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What does the Trump presidency imply for healthcare and healthcare IT?
From the survival of the ACA to the oversight of the FDA to the enforcement actions of the FTC, a look at what the new administration might mean for health technology.
November 21, 2016 10:10 AM
Many organizations have asked me to comment on the impact of the Trump Presidency on healthcare and healthcare IT. I served the Bush administration for four years and the Obama administration for six years. I know that change in Washington happens incrementally. There is always an evolution, not a revolution, regardless of speechmaking hyperbole.
What am I doing in Massachusetts? I'm staying the course, continuing my focus on social networking for healthcare, mobile, care management analytics, cloud, and security while leaving the strategic plan/budget as is.
I have no inside information and no involvement with the Trump campaign/transition team. From talking to people in Washington and reading publicly available resources, I believe there are 10 themes that will guide us over the next two years.
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Googling our medical symptoms is making us sicker
Every year, Americans spend at least $20 billion on unnecessary medical visits in the US. This is one of the drivers behind the spiraling cost of health care, which is predicted to soar to $5.5 trillion by 2024. The last thing you’d imagine is that the internet would have anything to do with this. But guess again.
Medical doctors are already aware of the connection, because they see it every day. Patients arrive at offices and clinics with a “Google stack,” as it’s sometimes called: a pile of print-outs from the online research they’ve done that has led them to form their own amateur medical opinion.
Seventy-two percent of Americans search for health information online, according to a 2013 Pew study. About 35% search for diagnostic information, and of those who attempt to self-diagnose, just over half proceed to make an appointment with a medical professional to talk about what they found online. In June 2016, Google reported that roughly 1% the site’s searches are related to medical symptoms.
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Best Hospital IT 2016: CIOs divulge their worst nightmares
Natural disasters. EHR downtime. Data breaches. They’re all on the list. The more surprising ones? Not being disruptive enough and building systems that don’t match what clinicians and patients actually need.
November 22, 2016 07:54 AM
When asked what IT-related event scares them most, several of the CIOs whose teams won our Best Hospital IT Departments rattled off a list of somewhat common dangers. Other executives, meanwhile, were more concerned with under-delivering on innovation.
"I don’t want to get a phone call one day telling me our datacenter is on fire," said Jesse Diaz, CIO of Phoebe Putney Health System (#2 Large hospital) in Albany, Georgia.
Henry County Medical Center (#3 Small hospital) IT director Pam Ridley added that a disaster – weather-related or otherwise – that knocked its data center out would be an IT nightmare for her.
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Machine learning aids diagnosis of athletes' heart conditions
Nov 22, 2016 2:19pm
Computer algorithms can interpret echocardiographic images and distinguish between two similar heart conditions affecting young athletes, according to research published in the Journal of the American College of Cardiology.
Researchers from the Icahn School of Medicine at Mount Sinai tested three different machine-learning algorithms for their effectiveness in the discrimination of physiological versus pathological hypertrophic cardiomyopathy.
Pathological hypertrophic cardiomyopathy (HCM), in which a portion of the myocardium enlarges, leading to impaired heart function, is the leading cause of sudden death in young athletes. Distinguishing between it and physiological hypertrophy (heart enlargement often due to exercise) generally requires testing for the two conditions with interpretation by a highly trained cardiologist, according to an announcement.
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Checklists for responding to a security crisis
Nov 23, 2016 8:35am
Responding effectively to a security crisis requires planning, leadership involvement and outside help.
Responding effectively to a security crisis requires planning, and an article at Hospitals & Health Networks provides checklists to guide that effort.
The article differentiates between a security incident, in which an authorized person gains access to one or more computers, networks or other assets, and a security crisis, in which an intrusion affects the organization’s ability to operate.
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Mayo Clinic telemedicine for high-risk births improves patient safety at community hospitals
Expert telemedicine consultation during high-risk newborn deliveries can improve patient safety in hospitals less familiar with advanced newborn resuscitation, according to a new study published in Mayo Clinic Proceedings.
Approximately one in 10 newborns need assistance breathing after birth and one in 1,000 need intensive resuscitation. For community hospitals less familiar with such interventions, these high-risk deliveries may prove problematic.
