Saturday, July 08, 2017

Weekly Overseas Health IT Links – 8th July, 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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Cerner, Epic shops begin electronic exchange of patient records

Competitors Novant Health, Carolinas HealthCare say it boosts patient safety.
June 29, 2017 04:16 PM
Two North Carolina-based rival healthcare systems, Novant Health and Carolinas HealthCare, will start exchanging patient records electronically, they announced June 28.
Novant is an Epic IT shop, while Carolinas HealthCare uses Cerner technology.
The goal for records exchange: To improve the quality and coordination of care for patients who use both systems by allowing doctors and clinicians to access portions of electronic medical records, the organizations said.
Charlotte-based Carolinas HealthCare and Winston-Salem-based Novant have about 9 million patient records between them. They have agreed to exchange demographics, test results, diagnoses and visit summaries.
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Informatics researchers combine algorithm with EHR data to predict secondary stroke risks

Jun 30, 2017 11:15am
Unleashing an algorithm on EHR data, researchers have found a way to predict whether patients are at risk for a second stroke.
Stroke patients that experience an irregular heartbeat are far more susceptible to a second stroke. Identifying that risk factor often requires significant resources, including 24/7 monitoring by physicians. 
But a team of cardiologists and informatics researchers in Northern California has developed a way to predict which patients will experience an irregular heartbeat, known as atrial fibrillation, following a stroke, allowing hospitals to focus energy and resources on those high-risk individuals.
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Senators introduce 'cyber hygiene' bill

Morgan Chalfant5
A bipartisan pair of senators introduced legislation Thursday that would direct the federal government to develop and publish voluntary best practices for "good cyber hygiene."
Sen. Orrin Hatch (R-Utah) couched the bill as an effort to combat cyber crime in the wake of the “WannaCry” ransomware attack that infected thousands of computers across the globe. 
The Promoting Good Cyber Hygiene Act, introduced by Hatch and Sen. Ed Markey (D-Mass.), would direct the National Institute of Standards and Technology to establish a set of baseline voluntary best practices for safeguarding against cyber intrusions that would be updated annually. 
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Portals – Advisory Series, June 2017

By Claire ReadDigital Health

In the second of Digital Health Intelligence’s new advisory series, Claire Read looks at how sustainability and transformation plans are embracing portals – and considers how the concept is evolving.
It’s a simple word, but ‘portals’ has a remarkable ability to polarise opinion in health IT. It’s fair to say Ciaron Hoye isn’t a big fan. “I absolutely hate the term,” admits Hoye, who is head of digital at Birmingham CrossCity Clinical Commissioning Group. He fears it is a “very vanilla description” which immediately conjures up an outdated understanding of its meaning.
“A lot of people when you say ‘portal’ think, ‘oh, right, a web page’,” he argues. “Well, no. That’s a very nineties and noughties idea of a portal.”
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Weill Cornell uses HL7 to help integrate structured genomic data into Epic EHR

Moving beyond the PDF, the medical center enables precision CDS for advanced oncology.
June 28, 2017 03:05 PM
One of the frustrating challenges in putting precision medicine to work more widely for clinical care is integrating complex and voluminous genomic data into the EHR.
Instead, in most cases, "we use a very highly interoperable standard for such material called 'PDF,'" joked Beth Israel Deaconess Medical Center CIO John Halamka, MD, when he spoke at the Healthcare IT News Precision Medicine Summit in Boston earlier this month.
That's not necessarily a drawback. 
"PDF is not so bad for visualization of data," said Olivier Elemento, associate director of the Institute for Computational Biomedicine at Weill Cornell Medicine in New York. "Clinicians can see the data in a way that's nice-looking and easy to understand," 
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NHS digitisation means mail blunder “unlikely” to occur again, Hunt tells Commons 

Laura Stevens

27 June 2017
The shift to electronic systems will mean the blunder that saw 709,000 items of medical correspondence not delivered is “unlikely” to occur again, according to the health secretary.
Jeremy Hunt faced an urgent question about the debacle in the House of Commons on Tuesday, following the publication of a damning National Audit Office (NAO) report that said at least 1,700 cases of potential patient harm have been identified, with investigations continuing.
“[It is] unlikely this will happen again because this is about paper correspondence”, said Hunt, who said the NHS is “recently moving all the transfers of communication to electronic systems”.
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Stanford researchers: Bring expectations for artificial intelligence back down to earth

