamWatch refer victims to iDcare for help dealing with a breach.
-----

Digital Health Chair plans new wave of innovation for SA

Professor Anthony Maeder is one of Australia's leading experts on digital health technologies.
Australia's first Chair in Digital Health Systems says he will make South Australia a world leader in healthcare innovation by spearheading Flinders University research into a mind boggling array of smart and interactive technologies.
And with the recent signing of the Inter-Governmental Agreement (IGA) on Digital Health, which establishes ongoing financial support for the Australian Digital Health Agency, Professor Anthony Maeder has joined Flinders at an opportune time.
Professor Maeder, whose position is supported by a South Australian Government Premier's Research and Industry Fund is the brains behind the Western Sydney University's TeleHealth Research and Innovation Laboratory (THRIL).
-----

You will have an electronic health record unless you opt out

May 16, 2016, 5:33 p.m.
A FORUM last Wednesday informed Hawkesbury residents about new online health records about to be implemented in our area. 
My Health Record will mean you don’t have to repeat your medical history and medications every time you visit a doctor or other healthcare professional.
The Hawkesbury is part of a trial where residents will be automatically given a My Health Record unless they choose not to have one. 
-----

North Queensland healthcare providers get behind My Health Record

Over 300 health care providers have jumped at the chance to get more familiar with the Australian Government’s digital health initiative My Health Record.
Northern Queensland Primary Health Network (NQPHN) and NEHTA (National E-Health Transition Authority) will deliver 2-hour accredited training sessions in Cairns, Innisfail, Mackay and Townsville this week to support healthcare providers in their understanding of My Health Record.
NQPHN’s Chief Executive Officer, Robin Moore, acknowledges the important role that GPs, practice managers, pharmacists, medical specialists and other allied health professionals will play in the rollout and utilisation of My Health Record.
-----

My Health Record

Austin Health is participating in the My Health Record system, formerly known as the Personally Controlled Electronic Health Record  (PCEHR).
Austin Health clinicians are now able to access your My Health Record.
In addition to being able to view your record, all inpatient discharge summaries will be uploaded to your My Health Record (if a record exists).
You have the right to withdraw consent to have your discharge summary uploaded to their My Health Record.
Please let us know at your next visit if you have any concerns about this.
-----
MEDIA RELEASE
19 MAY 2016

MedicalDirector Helix: The new cloud-based platform for Australian medical practices

Australia’s largest medical software and information provider, MedicalDirector, has announced its next generation cloud-platform, MedicalDirector Helix, delivering a new approach for patient-centred care.
“The Australian health sector is on the cusp of major change as it moves to using cloud-based software. We have developed MedicalDirector Helix to help practices adapt to this anticipated change, and with this platform we aim to transform their everyday patient and clinical interactions,” says Phil Offer, Executive Director at MedicalDirector.  
-----
19 May, 2016

Let the cloud games begin!

Posted by Jeremy Knibbs
Medical Director has declared itself a starter in the race for the future of the connected health ecosystem
The company, one of the country’s major patient management system providers, announced today that they are going to launch a “cloud” version of their iconic desktop management system – Medical Director Helix.
If it is a properly architected cloud version they intend to launch – truly non-device dependent, mobile and with seamless communication and data exchange features though a secure cloud environment – then Medical Director is putting a stake in the ground that indicates an intent to take on disruptive cloud patient-management start-ups head on, and in the very near future.
-----

Goodbye Digital Divide, Hello Digital Equity (and why we need to go the extra mile to get it)

Editor: Dr Ruth Armstrong Author: Lareen Newman and Mike Gurstein on: May 17, 2016
In the third annual Gavin Mooney Memorial Essay Competition, entrants were asked to answer the question, “In the digital era, whose voices are being heard?”
The winning essay in the competition, by Amin Ansari, was published in Inside Story earlier this year, and it is Croakey’s privilege to post here a runner-up essay by Lareen Newman and Mike Gurstein.
As well as honouring the work and writings of Professor Mooney, the competition seeks to draw public attention to the topic he was most passionate about: social justice and health equity.
------

Cancer big data project eyes worldwide reach

Sees treatment patterns in individuals’ e-health record data.

By Ry Crozier on May 18 2016 5:05PM
A big data project designed to aggregate and learn from the treatment of cancer patients is looking to expand internationally after a successful first year of operation in the United States.
CancerLinQ – which counts the oncology operations of major pharmaceutical companies among its sponsors – already has access to the de-identified, anonymised health data of one million US cancer sufferers.
It hopes to grow that number worldwide to identify patterns in the way different cancers are treated and to help medical practitioners compare and search symptoms and treatments in near real-time.
“Cancer isn’t an abstract topic,” CancerLinQ CEO Kevin Fitzpatrick told SAP’s annual SapphireNow conference.
-----

#FHIR Meeting Report – Montreal, May 2016

Posted on May 20, 2016 by Grahame Grieve
-----

Healthdirect charts path to Docker containers

Starting small.

