Interoperability

Dr. Manish Kohli, HIMSS Enterprise Board Chair, discusses physician burn-out and delivering insights for better clinical decision making, adding that success will come when the technology becomes invisible while patients are in front of doctors and nurses.

New Zealand’s Northern Region simulated a major cyberattack on its health system, saying it is a case of “when, not if” an attack will eventually occur. healthAlliance systems operations manager Simon Long presented at the HiNZ Conference 2018 in Wellington on 23 November on the mock incident, called ‘hot chilli’, which was run by the shared services agency. healthAlliance is one of the most significant shared services organisations for the health sector in New Zealand and jointly owned by the four Northern Region district health boards (DHBs) : Northland, Waitemata, Auckland and Counties Manukau Health. Long said low-scale cyberattacks on the health system happen on a daily basis and the mock incident escalated the scenario into a major attack that affected a number of systems. “The objective was to create, test and improve a regional view of business continuity and the recovery capability,” he told attendees. The exercise involved the four northern DHBs – Waitemata, Auckland, Northland and Counties Manukau – and was designed to be as close to real life as possible, so staff were not forewarned. Around 27,000 people work across the DHBs and healthAlliance. The mock attack involved the email systems being unavailable due to hacking, no wi-fi access on the sites and the data integrity of the clinical systems being untrustworthy, meaning National Health Index numbers were not validated. Webinar: The Future of Medicine: Protecting Privacy Without Impacting Quality of Care The simulation started at 9am and finished around 4pm followed by a debrief and “it was a really interesting day for everybody involved,” said Long. Key learnings were that one can never over-communicate in a crisis situation and the huge value of practice to get better and become more efficient. Long said other organisations had since asked healthAlliance for help in this area and the agency is happy to share its learnings. Ministry of Health chief security adviser Nick Baty presented with Long on his involvement with ‘hot chilli’ and how the experience has fed into the development of a health sector cybersecurity event response plan. In the article “Ethical hacking: What to look for in a pen tester”, author Jessica Davis notes that simulated attacks on a healthcare organisation can help infosec leaders assess their security posture, but not all pen testers are created equal and not every provider is ready to be tested. Pen testing is the practice of simulated cyberattacks on an organisation’s network or a specific function, such as IoT devices or web apps. The goal is to identify any system flaws or weaknesses and just how likely it is that a hacker can exploit these vulnerabilities. Lee Kim, director of privacy and security for HIMSS North America, said that a pen tester should have “real world experience and experience in business environments like [healthcare].” A version of this article first appeared on eHealthNews.nz.

Key European eHealth interoperability experts gathered in Brussels, Belgium, last week to discuss a multi-stakeholder initiative that could allow a one-time interoperability testing of eHealth products with mutual recognition across the EU and beyond. New usages, new technologies, an ageing population and many other factors have contributed to a change in healthcare, leading to more connectivity between systems and an increasing need for interoperability. Organised by the EURO-CAS project partners under the Horizon 2020 European research and innovation programme, including, among others, Integrating the Healthcare Enterprise Europe (IHE Europe), Agence eSanté Luxembourg, the European Institute for Biomedical Imaging Research (EIBIR) and Personal Connected Health Alliance (PCHAlliance), attendees looked at the potential use and scale of introducing a Conformity Assessment Scheme for Europe (CASforEU) based on existing well-used norms and standards to overcome interoperability challenges in the healthcare sector. Webinar: Interoperability Sets the Foundation for Care Coordination Dr Ceri Thomson, Head of Policy Sector, eHealth, Well-Being and Ageing at DG Connect, European Commission, stressed the importance of breaking down data silos and estimated that CASforEU could contribute to the key pillars for the transformation of digital health and care.  There are currently several examples of best practice of cross-border health information exchanges in the field of ePrescriptions and patient summaries that could be extended to other use cases, such as laboratory tests, images, discharge letters – but these are all subject to fundamental underpinning infrastructures being in place, Dr Thomson explained. CASforEU governance. Source: EURO-CAS project “Workshops in several Members States confirmed the need for pragmatic interoperability testing, and CASforEU as a solution," said Karima Bourquard, IHE-Europe Director of Interoperability. Assessing conformance to a common set of standards is critical for the future. A scheme like CASforEU could avoid costly and time-consuming need for re-testing across different countries and regions, it was argued. “The EURO-CAS Organization will drive CASforEU and be the place where procurers, vendors, users and all interested parties from all Europe can meet to ensure optimal applicability," added Samuel Danhardt, Interoperability Expert at Agence eSanté Luxembourg. For more harmonisation, CASforEU will be aligned with other existing international schemes, such as IHE-CAS and PCHAlliance’s Continua Certification, relying on ISO/IEC 17025 accredited test laboratories for EU-wide recognition. As discussed at the meeting, when put in practice, healthcare providers could procure CASforEU products or request testing before buying to ensure interoperability, and vendors would only need to do the CASforEU test once to access the Digital Single Market. Anett Molnar is a Senior Manager, Public Policy and Engagement, for HIMSS EMEA.

