Quote Of The Year

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


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

Saturday, September 15, 2018

Weekly Overseas Health IT Links – 15th September, 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.

NHS England chief executive hails new era of personalised medicine

NHS England’s chief executive has hailed the “beginning of a new era of personalised medicine” during his speech at the Health and Care Innovation Expo.
Hanna Crouch – Sep 6, 2018
Addressing a packed theatre in Manchester on 5 September, Simon Stevens celebrated how much had changed in the NHS since he joined it as a graduate – 30 years ago this week, he told delegates – thanks to innovations such as the development of gene therapy.
He added: “Progress will continue over the next few years, we are seeing the beginning of a new era of personalised medicine.”
He also enthused about increased use of artificial intelligence (AI) and machine learning.

Cybersecurity: Innovating staff buy-in and avoiding silver bullet tools

Hackers are constantly innovating attack methods and organizations need to follow suit, by following trends and choosing cybersecurity tools that fit their business needs.
September 07, 2018 09:31 AM
The healthcare security landscape is always in flux. From ransomware to phishing attacks, hackers have continued to target the sector at a steady pace over the last few years. While the attack vectors may shift, the fact remains security must continue to develop and innovate to keep pace with hackers.
A report from security firm SentinelOne saw less ransomware attacks in 2018 than reported the year prior, while fileless attacks have increased by 94 percent. However, with three major ransomware breaches reported over the summer, it’s yet to be seen whether reporting is down -- or the use of the malware.
Not only that but, according to Symantec, 10 percent more organizations reported a breach in 2017 than the previous year.

System enables telementoring on battlefield with AR technology

Published September 07 2018, 7:27am EDT
An augmented reality tool aims to help inexperienced physicians in war zones perform complicated medical procedures guided remotely by mentors.
Developed by Purdue University researchers, the approach involves a transparent headset screen display that enables mentees to view the patient in front of them, as well as receive real-time on-screen feedback from mentors located in separate locations using video monitors.
In addition, the system leverages computer vision algorithms to track and align the virtual notes and marks from the mentor with the surgical region in front of the mentee.

NHS IT: Can better use of tech give healthcare a shot in the arm?

Is improving tech the key to to making healthcare more efficient?
By Mark Samuels | August 28, 2018 -- 10:41 GMT (20:41 AEST) | Topic: Innovation
The NHS is under mounting pressure; can smarter use of technology help bridge the gap between what the system can provide and what patients expect?
"A digital health system is the only way that healthcare will still be affordable in five years' time," says Richard Corbridge, chief digital and information officer at Leeds Teaching Hospitals NHS Trust. "Efficiency can only be generated through modern, digital practices."
Corbridge points to the digital transformation that has already led to significant disruption in sectors like banking, travel and entertainment industries: now, it is the turn of healthcare to face similar disruption, he argues.

IT investment needed for better medication management, boosting patient safety

Physician informaticists from AMDIS say they're heartened by recent patient safety gains, but are still concerned by big gaps in processes, particularly with opioids.
September 06, 2018 03:11 PM
Hospital chief medical information officers are almost unanimous in recognizing the patient safety improvements that have been brought about by better medication management processes, according to a new poll from their U.S. trade group, the Association of Medical Directors of Information Systems.
The results come amid the ongoing opioid epidemic in America. Technology vendors are trying to help in the battle. IT-savvy hospitals such as Intermountain, which has tweaked its Cerner EHR to reduce such prescriptions in the first place, and Ochsner, which has integrated an opioid monitoring tool into its Epic system, are taking matters into their own hands. More and more states, meanwhile, are passing e-prescribing laws and standing up prescription drug monitoring programs.