To determine the potential efficacy of telemedicine newborn consultations in improving outcomes, Mayo Clinic's Division of Neonatal Medicine in Rochester, Minn., provided six health system sites with a total of 84 consultations for high-risk deliveries over a span of 20 months. Reasons for consultation included infant prematurity, respiratory distress and advanced resuscitation. After the consult, one-third of the infants were able to remain in the local hospital instead of being transferred to a larger hospital outside of the community.
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Air Force Medical Service Continues EHR Development Work
The Air Force Medical Service is working to develop a new electronic health record that can offer soldiers real-time data to help deliver treatment to wounded personnel deployed in harsh or isolated environments.
The U.S. Air Force said Wednesday the Theater Medical -Information Program – Air Force project management office helps test, update and train the Armed Forces Longitudinal Technology Application – Theater, the latter of which serves as the deployed EHR for the AFMS.
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Fully Implanted Brain–Computer Interface in a Locked-In Patient with ALS
Options for people with severe paralysis who have lost the ability to communicate orally are limited. We describe a method for communication in a patient with late-stage amyotrophic lateral sclerosis (ALS), involving a fully implanted brain–computer interface that consists of subdural electrodes placed over the motor cortex and a transmitter placed subcutaneously in the left side of the thorax. By attempting to move the hand on the side opposite the implanted electrodes, the patient accurately and independently controlled a computer typing program 28 weeks after electrode placement, at the equivalent of two letters per minute. The brain–computer interface offered autonomous communication that supplemented and at times supplanted the patient’s eye-tracking device. (Funded by the Government of the Netherlands and the European Union; ClinicalTrials.gov number, NCT02224469.)
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Digital Health Market Size to Grow at Over 25.9% CAGR to Reach $379bn by 2024: Global Market Insights Inc.
Nov 23, 2016, 05:00 ET
OCEAN VIEW, Delaware, November 23, 2016 /PRNewswire/ --
Digital Health Market size is estimated to exceed USD 379 billion by 2024; as per a new research report by Global Market Insights, Inc.
Increasing demand for remote patient monitoring services, strong investment outlookand favorable government initiatives should drive global digital health market size. Emergence of healthcare IT coupled with growing penetration of smartphones, tablets and other mobile platforms have led to increased adoption of new business models. Digital technology has enabled people make smarter choices and receive products with value added services.
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Google DeepMind and Royal Free in five-year deal
22 November 2016
Google DeepMind has extended its controversial partnership with the Royal Free London NHS Foundation Trust, signing a new five-year deal.
The London trust will work with the British machine learning company, which was acquired by Google in 2014, on further developing the Streams clinical app, which has so far used algorithms to detect acute kidney injury.
In a statement, Royal Free said that app will be used as a diagnostic support tool for a far wider range of illness, alerting doctors earlier of patients at risk of getting ill.
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Fears raised over Google’s DeepMind deal to use NHS medical data
Academics concerned over company’s access to private records for mobile app
A British artificial intelligence company has signed a five-year partnership with an NHS Trust to process medical data of its 1.6m patients via a mobile app, a move that academics and privacy advocates describe as “pressing” and “worrying”.
DeepMind, owned by Google, will launch Streams with the Royal Free NHS Trust in early 2017. The app will trigger mobile alerts when a patient’s vital signs or blood results are flagged as abnormal.
“10,000 people a year are dying from acute kidney injury, these are entirely preventable deaths,” said Mustafa Suleyman, head of DeepMind Health and the company’s co-founder. “We can trigger an alert that allows nurses or doctors to take preventative action, like giving intravenous antibiotics when your kidneys are dehydrated, to prevent escalation to the ICU.”
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NHS agrees to hand over 1.6MILLION patient records to Google in controversial five year data deal to develop a new mobile app they claim could ‘save 10,000 lives a year’
· Google's DeepMind agrees data share deal with Royal Free NHS hospitals
· London's Royal Free Trust did not need to ask patients before sharing data
· 'Streams' app is designed for kidney care - but contains medical history
· Campaigners unhappy Google will have free access to patient records
· Google says it could save 10,000 lives a year and is charging 'modest fee'
Google has agreed a five-year deal with one of the largest NHS trusts to handle the medical records of up to 1.6million people.
The tech giant's secretive DeepMind health business will use the data to help develop a mobile app they claim could save 10,000 lives a year.
In 2017 it will launch a warning system for acute kidney problems and blood poisoning at three London hospitals, although its 'Streams' app will also include test results, medical history and an instant messaging service.
