Saturday, February 27, 2016

Weekly Overseas Health IT Links - 27th February, 2016.

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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Failing to protect your mobile network: The cost for hospitals

January 29, 2016 | By Joanne Finnegan
The following is an excerpt from an article published in the FierceHealthIT's eBook "Best Practices for Securing Your Mobile Network." Download the eBook here to read more.
When it comes to protecting your mobile network, you can either pay now ... or pay later.
It's not an inexpensive proposition to pony up for security measures. But a failure to spend money up front to protect patients' protected health information (PHI) can potentially cost an organization millions of dollars down the line.
Just ask John Halamka, chief information officer for Beth Israel Deaconess Medical Center, a 631-bed teaching hospital in Boston. Each of his facility's reportable privacy breaches has cost more than a million dollars and has involved a single stolen mobile device, he says.
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Sharing Notes with Patients Boosts Engagement

Alexandra Wilson Pecci, for HealthLeaders Media , February 19, 2016

A two-year OpenNotes trial led researchers to a conclusion about transparency: "If you think patient engagement is important to your health system," then sharing the providers' notes "is a no-brainer."

Between 40% and 80% of what a healthcare provider tells patients is immediately forgotten, and half of what they do remember, they get wrong.
"Those are two of the most depressing statistics I've ever heard," says John Mafi, MD, a professor at the David Geffen School of Medicine at UCLA. "We have a big communication problem in our healthcare system, and that's an understatement."
The result of all this miscommunication and forgetfulness, Mafi says, are the very things that are plaguing the healthcare system as a whole: Low patient engagement, poorly managed chronic conditions, prescriptions that go unfilled, medications that lay forgotten in medicine cabinets, bad outcomes, and high costs.
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Tech support the Achilles heel for EHR implementations

Published February 17 2016, 2:29pm EST
As electronic health records become more widely used in the healthcare industry, providers are changing how they make decisions on which application to use.
For an increasing number, technical support will be an important differentiating factor.
And more providers are not happy with the service they are getting now, according to a recent survey from Black Book, a market research firm that regularly studies vendor satisfaction across several industries.
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EHR research: We're entering uncharted, exciting territory

February 17, 2016 | By Marla Durben Hirsch
That said, there's no denying the inroads they're making in research. Recent reports we highlight this week really highlight EHRs' potential to delve into new, and frankly incredible, areas of education.
It worked. The researchers are so confident in their screening tool that they predict using it would identify an additional 400,000 people with active, untreated diabetes. And since 25 percent of Type 2 diabetes patients in this country are undiagnosed due to inadequate screening, this development can have a huge impact on treatment, population health and the cost of healthcare. We've known that EHRs help support the treatment of diabetes; this breakthrough takes such involvement one step further.
What's more, the screening algorithm that the researchers developed also uncovered several previously unknown risk factors for diabetes, many of which seem pretty random, such as a history of sexual and gender identity disorders, Colitis and Chicken Pox. And some of these newly identified risk factors are better risk factors than a few of the ones for diabetes that we're familiar with, such as body mass index or high cholesterol.
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Researchers: Medical interns spent up to 7 hours a day using EHRs

February 15, 2016 | By Marla Durben Hirsch
Medical interns spent as much as seven hours a day on electronic health records and clocked an additional five hours a day on them even after they got used to the systems, according to a small study published in the Journal of Graduate Medical Education.
The researchers, from New York Methodist Hospital and St. Georges University School of Medicine in Granada, used a built-in tracking program to objectively quantify the EHR usage data of all 41 first-year internal medicine residents in a single program, using audit logs for May, July and October 2014, as well as January 2015. They tracked only active EHR use, defined as an electronic patient record encounter, which included chart review, orders, chart documentation and other activities, such as communicating with other providers via the EHR.
The researchers found that the interns spent an average of seven hours a day in active EHR use in July, when first starting to use the system. By January, the time had dropped, but still amounted to roughly five hours a day. The average number of minutes per electronic patient record encounter dropped from 41 minutes in July to 30 minutes in January. The researchers surmised that the numbers decreased as the interns became more familiar with the systems, improved efficiencies, and other factors.   
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EHRs may help prevent in-hospital adverse events

