Saturday, March 25, 2017

Weekly Overseas Health IT Links – 25th 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.

Adventist Health’s trigger tool uncovers thousands of additional harm occurrences

Mar 17, 2017 10:21am
After several years of using manual methods to identify and track patient harm, a real-time alert system helped Adventist Health System uncover thousands of additional instances of harm.
Over an 11-month period, an automated trigger tool uncovered nearly 2,700 instances of patient harm stemming from incidents both inside and outside the health system, according to a study published in The Joint Commission Journal for Patient Safety. Comparatively, the system’s manual method uncovered just 132 instances of patient harm during an 11-month period two years prior.
A major reason for the increase was the sheer number of records that the automated system could process through Adventist Health System's Patient Safety Organization. The trigger tool combed through more than 40,000 records compared to just 440 that were reviewed in the manual process.

Data breach fear for 26m GP records

Nadeem Badshah
March 18 2017, 12:01am, The Times
An investigation has been launched into the security of a computer system that holds 26 million patients’ records.
The Information Commissioner is looking into a potential breach involving 2,700 GP surgeries. It centres on SystmOne, which is used by family doctors. When GPs switch on “enhanced data sharing” so that records can be seen by a hospital, they also can be accessed by thousands of staff even if there is no medical reason to do so.

GAO details weaknesses in federal push to share patient data

By Joseph Conn  | March 16, 2017
A federal watchdog group said HHS isn't doing enough to measure how much patients are using their medical records. The Government Accountability Office also found patients aren't accessing their medical records because they can't aggregate all of their information into one medical record, underscoring the need to streamline and standardize systems.
Patients often have to go through different portals for each provider, the GAO said, adding that patients generally have to manage separate login information for each provider-specific portal.
Personal health record technology is available to collect the records, but these systems “are not widely used,” a 55-page GAO report stated.

DeepMind's first deal with the NHS has been torn apart in a new academic study

  • Mar. 16, 2017, 8:07 AM
A data-sharing deal between Google DeepMind and the Royal Free London NHS Foundation Trust was riddled with "inexcusable" mistakes, according to an academic paper published on Thursday.
The "Google DeepMind and healthcare in an age of algorithms" paper — coauthored by Cambridge University's Julia Powles and The Economist's Hal Hodson — questions why DeepMind was given permission to process millions of NHS patient records so easily and without patient approval.
"There remain many ongoing issues and it was important to document how the deal was set up, how it played out in public, and to try to caution against another deal from happening in this way in the future," Powles told Business Insider in Berlin the day before the paper was published.

Half of Medication Errors Involve CPOE, Data Shows

Alexandra Wilson Pecci, March 17, 2017

Computerized prescriber order entry systems and pharmacy systems are the most commonly reported factors contributing to medication errors in Pennsylvania healthcare facilities, data shows.

Although health IT tools can help prevent patient safety problems, they can also lead to significant patient safety errors if they're not used correctly, finds research from the Pennsylvania Patient Safety Authority.
Between January 1 and June 30, 2016, Pennsylvania healthcare facilities reported 889 medication-error events that indicated health IT as a contributing factor.
The most frequently reported errors included dose omission, wrong dose or overdosage, and extra dose. The most commonly reported systems involved in the errors were computerized prescriber order entry systems (CPOE) and the pharmacy systems.

Poorly implemented IT systems lead to medication errors

Mar 17, 2017 10:58am
IT systems designed to streamline medication ordering and administration can contribute to medication errors.
Health IT systems designed to improve prescription ordering and medication administration can just as easily contribute to medical errors.
That’s according to a study released by the Pennsylvania Patient Safety Advisory (PPSA), which found that computerized prescriber order entry (CPOE) systems, pharmacy IT systems and electronic medication administration tools were frequently to blame for medication errors. Nearly 70% of those errors reached the patient.
Last year, researchers at Johns Hopkins published a study indicating that medical errors are the third-leading cause of death in the U.S., a study that drew harsh criticism from many physicians. Some have warned that digital prescription systems miss potential drug errors, and the Office of the National Coordinator for Health IT has called on vendors and providers to reduce the number of “pick list” medication errors.

Top 10 patient safety concerns for 2017, according to ECRI

A new report says poor information management and faulty CDS implementation pose risks to patients. It also raises concerns about patient identification and process improvement activities.
March 14, 2017 01:10 PM
Health information technology holds enormous potential for improving patient safety, but only when implemented and used correctly. A new study from ECRI Institute spotlights EHR information management practices and clinical decision support as two areas of particular concern.
"The 10 patient safety concerns listed in our report are very real," says Catherine Pusey, RN, associate director, ECRI Institute Patient Safety Organization. "They are causing harm – often serious harm – to real people."
This list for 2017, which derives from PSO event data, focuses on concerns raised by provider organizations and ECRI experts.

