Saturday, August 05, 2017

Weekly Overseas Health IT Links – 5th 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.
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Wait! What? Amazon and Apple eye building EHRs

Just weeks after rumors hinted that Apple is working on a way to bring health records together on iPhones, Amazon appears to have launched an investigation about building EHR software.
July 27, 2017 04:38 PM
Amazon has started a secret lab at its Seattle headquarters to explore business prospects in the healthcare sector, including EHRs and telemedicine, according CNBC. That report comes on the heels of swirling rumors that Apple is in talks with hospitals and other healthcare organizations to explore the possibility of bringing health records together on the iPhone. 
It’s important to note that press reports thus far are based on unnamed sources and industry analysts speculate that even for the likes of Amazon and Apple stealing customers away from Epic, Cerner and Allscripts would likely be a difficult and lengthy process. 
Amazon is reportedly considering developing an EHR platform as well as telemedicine and health apps for existing devices, such as its Echo. 
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Doctors could use our Google searches to monitor type 2 diabetes development

Thu, 27 Jul 2017
Doctors could use our Google searches to monitor type 2 diabetes development
Healthcare professionals could more effectively monitor type 2 diabetes prevalence using our Google searches, research suggests.
A new study from the University of Warwick proposes that keywords entered into search engines, which are related to diabetes symptoms and risk factors, could indicate type 2 diabetes development across the UK.
Lead author Nataliya Tkachenko, from the University's Department of Computer Science, says these keywords, which could also be posted on social media, could provide real-time information on patients' symptoms and underlying conditions.
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Amazon has a secret health tech team called 1492 working on medical records, virtual doc visits

  • Amazon has a secret skunkworks lab called 1492, dedicated to health care tech.
  • Areas of exploration include a platform for electronic medical record data, telemedicine and health apps for existing devices like the Amazon Echo.
Thursday, 27 Jul 2017 | 2:30 PM ET
Amazon has started a secret skunkworks lab dedicated to opportunities in health care, including new areas such as electronic medical records and telemedicine. Amazon has dubbed this stealth team 1492, which appears to be a reference to the year Columbus first landed in the Americas.
The stealth team, which is headquartered in Seattle, is focused on both hardware and software projects, according to two people familiar. Amazon has become increasingly interested in exploring new business in healthcare. For example, Amazon has another unit exploring selling pharmaceuticals, CNBC reported in May.
The new team is currently looking at opportunities that involve pushing and pulling data from legacy electronic medical record systems. If successful, Amazon could make that information available to consumers and their doctors. It is also hoping to build a platform for telemedicine, which in turn could make it easier for people to have virtual consultations with doctors, one of the people said.
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Report: The top 5 cybersecurity threats of 2017

A report from Accenture has examined key threats that have emerged in the first half of 2017. Here's how businesses can stay safe.
By Conner Forrest | July 26, 2017, 8:11 AM PST
As large-scale cybersecurity attacks continue to proliferate in the enterprise, attackers are broadening their approach in order to strengthen their impact. A Tuesday report from Accenture Security outlined new methods that hackers are using to gain access, steal data, and make money.
According to a press release announcing the report, the results were collected from intelligence gathered from iDefense, a part of Accenture Security. In addition to the growth of the sheer number of attacks, they are also becoming more destructive and being utilized by other entities, such as nation-states, the release said.
"The first six months of 2017 have seen an evolution of ransomware producing more viral variants unleashed by potential state-sponsored actors and cybercriminals. Our findings confirm that a new bar has been set for cybersecurity teams across all industries to defend their assets in the coming months," Josh Ray, managing director at Accenture Security, said in the release.
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Republicans consider next steps after health reform setback

Published July 28 2017, 3:44pm EDT
Republicans in Congress have been unable agree on a way to repeal and replace Obamacare -- and now they’re divided on whether they should give up on their GOP-only approach.
Senator John McCain urged fellow senators Friday to "start fresh" and seek a bipartisan plan, hours after he provided the decisive vote against his chamber’s latest Obamacare-repeal proposal. "We can do this," the Arizona Republican said in a statement.
Other Republicans insist they got too close to a GOP-only agreement on demolishing Obamacare to turn back from that idea. The Senate fell one vote short of advancing a partial repeal of Obamacare early Friday, with opposition from McCain and two other Republicans. In May, the House passed its replacement plan on a razor-thin 217-213 vote.
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Changing dates in patient data drastically reduces risk of re-identification

