Quote Of The Year

Timeless Quotes - Sadly The Late 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."

Sunday, December 31, 2017

A New Year’s Eve Bon-Bon That Says It All – Pull At Your Peril!

Grahame Grieve has given us all a masterful one paragraph summary of where we are at, at the end of 2017, in response to a query about “What is going on?”!

To quote:

“I think it's pretty simple - the first round of development didn't quite meet the original goals, and the lack of consensus around the system - specifically, whether to consolidate or redesign - has prevented the government doing anything to address the actual concerns, so we end up in a situation where we have a half-done system that was baked in a hurry, but at the political level it's being treated as ready for prime-time. We're stuck.”

This is so true and so real it is just bloody painful. Just how the half-done system is going to handle the proposed transition to 'opt-out' must be a more than considerable worry to the bosses at the ADHA. I know I would be worried!

The question is what can we do in 2018 to ‘unstick’ ourselves?

Outside the box inspiration is urgently required! Comments please!

Happy New Year!


AusHealthIT Poll Number 403 – Results – 31st December, 2017.

Here are the results of the poll.

Do You Believe 'Replatforming' Can Solve The Issues That Presently Beset The myHR?

No - It Should Be Scrapped 84% (154)

No - More Fundamental Changes Are Needed 13% (24)

Yes 2% (4)

I Have No Idea 1% (2)

Total votes: 184

Any insights welcome as a comment, as usual. It seems that the vast majority think more than just updating the platform on which the myHR runs is required to save it.

This is consistent with all the discussion that has gone on in the comments last week. It seems there are a range of fundamental questions around the myHR and where it fits / should fit in the Digital Health ecosystem and just what it is for.

There is also pretty clear recognition that there are complex political dimensions to the myHR the realities of which we are stuck with and which, at present, are seemingly insoluble!

Whichever way you look at it is a pretty expensive and much less than ideal mess!

A really great turnout of votes!

We note two respondents who are clueless!

Again, many, many thanks to all those that voted!


Saturday, December 30, 2017

Weekly Overseas Health IT Links – 30th December, 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.

App monitors symptom severity in patients undergoing chemotherapy

Published December 22 2017, 7:04am EST
Using a smartphone and Fitbit device, cancer patients undergoing chemotherapy were able to be remotely monitored in real time by their physicians in order to better detect severe or worsening symptoms from the treatment and to intervene earlier between clinic visits.
The goal is preventing unnecessary doctor or hospital visits and improving patient quality of life, according to researchers from the University of Pittsburgh who led the study conducted last year.
Over a four-week period, 14 patients receiving chemotherapy for gastrointestinal cancer at UPMC Hillman Cancer Center carried an Android smartphone and wore a Fitbit device which provided data to doctors on patient mobility and activity, sleep, phone usage, as well as communication.

Digital Health’s Top 10 most read stories of 2017

Shireen Khalil

22 December 2017
It was a year filled with plenty of announcements, promises, deals and launches. We break down the Top 10 most viewed news stories of the year.
Care Quality Commission investigation reports dominated the charts, even beating the biggest health IT story of the year, the global Wannacry attack.
Other topics varied from senior resignations, GOSH going Epic and app launches. Our April Fools story even made the cut.

Digital Health’s review of the year, 2017

Shireen Khalil

22 December 2017
What a year 2017 has been in the world of digital health. It was a year you couldn’t avoid with AI, the ICO and CQC looming large.
It was a year that saw digital health apps like GP at Hand and Evergreen Life hit the UK mainstream, and come under scrutiny; and the year that NHS IT made international headlines for all the wrong reasons with Wannacry.  It was also a year Global Digital Exemplars and the new NHS Digital Academy began to find their feet.  Join us for the romp that is the Digital Health review of the year   

Top 10 Healthcare IT News stories of 2017

Our most popular stories with readers this past year included Epic's EHR happenings, blockchain and AI.
December 21, 2017 02:54 PM
EHR vendors Epic, Cerner and eClinicalWorks dominated the most-read articles throughout the last 12  months -- with news both good and bad. Also in the mix: patient safety struggles, artificial intelligence, blockchain and next generation of electronic health records that vendors are collectively agreeing will be CHRs, as in comprehensive health records. 
Here are the 10 most-read Healthcare IT News articles of 2017. 
Hospital watchdog Leapfrog released its Spring 2017 Hospital Safety Grade on April 12. It highlights hundreds of hospitals that are leading in preventing deadly medical errors at their facilities. The national healthcare rating is focused on errors, accidents and infections. It assigns ‘A’ through ‘F’ letter grades to hospitals.  Leapfrog rated 2,639 hospitals, and 823 hospitals earned an A, 706 earned a B, 933 earned a C, and 167 earned a D.

