VA Tackles Medical Device Vulnerabilities and Cyberthreats

VA recently signed partnerships with Massachusetts General Hospital and Shepherd University. This collaboration's research will address cybersecurity and compatibility measures needed in devices used for VA patient care. It will also refine existing and emerging cybersecurity standards and practices for network connectable medical devices, medical data systems and other related technology. Beyond VA, the agreements could have a broad impact in standardizing cybersecurity and safety requirements within the larger public health sector. VA is contributing to industry-wide awareness of both medical device vulnerabilities and threats, while applying further tests of the Underwriters Laboratories criteria and other emerging standards.

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Why the Founder of Apache Is All-in on Blockchain

Brian Behlendorf is perhaps best known for being a co-founder of the Apache Project, which became the Apache Software Foundation. Today, he's the executive director of the Hyperledger Foundation, an organization focused on enterprise-grade, open source, distributed ledgers (better known as blockchains). He also says he "put the first ad banner online and have been apologizing ever since." In a recent conversation on my podcast, Behlendorf talks about the goals of the Apache Project, the role of foundations generally, and his hopes for blockchain...

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Mortal Coils: Why We Must Stop Tolerating Failing Health Tech

Today, data are scattered across thousands of database tables within any single electronic medical record (EMR) system, but also across dozens of other systems that hold pharmacy data, imaging data, insurance data, laboratory data, etc. Pretty much none of it is available on demand in any given clinical setting. The inevitable result of this disconnected galaxy of data "black holes" is mistakes, or if not outright mistakes, well-intentioned missteps based on lack of background data within the acute-care setting.

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CMS Promoting Interoperability in 2021: All good things must come to an end?

We have spent years involved with the management of the Center for Medicare and Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Programs which were created by the HITECH Act (2009). These programs were recently renamed Promoting Interoperability (PI) programs. In a nutshell, these programs were tied to the Medicare and Medicaid insurance programs and provided financial incentives over a number of years to ambulatory providers and hospitals to adopt and use EHRs. Vendors submitted their technology products for testing and certification that they performed specific functions and could exchange data using specified message formats...But the provisions of the HITECH Act are due to expire on September 30, 2021 (see CMS timeline). These are the programs affected...

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How The VA and UL Created an Orchestrated Approach to Healthcare Cybersecurity Assurance

In today's high-risk Internet of Medical Things (IoMT) and cyber-warfare environment, one tool or individual line of cybersecurity solutions would likely not be able to satisfy the requirements for security and safety put forth by an HDO; hence, the aggregation of solutions branded as MedFusion was derived. The VA UL CRADA discovered that healthcare is strengthened in terms of security and safety of connectable medical devices through in-depth cybersecurity defense...Learning from the VA and UL cybersecurity research results, with respect to product-level management of vulnerabilities and threats to medical devices and their associated software algorithms, we can impact the quality of adoption of electronic health records and other data collection systems connected to the IoMT and consumers...

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The Current State of Blockchain and Where it's Going

In an earlier post, Blockchain evolution: A quick guide and why open source is at the heart of it, I discussed the first generations of blockchains: the public Bitcoin and cryptocurrency blockchains, followed by the Ethereum blockchain capable of executing programs ("smart contracts"), leading to permissioned versions of code-executing blockchains (e.g., Hyperledger Fabric, Quorum). Let's step back into the blockchain jungle and take a look at the current state of the ecosystem and the projects trying to solve some of the limitations of blockchain technology: speed and throughput, cross-blockchain information and value exchange, governance, and identity and account management.

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What Are We Prepared to Do in the United States to Save Primary Care?

I propose two significant changes to help make primary care relevant in the 21st century...I wrote a longer piece on [Virtual Care] earlier in the year. In short, it's a disgrace that we've put so many hurdles on telemedicine, and that it continues to be so underused. It is widely available in health plans, but rarely practiced by physicians nor by patients. Instead, we still mostly go to our doctors offices, to ERs, or perhaps now to drugstores.A televisit should be the first course of action for non-emergencies. We must remove regulatory and reimbursement barriers, and incent patients to take advantage of the speed and convenience of the option. Moreover, as AI options for diagnoses and advice quickly become more viable, we can use them to triage our needs, help assure continuity with physicians, and eventually reduce the need to talk to a human...

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The Community-Led Renaissance of Open Source

In a revival and expansion of the principles that drove the first generation of community-led open source commercial players, creators are now coming together in a new form of collaboration. Rather than withholding software under a different license, they're partnering with each other to provide the same kinds of professional assurances that companies such as Red Hat discovered were necessary back in the day, but for the thousands of discrete components that make up the modern development platform. Today's generation of entrepreneurial open source creators is leaving behind the scarcity mindset that bore open core and its brethren. Instead, they're advancing an optimistic, additive, and still practical model that adds missing commercial value on top of raw open source.

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Transforming Health Care Through A 360-Degree View Of Data

How medical care can be substantially improved through a full spectrum view of all factors that affect health was the topic of Payam Etminani's presentation at the 2019 IDGA Veterans Benefits Conference in Washington D.C. Etminani, the CEO of Bitscopic, argued that the ability to view all health data including social, environmental and genomic information in addition to the traditional clinical measures (vital signs, blood work, history of illness etc), would lead to significant improvement in care. Etminani described how recent advances in Big Data and Artificial Intelligence (AI) make combining and using these large and widely varied sets of information possible. Read More »

Big Tech Should Stay Out of Healthcare

Matthew Buck | Washington Monthly | December 2, 2019

...The use of digital technology in health care has enormous promise, to be sure. But, as the Wall Street Journal's coverage of Google's Project Nightingale revealed, there is also a potential dark side to these projects. Ascension, it noted, "also hopes to mine data to identify additional tests that could be necessary or other ways in which the system could generate more revenue from patients, documents show." That detail raises a key question that's largely overlooked in our health care debates: should the drive to maximize corporate revenues determine how health information technology develops and becomes integrated into medical practice, or should that be determined by medical science and the public?...An alternative path exists. In the 1970s, the Veterans Affairs Administration (VA) developed VistA, an open-source code system that was the country's first EHR system... Read More »