Saturday, November 26, 2016

Weekly Overseas Health IT Links – 26th 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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CIOs to Trump: Ditch Meaningful Use

Scott Mace, November 14, 2016

Healthcare CIOs describe their wishes for the incoming president. Among them: National data standards, stronger data security, and continuing efforts to advance technology.

Scuttling meaningful use for hospitals, continuing with value-based payment efforts, and using the most advanced technology available are some of the nuggets of advice some healthcare CIOs have for President-Elect Donald Trump.
"Stop MU and redirect resources focused on the program," advises Marc Probst, CIO of Intermountain Healthcare in Salt Lake City. "Any value that potentially came from MU is now over."
Probst, an original member of the Health IT Policy Committee of the Office of the National Coordinator, adds that "the check-the-box approach to HIT is severely limiting innovation, frustrating caregivers and increasing costs. [It's] time to let providers and other HIT organizations figure out for themselves how to best utilize the EMR technology and get value from their investments."
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E-discharge standards to GPs 'poor'

Ben Heather
10 November 2016
Central NHS organisations are rebooting attempts to improve communication between emergency departments and GPs, with the ‘perpetual winter’ crisis now affecting the NHS spurring new efforts.
NHS Digital has commissioned the Professional Record Standards Body, in partnership with the Royal College of Physicians, to develop standards for e-discharge summaries from emergency departments to GPs.
Standards should be finalised by the end of the year. Although they probably won’t be used in hospitals until at least October next year, those involved in the project say it is being given additional impetus by the pressing need for more information on the pressures on hospitals.
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Gareth Baxendale: can wearables count for medicine?

The head of technology for the NIHR Clinical Research Network says fitness apps are already being used to recruit people to clinical trials; but there are some hurdles to their being used in healthcare.
16 November 2016
Health wearables are now ubiquitous and are disrupting almost every field you can think of. According to sparkpe.org, even the humble school PE lesson is adopting the use of wearables to help kids appreciate the link between physical exercise and their daily lives.
So could these inexpensive, consumer focussed devices be used to inform medical professionals in a clinical setting? There is already a marked increase in their adoption for clinical trials.
A quick search of the US clinicaltrials.gov registry for Fitbit, Garmin and FuelBand will return a significant number of trials that are focussed on collecting data using consumer-level devices.
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ONC report tackles EHR drug 'pick list' errors

Nov 17, 2016 2:14pm
A new report from the ONC calls on vendors, providers and others to get involved in reducing “pick list” medication errors.
Vendors, providers and others all need to be involved in reducing “pick list” medication errors, according to a new report from the ONC.
The report, on the safe use of pick lists in ambulatory care settings, notes that pick lists, also known as drop-down menus, are “ubiquitous” features in every EHR and order entry system. While they save time and can reduce some errors, such as typographical mistakes stemming from sloppy physician handwriting, they have created new types of medication errors attributable to poor design, implementation and/or system configuration. The two general types of pick list errors are choosing the wrong patient record and choosing the wrong medication for a patient.
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Drug groups with known interactions rediscovered, new drug groups ID'd in warfarin-treated patients
THURSDAY, Nov. 17, 2016 (HealthDay News) -- Data mining can be used to discover unknown drug-drug interactions in cardiovascular medicine, according to a study published online Nov. 8 in Circulation: Cardiovascular Quality and Outcomes.
Peter Waede Hansen, M.D., from the Danish Heart Foundation in Copenhagen, and colleagues analyzed altered prothrombin time after initiation of a novel prescription in previously international normalized ratio (INR)-stable warfarin-treated patients with nonvalvular atrial fibrillation. A machine-learning method (random forest) was established to predict altered INR levels after novel prescriptions. The most important drugs from the analysis were further investigated in a new data set. A total of 220 drug groups were analyzed in 61,190 novel prescriptions.
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The Patient Portal Conundrum

Should we be encouraging all our patients to use it?

