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  • Is it time to change passwords?

    Yahoo’s Tumblr has advised all users to change their passwords as precaution following the discovery of the Heartbleed bug in OpenSSL.  It says it has no evidence of any breach and took immediate action to fix the issue, but it can’t overcome the risk that private information was accessible to anyone who knew about the exploit. It suggests that people change all their passwords, especially your high-security services like email, file storage, and banking. They may have compromised by the bug.

    Just as worrying is Tumblr’s comment that we’ll be “hearing more in the news over the coming days.”

  • Western Cape improves patient care with Datacentrix EPR

    Good eHealth experience lays a firm foundation for more eHealth investment. Western Cape Government’s (WCG) Department of Health (DoH) now has several successful years under the belt.  Datacentrix provides the DoH with its Enterprise Content Management (ECM) to create the Electronic Patient Record (EPR). WCG’s Forensic Pathology Services (FPS) uses Datacentrix’s case file management system too. The EPR provides a central repository for secure data capture and uses an indexing model for medical staff to access patient records quickly and easily using a few identifiers such as patient names and hospital numbers.

    Trish Dicks, strategic business development manager at Datacentrix’s says, “The DoH’s two drivers for the implementation of ECM at their health facilities are to ensure that patient information is accurately and completely recorded according to clinical, legal and ethical requirements, and that an efficient system is in place to archive and retrieve digital medical records or patient files.

    The EPR eliminates the movement of patient records through the institution, minimising lost files or missing content. Patient care teams have anywhere anytime access to scanned content in consulting rooms, doctors’ offices, OPDs and other health facilities. Dr Revere Thomson, Senior Executive Officer: Internal Medicine, says, “I have been using Datacentrix’s ECM solution remotely to access patient records. It all works well and I can browse the information on my iPhone or using my laptop”

    Dr Anwar Kharwa, Khayelitsha Hospital CEO says, “One of the major reasons for dissatisfaction within public sector hospitals and community health centres are the lengthy waiting times. Khayelitsha Hospital opened in January 2012 and patient file retrieval times in admissions have been reduced to zero as a result of doctors now being able to access them electronically.  In addition, the ECM project has help cut waiting times as doctors now have information about patients at hand before seeing them.”

    The EPR supports efficient running of, and reporting on the hospitals’ performance. Information extracted from the EPR provides functional teams, management groups, committees, task teams and other collaborative groupings with routine performance reports.

    The FPS has achieved significant efficiency gains and cost savings.  Omar Galant at UCT Medical School says, “We no longer print hundreds of autopsy photographs, instead the photos are loaded directly into the ECM Case File and a link is sent to the Forensic Officer to the electronic case file.”

    Electronic processing of claims has helped FPS to process overtime claims quicker, with less movement of paper, fewer multiple copies and a clear audit trail of approvals. Dion Bruinners, at FPS says, “Implementation of the workflow has definitely made us more cost effective, we are using significantly less paper”. 

    Datacentrix has won two new projects; deploying EPR in the new Mitchells Plain Hospital and a three-year contract to roll out ECM to hospitals and primary healthcare facilities.

  • This bug is a big one

    The latest servers’ security bug was found by researchers working for Google and security firm Codenomicon. It’s described on the torproject blog. It’s in OpenSSL CVE-2014-0160. Previous versions aren’t susceptible. The blog suggests that it affects many https webservers, and if strong anonymity or privacy on the Internet is a requirement, it may be better not to use the Internet at all for the next few days.

    The bug is in OpenSSL, a library in servers, operating systems, email and instant messaging systems. It’s goal in cyber-life is to protect sensitive data as it travels around the Internet. It seems that no one knows how widespread exploitation has been because the attacks leave no trace.

    OpenSSL is used in open source providers Apache and Nginx in server software, so it’s a big-scale vulnerability.

    Statistics from net monitoring firm Netcraft statistics say over half the web’s servers that host more than 500 million websites run these programs. Initially, it wasn’t clear how many of servers use the vulnerable versions of OpenSSL. What is known is that the bug allowed attackers to eavesdrop on communications, steal data the services and users and impersonate services and users. OpenSSL versions released on 7 April had the bug fixed.

