Saturday, December 17, 2016

Weekly Overseas Health IT Links – 17th December, 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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Commonwealth Fund, others offer 'playbook' for treating patients with complex needs

Five foundations assess scope of difficulties and offer new approaches to address hurdles patients encounter on the way to recovery.
December 09, 2016 02:14 PM
"Our research shows that when people with complex needs require medical help, they encounter a health care system that's expensive, inefficient and poorly coordinated," said David Blumenthal, MD, president of The Commonwealth Fund.
The results of a nationwide survey of patients with complex medical needs released December 9 by The Commonwealth Fund, shows that the healthcare system is failing them.
The results of the survey are bleak. It reveals that of those patients with a complex medical history:
  • Nearly half (47 percent) visited the emergency department multiple times in the past two years.
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CMS to test two models to boost patient engagement

Dec 9, 2016 11:30am
The government agency will test new models for patient engagement.
What’s the best way to get patients involved in their own healthcare? CMS is launching two new models to help determine what works best when it comes to encouraging shared decision-making between doctors and patients.
The two models from the CMS Innovation Center, which will test patient engagement both inside and outside the doctor’s office, will soon be tested by the Centers for Medicare & Medicaid Services, according to a blog post by Patrick Conway, MD, CMS’ principal deputy administrator and chief medical officer, and Andy B. Bindman, MD, director of the Agency for Healthcare Research and Quality (AHRQ).
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UC San Diego Health Offering EHR, iPad Access to Patients

December 8, 2016
by Rajiv Leventhal
Patients at the recently-opened Jacobs Medical Center at UC San Diego Health can be in more command with their own experience by assessing their own medical information, controlling room features and more.
Officials of UC San Diego Health noted in an announcement that with a swipe and tap of an iPad, patients at Jacobs Medical Center can be in command of their own experience by controlling room temperature, lighting, accessing their personal medical information, details on their patient care team and entertainment options all from their beds.
“By adding connectivity in every patient room, each person can take control of their hospital experience from regulation of their environment to connecting online with friends and family for support,” Thomas J. Savides, M.D., chief experience officer at UC San Diego Health, said in a statement. “Patients also see portions of their electronic medical record to help them understand their progress and anticipate daily events. We hope that feeling in control will aid in the healing process.”
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Could a Computer Someday Guide Breast Cancer Care?

'Watson Oncology' agreed with doctors 90 percent of the time in many cases, study finds
By Dennis Thompson
HealthDay Reporter
FRIDAY, Dec. 9, 2016 (HealthDay News) -- An artificially intelligent computer system is making breast cancer treatment recommendations on a par with those of cancer doctors, a new study reports.
The IBM computer system -- called Watson Oncology -- made treatment recommendations that jibed nine out of 10 times with those of a multidisciplinary board of doctors at a top cancer hospital in India, researchers say.
In cases involving more complex cancers, however, the computer did not hit that 90 percent mark.
Another version of Watson famously defeated two former winners on the game show "Jeopardy!" in 2011, winning a first-place prize of $1 million.
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NHS Digital sees off patient privacy challenge

Ben Heather
6 December 2016
NHS Digital has seen off a challenge to the way its anonymises millions of patients’ data, with a verdict finding the practice is in keeping with national guidelines
The Information Commissioner’s Office has not upheld a complaint from privacy group MedConfidental, which challenged the way NHS Digital anonymised Hospital Episodic Statistics.
The group complained this data, which is provided to dozens of companies and non-NHS organisations, was only pseudonymised, and the identity of patients could be uncovered and their privacy breached.
This meant NHS Digital’s pseudonymising practices did not meet the ICO’s Anonymisation Code of Practice, MedConfidential argued.
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Center for Internet Security expert offers a simple equation to manage cyber risk

'No matter what, you cannot take your vulnerability to zero,' says former NSA agent Tony Sager.
December 06, 2016 11:50 AM 
BOSTON – Tony Sager, senior vice president at the Center for Internet Security, promised to help simplify security – if not necessarily make it easy – at the HIMSS Health Privacy Forum on Tuesday.
Sager, who spent nearly four decades at the National Security Agency before he joined CIS, offered an equation to help put the situation in perspective: Risk = vulnerability, threat, consequence / controls.
In other words, an organization's cyber risk is a function of the vulnerability of their systems, the volume and variety of security threats and the consequence of an attack or breach – weighed against the strength of the organization's controls, what it can do about it.
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10 outdated security tools that need to be replaced

