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, December 15, 2018

Weekly Overseas Health IT Links – 15th December, 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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It’s not just about instant messaging – we need an integrated approach to clinical communication

DHI Admin – December 4, 2018
There is little doubt that instant messaging is being used by clinicians to share patient information – with all the related risks. John Safa believes that new guidance in the area and efforts to develop secure apps are welcome. But he argues that to truly address the issue requires a much more integrated approach to communication and data security across healthcare.
Speak to just about any doctor off the record and they will tell you that, yes, of course they have used instant messaging on their smartphone to send a clinical image to a colleague. They will use the technology that they have, that they are comfortable with and, here’s the most important bit, that works without interrupting their workflow.
Speak to just about anyone else and they will agree that doctors – and all other frontline healthcare professionals for that matter – have a very real need to be able to share patient data if they are to deliver excellent care. That this need to share information is often time critical is also not in doubt.
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EMIS reveals X-citing next phase of GP IT software

GP IT software company EMIS has launched its plans for its next phase of clinical technology, which includes video consultations and clinical triage.
Hanna Crouch – December 3, 2018
From this week, EMIS customers will be able to attend video consultations via the Patient Access app.
Patients can also access an online triage service, which can answer pressing questions they may have about certain symptoms and point them in the right direction.
In addition, EMIS has launched the next iteration of its web platform.
Known as EMIS-X, the cloud-based platform aims to create an ecosystem that supports NHS Digital interoperability standards, where applications are allowed to share selective live data with others.
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Can technology restore humanity to healthcare?

With EHR frustrations at a boiling point and physician burnout at epidemic levels, it's time to rethink the way IT is designed, developed and deployed to better enable a human touch, says one clinician.
December 07, 2018 03:51 PM

"At its core, technology would seem to be the antithesis of humanity," said Dr. Chris Derienzo, chief quality officer at Asheville, North Carolina-based Mission Health System. "It doesn't feel, it doesn't think and it can't see the humanity of the person in front of it," he explained."
Ask physicians how the feel about electronic health records, or read Atul Gawande's recent New Yorker feature, "Why Doctors Hate Their Computers," and it's apparent that most healthcare professionals' relationship with technology is ambivalent at best.
"It's tempting to say there's no way we can build or leverage technology in order to restore some humanity to the practice of medicine," said Derienzo. "But I think that's fundamentally a wrong assumption."
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Integrating EHR Use, Health Data Exchange Into Behavioral Health

Promoting health data exchange and EHR use in behavioral healthcare is the next frontier in comprehensive patient care.
December 06, 2018 - While EHR systems and health data exchange solutions have been common tools within hospitals and physician practices for nearly a decade, many behavioral healthcare providers are just beginning to integrate EHR use into care delivery.
Policymakers are also starting to turn their attention to legislation that could potentially support the use of EHR technology in behavioral health. At the same time, major health IT players in the private sector are identifying a new client base comprised of behavioral and mental healthcare providers.
These efforts to include behavioral health in the digitization of the industry at large mark progress toward enabling more comprehensive, complete patient care.
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FDA issues new framework to advance use of real-world data

Published December 07 2018, 7:03am EST
The Food and Drug Administration is expanding its use of real-world data—such as electronic health records, medical claims and registries—to improve regulatory decisions regarding drugs and biologics.
“Because they include data covering the experience of physicians and patients with the actual use of new treatments in practice—and not just in research studies—the collective evaluation of these data sources has the potential to inform clinical decision making by patients and providers, develop new hypotheses for further testing of new products to drive continued innovation and inform us about the performance of medical products,” said FDA Commissioner Scott Gottlieb, MD, in a written statement.
The agency on Thursday released a new strategic framework to serve as a roadmap for more fully incorporating real-world data (RWD) and real-world evidence (RWE) into its regulatory activities.
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HIT Think 3 top cybersecurity predictions for 2019

