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One of Australia's largest juvenile justice departments will soon streamline its health services under a single Electronic Medical Record. Justice Health Victoria is working towards implementing Global Health’s MasterCare Electronic Medical Record (EMR) in the support of clinical workflows across mental health, primary care, and alcohol and other drug services in its centres. Specifically, MasterCare EMR will be used by Justice Health clinicians to handle clients’ medical assessments and management plans, along with the monitoring and measuring of on-going service activity outcomes. MasterCare EMR comprises of an EMR and practice management solution with integration to MasterCare Data Warehouse for data analytics and ReferralNet for the secure exchange of clinical documents with external colleagues. According to a spokesperson for the Department of Justice and Community Safety, Justice Health Victoria had multiple programs in place for its youth justice system, which all needed to be streamlined into one platform. “This will ensure continuity in the healthcare services provided to young people in custody. Electronic medical records within the adult prison system are [and will continue to be] managed by Intrahealth,” the spokesperson told HITNA. The initial deployment will see the Department of Justice and Community Safety business unit roll out the Global Health solution for these three service divisions across Melbourne. This includes Malmsbury, Parkville and other community outlets around Melbourne across the youth justice sector. The Department of Justice and Community Safety spokesperson said the partnership came off the back of the Victorian Government’s $18.72 million investment for additional doctors, nurses and clinical staff to administer medication, as well as for extra allied health services. [Read more: SA Health to overhaul EPAS | Bass Coast Health integrates clinical and administrative system using MasterCare EMR] MasterCare EMR Product Manager Kye Cherian said the agreement will run for a minimum term of three years, with two further extension options. “It’s important to note that our project with Justice Health does not end here. Global Health and Justice Health are committed to continuing the partnership in order to further improve client care and data capture to support the continued improvement of Youth Justice Health services in Victoria,” Cherian said. Bass Coast Health also most recently equipped its healthcare facility with MasterCare EMR. Following rollout, the solution will be used by its clinicians to govern the assessment and management plans of clients, along with the monitoring and measuring of ongoing outcomes.

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The cybersecurity implications of medical devices have come under scrutiny, as the digitisation of healthcare reaches a wider net of professional, personal and public environments. In the bid to consider and plan for an evolving cybersecurity landscape to maintain patient safety, the Therapeutic Goods Administration (TGA) has released a draft regulation guidance on cybersecurity for medical devices, in line with the existing regulatory requirements. The Medical Device Cybersecurity Draft Guidance and Information for Consultation report calls for a clear regulatory environment for connected medical devices and identifies strategies to influence the approaches of those who use medical devices. “Connectivity and digitisation of medical device technologies may help improve or increase device functionality. However, the connection of devices to networks or the internet exposes devices to increased cyber vulnerabilities that can potentially lead to unacceptable risk of harm to patients,” the report identified. “These include denial of service or intended therapy, alteration of personal health data or alteration of device function so that it can cause actual patient harm. “In 2016, the Australian Government released Australia’s Cyber Security Strategy, detailing priority actions to improve Australia’s general cyber security posture, alongside supporting the growth of the local cyber security industry… In line with this, the continued safety, quality and performance of medical devices impacted by cyber-related issues is the responsibility of the TGA.” According to the TGA, operating environments are highly variable and cybersecurity risks are dependent on the knowledge, expertise and approach of the users of medical devices. “A compliant medical device will only be as secure as the most vulnerable aspect of the system it is expected to operate in. Users of medical devices also have share responsibility for providing a cyber- secure environment for these devices to operate in,” the report stated. What is necessary? Key to the implementation of medical devices, according to the report, is the development of a “clear and well documented” risk assessment and business continuity strategy, where the goal is to develop an environment where risk to patients is minimised. It includes an injunction for device manufacturers and users to develop a cybersecurity strategic plan, which includes a cyber-specific risk assessment and response strategies. “The plan should have clearly defined event response procedures that define the responsibilities of each department in the event of an incident, and