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."

Saturday, May 02, 2020

Weekly Overseas Health IT Links – 2 May, 2020.

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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‘Absence of evidence’ for Covid-19 contact-tracing apps, review finds

An “absence of evidence” to support the immediate deployment of a Covid-19 contact-tracing app risks “undermining public trust”, a research institute has warned.
Andrea Downey 22 April, 2020
The independent Ada Lovelace Institute has published a rapid review of the technical, social and public health evidence for contact-tracing apps, finding the current “technical limitations” and “social impacts” outweigh the potential benefits of an app.
To avoid the loss of public trust, the institute called for the introduction of legislation to regulate the development of apps and data processing, including strict purpose access to data and time limitations on its use.
Deployment of technologies should be subject to sign-off from a new Group of Advisors on Technology in Emergencies (GATE), established to oversee the development and testing of any digital tracing application, the review said.
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Imperial white paper outlines key data questions for contact-tracing tech

The NHS “cannot afford” to not use a contact-tracing app but special measures need to be taken to limit the risk a user could be identified, according to a new paper.
Andrea Downey 23 April, 2020
Imperial College London has published a white paper outlining the eight questions governments, public health authorities and developers should consider when developing contact-tracing apps.
Such apps could prove useful in avoiding long-term confinement measures, the college said, but as they collect sensitive information like location data, Bluetooth-enabled proximity information, and whether individuals are infected, caution needs to be exercised to protect privacy.
Dr Yves-Alexandre de Montjoye, of Imperial’s department of computing and author of the paper, said: “We need to do everything we can to help slow the outbreak. Contact tracing requires handling very sensitive data at scale, and solid and proven techniques exist to help us do it while protecting our fundamental right to privacy. We cannot afford to not use them.
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Contact-tracing apps could ‘catastrophically’ hamper trust, academics warn

Contact-tracing apps could “catastrophically hamper trust” if they become a tool for “large scale data collection on the population”, hundreds of academics have warned.
Andrea Downey – 23 April, 2020
An open letter, published on 19 April and signed by professors from 26 countries, urges governments and public health authorities to evaluate the potential dangers of developing contact-tracing technology before releasing an app to market.
They warned of risks to accuracy and privacy in using GPS-based apps, instead recommending the use of Bluetooth to trace users. But, they added, that could also come with risks.
“Some of the Bluetooth-based proposals respect the individual’s right to privacy, whilst others would enable (via mission creep) a form of government or private sector surveillance that would catastrophically hamper trust in and acceptance of such an application by society at large,” they wrote.
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Patients now able to nominate pharmacy using the NHS App

Patients across England are now able to choose a pharmacy to have their repeat prescriptions sent to directly, via the NHS App.
Hanna Crouch April 21, 2020
The functionality was something that could already be done by people in their GP practices, pharmacies or via some GP and pharmacy online services, but this move means patients can nominate a pharmacy no matter which IT system their GP surgery uses and without having to leave home.
Users can choose from all community high street pharmacies or nominate an online-only pharmacy.
In the initial phase of this functionality being live, those choosing an online-only option will be automatically directed to the online pharmacy’s website to complete their registration. At this stage the service is not available to patients registered at dispensing GP practices.
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Machine Learning Tools Predict Impact of Quarantine on COVID-19

Researchers are leveraging machine learning models to understand how quarantine measures will impact the spread of COVID-19.
April 22, 2020 - In the global effort to slow the spread of COVID-19, many countries have adopted social distancing and quarantine measures to mitigate the impact of the pandemic. Now, researchers are using machine learning tools to quantify the effects of these measures in specific parts of the world.
A team from MIT has developed a machine learning model that leverages coronavirus data and a neural network to determine the effectiveness of quarantine measures and predict the spread of the virus.
Most tools used to predict the spread of a disease follow the SEIR model, which groups people as susceptible, exposed, infected, or recovered. MIT researchers enhanced this model by training a neural network to capture the number of infected individuals who are under quarantine and no longer spreading the infection to others.
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Coronavirus Fuels Explosive Growth In Telehealth ― And Concern About Fraud

April 22, 2020
On March 17, Medicare chief Seema Verma stepped to the podium at a White House coronavirus briefing and unveiled a “historic action” to promote virtual medical care, or telehealth.
Verma temporarily lifted a variety of federal restrictions on the use of the service, which had been limited to rural areas. She praised telehealth, saying it could handle routine care for an older patient with diabetes without risking a visit to a medical office. She said a Medicare recipient with mild flu-like symptoms could receive advice from a doctor at home “instead of leaving the house and sitting in a waiting room full of other vulnerable people.”
But the Trump administration’s action also raised concerns that it could inadvertently unleash a wave of billing fraud and abuse and risk patient safety — especially if officials yield to industry pressure to make many of the emergency policy changes permanent.
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The difference-makers during the surge: 6 CIOs on top priorities and key advice amid COVID-19

Laura Dyrda (Twitter) -
The U.S. health system is going through seismic changes in response to the COVID-19 pandemic.
Across health systems, executives including CIOs have pivoted their focus to support their teams remotely and caregivers as they treat COVID-19 patients. Here, CIOs from hospitals and health systems in a few of the states hardest hit by the pandemic so far outline their top priorities and key advice for their colleagues preparing for a surge of coronavirus patients in the coming weeks.
Jeffrey Sturman. CIO of Memorial Healthcare System (Hollywood, Fla.): My top three priorities are:
1. Enhancing and rapidly pushing out our existing telehealth capabilities while also developing new way to communicate with our patients.
2. Helping to coordinate consistent and constant communication with our patients and consumers via any and all technology means; that includes websites, text, email, bots, telephone and even manually while also helping to facilitate communications to our internal healthcare staff, through video conferencing and all other traditional means.
3. Designing automated screening, scheduling, and results notification processes with our local, regional, and state representatives in the testing of COVID-19.
Key advice: We all need to remain extremely flexible in these uncertain times. We need to continue to do the 'magic' behind the scenes in keeping our systems up a running. We also need to be as proactive as possible, for example by addressing network bandwidth, and making sure what is typically not a remote working staff are able to do their jobs in a secure and effective way.
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Cyberattacks on US health care raise alarms among senators

Bipartisan group of lawmakers calls on Pentagon and Homeland Security to increase monitoring
Posted April 22, 2020 at 3:55pm
A bipartisan group of senators wrote to the top U.S. cybersecurity officials asking them to step up monitoring, warnings and, if needed, counterstrikes against a host of foreign hackers targeting the U.S. health care system and pharmaceutical companies through cyberattacks.
In an April 20 letter to Gen. Paul Nakasone, head of the military's U.S. Cyber Command, and Christopher Krebs, the top Homeland Security Department official at the Cybersecurity and Infrastructure Security Agency, the lawmakers said they were alarmed at a spate of recent reports from private threat intelligence companies that “Russian, Chinese, Iranian, and North Korean hacking operations have targeted the health care sector and used the coronavirus as a lure in their campaigns.”
The lawmakers include Sens. Richard Blumenthal, D-Conn., Mark Warner, D-Va., Edward J. Markey, D-Mass., Tom Cotton, R-Ark., and David Perdue, R-Ga.
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Hospitals are using AI to predict the decline of Covid-19 patients — before knowing it works

