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, February 06, 2016
Weekly Overseas Health IT Links - 6th 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.
Note: A very sad week with the closure of the iHealthBeat.org website. An invaluable resource for a very long time!
There’s no shortage of memory media at healthcare organizations; maintaining control of their whereabouts is a significant challenge for IT staff.
Even hard drives, which are wired into computing devices, can be hard to track when they’re removed. Centene, a health insurer offering coverage through the Medicaid, Medicare and health insurance exchange markets, recently announced that it could not account for six hard drives after it conducted an inventory of its information technology assets. Those hard drives contained personal health information or other data from about 950,000 individuals.
The company will offer protective services and is reviewing its IT asset management procedures. However, it isn’t alone in the struggle to track IT assets, says Tom Walsh, president and CEO at tw-Security, a healthcare consultancy. “It’s almost impossible to have true accountability of media in an organization,” he notes.
TouchCare, a Durham, N.C.-based telehealth company founded in 2013, is striving to make telehealth more intimate.
“Most third-party telehealth services assign patients to random doctors they don’t know,” says Dov Cohn, TouchCare’s senior vice president of products. “We focus on connecting patients with their own doctors and healthcare providers. Our approach builds on existing relationships, trust and access to previous health records. Those things are all shown to improve health outcomes.”
TouchCare offers more than just connectivity to patients; it helps doctors connect with each other, too. Providers to conduct HIPAA-compliant video consults with each other, talking face-to-face privately or sitting alongside a patient to present the case to a specialist anywhere in the world.
The debate about creating a national patient identifier is a contentious one--some think it can help protect privacy, others think it won't bring any added benefits to healthcare.
A national patient ID could help alleviate worries patients have about the security of their health information, Douglas Fridsma, M.D., Ph.D., president and CEO of the American Medical Informatics Association, tellsSTAT.
He adds that the conversation has been too focused on how it will help the American health system, and not Americans themselves.
Building a new all-digital hospital in Los Angeles county required creating a vision, selecting technologies that supported that vision and staying laser-focused on the goal, according to an article at Healthcare Dive.
The 131-bed Martin Luther King, Jr. Community Hospital opened last July to serve a population of 1.3 million residents in the area, many of whom were low-income and lacked insurance. Of the $158 million budget provided to build the hospital, nearly half--$70 million--was devoted to IT.
The facility boasts smart beds that track patients' movements, a patient interactive system and phones that allow doctors and nurses to communicate and share patient information on a secure internal network even outside the hospital, according to the article.
Avoidable medical errors -- so-called preventable adverse events, or PAEs -- contribute to the deaths of approximately 400,000 Americans each year. That makes PAEs the third leading cause of fatalities in the United States, behind heart disease and cancer. They are responsible for four times as many deaths as the number of people who perish from gun violence, breast cancer and automobile accidents combined.
We think that personal electronic health records, sometimes called PHRs, are an underutilized antidote to this problem; and that a perceived barrier to their adoption is a disproportional fear -- actively and cynically promoted in some circles -- that patients are at great risk of losing their privacy if their records are electronic, interoperable, accessible and shared.
Unfortunately, the discussion about poorly digitized medical practices and their contribution to the demise of nearly half a million lives annually is confined within the walls of hospitals, research institutions and the merchants of electronic medical records. And the first defense of inaction raised is almost always the well-flogged piñata of lost privacy.
The potential of digitization is well understood, yet healthcare systems are struggling to convert ambition into reality. Here’s what we recommend.
January 2016| byGerardo Aue, Stefan Biesdorf, and Nicolaus Henke
Health systems around the world clearly recognize the potential of digital health: over the past decade, they have invested heavily in national e-health programs. Yet most have delivered only modest returns when measured by higher care quality, greater efficiency, or better patient outcomes. And in some cases, e-health projects have been cancelled due to significant cost overruns and delays, such as the National Program for IT in the United Kingdom’s National Health Service (NHS).1 That’s because such ambitious information-technology initiatives—with a clear focus on IT support for clinical professionals—are typically beyond the core mission of healthcare systems, which also often struggle with legacy systems that impede data integration.
