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This post from 17th March 2012, nearly four years ago offers an interesting reflection on how the sector looked not so long ago.
Healthcare in the U.S. is largely a mess thanks to unfit citizens, underinformed doctors, and confounding and inefficient processes. Here’s a slew of innovative companies working to change all that.
Demand and technological capabilities are driving change, Cathy Riesenwitz, a researcher with software firm Capterra, told Healthcare IT News.
With the market for electronic health records predicted to be worth about $35.2 billion by 2019, the steady rise of data has increased the need to strengthen the software to make data more accessible, reduce errors and increase the ease of use.
1. EHRs are moving toward the cloud.
2. EHRs will improve the patient portal experience.
3. Telemedicine will finally find its stride.
4. EHRs are going mobile.
Digital Privacy: Is Giving Up Your Personal Information Online Leading To Surveillance And Discrimination? on PostDesk
Every day and every time we use our “smart phones” we are being tracked. From Facebook’s use of tracking cookies to monitor users to Carrier IQ key logging software for “smart phones”; companies and governments are using digital surveillance. The surveillance is troubling in its own right, but there is a deeper concern. When the […]
Parents are being urged to sign up for a free app which tells them the sugar content of food and drink, created by Public Health England.
Accenture predicts 51 percent of digital health startups will fail within two years | mobihealthnews
From their website;
About half of all US digital health startups will fail within two years of launching, according to an Accenture report that analyzed 900 healthcare IT start-ups…
For comparison, a Bureau of Labor Statistics report shows that between 1994 and 2009, at the two year mark, between 20 percent and 26 percent of startups across all fields failed.
Accenture also found that digital health startups on the brink of failure, which they call “zombie” startups, raised nearly $4 billion in funding between 2008 and 2013 and that there are 1,700 patents between the 900 startups analyzed. The report explains that these startups are often “aqui-hired” for top talent, patents, and technologies.
“Rather than discard the investment that has been made in getting sputtering start-ups off the ground, it often makes sense for healthcare stakeholders to acquire them, salvage their best people and technologies and awaken them from a zombie-like existence,” Kaveh Safavi, managing director for Accenture’s global healthcare business, said in a statement…
Accenture predicts that in the next two years, another $2.5 billion will be invested in digital health startups. Almost 30 percent of these funds will be invested infrastructure, while 25 percent will be invested in engagement, 25 percent will be invested in treatment, and 21 percent will be invested in diagnosis.
From their website;
The GlucoTrack uses an ear lobe clip-on similar to pulse oximeters to spot glucose levels through the skin. The sensor uses three different technologies to estimate blood glucose and sends its readings to a smartphone-like device that displays the numbers and keeps track of previous tests.
From their website;
Amsterdam-based dermatology app company SkinVision has raised $3.4 million from pharmaceutical company Leo Pharma with contributions from SkinVision’s existing investor and majority stakeholder Dutch investment firm Personal Health Solutions Capital. The complany plans to use the funding to move its app’s capabilities beyond melanoma recognition and into other skin conditions, according to a report in TechCrunch.
From their website;
BOTHELL, Wash.–(BUSINESS WIRE)–FUJIFILM SonoSite Inc., a specialist in designing cutting-edge ultrasound tools and world-leading education for access to point-of-care visualization, today announced CE mark for its newest Point-of-Care solution: the iViz. Inspired by clinicians, the iViz is a new platform that augments the value of ultrasound for clinical users from hospital settings to clinics in remote villages with the ability to perform ultrasound when and where it is needed.
From their website
Healthcare leads all industries in data breaches
September 17, 2015 | Jack McCarthy – Contributing Writer
POSTED IN: Privacy & Security
The healthcare sector experienced 187 data breaches in the first half of 2015, a startling number on its own, but even more so when considering that it accounts for 21.1 percent of all breaches worldwide.
That’s according to a report from data security company Gemalto.
“The healthcare industry historically has had the highest number of data breaches, and that was no different in the first half of 2015,” the report said.
The key finding is perhaps that the healthcare industry had 34 percent of its total records breached, amounting to 84 million data records compromised, the highest rate of any industry. Government accounted for the second highest rate of breaches at 77.2 million records lost, or 31.4 percent.
A contributing factor to the high rate of breaches encountered by the healthcare industry was the February heist of U.S. health insurance provider Anthem, in which criminal hackers broke into the firm’s servers and stole 78.8 million records that contain personally identifiable information, the report said.
