Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Saturday, September 02, 2017

Weekly Overseas Health IT Links – 2nd September, 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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Ten lessons from the Digital Health Summer Schools, an Irish perspective

Jon Hoeksma

16 August 2017
This year’s CIO, CCIO and CNIO Summer Schools built still further on the international collaboration between Ireland and the UK.
In Ireland, kids would tend to go to a series of themed camps in the summer rather than a single summer school, a camp for GAA, a camp to top up your Irish language skills or simply a music camp. With the advent of the CCIO and CIO karaoke it felt like it was the CCIO band camp as much as it felt like summer school.
One of the unintended consequences of the Irish CCIOs being part of the summer school is it brings us all together to reflect on what we have achieved and where we intend to go. The summer schools being on an academic campus adds to the feeling that learning is here to be done, but the best sort of learning, through sharing of stories.

Essential elements for a hacker-proof healthcare cybersecurity strategy

Declaring a strategic objective, naming a CISO, maintaining a separate budget, board involvement and strict vendor scrutiny are just a few crucial points, cybersecurity experts say.
August 24, 2017 09:50 AM
Health systems need to establish cybersecurity as a strategic objective that is defined and managed by the C-suite and has board of directors involvement..
As worldwide cyber threats shut down organizations and violate privacy left and right, hospitals and health systems need to make sure their cybersecurity strategies are primed to keep them ahead of the threats. It’s the only way to ensure that an organization can stay up and running while protecting its patients’ privacy and even their well-being.
Progressive health systems see the value of cybersecurity as providing a competitive advantage and ensuring better patient care, said Rich Curtiss, a managing consultant at Clearwater Compliance who specializes in cybersecurity and health data risk management.
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Intermountain tweaks Cerner EHR in bid to reduce opioid prescriptions

The health system is adding new prompts and default order sets into its electronic health record to help clinicians think more critically about how they help patients manage pain.
August 24, 2017 12:40 PM
As the opioid national emergency continues, Intermountain Healthcare is promising to reduce the number of hydrocodone, oxycodone and other opioids dispensed by its 22 hospitals and 180 clinics by 40 percent by the end of 2018.
Currently, the Salt Lake City-based health system prescribes more than 5 million opioid tablets each year. As it works to get that number down to 3 million or fewer, it's rolling out an array of news policies to help its clinicians think harder about what they're giving their patients, and how many – if any – opioid pills they really need.
Intermountain has trained 2,500 of its caregivers about potential alternatives to opioids, and plans to expand its education programs across the health system.
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3 ways to improve patients’ medication adherence

Aug 25, 2017 11:41am
Getting patients with chronic illnesses to take their prescribed medications so they stay well can be a big challenge for doctors.
There are many reasons why an estimated 80% of patients with chronic conditions don’t stick to their care management plans, including medication regimens, according to PatientEngagementHIT. Patients don’t take their medication because they forget, can’t afford the prescription or are afraid of side effects.
The cost of nonadherence was clear in a report released today by pharmacy benefits management company Express Scripts. Commercially insured people who were adherent to their oral diabetes medications had significantly fewer emergency room visits and inpatient hospitalizations and potentially avoided more than $210 million in healthcare spending in 2016, according to the report, which looked at adherence to diabetes medications.
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Replacing magazines with tablets can help patients learn about diabetes risk, take preventive action
WEDNESDAY, Aug. 23, 2017 (HealthDay News) -- The multispecialty San Bernardino Medical Group has replaced magazines with digital devices in waiting rooms, which can help patients learn about their risk of diabetes and take preventive action, according to a report published by the American Medical Association (AMA).
As part of its work to improve health outcomes, the AMA has collaborated with Outcome Health to provide devices to physician practices. These devices are designed to help patients identify their prediabetes risk, enable productive conversation with providers, and allow physicians to refer patients at risk to diabetes prevention programs.
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'Smart' Pill Bottles Aren't Always Enough To Help The Medicine Go Down

