Cloud Boon

Taken from http://www.healthcareitnews.com/news/forecasts-look-clear-cloud-computing:

DALLAS – Video may have killed the radio star, but the cloud is expected to rain on its parade, according to a new July report by MarketsandMarkets. Report authors announced Monday that the global healthcare cloud computing market is projected to precipitate a value of more than $5.4 billion by 2017.

The “Healthcare Cloud Computing Market – Global Trends, Challenges, Opportunities & Forecasts” report predicts that cloud computing will serve as a boon to the healthcare industry, as the market has already witnessed a deluge of this technology.

In an increasingly IT-driven world, healthcare providers are using cloud-based technologies to facilitate the exchange of patient information and to provide IT services at lower costs and faster speeds. In 2011, the penetration of cloud in the healthcare industry was estimated at 4 percent and valued at $1.7 billion. Moreover, according to report forecasts, the compound annual growth rate of the cloud computing market will grow 20.5 percent from 2010 to 2017.

Because healthcare organizations (HCOs) are expected to deliver more while simultaneously reining in healthcare costs with the technology, a large number of HCOs are allocating funds for migration to cloud computing over the next five years, the report noted.

North America represents the biggest share in the global cloud computing market, with the biggest players being CareCloud, Carestream Health, Merge Healthcare and GE Healthcare.

Kalyani Jekkaraju, author of the MarketsandMarkets report, explained that his study examines numerous aspects of the cloud computing market, from the business end to the challenges faced by the technology, such as security challenges and shifting market trends. “There is a lot of data in terms of how the cloud has evolved into the market and why it is believed to grow at a very faster pace compared to the other healthcare IT offerings," she said.

The report also finds that despite the shower of promises cloud computing brings, the entire healthcare industry isn’t singing in the rain quite yet. Private, public and hybrid clouds are the three deployment models available to healthcare, but the industry has been slow to adopt public clouds due to their highly regulated nature. Moreover, there has been increased scrutiny over potential privacy and security issues the technology poses – issues that further stymie the adoption process within the industry.

“The reason we took this particular market and we made a report on it is because cloud computing in the healthcare market is getting so much attraction," said Jekkaraju. "As it is, the cloud computing market is ever-growing in terms of its adaptability and its advantages.”

No More He-Said She-Said

A new smartphone app records patient calls and stores them in their electronic medical record.  Now a reliable account of doctor-patient conversations can be made available in case of legal disputes, such as the one in this article. 

Taken from http://www.healthcareitnews.com/news/new-smartphone-app-targets-clinical-miscommunication:

MENDHAM, NJ – With more and more doctors using their smartphones to conduct business outside of the office, the potential for communication errors – ranging from misunderstood directions to "he-said-she-said" moments – is increasing dramatically.

A New Jersey-based surgeon has created a mobile app designed to help doctors make sure their phone conversations are understood properly. The MedXCom app, part of a line of mHealth products developed by Giffen Solutions, records and stores the phone conversation between doctor and patient, giving both parties a HIPAA-compliant means of checking the facts.

"All we're doing is creating an environment where these messages are secure," said Michael Nusbaum, a bariatric surgeon at Morristown Medical Center who launched Giffen Solutions in 2010. "If (both doctor and patient) know their conversation is being recorded, this makes them more comfortable. This actually bumps up the level of conversation and improves the level of care."

Nusbaum said the idea of securely recording doctor-patient conversations came out of an unfortunate legal situation faced by a colleague. A woman had filed suit against his colleague over medical instructions given over the phone for her husband, and Nusbaum was drawn into the court battle over exactly what was said in the phone conversation.

"We need to avoid those 'he-said-she-said' moments and make sure there are no mistakes," said Nusbaum. "The future is in smartphones, and they're becoming a comfort tool for doctors."

Nusbaum began his career in mobile health IT back in 1998, when he founded Hamilton Scientific on the concept of creating a cloud-based electronic medical record. He eventually sold the company to MeridianEMR, and continued to explore how EMRs could evolve from what he called static data repositories to systems that could be more dynamic. Giffen Solutions was borne out of that idea, and MedXCom was created to connect EMRs to mobile devices and allow for real-time access and adjustments.

MedXCom, which is designed to work with any EMR, enables the physician to access a patient's medical records on a smartphone before or during the conversation, and to add the conversation to the medical record. The patient-facing side of the product enables patients to add information to the app, make appointments and receive reminders. Another product, MedXVault, allows consumers to use the app regardless of whether their physician is a MedXCom subscriber.

Nusbaum, who sees MedXCom as an alternative to answering services and after-hours messaging services that many physicians now use, said he's hoping to have more than 50,000 physicians in all 50 states using MedXCom by the end of the year.

Among the physicians using the app now is Richard Garden, DDS, an oral and maxillofacial surgeon with Chesapeake Oral Surgery Associates in Wayne, N.J.

"As a surgeon, I receive numerous phone calls via my smartphone on the weekend and after hours," Garden said in a press release issued on June 6. "MedXCom allows me to record all calls in order to improve the quality of care I deliver to my patients. My primary goal is to make sure that my patients are comfortable and well cared for in all instances, and the technology allows me to deliver superior service and communication."

"MedXCom's platform allows me to connect instantly with my patients and their health profiles," Garden added. "The ability to have all secure pertinent information at my fingertips while all communications are recorded and archived is critical."

Top 10 Security Bloopers

Taken from http://www.healthcareitnews.com/news/10-largest-data-breaches-2012-so-far?page=0,0:

1. Utah Department of Health. On March 30, approximately 780,000 Medicaid patients and recipients of the Children's Health Insurance Plan in Utah had personal information stolen after a hacker from Eastern Europe accessed the Utah Department of Technology Service's server. Initially, the number of those affected stood at 24,000, yet, according to UDOH, that number grew to 780,000, with Social Security numbers stolen from approximately 280,000 individuals and less-sensitive personal data stolen from approximately 500,000 others. The reason the hacker was able to access this information? Ultimately, it was due to a weak password.

2. Emory Healthcare. On April 18, Emory Healthcare in Atlanta announced a data breach after the organization misplaced 10 backup disks, which contained information for more than 315,000 patients. The 10 disks held information on surgical patients treated between 1990 and 2007 at Emory University Hospital Midtown and the Emory Clinic Ambulatory Surgery Center. Of the 315,000 patient files, approximately 228,000 included Social Security numbers, with other sensitive information at risk including names, dates of surgery, diagnoses, and procedure codes.

3. South Carolina Department of Health. An employee of the South Carolina Department of Health and Human Services was arrested on April 19 after he compiled data on more than 228,000 people and sent it to a private email account. Approximately 22,600 people had their Medicaid ID numbers taken, which were linked to their Social Security numbers. Others had names, addresses, phone numbers, and birth dates stolen as a result of the act. The former employee, Christopher Lykes Jr., was charged with five counts of violating medical confidentiality laws and one count of disclosure of confidential information. 

4. Howard University Hospital. Toward the end of March, Howard University Hospital in Washington D.C. notified approximately 34,503 patients of a potential disclosure of their PHI that supposedly occurred in late January. A laptop, which was password protected, was stolen from a contractor's vehicle, yet, according to the hospital, no evidence suggested any patient files were accessed. The records stolen did contain Social Security numbers for many of the patients affected. Today, the hospital requires all laptops issued to Howard University Health Sciences employees to be encrypted.

5. St. Joseph Health System. In February, St. Joseph Health System, in California, alerted approximately 31,800 patients of a possible security breach at three of their organizations throughout the state. According to the system, security settings were "incorrect," which allowed for the potential breach. Information accessed didn't include Social Security numbers, addresses, or financial data, yet patients' names and medical data were vulnerable. The records at risk were mostly for inpatients who received care from February through August of 2011. The data, the organization said, would have been available through Internet search engines from early 2011 to February 2012.

6. Indiana Internal Medicine Consultants. In early February, a stolen laptop resulted in a breach of 20,000 patient records at the Indiana Internal Medicine Consultants. The organization reported the incident about a month later, and the records were recovered. Although little information about the case exists, a lawsuit was filed as a result and an arrest was made. 

7. Our Lady of the Lake Regional Medical Center. Between March 16 and March 20, a laptop was stolen from a local physician office at the Our Lady of the Lake Regional Medical Center in Baton Rouge, La. The laptop contained limited health information for more than 17,000 former ICU patients, including patient names, ages, races, and dates of admission and discharge from the ICU. The organization said there is no evidence the information had been misused, or that there was any malicious intent. As of May, the investigation was still underway. 

