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, August 25, 2018

Weekly Overseas Health IT Links – 25th August, 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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Open-source snafu leaves patient data exposed

Millions of patient records are feared to have been jeopardised after security flaws were discovered in open-source healthcare software.
13 August 2018
Researchers at cyber security outfit Project Insecurity discovered dozens of security bugs in the OpenEMR system, which is described as the “most popular open source electronic health records and medical practice management solution”.
Many of the flaws were classified as being of high severity, leaving patient records and other sensitive information within easy reach of would-be hackers.
One critical flaw meant that an unauthenticated user was able to bypass the patient portal login simply by navigating to the registration page and modifying the URL, Project Insecurity reported in its findings.
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Black Hat and Defcon cybersecurity experts share tips on how to protect yourself

Here’s what people at the annual "hacker summer camp" think you need to do.
August 17, 2018 5:00 AM PDT
During the week of Black Hat and Defcon, tens of thousands of security experts and hackers flock to Las Vegas for the back-to-back conferences. They hold discussions on issues like smart cities getting hacked, two-factor authentication, and security issues with voice assistants.
It can all get a little technical. But with so much cybersecurity knowledge in one place, I decided to ask individual experts for a single useful cybersecurity tip for the average person.
One of these tips may end up making all the difference when a hacker comes after you. Learning a little about how to protect yourself is increasingly critical at a time when hacker attacks on companies like Equifax and Yahoo can expose your personal information. But cybersecurity advice tends to be technical or inconvenient, which is why a lot of people tend to ignore it.
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Leverage Tech to Solve Public Health Problems, Expert Urges

"We are missing a really tremendous opportunity," says former HHS official

  • by Shannon Firth, Washington Correspondent, MedPage Today August 14, 2018
WASHINGTON -- Healthcare leaders must partner with technology experts to effect real change in the public health sector, according to a former Obama administration official.
"There's a door open and if we don't run through that ... we are missing a really tremendous opportunity," said Karen DeSalvo, MD, MPH, who served as National Coordinator for Health IT in the Obama administration, at a recent National Academy of Medicine workshop, "Engaging Allies in the Culture of Health."
DeSalvo, now a professor at the University of Texas at Austin's Dell Medical School, highlighted several ways technology can be used to resolve pressing public heath problems. For example, the phone number 211 is used for community information and referrals and already has an application program interface.
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HIT Think How providers can benefit from more study of CDS benefits

Published August 17 2018, 5:49pm EDT
Amid healthcare’s complexities, many providers are trying to streamline their core business, delivering quality patient care at sustainable margins. The objective sounds deceptively simple: Serve the organizational mission by reducing services that provide little value to patients—and can occasionally cause harm. But providers have long sought effective strategies for reaching that elusive goal and continue to do so.
A new study shows how technology can help. Pop-up alerts can aid physicians in treating patients so they experience fewer complications and lower costs, leave the hospital sooner and are less likely to be readmitted. Patients realize these benefits when physicians adhere to alerts in EHRs with care instructions based on evidence-based guidelines, according to the study that was a collaboration between Cedars-Sinai and Optum.
Specifically, the study showed that when physicians follow all clinical decision support (CDS) alerts, their care correlated to significantly better outcomes than for physicians who did not follow all alerts:
  • Costs of care reduced by $944 from a median-cost hospital encounter—an improvement of more than 7 percent, after adjusting for differences in patient illness severity and case complexity.
  • Patients’ average length of hospital stay decreased by 6.2 percent.
  • The odds of complications improved by 29 percent.
  • The odds of hospital readmissions within 30 days of the patients’ original visits shrank by 14 percent.
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CDS alerts in hospital EHR reduce costs, improve outcomes

Published August 17 2018, 7:33am EDT
A new study finds that clinical decision support alerts embedded into a hospital records system have improved patient health and financial outcomes.
Researchers at Cedars-Sinai Medical Center say the results show the positive effects of leveraging Choosing Wisely recommendations. An article on the study was published this week in the American Journal of Managed Care.
For the study, Cedars-Sinai evaluated the 18 highest-volume Choosing Wisely alerts integrated into its Epic EHR. The observational study of 26,424 inpatient encounters examined the associations between adherence to Choosing Wisely recommendations embedded into CDS alerts and four measures of resource use and quality.
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Opinion: AI efficacy in healthcare still needs to be proven in clinical studies

