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."

Saturday, January 20, 2018

Weekly Overseas Health IT Links – 20th January, 2018.

Here are a few I came across last week.
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.

Leverage AI to revolutionize and advance healthcare

We chat with Andy Bartley, health and life sciences solution architect, Intel Corporation.
By Intel
January 11, 2018 09:37 AM

What is Intel doing in the area of artificial intelligence/machine learning?
Artificial intelligence is causing a technological revolution. Intel recognizes the power AI has to transform society and industries. We are committed to democratizing AI and machine-learning innovations so that everyone has the opportunity to benefit. To that end, we’ve been doing a number of things:
• Understanding the importance of integrating hardware and software advances to create AI experiences, we have invested in acquiring companies that are innovating around the hardware and the software driving intelligent applications – companies such as Nervana, Saffron, Movidius and Mobileye.
• We launched an AI products group that offers a broad palette of AI technologies to meet diverse needs. This group focuses on solutions that make it easy to incorporate custom AI solutions into existing infrastructure. These solutions let us create intelligent ecosystems that seamlessly connect applications and devices across the spectrum, allowing people and businesses to make better use of audio, video and text wherever they are.

FDA maintains its focus on digital health in 2018

Jan 12, 2018 11:36am
After what was widely viewed as a groundbreaking year for digital health oversight, the Food and Drug Administration plans to maintain its focus on easing the pathway for innovative technology and devices.
Advancing digital health is one of several priorities for FDA in the coming year, according to a 2018 Strategic Policy Roadmap released (PDF) by the agency on Thursday that identified four priority areas “that will be the focus of additional policy activity in 2018.”
In particular, the FDA plans to publish finalized guidance clarifying when digital health technology falls under the FDA’s regulatory purview and when the agency plans to exercise enforcement discretion. Unsurprisingly, the agency also plans to advance its software precriticization program after launching a pilot program in September involving nine companies including Apple and Fitbit.

4 Ways IBM Watson's Artificial Intelligence Is Changing Healthcare

Future, shmuture. IBM's presentation at the J. P. Morgan Healthcare Conference showed that artificial intelligence is changing healthcare today.

Keith Speights
Jan 12, 2018 at 6:04AM
Some say that artificial intelligence (AI) will radically change healthcare in the future. And they're right. But that prediction overlooks an important detail: AI is already significantly changing healthcare.
IBM (NYSE:IBM) Watson Health general manager Deborah DiSanzo spoke at the annual J. P. Morgan Healthcare Conference on Wednesday. She provided an update on the progress that IBM Watson, the AI system famous for beating Jeopardy! game show champions several years ago, is making in improving healthcare. DiSanzo highlighted four areas where AI is making a big difference today.

HIT Think 6 ways EHRs give time back to nurses

Published January 12 2018, 4:51pm EST
Nurses are on the front line of care, and as inpatients' conditions become more complex and time-intensive, these clinicians need more help. Unfortunately, many believe that the documentation and record-keeping requirements of electronic health records systems don't help make their jobs easier.
Pushback against EHRs, then, is to be expected. However, healthcare organizations can make better use of the tools within integrated EHR systems to help nurses become more efficient.
Here are some of the key capabilities of EHR systems that can provide time gains, and operational improvements, for nurses.

Trump executive order to aid rural broadband will help providers

Published January 11 2018, 7:09am EST
President Trump has signed an executive order directing federal agencies to “use all viable tools” to accelerate the deployment and adoption of high-speed broadband connectivity in rural parts of the country, a directive that’s expected to offer a boost to healthcare facilities.
“Americans need access to reliable, affordable broadband internet service to succeed in today's information-driven global economy,” states the executive order published today in the Federal Register. “Currently, too many American citizens and businesses still lack access to this basic tool of modern economic connectivity.”
This lack of access to high-speed Internet services in rural America hinders the ability of communities to “extend the reach of affordable, high-quality healthcare,” according to the order. By increasing rural provider access to modern broadband internet service, the Trump administration hopes to overcome some of the hurdles to healthcare delivery in these isolated and underserved communities by enabling clinicians to leverage broadband-enabled health technologies.

