Saturday, February 18, 2017

Weekly Overseas Health IT Links – 18th February, 2017.

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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Top 5 ways to bring doctors to the EHR optimization table

With barely one-third of physicians saying they're satisfied with their electronic health records, its time their voices were heard.
February 09, 2017 11:14 AM
While some speak optimistically about the "post-EHR era," electronic health records are still very much a going concern – and will be of great interest to many of the 45,000 or so attendees at the 2017 HIMSS Annual Conference & Exhibition later this month.
There will be education sessions on topics ranging from enabling EHR analytics to resolving usability issues that could impact patient safety to better integrating genomics data into clinical workflows. There's even a half-day User Experience Forum at HIMSS17 –  a major theme of which will be the ways UX can be improved for care teams to create a more transparent, intuitive way of care delivery.
Long story short: For all their ubiquity, EHRs still have a lot of improving to do.
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Cleveland Clinic’s IT expansion seen as critical to operations

Published February 10 2017, 6:56am EST
As one of America’s top hospitals, the Cleveland Clinic sees more than 4 million patients annually from all 50 states and 180 countries. The not-for-profit multispecialty academic medical center also has a global footprint that requires the health information technology infrastructure to support it.
Access Anytime Anywhere is the tagline on the healthcare organization’s website. In addition to its locations in northern Ohio, Weston, Fla., and Las Vegas, the health system has a presence in Abu Dhabi and Toronto, and it has started to develop a facility in London.
“We have various operating models in different regions, but ultimately, technology plays an important role in every single one of them,” says Doug Smith, the Cleveland Clinic’s interim chief information officer. “The key is design for scale. We can’t continue to create a new blueprint every time we deploy a hospital. We have this construct where we’re able to grow and deploy this global footprint while allowing for local tweaks and preferences.”
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Scientists use computer to predict outcomes in AML

Study uses the first computer machine-learning model to predict outcomes in acute myelogenous leukemia.
By Amy Wallace   |   Feb. 9, 2017 at 12:19 PM
Feb. 9 (UPI) -- Researchers from Indiana University - Purdue University Indianapolis School of Science have used a computer machine-learning model to accurately predict which patients with acute myelogenous leukemia, or AML, will relapse or go into remission.
"It's pretty straightforward to teach a computer to recognize AML, once you develop a robust algorithm, and in previous work we did it with almost 100 percent accuracy," Murat Dundar, associate professor of computer science in the School of Science at Indiana University - Purdue University Indianapolis and senior author of the study, said in a press release.
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Patient portals boost efficiency, engagement, but getting patients and physicians on board a challenge

Feb 10, 2017 11:49am
Patient portals can increase a practice's efficiency.
Many practices have implemented a patient portal, but a big challenge remains: getting patients and doctors to actually use it.
Practices use portals for a variety of reasons. They can allow patients to schedule visits, pay bills, request prescription refills, check test results and communicate with physicians and staff. That convenience put online portals at the top of a list of patient engagement strategies in a recent survey.
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Tom Price confirmed as HHS secretary, industry reacts

Feb 10, 2017 10:59am
As expected, the Senate voted along party lines this morning and confirmed Rep. Tom Price, R-Ga., as secretary of the Department of Health & Human Services. (http://tomprice.house.gov)
As expected, the Senate voted along party lines this morning to confirm Rep. Tom Price, R-Ga., as secretary of the Department of Health and Human Services.
The vote, 52 to 47, took place at around 2 a.m., after Democrats ran the clock out with 30 hours of debate. The confirmation required only a simple majority to vote for him, so in order to block the nominee, Democrats needed to convince a few Republicans to join them. They didn’t succeed.
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Why practices are struggling to exchange records

Published February 10 2017, 3:42pm EST
Medical record administrators are continuing to have difficulties exchanging patient records with other providers.
Data exchange is particularly difficult when receiving providers are not on the same electronic health record as the sender, according to results of a survey conducted in January by Black Book Research, which found that more than 40 percent of responding administrators admitted to record exchange challenges.
Those mixed results come even though vendors of EHRs are reconfiguring systems to better enable data exchange. The survey also measured how well respondents’ electronic health records vendors are optimizing EHRs, including the use of the emerging FHIR interoperability standard, to better support HIE.
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How 4 key practices can prevent ransomware incidents