Patient datasets often contain sensitive information and there is always a chance that the data might fall into the wrong hands and be misused. But now researchers have found that simply changing the dates can reduce the risk of re-identification of patients participating in a research.
“Researchers typically get access to de-identified data, that is, data without any personal identifying information, such as names, addresses, and Social Security numbers. However, this may not be sufficient to protect the privacy of individuals participating in a research study,” said study author Giske Ursin, Director of Cancer Registry of Norway, Institute of Population-based Research.
Ursin and her team also developed two de-identification methods and used k-anonymisation to significantly reduce the risk of re-identification by someone who had access to some of the information about the patients in the dataset.
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Leveraging social determinants of health data remains challenge

Published July 27 2017, 7:13am EDT
While social determinants—such as socioeconomic status, education, physical environment, and employment—have a significant impact on health outcomes, clinical systems are not currently designed to collect that kind of data.
However, there is a push going on within the healthcare industry to capture that information in electronic health records in order to improve clinical decision support and quality measurement, care coordination, as well as population health management.
On Wednesday, the Office of the National Coordinator for Health IT held a half-day webinar on how to leverage HIT to support the use of social determinants of health (SDOH) in clinical practice.
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OCR updates health data breach reporting tool

Published July 27 2017, 7:19am EDT
The Department of Health and Human Services’ Office for Civil Rights has revised a web-based tool making it easier for the public to obtain information about healthcare data breaches and for organizations to report incidents.
OCR first launched their HIPAA Breach Reporting Tool in 2009, as required by HITECH Act, to report breaches of unsecured protected health information of 500 or more individuals. However, based on feedback, the agency has updated the website to better identify recent data breaches and to make it easier to use and navigate.
“HHS heard from the public that we needed to focus more on the most recent breaches and clarify when entities have taken action to resolve the issues that might have led to their breaches,” said HHS Secretary Tom Price, MD, in a written statement. “To that end, we have taken steps to make this website, which features only larger breaches, a more positive, relevant source of information for concerned consumers.”
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Special Report: RIS and imaging

The song tells us love and marriage go together, as does a horse and carriage. If you were penning a healthcare IT version of this famous ditty, you might mention PACS and RIS.
For as long as these two types of systems have been in existence, they have been seen as interdependent. Radiologists have used picture archive and communication systems (PACS) to electronically review images, turning to a radiology information system (RIS) to track imaging requests and to share their findings.
But, to borrow from another song, the times they are a-changin’. As PACS and RIS have advanced, and as the needs of the market have evolved, the separate but complementary roles of each are becoming blurrier.
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How hospitals can shore up cybersecurity on a 'skinny' budget

The ongoing staffing shortage and budget constraints are making it difficult to protect health information, but it’s possible to piece together an effective security strategy by aligning the necessary pieces.
July 26, 2017 03:52 PM
Hospital infosec pros are battling a rise in increasingly sophisticated hacker and cyber attacks while simultaneously struggling amid a security staffing crisis. And if that scenario wasn’t hard enough, many are also operating on a shoestring budget. 
But there are some creative approaches to meeting security needs without the luxury of a bigger budget.
At a bare minimum all hospitals need someone able to manage vendors and help select providers. Not only that, this employee must be able to sit on top of that relationship, explained Kris Lovejoy, CEO of security firm BluVector.
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Internet of Things the real threat to healthcare security

Davey Winder

26 July 2017
Things can only get better, so the song by D:Ream assured us back in 1994. Last year, speaking on Charlie Brooker’s 2016 Wipe TV show, the D:Ream keyboard player at the time and now celebrity physicist, Professor Brian Cox said it was one of the “most misleading and scientifically inaccurate pop songs that’s ever been written.”
I mention this only because I think there should be a remix entitled Internet of Things security can only get better; not least as they surely can’t get any worse.
Just look at where the NHS is with regards to cyber security currently. Freedom of information request driven research carried out at the start of the year has revealed that NHS attacks have more than quadrupled across the past four years while security spending by trusts has remained pretty much the same.
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People want to share their health data with Google, report reveals

The highly anticipated report, Internet Trends 2017, reveals that people are willing to share their health data with leading tech brands such as Google, proving their position in the digital health market.

