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, February 17, 2019

Blog Readers Provide Additional Information Regarding A Very Worrying Article Around The ADHA And Its Attitude To Honesty And Transparency.

This appeared a day or do ago.

My Health Record 'minor glitch' still generating thousands of pages of internal files

Exclusive: agency in charge wants to charge $14,000 to release details of documents
Thousands of pages of internal documents are still being created about a My Health Record technical glitch that the government said was minor and resolved years ago.
But the agency in charge of My Health Record wants to charge $14,000 to release details on the files through Australia’s freedom of information regime.
Guardian Australia revealed last month that a technical problem with the My Health Record system had hampered attempts by some doctors to upload clinical information about their patients to the system.
According to a leaked briefing, some doctors in clinics using older IT systems were left oblivious to the problem, leading them to believe patient information had been properly updated when it hadn’t. The briefing warned it created risks of “missing clinical information in a consumer’s My Health Record” and “amendments not uploading resulting in out-of-date or incorrect information”.
The Australian Digital Health Agency, which administers the system, said the error was minor and was quickly dealt with when it emerged in March 2016.
“To be absolutely clear, the agency rejects any assertion that there is any clinical risk to patient safety or longstanding problem unresolved since 2016,” a spokeswoman said.
Deakin University academic Joshua Badge subsequently filed a freedom of information request, asking for all documents related to the glitch that were created in 2018.
The agency identified 95 documents with 4,192 pages relevant to the request. But it said processing Badge’s request would cost $13,894.77, with a deposit of $3,473.69.
The agency is now declining to comment on the matter, either to explain why a minor issue resolved in 2016 is still generating voluminous records two years later, or to explain the $13,000 processing charge.
“The Australian Digital Health Agency (the agency) is unable to comment on ongoing Freedom Of Information (FOI) cases to third parties,” it said in a statement. “For all FOI requests, the agency abides by the fee schedules and guidelines set out by the Freedom of Information (Charges) Regulations 1982.”
Badge, who has previously written on My Health Record and privacy concerns, later refined his request to ask only for documents between mid-December and mid-February.
The agency identified 35 documents with 259 pages in that period, and asked Badge to pay $700 to process the request. He has again refined the FOI request to lower the cost.
But he said the sheer volume of documents casts doubt on claims the glitch had been fixed.
“This new information indicates that the ADHA has written thousands of pages of emails and reports relating to the digital signature issue in the last year,” Badge said. “The immediate question is why there would be so many documents about a ‘minor issue’ from several years ago.”
Lots more here:
Over the next day or so readers added what I believe was considerable clarity with comments.
Anonymous said...
David something very fishy is going on here. Just what have the ADHA done or not done?

https://www.theguardian.com/australia-news/2019/feb/15/my-health-record-minor-glitch-still-generating-thousands-of-pages-of-internal-files
Anonymous said...
The thousands of pages is easily explained. In reality it is a few reports created each year and presented to whatever new deaf blind and dumb board/committee/group they put in place. The fact the information replicates is simply because the ADHA has no information or records management mindset, structure or discipline. The top brass in their wisdom even managed to kick the team out trying to drag them towards some resemblance of government record keeping and information management.

The ADHA is a danger to themselves and society in general.
Anonymous said...
Oh dear they do seem to be fumbling around in the dark making things worse for themselves. You are a brave man Minister.
Anonymous said...
Safe to assume that if the ADHA says there is nothing to be concerned about then there is a whole lot to worry about.
Anonymous said...
The ADHA spokesperson is fraudulent in the facts, or ADHA clearly has no record. The Microsoft Security Patch was released several months prior to ADHA official commencement. NEHTA tried to address the issue and it was NEHTA not ADHA that released the updated guidance.

This issue was carried over to ADHA with then then acting CEO of NEHTA. The issue was presented to the then interim CEO of ADHA. The current CEO, COO and The head of Core Services and System Operations. This issue has been carried with ADHA is has been well known from Directors to General Managers to Executives. The response to this has not been to work to ensure it is resolved but rather to leave a trail of “hush” sackings.