Published August 17 2018, 5:35pm EDT
There’s significant hype surrounding the use of artificial intelligence and its potential use in medicine.
Hardly a day passes without an announcement about AI software that can read medical imagery better than radiologists, arrive at diagnoses from a description of symptoms better than doctors or scrutinize hospital schedules to slash waiting-room times.
This, in turn, has people speculating about the future of human doctors—venture capitalist Vinod Khosla went so far as to claim radiologists would be obsolete by 2022.
Well, this past week, it was DeepMind’s turn. The AI company, owned by Google parent Alphabet, is best known for AlphaGo, the software that beat the world’s top humans at Go. DeepMind, which has a whole division devoted to healthcare, published a paper with NHS researchers contending that the software they had developed can diagnose 50 sight-threatening eye conditions as well, or better than experts.
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Peer holds key to unlock the value of NHS patient data

Philip Aldrick
August 18 2018, 12:01am, The Times
Lord Drayson could have been forgiven for wanting to take it easy after Labour lost the election in 2010. He had attended cabinet as science minister since 2008, having joined the government three years earlier, and could claim to be one of Britain’s most successful biotech entrepreneurs as the co-founder of Powderject Pharmaceuticals, the vaccine maker, in 1993. He was 50 and sufficiently well-heeled to have turned his car obsession into a full-time hobby, twice racing in the 24 Hours of Le Mans contest under his own team, Drayson Racing. Life was set for the peer to build out his garage of Aston Martins and enjoy the fruits of his labours.
Entrepreneurialism is an unrelenting itch, though. “After the election, I decided I had one more business in me,” he says. The germ of an idea had grown from the defeatism he encountered as science minister.
“You would talk to people about climate change or air pollution and they would say, ‘I’m just one person; what difference can I make?’ I felt, as an engineer, that technology offers us tools that show people do make a difference. So I had the idea of creating a network using citizen scientists: people power to monitor air pollution.” That business was Cleanspace, “fitbits for air quality”, as he describes it.
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Fax machines can be hacked to breach a network, using only its number

While CMS Administrator Seema Verma called for the end of fax machine use by 2020, new Check Point research found a hacker could steal data from a flaw in the fax protocol.
August 15, 2018 12:25 PM
Check Point researchers have discovered a vulnerability in the ITU T.30 fax protocol that could be hacked to launch a cyberattack and gain access to a network.
Security researchers have long bemoaned the use of fax machines, as the antiquated devices pose real privacy issues when it comes to transmitting patient data. Considering that an estimated 75 percent of all healthcare communications are still processed by fax, the security threat is real.
And while Centers for Medicare and Medicaid Services Administrator Seema Verma recently called for an end to provider fax machines by 2020, this newly discovered cybersecurity vulnerability suggests that plenty of networks could be at risk from the exploit over the next two years.
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Johns Hopkins researchers use deep learning to combat pancreatic cancer

Early detection is key to treatment, and with AI-enabled detection methods nearly a third of pancreatic cancer cases could be found four to 12 months sooner, they say.
August 16, 2018 01:02 PM
Only 7 percent of patients live five years after diagnosis of pancreatic cancer, the lowest rate for any cancer, according to the American Cancer Society. Elliot K. Fishman, MD, a researcher and radiologist at Johns Hopkins, is on the forefront of trying to change this statistic, and he's using artificial intelligence to do it.
Fishman aims to spot pancreatic cancers far sooner than humans alone can by applying GPU-accelerated deep learning artificial intelligence to the task. Johns Hopkins is suited to developing a deep learning system because it has the massive amounts of data on pancreatic cancer needed to teach a computer to detect the disease in a CT scan. Hospital researchers also have NVIDIA's DGX-1 AI Supercomputer.
Fishman is helping train deep learning algorithms to spot minute textural changes to tissue of the pancreas and nearby organs. These changes often are the first indication of cancer. Deep learning detection methods could mean earlier diagnosis. Fishman estimates that nearly a third of the cases he sees could have been detected four to 12 months sooner.
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Geisinger, Merck Partner to Launch EHR-Integrated FHIR Apps

A new partnership between Geisinger Health System and Merck leverages FHIR for EHR-integrated health IT tools.