Shireen Khalil

26 July 2017
The information is cited in investor and tech analyst Mary Meeker’s report, Internet Trends, which is highly regarded in the tech community for its insights into trends and predictions.
As part of the 31 May report, Meeker notes a survey stating that 60% (of US) consumers are willing to share their health data with tech giant Google in 2016, closely followed by Microsoft at 56%, Samsung, 54% and Apple at 50% – based on 4,015 respondents.
The other end of the graph showed consumers didn’t trust Amazon.com Inc. and IBM Corp. as much, with the companies only being trusted by 39% and 37% of people.
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London goes live with capital-wide child health information service

London has gone live with a capital-wide child health information service designed to reduce the risk of children falling through ‘gaps’.

Shireen Khalil

24 July 2017
The new service, powered by CarePlus (System C), provides a comprehensive electronic record of a child’s public health records. It replaces 18 different child health records departments using 18 separate IT solutions and was commissioned by NHS England (London region) in line with the new child health digital strategy.
Kenny Gibson, head of Public Health Commissioning London, said it is a way to keep track of children, and monitor and manage their care needs.
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HIT Think Four analytic errors that can defeat data project efforts

Published July 27 2017, 4:11pm EDT
As your organizations catches analytics fever—and as vendors hype analytics seemingly without restraint—it’s good to remember that information is not inherently valuable. In fact, without the requisite thoughtfulness and wisdom, analytics can actually drive people to do exactly what they shouldn’t do.
Here are four analytics-related errors that have become especially common and pernicious:
Analytic error No. 1: Bad metrics that drive bad behaviors
Some data merely appears useful, but isn’t. A classic example is call center talk-time. Call switching systems capture lots of data about caller and agent behaviors. Unfortunately, this has led some call center managers to obsess about talk-times as an indicator of staff productivity.
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The robot boom is coming to healthcare, but not so much for drones

Health systems will buy and deploy robots for clinical tasks in one to three years, IDC said, while drones investments may be five years away.
July 25, 2017 11:38 AM
From left, Boston Children's Hospital's food service robot; UCSF robot assists patients at Mission Bay; Boston Children's medical record robot.
Hospitals are planning to ramp up the use of robots in the next one to three years -- and the momentum will include clinical applications as well as automating simple tasks.
“Robots can deliver value by automating manual and laborious tasks,” IDC Health Insights research director Mutaz Shegewi said. “But they will also be increasingly adopted for direct clinical applications and emergent use cases.”
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EHR installs carry huge financial risks, Moody's says, so manage them wisely

While costs mean hospitals could find themselves walking an even thinner financial margin than they are used to, cybersecurity issues are also causing anxiety.
July 25, 2017 12:39 PM
Rolling out new electronic health record systems puts hospitals at a significant risk of financial losses, according to a new report by credit rating firm Moody’s.
“Hospitals run the risk of incurring operating losses, lower patient volumes and receivables write-offs if there are problems with adoption of a new EMR system,” Moody’s said in its Monday report.
Add to that the operational and financial disruptions that typically accompany complex IT projects, and hospitals could find themselves walking an even thinner financial margin than they are used to, Moody’s said.
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Hospitals can expect financial pain from EHR installs

By Dave Barkholz  | July 26, 2017
Hospitals installing new electronic health record systems should expect a sizable cash drain as the process disrupts business and adds technology and training expense, Moody's Investors Service said in a report this week.
During the first year of EHR installations, the median decline in operating cash flow for hospital systems is 10% with a 6% falloff in days cash on hand, Moody's said after examining system installs over the past several years. EHR installations can cost anywhere from several million dollars for a small, stand-alone hospital to a half-billion dollars for larger systems.
Moody's found in looking at 39 recent launches that the installs can disrupt billing and patient throughput.
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HIMSS names Hal Wolf as new CEO

