CARE ON OUR OWN TERMS.

We look at how patients are becoming consumers and are driving the growth of virtual technology in healthcare.

One of the most relevant discussions for the future of UK healthcare, was not taken in any formal setting. My colleague was not visible on my Skype screen, and I was some 500 miles distant, sitting on my sofa, drinking tea.

It is an irony that is not lost on either of us. At a time when the key assumption of the benefit of the HIMSS  2018 Conference, is face to face interaction, my counterpart Kaveh Safavi of Accenture is eloquently discussing the essential benefits of his Presentation on virtual healthcare, that he made just a few hours earlier sitting in Barcelona; and I am nowhere to be found.

“Virtual healthcare” has taken over as the buzzword from the more difficult term “A.I”, which nobody could understand. And it is not before time. If the WHO is saying that by the year 2030, we will have a shortage of some 15 million healthcare professionals – the one thing we don’t need is to carry on putting in place more and more clinics, with longer and longer waiting times, for an ever increasing number of patients, with nursing staff that we do not have. Better option is first enabling our existing resources to work optimally.

We have reached a critical moment where the population (that’s you and I) – are increasingly comfortable using our smartphones, our Apple Watches, our connected meters, etc – to deliver our our health data to responsible health people who can manage this. But our health service providers are standing still in their acceptance that things have to change. And so, if this remote interaction works – and the technology exists to bring health data remotely into the distant screens – why is the rate of traction in Europe and certainly the UK – so slow?

The answer is many and varied, and it comes from not communicating the benefits – and also a myopic fear on the part of our providers, of losing their jobs or reducing their salaries. From experience of automation in the commercial sector, neither of those latter scenarios actually would take place.

So far, virtual healthcare has been limited in its explanation, to automatically registering a patient appointment – to go to a clinic, let’s say. But this misses the point. The real benefit is far deeper than that. If we associate virtual healthcare with long standing conditions, let’s say Diabetes for example – (where remote tech is now starting to get traction) – patients and providers will get the immediate benefit of more rapid diagnosis, more motivated and engaged patients, far less cost per patient in monitoring. And they need never visit a clinic at all. In some clinics, holograms have taken over from even seeing a real person.

In short – virtual healthcare is convenient. It also increases the “quality” of the service provided; Because sure if things are wrong and your data is untoward – only then do you go to your clinic, and your Nurse will have far more time to see you, and your discussion will already be personalised and entirely based on the health data you have already sent, in real time, through the very technology you are already wearing on your wrist. You will not be rushed out of the door.

I take a pause in my dialogue with Kaveh and glance at my Apple Health app on my watch – my heart is beating a bit quicker, apparently. I think I’ll take another cup of tea.

COCIR launch new Healthcare Roadmap in Brussels.

There is a great deal of benefit from being connected with our nearest neighbours and being aware of and part of their healthcare initiatives on a broader scale.  We are pleased to publish the latest announcement.

The Integrated Care Alliance (ICA), of which COCIR is a founding member, has launched today its ‘Multi-Stakeholder Digital Health Roadmap’ in support of Integrated Care. The Roadmap is being launched at the 18th International Conference on Integrated Care in Utrecht hosted by the International Foundation for Integrated Care (IFIC).

The Roadmap follows up on the ICA’s successful Call to Action ‘United Towards Integrated Care’ launched in the European Parliament in June 2016. The ICA partners have worked through the points identified in the Call, recommending measures in four key areas; health policy, new care models, skills and training as well the use of digital care technologies. It also identified the need to build capacity to execute these measures at all levels – European, national and regional. The partners are also inviting those other stakeholder organisations that play critical roles in the integrated care value chain to become part of the initiative.

The publication emphasises the vital role that integrated care will play in reorienting healthcare delivery, creating systems designed to meet the needs and demands posed by an ageing population. At a time when budgetary and human resources are becoming increasingly scarce, an integrated care approach directs resources to where they have the greatest impact. Using the principles of integrated care systems engages citizens, makes provisions for patient education and allows primary and secondary prevention along with early diagnosis and intervention. Digital technologies and services can help ensure appropriate care is readily accessible outside the hospital setting.

Nicole Denjoy, COCIR Secretary General, said; “This Alliance will be key to accelerating the successful transition and scaling-up towards an integrated care mode. The multi-stakeholder approach brings the variety of approaches and insights that we need. It also provides the partners with an ideal platform of communication to share best practice and adds to the existing momentum provided by the ICA’s 2016 Call to Action. As one of the founding members of the ICA, COCIR is committed to making the work of this Alliance successful.”

