Saturday, September 17, 2016

Weekly Overseas Health IT Links – 17th September, 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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Alert system uses predictive analytics to combat sepsis

Published September 09 2016, 6:56am EDT
Tapping into electronic health record data and predictive analytics, hospitals are enlisting a new technology solution in the fight against sepsis, a leading cause of death and hospitalization in the United States.
According to the Centers for Disease Control and Prevention, there are more than 1 million cases of sepsis each year, killing more than 258,000 Americans annually.
However, Jersey City (N.J.) Medical Center, a 325-bed urban tertiary care facility, is implementing a sepsis alert system that constantly scans patients’ EHRs and leverages predictive analytics to determine which patients are septic or at risk for septic shock and alerts appropriate care team members.
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Must-haves for machine learning to thrive in healthcare

MIT professor John Guttag said that growing sets of aggregated data, federal rules mandating access to information, and existing tools make machine learning a reality today. Here’s what healthcare organizations need to know about the emerging technology.
September 08, 2016 07:53 AM
When John Guttag keynotes the HIMSS and Healthcare IT News Big Data and Healthcare Analytics Forum in Boston on October 24, the MIT professor will describe the unique challenges of applying machine learning to healthcare – as well as the huge potential for efficiencies and quality improvements as these data techniques become more widespread across the industry.
Guttag, who heads the Data Driven Inference Group at the MIT's Computer Science and Artificial Intelligence Laboratory, and his MIT students are currently working closely with Mass General on integrating machine learning into clinical workflows, specifically with the aim of reducing healthcare-associated infections.
"I want to actually see things change in the system, not just write papers saying things could change," Guttag said. "The goal here is to have something good happen. I hope a year from now I'm able to say, 'Guess what, we've lowered the rate of nosocomial infections at MGH – and more importantly put together a description of how we've done it that is exportable to other organizations.’” 
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MIT professor's quick primer on two types of machine learning for healthcare

These approaches have enormous potential to enable clinicians, doctors and researchers to spot patterns in existing data sets. Here’s a look at the two styles and what they mean to healthcare organizations.
September 08, 2016 07:42 AM
There are two main approaches to machine learning – supervised and unsupervised – and each has specific applications in the context of healthcare.
And even though their impact has not yet sent shockwaves through the industry, the potential of each is enormous, according to John Guttag, head of the Data Driven Inference Group at MIT's Computer Science and Artificial Intelligence Laboratory.
At its basic level, machine learning involves looking at data, and from that data finding information that is not readily visible. Example: Applying machine learning to data about patients infected with Zika or another virus and using what we can learn about what happens to those people to inform care decisions regarding the best ways to treat people who get infected in the future. 
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Online portals top list of patient engagement tools

by Aine Cryts 
Sep 9, 2016 12:20pm
Here’s the good news: Sixty-nine percent of healthcare providers are using patient engagement to get patients more involved in their own care. But it should be closer to 100 percent, argue Kevin Volpp, M.D., Ph.D., director of the Center for Health Incentives and Behavioral Economics at University of Pennsylvania’s Perelman School of Medicine, and Namita S. Mohta, M.D., clinical editor at NEJM Catalyst.
What patient engagement strategies are most popular?
Executives, clinical leaders and clinicians surveyed on patient engagement initiatives at their organizations said it's the patient portal at 88 percent, seconded by secure e-mail at 77 percent, according to Volpp and Mohta’s article in NEJM Catalyst.
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Commission on Care, lawmakers want commercial EHR for VA

  • By Aisha Chowdhry
  • Sep 08, 2016
Dr. Toby Cosgrove, vice chairperson of the Commission on Care, told the House Veterans' Affairs Committee that a commercial electronic health record system would eliminate many of the VA's billing and scheduling problems.
The leaders of the Commission on Care, which recently offered recommendations for improving the Department of Veterans Affairs' delivery of health care, told a House committee on Sept. 7 that the VA should abandon its homegrown electronic health record system in favor of a commercial solution.
Dr. Toby Cosgrove, vice chairperson of the commission and CEO of the Cleveland Clinic, said VistA is too decentralized and poorly maintained.
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Full ‘Medical Records’ for Trump and Clinton? That’s Fiction

