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, July 08, 2018

I Don’t Think Traditional Community Pharmacy Will Escape Digital Disruption And Patients Will Benefit I Believe.

This appeared yesterday.

Dispensing disruption: Are pharmacies ready for digital rivals?

By Nassim Khadem, Patrick Hatch
7 July 2018 — 12:05am
When Amazon announced its purchase last week of online pharmacy PillPack, which packages and delivers pre-sorted doses of prescribed drugs direct to consumers’ homes, major US-based pharmacies from CVS Health to Walgreens saw their share prices fall about 10 per cent.
It was Amazon’s play at a slice of the United States’ booming prescription drug market that in 2016 totalled $US328.6 billion ($443 billion).
It was also, possibly, a crystal ball into Australia’s destiny.
In an age when everything from a box of fresh vegetables to someone who will help assemble your Ikea furniture can arrive on your doorstep within hours after a few taps on a smartphone, how long will people continue to line up in pharmacies waiting for their medicine to be dispensed?
If and how soon an online giant might seek to take a slice out of the retail pharmacy market, and what kind of model they decide to operate, is unknown. There’s no sign Amazon has such designs here yet.
But the prospect has existing players worried their declining share of Australia’s $16 billion pharmacy market will fall further.
“In a perfect world we’d be partnering with those sorts of people,” Sigma chief executive Mark Hooper says.
Sigma is one of Australia’s major pharmaceutical wholesaler and distribution businesses. Its brands include Amcal, Chemist King, Discount Drug Stores, Guardian and PharmaSave.
On Monday it announced negotiations for a five-year contract with Chemist Warehouse had failed, allowing a competitor – EBOS Group – to move in and try and secure a deal with the private operator.
“The worst thing I could do is pretend they [Amazon] are not going to have an impact and ignore [the threat],” Hooper says.
Hooper says if Amazon does move into pharmaceuticals – and for now he thinks the online giant has other priorities – Sigma has the infrastructure to ensure prompt delivery to peoples’ homes.
“I’m trying to look for ways of working with new market entrants than trying to fight them,” he says, adding Sigma has reached out to Amazon “but there’s been no detailed discussions”.
“I need to make sure that I have a strategy that copes with them coming in as a possibility.”
The industry has already undergone heavy disruption due to government reforms as well as increased competition from discount pharmacy chains, despite long-held rules that restrict the number of pharmacies that can be owned in certain locations.

PBS hurdles

The entry of new corporate players, including private hospitals operator Ramsay Health Care, is also intensifying competition.
To survive, mergers have been on the rise. Under EBOS, Terry White Chemists merged with Chemmart in 2016 and now operates about 500 pharmacies across the country.
As the chains aim for scale, the number of independent pharmacies continue to decline.
But Hooper says it is reforms to Pharmaceutical Benefits Scheme (PBS) - the government scheme that subsidises the cost of drugs for all Australians – that has had the biggest impact on wholesalers like Sigma over the past decade.
He says while government reform of PBS was needed, it has squeezed wholesale margins.
IBIS World forecasts pharmacy industry revenue will grow at an annualised 1.1 per cent over the five years through 2022-23, to $17 billion, mainly due to demand for drugs from Australia’s ageing population.
Increasingly, pharmacies have moved away from relying on prescribed drug sales to providing community health services such as flu vaccines and health checks like blood tests and diabetes tests.
Some GPs are unhappy saying it is not the job of a pharmacist to provide health services, but the federal government, as part of the Sixth Community Pharmacy Agreement (6CPA) with the Pharmacy Guild, allocated $600 million from July 2017 to allow pharmacies to offer new community pharmacy services.
Marc Clavin who operates an Amcal chemist in Sorrento, Victoria, has worked as a pharmacist for more than 35 years. “The reality is we are retailers in the high street and to afford the high rents we need to take retail opportunities as they come,” he says.
Pharmacists cannot continue to stand by and watch heavy discounters take away market share, he says, which is why Clavin is now offering new services, including in-home medicine checks for his customers.
He says when visiting people in their homes and looking at the medicines stacked in their shoe box, he’s found instances where people have bought cheaper medicines from overseas online sites that are not suited to their particular needs.
He is also worried about the rise of discount chains. “The advance of these predators into our industry is of great concern,” he says. “The danger is that the consumer will be faced with the cheapest option.”
And as for digital competitors, he says, “clearly the Amazons are going to target the Sydney’s and Melbourne’s - that means people in rural areas miss out. They [remote-based Australians] will just be too expensive [for Amazon] to service.”
Australian Pharmaceutical Industries (API) managing director and chief executive Richard Vincent says, “I’m not for one minute underestimating Amazon".
"But I feel we are well-positioned to defend any entry in this space.”
API runs 466 Priceline stores across the country, and its emphasis on health and beauty means it has a buffer. It does not compete on selling medicines alone.
The company is also branching out – on June 25 API announced it had spent $127.4 million on acquiring Clearskincare Clinics which offers women laser services and other beauty treatments. Vincent says this will allow them to cross-sell between Priceline and the clinics.
Vincent says there are patients on chronic medication that will always want to talk to their pharmacist face-to-face.
"There’s a range of reasons that patients put their trust in their pharmacist rather than just order online,' he says.
John Cullity is the chief executive of EBOS, which recently entered negotiations to supply Chemist Warehouse for the next five years.
EBOS already supplies to the Terry White Chemmart brand and Cullity says its existing infrastructure can handle the extra work that will come if the Chemist Warehouse deal is sealed.
He also believes some people will always want face-to-face interaction with their pharmacist.
"You get sick, and you need drugs - what will you do, wait for next day delivery or take your script and go to your pharmacy and get it?
"We don’t pretend it [Amazon] is not a risk but we think we are well placed to manage those risks."

