This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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 30, 2017
Weekly Overseas Health IT Links – 30th 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.
Hospital executives are increasingly prioritizing telemedicine for delivering care services as the industry shifts from fee-for-service to value-based care.
Fifty-one percent of the executives and caregivers Reach Health surveyed, in fact, said telemedicine is a high priority and 36 percent ranked it as a medium priority. Only 13 percent responded that telehealth is a low priority today.
For its report, the “2017 U.S. Telemedicine Industry Benchmark Survey,” Reach Health also asked 436 executives and caregivers which telemedicine projects are already highly successful. More than half ranked improving outcomes, engagement and satisfaction as such, while 26 percent responded that efforts to reduce costs are highly successful and 18 percent said the same about reducing readmissions.
A new report from the National Quality Forum reveals that 5 percent or more patients in the U.S are being incorrectly diagnosed.
Those diagnoses contribute to nearly 10 percent of deaths annually, and up to 17 percent of adverse hospital events, according to NQF, whose mission is to improve health and healthcare quality with defined measures.
National Academies of Sciences, Engineering, and Medicine (formerly called the Institute of Medicine), supports that approach for improving diagnoses, noting that the lack of effective measurement related to the diagnostic process and diagnostic outcomes is a major contributing factor.
ONC will allow vendors to "self-declare" compliance with 30 EHR certification criteria, but experts are wary of the long-term effects.
The Office of the National Coordinator for Health IT is significantly pulling back on EHR certification attestation requirements, a move that will reduce the burden on users and developers and provide more bandwidth to advance interoperability, according to federal officials.
The announcement came as a surprise to several industry groups that spent Thursday trying to grasp the implications of the regulatory revisions amid questions over the possible downstream consequences.
We know that when patients are provided with access to their medical records, they feel more in control of their care, understand their health conditions and their care plans better, prepare for their visits, and adhere more to their medications. Despite patient portals’ usability challenges for certain groups of patients and disadvantaged populations, they not only help patients and their care partners but also are a significant means to reducing overhead costs for providers. When physicians are provided with instant electronic access to their patients’ medical data, both quality and efficiency of care radically improve. Overall, an interoperable system across the United States that provides instant access to medical records is estimated to reduce the costs of health care services by $371 billion per year.
Interoperability Efforts Have Failed
Given the benefits of interoperability and free flow of data, the US government has already spent more than $35 billion under the meaningful use program to subsidize the adoption cost of electronic health records (EHRs) systems. That was a massive investment. A part of this budget was allocated to the establishment of health information exchange platforms that were to connect these different EHR systems and allow the transmission of data among them. Yet, almost a decade after spending that budget, health information is rarely exchanged between providers, despite the fact that almost all of them now use an EHR system.
Hurricanes, in recent history, have had profound effects on healthcare organizations. The impact of Katrina on hospitals and healthcare is legendary, as a seemingly manageable Category 3 storm that morphed into a disaster of historic proportions and nearly destroyed one of America’s more storied cities.
Since Katrina there’s been Rita and Wilma, also in 2005, and Superstorm Sandy on the eastern seaboard in 2012. The recent arrivals of Harvey in Texas and Irma in Florida are healthcare IT’s first real opportunities to test existing infrastructure against Mother Nature.
The response of providers to the recent hurricanes has improved, but it’s still a work in progress. After all, many hospitals in New Orleans had EHRs, but it didn’t matter when the water kept rising.
A number of doctors involved in the clinical validation of an IT system that cost €35m and has so far accrued around €1m in additional consultancy fees said it has had “a positive impact on the hospitals who have deployed it”.
The Maternal and Newborn Clinical Management System (MN-CMS), designed to improve mother-and-baby care, was rolled out in Cork University Maternity Hospital (CUMH) before Christmas, after a six-month delay, followed by University Hospital Kerry in March. It has been criticised by GPs for the absence of a digital link with their IT systems, despite GPs and maternity hospitals operating a shared-care model.
However, hospital doctors involved in its rollout have written to the Irish Examiner to say that “while no service or system is perfect, the MN-CMS system has brought about improvement in management of patient information, patient safety and the communication between clinical teams”.
They say “it has led to standardisation of information collection and in the future will lead to standardisation of care”.
The service, which is on the NHS App Store, was developed by national healthcare company Evergreen Life which acquired PAERS Ltd, pioneers in online patient record access, and was accredited by the NHS in March this year.
From the start of the Precision Medicine Initiative, an ambitious research effort designed to take into account individual differences in people’s genes, environments and lifestyles, the success of PMI has been predicated on the collection of data from volunteers on a massive scale across the United States.
