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, November 05, 2022

Weekly Overseas Health IT Links – 5th November, 2022.

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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https://patientengagementhit.com/news/text-message-patient-outreach-cuts-30-day-hospital-readmission-risk-41

Text Message Patient Outreach Cuts 30-Day Hospital Readmission Risk 41%

Aside from lower 30-day hospital readmission, text message patient outreach was also linked to lower odds of emergency department utilization and 30- and 60-day mortality.

By Sara Heath

October 28, 2022 - Healthcare organizations may consider implementing text message patient outreach as part of their post-discharge patient engagement strategies, as the technology can yield a lower risk of 30-day hospital readmission, among other quality metrics, researchers wrote in JAMA Network Open.

Particularly, text message patient outreach yielded a 41 percent reduction in the risk for 30-day hospital readmission, a key clinical quality measure in many value-based care arrangements.

Patient engagement during the post-discharge process is critical. Keeping in touch with patients allows acute care providers to monitor issues and address them on an outpatient basis before symptoms deteriorate and require acute care in the ED or an inpatient setting.

Normally, this post-discharge patient engagement happens when nurses call the patient to check in.

“This approach has proven effective in some settings in reducing unplanned readmissions; however, the calls are limited in scope and present a significant operational burden,” the researchers wrote. “In our experience, the calls can be time intensive, often go unanswered, and generally connect with patients only once, early in the course of their recovery.”

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https://healthitsecurity.com/news/ocr-highlights-hipaa-security-rule-incident-response-procedures

OCR Highlights HIPAA Security Rule Incident Response Procedures

OCR stressed the importance of timely incident detection and response, as required by the HIPAA Security Rule.

By Jill McKeon

October 28, 2022 - The HHS Office for Civil Rights (OCR) utilized its October newsletter to remind covered entities of their incident response obligations under the HIPAA Security Rule. The newsletter provided a refresher of HIPAA Security Rule requirements as well as tips for implementation.

“In the health care sector, hacking is now the greatest threat to the privacy and security of PHI,” the newsletter explained. “A timely response to a cybersecurity incident is one of the best ways to prevent, mitigate, and recover from cyberattacks.”

In fact, about three-quarters of the healthcare data breaches reported to OCR in 2021 involved hacking/IT incidents, the newsletter noted.

Although the HIPAA Security Rule requires covered entities to implement incident response procedures, not all incident response plans are equally effective. Additionally, even with a robust incident detection and response plan, security incidents are nearly unavoidable.

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https://www.digitalhealth.net/2022/10/what-is-a-personal-health-record-anyway/

What is a personal health record anyway?

In a series of articles reflecting on 10 years of working with personal health records (PHRs), Kevin Hamer – who works as a freelance digital consultant and has spent 30 years in NHS IT innovation – starts with what they should look like.

DHI Newsteam 20 Oct, 2022

The NHS Digital website carries a definition of what a personal health record is. It can be found here and is summarised as follows “a record is a PHR if”:

·         it’s secure, usable and online

·         it’s managed by the person who the record is about and they can add information to their PHR

·         it stores information about that person’s health, care and wellbeing

·         health and care sources can add information to the PHR

I have always found this ‘what is a PHR’ definition useful and it goes on to give useful advice on what anyone developing a PHR should consider but it does not mandate any particular aspect. The difficulty with this is that suppliers are in a position to ignore the advice but can still call their offering a PHR if it meets the bullet pointed definition.

What does a good PHR look like?

The PHR market and co-production initiatives are growing – this can be evidenced through the increasing functionality in the NHS app and conference stands showcasing more patient-facing services than seen before. I think this increasingly evolving space demands a revision of not only what is useful but what is needed. ‘What does a good PHR look like’ is perhaps a better question.

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https://www.pewtrusts.org/en/research-and-analysis/reports/2022/10/biometrics-can-help-match-patients-to-their-electronic-health-records

Biometrics Can Help Match Patients to Their Electronic Health Records

Experts discuss how facial images, fingerprints enable health care providers to correctly access and share patient health information

Report  

The Pew Charitable Trusts

Overview

A patient dies from a heart attack when health care providers mistakenly access another patient’s do-not-resuscitate order.1 A newborn is given another baby’s breast milk from a mother infected with hepatitis B.2 A woman receives a kidney transplant intended for someone else with the same name.3 These real tragedies resulted from mismatched health records—a common, costly, and preventable problem.

Americans often have multiple electronic health records (EHRs) by different doctor’s offices, hospitals, and health systems. Health care providers must match those files to get a complete picture of their patients’ health history, but errors in matching records to the correct patient occur up to half of the time.4 According to a 2012 survey, nearly 1 in 5 hospital chief information officers indicated that patients at their hospitals had been harmed in the previous year because of record mismatches.5 Each year, these kinds of errors cost the U.S. health care system about $6 billion.6

Adding biometrics (such as fingerprints or scans of faces, palms, or irises) to patients’ EHRs can enhance matching and improve patient care and satisfaction, reduce health care costs, and boost innovation. Most Americans support using biometrics to enhance health record matching and prefer them over other approaches, such as issuing a unique national identifier to each patient (akin to a Social Security number for health care).7 However, a variety of logistical, legal, and ethical challenges hinder the use of biometrics. Indeed, there are no known cases of biometrics being used to match EHRs across different health systems in the U.S., and no national technical standards to facilitate the process.

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https://www.healthaffairs.org/content/forefront/healthcare-equity-requires-standardized-disability-data-ehr

Health Care Equity Requires Standardized Disability Data In The EHR

The electronic health record (EHR) is an essential tool for linking demographic and clinical data within and across health care systems, as well as to public health databases. Data collected within the EHR are crucial for understanding and addressing inequities that negatively impact health and health care outcomes of marginalized communities, including persons with disabilities. Unfortunately, the lack of standardized collection of patients’ disability status within EHRs has limited progress toward addressing inequities for people with disabilities.

In recent estimates, 27 percent of US adults have a disability. Persons with disabilities experience significant inequities in access to high-quality health care services due to factors such as clinician biases and inaccessible medical environments. Currently, the vast majority of health care systems do not systematically collect patients’ disability status, impeding efforts to identify and address these factors. The lack of data collection also impedes organizations’ efforts in providing mandated disability accommodations and modifications that ensure equitable care, as required by the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) of 1990, and Section 1557 of the 2010 Patient Protection and Affordable Care Act (ACA).

