Saturday, July 23, 2016

Weekly Overseas Health IT Links – 23rd July, 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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Healthcare industry is among the top users of encryption

Published July 14 2016, 3:06pm EDT
The biggest users of data encryption for security are companies in the healthcare and pharmaceuticals, financial services, and technology and software industries, according to a new report by the Ponemon Institute.
The study, sponsored by security company Thales, is part of an annual survey of more than 5,000 individuals covering 14 industry sectors and 11 countries. It focuses on how encryption is being used in conjunction with business applications in order to protect data.
Companies reporting extensive use of encryption rose 7 percentage points from the previous year to a total of 41 percent, the largest increase in the 11-year history of the report. Databases, Internet communications and laptop hard drives consistently top the list of areas where encryption is most frequently used.
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Privacy, security concerns continue to cloud mHealth’s future

Published July 15 2016, 6:48am EDT
Mobile health apps are emerging as disruptive technologies with the potential to shake up the healthcare industry with both benefits and risks for consumers. But mHealth privacy and security safeguards must be addressed immediately.
That’s the consensus of lawmakers and witnesses who appeared at a July 13 hearing of the House Subcommittee on Commerce, Manufacturing, and Trade.
With about 165,000 mHealth apps currently available on the market, the data generated by these apps shows promise in changing patient behaviors, which could improve outcomes.
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Editor's Corner: EHR copy, paste could land you in hot water

Jul 13, 2016 8:50am
We knew this day would come. Those handy electronic health record cut, copy and paste features can cause a provider to be in violation the False Claims Act.  
Louisville, Kentucky-based home healthcare provider MD2U Holding Company and its related entities have agreed to pay $3.3 million plus a percentage of net income to settle allegations that they violated the False Claims Act by taking advantage of the cut, copy and paste function of its EHRs to submit false Medicare bills to the government. Evidently MD2U cut, copied and pasted notes from visits that occurred weeks, months and even years before the current encounter, creating the illusion that clinicians were performing a “significant” amount of work when they really weren’t.
This manipulation was part of the company’s overall scheme to obtain more money than to which it was entitled, including upcoding and billing for medically unnecessary services.
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GAO: Full interoperability of VA, DoD health record systems 'years away'

Jul 14, 2016 11:43am
The Department of Veterans Affairs' approach to addressing its electronic health record needs is “uncertain” and full interoperability with the Department of Defense is “years away,” according to a new Government Accountability Office (GAO) report.
In testimony before a Senate subcommittee this week, Valerie Melvin, the GAO’s director of information management and technology resources issues, said concerns have been raised about the VA’s efforts regarding its EHR system, VistA. Those include questions about its interoperability goals and measures as well as issues with unnecessary duplication of the Department of Defense’s EHR modernization efforts. The two agencies abandoned their efforts to create a combined EHR system in 2013.
Melvin noted that since the GAO last released a report on its concerns, the VA has developed some plans to modernize the system, including standardizing systems to improve interoperability and creation of a roadmap to be deployed through fiscal year 2018. However, long delays have caused VistA to become outdated, and the modernization program is running into risks and technical issues, she said.

How ‘digitizing you and me’ could revolutionize medicine. At least in theory

Dr. Eric Topol is a big believer in the power of precision medicine.
July 15, 2016
There’s a whole lot of hype around precision medicine.
Proponents — up to and including President Barack Obama — predict a revolution that will bring us medical treatments as precisely tailored as a bespoke suit: Drug doses adjusted to your genome. Chemotherapy customized to your tumor’s DNA. Diets adapted perfectly to your risk for diabetes.
To propel research, Obama has proposed spending a $215 million on a Precision Medicine Initiative. The first step: Rally 1 million volunteers (or even more) to give up a slew of intimate details about their health, medical history, diet, lifestyle, genetics — and even the granular details of the bacteria that line their guts.
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FDA touts 3D printing in personalized medicine

By Christine Ayala - 07/14/16 04:22 PM EDT
The FDA touted the potential of 3D-printed medical devices and drugs Thursday, releasing regulatory science research on devices already cleared and approved by the agency. The FDA issued draft guidance on 3D-printed devices in May, which is currently open for comment until Aug. 8.
James Coburn, the principal investigator for the FDA’s Center for Devices and Radiological Health, highlighted the potential for advancements in personalized medicine through 3D printing, also called additive manufacturing.
“With patient-specific devices, there are a lot of areas where people have been thinking about doing this, but it’s been cost prohibitive or technologically prohibitive, and 3D printing has opened up a lot of those doors,” Coburn said.
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National Programme for IT ends, but not for everyone

