Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, April 28, 2018

Weekly Overseas Health IT Links – 28th April, 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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How a single source of truth database is helping one health system drive analytics success

Health Quest concluded it needed one database to help inform its approach to various clinical, financial and operational initiatives.
April 19, 2018 02:22 PM

Health Quest, a Hudson Valley-based health system comprising four hospitals and provider organizations, decided it needed a single source of truth database where it could send its staff for projects focused on achieving the Triple Aim.
With some work, it was able to combine its homegrown enterprise data warehouse with another developed by vendor Health Catalyst.
With that goal achieved, Health Quest is now seeing results.
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April 19, 2018 / 9:05 AM / 2 days ago

AI pharma firm BenevolentAI raises $115 million in funding

LONDON (Reuters) - BenevolentAI, a British pharmaceutical company that uses artificial intelligence to identify new drug candidates, said it had raised $115 million in a funding round that valued it at $2 billion. 
The company, which has more than 20 drugs in development, said it would use the funds to scale its activities, broaden the disease areas on which it focuses, and extend its AI platform capabilities.
Founder and chairman Ken Mulvany said the company had grown rapidly since it was founded in 2013.
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Is Your Health Data About to Get Hacked?

In March, Under Armour announced that the accounts of more than 150 million MyFitnessPal users had been compromised. What does that mean for the rest of the workout app industry?

Apr 19, 2018
Data breaches are now literally more than a daily occurrence—2,216 happened in the past year alone, according to Verizon’s annual Data Breach Investigations Report, released on April 10.
Health-related organizations accounted for a quarter of those incidents. Three weeks ago, that group claimed a troubling new member: Under Armour’s MyFitnessPal, which announced a data breach had exposed information (usernames, email addresses, and passwords) of up to 150 million users.
This is the first known data breach of a major consumer fitness app. (In 2016, Fitbit suffered a small breach, but the issue involved just a few dozen accounts where hackers stole user passwords independently, and used the accounts to seek fraudulent refunds.) But it likely won’t be the last. And what’s at stake is data far more intimate than passwords and usernames. Fitness trackers know our heart rates and step counts. They know we didn’t sleep well last night, maybe because they also know we ate barbecue and had a couple beers. And they track detailed patterns on when and where we like to work out, with whom, and where we live.
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FDA's 2019 budget request cites digital health; agency rolls out medical device initiative

April 18, 2018
Digital health appears to be making its way onto the national stage. Yesterday, FDA Commissioner Scott Gottlieb gave the field a shout-out in his remarks to the US House Subcommittee on Agriculture, Rural Development concerning the Fiscal Year 2019 budget request for the FDA. 
“The Budget requests new resources for the FDA to make significant investments in advancing critical areas of science, domestic technology and public health,” Gottlieb said to the subcommittee.  “Among these efforts, we're seeking to advance a new paradigm in the regulation of digital health technology that I believe will allow us to grow this promising field more quickly.”
The President’s Fiscal Year 2019 budget request asks for a total of $5.8 billion for the FDA, which means an increase of $663 million or 13 percent more than the FY 2018 Annualized Continuing Resolution, according to Gottlieb. 
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NHS Digital’s sharing of non-clinical patient data branded “inappropriate”

17 April 2018
NHS Digital’s sharing of non-clinical patient information with the Home Office has been branded “entirely inappropriate” by MPs, who say they are concerned about the body’s ability to act as a reliable steward of the data.
The Health and Social Care Committee launched an inquiry into the memorandum of understanding (MoU) on data sharing between NHS Digital, the Department of Health and Social Care and Home Office.
The memoradum, which came into effect in January 2017, allows the Home Office to gain access to patient data – including non-clinical information – for the purpose of tracing immigration offenders and vulnerable people.
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HIT Think How automation is thwarted when humans get involved

