Saturday, February 03, 2018

Weekly Overseas Health IT Links – 3rd 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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http://www.healthcareit.com.au/article/chaos-it-systems-two-nhs-health-areas-are-brought-down-technical-problems

Chaos as IT systems in two NHS health areas are brought down by technical problems

Lynne Minion | 25 Jan 2018
Technical issues have been blamed for a ‘major incident’ that caused outages across NHS systems in Wales and Manchester yesterday, with doctors and hospital staff unable to access online clinical systems.
As healthcare providers struggled to continue services without access to electronic records, patients were urged to attend emergency departments only for serious or life-threatening emergencies.
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NICE recommends app for depression should be trialled on the NHS

Hannah Crouch
25 January 2018
A new online and mobile app for depression should be trialled on the NHS, according to the National Institute for Health and Care Excellence (NICE).
The organisation believes Deprexis could help adults with depression get faster access to care.
The app, which was developed in Germany, uses cognitive behavioural therapy (CBT) to help people assess their own situation and find effective ways of coping.
It can be used on any device that has internet access including smartphones, tablets and desktops.
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Patient survey reveals preference for digital communications

Hannah Crouch
22 January 2018
A study has suggested that more than two-thirds of patients prefer digital communications from their healthcare provider over those sent via post. 
The independent survey, commissioned by Healthcare Communications, involved questioning 2,000 patients about their appointment habits.
Over two thirds of patients showed a preference for digital communications, with 68% stating they would prefer to manage medical appointments online or via a smartphone.
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Part 2: Can tech help in averting next winter crisis?

Shreshtha Trivedi
22 January 2018
In the first article of two-part series, we reported how some of the global digital exemplars are using digital to address the demands on the health service. 
In this second article, Shreshtha Trivedi looks at how primary care and urgent care sector are using digital to respond to these pressures, what is working and how can we accelerate the transformation agenda for next winter.   
As acute trusts struggle to cope with wider problems facing the NHS and social care, it all comes back to oft-asked question: how can we keep patients out of hospital in the first instance?
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Why Providers Need a Disaster Recovery Plan for EHR Security

Covered entities can help ensure a more comprehensive approach to EHR security by having a current disaster recovery plan in place.

January 24, 2018 - Whether healthcare providers are working to prepare for potential natural disasters like hurricanes or manmade cybersecurity issues (i.e., ransomware attacks, insider data breaches) having a disaster recovery plan is essential.
Entities of all sizes must ensure that patient care is not compromised during periods of downtime, and also that EHR security is never put at risk.
Having a current and comprehensive backup plan and contingency plan are also federal requirements under the HIPAA Security Rule.
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Oscar, Cleveland Clinic use FHIR to streamline data exchange



Oscar Health and the Cleveland Clinic are using a high-tech data exchange standard to improve the customer experience for members of their new co-branded insurance plans.
The standard, called Fast Healthcare Interoperability Resources (FHIR), is intended to help promote interoperability between the healthcare industry’s largely siloed electronic health records systems.
For their first project using FHIR, the Cleveland Clinic and Oscar have integrated it into a tool that allows members to select a primary care physician (PCP) through a mobile or web app, according to a post on Medium.
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Yale hospital command center uses real-time analytics to drive efficiencies

Published January 26 2018, 4:41pm EST
Yale New Haven Hospital has launched a command center that provides real-time data analytics so the healthcare organization can better manage patient capacity, operational processes and other critical decision making at the facility.
Developed jointly with electronic health record vendor Epic, the new center includes dashboards for clinicians and administrators with metrics such as bed capacity, bed cleaning turnaround time, patient transport times, delays for procedures and tests, as well as ambulatory utilization and quality and safety indicators.
The real-time dashboards—which are visible on the command center screens and are accessible to other staff—build on existing functionality in the Epic EHR, says Ohm Deshpande, MD, director of utilization review and clinical redesign at Yale New Haven Health System. He adds that the center is part of an ongoing initiative over the past five years to help Yale New Haven become a “high-reliability” organization.
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HIT Think 3 keys to simplifying data governance efforts

