Saturday, August 26, 2017
Weekly Overseas Health IT Links – 26th August, 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.
Published August 18 2017, 7:17am EDT
The House Committee on Rules this week released a combined appropriations bill for Fiscal Year 2018 with proposed funding for federal agencies. If passed by Congress, the Office of the National Coordinator for Health IT would receive a budget of only $38 million next year as part of the legislation.
While the Department of the Interior, Environment and Related Agencies Appropriations Act directs that the money be used for the “development and advancement of interoperable health information technology,” ONC’s funding level would see a reduction of almost $22 million from the $60 million it was appropriated for Fiscal Year 2017, which ends September 30.
The House of Representatives is not currently in session because of its August recess, but lawmakers will return in September to vote on the bill.
Protecting patients and their data should be as important as basic cleanliness, experts say.
By Bill Siwicki
August 18, 2017 03:02 PM
Hackers have proven they can get through hospital networks into medical and Internet of Things devices, which is why it is crucial that patient safety be prioritized when outlining a security strategy to make sure that hackers can’t physically affect patients.
“A CISO should talk in the risk management language of the business, not in the technical management language of the information security field,” said Bryan Hurd, senior executive, security strategy, at Versive, a vendor that uses artificial intelligence to hunt cyber-adversaries and insiders. Hurd previously was head of the Microsoft Cybercrime Center Intelligence Program.
Security executives can make the connection to patient safety by talking to fellow business executives in terms that they understand. Caring for patients transcends beyond their health and includes their information.
Amid the uproar about how hard electronic health records can be to use, a small contingency of doctors are saying the software has made them much better caregivers.
August 18, 2017 11:50 AM
EHR dissatisfaction is rampant. Doctors complain about too many clicks and unusable interfaces, to name just two common gripes. Health IT pros and clinicians hear and read about these problems a lot. But the other side of the story -- physicians who say the EHR makes them better doctors -- is less-often told.
“Yes, I love the EHR I use,” said James Legan, MD.
Legan, an internal medicine physician in Great Falls, Montana, who credits the EHR for helping him to practice medicine more effectively, is not alone. Medical Group Management Association CEO Halee Fischer-Wright, MD, while perhaps less exuberant than Legan, said EHRs have considerable promise in the practice of medicine. And then there’s Jeffrey Cleveland, MD, a pediatrician at Carolinas HealthCare System.
Aug 18, 2017 7:21am
Some doctors are skeptical of the Human Diagnosis Project that got a boost from several medical boards last week.
The Human Diagnosis Project might have the newfound support of the American Medical Association (AMA), but physicians are slightly more skeptical of the crowdsourced approach to medical care.
Several physicians expressed doubts about the initiative, which blends machine learning with crowdsourced information from specialists around the country, according to Axios. Ethan Weiss, a cardiologist and associate professor at the University of California San Francisco School of Medicine, told the website he was concerned the initiative would end up “spitting out garbage.”
August 17, 2017 - It can be daunting to choose the right mobile tools to help a healthcare organization stay innovative. It can be even more daunting though to ensure that mobile security remains a top priority and that PHI stays secure.
Healthcare IT leaders might see the value in implementing mobile options, but studies show that security is often a top concern.
How can entities properly budget for mobile options? What are the potential consequences if a HIPAA violation occurs? Why is employee training so critical for strong mobile security?
Aug 15, 2017 | Cara Livernois
Playing online team games can help diabetes patients lower their blood glucose levels, according to a study published in Diabetes Care.
Researchers examined if providing patients with diabetes self-management education (DSME) through online team-based games could improve patient engagement in their own care. The study, conducted at Brigham and Women's Hospital and the Veterans Affairs Boston Healthcare System, enrolled 456 patients on oral diabetes medication and assigned them to receive a DSME game with a booklet or a civics game with DSME booklet.
For all too many years, the healthcare industry’s attempts to innovate have run into the proverbial brick wall. An emerging standard is sparking much needed change, though.
