Saturday, June 30, 2018

Weekly Overseas Health IT Links – 30th June, 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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Healthcare must ‘systematize’ so the right care is easy to provide

Published June 22 2018, 7:35am EDT
Atul Gawande, MD, the newly named chief executive officer of the non-profit healthcare venture started by Amazon, Berkshire Hathaway and JPMorgan Chase, contends that the objective of modern care is not to “rescue” patients from “catastrophic” health episodes—but an ongoing process that takes into account patients’ physical, cognitive and emotional life goals that clinicians never ask them about.
“To measure and manage that over time is going to be highly technologically enabled in order to make that possible,” Gawande said on Thursday at the 2018 AHIP Institute & Expo in San Diego. “We need to act through the data, tracking you with your life on how you’re doing against those goals, and when our treatments are benefitting and when they’re not.”
Gawande, who starts as CEO of the Amazon-Berkshire-JPMorgan venture on July 9, spoke at AHIP’s conference the day after the three companies announced they had selected the prominent surgeon, writer and public health innovator to lead their new healthcare firm.
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PM announces £20bn annual cash boost for NHS and points to value of tech

Hanna Crouch
18 June 2018
The Prime Minister has said the NHS is to be given a “birthday present” of an extra £20 billion a year in funding annually by 2023, and argued technology must be a crucial part of driving productivity improvements over the next decade.
When questioned on the Andrew Marr Show on Sunday about what she would be “bringing to the party” ahead of the NHS’s 70th birthday on 5 July, Theresa May confirmed the NHS will receive an extra £20bn a year.
This means the current £114bn budget will rise by an average of 3.4% annually.
May said the extra funding will help “secure” the NHS’s future.
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House Passes Bill to Align SUD Rules with HIPAA Privacy Rule

The US House has passed the Overdose Prevention and Patient Safety Act, which would align privacy protections for substance use disorder patients with the HIPAA Privacy Rule.
June 21, 2018 - By a vote of 357-57, the US House passed the Overdose Prevention and Patient Safety Act (HR 6082) on June 20, which would align privacy protections for substance use disorder (SUD) patients with the HIPAA Privacy Rule.
HR 6082 would authorize the disclosure of SUD patient records without the patient’s written consent to a covered entity for the purposes of treatment, payment, healthcare operations and to a public health authority, as long as the disclosure is in line with HIPAA.
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What hospitals need to improve patient experience: Real-time point of care data

Beyond HCAHPS: CXOs are looking for technology to offer better patient experience as a competitive differentiator.
June 22, 2018 10:33 AM

At the HIMSS Patient Engagement and Experience Summit earlier this year, Adrienne Boissy, chief experience officer at the Cleveland Clinic, said hospitals have a lot of work to do when it comes to managing the patient experience.
"We have to design for what matters most – not just for our patients, but for our clinicians," said Boissy, to help create "not just a human experience, but humane. We must digitize moments that can be, and humanize moments that must be."
Increasingly hospitals are cognizant that developing better patient experience is essential – not just for the obvious quality and safety reasons, but as a key competitive differentiator. And they're learning that better and more easily accessible data is key to making that happen.
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Mayo Clinic exploring blockchain EHR use cases with UK startup

London-based Medicalchain is partnering with the health system to pilot an array of different distributed ledger projects.
June 20, 2018 09:30 AM
Medicalchain, a London-based startup that develops blockchain technology for storing electronic health records, announced this week that it is has signed a working agreement with the Mayo Clinic to explore different distributed ledger initiatives at the health system.
The company says its blockchain platform can securely store health records, describing it as a single source of truth that can easily and securely be accessed, updated and shared.
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mHealth Tools Help Hospitals Improve the Physician Query Process

Health systems are using mHealth tools and platforms to improve the often-cumbersome physician query process, resulting in more accurate medical records and billing processes and less-stressed physicians.

June 20, 2018 - Mobile health technology is helping to make the cumbersome process of responding to physician queries easier for physicians, giving them more time to spend with their patients.
Often considered a necessary evil in the hospital-based physician’s busy workflow, queries are administrative tasks designed to make sure the physician’s notes are accurate and complete in the medical record.
The traditional process calls for CDI specialists or coders to contact the physician to clarify any uncertainties. That query often comes in the form of a note in the EMR or an e-mail, with no guarantee that the physician will respond immediately. That delays the process, leading to incomplete medical records and delays in coding and billing.
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Common Rule’s Final Version Exempts Certain HIPAA Covered Entities

The federal government has issued the final rule for the Federal Policy for the Protection of Human Subjects, known as the Common Rule, that allows more secondary research of EHR data by exempting low-risk studies conducted by certain HIPAA covered entities.

