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Security in Data Migration, and When Not to Migrate

There’s no turning back on the cloud computing revolution. By 2020, more than 90 percent of data center traffic will be cloud traffic, according to Cisco’s Global Cloud Index forecast.

Separate analysis from 451 Research finds enterprise spending on hosting and cloud services up by 26 percent in 2017 over 2016, outpacing a 12 percent increase in total IT budgets during the same span. “Hosting and cloud services are becoming a focus of IT investment, via both new projects and the migration of existing workloads,” observes Liam Eagle, research manager at the firm.

In healthcare, 76 percent of new or existing workloads are moving to the cloud, in areas such as data archiving, backups/disaster recovery, back-office applications and server virtualization.

Some might even say the transition to cloud is happening too quickly. In fact, the simplicity of initiating cloud projects has raised eyebrows among industry observers — especially since protected health information (PHI) is at stake. “The ease of spinning up a cloud application can create, in and of itself, a risk,” says Shane Whitlatch, enterprise vice president at data security firm FairWarning. “Because cloud projects are easy to start, it’s also easy to just leave them there and not monitor them.”

Does he have a point?

Setting the record straight

Without a doubt, companies across all industries have made some missteps in migrating data to the cloud. In certain cases, organizations have viewed data migration as a one-time event rather a process that will likely be repeated over the years. Therefore, it’s important to analyze whether an IT infrastructure can hold up to the demands of a full-scale migration, reports HealthITInfrastructure.

Closer to home in healthcare, organizations often fail to assess data-quality issues before embarking on a migration. This might come into play, for example, when moving data from a legacy electronic health record (EHR) system to a new EHR application.

And while it’s certainly possible for a healthcare provider to fall victim to the scenario Whitlatch envisions (e.g., gathering PHI for research purposes and later abandoning that data outside established controls on a cloud-based platform), most organizations would avoid that type of vulnerability through due diligence. They recognize that cybersecurity is a shared responsibility between cloud provider and customer. HIPAA’s Security Rule, for instance, applies in equal force to data protection whether the data resides in on-premise systems or in the cloud.

Additionally, above all other factors, healthcare organizations are concerned about adherence to regulatory requirements such as HIPAA when selecting a cloud services provider, according to a 2016 study conducted by HIMSS Analytics.

NetDirector’s HealthData Exchange, a cloud-based platform for exchanging data between healthcare entities, has been certified as HIPAA-compliant under audit by a third-party security and compliance solutions provider. This certification “strengthens the trust that our clients place in us to safely integrate their platforms and transform their data,” explains NetDirector CEO Harry Beisswenger.

For more information on the HealthData Exchange platform, please contact us or request a free demo.

What Can We Learn from eClinicalWorks’ Big Mistake?

Electronic health record (EHR) vendor eClinicalWorks (eCW) and several of its executives are on the hook for $155 million to resolve a False Claims Act lawsuit alleging that the company misrepresented the capabilities of its software. The U.S. Department of Justice announced the settlement on May 31.

Resolution of the case also required eCW to enter into a Corporate Integrity Agreement (CIA) with the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS-OIG), which oversees “meaningful use” incentive payments to healthcare providers relating to their adoption and implementation of certified EHR technology.

According to the government, eCW concealed that its software was “hardcoded” to meet certification requirements for standardized drug codes instead of actually retrieving the proper drug codes from a complete database. Other cited faults in eCW’s software included:

  • not having an audit log for accurate recording of user actions;
  • not reliably recording diagnostic imaging orders;
  • not reliably performing drug interaction checks; and
  • failing to satisfy data portability requirements for transferring patient data from eCW’s system to other vendors’ software.

All told, because of the deficiencies, “eCW caused the submission of false claims for federal incentive payments based on the use of eCW’s software,” HHS-OIG charged. $125 million of the company’s fines will go to repay Medicare and Medicaid for incentive disbursements under their respective meaningful use programs. (eCW customers who successfully attested to meaningful use in good faith will not be linked in on the government repayments.)

