This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
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 occasional highlights. Enjoy!
Taxpayers spent $1.7 billion on a health record doctors don’t use
Sue Dunlevy, National Health Reporter, News Corp Australia Network
January 18, 2018 10:44pm
Taxpayers have spent nearly $1.7 billion on an internet based My Health Record that doctors are refusing to use and which can’t be emailed or shared with digital health apps.
Every Australian will get a My Health Record in 2018 unless they opt out of the system but doctors are warning of major issues with its ease of use and fear patients don’t understand the privacy implications.
Five years after it was launched five million Australians have opted to set up a My Health Record.
However, fewer than one in twelve of Australia’s 31,000 medical specialists are registered to use the My Health Record and they still rely on GPs faxing them referral letters and patient information.
Release 9.2 of the My Health Record system is a technology release which will improve some functionality for both individuals and healthcare providers. There will be minor visible changes to the user experience, mainly to improve access on mobile devices.
Release 9.2 is scheduled to go live on Monday 22nd January 2018.
There will be a planned outage from 8pm Friday 19th January to 6am Saturday 20th January.
There is some notable user experience improvements for individuals (consumers) including an improved experience using mobile devices and streamlined information for clarity of understanding when navigating.
Leading Learning 4 All website questioned by peak disability groups
Emily Baker
Published: January 13 2018 - 12:00AM
Disability organisations have hit out at a $646,000 project funded and endorsed by the federal government that one expert says shows "quite horrifying" examples of how to include children with disability in the classroom.
More than 100 peak bodies, experts, teachers and parents have signed an unanswered open letter to federal Education Minister Simon Birmingham calling for a review of the Leading Learning 4 All website.
The page - described by Senator Birmingham as "fantastic" at its launch at Melrose High School last year - offers resources aimed at promoting the inclusion of children with disability in schools, including video clips filmed by teachers throughout Australia.
SA election: Liberals reveal policy to reduce prescription drug abuse through real-time monitoring
Posted 7:25pm Jan 19, 2018
Prescription drug abuse in SA would be targeted under a $7 million State Liberal election policy to combat the scourge of so-called "prescription shopping".
Announcing the policy today, the party said the current drug monitoring system in the state was too relaxed, citing figures from a national drugs report that showed almost 5 per cent of Australians misused pharmaceuticals.
Prescription shopping involves patients going to multiple doctors or pharmacists to get more drugs than they need in order to satisfy an addiction or make money by selling the drugs.
When Josh Simmons joined the Queensland health system as a physiotherapist in 2000, he had no idea about the drastic turn his career would take.
With 17 years experience in this vocation under his belt, Simmons was given the opportunity to wear a new hat: his official job title is now team leader of adoption services for the Metro South Hospital & Health Service.
The path to this new career was entirely accidental: Metro South was rolling out its integrated electronic medical record (ieMR) system at the Princess Alexandra Hospital in Brisbane, when the IT team charged with the rollout approached Simmons to help it get users on board.
In what may be the most comprehensive national effort of its kind, the Australian government has created more than 5.4 million electronic medical records and plans to offer EMRs to the country’s 24 million citizens by the end of 2018.
The records contain information about each individual’s serious illnesses, surgeries, prescribed medications, and family medical histories—information that can be critical to making correct diagnoses.
ADHA CEO Tim Kelsey says that the ability to share a patient’s health information with doctors already has improved care in Australia.
The ultimate objective of Australia’s “My Health Record” program, begun in 2015 and run by the Australian Digital Health Agency (ADHA), is to speed life-saving treatment to citizens anytime and anywhere they need it.
The power of My Health Record was driven home to Adelaide-based GP Dr Chris Moy in an incident where he had to review an unwell patient who had been discharged early from hospital from another state without any information about his condition or follow up.
I was able to find a discharge letter immediately on My Health Record which summarised his admission and required follow up. This was bonus information which I would not otherwise have had access to and it made a significant difference in improving his care.
My Health Record will not be an overnight sensation.
At present, it is very much in its infancy in terms of its benefit. People need to look at My Health Record with a long term view. This is when it will really bloom as a critical tool in improving patient care. It will only be in the future, as it evolves with increasing functions and usability, and more importantly, as the amount of health information about each patient and their history accrues over the years, that we will be able to look with hindsight at the value of My Health Record as an indispensable tool in the everyday care of patients.
Groundbreaking telehealth platform brings dermatology to far-flung Australia
Thea Cowie | 17 Jan 2018
An Australian telehealth dermatology service has been described as “five years in front of” anything else in its field at a recent global conference.
The Teledermatologist smartphone platform, developed by the team behind Newcastle Dermatology, offers same-day consultations for patients in rural and regional areas.
“At the World Congress of Teledermatology last year, the feedback from committee members was that our service is five years in front of anyone else in terms of the way we've done it and the platform we've used,” said Murray Corbett, who is CEO at Newcastle Dermatology and has dedicated much of the last two and a half years to developing Teledermatologist.
Launched a year ago, Microsoft HealthVault Insights applications are being discontinued. But Microsoft continues to work on the intersection of AI and healthcare.
