Government & Policy

The agency’s Annual Report 2017–18 identified that “42 data breaches (in 28 notifications) were reported to the Office of the Australian Information Commissioner (OAIC)… concerning potential data security or integrity breaches”, but with “no purposeful or malicious attacks compromising the integrity or security of the My Health Record system”. Of the 42 instances, one breach resulted from unauthorised access to a My Health Record as a result of an incorrect parental authorised representative being assigned to a child. Two breaches resulted from suspected fraud against the Medicare program, where the incorrect records appeared in the My Health Record of the affected individual and were viewed without authority by the individual undertaking the suspected fraudulent activity. The ADHA report also identified that 17 breaches were a result of data integrity activity initiated by the Department of Human Services to “identify intertwined Medicare records (that is, where a single Medicare record has been used interchangeably between two or more individuals)”. The remaining 22 breaches were from suspected fraud against the Medicare program involving unauthorised Medicare claims being submitted, and the incorrect records appearing in the My Health Record of the affected customers. An ADHA spokesperson confirmed that in all instances, the Department of Human Services took action to correct the affected My Health Records. “Errors of this type occur due to either alleged fraudulent Medicare claims or manual human processing errors, as was the case for the breaches reported during the 2017-2018 financial year. There has been no reported unauthorised viewing of any individual’s health information from a notifiable data breach,” the spokesperson said. “In each case, the affected individuals have been contacted and the OAIC has examined the circumstances of the breach and no unauthorised breach has been determined.” The ADHA spokesperson added that there are more than 6.3 million people with a My Health Record, but in the six years of its operations, there have been “no reported unauthorised views of a person’s health information”. “When a person’s health information is stored in different places – hospitals, doctors’ offices, filing cabinets, computers – they don’t know who is accessing it or when. In a My Health Record, every access is listed in a person’s record access history. A person can be notified by text message about who is accessing their record or restrict access to all or parts of their record,” the spokesperson said. On 26 November 2018, the Federal Parliament passed legislation to strengthen privacy protections in My Health Records Act 2012 without debate or division.   The new legislation means that Australians can opt in or opt out of My Health Record at any time in their lives. Records will be created for every Australian who wants one after 31 January and after then, they have a choice to delete their record permanently at any time. “At the time of writing, almost one quarter of all Australians have registered for a My Health Record. That figure is expected to change dramatically with the transition to an opt out system early in the 2018–19 financial year,” ADHA CEO Tim Kelsey said in the report. “Once this resource becomes almost ubiquitous across the Australian health system, clinical workflows and consumer behaviours will gradually and irrevocably change to take advantage of its many benefits. “For many people the benefits of digital health will be realised gradually, as health and medical data gradually accumulates to form a comprehensive medical history,” Kelsey said. This article first appeared on Healthcare IT News Australia.

