Quote Of The Year

Timeless Quotes - Sadly The Late 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, December 01, 2018

Weekly Overseas Health IT Links – 1st 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.

Royal Free: ‘No changes to data-sharing’ as Google absorbs Streams

Royal Free London has confirmed that there will be no changes to its data-sharing agreement with DeepMind after Google absorbs its Streams technology.
Oven Hughes – November 22, 2018
The trust said it would remain in control of the information generated by the app, used to detect early signs of acute kidney infection (AKI), adding that “nothing will change without our consent”.
A Royal Free spokesperson said: “Patient safety and patient confidentiality is our absolute priority and Streams is governed by the strictest guidelines and laws – as is all of the information we handle.”

GP at Hand receives green light in NHS England safety assessment

Hammersmith and Fulham Clinical Commissioning Group (CCG) has relaxed restrictions on GP at Hand after a review by NHS England concluded that it met key national safety standards.
Owen Hughes – November 19, 2018
Board papers posted by the CCG reveal that previous restrictions stopping individuals with more complex medical needs registering with the online service have been lifted, though the papers note that the requirement to de-register from a local practice to use the service “may not be clinically appropriate” for some patients.
A ban on GP at Hand being expanded to English cities and regions outside of the London region remains in place.
NHS England said it would work with Hammersmith and Fulham CCG to ensure that service continued to meet the needs of patients.

Davey Winder: NHS cybersecurity needs to be less Captain Picard, more Locutus of Borg

On the same day the health and social care secretary addressed the annual meeting of International Association of National Public Health Institutes (IANPHI), his vision for putting prevention at the heart of the nation’s health was published.
Davey Winder 22 November 2018
I couldn’t help but wish Matt Hancock was talking about NHS cybersecurity, and my mind raced with thoughts of Star Trek when Captain Picard was transformed into Locutus of Borg. I’ll explain why in due course.
Both the publication date of 5 November and the document subtitle – ‘Our vision to help you live well for longer’ – made me want to light up the night sky with the message that breach protection is better than post-breach cure. Not that there ever seems to be an actual cure post-breach; just the application of a plaster or two and a quick slurp of whatever security medicine is available and affordable to take away the pain until the next attack.
In that IANPHI speech, Hancock spoke about the use of AI in ‘predictive prevention’ for improving health outcomes.

Ukrainians to get doctor's notes, prescriptions, medical history online from 2019

13:25, 23 November 2018 Ukraine  
Over 1,000 medical institutions in Ukraine are already connected to the eHealth electronic system. REUTERS
Ukrainians will be able to get doctor's notes, prescriptions or medical histories online from 2019.
Ukraine's healthcare reform gaining momentum: Free X-rays, e-records The Ministry of Health said this task would become a priority in 2020, according to a morning TV show, "Snidanok z 1+1."

Apple in Talks to Give Veterans Access to Electronic Medical Records

Under plans being discussed, Apple would create software allowing veterans to transfer health records to iPhones

By Ben Kesling and Tripp Mickle
Updated Nov. 21, 2018 3:28 p.m. ET
Apple Inc. AAPL -0.05% is in discussions with the Department of Veterans Affairs to provide portable electronic health records to military veterans, a partnership that would simplify patients’ hospital visits and allow the technology giant to tap millions of new customers, according to people familiar with the effort and emails reviewed by The Wall Street Journal.
Under the plans being discussed, Apple would create special software tools allowing the VA’s estimated nine million veterans currently enrolled in the system to transfer their health records to iPhones and provide engineering support to the agency. Apple in January announced its foray into the electronic-records field with a feature that allows patients to import and store medical information.
Top VA officials, as well as associates from President Trump’s Mar-a-Lago Club, discussed the project last year in a series of emails reviewed by the Journal. The emails show how the Trump administration wrestled early on with the project’s goals.

Survey: Most health informatics executives see ‘big tech’ as a threat

Nov 21, 2018 10:08am
Healthcare informatics executives are feeling a pinch of anxiety heading into next year thanks to a growing interest in healthcare from the world's foremost technology companies. 
Seven in 10 health IT executives are “somewhat concerned” about technology companies like Google, Amazon and Apple encroaching into the healthcare space, according to a new survey by the Center for Connected Medicine, jointly operated by GE Healthcare, Nokia and the University of Pittsburgh Medical Center.
Quantitative and qualitative polls conducted over the course of several months focused on informatics leaders in the C-suite, including chief informatics officers, chief medical informatics officers and chief nursing informatics officers spanning nearly 40 health systems.