The ICA is committed to strengthening and expanding integrated, sustainable health and care services across the EU Member States. The Alliance is made up of multi-stakeholder experts dedicated to sharing their experience and expertise while providing direction, advice and guidance for establishing and consolidating integrated care schemes.

By 2021, the Alliance aims to make innovative and interoperable digital care technologies central to healthcare delivery and to harmonise sharing of data plans routine in daily practice. The Alliance’s future work is fully aligned with the objectives of the Digital Single Market and Digital Transformation of Health Care in Europe.

For more information, contact:

Nicole Denjoy
COCIR Secretary General
Tel: +32 (0)2 706 8961
Opens window for sending emaildenjoy@cocir.org

IF A.I. IS SO IMPORTANT… CAN SOMEBODY PLEASE EXPLAIN WHAT IT WILL ACTUALLY DO?

We look at some examples of the  new focus in healthcare and ask; really?

The recent announcement of the upcoming HIMSS Impact 2018| Leading Digital Transformation and Big Data in Medicine – conference in Berlin later this year, coincides with an announcement in the uk from the Government, that it is now investing zillions into “AI”, to combat various troublesome diseases.

In theory,  and indeed in reality, a new focus on a different way of  handling patient information, will save time, not necessarily save money, but enable our services to do lots more. And it comes about because there are just too many people, needing too many services. And as one clinical director told me; ‘we can hardly put a new clinic in the hospital car park..”

But  at a time when most Hospitals are still coming to terms about moving from Windows XP, there are three major stumbling blocks, and it is important to spell these out before we all get too excited.

First – if the UK Gov attempts to roll out this Finance in the same way as it has done for previous bjg deals, let’s say such as COGDE or Scan 4 Safety, etc.. then nothing much new will happen at all. Those hospitals that did take up either of the above, have largely  spent money on things they were already doing – so it just became a way of getting finance but not improvement; or they embark on a lengthy process of milestones that alas could have been done cheaper and faster with existing tech in the private sector. 

The result is that those Hospitals that did not make the cut, so to say, have become confused, and do nothing, as opposed to at least try to do “something”. What we have found is that if the management of a hospital wants to advance its healthcare performance, it will do so, regardless of Gov announcements.

Second – AI is not a Hospital process, but a Community process. This means that the data from a patient does not require said patient to come to a clinic or be seen by anybody in a place called a hospital. The data is patient driven and comes from his/her smartphone, his Apple Watch, her Fitbit, etc – without anybody doing anything much. In other words, AI in health is consumer driven,   and there are already plenty of Apps that harness very specialist health data from each and everyone of us, that can already be viewed by our GP or Hospital. The secret to AI health is by increasing patient engagement.

But finally – we need to understand what all this will do to our actual lives. What AI means, is that our diabetes, our heart, our fitness, can be monitored remotely – and we ourselves will take greater ownership of our lifestyle. 

This means that conventional financial models of where money comes from and for what – have to change. The focus will be empowering the community, and paying hospitals to monitor that – rather than get paid only when we physically make a visit.

Because if this does not happen, then health provision will move to pharmacies, etc, who will provide this monitoring for us – and we will pay them money to do so, because it will be immediate and in real time – instead of waiting to see our local GP or clinic appointment.

Which in turn will distance us from the very organisations we already pay money to, to look after us.

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Is South America now worth going after?

When it comes to healthcare, it would certainly seem so. We have been monitoring where Israeli health vendors are now choosing to market their solutions.  Having seen a focus on cyber security in 2017 and 2018 at the HIMSS platform in the USA – their attention is now moving south.

This is interesting because it says what we have always suspected, that the lead time in getting traction in the UK and Europe, is just too long. Put it down to myopia or simple monotonous decision making times – other parts of the world are moving ahead of our own so called advanced healthcare, and South America is one of them, because of a faster uptake.

We publish a current editorial from Mobile and e-Health company G Medical Innovations Holdings Ltd (ASX: GMV), who have announced they will  be demonstrating its medical monitoring solutions for the first time in South America at Hospitalar 2018, commencing tomorrow in Brazil. Such a presence will enable the company to present its medical monitoring systems to a growing and dynamic region. What they say is this:

Hospitalar has been a leading trade fair in South America for the past 25 years, and is one of the most important shows in the healthcare sector for local and foreign markets.

The company will showcase the Prizma Medical Smartphone Case and Vital Sign Monitoring System with G Medical Patch (VSMS with GMP), including a demonstration of its Prizma’s User Portal and Doctor Portal and GMP’s nurse multiple and single patients view station. The Prizma has received approvals from regulatory authorities including the FDA, CE and TGA.