By Ry Crozier
May 18 2016 6:30AM
Healthdirect is emerging as another Australian early adopter of Docker containers, revealing the strategy it used to win the business over to the technology.
The company, which is fully government-funded and provides health services via web applications, “started really small” in its approach to Docker and has incrementally built upon early successes.
“We didn’t pitch Docker as if we were going to use it everywhere,” DevOps solution architect Scott Coulton said in a recent Docker webinar.
Docker provides a way to package and ship a Linux application or service into "containers" that can be easily moved between clouds or virtual machines.
-----

Real time monitoring best chance to curb codeine misuse

ASMI and the Pharmacy Guild say real-time monitoring of OTC codeine containing analgesics, in addition to a range of other targeted measures including mandatory warning statements, reducing pack sizes and educational materials, provides the best chance to curb potential misuse.

This was in response to a report published in Addiction titled “Codeine Misuse in Australia”.
ASMI welcomed the new report, as it says there is a need for more data on the topic.
“This new report would have provided additional useful insights if the authors had separately examined the prescription and OTC products (instead of pooling them), because it has been reported that misuse and abuse of prescription opiate and psychoactive drugs have escalated significantly over the past several years,” says Steve Scarff, ASMI Director Regulatory and Scientific Affairs.
-----

Australia's courts to rule on landmark definition of 'personal information'

Privacy commissioner welcomes critical ruling.

By Paris Cowan
May 16 2016 12:22PM
A full bench of the federal court will in August make a landmark ruling on what constitutes ‘personal information’ in the context of Australia's Privacy Act data protection rules.
The move was sparked by former Fairfax journalist Ben Grubb's three-year battle to get a hold of his metadata from Telstra.
Appeals and counter-appeals have meant the case has been bounced from tribunal to tribunal due to differences in the definition of what counts as information about Grubb, as opposed to information about his service or his device.
-----

Privacy watchdog works on big data guidelines

OAIC seeks feedback on draft guide to big data and Australia’s privacy regime
Rohan Pearce (Computerworld) 19 May, 2016 12:51
The Office of the Australian Information Commissioner is seeking feedback on a draft guide to the interaction between so-called big data and Australian privacy law.
In particular the draft examines how the Australian Privacy Principles (APPs) apply to big data.
“There is no doubt that big data practices challenge us to think about how key existing privacy principles — including notice and consent, data collection, use limitation, and retention minimisation, — work in practice,” acting Australian Information Commissioner Timothy Pilgrim said in remarks prepared for the launch of Privacy Awareness Week.
-----

The OAIC's tips for big data analytics that won’t break privacy rules

Commission releases draft guide.

By Paris Cowan
May 19 2016 3:00PM
The Office of the Australian Information Commissioner (OAIC) has released its draft checklist for conducting big data activities without breaching the limits of the Privacy Act.
The guide kicks off more than two months of consultation by Privacy Commissioner Timothy Pilgrim, as his office works to iron out the peculiar wrinkles and challenges raised by using big data for business purposes without offending the privacy expectations of consumers.
Unlike the privacy laws, the guide is not legally binding, the OAIC pointed out - but it is an indicator of how it will treat certain circumstances in the event of an assessment or review.
-----

Researchers easily extract personal details from metadata

US study debunks authorities' privacy claims.

By Juha Saarinen
May 20 2016 6:54AM
Academics from Stanford University in the United States have shown how trivially easy it can be to infer sensitive details about individuals from metadata on their communications.
They set out to test claims by the US National Security Agency that metadata is not personally identifiable information (PII).
Researchers Jonathan Meyer, Patrick Mutchler and John Mitchell collected the data for the study by running an application on Google Android phones used by 823 volunteers.
-----

Australian Digital Health Agency 

The Australian Digital Health Agency is part of the Health portfolio, and functions in an executive management capacity.
The Australian Digital Health Agency (the Agency) is governed by a skills-based Board which will be responsible for deciding the Agency’s objectives, policies and strategies, and for ensuring the proper and efficient performance of the Agency’s functions. The Agency is the single accountable organisation for national digital health systems in Australia.
-----

The Internet of Things: it's arrived and it's eyeing your job

Date May 21, 2016 - 12:15AM

Malcolm Maiden

Columnist

With a plan to make them a common sight on the roads.
We have been hearing about the Internet of Things for years, but get ready. It has finally arrived, and it has the potential to unleash economic disruption that makes what the internet has delivered so far look like child's play.
Telstra CEO Andy Penn is better placed than most to watch it happen. Telstra is in the middle of it, through initiatives of its own such as e-health and through its wireless network, which supports a growing universe of apps. A Telstra SIM connection allows Tesla cars to connect to the internet in this country, for example. A new one helps graziers manage stock by alerting them when gates have been left open.
Penn also drives a Tesla, Elon Musk's sculptural electric rocket.
-----

In Pictures: User guide to Windows 10

If you’re going for an immediate upgrade to Windows 10 from your Windows 7 or Windows 8/8.1 computer, this guide will get you up to speed as quickly as possible.
(I found this quite useful.)
-----

