Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Saturday, June 09, 2018

Weekly Overseas Health IT Links – 9th 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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Breast cancer screening error ‘may have affected thousands more’

The breast cancer screening error may have affected thousands more women across England, one researcher at Kings College London has claimed.
Hanna Crouch – 31 May 2018
Jeremy Hunt told MPs in May that a “computer algorithm failure”, which dated back to 2009, meant a group of women were not sent routine screening invitations before the cut off point of their 71st birthday.
Hunt said initial estimate by Public Health England (PHE) predict that up to 450,000 women may have been affected by the glitch, which dates back to 2009.
However Professor Peter Sasieni, a cancer screening and prevention researcher at King’s College London, has claimed the error could date back to early as 2005.
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Orion Health cuts 177 jobs and posts $40m loss

30 May 2018
New Zealand clinical integration and population health specialist Orion Health has posted losses of  NZD $40m (£20.9m) and revealed 177 jobs have been cut internationally.
Orion Health’s chairman also confirmed the company is continuing to work on, but has not yet been able to complete, a “strategic review”, likely to include a partial sale of the business.
The most recent job losses have included staff in the UK, and come at the same time as new government investment is being committed to regional interoperability initiatives.
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Updated: IBM Watson slashed workforce this week

With one employee describing the layoffs as a cost-cutting measure, estimates say Big Blue may have cut as much as 70 percent of its employees.
June 01, 2018 09:06 AM
After multiple press reports said IBM Watson laid off 50-70 percent of its workforce, a research note published by investment banking company Morgan Stanley on May 31 pushed back on that percentage. IBM, for its part, said the layoffs were small.
“First, any layoffs come on the back of IBM’s reported $613 million restructuring announced on the April 17th earnings call – of which, about $100 million related to the Cognitive business division,” according to Morgan Stanley. “IBM management, as recently as the March 8th, 2018 investor day, discussed aggressive hiring in strategic areas, including Oncology within Watson Health.”
“IBM is continuing to reposition our team to align with our focus on the high-value segments of the IT market,” the company said in a statement. “We’re not discussing specific numbers of employees affected, but it’s a small percentage of our global Watson Health workforce, as we move to more technology-intensive offerings, simplified processes and automation to drive speed.”
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Catching up with recent moves in EHR, interoperability initiatives

Apple, Allscripts, athenahealth, Cerner and others made noteworthy moves in the last few weeks.
June 01, 2018 09:29 AM
May might be the month for flowers but hospitals and other healthcare organizations have hardly slowed down to smell them if EHR implementations and interoperability work are any indication.
Instead, it’s been another busy one, not altogether unlike April before it. 
The biggest event, of course, came when the U.S. Department of Veterans Affairs, after much delay and the public firing via Twitter of Secretary David Shulkin, MD, officially signed the modernization contract with Cerner.
VA inked that pact as Cerner’s work with the Defense Department came under fire from an audit report for being “not operationally suitable,” after which Cerner President Zane Burke responded by suggesting that was fake news possibly.
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Prescription drug monitoring program use continues to rise

Published June 01 2018, 7:24am EDT
Physician use of state-run prescription drug monitoring programs is dramatically increasing while doctors have decreased opioid prescribing nationwide for the fifth consecutive year.
That’s among the findings of a new report released on Thursday by the American Medical Association, which the organization says shows progress toward reversing the U.S. opioid epidemic.
According to the AMA, the number of opioid prescriptions decreased by more than 55 million—a 22.2 percent decrease nationally—between 2013 and 2017, with a 9 percent decrease—more than 19 million fewer prescriptions—between 2016 and 2017. In fact, all 50 states have seen a decrease in opioid prescriptions over the last five years, notes the report.
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HIT Think Why provider IT systems aren’t ready to capitalize on patient data

Published June 01 2018, 3:44pm EDT
Value-based care is bringing about a shift in patient empowerment, forcing changes in their relationships with healthcare organizations, which now have to provider greater value, a better experience, accountability and transparency.
New technologies also are empowering patients, who are able to see benefits from the personal use of wearable devices, remote health monitoring and online diagnostic tools, health apps and telemedicine. These technologies can provide physicians with important insights to track, monitor and measure a patient’s progress. Engaging patients in this way will also reduce time in clinics, connect the circle of care and better deliver the quality of care that best suits them.
Factoring in the impact of artificial intelligence, predictive analytics and sensors, it’s clear that the vast amount of data now available to the provider community represents a challenge to manage. Using all this data to maximize the potential benefits also has to be balanced with maintaining patient privacy and trust—all the while not overwhelming physicians and clinicians with data that is not meaningful.
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Skyping the doctor? Poll shows it's not just for the young

