Saturday, July 18, 2015

Weekly Overseas Health IT Links -18th July, 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.
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A ‘Star Trek’ Future Might Be Closer Than We Think

By Anna North
July 10, 2015 11:10 am July 10, 2015 11:10 am
Set against some of the biggest sci-fi franchises of the last five years, many of which imagine the future as a wreckage in which the strong prey relentlessly upon the weak, “Star Trek” can seem kind of quaint. After all, the show, especially in its second and strongest incarnation, “The Next Generation,” takes place in a time when, essentially, everything has worked out.
But it is precisely this quality that interests Manu Saadia, the author of “Trekonomics,” a forthcoming book about the economics of the “Star Trek” universe. The book, which grew in part out of conversations between Mr. Saadia and his friend Chris Black, a former writer for “Star Trek: Enterprise,” will be sold through the publishing platform Inkshares. It examines “Star Trek’”s “post-economic” system, in which money no longer exists and anything you want can be made in a replicator, essentially for free.
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Posted July 10, 2015 - 4:33pm

Study shows elderly want to control what health information family sees

By LISA RAPAPORT
REUTERS
Elderly patients may be willing to let family members access their medical records and make decisions on their behalf, but they also want to retain granular control of their health information, a study suggests.
“Respecting and preserving the autonomy of the elder is critical,” said lead author Dr. Bradley Crotty. “Elders and families should have honest discussions about preferences for information sharing and decision-making, and share these conversations with healthcare providers.”
To understand how patients over 75 and the family members who care for them think about sharing medical information, Crotty and colleagues held separate focus groups in 2013 and 2014 with 30 elders and 23 caregivers.
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Clinician-centered design in EHRs improves workflow

July 10, 2015 | By Katie Dvorak
Design for electronic health records that is clinician-centered can help improve workflow in ambulatory healthcare settings, a recent report found.
The report, published at eGEMs (Generating Evidence & Methods to improve patient outcomes), examined lessons learned from implementing recommendations from the National Institute of Standards and Technology into a software prototype for the Veteran's Health Administration's VAi2 innovation project.
The authors of the report, from Ohio State University, NIST and Johns Hopkins University, put into play 12 of the 15 recommendations to improve workflow made by NIST.
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Online 'Symptom Checkers' Often Miss Diagnosis, Study Finds

Computer-generated analysis correctly identified problem about one-third of the time
By Alan Mozes
HealthDay Reporter
THURSDAY, July 9, 2015 (HealthDay News) -- Automated online "symptom checkers" that seem to offer patients a quick opportunity for self-diagnosis provide the right diagnosis in only about one-third of cases, a new analysis reveals.
The study team found that online checkers -- which are typically free services offered by medical schools, insurance companies, and even government entities -- are a more reliable and effective means to get a handle on symptoms than using web search engines such as Google.
The investigation also found that online medical checkers are about as accurate as primary care physician phone services that offer patients advice on whether or not a condition requires urgent care.
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Telemedicine at a Crossroads

by Rebecca Vesely, iHealthBeat Contributing Reporter Friday, July 10, 2015
When the U.S. Supreme Court upheld the Affordable Care Act's subsidies for the federal health insurance exchange late last month, one of telemedicine's chief advocates was elated.
Jonathan Linkous, CEO of the American Telemedicine Association, in a phone interview said that the high court's decision will allow more room for Congress to focus on other priorities this session -- including telemedicine.
"Congress would have been totally swept up in the decision for the rest of the year had the subsidies been struck down," Linkous said, adding, "Telemedicine has always enjoyed bipartisan support."
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Healthcare IT: Time to Train the Machines

JUL 9, 2015 7:49am ET
Healthcare executives expect that within the next three years their industry will need to focus as much on training machines as they do on training people, according to a new report from outsourcing and consulting firm Accenture.
The report, Accenture Healthcare Technology Vision 2015, is based on a survey of 601 doctors, 1,000 consumers and 101 healthcare executives and highlights emerging technology trends that will affect the industry in the next three to five years.
A majority of the health executives surveyed (84 percent) agree or strongly agree that their industry will need to focus as much on training machines, such as using algorithms, intelligent software and machine learning, as they do on training people in the next three years. Most agree that provider organizations, driven by a surge in clinical data, will soon need to manage intelligent machines as well as employees.
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AHRQ: Patient engagement tools both help, hurt clinician workflow

