Quote Of The Year

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


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, October 14, 2017

Weekly Overseas Health IT Links – 14th October, 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.

HIT Think How the cloud can bolster a provider’s security strategy

Published October 05 2017, 4:32pm EDT
The constant barrage of various studies and reports on cyberattacks on healthcare organizations make security executives anxious, and for good reason. Some reports suggest that more than 80 percent of hospitals, health systems, large physician groups and health plans have been hacked.
These attacks include ransomware, malware and theft of data. While all of these are bad, there is another risk that many healthcare IT professionals secretly fear but haven’t talked about much: If hackers get in, they could change or corrupt clinical data. Depending on the data that is affected, this could seriously compromise patient care, and it also could be nearly impossible to detect.
Altered clinical data can affect patient care and could lead to serious medical errors or even a patient death. And if hackers can breach an organization’s systems, they can alter clinical data and then hold hostage the information about what data was changed.

Epic CEO Judy Faulkner is standing behind switch from EHRs to 'CHRs'

A comprehensive health record, unlike today’s EHR, would incorporate more data types, notably social determinants, she says.
October 06, 2017 10:32 AM
You’ve probably heard that Epic Systems CEO Judy Faulkner wants to drop the E from electronic health records and replace it with a C.
“‘E’ has to go away now. It’s all electronic,” Faulkner said at the company’s user group meeting in late September. “We have to knock the walls down whether they’re the walls of the hospital or the walls of the clinic.” 
Faulkner made something of a splash when she called an EHR a CHR, but, according to her, the letter change represents a big shift.

Little-noticed Stage 3 meaningful use rule could pose big challenges for hospitals

The high threshold for patient engagement in 2019 will probably be amended in future rulemakings, but one MU expert says it highlights the limited utility of patient portals.
October 05, 2017 01:40 PM
Kathleen Sheehan's job is to focus every day on her health system's meaningful use compliance. But even she was surprised when a Cerner employee alerted her to a handful of percentages listed in the Stage 3 rulemaking.
Sheehan, program director for meaningful use, performance and process improvement at UHS of Delaware, couldn't believe it when she saw the thresholds for which hospitals could be accountable starting January 1, 2019.
The issue has to do with Stage 3 MU measures that are in play for 2018 – but are now optional for eligible hospitals since the Centers for Medicare and Medicaid Services announced in the Inpatient Prospective Payment System final rule that such hospitals have the option to either continue with the Modified Stage 2 program or move forward with Stage 3.

Human-centered design expert shares 4 tips for engaging patients

Set the bar high: Don’t be afraid to steal ideas that delight people and make them want to use the technology.
October 04, 2017 09:16 AM
CHICAGO — Patient engagement is so much more than simply getting people to come in and see a doctor, fill and take their prescriptions, arrange follow-up tests and other basic interactions with the healthcare system.
“I would argue that engagement means you have actually gotten to healthier behaviors,” said Amy Schwartz, Human Centric Design Thought Leader at Battelle. 
How, then, can healthcare organizations and software developers attain that level of engagement?

Nottingham to review digital care record due to patient safety concerns

Jon Hoeksma

5 October 2017
Nottingham University Hospitals NHS Trust is to urgently review its £14m digital records system after dozens of consultants wrote to the trust medical director expressing concerns about the system and its impact on patient safety.
Consultants at the trust have raised patient safety concerns around the difficulty of accessing electronic patient records and some records missing key data, including information on appointments.
The trust medical director said that the digital clinical records software did not meet the needs of consultants. The problems were discussed by the trust board in September which is now reviewing monthly.

NHS Digital directed to replace type two opt-outs

Laura Stevens

29 September 2017
NHS Digital has been directed by the Department of Health to replace the type 2 opt-outs with a new national data opt-out programme.
The national data opt-out programme is due to create, test, consult and implement a national opt-out, both online and in person, across England’s health and care system.
The instructions were received via a letter to Sarah Wilkinson, chief executive of NHS Digital, from Lorraine Jackson at the Department of Health in August, and told NHS Digital to:
  • Collect patient opt-out data
  • Create a national repository for central storage of the opt-out data
  • Create a new national opt-out system that allows health and care organisations to access the opt-out information
  • Write to those who already have the Type 2 to inform them of the transition
The third Caldicott report, published July 2016, was written by Dame Fiona Caldicott, the national data guardian.