August 15, 2017 11:45 AM
For all too many years, the healthcare industry’s attempts to innovate have run into the proverbial brick wall. Even though the industry has moved en masse to electronic medical records (EMRs), the fact that data resides in silos has made it difficult to create the innovative applications that can truly engage patients and transform the healthcare experience. An emerging standard is sparking much needed change, though.
Consider the following: A patient typically interacts with a variety of different, unaffiliated organizations such as hospitals, physician offices, pharmacies, health insurance companies, drug manufacturers and federal agencies. As a result, the care experience is highly fragmented and inconsistent. Data does not flow seamlessly across this ecosystem and there is no unified, real-time view of the patient.
Application programming interfaces (APIs) have been around for quite some time and were heralded as the programming solution that could assuage some of this disconnection. The problem: “Originally APIs were very proprietary. The API for Windows 3.1 was designed for interaction between the operating system and a Windows application and was used to build an app that would only run on Windows 3.1. The APIs of today are not proprietary, use web technology, and can be used to build an app that can run on any platform, even those that will manage the devices yet to come,” said Dan Tortorici, director of API product and solutions marketing at Axway.
15 August 2017
The Information Commissioner’s Office (ICO) has reminded NHS staff about the potentially serious consequences of prying into patients’ medical records without a valid reason.
The warning came after Brioney Woolfe, a former midwifery assistant at Colchester Hospital University NHS Foundation Trust, who described herself as ‘nosy’,was ordered to pay a total of £1,715 in fines and costs after pleading guilty to offences of unlawfully obtaining and unlawfully disclosing personal data.
An investigation, which followed a complaint by a patient, established that Woolfe had accessed the records of 29 people including family members, colleagues and others where no connection with the defendant is known, between December 2014 and May 2016.
Aug 17, 2017 10:50am
A new study shows "e-visits" may not be living up to their potential.
Healthcare providers that use technology to provide patients a convenient alternative to in-person care may not be getting the most out of those programs.
Researchers at the University of Wisconsin and the University of Pennsylvania reviewed 5 years of healthcare encounters at a larger primary care practice, including "e-visits," phone consultations and in-office visits, and discovered that providers that accepted e-visits actually saw a 6% increase in office visits. As a result, physicians spent more time each month seeing patients in person, which led to a 15% decline in new patients, according to the study, which will be published in Management Science.
By Kate Monica
August 16, 2017 - A recent report from Chilmark Research named Cerner Corporation’s EHR system as the best offering for health data analytics-based EHR capabilities over Allscripts, Athenahealth, eClinicalWorks, and Epic Systems.
The report evaluated the top health IT companies for their analytics and reporting software as part of an assessment of the most recent healthcare analytics market trends.
However, researchers found health IT companies consistently offer end users the same overall insights to facilitate the shift to value-based reimbursement as part of the Quality Payment Program (QPP) under MACRA.
New cost reductions make cloud options more compelling than ever but, in a twist, experts say cloud platforms can be more secure than managed data centers.
By Gus Venditto
August 15, 2017 11:51 AM
Healthcare did not lead the charge into the cloud. But it has been making up for lost time. The use of cloud platforms has grown substantially within healthcare provider organizations.
A recent HIMSS Analytics survey of provider C-suite executives found that more than half are using Infrastructure-as-a-Service (Iaas) cloud platforms to provide an environment for a wide range of uses ranging from hosting internally developed programs to a running fully functional EHR.
HIPAA privacy and security concerns were one reason for the slow start. But once HHS provided clear guidance on how to address PHI issues and work through Business Associate (BA) relationships, everything changed.
They’re difficult to memorize so employees skirt hospital IT rules when conjuring them up anyway, group says.
August 16, 2017 01:52 PM
The National Institute of Standards and Technology on Wednesday published new guidance on how to strengthen passwords. Why now? Research shows that the de facto standard practice of requiring users to include a mix of uppercase and lowercase letters, numbers and at least one symbol, is more trouble than it’s worth.