NHS announces new Genomic Medicine Service

Agency said the goal is to provide access to genetic testing to drive personalized treatments and enable interventions for the whole country.
September 06, 2018 02:41 PM
Manchester, UK – National Health Service Chief Scientific Officer for England Sue Hill formally announced a new national Genomic Medicine Service at the Health and Care Innovation Expo here.
The new service, set to be rolled out in October, will provide 'equitable access' to genetic and genomic testing, including whole genome sequencing, and drive personalized treatments and interventions for the country’s entire population, building on the 100,000 Genomes Project, delivered to ‘common national standards, specifications and protocols’.
The U.S. also has a similar undertaking, the National Institutes of Health’s All of Us program, which aims to enroll 100,000 participants to share their data for research purposes. Both it and the NHS program comes as hospitals and technology vendors are increasingly building next-gen tools for precision medicine and genomics based on machine learning, SMART on FHIR and EHR integration to meet the demand for consumerism in healthcare.

5 EHR Optimization Activities for Improving Clinical Efficiency

Streamlining clinical workflows and boosting usability during EHR optimization can improve physician productivity.

September 05, 2018 - Clinical efficiency and provider satisfaction often suffer after hospitals and health systems go live with new EHR implementations.
Disruptions to clinicians’ daily routines can sour providers and administrators against EHR technology and overshadow the potential benefits of new systems.
Launching an EHR optimization project after implementation can help to restore clinical efficiency, improve physician satisfaction, and reduce administrative burden on providers. Effective EHR optimization activities can also save healthcare organizations from investing in costly, time-consuming EHR replacements by resolving persistent problems with usability.

Open Source EHR Alliance to Launch International VistA System

The EHR alliance created by VA in 2010 is developing a VistA system capable of storing and displaying health data in any language.

September 05, 2018 - The Open Source EHR Alliance (OSEHRA) is creating a new version of its Veterans Health Information Systems and Technology Architecture (VistA) EHR system designed for international implementation.
VA established OSEHRA in 2010. VistA comprises more than 100 integrated applications and currently supports patient care delivery at 152 VA care sites and 928 ambulatory care and community-based outpatient clinics around the world.
In 2017, VA announced its decision to replace VistA with a commercial Cerner EHR system similar to the Department of Defense’s (DoD’s) MHS GENESIS system.

Why Catholic Health Initiatives' CISO says awareness training is pivotal in hospital cybersecurity

Written by Jackie Drees | September 05, 2018 | Print  | Email
Sheryl Rose, chief information security officer and senior vice president at Englewood, Colo.-based Catholic Health Initiatives, discusses the evolution of the CISO role and how hospital systems can implement the best practices for data protection.
Question: What tasks require most of your time as CISO?
Sheryl Rose: The role of the CISO has evolved over the years. It's important to have a solid technical background but as recent years have shown, having a strategic, balanced approach to security is extremely important. It is critical to understand your organization's threat landscape. The potential security threats that may impact an organization are continually changing. You must have strong processes for identifying, remediating and communicating risks to your organization. In some cases, you will have to think about compensating controls in mitigating the risks as not all risks can be addressed.
I spend a lot of time focusing on the projects that will enhance our security posture. This means working with the teams to have a solid focus on people, process and technology. Cyber threats in healthcare are real and spending your time focusing on how to prevent as well as detect [them] is critical. While I spend a large portion of my time working through our risk management processes and the associated projects, it is also extremely important to focus on strategy. Everyone's responsibility is security, and to get support is necessary to balance the business with the security needs.

Robust Health Data Security Needed for PHI-Laden Mobile Devices

Strong health data security is vital for electronic media and mobile devices that process and/or store PHI, stressed OCR in its August 2018 Cyber Security Newsletter.

September 05, 2018 - Strong health data security is vital for electronic media and mobile devices that process and/or store ePHI, stressed OCR in its August 2018 Cyber Security Newsletter.
“Anyone with physical access to such devices and media, including malicious actors, potentially has the ability to change configurations, install malicious programs, change information, or access sensitive information – any of these actions has the potential to adversely affect the confidentiality, integrity, or availability of PHI,” warned OCR.

