Saturday, May 21, 2016

Weekly Overseas Health IT Links - 21st May, 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.

6 privacy landmines and how to avoid stepping on them

A healthcare attorney spotlights big problems and offers advice on ways to navigate around the pitfalls, from cybersecurity insurance to HIPAA, social media to patient access.
May 12, 2016 05:10 PM
While the healthcare industry grapples with data breaches and privacy and security regulations, there are common pitfalls that are easy to run into without proper planning.
Erin Whaley, a partner at the law firm Troutman Sanders, outlined what those are and shared half-a-dozen tips for avoiding them.
Here is Whaley’s advice:
1. As long as I have cybersecurity insurance I’ll be covered in the event of a breach. It’s not that simple. Whaley said that even healthcare organizations that stack policies to get to $50 million in coverage may not have enough – though she’s not espousing that everyone simply plunk down for more insurance. Providers, instead, need to deploy solid security practices. “Having good security is a prerequisite to good coverage.”

'Machine learning' a boon for insurers, but can't replace human touch in healthcare

May 12, 2016 | By Leslie Small
The concept of "machine learning" has tremendous potential to help health insurers leverage data and improve care, though one prominent insurance CEO argues that such disruptive technologies will never be able to replace the valuable role of clinicians.
At UPMC, the Pittsburgh-based integrated health system's investment in big data analytics gave it a "$1.6 billion advantage," Pamela Peele, chief analytics officer for the company's Insurance Services Division, tells Healthcare Finance.
Peele's team, she says, invented its own models that marry predictive analytics with claims and local demographic data. Then machine learning--a process in which software roots out trends that the system can act on--analyzes the data.

42% of Consumers Using Digital Health Data Say Data Goes Nowhere

42% of digital health users say the data gathered by these tools goes nowhere, according to survey of 500 people who use digital health tools. The survey reveals a “disconnect” between where consumers would like their self-collected health data to go, and how easy it is to share it. The results are now available in the HealthMine Digital Health Report: The State and Impact of Digital Health Tools.
Three quarters of consumers who use mobile/internetconnected health apps are willing to share the data they collect with their doctor/healthcare provider, but only 32% say this happens automatically. 
Given that digital health data is going nowhere, 46% of respondents say their doctor is not incorporating self-collected health data in guiding their healthcare.  Wellness programs have the potential to be a bridge—connecting data generated by a growing crop of digital health tools—to patients’ complete health record.

Integrating EHRs with vaccine registries improves accuracy of pediatric immunizations

May 10, 2016 | By Marla Durben Hirsch
The exchange of vaccination data between a city immunization registry and clinicians' electronic health records resulted in "significant" improvements in pediatric immunization coverage, according to a recent study in the journal Pediatrics.
Record fragmentation increases the risk of over- and under-immunization. The researchers, from Columbia University Medical Center and elsewhere, reviewed the immunization data between the New York City Department of Health' immunization registry and five clinics in New York-Presbyterian's Ambulatory Care network, which is integrated with the hospital's immunization registry. New York City's registry is one of the first to allow clinicians to download immunization information directly to their local EHR.

Ponemon Institute: Poor state of healthcare cybersecurity causing industry finger pointing

May 12, 2016 | By Susan D. Hall
Criminal attacks continue to be the leading cause of data breaches in healthcare, with ransomware the latest threat, according to a new privacy and security survey conducted by the Ponemon Institute.
The study estimates the cost of breaches for the healthcare industry to be $6.2 billion, with the average cost to an individual organization at $2.2 million. For business associates the cost is more than $1 million. Nearly 90 percent of responding organizations said they experienced a data breach in the past two years, and 45 percent had more than five, though many of those were small incidents.
Ransomware, malware, and denial-of-service (DOS) attacks are the top cyberthreats that healthcare organizations face, the report notes, though they're also concerned about employee negligence, mobile device insecurity and use of public cloud services.

Post-acute IT 'getting interesting' as attention turns to EHRs, analytics, interoperability

The move toward value-based care is seeing LTPACs 'organize and have a stronger voice, with implications on the acute care side.'
May 12, 2016 10:07 AM
As the ACO movement gains momentum, providers in both acute and post-acute sectors are looking for enhanced dialogue, because "they realize they aren't separate pieces of care anymore," says LaDonna Sweeten, managing director with Chicago-based Huron Healthcare's technology consulting practice.
After years of dwelling in the shadows of healthcare, the long-term and post-acute care industry may finally be ready to join its hospital colleagues in the IT spotlight.
The path is long and steep, but operators of skilled nursing, outpatient rehabilitation, assisted living, memory care, hospice and home care agencies are embracing their important new roles as providers in the dynamic post-acute care environment.