“Analyses of breached password databases reveal that the benefit of such rules is not nearly as significant as initially thought,” NIST explained. “The impact on usability and memorability is severe.”
Said impact is both the root of the problem and the reason NIST revised its guidance about the strength of passwords: Because complex and arbitrary phrases are difficult to remember many employees essentially circumvent IT’s requirements by picking passwords that are easy to guess. Password1!, for instance.
Published August 17 2017, 7:27am EDT
The overall quality of healthcare in this country continued to improve from 2000 through 2015, particularly in the areas of person-centered care and patient safety.
That’s the finding of the 2016 National Healthcare Quality and Disparities Report just released by the Agency for Healthcare Research and Quality. AHRQ’s annual report, mandated by Congress, is based on more than 250 measures of quality and disparities covering a broad array of healthcare services and settings.
According to AHRQ, about 80 percent of quality measures improved for person-centered care, which evaluates how well patients are directly involved in decisions about their healthcare. In addition, nearly two-thirds of patient safety measures improved overall.
Cybersecurity requires strategy to succeed and that means putting your priorities in the right place. CISOs and other infosec pros must up their game to make protecting patients the top concern.
By Mike Miliard
August 15, 2017 01:55 PM
It probably won't surprise you that privacy, security, quality and safety are some of the most relevant topics to hospital executives and health IT pros these days.
At first glance, they might seem to stand at nearly opposite ends of the continuum linking healthcare and technology. While privacy and security are focused largely on technical infrastructure, quality and safety are focused on best practices for clinical care delivery.
But they have more in common than would first appear – especially as security threats are becoming all-enveloping and insidious, and increasingly threatening to disable critical clinical systems, potentially for weeks (or more) at a time.
Shop carefully. While cloud computing offers many advantages, it’s a big step and adequate planning is essential to ensure success.
By Gus Venditto
August 15, 2017 01:23 PM
To help with your planning, this Healthcare IT News Cloud Computing Buyers guide looks at the top four IaaS providers, Amazon, Microsoft, Google and IBM. A report from Synergy Research Group found that these platforms have over 60 percent of the public cloud market. (Amazon has the lion’s share with 33 percent share; the other three divide 27 percent of the market.) The market is far from stable, however; Microsoft and Google each achieved an annualized growth rate of 80 percent in the first quarter of 2017.
We also look at services from three companies who specialize in supporting healthcare providers with managed services: ClearData, CDW and VMware.
Shop carefully. “Read the fine print and really make sure you ask a lot of questions,” Snedaker says. “Don’t take a sales rep’s word for anything. Not to disparage sales reps, but if it’s not in the contract, it really doesn’t matter what the salesperson said.”
Two-thirds of hospitals use EHR systems from Cerner, Epic or Meditech, according to data compiled by HIMSS Analytics, a subsidiary of the Healthcare Information and Management Systems Society.
The data, which HIMSS Analytics provided to HISTalk, describes the EHR market as broken down by hospital bed size.
Care coordination between healthcare settings can have a significant impact on patient care.
Strong care coordination is particularly necessary for providers delivering care to high-risk patients.
Transitions of care and chronic disease management often require providers to straddle the space between hospitals or pharmacies and long-term post-acute care (LTPAC), home health, and ambulatory care settings.
EHR use and timely patient health data access can be pivotal to improving provider communication and ensuring providers have all the information they need to deliver appropriate patient care in collaborative environments.
August 15, 2017 - Individuals working in the Internet of Things (IoT) connected medical device ecosystem are most concerned with potential medical device cybersecurity issues, according to a recent Deloitte poll.
Nearly one-third of respondents – 35.6 percent – stated that their organization experienced a cybersecurity incident in the past year. Approximately 30 percent of those surveyed said identifying and mitigating potential risks in legacy and connected devices was the greatest cybersecurity challenge.