Among the items in the ‘security graveyard,’ Intermountain CISO Karl West included flat networks, SOC-less security and compliance-only security.
December 06, 2016 02:51 PM
Healthcare security is in constant flux. While most organizations recognize the need to involve multiple departments in the security discussion, security work was frequently designated to just one or two people in the past.
On Tuesday, Karl West, Salt Lake City-Intermountain Healthcare CISO broke down the 10 outdated security tools (and viewpoints) used in healthcare and how organizations can replace them.
1. Simple Passwords: Passwords like ‘MD’ or ‘1234’ have gone by the wayside. Passwords (hopefully) have increased in complexity, like 8 to 12 characters and special symbols.
2. Password only: Organizations need to move the single password mentality. West recommended multi-factor authentication, as passwords and PINs are no longer secure.
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APIs can unlock health information for patients

Dec 8, 2016 12:02pm
Already widely used in the banking and credit card industries, APIs could allow patients to easily access digital medical records.
Technology that allows consumers to withdraw money from any ATM in the world could also be the key to giving patients better access to their health data.
Application program interfaces (API), which facilitate secure information transfers between computer programs, are poised to take on a greater role in healthcare, according to researchers at The Commonwealth Fund. Already widely used within the banking and credit card industries, API technology would allow patients to easily access digital medical records and improve interoperability between different healthcare providers.
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Research of mHealth Apps Reveals Significant Gaps in Quality

December 7, 2016
by Rajiv Leventhal
An evaluation of 137 patient-facing mobile health (mHealth) apps revealed subpar findings, including that few apps address the needs of the patients who could benefit the most, according to research in December’s issue of Health Affairs.
Researchers from University of Michigan Medical School, the Department of Medicine at Brigham and Women’s Hospital, and elsewhere noted that key stakeholders, including medical professional societies, insurers, and policy makers, have largely avoided formally recommending apps, which forces patients to obtain recommendations from other sources. As such, the researchers evaluated apps that were intended for use by patients to manage their health, that were highly rated by consumers and recommended by experts, and that targeted high-need, high-cost populations.
They found that there is a wide variety of apps in the marketplace but that “few apps address the needs of the patients who could benefit the most. “We also found that consumers’ ratings were poor indications of apps’ clinical utility or usability and that most apps did not respond appropriately when a user entered potentially dangerous health information. Going forward, data privacy and security will continue to be major concerns in the dissemination of mHealth apps,” the researchers stated.
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Unisys launches new technology to stop cybercrime in its tracks

Built-in analytics, visualization and micro segmentation are key
December 06, 2016 10:24 AM
Unisys President and CEO Peter Altabef says his company is committed to tightening digital security.
Unisys Corporation today launched Unisys Stealth, a software application aimed at helping organizations ward off cybercrime.
The application makes it easier for organizations to deploy enterprise-wide, micro-segmentation security across extended networks. Unisys executives say it can be done with “the touch of a button.”
Built-in analytics and visualization provide immediate insight into security risk for automatic configuration and deployment of the technology, they add.
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ONC expects mission will continue during Trump presidency

Published December 07 2016, 7:03am EST
The Office of the National Coordinator for Health IT expects to weather the political changes resulting from a new Trump administration and the 21st Century Cures bill, expected to be signed into law soon.
The ONC is currently led by National Coordinator Vindell Washington, MD, ascending to the position in August—his position is appointed and could change under the new administration.
Speaking at Tuesday’s joint meeting of the Health IT Policy and Standards Committees, ONC’s Deputy National Coordinator Jon White, MD, reassured its members that while “there is an upcoming change in administration,” the statutory mission of ONC is firmly entrenched.
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21st Century Cures Act passes Senate; Barack Obama expected to sign wide-ranging healthcare bill into law

Dec 7, 2016 2:10pm
The Senate approved the 21st Century Cures Act Wednesday afternoon in a majority vote. President Barack Obama could sign it into law as early as tomorrow.
The final vote was 94 to 5. 
The act covers a broad range of medical reforms and innovations, including fixes to the Food and Drug Administration’s process for approving drugs, funding for the “Cancer Moonshot” and precision medicine initiatives, and expanded access to mental health services.
It also aims to support health information technology goals, including electronic health record interoperability and data privacy and security.
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IHI 2016: EMRs 'a 4,000-click-a-day problem,' says Verghese