  • Samsung’s Digital Village open for business

    Samsung has officially handed over its keys to the Digital Village in South Africa which aims to improve the lives of millions of Africans through renewable and environmentally sustainable solutions. It harnesses the sun’s power.

    Samsung’s Digital Village model addresses one of Africa’s most pressing economic challenges – electricity.  Fewer than 25% of rural areas on the continent benefit from electricity. The result is isolated communities with limited access to education, healthcare and connectivity, all of which are vital for socio-economic development.

    The Digital Village comprises:

    A Solar Powered Internet School A Solar Power Generator  A Solar Powered Health A Solar Powered Tele-Medical Centre  A Solar Powered Admin Centre

    “We have set an ambitious goal for ourselves in Africa: to positively impact five million lives by 2015,” says Sung Yong Hong, President and CEO of Samsung Africa. “Good health is at the centre of one’s well being and impacts society at a fundamental level. It affects a child’s ability to learn at full potential, and adults’ ability to provide for their families. This is why we have complemented our strong focus on education with a focus on quality healthcare.”

    African countries need more of this type of renewable and affordable innovative solutions to address the gap in education in Healthcare.

  • Device management is key for mobile security

    Mobile security is no longer enough. According to Richard Broeke, an ICT security expert at Securicom, companies are going to have to move to a Mobile Device Management (MDM) approach if they are going to embrace Bring Your Own Device (BYOD) without compromising information security.

    Its no secret that BYOD gives rise to a complex set of security risks. Broeke says that these cannot be adequately-addressed with disparately-applied mobile device security technologies. Mobile security and mobile device management is not the same thing. In fact there is a big difference.

    “BYOD is increasingly allowed in today’s business environments. It’s an approach that allows companies to cost-effectively empower people to work-on-the-go using their own devices of choice. Even if employees have some sort of mobile security software running on their devices, it’s not enough. Disparately-installed security technologies aren’t capable of protecting and managing a company’s intellectual property housed on devices. They simply cannot deliver the necessary level of control to manage how data is stored and used on employee devices.”

    Mobile security technologies are typically designed to protect the device against malware such as viruses. But, they aren’t geared towards protecting the data that is stored on the phone from unauthorized access or use.

    With an effective MDM solution, companies can enforce basic security requirements, such as virus protection, and also control how, when and by whom sensitive data is transferred and used on mobile devices. Employees not authorized to process or store sensitive information on their personally-owned devices can be prevented from doing so.

    This means that companies can effectively and efficiently empower employees to work and connect with their own devices, while controlling their network and data security.

  • Mainframes aren’t dinosaurs

    On 7 April 1964, IBM launched its System 360 into the world of work. Computer News Middle East (CNME) has a full report on its history and life. It took about three years to develop. It was very successful for IBM and changed the computing concept.

    The 360 had a common architecture shared among lower-end, less expensive machines and the priciest high-speed models. The top-end models would perform 40 times faster than the low-end models. Applying architecture to computer design was a revolution in the early 1960s. It enabled compatibility between different models.

    It spawned Amdahl’s Law, the performance gains that come from breaking a computer task into parallel operations is offset by the additional overhead incurred by managing multiple threads. Brooks’ Law came from it too. In the “The Mythical Man Month,” the Law said that adding more people to a software development project can slow development of the software because of the additional burden of managing the extra people.

    IBM has kept the mainframe relevant for current needs. It improved price:performance ratios so that mainframe computing remains viable. There have been many claims that the mainframe was dead, and replaced by minicomputers or servers. It seems that the new technologies have extended with the mainframe as the backbone.

  • IOp for medical devices may have big benefits

    West Health Institute is claiming big benefits for interoperability (IOp) for medical devices. Its report“Improving patient care with more than $30 billion in annual health care savings” says that benefits of US$30 to 40 billion may be feasible with set up costs of between US$6 to 10 billion and maintenance costs of 15% a year. The benefits arise mainly from an IOp backlog. Only about one third of hospitals use IOp to integrate medical devices into their information structure, but often only three devices when they use more than five that could integrate.

    Benefits arise from reduced waste and greater efficiency. They include fewer adverse drug events (ADE), clinical time-savings, shorter lengths of stay (LOS), expanded data sources for analytics and sub-optimal patient care.

    Affordability is a big constraint for the initiative. Even USA healthcare isn’t immune from it.