Federal And State Requirements And Standards For Documenting Disability Status

Section 4302 of the ACA, titled “Understand health disparities: Data collection and analysis,” requires “any federally conducted or supported health care or public health program, activity or survey” to collect race, ethnicity, sex, primary language, and disability status data from “applicants, recipients, or participants,” including “individuals receiving health care items or services under such programs and activities.” Unfortunately, the requirements of this section have not been implemented or enforced. This is likely due in part to guidance issued by the Office of the Assistant Secretary for Planning and Evaluation regarding Section 4302. The guidance document only discusses the application of Section 4302 to national population surveys. Consequently, health systems and organizations do not view Section 4302 as a mandate to collect disability status. As a demonstration of this, the Health Resources and Services Administration does not require their grantees to collect disability status as a part of their Uniform Data System, despite requiring collection of race, ethnicity, primary language, sexual orientation, and gender identity data under the auspices of Section 4302. This leads to large gaps in documentation of the quality and equity of care provided to persons with disabilities who live at the intersection of marginalized communities (such as those patients seeking care at federally qualified health centers and rural health clinics); these communities have a known higher prevalence of disabilities than the general population.

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https://healthtechmagazine.net/article/2022/10/5-common-security-monitoring-mistakes-healthcare

5 Common Security Monitoring Mistakes in Healthcare

Healthcare organizations don’t need to address these issues on their own. Here’s how a partner can help strengthen their strategies.

by  Matt Sickles

Oct 25, 2022

October may be Cybersecurity Awareness Month, but healthcare organizations need to stay attentive using a follow-the-sun method, especially as they grapple with ransomware attacks and data breaches.

The five most common mistakes I’ve seen health systems make when it comes to security monitoring are:

  1. Monitoring security in a silo
  2. Ineffective security tools that don’t lead to meaningful, actionable insight
  3. Failing to test and validate whether a solution fits into an ecosystem
  4. No effective written security policy
  5. Lackluster internal communication

Healthcare organizations don’t need to face daunting cybersecurity challenges alone. They can take steps toward a less reactive, more proactive approach through fostering growth in team members and bringing on a much-needed partner where it counts the most.

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https://securityaffairs.co/wordpress/137493/cyber-crime/daixin-team-targets-healthcare.html

Daixin Team targets health organizations with ransomware, US agencies warn

October 22, 2022  By Pierluigi Paganini

US government agencies warned that the Daixin Team cybercrime group is actively targeting the U.S. Healthcare and Public Health sector with ransomware.

CISA, the FBI, and the Department of Health and Human Services (HHS) warned that the Daixin Team cybercrime group is actively targeting U.S. businesses, mainly in the Healthcare and Public Health (HPH) Sector, with ransomware operations.

The Daixin Team is a ransomware and data extortion group that has been active since at least June 2022. The group focused on the HPH Sector with ransomware operations that aimed at deploying ransomware and exfiltrating personal identifiable information (PII) and patient health information (PHI) threatening to release the stolen data if a ransom is not paid.

The Daixin Team group gains initial access to victims through virtual private network (VPN) servers. In one successful attack, the attackers likely exploited an unpatched vulnerability in the organization’s VPN server. In another compromise, the group leveraged on compromised credentials to access a legacy VPN server. The threat actors obtained the VPN credentials through phishing attacks.

After gaining access to the target’s VPN server, Daixin actors move laterally via Secure Shell (SSH) and Remote Desktop Protocol (RDP). 

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https://www.healthcareitnews.com/news/cyberwarfare-against-health-systems-nation-state-threat

Global Edition

Privacy & Security

Cyberwarfare against health systems: The nation-state threat

Everything starts with understanding the basics and doing them flawlessly, one cybersecurity expert advises. But there is much more work to be done.

By Bill Siwicki

October 28, 2022 11:53 AM

While criminal organizations and chaos actors are responsible for a substantial percentage of the constant cyberattacks on provider organizations' data and information systems, another growing threat comes from nation-state perpetrators.

Earlier this year, for instance, as Russia's war on Ukraine began, the American Hospital Association issued a warning to hospitals and health systems to remain vigilant against cyberattacks as the conflict escalated.

On July 6, the Cybersecurity and Infrastructure Security Agency along with the FBI and the Department of the Treasury issued an alert about North Korea-sponsored hackers who had been targeting the healthcare and public health sector in the U.S. for more than a year.

And the U.S. Cybersecurity and Infrastructure Agency issued an alert – among many others in recent years – in November 2021 highlighting malicious activity from an advanced persistent threat group associated with the government of Iran.

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https://www.healthleadersmedia.com/technology/ahima-healthcare-technology-must-evolve-consumer-demands

AHIMA: Healthcare Technology Must Evolve With Consumer Demands

Analysis  |  By Scott Mace  |   October 28, 2022

An AHIMA white paper recommends more use of artificial intelligence and automation.

A white paper from a leading health IT education and advocacy group recommends more use of artificial intelligence and automation in healthcare to keep up with changing consumer demands.

"A Watershed Moment: Recommendations and Insights for the Health Information Profession to Meet the Emerging Needs of the Modern Healthcare Consumers," based on interviews with health system leaders, insurers, health technology companies, health information exchanges, academic institutions, patient advocacy groups, and trade associations, has been released by the American Health Information Management Association (AHIMA).

"Health information professionals must be prepared to leverage and embrace new technology to meet the demands of consumers," Keith Olenik, AHIMA's chief member relations and service officer said in a press release. "It is essential for the healthcare industry to harness the infinite amount of data being captured today. Health information professionals can turn this data into valuable information, empowering consumers to impact their health and wellbeing."

The report makes five core recommendations to support the healthcare field and other organizations in meeting consumer expectations:

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https://ehrintelligence.com/news/ne-hospital-taps-meditech-ehr-implementation-to-simplify-clinical-workflows

NE Hospital Taps MEDITECH EHR Implementation to Simplify Clinical Workflows

Box Butte General Hospital (BBGH) and MEDITECH held a mock live event for the EHR implementation to help fine-tune clinical workflows.