August 15, 2018 - Geisinger Health System and Merck have partnered to launch two new EHR-integrated, web-based health IT tools that leverage FHIR to utilize health data from a variety of EHR systems from different vendors.
The two applications were developed as part of Geisinger and Merck’s ongoing collaboration and are designed to integrate directly into provider workflows to enable clinical efficiency.
The applications include the Family Caregiver Application and MedTrue.
The Family Caregiver app allows for two-way communication between providers and caregivers to improve care coordination, while MedTrue integrates medication data into clinical workflows to enable better-informed clinical decision-making. MedTrue is intended to streamline medication reconciliation and adherence for a patient and provider-verified medication list. 
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HHS Grants Health Centers $125M for Quality Improvement, EHR Use

HHS gave health centers nationwide millions in quality improvement awards, including EHR Reporters Awards.

August 15, 2018 - HHS recently granted health centers in all 50 states and territories $125 million in health center quality improvement awards, including EHR Reporters Awards offered for health centers that employed EHRs to report on all clinical quality measures (CQMs) between 2016 and 2017.
All but 9 states received more than $1 million in awards. California received the highest award with $18,886,440 in grants devoted to quality improvement for health centers throughout the state.
“Community health centers provide coordinated, comprehensive, and patient-centered care to millions of Americans,” said HHS Deputy Secretary Eric Hargan. “They have a track record of delivering quality care at significantly lower cost, and are vital partners in our movement toward a health system that delivers quality, affordable, value-based health care for all Americans.”
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IT chaos in healthcare puts troops’ lives at risk

Alarm at computer debacle in military surgeries
Deborah Haynes, Defence Editor | Chris Smyth, Health Editor
August 17 2018, 12:01am, The Times
Britain’s armed forces are at serious risk because of chronic computer failures at military surgeries across the country, doctors have warned.
Service personnel are in danger of being given the wrong drugs and missing life-saving vaccines because GPs are routinely locked out of patient records, medical staff have told The Times.
One described the IT system as “the biggest threat to patient safety that I have encountered in my 20-year career”.
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CDC details health info exchange by office-based physicians

Published August 16 2018, 7:08am EDT
The Centers for Disease Control and Prevention has released its first national estimates on data exchange by physicians.
The agency on Wednesday released information on the types of patient health information that are electronically sent, received, integrated and searched for by physicians with EHR systems.
Using data from the 2015 National Electronic Health Records Survey, the CDC found that among office-based physicians who sent PHI electronically, the most commonly observed types of PHI sent were referrals (67.9 percent), laboratory results (67.2 percent) and medication lists (65.1 percent).
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HIT Think Why mainframe security risks are largely unrecognized

Published August 16 2018, 5:39pm EDT
In the past year, cybercriminals have made the healthcare industry a top target for sophisticated ransomware attacks, often exploiting known but unpatched vulnerabilities to gain access to clinical information.
The implications of those reported but unresolved vulnerabilities are scary, considering the wealth of patient data hospitals manage, as well as the potential life-and-death situations involved. But, what about the vulnerabilities that aren’t even on the radar of hospital IT departments?
Most modern hospitals depend on multiple electronic systems and connected IoT devices to operate around the clock. The largest hospitals also rely on mainframes to safeguard some of their mission-critical financial and billing data. The security of hospital systems isn’t always up to sufficiently high standards. And, while mainframes are arguably the most securable platform, they still aren’t impenetrable. Mainframes have weaknesses, like code-based vulnerabilities that, if exploited, could endanger the entire enterprise.
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Dr. Atul Gawande: Is health care a human right?

