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  • AI needs faster data access for researchers and analysts

    Maximising AI’s potential for clinical research and breakthroughs needs access to large data volumes to train then deploy AI models. A white paper by International Data Corporation (IDC), sponsored by: Pure Storage, says Hard Disk Drives (HDD) are too slow for the task. It says All-Flash Arrays (AFAs) are faster and more accurate. 

    An AFA’s a Solid State Disks (SSD) storage system with several flash memory drives. Instead of searching for data on spinning HDDs, SSDs have no moving parts, so are faster to access. The Tech Republic has an entry-level guide on AFAs. It says they’re disrupting traditional data storage resources. 

    IDC’s white paper emphasises AI as a learning process where researchers and analysts need prompt access to data for clinical projects. It has two main benefits:

    Shortens the clinical innovation time from desk to bedsideAttracting and retaining scarce clinical researchers and data scientists who look for leading-edge AI investment and infrastructure to succeed.

    Improved data response times with AFA benefits clinical teams that need access to clinical data for direct patient care too. Faster response times help to improve their productivity and efficiency. They also help to minimise eHealth frustrations and improve job satisfaction. 

    As eHealth foundations are vital parts of eHealth strategies, Africa’s health systems should consider SSDs along with expanding network capacity and connectivity capacity.  

  • Ada Lovelace’s 19th century computer book sold at auction

    The first female computer expert translated and expanded the Sketch of the Analytical Engine, published in 1843. She worked with Charles Babbage who invented the Analytical Engine, a mechanical calculator. It had four components that match modern computers. They were: 

    Mill, the calculating unit, the equivalent of the Central Processing Unit (CPU)Store, where data was held before processingReader, an input functionPrinter, an output function. 

    He unveiled his machine at a seminar at University of Turin in 1840. Italian military engineer and mathematician LF Menabrea, subsequently a prime minister, reported on the presentation. Babbage encouraged Lovelace to translate it into English. She added her own, substantial explanatory notes, which more than doubled the length of Menabrea's article and included an Analytic Engine’s algorithm.

    A report in the Antiques Trade Gazette say the book sold for auction in England for £95,000 (US$124,000). It’s one of seven known copies. It’s significant because she was the first person to recognise that the machine had applications beyond pure calculation, and published the first algorithm. She’s referred to as the Countess of Computing, reflecting her social standing and formal, title of Lady Lovelace, and the World’s First Computer Programmer, recognising her pioneering role in computer programming. When it was published, she was not credited as author. In 1848, she was, four years before her death, aged 36. 

    Her father was the poet Lord Byron. Her mother, Lady Byron, was educated in science and mathematics. It may be that inherited traits such as creativity and analysis combined in Ada Lovelace with a resultant impact on computer science and creation of the Ada Lovelace Institute.   

    How much will these abilities reflected in manuals of modern algorithms sell for in about 180 years from now? Presumably they’ll be in an eBook.

  • Villgro Kenya financing Uganda’s MamaOPe and clinicPesa

    East Africa’s startup ecosystem is growing. clinicPesa and MamaOpe, two innovative Ugandan enterprises, are set to take up capital from Villgro Kenya, an investment firm with its HG in India. The goals are to raise clinicPesa’s and MamaOpe’s  profiles, underpin the initial growth, and enhance the availability and accessibility of eHealth services in economically vulnerable areas.  

    clinicPesa’s support’s USD$40,000. MamaOpe’s USD$25,000

    An article in Wee Tracker says Villgro focuses on finance, mentoring and networking support for social enterprise startups. Its business model focuses on projects in agriculture, education, energy and health. Its partners are usually early-stage for-profit solutions for disadvantaged individuals and communities. The outfit’s recent extension into Kenya expands the reach of these broader.

    clinicPesa’s a digital micro-savings and loans platform. It provides users with convenient and affordable access to quality healthcare services by accessing their savings and loans for a range of registered health services providers. Many families slip further in to poverty after accidents or meeting unexpected medical emergencies. clinicPesa reduces out-of-pocket spending on medical bills, medicines or treatments so users to avoid excessive debt or property sales to cope.