  • by Fred N. Pelzman, MD
    November 17, 2016
At our biweekly small group practice meeting (given the size of our whole practice, we are divided up geographically into what we call the Green, Red, Blue, and Purple practices), one of the interns said that he had noticed that the show rate for his patients was dramatically higher in those who were already enrolled in the patient portal. He felt it had gotten to the point that he could look at his schedule the night before, and predict that those patients inactive in the portal would no-show for their appointments the next day.
Inspired by this, he has decided to create a quality improvement project, seeking to increase the penetration of enrollment in the patient portal among the house staff patients at our practice. He will be working with our clinical IT specialist, figuring out how to develop a report to see if his perception is correct, and then figuring out how to increase/maximize enrollment of patients who have not already joined the portal.
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Simple Digital Technologies Can Reduce Health Care Costs

November 14, 2016
Businesses that are serious about reducing health care costs — and improving the health and well-being of their employees — should take a serious look at digital therapeutics, which have the potential to provide effective, low-cost ways to prevent and treat chronic diseases and their consequences. Digital therapeutics are technology-based solutions that have a clinical impact on disease comparable to that of a drug. They primarily use consumer-grade technology such as mobile devices, wearable sensors, big data analytics, and behavioral science and can be delivered through web browsers, apps, or in conjunction with medical devices. They can also be deployed in real time and at scale, which is critical for intervention in chronic diseases.
These broad applications now include artificial-intelligence-driven smartphone apps that monitor patient activity and social interaction to detect and intervene in episodes of clinical depression, pills with ingestible embedded sensors that can tell patients and doctors whether a medication has been taken properly, and asthma inhalers that connect with networks of air-quality sensors to provide personalized feedback on the connections between patient behavior and environmental factors. (Full disclosure: One of us, Joseph Kvedar, is an advisor to several companies involved in the digital therapeutics space, including Claritas Mindsciences, Mavericks Capital, PureTech, and MD Revolution.)
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Why interoperability is becoming more important in radiology

Published November 18 2016, 3:44pm EST
This year, at RSNA 2016, radiologists are invited to think “Beyond Imaging” and “explore new ways to collaborate.”
As I think beyond exciting new imaging capabilities, such as knife-edge scans that build the 3D image of an anatomical slide and molecular imaging probes, I am equally excited about advances in interoperability, mobility and analytics. These advances together will truly transform how radiologists and other clinicians work, and work together.
Sure, the end-goal vision remains ambitious: a 360-degree, longitudinal patient health record that is continuously updated and captures all of the patient’s medical history, including diagnostic images. A record that can be securely accessed and amended by authorized members of the clinical team, anywhere and anytime.
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Medical records

Patient revolution

The public get the chance to manage their own medical files

Nov 19th 2016
THE news that someone in the National Health Service on November 14th had e-mailed all 1.2m employees, leading the entire system to crash as people clicked “reply all” to complain, will not have surprised those who have followed the woes of IT in the NHS. Efforts to reform the service’s technology, and to manage data generally, have proved as embarrassing as the system itself. “Connecting for Health”, an attempt to impose a national IT system, had to be scrapped in 2013, at a cost of £10bn ($12bn). Care.data, a recent initiative to copy records from local surgeries to a central database, has also been abandoned, wasting £8m. Although people shop and bank on the internet, most do not yet manage their health care online.
Now, in search of efficiencies and realising its approach to IT is floundering, the government is trying to allow a more bottom-up approach. Since last year, all general practitioners (GPs, or family doctors) have been obliged to allow patients to view their medical records online. From 2018 the same will be true for hospital records. Some private software companies are also stepping in to push for change.
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55 top HIT and healthcare experts you should follow on Twitter

Published November 17 2016, 5:00am EST
Leading tech experts share their expertise on Twitter
Social media has transformed the ability of those with expertise to share their views on recent events with a larger audience. Nowhere is this more true than on Twitter, which attracts millions of visits per day. Healthcare technology and IT experts are among those who frequently offer their slant on the news of the day.

