Tuesday, October 06, 2015

The Office Of The Information Commissioner Updates On Health Information Policy And Seeks Comments.

These two commentaries appeared last week. First we have:

Draft health privacy resources released for consultation

Australia October 1 2015
The Office of the Australian Information Commissioner (OAIC) has released for consultation a series of draft health privacy resources for health service providers and consumers (Resources).  The Resources will replace the OAIC’s existing health privacy guidance materials, which were released prior to the 2014 reforms to thePrivacy Act 1988 (Cth).
The Resources will supplement the OAIC's Australian Privacy Principle guidelines, providing more detailed guidance on the APPs in the health and research context.
The Resources comprise of 11 business resources for health service providers and 2 fact sheets for consumers.  They cover a number of topics relevant to the handling of health information by health service providers as follows:
  1. key concepts, such as the meaning of 'health service provider' and 'health information';
  2. collection, such as consent requirements (and exemptions) and how health information should be collected;
  3. use and disclosure, such as examples of directly related secondary purposes for the use and disclosure of health information;
  4. access and correction, such as examples of excess access charges and when access can be refused;
  5. business closure or change of circumstances, such as consent and notice requirements when a health service provider is sold or merged with another; and
  6. when permitted health situations exist for the collection, use or disclosure of personal information, with particular guidance on the following permitted health situations:
    a) management, funding or monitoring of a health service;
    b) research;
    c) serious threat to the life, health or safety of genetic relatives (in relation to genetic information); and
    d) impaired capacity.
The OAIC acknowledges that health service providers' privacy obligations extend beyond the APPs and provides some limited guidance in the Resources as to the interaction between these obligations.  For example, the Resources point out when additional obligations may apply to the private sector under health privacy laws in NSW, Victoria and the ACT. Although much of the interaction is left to the health service provider to investigate further, this guidance is welcomed in an area involving a complex web of legislation.
More here:
Second we have this here:

Health privacy in Australia – new OAIC guidance will help health providers navigate the legal landscape

Australia October 1 2015
Understandably most people are sensitive about protecting their personal health information. For this reason, Australia’s privacy laws give heath information a higher level of protection than other types of personal data.
However, the myriad of privacy laws that apply to health information make it challenging for health providers to know and comply with their obligations.  
This week’s release of new health privacy guidance by the Australian Privacy Commissioner is a welcome move, as is the recent guidance issued by the Australian Medical Association on taking clinical images with personal devices.
‘Health information’ is defined in the Privacy Act 1988 (Cth) to mean:
  • information or an opinion about an individual’s health or disability, an individual’s expressed wishes about future health services provided to them, or a health service provided or to be provided to that individual
  • other personal information collected to provide or in providing a health service, or in connection with organ donation
  • genetic information about an individual in a form that could be predictive of their health.
Examples include medical and dental records, notes of symptoms or diagnosis and treatment provided, records about an individual held by a fitness club or gym, and photos taken of a patient’s injury or symptom.
This is particularly so for health service providers operating in multiple jurisdictions across Australia.
The Privacy Act protects health information and imposes obligations on all private sector ‘health service providers’. If you provide a health service (even if that’s not your primary activity) and hold health information, you will be a ‘health service provider’.
The Personally Controlled Electronic Health Records Act 2012 (Cth) regulates the collection, use and disclosure of health information included in an individual’s e-health record, and the Healthcare Identifiers Act 2010 (Cth) regulates the use and disclosure of health care identifiers used in the e-health record system.
State and Territory government health departments (and other public health networks, districts and services) must comply with their local privacy legislation when handling health information, as well as other types of personal information[1].
Some States even have their own legislation that private sector providers must also comply with[2]. Confusingly, laws vary between States and Territories and there is also significant overlap between the Federal and State/Territory laws.
More here:
Here is the key link:
and here are the papers to be reviewed:

List of guidance

Health service provider business resources

Health service consumer fact sheets

The consultation period ends October 20, 2015 so time to browse and see if you think the OAIC has made things clear. Remember this is not about changing the laws - it is about making sure the recently revised law is well explained.
Very useful as an educational and awareness raising activity.

Monday, October 05, 2015

Weekly Australian Health IT Links – 5th October, 2015.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

Really a very quiet week - with all sorts of things going on in the background - apparently including all sorts of secret meetings regarding the ACeH. It really is a travesty just how un-transparent the present governance on e-Health it in Australia.

Thousands of medical devices are vulnerable to hacking, security researchers say

The security flaws put patients' health at risk
Next time you go for an MRI scan, remember that the doctor might not be the only one who sees your results.
Thousands of medical devices, including MRI scanners, x-ray machines and drug infusion pumps, are vulnerable to hacking, creating significant health risks for patients, security researchers said this week.
The risks arise partly because medical equipment is increasingly connected to the Internet so that data can be fed into electronic patient records systems, said researcher Scott Erven [cq], who presented his findings with fellow researcher Mark Collao [cq] at the DerbyCon security conference.
Besides the privacy concerns, there are safety implications if hackers can alter people's medical records and treatment plans, Erven said.
"As these devices start to become connected, not only can your data gets stolen but there are potential adverse safety issues," he said.
The researchers located medical devices by searching for terms like "radiology" and "podiatry" in Shodan, a search engine for finding Internet-connected devices.

Warning over 'Uberisation' of medicine

30 September, 2015 Tessa Hoffman 
A new service offering pay-by-the-minute GP telephone consults has been branded ‘Uber for medicine’ by health information experts.
Teleconsult, launched a week ago, allows patients to book phone consultations with GPs and other specialists through an online booking system.
Doctors who are signed up to the scheme set their own minute-by-minute fees, paying the company 25% a call, plus a 25 cent-per-minute charge to use the system.
There is no Medicare rebate for the service.
However, the system has been dubbed “Uber for medicine” by Professor Enrico Coiera, professor of health informatics at Macquarie University, in reference to the Uber taxi app that allows drivers without a taxi or hire car license to transport passengers for a fee.