ONC’s new chief privacy officer plans to use past experience to 'zone in' on emerging issues

Jan 11, 2018 9:56am
As the new chief privacy officer at the Office of the National Coordinator for Health IT, Kathryn Marchesini will confront an entirely new set of health IT privacy challenges, a growing number of industry players that fall outside HIPAA's purview and legislative mandates under the 21st Century Cures Act.
And she’ll have to do it with a potentially nonexistent privacy budget.
Three months after ONC’s former chief privacy officer Deven McGraw left the Department of Health and Human Services, the agency is handing the position to Marchesini, a seasoned privacy veteran with experience at several agencies within HHS, to navigate those privacy and security concerns.

Patients, Providers Need to Discuss E-Comm, Researchers Say

January 10, 2018
by Rajiv Leventhal
The relationship that a clinician has with a patient may have a greater impact on patient satisfaction than any technology that used to interact with one another, according to new research.
A new study led by Joy L. Lee, Ph.D., of the Regenstrief Institute's Center for Health Services Research compares these ways to communicate, compared how patients and their healthcare providers communicate with one another outside the clinic or doctor's office, specifically looking at how patients and their physicians feel about email, cell phone and text interactions.
The study, published in the European Journal for Person Centered Healthcare, also looked into provider concerns, finding that physicians worried most about patients potentially missing urgent messages, as well as possible patient misunderstanding of information contained in electronic messages. Clinicians were also concerned about the amount of time they spent on electronic communication with patients, and about data security, although both ranked lower.

HIT Think Why data on social determinants of health is growing in importance

Published January 11 2018, 5:14pm EST
According to the Centers for Disease Control, social determinants of health have a profound impact on health outcomes – much more, in fact, than the actual delivery of healthcare services.
The health of people and communities is heavily influenced by such factors as socioeconomic status, education, social network support, access to care, access to transportation and employment. Therefore, organizations that are committed to improving the health of populations should not overlook the social and economic conditions impacting the well-being of individual members.
Healthcare is continuing to shift from fee-for-service payment models to models that reward providers for delivering high-quality, cost-effective care. To achieve clinical and financial success in a value-based care world, providers need deep insights into the health of their patient populations.

Telemedicine Improves Rural ER Response Time

John Commins, January 11, 2018

Among patients who were transferred to other hospitals, the length-of-stay at the emergency room in the first hospital was shorter for patients who had telemedicine consults.

Emergency department patients at rural hospitals using telemedicine see a clinician six minutes sooner than patients in hospitals that have no such technology, a new study from University of Iowa shows.
And if that first clinician assessment is through a telemedicine encounter, as was the case 42% of the interactions examined in the study, the door-to-provider time is shortened by nearly 15 minutes, says study lead author Nicholas Mohr, MD, an emergency physician and associate professor at the Carver College of Medicine at the University of Iowa.

Pew to ONC: Expand data access through APIs

The nonprofit is asking Health IT to define the elements used in application programming interfaces and consider adding information from medical devices, genomic data and social determinants.
January 10, 2018 09:03 AM
The Office of the National Coordinator for Health IT should expand data available to patients and providers via APIs, going beyond common clinical data sets, Pew Charitable Trusts Manager of Health Information Technology Ben Moscovitch told ONC Chief Donald Rucker, MD, in a letter.
To Moscovitch, while CCDs contain key information on patient medical histories like allergies and medication, they omit essential data relevant to care.
Under the 21st Century Cures Act, the ONC is required to support API development to help health systems share more patient data with other networks. However, it fails to explain what information should be included.

EHRs in the cloud: Why smaller healthcare providers are making the leap

Providers say flexible platforms help them to prepare for population health management and value-based care.
November 28, 2017 09:25 AM
Add one more to the growing list of healthcare providers moving their EHRs into the cloud. Coastal Orthopedics in Conway, South Carolina, consolidated its legacy electronic health records and practice management systems into the cloud and is seeing tangible results already. 
Hospitals of various sizes, including University of California San Diego and UC Irvine Health just this month, have opted for cloud-based EHRs recently. On the smaller end of the provider scale, Lost Rivers Medical Center in Arco, Idaho, and Faith Community Hospital in Jacksboro, Texas, have also moved their EHR and related software into the cloud. 
While UCSD and UC Irvine Health are running Epic’s EHR in a private cloud on the vendor’s campus, Coastal Orthopedics went with athenahealth. 