Deloitte surveyed more than 370 professionals during a May 2017 webcast. The polled individuals worked in organizations operating in the medical device/IoT ecosystem.
Published August 16 2017, 3:16pm EDT
Not a day goes by without a discussion of the rapid increase in data breaches impacting the healthcare industry. Information and statistics in this regard are inescapable.
For instance, the so-called “Wall of Shame,” which is the public posting of breaches, recently crossed the 2,000 breach threshold. The Wall of Shame first came online in 2009 and took almost five years to hit the 1,000 barrier, but just needed another three years to hit 2,000. Clearly, the data show more breaches are happening more frequently.
While the Wall of Shame has now been around since 2009, there has not been a consistent, comprehensive source for information about healthcare data breaches. Sources are developing though, with the Protenus Breach Barometer being one of my favorites. The Breach Barometer is typically published on a monthly basis and highlights totals of known breaches from the previous month. Tracking the Breach Barometer reveals trends, which were highlighted in the recent mid-year Breach Barometer.
August 16, 2017
In June 2017, the new Food and Drug Administration (FDA) commissioner Scott Gottlieb pre-announced his agency’s Digital Health Innovation Action Plan that indicates notable shifts in the agency’s approach to digital health technologies. This plan is an important step in FDA regulation of this area, a process that began in 2011 with a draft guidance, followed by significant congressional actions. The new changes should not be surprising, given critiques published by Gottlieb prior to re-joining the FDA. In 2014, he wrote that smartphones are “purposely dumbed down” due to the “risk of unwieldy FDA regulation,” and in 2015, he argued that what most considered the FDA’s “light touch” on digital health was still too heavy-handed. The new plan signals two major shifts: first, a shift from premarket to postmarket review by the FDA; and second, a shift from oversight by the FDA to oversight by independent, nongovernment certifiers. These changes may be bellwethers for how a Trump-era FDA approaches areas far beyond digital health.
When considering the benefits of mobile working in the healthcare, the focus has often been on clinical staff working in the community. But mobile technology is also being valuably used to improve care within hospital walls and to help non-clinical staff work more efficiently, as Claire Read reports.
To welcome the concept of mobile working in a healthcare organisation is often to welcome a whole load of preconceptions along with it. Chief among them, according to James Reed, is the overly-simplistic idea that healthcare didn’t previously have a way of working in such a fashion.
“When you have hard copy notes, you’ve sort of got mobile working,” points out the chief clinical information officer at Birmingham and Solihull Mental Health NHS Foundation Trust. “OK, the notes are only in one place [at once], but when you have big trusts you often end up with multiple sets of notes, so the individual staff member can sort of do mobile working.
Published August 15 2017, 7:25am EDT
A cyber attack that affected a cloud-hosting and service provider resulted in access to patient data of Surgical Dermatology Group in Alabama, a specialty practice that has offices in Birmingham, Montgomery and Huntsville.
Hackers were able to penetrate TekLinks, which provides cloud services to Surgical Dermatology; the cloud provider notified the practice of the about the intrusion in early June.
“TekLinks has assured us that all unauthorized access was terminated on May 1, 2017, and that monitoring by TekLinks from April 22 through May 1 showed no further malicious activity during that time period,” the practice told patients in a notification letter.
San Mateo County Health System incorporated social determinants of health into its patient records to reduce ‘epistrophic’ events among its vulnerable population.
August 14, 2017 10:29 AM
Nestled between Cisco, Facebook, Google and other tech titans, San Mateo County Health System lies in Silicon Valley where billions are spent on biotech and big pharma, among the other VC dollars invested every month.
But as hard as it may be to imagine, 10 percent of the population in that wealthy region consists of people who are either covered by Medicaid or entirely uninsured.
“We actually have a homeless problem. It’s hard for people to get that,” said Eric Raffin, CIO of San Mateo Health. “We have a vulnerable group. So demand is on the rise to engage more actively in understanding the population we serve.”