Cloud-based surveillance may predict flu outbreaks a week before CDC

Written by Shannon Barnet (Twitter | Google+)  | May 11, 2016
The ability to detect and predict influenza outbreaks is crucial to minimizing their health effects. The CDC tracks flu-like illness, but a new approach using cloud-based EHR data may cut a week off of the agency's current two-week lag, according to a study published in Scientific Reports.
Researchers combined EHR data from athenahealth with historical flu outbreak patterns and a machine-learning algorithm to estimate flu activity in near real time. The estimates created using the cloud-based EHR approach had two to three times fewer errors than older models. Additionally, the algorithm correctly estimated the timing and magnitude of the national peak week during three flu seasons.

Changing default options in EHR increases generic prescribing rates

May 11, 2016
An intervention that changed default prescribing to dispense generic medications led to significantly increased overall generic prescribing rates, according to findings published in JAMA Internal Medicine.
The 23.1%-point increase could lead to increases in medication adherence and improved clinical outcomes, Mitesh S. Patel, MD, MBA, MS, an assistant professor of medicine and health care management at the Perelman School of Medicine and The Wharton School at the University of Pennsylvania, and colleagues wrote.
"The growing adoption of the electronic health record (EHR) brings new opportunities to improve physician decision making toward higher-value care," they wrote. "Default options, or the conditions that are set into place unless an alternative is actively chosen, have been shown to influence decisions in many contexts. However, the effectiveness of different ways of implementing defaults has not been systematically examined in health care, and many people may assume that changing defaults is a one-size-fits-all intervention that will always have the same effect."

Healthcare Suffers Estimated $6.2 Billion In Data Breaches

5/12/2016 12:01 AM
Nearly 90 percent of healthcare organizations were slammed by a breach in the past two years.
The 911 call has come in loud and clear for the healthcare industry: nearly 90% of all healthcare organizations suffered at least one data breach in the past two years with an average cost of $2.2 million per hack.
Despite heightened awareness and concern among the healthcare industry over its ability to thwart cybercrime, insider mistakes, and ransomware attacks, healthcare budgets for security have either dropped or remained the same in the past year, according to the newly released Sixth Annual Benchmark Study on Privacy & Security of Healthcare Data by the Ponemon Institute. Some 10% of budgets have declined, and more than half have remained static, and most believe they don’t have the budget to properly protect data.

5 steps to avoid failure with technology implementations

Published May 12 2016, 12:12pm EDT
Whenever people talk about business transformation, they talk about people, process and technology in that order—and there’s a lot to talk about, as technology creates business opportunities that continue to redefine healthcare. From sophisticated predictive analytics models to the simpler products and consumer-driven choices that provide information, technology tools are at the heart of the healthcare revolution.
So why do so many of these transformational projects face a challenging implementation, with planning difficulties and expensive disappointments that defy the best scheduling and budget intentions? The emphasis on investing in “tech for success” may be misplaced, and failing to make the investment in people is the root cause of why so many technology-enabled healthcare transformations fail.

Datapalooza: Slavitt Admits Gov't Failed in Health IT Push

MedPage Today, May 12, 2016

With just over 8 months on the job left to go, the head of the Centers for Medicare and Medicaid Services said Tuesday he now has "an obsession with the plight of independent physicians." From MedPage Today.

With just over 8 months on the job left to go, the head of the Centers for Medicare and Medicaid Services said Tuesday he now has "an obsession with the plight of independent physicians."
Since January, acting administrator Andy Slavitt and other members of agency have been traveling around the country listening to thousands of doctors complain about their electronic health record (EHR) systems, poor payment for their time, burnout, and confusion over quality metric requirements.
And all of this without measureable improvements in care for their patients.

CERT report identifies 10 at-risk emerging technologies

Published May 11 2016, 9:10am EDT
The Computer Emergency Readiness Team Division of the Software Engineering Institute at Carnegie Mellon University has issued a new study that identifies 10 at-risk emerging technologies.
In the report, 2016 Emerging Technology Domains Risk Survey, researchers examined the security of a large swath of technology domains being developed in industry and maturing over the next five years. The team focused on identifying domains that not only affect cyber security, but finance, personal health and safety as well.

