Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, April 04, 2020

Weekly Overseas Health IT Links – 4 April, 2020.

Here are a few I came across last week.
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.

Private Sector Coalition to Combat COVID-19 with Real-Time Data

Epic, Mayo Clinic, Amazon, and others will provide real-time data analytics to support care delivery during the COVID-19 pandemic.
March 25, 2020 - Private sector organizations have partnered to form the COVID-19 Healthcare Coalition, a collaborative effort that aims to provide real-time data analytics to help those on the front lines of the outbreak.
For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.
Coalition members include Arcadia.io, athenahealth, Amazon Web Services (AWS), Buoy Health, CommonWell Health Alliance, Epic, HCA Healthcare, Intermountain Healthcare, LabCorp, Leavitt Partners, MassChallenge, Mayo Clinic, Microsoft, MITRE, nference, Rush University System for Health, Salesforce and University of California Healthcare System, as well as the nation’s leading experts on pandemics at the strategic, clinical, and operational levels.

Why the new U.S. interoperability rules matter during the COVID-19 pandemic

Lucienne Marie Ide, MD, Ph.D.
March 25, 2020
Saying March has been a busy month for healthcare is an understatement. For the first time in 58 years, the HIMSS Global Health Conference & Exhibition — set to be held March 9-13 — was cancelled. Then, the Office of the National Coordinator for Health Information Technology and the Centers for Medicare & Medicaid Services issued final rules on interoperability and information blocking with the 21st Century Cures Act Final Rule. And on March 11, the World Health Organization (WHO) officially declared COVID-19 a pandemic.
The new interoperability rules could not have come at a better time as patients, providers and public health officials navigate what this pandemic means for them. Patients want to know if they are at-risk. They want to know when they should go see a doctor or what steps they should take. Providers want a way to triage patients to appropriate care (much of that being self-managed home care) and figure out how an influx of COVID-19 patients will fit into rapidly evolving workflows. Public health researchers, epidemiologists, and government officials need all-encompassing data, in a standardized format, to better understand this still-evolving disease and inform on guidelines. 
The Final Rules in part addresses information-blocking practices and anti-competitive behaviors by healthcare providers, developers of certified health IT products, health information exchanges and other information networks. Finalizing the Cures Act coinciding with the COVID-19 pandemic creates an opportunity for collaboration and seamless information sharing across the industry.

GoodSAM app being used to recruit NHS volunteers

The GoodSAM app is being used to help recruit around a quarter of a million volunteers for the NHS during the coronavirus outbreak.
Hanna Crouch – 25 March 2020
The digital tool is usually used to alert those with medical training to nearby emergencies so that potentially life-saving interventions can be given before the arrival of emergency services.
However, the app is now being used to help recruit volunteers for the NHS by helping people offer their services to people in need.
NHS Volunteer Responders can be called on to do simple but vital tasks, including:
  • Delivering medicines from pharmacies
  • Driving patients to appointments
  • Bringing them home from hospital
  • Making regular phone calls to check on people isolating at home

Sick notes to be automated through NHS 111 to prevent Covid-19 spread

People with suspected coronavirus will soon be able to have a sick note issued digitally through NHS 111.
Andrea Downey – 17 March 2020
Chancellor Rishi Sunak announced a raft of measures in this year’s budget to support the NHS during the spread of Covid-19. Part of the £30 billion package was the automation of sick notes for patients who are self-isolating.
The service is being built “as swiftly as possible”, according to an NHS Digital spokesperson.
“Once built, the system will work by generating a personalised document at the end of a 111 online triage process if it recommends that the patient self-isolates due to potential coronavirus symptoms,” the spokesperson told Digital Health News.
Currently, when a person becomes ill they can self-certify for up to seven days, but any time taken off work from then requires a fit note from a doctor for continued sick pay.

Coronavirus news round-up: Digital Health debrief

Andrea Downey – 27 March, 2020
Coronavirus developments continue to move at breakneck speed, resulting in a flurry of announcements on how healthcare providers and suppliers are mobilising themselves around the outbreak.
Much of this has centred on how the NHS can meet a surge in demand for digital services brought on by Covid-19, both enabling doctors to continue seeing patients, as well as supporting those involved in the delivery of healthcare to stay connected.
This week saw a number of important developments concerning digital responses to coronavirus. Here’s a recap of our coverage on Digital Health News.
March 27, 2020 / 5:58 AM / a day ago

U.S. preparing guidelines to classify county COVID-19 risk: Trump

WASHINGTON (Reuters) - President Donald Trump said on Thursday his administration is preparing new coronavirus guidelines that would characterize U.S. counties as high-risk, medium-risk or low-risk.
In a letter to U.S. governors, Trump said state and local leaders could use the guidelines to determine social distancing and other coronavirus mitigation measures. The guidelines will aim “to help classify counties with respect to continued risks posed by the virus,” the letter said.

Apple announces COVID-19 website and app in partnership with CDC and the White House

Key Points
  • Apple has developed a new website and app that will provide a screening tool for COVID-19 symptoms as well as up-to-date information from trusted sources about the coronavirus outbreak. 
  • The software announced Friday was developed in partnership with the Centers for Disease Control and Prevention, the White House-led coronavirus task force and the Federal Emergency Management Agency. 
  • Apple is not providing any tests. 
Apple has developed a new website and app that will provide a screening tool for COVID-19 symptoms as well as up-to-date information from trusted sources about the coronavirus outbreak. 
The software announced Friday was developed in partnership with the Centers for Disease Control, the White House-led coronavirus task force and the Federal Emergency Management Agency. 

Health information technology’s national blueprint for COVID-19

The 10-year-old National Broadband Plan identified three nationwide gaps: IT adoption by healthcare providers, information utilization by them and connectivity to patients. In many places, those gaps still remain.
March 27, 2020 10:30 AM
It’s been ten years this month since the release of the National Broadband Plan, a 376-page document that was one of the products of the American Recovery and Reinvestment Act of 2009.
In our current COVID-19 crisis, its Chapter 10, covering healthcare, deserves immediate and close attention to determine how its analysis and recommendations might be applicable to the critical decisions that must be made – both in confronting our pandemic and in anticipating the next pandemic to come.
First, let’s focus on what the plan revealed that underscores a persistent problem in dealing with COVID-19. "The United States is not taking full advantage of the opportunities that health IT provides."
Three national gaps were identified that remain today: adoption by health care providers, information utilization by them, and connectivity to patients.

