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, March 10, 2018

Weekly Overseas Health IT Links – 10th March, 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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Rock Health wants to reframe the discussion around digital health to focus on patients


A lot of money has flowed into the digital health industry over the last seven years—$23.8 billion to be exact.
But Rock Health, the venture capital firm that tracks funding across the industry, wants to shift the discussion about health startups from dollars and cents to human beings.
Most technology startups in the consumer world measure value based on online advertising or revenue to investors. But monetary figures associated with digital health companies are “not a metric of success,” according to Bill Evans, CEO and managing director of Rock Health.
“[Venture capital] is a measure of belief and potential within the industry, and that’s valid,” he told FierceHealthcare. “It’s useful to understand where folks are investing money, but it’s not a measure of the actual impact.”
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March 1, 2018 / 9:38 PM /

Big pharma, big data: why drugmakers want your health records

LONDON (Reuters) - Drugmakers are racing to scoop up patient health records and strike deals with technology companies as big data analytics start to unlock a trove of information about how medicines perform in the real world.
Studying such real-world evidence offers manufacturers a powerful tool to prove the value of their drugs - something Roche (ROG.S) aims to leverage, for example, with last month’s $2 billion purchase of Flatiron Health.
Real-world evidence involves collecting data outside traditional randomized clinical trials, the current gold standard for judging medicines, and interest in the field is ballooning.
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Intermountain launches global DNA database for medical research

Published March 02 2018, 7:13am EST
Intermountain Healthcare is building a new global DNA database based on electronic health histories from people around the world, which the research community will use to determine who might be at risk for developing genetic diseases.
The GeneRosity Registry, which is funded by the Intermountain Research and Medical Foundation, is attempting to leverage existing genetic test results from adult consumers who have already purchased commercial testing services such as AncestryDNA, MyHeritage and 23andMe.
The goal is to convince consumers to voluntarily upload their raw and unprocessed genetic data to the registry’s website, as well as provide a detailed personal and family medical history that includes information from three generations of relatives, such as children, brothers and sisters, parents, grandparents, aunts, uncles, nieces, nephews and cousins.
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HIT Think FDA extends regulatory reach to low-risk CDS software

Published March 02 2018, 6:04pm EST
Historically, the Food and Drug Administration hasn’t regulated most clinical decision support software. But it might be time for developers of this type of software to start paying attention to the FDA, because that’s likely going to change.
In a surprise move, the FDA published a draft guidance in December that would regulate essentially all CDS software, unless it meets special requirements of the 21st Century Cures Act.
According to the 21st Century Cures Act, CDS software is exempt from FDA regulation if the software enables a professional user “to independently review the basis for” any recommendations the software presents so that the user does not need to rely primarily” on the recommendations.
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How technology can help in the fight against opioids

Health IT is critical to deliver the right data to the right place at the right time and empower clinicians and pharmacists to make informed decisions.
February 28, 2018 12:22 PM
Directly or indirectly, the scourge of opiate addiction has deeply hurt many families to their core. That includes many members of our own Allscripts family. If we haven't been personally affected by this modern menace, chances are we know people who have.
The Centers for Disease Control and Prevention reports that prescription opioid use and overdoses have quadrupled since 1999. More than 40 Americans die every day from prescription opioid and opiate overdose alone. And when you factor in drugs from the street, which is often where patients turn when they can no longer obtain or afford their legal prescriptions, that number explodes to more than 115 Americans dying every day. The CDC estimates that the total economic impact of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment and criminal justice involvement.
Our industry knows technology can better support and empower those on the front lines, and help to reverse this frightening trend of overprescription, addiction, overdose and death. We know this to be true from our own experience, and what we are hearing from our clients.
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EHRs steal primary care doctors face time with patients, study finds

