Saturday, November 19, 2016

Weekly Overseas Health IT Links – 19th November, 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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Trump will face cybercrisis in first 100 days, Forrester predicts

A sophisticated cyberattack could inhibit the new President’s initial momentum for accomplishing important campaign issues, the analyst house said.
November 10, 2016 02:24 PM
If the cyberattacks perpetrated during the election cycle are any indication - DNC emails leaked, NSA exploit kits posted online and concerns the election itself would be attacked - the government is high on hackers’ hit lists. And research firm Forrester predicted that within the first 100 after taking the White House, President-elect Donald Trump will face a cybercrisis.
“The momentum of winning the election gives new presidents the public sponsorship to follow through on key initiatives of their campaigns. However, the 45th president will lose that momentum coming into office by finding themselves facing a cybersecurity incident,” the analyst firm wrote in a report.
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Following election, health IT policy picture is murky

by Dan Bowman 
Nov 9, 2016 11:22am
While Tuesday’s election results, in which Republicans retained control of the House and Senate and gained control of the presidency thanks to Donald Trump’s surprising victory, likely mean attempts to repeal and replace the Affordable Care Act are forthcoming, implications for health IT stakeholders are less clear.
Politicians who are staying put
Many lawmakers for whom health technology issues have been a priority will continue to serve, as Politico’s Morning eHealth has outlined. For instance, House members Will Hurd (R-Texas) and Erik Paulsen (R-Minn.) won re-election. Hurd has been outspoken both on issues pertaining to the Department of Veterans Affairs’ electronic health record efforts, as well as cybersecurity in the healthcare industry.
Paulsen, meanwhile, has pushed hard for repeal of the medical device tax included in the ACA.
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Trump's Impact on Health Data Privacy, Security

Experts Weigh In on Short-Term, Long-Term Implications of Election
 November 9, 2016  
The transition to a Donald Trump administration likely won't have a significant immediate impact on HIPAA enforcement or other healthcare privacy and security regulatory activity - but it could over the long haul. That's the consensus of CISOs, CIOs and other privacy and security experts who offered reactions to Trump's surprise victory in the Nov. 8 election.
The Department of Health and Human Services' Office for Civil Rights' enforcement activities will continue because "decisions concerning the enforcement of the HIPAA rules are made by career staff that will be unaffected by the change in administration," says attorney David Holtzman, vice president of compliance at the security consulting firm CynergisTek.
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Health IT stakeholders outline priorities for Trump administration

Nov 10, 2016 1:02pm
While uncertainty appears to be the predominant theme following Donald Trump’s election victory, health IT stakeholder groups already are making their priorities known regarding the incoming administration.
For instance, Robert Tennant, health information technology policy director with the Medical Group Management Association’s government affairs staff, tells FierceHealthIT that his organization plans to work closely with new leadership to try to educate it about the use of health IT to drive out needless administrative costs for providers.
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Donald Trump elected: His 7 point plan for healthcare

The president-elect promises to repeal Obamacare, hand over Medicaid reigns to state officials and allow individuals to deduct health insurance premiums from taxes, among others.
November 09, 2016 10:34 AM
President-elect Donald Trump campaigned on promises to shake up Washington, with radical ideas on immigration and trade - but that is only the beginning. He also made a big push to repeal and replace the Affordable Care Act.
His healthcare plan, released in March, focuses on seven broad bullet point measures that promise to overturn Obamacare, break down state barriers and even expand healthcare access.
1. A complete repeal of the Affordable Care Act, as no citizen should be forced to buy health insurance.
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Trump Victory Elicits Measured Response from Healthcare Leaders

John Commins, November 11, 2016

For the most part, the nation's major healthcare payer and provider associations are serving up predictable good-faith pledges to the president-elect, who has promised to upend the healthcare landscape.