One of Donald J. Trump’s recent attack lines against Hillary Clinton focuses on her health: If she has nothing to hide, he asks in a tweet, why doesn’t she release her medical records to the public?
For the moment, put aside Mr. Trump’s own revelations about his medical history, which consist of a hyperbolic, undated letter with little detail from his gastroenterologist. And put aside Mrs. Clinton’s own recent disclosures, which include a somewhat more detailed accounting of her health and medication history from the internist who has overseen her care in recent years. Put aside, finally, the question of whether complete medical records would allay the conspiracy theories of some of Mrs. Clinton’s critics, who say a recent cough is a sign of disqualifying illness or believe she experienced a seizure during a recent news conference.
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Wachter: strategic investment in clinical leaders is vital

7 September 2016
The much-anticipated review of NHS IT by US 'digital doctor' Robert Wachter says a significant proportion of healthcare IT funding needs to go on training and supporting chief clinical information officers. Jon Hoeksma reports and gets reaction from the Health and Social Care Innovation Expo in Manchester.
The Wachter Review of NHS IT has said significant new investment in developing chief clinical information officers is vital to the success of NHS digitisation.
The report from US ‘digital doctor’ Robert Wachter, which was published overnight, recommends that £42 million should be devoted to developing a new cadre of CCIOs, informatician clinicians, and other IT leaders.
This is equivalent to 1% of the £4.2 billion of investment in NHS IT over the next five years that was agreed with the Treasury in the last spending review and announced by health secretary Jeremy Hunt earlier this year.
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Hunt reveals instant patient record and excellence centres

Ben Heather
7 September 2016
Health secretary Jeremy Hunt has unveiled plans to “fast track digital excellence” today, including a further round of digital excellence centres and “instant access” to a personal online health record.
This comes in response to the release of Dr Bob Watcher's review of NHS digital health, released overnight, which focuses on the importance of clinical input in digital transformation.
In a speech at the Health and Social Care Expo in Manchester, Hunt said the strategy was focused on creating an "ivy league" of global exemplar hospitals and improving pateint access and control over their health information.
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Hunt: IT funds will support 'Ivy league' of exemplar trusts

Ben Heather
7 September 2016
In response to the Wachter review of NHS IT, health secretary Jeremy Hunt has announced there will be two waves of 'global' and 'national' digital exemplar trusts, forming an 'Ivy league' of digital excellence.
However, this could mean that half of all the trusts in the NHS could miss out on central funding ahead of the 2020 'paperless' target, which now seems to have been pushed out to 2023 to accommodate them.
At the Health and Social Care Expo in Manchester, Hunt gave an enthusiastic reception to Dr Robert Wachter long awaited review on the digital future of NHS IT, which was released overnight. Crucially, he backed its recommendation that central funding should be released in waves, with more digitally advanced trusts benefiting first.
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12 things Hillary Clinton said about health IT

The Democratic Candidate for president on big data, evidence-based medicine, quality outcomes, transparency in the healthcare system, and more.
September 07, 2016 11:29 AM
Hillary Clinton said at HIMSS14 that progress in healthcare requires the right infrastructure, attitude, talent and regulatory environment.
Current Democratic presidential candidate Hillary Clinton keynoted HIMSS14 and the speech gave a glimpse into her thinking about health IT.
Clinton spoke about important health issues including evidence-based medicine, innovative technology advancements, big data, quality outcomes and transitioning away from fee-for-service, among other topics.
Today, of course, Clinton is in the race and healthcare is among the pressing issues she must battle Republican nominee Donald Trump over between now and election day.
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ICIT report outlines ways breaches can ruin patients' lives

Sep 8, 2016 10:47am
Healthcare executives’ “lackadaisical approach” to cybersecurity endangers the lives and futures of breach victims, who have little help or recourse for dealing with identity theft, according to a new report from the Institute for Critical Infrastructure Technology.
It looks at how healthcare information is exploited on the Dark Web, with the data often being sold multiple times. Such information also can continue to be sold for the rest of the victim’s life, the authors say in their tersely worded report, adding that "for some, such as children, this can drastically hinder their future financial stability and limit the potential lives that they could lead.”
The report lays out testimony the organization will present at a Senate hearing on Sept. 22.
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Cancer Moonshot panel releases recommendations as precision medicine spreads

