Saturday, August 06, 2016

Weekly Overseas Health IT Links – 6th August, 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.

EHRs help improve the quality of inpatient nursing care

Jul 28, 2016 2:31pm
The use of electronic health records by hospital bedside nurses can improve the quality of care provided without increasing direct costs, according to a new study in the Journal of Nursing Administration.
The researchers conducted a retrospective analysis in a 431 bed urban hospital with 10 medical/surgical units and two critical care units. They measured the impact of implementing an integrated EHR on the quality of nursing care--reviewing hospital-acquired falls, hospital-acquired pressure ulcers, ventilator associated pneumonia (VAP), central line associated blood stream infections (CLABSI) and catheter associated urinary tract infections (CAUTI).
They found that EHR adoption had an overall positive effect without increasing costs. The rates for falls, CAUTI and CLABSI fell; for instance, the rate of falls declined 15 percent. The ulcer and VAP rates saw negative results at implementation but then followed with a significant rate reduction that surpassed the rate in the preimplementation period. Moreover, the costs were initially negatively impacted but returned to the baseline. 

Patients who discuss treatment online are more satisfied

Jul 29, 2016 11:00am
Patients who seek information online and discuss their healthcare treatment choices via email and on social media platforms feel better about their decisions, according to research published in JAMA Oncology.
Researchers analyzed a sample of 2,460 women recently diagnosed with breast cancer. They found 41 percent of the women responded to their diagnosis by discussing it through e-mail, text messages, Facebook, Twitter and online support groups, to determine the best treatment options and their therapeutic value.    
The study found a relationship between those patients who used online communication the most and those who weighed their treatment decisions with more care as well as reported greater satisfaction after making that decision.

Congress offers glimmer of hope for patient matching

Jul 29, 2016 11:06am
An industry trade group sees signs of hope that Congress will help move patient matching efforts forward--but they're also keeping an eye on the 2016 elections.
In a report accompanying a fiscal 2017 funding bill, the House appropriations committee directed HHS to provide technical assistance to private-sector-led patient-matching initiatives.
"AHIMA is very encouraged," Lynne Thomas Gordon, CEO of the American Health Information Management Association, said in an interview at Healthcare Info Security.

EHRs and digital health tools 'dramatically transforming' care experience, patients say

A new study found that patients of all ages, with Baby Boomers leading the charge, are interested in accessing medical records online and tapping into portals to book appointment, pay bills, and refill prescriptions. 
July 29, 2016 09:28 AM
Nearly 75 percent of patients expressed a high level of interest in accessing their electronic medical records, according to new research, and 33 percent indicated that EHRs have already changed their experience for the better.
"The patient experience is dramatically transforming,” CareCloud CEO Ken Comee said in a statement. “Patients of all ages are actually embracing digital online patient engagement tools from scheduling appointments to accessing their medical records and making online payments."
Contradicting stereotypes that millennials are the leading technology adopters, a CareCloud survey of 1,443 patients determined that Baby Boomers (51-65 years of age) are the group most likely to use healthcare tools.

Cleveland Clinic slashes unplanned ICU transfers, patient length of stay with population health and remote monitoring tools

The health system is using eHosptial and eCMU to create command centers where clinicians gather to keep an eye on the sickest patients and, in turn, more effectively handle rapid response calls. 
July 27, 2016 07:08 AM 
BOSTON — While electronic health records have had many positive effects on medicine, like many technologies EHRs also come with certain tradeoffs.
The demise of a single chart for each patient – and the need for multiple members of a care team to share it – removed a point of community and collaboration from care teams.  
Now Cleveland Clinic is looking for ways to use technology to bring that collaboration back, according to Associate CIO William Morris.
"You would all fight for the one chart. And you’d fight for it, but it would force these conversations. Five, 6, 7 years ago any nurse’s station was Grand Central Station. It was a packed resource, everyone jockeying for that one chart,” Morris said at the mHealth and Telehealth World Congress here. “But now it’s become a ghost town. You miss this natural collaboration. This is why we feel like there’s opportunities to bring that back to the nurse’s unit and actually use visualizations in population health, to bring these collaborations."