June 20, 2018 - The federal government has issued the final rule for the Federal Policy for the Protection of Human Subjects, known as the Common Rule, that allows, among other things, more secondary research of EHR data by exempting low-risk studies conducted by certain HIPAA covered entities.
The revised Common Rule is designed to protect individuals who volunteer to participate in research, while reducing regulatory and administrative burdens for low-risk research.
In January of this year, the federal government issued an interim final rule delaying the date for the rule to take effect from January 19, 2018, to July 19, 2018. The delay was intended to give federal agencies more time to get additional input from interested stakeholders and to enable greater cooperation between the federal government and clinical research community
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Patient experience, clinical excellence top drivers of hospital tech investments in next 12 months

Healthcare organizations are also planning to ramp up customer relationship tools as they continue on the path to self-disruption, according to new research from Ernst & Young.
June 20, 2018 02:28 PM
Hospital IT executives and professionals know that many healthcare organizations are amid a digital transformation. But where are they focusing those investments in the year ahead? 
A new nationwide poll released by Ernst and Young found that almost all of the participants -- 91 percent -- have or are planning to undertake a technology adoption initiative in the next 12 months. Seventy percent cite improving patient experience as a key factor driving the initiative, 58 percent cite clinical outcomes and 59 percent customer relationships. Yet almost half, 46 percent, are worried about insufficient funding.
Companies that have already taken steps to self-disrupt believe they’re benefiting from it, the report said. The more tech initiatives an organization has undertaken, the more likely they are to rate themselves ahead of the competition. This was particularly true for organizations advancing efforts related to clinical excellence and patient experience. Similarly, healthcare organizations that have adopted technology to improve the patient experience in the past 12 months are significantly more likely to feel well prepared for the future.
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ONC to work with CMS to reduce administrative burdens on physicians

Written by Julie Spitzer | June 20, 2018 |
HHS' ONC is working to reduce administrative burdens for physicians to meet the requirements of the 21st Century Cures Act, the National Coordinator for Health IT Don Rucker, MD, wrote in an agency blog post.
As part of the law, ONC is tasked with improving interoperability of health information, which is also a core tenet of the administration-wide MyHealthEData Initiative. Over the next few years, the agency will work with stakeholders and other federal agencies to advance application programming interfaces, address information blocking, devise a Trusted Exchange Framework and Common Agreement and develop a strategy to reduce administrative burdens through collaboration with CMS.
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Med Associates reports computer hack compromising 270K patient records

Written by Julie Spitzer | June 20, 2018 | Print  | Email
Hackers potentially stole nearly 270,000 health and insurance records when they broke into computers at Med Associates, a health billing claims company.
Med Associates officials discovered "unusual activity" at a computer workstation March 22. The company immediately launched an investigation into the incident, which remains ongoing.
Officials have determined patients' names, dates of birth, addresses, dates of service, diagnosis codes, procedure codes and insurance information, including insurance ID numbers, had been compromised. No banking or credit card information was stored on the affected workstation, and Med Associates does not currently believe any of the information has been misused.
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AHIP keynoter cites lack of evidence that mHealth works

Published June 21 2018, 7:44am EDT
There is a lack of clinical evidence supporting the efficacy of mobile healthcare interventions for improving the health outcomes of patients.
That’s the contention of Ezekiel Emanuel, MD, who holds a joint position in the University of Pennsylvania’s Wharton School of Business and the School of Medicine, where he chairs the Department of Medical Ethics & Health Policy.
 “There’s just not a single study that shows that any wearable, connectable smartphone, wireless (technology) has made a difference in terms of outcomes,” Emanuel told Wednesday’s opening session of the 2018 AHIP Institute & Expo in San Diego.
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HIT Think How AI and ML are transforming mobile app development

Published June 21 2018, 5:25pm EDT
Technology and mobile devices are revolutionizing the way consumers interact with the world now, and artificial intelligence and machine learning are making massive breakthroughs recently for mobile app development. These developments have a bearing for healthcare organizations, which are seeking ways to use the technology to better engage patients.
Machine learning (ML) is a subset of artificial intelligence (AI)—it gives machines the ability to enhance their decision-making skills and performance without any human interference. It is based on learning from experiences and examples, instead of programming rules, and machines collect and analyze data to come to relevant conclusions.
As ML is based on neural networks that simulate the biological neural networks, they are capable of accumulating experiences and recognizing patterns in a way similar to the human brain. This has enabled AI and ML to have much innovative functionality such as voice recognition, facial detection, preventive analysis, predictive analytics, and spam detection and prevention.
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Federal clinical guidance database to shut down because of funding cuts