  • By Lauran Neergaard and Emily Swanson, Associated Press
WASHINGTON — May 31, 2018, 1:40 PM ET
Every morning, 92-year-old Sidney Kramer wraps a blood pressure cuff around his arm and steps on a scale, and readings of his heart health beam to a team of nurses — and to his daughter's smartphone — miles from his Maryland home.
Red flags? A nurse immediately calls, a form of telemedicine that is helping Kramer live independently by keeping his congestive heart failure under tight control.
"It's reassuring both psychologically and physically. The way he's put it to me, it's like having a doctor appointment every morning," said Miriam Dubin, Kramer's daughter.
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How using blockchain in the supply chain could democratize innovation itself

The distributed ledger technology could help increase transparency, adding visibility and improving supply chain economics.
By Conner Forrest | June 1, 2018 -- 14:58 GMT (00:58 AEST)
Opinions about the business value of cryptocurrency are mixed, but the blockchain technology that underpins it has emerged as one of the potential next big things in enterprise technology. Organizations are just beginning to dip their toes in the blockchain waters, but a few industries have emerged as ripe for blockchain disruption.
Chief among those: Supply chain.
For the uninitiated, blockchain is a decentralized, distributed ledger technology that maintains transactional records known as blocks. The blocks are cryptographically secured and are immutable, making it easier for members of a given blockchain network to track the transaction history of a given asset and confirm its provenance. So, it's pretty clear why this would work so well for a supply chain.
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AI outperforms dermatologists in diagnosing skin cancer

Published May 30 2018, 7:22am EDT
Dermatologists are no match for artificial intelligence when it comes to diagnosing skin cancer, according to a new study by researchers in the United States, France and Germany.
The international team trained a convolutional neural network (CNN) to identify skin cancer by showing it more than 100,000 images of malignant melanomas as well as benign moles.
Specifically, they trained and validated Google’s Inception v4 CNN architecture using dermoscopic images at a 10-fold magnification and corresponding diagnoses. Then, they compared its performance with that of 58 international dermatologists from 17 countries—including 30 experts with more than five years of experience.
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Seniors Slow to Embrace Online Access to Doctors

WEDNESDAY, May 30, 2018 (HealthDay News) -- Many doctors have internet portals to help patients manage their care. But that doesn't mean older folks will use them.
A University of Michigan poll found only about half of patients 50 to 80 years old have set up an online account with their health care provider.
"The health care system has provided patient portals as an efficient way for patients to communicate with their providers. But many older adults are uncomfortable with electronic interactions substituting for a phone call or in-person conversation," co-associate poll director Sarah Clark said in a university news release.
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FDA launches innovation challenge to help stem opioid crisis

The contest aims to offer unique approaches to detecting, treating and preventing addiction, Food and Drug Administration officials said.
May 30, 2018 01:23 PM
The U.S. Food and Drug Administration on Wednesday announced an innovation challenge to address the national opioid epidemic. 
Specifically, FDA is looking to the developer community to build digital health technologies, such as medical devices, diagnostic tests and mobile apps to help stem the opioid crisis. The intent is to provide unique approaches to detecting, treating and preventing addiction, addressing diversion and treating pain.
As of March 2018, the most recent statistics on opioid use from the National Institute on Drug Abuse showed that 115 people in the U.S. die every day after overdosing on opioids. According to the latest statistics, opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states. In the Midwest, opioid overdoses increased 70 percent from July 2016 through September 2017.
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Kaiser to advance use of AI to personalize care interventions

Published May 31 2018, 4:55pm EDT
Kaiser Permanente is teaming with machine learning vendor Medial EarlySign on an initiative to use artificial intelligence to identify which Kaiser patients are most likely to respond to care interventions.
Kaiser has previously worked with the vendor in a project to identify patients with the highest risk of having undiagnosed colorectal cancer while in the early stages of the disease.
Now, Kaiser will use Medial EarlySign’s AlgoAnalyzer platform to stratify populations. It will enable the use of multiple sets of different types of algorithms that can help clinicians, care managers and population health managers predict risk in a population or an individual.
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Is your hospital ready for the many challenges of precision medicine?