Solution to GP email misery on the horizon

Alice Klein | 1 October, 2015 | 
There may be light at the end of the tunnel for GPs who are fed up with using multiple different secure messaging services to email patient information to other doctors, industry insiders say.
Australian doctors are currently forced to use up to 10 secure messaging services in order to be compatible with each other's email systems — a situation that the chair of the RACGP's e-health committee calls an "outrage".
"It's the same as if Telstra phones did not talk to Optus phones, which did not talk to Vodafone phones," Dr Nathan Pinskier told the audience at the RACGP's annual conference last week.
"The vendors have basically taken a lockdown perspective. They're saying, ‘I have a share of the pie; it's protected'."

Mental health app: MoodMission to deliver cognitive therapy on smartphones

Date October 4, 2015 - 12:15AM

Bianca Hall

Reporter for The Age

It seems like there's an app for everything these days – to help us sleep, to exercise better and even take care of our mental health.
Now, a Monash University project is aiming to bring cognitive behavioural therapy, a commonly used psychological treatment method, to users' smartphones.
David Bakker​, a doctor of psychology student, and his supervisor, Associate Professor Nikki Rickard, have been developing the app for the past 18 months.
The result is MoodMission​, which the researchers say could help people learn and use better ways of coping with low moods and anxious feelings.

Integral Diagnostics seeks to raise $133.7m in share float

Date October 1, 2015 - 4:31PM

Tim Binsted

Integral Diagnostics is seeking $133.7 million in an initial public offer that will see the diagnostic imaging company hit the ASX by the end of the month.
The nation's fourth-biggest provider of X-rays, PET scans and MRIs will offer 48.6 per cent of its shares at $1.91 a piece, as flagged by Street Talk.
In 2014-15, Integral provided almost 1 million patient images and generated $160 million in pro-forma revenue and $25.4 million of earnings before interest and tax from its 44 radiology sites.
"Integral is a leading diagnostics imaging business with a strong competitive position in the locations in which it operates," Integral chairman Helen Kurincic said in a statement.

Health privacy in Australia – new OAIC guidance will help health providers navigate the legal landscape

Australia October 1 2015
Understandably most people are sensitive about protecting their personal health information. For this reason, Australia’s privacy laws give heath information a higher level of protection than other types of personal data.
However, the myriad of privacy laws that apply to health information make it challenging for health providers to know and comply with their obligations.  
This week’s release of new health privacy guidance by the Australian Privacy Commissioner is a welcome move, as is the recent guidance issued by the Australian Medical Association on taking clinical images with personal devices.

Draft health privacy resources released for consultation

Australia October 1 2015
The Office of the Australian Information Commissioner (OAIC) has released for consultation a series of draft health privacy resources for health service providers and consumers (Resources).  The Resources will replace the OAIC’s existing health privacy guidance materials, which were released prior to the 2014 reforms to thePrivacy Act 1988 (Cth).
The Resources will supplement the OAIC's Australian Privacy Principle guidelines, providing more detailed guidance on the APPs in the health and research context.
The Resources comprise of 11 business resources for health service providers and 2 fact sheets for consumers.  They cover a number of topics relevant to the handling of health information by health service providers as follows:

“A slap in the face for pharmacists”

2 October, 2015 Chris Brooker 
The decision to up-schedule all codeine-containing products to S4 is a “slap in the face for pharmacy”, former Guild national president Kos Sclavos believes.
“Pharmacists should rightly be angry about the proposed decision to up schedule codeine based products to prescription only,” Mr Sclavos (pictured) says.
“Their proposed solution won’t fix the problem, will disadvantage millions of Australians, and it will cause further strain on an unsustainable Medicare system”.
“I can guarantee the proposal won’t work”.

Women don't hold back in web posts

30 September 2015
TO INVESTIGATE the impact of recurrent UTIs, researchers in the UK monitored the Cystitis & Overactive Bladder Foundation’s website.
There were 7870 posts to the forum, including contributions from Australians. Many women had a long history of recurrent infections. Common complaints were cystitis following sex and symptoms after the menopause.
The women described a broader range of problems than the classic UTI symptoms. Some attributed their bladder symptoms to causes other than infection, such as a lack of self-esteem.

App aims to help doctors avoid burnout

30 September 2015
IT WOULD be hard to find a doctor who has not experienced periods of high-level stress associated with their job, and statistics would suggest at least 40% of doctors suffer from burnout at some point in their careers.
For a cohort of workaholic perfectionists, Dr Dike Drummond, CEO of the Happy MD, feels that doctors can be reluctant to admit symptoms to themselves, let alone seek help. Using his experience as a coach for physicians, he produced this app for medical professionals to attempt to prevent physical and emotional exhaustion and compassion fatigue.
The app contains a wealth of tools and information. Firstly, there are five videos detailing the definition and basic signs and symptoms of burnout. These are followed by 14 short videos containing ‘burnout power tools’ for stress management, work/life balance and practice efficiency. Finally, there are audio guides for meditation.
  • Sep 30 2015 at 12:00 AM

ResApp on the road to diagnosis by smartphone

ASX-listed telehealth minnow ResApp will release clinical trial results on Wednesday demonstrating its technology can diagnose respiratory illnesses simply by having a patient cough into a smartphone.
The company, which has a market value of just $15 million, will publish the results of a trial testing ResApp's ability to diagnose pneumonia and asthma in almost 200 patients at the Joondalup Medical Campus and Princess Margaret Hospital in Perth.
"There's almost 100 per cent accuracy diagnosing illnesses from coughing into a phone. It's a world first," ResApp vice-president Brian Leedman said. 
ResApp chief executive Tony Keating said the technology had the potential to radically reduce healthcare costs and revolutionise diagnostic screening.