Silos that limit patient record access are hurting care, researchers say

Published September 06 2018, 7:32am EDT
Limited access to patients’ health information is having multiple negative effects on care delivery, according to a newly released report.
A recent paper examines how keeping information locked up is holding back the healthcare industry. The report was published in BMC Health Services Research and written by Anabel Castillo, an engineering and public policy researcher at Carnegie Mellon University, and professors Marvin Sirbu and Alexander Davis.
Healthcare organizations have gone to great lengths to keep medical records private but with most hospitals now using electronic health records, doctors are appreciating how the records can be used to improve care, according to the researchers.
The silos holding records have prevented patients’ new providers from having an accurate record of the medical history, which can cause errors in the treatment process, even as EHRs can make sharing records easier.

Medication management programs work but worries remain, CMIOs say

Published September 06 2018, 5:19pm EDT
Chief medical information officers say they believe medication management improvement programs improve patient safety and reduce adverse drug events.
However, a recent survey of CMIOs indicates that they still have concerns about the overall medication management process, with only half saying they are satisfied with the process in their organizations. Some 12 percent of respondents say they are dissatisfied.
The biggest concerns are incomplete patient medication histories, misaligned medication reconciliation and care transition cycles that can lead to misinformed decisions by care teams. CMIOs also have deep concerns about affordability, as the cost of medications continue to rise, straining patients’ abilities to pay, which can affect medication adherence regimens.

Physician Burnout: How to Write Shorter EHR Notes

By Christopher Cheney  |   September 06, 2018

Electronic health records contribute to physician burnout and writing shorter case notes can ease the EHR burden.


Research has shown that more than half of a primary care physician's work day is spent interacting with an EHR.
EHR use contributes to all three elements of physician burnout: lack of enthusiasm, lack of accomplishment, and cynicism.
Best practices for shortening EHR case notes include focusing on a patient's presenting complaint.
Electronic health records (EHRs) have become a primary driver of physician burnout, a recent research article says.

Technology is changing the way you see a doctor, but is that good for your health?

By Meera Senthilingam, CNN
Updated 0952 GMT (1752 HKT) August 30, 2018

Story highlights

  • Some health systems are exploring the idea of using artificial intelligence
  • One doctor worries it could affect continuity of care for patients
(CNN)One morning, Charlie Latuske woke up feverish and somewhat delirious in his home in Surrey in the UK, leaving him unable to function and in need of a doctor.
He'd endured a sore throat and general malaise for a few days, believing it would get better, but that morning in August 2017, he knew that he had to do something about it.
"I was quite out of it," said 27-year old Latuske, who was also due to go on vacation with his wife in just three days.

Trump admin tariffs will slow US cloud market, stifle innovation, says ITIF

Proposed import taxes could stymie development of cloud tech, put the U.S. at a competitive disadvantage and adversely impact consumers – and, potentially, patients, a new Information Technology and Innovation Foundation study shows.
September 04, 2018 01:38 PM
The tariffs being proposed by the administration of President Donald Trump, particularly those on certain Chinese imports, could harm the booming cloud computing industry in the United States, undermine U.S. leadership in the sector, and harm innovation – not least in healthcare.
That's according to a new report from the Information Technology and Innovation Foundation, the influential nonprofit tech policy think tank, based in Washington, D.C.
By stifling the development of fast-evolving cloud technology, the tariffs could put the U.S. at a competitive disadvantage and adversely impact consumers – and, potentially patients, according to the study, which spotlights some specific initiatives that could be affected by import taxes.
"For businesses large and small alike, in industries ranging from agriculture and manufacturing to healthcare and transportation, cloud computing has become an indispensable platform technology critical to their success," ITIF researchers wrote in the report.