Brain Training Protects Against Cognitive Decline, Dementia

Megan Brooks
July 25, 2016
TORONTO ― A cognitive training program targeting speed of processing in healthy elderly adults cut the risk for dementia nearly in half over a 10-year period in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study.
"We believe this is the first time a cognitive training intervention has been shown to protect against cognitive impairment or dementia in a large, randomized controlled trial," Jerri Edwards, PhD, of the School of Aging Studies and Byrd Alzheimer's Institute, University of South Florida, in Tampa, said in a statement.
Dr Edwards presented 10-year results from the ACTIVE study here at Alzheimer's Association International Conference (AAIC) 2016.

Four Technologies You Should Be Using in Your Practice

July 28, 2016
Physicians and their practices are becoming pretty comfortable using technology, according to the data from Physicians Practice's 2016 Technology Survey, which features 1,568 respondents from across the country. Apart from EHRs, which have made significant inroads into independent medical practice, there are a plethora of other technologies that can make a physician's life just a little bit easier and are increasingly being adopted into their practices.
Not surprising, a clear majority (78 percent) of practices say they use billing and coding software. Far more interesting, from our perspective, is that roughly a third of respondents say they use technology to conduct data analytics (33 percent) and manage their revenue cycle (29.4 percent), and 16 percent use technology to facilitate patient check-in and registration ( a 2 percent increase over 2015). While small, this number is significant given the fact that every dollar counts in medical practices, especially so for the smaller groups. In fact, when asked "What is your most pressing information technology problem?" after citing EHR-related problems, 8 percent of survey respondents said, "Costs to purchase and implement other technologies."
Viewpoint | July 28, 2016

What Happens When Underperforming Big Ideas in Research Become Entrenched?

Michael J. Joyner, MD1; Nigel Paneth, MD, MPH2; John P. A. Ioannidis, MD, DSc3
JAMA. Published online July 28, 2016. doi:10.1001/jama.2016.11076
For several decades now the biomedical research community has pursued a narrative positing that a combination of ever-deeper knowledge of subcellular biology, especially genetics, coupled with information technology will lead to transformative improvements in health care and human health. In this Viewpoint, we provide evidence for the extraordinary dominance of this narrative in biomedical funding and journal publications; discuss several prominent themes embedded in the narrative to show that this approach has largely failed; and propose a wholesale reevaluation of the way forward in biomedical research.

HIT Think Five key privacy weak spots in healthcare facilities

Published July 29 2016, 3:35pm EDT
Amid all the efforts to protect digital data in the healthcare industry, it can be easy to overlook the importance of protecting data in its physical or visual state.
Healthcare organizations continue to invest in and improve their cyber defense, forcing hackers seeking patient information to evolve their tactics in acquiring it. One of those tactics is visual hacking, which is the viewing or capturing of sensitive, confidential or private information for unauthorized use.
Healthcare organizations have an obligation to take all reasonable measures to protect sensitive data in this era of data breaches. This includes protecting patients’ personal demographic, health and financial information.

Worries about data quality put pressure on IT pros

Published July 27 2016, 4:06pm EDT
Data quality issues continue to plague the large majority of organizations, according to a new report from research firm TDWI.
The study found that 86 percent of the 411 organizations it surveyed are not fully satisfied with the quality of their data, and 94 percent are not very satisfied with their processes for addressing data duplication.
That puts a broad array of IT executives and professionals—including business and data analysts, line-of-business and departmental directors—under pressure to reduce the time needed to extract meaningful insights from data. As a result, more than 80 percent are evaluating self-service data preparation and infrastructure changes to accelerate information-driven decision-making.

Twelve million records shared in Merseyside

Ben Heather
28 July 2016
More than 12 million records have been shared across Merseyside, as an increasing number of health and social services sign-up to share information.
At the iLinks Innovations conference in Liverpool earlier this month, it was revealed that record sharing in the North Merseyside health economy has continued to grow, albeit at a slower rate.
Nearly 6 million records were shared in 12 months to July, compared to 5.5 million the year before.
The drive to share is part of the region’s iLinks transformation programme, which aims to improve patient pathways and outcome through improved use of technology.