The Prizma enables consumers to easily transform their smartphone into a highly-reliable mobile medical device for independently managing their own health. Currently the Prizma measurements include a 1-lead ECG, heart rate, stress levels, temperature and oxygen saturation. Consumers can continuously measure, monitor and share these biometrics with caregivers and loved ones. In addition to providing immediate access to personal health indicators, the medical data can be sent to the consumers’ personal Portal where it is stored, and can be easily viewed and shared with those involved in their medical care.

 The Vital Sign Monitoring System with G Medical Patch   is a modular, easy-to-use, clinical grade solution for monitoring patients, the VSMS with GMP utilizes patented wireless technologies, proprietary information technology and service platforms. This innovative solution is ideal for monitoring patients in most healthcare settings including clinics, assisted living residences, hospitals and out-patient locations. It can be used to monitor patients at all stages of the healthcare lifecycle, and takes the burden off medical and healthcare personnel, while still enhancing patient care.

G Medical will be exhibiting at Hospitalar 2018 from May 22-25, 2018, held in Sao Paolo, Brazil, as part of the broader Israeli E-Commerce Group presence at the show. Attendees at Hospitalar 2018 are welcome to visit G Medical, located at Hall 15, Stand #178 in the International Pavilion.

Does Your Cybersecurity Program Have What It Takes?

At a time when the risks of hacking into our health data has never been higher, we catch up with Dan Dodson, President of Fortified Health Security – to give us his views on where the risk is – and what you can do about it. This is what Dan says:

Hackers have clearly placed a bullseye on healthcare organizations. Cybersecurity breaches continue to occur among healthcare providers so pervasively that their numbers exceed those of health plans and business associates combined. Steps must be taken to protect patients, whether from ransomware or connected medical devices attacks, the stakes are simply too high.

Any significant cybersecurity breach results in a big drop in patient confidence. Pressure for patients, as well as inside organizations, are forcing healthcare providers to guard their reputations, develop strategies for better patient engagement and provide increased amounts of sensitive data to multiple interconnected devices.

It’s important for a healthcare organization to recognize the potential impacts of a breach on their organization before one occurs instead of only investing in cybersecurity after they have been negatively impacted by an incident. Yet, at that point, it may be too late for some patients. Reports suggest that nearly forty percent of consumers would abandon or hesitate using a health organization if it is hacked. Fifty percent of consumers would avoid or be wary of using a medical device if a breach was reported and thirty-eight percent would be wary of using a hospital associated with a previously hacked device.

The best prevention against any attack is understanding the fundamentals of a strong cybersecurity program. With proactive employee involvement, a clear process to identify and prevent cybersecurity threats, and understanding that technology is only part of the equation, healthcare providers can better serve and protect patients.

In my view, there are three simple steps that you can take.

Employee training is the first line of defense against hackers.

Your employees are your first line of defense to prevent successful attacks and/or breaches. Educating your employees/users on threats to your organization, safe web browsing practices, the hazards of clicking embedded links or opening attachments in unverified emails, and to scrutinize emails before opening them are just some of the basics.

In order to take your employees’ education to the next level, you should conduct simulated social engineering exercises and campaigns. This will give employees “real world” experience in dealing with such attacks. Social engineering is still the easiest and most effective way that malicious individuals are able to access sensitive information.

Have a process to identify and prevent cybersecurity threats.

Cybersecurity starts with people, but must be strengthened by processes for backups, incident reports, breach notifications, and disaster recovery. It is critical that organizations develop a multi-phased vulnerability management process that includes vulnerability scanning, risk acceptance, and remediation for security risks.

This process is critical to recognizing the potential impacts of a breach on your organization before one occurs so it is clear what steps your team will take to protect patient data. Far too often, healthcare organizations only start investing in a cybersecurity process after they have been negatively impacted by an incident, and at that point, it may be too late for some patients.

Cybersecurity is more than just technology.

Technology by itself is not the answer to protect an organization from a cybersecurity attack, but combined with dedicated people and a defined process, it completes the cybersecurity prevention trifecta.

Technologies such as Security Information and Event Management (SIEM), Data Loss Prevention or Intrusion Prevention Systems (IPS) can be leveraged to identify and even react to a ransomware attack as it is happening. Custom policy and rulesets can be utilized to alert in real time that there is something awry within the operating environment. Additionally, Network Access Control (NAC) platforms could make the isolation of infected devices quicker and easier.

Stakes are too high to put patients at risk.

Cybersecurity threats at their core are patient safety risks. The stakes are high and if you wait until after a breach or attack to take action, it’s too late. The best prevention against any attack is a proactive security strategy built around people, process and technology. Now that you know the fundamentals, lead your healthcare organization through a HIPAA Risk Analysis to see if your organization has what it takes. Remember, protecting your organization from a cybersecurity threat is a journey that requires constant attention and never stops.