To avoid repeating EHR missteps, involve physicians in artificial intelligence projects from the start

Dec 22, 2017 12:17pm
It’s time to bring two separate cultures—technology and physicians—together as artificial intelligence takes hold in healthcare, according to three Stanford University researchers.
Healthcare should take a lesson from electronic health records development, which when done with little input from doctors can be rife with unintended consequences that contribute to physician burnout, wroe Abraham Verghese, M.D., Nigam H. Shah, Ph.D., and Robert A. Harrington, M.D., of Stanford’s School of Medicine, in a JAMA opinion piece.
 “The lessons learned with the EMR should serve as a guide as artificial intelligence and machine learning are developed to help process and creatively use the vast amounts of data being generated in the healthcare system,” the researchers wrote.

HIT Think Why the cloud makes increasing sense for sharing medical images

Published December 22 2017, 3:35pm EST
When healthcare executives think about medical imaging, they most likely associate it first with the terms radiology and radiologist. Perhaps, later they might think of specific imaging types, like X-ray or MRI, and then, maybe for those who were really savvy, a mention of PACS or RIS.
However, few would ever say orthopedics, neurosurgery, cardiology, or clinical trials. But medical imaging has become a vital diagnostic tool and essential for almost all medical specialities.
For example, let’s take fictional patient Laura. While walking her dog, Laura slips on a pile of leaves and hits her head. The fall was rather hard, and her friend drives her to a local hospital where a head CT scan is done as a precaution. All is normal, but a few weeks later, Laura begins to have some head pain and dizziness and wants a second opinion. She goes to a local neurosurgeon, who cannot make a full assessment without access to her initial CT scan. After a wasted appointment, Laura finds out that she must head back to the hospital to pick-up her CD of imaging scans or have it mailed to her doctor’s office, a process that could take more than a week.

2017 Year in Review: A digital health boom, cyberattacks and navigating health IT’s awkward teenage years

Dec 21, 2017 2:42pm
Even if we’ve tried to forget, everyone remembers those painfully awkward teen years when we were still getting comfortable with who we were and our place in the world.
That’s where the health IT industry finds itself now: still getting comfortable in its own skin. 
Health systems have the basic IT infrastructure in place. They have an EHR system. They have analytics and population health tools. They have more data than they know what to do with. Now they’re just trying to pull it all together into a cohesive unit.

Epic's slimmed-down EHR 'Sonnet' to be released in March

Company said it is targeting smaller hospitals with a version of its EHR that has fewer modules and features, targeting rivals like athenahealth.
December 21, 2017 02:04 PM
Epic Systems just revealed that its new EHR, dubbed Sonnet, will be available in March 2018 and its new implementation tool Utility is already being used.
Epic CEO Judy Faulkner first mentioned Sonnet at HIMSS17, when she described it as a slimmer version of the Epic EHR one might see in many large healthcare systems today.
Sonnet has fewer modules and a reduced feature scope, Epic spokeswoman Meghan Roh said. “Sonnet provides the benefits of a robust, integrated EHR at a lower price point.”

Study: AI successfully identifies eye diseases from retinal images

Written by Jessica Kim Cohen | December 19, 2017 |
A team of international researchers developed a deep-learning system to screen patients for diabetic retinopathy and related eye diseases, according to a study published in JAMA Dec. 12.
The researchers trained a deep-learning system to identify diabetic retinopathy and possible glaucoma based on thousands of patients' retinal images.
The system, which was evaluated using 494,661 retinal images, demonstrated 90.5 percent sensitivity and 91.6 percent specificity for referable diabetic retinopathy. For vision-threatening diabetic retinopathy, the deep-learning system's sensitivity was 100 percent and its specificity was 91.1 percent.

ONC plans to release rule to tackle information blocking in early 2018

Published December 20 2017, 6:55am EST
The Office of the National Coordinator for Health IT, as directed by the 21st Century Cures Act, is currently developing a proposed rule—slated for release in the spring of 2018—that will address the definition of information blocking and could have potentially serious implications for bad actors.
“Networks often have issues of anti-competitive behavior in them,” observes National Coordinator for Health IT Donald Rucker, MD. “As we look at interoperability, there are a number of things we can do” to address information blocking, Rucker says.
Ultimately, ONC’s information blocking rule will be used by the Department of Health and Human Services’ Office of the Inspector General to guide its investigations and enforcement activities related to provider and vendor actions that serve to impede the electronic flow of data between healthcare organizations.