July 6, 2015 | By Marla Durben Hirsch
Health IT applications that engage patients can have both a positive and a negative effect on clinicians' workflow, according to a new final contract report funded by the Agency for Healthcare Research and Quality (AHRQ).
The report reviews patient use of secure messaging, electronic forms patients complete on a computer and portals to upload clinical data to their clinicians, and involves six different clinics in medium sized cities.
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Leapfrog out with troubling hospital safety numbers

Posted on Jul 09, 2015
By Bernie Monegain, Editor-at-Large
Patients may expect cleaner than clean conditions in a hospital – sterile even. Think again. In one of four hospitals across the country hand washing – the best-known way to prevent hospital infections – is apparently not a priority. Nearly a quarter of the hospitals – 23 percent – have yet to implement safe practices such as those.
That's according to a survey by hospital watchdog The Leapfrog Group. Overall, the results paint a picture of hospitals across the country struggling to provide safe care.
Health management company Castlight Health analyzed the results of the annual survey that measures a broad array of safety issues. It found that while hospitals overall showed improvement in 2014 for hand hygiene, rural hospitals aren’t performing as well as their urban counterparts.
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2015 'Most Wired' hospitals turn to new priorities

Posted on Jul 09, 2015
By Bernie Monegain, Editor-at-Large
Health data security and patient engagement are top priorities for the nation’s hospitals, according to results of the 17th annual Health Care’s Most Wired survey, released today by the American Hospital Association’s Health Forum and the College of Healthcare Information Management Executives.
The 2015 Most Wired survey and benchmarking study, conducted in partnership with CHIME and sponsored by VMware, is designed to provide a barometer measuring information technology use and adoption among hospitals nationwide. The survey of more than 741 participants, representing more than 2,213 hospitals, examined how organizations are leveraging IT to improve performance for value-based healthcare in the areas of infrastructure, business and administrative management, quality and safety, and clinical integration.
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Wales rolls-out patient portal

8 July 2015   Thomas Meek
Wales is nearing the complete roll-out of its My Health Online portal for online bookings and repeat prescriptions.
In its latest newsletter, the NHS Wales Informatics Service says the service needs to be implemented at one more GP practice in the Aneurin Bevan Health Board area and this will occur within the month.
Once completed, My Health Online will be live at all 458 GP practices in Wales, offering patients the opportunity do a variety of health-related tasks online, including booking appointments and ordering prescriptions. 
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NHS developing PHR adoption strategy

9 July 2015   Thomas Meek
NHS England is working on an adoption strategy to support the use of personal health records.
The strategy is intended to enable the NHS to develop an understanding of “what do we need to do at centre to help health economies and patients adopt PHRs,” according to Lenore Ogilvy, a commercial specialist at the commissioning board.
Ogilvy, who was speaking at a Future of Personal Health Records event this week organised by Sitekit, the co-creator of the eRedbook, said the plan is part of the National Information Board’s ‘Personalised Health and Care 2020’ framework to drive improved use of digital technology in healthcare.
The work on PHRs comes under workstream 1.1 of the framework, which is focused on enabling patients and the public to use digital tools to access health and care information and make informed choices.
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Congress gets another chance to advance telemedicine

July 08, 2015Eric Wicklund - Editor, mHealthNews
A new version of a bill designed to phase in telemedicine for Medicare beneficiaries is back on the table in Washington.
Rep. Mike Thompson, D-Calif., introduced the Medicare Health Parity Act of 2015 on July 7. Co-sponsors of the bill are Reps. Gregg Harper, R-Miss., Diane Black, R-Tenn., and Peter Welch, D-Vt.
The four legislators said this bill would put Medicare "on the path toward parity with in-person healthcare visits."
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Unless taxpayers stand up and take notice, politicians will continue to waste public funds with impunity.

eHealth Ontario – the Gift that Keeps on Taking

Once again, Ontario taxpayers will be shelling out tens of millions of dollars for a cancelled contract that sees them getting nothing in return.
This time, it’s a new $26.9 million bill from scandal plagued eHealth for a cancelled contract for the development of an unfinished registry of diabetes patients.
In 2010, the Ontario government signed a contract with CGI Information Systems to create a database to track the needs of diabetes patients. The six year contract was cancelled in September 2012 at the request of eHealth.
Deb Matthews (the Health Minister at the time) and eHealth took the position that the contract could be cancelled without a cost to taxpayers, because they alleged repeated delays had made the CGI database obsolete.
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Is Your Organization Ready for the Era of Cybercrime?