What we are witnessing is panic and ass covering. Internally the witch hunts have begun, but not towards The CEO, COO, Board or Executives for their neglect but simply because cruelty towards staff and the public are at the core of their DNA.
The last comment has a genuine ring of truth I believe. You would struggle to make such stuff up!
At the very least the problem is not resolved as the reporting would stop you would imagine if that was true.
The charging for documents that have already clearly been found makes a mockery of ADHA transparency and openness.
This mob is adding very little value as far as I can tell.
David.

AusHealthIT Poll Number 462 – Results – 17th February, 2019.

Here are the results of the poll.

Is A Large-Scale Data Breach Of The #myHealthRecord Virtually Inevitable Over The Next Few Years?

Yes 95% (122)

No 4% (5)

I Have No Idea 1% (1)

Total votes: 128

What an clear-cut poll. Most seem to think that despite the ADHA assurances the #myHealthRecord is likely to be breached at some point soon.

Any insights on the poll welcome as a comment, as usual.

A more than reasonable turnout of votes!

It must have been a pretty easy question as just 1/128 readers were not sure what the appropriate answer was.

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

David.

Saturday, February 16, 2019

Weekly Overseas Health IT Links – 16th February, 2019.

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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Un’appy times – the challenges facing the NHS App

The NHS App that launched at the end of December is a prestige project on the road to NHS digitisation, championed first by Jeremy Hunt and now by Matt Hancock. But it’s just lost two of its key leaders and will have to overcome serious technical challenges if it is to become the default digital gateway for patients. Digital Health editor Jon Hoeksma reports.
5 February, 2019
The NHS App has been loaded up with headline-catching public commitments by two successive health secretaries. The simple fact is it will struggle to keep them.
The pledge which grabbed most attention was the one to end the 8am phone scramble to make a GP appointment. Instead, the app was to make online appointment booking available to all.
Less discussed, though potentially more significant, is the ambition for the NHS App to be the future digital gateway into the NHS. Under this vision, the app would develop into the standard platform by which citizens access a range of local and national digital health services and apps.
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NHS England awards £16m to second stealth wave of LHCREs

NHS England has stealthily awarded over £16m of funding to a second wave of local health care records exemplar (LHCRE) sites and is also set to double the funding in London to £15m.
Joe Hoeksma – 8 February, 2019
Digital Health News can exclusively reveal that the three new selected LHCRE sites are the South West, Blackpool and Liverpool, and the Great Northern Care Record in the North East.  No public announcement has yet been made of the selection of the second wave sites, their funding or what they will do.
The LHCRE projects are, like the first wave sites announced in 2018, understood to be intended to provide reference sites for sharing patient data to support direct care and support regional population health management and the development of Integrated Care Systems
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International ransomware could deal $89 billion blow to US economy, says report

February 05, 2019
by John R. Fischer , Staff Reporter
An international ransomware attack could inflict an $89 billion blow to the U.S. economy, according to a new report by the Cyber Risk Management (cyRiM) project, an initiative for assessing cyber security risks, of which specialist insurance and reinsurance market, Lloyd’s is a founder.
Entitled Bashe attack: Global infection by contagious malware, the report asserts that the cost to the U.S. would be nearly half that of the $193 billion global price tag of an attack and lists global healthcare as one of the business sectors that would accrue the most damage.
“Overall, healthcare facilities have likely become susceptible to ransomware and other cybersecurity threats due to the lack of historical focus on cybersecurity as a key priority,” Juuso Leinonen, senior project engineer at ECRI Institute, told HCB News. The rapid trend in connecting medical devices and overall increase in connected data systems integral to patient care have likely exacerbated the problem. Healthcare facilities also house a plethora of protected health information, making them potential targets, as this data can be particularly attractive to malicious actors due to it being non-disposable and its high black market value.”
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OCR sets record in 2018 for HIPAA enforcement actions

Published February 08 2019, 6:56am EST
Last year, the Department of Health and Human Services’ Office for Civil Rights set an all-time record for HIPAA enforcement activity in terms of overall dollar value of its fines, according to HHS.
OCR racked up a total of $28.7 million in enforcement actions in 2018, including 10 settlements and a summary judgment in a case before an administrative law judge. The agency beat the previous record of $23.5 million in 2016 by 22 percent.
“Our record year underscores the need for covered entities to be proactive about data security if they want to avoid being on the wrong end of an enforcement action,” says Roger Severino, director of OCR.
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VA to share patient mortality data from EHR with CDC

