Saturday, March 11, 2017
Weekly Overseas Health IT Links – 11th March, 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.
Artificial intelligence and cognitive computing is being heralded as the brave new frontier of clinical IT, Kim Thomas reports on how it is already beginning to reshape radiology imaging and diagnostics.
Editor, Digital Health
IBM chose December’s annual meeting of the Radiological Society of North America to showcase the ability of its Watson supercomputer to rapidly analyse medical images and suggest a diagnosis. Mark Griffiths, a clinical radiologist at University Hospital Southampton NHS Foundation Trust, who attended RSNA, says he saw some “stunning demonstrations” of the technology, including chest X-rays being “reported in milliseconds.”
Watson is an example of a technology that IBM refers to as “cognitive computing”. Using a form of artificial intelligence known as natural language processing, Watson, a cloud-based system, is able to analyse vast stores of scholarly articles, patient records and medical images. (When IBM acquired Merge Healthcare in 2015, it gained access to the company’s database of 30 billion images.) This ability to interpret written language is what marks Watson out as different from other computer-based tools used to aid diagnosis.
Not enough radiologists to meet demand
In England, the volume of radiology images taken has increased at the rate of 3.6% a year for 20 years, and there are not enough radiologists to meet demand. Could Watson – and other AI tools – provide a solution to the problem of overstretched radiology departments? And – as some fear – could it replace radiologists altogether?
by Matt Kuhrt
Mar 3, 2017 9:24am
Almost 9 in 10 healthcare organizations surveyed by Aruba reported that they had already suffered an IoT-related security breach.
The healthcare sector sees the potential for big benefits in the Internet of Things (IoT), but security remains a major concern.
Objects that connect to the internet and share data have become widespread among organizations generally, according to a new study published by Aruba, part of Hewlett Packard Enterprise. Among sectors surveyed in the study, healthcare’s implementation of IoT lagged only the enterprise and industrial sectors, with 60% of healthcare organizations using the technology worldwide.
Computational biologists are starting to develop user-friendly platforms for analysing and interpreting genetic-sequence data.
28 February 2017
For doctors trying to treat people who have symptoms that have no clear cause, gene-sequencing technologies might help in pointing them to a diagnosis. But the vast amount of data generated can make it hard to get to the answer quickly.
Until a couple of years ago, doctors at US Naval Medical Research Unit-6 (NAMRU-6) in Lima had to send their sequence data to the United States for analysis, a process that could take weeks — much too long to make pressing decisions about treatment. “If all you could do was get the data that you then have to ship to the US, it's almost useless,” says Mariana Leguia, who heads the centre's genomics and pathogen-discovery unit.
But Leguia no longer has to wait for the analyses; she can get results in days or even hours — and she can do them in her own lab. Her unit makes use of EDGE (Empowering the Development of Genomics Expertise), a bioinformatics tool that hides common microbial-genomics tasks, such as sequence assembly and species identification, behind a slick interface that allows users to generate polished analyses. “We can have actionable information on site that allows us to make decisions very quickly about how to go forward,” Leguia says.
Published March 03 2017, 3:30pm EST
Healthcare providers have a number of threats from which they must protect patient data and maintain HIPAA compliance. In this highly targeted industry, there’s no shortage of hackers constantly seeking out unsecured devices, paper and information to make a profit.
In fact, the price of stolen healthcare records is falling because of the abundance of such records on the black market. That means that the recent wave of data breaches within healthcare companies has saturated the stolen data market, and the drum beating for expanded data protection to defend against these breaches is only growing louder.
But it’s not just external attacks worrying healthcare organizations; internal leaks also have IT executives taking notice. With most patient data breaches triggered by employees of the organization, protecting information from within becomes just as important, if not more.
At a pivotal moment for healthcare, it's time to reform regulatory approaches, improve access to data for care coordination, establish a national patient ID and more.
March 01, 2017 11:53 AM
At HIMSS17, I listened carefully to payers, providers, patients, developers, and researchers. Below is a distillation of what I heard from thousands of stakeholders.
This list is not partisan, and does not criticize the work of any person in industry, government or academia. It reflects lessons learned from the past 20 years of healthcare IT implementation and policymaking. Knowing where we are now and where we want to be, here are 10 guiding principles.