Time’s up for Jupiter’s secrets

  • Jonathan Leake
  • The Times
  • May 15, 2016 10:30AM
A NASA spacecraft has become the fastest object humanity has yet created, reaching more than 257,000km/h on a five-year journey that is about to see it enter orbit around Jupiter, the solar system’s biggest planet.
Next month the Juno probe will trigger its engines to decelerate into an orbit that will let it skim Jupiter’s cloud-tops and probe an atmosphere thousands of times thicker than ours to see what lies beneath.
Jupiter - 318 times bigger than Earth - was for a long time thought to be just a ball of spinning gas, but scientists now suspect this is wrong. One of Juno’s key tasks will be to find out if its dense clouds of hydrogen and helium might be hiding a rocky planet similar in origins to the Earth.
-----
Enjoy!
David.

Sunday, May 22, 2016

If All You Have Is A Hammer, Everything Looks Like A Nail - The Story Of myHR Use In Medical Home Trials.

This release appeared a while ago:

A Healthier Medicare for chronically-ill patients

The Australian Government will revolutionise the way we care for Australians with chronic diseases and complex conditions – aiming to keep them out-of-hospital and living happier and healthier lives at home.
Page last updated: 31 March 2016

Joint Media Release

The Hon. Malcolm Turnbull MP
Prime Minister

The Hon Sussan Ley MP
Minister for Health
Minister for Aged Care
Minister for Sport

31 March 2016
The Turnbull Government will revolutionise the way we care for Australians with chronic diseases and complex conditions – aiming to keep them out-of-hospital and living happier and healthier lives at home.
Our Healthier Medicare package is one of the biggest health system reforms since the introduction of Medicare 30 years ago.
Patients with multiple chronic conditions will get a health care package tailored to their needs and that care will then be co-ordinated to help them easily navigate the complex system.
As many as one-in-five Australians now live with two or more chronic health conditions.
The most prominent are diabetes, heart disease, cancer, mental health, eye disease, respiratory conditions and arthritis – requiring a range of health services from their GP through to specialists, nurses, pharmacists, physiotherapists, psychologists, dieticians and weight-loss programs.
This figure is even higher for Indigenous Australians, with a third reporting three or more long-term conditions.
Australians who are high users of the health system see as many as five different GPs per year – triple those with lower-use of the system. Seeing multiple GPs increases a patient’s risk of poor healthcare co-ordination and their likelihood of falling through the cracks and ending up in hospital.
Half of all potentially avoidable hospital admissions in 2013/14 were attributed to chronic conditions. That is one every two to three minutes.
The primary care package will be trialled through creating ‘Health Care Homes’ that will be responsible for the ongoing co-ordination, management and support of a patient’s care.
About 65,000 Australians will participate in initial two-year trials in up to 200 medical practices from 1 July 2017.
The Council of Australian Governments has discussed the benefits of primary care and the Prime Minister on Friday will invite state and territory leaders to partner with the Commonwealth on these reforms. We want to reduce the barriers patients face across fragmented health services, with the aim of keeping them well at home and out of hospital.
Simplifying a chronically-ill patient’s care by allowing them to nominate one GP practice as their ‘home base’, in conjunction with other Turnbull Government reforms such as our new digital MyHealth Record, will empower patients to take better control of their own care.
It will also reduce potentially life-threatening and costly inefficiencies in our health system, including hospitals.
We will provide quality patient outcomes in Commonwealth-funded primary health care services for the chronically ill to keep more Australians healthier, happier and out-of-hospital.
The announcement is a core part of Government’s response to our Primary Health Care Advisory Group review, released today and chaired by former Australian Medical Association President Steve Hambleton.
An extra $21 million will be committed to support the rollout of trials. The remaining balance of the package is expected to be cost neutral, in line with PHCAG recommendations, with further evaluation to continue ahead of a national rollout.
If we don’t act, Commonwealth health spending as a proportion of GDP will increase by over 50 per cent within 50 years because of higher rates of chronic disease.
Key Details
The Turnbull Government’s primary health care reforms, as part of its Healthier Medicare package, will consist of:
    • Tailored patient care plans developed in partnership with patients and their families.
    • The establishment of ‘Health Care Homes’, which will co-ordinate all of the medical, allied health and out-of-hospital services required as part of a patient’s tailored care plan. Health Care Homes will be delivered by GP practices or Aboriginal Medical Services. Patients will be able to enrol with the Home of their choice.
    • Payments for Health Care Homes will be bundled together into regular quarterly payments. This will encourage providers to be flexible and innovative in how they communicate and deliver care, and will ensure that the patient’s health care needs are regularly monitored and reviewed. This signals a move away from the current fee-for-service model for these eligible patients, except where a routine health issue does not relate to their chronic illness.
    • Improved use of digital health measures to improve patient access and efficiency, including the new MyHealth Record, telehealth and teleweb services, remote health monitoring and medication management technologies etc.
    • A risk stratification tool to determine an individual patient’s eligibility for the new packages.
    • Stronger data collection, measurement and evaluation tools to allow a patient’s individual progress to be measured and their care plan to be better tailored to their needs.
    • The creation of a National Minimum Data Set of de-identified information to help measure and benchmark primary health care performance at a local, regional and national level to inform policy and help identify regionally-specific issues and areas for improvement.
    • Processes to empower patients and their families to be partners in their own care and take greater responsibility for the management of their conditions.
    • Greater co-ordination between Primary Health Care Networks (PHNs) and Local Hospital Networks (LHNs) in the planning and procurement of health services for their local communities.
    • Additional training to care coordinators and providers so they are aware of their responsibilities under the new model.
    • A Health Care Home implementation advisory group to oversee the design, implementation and evaluation of the trials ahead of the national rollout.
Here is the link:
There are a few things to be said about all this but the main point I think needs to be made is as the blog title says - if all you have in patient records is myHR then that is what you will use to conduct the trials - rather than actually analyse what is needed in the trials and deploying a proper system to meet those needs.
Without playing favourites there are at least two systems available and implemented in Australia that are much better able to meet the needs of care-coordination and the range of users that need access and share to such information.
Additionally it is important to note that the concept of a Medical or Healthcare Home has been around for years and has not proved to be all that successful.
Here is a review of major trials in the US which really did not turn out all that well.