    MamaOpe group’s a biomedical initiative. It aims to minimise pneumonia misdiagnoses and associated delayed treatments. These are primary reasons many deaths from the disease.   The MamaOpe team’s developed a biomedical smart jacket to help healthcare workers who are not doctors in low resource areas to gauge pneumonia’s primary symptoms and diagnose it accurately.

    Villgro’s been keen to add East African startups to its portfolio. Kenya’s Villgro Innovations Foundation offers a structured programme that includes finance, mentoring and connections to wider healthcare networks. These contribute to steps towards East Africa’s Universal Health Coverage (UHC). Will Villgro be offering these opportunities across all Africa soon?

    Watch this YouTube clip about clinicPesa.

  • Singapore health system hacked

    About 5.9m people live in Singapore. About 25% of their demographic and personal data has been stolen from SingHealth. A report in Channel News Asia says theft of 1.5m records by the cyber-attack was the “most serious breach of personal data.” Some 160,000 patients had their dispensed medicines’ records stolen too. 

    The Ministries of Health and Communications and Information revealed that Prime Minister Lee Hsien Loong’s records were “specifically and repeatedly” targeted. It included his outpatient dispensed medicines details. Several other ministers were also affected. 

    Data taken included names, National Registration Identity Card (NRIC) numbers, addresses, genders, dates of birth and racial origins. Hackers didn’t amend or delete records. Nor did they steal medical records, such as diagnoses, doctors’ notes and health scans

    Database administrators detected unusual activity on a SingHealth’s IT database on July 4. They immediately to stopped it.

    Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System (IHIS) investigations found that the cyber-attack was “deliberate, targeted and well-planned.” They concluded that it was not the work of casual hackers or criminal gangs. They are not revealing more because of operational security reasons.

    Channel News Asia hints at a country’s behind it, with only a few that have the sophistication required. The motivation’s not known. 

    The incident’s another reminder for Africa’s health systems that cyber-security’s essential. Technical measures are not enough. SingHealth’s database managers’ rapid intervention shows that constant vigilance’s needed too. Without them, the breach could have affected more than 25% of the population.

  • Stethee reinvents the stethoscope with AI

    The worlds first Al enabled stethoscope system has been launched by M3DICINE Inc.

    The design itself is revolutionary and operates as easily as the traditional stethoscope. However, it allows users to listen to the lung and heart sounds with a more sophisticated amplification and filtering technology. Heart and respiratory sounds captured are sent via Bluetooth to the Stethee Android or iOS App which enables a wider range of diagnostic capabilities.

    The Stethee system comes in three core products:

    FDA cleared Stethee Pro for medical and healthcare professionalsStethee Vet for veterinarians and animal professionalsStethee Edu developed specifically as an education and research tool

    The technology platform behind the Stethee AI engine , named “Aida” can analyze the heart and lung sounds to build a unique personal biometric signature.  In addition to this, Aida automatically tags geo-location and environment data to each sample in real time.  This offers a completely new dimension of data analytics for public health planning by allowing one to understand what effects environmental factors such as pollution, temperature or humidity have on our heart and lungs.

    Aida also analyzes this encrypted and anonymised data in order to learn and report back quantitative clinically actionable data to vets, doctors and other healthcare professionals. Not only does it identify and analyze heart sounds and respiratory activity but also patterns that may indicate a disease condition. The data is represented in real time in the Stethee App, therefore making it easy to understand vital signs.

    The potential for the Stethee to be used in remote rural areas is quite vast because its relatively easy to use and results can be shared and analyzed promptly by a medical specialist anywhere in the world. This is invaluable to the improvement of patient care, more especially to remote rural areas where access to screening services or a cardiologist is very difficult.

  • Better eHealth can improve HIV monitoring and surveillance

    Ambitions to eliminate HIV are enthusiastically in place. Achieving them, such as the 90-90-90 goals can benefit from better eHealth. An article in the Journal of Medical Internet Research (JMIR) says questions remain about the sustainability of the programmes and the value of data initiatives. 

