Saturday, October 28, 2017

Weekly Overseas Health IT Links – 28th 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.
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71% of providers say interoperability not attainable by 2020

Published October 20 2017, 7:08am EDT
Less than a third of provider organizations believe that current federal policies, committees and regulations are sufficient to help the country attain meaningful health IT interoperability by 2020.
That’s among the findings of the eHealth Initiative’s just-released 2017 Survey on Access to Patient Information.
Researchers conducting the survey say the lack of confidence in the nation achieving interoperability over the next few years does not bode well for the healthcare industry as it transitions from fee-for-service to value-based care.
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Clinic pays ransom to recover from a hacking attack

Published October 18 2017, 4:20pm EDT
Namaste Healthcare, a small primary care clinic in Ashland, Mo., suffered a data breach on August 12 and 13 when a hacker remotely accessed the practice’s file server and potentially viewed protected health information.
On August 14, when the practice opened, data on the file server was found to be encrypted.
The practice disabled the unauthorized user’s access, took computers offline and with help from its technology contractor terminated further remote access. However, the data was still encrypted by the hackers, and the practice was forced to pay an undisclosed ransom to get the decryption key and restore the encrypted data, according to a notification letter mailed to affected individuals.
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Epic Named Best EDIS Enterprise Vendor in Overall Satisfaction

A recent KLAS report showed organizations using Epic as their EDIS system report significantly higher rates of overall satisfaction.

October 17, 2017 - The September 2017 KLAS report for emergency department information system (EDIS) usability showed provider leadership at organizations using Epic EHR have significantly higher rates of overall satisfaction than those using other enterprise vendor systems.
KLAS researchers attributed this success to the health IT company’s excellent support, relationships, and general experience.
However, Epic users reported lower rates of workflow satisfaction and usability compared to best-of-breed customers.
 “Several Epic customers report excessive and repetitive clicking, back-and-forth navigation, and upgrades that create additional clicks; at the same time, users admit that these steps/clicks have helped improve patient safety, and respondents report that the vendor delivers more information at-a-glance,” wrote KLAS researchers in the report.
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UVA Researchers Recommend Using EHRs for Reduced Medical Testing

Researchers at UVA recommend suggest using EHRs for reduced medical testing, such as limiting repetitive lab test ordering.

October 18, 2017 - Researchers at the University of Virginia (UVA) Health System and other universities have developed a plan to cut unnecessary medical testing in an effort to save money and improve patient safety, satisfaction, and health outcomes in part by using EHRs.
Hospital staff frequently perform routine lab tests on hospitalized patients. However, researchers suggest automatically testing patients is wasteful and potentially threatening to patient safety when medical testing is not a necessary part of treatment.
For example, researchers pointed out that excessive blood testing can lead to hospital-acquired anemia, increased medical costs, and additional unnecessary testing.
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Hospitals provide guidelines for eliminating unnecessary medical tests

Published October 19 2017, 7:12am EDT
Researchers have developed evidence-based guidelines intended to help hospitals eliminate unnecessary medical testing, and are developing an approach to deliver the guidelines to clinicians through electronic health records.
In addition to limiting unnecessary tests, the initiative intends to give providers real-time feedback on their ordering patterns with anonymized comparative data.
The guidelines, published this week in JAMA Internal Medicine, were developed by researchers at Johns Hopkins University, the University of Michigan, University of Pennsylvania, University of Toronto and the University of Virginia—all members of the High Value Practice Academic Alliance, a coalition of more than 80 academic medical centers working to improve healthcare by eliminating waste.
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Report: Insider Threats to Patient Data Remain Unnoticed

October 18, 2017
by Heather Landi
Of the reported healthcare data breach incidents that occurred in September, it took an average of 387 days for healthcare organizations to discover a breach had occurred, according to a report from cybersecurity software company Protenus.
There was a substantial uptick in the number of breach incidents reported in the month of September, with almost half a million patient records compromised, according to the report. There were 46 incidents in September, compared to 33 in August, 36 in July and 52 in June. The Protenus Breach Barometer is a monthly snapshot of reported or disclosed breaches impacting the healthcare industry, with data compiled and provided by DataBreaches.net. The report includes breach incidents either disclosed to the U.S. Department of Health and Human Services (HHS) or to the media in the past month.
For the 42 incidents for which Protenus had numbers, 499,144 patient records were affected. The largest single incident for which Protenus had numbers involved 128,000 patient records in a hacking incident that involved ransomware. Reports did make it clear that this patient data was made inaccessible by the hacking.
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Machine learning helps Mass General predict cancerous breast lesions