Skype, WhatsApp and FaceTime for consultations is fine, NHS tells doctors as it ramps up video conferencing

Cutting back on face-to-face consultations means a rapid increase in video-conferencing in healthcare.
By Steve Ranger | March 27, 2020 -- 16:13 GMT (03:13 AEDT) | Topic: Coronavirus: Business and technology in a pandemic
The NHS is speeding up the roll-out of video consultation services to doctors in a bid to reduce face-to-face contact with patients during the COVID-19 coronavirus outbreak.
The UK's health service said it was essential to reduce contact to protect patients and staff, and to minimise the risk of coronavirus infection. As most people are now staying at home , the NHS also needs to support doctors to care for people remotely.
NHSX, NHS England and NHS Improvement said they are accelerating the deployment of video consultation systems. For doctors' surgeries that don't have these systems in place yet, the NHS said it's also fine to use video conferencing tools such as Skype, WhatsApp and Facetime, "as well as commercial products designed specifically for this purpose".

Elderly in UK care home embrace technology to beat coronavirus lockdown

By Stuart McDill on Mar 27, 2020 1:18PM

Octogenarians prepare for three weeks of isolation.

Residents in a British care home are embracing technology to stay in touch with friends and family as the country faces the possibility of weeks of lockdown amid the coronavirus epidemic.
One newcomer to video-calling is 84-year-old Minnie Copping, a resident at Foxholes Care Home in Hertfordshire, north of London.
"It's absolutely marvellous because she's my best daughter. I've only got one, mind you, but she's the best daughter I've ever had," Copping said after a 10-minute, laughter-filled chat with her daughter Sandra.

New Initiative Will Leverage Supercomputers to Combat COVID-19

IBM and various other organizations launched an initiative to accelerate the process of COVID-19 treatment discovery through the use of supercomputers.
March 24, 2020 - IBM Watson recently launched an initiative with the White House Office of Science and Technology Policy, the US Department of Energy, and others to enhance researchers’ efforts to uncover possible COVID-19 treatments through supercomputers. 
The COVID-19 High Performance Computing Consortium will bring significant computing power, 16 systems with over 330 petaflops, 775,000 CPU cores, and 34,000 GPUs to help researchers understand COVID-19 potential treatments and cures. 
 “These high-performance computing systems allow researchers to run very large numbers of calculations in epidemiology, bioinformatics, and molecular modeling,” Dario Gil, director of IBM Research said in the announcement. “These experiments would take years to complete if worked by hand, or months if handled on slower, traditional computing platforms.”
The partners that helped launch the initiative include Lawrence Livermore National Lab (LLNL), Argonne National Lab (ANL), Oak Ridge National Laboratory (ORNL), Sandia National Laboratory (SNL), Los Alamos National Laboratory (LANL), The National Science Foundation (NSF), NASA, Massachusetts Institute of Technology (MIT), Rensselaer Polytechnic Institute (RPI), and various other companies. 

COVID-19 Affects Mental Health of Nurses, Frontline Workers More Than Others

MARCH 23, 2020
Samara Rosenfeld
Frontline healthcare workers, women, and nurses exposed to coronavirus disease 2019 (COVID-19) are at a greater risk of developing unfavorable mental health outcomes, according to new research.

Due to the toll COVID-19 is taking on both patients and providers alike, Jianbo Lai, MSc, and a team of China-based investigators used data from >1200 healthcare workers to assess the magnitude of mental health outcomes and associated factors among those treating patients who were exposed to the virus in China.

The team found that among the Chinese workers exposed to COVID-19, women, nurses, those in Wuhan, and frontline healthcare workers had a greater risk of worsening mental health outcomes than average.

The findings suggested that such individuals may need psychological support or interventions.

James Dyson designed a new ventilator in 10 days. He's making 15,000 for the pandemic fight

By Nada Bashir, CNN Business
Updated 1431 GMT (2231 HKT) March 26, 2020
London (CNN Business)Dyson has received an order from the UK government for 10,000 ventilators to support efforts by the country's National Health Service to treat coronavirus patients.
James Dyson, the company's billionaire founder, confirmed the order in a letter to employees shared with CNN on Wednesday.
"A ventilator supports a patient who is no longer able to maintain their own airways, but sadly there is currently a significant shortage, both in the UK and other countries around the world," Dyson wrote.
Dyson said the company had designed and built an entirely new ventilator, called the "CoVent," since he received a call 10 days ago from UK Prime Minister Boris Johnson.

Rapid Response to COVID-19: Health Informatics Support for Outbreak Management in an Academic Health System

Journal of the American Medical Informatics Association, ocaa037, https://doi.org/10.1093/jamia/ocaa037
Published: 24 March 2020


Objective: To describe the implementation of technological support important for optimizing clinical management of the COVID-19 pandemic.
Materials and Methods: Our health system has confirmed prior and current cases of COVID-19. An Incident Command Center was established early in the crisis and helped identify electronic health record (EHR) based tools to support clinical care.
Results: We outline the design and implementation of EHR based rapid screening processes, laboratory testing, clinical decision support, reporting tools, and patient-facing technology related to COVID-19.
Discussion: The EHR is a useful tool to enable rapid deployment of standardized processes. UC San Diego Health built multiple COVID-19-specific tools to support outbreak management, including scripted triaging, electronic check-in, standard ordering and documentation, secure messaging, real-time data analytics, and telemedicine capabilities. Challenges included the need to frequently adjust build to meet rapidly evolving requirements, communication and adoption, and coordinating the needs of multiple stakeholders while maintaining high-quality, pre-pandemic medical care.
Conclusion: The EHR is an essential tool in supporting the clinical needs of a health system managing the COVID-19 pandemic.