This is the second effort by Health Data Management to identify HIT and technology experts who are among the most influential on Twitter. Results are ranked by the number of followers each had in early November, with our last review occurring on November 15, 2016. Of course, the number of followers can change daily on Twitter.
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Months after IT crash, Leeds still using paper for tests

Ben Heather
16 November 2016
One of Europe’s biggest teaching trusts is still relying on paper and phones for parts of its pathology service two months after a major IT crash.
On 16 September, a hardware failure at Leeds Teaching Hospitals NHS Foundation Trust triggered the failure of its pathology system.
The failure lead to major delays in processing of test results, including routine blood tests, and the postponement of 147 non-urgent procedures.
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Digital patient tech may not save money - Nuffield report

Lyn Whitfield
17 November 2016
Politicians and policy makers should not assume that digital patient technologies will produce big savings, particularly in the short-term, the Nuffield Trust has warned.
In a review of technologies including wearables, symptom checkers, remote consultations, access to records, and apps, the think-tank says “technologies that patients can use offer some of the brightest hopes on the NHS horizon.”
However, its lead author, Sophie Castle-Clarke, added: “There is still a lot we don’t know. Without regulation, and a careful look at the evidence – not all of which is compelling – these digital tools could compromise the quality of care and disrupt the way care is provided.”
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Dallas: telehealth’s reboot reviewed

Whatever happened to the massive and well-funded Delivering Assisted Living Lifestyles at Scale programme, and did it deliver any results? Laura Stevens sets out to find out.
10 November 2016
When the Whole System Demonstrator project failed to deliver the business case for telehealth, the government decided to try again with the Delivering Assisted Living Lifestyles at Scale programme.
This massive, well-funded, three-year programme finished last year, and has been slowly publishing its findings. An online resource carries evaluations by the University of Glasgow and research on the potential for business from Databuild Research and Solutions.
The main evaluations focus on the two city-wide projects that were run, on the difficulty of getting these working in a multi-agency environment, on information governance and interoperability challenges, and on academic debates about how to gauge the value of this kind of intervention.
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Ransomware attacks to quadruple in 2016, study finds

Health data breaches caused by unintended disclosure are up sharply as well, according to a new report.
By Bill Siwicki November 16, 2016 06:29 AM
Based on the trends from the first nine months of 2016, the number of ransomware attacks this year will be four times higher than last year, according to data from Beazley, a data breach response insurance company.
Ransoms sought from targeted companies remain low, often in the region of $1,000; however, a ransom is not the only cost incurred by a company that suffers such an attack, Beazley said. For example, after a ransomware attack, typically an extensive review of company systems and data is required to ensure that the malware has been removed and data is clean.
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AMA adopts principles for use of mHealth apps

Nov 17, 2016 10:22am
The American Medical Association has released a new guidance promoting clinical mHealth apps that support patient-centered care delivery, care coordination and team-based communication. The AMA adopted them during its recent interim meeting.
“The new AMA principles aim to foster the integration of digital health innovations into clinical practice by promoting coverage and payment policies that are contingent upon whether mHealth apps and related devices are evidence-based, validated, interoperable and actionable,” said Steven J. Stack, M.D., AMA's immediate past president, in an announcement.
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Telemedicine best practices from Mass General

by Aine Cryts 
Nov 17, 2016 11:42am
Identifying the target patient population is key to a successful telemedicine practice.
There are many good reasons to launch telemedicine programs—including expanding a patient's access to care and reducing costs—but physicians who have the most effective practices target specific patient populations.
That was just one of the telemedicine success tips that Sarah Sossong, director of telehealth at Massachusetts General Hospital, shared this week at the American Heart Association's Scientific Sessions in New Orleans, as reported by Medical Economics.
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Mayo Leaders Call For New Health Records Standards

They say benefits from sequencing genomes can’t be widely applied without changes.