Published June 21 2018, 7:47am EDT
A reduction in federal funding for the Agency for Healthcare Research and Quality, which is charged with improving the safety and quality of the nation’s healthcare system, has resulted in defunding of the National Guideline Clearinghouse, a public database of evidence-based clinical practice guidelines operated by AHRQ.
“This is a decision that was made by AHRQ leadership in response to our current budget and the Agency’s priorities, consistent with decisions AHRQ often has to make about how best to invest the resources at our disposal,” according to an agency spokesman.
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VA tackles interoperability, massive data stores with open FHIR API project

Veterans Health Affairs’ director of standards and interoperability warns that FHIR is not a cure all, just one valuable asset in a tech toolbox.
June 19, 2018 04:15 PM
BOSTON -- The U.S. Department of Veterans Affairs over the last year has made a pointed shift to modernize the agency: First with the announcement to replace its legacy EHR with Cerner in June 2017 and next with several platforms to boost transparency and telemedicine efforts.
But the launch of its open API project in March – once dubbed Lighthouse and now called the VA API Developer Sandbox – is zeroed in on interoperability and modernization. Led by University of Pittsburgh Medical Center Chief Innovation Officer Rasu Shrestha, the project has grown with dozens of other hospitals joining the effort.
To Ken Rubin, director of standards and interoperability for the Veterans Health Affairs Office of Knowledge Based Systems, the VA has some pretty tremendous data challenges that it hopes the API project and FHIR can tackle.
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FHIR will support EHR data sharing in Beth Israel, Lahey merger, CIO John Halamka says

While there are challenges to fully utilizing FHIR, the specification will support workflows and provider experience between the organizations and multiple EHRs, Halamka said at HL7’s DevDays.
June 19, 2018 11:52 AM
BOSTON — Beth Israel Deaconess Medical Center and Lahey Health, along with three other hospitals, are currently in the midst of a mega-merger to bring the organizations under one umbrella. But as with most providers, they’re operating with a wide range of EHR vendors and versions.
There are three instances of Epic, three different versions of Meditech, athenahealth and Cerner, and the assumption is that we’ll rip and replace these versions and put in one monolith EHR, explained John Halamka, MD, Beth Israel Deaconess CIO at HL7’s DevDays on Tuesday.
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Next-gen medical devices: Security, AI, rethinking design for patient experience

Experts discuss where medical devices are headed as the internet of things continues to expand.
June 19, 2018 12:13 PM
Medical devices are proliferating throughout the healthcare landscape, especially with the advent of the Internet of Things and the myriad new products that come with it.
The medical device arena is undergoing a lot of change, in fact, as new technologies and calls for greater security push manufacturers to upgrade their products — and the next generation of medical devices could see many new features and functions.
As medical devices continue evolving, the top health IT areas manufacturers and hospitals will be ramping up include security, clinical workflow integration, data management automation and patient experience.
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Experts: Technology is key to addressing opioid epidemic

Jun 20, 2018 1:46pm
As the healthcare industry devises new solutions to tackle the opioid epidemic, experts say tech will take a leading role in monitoring the spread of drugs and flagging patients who are at risk. 
In West Virginia, which has the highest rate of overdose death in the country, public health officials conducted a "social autopsy" to get a complete picture of how the opioid epidemic was impacting the state.
Officials analyzed data on every person who died as a result of an opioid overdose in 2016, and looked at information on every facet of their lives, from employment to education to marital status to their interactions with the healthcare system, said Rahul Gupta, M.D., commissioner of the state's Bureau for Public Health.  It was a rare example of using big data to direct public health officials in getting their arms around the epidemic.
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Amazon, Berkshire Hathaway and JPMorgan Chase appoint CEO for healthcare venture

by Tina Reed 
Jun 20, 2018 10:25am
Amazon, Berkshire Hathaway and JP Morgan Chase have hired a widely recognized surgeon and best-selling author to lead their newly formed U.S. employee healthcare company. 
Public health researcher and writer of four New York Times bestsellers Atul Gawande, M.D., will begin serving as chief executive officer of the new company starting July 9, officials announced Wednesday morning. The position has been long-speculated since the creation of the healthcare company was first announced earlier this year.
The company will be headquartered in Boston and will operate as an independent entity free of profit-making incentives and constraints, officials said.
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Analysis: Health Data Breach Tally Trends

