Saturday, December 10, 2016
Weekly Overseas Health IT Links – 10th 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.
by Evan Sweeney
Dec 1, 2016 11:31am
Experts say radiology and pathology should merge into one specialty to make room for advancements in artificial intelligence.
With artificial intelligence poised to take over image-centric medical domains, some health experts are urging radiologists and pathologists to consider merging into a single specialty.
Advancements in deep learning have paved the way for computers to take on a bigger role in reading medical images, but that doesn’t mean machines will replace radiologists and pathologists entirely, according to a viewpoint published in JAMA. Instead, the authors argue that the two specialties should merge into a single role as “information specialists,” allowing computers to take over the menial tasks associated with reading images.
Ransomware is expected to become an even more insidious threat
December 01, 2016 11:08 AM
Global information services company Experian has released its 2017 data breach industry forecast, and the news is sobering.
Among the report's top five predictions? "Healthcare organizations will be the most targeted sector, with new sophisticated attacks emerging."
Experian sees healthcare as particularly vulnerable to cyberattacks because medical identity theft remains so lucrative and relatively easy for hackers to exploit – and they continue to find markets for reselling patient data.
Electronic health records remain likely to be a top target for hackers, Experian found. Also, as more healthcare institutions deploy new mobile applications, it's possible they will introduce new vulnerabilities that will also be attractive targets for attackers.
Auditor General annual report critical of program to switch to electronic health records
16 h by: Sudbury.com Staff
Ontario’s health-care sector spent more than $8 billion between 2002/03 and 2015/16 on various electronic health records projects and related initiatives, but significant components are still not operational, Ontario Auditor General Bonnie Lysyk said in her 2016 Annual Report. File photo.
Ontario’s health-care sector spent more than $8 billion between 2002/03 and 2015/16 on various electronic health records projects and related initiatives, but significant components are still not operational, Ontario Auditor General Bonnie Lysyk said in her 2016 Annual Report.
The government had committed in 2008 to providing an electronic health records for every Ontarian by 2015.
By Fred Bazzoli
Published November 30 2016, 7:26am EST
Much uncertainty and little industry awareness surround a new program that will require physicians ordering outpatient radiological procedures for Medicare beneficiaries to justify ahead of time that the imaging is necessary.
The reimbursement approach aims to have physicians refer to industry-developed appropriateness criteria before ordering advanced—and expensive—imaging procedures for patients, using clinical decision support modules that will be tied into organizations’ electronic health records systems.
The program, one of the provisions of the Protecting Access to Medicare Act of 2014, will go into effect on Jan. 1, 2018, but many specifics of how the program will work are still in development, said presenters at a session during the annual meeting of the Radiological Society of North America.
29 November 2016
NHS Digital is proposing to create a “clear, baseline analytical service”, according to a paper with significant implications for the business intelligence market.
The ‘data and information strategy’ paper says the baseline service will “raise the bar for analytics across the system” and do away with the need for local organisations to buy basic BI and analytics services.
Although this will have implications for companies that sell these services, the paper argues that the move will encourage “investments in innovation.”
Dec 1, 2016 8:30am
Despite the potential big data poses for improving healthcare, it also creates huge data quality, privacy and security problems.
It’s already being used in exciting ways. Technology developed by McLaren Applied Technologies to monitor conditions during Formula One races is being used to reduce leakage in the design of asthma inhalers and analyze heart and breathing rates among patients at Birmingham Children’s Hospital in the United Kingdom. Imperial College London uses its sensor technology to detect neurological dysfunction, reports the Financial Times.
Plans for a massive biobank in Latin America call for collecting genomic data from 1 million people over the next three years, analyzing 100 million data points as well as those of the other 19 biobanks around the world, in a quest to advance personalized medicine.
by Gienna Shaw
Dec 1, 2016 11:11am
After traveling around the world, John Halamka concluded that health IT pain points are the same wherever you go.