Published October 18 2017, 7:06am EDT
Researchers at Massachusetts General Hospital, working with MIT’s Computer Science and Artificial Intelligence Laboratory, have developed a machine learning tool to identify high-risk breast lesions that are likely to develop into cancer.
By accurately predicting which biopsy-diagnosed, high-risk lesions are likely to become cancerous, the technology has the potential to reduce unnecessary surgeries by nearly one-third in this specific patient population. That’s the finding of a new study published online in the journal Radiology.
“This study is our proof of concept that we can actually change the way we’re managing our patients through machine learning algorithms,” says Constance Lehman, MD, senior author of the study and director of breast imaging at Massachusetts General Hospital.
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Regular Employee Training Essential in Healthcare Cybersecurity

How do employee training programs help protect against evolving healthcare cybersecurity threats and reinforce HIPAA compliance?

October 16, 2017 - Healthcare cybersecurity threats are constantly evolving, forcing covered entities and business associates to subsequently adjust their privacy and security measures to keep PHI secure. A key aspect to data security though is regular employee training.
Health IT executives are increasingly concerned over their employees having a proper grasp of cybersecurity measures. The 2017 Level 3 Healthcare Security Study found that 80 percent of HIT leaders list employee security awareness as their top healthcare data security worry.
Sixty-nine percent of respondents said exposure from partners or third-parties was their top concern, followed by securing wireless or BYOD devices (54 percent) and a lack of actionable intelligence (36 percent).
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41% of Health Data Breaches Stem from Unintended Disclosure

The leading cause of health data breaches in 2017 so far are from unintended disclosure, followed by hacking or malware.

October 17, 2017 - Unintended data disclosure, such as emails containing PHI sent to the wrong recipient or servers left publicly accessible, accounted for 41 percent of reported health data breaches the first nine months in 2017, according to research from Beazley.
The second most common issue was from hacking or malware incidents (19 percent), followed by insider incidents (15 percent), and physical loss (8 percent).
Organizations need to understand the underlying causes of data breaches so necessary mitigation and management techniques can be put in place, Beazley Breach Response Services Global Head Katherine Keefe explained.
 “All organizations face the reality that data breaches have become inevitable,” Keefe said in a statement. “And the stakes are high: they hold personal data on trust for customers, employees and patients. The volume of protected health information maintained by healthcare organizations and the digitization of electronic health records have increased the vulnerability for large breaches.”
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Fighting physician burnout: How tech can undo the damage done by EHRs

Solutions should reduce the burden of repetitive data input that now takes place and enable seamless ways for clinicians to talk to each other, experts say.
October 16, 2017 10:39 AM
When it comes to doctor burnout, technology is both the problem and a potential solution.
“Let’s not dance around it – we all know how much the electronic health record has contributed to the physician burnout epidemic,” said Bridget Duffy, MD, chief medical officer at Vocera, co-founder of the Experience Innovation Network and former chief experience officer at the Cleveland Clinic.
“Physicians who once were absorbed in speaking with and examining their patients found themselves spending more time clicking through screens and pecking away at a keyboard.”
The widespread frustration felt by doctors wrangling with kludgy interfaces, interminable sign-ins and so many clicks is well-trodden at this point. Perhaps less understood, however, is how technologies including EHRs can be tuned to make physicians more efficient — and more happy.
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Texas Children’s doctor says artificial intelligence requires physicians to redefine their role in medical care

Oct 17, 2017 11:11am
Doctor's need to stop thinking of themselves as "victims of the machine," and decide which parts of their job are better left to computers.
To coexist with machines, one physician says doctors will need to delegate parts of their job to algorithms that are better equipped to support patient care.
Arguing that physicians are headed to “evolution, not extinction,” Bryan Vartabedian, M.D., an assistant professor of pediatrics at Baylor College of Medicine and an attending physician at Texas Children’s Hospital, said physicians need to redefine themselves not as “victims of the machine,” but participants in reshaping the future of medical care.
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Proposed bill calls for a national breach notification standard

Published October 17 2017, 4:03pm EDT
In the wake of the Equifax data breach that may have affected more than 143 million individuals, Rep. Jim Langevin (D-Rhode Island) has reintroduced legislation previously proposed to establish a single national breach notification standard, along with establishment of a federal regulator that would ensure information on a breach quickly reaches affected individuals.
The bill is H.R. 3806, entitled the Personal Data Notification and Protection Act. Alabama and South Dakota are the only states that don’t currently have a state breach notification law.
“There is much still to learn about the Equifax breach and its ramifications,” says Langevin in a statement. “What is abundantly clear, however, is that consumers are still not sure whether they were affected and what information was stolen.”
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EHRs Play Role in More Malpractice Claims

Alexandra Wilson Pecci, October 17, 2017

There was a continuous increase over the past decade in malpractice claims in which the use of EHRs contributed to patient injury, says a new study.