April 24, 2020
Dozens of hospitals across the country are using an artificial intelligence system created by Epic, the big electronic health record vendor, to predict which Covid-19 patients will become critically ill, even as many are struggling to validate the tool’s effectiveness on those with the new disease.
The rapid uptake of Epic’s deterioration index is a sign of the challenges imposed by the pandemic: Normally hospitals would take time to test the tool on hundreds of patients, refine the algorithm underlying it, and then adjust care practices to implement it in their clinics.
Covid-19 is not giving them that luxury. They need to be able to intervene to prevent patients from going downhill, or at least make sure a ventilator is available when they do. Because it is a new illness, doctors don’t have enough experience to determine who is at highest risk, so they are turning to AI for help — and in some cases cramming a validation process that often takes months or years into a couple weeks.
“Nobody has amassed the numbers to do a statistically valid” test of the AI, said Mark Pierce, a physician and chief medical informatics officer at Parkview Health, a nine-hospital health system in Indiana and Ohio that is using Epic’s tool. “But in times like this that are unprecedented in U.S. health care, you really do the best you can with the numbers you have, and err on the side of patient care.”
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EHR Tools Flag High-Risk Patients, Detect Undiagnosed Dementia

Researchers were able to develop an EHR tool that successfully diagnosed a previously undiagnosed dementia patient.
April 24, 2020 - A tool implemented into the EHR can be utilized to address the issue of missed or late diagnoses of dementia and can flag the patient record for a future follow up, according to a study published in the Journal of the American Geriatrics Society.
One of the top concerns of America’s aging population is the misdiagnosis or under-recognition of dementia.
Using this tool, clinicians can give patients an early diagnosis of dementia, which would allow for earlier, timelier patient care. However, roughly half of the patients with dementia are left undiagnosed.
So far, little work has been done to translate findings from models of future risk of dementia into EHR systems that could be used in primary care settings to detect undiagnosed cases.
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Half of physicians now using telehealth as COVID-19 changes practice operations

Apr 23, 2020 7:15am
Close to half of doctors are now using telehealth to treat patients as the COVID-19 pandemic changes practice patterns and how physicians deliver care.
That's up from 18% of physicians using telemedicine two years ago, based on The Physicians Foundation’s "2018 Survey of America's Physicians."
In this latest physician survey, Merritt Hawkins, a physician search company, found that the use of telemedicine has been rapidly accelerated by the COVID-19 epidemic, which has spurred changes to reimbursement policies that had previously limited its use. 
In a bid to help support practices, the Centers for Medicare & Medicaid Services (CMS) last month agreed to pay for virtual visits at the same rate as in-person visits while the coronavirus emergency remains in effect.
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28 companies, including tech firms, collaborate on EHR-fueled COVID-19 database

Doctors and other stakeholders can use the research database to, among other things, evaluate drug effectiveness using de-identified electronic health record and claims data.
April 24, 2020 11:31 AM
An assortment of 28 U.S. firms have formed a cross-industry collaboration to attack COVID-19. These include well-known technology companies such as Change Healthcare, SAS, Helix, Veradigm and Boston Health Economics.
WHY IT MATTERS
Boston Health Economics, for example, is an independent analytics organization that aids providers in conducting research and helps analytic teams in generating evidence to improve medical decision-making.
An example of the type of assessments that healthcare providers can conduct with or without help from the group of vendors includes queries to the group’s COVID-19 Research Database.
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Apr 24 2020

The future of work in an age of digital transformation

Health systems which invest in the digital employee experience will emerge as an employer of choice and retain staff.
Susan Morse, Managing Editor
The future of work depends on technology, good management and flexibility in the workplace, according to a HIMSS20 Digital session "Healthcare Perspectives on the Future of Work: An Analysis."
Ninety-two percent of healthcare leaders believe future technologies will continue to transform how clinicians and staff serve their communities, according to research conducted by The Workforce Institute at Kronos with Regina Corso Consulting.
THE SURVEY FINDINGS
Of  355 survey respondents, 152 are registered nurses, 102 are in information technology and 101 work in human resources, all in a healthcare setting.
The number one consideration valued by all three groups, not surprisingly, is competitive pay, followed by different priorities depending on the survey-taker.
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Why Telehealth Is Real Now – The Value Equation

April 24, 2020
Everyone sees the obvious when it comes to telehealth.  The Stay at Home and Physical Distancing that’s come with COVID-19 has almost required telehealth.  What other option did healthcare organizations have?  Embrace telehealth or die?
However, I think that’s actually a little simplistic.  If we want to really understand what happened to make telehealth go mainstream overnight (see this great example of telehealth growth) we have to dig a little deeper into what happened.  Plus, understanding these details will be key to us being able to ensure that telehealth isn’t just a flash in the pan effort that goes away as we’re able to finally return to offices and hospitals.
To understand this, we have to look at why telehealth wasn’t being more widely adopted in healthcare.  From the patient perspective, telehealth often made so much since.  I don’t know anyone who wouldn’t rather wait in their house than in a medical waiting room.  Not to mention the commute.  Not to mention finding parking in many places.  Not to mention the risk of infection.  Not to mention parents who have multiple kids.  As much fun as it was to sit in an exam room waiting for an hour with multiple children, I’ll be fine if I never have to do that again.
The list goes on and on.  One thing was clear.  Telehealth provided amazing value and benefits to patients.
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Patient Experience Good Despite Low Care Access During COVID-19

Good patient experience is up 7 percent since January, despite the limited care access and strain COVID-19 has put on the medical industry, The Beryl Institute and Ipsos say.
April 22, 2020 - Although patient access to primary care is down due to the COVID-19 outbreak, patient satisfaction with the quality of their care is up, according to new poll data from The Beryl Institute.
The PX Pulse poll conducted in partnership with Ipsos looked at patient experience of care during the first quarter of 2020, one that was defined by the outbreak of the novel coronavirus.
“COVID-19 is changing the way that Americans interact with the healthcare system, and the results are in,” Clifford Young, president of Public Affairs for Ipsos, said in a statement.
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Sens. to DHS CISA: Issue COVID-19 Cyber Threat Guidance for Healthcare