Published December 07 2018, 5:07pm EST
What will 2019 bring for the security landscape?
Making an informed prediction first requires us to think back on 2018. The year started with a big bang—Spectre and Meltdown (also known as Chipocalypse). Nothing like this had ever happened to computer security. Hundreds of millions of systems, as well as cloud environments, were affected.
The impact, as well as the ongoing research into related vulnerabilities, continues today.
Municipalities and healthcare organizations remain attractive, soft targets for attackers. The City of Atlanta is the prime example in the public sector. Ransomware demanding $55,000 worth of bitcoins disabled many of the city’s services and forced it to revert to pen and paper. Taxpayer’s bill for this attack currently hovers around $17 million.
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Special Article |4 December 2018

Ensuring Fairness in Machine Learning to Advance Health Equity

Alvin Rajkomar, MD *; Michaela Hardt, PhD *; Michael D. Howell, MD, MPH; Greg Corrado, PhD; Marshall H. Chin, MD, MPH

Abstract

Machine learning is used increasingly in clinical care to improve diagnosis, treatment selection, and health system efficiency. Because machine-learning models learn from historically collected data, populations that have experienced human and structural biases in the past—called protected groups—are vulnerable to harm by incorrect predictions or withholding of resources. This article describes how model design, biases in data, and the interactions of model predictions with clinicians and patients may exacerbate health care disparities. Rather than simply guarding against these harms passively, machine-learning systems should be used proactively to advance health equity. For that goal to be achieved, principles of distributive justice must be incorporated into model design, deployment, and evaluation. The article describes several technical implementations of distributive justice—specifically those that ensure equality in patient outcomes, performance, and resource allocation—and guides clinicians as to when they should prioritize each principle. Machine learning is providing increasingly sophisticated decision support and population-level monitoring, and it should encode principles of justice to ensure that models benefit all patients.
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HIPAA modernization push gets backing from AHIMA and AMIA

The 22-year-old privacy law should be updated for a mobile tech-centric and data-driven world, the information management and medical informatics groups said.
December 05, 2018 03:14 PM
The Health Insurance Portability and Accountability Act, better known (if not always spelled correctly) as HIPAA, was signed into law by President Bill Clinton in August 1996.
A lot has changed in the two decades since – in the ways consumers interact with health systems and the ways technology is transforming care delivery and the patient experience. So maybe it's time to give the privacy law a refresh, said the American Medical Informatics Association and the American Health Information Management Association.
WHY IT MATTERS
As access to personal health information is easier than ever, with smartphones now ubiquitous and apps and connected devices proliferating by the day, both AMIA and AHIMA have voiced support for HIPAA modernization.
In a joint appearance on Capitol Hill, in a presentation about unlocking data for patient empowerment, experts from the two groups highlighted how healthcare has a lot of catching up to do to serve a population used to online shopping, travel booking, review sites and more.
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How big data is redefining the CEO, CFO and COO roles

CIOs are in the best position as the originator and gatekeeper of data and as a fellow C-suite observer to comment on changing C-suite roles.
December 06, 2018 08:14 AM
Never before in the history of healthcare has the C-suite at hospitals and health systems had access to such a massive amount of data. And within all that data are insights and nuggets of wisdom that can bring untold benefits to healthcare provider organizations.
As a result of all of this, the roles of the CEO, CFO and COO have been tweaked. Reams of data are helping C-suite executives do their jobs better while improving care and trimming costs, achieving the Triple Aim of healthcare. And CIOs are in the best position as the originator and gatekeeper of data and as a fellow C-suite observer to comment on changing C-suite roles.
The flow of data
Today, there is a lot of data flowing from the CIO to the other members of the C-suite on a daily, weekly and monthly basis.
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APIs, TEFCA Expected to Boost EHR Interoperability Industry-Wide

As APIs improve and TEFCA goes into effect, ONC leaders expect health IT standardization and EHR interoperability will improve.