While Microsoft is continuing to focus on the intersection of health technology and artificial intelligence, it is discontinuing one of its projects in this space.
In the note about the discontinuation, Microsoft officials described HealthVault Insights as "a research project... with the goal of helping patients generate new insights about their health." Sounds like that is right in Microsoft's analytics/health/machine learning wheelhouse.
Electronic claiming for Medicare benefits was first introduced in 1992. Channels to facilitate electronic claiming were progressively introduced for use by medical practitioners, members of the public and private health insurers over the intervening decades. In 2016–17, claims for just over 97 per cent of the approximately $22 billion of Medicare benefits paid were lodged electronically.
The Department of Human Services (Human Services or the department) currently administers eight electronic claiming channels: six provider channels for point of service claiming1 and two channels for claiming by patients at their convenience. In addition Human Services provides a number of manual claiming options (in-person, dropbox, post and phone). Most of the electronic claiming channels were introduced ten or more years ago—prior to Medicare’s integration into the Department of Human Services in July 2011.2 The provider channels are:
Simple Mail Transfer Protocol (1999);
Medicare Online (2002);
Electronic Claim Lodgement and Information Processing Service Environment (2004);
The conversation with my new registrar goes something like this: I deliver a lecture about the importance of good record-keeping and put on my medicolegal hat to tell her that the primary purpose of this is to ensure patient safety and continuity of care.
I explain that keeping adequate records is also critical to avoiding claims and complaints, and enabling her to justify her Medicare billings.
And she responds: “But you just told me I need to be focused on the patient and that communicating clearly with the patient is the key. So which is it?”
It is a fair question and one I’ve spent a bit of time thinking about.
I stand by both pieces of advice.
However, I recognise the challenges inherent in balancing the need to keep good records, without allowing the process of record-keeping to get in the way of the patient interaction.
It should come as no surprise that when key industry bodies write submissions to government consultations they're self-serving. That's what such lobby groups are for, right?
But in its submission to the current consultation on developing a national Digital Economy Strategy, the Australian Chamber of Commerce and Industry (ACCI) has gone beyond the usual bleatings about tax breaks, more "flexible" employment conditions, and a call for the the government to pay for the vocational training that businesses have long since stopped doing for themselves.
The ACCI wants more access to government data.
"Other governments, such as the United Kingdom and Canada, are ahead of the Australian government in terms of open data," the ACCI writes in its submission [PDF]
If the history of human advancement has taught us one thing it is that genuine step-change does not occur because of a single technology breakthrough, but a combination of complimentary factors coming together at the same time.
This couldn’t be truer than when it comes to artificial intelligence (AI), the oft hyped technology of 2017 which is set to become the reality of 2018 and beyond.
While AI has been around for more than 65 years, it is only with the convergence of three important factors that we will see AI move from concept to an increasingly ubiquitous reality in the year ahead.
Estimation, resource management and KPIs are just a few of the key areas where machine learning and predictive analytics can have a positive impact on project outcomes.
From software development to construction to logistics and finance, every company has projects that need planning, managing and monitoring. But the tools we use to do that are often complex, designed for specialists and don’t do as much as they could to warn about potential problems. Could AI-powered decision support systems and automation make more of your projects successful by reducing costs and mistakes, analyzing risks, making things more efficient or keeping things on time and on budget?
Here is an early look at how artificial intelligence, machine learning and predictive analytics could affect project outcomes in the years to come.
AI's grades are improving but computers still can't read between the lines
Drew Harwell
Published: January 17 2018 - 3:39PM
When computer models designed by tech giants Alibaba and Microsoft this month surpassed humans for the first time in a reading and comprehension test, both companies celebrated the success as a historic milestone.
Luo Si, the chief scientist for natural-language processing at Alibaba's artificial intelligence research unit, struck a poetic note, saying, "Objective questions such as 'what causes rain' can now be answered with high accuracy by machines."
Teaching a computer to read has for decades been one of artificial intelligence's holiest grails, and the feat seemed to signal a coming future in which AI could understand words and process meaning with the same fluidity humans take for granted every day.
With up to 50 per cent of people with chronic medical conditions failing to take their medication regularly, the NSW Government is backing new technology that aims to encourage people to stick to their medication plan using games and rewards.
Sydney startup Perx received a $25,000 Minimum Viable Product grant from Jobs for NSW to develop its technology and the company is now trialling commercially with a $100,000 Building Partnerships grant.
Perx co-founder Hugo Rourke said the World Health Organisation estimates that 1 in 3 people in OECD countries have a chronic condition and up to half don't take medication as prescribed.
Australian hospital sees big potential in app for expectant mothers
Staff writer | 15 Jan 2018
A Melbourne private hospital is trialling software developed in-house aimed at improving the pregnancy and birthing experience of expectant mothers, by offering a single, all-inclusive pregnancy resource.
Cabrini Health is currently piloting Eve at its Malvern campus and Andrea Rindt, Nurse Director Women and Children, said the goal was to ensure that mothers-to-be had seamless communication with the maternity unit and a single source of evidence-based information.