Published April 20 2018, 3:41pm EDT
Automation holds incredible power to streamline our work and personal lives and is a significant contributor to the progress being experienced in healthcare. Automation has a huge impact on lowering cost, but too often “automated” processes require far too many manual touches.
It’s hard to think of another industry where data plays such a dynamic role, with millions of transactions occurring daily between healthcare providers and suppliers. Automation has helped to speed those orders and payment transactions, but too often, price discrepancies, bad data or other data errors require manual intervention that disrupts the entire process, creates more opportunity for error, and raises overall costs. It’s the cascading effect of humans.
What’s needed is a heightened priority for validating the accuracy of data before sending it through to the next function in the order-to-pay process. The best way to get speed into the process is accuracy. Errors will always stop automation cold.
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AMIA letter casts broadband as a social determinant of health

Published April 19 2018, 7:21am EDT
The American Medical Informatics Association is calling on Congress to provide some kind of exemption for healthcare uses of the Internet from recently finalized federal rules on net neutrality.
The professional organization this week wrote letters to Reps. Marsha Blackburn (R-Tenn.) and Michael Doyle (D-Pa.), leaders of the House Energy and Commerce committee, which recently held a hearing on the issue of Internet prioritization.
“We’re trying to say that when Congress thinks of policies impacting availability of and cost of broadband, they have to know that care has become digitized,” says Jeff Smith, AMIA’s vice president of public policy. “How we give care has become digital.”
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Telemedicine can accurately diagnose rare cause of preemie blindness

Published April 19 2018, 7:23am EDT
Telemedicine has been shown to accurately diagnosis a rare cause of blindness in premature babies as effectively overall as in-person eye exams.
Researchers from Oregon Health & Science University teamed with seven medical institutions to examine the eyes of 281 infants who were at risk for retinopathy of prematurity (ROP), a rare but devastating cause of blindness in preemies.
They compared the accuracy of in-person exams with digital eye images that were remotely evaluated using telemedicine and found that there was no difference in the overall accuracy between the two evaluation methods. Results of the study were published in the journal JAMA Ophthalmology.
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Interoperability at top of CMS, White House agenda

Published April 19 2018, 7:24am EDT
Interoperability is a top priority for the Centers for Medicare and Medicaid Services and the White House as well, according to Kate Goodrich, MD, chief medical officer and director of the CMS Center for Clinical Standards and Quality.
There’s “lots of ongoing work around interoperability,” including coordination with the Office of the National Coordinator for Health IT and the Department of Veterans Affairs, said Goodrich during Wednesday’s HIT Advisory Committee Meeting.
“We are looking very broadly at all of the levers we have within CMS around how we can promote interoperability,” she added. “There were a number of roundtables held at the White House around this topic, which actually gave us a lot of terrific ideas that we are actively exploring. You will see some provisions intended to enhance the ability for folks to have access to their data from a patient-centric point of view.”
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Special Report: Diagnostic digital pathology

While experts welcome the current interest in diagnostic digital pathology, they believe that implementation of digital workflows, which includes integration between systems and software, is key to achieving widespread adoption and driving improvements. Claire Read reports.
As a key voice in digital pathology, Darren Treanor admits with a chuckle that people probably expect him to have foreseen the “absolute explosion” of interest in the field over the past 12 months.
But after over a decade as one of the few UK pathologists using the technology – in which slides are scanned into a computer for review, rather than being viewed on a glass slide down a microscope – he and others had become used to waiting for a moment which seemed determined not to arrive.
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KLAS report explores health IT buying decisions, customer satisfaction

The new study takes a broad view of dozens of healthcare market segments, from acute EHRs to virtual care platforms, and assesses the how providers choose vendor partnerships.
April 18, 2018 04:32 PM
When choosing a vendor, customers focus on integration, consolidation and functionality, according to a new study from KLAS that looks at how IT decision-makers choose their technologies in different market segments.
Satisfaction level of existing customers and retention rate (the percent of buyers planning to continue with a given vendor) were also included as reasons.
The Decision Insights 2018 report draws on the insights of buyers of EHRs, population health platforms, analytics tools, imaging systems and more to track the rationale for the initial acquisition and assess customer satisfaction afterward.
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Lean Methodology Boosts EHR Documentation Quality, Efficiency

Lean methodologies helped improve EHR documentation quality and efficiency, extended patient care time, and increased patient and provider satisfaction.

