Saturday, August 16, 2014

Weekly Overseas Health IT Links - 16th August, 2014.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

IBM Unveils Chip Simulating Brain Functions

Tech Giant Claims Microchip Is a Sharp Break From Traditional Chip Design

By Don Clark
Aug. 7, 2014 2:00 p.m. ET
IBM has developed a microchip that simulates functions of neurons, synapses and other features of the brain to perform calculations.
SAN JOSE, Calif.— International Business Machines Corp. is claiming a major advance in emulating the brain in silicon.
The technology company has developed a microchip that simulates functions of neurons, synapses and other features of the brain to perform calculations. IBM says the chip, a sharp break from the fundamental design used in most computers, excels at chores like recognizing patterns and classifying objects while using much less electrical power than conventional hardware.
IBM's new chip is the latest in a series of efforts by the company and others to design brain-like chips as traditional chip manufacturing yields fewer breakthroughs. But its latest offering, described in a paper in the journal Science, has novel features that include its large size and the use of standard digital technology rather than esoteric materials or production processes.

De-identification effective in maintaining patient privacy if done right

August 8, 2014 | By Katie Dvorak
As hospitals and healthcare organizations adopt new ways to store and share data, privacy and security of the information is a top priority--and with that comes de-identification of data.
When it comes to HIPAA, there are two standards that allow for the sharing of data while maintaining privacy protections, according to privacy attorney Scot Ganow and Khaled El Emam, senior scientist at the Children's Hospital of Eastern Ontario Research Institute, both of whom spoke with
The first HIPAA method for de-identifying data, according to Ganow, of Faruki Ireland & Cox, is to strip out the data and identifiable elements, though, he added that doing so doesn't offer a lot of value. The second, he said, is to de-identify data through the expert determination standard, which allows researchers to "retain a lot of the value of the info ... [while] at the same time carrying a very low risk of re-identification."

Data mining slashes Medicaid ER visits

Posted on Aug 08, 2014
By Erin McCann, Associate Editor
By mining state Medicaid data and utilizing a population health platform, the Wyoming Department of Health was able to slash its Medicaid-related emergency room visits by 20 percent in a one-year period.
The state, which has nearly 88,000 Medicaid enrollees, also saw small improvements in 30-day hospital readmission rates, as they declined in 2013, down to 6.89 percent, compared with 7.4 percent in 2012. 
Xerox, who serves as the Wyoming Department of Health's Medicaid quality care management vendor and is responsible for processing claims and billing data, announced the statistics this week. After analyzing the claims data, officials were able to identify top cost drivers in the Medicaid program, one of which was found to be emergency room services. 

Why some docs will 'just say no' to MU

Posted on Aug 08, 2014
By Madelyn Kearns, Associate Editor, Medical Practice Insider
Thousands of eligible providers are working diligently toward EHR incentive payments, but some practices are choosing a different route: abandoning meaningful use altogether in favor of their own solutions, and finding ways to make up for the penalties they’ll incur down the road.
Some 6 percent of physicians, in fact, will be “abandoning meaningful use after meeting it in previous years,” according to the Medscape report on EHR use in 2014. In surveying nearly 20,000 doctors, Medscape found another 16 percent admitting that they would never be attesting to meaningful use in any capacity. 
And although those numbers may seem small now, chances are they won’t stay that way for long as MU requirements become progressively more stringent, said Art Gross, CEO of HIPAA Secure Now.

ONC Task Force Seeks Answers to Interoperability Challenges

AUG 7, 2014 7:15am ET
A task force of the Office of the National Coordinator for HIT held a second listening session August 5 with stakeholders to get feedback on a report concluding the lack of interoperability among data resources for electronic health records is a major barrier to information exchange.
An independent group of scientists called JASON, convened by contractor MITRE Corp. to advise the government, published the report which was funded by the Agency for Healthcare Research and Quality. Authors recommend the government establish a “comprehensive, transparent and overarching software architecture” that would create an open, interoperable health data infrastructure. Karen DeSalvo, M.D., national coordinator for HIT, has encouraged stakeholders to take a look at the JASON report's recommendations and to provide their feedback.

Poor ONC oversight left EHRs vulnerable to hackers

August 4, 2014 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT's lackluster monitoring of the Authorized Testing and Certified Bodies (ATCBs) under the temporary certification program did not fully ensure that test procedures and standards could secure and protect patient information in electronic health record, according to a new report by the U.S. Department of Health and Human Services' Office of Inspector General (OIG).
The report, released August 4, found that the ATCBs under the temporary certification program did not develop procedures to periodically evaluate whether certified EHRs continued to meet federal standards or develop training programs to ensure that staff were competent to test and certify EHRs and secure proprietary and sensitive electronic patient information. OIG pointed out that standards used met National Institute of Standards and Technology (NIST) requirements that ONC approved, but that they were not sufficient to ensure that EHRs were adequately secure. For instance, passwords were not sufficiently complex.

