Healthcare workers are increasingly being empowered with many powerful technologies, from BYOD, to social media, texting, and even personal email and USB sticks that have been around for a while. These tools provide new options to healthcare workers to get their jobs done.


Download a new white paper on risky security workarounds


Where healthcare solutions or security get in the way, or IT departments are perceived as being slow or overly restrictive, healthcare workers often use these options in workarounds that achieve the immediate goal, perhaps transferring a patient record unencrypted to a co-worker using a file transfer app on a personal device, but often add significant risk from a privacy and security standpoint.


A global survey of frontline healthcare workers completed January 2013 by HIMSS and Intel, with 674 respondents, reveals that more than half of respondents use workarounds either every day (22%), or sometimes (30%). In a recent blog series, we shared some early highlights of this survey including what is driving the use of workarounds, what specific types of workarounds are being used, and where privacy and security is challenged.


Download the white paper with many more details on the results of this survey and what they mean. Learn practical strategies for how to mitigate risks associated with workarounds, within a holistic, multi-layered approach:

1. Improving usability of solutions and security,

2. Improving responsiveness and agility of your IT department,

3. Choosing the right device, compute model and communication method for your tasks,

4. Improving the effectiveness of your administrative controls including policy, enforcement and effective training.


What questions do you have?

As HIMSS13 approaches next week, we conclude our pre-show guest blog series from health IT industry experts. Below is a guest contribution from Ashley Rodrigue, Healthcare Ambassador at Lenovo, on workflow and point-of-care devices such as tablets and convertibles.


With a variety of different workflows and use cases in healthcare environments, flexible technology ecosystems are essential. To that end, when it comes to point-of-care devices, one of the cardinal rules in effective HIT management is: One Size Does Not Fit All.


Many device manufacturers have responded to this challenge by expanding their portfolios to support a wide range of needs. Over the past few years, we’ve seen new categories of mobile computing emerge and the number of device options increase. As a result, we’ve also seen the number of devices that a person uses per day increase significantly as well.  It’s interesting to compare the differences between devices, but even more interesting perhaps, is to look at the commonalities that could potentially lend themselves to convergence.


Some of the hottest devices for mobility and point-of-care are tablets and Ultrabooks™. The interesting thing about tablets, though, is that the accessories often serve the purpose of making them more like notebooks. Many users require a physical keyboard or a case that can prop the screen up. Similarly, some of the most exciting Ultrabooks have tablet attributes, like touch screens and app based usability.


It is not uncommon for individuals to use and even carry one of each. Therefore, it makes sense that some of the newest and most desired devices are convertibles that provide the best of both in one solution. Windows* 8 Professional Ultrabooks with tablet-like touch screens that twist, flip, bend over backwards, and detach are becoming increasingly popular.


The great thing about this particular type of convergence is that it can result in better outcomes for clinical staff, IT professionals, and healthcare organizations. For clinical professionals, using one device can streamline user experience and provide a nice blend of performance and mobility with a solution that does not limit functionality.


This can result in better workflows, increased efficiency, and better patient experiences at the point-of-care. For IT professionals, these devices introduce far less risk because, even though they have tablet attributes, they can be managed and secured like traditional PCs. For organizations, in addition to the benefits already mentioned, the total cost of ownership (TCO) associated with deploying fewer devices is less. For these reasons, it’s no surprise that convertibles are becoming a hot new trend in healthcare environments.


What do you think?

As HIMSS13 approaches, we continue our pre-show guest blog series from health IT industry experts. Below is a guest contribution from Bettina Experton, MD, MPH, founder and CEO of Humetrix, an Adjunct Professor of Medicine at the University of California at San Diego School of Medicine, and a permanent member of the Faculty of the School of Medicine of Paris.


The federal Institute of Medicine has issued a call to reduce the annual toll of 100,000 preventable deaths and $750 billion in wasteful spending within the American healthcare system, caused largely by a lack of up-to-date patient information at the point of care.


