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Connected care, upskilled workers, tax reform, a Southwest Airlines approach, private equity and the Affordable Care Act all will impact healthcare organizations in 2019, a new PwC report says.

The private sector and government have accomplished a lot and the next phase is critical to the best use of APIs.

The health system saw an opportunity to leverage Information Technology Infrastructure Library best practices and key concepts to improve its remote care.

Northland District Health Board (DHB), which is based in Whangarei and covering the northernmost part of the North Island in New Zealand, has launched a web-based interactive version of the Health Needs Assessment (HNA). DHBs must produce an HNA report every 5–7 years as a way of monitoring the health and wellbeing of the population, as well as their need for health services. The reports are typically published as lengthy paper-based or PDF documents. Former Northland DHB clinician Juliet Rumball-Smith was instrumental in driving the development of an online HNA, which is intended to make the data easier to access and understand by anyone. Research associate Edith Bennett and data scientist Shameer Sathar at Northland DHB’s Health Intelligence Hub built the tool in-house using open-source software such as Python and Django. “There’s a lot of data already published, but it’s quite hard to access or understand, so we thought why not create an application where people can access information themselves and with interpretation already there,” Bennett says. “We can also update it as data becomes available, such as the Census 2018 data which will be published soon.” A survey completed with stakeholders before the new tool was published found that 86 per cent of respondents said the web-based format improved their ability to access the data. Sathar says future plans include making the tool more mobile compatible. “We’re also hoping to use it beyond the HNA by having forecasting and projections data available,” says Bennett. “Our real aim is to get a one-stop-shop for people to go to look for population health data specific to Northland.”   A version of this article first appeared on eHealthnews.nz.  

Amalgamating multiple services into one to provide a single overview of a patient is no easy feat – it requires the consolidation of multiple business process managements and the creation of a unified customer service platform, amongst other things. One organisation that recently progressed in its unification journey is Uniting Vic.Tas. With the need to combine 24 Uniting Care agencies across Tasmania and Victoria since its creation in October 2016, the organisation decided to create a “single organisation” with one customer service platform to better its service. Uniting Vic.Tas’ agencies previously had and ran their own customer service processes each, without any customer relationship management (CRM) solutions in place. But following changes to aged care, employment services and the National Disability Insurance Scheme, it saw the need to engage in a new service model to improve its servicing and have all its data housed under one system. As such, the company turned to SugarCRM’s interface platform combined with its partner, Loaded Technologies’ CRM solution, to create a “single source of truth” and deliver a “consistent approach to customer service”. “Given there was no CRM solution in place for any of the 24 agencies, it was difficult to provide consistent customer service to our clients. The merge of the different agencies highlighted how each had a different way of reporting and collecting client information,” Uniting Vic.Tas Quality and Program Performance General Manager Clare Jennings told HITNA. “As a result, it was crucial for us to streamline those different data sources if we wanted to deliver the best outcomes for our customers.” The solution streamlines business process management for Uniting Vic.Tas by bringing together data on its customers’ initial engagement, through the sales process and into the most appropriate type of care for that customer. “The community sector is constantly pressured to adapt its model of care to stay relevant in a competitive fast changing environment. In light of all the changes being made to consumer-directed care, aged care, employment services and the National Disability Insurance Scheme, we realised we needed to come up with a new service model,” Jennings said. “We came to market looking for a tool that would allow us to future-proof the work we do for our customers and their community.” [Read more: Aged care virtual clinic named Australia’s business of the year | How technology can support better aged care] Jennings said the move has helped the organisation better understand its customers’ journeys. “Partnering with SugarCRM provided Uniting Vic.Tas the solution support that was necessary to deliver on a better customer journey that we had mapped out prior to going to tender for a CRM solution. As a result of the new CRM solution, we now have the visibility to better learn about our customer journey and improve our processes.” According to Jennings, analysing data plays a crucial role in the organisation's future as it allows the organisation to better assess customer needs, which can then be used to inform future services that it delivers. “We plan to continue to streamline the systems and data we collect and use, which will optimise the use of SugarCRM. As a new entity, we have an ambitious technological building plan that will allow us to enhance our operational efficiencies, including developing a single view of our customers so we can focus on servicing them better,” she added.