Health IT coalition seeks scrutiny of ONC's regulatory role

By Rachel Z. Arndt  | March 14, 2017
Health IT Now is asking Congress and the Trump administration to examine the role the Office of the National Coordinator for Health Information Technology plays in regulating health IT and how that role relates to other regulatory agencies.
Not-for-profit advocacy group Health IT Now wrote in a letter Monday to HHS Secretary Tom Price that the coalition worries that recent ONC actions could raise costs and slow product development by going beyond what the Health Information Technology for Economic and Clinical Health Act allows the ONC to do.
Under the ONC's "enhanced oversight and accountability" final rule, the office is allowed to review products directly for patient safety concerns. According to the rule, direct review “will promote health IT developer accountability for the performance, reliability and safety of health IT.”

5 big challenges to utilizing genomic data for precision medicine

Two Advisory Board research leaders discuss the current state of precision medicine – and what it will take for genomics to become part of routine care.
March 14, 2017 05:18 PM
Precision medicine holds the key to better health. And as the industry moves more toward value-based care, its evidence-based principles can help providers ease into the transition.
"It's a big step to go from trial-and-error medicine to evidence-based medicine," said Jim Adams, executive director of research at The Advisory Board. "Even for evidence-based care and precision medicine, genomics data is really important. But it's not one-to-one.
"You can get to precision medicine without genomics data," he added. "There's a lot of work that can be done without the genomic data to achieve precision medicine while we wait for the technology and industry to catch up."

Do we need to certify digital health Leaders?

James Freed, CIO Health Education England and Andy Kinnear, chair of BCS Health and Care, ran a workshop at the recent Digital Health Leadership Summit on the case for certifying digital leaders, here they summarise what attendees said.
There has been much talk about certification, registration and regulation of digital health leaders, in particular CIOs and CCIOs, in recent (and not-so-recent) years, but this debate seems to be gathering pace since September last year.
That was when Secretary of State for Health Jeremy Hunt, following a key recommendation of the Wachter Review of NHS IT, announced plans for the development of a ‘Digital Academy’ to ensure CIOs and CCIOs, and aspirants to those hallowed positions, are as good as they can be.
Cue much discussion on ‘what good looks like’, and the validity of another NHS University. Indeed, we have written in the past about the role and duty, of CIOs in particular, to demonstrate their ability and their drive.

3 ways Trump’s FDA nominee could reshape digital health

Mar 16, 2017 11:37am
Under Scott Gottlieb, the FDA could see a subtle policy shift that loosens regulations for the digital health industry, observers tell FierceHealthcare.
President Donald Trump’s nominee to lead the Food and Drug Administration is a strong proponent of deregulating the drug industry, an approach that could be equally beneficial for the digital health industry that has occasionally butted heads with the federal agency.
Last week, Trump announced his intent to nominate Scott Gottlieb, M.D., a resident fellow at the conservative-leaning American Enterprise Institute and a former deputy commissioner for medical and scientific affairs at the FDA during the George W. Bush administration. Gottlieb, who has close ties to the pharmaceutical industry and has been vocal about the need for a new, streamlined approach to drug approvals, was applauded by PhRMA, the industry’s leading lobbying group.

Despite federal push to offer EHR access, patient engagement is low

Mar 16, 2017 11:50am
A new GAO report says HHS needs to improve the way it measures patient access to EHRs.
Although the vast majority of hospitals and physicians provided access to EHRs in 2015, very few patients took advantage, calling into question the effectiveness of efforts led by the Department of Health and Human Services.
Just 15% of hospital patients electronically accessed their medical records despite 88% of hospitals offering access, according to a report released by the Government Accountability Office (GAO). Nearly one-third of patients accessed EHRs offered by physician practices.

Study: Patients Typing Visit Agendas into EHRs Improves Communication with Physicians

March 15, 2017
by Rajiv Leventhal
Patients attending a safety-net primary care clinic in Seattle were interested and able to type their agenda into the electronic health record (EHR) visit note, and as a result, both patients and clinicians felt improved communication, according to new research in the Annals of Family Medicine.
More than 100 patients and clinicians at Seattle’s Harborview Medical Center (HMC) participated in the study, which took place in 2015. As the researchers stated, “existing OpenNotes research shows enthusiasm among both patients and clinicians, but this is the first Open-Notes study of cogeneration of clinic notes. Allowing patients to type their agenda into their clinic note before a visit may facilitate communication of health concerns,” they said.