April 18, 2018 - Applying Lean methodologies to an inefficient, first-generation electronic health record (EHR) system could enhance EHR documentation quality and efficiency, increase patient care time, and improve both provider and patient satisfaction, according to a study published in AHIMA’s Perspectives in Health Information Management.
Led by Maryane M. Dinkins, MS, PT, the research noted that many healthcare professionals are concerned that EHR use is obstructing quality care although one of the primary goals of an EHR is to provide clinicians with timely, accurate, and complete patient data,.
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FDA Announces Plan to Advance Medical Device Safety and Cybersecurity

April 18, 2018
by Heather Landi
While medical devices play an increasing role in patient care and provide life-saving benefits to patients, these devices can be vulnerable to security breaches and therefore pose significant risks to healthcare cybersecurity. To address medical device safety, the Food and Drug Administration (FDA) has announced plans to advance new frameworks for identifying risks and protecting consumers, including proposals aimed at advancing medical device cybersecurity.
This week, the FDA released the Medical Device Safety Action Plan: Protecting Patients, Promoting Public Health. This new Action Plan outlines the FDA’s vision for how the agency can continue to enhance programs and processes to assure the safety of medical devices. “Our aim is to make sure that the new advances in technology that are enabling better capabilities and benefits are also harnessed to bring added assurances of safety, so that more patients can benefit from new devices and address unmet needs,” FDA Commissioner Scott Gottlieb, M.D., said in a statement.
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What are the challenges to getting precision medicine into the mainstream?

Experts point to the need to demonstrate value, as well as challenges integrating genomic data into EHRs and handling massive amounts of data.
April 17, 2018 02:59 PM
Research and innovation in personalized medicine are surging. However, adoption of personalized medicine technologies into clinical practice is comparatively slow.
There are a number of significant challenges to the integration of personalized medicine into healthcare practice. The Personalized Medicine Coalition is one organization that has been working to help identify and categorize challenges as well as identify strategies for providers to overcome these challenges.
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US, UK accuse Russia of actively targeting internet routers, devices

The rare joint alert says Russia, behind the global NotPetya attack, has been laying the groundwork for future cyberattacks and targeting critical infrastructure.
April 17, 2018 12:59 PM
Russian hackers are actively targeting devices that control the flow of internet traffic to gain access and spy on Western governments and businesses, according to a rare joint alert from the U.S. and U.K. released Monday.
Delivered by the Department of Homeland Security, FBI and U.K. National Cybersecurity Centre, the warning outlines Russian state-sponsored cyberattacks penetrating software programs and devices, including firewalls and internet routers, on a global scale.
The goal, according to officials, is to steal company secrets and spy on these countries. The hackers also are attempting to lay the foundation for future cyberattacks, the agencies said.
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How Apple's Health Records could reshape patient engagement

Dignity Health's chief digital officer explains why he thinks Apple can succeed for population health and precision medicine efforts where other PHR launches have not.
April 18, 2018 09:46 AM
As a longtime collaborator with Apple – since before it even beta-tested its Health Records project, live now at 39 hospitals – San Francisco-based Dignity Health is in sync with the iPhone developer's vision, said Shez Partovi, MD.
"We had been working with Apple prior to their initial announcement for some time," said Partovi, chief digital officer and senior vice president of digital transformation at Dignity Health. "We'd been working with them for a while because we're aligned in our philosophies of empowering patients by giving them their data."
As part of the Health Records launch, Dignity will leverage HL7's FHIR standard to securely move patients' health data from own electronic health record system to the iPhones of patients using iOS 11.3 – enabling them manage meds, labs, allergies, conditions and more, and notifying them when the health system makes changes to their health information.
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DEA to share prescription drug data with 50 attorneys general, crack down on drugmakers

Apr 18, 2018 11:32am
The Drug Enforcement Agency has reached an agreement with 50 attorneys general to share prescription drug data with one another to support ongoing investigations.
As part of the agreement, the DEA will provide attorneys general in 48 states, the District of Columbia and Puerto Rico with data from its Automation of Reports and Consolidated Orders System (ARCOS), which collects 80 million prescription drug transactions from manufacturers and distributors each year.
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Obstetrician will no longer be able to deliver babies after refusing electronic records training