At the same time, the advent of smartphones, cloud computing, and global connectivity has created a universe of consumers accustomed to everything from checking bank balances, making purchases, and watching movies on mobile devices. Increasingly, those consumers wonder why health systems cannot provide similar service innovations. In that respect, digital-health companies would appear to be best positioned: innovation is in their DNA, they have attracted billions of dollars in venture capital, and they have the flexibility to design applications that cater directly to patient groups. Yet digital-health companies have been impeded by a lack of access to health data along with uncertainty about how to distribute the economic benefits generated by smartphone apps.
Vendor research firm KLAS Enterprises is out with its annual Best in KLAS awards for health information technology software vendors and service firms. Epic Systems is the top overall vendor for the 6th consecutive year and Impact Advisors is the No.1 IT services firm for the fourth straight year.
KLAS rankings, measuring satisfaction rates, are based on thousands of interviews with hospitals and physician practices during the past year. Health information exchange vendor Medicity scored 20 points higher than it did a year ago, making it the most improved vendor. Vendors with multiple top honors include Epic, Impact Advisors, Merge Healthcare, Athenahealth, CareTech Solutions, CureMD and Galen Healthcare. Here are the Best of KLAS winners:
Mount Pleasant Texas-based Titus Regional Medical Center (TRMC) is the latest victim of a cyberattack of its electronic health record system, with ransomware making it inaccessible, according to an article in The Daily Tribune.
The ransomware virus has encrypted files on several of TRMC's data base services, blocking TRMC's ability to enter or retrieve patient data in EHR. TRMC has implemented a conditional Hospital Incident Command System, and brought in a forensic specialist to deal with the problem. However, there was no indication if or when the virus neutralized. It also was not revealed how much money was demanded in ransom in order to unlock the cyberthief's encryption.
The push for healthcare providers to adopt electronic health records (EHRs) has been fueled by promises of improved efficiency and usability, greater accessibility to health information, and in some cases, better patient care.
But the implementation of EHRs has produced mixed results. Despite repeated warnings from government watchdog agencies, vulnerabilities within EHR systems continue to provide a conduit to improper billing and sometimes shockingly brazen fraud schemes.
This is not a new issue. For years, researchers and experts have been pointing to vulnerabilities with EHRs that could contribute to upcoding or facilitate outright fraud. A 2012 report by the Center for Public Integrity found that the rapid implementation of EHRs led to aggressive billing by providers. That same year, a New York Timesarticle revealed similar concerns about a rise in Medicare payments from providers that adopted EHRs.
The percentage of office-based physicians implementing certified electronic health records climbed to 74.1 percent in 2014, up from 67.5 percent in 2013, according to a new data brief published this week by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).
The data brief, based on the National Electronic Health Records Survey, found that EHR adoption varied widely by state, with 58.8 percent of physicians in Alaska using the systems, but 88.6 percent of those in Minnesota doing so, exceeding the national average. Other states where adoption was greater than the national average included Iowa, North Carolina, Oregon, Vermont and South Dakota.
Primary care physicians were more likely to use the EHRs (72.1 percent in 2013 and 78.6 percent in 2014) compared to specialists, with adoption rates of 63.1 percent in 2013 and 70.3 percent in 2014, respectively.
As cyber attacks increasingly buffet the healthcare industry, two prominent organizations are coming together to facilitate the sharing of threat data.
The National Health Information Sharing and Analysis Center has aligned with the Electronic Healthcare Network Accreditation Commission, which certifies healthcare vendors and business associates for meeting best business practices, will harmonize efforts to reduce the growing threat of HIPAA breaches, incidents and cybersecurity attacks.