Given the steady increase in COVID-19 cyber threats, a group of Senators are asking DHS CISA and its partners to develop and issue cybersecurity guidance for the healthcare sector.
April 22, 2020 - In light of the rapid increase in COVID-19 cyber threats, the Department of Homeland Security Cybersecurity and Infrastructure Security Agency and the US Cyber Command are being asked to develop and issue cybersecurity guidance to support the healthcare sector during the pandemic.
The letter, led by Sens. Richard Blumenthal, D-Connecticut and Mark Warner, D-Virginia, as well as three other Senators, raises “profound concerns” about the “unprecedented and perilous campaign of sophisticated hacking operations” from both domestic and foreign threat actors.
“The cybersecurity threat to our stretched and stressed medical and public health systems should not be ignored,” the Senators argued. “Prior to the pandemic, hospitals had already struggled to defend themselves against an onslaught of ransomware and data breaches. Our hospitals are dependent on electronic health records, email, and internal networks that often heavily rely on legacy equipment.”
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ONC Delays Final Interoperability Rule Deadline Due to Coronavirus

ONC and CMS will allow for hospitals and the ONC Health IT Certification Program to have more time to implement the ONC Final Interoperability Rule due to the spread of the coronavirus.
April 21, 2020 - The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) have extended the deadline for hospitals and health IT professionals to implement the final phase of the 21st Century Cures Act, due to the coronavirus outbreak.
“ONC remains committed to ensuring that patients and providers can access electronic health information, when and where it matters most,” Don Rucker, MD, National Coordinator for Health Information Technology, wrote in a statement. During this critical time, we understand that resources need to be focused on fighting the COVID-19 pandemic.”
ONC will extend the ONC Health IT Certification deadline up to three months due to the pandemic.
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23 Apr 2020 News

Alleged Neo-Nazis Post WHO and US Gov Log-ins Online

Phil Muncaster UK / EMEA News Reporter , Infosecurity Magazine
Twitter has been forced to take down thousands of breached email addresses and passwords from US and global health organizations first disseminated by alleged Neo-Nazi groups.
Rita Katz, director of SITE Intelligence Group, said the log-in combos were linked to the US National Institutes of Health (9938), Centers for Disease Control and Prevention (6857), the World Bank (5120), the Gates Foundation (269), Wuhan Institute of Virology (21) and the World Health Organization (2732).
She tweeted that “the far-right seized on the data with a harassment campaign as part of a months-long initiative to weaponize the pandemic.”
Right-wing groups have been blamed for spreading fake news and questioning scientific evidence about the COVID-19 pandemic.
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Nearly half of physicians using telehealth, up from just 18% in 2018

A new report also finds that because of the COVID-19 pandemic, 18% of physicians plan to retire, temporarily close their practices or opt out of patient care completely.
April 23, 2020 01:39 PM
Physicians are changing the patterns of their practice because of the COVID-19 pandemic, with nearly half of them using telehealth to treat patients, up from just 18% in 2018.
WHY IT MATTERS
These were the results of a survey of 842 physicians across the country that conducted by physician search firm Merritt Hawkins. It also revealed 14% of physicians indicated that they will change practice settings as a result of the outbreak.
The survey pointed to changes in reimbursement policies, which had previously limited the use of telehealth’s use by healthcare professionals, as a possible factor in its increased usage.
The 2018 survey had indicated that telemedicine use among physicians was more prominent among younger doctors. Physicians 45 or younger indicated they were practicing some form of telehealth at a higher rate than physicians 46 or older.
Among the other findings from the new survey was the revelation that nearly four in 10 physicians are handling COVID-19 patients, and that 30% of those treating COVID-19 patients said they are feeling “great stress” but still plan to see those patients.
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The Auto Documentation Telehealth Solution Will Be a Big Winner

April 23, 2020
Last week I started a project to create a list of all of the telehealth options out there.  Mostly, I wanted to be able to provide my friends and readers answer to the question I’m certain to get over the next year, “Which telehealth solution is best?”
It may take me another week to finish gathering this list, but we’re making good progress.  However, I’ve quickly realized that people are offering all flavors of telehealth.  More to come on how we plan to categorize all the various telehealth options so that medical practices and health systems can sort through all the telehealth noise and know what options they should consider.
While we continue our work on the telehealth list, I realized an opportunity for telehealth vendors that combines a video telehealth visit with ambient clinical voice technology.  In fact, I could see whoever figures out this combination of technology first is going to be a big winner in the market.
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These open-source projects are helping to tackle the coronavirus

In the face of projected ventilator shortages caused by coronavirus, diverse groups have sprung up to build alternative machines that could change healthcare far beyond the current crisis.
By Jo Best | April 23, 2020 -- 11:30 GMT (21:30 AEST) | Topic: Coronavirus: Business and technology in a pandemic
Since the onset of the coronavirus epidemic earlier this year, numerous countries have found themselves running short of ventilators. Ventilators, used in hospitals' intensive care units, are crucial to helping those worst affected by the virus to stay alive. They take on some of the work of breathing for COVID-19 patients who find themselves in respiratory failure. However, a number of innovative grassroots initiatives, built in weeks by altruistic engineers with distributed design methodologies and open-source licences, have sprung up to try and solve the shortage.
Ventilators are critical pieces of equipment for those with the most serious cases of COVID-19, and since the outbreak began, there have been fears that demand could ultimately outstrip supply. In the UK, the health secretary Matt Hancock said the country needed to expand the 5,000 ventilators it had many times over, and asked engineering companies to come up with new designs and expand production. In the US, earlier this month President Trump warned of a possible shortage of ventilators and subsequently announced a program to redistribute unused ventilators and spare parts to coronavirus hotspots.
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Threat Actors Targeting Hospitals with Double Extortion Ransomware

Check Point finds hospitals and other providers are being targeted with double extortion, where hackers first extract large troves of data before deploying the ransomware to pressure victims.
April 16, 2020 - An increasing number of hacking groups have begun following a disturbing trend first made public by the notorious Maze threat actors: targeting hospitals and other healthcare entities with double extortion attempts, according to new research from Check Point.
Maze hackers emerged in November 2019 targeting a wide range of sectors with a new type of extortion. After Allied Universal refused to pay a $2.3 million ransom demand, the Maze group threatened to use the data, email, and domain name certificates extracted from the security staffing company’s systems for a spam campaign impersonating Allied.
To further pressure the company, Maze published a sample of the stolen data online, which included medical data and other sensitive information. They later posted another claimed 10 percent of the stolen data on a Russian hacking forum, demanding a ransom 50 percent higher than the initial demand.
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State-Level Risk Assessments Critical for Reducing COVID-19 Measures