Germany benefits from digital health infrastructure during COVID-19 pandemic

Telemedicine platforms, bots and IT systems help secure medical care remotely and enable efficient crisis management and accurate resource planning.
March 26, 2020 12:20 PM
 “A year and a half ago, we began the process of establishing a new legal framework and innovation-friendly healthcare ecosystem. Since then, many digital solutions for patients and physicians have been implemented, and are now bringing benefits. Apps and telemedicine services can, at least to some extent, support medical workers and carers in what they do as well as provide patients with reliable information regarding COVID-19,” says Professor Jörg Debatin, head of the Health Innovation Hub (hih) in Germany. The think-tank, established by the Ministry of Health (Bundesministerium für Gesundheit, BMG), aims to accelerate the digitalisation of healthcare in Germany and help to translate new laws into practical solutions. Debatin was the guest during the 'Talking Points' webinar, hosted by the HIMSS D-A-CH Community on 17 March 2020.
Until 2018, remote consultations in Germany were not allowed. But a lot has changed since the legal restrictions were lifted. Some of the health insurance funds (Krankenkassen) reimburse telemedicine services that are certified by the National Association of Statutory Health Insurance Physicians (Die Kassenärztliche Bundesvereinigung). While digital health solutions have not been disseminated fully among doctors, stable regulations are now essential.
In response to the COVID-19 pandemic, Health Innovation Hub has published a list of trusted telemedicine services (including costs, reimbursement policy, functionality and prices) that can be easily integrated into a doctor’s practice without technical know-how or hardware investments. Most of them are available for free.

How hospital IT departments can prepare for COVID-19

A leading German hospital CIO advises IT to support clinicians and ensure IT systems are running robustly and securely whilst supplying timely information to management.
March 26, 2020 12:25 PM
Henning Schneider, CIO, Asklepios Kliniken, Germany, compares COVID-19 to recent epidemics during the latest 'Talking Points' webinar, organised by the HIMSS D-A-CH Community.
According to Schneider, Germany is in preparation mode. Like during the Ehec outbreak, he acknowledges great concern among the population and hospital staff, but also a willingness to take on additional responsibilities and come up with creative answers to unprecedented challenges. Above all, he notices all departments pulling together in a joint effort to help the unwell. Unlike the Ehec crisis, coronavirus represents a worldwide challenge that, for the first time, also affects manufacturers as their supply chains are disrupted. This only compounds the severity of the crisis.

Technology lessons learned for temporary hospital deployments

As the COVID-19 crisis forces hospitals to get creative, a retired Air Force Colonel offers some perspective on IT preparedness gained from previous emergency medical deployments.
March 26, 2020 04:25 PM
There is never good news when pandemics spread. As we move to deploy remote and IT-driven medical-care infrastructures, note that many American institutions (government, military and private sector) have already demonstrated extraordinary proficiency in these areas. We’ve done this before. We can do it now.
Make no mistake, the infrastructure needed to deliver world-class medical care is challenging to develop from scratch. Whether in a pop-up field hospital or a repurposed existing building, the demands are wide-ranging. These challenges run from setting up physical security, clean electric power and internet access, to deploying IT solutions secure enough to protect privacy and provide the analytics required by epidemiologists.
But this is nothing new for our nation. The U.S. military regularly sets up field hospitals in a matter of hours or days.  These remote facilities have sterile surgical lab services that offer first-world care to our war fighters. I’ve seen far-away patches of dirt quickly become bustling centers equipped with the impressive services found back home.

Coronavirus pandemic puts focus on strengths, weaknesses of EHRs

"EHR disaster preparedness testing in the future will need to be able to simulate large volumes of patients over long periods of time," says one nursing informatics consultant.
March 26, 2020 10:41 AM
A central problem the COVID-19 pandemic has highlighted is the fact that EHR systems are large, slow monoliths that don’t quickly adapt to new, emergent demands on their design and workflow.
Future planning will also need to include routine practice run-throughs for building rapid-alternative-care sites, as many hospitals are setting up alternative patient-care sites during this pandemic. Most EHR systems, however, are very location-based.
"EHR disaster preparedness testing in the future will need to be able to simulate large volumes of patients over long periods of time," Dana Bensinger, RN-BC, informatics nurse specialist and client-solution executive with CTG, told Healthcare IT News.
"Every hospital has disaster plans that typically involve how to handle a large influx of patients during a disaster, and these plans are tested on a regular basis."

Best Practices for Health System Emergency Preparedness

The coronavirus outbreak is forcing health systems to examine their emergency preparedness strategies and understand if they are truly ready to take on an influx of patients while also slowing the pandemic’s curve.

March 24, 2020 - The number of coronavirus cases in the United States continues to grow exponentially. As such, health systems are in a unique position to help slow the pandemic’s curve. These organizations have the resources to push for more rapid testing, the research support to develop innovative solutions, and the workforce to care for an increased number of patients.
When Providence St. Joseph Health System encountered the country’s first coronavirus patient in January, it did not have to scramble for a plan. Providers just flipped the switch on its emergency preparedness plan.
Because of how interconnected the world is, it was not a matter of if the virus would spread to the United States but when, according to Amy Compton-Phillips, MD, executive vice president and chief clinical officer of Providence St. Joseph Health.

Machine Learning Tool Uses Real-Time Data to Monitor Flu Trends

The portable device uses machine learning to detect coughing sounds and crowd size in real time, directly monitoring flu-like illnesses and flu trends.
March 24, 2020 - Researchers at the University of Massachusetts Amherst (UMass Amherst) have developed a portable surveillance tool that leverages machine learning and real-time data to monitor flu-like illnesses and flu patterns.
The device, called FluSense, can detect coughing sounds and crowd size in real time, and could add to the collection of tools used to forecast seasonal flu and other viral outbreaks. The team recently published the results of their research in the journal Proceedings of the Association for Computing Machinery on Interactive, Mobile, Wearable and Ubiquitous Technologies.
“This may allow us to predict flu trends in a much more accurate manner,” said Tauhidur Rahman, assistant professor of computer and information sciences and co-author of the study.
FluSense is run on an edge-computing platform, and processes information from a low-cost microphone and thermal imaging data. The platform stores no personally identifiable information like speech data or distinguishing images.

Coronavirus Relief Package Needs Privacy Focus, Groups Tell Congress

Any Coronavirus relief packages drafted by Congress must center around patient privacy protections, and waivers must exclusively serve public health, civil-society groups urge.

