Saturday, May 30, 2015

Weekly Overseas Health IT Links - 30th May, 2015.

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.

The CareFirst Hack: What Went Right, What Went Wrong

MAY 21, 2015 4:06pm ET
CareFirst BlueCross BlueShield first learned in May 2014 of malware on an information system that was hacked a month later, according to two health information security consultants. But the Blues plan apparently did not realize the malware was not completely eradicated and the system was hacked a month later.
This spring, as other health insurers including Anthem and Premera were announcing huge cyber attacks, CareFirst contracted with security firm Mandiant to conduct an end-to-end examination of its IT environment and the breach was found, CareFirst acknowledged on May 20.
David Holtzman, vice president of compliance at CynergisTek, a health information consultancy, praises the insurer for taking another look at their security posture after gaining knowledge of the Anthem and Premera hacks, which included programming and processes consistent with what CareFirst noticed in the spring of 2014. But security veteran Tom Walsh, president of Tom Walsh Consulting in Overland Park, Kan., has a different take: “Eleven months later, they finally begin to realize there still are issues out there.”

HL7's Reed Gelzer: EHR malpractice problem at 'critical mass'

May 22, 2015 | By Marla Durben Hirsch
As electronic health records become more common, they increasingly are being relied on in medical malpractice litigation, often to the detriment of the provider.
Reed Gelzer, M.D., co-facilitator of HL7 EHR Records Management and Evidentiary Support Profile Standard Workgroup and head of Newbury, New Hampshire-based consulting firm Trustworthy EHR, shared his insights on this growing problem in an exclusive interview with FierceEMR.
FierceEMR: Why are EHRs being used more often in malpractice litigation, and why are they creating more legal problems for providers than paper records?
Reed Gelzer: Until three or four years ago electronic records were not ubiquitous. Now there is critical mass. And in medical malpractice, there's also a lag in change in the legal process. The kinds of effects we predicted to occur now are occurring.

21st Century Cures Act

Posted on May 21, 2015
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
We are in a time of great turmoil in healthcare IT policy making. We have the CMS and ONC Notices of Proposed Rulemaking for Meaningful Use Stage 3, both of which need to be radically pared down. We have the Burgess Bill which attempts to fix interoperability with the blunt instrument of legislation. Most importantly we have the 21st Century Cures Act, which few want to publicly criticize. I’m happy to serve as the lightening rod for this discussion, pointing out the assumptions that are unlikely to be helpful and most likely to be hurtful.
The interoperability language to be included in the 21st Century Cures Act would sunset the Health IT Standards Committee while a new “charter organization” would help define the standards of interoperability.
Under the latest language, which was revised over the weekend and yesterday, electronic records must meet those interoperability standards by Jan. 1, 2018 and face being decertified by Jan. 1, 2019 if they don’t. 

Clinical Decision Support May Help Reduce Sepsis Mortality

Ken Terry
May 20, 2015
CHICAGO — Implementation of a cloud-based alerting system and change management were associated with a 53% drop in sepsis mortality in a single-site study.
Joycelyn Shipman Craighead, RN, MSPH, director of quality at Huntsville Hospital in Alabama, and colleagues compared the outcomes for patients with sepsis who were treated on two floors of the hospital before the use of the alerting system (January 2011 to September 2013) with the outcomes for patients with sepsis who were treated on the same floors after implementation (March through December 2014). The study floors consisted of three units in which nurses received automated sepsis alerts, including two respiratory units and a general medicine unit. The researchers excluded patients who had previously been in the intensive care unit and those who were receiving limited care because of poor prognoses.

Clinical health IT market to grow to $19.7B value by 2019

Written by Carrie Pallardy | May 21, 2015
The clinical health IT market is expected to reach a $19.7 billion value by 2019, according to a BCC Research report.

Security Survival Guide: 10 Steps for Protecting Patient Data

MAY 21, 2015 7:43am ET
With increasing numbers of access points to protected health information under attack, the healthcare industry continues to be plagued with damaging breaches. Just yesterday, CareFirst BlueCross BlueShield announced a hacking that compromised the information of more than a million of its members.
Not surprisingly, a Ponemon Institute report released earlier this month found that over 90 percent of healthcare organizations have been breached in the last two years and the breaches are a growing $6 billion annual epidemic that is putting millions of patients and their information at risk. The study, sponsored by security software vendor ID Experts, reveals that most healthcare organizations are still woefully unprepared to address the rapidly changing cyber threat environment and lack the resources and processes to protect patient data.
With cyber criminals actively targeting healthcare, Rick Kam, president and co-founder of ID Experts, argues that the threats to patient data have never been greater. However, as chair of the PHI Protection Network, a cross-industry collaboration of vendors formed to help expedite the adoption of PHI best practices, Kam also believes there are some critical strategies healthcare organizations can employ for protecting patient information.