While billions of dollars have been invested in establishing public and private health information exchanges (HIEs) to help solve these problems, studies have shown they are falling short of the vision of having an integrated patient record that can facilitate care as patients move between providers and different care settings.


In response to this failure, many healthcare industry CIOs are looking for alternative solutions, including using mobile apps to help patients coordinate and engage in their own care. In addition to offering a viable work-around for the industry’s interoperability issues, apps can help address the critical issues of preventable deaths, injuries and wasteful spending. So many people believe in the power of mobility to help drive and strengthen patient engagement and care coordination that the healthcare mobile applications market is expected to grow by over 70 percent in the next five years.


Among the latest mobile health apps to reach the market is iBlueButton®, which allows physicians and consumers to securely exchange health records and other clinical information at the point of care. The cross-platform data exchange solution seamlessly and securely transfers data between any enabled devices (iOS or Intel-powered Android® smartphones and tablets) and makes the health information actionable by presenting it to consumers and their providers in a usable and actionable format.


Other applications effectively engaging consumers in their care include iTriage® and ZocDoc®. These apps guide consumers through the healthcare process, from helping them check symptoms to choosing a provider available at a given time. The apps pride themselves on helping people find more cost effective care.


Much like HIEs, mobile apps can be a powerful care coordination tool, helping prevent costly adverse events like preventable hospital readmissions, while improving the overall quality of care delivered. The difference is that by putting the power of care in the palms of the patients’ hands, many of the technical and economic barriers that plague other HIE and care coordination solutions can be avoided, thus advancing the objectives of healthcare and health payment reform more quickly.


What do you think?

As HIMSS13 approaches, we continue our pre-show guest blog series from health IT industry experts. Below is a guest contribution from Andy Rocklin, Solution Partner, Health Sciences at EMC, on patient-facing IT engagement models. Watch for more pre-HIMSS posts this week as we get closer to the show.


If you have read any of my blogs, or my most recent Seducing Porcupines you know that I spend a significant amount of time analyzing how technology can influence the largest cost driver in healthcare: patient behaviors. This year’s HIMSS conference shines a spotlight on the many motives, methods and stakeholders offering related solutions.


An occupational hazard of consultants is to simplify the world to a level we can understand. For me, the explosion in patient-facing IT solutions boils down this equation:




To start let's unpack the factors on the left side of the equation.


Multiple interested constituents are affecting the transformation of healthcare. Consumers are being forced to become more accountable for their care, but they are not yet fully empowered to effect positive change in results. Employers and CMS, who are the ultimate Healthcare financiers in the U.S., are now positioned to use information technology to exert even more influence on insured individuals and Healthcare Payers. Providers are being asked to assume more risk in the burgeoning pay for performance model and they are feeling pressure to use technology to predict and manage their risks. Healthcare Payers, having all but exhausted their traditional levers for reducing costs, are exploring how to incent and engage members in managing their care.


New technologies platforms are multiplicative factors in this transformation. Patients need extended care teams and payers to communicate, collaborate, and plan—often across organizational and historical boundaries. For example robust mHealth and Care Coordination tools like those provided by Intel, enable Healthcare Provider teams to build a technology platform for engaging patients and managing care. These tools also support the growth of patient facing mobile applications which are on the leading edge of care transformation.


Though technology platforms are multipliers, aggregating, accessing and analyzing rapidly growing pools of Big Data will exponentially grow value that Healthcare Providers and Payers can deliver. Using technologies and services from EMC, healthcare providers and payers can create better customized care guidelines through refined benchmarking against more precise patient cohorts. Providers will be able to analyze their big data to do an immediate evaluation of health status changes and to build patient engagement models tied to psychographic profiles.