CHIME Advises HHS Improve Interoperability, Standardization

Recommendations submitted to the Department of Health & Human Services last month prioritize industry-wide standardization to improve health data exchange and interoperability.

March 13, 2017 - The College of Healthcare Information Management Executives (CHIME) recently submitted a list of recommendations to Department of Health & Human Services (HHS) Secretary Thomas Price, MD, on ways to improve patient care delivery in several areas, including interoperability.
In an effort to maintain momentum in improving interoperability, reducing stringent regulations on providers, and streamlining the transition to value-based care, CHIME submitted seven suggestions regarding steps HHS should consider when drafting future legislation.
“CHIME members have moved beyond adopting information technology and to pursuing strategies that promote population health, patient engagement and value-based payment,” members wrote. “However, significant barriers remain to harnessing the full power of these systems. Below are a set of priority areas and recommendations which, we believe, could propel us toward greater innovation in care delivery.”

More Than 300 Data Breaches to Date in 2017

The latest count from the Identity Theft Resource Center (ITRC) reports that there have been 312 data breaches recorded this year through March 14, 2017, and that over 1.3 million records have been exposed since the beginning of the year.
VisionQuest Eyecare in Indiana reported a data breach on March 2 that affected some 86,000 individual records. This was the largest incident reported so far in 2017, but the company has not revealed any further details about the event.
At the U.S. Department of Health and Human Services (HHS) breach portal, there is an entry for Commonwealth Health Corporation (Kentucky) indicating nearly 700,000 individuals have been affected by a theft of data, but no additional details are available for this incident.
March 16, 2017

Star Trek's Tricorder a sign of health care to come

"Take two apps and I'll call you in the morning": Game-changing technology puts data in hands of patients

Ontario startup CloudDX has created Vitaliti, a virtual doctor based on Star Trek’s tricorder device, one of several promising new technologies transforming health care. March 8, 2017
Richmond Hill Liberal
A trip to the doctor can be an ordeal.
Take time off work, drive to the health clinic, sit in the waiting room until the doctor can see you, have your throat swabbed or ear examined or head over to the medical lab for blood tests or imaging, then wait some more for the results, for the follow-ups, for the prescriptions ...
Dr. McCoy had a better way. The Star Trek doctor simply pulled out his trusty Tricorder and within seconds, you were diagnosed and on your way to better health.
Soon, you too may boldly go where science fiction has gone before.

Why telehealth study may underestimate the technology's benefits

Published March 15 2017, 4:51pm EDT
A new study published recently in Health Affairs cuts against the conventional wisdom on one of the biggest trends in healthcare: the increased use of direct-to-consumer telehealth services.
The study found that while these services increase patients' access to care, they also may increase overall healthcare spending—contrary to the widespread expectation that direct-to-consumer telehealth would cut costs.
But if you dig a little deeper, you'll find the study's takeaways aren't nearly as clear as they may seem.

GOP health plan to boost uninsured by 24 million, CBO says

Published March 13 2017, 6:19pm EDT
About 24 million more people would be uninsured under the Republican plan to replace Obamacare, according to the nonpartisan Congressional Budget Office, creating a daunting political impediment for a proposal that would reduce the deficit by more than $300 billion.
The coverage estimate is a setback for President Donald Trump, who promised that “insurance for everybody” would replace Obamacare, which used government subsidies and an expansion of Medicaid to bring coverage to 20 million people. But Republicans trying to pass the legislation without Democratic support argued that any reduction in the rolls of the insured isn’t as important as what they say will be cheaper coverage.
The CBO, the official scorekeeper of the budgetary effects of proposed legislation, said the GOP proposal would reduce the deficit by $337 billion over 10 years. Trump touted the plan Monday before the CBO score was released.

Hospital datacenters: Extinct in 5 years?

Prominent healthcare executives are predicting a drastic shift from on-premise IT infrastructure into the cloud. That includes electronic health records, clinical decision support and analytics.
March 13, 2017 09:22 AM
Richard Stroup of Children's Mercy in Kansas City joked that the datacenter of the future will have very few on-site employees. 
Every time Carolinas HealthCare System gets rid of server or storage hardware, someone in the IT department takes out a roll of red tape. They cut off two pieces and lay those down on the floor in the shape of an X, as in: Do not put any new hardware here. 
"I used to be so proud of my datacenter," Carolinas Chief Information and Analytics Officer Craig Richardville said. "Now I just can't wait to get rid of my datacenter." 
Other healthcare executives are of a similar mind. Count Beth Israel Deaconess Medical Center CIO John Halamka, MD, among those. 