Focus on innovation: 3 charts explain where healthcare is headed

New HIMSS Media research spotlights what innovations are needed most, top areas hospitals are prioritizing and sticking points to avoid.
September 05, 2018 08:00 AM
New research reveals hospital innovation needs to focus on interoperability, patient experience and telehealth.
Healthcare is at an exciting juncture right now. With analytics, cloud, mobile tools, open APIs, apps, and so much patient data being generated and opened to developers, there are plenty of reasons to be optimistic about how hospitals can use technology to fix our broken system.
That's exactly why we are focusing on innovation throughout September. We will be posting analysis, advice and insights about innovators, transformation, modernization, forward looking strategies and reality checks every day this month. You can read all our coverage about innovation here.
HIMSS Media conducted fresh research about innovation in health IT, in fact, that uncovered where innovation is most needed and hospitals’ top priorities as well as the main factors holding progress back — which just might surprise many health IT pros.

Almost 400k websites risk hacking, data theft via open .git repos, researcher warns

Your misconfigured website could be exposing sensitive data, including database passwords.
By Liam Tung | September 4, 2018 -- 13:22 GMT (23:22 AEST) | Topic: Security
Czech security researcher Vladimír Smitka is warning website operators to take a closer look at how they configure their site, in particular if they use a git to deploy and manage it.
Smitka recently scanned 230 million "interesting" sites across the globe over one month and found 390,000 web pages with an open .git directory.
Smitka said this situation represented "a nasty problem", because unauthorized outsiders can access current and past files with information about the website's structure, or very sensitive data such as database passwords, API keys, and more.

Predictive Analytics to Explore Link between Opioids, Suicide Risk

Kaiser Permanente researchers will use predictive analytics and machine learning to examine potential connections between opioid abuse and suicide risk.

September 04, 2018 - A three-year, $1.4 million Kaiser Permanente study will leverage predictive analytics and machine learning to understand the relationship between opioid use and suicide risk, allowing researchers to develop improved tools for identifying high-risk patients.
Both suicide deaths and opioid-related overdose deaths are on the rise in the US. Citing the National Center for Health Statistics, Kaiser Permanente noted that suicide rates increased by 27 percent between 1999 and 2015. Over the same period, the rate of suicides where opioid abuse was a contributing cause doubled.
“We’ve done preliminary work suggesting that 22 to 37 percent of opioid-related overdoses are, in fact, suicides or suicide attempts,” said Bobbi Jo Yarborough, PsyD, an investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon.

Who do patients want to share health data with?

Written by Jessica Kim Cohen | September 04, 2018 
Patients are most likely to agree to share their health data with a physician, and least likely to want to share their data with a tech company, according to a Rock Health report.
Rock Health, a seed fund focused on digital health startups, surveyed nearly 4,000 adults in the U.S. in 2017 for its report on digital health adoption among healthcare consumers.
Here's how the participants responded when asked if they were willing to share their health data — such as medical records, genetic information or physical activity data — with various entities:

Santa Clara County launches health data portal for residents

Published September 05 2018, 7:31am EDT
The Public Health Department in Santa Clara County, Calif., has launched a user-friendly online tool for residents to access health data.
“Data at the neighborhood level helps programs work better and smarter to address health inequities in our county,” says Ken Yeager, Santa Clara’s county supervisor. “This is part of the county’s investment to support local nonprofits, city governments and residents with the data they need to run great programs. We look forward to seeing how this data will continue to build innovative health solutions across Silicon Valley.”
The Open Data Portal, which is hosted by mapping and location analytics vendor Esri, includes searchable and downloadable information on more than 100 health topics, as well as the latest local metrics and demographics based on race, ethnicity and income.

New app helps the blind find their way easier

Published September 05 2018, 5:49pm EDT
A mobile app called WayAround, first introduced earlier this year to help persons with vision loss find items within the home, is now more widely available.
Its developers say the iPhone-based app now also is available in an Android version.
Both versions enable blind individuals, often getting assistance from family or friends, to create tags for a specific item, such as a certain piece of clothing. The tag—with embedded information about the clothing—is placed on the clothing or any other type of item, and the information also is stored on a smartphone or other mobile device.
A person with partial or total vision loss can go to the closet to get a charcoal suit with light pinstripes, hold the phone close to the clothes, and be verbally prompted when the phone reaches the right item.