Aside from the financial penalties, eCW’s CIA, which extends for five years, requires the company to retain an independent oversight organization to assess its software quality control systems, with semi-annual written reports to be filed with HHS-OIG. The CIA also mandates that eCW allow its customers to obtain free software updates; customers also have the option of transferring their data to another EHR vendor without penalties or service charges.

Industry fallout

eCW agreed to the settlement without acknowledging any wrongdoing. The company said it did so to avoid lengthy and costly litigation. eCW’s EHR system remains certified under the meaningful use program. Nonetheless, the underlying facts of the case appear to have cast a broad shadow across the health IT landscape.

A report compiled by market research firm Reaction Data after announcement of the settlement found 71 percent of respondents saying they would be extremely unlikely to consider eCW in the future. What’s more, 27 percent indicated that the case had lowered confidence in their current EHR vendor, and 35 percent reported being “significantly more suspicious” of other EHR vendors.

Healthcare attorney Bob Ramsey told Healthcare Informatics that the eCW allegations may be an extreme case, but added, “Interoperability and data portability is viewed as necessary in the health world, but it’s easier said than done.”

Peter DeVault, vice president of interoperability at EHR vendor Epic, recently noted that healthcare providers would be well served to rely less on EHR certifications moving forward and to concentrate more heavily on demonstrated benefits.

NetDirector’s vendor-neutral approach to data exchange elevates providers’ ability to achieve EHR interoperability while working toward meaningful use incentives. In an environment currently clouded by skepticism, the HealthData Exchange platform automates integrations in a manner that exceeds industry standards.

NetDirector CEO Harry Beisswenger puts the technology in perspective: “It’s important for us to aid healthcare providers and vendors in reaching meaningful use benchmarks because we know that ultimately impacts the level of patient care.”

For more information, please contact us or request a free demo.

NetDirector Streamlines Patient Experience in Healthcare with New Health Logix Integration Suite

Tampa, FL – June 27, 2017 – NetDirector, a cloud-based data exchange and integration platform, continues to expand the presence of their cloud-based integration-platform-as-a-service (iPaaS) in the healthcare industry. In their most recent integration, NetDirector has partnered with Health Logix to deliver a technologically advanced patient experience and to streamline the process of data acquisition for providers.

Health Logix is a Software-as-a-Service (SAAS) offering delivering its customers the ability to engage patients both before and after exams or appointments by confirming scheduling, for surveys, create a seamless check-in process, and more. The cloud-based integration with NetDirector helps those clients move pertinent information directly into their Information System (RIS, EHR, HIS, etc.) and patient billing databases, to keep patient records current and to leverage collected data most efficiently.  Health Logix additionally allows for the utilization of its full functionality including automating check-in procedures at a digital kiosk, and more.

By utilizing Health Logix and integrating with NetDirector the entire continuum of healthcare data becomes more accessible to both patient and provider. Patients feel more cared for and satisfied by having reminders and surveys, while providers have the information they need faster and more cost-effectively. The information collected through Health Logix is passed through the NetDirector HealthData Exchange and is delivered directly to billing databases and information systems through a one-to-many style integration.

Health Logix chief technology officer Reynold Yordy stated that “NetDirector’s ability to simultaneously, accurately, and cost-effectively move critical patient information, to multiple partner platforms, allows us to deliver a service that both saves cost and generates real revenue to our customers.”  He further stated, “after searching for many months, we are excited to have finally found an integration partner that actually deliver on true interoperability, one of the biggest gaps in healthcare”

Interoperability has been a major hurdle in healthcare – as providers and vendors work towards Meaningful Use Stage 3, interoperability becomes critical for all systems. Communication between existing and future systems is a must have, and the NetDirector integration with Health Logix is a strong example of this kind of interconnected healthcare environment.

“It’s important for us to aid healthcare providers and vendors in reaching their Meaningful Use benchmarks because we know that ultimately impacts the level of patient care,” said Harry Beisswenger, CEO of NetDirector. “Health Logix is an exceptional system, and we’re excited to make it even easier for healthcare providers to maximize the potential it has.”