So what’s the verdict who will be most effective helping moving the consumer behavior dial with robust technology platforms and big data analytics? Well, to be honest, the jury is still out. We’ve seen that changing patient behavior is hard to do as human nature will resist change, even for the good. (Anyone else with abandoned New Year’s resolutions already?) A look around HIMSS will show efforts and tools that many providers, payers and employers will test in efforts to change behavior and outcomes. Some will succeed. I believe the ingredients to meaningful change are in the equation above and I believe that  Intel and EMC have technologies and services to help our customers perfect the recipe.


What do you think?

In my last blog, What is Driving the Use of Risky Workarounds in Healthcare?, I explored the reasons why frontline healthcare workers are using workarounds that are out of compliance with policy, drive increased privacy and security risk, and can result in compromises to the confidentiality (breach) and integrity of patient records. An example of a workaround could be a healthcare worker taking a photo of a patient on a personal device and emailing this using their personal email to a co-worker.


A global survey of frontline healthcare workers completed January 2013 by HIMSS and Intel, with 674 respondents, reveals that more than half of respondents use workarounds either every day, or sometimes. In this blog we look at what types of tools healthcare workers are using for workarounds.

In this survey, we asked frontline healthcare workers globally what types of workarounds help deliver better care more quickly. Here’s what they said:


  • 59 percent indicated they use personal smartphones for workarounds, 50 percent personal tablets, and 39 percent personal laptops
  • Text messaging was used by 40 percent of respondents
  • Personal email is being used by 32 percent of healthcare workers in workarounds that help them get their job done
  • 21 percent of respondents indicated they are reverting to paper based workarounds where technology solutions or security get in the way


Many other respondents indicated personal apps (20%), personal USB keys (19%), photos using personal devices (17%), social media (12%), video using personal devices (8%) and several other types of workarounds


So what should you do about this? A proactive approach to enabling BYOD (Bring Your Own Device) is recommended, enabling the use of personal devices in ways that are in compliance with privacy and security. However, these results clearly show that personal devices may also be used in workarounds that are not compliant with privacy and security policy and drive significant additional risk of security incidents such as breaches.


Healthcare organizations are encouraged to explicitly treat the use of workarounds in their policy, procedures, and risk assessments. For the highest priority risks that need to be mitigated, this information on what types of workarounds are being used by healthcare workers is critical to make informed decisions on what types of safeguards to use to mitigate the associated risks. Some of these safeguards may be technical or physical. Effective training is also an increasingly important administrative safeguard to mitigate risks of workarounds, and is sure to grow further in importance as healthcare workers are increasingly being empowered by BYOD, social media, and many powerful new tools.


What types of workarounds do you see in your healthcare organization?


Stay tuned for more information in my weekly blog series. Next week we’ll start to take a look at further results from the survey that measure healthcare worker awareness of risks and why they use workarounds anyway.


We’ll be releasing these survey results in a whitepaper at a workshop at HIMSS 2013 on March 6. If you will be in New Orleans, join us for the workshop panel to explore this concept further. RSVP and reserve your spot.



As HIMSS13 approaches, we continue our pre-show guest blog series from health IT industry experts. Below is a guest contribution from Andrew Litt, M.D., chief medical officer, Dell Healthcare and Life Sciences, on mobile health IT features and benefits. Watch for more pre-HIMSS posts to come as we get closer to the show.


In a recent HIMSS survey, two-thirds of health IT executives said that the use of mobile technology will substantially or dramatically impact the delivery of healthcare in the future. Clearly, information technology implemented the right way at the point of care can empower medical professionals and make them more productive. But did you know that a mobile computing strategy can also serve as a positive recruiting and retention tool?


According to a recent commissioned Total Economic Impact™ (TEI) study conducted by Forrester Consulting on behalf of Dell, Tallahassee Memorial HealthCare (TMH) saved more than $600,000 and enhanced the productivity of clinicians in its Family Medicine Residency Program by implementing Dell’s Mobile Clinical Computing (MCC) solution powered by Intel.


Designed to improve clinician efficiency without compromising security, MCC combines desktop virtualization, single-sign-on and strong authentication technologies with expert consulting, implementation and support services. By storing information in the data center – not the endpoint device – MCC also helps reduce the risk of lost or stolen data and simplifies HIPAA compliance.