Launched in 2015 by President Obama, PMI’s goal is to generate medical breakthroughs by personalizing how the U.S. healthcare system treats disease and improves health. Building one of the world’s largest and most diverse biomedical datasets is foundational to the initiative, which will heavily leverage genomics and health information technology. The National Institutes of Health’s All of Us research program, the cornerstone of PMI, seeks to recruit a million or more Americans to contribute their health data over many years to a national cohort. This landmark longitudinal study is where the rubber meets the road for precision medicine research.
The program has just begun enrolling participants on an invitation-only basis; as of mid-September, about 2,500 people have agreed to participate during its beta phase. Testing of IT systems with these first enrollees will begin in early fall.
Leading technology analysis firm Gartner has said the NHS IT market is too reliant on closed proprietary systems, and must follow other industries and drive to open platforms and surrounding eco-systems.
Speaking at a recent event on OpenEHR in Salford’s Media City, Gartner health analyst Mike Jones said: “I think there is an over dominance in the market in systems that are not open.”
Proprietary systems, he said, result in data becoming locked in supplier’s systems, resulting in a lack of interoperability.
The use of artificial intelligence (AI) in UK healthcare should be increased, e-prescribing made mandatory, and researcher access to datasets simplified, a government-commissioned report has suggested.
The Office of the National Coordinator for Health IT on Thursday revealed two changes to its certification criteria that officials said are designed to reduce the burden on industry and make the meaningful use program more efficient.
The first is making more than half of test procedures self-declarable and the second is more discretion around randomized surveillance of certified health IT products.
Elise Anthony, director of policy at ONC, and Steven Posnack, director of ONC’s Office of Standards and Technology, wrote on the Health IT Buzz blog that 30 of the 55 criteria were intended to support CMS Quality Payment Program and those are now self-declaration only.
Digital apps could provide a blueprint to push substance abuse treatment into the "medical mainstream," says a former SAMHSA director.
The Food and Drug Administration’s approval of a mobile app to treat substance abuse marks a notable first step in a digital transformation that could reshape the way clinicians treat addiction, according to one former federal health official.
Last week, the FDA approved Reset, the first mobile medical application to treat substance abuse disorders in conjunction with outpatient therapy. Manufactured by Pear Therapeutics, the app delivers cognitive behavioral therapy to assist with treatment for alcohol, cocaine, marijuana and stimulants. It was approved by the agency after a 12-week clinical trial that showed patients using the app “showed a statistically significant increase in adherence to abstinence.”
Health IT Now, a coalition of patient groups, providers, employers and insurers, in large part agrees with new IT policies included in a recently issued proposed rule making changes to payment policies under the physician fee schedule for Calendar Year 2018.
However, the organization also has some serious concerns, particularly regarding telehealth policy, which it detailed in a comment letter sent to CMS Administrator Seema Verma.
The group sees the IT measures as fostering improved patient safety and outcomes by giving providers, patients and caregivers tools that will better enable them to manage health and wellness.
A survey of more than 1,100 healthcare consumers found that 97 percent across all age and gender demographics are familiar with cloud technology, yet 31 percent cannot easily access their medical records and only half of those can access medical records online via their healthcare provider, according to a report from Ambra Health.
The report from New York City-based Ambra Health, a medical data and image management SaaS company, also found that when it comes to moving diagnostic data like x-ray, CT and MRI from one provider to another, more than half of healthcare consumers (57 percent) report that they received their imaging via CDs, which they then had to give to their new provider or referred specialist. Only 17 percent of respondents reported that they were provided online access to their imaging that they could then share with another provider.
Health Fidelity, a risk adjustment vendor funded by the University of Pittsburgh Medical Center, has developed software that more accurately assesses risk adjustment results and reduce audit risk.
The software, called HF360 Compliance, uses natural language processing technology and statistical inference engines, mixed with analytics to identify and correct compliance risks. An inference engine uses artificial intelligence to apply rules to a specific knowledge base to arrive at a conclusion.
Use of the software is targeted at risk adjustment professionals such as coders, managers, quality assurance staff and internal auditors.
Keeping information safe is a topic that can truly cause insomnia, especially in the wake of WannaCry, Petya and other ransomware used in global cyber attacks. So where is the healthcare market in its effort to better secure information?
To find out, KLAS partnered with the College of Healthcare Information Management Executives (CHIME) to gauge the industry’s status and aspirations. The actions, planned and unplanned, of the nearly 200 organizations interviewed indicate significant movement toward a more secure environment for all types of healthcare information.
In general, healthcare organizations are putting many more resources toward information security. Areas garnering more support include leadership, program development, breach readiness and security-program funding.