The data breach, according to Anthem, extended into multiple brands that the company uses to market its healthcare plans, including Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Georgia, Empire Blue Cross and Blue Shield, Amerigroup, Caremore, and UniCare, the report said.
Also listed among the companies experiencing the largest data breaches was electronic health records vendor Medical Informatics engineering, which has 3.9 million records compromised, the report said.
Overall, companies across all sectors are feeling increased pressure from attackers.
“The first six months of 2015 demonstrated that hackers continue to get past conventional perimeter security with relative ease, targeting nearly every industry and executing several high profile data breaches that scored tens of millions of data records each,” the authors of the report wrote. “And, while identity theft remains one of the leading types of data breaches, the first half of 2015 has shown a shift in attack targets … data records stolen from state-sponsored attacks rose dramatically compared to previous years and healthcare and government overtook retail as the major sectors under siege with the number of compromised data records.”
Largely based in America there are an increaing number of online services which enable a patient to get a second opinion from an online Doctor. There is a mixture of online health services available and this contrasts with  online symptom checkers  artificial intelligence diagnostic aids and  online consultation.
From their own website
Get instant medical second opinion online. Ask a Board Certified doctor for medical advice. Prices starting at 49$.
Doctors voice concerns over plan for greater patient access to medical records | Society | The Guardian
From their website, Denis Campbell the Guardian’s Health Policy Editor writes;
(I think the articles is so good that I’m reproducing it in full
The health secretary, Jeremy Hunt, has announced plans to give patients in England access to their entire medical record by 2018, and to let them read and add to their GP record using their smartphone within a year.
The announcement at NHS England’s annual conference in Manchester prompted fears of a repeat of last year’s row over care.data, a programme in which patient records were shared outside the NHS without their consent. The opposition forced NHS England to halt the scheme temporarily while it addressed the concerns.
Phil Booth, coordinator of the campaign group MedConfidential, said: “Shoving highly sensitive information to patients via their smartphones really won’t help doctors treat them in 2016, and medical bodies like the Royal College of GPs have already pointed out it could expose the vulnerable to stalking, abuse and coercion, not to mention predatory companies who can’t wait to get their hands on such valuable data.”
Organisations representing doctors also expressed misgivings, with the British Medical Association (BMA) warning that vulnerable patients could be coerced by abusive partners to reveal what they had told their doctor.
Some doctors, especially GPs, are also concerned that, from 2018, notes that they and other health professionals have written in patients’ medical records, which they were never intended to see, will become known to the patients involved. For example, a GP may have recorded that a patient may be at risk of cancer because they smoke, but never told the person that directly.
Dame Fiona Caldicott, the national data guardian for health and care – whose role will be put on to a statutory footing as part of the overhaul of security – will take part in the review. As a first step, by January she will develop new guidelines for the protection of patients’ personal data, which every organisation providing health and care services will have to abide by.
That will be strengthened by using CQC inspections and the awarding of contracts by NHS England to ensure that stringent standards of data security are being applied.
As it stands patients can only view a summary of their medical history. But from 2018 they will be able to see their entire record, though it is not yet clear how that will happen.
Hunt said patient access to their own records would lead to mistakes being rectified and to patients taking their own health more seriously. Patients would be able to add what they see as useful information, such as the number of steps they walk each day, so their GP can monitor their physical activity, he said.
NHS in England delays sharing of medical records
The BMA said it had concerns about the security of patient records if they were to be placed online. “There is a big difference between being able to physically view private records in a secure, controlled environment of a practice and via a password that could be obtained by a third party,” a spokesman for the doctors’ union said.
Dr Maureen Baker, chair of the Royal College of GPs, said family doctors were already so busy that they did not have time to monitor and assess information added by patients themselves.
“GPs are under incredible pressure, seeing more patients than ever before, and we simply do not have the resources to analyse data that patients upload to their records as a matter of course,” Baker said.
“However, this data can be used to trigger conversations between GPs and their patients about leading healthier lifestyles – and as long as it is done safely and responsibly, this is something we would encourage.”
From their website, several of the Health Secretary, Jeremy Hunt’s quotes;
Powerful patients need to know about the quality of healthcare being provided, but they also need to be able to harness the many innovations now becoming possible.
To most of us it feels like there has been more change in the way we book taxis, shop, bank or store photos than the way we access healthcare. Yet for every single one of us healthcare is more important than all of those things.
Experience from other countries suggests that opening up access to your own medical record leads to a profound change in culture in a way that is transformative for people with complex or long term conditions.