    Five principles identified in Sustainable Monitoring and Surveillance Systems to Improve HIV Programs: Review are:

    Better quality, local, granular, and disaggregated data to design and support a sustainable responses to ending the AIDS epidemicSupporting the health services cascade needs a cascade of linked dataUsing surveillance data is an intervention in itself, allowing programmes and communities to improve services’ responsesSurveillance needs systematic investment of at least 5 to 10% of programme budgets so that remaining resources address the epidemic and its impact can be assessedIncreased support for routine, integrated, district health data as part of health information systems, including sexually transmitted infections and hepatitis, linked to real-time health decisions.

    The study found that data’s been removed from healthcare settings and communities. It’s part of anonymous testing, national surveys, and modelling. It says that routine data’s part of implementation and an essential part of public health interventions,  packages of prevention and care. Without routine data availability, it’s difficult to achieve an effective public health or community responses. 

    This highlights the need for Africa’s health systems to review their HIV data components to test how they fit the service requirements identified by the study. It seems that some development or resetting may be needed.

  • Planning, stumbling blocks and learning: Argentina’s advancing health centre eHealth programme

    While considerable challenges remain, Argentina’s eHealth revolution’s gaining ground.

    A report in eHealth Reporter Latin America says it’s the view from the Argentine Association of Users of Information Technology and Telecommunications, (USAIRA) at its 8th Forum of IT Health Argentina  at the National Academy of Medicine in Buenos Aires 

    Dr Daniel Rizzato Lede, Director of Development of Healthcare Information Systems at the Ministry of Health, described how the Argentinian National Digital Health Strategy will promote connectivity between different health centres and develop a dialogue between information systems in provinces. It’s part of a digital strategy for Ministry of Universal Health Coverage (CUS) project that connects 14 provinces and a unique EMR for all patients, regardless of local government, medical institution or facility. 

    Defining national eHealth standards is planned before the end of 2019. It’ll enable implementation of a national eHealth infrastructure with scalable projects in provinces that operate within regulatory and legal frameworks. Before 2023, these services will be in all Argentinian provinces. 

    Guidelines for a strategy for a paper-free environment are underway at the Hospital de Alta Complejidad en Red “El Cruce”, Buenos Aires. Matías Said, functional analyst and project coordinator says it’ll be in place in the 180-bed hospital before 2022. 

    The In addition, , from Swiss Medical Group (SMG) has a long-term project for a unique health information system that integrates management of 30 health care units. It began in 2014. Daniel Castro said it involves 11,000 doctors and dentists, 1,500 nurses, 1,200 administrative employees, 300 telemarketers and 1,700 assistants.

    Gonzalo Rojo, a pediatrician, shared the step by step EMR implementation in the Hospital Britanico de Buenos Aires. The project started from scratch in August 2016. There are 80 project team members, and 200 direct collaborators. Doctors are on the hospital group leading the initiative. His crucial insight that’s a lesson for all eHealth project’s is that “Sometimes, we lose sight how easy it is for the doctor to use paper.” 

    Other contributors included the collaborations between RedHat and the Massachusetts Open Cloud (MOC). Its aim’s to increase processing imaging speeds and diagnostics precision. OMINT in Brazil, presented research into chatbots. They show that only 16% of 1,700 calls required the intervention by a human operator. Some 95% os users registered satisfactory responses.  Here come the robots.

  • England’s NHS tale of two technologies

    While some of England’s NHS is leading the way with AI, as previously reported in eHNA, other parts seem heavily reliant on FAX machines. This tale of two technologies, with apologies to Charles Dickens for modifying his book’s title, was revealed in a survey by the Royal College of Surgeons (RCS).

    The Independent, a newspaper, says the RCS finding’s that the NHS remains "stubbornly attached" to fax machines. It identified almost 9,000 FAX machines in about 75% of NHS trusts. Using this archaic technology for a significant proportion of their communications looks even more odd when at the other extreme, aspirations for AI are underway and being fulfilled.