The cost savings and benefits to patients are significant. With the increase in productivity, the clinic will be able to schedule an additional one or two patients per day, per physician. In addition, they were able to implement electronic medical records in a secure environment that simplifies compliance with data security policies and regulations and allows clinicians more time to spend with patients.


But the Forrester study also revealed an unexpected – albeit unquantifiable – benefit: a strong mobile computing strategy can help hospitals recruit and retain physicians. Many medical schools are already using the latest IT tools and residency candidates expect the same leading-edge technology in their work environments. It may seem like a small thing, but by providing residency physicians with remote access via a secure portal, a hospital can help ensure a better work-life balance for the future generation of doctors.


What do you think?

As HIMSS13 approaches, we continue our pre-show guest blog series from health IT industry experts. Below is a guest contribution from Allscripts Director of Business Development Tinal Joros on judging for the company’s Open App Challenge. This post is also available on the Allscripts blog. Watch for more pre-HIMSS posts to come soon.


Developers showed they are eager to “Start a Revolution” by designing and integrating applications to extend Allscripts Open Electronic Health Records software. We have 217 companies and teams registered to participate. At the close of the Allscripts Open App Challenge Phase 1, 98 of those registered submitted their ideas and integration for judging.


The early concepts are incredible and include tools to improve diabetes management, patient scheduling and end-of-life planning. Some apps help make safety net facility information more accessible and others help providers manage sample medications. They all have a mission to improve healthcare.


Our judges now have the daunting task of reviewing the submissions and selecting 15 Phase 1 winners, to be announced at the HIMSS13 annual conference, on March 4, 2013 at 3 p.m. Central time at the Allscripts booth. Judges are looking for apps that either improve management of high-cost chronic diseases or address certain value-based care imperatives.


Introducing our expert panel of judges


We’re grateful to the following people for sharing their time and talent to review submissions to the Open App Challenge:


• Dr. Mark Blatt joined Intel in 2000 working in the New Business Group. He is currently Worldwide Medical Director, Enterprise Solution Sales, in the Sales and Marketing Group. In this role he concentrates on how health information technology (HIT) infrastructure can enable providers to deliver cost effective, quality care to all citizens. He has a particular interest in integrated care delivery, mobile point of care, secure computing and the emergence of cloud computing services.


Lennox Hoyte, MD, MSEECS is a fellowship-trained specialist in Urogynecology and Female Pelvic Medicine and Reconstructive Surgery. He received his MD from Stanford, and his MSEE from MIT. Dr. Hoyte specializes in advanced robotic surgery to correct vaginal prolapse. He authored two books to help educate women about diagnosis and treatment options for pelvic floor disorders. Prior to becoming a physician, he spent 10 years as a computer systems designer and design automation specialist. This helped to prepare him for his current role as Chief Medical Information Officer for the University of South Florida (USF) Physicians Group, where he is tasked with designing and implementing an electronic health record optimized for improving healthcare outcomes while dramatically lowering the cost of providing care.


Daniel Kraft, MD is a Stanford- and Harvard-trained, physician-scientist, inventor, entrepreneur and innovator. Dr. Kraft has more than 20 years of experience in clinical practice, biomedical research and healthcare innovation. Dr. Kraft chairs the Medicine track for Singularity University and is Executive Director for FutureMed, a program which explores convergent, exponentially developing technologies and their potential in biomedicine and healthcare.


Timathie Leslie is, a vice president with Booz Allen Hamilton. She has more than twenty years of experience in the healthcare industry, assisting healthcare organizations with technology strategy, policy development, program management and technical implementation. Leslie leads the government and commercial healthcare practice for Booz Allen in the Western and Pacific regions.


James R. Morrow, MD opened Morrow Family Medicine on the Northside Hospital Forsyth campus in 1998. His interests include sports medicine, episodic care (care of acute problems and illnesses), chronic disease management and urgent care. A 2004 winner of the HIMSS Davies Award for Excellence in EMR Implementation, he was also recognized as the 2006 Physician IT Leader of the Year by HIMSS.