10 health IT happenings we're thankful for in 2018

From innovations and emerging technology to the promise of regulatory relief for hospitals, healthcare has plenty to be grateful for this week and year round.
November 21, 2018 12:56 PM
As the 2018 holiday season kicks off and people across the country gather to reflect on everything they have to be thankful for, there's the traditional core of family, friends and food, of course. In the health IT space we also have plenty of reasons to give thanks: new innovations, encouraging progress on longstanding challenges and more.
Let's take a look at some of the most important and encouraging health IT advancements that we're grateful for this week.
1. The future will be data-driven, patient-centric and outside a hospital. The practical futurist Michael Rogers sketched what care delivery might look like in the late 2020s. Among his prediction: booths bearing smart sensors, 8K screens so patients can interact with clinicians, and diagnostic devices, among other cutting-edge tech.
2. Interoperability just had a big moment. CommonWell just this week implemented Carequality's nationwide connection that means hospitals participating to either can access data from any other member, regardless of which EHRs are used. Micky Tripathi, CEO of Massachusetts eHealth Collaborative and a board member of both CommonWell and The Sequoia Project overseeing Carequality called the development "a signature moment for nationwide interoperability."

CommonWell, Carequality link seen as basis for nationwide interoperability

Published November 21 2018, 6:58am EST
Healthcare stakeholders see last week’s announcement linking CommonWell Health Alliance to the Carequality framework as a watershed moment on the road to achieving nationwide interoperability.
At its core is the Carequality framework, providing for trusted national exchange through common “rules of the road,” defined technical specifications, as well as a participant directory.
Jitin Asnaani, executive director of CommonWell Health Alliance, describes the collaboration as a “golden spike” moment for health IT in which “two of the largest interoperability communities have come together and are now going to be enabled to exchange data with each other—which is amazing for patients and providers alike.”

Survey: Demise of PACS has been greatly exaggerated

Published November 21 2018, 5:20pm EST
Current trends in radiology imaging continue to shift at a rapid pace. However, predictions about the demise of picture archiving and communications systems are unfounded.
That’s among the findings of a survey of nearly 300 radiologists and medical imaging leaders by Reaction Data, a research and consulting firm.
“The rumors of PACS death have been greatly exaggerated,” according to Reaction Data. “PACS have been, and still is, very much the hub of the radiology department.”

HIT Think Providers aim to find the right formula for precision medicine

Published November 21 2018, 2:30pm EST
The transformative promise of precision medicine is often cited as the driving reason why healthcare organizations need to begin their own clinical genomics programs. But has precision medicine technology reached a point where pioneering provider organizations can realize a return on their investments?
Finding the path forward is critical to success in delivering the benefits of precision medicine to patients. A new study from KLAS, Precision Medicine Provider Validations 2018 – Part 2, asks providers what vendors have to offer and what best practices are moving precision medicine forward for them.
Nearly three-quarters of the providers interviewed for the study do not believe the electronic medical record will play a primary role in the future of precision medicine, with several citing inherent deficiencies within EMRs as root causes. Respondents believed that peers looking to begin a journey into precision medicine should focus on niche vendors that have the experience and capabilities needed to address the specific challenges inherent in precision medicine.

More than 100 digital health and care tools evaluated against key standards for NHS Apps Library

November 14, 2018
Approximately 120 apps are currently being evaluated by NHS Digital and two external assessors against key standards to be added to an NHS resource of trusted digital health and care tools for patients, citizens, healthcare professionals, and commissioners.
The NHS Apps Library currently includes 75 different apps and tools. The assessment process, which looks at clinical safety, accessibility, usability, and technical stability, along with other areas, can reportedly take from one to three months, depending on their functionality.
NHS Digital is working with third-party evaluators Our Mobile Health and ORCHA to manage demand. However, the apps that have been evaluated so far have all failed to get through the assessment the first time. 

Are EMRs alleviating preventable medical errors yet?

