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, February 04, 2023

Weekly Overseas Health IT Links – 4th February, 2023.

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://healthitanalytics.com/news/johns-hopkins-machine-learning-tools-predict-risk-of-icu-delirium

Johns Hopkins Machine-Learning Tools Predict Risk of ICU Delirium

New machine-learning models developed by Johns Hopkins researchers accurately predicted delirium-prone patients up to 90 percent of the time.

By Shania Kennedy

January 27, 2023 - Johns Hopkins University researchers have developed machine-learning (ML) algorithms that can detect the early warning signs of delirium and predict which patients will be at high risk of delirium at any point during an intensive care unit (ICU) stay.

The press release states that over one-third of patients admitted to the hospital and 80 percent of ICU patients develop delirium at some point during their hospital stay. Delirium can cause inattention, confusion, paranoia, agitation, and hallucinations in patients, which can worsen patient outcomes.

ICU delirium occurs more frequently in older and sicker patients and can lead to prolonged hospitalization, future dementia, and death, according to the press release. Anti-delirium interventions, such as care bundles, earlier-than-usual physical and occupational therapy, and medication changes, can be effective but are not used on every patient because of limited time and resources and the sometimes unpredictable needs of these patients.

To address this, the researchers set out to build delirium prediction models.

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https://ehrintelligence.com/news/klas-infection-control-health-it-streamlines-regulatory-reporting

KLAS: Infection Control Health IT Streamlines Regulatory Reporting

Many Epic EHR customers are leaving their best-of-breed infection control health IT and moving to Epic Bugsy for regulatory reporting, the KLAS report found.

By Hannah Nelson

January 27, 2023 - Healthcare organizations are looking to infection control health IT with strong technical support to help drive meaningful outcomes and optimize regulatory reporting, according to a KLAS report.

All five health IT vendors included in the KLAS report have significantly impacted respondents’ clinical, reporting, and patient outcomes. The most reported effect is easy reporting for regulatory agencies. Additionally, respondents for each vendor said that their solution helps decrease hospital-acquired infections year over year.  

Wolters Kluwer and Premier stood out for improving clinical workflows, compliance and quality reporting, and patient outcomes.

Wolters Kluwer customers were most likely to report that the product has needed functionality. Respondents also said strong customer guidance helps establish best practices.

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https://mhealthintelligence.com/news/telehealth-may-not-improve-opioid-use-disorder-treatment-quality-access

Telehealth May Not Improve Opioid Use Disorder Treatment Quality, Access

A recent study shows that a higher rate of telehealth use was not linked to increased access or improved quality of treatment for opioid use disorder patients.

By Mark Melchionna

January 27, 2023 - A study published in JAMA Network Open earlier this week found that clinical outcomes did not vary among opioid use disorder (OUD) patients receiving treatment from clinicians with high or low telehealth use, with no evidence showing that telehealth increased access or improved the quality of OUD treatment.

According to the Centers for Disease Control and Prevention (CDC), about 2.7 million people in the US reported suffering from OUD in 2020.

In this study, researchers aimed to gather information regarding the relationship between telehealth use and the treatment of OUD. They conducted a cohort study that included data from OptumLabs Data Warehouse.

Researchers included claims for telemedicine visits in both pre-and mid-pandemic periods, defined as March 14, 2019, to March 13, 2020, and March 14, 2020, to March 13, 2021, respectively. The criteria for inclusion in the study as a patient were having OUD and enrollment in commercial insurance or Medicare Advantage plans. Included clinicians were those who provided office-based OUD treatment. The clinicians were then grouped into low, medium, or high telehealth-use groups.

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https://www.digitalhealth.net/2023/01/huma-ceo-says-uk-risks-falling-behind-on-digital-health/

Huma CEO says UK risks falling behind on digital health

The CEO of Huma Health, Dan Vahdat, has warned that the NHS risks falling behind countries including US, Germany and France on adoption of digital health unless it aligns funding. 

Jon Hoeksma

24 January 2023

Vahdat said that although the UK rapidly deployed digital health technologies during the pandemic it had not since followed up with aligning accompanying regulatory policies and reimbursement regimes.  

Talking to Digital Health News from Davos, the annual meeting in Switzerland of politicians and global business leaders, where he was speaking on how digital health companies can help improve health equity, Vahdat said that digital health has hit the mainstream.   

“The Pandemic required people to do things differently and showed tech can work at larger scale and can add value. It massively accelerated adoption and 100% that pace of adoption will be sustained,” the Huma CEO said.   

One of the key differences was that many people hadn’t even been aware that things like remote consultations were possible three-years ago.  “Due to the pandemic many people have now experienced these services and lots of people love remote care.”    

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https://www.healthcaredive.com/news/artificial-intelligence-healthcare-savings-harvard-mckinsey-report/641163/

Artificial intelligence could save healthcare industry $360B a year

Published Jan. 26, 2023

Rebecca Pifer Senior Reporter

Dive Brief:

  • Artificial intelligence could save the U.S. up to $360 billion annually if adopted more widely in healthcare, according to a new report from McKinsey and Harvard researchers.
  • That’s a big “if,” as AI uptake has been limited in the industry due to a lack of trust among patients and doctors, heterogeneous data and misaligned incentives, the researchers said.
  • But broader adoption of AI is likely in the near future, and should also have a slew of non-financial benefits like better healthcare quality, increased care access and better patient and doctor satisfaction, according to the paper.

Dive Insight:

The buzz around AI has increased as the ChatGPT model takes the internet by storm. It’s no different in healthcare. The ChatGPT AI tool has passed the U.S. medical licensing examauthored a number of scientific papers and is being used to appeal insurance denials, hinting at real-world applications for the algorithms.

However, actual adoption of AI-based tools in the healthcare industry is low, despite research suggesting benefits of the tech.

In the new paper, researchers estimate that broader adoption of AI could lead to savings between 5% and 10% in healthcare spending, or roughly $200 billion to $360 billion a year. The estimates are based on AI use cases employing current technologies that are attainable within the next five years, without sacrificing quality or access.

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https://www.healthcareitnews.com/news/gaming-tech-being-used-dementia-treatment

Gaming tech is being used for dementia treatment

Andrus on Hudson's memory care residents become more engaged and social using a large gaming table designed specifically for people with cognitive challenges.

