Saturday, June 10, 2017

Weekly Overseas Health IT Links – 10th June, 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.
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The digital revolution in healthcare: achievements and challenges

June 03, 22:25 UTC+3
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CHALLENGES:
  • Digital inequality
“Cities are one thing, and rural areas are quite another, and elimination of digital inequality is on the agenda now, the basic one, in communication channels and infrastructure,” said Nikolay Nikiforov, Minister of Communications and Mass Media of the Russian Federation.
  • Data security
“Security of big data operations is a very sensitive matter. It is really a must,” said Natalya Komarova, Governor of Khanty-Mansi Autonomous Area–Yugra.
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GP statistics available to public through new data hub

Shireen Khalil

31 May 2017
The public can now access a wide range of statistical information on GP practices from across England, with the launch of a new data hub.
NHS Digital’s GP Data Hub, which launched in April, aims to bring together data from GP practises in an easily accessible format.
Over the next six months NHS Digital will add more figures from a variety of health areas onto the unique hub.
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Hospital survival guide for a world overflowing with unsecured medical devices

Tech-savvy hospitals like Mayo, Kaiser and Christiana are always testing, recognizing cybersecurity threats could get scarier, and aiming to change mindsets to focus on infosec as a patient safety issue.
May 30, 2017 10:34 AM
Medical device security is an utter mess.
Consider this: The machines themselves often have 10, 15 or even 20-year lifespans and replacing those legacy devices with more secure ones en masse is simply not a realistic option.
Take the Mayo Clinic, for instance. The organization has what Clinical Information Security Director Kevin McDonald described as a boatload of medical devices anchored down by legacy products.
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Health files are worth more than bank details on the dark web

David Sanderson
June 3 2017, 12:01am, The Times
Patient records sell for more money and cyberattacks on the NHS are likely to increase
Patient records are now more valuable on the dark web than credit card details, it was claimed yesterday.
Sir Nick Partridge, the former deputy chairman of NHS Digital, told the Hay Festival: “Systems [to protect] are there but there’s a growing understanding that patient records are now much more valuable on the dark web than credit card ratings.
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ONC’s John Fleming wants patients to have a single unified health record

Jun 2, 2017 10:48am
ONC administrator John Fleming wants patients to have more control of their health record.
A senior administrator with the Office of the National Coordinator for Health IT said he wants patients to have a unified health record that could pull data from various medical providers into a single record.
John Fleming, the ONC’s deputy assistant secretary for health technology reform, outlined his vision that would give patients more control of their medical information during the International Summit on the Future of Health Privacy hosted by Georgetown University Law.
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Zero Hospital Waiting Lists as Ireland Undergoing an eHealth Revolution?

Justin LawlerJune 2, 2017
Healthcare in Ireland has not had much positive coverage in the last few months or years, with an ‘improvement’ getting waiting times down to 15 months by October.
From better systems to telemedicine, and even to using Artificial Intelligence in the future – our healthcare systems will be a very different place in the years to come.
At the Dublin Future Health Summit, we got to hear how healthcare is transforming across the world. And how it’s already happening in Ireland.
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Putting health data in a public cloud? Make sure you encrypt

An alarming percentage of organizations don’t encrypt sensitive data in public cloud databases and too many have resources exposed to the internet.
May 31, 2017 10:58 AM
Hospitals are increasingly turning to cloud-based services and that will only continue as they need more robust infrastructure for data intensive trends including advanced analytics, population health, precision medicine and value-based care. 
But wIth HIPAA regulations on protected health information and personally identifiable information healthcare entities face unique challenges -- and risks -- when it comes to storing their data in the cloud. Among those is making sure that data is safe. 
82 percent of databases in public cloud computing environments are not encrypted, according to the Cloud Infrastructure Security Trends Report from cybersecurity vendor RedLock. 
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FCC's net neutrality reversal threatens telehealth, remote monitoring and data sharing

Jun 1, 2017 11:02am
FCC Commissioner Ajit Pai wants to roll back net neutrality regulations. That could spell trouble an increasingly connected healthcare industry.
Changes to net neutrality rules will have a significant impact on health IT innovation, particularly for rural providers, according to a group of informatics and public health experts.
Under the new leadership of Ajit Pai, the Federal Communications Commission (FCC) is working to overturn net neutrality rules established by the Obama administration. An overhaul would allow telecommunications companies to treat some businesses more favorably than others and raise connection fees for hospitals.
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Data overload, access and affordability limit patient monitoring technology

Jun 1, 2017 11:14am
Patient monitoring devices have potential, but widespread adoption is lagging.
Although some physicians see the potential in monitoring patients outside of the hospital or clinic, only a small portion of healthcare providers are using digital tools to track vital signs while patients are at home
That reluctance is associated with the overwhelming amount of data home health monitoring tools generate and the inability for some patients to purchase those devices, Joseph Kvedar, M.D. director of the Center for Connected Health at Partners HealthCare told Marketplace. He estimated just 10% of providers are using home monitoring devices routinely.
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HIT Think Why the eClinicalWorks settlement may rattle the industry