England, China and even Denmark, known for its healthcare technology savvy and innovation, are rethinking strategies and are not particularly happy with past progress, he wrote in a blog post on KevinMD.
The CIO of Boston’s Beth Israel Deaconess Medical Center offered up five universal lessons, including this reality check: Healthcare technology investments may never earn a financial return.
Published December 01 2016, 3:44pm EST
The new 21st Century Cures Act is about to change healthcare IT, and most of the industry never saw it coming.
Passed easily on Wednesday by the House of Representatives, the bill is expected to sail through the Senate next week. It is supported by President Obama, who undoubtedly will sign it.
Much of the bill focuses on significant FDA regulatory changes, support of mental and substance abuse-related healthcare, and funding for programs such as Vice President Biden’s Precision Medicine Initiative, the Brain Research Through Advancing Innovative Neurotechnologies Initiative, cancer research and regenerative stem cell-based medicine. It also includes mandates to improve healthcare IT—most notably, in relation to nationwide interoperability and information blocking. Suddenly, those “Interoperability Pledges” that EHR vendors signed earlier this year will not be toothless expressions of good will.
Susan Morse, Associate Editor
The American Hospital Association has asked President-elect Donald Trump to reduce the regulatory burden on hospitals by cancelling Stage 3 of meaningful use, suspending star ratings and continuing the fight against health insurance mergers in a letter sent Wednesday to Trump at Pennsylvania Avenue offices near the White House.
AHA President and CEO Richard Pollack congratulated Trump on being elected the 45th president and asked for help in modernizing healthcare policy, in four pages of recommendations.
"Reducing the administrative complexity of health care would save billions of dollars annually and would allow providers to spend more time on patients, not paperwork," Pollack said.
(Reuters Health) - - Treating depression with video conference calls may offer symptom improvement similar to in-person visits, a recent U.S. study suggests.
Researchers randomly assigned 241 depressed elderly veterans to receive eight weeks of psychotherapy either by visiting a clinician’s office or by using in-home videoconferencing technology. All of them could also take antidepressants.
After one year, there was little or no meaningful difference in satisfaction or symptom relief between the two groups, the study found.
By Fred Bazzoli
Published November 30 2016, 3:17pm EST
A partnership between the Department of Veterans Affairs and an artificial intelligence vendor aims to get at the underlying reasons why some people are more susceptible to diseases, with the intent of better identifying effective treatments.
The VA is pursuing the use of artificial intelligence approaches to care for its patient population after signing a five-year partnership with Flow Health.
Specifically, the agreement calls for the VA and Flow Health to build a “medical knowledge graph” that will help inform decision making and train artificial intelligence applications to personalize care plans to better treat patients.
Real-time confirmation is delivered when patient successfully referred to hospital
Private hospitals can now sign up to access e-referrals with Clanwilliam Health using Healthlink, the national messaging broker.
Following the recent deployment of the e-referrals service to all public hospitals, Clanwilliam has collaborated with eHealth Ireland to enable a similar capability for all private hospitals that sign up for the service.
This will enable private hospitals to send and receive clinical referrals and discharges to GPs through Healthlink.
Launching a patient portal is only step one, says HIMSS17 expert Jan Oldenburg. Empowering patients with the skills and technology to become partners in their own health takes much more than that.
By Mike Miliard
November 29, 2016 01:41 PM
Paying lip service to the concept of patient engagement is much easier than the reality of actually ensuring healthcare consumers are equal partners in their care. Equipping patients with the information and tools they need often requires fundamental rethinking of workflow, outreach and technology strategies.
In their HIMSS17 presentation, "The 'P' is for Participation, Partnering and emPowerment," Jan Oldenburg, principal at Participatory Health Consulting, and Mary Griskewicz, director of strategic sales at HIMSS will offer a talk – aimed at physicians, nurses and the C-suite – that seeks to demystify the process of an effective patient engagement strategy.