By Hannah Nelson

October 27, 2022 - Box Butte General Hospital (BBGH) in Nebraska has begun a MEDITECH EHR implementation to help drive quality care delivery and streamline clinical workflows.

The hospital began the move to MEDITECH in March 2022 to arm providers with timely patient health data for clinical decision support.

From September 20 to 22, the MEDITECH and BBGH MEDITECH project teams executed a mock live event. MEDITECH specialists came on campus to work with BBGH superusers. A superuser is someone the BBGH team can look to for guidance and training to understand the new EHR platform and best practice workflows.

The project team selected several different patient scenarios from old records from the hospital’s current Centriq system and ran the scenarios through the MEDITECH Expanse platform.

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https://ehrintelligence.com/news/cms-ipps-policies-set-to-advance-public-health-data-exchange

CMS IPPS Policies Set to Advance Public Health Data Exchange

The CMS 2023 IPPS final rule requires antimicrobial use and resistance (AUR) data exchange to help advance public health reporting.

By Hannah Nelson

October 27, 2022 - Policies in the CMS 2023 Inpatient Prospective Payment System (IPPS) final rule aim to advance public health data exchange, according to an ONC HealthITBuzz blog post.

The 2023 IPPS rule expands the list of required public health measures under the CMS Promoting Interoperability Program to include antimicrobial use and resistance (AUR) surveillance.

Beginning in 2024, hospitals must report AUR data to CDC’s National Healthcare Safety Network (NHSN) to earn full credit under the Public Health Objective.

Hospitals must use health IT certified under ONC’s certification program to the “Transmission to public health agencies — antimicrobial use and resistance reporting” certification criterion to complete this reporting.

“While this capability has been included in the ONC Health IT Certification Program since 2015, and many hospitals are already tracking AUR data, this new, dedicated measure will help to ensure this important reporting activity is conducted at a national scale,” Alex Baker and Elisabeth Myers of ONC wrote in the blog post.

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https://healthitsecurity.com/news/mdic-releases-medical-device-security-maturity-benchmarking-report

MDIC Releases Medical Device Security Maturity Benchmarking Report

The medical device security maturity benchmarking report provides a baseline for assessing the current state of device cybersecurity efforts.

By Jill McKeon

October 27, 2022 - Medical device security continues to be a top concern in the healthcare sector. The prevalence of legacy devices, the increasing interconnectedness of the sector, and the need for industry-wide standards in the medical device security space have presented numerous hurdles for the sector and could pose threats to patient safety.

To address these challenges and gain insight into the current state of the industry, the Medical Device Innovation Consortium (MDIC) released its first medical device security maturity benchmarking tool and report based on survey responses from 17 medical device manufacturers (MDMs).

In collaboration with Booz Allen Hamilton, MDIC leveraged the Health Sector Coordinating Council’s (HSCC) Joint Security Plan (JSP), a product lifecycle reference guide to developing, deploying, and supporting secure medical devices and health IT products and solutions, to develop 44 survey questions in four categories.

“There was no mutual understanding about shared responsibility between device manufacturers, hospital systems, and healthcare providers,” Greg Garcia, executive director for cybersecurity at HSCC explained in a June 2022 interview with HealthITSecurity regarding the survey.

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https://www.fiercehealthcare.com/health-tech/highmark-expands-coverage-prescription-digital-therapeutics-app-makers-see-momentum

Highmark steps up coverage of prescription digital therapies as companies see momentum in the payer market

By Heather Landi

Oct 24, 2022 07:40am

Pittsburgh-based Highmark plans to expand insurance coverage for some prescription digital therapeutics cleared by the Food and Drug Administration, marking a major step forward for app makers in the market.

Highmark, a provider-payer organization, is not the first payer to cover some prescription digital therapeutics, also called PDTs. However, Highmark is the first large commercial insurer to signal it intends to pay for claims for the use of apps that help treat psychiatric disorders and other complex conditions. The company has 6 million members in Pennsylvania, Delaware, West Virginia and New York

“It’s a big deal for the industry,” said Eddie Martucci, co-founder and CEO of Akili Interactive, a company that developed a video game treatment for pediatric attention-deficit/hyperactivity disorder.

The company’s product EndeavorRx, which has been cleared by the Food and Drug Administration (FDA), is included on a number of formularies, Martucci said.

“We've seen other companies included on formularies or being in Medicaid plans but this is a big deal because Highmark is the first large regional that created a medical policy saying, ‘These FDA-approved products are considered medically necessary when prescribed by a doctor on label,' full stop," he said.

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https://www.fiercebiotech.com/medtech/biointellisense-expands-hospital-monitoring-patient-tracking-wearable-alertwatch-buy

BioIntelliSense expands in-hospital monitoring for patient-tracking wearable with AlertWatch buy

By Andrea Park

Oct 24, 2022 07:30am

Though only about an inch in diameter, BioIntelliSense’s BioButton wearable device for remote monitoring boasts an impressive reach—and one that’s still growing, thanks to the company’s recent acquisition of additional patient-tracking software.

The single-use, rechargeable BioButton can be worn for 90 days, during which it measures vital signs around the clock. It tracks nearly two dozen factors including skin temperature, heart and respiratory rate, sleep performance, gait analysis and symptoms like vomiting, sneezing and coughing that may indicate an infection—all culminating in up to 1,440 readings per day.

The device is meant to be used both at home and in hospitals. The latter setting is the focus of BioIntelliSense’s acquisition of AlertWatch, which the devicemaker announced this week and which will allow the wearable’s data to enhance the monitoring and subsequent treatment of patients in healthcare settings.

AlertWatch’s software gathers information from a hospital’s electronic health record (EHR) system, lab test results and real-time readings of any medical devices that are being used to monitor or treat an inpatient at the time.

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https://www.fiercehealthcare.com/telehealth/hospital-special-surgery-scored-21m-series-funding-spin-virtual-physical-therapy

Hospital for Special Surgery scores $21M to spin off virtual physical therapy platform

By Annie Burky

Oct 26, 2022 08:45am

Hospital for Special Surgery has announced $21 million in series A funding that will help launch RightMove Powered by HSS, a for-profit company independent of the nonprofit hospital.

