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."

Sunday, May 28, 2017

The Magical Belief In The Power Of Digital Health Seems To Be Unchallenged And All Pervasive.

We had a presentation from Tim Kelsey, CEO of the Australian Digital Health Authority to CeBIT a few days ago. Here is the blog reporting what was said.

How to make digital health a viable solution in Australia

Holistic and intergrated approaches to digital health

Tim Kelsey – CEO - ADHA
May 25, 2017
‘We’re all in this room because we share a common vision, putting to work digital enablement to help out patients. Yet there is still some work to be done - we’re not where we want to be yet.’
Tim Kelsey, Chief Executive Officer, Australian Digital Health Agency, kicked off his presentation by bluntly stating that digital health services in the country still have a way to go.
He stated at present, that 2 out of 3 hospital admissions there will be an error with medications, leading to more deaths from incorrect administering of medication than from traffic accidents.
To that end, he describes paper-based systems 'as ludicrous, but also dangerous’ and that ‘the solution ‘is so well established that we don’t have an excuse to ignore it.'
The response to this issue by state and federal governments has been ‘to draw a line in the sand and say, “we can no longer be dominated by the tyranny of the fax machine.”’ To ensure that Australia has a robust, agile and functioning digital health system, Kelsey said that two key priorities have been announced.
  1. Getting My Health Record on track
  2. The Development of the Digital Health Strategy

My Health Record

Simply put, My Health Record is the national infrastructure that allows patients to control their own medical information and to decide with whom that information is shared. Its potential is such that the President of the Australian Medical Association, Dr Michael Gannon has described it as ‘the future of medicine.’
Ultimately the national expansion program aims to give everyone a record by default - the exception being for those who choose to opt-out. Initial trials were run in rural Queensland and New South Wales. The outcome was ‘overwhelming support for a comprehensive shared record.’ The primary focus, Kelsey asserts, was ‘the quality of safety. The first thing you want to be assured of when you’ve been in an accident, for example, is that the clinician has access to your records. You want to see that your clinicians can prepare your care effectively.’ In fact the measure was so popular that only 1.9%-2% of those trialled opted out.
Kelsey also acknowledges that while there has been substantive support for the digital health platform, ‘there has been widespread and justified criticism.’ He said ‘While the principle is widely supported, the reality is that My Health Record isn’t where we want it to be yet.’
However, Kelsey is optimistic to the future of the project with a national expansion of the program, to be rolled out in 2018. Integral to its success is the ongoing collaboration with the community and with the tech industry. Kelsey also announced the creation of a developer engagement program called ‘Refresh’ which aimed to partner with healthcare, technology and research professionals who might be able to provide unique perspectives and industry knowledge.

The National Digital Health Strategy

The National Digital Health Strategy is the consensus on what the key priorities are for Australian digital healthcare. From the thousands of people consulted, 7 key priorities emerged, Kelsey describes them as ‘the core foundation that the community is telling us that they would like to see in a healthcare system that is safe, that is accurate and that works.’ The 7 key priorities are:
  1. My health information is available to me whenever and wherever it is needed
  2. My health information is secure and can be shared by me or my healthcare provider
  3. I, my carers, and my healthcare providers can use my healthcare information
  4. My prescriptions and medications are stored digitally and are used to improve my health
  5. I have more options and more choice for accessing my healthcare
  6. I feel confident using digital technologies to access and deliver healthcare
  7. It is faster and easier for me to develop and deliver health and care innovations

Journey to digital health 

While there is still work to be done Kelsey is optimistic about the direction of digital healthcare in Australia. ‘When established, these initiatives can ensure the safe care of those who are most vulnerable, who are most at risk.’
Here is the link:

http://blog.cebit.com.au/how-to-make-digital-health-a-viable-solution-in-australia

Other than pointing out that the ADHA has nothing to do with hospitals in any way that would affect medication errors within hospitals and to wonder just what the ADHA was doing to improve practice computer systems (Clinicians seem notably absent from their strategy thoughts) I will leave it to the readers to comment on this blog.