A better way to manage healthcare technology projects

Published May 11 2016, 12:47pm EDT
Starting a project team is one of the key determinates to the ultimate outcome of the project. So often, lacking any general guidance and when asked to provide resources for a year-long project, leaders tend to naturally offer up employees who may the least missed by their work unit.
This may not be good for the project. If the employee is not a self-starter because he or she may be on the wrong career path, then reassignment to a multi-million dollar, interdisciplinary project team may not inspire a personal change.
On the other hand, a less risky approach may be to reward the employee who is respected by colleagues and would definitely be missed by the work unit because she or he continually seeks out new challenges. A project assignment might be exactly what will re-energize, challenge, and enable top performing employees to grow in to the areas required to the meet the new challenges. Such growth often leads to a larger role in the organization after the project such as clinical informatics or information technology application support.

What holds healthcare back from the cloud

Published May 10 2016, 5:08pm EDT
Web designer Chris Watterston put it best when he created a sticker that went viral: “there is no cloud, it’s just someone else’s computer.”
It’s that very issue that makes the cloud both appealing and unappealing to healthcare providers. It’s appealing because it provides the scalable, usable storage for the expanded needs of today’s healthcare market, including the storage of large genomic files and digital imagery. Few providers can store this kind of data in-house – and so, they use the cloud.
But the fear of the cloud being “out there” leaves the sensation that data is vulnerable, and keeps some healthcare providers away.
Ed Cantwell, executive director, Center for Medical Interoperability says people get tripped up with who accesses the cloud, and how. “They think, if it’s in the cloud, it’s a free-for-all. But that’s not the case at all,” he says. “I’m not so sure if a hacker cares if you are in the cloud or locked in a vault. If you’re in the cloud, you’re still located somewhere physically.”

Are robots superior to surgeons?

Published May 11 2016, 1:36am EDT
Researchers have developed a robotic arm to conduct suturing during soft tissue surgery, which has the potential for improved patient safety due to a reduction in surgical errors and increased efficiency.
Suturing soft tissue can be challenging even for a skilled surgeon--the tissue can move and change shape in complex ways as stitching occurs, requiring the ability to keep sutures tightly and evenly placed. Not surprisingly, leakage along the seams is a significant problem in nearly 20 percent of colorectal surgeries and 25 to 30 percent of abdominal surgeries.
The Smart Tissue Automation Robot (STAR) features a 3D imaging system and a near-infrared sensor to spot fluorescent markers along the edges of the tissue to keep the robotic suture needle on track and consistent in its placement.

Focus on analytics results in a 400 percent return on investment

Jeff Rowe
May 10, 2016
What difference does a name make?
Well, if switching one person’s job title at a health system results in greater patient safety, lower costs and more productive use of health data across the system, then it can mean quite a bit.
At HealthcareIT News, editor Mike Miliard recently described the gains being made at the University of Mississippi Medical Center (UMMC), and, in part, the transformations that lead to those gains included changing the organizational title of John Showalter, MD, from chief medical information officer to chief health information officer.
"The chief health information officer position here is really much more focused on analytics and driving institutional return on investment from our clinical IT," Showalter explained. "When I was the CMIO, I was much more focused on adoption and usability for the clinicians.”

Calling for semantic interoperability standards that enable clinical data discovery

Penn Medicine associate vice president of health technology Brian Wells makes the case for creating standards that map rich clinical data in EHRs and other sources to large patient cohorts.
May 09, 2016 04:54 PM
There are many promising initiatives underway that seek to combine rich clinical data from electronic health record systems running in provider sites across the county into large patient cohorts and then combine that data with genetic sequences created from samples provided by each patient in the cohort.
The sponsors of these initiatives span industry, private foundations and the federal government. While the ambitious goals are commendable and the potential for discovery is worthy of the effort, there are data quality and semantic interoperability requirements that must be met prior to the combining of the clinical data. 

Andy Slavitt: Health IT must be 'a national priority'

May 10, 2016 | By Katie Dvorak
WASHINGTON--When Andy Slavitt came to the District of Columbia two years ago, it was because technology was putting health reform in the U.S. at risk. Now, he says, technology is not doing all it can when it comes to patient care, and the industry must "refocus on our customers and rise above proprietary interests to make this a national priority."
"Robots can perform your mom's surgery, but reminding her to refill a prescription? No, it can't do that," he said during a keynote speech Tuesday at Health Datapalooza. "Technology isn't doing what we know it can. It's not helping make us smarter, it's not helping us make better decisions, it's not reducing our waste of time."
However, that doesn't mean it can't do those things and more.