Bill Spooner has been chief information officer (CIO) for more than 15 of his 30 years at Sharp HealthCare. He has led an aggressive IT effort that placed Sharp on the Hospitals and Health Networks 100 Most Wired list for 12 of the list's first 14 years. Sharp was an early leader in electronic health records and has received several awards for its consumer website. In 2011 he was named by Information Week as one of the 25 leaders driving the health care IT revolution.


Jeffrey L. Sunshine, MD PhD is vice president and chief medical information officer at University Hospitals (UH), in Cleveland. Dr. Sunshine provides leadership to the information technology and services teams as they developed and now expand the health system’s $100 million electronic medical record (EMR) project.  In addition to 10 years in healthcare information technology, he has more than 20 years of experience in Neuroradiology.


We’re off to a great start, thanks to these dedicated judges and the innovators who submitted apps. We’re also grateful to Intel for co-sponsoring the Allscripts Open App Challenge Developer Conferences.


We’ll share the Phase 1 results at HIMSS13. You can find updates on our website.


Any words of advice or encouragement you’d like to share with our judges?

Healthcare organizations nationwide are moving quickly to implement electronic medical records (EMR) and other advanced information technologies to improve the quality, efficiency and cost-effectiveness of patient care.


That’s why Dell*, RedHat*, Intel, VMware* and Epic* (DRIVE) have come together to provide a Center of Excellence to support Epic customers throughout the planning process - from consulting to implementation, service desk support, hardware support and more.


At HIMSS13, you are invited to learn more about what the DRIVE program involves and how Dell, RedHat, Intel, VMware and Epic can provide you with the expertise required to make the transition to Epic on Linux more efficient.  Come join us for lunch on Monday, March 4, at 11:30 a.m. in the Intel hospitality suite (Riverside #215).


Learn more and RSVP to this unique event.

North Carolina is known for basketball, barbecue and beaches. However, my current home state is also becoming a hotbed of healthcare IT innovation.


That’s why the North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) and Intel Corporation have announced a new series of Health IT Innovation Awards to recognize outstanding applications of technology and unique approaches to improve the quality and efficiency of healthcare delivery within the United States.


Three broad categories have been designated for award consideration: Information Technology, Informatics/Analytics, and Consumer Engagement:


Information Technology – Innovations in the use of IT including: improving quality at the point of care; strengthening the security of protected health information; facilitating health information exchange; achieving Meaningful Use, etc.


Informatics & Analytics – Innovations in the use of informatics and analytics to improve: the quality of care; health outcomes; population health, etc.


Consumer Engagement – Innovations that improve consumer engagement with their care while protecting patient privacy including such tools as: patient portals; mobile apps, etc.


Nominations are due by March 8, 2013. You do not need to be from North Carolina to enter.


Three finalists in each category will be selected by a panel of NCHICA members and other industry experts serving on the Awards Selection Committee. Nine finalists will be notified on March 29. The finalists will be recognized and the three winners will be announced and honored at a Gala Awards Celebration on May 7, 2013. 


For further details and nominating criteria, visit


What questions do you have?

As HIMSS13 approaches, today we kick off our pre-show guest blog series from health IT industry experts. Below is a guest contribution from Allscripts Director of Strategic Marketing, Michael Loesel, on phase one of the company’s Open App Challenge. This post is also available on the Allscripts blog. Watch for more pre-HIMSS posts to come in the next two weeks.


As I shared in my post, What’s Motivating Healthcare Innovators?, I’m encouraged by my conversations with Allscripts Open App Challenge developers. Solving healthcare problems is not about financial gain for them; it’s a mission to help others.


It’s about transforming healthcare. To make this happen, all of healthcare IT has to work together – and so do our solutions. Interoperability is key to unlocking the potential that technology has to offer. The Open App Challenge holds promise beyond any one vendor or company. By fostering innovation and collaboration, we have a much better chance to solve problems we once thought were unsolvable.