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. With security and longevity as a focus, NetDirector is a Certified HIPAA Compliant company, a 6-year member of the prominent Inc. 5000, and currently, processes more than 9 million transactions per month.

Midyear Healthcare and Technology Progress Report

High availability, interoperability, and utility in population health management all figured prominently in an early 2017 forecast of areas where healthcare CIOs expect information technology (IT) to deliver significant impact for their organizations.

Here’s a look at how things are shaping up at the year’s midpoint.

Systems availability

While natural disasters or cyber-attacks can knock out — or lock out — critical IT systems without warning, healthcare entities still need to prepare for such events. In fact, the HIPAA Security Rule requires health care covered entities to have a contingency plan for responding to unavailability of electronic health information systems.

The Department of Health and Human Services’ Inspector General reported last year in a survey of 400 hospitals that about two-thirds have contingency plans addressing data backup, disaster recovery, emergency mode operations and testing/ revision procedures. Nonetheless, over half of the surveyed hospitals confirmed an unplanned disruption to their electronic health record (EHR) system, and about a quarter of those experienced delays in patient care as a result.

So far this year, EHR outages continue to make headlines:

  • An April 2017 poll, conducted by online physician community Sermo, found that 55 percent of 1,678 responding U.S. doctors had experienced an EHR outage or malfunction that jeopardized the health or safety of a patient.
  • Also in April, Erie County Medical Center and an associated long-term care facility experienced a system-wide shutdown attributed to a ransomware attack. The hospital’s backup process prevented loss of any patient records or financial data, but its EHR was taken offline for six weeks, during which time activities such as patient admissions and prescription writing had to be handled manually.
  • In a separate incident at the end of February, an ophthalmology-specific EHR experienced “technical difficulties” due to outages of Amazon’s S3 cloud-based hosting service.

Data center and cloud services provider Peak 10 recommends that healthcare entities not only review their IT privacy and security policies and procedures but also insist that their service level agreements with technology providers specify agreed-upon security objectives and how compliance will be ensured.

Interoperability

In late March, the Office of the National Coordinator for Health IT (ONC) shared several examples of what it described as “interoperability in action from coast to coast.” Among the programs ONC showcased:

  • An app that imports patient data — including personal and medical device data, remote monitoring and reminders — into a comprehensive family health dashboard.
  • A solution that allows clinicians to create customizable push notifications that can be tailored to individual patients or groups.
  • A smartphone app that allows patients to grant or revoke permission for providers to access, send or receive health information electronically.
  • A secure system for users to seamlessly store and share data with trusted care professionals.

Additional projects outside of ONC’s purview are taking aim at other aspects of interoperability. In April, Ascension Health, Cedars-Sinai Health System and Hospital Corporation of America opened the Center for Medical Interoperability. The lab will provide resources for researchers to test data-sharing connections for medical devices and EHRs. In February, the Personal Connected Health Alliance agreed to partner with the Integrating the Healthcare Enterprise initiative in efforts to improve health data exchange through conformity testing and certification with a focus on standards-based, open specifications.

Population health

No single type of data serves as a comprehensive source of information for population health management. For example, claims data includes patient demographics, diagnosis codes, and dates and costs of services; however, the information is retrospective and limited to just billable aspects of care, explains a recent HealthITAnalytics report. Likewise, EHR systems provide clinical details but often contain unstructured, free-text descriptions that are difficult to extract and analyze.

Still, healthcare organizations continue to press forward with population health initiatives. Vanderbilt University just released a report card — the first of its kind in the nation — intended to guide the planning, implementation, and evaluation of programs and policies to improve men’s health across the entire state of Tennessee. It identifies heart disease and cancer as the leading causes of death in the state and reveals a deficit in men having a personal health provider. Meanwhile, Stanford University’s Center for Population Health Sciences has awarded $275,000 in pilot grants to fund studies seeking to improve population and community health, including a mobile surveillance system that will map autism and gaps in treatment services.

Efforts such as these will help drive discovery of what works in real-world practice of population health management. “As an industry, we can increase the socialization of toolkits and case studies so that healthcare organizations can more clearly define all aspects of population health management model design,” observes Jennifer Rogers, an analyst at Chilmark Research. She adds that optimal IT deployment will speed up gains in value for current and future adopters of population health models.