Jun 29, 2017 8:40am
Healthcare needs to recalibrate its expectations of AI and find ways for the technology to work with physicians.
Artificial intelligence is hitting its stride—at least when it comes to hype.
The unbridled excitement surrounding AI and machine learning technology is higher than ever before, so much so that it’s become a distraction for the medical community, according to two Stanford researchers.
Arguing that AI has reached the “peak of inflated expectations,” Stanford researchers say the healthcare industry needs to shift its focus to how rapidly evolving technology can improve care.
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Health IT Tools, Capabilities Required for Value-Based Care

At Value-Based Care Summit, AMA calls for meaningful collaboration among healthcare providers and health IT developers.

Kyle Murphy, PhD

Director of Editorial
kmurphy@xtelligentmedia.com
June 27, 2017 - A successful transition to value-based care will require effective partnerships between healthcare providers and health IT developers as well as among providers themselves to ensure that current and future EHR and health IT infrastructure lead to improved care delivery.
That was the message delivered by the keynote speaker at last week’s Value-Based Care Summit in Chicago.
“Technology is a critically important driver of value-based care. If we don’t have functional systems in place — technology that is connected, easy to use, provides a free flow of information across systems — then it will be impossible to effectively migrate to a value-based care model,” said American Medical Association Board of Trustees Secretary Jesse M. Ehrenfeld, MD, MPH.
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HHS Will Award $195 Million to Health Centers to Leverage Health IT

June 27, 2017
by Heather Landi
The Department of Health and Human Services (HHS) announced the availability of $195 million in a new funding opportunity for community health centers to expand access to mental health and substance abuse services focusing on the treatment, prevention and awareness of opioid abuse in all U.S. states, territories and the District of Columbia. The awards are expected to be made in September of this year.
Health centers that receive an award will use the funds to increase the number of personnel dedicated to mental health and substance abuse services and to leverage health information technology and training to support the expansion of mental health and substance abuse services and their integration into primary care. 
“Addressing serious mental illness across our nation and combating the opioid epidemic are two of the Department’s top priorities,” HHS Secretary Tom Price, M.D., said in a statement. “Integration is key to solving these challenges. This funding will help our nation’s health centers provide that integration for mental health services and opioid addiction treatment.”
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Big data investments to top $76B worldwide by 2020

Published June 29 2017, 4:01pm EDT
Despite roadblocks relating to privacy concerns and organizational resistance, big data investments are gaining steam worldwide.
SNS Research estimates that big data investments will account for over $57 billion in 2017 alone, according to a new study. Big data vendors will get this revenue for the exchange of hardware, software, and professional services. These investments are expected to grow at a compound annual growth rate of 10 percent over the next three years, eventually reaching over $76 billion by the end of 2020.
While the meaning of the term “big data” used to refer to datasets whose size is beyond the ability of traditional databases to capture, store, manage and analyze, the meaning of the term has broadened a bit in recent years to include the set of technologies that capture, store, manage and analyze large and variable collections of data in order to solve complex problems.
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With Apple consulting Argonaut Project on health records, interoperability could get the push it needs

HL7 collaborative chief says aggregating records on the iPhone could lead consumers to help solve the interoperability problem themselves.
June 27, 2017 09:33 AM
Apple is said to be working with the Argonaut Project to integrate more electronic health data with the iPhone, a move experts say could go a long way towards advancing medical record interoperability.
Participants in the Argonaut Project – an HL7-led initiative focused on expanding the use of open standards for health data exchange, notably HL7's FHIR specification – are some of the industry’s most notable vendors and providers: Accenture, athenahealth, Cerner, Epic, McKesson, Meditech, Surescripts, The Advisory Board Company, Beth Israel Deaconess Medical Center, Boston Children's Hospital, Intermountain Healthcare, Mayo Clinic, Partners HealthCare.
It's not a bad place, then, for Apple to get some ideas about better integrating its products into a complex and fragmented healthcare ecosystem.
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Artificial Intelligence is becoming the new operating system in health