Survey: 16 Percent of Ambulatory Physicians Looking to Replace EHR Vendor

January 9, 2018
by Heather Landi
It is widely known that many physicians are dissatisfied with their electronic health record (EHR) system and a new survey examines EHR satisfaction according to physicians. The survey found that 11 percent of physicians working in acute facilities and 16 percent of physicians working in ambulatory facilities are looking to replace their vendor.
Reaction Data, an American For,k Utah-based firm that provides Research as a Service, conducted an EHR satisfaction survey with feedback from close to 900 physicians. Reaction Data’s research report, based on survey results from 889 physicians across many specialties, also drills down into the 10 most used EHR companies and indicates those vendors’ acute and ambulatory user rates, average facility bed count, average facility revenue and facility type.
The survey reflects the opinions of physicians in numerous specialties—21 percent are pediatricians, 12 percent specialize in internal medicine, 11 percent specialize in anesthesiology, and the remaining cited specialties such as psychiatry, emergency medicine, orthopedic surgery, family medicine, neurology, urology and endocrinology.

Four Key Themes for CIOs in 2018

Key themes for CIOs for 2018 include many of the same themes seen at the beginning of 2017, but with differing priorities. For example, the significance of agile development has been known for decades, but others in the organization, including fellow C-suite executives, have only just begun to realize its importance to the bottom line. Agility moves up this year in importance for CIOs and CEOs alike, as demands for speed and productivity continue to drive agility and innovation in both software development and business operations.
As IT departments will continue to have to do more with less, CIOs are shifting priorities, focusing more on the digital ecosystem to meet demands for connected lifestyles. Budget constraints have driven IT departments to innovation, despite slowing the market a bit, and to finding ways to accomplish what needs to be accomplished in the leanest, most cost-effective ways possible. Behind every great business though, are great customers, and so as part of cost-saving ways to meet customer needs and bring products and services to market faster, increased customer interaction tops this year’s list of four key themes for CIOs in 2018.

Cerner names Philips leader Brent Shafer as CEO

Shafer takes over the position left vacant after the death of co-founder Neal Patterson.
January 10, 2018 05:04 PM
Brent Shafer will take the helm at healthcare IT giant Cerner on February 1, the company announced today. He will also lead the board of directors as chairman.
Formerly, Shafer served as CEO of Philips North America. Over 12 years, he played a key role in helping Philips develop and strengthen its healthcare focus, increase its profitability and grow its market share, Cerner officials noted in announcing the move. 
At Philips North America, Shafer oversaw the largest market of global technology, a portfolio that includes a wide range of solutions and services covering patient monitoring, imaging, clinical informatics, sleep and respiratory care as well as a group of market-leading consumer-oriented brands.

Telemedicine program reduces ER visits for students with asthma

Published January 10 2018, 7:20am EST
The University of Rochester Medical Center has partnered with the Rochester City School District to ensure that students with asthma receive the appropriate medication therapy through a telemedicine approach that enables visits from the children’s primary care providers to aid in-school nurses.
“We know that asthma is a significant problem particularly for kids living in the city in terms of causing ongoing symptoms, missed school days and emergency visits,” says Jill Halterman, MD, chief of the Division of General Pediatrics at URMC. “We also know that a lot of kids aren’t getting medications that might have prevented these symptoms.”
In a study, URMC and researchers from Johns Hopkins School of Medicine and University of Arkansas for Medical Sciences enrolled 400 students between the ages of 3 and 10 in Rochester, N.Y., to measure the impact of a school-based intervention—including supervised asthma therapy and telemedicine visits—on urban children with asthma.