ICD-10: Reality and rhetoric

Posted on May 20, 2015
By Tom Sullivan, Executive Editor, HIMSS Media
For healthcare executives and political aficionados following the latest proposed legislation that could affect ICD-10’s fate, it’s time to recognize three critical facts.
First, the proposed bills — one of which aims to kill ICD-10 outright while the other advocates a transition period — are both longshots. Second, and perhaps more important, the previous two fashions in which ICD-10 was delayed were also once considered quite unlikely. And third: Even though another delay could happen, it would be dangerous for payers or providers to bank on that and backburner the conversion.
That’s the reality. Even still, the mere mention of adjusting the ICD-10 compliance deadline sparked a real mess, rhetoric-wise, concerning the transition these past couple weeks.

Records access target hit

19 May 2015   Thomas Meek
Nearly all GP practices in England are able to offer a variety of online services to patients, including access to a summary of their record, appointment booking, and ordering repeat prescriptions.
Data published today by the Health and Social Care Information Centre appears to justify the “optimism” expressed by NHS England in March that that the government’s target for online access to medical records would be hit.

Security experts worry about 'spear phishing' in wake of CareFirst breach

May 21, 2015 | By Dan Bowman
Security experts weighing in on Wednesday's breach of health insurer CareFirst, which impacted 1.1 million current and former customers, said the compromised information could be used for everything from medical identity fraud to future attacks geared toward extracting even more data from victims. What's more, they believe this is only the beginning for breaches of this nature.
Raj Samani, vice president and EMEA (Europe, the Middle East and Africa) chief technology officer for Intel Security, told FierceHealthIT in an exclusive interview that spear phishing attacks could be a high likelihood.
"Consumers may receive an email that knows their name, their date of birth, that knows specific information about them that would lead them to believe that this was a legitimate email. But in this particular case, it may well not be because actually it appears that this is the type of data that's being compromised," Samani said. "This type of data has market value, as well."

Finland adopts e-health platform

by Carol Matlack, May 21 2015, 05:53
LOCATED just 150km below the Arctic Circle, Oulu, Finland, was famous for years for only one thing: the Air Guitar World Championships each August. Now the city of 196,000 has a new distinction: It boasts one of the world’s most advanced e-health programmes.
A digital platform introduced in 2008 lets patients make appointments, refill prescriptions, and exchange messages with doctors from their home computers. There’s even a device that diagnoses ear infections by measuring vibration of the tympanic membrane. Some 70,000 residents are already on the system, called Self Care.
Most medical care in the country is provided by local governments, and Oulu introduced its e-health platform to control per capita health spending that ranked among Finland’s highest.

Rapid growth projected for global telemedicine market

May 20, 2015 | By Susan D. Hall
The global market for telemedicine technologies is expected to expand at a compound annual growth rate of 18.4 percent from the $17.8 billion spent on hardware, software and services through 2020, according to a new report from RNCOS.
The report cites a shortage of physicians in rural and remote areas, the high prevalence of chronic diseases, growing elderly populations, increasing numbers of smartphone users and the need for improved quality services as factors fueling the growth of telemedicine, according to an announcement.
On the other hand, reimbursement challenges, uneven distribution of telecom networks in remote areas and high operating cost are major factors hindering its implementation, the report adds.

John Halamka: Charter organization to ensure interoperability doesn't make sense

May 20, 2015 | By Dan Bowman
Beth Israel Deaconess Medical Center CIO John Halamka, speaking out against a bill included in the 21st Century Cures Act that would result in the dissolution of the Health IT Standards Committee, offers up several ways to accelerate the interoperability of electronic health records in a recent blog post.
Halamka (pictured), who serves as co-chair of the of the Office of the National Coordinator for Health IT's standards committee, says the bill's suggestion to work with a charter organization backed by $10 million to develop interoperability standards doesn't make sense, adding that the field currently working on such matters is "already crowded."
"Why not just direct ONC to create a permanent task force that reports to the HIT Standards Committee, and let ONC support it out of existing resources?" Halamka asks.