In the decade-and-a-half since the startling “To Err is Human” report, it’s still hard to discern whether billions invested in electronic medical records are improving patient safety.
November 20, 2018 08:39 AM
Health systems have made significant investments in digitizing their operations primarily through the deployment of the electronic medical record (EMR). The EMR platform, in fact, holds the promise of being the foundation to address the many clinical shortfalls documented in the Institute of Medicine (IOM) 1999 landmark report “To Err is Human: Building a Safer Health System.”  
The report identified that as many as 98,000 people die in U.S. hospitals each year as a result of preventable medical errors. The source for a significant percentage of these errors is the lack of appropriate patient data available to clinicians at the point of patient care.
With more than 15 years since the IOM report, the question is: “Have these EMR investments made a difference in reducing the reported eye-opening outcomes?" 

Center for Connected Medicine polls top health systems about 2019 priorities

Cybersecurity is still the big one. But interoperability and telehealth are not far behind for leading organizations' technology goals.
November 20, 2018 10:22 AM
The Center for Connected Medicine polled IT executives across 38 health systems for its 2019 Top of Mind survey. Cybersecurity continues to be the biggest concern across the industry, with telehealth and interoperability not far behind.
Those topics arguably represent something of a return to basics after last year's #2 and #3 items: consumer-facing technology and predictive analytics.
The CCM, which is run jointly by UPMC, Nokia and GE Healthcare, partnered with The Academy for the new survey, polling tech execs – CIOs, CMIOs, CNIOs – to get a sense of the the state of the industry: the challenges that exist, and how C-suite leaders will be tackling them in the year ahead.
While it continues to be a top area of spending and development, cybersecurity breaches still cause "reputational and financial harm" to even large organizations. The survey finds only 20 percent of respondents are confident about being able to recover from a security breach. Executives say education and training are the biggest weak points; a concern that will only grow as IoT and connectivity demands increase.

Congress Facing Pressure to Pass Telehealth Bill for Senior Care

Connected care advocates are pressuring Congress to pass the RUSH Act, which aims to increase telehealth and telemedicine services in senior care facilities.

November 19, 2018 - Connected care advocates are lobbying Congress to pass the Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2018, which aims to reduce rehospitalizations at qualified skilled nursing facilities by giving them more incentives to use telemedicine and telehealth to improve patient care.
And they want it done soon.
Among those pushing for passage of the bill is Health IT Now. The broad-based coalition fired off a letter to lawmakers last week following the Centers for Medicare & Medicaid Services’ release of a report on the use of telehealth in Medicare.

Health Data Exchange Helps Identify Disparities in Hypertension Care

New research shows healthcare organizations that engage in health data exchange may be better able to identify disparities in hypertension care.

November 19, 2018 - Health data exchange may be enable healthcare organizations to identify common disparities in hypertension care across facilities for better-informed quality improvement efforts and more effective practice-based interventions.
This finding comes from a recent Journal of the American Board of Family Medicine (JABFM) study by Selby, et al.
Selby and his team standardized EHR data collection from three California health systems participating in the San Francisco Bay Collaborative Research Network. Participating health systems included one academic health system and two county-run primary healthcare systems. Two health systems part of the study used Epic EHR, while one used an eClinicalWorks system.

Top considerations for specialty-specific practices when adopting an EHR

Written by Dr. Arnold Levy, advisor of gMed, Inc., a Modernizing Medicine company | November 19, 2018 
As every physician can likely attest, providing your patients with quality care while simultaneously staying on top of the rapid pace of innovation in the healthcare space can be daunting.
Further compounding this challenge is the headache of endless paperwork, which can not only take away from time with patients, but can also lead to physician burnout. To reduce this burden, many physicians use next-generation software, such as electronic health record (EHR) systems, to decrease the time spent on reporting and paperwork. With the healthcare industry’s recent shift toward value-based care, practices are putting an emphasis on patient outcomes, resulting in new reporting requirements. Gastroenterology, for example, is adopting specific measurement parameters to demonstrate positive patient outcomes after treatment, and must provide access to clinical data registries.
With that said, quality and value can be difficult to measure if specific parameters aren’t being utilized. This is where a streamlined, sophisticated EHR system can be beneficial. Below are some of the top factors to consider when selecting an EHR system to help make the right decision for your practice.