The digitized hospital of the future will include clinical command centers and interoperable EHRs

Oct 5, 2017 11:25am
In 10 years, hospitals will be outfitted with a centralized clinical command center that collects real-time data, wearable sensors and yes, even interoperable medical records. 
That’s according to a group of 33 experts from around the globe that unveiled their vision for digitized hospitals in the next decade based on specific use cases. Their input was outlined in a report released by Deloitte earlier this week.
The experts envision hospitals using a central command center that mimics an air traffic control system for patients by collecting real-time data using wearable sensors to identify patients at risk for complications and help clinicians make quicker decisions. Using artificial intelligence and data analytics, this technology will suggest interventions to caregivers.

Donald Rucker defends EHR certification self-attestation, says complaint process will drive transparency

Oct 4, 2017 11:25am
ONC's national coordinator said a legislatively mandated complaint process will ensure transparency among EHR developers.
Donald Rucker, M.D., defended the Office of the National Coordinator for Health IT’s recent restructuring of EHR certification attestation requirements, noting that requirements within the 21st Century Cures Act will ensure transparency among EHR developers.
During a fireside chat on Wednesday at the 11th annual Health 2.0 conference, ONC’s national coordinator riffed on the agency’s delicate touch when it comes to standards and regulations and argued that the ONC’s tweaks to certification will be a net benefit for providers and vendors.

New tool shows promise in detecting colon cancer earlier

Published October 03 2017, 4:07pm EDT
A new computational tool may help physicians identify patients with the highest risk of having undiagnosed colorectal cancer while the disease is still in an early stage.
The tool, called ColonFlag, was developed by Medial EarlySign, an artificial intelligence and machine learning vendor. It predicts and stratifies individuals at high risk by analyzing routine blood test results and electronic health records data. The company also is developing additional disease predictors for other types of cancers, diabetes and other life-threatening conditions.
In a study published in the journal Digestive Diseases and Sciences, ColonFlag was able to identify risk for colorectal cancer as much as a year earlier than conventional diagnostic practices, study authors say.

5 IT Practices That Put Enterprises at Risk

10/2/2017 10:30 AM
Darren McCue
No one solution will keep you 100% protected, but if you avoid these common missteps, you can shore up your security posture.
A billion data records are compromised in the US in more than 90 million different cyber-related incidents each year, with each event costing a company an average of $15 million in damages. Certainly, cybersecurity threats continue to increase in size and complexity, but the real problem is that too many IT organizations are leaving their enterprises vulnerable to attacks because they overlook a number of simple tasks. Although no single solution or approach will keep organizations completely protected, there are some things to avoid so that IT teams can shore up their security posture and ensure continual improvement to match the advancing threat.
1. Using Old Printers
Surprisingly, office printers present three threat vectors. First, printers store images of documents. Don't forget to destroy the remains of sensitive corporate data or personally identifiable information that may be left on an internal hard drive of an office printer.
In addition, IT staffers often miss updates or news of exploitable office vulnerabilities. Tracking firmware updates for printers is something for which no one really has the time or patience. Most updates will require at least some physical access to the device (especially if something doesn't go as expected). Doing routine update checks is a great idea, and if you can't keep up with multiple vendor patches, make sure that you at least isolate printers on a separate VLAN with access limited to core protocols for printing. 

NHITweek: HIMSS posts 3 Congressional asks for 2017

Telehealth, infrastructure modernization and a cyber exec for HHS. They’re all on this year’s list.
October 04, 2017 05:00 PM
HIMSS on Wednesday unveiled its annual ‘Congressional Asks’ during National Health IT Week — and this time around they tackle cybersecurity, telehealth and critical infrastructure modernization.
“Health IT policy is always evolving and we’ve certainly seen some important bipartisan advances on key issues, including passage of the CHRONIC Care Act in the Senate, movement on multiple telehealth bills in the House Energy and Commerce Committee and significant focus on healthcare cyber,” said Samantha Burch, Senior Director of Congressional Affairs at HIMSS.
The first ask is for Congress to empower the Health and Human Services chief information security office to the same rank as HHS CIO and, in so doing, require the CISO to create sector-specific plans, goals and priorities for cybersecurity, such as advance threat intelligence sharing, enhance workforce education, expand the cyber talent pool and focus on holistic security.

Patient engagement a surprise benefit of tablet-based registration

Published October 05 2017, 7:32am EDT
Patients arriving for appointments at Academic Allergy and Asthma Center of South Florida typically received a clipboard full of paperwork to fill out, a repetitive and duplicative practice common at most physician practices.
But this past June, the practice became a beta test site for a new patient engagement platform. Now, when patients arrive, they use a tablet computer to complete registration documents—they do little writing, but complete their work by tapping a finger on the tablet to fill in the blanks.
And the system, developed by ambulatory software vendor CareCloud and card processing and payments solutions vendor First Data, aids practice staff as well, because they no longer spend hours putting together registration packets for patients.