Patient access to medical records key to stemming inaccuracies

May 10, 2016 | By Katie Dvorak
WASHINGTON--Unlike what happens in Vegas, what happens in a patient's medical record--especially inaccuracies--can stay with them forever, Dhruv Khullar, a resident physician at Massachusetts General Hospital, said during a Tuesday session at Health Datapalooza 2016 in the District of Columbia.
The panelists, ranging from a government official to university members, gathered to discuss their experiences and views of patient data safety and data sharing.
Khullar said it's growing more difficult to trust what is in the electronic health records of patients. "When I speak with patients, I find that their electronic medical record is littered with inaccuracies," he said.

Scanning the future

How much paper is it worth scanning as part of an electronic document management project? It's a fraught question, but he answer seems to be 'less than you might think' with legacy records and 'only what you can plan for' with new ones.
In 2018, Papworth, the renowned heart and lung hospital, will move to a new site near Addenbrooke's Hospital.
The site has no space for a paper records library; which has proved a good incentive for switching from a paper-based record system to an electronic one.
The hospital implemented an electronic document records and management system from CCube. While it decided that every new referral would be handled electronically, it chose not to scan legacy records.

Digital transactions can mean big savings for physicians

May 11, 2016
Electronic transactions can save the healthcare industry around $8 billion each year, according to the 2015 CAQH Index Report, as well as save physicians precious time and money.
Reynard Washington, senior manager for research and measurement at The Council for Affordable Quality Healthcare (CAQH) told Medical Economics that of all the different entities involved in the revenue cycle of a typical episode of care, physicians stand to gain the greatest benefit from transitioning to digital transactions, because doing so will shorten the time to payment, as well as provide savings in labor costs. 
This year’s report includes an informative graph, titled “How Much Does the Healthcare Industry Spend on Claims-Related Business Transactions?” that shows the financial breakdown between processing certain transactions electronically versus digitally. The graph reveals some striking points, which support Washington’s assertion that digital processing really will save practices money. For instance, the average cost of a claims verification performed manually is $10.83, whereas electronically it is $2.51.

Telepharmacy software helps free up workflow, lets pharmacists focus on patients

Cloud-based technology lets pharmacists spend more time with clinical teams, or work on projects such as EMR implementations or quality programs.
May 10, 2016 10:45 AM
Getting pharmacists involved in patient-centric activities, including being part of clinical care teams, is a little easier thanks to telepharmacy technology.
When Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, needed to optimize its pharmacy workflow with the goal of improving patient care, it turned to PowergridRx, a cloud-based HIPAA–compliant telepharmacy platform from San Francisco-based PipelineRx.
Starting in February, Dartmouth-Hitchcock began deploying PowerGridRx in its hospitals across New England.
PowerGridRx is a software as a service platform that aggregates, manages and optimizes virtual pharmacy management for health systems. In addition, it differentiates Dartmouth-Hitchcock's telepharmacy network and manages the order verification process for current and future facilities.

Mount Sinai's Linda Rogers: mHealth poised for explosive growth

May 10, 2016 | By Judy Mottl
The Icahn School of Medicine at Mount Sinai in New York is tapping mHealth for asthma treatment, recently developing its own app. The Asthma Health App, which lets patients conduct self-monitoring of symptoms and disease triggers, and fosters positive behavioral decisions, is also helping patients adhere to treatment regimens. What's more, it's providing researchers with invaluable data aimed at helping the 25 million U.S. residents suffering from the chronic disease.
Currently, there is no cure for asthma, but Mount Sinai medical leaders believe a personal care plan can help prevent attacks and help patients live a fuller and more active lifestyle. FierceMobileHealthcare recently spoke with Linda Rogers, associate professor of pulmonary, critical care and sleep medicine at the school, to gain deeper insight on mHealth strategies and the continuing focus on new innovations.

Joe Biden: Sharing of health data 'a matter of life and death'

May 10, 2016 | By Dan Bowman
WASHINGTON--Not even the vice president of the United States is immune to poor electronic health record interoperability.
In a speech Monday at Health Datapalooza in the District of Columbia, Vice President Joe Biden shared that in the midst of his son Beau's treatment for brain cancer, the family struggled to have health records sent between providers at Walter Reed National Military Medical Center and the University of Texas MD Anderson Cancer Center. In fact, he said, because the two health systems' EHRs were not compatible with one another, the information needed to be physically transported from the Bethesda, Maryland-based hospital to Houston.
Beau Biden died last May.