There are big and complex questions as genomics moves into general practice, but they're ones providers who want to stay competitive will have to grapple with soon.
May 30, 2018 09:30 AM
If your hospital or health system hasn't yet started thinking about how to handle the fundamental changes soon to arrive thanks to precision medicine, now is the time.
Before long, care and treatment based on genetic sequencing and other omic factors will become the standard of care, says one informaticist, and providers will need to be ready to compete.
"My prediction is that genomic medicine will move from a specialty that did not even require an MD degree, to become an integral part of practice that's required of everyone with an MD degree," Nephi Walton, MD, assistant professor of genomic medicine at Geisinger, said at the HIMSS Precision Medicine Summit in Washington, D.C. this month. 
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5 critical factors for a successful telehealth program

Written by Jessica Kim Cohen | May 29, 2018 
Three-quarters of U.S. hospitals either have consumer telehealth services in place or plan to implement the capability by the end of 2019, according to Teladoc's second annual state of consumer telehealth benchmark survey.
During a May 15 webinar, sponsored by Teladoc and hosted by Becker's Hospital Review, Alan Roga, MD, president of Teladoc's hospital and health systems division, presented key findings from the company's annual survey. Teladoc, the nation's leading telehealth solutions company, works with health systems, employers and insurers providing virtual care delivery services to more than 23 million members. The company's dedicated business unit for hospital and health system clients offers services including account management, marketing and technology support.
For the survey, Teladoc partnered with Becker's in 2017 to poll nearly 300 C-suite executives and directors from hospitals of various sizes across the U.S. about their experiences with telehealth and priorities for the next year. Nearly half of the hospitals represented — 45 percent — first implemented their telehealth program one to three years prior to the survey.
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Feds Need to Do Better Job With EHR Data Security, Privacy

The US federal government needs to do a better job at EHR data security and privacy, concluded a recent federal IT systems audit by GAO.

May 29, 2018 - The US federal government needs to do a better job at EHR data security and privacy, concluded a federal IT systems audit by the Government Accountability Office (GAO) released May 23.
The federal government also must ensure privacy is guaranteed when facial recognition systems are used and better protect the privacy of users’ data on state-based health insurance marketplaces, GAO concluded.
To accomplish these goals and improve lax federal cybersecurity in general, agencies should implement the information security program mandated by the Federal Information Security Management Act (FISMA)
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EHRs exacerbate the pen and paper problems they were meant to solve: study

May 30, 2018
by John R. Fischer , Staff Reporter
The current set-up of EHRs has led to greater physician work load, higher risk for burnout and an increase in other challenges it was meant to fix.
That is what researchers at Penn Medicine argue in a new study, referring to EHRs as mere digital remakes of pen and paper files, and opting for a system that enables physicians to "subscribe" to patients, receiving push notifications on real-time updates for when action is required, as they do on social media and news app feeds.
"I think that firms have created platforms that focus almost entirely on the technical task of making medical records digital and not the design task of making them useful," senior author David Asch, executive director of the Penn Medicine Center for Health Care Innovation, told HCB News. "You end up creating something that looks very much like a paper chart. If you focus on the task of making electronic records more useful and think about what people really want from them, you can create something even better.”
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HIT Think How social determinants of health and analytics can aid suicide prevention

Published May 30 2018, 3:45pm EDT
There’s growing urgency around the need to take proactive steps to prevent suicides by veterans. An average of 20 Veterans per day committed suicide in 2014, according to the Department of Veterans Affairs. Veterans, who constitute 8.5 percent of the U.S. population, accounted for 18 percent of all suicide deaths.
Despite the obvious challenge and risk of mortality, suicide prevention for veterans is a challenging service to provide. However, emerging interest in new types of social data—paired with medical information contained in veterans’ health records—holds new promise in assisting clinicians to find those who are at risk. And the increased use of analytics also may be able to sift through mounds of seemingly unrelated medical data to find crucial correlations that may identify suicide risks that warrant intervention.
Many behavioral experts say data is crucial in understanding the risks of suicide, and anticipating and intervening before something dire happens. The difference between an individual falling victim to suicide or not often is whether someone can intervene and prevent that individual from taking the ultimate step.
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EHR vendors target small hospitals as market tightens

May 30, 2018 1:46pm
EHR vendors are finding some success among smaller hospitals even as many of those hospitals are being bought up by larger systems and forced to integrate onto a single platform.
Several vendors—including Athenahealth and Meditech—have found a groove in a post-Meaningful Use marketplace where the number of systems inking new EHR contracts has declined over the last three years, according to an annual report by KLAS that analyzes EHR market share.
Last year, 216 acute care hospitals with fewer than 200 beds signed a new EHR contract, accounting for 80% of deals throughout 2017.
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Health IT, mental health groups back bill to eliminate telehealth restrictions for opioid treatment