Aug 14, 2017 4:38pm
Aetna is exploring a deal with Apple that would make Apple Watches a membership perk.
A series of meetings involving senior executives at Apple and Aetna have reportedly included discussions about making the Apple Watch available to the insurer’s 23 million members.
The potential deal, reported by CNBC, would expand Aetna’s existing relationship with the consumer tech giant that has been showing more behind-the-scenes interest in the healthcare industry. Last fall, Aetna announced plans to subsidize a portion of the cost of an Apple Watch for its 50,000 employees as part of the company’s employee wellness program.
The vast majority of senior living providers rely, in some way or another, on outsourcing—whether that means tapping other companies to provide their ancillary services or using medical record software from third-party providers.
The most-preferred third-party vendors of many providers were outlined in a recent survey by Ziegler.
The Chicago-based specialty investment bank polled 143 chief financial officers and financial professionals from senior living companies nationwide. About 67% of respondents were from single-site organizations and 33% were from multi-sites.
Experts from HL7 and DirectTrust say hospitals can benefit from combining the two interoperability specs.
By Mike Miliard
August 14, 2017 03:34 PM
As HL7's FHIR standard continues to catch on across healthcare, there are ways it can be leveraged to work in tandem with the Direct protocol for better information exchange, a new report from DirectTrust shows.
Hospitals and medical practices could make progress in their interoperability initiatives by availing themselves of both approaches, according to the report, coauthored by DirectTrust CEO David Kibbe, MD, members of the DirectTrust Policy Committee and FHIR architect Grahame Grieve of HL7.
The two approaches are different, but offer synergies that bear exploration. FHIR is a standards framework created by HL7; Direct is an exchange network for easy and exchange of personal health information between providers and between provider and patients.
The white paper, "Direct, DirectTrust, and FHIR: A Value Proposition," explores different ways FHIR's web APIs can complement the Direct standard for more seamlessly exchanging healthcare data.
Published August 15 2017, 4:00pm EDT
This country is in the midst of an opioid overdose epidemic as millions of Americans struggle with pain and addiction—according to the Centers for Disease Control and Prevention, opioids killed more than 28,000 people in 2014, more than any year on record.
There are many factors that contribute to the increase in abuse, but the reality is, prescription drugs are more accessible now than ever before. Some individuals abuse the system by getting appropriately prescribed medications from friends and family. Others are counting on the fact that providers are not aware of their addiction as they hop from one healthcare system to another to get their fix.
Alexandra Wilson Pecci, August 15, 2017
Randomized, blinded, or controlled trial designs are the "gold standards" for clinical trials, but when it comes to trials that test changes in how high-risk medical devices are designed or used, these standards often aren’t met.
That’s according to a new study by researchers at the University of California, San Francisco and Yale School of Medicine and published today in JAMA.
News Aug 15, 2017 05:39 by Johanna Weidner Waterloo Region Record
WATERLOO REGION — An online medical referral system developed locally is being duplicated across Ontario.
The province announced recently it was investing $12.9 million over two years to support the expansion of the innovative eReferral system in the Waterloo Wellington Local Health Integration Network and seven more health networks.
The aim is to reduce wait times by connecting patients to specialists and other health care services in their community faster.
Published August 14 2017, 6:49am EDT
Monitoring multiple patients simultaneously in combat and effectively triaging them has never been an easy task for medics. However, mobile technology is enabling Air Force pararescue jumpers to have health data at their fingertips, giving them the ability to treat the most critically wounded first.
The wrist-mounted Battlefield Assisted Trauma Distributed Observation Kit (BATDOK), developed by the Air Force Research Laboratory at Wright-Patterson AFB in Ohio, runs on a Samsung Galaxy S series Android smartphone connected to FDA-approved wireless sensors that display the health status of casualties, providing instant alerts if certain vital signs drop or spike.