December 05, 2018 - EHR interoperability will likely improve in the next few years as ONC makes progress toward promoting the use of application programming interfaces (APIs) and implementing provisions of the 21st Century Cures Act, according to National Coordinator for Health Information Technology Donald Rucker.
In his keynote speech at the ONC 2018 Annual Meeting, Rucker outlined the federal agency’s plans to reduce provider burden and boost interoperability.
Rucker and others at ONC are teaming up with CMS to develop a strategy for addressing problems with regulatory and administrative burden. The draft strategy is open for public comment until January 28.
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Study links stress from EHR use to physician burnout

Published December 06 2018, 7:24am EST
Doctor use of electronic health records is causing stress that is strongly associated with physician burnout, according to a new study.
That’s the conclusion of an analysis of results from a 2017 Rhode Island Department of Health survey in which 4,197 practicing physicians in the state were surveyed on their EHR use.
Of the 1,792 doctors who responded to the survey (a 43 percent response rate), 26 percent reported experiencing physician burnout.
Researchers at Brown University’s Warren Alpert Medical School and other organizations conducted the analysis of the survey results, which were published on Wednesday in the Journal of the American Medical Informatics Association.
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Survey reveals the benefits and downside of online medical information

Published December 06 2018, 3:16pm EST
A survey of 240 family physicians finds patient engagement is increasing as patients read about symptoms and treatments online.
The survey found that doctors’ patients are more likely to question their diagnosis. However, the research found that nearly all of the patients are coming in the office with misinformation.
Merck Manuals, a publishing firm and part of biopharmaceutical company Merck, conducted the survey in October during a national conference.
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HIT Think The long and winding road to health data exchange

Published December 06 2018, 3:52pm EST
I have been looking back at all of the work accomplished on health data exchange as well as some of the challenges that still remain.
In 2008, most of our healthcare system was still paper-based. Fewer than 10 percent of hospitals had implemented even a basic electronic health records system.
As we can see from the data, provided by the Office of the Nation Coordinator (ONC), a great deal of progress occurred from 2008 to 2015. Of course, much of this was a result of the federal incentives for EHR adoption incorporated in the Health Information Technology for Economic and Clinical Health (HITECH) Act. The HITECH Act was enacted as part of the American Recovery and Reinvestment Act of 2009, and signed into law on Feb. 17, 2009, to promote the adoption and meaningful use of health information technology.
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ECG app on Apple Watch lets users identify irregular heart rhythms

Published December 07 2018, 6:52am EST
Apple on Thursday announced what it says is the first direct-to-consumer product that enables users to take an electrocardiogram from their smartwatch to identify atrial fibrillation.
Available immediately as part of a free update to watchOS 5.1.2, the ECG app on Apple Watch Series 4 and the irregular heart rhythm notification feature analyzes pulse rate data for signs of AFib.
“New electrodes built into the back crystal and Digital Crown on Apple Watch Series 4 work together with the ECG app to enable customers to take an ECG similar to a single-lead reading,” according to the announcement. “After 30 seconds, the heart rhythm is classified as either AFib, sinus rhythm or inconclusive. All recordings, their associated classifications and any noted symptoms are stored securely in the Health app on iPhone. Users can share a PDF of the results with physicians.”
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In Grandma’s Stocking: An Apple Watch To Monitor Falls, Track Heart Rhythms

By Rachel Bluth December 4, 2018
For more than a decade, the latest Apple products have been the annual must-have holiday gift for the tech-savvy. That raises the question: Is the newest Apple Watch on your list — either to give or receive — this year?
At first glance, the watch appears to be an ideal present for Apple’s most familiar market: the hip early adopters. Its promotional website is full of svelte young people stretching into yoga poses, kickboxing and playing basketball.
But when Apple unveiled its latest model in September — the Series 4, which starts at $399 — it was clear it was expanding its target audience. This Apple Watch includes new features designed to detect falls and heart problems. With descriptions like “part guardian, part guru” and “designed to improve your health … and powerful enough to protect it,” the tech giant signaled its move toward preventive health and a much wider demographic.
“The health care market is obviously important to Apple,” Andy Hargreaves, an Apple analyst with KeyBanc Capital Markets, wrote in an email. The fall prevention and electrocardiogram apps are a “play to sell people more stuff” and bring health-monitoring apps beyond just “fitness people” to baby boomers who want to keep themselves and their parents healthy, he added.
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Imprivata, DigiCert team up on EPCS technology to tighten opioid prescription access