Phase One of the challenge is underway

We’ll likely have far more high-quality applications than we can recognize. I wish I were one of the judges that will review fascinating ideas from inspiring innovators.


Consider Dr. Phillip Lisagor, a retired cardio-thoracic surgeon. His mission is to help physicians and patients have the tough conversations needed to plan for end of life. Dr. Lisagor envisions “Rest Of Your Life” or “ROYL” champions in healthcare.


Then there is Dr. Tashfeen Ekram. After having difficulty rescheduling a dentist appointment for himself, he recognized a need for better scheduling options for patients in his own practice. He’s working towards a solution that will notify patients who are willing to be seen sooner of recent cancellations.


Declan Frye has a mission, too. He is creating tools for social workers and hospital discharge planners to quickly identify safety net facilities – such as nursing homes, mental health or substance abuse facilities. Access to this information can improve care coordination for patients as they move from one provider to another.


These are just a few examples from the surge of innovations happening today in healthcare. We’ll share more news from the Open App Challenge as it progresses.


You can see highlights of my video chats with CEOs and Founders of, SampleRx, Purple Binder, ROYL, Chiron Data Systems, mHealthCoach and more.


What do their stories tell you about today’s healthcare innovators?


In my last blog, I discussed the extent to which healthcare workers are doing workarounds to get their jobs done, using personal smartphones, tablets, laptops, USB keys, apps, email, texting, social media and others. Workarounds are out of compliance with policy and drive increased risk to confidentiality which can lead to breach, as well as risk to the integrity of the patient record since data in such workarounds often doesn’t get updated in the patient record.


An example of a workaround could be a healthcare worker texting sensitive healthcare data to a co-worker. A global survey of frontline healthcare workers completed this past January by HIMSS and Intel, with 674 respondents, revealed that more than half of respondents use workarounds either every day, or sometimes.


Why is this occurring? To measure drivers compelling healthcare workers to use workarounds, we posed the following question in the recent survey: “What factors motivate the use of workarounds in your organization?” Here’s what came back:


-45 percent of healthcare workers responding to the survey indicated that they use workarounds because they are simply easier to use. They indicated room for improvement in the usability of healthcare solutions and security around them.


-40 percent indicated their IT departments were too slow to enable new technologies.


-22 percent indicated the list of approved apps is too restricted, suggesting that if healthcare IT departments are perceived as being too slow in enabling new technologies, or too restrictive with approved technologies, then healthcare workers can bypass them with workarounds that are increasingly available to them.


-36 percent indicated that there are too many layers of login required, pointing to the need for single sign on technologies, and authentication methods that are more user friendly such as those using proximity tokens and biometrics.


-24 percent of healthcare workers responding to the survey indicated that workarounds help deliver better care, suggesting a decision by healthcare workers to waive the risks of workarounds in light of the benefits of improved care.


Many other drivers were measured in the survey including web browser and thin client challenges with network availability / performance, 2-factor authentication, slow encryption, and so forth.


What factors do you see in your healthcare organization compelling the use of workarounds?


Stay tuned for more information in my weekly blog series. Next week we’ll look at the specific methods being used by healthcare worker to do workarounds.


We’ll be releasing these survey results in a whitepaper at HIMSS 2013. If you will be at HIMSS13 in New Orleans, join us for a workshop panel to explore this concept further. RSVP and reserve your spot.



Intel was a supporter of last week’s GETHealth Summit in New York City. Below is a guest blog from Alice Borrelli, Director, Global Healthcare Policy, Intel Corporation, who participated in one of the event’s panel discussions.


Last week at the United Nations, more than 400 delegates from around the world met at the GETHealth Summit to discuss the question, “how do we GETHealth in emerging markets through ICT for the frontline healthcare worker?”