Physicians question safety of medical auction site

August 6, 2014 | By Katie Dvorak
When prices for surgery and other medical procedures rise above what a patient can afford, they may find a cheaper deal online--but some physicians are critical of the practice.
One medical auction site is receiving some of that criticism. The site, now four years old, links patients with facilities and physicians that offer non-emergency care at lower costs, according to an article at Kaiser Health News. People can go on the website to post requests for surgery and receive bids from doctors around the country.
"Cheap sounds good, but in these auctions you're not getting any information: Was the guy at the bottom of his class in medical school?" Arthur L. Caplan, head of the division of bioethics at NYU Langone Medical Center in New York, tells Kaiser Health News.

Guidebook offers action plan to address alarm fatigue

August 7, 2014 | By Susan D. Hall
The ECRI has issued a guidebook to help hospitals address what the institute has deemed a top health technology hazard, alarm fatigue.
"The Alarm Safety Handbook: Strategies, Tools, and Guidance"--available in print and in electronic formats--is designed to help hospitals identify ways to minimize alarm fatigue, develop an action plan and put that plan into practice.
"We hope hospitals look to this as a blueprint for building a sound alarm management safety process," James P. Keller Jr., ECRI vice president of health technology evaluation and safety, says in an announcement.

As EHR adoption spikes, Meaningful Use Stage 2, HIE implementation lags

August 7, 2014 | By Katie Dvorak
Hospitals and healthcare systems made significant progress in adopting electronic health records in 2013, according to two studies published in the journal Health Affairs, but have a long road ahead of them to meet all the criteria for Meaningful Use (MU) Stage 2 and the implementation of health information exchanges (HIEs).
The authors of the studies and National Coordinator for Health Information Technology Karen DeSalvo spoke about the state of health IT at a briefing on the studies held today in Washington.
"We've made great investments and we need to build on them and weave together a fabric that serves everybody," DeSalvo said during her opening remarks.

EHR Adoption Slow, Information Exchange Lagging

Cheryl Clark, for HealthLeaders Media , August 8, 2014

While many providers have the essential EHR components required to obtain federal financial incentives and avoid penalties, about 90% of hospitals still can't allow patients to view online, download, or transmit health information.

Thousands of hospitals and physicians in small office practices will be left out of meaningful use incentive payments, and may eventually be financially penalized, unless they speed up adoption of electronic health records systems to satisfy meaningful use 2 requirements, analysis indicates.
The findings of two papers published Thursday in Health Affairs arebased on survey data showing how many providers have the essential system components required to obtain financial incentives and avoid penalties under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.

Can Healthcare Execs Be Security Experts Too?

8/6/2014 09:06 AM
Mansur Hasib
Trying to teach healthcare professionals security technologies is a risky idea. It's far easier to teach healthcare to security experts.
In the urgent scramble to hire cyber security executives, some organizations appear to favor time spent within a business vertical such as healthcare -- often against the advice of competent counsel. They bypass stronger cyber security professionals who would need to learn the new business environment in favor of candidates who understand the industry but need to learn cyber security. Essentially these organizations try to turn healthcare executives into cyber security executives, a very risky idea indeed.
It will take an organization about a year to figure out it hired the wrong person. During that time more damage and more atrophy will occur. Even a wizard cannot fix years of neglect quickly, so hiring the right person the first time matters greatly.

Simple EHR Function May Trigger Audits, Hospitalist Cautions

Cheryl Clark, for HealthLeaders Media , August 7, 2014

Hospitals should adopt policies to encourage the appropriate use of the copy and paste function in electronic medical records systems because Recovery Audit Contractors who find similarities among patient records may use them as a basis to deny claims, says a physician.

Clinicians' use of the "copy and paste" function in electronic health record systems may soon be the subject of indiscriminate Recovery Audit Contractor reviews, a prominent hospitalist warns.
"We're worried that we're going to be audited based on good use of copy and paste, and that we're going to be prohibited from using copy and paste for the things that it really is good for," says Ann Sheehy, MD, a member of the Society for Hospital Medicine's Public Policy committee.