Published June 01 2017, 2:27pm EDT
The legal settlement between the Department of Justice and eClinicalWorks is a jolt to the system for vendors of electronic health records systems.
Granted, the announcement Wednesday afternoon just applied to the terms of the settlement between the federal agency and that one specific vendor. But the impact can be felt more widely, as developers of these systems now see they could be held similarly accountable.
It's important to underscore that, in the settlement, eClinicalWorks has denied any wrongdoing in agreeing to the terms, and that the claims "settled by the agreement are allegations only, and there has been no determination of liability." The company settled to "avoid the cost and uncertainty inherent in protracted litigation."
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OCR Newsletter Reviews Healthcare Cybersecurity Best Practices

Understanding when a security incident is a data breach was one healthcare cybersecurity best practice area discussed in the latest OCR newsletter.

Elizabeth Snell

May 31, 2017 - Even the most current and comprehensive security controls cannot guarantee that PHI security will never be compromised, which is why healthcare cybersecurity best practices should be regularly reviewed.
OCR’s May cybersecurity newsletter further underlines this point, and urged healthcare organizations to “plan, respond, and report” any privacy or security incident.
“Incidents do happen and when they do, effective response planning can be a major factor of how significant an organization suffers operational or reputational harm or legal liability,” OCR warned. “Being able to respond to incidents in a systematic way ensures that appropriate response steps are taken each time to help minimize the impact of breaches.”
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Boston hospitals use machine learning to manage the most expensive illnesses

May 31, 2017 9:12am
Several Boston hospitals are using machine learning to predict diabetes and heart disease hospitalizations a year in advance.
Machine learning is already outpacing humans when it comes to predicting certain illnesses like heart disease and diabetes—and those algorithms are likely to become even more accurate with the ability to factor in personal data captured on smartphones and wearables.
Engineers at Boston University are working with local hospitals like Brigham and Women’s Hospital and Boston Medical Center to manage heart disease and diabetes using algorithms that have the ability to predict hospitalizations up to a year in advance with 82% accuracy, Yannis Paschalidis, the director of the Center for Information Systems Engineering at Boston University, wrote in Harvard Business Review.
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Health IT Now to Tom Price: Limit ONC's 'overstep and mission creep'

The industry group calls on the HHS secretary to rein in the Office of the National Coordinator from unnecessarily burdensome regulatory authority.
May 31, 2017 04:20 PM
Industry coalition Health IT Now on Wednesday called on Health and Human Services Secretary Tom Price to focus on interoperability, kill information blocking, and reduce both healthcare costs and the existing regulatory burden on hospitals and physicians.
“We must incent the free flow of information to better deliver and pay for care,” Health IT Now executive director Joel White wrote in an open letter to Price. “Under your leadership HHS has a fantastic opportunity to incent the uptake and use of health IT that makes providers’ lives easier and better patient outcomes through more accessible information.”
Health IT Now’s calls on Congress arrive a week after President Trump’s proposed budget cut gutted the office by 37% of its annual budget and aims to sunset a number of its existing programs and offices, notably those focused on privacy and security, eHealth and the health IT and provider adoption units. 
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EHRs are overflowing with copy-and-paste records, JAMA study shows

Of thousands of Epic notes examined by UCSF researchers, just 18 percent were newly entered by clinicians.
May 31, 2017 02:29 PM
For all the benefits brought about by electronic health records, it's long been known that they have their pitfalls, whether it's ungainly user experience or agita caused by alert fatigue.
Another major risk for EHRs is the temptation toward "note bloat" caused by caregivers' easy ability to copy-and-paste data from other parts of the chart. This defeats the purpose of electronic documentation, of course, creating a large and unwieldy record that can be hard to make sense of – potentially putting patient safety at risk.
A new study from the Journal of the American Medical Association doesn't offer much in the way of encouragement.
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IoT, EHRs to Push Healthcare API Market to $243M by 2024

The healthcare API marketplace will see rapid growth due to innovations in electronic health records and the expansion of the Internet of Things.