JUL 7, 2015 6:08pm ET
Cybercrime is on the rise, and the healthcare industry is the hot new target for increasingly sophisticated, intelligent hackers.
On the black markets of the Dark Web, stolen patient health records can fetch as much as $363 per record, according to data from the Ponemon Institute, which is more than any other piece of data from any other industry. This is because, unlike credit cards and other data, health records contain information that can’t be easily changed or deleted – social security numbers, birth dates and more.
As we see more high-profile attacks against healthcare organizations, our government is responding with increased regulation as a first defense. Compliance demands continue to grow, especially when it comes to protecting personal information. The pending Data Security and Breach Notification Act of 2015 would be the first federal rule requiring organizations to inform consumers that their personal information may have been compromised, and then take reasonable steps to protect personal information they maintain in electronic form.
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Digital Health Funding in 2015 Slightly Behind 2014

JUL 8, 2015 7:35am ET
Funding for digital health companies reached $2.1 billion in the first half of 2015—just short of the $2.3 billion during the same time period during 2014’s record-breaking year—according to Rock Health, which funds and supports early stage healthcare companies.
Rock Health released its 2015 Midyear Report revealing that there were 139 deals in the first six months of the year with the average deal size pegged at more than $15 million, exceeding $14.6 million in 2014. The firm’s funding data only includes disclosed U.S. deals over $2 million.
According to Rock Health, digital health funding was approximately 5 percent of total venture funding in the first quarter (latest data available), outpacing overall funding, the software sector, and traditional healthcare sectors—including biotech and medical devices.
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The seedy underworld of medical data trafficking

Posted on Jul 08, 2015
By Chris Bowen, ClearDATA
As more healthcare organizations are discovering to their woe, having direct access to patients' personal health information puts a giant target on their backs for cyber thieves that traffic in stolen medical records. Medical data breaches are increasing in frequency and scope, with millions of Americans now victims of medical identity theft. Who are the criminals behind this digital era crime wave?
IBM research shows that the vast majority of cybercrime is highly organized and generating unprecedented profits, noting that the largest bank heist in history was $30 million compared to the annual $445 billion cost of cybercrime. Solo cybercriminals are also out there, however. Trend Micro observes that these different classes of criminals also dwell in different forums, with petty thieves showing up in more easily accessed sites, and organized cyber thieves residing in closed forums of their own.
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Patient portal design should be more fluid, varied, researchers say

July 7, 2015 | By Marla Durben Hirsch
Patient portals can be a helpful way to share older adults' health information with their caregivers, but privacy and autonomy issues indicate that full access by proxy may not be the best approach, according to a new study in JAMA Internal Medicine.
The researchers, from Beth Israel Deaconess Medical Center and elsewhere, conducted 10 professionally moderated focus groups from October 2013 to February 2014 as part of a broader inquiry regarding the information needs of the elderly and their caregivers. They found there to be "broad support" in general for information sharing if it benefited the older adult, but the elders and caregivers had different perspectives.
For instance, while caregivers wanted access to information to reduce their own stress levels and be helpful, elders resisted sharing because they didn't want to burden their caregiver family member with the information.
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White House announces Precision Medicine Initiative commitments

July 8, 2015 | By Katie Dvorak
The Precision Medicine Initiative was announced by President Barack Obama six months ago, and this week the administration detailed new commitments to the program.
The administration released a rough draft for guiding principles in regard to privacy and trust when it comes to precision medicine projects. It offers guidance on governance; transparency; data sharing, access and use; data security and more.
Some of the guidelines include:
  • Unauthorized re-identification and re-contacting of participants will be expressly prohibited
  • Mechanisms should be created to ensure data integrity is preserved at all stages: collection, maintenance, use, and dissemination
  • A Data Security Framework should be developed with help from experts in data science, security and health IT
The White House is seeking comment from the public on the principles through Aug. 7.
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Program helps to address inconsistencies in use of clinical decision support tools