AI can help drive the Triple Aim in healthcare, reducing cost, improving quality and expanding access, according to a new report from Accenture.
June 27, 2017
Acquistions of AI startups are rapidly increasing while the health AI market is set to register an explosive CAGR of 40 percent through 2021.
Artificial Intelligence can help drive the Triple Aim in healthcare, reducing cost, improving quality and expanding access, according to Artificial Intelligence: Healthcare’s New Nervous System from Accenture.
Acquisitions of AI developers in health will be fast-paced, growing at a compound annual growth rate of 40 percent – “explosive” in the word of Accenture – moving from $600 million in 2014 to $6.6 billion in 2021.
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3 areas where digital technology could ease the burden for family caregivers

Jun 28, 2017 11:50am
Family caregivers are looking for digital tools that can manage care tasks and communicate with providers.
Opportunities exist for digital tools to ease the isolation and stress that family caregivers often experience while caring for a loved one, many of whom are open to solutions that provide easy access to information.
AARP has pointed to the 40 million Americans providing care to family members as a huge market opportunity for IT innovators. But it appears that market is still ripe for new solutions that can resolve specific problems.
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Digital apps show promise for depression treatment

Jun 28, 2017 11:23am
Previous research shows mental health apps are often flawed, but some say technology could help those with mild depression.
Mental health experts are beginning to see some value in mobile solutions and digital technology to treat patients with mild depression despite evidence that mental health apps are still working through significant growing pains.
Researchers have repeatedly pointed out the shortcomings within the mental health app market, including poor rating metrics and apps that lack clinical evidence. Experts at Beth Israel Deaconess Medical Center and Harvard Medical School recently identified digital biomarkers as the new "digital divide" among mobile apps targeting mental health conditions.
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Opinion 7 things to do to thwart the next ransomware attack

Published June 28 2017, 10:24am EDT
Yesterday’s ransomware attack again highlights the importance of cybersecurity vigilance.
Unfortunately, many will respond to this latest event with a combination of relief, denial and/or a much-too-narrow augmentation of their ransomware defenses.
That’s not smart. Your objective isn’t to dodge the attack that just occurred. It’s to dodge the next one—or, just as important, to fully mitigate the impact of that next attack, should you be breached.
Here, then, are seven best practices to put into action before the next exploit hits.
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SMS: The digital health tool of the century

Leading hospitals deploying secure messaging are finding that once the technology is in use, it opens up new doors to more innovation.
June 26, 2017 09:16 AM
Halifax Health CIO Tom Stafford doesn’t want nurses or doctors even looking at computers when a patient is in the room.
“Patients want to see them providing comfort and giving them control back,” Stafford said. “If a nurse is across the room typing into a computer, that’s not where they should be.”  
That catalyzed a journey to find tools Halifax clinicians can use at the point of care to more effectively and efficiently communicate with other caregivers that ultimately led to deploying SMS.
Secure messaging seems like such a simple, almost everyday technology that it might be easy to overlook its potential.
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AI’s success relies on solving healthcare's data problem

Jun 27, 2017 10:21am
IBM and several other major technology companies will need to grapple with healthcare's data flaws before AI will find success.
Technology giants like IBM, General Electric and Google have been eager to capitalize on AI advancements that could improve medical care. But for AI to make its mark, it will have to overcome a fundamental flaw that has clung to healthcare for decades: access to patient data.
Access to data is just one piece of the puzzle. Machine learning tools also need to be fed data that differentiates right answers from wrong answers. For particularly complex conditions, that kind of easily digestible data might not exist.
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New cyberattack hits organizations worldwide

Published June 27 2017, 1:24pm EDT
A new cyberattack similar to WannaCry is spreading from Europe to the U.S., hitting port operators in New York and Rotterdam, disrupting government systems in Kiev, and disabling operations at companies including Rosneft PJSC and advertiser WPP Plc.
More than 80 companies in Russia and Ukraine were initially affected by the Petya virus that disabled computers Tuesday and told users to pay $300 in cryptocurrency to unlock them, according to the Moscow-based cybersecurity company Group-IB. Telecommunications operators and retailers were also affected and the virus is spreading in a similar way to the WannaCry attack in May, it said.
Rob Wainwright, executive director at Europol, said the agency is "urgently responding" to reports of the new cyber attack. In a separate statement, Europol said it’s in talks with "member states and key industry partners to establish the full nature of this attack at this time."
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HIT Think Why insider breaches are on the rise