Published January 26 2018, 5:17pm EST
Every organization needs ready access to timely and trustworthy information, and more healthcare organizations are realizing that their strategic initiatives can’t succeed without a base level of data quality and the ability to understand and manage a rapidly growing volume of business information.
These capabilities are the province of data governance—a discipline that leverages the business value of data by improving its availability, usability, integrity and security.
Data governance has a reputation for being a daunting task that is prone to delays and failure. Surveys report that as many as two-thirds of all initial data governance efforts die on the vine. The major reason is that many well-intentioned efforts mushroom into such complexity during the planning and design phases that they are abandoned before they have the chance to deliver any value.
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Health IT Now’s new Opioid Safety Alliance focuses on leveraging technology to fight opioid misuse

Jan 25, 2018 2:19pm
A new alliance launched by Health IT Now features providers, technology startups and medical associations geared towards leveraging data and technology to combat the opioid epidemic.
The Opioid Safety Alliance, which includes Intermountain Healthcare, Walgreens, the Association of Behavioral Health and Wellness, IBM and the National Council for Prescription Drug Programs, to name a few, plans to focus on “advancing technology-enabled solutions to combat the scourge of opioid misuse,” Health IT Now announced on Thursday.
Among the group's key focus areas: reforming federal regulations that limit substance abuse data sharing between clinicians, leveraging telehealth and digital tools to expand substance use disorder treatment options and advocating Congress to make “smart, targeted investments” in technology to enhance prescription drug monitoring programs (PDMP).
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Regulators focus on reducing physician EHR burden

January 25, 2018
Solving the long-standing puzzle that is lack of interoperability among electronic health records (EHRs) requires computer system savvy as well as knowledge about improving patient care.
The Office of the National Coordinator for Health Information Technology (ONC) may, then, have the right person to guide it in Don Rucker, MD. Rucker, named to the post in March 2017, is skilled in informatics, board certified in emergency and internal medicine and built an early version of an EHR nearly two decades ago.
Medical Economics spoke with Rucker at the ONC’s recent annual conference in Washington, D.C. about his vision for healthcare IT and how to address his peers’ frustrations with EHRs, among other topics. 
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HIT Think How to assess weak links in a cloud data strategy

Published January 25 2018, 4:37pm EST
The cost, flexibility and scalability advantages of the cloud are impossible to ignore, and today many healthcare organizations are moving not only business data to the cloud, but also clinical data.
A variety of cloud initiatives are surging in popularity, including the adoption of cloud-based Software as a Service (SaaS) applications, moving data backup to public cloud services such as AWS or Microsoft Azure, and the use of these same cloud services as their primary location for the storage of business or clinical data.
Three cloud initiative best practices are emerging as crucial for healthcare IT executives:
  • Evaluating the potential problems associated with any cloud initiative.
  • Developing a strong data management strategy that addresses these problems.
  • Vetting and partnering with vendors that can fully support a data management strategy.
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Work begins on boosting adoption of gene editing technologies

Published January 25 2018, 4:34pm EST
A new program at the National Human Genome Research Institute within the National Institutes of Health hopes to increase adoption of genome editing technologies for treating disease, with up to $190 million available to researchers over six years.
Genome editing is a molecular approach to make precise changes to the sequence of DNA, which is the hereditary material inside live cells. Editing can change who DNA interacts with RNA, which carries instructions from DNA to control proteins.
The new sequence can change the course of a disease in a person who inherited a disease. For example, a particular sequence in a patient with brain degeneration could slow the degeneration over time.
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Chatbot campaign for flu shots bolsters patient response rate by 30%

Brett Swenson, MD, deployed a chatbot to improve engagement from EHRs to triage and found real success in reaching patients with information about flu shots.
January 24, 2018 11:42 AM
Communicating with patients can be tough. Reminder pamphlets often go straight into the rubbish and emails are deleted before they are read. But one doctor found that chatbots could be a key to patient outreach. 
Brett Swenson, MD, is no stranger to digital health. He runs a concierge practice in Arizona and started working with EMRs about 20 years ago when they were first introduced. He said he is a keen adopter of new technology. 
So when he heard about using chatbots at a conference a little over a year ago he decided to dig a little deeper. A number of vendors are offering chatbots for healthcare, notably Babylon Health Buoy Health, Catalia Health, Florence, Memora Health, SapientX, SimplifiMed and Your.MD, among others. 
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AI is transforming business processes but data quality and workforce challenges remain