emphasise the importance of each area being familiar with these procedures,” it said. “The strategy will need to be revised as new types and classes of connected medical devices are added to the healthcare environment.” Cross-functional collaboration is a tool that the report claimed is essential for effective cybersecurity control of medical devices. The TGA said healthcare service providers should aim to facilitate an environment which drives cross functional collaboration between the biomedical, clinical support and IT teams, helping all areas develop a better understanding of the work completed within each team. “The biomedical team should… engage with medical professionals within the healthcare organisation to help broaden their understanding of the operating profile of their devices, the technology under their management, implementation of cyber security controls and the associated risk,” it said. Collaborative procurement is another area for improvement as updating procurement practices to ensure the purchase of appropriately secure devices will create greater demand for improved cybersecurity within medical devices, the report identified. “[One way is to] incentivise procurement teams to work with IT and biomedical teams on the procurement of new medical devices to help ensure that cybersecurity is a measurable factor in procurement.” The report also suggested that organisations develop an inventory and risk profile of the current state of connected medical devices, providing insight to vulnerabilities in the operating environment. This inventory could include information such as the operation and purpose of a medical device, its secondary uses, who the primary users are, expected life-span of the device, support agreements in place and support for critical components. The report also called for more general training for all staff within organisations to raise baseline security awareness and skills. “Many professionals in the health and medical sector have received little training on cybersecurity. [Organisations need to] actively work to create a culture of cyber security awareness, vigilance and reporting, and regularly communicate potential cyber security issues,” it said. Segmenting the corporate network from the biomedical network could also help improve cybersecurity attacks. “Ideally, this should be done with an internal firewall. This will significantly reduce the risk of malware spreading from one network to another. Medical devices should be segmented into logical groups (manufacturer or modality) to reduce the attack surface. When possible, medical devices should be isolated,” the report said. In addition, it recommended that healthcare organisations consider implementing multi-factor authentication for staff access to networks, especially in areas of high traffic, and reduce privileges to only those required.   “Access to the network is critical for most medical devices, especially with an Electronic Medical Record (EMR) system. Ensuring that only authenticated access is provided is key but when credentials are compromised, it can be challenging to define authenticated but unauthorised access. “So, regular reviews of network access should be completed. These must be managed to ensure usability of systems is not adversely impacted.” The report also said that more focus should be given to securing medical devices themselves, instead of just to ICT equipments. “Monitoring the internal and external environment for medical device abnormalities and cyber security threats is important to building a stronger cyber security posture. One advantage of monitoring medical devices is that their range of normal operation is narrow. This means that anomalies can be easier to spot in medical devices than ICT equipment,” it identified. The TGA has invited industry, peak bodies, professional and consumer groups, and individuals to provide comment on the draft guidance. Submissions for comment close on 14 February and will be used to help inform the final guidance document. This article first appeared on Healthcare IT News Australia.

Australia is in an unprecedented period of technology innovation where data, analytics and artificial intelligence (AI) is impacting all sectors including the life sciences industry. AI is defined as the broad field of new technologies that enable software to sense, comprehend, act and learn. It is disrupting how life science organisations operate and compete, while also accelerating the delivery of business outcomes in the ‘as-a-service’ economy. Analyst firm IDC has predicted that the worldwide content analytics, discovery and cognitive systems software market will more than double from US$4.5 billion in 2014 to US$9.2 billion in 2019. And using AI on the commercial side of the business offers tremendous opportunities. In a recent Accenture survey, more than 90 per cent of life sciences’ executives recognised AI as important in driving innovation and achieving outcomes, such as hyper-personalised experiences, new sources of growth and new levels of efficiency. So, what kind of use cases might arise? Accenture’s experience in AI shows just how broad the possibilities are with examples in commercial, marketing and sales operations as well as patient engagement: SPEEDING UP COMMERCIAL OPERATIONS By including AI as part of commercial operations, companies can automate processes that are