Electronic Health Records (EHR, EMR)

Intermountain's longtime chief information officer will receive the John E. Gall Jr. award at HIMSS20 in Orlando this March.

Nurse and therapist communities make up the largest of Meditech’s user groups. And professional services will help with EHR customization and more.

Dr. Larry Allen, the medical director of advanced heart failure at University of Colorado School of Medicine, describes why the health industry should be excited over the advancements in EHR technologies.

Nearing the first anniversary of the My Health Record (MHR) collection deadline on 31st January 2020, the Australian Digital Health Agency (ADHA) has announced that the total number of MHRs with information has reached 12.99 million, based on the latest statistics from December 2019. The Agency also said that between November and December 2019, there was an 11% increase in the volume of medicine documents uploaded by healthcare providers like GPs and pharmacies, to more than 100 million documents and a 13% increase in clinical documents uploaded by healthcare providers like hospitals, pathologists and radiologists. In December alone, GPs uploaded nearly 3 million documents and their viewing increased 10%. The total number of documents in the MHR system is now 1.7 billion. THE LARGER PICTURE Based on the latest statistics from ADHA as of December 2019, there are 22.68 million MHRs, of which 12.99 million records have information in them. The Agency said last year that one in 10 Australians have opted out of the MHR system, leaving participation rates at 90.1 per cent. Last December, there was a marked increase in the uploading of information to the MHR. Pharmacists uploaded more than 5 million documents, GPs uploaded nearly 3 million documents, hospitals uploaded just over 1.5 million documents and more than 1 million pathology/diagnostic images were uploaded. ON THE RECORD “While it was not expected that all My Health Records would have documents uploaded in the first year as not everyone would see a GP or other connected healthcare provider service in that timeframe, we are now seeing significant increases in uploaded clinical documents and My Health Records with valuable clinical information,” said Professor Meredith Makeham, Chief Medical Adviser, ADHA in a statement. Paul Smith, a pharmacist at Capital Chemist in Huskisson NSW, said: “In the lead up to New Year’s Eve, Huskisson and surrounding towns in NSW had an unusually large number of travelers and locals seemingly stranded without their prescriptions or regular medications. These medications included your run-of-the-mill blood pressure tablets and the like, but there were patients without their insulin, anti-epileptic medications, anti-depressants, preventative asthma inhalers, and numerous others.” “Having access to the My Health Record database certainly helped me a great deal during this unprecedented time, as I was able to ensure a continuity of care in a safe and legal fashion.”  “The main hurdle I faced was assisting patients who had chosen to opt out of the My Health Record system. It is an extremely bad situation to be in when there were no local surgeries open, the roads to the closest public hospital were closed, and the person had nothing to show you that they are normally prescribed.”

Ransomware, coupled with an expanded attack surface thanks to a proliferation of internet-connected medical devices, are among the top security concerns health players should be concerned about in 2020. Additionally, a troubling new trend of attacking automatic software and firmware update systems, as highlighted in March 2019’s "Shadowhammer" attacks, is another vector for malware that can be hard to protect. These trending risks are particularly important due to the proliferation of new medical technologies and because often with these technologies the stakes are higher. "Ransomware will continue to be the biggest issue as attackers have seen the urgency they can create that can lead to payment," Dr. Saif Abed, CEO of Clinical Cyber Defense Systems, told HealthcareIT News. "Attacks will become more frequent and indiscriminate." He predicted the "zero trust" approach would emerge as a key strategic approach, an IT security model that requires strict identity verification for every person and device trying to access resources on a private network, regardless of whether they are sitting within or outside of the network perimeter. "The reality will be focusing on the basics," he said. "Know what and who are connecting to your network, identify vulnerabilities and have a patching strategy." He noted that while much is made of the security issues surrounding medical devices it’s much bigger than that as far the broadening of the attack surface. "Interoperability coupled with increasing M&A activity in healthcare will be larger driving factors that attackers will exploit," he said. "Unpatched IoT endpoints, whether they’re medical devices or not, will simply contribute to the porosity of networks and the ability to move laterally to maximize harm." He explained most attackers exploit simple vulnerabilities and, unfortunately, these continue be pervasive.. "Health systems are gradually improving with more leadership in the space but far greater investment is needed in people, processes and technology to get most where they need to be," Abed said. Mounir Hahad, head of Juniper Threat Labs at Juniper Network, told HealthCareITNews he believes ransomware would continue to pose a significant risk to many verticals, with healthcare "very near the top" of that target list. "This is because attackers know there are lives at stake in an industry where cybersecurity is not a primary concern for most users--practitioners and staff," Hahad explained. "This makes them an easier target for social engineering attacks and also a wealthy target that cannot withstand long downtimes." KnowBe4 security awareness advocate Erich Kron predicted that until industries can disrupt the income being generated by ransomware, the threat would continue to grow. "The healthcare industry is especially vulnerable due to the need for timely access to medical records for treatment, the amount of sensitive data being collected and the threat of substantial fines for non-compliance and data breaches," he noted. "The attackers know this and use this to their advantage." Kron said the biggest threat to healthcare he sees evolving in 2020 is the threat of exfiltrating and then leaking data when organizations fail to pay the ransom. He explained that in the past, a good backup strategy, offsite copies of data and the ability to quickly restore data have been enough to avoid paying the ransom. "However, with the threat of data being exposed, these steps, no matter how well executed can still end up with disastrous consequences," he said. "Just the fact that they attackers can exfiltrate data and have the keys to decrypt it will be a major concern with respect to HIPAA violations in future events."  Meanwhile, cellular 5G technology will allow a much larger proliferation of IoT medical devices as we enter 2020, and the security implications of this are enormous. "A lot of processing of information will move closer to the edge of networks and will be disaggregated for scale and performance, shining a light on new attack surfaces," Hahad explained. Kron pointed out that as more equipment is introduced to hospital networks, the ability to monitor, patch and secure devices becomes exponentially more difficult. "In addition, the increasing complexity of connected equipment significantly raises the stakes with respect to failures in these areas," he said. "Not only do we need to be concerned about taking a connected pump offline or disrupting monitoring stations, we are also having to concern ourselves with securing immensely more complex systems such as surgical robots." Nathan Eddy is a healthcare and technology freelancer based in Berlin. Email the writer: nathaneddy@gmail.com Twitter: @dropdeaded209

Careful planning of one's time in Orlando is a must – with so much going on at once across the sprawling convention center, having a flexible but well thought out to-do list is essential.

It’s a big change for the EHR giant. A company vice president and its external design expert explain what human-centered design is – and what it means for its healthcare customers.

Seoul National University Bundang Hospital, South Korea's first fully digital, paperless hospital with its own homegrown EHR, is staying at the forefront of innovation, says CIO Hee Hwang.

The ONC final rules on interoperability and patient access are expected soon, and Sequoia's info blocking workgroup seeks to help organizations prepare for compliance.