Use of Patient Genetic Data Raises Ethical Concerns

Jonathan Bees, October 5, 2017

Providers need to consider the ethical implications for patient care when using genetic data for analytics.

Healthcare organizations expect to face a number of data-related challenges in performing analytics over the next three years, according to respondents in the 2017 HealthLeaders Media Analytics in Healthcare Survey. The top three challenges are integrating internal clinical and financial data (47%), establishing/improving EHR interoperability (43%), and integrating external clinical and financial data (43%). In each case, the data comes from multiple sources and is not easily collated, which is likely why it is a challenge for providers.
Although the response for ethical concerns regarding the use of patient genetic data (8%) receives a low response in the survey, it is also true that the provider usage rate of patient genetic data for analytics is currently quite small. For example, only 9% of respondents say that they draw on patient genetic data when conducting patient-related data analytics. As such use becomes more widespread, concern about ethical issues may also grow.

Interoperability shows progress, but it's slow progress at best

Hospitals’ use of data for patient care from outside providers is low, with only 18.7 percent of hospitals reporting they “often” used these data, Health Affairs report finds.
October 03, 2017 12:57 PM
A new Health Affairs report on the state of interoperability in healthcare reveals scant progress in spite of what the authors of the report called “substantial efforts.”
The researchers looked at 2014 and 2015 data and found that 2014 national data suggested that hospital engagement with interoperability were at low levels.
They examined the 2015 data for national trends in engagement in four areas of interoperability: finding, sending, receiving and integrating electronic patient information from outside providers. They found small gains in 2015, with 29.7 percent of hospitals engaging in all four domains compared to 24.5 percent in 2014.
Sending information showed an increase of 8.1 percent while receiving information showed an increase of 8.4 percent.

EHR-based sepsis protocols could add to superbug threat

Oct 4, 2017 12:05pm
Integrated electronic sepsis care protocols may lead to more superbug infections, according to new research.
Relying on electronic health record systems for integrated sepsis care protocols could have unintended consequences, including a rise in superbug infections, according to a new study. 
Researchers at Mount Sinai Health System studied electronic sepsis screenings at a large, tertiary, urban academic medical center and found the system recommended treatments that could lead to the use of more broad-spectrum antibiotics. And that increases the risk of hospital-acquired Clostridium difficile infections, notes the study, which was published in the American Journal of Infection Control. 

Blockchain interest gaining, but cost questions cause providers pause

While most payers are implementing or are planning to launch blockchain projects by 2019, providers are still waiting to see how federal regulations unfold.
October 03, 2017 02:37 PM
Interest and understanding of blockchain technology has improved exponentially in the healthcare sector in 2017, which is being fueled by its potential to solve issues with interoperability, connectivity, privacy and patient record sharing, according to a new Black Book report.
In fact, blockchain has become so popular that 88 percent of payers are considering deploying or currently implementing blockchain, the report found. Nearly all payers with plans with more than 500,000 members are actively considering or deploying the tech, and 14 percent are involved in trial deployments.
The increased consideration and implementations stem from a better understanding of the technology, as 29 percent of hospital leaders and 82 percent of health insurance executives said they have a ‘working understanding’ of blockchain.

Experts on AI in healthcare: 'We need to be more realistic'

Talking about artificial intelligence as a cure for cancer does doctors, hospitals and patients a disservice, speakers at the Pop Health Forum say.
October 02, 2017 02:24 PM
CHICAGO — Artificial intelligence in healthcare has become more buzzword than practicable application thanks, in part, to bold claims that AI will be able to transform healthcare by combining billions of data points and diagnosing diseases, notably cancers, faster than any doctor ever could.
“We do ourselves a disservice when we refer to AI as something that we just take a ton of data, push a button and cure cancer,” Leonard D’Avolio, CEO and co-founder of machine learning startup Cyft said at the HIMSS and Healthcare IT News Pop Health Forum in Chicago Monday. “We need to be more realistic about what these tools can and can’t do.”
John Supra, vice president of solutions and services at the Care Coordination Institute, agreed that just having machines tell doctors exactly what to do is not necessarily what healthcare really needs.