The agreement was formalized through a memorandum of understanding, says Denise Anderson, president of NH-ISAC. The collaboration is significant, because there’s growing need for healthcare organizations to share threat level data; this information has been ineffectively shared in the past because of competitive pressures and the disjointed nature of the industry. As cyber attacks rise against healthcare organization, it will become increasingly important for threat information to be shared quickly and widely.
Cyberattacks around the world are growing in size and complexity, according to Arbor Networks 11th Annual Worldwide Infrastructure Security Report, released January 26 by Arbor Networks, the security division of NETSCOUT.
For the first time, nearly half of the respondents were from enterprise, government and educational organizations, with service providers at 52 percent. Healthcare is one of the verticals included in the enterprise category.
The survey garnered 354 responses, up from 287 received last year, from a mix of Tier 1 and Tier 2/3 service providers, hosting, mobile, enterprise and other types of network operators from around the world.
Electronic data interchange and in-house transcription are just two of the five emerging health IT applications that will surge in 2016, according to a new report by HIMSS Analytics.
Simply put, there's "tons and tons of activity" forecast for the year ahead as hospitals look to install or upgrade technologies, said Matt Schuchardt, HIMSS Analytics' director of market intelligence solutions sales.
The report examines the tech that will be shaping hospitals' buying plans in 2016, with these five technologies poised for growth of 200 percent or more compared with 2015.
Clinical data warehousing/mining (500 percent more hospitals with plans this year than last year). The huge increase indicates that a critical mass of providers are now moving to the next phase of IT maturity, understanding that electronic medical records are just the basic building blocks for care improvement.
"EMR systems are, at a very base level, sophisticated billing systems," said Schuchardt. "They capture a lot more data and allow you to bill more effectively. But they're just the very beginning of what the big data revolution is going to do to health. Hospitals are starting to realize that: The EMR is not the end of the transformation but the very, very beginning."
Joining up healthcare services and integrating with social care is now a major focus for national policy; but the IT architecture and the systems needed to do it are still being developed.
Fiona Barr hears about the growing sophistication of information and record sharing models, and about some of the different systems that are being put through their paces by vanguards and pioneers.
The desire to deliver integrated care has been around for a long time. In 2016, however, the pace of change is accelerating as it becomes a focus for national policy.
And while integrated care is far more than an IT system, record sharing capability is an essential component. Choosing the right model may not be easy, however, when it can sometimes feel as if everybody claims to have the answer – and all the answers are subtly different.
Galvanized in large in part by the Affordable Care act and payment reform from fee for service to value based payment, provider organizations are reacting and preparing for seismic change. Everyone agrees these changes must happen in order to ‘bend the cost curve’ and provide better outcomes for the cost of care being delivered.
The hope, of course, is that the churn of patients entering and exiting the system will no longer be profitable to provider organizations. Instead, they will be incentivized to provide the quality care patients demand.
As healthcare costs continue to rise, patients’ wallets are being hit with high deductible insurance plans and rising out of pocket costs. What’s emerging is an active healthcare consumer actively assessing the value and cost of medical care. Quality care will be just one facet that determines value for patients in the value-based era.
Prospects for nationwide interoperability got a big boost last week when five leading health IT organizations announced they will implement the interoperability framework launched in December by the health health information network collaborative known as Carequality.
Under the framework – which consists of legal terms, policy requirements, technical specifications, and governance processes – the new partners have agreed to provide health information exchange services for their customers. The five companies include athenahealth®, eClinicalWorks, Epic, NextGen Healthcare and Surescripts.
"The adoption of the Carequality Framework represents a major leap forward for nationwide interoperability," explained Dave Cassel, director of Carequality, in a statement at the time of the announcement. "By these organizations committing to unified Rules of the Road, they are simplifying system-to-system connections to make data exchange easier for a significant portion of the healthcare ecosystem.”
A national patient ID could improve privacy and security, but if a person is linked to the wrong records, the outcomes could be very serious, Marc Probst, CIO of Intermountain Healthcare, said in an interview at HealthcareInfoSecurity.
