Saturday, January 27, 2018

Weekly Overseas Health IT Links – 27th 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.
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FDA approves clinical platform that predicts patient deterioration

Published January 19 2018, 7:24am EST
The Food and Drug Administration has approved a clinical monitoring platform that alerts hospital staff in near real time of a patient’s deteriorating condition using a predictive algorithm.
The WAVE Clinical Platform from Excel Medical acts as an early warning system that automatically calculates the risk of patient deterioration about six hours before the patient actually worsens, enabling clinicians to take corrective action before it’s too late to intervene.
According to Mary Baum, chief strategy officer for Excel Medical, WAVE is designed to eliminate unexpected deaths in U.S. hospitals which take the lives of more than 400,000 Americans each year and is the country’s third-leading cause of death.
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Allscripts hit with a ransomware attack affecting a 'limited number' of applications

Jan 18, 2018 4:12pm
This story has been updated to include comments from Northwell Health. 
Allscripts is investigating a ransomware attack impacting a "limited number" of applications, according to a company spokesperson.
“We are working diligently to restore these systems, and most importantly, to ensure our clients’ data is protected,” Allscripts spokesperson Concetta Rasiarmos said in an email to FierceHealthcare. “Although our investigation is ongoing, there is currently no evidence that any data has been removed from our systems. We regret any inconvenience caused by this temporary outage.”
Rasiarmos did not respond to questions about what specific applications were impacted.
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Can mHealth Make the Connection Between Providers and Minorities?

Two new studies report that minorities are much more likely to access mHealth information on smartphones.This may be the link doctors need to create effective population health outreach.

January 18, 2018 - Healthcare providers looking to connect with minorities should develop an mHealth strategy that focuses on the smartphone.
That’s the takeaway from a pair of studies published this month in the American Journal of Managed Care. The studies – one focusing on the variation of devices used to access patient portals and the other examining mobile access to personal health records – found that black and Hispanic populations use smartphones far more often than non-Hispanic whites to access mHealth data, and in many cases  that’s the only device they use.
The studies offer guidance on how to reach underserved populations, as well as offering a warning that mHealth programs now in place may be missing their target patients.
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EHR Data Useful for Measuring Low-Value Clinical Service Overuse

Research shows analyzing EHR data can help identify the prevalence of unnecessary or low-value testing and clinical services.

January 19, 2018 - EHR data can be useful for accurately measuring overused clinical services and low-value testing, according to a recent study published in the American Journal of Managed Care (AJMC).
A research team led by Thomas Isaac, MD, extracted performance information on 13 healthcare services. The services were identified by the Choosing Wisely campaign using EHR data at a large physician practice group from 2011 to 2013. The Choosing Wisely campaign identifies health services that are frequently ineffectual to help providers cut back on unnecessary testing.
In addition to using EHR data to measure rates of clinical services overuse, researchers also manually reviewed charts for 200 cases of overuse for each measure to see if tests had been ordered due to clinical risk factors.
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Report: Best practice programs foster better physician notes

Written by Julie Spitzer | January 18, 2018 | Print  |
Physicians take higher-quality and more efficient notes when they receive education and guidelines that emphasis note-taking best practices, according to a UC-Los Angeles study.
For the study, Neveen El-Farra, MD, and Daniel Kahn, MD, distributed note-taking templates that incorporated best practices at four academic internal medicine residency programs. Residents received both a brief educational conference and the electronic progress note template, which included an inpatient checklist for documenting patient concerns, quality measures and discharge planning. The template offered physicians a way to minimize the use of common efficiency tools — including the auto-population of notes — and instead, encourage them to enter only relevant information.
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EHR Use, Administrative Burden Accelerating Physician Burnout

A response to a recent study of family physician burnout points the finger at increased EHR use and administrative burden.