8. Memorial Healthcare System. On January 27, Memorial Healthcare System in South Florida learned of an employee who accessed patient information, as well as a second employee who accessed patient information with the intent to process fraudulent tax returns. The organization notified 9,497 patients that information including names, dates of birth, and Social Security numbers were accessed, yet, according to their statement, no medical records were taken. Letters weren't sent out to those affected until April 12^th, in an effort to not impede on investigations conducted by law enforcement. The two employees have since been fired. 

9. The Kansas Department of Aging. In January, a laptop computer, flash drive, and paper files were stolen out of a car belonging to an employee of the Kansas Department of Aging. The Social Security numbers of approximately 100 patients were stolen, while 7,000 other seniors, and their information, were put at risk. The stolen data included names, addresses, dates of birth, gender, in-home services program participation information, Medicaid identification numbers, and more. The Social Security numbers stolen were of those patients participating in the Senior Care Act program. The organization contacted those patients via phone and sent mail notifications to all others affected.  

10. The University of Arkansas for Medical Sciences. In April, the University of Arkansas for Medical Sciences investigated a breach after a document wasn't properly redacted. Approximately 7,000 patients were affected after an unidentified physician sent financial information on a patient to someone outside of the UAMS offices in mid-February. The physician didn't remove all identifiers of the patients, such as names, account numbers and dates of services. Of those affected, most were in the interventional radiology program at UAMS between 2009 and 2011. The man who received the information via email claimed he hadn't released it to anyone.

Yes, I know... these security breaches are not bloopers, they're disasters.  Yet, a lot of these breaches could've been easily prevented.  Take, for example, the two instances where a laptop was stolen and confidential data was compromised.  1 of these situations, in my opinion, shouldn't be in the top 10 and that's the one where the laptop was stolen, but the files were encrypted.  There was no evidence that the info had been decrypted or that it was in harm's way.  Yet the other scenario involved a laptop without encryption, which should be standard when deploying any type of mobile device.  Bottom line is we need to make sure that we've covered all of our basis when information security is involved.  Patient data is too sensitive.

Do's and Don'ts of Cloud Computing

Taken from http://www.healthcareitnews.com/news/9-dos-and-donts-cloud-computing:

At this point, the trend toward cloud-computing is strong, even though some are still skeptical of its "chaotic" use and its ability to meet the needs of health IT professionals. Mariano Maluf, CTO at Atlanta-based GNAX, says now is the time to strongly consider the cloud – while keeping some basic tips in mind.

"The shifting IT landscape is prompting more and more questions around cloud computing models and their immediate value proposition," said Maluf. "Changes in work style and device formats, coupled with new application platforms and delivery methods, all coalesce to challenge the IT status quo."

"Given the state of technology today, it's clear that when used in the right context, cloud computing and storage models can be effectively leveraged today, with tangible benefits and real value," he added. "This is an irreversible trend, so caution does not mean inaction; you will be better off by learning how to live in this new reality sooner rather than later."

Maluf outlines nine basic dos and don'ts of cloud computing.

 1. Do learn about cloud technologies. This includes industry trends and available services, said Maluf. "All clouds are not created equal, and there are important distinctions, [like] consumer-oriented versus enterprise-grade," he said. "Research cloud service providers and their capabilities and services."

2. Don't be fooled by pitches. Beware of the one-size-fits-all pitch, said Maluf. "Seek a blend of prescriptive and flexible strategies, focused on your particular set of challenges."

3. Do assess your environment and capabilities. This will allow you to identify short-term and long-term opportunities, Maluf said. "Understand your application landscape, and categorize and prioritize environments."

4. Don't assume the cloud is a "cure-all" remedy. There are environments that can't – and shouldn't – be migrated initially, said Maluf. "Cloud is a multi-dimensional solution, so there's life beyond the private cloud," he said. "Hybrid models, secure, multi-tenant public cloud infrastructures, or enterprise-grade cloud storage platforms can be very effective answers."

5. Do map certain services. This includes DR, image archiving, and application delivery against your assessment, said Maluf. "Some cloud quick-wins will hopefully become obvious next steps."

6. Don't forget the details. Maluf said to be sure to review aspects such as architectural dependencies, refresh cycles and application latency tolerance. And, he added, don't neglect application performance management analysis, "otherwise, pre- and post-cloud migration user experience will be hard to quantify, and SLAs will be tough to agree upon and effectively manage."

7. Do start with a strategy. Start building an integrated cloud strategy, and an associated roadmap, said Maluf. "Focus on incremental value by emphasizing infrastructure delivery and management simplification," he said. 

8. Don't delay. Now is the time to start thinking about the cloud, said Maluf. "There's a price for waiting, so pursue your cloud strategy with caution, but do take incremental steps."

9. Do remember that change management matters. "A cloud strategy isn't just about changing the 'plumbing,'" said Maluf. "Abstracting infrastructure layers and providing metered, self-service elastic growth requite a multi-layer approach."

This article offers good advice for businesses in general interested in moving over to a cloud environment of some sort.  The underlying truth in this article... cloud computing is the future, might as well embrace it now.  The article places a sense of urgency on migrating to the cloud.  Healthcare still thinks cloud computing is murky waters, however, strides have been made to make sure data is secure and that the cloud is healthcare friendly.

Legalities of Social Media

Taken from http://www.healthcareitnews.com/news/5-keys-legal-issues-social-media:

Social media is without a doubt playing a major part in patient engagement, marketing efforts, and an overall sense of communication within the industry. Yet with the growth of these tools come other issues to keep in mind — like the legal ramifications of using outlets like Twitter, Facebook, and LinkedIn within a healthcare setting.

"These social media sites have moved beyond the novelty stage and into the mainstream," read a recent whitepaper by Actiance. "They have become so pervasive that they have emerged as effective tools within the corporate setting as well. The line separating the recreational use of these tools from legitimate business purposes has become increasingly blurred."

"The potential legal issues that can arise from social networking activities run the gamut," it continued. "Privacy, unauthorized activities, and intellectual property issues stand top-of-mind for many individuals and enterprises. Other areas, such as content ownership, regulatory compliance, and even criminal activity, are impacted by social media, too."

Here are five keys to the legal issues of social media, as outlined in the report.

1. Privacy. According to the report, no issue resonates so strongly with the legal aspects of social media as privacy. "With so much content out there, and so many ways to access these social media tools, privacy has become somewhat elusive for many," it reads. "From a legal standpoint, whether an individual has a reasonable expectation of privacy or not is the critical factor in determining whether one’s actions are protected by privacy laws." When thinking about social media in the workplace, the report notes that determining if an employee has a reasonable expectation of privacy hinges on whether or not the website is password protected. "If it is, then the argument that the employee has a reasonable expectation of privacy is strengthened. If not, then employers may have the justification to monitor the activities of that site." The key takeaway, the report concludes, is individuals should always be mindful of privacy settings on these sites, along with the corporate policy for using social media tools within the enterprise.

2. Content ownership. As with many sites that are "content-rich," the issue about who owns the content is inevitable, according to the report. "Typically, each site has its own 'Terms of Use page,' detailing the extent of its rights over end users' content," it reads. "Great care must be taken by end users to fully understand what they are getting into." For example, it continued, when you close a Facebook account, do you no longer own the rights to your content? "At the very least, end users should think twice about disclosing sensitive or proprietary information on social networking sites," it notes.

3. Intellectual property infringement. "Not surprisingly, given the abundance of content and the myriad ways to access it, intellectual property infringement is an area generating much legal interest," reads the report. For example, copyright infringement comes into play when there are photos, videos, graphics and blogs being exchanged and posted on social media sites. "From posting someone else's photo on a Facebook wall to sending a song to a friend via Twitter, using any third-party content without permission can result in both criminal and civil liability." It adds that protection of trade secrets is another aspect of intellectual property infringement that warrants attention; for example, if an ex-employee shares a former employer's confidential information, they would be held liable.

4. Unauthorized activities. Several legal issues fall under the umbrella of unauthorized activities, according to the report, with many of these issues evaluated under the same criteria that existed before the advent of social media platforms. The report outlined several unauthorized activities – including harassment, discrimination, defamation, disclosure of confidential information and criminal activity – which are all addressed in the same manner as if they happened offline.

5. Regulatory compliance. The last key area were social sites have gained more scrutiny is in regard to regulatory compliance. "The high-profile financial scandals of the last 10 years have brought to the fore front tighter regulation of certain industries," the report reads. "The rapid growth of social networking sites has driven these industries to develop or refine guidelines specifically for social networking, or, at the very least, electronic communications." When looking at healthcare, HIPAA requires a patient's identity and personal health information to be protected. "Specifically, it applies to 'covered entities' and 'business associates' – essentially anyone with patient demographic or clinical information."

