Saturday, June 16, 2018

Weekly Overseas Health IT Links – 16th 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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ONC Adds Patient-Generated Health Data to Patient Engagement Guide

The guide now also explains how healthcare organizations and providers can collect and leverage patient-generated health data.
June 07, 2018 - The Office of the National Coordinator for Health IT (ONC) has updated its Patient Engagement Playbook to include information about integrating patient-generated health data (PGHD) into patient care, the agency said in a public email announcement.
PGHD is health data produced by the patient and can include data from mHealth apps, wearable devices, and other remote patient monitoring systems. PGHD can also include patient and family health histories and other data patients can recall and enter into the patient portal.
Those PGHD technology sources have considerably altered the way in which healthcare professionals interact with this data. Prior to ubiquitous health IT adoption, healthcare professionals had to manually elicit PGHD from their patients. The use of wearables and other mHealth tools has created more PGHD and opened some roads (albeit littered with roadblocks) for collecting and using PGHD.
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Software accurately measures bone metastases in prostate cancer patients

Published June 08 2018, 7:43am EDT
Researchers at the Duke Cancer Institute successfully led a large global multicenter study in which they tested the speed and accuracy of a software program to automatically measure bone metastases in patients with advanced prostate cancer.
In a Duke-led randomized clinical trial, 721 men with advanced prostate cancer were evaluated using the software, the automated Bone Scan Index (aBSI) from Swedish company EXINI Diagnostics.
Clinicians must be able to reliably quantify bone metastases in advanced prostate cancer patients in order to predict their survival and to determine the best potential treatments. The current method to do so includes a CT or MRI scan along with a nuclear medicine test that involves a manual assessment of the bone metastases—a process that is subjective and time-consuming.
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Surrey Care Record due to launch in August

Hanna Crouch – June 5, 2018
Surrey Heartlands Health and Care Partnership together with NHS East Surrey Clinical Commissioning Group (CCG) has announced that the Surrey Care Record is due to be launched in August.
The record will see some GP records being made available to clinicians within the A&E departments of the four local hospital trusts – St Peter’s, Royal Surrey, Epsom and East Surrey.
Local GPs will also have access to the record when it is launched on 29 August.
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June 7, 2018 / 9:33 PM

Israel's Zebra Medical Vision raises $30 million

TEL AVIV, June 7 (Reuters) - Israeli startup Zebra Medical Vision said on Thursday it raised $30 million in an investment round led by healthcare fund aMoon, bringing its total raised to date to $50 million.
Strategic healthcare investors Aurum, Johnson & Johnson Innovation JJDC Inc and Intermountain Healthcare also participated in the funding.
Zebra Medical Vision said it has been developing an automated artificial intelligence-based chest x-ray reader. The analytics product was trained using nearly 2 million images to identify 40 different common clinical findings.
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HHS cybersecurity center so unstable staff don't know if it exists, Congress argues

House and Senate committees criticize department with essentially the same case sidelined Deputy CISO Leo Scanlon made in March.
June 06, 2018  11:45 AM
The Senate HELP and House Energy and Committees are highly concerned about the U.S. Department of Health and Human Services’ cybersecurity plan, preparedness and the lack of leadership of its Healthcare Cybersecurity and Communications Integration Center -- and is demanding answers from HHS Secretary Alex Azar.
The bipartisan letter to Azar outlines a laundry list of issues at HHS when it comes to its security plan. Among them, includes the temporary reassignment of two senior HCCIC officials in charge of the day-to-day operations.
HHS removed Deputy CISO Leo Scanlon and HCCIC Director Maggie Amato for what they called “ethics violations.” While Amato left HHS entirely, Scanlon stayed on to fight those allegations he argued were made for whistleblowing, and the situation is under investigation.
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HIT Think How IT can help support patient engagement after discharge

