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“Shadow” Devices Expose Networks To New Threats

Posted on June 4, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new report by security vendor Infoblox suggests that threats posed by “shadow” personal devices connected to healthcare networks are getting worse.

The study, which looks at healthcare organizations in the US, UK, Germany, and UAE, notes that the average organization has thousands of personal devices connected to their enterprise network. Including personal laptops, Kindles and mobile phones.

Employees from the US and the UK report using personal devices connected to their enterprise network for multiple activities, including social media use (39%), downloading apps (24%), games (13%) and films (7%), the report says.

It would be bad enough if these pastimes only consumed network resources and time, but the problem goes far beyond that. Use of these shadow devices can open up healthcare networks to nasty attacks. For example, social media is increasingly a vector of malware infection, where bad actors launch attacks successfully urging them to download unfamiliar files.

Health IT directors responding to the study also said there were a significant number of non-business IoT devices connected to their network including fitness trackers (49%), digital assistants like Amazon Alexa (47%), smart TVs (46%), smart kitchen devices such as connected kettles of microwaves (33%) and game consoles such as the Xbox or PlayStation (30%).

In many cases, exploits can take total control of these devices, with serious potential consequences. For example, one can turn a Samsung Smart TV into a live microphone and other smart TVs could be used to steal data and install unwanted apps.

Of course. IT directors aren’t standing around and ignoring these threats and have developed policies for dealing with them. But the report argues that their security policies for connected devices aren’t as effective as they think. For example, while 88% of the IT leaders surveyed said their security policy was either effective or very effective, employees didn’t even know it was in effect in many cases.

In addition, 85% of healthcare organizations have also increased their cybersecurity spending over the past year, and 12% of organizations have increased it by over 50%. Most HIT leaders appear to be focused on traditional solutions, including antivirus software (60%) and cybersecurity investments (57%). In addition, more than half of US healthcare IT professionals said their company invests in encryption software.

Also, about one-third of healthcare IT professionals said the company is investing in employee education (35%), email security solutions and threat intelligence (30%). One in five were investing in biometric solutions.

Ultimately, what this report makes clear is that health IT organizations need to reduce the number of unauthorized personal devices connected to their network. Nearly any other strategy just puts a band-aid on a gaping wound.

Aggregate Fitness Tracker Data is More Valuable than Individual Results?

Posted on March 30, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A recent New York Times article made an interesting conclusion about the value of fitness tracker data:

Ultimately, it is those aggregate numbers that offer the most exciting possibilities: The collective data stream from our devices amounts to by far the largest and most comprehensive observational health trial ever conducted. We have the data; now we just need to figure out what it means.

As a preface to this discussion, it’s worth letting you take a minute to read my article about the clinical relevance of FitBit data (or lack thereof). For those who don’t click over, I argue that doctors don’t care about FitBit (and other Fitness Tracker) data because it’s not clinically relevant. However, new sensors are on their way that will be clinically relevant.

While I fundamentally believe that current FitBit data isn’t that interesting to the individual, it’s worth considering if the aggregate FitBit data is going to provide some clinical and health insights. My reaction is that the aggregate FitBit data is likely to provide a much larger benefit than the individual data. Although, that’s not saying too much since I just said that I didn’t think it was that clinically relevant for an individual.

I do think the aggregate data will tell an interesting story about the population as a whole. If we get enough data (and this will likely require all fitness tracking companies to work together), then we could look at some interesting trends that happen across various regions and shifts in activity over time.

One of the big complaints about value based reimbursement efforts is that there’s no baseline that will allow a doctor to say that their patient population is sicker than another doctor’s population. However, under this new model, we’re planning to reimburse them based on how well they keep the population healthy. We can all see how this isn’t fair and could lead to doctors only working with the most healthy patients.

Could a baseline of personal health tracking data (yes, it will likely need to be more than just step trackers) allow us to understand in a really detailed way the health or sickness of a physician’s patient population?

Yes, this all gets quite messy very quickly. However, it also gets quite exciting. Could enough data help us understand what doctors have said for years, “My patients are more sick!”? I think it could. It won’t be perfect, but it will be better than what we have today.

Of course, the solutions to actually improving the health of patients is a whole other challenge. However, understanding the health of a population as compared to other populations and how their health changes over time is going to be very valuable to the future of healthcare as we know it.