November 16, 2016
The promise of tailoring medical treatments to patients’ individual genomes is huge, but can’t be widely applied until medical records are standardized to cope with the massive amounts of data generated by genome sequencing. That’s according to leaders of the Mayo Clinic’s precision medicine efforts.
Work now being done by Mayo and others has brought us to the brink of having genetic information about patients available to caregivers at the bedside, where they can use it to tailor day-to-day decisions about what kinds of drugs would best benefit them against cancer and many other ailments.
But because there are few standards for representing those complex datasets on electronic health records (EHRs), the goal of applying precision medicine on a large scale will be hard to reach unless major changes are made in how those health records are kept.
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40% of healthcare breaches caused by unintended disclosure, says Beazley report

Written by Jessica Kim Cohen | November 16, 2016 |
The most commonly cited cause of healthcare breaches is unintended disclosure, according to a Beazley survey of its cases in the first three quarters of 2016.
Beazley — a London, U.K.-based cybersecurity insurance company with offices in Asia, Australia, Middle East, South America and the United States — has noticed an increase in unintended disclosure incidents, which sat at only 28 percent in the first three quarters of 2015. The company credits this trend with the large amounts of data healthcare facilities share between organizations.
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Managing authentication in a world of fraud: It takes more than passwords

Reliance on user IDs and passwords has put many organizations in a bad place. But more complex, secure and usable solutions exist to ensure individuals accessing a system are indeed who they say they are, says cybersecurity expert Mansur Hasib.
November 15, 2016 12:10 PM
Cybersecurity expert Mansur Hasib says that healthcare organizations need to look for more complex security solutions but also be sure not to ignore usability. 
Healthcare organizations are increasingly the targets of malicious hackers and that means healthcare executives must first and foremost make sure that the individuals they are allowing to access their data are indeed the individuals they say they are. Today, it’s not too difficult for a hacker to masquerade as a legitimate user in order to gain access to confidential and valuable information.
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AHA cardiology event: Health IT's impact on the Triple Aim

Nov 16, 2016 10:05am
Healthcare providers must encourage patients to take charge of their health by engaging with them through technology, according to Maulik D. Majmudar, M.D., clinical cardiologist and associate director of the Healthcare Transformation Lab at Massachusetts General Hospital in Boston.
Majmudar spoke at multiple events during the recent American Heart Association Scientific Sessions in New Orleans this week.
 “To get to the Triple Aim and do it in a cost-effective way, we need to leverage technology like mobile applications and wearable devices to monitor people in their own environments; when they are not in front of their doctor or in the hospital, which is 99.9 percent of the time,” he said, according to a report in Medical Economics.
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UCSF puts machine learning in clinicians' hands

Nov 16, 2016 4:52pm
The University of California San Francisco will put machine-learning capabilities in the hands of clinicians under a program that will allow them to access actionable data and images with greater speed, said Michael Blum, M.D., associate vice chancellor of informatics at UCSF, in an announcement.
“There’s tremendous opportunity to look at large datasets, like medical images, to predict how patients will do,” Blum told FastCompany.
The aim is to help clinicians use data in a way that helps them treat common and complex conditions faster and more effectively. Radiologists in particular could benefit from integrated data collected from imaging technologies already in use, such as CT scans, MRIs and x-rays, the announcement says.
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Is information blocking finally on its last leg?

Published November 16 2016, 3:39pm EST
Healthcare industry market analysts, technology gurus and IT reporters sometimes like to envision a powerfully capable future in which software architectures are open, small application developers are thriving and healthcare IT solutions from numerous sources create a confluence of patient data that will advance healthcare quality.
A survey organized by the California Health Care Foundation and Health 2.0 suggests we may be far from that ideal.
In a nutshell, the survey of more than 100 small healthcare IT companies tells us this:
  • Information blocking is a real thing, although it’s not always the fault of big EHR vendors and there is broad variation in the degree of blocking by individual companies.
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Commentary: Trump must respect the value of health IT as U.S. President

Obama's Precision Medicine Initiative and Biden's Cancer Moonshot deserve to continue, too. 
November 14, 2016 06:53 AM
Donald Trump has been president-elect for less than a week. What we can expect from him once he's handed the reins of power on Jan. 20, 2017, is anyone's guess.
Whether Trump follows through on some of his bolder healthcare-related proclamations will be seen in the months ahead. At a minimum, he seems likely to make good on his promise to repeal the Affordable Care Act. He has also pledged to tear down state barriers for health insurance and allow people to deduct insurance premium payments from taxes.
However Trump's health policy eventually plays out, the results of a post-election day snap poll on HealthcareITNews.com showed deep skepticism among our readers about what a "megalomaniac with a wrecking ball mentality" might do to a U.S. healthcare system that, for all its faults, has been working in earnest to improve itself over the past decade-plus.
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Great Lakes Health Connect HIE improves hospital services

