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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Investment in e-health proposed under development plan
Previous estimates for electronic health record suggest it will cost up to €875 million
17 February, 2018
Digital health services will enable the right information about the right patients to be available securely in the right health care setting at the right time.
Investment in electronic health records and new IT systems will directly improve patient services and allow chronic disease to be managed at home and in the community, the new National Development Plan says.
The plan confirms proposals already announced by the Health Service Executive in recent years, which were also a feature of the Sláintecare report on reforming the health system.
It says ICT systems such as electronic prescribing and tele-health will “directly improve patient services allowing chronic disease to be managed in a more patient centred environment at community level including in patient’s homes”.
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Nokia starts review of digital health business, cuts jobs in Finland
Reuters Staff
HELSINKI (Reuters) - Finnish network gear maker Nokia has started a strategic review of its digital health business and announced more than 400 job cuts in its home country.
FILE PHOTO: Flags with the Nokia logo flutter at company's headquarters in Espoo, Finland, May 5, 2017. REUTERS/Ints Kalnins /File Photo
Digital health, part of Nokia Technologies unit, is one of the areas where the company had been looking for growth opportunities amid a tough market for its mainstay telecom network gear business.
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Roche to buy Flatiron Health for $1.9B
by Evan Sweeney
Feb 16, 2018 12:29pm
Roche has agreed to buy Flatiron Health for $1.9 billion. (Getty/Martin Barraud)
One of the world’s largest pharmaceutical companies has agreed to buy Flatiron Health, a health IT company founded by two former Google employees.
Switzerland-based Roche Group has agreed to pay $1.9 billion for the health IT company. The pharmaceutical and biotechnology company had already invested $200 million into Flatiron and owned 12.6% of the company.
The acquisition was first reported by CNBC and then confirmed in a joint announcement by the two companies.
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Special Report: Cybersecurity
The recent review of WannaCry attack by NHS England CIO has shone a bright light into NHS cyber defence deficiencies. With the General Data Protection Regulation coming into force this Spring, and an array of legacy Microsoft systems hitting their end of support status, just where do things stand now regarding cybersecurity strategy within the NHS? Davey Winder investigates.
According to the newly published review authored by Will Smart, chief information officer of NHS England, only 1 percent of NHS activity was directly impacted by WannaCry with 80 of the 236 hospital trusts affected, plus 595 of the 7,545 GP practices. However, the vulnerability of NHS infrastructure was laid bare for all to see.
An historic underinvestment in network security, unpatched legacy software and unpatchable hardware devices, were exposed; along with poor discipline and accountability at the highest levels within individual trusts.
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HHS wants to leverage data to track opioid prescribing
Published February 16 2018, 7:24am EST
President Trump’s proposed Fiscal Year 2019 budget for the Department of Health and Human Services would make combating the opioid epidemic one of the agency’s top priorities, including $10 billion in HHS funding to address the crisis.
As part of the effort, a proposal in the administration’s FY 2019 budget is to “require states to monitor high-risk billing activity to identify and remediate abnormal prescribing and utilization patterns that may indicate abuse in the Medicaid system,” HHS Secretary Alex Azar told members of Congress Thursday.
Rep. Michael Burgess, MD (R-Texas), chairman of the House Energy and Commerce Subcommittee on Health, agreed that the Centers for Medicare and Medicaid Services has a lot of data that could be used to “identify a practitioner who is writing an inordinate number of prescriptions.” Burgess added that this information is “actually knowable” within CMS databases.
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EMR alert may help physicians screen children for physical abuse, study suggests
A team of researchers from Children's Hospital of Pittsburgh of UPMC developed an EMR-based alert system to improve rates of screening for physical abuse among pediatric patients, according to a study published in the February issue of the Journal of the American Medical Informatics Association.
To develop the child physical abuse alert system, the researchers coded 30 age-specific "triggers" into the EMR at a freestanding pediatric hospital with a level 1 trauma center. These triggers would identify children under 2 years of age who were at risk for physical abuse.
Between October 2014 and April 2015, the system flagged 226 children as being at risk for physical abuse. The system ran in "silent mode" in the background of the EMR, meaning that while physicians were unaware of the system, study personnel received data on children who triggered an alert.
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4 study insights into physicians overriding decision support alerts in EHRs
Clinical decision support alerts displayed in EHRs are associated with reduced incidence of medication errors and adverse drug events. However, a physician who inappropriately overrides one of these alerts may hinder their full potential to influence patient safety.