August 22, 201712:56 PM ET
Lauren Silverman
What if I told you there was a way to use technology to save an estimated $100 billion to $300 billion dollars a year in health care spending in the U.S.? That's the estimated cost incurred because people don't take the medications they're prescribed.
A number of companies are now selling wireless "smart" pill bottles, Internet-linked devices aimed at reminding people to take their pills. But recent research suggests that actually changing that behavior may take more than an electronic nudge.
All agree it's a worthy goal. Dr. Niteesh Choudhry, an internist at Harvard Medical School, describes the problem of not taking medication as "the final cascade of all of science."
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Doc.ai is creating robo-doctors that can converse with patients (Updated)

Aug 24, 2017 at 3:31 PM
Imagine having your own mini-artificial intelligence doctor in your pocket.
That’s the world that doc.ai has in mind.
The Palo Alto-based startup came out of stealth mode Thursday and launched its blockchain-based natural language processing platform.
“We want to create a whole new place where people can … put their data in and basically train their own AI,” doc.ai founder and CEO Walter De Brouwer said in a recent phone interview.
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Amazon has no fear about entering the health business, say former leaders at the company

  • Aaron Marin and Curtis Kopf previously worked as directors for Amazon's publishing business.
  • Now, they work in health care.
  • No industry is immune from potential disruption, they say, even the regulated ones.
Published 2:14 PM ET Thu, 24 Aug 2017  | Updated 3:13 PM ET Thu, 24 Aug 2017
As Amazon takes its first steps into the health sector, many established players say they have little to fear.
As Walgreens CEO Stefano Pessina stressed on a recent earnings call with investors, Amazon has "opportunities around the world and in other categories, which are much, much simpler than health care, which is a very regulated business."
In other words, it's too complicated for an e-commerce company like Amazon.
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NHS Digital endorses “Every nurse an e-nurse” campaign

Laura Stevens

21 August 2017
NHS Digital has endorsed a national campaign to encourage digital training for nurses at the launch of its inaugural e-nursing week.
The Royal College of Nursing’s (RCN) “Every nurse an e-nurse” wants every UK nurse to be an e-nurse by 2020.
NHS Digital’s e-nursing week, which begins on Monday, 21 August, will be focusing on various aspects of e-nursing, including technology at patient’s bedsides, data-sharing, digital security and the role of apps and wearables.
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Rural safety-net hospitals lack advanced EHR capabilities, raising concerns about an emerging digital divide

Aug 24, 2017 10:59am
U.S. hospitals have achieved widespread EHR adoption, but an emerging gap could leave safety-net hospitals behind.
The majority of U.S. hospitals have adopted an EHR system as the entire industry is on pace transition to a digital system within the next four years.
But a worrying trend has emerged over the last several years: Far fewer critical-access hospitals have integrated advanced capabilities, raising concerns about an impending “digital divide” that disproportionately impacts small, rural facilities that care for low-income patient populations.
Eighty percent of hospitals across the country have adopted at least a basic EHR system, according to new research published this week in the Journal of the American Medical Informatics Association, up 5.3 percentage points since 2014. The incentive program established under the HITECH Act, passed in 2009 has been a primary driver behind getting hospitals to make the transition to electronic records.
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Utilizing Medication Aids to Improve Adherence in Transplant Patients

Brianne Molnar, Kara Patterson, & Jonathan Ogurchak, PharmD, CSP
Publish Date: Tuesday, August 22, 2017
At times, it can be difficult for patients to remember to take their medications, especially those with a new or complex dosing regimen. Even if a patient knows that it is vital for them to take their medication for a chronic disease state, there is still a large percentage of patients who are non-adherent.
Patients who have undergone an organ transplant often fall into this category. Those who have received a transplant and are non-adherent to their medication regimens are more likely to experience graft failure and higher health care costs.
There have been some improvements in adherence when patients are counseled on the importance of taking their medication as prescribed, but there are still a large percentage of patients with chronic disease states that are non-adherent. Medication aids, such as pillboxes and reminder devices like alarms, have been shown to cause an increase in adherence across multiple disease state populations. Transplant recipients have been shown to be more successful with adherence when utilizing one of the many medication aids available, as opposed to remembering on their own.
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Google Glass Isn’t Just for Remote Scribes