The telehealth platform plans to bring HSS’ honed musculoskeletal care to all Americans through virtual physical therapy.

HSS believes that its creation and collaboration with RightMove will help address the $380 billion national musculoskeletal health burden while also offering a new model for telehealth. The telehealth platform expects to launch in the late second quarter of 2023 with partners or regional focuses yet to be determined, executives said.

The funding round, led by Flare Capital and HSS, will help develop RightMove’s technology platform and establish a nationwide network of specialty-trained physical therapists.

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https://www.govinfosecurity.com/pressure-on-meta-mounts-over-pixel-collecting-health-data-a-20327

Pressure on Meta Mounts Over Pixel Collecting Health Data

Sen. Mark Warner Demands Answers From Meta on its Pixel Practices Marianne Kolbasuk McGeeOctober 25, 2022

A Virginia Democratic senator is adding to the pressure on Meta following revelations that its online Pixel tracking tool captures sensitive health information.

Sen. Mark Warner wrote to Meta CEO Mark Zuckerberg last Thursday expressing concern over the company's ability to obtain data including medial conditions, appointment dates and treating physician names.

Controversy has steadily mounted this summer and fall over revelations that hospitals and other healthcare providers have incorporated into patient portals web tracking technology offered by Meta and Google.

A recent study by data privacy firm Lokker found that more than 2,500 U.S. hospitals and healthcare provider websites and patient portals use tracking tools.

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https://mhealthintelligence.com/news/virtual-care-on-par-with-in-clinic-treatment-of-high-blood-pressure

Virtual Care On Par with In-Clinic Treatment of High Blood Pressure

New research shows that telehealth can be used to monitor and manage high blood pressure as effectively as clinic-based care methods.

By Mark Melchionna

October 26, 2022 - A new study concluded that virtual care could be used to monitor and treat high blood pressure with the same level of quality as clinic-based methods while improving patient satisfaction.

In the last several years, research on the comparison of in-person and virtual healthcare has grown. Published in the American Heart Association journal, Hypertension, this study aimed to determine how patients responded to high blood pressure treatment in various settings.

High blood pressure, or hypertension, is a highly prevalent risk factor associated with cardiovascular-related deaths in the US. Nearly half of US adults have hypertension, however, only 20 percent have it under control.

Researchers included 3,071 people with an average age of 60 in the study. They received care at 21 primary care clinics in Minnesota and Wisconsin. The research aimed to compare clinic-based and telehealth-enabled care for uncontrolled blood pressure. The clinic-based method involved face-to-face interactions with doctors and medical assistants, and the telehealth method included home-based blood pressure telemonitoring. It also included remote care through telephone calls with a pharmacist or a nurse.

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https://patientengagementhit.com/news/was-medical-misinformation-the-culprit-of-low-covid-vax-uptake

Was Medical Misinformation The Culprit of Low COVID Vax Uptake?

New data indicates that medical misinformation played an outsized role in sowing mistrust in COVID-19 vaccine efficacy.

By Sara Heath

October 26, 2022 - Medical misinformation, not lapses in patient trust, may have been behind initially low COVID-19 vaccine uptake among Black and Hispanic individuals, according to DePaul University researchers who said these findings could help tailor public health messaging in the future.

The start of the COVID-19 vaccine campaign showed little uptake among Black and Hispanic individuals. Per figures from the Kaiser Family Foundation, vaccination rates for Black and Hispanic people trailed those of White people in the spring of 2020, when the shots first became widely available.

Numerous reports indicated that lower vaccine uptake among populations of color could be linked back to historical distrust in the medical establishment. The US has a grotesque history of mistreating Black and Brown bodies, and even today, experiences of healthcare discrimination and implicit bias have limited trust in medicine.

But this latest data calls that notion into question. In a survey of 109 Black and Hispanic people receiving care at Chicago’s Brothers Health Collective, the DePaul researchers found that prevalent misinformation led to notions that the COVID-19 vaccine was not effective.

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https://www.fiercehealthcare.com/digital-health/new-upmc-redesign-health-startup-launch-pilot-fall

UPMC, Redesign Health collaboration launches its first startup, app that prepares patients for surgery

By Anastassia Gliadkovskaya

Oct 25, 2022 08:00am

The University of Pittsburgh Medical Center and Redesign Health have founded a new startup, Pip Care, that helps patients prepare for and recover from surgery.

It is the first company to be launched from the partnership, which recently began. Redesign Health, a healthcare startup creator, raised $65 million in September from investors like UPMC Enterprises, CVS Health Ventures and General Catalyst. 

UPMC has three centers for perioperative care at UPMC Shadyside, UPMC Presbyterian and UPMC Horizon. The centers help patients manage chronic conditions and prepare for surgery. This fall, Pip Care will launch a pilot program at all three hospitals, enabling patients to access to its services like personal, certified health coaches and appointment reminders in its app. The aim is to improve patient confidence and compliance and reduce the chance of complications post-surgery.

“While patients understand a planned surgery can reduce pain, improve mobility and change their quality of life, questions and fears about surgical procedures can lead to delays or even no-shows,” Kathy Kaluhiokalani, founder and CEO of Pip Care, said in a press release. That’s why having human interaction within the app is key, she added.  

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https://www.healthdatamanagement.com/articles/ehra-genomic-data-sharing-policies-must-protect-privacy-minimize-risk?id=131596

EHRA: Genomic data sharing policies must protect privacy, minimize risk

The association provided feedback in response to NIH’s recent RFI on proposed updates to its ‘Genomic Data Sharing Policy.’

Oct 21 2022


Michael Saito

Epic, Chair, EHRA Privacy & Security Workgroup

Nam Nguyen

Allscripts, Vice Chair, EHRA Privacy & Security Workgroup

Patient privacy protection is crucial as organizations aim to share genomic data, EHRA contends


The HIMSS Electronic Health Records Association (EHRA), whose member companies sell EHR and other IT systems, supports the National Institutes of Health’s ongoing objective of sharing research data sets to facilitate additional study. But EHRA stresses the need to protect patient privacy, ensure patients can provide informed and meaningful consent for use of their data, and minimize the risk that patients’ genomic and other health data can be re-identified or misused. 