February 16, 2016 | By Marla Durben Hirsch
Hospitals using a "fully electronic EHR"--a system "in which all physician notes, nursing assessments, problem lists, medication lists, discharge summaries and provider orders are electronically" developed--recorded lower incidences of in-hospital adverse events, according to a new study in the Journal of Patient Safety.
The study, sponsored by the Agency for Healthcare Research and Quality (AHRQ), examined EHR adoption and occurrence rates of patient safety adverse events by analyzing patient discharges, using data from the 2012 and 2013 Medicare Patient Safety Monitoring system. The authors looked at patients 18 years of age or older who were hospitalized for acute cardiovascular disease, pneumonia or conditions requiring surgery.
The outcome measures were in-hospital adverse events, including hospital acquired infections, adverse drug events, general events and post-procedural events. The study sample included 45,235 patients at risk for 347,281 adverse events at 1,351 hospitals
The researchers found that patient exposure to a hospital with a fully electronic EHR correlated with 17 to 30 percent lower odds of having an in-hospital adverse event. For example, such patients who were hospitalized for pneumonia had 35 percent lower odds of an adverse drug event and 34 percent lower odds of a hospital acquired infection.
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IT managers are hacking their own systems, even in healthcare, survey finds

The Absolute report also showed that 65 percent of IT decision makers believe they would lose their job in the event of a breach.
February 18, 2016 03:21 PM
A high percentage of IT workers admit to not following the same security protocols they are expected to enforce, according to a new survey conducted across the United States by Absolute, a Canadian security firm.
In fact, 33 percent admitted to successfully hacking their own or another organization and 45 percent admitted to knowingly circumventing their own organization's security policies.
"The big surprise for us in this survey is that the gatekeepers are really the gatecrashers," said Stephen Midgley, vice president of global marketing for Absolute. Moreover, he said, while the survey of IT department managers included several industries, the findings apply across the board, with healthcare no exception.
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CDS applications, natural language processing help reduce mortality rates for heart failure patients

February 18, 2016 | By Katie Dvorak
Clinical decision support applications that use natural language processing to identify heart failure (HF) patients and calculate readmission risk helped reduce 30-day mortality while improving discharge rates, according to a study published online in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from Intermountain Healthcare and the University of Utah, were able to identify HF patients earlier by using natural processing, and with that information--as well as data from the electronic health record--created a predicative score of the risk for each patient to be readmitted within 30 days.
Once the patients with HF risk and readmission risk were identified, the researchers were able to track the patients' care through a multidisciplinary care process pathway (CPP).
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IBM to acquire Truven Health Analytics for $2.6B to bolster Watson Health

February 18, 2016 | By Dan Bowman
IBM aims to improve the capabilities of its Watson Health system by acquiring Ann Arbor, Michigan-based Truven Health Analytics, it announced Thursday.
IBM will pay $2.6 billion for Truven, a health data analytics company that counts federal and state government agencies, hospitals and health plans among its 8,500 clients. Truven's "technology, methodologies and health claims data will be integrated into the Watson Health Cloud over time," the announcement notes.
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Publishing BI data improves hospital performance

Rebecca McBeth
16 February 2016
Publishing regular comparative performance data has driven significant clinical operational and financial improvements at a Gateshead trust, its chief clinical information officer has said.
Gateshead Health NHS Foundation Trust has used a business intelligence tool from System C to create a suite of reports and dashboards, including the quality and speed of discharges sent to GPs and results acknowledgement.
These are available to other System C users via a newly launched tool called Medway BI Data Visualisation, which is based on software from Yellowfin.
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Hospitals need to get to grips with IT - Nuffield report

Lyn Whitfield
17 February 2016
NHS hospital boards need to get to grips with the potential benefits and pitfalls of implementing information technology, a new report from the Nuffield Trust urges.
‘Delivering the Benefits of Digital Healthcare’ identifies seven areas in which the think-tank argues that there are systems available that could deliver “huge scope from major improvements in quality and productivity.”
But it also warns that “without careful implementation” such technologies can “create inefficiencies, staff frustration, and even threaten quality of care.”
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Ransomware Hits Hospitals