    As mHealth expands in Africa, extended IOp could become more important. It’s worth including it in strategies and plans now.

  • My Healthline: Cameroon's first healthcare hotline

    With two doctors per 10,000 and 50% of the population living in rural areas, access to healthcare is difficult in Cameroon. Help may be on the way.

    In an attempt to help close the gap and meet healthcare demands, Orange has set up My Healthline, a healthcare hotline. Orange customers can access personalized advice on a number of health issues including contraception, HIV / AIDS, sexuality and sexually transmitted diseases (STD). Users can text 929 between 8.00 am and 10.00 pm seven days a week for advice from specialists within an hour.

    Orange will transmit all questions to Cameroonian nurses and doctors. After analysis, Orange sends the healthcare professionals’ answers back to the users. The service will provide customers with reliable medical information at minimal cost (XOF 200 per text message, i.e. EUR 0.25).

    My Healthline allows for anonymity and confidentiality and covers topics often thought of as taboo. The service is to be provided in French, English and Pidgin.

    Orange aims to expand My Healthline to other sub-Saharan African countries and extend the scope of questions they are capable of dealing with.

  • Are all EHRs good EHRs?

    Not all doctors and other healthcare professionals see EHRs as beneficial. It seems that some don’t save time with their EHRs, they need extra time. A report of a survey in Health Affairs Blog says that policy makers and professional organizations are increasingly concerned about user satisfaction.

    A study of professional satisfaction in 30 USA practices found that EHRs offer:

    Perceived ability to deliver high-quality patient care Reasonable control over the work environment, pace, and content Sharing clinical values with organizational leadership Respectful professional relationships Incomes perceived as predictable and fair.

    Physicians also reported some negative effects of current EHRs on their professional lives and patient care:

    Poor EHR usability does not match clinical workflows Creates time-consuming data entry Interferes with face-to-face patient care Sends an overwhelming numbers of electronic messages and alerts Perform tasks that are more efficient by clerks and transcriptionists.

    The inability of EHRs to exchange health information electronically was deeply disappointing to physicians. Instead, some still fax medical documents from outside providers.  Physicians also expressed concerns about potential misuse of template-based notes with pre-formatted, computer-generated text. Using them can improve the efficiency for data entry when used appropriately, but there inappropriate use contain extraneous and inaccurate information about patients’ clinical histories, leading some physicians to question reliability of these types of medical records. On the money aspects, they see EHRs as significantly more expensive than planned, creating uncertainties about their sustainability.

    The American Medical Informatics Association (AMIA) is undertaking a multi-stakeholder effort to deal with the EHR issues. It includes:

    Organizing and leading work with EHR vendors and user communities to improve usability Helping physicians become better purchasers and EHR users to increase practice efficiency and augment direct physician-patient time Keep working with federal regulators, such as the Office of the National Coordinator for Health Information Technology (ONC) to address usability concerns and resolve problems with the details and pace of certifying EHR systems Working to reduce the number and pace of EHR requirements that vendors must satisfy for certification Working with policymakers and others concerned about institutional liability to liberalize the ability to use office support personnel to reduce physician clerical needed to use EHRs.

    Whilst EHRs can have considerable value and benefits, African countries need to establish physicians and other health professionals value their EHR solutions. The Health Affairs Blog highlights the essential role of continuous engagement with healthcare professionals from the first decisions to consider EHRs and beyond procurement and implementation and into benefits realisation. This is just as important as the ICT bits.

  • XP users might find it worse than the Ides of March

    Julius Caesar never used Microsoft, but it didn’t stop the Soothsayer telling him to “Beware the Ides of March.” Luckily, we’re a few weeks passed it, but there’s an equivalent looming. On 9th April, Microsoft is withdrawing support for Windows XP. Any computer running XP after this date is vulnerable to security breaches. Like Caser’s disillusioned comrades, it seems that hackers are gearing up, knowing that Microsoft won’t block their attempts after this date.