Availability, interoperability, and population health projects face a balance of challenges and opportunities as we enter the second half of 2017. NetDirector continues to innovate with cloud-based, foundational integration solutions that will help healthcare organizations seamlessly handle the electronic exchange of information in each of these areas within their respective ecosystems. For more information, please contact us or request a free demo.

Addiction Care 101 Partners with NetDirector to Automate Key Pieces of the Opioid Addiction Recovery Process

Tampa, FL – June 13, 2017 – NetDirector, a cloud-based data exchange and integration platform, continues to solidify their presence in the healthcare industry as a leading provider of integration services. Most recently, NetDirector has partnered with Addiction Care 101 to aid in the delivery of treatment for the growing opioid crisis around the country.

Addiction Care 101 (A101) is a cloud-based software platform that assists doctors in performing Medication-Assisted Treatment (MAT) for people with prescription opioid and heroin use disorders. Medications (such as Suboxone) are used to prevent the patient from experiencing opioid withdrawal while they receive the necessary treatment, provided via telemedicine by their network of doctors and therapists to assist their recovery.

The software is based on a proven, successful model delivered on a solid platform of risk management and compliance to physicians and patients. The A101 platform allows for users to anonymously go through treatment and recovery without requiring family or employers to know. Technology including telemedicine and e-prescribing allows members (assisted by the network of doctors, drug counselors, and the A101 team) to pursue sobriety without having to worry about being seen in an addiction care facility.

Laurie Peregoy JD, Director of Program Compliance, states that “NetDirector’s cutting edge integration technology allows A101 to more accurately monitor their member’s compliance. Specifically, the ease in which we are able to routinely access the Controlled Substance Database using their automated process gives A101 the critical assurance that members are not seeking drugs beyond their treatment program.”

By providing an automated integration to Controlled Substance Databases, NetDirector helps prevent “medication farming” – a major contributor to the abuse of opioid recovery drugs that has hindered the opioid rehabilitation efforts in the past.

William Beasley, one of A101’s network of Drug Counselors, further stated “NetDirector’s bidirectional integration with our lab testing partners makes my job of treating my patients more thorough due to immediate alerts to both myself and my patient if the results expose compliance or other potentially life-threatening outcomes.”

By integrating with labs via a cloud-based, one-to-many style integration, NetDirector allows the practitioners and counselors that are part of the A101 network to stay informed and to expand their ability to treat opioid addiction disorders in recovery patients with greater accuracy. The compliance gains noted by A101 are a key benefit to the integration, as well, so that the program can continue to function while maintaining the highest levels of transparency and discretion when needed.

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. With security and longevity as a focus, NetDirector is a certified HIPAA Compliant company, a 6-year member of the prominent Inc. 5000, and currently processes more than 9 million transactions per month.

When a Health IT Rollout Runs Off the Rails

If ever a large-scale health IT project needed a reboot, it was the rollout of Healthcare.gov. Fortunately, it got one — in the form of an emergency, behind-the-scenes “tech surge” assembled to salvage the government’s new health insurance portal after a halting launch.

To recap, only six people completed the online enrollment process on Oct. 1, 2013, the day Healthcare.gov officially opened for business, according to notes from war room meetings at the Center for Medicare and Medicaid Services (CMS), the agency charged with implementing the site. Things didn’t improve much the next two days, with a cumulative total of 248 enrollments successfully submitted and at times up to 40,000 consumers stuck in a waiting stage.

Malfunctions crashed Healthcare.gov twice more the last week of October, the second time while Kathleen Sebelius, Secretary of Health and Human Services (HHS), the parent department of CMS, was testifying before Congress about the website’s problems.

Administration officials advised consumers who experienced trouble with the online process to apply by phone — or even mail in a hard copy form.

President Obama called it a “well-documented disaster” and pundits had a field day.