New research determined that providers spend more than half of clinic visits working with their EHRs than they do interacting with patients.
March 01, 2018 10:12 AM
Primary care providers spend more time working with their electronic health record systems than they do looking at patients during visits, according to new research published in Family Medicine.
Researchers performed an observational study of family physician residents, attendings and ambulatory patients across 982 clinic visits, associated with 10 Residency Research Network of Texas (RRNeT) residencies from May to June 2015.
They found family providers spend about 18.6 minutes on clinical documentation in the EHR, but about 16.5 minutes on face-to-face interaction with patients. The length of time spent on a patient visit was more for the number of reasons for the visit, new patients, number of medications and the like.
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Bipartisan Senate bill would require EPCS nationwide to fight opioids

The Every Prescription Conveyed Securely Act calls for mandated e-prescribing of controlled substances under Medicare Part D, starting in 2020.
February 28, 2018 02:23 PM
A bipartisan group of U.S. Senators – Elizabeth Warren, D-Massachusetts; Michael Bennet, D-Colorado; Dean Heller, R-Nevada, and Pat Toomey, R-Pennsylvania – introduced a bill on Feb. 27 that seeks to harness health IT to help combat the opioid crisis.
The Every Prescription Conveyed Securely Act would mandate electronic prescriptions for all controlled substances under Medicare.
"We need to be using every tool at our disposal to fight the opioid epidemic," said Warren in a statement, noting that EPCS would "help gather better data on the opioid epidemic while also helping health care providers make the best decisions for their patients."
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Pregnancy Apps: Your Patients Use Them—Are You Up to Speed?

Tara Haelle
February 28, 2018

No Shortage of Apps for Pregnant Women

As many as 4 in 5 US women of childbearing age have a smartphone, and about one fourth of these women use health apps, according to Katherine Chen, MD, professor and vice-chair of education in the Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai in New York City. Among more than 90,000 apps in the Apple iTunes® store, 7% focus on women's health and pregnancy.[1]
These apps, which number in the thousands, aim to capture the attention of pregnant women by offering tools for everything from tracking fetal development to timing contractions. "Apps are becoming more patient-centered," said Dr Chen, who studies ob/gyn-related mobile apps. Although she focuses on apps for clinicians, Dr Chen sees growing interest in apps that help pregnant women track their health and communicate with providers.
Few data exist on how many women use pregnancy apps or which apps are most used, but their popularity is undeniable. A 2013 report by ByteMobile[2] found that pregnancy-related apps edged out fitness apps as the most-used health apps. Among smartphone owners using health apps, 47% were using one or more apps related to pregnancy, compared with 39% who were using fitness apps. More recent analytics on health apps are hard to come by, but US smartphone use has more than doubled since 2011, from 35% to 77% in 2016,[3] suggesting more widespread app use.
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Decision-support solution aims to aid clinicians with personalized care

Published March 01 2018, 4:14pm EST
Wolters Kluwer Health is launching a solution intended to support clinicians in making decisions and encourage fewer variations in care through the use of clinical pathways.
The product, UpToDate Advanced, enables clinicians to use interactive clinical decision making so they can streamline care at different points of the care delivery process.
Executives of the company say they expect the product to help physicians deliver personalized, patient-specific care while helping to limit variations in care.
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HIT Think Why digital transformation is crucial for healthcare providers

Published March 01 2018, 5:43pm EST
In some respects, the future of healthcare is already here. There are ground-breaking treatments and medications that were unimaginable a few years ago. Researchers are exploring how nanotechnology can be used to deliver lifesaving medications, and robots are assisting surgeons in the operating room.
While the future of healthcare is here, unfortunately, it continues to get more expensive every year. A few days ago, the Centers for Medicare & Medicaid Services (CMS) announced its healthcare expenditures forecast for the next eight years. CMS expects U.S. health spending to increase by 5.5 percent every year until 2026, when the dollar amount for care is estimated to hit a staggering $5.7 trillion. From this data, it’s clear that healthcare will remain expensive.
While CMS cites several contributing factors, the “increases in prices for medical goods and services” impacts many people directly. This price surge has not gone unnoticed by healthcare consumers, who are already challenging the healthcare industry status quo as they read and post online reviews of providers and hospitals, search for care by quality and price, and generally push healthcare to become akin to an online retail experience.
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Healthcare Orgs Increasingly Value Information Governance

Eighty-four percent of surveyed healthcare organizations are familiar with information governance, according to AHIMA.