Patient-centered medical home program results in little improvement in quality

Date: February 25, 2014
Source: The JAMA Network Journals
Summary:
One of the first, largest, and longest-running multipayer trials of patient-centered medical home medical practices in the United States was associated with limited improvements in quality and was not associated with reductions in use of hospital, emergency department, or ambulatory care services or total costs of care over three years, according to a study. The patient-centered medical home is a team-based model of primary care practice intended to improve the quality, efficiency, and patient experience of care. Professional associations, payers, policy makers, and other stakeholders have advocated for the patient-centered medical home model.
See a lot more information here:
All we can do is hope that light will dawn and the trials will be enabled by the best possible technology to give the whole initiative at least some small chance of success. Dream on I guess.
David.

AusHealthIT Poll Number 321 – Results – 22nd May, 2016.

Here are the results of the poll.

With The Election Coming Soon Which Party Do You Think Has The Best Approach To, And Understanding Of, e-Health?

Labor 3% (3)

Coalition 5% (5)

Greens 1% (1)

Other 1% (1)

No-one Has A Clue 57% (59)

All Are Fine 17% (17)

I Have No Idea 17% (17)

Total votes: 103

Pretty clear outcome with trust in our polity hardly strong! At least e-Health is not seen as too much of a politically divisive topic.

Good turnout of votes as well!

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

David.

Saturday, May 21, 2016

Weekly Overseas Health IT Links - 21st May, 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.
-----

6 privacy landmines and how to avoid stepping on them

A healthcare attorney spotlights big problems and offers advice on ways to navigate around the pitfalls, from cybersecurity insurance to HIPAA, social media to patient access.
May 12, 2016 05:10 PM
While the healthcare industry grapples with data breaches and privacy and security regulations, there are common pitfalls that are easy to run into without proper planning.
Erin Whaley, a partner at the law firm Troutman Sanders, outlined what those are and shared half-a-dozen tips for avoiding them.
Here is Whaley’s advice:
1. As long as I have cybersecurity insurance I’ll be covered in the event of a breach. It’s not that simple. Whaley said that even healthcare organizations that stack policies to get to $50 million in coverage may not have enough – though she’s not espousing that everyone simply plunk down for more insurance. Providers, instead, need to deploy solid security practices. “Having good security is a prerequisite to good coverage.”
-----

'Machine learning' a boon for insurers, but can't replace human touch in healthcare

May 12, 2016 | By Leslie Small
The concept of "machine learning" has tremendous potential to help health insurers leverage data and improve care, though one prominent insurance CEO argues that such disruptive technologies will never be able to replace the valuable role of clinicians.
At UPMC, the Pittsburgh-based integrated health system's investment in big data analytics gave it a "$1.6 billion advantage," Pamela Peele, chief analytics officer for the company's Insurance Services Division, tells Healthcare Finance.
Peele's team, she says, invented its own models that marry predictive analytics with claims and local demographic data. Then machine learning--a process in which software roots out trends that the system can act on--analyzes the data.
-----

42% of Consumers Using Digital Health Data Say Data Goes Nowhere

42% of digital health users say the data gathered by these tools goes nowhere, according to survey of 500 people who use digital health tools. The survey reveals a “disconnect” between where consumers would like their self-collected health data to go, and how easy it is to share it. The results are now available in the HealthMine Digital Health Report: The State and Impact of Digital Health Tools.
Three quarters of consumers who use mobile/internetconnected health apps are willing to share the data they collect with their doctor/healthcare provider, but only 32% say this happens automatically. 
Given that digital health data is going nowhere, 46% of respondents say their doctor is not incorporating self-collected health data in guiding their healthcare.  Wellness programs have the potential to be a bridge—connecting data generated by a growing crop of digital health tools—to patients’ complete health record.
-----