January 16, 2018 - In response to a new study about high levels of physician burnout among family physicians, Ohio State University Wexner Medical Center family physician Donald O. Mack, MD, suggested the recent transition to a value-based care system and increased EHR use may have augmented the problem.
“Burnout is associated with lower patient satisfaction and care quality, higher medical error rates and malpractice risk, higher physician and staff turnover, physician substance abuse/addiction, and physician suicide,” he wrote.
“The causes are numerous, and in many cases physicians point to the increasing demands of electronic medical records, quality metrics, administrative tasks such as prior authorization, and value-based payment requirements, which take time away from direct clinical care,” Mack continued.
Mack’s commentary came in response to a recent study by Hansen et al. that showed levels of physician burnout vary significantly between states, with Michigan and Minnesota physicians reporting the highest rates of exhaustion.
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Cloud use spurs concerns about data security, access and complexity

Published January 18 2018, 4:22pm EST
Security, management and compliance challenges are impacting the benefits that organizations are receiving from using the cloud, as their infrastructures become more complex, according to a report by WinMagic, a data security provider.
Some 39 percent of respondents surveyed for the research reported that their infrastructure was more complex since they began using the cloud. More than half—53 percent—spend more time on management tasks than they have done previously.
WinMagic surveyed 1,029 IT decision makers in the U.S., U.K., and Germany in November, and found that the vast majority of the organizations (98 percent) reported using the cloud, with an average 50 percent of their infrastructure now in the cloud. One third reported that data is only partially encrypted in the cloud, and 39 percent admitted to not having unbroken security audit trails across virtual machines in the cloud, leaving them exposed.
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ONC: Rise of Alexa, frustrations with legacy systems giving healthcare AI a boost

But the advisory group says acceptance in clinical practice, the ability to leverage personal devices and the availability of quality data are still challenges.
January 17, 2018 02:49 PM
Artificial intelligence has been hyped as much, if not more, than just about any other major technological advancement in recent history — and that is at least as true in healthcare today as it is elsewhere.
But is this time different for AI or will the hype fade away again in the near future?
“The use of artificial intelligence in health and healthcare is promising – and doable,” officials wrote on ONC’s HealthITBuzz blog. 
That’s the conclusion to come out of a new report posted by the Office of the National
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Scientists say artificial intelligence will deliver results in healthcare

Published January 17 2018, 4:46pm EST
Artificial intelligence is starting to play a transformational role in the healthcare industry, even if opportunities for using it are just beginning to be explored.
That’s an initial finding of a new report from JASON, an independent group of scientists advising the federal government on science and technology issues. The Department of Health and Human Services and the Robert Wood Johnson Foundation commissioned the report; the names of the scientists who developed the report are not being released.
Computers can match human competence in image recognition and, in some studies, can make diagnostic decisions on medical images that match or exceed the ability of clinicians. Technology is also getting better at speech recognition and natural language processing.
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Medical Boards Prioritize Opioids, Telemedicine

John Commins, January 17, 2018

Telemedicine, physician burnout, medical marijuana, and interstate medical licensure top the list of concerns for the nation’s state medical boards.

Opioid prescribing and telemedicine are the most important regulatory issues for state medical boards, according to an annual survey by the Federation of State Medical Boards.
"Our member boards play a central role in providing guidance to policymakers and healthcare professionals on how to navigate some of our nation's most pressing medical issues," said Humayun J. Chaudhry, DO, president and CEO of the FSMB.
"Anticipating these trends will help the FSMB provide boards with resources they need to address these challenges and continue their mission," Chaudhry said.
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Canadian Cerner EHR investigation finds install was mismanaged, underfunded

The Ministry of Health's second investigation into Nanaimo's EHR project found that managers failed to leverage advice that could have helped prevent some of those issues.
January 15, 2018 03:46 PM
The Vancouver Island Health Authority's electronic health record implementation has been fraught with controversy since its launch in March 2016. And the latest investigation, by British Columbia's Ministry of Health, stands by provider complaints: The Cerner project was mismanaged – neither properly planned nor implemented.
In fact, the report found that had officials leaned on advice or experiences from other Canadian EHR installs, many of the problems could have been prevented.
The Cerner project went live in March 2016 at Nanaimo Regional General Hospital, Dufferin Place Residential Care Centre in Nanaimo and Oceanside Health Centre in Parksville. But the launch was quickly denounced by many providers -- some even refused to use the technology. This led to Island Health creating some stiff enforcement policies.
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Study shows wearables lack clinical impact, but researchers haven’t lost hope