Telehealth Project Aims To Improve Health Care Access for American Indian Tribes

by Lauren McSherry, iHealthBeat Contributing Reporter Wednesday, May 20, 2015
A health care system serving nine American Indian tribes in California's Inland Empire is using telehealth to reach patients in remote areas and address rising rates of diabetes, a particular problem among American Indians.
Riverside-San Bernardino County Indian Health serves nine tribes in the expansive Inland Empire region of Southern California. The region encompasses nearly 30,000 square miles, an area the size of Vermont and New Hampshire combined. Patients who live in rural parts of Riverside and San Bernardino counties must travel long distances for health care. Those who live near the Colorado River and in cities such as Needles and Blythe, which lie along the Arizona border, sometimes must travel several hours for specialty care.
"If you think about that vast expanse with an urban corner, it makes all the sense in the world to have all forms of telehealth," said Mario Gutierrez, executive director of the Center for Connected Health Policy. "Telehealth has always been thought of as a rural tool."

Half of medical errors in pediatric cases are preventable

Posted on May 19, 2015
By Erin McCann, Managing Editor
A trigger tool developed to scan the electronic medical record of pediatric patients was able to identify that 45 percent of patient medical errors that caused harm were most likely preventable. 
In the study, researchers at six pediatric hospitals teamed up with clinical analytics company Pascal Metrics to develop a tool, the Pediatric All-Cause Harm Measurement Tool, that detected triggers in the electronic medical record that determined cases of patient harm. 
Researches used Institute for Healthcare Improvement's Global Trigger Tool as a model and adapted it for pediatric use. They used the trigger tool to examine 100 randomly selected inpatient records at each hospital. A total of 600 patient records were examined, and the tool was able to identity 240 "harmful events," according to the study, representing a rate of 40 harms per 100 admitted patients, a much higher number than many previous academic studies have shown. 

Connecting Care ramps up

18 May 2015   Rebecca McBeth
Bristol’s shared care record scheme has moved into phase two, with the aim of reaching 10,000 users over the next five to seven years.
The Connecting Care programme went live in Bristol, North Somerset and South Gloucestershire in December 2013.
It shares real-time patient data between GPs, community providers, local authorities and three acute trusts via an Orion portal.
South, Central and West Commissioning Support Unit senior business analyst Natasha Neads told Digital Health News the local mental health trust has also recently joined the programme.

Electronic pillbox boosts remote care for diabetics

May 19, 2015 | By Susan D. Hall
A telehealth program for patients with poorly controlled diabetes showed encouraging results, though it involved a small sample made up primarily of African-American women, according to research published this month in Telemedicine and e-Health.
The three-month program involved 30 participants from an urban poor clinic population and was designed as a non-urgent service to complement usual medical care. Each participant was given a Bluetooth-enabled blood glucose monitor, automatic blood pressure cuff and an electronic pillbox. These pillboxes provided automatic data uploaded via a cellular communications network, and provided the patient with daily organization of pills, adherence reminders, and feedback on adherence patterns. They also offered alerts and clinical decision support (CDS) summaries to physicians.

IEEE publishes medical device security guidance for software development

May 19, 2015 | By Katie Dvorak
IEEE Cybersecurity Initiative is addressing medical device security with a new set of software development guidelines.
The guidance, Building Code for Medical Device Software Security, is authored by security research scientists Tom Haigh and Carl Landwehr and tackles "the bricks used to build the structure, not its architecture."
The devices the guideline addresses are wide-ranging, from wearables and bedside tools to MRIs and electronic health systems.

How Technology is Redefining Outpatient Care

Scott Mace, for HealthLeaders Media , May 19, 2015

Advances in telemedicine are redefining who is deciding to form outpatient clinics and how they should run. "If you don't have a virtual model of practice somewhere within a practice, then you're behind the times," says one virtual practice owner.

Forget patients checking in at the receptionists' desk. Maybe forget waiting rooms. Forget brick-and-mortar clinics. Forget leaving home to get to them.
Technology is redefining what it makes to be an outpatient clinic. It's also redefining the requirements to start one. And those things are redefining who is deciding to form clinics, and how they should run, if the old ways of running them are not as friendly as possible to the clientele—or the workforce.

Analytics Model Predicts Heart Failure Readmissions

MAY 18, 2015 7:24am ET
An analytics model developed by researchers from the University of Texas at Dallas shows that health information technology systems can help predict hospital readmission rates for congestive heart failure patients and to identify those high-risk patients.
Tracking patient demographic, clinical and administrative data from across 67 hospitals in North Texas during a four-year period, researchers assessed the link between hospital usage of health IT and readmission risk. From 2006 to 2010 in the Dallas-Fort Worth region, nearly 30 percent of congestive heart failure patients were readmitted within 30 days.