By Bill Siwicki

January 27, 2023 10:44 AM

Research shows that apathy is a significant challenge for people living with dementia. They lose the ability to take initiative, which has an enormous effect on their emotional and physical wellbeing. This makes the disorder much harder to treat.

THE PROBLEM

Andrus on Hudson, based in Hastings-on-Hudson, New York, serves and cares for individuals ("residents," to reflect the environment in which they receive care) who have various types of dementia. One of the primary challenges caregivers and residents face are negative behaviors that occur when there are downtimes during the day and/or the sundown window.

These negative behaviors include agitation and wandering. While AOH uses best practices to provide care to these residents, such as responding to those negative behaviors, it's important for caregivers to expand the "tool kit" for this special population, said Andruette "Kerry" Beckford, RN, director of nursing at AOH.

"In addition to robust recreational therapy programming, tools within the tool kit are effective, but should be used in moderation, such as having residents watch TV or similar approaches to help reduce negative behavior," she explained. "However, these do not always fully engage the resident."

PROPOSAL

To help with the challenge, AOH turned to Netherlands-based Tover, a healthcare technology company that focuses on people facing cognitive challenges that include dementia and intellectual disabilities. Tover markets the Tovertafel, a gaming table for individuals with cognitive disabilities.

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https://www.healthcareittoday.com/2023/01/27/digital-healthcare-delivery-four-things-that-matter-most/

Digital Healthcare Delivery: Four Things That Matter Most

January 27, 2023

The following is a guest article by Janelle Estes, Chief Insights Officer at UserTesting, a video-based human insight platform.

In a world that runs at lightning speed and thrives on instant gratification, getting in to see a doctor tends to be a painfully slow exception.

On average, it takes 26 days to schedule a new patient appointment in-office in large U.S. cities, according to a recent study by medical staffing firm AMN Healthcare. And that number is rising, up from 24 days five years ago.

No wonder telehealth adoption is surging.

Development and innovation in telehealth was already underway in recent years, but usage skyrocketed during the pandemic as people sought alternatives to in-person visits and it remains high today. According to a McKinsey report, telehealth utilization is 38 times higher than before COVID-19. 

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https://www.healthleadersmedia.com/revenue-cycle/looking-beyond-reimbursement-capturing-sdoh-data-revenue-cycle

Looking Beyond Reimbursement: Capturing SDOH Data in The Revenue Cycle

Analysis  |  By Amanda Norris  |   January 27, 2023

SDOH capture can result in improved patient satisfaction scores and reduced provider burnout.


KEY TAKEAWAYS

·         With increasing attention on population health and quality initiatives, some organizations have turned their focus on capturing patients' SDOH.

·         SDOH codes are not currently tied to reimbursement, meaning SDOH capture isn’t on the list of priorities for all revenue cycle leaders.

·         One leader says there are many more positives to collecting this data other than reimbursement, including reduced provider frustration and burnout.

The CDC recently announced 42 new ICD-10-CM diagnosis codes for 2023 effective April 1. Taking the spotlight for these changes are new codes for reporting certain social determinants of heath (SDOH).

With increasing attention on population health and quality initiatives, organizations have turned their focus on SDOH and how capturing those ICD-10-CM codes impacts their patient population and their success in caring for that population.

Capturing SDOH is critical for revenue cycle teams. SDOH data can provide revenue cycle leaders with a better understanding of patient populations to inform revenue planning and strategy.

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https://www.imt.ie/news/technology-and-ehealth-solutions-must-be-radically-overhauled-27-01-2023/

Technology and e-Health solutions must be ‘radically overhauled’

By Paulie Doyle 27th January 2023

Technology and eHealth are an essential part of delivering integrated care as outlined in Sláintecare – yet the HSE trails behind other countries in its implementation, an Oireachtas Health Committee meeting heard earlier this week

The HSE’s technology and eHealth solutions need to be radically overhauled to provide the standard of care offered by a modern health service, a meeting of the Oireachtas Health Committee has heard.

“There’s a long road to go, and other countries are ahead of us,” Fran Thompson, Chief Information Officer for the HSE, told the Committee earlier this week.

Thompson explained that the health service is being ‘held back’ with inefficient, and often paper-based patient interactions. Patients’ outcomes are negatively impacted by retrograde systems managing their health data: paper-based systems are more likely to cause clinicians to make mistakes. They also stifle their ability to share a patient’s data with other healthcare professionals.

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https://ehrintelligence.com/news/88-of-hospitals-use-health-data-exchange-onc-interoperability-report-finds

88% of Hospitals Use Health Data Exchange, ONC Interoperability Report Finds

HIEs and interface connections with EHRs were the most used interoperability methods for health data exchange in 2021.

By Hannah Nelson

January 26, 2023 - Interoperability continues to improve, with 88 percent of hospitals participating in electronic health data exchange as of 2021, according to an ONC data brief based on the AHA Information Technology (IT) Supplement to the AHA Annual Survey.

Since 2017, the number of hospitals engaged in integrating patient health data into EHRs has grown 40 percent, with around three-quarters of hospitals engaging in this activity in 2021.

Additionally, rural and small hospitals’ usage of information received electronically from outside sources increased at twice the rate of hospitals nationally (over 40 percent vs. over 20 percent) between 2017 and 2021.

Rural and small hospitals’ rates of having patient information available at the point of care increased by 26 percent from 2017 to 2021, reaching 48 percent. 

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https://mhealthintelligence.com/news/race-age-language-barriers-fuel-telehealth-delivery-disparities

Race, Age, Language Barriers Fuel Telehealth Delivery Disparities

A recent study found that hurdles related to race, age, language, and access to technology lead to healthcare disparities among telehealth users.

By Mark Melchionna

January 26, 2023 - The UCLA Latino Policy and Politics Institute conducted a study that shows healthcare disparities linked to telehealth use during the COVID-19 pandemic resulted from race, age, language, and technology access barriers.

Restrictions to in-person healthcare led many patients and providers to use telehealth services after the COVID-19 pandemic hit. According to the Centers for Disease Control and Prevention (CDC), 37 percent of adults said they used telehealth within a year before 2021.

Although telehealth has served as a valuable resource for many, the UCLA Latino Policy and Politics Institute found that issues, including language barriers and insufficient access to technology, often prevented many people from reaping telehealth's benefits.