February 27, 2018 - More healthcare organizations view information governance (IG) as a business imperative rather than a buzzword, according to a recent survey from the American Health Information Management Association (AHIMA).
AHIMA presented these findings in a February white paper titled The Pulse on Information Governance in Healthcare.
AHIMA gathered responses from 1,500 healthcare professionals from July to August 2017 to gain insight into the level of IG adoption across the industry. The association also surveyed respondents about their current knowledge of IG, their views on the drivers for IG, current barriers to IG progress, and project priorities for IG, among other areas of interest.
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SEC’s updated cybersecurity guidance could have implications for healthcare M&A

Feb 28, 2018 12:57pm
Updated cybersecurity guidance from the Securities and Exchange Commission (SEC) could have trickle-down effect on the healthcare industry, with implications for mergers and acquisitions, according to legal and cybersecurity experts.
Released by the SEC last week, the new interpretive guidance (PDF) outlines the regulator's cybersecurity disclosure expectations, requiring public companies to inform investors about “material cybersecurity risks and incidents in a timely fashion.” The agency also stipulates that directors, officers and corporate insiders are prohibited from trading securities in the wake of a cyberattack.
Additionally, companies must have policies and procedures in place to prevent corporate insiders from trading stock during the period between the discovery of an incident and a public disclosure.
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Groups offer strategy for regulating health IT

Published February 28 2018, 7:24am EST
The Bipartisan Policy Center and Health IT Now are calling on the federal government to implement a more modern oversight framework for digital healthcare and HIT that reduces burdens for users and technology developers, fostering innovation while ensuring consumer protections.
On Tuesday, the organizations released a report—based on feedback of a work group of nearly 50 individuals representing patients, providers, and vendors—that lays out principles and recommendations for policymakers to consider as they seek to reduce burdens and advance regulatory reforms.
“Nearly 10 years after the passage of the HITECH Act, the time is now to update the course of federal health IT policy,” states the report.
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Microsoft again aims to crack healthcare market with cloud tools

Published February 28 2018, 5:36pm EST
Microsoft is releasing new cloud technologies to fight disease and help healthcare companies abide by privacy laws as the software giant looks to win more business as the medical sector moves to internet-based computing.
Microsoft unveiled a tool for its Azure service that puts powerful computing resources to the task of gene-analysis for precision medicine—things like tailoring therapies to specific cancers. It’s already in use at St. Jude Children’s Research Hospital, which will report its progress with extremely rare cancers at the American Association for Cancer Research conference in April, said Peter Lee, a Microsoft vice president for artificial intelligence and research.
The company is also releasing a blueprint for firms that want to move health data to the cloud while following privacy regulations. The company made the announcements ahead of the annual HIMSS conference and exposition next week in Las Vegas.
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VA taps Google's DeepMind to predict patient deterioration

Feb 26, 2018 12:35pm
The Department of Veterans Affairs has launched a partnership with Google’s DeepMind to analyze patient records and build a model that can predict when a patient is deteriorating.
The VA said it will allow DeepMind’s algorithm to parse through 700,000 depersonalized health records, allowing the company’s algorithm to initially focus on predicting the onset of acute kidney injuries.
“Medicine is more than treating patients’ problems,” VA Secretary David Shulkin, M.D., said in an announcement. “Clinicians need to be able to identify risks to help prevent disease. This collaboration is an opportunity to advance the quality of care for our nation’s veterans by predicting deterioration and applying interventions early.” 
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Cyber-Security Reports Reveal Growing Concerns About Data Breach Risks

