This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Saturday, February 25, 2017
Weekly Overseas Health IT Links – 25th February, 2017.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
DR. A.J. Published February 18, 2017 - 4:00am Last Updated February 18, 2017 - 4:01am
Since the province pays for services offered by doctors and hospitals, these are the affordable defaults for health needs.
But do these services cogs work smoothly and synchronously? Have they benefitted from E-health innovations? Do these innovations result in outcomes that save money and lives?
As systems grow more complex, the test of their performance lies in their ability to work cohesively. Gains are expected from the investment of public funds as well as the blood, sweat and tears from the human resources operating them.
Electronic health record platforms are among the most complex, interconnected, data-intensive software applications on the planet. Think about the seemingly endless fragments of patient information that an EHR is asked to store and maintain – basic demographics, diagnoses, chart notes, medications, allergies, upcoming appointments, previous surgeries and procedures, historical lab values, imaging studies, standing lab orders, e-prescription transmission transactions, claim submissions, and on and on.
Physicians and their staff also need to be able to review, transmit, reconcile, approve, and synthesize all of that clinical information to help make better, more informed decisions with their patients
Users say OpenNotes can help patients better understand their health conditions.
As more health systems are integrating OpenNotes into their facilities, the benefits of allowing patients to view their medical records are becoming clearer.
One primary benefit is increased transparency between patients and doctors, Eric Topol, M.D., a cardiologist and professor of genomics at The Scripps Research Institute, told U.S. News & World Report. According to Topol, there has been a long-standing undercurrent of "medical paternalism" among physicians, but the OpenNotes platform allows patients to correct mistakes and be more involved in their care.
“Notes are fraught with errors when they’ve been audited,” Topol said. “So why not have the patients involved? It’s their care, it’s their body. They paid for the visit one way or another. But yet they have no work product.”
Digital health technologies will transform healthcare. Mobile phones have given health care providers the ability to engage with patients 24-7 and patients are able to capture and share data that may be helpful in tracking and personalizing their health care. Genomics, analytics, artificial intelligence and deep learning technologies are all making inroads in this emerging sector. Although the amount of money invested in the sector slightly decreased from last year, according to Rock Health, venture capital interest in the digital health sector is still significant with $4.2 billion invested in 2016.
It’s a very diverse sector that spans from general wellness applications targeting consumers to highly clinical solutions that typically require FDA approval. At AMV, we focus more on clinically oriented digital solutions tackling healthcare problems and have invested in dozens of early-stage companies since we began looking at digital health in 2003.
The Argonaut Project, an industry-wide effort to accelerate the development and adoption of HL7’s Fast Healthcare Interoperability Resources, has released a FHIR implementation guide to simplify and standardize the exchange of basic clinical data.
This is the first major publication of an open-industry general FHIR implementation guide, says Micky Tripathi, project manager of the Argonaut Project, and the culmination of two years of work by vendors and providers to produce “road-tested” specifications for developers looking to build interoperability capabilities based on modern Internet architectures.
“It’s really the first foundational, open-industry implementation guide that’s being made available for people who want to build basic, core FHIR-based apps,” Tripathi says.
If Seema Verma, President Trump’s nominee to head the Centers for Medicare and Medicaid Services, is confirmed by the Senate, she will seek to modernize CMS’s programs to better address the changing needs of the people the agency serves, leveraging innovation and technology to drive coordinated, cost-effective care.
“Doctors are increasingly frustrated by the number of costly and time-consuming burdens,” Verma testified February 16 before the Senate Finance Committee. “We should support doctors in providing high-quality care to their patients and ensuring that CMS’s rules and regulations don’t drive doctors and providers from serving the people or beneficiaries.”
At the Senate confirmation hearing, Verma called out the need to help reduce regulatory burdens on rural and other healthcare providers, including electronic health record requirements under the Meaningful Use program.
According to Stratistics MRC, the Global E-Health Market is accounted for $99.35 billion in 2015 and is expected to reach $285.57 billion by 2022 growing at a CAGR of 16.2% during the forecast period. Factors such as growing occurrence of chronic diseases and technological advancements are favouring the market growth. However, increasing privacy concerns and growing demand for the safe infrastructure of data confidentiality are hampering the market.