March 23, 2020 - Thirteen civil-society groups are urging Congress to keep patient privacy protections center stage in any drafted Coronavirus relief packages, and any waivers of these protections must exclusively serve the nation’s overall public health.
Over the weekend, the Senate worked to come to a compromise as to just what elements would be included in relief legislation, but to no avail. However, the Trump Administration, the Department of Health and Human Services, and the Office for Civil Rights are all moving to expand telehealth use during the national emergency.
In a letter to Congress, Amnesty International-USA, Center for Human Rights and Privacy, Public Citizen, and U.S. PIRG, among others, stressed that the use of personal data during the COVID-19 crisis could benefit the overall public health. But fueling data sharing during the crisis could dramatically increase privacy and security risks.

Can location data from smartphones help slow the coronavirus? Facebook is giving academics a chance to try

March 24, 2020
It’s emerging as one of the more promising — and potentially controversial — ideas to slow the spread of the coronavirus: collecting smartphone data to track where people have gone and who they’ve crossed paths with.
The White House has discussed the notion, and several companies are reportedly in talks with the Trump administration to share aggregated user data. Researchers in the U.K. are working on one such app, and a team led by researchers at the Massachusetts Institute of Technology is building another, with an eye toward protecting user privacy. China and South Korea developed their own smartphone surveillance systems to try to clamp down on their own outbreaks, though their approaches likely wouldn’t be palatable in countries with greater expectations of privacy.
Then there’s Facebook, which collects data from its users around the world who opt in to sharing their location when using its smartphone app. Facebook does not share this information with governments. But in recent weeks, the social media giant has been sharing these data — in aggregated and anonymized form — with academic and nonprofit researchers analyzing the spread of the coronavirus.
Among the universities where Covid-19 researchers are harnessing Facebook’s data: the Harvard T.H. Chan School of Public Health, National Tsing Hua University in Taiwan, University of Pavia in Italy, and the London School of Hygiene and Tropical Medicine.

Headlines have touted AI over docs in reading medical images. New review finds evidence is limited

By Matt Kuhrt 
Mar 25, 2020 6:30pm
There have been plenty of headlines in recent years about studies suggesting artificial intelligence can outperform clinicians when it comes to reading X-rays or CT scans.
But a new review, published Wednesday in the BMJ, suggests those many of those studies have been flawed and overexaggerate those claims.
Led by experts at The Alan Turing Institute in London, researchers examined a sample of more than 7,000 studies that compared the performance of AI against clinicians to assess the methods, risk of bias and adherence to reporting standards.
In that sample, researchers say more than two-thirds of the studies had design issues that increased the risk of biased results. They also found a tendency to overstate the actual results in abstracts, the authors wrote in the review.

Former FDA chief Gottlieb has dire warnings about hitting the brakes on social distancing measures

Mar 25, 2020 1:00pm
Former FDA chief Scott Gottlieb, M.D., said public policy leaders will not be able to "hit the brakes" on social distancing measures until the epidemic curve begins to drop, and that could be several weeks away. (FDA)
Hard-hit coronavirus "hot spots" like New York City are two to three weeks away from hitting peak COVID-19 cases, according to former federal official Scott Gottlieb.
Many other cities and states could be two weeks behind.
"I’m worried about Florida; I'm worried about cities like New Orleans and cities where mass transit systems were late to implement mitigation strategies like Chicago," said Gottlieb, M.D., former Food and Drug Administration Commissioner, during a Wall Street Journal Health Forum hosted virtually this week.

OCR Shares COVID-19 PHI, Data Sharing Guidance for First Responders

In light of the COVID-19 pandemic, OCR provided insights on how protected health information can be shared with first responders and law enforcement in compliance with the HIPAA Privacy Rule.
March 25, 2020 - The Office for Civil Rights released guidance for how protected health information on patients exposed or infected with COVID-19 can be shared with first responders, such as law enforcement, paramedics, and public health authorities, in compliance with the HIPAA Privacy Rule.
HIPAA allows for sharing of information of patients infected or exposed to the Coronavirus with law enforcement, paramedics, and other first responders without an individual’s authorization in certain circumstances.
In the guide, OCR clarifies regulatory permissions covered entities may use to disclose PHI to first responders and others. Health organizations can leverage the guide to determine the circumstances in which a covered entity is permitted to disclose PHI without their HIPAA authorization, when it’s needed to provide treatment, required by law, and when first responders are at risk for infection.

Collective Medical debuts free tool to help public health response to pandemic

New functionality helps healthcare teams identify, track and isolate the community spread of COVID-19.
March 25, 2020 02:26 PM
Collective Medical, an ADT-based care collaboration network, has rolled out new functionality to support the public health response to COVID-19 at no cost.
The company’s platform and nationwide network, which covers many ports of entry into the U.S., is positioned to support regions’ and states’ ability to identify, treat, trace and analyze infectious diseases, including COVID-19.
Collective is offering this COVID-19 functionality at no charge for all existing organizations on its network. For hospitals, health plans, public health agencies and other healthcare stakeholders not yet on the network, Collective has developed a lightweight and rapidly deployable version that can be live in under a week. There will be no costs incurred by healthcare organizations for this version throughout 2020, and there will be no obligation during or after this period to continue using the system.

Getting it right: The rise of digital health

Professor Maureen Baker, chair of the Professional Records Standards Body, writes about the organisation's work to help build a fully integrated health and care system in the UK.
March 25, 2020 01:25 PM
Transforming the way people’s information is shared between health and social care services is at the heart of the long-term plans for the NHS and social care across all four nations of the UK. Digital health and care records are the essential building blocks for a fully integrated health and care system, and the Professional Record Standards Body (PRSB) has a vital role to play in bringing this transformation about.
The PRSB is working closely with health and care professionals and patients to develop clinical standards for people’s care records. Once implemented, these standards will allow health and care professionals to share and access information digitally between different services. As part of our work, we have delivered a series of standards to support transfers of care, which will make sure that people in different services have access to the information they need at the right time. Our e-discharge summary standard is already being implemented across the UK, leading to improvements in care.
While sharing information at handover is vital to continuity of care, having access to a shared care record that provides a history of an individual’s interactions with services is the foundation stone of all care. Last year, we created such a standard, which is being piloted by NHS England’s local health and care records programme. Called the core information standard, it was developed with the help of more than 1,500 people. The standard includes a wide range of information from different services, including the GP, hospitals, social care and mental health services among others. It will incorporate an ‘about me’ section, which outlines what people want professionals to know about their care, as well as other crucial information, such as allergies, medications and alerts. Once implemented, it will mean that everyone involved in a person’s care, including the patient, carer and guardian, will have access to relevant data. As a result, people won’t have to repeat their history and services can deliver tailored, personalised care. This in turn will lead people to feel more empowered to get involved with their own health and manage certain aspects of it themselves- especially if they are able to access records in future. 