When Mental Health Center of Denver first launched an illness management program, it began by sending treatment data back to the patients, detailing their progress toward recovery, using as a basis the information contained on patient and therapist surveys. Patients received reports every three months, and the therapy center hoped the additional information would spark new conversations between patients and therapists.
Later, the center added a harm reduction initiative—it included questions intended to assess patients’ risk for suicide. Their answers would alert therapists if a patient might require intervention. Over time, other behavior risk factors were added to the exercise, such as whether a patient was arrested, lost a job, had substance abuse issues, committed a violent assault, tried to commit suicide or was hospitalized.
Now, the center is further enlarging its efforts to use such “non-clinical” information to improve care for patients, says Wesley Williams, vice president and CIO at the Mental Health Center of Denver.
Mobile health apps hold tremendous potential, but not without a structured apporach to data collection.
Enormous potential exists for mHealth devices to advance medical research and improve patient care. Exactly how to reach that potential is still unclear.
That’s why a group of experts has recommended that ongoing mHealth research efforts focus specifically on how to streamline and standardize data collection by leveraging public-private collaborations designed to better understand how to effectively use information generated from rapidly advancing wearables and mobile apps.
It seems like it was only a few years ago that the term “big data” went from a promising area of research and interest to something so ubiquitous that it lost all meaning, descending ultimately into the butt of jokes.
Thankfully, the noise associated with “big data” is abating as sophistication and common sense take hold. In fact, in many circles, the term actually exposes the user as someone who doesn’t really understand the space. Unfortunately, the same malady has now afflicted artificial intelligence (AI). Everyone I meet is doing an “AI play.”
AI is, unfortunately, the new “big data.” While not good, it is not all bad either. After all, the data ecosystem benefited from all of the “big data” attention and investment, creating some amazing software and producing some exceptional productivity gains.
However, remote automated education program alone did not significantly improve adherence
TUESDAY, Sept. 19, 2017 (HealthDay News) -- The use of continuous positive airway pressure therapy (CPAP) telemonitoring with automated feedback messaging improves 90-day adherence in patients with obstructive sleep apnea (OSA), according to a study published online Aug. 31 in the American Journal of Respiratory and Critical Care Medicine.
Dennis Hwang, M.D., from Southern California Permanente Medical Group in Fontana, and colleagues assessed 1,455 patients (51 percent women) referred for suspected OSA. Home sleep apnea testing was performed in 956 patients, and 556 were and prescribed CPAP. Patients were randomized to usual care, web-based OSA education (tel-ed added), CPAP telemonitoring with automated patient feedback (tel-TM added), or tel-ed and tel-TM added (tel-both).
Interoperability is one of the most difficult challenges with electronic health record optimization: The ability to share clinical data across health systems and respective EHRs. Sometimes it takes a personal experience to drive home the meaning of interoperability, not only to the healthcare professionals who regularly interface with the EHR, but the patients.
When EHR interoperability hits home
For those that read my last post, you know that I lost my 40-year-old brother to a heart attack in 2015. I had a physical about two months after my brother died, but due to my family history of heart disease, I also made a long-overdue appointment to see a cardiologist. Both my primary care physician and cardiologist work within the same system and use the same ‘integrated’ EHR. And yet the scheduler for the cardiologist requested I fax my EKG and history, including labs, to the office prior to my appointment.
Blockchain, if deployed wisely, could underpin an array of new innovations that could help reduce costs, enable efficiency, protect privacy and spur interoperability.
The variety of potential blockchain deployments in healthcare is getting wider. When ONC put forth its call for white papers in its blockchain challenge, for instance, it received more than 70 submissions earlier this year, exploring everything from medication reconciliation to alternative payment models.
And as the distributed ledger tool gains ground in other industries, the thinking about how it can help healthcare's many challenges has only gotten more creative.
Artificial intelligence tech can cause a number of challenges for providers looking to use it.
Artificial intelligence technology has promise for healthcare, but providers looking to deploy the technology could run into some significant challenges.
AI tools are being applied to cybersecurity, precision medicine, wellness and a variety of other major initiatives in the industry. But for them to truly work, providers must analyze the costs effectively and tie the tech to a particular issue, write Jennifer S. Geeter and Dale C. Van Demark, healthcare attorneys at McDermott Will & Emery, in an article for Hospitals & Health Networks.
It’s become clear that the ransomware attacks on hospitals are increasing in scale and sophistication and becoming a serious threat to patient lives and health.
In 2016, a California hospital became the first to pay a $17,000 ransom to cyber criminals who held its medical records and crucial computer systems ‘hostage’ for over 10 days. Just this year, a worldwide attack using sophisticated cyberwarfare tools stolen from the National Security Agency hit more than 40 hospital systems across the UK and US, causing widespread disruption. Even medical devices, including vital radiology equipment used in MRI scanners, have been infected by ransomware.