Published February 08 2019, 6:48am EST
Two government agencies are working to improve public health surveillance by advancing how quickly deaths are recorded and reported.
Under the new partnership between the Department of Veterans Affairs and the Centers for Disease Control and Prevention, the VA will integrate patient mortality data from its electronic health record system to support the CDC’s Modernizing Death Reporting project, an effort to increase the speed, quality and interoperability of information that is captured and reported.
“Delivering data directly to CDC’s systems in this manner underscores VA’s commitment to a modern interoperability strategy,” said VA Secretary Robert Wilkie in a written statement. “We look forward to future opportunities to enhance our partnerships and champion interoperability across the federal government.”
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HIT Think Best practices for thwarting DNS hijacking attacks

Published February 08 2019, 6:07pm EST
The DHS emergency order validates what security experts have been advising customers and organizations to do in general for some time. The use of multifactor authentication and ongoing monitoring of DNS records are basic security measures all organizations should be taking to protect their sites and underlying customer data from DNS hijacking attacks.
We also strongly recommend implementing DNSSEC, which enables recursive DNS resolvers to check the authenticity of the information received from the previous authoritative DNS server in the series of lookups required to return a DNS answer to a user. This prevents a criminal from sending a user to a malicious site instead of the intended business web site.
DNS is a critical technology that connects all aspects of IT infrastructure, applications and online services—everything between the server and the user—which makes it an extremely attractive target for cybercriminals.
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5 cybersecurity threats healthcare faces in 2019 and beyond

They’re not entirely new but each brings fresh twists health and IT executives will need to keep pace with moving forward.
February 08, 2019 09:12 AM
Mobile device exploits, cloud based-data breaches, ransomware — these are just three of the major information security threats healthcare organizations will have to watch out for in 2019 and the years that follow.
It will be critical to ensure that information communication technology (ICT) infrastructure is secure, a task that has become exponentially more complicated due to the proliferation of mobile devices like smartphones and tablets, which are used by healthcare professionals in the field and in hospitals.
In addition to securing mobile devices, the proliferation of connected devices like medical equipment and other Web connected elements—the Internet of Things (IoT)— can be particularly weak security endpoints, and need to be properly secured and updated at all times.
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JAMA: 5 tips to fix EHR usability, 10 years post-HITECH

A national database of usability and safety issues, and enforcement of basic design and UX standards, are just two ways the promise of the past decade can be realized.
February 08, 2019 03:25 PM
Hard as it may be to believe, it's been a decade, almost exactly, since the healthcare information and technology industry was turbocharged and totally transformed by tens of billions of federal incentive dollars.
It was February 17, 2009, when, in the ongoing aftermath of the Great Recession, a newly-inaugurated President Barack Obama signed the American Recovery and Reinvestment Act into law.
It contained $787 billion of stimulus funding at the time, with $19 billion of it earmarked specifically for health technology investments – a number that would almost double in the years ahead. (Read our coverage of it here.)
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5 steps to make EHRs more user-friendly

Megan Knowles - Print  | Email
Researchers from the Baylor College of Medicine in Houston and their collaborators have come up with a five-point plan to improve the usability of EHRs in a paper published in JAMA.
"People expected information technology in healthcare to work similar wonders as elsewhere, such as on our phones, so expectations were naturally high when electronic health records were implemented nationally. But healthcare is much more complex, and usability and safety challenges have emerged," said senior author Hardeep Singh, MD.
The paper is based on lessons from 10 years of initiatives to make EHRs easier to use.
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FDA clears AI-based wearable device to monitor hospital patients

Published February 07 2019, 7:13am EST
The Food and Drug Administration has approved a wireless device that continuously and automatically monitors patients using artificial intelligence to provide clinicians with actionable insights.
Scottish company Current Health, the manufacturer of the wearable device, announced on Wednesday that it has received Class II clearance from the FDA for hospital care.
According to the vendor, the device monitors patients’ vital signs using proprietary algorithms that continuously analyze the data to help better predict their health trajectory and to enable clinicians to intervene earlier and improve outcomes.
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Cross-border access to health data: EU moves one step closer

