This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Saturday, December 19, 2015
Weekly Overseas Health IT Links -19th December, 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 healthcare industry is among the most aggressive when it comes to issues related to data collection, access, and privacy, but one clinical data expert believes that the future of health data management lies in turning data ownership over to patients.
Robert Rowley, MD, the chief medical information officer and founder at Flow Health in San Francisco, who previously started physician software vendor Practice Fusion, spoke with Information Management about the growing complexity with capturing and sharing a complete patient data profile, and how these challenges are impacting quality of care.
Although many individuals use health apps on their mobile phones, a substantial proportion of the U.S. population does not. And many who try health apps eventually stop using them, according to results of a national survey of health app use among U.S. mobile phone owners.
In the survey of more than 1,600 mobile phone users funded by the Verizon Foundation, a little more than half of respondents indicated that they had downloaded a health app—fitness and nutrition were the most popular types—with most using them at least daily. However, of those who used such apps, about half stopped using them due to time-consuming data entry and loss of interest.
It's that time of year when healthcare pundits take stock of the waning year and predict what's in store the year ahead. PwC's Health Research Institute is out with its 10 anticipated healthcare trends for 2016.
"It will be a year of firsts for healthcare consumers, organizations and new entrants as innovative tools and services enter the new health economy," accoding to PwC.
Its "Top health industry issues" report highlights the trends likely to have the most impact on the industry, with a look back at key events from the past decade.
A draft report cites thousands of instances in which telehealth, telemedicine, eHealth and mHealth are mentioned, but not enough evidence that they're effective. It also calls for more study of value-based care models.
Although there have been hundreds of reviews and hundreds of thousands of mentions since 2006, telehealth is still very much a cutting-edge technology – and not validated enough in most cases that legislators can draft adequate policies or standards.
National Coordinator for Health IT Karen DeSalvo, M.D., has laid out her office’s 2016 goals which include connecting health information exchanges across the “entire country within a year,” as part of the agency’s big push towards interoperability on a national level.
In a Dec. 8 speech before the Bipartisan Policy Center in Washington, D.C., DeSalvo observed that some communities such as Maryland are “already connected across state lines” and that ONC’s ultimate objective is to achieve nationwide HIE in 2016. However, three prominent interoperability experts dismiss the realistic chance of this goal being met.
As the healthcare industry moves toward a more patient-centered mission, security measures and interoperability will progress at a steady rate, according to DirectTrust, a healthcare industry alliance created by Direct exchange network participants.
The group recently released its predictions on the six trends for interoperable electronic exchange of health information for the upcoming year.
"In the world of electronic health information exchange, we're on track for another year of momentous forward movement in increased adoption by providers and greater interoperability between Federal and state agencies with private-sector providers," said David Kibbe, MD, DirectTrust president and CEO, in a press statement.
(Reuters Health) - Asking cancer patients to periodically report their symptoms online may improve their quality of life and possibly even their survival, according to a new study.
Researchers found that patients who used a website to report their symptoms had better quality of life, were less likely to go to the emergency room, stayed on treatment longer and survived longer than people who were just monitored by their doctors.
"We asked people about the most common and impactful symptoms that we would see across advanced cancers," said lead author Dr. Ethan Basch. "This would be pain, vomiting, nausea, diarrhea, constipation, energy loss, weight loss and sleep disturbances. Things that are highly common, subjective and frequently missed."
Written by Alex Tate, Health IT Consultant, CureMD | December 09, 2015
Though electronic health records (EHR) bring a whole new level of convenience and user-friendly operations to your healthcare facility, there is probably always that lingering fear in the back of your mind: "What happens when our EHR fails?" After reports of total EHR outages, it is a valid fear for any hospital or medical office that uses these systems in order to store their patients' information.
The loss of such information, especially when you have a great number of patients, could be catastrophic.
Instead of worrying over the loss of information, you should be asking yourself: "How can we prepare for this?" If you put the right motions into place, worrying over such a failure is a thought that won't cross your mind. Here are a few steps you can take in order to create a backup plan, to prepare for EHR failure and lessen the risk of losing all your patients' information.
Some 43 percent of consumers said using artificial intelligence to create a personal medical advisor would be a good idea, according to Ericsson's annual Hot Consumer Trends Survey of 6,649 iOS and Android urban smartphone users in cities around the world. The company's annual survey asks consumers for their take on futuristic scenarios. For example, last year one of the survey categories was "mind sharing" and this year another, focused on invasive connected devices, is internables.
