Saturday, March 26, 2016

Weekly Overseas Health IT Links - 26th March, 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.

Project uses EHR data to cut heart disease risks

Published March 17 2016, 2:58pm EDT
De-identified electronic health records data is being used in a small Minnesota town to monitor the heart health of its population and to reduce risk factors for cardiovascular disease.
In 2009, Minneapolis Heart Institute Foundation, along with Allina Health, New Ulm Medical Center and the community of New Ulm, began a 10-year population health research project to learn if heart attacks and heart disease risk factors could be decreased through collaborative efforts.
Called the Heart of New Ulm Project, it focuses on reducing factors known for increasing heart attack risk, including high cholesterol, high blood pressure, uncontrolled glucose, obesity, tobacco use, physical inactivity, low fruit and vegetable intake, as well as medication underutilization and non-adherence.

HIT Think How to give physicians some relief from distracting alerts

Published March 17 2016, 3:05pm EDT
Clinical information systems now produce great quantities of data. That can be both blessing and curse.
Perhaps no one knows this better than physicians, who are looking for help in separating important information from that which is not. Systems that can’t help them with that process can impede their ability to provide effective care.
Alert notifications have been often cited as culprits in this gush of information. Intended to let physicians know when patient conditions merit their attention, the ability of systems to crank out alerts at a dizzying pace has had the opposite effect, at times.

Epic round-up: seven stories worth another read

Rebecca McBeth
17 March 2016
Articles involving US software company Epic really seem to get our readers going and have been the most read on Digital Health over the past year. We’ve decided to recap our coverage for anyone who missed it, or who wants to jog their memory.
The EpicCare electronic patient record, which is in widespread use in the US, entered the UK market when it went live at Cambridge University Hospitals NHS Foundation Trust in 2014, following a high-profile and closely fought procurement. The implementation has since been revealed to have been problematic.
Only now are some of the details about where the deployment went wrong becoming clear. Our most recent coverage includes comments from the president of the Royal College of Surgeons Clare Marx.

CIT: Ransomware will 'wreak havoc' in 2016; healthcare already 'relentlessly' targeted

March 18, 2016 | By Katie Dvorak
Ransomware in 2016 will "wreak havoc on America's critical infrastructure community," and the healthcare industry is already seeing an influx of such attacks, according to a recent Institute for Critical Infrastructure Technology report on the threat.
In addition to an increase of new ransomware attacks, older vulnerabilities that were exploited last year will allow malicious actors to "capitalize upon positions that they have previously laid claim," the authors write.
The report points to the healthcare industry, which has previously been off-limits, as one that now is "brutally" and "relentlessly" targeted. The authors say healthcare organizations may have escaped these attacks previously because shutting down systems could endanger the lives of patients, but that mentality is changing.

Google, Harvard team up for better insights into health IT

March 18, 2016 | By Susan D. Hall
A new executive education program brings Google staff to Harvard Medical School in an attempt to help them better align technology with the needs of healthcare.
It's not about learning what the liver is and how it works--you can Google that; rather, the course's fundamental premise focuses on teaching how doctors think, according to an article.
The course looks at how diagnoses are made, how data drives healthcare and how healthcare delivery can vary geographically and demographically in the hope that Google tech experts can create better tools for the industry.

University of Buffalo researchers develop necklace that tracks food intake by listening

March 17, 2016
Researchers at the University of Buffalo have developed a necklace that could help passively track nutrition by listening to the sound of the wearer chewing.
University at Buffalo computer scientist Wenyao Xu is developing the wearable, called AutoDietary, with a small microphone on the back that records the sound of people eating food. The sounds are sent to a smartphone via Bluetooth and compared against a database of chewing and swallowing sounds for different foods, including cookies, peanuts, and apples. 
“There is no shortage of wearable devices that tell us how many calories we burn, but creating a device that reliably measures caloric intake isn’t so easy,” Xu said in a statement.

HIT Think In light of pervasive security threats, why not encrypt everything?

Published March 18 2016, 4:23pm EDT
In healthcare, we all know what a breach is. Generally, it’s an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of protected health information.
We all know what protected health information is, or at least we should, by this late date. The requirement has been around since 2009: it is personal health information that is not rendered unusable, unreadable or indecipherable.
Further, information released to unauthorized persons may be rendered unusable, unreadable or indecipherable through the use of a technology or methodology specified by the Secretary in guidance, such as encryption for electronic PHI.