New recommendations aim to advance the sharing and access of health data across borders in the European Union.
February 07, 2019 03:45 AM
The European Commission has published this week a Recommendation on the development of a European EHR exchange format that would enable EU citizens to access their electronic health information securely across borders.
The Commission says this will boost medical research, increase quality of care and decrease costs.
Some EU countries have already made progress on making parts of health records accessible and exchangeable, and yesterday’s news follows a recent announcement that Finnish citizens can now retrieve medicines in Estonian pharmacies that are prescribed electronically by their doctors back home through the eHealth Digital Service Infrastructure.
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Frost & Sullivan names 10 big growth opportunities in precision medicine

Imaging informatics will be ripe for transformation in the years ahead as precision analytics, AI, deep learning, and 3D printing are brought to bear.
February 07, 2019 02:18 PM
The precision medical imaging market is pegged to grow from $120 million in 2017 to more than $8 billion by 2027, according to a new study from Frost & Sullivan. As it does, there's huge opportunity for growth in a variety of technologies that can impact the way imaging is applied to personalized care.
WHY IT MATTERS
In the new report, Growth Opportunities in Precision Medical Imaging, Forecast to 2022, Frost & Sullivan assesses those market opportunities and how they jibe with the various stages of imaging as they exist today: image ordering, acquisition, interpretation, intervention, etc.
In the near-term future, there's enormous potential for emerging technologies to make themselves felt in the market, the study shows, as personalization of diagnostic and therapeutic imaging paves the way for new applications of advanced, AI-enabled clinical decision support, sensors technology, deep learning, 3D printing and more.
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DOJ lawyer in Greenway case: EHR vendors are now on notice

The agency will continue its resolve to uncover and pursue cases to protect the public from corporate greed, U.S. Attorney Christina Nolan says.
February 07, 2019 07:37 AM
When Greenway Health settled the $57.25 million False Claims and Anti-Kickback charges with the U.S. Department of Justice on Wednesday, the EHR vendor became the second one to meet a similar fate.
eClinicalWorks in late May of 2017 settled its own False Claims case to the tune of $155 million.
With the major settlements completed, the attorneys involved are cautioning other electronic health record vendors as well.
"In the last two years my office has resolved two matters against leading EHR developers where we alleged significant fraudulent conduct," said United States Attorney for the District of Vermont Christina Nolan in a statement. "These are the two largest recoveries in the history of this District and represent the return of over two-hundred and twelve million dollars of fraudulently-obtained taxpayer monies."
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Cerner misses earnings and revenue expectations despite an increase in bookings

Feb 6, 2019 2:59pm
Despite boosts from a VA contract and near-record bookings in the fourth quarter, Cerner's earnings took a dip last year and fourth-quarter revenue came in slightly below expectations.
CEO Brent Shafer, who took the helm only a year ago, said during an earnings call on Tuesday that the company had plans in place to increase profitability and predictability.
The company reported fourth-quarter 2018 revenue of $1.36 billion. That was up 4% compared to fourth-quarter 2017’s revenue of $1.31 billion but fell short of the low range of its own guidance of $1.37 billion. Annual revenue also increased by 4% to $5.36 billion in 2018.
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Survey: 96% of healthcare leaders said their hospital uses clinical surveillance solution

The finding comes from a survey of 100 hospital executives that VigiLanz, a clinical surveillance company, commissioned healthcare research firm Sage Growth Partners to conduct.

Feb 5, 2019 at 11:58 AM
A new survey found the majority of healthcare executives — 96 percent — said their hospital uses some kind of clinical surveillance solution, either from a third party, as part of their EHR or a tool created in-house. Four percent said they don’t perform any type of clinical surveillance.
VigiLanz, a clinical surveillance company, commissioned healthcare research firm Sage Growth Partners to survey 100 hospital executives across the U.S. in November 2018. Ninety-four percent of respondents held C-suite positions, such as CEO, CFO, CIO, CMO and CNO. Survey participants came from children’s hospitals, rehabilitation hospitals, long-term acute care hospitals, specialty hospitals and short-term acute care hospitals.
Since the majority of respondents indicated their organization uses clinical surveillance tech, it comes as no surprise that 88 percent said clinical surveillance is extremely, very or moderately important to their organization. Meanwhile, 9 percent said it’s slightly important and 3 percent noted it wasn’t important at all or they didn’t know its importance.
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2/4/2019
05:30 PM