    The BBC has highlighted that one NHS trust has 603 machines, over 6.5% of the total identified. Nest in line are 400 and 369 at England's biggest trust. Taken together, the three organisations have about 15% of the total. It’s a heavily skewed distribution.

    In its blog last year, Deep Mind had identified that the NHS was the world’s biggest buyer of FAX machines. The RCS findings are not a surprise. 

    Another dimension of the ICT legacy is that National Health Executive, a blog, highlighted that most NHS trusts had about 160 different computer systems. It seem that one end of the NHS’s two technology continuum’s a long way from the other, AI end. It reveals a legacy and investment challenge that all healthcare organisations face.

  • Wearable heart rate monitors don’t tick the box

    A cynical insight from Napoleon Bonaparte was “If you wish to be a success in the world, promise everything, deliver nothing.” I doesn’t fit wearable mHealth, where reliable results are everything.

    Research in the Journal of Medical Internet Research (JMIR) says some wearables have considerable promise, but have to do much better at delivery.

    It sees an important role for wearable sensor technology in clinical research and healthcare. Before it can, it must undergo rigorous evaluation prior to market launch and its performance should be supported by evidences. The researchers found that match between three heart rate monitoring devices and an electrocardiography (ECG) reference was weak.

    Many studies have tried to validate wrist-worn photoplethysmography (PPG) heart rate monitors, but contrasting results question their utility. A big problem’s inadequate methodologies.

    Validation strategies should consider the nature of data provided by both the investigational and reference devices. There must be uniformity in the statistical approach to the analyses too. Investigators should test the technology in user populations and in appropriate settings for the planned uses. Developers, suppliers and scientific communities need robust standards to validate new wearable sensor technology. 

    There’s a lot more to do before wearables can become mainstream clinical devices. The findings and recommendations should be considered be Africa’s health systems as they advance their mHealth strategies and plans.

  • AI in England’s NHS improves precision and saves time

    The UK’s NHS is 70 years old this year. It was born on 5 July 1948, so happy birthday Since then, it’s seen a continuous surge in new technologies and techniques leading to transformation. eHealth’s been an increasing component over the last 30 years or so. Now, AI’s coming into the investment frame.

    The Guardian has an article on AI at  Addenbooke’s Hospital, Cambridge. It’s used to delineate tumours. AI completes the work in minutes. Doctors use InnerEye from Microsof to mark-up scans prostate cancer patients. Images from completed scans are anonymised, encrypted and sent to InnerEye to create 3D models. It’s learnt to do by training with previous patients

    Brain tumours are next on the list. For some cancer patients, may have to review over 100 images doctors to plan their radiotherapy treatment. It’s obviously time-consuming, both for doctors, their colleagues and can defer the start of treatment for patients.

    The other significant AI benefit’s greater precision, so improved effectiveness. By focusing more precisely on cancer cells, it helps doctors providing radiotherapy treatments to avoid healthy tissues. 

    Both benefits, precision and time-saving, are leading to more streamlined, more effective and more efficient healthcare. These are some of eHealth’s main goals.

    The NHS has also Heart Flow, developed by Stanford University. It’s AI uses routine CT scans from patients with suspected heart disease AI to create personalised 3D models of their hearts and blood flow. It reveals how specific blockages disrupt blood flow in individual blood vessels, leading to better treatment decision, or none where appropriate. Over half the patients with HeartFlow data avoided angiograms. 

    London’s Royal Free Hospital has an AI development underway. It analyses and refines blood test results and to predict which patients are most likely to die, or have serious problems such as kidney failure. It’s trained from almost 1 billion blood test results from 20 hospitals, and identifies subtle changes in red and white blood cells and electrolytes such as sodium and potassium. It reveals which patients’ health may be deteriorating. 

    Other AI services include:

    Skin cancer diagnosesEye disorders from retinal scansHeart disease from echocardiogramsStrokes.