Social Media has clearly taken over all aspects of business including healthcare.  Most hospitals have a social media account of some sort.  Usually the postings revolve around accomplishments or recognition received and serve as a means to market the hospital.  A lot of the legal issues of social media are obvious, yet some are not that cut and dry.  For example, would you ever think that something you post on facebook could get you accused of intellectual property infringement?

Tech Team for Docs

Taken from http://blogs.computerworld.com/17068/supporting_technology_infrastructure_for_physician_practices:

Technology is being used to create an integrated system of care that connects patients, clinicians, payers, and support organizations so that all key stakeholders can exchange information more effectively. Among the business challenges that confront the healthcare industry are service, quality, safety, rising costs, and a shortage of skilled staff to meet the needs of an expanding number of stakeholders.

With an ever increasing amount of information being transferred electronically -- from not only healthcare providers but all stakeholders in the US healthcare system -- IT professionals are taking a stake in how to design and implement electronic healthcare records (EHR). When the EHR system is down, it can cripple a healthcare organization and trickle down to the key stakeholders involved. For instance, physicians cannot effectively see patients if they can't pull up their patient records.  When systems are down, they are unable to document visits for insurance, order tests with labs, or provide referrals with associated hospitals or specialty groups.  Physician practices would benefit tremendously from support across a spectrum of services, including remote monitoring, help desk and technical field support.

Stabilize Your IT Efforts

Supporting the automation of an EHR within a healthcare network creates many challenges. For instance, one physician practice may seem insignificant from an IT perspective but usually it's hundreds of practices that need to be tied back to a hospital and associated payers. This can be an IT nightmare, and happens when practices do not have an in-house healthcare IT professional and use outsourced IT resources that are not experienced working within healthcare IT.  Today, such resources are woefully inadequate, falling short of correctly automating and supporting practices. 

Ultimately a "Tech Team for Docs" comprised of healthcare IT professionals, would remedy such a situation.  The team would evaluate the current state of the target model office environment to understand the primary applications being used in order to automate processes.  An initial assessment would include the examination of gaps in coverage for meeting a secure and effective healthcare IT network infrastructure. The next step would be the development of a clear roadmap of all milestones, activities, timelines and costs associated with meeting the specific requirements derived from an initial assessment.   

Workflow in healthcare is an important term for the healthcare IT Professional and needs to be part of an initial assessment.  The workflow describes the full process of how the office, patient, hospital, payers and associated groups work with each other -- from the moment the patient calls to setup an exam, to the billers working on the claims.  Healthcare organizations receives hundreds, maybe thousands, of documents each day --all of which contain data that needs to be entered into back-end systems.

There is a need for ongoing support that proactively and remotely monitors mission critical systems (early indicators, rapid responses), and offers help desk support or on-site field service support.  Help desk support can troubleshoot and correct the majority of practice-level issues.  It looks at the most current and most requested research, and interprets how that affects the day-to-day clinical practice.  With so much involved in installing a new system, it's not possible for an office to learn everything about the software in the first couple of months. The help desk provides information and assistance to a practice's users of the computer network, streamlining traffic, activity, and third parties on behalf of a physician practice.  It also helps in minimizing communications that can occur when multiple vendors are involved.  If remote monitoring or help desk support can't resolve such issues, then on-site field service support can be valuable.

"With EHR implementation comes the need to have a trained and skilled IT manager to oversee issues like hardware and software upgrades, network connectivity, and the assured privacy and security of patient health information," states Dr. Amanda Parsons, Assistant Commissioner for the Primary Care Information Project at the NYC Health Department.  "In fact, we have made it a mandatory component for practices who wish to receive subsidized licenses or technical assistance from us because we have learned over time that those who don't get IT support end up with complications that hinder practice workflows and negatively impact patient care."

IT managers don't want to be called into the physician group in the midst of a crisis. By being proactive before any issue causes a surprise and working with a carefully chosen IT resource -- a "Tech Team for Docs" -- should prevent calamities and offer support across the entire spectrum of a physician organization for remote monitoring, help desk, and field service.

This is actually something that we've had at St. Francis Hospital for quite some time now.  We call this team Physician Support Services and it is a team that I used to work for.  PSS basically works with doctor's offices and oversees their implementation of EMR and a practice management system.  PSS then provides ongoing support of these applications and IT infrastructure.

What Mobilty Really Means to Healthcare

Taken from http://blogs.computerworld.com/healthcare-it/20545/what-mobility:

Much thought and focus is being devoted to the future of health care delivery and the role that  mobility will play. For example, Fierce Mobile Healthcare’s Sara Jackson recently brought up an interesting question: will hospitals need chief mobility officers? She argues that mobility represents a transformational paradigm shift in our ability to deliver and receive care, and such a shift needs an enterprise-level focus that crosses people (HR/COO), process (COO) and technology (CIO/CTO) functions.

But while organizations and solution providers are identifying mobility needs and executing mobility programs, they often fail to think deeply about what mobility truly means. As a result, mobility is often defined in narrowly technical terms, with the focus placed on devices (iPhone, Blackberry), operating systems (Android, Blackberry OS, iOS, Symbian, and others), and the related issues of signal coverage, bandwidth (3G/4G/LTE), system security, and data management.

However, mobility in health care is about more than just mobile devices. For example, when I asked fifteen Kaiser Permanente physicians what mobility meant to them, I got many answers: “remote monitoring,” “care anywhere,” “telemedicine,” and “virtual diagnosis.” All focused on the ability to provide service anywhere; none dwelled on technology.

All of which brings me to my central stance: The most effective way to frame a mobile strategy is as an ecosystem comprised of multiple components that work together to enable mobile behavior.

Patients, providers, and payers are already buying into the mobile way because it is convenient and effective. Care interactions are happening in an increasingly wide range of locations: hospitals, rural clinics, mobile health vans, homes, or even during the course of a person’s daily activities. The core objective of a mobility strategy should be to develop processes, organizational structure, and technologies that support and nurture these interactions.

With a mobile strategy focused on outcomes, we can make these experiences even richer and more capable, delivering daily care and monitoring, critical care, health administration, specialty care, and ancillary support services “anywhere, anytime.” As David Aylward points out in his HBR Blog, mobile health could be a major force multiplier, empowering multiple constituents by breaking physical boundaries and providing true end-to-end information transparency across the care continuum.

By thinking about mobility as a business and functional proposition, not merely a technical one, we can use the familiar “people, process, technology” framework to develop some useful models for a mobile environment.

We already know that the people will be mobile. The process—the health care organization’s core operating model, its end-to-end process of delivering care to its customers, its malleability to the new care continuum—should be amenable to a world where physical boundaries are immaterial—even irrelevant.
The technology then becomes whatever is necessary to deliver that experience in a scalable, secure manner while adhering to the needs and standards of each health care organization. Take some simple examples: a patient’s health records should be instantly available no matter where they are: hospital, clinic, or pharmacy. From the care professional’s perspective, mobility might mean the consistent ability to access support resources no matter where they are, whether it’s traveling from location to location, or even room-to-room within a single facility. Mobile devices may play a part in delivering these services, but they’re only the visible tip of a much broader supporting infrastructure. In some cases, the endpoints that deliver these mobile services may not be mobile themselves.

So, while gadgets and applications are glamorous and exciting, the true measure of mobility is far broader and multi-dimensional than just the devices we hold in our hands.

I guess you can say this article is all about perception.  For us IT folk, we think of mobility in terms of phones, tablets, and laptops.  In this article, we learn that healthcare professionals have an entirely different meaning for it.  For the most part, technology in terms of electronics devices was not their idea of mobility.  It's also not that far off, however, as technology does play an important part in things like remote monitoring, care anywhere, telemedicine.

Social Media Site for Healthcare

Taken from http://www.technewsworld.com/story/74445.html:

Former Sun Microsystems CEO Jonathan Schwartz is offering caregivers a social networking service designed to be free of confusing privacy policies and invasive advertising.

Social networking is far older than Facebook, MySpace or even Friendster, according to Schwartz, CareZone founder and CEO. Family is actually the world's oldest social network, and whether by birth or by choice everyone is pretty much part of it.

However, this original social network doesn't always make for a good fit with today's online social media, he maintained -- especially when it comes to privacy.

For many social media sites, the user isn't the customer but the rather the product. The goal of CareZone is to change this so that productivity and privacy don't have to be mutually exclusive.

"The network's goals are to serve the needs of those that care for their parents, their children or the loved ones we consider part of our family," Schwartz told TechNewsWorld.