Tabbot Foundation phone abortion service seeks extra help due to overwhelming demand

Date September 30, 2015 - 4:31PM

Amy Corderoy

Health Editor, Sydney Morning Herald

Abortion medications now available by phone

Reproductive Choice Australia say a new telephone service will make abortion drugs more accessible in rural areas.
A new telephone abortion service that allows women to terminate their pregnancy without meeting a doctor or pharmacist face-to-face has been so overwhelmed by prospective patients it cannot meet the demand, its medical director says.
On Monday, Fairfax Media revealed a service called the Tabbot Foundation would prescribe mifepristone and misoprostol (commonly known as RU486) for women who are suitable for a medical abortion and are assessed via telephone consultation.
The service has since received enquiries from four times the number of people it is able to treat, and is now trying to find alternative services for some women. 

Australia Now Offers Abortion-By-Phone To Improve Access In Rural Areas

Sep 28, 2015 05:08 PM By Susan Scutti
The Australian government increased pregnancy termination access by launching a new abortion-by-phone service on Monday. Kenji Nakamura, CC by 2.0
As of Monday, the Australian government increased pregnancy termination access by launching a new abortion-by-phone service, The Sydney Morning Herald reported.
Women seeking an abortion can call the Tabbot Foundation, which will arrange referrals for ultrasound and pathology tests, followed by a phone consultation. If all goes well, the foundation will then mail the abortion drug, mifepristone, along with step-by-step instructions directly to the woman. (In July 2013, Australia’s Minister of Health first approved mifepristone as part of the country’s pharmaceutical benefits program.) According to the Tabbot Foundation’s website, mifepristone is a safe procedure that has already been used by millions of women in more than 50 countries.

WA Health ordered to hire CIO "as soon as possible"

Apr 14 2014 5:22AM

Parliamentary committee decries IT governance.

The WA Parliament’s education and health committee has formally called on the state’s Health department to appoint a permanent chief information officer with haste, as four years of acting executives has undermined its IT capabilities.
Late last week the committee handed down the findings of its inquiry in the Fiona Stanley Hospital build, which concluded that weak and nebulous leadership of the project allowed serious IT concerns to simmer away unnoticed until they resulted in a six month delay to the facility opening its doors, costing the state nearly $120 million.
The department’s IT branch, the Health Information Network, was always underequipped to meet the ambitious technology vision set out for the hospital, the committee found – and the fact that it hasn’t had a permanent CIO for nearly four years hasn’t helped.

Disruptive Health Business GP2U Attracts Series A Funding

Telehealth GP and Specialist consultation business  lands two strategic investors and new CEO
“I suppose you could say we’ve done something radical,” explains GP2U founder Dr James Freeman.  “It used to be that the only way to see a doctor was first to travel to a location of the doctors choosing. With Telehealth we can deliver the care at a time and place that suits both parties in a way that is convenient, efficient and patient centric.”
“As medical students we’re taught 70% or more of diagnosis lies in the history, so talking face to face and making visual observations lives at the heart of good medicine.  Of course you can’t do everything remotely but why insist patients always come to us when we can bring some of Australia’s best doctors to them via video online?” says Dr Freeman.
Last year GP2U provided over 20,000 GP and Specialist appointments and is growing rapidly.
“Our goal is to deliver high quality care to patients, regardless of where they live, using the latest communications technologies.  It’s attracting strong investor interest and we’re happy to announce two major new investors,” Dr Freeman said.

Mobile health potential

Nicole MacKee
Monday, 28 September, 2015
NEW Australian research showing text messaging can be an effective health promotion tool for patients with coronary heart disease has been welcomed by experts, but they say more sophisticated, individualised approaches could yield even greater health benefits. (1)
Professor Sven-Erik Bursell, professor of telehealth at the NHMRC Clinical Trials Centre, Sydney Medical School, said existing mobile technology could be used to personalise health education for patients, to help them sustain lifestyle modification over longer periods and improve clinical outcomes.
“We can go a long way beyond your generic SMS [short message service] and, if we can do this in a meaningful way, then the clinical outcomes improvement and health impacts can increase significantly”, Professor Bursell told MJA InSight.

All the bottom-line action

September 28, 2015
Peter Mac to recover $1.4 million pa with PowerHealth’s Enterprise Billing System
Melbourne’s Peter MacCallum Cancer Centre has replaced their five aging billing systems with PowerHealth Solutions’ enterprise patient billing system and is set to recover an estimated $1.4 million per annum in rejected claims and delayed or uncollected payments. The Peter MacCallum Cancer Centre is Australia’s only public hospital solely dedicated to cancer and one of an elite group of cancer hospitals worldwide with embedded research laboratories, which are uniquely integrated with extensive clinical and cancer experiences research programs. Peter Mac treats more cancer patients each year than any other hospital in Australia and their highly skilled medical, nursing and allied health team is backed by the largest cancer research group in the country. Peter Mac Chief Finance Officer Dennis O’Keeffe said, “PowerHealth Solutions are an exceptional and responsive vendor who go well beyond the call of duty. They have worked hard alongside our project team to deliver the new system on schedule, in time for our move to our new home in Parkville in 2016.”

NBN satellite Sky Muster set for blast off as ground stations prepare for new internet service

September 29, 2015
A network of 10 ground stations around Australia are ready and waiting for the launch of NBN's satellite, Sky Muster, which leaves Earth on Thursday to improve services in rural and remote areas.
The stations, in locations like Geeveston in southern Tasmania, Roma in outback Queensland, Kalgoorlie in Western Australia and Bourke in north-west New South Wales, will form a network that beams the NBN to the most remote parts of Australia.
That includes as far south as Macquarie Island, east to Norfolk Island and far off Australia's west coast to Christmas Island and the Cocos Islands.
NBN's corporate affairs manager in Tasmania, Russell Kelly, said the $2 billion network was the final piece of the NBN puzzle.