EHRA provided feedback in response to NIH’s recent request for information on the proposed updates to and long-term considerations for its “Genomic Data Sharing Policy” in the areas of de-identification, potentially identifiable information and data linkages. Following is a summary of that feedback.

De-identification

The EHRA supports adding the “expert determination” method as an acceptable option for de-identification under the GDS Policy. However, when employing this method, the person responsible for determining the level of re-identification risk should be made aware of the intention to submit the data set to an NIH repository as well as that repository’s policies for access and re-disclosure of the data set, which will inform the final determination of the risk of re-identification. 

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https://www.healthdatamanagement.com/articles/can-better-ehr-training-reduce-physician-burnout?id=131613

Can better EHR training reduce physician burnout?

Organizations can take a number of steps to reduce the negative impact EHRs have on their physicians and improve satisfaction. KLAS Research’ s Arch Collaborative provides tips for successful EHR training and support.

Oct 26 2022


Jordan Edwards

Marketing Manager, uPerform

The topic of physician burnout has received a lot of attention. The COVID-19 pandemic has added immense pressure and stress to what was already a challenging career, leading to longer shifts, limited resources and increased risk for frontline workers.

But burnout had been affecting healthcare organizations long before COVID-19. 

In 2017, 44 percent of surveyed physicians reported symptoms of burnout. Physician burnout can impact patient care and increase the risk of medical mistakes. It can also lead to physicians leaving the medical field. In 2018, the AMA estimated that the U.S. economic impact of physician burnout was $4.6 billion per year.

EHRs: A leading cause of physician burnout

There are many causes of physician burnout, such as too many administrative tasks, not having enough time with patients and working too many hours. But the increased use of electronic health records is a critical factor. The 2018 Harris Poll conducted by Stanford Medicine found that seven in 10 physicians agree that “EHRs contribute greatly to physician burnout.”  

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https://ehrintelligence.com/news/providers-focus-on-ehr-optimization-to-boost-interoperability

Providers Focus on EHR Optimization to Boost Interoperability

To improve cross-solution interoperability, providers are looking for EHR optimization in areas like telehealth, which remains a critical strategic priority.

By Hannah Nelson

October 25, 2022 - Many providers are planning health IT investments focused on EHR optimization to boost interoperability and productivity, according to the 2022 Healthcare Provider IT Report from Bain & Company and KLAS Research.

Regardless of size or sophistication, provider organizations are emerging from the COVID-19 pandemic and taking inventory of their software solutions.  

In the short term, clinician shortages and wage inflation are increasing the demand for health IT that improves productivity and mitigates labor needs.

“Against this backdrop, vendors face growing competition from large EHR incumbents pursuing product adjacencies, big tech, and innovative venture capital–funded start-ups,” the authors wrote.

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https://healthitanalytics.com/news/cleveland-clinic-ibm-partner-to-install-first-healthcare-quantum-computer

Cleveland Clinic, IBM Partner to Install First Healthcare Quantum Computer

The computer is a key part of the organizations’ ongoing partnership aimed at accelerating discovery in healthcare and life sciences.

By Shania Kennedy

October 19, 2022 - Cleveland Clinic and IBM announced that the deployment of the first healthcare quantum computer in the US has begun on the health system’s main campus, a key component of the two organizations’ 10-year partnership to advance biomedical research through high-performance computing.

The computer, called IBM Quantum System One, is the first private sector onsite, IBM-managed quantum computer in the country, according to the press release. Its installation at Cleveland Clinic is set to be completed in early 2023. The installation is part of the Cleveland Clinic-IBM Discovery Accelerator, announced in 2021, which aims to leverage Cleveland Clinic’s medical expertise and IBM’s expertise in technology and quantum computing.

As part of the partnership, the organizations will utilize quantum computing, artificial intelligence (AI), and hybrid cloud technology to accelerate biomedical discovery.

“The current pace of scientific discovery is unacceptably slow, while our research needs are growing exponentially,” said Lara Jehi, MD, Cleveland Clinic’s chief research information officer, in the press release. “We cannot afford to continue to spend a decade or more going from a research idea in a lab to therapies on the market. Quantum offers a future to transform this pace, particularly in drug discovery and machine learning.”

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https://www.yahoo.com/gma/private-lab-data-covid-quest-090025114.html

Private lab data before COVID: Quest and Labcorp are warring rivals in a testing duopoly

Sun, October 23, 2022 at 8:00 PM·11 min read

Mark Brown witnessed the birth of modern diagnostic testing from the back seat of his mother's station wagon. He just doesn't remember it, because he was a newborn himself. Mark’s father, Paul Brown, was 29 in 1967 when he founded Metropolitan Pathology Laboratory by borrowing $500 to rent an apartment in upper Manhattan.

The operation’s logistics were straightforward. Paul Brown’s wife, Cynthia, packed their eldest son, Richard, 3, and Mark, the infant, into the family station wagon. She drove a few blocks to Columbia Presbyterian Hospital to pick up Pap smear slides. Then she drove back to the apartment, where her husband stained the slides by hand in the bathtub.

“I do remember double-parking at the hospital,” Cynthia Brown said by email.

Brown and Dr. James Powell were residents together at Englewood Hospital in New Jersey, where they worked with one of the first commercially available automated testing machines. Brown integrated such machines into his company, later renamed MetPath, which became Quest Diagnostics.

Powell returned to his hometown of Burlington, North Carolina, to create Biomedical Laboratories, which used similar technology. After a series of mergers and acquisitions, Powell’s company became Labcorp.

Both companies — called the "blood brothers" within the testing industry — grew aggressively, simultaneously and by similar means. Automated lab machines were expensive, and required vast quantities of samples to operate profitably. Using these greater economies of scale, both companies lured testing contracts away from traditional, smaller labs by promising doctors and hospitals faster, cheaper tests.

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https://www.govconwire.com/2022/10/va-awards-oracle-cerner-956m-in-ehr-modernization-task-orders/

VA Awards Oracle Cerner $956M in EHR Modernization Task Orders

Oracle‘s (NYSE: ORCL) Cerner subsidiary has secured a pair of task orders worth $956 million combined to continue to the deployment of an electronic health record system to Department of Veterans Affairs-run facilities, FedHealth IT reported Thursday.