State-level risk assessments will help leaders make informed decisions about reopening businesses, schools, and other settings during COVID-19.
April 20, 2020 - In the context of COVID-19, state-level decision-makers should conduct risk assessments to better understand how to move from strict social distancing measures to a staged reopening phase, according to a report from the Johns Hopkins Center for Health Security.
Most states have adopted social distancing measures to reduce the spread of COVID-19, with nonessential businesses, schools, and outdoor spaces being shut down to mitigate the impact of the virus. The process of reopening these community settings will look different in each state, the report authors said.
“Although no states are ready to lift physical distancing measures, there is immense pressure to get back to business as usual, and these developments have prompted questions around how to reopen in individual states when it becomes safer to do so,” researchers stated.
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Smart Technology Gains Traction in Post-MI Care

Patrice Wendling
April 22, 2020
Using a set of four smartphone-enabled monitoring devices to follow patients after an acute myocardial infarction (MI) provides blood pressure (BP) control similar to standard in-person visits, randomized data show.
Of special note, 90% of patients were satisfied with the smart technology intervention, called "The Box."
The feasibility study was designed in 2015 when there was some skepticism toward e-health and what it may contribute, explained lead study author Roderick Treskes, PhD, Leiden University Medical Center, the Netherlands.
During planning meetings, cardiologists raised concerns that patients wouldn't want or accept e-visits because of their age or lack of Internet access, even though around 95% of the Dutch population already had Internet access.
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VA, DOD launch joint HIE to ease data sharing with community providers

Apr 21, 2020 7:35am
The Department of Veterans Affairs (VA) and the Department of Defense (DOD) unveiled a joint health information exchange to enable medical providers at both agencies to share patient data with private sector healthcare organizations.
The joint HIE enables interoperable health information sharing between VA, DOD and community providers.
Participating community providers now have a single point of entry to request and access DOD and VA electronic health records (EHRs) for patients they are treating, the VA said in a press release.
“The recent COVID-19 pandemic underlines the importance for clinicians on the front lines to quickly access a patient’s health record, regardless of where that patient previously received care,” said Neil Evans, M.D., interim director of the Federal Electronic Health Record Modernization program office, in a statement.
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Big Data Dashboard Tracks COVID-19 Cases and Response in Indiana

The big data dashboard includes information about patients’ course of care in health systems across Indiana.
April 21, 2020 - Regenstrief Institute has developed a big data dashboard to help the state of Indiana track and respond to the COVID-19 outbreak.
The dashboard adds to the state’s information by providing data on patients’ course of care through local health systems. This data can give leaders a more comprehensive picture of the COVID-19 pandemic and its impact on people in Indiana, as well as an opportunity to anticipate emerging hotspots and surges.
For this effort, Regenstrief partnered with the Indiana State Department of Health (ISDH), Indiana Family Social Services Administration (FSSA), Indiana Management Performance Hub (MPH), Indiana Health Information Exchange (IHIE), Indiana University Richard M. Fairbanks School of Public Health, and Indiana University School of Medicine.
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As states consider reopening, CDC director warns coronavirus outbreak could be worse this winter

By Mallory Simon, Christina Maxouris and Jason Hanna, CNN
Updated 0216 GMT (1016 HKT) April 22, 2020
(CNN)The director of the US Centers for Disease Control and Prevention warned a second wave of the coronavirus this year could be worse because it will coincide with flu season.
"There's a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through," CDC Director Dr. Robert Redfield said in an interview with The Washington Post.
"And when I've said this to others, they kind of put their head back, they don't understand what I mean."
Redfield told the Post that having two respiratory outbreaks would burden the health care system.
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1 in 5 primary care practices predicts closure in a month, but telehealth could help

One telemedicine vendor, which is giving away its technology for two months during the pandemic, discusses the value of virtual care during physical distancing.
April 22, 2020 12:39 PM
As many as 20% of primary care practices predict they could close within four weeks because of the COVID-19 pandemic, according to a survey conducted between April 10 and April 13 by the nonprofit Primary Care Collaborative.
With COVID-19 dropping non-urgent care to next to zero, the loss in revenue is putting a dire strain on resources and operations. Physicians need to respond quickly to the changing environment, and some technology vendors are recognizing the opportunity to help these members of the healthcare ecosystem brace for these uncertain times.

Telehealth saves a clinic

For example, during the COVID-19 pandemic, business at Gastro Health in Miami came to a halt. In order to uphold social-distancing practices, patients stayed at home and thus physicians at the practice did not have access to them. Additionally, all elective endoscopic procedures were cancelled. Only urgent procedures were performed. There was a dramatic drop in business.
Gastro Health staff turned to the Healow telehealth system by eClinicalWorks.
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IBM Watson-powered CDS, integrated into Epic EHR, boosts efficiency and safety

Getting specific answers to questions as they arise within care-delivery workflows has streamlined processes at Peninsula Regional Medical Center, pharmacists there explain.
April 22, 2020 11:52 AM
A pharmacy clinical-decision support tool that employs artificial intelligence, integrated into an electronic health records system, is providing tangible benefits for clinicians and pharmacists at one Maryland hospital system, its presenters explained in a recent HIMSS20 Digital presentation.
The system is saving clinicians time in finding answers to frequent common questions about medications and their administration that clinicians traditionally have answered either by using background knowledge to make educated guesses or by contacting the pharmacy department for answers.
Now, with the AI-based system, they're finding most answers quickly, using natural language to form their queries.
The adoption of the system at Peninsula Regional Medical Center in Salisbury, Maryland, is freeing up time for clinician-pharmacy department dialogues on more complex questions or patient-specific queries, said Rachel Cordrey, pharmacy supervisor for the organization.
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Temporary hospitals are rife with cybersecurity vulnerabilities

Ad hoc COVID-19 medical centers have a unique set of vulnerabilities: They're remote, they sit outside of a defense-in-depth architecture and the very nature of their purpose – care in a time of crisis – means security is a lower priority.
April 22, 2020 12:53 PM
The COVID-19 outbreak has led to a series of rapidly established medical-treatment units the world over, which will be utilizing remote-care devices that lack proper protection. The situation gives hackers more opportunities to perpetrate attacks.
They could also infiltrate these devices to steal a patient's personal health information, causing complications for both the users of these devices and the healthcare providers themselves.
Temporary medical units carry a unique set of vulnerabilities due to the fact they are remote and sit outside of a defense-in-depth architecture. Because of the very nature of their purpose – to care for patients in a time of crisis – IT security is naturally lower on the priority list.
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What Major Security Threats Does Healthcare Face Amidst COVID-19 and What Can You Do About It?