Ben Heather
11 July 2016
The National Programme for IT has finally come to an end, although the bill for the enormously expensive and controversial project will continue to be paid for years to come.
The deadline to exit NPfIT national contracts in the North, Midlands and East passed on 7 July, marking the end of the final chapter of the £12.7 billion attempt to bring the NHS into the digital age.
Trusts in these regions should have now signed new local contracts but most have opted to simply stick with those services that were deployed under the national contracts with United States-based company CSC.
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Lorenzo: the end of the beginning

The National Programme for IT in the NHS came to an end in the North, Midlands and East last week. Its flagship electronic patient record was Lorenzo. After ten years trying, and millions of pounds of investment, how are recent deployments going, and what legacy will it leave? Ben Heather reports.
Peruse the board papers of Norfolk and Suffolk NHS Foundation Trust and it soon becomes clear that it’s been a rough year on the IT front.
The trust deployed CSC’s Lorenzo as its electronic patient record on 20 May last year. It was hoped the new system would turbocharge Norfolk and Suffolk into the digital age, replacing paper and ageing, clunky software with a slick, adaptive platform. It hasn’t quite worked out that way, at least not yet.
In October last year, the Care Quality Commission warned the trust it needed to get Lorenzo in order, but as recently as June the trust’s board was still being told “performance issues” with the EPR were an “outstanding risk”.
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Jeremy Hunt retains post as health secretary

Lyn Whitfield
14 July 2016
Jeremy Hunt has retained his post as health secretary in the re-shuffle triggered by Theresa May’s appointment as Prime Minister, following the Brexit vote and David Cameron’s departure.
The news is likely to disappoint medics who took to Twitter to celebrate Hunt's departure from Richmond House following false reports that he had been sacked on Thursday morning. 
Staff took to the social media platform to claim there had been cheering in their hospitals when the news filtered through, and to post jokes about how he would now be able to enjoy his weekends.
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How telehealth is shaping the future of healthcare

Jul 14, 2016 11:35am
Telehealth has the potential to greatly expand the reach of medicine, not only in remote areas around the globe, but also for various socio-economic groups, according to an article in The New England Journal of Medicine.
Technology has the potential to disrupt established patterns of care and address ongoing concerns about the distribution of providers, according to the authors, E. Ray Dorsey, M.D., of the University of Rochester Medical Center, and Eric Topol, M.D., with the Scripps Research Institute.
They point to three trends shaping telehealth: a shift in focus from increasing access to convenience and lower costs; expansion beyond addressing acute conditions such as stroke to wider uses including chronic care management; and the movement away from hospitals and clinics to patient homes and mobile devices.
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Electronic hand-hygiene monitoring cuts MRSA rates by nearly half

Jul 14, 2016 11:17am
Electronic monitoring of healthcare workers’ hand-washing habits cuts Methicillin-resistant Staphylococcus aureus (MRSA) infection rates by 42 percent, according to a study published in the American Journal of Infection Control.
Researchers at Greenville (South Carolina) Health System analyzed hand- hygiene compliance data from an electronic monitoring system in 23 inpatient units between July 2012 and March 2015. They found that under the system, in addition to a 42 percent drop in MRSA infection rates, compliance rates increased by 25.5 percent. Furthermore, the organization saved approximately $434,000 in "avoided care" costs that it would have provided to patients who contracted a hospital-acquired infection because clinicians failed to wash their hands. 
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Google Cardboard saved their baby's life

By Elizabeth Cohen, Senior Medical Correspondent
Updated 1528 GMT (2328 HKT) July 13, 2016
(CNN)In the past six months, Cassidy and Chad Lexcen have been too busy to look at the Google Cardboard images that saved their baby's life.
During that time they had to tend to their daughter, Teegan, who teetered on the brink of life and death at Nicklaus Children's Hospital in Miami, plus they had to fly back and forth to care for their other three children in Chaska, Minnesota.
But CNN recently brought the images of Teegan's heart to the Lexcens, and seeing them for the first time brought on deep emotions -- both happy and sad.
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Why 55% of health IT professionals are constantly stressed: 7 survey findings