Nov 15, 2016 11:15am
Sharing information across hospitals in real time is offering hospitals access to much-needed patient data.
Doug Dietzman, executive director at Great Lakes Health Connect, a Michigan health information exchange, told Hospitals & Health Networks that a hospital was able to detect that a patient in the ER who just requested a series of services and tests had actually been to another hospital a few minutes down the road just one hour earlier.
As a result, the hospital did not perform care that would eventually go uncompensated, and further, the hospital was able to assemble the behavioral health resources for this person who was visiting two ERs in under an hour, he said in the video interview.
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IT Exec to EHR vendors: We need these 7 features to put genetic data to work at the point of care

Penn Medicine’s Brian Wells puts out a call to technology companies to incorporate new functionalities that could vastly improve how physicians personalize care and eradicate killer diseases. 
November 14, 2016 07:24 AM
The healthcare industry is experiencing an explosion of demand for new technologies designed to help patients and clinicians understand the value of leveraging genetic data to more precisely diagnose, prevent and treat disease. 
From cancer to cardiology, discoveries are made monthly that tie specific inherited genes (germ line) to disease or identify genetic mutations in tumor cells (somatic) that would enable certain drugs or treatments to destroy those cells. 
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8 Steps to Developing a Health IT Security Training Program

This year, Verizon released a "Data Breach Investigations Report" and noted that healthcare data breaches were most likely to be caused by human error. In its analysis of 2015 breaches, Verizon identified the following as significant contributors:
• Lost and stolen assets, such as laptops and smartphones;
• Sending sensitive information to the wrong person;
• Use of weak, default or stolen passwords; and
• Opening malicious attachments or nefarious links in an email.
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Health Technology And Human Touch Need Not Be At Odds

November 15, 2016
In the October issue of Health Affairs, Abraham Verghese had a wonderful essay about the practice of medicine entitled “The Importance of Being,” in which he straightforwardly states: “I want to teach the art of being present.” He aptly points out that, as physicians, “we are chained to the [electronic] medical record, and every added keystroke adds another link in the chain.” He calls for us to break that chain. Indeed, the intrusion of health information technology has led to a serious erosion of doctor-patient communication during visits, often with frank dissociation between both. But, as Dr. Verghese points out, what patients really want and need is for their doctors to be present, listening, caring, and totally connected with them during an encounter. Most doctors would like that, too. That’s why they went into medicine in the first place, not to type on keyboards or keep their eyes peeled on electronic screens. The last two words of Verghese’s piece nailed the essential missing component: Presence. Period.
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Increased Focus on Computer based Quality Measurement Negatively Affects Clinical Workflows and Patient-provider Interactions

The slow, but steady, move from fee-for service to pay-for-performance payment models in health care has given rise to more EHR-based clinical quality measurement. This push for quality measurement has necessitated an increased need for capturing complete, accurate, structured data that can easily be extracted, aggregated, and reported to administrators, quality oversight organizations (e.g., University Health Consortium), and payers – both public and private. The need to capture structured data items such as “smoking status” [47], “pain scores” [48], venous thromboembolism prophylaxis, and documentation of the need for patient restraints every 24 hours has led to many convoluted clinical documentation workflows [49]. These new workflows are not only changing the way clinicians perform their work, but they are potentially interfering with their diagnostic and therapeutic critical thinking tasks leading to serious, preventable, adverse events [50], as well as having a negative impact on patient-provider interactions at the point of care [51].
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Keys to Interoperability May be in Consumers' Hands

Scott Mace, November 15, 2016

Making patients the stewards of their own health data could result in better access, despite a business environment where health systems do not make sharing a patient's data with each other a top priority.