I also want patients not just to be able to read their medical record on their smartphone but to add to it, whether by recording their own comments or by plugging in their own wearable devices to it.
In addition, by the end of 2018 all doctors and nurses will be able to access the most up-to-date lifesaving information across GP surgeries, ambulance services and A&E departments, no matter where a patient is in England. By 2020 this will include the social care system as well.
As the internet drives forward the next wave of innovation, all over the world healthcare still seems to be at the back of the queue.
We will only really be putting patients first if we can give them confidence that every part of the system knows their care plan, is up to date with their progress and doesn’t need them to repeat their story time after time.
We no longer have to carry round our cheque books or boarding passes, and we shouldn’t accept any less when it comes to our health.
As the use of technology increases, so does the need to reassure the public that their personal medical data is being held securely.
Exciting though this all is, we will throw away these opportunities if the public do not believe they can trust us to look after their personal medical data securely.
The NHS has not yet won the public’s trust in an area that is vital for the future of patient care.
Nothing matters more to us than our health, and people rightly say we must be able to assure the security of confidential medical information.
The key points are  consent  adequate assessment including consideration of access to previous records, modality of communication, need for physical examination.
The GMC guidance is given as;
60. Before you prescribe for a patient via telephone, video-link or online, you must satisfy yourself that you can make an adequate assessment, establish a dialogue and obtain the patient’s consent in accordance with the guidance at paragraphs 20–29.
61. You may prescribe only when you have adequate knowledge of the patient’s health, and are satisfied that the medicines serve the patient’s needs. You must consider:
a. the limitations of the medium through which you are communicating with the patient
b. the need for physical examination or other assessments
c. whether you have access to the patient’s medical records.
62. You must undertake a physical examination of patients before prescribing non-surgical cosmetic medicinal products such as Botox, Dysport or Vistabel or other injectable cosmetic medicines. You must not therefore prescribe these medicines by telephone, video-link, or online.
Update July 2015
A new EU law came into effect on 1 July 2015 that requires doctors to prescribe only drugs that are licensed for use where the patient lives – for example, when they are prescribing drugs via online consultations. >> Find out more in section 7 of the MHRA’s document (pdf)
2012 Guidance about requirements a website must adhere to (not all relevant to Cld.Ht);
Web Accessibility and the Disability Discrimination Act
The Data Protection Act
Consumer Protection (Distance Selling) Regulations
Electronic Commerce Regulations (EC Directive)
Payment Card Industry Data Security Standard (PCI DSS)
The EU Anti Spam Laws
The EU Cookie Directive
The BMA quotes the GMC guidance on advertising and elaborates with details (follow link)
Doctors may advertise their services, for example on the internet, in formal advertisements in newspapers or magazines, a practice leaflet, or an editorial or news piece in a newspaper. However, all advertising must follow the guidelines set out by the General Medical Council.
The GMC guidance states that any information provided about medical services MUST:
- comply with the law and guidance issues by the Advertising Standards Authority
- be factual and verifiable
- not make unjustifiable claims about the quality of service
- not offer guarantees of cures or exploit patients’ vulnerability or lack of medical knowledge
- not put pressure on people to use the service, for example, by arousing ill founded fear for their future health or by visiting or telephoning prospective patients
The potential pitfalls of social media that the BMA identifies are;
Patient confidentiality violations. ref(1)
Use of discriminatory & profane language. ref(1)
Depictions of intoxication and illicit substance use. ref(1)
Maintaining boundaries – sharing (professional’s) personal information
“Where you post significant amounts of personal information on social media, patients may gain unrestricted access and you need to consider carefully what impact this might have on your professional relationships.”
Maintaining boundaries – inappropriate Doctor-Patient relationships
“Social networking sites such as Facebook also facilitate the development of online friendship networks. Doctors and medical students have reported, for example, that patients and former patients have sent them friend requests on Facebook. We recommend that, in these circumstances, if you receive friend requests you should politely decline.“
Professionalism – consider the public interest argument of how the Public regards/ may regard the profession as a result
ref(1) – Chretien KC et al. (2009) Online Posting of Unprofessional Content by Medical Students. JAMA 302(12):1309-15.
Care.data: How did it go so wrong? – http://www.bbc.co.uk/news/health-26259101
Health insurer Vitality attacked over Facebook app push – http://www.bbc.co.uk/news/technology-33315569
Details regarding doctor’s using anonymity online
2014 Summary and Opinion by Craig MacLean, Deputy Chair of the British Medical Association (BMA) Scottish Medical Students’ Committee.