From innovations and emerging technology to the promise of regulatory relief for hospitals, healthcare has plenty to be grateful for this week and year round.

Cybersecurity is still the big one. But interoperability and telehealth are not far behind for leading organizations' technology goals.

The device maker is betting the company's AI-powered security capabilities will help its enterprise customers, in healthcare and elseware, safeguard their connected devices.

Advice for hospitals: Making inroads on blockchain now, with smaller projects that don't involve patient data, can help prepare them for larger opportunities ahead.

Hospitals and health systems using IT from CommonWell member companies will be able to bilaterally exchange patient data within their EHR workflows.

Dunedin, the second largest city in the South Island of New Zealand and the principal city of the Otago region, is currently making plans for a new digital hospital. The Southern District Health Board’s (DHB) Executive Director People, Culture & Technology, Mike Collins said that the new hospital will be largely paperless and will leverage technology to save time for both staff and patients. Collins is responsible for the technology infrastructure for the new hospital, which will be built on the former Cadbury factory site, and says the focus is currently on the ambulatory care block. “We are trying to implement new technologies and solutions well before the hospital opens. From a change management perspective, I want staff to be comfortable working in that digital environment before the doors open,” he added. His team is running workshops with clinicians and the community and taking a persona-based approach to designing the technology needed to enable better experiences for patients and staff. A key question asked when looking at patient journeys is whether the person really needs to go to hospital or whether they can be cared for closer to home. Webinar: How Chief Digital Officers Can Boost Digital Transformation This planning is not based solely around the DHB, but around the southern health system as a whole, and incorporates the region’s new Primary and Community Care Strategy. Dr John Adams, the new Chair of the Clinical Leadership Group – the senior clinical staff guiding the clinical direction of the New Dunedin Hospital, also emphasised the importance of an integrated approach to healthcare in the Southern region in an interview: “It’s certainly clear to me that this is not just about building a physical hospital. It’s about building on the moves that have already been made around how the hospital works, and how it relates with primary care and the whole plan of health services in the region and the South Island. The New Dunedin Hospital is going to be a really important cog in the whole of the health services in the South Island. Part of the planning will be about how the clinicians continue to develop those exciting new ways of collaborative functioning, both internally and externally.” The region has developed a digital strategy and is working with the Ministry of Health to identify key strategic goals, such as the implementation of interoperability standards. The strategy plans for the next five to six years and is in line with the South Island Alliance’s regional strategy and the Ministry’s Digital Health Strategy, which is still in draft form. A version of this article first appeared on eHealthNews.nz.

Myongji Hospital, which was established in 1987 in South Korea, has recently signed an agreement with BICube, an IT company based in Korea to co-develop a blockchain-based medical information exchange system. According to the official press release by the hospital, the main purpose of the agreement is to “build a hybrid cloud that combines public and private clouds, and to secure the safety of online medical information exchange system by combining blockchain technology in the process of exchanging medical data through the cloud.” Although blockchain technologies are commonly associated with the virtual currency-based technologies, the hospital said that this project will use medical data and store new data, as well as prevent the data from being tampered. The two parties plan to use to use a virtual private network (VPN) solution to build a security system which includes features such as physical authentication and anti-piracy, anti-tampering, data protection through device authentication, remote verification, and signature codes. Webinar: IEEE: Bringing Together Blockchain, Healthcare and Emerging Technology With the patient’s agreement to release their medical information, the hospital will also provide its data exchange service through the inter-hospital blockchain to other hospitals online. During the information exchange process, the hybrid cloud plays the role of data relay, communicating between the patient and the hospital, and takes charge of various payments but does not store any medical information. Both parties plan to commercialise the blockchain-based service by 2019. Myongji Hospital Director Kim Hyung-soo said, “When a blockchain-based medical information exchange system is commercialised, it can prevent unnecessary administrative procedures as well as ensuring safety.” Earlier in June this year, Myongji Hospital became the first hospital in South Korea to join the Mayo Clinic Care Network. Launched in 2011, the Mayo Clinic Care Network consists of more than 40 member organisations in the U.S., China, Mexico, Philippines, Saudi Arabia, Singapore and the United Arab Emirates.