Published June 07 2018, 5:46pm EDT
Until fairly recently, patient engagement was not a business imperative for hospitals. The importance of patient engagement has increased primarily because of two changes in the way Medicare pays healthcare providers—the advent of readmission penalties and the transition to value-based reimbursement.
These changes have created a strong inducement for hospitals and health systems to get patients involved in their own care. Unless more patients make a real effort to adhere to care plans and learn how to manage their own conditions after discharge, there’s little chance that healthcare providers and accountable care organizations (ACOs) will cut costs enough to succeed under value-based reimbursement.
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Big data, advanced analytics tools drive growth in data lakes

Published June 07 2018, 5:56pm EDT
The explosive growth of big data, coupled with advancements in data lakes analytics, is expected to drive growth of the data lakes market in the coming years, according to a recent report by Market Research Future.
The global data lakes market is projected to grow at a compound annual growth rate of 28 percent from 2017 to 2023, the consulting and research firm estimates.
In addition to massive growth of data in industries such as healthcare, other drivers contributing to the rise in demand for data lakes include the need for data backup because of government regulations to store and maintain data; and the growing volume of larger file types, such as media files, developing social networking and media Web sites, Internet connectivity, bandwidth and others.
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4 Insights to Build a Better Capacity Command Center

Mandy Roth, June 7, 2018

As more capacity command centers launch around the nation, Johns Hopkins Medicine shares tips to achieve greater operational efficiency and ROI.

Johns Hopkins Medicine has cracked a complex puzzle: How could they increase hospital capacity without adding beds?
The solution came from the health system's Judy Reitz Capacity Command Center, launched in October 2016. Operational efficiency has improved so greatly, "we've essentially created 16 additional beds of capacity, without actually opening 16 beds," says Jim Scheulen, MBA, PA, chief administrative officer for emergency medicine and capacity management at Johns Hopkins Medicine.
The massive 5,200-square-foot hub, developed with GE Healthcare Partners, resembles the NASA nerve center. More than 20 gigantic digital screens line the walls, filled with dashboards that deliver real-time information to staff members situated at 38 work stations.
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92 million user accounts of MyHeritage genealogy website breached

The breach was contained to hashed passwords and usernames, but the DNA testing service site didn’t waste time notifying its users of the security incident.
June 05, 2018 03:59 PM
According to the notice, a security researcher notified MyHeritage on June 4 after discovering a file containing user log-in and hashed password information on a private server not owned by the genealogy site.
The site’s security reviewed the file and confirmed it contents. The file contained the email addresses and hashed password of all users who signed up to use the site since Oct. 26, 2017 -- the date the breach occurred.
Upon discovery, MyHeritage launched an investigation to determine how the file was obtained, as well as whether there were other breaches of the site. While the file was determined to be legitimate, the impact should be minimal as the file only contained login information.
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Autism app shows promise for screening children at home

Published June 06 2018, 7:10am EDT
An iPhone app, built on Apple’s ResearchKit platform, has been shown to be an effective means for conducting in-home screenings of young children for signs of autism.
Currently, autism screening in young children is conducted in clinical settings by highly trained medical professionals who administer the tests and analyze the results.
However, a new one-year study—published in the journal npj Digital Medicine—of 1,756 families with children ages one to six years demonstrated that the app is a novel, easy to use, and scalable method for collecting high-quality and scientifically valid data in a child's natural environment.
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Apple’s new Health Records feature reduces friction for app developers

Jun 6, 2018 2:07pm
Apple is opening its Health Records platform to app developers, laying the groundwork for an “ecosystem” of new digital tools and allowing patients information from their medical records with trusted apps.
The Health Records API, which will be available in iOS 12 this fall, builds on Apple’s entry into the medical records space. More than 500 hospitals are connected to the Health Records app representing 50 health systems, according to an Apple spokesperson. Eleven additional systems have joined the platform since Apple’s last update in March.  
“With the potential of Health Records information paired with HealthKit data, patients are on the path to receiving a holistic view of their health,” Apple’s Chief Operating Officer Jeff Williams said in a statement. “With the Health Records API open to our incredible community of developers and researchers, consumers can personalize their health needs with the apps they use every day.”
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Why Apple Can’t Tackle Digital Wellness in a Vacuum