Published February 10 2017, 3:57pm EST
You're the CIO of a major healthcare provider. You log in to your computer and see a strange page with a ticking clock and a message that says that your files have been encrypted. You try to open some of your files, but they all appear to be gibberish. And then it hits you: Your hospital has been infected by ransomware.
Ransomware is a form of malware that targets your critical data and systems for extortion. Typically, ransomware encrypts data with a key known only to the attacker until a ransom (usually in a cryptocurrency such as Bitcoin) is paid. After the ransom is paid, the attacker will sometimes provide a decryption key.
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DOD launches new EHR system; House committee wants quarterly updates from the VA

Feb 9, 2017 11:42am
Lawmakers have asked the VA to provider quarterly reports on IT modernization efforts.
After a four-year buildup, the Department of Defense has officially gone live with an upgraded EHR system at an Air Force Base in Washington.
Technical issues forced the Pentagon to push back the rollout of the new system that was expected to launch at Fairchild Air Force Base and Naval Hospital Oak Harbor in December. The new system is now live at Fairchild and running as expected, officials told FCW.
Implementation of the new system was led by Leidos and Cerner, which secured a $4.3 billion contract in June 2015. Even before that contract was awarded, some health IT experts warned that the modernization efforts were “doomed to fail." 
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Wearables And Health: Where Do They Intersect?

02/07/2017 By Brian Thomas
Brian Thomas, VP & CIO, Swope Health Services
In the last entry, we talked about what to watch for in the way of wearable technology this year. Now we’ll discuss how this innovative form of technology can be used to promote a healthier population. We all know that health insurance payers give incentives to providers for healthy patients; to obtain these incentives, providers must gather more data, communicate more effectively with their patients, and get them engaged in managing their own health. Why not use technology to automatically gather this data and send it back to the patient’s medical record? This method ensures accuracy, efficiency, timeliness, and accountability — things that can be sorely lacking in today’s healthcare management system.
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3 emerging technologies that will impact healthcare

Published February 09 2017, 4:34pm EST
If you read my previous article concerning the progress we have made in health information technology adoption and the development of digital health tools, yo. I believe we have made significant progress in many areas, but there are also some places where we have a long way to go.
I am optimistic that if we unleash the creativity of entrepreneurs and innovators, we can solve some big problems society is facing and certainly build a better healthcare system. Things are changing quickly and the policy landscape is shifting under our feet (often feeling like quicksand). There is confusion and sometimes chaos in the uncertain future of federal policy, yet this also creates opportunity for those bold enough to charge ahead.
There are going to be some big changes coming to healthcare, driven by these new policies and a different kind of leadership in Washington, but technology will still play a key role in transforming the healthcare system, creating change on a monumental scale. This massive change will occur because of the exponential growth of information technology, and this will impact all emerging technologies—robotics, automation, 3D printing, quantum computing, virtual and augmented reality, nanotube electronics, sensors, mobile technology, artificial intelligence, machine learning, natural language processing, cloud storage, big data analytics, the Internet of Things, and much more.
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Tapping into the EHR data flow to improve patient care

Elizabeth Meyers, RN, PhD(c), CPHIMS, February 8, 2017
Each time a patient is admitted to the hospital, a tiny message is generated to let every software system know the patient has arrived. Similar messages are sent as the patient is transferred from department to department during their stay, and when they are discharged. Other messages carry lab results, vital signs, and medication orders from system to system. The more technology is employed by a hospital, the larger the interface web becomes. Until, volumes and volumes of data are streaming behind the scenes, making modern patient care possible.
These connections do a great job serving their primary purpose – getting data from one place to another to enable continuity of excellent patient care.  But, what if we could tap into those data feeds in real time?  What things could be improved if this engine suddenly became aware of the meaning of the data flowing through it?
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Interoperability reality check: FHIR, population health and the patient experience

Experts from the Advisory Board weigh in on progress made during the last 12 months, take a look at how widespread health data exchange can enable hospitals to better serve patients and address lingering questions about interoperability. 
February 06, 2017 04:19 PM
The year 2016 was a big one for interoperability — particularly FHIR (Fast Health Interoperability Resources) development and the implications the emerging standard has for EHRs, health information exchange and population health. Even still, hospital CIOs and IT executives face a number of pressing questions.
"The major EHR and interoperability vendors embraced FHIR with enthusiasm, and many are now delivering working technology previews," said Greg Kuhnen, senior director of research at Advisory Board. “That’s remarkable progress for a standard that has no regulatory mandate or direct financial incentive.”
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How hospitals put predictive analytics into action