Their automated identity proofing process helps providers to adhere to looming government-mandated EPCS verification standards, enabling them to approve or deny prescriptions remotely.
December 05, 2018 01:05 PM
Electronic prescribing for controlled substances continues to gain momentum as a valuable weapon in the fight against the national opioid epidemic. Imprivata, the healthcare-focused security firm, and DigiCert, the SSL certificate authority, have teamed up to deliver an automated identity proofing process, Imprivata Confirm ID, that will make EPCS compliance easier.
WHY IT MATTERS
Thirteen states have passed laws requiring EPCS, and the massive opioid bill signed by President Trump in October, the SUPPORT for Patients and Communities Act, includes mandatory EPCS for Medicare Part D by 2021 as one of its many provisions.
EPCS provides a convenient and secure way for verified practitioners to approve or deny opioid prescriptions for patients. Using two factor authentication, doctors can approve the prescriptions remotely or while in a healthcare system's trusted network. Electronic prescribing has a major benefit of getting paper prescriptions off the street, reducing the opportunities for doctor shopping, theft or fraud.  
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How HIE Adoption Simplifies, Streamlines Health Data Exchange

HIE adoption can help healthcare organizations increase rates of health data exchange and succeed in federal incentive programs.

December 03, 2018 - After years of frustration among stakeholders over the lack of complete, timely health data exchange across the healthcare sector, CMS is taking a firm stance on interoperability with its Promoting Interoperability programs.
CMS announced its decision to rebrand the EHR Incentive Programs (i.e., meaningful use) as Promoting Interoperability in Spring 2018. The new name is emblematic of the federal agency’s focus on encouraging hospitals and health systems to increase rates of health data exchange for better-informed care delivery.
While the effects of the federal agency’s efforts to increase interoperability remain to be seen, industry stakeholders are largely supportive of the federal agency’s decision to emphasize the need for enhanced health data exchange.
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Most EHR Vendors Have Enabled CommonWell, Carequality Connection

Most popular EHR vendors allow providers to connect to CommonWell or Carequality, representing progress for interoperability.

December 04, 2018 - The majority of EHR vendors with sizeable marketshare currently enable providers to connect with CommonWell or Carequality, indicating the healthcare industry may be poised for a breakthrough in interoperability.
This finding comes from a recent KLAS report gauging the industry’s progress toward achieving interoperability through CommonWell and Carequality.
The report comes a month after CommonWell and Carequality announced the CommonWell-Carequality connection is now generally available to all CommonWell members.
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Cyber security: Hackers step out of the shadows with bigger, bolder attacks

Successful hacking campaigns used to be all about keeping under the radar. But, for some, making a big splash is now now more important than lurking in the shadows.
By Danny Palmer | December 4, 2018 -- 10:56 GMT (21:56 AEDT) | Topic: Security
Stealth and secrecy use to be the hallmarks of cyber espionage and cyberwarfare, with spies and hackers sneaking in and out of target networks without leaving a trace or evidence that could be linked back to them.
But increasingly, cyber attacks are now carried out in fully public view, and many attackers don't appear to worry so much about keeping under the radar. Some even seem to go out of their way to make sure they are spotted.
One example of the way cyberattacks have gone public: the WannaCry ransomware caused chaos and made headlines around the world, with many businesses locked out of their PCs by hackers who demanded a bitcoin ransom in exchange for restoring access to data.
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HIT Think Why data integrity is the key to machine learning in healthcare

Published December 05 2018, 5:20pm EST
As innovative technologies designed to support implementation of value-based care models continue to flood the market and patient demand for transparency of quality and cost of the care grows, patient-centric, data-driven technologies will lead the roost.
These technology platforms address the need for timely, actionable patient-specific insights and leverage data to meaningfully improve quality, drive efficiencies and lower costs.
Leading the way in delivering differentiated value, artificial intelligence (AI) technologies, such as machine learning (ML) and natural language processing (NLP), are entering the mainstream with the potential to transform healthcare delivery and better meet patient expectations.
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EHR Upgrades Are Pain Point for Rev Cycle Execs

By Alexandra Wilson Pecci  |   December 04, 2018

Fifty-six percent of surveyed executives said their organizations can't keep up with EHR upgrades or underuse available EHR functions.