“Eve addresses the issue of information overload faced by many first-time mums and provides them with a means of contacting the birth suite at their hospital with the click of a button,” she said.
Australia's Notifiable Data Breaches scheme will come into force next month. Here is what it means and how it will affect organisations, and individuals, in Australia.
Australia's Notifiable Data Breaches (NDB) scheme comes into effect on February 22, 2018, and as the legislative direction is aimed at protecting the individual, there's a lot of responsibility on each organisation to secure the data it holds.
The NDB scheme falls under Part IIIC of the Australian Privacy Act 1988 and establishes requirements for entities in responding to data breaches.
What that means is all agencies and organisations in Australia that are covered by the Privacy Act will be required to notify individuals whose personal information is involved in a data breach that is likely to result in "serious harm", as soon as practicable after becoming aware of a breach.
Truth about NBN is that Australians do not want to pay for internet speed they do not need
Mitch Fifield
Published: January 17 2018 - 5:03PM
When Australians are given the choice between the fastest broadband speeds available or more affordable broadband that meets their needs, what are they choosing?
Overwhelmingly, they are voting with their wallets and choosing more affordable internet plans that deliver the services they are after.
But if you listen to Labor's hyperbole on the NBN, you could be mistaken for thinking that Australians are being left wanting for faster broadband speeds – when the evidence clearly shows that when such speeds are available, the vast majority of Australians are not prepared to pay for them.
NBN admits three in four FTTN customers won't get top speeds
Jennifer Duke
Published: January 17 2018 - 9:24AM
The National Broadband Network has admitted only one in four customers connecting through the most controversial technology in the mix will access its much-touted top speeds.
The disclosure, to a parliamentary committee, comes as pressure is mounting for the government to write down the value of the multi-billion dollar project as it struggles to deliver the service that would underpin its financial worth and the taxpayer investment in it.
What the NBN response shows is that when the rollout concludes in 2020, three out of four fibre-to-the-node (FTTN) customers are not expected to be able to access its fastest download speeds, of 100 Mbps.
The government has rejected a parliamentary inquiry’s recommendation that NBN be directed to complete as much as possible of the remaining fixed-line portion of the National Broadband Network using fibre to the curb (FTTC) or fibre to the premises (FTTP).
The government’s said that it “remains committed to the Multi Technology Mix” which it said “well see the roll out of fast broadband as soon as possible, at affordable prices and at least cost to tax payers”.
NBN ready to disconnect landlines to one million homes and businesses
The Australian
12:00AM January 15, 2018
Anthony Klan
Landline phone networks servicing almost one million homes and businesses will be permanently decommissioned in the next six months, with 313,000 formal disconnections next month as the National Broadband Network enters its peak switchover phase.
According to the NBN, 926,235 premises will face “formal disconnections” in the six months to June, with the average rate of formal disconnections continuing to grow, to average about 50,000 a week from mid-year.
Under the terms of the NBN, existing phone networks are to be disconnected 18 months after the NBN is made available in an area, with the approaching surge reflecting the beginning of “peak rollout” of the NBN between 12 and 18 months ago.
A write-down of the national broadband network is now firmly on the cards after the competition watchdog joined the chorus supporting it, according to telecommunications analyst Paul Budde.
In a blog post published on Sunday, he said that since Prime Minister Malcolm Turnbull had not introduced essential structural changes after the 2016 election, it had become obvious that the value of the network would have to be cut by half.
While the government did not welcome this reality, many others, including the ACCC, had now joined the call for a write-down, Budde said.
Scientists have created a blood test that can detect eight of the most common cancers long before they turn lethal, in a breakthrough that could save millions of people from premature death.
The “liquid biopsy” identifies early-stage tumours from proteins and genetic mutations circulating in the blood.
Trials have found that it can uncover fledgling cancers in about 70 per cent of cases, and up to 98 per cent for some types, long before they become detectable by other means. They include deadly conditions such as pancreatic cancer, which usually goes unnoticed until it has spread. The goal is to spot tumours before that happens, when survival rates are still high.
Dubbed CancerSEEK, the test delivers almost no false positives, sparing patients needless heartache and unnecessary medical procedures for non-existent diseases. It can also pinpoint tumours’ locations in about five cases out of six, paving the way for rapid treatment.
Astronomers probe source of mysterious, powerful radio signal from beyond our galaxy
Liam Mannix
Published: January 12 2018 - 5:04PM
Fast radio bursts beaming from beyond our galaxy, are astonishingly powerful, and nobody knows what – or who – is making them.
Now an international team of astronomers, including Australian scientists, have made a discovery that could start to unravel the mystery.
In a cover story published in Nature on Thursday, they report the bursts are coming from one of the most extreme and unusual objects ever seen – possibly a tiny but powerful star trapped in a field of ionised gas that has been spun off by a nebula, or been ejected from a supernova.