Parkland doctor hoping his Dallas health care software startup can ease other doctors’ headaches

Melissa Repko Email
Published: March 17, 2016 3:11 pm
A software platform for health care that began under Parkland Memorial Hospital has spun off into a Dallas-based tech startup and raised $21.6 million from venture capital firms, Dallas investors and hospital systems.
Dr. Ruben Amarasingham said he hopes his software brings joy back to the practice of medicine by eliminating some of the paperwork and giving doctors and nurses more time to build relationships with patients.
Pieces Technologies announced today that it has become a health information technology company. It raised millions in a Series A funding round to create a sales and marketing team, invest in cloud-based infrastructure and add more features to its software, said Dr. Ruben Amarasingham, its founder and CEO.
He hopes to see his company’s software used by hospitals and health care systems around the world.

Report: Fewer docs using ambulatory EHRs than last year

March 14, 2016 | By Marla Durben Hirsch
Physician use of ambulatory electronic health records has dropped in the past 12 months, according to a report from SK&A.
The new market insights report of physician office usage of EHR software, based on telephone interviews with 290,155 medical offices, found that overall office adoption and use decreased from 62.8 percent in January 2015 to 59 percent in January 2016.
Usage also dropped from 54.5 percent to 50 percent for solo practitioners, from 73 percent to 70.5 percent for groups of three to five physicians, and from 77.2 percent to 75.6 percent for groups of 26 or more physicians.

'Community' HIEs may need help to compete with 'enterprise' models

March 14, 2016 | By Marla Durben Hirsch
"Community" and "enterprise" health information exchanges (HIEs) have different priorities and goals, and while they could be complementary, currently they compete with each other, according to a new report in Milbank Quarterly.
HIEs are a major focus of data exchange and the Meaningful Use program. The researchers--from Indiana University School of Public Health and Texas A&M Health Sciences Center--wanted to determine why some health systems join community HIEs, which bring in a broad spectrum of participating providers, and why others create their own enterprise HIEs.
The authors conducted semi-structured interviews with 40 HIE leaders, policy makers and healthcare executives from 19 different organizations. They found that health systems that create enterprise HIEs of affiliated desired trading partners do so to as a "stepping stone" to leverage their own data and technology for their strategic goals, such as to participate in accountable care organizations and other payment reforms. 

EHR notification overload costs doctors an hour a workday, JAMA says

Primary care doctors are subject to twice as many notifications as specialists, researchers found, but both are facing information overload.
March 17, 2016 08:37 AM
Primary care doctors now lose more than an hour a day to sorting through approximately 77 electronic health record notifications, researchers at Baylor University found.
“Information overload is of concern because new types of notifications and ‘FYI’ (for your information) messages can be easily created in the EHR (vs in a paper-based system),” the researchers wrote in the Journal of the American Medical Association  Internal Medicine.     
Making the workload harder to endure, reading and processing these messages is uncompensated in an environment of reduced reimbursements for office-based care, according to the study.

PCAST touts telehealth, wearable sensors as key to keeping aging population connected

Report to President Obama claims remote monitoring technologies, robust Internet are essential as Americans live longer.
March 17, 2016 11:39 AM 
A new report from the President’s Council of Advisors on Science and Technology claims technologies such as telehealth and wearable sensors should be put to work to help more elderly Americans stay healthy and connected as they age.
The report by PCAST, an advisory group of scientists and engineers appointed by President Barack Obama to make policy recommendations related to technology and science, found these types of technologies can help elderly Americans face challenges tied to social connectivity, emotional health and cognitive and physical ability.
"With many Americans wishing to live in their homes and communities for as long as possible, technology such as prosthetics, wearable sensors, and other tools for daily living can make that possible," said PCAST members Christine Cassel and Ed Penhoet.

Surrey and Sussex trust to use PKB with 3,200 IBD patients

Daloni Carlisle
16 March 2016
Surrey and Sussex Healthcare NHS Trust is to offer patient-controlled electronic records to more than 3,200 people with inflammatory bowel disease.
A pilot study funded by pharmaceutical company Janssen (part of Johnson and Johnson) has already seen more than 400 patients with IBD use the Patients Know Best system.
The solution is integrated with the hospital’s Cerner Millennium electronic patient record, allowing the patient record to augment the hospital record.
Dr Azhar Ansari, project lead and consultant gastroenterologist at Surrey and Sussex Healthcare said: “By using Patients Know Best, the patient can self manage their condition far more effectively and warn us before problems occur.
“In many cases we can avoid A&E visits and that’s good news for the patient – and for our hospital.”