1. Stop designing health IT by regulation. Through its certification program, ONC directs the specific features, functionality, and design of electronic health records. As a result, technology developers devote the majority of their development resources to fulfilling government requirements instead of innovating to meet market and clinician demands. The certification program has established a culture of compliance in an industry ready for data-driven innovations. ONC’s role in the health IT industry made sense eight years ago when IT adoption in healthcare lagged considerably behind all other sectors, but today the certification program impedes a functioning market and must be reformed.
27 February 2017
Health secretary Jeremy Hunt was told more than 500,000 missing confidential NHS correspondence a year ago but kept the information secret on official advice.
Hunt faced urgent questions in the Commons after a report in The Guardian that 709,000 letters sent between GPs and hospitals in the five years to 2016 never arrived at their destination. About 500,000 contained confidential clinical data.
Instead, NHS Shared Businesses Services, the company charged with transporting the letters, stored the information in a warehouse, in some case for years.
February 28, 2017
ORLANDO, Florida ― A rapidly maturing HL7 standards framework promises to help physicians expand the capabilities of their electronic health records (EHRs) and will make it easier for them to comply with the requirement of the Merit-Based Incentive Payment System (MIPS) that lets patients have easy electronic access to their health information. These budding standards are already starting to have an impact on the healthcare industry.
Showcased in a daylong series of presentations at the recent Healthcare Information and Management Systems Society (HIMSS) 2017 Conference here in Orlando, the data standards, known collectively as Fast Health Interoperability Resources (FHIR), are already allowing physicians in about two dozen healthcare institutions to do things they could never do before with their EHRs. Among the outside applications that FHIR application programming interfaces (APIs) are letting these doctors use are programs for pediatric growth charts, the measurement of bilirubin levels, and the translation of medication instructions in more than 20 languages.
Telemedicine, predictive diagnostics, wearable sensors and a host of new apps will transform how people manage their health
Mar 2nd 2017
WHEN someone goes into cardiac arrest, survival depends on how quickly the heart can be restarted. Enter Amazon’s Echo, a voice-driven computer that answers to the name of Alexa, which can recite life-saving instructions about cardiopulmonary resuscitation, a skill taught to it by the American Heart Association. Alexa is accumulating other health-care skills, too, including acting as a companion for the elderly and answering questions about children’s illnesses. In the near future she will probably help doctors with grubby hands to take notes and to request scans, as well as remind patients to take their pills.
Alexa is one manifestation of a drive to disrupt an industry that has so far largely failed to deliver on the potential of digital information. Health care is over-regulated and expensive to innovate in, and has a history of failing to implement ambitious IT projects. But the momentum towards a digital future is gathering pace. Investment into digital health care has soared (see chart).
Published February 28 2017, 4:20pm EST
In late December, executives at Vanderbilt University Medical Center learned that two employees in the patient transport department were inappropriately accessing patients’ electronic medical records, obtaining more information than they needed to do their jobs, according to the hospital.
An audit found that the activity had been going on for 20 months with 3,247 patients affected. For a smaller but undisclosed number of patients, their Social Security numbers were viewed.
The technology's implications for interoperability, privacy, claims processing and more are intriguing. But many challenges must be addressed before wider applications become possible.
By Mike Miliard
February 22, 2017 05:56 PM
ORLANDO – At HIMSS17 on Wednesday, IEEE Computer Society and the Personal Connected Health Alliance hosted a day-long event focused on the potentially transformative promise of an intriguing innovation: Blockchain.
Kicking off the symposium, "Blockchain in Healthcare: A Rock Stars of Technology Event," Tamara StClaire, previous chief innovation officer at Conduent Health (formerly known as Xerox Healthcare), made the case that the bitcoin-derived secure digital ledger technology could just maybe offer the answer to an array of vexing healthcare challenges – not least of which is interoperability.
"The current infrastructure is really inadequate to handle information exchange," she said. "Blockchain has the opportunity to impact those infrastructure challenges."
By Fred Bazzoli
Published March 01 2017, 3:24pm EST
Patient-generated health data may be a matter for contention now, but a trade association for consumer wearable companies says its recent research suggests that acceptance of the data by physicians is nearing.
A report by the Consumer Technology Association (CTA) predicts that the U.S. could reach a “tipping point” of physicians using patient-generated data from devices such as wearables by 2020.