Hacks, Unauthorized Access/Disclosure and Theft Incidents Top the List
Marianne Kolbasuk McGeeJune 19, 2018
The addition to the federal tally in recent weeks of about three dozen major health data breaches, including many hacking and unauthorized access/disclosure incidents, pushed the total number of breach victims so far this year to almost 2.9 million.
A Tuesday snapshot of the Department of Health and Human Services' HIPAA Breach Reporting Tool website - commonly called the "wall of shame," shows a total of 161 breaches added so far in 2018.
"Unauthorized access/disclosure" breaches are the most common type of incident posted on the wall of shame this year. Those 73 incidents - including breaches involving email, electronic medical records and paper/film - impacted a total of nearly 558,000 victims.
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Considerable Costs Associated With Switching EHR
Costs include time needed for research and testing, maintenance and other fees, hardware updates
TUESDAY, June 19, 2018 (HealthDay News) -- Switching electronic health record (EHR) systems can result in increased efficiency and productivity gains, but there are significant costs associated with the switch, according to an article published in Medical Economics.
Noting that 62 percent of respondents to the Medical Economics 2017 EHR Report had already switched systems at some point in their careers, the article addresses the true cost of switching. Although the payoffs for switching can be positive, with gains from increased efficiencies and productivity, the costs can also be significant and include new software and hardware.
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New York HIE offers $76K to help providers connect EHRs

Written by Jessica Kim Cohen | June 19, 2018 | Print  | Email
HealthlinkNY, which operates one of New York state's health information exchanges, will offer $76,000 in discounts to encourage providers to fully connect and contribute data to the HIE, HealthlinkNY announced June 15.
To receive the discounts, healthcare organizations — including providers, payers, social services programs, public health agencies, health homes, ACOs and disaster relief agencies — must sign a participation agreement with HealthlinkNY and begin contributing records to the exchange by September 30. Incentives are also available for existing HealthlinkNY participants who have not yet fully connected to the HIE.
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4 insights on patients' top concerns, how they use health tech

Written by Megan Knowles | June 19, 2018 | Print  | Email
Patients are increasingly looking for ways to boost their mental health and well-being — and want more flexibility in accessing resources that help them reach health goals, a recent survey conducted by Aetna found. 
As part of its inaugural "Health Ambitions Study," Aetna gathered 1,000 responses from consumers 18 and older in December 2017. 
Here are four insights on patients' top concerns and how they are using healthcare technology:
1. Younger consumers turn to digital health tools more often than older consumers to communicate with their physicians. About one-third (32 percent) of respondents ages 18 to 34 said virtual office visits would be valuable, compared to 17 percent of patients over age 65.
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Most Under-35s OK With Insurers Digital Spying If It Cuts Prices

By
Julie Edde
June 19, 2018, 7:00 PM GMT+10
  • Majority of millennials trust insurers with their private data
  • 56% would switch insurance provider if digital service is poor
The majority of people between 18 and 34 would be willing to let insurance companies dig through their digital data from social media to health devices if it meant lowering their premiums, a survey shows.
In the younger group, 62 percent said they’d be happy for insurers to use third-party data from the likes of Facebook, fitness apps and smart-home devices to lower prices, according to a survey of more than 8,000 consumers globally by Salesforce.com Inc.’s MuleSoft Inc. That drops to 44 percent when the older generations are included.
As consumers share more of their personal data online, governments increased their scrutiny of how it’s collected and used following the harvest of 61 millions Facebook users’ accounts by U.K. firm Cambridge Analytica. The European Union’s new privacy law, known as the General Data Protection Rules, took effect on May 25.
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HIT Think How to identify key security gaps in data protection strategies

Published June 20 2018, 5:50pm EDT
The “digital mesh”—the entwining of people, devices, content and services—will be one of the top 10 strategic technology trends for this year, playing a large role in improving the healthcare experience and environment for patients and employees.
However, increased collaboration and quick access to information comes at a price, particularly in protecting sensitive patient information as it increasingly circulates among these different technologies. Failing to be prepared for cyberattacks is no longer an option.
The way the healthcare industry thinks about, and prioritizes, cybersecurity needs to evolve to keep pace with the rapidly changing cyber-threat landscape. To accomplish this, security needs to be embedded within the network and platforms to enable a start-to-finish security infrastructure that can be managed and measured.
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House passes law to aid data exchange for addiction specialists

Published June 20 2018, 5:41pm EDT
The House of Representatives Wednesday voted to pass the Overdose Prevention and Patient Safety Act, H.R. 6082. The bill now moves to the Senate chamber to receive consideration.
Earlier this week, the nation’s governors and a large group of healthcare industry stakeholders urged the House to the pass the legislation, which would ease restrictions on the sharing of medical records among physicians treating patients with addictions.
The industry groups that are supporting the policy statement, put forth by the National Governors Association, included more than 100 patient and provider organizations brought together in an alliance with Premier, a large national group purchasing and service organization.
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Interoperability a key enabler in new Digital Health Strategy

Monday, 18 June 2018  
 eHealthNews editor Rebecca McBeth
Interoperability and architecture and standards are key enablers in the new Digital Health Strategy, a Ministry of Health manager says.
 Ministry of Health manager architecture and standards, technology and digital services Peter Marks spoke at the HL7 New Zealand mid-year seminar Interoperability in Action in Auckland today.
He said technology is required to build the sustainable future that the New Zealand Health Strategy calls for and that the Digital Health Strategy, which is still in draft form, aims to ensure the right levers, standards, technologies and investment are in place to deliver that.
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UK report warns DeepMind Health could gain ‘excessive monopoly power’