Ericsson asked consumers to choose which artificial intelligence use cases they think would be useful from a list. Four options, including search engine, travel guide, personal assistant, and teacher, ranked higher than medical advisor. The only two that were less popular than medical advisor were financial advisor and an AI that provides companionship.
The Office of the National Coordinator for Health IT has established the ambitious goal of connecting the nation’s health information exchanges—both public and private—by the end of 2016 to make a big push toward nationwide interoperability.
“We have built—through the hard work of the private sector, states, and support from the HITECH Act—an infrastructure in this country where essentially every state has a health information highway,” said National Coordinator for Health IT Karen DeSalvo, M.D. “Our goal is to see that we can connect those highways—including the health information exchanges but also the private sector exchanges—in the entire country within a year.”
David Kibbe, M.D., CEO at secure messaging vendor DirectTrust, admits his trend forecasts for health information exchange in 2016 are optimistic, but if they come anywhere close to fruition it will be a powerful year of change.
To start, Kibbe sees patients participating more in electronic exchange of health data. “There is very little consumer involvement in HIE now, but I think we’re at a turning point.” He believes patients and other health consumers will become more active participants in electronic exchange of data as patient portals give them greater access to their clinical records and providers continue to accept patient engagement as necessary to attain better health outcomes.
Kibbe, who needs some cleanup work on a hip at Mayo Clinic, sees the change in physician acceptance of HIE in his own rural North Carolina and non-technical internist, who called and asked him for the Direct messaging address of Mayo so he could send medical records.
The Chancellor is warning of cyber terrorism. US healthcare organisations are under siege from hackers. Should the NHS be alarmed? Will the new careCERT help? And what should IT directors be doing? Daloni Carlisle reports.
Last month, Chancellor George Osborne announced that the UK is to double its spending on cyber security to £1.9 billion by 2020 in a bid both to protect national infrastructure from hostile forces and, as he put it, to take the fight to those who would harm us.
Islamic State was already using the internet for propaganda, to radicalise people and for planning purposes, he told an audience at the GCHQ eavesdropping agency.
It’s a central tenant of management science: size provides a competitive advantage. As companies get bigger, they realize efficiencies of scale and increased market power; they use both to reach the coveted position of stable incumbent. But are the protective effects of size eroding? Is the era of scale over? And, if so, what does that mean for health care organizations?
In a recent article for Harvard Business Review, Nicco Mele, author of the The End of Big highlights an interesting paradox. Incumbents in most industries in the U.S. are chasing size at all costs. From computing to health care insurance to beer, we are living in an era of mega-mergers. As a recent Wall St. Journal analysis showed, in nearly a third of industries, most U.S. companies compete in markets that would be considered highly concentrated under current federal antitrust standards, up from about a quarter in 1996.
When it comes to secure health information exchange, all eyes are on 2016. At an event Tuesday hosted by the Bipartisan Policy Committee, government officials spoke of their interoperability plans for the coming year.
The Office of the National Coordinator for Health IT is focusing on "near-term challenges," National Coordinator Karen DeSalvo said during the event.
Next year will be another one of "momentous forward movement" when it comes to interoperability in the healthcare sector, DirectTrust predicts.
The industry alliance of Direct exchange network users Tuesday released a report on 2016 healthcare trends in the interoperable exchange of information.
"In the world of electronic health information exchange, we're on track for ... increased adoption by providers and greater interoperability between federal and state agencies with private-sector providers. We'll also see, finally, patient and consumer participation in the use of electronic health information exchange," David Kibbe, M.D., president and CEO of DirectTrust, said in an announcement.
Not so long ago, telemedicine vendors had proprietary standards to connect point-to-point devices via the Internet to conduct a telehealth session. Now, there are open connectivity standards that eliminate additional steps to launch a session, making use of telemedicine simpler.
There remain significant differences among vendors in the architecture of telemedicine systems, says Steve McGraw, CEO at telemedicine vendor Reach Health, but proprietary standards for network connections are going away fast. “We worry about writing code now,” he adds. “Standards lets us write software that replicates the physician session rather than worrying about connectivity.”
That’s one of five major telemedicine technology trends that McGraw sees becoming more prominent in 2016.
Before patients can leverage application programming interfaces to access their healthcare data, as called for in the final Stage 3 electronic health record Meaningful Use rule, there are privacy and security issues that must be addressed.