    The results are encouraging. Africa’s eHealth strategies and plans need a place for AI the data it needs.

  • Intermountain Healthcare integrates telehealth and mHealth in a connected care platform

    Information silos are huge obstacles to integrated healthcare. And integrated care is the kind most of us want for ourselves and for our loved ones. It's a key eHealth challenge.

    In a report in Research Information, research platform outfit Dimensions says they’re usually created unintentionally, and are a phenomenon to “escape” from.

    Intermountain Healthcare, based on Salt Lake City, US, seems to be free of these troubles. A report in mHealth Intelligence says it’s integrated 35 different telehealth and mHealth services into Connect Care Pro, a single connected care platform. Objectives are to improve care coordination and keep care in communities, both of which could be good for patients and health systems. It took five years to plan. 

    The services it supports include: 

    Virtual or tele-programmesTelestrokeTelehealth programmes for behavioural healthTelehealth programmes for newborn critical careTelepharmacy serviceseHealth services using connected health devices.

    The legacy was a history of launches of several telehealth and mHealth programs and pilots that didn’t integrate easily. Intermountain sees their integration initiative as the next telehealth phase.

    The initiative has valuable lessons for our African countries' mHealth and telehealth programmes. It makes sense to start constructing equivalent platforms without delay. It’ll be easier and cheaper than waiting until more silos need integrating. Even more important, it’ll bring extra patient and healthcare benefits, sooner, for our patients, our families and ourselves. 

  • What does eHealth have to do for radiology services?

    Radiologists are in short supply.  Radiology workloads and demand are rising. A report from Digital Health explores the opportunities to use AI and Radiology Information Systems (RIS) in the UK’s NHS to fill the gap. It identifies essential requirements for national eHealth too.

    Two solutions are proposed, both needing RIS: 

    Sharing reporting workloads across healthcare organisations

    Using AI to automate some of the clinical workload.

    Current images and workflow sharing relies on  an Image Exchange Portal run by Sectra. It’s fast, but seems it needs replacing to meet radiologists’ needs of: 

    Knowing when an image is there for reviewA single system that displays their own images and other clinicians’ images for individual patientsAccess to each patient’s reporting history and images needed for full and useful reports.

    This needs a specific organisational structure, a lesson for Africa’s health systems. In the days before England’s National Programme for IT (NPfIT) was abandoned, radiology information could be shared across each of England’s five NPfIT regions.

    Since then, smaller geographic consortia have emerged to procure Picture Archiving and Communications Systems (PACS) and RIS from single vendors. It achieves lower costs, smoother, more efficient workflows and makes their sharing easier. Patients, radiologists and organisations outside these consortia don’t benefit.

    Vendor-neutral standards are the solution. Two, Soliton and Wellbeing Software, provide solutions share radiology reporting across several sites with different RIS vendors. Their impacts are constrained because there isn’t a single or unified procurement organisation.

    Is RIS becoming obsolete? EPRs and PACS may be able to deal with scheduling and remote reporting. Some radiologists see it differently. They may be increasingly dependent on RIS.

    AI may be a solution too. It’s already dealing with some basic reporting. Wellbeing has a platform for  an AI algorithm to report directly into its RIS. 

    Agfa uses the term Augmented Imaging (AI). It’s exploring the potential for its AI to automate some administrative tasks. Algorithms are already available to detect TB on chest X-rays. Partnering’s already in place with hospitals and research institutes that need Agfa’s workflow engine to develop their own algorithms. 

    Lessons for Africa’s eHealth are clear. Radiology needs its own eHealth engagement, strategy, plans and procurement.

  • There’s a comprehensive cyber-security manual from KnowBe4

    Cyber-security firms regularly release short cyber-security white papers dealing with a single theme. Now, there’s an updated, big-scale, 221-page manual, and it’s free.

    Cyberheist 2018 fromKnowBe4 extends across cyber-security’s wide range. Written by Stu Sjouwerman, Sunbelt Software co-founder and anti-spyware specialist, and a supporting team, Cyberheist’s 19 chapters provides Africa’s eHealth programmes with a comprehensive view of their cyber-security requirements. While there’s an emphasis on commercial and business activities, such as banking, retailer and ePayment scams, cyber-security principles in these chapters are relevant for eHealth. 