Providers are still struggling to exchange data on patients

Published January 10 2018, 5:07pm EST
The healthcare industry is making a push for true interoperability that would offer the seamless exchange of healthcare information among clinicians, administrators, patients and other stakeholders.
While various standards and organizations exist to promote data exchange—known by an alphabet soup of acronyms, including HL7, FHIR, DICOM, NCPDP, IEEE and LOINC, among others—physicians still struggle, particularly impeded by a barrage of free text and PDF files that must be manually entered into the electronic health record system, says Dave Lareau, CEO at Medicomp.
Too often, data in various file formats is not actionable, Lareau contends. “It’s up to the recipient to sort through the data sent and find the data they care about for the patient in front of them.”

HIT Think Why tech giants won’t solve all of healthcare’s IT ills

Published January 10 2018, 5:20pm EST
Healthcare’s IT challenges are numerous and widely known—there are multiple issues with interoperability, exploding quantities of data, security and usability, just to name a few.
To date, health IT largely has been the domain of specialized vendors whose names—Epic, Cerner, Allscripts, and Meditech, among others—are familiar primarily to providers and others in the healthcare IT industry.
But now, global technology giants such as Google, Apple and Amazon are either announcing or at least hinting at plans to enter the market. With the best of the best in the IT world joining the fray, optimism typically rises that vexing problems, such as interoperability and usability, will be solved in the near future.

EHR Sector Poised to Consolidate

John Commins, January 10, 2018

Meaningful use mandates for electronic health records under the HITECH Act have largely been met, or at least initiated, by most payers and providers, which means that software vendors will have a smaller customer base, and less room to grow.

The widespread adoption of electronic health records by payers and providers in recent years means fewer customers for software vendors, and that could lead to significant consolidation within the EHR sector, according to a report by Standard & Poor’s Global Ratings.
"The high degree of penetration, and the resultant decline in the new customer base, has spurred industry consolidation as leading participants seek new avenues for revenue growth, including enhanced features and capabilities to existing products," S&P analyst Sarah Kahn said.

IoT risks, insider threats, password hacks, biometric cracks: Cybersecurity in 2018 looks messy

A new report from Aon's security experts predicts more and different cyberattacks, and highlights the pressing need for healthcare organizations to change some of their approaches.
January 08, 2018 02:47 PM
Some organizations have been implementing new methods of authentication beyond passwords - from facial recognition to fingerprints. 
Ramped-up attacks on the healthcare Internet of Things. More success with cracking passwords and biometrics. Increased risk from insider attacks. A heightened need for chief risk officers. This is what 2018 will look like on the cybersecurity front, according to professional services firm Aon's industry specialists in its new 2018 Cybersecurity Predictions report.
"In 2018, we anticipate heightened cyber exposure due to a convergence of three trends: first, companies' increasing reliance on technology; second, regulators' intensified focus on protecting consumer data; and third, the rising value of non-physical assets," said Jason Hogg, CEO of Aon Cyber Solutions.

Digital Health Year in Review: 2017 Trends and Looking Ahead to 2018

Tuesday, January 9, 2018


Throughout 2017, the health care and life science industries experienced a widespread proliferation of digital health innovation that presents challenges to traditional notions of health care delivery and payment as well as product research, development and commercialization for both long-standing and new stakeholders. At the same time, lawmakers and regulators made meaningful progress toward modernizing the existing legal framework in a way that will both adequately protect patients and consumers and support and encourage continued innovation, but their efforts have not kept pace with what has become the light speed of innovation. As a result, some obstacles, misalignment and ambiguity remain.

Privacy and Cybersecurity

Cybersecurity continues to be one of today’s most material and pervasive enterprise risks, and is faced by all stakeholders who are active in the digital health ecosystem. That risk will continue to escalate with the rapid demand for and proliferation of collaborations and other initiatives to promote patient and consumer engagement through digital health mobile wellness and disease management apps that collect unstructured, identifiable health care and personal information from providers, patients, consumers and others. In this context, even a minor or inadvertent violation of the law could result in significant fines and penalties, reputational harm and loss of user trust. Management of this risk demands relentless diligence in identifying and assessing risks under applicable federal and state laws and establishing, maintaining, assessing and improving privacy and cybersecurity compliance and risk management programs that include, among other things, a thorough and well-tested cybersecurity breach or cyberattack preparedness response plan.

NH-ISAC Cybersecurity Warning Shows Importance of Regular Updates

A recent cybersecurity warning from NH-ISAC further underlines why healthcare organizations must implement regular updates and patches.