KEY TAKEAWAYS

Executives should prioritize EHR upgrades that will improve financial results and patient safety and satisfaction.  
Each upgrade must be planned for, tested, and include results measurements.
The struggle to keep up with EHR upgrades is an area of concern for revenue cycle professionals, finds a Navigant/Healthcare Financial Management Association analysis.
According to a survey 107 hospital and health system revenue cycle executives and chief financial officers, 56% of respondents said their organizations can't keep up with EHR upgrades or underuse available EHR functions, up from 51% last year.
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VA Shadow Rulers Had Sway Over Contracting and Budgeting

New disclosures and investigations are straining the three Trump associates’ relationship with the new VA secretary.

Dec. 3, 5 a.m. EST

Investigating Trump’s Promises to America’s Veterans

Newly released emails about the three Trump associates who secretly steered the Department of Veterans Affairs show how deeply the trio was involved in some of the agency’s most consequential matters, most notably a multibillion-dollar effort to overhaul electronic health records for millions of veterans.
Marvel Entertainment chairman Ike Perlmutter, West Palm Beach physician Bruce Moskowitz and lawyer Marc Sherman — part of the president’s circle at his Mar-a-Lago resort in Florida — reviewed a confidential draft of a $10 billion government contract for the electronic-records project, even though they lack any relevant expertise.
In preparing the contract, the agency consulted more than 40 outside experts, such as hospital executives, according to the records, which were released under the Freedom of Information Act. The Mar-a-Lago trio were listed among those experts. Perlmutter, a comic book tycoon, appears on the list between representatives from the University of Washington Medical Center, Intermountain Healthcare and Johns Hopkins University.
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Blockchain for healthcare: How CIOs should be approaching it

The concept is simpler than many realize, but the implementation can be complex and challenging. Health systems should think deliberately about new proofs-of-concept, but get on board soon.
December 04, 2018 09:21 AM
What is blockchain, and what do CIOs need to know about how it can improve healthcare? It's a question that's both straightforward and complex.
There's a forum on Reddit called Explain Like I'm Five. And there's plenty of discussion there about the basic concepts behind distributed ledger technology, from the mechanics of how it's designed to the real-world problems it could solve.
But one of the best explainers we've seen is one from Wired, where a blockchain expert literally explains how it works to a child (and, with ever-mounting layers of complexity, to a teenager, a college student, a grad student and a fellow expert).
At its essence, of course, blockchain is a network to enable easier peer to peer exchange and reduce dependence on intermediaries. As blockchain researcher Bettina Warburg explained to the girl, it's "a type of technology that means you could trade with any kid, all over the world … you don't need the store and you don't even necessarily need to know the other person."
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How a scribe tool linked to Epic EHR is helping ease physician burnout

Some doctors at Massachusetts General Physicians Organization have saved more than two hours per clinical session with virtual scribe technology.
December 03, 2018 03:02 PM
In surveys Massachusetts General Physicians Organization conducted of its physicians, the healthcare organization found that 46 percent exhibited some degree of burnout. When asked what contributed to that burnout, they blamed the administrative burden added to the work of patient care.
THE PROBLEM
Chief among those administrative burdens was documenting in the electronic health record. Many physicians were spending two hours or more after each clinical session documenting in the EHR.
As a result, they were missing family events and staying up late at night typing clinical notes. And in the office, they were too burdened to add new patients to their panels or focus on improving care and outcomes of their existing patients.
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15% of physicians have worked in organizations that offer telemedicine: 6 survey insights

Written by Julie Spitzer | December 03, 2018 | Print  | Email
Despite regulatory changes that encourage the use of telemedicine, only 15 percent of physicians have  worked in practices offering telemedicine, according to a recent study published in Health Affairs and commissioned by the American Medical Association.
The study, based on a 2016 survey of 3,500 physicians, sought to  gauge how physicians are using telemedicine and how organizations are integrating it into healthcare delivery.
Here are six things to know:
1. Fifteen percent of physicians said they've worked in practices that used telemedicine for patient interactions, such as diagnosing or treating patients.
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Satisfaction High with Epic, Cerner Clinical Surveillance Tools

Satisfaction with clinical surveillance tools is high, but users of Epic and Cerner still face some optimization and functionality challenges.