August 22, 2017
Saskatchewan piloting Glass solution for remote presence of specialists
One of the fast-growing companies I profiled for Healthcare Informatics’ Up-and-Comer list of companies for 2017 is San Francisco-based Augmedix, which that has developed a physician charting solution using Google Glass. Before entering the exam room, a doctor dons Google Glass and then proceeds to talk with patients, rather than typing into a computer screen. A remote scribe fills out forms, health history, lab orders, prescriptions and more for the physician to sign off on.
But charting isn’t the only way that Google Glass is being put to use in healthcare. In remote areas of Saskatchewan, nurses and general practitioners are donning Google Glasses so that specialists in a tertiary care centers, such as the one in Saskatoon, can diagnose and triage patients. A few weeks ago, I had the opportunity to speak with Ivar Mendez, M.D., who heads up the Department of Surgery at the University of Saskatchewan and Saskatoon Health Region, about this pilot project.
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HIT Think How machine learning can speed quality measure development

Published August 24 2017, 4:21pm EDT
Quality measures have become an essential component of the healthcare system. But ensuring that new measures are valid, reliable and evidence-based is a time- and labor-intensive process.
Advanced algorithms using machine learning and natural language processing can help measure developers significantly reduce the research time involved and find patterns in the evidence base that human readers may miss.
Such automation also may eventually help healthcare organizations themselves with self-improvement efforts based on their own research and their data.
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How processing health data has become increasingly problematic

Ethical issues that arise in stem-cell research, embryo research and reproductive cloning, genome sequencing, gene editing and population-scale biobanks are huge

24 August, 2017
Medical and scientific researchers are closely watching the new EU General Data Protection Regulation and what it might mean for their work after it takes effect next May
Almost four and a half years ago, then minister for health Dr James Reilly ordered the Health Service Executive not to destroy more than one million blood samples taken from newborn children in the Republic between 1984 and 2002.
The heel-prick tests, known as Guthrie tests, are carried out on all babies to screen for genetic conditions.
The decision to destroy the cards with the blood samples on them came after it emerged that those taken before July 1st, 2011, were being retained without consent, and therefore in breach of national and EU data protection law.
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Open source EHR platform tailored to treat Ebola patients

Published August 23 2017, 7:23am EDT
An open-source electronic health record system developed to treat Ebola patients during the recent epidemic in West Africa is being touted as a potential solution for clinical data collection in highly infectious environments and resource-constrained healthcare settings.
Implemented two years ago at Save the Children International’s Kerry Town Ebola treatment center in Sierra Leone, the EHR leverages a Java-based web application called OpenMRS that enables the design of a customized medical records system with no programming.
Developed in less than three months, OpenMRS-Ebola consists of a modular stand-alone EHR system with a tablet-based application for infectious patient wards (red zone) and a desktop-based application for noninfectious areas (green zone). The Sony Xperia Z2 10.1-inch tablet was selected for the EHR because it was waterproof and could be disinfected with chlorine.
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Karen DeSalvo lays out vision for 'Public Health 3.0,' focuses on social determinants of health

The former national coordinator says addressing social determinants is critical to the success of value-based care and that big infrastructure investment will enable localized approaches to public health.
August 23, 2017 02:11 PM
Improving social determinants of health is a must-do for value-based care models that seek to improve and maintain health instead of treating illness, said former National Coordinator for Health IT Karen DeSalvo, MD.
Writing in Health Affairs, along with Jeffrey Levi, professor of health management & policy at the Milken Institute School of Public Health at The George Washington University, DeSalvo raised the alarm that "for the first time in generations, life expectancy has plateaued and is declining."
That's largely due to socioeconomic, racial, geographic and behavioral factors that aren't being adequately addressed by the U.S. healthcare system.
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Could cloud automation solve patient matching challenges?