To evaluate this concern, a team of researchers analyzed 712 encounters from patients admitted to one of six intensive care units between July 2016 and April 2017, according to a study published in BMJ Quality & Safety. The researchers considered potential patient harm associated with medication-related CDS overrides for doses, drug allergies, drug interactions, and geriatric and renal alerts.Here are four insights from the study.
1. The researchers identified 2,448 overridden CDS alerts from 712 patient encounters. Of the 2,448 alerts, 81.6 percent of the alerts were appropriately overridden.
2. The researchers found more potential and definite adverse drug events following inappropriate overrides, compared to appropriate overrides.
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Report: Healthcare Way Behind other Major Sectors in Proper Cybersecurity Protocols
February 14, 2018
by Rajiv Leventhal
The healthcare industry is one of the lowest performing industries in terms of endpoint security, and the sector as a whole ranks near the bottom in cybersecurity strength compared to other major industries, according to a new report from New York City-based security risk company SecurityScorecard.
The report, "SecurityScorecard 2018 Healthcare Report: A Pulse on The Healthcare Industry's Cybersecurity Risks," pulls data from more than 1,200 healthcare companies. SecurityScorecard's research team analyzed information such as issue severity, industry-defined risk level, corporate peer performance, and more. The team's analysis revealed insights on how the healthcare industry performs compared to others, and specific areas of cybersecurity weakness within healthcare organizations.
Some of the report’s key insights include:
- The healthcare industry ranks 15th when compared to 17 other major U.S. industries.
- The healthcare industry is one of the lowest performing industries in terms of endpoint security, posing a threat to patient data and potentially patient lives.
- Social engineering attacks continue to put patient data at risk.
- 60 percent of the most common cybersecurity issues in the healthcare industry relate to poor patching cadence (which measures how quickly an organization applies an update that patches a security vulnerability).
- All healthcare organizations struggled with patching cadence and network security.
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U.K. says Russia was behind Petya cyberattack that shut down Nuance, hospitals
Officials found the Russian military “was almost certainly responsible” for the massive global attack, and serves as a reminder that nation-state actors can impact even small organizations that weren’t the intended target.
February 15, 201812:33 PM
The hackers disguised the wiper malware, Petya, as ransomware in order to distract from its real purpose -- to destroy data.
The U.K. government has found the Russian government responsible for the global Petya cyberattack that shut down a wide range of major companies in June, including parts of FedEx, biopharma giant Merck, Nuance Communications and some U.S. health systems.
Officials specifically find the Russian military at fault.
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Bedrock for pop health success: physician buy-in
The best population health management program is built on data and supported by robust operations that can scale up to meet the organization’s needs.
By Susan Morse
February 15, 2018 10:46 AM
A good population health strategy requires physician engagement, C-suite involvement and the flexibility to be able to scale up to meet the organization’s needs, according to Renee Broadbent, associate vice president of Population Health Information Technology and Strategy for UMass Memorial Healthcare.
Broadbent’s role is to organize the data for the numerous hospitals and physician offices within the UMass system that may be located on the other end of state. Many are also in an accountable care organization.
Only about 60 percent use the same electronic medical record, Epic, while the other 40 percent are in various EMRs.
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Blockchain not a panacea for managing health records, fed expert says
Published February 15 2018, 7:42am EST
While blockchain has a number of potentially promising healthcare applications, including the management of electronic health records, the technology has certain pitfalls that may inhibit its utility.
That’s the message delivered on Wednesday to lawmakers by Chris Jaikaran, a cybersecurity policy analyst in the Government and Finance Division at the Congressional Research Service.
Blockchain technology employs a data structure that can be time-stamped and signed using a private key to prevent tampering; many experts in the healthcare industry see the technology as a natural fit for managing the accountability, authentication, confidentiality and sharing of information.
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HIT Think Three keys to a multi-layer security strategy
By David Wagner
Published February 14 2018, 5:30pm EST
User-based protections. As many as 68 percent of attacks are caused by internal users. Healthcare organizations have an even greater responsibility to educate and train their users, given the number of people who have access to sensitive information and the frequency with which that information is distributed. Prioritizing regular training, testing and education and requiring users to use complex passwords and two-factor authentication will help to limit unauthorized access and minimize the risk of a threat.
Contingency plans. Every effort must be made to block cyberattacks, but there must also be contingency plans in place to limit the scope and scale of the damage in the event a breach occurs. Abnormal traffic monitoring and refined network segmentation do just that. If a hacker is exporting data out of a system and into an independent server, then a spike in traffic results. Monitoring for these spikes enables a faster mitigation response, and networks that are properly segmented fundamentally limit the effects of an attack from spreading.