Natasha Lomas@riptari / Jun 16, 2018
DeepMind’s foray into digital health services continues to raise concerns. The latest worries are voiced by a panel of external reviewers appointed by the Google-owned AI company to report on its operations after its initial data-sharing arrangements with the U.K.’s National Health Service (NHS) ran into a major public controversy in 2016.
The DeepMind Health Independent Reviewers’ 2018 report flags a series of risks and concerns, as they see it, including the potential for DeepMind Health to be able to “exert excessive monopoly power” as a result of the data access and streaming infrastructure that’s bundled with provision of the Streams app — and which, contractually, positions DeepMind as the access-controlling intermediary between the structured health data and any other third parties that might, in the future, want to offer their own digital assistance solutions to the Trust.
While the underlying FHIR (aka, fast healthcare interoperability resource) deployed by DeepMind for Streams uses an open API, the contract between the company and the Royal Free Trust funnels connections via DeepMind’s own servers, and prohibits connections to other FHIR servers. A commercial structure that seemingly works against the openness and interoperability DeepMind’s co-founder Mustafa Suleyman has claimed to support.
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Two-thirds of physicians blame e-health system for increased paperwork - survey

  • 2018-06-20
  • LETA/TBT Staff
RIGA - About two-thirds of 67 percent of physicians in Latvia have to spend longer hours on paperwork with the introduction of the new-e-health system while only 16 percent said they were now spending less time working with different documents, according to a survey conducted among physicians about health care reforms and the new e-health system.
The Latvian Medical Association which ordered the survey said that just 16 percent of physicians had said they had not experienced any major functionality problems while working with the e-health system in the previous two weeks. At the same time, 16 percent encountered malfunctions in the system ten or more times during the two-week period, 3 percent had problems eight to nine times, 6 percent six to seven times, 14 percent four to five time, 26 percent two to three times and 15 percent once during the two-week period.
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Healthcare analytics has a long way to go - but could get there quickly

The HIMSS Big Data and Healthcare Analytics Forum showed that, even if healthcare still lags behind other industries in analytics prowess, it can (and probably will) make up a lot of ground in a short time.
June 19, 2018 08:46 AM
I'm not always a fan of assigning a score, on the fabled scale of one to 10, to assess the maturity or readiness of a particular sector of a particular industry.
But sometimes, as it was at the HIMSS Big Data and Healthcare Analytics Forum in San Francisco this past week, getting those who work in the trenches to hang a specific number on it can be illustrative.
At the conference, I moderated a panel featuring four healthcare professionals whose heterogeneous approaches to the management and use of healthcare data together offered an interesting snapshot of how U.S. healthcare is doing with its IT-enabled analytics initiatives.
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CMS may require hospitals to electronically share patient data

Written by Julie Spitzer | June 18, 2018 | Print  | Email
CMS is proposing a new rule that would require hospitals participating in Medicare to electronically share medically necessary information with other providers when a patient is transferred or discharged.
Stakeholders have until June 26 to comment on the request for information, which CMS posted in April. Specifically, the agency wants to know if making data sharing a requirement for Medicare would reduce information blocking as defined in the 21st Century Cures Act and the barriers providers may face to comply with such a rule.
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MIT algorithm speeds process of image registration

Published June 19 2018, 3:51pm EDT
Researchers from the Massachusetts Institute of Technology are using a machine learning algorithm that is able to vastly accelerate the process of overlapping medical images to enable radiologists to study differences between them.
Historically, it’s taken radiologists as long as two hours using imaging systems to align millions of pixels in scans that they wish to compare through medical imaging registration. The technique is crucial for taking two MRI scans to analyze differences—for example, if a patient has a brain tumor, image registration enables clinicians to put one image from several months ago on top of a recent scan to gauge the growth of the disease.
But the work of the MIT researchers has resulted in an algorithm that can line up brain scans and other 3-D images more than 1,000 times faster using new learning techniques. It works by “learning” while registering thousands of pairs of images—that enables it to gain information on how to best align images, estimating some optical alignment parameters. After going through this learning process, it uses those parameters to map all the pixels of one image to another instantaneously.
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Health execs not ready for societal, liability issues from AI