Researchers used data from a Los Angeles County healthcare system for the study. They analyzed visits that took place between January and December 2020. They also surveyed 39 healthcare providers from seven health systems between August 2021 and April 2022.

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https://healthitsecurity.com/news/downloaders-ransomware-among-top-healthcare-cyberattack-tactics-in-q4

Downloaders, Ransomware, Among Top Healthcare Cyberattack Tactics in Q4

A new report from BlackBerry sheds light on Q4 2022 healthcare cyberattack trends, showing that ransomware is still a dominant tactic.

By Jill McKeon

January 25, 2023 - Ransomware remained a primary healthcare cyberattack tactic in Q4 2022, BlackBerry noted in its new Global Threat Intelligence Report. BlackBerry's Threat Research and Intelligence team leveraged data collected by its own security solutions between September 1 and November 30, 2022, along with information from public and private intelligence sources.  

Throughout the 90-day period, researchers observed threat actors using a variety of tactics, from downloaders to ransomware, infostealers, and remote access Trojans (RATs). For the healthcare sector in particular, ransomware “still poses the biggest threat,” the report indicated.

“In the past, some RaaS groups like Maze indicated they would not attack hospitals, but such promises cannot be guaranteed,” BlackBerry noted.

“With the diversity of multiple RaaS groups and the proliferation of affiliate models, the group that executes an attack may not be the same group that developed the malware, which makes tracing and attribution a concern.”

The most popular Trojan used against healthcare was Qakbot, which the Cybersecurity and Infrastructure Security Agency (CISA) listed as one of the top 11 malware threats of 2021. HHS also released a threat brief regarding Qakbot in 2020. Qakbot is often delivered via email as malicious attachments, embedded images, or hyperlinks.

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https://www.medscape.com/viewarticle/987455

FDA Okays Tidepool Loop App to Help Guide Insulin Delivery

Miriam E. Tucker

January 24, 2023

The US Food and Drug Administration (FDA) has cleared the Tidepool Loop, a mobile application for use with compatible continuous glucose monitors (CGMs) and insulin pumps to enable automated insulin delivery.

Indicated for people with type 1 diabetes ages 6 years and up, the app algorithm was developed by the diabetes startup Tidepool, which already hosts a cloud-based platform for users to download and review data from different glucose meters, insulin pumps, and CGM systems. The Tidepool Loop project arose from patient-led, open-source initiatives, as previously reported by Medscape Medical News, to enable interoperability between the devices.

"The [FDA] authorization of the Tidepool Loop is a huge win for the type 1 diabetes (T1D) community and is a vital step towards a world where people with T1D can choose the pump, CGM, and algorithm that are best for them — and have all three work together seamlessly," Aaron Kowalski, PhD, CEO of the advocacy organization JDRF, said in a statement.

JDRF helped support preclinical and clinical research in the development of the Loop algorithm, along with The Leona M. and Harry B. Helmsley Charitable Trust, the Tullman Foundation, and partnerships with device makers and donations from the T1D community.

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https://www.nature.com/articles/d41586-023-00191-1

·         EDITORIAL

·         24 January 2023

Tools such as ChatGPT threaten transparent science; here are our ground rules for their use

As researchers dive into the brave new world of advanced AI chatbots, publishers need to acknowledge their legitimate uses and lay down clear guidelines to avoid abuse.

It has been clear for several years that artificial intelligence (AI) is gaining the ability to generate fluent language, churning out sentences that are increasingly hard to distinguish from text written by people. Last year, Nature reported that some scientists were already using chatbots as research assistants — to help organize their thinking, generate feedback on their work, assist with writing code and summarize research literature (Nature 611, 192–193; 2022).

But the release of the AI chatbot ChatGPT in November has brought the capabilities of such tools, known as large language models (LLMs), to a mass audience. Its developers, OpenAI in San Francisco, California, have made the chatbot free to use and easily accessible for people who don’t have technical expertise. Millions are using it, and the result has been an explosion of fun and sometimes frightening writing experiments that have turbocharged the growing excitement and consternation about these tools.

ChatGPT can write presentable student essays, summarize research papers, answer questions well enough to pass medical exams and generate helpful computer code. It has produced research abstracts good enough that scientists found it hard to spot that a computer had written them. Worryingly for society, it could also make spam, ransomware and other malicious outputs easier to produce. Although OpenAI has tried to put guard rails on what the chatbot will do, users are already finding ways around them.

The big worry in the research community is that students and scientists could deceitfully pass off LLM-written text as their own, or use LLMs in a simplistic fashion (such as to conduct an incomplete literature review) and produce work that is unreliable. Several preprints and published articles have already credited ChatGPT with formal authorship.

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https://www.healthcareitnews.com/news/orlando-health-launch-ai-driven-hospital-home-services

Orlando Health to launch AI-driven hospital-at-home services

The health system selected Biofourmis, which can analyze more than 120 biomarkers in real-time, to extend hospital-level care to patients across Central Florida.

By Andrea Fox

January 26, 2023 10:16 AM

Data from the new hospital-at-home platform will be accessible through Orlando Health's Epic electronic health records through a multi-year agreement with the connected health and digital therapeutics company.

WHY IT MATTERS

Orlando Health – a non-profit health system with 18 hospitals and emergency rooms with five in development serving the southeastern United States – is expected to launch the new advanced remote patient monitoring capabilities in early 2023. 

Adding a virtual provider network can improve patient outcomes, prevent hospital readmissions, accelerate drug development and closes critical gaps in care, according to the Bifourmis announcement. 

The data-driven platform takes physiological signal data from patient sensors – like heart rate, blood pulse wave, heart-rate variability, respiration rate and numerous others – and applies advanced AI and machine-learning techniques to flag changes in at-home patient conditions that could indicate disease progression.

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https://www.healthcarefinancenews.com/news/how-one-health-system-developed-ai-tackle-patient-safety

  2023

How one health system developed AI to tackle patient safety

An innovation culture at Sheba Medical Center has produced efficiencies and cost savings.

Susan Morse, Executive Editor

Sheba Medical Center is focused on using artificial intelligence to turn around statistics on patient safety.

"In terms of patient safety, we've made no progress over the past 30 years," said Prof. Dr. Eyal Zimlichman, chief transformation and innovation officer at Sheba Medical Center, which is located on the outskirts of Tel Aviv. 