FWIW my take is that all this goes very little along the way to show real support of clinicians in delivering safer and better care for patients and offers very few solutions to the problems we face. Surely all this totally misunderstands to scale of the task and where the priorities should be.

Surely the faith in an evolving myHR must be pretty challenged by this morning's poll!

See here:

https://aushealthit.blogspot.com.au/2017/05/aushealthit-poll-number-372-results.html

What do others think? – and feel totally free to disagree!

David.

AusHealthIT Poll Number 372 – Results – 28th May, 2017.

Here are the results of the poll.

Do You Believe The myHR System Is Already Technically Obsolete?

Yes 95% (167)

No 5% (8)

I Have No Idea 0% (0)

Total votes: 175

The numbers speak for themselves – the myHR is an obsolete clunker!

A really great turnout of votes!

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

David.

Saturday, May 27, 2017

Weekly Overseas Health IT Links – 27th May, 2017.

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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Google to offer new AI `supercomputer' chip via cloud

Published May 18 2017, 4:10pm EDT
At the I/O developer conference last year, Google debuted its first chip. The company kept the component mostly for internal artificial intelligence needs. This week, the second version arrived, and Google is selling this one.
Chief Executive Officer Sundar Pichai announced the new chip on Wednesday during a keynote address at the Alphabet unit’s annual I/O event. Normally, the gathering focuses on mobile software. This year’s spotlight on hardware underscores Pichai’s effort to transform the search giant into an "AI-first" company and a real cloud-computing contender.
Companies will be able to purchase the hardware, called Cloud Tensor Processing Units (TPUs), through a Google Cloud service. Google hopes it will quicken the pace of AI advancements, and despite official statements to the contrary, it may also threaten Intel and Nvidia, the main suppliers of powerful semiconductors that run large processing tasks.
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EHR natural language processing isn't perfect, but it's really useful

Advocate Health Care informaticist says there are both challenges and opportunities for as technology becomes more widely used in clinical settings.
May 18, 2017 02:51 PM
The rise of electronic health records with natural language processing technology is transforming provider workflow and clinical documentation.
Though NLP is not without its challenges, it can offer valuable benefits when used wisely, said Anupam Goel, vice president of clinical information at Chicago-based Advocate Health Care.
While NLP can offer advanced diagnostic benefits, it depends heavily on the specifics of how clinicians enter their documentation, Goel said this week at the Healthcare IT News and HIMSS Big Data and Healthcare Analytics Forum in San Francisco.
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Partners HealthCare launches 10-year project to boost AI use

Partnership with GE Healthcare with first focus on improving clinician productivity and patient outcomes in diagnostic imaging.
May 18, 2017 10:06 AM
Boston-based Partners HealthCare on Wednesday said it plans to integrate deep learning technology from GE Healthcare across its network.
The 10-year collaboration will involve Massachusetts General Hospital and Brigham and Women's Hospital Center for Clinical Data Science.
The initiative will feature co-located, multidisciplinary teams with broad access to data, computational infrastructure and clinical expertise. The initial focus will be on the development of applications aimed at improving clinician productivity and patient outcomes in diagnostic imaging.
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Special Report: Electronic Document Management – May 2017

Electronic document management is one of the most challenging areas of hospital digitisation, touching on just about every aspect of how an organisation runs and a vital accompaniment to an EPR. Claire Read reports on how leading trusts have approached it.
If you took the shelves out of University Hospital Southampton NHS Foundation Trust’s health records library, laid them flat one after the other, and jogged alongside them, then you’d be well on your way to having completed a marathon. It takes no less than 17 miles’ worth of shelving to house the trust’s paper notes on its patients.
Toby Cave, the organisation’s electronic document management system (EDMS) project manager, is in no doubt that there is a strong business case for making such records digital.
“We spend £1.3 million a year on our health records library,” he reports. “It’s an expensive facility, with staff there pulling records, transferring them to the trust, and then there’s the transport and the porters to move the records around the trust for clinical care.”
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VR Transforms Physical Therapy, One Baby Boomer at a Time