One of the most contentious and shocking presidential elections in U.S. history has been greeted with safely worded platitudes by the nation's major healthcare provider and payer associations.
Republican President-elect Donald J. Trump has promised to repeal Obamacare and replace it with "something better," which could create chaos for the healthcare sector.
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Robots present a cyber risk

The security of robots lies with many in organizations

CSO | Nov 9, 2016 3:37 AM PT
The prospect of an army of robots marching in unison to launch an attack on an unsuspecting city belongs in the realm of science fiction—as do most images of menacing autonomous machines wreaking all kinds of havoc on civilization.
That’s not to say robotics is free from security and safety threats, however. In fact, experts say the growing use of robots by companies such as manufacturers, retailers, healthcare institutions and other businesses can present a number of cyber risks.
There are two primary issues related to security and robotics, says Michael Overly, a partner and information security attorney at law firm Foley & Lardner.
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Bringing the Power of Platforms to Health Care

November 10, 2016
Last month one of us (Jonathan) gave a talk at Stanford to a hall full of healthcare entrepreneurs. The comments began with a favorite quip used, to desired effect, many times over the years: “I really think…this internet thing is going to be big.” There, in the shadow of Google’s global headquarters, the audience laughed on cue, quickly grokking the embarrassing point: it’s 2016 and this $3 trillion industry that our lives depend upon still relies on faxes, clipboards, and isolated instances of legacy software locked away in hospital basements.
Despite healthcare’s remarkable track record holding out against the tides of change, there are finally holes in the dam. The healthcare internet is emerging node-by-node, provider-by-provider, and patient-by-patient. So, there’s really no longer a question of whether healthcare will join the rest of the economy and concede to the inevitable. The real question is what it will look and feel like for patients and providers once care is connected and the “network effect” begin to take hold.
It turns out we have a pretty good sense of what’s to come because we know what AirBnB has done to hotels (and homes), Waze to GPS systems and fold-up maps, and Uber to taxis. To us, these disrupters illustrate well the three dimensions of the network effect that is poised to transform healthcare: administrative automation, networked knowledge, and resource orchestration.
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New disruption comes to radiology

Published November 09 2016, 3:19pm EST
New disruption comes to radiology
Twenty years ago, picture archiving and communication systems came into healthcare and changed radiology. Film was used for display, storage and transfer, recalls Keith Dreyer, D. O., vice chair of radiology at Massachusetts General Hospital and an associate professor of radiology at Harvard Medical School.
With PACS came display monitors, storage off-site and distribution changes such as moving medical images to the Internet. The promise of PACS was that it would increase radiologists’ productivity—it takes a while to hang up 50 images of one patient and look through all the images, Dreyer notes. With PACS, productivity increased and accuracy improved, as radiologists were seeing things they never saw before on film.
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Why is telehealth still not as widespread as many think it should be? Three reasons

Lingering issues include quality of care, ethics and reimbursement
November 09, 2016 09:38 AM
Shivan Mehta, MD, director of operations at the Penn Medicine Center for Health Care Innovation, says a whole range of possible telehealth formats, including social media and text messaging, could be employed to forge an even deeper connection with underserved populations.
The advent of telemedicine has introduced an unprecedented degree of convenience and immediacy, data sharing and communications among care teams and resource availability for value-based, patient-centered care.
But ensuring uniformly high-quality telehealth requires providers, technology vendors and ethicists to address and answer some big questions about the efficacy of remote vs. in-person care, the extent to which physicians can be reimbursed for telemedicine services and the ethical standards to which telehealth should adhere.
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Global healthcare analytics market to surge to $24.6B by 2021: 5 takeaways 

Written by  Mary Rechtoris | Wednesday, 09 November 2016 17:33
From 2016 through 2021, the global healthcare analytics market is projected to grow substantially, a Reports N Reports analysis found.
Here are five takeaways:
1. The market is projected to hit $24.55 billion by 2021, increasing at a compound annual growth rate of 27.1 percent.
2. This year, the market was valued at $7.39 billion.
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The not-so-precise side of precision medicine