Sep 8, 2016 12:05pm
The expert panel for Vice President Joe Biden’s Cancer Moonshot initiative has outlined its recommendations for researching the disease in hopes of achieving a goal of 10 years’ progress over a five-year period.
The 28-member Blue Ribbon Panel this week released a plan containing 10 key recommendations, including:
  • Form a direct patient-involvement network, which engages patients to help with development of a comprehensive, patient-centered profile
  • Create strategies to overcome cancer’s resistance to therapy
  • Develop a network for immunotherapy clinical trials that focuses on discovering and evaluating new approaches
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The intelligent hospital—how we can make the future of connected health a reality

Written by Susmit Pal, Healthcare Strategist, Healthcare & Life Sciences, Dell | September 07, 2016 |
The concept of the Intelligent Hospital was introduced by the Radio-Frequency Identification (RFID) in Health Care Consortium in 2009. By placing patient care at the center of all operational systems, the Intelligent Hospital brings together the architecture and design of the hospital space, innovative technology, and best practices in healthcare to achieve optimal patient care.
The Intelligent Hospital connects otherwise disparate clinical activities for more seamless operations. By enabling more automatic exchanges of information, caregivers and staff can provide detailed and effective patient care while equipping healthcare administrators with the insights needed to improve protocols and policies that help increase efficiency and lower costs.
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Interest in Technology-Enabled Care Grows, But Concerns about Quality, Data Security Remain, Study Finds

September 6, 2016
by Heather Landi
Consumers are open to technology-enabled healthcare, such as using remote patient monitoring tools and telemedicine, but continue to have strong concerns about the quality of care and the security of their healthcare data, according to a recent consumer survey-based study.
The 2016 Survey of U.S. Health Care Consumers study by Deloitte Center for Health Solutions, the research division of Deloitte Life Sciences and Health Care practice, polled 3,700 Americans in February and March 2016 about their current use of technology as well as their expectations, preferences, and concerns around technologies, including re­mote monitoring (the IoT), telemedicine, and ro­bots and drones, that can deliver health care ser­vices outside of traditional care settings.
Consumers have an appetite for using technology-enabled care, according to the study findings. Seven in ten respondents are likely to use at least one of the tech­nologies presented in the survey. The study examined consumers’ use of technology for health and fitness purposes compared to other uses, such as financial planning, tax filling, mobile banking and shopping. Overall, while use of technology for health and fitness purpose is growing, it’s still lagging behind other uses. Eighty-six percent of consumers use technology for shopping and 72 percent use it for mobile banking compared to only 32 percent of respondents who use it for measuring health and fitness goals.
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Why hackers like cash-intensive hospital departments

Published September 07 2016, 6:45am EDT
The cash-intensive areas of a hospital, such as the cafeteria and billing department, as well as non-cash units like marketing, are desirable targets for hackers. Even so, the data security threats are not being adequately addressed, says Christopher Ensey, chief operating officer at Dunbar Security Solutions, a customized security services firm.
Information systems in departments that process cash and debit-credit card payments often share a network with other units in the facility. But Ensey contends that these departments need their own separate, isolated networks “so they don’t get pulled into someone else’s breach,” he adds.
That’s because departments that process payments and operate systems on a shared network can be easily hacked if another department on that network is attacked.
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Providers must rethink defensive cybersecurity strategies

Sep 7, 2016 9:45am
Healthcare providers must strengthen their defensive strategies to best fight off the cyberattacks constantly hitting the industry.
Cybersecurity defense, according to John Nye of health IT consulting firm CynergisTek, must be proactive, he writes at HealthITSecurity.com. Strategies that rely on automated tools and occasionally traffic monitoring will not be effective in stopping hackers, he says.
It’s especially important, Nye adds, to beef up defensive security because of the ways technology use has changed, including bring-your-own-device trends and the ability to work remotely.
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Coordinating Patient Care in an Age of Incomplete Interoperability

CMS and the Office of the National Coordinator have created programs, standards, incentives and penalties to encourage interoperability for the exchange of electronic patient health information. In spite of these efforts, our healthcare system as a whole still falls short of its potential for improving care coordination and clinical outcomes, or reducing cost through the exchange of patient health information.
Electronic health record (EHR) interoperability, as defined by technical standards and frameworks, is only the infrastructure or ‘plumbing’ for secure exchange, and significant technology and operational gaps within this infrastructure remain.
Change management, including development and testing of new workflows, is one of the most critical, often overlooked components for achieving better care coordination through interoperability.  Interoperability of EHRs is potentially transformative, but is also rapidly evolving, and will require flexibility and vigilance for people and processes throughout its evolution to maximize care coordination benefits.
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AI technique for mammography shows promise for improved accuracy