The report noted Cerner Government Services will perform waves K to O deployments under a 27-month, $906 million task order and waves N to U deployments under a three-year, $50 million task order.

VA initially obligated a total of $789.3 million to Cerner for the additional work association with the department’s EHR modernization project.

The task orders were awarded as part of the multibillion-dollar indefinite-delivery/indefinite-quantity contract the health technology maker received in May 2018.

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https://www.healthcareitnews.com/news/himss-promotes-key-policies-telehealth-expansion-maternal-health

HIMSS promotes key policies on telehealth expansion, maternal health

During Global Health Equity Week, HIMSS is calling on its members to contact senators and state governors to make policy changes preserving virtual care flexibilities and modernizing information and technology systems to improve perinatal healthcare.

By Mike Miliard

October 25, 2022 09:31 AM

HIMSS is calling on healthcare stakeholders to get involved in two initiatives to help expand access to quality care for underserved and at-risk populations.

As part of its Global Health Equity Week, HIMSS (parent organization of Healthcare IT News), is promoting two policy campaigns, at the federal and state level, respectively.

The first is focused on protecting access to care via the telehealth flexibilities that have enabled broad expansion and uptake of virtual care since the start of the COVID-19 pandemic.

With those flexibilities due to sunset 151 days after the federal Public Health Emergency expires, HIMSS is calling on its members to contact their senators and representatives and urge them to extend coverage of telehealth services under Medicare until at least December 31, 2024.

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https://www.healthcareitnews.com/news/intersection-remote-patient-monitoring-and-ai

The intersection of remote patient monitoring and AI

Robin Farmanfarmaian, a Silicon Valley AI entrepreneur and author, explains how artificial intelligence can boost the efficacy of RPM and help democratize healthcare.

Bill Siwicki

October 25, 2022

Robin Farmanfarmaian is a Silicon Valley-based entrepreneur working in technology and artificial intelligence. She has been involved with more than 20 early-stage biotech and healthcare startups, including ones working on medical devices and digital health.

With more than 180 speaking engagements in 15 countries, she has educated audiences on many aspects of technology intersecting healthcare, including artificial intelligence and the shift in healthcare delivery to the patient's home.

She has written four books, including The Patient as CEO: How Technology Empowers the Healthcare Consumer and, most recently, How AI Can Democratize Healthcare: The Rise in Digital Care.

Healthcare IT News spoke with Farmanfarmaian to discuss where AI is impacting remote patient monitoring today, and how AI can democratize healthcare.

Q. Where is remote patient monitoring today? Where do you see RPM five and 10 years from now?

A. Remote patient monitoring is still in the first five years of adoption and integration into the healthcare system, and the pandemic accelerated this trend by illustrating the need and value of RPM. There are many clinical-grade devices now that patients can buy or use to measure and monitor various vital signs, including EKG, heart rate, heart rate variability, blood pressure and blood oxygen level.

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https://www.healthcareittoday.com/2022/10/25/is-disruptive-innovation-really-such-a-good-thing/

Is Disruptive Innovation Really Such A Good Thing?

October 25, 2022

Anne Zieger

This week I read an essay by Health Futures President Jeff Goldsmith which made a case for moving beyond a much-beloved way of thinking about innovation and growth.

In his essay, which appeared in The Health Care Blog, author Goldsmith argues that the concept of disruption as having “passed its sell-by date” after mass adoption by those who see it as gospel.

To be certain, there’s much to admire in the theory, which was outlined by Clayton Christensen in his 1997 book The Innovator’s Dilemma: When New Technologies Cause Great Firms to Fail.

In this book, Christensen defines disruptive innovation as the process in which a smaller company with fewer resources gradually takes over a market niche by capturing customers at the bottom of the market.

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https://ehrintelligence.com/news/pcp-ehr-screen-time-linked-to-higher-quality-outcomes

PCP EHR Screen Time Linked to Higher Quality Outcomes

While PCP EHR screen time has been associated with clinician burnout, it may represent a level of thoroughness that enhances certain quality outcomes.

By Hannah Nelson

October 24, 2022 - Primary care physician (PCP) EHR screen time spent on in-basket and clinical review was linked to higher quality outcomes for certain metrics, like breast cancer screening rates, according to a JAMA Network Open study.

Researchers conducted a cross-sectional study of PCPs at two large academic health centers.

The study found that each additional 15 minutes of daily EHR time was associated with 0.55 percentage points greater hypertension control. Further, each additional 15 minutes of daily EHR notes time was associated with 0.47 percentage points greater hypertension control.

“These results underscore the need to create team structures, examine PCP and office workflows, and enhance EHR-based technologies and decision support tools in ways that enable high quality of care, while optimizing time spent on the EHR,” the study authors wrote.

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https://www.fiercehealthcare.com/health-tech/alife-launches-ai-platform-improve-ivf-treatment-outcomes-lower-costs

Alife launches AI technology to advance IVF treatment outcomes, lower costs

By Heather Landi

Oct 24, 2022 09:00am

The demand for fertility treatments is on the rise, driven by a number of macro factors: People are starting families later, same-sex couples are seeking out services and studies show that male fertility has been steadily dropping.

U.S. births assisted by fertility treatments increased more than threefold from 1996 to 2015, according to the Pew Research Center.

Today, 1 in 8 couples struggle with infertility, and the treatment options are expensive. A single in vitro fertilization (IVF) cycle in the U.S. costs around $12,000, and that price can rise up to $25,000 with medication. And many patients don't just go through one cycle, but three to five cycles on average in order to have a successful pregnancy.

After two years of R&D, startup Alife launched new artificial intelligence software to help fertility clinics optimize and support clinical decision-making during critical stages of the IVF process.

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https://www.medpagetoday.com/opinion/second-opinions/101354

Electronic Medical Records Are Strangling American Medicine

— The implications for burnout are staggering

by Dane Brodke, MD, MPH October 23, 2022

Last month, 15,000 nurses went on strike in Minnesota in the largest private-sector nursing strike in U.S. history. They were protesting understaffing and overwork at a time when provider burnout has reached epidemic proportions -- approximately 63% of physicians and 80% of nurses now report symptoms of burnout. Meanwhile, healthcare continues to struggle with overwhelming cost pressures. We still spend more money for worse outcomes than any other developed country. As a surgical resident, I've heard too many structural explanations for cost and burnout problems that overlook a specific, fixable culprit: Our electronic medical records (EMRs) are still hopelessly broken.