"We believe with life expectancies extending nearly everywhere on Earth, and with the burdens falling increasingly on those already challenged with kids, our service is timely and high value," he added.

Entirely Private

The concept behind CareZone is to provide an online account that can be opened on behalf of a loved one, and which remains entirely private and available by default only to the person who opened it. The service, which launched this week, offers subscriptions ranging from US$5 a month to $48 a year per individual.

Accessible online, the CareZone could be used to provide a permanent reference for key information including names and addresses, blood type and allergies. It also provides a way to manage medications and therapies, including dosage, frequency and reactions.

General purpose social networks have played a huge role in encouraging people to share more, but as the online social world evolves, participants will look for networks that offer more value for their personal and professional interests. But will Schwartz's background bring the attention that CareZone might need to succeed?

"It may mean something in Silicon Valley VC circles, but consumers in virtually all markets don't know who he is," said Josh Crandall, cofounder of Netpop Research. "They won't take it into consideration when evaluating the service."

This service is thus a significant departure from the Facebook-type social networking sites that provide the usual "what you're doing right now" type of social commentary, but for this reason it could offer something unique as well.

"Launching a social network for a niche audience requires deep expertise and passion for the subject," Crandall told TechNewsWorld.

The challenge is to differentiate itself through specialization from general purpose social networks, he said. "By focusing on a particular niche, the product team must focus on building features that general purpose social networks don't have time and bandwidth to tackle."

Not a Niche

However, Schwartz doesn't even believe that there is such a selective market.

"We don't view taking care of an older parent or a child as niche: It's what the vast, vast majority of people on Earth do every day," he said.

Technology will not be a barrier, in his view. "We're focused on those that are responsible for care -- not necessarily the objects of their caring attention -- and those that are already connected via smartphones, tablets and PCs. That's 4 billion and counting. It doesn't matter to us whether your Mom has access to the network, it's whether you and your sisters do -- you're the ones whose challenges we can lighten with the smart application of basic technologies."

The fastest-growing segment on popular social networking sites such as Facebook is comprised of those 50 and older, noted Lynne A. Dunbrack, program director, connected health IT strategies, at IDC Health Insights.

"There are already plenty of people who want to share health issues, good or bad," she told TechNewsWorld, "and this could be a good extension of that."

This is one of those things that I would have to see to believe in terms of success.  I was actually shocked to see that there will be subscription costs in order to use this site.  This totally isolates itself from other social networks and this is the first one I've heard of that requires it's user community to pay up.  Would you be interested in a healthcare version of Facebook that you have to pay for?

Ethical Use of Big Data

Taken from http://www.businessweek.com/articles/2012-05-17/the-health-care-industry-turns-to-big-data:

When patients show up at a hospital, something dangerous happens: They’re looked at by humans. Because of the hustle in busy emergency rooms and admission wards, many patients get only a cursory review of their health, according to Nicholas Morrissey, a surgeon at New York-Presbyterian Hospital. Mistakes can lead to complications or missed warning signs and may increase a patient’s chance of winding up back in the hospital. So Morrissey is working with Microsoft to train computers to make the kind of snap judgments about new patients’ risk factors that hurried humans often flub. “We don’t want to take the intuition and clinical decision-making out of the process,” he says. “We want to facilitate it.”

As hospitals digitize patient records and amass huge amounts of data, many are turning to companies such as Microsoft, SAS, Dell, IBM, and Oracle for their data-mining expertise, which can help medical providers perform detective work and improve care. The so-called Big Data business has already permeated other industries and generated more than $30 billion in revenues last year, according to research firm IDC. It’s expected to grow to close to $34 billion this year in part because of increased use in the health-care industry. Crunching numbers is potentially good business for hospitals as well. By making “meaningful use” of computer systems, they’re eligible for millions of dollars in government funding from the Obama administration’s $14.6 billion program launched in 2009 to encourage adoption of electronic medical records.

The use of data-mining technology has already led to some measurable improvements in patient care. New York-Presbyterian, which started using Microsoft technology to scan patient records in 2010, has reduced the rate of potentially fatal blood clots by about a third, says Morrissey. “I wouldn’t be out there saying we’ve solved the problem, but we’re definitely making progress. That was a significant drop,” says Morrissey.

Seton Healthcare Family, a hospital system in central Texas, learned from IBM software last year that a bulging jugular vein is a strong—and easily observed—predictor that a patient admitted for congestive heart failure is likely to wind up back in the hospital. “We’ve gotten some really tremendous results,” says Ryan Leslie, Seton’s vice president of analytics and health economics.

Patients don’t usually know when their records are being analyzed in this way. Federal law prohibits medical providers from disclosing certain health information without patient consent, but there is an exemption for activities that fall under “quality improvement,” says Susan McAndrew, deputy of health information privacy at the U.S. Department of Health and Human Services’ office for civil rights. During the analyses done at New York-Presbyterian and Seton, for example, patients weren’t informed their medical records were being studied by outsiders’ software.

“People do not like to have researchers of any stripe using their electronic health records,” says Deborah Peel, founder of Austin (Tex.)-based Patient Privacy Rights. “As a matter of respect and autonomy and patient-centeredness, patients want to be asked. When they are asked, by and large they support this. It’s the not-being-asked stuff that’s really bad.”

Deven McGraw, director of the health privacy project with the Center for Democracy & Technology in Washington, disagrees. Notifying patients too often can be unnecessarily confusing. Only ask for permissions, she says, when data “is used in ways that people might not expect,” she said.

An interest debate is presented in this article.  In Seton Hospital, the use of big data has shown to have positive results in patient diagnosis using technology from Microsoft.  While the use of this technology has helped patients immensely, they are not told that their ailments are being analyzed by a third party.  The law, however, does state that the uses of big data in this manner are acceptable and that the patient does not need to be notified under these circumstances.  The other view presented here is that, out of respect, a patient should be notified when their medical information is being seen by a third party.  What do you think?

Big Data Clouds

Taken from http://blogs.computerworld.com/cloud-computing/20488/centralizing-healthcare-big-data-cloud:

Can the medical community make better use of big data, government regulations and the cloud to improve service and save lives?

There is a lot of buzz going around about big data and cloud computing, but there is also a lot of confusion about how to incorporate them for an advantage. Cloud computing is all about providing services over the network, and big data is all about analyzing lots of data to gain insights and find trends. Government regulations are all about protecting the data and forcing the owners of the data to save it, just in case.

The problem is many folks are afraid of cloud-based solutions because they feel the data may not be secure, and sometimes big data may really just contain useless or redundant (what I call fat data), and regulations are just a pain to accommodate. There needs to be a better way.

In a previous blog, Reduce healthcare costs with cloud computing, I covered the notion of hospitals transforming their data centers from cost centers to profit centers by implementing cloud services for their affiliated physicians. The idea is to solve the Health Insurance Portability and Accountability Act (HIPAA) compliance issue for doctors by using hospitals’ IT departments as central locations for patient records for all affiliated physicians. (Many physicians are lost when it comes to IT, and they are struggling to figure out how to comply with HIPAA regulations related to securing patient records.)

Taking that concept a step further, there is a possibility we could improve overall healthcare in the country while reducing costs and speeding services if hospitals joined together with insurance companies to provide centralized, secure access to patient information. Now THAT would be big data. Imagine the ability to sift through clinical data from every hospital in the U.S. to look for trends in healthcare. It would be much easier to share important test results between doctors and specialists when required. Patients would benefit by having their entire medical histories readily available in an emergency. There are thousands of examples of the benefits of moving patient data to the cloud.

All it would take to enable this capability is better standardization and security. As an example, X-ray data and other clinical information are stored in multiple formats, so it's hard to share information unless everyone uses the same application. Even with standards such as Digital Imaging and Communications in Medicine (DICOM), many manufacturers implement technology differently, so data interchange remains difficult.

The insurance companies figured out how to handle this a long time ago, as most billing data includes sensitive patient information, but much of it is done electronically. The insurance companies rely on medical billing clearing houses to consolidate records into a standard electronic format . A similar methodology could be leveraged to start on the path to cloud-based medical information. The U.S. needs to invest in a secure electronic data interchange (EDI) standard for medical data (there are EDI solutions available for DICOM already) so hospitals and insurance companies can begin to securely connect their data centers to share information and analyze big data to spot trends and speed up diagnoses. The regulatory mandates of storing patient records for life would then actually provide a benefit, as that data could be used to gain insight into the long-term effectiveness of treatments for specific diseases and positive or negative patient outcomes.