These attacks are set to increase, as the growth of “connected healthcare” from wearable health technology to surgical robots widens the number of potential targets for hackers. Increasingly hospitals are making their digital systems interoperable and also sharing patient data with external data analytics companies to create personalized predictive healthcare, further expanding the potential attack surface.
The Electronic Health Records Meaningful Use program has generated a poor return for the industry, according to 1,100 healthcare professionals responding to a recent survey.
However, many of the respondents also indicated that they have high hopes that data analytics will make clinical data in EHRs more valuable, as the industry moves from data collection to data analysis in support of the move to value-based reimbursement.
The survey was conducted at the Healthcare Analytics Summit in Salt Lake City, an event hosted by analytics vendor Health Catalyst. Asked to assess the return on the EHR investments, 19 percent of respondents said it terrible, and 42 percent rated the return as poor.
Smartphones are maligned for many things, but they might actually be helping improve the health of at least some users.
According to new research from mobile analytics firm Flurry, now part of Oath, health and fitness app usage in the US has seen a sharp uptick over the past few years, growing by 330% between 2014 and 2017.
These users are loading up their apps with a relatively high level of frequency. Flurry’s survey, conducted in August 2017, found that three-quarters of the health and fitness app users opened their apps at least twice per week. And more than one-quarter of respondents were at the very high end of usage, opening their app 10 times or more on a weekly basis.
By using a prompt in its electronic health record system, Michigan Medicine has been able to improve the hepatitis C virus screening rate fivefold among Baby Boomers as well as increase follow-up specialty care for infected patients.
In a study comparing screening-eligible patients in the six months before the prompt was implemented with patients in the year after implementation, hepatitis C virus (HCV) screening rates increased from 7.6 percent to 72 percent. Results of the study were published online last week in the journal Hepatology.
In addition, 100 percent of newly diagnosed patients in the study were referred to specialty care, while 67 percent of patients were subsequently prescribed treatment—rates much higher than any previously reported to date.
The latest count from the Identity Theft Resource Center (ITRC) reports that there have been 1,002 data breaches recorded this year through September 12 and that more than 163 million records have been exposed since the beginning of the year. The incident total is 23.7% higher than at the same time last year.
In 2016, the ITRC reported a record total of 1,093 breaches and at the current pace that total could rise to around 1,500 in 2017.
This week’s data includes the 143 million records exposed in a breach at Equifax Inc. (NYSE: EFX). The credit reporting firm revealed the breach on September 7. This past Thursday the company admitted that it failed to fix a vulnerability — called Apache Struts — that had been discovered in March and that was exploited by the attackers.
Many patients abandon wearable device shortly after receiving them.
People with higher satisfaction in their lives are more likely to stick with wellness programs that include wearables, according to a new study. It also looked at why other people give up.
Researchers at the University of Southern California wanted to dive into personality and lifestyle traits that make people continue to use wearables and apps longer than the average, which is about six months, according to a blog post published in NEJM Catalyst.
Researchers monitored 275 people through a fitness tracker embedded in a pair of prescription eyeglasses that the patients wore for 15 weeks.
Electronic medical records require a lot of interaction on the part of physicians and other providers to get all necessary information entered. There are drop down menus, boxes to check and other information to fill in.
With the well-documented complaints about impact on workflow, a number of workarounds have been mentioned for a long time. Foremost among the workarounds is the use of copy and paste functionality. Copy and paste can come in many forms, including taking the entire contents of one note and bringing it forward; using templates to fill in predetermined information based on a set of standards; or other similar uses. The premise is to make the use of the EMR easier and more user-friendly. However, like most actions within healthcare, there are risks.
September 15, 2017 - Hacking and IT security issues, including phishing scams and ransomware attacks, are still the leading causes for the largest health data breaches in 2017, according to data from OCR.
The three largest incidents thus far – two of which are classified as either hacking or an IT incident – have also potentially impacted 1,497,800 individuals.
No healthcare provider can ensure that a data breach will never take place, but these incidents further show why organizations need to take the time to regularly review their physical, technical, and administrative safeguards. Comprehensive employee training is also critical, especially with ransomware attacks on the rise.
The number one reason threat intelligence is often ineffective is due to lack of expertise, a new report says.
While there’s been a steady increase in interest in threat intelligence within the healthcare industry, a recent Ponemon study found a lack of staff expertise is hindering the ability of security experts from getting the most value from the tool.
Ponemon Institute surveyed over 1,000 IT and IT security professionals from the U.S. and U.K. to determine whether or how threat intelligence is used within their organization’s cybersecurity program.