Integrating EHRs with vaccine registries improves accuracy of pediatric immunizations

May 10, 2016 | By Marla Durben Hirsch
The exchange of vaccination data between a city immunization registry and clinicians' electronic health records resulted in "significant" improvements in pediatric immunization coverage, according to a recent study in the journal Pediatrics.
Record fragmentation increases the risk of over- and under-immunization. The researchers, from Columbia University Medical Center and elsewhere, reviewed the immunization data between the New York City Department of Health' immunization registry and five clinics in New York-Presbyterian's Ambulatory Care network, which is integrated with the hospital's immunization registry. New York City's registry is one of the first to allow clinicians to download immunization information directly to their local EHR.
-----

Ponemon Institute: Poor state of healthcare cybersecurity causing industry finger pointing

May 12, 2016 | By Susan D. Hall
Criminal attacks continue to be the leading cause of data breaches in healthcare, with ransomware the latest threat, according to a new privacy and security survey conducted by the Ponemon Institute.
The study estimates the cost of breaches for the healthcare industry to be $6.2 billion, with the average cost to an individual organization at $2.2 million. For business associates the cost is more than $1 million. Nearly 90 percent of responding organizations said they experienced a data breach in the past two years, and 45 percent had more than five, though many of those were small incidents.
Ransomware, malware, and denial-of-service (DOS) attacks are the top cyberthreats that healthcare organizations face, the report notes, though they're also concerned about employee negligence, mobile device insecurity and use of public cloud services.
-----

Post-acute IT 'getting interesting' as attention turns to EHRs, analytics, interoperability

The move toward value-based care is seeing LTPACs 'organize and have a stronger voice, with implications on the acute care side.'
May 12, 2016 10:07 AM
As the ACO movement gains momentum, providers in both acute and post-acute sectors are looking for enhanced dialogue, because "they realize they aren't separate pieces of care anymore," says LaDonna Sweeten, managing director with Chicago-based Huron Healthcare's technology consulting practice.
After years of dwelling in the shadows of healthcare, the long-term and post-acute care industry may finally be ready to join its hospital colleagues in the IT spotlight.
The path is long and steep, but operators of skilled nursing, outpatient rehabilitation, assisted living, memory care, hospice and home care agencies are embracing their important new roles as providers in the dynamic post-acute care environment.
-----

Cloud-based surveillance may predict flu outbreaks a week before CDC

Written by Shannon Barnet (Twitter | Google+)  | May 11, 2016
The ability to detect and predict influenza outbreaks is crucial to minimizing their health effects. The CDC tracks flu-like illness, but a new approach using cloud-based EHR data may cut a week off of the agency's current two-week lag, according to a study published in Scientific Reports.
Researchers combined EHR data from athenahealth with historical flu outbreak patterns and a machine-learning algorithm to estimate flu activity in near real time. The estimates created using the cloud-based EHR approach had two to three times fewer errors than older models. Additionally, the algorithm correctly estimated the timing and magnitude of the national peak week during three flu seasons.
-----

Changing default options in EHR increases generic prescribing rates

May 11, 2016
An intervention that changed default prescribing to dispense generic medications led to significantly increased overall generic prescribing rates, according to findings published in JAMA Internal Medicine.
The 23.1%-point increase could lead to increases in medication adherence and improved clinical outcomes, Mitesh S. Patel, MD, MBA, MS, an assistant professor of medicine and health care management at the Perelman School of Medicine and The Wharton School at the University of Pennsylvania, and colleagues wrote.
"The growing adoption of the electronic health record (EHR) brings new opportunities to improve physician decision making toward higher-value care," they wrote. "Default options, or the conditions that are set into place unless an alternative is actively chosen, have been shown to influence decisions in many contexts. However, the effectiveness of different ways of implementing defaults has not been systematically examined in health care, and many people may assume that changing defaults is a one-size-fits-all intervention that will always have the same effect."
-----

Healthcare Suffers Estimated $6.2 Billion In Data Breaches

5/12/2016 12:01 AM
Nearly 90 percent of healthcare organizations were slammed by a breach in the past two years.
The 911 call has come in loud and clear for the healthcare industry: nearly 90% of all healthcare organizations suffered at least one data breach in the past two years with an average cost of $2.2 million per hack.
Despite heightened awareness and concern among the healthcare industry over its ability to thwart cybercrime, insider mistakes, and ransomware attacks, healthcare budgets for security have either dropped or remained the same in the past year, according to the newly released Sixth Annual Benchmark Study on Privacy & Security of Healthcare Data by the Ponemon Institute. Some 10% of budgets have declined, and more than half have remained static, and most believe they don’t have the budget to properly protect data.
-----