Emily Waite
On Monday at its annual developer's conference, Apple unveiled several new features designed to help users understand and manage the time they spend on their iOS devices. There's new time-and location-based Do Not Disturb modes; a suite of notification-management tools; and a clever lock screen feature that organizes your push alerts into tidy little topic-specific bundles. By taming your notifications, Apple seemed to say, you can limit distractions and better manage your time on and off your phone.
Speaking of time management: Apple introduced a tool to help with that, too. The company calls it Screen Time. It tracks things like which apps you use, how often you pick up your phone, and how frequently your apps buzz you for your attention. Once a week, Screen Time collects that data into a report so you can reflect on your usage habits and decide whether and where to cut back. Need a little help controlling your impulsive Twitter habit? Screen Time also lets you set limits on how much time you spend in specific apps. When you hit your quota, your phone will block the app from opening and tell you to move along.
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Better hospital IT security doesn't mean fewer cyberattacks

Written by Julie Spitzer | June 05, 2018 
In healthcare, using more IT security doesn't equate to fewer data breaches, according to a new study published in MIS Quarterly.
For the study, titled "When do IT security investments matter? Accounting for the influence of institutional factors in the context of healthcare data breaches," a team of researchers led by Corey Angst, PhD, associate professor at the University of Notre Dame (Ind.) Mendoza College of Business, analyzed 938 U.S. hospital data breaches from 2005 to 2013. The researchers continued to collect additional hospital breach data through May 2018.
The study argues institutional factors play a role in determining which hospitals — such as  smaller health systems, older health systems, for-profit or nonprofit — are less likely to suffer repercussions from a data breach.
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HIT Think How 4 organizations are leveraging IT to address SDOH

Published June 06 2018, 5:25pm EDT
The US healthcare system has historically overemphasized the importance of medical care in efforts to improve health outcomes. Compared with other developed Western countries, the United States spends far less on social services, while vastly outspending others on medical care.
The problem with this disproportionate spend is that Americans fare worse than other peer countries across many measures of health, including maternal mortality, life expectancy, low birthweight and infant mortality.
As the country continues the transition toward value-based care, provider organizations are re-examining the concept of healthcare services and evaluating how social, economic and environmental factors influence our health and quality of life. While estimates of impact vary according to different sources, our health status and overall well-being are driven by a number of factors:
  • Traditional healthcare (10 to 25 percent)
  • Genetics (as much as 30 percent)
  • Physical environment (5 to 10 percent)
  • Social and economic factors (15 to 40 percent)
  • Individual behavior (30 to 40 percent)
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How AI is shaping healthcare

As keepers of the world’s ‘big data’, many of the major tech companies are naturally well placed to turn to the data-hungry development of artificial intelligence, or AI. And while AI is a hot topic in almost every industry, its presence and potential application in healthcare is exploding.
AI – what is it exactly?
In the simplest sense, AI is a computer system that can reason and perform a task in a human-like way. This can mean computer systems that are able to learn, communicate, make decisions and solve complex problems on their own.
Traditionally, AI’s application in medicine has been limited to the use of algorithms to analyse data and suggest diagnoses or recommend treatments. An example is the treatment of cancer. By feeding patient data into algorithms, a computer can review treatment alternatives and recommend a combination of chemotherapy drugs for a particular patient.
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AI is coming to a doctor's office near you, and AMA wants to be ready

The American Medical Association assesses the implications of artificial and "augmented" intelligence, proposing policy recommendations as it prepares for its annual meeting, which starts June 9.
June 04, 2018 04:41 PM
AI's success in healthcare depends on enthused buy-in from physicians AMA President James Madara, MD, said at HIMSS18. 
For an organization that has no shortage of strongly held opinions on an array of topics affecting providers and the healthcare industry, the American Medical Association currently does not have an artificial intelligence policy.
That will be changing soon, as AMA heads into its annual meeting next week, according to the group's report to its board of trustees.
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Stronger Patient Data Access Improves Overall Care Process

Having an improved patient data access process will create more empowered patients and help ensure proper patient care.