Evidence of flowing water on Mars, says NASA

  • Tom Whipple
  • The Times
  • September 29, 2015 10:50AM
The streaks form in the spring on the sun-facing sides of mountain ranges on Mars. Dark smears on the sand, they grow and lengthen as summer progresses. Then the planet’s all too brief balmy period, when temperatures exceed minus 20 Celsius, ends. And with it, they just disappear.
Now scientists believe they have an explanation for these enigmatic lines and, for a planet until recently considered arid, desolate and lifeless, the implications are profound.
Water is flowing on Mars.
More than that though, the annual ebb and flow of these salty streams could lead to the resolution of a particular terrestrial obsession that has itself ebbed and flowed through the centuries: is there life on Mars?
It was back in 2010 when the lines were first spotted, from an orbiter 24,000 kilometres above the surface. Some were big, up to five metres wide. Others were only 25cms across, right at the limits of the satellite’s resolution. The interesting thing, though, was they were not static.

Sunday, October 04, 2015

An New App For The Mental Health Week Being Conducted By The ABC. Looks Pretty Well Thought Out.

This appeared earlier today.

Mental health app: MoodMission to deliver cognitive therapy on smartphones

Date October 4, 2015 - 12:15AM

Bianca Hall

Reporter for The Age

It seems like there's an app for everything these days – to help us sleep, to exercise better and even take care of our mental health.
Now, a Monash University project is aiming to bring cognitive behavioural therapy, a commonly used psychological treatment method, to users' smartphones.
David Bakker​, a doctor of psychology student, and his supervisor, Associate Professor Nikki Rickard, have been developing the app for the past 18 months.
The result is MoodMission​, which the researchers say could help people learn and use better ways of coping with low moods and anxious feelings.
While there are more than 3000 apps targeting mental health on the market, it's been estimated that fewer than 1 per cent of those have been tested for efficacy. Bakker and Rickard hope theirs will be among the first in the world to undergo randomised controlled testing to make sure it is effective.
Cognitive behavioural therapy is designed to help people change unhealthy or destructive habits and behaviours over time.
"MoodMission ​ works in a similar way by recommending useful, brief, easily achieved coping strategies to users to help them deal with negative thoughts, feelings, or behaviours," Bakker said.
The app uses the principles of games to engage its users. If people take part in good coping strategies, they will have "completed missions" and be rewarded by the app in an attempt to motivate them further.
Paradoxically enough, Bakker said, technology can often isolate people from support services. "Technology without social purpose can be correlated to negative mental health outcomes."
More commentary here:
I like the careful and considered scientific approach that is being taken with this app - although I do wonder how you conduct a randomized trial of an app. (Do you have ½ the customers with a non-working app and the other ½ with a working one? - surely the clients would know?)
Worth a look for those who are interested in looking for more considered e-mental health app for their friends or themselves.
The ABC web site for the week of discussion and interaction on Mental Health is found here:
Also worth a look for those interested.

AusHealthIT Poll Number 290 – Results – 4th October, 2015.

Here are the results of the poll.

Are You Expecting Better Progress In E-Health With The New Prime Minister?

For Sure 3% (3)

Maybe 11% (11)

Neutral 5% (5)

Probably Not 30% (29)

Of Course Not 49% (47)

I Have No Idea 1% (1)

Total votes: 96

Pretty clear cut - the new Government is not expected to make much difference.

Good to see such a great number of responses!

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


Saturday, October 03, 2015

Weekly Overseas Health IT Links -3rd October, 2015.

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.

High-profile breaches drive data security spending to $75B

Posted on Sep 25, 2015
By Bernie Monegain, Editor-at-Large
Global spending on information security will reach $75.4 billion in 2015, an increase of 4.7 percent over 2014, according to analyst firm Gartner.
Driving the spending are government initiatives, increased legislation and high-profile data breaches.
Security testing, IT outsourcing, and identity and access management present the biggest growth opportunities for technology providers.

Medjacking: The newest healthcare risk?

Posted on Sep 24, 2015
By Mahmood Sher-Jan, Executive vice president and general manager, RADAR business unit of ID Experts
In early August, Popular Science reported an FDA safety warning against an infusion pump used in hospitals. According to the FDA, a type of pump used to administer IV fluids is vulnerable to cyber-attack, potentially putting patients' lives at risk. The article points out that, in an episode of the TV series Homeland, hackers killed the U.S. vice-president by hacking and disabling his pacemaker.
While that kind of attack is a great plot device for a TV drama (and makes medical device security an entertaining topic for Popular Science), the wider security threats posed by medical devices are both more mundane and potentially more destructive. Healthcare information is being exposed in more places every day, creating new risks for patients, providers, payers, and other organizations. In this article, I'll look at how medical devices fit into the risk profile.

EMR-based model predicts patients' healthcare needs 6 months out

September 24, 2015 | By Susan D. Hall
Using data from HealthInfoNet, Maine's health information exchange (HIE), researchers have created an electronic medical record-based online risk model to predict the healthcare resources patients would need six months out.
Such predictions can help health organizations better plan care, and are vital in the shifting U.S. healthcare payment system, according to an article published in the Journal of Medical Internet Research.
The researchers are touting success with the model after testing it at both the individual patient level and population level. The analysis involved aggregated data from more than 1 million patients about their care from the preceding 12 months.

Report: Healthcare more susceptible to privacy attacks than other industries

September 25, 2015 | By Dan Bowman
The global healthcare industry is much more susceptible to hacking and other privacy attacks, according to a new report.
The report, published by Raytheon | Websense Security Labs, notes that compared to the average industry, healthcare entities are plagued by 340 percent more incidents. What's more, the industry is 400 percent more likely to be impacted by advanced malware attacks and 74 percent more likely to be impacted by phishing schemes, according to the report.
The authors also note that so far in 2015, nearly 84 percent of all "Dropper incidents"--in which malware is deposited via open "backdoor" channels to electronic systems--have occurred in the healthcare industry.