$3.6 Million in Bitcoins Demanded from Hollywood Hospital Mathew J. Schwartz (euroinfosec) • February 16, 2016    
A string of hospitals around the world - from Hollywood to Germany - have been hit recently by ransomware attacks, in a reminder that no organization is immune to outbreaks of malware that's designed to forcibly encrypt all data stored on PCs and servers (see Ransomware: Are We in Denial?).
One of the most severe cases involves Hollywood Presbyterian Medical Center, based in Los Angeles, which declared an "internal emergency" after staff noticed an apparent ransomware outbreak begin on Feb. 5, reports NBC. The attackers have demanded 9,000 bitcoins, currently worth about $3.6 million, reports Fox News.
The hospital couldn't immediately be reached for comment. But as of Feb. 12, multiple patients had been transferred to other hospitals as a result of the attack, electronic patient records remained inaccessible, and all hospital departments - lacking email access - were attempting to communicate via "jammed fax lines," NBC reports.
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Hackensack University follows FHIR-enabled route to data exchange

Published February 17 2016, 5:32am EST
After his daughter suffered a concussion last year, Shafiq Rab, MD, CIO at Hackensack University Medical Center, saw how a lack of coordination and data exchange complicates the patient experience. “We had to go to the primary care physician, a neurologist, a vision doctor, a physical therapist—and I became the care coordinator,” he says.
The frustrating experience intensified Rab’s desire to use technology to improve healthcare delivery, helping patients and caregivers seamlessly connect and share information whenever and wherever they need to.
Toward this end, Rab and his team just released a Hackensack University app, which enables patients to make appointments with participating physicians, fill out forms, and access test results—all on their handheld phones or devices.
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EHR data provides a trove of insights into diabetes

Published February 17 2016, 5:23am EST
A nationwide analysis of the electronic health records for nearly 10,000 patients by UCLA researchers has uncovered several previously unknown risk factors for Type 2 diabetes, including sexual and gender disorders, intestinal infections and some sexually transmitted diseases.
Using a newly developed screening algorithm and 9,948 electronic records gathered from hospitals, clinics and doctors’ offices in all 50 states, the research team was able to improve screening for the disease by predicting the likelihood of an individual having the disease and then successfully testing the pre-screening tool.
In the process, they believe they have developed a more accurate and less expensive way to identify patients who have undiagnosed Type 2 diabetes.
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Hollywood Presbyterian hack signals more ransomware attacks to come

Experts says cybercriminals favor these types of attacks because they are reasonably easy to pull off and have a big impact.
February 17, 2016 01:41 PM
As hackers hold Hollywood Presbyterian Medical Center’s data and demand $3.4 million Bitcoin to give it back, experts say the “hostage situation” likely signals more ransomware attacks to come.
“There is no style to this attack,” said Kevin Johnson, CEO of firm Secure Ideas. Johnson said that it was likely messaging-based, whether a malicious link in an email or perpetrated via a social network and, basically, an employee fell for it.
Such attacks are particularly alluring to cybercriminals, in fact, because they are reasonably easy to pull off and have a big impact. 
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Docs: Why the time for 'precision delivery' is now

February 17, 2016 | By Katie Dvorak
The healthcare industry must catch up with other sectors by using predictive data analytics at scale to improve clinical practice and care delivery, according to doctors at Brigham and Women's Hospital in Boston.
Providers must use patients' electronic health data to move into "precision delivery," Ravi B. Parikh, M.D., Meetali Kakad, M.D., and David W. Bates, M.D., write in a viewpoint published in the Journal of the American Medical Association.
There are already some instances where healthcare systems are starting to successfully implement analytics into practice, they write. Some examples they highlight include:
  • Lowering readmissions: At Parkland Health and Hospital System in Dallas, an algorithm created using clinical data and social and behavioral information was used to predict the probability of patients with heart failure being readmitted. By knowing which patients were most at risk, the health system was able to provide them with interventions such as education and follow-up communication on medication adherence. For those who participated in the interventions, there was a 26 percent reduction in odds of readmission, according to the viewpoint's authors.
  • Improving care for patients with serious illnesses: Analytics were used by the Veterans Health Administration to improve care quality for patients with serious illnesses. The VHA used its Corporate Data Warehouse (CDW), which stores patient data from across the department. The CDW calculated risk scores for patients that predicted hospitalization and death, and those scores help nurse care managers to guide services.
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The endless possibilities of information and technology for improving health