Jul 26, 2017 2:09pm
HIMSS has appointed former health IT consultant and Kaiser Permanente executive Harold “Hal” Wolf III as the organization’s new CEO.
Wolf, who has served as an adviser to the board at HIMSS and as vice chair of the board of directors, was most recently the director of The Chartis Group, a healthcare advisory and analytics services firm where he helped healthcare organizations develop “integrated information and digital health strategies,” according to his biography.
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HIT Think Why IoT security is everyone’s responsibility

Published July 26 2017, 3:09pm EDT
Few patients think about the potential security risks when they unwrap their shiny new fitness tracker or Bluetooth-enabled blood pressure monitor. A growing number of payers are offering incentives to patients who wear fitness trackers and achieve fitness goals. Providers are “prescribing” digital health tools with increasing frequency.
Yet, wearables and connected devices are quickly becoming healthcare’s biggest cyber vulnerabilities. A recent Forrester report indicated that in 2017 healthcare breaches will become as common as retail breaches, and more than 500,000 IoT devices will be compromised.
The dangers are clear: device breaches can compromise patient safety and privacy and also provide an entry point for attackers to access health systems’ networks. While every security expert on earth wishes there was a silver bullet that could eliminate cyber risks, no such “one size fits all” solution exists. Regardless of our role in the delivery of healthcare, cyber threats affect all of us, which means that everyone—regulators, device manufacturers, providers and even patients—has a responsibility to help mitigate risk.
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A DNA App Store Is Here, but Proceed with Caution

Helix will sequence your genes for $80 and lure app developers to sell you access to different parts of it.

A Silicon Valley startup called Helix is betting on the notion that not only do people want to learn more about their DNA, but they'll also pay to keep interacting with it.
Today the company, which was founded in 2015 with $100 million from genomics giant Illumina, is launching its much-anticipated online hub where people can digitally explore their genetic code by downloading different applications on their computers or mobile devices. Think of it as an app store for your genome (see “10 Breakthrough Technologies 2016: DNA App Store”).
Personalized genetic information has become an affordable commodity. The early success of leaders like 23andMe and AncestryDNA, which sell DNA testing kits for $200 or less, has ushered in a wave of new companies offering direct-to-consumer genetic tests for everything from ancestry to the wine you should drink based on your DNA.
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Beyond EHR Optimization: The Advisory Board’s Barras Parses the Post-Implementation Challenges Facing CIOs

July 23, 2017
by Mark Hagland
As the leaders of patient care organizations move forward into the post-EHR-implementation phase, they face a welter of challenges around interoperability and analytics for performance improvement
As the leaders of patient care organizations move forward into the post-implementation phase around electronic health records (EHRs), they face a welter of challenges. Facing intensifying and accelerating policy, payment, business, operational, and clinical practice challenges, they are realizing that what has been called “EHR optimization” is really a very broad set of challenges around interoperability, information systems optimization, and IT strategy, organized around the need for patient care systems to become remarkably more efficient, cost-effective, and demonstrative of improved patient outcomes, and more clinician end-user-friendly, all with the ultimate aim of organization performance improvement.
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Study: 4 reasons patients value reading physician notes

Written by Jessica Kim Cohen | July 24, 2017 | Print | Email
Many patients whose providers adopt OpenNotes — a project in which providers share medical notes with their patients — report the option is helpful, according to recent research out of Boston-based Beth Israel Deaconess Medical Center.
The researchers — led by Macda Gerard of the hospital's department of medicine — developed a patient feedback tool linked to OpenNotes to investigate patients' motivation to engage with the EHR. The researchers invited patients who had appointments with one of two primary care teams to write comments about what they liked about reading physician notes.
Their findings, published in Journal of Medical Internet Research, determined almost all of the comments (98.5 percent) said the reporting tool was valuable. The majority of respondents (68.8 percent) also provided feedback as to why they liked reading physician notes.
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Hospitals need to be better prepared for a cyberattack against the nation’s power grid

Jul 24, 2017 11:55am
A coordinated attack on the nation's energy supply would be devastating for hospitals.
Hospitals already have their hands full fighting off sector-specific cyberattacks, but a new warning from researchers indicates the industry needs to do more to prepare for the ripple effects of a cyberattack against the nation’s power grid.
Like the healthcare industry, automation within utility systems has created new cybersecurity vulnerabilities, raising the potential for large power outages that could disrupt the country’s critical infrastructure.
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July 26, 2017 / 6:39 AM / a day ago