OCR revamps HIPAA guidance in wake of opioid crisis, 21st Century Cures rules

HHS Office for Civil Rights offers new perspective on the privacy law as it relates to mental health and substance abuse, clinical research.
December 19, 2017 03:20 PM
As it works to implement the provisions of the 21st Century Cures Act, the Office for Civil Rights is also keeping an eye on the data sharing needs of the ongoing opioid crisis. In response to both, the HHS office has published some new information related to HIPAA.
OCR has launched two new websites – one for patients and their families and another for providers – related to how HIPAA applies to mental and behavioral health information.
The sites are meant to reorganize existing HIPAA provisions to make the guidance more user-friendly, officials say, offering central location for new materials and clarify the circumstances under which HIPAA allows covered entities to disclose information, especially that related to mental health and substance use disorders, to family and caregivers.

Pew Charitable Trusts advocates for a national health IT safety collaborative with a $20M price tag

Dec 20, 2017 5:26pm
The idea of a health IT safety collaborative in which developers, providers and practitioners could work together to resolve safety concerns associated with EHRs has been around for more than six years, but it's never come to fruition.
Pew Charitable Trusts is taking another stab, reviving the argument that a public-private collaborative would help the industry solve complex safety concerns, but with a price tag as high as $20 million.
A new report (PDF) released by the organization this week recaps some of the discussion points from a meeting with the Office of the National Coordinator for Health IT last December and advocates for a national health IT safety collaborative that could root out EHR usability issues that lead to medical errors.

Biggest EHR challenges for 2018: Security, interoperability, clinician burnout

Hospital and health system execs discuss the hurdles they’re facing as they move into the new year – and some of the tools they're using to tackle those challenges.
December 19, 2017 03:06 PM
Moving into 2018, hospitals and health systems continue to face many challenges in implementing, maintaining and upgrading their electronic health record systems. These challenges range from technical to security to strategy to human interaction.
Kris K. Wilson, chief information officer at Hilo Medical Center, a Hawaii hospital that has achieved the top HIMSS Stage 7 ranking for its IT work, says cybersecurity will be a top challenge hospitals must face in 2018 when it comes to their EHRs.
"As EHRs mature and collect vast amounts of data, keeping this data safe as adept cybersecurity threats increase must remain at the forefront," said Wilson. "Educating staff on the proper use of hospital systems and placing safeguards within your EHR to limit the amount of data accessible is a good start to overcoming this challenge."

HIT Think Five key steps can block potential avenues for cyberattacks

Published December 20 2017, 4:45pm EST
With efforts to breach healthcare organizations for data on the rise, for those with the daunting responsibility of overseeing data security, it is crucial to understand vulnerability management and its role in the overall process for foiling the impacts of data breaches.
Vulnerability management is the practice of researching, identifying and understanding the vulnerabilities of an organization and its systems, and then developing a plan for mitigating and protecting them, followed by consistent evaluation of that plan. It’s an ever-evolving process that’s hastened by the pressure of increasingly sophisticated breach attempts.

Proposed legislation would give patients improved access to records

Published December 19 2017, 7:30am EST
ecently introduced legislation in the House of Representatives seeks to reduce patient frustration in dealing with a variety of interactions with the nation’s healthcare providers as they try to access their health records.
Rep. Cathy McMorris Rodgers, (R-Wash.) introduced the bill, H.R 4613, which would authorize claims clearinghouses to build longitudinal health records for patients, for a reasonable cost-based fee, while also enabling the clearinghouses to analyze claims data including data on providers, diagnoses and treatment for episodes of care for the public good.

Apps for evidence-based medicine help physicians engage patients in shared decision-making

Smartphone software programs from the likes of athenahealth’s Epocrates, Doximity, Medscape, Wolters Kluwer and others are giving both clinicians and patients more confidence in diagnosis and treatment options.
December 18, 2017 09:45 AM
Manish Naik, MD, recently examined a patient in his office who was reluctant to get a flu vaccine because of a history of egg allergy. Naik conducted a quick search through his medical reference app and reviewed study data with the patient on the safety of flu vaccination in patients with egg allergy.