In 2022, software is suffocating American medicine.

The 2009 HITECH Act kicked off the modern era of the EMR with federal incentives for EMR use. Unfortunately, the legislation also favored established firms over smaller competitors with its many requirements and short timeframe. Today, many of the top-ranking hospitals use EMRs from one of two vendors, Epic Systems or Cerner Corporation (now part of Oracle). Epic alone has medical records on 250 million people, while Cerner won a $16 billion contract to introduce its EMR to the Veterans Health Administration. These businesses had a combined revenue of nearly $10 billion in 2021, with both reporting double-digit year-over-year growth.

Despite ballooning funding, I haven't experienced any significant upgrades to the Epic or Cerner EMR systems in the last 8 years. I find the interfaces to be comically inelegant. I'm frequently staring at screens with over 30 tabs, and when I click one, the system stutters and lags before showing a result. This flawed user experience slows providers down drastically. In one study of a North Carolina orthopedic clinic, the adoption of Epic's EMR increased physician documentation time by 230% and increased labor costs per visit by 25%. Family medicine physicians have it worse: many spend a whopping 6 hours a day on the EMR. Nurses often spend more time charting in the EMR than on any other task. Multiply this out by the whole healthcare system and the idea that an extra MRI here and there is driving our cost crisis seems laughable. Every day, expensive physician and nursing labor is squandered through unnecessary clicking and scrolling.

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https://www.healthcareitnews.com/news/rpm-leads-early-detection-stroke-risk-blood-pressure-boston-medical-center

RPM leads to early detection of stroke-risk blood pressure at Boston Medical Center

The academic medical center's physician chief of maternal fetal medicine explains how remote patient monitoring technology improves care during a very sensitive time in a woman's life.

By Bill Siwicki

October 24, 2022 10:47 AM

Boston Medical Center is a not-for-profit academic medical center and the largest safety-net hospital in New England. It provides medical care for infants, children, teens and adults.

Dr. Christina Yarrington is chief of maternal fetal medicine at Boston Medical Center. As a leader in obstetrics at the medical center, her focus is on ensuring the facility's population has the resources needed to monitor patients at high risk of postpartum hypertension to reduce overall health risks in a way that doesn't disrupt the important early days of infant bonding at home.

THE PROBLEM

Postpartum hypertension is a leading cause of postpartum hospital readmissions and severe maternal morbidity, since it can lead to heart attacks and strokes, which makes it vital to monitor blood pressure closely and then be able to leverage data from blood pressure readings.

There are challenges in getting timely blood pressure data if dependent on a visiting nurse or if coming into the doctor's office with an infant is sometimes impossible. The pandemic magnified these challenges.

"Fortunately, we already had started to explore remote patient monitoring solutions that integrated with our Epic EHR, were easily accessible and required minimal effort by the patient," Yarrington noted.

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https://www.healthcareitnews.com/news/henry-ford-makes-homegrown-rx-platform-available-health-systems-nationwide

Henry Ford makes homegrown Rx platform available to health systems nationwide

DromosPTM is a specialty pharmacy software, designed to help coordinate medications for rare conditions that need unique handling and distribution.

By Mike Miliard

October 24, 2022 10:41 AM

A specialty pharmacy platform, developed in 2013 by Detroit-based Henry Ford Health to help address a unique need, is now available for other health system customers across the country.

WHY IT MATTERS
Henry Ford Innovations announced on Friday that the software, called DromosPTM, is now commercially available for pharmacies nationwide. The platform is designed to meet an often unmet need in the specialty pharmacy space – helping coordinate highly-specific aspects of patient care and disease management.

Focused on medications, often for chronic and rare conditions, that demand special handling, storage and distribution, DromosPTM can help pharmacists and providers find financial assistance for costly prescriptions.

It can also help boost patient engagement and improve medication adherence, integrating with patient portals to enable easier requests of often-complicated prescription refills and transfers, according to Henry Ford Innovations.

DromosPTM was designed and developed at Henry Ford Health's specialty pharmacy, Pharmacy Advantage, which is supported by CarepathRx.

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How CIOs and IT Can Help with Clinician Retention

October 24, 2022

Colin Hung

It certainly feels like we are just moving from one crisis to another in healthcare right now. As we emerged from the COVID-19 pandemic, we were suddenly hit with a healthcare workforce challenge. We find ourselves again in a “all-hands-on-deck” situation where every department needs to contribute to solving the problem. But what can healthcare CIOs and IT departments do to help retain clinicians? A new eBook offers five practical ways to help.

The eBook was written in collaboration with CareAlign, a company that provides a secure, HIPAA compliant workspace to build care plans, manage tasks, and generate notes.

Cognitive Load

The eBook is centered on Cognitive Load – the amount of information that a person needs to hold and process to perform an activity like diagnose a patient, document an encounter, or administer medication. It turns out that cognitive load is an overlooked factor in staff dissatisfaction and frustration.

In a nutshell, the higher the cognitive load, the more effort it takes to perform a task. The more effort it takes, the more frustrated people become which can ultimately lead to that person leaving the organization. Tasks with high cognitive load are silently and insidiously sapping the energy from the healthcare workforce.

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Enjoy!

David.

Friday, November 04, 2022

For Professionals There Is No Excuse For Not Observing Appropriate Standards On Social Media.

This appeared last week:

The perils of social media - recent Tribunal decision

25 Oct 2022

Mark Helier Solicitor - Legal Services

A recent Tribunal decision has demonstrated the Medical Board’s desire to send a “strong and clear message” that unacceptable online content posted by practitioners of a serious nature will have serious consequences.
 
In the decision, Medical Board of Australia v Lee [2022] VCAT  667, the Tribunal found that Dr Lee had engaged in professional misconduct resulting in a reprimand, cancelling of his registration and disqualification from applying for registration (totalling 54 months) which, taking account of suspension already served, will be in December 2023.
 