Two recent studies have highlighted issues related to the reliability of genetic testing, and a lack of genomic data from minority populations.
November 07, 2016 02:05 PM
The launch of the Precision Medicine Initiative in 2015, along with this year's Cancer Moonshot, have touted the promise of genomic data for population health and more personalized diagnosis. As a result, more consumers are seeking genetic testing and more researchers are contributing to these initiatives.
But the healthcare industry isn't necessarily prepared for this shift.
The popularity of genetic testing doesn't come without risks, according to Mayo Clinic's recent report, The Promise and Peril of Precision Medicine.
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Two Regenstrief innovators win AMIA's Lindberg Award for open source EHR work in developing countries

The prize recognizes technological research and innovation in informatics.
November 08, 2016 10:16 AM
Burke Mamlin, MD, and Paul Biondich, MD, of the Regenstrief Institute and Indiana University School of Medicine, will receive the 2016 Donald A.B. Lindberg Award for Innovation in Informatics from the American Medical Informatics Association for their work on open source software.
AMIA's Lindberg award recognizes individuals for technological, research, or educational contribution that advances biomedical informatics.
Mamlin, an internist, and Biondich, a pediatrician, are pioneers in the development, testing, and use of open source software to support the delivery of healthcare in developing countries. 
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Most doctors with EHRs still not taking advantage of their benefits

'Miles to go before we see and benefit from the ROI from fully interoperable digital health records.'
November 07, 2016 12:30 PM
Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control.
About 8 in 10 U.S. physicians had an electronic health records system in 2015. One-third of these doctors electronically sent, received, integrated or searched for patient health information — indicating that most physicians still aren’t using EHRs to their fullest extent. These findings come from the NCHS Data Brief from the CDC, State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015.. Only 9 percent of physicians took advantage of all four functions.
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Special Report: Electronic document management

Feature
Electronic document management systems are being used for unstructured content of all kinds – not just in hospitals, but beyond. Kim Thomas reports.
Hospitals have always required large volumes of paper to run smoothly. But storage is expensive, and paper processes are slow and inefficient.
Electronic document management solutions, which involve scanning in paper documents and storing them in an easily retrievable way, can bring huge savings in storage space and improve operational efficiency.
Until recently that was the extent of their use. As Vijay Magon, managing director of CCube Solutions says, “In the early years, people were digitising the medical record because they wanted to alleviate paper problems at the departmental level, to stop the paper record library growing.
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Pew Analysis: Despite ONC’s EHR Oversight, Patient Safety Issues Persist

November 8, 2016
by Rajiv Leventhal
According to a new analysis from the Pew Charitable Trusts, despite the Office of the National Coordinator for Health Information Technology’s (ONC’s) new regulations on electronic health record (EHR) oversight, gaps will persist that could put patients at risk.
On Oct. 14, the ONC issued a final rule that updates the ONC Health IT Certification Program which sets up a regulatory framework for ONC to directly review certified health IT products and gives the agency more direct oversight of health IT testing labs, as reported by Healthcare Informatics. According to an ONC blog post about the rule, specifically, the final rule focuses on: (1) establishing a regulatory process for the direct review of certified health IT by ONC; (2) updating ONC authorization and oversight of accredited testing labs (ONC-ATLs); (3) and making identifiable surveillance results of ONC-Authorized Certification Bodies (ONC-ACBs) available on ONC’s Certified Health IT Products List (CHPL).
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ONC to Congress: More work needed on interoperability

Published November 08 2016, 6:49am EST
While hospitals and physicians are using healthcare IT at unprecedented levels, providers must now make progress to ensure the seamless and secure flow of electronic health information that is necessary to improve patient care.
That’s the contention of the Office of the National Coordinator for HIT in its annual report to Congress.
According to ONC, interoperability is foundational to several national priorities including delivery system reform, the Cancer Moonshot, and the Precision Medicine Initiative, as well as the modernization of public health and the advancement of research and innovation.
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ONC to Congress: More work needed on interoperability