June 04, 2018 - With technology continuing to evolve at a rapid pace, working towards more seamless healthcare interoperability remains a top priority for healthcare organizations. Having a stronger patient data access process is often hailed as a way to improve patient care, but there can still be hesitancy in how much access should be given.
Back when meaningful use started and with some of initial patient engagement requirements, there was a lot of initial concern with some providers, Tufts Medical Center Chief Medical Information Officer Dr. William Harvey explained.
Harvey is also a practicing rheumatologist and serves as the clinical director of the Tufts rheumatology clinic. He noted that there was concern within his specific line of work because a fairly large percentage of the patients that seek such care are older adults who may not be very technologically literate.
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59% of physicians want an EHR overhaul: 5 study insights

Written by Julie Spitzer | June 04, 2018 | Print  | Email
U.S. physicians want to see changes to the current EHR, according to research by Stanford (Calif.) Medicine and a survey by The Harris Poll.
More than 500 primary care physicians responded to an online poll seeking input on the current state of EHRs and the impact EHRs have on job satisfaction.
Here are five survey insights:
  1. Although 63 percent of physicians think EHRs have generally led to improved patient care, 40 percent believe there are more challenges with EHRs than benefits and 59 percent believe EHRs need a complete overhaul.
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Imaging tech not good enough to reduce needless breast biopsies

Published June 05 2018, 5:22pm EDT
A large-scale study of mammography exams has found that clinicians are too quick to order invasive biopsies because of high rates of false positive results from initial imaging examinations.
The national study, published in ClinicoEconomics and Outcomes Research, pulled data from a sample of 875,000 women, and sought to determine the extent of follow-up procedures after initial screenings, such as mammography or breast examinations, showed suspicious findings.
The study estimates the annual cost of false-positive breast biopsies exceeds $2.1 billion, with a total annual price tag of $8 billion in total expenses, including the costs of additional breast diagnostic testing. It was conducted by a team of health outcomes research scientists at IBM Watson Health in collaboration with Seno Medical.
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Apple to offer Health Records API to developers

Published June 05 2018, 1:54pm EDT
Apple will make a Health Records API available to developers and medical researchers this fall in an effort to create an ecosystem of apps leveraging healthcare data designed to help consumers better manage their medications, nutrition plans, as well as diagnosed diseases.
The tech behemoth made the announcement on Monday at its 2018 Worldwide Developers Conference in San Jose.
“The Health Records feature allows patients of more than 500 hospitals and clinics to access medical information from various institutions organized into one view on their iPhone,” according to Apple. “For the first time, consumers will be able to share medical records from multiple hospitals with their favorite trusted apps, helping them improve their overall health.”
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Editorials

Digital clinical encounters

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2061 (Published 14 May 2018) Cite this as: BMJ 2018;361:k2061
  1. Glyn Elwyn, professor1,
  2. Paul J Barr, assistant professor2,
  3. Sheri Piper, patient2
  1. Correspondence to: G Elwyn glynelwyn@gmail.com
Managed safely, digital recordings could transform healthcare
Many patients already record clinical encounters, usually on smart phones.1 Data on the prevalence of this behaviour are being collected and already indicate that it occurs in most clinical settings.2 UK patients are not breaking the law when they record their visits; in other countries, the law might be more complex.3 Whatever legal frame might exist, we predict that more and more patients will make a digital recording of clinical conversations and that health systems will follow. In the advent of powerful artificial intelligence (AI) the broad implementation of audiorecording in healthcare could greatly benefit both patients and clinicians, but risks also exist, and clear principles to guide the collection and use of recordings must be established from the outset.
Patients make recordings so that they can relisten to the clinic discussion and share it with a family member or care giver. They can revisit and clarify medical information that is often forgotten, check that they have clearly communicated important information to their clinician, and monitor agreed treatment goals before their next visit.4 Few patients are motivated by an intent to prove neglect or wrongdoing.1 Lawyers, reviewing the practice of giving patients copies of recordings, thought that it did not add to the risk of malpractice complaints.5
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What’s going on at IBM’s Watson Health?