E-discharge: standard clinical headings required by Dec

Rebecca McBeth
14 March 2016
All NHS providers must send digital discharge summaries to GPs using standard clinical headings by December this year, the new draft NHS standard contract says.
The contract, which is out for consultation, also encourages providers to adopt structured messaging for discharge summaries, but this will not become a formal requirement until next year’s contract, NHS England head of enterprise architecture Inderjit Singh told Digital Health News.
The new General Medical Services contract will also make it a requirement for GPs to be able to receive discharges electronically from next month.

HIT Think Breach notification planning should include the consumer angle

Published March 16 2016, 4:10pm EDT
Customer-facing breach notification and response should be a part of a healthcare organization’s incident response plan, but it’s often not top-of-mind when the worst happens for a healthcare organization.
Federal and state laws often dictate specific steps healthcare organizations need to take, particularly when they are victimized by large breaches. There are many steps to be taken, including public notification and release of information to the media in the event of large breaches.
However, that doesn’t replace the need to handle notifications to people whose information may have been compromised, communicate to employees and the public about what happened, and otherwise set the tone for recovery. It's more art than science, with different factors that influence what and how you do the notification and response.

Hospital exec quits, compares $764M upgrade to Challenger disaster

A senior official was so worried a new $764 million medical records system for the municipal hospital system was launching too early that he resigned, comparing it to the disastrous space shuttle Challenger launch in 1986.
In a “resignation and thank-you” email last week, Dr. Charles Perry urged colleagues at NYC Health + Hospitals — formerly the Health and Hospitals Corp. — to sound the alarm and press for an “external review” to stop the system from going live next month.
Perry was chief medical information officer of Queens and Elmhurst Hospital Centers, the first scheduled to get the new electronic medical data system.

HIE use sees 'considerable growth,' but only in a few states

March 16, 2016 | By Katie Dvorak
Health information exchange adoption and use continues to see "considerable growth," but is driven only by a small number of states, according to a new report from NORC at the University of Chicago researchers.
Examining the State HIE Cooperative Agreement Program, NORC found that from 2011 to 2013, directed transactions increased more than threefold and patient record queries increased more than fourfold. However, the authors note that those numbers do not reflect high participation from all states, but only from a select few.
For example, in the second quarter of 2012 Indiana, Colorado and New York accounted for more than 85 percent of transactions, while in Q3 of 2013, Michigan, Colorado, Indiana, New York and Vermont accounted for more than 85 percent of the total.

Cyber threats multiply as foreign 'hacktivists' set sights on healthcare data

Jeff Rowe
Mar 15, 2016
Until recently, the idea of health data being the target of international cyber criminals would have been considered the stuff of science fiction, or at least the very distant future. 
But the future began back in 2012, writes our colleague Tom Sullivan over at HealthcareIT News, when organized criminals “found that stealing patient data enabled them to monetize that information in a number of ways. Since then attacks have grown increasingly sophisticated ever since. And attackers are launching attempts now than ever.”
He cites a study from the Ponemon Institute, which found that healthcare organizations have been hit by one hack per month during the last year. “Ponemon questioned 535 IT security professionals working at public, private and government healthcare organizations and found that the most common threat is attackers exploiting existing software vulnerabilities that are more than three months old. Newer vulnerabilities and spearphishing -- sending targets an email aiming to get them to click on an executable or other malicious code -- ranked second and third, respectively.”

NQF identifies key health IT patient safety issues

Jeff Rowe
Mar 16, 2016
While issues surrounding cybersecurity may currently be top of mind for a majority of health IT stakeholders, concerns surrounding patient safety are bound to grow as EHRs and other IT systems continue to spread across the sector.
With that concern in mind, the National Quality Forum (NQF) has issued a report that identifies and addresses what the forum considers the key issues for stakeholders to understand.  To be sure, the report, "Identification and Prioritization of Health IT Patient Safety Measures," notes that with proper design, implementation and use, healthcare organizations can reduce medical errors and improve care quality, but it also discusses the potential for new hazards.
”HIT will fulfill its potential only if the risks associated with its use are identified and a coordinated effort is developed to mitigate those risks," the report argues. "Accordingly, there is a need for measures to help identify the nature, scope, and prevalence of HIT-related safety issues and to assess how well providers, vendors, and others are preventing or mitigating HIT-related safety concerns.”