How one statewide HIE is helping coordinate coronavirus response

The CIO of Arizona's Health Current describes the health information exchange's efforts to serve its participants during the COVID-19 crisis – and discusses its ongoing efforts to boost data quality and consistency across the state.
March 25, 2020 02:42 PM
Phoenix-based Health Current, Arizona's statewide health information exchange, serves more than 500 organizations: ACOs, behavioral health and community providers, emergency medical services, rural health clinics, hospitals and health systems, payers, labs, LTPAC organizations, and state and local health agencies.
For some time now, the HIE has been engaged with a major initiative focused on data governance and data-quality improvement, working to integrate more clinical and behavioral data across its network. Having seen 700% growth over the past three years, with its participants becoming ever more diverse, Health Current has been grappling with big challenges related to the sprawl and diversity of coding terminologies and data content across its stakeholders.
Since 2017, it has worked across its community of data suppliers and end users to work toward more commonality and uniformity in how data is relayed. That approach has been helpful in recent weeks as Health Current has had to pivot to focus on marshalling healthcare-data resources across Arizona in response to the COVID-19 crisis.
The HIE is working to ensure its data centers and IT infrastructure are solid and backed by multiple redundancies, even as its team members are observing social distancing by working remotely. The aim is to ensure all participants have easy access to critical data without any drop in service levels.

Change Needed to Make ONC Interoperability Rule Work for ACOs

Reprioritizing provider-to-provider data exchange and integrating social determinants of health data (SDOH) should be a priority for the ONC interoperability rule.
March 25, 2020 - The Office of the National Coordinator for Health Information Technology’s (ONC) interoperability rule should weight the considerations of providers focused on advanced payment methods (APMs) and value-based care models, Clif Gaus, SD, president and CEO of NAACOS, wrote in a letter to ONC.
In early March, the Department of Health and Human Services (HHS) finalized the ONC interoperability rule, aiming to provide patients with more control of their health data and to eradicate information blocking.
Originally proposed in February 2019, the rule supports patients accessing and sharing their electronic health information, allowing them the ability to coordinate their own healthcare.
Gaus applauded ONC for its interoperability efforts, noting accountable care organizations (ACO) need data to be easily exchanged among hospitals, physician offices, and other community providers. If that data could not be exchanged, then care coordination and care management would be difficult, he continued.

New Coalition Forms To Share Data, Coordinate Response To COVID-19 Threat

March 25, 2020
A group of healthcare, tech and non-profit organizations has come together to support the rapid deployment of open source solutions addressing the COVID-19 virus.
The COVID-19 Healthcare Coalition’s members include Amazon Web Services (AWS), athenahealth, CommonWell Health Alliance, Epic, HCA Healthcare, Intermountain Healthcare, LabCorp, Mayo Clinic, Microsoft, Rush University System for Health, Buoy Health, Arcadia.io, Leavitt Partners, MassChallenge, Salesforce, Walgreens, Cerner, Diagnostic Robots, and the University of California Healthcare System. Expect to see other health IT giants and at least some health plans. It won’t take long for this to become an industry-wide party.
Coalition members have agreed to work with MITRE Corp. to manage group data-sharing efforts, a smart move given that the project could lose momentum if it got bogged down within the bureaucracy of any individual company.  MITRE will support inter-group communication and aggregate de-identified data to spark clinical insights and track requirements for resources like beds and ventilators.

Movement Data from Sees Drop Amidst COVID-19 Social Distancing

March 25, 2020
Yesterday we shared about the importance of physical distancing (many are calling social distancing which is probably not the best term) in helping us get COVID-19 under control and what we’ll need in place to go back to more normal social activity.
Turns out, our various wearable devices and cell phones are collecting a lot of movement data that can be used to understand how well we’re doing at staying at home.  If you want to see how your state and county are doing, check out the Social Distancing Dashboard from Unacast.
Also, Evidation Health has been sharing some related data in what they call their COVID-19 Pulse.  Here are a few highlights they shared from the data they collected from over 140,000 individuals:

Patient Portal Use in Senior Patients Soaring, Spur Adoption Goals

Data shows that older adults and their caregivers have high patient portal use, suggesting that clinicians need to promote the portal to this demographic.
March 23, 2020 - Contrary to conventional wisdom, patients over the age of 85 do use the patient portal, sending a combined 1,254 patient portal messages to their providers across 62 individual patients, according to data from the Division of General Internal Medicine and Geriatrics at the Northwestern University Feinberg School of Medicine.
The patient portal has widely been regarding as the epicenter strong patient engagement, providing patients with a technology-enabled connection to their providers and their health data even when they are outside the healthcare facility.
The technology, which was mandated as a part of the Medicare and Medicaid EHR Incentive Programs, has reached near ubiquity. Ninety percent of hospitals offered patients access to the patient portal in 2019, according to figures from the Office of the National Coordinator for Health IT.

Best Practice Cybersecurity Methods for Remote Care, Patient Portals

Experian Health’s Jason Considine shares best practice cybersecurity methods, as providers potentially expose themselves to greater risk with the use of mobile and patient portals.
March 20, 2020 - A recent study from Kantar shows that privacy and security concerns are hindering patients’ willingness to use health technology, such as patient portals to improve their care. And while many in healthcare are embracing new technologies and mobile care, cybersecurity is not always prioritized.
The increased use of remote work and telehealth in light of the Coronavirus is also adding to the challenge of securing the healthcare threat landscape. And in the time of a pandemic, ensuring there are no service disruptions will be critical to patient safety.
Jason Considine, senior vice president and general manager of Experian Health’s Patient Experience Solutions recently shared sound tech and policy insights with HealthITSecurity.com that can address some of these challenges, from necessary tools to ensuring employees are properly trained.