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Gates Foundation gives Factom a grant to deploy blockchain for medical records
The technology company said it will use the money to focus on secure access of health data via smartphones in developing nations.
November 21, 2016 12:36 PM
Factom, an Austin-based technology firm that develops blockchain-based tools for data management and security, has received a grant from the Bill & Melinda Gates Foundation to develop secure, readily and reliably available medical records.
Using blockchain, Factom builds globally distributed records that can be accessed, irrespective of location, by any authorized person with biometric verification, the company said.
Creating medical records around an individual and securing them with the Factom blockchain solves both these problems in an affordable and practical way. Factom officials said blockchain-based medical records – accessible via smartphone – are especially useful in the developing world, enabling medical professionals to see the information they need to treat patients and coordinate care.
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Re-engage with patients who don't sign up for patient portals
Nov 21, 2016 11:55am
Your practice’s patient portal: It’s the easiest place for patients to access their lab results, get prescription refills, send a message to their doctor or schedule an appointment. Yet not all patients are sold on the idea. One physician's advice: Re-engage with patients and sell them on the benefits of signing up.
Some patients just want to get a phone call or a letter in the mail about their lab results, writes Fred Pelzman, M.D., a New York-based internal medicine physician, in MedPage Today. But for all of the other patients who aren’t signed up for your patient portal, you should ask why.
Pelzman segments patients at his practice who are “ripe” for re-engagement about the patient portal.
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Hospital Impact: 6 tips for using digital media to reach and engage patients
Nov 22, 2016 4:07pm
In order for hospitals to be heard over the "noise" of all of today's digital media, they must find unique ways to provide information to patients that resonates with them.
In today’s always-on world, your organization is competing for mindshare with programming on TV and Netflix, Facebook posts from friends, images on Pinterest and Instagram, and the noise of everyday life. The problem facing hospitals is how to be heard over the noise and provide information that resonates with patients.
You have to ask yourself: Do your communications sound like a college professor (dry and academic) or are they generic and sound like every other hospital in your community? It’s important to find the tone that’s unique to your organization and provides value to your community. The key is making the most of digital media.
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Why user experience is critical to advancing HIT adoption
Published November 22 2016, 3:16pm EST
I have a friend who lives in New York City. For the sake of protecting the innocent, let’s call him Sam. What follows is his experience during a recent appointment with his urologist for a post-surgery check-up as well as some pertinent observations.
Sam uses a big group practice affiliated with a large teaching hospital in Manhattan. He’s more technically savvy than most, so the idea of working through a portal to make an appointment or check on test results doesn’t faze him. He even uses the HIPAA-compliant messaging system to ask questions of the doctors in the practice. He finds it amusing that an emailed notice of a bill sitting somewhere on the portal shows up a day or two after the same bill in paper form shows up in the snail mail.
Now let’s get back to his recent visit.
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MACRA's Information Blocking Threat May be Toothless
Scott Mace, November 22, 2016
Whether the practice of reasonable or unreasonable data blocking yields to government or market forces in 2017 remains to be seen.
As we await stronger signals about where the Trump administration will take health IT from here, keep in mind that the Republican contribution to the MACRA legislation talked tough about information blocking by healthcare providers and HIT vendors.
This tough talk, which originated in Senate hearings in 2014 and 2015, pegged information blocking as a key factor inhibiting the growth of value-based care and was echoed in a 2015 ONC report commissioned by the Republican-controlled Congress as well as ranking committee Democrats in the House and the Senate..
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Ireland to go-live with national maternity electronic record
22 November 2016
Ireland’s biggest maternity hospital will go-live with Cerner next month, as part of an upgrade that will see all its maternity units switch to the electronic health record system.
Cork University Maternity hospital will deploy Cerner on the weekend of 3 December. By the end of 2017, the country’s 17 maternity hospitals that will share a single nationwide Cerner record.
eHealth Ireland chief executive Richard Corbridge told Digital Health News that Cerner had rebuilt and validated the system specifically for Ireland’s maternity context.
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Surgeon General: EHRs, mHealth, evidence-based medicine crucial to fighting addiction
Calling addiction the biggest U.S. health concern, Vivek Murthy, MD, says it should be seen as a chronic disease and treated as such.