Doctors view technology as largely problematic

SAN FRANCISCO (Reuters Health) - When an endurance runner with a history of heart failure felt under the weather, he brought his activity tracker data from a workout to his cardiologist.
Dr. Michael Blum examined the runner’s heart rate readings. The cardiologist could see when his patient was pushing to climb a hill or to increase his speed, and when he was slowing down.
“I could tell how hard he was working,” said Blum, a professor at the University of California, San Francisco. “I had this amazing data.”
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ONC seeks comment on Trusted Exchange and Common Agreement

Published July 25 2017, 7:28am EDT
The Office of the National Coordinator for Health Information Technology convened industry stakeholders at a kick-off meeting on Monday in Washington to help develop consensus around enabling network-to-network exchange of healthcare data nationally.
Charged with supporting nationwide interoperability under the 21st Century Cures Act, Section 4003 of the law directs ONC to establish a trusted exchange framework for policies and practices as well as a common agreement for exchange between health information networks. In addition, the legislation mandated that ONC bring together public and private stakeholders to discuss those efforts.
“Medical information is extremely heterogeneous, so to just sort of say, ‘It will all connect,’ is obviously a challenge,” said National Coordinator for Health IT Donald Rucker, MD, during Monday’s initial meeting to discuss the Cures Act’s Trusted Exchange and Common Agreement.
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WebMD sold to Internet Brands for $2.8 billion

Rumors that WebMD was shopping around for a buyer are finally confirmed.
July 24, 2017 01:02 PM
WebMD Health Corp., operators of the popular WebMD website, is being acquired by Internet Brands, a portfolio company of KKR, for about $2.8 billion.
A subsidiary of Internet Brands will float a tender offer in the next 10 business days to acquire all of the issued and outstanding shares of WebMD common stock for $66.50 per share, to be paid in cash when the transaction’s a done deal.
The valuation represents a premium of about 30 percent to WebMD's share price on February 15 of this year -- the day before WebMD announced that it was starting to explore and evaluate potential strategic alternatives -- as well as a premium of around 20 percent over WebMD's closing share price on July 21.
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GAO Examines Patients’ Frustrations with EHRs

July 24, 2017
by Rajiv Leventhal
Following up on a Government Accountability Office (GAO) report from earlier this year on patients’ accessing their health records, a new blog post from the agency explores some of the reasons why people don’t use their electronic health records (EHRs) more.
Indeed, a GAO report from the spring noted that healthcare providers who participated in the Medicare Electronic Health Record Incentive Program offered nearly 9 out of 10 patients the ability to access their health information online. However, GAO found that relatively few of these patients accessed their records online, and patients typically did so in response to a medical visit. To this end, the GAO WatchBlog blog, via direct interviews with patients, just recently examined some of the reasons why people don’t use their electronic health records, even if they do have access.
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Secure Messaging App Implemented in 26% of Healthcare Orgs

Secure messaging is not the most commonly used form of mobile communications, with pagers still being used by the majority of hospital-based clinicians.

July 24, 2017 - Few hospitals have access to a fully implemented secure messaging system, according to a recent study published in the Journal of Hospital Medicine.
The majority of hospital-based clinicians – 79.8 percent – are provided pagers for communications, with 49 percent of respondents saying they receive patient care–related (PCR) communication through pagers.
Researchers analyzed data from 620 survey respondents, using a Society of Hospital Medicine database to survey hospital-based clinicians.
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Physician practices bemoan skyrocketing cost of IT maintenance

MGMA survey shows some spending $19,000 per doctor, per year.
July 24, 2017 12:13 PM
Physician office IT costs are rising as much as $2,000 to $4,000 more per physician compared with the prior – totalling $14,000 to $19,000 annually per doctor, depending on specialty, according to the 2017 MGMA DataDive Cost and Revenue Survey released this past week by the Medical Group Management Association.
Between 2015 and 2016, operating expenses for practices increased at nearly the same rate as revenue, according to the survey.
Those costs – which include purchased IT (maintenance of electronic health records and patient portals, for instance) and contracted expenses for upkeep of hardware and software – are less for hospital-owned practices, however.
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Stanford Children's CMIO Talks Home-grown Clinical Decision Support

Alexandra Wilson Pecci, July 25, 2017

Innovating on top of the EHR enables clinicians to get information about a patient, create clinical decision support, and integrate the data with the workflow, says Natalie M. Pageler, MD.