Digital health investments maintain steady pace in Q3, surpassing last year’s total

Oct 3, 2017 5:45pm
Digital health funding hit $4.7 billion in 2017, leapfrogging last year's total.
Digital health investments have exceeded last year’s total by $100 million with a full quarter left to go.
Coming off a torrid first half of 2017 that saw unprecedented investment in digital health, third-quarter funding was slightly more modest, but it was enough to push past last record-setting totals in 2015.
Third-quarter digital health investments reached $1.2 billion, bringing the 2017 total to $4.7 billion, according to Rock Health, which tracks U.S.-based deals that exceed $2 million. Total funding in 2016 reached $4.4 billion. In July, Rock Health Research Director Megan Zweig told FierceHealthcare she expects 2017 “to be a banner year.”

Few U.S. hospitals can fully share electronic medical records

 (Reuters Health) - Less than one in three U.S. hospitals can find, send, and receive electronic medical records for patients who receive care somewhere else, a new study suggests.
Just 30 percent of hospitals had achieved so-called interoperability as of 2015, the study found. While that’s slight improvement over the previous year, when 25 percent met this goal, it shows hospitals still have a long way to go, researchers report in Health Affairs.
“What this means is there is potentially a significant amount of waste and inefficiency in hospitals,” said lead study author Jay Holmgren of Harvard Business School in Boston.

VisualDx updates its AI app to help clinicians classify skin lesions

October 02, 2017
by Lauren Dubinsky , Senior Reporter
VisualDx announced on Friday that it updated its artificial intelligence app for the iPhone or iPad to help non-dermatologists assess skin lesions and rashes.
"People expect expertise of their doctors, nurse practitioners and physician assistants, and we cannot expect these generalists to memorize all medical information," Dr. Art Papier, CEO and co-founder of VisualDx, told HCB News.
Over 65 percent of skin complaints are addressed by non-dermatologists, and 15 percent of primary care visits involve skin-related issues, according to a study published in the Journal of the American Academy of Dermatology.

HIT Think Why more providers are relying on the NIST Cybersecurity Framework

Published October 03 2017, 4:38pm EDT
Healthcare organizations are just beginning to understand the importance of adopting a cybersecurity framework as part of their overall information risk management program. A study by Dimensional Research, on behalf of Tenable Network Security, found that the healthcare industry lags behind many other industries in the adoption of a cybersecurity framework.
Tenable’s research showed that only 61 percent of healthcare or medical organizations had adopted a security framework, compared with 88 percent in banking and finance; 87 percent in information technology; 86 percent in government; 83 percent in manufacturing and 77 percent in education.
Those numbers are starting to change, however. One reason is the increasing traction of the National Institute of Standards and Technology (NIST) Cybersecurity Framework (CSF) across all industries, including healthcare. A study by HIMSS Analytics, conducted on behalf of Symantec, found that of those healthcare organizations that had adopted a cybersecurity framework, the majority (56 percent) had adopted the NIST Cybersecurity Framework.

New tool shows promise in detecting colon cancer earlier

Published October 03 2017, 4:07pm EDT
A new computational tool may help physicians identify patients with the highest risk of having undiagnosed colorectal cancer while the disease is still in an early stage.
The tool, called ColonFlag, was developed by Medial EarlySign, an artificial intelligence and machine learning vendor. It predicts and stratifies individuals at high risk by analyzing routine blood test results and electronic health records data. The company also is developing additional disease predictors for other types of cancers, diabetes and other life-threatening conditions.
In a study published in the journal Digestive Diseases and Sciences, ColonFlag was able to identify risk for colorectal cancer as much as a year earlier than conventional diagnostic practices, study authors say.

Robot rivals are forcing cancer centres to close

Kat Lay, Health Correspondent
October 4 2017, 12:01am, The Times
Cancer treatment centres are closing because patients are attracted to hospitals promising to use new technology even though there is no evidence that it is better than traditional surgery.
Researchers said that 16 prostate cancer surgical centres had closed since 2010 but there was no evidence that they had provided poor care.
None of them, however, offered robotic surgery in which a machine helps surgeons to perform keyhole surgery, rather than traditional open surgery or keyhole surgery by hand.

NIH releases large chest X-ray dataset to researchers

Published October 02 2017, 7:26am EDT
The National Institutes of Health has released one of the largest publicly available chest X-ray datasets to the scientific community, including more than 100,000 anonymized images of scans from more than 30,000 patients—many who have advanced lung disease.
Before it was released, the dataset was rigorously screened to remove all personally identifiable information, according to NIH. The images come from patients at the NIH Clinical Center, a research hospital, who voluntarily enrolled to participate in clinical trials.
The agency is hoping that by releasing the de-identified dataset to researchers that they will be able to teach computers how to read and process extremely large numbers of scans, thereby confirming results radiologists have found and potentially detecting and diagnosing other findings that may have been overlooked.