As EHR usage grows more widespread, so too does the technology’s role in malpractice claims, finds a new study.
The Doctors Company, a physician-owned medical malpractice insurer, found a continuous increase over the past decade in malpractice claims in which the use of EHRs contributed to patient injury.
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EHR-related malpractice claims are rising, and risk-mitigation strategies more important than ever

System factors in the EHR itself – poor integration, suboptimal design and UX, failures of alerts and alarms – were up 8 percent since the last time The Doctors Company did a similar report.
October 17, 2017 04:11 PM
Malpractice claims for errors caused, all or in part, by electronic health records have risen significantly, according to a report from The Doctors Company, a physician-owned malpractice insurer. The study offers some useful tips to help providers protect against that risk.
There were just two claims for which EHRs were either the cause or (more likely) a contributing factor between 2007 and 2010, according to report. From from 2011 through the end of 2016, however, there were 161.
The new study examined more than five dozen of those claims and found a wide array of factors – some related to technology and system design (drop-down menus, templates, alerts) and some having to do with human error (lack of training, inappropriate use of copy-and-paste) – contributing to the alleged medical errors.
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What hospitals should consider when choosing AI tools

AI and machine learning are augmentative tools, size matters among data sets, real-world applicability is a must, and tools must be validated, experts say.
October 13, 2017 11:25 AM
Some healthcare organizations are turning to artificial intelligence and machine learning because of the enhancements these advanced technologies can make to patient care, operations and security. But assessing the promises of the technologies can be difficult and time-consuming, unless you’re an expert.
Two such experts weigh in with insights hospitals should understand when both planning and purchasing AI tools. 
Raj Tiwari is chief architect at Health Fidelity, which uses natural language processing technology and statistical inference engines, mixed with analytics, to identify and correct compliance risks, and Brent Vaughan is the CEO of Cognoa, a company that develops AI tools for diagnosing medical conditions.
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Epic's rival EHR vendors say they too are making the 'CHR' switch

Cerner, athenahealth and eClinicalWorks said they are incorporating new data types, such as social determinants, population health and precision medicine to make EHRs more “comprehensive.”
October 13, 2017 11:00 AM
Epic Systems CEO Judy Faulkner drove a stake into the ground when she said the company is transforming today’s EHR into a Comprehensive Health Record, a.k.a CHR.
But health and IT executives should take note: The new moniker does not mean that Epic has intrepidly moved into undiscovered country. Instead, rival EHR makers are already taking a similar tack. It’s just that no one has publicly attempted such a bold rebranding of the category.
“We’ve been discussing longitudinal health records that include social determinants and other relevant data for at least two years now, and there are more than 100 clients today using Cerner’s population health management platform (including many Epic EHR clients),” Cerner President Zane Burke said. “We’ve worked with these clients to develop solutions like HealtheIntent that are EHR-agnostic and aggregate data from multiple, disparate sources outside the four walls of the hospital or clinic.”
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Eric Topol draws line in sand: Patients own their medical data

The renowned author and physician-scientist highlights the hurdles to sharing data with patients and asserts that giving patients their records could save lives.
October 13, 2017 12:50 PM
In a firm, bulleted-list, notable author and physician-scientist Eric Topol, MD, sparked a Twitter debate on his insights about the barriers to giving patients their medical record -- and why the shift needs to happen.
“Hospitals won’t or can’t share your data… Your doctor (more than 65 percent) won’t give you a copy of your office notes,” Topol tweeted. “Access or ‘control’ of your data is not enough.”
The tweet has been shared about 775 times and liked by more than 1,200 users.
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Athenahealth, Cerner, Epic see wide adoption of population health platforms

But KLAS analysis suggests that what providers want in a PHM solution going forward is likely to evolve.
October 13, 2017 01:35 PM
While much of the population health management work hospitals are undertaking today relies on EHRs, new research from KLAS uncovered a crop of technology companies gaining purchase in the realm: IBM Watson Health, Philips Wellcentive and HealthEC. 
EHR vendors athenahealth, Cerner and Epic are still seeing stronger deployment of their pop health tools than these third-party vendors, KLAS noted. 
Research firm BlackBook said over the summer that Epic, Cerner and Allscripts are poised to dominate the population health market as a wave of mergers, acquisitions and consolidation is coming. 
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AMA Launches Integrated Healthcare Big Data Analytics Platform

The physician-led Integrated Health Model Initiative aims to bring standardized healthcare big data analytics to the care continuum.

