Saturday, May 13, 2017

Massive Ransomware Cybersecurity Attack brings down NHS in U.K.

Early reports suggested it was targeted at the UK’s National Health Service,

The BBC reports that up to 25 NHS organisations and some GP practices have been affected.

Cybersecurity can no longer be treated as "it won't happen to us". Although the attack targetted the U.K. N.H.S. it rapidly became a global attack.  The NHK system in many locales became unusable and emergency services required diversions to hospitals still functioning. For those hospitals . still functioning, many IT services were disrupted including appointments and data in electronic health records.  Critical medical information became unavailable in intensive care units and surgery suites.

For users attempting to log in to their systems, this is what they saw.

Imagine if this is your hospital and you have a patient for whom you must have critical laboratory or images immediately....Do you have a fall back plan to obtain it ?

This occurence evolved due to the lack of updates to the NHS IT systems. Due to cost issues and decreased budget allotments their systems run on out dated and obsolete operating systems.

Users with Windows 10 escaped the attack because Windows 10 uses daily updated protection.

How many health systems still operate with Windows XP or Windows Vista.

Many institutions are reluctant to upgrade their current systems due to incompatibility with newer operating systems.  It may often require a complete replacement of software and/or hardware. The expense will be considerable, but now is essential.

A Kaspersky lab analysis puts the number of infected computers at more than 45,000 as of early Friday afternoon, the vast majority of which are Russian (Ukraine, India, and Taiwan follow). The ransomware’s code makes it pretty clear that it’s taking advantage of an exploit called EternalBlue, published in April by the Shadow Brokers but patched preemptively by Microsoft in March.

For those of you who want to take immediate action, TechCrunch offers these suggestions.

Microsoft offers regular security updates, however Microsoft no longer supports XP, Vista or 7.  Automatic updates will not occur for those products.

Our world has become small and intimate.  Watch this report which graphically depicts the cyber wars that are ongoing.

Ransomware based on leaked NSA tools spreads to dozens of countries | TechCrunch

Monday, May 8, 2017

Detecting Vision Loss in Underdeveloped Countries, and at Home

The Ceeable Visual Field Analyzer (CVFA) is cloud-based digital platform used to detect and diagnose retinal disease. There are more that 300 million people worldwide that suffer from retinal disease. The Ceeable technology has the ability to reach more people worldwide than any currently available retinal diagnostic technology. Better patient management of eye disease will reduce healthcare systems costs and help to prevent blindness.

The Ceeable Visual Field Analyzer (CVFA) is cloud-based digital platform which can be operated on a PC or iOS tablet.  It is cloud based, and using an internet connection globally can upload the data to the cloud for interpretation.

It bypasses the need for a large Visual Field analyzer, that is not portable, and only available in clinics.

Ceeable's Tablet Visual Field Screening Tool

Humphrey VFA (Visual Field Analyzer

Detecting Glaucoma and other retinal diseases such as retinitis pigmentosa, optic nerve disorders earlier before there are symptoms would decrease world-wide vision loss, and increase the liklihood of successful treatment.

Ref: Ceeable

Friday, May 5, 2017

Price at Health Datapalooza: 'Rules of the road' are needed for 'true interoperability' | Healthcare Dive

  • “True interoperability has always been the goal,” HHS Secretary Tom Price said at Health Datapalooza 2017 in Washington D.C. on Thursday.
  • Yet the path toward achieving that goal has been getting bogged down in recent years, Price said, suggesting guidance from the HHS to be able to decide on “the rules of the road.”
  • He also believes that the industry is in need of new healthcare policies focused on “accessibility, affordability, quality and empowering patients," as well as patient-centered care that reduces the administrative burdens that more and more clinicians have been reporting.
This was Price’s first speech after being confirmed as the HHS Secretary and he has a lot to say about the hurdles in the digital health space, including the challenges the industry has been facing with data entry. 
Achieving true interoperability is no easy task. But the Obama administration made some progress with the Precision Medicine Initiative, which aims to use health data for improving research and care, the Interoperability Standards Advisory Task Force and The Sequoia Project. 
There is still a lot of room for improvement. Legacy EHR vendorshealth IT companies and several healthcare organizations, such as Partners Healthcare and UPMC, have embarked on their own push to bring down barriers to interoperability over the past few years.
Being able to streamline the process of sharing health data can help providers craft more personalized care plans and improve outcomes. This has become even more important now as the federal government continues its push toward value-based care where clinicians have their payments tied to the quality of care they provide.
Yet most (72%) healthcare executives and clinicians who responded to a recent survey from NEJM Catalyst believe the lack of interoperability is the top barrier to better use of patient data. Respondents also said the biggest opportunities for information-sharing in healthcare are care coordination (81%), decision support (79%), predictive analytics (68%) and precision medicine (45%).

The issues of interoperability date back to 2004, when then President George W. Bush by executive order created the Office of National Health Information Technology (ONCHIT), headed by David Brailer, M.D. Brailer had experience with one of the earliest attempts at Regional Health Information Exchanges, the Santa Barbara initiative.  Since that time there has been a highly visible retinue of administrators who stay on a year or so, and move on to other positions.  It seemed to have become a stepping stone to higher offices.  The lack of personel stability cannot be discounted . in implementation of interoperability.  The standards were developed by ONCHIT and several organizations were selected as certification entitites.
Much of the reticence has been from institutions and medical organizations who are opposed to sharing 'proprietary information.  However it has been established that patients are the owners of their data in the EHR itself.

Price at Health Datapalooza: 'Rules of the road' are needed for 'true interoperability' | Healthcare Dive


  • NYC Health + Hospitals will revamp its management framework over the next few months, Becker’s Hospital Review reported.
  • In a statement to the publication, the health system said it is “redesigning [its] management structure to create a more efficient and financially sustainable organization that can direct resources where we need them most — at the front line of patient care.”
The most recent financial audit clearly shows (although not noted) the correlation between losses and cost of the electronic health record system.

The announcement follows last month’s release of unaudited financial statements showing a $776 million operating loss in the fiscal 2017 first half. Roughly $78 million in municipal contributions brought the public health system’s net loss to $736 million.

The beleaguered system has weathered a string of bad news, from multi-year operating losses to an exiting CMIO’s criticism of launch preparations for a $764 million EHR system. And physicians have complained that the system’s quality goals are too high and threaten the loss of tens of thousands of dollars in incentive payments.

This health system is not unique. The federal government's intense and hasty requirement to bring information technology to health care is disrupting prudent financial planning by threatening to penalize those who do not comply with rigid requirments.  So far the only segment that is gaining income, at the expense of health providers, is hardware and software vendors.
The IT offerings have not proven to have substantial return on investment.

The coming 'reinvention of ObamaCare" promises a new opportunity to carefully evaluate the role of new technology and the ROI of what is now in place.

NYC Health Hospitals plans management makeover | Healthcare Dive