Electronic prescriptions

David Quilty, executive director of the powerful Pharmacy Guild of Australia, talks down suggestions the almost 5500 community pharmacies he represents could be upended by a digital disrupter.
He says the rules controlling the industry remove the two major enticements that have seen consumer go online for their shopping needs - price and convenience.
There is vastly more here:
A quick read reveals all the players are just worried about their bottom lines and how to protect their margins.
Concepts of customer service and convenience are mentioned only to say they are not important as they are a threat to profits.
From Chemist Warehouse to Amazon (and Wollies and Coles) who can deliver basic prescription supply way better than a corner shop so the corner shop keepers have lobbied to have absurdly restrictive laws in place. Now Chem Warehouse and Ramsay have worked out how to crack to model I believe it is only time before the whole pack of cards comes tumbling down.
For more advanced services (medication reviews etc.) a pharmacist is appropriate and they need a different payment model for providing those services.
The King Review which showed the way forward was scuppered by politics and the Pharmacy Guild recognized most of this and knew where things were heading. Right now the Guild looks like the boy with a finger in the dyke and facing rising water!
A great read that nicely points out the likely future.
There is also another article from a commercial perspective making similar points:
  • Updated Jul 6 2018 at 6:24 PM

Chemist Warehouse flexes muscles as independent pharmacists battle corporates

Over the past two decades David Vo has owned pharmacies in the rural community of Orange to Sydney's Rose Bay North. His latest investment was up the hill from Clovelly Beach – three months ago he bought the only pharmacy in the small Sydney suburb.

Vo still believes there is a place for smaller independently owned pharmacies which, he says, are more focused on the patient and providing health advice, rather than the till.
"We are not just a cashier," he says. "We have a concern for the customer. People feel like we are family and they talk to us and we have more time for them."

Changes in the highly protected pharmacy industry over the past 20 years have been dramatic, Vo says.

"Apart for the squeeze on government funding, we have been caught off guard with the Chemist Warehouse model. We were always more worried about Woolies coming in, but it's Chemist Warehouse that changed things."

This week Chemist Warehouse – the gorilla of Australia's fragmented retail pharmacy sector – flexed its muscles when it dropped wholesaler Sigma Healthcare and handed a $1 billion-a-year contract to rival wholesaler EBOS Group. The pair have had a difficult relationship, with Sigma taking Chemist Warehouse to court last year over breach of contract, which was later settled.

The change in contract has left Sigma relying heavily on its independent pharmacy network which is under pressure from encroaching corporates, including the nation's largest private hospitals operator, Ramsay Health Care.

In favour of deregulation

The news forced Sigma to issue a profit downgrade and wiped about $322 million off its market capitalisation on Monday. EBOS shares rose 7 per cent, adding about $NZ197 million ($181 million) to its market cap. The contract win came at a cost for EBOS, with several sources saying it agreed to give Chemist Warehouse a $75 million up-front payment and committed another $200 million of working capital. Other sources said negotiations were ongoing.

Again lots more here:

So no matter where you look digital and commercial disruption is on the way. It’s only a matter of time.
David.

AusHealthIT Poll Number 430 – Results – 8th July, 2018.

Here are the results of the poll.

Is HealthEngine Doomed?

Yes 41% (49)

No 53% (63)

I Have No Idea 7% (8)

Total votes: 120

A pretty even split with survival just favoured. The changes that have been announced late last week may help a little.

Any insights welcome as a comment, as usual.

A really, great turnout of votes!

It must have been a pretty hard question as 8/120 readers were not sure what the appropriate answer was.

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

David.

Saturday, July 07, 2018

Weekly Overseas Health IT Links – 07th July, 2018

Here are a few I came across last week.
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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NHS to log private healthcare data to address gaps in care records

The NHS will begin recording data from the private healthcare sector for the first time, in an attempt to bridge gaps in patient health records and improve the quality of available information.
28 June 2018
An initiative has been launched by NHS Digital and the Private Healthcare Information Network (PHIN) that will see performance data, published by private hospitals, integrated into NHS systems.
Called the Acute Data Alignment Programme (ADAPt), the initiative aims, in part, to address cases in which an individual may have received care privately and therefore has treatment information missing from their NHS health record.
The programme is being jointly led by NHS Digital and PHIN, in partnership with the Department of Health and Social Care, NHS England, NHS Improvement, and the Care Quality Commission (CQC).
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HealthSteps wins AMA-Google’s Interoperability and Innovation Challenge

Published June 29 2018, 6:49am EDT
A mobile platform designed to help keep patients on track with their care plans is the winner of the Health Care Interoperability and Innovation Challenge, an American Medical Association-led effort with sponsorship from Google.
HealthSteps was among eight finalists that pitched their ideas on Thursday in front of a live audience and panel of judges at Google’s office in Cambridge, Mass., with the Gainesville, Fla.-based company selected as the winner and receiving $25,000 in Google Cloud credits.
The aim of the challenge was to evaluate solutions that use patient-generated data in meaningful ways to improve clinical outcomes, streamline physician workflows and reduce costs.
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Next-gen health IT consulting: Moving into post-EHR era