If You Can't Properly ID Your Patients, You Can't Properly Bill Them

By Alexandra Wilson Pecci  |   August 31, 2018

Mobile phones and apps may help improve healthcare record matching.

Mobile technology, like phones and smartphone apps, may help to ensure that patient medical records are matched correctly when shared between healthcare providers, according to a new RAND Corporation report sponsored by the Pew Charitable Trusts.
Exchanging healthcare data electronically has its advantages, but its value is lost when the data that's shared is incorrect. Mixing up patient details, like phone numbers and the correct spelling of names, is costly to hospitals.
For instance, 33% of all denied claims result from inaccurate patient identification or information, according to April 2018 Black Book data. That cost the average hospital $1.5 million in 2017 and the U.S. healthcare system over $6 billion dollars annually.
The Black Book data also showed that the average expense of repeated medical care because of duplicate records cost an average of $1,950 per patient per inpatient stay and more than $800 per ED visit.

Meditech adds PDMP access to Expanse EHR

Written by Jessica Kim Cohen | August 31, 2018 | Print  | Email
Meditech integrated access to state-regulated electronic prescription drug monitoring programs into its newest EHR and patient administration system, a web-based platform called Expanse.
Meditech added the capability through a collaboration with DrFirst, a medication management solutions provider. DrFirst links cooperating state PDMPs together, providing users with a comprehensive view of a patient's prescription history of controlled substances at the point of care.

Facial recognition zeroes in on genetic disorders

By Jonathan Saltzman Globe Staff  August 30, 2018
Dr. Olaf Bodamer wasn’t sure what was wrong with the 3-year-old boy he recently examined at Boston Children’s Hospital, but he had a hunch.
The child’s muscle tone was weak, and he had taken longer than expected to start walking and talking. He also had unusual facial features: a cleft palate, arched eyebrows, and large, misshaped ears.
Bodamer, a 55-year-old clinical geneticist, suspected Kabuki syndrome, a rare genetic disorder. Children with the condition have distinctive features that Japanese doctors, who first identified it in 1981, likened to the makeup worn by actors in kabuki theater. But patients also typically have a flattened nose. This boy didn’t.
So Bodamer did something a growing number of specialists in genetic disorders are trying. He took a photograph of the toddler’s face on his iPad and uploaded it to a facial recognition app called Face2Gene, developed by Boston-based digital health startup FDNA.

Forget WannaCry, staff themselves pose a risk to healthcare data

Almost 60% of breaches had an insider element in 2017

By John E Dunn 3 Sep 2018 at 08:45
More than half of all healthcare data breaches reported during 2017 could be traced back to people on the inside of victim organisations, according to an annual study by Verizon.
The company's latest Protected Health Information Data Breach Report (PHIDBR) looked at 1,368 mostly US examples, identifying 782 (57.5 per cent) as having an insider element.
A further 571 (42 per cent) were external attacks, 80 (5.9 per cent) happened via partners, and 69 (5.1 per cent) involved collusion between entities on the inside or outside.
PHIDBR is a more detailed breakdown of data from Verizon's Data Breach Investigations Report from April and comes almost a year in arrears.

Email phishing attack compromises data of respiratory care provider

Published September 04 2018, 5:15pm EDT
Hackers were able to breach networks of Reliable Respiratory, Norwood, Mass., in early July, and it’s now releasing details of the attack.
On July 3, the organization became aware of unusual activity in the employee’s email and identified a phishing campaign that compromised the employee’s credentials. Reliable then engaged forensic specialists to determine the nature and scope of the incident—analysis found that access was gained between June 28 and July 2.
Information that may have been affected included at least 15 different types of protected health information.