Jennifer Bresnick

Director of Editorial
jbresnick@xtelligentmedia.com
May 30, 2017 - The Internet of Things (IoT) and rising investments in state-of-the-art EHR technology will contribute to the ongoing growth of the healthcare application programming interface (API) marketplace, according to a new report by Transparency Market Research.
Globally, the API ecosystem will expand from $162.4 million in 2015 to $243 million by 2024, representing a 4.2 percent compound annual growth rate (CAGR).
“Growing focus on patient-centric healthcare delivery via application programming interfaces has been noted over the recent past and the emergence of a host of services, such as wearable medical devices and remote patient monitoring has spurred the demand for healthcare API solutions,” an accompanying press release says.
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Global Healthcare IT Market Projected to Hit $280B by 2021

May 30, 2017
by Heather Landi
The global healthcare IT market is estimated to reach $280.25 billion by 2021 with 15.9 percent growth, with the majority of the demand for healthcare IT solutions driven by the growing need to reduce healthcare costs while adhering to ongoing regulatory requirements, according to a report by Research N Reports.
Along with the demand to drive down healthcare costs, the estimated growth of the healthcare IT market through 2012 also can be attributed to the regulatory requirements set by government organizations for ensuring safety, security, and confidentiality of patient information, according to a summary of the report.
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Patients renew demands for better protection of medical records

Published May 26 2017, 3:46pm EDT
The publicity around the recent WannaCry ransomware onslaught has raised the awareness of patients, and the ransomware attack has renewed their demands that providers protect their sensitive health information.
That’s evident from the results of a recently completed survey, which found that 68 percent of consumers said they would consider leaving their healthcare provider if it was hit by ransomware.
Carbon Black, a security firm specializing in protecting network endpoints, conducted the survey of 5,000 individuals the weekend that the WannaCry ransomware event was gaining international headlines, as it crippled facilities in the United Kingdom’s National Health Service.
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A CIO's guide: Building the right IT team for a successful EHR go-live

An electronic medical record implementation requires accuracy and precision. And making that happen demands a variety of skillsets, professional backgrounds and expertise. Here’s what worked for Penn Medicine. 
May 30, 2017 02:27 AM
In the world of healthcare IT rarely is one person or small group of individuals able to complete the entire value chain of delivering IT solutions that properly define operational requirements and workflows and translate these needs into technical programs or application builds. A variety of backgrounds are needed including input from people with diverse and unique expertise that lie in different areas of the organization. As a result, comprehensive teamwork is essentially required to successfully launch and deploy projects that result in ongoing improvement in patient care, advancements in research and overall operational efficiency. 
So what are some of the specific essential components of building the right team to ensure success in an environment that requires absolute preciseness and accuracy? 
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3 obstacles to care coordination

May 30, 2017 11:31am
Care coordination presents obstacles to primary care doctors and specialists.
Primary care physicians and specialists frequently collaborate to treat patients, but care coordination presents a number of obstacles.
For physicians, those challenges often include incompatible electronic health records (EHRs), poor communication and lack of payment for care coordination activities, according to Medical Economics.
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Report: Healthcare organizations are moving to the cloud at different speeds

May 30, 2017 10:47am
Cloud adoption levels vary widely among payers and providers.
Payers and providers are moving to the cloud, but adoption levels vary widely depending on each organization’s priorities.
Increasingly, hospital CIOs are ditching their data centers in favor of the cloud, and some have predicted that data centers will be extinct in just a matter of years. Sutter Health Chief Technology Officer Wes Wright recently said the cloud offers “a level of elasticity that we could never achieve in our own data centers.”
But healthcare payers and providers are at varying levels of the cloud adoption maturity curve, according to an IDC MaturityScape: Cloud in Healthcare 2.0 report, which lays out a pathway for optimized cloud use among healthcare organizations. While some organizations are using the cloud on an ad hoc basis for specific apps or pilot projects, others have adopted an “enterprise-wide approach.” Organizations at the upper echelon of cloud adoption are using cloud computing to drive down costs and speed up delivery while leveraging new technology for value-based payment initiatives.
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FDA to Create Digital Health Unit

With ongoing work on guidance related to software as a medical device, and a new dedicated unit to digital health coming to the US Food and Drug Administration’s Center for Devices and Radiological Health (CDRH), the agency is slowly but surely dipping its toe into the rapidly advancing field.
Bakul Patel, ‎associate center director for digital health at FDA, told attendees at MedCon in Cincinnati on Thursday that current work is directed at funneling through about 1,400 comments on draft guidance on software as a medical device released last October, which is also a priority for the International Medical Device Regulators Forum (IMDRF).
Patel noted that FDA is currently working on "what clinical validation looks like for software," adding that the 46-page document will likely be simplified to 20 pages when finalized.
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UPenn Uses Machine Learning, EHRs to Target Severe Sepsis

A machine learning algorithm that continuously monitors EHR data for signs of severe sepsis can reduce the time to detection by 12 hours.