“Only the government could come up with a website that’s slower than sending something by mail.” — Jay Leno

“If you are in need of healthcare, you have two choices: You can wait for them to get the site fixed, or you can enroll in medical school, graduate, and then just take care of yourself.” — Jimmy Kimmel

“People are getting a busy signal when they try to apply over the phone. You can’t use the Internet and you can’t use the phone. So now fax machines are like, ‘Look who’s come crawling back!’” — Jimmy Fallon

To its credit, the administration retooled and relaunched the site by December 2013 and hit its stated goal of signing up 7 million people by the end of the first quarter of 2014. Nonetheless, substantial damage had already been done. Hundreds of millions of dollars had been spent, and by April 2014 Sebelius had resigned after taking ultimate responsibility for the launch debacle.

What went wrong

In retrospect, the management and technical problems that plagued Healthcare.gov throughout its development seem fairly apparent.

A February 2016 report issued by HHS’ Office of the Inspector General stated that the most critical misstep made by the project team leading up to launch was “absence of clear leadership, which caused delays in decision-making, lack of clarity in project tasks and the inability of CMS to recognize the magnitude of problems as the project deteriorated.” Other contributing factors included devoting too much time to policy issues rather than to actual site development, poor technical decisions and improper management of the key development contract. The report also criticized CMS’ organizational structure and culture, which hampered coordination, pushed back against warnings of “bad news” and failed to alter plans in the face of problems.

The Government Accountability Office (GAO), in a separate analysis, pointed out CMS shortcomings in the areas of capacity planning for the site, as well as failure to correct software coding errors and implement full functionality prior to launch. Additionally, GAO said, “Healthcare.gov and its supporting systems were not fully tested prior to launch, and test documentation was missing key elements such as criteria for determining whether a system passed a test.”

A CIO retrospective summarized the project’s faults and how the fiasco could have been prevented: “Healthcare.gov was a single, Big Bang rollout that couldn’t be stopped.” The huge undertaking should have been tracked forward in incremental stages, with early and complete testing, and a more flexible scope to find areas of risk before they unexpectedly appeared.

Not a singular instance

Despite all the negative fallout, perhaps we shouldn’t be surprised with Healthcare.gov’s early-phase stumbles. Standish Group, an advisory firm focusing on software project performance, studied 3,555 projects from 2003 through 2012 that had labor costs of at least $10 million.

The takeaway: Only about 6 percent were deemed successful. A majority, 52 percent were “challenged” — meaning over budget, behind schedule or failed to meet user expectations. The rest, about 42 percent, were either scrapped or started anew from scratch.

Further research, from Forrester Consulting, shows that less than 40 percent of IT executives believe their internal IT organizations can regularly deliver projects on time and within budget, due in large part to continually changing user requirements and overburdened departmental resources.

In general commercial environments, such a low success rate may be accepted as a “cost of doing business,” and the worst outcome could be scope creep or project delays. In healthcare, the stakes are higher, with patient lives potentially on the line when IT systems don’t work or aren’t available when needed. That’s why many healthcare entities are looking for trusted third-party help in gaining control over their interconnected systems and expanding ecosystems.

NetDirector has been around for almost 15 years, offering cloud-based services that are now considered a staple solution for data integration in healthcare and other industries. Learn more about the HealthData Exchange platform here or request a free demo.

NetDirector Enables Next-Generation Integration in Radiology with American Health Imaging

Tampa, FL – May 24, 2017 – NetDirector, a cloud-based data exchange and integration platform, has engaged in a rapid expansion strategy in the healthcare industry over the last few years. Recently, the Integration-Platform-as-a-Service (iPaaS) has completed implementation with American Health Imaging, a regional network of radiology providers across multiple states, to provide increased accessibility and data utility in their company.

American Health Imaging (AHI) began providing diagnostic imaging services in Decatur, Georgia, in 1998, and has since expanded to 21 locations. In each area, they distinguished themselves by providing excellent customer service and high quality diagnostic imaging for their patients and referring physicians. By partnering with NetDirector to provide cloud-based integration services, it is the goal of AHI to create an automation platform that will increase overall customer satisfaction through streamlined processes and to create internal manpower savings through enhancing their ability to scale the business without having to add staff.