The impact of VR technologies on health care and physical therapy specifically will be huge!
The term “virtual reality” evokes images of gamers huddled around new devices, Millennials sipping coffee as they chat about the latest gadgets, and technophiles miming about in space age glasses at popular events. While it might seem consumer-centric, virtual reality (VR) and its practical applications are rapidly being discovered in industries outside the consumer realm, including manufacturing, retail and healthcare. In fact, through the implementation of VR technologies, the landscape of healthcare has begun to transform dramatically, as physical therapist seek new ways to care for patients. Baby boomers are especially reaping the benefits, as VR has begun to play a unique role in physical therapy and rehabilitation (not to mention in such procedures as knee and hip replacement surgeries).
The benefits of VR in healthcare – especially as it applies to baby boomers – are undeniable, with increase accessibility, time and cost savings, the reality of its advancement in physical therapy is far more than just virtual.
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HIT Think Why providers should push for patient ownership of medical records

Published May 19 2017, 4:02pm EDT
Healthcare IT executives may believe the digital revolution is mostly behind them, after the long push to implement EHRs. They will be surprised that EMR adoption has only paved the way for an increased desire to enable patient-owned electronic medical records.
The convergence of healthcare activism, consumerism and technology will make consumers demand stewardship or ownership of their own data. Recent trends such as the following will only increase the pressure:
  • Unprecedented cost increases and loss of benefits. The politicization of healthcare has made consumers acutely aware of their increasing costs. Costs of both coverage and direct expenses are going up at a faster rate than consumers’ ability to pay. Employers are shifting their increased costs to employees through premium sharing, deductibles and co-insurance. As consumers are being pushed to be conscientious purchasers, they will also need and want direct access to their healthcare information.
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Electronic Health Records (EHR) Market to Reach $33 Billion by 2025 - Key Players are Cerner, Allscripts, McKesson, MEDITECH, Epic Systems Corporation & NextGen Healthcare - Research and Markets

May 19, 2017 05:42 AM Eastern Daylight Time
“Electronic Health Records (EHR) Market Analysis By Product (Client Server-based, Web-based), By Type (Acute, Ambulatory, Post-Acute) By End-use (Hospitals, Ambulatory Care), And Segment Forecasts, 2014 - 2025”
The global Electronic Health Records (EHR) market is expected to reach USD 33.41 billion by 2025. The government initiatives undertaken in support of EHR adoption are most likely to accentuate the market growth.
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NHS urged to consider Microsoft alternatives following cyber attacks

Jon Hoeksma

17 May 2017
In the wake of Friday’s international cyber attacks, which caused widespread disruption across NHS organisations, a small team of developers is recommending the health service reduce its reliance on Microsoft.
The NHS almost exclusively uses Microsoft operating systems, some of which – like Windows XP – are no longer officially supported.
To demonstrate that there is a licence-free alternative, GP Marcus Baw and technologist Rob Dyke have adapted the open source Linux-based Ubuntu operating system specifically for the NHS. They call it NHSbuntu.
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Trust and time: Two critical elements that will shape the future of health technology

May 18, 2017 11:10am
Perception and reality aren’t always aligned—especially when it comes to technology.
But in the U.S there is a narrow gap between how patients and healthcare providers perceive the integration of health technology and what is actually happening. According to “The Future of Health Index,” a report commissioned by Philips that captures healthcare connectivity across the globe, the U.S. had the smallest perception versus reality disconnect when it came to health IT integration—notably smaller than countries like the U.K. and France where perception lags behind reality.
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Partners HealthCare looks to develop—and commercialize—artificial intelligence

May 17, 2017 5:40pm
A new 10-year partnership between GE and Partners Healthcare aims to put AI into the clinical environment.
Boston-based Partners HealthCare is jumping headlong into the artificial intelligence sector, inking a partnership with GE Healthcare to create new AI platforms that can be used well beyond the integrated health system.
The 10-year deal announced on Wednesday looks to unite the clinical capabilities and the massive data sets within the Partners HealthCare system—which includes Brigham and Women’s Hospital and Massachusetts General Hospital—with GE’s computing power to put AI in the hands of clinicians.
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U. of C. Medicine, Google hope to use patterns in patient records to predict health