Electronic Health Records Need an Ethical Tune-Up

Without oversight, the technologies at the heart of the health system are vulnerable to corruption
By Enid Montague on March 24, 2020
As a result of criminal and civil charges earlier this year, Practice Fusion agreed to pay $145 million in restitution related to intentionally designing an electronic health record system to influence physicians to prescribe more opioids. The company admitted to receiving payments from an opioid manufacturer in exchange for using the software to influence prescriptions. 
For me, this is both personal and professional.
Last year, my high school friend died from a drug overdose that began as an addiction to prescription painkillers. I’m also a professor of computer science and general internal medicine at DePaul University and Northwestern University; I teach courses in health informatics and human-computer interaction.
My research and teaching career is dedicated to improving human well-being with human-centered, effective, efficient and safe technology design. I’ve also been studying how doctors and patients interact with electronic health records since the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009

Six 2020 predictions for real-world evidence

20th March 2020
Interest in real-world evidence (RWE) in the pharmaceutical industry continues to increase due to regulatory opportunities and payer demands.
Sources of real-word data are numerous and include electronic health records (EHRs), medical- or pharmacy-claims data, product and disease registries, and patient-generated data from wearable devices. EHRs present a viable source of clinical information and, when data is analysed appropriately, the resulting RWE yields insights that can improve both the overall standard of care and health outcomes for individual patients.
However, data collected for clinical rather than research purposes requires strict protocols to ensure data validity. This limits one’s ability to develop RWE-based insights that are reliable and clinically accurate enough to inform regulatory, payer and clinical decision-making.
Fortunately, ongoing improvements in compute power and data-analytics – including but not limited to natural language processing and other artificial-intelligence based machine-learning and modelling techniques – are allowing stakeholders to gain accurate and reliable insights from EHR data, in ways that were not possible even a few years ago.

No privacy review completed of controversial Telus Health Babylon app

Alberta privacy commissioner says review of privacy implications could take a year

Charles Rusnell · CBC News · Posted: Mar 23, 2020 6:01 PM MT | Last Updated: March 24
A privacy review of Babylon, the controversial telehealth doctor consultation app, may not be completed for a year or more.
Telus Health has submitted a privacy impact assessment of the app to Alberta's privacy commissioner but a review of its impact on the confidentiality of individuals' health information will take time.
Scott Sibbald, a spokesperson for commissioner Jill Clayton, confirmed Monday that Telus Health met its obligation under the provincial privacy act by submitting an assessment before the app was recently launched.
But due to the volume of cases in the queue at the privacy commissioner's office, Sibbald said it could take up to a year just to assign someone to review the privacy impact assessment provided by Telus. 

Clinical AI vendor Jvion unveils COVID Community Vulnerability Map

The map identifies populations likely to experience severe outcomes once infected – and the socioeconomic drivers for such a risk, helping providers allocate resources.
March 24, 2020 01:26 PM
Jvion, a clinical AI technology company, has launched what it calls the COVID Community Vulnerability Map, a free tool designed to help healthcare-provider organizations and community leaders combat the COVID-19 pandemic.
The public-facing tool, built on Microsoft Azure maps, enables providers and leaders to identify the social determinants of health (SDOH) that put populations at greater risk. The map can inform community planning and resource allocation in order to proactively mitigate the risk to vulnerable populations.
The interactive map identifies populations down to the census-block level that are at risk for severe outcomes upon contracting a virus like COVID. Severe outcomes include hospitalization, organ failure and mortality. Additionally, the map surfaces the socioeconomic and environmental factors, such as lack of access to transportation or nutritious food, that put patients at greater risk.
The map also is overlaid with points of interest, such as hospitals, food sources and transportation, in relation to the at-risk communities. These insights can help inform providers, public health organizations and community support agencies as they look to deploy interventions, outreach and other services to keep individuals from contracting the virus. Once people are infected, the same insights can help in managing care towards a positive outcome, the company said.

WHO, coronavirus testing lab hit by hackers as opportunistic attacks ramp up

The World Health Organization has reportedly seen attempted cyberattacks double since the onset of the COVID-19 crisis, and a vaccine testing facility has also been targeted with ransomware.
March 24, 2020 10:58 AM
The World Health Organization is just the most recent agency on the front lines of the ongoing coronavirus pandemic to be fighting off cyber criminals as it battles worldwide spread of COVID-19.
According to Reuters, WHO has seen a marked increase in attempted cyberattacks – with one of the most recent reportedly perpetrated by a hacker group called DarkHotel. The unsuccessful attack spoofed a webpage to look like a login portal for agency employees in an attempt to steal passwords.
As healthcare organizations battle the COVID-19 pandemic, they’re also facing heightened cybersecurity threats from malicious actors looking to take advantage of the crisis caused by the outbreak.
The U.S. Department of Health and Human Services also fended off an attack recently as it was simultaneously focused on coronavirus response.

Health IT heavy-hitters join forces for COVID-19 Healthcare Coalition

The private-sector collaborative includes EHR vendors (Epic, athenahealth), Big Tech (AWS, Microsoft), health systems (Mayo, Intermountain) and others, all working to speed development of "secure, ethical, innovative, open source" tools.
March 24, 2020 04:00 PM
The new COVID-19 Healthcare Coalition is bringing together some notable heavy-hitters from across the healthcare and technology industries – each with different specialties, but all working toward the single aim of saving lives by helping healthcare organizations gain better data insights to fight back against coronavirus.
Members so far include: Amazon Web Services, Arcadia.io, athenahealth, Buoy Health, CommonWell Health Alliance, Epic, HCA Healthcare, Intermountain Healthcare, LabCorp, Leavitt Partners, MassChallenge, Mayo Clinic, Microsoft, MITRE, nference, Rush University System for Health, Salesforce, University of California Healthcare System and Walgreens.
The COVID-19 Healthcare Coalition is also consulting with national experts on pandemics about the strategic, clinical and operational imperatives they should be helping their clients manage.
First convened by leaders from Mayo Clinic, Leavitt Partners and Massachusetts Institute of Technology – and coordinated by MITRE – the coalition aims to channel the private-sector response to the ongoing pandemic, and help facilitate communication, aggregate de-identified data – whether it's clinical insights into the behavior of the coronavirus and COVID-19 or resource requirements such as ICU beds and ventilators.