Jennifer Bresnick

Director of Editorial
jbresnick@xtelligentmedia.com
May 25, 2017 - Researchers at the University of Pennsylvania Health System have developed a machine learning tool that helps predict patients at highest risk for developing severe sepsis, a common and fast-moving killer in the inpatient setting.
Using electronic health record (EHR) data from more than 160,000 patients and a random forest classifier to train the algorithm, the team created a tool that can monitor hundreds of key variables in real-time.
The machine learning algorithm, which was validated in clinical practice using a sample of over 10,000 individuals, identified patients headed for severe sepsis or shock a full 12 hours before the onset of the illness.
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Penn leverages machine learning to identify severe sepsis early

Published June 02 2017, 6:48am EDT
A machine learning algorithm has been developed by researchers at the University of Pennsylvania Health System to identify hospitalized patients most at risk for severe sepsis or septic shock by leveraging electronic health records, and then using the EHR to alert care teams.
“One of the major causes of preventable mortality in hospitals is sepsis. And, there’s some evidence that sepsis is not recognized as early as it could be,” says Craig Umscheid, MD, associate professor of medicine and epidemiology at the University of Pennsylvania Perelman School of Medicine. “There’s also good evidence that the sooner you recognize sepsis and initiate effective treatment, the better the outcome.”
Delayed diagnosis and treatment of sepsis, an immune system response to infection, has made it one of the most deadly and costly medical conditions confronting U.S. hospitals, with more than 1 million cases each year and 250,000 fatalities annually.
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ECRI Institute Publishes Guidance for Protecting Medical Devices from Ransomware Attacks

May 26, 2017
by Heather Landi
The ECRI Institute has released a new guidance article, "Ransomware Attacks: How to Protect Your Medical Device Systems, with recommendations to help hospitals identify and protect against ransomware attacks.
Ransomware is a form of computer malware that holds systems hostage with a ransom demand. Medical systems are vulnerable to such attacks, which can damage hospital operations and compromise patient care by barring users from accessing critical functions and data.
“With the recent news of nationwide cyberattacks, we thought it was very important to make this information available to the public as quickly as possible," Juuso Leinonen, project officer, Health Devices Group, ECRI Institute, said in a statement. "Following these recommendations will allow hospitals to minimize impact to normal operations and mitigate the risk of a ransomware infection with your medical devices."
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What Hospitals Can Do to Be Ready for Smart Pump-EMR Interoperability

PSQH: Patient Safety & Quality Healthcare, May 30, 2017

Hospitals that assess their technologies, align their databases, and strengthen their culture of safety can reduce error-prone manual infusion programming, streamline nursing workflow, and ensure accurate and timely capture of infusion data.

By Tim Vanderveen, PharmD, MS; Nicole Wilson, RN, MSN, CPHIMS; Katie Moatsos, BS; Monica Obsheatz, RPh, MPM
The following article is based on the knowledge gained from implementation of infusion system–electronic medical record (EMR) interoperability at more than 135 hospitals to date. Many considerations go into preparing for safe and reliable smart pump–EMR interoperability. The authors realize that many infusion device companies are addressing these issues; however, as employees of BD/CareFusion, they have no direct knowledge of these efforts. The approaches suggested in this article are presented to help educate and encourage further discussion of what hospitals can do before the actual implementation begins to optimize the success of smart pump–EMR interoperability.
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Australian hospitals fighting system failure after botched WannaCry patch

Five Queensland Health hospitals were forced back to pencil and paper after the IT failure, and the system will likely remain sluggish for at least a week.
May 26, 2017 12:30 PM
Queensland Health, in its attempt to protect its computer systems from the major WannaCry ransomware campaign, inadvertently shut down the electronic health records systems at five of its key hospitals on Tuesday.
Brisbane’s Princess Alexandra and Lady Cilento Children’s hospitals, as well as Cairns, Mackay and Townsville hospitals are experiencing system slowness, after the attempt to patch system security backfired, Australia’s Courier-Mail reported.
“Over the course of that weekend as part of protecting our systems from cyberattack, a series of security patches provided by software owners such as Microsoft, Cerner and Citrix were loaded to further protect Queensland Health systems from attack,” said Health Minister Cameron Dick.
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As AI spreads through healthcare, ethical questions arise

New Infosys report points to the importance of "ethical standards" for maintaining and sometimes retraining talent as automation changes workflows.
May 26, 2017 01:37 PM
As U.S. hospitals work to transform their IT infrastructure, workflows and data management processes, an impressive number of them are doing with the help of artificial intelligence, a new report from Infosys shows. That demands awareness around new staffing and training processes.
Respondents to the survey cite three big digital transformation goals: changing their culture to embrace innovation (65 percent), making smarter and more ubiquitous use of mobile tools (63 percent) and working to become more agile and customer-centric (58 percent).
As they do, several specific AI-supported processes are playing a significant role, according to Infosys. These include machine learning (77 percent), robotic automation (61 percent), institutionalization of enterprise knowledge using AI (59 percent), cognitive AI-led processes or tasks (50 percent) and automated predictive analytics (47 percent).
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Enjoy!
David.

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