Published June 01 2018, 9:56pm EDT
IBM has laid off a number of employees in its Watson Health unit, but says initial reports that as much as 50 percent to 70 percent of the unit’s workforce was furloughed are not accurate and that the reductions will not hurt its core cognitive computing business.
A company representative, however, would not provide additional details or give the specific number of employees being let go. The company also refused to say how many people are employed in the Watson Health unit.
“IBM is continuing to reposition our team to focus on the high-value segments of the IT market, and we continue to hire aggressively in critical new areas that deliver value for our clients and IBM,” said the vendor in a written statement. “This activity affects a small percentage of our Watson Health workforce, as we move to more technology-intensive offerings, simplified processes and automation to drive speed.”
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Mass General, Brigham and Women's to apply deep learning to medical records and images

Hospitals say the AI method is in use today automating things humans do well but don't have the time for – and there's much more to come.
June 04, 2018 10:16 AM
Artificial intelligence is beginning to reshape healthcare and life sciences. And one application of AI, deep learning, is coming into its own.
Deep learning is a type of machine learning based on data representations rather than task-specific algorithms. Learning can be supervised, semi-supervised or unsupervised.
Much of the excitement around AI today is fundamental because of three ingredients: the development of algorithms that make artificial neural networks, the increasing supply of digital data that now can be created, and, critically, the "GPU" chip architecture – it stands for graphics processing unit – pioneered by vendor NVIDIA, said Mark Michalski, MD, executive director of the Massachusetts General Hospital and Brigham and Women's Hospital Center for Clinical Data Science.
"GPU chips are different than the CPU chips that run many of our computers today in that they solve many simple problems simultaneously, as opposed to one big problem at a time, like CPUs," Michalski explained. "It turns our brain's work in a similar way to GPUs, which is perhaps why GPU chips are so effective as tools for machine learning."
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The future of personalized health is scientific wellness

A new quantitative era is emerging for digital health, AI, social networks, analytics and precision medicine that will eclipse the disease industry that exists today.
June 04, 2018 10:00 AM
The convergence of personalized medicine with digital health and artificial intelligence, systems biology, social networks, big data analytics and precision medicine is on the cusp of enabling an emerging field: scientific wellness.
“Over the next 10-15 years there will be a scientific wellness industry in contrast to the disease industry and the market cap will far exceed that of the disease industry,” said Leroy Hood, Chief Science Officer at Providence St. Joseph. “The contrast between 20th and 21st Century medicine is striking, 21st is proactive, focused on the individual, disease and it employs personalized data clouds to explore the complexities of human beings.”
The idea of scientific wellness is a quantitative approach that includes improving the health of individuals, create personalized treatments, reverse disease transitions and reduce costs — distinct from the current wellness trend focusing primarily on behaviors such as diet and lifestyle.  
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SIIM 2018: Radiology, digital pathology should look to search engines to revolutionize healthcare

June 01, 2018 | Matt O'Connor
Last year, the Food and Drug Administration (FDA) approved the first whole slide imaging system for digital pathology, which opened a new door for the technology to advance.
To capitalize on this “watershed moment,” as one expert described it during a session at the Society for Imaging Informatics in Medicine (SIIM) 2018 annual meeting in National Harbor, Maryland, pathology must join with radiology—a leader in adopting new technologies—to realize the true potential of digital pathology.
“If we don’t partner with radiology—meaning pathology imaging—then we’re going to have a tough battle to create the infrastructure, use cases and solve the issues … that radiology has largely solved,” said Michael J. Becich, MD, PhD, the chairman of the department of biomedical informatics at the University of Pittsburgh Medical Center, during the session. “Pathology needs radiology more than it ever has because of the FDA approval.”
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A Generalizable Infection Risk Predictor Based on EHR Data