July 8, 2015 | By Susan D. Hall
A conference series known as TEACH (Teaching Evidence Assimilation for Collaborative Health Care) shows promise for promoting evidence-based practice.
Despite advances in research, clinical guidelines continue to be ignored and clinical decision support (CDS) tools used inconsistently or not at all, according to an article at eGEMS (Generating Evidence & Methods to improve patient outcomes).
The program was developed at the New York Academy of Medicine to look beyond technology to address problems of habit, policy and organizational culture to better align practice with clinical evidence.
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Vital intelligence

The technology funds encouraged trusts to bid for systems that can be used to record vital signs and calculate early warning scores. While they get to grips with their implementations, Fiona Barr discovers that early adopters are starting to extend the use of their devices; and to gain some unexpected benefits.

In the fourth biggest hospital in England, every doctor and nurse has a mobile device in their pocket and uses it throughout their working day.
The IT used by staff at Nottingham University Hospitals NHS Trust is not part of an electronic patient record deployment, but a vital signs project that has made iPods and iPhones as ubiquitous on the ward as they are at home.
The Nottingham project was one of many vital signs projects partly paid for by the government’s health technology funds, which helped to kick-start substantial growth in the vital signs’ market a year ago.
Twelve months on, the second round of the Nursing Tech Fund has supported 24 more projects and the momentum is continuing as trusts start to self-fund the schemes and add more functionality.
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Physicians Increasingly Open to Video Consultations

JUL 7, 2015 7:30am ET
A nationwide survey of more than 2,000 primary care doctors found that 57 percent of physicians are willing to conduct video visits with their patients.
Just 12 percent of respondents are unwilling to see a patient over video and 31 percent remain uncertain. In the online survey conducted by telehealth vendor American Well, physicians cited work-life balance as the most popular reason for seeing patients over video, followed by increased earning opportunity, and improved patient outcomes.
When it comes to technology platforms, 69 percent of doctors indicated that video is superior to phone or email communication for making accurate diagnoses for new patient consults. Only 5 percent of those surveyed said email was best for diagnosis and just 1 percent said text was best.
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July Feature: EHRs Going Against the Flow

JUL 7, 2015 7:24am ET
Implementing clinical information systems at healthcare organizations can be a jarring experience. And when those systems conflict with long-used work processes for accomplishing clinical tasks, it's more than annoying. It can make an IT project a long, uphill slog.
For a health IT project to succeed, the flow of information must be synchronized with clinical workflow-that's how an organization can best ensure it will achieve significant gains in efficiency and quality of care. Conversely, when those flows don't match up, providers become less efficient, forced to take additional steps or create workarounds for incongruities.
Such synchronicity is hard to come by for providers. In fact, studies suggest that the rapid adoption of electronic health record (EHR) systems, spurred by federal incentive programs, have led to usability, workflow and cognitive support issues that hinder patient care.
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Online CME learning has hidden benefits

Posted on Jul 07, 2015
By Sherree Geyer, Contributing writer
Hospitals that leverage online learning to reduce the cost of continuing education requirements may experience a bonus: lower lengths of stay, reduced readmissions and improved quality indicators.
So says Teresa Fugate, a case management consultant who credits online learning tools with lower lengths of stay at Knoxville, Tenn.-based Covenant Health, where she served as vice president of case management for five years.