By: Sean Michael Kerner | February 23, 2018
NEW ANALYSIS: Nine different cyber-security reports released the week of Feb.19 - 23 show a rising volume of cyber-threats, though not all organizations are preparing for the right types of attacks.
The week of Feb. 19 was a busy one for cyber-security industry reports as at least nine different technology companies released studies that tried to provide insight into a wide array of cyber-risks.
Among the organizations that released reports this week were Akamai, Cisco, RedLock, Fortinet, Trend Micro, Raytheon, Thales, Verizon and Centrify. Some of the reports provide broad industry context for the state of cyber-security in 2018, while others focused on more specific areas like mobility and the gap between cyber-security perceptions and reality.
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Algorithm uses EHR data to identify undiagnosed hypertension patients

Published February 27 2018, 7:23am EST
A computerized algorithm used to analyze electronic health record data from 10 health centers was able to improve the identification and diagnosis of patients with hypertension in underserved communities.
The 10 health centers in Arkansas, California, Kentucky and Missouri were selected for the EHR analysis because they had a high prevalence of hypertension in their respective patient populations, compared with the national average, according to Margaret Meador, director of clinical integration and education at the National Association of Community Health Centers.
Meador, who led the study funded by the Centers for Disease Control and Prevention, contends that researchers developed an algorithm specifically for use in safety-net health centers to confirm elevated blood pressure readings and to diagnose patients with hypertension. Ultimately, Meador says what they discovered by mining EHR data were cases of undiagnosed hypertension.
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Pilot project aims to use direct messaging on eHealth Exchange

Published February 27 2018, 4:24pm EST
Document Storage Systems is working on a pilot project with the Sequoia Project interoperability initiative to bring direct messaging technology to community care providers.
The program’s goal is to increase the secure sharing of provider data with federal agencies that are using direct messaging by tapping into Sequoia’s Direct Trust health data exchange.
The company’s Direct Messaging pilot program on the nationwide eHealth Exchange health data sharing network is expected to increase the ability to coordinate care with community facilities by reaching more rural care providers, including critical access hospitals. The program is designed to bridge a gap for secure relevant data sharing with federal agencies using Direct Messaging.
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HIT Think How HIT is rapidly evolving to meet new treatment patterns

Published February 27 2018, 5:32pm EST
Healthcare is evolving quickly and HIMSS18 offers a broad range of healthcare issues to explore, but will it mourn the passing of the traditional office visit and embrace new HIT driven meet ups?
New requirements for implementing HIT systems are changing as new health IT priorities and procedures emerge. Convergence in the healthcare sector is accelerating the need for interoperability, not just for EHRs, but also across clinical, financial and operational systems. This need also is challenging and changing one of the biggest traditions in healthcare—the doctor-patient medical visit.
In the past, patients would simply make appointments to visit their physicians, but now, we have the popularity of annual wellness visits and the growing need for chronic care treatments caused by the opioid epidemic and other behavioral health issues. These trends are causing physicians to be the ones actively pursuing patients, but with both sides reaping the benefits. This new approach to the traditional doctor-patient relationship enables patients to receive better care while clinics and hospitals build up a roster of new and potentially long care patients.
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Apple to launch 'technology enabled' healthcare service

Following Amazon’s lead, iPhone maker creating in-house clinics and health service for employees
Two healthcare centres are planned to open in the spring within Santa Clara County, Californian, near Apple Park (above) and Infinite Loop headquarters. Photograph: Justin Sullivan/Getty Images
Apple is launching its own primary care health clinics called AC Wellness, following Amazon and Warren Buffett’s push into healthcare.
Similar to Amazon’s team up with Berkshire Hathaway and JP Morgan, the AC Wellness Network aims to serve Apple’s roster of employees and their families providing “compassionate, effective healthcare to the Apple employee population”.
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InterSystems to debut FHIR interoperability sandbox at HIMSS18