Published June 19 2018, 7:43am EDT
The vast majority of healthcare organizations lack the capabilities needed to ensure that their artificial intelligence systems act accurately, responsibly and transparently, finds a new survey by consulting and professional services firm Accenture.
AI has the potential to be a transformative technology in healthcare. In the Accenture survey, 80 percent of health executives agree that within the next two years, AI will work next to humans in their organization, as a coworker, collaborator and trusted advisor.
However, 81 percent of health executives say their organizations are not prepared to face the societal and liability issues that will require them to explain their AI-based actions and decisions, should issues arise, according to Accenture’s Digital Health Technology Vision 2018 report.
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HIT Think Three ways conversational AI can aid engagement

Published June 19 2018, 5:47pm EDT
Everyone has waited for what seems like hours to visit a doctor or nurse practitioner, only to spend five minutes getting simple information on how to take a prescription. These routine visits—crucial to a patient’s health—burden the healthcare industry with enormous costs and can wreak havoc on a patient’s schedule.
According to a survey of specialty physicians in 15 major cities in the U.S., patients wait an average of 24 days to schedule an appointment with a doctor.
Some of the most frequent frustrations of healthcare, however, are changing thanks to what’s known as conversational AI (artificial intelligence), where computers communicate with patients via phone or text in a way that feels authentic, even almost human. Conversational AI is helping improve essential medical services like scheduling doctor's appointments, locating specialists, setting up referrals and managing ongoing care, often through a single virtual conversation.
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Patents hold clues about Apple, Amazon, Google and Microsoft plans for healthcare

A brief look at what hospitals should know about hundreds of patents tech giants have filed relative to health IT.
June 18, 2018 09:01 AM
Many eyes are watching the likes of Amazon, Apple, Google, Microsoft and other tech stalwarts for some kind of signal about their healthcare intentions. While some moves are already out in the open, such as Apple Health Records and Amazon Web Services expressing interest in longitudinal health records and analytics, the companies also have patents that potentially foretell the future. 
As of Jan. 23, Amazon-owned 7,096 U.S. patents, according to the United States Patent and Trademark Office.
In addition, Amazon Technologies, Inc., had filed and published 870 patent applications in the U.S. as of Jan. 23, and Amazon.com, Inc., had filed and published 16 patent applications.
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Medibio developing apps to help detect early signs of mental illness

Medibio, which has its U.S. headquarters in Savage, is developing apps to diagnose mental-health problems. 
By Joe Carlson Star Tribune
June 17, 2018 — 12:01am
Mental illnesses such as major depression touch millions of lives every year and can lead to catastrophic ends, as tallied in the growing loss of life from suicide seen in recent years in Minnesota.
Yet tools to objectively measure and diagnose mental illness remain elusive. The National Institute of Mental Health wrote last year that the outward manifestations of mental illnesses are probably “late signs” of changes in the brain that took hold much earlier, emphasizing the need for tools to detect problems sooner.
“The opportunity to identify individuals at highest risk early in the disease trajectory, and to intervene at the earliest possible time, promises to potentially prevent illness onset and minimize the overall burden of illness,” the NIMH wrote.
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States Should Revisit Their Data Breach Laws

Do states need to update their regulations after the Cambridge Analytica debacle?

by Daniel Castro / June 2018
Data breaches are a serious problem. Last year, there were a record number of data breaches in the U.S., with the total increasing 44 percent over the previous year. Following revelations that Cambridge Analytica, a UK political consultancy, gained illicit access to data on 87 million Facebook users, many were left with a simple question: Was this a data breach?
According to Facebook, it was not. Indeed, the circumstances around how Cambridge Analytica came to acquire the data in question do not fit the profile of a typical security breach.
Most data breaches involve some type of hacking, such as phishing attacks and ransomware, where an attacker successfully exfiltrates data from an adversary’s computer system. In this case, 300,000 Facebook users downloaded an app created by Aleksandr Kogan, a Cambridge University researcher, allowing him to collect data on them and their friends. As Paul Grewal, Facebook’s deputy general counsel, notes, “People knowingly provided their information, no systems were infiltrated, and no passwords or sensitive pieces of information were stolen or hacked.”
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Report: Cyber Attacks on the Rise and Evolving, as Ransomware Declines

June 14, 2018
by Heather Landi
Cyberthreats are continuing to increase and shift, and even though ransomware attacks are significantly declining, cyberattacks are on the rise, according to a new report from the global association ISACA.
Previously known as the Information Systems Audit and Control Association, ISACA, which now goes by its acronym only, is an independent, global, nonprofit association that engages in the development, adoption and use of globally accepted practices for information systems.
ISACA’s “State of Cybersecurity 2018: Part 2, Threat Landscape and Defense Techniques” report provides findings from a survey of 2,366 cybersecurity professionals and individuals in information security positions. Of the survey respondents, six percent work in healthcare/medical. Twenty-six percent of respondents work in technology services/consulting and 23 percent work in financial/banking, and the remaining work in various other fields.
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House appropriations bill cuts ONC budget by $17.7M