Sue Dunlevy, National Health Reporter, News Corp Australia Network
January 18, 2018 10:44pm
Taxpayers have spent nearly $1.7 billion on an internet based My Health Record that doctors are refusing to use and which can’t be emailed or shared with digital health apps.
Every Australian will get a My Health Record in 2018 unless they opt out of the system but doctors are warning of major issues with its ease of use and fear patients don’t understand the privacy implications.
Five years after it was launched five million Australians have opted to set up a My Health Record.
However, fewer than one in twelve of Australia’s 31,000 medical specialists are registered to use the My Health Record and they still rely on GPs faxing them referral letters and patient information.
For the records to be useful, GPs have to upload a summary of a patient’s health condition, but this has happened in fewer than one in four cases.
The government has offered incentive payments to upload these summaries, but 1,440 GP practices had to repay this cash because they failed to meet the criteria.
Dr Rob Hosking the deputy chair of the Royal Australian College of General Practitioners e-health committee supports the concept of a digital record but he questions who uses it.
“None of the hospitals my patients attend have access to the My Health Record,” he says.
None of the specialists he sends his patients to use the record either and he has to use a separate private secure messaging service to communicate with specialists because he can’t do it through the My Health Record, he says.
“It’s quicker to pick up the phone and call the pharmacists to find out what medicines the patient is on because the (My Health Record) user interface is difficult to use,” he said.
If doctors do put a shared health summary on a patient’s record there is no incentive or even reminder to update it if a new medicine is prescribed or if the patient develops a new health condition which means it could be out of date, Dr Hosking says.
The Australian Medical Association has also warned in its budget submission the record is plagued with problems.
“Problems uploading specialists’ letters, poor search functionality, time-consuming adaptations to existing medical practitioner work practices, or inappropriate workarounds will erode clinical utility and deter doctor use — and, more importantly, take time away from focusing on the patient,” the submission says.
The problems with the record will reach a critical mass this year as the government switches from an opt in system and sets up a digital My Health Record for every Australian unless they opt out.
The Australian Digital Health Agency says there will be no television, radio or print advertising campaign to make Australians aware of the fact they are getting a digital health record or how they can opt out, instead patients will learn about it from social media and posters in doctor’s offices.
The AMA has told the government in its budget submission that doctors don’t have the time to educate the public about the new record.
“Doctors do not have time to talk their patients through the My Health Record arrangements for opt-out, privacy, setting access controls in standing consent for health providers to upload health information. This is the work of the government. Doctors must be allowed to focus on what they do best — caring for patients,” the submission says.
“Some Australians will be surprised to learn that a My Health Record has been created for them without their explicit consent,” the AMA says.
I have seen e-mails from the ADHA claiming this reports are inaccurate but I can see nothing here that is in any way in error or unfair.
To me there seems to be some serious clinician dissatisfaction with the way the myHR is going and to them the apparent uselessness of the system contrasted with the rather large cost. This is despite the Memorandums these organisations have signed with the ADHA and Government on usage etc.
How Long Do You Think It Will Be Before The ADHA Quietly Allows The myHR To Be Abandoned Or Otherwise Downplayed?
Six Months 3% (4)
A Year 8% (11)
A Couple Of Years 12% (16)
Five Years 58% (80)
It Will Be A Success And Never Abandoned 11% (15)
I Have No Idea 9% (13)
Total votes: 139
Any insights welcome as a comment, as usual.
It seems that most think that the death of the myHR will be a long and drawn out process, but ultimately inevitable, with only 20% of respondents not knowing if it will be a success or believing it will be an ultimate success.
A really great turnout of votes!
It must have been a hard question with 9% not sure what the correct answer was.
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.
What is Intel doing in the area of artificial intelligence/machine learning?
Artificial intelligence is causing a technological revolution. Intel recognizes the power AI has to transform society and industries. We are committed to democratizing AI and machine-learning innovations so that everyone has the opportunity to benefit. To that end, we’ve been doing a number of things:
• Understanding the importance of integrating hardware and software advances to create AI experiences, we have invested in acquiring companies that are innovating around the hardware and the software driving intelligent applications – companies such as Nervana, Saffron, Movidius and Mobileye.
• We launched an AI products group that offers a broad palette of AI technologies to meet diverse needs. This group focuses on solutions that make it easy to incorporate custom AI solutions into existing infrastructure. These solutions let us create intelligent ecosystems that seamlessly connect applications and devices across the spectrum, allowing people and businesses to make better use of audio, video and text wherever they are.
After what was widely viewed as a groundbreaking year for digital health oversight, the Food and Drug Administration plans to maintain its focus on easing the pathway for innovative technology and devices.
Advancing digital health is one of several priorities for FDA in the coming year, according to a 2018 Strategic Policy Roadmap released (PDF) by the agency on Thursday that identified four priority areas “that will be the focus of additional policy activity in 2018.”
In particular, the FDA plans to publish finalized guidance clarifying when digital health technology falls under the FDA’s regulatory purview and when the agency plans to exercise enforcement discretion. Unsurprisingly, the agency also plans to advance its software precriticization program after launching a pilot program in September involving nine companies including Apple and Fitbit.