December 03, 2018 - Clinical surveillance tools are generally doing a good job of alerting providers to sudden patient downturns and delivering meaningful decision support, yet optimizing these health IT tools to produce positive results isn’t always easy.
According to a new report from KLAS, clinical surveillance tools can be a challenge to use and may be missing key functionalities, which could limit their helpfulness.
As healthcare organizations look to get further ahead of costly and potentially deadly conditions such as sepsis and respiratory failure, deploying analytics tools that offer timely, trustworthy alerts in an intuitive manner will only become more important.
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Top Three 2019 Healthcare Cybersecurity Trends

December 3, 2018
by Christian Aboujaoude, Industry Voice, Senior Director Enterprise Architecture, Scripps Health
There are non-complex strategies that can be easily implemented that can help keep data secure
In recent months, the healthcare industry has been the number one target of cyberattacks, exposing tens of millions of customers’ identities around the world, costing more than $1 billion USD in losses.
Executives from the National Association of County and City Health Officials say that healthcare breaches can cost up to $400 a patient, and yet, only 33 percent of the industry has taken the preventative measure of protecting themselves properly.  With billions of people across the world entrusting healthcare organizations to protect their identities, and these same organizations relying on their critical infrastructure to secure it all, it becomes crucial to not just have the right cybersecurity solution in place to stop an attack before it has a catastrophic impact, but to ensure they are able to prevent future ones from ever happening.
My provider organization— the San Diego-based Scripps Health—takes cybersecurity seriously, and has for many years. In 2013, we determined to take an identity-first approach to protect both internal and external data, and engaged with firms such as SecureAuth to pioneer an identity solution that would protect both internal and external data according to our unique needs. Today, we continue to evolve our solution to keep up emerging threats, and to stay ahead of threat trends and attackers.
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VA, GE Healthcare partner to expand use of 3D printing in care

Published December 04 2018, 7:21am EST
The Department of Veterans Affairs is entering an initiative to accelerate the use of three-dimensional printing in patient care.
One of the VA’s regional systems, VA Puget Sound Health Care System—has announced an effort to work with GE Healthcare to accelerate the use of 3D printing in patient care.
The project aims to reduce the time it takes for radiologists to create 3D-printed model and prosthetics to a matter of minutes. The partners say the initiative, when fully mature, could benefit the VA’s 9 million patients, while informing future research, development and scalability of 3D printing applications in healthcare.
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AMA: Telemedicine use by docs is exception rather than rule

Published December 04 2018, 7:33am EST
The first nationally representative estimates of physicians’ use of telemedicine has found the numbers lacking, according to the American Medical Association.
Data from the AMA’s 2016 Physician Practice Benchmark Survey of 3,500 doctors, published in the December issue of Health Affairs, show that only 15 percent of physicians worked in practices that used telemedicine for patient interactions, such as diagnosing or treating patients, following up with patients or managing patients with chronic conditions.
In addition, just 11 percent of doctors worked in practices that used telemedicine for interactions with healthcare professionals, such as having a specialty consultation or getting a second opinion.
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Surescripts says tool aids transparency, drug affordability and adherence

Published December 04 2018, 5:17pm EST
Surescripts is touting the benefits of its real-time prescription benefit tool to help clinicians quickly find a more affordable drug, saving patients money and tying them closer to the provider organization.
For example, clinicians can have benefit information automatically pulled from pharmacy benefit manager firms and inserted into the electronic health record, then select an appropriate therapy for a patient and pick the patient’s preferred pharmacy.
Using the prescription benefit tool one clinician found that a patient’s medication cost $1,361.40, but a generic alternative though the patient’s pharmacy benefit plan cost $4.
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HIT Think 4 keys to success with AI and machine learning

Published December 04 2018, 4:40pm EST
While artificial intelligence and machine learning have revolutionized other industries, they are still newer concepts in healthcare.
AI is all around our daily lives now. Consider some of the personalized experiences we get from algorithms working behind the scenes in other areas; for example, “People You May Know,” and “You Might Also Like.”
Many clinicians would love to have this type of experience when they open their electronic health record (EHR), tailored to meet their specialty-specific workflows and documentation styles. The algorithms behind AI and machine learning will eventually transform healthcare, especially through enhanced population health management, healthcare access and quality.
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EHR Relief in Sight? HHS Issues Draft Strategy to Reduce Health IT Burdens

By Mandy Roth  |   December 04, 2018

Opportunity for public commentary is open through January 28.