Feb 7, 2017 4:53pm
Predictive data analytics has a lot of value to providers seeking to better understand trends in their facilities, but applying that information for change may be more complicated.
Predictive analytics can tell healthcare leaders a lot about trends in their facilities, but turning that information into action is a bigger challenge. 
Just over 30% of hospitals have used some type of predictive data analytics for a year or longer, according to an article from Hospitals & Health Networks, and the vast majority of healthcare executives (80%) say they think the technology can improve patient care.
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VA admits past IT failures, turns to commercial solutions

Feb 8, 2017 11:13am
VA officials testified Tuesday that they are in the process of purchasing commercial IT products, shifting from its previous in-house approach.
Officials with the Department of Veterans Affairs repeatedly told lawmakers that the agency is moving on from its failed approach of building in-house IT systems, and is instead seeking commercial, off-the-shelf options to improve scheduling, EHR interoperability, and billing and claims processing.
In a hearing before the House Committee on Veterans’ Affairs on Tuesday, Rob Thomas, acting assistant secretary for information technology and CIO for the Office of Information and Technology at the VA, acknowledged previous failures in the agency’s attempt to modernize IT systems, but noted that it is no longer trying to build systems from the ground up.  
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Feds: Provider-owned devices affected by St. Jude cybersecurity vulnerability

By Adam Rubenfire  | February 7, 2017
Cybersecurity vulnerabilities in a St. Jude Medical cardiovascular device extend to a piece of equipment that is used within healthcare facilities, according to an update from the U.S. Department of Homeland Security.
DHS and the Food and Drug Administration said that hackers could deplete the battery of a St. Jude cardiac device or send inappropriate shocks to a patient by exploiting vulnerabilities in Merlin@home, a device that transmits device data to clinicians. In an update Tuesday, DHS released details on which Merlin models are affected by the vulnerability, including those used by clinicians.
Merlin transmitters used in medical offices have a MerlinOnDemand capability, which allows them to gather data from multiple implants within patients who are being seen by clinicians. These transmitters are deployed across the industry, but represent only 0.1% of all transmitters worldwide, according to the alert.
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Cancer survivors find telehealth services useful, study shows

Written by Anuja Vaidya (Twitter | Google+)  | February 06, 2017 | Print | Email
Researchers from United Kingdom-based University of Surrey found that the majority of cancer survivors report that the use of telehealth is a positive and worthwhile experience.
The researchers examined studies which reported cancer patients' direct views on their experience of telehealth.
Overall, cancer survivors who had used telehealth for meetings and follow-up consultations with their providers appreciated the flexibility and convenience of the program. Additionally, the research shows that telehealth provides a perceived anonymity that reduces cancer survivors' sense of vulnerability and allows them to voice concerns they may not have voiced face-to-face.
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The age of the BIONIC BODY: From robot hands controlled by your mind to electronic eyeballs, experts reveal 6 medical marvels introduced by new technology

  • While bionic limbs once belonged in science fiction, today it is less extraordinary
  • Last week, paralysed former policewoman Nicki Donnelly walked on robotic legs
  • Today, experts reveal six other robotic limbs that may change medicine for ever
When The Six Million Dollar Man first aired in the Seventies, with its badly injured astronaut being rebuilt with machine parts, the TV show seemed a far-fetched fantasy.
But fast-forward 40 years and the idea of a part-man, part-robot doesn't seem so extraordinary after all.
Today, the idea of a part-man, part-robot doesn't seem so extraordinary after all. For example, robotic arms controlled by thought are now being developed in Britain 
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EHRs are everywhere: Now what?