Iodine’s new antidepressant tracking app sets sights on postpartum depression

By: Jonah Comstock | Sep 24, 2015        
Iodine, the crowdsourced drug review startup that launched last year, is continuing to focus on antidepressants. Three weeks ago, the company launched an iOS app called Start to help users document their experience with antidepressants, and today the company announced a partnership with Postpartum Progress, a nonprofit that supports women with postpartum depression.
“Start is our mobile health program designed to help people track their experience with an antidepressant and determine if it’s working for them as fast as possible,” the company wrote in a blog post. “It helps people know what to expect from a medication, and also helps them remember to take it. For those who feel their medication isn’t working – which could be as many as half, judging by medical research – we help them talk to their doctor about options.”

Top Challenges to Analytics in Healthcare? Not Technology

SEP 23, 2015 6:02pm ET
A variety of challenges stand in the way of successfully implementing analytics in healthcare organizations. Not surprisingly, the top issues don’t always involve technology.
This finding became clear in a study conducted by the Healthcare Center of Excellence this summer, which sought to determine what are perceived to be the top challenges facing analytics.
The study reveals the importance of executive leadership skills in bringing about support of analytics and the extent to which findings from analytic efforts are incorporated into how organizations change and adapt. This aspect of leadership, while learnable, needs to happen quickly if organizations want to achieve the desired incomes from their forays into analytics.
Methodology of the Study
During a workshop at Health Data Management’s Healthcare Analytics Symposium, held in Chicago in July, participants were asked what they believe to be the top challenges they face in implementing analytics at their healthcare organization. They each were asked to identify as many as five challenges they face, and then were put into groups to develop three solutions to overcome those challenges.

Program Helps Patients with Undiagnosed Diseases

SEP 24, 2015 7:36am ET
An online patient application portal funded by the National Institutes of Health now is live to help diagnose patients who suffer from conditions that even skilled physicians have been unable to diagnose despite extensive clinical investigation.
Part of the Undiagnosed Diseases Network (UDN), the portal replaces what had previously been a paper and mail application process. Patients accepted into the program are seen by researchers and physicians from an array of medical specialties.
“We have seven clinical sites that are spread across the country and to make it easier for patients we created this online application system,” says Anastasia Wise, program director of the National Human Genome Research Institute’s Division of Genomic Medicine and co-coordinator of UDN. “We want to be able to help improve the level of diagnosis and care for these patients that haven’t been able to receive a diagnosis yet.”

Study: Commercial EHR use increases ED task-shifting, poses safety hazard

September 21, 2015 | By Marla Durben Hirsch
Switching from a homegrown electronic health record system to a commercial one in a hospital's emergency department greatly increased the frequency of task-switching by physicians, which can have a negative impact on patient safety, according to a study published recently in the Annals of Emergency Medicine.
The researchers, from MedStar Health in the District of Columbia, and elsewhere, conducted a quasi-experimental study in an urban tertiary care academic emergency department with 90,000 annual patient visits, observing 14 physicians minute by minute to record their time allocation in five categories: use of a computer, verbal communication, time in patient room, time on paper and other. The study was conducted in three phases: prior to the transition from the homegrown EHR to the commercial one; during the transition; and three to four months after the transition.
Not surprisingly, they found an initial increase in computer-related tasks during the transition, which eventually returned to the baseline.

Docs are paying more for technology than ever before

Posted on Sep 24, 2015
By Erin McCann, Managing Editor
Medical practices across the U.S. are now spending a lot more on technology this year, up nearly 34 percent from four years ago, according to a new MGMA report.
The annual report published by Medical Group Management Association, which represents physician practice groups nationwide, shows that just from last year alone, physician-owned multi-specialty groups reported nearly a 12 percent increase in technology-related operating costs. Overall, those costs tallied to $20,693 per full-time physician in 2014. This uptick, as the report suggests, is due in large part to the federal meaningful use program and its mandate to switch to digital records.
When looking back just four years ago, that number has shot up nearly 34 percent, according to survey results, which were collected from physician multi specialty practices across the U.S. 

Asking the question

Thomas Meek visits a GP surgery in Romford that is trying out AskMyGP; an online access service that is trying to prevent unnecessary appointments; an idea right in line with local ‘vanguard’ work.
Among the many health messages that the different political parties have pushed in the past few years, one that seems to have been consistent across the board is that of patient power.
The likes of Jeremy Hunt, Andy Burnham and Norman Lamb have followed in the footsteps of their predecessors in the 1990s and 2000s in calling for patients to be at the centre of their care, with more control and, crucially, more choice.
One practice trying out a new way of working is Rydal Group Practice, part of the NHS Redbridge Clinical Commissioning Group in east London.

East London exchanges health information

Rebecca McBeth
21 September 2015
Barts Health NHS Trust is exchanging patient information in real time with more than 100 practices across East London via Cerner’s Health Information Exchange.
Barts Health was the first English trust to go live with Cerner’s HIE in late 2013, with GP information available via a button embedded in its Millennium electronic patient record system. Usage has hit up to 1800 views a month.
It is now available at well over 100 GP practices in the East London area, including all 36 in Tower Hamlets and 57 out of 60 in Newham. Another 26 in Waltham Forest have also recently gone live.

Care.data delayed by two years

Thomas Meek
22 September 2015
Final approval for the ‘pathfinder’ stage of the controversial care.data programme to go ahead will not be given until early next year.
This means the patient data collection scheme will be delayed by at least two years after the patient information campaign was first launched in early 2014.
A number of issues need to be addressed by NHS England and final authorisation for patient data to be collected now sits with National Data Guardian for health and care Dame Fiona Caldicott.