Written by Akanksha Jayanthi (Twitter | Google+)  | July 13, 2016
More than half of health IT professionals report being frequently or constantly stressed, and it is taking a toll on their physical and mental wellbeing, finds a new survey from HealthITJobs.com.
The survey gathered responses from nearly 500 health IT professionals in April 2016. Here are seven key findings from the survey.
1. Fifty-five percent of health IT professionals reported being frequently or constantly stressed, 38 percent said their stress is high or extremely high, and 45 percent said their stress occurs on a frequent or constant basis.
2. Key factors correlating with higher frequency of stress include working in management roles, spending more than 11 hours in meetings each week, working more than 51 hours each week, having little control over deadlines, being given an unrealistic amount of work to complete in a certain time and exercising no more than one day per week.
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Mobile Devices Speed and Streamline Pre-hospital Care

Tinker Ready, July 14, 2016

Mobile devices allow telemedicine providers to virtually assess patients, and have the potential to improve stroke care and reduce emergency department traffic.

Smartphones and tablets often come with the promise that advanced technology and more powerful cellular networks will lead to better connections and faster streaming video.
But those promise could mean a lot more in a medical emergency.
Clearer pictures and reliable connectivity are making telemedicine more mobile and more reliable. The result: better tools for pre-hospital providers and the emergency department teams they work with.
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How the NHS got it so wrong with care.data 

Sarah Knapton
7 July 2016 • 12:29pm
In early 2014 the health press were invited for a briefing on the NHS’s new project 'care.data' - a vast database which would include the records of everyone in Britain.
It was a public relations masterpiece. NHS England wheeled out the great and the good of academia as well as the medical directors some of Britain’s biggest charities such as Cancer Research UK and the British Heart Foundation to back the scheme.
The UK’s leading doctors told us how access to so many NHS records would help them understand the causes of disease, quickly spot the side-effects of new drugs and detect outbreaks of infectious diseases.
They showed us a slick advert in which cancer survivor Richard Stephens described how his life had been saved because of big data, and called on Britain to ‘do their bit’ in allowing their medical notes to be shared.
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FBI sees rising cyber threats to healthcare

Published July 13 2016, 7:11am EDT
The Federal Bureau of Investigation sees increasing pressure from hackers trying to access patient information from providers.
Recent events suggest that the pressure may be rising, as offers to sell patient records with protected health information on the “Dark Web” market represent a new level of threat for healthcare organizations trying to protect health information.
In late June, a hacker known as “The Dark Overlord” reported the theft of nearly 10 million patient medical records from providers and a major insurer and put them on the Dark Web market where hackers conduct buy and sell data taken from a variety of sources. As of this writing, the records have not been sold, and the seller may be having trouble selling the treasure trove of protected health information.
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Appropriations says HHS can 'examine' national patient ID

Jul 13, 2016 10:06am
The College of Healthcare Information Management Executives (CHIME) “applauds” the House Appropriations Committee for acknowledging issues surrounding the lack of a unique patient health identifier.
In its Labor, Health and Human Services and Education appropriations report, the committee says it is “aware” that without a national patient data matching strategy, barriers to health information exchange persist. While it will continue to prohibit the use of funds by HHS to adopt any standards for a patient ID, the “limitation does not prohibit HHS from examining the issues around patient matching.”
Unique patient identifiers were required by the 1996 Health Insurance Portability and Accountability Act (HIPAA), but in 2000 Congress prohibited not only the identifier but also any testing of one.
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ONC certifies first open API for Stage 3 meaningful use interoperability requirements

Carefluence OpenAPI proved to be compliant with Office of the National Coordinator criteria by using the FHIR standard. The application programming interface also can used with EHRs for open access.
July 13, 2016 10:40 AM
The Office of the National Coordinator has awarded its first Stage 3 meaningful use certification for interoperability requirements using the FHIR (Fast Healthcare Interoperability Resources) standard to Carefluence, for its open application programming interface platform, the company announced on July 12.
Carefluence OpenAPI is a plug-and-play software platform compliant with the FHIR standard, which provides insights on datasets to support health information exchange across disparate EHR systems. As a result, any EHR vendor will be able to license Carefluence OpenAPI and offer it to customers, with the knowledge it’s compliant with meaningful use.
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Special report: e-observation and vital signs systems

Charting a new future
E-observations are now well established at many trusts; and the quest is on to extend them to new areas. Daloni Carlisle reports.
The image of the nurse with her hand on the patient’s wrist, her eye on the watch dangling from her top pocket, and her other hand reaching for a pen to make a note on a bedside chart is history.
Today’s nurse will be wheeling a small trolley full of the machines that she will need to make observations and frequently will be using a tablet or smartphone to record them. Welcome to the brave new world of e-observations.
Achieving scale
There are now a number of hospitals that have rolled out e-observations at scale. Nottingham University Hospitals NHS Trust has placed more than 4,000 mobile devices in clinicians’ hands, for example.
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Report: Healthcare Analytics Market Expected to Reach $43B by 2024