They'll offer tips on creating a truly participatory healthcare system that involves patients and clinicians, judiciously deploying digital tools to help ensure patients are reached where and how they're most likely to respond.
by Gienna Shaw
Nov 30, 2016 4:28pm
By next summer, the VA plans to consolidate more than 500 public-facing websites into one portal.
The VA is taking steps to mitigate its reputation as slow to adopt technology by creating patient portals, launching an online scheduling app and turning to artificial intelligence to boost precision medicine efforts.
This summer, a Commission on Care final report listed IT systems among the VA’s many problems, noting that “antiquated” key systems do not adequately support the needs of 21st century healthcare.
Since then, the VA has turned to the private sector in search of an EHR system to replace VistA, its decades-old homegrown system, in favor of one that would support a variety of functions including scheduling, billing, claims, payment, mobile applications and telehealth and would include tools to help veterans better manage their health.
By Mitch Work
Published November 30 2016, 3:39pm EST
Renowned business author Jim Collins often points to the important role that passion plays when companies attempt to move beyond the status quo. The lesson wasn’t lost on clinicians at MultiCare Health System, a non-profit integrated healthcare system based in Tacoma, Wash.
After wanting to use video conferencing as part of a remote patient monitoring program, clinicians have watched their telehealth program take off. MultiCare launched its telehealth program well over a decade ago by providing home care patients, primarily those who suffer from heart conditions and chronic pulmonary obstructive disorder (COPD), with devices that could remotely monitor a variety of vital signs such as blood pressure, weight and oxygen saturation.
“It’s been really effective in allowing us to get our onsite visit utilization down,” said Lynnell Hornbeck, manager of home health at MultiCare. “And, we’ve also been able to get some good clinical outcomes.”
Biomedical research is going big-time: Megaprojects that collect vast stores of data are proliferating rapidly. But scientists' ability to make sense of all that information isn't keeping up.
This conundrum took center stage at a meeting of patient advocates, called Partnering For Cures, in New York City on Nov. 15.
On the one hand, there's an embarrassment of riches, as billions of dollars are spent on these megaprojects.
There's the White House's Cancer Moonshot (which seeks to make 10 years of progress in cancer research over the next five years), the Precision Medicine Initiative (which is trying to recruit a million Americans to glean hints about health and disease from their data), The BRAIN Initiative (to map the neural circuits and understand the mechanics of thought and memory) and the International Human Cell Atlas Initiative (to identify and describe all human cell types).
By Sara Heath on November 29, 2016
The Friday following Thanksgiving, Republican members of Congress put forward an amended version of the 21st Century Cures Act, which contains several provisions regarding EHR use and adoption.
Notably, the legislation refers to EHR use as a part of its efforts toward assisting providers in improving patient quality care. The legislation details strategies to reduce provider reporting burden, health IT certification, and meaningful use hardship exemptions.
By Elizabeth Snell on November 29, 2016
Numerous industries have been working to combat, prevent, and mitigate malicious malware attacks. The healthcare sector has found itself particularly vulnerable to such attacks, and research has shown that the number of healthcare ransomware attacks often outweighs other industries.
Unfortunately, the latest IDC FutureScape predictions for healthcare IT does not show a change in this trend, and that healthcare ransomware will only continue to increase over the next two years. Specifically, ransomware attacks against healthcare organizations will double by 2018, according to IDC FutureScape: Worldwide Healthcare IT 2017 Predictions.
It’s important for the healthcare industry to be willing to work to find the right balance between innovation and security, Lynne Dunbrack, research president of IDC Health Insights, told HealthITSecurity.com.
By Shawn Jeffords, Political Bureau Chief
More than $8 billion and 14 years later and Ontario still doesn’t have a working electronic health records system.
That according to Ontario’s Auditor General who tabled her annual report Wednesday. In it, she notes that “significant components” of the system are still not working in 2016 after a government pledge seven years ago to have electronic health records for every Ontarian by 2015.