I would love to be handed an iPad rather than a clipboard at my doctor’s office to input my family and medical history.  My information would be electronically encrypted and immediately replicated to the local hospital’s database, where it would also be available to emergency room staff (as long as I approved of this up front). If I were ever in a car accident, all my medical information (such as blood type, allergies, X-rays and family history) would be immediately available, so my treatment could be more efficient and perhaps save my life.

I know some folks will have issues with their data being in the cloud, even if it is encrypted and secure, so there should be an option to opt out. For the rest of us, though, cloud-based medicine could have a dramatic impact on improving healthcare while reducing medical costs in the U.S. 

Insurance companies harbor a great deal of patient data.  The data might be even be more accurate than a patient's medical chart itself.  Think about it... every prescription, procedure, and doctor's visit is sent to the insurance companies for billing, compiling a very accurate and detailed account for the patient's medical history.  The idea of a big data collaboration with hospitals and insurance companies would create a strong base in which a patient medical record is compiled accurately and accessed easily.

Cloud Computing Reduces Costs

Taken from http://blogs.computerworld.com/16534/the_real_costs_of_healthcare:

The health care industry has always been a leader when it comes to leveraging technical innovation to provide better quality services. Wonders such as Computer-Aided Tomography (CAT) scans, sonograms and even nuclear medical imaging technology allow doctors to peer inside the human body and diagnose problems, without the need for expensive and intrusive surgery.

Although the cost of these highly technical machines can be high, they enable doctors to diagnose illnesses without the need for risky and costly surgery, which minimizes the hospital stay to recuperate, which in turn reduces those costs.

So why are health care costs still rising? Shouldn't they actually be going down?  Inefficiency drives up costs, and inefficiency in information technology can be a major factor in higher costs.

Why is this the case?

As the population grows, so does the need to keep medical records. From the time you are born to the time you die, a record needs to be kept and stored for every tooth pulled, tonsil removed or other medical procedure performed. Government regulations also dictate that doctors, hospitals and insurance companies keep these patient records available for many years, if not forever.

The problem arises from the fact that in many cases the same doctors who perform highly technical, lifesaving procedures in the hospital may still be storing patient records on paper in their office.

Have you ever tried to change your primary care physician? Have you ever had to pick up an X-ray from one doctor and deliver it to a specialist? It seems any time I or my family members change or see a new doctor or specialist, they always ask me to fill out a new chart with my insurance information, family history and medical history. Why can't the specialist just download that information from the primary care physician's office?
All of this wasted time and duplication of efforts drives up costs and adds inefficiency. Think of all the wasted office space dedicated to storing patient records!

Physicians could reduce their costs in office space and personnel and become much more efficient and secure in sharing patient data between other providers by outsourcing the storage of patient record data to a cloud service provider. One way I see for this to happen quickly is for hospitals to become the IT cloud service providers for their affiliated physicians. 

Each affiliated doctor would procure application and patient records services from a central IT department at the hospital. The physicians would scan all their records into an appliance in their office where the data would be encrypted and deduplicated prior to transmission into the cloud. Patients and doctors could access the records securely by exchanging secure electronic keys, similar to the way secure credit card transactions occur over the internet.

The doctors would use the appliance in their office to input and retrieve records. Patient records could be securely transferred between physicians and specialists by providing access to the key, and hospitals could transmit and store data in a secure fashion between their affiliated physicians and even other hospitals.

Hospitals that sign up for this could transform their IT departments from a cost center into a new stream of revenue, enable their affiliated doctors to reduce the costly burden of having their own IT staff, and provide a simple means for them to cost effectively achieve regulatory compliance for their patient records.

Some hospitals are already seeing the light and getting on board. For instance, Steve Aylward, general manager of U.S. Health & Life Sciences writes on The Official Microsoft Blog about how cloud computing promises enormous benefits for the health care world.

My hope is that soon practices such as these are standardized around the world so that we all can benefit.

A centralized national EMR solution remains the primary goal of healthcare today.  This article shows us how we might be able to achieve that using cloud technology as a means of accessing patient medical records from anywhere in the world.  Of course, in order for this to work, a computing language standard must be put in place so that different EMR applications can access and decrypt the data.  Perhaps the government can create and develop its own cloud for this purpose.

Intro to Big Data

Taken from http://www.mckinsey.com/insights/mgi/research/technology_and_innovation/big_data_the_next_frontier_for_innovation:

The amount of data in our world has been exploding, and analyzing large data sets—so-called big data—will become a key basis of competition, underpinning new waves of productivity growth, innovation, and consumer surplus, according to research by MGI and McKinsey's Business Technology Office. Leaders in every sector will have to grapple with the implications of big data, not just a few data-oriented managers. The increasing volume and detail of information captured by enterprises, the rise of multimedia, social media, and the Internet of Things will fuel exponential growth in data for the foreseeable future.

Research by MGI and McKinsey's Business Technology Office examines the state of digital data and documents the significant value that can potentially be unlocked.

MGI studied big data in five domains—healthcare in the United States, the public sector in Europe, retail in the United States, and manufacturing and personal-location data globally. Big data can generate value in each. For example, a retailer using big data to the full could increase its operating margin by more than 60 percent. Harnessing big data in the public sector has enormous potential, too. If US healthcare were to use big data creatively and effectively to drive efficiency and quality, the sector could create more than $300 billion in value every year. Two-thirds of that would be in the form of reducing US healthcare expenditure by about 8 percent. In the developed economies of Europe, government administrators could save more than €100 billion ($149 billion) in operational efficiency improvements alone by using big data, not including using big data to reduce fraud and errors and boost the collection of tax revenues. And users of services enabled by personal-location data could capture $600 billion in consumer surplus. The research offers seven key insights.

1. Data have swept into every industry and business function and are now an important factor of production, alongside labor and capital. We estimated that, by 2009, nearly all sectors in the US economy had at least an average of 200 terabytes of stored data (twice the size of US retailer Wal-Mart's data warehouse in 1999) per company with more than 1,000 employees.

2. There are five broad ways in which using big data can create value. First, big data can unlock significant value by making information transparent and usable at much higher frequency. Second, as organizations create and store more transactional data in digital form, they can collect more accurate and detailed performance information on everything from product inventories to sick days, and therefore expose variability and boost performance. Leading companies are using data collection and analysis to conduct controlled experiments to make better management decisions; others are using data for basic low-frequency forecasting to high-frequency nowcasting to adjust their business levers just in time. Third, big data allows ever-narrower segmentation of customers and therefore much more precisely tailored products or services. Fourth, sophisticated analytics can substantially improve decision-making. Finally, big data can be used to improve the development of the next generation of products and services. For instance, manufacturers are using data obtained from sensors embedded in products to create innovative after-sales service offerings such as proactive maintenance (preventive measures that take place before a failure occurs or is even noticed).

3. The use of big data will become a key basis of competition and growth for individual firms. From the standpoint of competitiveness and the potential capture of value, all companies need to take big data seriously. In most industries, established competitors and new entrants alike will leverage data-driven strategies to innovate, compete, and capture value from deep and up-to-real-time information. Indeed, we found early examples of such use of data in every sector we examined.

4. The use of big data will underpin new waves of productivity growth and consumer surplus. For example, we estimate that a retailer using big data to the full has the potential to increase its operating margin by more than 60 percent. Big data offers considerable benefits to consumers as well as to companies and organizations. For instance, services enabled by personal-location data can allow consumers to capture $600 billion in economic surplus.

5. While the use of big data will matter across sectors, some sectors are set for greater gains. We compared the historical productivity of sectors in the United States with the potential of these sectors to capture value from big data (using an index that combines several quantitative metrics), and found that the opportunities and challenges vary from sector to sector. The computer and electronic products and information sectors, as well as finance and insurance, and government are poised to gain substantially from the use of big data.

6. There will be a shortage of talent necessary for organizations to take advantage of big data. By 2018, the United States alone could face a shortage of 140,000 to 190,000 people with deep analytical skills as well as 1.5 million managers and analysts with the know-how to use the analysis of big data to make effective decisions.

7. Several issues will have to be addressed to capture the full potential of big data. Policies related to privacy, security, intellectual property, and even liability will need to be addressed in a big data world. Organizations need not only to put the right talent and technology in place but also structure workflows and incentives to optimize the use of big data. Access to data is critical—companies will increasingly need to integrate information from multiple data sources, often from third parties, and the incentives have to be in place to enable this.

Big data is one of those emerging technologies that could potentially change the face of many industries, including healthcare. 