Special report: radiology information systems

Increasingly, trusts need to collaborate on reporting on images to cope with demand. Is that best done using a RIS or another core IT system? Kim Thomas reports. are now well established at many trusts; and the quest is on to extend them to new areas. Daloni Carlisle reports.
The National Programme for IT formally ended earlier this month. Apart from a few stragglers, such as the handful of London trusts running RadCentre, trusts have replaced their radiology information systems or, in most cases, upgraded their existing one.
Some trusts that opted for tactical extensions to their existing contracts may go out to tender within the next year or two, while Scotland has issued a prior information notice and is expected to replace its existing RIS within the next year (currently, Scottish boards are using either Carestream or HSS RIS.)
The push for collaboration
Vendors agree that the main driver for new RIS and picture archiving and communications system procurements is the need for trusts to collaborate. The shortage of radiologists, combined with an increase in the number of images, has led to some trusts using expensive outsourcing companies to report on images.

Switching EHRs has no impact on patient safety or mortality rates, Harvard researchers say

Despite what appear to be common industry fears about new electronic health records having adverse effects on care delivery, Harvard’s School of Public Health officials said recent research should be encouraging to doctors.
July 28, 2016 11:09 AM
A Harvard study found that switching to a new electronic health record platform has no effect on patient safety or mortality rates.
"Physicians' tremendous frustration in switching to new electronic health records can spill over into concerns that patient care is actually worse because of these systems," said Harvard assistant professor Michael Barnett, who led the study. "Happily, our results suggest that switching to a new system is a challenge that hospitals are prepared to handle safely."
Researchers from Harvard Medical School and the Harvard T.H. Chan School of Public Health, in fact, considered the short-term impact of implementing EHR systems nationally, and identified 17 hospitals that went live in one day. 

Are EHR vendors poised to extinguish public HIEs?

With the number of health information exchanges declining since 2012, and EHR makers creating their own exchanges, the latter might just be a more effective way to share patient data. 
July 28, 2016 07:12 AM
The longevity of public health information exchanges has long been obscured with questions of financial sustainability and the viability to provide services hospitals cannot undertake on their own.
This month researchers at the University of Michigan found an 11 percent drop in the number of state and community exchanges between 2012 and 2014 from a total of 119 HIEs down to 106 — and perhaps the more telling discovery is that all are facing barriers to success while only half of those reported financial stability.
"Our results suggest early signs of a shakeout as these efforts try to prove they are creating value," University of Michigan’s Schools Public Health Assistant Professor Julia Adler-Milstein said in a statement.

Connected health advances care across the globe

Connected health - technology-enabled care solutions that facilitate communication between patients, providers and caregivers - is becoming more prevalent in the United States and spreading across the globe.
July 28, 2016 08:15 AM 
By Chris Edwards, Chief Marketing Officer, Validic
Connected health – technology-enabled care solutions that facilitate communication between patients, providers and caregivers – is becoming more prevalent in the United States. But, this idea of improving outcomes and patient experience with digital-health technologies is also spreading across the globe. There are a number of examples of countries and companies abroad launching successful and innovative strategies.
For example, an African governmental body recently provided residents of a remote village with smartphones that enable them to monitor their vital signs. Patients are then able to supply that information, which includes blood pressure and heart rate data, to doctors and caregivers – who, in turn, can respond with treatment advice. Connected technology makes it possible for this population to receive much-needed clinical care remotely, which saves the men, women and children from walking for days to visit the nearest healthcare facility.
In the United Kingdom, clinicians are monitoring patient’s lifestyle data – such as sleep, exercise, diet, weight, blood pressure and blood-glucose levels – to then leverage real-time video consultations with patients. And, in Australia, a company is leveraging digital-health devices to monitor and manage the health, wellness and nutrition of members of the Australian Rugby team in an effort to ensure that these elite athletes are in top physical condition for key competitions.