Apr 18, 2018 8:50pm
Computers have spelled the end of delivering babies for an Illinois obstetrician.
Jeffrey B. Johnson, M.D., 75, has declined to participate in mandatory training to learn how to use the new electronic medical record system at St. Alexius Medical Center located in Hoffman Estates, Illinois, a Northwest suburb of Chicago. 
That means he won’t be able to continue to deliver babies at the medical center after a more than 50-year career, according to a column in the Daily Herald.
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Smaller practices struggle to use advanced EHR features, Black Book finds

Author Tony Abraham

Published April 17, 2018

Dive Brief:

  • Nearly 90% of practices with six or fewer practitioners aren't using advanced EHR features such as electronic messaging, clinical decision support, interoperability, data sharing and patient engagement, according to a recent Black Book survey of about 19,000 EHR users.
  • The majority of larger practices use advanced features frequently, and 30% of practices with 11 or more clinicians said they expect to replace their current EHR system by 2021. 
  • Although larger practices are better positioned to implement new IT tools, 93% of all practices with functioning EHR systems are using basic features that are directly tied to customer satisfaction. 
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NIST Unveils Latest Version of Its Popular Cybersecurity Framework

The National Institute of Standards and Technology has released version 1.1 of its popular Cybersecurity Framework.

April 17, 2018 - The National Institute of Standards and Technology (NIST) recently released version 1.1 of its popular Cybersecurity Framework, which incorporates feedback received from public comments and workshops during 2016 and 2017.
Version 1.1 of the Framework for Improving Critical Infrastructure Cybersecurity (The Framework) includes updates on authentication and identity, self-assessing cybersecurity risk, managing cybersecurity within the supply chain, and vulnerability disclosure.
The new version adds a section explaining how the Framework can be used by organizations to understand and assess their cyber risk and sections on risks associated with the supply chain and purchasing commercial off-the-shelf products and services.
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Physician practices disillusioned as they don’t maximize EHR benefits

Published April 18 2018, 5:26pm EDT
Nearly 90 percent of physician practices with six or fewer practitioners are not using optimization tools included in their electronic health record systems, according to findings in a new report from Black Book Research.
Those capabilities give practices the ability to take advantage of patient engagement services, secure messaging, decision support and health information exchange. Black Book surveyed about 19,000 EHR users across practices of all sizes and types to assess the industry environment for EHR replacement activity.
“Traditionally, it’s been the smaller and solo practices with the highest dissatisfaction ratings for electronic health record applications,” says Doug Brown, managing director at Black Book. “We confirmed also that the smaller the practice, the less likely they are to use advanced IT tools, and that’s where EHR frustration among small practices is generally focused.”
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HIT Think Why the new EU privacy rule will be challenging for providers

Published April 18 2018, 5:53pm EDT
While Facebook is in the hot seat for failing to safeguard data privacy, the European Union is about to take a giant step forward to protect personal data. The EU’s General Data Protection Regulation (GDPR), adopted two years ago, will go into effect on May 25, and the implications are large for companies that handle data belonging to Europeans.
This includes SaaS providers looking to develop and deploy apps that work with data across international boundaries. It also impacts healthcare organizations collaborating with countries in Europe to speed research and development of healthcare solutions.
Key provisions
The GDPR takes a broad view of what constitutes personal identification information. Organizations that must comply with GDPR will need the same level of protection for an individual’s IP address and cookie data as for their name, address and medical ID number. Companies can hold and process only the minimum amount of data needed to achieve their objectives, only for as long as necessary.
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Facebook knows a ton about your health. Now they want to make money off it.

April 18 at 6:00 AM
Kirsten Ostherr is a media scholar and digital health technology researcher at Rice University.
Let’s say you have had discussions on Facebook about your breast cancer diagnosis. It has been a useful forum for comparing treatment options with others who have dealt with similar health issues. There’s only one problem: Facebook has now categorized you as a patient, and you constantly receive precisely targeted ads about cancer services available near you. They are showing up on your computer screen at work, for all your co-workers to see, right when you’re up for a big promotion.
Many users experience a version of this scenario when they receive creepily personalized ads while browsing on Facebook. When those ads follow users onto sites outside Facebook, it feels like an invasion of privacy. But how do you regulate data privacy in an age of big-data black boxes?
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CIO reflections from HIMSS18: What to do with all that EHR data