    Zybert Computing has a blog on the dangers. CC Communications is concerned too. It says that people running Windows XP have seven reasons to worry:

    Tons of viruses. There is a huge library of viruses aimed at Windows XP and antivirus support is becoming more and more limited every day XP is very old, nearly twelve years old. The first iPod emerged in the same year as Windows XP. Now that we have the fifth iPhone, no one should be left using an Operating System that predates the first iPod Least secure operating system by far. All other platforms, including Windows 8.1, Windows 8, Windows 7, OS X and Linux are more secure than XP by a huge margin. Windows Vista is also a safer option Built for a simpler time. XP entered a technology much simpler than todays. It was formatted to fit to a screen only 640 pixels wide, and showcased Internet Explorer 6 as a new product. The Internet was a different place when XP was developed. There were no smart phones, laptops were a luxury and tablet computers were science fiction No more band-aids. Only so many band-aid fixes on top of each other can be effective Support is ending. All XP support ends on 9 April 2014. It’s time to replace, or upgrade computers now to a new, fast PC with no pop-ups, viruses or other nuisances Malware’s everywhere. XP can still be used, but with more malware than ever, XP is by far the most vulnerable platform to connect to the Internet.

    Caesar’s alleged famous quote was “veni, vidi vici,” (vvv), which was quite smart some 2000 years before www, but it didn’t do him a lot of good. He suffered multiple attacks, and died, hacked to pieces, a couple of years later, on the Ides of March. He did set in train the switch from the Roman Republic to the Roman Empire, and his heir, Augustus, drove it on and added the Pax Romana. If Augustus had been an XP user, he’d have switched to something up-to-date by now. Now there’s a role model for Africa.


  • Server clocks are hackers’ targets

    It looks as though William Shakespeare was wrong when he wrote “Nothing ‘gainst Time’s scythe can make defence.” An international team has nearly fixed it.

    After months of increasing attacks on unprotected clocks in servers, a global initiative aims to fight back and secure them against hackers. A report on the BBC technology website says that about 93% of the vulnerable servers now have patches that secure them. Without them, hackers can use the unprotected servers’ clocks to swamp target computers with huge amounts of data, clogging them up. The attacks can generate hundreds of gigabits of traffic each second.

    The Derp Trolling hacker group was behind the attack that prompted international action. It picked out servers for the League of Legends, a popular online game, and exploited weaknesses in older versions of the software underlying the network time protocol (NTP). The attack is an “NTP reflection”. It used several thousand poorly configured computers handling NTP requests to send data to the League of Legend servers. An estimated 1.6 million NTP servers were vulnerable.

    Precise timings are vital to the Internet’s stability. Are there similar vulnerabilities in African eHealth services? Maybe Roald Dahl was more right than Shakespeare when he wrote “We have so much time and so little to do. Strike that, reverse it.” Derp Trolling’s attempts seem to have been reversed, for now.

  • New research and innovation hub for Kenya

    Royal Philips has announced the opening of its Africa Innovation Hub in Nairobi, Kenya. The Innovation Hub will work with international researchers and developers to create new inventions and bring these to market.

    The hub will focus on addressing key challenges such as improving access to lighting and affordable healthcare. Some of the innovations that Philips was already working on has been absorbed by the Innovation Hub. One of these is the Respiratory rate monitor to support pneumonia diagnosis.

    The hub is working on the development and clinical testing of a robust and affordable Automated Respiratory Rate Monitor that supports the diagnosis of pneumonia among infants and children. The device uses smart sensing technology, especially for use by community health workers and nurses in rural areas. Discussions are already underway with the Kenya Medical Research Institute (KEMRI) to develop this project and co-create a solution tailored to Africa’s needs and circumstances.

  • More time to submit abstracts for AHILA 14

    The 14th Congress of the Association for Health Information and Libraries in Africa (AHILA) and (AIBSA) is now 1 May 2014. The limit is 500 words. The event is Dar Es Salaam, Tanzania from 20th -24th October, 2014.

    The main theme is ICTs, Access and Knowledge: building strong knowledge societies for sustainable development in Africa. The sub-themes are:

    ICTs, health information and knowledge management systems for sustainable development Health information literacy and information behaviour Social media networking and dissemination of health information and knowledge: its contribution to creating knowledge societies Capacity building of health information professionals: the role of Libraries and Information Science (LIS) education in Africa Capacity building of Health Information Professionals and the role of LIS education in Africa

    The Congress includes the 2nd Healthcare Information For All (HIFA) International Conference. Delegates will review progress HIFA’s launch AHILA 10 in Mombasa, Kenya in 2006. It aims to accelerate progress towards HIFA2015 in Africa and worldwide.