4 Ways IBM Watson's Artificial Intelligence Is Changing Healthcare
Future, shmuture. IBM's presentation at the J. P. Morgan Healthcare Conference showed that artificial intelligence is changing healthcare today.
Keith Speights
Jan 12, 2018 at 6:04AM
Some say that artificial intelligence (AI) will radically change healthcare in the future. And they're right. But that prediction overlooks an important detail: AI is already significantly changing healthcare.
IBM(NYSE:IBM) Watson Health general manager Deborah DiSanzo spoke at the annual J. P. Morgan Healthcare Conference on Wednesday. She provided an update on the progress that IBM Watson, the AI system famous for beating Jeopardy! game show champions several years ago, is making in improving healthcare. DiSanzo highlighted four areas where AI is making a big difference today.
Nurses are on the front line of care, and as inpatients' conditions become more complex and time-intensive, these clinicians need more help. Unfortunately, many believe that the documentation and record-keeping requirements of electronic health records systems don't help make their jobs easier.
Pushback against EHRs, then, is to be expected. However, healthcare organizations can make better use of the tools within integrated EHR systems to help nurses become more efficient.
Here are some of the key capabilities of EHR systems that can provide time gains, and operational improvements, for nurses.
President Trump has signed an executive order directing federal agencies to “use all viable tools” to accelerate the deployment and adoption of high-speed broadband connectivity in rural parts of the country, a directive that’s expected to offer a boost to healthcare facilities.
“Americans need access to reliable, affordable broadband internet service to succeed in today's information-driven global economy,” states the executive order published today in the Federal Register. “Currently, too many American citizens and businesses still lack access to this basic tool of modern economic connectivity.”
This lack of access to high-speed Internet services in rural America hinders the ability of communities to “extend the reach of affordable, high-quality healthcare,” according to the order. By increasing rural provider access to modern broadband internet service, the Trump administration hopes to overcome some of the hurdles to healthcare delivery in these isolated and underserved communities by enabling clinicians to leverage broadband-enabled health technologies.
As the new chief privacy officer at the Office of the National Coordinator for Health IT, Kathryn Marchesini will confront an entirely new set of health IT privacy challenges, a growing number of industry players that fall outside HIPAA's purview and legislative mandates under the 21st Century Cures Act.
And she’ll have to do it with a potentially nonexistent privacy budget.
Three months after ONC’s former chief privacy officer Deven McGraw left the Department of Health and Human Services, the agency is handing the position to Marchesini, a seasoned privacy veteran with experience at several agencies within HHS, to navigate those privacy and security concerns.
Patients, Providers Need to Discuss E-Comm, Researchers Say
January 10, 2018
by Rajiv Leventhal
The relationship that a clinician has with a patient may have a greater impact on patient satisfaction than any technology that used to interact with one another, according to new research.
A new study led by Joy L. Lee, Ph.D., of the Regenstrief Institute's Center for Health Services Research compares these ways to communicate, compared how patients and their healthcare providers communicate with one another outside the clinic or doctor's office, specifically looking at how patients and their physicians feel about email, cell phone and text interactions.
The study, published in the European Journal for Person Centered Healthcare, also looked into provider concerns, finding that physicians worried most about patients potentially missing urgent messages, as well as possible patient misunderstanding of information contained in electronic messages. Clinicians were also concerned about the amount of time they spent on electronic communication with patients, and about data security, although both ranked lower.
According to the Centers for Disease Control, social determinants of health have a profound impact on health outcomes – much more, in fact, than the actual delivery of healthcare services.
The health of people and communities is heavily influenced by such factors as socioeconomic status, education, social network support, access to care, access to transportation and employment. Therefore, organizations that are committed to improving the health of populations should not overlook the social and economic conditions impacting the well-being of individual members.
Healthcare is continuing to shift from fee-for-service payment models to models that reward providers for delivering high-quality, cost-effective care. To achieve clinical and financial success in a value-based care world, providers need deep insights into the health of their patient populations.
Among patients who were transferred to other hospitals, the length-of-stay at the emergency room in the first hospital was shorter for patients who had telemedicine consults.
Emergency department patients at rural hospitals using telemedicine see a clinician six minutes sooner than patients in hospitals that have no such technology, a new study from University of Iowa shows.
And if that first clinician assessment is through a telemedicine encounter, as was the case 42% of the interactions examined in the study, the door-to-provider time is shortened by nearly 15 minutes, says study lead author Nicholas Mohr, MD, an emergency physician and associate professor at the Carver College of Medicine at the University of Iowa.
The nonprofit is asking Health IT to define the elements used in application programming interfaces and consider adding information from medical devices, genomic data and social determinants.
The Office of the National Coordinator for Health IT should expand data available to patients and providers via APIs, going beyond common clinical data sets, Pew Charitable Trusts Manager of Health Information Technology Ben Moscovitch told ONC Chief Donald Rucker, MD, in a letter.
To Moscovitch, while CCDs contain key information on patient medical histories like allergies and medication, they omit essential data relevant to care.