Politics MPR News Staff · Aug 15, 2018
50min 20sec
Dr. Atul Gawande, the famed surgeon, New Yorker writer and best-selling author was invited to the Aspen Ideas Festival in Colorado to address the question, "Is health care a human right?"
Atul Gawande says our health care system is a hodge-podge, and there will be winners and losers in the transition to something better and more affordable.
The reason there is greater support for Medicare, than for Medicaid and Obamacare, Gawande says, is because we all pay for Medicare, according to our income, and we feel we're benefiting fairly.
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Healthcare app economy is coming: Get ready for the dataquake

Cloud giants are poised to reshape the industry with FHIR and open APIs to unleash the power of consumerism.
August 15, 2018 11:29 AM
Before the Blue Button Developer Conference on Monday, I stepped inside the U.S. Digital Service for something of a pre-party. USDS hosted this mix of people in full suits rubbing elbows with tattooed technologists wearing t-shirts.
In the packed room, USDS Deputy Administrator Edward Hartwig climbed onto a couch to deliver congratulations to the team that worked with the Centers for Medicare and Medicaid Services on the API-first Blue Button 2.0.
"We're on the cutting edge of what digital medicine is going to be in this country," Hartwig said.
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CMS, USDS innovators on the future of Blue Button 2.0

With more than 700 developers now in the Blue Button sandbox, officials from the Centers for Medicare and Medicaid Services and the U.S. Digital Service say we are just scratching the surface of what the API-first approach can accomplish.
August 14, 2018 01:23 PM
Ahead of the event, I spoke with two technologists, one from CMS and one from the United States Digital Service (which worked with the agency to develop the Blue Button API). 
Mark Scrimshire is CMS Blue Button Innovator and a developer evangelist. Kelly Taylor is a product manager at the United States Digital Service. They discussed the momentum that CMS has picked up recently in the developer sandbox, the ideal example of what Verily is doing with the API and what they hope other developers do with the tools moving forward.
Q: The White House hackathon is about Blue Button 2.0 – where is Blue Button now?
Scrimshire: When (CMS Administrator) Seema Verma announced the sandbox at HIMSS18 we thought we’d get 20-30 people but we came away with more than 200 developers registered – and it’s still growing. We didn’t try to create something unique to CMS. The resource was meant to be friendly and familiar to the payer industry and, in fact, there are four or five payers that have taken it and are using to do things like send data to analytics vendors. We deliver the API, documentation, implementation guide, sample apps, code samples, there’s a support forum on Google.
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Why companies shouldn’t wait for regulation to step up their privacy practices

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The views expressed by contributors are their own and not the view of The Hill
In light of recent well-documented data breaches and privacy violations like those at Equifax and Facebook, there have been numerous reports that Internet companies are finally warming to United States federal privacy regulations after fending them off for years. In late July, California drew a regulatory line in the sand, passing the California Consumer Privacy Act of 2018. Many are calling this the United States’ toughest privacy law, and given the state’s outsized market influence and its history of acting as a role model for other states, expect it to have wide-reaching ramifications. 
But it shouldn’t take legislation to motivate companies to re-examine what they do with personal data. Almost every day there is news of yet another serious data breach or privacy violation. Clearly, more is needed.
Many Internet companies have extraordinary access to individuals’ personal data – their actions, their friends, their preferences, their interests, and their most intimate secrets. Access to that kind of information should not be taken for granted: it should be handled responsibly. 
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4 Observations From the 2018 HealthLeaders CFO Exchange

By Jack O'Brien  |   August 14, 2018

Last week's CFO Exchange in Santa Barbara fostered a dynamic conversation between hospital finance leaders on issues facing their respective systems. 

The 2018 HealthLeaders CFO Exchange brought more than 40 leading health system CFOs from across the country together at the Ritz-Carlton Bacara Resort in Santa Barbara, California to discuss the changing internal and external dynamics of the healthcare journey. 
CFOs participated in workgroups and breakout sessions aimed at reviewing the overall efficiency of the clinical enterprise and considering the potential impact of external disrupting factors to the healthcare industry. The exchange of ideas brought out engaging conversations on how to make improvements not only for their bottom line, but the experience of their patients as well. 
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EHR vendor profits dip in the first half of 2018

Aug 15, 2018 11:22am
The largest publicly-traded EHR vendors netted more than $465 million in profits during the first half of 2018, a 15.7% decline from the first half of 2017.
Revenues, on the other hand, increased 7.5% with every company seeing a boost.
FierceHealthcare tracked financial data from the EHR vendors that publicly report quarterly earnings to the Securities and Exchange Commission (SEC) including Cerner, Allscripts, Athenahealth, Meditech, NextGen Healthcare and CPSI.
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AI tool screens CT scans for acute neurological illnesses