“The initiative has certainly advanced since our last audit in 2009,” Lysyk said in a news release. “However, it is still not possible to say if it is on budget because the government never set an overall budget for it. In effect, we cannot say if the $8 billion is a reasonable figure.”
Examples include cracked highways, overspending on eHealth records, shoddy Metrolinx oversight of contractors, and a climate change plan that will do more in California than Ontario.
Wed., Nov. 30, 2016
Crumbling highways, shoddy transit contractors, $8 billion spent on still-incomplete eHealth electronic medical records, and a climate change plan that will do more in California than Ontario.
Those are some of a litany of government snafus exposed by auditor general Bonnie Lysyk in her annual two-volume, 1,063-page report to the legislature on Wednesday.
The independent watchdog said a common theme throughout her 13 value-for-money audits was government contractors and suppliers screwing up yet still being rewarded with additional business.
“They probably receive more chances than you and I would give them if they were renovating our house,” said Lysyk.
The renowned security expert and former confidence artist will discuss cybersecurity issues and identity theft at HIMSS17.
By Bill Siwicki
November 28, 2016 02:19 PM
Frank Abagnale will discuss privacy and security at HIMSS17 in Orlando during February.
Why do data security breaches happen? One reason, plain and simple: People, said Frank Abagnale, president of Abagnale and Associates.
Abagnale is a 40-year veteran of the FBI and one of the world’s most respected authorities on forgery, fraud, embezzlement and secure documents. He is also a self-described confidence artist whose story was made into the film Catch Me If You Can, starring Leonardo DiCaprio.
“Every breach occurs because someone in that company did something they were not supposed to do or because someone in that company failed to do something they were supposed to do,” Abagnale said. “There is not a master hacker sitting in Russia who will get through the company. The hacker will say, ‘I am not getting into JP Morgan Chase because they spend a fortune every year on cybersecurity, but they employ 200,000 people worldwide, so all I am looking for is one of those people who failed to do something they were supposed to or did something they were not supposed to do.’”
By Elizabeth Snell on November 28, 2016
The healthcare industry will likely continue to be plagued by technological issues, such as healthcare data breaches and ransomware attacks, going into next year, according to recent predictions.
The latest Black Book poll of healthcare PR clients showed that physician satisfaction and medico-legal problems are no longer the key concerns, and that 2017 will see a higher focus on technological and financial issues. This includes data breaches, system failures, hacking, ransomware, and a disrupted flow of financial records.
Approximately 1,900 executive level officers from 334 hospitals, 218 physician groups and ambulatory organizations, and 107 payers were interviewed for the survey.
What is LOINC, and how does it work?
LOINC—Logical Observation Identifiers, Names, and Codes—is a universal code system for identifying clinical information in electronic records. Although the Regenstrief Institute holds the copyright to LOINC, this versatile system is available for free at www.loinc.org.
The LOINC vocabulary standard identifies lab assays, clinical observations, and survey assessments by combining up to six attributes: component, property, timing, system, scale, and method. The User’s Guide documentation of Regenstrief’s open-source tool, RELMA, provides in-depth attribute descriptions. A LOINC term is numeric in nature with a check digit, to assure correct transcription. Changing even one of the six attributes points to a different term:
• Urine glucose on a chemistry analyzer in mg/dL = 2350-7
• Urine glucose from a dipstick = 5792-7
I track how technology innovations move markets and careers
Opinions expressed by Forbes Contributors are their own.
Despite intense concerns about data and HIPAA rules, the cloud is poised to become a big part of healthcare. But much of it is likely to remain on-premises or private clouds, with some reliance on the public kind.