Moving Objects With Your Mind

Taken from http://www.technewsworld.com/story/75146.html:

Researchers have developed a robotic arm that has enabled a paralyzed woman to drink a cup of coffee -- by directly controlling it with her mind. The development has raised the question of whether this approach could perhaps restore some mobility to similarly affected people in the future.  The 58-year-old woman was one of two participants in the BrainGate 2 project who controlled a robotic arm with their thoughts.  Implants the size of baby aspirin tablets in the subjects' brains let them control the robotic arms. The project is led by Brown University and includes researchers from the United States Department of Veterans Affairs, Massachusetts General Hospital, Harvard Medical School and the German Aerospace Center.  "Our device connects back from the brain to the outside world, which could be a computer, a robot on a table which could be a useful assistant, or to a prosthetic limb that would carry out limb-like functions driven by your brain," John Donoghue, a professor of neuroscience and engineering at Brown University and one of the study's senior authors, told TechNewsWorld.

How the System Works

An electrode array is placed in the brain's motor cortex, which governs the motion of the limbs. Specifically, it's placed in the hand/arm area of the motor cortex. It reads the pattern of activity among nearby brain cells and feeds those signals to a computer that then uses these signals to move the robotic arm.  "The spatial and temporal pattern of activity across many neurons in [the hand/arm] area normally determines the direction and amplitude of arm movement," Scott Currie, associate professor of neuroscience at the University of California at Riverside, told TechNewsWorld. This pattern of activity, called a "neuronal population vector," is generated if a person even imagines the arm movement.  The subject, Cathy Hutchinson, used the robotic arm to grab a flask of coffee on a nearby table, lift it and hold it to her lips. She was paralyzed and left unable to speak by a stroke nearly 15 years ago.  Hutchinson used a robotic arm attached to computers that process the information sent from her brain. These computers are currently about the size of a minifridge but could be shrunk down over time to something "the size of a smartphone," Brown University's Donoghue  said. A prosthetic limb that will be usable in real life is about 10 to 15 years away, he suggested.

It's a Long, Hard Road

The signals sent by the implant in the woman's brain to the robotic arm may have enabled her to raise a flask to her mouth, but much more work will need to be done before the system is fit for common use, Lee Miller, the Edgar C. Stuntz distinguished professor of neuroscience at Northwestern University, told  TechNewsWorld.  "There's no question [BrainGate2] is an impressive development, but if you look at the quality of those movements, it's not really something that's functionally useful at this point," Miller remarked. "Clearly it's early stage."  Miller led a study at Northwestern in which monkeys were used as test subjects for brain electrode implants.

Fit the Solution to the Problem

BrainGate2 "is certainly a very promising direction for neuroprosthetics research, but it's one of many, so I wouldn't call it the future of prosthetics," UC Riverside's Currie said.  BrainGate2 is being used for people who had a stroke, Northwestern University's Miller said. It might not be suitable for amputees or people with cervical spine issues.  For example, Todd Kuiken and Gregory Dumanian of NorthWestern University have pioneered targeted reinnervation, Miller pointed out. Here, the nerves of a targeted muscle are cut or deactivated and replaced by the remaining nerves of an amputated limb to drive a prosthetic device.

Although the article states that this technology is over a decade away, the progress that has been made thus far is very impressive.  To think that in the near future, amputees and paraplegics will be able to gain their mobility.

Valid Medical Resources Online

Taken from http://www.technewsworld.com/story/74457.html:

Online medical resources are improving healthcare, access to information and communication between patients and physicians.  Patients -- and even doctors -- who want more information about a health topic are more likely to turn to the Web than any other source, and that trend is only increasing.  This arena is one Karolyn Gazella understands firsthand. She collaborates with the American Association of Naturopathic Physicians to publish the Natural Medicine Journal, and though she started her career in traditional print media, she sees electronic information as a boon to people interested in learning more about health issues and topics.

"As an 'old school' print publisher, it was difficult at first to enter the world of online health publishing, but now I wonder most days how we lived without it," Gazella told TechNewsWorld. "Because we are an e-journal, we can reach a much broader audience."  A primary benefit of online publishing in the medical community is the ability to respond quickly to new information as it's released.  "Compared to a print journal, Natural Medicine Journal can respond quickly to important events," said Gazella. "For example, the natural health industry has ingredients sourced from Japan, so we did stories regarding the nuclear disaster in Japan shortly after it happened."  The downside of finding medical information online, however, is that it's not always true, and consumers might not understand the commercial or other interests behind the information.  "Surveys show that one of the key reasons many people use the Web is to gather health information," said Gazella. "This has become a double-edged sword because not all information on the Web is accurate or can be trusted. Armed with misinformation, patients can make life-changing decisions that could in fact cause harm to their health. On the other hand, when consumers find quality, trusted information, they become more empowered, informed and inclined to be proactive. When used properly, medical information found on the Web can be incredibly important to one's health."  Cancer sites, in particular, are sometimes suspect, according to Gazella, who also publishes a site called CancerThrivers, which offers information about cancer treatments and research.  "The worst offenders are sites that make claims for cancer cures that are not substantiated in the scientific literature or sites that encourage cancer patients to deny conventional treatment in place of an unproven treatment," said Gazella. "Cancer patients and their families are some of the most frequent visitors to health information websites, so we need to take care not to be irresponsible in our discussions surrounding alternative cancer treatments."

Health Hubs

Remedy Health Media is another company that provides a variety of sites and services for health-related information.  One of its sites, HealthCentral, provides expert patient and physician information from around 2,000 people living with over 30 diseases and conditions, including everything from heart problems and rheumatoid arthritis to cancer.  "A lot of people in the industry talk about 'living-with information,' and HealthCentral has the most expert living-with information, because of the patient experts who write it," Jim Curtis, Remedy Health Media's chief revenue officer, told TechNewsWorld. "It's the most real living-with content because it's coming from someone who's living with it."  Remedy also provides health content in partnership with Johns Hopkins Medicine on its HealthCommunities site, and it publishes one of the oldest HIV-related sites on the Web, called The Body, which was founded in 1995.  "[People] can get information about being safe, patient testimonials, symptoms and treatments, and breaking news," said Curtis. "It's a site that allows people to connect with a community about being diagnosed and find ways to live with the disease."

Making the Grade

Patients can also get information about physicians and hospitals online, facilitated by companies such as HealthGrades, which publishes profiles of 750,000 physicians in the U.S. as well as information about and ratings of most major hospitals.  "HealthGrades is the number one provider of quality healthcare information," Kristin Reed, vice president of hospital ratings for HealthGrades, told TechNewsWorld. "Our goal is to give consumers information that they need to make important quality decisions."  Information about physicians comes from public and private databases, patient reviews and physicians themselves. Hospital information comes from the Centers for Medicare & Medicaid Services. HealthGrades reviews risk-adjusted mortality rates and then assigns ratings to hospitals based on that data.  "Our mission is to guide America to its best health," said Reed. "What we're trying to do is empower consumers with the information they need. We really try to provide as comprehensive information as possible."  For people searching for information online, Reed suggests that they do thorough research using trusted sources.  "Research everything," said Reed. "Know everything you can about your condition. Don't make your decision based on reputation alone. Reputation is not an objective source of information."  Perhaps the most useful function of online medical resources is that they encourage and facilitate conversations between patients and their doctors.  "With digital medical information, it's much easier for people to get information," said Curtis. "They can be more informed and have better doctor discussions. People will read information on a website and then come up with questions to ask their doctor."

I happen to be one of those people who constantly turn to the web for medical knowledge.  Now I'm not a physician looking for medical information, but if i could diagnose myself for something simple as opposed to making a visit to the doctor's office, I'm all for it.  Usually I turn to WebMD but sometimes I want to see what other sites think, so I'll do a Google search.  Ultimately, I end up getting frustrated because the information can sometimes be inconsistent, usually based on personal opinion rather than actual facts.  This issue obviously affects physician than your average person.  This article addresses the issue and points out where physicians can find accurate medical information.

Avaya to Bring in New Medical Apps

Taken from http://www.technewsworld.com/story/74472.html:

Avaya has provided a sneak preview of several healthcare IT-based mobile applications it will be rolling out later this year at the 2012 HIMSS Conference and Exhibition now under way in Las Vegas. These include Avaya Mobile Activity Assistant, Avaya Flare Communicator for iPad, and other collaborative service offerings in telehealth and social media.  Healthcare is one of Avaya's chief verticals, said Sanjeev Gupta, general manager of Avaya's Healthcare Solutions group.  "When you look at where the industry is going, you see that mobile collaboration and telehealth -- two areas of focus for us -- has become a critical area for firms. There are (US)$300 million to $400 million worth of opportunities in this space," he told CRM Buyer.  The common themes running through Avaya's next set of product releases include care coordination, patient interaction and telehealth/home-care delivery, said Gupta.  The Avaya Mobile Activity Assistant, for example, is a "closed-loop" HIPAA-compliant mobile application that prioritizes and consolidates nurse call alerts, critical result notifications, stat requests, and coworker messages.  It will be first available on the iOS mobile platform.  "What we did was create a single client that combines all of the communications forms that a nurse needs, from text messaging to phone calls to alarms and notifications," Gupta said. "The entire history of this communication is maintained on the system's back end."  Mobile Activity Assistant also lets users see if their coworkers are available -- it features "presence" in other words -- and gives them the ability to contact via voice or text. It also comes with  preconfigured text messages to speed responses.