5 steps to avoid failure with technology implementations

Published May 12 2016, 12:12pm EDT
Whenever people talk about business transformation, they talk about people, process and technology in that order—and there’s a lot to talk about, as technology creates business opportunities that continue to redefine healthcare. From sophisticated predictive analytics models to the simpler products and consumer-driven choices that provide information, technology tools are at the heart of the healthcare revolution.
So why do so many of these transformational projects face a challenging implementation, with planning difficulties and expensive disappointments that defy the best scheduling and budget intentions? The emphasis on investing in “tech for success” may be misplaced, and failing to make the investment in people is the root cause of why so many technology-enabled healthcare transformations fail.
-----

Datapalooza: Slavitt Admits Gov't Failed in Health IT Push

MedPage Today, May 12, 2016

With just over 8 months on the job left to go, the head of the Centers for Medicare and Medicaid Services said Tuesday he now has "an obsession with the plight of independent physicians." From MedPage Today.

With just over 8 months on the job left to go, the head of the Centers for Medicare and Medicaid Services said Tuesday he now has "an obsession with the plight of independent physicians."
Since January, acting administrator Andy Slavitt and other members of agency have been traveling around the country listening to thousands of doctors complain about their electronic health record (EHR) systems, poor payment for their time, burnout, and confusion over quality metric requirements.
And all of this without measureable improvements in care for their patients.
-----

CERT report identifies 10 at-risk emerging technologies

Published May 11 2016, 9:10am EDT
The Computer Emergency Readiness Team Division of the Software Engineering Institute at Carnegie Mellon University has issued a new study that identifies 10 at-risk emerging technologies.
In the report, 2016 Emerging Technology Domains Risk Survey, researchers examined the security of a large swath of technology domains being developed in industry and maturing over the next five years. The team focused on identifying domains that not only affect cyber security, but finance, personal health and safety as well.
-----

A better way to manage healthcare technology projects

Published May 11 2016, 12:47pm EDT
Starting a project team is one of the key determinates to the ultimate outcome of the project. So often, lacking any general guidance and when asked to provide resources for a year-long project, leaders tend to naturally offer up employees who may the least missed by their work unit.
This may not be good for the project. If the employee is not a self-starter because he or she may be on the wrong career path, then reassignment to a multi-million dollar, interdisciplinary project team may not inspire a personal change.
On the other hand, a less risky approach may be to reward the employee who is respected by colleagues and would definitely be missed by the work unit because she or he continually seeks out new challenges. A project assignment might be exactly what will re-energize, challenge, and enable top performing employees to grow in to the areas required to the meet the new challenges. Such growth often leads to a larger role in the organization after the project such as clinical informatics or information technology application support.
-----

What holds healthcare back from the cloud

Published May 10 2016, 5:08pm EDT
Web designer Chris Watterston put it best when he created a sticker that went viral: “there is no cloud, it’s just someone else’s computer.”
It’s that very issue that makes the cloud both appealing and unappealing to healthcare providers. It’s appealing because it provides the scalable, usable storage for the expanded needs of today’s healthcare market, including the storage of large genomic files and digital imagery. Few providers can store this kind of data in-house – and so, they use the cloud.
But the fear of the cloud being “out there” leaves the sensation that data is vulnerable, and keeps some healthcare providers away.
Ed Cantwell, executive director, Center for Medical Interoperability says people get tripped up with who accesses the cloud, and how. “They think, if it’s in the cloud, it’s a free-for-all. But that’s not the case at all,” he says. “I’m not so sure if a hacker cares if you are in the cloud or locked in a vault. If you’re in the cloud, you’re still located somewhere physically.”
-----

Are robots superior to surgeons?

Published May 11 2016, 1:36am EDT
Researchers have developed a robotic arm to conduct suturing during soft tissue surgery, which has the potential for improved patient safety due to a reduction in surgical errors and increased efficiency.
Suturing soft tissue can be challenging even for a skilled surgeon--the tissue can move and change shape in complex ways as stitching occurs, requiring the ability to keep sutures tightly and evenly placed. Not surprisingly, leakage along the seams is a significant problem in nearly 20 percent of colorectal surgeries and 25 to 30 percent of abdominal surgeries.
The Smart Tissue Automation Robot (STAR) features a 3D imaging system and a near-infrared sensor to spot fluorescent markers along the edges of the tissue to keep the robotic suture needle on track and consistent in its placement.
-----

Focus on analytics results in a 400 percent return on investment

Jeff Rowe
May 10, 2016
What difference does a name make?
Well, if switching one person’s job title at a health system results in greater patient safety, lower costs and more productive use of health data across the system, then it can mean quite a bit.
At HealthcareIT News, editor Mike Miliard recently described the gains being made at the University of Mississippi Medical Center (UMMC), and, in part, the transformations that lead to those gains included changing the organizational title of John Showalter, MD, from chief medical information officer to chief health information officer.
"The chief health information officer position here is really much more focused on analytics and driving institutional return on investment from our clinical IT," Showalter explained. "When I was the CMIO, I was much more focused on adoption and usability for the clinicians.”
-----