Public and private sector leaders of health programs, educators, donors, governments, and the IT industry came together equipped with our technology solutions, eLearning modules, best practices and social media reach and found a distinct difference at this conference. The time for pilots and PowerPoint presentations is over. They were replaced with a dynamic conversation, systems design, mapping in-country progress and an announcement of a serious fund raising initiative.


We were reminded of the critical importance of training healthcare workers who augment care in African countries with less than five physicians per 100,000 patients. Can a combination of digital learning, access to clinical decision support tools and patient records provide the needed training that will lower those shocking statistics? All while ensuring that mothers and children have a chance for not only survival, but a healthy live course? Can this become the new norm?

GETHealth photo.JPG

Joining the panel on institutional policy and regulations last week at the GETHealth Summit were (right to left): Gary Fowlie, Head of Strategy and Policy Unit, ITU; Larry Irving, Co-Founder, The Mobile Alliance for Global Good; Alice Borrelli, Director of Global Health and Workforce Policy, Intel; Mick Keyes, Senior Technologist, Enterprise Group, Hewlett Packard, and Karen Schulder Rheuban, Director of University of Virginia Center for Telehealth.


As I see it, the answers to these questions are, “not without global and local policies in place that will create a pathway to speed the necessary training, testing, and refresher programs to the frontline worker.” Joining the panel on institutional policy and regulations last week at the GETHealth Summit, I came prepared to offer the Intel experience of standards based solutions for rapid growth, innovation and lower costs to go to market by instituting tried and tested Health IT “gold standards” including HL7, LOINC, SNOMED CT, ICD10, RxNorm and Continua.


The use of these standards facilitates data exchange among communities, hospitals and regions. Not everyone in the session agreed, and challenges to these recommendations were thoughtful and important to consider in emerging markets. These questions were brought to the discussion: “should we pursue a lighter standards approach?, and are there emerging  technologies that will ensure the connection of training materials to health records and population health data repositories that will give a more in-depth understanding of the region’s healthcare challenges and treatments?


WHO and the ITU are convening standards bodies, governments, ICT companies and NGOs to discuss these issues and we are encouraged by their progress. Intel is supporting these efforts by providing expertise and technical assistance. We would go one step further and propose to the NGOs, foundations, governments and corporations that have been supporters and funders of frontline healthcare worker training, that we unite in our commitment to standards and the interoperability of both technology and programs.


Can we agree to require future funding be tied to the demonstrated ability for programs and technology to work together at every level before the funding is released? Should standards based designs be a requirement for the deployment of the digital delivery of education for frontline healthcare workers?  It’s an approach that we hope will be debated as the next level of funding is rolled out through the leadership of Jeffrey, Sachs, Director, The Earth Institute, which we expect to be the turning point for achieving the 1 million X 2015 goal.


Sincere thanks to Bob Bollinger and the leadership teams from Johns Hopkins Center for Clinical Global Health Education, the Global Partnerships Forum and the governments of Ethiopia, Norway, Rwanda and Uganda for convening this inspirational and impactful conference.  We are ready to go beyond Powerpoints.


What questions do you have?


More information on the Intel skoool™ Healthcare Education Platform, the company’s open access multi-media platform to strengthen the skills of midwives and community health workers maybe found through the partnership organizations: UNFPA, and USAID’s mPowering Frontline Health Workers.

In my last blog, I mentioned a global survey of frontline healthcare workers completed January 2013 by HIMSS and Intel on what motivates the use of workarounds, what types of workarounds are being used, and where there may be challenges in privacy and security.


One of the most interesting questions from the survey asked healthcare workers was, “How commonly do 'workarounds' happen in your organization, which may involve the use of alternative tools such as personal device/apps or social media that may be out of compliance with policy?”.