Strategies for Switching or Merging EHRs

Focusing on practice work flow is key to a successful transition

by Shannon Firth
Washington Correspondent, MedPage Today

WASHINGTON – As more physician practices merge or consolidate the question of how to integrate electronic medical records becomes increasingly important.
"You've heard the three lies. The check's in the mail. I'll respect you in the morning. And this EHR merger will be seamless," said Jacqueline Fincher, MD, a primary care physician and member of the American College Physicians' Board of Regents, speaking at the ACP's annual meeting here.
When Fincher and her husband joined her father-in-law's solo physician practice McDuffie Medical Associates in Thomson, Ga., in 1988, there was no electronic medical record. Her father-in-law used 5x7 patient card files to document individual medical records. The practice graduated to 8x11 cards soon after her arrival, then to templated notes a decade later. Finally in 2006, they invested in an electronic health record from a Top 5 vendor.

FBI says not to pay ransom; data, system backups critical for health systems

May 9, 2016 | By Katie Dvorak
Jason Rolla, chief technology officer of Illinois-based Christopher Rural Health, feared that his health system would have to pay hackers who used malware to lock employees out of systems last year--but luckily that never came to be.
Rolla told Fortune that the health system had previously hired a vendor to back the information up, and his team was able to restore the office's systems without forking over the hundreds of dollars the hackers demanded.

HL7 posts new FHIR test version tuned for clinical decision support, complex queries, genomics data

Dubbed release candidate number 3, the latest incarnation of the emerging interoperability standard also brings advancements for workflow, eClaims, CCDA profiles and provider directories. 
May 06, 2016 02:20 PM
HL7 Fellow and Corepoint Health CTO Dave Shaver said HL7 will take what develoeprs discover about FHIR at the Montreal Connectathon and roll that into the next version of the emerging interoperability standard. 
The May 2016 iteration of FHIR, as in Fast Healthcare Information Resources, has arrived. Most notable among its new capabilities: support for the Clinical Quality Language for clinical decision support as well as further development of work on genomic data, workflow, eClaims, provider directories and CCDA profiles.

Cybersecurity experts conduct hacker test on medical devices

Elizabeth Jia, WUSA 12:15 AM. EST May 09, 2016
WASHINGTON (WUSA9) ---  Cybersecurity experts have found ways to hack into hospital equipment.
 A recent IT study exposed the vulnerabilities of technology used inside medical facilities. The study conducted by Independent Security Evaluators (ISE) tested the hackability of hospital software and medical devices keeping patients alive.
One of the 12 hospitals in the study was located in the Washington Metropolitan area.  Although the healthcare facilities volunteered for the study, the authors of the ISE research report kept the hospital names anonymous.

Report: System incompatibility a health care problem

Published 12:00 am, Sunday, May 8, 2016
Health care organizations’ information technologies and workflows often don’t support each other, according to a patient care-focused nonprofit that flagged the problem as one of the top safety issues facing the industry.
The ECRI Institute, which recently released its third annual ranking of the Top 10 Patient Safety Concerns for Healthcare Organizations, reported that patient identification errors and inadequate management of behavioral health issues in non-behavioral health settings were its No. 2 and No. 3 issues for health care organizations.
When a health IT system is introduced, health care organizations should tailor it to their workflow, and vice versa, according to ECRI, which is based in Pennsylvania. But often, “after the implementation, people continue to do things the same way and really don’t adjust the health IT system or their workflow,” Robert Giannini, patient safety analyst at ECRI, said in a statement.

HSE board gives its approval to €900m e-health plan

Sarah McCabe

Published 08/05/2016 | 02:30
The Health Service Executive has approved the business case for a €900m e-health plan designed to digitalise Ireland's health system.
The intention is to provide digital health records for all Irish patients by the middle of 2019. The first site that will go live with electronic health records will be the National Children's Hospital.
Multi-million state contracts will probably be awarded to private companies to deliver the plan.



Anonymous said...

Re the hacker tests on medical devices. My partner was recently in hospital for a small operation and had to have an ECG as part of the pre-op proceedings. When done, the nurse said that it had been sent to the cardiology guys, offsite somewhere else, for them to review before the op. And this with the machine only plugged into the power. The security professional in me had loads of questions immediately of course about how, where, the protections in place and so on given the amount of personal data she had to punch into the thing before she could take the ECG. She was a student nurse, there for a month, & I'm sure that device security is low down the totem pole when it comes to their training.

Anonymous said...

"HSE board gives its approval to €900m e-health plan
Multi-million state contracts will probably be awarded to private companies to deliver the plan."

Oh-no... Has not Ireland suffered enough? Here comes the invasion of lobbyists on the behalf of some rent seekers and other assorted opportunists...