Exposed Consumer Data Skyrocketed 126% in 2018

The number of data breaches dropped overall, but the amount of sensitive records exposed jumped to 446.5 million last year, according to the ITRC.
Good news: The number of data breaches reported in 2018 dropped 23% compared with 2017. Bad news: The number of sensitive consumer records exposed increased 126% year-over-year.
The data comes from the Identity Theft Resource Center (ITRC), which has been tracking publicly available breach disclosures and reporting on trends since 2005 alongside sponsor CyberScout. Its "2018 End-of-Year Data Breach Report" reflects severe compromise of sensitive consumer data and the methods with which cybercriminals now access personal information.
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Activity monitors measure step counts for surgery patients

Published February 06 2019, 7:30am EST
Patients wearing Fitbit devices were able to measure step count after major surgery, improving clinical assessment of daily ambulation and helping to predict their length of hospital stay.
A prospective cohort study of 100 patients at Cedars-Sinai Medical Center, published in JAMA Network Open, found that for every 100 steps taken by post-operative participants they decreased their length of stay by 4 percent.
“We measure everything about our patients—whether it’s heart rate, blood pressure (and such)—but nowhere do we measure steps, even though we know steps are so important for a patient’s wellbeing. Now we have the ability to do so,” says Brennan Spiegel, MD, senior author of the study and director of Cedars-Sinai’s Center for Outcomes Research and Education.
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HIT Think How to address disparities in access to healthcare information

Published February 06 2019, 5:35pm EST
Addressing disparities in access to health information is a challenge given the diverse sources of information and users’ trust in and preference for one source over another.
Not an issue to be taken lightly, an individual’s ability to access credible health information directly impacts decision-making and health outcomes. Therefore, patient engagement is an important subject to explore.
Patient engagement is defined by the Center for Advancing Health as “actions individuals must take to obtain the greatest benefit from the health care services available to them.” Certainly, such engagement is essential when it comes to one of the most important patient actions of all: taking medications. After all, as a Yoruba proverb says: “Medicine left in the bottle can’t help.”
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Alphabet’s experimental health unit takes on the opioid epidemic

Published February 07 2019, 5:25pm EST
Alphabet’s experimental healthcare unit Verily plans to partner with hospitals in Ohio on a tech-heavy approach for treatment of substance abuse disorders.
Verily said on Tuesday that it will help launch an independent not-for-profit called OneFifteen that plans to set up an addiction treatment facility in Dayton with housing and a behavioral health treatment center.
The idea is to apply Verily’s data-centric approach to addiction, using analytics to improve care by gleaning insight over time from operational and clinical data. Samaritan Behavioral Health, a subsidiary of Premier Health, will work with Verily to provide clinical care for the project. Kettering Health Network is also a partner.
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Alphabet is taking on health care with a bunch of projects – here are some of the most ambitious

Published Wed, Feb 6 2019 • 11:32 AM EST | Updated 3 hours ago
Key Points
  • Alphabet is dabbling in a wide range of health-care projects across its different companies, including Verily and Calico.
  • Some are farther along and have a real shot at having an impact, while others are wildly speculative.
  • On Wednesday, Alphabet announced a new effort to take on the opioid crisis.
Alphabet’s Verily unit said on Wednesday that’s it taking on the opioid crisis, joining with two health networks to build a tech-infused rehab campus in Dayton, Ohio.
Verily is one of Alphabet’s “Other Bets,” and marks its most advanced effort in the health-care market. But long before Alphabet was created as the parent company of Google and its side projects in 2015, the internet giant was dabbling in health. In 2008, there was the launch of Google Health, a site that failed because consumers weren’t willing to upload their personal data.
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FDA: Real-World Data, Machine Learning Critical for Clinical Trials

Real-world data, machine learning, and artificial intelligence will help to support effective clinical trials, says the FDA's Scott Gottlieb.