“We want to provide the best possible patient care, to the maximum number of patients, while minimizing the need for human intervention in the process,” said Dan Balentine, Chief Operating Officer at AHI. “By utilizing the NetDirector integration, it has allowed us to take our staff’s focus off of the day to day busywork, and shift focus to providing unmatched patient care.”

With traditional integrations, a company like AHI could be paying upwards of $20,000 plus an 18% annual maintenance fee for each vendor that would be integrated with AHI’s EMR and other in-house systems. For AHI, this was clearly not the optimum solution. Several vendors might not have the volume of transactions to justify the integration cost, creating a system built around the exception and not the constant. NetDirector’s one-to-many integration approach allowed AHI to integrate once with NetDirector, and use that single integration to connect to the entire hub of HealthData Exchange participants.

Three main technologies formed the backbone of the AHI-NetDirector integration – HealthLogix, Exchange EDI, and IntScripts.

HealthLogix Integration – Patient Check-In, Appointment Confirmation, Patient Billing

AHI utilizes a patient engagement platform called HealthLogix to help follow up with patients after exams or appointments, confirm scheduling, prompt for surveys, create a seamless check-in process, and more. The cloud-based integration model helped AHI bring this information directly into their Fuji Radiology Information System (RIS) and patient billing databases, to keep patient records current and to leverage the data they were collecting most efficiently, and allowed the utilization of HealthLogix’s full functionality such as automating check-in procedures at a digital kiosk, and more.

Exchange EDI Integration – Insurance Coverage Confirmation & Verification

Additionally, in a time where high-deductible insurance policies are increasingly commonplace, insurance confirmation simply isn’t enough information. AHI utilized NetDirector to connect with Exchange EDI, which not only confirms the participation in an insurance policy or group but analyzes policy levels and remaining deductibles. This allows patients and providers alike to understand the patient’s responsibility up front – the transparency provided by this data allows for accurate collection of copays during visits, reduced collection costs down the line, and overall reduced revenue leakage for providers.

IntScripts Integration – Physician Referrals and Radiology Communication Integration

Finally, it was critical to make the ordering process for their referring physician population as simple as possible, so an integration was performed with IntScripts, which provided the ability to directly receive orders from the referrer’s EHR and have the results automatically dropped right into the patient’s chart.  This automation eliminates the traditional manual processes that were previously encountered by both AHI and referring physicians.

For patients, the NetDirector integration platform provides not only an elevated level of understanding of their coverage and responsibility through stronger integration between provider and vendor, but also makes life easier for their primary care doctor or other referring physician to communicate and refer patients. This increases the likelihood of single-service care, as primary care physicians are more likely to refer patients as needed, and patients can trust they are receiving the right treatment for them.

“The integration that we have created for American Health Imaging is a model case for the value of cloud-based integration in healthcare,” said Harry Beisswenger, NetDirector CEO. “When we set out to enter the healthcare industry, our primary goals were to reduce costs for providers, increase potential care level provided to patients, and create an environment of data transparency and communication. AHI’s integration has accomplished all of this and more.”

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. With security and longevity as a focus, NetDirector is a certified HIPAA Compliant company, a 6-year member of the prominent Inc. 5000, and currently processes more than 8 million transactions per month.

Healthcare Innovation: New Threats, New Technology

On the heels of the May 12 WannaCry malware attack that infected more than 300,000 computers in at least 150 countries — the largest hack in nearly a decade — investigators continue to evaluate what happened while victims assess the resulting damage.

The exploit emerged as ransomware, which encrypted files stored in unprotected computers and effectively held them hostage to demands for money in exchange for decryption.

“The suspected syndicated attack is … using a particularly nasty form of malware that can move through a corporate network from a single entry point,” noted Simon Crosby, chief technology officer of cybersecurity firm Bromium. He added that healthcare organizations, governments, police and fire departments and military organizations are “massively vulnerable.

The outbreak started in Europe and in one of the most significant impact zones affected about 20 percent of the United Kingdom’s publicly funded National Health Service. Routine surgeries and outpatient appointments were canceled, while seven hospitals had to divert emergency patients due to disruptions, BBC reported, although media accounts said patient data had not been accessed.