Dec 7, 2016 12:13am
ORLANDO, Fla.–Technology has advanced medicine in many ways, but it has also led physicians to focus more on data than patients, said best-selling author Abraham Verghese, M.D.
Verghese, the keynote speaker Tuesday at the Institute for Healthcare Improvement’s 28th annual National Forum on Quality Improvement in Healthcare in Orlando, Florida, said physicians’ attention has been diverted and patients suffer as a result.
Patients don’t like it when doctors break eye contact with them, said Verghese, senior associate chair, Stanford University School of Medicine. They want to feel like their doctors are paying attention to them.
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Why implementing EHR systems still is fraught with risk

Published December 07 2016, 3:15pm EST
The often-cited challenges to the implementation of electronic health record systems are not what healthcare providers say they are.
That’s the finding of researchers from Johns Hopkins University’s Bloomberg School of Public Health who analyzed data from the American Hospital Association (AHA) Annual Survey Information Technology Supplement.
“Many people were saying that the biggest challenges to EHR adoption were the purchase price and meeting the Meaningful Use requirements,” says Eric Ford, professor and associate department chair at the Bloomberg School of Public Health. “While those are the most common concerns, that doesn’t necessarily mean they’re the greatest concerns in terms of being actual challenges.”
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Strong Cybersecurity Measures Need Security in IoT Devices

By Elizabeth Snell on December 05, 2016

NIST released guidelines on cybersecurity measures for IoT and why an engineering-based approach building security systems directly into IoT technology is needed.

The National Institute of Standards and Technology (NIST) recently published guidelines on how organizations can utilize cybersecurity measures for IoT devices, and underlined the importance of ensuring that security systems are built directly into IoT technology.
Systems Security Engineering: Considerations for a Multidisciplinary Approach in the Engineering of Trustworthy Secure Systems explains that the need for trustworthy and secure systems has become stronger as the cybersecurity threats continue to evolve.
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Healthcare Cloud Becoming Critical IT Infrastructure Tool

By Elizabeth O'Dowd on December 05, 2016

Healthcare organizations are embracing the cloud and no longer hesitant to trust cloud security as a recent HIMSS study points to future healthcare cloud dependence.

Healthcare organizations are increasing their dependence on cloud technology as It decision-makers are putting more trust in the cloud.
The HIMSS Analytics 2016 Cloud Survey cites the strategic benefits of the cloud eclipse the previous security reservations. Healthcare organizations are generally rolling out cloud deployments first on back office applications, with plans to expand to analytics and patient facing apps. HIMSS analysts predict that cloud will become a mission-critical tool for all healthcare IT infrastructure incentives.
According to the survey, the use of cloud computing in the healthcare setting has tripled since 2014 due to the different ways organizations are leveraging the technology. In 2014, cloud was seen primarily as a way to support health information exchange (HIE) and store data, but in 2016, organizations are implementing the cloud for application development, patient engagement, and more.
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IoT threatens patient safety, but regs could stifle innovation

Dec 6, 2016 9:15am
Connected devices powered by the Internet of Things is vulnerable to hackers, malware and other privacy and security threats.
The rise of connected devices in healthcare and the Internet of Things (IoT) might help improve patient care by making data-sharing easier, but it could also put patients in danger.
While many are calling for more government oversight and regulation in the area, others warn that could stifle innovation, according to an MIT Technology Review article.
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Futuristic tech could extend lifespans, improve care quality

Dec 6, 2016 11:34am
Technology—from nanotech to DNA-fueled precision medicine to the much-hyped Google Glass—could extend human life expectancy into the triple digits, says Nicole Sirotin, chief of the internal medicine department and director of the executive health program at Cleveland Clinic Abu Dhabi.
Patients could soon be issued "insideables," chips planted just under the skin, and "ingestibles,” tiny sensor pills. A "health check chair" could bolster efficiency by automatically and simultaneously checking patients’ vital signs while they sit, Sirotin writes in an opinion piece in The National.
“Medical staff, especially trauma specialists, can use head-mounted Google Glass technology to have hands-free access to the internet and instantaneous access to patients’ medical history, medical checklists and the availability of hospital resources,” she adds.
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Most mHealth apps aren't effective for chronic conditions

