Quote Of The Year

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

Saturday, February 17, 2018

Weekly Overseas Health IT Links – 17th February, 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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Tips to tackle the biggest cyber challenge hospitals face: medical device security

Experts from a leading nonprofit ranked device cybersecurity as the single biggest challenge hospital face today.
February 08, 2018 11:40 AM

The ECRI Institute put managing medical device cybersecurity threats at numero uno on its 2018 list of top 10 challenges facing healthcare. 
When dealing with medical device cybersecurity, ECRI’s focus has been largely making sure it provides practical guidance for its member hospitals, Leinonen said.
“We really need to make sure that there are appropriate resources for the healthcare facility to tackle medical device cybersecurity,” ECRI project engineer Juuso Leinonen said. As he sees it, a practical path to reach organizations’ security goals to improve their “security posture” is critical.
When asked what actions health systems could take now to boost medical device security, he didn’t have to think about it.
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NHS to offer Skype consultations for new mums affected by mental ill health

8 February 2018
New mums who experience mental ill health are to be given access to consultations through Skype as part of further new investment in perinatal mental healthcare.
NHS England has already committed to investing £365m to improving mental health services for new mothers. But on Monday (5 February), the national body announced a further £23m of funding, with a particular focus on developing community services.
The overall aim is to increase access to perinatal mental healthcare. Plans include four new mother and baby units and the recruitment of over 200 specialist staff, including 21 consultant psychiatrists and more than 100 nurses and therapists.
Claire Murdoch, director of mental health for NHS England, said: “With so many new mums having the joy of motherhood interrupted by mental ill health, improving care, investment and focus on this issue, is crucial.
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WhatsApp doc: Legal and practical perspectives of using mobile messaging

DHI Admin
9 February, 2018
With General Data Protection Regulation (GDPR) coming into force in Spring 2018, our guest columnists explore the legal and practical implications of using mobile messengers in the healthcare sector and finding a balance between convenience and compliance.
Research published in BMJ Innovations found a widespread use of WhatsApp for communication between healthcare professionals. According to the study, 97% of surveyed doctors routinely send patient information on instant messenger without consent, despite the fact 68% were concerned about sharing information in this way.
Having reviewed over 100 clinician-led studies, there are clear advantages to using a mobile messenger service like WhatsApp in a clinical setting, such as more efficient spreading of medical knowledge and overcoming inefficient hierarchical barriers within clinical teams.
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Trump signs spending bill into law: Here are health IT's biggest wins

HIMSS Senior Director of Congressional Affairs broke down how the massive spending bill will boost telehealth, Medicaid and other crucial health IT needs.
February 09, 2018 12:39 PM

Congressional leaders passed the spending bill last night, after a 5-hour government shutdown. Senate passed the spending bill around 1:45 a.m. with a 71-28 vote, while the House pushed through the legislation at about 5:30 this morning with a 240-186 vote.
The President tweeted that he signed the bill into law at 8:40 this morning.
The shutdown was caused by a one-man protest by Sen. Rand Paul, R-Kentucky, who opposed adding another $320 billion to the federal budget deficit. Indeed the massive spending bill adds hundreds of billions of dollars for the military, disaster relief and domestic programs.
While budget appropriators will have until Mar. 23 to determine how to specifically dole out the funding, there are a lot of wins for healthcare, according to Samantha Burch, senior director of congressional affairs for HIMSS.
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Bill gives providers relief in Meaningful Use, MIPS programs

Published February 09 2018, 5:17pm EST
The budget bill passed by Congress on Friday morning includes several health information technology provisions for which provider organizations generally voiced support.
In particular, it includes changes to the Electronic Health Record Meaningful Use Program designed to reduce burdens on providers and keep more of them in the program. The bill also makes beneficial changes to the MIPS payment program that rewards doctors for quality care and improved outcomes.
Provider trade associations were pleased with much of what they saw in the bill.
“The Bipartisan Budget Act of 2018 is largely a win for physician practices,” according to the Medical Group Management Association representing larger provider practices. “Reducing burden in the MIPS program, eliminating the unelected Medicare cost-cutting board known as the IPAB and averting a flawed mis-valued code policy that would have resulted in drastic across-the-board payment cuts in 2019 and 2020 are all top MGMA priorities.”
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AMIA wants more specificity from FDA decision support guidance