repetitive and time consuming for staff. This could result in an increase in the overall process efficiency of the organisation. Accenture’s experience shows that Robotic Process Automation (RPA) can increase work efficiency by 20 per cent and increase accuracy by 40 per cent. For example, Medical Legal Regulatory (MLR) Review Automation uses RPA and machine learning to screen all MLR submissions in the identification and alerts of compliance issues before they reach reviewers. This is made possible by the AI algorithm which can scan materials, identify possible gaps based on a checklist and make pre-approval recommendations based on precedents. The benefits of using this technology is significant, as it notably speeds up the time to market and improves consistency because the process minimises human error whilst increasing the MLR reviewer’s capacity. OPTIMISING MARKETING CAMPAIGNS Perhaps the most mature use case of machine learning is the ability to leverage data science to create more personalised interactions with customers. Today, applications can predict the next best channel, message and timing for customer engagement. AI has the ability to bring together data from across business units using technologies that automate tasks associated with traditional marketing activities. This allows marketers to concentrate on higher order tasks such as developing a creative campaign, resulting in direct benefits such as improved customer satisfaction, retention and more sales. Life sciences organisations also invest a significant amount in marketing promotions. Through AI, organisations can generate useful customer insights to ensure these efforts are highly targeted and generate ROI. HELPING SALES REPS BECOME TRUSTED ADVISORS The key to a company's’ sales success is building trusted relationships with the right prescribing doctors; so, having access to the right data can make all the difference. Data such as the doctor’s prescribing habits, demographics of the area they serve, managed care impact on the drug they are selling and new treatments that are available is very valuable. Most importantly, AI enables the pharmaceutical sales representative to provide personalised recommendations to the doctor. AI could enable sales reps to have greater insights into the prescribing doctors’ profiles and provide the right drug information including benefits, safety and side effects. The technology could also make real-time content recommendations for a sales representative, tailored to where they are in the sales cycle, and greatly improve their chances of a successful outcome. ENGAGING MORE PATIENTS One of the biggest challenges healthcare practitioners face today is in the area of patient compliance, particularly in the case of chronic conditions. Research has shown that during treatment of chronic illnesses, approximately 50 per cent of patients fail to comply with their doctors’ long-term therapy recommendations. Being able to improve patient engagement is an important area of focus for life sciences companies and one where technologies such as AI play a key role. AI, when embedded in wearable devices, smartphones and tablets can be highly effective at keeping patients on track with their treatment pathway. Intuitive apps empower patients to self-manage their medication regimens and appointment schedules from their mobile or tablet devices. When connected to cloud-based platforms, these technologies allow doctors and pharmacists to communicate with these patients to clarify their understanding of conditions, complex drug regimens and potential side effects. For example, medical device company, Medtronic recently launched Sugar.IQ, a personal diabetes assistant exclusively available to Guardian Connect CGM customers on insulin injections. The mobile app leverages the power of AI along with Medtronic’s diabetes knowledge. The app provides real-time information to the patient, helping them monitor their glucose levels and know when and how much insulin to use. Another example is HealthTap, a World Economic Forum Technology Pioneer. It launched Dr. A.I., a personal AI-powered chatbot which operates like a ‘doctor’, translating a person’s symptoms into personalised, doctor-recommended courses of action. Dr A.I. leverages HealthTap’s repository of data and doctor knowledge and, applies complex algorithms to shape clinical expertise and inform patients to the level of doctor recommended care. KEY SUCCESS FACTORS The best way to capitalise on AI’s potential is to start small, with highly targeted use-cases. Here are some guiding principles to consider:  Treat AI as a co-worker, collaborator, trusted advisor and enabler of rapid response to patients’ and the healthcare ecosystem’s needs Ensure you have the appropriate budget and a task force to support AI development  Accept that failure is an option Have enough data to draw conclusions or generate recommendations Know what questions you would like your computer model to answer and what the next steps are once you know the answers.  If companies’ leverage the value of AI, they could propel themselves into a new level of efficiency, revenue making, customer personalisation and patient outcomes. Those that do not take on board these new technologies are at risk of being left behind, which may have profound effects on their business. Dhannu Daniel is Accenture’s ANZ Life Sciences Lead.