Health Care Technology Leadership in the Midst of COVID-19

March 24, 2020
The world is facing a viral pandemic, and news coverage has reflected public anxiety and confusion. Some of the largest health care conferences in the country have been cancelled this year, and we are still not sure what the new normal will be. I was planning to meet with leaders in physician burnout at those conferences, but found myself like a deer in headlights confused about the way forward. 
Even prior to the coronavirus pandemic, the American health care system had rising rates of physician burnout and a physician shortage. Now, we also are expecting a surge and overload of our care capacity. I reached out to Bridgette Duffy, MD, to ask her insight about the current state of physician burnout. (We were going to meet at HIMSS in person–so with that cancelled, I called her on the phone.) Dr. Duffy believes that in the face of crisis, physicians will show up for their patients. Her prediction? Physicians will work at the peak of their licenses, the peak of their efficiency, and the peak of their humanity.
Human Centered Leadership in Crisis 
The stress that people are feeling now is a concentrated picture of the stress physicians and nurses feel regularly. Our instincts and procedures become more important, and a well organized system will have better outcomes.

4 Ways You Haven't Thought About Using Telehealth During the COVID-19 Pandemic

By Mandy Roth  |   March 24, 2020

Learn how healthcare systems are using telehealth to address workforce issues, care for at-risk populations, and deliver more efficient care.


·         Telehealth offers an opportunity to increase physician supply through geographic "load balancing."
·         Health systems can maximize workforce potential by using quarantined physicians to provide virtual care.
With the arrival of the COVID-19 pandemic, telehealth has finally come of age. Like a lonely teenager who once struggled to make connections with a broader network of friends and was bound by strict parental controls, suddenly, telehealth has blossomed into the most popular kid in school by becoming an essential tool in the healthcare armament against this pandemic.
Almost overnight, telehealth providers reported an upswing in demand (see item #4 in this story) as key barriers to widespread telehealth usage vanished, including consumer awareness and physician and consumer acceptance. In an effort to quell the spread of disease and direct patients to the most appropriate setting, the Centers for Medicare & Medicaid Services changed access requirements and reimbursement restrictions, and many other payers have followed suit.
While the primary focus of telehealth during these early days of the coronavirus public health crisis has been on screening COVID-19 patients and treating those who can manage their symptoms at home, there are four ways this form of care can help hospitals and healthcare systems address the issues that the pandemic has created.

Britain challenges start-ups to support mental health of self-isolators

By Staff Writer on Mar 24, 2020 6:29AM

£25,000 grants available for digital solutions that can be running in next few weeks.

Britain has challenged tech start-ups to help counter the effects of social isolation on people's mental health, with grants of 25,000 pounds available for digital solutions that can be up and running in the next few weeks.
All Britons have been told to avoid unnecessary interaction to slow the spread of coronavirus and a further 1.5 million people with underlying health conditions have been instructed to cease all social contact for 12 weeks.
The government said a total of £500,000 ($578,000) of funding would be available to innovators who can find digital ways to support those who need help during the outbreak – including people requiring mental health support and those with social care needs.

Special Report: Imaging (PACS)

Picture archiving and communications systems (PACS) systems allow clinicians fast access to high-quality images which means health teams access the best possible information to aid in decision-making. Jennifer Trueland explores whether investment in technology and infrastructure could help PACS make the leap from good to great.
As an oncologist of many years, Jeanette Dickson remembers life before PACS. She describes a world of giant envelopes filled with ill-sorted and often elusive, difficulty in comparing images – and the ever-present risk of smarting fingers from paper or film cuts. The difference that PACS has made to her and to her colleagues has been stunning.
“It means that when I want to see an image, I don’t have to rummage around in a big package of films,” she says simply.
“It used to be that if I was doing an out-patient clinic, and Joe Bloggs came in, I had to find his packet of films amongst the ones that had been pulled for the clinic – if they had actually been found.

States Move Quickly to Address Coronavirus Pandemic With Telehealth

Eighteen states and Washington DC have enacted emergency regulations to increase the use of telehealth to tackle the Coronavirus epidemic, including in some cases allowing doctors and patients to collaborate by phone.
March 20, 2020 - Eighteen states and the District of Columbia have so far amended existing laws or issued new declarations to expand the use of telehealth and mHealth tool during the Coronavirus (COVID-19) pandemic.
According to the California-based Center for Connected Health Policy, states have been primarily waiving Medicaid requirements, including allowing telehealth – even phone calls – to qualify as the establishment of a doctor-patient relationship. Some have also eased the rules to allow residents to access telemental health services from their homes.
CCHP is also providing – and updating daily – a listing of telehealth coverage policies and a separate fact sheet on coverage.
With states shutting non-essential services and in some cases issuing stay-in-place orders, executives and lawmakers are scrambling to eliminate barriers to telehealth use to help residents access care remotely and reduce the strain on hospitals and clinics. The federal government has chipped in as well, with changes to Medicare guidelines.

Geisinger, UPMC among health systems fast-tracking tech, telehealth projects for COVID-19

Mar 23, 2020 12:56pm
Health IT leaders at hospitals and health systems are fast-tracking major technology projects—some in a matter of days.
As coronavirus cases rapidly increase in the U.S., healthcare chief information officers (CIOs) and IT executives are facing an unprecedented situation with a demand to ramp up technology tools on multiple fronts.
Hospital CIOs are quickly putting up telehealth infrastructure and telecommuting capabilities for thousands of employees and also developing screening chatbots and tracking tools to help frontline healthcare workers respond to the coronavirus pandemic.
"The leaders out in the field, at clinics, nursing homes, and hospitals, they are working at a pace that is heroic at best. What they are doing is right now is pretty amazing," said Russell Branzell, president and CEO of the College of Healthcare Information Management Executives (CHIME).