Philips, Accenture Partner on Mind-Controlled Technology

AUG 6, 2014 7:26am ET
Royal Philips and Accenture have developed proof-of-concept software the companies say could ultimately give more independence to patients with amyotrophic lateral sclerosis (ALS) and other neurodegenerative diseases.
The application, connecting a wearable display to Emotiv Insight Brainware, demonstrates how existing technology could be used to transform the quality of life for ALS patients. When patients lose muscle control and eye tracking ability, they can still potentially operate the Philips suite of connected products, including a medical alert service, Philips SmartTV, and personal lighting, in their home environment through brain commands.

ONC's interoperability vision draws concern from federal advisers

August 6, 2014 | By Dan Bowman
While an official with the Office of the National Coordinator for Health IT provided an overview of a forthcoming interoperability roadmap at a virtual meeting of the agency's health IT policy committee on Wednesday, committee members raised concerns that perhaps the aim of the agency's effort is too broad.
Erica Galvez, the interoperability and exchange portfolio manager at ONC, said a draft of the roadmap--which will be a companion document to the agency's vision paper published in June--is due to be published in October. A more robust version that includes feedback from ONC's health IT policy and standards committees would then be available for public comment by January.
Version 1.0 of the roadmap, which Galvez stressed would be a "living document," is anticipated to be ready by March 2015.

SAMHSA Mulls Changes to Federal Substance Abuse Confidentiality Rules

by Helen R. Pfister, Susan R. Ingargiola and Marlee Ickowicz, Manatt Health Solutions Wednesday, August 6, 2014
The federal substance abuse confidentiality regulations (also known as the "Part 2 Regulations") have long provided important privacy protections for certain alcohol and drug abuse treatment information. However, in today's increasingly connected health care system, some health care providers perceive the Part 2 Regulations as a roadblock to coordination of a patient's alcohol or drug abuse treatment with other types of health care services. Accordingly, the Substance Abuse and Mental Health Services Administration, the federal agency that oversees the Part 2 Regulations, is considering several possible changes to the regulations to encourage more widespread sharing of alcohol and drug abuse treatment information.

Background on Part 2 Regulations

HIPAA is the legal foundation for health information privacy in the U.S. The HIPAA Privacy Rule restricts the use and disclosure of protected health information, or PHI, maintained by covered entities, which include health care providers, health plans and health care clearinghouses. HIPAA permits covered entities to use and disclose PHI for treatment, payment and health care operations without patient authorization. Alcohol and drug abuse treatment records covered under the Part 2 Regulations ("Part 2 Records"), on the other hand, are subject to more stringent protection. Unlike under HIPAA, a patient's authorization is generally required for release of these records, with few exceptions.

On the intersection of artificial intelligence and bioinformatics

By Ron Vatalaro, Bisk Education/University Alliance
The field of health informatics has roots dating back to the 1960s when researchers realized how useful computer programs could be in storing and managing large amounts of data.
Today’s increasingly intelligent computer programs, meanwhile, have broadened the scope of study, fostering highly complex research while providing tools researchers can use to help them store, manipulate study and analyze data.
Let’s take a look at the current landscape, wherein AI and bioinformatics are moving closer to each other — just not without some challenges

7 add-on apps to enrich your EHR

August 01, 2014 | Frank Irving - Editor
With more than four out of five doctors actively using EHR systems, we can confidently negate the notion that physicians resist new technology. Indeed, a growing number of applications and platforms target physician practices seeking enhanced usability or increased value from their EHR.
It's a matter of making good technology better.
Some sixty-three percent of 18,575 physicians surveyed by Medscape between April and June 2014, for instance, said their EHR improves clinical documentation. Still, there's room for improvement.

OIG: Certified EHRs aren't so secure

Posted on Aug 05, 2014
By Erin McCann, Associate Editor
It turns out, ONC's electronic health record certification process has some serious shortcomings -- chief among them security practices that are wholly insufficient to adequately protect patient health information, according to a new report from the Office of Inspector General.
The report sheds light on the EHR certification procedure in its current form, which involves oversight from the Office of the National Coordinator for Health IT, and includes the National Institute of Standards and Technology, or NIST, the group responsible for developing these standards for testing and certification bodies to use.
When providers purchase certified EHRs (as of June more than 408,000 healthcare providers have received meaningful use incentive payments after purchasing a certified EHR, with CMS paying out a whopping $24.1 billion in incentives), they presumably expect these multi-million-dollar systems to meet federal security standards.

Power to the people on testing times

Paul Hodgkin examines the mathematics of testing for disease, and concludes that professionals and patients are going to need some very clever apps to guide them through the results.
5 August 2014
So we can get our DNA tested with no questions asked. Boots will do it for you £129.
All sorts of tests are available at a price. If you want to know if your spouse, teenage son or direct reports are taking drugs, send off a hair sample and screen them to see what substances they’ve been consuming over the past 90 days.
Self-evidently the technology is running way ahead of the ethics here.   