As a patient, your electronic medical record contains a wealth of information about you: vital signs, notes from physicians and medications.
Doctors use that information to track your medical history and keep tabs on you in the hospital — but what if they could also use it to predict your future health?
It's an idea inching closer to reality.
On Wednesday, Google announced it's teaming up with University of Chicago Medicine to research ways to use machine learning to predict medical events — such as whether someone will be hospitalized, how long that hospitalization will last and whether a patient's health is deteriorating. Google has formed similar partnerships with Stanford Medicine and the University of California at San Francisco.
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Clinical cognitive science is healthcare’s new tipping point

But the looming shortage of data scientists will likely slow down adoption.
May 16, 2017 01:13 PM
SAN FRANCISCO — Many of the technologies that healthcare and other industries have spent the last decade working on are coming together in new ways to enable the next-generation of care delivery.
These include not only the near-ubiquitous electronic health records platforms but also emerging technologies including artificial intelligence, big data analytics and machine learning tools.
“Clinical cognitive science is at a tipping point,” said Terry Sullivan, CMO of OnPointe. “It will be happening here in the next couple of years.”
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Want a better electronic health record system? Ask a doctor

May 17, 2017 12:35pm
Doctors have plenty of ideas for how to improve electronic health records.
Poorly designed electronic health records (EHRs) are the bane of many doctors’ existence.
They’re blamed for an increase in physician burnout and a decrease in physician satisfaction.
“If you were to start from scratch, you wouldn’t come up with the systems we have today,” Jesse M. Ehrenfeld, M.D., an associate professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University School of Medicine, told Medical Economics.
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For hospitals defending against cyberattacks, patch management remains a struggle

May 17, 2017 9:30am
The "overwhelming task" of patch management is exacerbated by a lack of cybersecurity professionals.
Cybersecurity experts were disturbed, but not necessarily surprised at the WannaCry ransomware attack that ripped through more than 150 countries over the weekend. Many had predicted an attack of this size and scope was an imminent threat for some time, and most were relieved that U.S. hospitals and systems were generally spared.
Two specific issues have bubbled to the surface in the wake of that attack, highlighting the gaps that still exist within the healthcare industry with even basic cybersecurity controls.
Workforce shortages and patch management—two issues that often go hand in hand—raised concerns about the industry’s ability to fight of future attacks that may be even more targeted. Some of these concerns are addressed in a report from the Department of Health and Human Services’ Cybersecurity Task Force, which is expected to be released next week.
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Wearable Devices, mHealth Apps Combine for Chronic Disease Care

A combination of wearable devices and mHealth apps may help patients engage with their chronic disease management needs.

Thomas Beaton

May 16, 2017 - A study published in the Journal of Medical Internet Research suggests the next step in chronic disease management could involve a combination of wearable devices and mHealth apps that focus on improving health conditions.
Patients with osteoarthritis (OA) in their knees that were given both an app and wearable device to monitor their activity saw a 55 percent decrease in pain based on a six-minute walking test (Group A). Comparatively, patients that only received a monitoring solution experienced a 33.8 percent decrease in pain (Group B).
The findings revealed that even though both groups of OA patients benefited from any mHealth tool, the patients that used a combination of the specialized app and monitoring experienced 22 percent less pain overall than the patients with just a monitoring device.
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Sutter Health, IBM Collaborate on Early Detection of Heart Failure Using EHR Data and AI

May 16, 2017
by Heather Landi
A team of scientists at IBM Research, in collaboration with scientists from Sacramento-based Sutter Health, recently completed research developing methods to help predict heart failure based on hidden clues in Electronic Health Records (EHRs). Over the last three years, using the latest advances in artificial intelligence (AI) like natural language processing, machine learning and big data analytics, the team trained models to help predict heart failure.
Today, doctors will typically document signs and symptoms of heart failure in the patient record and also order diagnostic tests that help indicate the possibility that a person may experience heart failure. Despite best efforts, a patient is usually diagnosed with heart failure after an acute event that involves a hospitalization where the disease has advanced with possibly irreversible and progressive organ damage.
According to a press release, the research uncovered important insights about the practical tradeoffs and types of data needed to train models, and developed possible new application methods that could allow future models to be more easily adopted by medical professionals. For example, the research showed that only six of the 28 original risk factors contained within the Framingham Heart Failure Signs and Symptoms (FHFSS) were consistently found to be predictors of a future diagnosis of heart failure.
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Physicians dream up a better EHR