The Power of WeChat for Chinese Health Trackers

Posted on March 24, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been meaning to write this post ever since CES at the start of this year. It was one of the most impressive and interesting things I saw at CES. However, it requires a real international perspective to understand the impact of the story. Hopefully I can flesh it out for you.

While at CES I ran into a company called Lifesense (All in Chinese). I almost didn’t stop at their booth because their booth was in Chinese, but I did recognize the pictures they had and the guy at the booth came out and said hi. I try to respectful so I stopped and talked for a minute.

At first appearance I just thought they were one of the hundreds of copy cat companies I’d seen all over the Fitness area of CES. They had a fitness tracker, a scale, a blood pressure cuff, etc. I guess in some ways they were/are a copy cat company since none of those things made them special (at least nothing I could see). However, it turned out that there was more than meets the eye and there was a reason their booth and website were in Chinese.

Turns out that Lifesense was only in China. They had no US presence (although, he thought that one day they might). As someone who’s always curious I wondered how well their health tracking products had done in China. He then recounted to me that they were lucky to be major partners with WeChat and so they’d had tremendous success in the Chinese market.

This is where I got most interested. For those not familiar with WeChat, it’s the go to IM/SMS/Facebook Messenger/SnapChat/Kik/Whatsapp/etc app for China. Everyone in China is pretty much on WeChat. Plus, unlike the companies that I just listed WeChat also has a built in commerce platform and engine for running third party apps. It’s amazing to think that an IM platform could be so powerful, but WeChat has shown that it can be. You literally can order Pizza or an Uber from within WeChat.

With that in mind, building a health tracking platform on WeChat solves so many of the challenges that US based fitness tracking applications have going against them. Take for example the experience with Fitbit. You can connect with your friends and “compete” against them to see who takes the most steps. However, it can be a pain to get all of your friends on the Fitbit platform so you can compete. Plus, this doesn’t even take into account that your friend has to have a Fitbit device.

Turns out that since Lifesense has built their Fitness tracking on WeChat, they can already connect you to all your other friends that are tracking their fitness with no work on your part. That feature literally just comes built in with WeChat. That’s so incredibly powerful since the social element to health is so important.

The problem in the US is that we don’t have a WeChat. There are a lot of platforms that are trying to do what WeChat’s done in China in the US, but they still have a long ways to go. Plus, it’s hard to imagine them ever becoming the dominant force that WeChat is in China.

As usual, I think there’s lots that we can learn from other countries. I think that’s the case with simple integrations like WeChat that open up all sorts of easy doors to improving health.

Here are some screenshots of the LifeSense app in WeChat for those that are interested to see how the app looks on top of WeChat:

Measuring Steps to Patient Empowerment – Breakaway Thinking

Posted on November 19, 2014 I Written By

The following is a guest blog post by Jennifer Bergeron, Learning and Development Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Jennifer Bergeron

Trends and fads come and go. When they stick, it’s clear they address a consumer need, whether it’s a service, promise, or hope. Here at The Breakaway Group, A Xerox Company (TBG), we operate within a proven methodology that includes metrics, and it’s exciting to those of us who can’t get enough of good data. Most people find metrics interesting, especially when they understand how it relates to them, and the results are something they can control. Metrics are powerful.

To understand the power of data in shaping behaviors, consider the popularity of the self-monitoring fitness tracker or wearable technology. Even as their accuracy is scrutinized, sales in 2014 are predicted to land somewhere in the $14 billion range.1 Do mobile fitness trackers actually help people change their activity habits? Could doctors actually use the data to help their patients? Can companies be built on the concept of improving health with a wearable device? Not conclusively.2 Does a dedicated athlete need this kind of information? Some think not.3

So what is driving the growth of the fitness tracker market and what are these devices offering that creates millions of dedicated users? The answer is real-time data, personalized goals and feedback, and a sense of control; in other words, empowerment.

In the 70s and 80s, my grandparents spoke about their doctor as though he were infallible. They didn’t doubt, question, or even note what he prescribed, but took his advice and dealt with the outcomes. If healing didn’t progress as planned, my grandmother blamed herself, as though she’d failed him.