After seeing a report on these findings, Zimlichman said he and his team realized two things: It was a huge challenge; and they had "no clue how to handle" it. Zimlichman, who has also served as the health system's CMO since 2017, turned to digital health technology to tackle patient safety.

Zimlichman leads the Accelerate Redesign Collaborate (ARC) Innovation Center at Sheba, which, with close to 2,000 beds, is among the largest health systems in the Middle East. ARC is focused on precision medicine, big data, artificial intelligence, predictive analytics, telemedicine and mobile health.

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https://www.healthcareitnews.com/news/omaha-program-uses-hie-tech-improve-postpartum-care-minority-parents-and-children

Omaha program uses HIE tech to improve postpartum care for minority parents and children

The CyncHealth health information exchange for Nebraska and Iowa and its two partners are being recognized by HHS's Racial Equity in Postpartum Care Challenge.

By Bill Siwicki

January 26, 2023 10:34 AM

CyncHealth, Collective Medical and Innsena are being recognized by the Department of Health and Human Services' Racial Equity in Postpartum Care Challenge, including federal funding of $40,000, for their postpartum care program in Omaha.

Pregnancy-related deaths are three to four times more common among minorities than among Caucasian women, even among those with a college degree. This program improves postpartum care for Black and Indigenous parents and children with high-risk conditions who participate in Medicaid and the Children's Health Insurance Program, and significantly reduces maternal and neonatal mortality.

Out of the 25 winners recognized by HHS, this program is the only one using health information exchange technology to improve personalized care at the community level.

THE PROBLEM

"Support throughout pregnancy and postpartum is critical for creating lifelong health and wellbeing, physically and mentally, for mother and infant," said Jaime Bland, CEO of CyncHealth, the HIE. "In the days, weeks and months following childbirth, women are in a critical time for their care as they experience physical, social and psychological changes.

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https://healthitanalytics.com/news/new-tool-provides-population-health-insights-in-us-congressional-districts

New Tool Provides Population Health Insights in US Congressional Districts

The Congressional District Health Dashboard is designed to provide policymakers and the public with actionable and nonpartisan health data at the congressional district level.

By Shania Kennedy

January 25, 2023 - Researchers from New York University (NYU) Grossman School of Medicine and the Robert Wood Johnson Foundation (RWJF) unveiled the Congressional District Health Dashboard (CDHD), an online data tool that provides health data for all 435 US congressional districts and the District of Columbia.

According to the press release, the tool incorporates 36 critical measures of health and its drivers, such as deaths from breast cancer and cardiovascular disease, diabetes rates, housing affordability, and access to nutritious foods. Until now, much of these data were difficult for the public to access or unavailable at the congressional district level.

Dashboard users can explore data on health, poverty, education, and other factors by congressional district and compare the rates of these metrics among demographic groups within districts. The tool also enables users to view any district's snapshot, which shows all 36 measures compared to the national average.

“The Congressional District Health Dashboard will help fill a critical need for timely, rigorous, and actionable data that can inform evidence-based policymaking,” said Marc Gourevitch, MD, chair of the Department of Population Health at NYU Langone Health and the initiative’s principal architect, in the press release. “Now, policymakers, advocates, and others can drill down to their specific congressional districts to identify the opportunities and challenges affecting the health and wellbeing of all the people they serve, regardless of income, race, or zip code.”

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https://www.spokesman.com/stories/2023/jan/24/computer-problems-slow-spokane-va-after-defense-de/

Computer problems slow Spokane VA after Defense Department update to electronic health record system

Jan. 24, 2023 Updated Tue., Jan. 24, 2023 at 8:43 p.m.

By Orion Donovan-Smith

WASHINGTON – Spokane’s VA hospital and other medical facilities across the country suffered a major slowdown Monday and part of Tuesday after an update to a troubled electronic health record system caused a “performance degradation,” the Department of Veterans Affairs said Tuesday.

Employees at Mann-Grandstaff VA Medical Center alerted The Spokesman-Review to the problem. VA Press Secretary Terrence Hayes confirmed changes made to the system by the Department of Defense, which shares a database with the VA, “had the unintended consequence of interrupting services that provide connectivity to the network.”

As a result, Hayes said in a statement, each time users clicked a button in the system, they had to wait “long intervals” for the next screen. That further slowed a system whose clunky design has reduced the number of patients the Spokane hospital can serve and left employees exhausted.

Hayes confirmed the slowdown affected every medical facility using the system, including more than half of all Military Health System providers, as well as VA clinics and hospitals in Washington, Idaho, Oregon and Ohio. As of Tuesday afternoon, “configuration changes” had been made to resolve the issue, he said, adding the VA would “continue to monitor the system and user feedback to confirm the lag is fixed.”

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https://www.fiercehealthcare.com/digital-health/cdc-study-man-therapy-brings-effective-digital-support-population-most-likely-commit

Man Therapy brings effective digital mental health support to the population most likely to commit suicide, CDC study finds

By Annie Burky

Jan 24, 2023 01:02pm

Men-identifying Americans are four times more likely to die by suicide than women-identifying Americans. In the U.S., 78% of all suicides are committed by men ages 16-64 years.

"They're really struggling but they're struggling in silence, and it's below the surface," said Joe Conrad, an entrepreneur and digital health executive.

Conrad, the founder of Grit Digital Health, helped to launch Man Therapy in 2010, as an interactive mental health campaign targeting working-age men that employs humor to cut through stigma and tackle issues like depression. The website is designed to educate, reduce stigma and encourage men to seek help in times of crisis.

Ten years ago, the Colorado Department of Public Health and Environment wanted to find a new way to help men reject the “cowboy-up” approach to mental health. With billboards trumpeting that “You can’t fix your mental health with duct tape” and Dr. Rich Mahogany starring in mental health informational videos, the government saw men of working age seeking treatment for the first time.

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https://www.fiercehealthcare.com/health-tech/amazon-pharmacy-rolls-out-rolls-out-service-unlimited-generic-prescriptions-5-month

Amazon Pharmacy rolls out service for unlimited generic drug prescriptions for $5 a month

By Heather Landi

Jan 24, 2023 03:01am

Amazon rolled out a new prescription drug subscription for Prime members called RxPass that will ship generic medications to customers' homes for a flat monthly fee of $5.