Mary Toppings
Feb 16, 2016
Patients are not singular problems. Health care largely takes place outside of the office visit bubble, where complex humans carve out paths through everyday life. It occurs when parents, caregivers, second shift and working professionals make decisions like food choices and tradeoffs like exercise versus family time or overtime to pad a paycheck.
By enabling new care delivery methods, technology such as video visits is nudging provider awareness closer to that patient reality and feeding a growing knowledge base for providers. Combining that new information with technologies for care collaboration produces endless possibilities for improving health. Leaders face the challenge of supporting and identifying those innovations that best suit an organization and its customers, as well as implementing them.
Dr. Bill Marsh knows how leadership fosters innovation. Now Associate Executive Director of Care Delivery IT for The Permanente Federation, in a previous role with the Colorado Permanente Medical Group Dr. Marsh co-chaired a workgroup tasked with hatching new virtual care capabilities, including mobile applications, telemedicine and telehealth.
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HIPAA and mHealth: OCR unveils new guidance on role of developers

February 16, 2016 | By Katie Dvorak
The federal government is continuing its push to help those in the healthcare industry better understand HIPAA regulations--most recently releasing guidance focusing on mHealth.
The new guidance examines six scenarios overall focusing on two questions that deal with health apps and HIPAA:
  • How does HIPAA apply to health information that a patient creates, manages or organizes through the use of a health app?
  • When might an app developer need to comply with the HIPAA Rules?
The scenarios provided address whether an app developer would be considered a HIPAA business associate (BA). However, the report's authors add that covered entities that transmit private health information also must apply safeguards.
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In study, CBT app MoodHacker matches web-based programs for depression care

February 16, 2016
A cognitive behavioral therapy-based mobile app can be effective in treating depression symptoms, but is more effective in combination with an employee assistance program, according to a new study by Orcas of their MoodHacker app.
"To date, very few randomized clinical trials of mobile apps targeting depression and emotional well-being have been published in the peer-reviewed literature," Michael Mulvihill, CEO of Orcas, said in a statement. "We're excited to be contributing to the mobile health research community. The results of the study tell us we're moving in the right direction."
Orcas, which originally stood for Oregon Center for Applied Science, was founded in 1989 as a research organization looking into ways people could use technology to improve their own health. The organization has developed a number of mobile health apps and other interventions with funding from the National Institutes of Health. It transitioned in 2013 from a government-funded research group to a commercial company, offering their clinically validated apps as B2B products for employers.
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OSU Wexner Medical Center masters change during award-winning IT effort

Published February 16 2016, 5:45am EST
Ohio State University Wexner Medical Center (OSUWMC) has plenty of experience implementing technology. After all, it’s the first two-time winner of the HIMSS Davies Award.
Managing the changes that technology brings about also requires significant commitment and effort, the organization has found. It’s also worked hard to manage the change that information technology brings to a staff.
Enabling change management is no small taks at OSUWMC, which serves all patients and populations, with the uninsured and Medicaid population comprising approximately 25 percent of the organization’s patient mix. It has six hospitals with 1,300 beds, a staff of 20,000, and more than 58,000 admissions per year, with 1.66 million outpatient visits.
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Black Book: Tech support from EHR vendors essential as many hospital clients vent frustrations