Innovations that could solve the longstanding problem of patient ID included neural networks and facial recognition, AHIMA research suggests.
August 22, 2017
02:15 PM
As providers drive patient engagement initiatives, population health management programs and quality improvement projects, they're still stymied by challenges with patient identification.
In fact, many organizations have troves of electronic health records that can't avail themselves of analytics because they can't be matched with other records, according to a new report in the Journal of AHIMA.
In the article, "Applying Innovation to the Patient Identification Challenge," Lorraine Fernandes, president-elect of the International Federation of Health Information Management Associations, Jim Burke, EMPI and HIE practice lead at Himformatics and Michele O’Connor, services manager at data governance startup Collibra, spotlight "innovations that can move the healthcare industry beyond the traditional human resource-heavy, back-end retrospective approach to accurate, automated patient identification and record matching."
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Machine learning versus AI: what's the difference?

AI and machine learning are very much related, but they're not quite the same thing
Thursday 1 December 2016
Thanks to the likes of Google, Amazon, and Facebook, the terms artificial intelligence (AI) and machine learning have become much more widespread than ever before. They are often used interchangeably and promise all sorts from smarter home appliances to robots taking our jobs.
But while AI and machine learning are very much related, they are not quite the same thing.
AI is a branch of computer science attempting to build machines capable of intelligent behaviour, while Stanford University defines machine learning as the science of getting computers to act without being explicitly programmed. You need AI researchers to build the smart machines, but you need machine learning experts to make them truly intelligent.
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Stanford researchers see 'genome cloaking' as a way to alleviate patient privacy fears

Aug 22, 2017 12:50pm
Cryptography can hide irrelevant parts of a participant's genetic data, potentially leading to greater participation in genetic studies.
Researchers at Stanford University may have discovered a way to address latent privacy concerns associated with genetic data, while also advancing the genomic research driving precision medicine initiatives across the country.
A group of computer scientists, engineers, biologists and geneticists found an approach that allows researchers access to specific gene mutations while hiding the remainder of the patient’s genetic information. Using cryptography, the Stanford researchers were able to mask more than 99% of genetic information, according to a study published in Science.
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Successful patient matching pairs technology with outside data sources

Aug 22, 2017 11:25am
Credit bureaus provide a key partnership for obtaining quality patient-matching data.
The challenges associated with patient matching can’t be solved by technology alone. At a more basic level, better quality data and information culled from outside sources is a critical initial step toward innovation. 
Obtaining that data is necessary to test new technology or systems that can improve patient identification, according to the Journal of the American Health Information Management Association (AHIMA).
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Evidence Supports Push for Social Determinants in EHR Data

Research and use cases are providing support for the push to integrate social determinants of health data into EHR data.

August 21, 2017 - Healthcare organizations today are expanding their ideas of what influences a patient’s health beyond orange pill bottles and family history.
Increasingly, physicians are adamant about underlying influence of social determinants of health.
Defined by the World Health Organization as “the conditions in which people are born, grow, work, live, and age,” social determinants of health are at forefront of health management geared toward addressing all the aspects of a patient’s life to improve overall health.
And for good reason. Social determinants of health have been linked to better patient outcomes and reduced medical expenditures in a study by the Robert Wood Johnson Foundation. According to the report released in June, increasing the median social-to-health spending ratio from last decade by 20 percent resulted in 85,000 fewer adults with obesity.
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HIT Think 4 key health drivers that will influence IT strategy

Published August 22 2017, 4:38pm EDT
In general, there are two routes to take in modernizing IT infrastructure. In one, C-suite executives make requests of IT on a project-by-project basis—this is aimed at tactical success, but the downside is that the technology may become obsolete even before the project is completed.
With the other approach, executives look more holistically at the way business is changing, so that they can build a flexible, scalable system to meet current and future needs. That makes more sense in order to optimize IT dollars for long-term value.
Looking at trends in the industry, there are four key health drivers that can be viewed as opportunities to sculpt a long-term IT investment strategy.
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Could Electronic Communication Between Providers and Patients Have Unintended and Negative Consequences?