Even following these practices, organizations should consider using external audits to better assess their security strategy and look for the deeper gaps that may exist. In the U.S., the American Institute of Certified Public Accountants’ Service Organization Control 2 accreditation and SOC3 certification can help ensure that service organizations provide the appropriate controls for security, availability, integrity and confidentiality.
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The training of Dr. Robot: Data wave hits medical care
Feb 15, 2018 12:08pm
Artificial intelligence could help doctors recognize dangerous infections, but the use of algorithms in healthcare is still novel.
The technology used by Facebook, Google and Amazon to turn spoken language into text, recognize faces and target advertising could help doctors combat one of the deadliest killers in American hospitals.
Clostridium difficile, a deadly bacterium spread by physical contact with objects or infected people, thrives in hospitals, causing 453,000 cases a year and 29,000 deaths in the United States, according to a 2015 study in the New England Journal of Medicine. Traditional methods such as monitoring hygiene and warning signs often fail to stop the disease.
But what if it were possible to systematically target those most vulnerable to C-diff? Erica Shenoy, an infectious-disease specialist at Massachusetts General Hospital, and Jenna Wiens, a computer scientist and assistant professor of engineering at the University of Michigan, did just that when they created an algorithm to predict a patient’s risk of developing a C-diff infection, or CDI. Using patients’ vital signs and other health records, this method—still in an experimental phase—is something both researchers want to see integrated into hospital routines.
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The future of harvesting patient generated health data
The trickiest part is getting people to keep using the devices, even six months is a challenge.
By Laura Lovett
February 13, 2018 03:32 PM
As remote monitoring becomes more and more popular providers are starting discussions about how to harvest and use the incoming data. But a serious challenge lies in how to synthesize data coming in from different sources. People have preferences — you might even go so far as to say there are “Fitbit people” and “Apple Watch people.”
“What we are trying to do with these devices is collect non-episodic data. Apple watches, Fitbits, all of these devices capture it for you now,” said Ajay Mittal, associate director of IT at the American College of Cardiology. “Our top process was to harness this data that people are already using to support better outcomes.”
Mittal and the team at ACC ran a pilot study aimed at integrating non-episodic data, or data that wasn’t collected at a doctor’s appointment, into the providers system. The team then looked at whether these data points could help improve long-term outcomes.
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Precision medicine: Huge promise, but high health IT-related hurdles, too
John Halamka and Paul Cerrato sift through the hope and the hype of personally-tailored care, spotlighting to real-world success stories while not ignoring some significant potential pitfalls along the way.
By Mike Miliard
February 13, 2018 03:42 PM
John Halamka (above) and Paul Cerrato to talk about some of the biggest obstacles holding back more widespread implementation of precision medicine at HIMSS18.
In their new book, Realizing the Promise of Precision Medicine, Paul Cerrato and John Halamka, MD, take a hard look at the potential for genomic discovery and technological advances set to cause a sea change in how healthcare is delivered.
"The goal of the precision medicine movement is to give clinicians and patients access to the kinds of information needed to create individually tailored programs to treat a variety of diseases and to ward off those that are preventable," they wrote. "To accomplish those twin goals will require the collection of far more data than clinicians now collect when they evaluate patients. It will require more sophisticated analytic tools to glean meaningful insights from the data collected. And equally important, it will require the public to become more engaged in its own care."
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FDA approves AI stroke application, signaling a shift in triage software oversight
by Evan Sweeney
Feb 14, 2018 12:00pm
Attorney Bradley Merrill Thompson says the FDA's latest approval shows the agency "seems to be warming to artificial intelligence used for triage." (FDA)
The Food and Drug Administration (FDA) approved an application that uses artificial intelligence to alert physicians of a potential stroke, signaling a notable shift in the way the agency reviews clinical decision support software used for triage.
The application, called Viz.AI Contact, uses an AI algorithm to analyze computed tomography (CT) scans and identify signs of a stroke in patients. The application notifies a neurovascular specialist via smartphone or tablet when it has identified a potential blockage in the brain, reducing the time it takes for a specialty provider to review the scans.
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FDA’s Scott Gottlieb wants to use funding boost to create a Center of Excellence on Digital Health
by Evan Sweeney
Feb 15, 2018 10:18am
The Food and Drug Administration plans to use a proposed $400 million boost in federal funding to focus on a range of innovative approaches to speed the approval of new medical devices and create a new center that would support digital health oversight and address cybersecurity concerns.