EHR management tops ECRI’s list of patient safety concerns

Mar 14, 2017 10:31am
Two health IT systems—EHR management and clinical decision support systems—are among the top three patient safety concerns facing hospitals in 2017.
Information management within EHRs topped the annual list published by the ECRI Institute, which identified the top ten patient safety concerns through a review of the ECRI’s incident reporting database, member root-cause analyses, a member survey and input from an expert panel.
ECRI’s report urged hospitals to “approach health IT safety holistically” by including IT management professionals and encouraging users to report concerns about EHR usability.

Apple's ResearchKit generates reliable health data — at least for asthma patients

Good news, since there are so many smartphones

by Angela Chen@chengelaMar 13, 2017, 12:08pm EDT
Health data collected entirely from smartphones can be reliable, research from Mount Sinai Hospital claims. The researchers involved found that Apple’s ResearchKit platform and an app for asthma were fairly accurate when compared to existing patient studies.
Finding and recruiting participants is a big hurdle for medical studies. In recent years, people have started collecting health data from smartphones, which seems sensible given how common smartphones are. But this raises questions about whether data gathered this way can be trusted. Today’s study, published today in the journal Nature Biotechnology, suggests that health care apps may be reliable, at least in regards to asthma. This is good news since smartphone usage is only increasing — there are supposed to be 6 billion smartphones used worldwide by 2020 — and collecting reliable health data from them could be very good for research.
Apple launched ResearchKit, a software medical platform, in 2015. It helps researchers recruit participants for studies; participants can enroll in trials and take surveys or provide other data. Early research partners included big names like the University of Oxford, Stanford Medicine, and the Dana-Farber Cancer Institute. The asthma mobile app from today’s study was one of the five disease-specific apps that Apple launched with the initial release of ResearchKit.

Artificial intelligence could create smarter EHRs

March 16, 2017
Intermountain Healthcare has approximately 150 protocols built into its electronic health record (EHR) system, alerting clinicians when the patient information they enter indicates certain conditions and then guiding them through further examinations and potential treatments.
A 12-member team of doctors, nurses and analytics experts takes upwards of a year to analyze data and build each protocol, said Marc Probst, the chief information officer at the not-for-profit health system based in Salt Lake City.
Recently, though, Intermountain teamed with a company that uses artificial intelligence (AI) to do the same work. But AI works faster and more thoroughly, taking just 10 days to develop a protocol that included additional data points not previously identified, Probst said.

Genomics, patient generated health data to be top information sources in five years, survey finds

The lack of adequate EHR interoperability continues to hinder healthcare organizations ability to use patient data in care delivery, the report’s author said.
March 13, 2017 09:42 AM
The importance of genomic and patient-generated data will increase dramatically in the next five years as healthcare managers gain control of Big Data to develop precision medicine.
Forty percent of respondents to a new survey, in fact, said genomic data will become one of the most useful data sources in five years, up from just 17 percent today. And forty percent said patient-generated data will be a top source of data in five years, opposed to 30 percent listed it as a top source today.
“The landscape is shifting from one of despair over the unfulfilled promises of big data to a more realistic vision of what sophisticated analytics can do to transform care delivery,” wrote Amy Compton-Phillips MD, chief clinical officer for Providence St. Joseph Health, who authored the report for NEJM Catalyst

State Opioid Database Links with EHR in Pilot Program

Alexandra Wilson Pecci, March 14, 2017

In an effort to encourage physicians to use the databases, a pilot program has linked the Colorado Prescription Drug Monitoring Program with the University of Colorado Hospital's EHR/EMR.

Despite the growing number of online prescription drug databases that aim to counter the misuse of opioids and other controlled substances, many physicians don't use them.
In an effort to encourage physicians to use the databases, a pilot program at the University of Colorado Anschutz Medical Campus has linked the Colorado Prescription Drug Monitoring Program (PDMP) with the University of Colorado Hospital's EHR/EMR.
PDMPs are state-run databases to track information related to a patient's controlled substance prescription history and are used to monitor suspected abuse or diversion, according to the CDC.

Telemedicine OK for ICU Coma Assessment, Researchers Say

Alexandra Wilson Pecci, March 14, 2017

Assessments of coma severity were similar when conducted remotely and in person, Mayo Clinic researchers found.

Telemedicine is a reliable way to assess comatose patients, according to new research. Stroke assessments via telemedicine have been studied before, but research conducted at the Mayo Clinic Hospital in Arizona and published in Telemedicine and e-Health is the first to look specifically at using telemedicine for patients in a coma.
The study was conducted over a 15-month period and included 100 patients who were randomly assigned two Mayo Clinic physicians, one who conducted their assessments at the bedside and another who assessed patients via a desktop workstation on another floor in the same hospital.