August 22, 2017
E-visits have plenty of suggested benefits, but new research says that there are two sides to the story
Using technology to strengthen the patient-provider relationship has been a goal of most physicians, hospitals and health systems over the past several years, but new research points to issues that could arise for physicians who adopt electronic visits (e-visits).
As researchers from the Wisconsin School of Business at the University of Wisconsin–Madison stated in their paper, “The Impact of E-Visits on Visit Frequencies and Patient Health: Evidence from Primary Care,” there are plenty of frequently suggested benefits of e-visits and of electronic communication between providers and patients, such as enabling providers to give patients a low-cost alternative to visiting the doctor’s office. “Creating an online channel for care delivery offered the promise of reducing healthcare costs, while increasing the capacity of primary care physicians to see more patients by allowing them to handle routine questions or concerns through e-visits. At the same time, e-visits were seen as an innovation that could improve patient health by allowing patients to receive more attention and increased monitoring,” the paper’s authors wrote.
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UC San Diego Health shifts records system to the cloud

Published August 21 2017, 7:14am EDT
UC San Diego Health has migrated its on-premise Epic electronic health record system to a cloud environment hosted by the EHR vendor as part of a long-term strategy to shift away from a traditional data center model.
In fact, UC San Diego Health is the first academic health system to make the transition from a self-hosted Epic IT infrastructure to the vendor’s cloud hosting environment. Epic offers both on-premise and hosted data solutions for its customers.
So far, UC San Diego Health has moved about 10,000 desktops to this hosted environment, enabling its users to access the EHR through the cloud. In addition, the healthcare organization’s system is supporting UC Riverside Health and community practice affiliates. Further, beginning in November, it also will also share its Epic EHR with UC Irvine Health.
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Researchers use machine learning to target diabetes, predict changes in ICU patients

Aug 21, 2017 12:28pm
New research out of MIT shows the predictive power of machine learning for physicians in the ICU.
A global organization focused on diabetes research is using machine learning to analyze years of data among pediatric patients, while new studies out of MIT indicate machine learning could be a critical tool for physicians caring for ICU patients.
On Friday, JDRF, a global organization that funds Type 1 diabetes research, announced a new partnership with IBM to uncover factors that lead to Type 1 diabetes in children by using machine learning to comb through years of research data. Data scientists plan to tap into three different datasets to identify themes and patterns that reveal triggers for diabetes.
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Trump quietly signs FDA reauthorization bill, officially funding a new digital health unit

Aug 21, 2017 12:17pm
The new medical device user fee agreement establishes a central digital health unit within the FDA.
President Donald Trump signed a bill reauthorizing the Food and Drug Administration’s user fee agreements for drugs and devices that will fund a new digital health unit and allow the agency to tap into new data sources.
The bill’s signing on Friday came without much fanfare from the White House, which had pushed to increase user fees. But the FDA Reauthorization Act of 2017 easily passed the House and Senate with broad bipartisan support from lawmakers that were eager to get new user fee agreements in place before the current agreements expired in October.
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Online visits saved patients more than two hours and 100 miles of driving, researchers found
FRIDAY, Aug. 18, 2017 (HealthDay News) -- Virtual house calls by neurologists may be of great interest to and provide substantial convenience for patients with Parkinson's disease, according to a study published online Aug. 16 in Neurology.
The research included 195 patients who received either care from their usual doctor or their usual care plus up to four video (virtual) visits with a neurologist they had not seen before.
The virtual visits were as effective as in-person visits. In both groups, quality of life, quality of care, and burden on caregivers was the same, the researchers found. Each virtual visit saved patients an average of 169 minutes and nearly 100 miles of driving, according to a journal news release accompanying the study.
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Enjoy!
David.

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