October 16, 2017 - The American Medical Association is working to develop an integrated big data analytics and clinical informatics platform that will offer a common data model for organizations seeking to deliver the highest possible quality of coordinated care.
With initial partners including Cerner Corporation, IBM, Intermountain Healthcare, PCORI, AMIA, and SNOMED, the Integrated Health Model Initiative (IHMI) will prioritize a collaborative approach to better chronic disease care and population health management.
“We spend more than three trillion dollars a year on health care in America and generate more health data than ever before. Yet some of the most meaningful data – data to unlock potential improvements in patient outcomes – is fragmented, inaccessible or incomplete,” said AMA CEO James L. Madara, MD.
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Virtual interviewers may help soldiers speak up about PTSD

October 12, 2017
Service members unwilling to open up about their PTSD in person may be more likely to speak with computer-generated virtual interviewers, newly published research suggests.
Due to their anonymity and rapport-building capabilities, these virtual interviewers could be uniquely positioned to break through soldiers’ fears of discrimination and career-affecting stigma and improve mental health care, Gale M. Lucas, senior research associate at the University of Southern California’s Institute for Creative Technologies, and colleagues wrote.
“We envisioned a technology system – a virtual human interviewer – whereby military service members can get feedback about their risk for PTSD in a safe place without stigma,” Lucas told MobiHealthNews in an email. “Our prior research has shown that, because its ‘just a computer’ (therefore safe and anonymous), this virtual human interviewer helps people to feel safe discussing sensitive issues like mental health symptoms.”
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Quality Issues for Both Paper-, Electronic-Based Health Records

Study affirms poor quality of nursing documentation, as well as lack of knowledge and skills
FRIDAY, Oct. 13, 2017 (HealthDay News) -- Both paper-based and electronic health records (EHRs) have shortcomings in terms of quality of content, process, and structure, with poor quality of nursing documentation seen for both methods, according to a study published online Oct. 5 in the Journal of Clinical Nursing.
Laila M. Akhu-Zaheya, Ph.D., R.N., from Jordan University of Science and Technology, and colleagues compared the quality of paper-based and electronic-based health records according to content, documentation process, and structure in a retrospective descriptive study. A total of 434 paper-based records and EHRs were audited using the Cat-ch-Ing Audit Instrument.
The researchers found that in terms of process and structure, EHRs were better than paper-based health records. Paper-based records were better than EHRs in terms of quantity and quality content. Poor quality of nursing documentation was affirmed in the study, as was nurses' lack of knowledge and skills in the nursing process and its application in both paper-based and EHR systems.
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HIT Think How tinkering with the ACA puts health IT investment at risk

Published October 16 2017, 3:30pm EDT
Laws put in place over the past 70 years typically are done so with a delicate balance in mind—a bull in a china shop approach can do much damage in often unforeseen ways.
However, it’s apparent that recent events portend myriad challenges for providers throughout the country, and risk negating some of the benefits the country had hoped to derive from efforts to implement health information technology in the last 10 years.
For example, in 1946, the 79th Congress passed and President Truman signed the Hill-Burton Act, a federal law that required any facility receiving federal funds to treat any person with life-threatening injuries without concern for their ability to pay. Although rarely enforced for almost 30 years, the law was amended in the 1970s to include provisions to test compliance and impose penalties when indicated.
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Has somebody shared your 'anonymised' health data? Bad news

Harvard boffins unmask 100% of 'encrypted' S Korean records

By Alexander J Martin
Researchers from Harvard University have published a paper claiming a 100 per cent success rate in de-anonymising patients from their supposedly anonymised healthcare data in South Korea.
The study, which bears the ronseal title of "De-anonymizing South Korean Resident Registration Numbers Shared in Prescription Data", was published this week in Technology Science.
Two de-anonymisation experiments were conducted in the study on prescription data from deceased South Koreans, with encrypted national identifiers - Resident Registration Numbers (RNN) - included.
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Enjoy!
David.

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