Electronic data-sharing errors could compromise patient privacy

September 24, 2015 | By Susan D. Hall
As electronic data-sharing becomes more common in healthcare, the potential grows not just for hacking, but for errors that compromise patient safety and privacy.
For instance, in one case highlighted in a report from Bloomberg, a mother's prescriptions became known to her daughter through an insurance database mixup. The mother had not told her daughter about the prescriptions, and it created a difficult conversation between the two about the mother's health.
In a complaint to the Department of Health and Human Services (HHS), the mother argued that her privacy had been violated. But because the insurance subcontractors did not reveal the mother's prescriptions to the daughter--she figured it out on her own--HHS's Office for Civil Rights found no wrongdoing, according to Bloomberg.
Wed Sep 23, 2015 4:20pm EDT
Related: Health

Telehealth visits may be an option after surgery

By Andrew M. Seaman
(Reuters Health) - People may happily, and safely, forgo in-person doctors' visits after surgery by opting instead for talking with their surgeons by phone or video, suggests a small study of U.S. veterans.
Most patients preferred the virtual visits and the doctors didn't miss any infections that popped up after surgery, the researchers report in JAMA Surgery.
"These kinds of methods are really important in the climate we’re in now," said lead author Dr. Michael Vella, of Vanderbilt University Medical Center in Nashville. "So I think anything you can do to save money, see more patients and improve access to care is really important."
There is interest in so-called telehealth to increase access to healthcare while also decreasing the costs associated with traveling to office visits, Vella and his colleagues write.

Hong Kong leading the way on digital government

The Hong Kong government is on the forefront of digital government, backing its push into apps, IoT, and digital IDs with a modernised legal framework.
By Corinne Reichert | September 24, 2015 -- 05:07 GMT (15:07 AEST) | Topic: Government : Asia
Hong Kong has been staying ahead of the technology curve by working on digitising its departments and agencies since the 1990s, according to former CIO of the Hong Kong government Daniel Lai, with the government now focusing on apps, digital IDs, e-health, city-wide free Wi-Fi, the Internet of Things (IoT), digital open data, and digital inclusion.
Speaking at Telstra's Vantage 2015 conference in Melbourne on Wednesday, Lai, now the interim vice president (administration) at Hong Kong Polytechnic University, said the government's digital strategy involved initially building out infrastructure, then adapting to internet usage, and most recently staying abreast of trends in mobility and cloud computing.
"In the earlier days, in 1998, it very much focused on building and introducing the ICT infrastructure necessary to support a digital city. Then, in the early 2000s, it was a matter of using internet to support government services to deliver public services through internet," he said.

How many health apps actually matter?

Posted on Sep 23, 2015
By Jack McCarthy, Contributing Writer
Apps are all the rage in healthcare and pretty much everywhere else. Despite so much buzz about consumers using mobile healthcare apps, however, the options proving useful are few and far between.
With some 165,000 health-related apps available, in fact, a mere 36 comprise nearly 50 percent of downloads. Not to be confused with 36 percent, that's a total of 36 applications, according to a study by the IMS Institute for Healthcare Informatics that analyzed 26,000 apps. 
Two key data points illustrate how almost all of the apps fall short: Just 10 percent can connect to a device or sensor while a mere 2 percent sync into providers' systems, IMS found, and that functionality could greatly improve both accuracy and convenience of data collection.

BI don’t care if the weather ain’t fine

It feels as if winter has come early this year, but for the NHS it starts officially on 1 December, when trusts start sending their daily situation reports to NHS England. Many trusts will ‘hand crank’ these reports; but some are looking for electronic solutions – and for data that will help them to predict and prepare for likely demand. Daloni Carlisle reports.
Winter is fast approaching and acute trust informatics departments up and down the country will be gearing up to send their daily situation reports to NHS England starting on 1 December.
For many, this will be an onerous task that will involve pulling together a daily return with information about capacity that includes bed occupancy and availability, demand including emergency department attendances and emergency admissions, and any ED closures or diverts.
“Responsibilities around sit reps creates a significant overhead for informatics departments,” says Dr Mark Davies, medical director of MedeAnalytics. Often these rely heavily on manual processes to the point that Davies refers to them as “hand cranked”.

HIEs: building connections one provider at a time

Jeff Rowe
Sep 23, 2015
Between Congressional inquiries into the state of health IT interoperability and ONC’s 10-year plan, there’s certainly been no shortage of discussion of how best to ensure that disparate IT systems might ultimately “talk to” each other.
But meanwhile, Scott Mace, of HealthLeaders Media, recently pointed out, health information exchanges are moving toward essentially the same goal as they expand their capabilities and increasingly connect providers who, not so long ago, were still working in silos.
For example, in Pennsylvania, “the Keystone Health Information Exchange (KeyHIE) connects 20 hospitals, 239 physician practices, and 30 home health locations primarily located in 31 counties in central, northern, and northeastern Pennsylvania, as well as 69 long-term care facilities spread throughout the state.”

What Retail Telemedicine Means for Health Care Providers

by Jane Sarasohn-Kahn Wednesday, September 23, 2015
Direct-to-consumer retail health options are fast-growing in the U.S. health ecosystem. CVS Health brought three telemedicine vendors to its pharmacy brick-and-mortar stores. CVS also acquired Target's pharmacies, expanding its retail health footprint. Rite Aid has added HealthSpot kiosks to its pharmacies, while Walgreens expanded its relationship with MDLive. And, Cox Cable acquired Trapollo to bring remote health monitoring into subscribers' homes.
Coupled with the growing supply side of telemedicine vendors, the latest National Business Group on Health survey found that most large employers plan to expand the telemedicine services they offer. Three in four large employers (74%) plan to offer telemedicine to workers in 2016, a dramatic increase from 48% in 2015. This trend is part of business' continued challenge of bending corporate cost curves for health and designing the health benefit to deliver lower-cost, convenient on-ramps to health care for employees looking for lower-cost services paid out by their own high-deductible health plans.

In Telemedicine Recommendations, ACP Advises Caution

Alexandra Wilson Pecci, for HealthLeaders Media , September 23, 2015

The American College of Physicians outlines when and how telemedicine can be used appropriately in primary care and what's needed to make it better.