May 30, 2018 3:52pm
Nearly a dozen healthcare groups are voicing their support for legislation that would allow providers to utilize telehealth to treat substance abuse.
In a letter to lawmakers last week, 11 groups—including the College of Healthcare Information Management Executives, HIMSS and the American Telemedicine Association—urged lawmakers to include the Expanding Telehealth Response to Ensure Addiction Treatment Act (eTREAT) Act in efforts to address the opioid crisis. The bill, introduced by a bipartisan group of senators earlier this month, would waive site restrictions on Medicare reimbursement for telehealth treatment for substance abuse disorders.
The health IT groups were joined by the Association for Behavioral Health and Wellness, the National Alliance on Mental Health and Mental Health America.
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Clinical decision support benefits radiology trainees, significantly improves appropriateness scores

May 25, 2018 | Melissa Rohman
University of Virginia researchers found that radiology trainees benefit the most from a commercially available clinical decision support (CDS) program being implemented into an electronic health record, which overall improves the appropriateness scores of ordered imaging studies significantly.  
The study was published May 25 in the Journal of the American College of Radiology.  
Designed around the American College of Radiology (ACR) Appropriateness Criteria, CDS helps health care providers choose appropriate imaging studies at the time of order entry, wrote led author Timothy Huber, MD, and colleagues.  
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How Amazon’s digital health moves could affect providers

Published May 29 2018, 7:33am EDT
Amazon this year has made a number of significant moves that are fueling speculation about what the online giant’s ambitions might be in the healthcare sector—and what impact such a push by the company might have on traditional providers.
Employers, federal and state governments and consumer groups have expressed frustration for years about the healthcare industry’s 18-percent-plus share of the GDP and the failure of myriad reform efforts to significantly change the industry’s cost structure or create a truly patient-focused approach to care. Many healthcare experts believe that Amazon might be getting ready to step in with alternative solutions.
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HIT Think Why preparation is crucial to success in data analytics

Published May 29 2018, 5:34pm EDT
Preparation is critically important to any initiative, but let’s be clear about something—it is not easy. We have all participated in projects or initiatives that lacked proper planning or preparation, and we’ve experienced the fallout from those poorly planned initiatives.
Value-based care, and the associated requirements, has wrung all of the wiggle room out of strategic initiatives. Provider organizations are under enormous pressure to create efficiencies from EHR investments in preparation for value-based care. These organizations are about as well prepared to take on the risk of patient care as they are to start a casino.
Organizations may have a deluge of data, but without having data structured or related to care-based decisions, organizations are, in essence, flying blind.
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Clinical decision support in EHR helps reduce low-value imaging

Published May 29 2018, 3:03pm EDT
The use of clinical decision support software can help young physicians more appropriately order imaging studies, reducing the number of studies they order that have minimal benefit to the treatment process.
In a recently published study, medical residents and fellows benefitted the most from the use of clinical decision support in ordering imaging examinations, said researchers from the University of Virginia.
Providers who followed the criteria on the appropriateness of imaging requests—guidance on which was integrated into the organization’s electronic health records system—ordered 50 percent fewer “low utility” studies that would not aid clinicians in diagnosing conditions. On the plus side, the rate of ordering appropriate imaging studies rose to more than 80 percent. Results of the study were published in the May 25 online version of the Journal of the American College of Radiology.
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Health reforms to enable sharing of patient data

Future Health Summit took place at the Convention Centre Dublin on Tuesday

29 May, 2018
The Department of Health will introduce new regulations to enable patient data to be shared, including for research, ahead of the rollout of electronic health records in the coming years.
Muiris O’Connor of the department told the Future Health Summit at the Convention Centre Dublin on Tuesday that it was putting in place regulations in line with the new EU General Data Protection Regulation (GDPR), which became enforceable from May 25th.
He said money would be coming from the Government from next year onwards to help drive the transformation of the health service.
At present, he said information within the Health Service Executive (HSE) went into “its own little pockets” and that e-health was a “critical enabler”.
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How Blockchain Could Help Lower Health Costs

The digital ledger could replace fragmented data systems, simplifying record-keeping and improving care

By Tomio Geron
May 28, 2018 10:04 p.m. ET
In the continuing push for affordable health care, one of the biggest stumbling blocks is still the confused and error-filled manner in which electronic data is shared among doctors, insurers, hospitals and patients.
One solution could be blockchain technology.
In the current tangle of incompatible records systems that typifies U.S. health care, incorrect information can creep in when patient data gets re-entered multiple times by doctors’ offices, insurers and hospital staff. Big errors can seriously affect the quality of care that patients receive, small discrepancies can result in wrongful denials of insurance coverage, and errors of all types add to the system’s cost.
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Enjoy!
David.

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