IT support is emerging as a key factor in hospital satisfaction and many trends will shape these relationships, report says.
February 16, 2016 04:35 PM
Electronic health record vendors that don't offer robust customer technical support services risk losing established clients and new customers, according to a new report from Black Book Market Research that found that one-third of hospitals surveyed are currently unhappy with their IT support.
More than 82 percent of hospitals say tech support, whether from the vendor itself or from an outsourced partnering firm, will be a leading competitive differentiator in 2016, according to Black Book.
Tech support outsourcing is expanding, the survey data shows, with 16 percent of hospital respondents outsourcing at least half of their IT support needs. By the end this year, some 35 percent of hospitals with more than 100 beds expect to increase spending on outsourced support by 100 percent.
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Hollywood hospital held to ransom by hackers

Image copyright HPMC Image caption Staff at the Hollywood Presbyterian Medical Center are using pen and paper to handle records
Ransomware is a growing menace for computer users - but when a hospital is targeted, it makes the disruption far more serious.
Computer systems at Hollywood Presbyterian Medical Center have been offline for more than a week following a ransomware attack.
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From Meaningful Use to Meaningful Outcomes

February 15, 2016
by Marc Probst, CIO and vice president, Intermountain Healthcare
The federal government recently announced that its mandate for health information technology will move in a different direction. The change represents a vital opportunity that could lead to dramatic improvements in health care delivery.
Andy Slavitt, Acting Administrator of the U.S. Centers for Medicare and Medicaid Services (CMS), made the announcement on January 11th when he said at the J.P. Morgan Annual Health Care Conference, “The Meaningful Use program as it has existed will now be effectively over and replaced with something better… the focus will move away from rewarding providers for the use of technology and towards the outcome they achieve with their patients… And finally, we are deadly serious about interoperability.”
The distinction that Andy Slavitt makes—between functionality and outcomes—is crucial to the future and extraordinary potential of health IT. So is the need for interoperability.
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ONC: Time to Get Busy with Value-based Payment Models

Scott Mace, for HealthLeaders Media , February 16, 2016

"We're in a little bit of a we-don't-know-what-we-don't-know state as an industry. And it's going to dawn on people really quickly that MACRA is a really big deal," says a co-chair of ONC's Health IT Standards Committee.

With a new year comes new leadership at ONC's Health IT Standards Committee. One of the recently appointed co-chairs of the committee is Arien Malec, vice president for the data platform solution line at RelayHealth. Last week I asked Malec what to expect from the committee in 2016. The transcript below has been lightly edited.
HealthLeaders: We had a lot of rulemaking at the end of last year, we had some spin put on the rulemaking by people like Andy Slavitt in January. So what is the industry thinking about meaningful use itself, and about stage 3 in particular?
Malec: The joking statement that I've done on Twitter is to keep calm and await MACRA-enabling regulation. Meaningful use is indelibly written in the ink of MACRA. It is indelibly written into the MIPS calculation, as 25% of the overall MIPS score.
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Jane Sarasohn-Kahn: Health economist and trend weaver

"Health is where we live, work, play and pray. It's really everybody's responsibility."
March 25, 2015 12:03 PM
Jane Sarasohn-Kahn is passionate about collecting and constructing LEGO bricks because she truly embraces the Danish phrase from which the brand derived its name: 'leg godt,' meaning 'play well.'
In a playful mix of business and art, Sarasohn-Kahn clips her favorite publications (Rolling Stone, The Economist, Financial Times, The Wall Street Journal, The New Yorker) and adds fabric to create mixed media collages.
But scrapbooking isn't just what she does, it's how this trend weaver thinks: "I see health everywhere, at the grocery store, in the car — it's just my lens on things. And then I look at the economics and at the market."
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HHS Plans to Strengthen Adult Immunization Health IT Infrastructure

February 12, 2016
by Heather Landi
The U.S. Department of Health and Human Services (HHS) plans to improve adult vaccination rates through its National Adult Immunization Plan, which includes plans to improve the health IT infrastructure behind adult immunization registries.
In a press release announcing the new National Adult Immunization Plan (NAIP), HHS officials cited Centers for Disease Control and Prevention (CDC) data that indicates 80 percent of adults ages 19 and older have not received recommended vaccinations to protect them against tetanus, diphtheria and pertussis (whooping cough) and more than 70 percent of adults ages 60 and older have not received recommended shingles vaccinations.
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Enjoy!
David.

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