Under the 21st Century Cures Act, the ONC is required to support API development to help health systems share more patient data with other networks. However, it fails to explain what information should be included.
Add one more to the growing list of healthcare providers moving their EHRs into the cloud. Coastal Orthopedics in Conway, South Carolina, consolidated its legacy electronic health records and practice management systems into the cloud and is seeing tangible results already.
Hospitals of various sizes, including University of California San Diego and UC Irvine Health just this month, have opted for cloud-based EHRs recently. On the smaller end of the provider scale, Lost Rivers Medical Center in Arco, Idaho, and Faith Community Hospital in Jacksboro, Texas, have also moved their EHR and related software into the cloud.
While UCSD and UC Irvine Health are running Epic’s EHR in a private cloud on the vendor’s campus, Coastal Orthopedics went with athenahealth.
Survey: 16 Percent of Ambulatory Physicians Looking to Replace EHR Vendor
January 9, 2018
by Heather Landi
It is widely known that many physicians are dissatisfied with their electronic health record (EHR) system and a new survey examines EHR satisfaction according to physicians. The survey found that 11 percent of physicians working in acute facilities and 16 percent of physicians working in ambulatory facilities are looking to replace their vendor.
Reaction Data, an American For,k Utah-based firm that provides Research as a Service, conducted an EHR satisfaction survey with feedback from close to 900 physicians. Reaction Data’s research report, based on survey results from 889 physicians across many specialties, also drills down into the 10 most used EHR companies and indicates those vendors’ acute and ambulatory user rates, average facility bed count, average facility revenue and facility type.
The survey reflects the opinions of physicians in numerous specialties—21 percent are pediatricians, 12 percent specialize in internal medicine, 11 percent specialize in anesthesiology, and the remaining cited specialties such as psychiatry, emergency medicine, orthopedic surgery, family medicine, neurology, urology and endocrinology.
Key themes for CIOs for 2018 include many of the same themes seen at the beginning of 2017, but with differing priorities. For example, the significance of agile development has been known for decades, but others in the organization, including fellow C-suite executives, have only just begun to realize its importance to the bottom line. Agility moves up this year in importance for CIOs and CEOs alike, as demands for speed and productivity continue to drive agility and innovation in both software development and business operations.
As IT departments will continue to have to do more with less, CIOs are shifting priorities, focusing more on the digital ecosystem to meet demands for connected lifestyles. Budget constraints have driven IT departments to innovation, despite slowing the market a bit, and to finding ways to accomplish what needs to be accomplished in the leanest, most cost-effective ways possible. Behind every great business though, are great customers, and so as part of cost-saving ways to meet customer needs and bring products and services to market faster, increased customer interaction tops this year’s list of four key themes for CIOs in 2018.
Brent Shafer will take the helm at healthcare IT giant Cerner on February 1, the company announced today. He will also lead the board of directors as chairman.
Formerly, Shafer served as CEO of Philips North America. Over 12 years, he played a key role in helping Philips develop and strengthen its healthcare focus, increase its profitability and grow its market share, Cerner officials noted in announcing the move.
At Philips North America, Shafer oversaw the largest market of global technology, a portfolio that includes a wide range of solutions and services covering patient monitoring, imaging, clinical informatics, sleep and respiratory care as well as a group of market-leading consumer-oriented brands.
The University of Rochester Medical Center has partnered with the Rochester City School District to ensure that students with asthma receive the appropriate medication therapy through a telemedicine approach that enables visits from the children’s primary care providers to aid in-school nurses.
“We know that asthma is a significant problem particularly for kids living in the city in terms of causing ongoing symptoms, missed school days and emergency visits,” says Jill Halterman, MD, chief of the Division of General Pediatrics at URMC. “We also know that a lot of kids aren’t getting medications that might have prevented these symptoms.”
In a study, URMC and researchers from Johns Hopkins School of Medicine and University of Arkansas for Medical Sciences enrolled 400 students between the ages of 3 and 10 in Rochester, N.Y., to measure the impact of a school-based intervention—including supervised asthma therapy and telemedicine visits—on urban children with asthma.
The healthcare industry is making a push for true interoperability that would offer the seamless exchange of healthcare information among clinicians, administrators, patients and other stakeholders.
While various standards and organizations exist to promote data exchange—known by an alphabet soup of acronyms, including HL7, FHIR, DICOM, NCPDP, IEEE and LOINC, among others—physicians still struggle, particularly impeded by a barrage of free text and PDF files that must be manually entered into the electronic health record system, says Dave Lareau, CEO at Medicomp.
Too often, data in various file formats is not actionable, Lareau contends. “It’s up to the recipient to sort through the data sent and find the data they care about for the patient in front of them.”
Healthcare’s IT challenges are numerous and widely known—there are multiple issues with interoperability, exploding quantities of data, security and usability, just to name a few.
To date, health IT largely has been the domain of specialized vendors whose names—Epic, Cerner, Allscripts, and Meditech, among others—are familiar primarily to providers and others in the healthcare IT industry.