“BATDOK by design is an open architecture, so as a new FDA-approved sensor comes online, we can adopt that protocol,” says Gregory Burnett of the Airman Systems Directorate in the Warfighter Interface Division of the 711th Human Performance Wing, who managed the development of the software. “It is very modular and scalable to meet today’s and tomorrow’s demands.”
The group published the guidance to help hospitals define what job roles cybersecurity teams require and, ultimately, to help them find top talent.
August 11, 2017 01:16 PM
Cyber ops planner. As a professional title that sounds like either a shadowy special agent or some new age name for a nefarious hacker.
Instead, it is one of the job roles that the National Institute of Standards and Technology outlined in its just-finalized draft Cybersecurity Education (NICE) Cybersecurity Workforce Framework.
Infosec pros already know what a CISO is, of course, but some of the other intriguing titles NIST described include target developer and target network analyst, exploitation analyst, threat/warning analyst, cyber intel planner and cyber defense forensics analyst, just to name a few.
Aug 14, 2017 11:54am
A majority of consumers say they are interested in virtual care options, indicating strong potential within the market.
The majority of consumers are interested in some kind of virtual medical care, particularly following a hospital stay, according to a new survey.
Sixty percent of broadband households say they are interested in remote care options, an indication that strong potential exists within the virtual care market moving forwards, according to portions of a survey released by Parks Associates. The firm plans to present the full findings at the Connected Health Summit in San Diego at the end of August.
Aug 14, 2017 11:52am
The Illinois Pain Institute has done what many physicians only dream about doing. The practice, which has multiple locations in four Illinois counties, just ditched its electronic health record (EHR) and went back to paper records.
The private practice voted unanimously to take the step back to paper records two years ago and has not regretted it, John Prunskis, M.D., founder and co-director, told Becker’s Hospital Review.
"We felt the level of patient care was not enhanced by an electronic health record. We saw it was inefficient and added nonproductive work to physicians' time,” Prunskis told the publication.
Cybersecurity workers face many challenges on the job. Here are 10 bad habits they must avoid in order to be most effective.
Demand for cybersecurity professionals continues to rise, with the projected talent gap in the field reaching 1.8 million jobs by 2022. Those that take on these roles play a key role in the enterprise, as the average cost of a data breach worldwide is now $3.62 million.
A number of common mistakes arise in the field that can make your job more difficult and put your company at risk. Here are 10 bad habits cybersecurity workers must break to be most effective in their role.
The most common mistake made by cybersecurity professionals is overconfidence, and a false sense of security, said Bahram Attaie, assistant professor of practice at the School of Information Studies at Syracuse University. "They believe that they have implemented all the right controls, and as a result they think they are un-hackable," Attaie said.
Analysis: What the Latest Breach Statistics Mean Marianne Kolbasuk McGee (HealthInfoSec) • August 9, 2017
The federal tally that lists major health data breaches has hit a new milestone: More than 2,000 breaches affecting 500 or more individuals have been reported since September 2009. And the tally shows a significant recent shift in the kinds of breaches being reported.
An Aug. 9 snapshot of the Department of Health and Human Services' HIPAA Breach Reporting Tool website - often called the "wall of shame" - shows a total of 2,018 breaches since 2009.
It took about five years - from September 2009, when HHS began tallying breaches, to about April 2014 - for the wall of shame to reach the 1,000-breach milestone. More than 1,000 additional breaches have been added to the HHS Office for Civil Rights' tally in the three years since then.
By Ali Stratton
Aug. 13, 2017 10:12 p.m. ET
In the digital age, people seeking health-related assistance online have more options than ever before. Innovative technologies, as well as cloud computing and machine learning enable the newly medicalized smartphone to permeate every aspect of health care.
As a health information provider, WebMD WBMD 0.08% is well aware of these changes. According to the company’s chief financial officer, Blake DeSimone, who was appointed to the position in September, WebMD is in the process of transforming its flagship site for consumers, WebMD.com, from a one-stop shop for information to a platform people can engage with and take action to improve their health.
Posted by Dr David G More MB PhD at Saturday, August 26, 2017