  • EHR data can predict sepsis

    Every year, about a quarter of 1% of the USA population suffers from sepsis, often called blood poisoning or septicaemia. About a third of the patients die. A team at the Department of Computer Science, University of California set out to develop a decision support system to identify patients at high risk for hyperlactatemia, often accompanying sepsis, based upon routinely measured vital signs and laboratory studies. Whilst “Science fiction is very bad at prediction,” says China Miéville, a sci-fi writer, in this case science shows it can predict.

    The Journal of American Medical Informatics Association (JAMIA) reports that the study identified and used data from EHRs to make effective predictions of lactate levels and mortality risk. It needs a few clinical variables when put alongside the temporal aspect and variability of patient data. From this, the study leads to new protocols to predict lactate levels and mortality risk that inform the decisions by clinical staff for patient treatment and outcome.

    FierceHealthIT has a report on the study and three other studies on sepsis.

    A project by Lockheed Martin applies missile defence data-crunching techniques to patient information. It says it has achieved 90% accuracy in identifying sepsis 16 hours before it manifests. A report is inHealth IT Analytics.

    A preview of a study scheduled for publication on in the New England Journal of Medicine says that current practices for sepsis treatment don’t increase patients’ chances of survival.

    In December, a FierceHealthIT report said Mount Sinai Hospital in New York is expanding a successful programme to reduce sepsis in the hospital after achieving a 40% reduction from a trial using alerts generated by EMRs. The EMR intervention program triggered a red alert from data showing subtle changes in vital signs, including higher temperatures and pulse or breathing rates. Previously, these rarely prompted intervention.

    These are more examples of the emerging value of analytics in healthcare. They bring another layer of benefits and value for EHRs. African countries should develop these skills as a strategic resource. Ray Bradbury, another sci-fi writer, said “Science fiction … it’s the history of ideas”.  Health analytics is creating a new version. African countries need to join in.

  • Ghana gets $3.8 million to accelerate ICT job growth

    The Rockefeller Foundation has announced a $3.8 million grant to the Ghanaian government in partnership with the World Bank. The money will support the establishment of world class facilities attracting IT and IT enabled firms to create jobs for Ghanaian youth.

    The grant will be used to create a new mini ICT Park in Accra and is expected to provide direct and indirect employment to over 10,000 people.

    “As the Rockefeller Foundation enters its second year of our $100m Digital Jobs Africa initiative, we applaud the commitment of the Ghanaian government for steering the hiring at this new state of the art ICT Park towards poor and vulnerable youth” said Mamadou Biteye, Managing Director of the Rockefeller Foundation Africa Regional Office.

    The Rockefeller Foundation’s Digital Jobs Africa initiative is being implemented in six countries in Africa – Ghana, Nigeria, Kenya, South Africa, Egypt and Morocco.

    The grant will support and provide new opportunities for the ICT industry. This is likely to spill over into other sectors, such as healthcare. In order for eHealth to be successful, the healthcare system requires a wide range of ICT specific skills. eHealth systems the world over are in desperate need for the skills to drive the initiatives. The grant will help educate people to full these vital jobs, becoming fundamental cogs in the healthcare system.

  • eDecision switches into Clinical Quality Framework

    There’s nothing new about quality. Aristotle said that “Quality is not an act, it is a habit.”  The USA’s Office of National Coordinator for Health Information Technology (ONC) seems keen on the idea. Over the days 21 to 27 March, it switched its Health eDecision (HeD) project into its Clinical Quality Framework (CQF). The change is set out in Dr Doug Fridsma’s blog on Health IT buzz.

    HeD is linked to the Standards and Interoperability Framework, (S&I Framework) and created three implementation guides and authored six HL7 standards with the guidance of the HL7 Clinical Decision Support (CDS) Work Group. The six standards are:

    CDS Knowledge Artifact Implementation Guide Decision Support Service (DSS) Implementation Guide Virtual Medical Record (vMR) Logical Model vMR XML Specification vMR Templates DSS Standard.