Dec 6, 2016 7:30am
An explosion of new mobile health apps offers consumers an unprecedented level of choice, but clinical utility is still lacking for those with chronic conditions.
Although there is a rapidly growing market of mHealth apps targeting high-cost, high-need health conditions, the majority of those apps are unable to go beyond a basic level of patient engagement that would be clinically effective in helping consumers manage specific chronic illnesses, according to a study published in the December issue of JAMA.
Of the 137 mobile health apps evaluated by researchers targeting illnesses such as diabetes, hypertension, obesity, arthritis, and depression and bipolar disorder, very few offered functionalities like providing guidance based on user-entered information or rewarding behavior changes. Researchers also discovered that user ratings offer a poor indication of the apps clinical impact, an indication that patients and clinicians value certain functionalities differently, and echoing previous findings that app reviews aren’t trustworthy.
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How data warehouses can speed identification of rare diseases

Published December 06 2016, 3:02pm EST
There are more than 7,000 rare diseases for physicians to consider when diagnosing a patient. For even the most experienced physician, this is a daunting task. This is further compounded by the fact that one in ten people have one of these diseases.
Recognizing and sifting through a plethora of signs and symptoms takes an average of seven years and seven doctors, leaving patients suffering for years from rare diseases and a lack of answers. It takes an emotional and financial toll on patients and their families as they wait, hoping for a positive health outcome.
The future demands a new approach, where phenotypic and genomic data are captured and stored in a way that is easily understood and used to make more informed decisions during patient evaluations, improving the diagnostic process of rare genetic disorders.
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27 hot health techs to watch in 2017

A look at the leading health information technologies hospitals told HIMSS Analytics they plan to buy in the next 12 months. 
December 02, 2016 02:14 PM
Laboratory-focused technologies, such as transfusion and specimen collection management systems, lab outreach services and molecular diagnostics, are seeing big upticks in purchasing plans, according to HIMSS Analytics.
Seven years since the HITECH Act's meaningful use incentives turbocharged hospitals' information technology purchasing plans, providers are still investing big money in their IT infrastructure. Having moved well beyond basic electronic health record systems, they're now looking for efficiencies in communication, data storage and security, analytics, asset tracking, bed management and more.
We consulted with HIMSS Analytics to spotlight technologies that have the greatest predicted buying activity for U.S. hospitals in the coming year.
"These are the technologies that are showing the most potential for growth for 2017," said Matt Schuchardt, director of market intelligence solutions sales at HIMSS Analytics.
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Healthcare gets a 'D' on cybersecurity report card

Dec 5, 2016 10:25am
A new report gives healthcare a "D" grade in network security.
Healthcare security professionals are less confident in their ability to assess security risk than in the past.
That’s part of the reason network security firm Tenable gave the industry an overall “D” grade on its global cybersecurity report card.
In another recent survey of healthcare public relations pros, payer and provider executives said technology catastrophes were their top concern. That's a shift from previous years, when workforce issues, physician satisfaction and medical-legal problems were top of mind.
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Nurse fired after 528 patients' records breached at Glendale Adventist Medical Center

A health-care professional at Glendale Adventist Medical Center was fired Wednesday over a privacy breach involving hundreds of patient medical records.
Glendale Adventist officials said in a statement on Friday that the protected health information of 528 patients was accessed without authorization by a hospital employee. The unauthorized access included 88 patient records from Glendale Adventist’s sister hospital, White Memorial Medical Center in Boyle Heights.
The breach was discovered during a routine security review in June and, after an investigation, the source was confirmed as an employee and not an external hack. The employee, who was terminated, was working as a per-diem nurse.
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The Situation Report: Cerner Positions Itself For EHR Deal With Veterans Affairs

Dec 1, 2016 | 12:03 pm
The technological stars may be aligning for health IT giant Cerner. And that could mean another multibillion-dollar government contract–this time with the Department of Veterans Affairs.
Kansas City-based Cerner announced this month an agreement with American Well, a telehealth technology company, to deliver a virtual health care experience within Cerner’s electronic health record (EHR) system–an industry first.
Integrating telehealth capabilities into the EHR experience puts Cerner in a highly competitive position as the VA continues to deliberate the fate of its aging VistA EHR platform. Telehealth has been a major component of VA’s efforts to improve access to care for veterans, especially for those veterans who do not live close to a VA hospital or clinic. Making the Cerner EHR even more attractive to VA is the company’s recent win of the Defense Department’s $4.6 billion EHR contract.
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Irish e-health projects target heart disease, prescriptions