January 31, 2019 - Real-world data gathered directly from EHRs and other data sources, paired with advances in machine learning, will be crucial for architecting the next generation of successful clinical trials, says FDA Commissioner Dr. Scott Gottlieb.
In a speech to the Bipartisan Policy Center on January 28, Gottlieb stressed the importance of modernizing the clinical trial process to take advantage of EHR data, Internet of Things (IoT) devices, claims data, and other non-traditional sources to support scientific investigations.
“Digital technologies are one of the most promising tools we have for making health care more efficient and more patient-focused,” Gottlieb said.  “This isn’t an indictment of the randomized controlled trial. Far from it.”
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Future of Psychiatry Promises to be Digital, From Apps That Track Your Mood to Smartphone Therapy

02/01/2019 - 8:00am
by David Gratzer
Ella, who is in her early 20s, has depression. When her sleep started to fall away after a stressful term at school, her smartphone was programmed to note the late-night texts and phone conversations indicating her insomnia. It made suggestions to improve her sleep.
When her social media posts grew more negative and she was calling friends less often, her phone had her do a depression scale, booked her in to see her psychiatrist, then uploaded the scale results and a log of her recent sleep patterns.
She connected with her psychiatrist though videoconferencing and this doctor made some medication adjustments. Ella also began some focused psychotherapy through an app.
Ella isn't real, but hundreds of thousands of Canadians do have major depressive disorder. Today, smartphones don't pick up on insomnia, and they don't set up appointments with psychiatrists. But one day they could.
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Top News – Cerner Results

Cerner reports Q4 results: revenue up 4 percent, adjusted EPS $0.63 vs., $0.58, meeting earnings expectations but falling short on revenue.
The company announced plans to start paying a quarterly dividend of $0.15 in Q3 2019.
Also in Cerner news, the company will lay off 129 employees at its Augusta, GA office on March 31, according to WARN Act filings. I assume that’s at Augusta University Health, which I believe outsourced IT to Cerner a few years back but seems to be using at least some Epic now.
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Providers look to ramp up efforts to optimize records systems

Published February 05 2019, 7:07am EST
The federal government’s Meaningful Use Program—intended to incentivize healthcare organizations to rapidly adopt electronic health records systems—provided significant impetus to get providers to invest in digital records systems.
In 2009, when the MU program began, as one of the key objectives of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the Federal Health IT Strategic Plan, fewer than one of eight (12.2 percent) non-federal acute care hospitals had record systems in place, according to data from the American Hospital Association. By 2015, seven out of every eight hospitals had a basic EHR in use (83.8 percent), and that percentage has inched even higher, four years later.
Now, after billions of dollars in investment in EHR technology over the past decade, healthcare organizations are trying to cash in. Meaningful use is transitioning into measurable results.
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KLAS: Small practices want more usable EHRs, not more bells and whistles

Researchers uncover a disconnect between what customers want and the top priorities of vendors.
February 05, 2019 01:26 PM
As the industry moves beyond mere EHR adoption and meaningful use, small practices of 10 physicians or fewer told researchers that they want their EMRs to do more than just meet regulatory requirements, a new KLAS report on small physician practices finds. But first, they want the basics to just work better. That means tailoring usability for them and improving customer service.
WHY IT MATTERS
Over the past year, small physician practices have varied greatly on what they think of their EMR vendors — some by as much as 10 percentage points. KLAS discovered, however that all-in-all, small physician practices want their EMR and practice management vendors to figure out how to meet unique needs for functionality, usability, and vendor support and guidance — before they do anything else for them.
The KLAS study, titled “Small Practice, Ambulatory EMR/PM, 2019,” also found that practices want ease of use and better customer service as some of their top priorities.
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GDPR status check: Healthcare faces daunting challenges

The industry is faring worse than others in complying with the European Union’s General Data Protection Rules, one expert says.
February 05, 2019 09:02 AM
After four years of preparation and debate in the European Union Parliament, the General Data Protection Regulation (GDPR) came into force in May 2018. Now, as the one-year anniversary of the most important shift in data privacy regulation in 20 years approaches, widespread changes are already being felt in the healthcare industry, which is facing multiple challenges to protect sensitive data.
The regulations mean the healthcare sector needs to rapidly deploy a more holistic approach to data management, especially considering data concerning health has special mention under the GDPR.
That’s particularly true as healthcare and other industries wrestle with GDPR compliance.
GDPR non-compliance a problem in healthcare
Jonathan Armstrong, a technology and compliance lawyer at London-based legal services firm Cordery said there are still fairly concerning levels of GDPR non-compliance in healthcare.
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February 1, 2019