A survey from Level 3 and HIMMS Analytics finds growing adoption of cloud for a range of healthcare functions, significantly growing in just the past two years. The survey finds 47% of survey respondents were planning to use the cloud for back office functions, up from 22% just two years ago. Likewise, 47% were planning to use the cloud for business continuity and disaster recovery in 2014 — up from 31% in 2014. Another 41% are using cloud services to support involvement in health information exchanges, up from 20% two years ago. “There’s more to come,” the survey’s authors add, “as the cloud is poised to play a prominent role when healthcare organizations deploy telemedicine, mobile health applications and remote monitoring tools.”
Published November 10 2016, 7:01am EST
Healthcare IT executives are anxiously looking for a sense of how HIT policy will turn under the Trump administration.
Some of the president-elect’s positions on healthcare are well-known, such as his stated intent to repeal and replace the Affordable Care Act with health savings accounts, and working with Congress to create a “patient-centered healthcare system that promotes choice, quality, and affordability.”
But, when it comes to Trump’s approach to health IT, little is known about the kinds of changes and policy prescriptions he would bring to the White House.
Published November 29 2016, 1:16pm EST
Rep. Tom Price, MD (R-Ga.), President-elect Donald Trump’s pick to head the Department of Health and Human Services, is receiving praise from stakeholder groups for his legislative background in health IT policy and efforts to ease burdens on providers struggling with electronic health records.
Jeff Smith, vice president of public policy for the American Medical Informatics Association, believes that Price has a strong history of involvement in HIT policy, stemming from his time as head of the Republican Study Committee and his current role as chairman of the Ways & Means Subcommittee on Health.
“As far as health IT is concerned, Rep. Price introduced the Meaningful Use Hardship Relief Act of 2015 (H.R. 3940) and was an early co-sponsor of the FLEX-IT Act (H.R. 5001),” adds Smith. “In both instances, Rep. Price and his staff demonstrated a strong grasp of the issues impacting clinicians participating in the EHR Incentive Program.”
Published November 29 2016, 12:44pm EST
Congressional Republicans are considering a lightning-strike rollback of Obamacare early next year to kick off the Donald Trump era, but first they have to agree on a plan limited enough to hold their caucus together.
Republicans won’t have much room for error to successfully repeal Obamacare, a top campaign promise of Trump and congressional Republicans. Even if they delay the repeal to allow more time to come up with a replacement, there will be pressure to use the legislative maneuver to push through other top GOP priorities, such as defunding Planned Parenthood.
But Senate Republicans would have to keep unified the 52 senators they expect to have when the new Congress convenes Jan. 3.
The Republican plan would take advantage of reconciliation, a budget-related mechanism to circumvent the 60-vote threshold in the Senate and prevent Democrats from being able to block legislation on their own. By striking early, the GOP could set itself up to invoke the same procedure again later in the year on a broader range of targets, including tax cuts.
Scott Mace, November 29, 2016
Machine learning is not new to healthcare, and we have IBM's Watson technology to thank for that.
Until recently, many of the machine learning applications talked about for healthcare had been used to teach computing systems enough to be able to suggest a diagnosis on a specific disease.
IBM took things further. It essentially sent Watson to medical school.
IBM had Watson ingest large amounts of medical literature to learn everything physicians are taught about patients' conditions, and then taught it to make diagnoses.
Nov 29, 2016 11:56am
President-elect Donald Trump has assembled his healthcare dream team: Rep. Tom Price, R-Ga., a longtime critic of the Affordable Care Act but champion of health IT legislation that reduces the burden on physicians, is his pick to lead the Department of Health and Human Services. And he selected Seema Verma, founder and CEO of consulting firm SVC Inc., to serve as administrator of the Centers for Medicare & Medicaid Services.
Price, a representative from Georgia’s 6th Congressional District and chairman of the House Budget Committee, supported Trump throughout his candidacy, arguing that the healthcare reform law had “destroyed” the healthcare system.
Indeed, The Washington Post notes that he was a leader in Republican opposition to the ACA and worked on several comprehensive bills to replace it.