Consultants weigh in on what hospitals should expect from them as healthcare moves beyond digitization and into the age of consumerism.
June 28, 2018 01:11 PM
Healthcare information technology is evolving in many ways, and quickly so. That means health IT consulting has to change with the times, to evolve alongside the technology consultants help healthcare provider organizations master.
Consultants from top firms across the health IT consulting spectrum have various ideas on what firms must do next to successfully aid provider organizations with technology. Call them next-generation health IT consulting goals.
For example, health IT consultants must move beyond prediction, said Jeff Geppert, a senior research leader at Battelle, an independent research, consulting and development organization that applies science, technology and engineering to challenges in various industries, including healthcare.
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Robots May Soon Join Ranks of Alzheimer's Caregivers

By Dennis Thompson
HealthDay Reporter
THURSDAY, June 28, 2018 (HealthDay News) -- Robots work on assembly lines and assist doctors in the operating room. They manage inventory in warehouses and vacuum floors in homes.
And one day soon, they could help care for Alzheimer's patients.
Several teams of scientists from around the world are investigating ways in which robots might help manage the daily living tasks of people with Alzheimer's disease.
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AI, radar may help diabetics monitor sugar without drawing blood

By Allen Cone  |  June 28, 2018 at 1:05 PM
June 28 (UPI) -- Researchers have developed a way for people with diabetes to detect blood sugar levels without drawing blood.
Researchers at the University of Waterloo combined radar and artificial intelligence technologies to detect changes in glucose levels several times a day, but without requiring finger pricks. The system is outlined in a study published this month in the International Journal of Mobile Human-Computer Interaction.
"We want to sense blood inside the body without actually having to sample any fluid," George Shaker, an engineering professor at Waterloo, said in a press release. "Our hope is this can be realized as a smartwatch to monitor glucose continuously."
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Microsoft Healthcare is a new effort to push doctors to the cloud

Microsoft wants to be a big part of the cloud and AI healthcare race

By
Microsoft has been working on health-related initiatives for years, but the company is now bringing its efforts together into a new Microsoft Healthcare team. This doesn’t mean you’ll be visiting a Microsoft Store anytime soon for human virus scans, instead it’s a bigger effort to create cloud-based patient profiles, push doctors to the cloud, and eventually have artificial intelligence analyzing data.
The software maker has hired two industry veterans to help out: Jim Weinstein and Joshua Mandel. Weinstein is the former CEO of the Dartmouth-Hitchcock Health system and joins Microsoft as the VP of Microsoft Healthcare, and will work with healthcare organizations to move systems to the cloud. Mandel joins as Microsoft Healthcare chief architect, after completing a nearly two-year stint at Google as an executive for the company’s Verily venture (formerly Google Life Sciences). Mandel will be working closely with the open standards community to create an open cloud architecture for all healthcare providers.
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Exploring the strategic benefits of a move to the cloud

Healthcare IT managers are making the move to the cloud one step at a time, evaluating the success of each migrated application before preparing the next move.
June 27, 2018 12:56 PM
Healthcare organizations traditionally are cautious in their approach to new technologies. With good reason, of course. Healthcare IT supports a mission that leaves no room for error. And as cloud computing has emerged in recent years as a cost-effective alternative to expensive data warehouses, healthcare was not an early adopter.
But recent research shows that an increasing number of hospitals and private practices are migrating databases, applications, and services (such as disaster recovery) to the cloud, with no slowdown in sight.
In a HIMSS Analytics survey of healthcare IT executives taken in January 2017, 65 percent of respondents said their healthcare organizations currently utilize the cloud or cloud services. “Much of the usage leans toward clinical application and data hosting, data recovery and backup, and the hosting of operational applications,” HIMSS Analytics reported.
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VA sets 1st Cerner go-live for 2020

Written by Julie Spitzer | June 27, 2018 | Print  | Email
The U.S. Department of Veterans Affairs plans to be fully functional on its new Cerner EHR at three test sites in the Pacific Northwest by March 2020, officials said in a hearing before the House Committee on Veterans Affairs June 26.
The overhaul will follow a wave model, with the first go-lives slated at Washington VA facilities in Spokane, Seattle and American Lake this July. Implementation is set for October.
VA finalized its contract with Cerner May 17, awarding the EHR vendor $10 billion over the next 10 years to put the VA on the same records system as the U.S. Defense Department. The goal is to take lessons learned from DOD's early implementations to avoid similar mishaps and complications. DOD began its transition to Cerner in February 2017 and has been criticized for numerous problems, including the management and documentation of patient care, poor system usability, insufficient training and inadequate help desk support.
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Cybercriminals Target Hospitals with SamSam Ransomware Attacks

Cybercriminals increased their SamSam ransomware attacks against the healthcare sector in the first quarter of 2018, with numerous cases reported of hospitals paying the ransom to regain access to their systems.