April 22, 2020
The following is an interview with Dan Schaupner, Head of Cybersecurity Consulting, North America BDS at Atos and John Lynn, Founder and Chief Editor at Healthcare IT Today.
Tell us about yourself and Atos
Atos is a leading global information security services provider, with over 100,000 employees worldwide, supporting many major customers in many countries. I am the Head of Cybersecurity Consulting for our North American group and we advise organizations on cybersecurity strategy, security architecture, and digital transformation.
One story I read recently said that some ransomware networks are avoiding healthcare during COVID-19.  Should healthcare feel any safer from hackers and other security threats amidst the crisis?
Absolutely not. If anything, they should be wary of many entities who want to take advantage of this crisis for various motivations.
What are the major security threats in healthcare that are being exploited because of COVID-19?  What should healthcare organizations and CISOs be watching for?
Phishing and disinformation awareness are at the top of my list. Given that healthcare organizations and the general public are expected to play significant roles in defeating COVID-19, it is critical that they are getting the best information possible. Failure to address this can significantly impact the organization.
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UW Medicine Makes Rapid IT Shift To Support COVID-19 Response

April 22, 2020
Like its peers, the UW Medicine health system has been struggling to keep up with the preparations for COVID-19 patients seeking treatment. To address this problem, the medical center’s health IT leaders made some broad changes to its processes which are allowing to rapidly deploy solutions that support clinical responses to the pandemic.
The UW Medicine system incorporates four hospitals, 15 neighborhood clinics the University of Washington School of Medicine. It handles roughly 64,000 hospital admissions and nearly 205,000 emergency department visits per year.
In February, when it began to see a growing volume of COVID-19 patients, one of its responses was to create a new governance structure allowing its IT department to tackle emerging problems quickly. The structures UW Medicine put in place include the following:
  • Emergency management infrastructure
The health system established a system designed to respond to emergencies, which includes eight site-based incident command centers. Each of the incident command centers includes a clinical informatician whose key responsibilities include addressing people, EHR/clinical issues and technology.
The command centers are tied into an enterprise-wide Hospital Incident Command System which helps with shared planning, logistics and operational issues. The system’s Business Continuity and Disaster Recovery program manages IT integration into the Command System.
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COVID-19 Strikes Interoperability Rules

By Mandy Roth  |   April 22, 2020
HHS announces compliance flexibilities to ease the burden on the healthcare industry and focus resources on the pandemic.
KEY TAKEAWAYS
·         Deadlines for CMS regulations related to admission, discharge, and transfer (ADT) notification have been extended from six months to 12 months after the CMS final rule is published in the Federal Register.
·         Certain ONC Health IT Certification Program compliance dates have been extended by three months.
·         Member of The Sequoia Project expresses concerns that delays should not apply to technology and other healthcare IT companies.
On March 9, the U.S. Department of Health & Human Services (HHS) announced two final interoperability rules, hailed by many as a historic step to provide patients access to their own records. Progress toward that goal is being sidelined by COVID-19.
Late yesterday the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS), in conjunction with the HHS Office of Inspector General (OIG), announced that restrictions on some of the requirements will be eased, enabling the healthcare industry to focus vital resources on responding to the pandemic.  
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How Is Coronavirus Affecting Chronic Disease Management Care?

Chronic disease management is taking a backseat during the coronavirus outbreak, with patients avoiding doctor's visits to prevent disease spread.
April 20, 2020 - Chronic disease management and treatment adherence are taking a pretty serious hit as of late, and that is largely thanks to the spread of the novel coronavirus, according to data reported by Evidation.
As the virus continues to loom large over the nation, patients are fearful of engaging with the healthcare system, even for needs unrelated to COVID-19, according to the survey data from some 185,000 patients across the country.
Overall, about one-fifth of patients regardless of disease state are worried about maintaining their health during the coronavirus outbreak. Over half are worried about visiting the doctor’s office, with 10 percent saying they are so worried they would forego care altogether.
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ACLU, Scientists Urge Privacy Focus for COVID-19 Tracing Technology

Following the Google and Apple announcement of their partnership on COVID-19 contact tracing technology, the ACLU and 200 scientists are highlighting potential privacy risks.
April 20, 2020 - As Google, Apple, and others work to develop COVID-19 contact tracing technology, the American Civil Liberties Union and a group of 200 scientists are warning of potential privacy risks posed by these technologies and are urging developers to ensure these apps do not overreach.
Last week, the tech giants made the announcement that they were partnering on the development of a contract tracing app using Bluetooth Low Energy, which would let individuals know if they’ve come into contact with someone who has COVID-19.
The proposed tech would rely on location or proximity data from mobile phones and deliver alerts to users on potential exposures. Google provided its planned privacy policies, which does include a requirement for explicit user consent.
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CDC Unveils FHIR-Based COVID-19 EHR Reporting Application

The CDC told members of the Health IT Advisory Committee that they are in the process of implementing a COVID-19 FHIR-based application for organizations that do not have the EHR capabilities.
April 20, 2020 - The Centers for Disease Control and Prevention (CDC) has unveiled a new FHIR-based application called eCR Now, that aims to give public health officials a more detailed and real-time view of the spread of COVID-19.
This comes as COVID-19 is designated as a reportable condition, meaning healthcare providers are mandated by state law to report incidences of the disease to public health officials. eCR now aims to enable that.
According to the CDC, electronic case reporting (eCR) is defined as the automated generation and sending of EHR case reports to public health officials.
eCR allows for automatic, complete, and accurate data to be reported in real-time. In return, it lessens burden for providers by improving the timeliness and accuracy of case reports. It also supports the public health reporting measure of the Department of Health and Human Services (HHS) Promoting Interoperability Program requirements.
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Have EHRs Been a Burden or an Asset During the Coronavirus?

One health IT professional says EHR systems and its tools have been vital to stopping the spread of the coronavirus.
April 17, 2020 - At the onset of the spread of the coronavirus, some believed EHR systems would get exposed or be a burden, rather than an asset, to patient care. But as the outbreak continues, Tom Still, president of the Wisconsin Technology Council, said that EHR systems have been more of an asset, than a burden.
In an op-ed written on the Wisconsin State Journal, Still explained how EHRs and embedded telehealth technology are an aid to clinicians as they attempt to decrease the spread of the coronavirus by testing and managing patients who have contracted the virus.
With the Epic Systems campus residing in Wisconsin, Still has the benefit of seeing the positive impact that EHRs may have on health systems. He said the state is up to 10 percentage points higher than the national average for EHR adoption by patients, health facilities, and health systems.
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Apr 17, 2020 - Technology

Exclusive: Mary Meeker's coronavirus trends report

Bond Capital, a Silicon Valley VC firm whose portfolio companies include Slack and Uber, told its investors this morning via email that the coronavirus' high-speed spread and impact has similarities to the devastating San Francisco earthquake of 1906.
Why it matters: Bond's best-known partner, Mary Meeker, is a former bank analyst renowned for her annual Internet Trends Report, which many investors and entrepreneurs use as a touchstone for where tech is now and where it's going. Today's 28-page report to Bond's limited partners, obtained by Axios, shares some structural similarities.
Some takeaways:
  • "Covid-19 has upended our modern lives in ways we’re just starting to understand."
  • Prior epic viruses have permanently changed the world, but coronavirus may prove less impactful because of our information-sharing and scientific technologies.
  • Scientists and other domain experts are getting "more seats at the table."
  • Digital transformation is accelerating, due to so many people working from home. New work-life balances are also being struck.
  • This may become the "call to arms" to better marry technology with healthcare, in terms of everything from telehealth to rapid point-of-care diagnostics, to applying automation and AI to health care services.
  • "We are optimists and believe there is hope on the other side of despair.... We need government, business and entrepreneurial intervention at scale (deployed logically and effectively) to get to the other side."
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'You may have been exposed to the virus': What to expect when a contact tracer calls you