GPs may soon see back of dot matrix printers
5 December 2016 | 0
An Irish-led team of researchers is working on ways of using technology to improve these numbers. The group is led by Dr Kieran Moran of Ireland’s Insight Centre for Data Analytics at DCU.
Exercise reduces the likelihood of patients dying prematurely from a cardiac event by 25%. However research has found that despite suffering a cardian event, only 10% of patients participate in a cardiac rehabilitation programme after leaving hospital.
“While patients tend to be aware of the benefits of exercise there are a number of barriers for people who want to exercise after a cardiac event,” said Dr Moran. “They not only have the usual barriers such as time constraints and ‘exercising takes effort’, that we all have, they also cannot find classes relevant to them. They want to exercise with others recovering from the same condition and often feel that they won’t be able to do the exercises. The use e-health and other technological solutions may offer an alternative.”
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Grab Bag Of Goodies In 21st Century Cures Act

By Sydney Lupkin and Steven Findlay December 2, 2016
A sprawling health bill expected to pass the Senate and become law before the end of the year is a grab bag for industries that spent plenty of money lobbying to make sure it happened that way.
Here are some of the winners and losers in the 21st Century Cures Act:
Winners
Pharmaceutical and Medical Device Companies. The bill will likely save drug and device companies billions of dollars bringing products to market by giving the Food and Drug Administration new authority and tools to demand fewer studies from those companies and speed up approvals.
The changes represent a massive lobbying effort by 58 pharmaceutical companies, 24 device companies and 26 “biotech products and research” companies, according to a Kaiser Health News analysis of lobbying data compiled by the Center for Responsive Politics. The groups reported more than $192 million in lobbying expenses on the Cures Act and other legislative priorities, the analysis shows.
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21st Century Cures Act May Reduce HIT Regulatory Burden

Scott Mace, December 6, 2016

Legislation on its way to the U.S. Senate offers a possible path toward solving the patient ID problem.

Last week's passage of the 21st Century Cures Act in the U.S. House of Representatives may result in reduced regulatory burdens for providers struggling to comply with meaningful use and other health IT-related requirements.
The bipartisan legislation is expected to pass the Senate this week and head to President Obama's desk for a promised approval.
It directs the Department of Health and Human Services to create a report outlining how the department could reduce regulatory and administrative burdens, says Leslie Krigstein, vice president of congressional affairs at College of Healthcare Information Management Executives (CHIME).
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21st Century Cures Act Could Have Big Tech Impact

Ken Terry
December 05, 2016
The 21st Century Cures Act, which the US House of Representatives adopted by an overwhelming vote last week and which is expected to pass the Senate and be signed by President Obama, has major implications for the future of health information technology. Not only does the legislation take a strong stand against "information blocking" by electronic health record (EHR) vendors and healthcare providers, but it also mandates the use of new methods of exchanging data between disparate EHRs.
Within 1 year after the bill's passage, the US Department of Health and Human Services (HHS) will have to require EHR developers to attest, as a condition of product certification, that they have not and will not engage in information blocking. The measure defines information blocking as practices that restrict authorized access, exchange, or use of information for treatment and other permitted purposes.
The HHS Office of Inspector General will be responsible for enforcing the prohibition against information blocking. Beyond the threat of decertification, "developers, networks and exchanges" found guilty of these practices will be fined up to $1 million per violation.
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U.S. healthcare spending skyrockets to $10K per person

Dec 5, 2016 10:38am
A new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services and published by Health Affairs indicates that healthcare spending has exploded, reaching $3.2 trillion in 2015. Photo credit: Getty/MrLonelyWalker
The rising cost of private health insurance, hospital care, physician and clinical services, and prescription drugs are a few reasons that in 2015 healthcare spending in the United States grew at a rate of 5.8% and reached $3.2 trillion.
Those figures equate to $9,990 per person, according to a new report from the Office of the Actuary at the Centers for Medicare & Medicaid Services and published by Health Affairs.
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Going digital: Rollout begins for e-health records from babies' birth

The new system is the first national electronic patient chart for maternity anywhere in the world.

December 5, 2016
OVER THE WEEKEND, Emily was born – one of Ireland’s first newborns to have their own electronic health record from birth.
Weighing 7lb 5oz, Emily was born to Ellen and Aidan in Cork University Maternity Hospital last Saturday 3 December.
Her birth heralds the introduction of an electronic health record for all women and babies in maternity services in Ireland – the nationwide system being a world first.
Ireland’s Maternal & Newborn Clinical Management System (MN-CMS) will allow clinical record information to be shared with relevant providers of care when needed.
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Enjoy!
David.

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