Calling for semantic interoperability standards that enable clinical data discovery

Penn Medicine associate vice president of health technology Brian Wells makes the case for creating standards that map rich clinical data in EHRs and other sources to large patient cohorts.
May 09, 2016 04:54 PM
There are many promising initiatives underway that seek to combine rich clinical data from electronic health record systems running in provider sites across the county into large patient cohorts and then combine that data with genetic sequences created from samples provided by each patient in the cohort.
The sponsors of these initiatives span industry, private foundations and the federal government. While the ambitious goals are commendable and the potential for discovery is worthy of the effort, there are data quality and semantic interoperability requirements that must be met prior to the combining of the clinical data. 
-----

Andy Slavitt: Health IT must be 'a national priority'

May 10, 2016 | By Katie Dvorak
WASHINGTON--When Andy Slavitt came to the District of Columbia two years ago, it was because technology was putting health reform in the U.S. at risk. Now, he says, technology is not doing all it can when it comes to patient care, and the industry must "refocus on our customers and rise above proprietary interests to make this a national priority."
"Robots can perform your mom's surgery, but reminding her to refill a prescription? No, it can't do that," he said during a keynote speech Tuesday at Health Datapalooza. "Technology isn't doing what we know it can. It's not helping make us smarter, it's not helping us make better decisions, it's not reducing our waste of time."
However, that doesn't mean it can't do those things and more.
-----

Patient access to medical records key to stemming inaccuracies

May 10, 2016 | By Katie Dvorak
WASHINGTON--Unlike what happens in Vegas, what happens in a patient's medical record--especially inaccuracies--can stay with them forever, Dhruv Khullar, a resident physician at Massachusetts General Hospital, said during a Tuesday session at Health Datapalooza 2016 in the District of Columbia.
The panelists, ranging from a government official to university members, gathered to discuss their experiences and views of patient data safety and data sharing.
Khullar said it's growing more difficult to trust what is in the electronic health records of patients. "When I speak with patients, I find that their electronic medical record is littered with inaccuracies," he said.
-----

Scanning the future

How much paper is it worth scanning as part of an electronic document management project? It's a fraught question, but he answer seems to be 'less than you might think' with legacy records and 'only what you can plan for' with new ones.
In 2018, Papworth, the renowned heart and lung hospital, will move to a new site near Addenbrooke's Hospital.
The site has no space for a paper records library; which has proved a good incentive for switching from a paper-based record system to an electronic one.
The hospital implemented an electronic document records and management system from CCube. While it decided that every new referral would be handled electronically, it chose not to scan legacy records.
-----

Digital transactions can mean big savings for physicians

May 11, 2016
Electronic transactions can save the healthcare industry around $8 billion each year, according to the 2015 CAQH Index Report, as well as save physicians precious time and money.
Reynard Washington, senior manager for research and measurement at The Council for Affordable Quality Healthcare (CAQH) told Medical Economics that of all the different entities involved in the revenue cycle of a typical episode of care, physicians stand to gain the greatest benefit from transitioning to digital transactions, because doing so will shorten the time to payment, as well as provide savings in labor costs. 
This year’s report includes an informative graph, titled “How Much Does the Healthcare Industry Spend on Claims-Related Business Transactions?” that shows the financial breakdown between processing certain transactions electronically versus digitally. The graph reveals some striking points, which support Washington’s assertion that digital processing really will save practices money. For instance, the average cost of a claims verification performed manually is $10.83, whereas electronically it is $2.51.
-----

Telepharmacy software helps free up workflow, lets pharmacists focus on patients

Cloud-based technology lets pharmacists spend more time with clinical teams, or work on projects such as EMR implementations or quality programs.
May 10, 2016 10:45 AM
Getting pharmacists involved in patient-centric activities, including being part of clinical care teams, is a little easier thanks to telepharmacy technology.
When Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, needed to optimize its pharmacy workflow with the goal of improving patient care, it turned to PowergridRx, a cloud-based HIPAA–compliant telepharmacy platform from San Francisco-based PipelineRx.
Starting in February, Dartmouth-Hitchcock began deploying PowerGridRx in its hospitals across New England.
PowerGridRx is a software as a service platform that aggregates, manages and optimizes virtual pharmacy management for health systems. In addition, it differentiates Dartmouth-Hitchcock's telepharmacy network and manages the order verification process for current and future facilities.
-----

Mount Sinai's Linda Rogers: mHealth poised for explosive growth

May 10, 2016 | By Judy Mottl
The Icahn School of Medicine at Mount Sinai in New York is tapping mHealth for asthma treatment, recently developing its own app. The Asthma Health App, which lets patients conduct self-monitoring of symptoms and disease triggers, and fosters positive behavioral decisions, is also helping patients adhere to treatment regimens. What's more, it's providing researchers with invaluable data aimed at helping the 25 million U.S. residents suffering from the chronic disease.
Currently, there is no cure for asthma, but Mount Sinai medical leaders believe a personal care plan can help prevent attacks and help patients live a fuller and more active lifestyle. FierceMobileHealthcare recently spoke with Linda Rogers, associate professor of pulmonary, critical care and sleep medicine at the school, to gain deeper insight on mHealth strategies and the continuing focus on new innovations.
-----