The informatics group says that with big innovation on the horizon it still sees ongoing confusion among developers and clinicians over which CDS and PDS software is considered a "device" and which isn't.
February 07, 201801:27 PM
The American Medical Informatics Association said recent guidance from the U.S. Food and Drug Administration for clinical and patient decision support tools is "well-timed to initiate a broad discussion" about the future of CDS and PDS. But AMIA also says there's still a lot to discuss.
Section 3060 of the 21st Century Cures Act calls on FDA to exclude specific functionalities from its definition of medical device – legalese that essentially bars FDA from regulating that software as a device (which would require pre-market review, clinical trials and/or other agency clearances).
Certain of those excluded functionalities describe what is normally understood as clinical decision support and its consumer-facing cousin, patient decision support. But not all CDS/PDS was excluded from the definition of the device by the Cures Act.
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24% of physicians can't identify phishing emails: 5 things to know

Written by Julie Spitzer | February 07, 2018 | Print  |
At least 24 percent of physicians couldn't differentiate phishing emails from legitimate ones, according to Media Pro's 2017 State of Privacy and Security Awareness Report.
Media Pro asked 1,009 U.S. healthcare employees about their privacy and security awareness.
Here are five survey insights.
1. About 18 percent of respondents identified phishing emails as legitimate ones —  physicians were three times worse at identifying phishing emails than their non-physician counterparts. The most misidentified email of the four examples presented was an email from a suspicious "from" address containing an image attachment.
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HIT Think How University of Utah Health uses IT to treat sepsis faster

Published February 08 2018, 5:50pm EST
A recent success story illustrates the power of IT and a coordinated plan to deal with sepsis at University of Utah Health.
The patient was admitted for hypoxia and fatigue, and by the next day, he had his first fever and registered a modified early warning system (MEWS) score of 8. Sepsis protocol was initiated to alert the rapid response team, and the provider was at the bedside within just seven minutes after the alert. Within 20 minutes, lactate and blood cultures were collected, and fluids and antibiotics were infused in less than an hour. The patient improved over the next few days and was eventually discharged.
This sepsis management success story is just one of many examples of University of Utah Health’s work to improve outcomes and reduce costs. Part of that work has centered on combating sepsis, a leading cause of death in the U.S.—and the most common cause of death among critically ill patients in noncoronary intensive care units. Additionally, sepsis is incredibly expensive for hospitals: The Agency for Healthcare Research and Quality lists sepsis as the most expensive condition treated in U.S. hospitals, costing nearly $24 billion to treat in 2013.
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Electronic Health Records: a “Quadruple Win,” a “Quadruple Failure,” or Simply Time for a Reboot?

Editorial
First Online: 05 February 2018
Michael  Hochman
Download article PDF
Just a decade ago, when paper charts were commonplace in the USA, it seemed that electronic health records (EHRs) were destined to transform the quality and efficiency of healthcare delivery, as well as the care experience for patients and clinicians. Few would deny that old fashion paper charts can be awkward to navigate, burdensome to read, poorly amenable for health information exchange, and inadequate for supporting systematic quality improvement. The sentiment that EHRs could solve these problems was pervasive, and many experts predicted that widespread EHR implementation would save billions.1
The reality over the ensuring years has, to put it mildly, not met expectations. According to a 2014 analysis led by the Office of the National Coordinator for Health Information,2 over 80% of US doctors now use EHRs. Yet, many of the predictions about the benefits of EHRs have yet to materialize to the extent predicted. Though EHRs have facilitated some substantial improvements—the ability for clinicians to access charts from any wired location, electronic transmission of prescriptions, and enhanced tracking of population health measures, to name just a few—they have also resulted in numerous unintended consequences. Noteworthy concerns include egregious medical errors resulting from design glitches3, charting templates filled extensively with meaningless boilerplate, the common practice of pasting old notes4 that makes it difficult to know which documentation is “real,” “alert fatigue”5 due to excessive EHR warnings, and even reduced communication among clinical team members.6
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Changes to telehealth reimbursement, Meaningful Use included in House short-term funding proposal  

by Evan Sweeney 

Feb 6, 2018 12:18pm
A short-term funding bill unveiled by the House of Representatives on Monday evening includes legislation that would expand telehealth for Medicare Advantage members and ease Meaningful Use requirements moving forward.
The continuing resolution comes just days before government funding is set to expire, which would trigger another partial shutdown. The bill (PDF) includes the popular CHRONIC Care Act, which expands telehealth benefits for Medicare Advantage members in 2020 and allows accountable care organizations to expand the use of telemedicine.
The joint resolution would also expand access to stroke telemedicine services, allowing providers to be reimbursed for a neurological consult via telehealth. Both bills have received broad bipartisan support from lawmakers pushing to expand access to virtual services.
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CHIME Opioid Task Force Launches to Discuss Community Health

The CHIME Opioid Task Force seeks to prevent and treat opioid addiction by harnessing the data and knowledge of healthcare CIOs.