June 27, 2018 - Cybercriminals increased their SamSam (aka SAMSA) ransomware attacks against the healthcare sector in the first quarter of 2018, with numerous cases reported of hospitals paying the ransom to regain access to their systems, according to McAfee Labs Threats Report: June 2018.
Earlier in the year, HHS warned about an increase in SamSam ransomware attacks targeting healthcare and government organizations.
The SamSam ransomware seeks out insecure remote desktop protocol (RDP) connections as well as vulnerable JBoss systems to carry out its infections.
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HIE collaboration brings more data to physicians at the point of care

Published June 28 2018, 5:01pm EDT
SacValley Medshare, a health information exchange serving the North Central Valley of California, is bulking up its data repository so it can provide physicians with a richer set of patient information at the point of care.
The HIE is working with vendor Collective Medical, which collects health insurance and other data from emergency rooms, including patient-specific care guidelines and plans, utilization patterns and pain management histories. Collective Medical also pulls in and stores details that hospitals generally don’t have, such as a specific patient being anxious or combative, or having a history of opioid use.
Under their pact, Collective Medical will provide its data to SacValley Medshare in real-time, which the HIE could then immediately feed to the hospitals in its network.
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HIT Think 5 ways smaller healthcare organizations can bolster security

Published June 28 2018, 5:10pm EDT
The mergers and acquisition market is heating up in healthcare, both in the number and size of deals. As of late September 2017, there had been at least 561 hospital mergers since 2010, and four of the biggest last year involved entities with revenue of more than $1 billion. As the healthcare landscape continues to transform, M&A is likely to become a common occurrence and a ubiquitous strategy for smaller organizations.
As these provider organizations increasingly pursue buyout offers, they must begin thinking about their actual value to a larger company. When two companies merge, their strengths and weaknesses get married. If those weaknesses are too large or too unpredictable, the marriage often falls apart.
The due diligence process to determine those weaknesses is already exhaustive. But now that cyber crime has risen to the top of the threat landscape, evaluators are making it a prime focus. If a potential acquisition has weak security measures, a lax security culture or a demonstrated history of security failures, it’s now considered a significant liability.
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This AI Can Provide Health Advice That Is as Good as a Real Doctor's

By Aristos Georgiou On 6/27/18 at 5:21 PM
A new artificial intelligence platform has demonstrated its ability to provide health advice that is as good as a human doctor’s, according to research published on the preprint server arXiv.org.
The technology, which has been developed by British company Babylon Health, takes the form of a mobile phone app, or website, that patients interact with via a chat service. (A voice-controlled version will also be available soon.)
The AI system has been put through rigorous testing that took place in collaboration with the U.K.'s Royal College of Physicians, as well as researchers from Stanford University and the Yale New Haven Health System.
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AI tools improve diagnostic accuracy to match that of docs

Published June 28 2018, 5:00pm EDT
Babylon Healthcare Services, a new mobile medical consultation service, says its artificial intelligence software, in tests, can assess common conditions more accurately than human doctors.
London-based Babylon’s AI correctly answered 81 percent of diagnostic questions designed to mimic those trainee doctors must answer as part of the Royal College of General Practitioner’s exam that must be passed to become a qualified GP doctor in the U.K. The exam is graded on a curve, but over the past five years, the average score trainees needed to pass was 72 percent.
Babylon demonstrated this technology publicly for the first time in a live test at an event at London’s Royal College of Physicians on Wednesday.
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Special Report: Radiology Information Systems

With the shortage of radiologists showing no signs of abating – and the demand for scans increasing year on year – attention understandably continues to fall on how technology might help. Can radiology information systems be the key to better management of workload? And will artificial intelligence make a difference? Kim Thomas reports.
Last year, the Royal College of Radiologists revealed figures showing an “increasingly desperate situation in UK radiology”. A shortage of radiologists – one in 10 radiologist posts were vacant in 2016 – was said to make late hospital diagnoses and delayed scan results a “very real likelihood for patients”. In the same year, the NHS paid £88m to third parties for out-of-hours reporting of X-rays and scans.
As the number of scans taken every year continues to increase, the difficulty in meeting demand is worsening. Tackling the shortage of radiologists is a long-term project, but in the shorter term technology has the potential to help in two main ways: by sharing the reporting workload across NHS trusts, and perhaps by using artificial intelligence to automate some of the work currently performed by clinicians. Radiology information systems are integral to making those changes.
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CMS creates Chief Health Informatics Officer position to lead interoperability push

The CHIO will support health IT management and technology innovation policy within the agency, while coordinating those efforts among staff.
June 26, 2018 01:27 PM
The Centers for Medicare and Medicaid Services posted a new leadership position, Chief Health Informatics Officer, which will lead the agency’s interoperability efforts and health IT strategy.
Posted late last week, the CHIO will focus on improving interoperability and innovation for CMS. According to the job posting, the executive will also develop CMS’ IT strategy, work with outside partners and act as a liaison between the agency and the private sector.
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Next-gen interoperability: AI, blockchain, FHIR and open source analytics

Healthcare has struggled with data sharing for a long time but, even still, experts said the future will be robust as emerging technologies and standards become more common.
June 27, 2018 09:35 AM
Interoperability is the ultimate goal of healthcare information systems. Software and cloud-based services need to be able to talk to one another, to exchange clinical and administrative data to enable complete access to a patient’s record and help clinicians deliver the best possible care.
But health IT vendors and healthcare provider organizations still have a long way to go when it comes to attaining interoperability. In the years ahead, though, progress will be made and there will be various next-generation tactics and techniques that help advance this goal.
For one, artificial intelligence will assist interaction with data to push interoperability forward, said Jitin Asnanni, executive director of the CommonWell Health Alliance, a trade association of health IT companies working to create nationwide access to data.
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Healthcare Internet Crimes Cost Victims $925,849 Last Year

Healthcare internet crimes cost victims $925,849 last year, according to the FBI Internet Crime Complaint Center’s 2017 Internet Crime Report.