Telecare "not magic bullet" - WSD study

1 August 2014   Lyn Whitfield
Policy makers have been warned to avoid describing telecare as a “magic bullet” in the latest study to cast serious doubt on the cost effectiveness of remote monitoring and intervention.
The WSD projects in Newham, Kent and Cornwall were set up by the Department of Health in 2008, with the explicit aim of finding an evidence base for telehealth and telecare. 

3 ways to avoid HIE missteps

August 5, 2014 | By Katie Dvorak
Organizations juggling having a fee-for-services business model while implementing value-based programs may face obstacles when it comes to interoperability and health information exchanges, Brian Ahier, director of standards and government affairs at Medicity, writes in a post for GovernmentHealthIT.
In order to enter that value-based care arena, the industry must avoid common missteps that may impede the sustainability of HIEs, Ahier says.

Cerner to acquire Siemens' health IT division for $1.3 billion

August 5, 2014 | By Marla Durben Hirsch
Cerner Corporation and Siemens AG have announced that they have entered into a definitive agreement for Cerner to acquire Siemens' health IT business unit, Siemens Health Services, for $1.3 billion in cash.
The two companies will have a combined total of $4.5 billion annual revenue, $650 million in annual research and development investment, 20,000 associates in more than 30 countries and 18,000 client facilities worldwide.

What Cerner Gets from Buying Siemens

AUG 5, 2014 6:20pm ET
Cerner Corp. is paying $1.3 billion in cash to acquire the hospital information systems business line of Siemens Healthcare. Large acquisitions usually don't succeed and time will tell on this one.
The acquisition, likely closing in early 2015, was expected as rumors have circulated in the industry for more than a week. The transaction does not include Siemens’ diagnostic imaging products and laboratory equipment lines, although Germany-based Siemens AG and Cerner have a new strategic alliance to combine Cerner’s I.T. products with Siemens’ imaging and medical device products.
Through the acquisition, Cerner gets the products and customers of another major U.S. health information technology vendor with a price tag closely matching annual revenue from the Malvern unit, says Steven Lazarus, president of Boundary Information Group, a Denver-based consultancy. “It’s that size issue, you’ve got that ongoing revenue stream,” he adds. Further, the cost of maintaining Siemens products and customers is much cheaper than the cost of getting new clients.

Cerner Faces Challenges in Integrating Siemens

AUG 6, 2014 12:10pm ET
The pending $1.3 billion acquisition of the hospital information systems business line of Siemens Healthcare will enable Cerner Corp. to be a stronger competitor to Epic Systems Corp., while also being in line with Cerner CEO Neal Patterson’s vision of embracing change to make a difference. But danger looms.
That is the view of health information technology mergers and acquisitions consultant John Osberg, managing partner at Informed Partners LLC in Marietta, Ga. “But it will take a monumental effort to integrate Siemens, and some time,” he contends in comments to Health Data Management. “This deal was not for the amateurs. It is a lot more than a financial change of ownership.”
The industry is better served by having Siemens again under U.S. ownership, Osberg believes. German ownership was a barrier to growth and development of Siemens, as the company did not adapt to a rapidly changing healthcare industry.

FDA proposal a huge boost to mHealth innovation

August 04, 2014Eric Wicklund - Editor, mHealthNews
In what's being hailed as a positive step for mHealth innovation, the U.S. Food and Drug Administration has freed dozens of mobile medical devices from the requirements of increased regulation.
The 12-page document issued on August 1 is part of the FDA's draft guidance for the regulation of mobile medical devices and apps. In this latest posting, the FDA has proposed that it will not require premarket submission requirements from certain Class I and II medical devices under the reserved criteria of section 501(I) of the Federal Food, Drug and Cosmetic Act of 2012.
The proposal is "a huge boost the to mHealth industry," said Bradley Merrill Thompson, an attorney for the Washington D.C. law firm of Epstein Becker Green and counsel for the mHealth Regulatory Coalition. 

As Apple and Google Swarm Healthcare, StartUp Health Shares Lessons

Scott Mace, for HealthLeaders Media , August 5, 2014

By one measure, the amount of money invested in healthcare startups in the first half of 2014 exceeds the total amount invested in all of 2013. The co-founder of StartUp Health talks about where innovation is headed.