"We saw a reduction in LOS by getting tidbits (of information) on how to handle a chronic case," she says – adding that informed case managers made informed decisions.
"The more expertise, the more confident they are and assertive to have conversations with doctors," says Fugate. "If they knew the criteria and could cite the source, the doctor would have more respect and was more likely to take their suggestion."
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Over-budget GPES has no future - NAO

2 July 2015   Rebecca McBeth
Significant delays to the General Practice Extraction Service have seen costs rise from £14 million to £40 million - and design failures mean it is unlikely to have a long-term future, a National Audit Office report has said.
The NAO has today published the findings from an investigation into the service, which collects data from all GP clinical systems in England.
In a statement, it says mistakes in the original procurement and contract management have increased costs, while the HSCIC may get as little as two more years’ use from the system.
“The total expected cost of the GPES programme increased from £14 million to £40 million during the planning and procurement stage,” the report states.
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Niam Yaraghi: Stage 2 of Meaningful Use has 'failed'

July 6, 2015 | By Marla Durben Hirsch
While there are many benefits of health IT, forcing providers to comply with Stage 2 of the Meaningful Use program has been a failure, according to Niam Yaraghi, a fellow at the Brooking Institution's Center for Technology Innovation.
In a recent blog post, Yaraghi says that Stage 1 of the program created an artificial market for electronic health record systems, and that providers were willing to buy the government-subsidized products without worrying about actually using them.
Now that Stage 2 has gone into effect, however, providers are required to use their EHRs; to that end, forcing physicians to adopt and use a one size fits all program was "destined to fail," he says. Instead, according to Yaraghi, adoption should have been allowed to be "organic and voluntary." Health IT, he adds, is a means to achieve the goal of efficiency and forcing an EHR as the only IT solution ignores the fact that other IT services likely would be better.
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Privileged access controls essential to healthcare security strategy

July 7, 2015 | By Susan D. Hall
Recent healthcare data breaches in which hackers got in through administrator credentials highlight the need for privileged access management, Sudhakar Gummadi, chief information security officer at California-based Molina Healthcare, says in an interview at HealthcareInfoSecurity.
Privileged access, which IT workers use to do their jobs of building and maintaining the infrastructure, essentially gives them the keys to the kingdom. These days, though, it doesn't make sense to offer them 24/7 privileged access, Gummadi says.
While encryption and other tactics are good to have as part of a good defense-in-depth strategy, it's critical to have controls for privileged-access management, he says.
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Stop Complaining About ICD-10 and Start Training

Scott Mace, for HealthLeaders Media , July 7, 2015

Misinformation and misunderstandings surround ICD-10 as the go-live date nears. One result is that too many providers have yet to conduct testing. They should take advantage of CMS's grace period, starting now.

The announcement yesterday that the American Medical Association is now working jointly with CMS to educate its membership about ICD-10 is better late than never.
Consider that, according to a survey conducted by the American Health Information Management Association (AHIMA) between May and June, the majority of providers have not yet conducted ICD-10 testing. This annual survey found that 19% of respondents do not even plan to conduct any end-to-end testing.
That is a fairly astounding finding, nearly as astounding as some of the continuing misinformation being circulated about how coding errors in ICD-10 will affect physician's payments. For some clarification on this, I again turned to AHIMA.
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Time to Lower E-Communication Walls between Patients, Docs

JUL 6, 2015 7:33am ET
The results of a recent survey conducted by Johns Hopkins University, Brigham and Women's Hospital, and CVS Health point to a clear conclusion: It is time to give more than lip service to finding a mutually agreeable way for patients and their providers to communicate electronically beyond “official” platforms such as EHRs and patient portals.
The survey, which gauged patient use of, and interest in, using email, provider websites, and social media – specifically Facebook – was published in the Journal of General Internal Medicine.
 “The easy answer is there are takeaways for everyone,” lead author Joy Lee, a post-doctoral research fellow at the Bloomberg School of Public Health at Johns Hopkins, told Health Data Management about her team's findings, “but especially for healthcare organizations like hospitals, and then providers. For hospitals and clinics, an important finding is pointing out the realization that demand is there – yes, there are concerns about data security, but this is right now an unmet need.”
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IT Leaders to Congress: We Need Patient Identifier Now