Published November 08 2016, 6:49am EST
While hospitals and physicians are using healthcare IT at unprecedented levels, providers must now make progress to ensure the seamless and secure flow of electronic health information that is necessary to improve patient care.
That’s the contention of the Office of the National Coordinator for HIT in its annual report to Congress.
According to ONC, interoperability is foundational to several national priorities including delivery system reform, the Cancer Moonshot, and the Precision Medicine Initiative, as well as the modernization of public health and the advancement of research and innovation.
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ECRI out with 10 deadly healthcare technology hazards for 2017

Annual report aims to alert hospitals to high risks so they’ll take safety measures
November 07, 2016 10:49 AM
ECRI Institute has released its 2017 list of worst technology hazards occurring today. The goal of the annual list, say ECRI leaders, is to inform healthcare facilities about important safety issues involving the use of medical devices and systems. Any of the items listed in the top 10 could be deadly, they say. The hazards range from inadequate cleaning of resusable instruments to the misuse of surgical staplers.
"Although today’s pumps incorporate features that reduce the risks of infusion errors, these safety mechanisms cannot eliminate all potential errors, and the mechanisms themselves have been known to fail," ECRI points out in its executive summary.
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Post-EHR era: Bunk buzzword or here before long?

CIOs from Healthcare IT News' Best Hospital IT Departments 2016 share their take on the fate of electronic health records.
November 07, 2016 06:30 AM
Electronic health records certainly enjoy their share of controversy and criticism. The software is hard for clinicians to use, the data therein more often than not is difficult to exchange with other systems and it appears there is little relief in sight. 
So it's not entirely surprising that even while EHRs are storming toward near-ubiquity among healthcare providers many forward-looking health IT professionals are already predicting the post-EHR era.
When Healthcare IT News interviewed CIOs whose teams won our Best Hospital IT Departments 2016 awards, we asked for their take on the future of EHRs.
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Researchers: Portal communications fail to limit phone call volume

Nov 8, 2016 10:58am
Implementation of patient portal communications did not reduce the volume of phone calls that clinic staff fielded, according to researchers from Oregon Health & Science University in Portland.
In a study published in the Journal of the American Board of Family Medicine, the researchers expected that providing portal access to patients would lessen the workload on clinic staff. To that end, they compared portal adoption rates and the number of telephone calls over time at four clinics between February and June of 2014.
Despite increased adoption rates at all four clinics, call volume increased at two of the clinics--a commercial, community-based health center; and a university-based health center. Still, call volume remained steady at the other two clinics--a rural health center and a federally qualified health center.
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ONC: Priorities shifting from HIT adoption to flow of data

Nov 7, 2016 4:42pm
The health IT landscape has evolved “dramatically” since the HITECH Act was enacted in 2009. Now, it must shift toward a focus on the flow of electronic information, according to the Office of the National Coordinator for Health IT's annual report to Congress on health IT progress.
The report, unveiled Monday, notes that with 96 percent of hospitals and 78 percent of physician offices using electronic health records, a significant majority of people have a “digital footprint” of their health and care experience. ONC now is moving toward seamless and secure data exchange, focused on three priority areas: promoting common standards, including through use of standardized, open application programming interfaces; supporting a business case for interoperability, especially through delivery system reform efforts; and changing the culture around access to information. ONC has also been working on the privacy and security of data and supporting providers who use health IT with assistance and guidance. These efforts will help to advance national priorities, such as the Cancer Moonshot, the Precision Medicine Initiative and combating opioid misuse, according to the report.
The HITECH Act requires ONC to report annually to Congress.
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Choosey moms choose more digital healthcare

November 7, 2016
Time-starved mothers value more access to digital healthcare.
That’s the conclusion of a new survey of 500 moms by Blue Cross and Blue Shield of Georgia and mobile health app developer and telehealth services provider LiveHealth Online.
The survey found that that moms are constantly looking for better and easier ways to manage their family’s health, with 100% agreeing that having round-the-clock access to a doctor would be helpful. Additionally 71% of moms surveyed reported losing more than two hours from the work/school day due to taking their child for a doctor visit.
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Tally Shows Healthcare Hacker Attacks Keep Coming

