May 17, 2020

Experts Propose Sweeping Changes to Medical Education System to Meet Health Needs

United States Healthcare
Hospital Leadership
Health Fundin
Hospital Leadership
Admin
3 min
According to the report, recently trained physicians cannot perform simple tasks required in office-based practice due to a lack of training and experience.
A panel of experts recommended Tuesday, July 30 reexamining government health funding, saying the current $15 billion graduate medical education system...

A panel of experts recommended Tuesday, July 30 reexamining government health funding, saying the current $15 billion graduate medical education system is no longer proving effective. 

“We recognize we are recommending substantial change,” said health economist and former Medicare Administrator Gail Wilenskym, co-chairwoman of the nonpartisan Institute of Medicine, in a news release. “We think it’s key to justifying the continued use of public funds.”

American taxpayers have helped support physician education for generations, and the nation’s teaching hospitals have been integral to the production of preparing a physician workforce. According to the report, newly trained physicians entering today’s workforce have “strong scientific underpinnings in the biological and physical sciences as well as supervised practical experience.”

Primarily though the Medicare program, the federal government provides more than $11 billion per year to the hospitals that sponsor interns and residents to support the training of doctors who have recently graduated from medical school. An additional $4 billion is generated through the Medicaid program.

“The scale of government support for this phase of physician education is unlike that of given to any other profession in the nation,” said the report.

But despite a growing public investment in graduate medical education, the report found that there are persistent problems with geographic maldistribution of physicians, a mismatch between health needs and physician specialty make-up, and a lack of cultural diversity in the health care workforce.

Additionally, recently trained physicians cannot perform simple tasks required in office-based practice due to a lack of training and experience.

To improve this, the committee proposes a sweeping overhaul of the entire financing program for graduate medical education, with the goal of shifting the program to a “performance-based system.”

The panel recommends that funding from Medicare should remain consistent across the board over the decade, adjusted for inflation. The way said funding is distributed, however, should be changed, with a declining share providing direct subsidies to teaching programs. An increasing share would finance new ways to provide and pay for training.

The funds would continue to be distributed through the Medicare program, but a new “GME (graduate medical education) Policy Council” would be created under the office of the Secretary of Health and Human Services.

Those most immediately affected would include major teaching hospitals in the Northeast, which currently account for a disproportionate amount of Medicare medical education funding, Kaiser Health News reported.

The Association of American Medical Colleges was critical of the report, telling Kaiser Health News that the recommendations would “threaten the world’s best training programs for health professionals and jeopardize patients.”

“By proposing as much as a 35 percent reduction in payments to teaching hospitals, the [Institute Of Medicine]’s recommendations will slash funding for vital care and services available almost exclusively at teaching hospitals, including Level 1 trauma centers, pediatric intensive care units, burn centers, and access to clinical trials,” AAMC President Darrell G. Kirch said. “In addition to hurting patient care, these cuts will limit critical training settings for future physicians, nurses, and other health professionals.”

According to Wilensky, the rapid evolution of the health care sector “was an important rationale for potentially using the leverage provided by government funding to try to train the health care workforce we needed for a 21st century delivery system.”

Increasing the number of physicians, however, won’t likely solve the current workforce issues, he added.  

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Jun 13, 2021

How healthcare can safeguard itself against cyberthreats

#Cybersecurity
#cyberattacks
#digitaltransformation
#covid19
Jonathan Miles
6 min
Jonathan Miles, Head of Strategic Intelligence and Security Research at Mimecast, tells us how the healthcare sector can protect itself from attacks

One of the most fundamental lessons from the COVID crisis is that health should always be a priority.  In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.

The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics. 

From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world. 

Going digital 

The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years. 

This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate. 

Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.

To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care. 

Strengthening defences

Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change. 

It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device. 

These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.

Despite this, there are fundamentals that any organisation should implement: 
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.

In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.

Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents. 

Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.

This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents. 
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.

Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.

As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.  

Fighting future threats

With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.

To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced. 

This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.

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