Overall, the FDA would receive an additional $473 million in discretionary spending under a budget proposal released by the Trump administration earlier this week, bringing the agency’s total to $3.25 billion in 2019. If that level of spending moves through Congress, the FDA plans to funnel about $400 million to promote innovation and competition, FDA Commissioner Scott Gottlieb, M.D., announced on Wednesday. That would include specific carve-outs planned for a new Center of Excellence on Digital Health and furthering the agency’s ability to use EHR data to evaluate medical devices.
The Center for Excellence on Digital Health would oversee a revamped regulatory paradigm created through the FDA’s new software precertification program launched with nine companies in September. But the center would also create a cybersecurity unit to “enhance its ability to coordinate device-specific responses to cybersecurity vulnerabilities and incidents.” Over the past several years, medical device cybersecurity has emerged as particular concern for industry and regulators.
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Trump budget eliminates AHRQ, makes major cuts to OCR, ONC
Published February 13 2018, 7:38am EST
President Trump on Monday released his proposed Fiscal Year 2019 budget for the Department of Health and Human Services, suggesting the elimination of funding for the Agency for Healthcare Research and Quality and slashing budgets for the Office of the National Coordinator for Health IT and HHS Office for Civil Rights.
Congress has traditionally ignored past White House budget proposals, but the plan does show the Trump administration‘s overall intentions for managing federal spending.
The FY 2019 HHS budget includes $256 million to consolidate the activities of AHRQ, which supports health services research addressing patient safety and healthcare quality as well as the application of HIT, into the National Institutes of Health—as the National Institute for Research on Safety and Quality (NIRSQ)—to eliminate duplication and redundancies.
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Azar: 'I Am a Big Supporter of Telehealth'
Steven Porter, February 15, 2018
The HHS secretary’s words of support coincide with a number of other promising signs for burgeoning acceptance and application of the technology.
During his third congressional hearing within 24 hours, Health and Human Services Secretary Alex Azar told lawmakers Thursday he’s looking forward to clearing reimbursement obstacles that have impeded the growth of telemedicine.
Azar, who’s been on the job two weeks, fielded questions from the House Energy and Commerce Committee, covering a wide range of issues facing the massive department.
Rep. Morgan Griffith, R-Va., asked specifically about how payments for telehealth services are handled currently and how they might be better handled in the future.
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AI just at the early stages of showing real results
By Linda Wilson
Published February 09 2018, 7:16am EST
Artificial intelligence—a broad set of technologies that enable machines to mimic the human brain’s ability to process information, learn and adapt—holds potential in healthcare to improve patient outcomes and reduce costs, but it hasn’t yet been widely adopted in daily clinical practice.
However, some leading healthcare organizations, such as the Cleveland Clinic, Intermountain Healthcare and others, are beginning to build the infrastructure and data science capabilities to use AI to deliver clinical and financial benefits.
While some industries are using AI programs designed to recognize speech, written language or visual data or do problem-solving, health systems are gaining experience with machine learning, a subset of AI focused on finding patterns or relationships in data in an iterative, or learning, fashion. Early projects have demonstrated promising results.
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AAFP calls on feds to eliminate health IT utilization measures, focus on data blocking
by Evan Sweeney
Feb 12, 2018 10:23am
The nation’s leading association of family physicians is urging federal officials to eliminate health IT utilization measures, pare down documentation guidelines and instead focus their energy eliminating data blocking.
In a letter (PDF) to the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma and Donald Rucker, M.D., the top official at the Office of the National Coordinator for the Health IT(ONC), the American Academy of Family Physicians (AAFP) outlined ways in which the two agencies can ease the “crushing administrative and regulatory burden” that drives physicians out of practice.
The letter comes on the heels of an announcement that the organization plans to focus on administrative simplification, with medical record documentation listed among its four priorities.
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What’s propelling health IT spending in 2018?
Feb 7, 2018 at 12:26 PM
Value-based care initiatives are the biggest drivers of healthcare technology spending this year, according to a new survey from Damo Consulting.
Patient engagement and care management efforts came in as the number two drivers.
The Illinois-based healthcare advisory firm surveyed 38 individuals from global tech firms, population health management organizations, digital health companies, global management consulting firms and more. The majority of respondents were CEOs, heads of business or in sales/marketing roles.
Other key topics pushing health IT spending include enterprise digital transformation (47.37 percent of respondents), cybersecurity and ransomware (39.47 percent) and population health management (28.95 percent). M&A doesn’t appear to be as significant of a driver, as less than 11 percent of respondents selected it.
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Enjoy!
David.
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