JUL 6, 2015 7:18am ET
The College of Healthcare Information Management Executives is calling for a renewed push to establish a unique national patient identifier and is unleashing its 1,600 chief information officers and clinical medical informatics officers to press Congress to remove the current prohibition on such an identifier.
In recent months, U.S. House and Senate committees—particularly the House Energy and Commerce and the Senate Health, Education, Labor and Pensions Committees—have  held a series of hearings on issues surrounding health information technology. These include electronic health records interoperability, Medicare reimbursement for telemedicine services, improving health IT safety, and regulation of certain software as medical devices, as policymakers seek ways for health IT to better support population health management and cost control.
Time and time again, the lack of a sufficient national patient identifier has been cited by testifying stakeholders as a major impediment to interoperability and patient safety. And, with the House Energy and Commerce Committee sending the 21st Century Cures Act to the House floor for consideration, now is the time for CHIME and other industry associations to make a concerted effort on the identifier issue, says Leslie Krigstein, interim vice president of public policy at CHIME.
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The 'fatal cost' of poor IT rollouts

Posted on Jul 06, 2015
By Mike Miliard, Editor
Too often, health organizations "make rookie mistakes" in their technology implementations, writes Leapfrog President and CEO Leah Binder. And too often, these rollouts leave hospitals vulnerable to serious patient safety risks.
Writing in the Wall Street Journal on July 1, Binder lays out a familiar list of complaints.
"They assume everything is plug-and-play, then panic when things go wrong. They set unrealistic timelines that demoralize staff. They rely too much on vendors. And they expect technology to somehow electronically solve complex human and managerial issues."
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Report: IoT in healthcare could have economic impact of up to $1.7T

July 6, 2015 | By Katie Dvorak
The Internet of Things, when used to improve healthcare and help those with chronic conditions, could have an economic impact ranging from $170 billion to $1.7 trillion a year, according to a recent report from McKinsey & Company.
By 2025, the report estimates that the IoT will have a "total potential economic impact" of almost $4 trillion up to a possible $11.1 trillion per year.
That healthcare figures are based on "cost savings in treatment and the value of longer lives and improved quality of life that patients with chronic conditions could enjoy if IoT monitoring helps them avoid disease complications," the report adds.
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Efficient health information exchange could mean huge savings for hospitals

Written by Max Green | July 02, 2015
Including a health information exchange query for every patient encounter in a emergency department setting could significantly reduce the number of tests and examinations ordered in hospitals and reduce costs, according to a recent study published in the Journal of the American Medical Informatics Association.
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The Evolution From Analytics to Dynamics

by Jacob Kuriyan Monday, July 6, 2015
As health care begins to accumulate and merge electronic health record, claims and "big" data, new IT tools and methodologies will be needed to digest them into information. The challenges are non-trivial and the consequent disruptions to IT and its professionals can be severe.
Currently an important role of analytics in health care is to spot outliers -- highest-cost patients, highest utilizers -- to minimize fraud and abuse and increase efficiency. Analyses of cost and utilization using statistics and other methods help set premiums, evaluate performances and devise incentives to improve quality and care. An alternative approach to statistical analysis is the method of dynamical systems, which has shown value in the study of physical systems in many fields such as physics, ecology, biology and electrical engineering. 
Epidemiologists, for instance, have modeled an HIV population as a dynamical system. Known as the SIR model -- for "susceptible," "infected" and "recovered," the three segments of the population in the model -- it successfully forecasts the spread of HIV in a population. In cancer research, dynamic modeling is used to study the growth and spread of tumors. Amusingly, advertisers and marketers use dynamical system models to understand the viral propagation of rumors and gossip on social networks.
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Enjoy!
David.

1 comment:

Bernard Robertson-Dunn said...

Hands up all those who saw this amongst David's items?

"Study shows elderly want to control what health information family sees"

The report does not cover the Australian context, but there is no indication that Australians are likely to be any different.

Can the PCEHR control access to a patient's health record at the family or carer level? I may be wrong, but AFAIK, the only control is at the health provider organisation.

In fact, the ConOp never even identified such a level of control as a requirement. If I remember correctly, the ConOp strongly recommended control at the individual health carer level, but it was seen as being too difficult. And anyway, it would have required NASH.

This new potential requirement - which probably applies to more than just the elderly - that seems to have been identified rather puts the claim of "personally controlled" even less valid.

At least, when it was opt-in, a patient could just ignore the PCEHR. Now a patient will need to go through the rigmarole of opting-out as well as having to explain to people they may not want to, why they are opting out.