Now that the healthcare industry is essentially digitized, analytics are moving to the fore for population, risk-sharing and value-based care, according to Geneia CTO Fred Rahmanian.
February 06, 201709:16 AM
Since meaningful use incentivized what has become near-ubiquity of electronic health records, hospitals and providers are looking at what they can do on top of the digitized platform.
“The EHR market has commoditized now and the healthcare domain is coming into an era where most other domains, like the financial domain, have been for a long time – understanding risk, identifying and mitigating risk, and finding tools to do so,” said Fred Rahmanian, chief technology officer at Geneia, a vendor of population health, remote patient monitoring and analytics systems. “One reason people will see a lot of activity here is because of the ability to ingest a lot of data and extract insights from that data. Healthcare analytics is front and center now.”
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Wearable device market expected to nearly triple by 2021

Published February 07 2017, 3:33pm EST
The global wearable devices market was valued at more than $2 billion in 2016 and is expected to reach almost $6 billion by 2021, according to a new report from Technavio Research.
In developed regions, including North America and Western Europe, the demand for and shipment of smart wearable devices— smartwatches, wearable bands, wristbands, medical devices and the like—has increased recently, the report said. The decline in the cost of these products is a major driving force behind the adoption of wearable devices, it said.
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E-pills that can monitor patient health in the offing

The device may offer a safer and lower-cost alternative to the traditional batteries now used to power such devices, researchers said.PTI  |  February 07, 2017, 13:34 IST
Boston, Feb 7: MIT scientists have developed a small battery that runs on stomach acids and could power next-generation ingestible electronic pills which may monitor patient health or treat diseases by residing in the gastrointestinal tract for extended periods of time.
The device may offer a safer and lower-cost alternative to the traditional batteries now used to power such devices, researchers said.
"We need to come up with ways to power these ingestible systems for a long time," said Giovanni Traverso, from Massachusetts Institute of Technology's (MIT) in the US.
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Study: Can EMRs streamline care in mental health facilities?

Written by Jessica Kim Cohen | February 06, 2017 | Print | Email
A study in Journal of Medical Internet Research: Medical Informatics investigated whether using an EMR in a mental health facility would lead to quality improvement outcomes.
A tertiary-level mental health facility in Ontario, Canada, implemented an EMR, which included workflow and documentation tools for point-of-care staff. Over two years, the number of restraint incidents decreased 19.7 percent, representing cost savings of more than $1 million.
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Lingering obstacles block the path to interoperability

A host of challenges – technological, financial, even cultural – are stymieing the goal so many stakeholders say they want.
February 06, 2017 01:28 PM
Acknowledgement of the value of interoperability – and the desire to implement it – are seemingly widespread in healthcare. So why is the industry still so short of achieving it? For many reasons – technology, financial or logistical obstacles, a lack of standardization, fear of new procedures, or data gaps in EHR systems – the goal of being able to easily and securely exchange accurate patient data across healthcare providers remains elusive.
Technology isn't enough
Getting a handle on advancing interoperability requires that technical and business process/policy challenges are addressed together, instead of in isolation, so that there's an integration of technology and policy workflows and scaling. "Simply putting the technology in peoples' hands isn't enough," said Steven Posnack, director of the Office of Standards and Technology for the Office of the National Coordinator in the U.S. Department of Health and Human Services.
"There need to be business agreements in place and, in many cases, a business model around exchanging information that impacts the delivery of care." Whatever the intention is – e.g., sending a patient for a referral, requesting information from a patient or sending an electronic prescription -- the training and workflow implementation involved with interoperability technology must make it a more usable and seamless part of the health information technology and patient care delivery infrastructure.
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Top News

A National Academy of Sciences article describes a reusable, inkjet-printable lab-on-a-chip for point-of-care diagnostics that costs just $0.01.
Heading the NIH-funded project is Stanford Genome Technology Center’s Rahim Esfandyarpour, PhD, an engineering associate who says inexpensive diagnostics could improve low survival rates in developing countries of conditions such as breast cancer, malaria, tuberculosis, and HIV.
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Timeline is uncertain for release of normative version of FHIR

Published February 06 2017, 7:10am EST
As the healthcare industry eagerly awaits a normative version of Health Level Seven International’s Fast Healthcare Interoperability Resources data exchange standard, the timeline for realizing a stable version remains murky, with HL7 executives offering different opinions.
Work is continuing to advance FHIR, and it's being used by some large vendors in an increasing number of situations. But many vendors are waiting for HL7 to get farther along in its standard-setting process before investing in the development needed to incorporate FHIR into their products. A significant milestone for any standard is when it reaches a normative version--that is, a mature standard that works in most cases and most industry participants accept as essential to use.
FHIR continues to mature as an open standard for exchanging healthcare data between information systems. According to FHIR Product Director Graham Grieve, STU3 Standard for Trial Use, release 3 (STU3)—the third major milestone for the initiative—is expected to be published in late March.
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Claims that mHealth can save costs may miss the mark