The group says the report’s findings were based on studying other industry research and on a series of interviews with “key U.S. healthcare industry stakeholders,” including physicians, insurance industry executives, clinical informaticists and experts in the field of digital health technology.
Published March 01 2017, 3:26pm EST
Every day brings a new report of a security breach or other security based problem within healthcare. The unceasing cycle of issues gives rise to the question of what is healthcare doing about security and in particular cyber security, and what more can be done.
That is a question that is front and center for many individuals within the industry and examining the industry. It was also the focus of a recent discussion I had with Stephen Cobb, a security industry veteran currently running a research team at ESET.
Cobb focuses his research on emerging security threats. Given his prior experience in the privacy realm, he brings a somewhat different approach to security.
March 01, 2017
Post-acute care providers may think of electronic health records systems as too complicated and costly, according to a federal report published Monday.
Post-acute settings have limited use of EHRs, which spurred the Government Accountability Office to investigate why adoption is slow, according to the report.
Cost is the top factor inhibiting use, along with ability to exchange EHR information, the watchdog agency found. Facilities' financial resources are often limited to cover initial implementation costs of an EHR, let alone costs of exchanging information and maintenance, the report said.
Varying implementation standards, finding post-acute relevant health information among exchanged data, workflow disruptions and technological challenges also ranked as barriers to EHR use. Post-acute providers also told the GAO that a lack of staff expertise, coupled with high staff turnover, leads to a “constant need” to train staff on the technology.
By Heather Mack
February 28, 2017
By necessity, people who are living with a chronic condition are more familiar with the healthcare system than those who are not. As a natural extension of that relationship, these same people are also more in tune with the technology available to improve their engagement with their health, a new poll from health IT company CDW Healthcare shows.
Building on last year’s efforts to examine what’s driving, influencing and presenting barriers to the patient engagement space, CDW surveyed 200 patients and 200 providers (physicians and physician assistants) to assess the impact of digital tools and communication outreach efforts between the two.
All patients surveyed were chronic – defined as having been to the doctor six or more times in the past year. Of this group, 70 percent said they have become more engaged with their care in the past two years, representing a 13 percent increase from 2016. In the past year, 74 percent of patients joined a patient portal (a nearly 30 percent jump from 2016), which resulted in 69 percent speaking with their healthcare provider more often and 69 percent of respondents accessing their healthcare information online.
The companies said they intend to put the artificial intelligence-powered text analytics technology to work accelerating advances in patient care.
February 27, 2017 01:10 PM
Regenstrief Institute CEO Peter Embi, MD, said the deal will help patients benefit from unstructured data.
Health Catalyst and the Regenstrief Institute are working together to commercialize nDepth, Regenstrief’s natural language processing technology.
nDepth is an acronym for NLP Data Extraction Providing Targeted Healthcare. Indianapolis-based Regenstrief developed the technology to harness unstructured data.
Salt-Lake City-based Health Catalyst, a data warehousing and analytics company, has been in the business of extracting data to boost care quality since it launched in 2008.
Self-guided internet-based CBT significantly more effective for symptom severity, tx response
FRIDAY, Feb. 24, 2017 (HealthDay News) -- Self-guided internet-based cognitive behavioral therapy (iCBT) is effective for treating adults with depressive symptoms, according to a review published online Feb. 22 in JAMA Psychiatry.
Eirini Karyotaki, from the Vrije Universiteit Amsterdam, and colleagues conducted a systematic review to estimate the effect of self-guided iCBT in treating adults with depressive symptoms versus controls. Individual participant data were included for 3,876 participants from 13 of 16 eligible randomized clinical trials in which self-guided iCBT was compared with a control (usual care, waiting list, or attention control); multiple imputations were used to handle missing data.
February 27, 2017 - A recent report found despite secure messaging being cited as the second-most effective real-time communication in emergency departments (ED) behind face-to-face interactions, less than fifty percent of surveyed hospital ED staff report utilizing this form of communication.
Based on a poll of 158 ED staff members conducted by Everbridge, the report showed that while secure messaging (such as Direct messaging) is reportedly the most effective form of non-real time communication, it is still less prevalent in hospitals than communication via EHR technology, email, overhead systems, and fax machines.
Communication in emergency departments is inordinately complex and fast-paced. Errors in sharing information are extremely common, with more than half of surveyed ED staff members reporting over ten percent of handoffs in patient care contain communication errors, and 21 percent of respondents reporting communication errors in more than 1 in 5 handoffs.