    Cyberheist deals with:

    What drives cybercrime?How and why scams survive, thrive, and succeedTypes and methods of attacksPhishing explored and explained Phishing variations: smishing and vishingTargeted scams, including spear phishing, whalingUnderstanding cyber-crime losses and exposureScary cyber-crime reports and statisticsBank scamsCredit card and ePayment scamsMortgage rescue scamsAutomated clearing house scamsRetailer scamsSocial networking scams Safe computing fundamentalsSyncing security policies, user training and monitoringSecurity technology to protect people and assetsManaging online banking securityFostering cyber-security awareness. 

    It has two main goals. One is to help organisations recognise the increasing danger that they, and individuals, face when they use the Internet. The other’s to enable organisations to take proactive measures to protect them from cyber-threats. After reading Cyberheist, strategies and techniques are needed for protection. These should be core to Africa’s eHealth strategies.

  • GPS tracking finds a role for dementia patients

    Location, location, location’s not just a property agents’ mantra for house hunting and valuations. It’s essential for dementia patients and their health workers and family carers too. Knowing the whereabouts of the patients and loved ones can be supported by GPS. A NHS organisation in Dorset, UK’s testing a tracking device in shoe insoles to know patients’ locations and help to keep them safe.

    It was reported in a BBC Radio 4 programme that alerts are sent to carers’ mobiles when users stray from designated areas. The can be a nursing home yard or garden. The GPS can pinpoint patients precisely to map. When they stray, they can be found, minimising the risk of harm and needing hospital care. 

    Alz Products makes trackers prices at £75 and a £26 monthly fee. They can be transferred to other footwear, so it’s a price per user. 

    A report from the South Central Region of the Dementia Action Alliance South Central Region says there are 670,000 people with dementia in England and 550,000 friends and family acting as their primary carers. Socio-economic costs across healthcare, social care and wider society are estimated at £19b in 2011. It’s more than cancer, heart disease or stroke costs.   

    These kinds of impacts from imaginative innovation offer Africa’s eHealth programmes direct patient and healthcare benefits. They need a significant place in their strategies and plans.

  • QuantumMDx offers low cost DNA tests at points of care

    As technology help DNA test costs and prices tumble, the range of opportunities expands. While conventional supply and demand economics hints that higher prices attract suppliers, lower prices reduces them, disruptive technology’s changing the DNA testing model. 

    QuantumMDx, a UK firm based in Newcastle UK,, offers DNA tests at point of care. They can cost as little as £5, about US$6.65, each. It takes a few minutes to extract DNA into a biosensor that can multiplex in thousands. Its Q-POC™ assays provide data for whole genome sequencing and creating gold pathogen surveillance networks. Global Good Intellectual Ventures aims to bring technology to solve global problems. QuantumMDx works with them.

    Plans are in place to expand from the four main services currently supported. They’re: 

    Tuberculosis has an in vitro diagnostic device for future multi-drug resistance Tuberculosis treatment regimensWarfarin has a pharmacogenomic assay to determine optimum dosage of the anti-coagulantSexually Transmitted Infections (STI) uses a  panel test for quick and easy screening to help containment, including a test for Human Papilloma Virus (HPV) enabling health workers to use molecular diagnostics to screen and treat in a single visitMalaria has uses a drug susceptibility panel to support malaria eradication initiatives.

    Africa’s an important market for QuantumMDx. It has the highest regional malaria burden and the lack of healthcare infrastructure in many communities hinders health workers’ ability to diagnose and treat the infection. Empiric diagnosis is a common technique. 

    Rapid Diagnostic Tests (RDTs) are simple to use and don’t need laboratory infrastructure. They’ve been crucial in dealing with malaria, but have an inherent lack of sensitivity to detect low-level asymptomatic infections, so cannot alone move a country from high burdens to eradication. QuanumMDx sees its role as essential. How will Africa’s health systems move to mobile diagnostics at points of care.