Those are among the challenges that a new Health IT Policy Committee task force is attempting to tackle. The API task force, co-chaired by Harvard Medical School research faculty member Josh Mandel, M.D., and Cerner’s Director of Health Policy Meg Marshall, held its first two meetings last week to lay out the group’s agenda and work plan.
Ultimately, the goal is to provide the Office of the National Coordinator for Health IT with recommendations to help consumers leverage API technology to access patient data, while ensuring the appropriate level of privacy and security protection.
Despite security concerns, the vast majority of medical residents prefer short message service (SMS) text messaging compared with other forms of in-hospital communication, according to a recent survey conducted at the University of Chicago as well as Advocate Christ Medical Center in Oak Lawn, Ill.
In the survey, about 130 internal medicine residents were given several possible communication options: telephone, email, hospital paging, and SMS text messaging. Survey results, published in the Journal of Medical Internet Research, show that SMS text messaging was the preferred mode of in-hospital communication by 71.7 percent of respondents due to its efficiency and by 79.8 percent because of its ease of use.
At the University of Mississippi Medical School, CHIO John Showalter, M.D., is all about the data. While a chief medical information officer focuses on community health and physician engagement, he aims to make "healthcare function on an operational level and [ease] the technology burden on physicians and nurses as they deliver care," he said in an interview with Healthcare IT News.
He focuses on data integration and analytics, with an eye toward using insights to improve care and care delivery. The position is parallel with the CIO, but has an independent academic bent, reporting to the vice chancellor of research, according to the article.
According to a new survey, the demand for access to health data is outpacing the ability of organizations to ensure patient privacy. A survey conducted by Privacy Analytics, a de-identification technology vendor, found that more than two out of three healthcare organizations lack complete confidence in their ability to share data without putting patients’ privacy at risk.
The survey, conducted in collaboration with the Electronic Health Information Laboratory, a group that conducts theoretical and applied research on the de-identification of health information, also indicated that despite organizations’ lack of confidence, data sharing activities continue to grow.
Scott Mace, for HealthLeaders Media , December 8, 2015
Advances in natural language-processing and the ability to read large volumes of data are creating new insights for clinicians.
This article appears in the November 2015 issue of HealthLeaders magazine.
Until now, the electronic health record has been largely about structuring data to drive initiatives such as value-based care and population health. But now technology is unlocking unstructured information from clinical narratives, making it useful and actionable.
"It's still a work in progress, but a necessary piece of technology that we need to learn to leverage to fully get information out of our EMRs," says Steve Morgan MD, senior vice president and chief medical information officer for Carilion Clinic, an integrated delivery network headquartered in Roanoke, Virginia.
Providers considering two-factor authorization, which requires users to provide at least one more proof of identity beyond user name and password to access information systems, face a big issue early on by deciding which members of the organization will use the new technology.
In some cases, it may make sense for all personnel who access multiple systems to move to two-factor authentication. But that could be financially prohibitive for hospitals that may decide on a limited deployment to select groups of employees, or to physicians and nurses who spend the day moving from workstation to workstation.
Providers also have multiple options for the additional identity measure, such as a biometric scan, token, scanning an ID badge with a reader on the computer, or a smartphone app that sends a PIN to the computer and the user then enters a password, says Dean Wiech, managing director at Tools4ever, a vendor of two-factor authentication software. Further, Microsoft Windows 10 has a camera that supports facial recognition software.
By John Halamka, Beth Israel Deaconess Medical Center
It's now December and as each year ends, I always look back on the challenges and achievements of the past 12 months. Here's my sense of 2015.
Billions were spent, countless other projects were delayed, and the transition occurred on October 1 without a major incident. We're monitoring daily cash at all our hospitals and there has not been significant impact on denials, payments, or discharged but not final billed accounts. Did we get our money's worth? I have argued and will continue to assert that ICD-10 benefited no one. The diagnoses used are more variable so there is less precision in their use. Clinical documentation (in general in the industry) does not have the specificity needed to justify the more granular ICD-10 codes. The notion that quality measures can now be computed more accurately from ICD-10 coded administrative data is just not true. The right path is to plan for a future in which fee for service is replaced by bundled payments so that ICD vocabularies do not need to be used at all for billing. Natural language processing will be able to turn unstructured text into SNOMED-CT coded observations to support analytics. I know that ICD-9 is obsolete and did not include many modern concepts. However, we should have saved our billions and waited until natural language processing and SNOMED-CT was ready (or a convergence of SNOMED-CT and ICD ideas such as will be implemented in ICD-11). The end result of years of work 2012-2015 is that many IT stakeholders think IT was distracted by projects that added little value. The good news is that now that ICD-10 has passed, we can return control of IT priority setting to customers.