Healthcare providers segment held a substantial share in 2014, as e-Health offers great convenience to healthcare professionals in terms of patient work flow and data management. North America commanded the market attributed to the availability of supportive infrastructure such as high-speed internet. Asia-Pacific is expected to witness lucrative growth during the forecast period owing to increasing government support to improve healthcare infrastructure.
A fact-finding trip to Seoul has left Joe McDonald contemplating the quality of freedom and privacy back in the UK, and the difference between placing your trust in the citizen or the state.
At 35,000 Feet above Moscow a little turbulence rattled the ice in my gin and tonic as I reflected on my visit to South Korea and in particular the museum in Samsung’s Global Headquarters in Seoul. South Korea is a remarkable country full of remarkable, resourceful and charming people.
The country has gone from the third world to first world economic powerhouse in just 40 years, “The Miracle on the Han River” they call it. Meanwhile just 35 miles to the North, the people of North Korea remain oppressed, frequently hungry and devoid of basic human rights.
Freedom to choose
My mind went back to the pictured exhibit in the Samsung museum, a combined VHS and DVD player which clearly captures a tipping point in the history of video technology and also how nimble Samsung are in their product development. Not sure which way the video market is going to go? Doesn’t matter, we’ll design another one in 3 months when we have a better idea.
Patients will always receive care across multiple venues, and that means healthcare providers must learn how to exchange data. Application programming interfaces are the way forward for interoperability.
Interoperability is a key area of emphasis in modern healthcare. New technology has made the exchange of health information between systems easier and faster, forging the path for a robust health IT ecosystem devoted to advancing patient care. Though there's still a marathon ahead of us as we work toward this goal, interoperability has become the rallying cry for innovative providers devoted to putting the person at the center of care.
One of the challenges of advancing interoperability lies in consumer expectations. As technology has become more sophisticated, so has its users. Patients now demand timely access to their health information, and they want as few impediments to that access as possible.
It's not just a consumer expectation, either. Data access has become a regulatory requirement. Beginning Jan. 1, 2018, as part of the Stage 3 meaningful use program set by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT, all healthcare providers will be required to give consumers direct connectivity to their healthcare data using application programming interfaces.
A tremendous amount of healthcare data will be moved to the Amazon Web Services and Microsoft Azure clouds for either private or public use in 2017. It makes sense, because hospital leaders are of the mindset that they prefer to be in the business of treating patients, rather than managing data centers.
The fact that cloud computing can be a less expensive option helps, too. As the cloud computing trend takes off in healthcare, a carefully architected data security strategy
Microsoft is trying again in healthcare, betting its prowess in cloud services and artificial intelligence can help it expand in a market that's been notoriously hard for technology companies.
A new initiative called Healthcare NExT will combine work from existing industry players and Microsoft's Research and AI units to help doctors reduce data entry tasks, triage sick patients more efficiently and ease outpatient care.
"I want to bring our research capabilities and our hyper-scale cloud to bear so our partners can have huge success in the healthcare world," said Peter Lee, a Microsoft Research vice president who heads Healthcare NExT.
KOCHI: Even as the government proposes to digitize medical records, already the corporate tertiary care hospitals in Kochi are in the process of going paperless. While few of them have fully gone paperless, there are many others who have ensured that all their out-patient records are digitized.
"We have a completely paperless medical system. It improves the overall quality of healthcare- from patient safety to provider efficiency. Electronic medical system is a critical tool in achieving health information exchange across doctors. The records are available whenever and wherever it is needed," Santy Sajan, Chief Operating Officer, Aster Medcity.
"On the technology front, it decreases the carbon footprint and makes sure that the data is available, archived well and retrieved easily," said Dr Binu Joy, Head-Division of Digital Health and Innovation, Rajagiri Hospital.
Doctors are slow to adopt evidence-based care protocols. But why?
It can take the healthcare industry close to two decades to implement evidence-based care protocols. There are four reasons clinicians embrace new data at a “snail’s pace,” writes Kyle Jones, M.D., a faculty member at the University of Utah’s Family Medicine Residency Program, in an article for the American Academy of Family Physicians.