Telemedicine is good, when it's an appropriate use of the technology, but there are still some hurdles to jump along the way to make it as good as it can be.
Those are the main takeaways from the American College of Physicians' position paper outlining its policy recommendations for using telemedicine in primary care settings.

ONC unveils draft 2016 Interoperability Standards Advisory for comment

September 23, 2015 | By Katie Dvorak
A draft 2016 Interoperability Standards Advisory has been released by the Office of the National Coordinator for Health IT and reflects updates based on input obtained from the public as well as the Health IT Standards Committee.
The new draft advisory is open for public comment, and will be altered during the comment period. A final advisory will be published at the end of the year, according to ONC.
Discussion on the scope of the 2015 advisory was wide-ranging and has little consistency, FierceEMR previously reported.

Facing an EHR update? Here are 5 steps for success

Written by Phil Stravers, Partner | ICE Technologies, Inc. | September 23, 2015
Updating your community hospital's EHR system (or any technology system, for that matter) requires a solid strategy and a methodical process.
If you just "go at it" with a generic plan, you could spend big and still end up with problems that affect patient care, workflow and revenue.
Don't let your next update grind operations to a halt. Before you execute, print out these five success steps and tape them to your monitor.

'Countless' Patients Harmed By Wrong or Delayed Diagnoses

Evidence is incomplete, but still shows most patients will be impacted by the problem at some point in their lives.

By Steve Sternberg Sept. 22, 2015 | 11:25 a.m. EDT
The Institute of Medicine on Tuesday released a ground-breaking report calling wrong or delayed diagnoses a vast "blind-spot" in U.S. healthcare and blaming them for harming countless patients each year.
The report, called "Improving Diagnosis in Health Care," asserts that diagnostic errors occur daily in every health care setting nationwide, yet they have never been adequately studied. No one knows how many people suffer from misdiagnoses or delays that affect their care.
Despite the sketchy evidence, the authors conclude that "most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences."

Patient engagement tips from the pros

Posted on Sep 22, 2015
By Erin McCann, Managing Editor
Looking to move forward with a patient engagement initiative? Best to talk with the folks who have been ahead of the game for some time.
Geisinger Health System's Chanin Wendling is one of those people. Wendling, the director of Geisinger in Motion in the applied research and clinical informatics division, has been spearheading patient engagement initiatives since late 2010.
We're talking using iPads, text messaging appointment reminders, patient portals and mobile apps for lumbar spine surgeries, all with the common goal of improving care by better connecting with patients.

Final Federal Health IT Strategic Plan Moves Beyond EHRs

SEP 22, 2015 7:54am ET
The Office of the National Coordinator for Health Information Technology on Monday released the final Federal Health IT Strategic Plan for 2015-2020, aimed at modernizing the nation’s health IT infrastructure beyond just electronic health records.
The plan results from collaboration between more than 35 federal offices, laying out the vision, goals, and actions that the government will pursue to achieve “high-quality care, lower costs, healthy population, and engaged individuals” through widespread use of all forms of health IT. Specifically, federal agencies are looking to “expand the ability of individuals to contribute electronic health information that is personally relevant and usable to their care providers so that both can use it effectively in health planning.”

Updated federal HIT strategic plan focuses on person-centered care

September 22, 2015 | By Dan Bowman
An updated version of the Department of Health and Human Services' federal health IT strategic plan will focus on ensuring care is more person-centered, federal officials said on a call Monday.
The plan, developed by the Office of the National Coordinator for Health IT, represents the government's strategy through 2020 for improving the health and wellness of individuals through the use of health IT. It outlines four overarching goals, including:
  1. Advancing person-centered and self-managed care
  2. Transforming healthcare delivery and community health
  3. Improving research and innovation efforts
  4. Enhancing the national health IT infrastructure
National Coordinator for Health IT Karen DeSalvo (pictured) called the plan a "shift" from the government's prior plan, released last December, in which electronic health record adoption by providers was a heavy focus.

ONC releases final Federal Health IT Strategic Plan 2015-2020

Posted on Sep 22, 2015
By Mike Miliard, Editor
Embracing a long-term vision for nationwide health information technology that 'puts the person at the center,' the Office of the National Coordinator for Health IT has finalized its strategy for the next five years.
The document represents an "action plan for federal partners, as they work to expedite high-quality, accurate, secure, and relevant electronic health information for stakeholders across the nation," writes National Coordinator for Health IT Karen DeSalvo on the ONC website.
"The Plan's strategies for achieving this aim focus on making electronic information available so individuals can manage their health, providers can deliver high-quality care to their patients, public health entities and long-term services and supports can improve community health, and scientists and innovators can advance cutting-edge research and solutions."

CRM Aims to Finish the Job EHRs Started

Scott Mace, for HealthLeaders Media , September 22, 2015

A few pioneering healthcare providers have figured that because customer relationship management apps are so good at the people-oriented workflow details necessary for care coordination, the effort to customize CRM for healthcare would be worth it.

The more I look into the status of meaningful use—it's a source of distress—the more I find beleaguered care coordinators using notebooks, Excel spreadsheets, and sticky notes to keep track of risk-stratified populations.
The reasons why they are not using EHRs to do this are varied, but fall into two general categories:
  1. Too many EHRs either require care coordinators to adopt unfamiliar workflows.
  2. EHRs require too much time, effort, training and retraining to provide workflows which are sufficiently tailored to the provider's way of doing things, or to the workflows that make the most sense for care coordinators.

5% of Patients Experience Diagnostic Error, Says IOM

John Commins, for HealthLeaders Media , September 22, 2015

An Institute of Medicine report estimates that most people will experience at least one diagnostic error in their lives and that that the severity of these errors will "worsen as the delivery of healthcare and the diagnostic process continue to increase in complexity."