January 08, 2018 - The National Health Information Sharing and Analysis Center’s (NH-ISAC) Threat Intelligence Committee released a cybersecurity warning last week urging entities to be aware of two potential vulnerabilities.
Researchers determined that Meltdown and Spectre could circumvent certain protections and expose “nearly any data the computer processes, such as passwords, proprietary information, or encrypted communications.”
“Meltdown affects Intel processors, and works by breaking through the barrier that prevents applications from accessing arbitrary locations in kernel memory,” stated the warning, which AHA posted on its website. “Segregating and protecting memory spaces prevents applications from accidentally interfering with one another’s data, or malicious software from being able to see and modify it at will. Meltdown makes this fundamental process fundamentally unreliable.”

Report: Ransomware Attacks Against Healthcare Orgs Increased 89 Percent in 2017

January 8, 2018
by Heather Landi
The number of reported major IT/hacking events attributed to ransomware by health care institutions increased by 89 percent from 2016 to 2017, according to cyber defense firm Cryptonite’s 2017 Healthcare Cyber Research Report, which used data reported to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR).
The research conducted by Rockville, Md.-based Cryptonite looks at healthcare cyber attack activity last year and finds that 2017 was a very challenging year for healthcare institutions as these organizations remain under sustained attack by cyber attackers that continue to target their networks through the use of well understood vulnerabilities. According to the report, there were a total of 140 data breach events characterized and reported to HHS OCR as IT/hacking in 2017, representing an almost 24 percent increase over the 113 IT/hacking events reported in 2016. For an historical view, there were 57 reports for IT/hacking in 2015 and 35 reports in 2014.

Kaiser's 'Pit Crew' Treats 87% of Stroke Patients in 60 Minutes or Less

Alexandra Wilson Pecci, January 9, 2018

Kaiser Permanente's coordinated telemedicine response workflow slashes ‘door-to-needle’ time for stroke patients.

Telemedicine is at the heart of a complete workflow redesign of the way stroke alerts are handled across Kaiser Permanente's 21 Northern California hospitals, resulting in new stroke patients being treated twice as fast as the national average, according to a study.
American Heart Association and American Stroke Association guidelines recommend a "door-to-needle" time of 60 minutes or less for administering intravenous r-tPA, also known as alteplase, a drug that dissolves the stroke-causing clot and restores blood flow to the brain.
A study in the journal Stroke compared door-to-needle times for six months before implementation of the telemedicine program to a six-month calendar period after implementation. It showed that across the 21 hospitals, the average treatment time for intravenous r-tPA was 34 minutes. The study also showed that:
  • 87% of stroke patients were treated in 60 minutes or less
  • 73% were treated in 45 minutes or less
  • 41% were treated in under 30 minutes

Akiri to offer blockchain platform to securely share data

Published January 08 2018, 7:30am EST
A new company formed out of an incubator backed by the American Medical Association hopes to build a network as a service platform that will use blockchain technology to move healthcare information.
Akiri, based in San Francisco, is working on using information technology to develop its platform to securely share information with participants, using the capabilities of blockchain to build a network of trusted partners to exchange data.
Blockchain is a distributed ledger technology implemented in a decentralized manner used to record transactions.

As ONC searches for a chief privacy officer, new priorities put the agency at a crossroads

Jan 8, 2018 9:17am
Nearly three months after losing its chief privacy officer, the Office of the National Coordinator for Health IT says it is actively looking for a replacement in order to comply with a legislative mandate that requires the federal agency to fill the leadership position. 
But ONC also finds itself at a crossroads, facing a potentially slimmer budget along with new privacy considerations that have evolved over the past decade, according to several privacy experts and former government officials who spoke with FierceHealthcare.
Some, like former chief privacy officer Deven McGraw, said the agency could replace the position with ongoing collaboration with OCR, while others said the agency would benefit from a "seasoned" leader who can navigate new data privacy concerns associated with mobile devices, precision medicine and consumer access.