Instead of envisioning AI outpacing humanity as we know it, researchers spot prime opportunities for clinical decision support, patient monitoring, surgery and more.
November 28, 2016 09:08 AM
When it comes to artificial intelligence, forget the scary movies about rebellious robots or the dire warnings of a dystopian world of disconnected humanity imagined by some popular writers. AI promises, rather, to change our lives in profound ways we are just beginning to experience, according to a ground-breaking survey produced by Stanford University.
Stanford is taking the long view of AI, with a project called One Hundred Study on Artificial Intelligence (AI100). The study, written by a panel of AI experts from multiple fields including healthcare, will continue as an ongoing activity, with periodic reports examining how AI will touch different aspects of daily life.
The first of those reports, "Artificial Intelligence and Life in 2030," looks into the effects that AI advancements will have on a typical North American city a little more than a decade from now.
Nov 28, 2016 10:10am
Technology in medicine can be seen as an unwelcome shift away from human interaction, but digital medicine may actually play a key role in humanizing the healthcare system.
After experiencing a bout of cardiac arrhythmia, Robert Graboyes, a healthcare researcher at the Mercatus Center of George Mason University, installed an app that now allows him to perform an EKG in 30 seconds and get an immediate analysis. These types of developments enable primary care providers to skip time-consuming, unnecessary tasks, Graboyes argues in a recent article published at InsideSources.com.
Nov 28, 2016 10:49am
As the price point for virtual reality falls, an increasing number of vendors are showing interest in new ways to apply the technology.
Virtual reality offers the potential to address pain and stress management, behavioral health, even mobility training for stroke and spinal cord injury patients.
Brennan Spiegel, MD, who is launching the largest VR-based clinical study to date at Cedars-Sinai in Los Angeles, says he has patients asking daily for ways to alleviate pain without medication, according to an mHealth Intelligence article.
Kate Kelland | LONDON
Scientists in the United States have developed a flexible microfluidic device that easily sticks to the skin and measures sweat levels to show how the wearer's body is responding to exercise.
The low-cost device, which can quickly analyse key elements such as lactate, Ph or glucose levels and let the user know if they should stop or change their activity, could also in future help diagnose and monitor disease, the researchers said.
"Sweat is a rich, chemical broth containing a number of important chemical compounds with physiological health information," said John Rogers, a professor Northwestern University in the United States who led the development of what he called a "lab on the skin"
The attack potential grows exponentially as IoT technologies are implemented, warns European cyber security agency.
Ransomware and denial of service attacks are just a glimpse of things to come: hospitals are the next big target for cyber-attacks and the introduction of Internet of Things (IoT) devices make healthcare even more vulnerable.
Connected medical devices can bring increased patient safety and efficiency, particularly if connected to clinical information systems, but European tech security agency Enisa is warning that introducing such technologies also increases risks.
As a result, it said, hospitals need to change their attitude towards security: "The need for improved, and even remote, patient care drives hospitals to transform by adapting smart solutions, ignoring sometimes the emerging security and safety issues. Nothing comes without a price: hospitals are the next target for cyber-attacks," Enisa warned.
Published November 28 2016, 3:10pm EST
If community hospitals are a general barometer of health in the surrounding area, the emergency room is the canary in the coal mine. Viral outbreaks, increases in violence, loss of health insurance from local layoffs—all are social ills that make their presence known first in the ER.
Based on recent ER studies, the U.S. is on the cusp of a full-blown mental health crisis.
According to a recent survey of more than 1,700 emergency physicians by the American College of Emergency Physicians (ACEP), three-quarters of ER physicians evaluate at least one individual per shift who requires hospitalization for mental illness. Slightly more than 20 percent say patients wait from two to five days for an inpatient bed. Only 16.9 percent of ERs have a psychiatrist to call in emergencies, and 11.9 percent have no one at all to call when mental illnesses erupt in the ER.
Posted by Dr David More MB PhD FACHI at Saturday, December 10, 2016