Enabling the iPad in the Hospital

Another new product release will be Avaya Flare Communicator for iPad for the healthcare industry. It is a tablet application to be used over secure WiFi and 3G networks.  It too comes with presence functionality, so the user can see if a specialist or clinician or a patient's particular doctor is available. Users can initiate instant messages, emails, calls and conferences as well. Flare Communicator for iPad also lets users share other important data such as X-rays and lab results.  Such applications are in high demand by hospital CIOs right now, Gupta said. "Enabling mobile devices with secure applications is a big challenge."  For example, the CIO of a large healthcare organization including a teaching hospital is in the process of equipping its doctors, residents and clinical staff with 3,000 iPads, he noted, so they can access patient records and better communicate on the go.  Social Media Outreach Avaya is also introducing Avaya Social Media Manager later this year. Part marketing, part social media and part contact center and scheduling app, the product inserts a doctor's office into a social media conversation to offer relevant information -- and hopefully, a chance for the prospect to make an appointment.  Such conversations must be initiated carefully, Gupta acknowledged. He doesn't envision doctors or hospitals making unsolicited offers via the social media application. Rather, it will be used as part of an ongoing conversation.  "Suppose someone asks for a recommendation for a particular doctor's specialty or asks about which hospital is best for a procedure. Using Social Media Manager, the office can offer information -- say an article in U.S. News and World Report listing the top 10 hospitals where that type of surgery has the greatest success rate. Then, if the person is interested, the application can offer an appointment."  Such a product will be better received by a younger generation of patient, Nucleus Research Vice President Rebecca Wettemann told CRM Buyer.  "However, concerns about privacy and the security of social networks will make a lot of people think twice about sharing information over a social network," she added. For this reason, "we have not yet seen a lot of adoption of social media in the field of medicine."  By contrast, tablets have significant potential in this space, noted Wettemann. "We think we will see, as tablets become more broadly adopted, such applications grow -- especially as healthcare IT providers show the real benefits they provide to patients."  There are a number of security measures in both the social media and the tablet applications, Gupta said. With tablets, for example, the application can erase all patient data remotely if a tablet is lost or stolen.

Expanding Telehealth Opportunities

Avaya also debuted its Telehealth and Home-Care Delivery application at HIMSS.  A video communication tool, it gives home care nurses and rural hospital workers access to specialists around the world.  Users can initiate a video conference by selecting a link from an email. A nurse could conduct certain diagnostic tests -- for example, taking a throat culture. Then, the doctor at the other end of the video transmission would receive high-quality images of the test's results. "Instead of driving two hours to an appointment -- for someone in a rural area -- or worse, having to wait several months for an appointment to see a specialist, a nurse at a local facility can help facilitate a video conference with an off-location doctor," Gupta said.

Avaya is hitting the nail right on the head with it's latest array of healthcare driven mobile apps.  Focusing on ways for medical professionals to communicate fast and effectively is very important.  I think that utilizing Wi-Fi is very important since cell phone reception in hospitals can be spotty and, in some areas, not even allowed.  At my organization, we are always trying to find ways to utilize Wi-Fi as much as possible to provide a more reliable means of receiving email, texts, and video calling.  Taking advantage of Wi-Fi also cuts down costs on corporate phones since 3G is not being used as much.

More on BYOD and Encryption

Taken from http://www.technewsworld.com/story/75245.html:

The growth of the bring-your-own-device (BYOD) trend, in which employees use their personal devices in the workplace, is proving to be a huge headache for IT.  Often underfunded, understaffed and overworked, IT now has to cope with a plethora of different devices running different operating systems -- or different versions of an operating system. These devices often contain sensitive enterprise material and are basically not secured.  That has led to a flood of vendors offering mobile device management (MDM) and mobile security products. These will let corporations enforce policies, remotely wipe devices and control access to sensitive corporate information on devices.  But what if a device is lost and the owner doesn't even realize it for hours? How can you locate a device or wipe it if you don't even know it's lost? And what if the  employee doesn't report the loss because the device is a personal rather than a corporate one?  "The mere fact that the owner of the device is not the organization itself or an entity that has met compliance requirements may give chief privacy officers and legal staff serious cause for concern," Stephen Cobb, a security evangelist at ESET, told TechNewsWorld. Further, "77 percent of employees never reported their devices lost, and 160,000 portable devices are left in taxis in Chicago every year."  "The primary enterprise app that BYOD employees want on their smartphone is corporate email," Dan Shey, a practice director at ABI Research, told TechNewsWorld. One of the "biggest concerns" with that is that more corporate communications, and possibly data, are leaving the workplace. "At a minimum, smartphones need password protection, but activating encryption on the device is even better."  Providing security on mobile devices "was cited as one of the top priorities for IT security professionals for 2012" in McAfee's State of Security report published in March, Ratinder Ahuja, chief technology officer and vice president of mobile, network, cloud and content at McAfee, told TechNewsWorld. The company surveyed nearly 500 companies with 1,000 or more employees worldwide.

When to Encrypt

Mobile devices should be encrypted "wherever highly sensitive data are found on the device," Tom Wills, managing director of Singapore-based consultants Secure Strategies, told TechNewsWorld.  Such data includes the power-on and screensaver password, the SIM card, passwords to open apps or certain functions within apps such as logging into an e-commerce retailer account, confidential email, instant messages, SMS messages, and confidential data and medical files.  "The more sensitive and valuable the data, the greater the need for stronger encryption," Wills said.  Many enterprises take a risk management approach to security, but this shouldn't be used when deciding whether or not to encrypt data, Wills warned.

Types of Encryption

Enterprises can opt to encrypt applications or for hardware encryption.  For example, Enlocked offers an app that secures email in transit through a simple plug-in. It works with popular email systems and runs on PCs, Macs, iPads, iPhones and Android smartphones. Users can secure individual messages. The company has announced plans to offer an enterprise-level version.  However, software encryption is CPU-intensive and tends to slow applications down, Secure Strategies' Wills pointed out.  Hardware encryption is another option. "The nice thing about hardware-based encryption is the performance," Randy Abrams, an independent security consultant, told TechNewsWorld. However, "there is no universal hardware-based encryption protocol for the myriad of devices out there."  On the other hand, application-level encryption is portable "and allows for flexibility in providing different levels of encryption for different needs," Abrams pointed out.

Taking Encryption Further

Essentially, only the newer mobile devices in the market offer hardware-level encryption, Xuxian Jiang, chief scientist at NQ Mobile, told TechNewsWorld. Both iPhones and iPads running iOS 4.0 or later offer hardware-level encryption but earlier versions of the OS do not. Android devices running Honeycomb or Ice Cream Sandwich also support hardware-level encryption.  As currently implemented, however, weaknesses in both Android and iOS "make application-level encryption preferable when IT is developing corporate apps," ESET's Cobb said.  "NQ Mobile is currently exploring the effectiveness of different encryption approaches for mobile devices," Jiang said. Meanwhile, "the major mobile software platforms are shifting towards making encryption available, and the underlying device hardware is becoming powerful enough to warrant widespread encryption."  Organizations "are going to have to encrypt sensitive data transmitted to and from mobile devices, and data stored on those devices," ESET's Cobb remarked. "Courts may well find, if not now then before too long, that failure to encrypt falls short of a reasonable standard of due care."

Tailor Encryption to Your Needs

Before implementing encryption on all mobile devices in the enterprise, it's best to think through what's needed and where.  The encryption schema should match the mission of the organization and the role of the mobile device within that structure, ESET security researcher Cameron Camp told TechNewsWorld. For example, the salesforce may need encryption of traffic and files, while employees with mobile access to critical intellectual property "would need more advanced protections like fewer failed passwords before the device auto-wipes the data, remote wipe by IT over the air, and GPS-based tracking."  Organizations should start by defining their needs, or they will "end up trying to find solutions for the wrong problem," consultant Abrams said. Once an organization understands its topology, it can implement appropriate access control. Then assessing security needs for the rest of the data "leaves more tightly defined requirements that solutions can be properly aligned to."