  • Drones are good for your health

    Stuck in in deep marshland in Norfolk, a very rural, flat part of England, or anywhere else, isn’t a good health initiative. Being rescued by a drone is. A report on the BBC website says a 75 year old man was separated from his friends while walking near Titchwell, a particularly wet and soggy part of the county. He was missing for 21 hours, and stuck in a marsh.

    Police used a drone to find him, and it did. He was admitted to hospital and treated for hypothermia. It’s another example of good drone use.

    Without the drone, the outcome could’ve been different. It’s another graphic illustration of the case for drones. Africa’s eHealth strategies for emergency services should have plenty of them.


  • KnowBe4 updates its ransomware rescue manual

    Cyber-security companies have to keep up with cyber-criminal’s expanding ingenuity. KnowBe4, a cyber-security firm, does it to keep users up to speed. It’s overhauled its Ransomware Hostage Manual What You Need to Know To Prepareand Recover from a Ransomware Attack, available from Health IT Security. It reflects the increasing professionalism of cyber-crime activity over the last five years or so. It deals with:

    What’s ransomware?

    RansomwareBitcoin and cryptocurrencyCryptominingThe Onion Router (TOR)

    Am I infected?

    SymptomsInfection vectors

    I’m infected, now what?

    Disconnect!Determine the scopeWhat strain of ransomware?Evaluate your responses: restore, decrypt, do nothing

    Negotiate or pay the ransom

    First response: restore from backup or shadow volumeSecond response: try to decryptThird response: do nothing and lose filesFourth response: negotiate or pay the ransomRansomware attack response checklist

    Protecting yourself in the future

    Defence in depthSecurity awareness trainingSimulated attacksAntivirus, antispam and firewallsBackups


    Ransomware attack response checklistRansomware prevention Checklist.

    KnowBe4’s checklist’s for dealing with a cyber-attack’s extensive.  It’s in two parts, actions and resources. The main headings are: 

    STEP 1: disconnect everything

    STEP 2: determine the infection’s scope and check the of encryption signs

    STEP 3: determine the ransomware strain

    STEP 4: determine the response

    Response 1: restore files from backupResponse 2: try to decryptResponse 3: do nothing and lose filesResponse 4: negotiate or pay the ransom

    STEP 5: protecting yourself in the future


    Users are the first line of defenceSoftware’s the second lineBackups are third

    For cryptomining attacks:

    Train users to avoid downloading it or exploit kits in the first placeIdentify a baseline performance metric for computers and  servers and monitor and alert excessive utilisationInstruct users to report significant system slowdowns or strange behaviourEnsure endpoint protection’s updated frequentlyConfigure web filtering to update frequently and block outgoing firewall traffic to suspicious IP addresses and Command and Control (C2) networks.

    With users as the first line of defence, effective cyber-security training’s essential. It’s been said before, so sustained users awareness and training should already be in place. It is?

  • Duplicate patient records keep turning up

    Achieving accurate patients’ IDs’s a constant theme of managing EHRs. Duplicate records just won’t go away. University of Washington (UW) Medicine based in Seattle regularly reviews and improves the reliability and accuracy of its EHRs. Cleaning duplicate records is an important part of the task. 

    Its latest initiative, available from EHR Intelligence, is  with Just Associates,  a consultancy that identifies and resolves patient data integrity problems, reveals some critical lessons for Africa’s eHealth. It found that the duplicate rate was significantly higher than the 10% to 20% it usually finds. The main cause was inadequate information. Many records contained only four of six ID components. They’re last name, first name, middle name, gender, fate of birth and social security number. 

    The review identifies the source of ID issues and issues that create duplicates. This information has helped UW Medicine to develop its strategy and planning to control duplicate rates.

    There’s a long-standing ID challenge. It’s an “uphill battle to dedicate the appropriate resources.”