Prime members can use the new service to order commonly prescribed generic medications that treat more than 80 common health conditions, including high blood pressure and acid reflux, and the service includes free delivery. 

RxPass, which is available starting Tuesday in most U.S. states, includes 50-plus generic drugs, according to John Love, vice president of Amazon Pharmacy. The aim is to provide affordable access to commonly prescribed generic medications, he said.

"At $5 a month, you know what you're going to pay for your medications. In most places, that's less than a mocha or a cup of coffee. This is the starting list, and we're excited about the coverage that it provides," he said in an interview.

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https://www.healthdatamanagement.com/articles/acos-real-time-data-helps-providers-give-targeted-care?id=131983

ACO’s real-time data helps providers give targeted care

Pathways Health Partners’ efforts are reducing readmission rates, offering insights into discharge data and accelerating treatment.

Jan 03 2023


Ricardo Matos

CIO, Pathways Health Partners

Pathways Health Partners, an Accountable Care Organization based in the Central Florida region, is helping healthcare providers expand access to value-based care.

The organization currently works with more than 280 providers across multiple clinical specialties. Pathways supports its providers by enabling more immediate access to patient records, connected care platforms and new technological advancements.

In its work with providers, the ACO recognized the growing need for real-time notifications and access to patient information to advance value-based care goals. Lack of timely patient information sharing, regardless of where care is delivered, is a widely recognized gap in the healthcare ecosystem. It was also a key impetus for e-notification requirements within the CMS Interoperability and Patient Access Rule.

To expand the ACO’s data receipt and sharing capabilities for providers, it pursued three strategies – connecting to a national data exchange, providing real-time access to encounter notifications and discharge documents, and enabling mobile device push notifications. A standards-based notifications system was used to support these initiatives, resulting in further improvements in patient outcomes for Pathways providers.

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https://www.healthcareitnews.com/news/csri-ehealth-exchange-partner-tefca

CSRI, eHealth Exchange partner up for TEFCA

The collaboration will see five of the biggest health data exchanges in the U.S. working with the planned Qualified Health Information Network on the interoperability framework.

By Mike Miliard

January 25, 2023 11:10 AM

eHealth Exchange this week announced that it will be partnering with the Consortium for State and Regional Interoperability – comprising the largest nonprofit health data networks in the U.S. – in its anticipated role as a Qualified Health Information Network.

WHY IT MATTERS
As one of the nation's oldest and largest health information networks, eHealth Exchange brings 13 years of experience to its planned QHIN status under the Office of the National Coordinator for Health IT's Trusted Exchange Framework and Common Agreement, or TEFCA.

That includes linking 61 regional and state health information exchanges and five federal agencies, enabling exchange across more than two dozen different electronic health record systems. It supports the secure exchange of more than 14 billion EHR transactions annually.

The Consortium for State and Regional Interoperability, meanwhile, also gathers some of the nation's biggest health information, including Contexture, CRISP, CyncHealth, Indiana Health Information Exchange and Manifest MedEx. Together those HIEs and their affiliated services connect more than 80 million records for patients across several states.

Working together on TEFCA will enable a QHIN with a massive nationwide footprint.

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https://www.healthcareittoday.com/2023/01/25/top-healthcare-hazards-for-2023/

Top Healthcare Hazards for 2023

January 25, 2023

Colin Hung

Communication gaps with recalls of home-use medical devices tops the list of healthcare hazards in 2023, according to the latest report from ECRI, the nation’s largest non-profit patient safety organization. Other hazards that made ECRI’s top 10 list of healthcare hazards in 2023 include: failure to manage cybersecurity risks in cloud-based clinical systems, defective single-use medical devices, and inappropriate use of automated dispensing cabinet overrides.

Home healthcare is a growing trend and the experts at ECRI are concerned that patients are not receiving safety notices, warnings, and recalls for the devices they are using. Since devices are sold and distributed to patients through intermediaries (like hospitals, pharmacies, retailers, payers, employers, etc.), device manufacturers do not have direct lines of communications with their end-users. Unlike cars, there is no central database that ties the current owner with a specific vehicle. As a result, patients may not learn of safety issues or recalls until months later.

In addition, the language of the notifications can be confusing. One example, cited by ECRI, was the recall of continuous positive airway pressure (CPAP) devices. The recall was initiated in June 2021 and affected 5.5 million devices. It took months for some patients to become aware of the recall and the notice was unclear whether it was safe for patients to continue using the device or what actions they needed to take.

In a press release, Marcus Schabacker, MD, PhD, president and CEO of ECRI had this to say about the communication gap: “Even if patients do receive notifications, the language may be jargon-heavy and perplexing, and patients may have difficulty determining whether their device is affected or what to do about it. Without clear, understandable information about a product recall, patients cannot accurately assess the health risks and may harm themselves by continuing to use an unsafe device, or by inappropriately stopping use of a device.”

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https://ehrintelligence.com/news/regenstrief-institute-framework-addresses-patient-matching-accuracy

Regenstrief Institute Framework Addresses Patient Matching Accuracy

The eight-pronged framework will work as a ‘measuring stick,’ providing consistent guidelines to assess the accuracy of patient matching algorithms.

By Sarai Rodriguez

January 24, 2023 - Regenstrief Institute researchers recently announced the launch of an eight-point framework that aims to improve patient matching accuracy through algorithm evaluations.

Connecting patent records from disparate sources across medical providers or facilities, known as patient matching, can significantly impact patient care.

Patient health data is often spread across several EHRs from doctors' offices, hospitals, and health systems. Healthcare providers must match those files to get a complete picture of their patient’s health history.

However, patient matching often falls short for many health systems across the United States, posing risks to interoperability, hospital finances, and patient safety. Some studies put the cost of duplicate medical records and mismatched data at $1,950 per patient per inpatient stay.

Additionally, researchers pointed out that one-third of rejected insurance claims are linked to inaccurate patient identification, costing the US healthcare system $6 billion annually.

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https://healthitanalytics.com/news/more-legal-clarification-needed-for-clinical-algorithm-development-use

More Legal Clarification Needed For Clinical Algorithm Development, Use

Researchers argue that without further legal clarity, recent directives from the HHS and FDA around the use and development of clinical algorithms may worsen patient outcomes.