The cloud service will enable developers to build FHIR apps in a vendor-neutral environment.
February 23, 2018 10:16 AM
This year at HIMSS18, InterSystems will be launching a new fast healthcare interoperability resource (FHIR) sandbox, which acts as a virtual testing environment. The technology is designed to enable developers to connect to multi-source health records when they are testing and developing their apps. The technology specifically targets app platforms that let inventors create SMART on FHIR apps in a vendor-neutral environment.
“We thought a vendor-neutral sandbox would be good for the community to learn about FHIR and FHIR apps,” said Don Woodlock, vice president of InterSystems HealthShare. 
Woodlock explained that developers can look at or download FHIR apps, understand the code and best practices, and then build their own apps. The technology will make it easier for health IT innovators to join the app ecosystem, according to the company. Currently, most SMART apps are tested on an FHIR that is specific to a company’s EHR but the sandbox program runs on InterSystems’ HealthShare program, which is aimed at tackling interoperability. 
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What the Hospitals of the Future Look Like

The sprawling institutions we know are radically changing—becoming smaller, more digital, or disappearing completely. The result should be cheaper and better care.

By Laura Landro
Feb. 25, 2018 10:11 p.m. ET
The days of the hospital as we know it may be numbered.
In a shift away from their traditional inpatient facilities, health-care providers are investing in outpatient clinics, same-day surgery centers, free-standing emergency rooms and microhospitals, which offer as few as eight beds for overnight stays. They are setting up programs that monitor people 24/7 in their own homes. And they are turning to digital technology to treat and keep tabs on patients remotely from a high-tech hub.
For the most part, the investments in outside treatment are driven by simple economics: Traditional hospital care is too costly and inefficient for many medical issues. Inpatient pneumonia treatment, for example, can cost 15 to 25 times more, yet many low-risk patients who could be safely treated as outpatients are hospitalized, studies have shown.
And being hospitalized carries its own risks: With the rise in antibiotic-resistant bacteria, at any given time one in 25 patients in the U.S. is battling an infection acquired in the hospital, according to the Centers for Disease Control and Prevention—at a cost of $10 billion annually for the five most common infections.
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Do EHRs Save on Administrative Costs? Study Contradicts Expectations

Revenue Cycle Advisor, February 23, 2018

Early on, the belief that EHRs would reduce administrative costs for providers was widespread. A study says that hasn't been the case. But it may not be the fault of EHRs themselves.

Electronic health records (EHR) aren’t able to reduce administrative costs, according to a study published February 20 in the Journal of the American Medical Association (JAMA).
The study aimed to determine the administrative costs of billing and insurance-related activity at an academic healthcare system with an EHR. The study looked at the amount of time it took to complete billing and insurance activities in the EHR and the cost of personnel and overhead. The study authors then used the cost data to determine what percentage of professional revenue the costs represent.
Both the estimated cost and the percentage of professional revenue represented by the cost varied greatly.
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Health informatics leaders say it’s time for Congress to lift its ban on a unique patient identifier

Feb 26, 2018 11:40am
Citing the potential to minimize misidentification and medical errors, health informatics leaders from England, Scotland and the United States are calling on Congress to lift a 20-year ban on using federal funds to establish a unique patient identifier.
John Halamka, M.D., CIO at Beth Israel Deaconess Medical Center and David Bates, M.D., senior vice president and chief innovation officer at Brigham and Women’s Hospital, were joined by health IT leaders at Britain’s National Health Service and the University of Edinburgh in advocating for the use of patient identifiers in the U.S. Although HIPAA initially required the creation of a health identifier in 1998, Congress overruled the legislation, barring federal agencies from investigating or creating patient identifiers out of privacy concerns.
In an op-ed published in NEJM Catalyst, the group said Congress responded to a “highly vocal minority” and called on the Office of the National Coordinator for Health IT to push lawmakers to lift the decades-old ban and begin piloting possible solutions.
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Strong IT and vendor partnerships are key to successful system-wide telehealth

Written by Mike Baird | February 21, 2018 | Print  |
Telehealth is widely successful in the areas of stroke management, mental health care and primary care consultations for remote patients.
So it should come as no surprise that telehealth is now used by more than 70 percent of healthcare providers, according to recent industry estimates.
Yet telehealth’s greatest potential lies in its ability to impact multiple patient demographics — beyond stroke management and other high-acuity cases. A growing number of healthcare leaders understand this potential, and are now trying to determine how to scale their organizations’ existing telehealth programs to impact low-acuity, post-acute and non-emergent care.
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Industry Associations Line Up to Offer Comments on ONC’s TEFCA