By Vinil Menon, CitiusTech Inc. and Viren Chakraborty, Healthcare consultant
With the release of Windows 10, Microsoft is radically changing the way they think about the operating system. Instead of discrete OS releases every couple of years, Microsoft is encouraging the world to move toward continuous OS updates.
Unshackled from the traditional model, Microsoft will be able to push out relevant updates to ensure the latest in OS is always available to all consumers. This doesn't just include new features, but is going all the way to instant patches and fixes for vulnerabilities, and even drive adoption. Microsoft calls this new model the 'Operating System as a Service'.
Windows 10 introduces a variety of new features. While some features like Windows Media Center, Windows 7 desktop gadgets and USB floppy drivers have been dropped, there is a considerable amount of innovative new features in the Windows 10 release that will be useful to healthcare users.
by Lisa Zamosky, iHealthBeat Contributing Reporter Monday, December 7, 2015
Corporate wellness programs have fast become a staple of employer health benefits. More than eight in 10 large employers offer a wellness program aimed at helping employees stop smoking, lose weight or make other lifestyle or behavioral changes, according to the Kaiser Family Foundation.
Under the Affordable Care Act, employers have further embraced wellness. The law allows employers to offer financial incentives, making it now common to tie rewards and penalties to the achievement of certain goals, such as weight loss or managing cholesterol.
Despite spotty evidence that these programs can help lower health care costs as intended, wellness vendors have proliferated in recent years. There's no sign of that trend slowing. According to research firm IBISWorld, wellness industry revenue is expected to grow by 8.4% annually, becoming a $12.1 billion business by 2020.
Can machines outperform doctors? Not yet. But in some areas of medicine, they can make the care doctors deliver better.
Humans repeatedly fail where computers — or humans behaving a little bit more like computers — can help. Even doctors, some of the smartest and best-trained professionals, can be forgetful, fallible and prone to distraction. These statistics might be disquieting for anyone scheduled for surgery: One in about 100,000 operations is on the wrong body part. In one in 10,000, a foreign object — like a surgical tool — is accidentally left inside the body.
Something as simple as a checklist — a very low tech-type of automation — can reduce such errors. For example, in a wide range of settings, surgical complications and mortality fell after implementation of a basic checklist including verification of patient identity and body part for surgery, confirmation of sterility of the surgical environment and equipment, and post-surgical accounting for all medical tools.
Earlier this week, JAMA Internal Medicinepublished a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”.
A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point:
High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction and observable communication differences … Concurrent computer use may inhibit authentic engagement, and multitasking clinicians may miss openings for deeper connection with their patients.
Doctors focused on entering data into electronic health records during visits are putting physician-patient relationships at risk as well as potentially the safety of patients.
So argues Regenstrief Institute investigator and Indiana University School of Medicine professor Richard Frankel, Ph.D., a medical sociologist who has studied exam room computer use and conducted extensive interviews with physicians. The problem is that some doctors spend more than 80 percent of the visit time interacting with the computer screen instead of their patients, according to Frankel.
After more than 40 years of focusing primarily on software for large businesses, SAP is taking a bold step in a new direction: precision medicine.
Targeting healthcare organizations, life sciences companies and research institutions, the German software giant on Tuesday rolled out SAP Foundation for Health, a brand-new platform based on its Hana in-memory engine that's aimed at helping such organizations uncover insights from patient data in real time.
"Our strategy is very simple but very ambitious," said Dinesh Vandayar, vice president of personalized medicine for SAP. "Our vision is to create a health network enabling personalized medicine."
SAP also unveiled SAP Medical Research Insights, the first accompanying application, with a focus on clinical researchers and life sciences companies.
Google has filed a patent application for a wearable device that can test diabetics' blood sugar levels without the use of a needle.
The application, filed with the U.S. Patent & Trademark Office on Dec. 3, is for a wrist-worn device that uses pressurized gas to pierce the user's skin and draw in a "micro-emergence" of blood to be tested.
The device might not be for diabetics alone. The patent application notes that blood could be tested for various qualities, including hormone levels, proteins and enzymes, which could factor into various medical conditions.