June 26, 2018 - Healthcare internet crimes cost victims $925,849 last year, according to the FBI Internet Crime Complaint Center’s (IC3) 2017 Internet Crime Report
The report includes stats on internet crime complaints received by the center during 1997. The center defines a healthcare-related crime as a “scheme attempting to defraud private or government health care programs, usually involving health care providers, companies, or individuals.”
“Schemes may include offers for fake insurance cards, health insurance marketplace assistance, stolen health information, or may involve medications, supplements, weight loss products, or diversion/pill mill practices. These scams are often initiated through spam email, Internet advertisements, links in forums or social media, and fraudulent websites,” the report explained.
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Lawmakers cite VA leadership holes in EHR implementation with first go-live scheduled for 2020

Jun 27, 2018 6:00am
Representatives on the House Committee on Veterans Affairs grilled senior officials at the Department of Veterans Affairs about a lack of leadership that could derail the agency’s ability to execute on a massive medical records modernization project with several positions still unfilled.
Currently, the VA is operating without permanent appointments to three positions critical to the implementation of Cerner’s EHR platform, a 10-year, $16 billion project: The deputy secretary, the undersecretary for health and the chief information officer have yet to be confirmed.
Robert Wilkie, tapped to replace former Secretary David Shulkin, will undergo confirmation hearings on Wednesday. 
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HIT Think Why the recent MD Anderson fine raises prospects for encrypting all information

Published June 27 2018, 5:44pm EDT
On June 18, the Office for Civil Rights released a decision and memorandum from an Administrative Law Judge after a dispute over HIPAA fines imposed against The University of Texas MD Anderson Cancer Center. The decision draws a clear line in the sand that encryption—despite being an addressable element under the Security Rule—cannot be avoided.
Here’s the history—OCR investigated MD Anderson after it submitted three separate breach notifications. One notification concerned a stolen laptop, and the other two involved stolen thumb drives. In each instance, the device was not encrypted. As described in the decision, MD Anderson for years identified the risk associated with unencrypted data on laptops, portable devices and other devices. At many points in time, MD Anderson had set internal policies that encryption was the most appropriate means of addressing the risk posed by such devices.
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Patient matching will lead to interoperability, Pew says

In a letter to CMS, Pew says patient matching unlocks critical information, but identification is often elusive and better standards are needed.
June 26, 2018 10:30 AM
The Pew Charitable Trusts is urging the Centers for Medicare & Medicaid Services to tackle interoperability, patient identification and limited use of standards to describe clinical information.
In a June 25 letter, Pew asserted the proposed changes to Medicare payment programs that promote interoperability would make it possible for patients and clinicians to access critical health data when and where they need it to inform care decisions.
Pew is commenting on the 2019 Hospital Inpatient Prospective Payment System, or HIPPS, a proposed rule that replaces the Meaningful Use Program with a new set of interoperability-focused measures, including several provisions designed to advance data exchange. 
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Next-gen clinical communication: Real-time location, context-aware and mobile

Here are the features and functionality clinical communication tool vendors think will emerge next.
June 26, 2018 08:35 AM
Communication technology has evolved quickly in the last few years, and this has enabled new trends in healthcare delivery. While this is the case throughout the industry, it is especially true in hospitals and health systems where a significant amount of time and energy have been invested into providing improved communication and data sharing among clinicians.
The Centers for Medicare and Medicaid Services Administrator Seema Verma recently stated that “one of the most common complaints from patients and providers is the inefficiency of EHRs to effectively coordinate care for their patients.” And this is where effective clinical communication technology can help.
In the Spyglass Consulting Group’s healthcare study, “Trends in Clinical Communications and Collaboration 2018,” researchers found that 90 percent of hospitals surveyed are making significant enterprise-wide investments in smartphones and secure mobile communications platforms to drive clinical transformation and address the mission- and patient-critical communications requirements of clinical and non-clinical mobile workers within the hospital and across the care continuum.
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Florida Hospital building state-of-the-art command center

June 25, 2018
In an effort to run more efficiently, reduce patient wait times and improve quality of care, Florida Hospital is building a 10,000-square-foot mission control center for its nine hospitals in Central Florida.
“It takes paper-based processes of today and makes them transparent and live, so we can see where the patients are, where our capacity and expertise are while keeping the patient at the center of our thinking,” said Eric Stevens, a senior executive at Florida Hospital.
With an initial investment of $15 million, the health system is working with GE Healthcare to build the center in its Orlando campus where a Wall of Analytics will display real-time data to bed coordinators, the patient transfer team, the care management team, staffing and other teams that are brought together from different corners of the hospital under one roof.
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Medtronic announces commercially availability of AI-powered diabetes management app

MDBR Staff Writer  Published 25 June 2018
Medtronic, along with its technology partner IBM Watson Health, has announced commercially availability of artificial intelligence (AI) powered Sugar.IQ diabetes management app.
The Sugar.IQ smart diabetes assistant is a first-of-its-kind intelligent app, which will help simplify and improve daily diabetes management.
According to Medtronic, around 30.3 million Americans have been diagnosed with diabetes, with 1.5 million new cases being diagnosed each year.
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Jun 25, 2018 @ 06:25 AM 962

Password123456? Has The Password Had Its Day?