Published August 15 2018, 7:00am EDT
Researchers at Mount Sinai’s Icahn School of Medicine have developed an artificial intelligence tool that rapidly screens head CT scans.
Those who developed the system say it can be used to quickly review images for acute neurological illnesses, such as stroke and hemorrhage.
A deep neural network trained using 37,236 head CTs was tested in a randomized, double-blinded, prospective trial in a simulated clinical environment. Results of the study, published this week in the journal Nature Medicine, show that the AI algorithm was much faster than human diagnosis—in fact, 150 faster than the time it takes for physicians to read the images.
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HIT Think Why HIEs could play a key role in accelerating interoperability

Published August 15 2018, 5:39pm EDT
The concept of health information exchanges is not new for healthcare. States, regions and other collections of healthcare entities have been attempting to scale up these exchanges for years.
Such efforts clearly predate the major drive into electronic health information that was caused by the Meaningful Use program that has ended up with the vast majority of health systems and physician practices having electronic medical records.
The roots of the recent push to put HIEs into place can be found in the Affordable Care Act, the Meaningful Use program and other initiatives to digitally transform healthcare. As a refresher, an HIE is a dynamic network connecting distinct healthcare systems that enables the transmission of data while maintaining the integrity of the data. The definition of an HIE reveals the idealistic nature of the concept, an idealism that cannot always be matched in actual practice.
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Organizations turning to software to protect data privacy

Published August 15 2018, 5:34pm EDT
The use of data privacy management technology is on the rise, as a variety of security professionals try to bulk up defenses against hacking.
Among the 328 privacy professionals worldwide who were recently polled on the topic, 33 percent have deployed privacy program assessment and management software, while another 32 percent either plan to purchase the technology or have already purchased but have yet to implement the software.
Another 24 percent have purchased data mapping and flow technologies, while 21 percent have purchased personal data discovery tools, according to the study by TrustArc, a data privacy management company, and the International Association of Privacy Professionals, a global information privacy community. These two technologies also data privacy tools that organizations are most likely to implement in the future.
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NHS ‘owes it to society to make money from patients’ information’

Chris Smyth, Health Editor
August 16 2018, 12:01am, The Times
The NHS has a “responsibility to society” to make money out of patient data rather than allowing the profits to be captured by US technology companies, a former science minister has argued.
Lord Drayson, who is taking his artificial intelligence company public tomorrow, also said that there was an “ethical imperative” to use anonymised data to improve care, comparing controversies over confidentiality to the animal rights extremism of the 1990s.
After results from Deepmind, the Google AI company, this week suggested that computers could do better than doctors at spotting eye and brain disease, there was mounting optimism over the potential for machine learning to diagnose and manage illness. At the same time there has been controversy over how patient data is used to train such software after the collapse of an NHS attempt to link GP records. Deepmind was involved in a separate deal with the Royal Free hospital that was criticised by the information commissioner over handling of patient records.
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IBM responds to recent Watson media coverage

Several news stories have questioned what reported struggles with the cognitive platform mean for the larger idea of AI in healthcare.
August 14, 2018 02:34 PM
Back in 2011, IBM's new Watson technology was the focus of a lot of excited expectation about what its artificial intelligence platform – having famously bested human opponents on Jeopardy! – could do for healthcare. Seven years later, some media reports are wondering whether Watson's potential was over-promised.
Recent stories, in Stat News, the Wall Street Journal and elsewhere have taken aim at the AI technology's diagnostic track record, drawn attention to potential patient safety risks, and questioned whether the billions of dollars Big Blue has spent building and training the platform have worth it.
The Stat News story reported on internal IBM documents that showed "multiple examples of unsafe and incorrect treatment recommendations" from the Watson for Oncology system.
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Four Pros to Integrating EHR, Practice Management Software
Consolidating software allows practices to save time and money, make fewer mistakes, protect privacy
MONDAY, Aug. 13, 2018 (HealthDay News) -- Consolidating electronic health records and practice management software allows practices to save time and money, make fewer mistakes, and reduce the risk of privacy breaches, according to an article published in Physicians Practice.
Integration of medical records and practice management software can cut out duplicate efforts; if programs are not integrated, billing staff has to re-key what has been written or logged elsewhere. When systems are combined, the information is entered and the codes and other information go straight through to billing.
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Tech industry giants vow support for healthcare interoperability