Contact tracers want to know a person's demographics, living situation, health and exposure as part of a greater effort to isolate the coronavirus and stem its spread.
April 21, 2020, 9:08 AM AEST
By Erik Ortiz
From San Francisco to Massachusetts, local and state health departments across the country have begun rolling out efforts to stem the spread of the coronavirus by tracing the contacts of those who have tested positive for COVID-19, the disease it causes.
The initiative, known as contact tracing, aims to first locate the infected person, log where they went and with whom they’ve been in contact, then follow up with those contacts to see how they are feeling, if they have been tested and to determine if they should quarantine.
The desired outcome: break the chains of transmission of the contagious disease, empower health departments to know where it resides in a community, and ultimately, use that knowledge to know where and in what capacity to lift isolation orders and reopen the economy.
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Apr 20, 2020,09:36am EDT

Apple And Google Contact-Tracing Surprise: 2.5 Billion Users Will Miss Out

Zak Doffman
Just over a week ago, Apple and Google announced a joint contact-tracing program “to harness the power of technology to help countries slow the spread of COVID-19.” It was widely welcomed. The privacy-first approach was designed to prevent governments from collecting data on their citizens. And, technically, the U.S. firms behind the world’s leading operating systems resolved issues with getting Bluetooth proximity sensing and anonymized identifiers working in tandem.
The decision to opt for Bluetooth over GPS or cell tracking was broadly made before Apple and Google stepped into the ring. If it works—and this has not yet been deployed at the tens of millions scale—it promises a near real-time reporting and alert system that cannot be achieved with manual contact-tracing options. The issue, as I’ve reported before, is the 60% take-up across smartphone users needed.
We already know that Android smartphones in China will not be eligible for the new technology framework. Google’s software and services are banned in the country, and this will be deployed as an update to Google’s Play Services. Android predominates across China’s more than 700 million smartphone users, with a 75% to 80% market share, impacting 500 million users. We also know that Huawei phones released post the U.S. blacklist last year will also be ineligible for the same reason—and this impacts users outside China who have bought Mate 30s and P40s.
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When will a second wave of the coronavirus hit, and what will it look like?

USA TODAY
21 April, 2020
Even before the first horrific phase of the COVID-19 pandemic has run its course, scientists are worried about the second wave of the disease.
It could crash worse than the first, killing tens of thousands of people who did such a good job of sheltering in place they remain virgin ground for the virus. Or it could be a mere swell, with so many people having been infected without symptoms that levels of immunity are higher than realized.
There is no crystal ball to look to, because so many crucial pieces of information remain missing. 
Are people who've had COVID-19 immune? How long does immunity last? Will the virus play out like influenza and the common cold, peaking during cooler months and falling during warmer ones? Is its deadly path undeterred whatever the weather?
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Collective defense: A different way to approach healthcare cybersecurity

CIOs and CISOs take note: In a HIMSS20 Digital session, the former commander of U.S. CyberCommand explains what collective defense is and how it works.
April 21, 2020 02:08 PM
For some time, healthcare organizations have been defending against cyberattacks on their own while malicious actors have been organizing into increasingly sophisticated networks of attackers.
A better way to combat cybersecurity threats is by sharing and correlating events across organizations, both within the healthcare sector and across industry sectors, contend experts at IronNet Cybersecurity.
General (Retired) Keith Alexander, co-CEO of IronNet Cybersecurity, former NSA director and former commander of the U.S. CyberCommand, explored this notion in a recent HIMSS20 Digital session, "Cybersecurity’s Tectonic Shift: A Call for Collaboration."
Along with IronNet Cybersecurity Chief Marketing Officer Russ Cobb, Alexander described the people, processes and technologies that are making “collective defense” a reality.
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COVID-19 and digital transformation

The director of international relations at NHS Confederation, Dr Layla McCay writes about significant acceleration of digital transformation across the UK.
April 21, 2020 03:32 AM
‘Necessity is the mother of invention’ is an old proverb proving true as health services across the world race to adapt to manage the challenges of the current coronavirus pandemic. Despite the significant pressures on services across the NHS associated with our COVID-19 response, and indeed because of them, there has been a significant acceleration of digital transformation across many areas of health in the UK. Digital innovation that might have once taken months or years to be adopted has been integrated into practice in days or weeks as people see and meet the need of the moment.
For instance, the coronavirus response has made clear the value of online and video-consultations in primary care, and we have seen a remarkable expansion of digital platforms. In the space of weeks, primary care services in the UK have switched from 1.2 million face-to-face consultations a day to the majority being carried out remotely. According to a 12 April BBC report, GPs are now seeing just seven in every 100 patients face-to-face. Similar progress has been made in secondary care, with widespread moves towards digital-first outpatient appointments and some hospitals supplying iPads to enable loved ones to ‘visit’ their relatives who have been hospitalised with coronavirus, without risk of infection.

It's not all plain sailing, of course

A key issue has been, and will continue be, how well staff are able to adapt to the new ways of working that are required as a result. The recommendations of the recent Topol Review are now more important than ever, including increased training and resources for staff to ensure that they have the requisite skillset for digital working.
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Google Cloud Healthcare API focused on interoperability, during pandemic and beyond

The standard, in use at the Mayo Clinic since 2019, can help providers manage their COVID-19 response and comply with CMS and ONC data-exchange regulations, the company says.
April 21, 2020 12:35 PM
Google on Monday announced the launch of Google Cloud Healthcare API, which is designed to enable standardized data exchange between healthcare applications and solutions built on Google Cloud.
WHY IT MATTERS
Backed by Google Cloud's privacy and security features, and HIPAA compliant, the API offers pre-built connectors for streaming data processing in Dataflow, scalable analytics with BigQuery and machine learning with AI Platform.
The platform also provides support for healthcare data standards, including HL7, FHIR, HL7 v2 and DICOM, as well as automated DICOM and FHIR de-identification to better prepare data for these platforms.
The goal is to provide healthcare and life sciences organizations with scalable, real-time data analytics during the pandemic, using tools like machine learning and giving providers the ability to interact with data using web-friendly, REST-based endpoints.
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Federal Effort Aims to Optimize Search Engines for COVID-19 Research