The barest outlines of the Trump Administration's healthcare policy were not yet clear on the morning after Donald Trump's upset presidential victory, but the CIO of a New York City health system was already looking forward to resolving issues unresolved by the election.
"If we were all on a common shared data platform and could easily access one another's patient data, I think we would do a much better job of keeping people healthy," said Daniel Barchi, senior vice president and chief information officer of New York Presbyterian Hospital in New York.
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Medical devices pose weak link in preventing cyber attacks

Published November 14 2016, 6:52am EST
For many users of Johnson & Johnson’s OneTouch Ping insulin pump, the benefit of ease of use has been outweighed by the fear of hacking.
In early October, the company sent letters to patients using the devices, alerting them to the fact that the OneTouch contained a cybersecurity flaw that could allow a hacker to reprogram the device to administer additional doses of the diabetes drug, which could be life-threatening.
In its letter to patients, Johnson & Johnson portrayed the risk as minimal. “The probability of unauthorized access to the OneTouch Ping System is extremely low,” it noted. “It would require technical expertise, sophisticated equipment and proximity to the pump.”
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What C-suite execs expect to happen in healthcare when Trump takes over as President

Survey responses range from massive disruption to more competitive markets. Hospital leaders are hoping that prices go down but alternative payment models MACRA, MIPS and the Medicare Shared Savings Program remain.
November 11, 2016 07:18 AM
Everyone in the healthcare industry is wondering how President-elect Donald Trump’s campaign promise to repeal and replace the Affordable Care Act will actually play out when he moves into the White House.
It’s starting to look like ending Obamacare, whether via formal legislative action or budget reconciliation, is legitimately possible.
But how will that happen and what comes next?
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Digital health tech prospects under a Trump administration

Nov 14, 2016 10:14am
With a full sweep of the House, Senate and White House, Republicans have the long-sought political capital to overturn the Affordable Care Act, and the new policy universe may have serious effects on investment in digital health.
New regulations that place a greater burden of healthcare’s financial risks on consumers may spur a wave of investment in digital health technologies, HIT Consultant reports.
The article cites several areas that could be fertile ground for investment dollars, including:
User-facing technologies, as consumers are poised to spend limited dollars to buy health plans on the open market – meaning “they will need help, in much more significant ways than exist now in shopping for care,” the article notes.
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3 lessons CIOs can take from the Ebola outbreak

Nov 14, 2016 1:49pm
The World Health Organization's new CIO says that when a healthcare crisis hits, CIOs must act as agents for change.
When a healthcare crisis hits, CIOs must act as agents for change, something the World Health Organization's new CIO learned very quickly. 
During his first three months on the job, Marc Touitou had to get a grip on the West Africa Ebola outbreak and use his IT skills to help prevent its spread.
“My first 100 days was Ebola, and nothing prepares you for that. You have a new reality,” Touitou said during an interview with ComputerWeekly.
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Survey: 63% of healthcare organizations leverage mobile apps for internal productivity

Written by Jessica Kim Cohen | November 11, 2016 |
In 2016, 82 percent of healthcare organizations had a fully implemented mobile strategy, according to a Red Hat survey, commissioned with Vanson Bourne.
The survey includes responses from 200 IT leaders in public healthcare, private healthcare, life sciences and pharmaceutical organizations, including organizations in the United States, France, Germany and the United Kingdom.
Here's what you need to know about responses from IT leaders in the United States.
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Enjoy!
David.

1 comment:

Bernard Robertson-Dunn said...

Extracting just one quote from the cornucopia of reports David has accumulated, this should inform responses to this week's poll.

'However, the Nuffield Trust notes: “At the moment, we are lacking robust evidence about the impact that many technologies will have, and in what context. In particular, the potential impact on health outcomes, and to a less extent demand, remains somewhat unclear from a range of technologies.”

The think-tank says research effort should be put into particularly promising areas, such as self-triage, online access to records, and remote consultations.'

Digital patient tech may not save money - Nuffield report
http://www.digitalhealth.net/digital_patient/48289/digital-patient-tech-may-not-save-money---nuffield-report

It would seem that ADHA's strategy should be strongly research based, not on unproven, unjustified IT solutions.