Joe Biden: Sharing of health data 'a matter of life and death'

May 10, 2016 | By Dan Bowman
WASHINGTON--Not even the vice president of the United States is immune to poor electronic health record interoperability.
In a speech Monday at Health Datapalooza in the District of Columbia, Vice President Joe Biden shared that in the midst of his son Beau's treatment for brain cancer, the family struggled to have health records sent between providers at Walter Reed National Military Medical Center and the University of Texas MD Anderson Cancer Center. In fact, he said, because the two health systems' EHRs were not compatible with one another, the information needed to be physically transported from the Bethesda, Maryland-based hospital to Houston.
Beau Biden died last May.
-----

Strategies for Switching or Merging EHRs

Focusing on practice work flow is key to a successful transition

by Shannon Firth
Washington Correspondent, MedPage Today

WASHINGTON – As more physician practices merge or consolidate the question of how to integrate electronic medical records becomes increasingly important.
"You've heard the three lies. The check's in the mail. I'll respect you in the morning. And this EHR merger will be seamless," said Jacqueline Fincher, MD, a primary care physician and member of the American College Physicians' Board of Regents, speaking at the ACP's annual meeting here.
When Fincher and her husband joined her father-in-law's solo physician practice McDuffie Medical Associates in Thomson, Ga., in 1988, there was no electronic medical record. Her father-in-law used 5x7 patient card files to document individual medical records. The practice graduated to 8x11 cards soon after her arrival, then to templated notes a decade later. Finally in 2006, they invested in an electronic health record from a Top 5 vendor.
-----

FBI says not to pay ransom; data, system backups critical for health systems

May 9, 2016 | By Katie Dvorak
Jason Rolla, chief technology officer of Illinois-based Christopher Rural Health, feared that his health system would have to pay hackers who used malware to lock employees out of systems last year--but luckily that never came to be.
Rolla told Fortune that the health system had previously hired a vendor to back the information up, and his team was able to restore the office's systems without forking over the hundreds of dollars the hackers demanded.
-----

HL7 posts new FHIR test version tuned for clinical decision support, complex queries, genomics data

Dubbed release candidate number 3, the latest incarnation of the emerging interoperability standard also brings advancements for workflow, eClaims, CCDA profiles and provider directories. 
May 06, 2016 02:20 PM
HL7 Fellow and Corepoint Health CTO Dave Shaver said HL7 will take what develoeprs discover about FHIR at the Montreal Connectathon and roll that into the next version of the emerging interoperability standard. 
The May 2016 iteration of FHIR, as in Fast Healthcare Information Resources, has arrived. Most notable among its new capabilities: support for the Clinical Quality Language for clinical decision support as well as further development of work on genomic data, workflow, eClaims, provider directories and CCDA profiles.
-----

Cybersecurity experts conduct hacker test on medical devices

Elizabeth Jia, WUSA 12:15 AM. EST May 09, 2016
WASHINGTON (WUSA9) ---  Cybersecurity experts have found ways to hack into hospital equipment.
 A recent IT study exposed the vulnerabilities of technology used inside medical facilities. The study conducted by Independent Security Evaluators (ISE) tested the hackability of hospital software and medical devices keeping patients alive.
One of the 12 hospitals in the study was located in the Washington Metropolitan area.  Although the healthcare facilities volunteered for the study, the authors of the ISE research report kept the hospital names anonymous.
-----

Report: System incompatibility a health care problem

Published 12:00 am, Sunday, May 8, 2016
Health care organizations’ information technologies and workflows often don’t support each other, according to a patient care-focused nonprofit that flagged the problem as one of the top safety issues facing the industry.
The ECRI Institute, which recently released its third annual ranking of the Top 10 Patient Safety Concerns for Healthcare Organizations, reported that patient identification errors and inadequate management of behavioral health issues in non-behavioral health settings were its No. 2 and No. 3 issues for health care organizations.
When a health IT system is introduced, health care organizations should tailor it to their workflow, and vice versa, according to ECRI, which is based in Pennsylvania. But often, “after the implementation, people continue to do things the same way and really don’t adjust the health IT system or their workflow,” Robert Giannini, patient safety analyst at ECRI, said in a statement.
-----

HSE board gives its approval to €900m e-health plan

Sarah McCabe

Published 08/05/2016 | 02:30
The Health Service Executive has approved the business case for a €900m e-health plan designed to digitalise Ireland's health system.
The intention is to provide digital health records for all Irish patients by the middle of 2019. The first site that will go live with electronic health records will be the National Children's Hospital.
Multi-million state contracts will probably be awarded to private companies to deliver the plan.
-----

Enjoy!
David.