IBM, White House, Department of Energy, and others launch consortium to give coronavirus researchers access to supercomputers

Kyle Wiggers @Kyle_L_Wiggers March 22, 2020 2:30 PM
Following the launch of its 2020 Call for Code Global Challenge, IBM today announced that it will help coordinate an effort to provide over 330 petaflops of computing power to scientists researching COVID-19, which has sickened over 300,000 people. The company anticipates that the capacity will be used to develop algorithms that assess how COVID-19 is progressing and to model potential therapies in pursuit of a possible vaccine.
“These high-performance computing systems allow researchers to run very large numbers of calculations in epidemiology, bioinformatics, and molecular modeling. These experiments would take years to complete if worked by hand, or months if handled on slower, traditional computing platforms,” wrote IBM Research director Dario Gil in a blog post. “Since the start of the COVID-19 pandemic, we have been working closely with governments in the U.S. and worldwide to find all available options to put our technology and expertise to work to help organizations be resilient and adapt to the consequences of the pandemic.”
As part of a newly launched consortium — the COVID-19 High Performance Computing (HPC) Consortium — which includes the White House Office of Science and Technology Policy, the U.S. Department of Energy, MIT, Rensselaer Polytechnic Institute, Lawrence Livermore National Lab, Argonne National Lab, Oak Ridge National Laboratory, Sandia National Laboratory, Los Alamos National Laboratory, NASA, the National Science Foundation, Microsoft, Google, Hewlett Packard Enterprise, and Amazon, IBM says it will assist in evaluating proposals from institutions and provide access to compute for projects that can “make the most immediate impact.” Teams will have at their disposal 16 systems with a combined 775,000 processor cores and 34,000 GPUs, which can perform around 330 trillion floating-point operations per second (330 petaflops).

Smartphones help track global virus spread

Mar 22, 2020
Researchers, industry and governments across the globe are partnering to develop apps that track possible transmission of the coronavirus based on location data from smartphones.
On Feb. 11, China launched the Hangzhou Health Code app that assigns a green, orange or red QR code to users based on their health status. After users answer questions related to their recent travel and contacts, the system combines that information with background data from government systems and determines which color code a user is assigned. That code tells users if they have come into contact with someone who might have the virus and dictates whether users should be out in public, at home for seven days or under a two-week quarantine, which requires the patient to regularly check in with health authorities via DingTalk, a workplace chat app run by Alibaba.
The health database is closely monitored by Hangzhou’s Center for Disease Control and Prevention, according to the World Economic Forum.
The phone-based app displays the code, which must be scanned by users entering public spaces, large buildings, shopping areas, buses or trains and at health checkpoints. The color will likely change if users’ close contacts become infected or recover from the illness.
That status makes it possible for the “close contact detector” app to alert other residents if they’ve been seated near a possibly contagious person on a train or plane and to identify the homes of persons known to be infected. Those who have been in close contact with the virus-positive are advised to stay at home and get in touch with local health authorities. The app also lets users check the health status of three others by entering their ID numbers.

How Vendors are Using EHR Optimization to Combat Coronavirus

With the coronavirus spreading at a rapid rate, EHRs need to be updated and optimized to limit the spread of the virus and battle clinician burden.
March 23, 2020 - The spread of the coronavirus has put a massive stress test on EHR vendors to ensure their EHR software is updated and ultimately helps clinicians address the complex battle of capping virus spread.
Function and usability will be a major test for EHRs, because they are designed to track and bill procedures, rather than provide optimal patient care, Eric Perakslis, PhD, Rubenstein fellow at Duke University, and Erich Huang, MD, data scientist and chief data officer for quality for Duke Health, wrote in a STAT op-ed.
In a time where health systems are under immense pressure from overcrowding and uncertainty, EHR optimization is crucial. It’s meant to improve clinical productivity and efficiency, enhance patient care, and lessen clinician burnout.
Epic Systems, Allscripts, and athenahealth have all rolled out updates to optimize EHR use amid the coronavirus outbreak.

AI algorithm IDs abnormal chest X-rays from COVID-19 patients

“Instant triage” capability from behold.ai could speed diagnosis of COVID-19 and help ensure resources are allocated properly.
March 23, 2020 11:13 AM
AI-powered cognitive computing platform vendor behold.ai today announced that its artificial intelligence-based red dot algorithm quickly identifies chest X-rays from COVID-19 patients as abnormal.
The vendor calls this “instant triage,” and it could potentially speed diagnosis of individuals with COVID-19 and ensure resources are allocated properly.
These findings follow recent news that behold.ai’s algorithm has been cleared by the U.S. Food and Drug Administration.
“The majority of deaths from COVID-19 are owing to pneumonia in the lungs of vulnerable patients,” said Dr. Tom Naunton Morgan, chief medical officer at behold.ai. “Pneumonia is a potentially life-threatening condition caused by a number of pathogens including, directly or indirectly, COVID-19 infection. Our algorithm can detect abnormal chest X-rays including pneumonia almost instantly.”

AWS initiative to accelerate COVID-19 diagnostics, research

Backed by an initial investment of $20 million, the project is open to accredited research institutions and private entities using AWS to support development of point-of-care diagnostics.
March 23, 2020 12:02 PM
Amazon joins a growing list of global technology giants stepping up to help battle the global COVID-19 pandemic through the AWS Diagnostic Development Initiative, which aims to accelerate COVID-19 diagnostics, research, and testing.
The program, which is backed by an initial investment of $20 million, is open to accredited research institutions and private entities using AWS to support research-oriented workloads for the development of point-of-care diagnostics.
This type of diagnostic treatment refers to testing that can be done at home or at a clinic with same-day results.

Is Artificial Intelligence Mature Enough to Combat COVID-19?

Organizations at the federal, community, and commercial levels are leveraging artificial intelligence to control the spread of COVID-19, but is the technology ready?
March 18, 2020 - Before the world was even conscious of the threat posed by COVID-19, artificial intelligence had detected the beginnings of the outbreak.
On December 30, 2019, researchers from BlueDot, a company that uses AI to track and anticipate infectious diseases, spotted a report about a pneumonia of unknown aetiology in China.
Nearly a week later, on January 5, 2020, the World Health Organization (WHO) issued a request for more information from Chinese public health authorities. At the time, there had been 44 cases reported, with eleven patients in critical condition.
In the worldwide crisis that has since ensued, leaders from all sectors of the healthcare industry have turned to novel technologies to help monitor and control the spread of COVID-19 – the same technologies that were able to detect the initial outbreak.

Weekly News Recap

  • Hospitals ask the federal government for a $100 billion bailout to offset their costs of diagnosing and treating COVID-19.
  • COVID-19 predictions and recommended federal government actions dominated the news.
  • HHS announces that it will allow physicians to practice across state lines, although individual states must waive their own requirements.
  • HHS OCR relaxes its requirements on the use of consumer video technologies such as Skype and FaceTime for offering telehealth services.
  • Telemedicine companies struggle with a high volume of demand that strains their infrastructure and provider availability.
  • WebMD acquires StayWell.
  • Epic cancels its XGM conference.
  • Cerner asks all employees who are able to work from home to do so.