Jun 15, 2018 5:00am
The Office of the National Coordinator for Health IT (ONC) would see a $17.7 million budget cut under a proposed budget from the House Appropriations Committee.
The ONC would receive $42.7 million in total funding for fiscal year 2019 under the proposal. The 29% reduction is smaller than cuts previously proposed by the White House, which proposed slashing the agency’s budget by $22 million.
A government spending bill passed earlier this year maintained ONC’s funding at $60.4 million through September 2018.
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VA telemedicine program reduces inter-hospital ICU transfers

Published June 18 2018, 7:23am EDT
The Department of Veterans Affairs’ Tele-ICU program, which provides remote access to comprehensive acute care, is helping to reduce inter-hospital transfers of critically ill patients to other facilities by leveraging telemedicine.
Small, community and regional ICUs in the VA’s health system often lack intensivists to provide advanced critical care. That’s where telemedicine serves to fill the gap, enabling staff to treat patients on site rather than transferring them to other hospitals.
According to Spyridon Fortis, MD, clinical assistant professor of medicine at the University of Iowa Hospitals and Clinics, tele-intensivists collaborate with local staff to co-manage patient care at the bedside, avoiding the need to triage patients to facilities that have more advanced capabilities.
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Google continues work to use machines for health analytics

Published June 18 2018, 1:34pm EDT
A woman with late-stage breast cancer came to a city hospital, fluids already flooding her lungs. She saw two doctors and got a radiology scan. The hospital’s computers read her vital signs and estimated a 9.3 percent chance she would die during her stay.
Then came Google’s turn. An new type of algorithm created by the company read up on the woman—175,639 data points—and rendered its assessment of her death risk: 19.9 percent. She passed away in a matter of days.
The harrowing account of the unidentified woman’s death was published by Google in May in research highlighting the healthcare potential of neural networks, a form of artificial intelligence software that’s particularly good at using data to automatically learn and improve. Google had created a tool that could forecast a host of patient outcomes, including how long people may stay in hospitals, their odds of re-admission and chances they will soon die.
What impressed medical experts most was Google’s ability to sift through data previously out of reach: notes buried in PDFs or scribbled on old charts. The neural net gobbled up all this unruly information then spat out predictions. And it did it far faster and more accurately than existing techniques. Google’s system even showed which records led it to conclusions.
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HIT Think How silos restrict key information sharing within hospitals

Published June 18 2018, 5:54pm EDT
The healthcare industry is undergoing a massive change as it transitions toward a connected network of clinical and administrative services, with the goal of improving patient quality and clinical outcomes. However, as demonstrated through electronic health record systems utilization, an interconnected network can be a complex endeavor.
The rush to deploy EHR systems was driven largely by the Centers for Medicare and Medicaid’s Meaningful Use federal incentive program. Huge financial incentives helped speed the transition from paper to digital records. While great strides have been made in this transition, a new light has been cast on EHRs and the significant interoperability challenges that continue to exist.
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AMA issues policy statement on use of ‘augmented intelligence’

Published June 18 2018, 5:20pm EDT
The American Medical Association is weighing in on the potential of what it is calling “augmented intelligence” in fields such as radiology and the practice of medicine by clinicians.
The nation’s largest professional association for medical professionals issued its first policy addressing augmented intelligence at its annual meeting last week, adopting broad recommendations for health and technology stakeholders.
The AMA action cites both the potential of innovation and concern about the role it will play in the practice of medicine and affect patients in the near future.
“As technology continues to advance and evolve, we have a unique opportunity to ensure that augmented intelligence is used to benefit patients, physicians and the broad healthcare community,” says Jesse Ehrenfeld, MD, one of the AMA’s board members.
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The Emerging World of Online Health Communities

Platforms that provide a way for patients, caregivers, and health care staff to share stories and develop solutions across the health system are disrupting traditional hierarchies in medicine.
We are witnessing the emergence of a new phenomenon in health care: self-organizing, online communities of patients, caregivers, clinicians, researchers, academics, and industry, all focused on a particular disease.
Patient-led sites that offer support and information are the most well-known. They typically offer a moderated forum, blogs, advice, support, academic references, and a place to shop for relevant products. IBDrelief, a well-managed platform focused on inflammatory bowel disease, is just one example. 
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Next-gen quality and safety: Genetics, communication, social determinants, data all are at play

In the future, patients will have more access to their own data and more communication channels with their extended care team.
June 11, 2018 10:25 AM
Quality and safety may very well be the highest goals in healthcare. Healthcare provider organizations clearly aim to deliver the highest quality of care in the safest manners and settings possible.
Technology has a part to play when it comes to quality and safety. And there are changes afoot that healthcare executives will need to keep their eyes on.