By combining readings of clinical reports and X-rays, a team of researchers believes it can significantly reduce unnecessary biopsies.
September 06, 2016 04:06 PM 
A Houston Methodist team hopes to provide clinicians with more accurate assessment models that can reduce unnecessary biopsies
False positives in mammography test results have been a persistent problem in screening for breast cancer. The American Cancer Society has estimated that up to 50 percent of test results may result in a woman requiring additional testing for no reason.
Now, a team at Houston Methodist believes it has developed an artificial intelligence software program that can improve readings to 99 percent accuracy by analyzing values from X-ray images and the text of clinical reports, complementing BI-RADS categories with additional information and parameters. 
The team, led by Stephen T. Wong, chair of the Department of Systems Medicine and Bioengineering at Houston Methodist Research Institute, and Jenny Chang, MD, director of the Houston Methodist Cancer Center, developed a software technique that scans patient charts, collected diagnostic features and correlated mammogram findings with breast cancer subtype. Clinicians used results, such as the expression of tumor proteins, to accurately predict each patient’s probability of breast cancer diagnosis.
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Patients to diagnose themselves on smartphone

Chris Smyth, Health Editor
September 7 2016, 12:01am,
The Times
The health secretary has had to abandon plans to make the NHS paperless by the end of next year
Patients will be able to check their symptoms, book GP appointments and see their medical records on their smartphones, the health secretary will promise today.
Jeremy Hunt wants to make medical advice and health records available online at the touch of a button. However, he has been forced to accept that a previous pledge to make the NHS paperless by the end of next year will not be met after a review found that half of hospitals would not have proper digital records until at least 2023.
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Use of telemedicine grows in long-term care settings

Published September 06 2016, 6:39am EDT
The use of telemedicine is expanding to long-term care settings, where frail patients are likely to have emergency care needs, and caregivers need quick assessments from outside medical professionals to enable them to intervene as soon as possible.
In rural America, or on urban evenings and weekends, the nurse may not be able to wait for a physician to return a call and begin the traditional intervention by visiting the patient in the facility. With frail patients, immediate observation of a patient can be crucial, and thus telemedicine can fill the void.
“If you can imagine a community with two providers and maybe an advanced practice nurse or a PA, they are expected to provide care for the community,” says Deanna Larson, CEO of Avera Health, Sioux Falls, S.D. “And that includes all the clinic care, wellness care that goes on Monday through Friday, all the hospitalizations that go on Monday through Sunday, ED work that’s all night long. And in addition to that, oftentimes in the communities, there will be nursing homes.”
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Telemedicine's Future on Display Now at UnityPoint Health

John Commins, September 7, 2016

The Iowa-based health system's Remote Patient Monitoring program looks to deliver on its promise to improve rural population health and reduce readmissions and ED visits by using targeted interventions.

At some point the promise of telemedicine will arrive for rural America, and it will look like what is happening right now at UnityPoint Health.
Over the past two years, the Quad State-area health system headquartered in Des Moines, IA has slowly rolled out an updated and enhanced remote patient monitoring program through its UnityPoint at Home division. If the program works as promised, it will reduce readmissions and ED visits, while improving outcomes and maintaining health for the chronically ill population it serves.
"When you have a remote patient monitor, the goal is to help them self-manage their chronic conditions because they are going to have it long-term," says Vicki Wildman, RN, virtual care director UnityPoint at Home.
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Precision medicine to transform health IT market in 4 ways

As genomics moves beyond the confines of academic medical centers and multi-hospital health systems, the population health needs of smaller providers should spur technology improvements on several fronts.
September 02, 2016 01:06 PM 
Fewer than one-third of healthcare providers polled for the newest HIMSS Analytics Essentials Brief are currently pursuing precision medicine initiatives – with the majority who don't saying that limitations in funding, technology or expertise are holding them back. But that's poised to change very soon.
Indeed, the places where genetic, environmental and lifestyle factors are factored into clinical treatment and disease prevention tend to be research-based organizations such as academic medical centers (35 percent), multi-hospital health systems (25 percent) or larger providers with more than 500 beds (41 percent).
But the promise of precision medicine is too tantalizing to stay so segmented, and HIMSS Analytics sees the trend shaping IT solutions in four key ways in the near future.
The report, which polled 137 professionals at AMCs, health systems and standalone hospital, sees opportunities for precision medicine integration to shape technology offerings on four main fronts.
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Study: Mobile devices, Internet help to spur healthy behaviors