One of the fast-growing sectors that have been identified in Thailand is healthcare and it is expected to be a key driver of the country’s economy. Deloitte estimates that the health care spending in Thailand would have reached $18.7bn last year, growing by 8% between 2014 and 2018. The consultancy added that total spending was $12.8bn in 2013. The medical equipment market is growing quickly as well, having risen in value from BT25.92bn ($780.2m) in 2010 to BT38bn ($1.1bn) in 2015. Nearly 80% of this medical equipment is imported. The government’s share of sector spending is the second highest in the region, at 77%, yet private sector spending is on the rise. In 2008, the Thai government spent BT8.2bn ($246.8m) on health care while the private sector spent BT2.6bn ($78.3m). By 2015, the government was spending BT12.5bn ($376.3m) for health care, while the private sector spent BT4bn ($120.4m). Private hospitals have benefited from government efforts to provide universal health care. Local hospitals report having experienced sharp increases in patient numbers, and this has led patients with the financial means to seek treatment at privately run establishments. Private sector growth According to the data from the Health Service Support Department at the Ministry of Public Health in 2015, there were 343 private hospitals operating in Thailand, up from 321 in 2011. Around 40% of these were in the Bangkok Metropolitan Area. The private hospital sector has been undergoing structural change and the effects of this are becoming increasingly clear. Large hospitals which are able to expand rapidly are doing so through mergers and acquisitions and by expanding their commercial networks both in the Bangkok Metropolitan Area and in important regional centers, especially those in border regions. Thailand’s Medical tourism industry is largely driven by private hospitals. Some of the well-known private hospital groups in the country include: (i) Bangkok Dusit Medical Services, the largest private hospital group in Thailand which consists of six major hospital groups – Bangkok Hospital, Samitivej Hospital, BNH Hospital, Phyathai Hospital, Paolo Hospital and The Royal Hospital and (ii) Bumrungrad International Hospital, one of the largest private hospitals in Southeast Asia and the first hospital in Asia to receive Joint Commission International (JCI) accreditation in 2002. The above-mentioned private hospitals are also continually looking to expand their international reach through Memorandum of Understanding (MoUs) with foreign online health platforms or companies. For instance, Bangkok Dusit Medical Services signed an MoU with China’s Ping An Good Doctor in November 2018 and Bumrungrad International Hospital signed an MoU with Malaysia’s BookDoc in June 2018. New players such as huge conglomerate companies in Thailand are also increasingly interested in investing in healthcare. These investments are huge and tend to be concentrated in the Bangkok Metropolitan Region. Examples of investors include Pruksa Holdings (Vimutti Hospital, scheduled for opening in 2020), RSU Group (RSU International Hospital, also scheduled for opening in 2020), CP Group, and TCC Group. Convergence of public initiatives and private sector developments Through a number of incentives, the Thai government wants to capitalise on the market development of medical tourism. Thailand is shifting public policy towards creating an environment wherein medical tourists can access the country’s services with ease. Part of the government’s strategic plan to become a global medical hub involves the loosening of visa restrictions and the creation of smart visas. Extending visas from 30 days to 90 days for citizens of China along with those of Cambodia, Laos, Myanmar and Vietnam (CLMV) will increase treatment options and draw customers with the promise of quality facilities. The private healthcare sector will be expected to grow and become more competitive due to the entry of non-traditional players such as huge conglomerate companies. Additionally, some public hospitals have also noticed the potential opportunities and have developed services (e.g. specialist treatments or providing services outside regular working hours) that match the standards of the private hospitals. Piyamaharajkarun Hospital, part of the Siriraj Hospital network and the Somdech Phra Debaratana Medical Centre at Ramathibodi Hospital are examples of public hospitals which have followed this path. Challenges and conclusion Thailand provides universal health coverage to its citizens, which is great but comes with several challenges. Some of these big challenges include fiscal sustainability in the long term, maintaining healthcare service quality and the shortage of healthcare professionals to meet the demands of universal health coverage. There is also the existing urban-rural divide in terms of the provision and quality of healthcare. The clever and practical use of technologies could address some of these issues, but this also requires significant buy-in and commitment from the policy makers and public sector.

Providers, patients and payers all still lack access to patient where and when they need it, the Office of the National Coordinator for Health IT said.

The new Digital Health Innovation Action Plan is part of the agency’s broader effort to improve oversight of technologies.