Imaging biomarker measures coronary inflammation from fatty tissue

Published September 04 2018, 7:25am EDT
A novel imaging biomarker is able to detect inflammation of fatty tissue surrounding the coronary arteries using computed tomography.
Researchers also say the non-invasive approach can predict all-cause and cardiac mortality.
Developed by researchers at the Cleveland Clinic, University of Erlangen in Germany and University of Oxford in the United Kingdom, the imaging biomarker captures inflammation by mapping spatial changes of perivascular fat attenuation on coronary computed tomography angiography.

HIT Think How best to manage artificial intelligence in radiology

Published September 04 2018, 4:28pm EDT
For well over a decade, VNA solutions have been available to provide a shared multi-department, multi-facility repository and integration point for healthcare enterprises.
Organizations employing these systems, often in conjunction with an enterprise-wide electronic medical record (EMR) system, typically benefit from a reduction in complexity, compared with managing disparate archives for each site and department. These organizations can invest their IT dollars in ensuring that the system is fast and provides maximum uptime, using on-premises or cloud deployments. And it can act as a central, managed broker for interoperability with other enterprises.
The ability to standardize on the format, metadata structure, quality of data (completeness and consistency of data across records, driven by organizational policy), and interfaces for storage, discovery and access of records is much more feasible with a single centrally managed system. Ensuring adherence to healthcare IT standards, such as HL7 and DICOM, for all imaging records across the enterprise is possible with a shared repository that has mature data analytics capabilities and quality control tools.

HIT Think Achieving optimal sepsis sensitivity and specificity with EMR surveillance

Published August 31 2018, 12:08pm EDT
Sepsis accounts for half of hospital deaths, according to research published in the Journal of the American Medical Association. It’s the leading cause of readmissions, and more than $20 billion is spent on it annually.
According to the Centers for Disease Control and Prevention, sepsis has become a medical emergency. Every year there are at least 1.7 million cases of sepsis implicated in as many as 270,000 deaths, the CDC says.
Sepsis starts with any kind of infection or any time germs enter the bloodstream. The human body tries to fight the infection but fails. The organs shut down one by one. But what’s unique about sepsis, compared to cancer, for instance, is that there is a known cure – usually antibiotics and fluids are sufficient. This means, that for the medical community, the most critical issue with regard to sepsis is detection, not treatment.

Telehealth helps Einstein Medical Center slash readmissions, boost value-based care

Since using remote patient monitoring technology, the hospital has had zero readmissions for patients with liver failure.
September 04, 2018 01:46 PM
The Einstein Medical Center wanted to decrease readmissions for liver failure patients by 50 percent. Caregivers had a longtime interest in the potential for remote patient monitoring and turned to telehealth technology to address this mandate.
Thus far, since implementing the RPM processes, the hospital has gone more than two months without any readmissions.
"The problems we encountered included issues that come up with all patients with a severe chronic illness," said Richard Kalman, MD, assistant professor of medicine SKMC in the department of digestive disease and transplantation in the division of hepatology at the Albert Einstein Healthcare Network in Philadelphia.

Nationwide prescription safety alert system proposed by House bill

The bipartisan legislation would require HHS to work with the private sector to analyze data from payers and pharmacists, flagging patients at risk of overuse based on prescription history.
August 31, 2018 02:57 PM
A House bill introduced on Aug. 30 would create a nationwide Prescription Safety Alert System, designed to better protect patients at risk of opioid overuse.
If passed, the Analyzing and Leveraging Existing Rx Transactions (ALERT) Act would mandate the Department of Health and Human Services to work with the private sector on a system that can analyze data from payers and pharmacists to protect patients from opioid abuse.
The system would flag patients at risk of overuse based on prescription history. Pharmacists would get the data right in the workflow, including capturing transactions from across state lines and any unsuccessful opioid fill attempts.

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