Jump ahead a few decades when more emphasis is being placed on collaboration. We expect our physicians to work with us, rather than dictate our treatment decisions.4 Section 3506 of the Affordable Care Act, the Program to Facilitate Shared Decision Making, states that the U.S. Department of Health and Human Services is “required to establish a program that develops, tests and disseminates certificated patient decision aids.”5 The intent is to provide patients and caregivers educational materials that will help improve communication about treatment options and decisions.6

Patient portals are important tools in helping to build this foundation of shared information. The portals house and track patient health data on web-based platforms, enabling patients and physicians to easily collaborate on the patient’s health management.7  Use of patient portals is a Meaningful Use Stage 2 objective.

The first measure of meeting this objective states that more than half the patients seen during a specified Electronic Health Record reporting period must have online access to their records. The second measure puts the spotlight on the patient and their use of that web-based information. MU Stage 2 requires that more than 5% of a provider’s patients must have viewed, downloaded, or transmitted their information to another provider in order for the provider to qualify for financial incentives from the Federal government.8

Empowered consumers want information immediately, whether it’s a restaurant review, number of steps taken in the last hour, how many calories they’ve burned, or their most recent checkup results. We like to weigh the input, make a decision, and then take action. Learning and information intake, no matter the topic, is expected to happen fast.

Metrics show us where we stand and how far we’ve come, which empowers us to keep going or make a change, and then measure again. We’re in an age of wanting to know but also wanting to know what to do next. The wearable device market has met a very real need of consumers. Whether or not fitness trackers make us healthier, whether or not our doctors know what to do with the information, or if this is information an athlete would really use, these devices can serve the purpose of putting many people in control of their own health, one measurable step at a time.

Sources:
1 Harrop, D., Das, R., & Chansin G. (2014) . Wearable technology 2014-2024: Technologies, markets, forecasts. Retrieved from http://www.idtechex.com/research/reports/wearable-technology-2014-2024-technologies-markets-forecasts-000379.asp

2 Hixon, T. (2014) . Are health and fitness wearables running out of gas? Retrieved from  http://www.forbes.com/sites/toddhixon/2014/04/24/are-health-and-fitness-wearables-running-out-of-gas/

3 Real athletes don’t need wearable tech. (2014) . Retrieved from http://www.outsideonline.com/outdoor-gear/gear-shed/tech-talk/Real-Athletes-Dont-Need-Wearable-Tech.html

4 Chen, P. (2012) . Afraid to speak up at the doctor’s office. Retrieved from  http://well.blogs.nytimes.com/2012/05/31/afraid-to-speak-up-at-the-doctors-office/?_r=0

5 Informed Medical Decisions Foundation. (2011-2014) .  Affordable care act. Retrieved from http://www.informedmedicaldecisions.org/shared-decision-making-policy/federal-legislation/affordable-care-act/

6 HealthcareITNews. (2014) . Patient pjortals. Retrieved from http://www.healthcareitnews.com/directory/patient-portals

7 Bajarin, T. (2014) . Where wearable health gadgets are headed. Retrieved from http://time.com/2938202/health-fitness-gadgets/

8 HealthIT.gov. (2014) . Patient ability to electronically view, download & transmit (VDT) health information. Retrieved from http://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures-2/patient-ability-electronically-view-download-transmit-vdt-health-information

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

Decline of Health and Fitness Tracker Usage

Posted on May 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve started hearing a number of people mention this. In some cases it’s first hand accounts of their own usage and in other cases it’s people talking about the health and fitness tracker usage trend. Basically, it seems that we haven’t yet figured out how to make a health and fitness tracker sticky. This chart from Edneavour Partners shows the tracker usage trend really well:
Health and Fitness Tracker Usage

From my own personal experience, I’ve found a similar usage curve. The big challenge is that the value of the tracker 3 months out isn’t clear. When you first start using the tracker, the data is quite interesting because you’ve never seen the fitness tracking data. Plus, you’re interested to see how it changes over time. Once you reach the 3 month plateau, you already basically know the patterns and so they lose their value.

What’s not clear is whether these companies (or some outside company) will find a way to leverage a long term history of tracking into something really valuable. Will having blood pressure trends for 3 years make it so you can detect potential health issues that you wouldn’t have discovered otherwise? I think this is the potential for the quantified self movement, but I’m skeptical that the current set of trackers and sensors will get us there. How much value can be gotten from steps, weight, and blood pressure? I think we’ll need a more advanced set of trackers to be able to reach that longer term goal.