The regulatory and administrative demands electronic health records (EHRs) place on clinicians are about to get a do-over. The U.S. Department of Health and Human Services (HHS) has issued a draft strategy designed to help reduce the burden caused by the use of health information technology, such as EHRs.
Public commentary on Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs is open through Jan. 28, providing an opportunity for health systems and other interested stakeholders to mold the final document. Development of the draft was led by the Office of the National Coordinator for Health Information Technology (ONC), in partnership with the Centers for Medicare & Medicaid Services (CMS), as required by Congress under the 21st Century Cures Act.
“Usable, interoperable health IT was one of the first elements of the vision I laid out earlier this year for transforming our health system into one that pays for value,” said HHS Secretary Alex Azar in a news release.
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Digital transformation: 3 charts spotlight what top business decision makers need to know

Here’s a look at what hospitals need to move forward, and the top priorities and biggest obstacles they face today.
December 03, 2018 08:59 AM
Digital transformation is not just about the IT shop.
CIOs play the central role, to be certain, but a successful enterprise initiative also increasingly involves the entire C-suite — notably CEOs, CFOs and COOs, not to mention the emerging chiefs of innovation, transformation, medicine, marketing, nursing, informatics and more.
That’s why we have a Focus on The Business of Healthcare, aimed at the top decision makers shaping the future – agents of change, if you will – during December.
HIMSS Media research determined what digital transformation will take, what hospitals are prioritizing today and the biggest inhibitors to forward progress.
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How Information Blocking Regulations Can Promote EHR Usability

AMA and Medstar recommended three information blocking policies that may help to boost EHR usability and safety.

November 30, 2018 - Further transparency in EHR testing and development is imperative to improving EHR usability and reducing patient harm associated with EHR use, according to AMA and Medstar.
The organizations offered recommendations for three information blocking regulations that may improve EHR usability and safety in a recent JAMA Network perspective.
“A major impediment to addressing usability and safety issues has been the inability of clinicians, researchers, and developers to communicate openly and share specific usability and safety challenges associated with EHR technology,” wrote AMA and Medstar.
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EHRA Publishes EHR Implementation Guide for Opioid Prescribing

A new guide from EHRA offers recommendations for using CDC’s opioid prescribing resource with EHR implementations.

November 29, 2018 - Volunteer members of the EHR Association (EHRA) have developed a guide to help healthcare organizations apply the 12 recommendations outlined in CDC’s Guideline for Prescribing Opioids for Chronic Pain to EHR implementations.
CDC published its recommendations for opioid prescribing in 2016 to address problems with prescribing, optimize patient safety, and curb the opioid epidemic.
The guide’s recommendations apply to opioid prescribing for chronic pain but exclude prescribing for patients with active cancer, patients in palliative care, and patients with sickle-cell disease. The recommendations apply mostly to physicians, physician assistants, and advanced nurse prescribers of opioids making treatment decisions.
CDC’s twelve recommendations are as follows:
  1. Opioids are not front line therapy
  2. Establish goals for pain and function
  3. Discuss risks and benefits
  4. Use immediate-release opioids when starting
  5. Use the lowest effective dose
  6. Prescribe short durations for acute pain
  7. Evaluate benefits and harms frequently
  8. Use strategies to mitigate risks
  9. Review PDMP data
  10. Use urine drug testing
  11. Avoid concurrent opioid and benzodiazepine prescribing
  12. Offer treatment for opioid use disorder
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Industry Voices—Why blockchain is the healthcare disrupter we’ve been waiting for