System Analyzes Vital Signs to Diagnose Life-Threatening Bleeding

MAY 18, 2015 7:31am ET
By monitoring patients in transit to trauma centers, an automated system that analyzes vital signs could significantly improve the ability to diagnose patients with life-threatening bleeding before they arrive at the hospital.
A research team from Massachusetts General Hospital, the U.S. Army, air ambulance service Boston MedFlight, and two other Boston trauma centers, field tested the Automated Processing of the Physiological Registry for Assessment of Injury Severity (APPRAISE) system, which analyzes blood pressure, heart rate, and breathing patterns during emergency transport.
The pattern-recognition capabilities provided by the APPRAISE system successfully identified 75 to 80 percent of patients with life-threatening bleeding, compared with 50 percent who were identified by standard clinical practice.

What Happens When Health Data Is Transferred, How to Protect It

MAY 18, 2015 7:41am ET
When it comes to medical records, there is no lack of people with bad intentions trying to get their hands on that information. Unless healthcare organizations use available technology to protect this data flowing over the Internet, we are bound to witness more attacks like those that struck Anthem and Premera.
Strong authentication and encryption must be the norm. Let’s imagine something as simple as a family practitioner referring a patient to a specialist. There are various formats in which data can be sent from one office to the other, and the sending and receiving providers need to both understand which are being used. The primary way presently is by sending electronic information via Directed Exchange secure messaging, known as Direct. However, the emerging Fast Healthcare Interoperability Resource standard (FHIR) could soon be available. FHIR is a first generation application programming interface (API) and core data services specification to expand sharing among electronic health record systems as well as other health IT systems.

Innovation Pulse: Hardest part for FHIR lies ahead

Posted on May 18, 2015
By Tom Sullivan, Executive Editor, HIMSS Media
Around the turn of this century a phrase manifested in certain IT circles: We’re all going to agree on specification and compete on implementation.
And that sounded so good when Sun Microsystems multi-billionaire CEO Scott McNealy added it to his vibrant repertoire – other McNealy favorites of mine, to paraphrase, included “Budweiser, please” and “I just made my semiannual trip to Supercuts” – but the reality was much more complicated.
Those specifications included the likes of Java, XML, SOAP and the WS-x standards forming the Web services stack and they were engineered to enable integration, interfaces and, of course, interoperability.

Apple Watch aims to boost cancer treatments

May 17, 2015 | By Judy Mottl
A new Apple Watch app aims to enhance cancer care and improve patient monitoring during treatments such as chemotherapy.
The Medopad Apple Watch Chemotherapy app, now in pilot at London's King's College Hospital, reminds users about medication intake and lets them share data with caregivers on everything from physical activity to temperature and other body vital signs, according to a report at Wareable. The app also provides caregivers with data access via the Watch's accelerometer.
More on ICD-10 & Coding

AMA chief throws support behind bill to delay ICD-10, says US should wait for ICD-11

Steven Stack, the incoming president of the American Medical Association, says problems with ICD-10 for physicians are too big

Susan Morse, Associate Editor
Steven Stack, the incoming president of the American Medical Association, says problems with ICD-10 for physicians are too big to allow it to move forward.
ICD-10 should not only be delayed, but scrapped, said Steven Stack, the incoming president of the American Medical Association, throwing his organization’s support behind a bill by Texas Republican Rep. Ted Poe delaying its rollout.
“We support Rep. Poe’s bill,” he said. “We strongly support that.”
Instead, Stack said the United States should wait to change its diagnostic medical coding system until the implementation of ICD-11, Stack said.

Meaningful Use Proposals: An Opportunity To Provide Comment

by Bethany Jones Monday, May 18, 2015
Public comment is open for three recently published notices of proposed rulemaking that intend to restructure the Electronic Health Record Incentive Program (aka meaningful use) requirements starting this year through 2017, as well as define Stage 3 meaningful use, set to begin in 2018.
CMS and the Office of the National Coordinator for Health IT's NPRMs will affect more than 538,000 active program registrants, including eligible hospitals (EHs), critical access hospitals (CAHs), eligible professionals (EPs) and the developers of more than 2,600 health IT products currently used to meet meaningful use. Most importantly, the meaningful use program will continue to affect care delivery in the U.S. health care system as a whole with the potential to improve patient outcomes.


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