February 21, 2018
by Rajiv Leventhal and David Raths
Healthcare groups seem concerned about the TEFCA’s timeline, details, and how it will be aligned with other 21st Century Cures Act provisions
An array of healthcare IT trade groups have sent in comments offering insight and recommendations on ONC’s draft Trusted Exchange Framework and Common Agreement (TEFCA).
For background, last month the Department of Health and Human Services (HHS) released its draft Trusted Exchange Framework, as required by the 21st Century Cures Act of 2016. Specifically, Congress directed ONC (the Office of the National Coordinator for Health IT) in the legislation to “develop or support a trusted exchange framework, including a common agreement among health information networks nationally.”
The draft Trusted Exchange Framework, released on Jan. 5, 2018, outlines a common set of principles for trusted exchange and minimum terms and conditions for trusted exchange. This is designed to bridge the gap between providers’ and patients’ information systems and enable interoperability across disparate health information networks (HINs) by providing a “single on-ramp” to patient information, according to ONC officials. What’s more, the TEFCA will be facilitated through ONC in collaboration with a single recognized coordinating entity (RCE).
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CHIME offers guidance on using tech to fight opioid epidemic

Published February 21 2018, 7:27am EST
As the Senate Finance Committee examines new policies to improve access to care and the quality of treatment by addressing root causes that lead to substance abuse, healthcare chief information officers are giving committee leaders Orrin Hatch (R-Utah) and Ron Wyden (D-Ore.) some guidance.
The College of Healthcare Information Management Executives recently rolled out an opioid task force to identify ways to use technology and data to find solutions.
In a letter to lawmakers, CHIME leaders cautioned against imposing unfunded mandates on providers for more infrastructure but to continue to build off existing technologies including the nearly universal use of electronic health record systems.
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Clinicians to CMS, ONC: “Right the Ship” to Simplify Reporting, Ease Regulatory Burdens

February 23, 2018
by Heather Landi
During a daylong listening session sponsored by federal healthcare and health IT officials focused on the issue of reducing clinician burden, healthcare industry stakeholders—physicians, nurses, patient advocates and entrepreneurs—shared a litany of frustrations and complaints about electronic health records (EHRs) systems adding to administrative burden and contributing to physician burnout.
Officials with the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC), both within the U.S. Department of Health and Human Services (HHS), got an earful from clinicians and other stakeholders about poor health IT workflows and the challenge of keeping up with government reporting requirements. The listening session took place in person in Washington, D.C., as well as via telephone.
One semi-retired practicing physician said that in the process of adopting health IT and EHRs, the healthcare industry’s focus has shifted from the patients to billing.
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HIT Think How embedding care pathways in an EHR improves care

Published February 26 2018, 5:49pm EST
Regardless of which term you use, the concept of managing patients via care pathways is familiar to many healthcare providers. But the execution of care pathways looks different from one organization to another.
The general concept of a care pathway is a multidisciplinary-managed, tool-based health care plan for a specific group of patients with a predictable clinical course in which the different tasks by the professionals involved in the patients’ care are defined, optimized and sequenced. Using clinical care paths benefits both patients—by improving patient experience and care quality—and health systems—by containing costs, helping to reallocate resources appropriately, uncovering areas of needed improvement and benchmarking performance.
Our organization has partnering with Cleveland Clinic’s Heart and Vascular Institute to embed and enable care pathways within the EHR—a task for which there is no clear industry standard. By successfully embedding the Coronary Artery Bypass Graft (CABG) care pathway into the EHR, Cleveland Clinic has not only helped redefine what a care path looks like, but the Clinic has also been able to test whether electronic care pathways can reduce care variation—with promising results.
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Enjoy!
David.

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