“This seems absolutely ridiculous. Why wouldn't we want to do the best we can to help our patients?” he writes. “Many of the reasons are in our control, but many are not.”
About 78% of consumers say they would be interested in receiving virtual health services, but only 1 in 5 has had that opportunity, according to a new survey from Accenture conducted by Nielsen.
Physicians could save big money by providing more virtual services in combination with seeing patients in their offices, said Frances Dare, Accenture managing director of virtual health services.
About $7 billion worth of primary-care physicians' time annually could be saved if patients could shift annual exams out of the doctor's office to home; do electronic visits for after-care and question-answering; and if they didn't have to go to the doctor for certain chronic disease management, such as for hypertension and diabetes, Dare said. Accenture made those estimates by analyzing federal health data, she said.
During my 22 years as a hospital CIO, I experienced plenty of challenges – along with many successes – while working to implement new technologies, change outdated processes and modify inefficient workflows. One particularly demanding period followed the 2006 Joint Commission Sentinel Alert Event, which called for medication reconciliation at every transition of care.
Truthfully, when the standards were announced, I thought the task would be relatively easy and involve just a few tweaks to workflows, plus the creation of a couple of new forms. I never expected the amount of pushback that I received from doctors and staff, who complained that they lacked the time to perform reconciliations, especially when so few patients could accurately list all of their medications.
However, I knew the project was in big trouble the day my director of pharmacy called to ask which street corner he should stand on to buy marijuana, which at that time was illegal in every state. Apparently, an intake nurse had diligently noted a patient’s reported use of marijuana twice a day. When the patient was transferred from the emergency department (ED) to inpatient care, the doctor signed the reconciliation, noting that the patient should “continue all as originally taken.” Yes, we were indeed in big trouble.
Commonwealth Care Alliance chief of clinical innovation John Loughnane, MD, said the industry is on the verge of voice technologies that can be used to tailor individualized care regimens.
“Alexa, when will you be in my doctor’s office?”
“Silly human — I already am!”
Okay, so Alexa’s response might not be that sassy precisely, but you get the picture. Artificial intelligence voice technologies are on the verge of changing the dynamics of how we interface with machines and, consequently, how humans interact with each other.
A new report from DirectTrust includes more than 50 recommendations for secure clinical messaging.
New recommendations from a DirectTrust workgroup aim to improve Direct messaging capabilities, calling on EHR software vendors to address significant gaps in clinical messaging usability and security.
The new recommendations, released in a report (PDF) by the DirectTrust Clinicians’ Steering Group, include a range of clinical messaging issues for organizations utilizing Direct Interoperability standards, which remain “poorly understood by many clinicians.”
Stanford University School of Medicine
Companies should look for lessons in other industries, create products that are tailored to population subsets, develop synergistic partnerships, and understand the performance characteristics of products in the real world.
Despite years of hype in the field of digital health products — a term that we use here to describe technologies that are designed to have clinical impact on disease — fewer products than expected are being deployed in real-world clinical settings. Many digital health products that demonstrate impressive results in clinical trials often fail to do so in real-world settings.
Why? Much of the success of digital health products is predicated on patient engagement, and clinical trials are among the most engaging environments in health care. Clinical trials involve the use of a variety of tools (e.g., training, close monitoring, payments) to ensure that patients use the technologies appropriately, but few of these tools are used in the real world. In order to cross the chasm from success in clinical trials to success in practice, digital health companies need to focus on patient engagement.
Today’s Senate confirmation of Rep. Tom Price, MD (R-Ga.) to be the next Secretary of Health and Human Services is generating positive reactions from healthcare information technology groups.
While Senate Democrats voted along party lines against Price’s nomination because of concerns about his strong support for repealing the Affordable Care Act, health IT stakeholders generally see his combined legislator and physician experience as a big plus for taking the helm at HHS.
In particular, they point to the fact that as a member of Congress, 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) to ease the burdens on providers in adopting HIT so that they can better focus on patient care.
As doctors in all parts of the hospital, including the emergency department, rely increasingly on digital tools, more mobile apps for a variety of treatment options are flooding the market—some of which tackle issues one might not expect.