Machine Learning for Sepsis Identification

Daniel M. Lindberg, MD reviewing
A new score, identified with use of artificial intelligence techniques, outperformed current metrics.
Early sepsis identification improves outcomes, but currently there is no early definition of sepsis with acceptable sensitivity and specificity. These authors used machine learning to derive and validate a new “Risk of Sepsis” score in a large emergency department (ED) population.
The authors randomly divided a retrospective cohort of ED encounters from a large healthcare system into a training cohort (67%) and a testing cohort (33%). The definition of sepsis presumed infection plus organ dysfunction, and notably did not include lactate results. Risk of Sepsis scores were reported at 1, 3, 6, 12, and 24 hours and were compared against several other sepsis scores.
Among nearly 3 million patients, 54,661 (2.0%) had sepsis according to the study definition, with 53% of these admitted to the intensive care unit and 11.9% dying in hospital. The Risk of Sepsis score had an alert rate of 5% and included 13 features (vital signs, shock index multiplied by age, and eight laboratory values). Lactic acid was the most influential feature, responsible for >50% of the risk estimate. The score's area under the receiver operating characteristics curve ranged from 0.93 at 1 hour to 0.97 at 24 hours, and outperformed other scores (SIRS, qSOFA, ompSOFA, NEWS, and MEWS) at each time point.
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Why it’s time to rethink the laws that keep our health data private

A new proposal could provide an opportunity to revamp health privacy law, but what would an ideal policy look like?

By Angela Chen@chengela
In 1996, the year Congress passed its landmark health privacy law, there was no Apple Watch, no Fitbit, no Facebook support groups or patients tweeting about their medical care. Health data was between you, your doctor, and the health care system. More than two decades later, that law — the Health Insurance Portability and Accountability Act (HIPAA) — is still the key piece of legislation protecting our medical privacy, despite being woefully inadequate for dealing with the health-related data we constantly generate outside of the health care system. Now, there could be an opportunity for a revamp.
Earlier this month, Sen. Marco Rubio (R-FL) announced a data privacy bill that would direct the Federal Trade Commission to write new privacy recommendations that overrule state laws. Similarly, a prominent technology think tank, the Information Technology and Innovation Foundation, has suggested a “grand bargain” of a new federal data law that would not only preempt state laws, but entirely repeal sector-specific federal privacy laws like the Family Educational Rights and Privacy Act (FERPA), Children’s Online Privacy Protection Rule (COPPA) and, of course, HIPAA.
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More than half of patients willing to use digital therapeutic, study says

The report also found that 56 percent of physicians have brought up the potential for a digital therapy as an option for their patients, and 26 percent have discussed the option after a patient brought it up.

Post a comment / Feb 1, 2019 at 8:14 AM
The emerging field of digital therapeutics has developed new tools with the promise to either replace or supplement traditional medical devices and therapies.
Increasingly, it appears that the general public is open to using these digital tools as part of their part of their treatment options.
A new report from PWC found that 54 percent of surveyed consumers would be open to trying an FDA approved digital app or online tool to treat their medical condition.
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Improving Cybersecurity Means Taking More Care with What We Digitize

February 01, 2019
Security researcher Troy Hunt recently discovered one of the largest online troves of leaked personal information in history — a collection of nearly 773 million hacked e-mails and passwords.
Hunt’s discovery stresses a point that’s been evident for some time: Once information is digitized, no one can fully guarantee its safety.
So how do we fix our cybersecurity troubles? In two words: Slow down. Put simply, the time has come to more purposefully control what it is we digitize. This means slowing down the pace of adoption of networked technology with new laws and standards aimed at increasing the quality and reliability of any device with an IP address. And it means carefully preserving analog capabilities, even as we embrace the digital.
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Google patent indicates plans to develop EHR to predict patients' clinical outcomes

Feb 4, 2019 3:34pm
Google appears to have plans to develop its own electronic health record (EHR) for clinicians that gathers patients’ medical records and then leverages machine learning to predict clinical outcomes, according to a patent application published by the U.S. Patent and Trademark Office last week.
First reported by Politico today, the patent application was filed back in August 2017. Among the inventors on the application are more than 20 Google employees, particularly from the Google Brain team, or its artificial intelligence division, including AI head Jeffrey Dean.
The 40-page application describes a new computer system, with a healthcare provider-facing interface, that predicts and summarizes medical events from EHRs.
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Google might be building an EHR: 4 notes