About the Author

Dan L. Dodson serves as President of Fortified Health Security where he helps healthcare organizations effectively develop the best path forward for their security program based on their unique situation. Dan currently serves on the Southern Methodist University Cyber Security Advisory Board. Dan holds a M.B.A. in Health Organization Management and a B.S. in Accounting and Finance from Texas Tech University.

Cyber Security in Healthcare.

It is commonly understood that the recent UK hacking situation in the NHS, was via its connected machinery, rather than direct into the hospital servers. We focus on what’s up at the forthcoming conference in San Francisco, with this  timely announcement from Tel Aviv based company Cynerio, who today announced its mission to protect the future of healthcare by focusing on its weakest link – the connected medical device ecosystem.

What they say is, by building a tailor-made solution for healthcare providers, they deliver  complete visibility into a healthcare organization’s medical device ecosystem, protecting it from cyber threats and helping the organization meet HIPAA regulatory requirements.

The company was founded by cybersecurity experts Leon Lerman, CEO, and Daniel Brodie, CTO, to deliver a cybersecurity solution specially designed for healthcare providers, based on the industry’s first technology that combines device behavior modeling with medical workflow analysis to provide full visibility into medical device behavior and activity on the network, accurately detect anomalies with deep understanding of the medical context and stop the threat to ensure patient safety and data protection.

“Connected medical devices are delivering a new level of patient care, but present new challenges of managing and securing the growing clinical ecosystem. For attackers, medical devices are easy targets, as the devices aren’t built with security in mind and healthcare security teams have limited ability to protect these devices with traditional IT security solutions that are more focused on standard platforms. Our technology offers a comprehensive solution, purposely built to protect the medical device ecosystem and their sensitive data,” explained Lerman.

Cybersecurity again in the News…

We look briefly at two companies that have got in touch…

Fortified Health Security have recently recently partnered with Beacon Health System to strengthen the health system’s overarching cybersecurity program. Their Kristin Deuber writes to us to say:

“The program kicked off in April 2017, during the formation of Beacon, which required the health system to consolidate policies and to implement a more unified and centralized cybersecurity program. Fortified discovered through its baseline research that the health system had moderate cybersecurity system development with data loss prevention, and had deployed a SIEM solution on limited systems. In addition, like most healthcare organizations today, there was zero SIEM visibility into their medical device inventory, as well as the risks associated with those connected devices.”  She attached some deeper info, which is available on demand from us here at ProfoMedia. And we have invited their President, Dan Dodson,  to write a guest article – so watch this space.

Also out of the blue, is the Proficio company, whose Tamara Yaravoy says that they have won some eleven Cybersecurity Excellence Awards. This is clearly better than my 200 mtrs  swimming certificate when I was a kid.  She goes on to explain in more detail:

“In the Cybersecurity Excellence Awards, Proficio won gold in the Best Managed Security Services and Cybersecurity Team of the Year – North America categories. The company was also recognized with a bronze award in the Best Cybersecurity Company category, where they had competed against forty other cybersecurity companies.

Proficio secured top honors in the Info Security PG’s Global Excellence Awards, placing in four different categories. The company won gold in the Cyber Security Vendor Achievement of the Year category for significantly expanding its operations in North America, EMEA, and APAC, silver for Best Security Company of the Year (Services), bronze in the Best Overall Security Company of the Year category, silver in the Managed Security Services category for its SOC-as-a-Service offering, and bronze in the Managed Security Services category for its Splunk Enterprise and Splunk Enterprise Security services. Proficio was the only cybersecurity company to be recognized with two awards in the Managed Security Services category.

In the Cloud Computing Excellence Awards, Proficio was recognized for excellence and innovation in their SOC-as-a-Service offering. Proficio was one of only nine companies selected for this award which honors vendors that have most effectively leveraged cloud computing in their efforts to bring new, differentiated offerings to market.

Proficio was once again awarded a placement on the Security 100 of CRN’s 2018 MSP 500 list as well as San Diego Business Journal’s Top Cybersecurity Organization List. The CRN Security 100 list is designed to help partners wade through the ever-expanding security market, from the long-standing legacy vendors to the niche players, and navigate the fast-growing security vendor market.”

Cyber security in healthcare,  is expected to be the target of choice for those malovelences trying to destabilise how our services work. Last year’s attacks on UK hospitals showed the issues of Windows XP reliance, and that was just a baseline start.

You can look back at our earlier pages on other cyber vendors. Do contact these and the above vendors as this topic will become more visible as the year goes on.