May 22, 2017
When the American Medical Association (AMA) last year announced study results that found physicians spend nearly half their office day entering data into electronic health records (EHRs) and handling other administrative deskwork, the organization said poorly designed EHRs were part of the problem.
“If you were to start from scratch, you wouldn’t come up with the systems we have today,” said Jesse M. Ehrenfeld, MD, MPH, an associate professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University School of Medicine who was elected to the American Medical Association Board of Trustees in 2014.
The AMA developed a list of eight items it believes vendors need to improve or develop to make EHRs better for physicians and their staff.
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After WannaCry, experts worry healthcare’s vulnerabilities will make the next ransomware attack even worse

May 16, 2017 11:59am
Cybersecurity experts are worried that future ransomware attacks will prey on healthcare's vulnerabilities and disrupt patient care.
As industries across the globe recover from the WannaCry ransomware attack that hit more than 300,000 machines in 150 countries, cybersecurity experts are concerned that the next attack will be even more vicious and damaging. And healthcare providers with legacy systems and subpar defenses will inevitably end up in the crosshairs. 
In the immediate aftermath of Friday’s attack, government officials and healthcare cybersecurity experts stressed the importance of patching and updating legacy systems immediately.
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HIT Think Why interoperability will get worse before it gets better

Published May 16 2017, 4:21pm EDT
We hear the same thing from the health IT community every year: We’re committed to enabling seamless health data sharing. It’s the industry’s perennial commitment that electronic health records (EHRs) will soon share patient data across different platforms to ensure coordinated, high-quality care. Walls will come down in the name of better patient outcomes.
Unfortunately, none of this is going to happen any time soon. In fact, I predict our industry’s struggle with interoperability will get worse before it gets better. Here are three reasons why:
There are too many competing siloed solutions. There are many EHRs and other data analytic tools in the market, each with countless one-off solutions being built around their insular, proprietary systems. From supporting revenue cycle management to care coordination and virtual visits, these vendors are all vying to become the superior “Swiss Army Knife,” with little thought of integrating with other solution providers. Despite standardization initiatives—as this trend continues—the current health IT landscape is getting more, not less, fragmented.
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Why a national patient identifier may be closer to reality

Published May 16 2017, 4:07pm EDT
As healthcare is facing calls for improved interoperability, the long-time congressional stance opposing a unique patient identifier appears to be softening.
Congress is enabling the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services to work with the industry on patient ID and matching initiatives.
That stands in contrast to a long-time restriction by Congress, which, pushed by privacy advocates 18 years ago, forbid the Department of Health and Human Services from using any federal funds to develop, adopt or assign a unique health identifier for individuals.
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Tuesday, May 16, 2017

E-Health Files for 66m Iranians

A total of 590 hospitals have been connected to the national Electronic Health Record (EHR) system (abbreviated as ‘SEPAS’ in Persian), said Health Minister Hassan Qazizadeh Hashemi.
“Electronic health files have been created for 66 million people (82% of the population),” he was quoted as saying on the sidelines of the unveiling ceremony of electronic doctor’s signatures on Monday, ISNA reported.
Electronic health files or the EHR system is a prerequisite for the Health Ministry’s family physician project, and is projected to extend its coverage to 100% by September-end.
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Discharges in the ER go faster when doctors get lab results on their smartphones

May 12, 2017 4:46pm
Patients who came to the ER for chest pain spent 26 minutes less time waiting to be discharged when emergency physicians received lab results on their smartphone compared to when doctors waited for the results to appear in the EHR. (Getty/wmiami)
The long wait for lab results to determine whether they stay in the hospital or go home is often the most difficult part of an emergency visit for patients.
One way to reduce the waiting time may be to have emergency physicians receive lab results directly on their smartphones instead of via the electronic health record system, according to a recent study published in Annals of Emergency Medicine.
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Should hospitals pay up following a ransomware attack? The answer is far from simple