As AI finds its way into common practice, majorities are using it to automate business processes – but not all have data ready to support it.
January 24, 2018 02:37 PM
Artificial intelligence is starting to have a transformative impact on many industries, healthcare included, as it moves beyond the theoretical and into common practice.
"We are no longer on the brink of change resulting from AI — we are already immersed in a world with software-driven machines learning to process unstructured information in meaningful ways, something that until relatively recently was the domain of humans alone," Infosys researchers wrote in a report released this week at the World Economic Forum in Davos, Switzerland.
It's clear that something that seemed sci-fi even five years ago is already changing the landscape in a real and profound way, the study "Leadership in the Age of AI," suggested and include workforces alongside the technology. 
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Here are the first steps to becoming a cloud-first hospital

Like so many IT projects, it starts with culture, according to David Chou, CIO of Children’s Mercy.
January 17, 2018 09:30 AM
There’s little doubt that many hospitals are going to start moving more and more of their technological infrastructure and software into the cloud.
As that happens, consultancies such as IDC are predicting the cloud model will effectively change the way IT shops typically operate. Instead of performing many of the tasks historically considered to be information technology, for instance, hospital tech departments will become more akin to lines of business that acquire those functions, IDC’s projection suggests.
But how can hospitals considering tapping into more cloud services or even embarking on a cloud-first mindset begin?
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Senate confirms former pharma exec Alex Azar as secretary of Health and Human Services

Jan 24, 2018 3:24pm
Former pharma executive Alex Azar has a new title: secretary of Health and Human Services.
The Senate voted 55-43 to confirm the nomination of Azar, the former head of pharmaceutical giant Eli Lilly’s U.S. operations, to serve in the role vacated by Tom Price, M.D.
Price, a former congressman, resigned in September after eight months on the job due to controversy over use of private planes for government travel using taxpayer money. President Donald Trump soon tapped Azar to fill the role, saying he would be “a star for better healthcare and lower drug prices!”
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2017 Breach Report: 477 Breaches, 5.6M Patient Records Affected

January 23, 2018
by Heather Landi
Although 2017 saw fewer massive health data breaches when compared to 2016, there was still an average of at least one health data breach per day throughout the entire year, according to a year in review report from cybersecurity software company Protenus.
Progress is being made, but there is still much that healthcare organizations must do in order to ensure that the patient data entrusted to them is properly secured, Protenus' Breach Barometer 2017 year-in-review report states.
In 2017, there were 477 healthcare breaches reported to the U.S. Department of Health and Human Services (HHS) or the media, and information available for 407 of those incidents, which affected a total of 5.579 million patient records, according to Protenus, which tracks disclosed breaches impacting the healthcare industry, with data compiled and provided by DataBreaches.net.
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Apple to launch Health Records app with HL7's FHIR specifications at 12 hospitals

At launch, Apple is working with Penn Medicine, Cedars-Sinai in Los Angeles, Johns Hopkins, Geisinger Health System and others across the country.
January 24, 2018 11:23 AM
After many months of rumors, Apple announced that it is launching a personal health record (PHR) feature with iOS 11.3, the beta of which launched Wednesday to users in Apple's iOS Developer Program. The feature, called Health Records, will aggregate existing patient-generated data in the Health app with data from a user's electronic medical record — if the user is a patient at a participating hospital. At launch, Apple is working with 12 hospitals across the country, including Penn Medicine, Cedars-Sinai in Los Angeles, Johns Hopkins, and Geisinger Health System.
“Our goal is to help consumers live a better day," Apple COO Jeff Williams said in a statement. "We’ve worked closely with the health community to create an experience everyone has wanted for years — to view medical records easily and securely right on your iPhone. By empowering customers to see their overall health, we hope to help consumers better understand their health and help them lead healthier lives.”
The feature will use HL7's FHIR (Fast Healthcare Interoperability Resources) specification. Users will be able to see things like allergies, medications, conditions, and immunizations, as well as the sort of things they might check an EHR patient portal for, such as lab results. They can be notified when the hospital updates their data. The data will be encrypted, and users will need to enter a password to view it.
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Best practices, template improve EHR documentation quality

Published January 24 2018, 7:20am EST
While the use of electronic health records by providers is nearly universal, it has resulted in major challenges in managing EHR documentation by doctors, who are more likely to include inaccurate, inconsistent and excessive information in progress notes on patients.
The phenomenon is known as “note bloat,” a moniker for the trend describing how physician notes contain multiple pages of nonessential information, according to Neveen El-Farra, MD, associate clinical professor of medicine and associate dean for curricular affairs at UCLA’s David Geffen School of Medicine.
“The electronic health record makes it so easy to import all this data,” adds El-Farra, who is also a hospitalist in the Department of Medicine and associate program director of the internal medicine residency program. “EHRs were supposed to be the best things ever, but they have a lot of issues and are the No. 1 cause of burnout among physicians.”
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HIT Think Deep learning will create more benefits than classic machine learning