609 years and 11 months. That’s how long the password generator website Random-ize tells me it would take hackers to brute force their way through my most important password. This timescale is reassuring - but those of us who work in technology are likely to have been on top of password complexity for many years. Incredibly, many jaw-droppingly woeful passwords are still popular, for example: ‘qwerty’, ‘123456’ and indeed ‘password’. According to SplashData’s most recent annual top 100 chart of the World’s Worst Passwords, the majority of the top ten can be cracked in less than one second.
Like them or loathe them, passwords are an essential factor for so many of the tasks that shape our daily lives: from checking our bank balances to signing in to a Netflix account or unlocking our mobile phones. According to a 2017 study by Digital Guardian, 70% of people have more than ten password-protected accounts online, and 30% have “too many to count.” However, we are repeatedly advised that we should have different passwords for every login. Hands up if you clicked the ‘forgotten password’ option at least once in the last month. With my current tally of 276 passwords (and rising), it is safe to say that recently adopting a password manager has been a life-changing experience for me.
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Poor Data Sharing Leads to Delays in Care, Global Survey Finds

June 25, 2018
by Rajiv Leventhal
Healthcare providers are struggling to use the patient data that is available to them to deliver a better standard of care, and over half of consumers in a recent survey said they have experienced delays in care due to poor data sharing between healthcare professionals.
The “Consumer Connectivity Insights 2018” survey from MuleSoft, a San Francisco-based provider of a platform for building application networks, included more than 8,000 consumers globally to analyze whether organizations are meeting customer expectations for a connected, personalized experience across industries and geographies.
One key finding was that poor data utilization is impacting patient care. Digging deeper, the results showed:
  • Half of consumers (51 percent) say they, or someone they know, have experienced a delay in care due to information not being shared between healthcare professionals.
  • Less than half (42 percent) of consumers believe that healthcare providers make effective use of all the data (e.g. from wearable tech and health apps) available to them to deliver a better standard of care.
  • The research revealed that consumers in the U.S. (54 percent) and Singapore (62 percent) were most positive when it came to healthcare providers making effective use of the data available to them. In contrast, U.K. consumers (26 percent) were by far the least positive.
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House passes opioid bill to expand telehealth, e-prescribing

Published June 26 2018, 7:03am EDT
The House of Representatives on Friday passed legislation that would expand access to treatment via telehealth in the Medicare program and require electronic prescribing for controlled substances within Medicare’s prescription drug program—with certain exceptions.
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6), sponsored by Rep. Greg Walden (R-Ore.), now moves on to the Senate for consideration.
The House passage of the bill was applauded by Health IT Now, a coalition of patient groups, provider organizations, employers and payers, which launched the Opioid Safety Alliance in January—along with IBM, Intermountain Healthcare, McKesson, Oracle and Walgreens—to advance a health IT-centric policy agenda to combat the problem of opioids.
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Prospects for GE’s spun-off health unit said to be strong

Published June 26 2018, 6:00pm EDT
GE officials presented a bright future for GE Healthcare when they announced on Tuesday that the medical equipment unit will be spun off in a major corporate restructuring.
The health business, which last year reported more than $19 billion in revenues and posted 5 percent revenue growth and 9 percent segment profit growth, provides medical imaging, monitoring, bio-manufacturing and cell therapy technology to hospitals as well as laboratory supplies to biotech firms.
Under the corporate restructuring, Kieran Murphy—president and CEO of GE Healthcare—will continue to lead the business unit once it becomes a separate entity.
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Medical informaticists urge CMS to think boldly to improve care

Published June 26 2018, 3:37pm EDT
The American Medical Informatics Association has proposed a radical change to the way CMS measures how well providers are using health IT to improve patient care.
In a comment letter to the Centers for Medicare and Medicaid Services, AMIA recommended that the agency replace existing EHR measurement-reporting requirements with an activities-based approach that would allow hospitals to demonstrate how they are using health IT to improve care for “their specific patient populations and priorities.”
AMIA was responding to CMS’ proposed FY2019 Hospital Inpatient Prospective Payment System rule, which the agency released in April.
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Next-gen population health: mHealth, social determinants, prescriptive analytics

Experts share insights about where pop health technology and tools are headed in the immediate future.
June 25, 2018 08:45 AM
Population health is increasingly viewed as a key to the successful delivery of healthcare in the future, especially as more hospitals and health systems fall under value-based care contracts.
Fortunately for provider organizations, there already are plenty of population health information systems on the market to help them navigate the challenges of managing the health of a population and not just an individual. And the next generation of population health IT will have more features and functions to help ensure success with pop health efforts.
Mobile technology is leading the race to better population health, said Paul Cerrato, an independent writer who has collaborated on three healthcare books with Beth Israel Deaconess System CIO John Halamka.
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How Phoenix Children's structured its EHRs to be disease specific to improve care, drive savings