After seeing the latest study data and guidelines, the patient agreed to get both the flu and pneumonia vaccines. Because the patient’s underlying medical conditions placed him at higher risk for complications from flu or pneumonia, he received an important treatment directly because of quick and easy access to good data, said Naik, chief medical information officer and a practicing internist at Austin Regional Clinic.

Various app players

A variety of tech vendors offer medical reference apps on the market. These include Doximity, DynaMed Mobile, athenahealth’s Epocrates, Figure 1, Isabel, Medscape, Pepid and Read by QxMD.

ONC launches framework to improve patient data matching

Dec 19, 2017 12:06pm
ONC has co-developed a framework to help providers improve patient data matching.
ONC has launched a new patient demographic tool aimed at helping organizations match patient data to prevent errors. 
The Department of Health and Human Services Office of the National Coordinator for Health IT partnered with the Pittsburgh-based CMMI Institute to develop the Patient Demographic Data Quality framework, which seeks to better match patient data both internally and between different organizations, according to an announcement

Finance executives bullish on health IT investment in 2018

Dec 19, 2017 11:35am
Healthcare finance executives have lofty expectations for the health IT sector over the next two years, according to a new survey.
More than half of executives expect health IT and data to see “a lot” of investment activity in 2018 and 2019, outpacing other notable industries like pharma and biotech and health system operations. Eighty-five percent of respondents said health IT will experience modest or high growth in the coming years, according to a survey conducted by KPMG and Leavitt Partners that included feedback from 265 finance executives at healthcare corporations across the industry.

Mayo expands, improves telemedicine network

TRIBUNE CONTENT AGENCY Published 4:00 p.m. CT Dec. 17, 2017
ROCHESTER — Dr. Sean Caples doesn't claim to be the Wizard of Oz, but there are some striking similarities.
Tucked away at Mayo Clinic's command center in downtown Rochester, Caples has pulled the strings at Mayo's enhanced-intensive care unit since its inception in 2013. Using video monitors and advanced technology, his specialized team monitors ICU patients from eight regional sites as a key part of Mayo's foray into telemedicine.
While telemedicine once was viewed with some skepticism, the results at Mayo have been nothing short of, well, magical.
Caples has emerged from behind the curtain, so to speak, to discuss the intricacies and success of his burgeoning program.

New MRI contrast agent offers a way to detect inflammation

Published December 19 2017, 2:59pm EST
Researchers at Binghamton University and Temple University have developed a new nanoparticle-based contrast agent for MRI imaging that could help physicians more accurately detect inflammation in the body, which is common to many diseases.
Chronic inflammation can ultimately cause several conditions including heart disease, according to Amber Doiron, research assistant professor in the biomedical engineering department at Binghamton University.
However, the new contrast agent—interpolymer complex-superparamagnetic iron oxide nanoparticles—is meant to detect inflammatory diseases sooner while pinpointing where the inflammation is in the body via an MRI scan, she contends.
Dec 15, 2017 @ 07:30 AM 1,362 The Little Black Book of Billionaire Secrets

The Real Threat Of Identity Theft Is In Your Medical Records, Not Credit Cards

Post written by Robert Lord
Co-Founder and President of Protenus, an analytics platform that detects inappropriate activity in healthcare institutions.
The 2017 holiday season has been complicated by data breaches that have plagued consumers all year long, such as the massive Equifax hack. As a result, consumers must worry about fraud and the misuse of our financial information during a time of increased financial transactions, tight budgets and heightened stresses. 
In 2016, there were 3 million consumer credit card complaints, 42% of them fraud-related and 13% connected to identity theft. A huge number of incidents to be sure, with nearly 1% of the total U.S. population having such an issue during the year.
However, there’s a much greater threat to our personal data that few are thinking about at all. That threat is the theft and sale of our health records on the black market, a thriving business with “dark web” online stores that don’t look much different from an Amazon marketplace. In fact, there were nine times more medical than financial records breached in 2016 — 27 million — representing nearly 10% of the U.S. population.

ONC posts patient-data matching best practices framework

The framework's five categories include data governance, data quality, data operations, platforms and standards and supporting processes.
December 15, 2017 02:01 PM
The Office of the National Coordinator for Health IT published the Patient Demographic Data Quality Framework of best practices for data management processes that enable hospitals to more effectively match patient records.
Developed in conjunction with Pittsburgh-based CMMI Institute and the Department of Health and Human Services, the tool arrives after CHIME announced in November it would abandon its two-year effort to resolve this issue with its National Patient ID Challenge.
ONC’s goal is to boost patient safety by accurately and consistently matching patient data internally as well as between organizations.