Electronic clinical quality measures

Next generation quality and safety products will need to support standards-based interoperability and all aspects of electronic clinical quality measures (eCQMs), said Zahid Butt, MD, CEO of quality reporting software vendor Medisolv and vice-chair of the HIMSS Quality, Cost and Patient Safety Committee.
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Enjoy!
David.

Friday, June 29, 2018

Professional Medical Organisations Are Starting To Think About AI And It Implications!

This appeared last week.

AMA issues policy statement on use of ‘augmented intelligence’

Published June 18 2018, 5:20pm EDT
The American Medical Association is weighing in on the potential of what it is calling “augmented intelligence” in fields such as radiology and the practice of medicine by clinicians.
The nation’s largest professional association for medical professionals issued its first policy addressing augmented intelligence at its annual meeting last week, adopting broad recommendations for health and technology stakeholders.
The AMA action cites both the potential of innovation and concern about the role it will play in the practice of medicine and affect patients in the near future.
“As technology continues to advance and evolve, we have a unique opportunity to ensure that augmented intelligence is used to benefit patients, physicians and the broad healthcare community,” says Jesse Ehrenfeld, MD, one of the AMA’s board members.
The technology can assist radiologists, physicians and other medical professionals in making decisions that result in better and more appropriate use of medical care, Ehrenfeld adds.
 “Combining AI methods and systems with an irreplaceable human clinician can advance the delivery of care in a way that outperforms what either can do alone,” he says. “But we must address challenges in the design, evaluation and implementation, as this technology is increasingly integrated into physicians’ delivery of care to patients.”
AMA’s policy says the group will:
• Leverage its ongoing engagement in digital health and other priority areas for improving patient outcomes and physicians’ professional satisfaction to help set priorities for the use of AI in healthcare.
• Identify opportunities to integrate the perspective of practicing physicians into the development, design, validation and implementation of AI in healthcare.
• Promote development of thoughtfully designed, high-quality, clinically validated healthcare AI, which should conform to user-centered design practices, is transparent, conforms to leading standards to engender reproducibility, identifies and avoids bias and avoids introducing healthcare disparities, and safeguards individuals’ privacy and data security.
• Encourage education for patients, physicians, medical students and other professionals to inform others of the promise and limitations of healthcare AI.
• Explore the legal implications of healthcare AI, such as issues of intellectual property, and advocate for “appropriate professional and governmental oversight.”
More here:
We also has this from the UK.

UK report warns DeepMind Health could gain ‘excessive monopoly power’

Natasha Lomas@riptari / Jun 16, 2018
DeepMind’s foray into digital health services continues to raise concerns. The latest worries are voiced by a panel of external reviewers appointed by the Google-owned AI company to report on its operations after its initial data-sharing arrangements with the U.K.’s National Health Service (NHS) ran into a major public controversy in 2016.
The DeepMind Health Independent Reviewers’ 2018 report flags a series of risks and concerns, as they see it, including the potential for DeepMind Health to be able to “exert excessive monopoly power” as a result of the data access and streaming infrastructure that’s bundled with provision of the Streams app — and which, contractually, positions DeepMind as the access-controlling intermediary between the structured health data and any other third parties that might, in the future, want to offer their own digital assistance solutions to the Trust.
While the underlying FHIR (aka, fast healthcare interoperability resource) deployed by DeepMind for Streams uses an open API, the contract between the company and the Royal Free Trust funnels connections via DeepMind’s own servers, and prohibits connections to other FHIR servers. A commercial structure that seemingly works against the openness and interoperability DeepMind’s co-founder Mustafa Suleyman has claimed to support.
There are many examples in the IT arena where companies lock their customers into systems that are difficult to change or replace. Such arrangements are not in the interests of the public. And we do not want to see DeepMind Health putting itself in a position where clients, such as hospitals, find themselves forced to stay with DeepMind Health even if it is no longer financially or clinically sensible to do so; we want DeepMind Health to compete on quality and price, not by entrenching legacy position,” the reviewers write.
Lots more here:
As well awareness of other potential complications is rising:

Health execs not ready for societal, liability issues from AI

Published June 19 2018, 7:43am EDT
The vast majority of healthcare organizations lack the capabilities needed to ensure that their artificial intelligence systems act accurately, responsibly and transparently, finds a new survey by consulting and professional services firm Accenture.
AI has the potential to be a transformative technology in healthcare. In the Accenture survey, 80 percent of health executives agree that within the next two years, AI will work next to humans in their organization, as a coworker, collaborator and trusted advisor.
However, 81 percent of health executives say their organizations are not prepared to face the societal and liability issues that will require them to explain their AI-based actions and decisions, should issues arise, according to Accenture’s Digital Health Technology Vision 2018 report.
Lots more here:
All this is getting more and more interesting!
David.