Clinical decision support is getting more personalized and nuanced all the time.
HealthLeaders recently talked with Natalie M. Pageler, MD, chief medical information officer at Stanford Children's Health and clinical associate professor of pediatric critical care and Stanford University, about some of the tools that the hospital is developing.
This is the first of two parts. The transcript below has been lightly edited.
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SA e-health startup hearX Group raises $2.8m funding

By Tom Jackson on July 25, 2017
South African e-health startup the hearX Group has raised just over US$2.8 million from international investors and funding grants over the last 16 months to help it expand internationally and build its product range.
Developed at the University of Pretoria by Prof De Wet Swanepoel and Dr Herman Myburgh in 2013, the hearX Group launched as a startup during 2015.
Its first product, hearScreen, was a smartphone app that detects hearing loss and links patients to health services. The product uses a smartphone and headphones, together with a custom-developed software application, to detect hearing loss, incorporating real-time environmental monitoring during testing to ensure compliant noise levels.
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AHIMA develops form for patients to request health information

Published July 21 2017, 3:05pm EDT
The American Health Information Management Association is offering a standardized model that providers can offer to patients who want to request their health information.
The professional association for health information professionals says it created the new standardized model form in response to concerns from federal agencies and patient groups that it is difficult for patients to obtain their medical information from providers.
Recently, the Office of the National Coordinator for Health Information Technology issued a report recommending that providers offer a more transparent patient records process, and AHIMA executives say the development of the Patient Request for Health Information form comes in response to those issues.
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Proposed House bill would roll back meaningful use stringent deadlines

Introduced Thursday to the Energy and Commerce Committee, the bill would reduce the volume of future EHR-related significant hardship requests.
July 21, 2017 11:32 AM
A bill proposed Thursday by Rep. Michael Burgess, R-Texas, would repeal the meaningful use requirement that the program increasingly grow more stringent.
In his testimony to the Energy and Commerce Committee, Kaleida Health CIO Cletis Earle said these rules stifle innovation.
“As we stand now, more than eight years after passage of HITECH, there exists an opportunity to make policy decisions apart from the arbitrary deadlines and measures of the EHR Incentive Program,” Earle said.
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Large senior living facilities adopting EHRs faster than other long-term, post-acute care facilities

Written by Julie Spitzer | July 21, 2017 
Large nonprofit senior living organizations are implementing more sophisticated EHRs at a faster rate than other long-term and post-acute care providers, according to findings from two recent surveys.
Washington, D.C.-based LeadingAge Center for Aging Services Technologies, a research and resource center focused on improving the aging experience through technology, and Chicago-based Ziegler, an underwriter of nonprofit senior living tax-exempt municipal bond financings, collaborated to administer its annual LeadingAge Ziegler 150 survey, which ranks and analyzes the nation's largest 150 nonprofit senior living providers.
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Kaiser plans to invest in telemedicine for mental health as part of an agreement with state regulators

Jul 21, 2017 12:31pm
Kaiser Permanente is investing in telehealth technology as part of a broad effort to resolve behavioral health deficiencies identified by California state regulators.
The commitment to expanding telehealth services is part of a settlement agreement (PDF) between the integrated health system and the Department of Managed Health Care (DMHC) to resolve deficiencies identified by state regulators over the last 5 years.
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DirectTrust touts nearly 100,000 provider users

The number of trusted Direct addresses able to share protected health information grew 15 percent to nearly 1.5 million in the second quarter, the information exchange group said.
July 21, 2017 03:04 PM
DirectTrust is seeing solid growth in the number of healthcare providers using Direct protocols to share information, an increase in new addresses and is logging more transactions than ever.
DirectTrust – which convenes participants using the Direct exchange network for secure data transfer – also added five new members since the beginning of the second quarter, the group said. Since April 1, five healthcare organizations have joined, bringing total membership to 129 organizations.
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Enjoy!
David.

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