The global healthcare analytics market is expected to reach $42.8 billion by 2024, according to a new report by Grand View Research, Inc. 
Growth in the healthcare analytics market is largely being driven by:
– providers ability to identify clinically meaningful outcomes in relation to costs through the investigational mining of EMRs to identify inherent medical inaccuracies in the system to provide cost effective patient treatment
– accelerated adoption of big data that enables informed patient decision-making, allowing patients to take better control of their health as well as to receive customized care
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Telemedicine Enables 'Skip the Trip' to the ER Option

HealthLeaders Media News, July 13, 2016

Patients connect with hospital staff via its website, which promises to provide speedy diagnoses for common ailments for a set fee.

St. Vincent's Medical Center in Bridgeport, CT has launched an online diagnosis and treatment service with the hopes that the technology will free up its clinicians. The hospital is promoting the service by telling patients to "skip the trip!" to the ED.
The website connects patients with St. Vincent staff and promises to provide speedy diagnosis and treatment for common ailments, such as colds, conjunctivitis, eczema, and bladder infections.
"With Myvirtualcare.com, patients can skip the trip to the doctor's office and still get the care they need, when and how they need it," Dianne Auger, senior vice president and chief strategy officer for St. Vincent's Medical Center, told local media.

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ONC seeks proposals for using blockchain in healthcare

Published July 12 2016, 6:51am EDT
A federal agency wants to take a closer look at proposals to use blockchain technology in healthcare.
To solicit potential uses for blockchain, the Office of the National Coordinator for Health Information Technology is sponsoring a challenge that’s seeking ideas for the use of the advanced IT technology.
In the challenge, announced last week, ONC is soliciting white papers on the technology and its potential use in health IT “to address privacy, security and scalability challenges of managing electronic health records and resources.”
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Mandatory e-prescribing could solve opioid abuse problem

Jul 12, 2016 11:05am
Most of the conversations around the growing opioid abuse problem in the United States are missing one important element: E-prescribing.
That’s according to Devon Herrik, Ph.D., a senior fellow for the National Center for Policy Analysis, who writes that e-prescribing is a common sense solution that is basically being ignored.
“Mandatory e-prescribing of controlled substances adds electronic checks and balances to an existing system,” he writes.
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OCR’s HIPAA guidance on ransomware puts pressure on providers

Published July 12 2016, 4:24pm EDT
With the healthcare industry increasingly coming under attack from ransomware gambits, the Department of Health and Human Services’ Office for Civil Rights has released new HIPAA guidance on the risks of being victimized by file-encrypting malware.
The OCR’s guidance underscores the serious nature of ransomware and providers’ responsibility in preventing and recovering from such attacks.
“This document describes ransomware attack prevention and recovery from a healthcare sector perspective, including the role the Health Insurance Portability and Accountability Act has in assisting HIPAA covered entities and business associates to prevent and recover from ransomware attacks, and how HIPAA breach notification processes should be managed in response to a ransomware attack,” states OCR.
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HHS Office for Civil Rights releases ransomware guidance

Its advice includes ways to prevent and contain malware threats; OCR officials stress that these viruses are considered security incidents under HIPAA.
July 12, 2016 11:18 AM
"One of the biggest current threats to health information privacy is the serious compromise of the integrity and availability of data caused by malicious cyberattacks on electronic health information systems, such as through ransomware," said OCR Director Jocelyn Samuels.
The U.S. Department of Health and Human Services Office for Civil Rights has released its guidance to help healthcare organizations handle ransomware attacks, including prevention methods, a detailed description of ransomware and advice on how to respond to a ransomware threat.
One important highlight is the reiteration that both malware and ransomware constitute a security incident under HIPAA. Therefore, any affected organizations must initiate security incident response and reporting procedures.
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Behind the Expansion of Home Dialysis, Rigorous Training and Texting

Scott Mace, July 12, 2016

More training and the use of timely communication are helping home dialysis patients overcome some of the workflow problems they face there.