By Shania Kennedy

January 24, 2023 - Researchers explored the intersection of clinical algorithms, anti-discrimination laws, and medical device regulation in a JAMA viewpoint published this month, arguing that recent directives from the US Department of Health and Human Services (HHS) and Food and Drug Administration (FDA) on the fairness, accuracy, and transparency of clinical algorithms may stifle research and worsen patient outcomes.

The authors noted that clinical algorithms include both complex, automated tools, such as sepsis alert systems, and simpler tools for risk calculation, predictions, and clinical scoring. These algorithms have the potential to help reduce implicit biases and medical errors that can occur during clinical decision-making, but they can exacerbate disparities and impact patient safety if insufficiently validated.

Currently, no binding, comprehensive guidelines exist for the development, validation, and remediation of these algorithms, making addressing biases or inaccuracies legally unenforceable and voluntary, the authors stated. The FDA and HHS have recently taken steps toward creating such guidelines, including releasing new guidance for AI-driven clinical decision support tools and a proposed rule to update Section 1557 of the Affordable Care Act (ACA), known as §92.210.

Section 1557 of the Affordable Care Act makes it unlawful for healthcare professionals who receive federal funding to discriminate based on protected traits, such as race and sex. The proposed rule would extend these anti-discrimination requirements to clinical algorithms.

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https://www.healthcareitnews.com/news/hyndman-area-health-center-cuts-it-bill-half-cloud

Hyndman Area Health Center cuts IT bill in half with the cloud

It has experienced a more than 150% increase in patients and has saved hundreds of thousands of dollars over the past few years since it no longer relies on physical servers.

By Bill Siwicki

January 24, 2023 11:12 AM

Hyndman Area Health Center – a holistic Pennsylvania-based health center providing family medicine, dental health, behavioral health and more – transitioned from client-hosted servers to eClinicalWorks cloud-based servers to expand its network capacity and meet a rising data demand.

Since then, it has experienced a more than 150% increase in patients and has saved hundreds of thousands of dollars over the past few years since it no longer relies on physical servers.

Healthcare IT News sat down with Bill Kurtycz, CEO of Hyndman Area Health Center, to discuss cloud technology, cloud EHRs and telehealth, and how the technologies have benefitted the provider organization.

Q. Hyndman Area Health Center delivers, among other things, family medicine, dental health, pediatrics and women's health. Please talk about the problems you faced before telehealth and how telemedicine helped overcome them.

A. Like many healthcare practices, we turned to telehealth during the pandemic. With so much uncertainty, one thing remained consistent – our patients needed care. But we didn't know how we were going to triage new patients, if they were going to come into our facilities, or how we were going to track patients with existing medical conditions.

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https://ehrintelligence.com/news/lack-of-interoperability-exacerbates-staffing-shortages-clinician-burnout

Lack of Interoperability Exacerbates Staffing Shortages, Clinician Burnout

Provider organizations noted poor interoperability as the most common problem they need help addressing, as it worsens clinician burnout and staffing shortages.

By Hannah Nelson

January 23, 2023 - Top healthcare pain points among provider organizations include poor interoperability and long-term solutions to staffing shortages and clinician burnout, according to a KLAS whitepaper.

In September 2022, KLAS hosted its sixth annual Digital Health Investment Symposium (DHIS), bringing together provider organization executives, health IT vendors, investors, and innovators to discuss health IT developments.

To gather insights before the symposium, KLAS asked attendees to complete a pre-summit survey identifying top pain points in healthcare and how confident they feel addressing those challenges.

In the pre-summit survey, respondents from provider organizations noted technology and data siloes as the most common problem they need more help addressing; none feel confident tackling this issue.

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https://healthitsecurity.com/news/hacking-accounted-for-nearly-80-of-healthcare-data-breaches-last-year

Hacking Accounted For Nearly 80% of Healthcare Data Breaches Last Year

In past years, unauthorized disclosures, loss, theft, and improper disposal accounted for more healthcare data breaches than malicious hacking.

By Jill McKeon

January 23, 2023 - Nearly 80 percent of healthcare data breaches reported to the HHS Office for Civil Rights (OCR) in 2022 were attributed to hacking and IT incidents, Fortified Health Security noted in its “2023 Horizon Report,” signifying a 45 percent increase from just five years ago.

What’s more, 70 percent of reported breaches (impacting more than 500 individuals each) affected healthcare providers, with business associates and health plans making up a much smaller portion of the total number of impacted entities. In total, 51.4 million healthcare records were breached in 2022, compared to 49.4 million in 2021.

As previously reported, many of the top ten largest healthcare data breaches reported to HHS in 2022 stemmed from third-party vendors, underscoring the need for better third-party risk management. These trends are likely to continue into 2023 and beyond, Fortified Health Security suggested.

“Healthcare organizations must get granular with cybersecurity precautions if they want to stem the tide of breaches,” the report continued.

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https://www.medpagetoday.com/opinion/second-opinions/102722

Death by 10,000 Clicks: The Electronic Health Record

— Here are a few steps to relieve the burden

by Anthony M. DiGiorgio, DO, MHA, and Praveen V. Mummaneni, MD, MBA January 21, 2023

Electronic health records (EHRs), once promised to revolutionize healthcare, are becoming a burden. We audited the EHR logs at our institution, University of California San Francisco, to examine the work of our neurosurgery residents and get a better understanding of the benefits and burdens. The results shocked us: the on-call residents spent 20 hours opens in a new tab or window logged into the EHR over a single shift.

When we shared these results with the residents, they weren't surprised. They feel that EHR burden every day.

The Promise and Disappointment of EHRs

The EHR has plenty of benefits. Gone are the days of hunting for films in the radiology basement, searching the floors for that missing chart, or deciphering the infamously bad doctor handwriting. For patients who have a usual place of care, having quick access to their past records is valuable.

We considered whether perhaps this busywork had been replaced by more efficient EHR workflows. To see if this was the case, we examined what tasks the residents were doing when they were interacting with certain areas of the EHR. This "active time" (any time they spent moving the mouse or clicking the keyboard while in a patient chart) totaled 9 hours per shift but excluded computer activities outside of patient charts, most notably imaging review. This active time log revealed several inefficiencies, such as a daily average of 45 minutes spent searching for orders, reconciling orders, and navigating order decision support tools. This deep dive showed us that the scut work of old has been replaced with a worse EHR burden.