    HeD also completed work on two Use Cases:

    Clinical Decision Support Artifact Sharing, dealing with using a good clinical decision support rule with someone else in an electronic format, so they can use the rule in their EHR Clinical Decisions Support Guidance Service, dealing with the technicalities of sending important data to an up-to-date website or service that provides advice on immunizations or other complex decisions.

    CQF’s goal is to harmonise CDS standards and electronic clinical quality measurement (eCQM). It takes HeD’s work further.

    These are long-term initiatives that need stamina and patience. Like Aristotle said, “Friendship is a slow ripening fruit.” He hadn’t heard of S&I.

  • Is foreign ICT an eHealth security risk?

    The increase of foreign ICT in the country is capable of threatening the security of Nigeria, NigComSat Limited has warned.

    NigComSat Board chairman, Prof. Turner Isoun, is concerned about the proliferation of foreign vendors, arguing that the increase in the number of vendors supplying equipment and security solutions to the country poses a serious threat. Isoun warned that the practice exposes Nigeria “to a myriad of potential security threats from otherwise restricted data being exposed to numerous vendors.”

    The same goes for health data. The increase in vendors in the sector intensifies the risk of personal and private health data being exposed. It is crucial to have the eHealth regulations in place to keep health data private and secure. Alongside this, countries need to test compliance. This is the teeth of the barking dog of regulation.

  • Google’s Android is now for wearables

    Building on its experience with Google Glass, Google has developed Android Wear, version of its Android operating system specifically for wearable devices. A BBC report on its technology web pages says the first release is with smart watches to support and follow voice commands. There are a wide range of partners involved, including electronics firms, chip makers and fashion labels on wearable gadgets that run Android. The software is for gadgets that monitor key health parameters and fitness monitors for people who jog, run or cycle, and equivalent activities. It can lead to devices that respond promptly to voice commands, such as answering short questions, booking a taxi or sending a text without having to tap input on a smartphone touchscreen.

    Motorola’s Moto 360 smart watch will be an early adopter. It’ll be on sale in the summer.

    Google announced the initiative on its Google blog. It’s a major step for the company into the wearables sector.

    Entering the wearables market expands Google’s competition with Apple, so there’s a good spectator sport for the next few months. Which versions will succeed in Africa?

  • How secure is your cloud data?

    Cloud is gaining popularity the world over as an effective way to exchange and store large amounts of information. Everything from personal documents and photo’s to critical and confidential business documents are in the cloud. How can we be sure our information is secure and safe?

    Simon Campbell-Young, CEO of Phoenix Distribution says we can’t. “Snowden’s revelations last year have raised concerns as to how secure information in the cloud really is, and who is able to access our most personal information.”

    According to Simon, legislation on data privacy isn’t keeping up with the speed of the development and roll out of new technologies. This is in line with the findings of the eHealth regulation study completed by a consortium led by Greenfield Management Solutions.

    Cloud security is now top of the security agenda. He added that “Over and above companies implementing additional security measures to secure their data stored off-premise, they will also re-evaluate policy on what data can be stored in the cloud, and what data cannot. We will see businesses blocking access to data storing sites that they do not control, such as Dropbox, and will start focusing on the more secure private clouds, and move away from public clouds. In this way, they will take steps to ensure that their most valuable data remains firmly in their control.”

    African eHealth initiatives need to take these risks into account and make sure that personal data is not stored in cloud applications that are accessible to anyone outside the predetermined group. Healthcare facilities could be risking losing personal patient data if the necessary security measures are not put in place.

  • Kenya’s draft cyber security strategy out for review

    Kenya is putting the finishing touches to its cyber security strategy. The ICT Ministry has recently released the draft strategy document and encourages Kenyans and interested stakeholders to provide comments and inputs which will be incorporated in the final document.

    The new strategy document will guide the management of cybersecurity issues in the country. According to Phyllis Nyambura, Communication Department, ICT Authority, the strategy will address loopholes in Information Security.

    “Cyber-crimes take various forms and include all manner of offences against the confidentiality, integrity and availability of computer data systems, content, copyright and trademark, computer offences and cyber terrorism, cyber warfare and cyber laundering among other crimes.”

    To participate in the review all comments should be submitted by Friday, 28th March, 2014.  Comments can be sent to cybersecuritystrategy@ict.go.ke. Stakeholders are invited to download the Draft Cybersecurity Strategy at http://goo.gl/6CyMRO