ONC Report on Health IT Details Barriers to Interoperability

HCPro Staff, March 16, 2016

Although some progress has been seen, a lack of health IT vendor transparency and cooperation have been named as barriers to interoperability in the ONC’s annual report.

A version of this article originally appeared on
The Office of the National Coordinator of Health IT has published its annual report to Congress detailing the ups and downs of health IT in 2015 and plans for 2016. The report summarizes actions taken by various government agencies to advance health IT, such as the Department of Health and Human Services’ Federal Health IT Strategic Plan, the ONC’s Interoperability Roadmap, and CMS’s EHR Incentive Programs, and touches on the pivotal role private-sector industry plays in realizing the goals outlined in the report. 

Epic, InterSystems take top spots for HIE and interoperability in new KLAS rankings

A new report based on customer scores found that the two companies outperformed other EHR-dependent and EHR-independent vendors.
March 15, 2016 10:54 AM
Epic Systems and InterSystems earned the highest performance scores in the field of health information exchange and interoperability in the latest study from independent research firm KLAS.
A primary question KLAS asked providers was, “Will your vendor be able to meet your interoperability needs in the next few years?"
KLAS ranked Epic the highest customer score (91.3 out of 100) among electronic health records-dependent vendors – and among all vendors. InterSystems was given the highest customer score (87.1) in the EHR-independent category.

How a hospital's analytics department helps clinical staff build data skills

March 15, 2016 | By Susan D. Hall
The homegrown data analytics department at Medical Center Health System (MCHS) in Odessa, Texas, aims to help clinicians drill down into data and answer the question of "why," according to an article at HealthData Management.
"Our goal is to supply them with the tools so they can answer those questions themselves," says Alan Snider, senior decision support data analyst in the department.
In setting up the department nearly three years ago, leaders at the 402-bed regional medical center combined decision support and analytics into one department because they believed implementing an electronic medical record and leaving analytics at the department level would have little effect on outcomes and wouldn't allow the organization to tie process metrics to outcomes.

The 4 big trends of the information economy

Written by Carrie Pallardy | March 14, 2016
The information economy is comprised of "a community of digital citizens living in a global network, always connected with the world's information at our fingertips," according to a "The Information Generation Transforming the Future, Today" report from EMC.
The information economy is driven by using data to identify new opportunities, innovative products, transparency, desire for a personalized experience and 24/7 availability. The four big trends of this economy include:
1. Big data. In healthcare big data is being looked at to better understand populations and drive improvements in patient care.

HIT Think New standard can ‘FHIR up’ precision medicine

Published March 15 2016, 2:29pm EDT
On February 25, President Obama at the White House celebrated the one year anniversary of his announcement of the Precision Medicine Initiative. The Initiative, first announced in the President’s State of the Union Address last year, initially invested $215 million in this research approach.
Most medical treatments are designed to treat the average patient. This broad approach fails to account for the differences in genetics, physiology, environments and lifestyles that greatly affect the effectiveness of therapies. Precision medicine works to overcome these shortcomings by conducting research into the efficacy of the available treatments in different patients using these and additional factors.
For example, Warfarin is a drug used in anticoagulation therapy for patients who need to prevent blood clots from forming (for example, patients with implanted heart valves or who recently suffered a stroke), and it showcases the value of precision medicine research.

Dashboards Make Sense of Scattered EHR Data

Scott Mace, March 15, 2016

Savvy health IT customers understand that business intelligence tools are needed to leverage electronic health records data to the fullest.

Sometimes, we are at the mercy of technology.
Some years back, I was helping a nonprofit understand its customer relationship management system, as part of its intent to migrate from one CRM to another. In my naiveté, I sought to understand the underlying data structure of the CRM, which would help us figure out where the data lived, which data we had to move, and how best to arrange it after the move.
But the nonprofit's CRM, like the average CRM, and for that matter, like the average EHR, was populated with thousands of tables. Nine thousand tables.

Can IT help better manage chronic pain?

Published March 14 2016, 7:34am EDT
New research starting at the Indiana University School of Public Health seeks to develop information technology tools to support the care of patients with chronic pain, as well as educate patients on the benefits of permitting their electronic health records data to be used for research purposes.
Researcher Christopher Harle has received a $1.1 million grant from the Agency for Healthcare Research and Quality to develop technology tools, and a $1.9 million grant from the National Institutes of Health to build software that helps patients through the process of sharing their data for research.
“It is fair to say the typical EHR doesn’t provide decision support content that fully recognizes the complexity of chronic pain and that patients often also have multiple other conditions,” Harle says.


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