Alexandra Wilson Pecci, February 28, 2017
Although the Office of the National Coordinator of Health IT puts electronic medical record system and electronic health record system implementation rates at more than 95% of hospitals, most EMR/EHR systems aren’t optimized for users, says a KPMG report.
Instead, the systems were “implemented as one-time, factory boilerplate-style system installations,” the report says.
The report advises hospitals to assemble cross-functional teams "that comprise technology professionals as well as clinical and business leaders to focus on executing an [EMR/EHR] post-implementation strategy."
February 28, 2017
Editor’s note: This post is part of a series stemming from the Fifth Annual Health Law Year in P/Review event held at Harvard Law School on Monday, January 23rd, 2017. The conference brought together leading experts to review major developments in health law over the previous year, and preview what is to come.
In his 2015 State of the Union address, President Obama launched the Precision Medicine Initiative (PMI), which is intended to help move medicine from the traditional “one-size-fits-all” approach where treatments are designed for the “average” patient, to one that “takes into account individual differences in people’s genes, environments, and lifestyles,” thereby personalizing treatment. According to the White House, a major goal is to “bring us closer to curing diseases like cancer and diabetes.” In December 2016, the 21st Century Cures Act was signed into law, authorizing up to $1.455 billion in funding for the initiative, spread over 10 years (although, importantly, the statute does not guarantee any of the funds, which will be subject to budget negotiations each year).
by: Clive Cookson
February 28, 2017
Kate Palmer and Simon Wright were in despair. Their four-year-old daughter Jessica was suffering from epilepsy, poorly co-ordinated movement and slow mental development but doctors had been unable to pinpoint the rare disorder causing these problems. A series of tests including MRI scans, electroencephalography (EEG) recordings and lumber punctures had failed to provide diagnostic clues.
Then they enlisted Jessica in the UK government’s new 100,000 Genomes Project, through Great Ormond Street Hospital in London. By analysing Jessica’s genome — the 3bn biochemical letters of genetic code that control every cell in the body — and comparing it with her parents’ DNA, researchers identified the likely cause of her condition. A mutation in a gene called SLC2A1 was starving her brain of the sugar needed for efficient metabolism. Although the condition is extremely rare, affecting about 500 people worldwide, clinicians have developed a treatment in the form of a diet that enables the brain to maximise glucose production.
Published February 27 2017, 5:00am EST
Despite the fact that sepsis is one of the most deadly and costly medical conditions for hospitals, doctors frequently fail to properly document this immune system response to infection that kills more than 250,000 Americans each year.
“At least 30 percent of the time, the physicians who are writing their notes do not use the words sepsis, severe sepsis or septic shock. And, so it doesn’t appear in the record,” says Steven Simpson, MD, professor of medicine and interim director of the Division of Pulmonary and Critical Care Medicine at the University of Kansas.
Traditionally, tracking sepsis is done using diagnosis billing codes. The lack of documentation in the electronic health record (EHR) is why it is so difficult to get an accurate picture of septic shock trends, according to Simpson.
The new system delivers optimized EHR data for physicians that is easy to digest and promotes new levels of clinical insights, the vendor says.
By Bill Siwicki
February 24, 2017 12:20 PM
Medicomp Systems, a patient data systems vendor, unveiled at HIMSS17 Quippe Clinical Lens, the company’s newest point-of-care decision support tool.
The new system delivers optimized EHR data for physicians that is easy to digest and promotes new levels of clinical insights, the vendor said. Meridian Medical Management has incorporated Quippe Clinical Lens into its EHR.
Quippe Clinical Lens is a web-based application that can be added to any EHR or health information exchange with the aim of making sense of data from multiple encounters across systems, Medicomp said. It’s the latest addition to the Quippe suite of systems, which is designed to deliver longitudinal patient information within a problem-oriented clinical view. It mirrors the way physicians think and work to drive optimal patient outcomes.
The new system delivers optimized EHR data for physicians that is easy to digest and promotes new levels of clinical insights, the vendor says.
By Bill Siwicki
February 24, 2017 12:53 PM
The Partnership for Health IT Patient Safety, an ECRI Institute collaborative, announced at HIMSS17 its second set of Safe Practice Recommendations aimed at reducing patient misidentification.