More Incidents Added to HHS 'Wall of Shame' Marianne Kolbasuk McGee (HealthInfoSec) • November 7, 2016    
A Nov. 7 snapshot of the Department of Health and Human Services' Office for Civil Rights' "wall of shame" website of breaches impacting 500 or more individuals shows a continuing uptick in reported hacker incidents compared to last year.
For instance, so far the wall of shame shows 23 hacker/IT incidents added to the HHS tally in September and October 2016, compared with eight reported during the same months a year ago. From Jan. 1 to Nov. 7, 2015, there were 51 hacker/IT incidents posted on the wall of shame, compared with 87 such breaches posted in the same period this year.
The surge in hacker attacks gained attention back in early 2015 with major breaches of several large U.S. health plans. The largest of those attacks - and still a record to date - was the hacker assault on Anthem Inc. revealed in February 2015, which impacted nearly 80 million individuals.
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Why network protection needs to evolve to keep pace with new attacks

Published November 08 2016, 2:00pm EST
It’s no longer news that hacking is the new normal.
There’s nothing alarmist about acknowledging that ransomware and Distributed Denial of Service (DDoS) attacks are becoming more acute, especially in healthcare. As ZDNet recently noted, a report from cybersecurity researchers at Kaspersky Lab revealed 2,900 new ransomware malware modifications between January and March 2016, a 14 percent jump from the fourth quarter.
As reported in Health Data Management, the fourth annual IT security study by the Ponemon Institute shows that “data breach preparedness certainly is on companies’ radar, and having a response plan in place is par for the course.” While the number of organizations with a plan increased from 61 percent in 2013 to 86 percent in 2016, some 38 percent have no set time period for reviewing and updating [their plan], and 29 percent have not reviewed or updated their plan since it was put in place.”
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MU 'Modified Stage 2' Gives CIOs Some Breathing Room

Scott Mace, November 8, 2016

Relief is welcome, but the challenges that hospital physicians face in complying with MACRA starting in 2017 will be followed by increasing demands in subsequent years.

Hospital CIOs had something to celebrate last week: a relaxation of some reporting requirements for meaningful use stage 2.
It came as a result of the release last week of the final rule for CMS's 2017 Hospital Outpatient Prospective Payment System (OPPS).
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Report to Congress

November 2016
2016 Report to Congress on Health IT Progress: Examining the HITECH Era and the Future of Health IT
This annual report is submitted pursuant to Section 3001(c)(6) of the Public Health Service Act and section 13113(a) of the HITECH Act
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U.S. CIO Tony Scott cautions about inherent threats of maximum interoperability

The Obama appointee also shed light on what’s necessary for digitizing and transforming an enterprise.
November 04, 2016 07:37 AM
PHOENIX — Tony Scott is perhaps the biggest bigwig in information technology. He is the CIO of the United States, with an office on the White House campus. He is the third CIO of the United States, appointed by President Barack Obama on February 5, 2015. When it comes to IT in the government: What he says, goes.
Scott gave a special address to attendees at the CHIME 2016 CIO Fall Forum, where he emphasized two key points about the realm of IT today: the process of digitization and the threat inherent in maximum interoperability.
Scott discussed a key matter in health IT today, which, according to him, is the threat posed by the technical paradigm of the last 40 years: maximum interoperability.
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Top health tech hazards include missed alarms, dirty devices

by Dan Bowman 
Nov 7, 2016 1:10pm
Mismanagement of medical device software could leave such technology vulnerable to cyberattacks or downtime, putting patients at risk, according to the ECRI Institute.
The issue is one of 10 included on ECRI’s latest top health technology hazards list for 2017. Listed at No. 6 , ECRI says management gaps could cause delays in identifying necessary updates, “including those that address safety concerns.”
Infusion pump errors due to overlooked safety steps topped ECRI’s list, with the organization saying that it continues to hear about instances of medical staff “unknowingly defeating” safety mechanisms in place or incorrectly programming such devices. The report notes that new “advanced safety features” of such tools has led to “implicit trust.”
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Technology boosts nursing home care, study reveals