The issue led to a congressional ban of creating a national patient ID, said Probst, a member of the Office of the National Coordinator for Health IT's HIT Policy Committee and CHIME board chair. However, the sentiment in changing, he added.
The United States Defense Advanced Research Projects Agency, or DARPA, last week announced a new program that aims to build a connection between the human brain and the digital world.
To achieve the goals of the Neural Engineering System Design program, DARPA has invited proposals to design, build, demonstrate and validate a human-computer interface that can record from more than 1 million neurons and stimulate more than 100 thousand neurons in the brain in real time.
The interface must perform continuous, simultaneous full-duplex interaction with at least 1,000 neurons -- initially in regions of the human auditory, visual, and somatosensory cortex.
Adoption of electronic health records since 2009 has been rapid and pervasive in the healthcare industry. Using meaningful use as a barometer, 95 percent of all eligible hospitals and 54 percent of office-based physicians have installed the systems to an extent enough to qualify for incentive funding under the federal EHR Incentive Program.
But there’s mixed opinion on whether those systems have delivered real value. Much depends on the measuring stick that researchers hold against EHRs.
For example, the ability to derive value from the systems has been limited by ease of use issues, contends the American Medical Association. The national professional association for physicians is becoming more vocal in its message that the very incentives intended to drive widespread adoption of EHRs have exacerbated and, in some instances, directly caused usability issues.
Britain's National Health Service has announced pilot projects in seven locations to test how technology can help monitor people with long-term conditions, according to an article in The Telegraph.
Introducing the trials, NHS England Chief Executive Simon Stevens said: "Over the next decade, major health gains won't just come from a few 'miracle cures,' but also from combining diverse breakthroughs in fields such as biosensors, medtech and drug discovery, mobile communications, and AI computing.
"Our new program aims to cut through the hype and test the practical benefits for patients when we bring together some of these most promising technologies."
HIMSS and the Personal Connected Health Alliance are urging the Agency for Healthcare Research and Quality (AHRQ) to consider conducting additional studies that provide more data on the benefits of telehealth and remote patient monitoring.
In a letter, the two organizations provide comments to an AHRQ technical brief on telemedicine issued in December. That effort, based on 44 systematic reviews and interviews with key stakeholders, determined telehealth interventions produced "positive results," primarily through improved communication, but called for more research on its effectiveness in chronic disease management.
Sens. Bill Nelson (D-Fla.) and John Thune (R-S.D.), in December 2014, had asked AHRQ to review the value of telehealth and remote patient monitoring, particularly for the chronically ill.
Scott Mace, for HealthLeaders Media , January 26, 2016
It is no surprise that a growing number of healthcare institutions are seeking partnerships to fund and nourish innovative startups. Massachusetts and New York are at the forefront of fostering such relationships.
Earlier this month, I attended CES 2016 (formerly known as the Consumer Electronics Show) in Las Vegas, walking aisle upon aisle of digital health technology offerings. I do this every couple of years to take the pulse of a consumer phenomenon that continues to attract millions in venture capital funding: mobile health and wellness trackers, sensors, monitors, appliances, and personal medical devices.
I'm mindful that every time I attend, there will be plenty of new startups, but scant clinical evidence to support the worthiness of their efforts, and often not a trace of the promising startups that made the trek to Vegas just two years prior.
There’s a debate raging in healthcare about whether patients should have control over their own health data. It’s the kind of transformational discussion upon which the future of medicine depends.
Proponents argue that patients must be empowered with information if they are ever to manage their own health and if the industry is to truly realize the Triple Aim of improving patient experience, improving population health and reducing the per capita cost of care.
However, patient-controlled data remains an elusive goal—at least in the current healthcare environment dictated by the information hegemony of providers. As pressures grow on healthcare organizations to optimize care, CIOs and other HIT executives will be involved in data ownership debates within organizations, and then face the challenge of executing each organization’s strategy.