The collaborative project will apply powerful search engines to the COVID-19 Open Research Dataset.
April 17, 2020 - The US Department of Commerce’s National Institute of Standards and Technology (NIST) and the White House Office of Science and Technology Policy (OSTP) have partnered to support the development of a search engine that will enhance COVID-19 research.
For the project, NIST will initially work with the Allen Institute for Artificial Intelligence, the National Library of Medicine (NLM), Oregon Health & Science University (OHSU), and the University of Texas Health Science Center at Houston (UTHealth).
The group will apply the Text Retrieval Conference (TREC), a long-running program of expert engagement and technology assessment, to the COVID-19 Open Research Dataset (CORD-19). CORD-19 contains more than 44,000 research articles and related data about COVID-19 and the coronavirus family of viruses.
Released in March 2020, CORD-19 is an extensive machine-readable coronavirus literature collection available for data mining. The dataset was put together by researchers from the Allen Institute for AI, the Chan Zuckerberg Initiative (CHI), Microsoft, and others to better understand the nature and spread of COVID-19.
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Medicare Beneficiaries at High Risk in COVID-19-Prevalent Counties

In US counties with high rates of COVID-19 cases, two-thirds of Medicare beneficiaries have one or more high-risk medical conditions.
April 16, 2020 - In the top 25 US counties with the highest prevalence of COVID-19, the majority of adults over age 65 are at high risk for severe illness if they contract the virus, according to an analysis from Avalere.
While COVID-19 is still a new disease, research suggests that certain patient populations are more likely to develop serious complications from the virus. Although the majority of cases seem to be mild, those who develop more severe symptoms often need oxygen and prolonged ventilation.
“The CDC has identified specific populations of individuals who are at higher risk for severe illness from COVID-19, including adults aged 65 and older and people of all ages with certain underlying health conditions,” Avalere researchers stated.
According to the CDC, these underlying conditions include moderate-to-severe asthma, chronic lung disease, diabetes, obesity, chronic kidney disease, and other disorders.
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Big Brother wants to track your location and health data. And that's not all bad

Apr 20, 2020 11:34am
A growing mix of health and technology experts are convinced that if the U.S. is to ever effectively track the coronavirus and slow its spread, then both self-reported and more surreptitiously gathered personal data—a mix of information about location, travel, symptoms and health conditions―must be gathered from millions of Americans.
With the pandemic far from over, public health needs are paramount. Public health experts say that collecting personal data may be the only way to analyze information on the massive scale needed. But how that information is used and by whom worries some privacy advocates.
A number of academics, data firms and technology companies are using mobile devices to gather data. Some use the phones’ Bluetooth signals to aid in contact tracing by registering other nearby devices. Location information recorded on smartphones can help them map whether people are staying home and where they do venture out. Others have built symptom-tracker apps designed to predict where the virus might turn up next.
And more may be coming. Just look to other countries, including Taiwan, Singapore and Ireland, which are using big data or apps to aid in their pandemic responses. As the U.S. contemplates its move to open back up for business, organizations such as the left-leaning Center for American Progress and the conservative American Enterprise Institute have recommended a range of steps, including much more testing and digital surveillance.
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CDC plans to roll out app in May to speed up COVID-19 case reporting

Apr 17, 2020 10:30am
The Centers for Disease Control and Prevention (CDC) plans to roll out an app in May that will accelerate electronic case reporting of COVID-19 cases.
The app, based on Fast Healthcare Interoperability Resources (FHIR) standards, can be implemented quickly to automate COVID case reporting, said Laura Conn, health scientist and eCR lead in the CDC's Center for Surveillance, Epidemiology, and Laboratory Services.
The app enables healthcare providers that don't have the capability to automatically send case reports from their health IT systems to more efficiently send data to public health agencies.
"The FHIR app can be rapidly implemented to automate COVID-19 electronic case reporting (eCR) in otherwise non-enabled EHRs. The app will connect COVID-19 eCR to existing infrastructure to confirm cases and route to appropriate public health surveillance systems. We are making sure that can be easily used without requiring a software release by the vendors," said Conn during a meeting this week of a Congressional health IT advisory committee (HITAC).
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Philippines’ DOH launches new COVID-19 tracker

The public can now have a snapshot of the country’s health system's capacity in responding to the pandemic based on data collected from the DOH DataCollect application.
April 17, 2020 01:28 AM
Earlier this week, the Department of Health (DOH) of the Philippines launched its new COVID-19 Tracker. The revamped tracker features additional information on the epidemiology of COVID-19 in the country, COVID-19 testing, health facilities, and availability of personal protective equipment (PPEs). The public can now view data on the laboratory testing capacities of the DOH accredited laboratories including the total number of tests and unique individuals tested. 
The public can now also have a snapshot of the country’s health system's capacity in responding to the pandemic based on data collected from the DOH DataCollect application.
The DataCollect app gathers daily data from hospitals and stakeholders such as essential resources and supplies, availability of hospital beds, isolation rooms, ICU beds and mechanical ventilators, and human resource needs. The application will also be able to accurately calculate the projected need of PPEs, and link to our logistics offices for delivery of supplies. This will facilitate easier and faster tracking of reports between DOH offices. Under the “Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act" or RA 11332, all of DOH’s partner hospitals are mandated to implement this system of data collection.
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Roundup: NHS Wales creates system for storing COVID-19 results, X-ON develops remote consultations and more briefs

Also, Google blocks millions of scam COVID-19 emails
April 20, 2020 05:04 AM
GOOGLE BLOCKS MILLIONS OF COVID-19 SCAM EMAILS DAILY
Product manager at Google Security, Neil Kumaran, and lead security product marketing manager for G Suite and GCP platform, Sam Lugani, issued a statement last week (16 April) in which they underlined the extent of their security measures set up to protect against phishing and malware attacks sent to gmail accounts. They stated that, in the past week alone, they saw “18 million daily malware and phishing emails related to COVID-19” with millions more spam emails, and were able to stop 99.9% of them reaching the account holder.
They continued: “We have put proactive monitoring in place for COVID-19-related malware and phishing across our systems and workflows. In many cases, these threats are not new—rather, they’re existing malware campaigns that have simply been updated to exploit the heightened attention on COVID-19.” 