Jan 16, 2018 8:57am
New research shows that wearables and remote patient monitoring technology have a limited impact on clinical outcomes. But digital health researchers aren't ready to abandon the promise of mobile technology. 
A literature analysis published in the new Nature Partner Journal (npj) Digital Medicine reviewed 27 randomized control studies focused on wearable biosensors and found no statistically significant impact on factors like body mass, waist circumference, body fat percentage, and systolic and diastolic blood pressure. The study adds to a growing body of research indicating that clinical evidence has struggled to keep pace with the hype surrounding wearables.
However, digging into 16 “high-quality” remote patient monitoring studies, the researchers, from Cedars-Sinai Medical Center in Los Angeles, found pockets of promising evidence for certain conditions like obstructive pulmonary disease, Parkinson’s, hypertension and lower back pain. Even more specifically, interventions that use validated health behavior models and tailored coaching saw the highest success rates. In one study, monitoring technology had a significant impact on blood pressure for adults 55 and older.
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Study shows little evidence that wearable biosensors aid clinical outcomes

Published January 17 2018, 7:32am EST
While wearable biosensors have the potential to gather health data to support remote patient monitoring, there is a lack of medical evidence that these devices improve clinical outcomes.
Researchers at Cedars-Sinai Medical Center in Los Angeles note the popularity of wearable biosensors for health and fitness applications such as activity trackers, blood pressure monitors and sleep assessment. But, as Michelle Keller, clinical research specialist at the Cedars-Sinai Center for Outcomes Research and Education, contends, “There is a big difference between using these sensors to track sleep for self-betterment and using them to make medical decisions.”
While their analysis found that the wearable biosensors did show early promise in improving outcomes for certain conditions, including obstructive pulmonary disease, Parkinson's disease, hypertension and low back pain, researchers revealed that remote patient monitoring with these devices had no statistically significant impact on any of six reported clinical outcomes—body mass index, weight, waist circumference, body fat percentage, as well as systolic and diastolic blood pressure.
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Hospital pays $55,000 ransom; no patient data stolen

By Samm Quinn -

1/15/18 11:27 PM
GREENFIELD — Hancock Health paid a $55,000 ransom to hackers to regain access to its computer systems, hospital officials said.
Part of the health network had been held hostage since late Thursday, when ransomware locked files including patient medical records.
The hackers targeted more than 1,400 files, the names of every one temporarily changed to “I’m sorry.” They gave the hospital seven days to pay or the files would be permanently encrypted, officials said.
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Speech recognition for insulin bolus calculator improves postprandial glycemia

January 15, 2018
Patients with type 1 diabetes on insulin pump therapy who used an automatic bolus calculator designed to recognize voice descriptions of meals were more likely than those without the technology to have 2-hour postprandial glucose levels within the target range, according to findings reported in the Journal of Diabetes.
The VoiceDiab system consists of an Android-system smartphone with an app that communicates with a set of three servers, according to Piotr Foltynski, PhD, of the Nalecz Institute of Biocybernetics and Biomedical Engineering at the Polish Academy of Sciences in Warsaw, and colleagues. The servers are responsible for automatic speech recognition and transformation of the verbal description of meals into text, analysis of the textual description of the meal to determine its composition (ie, amount of protein, fat and carbohydrate), and calculation of the insulin dose compensating the meal, according to an algorithm.
“The primary reasons for the use of software applications in bolus calculation are technological opportunities and the reduction of errors in dose calculation by patients using bolus calculators,” Foltynski and colleagues wrote. “Low numeracy is associated with poor diabetes control; therefore, the use of bolus advisors may bring benefits to the patients.”
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AI-based computer model accurately analyzes kidney biopsy images

Published January 16 2018, 1:28pm EST
Boston University School of Medicine has developed computer models based on artificial intelligence that significantly improve the analysis of routine kidney biopsy images.
BU researchers, who conducted a proof-of-principle study on kidney biopsy sections, contend that their AI-based models have both diagnostic and prognostic applications and could lead to the development of software for diagnosing kidney disease as well as predicting kidney survival.
In the study, images processed from renal biopsy samples were collected on 171 patients treated at the Boston Medical Center and were analyzed by convolutional neural networks (CNN) models and nephropathologists, who specialize in the analysis of kidney biopsy images.
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'Explainable AI' Could Reduce Readmissions (and Win Clinicians' Trust)