WannaCry manipulated flaws in Microsoft’s Windows operating system that had not been updated by many of the targets. While analysts believe elements of the malicious software had been leaked by a hacking group from a trove of cyber-attack tools held by the U.S. National Security Agency (NSA), Microsoft reportedly was aware of the Windows weakness and had issued a free fix on March 14.

“Say what you want to say about the NSA or disclosure process, but this is one in which what’s broken is the system by which we fix,” commented Zeynep Tufeki, a professor at the University of North Carolina.

Hackers target healthcare

The 2017 Healthcare Breach Report, compiled by data protection firm Bitglass from U.S. Department of Health and Human Services records, reveals that 328 U.S. healthcare organizations disclosed data breaches in 2016, up from 268 the prior year. All five of the largest breaches were the result of hacking and IT incidents in 2016, according to the report. What’s more, network servers were almost always the targets for hacking-related breaches.

Robert Herjavec, CEO of a global information security company (but perhaps more widely known as one of the venture capitalist investors on the television show Shark Tank), recently told Healthcare IT News that the industry needs to prioritize a proactive approach to security.

Herjavec emphasized that providers are vulnerable to hacks in part because they are highly dependent on information systems, but it is difficult to keep them up-to-date and refreshed with current security patches. He added that large projects “can take years, and security considerations and proactive protection often fall by the wayside during these transitions.”

In general terms, he recommends increased use of account access management tools while restricting access to HIM systems to the greatest extent possible. Additionally, as shown in the WannaCry incident, operating systems must be updated regularly and endpoints patched aggressively — all while staff and clinicians receive training on cybersecurity risks and challenges.

NetDirector recognizes that unknowns in cybersecurity will always create gaps between emerging exploits and preventive measures. That’s all the more reason for the company to stay ahead of the curve in its technology development. With its HealthData Exchange platform, for example, clinical and financial data move electronically among disparate systems via a cloud-based solution that fully complies with HIPAA and SOC2 standards. NetDirector securely processes over 10 million data and document transactions per month for its healthcare clients.

For more information, please contact us or request a free demo.

Integration Can Power the Tools for Patient Engagement

Roughly 70 percent of health systems, hospitals and physician practices proactively work toward getting patients more involved in their own care, according to a 2016 NEJM Catalyst survey. However, considering the drive to implement and deliver value-based care, industry observers are wondering why that number isn’t closer to 100 percent.

“[We] need to engage patients outside the exam room with frequent, creative interactions that do not have to always include their physicians,” according to Kevin Volpp, MD, PhD, and Namita Mohta, MD, who analyzed the survey results.

Patient portals, secure email, online/mobile scheduling, patient-generated data and social networks lead the way among engagement initiatives currently being used at scale, according to respondents.

Nonetheless, portals in particular tend to be “systems of record, not systems of engagement,” observes analyst Brian Eastwood of Chilmark Research, a health IT advisory firm. Today’s portals aren’t optimized for value-based care or population health management because they’re geared toward the individual and don’t encourage behavior change, he adds.

Forward-looking solutions must be built on a broader engagement model that loops in coordinated community care teams and enables bi-directional information flow, Eastwood explains. “The point solutions that consumers use to access the healthcare system will get bigger,” he continues. “We need to try to connect to these solutions in some way — and integration is the best we can hope for.”

A pathway to future success

Design and usability will be the main drivers of behavior changes in patient engagement, predicts Sean Duffy, CEO of Omada Health, a tech-based company targeting diabetes care through analytically identified trends.

“It’s about fine-tuning and personalization, [which will spawn] an incredible wave of potential in the way we work to improve the health of the country,” Duffy tells FierceHealthcare. Optimizing the way patients interact with engagement technology is a core part of the process so that a wide range of individuals can be effectively served.

And there’s good reason to expect positive patient response to emerging engagement technology. CDW’s 2017 Patient Engagement Perspective Study finds 70 percent of patient respondents saying they’ve become more knowledgeable about their personal medical information because of online access. Half of the same sample said they’ve noticed increased engagement with their own healthcare.