But now, global technology giants such as Google, Apple and Amazon are either announcing or at least hinting at plans to enter the market. With the best of the best in the IT world joining the fray, optimism typically rises that vexing problems, such as interoperability and usability, will be solved in the near future.
Meaningful use mandates for electronic health records under the HITECH Act have largely been met, or at least initiated, by most payers and providers, which means that software vendors will have a smaller customer base, and less room to grow.
The widespread adoption of electronic health records by payers and providers in recent years means fewer customers for software vendors, and that could lead to significant consolidation within the EHR sector, according to a report by Standard & Poor’s Global Ratings.
"The high degree of penetration, and the resultant decline in the new customer base, has spurred industry consolidation as leading participants seek new avenues for revenue growth, including enhanced features and capabilities to existing products," S&P analyst Sarah Kahn said.
A new report from Aon's security experts predicts more and different cyberattacks, and highlights the pressing need for healthcare organizations to change some of their approaches.
Some organizations have been implementing new methods of authentication beyond passwords - from facial recognition to fingerprints.
Ramped-up attacks on the healthcare Internet of Things. More success with cracking passwords and biometrics. Increased risk from insider attacks. A heightened need for chief risk officers. This is what 2018 will look like on the cybersecurity front, according to professional services firm Aon's industry specialists in its new 2018 Cybersecurity Predictions report.
"In 2018, we anticipate heightened cyber exposure due to a convergence of three trends: first, companies' increasing reliance on technology; second, regulators' intensified focus on protecting consumer data; and third, the rising value of non-physical assets," said Jason Hogg, CEO of Aon Cyber Solutions.
Digital Health Year in Review: 2017 Trends and Looking Ahead to 2018
Tuesday, January 9, 2018
Introduction
Throughout 2017, the health care and life science industries experienced a widespread proliferation of digital health innovation that presents challenges to traditional notions of health care delivery and payment as well as product research, development and commercialization for both long-standing and new stakeholders. At the same time, lawmakers and regulators made meaningful progress toward modernizing the existing legal framework in a way that will both adequately protect patients and consumers and support and encourage continued innovation, but their efforts have not kept pace with what has become the light speed of innovation. As a result, some obstacles, misalignment and ambiguity remain.
Privacy and Cybersecurity
Cybersecurity continues to be one of today’s most material and pervasive enterprise risks, and is faced by all stakeholders who are active in the digital health ecosystem. That risk will continue to escalate with the rapid demand for and proliferation of collaborations and other initiatives to promote patient and consumer engagement through digital health mobile wellness and disease management apps that collect unstructured, identifiable health care and personal information from providers, patients, consumers and others. In this context, even a minor or inadvertent violation of the law could result in significant fines and penalties, reputational harm and loss of user trust. Management of this risk demands relentless diligence in identifying and assessing risks under applicable federal and state laws and establishing, maintaining, assessing and improving privacy and cybersecurity compliance and risk management programs that include, among other things, a thorough and well-tested cybersecurity breach or cyberattack preparedness response plan.
January 08, 2018 - The National Health Information Sharing and Analysis Center’s (NH-ISAC) Threat Intelligence Committee released a cybersecurity warning last week urging entities to be aware of two potential vulnerabilities.
Researchers determined that Meltdown and Spectre could circumvent certain protections and expose “nearly any data the computer processes, such as passwords, proprietary information, or encrypted communications.”
“Meltdown affects Intel processors, and works by breaking through the barrier that prevents applications from accessing arbitrary locations in kernel memory,” stated the warning, which AHA posted on its website. “Segregating and protecting memory spaces prevents applications from accidentally interfering with one another’s data, or malicious software from being able to see and modify it at will. Meltdown makes this fundamental process fundamentally unreliable.”
Report: Ransomware Attacks Against Healthcare Orgs Increased 89 Percent in 2017
January 8, 2018
by Heather Landi
The number of reported major IT/hacking events attributed to ransomware by health care institutions increased by 89 percent from 2016 to 2017, according to cyber defense firm Cryptonite’s 2017 Healthcare Cyber Research Report, which used data reported to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR).
The research conducted by Rockville, Md.-based Cryptonite looks at healthcare cyber attack activity last year and finds that 2017 was a very challenging year for healthcare institutions as these organizations remain under sustained attack by cyber attackers that continue to target their networks through the use of well understood vulnerabilities. According to the report, there were a total of 140 data breach events characterized and reported to HHS OCR as IT/hacking in 2017, representing an almost 24 percent increase over the 113 IT/hacking events reported in 2016. For an historical view, there were 57 reports for IT/hacking in 2015 and 35 reports in 2014.
Kaiser's 'Pit Crew' Treats 87% of Stroke Patients in 60 Minutes or Less
Alexandra Wilson Pecci, January 9, 2018
Kaiser Permanente's coordinated telemedicine response workflow slashes ‘door-to-needle’ time for stroke patients.
Telemedicine is at the heart of a complete workflow redesign of the way stroke alerts are handled across Kaiser Permanente's 21 Northern California hospitals, resulting in new stroke patients being treated twice as fast as the national average, according to a study.