Penn Medicine chief information officer Mike Restuccia shares four tactics for ensuring success with big data projects.
April 17, 2018 08:53 AM
The HIMSS18 Global Conference held in Las Vegas, Nevada was once again a delight to attend and exchange thought leadership among fellow colleagues. It seemed that thousands of vendors promoted services and solutions, all with the intent of facilitating better patient care, advancements in research, safer work environments and more efficient organizations.  
At the core of many of these offerings is data, and in some cases vast amounts of Big Data. Patient monitoring systems, wearables, patient reported outcomes, and new research algorithms are just a few of those offerings which transmit large streams of data.  Almost as befuddling to the Information Services executive as attempting to navigate the HIMSS18 vendor floor is what to do with all of this data.  The challenge is multi-faceted and despite the claims of many in the vendor community; not easily addressed.  
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Follow the money: Where Gartner, IDC and HIMSS Analytics say hospitals will invest the most in 2018

With bold projections that we are on the cusp of the biggest IT spending growth in a decade, new predictions from industry analysts show how much, and on which technologies, hospitals will acquire, modernize or optimize IT.
April 17, 2018 09:24 AM
IT spending is on the rise. Everyone working in healthcare leadership positions, information and technology, or even remotely paying attention to the sector already knows that.
And for executives trying to balance a budget to stay competitive amid a tech talent shortage and ever-evolving regulatory landscape, having a strong sense of where rivals and even partners are planning to spend on IT could prove to be make-or-break insightful.
Let’s take a look at what Gartner, IDC and HIMSS Analytics have to say about IT investment plans in 2018 and beyond.  
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Alexa Is a Revelation for the Blind

Legally blind since age 18, my father missed out on the first digital revolution.
“Is it ‘Electra?’” my father asks, leaning in close to the Amazon Echo my mother has just installed. Leaning in close is his trademark maneuver: Dad has been legally blind since age 18, the result of a horrible car crash in 1954. He has lived, mostly successfully, with limited vision for the 64 years since.
“Call it the right name!” my mom shouts as Dad tries to get the device’s attention. In response, he adopts an awkward familiarity, nicknaming the Echo “Lexi.” Hearing this, I groan. There goes Dad again, trying to be clever, getting it wrong, and relishing the ensuing chaos.
Then I stop myself. Isn’t it possible that he expects Alexa to recognize a prompt that’s close enough? A person certainly would. Perhaps Dad isn’t being obstreperous. Maybe he doesn’t know how to interact with a machine pretending to be human—especially after he missed the evolution of personal computing because of his disability. Watching him try to use the Echo made me realize just how much technology forms the basis of contemporary life—and how thoroughly Dad had been sidelined from it.
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How many hospitals are on each stage of HIMSS Analytics' EMR Adoption Model?

Written by Jessica Kim Cohen | April 16, 2018 
Most hospitals sit on the second-highest level of the EMR Adoption Model, an eight-stage roadmap developed by Healthcare Information and Management Systems Society subsidiary HIMSS Analytics.
The EMR Adoption Model, which runs from Stage 0 to Stage 7, measures the degree to which a hospital utilizes its EMR functions. Hospitals are scored on standards related to digital imaging, interoperability and data security, among other capabilities.
Here's how all 5,487 registered U.S. hospitals stacked up in the fourth quarter of 2017.
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Report: VA, DoD EHR Contracts to Spur Federal Health IT Spending

April 16, 2018
by Rajiv Leventhal
The federal government has estimated that federal healthcare spending will increase 80 percent, from $918 billion in 2015 to $1.7 trillion in 2025, with one of the key IT-related factors being the Department of Veterans Affairs’ (VA) and Department of Defense’s (DoD) implementations of new EHR (electronic health record) systems.
The estimation, coming from Deltek’s Federal Health Information Technology Market report, noted that “Federal health IT spending over the forecasted period is greatly influenced by these new EHR platforms as well as potential solutions by the Coast Guard and Department of State. Efforts to increase medical innovation, mobile health, healthcare cost control and combat public health issues such as the current opioid epidemic will also solidify investments in health IT products and services.”
The report’s authors also stated that requirements for improved quality, interoperability, data sharing and privacy will drive federal agencies taking on the role of promoter, provider or payer to invest in more IT solutions for enhanced health effects and to thwart waste, fraud and abuse.
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Every hospital tested for cybersecurity has failed