Alexandra Wilson Pecci, January 16, 2018
This technology can accurately predict 30-day readmissions and clarify the AI process for clinicians.
Artificial intelligence (AI) has the potential to change the healthcare industry, but gaining the trust of clinicians to use it can be a barrier to adoption.
"A lot of the resistance from clinicians … is because people don't quite understand how [AI analytics] work," says Kamal Jethwani, MD, MPH, senior director of Connected Health Innovation at Partners HealthCare.
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In-Depth: News and views from CES 2018

January 12, 2018
Las Vegas was once again host to the annual CES conference (formerly known as the Consumer Electronics Show), and digital health players came out in force. Along with a roundup of all the device launches and announcements that caught our eye, MobiHealthNews has put together a primer on the biggest news and discussion points that came out of the trade show and its Digital Health Summit.
Big brands talk healthcare consumerization
Unsurprisingly, several of the conference’s participants were eager to talk about the impact consumerization has had on the industry. For certain companies, like Johnson & Johnson, that means creating health products and services that aren’t just useful, but also easy to stomach.
“It goes beyond just the care itself, which may be top quality, but all the pre- and post-care, administrative, and other aspects of it just feel like they are 100 years behind, where the rest of the economy isn’t,” Marc Leibowitz, global head of health technology and Johnson & Johnson, said during a roundtable session. “As leaders in the healthcare field, our mission is to borrow from the successful work that has been done in retail and other areas, and apply those in healthcare to enhance the overall experience.”
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Healthcare at CES 2018: Blockchain, Blue Button and interoperability among hot topics

Health data sharing, telemedicine, even federal value-based payment plans were all part of the excitement at the Consumer Electronics Show in Las Vegas.
January 12, 2018 02:23 PM
LAS VEGAS -- The tech world descended upon Las Vegas this week for the annual Consumer Electronics Show, and plenty of health IT’s biggest players were in attendance. While much of the discussion was on consumer-friendly health tools and novel digital interventions, there were still a handful of products and discussions between executives and entrepreneurs focused on healthcare’s largest roadblocks — namely, data management and analytics.
“Everyone loves playing in their own sandbox. How does it get to the point of sharing that data? How do we have EMRs being shared across systems today?” Pat Keran, VP of innovation and R&D at Optum Technologies, said during a roundtable discussion at CES’ Digital Health Summit. “I think data sharing is first and foremost, but even for the data that we have, how do we effectively analyze that today? How do we use artificial intelligence, deep learning, those types of things that are starting to evolve right now into being a lot more effective for where we’re at today?” 
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Doctors must stop blaming EHRs for clinical documentation shortcut failures

With copy and paste rampant, UW Health chief medical information officer Shannon Dean says toolkits and vendors can help, but physicians need to take responsibility for proper clinical documentation.
January 12, 2018 04:11 PM
Overuse of copy and paste in electronic health records is a problem. Sure, it's convenient. And it's entirely understandable why it's a common shortcut used by scores of physicians. But it often results in note bloat – unwieldy patient records overflowing with repetitive documentation – that can potentially lead to serious safety risks.
"Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error," wrote researchers in a 2017 study in Journal of the American Medical Association.
The practice of copy and paste has to be reigned in, and one chief medical information officer, writing for the Agency for Healthcare Research and Quality, says that has to start with the physicians themselves.
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Connecticut Supreme Court allows patients to sue providers for HIPAA violations

Jan 15, 2018 10:58am
Add Connecticut to the list of states that allow patients to sue providers for unauthorized disclosure of their medical records.
The Connecticut Supreme Court ruled last week that patients have the right to bring legal action against a provider. Other courts throughout the state have ruled that although HIPAA allows the federal government to issue penalties for violating patient confidentiality, the federal law does not provide a private right of action for patients to collect damages.
The high court's ruling establishes a new legal precedent for the state, falling in line with other jurisdictions that allow patients to sue providers for damages tied to confidentiality violations.
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  • 01.11.18

Having A Heart Attack? This AI Helps Emergency Dispatchers Find Out

The time between calling 911 and the ambulance arriving can be critical for saving heart attack victims, but the person on the phone may not know what’s happening: this AI parses non-verbal clues to help diagnose from a distance.