President signs order to improve cyber attack responses

Published July 27 2016, 6:42am EDT
President Obama has released Presidential Policy Directive/PPD 41, establishing principles to govern responses to major federal and private sector cyber attacks.
Although not specifically focused on cyber incidents at healthcare organizations, the directive does recognize the serious impact that such incidents can have on “public health and safety.”
“While the vast majority of cyber incidents can be handled through existing policies, certain cyber incidents that have significant impacts on an entity, our national security or the broader economy require a unique approach to response efforts,” according to the directive. “These significant cyber incidents demand unity of effort within the Federal Government and especially close coordination between the public and private sectors.”

AHA lauds growth in patient access to electronic records

Published July 26 2016, 4:41pm EDT
Prodded by requirements in the Electronic Health Records Incentive Program, hospitals are increasingly making it easier for patients to access their medical records, according to data collected by the American Hospital Association.
Last year, 92 percent of hospitals could let patients view their records online, more than double the percentage that were able to do so in 2013, when only 43 percent of hospitals could deliver that information to patients, the industry’s trade organization for hospitals said in a report released last week.
Other results quantifying the increasing ability of hospitals to communicate with patients are just as striking, the AHA report said.

Researchers leverage EHR data to reduce alarm fatigue

Published July 27 2016, 6:32am EDT
Hospitals are places where clinicians are typically bombarded with a variety of alarms sounding from medical devices. However, the noise has become a serious distraction for clinicians who are being bombarded daily with thousands of alarms—the vast majority of which are false or not clinically actionable. All that noise is impacting patient safety, critics say.
Not surprisingly, providers have become desensitized to these alarms, a phenomenon known as alarm fatigue. To help address the problem, a 2014 Joint Commission National Patient Safety Goal urged hospitals to prioritize alarm system safety and to develop policies and procedures to manage alarms and alarm fatigue. Yet, progress has been slow.
“There are tens of thousands of alarms that go off every single day at individual hospitals, and providers are expected to triage all of those stimuli on a moment-to-moment basis when they’re trying to care for patients,” says Veena Goel, MD, a pediatric hospitalist for the Palo Alto Medical Foundation and adjunct clinical assistant professor at Stanford Medicine.

Emisoft unveils free ransomware decryptor to unlock your own data

The anti-malware vendor said that hospitals hit by a Stampado ransomware attack can download their software to gain back access to locked data.
July 27, 2016 07:06 AM
Anti-malware software maker Emisoft has posted a free decryptor that hospitals and other organizations hit by the ransomware strain Stampado can use to unlock their data.
Stampado, which is being aggressively advertised on the dark web for $39 in Bitcoin, boasts similar functionality to Cryptolocker and other ransomware strains.
First discovered by Heimdal Security firm, Stampado is fully-functional and when installed it encrypts the victim’s files using AES encryption. From there, the code demands a ransom to decrypt files, according to malware removal and computer forensics specialist Lawrence Abrams, who founded the tech support site 

Canadian clinicians report 'positive' experience with interoperability

Jul 27, 2016 8:44am
Most Canadian healthcare professionals are enjoying a positive experience with information sharing, according to a study published this month in BMC Medical Informatics and Decision Making.
The clinical components of interoperable electronic health records (iEHRs) are at varying levels of availability across Canada. All provinces and territories have at least two of four clinical components (diagnostic imaging, lab test results, dispensed drugs and clinical reports/immunizations) available; five provinces/territories have all four components available. About half of healthcare professionals (250,000) in the country indicate that they electronically access data from outside their main practice settings.
The researchers, affiliated with Canada Health Infoway, which tracks EHR use in Canada, conducted a series of surveys of 2,316 iEHR users in six Canadian provinces and territories between 2006 and 2014 to determine what iEHR users thought of their experiences with data exchange. They found overwhelmingly positive results.   

Report: Healthcare tops for ransomware incidents in Q2

by Dan Bowman 
Jul 27, 2016 11:32am
The healthcare industry, far and away, led all others in volume of ransomware detections in the second quarter of 2016, according to a recent security firm report.
Roughly 88 percent of all ransomware detected was discovered in healthcare, while the next most targeted industry was education at 6 percent, according to the report, published by Solutionary. One reason? Its stakeholders often pay hackers.
The report, which examined “information through the research of significant events identified through global visibility” of a company’s client base, also points to “an abundance of systems and devices” as pathways for hackers. It also notes that ransomware detections between March and May of this year increased by 11 percent per month. The report highlights that, according to the FBI, since October 2013, business email compromise scams have resulted in more than $3 billion lost for more than 22,000 victims.