Published June 27 2017, 2:36pm EDT
Data remains exposed in significant numbers in the healthcare industry. The monthly Protenus Breach Barometer shows that the trend of at least one breach per day is continuing.
Protenus and Databreaches.net showed 37 breaches being disclosed for the first time in May. The number is significant, demonstrating the ongoing challenge for the healthcare industry. The not-so-old adage of it is not a matter of if you get breached, but when you get breached is only proving to be more accurate.
A couple of findings from the report stand out. First, three breaches were not reported for more than 1,000 days from the date of discovery. This is a substantial period of time for a breach to remain unreported. Why does it take so long for these organizations to report? What breakdown in auditing and monitoring of systems occurred?
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FDA’s new digital health unit and guidance for mHealth and telemedicine companies

Written by Taylor Whitten, Jason Drori, and Nathaniel Lacktman, Foley & Lardner LLP | June 26, 2017
In connection with its efforts to support technological innovation and advancement of digital health, the U.S. Food and Drug Administration (FDA) has announced two new resources: 1) the creation of a new centralized Digital Health Unit within its Center for Devices and Radiological Health (CDRH) and 2) the issuance of draft guidance on Software as a Medical Device (SaMD): Clinical Evaluation released last fall.
SaMD is an area of digital health where FDA guidance has been rapidly evolving.
Why is the FDA Focusing on Digital Health?
The FDA defines digital health to include categories such as mobile health (mHealth), health information technology (HIT), wearable devices, telehealth and telemedicine, and personalized medicine. According to the
FDA’s digital health website, many medical devices now have the ability to connect to and communicate with other devices or systems. Devices that are already FDA approved or cleared are being updated to add digital features. New types of devices that already have these capabilities are being explored. Many stakeholders are involved in digital health activities, including patients, health care practitioners, researchers, traditional medical device industry firms, and firms new to FDA regulatory requirements, such as mobile application developers.
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EPCS Jumps 256% in One Year

Alexandra Wilson Pecci, June 26, 2017

Many prescribers erroneously believe electronic prescribing of controlled substances is illegal, but experts say it is a key tool in the fight against opioid abuse.

There are many resources and possible solutions in the fight against opioid abuse, but one is gaining traction across the country: electronic prescribing of controlled substances (EPCS).
According to the Surescripts 2016 National Progress Report, there were 45.34 million prescriptions for controlled substances delivered electronically in 2016, representing a 256% increase over the year before.
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Timeline: How Apple is piecing together its secret healthcare plan

From the launch of its HealthKit API in September 2014 to revelations this month of EHR-like work with a tiny startup, it’s clear that healthcare is in Apple’s eye.
June 23, 2017 11:16 AM
Rumors are at a fever pitch that Apple has big plans for healthcare, including putting a medical record on the iPhone, possibly acquiring its way into the EHR market.
From its leap into healthcare in 2014 with its HealthKit application programming interface in September 2014 to the June 19 revelation of Apple’s work with the tiny start-up Health Gorilla, Apple has made a series of moves in healthcare that clearly indicate the company has plans for the space that will somehow manifest on its mega-popular iPhone and iPad products.
Here’s a look at how Apple got to where it is today in healthcare.
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Researchers: Better use of existing data could improve medical device safety

Jun 26, 2017 11:48am
Integrating existing claims data into device reviews could identify potential safety concerns.
Citing nearly $1 billion in potential savings associated with a single medical device, researchers at the University of Michigan say the FDA needs to make use of existing administrative data to improve medical device safety.
Furthermore, requiring all medical devices to have a unique identifier would allow regulators to connect valuable claims data with each device to spot potential problems sooner.
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Smart pill bottles didn’t improve medication adherence for heart attack patients, but earlier intervention could help

Jun 26, 2017 11:31am
Despite their latest findings, University of Pennsylvania researchers still see value in using technology to improve medication adherence.
New research shows smart pill bottles may not be the cure for medication adherence, but researchers are still holding out hope that new technology, paired with behavioral interventions, can make an impact.
The use of electronic pill bottles that tracked when patients took medication, combined with monetary incentives and support from friends, family and engagement advisers, offered no significant improvement in medication adherence for patients that were recovering from a heart attack, according to a new study published in JAMA Internal Medicine.
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In a quest to integrate digital tools, health systems see value in targeting chronic conditions