Diagnostic errors are a factor in 10% of patient deaths, account for as much as 17% of hospital adverse events, and are a leading driver of medical malpractice claims, according to a sweeping report released Tuesday by the Institute of Medicine.
The report, Improving Diagnosis in Health Care, calls diagnostic errors "a blind spot" in healthcare delivery that has been around for decades which persists across all care settings and harms "an unacceptable number of patients."

Need to Address Diagnostic Errors is Urgent, IOM Says

SEP 23, 2015 7:28am ET
Diagnostic errors in healthcare are at epidemic proportions and causing serious safety concerns, yet the problem has received limited attention from the medical community, according to a core finding in an Institute of Medicine report on diagnostic errors released on Tuesday.
“Urgent change is warranted to address this challenge,” states the IOM report. “For decades, diagnostic errors—inaccurate or delayed diagno­ses—have represented a blind spot in the delivery of quality healthcare. Diagnostic errors persist throughout all settings of care and continue to harm an unacceptable number of patients.”
Errors in diagnosis affect one in 20 patients annually, an estimated 12 million Americans, according the report, which concludes that “most people will experience at least one diagnostic error in their lifetime, sometimes with devastating conse­quences.”

Commentary: Six Ways to Ease Healthcare Data Management

SEP 21, 2015 7:51am ET
The healthcare industry is struggling to redefine best practices in data management. To some extent external forces, such as hospital consolidation, government regulation and technology advancement are driving this change. 
Healthcare organizations struggling to better consolidate, organize and manage their structured and unstructured data may want to consider use of an enterprise clinical archive, a standards-based, centralized repository for all hospital data.  Let’s look at the six ways in which an enterprise archive can resolve data management challenges.
Improve Data Quality: An enterprise archive provides fully indexed patient data gathered from multiple disparate diagnostic applications. Consequently, when clinicians want to find specific patient information, powerful search tools make the process swift and straightforward. The archive environment is configured to enforce data quality rules on ingestion that can be maintained over time. And, as it’s built on and adheres to healthcare’s open data standards, the archive will use these standards to maintain data quality, including demographics and content synchronization.

Developing your mHealth Strategy? This Guidance Can Help

SEP 21, 2015 7:42am ET
Providers, insurers and consumers trying to better understand the mobile health app market have a daunting task: There are more than 165,000 mhealth apps. Apple alone has about 91,000, which is more than double what it offered two years ago.
A 63-page report from the IMS Institute for Healthcare Informatics walks industry stakeholders through the availability and use of mHealth apps from the Apple and Google stores. Almost 25 percent of the apps target chronic care management, but in totality half of apps have limited functionality, primarily providing information, according to the report. And, only 2 percent of apps can communicate with a provider information system.
“One in 10 mHealth apps have the capability to connect to a device or sensor, which greatly improves the accuracy and convenience of data collection for mHealth apps,” report authors note. “Of the top mHealth apps, 65 percent connect to social media, underscoring the importance of this feature for consumer engagement.”

Where are we headed, post-HITECH?

Posted on Sep 21, 2015
By Mike Miliard, Editor
The Robert Wood Johnson Foundation surveys the state of a digitizing health system in a new report, taking stock of the meaningful use program's successes and limitations -- and forecasting emerging healthcare trends.
In the study, Health Information Technology in the United States, 2015: Transition to a Post-HITECH World, RWJF (along with researchers from Mathematica, Harvard School of Public Health and University of Michigan, School of Information) looks back on "highlights and milestones of the past eight years" – and tries to assess how well the HITECH stimulus program has positioned the industry for a challenging future.
Meaningful use has been both a boon and for adoption and something of a bother for many of the providers trying to keep pace with its mandates, the report shows.
"The most recently available survey data finds approximately three-quarters of U.S. nonfederal acute care hospitals have at least a basic electronic health
record system, according to RWJF. "While this represents a significant increase from the prior year, many fewer hospitals appear to be ready to meet Stage 2 meaningful use criteria and may be subject to penalties."

RWJF: HITECH Act falls short of overall goals

September 21, 2015 | By Marla Durben Hirsch
The HITECH Act has helped initiate "significant" progress in the use of health IT, but has fallen short of its goal to create an efficient and effective healthcare system with the advanced use of health IT, according to a Robert Wood Johnson Foundation report.
The report, entitled Health Information Technology in the United States, 2015: Transition to a Post-HITECH World, found both successes and disappointments in HITECH and the Meaningful Use program. These include:
  • While HITECH was a key driver to the adoption of electronic health records, only 1,826 hospitals had successfully attested to Stage 2 of the program in 2014, far fewer than the 4,379 that attested previously to Stage 1. That indicates that providers were facing substantial challenges in meeting the more stringent requirements. Physician participation in the Program has declined in the past year.
  • Health information exchanges (HIEs) were operating in most states and could support the sharing of different kinds of data, but were faced with obstacles, such as the ability to hire and retain staff, disagreement on what "HIE" includes, privacy concerns and problems with financial sustainability.

ATA Fall Forum: Experts Discuss How To Overcome Barriers to Telehealth

by Joe Infantino, iHealthBeat Senior Staff Writer Monday, September 21, 2015
WASHINGTON -- Telehealth has the potential to solve some of health care's most persistent problems -- high costs and access to care, in particular -- but concerns about reimbursement, licensure and standards stand in the way of realizing the technology's promise, stakeholders said at the American Telemedicine Association's 2015 Fall Forum last week.
"It's a new solution to old problems, but we can't innovate for the sake of innovation," ATA President Reed Tuckson said. Instead, these technologies "must deliver on quality and improve cost effectiveness so as to sustain access to care that meets the needs of people around the country."
Tuckson was among several speakers at ATA's 2015 Fall Forum in Washington, D.C., last week who highlighted telehealth's potential to improve health care, the barriers limiting adoption and the steps necessary to overcome those hurdles.