    Sustaining appropriate staffing levels for ID management’s a challenge. Part of the solution’s relying on ICT tools. An objective’s to using technology to improve efficiency and reduce staff time manually accessing and matching records. It means that staff can then deal directly, efficiently and successfully with awkward ID cases and records.

    A valuable lesson for Africa’s eHealth’s that EHRs alone are not enough. Extra resources are needed to ensure the value of data in EHRs. With a typical duplicate rate of 10% to 20%, any drift in ID management seems to lead to higher rates, so greatly diminished value of EHRs’ data.

  • A coffee case study has lessons for blockchain in healthcare

    Coffee has loads of health benefits, though it’s not typically the go-to place for innovative approaches to health information systems. So I was intrigued by a coffee story that appeared in a June edition of Seattle Business magazine.

    Scott Tupper is an anthropologist and founder of Onda Origins coffee, a company that combines ideas on improving wealth disparity in the world, with a passion for information technology, and coffee. He uses the unique characteristics of blockchain technology to improve information accuracy and accountability in the coffee trade, driven through Yave, a company he started for this purpose.

    Blockchain structures are used to capture information at key steps along the coffee supply chain, from farmer to consumer. This creates a single source of truth about the coffee bean’s journey, encrypted and shared across a trusted, distributed network. And that sounds a lot like what we aim to achieve when building health records.

    Yave constructs multiple registers for each coffee consignment journey. The first register records the coffee producer’s name and electronic ID, the shipment’s ID, the coffee’s place of origin, the amount of coffee and the coffee’s description and quality score. That is encrypted and becomes the first block in a new blockchain.

    At key stages in the supply chain, an additional block is added to the chain, such as when the shipment is received at a mill, or passes through exporters and importers, or roasters. The mill register includes details about the milling process followed, initial roasting, and the results of taste test scores. At each stage new registers are created and existing data, such as taste scores, may be updated with new values. Since blockchain data is immutable, the old data is never overwritten. When new data is added, both new and old values remain in the chain and are auditable. At each stage, the new data is broadcast to the network, which can access all the information.

    How these details change across the supply chain helps to set the final assessment of the quality of the coffee bean, which affects pricing, and helps to review the quality of the supply chain, which drives operational improvements. The coffee-folk believe that one of the most valuable aspects of this application of blockchain is the ability to verify coffee’s origin and other key details of steps along the way to our cups, thereby making it easier to make value judgements about the final product and what you and I should pay for it.

    As we learn more about Blockchain technical attributes, we are beginning to recognise it as a tool for democratisation, sharing data ownership and access equally with all participants. This distributed architecture puts participants in control of their data in new ways that are technically extremely challenging with more conventional systems architectures.

    While Blockchain protects our coffee supply chain, it has the potential to transform ownership of our health data too. 


    Image from the Yave site, https://www.yave.io/


  • mHealth can help to reduce hospital readmissions

    Using mHealth to improve hospital services’s a common theme in Africa’s eHealth strategies and plans. Reducing readmissions’s an important part of these initiatives. A report from MobileSmith says how three mHealth solutions can help. 

    How to Reduce Preventable Readmissions with Healthcare IT describes:

    Efficient mHealth strategies for reducing hospital readmissionsStrategic use cases for prompt implementationSix best practices for cost-effective apps for engaging patient and doctors. 

    Efficient mHealth should provide:

    Relevant discharge communicationFamily and carer engagementImproved medication adherenceChronic disease control.

    The six best practices are: 

    Research and know target patient groupsThink big, start small, act fast, so avoid mHealth that does everything for everybody, so unlikely to be user-friendlyPolish user interfaces and experiencesKeep mHealth freshEstablish secure data exchangesAdopt analytics. 

    Underpinning each of these’s the core goal to empower patients. mHealth’s the bridge that healthcare can leveraging now to empower patients. It can only work with easy-to-use mHealth so patients are encouraged to become more proactive towards their health. These themes need expanding in Africa’s next wave of mHealth strategies and plans. They also need setting alongside high priority patient groups and clinical conditions.