An automated system within its EHR enables clinicians to capture 99 percent of notes in a structured format, as opposed to free-text, virtually eliminating the need for transcription and making EHR content more searchable.
June 25, 2018 10:31 AM
By optimizing its EHR's advanced clinical documentation technology for treating rheumatoid arthritis patients, Phoenix Children’s enhanced care and physician productivity while also saving about $1 million dollars.
Documentation for Juvenile Idiopathic Arthritis is challenging because of the complexity of this chronic relapsing disease that causes disabling joint inflammation and potential for permanent joint damage and deformity, said Vinay Vaidya, MD, vice president and chief medical information officer at Phoenix Children’s Hospital.
“When we were rolling out our ambulatory EHR four years ago, we made a focused effort to design our templates to be disease-specific,” Vaidya explained. “We ensured that the key disease measures were captured at the outset, so that this data would be easily accessible for analytics, decision support and chronic disease management.”
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GDPR Compliance Process for Health Care Providers

Confidentiality is a key aspect of health care provision, and health professionals must take extraordinary care in order to protect their patient’s privacy.
GDPR introduces significantly stricter general rules for personal data processing in comparison to the previous ones and its extraterritorial application for non-EU data controllers in cases which we previously wrote about. The strictest data processing rules relate to personal data concerning health, i.e. related to physical or mental health of a natural person, including the provision of health services, which reveal information about one’s health status.
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10 insider tricks to keep hackers and scammers from stealing from you

Kim Komando, Special for USA TODAY Published 10:47 a.m. ET June 22, 2018 | Updated 10:31 a.m. ET June 25, 2018
With cybercrime so rampant, you need to be proactive about protecting yourself.
Cybercriminals are out in full force looking for ways to steal your data. It’s worth money to them. That’s why we’ve seen a massive uptick in the number of data breaches over the past few years.
Unfortunately, most folks don’t know they’ve been hacked until it’s too late. So you don’t fall into that category, do one thing right now. Click here to see if your email address has been hacked or stolen.
With cybercrime so rampant, you need to be proactive about protecting yourself. To help you out, here are some things I do to keep hackers and scammers at bay.
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AHA ‘strongly opposes’ interoperability as a Medicare requirement

Jun 25, 2018 3:37pm
The American Hospital Association (AHA) has come out against a policy floated by the Centers for Medicare & Medicaid Services (CMS) to make interoperability a requirement to bill Medicare and Medicaid.
In a proposed hospital payment rule issued in April, CMS included a request for information regarding a revision to hospital Conditions of Participation (CoP) and Medicaid Conditions for Coverage (CfC) that would require hospitals to share data electronically with other hospitals, community providers and patients “if possible.”
In comments (PDF) submitted to CMS, the AHA said it “strongly opposes creating additional CoPs/CfCs to promote interoperability of health information.”
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HIT Think Why HIT executives are worried about business continuity

Published June 25 2018, 5:52pm EDT
The mid-year outlook for cyberattacks, phishing and breaches continues to look grim. Recent reports litter the headlines, such as the ransomware attack impacting 85,000 patients in California, or the misconfigured FTP server exposing data of 205,000 patients. This disturbing trend plaguing the healthcare industry, remains a top-of-mind concern for hospital and health system executives. In fact, 67 percent of CISOs believe a cybersecurity attack will happen to their organization in 2018, according to a recent report conducted by the Ponemon Institute and sponsored by Opus.
The threat is real and healthcare leaders know it. But they’re not hiding their heads in the sand; hospitals are putting the technology, resources, and plans in place to meet today’s growing number of threats by establishing business continuity plans and defining policies for IT disaster recovery.
In a Spok survey of CHIME CIOs conducted in early 2018, healthcare leaders were asked how confident they are their organization could recover from a disaster scenario. The results show seven in 10 CIOs are only “somewhat” or “not very” confident their hospital could recover from a disaster (5 percent have no confidence at all). It appears business continuity plans might be keeping healthcare leaders up at night.
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Amazon-Berkshire-JPMorgan health venture takes aim at middlemen

By Zachary Tracer
  • Bloomberg
Published June 25 2018, 10:34am EDT
 (Bloomberg) -- The health venture established by Amazon.com Inc., Berkshire Hathaway Inc. and JPMorgan Chase & Co. will take aim at intermediaries in the health-care system as a part of a broad effort to reduce wasteful spending, the venture’s newly named chief executive officer said.
The still-unnamed business will initially seek to develop ways to improve care for the more than 1 million individuals who get health insurance from the three firms. Over time, the venture will make those innovations available freely to other companies, meaning that if it’s successful, its effects could be felt more broadly among the more than 150 million people in the U.S. who get their health insurance through work.
“My job for them is to figure out ways that we’re going to drive better outcomes, better satisfaction with care and better cost efficiency with new models that can be incubated for all,” Atul Gawande, the Harvard surgeon and journalist who was named last week to run the initiative, said Saturday at an Aspen Institute event.
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* Sri Lanka to introduce an e-Health card for all

Sat, Jun 23, 2018, 08:10 pm SL Time, ColomboPage News Desk, Sri Lanka.
June 23, Colombo: The Minister of Healthcare, Nutrition and Indigenous Medicine Dr. Rajitha Senaratne says an electronic health card containing all the health information of the patient will be introduced for all soon.
The Minister addressing an event held to launch the Hospital Information Management System at the Castle Street Women's Hospital in Borella yesterday (22) said the e-Health project was initiated due to the shortage of drugs in hospitals.
He said there were shortages of about 44-79 types of drugs daily and therefore, a software was introduced to handle the shortages. Using this software the hospital director is able to get the medicine from any hospital and this system will be extended to peripheral hospitals as well.
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Enjoy!
David.