As cyberthreats grow, the best way for providers to ensure their systems are as secure as possible is to implement multiple layers of protection.
In addition, according to an article in Health Data Management, those layers of tools must also be backed by systems that can detect hackers before they break into the system.
It's not just enough to have firewalls; providers should also have intrusion detection and prevention inside those firewalls, especially for specific servers, David Reis, vice president of IT governance and security at Lahey Health, Burlington, Massachusetts, tells HDM.
The next four years will bring a seismic shift in connected healthcare technology, with an increased emphasis on chronic condition management, personal fitness and wellness and remote patient monitoring, according to a new report.
What's more, the market is projected to hit $117 billion by 2020 and 86 percent of clinicians believe mobile apps will be central to patient health in that time frame, according to the newly released "State of the App Economy," report from ACT | The App Association.
"Over the next few years, there will be a transition to much more focused products in this space," ACT Executive Director Morgan Reed tells FierceMobileHealthcare in an interview.
A research trial evaluating mobile healthcare technology versus traditional disease management reveals "little evidence" digital medicine intervention reduces healthcare costs or drives greater consumer healthcare interest, though some improvement in health self-management was reported.
The six-month Scripps Translational Science Institute trial provided 160 participants managing hypertension, diabetes and/or cardiac arrhythmia with iPhone-enabled biosensors, blood pressure monitors, blood glucose meters or a mobile ECG device. Participants were provided data aggregation and visualization tools to track and view data via an online dashboard accessible to caregivers. The goal was to ascertain if mHealth utilization impacted healthcare insurance claims.
"Overall we found little in terms of differences in health insurance claims between individuals enrolled in the control and monitoring arm," the Scripps researchers said, noting that they expected a moderate impact--approximately a doubling of insurance claims dollars. "This suggests that while there may be small, short-term increases in healthcare utilization as a result of mobile health monitoring, there is likely not a major effect. "
While rural providers have adopted health IT at the same time or at greater rates as their urban counterparts, meaningful use varies dramatically among them, according to a recent HealthAffairs study.
About 97.2 percent of rural hospitals with fewer than 100 beds initially achieved meaningful use; a rate consistent with larger hospitals with more than 400 beds, at about 97.4 percent. Critical access hospitals had slightly lower meaningful use achievement rates at about 92 percent.
However, many rural providers failed to continue achieving meaningful use after the initial year, which leads to a greater financial disadvantage.
Some big names, including Donald Trump and Ashley Madison, fell victim to cybercrime in 2015, along with hundreds of millions of individuals and organizations. A single attack on insurer Anthem left almost 80 million customers and employees exposed. An attack on The United States Office of Personnel Management resulted in 18 million U.S. citizens' records and 5.6 million sets of fingerprints being stolen.
"Given the ongoing, evolutionary nature of cyber attacks, coupled with the relatively low share of total IT spend security accounts for, we believe industry growth rates will remain stronger than industry forecasts," said the investment bank Columbia Threadneedle Investments. Those rates are 10%-to-15% over the next three to five years, according Columbia Threadneedle, or 8%-to-10%, according to industry analysts at Gartner.
In a $75 billion market, growth rates such as these create immense opportunities for innovative cybersecurity companies, as well as potentially outsized investment returns for those capitalizing on market demand.
by Bonnie Darves, iHealthBeat Contributing Reporter Monday, January 25, 2016
Many in the health IT sector and the health professional community view electronic health records as both a blessing and a curse. EHRs have significantly improved documentation and dissemination of patients' clinical information, streamlined certain tasks and improved safety in areas such as medication management. But EHRs also have made some aspects of health care providers' workload more time consuming than in the "paper" days and sometimes compromise patient safety.
EHRs' negative effect on workflow is a chief reason why clinical users are tempted to devise and use workarounds to simplify or expedite task completion.
Those workarounds, depending on the system and the user, might be harmless in some cases but potentially dangerous in others.