Apr 27, 2017 12:20pm
As cyberattackers target healthcare, hospitals are grappling with whether to pay the ransom.
As hospitals and health systems battle the growing threat of ransomware, CEOs are coming face-to-face with an increasingly tricky decision about whether to pay the ransom.
Each option is accompanied with its own baggage, former FBI agents and cybersecurity analysts told FierceHealthcare in exclusive interviews, which leaves health systems victimized by ransomware attacks facing a web of complexities and few desirable outcomes. Pay the ransom, and hospitals open themselves up to future attacks and help fund criminal enterprises or potentially feed money into overseas terrorist organizations. Refuse to pay, and the hospital loses access to vital IT systems that could compromise patient lives.
In a complex healthcare environment where patient care hangs in the balance, there are few easy answers. The decision a hospital makes depends on several factors, including which data or systems were compromised and how much hackers demand in ransom.
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Healthcare industry braces as experts predict second round of ransomware attacks

May 15, 2017 11:11am
Businesses and hospitals around the globe braced for more ransomware attacks this week. A U.S. official said on Monday that “for right now, we’ve got it under control.”
Cybersecurity experts warned that businesses around the world could face a second wave of ransomware attacks this week following Friday’s attack that infected more than 200,000 computers in 150 countries, including hospitals in Britain.
Officials with Europol, the European Union’s law enforcement agency, told The Guardian that businesses across the globe were likely to see a fresh round of attacks when employees returned to work on Monday. Copycat variants of the malware could also contribute another wave of attacks this week after a 22-year-old British researcher that goes by the name “MalwareTech” stumbled on a “kill switch” that slowed the spread of the initial virus.
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Workplace Factors Contribute to Burnout in Family Physicians

Diana Phillips
May 10, 2017
Family physicians who work in a hectic or chaotic environment, those who report high rates of job-related stress, and those who spend time at home working on electronic medical record (EMR) tasks may be particularly vulnerable to burnout, researchers report.
In a study designed to assess workplace factors associated with burnout among family physicians, Monee Rassolian, MD, from Michigan State University, Flint, and colleagues administered an abbreviated burnout survey to a random sample of family physicians applying to take the 2016 American Board of Family Medicine Certification Examination. They report their findings online May 8 in JAMA Internal Medicine.
Twenty-five percent of the final survey sample of 1752 physicians reported symptoms of burnout on the basis of the 10‑item Zero Burnout Program survey, also referred to as the Mini Z survey, developed from the Maslach Burnout Inventory. The Mini Z survey enables the assessment of burnout with a single item that correlates with the emotional exhaustion subscale of the Maslach Burnout Inventory.
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HIT Think Why WannaCry is a wakeup call for healthcare

Published May 15 2017, 4:32pm EDT
Avi Rubin, professor of computer science at The Johns Hopkins University and director of the school’s Health and Medical Security Lab, which was established with funding from the Office of the National Coordinator for Health Information Technology, has been closely following the WannaCry cyberattack. The prominent healthcare cybersecurity expert spoke today with Health Data Management on why providers are vulnerable and the steps they should take to protect themselves from future hacks.
HDM: The origins of the WannaCry ransomware was the U.S. National Security Agency, correct?
Rubin: It was a hacking tool leaked out with the Edward Snowden materials.
HDM: Is it fair to say that different variants of the NSA tool are now being propagated?
Rubin: People are creating the variants. I don’t think it is happening automatically.
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Email consultations becoming the norm

12 May, 2017 
British GPs are being encouraged by the NHS to reduce face-to-face consultations and opt for phone and email when practicable.
An online poll of 265 GP practice partners suggests that they have embraced this directive, with almost all reporting that they regularly do phone consultations and one in six saying they now carry out email consultations.
The NHS says the strategy behind the move is to “improve continuity and convenience for the patient and reduce clinical contact time”.
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Enjoy!
David.