Home-based kidney dialysis remains a relative rarity, with only one in ten U.S. patients able to receive peritoneal dialysis and hemodialysis at home, according to national averages.
But driven by the staggering cost of outpatient dialysis treatments and improvements in home dialysis technology, one chain of dialysis clinics has been able to double that average. And it aims to double it again through an innovative program involving feedback from patients as well as nephrologists and payers.
The costs paid by Medicare tell the tale: While dialysis patients represent less than 1% of the Medicare population, they also represent 6% to 7% of the total cost of Medicare.
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Active market for healthcare records looms as newest cyber threat

Published July 11 2016, 6:31am EDT
Offers to sell patient records with protected health information on the “Dark Web” market represent a new level of threat for healthcare organizations trying to protect health information, offering further monetary inducement to hackers trying to access records.
The addition of a new potential for profiting from hacking could increase the “demand” side of the equation for records, increasing the likelihood of attacks and the need for healthcare organizations to stiffen defenses.
In late June, a hacker known as “The Dark Overlord” reported the theft of nearly 10 million patient medical records from providers and a major insurer and put them on the Dark Web market where hackers conduct buy and sell data taken from a variety of sources. As of this writing, the records have not been sold, and the seller may be having trouble selling the treasure trove of protected health information.
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Buyers Guide to intrusion detection and prevention tools

Amid the evolving cybersecurity threat landscape peppered with hackers, ransomware, nation-states gunning for coveted PHI, hospitals must safeguard against attempts to penetrate their networks. Here's a roundup of the top IDS and IPS tools for doing that.
July 11, 2016 08:07 AM
To help Healthcare IT News readers put up a stronger defense, we created this guide to Intrusion Detection Systems and Intrusion Prevention Systems software with details on the leaders in the field and the products they offer. 
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Rush OB/GYN residents to practice surgical skills using virtual reality

Jul 11, 2016 10:09am
Obstetrics and gynecology residents at Rush University Medical Center in Chicago will begin using a virtual reality system later this summer to practice surgical procedures, reports the Chicago Sun-Times.
The VR system will allow students to practice standard procedures on the uterus, ovaries and fallopian tubes using a joystick or other surgical tool while viewing a virtual patient on a screen.
The students will be able to practice on their own time without supervision and gain confidence in doing the procedures. The VR technology will alow them to practice as many times as it takes to get it right.
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Cybersecurity, telehealth top of mind for 'Most Wired' hospitals

Jul 11, 2016 10:53am
The major healthcare breaches of 2015 and recent ransomware attacks have put cybersecurity at the forefront for 2016's "Most Wired" hospitals.
More than 680 providers, who represent more than 2,146 hospitals, responded to the survey about their IT use. The report is sponsored by the American Hospital Association’s Health Forum and publlished at Hospitals & Health Networks.
In addition to defensive measures, such as intrusion detection systems, and employee education on security risks, 67 percent of the Most Wired hospitals are using pattern detection to prevent automated logins, up from 48 percent in 2013.
Telemedicine is another area these organizations are giving a lot of attention.
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Dr. John Halamka proposes alternate IT certification plan

Written by Akanksha Jayanthi (Twitter | Google+)  | July 08, 2016
In his perfect world, John Halamka, MD, CIO of Boston-based Beth Israel Deaconess Medical Center would reduce or eliminate the 2015 EHR Certification Rule and instead require just five elements for health IT certification.
He wrote in a post on "The Health Care Blog" that the technical requirements of the Medicare Access and CHIP Reauthorization Act are overly restrictive and place a significant burden on developers.
While MACRA intends to provide flexibility for providers by offering them a choice of metrics to meet, it means developers have to design products meeting every single standard. "For vendors, every 'OR' means an 'AND' — developers must implement everything in the rule because some stakeholder will demand every transaction in the regulation," Dr. Halamka wrote. "There was little curation in the rule and most of the HIT Standards Committee recommendations to limit scope were ignored."
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Prescription-drug monitoring saves lives, could save more

(Reuters Health) - State programs that monitor narcotic prescriptions help prevent 10 opioid-overdose deaths a day in the U.S., yet improvements could save another two people a day, a new study finds.
States with the most robust programs - ones that tracked a greater number of potentially addictive medications and updated their databases at least weekly - saw the biggest drops in overdose deaths, the research showed.
Implementing drug monitoring in all states and strengthening weaker programs could prevent another 600 opioid-overdose deaths this year, researchers calculated.
“Prescription drug-monitoring programs are a public health tool to ensure that we’re using opioids appropriately but limiting the negative health impacts we see in almost every community in the United States,” lead author Dr. Stephen W. Patrick said in a phone interview.
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Enjoy!
David.

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