HCA News Staff
MAY 31, 2018
No 2 hospitals are alike, and the predictive analytics tools that they use must acknowledge that. In a new report, researchers claim that they have developed a generalizable model for predicting patients at risk of one of the most common—and serious—hospital-based infections, based on that hospital’s unique population.
The team analyzed electronic health records (EHR) data from nearly 200,000 admissions to University of Michigan Hospitals (UM) and more than 60,000 admissions to Massachusetts General Hospital (MGH), pulling out invariant (think demographic) and variant (like medical condition) metrics. They were looking to predict stratify patient risk for Clostridium difficile (C. difficile) infection, which impacts about half a million Americans each year.
And they believe the system that they built does just that. They pulled about 4,800 unique features from the UM dataset and roughly 1,800 from MGH. Applying an L2 regularized logistical regression to the models, they applied them to additional data from the 2 health systems.
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Jamie Dimon: Amazon, Berkshire partnership ‘pissed off’ healthcare companies

Jun 1, 2018 2:14pm
JP Morgan CEO Jamie Dimon got a few nasty phone calls in the wake of his healthcare-focused partnership with Amazon and Berkshire Hathaway announced earlier this year.
In a not-so-subtle nod to the insurance industry, Dimon told attendees at Bernstein Research’s Annual Strategic Decisions Conference that the trio’s effort to reduce healthcare costs for a combined 1.5 million employees didn’t sit well with some industry stalwarts. And they let him know.
“I expect a lot of these people we already do business with to call us up and say, ‘What can we do to help?’” Dimon said. “Quite a bit of them were pissed off. Which kind of pissed me off. They’re going to tell me I can’t do a better job for my employees? Isn’t that what they’re supposed to help me do anyway?” he added.
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OIG approves telehealth purchasing arrangement that would support HIV care

Jun 4, 2018 12:40pm
The Department of Health and Human Services Office of Inspector General (OIG) weighed in on the legality of a telehealth relationship for the fifth time, giving the nod to an equipment sharing scenario to assist with HIV prevention.
In an advisory (PDF) released on Friday, the OIG responded to a request involving a federally qualified health center and a county health clinic in which the hospital would purchase equipment—including a laptop, webcam, microphone and video conferencing software—for a county-run clinic to provide free HIV prevention consultations. Regulators ruled that although the arrangement could potentially induce referrals by providing free telehealth consultations, the OIG would not impose administrative actions under the anti-kickback statute.
The requesters noted that the hospital is 80 miles from the clinic and the telehealth equipment would give patients access to HIV services, particularly consultations for pre- and post-exposure medications that must be taken within 72 hours after exposure.
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Analytics, machine learning help spot drug diversion at Piedmont Athens

Published June 04 2018, 5:19pm EDT
For 20 years, Russ Nix worked in the public safety and law enforcement arenas; while working as an undercover narcotics officer, he saw the impact of the growing opioid crisis and addictions to other medications.
Now, Nix works as a drug diversion specialist at Piedmont Athens (Ga.) Regional Medical Center, a job he pitched to the 360-bed hospital and got. He’s one of a growing number of specialists working in hospitals to tamp down on illicit diversions of drugs.
Drug diversion is the taking of medications outside of the hospital or pharmacy and it is primarily done by inside personnel, such as a nurse or physician and most likely a pharmacist.
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HIT Think 5 ways clinical decision support can address current provider challenges

Published June 04 2018, 5:33pm EDT
Healthcare consumers demand a lot from care delivery. It’s no wonder why—medical knowledge is increasing at an accelerated rate, and it seems like each day, new standards of evidence-based care are added to our clinical teams are expected to know and have seamlessly available in their workflows.
That’s why the role of clinical decision support (CDS) systems in care delivery can be so powerful. Decision support can increase safety in helping to avoid errors and adverse events, decrease operational costs, boost clinician and patient satisfaction, and perhaps most importantly, improve the quality of care and enhance health outcomes. When this intelligence is applied effectively, it not only reduces the cognitive burden on what providers are expected to easily recall, but can improve the entire process including experiences and outcomes.
New and more sophisticated capabilities are being added to EHRs, improving data access and usability, which means that healthcare systems today can have better clinical guidance technology than ever before. Innovation and investments in artificial intelligence will continue to shape healthcare technology in the years to come, but clinical decision support tools are not limited to a future standard. By leveraging a wide set of tools in the electronic health record (EHR)—such as analytics, machine learning, predictive models and rules engines—alongside evidence-based content, organizations can improve their clinical decision support capabilities.
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Enjoy!
David.

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