Chris Smyth, Health Editor
April 18 2018, 12:01am, The Times
All 200 hospitals and other NHS organisations tested so far have failed cybersecurity checks, according to a report by MPs that finds not enough has been done to protect patients from hackers.
Some hospitals have not fixed the original vulnerability that led to last year’s cyberattack and NHS chiefs are not working fast enough to protect the health service, even though a repeat is a matter of “when, not if”, the public accounts committee (PAC) says.
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Netsmart introduces EHR focused on post-acute care

Written by Anuja Vaidya (Twitter | Google+)  | April 13, 2018 
Netsmart, an EHR solutions and services provider, launched a cloud-based EHR geared toward home health and senior living communities.
The myUnity platform features analytics, interoperability as well as consumer and family engagement capabilities. It aims to consider the unique needs of various types of post-acute organizations.
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How health apps factor into a $950B ecosystem

Apr 16, 2018 2:34pm
Healthcare apps played a prominent role in a new report that estimates the mobile app industry has evolved into a $950 billion ecosystem.
Highlighting the ubiquity and importance of smartphones across multiple industries, a new report by ACT | The App Association indicated that two out of three businesses utilize enterprise apps. And many of those opportunities are rising up throughout the healthcare industry.
“Innovations in the app economy are providing new avenues for users to interact with their doctors, make financial transactions, manage employee contracts, and even secure parking permits,” the report stated. “With these new opportunities, patients will need secure channels to share health data with their doctors and insurance companies.”
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Impact of the implementation of electronic health records on the quality of discharge summaries and on the coding of hospitalization episodes

International Journal for Quality in Health Care, mzy075, https://doi.org/10.1093/intqhc/mzy075
Published: 13 April 2018

Abstract

Objective:To determine whether the implementation and use of the electronic health records (EHR) modifies the quality, readability and/or the length of the discharge summaries (DS) and the average number of coded diagnosis and procedures per hospitalization episode.
Design: A pre–post-intervention descriptive study conducted between 2010 and 2014.
Setting:The ‘Hospital Universitario 12 de Octubre’ (H12O) of Madrid (Spain). A tertiary University Hospital of up to 1200 beds.
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6 health data privacy takeaways from Zuckerberg testimony

Published April 13 2018, 8:46pm EDT
Facebook CEO Mark Zuckerberg spent two days on the hot seat getting grilled by members of Congress regarding the social media company’s use of consumer data. In separate Senate and House hearings earlier this week, Zuckerberg was both apologetic and defiant in response to questions and allegations from lawmakers about Facebook’s abuse of personal information collected by the online platform.
Zuckerberg was specifically called to Washington to respond to the Cambridge Analytics scandal and Russia’s interference in the 2016 U.S. election. However, he was more broadly questioned about Facebook’s sharing of sensitive consumer data—including health information—with third parties.
Apps that collect information from consumers—and not on behalf a provider, health plan or healthcare clearinghouse—are not subject to the Health Insurance Portability and Accountability Act as either a covered entity or business associate. As a result, developers are not required under HIPAA to protect the privacy and security of consumers’ data, which is not considered protected health information (PHI). It’s a loophole that has gotten the attention of lawmakers in the Zuckerberg hearings.
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Opioid Crisis: How 4 health providers are using tech to fight the epidemic

Published April 13 2018, 11:57pm EDT
America’s opioid epidemic shows no sign of letting up. Addiction to legal painkillers and illegal drugs like heroin has resulted in more than 42,000 overdose deaths in 2016, according to Centers for Disease Control and Prevention figures released at the end of March.
Health Data Management, over the past few months, has profiled a number of healthcare organizations that are turning to health information technology to combat the crisis. What follows is a look at four of those initiatives.
Geisinger: Pairing EHR and e-prescribing data
Geisinger, an integrated health system, is curbing patient use of opioids by leveraging health information technology and electronic prescribing, according to CIO John Kravitz, who contends that other healthcare organizations can generate similar results through effectively using their EHRs or clinical order entry systems.
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Enjoy!
David.

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