American Heart Association and American Stroke Association guidelines recommend a "door-to-needle" time of 60 minutes or less for administering intravenous r-tPA, also known as alteplase, a drug that dissolves the stroke-causing clot and restores blood flow to the brain.
A study in the journal Stroke compared door-to-needle times for six months before implementation of the telemedicine program to a six-month calendar period after implementation. It showed that across the 21 hospitals, the average treatment time for intravenous r-tPA was 34 minutes. The study also showed that:
87% of stroke patients were treated in 60 minutes or less
A new company formed out of an incubator backed by the American Medical Association hopes to build a network as a service platform that will use blockchain technology to move healthcare information.
Akiri, based in San Francisco, is working on using information technology to develop its platform to securely share information with participants, using the capabilities of blockchain to build a network of trusted partners to exchange data.
Blockchain is a distributed ledger technology implemented in a decentralized manner used to record transactions.
Nearly three months after losing its chief privacy officer, the Office of the National Coordinator for Health IT says it is actively looking for a replacement in order to comply with a legislative mandate that requires the federal agency to fill the leadership position.
But ONC also finds itself at a crossroads, facing a potentially slimmer budget along with new privacy considerations that have evolved over the past decade, according to several privacy experts and former government officials who spoke with FierceHealthcare.
Some, like former chief privacy officer Deven McGraw, said the agency could replace the position with ongoing collaboration with OCR, while others said the agency would benefit from a "seasoned" leader who can navigate new data privacy concerns associated with mobile devices, precision medicine and consumer access.
Allscripts announced it will purchase EHR vendor Practice Fusion for $100 million, expanding its portfolio of solutions geared toward small physician practices and ambulatory clinics.
The acquisition was announced in an SEC filing on Friday. Allscripts expects to complete the transaction by the end of the first quarter following a waiting period required under antitrust laws. The filing also hints at a civil investigation into Practice Fusion’s EHR certification.
The deal comes on heels of Allscripts’ $185 million acquisition of McKesson’s health IT portfolio, including Paragon, which is geared towards the small hospital market. Practice Fusion, which is used by 30,000 ambulatory practices, expands Allscripts’ focus on ambulatory care provider and physician practices.
The Strategic Health Information Exchange Collaborative announced a nationwide expansion of what it calls the Patient Centered Data Home.
Essentially, PCDH is an inter-HIE data sharing system and notification that allows patients' records to follow them wherever they seek care, nationwide – enabling easier access to their records, even if they present at a hospital or clinic that's not a part of the HIE in which their local providers participate.
The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology released the much anticipated Trusted Exchange Framework to bolster its interoperability work as required by the 21st Century Cures Act.
“This is really a network of networks concept,” ONC head Donald Rucker, MD, said during a press call Friday.
The proposed framework establishes a set of minimum requirements and conditions for a trusted exchange and attempts to streamline patient data access and exchange provisions set out in the 21st Century Cures Act.
Education is key to getting patients to share electronic medical records
By making patients more aware of existing privacy policies and security measures, healthcare providers create an environment where patients are more likely to share.
Education is the key to getting patients to share their medical records electronically with healthcare providers, according to a new study from the University at Buffalo School of Management.
Published in the Journal of Medical Internet Research, the study found that while patient education has typically focused on the benefits of electronic records, privacy concerns are what keep most from signing up.
That dynamic has the potential to make things complicated. When a patient decides not to share their records in that manner, costs can often increase, the study found. Medical errors and poorer health outcomes are also more common.
January 05, 2018 - ONC recently announced the release of its Trusted Exchange Framework and Common Agreement draft intended to advance health data exchange and interoperability.
“This is really the network of networks concept,” said National Coordinator for Health IT Don Rucker, MD, in an ONC media call.
The proposed framework is designed to streamline patient health data access and exchange per provisions of the 21st Century Cures Act. ONC has been working to develop the framework and common agreement since the summer of 2017 through a series of stakeholder meetings.
The first major phase of Berkshire’s shared care record
initiative has gone live across 18 health and social care organisations.
New computer system Connected Care brings together key
health and care patient information, building on Graphnet’s CareCentric shared
record software. The shared care record programme has been dubbed Share Your Care.
The first phase of the system enables the sharing of
information across two different Sustainability and Transformation Partnerships
(STPs), covering 98 GP practices, 18 health and social care organisations
including Royal Berkshire NHS Foundation Trust and Berkshire Healthcare NHS
Foundation Trust, and two local authorities.
Many hospitals will have two systems at the core of their IT
through nothing other than pure legacy. The first is a Patient Administration
System (PAS) that largely came about to collect the NHS data model that arose
out of the work of Edith Körner in the 1980s.
They will also have a pathology system that arose out of the
fact that labs had analysers that were connectable and a naturally technically
able workforce who wanted to join it up.
Both of these systems have in fact outgrown themselves for
similar reasons. When people are doing things they look in the toolbox and see
what they have. There’s a well known saying on this: if your tool is a hammer
then every problem is a nail.