Long-term care administrators can expect to see an even greater push to share data electronically with hospitals and other post-acute facilities,  thanks to new research out of the University of Missouri. 
The study shows that increasing information technology sophistication in nursing homes leads to improvements in healthcare quality measures.
It's a sector that hasn't seen much research about the impact of technology on patient care, likely because nursing homes do not receive the same level of investment in technology as hospitals, said author Gregory Alexander, Ph.D., RN, a nursing professor at the University of Missouri.
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Study: Dictation, natural language processing technology streamlines EHR usage

Written by Jessica Kim Cohen | November 04, 2016 | Print | Email
A study in Journal of Medical Internet Research: Medical Informatics investigated how natural language processing can be applied to EHR documentation.
Developing a new process for documentation is noteworthy for patient care, since many physicians have complained about EHRs being time consuming and inefficient. The researchers analyzed four documentation protocols to determine how documentation time, quality and usability compare between natural language processing with dictation methods and standard keyboard-and-mouse input method for EHRs.
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Medtronic agrees to share data in patient-safety effort

The Patient Safety Movement Foundation was founded four years ago by Masimo CEO Joe Kiani. 
By Joe Carlson Star Tribune
November 4, 2016 — 8:27pm
Medtronic CEO Omar Ishrak announced this week that he is joining the board of the Patient Safety Movement Foundation, which was founded four years ago by Masimo CEO Joe Kiani.
Minnesota-run Medtronic PLC and California-based Masimo Corp. are bitter rivals when it comes to selling medical devices that detect health problems by measuring patients’ blood oxygen levels in the hospital or clinic.
But when it comes to patient safety, the leaders of the two companies are now sitting at the same table to discuss how they can share de-identified patient data with each other, as well as outside researchers and entrepreneurs, to predict health problems.
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EHNAC, HITRUST Eliminate Health Data Security Redundancies

By Elizabeth Snell on November 04, 2016

The two accreditation and certification organizations recently collaborated in an effort to eliminate health data security and privacy overlap in their programs.

In an effort to help healthcare organizations cut down on certain health data security and privacy redundancies, two accreditation and certification organizations recently decided to work together on reducing costs and streamlining the processes for the healthcare industry.
Last month, the Electronic Healthcare Network Accreditation Commission (EHNAC) and the Health Information Trust Alliance (HITRUST) announced that they were collaborating to streamline their accreditation and certification programs.
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How to solve the core problem of patient record matching

Published November 07 2016, 3:28pm EST
Healthcare organizations are becoming increasingly sensitive about the problems involved in matching multiple patient identities within the healthcare system, and most solutions rely on record linkage. However, there’s another way to look at it: what we ultimately need are tools that intelligently adapt and learn variations in ID record fields, and can take advantage of all the available information to properly identify someone.
Consider what we learned in the final report on the Patient Identification and Matching Initiative sponsored by the Office of the National Coordinator for Health Information Technology (ONC). The report found health systems can achieve matching rates of 90 percent or better within a single hospital. Not bad. But the rate drops dramatically when matching records with other providers—even those using the same MDM/MPI vendor.
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Trans patients get help from afar thanks to telemedicine

November 5, 2016 Updated: November 5, 2016 4:47pm
A young doctor from Delaware with a transgender patient wanted to know how his medications for bipolar disorder would affect his hormone therapy.
The physician, still in a residency program, contacted TransLine, an e-consultation service that operates out of San Francisco’s Lyon-Martin Health Services, which serves women and transgender people.
“I’ve never done this before,” the doctor wrote. “Do you have any advice on whether I’m doing the right thing?”
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Enjoy!
David.

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