Published August 14 2018, 7:50am EDT
Amazon, Google, IBM, Microsoft, Oracle and Salesforce have pledged to work to advance open standards to enable healthcare interoperability.
The tech companies made the joint announcement to coincide with their participation in Monday’s Blue Button 2.0 Developer Conference at the White House. The Blue Button 2.0 application programming interface leverages the FHIR standard from HL7, enabling Medicare beneficiaries to share their claims data with third-party apps.
“IBM believes that patients should have access to their data, and the flexibility to use products and services across different healthcare systems, with confidence that they all are working seamlessly for their care,” said Mark Dudman, head of global product and AI development at IBM Watson Health. “We are proud to participate in this pledge and look forward to working with industry and the developer community to ensure appropriate access to data and the use of that data to support vibrant communities and solve health challenges for people everywhere.”
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Feds want Blue Button 2.0 initiative to spark data sharing in industry

Published August 14 2018, 7:40am EDT
The Trump administration is committed to unleashing technological innovation in the private sector to improve healthcare in America.
“We recognize the power of the private sector to drive innovation and to solve difficult problems,” said Chris Liddell, deputy chief of staff for policy coordination, at the Blue Button 2.0 Developer Conference held at the White House on Monday for health IT developers, featuring new apps that leverage Medicare data.
Blue Button 2.0, which utilizes HL7’s Fast Healthcare Interoperability Resources (FHIR) standard, is an application programming interface (API) that enables Medicare beneficiaries to share their claims data with third-party apps. In March, the Centers for Medicare and Medicaid Services announced the launch of the API as part of the MyHealthEData initiative, an effort to put patients in control of their own healthcare information.
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HIT Think How to assess IoT risks that fly under the radar

Published August 14 2018, 5:13pm EDT
In the last few years, it has become common practice to “improve” almost everything by adding an embedded computer and connecting it to a network.
Just one decade ago, the average enterprise network primarily consisted of PCs, servers and network devices. The only endpoint devices that were treated differently were the printers and multi-function devices, which have been the cause of much pain over the years.
Fast-forward to 2018, and that same network will include hundreds or thousands of connected devices—or endpoints—that are not treated like a PC or server.
Most of these connected devices, commonly called “smart devices,” are inexpensive and designed to have a simple setup, which translates to cheap and poorly secured. This, in conjunction with common “bring your own device” (BYOD) policies, has led to a drastic uptick in the number and type of devices that are connected to an enterprise’s network.
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How Blockchain can help with healthcare's patient matching problem

The technology alone won’t fix patient ID issues but it can bring some of the data accessibility, interoperability, integrity and security hospitals need.
August 13, 2018 07:16 AM
Blockchain. The distributed ledger technology has considerable promise in healthcare and, as so often happens with emerging technologies, it’s being hailed as something close to a cure-all for just about everything.
From cybersecurity to electronic health records and data interoperability, to supply chain and clinical trials, even patient engagement. They’re all been named as potential use cases.
But what about the challenge of patient matching? Can blockchain cure the woe of successfully identifying the same patient throughout an intricate web of information systems?
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Canadian pharmacist fined for routinely accessing health records of acquaintances

She snooped in the EHRs of nearly four dozen people over two years.
August 13, 2018 11:27 AM
A pharmacist in Canada has been fined and suspended from practice for six months for spying on the electronic health records of 46 people she knew, including her child's girlfriend.
Robyn Keddy, manager of a Nova Scotia pharmacy operated by Sobeys, one of the Canada's major grocery retail chains, had used the provincial Drug Information System to trawl the confidential records over two years, including those of former classmates, her doctor, a person with whom she'd had a car accident, and her child's therapist, the Nova Scotia Information and Privacy Commissioner Catherine Tully found.
In her investigations into privacy breaches involving the pharmacist launched in December last year, Tully also found Keddy had created false profiles to access the DIS and discussed the private health information with her spouse.
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Flagler Hospital uses AI to create clinical pathways that enhance care and slash costs