ONC releases data for top vendors used in EHR Incentive Program

Published July 26 2016, 1:01pm EDT
The Office of the National Coordinator for Healthcare Information Technology has released its data for top vendors used by providers participating in the EHR Incentive Program. Data is based on 2015 information compiled by the agency.
The Quick Stats split out the total number of providers that reported using a vendor's certified technology by the technology's certification edition, either the 2011 or 2014 edition.
The top 10 certified health IT vendors for hospitals include Cerner, 1,029; Meditech, 953; Epic Systems, 869; Evident, 636; McKesson, 462; MEDHOST, 359; Allscripts, 235; Sunquest Information Systems, 200; FairWarning Technologies, 172; and Iatric Systems, 161.

CMS fraud prevention efforts save $42 billion

Published July 26 2016, 6:30am EDT
The Centers for Medicare and Medicaid Services has embraced a multifaceted, proactive approach to preventing fraud, using a heavy investment in analytics and enforcement agency resources to save $42 billion in fiscal years 2013 and 2014.
CMS highlighted the importance of the savings in preventing fraud in order to ensure sustainability of the Medicare program and making sure beneficiaries have future access to care.
In CMS’ annual report to Congress on the effectiveness of the Recovery Audit Program—a strategy to combat fraud, waste and abuse at a federal level—that was released last week, the agency reported $24.8 billion of the $42 billion recovered came from prepayment review that employed advanced analytics.

The simple concept behind cloud's benefit to hospitals

by Matt Kuhrt 
Jul 26, 2016 4:30pm
Editor's note: The following is an excerpt from FierceHealthIT's eBook, Hospitals in the Cloud: How the technology is helping executives boost quality and cut costsYou can download it for free
The use of cloud technology in hospitals has accelerated in recent years, leading to an increasing variety of solutions and a growing awareness of the value such tools unlock in organizations. Among other benefits, cloud technology can help hospital executives save money, improve efficiency and reduce administrative overhead.
As with any technology, however, a cloud-based solution only offers benefits if it is implemented appropriately and measured accurately. The cloud is already reshaping the role of healthcare IT departments, shifting their focus from installing and running systems to coordinating and managing a growing suite of services. This trend is likely to continue as hospitals find new ways to use the cloud to improve their operations.

Hospitals 'largely' addressing HIPAA requirements for EHR contingency plans

Jul 25, 2016 4:56pm
Hospitals are doing a fairly good job at protecting their electronic health record data as required by the HIPAA security rule, according to a new report from the Department of Health and Human Services’ Office of Inspector General (OIG).
The OIG sent a questionnaire to a sample of 400 hospitals that had received Medicare incentive payments for using a certified EHR pursuant to the Meaningful Use program as of September 2014. It also conducted site visits at six hospitals.
The survey found that 95 percent of the hospitals had a written EHR contingency plan, and more than two-thirds (68 percent) reported that their plan addressed the four HIPAA requirements that the OIG reviewed: having a data backup plan; having a disaster recovery plan; having an emergency mode operations plan; and having testing and revision procedures.

Medical students track former patients' electronic health records, study says

Although most students follow patient treatment outcomes after they are no longer involved with their care, ethical questions about the practice are raised in a recent study.
By Stephen Feller   |   July 26, 2016 at 9:51 AM
CHICAGO, July 26 (UPI) -- Although it is suspected to be largely for educational purposes, researchers in a recent study say the following of patient electronic health records as part of training poses ethical questions for the handling of those records.
A majority of medical students reported they find it beneficial to follow patient medical histories by accessing electronic health records, but some are checking cases they are not involved with out of curiosity -- which may not pose an actual problem, but poses an ethical one, say researchers at Northwestern University.
Some doctors have complained that electronic records, considered essential for better coordination of patient care and improvement of precision medicine, is too significant a burden on their time.