EXCLUSIVE: 'Scotland as a leader in digital health and care'

Article posted on: March 14, 2017
Author: Dr Pieter van de Graaf, eHealth Clinical Strategy Team Leader, Scottish Government
The above may seem ambitious, but it’s exactly the challenge set earlier this month by Scotland’s Cabinet Secretary for Health and Sport, Shona Robison MSP, at a major conference in Edinburgh. It’s a challenge that the Scottish Government is looking forward to meet in close partnership with colleagues across NHS Scotland, local authorities, Third Sector, academia and industry.
The Digital Health and Care Scotland conference, organised by Holyrood Events, saw around 300 delegates from across health and social care sharing and reflecting on achievements to date, exploring current issues and challenges, and discussing future priorities.
The Cabinet Secretary’s message that, in health and social care, like other aspects of everyday life, digital is no longer an ‘add-on’ was recognised by many delegates. Digital is increasingly central to everything we do and every decision we make, whether as a clinician, a carer or a patient.

ECRI's top 10 patient safety dangers for 2017

Mar 14, 2017 12:17pm
Providers should be aware of these 10 patient safety dangers in 2017.
ECRI Institute has identified its 10 greatest patient safety dangers for 2017. Among them: antibiotic stewardship and identification errors.
The list is compiled each year to help providers identify areas for improvement and innovation. The ECRI report also includes strategies that hospitals and other providers can use to address these concerns in their own facilities.
"The 10 patient safety concerns listed in our report are very real," Catherine Pusey, R.N., the associate director of ECRI Institute’s patient safety organization said in announcement. "They are causing harm—often serious harm—to real people."

Poll: Where readers stand on artificial intelligence, cloud computing and population health

Healthcare IT News conducted a post-HIMSS17 survey to gauge real implementations of the conference’s big buzzwords. Respondents also revealed their favorite part of this year’s conference.
March 10, 2017 01:53 PM
The showroom floor came in tops as favorite part of HIMSS17.
When IBM CEO Ginni Rometty delivered the opening keynote at HIMSS17 she effectively set the stage for artificial intelligence, cognitive computing and machine learning to be prevalent themes throughout the rest of the conference.
Other top trends buzzed about in Orlando: cloud computing and population health.
Healthcare IT News asked our readers where they stand in terms of these initiatives. And we threw in a bonus question to figure out what their favorite part of HIMSS17 was.

Safety huddles offer a pathway to address EHR failures

Mar 13, 2017 11:49am
Daily safety huddles offer an opportunity to address EHR patient safety concerns.
A group of Texas informatics researchers are urging hospitals to utilize daily safety huddles to identify EHR shortcomings that impact patient care.
Widely adopted on the clinical side, hospitals and health systems have used daily safety huddles to identify patient safety concerns and discuss medical errors. But a one-year review of patient safety huddles in a midsized tertiary care hospital found those huddles frequently included discussions related to EHRs, according to a study published in the Journal of the American Informatics Association.
Researchers at the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety and Baylor Scott and White Health found that safety huddles spanning 249 days identified 245 EHR-related safety concerns, representing 7% of all safety concerns addressed in the huddles. Two-thirds of the concerns were traced back the EHR system either working incorrectly or not at all.

Big EHR vendors set their sights on smaller targets

Mar 13, 2017 11:16am
Looking for new customers, electronic health record companies are turning their attention to physician practices and small hospitals.
Electronic health record system vendors are turning their attention to an untapped market: Physician practices and small and rural hospitals.
Those healthcare settings present an opportunity for new sales of EHR systems, according to a report by Healthcare Dive.

Some docs skeptical of house call apps

Mar 13, 2017 9:52am
Some patients are adopting apps that allow them to summon a doctor for a house call.
Apps that allow patients to summon a doctor for a house call may be the way of the future, but many physicians are skeptical of the trend.
Docs that participate in such programs like that it allows them to get back to the basics of medicine, according to an article from MedPage Today. But some physicians have expressed concerns that certain apps may lead to subpar care, as docs treat conditions they’re not trained to handle.

42% of providers set to deploy digital transformation projects

Written by Jessica Kim Cohen | March 10, 2017 | Print | Email
Ten percent of providers and payers are currently working on digital transformation projects, but this number is expected to increase throughout 2017, according to an IDC report.
For the report, titled Payer and Provider Investment Plans for Digital Transformation, IDC Health Insights surveyed providers and payers to better understand their investment plans related to clinical communication, connected health, Internet of Things and value-based care.
Here are four things to know.
1. The majority of current digital transformation projects are still in their pilot or research phases.


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