Secondary care providers in England are expected to be “fully digitised” by 2024, according to the 10-year NHS plan released today. NHS leaders were asked to develop the blueprint following an announcement in the summer of 2018 that the NHS would receive increased funding of £20.5bn per year in real terms by 2023/24, which applies to NHS England’s budget and not the overall health budget. The new plan outlines a series of “practical priorities” to ensure that digital services become a “mainstream” part of the NHS, and the new secondary care digitisation “milestone” covers “clinical and operational processes across all settings, locations and departments". It includes a focus on ensuring that clinicians can access and interact with patient records and care plans “wherever they are”, protecting patients’ privacy and putting them in control of their records, while encouraging a “world leading health IT industry in England with a supportive environment for software developers and innovators”.  Technology standards will be mandated and enforced, as mentioned in the digital, data and technology strategy published by the Department of Health and Social Care towards the end of last year, to ensure that “data is interoperable and accessible”, and the plan also pledges investment in expanding the NHS Digital Academy programme and increasing the training of health and care staff in digital capabilities. Improvements to require "staged action" The NHS App will offer a “standard online way” for people to access services, with an open environment to be created for developers to “build enhancements”, and patients with long-term conditions will reportedly be able to access their Summary Care Record through the app by 2020. Separately, it is expected that 100,000 women will be able to digitally access their maternity records in 2019/20, with plans for the coverage to be extended to the whole country by 2023/24, while a new wave of Global Digital Exemplars (GDEs) is also reportedly on the way, along with seven other Fast Followers.  “The continued roll-out of GDE blueprints to more Fast Followers will ensure the NHS achieves maximum value by reducing duplication and sharing systems between organisations where possible based on open standards and interoperability. Central funding will be made available to trusts (subject to an upper limit) to help them meet mandated standards and technical requirements,” it is added. In a speech today marking the publication of the plan at Alder Hey Children’s Hospital in Liverpool, NHS England chief executive Simon Stevens said some improvements would require "staged action over the next 10 years", while others would "happen quite quickly".  "The ability to share and access high quality data driven insights - led by patients - is key to improving patient care in the NHS," said Dan Vahdat, CEO and founder of UK health tech company Medopad. "Helping patients understand their own conditions and sharing ongoing updates with their clinicians can enable clinical teams to drive earlier interventions and ultimately, use that data to predict issues before they arise." Commenting on the publication of the long-term plan, Professor Carrie MacEwen, chair of the Academy of Medical Royal Colleges, added: “It’s good to have a plan which sets a clear direction for the NHS and tackles many of the issues the Academy has long been saying need to be addressed if we are to improve patient care. Our challenge now is to make sure it’s properly implemented and in this regard we, that is everyone who works in the NHS and patients who use the service, must all play our part if we are to make it a success.” Charles Alessi, Chief Clinical Officer for HIMSS, parent company of Healthcare IT News, said: “The announcements around the evolution of the health and care system in England are welcome and encouraging. The extra resources promise to accelerate the journey around digital transformation that is long overdue. They will assist England in improving outcomes for patients by ensuring that services are digitally enabled and patients get more involved in their care. "This approach will assist the NHS in its quest for quality, and enable it to be compared with its peers globally, not only in terms of financial efficiency, but also in terms of outcomes for patients.  We look forward to seeing the detail of these plans and working with the NHS around this transformation.” Editor's note, 10 January 2019: This article has been updated to include a statement from Dan Vahdat, CEO and founder of Medopad, and Charles Alessi, HIMSS Chief Clinical Officer. Healthcare IT News is a HIMSS Media publication. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

The Australian Institute of Health and Welfare (AIHW) built the tool and said it provides a new way of comparing Australia’s performance across a range of health-related measures from the data of 36 Organisation for Economic Co-operation and Development (OECD) member countries. Some of these countries include Japan, Spain, Italy, Switzerland, Canada, New Zealand, the UK, the US, France, Korea, Israel, Norway, Germany and Denmark. The data tool, International health data comparisons 2018, gives users interactive data visualisations of snapshot comparisons of key health indicators such as life expectancy, health risk factors and causes of death. It also aims to give insights into how Australia’s healthcare system compares, including data on the pharmaceutical market, health insurance coverage and waiting times for elective surgery. All data is sourced from the OECD Health Statistics 2018 website and results are for 2017 or the nearest available year of data for countries with available data. According to the AIHW, the tool was built to aid local healthcare professionals compare health and healthcare data between countries and get a better understanding of how the market compares to other countries. "This new data tool is an important resource, facilitating international comparative reporting, supporting policy planning and decision-making and enabling new types of research and analysis," AIHW spokesperson Claire Sparke said. How does Australia’s health compare to other OECD countries? The AIHW data presented some key findings for Australia, as compared to the rest of these 36 OECD member countries, including: Australia has the 6th lowest proportion of daily smokers (12 per cent) across OECD countries, below the OECD average of 18 per cent.  Australia has the 9th highest rates of overweight and obesity (63 per cent). This is even more notable for men, with Australian men having the 3rd highest rate of overweight and obesity, behind the US and Chile. Waiting times for most elective surgery procedures in Australia are below the OECD average. For example, Australians waited a median of 13 days for coronary bypass compared to the OECD average 22 days. “The data show that Australia performs relatively well across most of the indicators. For example, Australia has a life expectancy at birth of 82.5 years – above the OECD average of 80.6 years, and 6th highest among OECD countries,” Sparke said. “However, the data show that there are some areas where Australia could be doing better, such as rates of overweight and obesity”. This article first appeared on Healthcare IT News Australia.

Gfrerer, who advocated keeping the proprietary VistA Veterans Affairs EHR during his hearing, will lead the multi-billion dollar modernization project.

The four-part report was compiled for hospital executives as well as infosec pros, HHS said.

Federal officials are working on policy about the emerging technology deliberately, helping to set expectations for near- and medium-term healthcare applications.

The chair of the House VA Subcommittee on Technology Modernization wants the agency to answer some questions with regard to the $624 million Medical Appointment Scheduling System contract.