While the healthcare industry struggles to meet its mandates and stay in business, players outside the traditional industry have not been idle.
Google recently announced its Google X Baseline study to map the human body. In June, Apple launched its new Health app and HealthKit developer tool, to build an application platform for innovative mobile solutions. IBM promptly signed a deal with Apple to integrate its Watson analytics platform with Apple's technology. And Samsung announced it was investing $50 million to accelerate innovation in personal health.

Where Health care is Going in the Cloud

AUG 1, 2014
As a model for enabling on-demand network access to a shared pool of configurable computing resources, the cloud seems to be everywhere these days, challenging traditional approaches to data center and enterprise application design and management.
However, cloud computing is not as ubiquitous in health care as it is in other industries. Out of eight sectors analyzed by technology vendor CDW, health care ranks seventh in terms of cloud adoption-just edging out state and local governments-according to a 2013 survey.
While health care might lag behind, it's still adopting at a pretty brisk clip: A June 2014 HIMSS Analytics survey found that 83 percent of surveyed medical practices, hospitals and health care systems are using cloud services, citing lower maintenance costs, speed of deployment and lack of internal staffing resources.

FDA plan a 'huge' boost for mHealth

Posted on Aug 04, 2014
By Eric Wicklund, Editor, mHealthNews
In a move that's being lauded by mobile health innovators, the U.S. Food and Drug Administration has released dozens of mHealth medical devices from the requirements of added regulation.
The 12-page document issued Aug. 1 is part of the FDA's draft guidance for the regulation of mobile medical devices and apps. In this latest posting, the FDA has proposed that it will not require premarket submission requirements from certain Class I and II medical devices under the reserved criteria of section 501(I) of the Federal Food, Drug and Cosmetic Act of 2012.
The proposal is "a huge boost to the mHealth industry," said Bradley Merrill Thompson, an attorney for the Washington, D.C., law firm of Epstein Becker Green and counsel for the mHealth Regulatory Coalition. 

Stage 2 MU: A bridge too far?

Posted on Aug 04, 2014
By Mike Miliard, Managing Editor
It turns out this stuff is really hard, after all.
About this time last year, we ran an article titled, "Stage 2 changes may be rude awakening." In it, one hospital IT honcho made the point that, with attestation for meaningful use still off in the distance, most providers were blissfully ignorant of just how difficult the process would be.
Too few people "really, truly grasp the magnitude of some of the changes," compared to Stage 1, he said.
Here we are, more than halfway through 2014, and the numbers are starting to roll in. They're anything but impressive.

4 keys to successful HIT vendor-client relationships

August 4, 2014 | By Katie Dvorak
When it comes to relationships between health IT vendors and clients, there are many ways to ensure they are positive for both parties involved.
Whether the partnership is for implemenation of a core electronic health record, a specific system or an innovative program, vendor-client relationships all have common elements, Sue Schade, CIO at University of Michigan Hospitals and Health Centers, says in a post.

The rise of nurses in health IT

August 4, 2014 | By Katie Dvorak
By Katie Dvorak
From chief nursing informatics officers to chief information officers, nurses increasingly are taking on new leadership roles in health IT and having a major impact on healthcare innovation and delivery.
For instance, nurse informatics are vital to information system development, implementation and optimization, according to the Healthcare Information and Management Systems Society's 2014 Nursing Informatics Workforce Survey, released in February. More than 70 percent of the survey's respondents hold a title that specifies informatics, and interest in additional training within the field is also shown to be on the rise.

Electronic Reminders Can Help Patients Prevent Surgical Site Infections

August 1, 2014
A study reports on a simple digital messaging system that significantly increases patient compliance with a preadmission showering
The use of electronic reminders such as text messages, emails or voicemails is highly effective at getting surgical patients to adhere to a preadmission antiseptic showering regimen known to help reduce risk of surgical site infections (SSIs), according a study published in the August issue of the Journal of the American College of Surgeons.
Each year approximately 400,000 SSIs occur and lead to a death rate approaching nearly 100,000 according to data sources cited by study authors. To help reduce the risk of these dangerous infections, clinicians recommend that surgical patients take antiseptic showers 24 to 48 hours before admission.

Only about 0.1% of mHealth apps are FDA-approved

Written by Akanksha Jayanthi (Twitter | Google+)  | August 01, 2014
Of the nearly 100,000 mHealth apps available on the market, only 100 are approved by the U.S. Food and Drug Administration, according to a New England Journal of Medicine report.
The industry is debating the level of mHealth app regulation the FDA should exert. While one side sees FDA-approval as critical to maintaining clinical quality and patient safety standards, others see the regulatory process as a barrier to innovation.


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