A pneumonia pathway saved $1,356 per patient, lowered length of stay by two days and significantly reduced readmission rates.
August 13, 2018 06:51 AM
Flagler Hospital in Saint Augustine, Florida, is using artificial intelligence tools to improve the treatment of pneumonia, sepsis and a dozen other high-cost, high-mortality conditions. Usually, it’s large academic medical centers or wide-ranging health systems, not community hospitals, that so aggressively use AI in attempts to improve care and trim costs.
The AI tools automatically revealed new, improved care pathways for pneumonia and sepsis after analyzing thousands of patient records from the hospital and identifying the commonalities for those with the best outcomes. The hospital quickly implemented the new pneumonia pathway by changing the order set in its Allscripts EHR.
It expects to save $1,356.35 per pneumonia patient in direct variable costs (35 percent savings) versus the status quo, while reducing length of stay by two days. The new sepsis pathway has also been deployed.
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AAFP, Other Groups Demand HHS Stop Stalling on Regulations

Information Blocking Provisions Mired in Bureaucracy

August 09, 2018 02:12 pm News Staff – Enough is enough. The AAFP recently joined 13 other medical associations and health care organizations in telling the federal government it has dragged out the regulation-writing process on an important topic far too long.
At issue are the information blocking provisions of the 21st Century Cures Act,(www.congress.gov) which was enacted in December 2016.
As the Aug. 6 letter(2 page PDF) to National Coordinator for Health IT Donald Rucker, M.D., and HHS Inspector General Daniel Levinson points out, more than 600 days have passed since that law was signed into law.
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EHR Patient Data from Rochester RHIO Fueled HPV Vaccine Study

Rochester RHIO contributed EHR patient data to a CDC-sponsored project analyzing the effect of HPV vaccinations.

August 09, 2018 - Rochester RHIO is helping the Centers for Disease Control and Prevention (CDC) assess the impact of HPV vaccinations by contributing EHR patient data to researchers.
The CDC-sponsored project is spearheaded by the Center for Community Health and Prevention of the University of Rochester. To assist researchers, the New York regional health information exchange (HIE) is providing anonymized clinical data about cervical cancer screenings and trends from around the area.
In addition to RHIO, researchers are also utilizing data from California, Connecticut, Oregon, and Tennessee for use in the HPV Vaccine Impact Monitoring Project (HPV-IMPACT).
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Most hospitals won't reach HIMSS Analytics Stage 7 until 2035, study finds

Written by Jessica Kim Cohen | August 10, 2018
Most hospitals have already adopted EMRs. However, the majority won't deploy more advanced capabilities on the software until 2035, according to a study published in the Journal of Medical Internet Research.
To forecast EMR functionality among U.S. hospitals through 2035, the research team — comprised of five scientists from across the U.S. and one from Australia — analyzed data collected from the eight-stage EMR Adoption Model, a program of Healthcare Information and Management Systems Society subsidiary HIMSS Analytics, between 2006 to 2014.
The EMR Adoption model measures the degree to which a hospital uses its EMR functions, such as integrating device encryption or smart infusion pumps.
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By Ms. Smith, CSO | Aug 12, 2018 10:08 AM PT
Ms. Smith (not her real name) is a freelance writer and programmer with a special and somewhat personal interest in IT privacy and security issues.

Hacking pacemakers, insulin pumps and patients' vital signs in real time

At the recent Black Hat and Def Con events, researchers showed how they are able to hack pacemakers, insulin pumps, and patients' vital signs in real time.

Medical device insecurity was covered at the recent Black Hat and Def Con security conferences in Las Vegas. One set of researchers showed off hacks to pacemakers and insulin pumps that could potentially prove lethal, while another researcher explained how hospital patients’ vital signs could be falsified in real time.