OIG: 60 percent of hospitals reported unplanned EHR disruption - before rise of ransomware

The Office of the Inspector General posted research from 2014 so there’s reason to believe the proliferation of cyberattacks and malware could create even more downtime. OIG recommended that hospitals institute and continuously update contingency plans.
July 25, 2016 01:01 AM
Nearly 60 percent of hospitals have experienced an EHR outage. According to a new report from the Health and Human Services Office of the Inspector General, in fact, 25 percent of those that have had EHR downtime said it delayed patient care. 
Put another way: 15 percent of hospitals have had a dysfunctional EHR negatively impact their ability to treat patients and 9 percent were forced to reroute patient care. What’s more, 20 percent of the outages lasted more than eight hours.
OIG found that the top cause of EHR outages is attributable to hardware malfunctioning, internet connectivity problems, power failures, natural disasters and it’s worth noting that hacking attacks only accounted for 1 percent of EHR downtime incidents. 

ONC seeks info sharing organization to help health sector thwart cyberattacks

Jul 25, 2016 11:32am
Visibility of cybersecurity threat detection and response is one way to thwart evolving attacks on the healthcare industry. With that in mind, the Office of the National Coordinator for Health IT today announced two funding opportunities for an Information Sharing and Analysis Organization (ISAO) that wants to help.
ONC, along with the Assistant Secretary for Preparedness and Response (ASPR), is searching for an existing ISAO to help the sector by providing information on the types of threats impacting the industry, expanding education to healthcare entities on cybersecurity awareness, helping stakeholders use that education and information in practice and sharing information throughout the industry.
“In short, the ISAO will create a more robust cyber information sharing environment, especially for smaller entities that may not have the resources to access such information on their own, by leveraging existing relationships,” National Coordinator for Health IT Karen DeSalvo wrote in a blog post.

Andy Slavitt: Health IT must 'wrap around' needs of patients, clinicians

Jul 25, 2016 10:41am
The purpose of the Medicare Access and CHIP Reauthorization Act, according to Andy Slavitt, is to “return the focus to patient care, not spend time learning a new program.”
Slavitt, acting administrator for the Centers for Medicare & Medicaid Services, spoke to the American Osteopathic Association late last week about all the possibilities the program holds, as well as its many pitfalls--which he said the agency is working to address.
Those include many issues on the technology side, including making sure that IT use wraps “around the needs of patients and clinicians and how they use the healthcare systems, not residing in the silos of health IT companies.”

Kaiser Permenente testing novel hospital IT tools

Jul 25, 2016 9:38am
In a 37,000-square-foot warehouse near Oakland, California, Kaiser Permanente is trying to re-imagine healthcare of the future and technology’s role in it, reports BloombergBusinessweek.
It’s outfitted a model apartment filled with sleep monitors, fall detectors and a smart fridge for a patient of the future named Leo. In one scenario, the 68-year-old retiree develops arrhythmia while shopping and a driverless car filled with diagnostic gear is dispatched to determine whether he needs to go to the hospital.
Rather than relying on existing offerings, it wants to direct the development of new hardware and software.
“It frees us up so we don’t get so stuck on the realities of today,” Kaiser CEO Bernard Tyson says.
The warehouse also includes mock hospital rooms, an operating room, and a neonatal intensive care unit where staff can practice new procedures.

HIT Think How IoT will affect information governance

Published July 25 2016, 3:06pm EDT
Malcom Gladwell popularized the phrase “the tipping point” in his best-selling book that highlighted how a series of events over time can lead to a moment when massive growth and expansion materializes.
Often, the triggers that drive these significant tipping point events are obscure and have enough latency that they may not be recognized or understood until after the fact. In other words, grasping the isolated multiple threads for a trend—whether societal, fashion or product related—that actually contribute to a tipping point event are a challenge.
Technological innovation is one area where we have no shortage of visionaries that conjure up the what, when and how technology will change the paradigm in which we live and work. We have a world of microprocessors powering billions of devices connected in the cloud.


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