Allscripts to acquire Practice Fusion for $100M

Jan 8, 2018 10:11am
Allscripts announced it will purchase EHR vendor Practice Fusion for $100 million, expanding its portfolio of solutions geared toward small physician practices and ambulatory clinics.
The acquisition was announced in an SEC filing on Friday. Allscripts expects to complete the transaction by the end of the first quarter following a waiting period required under antitrust laws. The filing also hints at a civil investigation into Practice Fusion’s EHR certification.
The deal comes on heels of Allscripts’ $185 million acquisition of McKesson’s health IT portfolio, including Paragon, which is geared towards the small hospital market. Practice Fusion, which is used by 30,000 ambulatory practices, expands Allscripts’ focus on ambulatory care provider and physician practices.

SHIEC expands 'Patient Centered Data Home' initiative, linking HIEs nationwide

The national rollout from The Strategic Health Information Exchange Collaborative enables hospitals and patients to more easily share health data.
January 05, 201801:22 PM
The Strategic Health Information Exchange Collaborative announced a nationwide expansion of what it calls the Patient Centered Data Home.
Essentially, PCDH is an inter-HIE data sharing system and notification that allows patients' records to follow them wherever they seek care, nationwide – enabling easier access to their records, even if they present at a hospital or clinic that's not a part of the HIE in which their local providers participate.

ONC's draft interoperability framework floats 'network of networks' concept

The Trusted Exchange Framework, required by the 21st Century Cures Act, includes a common agreement of exchange procedures.
January 05, 2018 03:08 PM
The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology released the much anticipated Trusted Exchange Framework to bolster its interoperability work as required by the 21st Century Cures Act.
“This is really a network of networks concept,” ONC head Donald Rucker, MD, said during a press call Friday.
The proposed framework establishes a set of minimum requirements and conditions for a trusted exchange and attempts to streamline patient data access and exchange provisions set out in the 21st Century Cures Act.

Education is key to getting patients to share electronic medical records

By making patients more aware of existing privacy policies and security measures, healthcare providers create an environment where patients are more likely to share.
December 05, 201712:53 PM
Education is the key to getting patients to share their medical records electronically with healthcare providers, according to a new study from the University at Buffalo School of Management.
Published in the Journal of Medical Internet Research, the study found that while patient education has typically focused on the benefits of electronic records, privacy concerns are what keep most from signing up.
That dynamic has the potential to make things complicated. When a patient decides not to share their records in that manner, costs can often increase, the study found. Medical errors and poorer health outcomes are also more common. 

ONC Releases Trusted Health Data Exchange Framework Draft

The health data exchange framework is open for public comment until February 18.

January 05, 2018 - ONC recently announced the release of its Trusted Exchange Framework and Common Agreement draft intended to advance health data exchange and interoperability.
“This is really the network of networks concept,” said National Coordinator for Health IT Don Rucker, MD, in an ONC media call.
The proposed framework is designed to streamline patient health data access and exchange per provisions of the 21st Century Cures Act. ONC has been working to develop the framework and common agreement since the summer of 2017 through a series of stakeholder meetings.

First major phase of Berkshire’s shared care record goes live
11 January 2018
The first major phase of Berkshire’s shared care record initiative has gone live across 18 health and social care organisations.
New computer system Connected Care brings together key health and care patient information, building on Graphnet’s CareCentric shared record software. The shared care record programme has been dubbed Share Your Care.
The first phase of the system enables the sharing of  information across two different Sustainability and Transformation Partnerships (STPs), covering 98 GP practices, 18 health and social care organisations including Royal Berkshire NHS Foundation Trust and Berkshire Healthcare NHS Foundation Trust, and two local authorities.
PAS and pathology – the problem with old systems
9 January 2018
Many hospitals will have two systems at the core of their IT through nothing other than pure legacy. The first is a Patient Administration System (PAS) that largely came about to collect the NHS data model that arose out of the work of Edith Körner in the 1980s.
They will also have a pathology system that arose out of the fact that labs had analysers that were connectable and a naturally technically able workforce who wanted to join it up.
Both of these systems have in fact outgrown themselves for similar reasons. When people are doing things they look in the toolbox and see what they have. There’s a well known saying on this: if your tool is a hammer then every problem is a nail.

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