At the same time, it’s essential to view patient engagement as a two-way street. To wit, 67 percent of providers surveyed by CDW consider patient engagement to be an important part of improving overall care and the top motivating factor in spurring their respective organizations into action.

Indeed, leading healthcare institutions such as Johns Hopkins Medicine are making sure employees understand patient data and know how to communicate it. That behavior is “becoming very ingrained in the way we do our work,” says chief patient experience officer Lisa Allen.

NetDirector’s HealthData Exchange platform supports such initiatives by electronically moving clinical and financial data among disparate systems — transparently mapping it to the correct format of the recipient. In this way, HealthData Exchange serves as an engine for integrating engagement technologies, increasing the likelihood of not only utilization, but also the accuracy of data circulating in multiple environments without human intervention.

For more information, please contact us or request a free demo.

What’s Top-of-Mind for Healthcare Provider Connectivity?

Healthcare connectivity covers a lot of virtual territories, evolving technologies, and boots-on-the-ground personnel. On the human side alone, stakeholders involved in the creation, exchange, and use of health information include individuals, patients, physicians, hospitals, payers, suppliers and ancillary service providers.

Concurrently, healthcare’s ecosystem relies on technical standards, policies, and protocols “to enable seamless and secure capture, discovery, exchange and utilization of information” in all its various forms among stakeholder parties, according to the HIMSS Interoperability & HIE Committee.

Healthcare organizations have been hammering away at this multi-faceted challenge for decades, making incremental progress. “The next step is taking data and using it to create a more accurate picture of the patient that drives better healthcare decisions,” observes Carla Smith, HIMSS executive vice president.

Industry-wide activity is trending toward population health initiatives. Case in point: Catholic Health Initiatives (CHI) in Englewood, Colo., has stepped up its population health strategy through the use of advanced data analytics. Since rolling out the program, CHI has cut pneumonia mortality by 21 percent; catheter-associated urinary tract infections by 27 percent; surgical site infections (SSIs) following colon surgery by 34 percent; and SSIs following hysterectomy by 45 percent.

Concurrently, Atrius Health in Newton, Mass., is focusing on lowering inappropriate hospitalizations and reducing lengths of stay in nursing facilities. Atrius pairs patient histories from its EHR with claims data for alternative payment contracts to identify at-risk groups who could benefit from early interventions (e.g., those with chronic kidney disease) while also managing patients already diagnosed with chronic conditions, reports Becker’s Hospital Review. The goal is to develop customized and comprehensive care and treatment plans.

Areas of opportunity

Aside from these types of leading-edge programs, hospitals and health systems are hard at work in more fundamental areas of health information exchange. The U.S. Department of Health and Human Services (HHS), in a 2016 statutorily required report to Congress, noted that about three-quarters of hospitals could electronically exchange health information with outside providers, highlighted by a spike of 23 percent between 2013 and 2014. However, physician practices lagged behind in their ability to electronically share patient health information in the same manner.

At the same time, HHS said it will pursue incentives “to stimulate more collaborative business arrangements and uninterrupted information flow.” In broad terms, these financial levers will be intended to motivate higher-value care, reward teamwork and integration in the delivery of care, pave the way for more effective coordination of providers across settings, and “harness the power of information” in improving care across populations of patients.

All this needs to happen in concert with more fully engaged patients. While 72 percent of hospitals enable patients to electronically request an amendment to their own health information, other areas must come up to speed. For instance, only about 40 percent of hospital patients can request prescription refills or schedule appointments online, and just slightly over half of hospitals allow patients to send and receive secure messages electronically.

Increasingly, healthcare providers are looking to build out capabilities in a unified, streamlined ecosystem. NetDirector’s cloud-based HealthData Exchange platform is designed to make this level of connectivity a reality. HealthData Exchange allows hospitals and physician practices to make a single connection that instantly gives them access to dozens — and potentially hundreds — of other providers and vendors via pre-defined integrations. NetDirector currently processes more than 10 million data and document transactions per month.

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