Dec 3, 2018 2:31pm
We all know the current healthcare system isn’t sustainable.
It’s too expensive, the fee-for-service model is challenged and our aging population demands quality. With healthcare expenditures approaching 20% of GDP—that's trillions of dollars!—we can’t bear much more. Worse yet, it’s generally agreed that $500+ billion of this expense is unnecessary.
Everyone’s looking for a solution: a silver bullet that will transform the healthcare industry overnight; a mechanism that can end fragmentation, unlock and make meaningful patient data housed in “silos,” often traditional databases, while cutting costs and improving quality. 
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Propeller Health acquired by ResMed for $225M

Dec 3, 2018 11:35am
A Wisconsin-based startup that makes digital inhalers has been purchased by medical device giant ResMed for $225 million.
Propeller Health, which bills itself as the “leading digital therapeutics company” created a digital inhaler to help patients with chronic obstructive pulmonary disease (COPD), a disease that impacts 16 million Americans. 
ResMed CEO Mick Farrell called the purchase a “significant step for ResMed towards becoming the global leader in digital health for COPD.” ResMed has manufactured more than 6 million cloud-connected remote monitoring devices, with a focus on sleep apnea and respiratory illnesses.
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Information blocking provisions will be 'largely common sense,' says ONC’s Rucker

Nov 30, 2018 2:46pm
The Department of Health and Human Services’ top health IT official offered some vague hints on Friday about a forthcoming information blocking rule the healthcare industry is eagerly anticipating.
“I think you’ll see the provisions we have are largely common-sense types of things,” National Coordinator Donald Rucker, M.D., told the audience at the Office of the National Coordinator for Health IT’s (ONC) annual meeting.
“If you put yourselves in the shoes we have to fill in terms of how would you free up information, I think you would come to something similar,” he added.
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NVIDIA builds partnerships, offers tools to use AI in imaging

Published December 03 2018, 5:07pm EST
NVIDIA is expanding its footprint into radiology by establishing more partnerships and developing tools to assist radiologists.
The company says it’s now working with 75 partners, including several academic medical centers and the National Institutes of Health, to advance the use of artificial intelligence in radiology practice.
In sum, NVIDIA executives now say the company is working with partners including medical centers, medical imaging companies, research institutes, healthcare startups and other provider organizations. The company is growing from its base of developing graphic processing units (GPUs) that enable display of radiological images.
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Payers, providers peg blockchain to improve demographic data

Published December 03 2018, 5:20pm EST
An initiative to assess how blockchain technology can be used to improve the veracity of healthcare data is gaining new participants.
Health insurer Aetna and Ascension, the nation’s largest Catholic delivery system, have announced they are joining the Synaptic Health Alliance, a pilot program that’s studying how blockchain technology could benefit the healthcare industry.
This past April, five health insurers and clinical laboratory Quest Diagnostics launched the Synaptic Health Alliance to assess how blockchain technology could be used to ensure the most current provider information is available in health plan provider directories, thus making it easier for consumers to have the right information when seeking care.
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Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

Published: December 03, 2018
DOI:  https://doi.org/10.1016/S2215-0366(18)30302-X

Summary

Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched seven databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with interventions or complete them. The complexity of the interventions was a barrier for people with psychiatric symptoms, low premorbid intelligence quotient, or minimal information technology skills. The accessibility and adaptability of interventions were key facilitators, but insufficient resources, finances, and staff time were barriers to implementation. Interventions need to be user friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder, and the staff who support their implementation. Service users and staff should cofacilitate the process of developing and implementing the interventions.
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HIT Think How CRM can add personal care to healthcare

Published December 03 2018, 5:41pm EST
For decades, retailers, wholesalers and other business enterprises have leveraged customer relationship management systems to manage transactions and communicate with customers.
The increasingly refined data gathering, analysis and collaboration capabilities of today’s CRM platforms are a powerful combination that enable faster response, more informed decisions, customized experiences and higher levels of customer satisfaction.
While information sharing is a valuable tool for healthcare organizations, perhaps an even greater opportunity for CRMs is the ability to create communities between providers and patients.
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Enjoy!
David.

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