Published January 24 2018, 5:00pm EST
Deep learning’s pre-eminence to the enterprise today is significant for two reasons. It represents the ultimate expression of machine learning’s advanced capabilities and, as such, has become virtually synonymous with artificial intelligence because of its progressive learning prowess.
Deep learning is at the core of the most intricate AI capabilities including speech recognition, image and video recognition, speech generation and aspects of robotics. It’s unparalleled at swiftly analyzing data at scale in accordance with the differentiation characteristic of big data.
In considering the massive influx of unstructured data besieging enterprises such as healthcare organizations, the ascending interest in AI, and the pivotal context with which deep learning purveys nearly any use case, it’s clear 2018 is the year this technology’s utility will finally supersede classic machine learning’s.
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Physician practices still holding back on telemedicine

Jan 23, 2018 1:41pm
A slightly higher percentage of physician practices are offering telemedicine services to patients in the coming year, but the majority are still wary of virtual services, according to a new poll.
The portion of physician practices currently offering telehealth services increased three percentage points compared to last year, according to a poll by Medical Group Management Association. Of the nearly 1,300 respondents, 26% said they are offering telemedicine to patients this year.
But just 15% of practices plan to offer telemedicine services in 2018, down from 18% in last year's survey. And despite telemedicine’s growing popularity throughout 2017, most providers haven’t been persuaded to implement programs: 39% said they would not provide care via telehealth and 20% were still unsure.
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How technology could transform medical training, ease global shortage of doctors

Jan 23, 2018 1:10pm
Technological innovations are transforming medical training and could help ease a global shortage of healthcare professionals.
One leader in the effort is Shafi Ahmed, a British colorectal surgeon, who last year used Snap Inc.’s high-tech spectacles and the Snapchat photo-sharing app to broadcast a real-time hernia operation to doctors and millions of curious viewers, according to Bloomberg Technology.
Ahmed, who connected with more than two million viewers for that Snapchat surgery, sees the social media platform as a promising way to help train the next generation of doctors, according to the article. And such efforts could help ease a projected global shortage of 15 million healthcare workers by 2030.
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Johns Hopkins researchers use big data analytics to target diagnostic errors, improve quality 

Jan 23, 2018 12:53pm
Reducing diagnostic errors is a crucial component of improving care quality, but current methods of monitoring such mistakes may be time consuming. Now, researchers at Johns Hopkins have developed a strategy that uses big data to speed up the process. 
David Newman-Toker, M.D., director of the Center for Diagnostic Excellence at Johns Hopkins' Armstrong Institute for Patient Safety and Quality, and his team developed a new approach called SPADE (Symptom-Disease Pair Analysis of Diagnostic Error) to allow providers to harness databases instead of having staff members comb medical records for more information, according to a study published in BMJ Quality & Safety. 
SPADE uses statistical analyses to find and flag patterns that can predict diagnostic errors. It mines available databases for common symptoms that lead patients to visit a doctor and then compares those data with diseases that are often misdiagnosed.  
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VA Patient Data Disclosure to HIEs Permitted in Proposed Rule

A recently proposed federal rule would permit the VA to allow patient data disclosure to HIEs even if there is not a physical copy of written patient consent.

January 19, 2018 - The Department of Veterans Affairs (VA) published a proposed rule that would amend its current regulations on allowing patient data disclosure to health information exchanges (HIEs). The updated rule would permit VA to release a patient’s medical records to an HIE even if there is not a physical copy of the patient’s written consent.
“This proposed rule would be a reinterpretation of an existing, long-standing regulation and is necessary to facilitate modern requirements for the sharing of patient records with community health care providers, health plans, governmental agencies, and other entities participating in electronic HIEs,” the rule summary stated.
“This revision would ensure that more community health care providers and other HIE community partners can deliver informed medical care to patients by having access to the patient's VA medical records at the point of care.”
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UCSF Tech Tool Empowers Patients

Alexandra Wilson Pecci, January 23, 2018

Tablet technology is a 'key enabler' to patient experience.