Black Book ranks top 50 disruptive health IT companies, see the list

Hospitals and payers voted on their favorite innovators - athenahealth, Salesforce, M*Modal and more - based on client experience metrics.
September 29, 2017 11:33 AM
Black Book on Friday published its roster of the 50 most disruptive tech companies in healthcare.
From startups to household names — literally spanning athenahealth to ZeOmega — these are the companies that hospitals and payers rated highest in the firm’s indicators of positive client experiences. 
Black Book broke out the winners by categories including analytics, cybersecurity, HIM & coding, interoperability, mobile and telehealth as well as pop health and value-based care, among others.

Canada's Alberta Health Services signs $459 million contract for Epic EHR

The facilities include hospitals, clinics, continuing care facilities, mental health facilities and community health sites.
September 29, 2017 02:59 PM
After almost one year of consultation with hundreds of physicians, staff and patients, Alberta Health Services is poised to lay the groundwork for a system-wide EHR from Wisconsin-based Epic Systems.
AHS operates 400 facilities across the province, which is one Canada’s western provinces. The facilities include hospitals, clinics, continuing care facilities, mental health facilities and community health sites.
Rather than referring to the technology as an EHR, Alberta Health Services executives refer to it as CIS, for Clinical Information Systems. AHS executives have named the CIS “Connect Care.” The initial work is expected to begin soon and continue over five years.

Pew to ONC: Fix pediatric EHRs to avoid dangerous medical mistakes

A voluntary certification program is already mandated by the 21st Century Cures Act.
September 29, 2017 10:31 AM
The Pew Charitable Trusts on Friday called on Office of the National Coordinator for Health IT head Donald Rucker, MD, to focus on electronic health records safety particular to pediatric patients as it institutes a voluntary certification program.
“The use of EHRs has contributed to new, unanticipated safety concerns that were not present with paper-based records, and left some safety hazards unmitigated,” Pew wrote in the letter to Rucker. “Many of these safety challenges directly affect care for pediatric patients.”
Pew’s letter was cosigned by the American College Cardiology, American College of Physicians, American Medical Group Association, American Nurses Association, and Children’s Hospital Association.

Lax Security to Blame For Record Pace of HIPAA Breaches, Feds Say

Sep 28, 2017 Aldrin Brown
A spike in large breaches – those affecting at least 500 people – is being driven by an 82 percent year-over-year increase in successful hacking of healthcare organizations.
A continued lax security posture by too many healthcare organizations is making them increasingly attractive targets for cyber criminals, who have executed a record number of successful breaches of HIPAA-protected information this year, federal health officials told MSPmentor.
The 221 major breaches reported under HIPAA regulations so far this year mark a 66-percent increase over the 133 breaches reported for all of 2016, according to our analysis of records from the U.S. Department of Health and Human Services Office of Civil Rights (OCR).

HIT Think Why interoperability between EHRs and telehealth platforms will be crucial

Published October 02 2017, 4:23pm EDT
Interoperability, which allows disparate technology systems to communicate openly, could easily be called the secret sauce for successful value-based care models. But as we approach the era of value-based care, the industry needs to think beyond EHR interoperability. Interoperability for telehealth—a critical part of the care delivery system of the future—must be top of mind.
The healthcare industry is moving into an age where quality, efficiency and positive outcomes outpace volume in importance; being able to exchange data easily and securely is front and center. However, healthcare systems and stakeholders still use multiple technology systems that, by and large, don’t communicate well. This wastes a lot of resources, puts patient safety at risk and hinders the progress of medicine—especially for the many healthcare providers entering into shared-risk groups, such as Accountable Care Organizations.
The 21st Century Cures Act, signed into law in December 2016, emphasizes the urgency around open communication, calling for greater interoperability among EHRs, while discouraging information blocking.

Sepsis Study Pits EHR vs. Claims Data

Tinker Ready, October 2, 2017

A study of sepsis cases using EHR rather than claims data finds little change in either incidence of infection or mortality over a four-year period.

Is the incidence of sepsis stable or is it increasing?
Awareness campaigns and clinical education programs would suggest a rise in the potentially fatal condition, which the Centers for Disease Control and Prevention describes as a "complication caused by the body's overwhelming and life-threatening response to infection."
Now, a study based on data from electronic health records suggests that the rate of sepsis and it corresponding death rate may have stabilized between 2009 and 2014.


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