Feb 6, 2017 11:22am
mHealth research doesn't always offer a comprehensive account of the economic impact.
Proponents of mHealth apps often say the tools can help hospitals cut patient treatment costs by streamlining care. But a more detailed look shows there's often inadequate evidence to support those assertions.
Although almost all studies address the economic factors of an mHealth intervention, including cost savings tied to improved outcomes, many of those studies fail to consider a range of factors that could influence the economic impact, according to a study published in PLOS One.
Researchers with the University of Washington and Columbia University reviewed 39 studies spanning several mHealth interventions—including behavioral health and text messaging—and found that most do not account for all of the Consolidated Health Economic Evaluations Reporting Standards (CHEERS) developed by the International Society for Pharmacoeconomics and Outcomes Researcher (ISPOR), which include a broad spectrum of economic factors.
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NIST review confirms copy-and-paste safety concerns

Feb 6, 2017 12:01pm
Copying ad pasting text into EHRs is a safety concern.
New evidence supports fears that a common physician documentation shortcut can jeopardize patient safety. When docs copy and paste template text into a patient's electronic health record. 
Clinicians reported that while copying text from a template and pasting it into a patient's electronic health record streamlined workflow, it also created the potential for inaccurate information and made it difficult to parse out new relevant patient information, according to a report from the National Institute of Standards and Technology (NIST). 
The results of the study aligned with recommendations by the Partnership for Health IT Patient Safety that called on hospitals to make copy-and-paste material easy to differentiate and offer staff training on the appropriate use of the function.
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How Kaiser cut the clinical decision support noise

Published February 06 2017, 12:37pm EST
To improve drug-disease interaction clinical decision support, the Northern California region of Kaiser Permanente worked with content vendor First Databank to develop a scoring tool to indicate if a particular procedure or drug should be used in the treatment of a patient.
The product is the Disease Interaction Scoring Tool, which Jeff Bubp, PhamD, manager of the decision support group at First Databank; and Brian Hoberman, MD, a physician leader at Kaiser, will explain during an education session at HIMSS17.
The idea, Bubp says, was to develop a standard way to evaluate drug disease clinical support to identify the most appropriate disease alerts. For example, with a new drug order for a patient, the electronic health record checks the order against patient problems to decide if the drug is appropriate.
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Why the pressure’s rising for EMRs to make an impact

Published February 06 2017, 2:44pm EST
As the country wonders about the next iteration or obliteration of the Affordable Care Act, the 1996 movie Jerry Maguire starring Tom Cruise and Cuba Gooding, Jr., provides all the information needed to prepare for changes in the healthcare marketplace in 2017. Cruise plays sports agent Jerry Maguire who represents Rod Tidwell, a fictional Arizona Cardinals wide receiver played by Gooding.
In one poignant scene, Rod chastises Jerry in an effort to motivate him to work harder to secure a more valuable contract for Rod’s services to the Cardinals. Through the repetitive mantra “Show me the money, Jerry,” Rod makes it clear to his agent that only the monetary value of the contract matters.
After spending more than $30 billion on incentive payments, many in and outside government wonder what value that investment in electronic medical records (EMR) delivers to patients. Similarly, many hospital boards of directors, provider organization leadership groups and physicians in private practice wonder what type of return on investment they are receiving from implementing these healthcare information technology (HIT) systems.
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Cybercriminals deploy malware for half of successful cyberattacks, IBM study finds

Breaches rose in number last year and continued causing operational, financial and reputational damage to healthcare organizations.
February 02, 2017 09:05 AM
Forty eight percent of successful healthcare cyberattacks result from a criminal gaining access to a system or data by injecting malicious content. Such attacks include injecting unexpected items into a system database or through the host operating system running a website that then tells the system how to act, a new report from IBM Managed Security Services found.
What’s more, 19 percent of successful healthcare cyber-attackers gain unauthorized access through the manipulation of system data structures, according to the new report entitled “Security Trends in the Healthcare Industry.” Here, a hacker leverages vulnerabilities in data processing to alter the execution path of a process and then takes over.
The report also found that 9 percent of healthcare cyber-attackers attempt to manipulate or corrupt the availability or aspect of a resource’s state (i.e. files, applications, libraries, infrastructure, etc.). Successful attacks here enable an attacker to cause a denial of service, as well as execute arbitrary code on a target machine.
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Enjoy!
David.

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