Jun 26, 2017 10:35am
As hospitals search for effective digital health solutions, some providers are finding success with mobile apps that target several chronic conditions.
Major hospital systems like Rush University Medical Center, the Mayo Clinic and Intermountain Healthcare are building a body of evidence around new technology that can improve outcomes associated with diabetes, high blood pressure and heart disease, according to the Wall Street Journal.
That success can be hard to come by in an industry that is increasingly inundated with new technology and apps claiming to solve some of healthcare’s most complex illnesses. More patients are using digital health tools ranging from telehealth to wearable devices, but physicians still find the data generated from those tools untrustworthy or overwhelming.
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CBO: 22M more uninsured, but Senate healthcare reform bill would stabilize markets, reduce deficit

Jun 26, 2017 4:40pm
The CBO predicts that 22 million more people will be uninsured under the Senate healthcare bill to replace the Affordable Care Act.
An estimated 22 million people would either lose or voluntarily give up their health insurance by 2026 under the Senate’s plan to repeal and replace the Affordable Care Act. That’s just a little less than the increase in the number of uninsured estimated for the House-passed legislation. 
The Affordable Care Act added an estimated 20 million people to the insurance rolls.
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Hospitals Pan Senate ACA Repeal Plan

John Commins, June 22, 2017

The hospital sector offers unanimous thumbs down to the Senate’s proposal to repeal and replace the Affordable Care Act. 

The nation’s largest hospital associations united in rejecting the Senate’s proposal to repeal and replace the Affordable Care Act, and urged lawmakers to “hit reset” and “go back to the drawing board.”
The response to the Senate plan released Thursday was virtually identical to the unanimous disdain shown this spring for the House Republicans' American Health Care Act.
That is not surprising because the two bills are fundamentally the same on key points. They both eliminate the individual mandate, slash Medicaid, and eliminate a 3.8% tax on investment income above $200,000 that is a key funding source for Obamacare.
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The Senate’s three big lies about health care

E.J. Dionne Jr. Opinion writer June 25 at 7:07 PM
To succeed in gutting health coverage for millions of Americans, Senate Republican leaders need to get a series of lies accepted as truth. Journalists and other neutral arbiters must resist the temptation to report these lies as just a point of view. A lie is a lie.
Lie One: Democrats and progressives are unwilling to work with Republicans and conservatives on this issue. “If we went and got the single greatest health-care plan in the history of the world, we would not get one Democrat vote,” President Trump told an Iowa crowd last Wednesday.
In fact, Democrats, including President Barack Obama when he was in office, have said repeatedly that they would like to work with Republicans to improve the Affordable Care Act. Senate Democratic leader Charles E. Schumer’s office put out a list of such offers, including a June 15 letter from Schumer to Senate Majority Leader Mitch McConnell calling for a cross-party meeting to “find a way to make health care more affordable and accessible.”
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Maria Hägglund: Electronic health records in Sweden—how can we go from transparency to collaboration?

June 23, 2017
I have had full access to my electronic health record (EHR) online since 2012, when Uppsala became the first region in Sweden to make EHR accessible to patients. I remember the excitement I felt the first time I logged in, and I’ve continued to use the patient accessible EHR (PAEHR) referred to as “Journalen” ever since. As a health informatics researcher and a member of the DOME research consortium, I also have a special interest in how the PAEHR is designed and used.
In March 2017, I attended a session at the Salzburg Global Seminar called “Toward a Shared Culture of Health: Enriching and Charting the Patient-Clinician Relationship.” The session was focused on transparency and the importance of patients being able to access their EHRs. The Swedish national health information exchange (HIE) platform and PAEHR received a lot of attention (both during the seminar and afterwards), but I left Salzburg with mixed feelings. I am proud of the work done in Sweden to give all patients access to their EHR online—I believe that this is a fundamental right that everyone should have. Currently, the Swedish PAEHR has about 1 million users (out of 10 million citizens), and in April 2017 39,5% of the Swedish population had created accounts in the national patient portal 1177 (through which the PAEHR can be accessed). Yet, we have a long way to go. Despite the national HIE platform and the intention to provide patients with a complete overview of their health related data, the view remains fragmented depending on where, when, and why a patient seeks treatment. [1, 2] There are important differences in how much information each care provider allows access to ( see figure 1).
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Enjoy!
David.

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