AHIMA releases 17 steps to cybersecurity as attacks increase

The information management group has compiled a comprehensive, 17-step plan that leads provider groups through a series of actions, both proactive and reactive, meant to sharpen their cybersecurity posture.
December 15, 2017 01:00 PM
In response to an ever-worsening cybersecurity environment in healthcare, with an increasing number of cyberattacks on hospitals, health systems and clinics, the American Health Information Management Association has issued new cybersecurity guidelines for healthcare professionals to reference as they seek ways to implement cybersecurity prevention measures.
These include actions that can be started immediately as well as comprehensive efforts that require more long-term commitments. The roadmap, tittled, AHIMA Guidelines: The Cybersecurity Plan, was primarily authored by Kathy Downing, vice president, information governance, informatics, privacy and security, at AHIMA, who has the apt Twitter handle @HIPAAQueen.

HHS and CDC push back on reports that Trump administration has banned words like 'science-based'

Dec 18, 2017 12:15pm
The Trump administration wants the CDC to avoid using words like "fetus" and "transgender," according to a new report.
The Trump administration has submitted a list of terms to several HHS agencies that they should avoid in draft documents for next year's budget, according to a new report. 
Multiple agencies within the Department of Health and Human Services were instructed to avoid using terms like "entitlement," "diversity" and "vulnerable" in their budget documents, sources told The Washington Post. The Centers for Disease Control and Prevention received a list of seven banned words that included "fetus," "transgender," "evidence-based" and "science-based," according to the article. 

Medical device cybersecurity critical for patient safety

News and Features Writer

At RSNA 2017, an expert warns that insecurity of medical devices, including imaging hardware, threatens patient safety. A security director tells how Mayo Clinic protects devices.

CHICAGO -- Healthcare providers, awakened to the need for cybersecurity, are locking down protected health data, but now pervasive medical device cybersecurity weaknesses are posing potentially lethal threats to patient safety.
At the RSNA 2017 medical imaging conference, a health IT and radiology expert warned of what he said is a general obliviousness to medical device cybersecurity among many vendors, and providers.

New FDA Web Page Has Latest Info on Best Antibiotic Choice

Megan Brooks
December 14, 2017
As part of ongoing efforts to combat antimicrobial resistance, the US Food and Drug Administration (FDA) has created a Web page to provide constant, up-to-date information for clinicians on antimicrobial drug susceptibility.
The Web page will provide "direct and timely" access to information about when bacterial or fungal infections are likely to respond to a certain drug, the FDA said in a news release. The goal is to help providers make more informed prescribing decisions that will benefit their patients and help prevent the spread of resistant bacteria.
Susceptibility test interpretive criteria, also known as "breakpoints," help determine whether specific bacteria or fungi are susceptible to antibacterial or antifungal drugs. Changes in bacteria and fungi over time may result in decreased susceptibility to some drugs. When this occurs, breakpoints have to be updated.

Rochester Regional Health uses EHR to slash bloodstream infection rate 65%

Published December 18 2017, 7:25am EST
Rochester Regional Health, an integrated healthcare delivery system serving Western New York and the Finger Lakes region, has reduced its central line-associated bloodstream infections rate by 65 percent over the last two years using its Epic electronic health record system.
According to the Centers for Disease Control and Prevention, there are about 250,000 central line-associated bloodstream infections (CLABSI) events annually, which cost the healthcare industry more than $1 billion to treat. This severe form of blood infection can lead to death for patients.
However, by leveraging the full value of their EHR data and streamlining clinical workflows, Rochester Regional Health went from a rate of 1.0 per 1000 infections per 1,000 central line days in 2015 down to 0.35 infections per 1000 in 2017—with zero infections in July and August of this year.

HIT Think How natural language processing will help achieve a payback on EHRs

Published December 18 2017, 4:47pm EST
One of the most talked-about buzzwords in healthcare is natural language processing. While NLP has carried some industry weight for a while, many think the practical applications and impact of NLP haven’t lived up to the hype.
So why are all of the organizations we are talking with about risk adjustment asking about natural language processing and wanting this capability? The answer: If done correctly, NLP can offload burden from physicians, enhance accurate risk capture and impact care delivery in a big way.
Natural language processing is the process by which computer algorithms pull out key elements and mine meaning from large amounts of unstructured, hand-typed or dictated notes within an electronic health record. Unlike text dictation platforms, NLP processes unstructured text and converts it to structured data that can be used to drive analytics and clinical action.