Pacemaker and insulin pump hacks at Black Hat USA

A decade has passed since we learned about pacemaker hacks, but still implantable medical devices that can save patients’ lives can be hacked to potentially kill them. Even now, as was highlighted at Black Hat USA, attackers can cause pacemakers to deliver a deadly shock to the heart or deny a life-saving shock, as well as prevent insulin pumps from delivering needed insulin.
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Cybersecurity researchers hack patient monitor data stream, falsify vital signs

Aug 13, 2018 2:21pm
The data stream that transmits vital signs information from hospital patient monitors to a central hub can be hacked and falsified, according to cybersecurity researchers, highlighting new concerns about medical device vulnerabilities.
Using a patient monitor and a compatible central monitoring station purchased from eBay, members of the McAfee Advanced Threat Research team were able to emulate and modify data coming from a patient monitor, including heart rate, oxygen levels and blood pressure.
While the monitor itself was not directly affected, researchers found they could alter the information transmitted to the monitoring station, used by clinicians to oversee multiple patients at once. Altering the data to make it appear that a patient’s heart rhythm had either sped up or slowed down, for example, could prompt physicians to intervene or make medical decisions based on erroneous information.
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Amazon, Google, Microsoft and IBM pledge support for healthcare interoperability

Aug 13, 2018 4:28pm
Six of the world's largest technology giants have thrown their sizable weight behind advancing interoperability in healthcare. 
Microsoft, Amazon, Google, IBM, Oracle and Salesforce issued a joint statement on Monday vowing to remove the barriers to interoperability by promoting the "frictionless exchange of healthcare data" through open standards and active engagement with the healthcare industry. 
"We are jointly committed to removing barriers for the adoption of technologies for healthcare interoperability, particularly those that are enabled through the cloud and AI," the joint statement read (PDF). "We share the common quest to unlock the potential in healthcare data, to deliver better outcomes at lower costs."
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FDA clears mobile contraceptive app for women

Published August 13 2018, 7:29am EDT
A federal agency has approved an app that analyzes a woman’s basal body temperature and identifies when ovulation has occurred.
The Food and Drug Administration has cleared the app as a method of contraception to prevent pregnancy. Called Natural Cycles, it leverages an algorithm that calculates fertile days when protection or abstinence is required.
Intended for use in pre-menopausal women aged 18 and older, users measure their basal temperature in the morning—five values per week are recommended—and then enter the data into the app, which gets to know their individual menstrual cycle. With one to three cycles of measurement, the app has enough data to confirm when ovulation has occurred and accurately predict fertility.
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Google’s DeepMind to create AI product to spot eye disease

Published August 13 2018, 4:25pm EDT
DeepMind plans to develop a product that will help doctors detect more than 50 sight-threatening conditions from a common eye scan.
DeepMind, the London-based artificial intelligence company that is owned by Alphabet, trained artificial intelligence software to detect signs of disease better than human doctors, according to a study published in the scientific journal Nature Medicine. DeepMind and its partners in the research, London’s Moorfields Eye Hospital and the University College London Institute of Ophthalmology, said they plan prospective clinical trials of the technology in 2019.
If those trials are successful, DeepMind said it would seek to create a regulator-approved product that Moorfields could roll out across the U.K. It said the product would be free for an initial five-year period. The software would be the first time a DeepMind AI algorithm using machine learning has ended up in a healthcare product.
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Deep learning technique works on smartphone to find skin lesions

Published August 13 2018, 5:06pm EDT
A novel way to locate “regions of interest” in dermoscopy images can improve the detection of skin lesions.
Such review, augmented by deep learning, can be conducted using an app on a consumer mobile device, enabling real time identification and diagnosis of cancer and other skin conditions, according to new research reported in arXiv.org, part of the Cornell University Library.
The incidence of skin cancer is more than breast, lung, colon and prostate cancer combined.
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HIT Think How to avoid security risks through better data practices

Published August 13 2018, 4:57pm EDT
A recent security incident at the Nashville Metro Public Health Department in Tennessee exposed the information of thousands of individuals with HIV/AIDS. According to the Tennessean news site, this information was accessible in a public folder on a shared server open to all health department employees for nine months.
Investigation of the incident suggested no evidence that the data had been inappropriately accessed, concluding that the incident did not constitute a breach. The agency did not discipline anyone, but rather used the incident as a teaching moment for its staff and made improvements to its server infrastructure to better accommodate sensitive data.
Unfortunately, this scenario is all too common in healthcare. Data is often viewed as an afterthought instead of an organizational asset to be proactively managed and protected internally and externally.
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Enjoy!
David.

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