Minister for Health Gan Kim Yong delivered a ministerial statement on the Committee of Inquiry (COI) report on the SingHealth cyberattack in the Singapore Parliament on January 15 2019. In the statement, he said that the Ministry of Health (MOH) has appointed a Cybersecurity Advisory Committee to conduct a horizontal review of the cybersecurity governance structures and processes across the public healthcare clusters and Integrated Health Information Systems (IHiS), the IT agency for the Ministry. He also outlined four key responses to the COI report’s recommendations. The first is enhancing governance and organisational structures as there is a “need for clearer cybersecurity risk ownership and accountability between IHiS and the public healthcare clusters, underpinned by a strong relationship to avoid fragmenting the Ministry’s healthcare IT strategy.” At MOH, the Chief Information Security Officer (CISO) is currently also the Director of Cyber Security Governance at IHiS but these roles will be separated. The MOH CISO will be supported by a dedicated office in MOH and report to the Permanent Secretary. The MOH CISO office will be the cybersecurity sector lead for the healthcare sector. It will coordinate efforts to protect Critical Information Infrastructure in the healthcare sector, and ensure that the sector fulfils its regulatory obligations under the Cybersecurity Act.  For its part, IHiS will have its own separate Director of Cyber Security Governance. At the clusters, the cluster Group CIO office will now be made fully accountable to the respective cluster management and Boards. The GCIO office will be adequately resourced to carry out its role. The position of the Cluster Information Security Officer will be elevated to report directly to cluster management, and be accountable to the IT and Risk Management Committees of the cluster Boards. Secondly, a cybersecurity model with multiple lines of defence will be put in place. A more robust ‘Three Lines of Defence’ structure within the public healthcare: The first line comprises units and personnel who develop, deliver and operate the IT systems. This is the Delivery Group. MOH will strengthen the IT delivery group to better integrate cybersecurity into IT delivery initiatives, improve the management of network security, and increase emphasis on security architecture and monitoring.    The second line of defence comprises units and personnel who have the specific responsibility to oversee security strategy, risk management and compliance. MOH will strengthen and elevate this second line of defence by establishing a dedicated Cyber Defence Group in IHiS headed by a senior leader at or equivalent to the Deputy Chief Executive level. The strengthened group will have independent oversight of cybersecurity implementation, compliance and risk management, and will oversee incident reporting and management. This will ensure that cybersecurity is managed at the senior management level, and an appropriate balance is struck between service delivery and cybersecurity considerations.   The third line of defence comprises checks and assurances independent of IHiS and our healthcare clusters, and independent of the first two lines of defence. MOH Holdings Group Internal Audit will continue to play this role. MOH also intends to commission and tap on independent third parties where appropriate. The third aspect would be improving the cybersecurity awareness and capacity of staff. Starting this year, IHiS will engage specialist providers to conduct realistic hands-on “Cyber Range” simulation training to raise the competence of their security incident response personnel. IHiS also intends to learn from GovTech’s bug bounty and vulnerability disclosure programmes and start similar efforts. Lastly, a tiered model of Internet access will be considered. In its report, the COI has recommended that an internet access strategy which minimises exposure to external threats should be implemented. Following the cyberattack, temporary Internet Surfing Separation (ISS) was implemented across Singapore’s public healthcare sector. However, the implementation of the ISS has posed several challenges in the provision of patient care in some areas such as emergency care, decision-support for prescriptions and treatments, access to patient education resources, and booking of clinical appointments. ISS also caused delays to frontline patient management and backend administrative tasks. Research and education initiatives in the public healthcare institutions have also been impacted by ISS. The current model of ISS is still workable but there needs to be longer-term solutions that are more efficient and sustainable. One such solution is the “virtual browser”, which allows access to the Internet through strictly controlled and monitored client servers. The client server acts like a decontamination room in which a file is opened and only an image/copy of the file is taken and sent to the recipient. In this manner, any malicious material or hidden content is ‘left behind’ in the decontamination room, greatly reducing cybersecurity risks. This “virtual browser” pilot will begin in the first quarter in 2019 at the National University Health System. “Virtual browsers” will be deployed in selected job functions at selected departments and clinics. Some of the job roles participating in the pilot include frontline pharmacists, and emergency department clinicians. The conduct and evaluation of the pilot is expected to take about 6 months and MOH will closely with the Cybersecurity Agency of Singapore (CSA) to assess the cybersecurity adequacy of the solution. The effectiveness of the Virtual Brower will also be assessed. Mandatory contributions to the National Electronic Health Record (NEHR) system will continue to be deferred as it is undergoing a series of cybersecurity assessments conducted by the CSA, GovTech, and independent firm PwC. The NEHR will also be subject to further testing and reviews, including exercises to test its defences against targeted attacks, as well as business continuity and disaster recovery plans.

Hospital, startup say they will integrate tools to improve continuity of care for pediatric patients.

Charlotte Yeh discusses the assets of age and which technologies could help address isolation and loneliness.

PerfectServe plans to integrate Telmediq’s technology into its cloud-based care team collaboration platform.  

The health system takes a practical approach, building analytics dashboards for nurses to enable proactive quality improvement.