Julie Spitzer - Print  | Email
Google may be building its own EHR and analytics system, according to a July 2017 patent application that was published by the U.S. Patent Office Jan. 31, the Politico Morning eHealth newsletter reports.
Google's 40-page patent application describes a "system and method for predicting and summarizing medical events from electronic health records."
Four notes:
1. The patent application listed 21 Google employees as its inventors, including the head of Google.ai and senior research fellow Jeffrey Dean, PhD.
2. According to the application, the system has three parts:
  • Storage for aggregated EHR data from millions of patients
  • Deep learning capabilities to analyze records in a standardized data format
  • A configuration with clinician-facing device to display the predicted clinical events, as well as the patient's relevant past medical history
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HIT Think How healthcare organizations can jump-start IoT implementations

Published February 04 2019, 5:59pm EST
Healthcare organizations face a new challenge as they prepare for the next wave of innovation: they must re-imagine and modernize their digital infrastructure now.
Rapidly changing patient expectations and the continuing shift to value-based care are creating new requirements and opportunities to better leverage data for actionable clinical and business decisions.
The explosive growth of connected devices and Internet of Things (IoT) systems is driving the need for strategic action. While many healthcare organizations may start their IoT journey with just one application, the true potential of IoT is the ability to connect systems to deliver intelligent outcomes from an open, scalable “system of systems” and the related data generation network effect.
Start small and break down data silos as you scale
As healthcare organizations invest in IoT, leaders need to demonstrate early wins, and incubate projects while building the supporting infrastructure to strategically scale for the future. Large public clouds may make it easier to get an IoT project off the ground, but IT organizations also need to consider the benefits of an open, interoperable environment across the collaborative care continuum. In fact, sending data to a large public cloud may actually result in “locking” information into new silos. It also may be cost prohibitive to retrieve the data to create new value – which is the ultimate goal of IoT.
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Ransomware in 2019 and beyond: Don't get complacent

Infosec and IT teams should expect ransomware attacks to continue and that’s as true in healthcare as any other industry.
February 04, 2019 11:47 AM
Although much of the buzz about ransomware has quieted down in the days since the NotPetya and WannaCry attacks, the threat persists and hospital IT and security teams should remain vigilant.  
Just like phishing attacks and other types of malware, expect hackers and cybercriminals to keep launching ransomware attacks against your network for the foreseeable future.
That means healthcare organizations should be putting in place or shoring up robust measures needed to secure patient data and prevent malicious attacks on critical systems and information.
Ransomware status check
Ransomware, a type of malicious software that infects computer servers, desktops, laptops and other mobile devices, encrypts critical files and then alerts the organization to its monetary demands with a ransom note.  
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Weekly News Recap

  • EMDs acquires Aprima
  • Nordic acquires Healthtech Consultants
  • Harris Healthcare’s Iatric Systems acquires Haystack Informatics
  • The VA ends its pilot of Epic scheduling and will instead implement Cerner at all facilities
  • KLAS releases “Best in KLAS 2019”
  • Australia’s Queensland Health and SA Health struggle with their Cerner and Allscripts projects, respectively
  • FDA Commissioner Scott Gottlieb, MD outlines several ways in which the agency will use digital systems to make healthcare more efficient and patient focused
  • The VA’s Office of Electronic Health Record Modernization opens positions for deputy chief medical officers to help oversee its Cerner implementation
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How your health information is sold and turned into ‘risk scores’

Information used to gauge opioid overdose risk is unregulated and used without patient consent.
02/03/2019 06:56 AM EST
Companies are starting to sell “risk scores” to doctors, insurers and hospitals to identify patients at risk of opioid addiction or overdose, without patient consent and with little regulation of the kinds of personal information used to create the scores.
While the data collection is aimed at helping doctors make more informed decisions on prescribing opioids, it could also lead to blacklisting of some patients and keep them from getting the drugs they need, according to patient advocates.
Over the past year, powerful companies such as LexisNexis have begun hoovering up the data from insurance claims, digital health records, housing records, and even information about a patient’s friends, family and roommates, without telling the patient they are accessing the information, and creating risk scores for health care providers and insurers. Health insurance giant Cigna and UnitedHealth's Optum are also using risk scores.
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Enjoy!
David.