When someone goes into cardiac arrest outside of a hospital, time is critical: The chance of survival decreases about 10% with each minute. The first step–recognizing that it’s cardiac arrest, when your heart fully stops–is challenging for emergency dispatchers on the phone, who have to make sense of symptoms relayed by a panicked friend or relative.
In Copenhagen, dispatchers now have help from AI. If you call for an ambulance, an artificially intelligent assistant called Corti will be on the line, using speech recognition software to transcribe the conversation, and using machine learning to analyze the words and other clues in the background that point to a heart attack diagnosis. The dispatcher gets alerts from the bot in real time.
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Strong Growth Forecast for Telemedicine

John Commins, January 15, 2018

The industry is riding sustained tailwinds that will push growth of 30% to more than 40% in coming years. Factors include a growing dearth of clinicians, an aging population, and technological innovations that will improve patient access and experience.

If Teledoc, Inc. is a bellwether for the telemedicine industry, the outlook is bright.
Jason Gorevic, CEO of the Purchase, NY-based telemedicine provider, called 2017 "a landmark year as we redefined the virtual care delivery landscape with our acquisition of Best Doctors."
"Through rapid integration, Teladoc has brought to market innovation that gives members a single point of access for a wide array of medical needs. We are seeing a tremendous reception from both clients and prospects to this unique, comprehensive solution," he said.
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6 digital health predictions for 2018

  • The IPO market won't open up in 2018, but expect plenty of M&A.
  • Artificial intelligence will be used in unsexy ways before it disrupts clinical workflows.
  • Tech companies will make big moves in the space.
Steve Kraus, Bessemer Venture Partners
Published 2:16 PM ET Sun, 14 Jan 2018
Steve Kraus, one of the most active health-tech investors in the industry, gave his predictions for 2018, following the J.P. Morgan Healthcare Conference this week in San Francisco.

Don't expect IPOs

I think the public markets will remain closed in 2018 for health-tech companies. However, I do expect 2019 and the years beyond that to start to look more fruitful for initial public offerings, as well-funded start-ups like Health Catalyst, Flatiron Health, Welltok, Grand Rounds Health and others start to scale beyond $100 million in revenue and some of them start to reach positive EBITDA levels.
Healthcare mergers and acquisitions will remain robust but will focus more around health-care service businesses — many of which may be tech-enabled — rather than pure health-care IT companies.
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Part 1: How can NHS use technology to reduce winter pressures?
18 January 2018
As the NHS grapples with a winter crisis, can technology help in alleviating some of the pressures? In this first article of two-part series, we look at how some of the global digital exemplars are using digital to address the demands on the health service. 
As more reports emerge about accident and emergency departments in England missing waiting targets, doctors warning about dying patients and hospitals cancelling elective operations until 31 January 2018, the NHS winter crisis shows no sign of abating.
Amid calls for additional money, more resources for social care and increase in staffing levels, an important point that has been missing in most of these discussions (at least in the mainstream media), is the role of technology in alleviating winter pressures.
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Overcoming the barriers to greater use of mobile technology in healthcare
19 January 2018
For many of us, the idea of navigating daily life without a smartphone or tablet computer has become unthinkable. And yet, while on the up, such technology has not yet achieved ubiquitous status in healthcare settings. Claire Read reports on new Digital Health Intelligence research exploring why that is, and how barriers to greater use of mobile technology in healthcare might be overcome.
You’re walking down the street and spy someone coming towards you, but it’s very clear they haven’t spied you. Their eyes are cast downwards, at a shiny rectangular object in their hand. And they can’t even hear your footsteps, what with the music blaring from the distinctive white earbuds dangling from their ears.
If it feels like the vast majority of the people you encounter are obsessed with their phone, then that’s because they probably are. According to research by UK telecommunications regular Ofcom, three quarters of UK adults now own a smartphone, and almost 60% have a tablet computer. And that near-ubiquity of mobile devices is, undoubtedly, impacting healthcare.
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Enjoy!
David.

1 comment:

Bernard Robertson-Dunn said...

re: "FDA approves clinical platform that predicts patient deterioration"

I don't know much about that system and there's probably a bit of vendor exaggeration, but it's a lot more like proper Digital Health than anything myhr could ever do.

For a start it's point of care; it is patient centric - it monitors an individual and looks for changes in that individual; it is evidence based and has been subjected to trials to identify if it works and has value. Compare that with PCEHR/MyHR....

If you read the research it's based upon, it's not exactly rocket surgery, but it seems to be something worth doing.

And not a health record in sight.