Seth Bokser, MD, a practicing pediatric hospitalist at UCSF Benioff Children's Hospital, and chief medical officer at health technology company Oneview Healthcare, is helping hospitals achieve goals such as improving patient experience using Oneview's IT solution.
Oneview's technology is in use at a number of facilities around the world, including UCSF.

How it works

Oneview's personalized hospital bedside tablets or monitors allow patients to communicate directly with their care team, select and order meals, set and track recovery goals, Skype with family during a clinical consultation, play video games, watch movies, receive patient education, and other functions.
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FHIR transformative, blockchain overhyped, CIOs say

Innovation was the largest divergence among results with only 14 percent having a dedicated innovation center and a third with no innovation plans in the next 24 months.
January 19, 201801:34 PM
HL7's FHIR specification was seen as the one with the most potential to have an impact in the next two years.
Innovation is something everyone in healthcare is after. But not everyone is approaching it the same way – and not everyone is able to prioritize it in the ways they'd prefer. That's according to a new survey of CHIME member CIOs from Impact Advisors.
The poll finds significant divergence across health systems with regard to innovation efforts, and an uneven pace of change as certain IT leaders are freer to innovate than others, with the budgets, staff resources and leadership support to put technology to work in envelope-pushing ways.
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Physician practices forced to use paper records lash out at Allscripts over ransomware response

Jan 22, 2018 2:10pm
Allscripts is still working to bring its cloud-hosted services back online after a ransomware attack took down several applications, prompting an outcry from physicians who lost access to their EHR and appointment systems. 
In a notice to Allscripts clients early Monday morning, the company said its Electronic Prescriptions for Controlled Substances (EPCS) had been restored, but the company is still working to restore cloud-hosted services like Allscripts PM and its Professional EHR. Those outages are becoming increasingly frustrating for smaller physician practices that have resorted to pen and paper after having no access to medical records, scheduling or payment systems for the last five days.
“Allscripts has totally dropped the ball in downplaying what is going on and not coming forward with exactly what is happening,” Mansoor Ahmed, the office manager for Capital Internal Medicine, a single-physician practice in Raleigh, North Carolina, told FierceHealthcare. “All the stuff they have brought back up are secondary services.”
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7 cybersecurity trends to watch out for in 2018

Will 2018 be better or worse than 2017? Current trends and future predictions.

I think it's fair to say, 2017 wasn't a great year for cyber-security. We saw a large number of high-profile cyberattacks; including Uber, Deloitte, Equifax and the now infamous WannaCry ransomware attack. Despite the constant flow of security updates and patches, the number of attacks continue to rise.
This raises the question…will 2018 be better or worse than 2017? Let’s take a look at some of the current trends and future predictions.

1. AI-powered attacks

AI/Machine Learning (ML) software has the ability to "learn" from the consequences of past events in order to help predict and identify cybersecurity threats. According to a report by Webroot, AI is used by approximately 87% of US cybersecurity professionals. However, AI may prove to be a double-edged sword as 91% of security professionals are concerned that hackers will use AI to launch even more sophisticated cyber-attacks.
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Latvia should consider creating single agency to oversee all e-projects - Green Party leader

RIGA - Latvia should consider creating a single government agency employing highly skilled and well-paid professionals to oversee implementation of all major e-projects, said Edgars Tavars, the board chairman of the Latvian Green Party which is a member of the ruling Greens/Farmers bloc.
He said that people with special competences were required for implementation of nationwide e-projects and there were few such people in the Latvian public administration, each working for a different agency.
Following the troubles with implementation of the e-health project, it is time to consider creating a single government agency employing highly skilled and well-paid professionals to handle all major e-projects, Tavars suggested.
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HIT Think How blockchain can help reduce administrative costs

Published January 22 2018, 5:35pm EST
Patients payments for healthcare services now represent about 35 percent of the healthcare spend. As a consequence, they’re expecting more value for their money.
From the payer perspective, their value proposition now includes providing adequate coverage while controlling overall costs. Policy administration, however, is not an easy task. In fact, it’s one of the areas in which costs have spiraled out of control.
Consequently, policy administration is an area in which intermediaries could benefit most from blockchain technology. It can simplify tasks related to claims, fraud and verification, enabling payers to direct more time and funds to providing better, more affordable coverage for policyholders.
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Enjoy!
David.

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