Sep 5, 2016 5:00pm
Mobile devices and Internet access can help to drive heart-healthy behaviors such as eating better and being more active, new research finds, but it’s not yet clear if such behavior changes are sustainable.
The study, which evaluated 224 research efforts conducted between 1990 and 2013, was published in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association. According to the authors, a good number of research-based mHealth and Internet interventions reviewed lasted less than six months.
“Programs that have components such as goal setting and self-monitoring and use multiple modes of communication with tailored messages tended to be more effective,” lead study author Ashkan Afshin , an acting assistant professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, said in an announcement. “We also found these programs were more effective if they included some interactions with healthcare providers.”
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Home health scrutiny heating up as industry enters pre-claims review

Sep 6, 2016 4:57pm
Home health providers are facing calls for lower reimbursement along with double-digit fraud sentences as several states prepare for what one expert is calling the “chaos” of pre-claims review.
According to an op-ed published in the The National Law Review by healthcare attorney Bob Morgan, the new pre-claims review for home health providers designed to prevent fraud will cause “chaos” as new payment regulations lead to “ambiguity and confusion” regarding reimbursement requirements. Morgan notes that several questions still surround the program, including how to document a face-to-face encounter between a physician and patient eligible for home health services.
The pre-claims review program has faced resistance from the home health industry, while the Centers for Medicare & Medicaid Services' previous plan involving prior authorization drew criticism from more than 100 legislators.
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Cybersecurity Attacks Leading Large Health Data Breach Cause

By Elizabeth Snell on September 02, 2016

The past summer included several large health data breaches, with the majority of them stemming from cybersecurity attacks and unauthorized online access.

While the summer of 2016 is quickly coming to an end, covered entities and their business associates cannot ease up on their data security measures. If the past three months have been any indication, large health data breaches are not about to cease anytime soon.
Between June 1, 2016 and August 31, 2016, the Office for Civil Rights (OCR) shows that the majority of reported incidents were classified as unauthorized access or disclosure, with 28 cases being listed as such. Hacking incidents were a close second, with 25 reported incidents in the same time frame.
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MLK Jr. Community Hospital Sets Blueprint for Hospital Reboots

Scott Mace, September 6, 2016

Since reopening last year, MLK Community Hospital has been a showcase of how a safety net hospital can employ new technology and new thinking to serve a community.

In technology, too many problems often end up being solved by completely restarting a system.
In the hospital world, that's considered the last resort, but a hospital I visited last week suggests there is value in this approach when it's applied on a large scale, too—to an entire hospital.
And so it is that Martin Luther King Jr. Community Hospital, a 131-bed reboot and rethink of the old 400-bed Martin Luther King Jr./Drew Medical Center in south central Los Angeles, has become a blueprint for how to do such a restart.
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EHR Burdens Leave Docs Burned Out, in Critical Condition

John Commins, September 6, 2016

Physicians spend two-thirds of their day completing tasks on cumbersome electronic health records systems. It's a leading cause of physician burnout, research shows.

The electronic medical records that came with a promise of improving care efficiency are instead forcing physicians to spend more face time with a computer screen than with their patients.
An observational analysis and survey of 57 primary care and specialty physicians in four states that was detailed this week in Annals of Internal Medicine shows that for every hour a physician spends providing direct clinical face time with a patient, nearly two additional hours are spent on EHRs and administrative tasks.
The time it takes to record a wide array of EHR data points has become a leading factor in physician burnout, says study lead author Christine Sinsky, MD, a Dubuque, IA-based internist, and vice president of professional satisfaction for the American Medical Association.
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E-Records a Grind for Many Doctors

And this may contribute to physician burnout, study suggests
MONDAY, Sept. 5, 2016 (HealthDay News) -- The large amount of time spent on electronic health records and other clerical duties may contribute to doctor burnout, a new study suggests.
"Time spent in meaningful interactions with patients is a powerful driver of physician career satisfaction, but increased paperwork and time on the computer means less time for direct patient care," said researchers led by Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association.
For the report, 57 American physicians in four states outlined how their time was divided during and after the workday.
They spent 27 percent of their office day in direct contact with patients and more than 49 percent of their time on electronic health records and other desk work, the physicians revealed.
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Enjoy!
David.

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