The evidence-based recommendations for the use of health IT in patient identification are designed to improve health IT safety and build upon other work in patient identification, the collaborative said.
In the publicly available toolkit, “Health IT Safe Practices: Toolkit for the Safe Use of Health IT for Patient Identification,” the Partnership presents eight safe practice recommendations, along with actionable resources to facilitate the implementation of these recommended safe practices.
by Evan Sweeney
Feb 27, 2017 10:58am
Despite the low price point, open-source EHRs struggle with functionality and require additional IT resources.
Given the high costs associated with commercial EHR implementation, open-source software has become a financially alluring option for hospitals and physicians. But usability continues to plague the free software that is currently available.
Just four of the 54 available open-source EHR projects have been certified by the Office of the National Coordinator for Health IT, according to a study published in the Journal of Medical Internet Research Medical Informatics.
February 23, 2017
Fifty-one percent of clinical leaders report they use mobile or desktop applications at the point-of-care, according to a KLAS report.
For the report, titled Connected Apps in Healthcare 2017, researchers interviewed 47 members of clinical leadership at large healthcare organizations. The goal of the report was to determine how clinicians use software today and what they would like to see in the future.
Here are the eight suggestions respondents shared when asked what applications they would want to create or purchase, ranked by popularity.
By Alex Vadas
Published February 27 2017, 3:20pm EST
Cancer is one of the leading causes of death, with some 1.7 million Americans expected to be diagnosed with some form of the disease this year alone. Yet in the vast majority of cases, the details of their disease and treatment—from the tumor’s composition to which drugs were tried and what the results of those treatments were—remain stuck in medical records that offer no help to others facing similar circumstances.
Instead, most of what’s known comes from the 3 percent of patients who’ve taken part in clinical trials, leaving enormous gaps in our understanding of the multiplicity of diseases that are grouped together as cancer and why certain patients respond or don’t to various treatment regimens.
In many ways, it’s puzzling that the power of big data is not being unleashed to the extent it might to help cure cancer. Therefore, there’s a real opportunity for big data providers, the healthcare industry, health policy makers and the new administration in Washington to step up.
By Irving Wladawsky-Berger
Feb 24, 2017 12:25 pm ET
A Fourth Industrial Revolution linking physical, digital, and biological worlds was the central theme of the 2016 World Economic Forum that took place a year ago in Davos, Switzerland. It continued to play a prominent role in the recently concluded 2017 annual meeting. Coming to grips with the impact of the Fourth Industrial Revolution was among the top leadership priorities discussed at this year’s meeting.
Over the past year, Klaus Schwab, WEF founder and executive chairman, has described his vision for the fourth industrial revolution in a number of articles as well as a book on the subject. Dr. Schwab positions the 4IR within the historical context of three previous industrial revolutions. The First, starting in the last third of the 18th century, introduced new tools and manufacturing processes based on steam and water power. The Second, a century later, saw the advent of steel, oil, electricity, mass production and associated inventions including the telephone, light bulbs phonographs and cars. The Third, starting in the middle of the last century, has brought us digital technologies, computers, the IT industry, and the automation of processes in just about all industries.
By Laura Landro
Updated Feb. 26, 2017 11:08 p.m. ET
For years, patients have been hearing the same message from the health-care industry: Get involved.
They’re told they need to do more to monitor their chronic conditions. They are directed to be more active in deciding what treatments to have, or whether to treat a condition at all.
That has proved easier said than done. For some people, it’s a matter of feeling intimidated: Better to let the doctors decide. Some are overwhelmed by the choices they have to make about their care, which seem to get more complex every year. At the same time, many doctors are reluctant to change old ways of working.
The computer gathers relevant disease information from 200 documents in just a few seconds. Doctors have no chance at matching its tempo.
"This technology contributes to more accurate and updated information about pain and risk, and makes this information available to doctors involved in patient care. The research results show, at this stage, that the system's precision is not far off the level of experienced clinicians, and the computer is in addition much quicker than the doctors," says Geir Thore Berge.
He is a qualified nurse, and works with IT and information systems at the Department of Technology and e-Health at Sørlandet Hospital HF. As a PhD research fellow, he is associated with the Centre for e-Health and Care Technology and the Department of Information Systems at the University of Agder (UiA).
Posted by Dr David More MB PhD FACHI at Saturday, March 11, 2017