DIGITAL APPOINTMENTS COULD BE PROBLEMATIC FOR MENTAL HEALTH PATIENTS
Chair of the Royal College of General Practitioners, Professor Martin Marshall, has expressed concern as to the suitability of remote consultations for managing patients with mental health issues. He expressed that the nature of the appointments could deter patients from approaching their GP and so limit the availability of early intervention and diagnosis.
He noted in a statement to HSJ: “Patients often feel that face-to-face consultations provide a more comfortable and open environment to discuss mental health as they enable the patient to feel listened to and that their mental health needs are being taken seriously. […] Our concern, therefore, is that the system of remote consulting during COVID-19 may make patients with mental health problems feel uneasy and in some instances less likely to contact their GP. This will make it more difficult for GPs to diagnose and manage patients’ mental health problems during the pandemic.”
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Addressing social determinants of health with data interoperability

Access to a complete picture of the patient – including the behavioral and environmental factors that influence daily health – is critical to realizing the shared benefits of value-based, holistic care.
April 20, 2020 01:24 PM
Across the spectrum of healthcare delivery – payor, provider, vendor, consumer, there is a land rush underway to embrace consumer-centric care. With tools like value-based care, chronic disease management, retail services, analytics, and remote patient monitoring, healthcare organizations are pivoting towards capabilities that provide a deeper understanding of patient behaviors and address the whole patient and not just the condition.
For the industry, it's a stretch: Healthcare has traditionally been an insular sector, unaccustomed to the kind of broad based, multi-stakeholder cooperation and collaboration that the healthcare consumer increasingly expects.
But access to a complete picture of the patient – including the behavioral and environmental factors that influence daily health – is critical to realizing the shared benefits of value-based, holistic care.
The challenge extends far beyond service efficiencies that can be gleaned from the patient encounter. Consider: medical care only accounts for between 10% and 20% of health outcomes, whereas the physical environment, social determinants and behavioral factors account for 80% to 90% of outcomes.
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Amazon Launches Public Data Lake Making COVID-19 Data Accessible

April 20, 2020
Amazon has announced that it has made an AWS COVID-19 data lake available to the public for use in better understanding the virus.
The data lake, a centralized repository of up-to-date curated datasets on or related to the spread and characteristics of the pandemic, will be hosted on the AWS cloud.
Its content includes case tracking data from Johns Hopkins and The New York Times, along with hospital bed availability data from Definitive Healthcare. It will also feature more than 45,000 research articles on COVID-19 topics provided by the Allen Institute for AI.
The idea behind the data lake project is to help improve access to this data and make it easier to experiment with it without having to spend time extracting and wrangling data from already-available data sources.
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Integrated Medical Device Tracking Improves Patient Safety

April 20, 2020
As the number of medical devices increases, the need for better tracking and traceability of those devices becomes more and more important. Imagine the chaos and risk to patient safety if a device manufacturer issues a recall order and there wasn’t a good system for device record-keeping. Thankfully Zebra’s Unique Device Identity (UDI) Platform can help healthcare organizations as well as manufacturers comply with new regulations and requirements for medical device tracking.
When you think of tracking items, most think about UPS or FedEx. These days, you might even think of UberEats or DoorDash as you watch a little car icon move through a map to your house, preparing to deliver a sandwich from your favorite restaurant. Even in healthcare, “tracking” usually means knowing your inventory or monitoring in real-time, your asset locations.
Imagine you are a patient and you just had a pacemaker or an IUD implanted. Now imagine there was a recall on that device two weeks before you had it put in, yet nobody knew about it. Cringeworthy, right? That’s why Chris Sullivan, Global Healthcare Practice Lead and Rikki Jennings, Chief Nursing Informatics Officer (recognized as one of Crain’s Chicago Business’s “Notable Women in Healthcare.”) at Zebra were so excited about their company’s UDI solution, which they were going to showcase at HIMSS20 (alas).
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Weekly News Recap

  • The FCC starts accepting applications for its $200 million telehealth expense reimbursement program and issues the first set of grants.
  • The American Medical Association and American Hospital Association publish a cybersecurity guide for working from home.
  • Meadville Medical Center (PA) recovers from its second malware-caused downtime of 2020.
  • Apple and Google announce plans to work together to develop Bluetooth-powered COVID-19 contract tracing on mobile phones.
  • Alphabet’s Verily defends its decision to limit access to its COVID-19 screening website to users who have created Google accounts.
  • Allscripts subsidiary CarePort Health publishes an analysis of COVID-19 using the inpatient EHR data it stores.
  • Democratic lawmakers express privacy concerns about a White House discussion of using hospital information for coronavirus surveillance, with Politico reporting that health HIT vendors Collective Medical, PatientPing, and Juvare have responded to White House inquiries.
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Enjoy!
David.

Friday, May 01, 2020

On The Face Of It This Report Is Pretty Troubling From All Sorts Of Angles.

This appeared last week.

How these agencies are breaching patient privacy

Posted by Felicity Nelson
Privacy experts have criticised Services Australia and AHPRA for sharing thousands of private health records every year without informing patients, a practice that appears to contradict the government’s own guidelines.
Large volumes of Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) data are routinely shared between the two agencies to aid AHPRA’s investigations into alleged doctor misconduct.
While doctors are informed when their own private health data, or their practice data, is transferred to AHPRA during an investigation, patients are not routinely alerted by either agency that their privacy has been breached.
In 2019, Services Australia released 2,625 private health records to AHPRA, which represented an increase in disclosures since 2017.

Access to MBS and PBS data can help AHPRA determine whether a complaint about a doctor is valid.
But PBS and MBS data contains personal information about what scripts a patient has filled and which Medicare items were billed during a consultation and can reveal highly sensitive information about the patient.
“It is very troubling that Services Australia is sharing private medical data with AHPRA without consulting the patients involved,” Jonathan Crowe, a professor of law at Bond University, said.
Patients should be systematically informed that their data had been shared between agencies, even if it was necessary to wait until after an AHPRA investigation had concluded, Assistant Professor Bruce Baer Arnold, a legal academic at the University of Canberra, said.
“It would be easy to build such a communication mechanism into systems,” he said.
Secret data sharing arrangements such as these often stemmed from a “culture of bureaucratic laziness” and could be interpreted as a lack of respect for the patient.
While a patient making a complaint about a health practitioner to AHPRA might assume that their private MBS and PBS data could be shared between agencies as part of the investigation, around half of complaints are not made by patients.
When complaints are made about doctors by third parties (such as other practitioners, employers or relatives), patients are generally unaware AHPRA is accessing their data and have no opportunity to provide informed consent.
After a year-long freedom of information battle, The Medical Republic has finally secured an unredacted copy of the internal guidelines used by Services Australia officials to make decisions about sharing MBS and PBS data with external agencies.
Page 11 of those guidelines states that: “…in circumstances where it is practicable and reasonable to do so, persons about whom information may be released should be consulted and their views taken into account in making the decision to release information in the public interest.
“Further, where it is practicable and reasonable to do so, persons about whom information is released should be informed that information about them has been disclosed in the public interest to a third party and identify that party.”
Services Australia and AHPRA could be behaving unlawfully by failing to inform patients when their private health data was shared between agencies, barrister and privacy advocate Peter Clarke said.
More here:
This looks to me like a story with a good way to run, given the comments from the academics who have reviewed the details. Good on the Medical Republic journalists for keeping the pressure on.
We need more, not less, accountability on who is accessing our private information without our consent.
David.