Just To Point Out It Is Seven Months Since We Heard From The ADHA Board

Captured today at 1:30pm.

Australian Digital Health Agency Board

Mr Jim Birch AM

Mr Jim Birch AM, Chair

is also Chair of the Australian Red Cross Blood Service, Deputy Chair of the Independent Hospital Pricing Authority, Chair of Mary MacKillop Care SA and a board member of the Australian Red Cross Society, the Little Company of Mary Health Care and Cancer SA. He was formally a Partner in Ernst and Young having been the Global Health Leader. He has also been the Government and Public Sector Leader from 2012 until the end of 2014. Formerly Mr Birch was also the Lead Partner in Health and Human Services for Asia Pacific. He has over thirty five years’ experience in planning, leading and implementing change in complex organisations transcending such areas as healthcare, justice and human services. Mr Birch has been a Chief Executive of a Human Services and Health Department (South Australia), Deputy Chief Executive of Justice and Chief Executive of major health service delivery organisations, including teaching hospitals. Mr Birch has previously been Chair of the Australian Health Ministers’ Advisory Council, a member of the Australian Commission on Safety and Quality in Health Care and was a Board Member of the National E-Health Transition Authority and Chair of Rural Health Workforce Australia. He has a Bachelor of Health Administration from the University of New South Wales.
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The above is just so you know who is actually responsible for this issue....
I note there seems to have been some turnover of the Board recently and I wonder if that is causing issues?
David.



Friday, July 06, 2018

Concerns Regarding The Handling Of Health Information Is Reaching The Mainstream.

This appeared on Sunday:

'You can’t undo that damage': How safe is your health data?

By Jennifer Duke
1 July 2018 — 12:15am
For the next three months, Australians have the chance to stop the government creating a digital medical health record with their information.
Among those planning to opt out is Monash University software engineering lecturer Robert Merkel, who has concerns about the safety of his information under the government's My Health Record system.
 “I don’t think the security measures [health care providers have] are commensurate with the sensitivity of that data and the incentives that some criminals may have to illegally gain access to it,” Dr Merkel said. “The security on your bank systems is not perfect either, but in general if you lose money, you can be compensated for that. If your private health information is leaked you can’t undo that damage.”

A bitter pill to swallow

From February, when the rules were changed to force businesses to report data breaches that cause "serious harm", to the end of March, about a quarter of the 63 incidences reported to the Privacy Commissioner involved health care providers. About 100 people were affected.
Not every data breach is a cybersecurity issue, but hackers are increasingly looking for weak systems to collect information for intelligence reasons, fraudulent insurance claims, identity theft and "ransomware", where a malicious program stops a user from accessing devices until a payment is made.
However, even in the world’s most online security-focused countries like Israel, which was among the first to digitise health records, protecting medical organisations is a relatively recent consideration.
Speaking at Tel Aviv University's annual international cybersecurity conference, Cyber Week 2018, professor Isaac Ben-Israel, head of the Blavatnik Interdisciplinary cyber research centre and chairman of the conference, said he had focused on cybersecurity for decades but health was often overlooked.
In 1999, when working for the Israel Defence Forces, Professor Ben-Israel gave the Israeli government a 36-strong list of critical infrastructure, from power production and water supply to banking, under threat from cyber attacks. Healthcare was not added to the list until 2010.
“We had a red team [a group of white-hat, or ethical, hackers that test security] sent to one of the hospitals in Israel ... what they found is still common to all hospitals,” he said.
They discovered many ways to cause harm by compromising hospital security systems.
Part of the difficulty is simply the public nature of hospitals, explains Ophir Zilbiger, head of the Israel-based BDO Cybersecurity Centre and a speaker at Cyber Week.
“Imagine yourself walking the corridors of a hospital,” Mr Zilbiger said. “Computers are just mixed with the general public, it’s not like a bank branch, where the tellers' computers are behind the desk and the public is in front of the desk.
“So it’s really easy for hackers to gain access to medical information side-by-side with the fact healthcare represents privacy risks."
Then consider how many different branches and clinics there are across the country, each often using different software and devices.
In early-2018, for instance, a flaw found in software used by more than 40,000 health specialists in Australia, and distributed by Telstra, left some medical records potentially exposed to hackers.
Macquarie University senior lecturer in cyber security Stephen McCombie said small branches could be considered “easy targets” by attackers who wanted quick access.
“The difficulty with health is you have lots of small providers, the potential to be attacked is pretty big as there are a lot of places where a compromise can happen," Dr McCombie said.
He believes the government's awareness of the risks has benefited from the 2017 North Korean ransomware attack WannaCry that hit 230,000 computers globally, including a dozen Australian businesses, and drastically affected UK hospitals.
Much more here:
With only a few weeks to run till the commencement of the three month opt-out period for the myHR it is useful to see that the mainstream media is pointing out that the case for having a myHR is not a lay down mazaire, there being a range of security, privacy, accuracy and technical risks which ought not be ignored.
I hope at least this will encourage more informed discussion and decision making.
David.