February 02, 2018 - On January 24 and 25, over two dozen healthcare IT leaders gathered in Washington, DC for the first meeting of the CHIME Opioid Task Force. Attendees sought to determine how to best use CHIME members’ expertise and access to critical data to help fight the opioid crisis and improve community health.
The meeting was overseen by Ed Kopetsky, CIO of Lucile Packard Children’s Hospital Stanford in Palo Alto, and Jim Turnbull, CIO of University of Utah Health in Salt Lake City. Turnbull first introduced the concept in November at the 2017 Fall CIO Forum in San Antonio.
"We need to empower and assist the healthcare community and help them see that there are pathways to success, whether that is eliminating overprescribing of opioids, finding interventions in clinical care or following best treatment practices," Turnbull said. "CHIME members have the data and skills to illuminate what has worked and what hasn't."
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Health IT adoption has positive effect on medical outcomes

Published February 07 2018, 7:29am EST
There is a positive association between the adoption of health information technology and its effect on medical outcomes in terms of efficiency or effectiveness.
That’s the conclusion of a new study published this week in the Journal of Medical Internet Research that analyzed the current literature on the subject over the last five years.
Researchers queried the Cumulative Index of Nursing and Allied Health Literature and Medical Literature Analysis and Retrieval System Online by PubMed databases for peer-reviewed publications. Studies from CINAHL and PubMed that defined an HIT intervention and a corresponding effect on medical outcomes stated in terms of efficiency or effectiveness were eligible for selection. Ultimately, 37 studies were chosen out of 3,636 papers for the review.
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Texas HIE to Link Social Determinants of Health to Patient EHRs

The pilot project will allow for more holistic patient care by incorporating data on social determinants of health into patient EHRs.

February 05, 2018 - Methodist Healthcare Ministries of South Texas and the state’s health information exchange (HIE) HASA are partnering to launch a pilot project for linking social determinants of health data to patient EHRs.
The two San Antonio-based organizations will enable providers to use a more comprehensive picture of a patient’s health for complete care delivery.
As part of the partnership, Methodist Healthcare Ministries award HASA a $175,000 grant to expand its services to include social determinants of health data that may influence patient health. Using the grant, HASA will integrate social determinant data into its clinical data repository through a cloud-based app.
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ACR project to test use of algorithms in cancer screening

Published February 06 2018, 2:51pm EST
A program funded by the Food and Drug Administration has selected an American College of Radiology-supported project in lung cancer screening as one of 11 projects assessing the benefits of real-world evidence to healthcare.
The National Evaluation System for Health Technology Coordinating Center (NESTcc) has picked the ACR’s Lung CT Screening Reporting and Data System, which is intended to standardize lung cancer screening and provide recommendations to manage use of the technology.
Participating with the ACR are Brigham & Women’s Hospital and Massachusetts General Hospital as implementation sites; GE Healthcare and Nuance as radiology workflow companies; and Aidence, Enlitic, Infervision and Mindshare Medical as algorithm vendors.
The ACR program intends to use a lung cancer screening registry that will enable data to be captured for quality reporting, a requirement providers will face from the Centers for Medicare and Medicaid Services in receiving payment for lung cancer screenings.
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KLAS research shows age of users affects perceptions of EHRs

Published February 05 2018, 7:29am EST
Physician dissatisfaction with the performance of their electronic health records systems is not a new phenomenon, but it continues to be a factor in many healthcare organizations and a contributor to physician burnout.
The age of the physician using a records system provides some of the most striking differences in how doctors interact with and like EHRs, according to research by KLAS Enterprises.
A HIT vendor research firm, KLAS in November started studying ways to create a better EHR, inviting 10 organizations to complete a survey and getting results from five. KLAS received responses from physicians within the five organizations.
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New venture with Amazon, Berkshire Hathaway worried JPMorgan's healthcare clients, report says

Feb 5, 2018 11:44am
Though there are still few details about the new healthcare venture between Amazon, Berkshire Hathaway and JPMorgan, the announcement apparently spooked some healthcare executives enough to call the bank about their concerns.
That includes at least two of the country’s five largest health insurers, according to The Wall Street Journal, which cited anonymous sources familiar with the matter. In response, JP Morgan CEO James Dimon personally spoke to some healthcare leaders to assure them that the venture will only serve the three companies’ employees and therefore not compete with them. 
Still, the initial announcement does seem to suggest that venture could eventually expand to reach beyond just the people who work at Amazon, Berkshire Hathaway and JPMorgan. The firms said want to “to create solutions that benefit our U.S. employees, their families and, potentially, all Americans."
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When it comes to medical records, experts see the potential for Apple to succeed where others have failed