The conduct by Dr Lee had to be extremely serious to warrant this sort of penalty. There were two allegations of professional misconduct, one relating to posts by Dr Lee described by the Tribunal as gruesome images and abhorrent messages and the second relating to confidential patient information on internet forums and social media sites.
 
The judgement provides significantly more detail regarding the allegations. The posts included graphic and gory images. Dr Lee provided commentary about those images. Intimate photographs of Dr Lee’s wife were posted without her consent. The judgement describes the commentary as:

  • Extremely misogynistic which endorsed violence against women, objectifying or humiliating women including Dr Lee’s wife;
  • Xenophobic, racist, bigoted and discriminatory in relation to Muslims, Indian men, Palestinians and Singaporean women;
  • Endorsing violence against women, persons with mental illnesses and physical disabilities.

In relation to the confidentiality issues, the images contained Dr Lee at work, patients, clinical records and his treatment of some patients.
 
In 2019 Dr Lee was subject to immediate action by the Board resulting in the suspension of his registration. He had not practised from the time of the immediate action to the Tribunal hearing, some 3 years later.
 
At the hearing, Dr Lee accepted the posts were ‘utterly unacceptable’ and that his conduct in relation to the posts amounted to professional misconduct. Professional misconduct is defined in section 5 of the National Law as:
 
(a) unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and
 
(b) more than one instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and
 
(c) conduct of the practitioner, whether occurring in connection with the practice of the health practitioner’s profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession.
 
The Tribunal found that Dr Lee’s conduct fit that definition.
 
There were submissions on penalty – should Dr Lee have his registration suspended or cancelled and, if so, for how long?
 
Dr Lee’s position was that suspension was an appropriate penalty as his conduct was causally linked to a (previously undiagnosed) mental health condition, Autism Spectrum Disorder (ASD). The Board’s position was that having regard to all of the conduct, cancellation of Dr Lee’s registration was appropriate and that his ASD did not significantly reduce his moral culpability.
 
The judgement sets out the Tribunal’s considerations regarding the purpose of determinations (being caution, reprimand, fine, suspension or cancellation of registration) and their application in this matter. Their purpose is to protect the public with an assessment of the ongoing risk posed by the doctor and the degree of insight shown by the practitioner.  The Tribunal also has to consider the effect of Dr Lee’s ASD on his moral culpability.
 
By the time of the hearing, Dr Lee had proactively engaged in treatment of his ASD and he understood the factors that had led to the misconduct, had developed insight and remorse and strategies to manage the ASD to avoid a repeat of his conduct.
 
The Tribunal decided to cancel Dr Lee’s registration.

More here:

https://www.miga.com.au/Bulletin/perils-of-social-media-recent-Tribunal-decision

This is a pretty ugly and really quite sad but it does go to show there are real limits, and for professionals, crossing lines can have life altering and disastrous outcomes!

Think before you type seems to be a sensible rule for a long and happy life on social media I reckon!

David.

 

This Is A Useful Discussion On Getting Ready For The Inevitable Ransomware Attack.

I spotted this last week

How can you prepare for ransomware attacks?

VMware Global Inc

By Darren Reid, Director of the Security Business Unit, VMware, ANZ
Wednesday, 19 October, 2022

If the last weeks have taught security practitioners anything, it’s that no organisation — regardless of size, sector or security budget — is immune to ransomware or the threat of a cyber attack.

In Australia, the healthcare industry has been one of the most targeted, with the Australian Cyber Security Centre (ACSC) stating that ransomware attacks against the Australian healthcare sector are growing. As an example, in 2021 large Australian organisations such as Eastern Health and Melbourne Heart group fell victim to ransomware. Of course, ransomware attacks are not exclusive to the healthcare sector, and VMware’s recent Global IR Threat Report found that over 60% of respondents had encountered ransomware attacks over the past year.

Business leaders and security professionals alike have only become more concerned about ransomware, and rightly so. This is due to a much more complex and broad attack surface than that of a decade ago. In tandem, cybercriminals have taken full advantage of the shift in working styles, becoming more motivated and sophisticated in their attack methods. In fact, the Global IR Threat Report also flagged that ransomware attacks have become increasingly malevolent, with over half of the reported encounters including double-extortion techniques. Furthermore, the Verizon Business 2022 Data Breach Investigations Report found that ransomware increased by 13% over the past year, representing an uptick greater than the past five years combined — with no relief in sight for the next year ahead.

Organisations must operate under the assumption that they will at some point be hit by ransomware. This requires having a holistic view of how such cyber attacks occur. An often overlooked element is the length of time an attacker may remain in a business’s environment before they trigger an attack. The longer they remain inside, the more information they can gather, the greater they can raise their access privileges and the more likely they are to cause catastrophic damage to your business.

Take the recent breach of Uber as an example. Information appears to demonstrate that the attacker operated within Uber’s environment for some time and has moved laterally across applications and platforms to gain broad access to a variety of highly sensitive, and potentially damaging, information. This is the biggest risk to most businesses — that the attacker will move laterally across the organisations and compromise multiple systems along the way.

This is why businesses need to choose the adequate tools and monitoring approaches to achieve ongoing vigilance and constant visibility into the normal behaviour of your applications, network, staff and systems.

Understanding how cyber attacks occur

As with anything, organisations must first ensure they have the fundamental view of risk, and an understanding of where cyber attacks arise from. Your view on risk will depend on your own business and applications used within the company. Businesses should reference known frameworks (such as NIST, Essential 8 and others) to understand which attacks are most likely in their industry or environment. Of those, which ones are the most dangerous, either in terms of pervasiveness or impact to the business? Of those that are high-risk or high-impact, which are most likely and how do they manifest? From these points, how does an attacker enter the business environment, whether it be through endpoint, email, physical access or a combination, and what mitigations are in place to prevent this type of intrusion?

Security teams must be able to see all the data and assets in an organisation in order to properly protect it and support these environments to continue running in the event of an attack. For this reason, it’s critical to establish a complete inventory of what the organisation has deployed in its environment — including what its current running state is and what the basic controls are around access and more specifically, privileged access.

Lots more here:

https://www.technologydecisions.com.au/content/security/article/how-can-you-prepare-for-ransomware-attacks--1201478022

A timely read I reckon.

David