Iltifat Husain, M.D., a former emergency physician and CEO of Decision Point Informatics, compiled for Medpage Today and iMedicalApps.com a list of apps that docs in the ER should try for issues ranging from prescription discounts for patients to gout diagnoses and virtual surgery simulators.
Potential trends include improved natural language processing, use of telehealth, enhanced clinical decision support, and more mobile use.
Author Meg Bryant
Published Feb. 9, 2017
While there is still plenty of room for improving the usability of electronic health records (EHRs) and making them more affordable for care providers, experts are trying to get folks to focus on their future potential. The barriers to EHR implementation and interoperability are slowly coming down and once they do, vendors will start looking to add more functionalities to the systems.
It’s hard to predict which new capabilities will catch on, but potential trends include improved natural language processing, use of telehealth, enhanced clinical decision support, more mobile use, and remote monitoring.
What EHRs could look like with new capabilities
To begin with, EHRs could serve as a hub for advanced analytics—not just retrospectively, as they are today, but enabling advanced analytics and decision support capabilities.
According to the 2017 Xerox eHealth Survey, released by Xerox today, nearly half of Americans (44 percent) are worried about having their personal healthcare information stolen. In 2016, more than one data breach was reported each day2 and healthcare providers can help protect personal information against these threats.
The Xerox survey, conducted online by Harris Poll in January 2017 among more than 3,000 U.S. adults ages 18 and older, shows more than three quarters (76 percent) believe it would be more secure to share healthcare information between providers through a secure electronic method rather than faxing paper documents.
The 2017 Xerox eHealth Survey also uncovered that patients believe that information sharing between providers can improve care coordination and reduce wait times for test results and diagnoses. Other key findings from the survey include:
With almost any industry, there are a few companies that have the majority of market share. We’re all familiar with the dominant players in the EHR market, those top 10 systems who hold the 80 percent to 90 percent of market share year to year. According to market research, Epic, Cerner and Allscripts currently top that list.
I can’t tell you how many times I get asked, “Should I just switch to Cerner or Epic or Allscripts?” by health IT executives whose health system uses an EHR other than one of these major systems. Health system leaders should take a close look at their current situation alongside their short- and long-term objectives to determine the right answer for their organization—with only a little consideration for what’s popular in the market.
Health systems tend to switch EHRs for a number of reasons, but I like to categorize them into urgent and non-urgent reasons to help weigh the pros and the cons of investing in a new system.
AI will have a major impact on jobs and the very nature of work, but it’s much less clear what that impact will be.
By Irving Wladawsky-Berger
Feb 10, 2017 1:08 pm ET
English economist John Maynard Keynes in a 1930 essay, Economic Possibilities for our Grandchildren, wrote about the onset of “a new disease” which he called technological unemployment, that is “unemployment due to our discovery of means of economising the use of labour outrunning the pace at which we can find new uses for labour.”
“But this is only a temporary phase of maladjustment,” he added. “I would predict that the standard of life in progressive countries one hundred years hence will be between four and eight times as high as it is.” Mr. Keynes believed that technological progress would lead us to a brighter future. By 2030, people would likely work no more than 15 hours a week, and their biggest problem would be how to use their leisure and freedom from economic cares.
I was reminded of Mr. Keynes’ predictions while reading a number of recent articles on our emerging age of artificial intelligence. After decades of unfulfilled promises and hype, AI seems to be reaching a tipping point. The necessary ingredients are finally coming together: lots and lots of data, with the volume of data pouring in expected to double every three years or so; advanced machine learning algorithms that extract insights and learn from all that data; drastically lowered technology costs for collecting, storing and analyzing these oceans of information; and access to an increasing variety of data-driven, cloud-based AI applications.
Last year, it was reported that supercomputer IBM Watson diagnosed a rare form of leukaemia in a patient at a University of Tokyo-affiliated hospital whose case had baffled her medical team.
The cloud-based, artificial intelligence-powered supercomputer is capable of cross-referencing and analysing data from tens of millions of oncology papers from research institutes all over the world. From vast volumes of data, it can instantly pull out the information it needs, much faster than humans can.
The University of Tokyo reported that the 60-year-old Japanese woman was correctly diagnosed in just 10 minutes by Watson, after her genetic data was cross-referenced with the computer’s own database.