The results found that 22 percent of healthcare workers indicated they use workarounds every day, and 30 percent indicated using workarounds sometimes. Combined these represent more than half of 674 global healthcare worker respondents that acknowledge using workarounds, risking the confidentiality and integrity of sensitive healthcare data. Workarounds may include personal smartphones, tablets, laptops, USB keys, apps, email, texting, social media and others. The interesting thing about these types of risks is that they can happen even with thin client/VDI solutions, and even the most secure platform including corporate provisioned devices can be impacted if the healthcare worker has personal devices on them, is able to install apps, can use social media, do text messaging and so forth.


A key take-away of this result is that the use of workarounds is currently real, serious, and should be included in risk assessments done by healthcare organizations. These types of risks are also poised to grow as healthcare workers are increasingly empowered with more exciting and powerful personal devices, apps, social media and tools they can and do use to improve healthcare, but in many cases inadvertently also add privacy and security risk.


Stay tuned for more information in my weekly blog series. Next week we’ll look at the specific motivations and drivers that are compelling healthcare workers to use workarounds, ranging from healthcare solutions that are unusable, to IT departments that are too slow to enable new technologies and apps, to cumbersome security controls that are impeding healthcare workers.


Are you currently including risks of workarounds used by healthcare workers in your risk assessments?


If you will be at HIMSS13 in New Orleans, join us for a workshop panel to explore this concept further. RSVP and reserve your spot.



We spend a lot of time and attention analyzing vulnerabilities with specific endpoint devices or cloud platforms, which is warranted, but often not the most significant source of privacy and security risk.


Healthcare workers are being increasingly empowered with tools from bring your own device (BYOD) personal smartphones, tablets, laptops, to personal apps for file transfer, note sharing and other tasks, to social media, texting, personal email, USB keys and so on. When healthcare solutions, or the security around them, are perceived by healthcare workers as unusable or cumbersome, they can and do use workarounds that can drive additional risk.


One specific example is moving unencrypted patient information using a file transfer service accessed using an app running on a personal device. In this case the sensitive healthcare data is moving through the data transfer cloud associated with the file transfer app. This moves the protected healthcare data into a “side channel”, separate from the EHR, out of the control of the healthcare organization. This in turn adds risk to confidentiality of breaches, as well as risk to the integrity or completeness of the patient record since data moving in side channels like this, out of band with the official repository eg EHR (Electronic Health Record) solution, often does not result in updates to the patient record.


Over time the patient record can become incomplete or dated. In a best case this can result in suboptimal healthcare, and in a worst case become a patient safety concern.  This vulnerability can exist even with a secure endpoint device and secure cloud behind it, and even if a thin / VDI client is used, since it only requires the user to have the ability to install and use the file transfer app.


Cloud Security Slide.jpg


In January 2013, HIMSS surveyed frontline healthcare workers globally on what motivates the use of workarounds, what types of workarounds are being used, and where there may be challenges in privacy and security such as lack of policy, enforcement, or ineffective training. This survey greatly exceeded expected response rate with more than triple the target number of responses, or 674 total respondents. Here’s some quick bites of information about the respondents:


  • 77% of respondents were in North America
  • 11% in Europe
  • 4.5% Middle East
  • 46% of respondents were working in hospitals
  • 27% in multi-hospital systems or integrated delivery systems
  • 7% in ambulatory care facilities
  • 66% of respondents were in large organizations with more than 500 employees
  • 23% in medium sized organizations with 50-500 employees
  • 10% in small organizations with less than 50 employees


The largest categories of roles of respondents were nurses at 14 percent, doctors/PAs/nurse practitioners at 13 percent, administrative directors/managers at 11 percent, and several other healthcare frontline worker roles across provider, payer, life sciences and pharma sectors of healthcare.


What did they have to say? Stay tuned for more information in my weekly blog series leading up to HIMSS13 on the drivers motivating use of workarounds by healthcare workers, what specific workarounds they are using, and where privacy and security is breaking down.


What risks are you seeing in your healthcare organization with sensitive healthcare data moving from endpoint devices into unsecured clouds?


If you will be at HIMSS13 in New Orleans, join us for a workshop panel to explore this concept further. RSVP and reserve your spot.



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