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https://www.fiercehealthcare.com/health-tech/microsoft-announced-pivot-ai-will-leave-10000-without-jobs

Microsoft to lay off 10,000 employees to cut costs as it doubles down on artificial intelligence

By Annie Burky

Jan 19, 2023 05:00pm

Microsoft announced a jarring pivot this week by firing 10,000 employees and moving resources toward artificial intelligence.

Paige, the only company FDA-approved for a clinical AI application in digital pathology, is one enterprise a touting recent partnership with the tech giant.

AI-powered pathology company Paige announced the partnership last Wednesday, a week before Microsoft CEO Satya Nadella sent an email to employees announcing the layoffs, according to a filing with the U.S. Securities and Exchange Commission. The 47-year-old company is only the latest in a string of tech giants cutting the fat after accelerating hiring during the pandemic to meet to demand for online services and the expansion of cloud computing.

“During the pandemic, there was rapid acceleration. I think we’re going to go through a phase today there’s going to be some amount of normalization of that demand,” Nadella said at the World Economic Forum annual meeting in Davos, Switzerland, yesterday.

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https://www.healthcareitnews.com/news/three-2023-telemedicine-trends-advance-new-normal-healthcare

Three 2023 telemedicine trends that advance the 'new normal' in healthcare

A telehealth and remote patient monitoring expert points to ongoing momentum, market positioning and specialty care as keys moving forward.

By Bill Siwicki

January 23, 2023 11:07 AM

This past year may very well have been the year the "new normal" was sealed for healthcare – one that includes a lot more telehealth, remote monitoring and other virtual care than ever before. Technology has became culturally accepted as an integral part of the patient experience as telemedicine gained popularity.

As healthcare providers look ahead to 2023, being at the forefront of what's next in telehealth and strategically integrating the technology necessary to stay there may be critical to future success.

Trapollo, a Cox Business company that specializes in telemedicine and RPM technologies and services, has many insights into why healthcare provider organizations should prioritize telemedicine offerings and advancements to meet patients where they are and stay ahead of the competition.

We interviewed George Valentine, associate vice president, new growth and development, at Trapollo, to discuss three trends he sees along these lines becoming very important in 2023.

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https://www.healthcareitnews.com/news/whats-ahead-health-it-policy-and-legislation-2023

What's ahead for health IT policy and legislation in 2023 

The government relations team at HIMSS offers some insights on what's next for telehealth, broadband expansion, interoperability rules and more in the year ahead.

By Andrea Fox

January 23, 2023 11:38 AM

With Congress providing telehealth waivers as part of its omnibus spending bill at the close of 2022, delaying the "telehealth cliff" for two years, HIMSS says it's now ready to make the case for permanent reimbursement of virtual care.

Also on its policy agenda for the year ahead: advocating for data standardization, offering input for interoperability rulemaking and engaging with agencies and states to increase telehealth access. We spoke with the HIMSS government relations team for their thoughts on those priorities and more in 2023 and beyond.

Making telehealth's case for cost control

Telehealth has proven to reduce burdens on healthcare providers and improve access and has been a priority for HIMSS for many years, but the Congressional Budget Office has long complained that all of the data has been for non-Medicare patients, explained Tom Leary, senior vice president and head of government relations at HIMSS, parent company of Healthcare IT News.

Budget leaders have asked, "How do you really know what the impact on the Medicare population and the Medicare Trust Fund will be? We now have three years of data on the impact to the Medicare Trust Fund," he said.

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https://www.msn.com/en-gb/health/medical/pictured-doctor-shows-army-of-pointless-forms-burying-nhs-hospitals/ar-AA16B2b2?ocid=sf

Pictured: Doctor shows army of ‘pointless’ forms burying NHS hospitals

Story by Laura Donnelly • 22 January, 2023 

“Pointless” bureaucracy is helping hospitals grind to a halt, a leading doctor has warned.

Dr Gordon Caldwell, who has just retired after 40 years as an NHS hospital consultant, said “horribly inefficient” paperwork around patients moving in and out of wards is fuelling record delays.

The senior doctor took a photograph of all the forms required for one medical admission to an NHS hospital, laid against his 5ft 10in frame.

Dr Caldwell said promises by the NHS to “digitise” the health service had simply seen needless bureaucracy transferred on to poor computer systems that were often incompatible with each other.

The specialist in general medicine and diabetes endocrinology said: “A few years ago there were estimates that nurses were spending around 50 per cent of their time on paperwork;  now I’d say it’s closer to 70 per cent.”

“It’s bureaucratic and it’s very slow and horribly inefficient,” he said.

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Enjoy!

David.

 

Friday, February 03, 2023

MyHR Alert - The New Health Minister Has Drunk The MyHR Kool-Aid.

 In comments made an hour or so ago he indicates that it is planned to update and improve the MyHR system to save and enhance the Medicare System.

The details will be very interesting!

You can read the full report here:

Strengthening Medicare Taskforce Report (13 pages)

https://www.health.gov.au/resources/publications/strengthening-medicare-taskforce-report?language=en

Here is the key paragraph!

Strengthening Medicare Taskforce report

Page 9 

Recommendations:

Modernise My Health Record to significantly increase the health information available to individuals and their health care professionals, including by requiring ‘sharing by default’ for private and public practitioners and services, and make it easier for people and their health care teams to use at the point of care.

Details are clearly to follow!

David.

Gilbert + Tobin Provides Some Legal Perspectives on Digital Health.

These 2 articles appeared recently.

First we had:

At a glance: data protection and management of health data in Australia

Gilbert + Tobin  Andrew HiiJohn Lee Kevin Ko and Susan Jones

Australia January 25 2023

Data protection and management

Definition of ‘health data’

What constitutes ‘health data’? Is there a definition of ‘anonymised’ health data?

Health data includes:

  • information or an opinion about an individual’s health or any health services provided, or to be provided, to the individual;
  • any personal information collected to provide or in providing a ‘health service’ to an individual (including organ donation); and
  • genetic information about an individual that is in a form that could be predictive about the health of an individual (or relative of the individual).

 The concept of ‘providing health services’ is very broad and can capture a range of services that may not be front of mind when thinking about health – for example, information collected by a gym on an individual in connection with a gym class, or Medicare billing information held by an insurance provider or debt collector.