November 18, 2016 02:45 PM
The biggest public health concern in the U.S. is addiction, said Surgeon General Vivek Murthy, MD, in a massive report released Thursday. In it, he outlines the severity of substance abuse in the country, likens addiction to chronic disease and outlines how each healthcare stakeholder can work toward combatting the growing problem.
About 27 million Americans suffer with addiction problems - which includes alcohol, drug and prescription misuse and substance use disorders - and another 66 million partake in binge drinking, according to the report.
Further, 78 people die each day from opioid overdose. Murthy said despite these staggering numbers only 10 percent of these people seek treatment.
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Ransomware: 97 percent of phishing e-mails contain it
Locky dominates the onslaught. And there has been an increase in deployment of so-called quiet malware such as remote access Trojan malware like jRAT, according to new research from PhishMe.
November 18, 2016 08:44 AM
The number of phishing e-mails containing a form of ransomware grew to 97 percent during the third quarter of 2016, up from 92 percent in the first quarter, according to research from PhishMe, a vendor of human phishing defense solutions.
Remaining at the forefront of the malware onslaught is Locky encryption ransomware, which has introduced a number of techniques to resist detection during the infection process, PhishMe said.
PhishMe’s Q3 2016 Malware Review identified three trends previously noticed throughout 2016. These trends, the company said, have come to full fruition in the last few months.
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How AI could aid an often-overlooked aspect of experience
Nov 21, 2016 10:05am
Artificial intelligence may soon help hospitals reach their goal of improving patient satisfaction.
Hospitals looking to up their patient satisfaction game might do well to ensure that patients' family and other visitors have a positive experience, as well. And artificial intelligence may soon help organizations reach that goal.
Smart AI-powered devices and systems can sense what we’re doing and make suggestions based on past behavior—and even drill down to fine details, such as suggesting that a visitor buy a bouquet of balloons because the patient is allergic to flowers, according to a recent Harvard Business Review article.
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AMA approves HIT policies to aid improvements in care
Published November 17 2016, 3:32pm EST
The American Medical Association has adopted policies and principles to support the use of information technology by physicians, including electronic health records and mobile applications.
While the nation’s largest physician group has expressed serious reservations regarding digital health technologies in the past, the AMA now appears to believe that the medical benefits of EHRs and mHealth apps outweigh the disadvantages. The organizations affirmed the use of IT at its interim meeting this week in Orlando.
When it comes to mobile healthcare, in particular, the group’s members voted to approve a “list of principles to guide coverage and payment policies supporting the use of mHealth apps and associated devices that are accurate, effective, safe and secure,” with the “potential to be integrated into everyday practice.”
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Working Smarter, Not Harder: Helping Clinicians Optimize Use of EHRs
November 18, 2016
Electronic health records (EHRs) are here to stay in medical practice. And doctors spend a lot of time with them. A recent study found that doctors spend at least two hours during the office day working with EHRs, and between one and two additional hours after work with tasks associated with the technology. Some of that time involves using EHRs during clinical face time for diagnosis and treatment, such as sending electronic prescriptions and verifying lab results to inform treatment decisions. The remainder is spent on administrative tasks, including data entry and checking all the boxes required for pay-for-performance by various public and private insurers.
It can be overwhelming, but doesn’t have to be. The answer is working smarter, not harder, by optimizing the use of EHRs. A better work flow has practice benefits, such as improved quality, safety and efficiency. Using EHRs more efficiently will help doctors meet new requirements posed by the Medicare Access and CHIP Reauthorization Act (MACRA). These will have a direct impact on how physicians will be paid under Medicare or have downward payment adjustments. MACRA requirements replace those previously compelled under the meaningful use EHR incentive program. Finally, optimizing use of EHRs can lead to a better work-life balance, which is something everyone can get behind.
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Wearable technology: gathering data from tooth to toe
Workplace health schemes have spotted opportunities for gathering information about employee ‘wellness’
From fitness trackers to sleep monitors, ever more gadgets are on the market to log our waking or slumbering hours. This is the era of the “quantified self”, in which the path to self-knowledge comes through wearable technology and the health metrics it can generate.
But the tech is not merely solipsistic: employers, workplace health schemes, and insurance companies have spotted opportunities for gathering more information about our “wellness”, too.
They may be taking a cautious approach for now, says Ramon Llamas, analyst at research firm IDC, but they are “trying to figure out how they incorporate these wearables into their strategy”.
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Enjoy!
David.
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