Encryption plays an integral part in making sure sensitive information does not end up in the wrong hands.  This was something that always existed, however, with the introduction of BYOD, there is now this sense of urgency to make sure information is kept within an organization.  The key challenge that was brought up in this article is making sure data does not leave the organization along with the device.  It is easy to lock down a computer, a laptop, or even a corporate cell phone that belongs to the company, but that's a viable option when a personal device comes into play. 

New technologies such as ForeScout CounterACT analyze the network and allows to get detailed information about who is on your network.  This is a hardware-based appliance which means nothing gets installed on a user's personal device.  We are currently using a demo of this at the hospital and, contrary to what the article said, everything is viewable from PCs, laptops, iPhones, Androids, and even printers.

There are still kinks to work out concerning the whole BYOD subject.  While there are pros and cons to both hardware and software encryption, they are still the best options in making sure sensitive material does not get out into the open.  There are many other things we can do in our organization to help against theft of data including limiting access via a portal and preventing downloads from company shared drives.

BYOD: Bring Your Own Device

Taken from http://blogs.computerworld.com/20227/implementing_a_byod_policy_on_your_network:

BYOD seems to be one of the hottest topics in IT security right now. Every day I read about new concerns which can arise when employees access networks with their own devices. From what I experience the adoption of BYOD is on the increase.

We need to look at ways of securing mobile devices and educating users on best practices for using them. It can be very challenging implementing policies which ban the devices completely; someone somewhere will have a very compelling need for using mobile devices when they are out of the office.  A properly secured mobile device can become a very useful business tool.

New technologies have also come online which promise to do everything from detecting to blocking mobile devices on your network. There are two main things to focus on for BYOD. Firstly you need to be aware of what devices are connecting to your network and secondly you need to understand what they are been used for. A number of vendors have developed products that claim to be able to detect mobile devices on your network. If you are considering getting something in this space, I would recommend that you check if the solution can also report on what data is been copied to these devices.

You then need to understand why mobile devices are used in the first place. For most people it means the ability to access their work email when they are away from the office. For others it means the ability to access ERP and customer management systems. It is important to check if the mobile applications store any local data.

One of the biggest problems with BYOD is what happens when the devices leave your network. A device that is loaded with company data and emails is very dangerous if it were to fall into the wrong hands. Most mobile devices come with basic security features like password and gesture locks. However most people do not enable these and when they do they use very weak passwords and typing in long passwords on a small screen is time consuming. The inbuilt security features of mobile devices should also be treated with caution as bugs and flaws can be found with them. An example of this was a bug with the way a smart cover could be used to unlock an iPad 2 when running certain versions of the Apple iOS.

You also have the problem of what becomes of the data on mobile devices when an employee leaves their job. In the past you handed back your laptop and your logon account was disabled when you moved on to another job. I don't think it will be well received when you ask an employee to hand over their smart devices so that they can be erased.

If you are going to allow BYOD on your network, the task of educating employees on best practices for securing their devices should be a top priority. Complex passwords to unlock devices should be mandatory and try to spot check if users are adhering to this policy. If you have to give users access to business applications, try and use web portals as much as possible. Web portals avoid the need to store local copies of data on mobile devices. You should try and ensure that once a user disconnects from your network no company data remains on their device. A mobile device should be a window for looking in on your work, not a local copy of your work. 

BYOD (Bring Your Own Device) is definitely a hot topic and a big security concern.  Users want to link up their personal devices to their companies network so that they can gain access to company resources such as shared folders and email.  This has definitely become more of a necessity with the use of smartphones.  A good way to control devices and what they get access to is to present them with a login screen where they can either login as a guest where get limited or internet only access, or login with their user credentials give them their standard level of access they normally would get at their desk. Now although I agree that it is definitely a concern if users are saving sensitive data to their devices, but I'm not sure how it's any different than using your company's VPN.  For years, we have allowed users to login in from home using the VPN but there was never mention of security concerns.  All in all, BYOD software is a good way to monitor and control who gets what type of access.

New Age in Healthcare

Taken from http://blogs.computerworld.com/20046/glitz_glam_and_the_glimmer_of_a_new_age_in_health_care:

Many wonder how information technology can shape the future of health care. There is no better place to find that answer than at the 2012 Healthcare Information and Management Systems Society (HIMSS) in Las Vegas. HIMSS is an annual gathering of 38,000 mobile-device-wielding doctors, nurses, IT evangelists, exhibitors, state and federal government officials, all attempting to answer that very question.

It's not an idle query, either. The U.S. spent nearly $2.6 trillion on health care in 2010. It's clear that IT has a significant opportunity to help increase the effectiveness and efficiency of the healthcare industry.

EHR growth trajectory
A couple of trends caught my eye at HIMSS, beginning with the increasing number of electronic health record (EHR) solutions available. The health care industry has been trying to move to electronic health records for years, but it can be a complicated and expensive process. Recent changes in federal regulations and incentives are intended to effectively mandate EHRs, turning the status quo upside down.

An EHR provides the necessary foundation to expand and exchange health data across organizational boundaries. For instance, by 2020, I envision being able to seamlessly receive health care services from anybody I choose, just like using my Visa card to shop at stores that cater to my interests.

For IT pros, dramatic growth in EHR systems will bring more intense demands on computing, storage, and imaging resources. These are familiar challenges, but what some may not realize is that EHR systems are not ordinary-the data supports life-critical applications, which means that these systems must be continuously available. If an organization wants to be part of the integrated health data exchange, it could be looking at billions of transactions in a single year.

Also, increased variety in EHR solutions also makes it more difficult to figure out how to accept data from other organizations. Data standards like ICD-10 can help. But there are many types of critical data that remain a challenge, including encounter information. And frankly, that's the low-hanging fruit. As health care organizations move toward a more preventative approach to health maintenance, the types and volume of health data will expand. After all, wouldn't you want information like your preventative health alerts and record of healthy activities to travel with you?

Volume, velocity and variety of medical data
Another game changer in healthcare is the personalization of medicine based on the analysis of large cohorts of historical data. A presenter at HIMSS mentioned, studies suggest that it takes an average of 17 years for research evidence to reach clinical practice. Instead, imagine the ability to bring evidence from thousands of cases over decades directly to the point of care in every patient encounter, providing treatment options contextualized to the individual patient.

Big data technologies and their ability to digest structured and unstructured data are key to making this vision a reality. For example, health care organizations have been storing images (e.g. X-ray, MRI, CAT) electronically for quite some time; however, the resolution of the images has been increasing, while more and more organizations are using software for analysis, in addition to storage and retrieval. Continuously analyzing large numbers of high resolution images will require the ability to handle data at the scale of companies like Google or Yahoo. Fortunately, if the number of HIMSS exhibitors is any indication, this message has been received loud and clear by the industry. That's a good thing, because this is an area where we need to move quickly.

From the perspective of IT, health care has been relatively quiet industry for decades. That has changed. There is immense opportunity to innovate and make a difference. The pieces exist to make health care better; we just need to put those pieces together. The black box is open.

 I couldn't agree more with the last paragraph of this article.  I have worked in the healthcare IT field for just over 4 years now and there has been so many changes to our environment.  When I first began, there was sort of a mixed-bag of technologies.  Most systems, however, were old archaic ones based off of Unix and even MS-DOS (and yes, I know this is not shocking to a lot of companies out there who still work off these systems).  As I began to move forward in my career, I had seen systems that hadn't been touched in years become replaced with newer systems that offered bleeding edge technology solutions.  That means tremendous growth within the healthcare IT industry and new radical ways to look at healthcare.

EMR is quickly growing and physicians are embracing it now than ever before.  This is mostly due to an EMR stimulus plan implemented by President Obama in 2009.  This plan basically offered potentially $44,000 in incentives to physicians who go electronic.  In just one year, the amount of St. Francis affiliated physicians who have adopted an EMR solution is more than tripled.  In 2011, a New York-based research firm estimated the U.S. EHR market at nearly $15.8 billion and predicts it will rise to $31.9 billion in 2015.  The goal is to have a system which integrates all EHR so that it may be available anywhere in the U.S.  What this means is basically if you need to be hospitalized for any reason while being on vacation at, let's say, Honolulu, your medical records can be accessed at the hospital where you are receiving treatment.  Although we are getting a step closer to that ultimate goal, we are ways away from that coming to fruition.  The biggest challenge I see is integrating the many varieties of EHR into a system that would allow them to talk to each other.