Feb 5, 2018 11:46am
Company’s like Microsoft and Google have tried and failed to improve patient access to health data, but experts say Apple’s attempt could finally do what other consumer tech giants could not.
One big reason Apple could succeed in its medical records venture is because it is tapping into an open interface and using standardized frameworks for data exchange, Ken Mandl, M.D., who directs the Computational Health Informatics Program at Boston Children's Hospital wrote in an op-ed for CNBC.
At the same, far more providers have adopted EHRs compared to a decade ago when GoogleHealth and Microsoft Health Vault came onto the scene. With a nudge from federal policy and EHR certification standards that emphasize APIs, EHR vendors have begun using standardized interfaces to improve mobile access to medical records 
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Yale professors say AI will be a ‘powerful tool’ for pathology in a value-based world

Feb 5, 2018 10:15am
A growing body of research shows computer algorithms may soon outperform human pathologists in both accuracy and speed.
But rather than hand their diagnostic keys to machines, two pathology professors from Yale argue that artificial intelligence will emerge as a “powerful tool” that can accurately identify the drug or therapy that will be most beneficial to an individual patient’s disease.
“Should we human pathologists fold our tents and pledge supplication to our computer overlords?” Balazs Acs, M.D., and David Rimm, M.D., Ph.D., wrote in JAMA Oncology. “No, just the opposite; intelligent digital pathology will make us more valuable to patients, providers, and payers."
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Healthcare made up 26% of January's data breaches

Written by Julie Spitzer | February 02, 2018 | Print  | Email
Of January's 116 total data breaches, healthcare accounted for 31 of them, or about 26.7 percent, according to the Identity Theft Resource Center's January data breach report.
The ITRC breach list aggregates all data breaches that could result in identity theft reported to media sources or confirmed on notification lists from state governmental agencies.
The single largest incident involved a Jason's Deli restaurant in Texas, where a RAM-scraping malware attack was launched on its point-of-sale terminals at various corporate-owned locations. Nearly 2 million records were compromised in the attack, which began June 8, 2017.
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Digital command center for EHR implementation gains efficiencies and saves $100,000

A digital command center can add value and efficiency to an organization’s go-live operations, says a Thomas Jefferson University executive.
February 01, 2018 01:51 PM
There is tremendous irony in the fact that so much of the go-live operations management process is often done on paper. One such example of this is how go-live command centers are managed.
These command centers often are manned by staff who are constantly updating whiteboards, transcribing issues into electronic issue management systems, and manually generating status reports for overall progress. These procedures are cumbersome and add delays into the process of identifying support issues that may be pervasive.
Leveraging technology to record support issues at the point of incident allows an easier input method and an issue to be triaged more quickly. Simple mobile apps and other technology can be used to record these incidents and electronic dashboards can be used to highlight pervasive issues and generate automated status reports of overall system health.
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Factors Identified That Impact Physicians IT Adoption
Key facilitators of digital health adoption include resources and training, access to accurate data
FRIDAY, Feb. 2, 2018 (HealthDay News) -- Physicians have considerable concerns about the efficacy and evidence base of health information technology (IT), according to a report published by the American Medical Association (AMA).
Noting that one of the main questions physicians have about digital health is whether it will actually work in practice, researchers from Partners HealthCare Center for Connected Health and the AMA conducted a review to examine the facilitators and barriers to physician adoption of digital health solutions.
According to the report, few papers talked about provider adoption, with only 57 studies out of more than 3,000 papers mentioning provider adoption. Interim results showed that key facilitators of adoption include availability of additional resources and training, access to accurate data, positive impact on quality of care, and evidence base for the digital health solution. Physicians encounter many frustrations every day, and they are unlikely use a digital health solution that is frustrating or logistically challenging. Physicians also highlight concerns about the accuracy and reliability of data in digital health systems. Another concern was how digital health solutions would affect face time with patients.
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NLP enables Atrius Health to gain insights from unstructured data

Published February 05 2018, 7:37am EST
Atrius Health, a large multi-specialty ambulatory group practice serving eastern and central Massachusetts, is leveraging natural language processing to tap into a treasure trove of unstructured patient data used to support its value-based care initiatives.
By implementing an NLP platform from Linguamatics, Atrius is able to mine critical clinical information hidden within unstructured text to improve Medicare Advantage reimbursement, streamline accountable care organization reporting and close gaps in care delivery.
“The majority of clinically useful information is unstructured text that includes physician notes and radiology reports, which impacts our patients and our practice,” says Craig Monsen, MD, Atrius Health’s medical director of analytics. “I’d estimate that probably 50 percent to 80 percent is unstructured data.”
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Enjoy!
David.

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