Anonymised health data is not defined, although the Australian Privacy Principles (APP) Guidelines state that ‘anonymity’ means that an individual dealing with an entity cannot be identified. Critically, health data that may be anonymous in the hands of one entity may not be anonymous in the hands of another. The ability of an entity to link a data set with other information is relevant to whether data is truly anonymised.

Data protection law

What legal protection is afforded to health data in your jurisdiction? Is the level of protection greater than that afforded to other personal data?

Given the sensitivity of health information, its collection, use and management are regulated by the Privacy Act 1988 (Cth) (the Privacy Act).

Health data is treated more strictly than personal information under the Privacy Act. Health data is a subset of ‘sensitive information’ and consent is required for its collection.

Generally, an organisation can collect health data from a person if:

  • the person provides their consent (express or implied); and
  • the information is reasonably necessary for the organisation’s activities.

Implied consent arises when consent can be inferred from the circumstances and conduct of the person providing the health information. This is a higher test than that imposed on other personal information. The Australian government is currently undertaking a review of the Privacy Act. As part of this review, the government is considering updating the definition of ‘consent’ to be voluntary, informed, current, specific, and an unambiguous indication through clear action.

APP 11 requires entities to take reasonable steps to protect personal information (including sensitive information, such as health information) it holds from misuse, interference and loss, and from unauthorised access, modification or disclosure. According to the Office of the Australian Information Commissioner (OAIC) APP Guidelines, ‘reasonable steps’ will depend on the circumstances in each particular case and may include governance, culture and training, internal practices, procedures and systems, information and communications technology security, access security, and destruction and de-identification.

In addition, the handling of health information is also subject to certain state-based legislation, which differs from the Privacy Act in some aspects, but the differences are relatively minor.

Anonymised health data

Is anonymised health data subject to specific regulations or guidelines?

APP 2 provides that individuals must have the option of dealing anonymously or by pseudonym with entities subject to the Privacy Act. However, entities are not required to provide these options if the entity is required or authorised by law to deal with identified individuals or if it is impracticable for the entity to deal with individuals who have not identified themselves. There may also be practical consequences for patients who do not wish to identify themselves, as their ongoing healthcare may be difficult for organisations to manage and they are unlikely to be able to claim a Medicare or health fund rebate.

De-identification may be one way to protect the privacy of individuals. De-identification involves removing personal identifiers (such as name, address, date of birth, etc) and removing or altering other information that could identify an individual (such as unique characteristics). However, with the increasing capability of technology and the sophistication of cyber-attacks, it is becoming more and more difficult to de-identify data effectively. The Australian government is currently reviewing the Privacy Act, and considering increasing the relevant threshold from ‘de-identified’ to ‘anonymous’ (for information to no longer be considered ‘personal information’).

Types of de-identified health data include Medicare numbers and healthcare identifiers. Medicare numbers are primarily used by individuals to claim benefits under the Medicare Benefits Scheme. APP 9 restricts the use or disclosure of a patient’s government-related identifier to specific circumstances (eg, it is reasonably necessary to verify the patient’s identity for an organisation’s activities).

Healthcare identifiers are unique 16-digit numbers that identify individual healthcare providers, healthcare provider organisations (such as digital health organisations) and individuals receiving healthcare. Healthcare identifiers help to reduce the potential for mix-ups with health data and are the foundation for government initiatives such as the My Health Record system, in which individuals’ health information can be viewed securely online. They are not health records, but are limited to identifying information such as name, date of birth and sex to uniquely identify patients. The use of healthcare identifiers is regulated by the Healthcare Identifiers Act 2010 (Cth) and Healthcare Identifiers Regulations 2020 (Cth), which provide that healthcare identifiers may only be collected, accessed, used and disclosed for limited purposes (such as providing healthcare, for example, by using it to access the My Health Record of a healthcare recipient). In circumstances where a healthcare identifier is used or disclosed for purposes not permitted by the legislation, criminal and civil penalties may apply.

Lots more here:

https://www.lexology.com/library/detail.aspx?g=ed623baa-5d82-431c-b910-93df1efb76a6

And second we had:

At a glance: intellectual property for digital health in Australia

Gilbert + Tobin

Australia January 25 2023

Intellectual property

Patentability and inventorship

What are the most noteworthy rules and considerations relating to the patentability and inventorship of digital health-related inventions?

Patentees of digital health-related inventions, which often require computer implementation in one form or another, need to navigate the patentability requirement in Australia. While abstract ideas and computer-implemented inventions are not regarded as patentable subject matter in Australia, patents directed to other aspects of digital health-related inventions such as hardware, telemetry and diagnostic tools may be patent-eligible.

Recently, the Full Federal Court of Australia found that an artificial intelligence system could not be named as an inventor on a patent application (Commissioner of Patents v Thaler [2022] FCAFC 62). The High Court of Australia (Australia’s apex court) declined to hear an appeal of this decision (Thaler v Commissioner of Patents [2022] HCATrans 199).

Patent prosecution

What is the patent application and registration procedure for digital health technologies in your jurisdiction?

The Australian patent system provides the same application process across all technologies, including digital health. There are no specific provisions for digital health technologies. IP Australia (incorporating the Australian Patent Office) is responsible for pre-grant examinations, pre-grant oppositions, re-examinations and amendments to patents and patent applications. As in other jurisdictions, the process of filing to grant can take more than 18 months.

Other IP rights

Are any other IP rights relevant in the context of digital health offerings? How are these rights secured?

Registrable IP rights are available in the form of design rights that safeguard the visual appearance of new and distinctive products, such as wearable devices that incorporate digital health offerings. Design rights are secured through an application process administered by IP Australia and last for five years initially (renewable for another five years).

Additionally, unregistrable forms of IP including copyright, know-how, trade secrets and confidential information may arise in the context of digital health technologies and offerings. Contractual measures (such as non-disclosure agreements) may help to protect the know-how, trade secrets and confidential information, such as secret algorithms in a digital health app, often in conjunction with physical and technological security measures. Copyright arises automatically in some subject matter likely to be integral to digital health offerings, such as in computer code in a digital health app.

More here:

https://www.lexology.com/library/detail.aspx?g=d962e883-acdd-4d0a-9ed2-12796cdd061f

As I browsed through all this I was reminded just how little I knew about Digital Health law and just how wide the topic was. If you are in a similar situation this may be a good place to start!

David.