Cybersecurity, Telehealth and Interoperability “Top of Mind” for IT Execs in 2019

November 19, 2018
by Heather Landi, Associate Editor
As health system leaders look ahead to the challenges and opportunities of the coming year, they are increasing their spending to defend against cyberattacks, expressing optimism about reimbursement for telehealth services, and feeling anxiety about Apple, Amazon and Google entering the health care space, according to a new survey.
The second annual survey, conducted by the Pittsburgh-based Center for Connected Medicine (CCM) in partnership with the Health Management Academy, reflects the opinions of healthcare C-suite leaders from nearly 40 major U.S. health systems across the country about their IT priorities for the year ahead. CCM is a collaborative health care executive briefing center jointly operated by GE Healthcare, Nokia and UPMC. The Alexandra, Va.-based Health Management Academy is a membership organization consisting of executives from the country’s top 100 health systems focused on sharing best practices.
Conducted in three parts, the research started with a survey of health system information officers—CIOs, chief medical informatics officers (CMIOs) and chief nursing informatics officers (CNIOs— in May 2018 to determine the top areas of health IT for 2019. A quantitative survey was conducted in July 2018 with questions focused on cybersecurity, telehealth and interoperability. In September 2018, qualitative interviews were completed with 18 C-suite executives, including chief executive officers, chief operating officers, CIOs and CMIOs.

Hospitals, insurance companies leak more health data than hackers

Brittany A. Roston - Nov 19, 2018, 8:05 pm CST
Hospitals, insurance firms, physician offices, and similar companies leak more personal health data than hackers, a new study has revealed. According to researchers with two major US universities, more than half of personal health data breaches resulted from problems with the medical providers themselves rather than an external force, such as hackers.
The findings come from researchers with Johns Hopkins and Michigan State University; the study has been published in JAMA Internal Medicine. According to the research, internal issues with providers result in more data leaks than external forces. Negligence, not hackers, is behind a substantial percentage of personal health info making its way into unauthorized hands.
A previous study published last year found almost 1,800 instances of big patient data breaches in the span of seven years. As well, 33 US hospitals were found to have suffered multiple “substantial” data breaches during that time.

Geisinger surgical redesign seeks to reduce opioid use

Published November 20 2018, 5:13pm EST
On the heels of a successful pilot test last year, Geisinger Health in Pennsylvania is implementing an enterprise-wide surgical redesign program to decrease the use of opioids.
In June 2017, Geisinger launched a pilot test called ProvenRecovery, a surgical redesign initiative to expedite healing, improve pain management and reduce opioid use.
During the pilot, Geisinger achieved an 18 percent decrease in opioid use across the organization, while at the same time neurosurgery and colorectal surgery patients had their hospital stays cut in half, which drove $1.5 million in savings.

HIT Think Tips for protecting your data when losing an employee

Published November 20 2018, 2:30pm EST
Companies spend a lot of time talking about staff retention, when perhaps they should be equally concerned about data retention. Most employers would be surprised to learn that departing internal employees can pose a much bigger threat to their business’s data security than external hackers.
Alarmingly, 87 percent of employees who leave a job take with them data they created at that job, and 28 percent take data that others had created, according to a survey from Biscom. Eighty-eight percent take corporate presentations or strategy documents, 31 percent take customer lists and 25 percent take intellectual property. A survey by Osterman Research also found one in five ex-staffers uploads these sensitive and confidential files to an external cloud service specifically for the purpose of sharing them with others.
The former employees’ motivations range from simply wanting to keep a copy of their work to wanting to use the data destructively, or to gain a competitive or financial advantage. Earlier this year, for example, Tesla reported that an ex-employee stole gigabytes of data and shared some of it with various news outlets, causing Tesla to suffer losses in business and profits, as well as damage to its reputation.

5 Telehealth Insights from CMS' Seema Verma

By Mandy Roth  |   November 15, 2018

Telehealth is changing the face of healthcare, and Medicare must adapt, said the CMS administrator.

Innovation is vital to the evolution and sustainability of the American healthcare system, and the Centers for Medicare & Medicaid Services (CMS) is working to be part of the transformation, according to its administrator.
In a speech on Thursday to the Alliance for Connected Care Telehealth Policy Forum for Health Systems, CMS Administrator Seema Verma spoke about how "relentless innovation is a crucial driver in creating value across all industries." She addressed the role of telehealth in the future of healthcare and reimbursement progress for 2019. In addition, she talked about how Medicare can serve as a barrier to innovation, as well as what CMS is doing to help patients control their healthcare data and resolve interoperability issues.
CMS has been working to create a foundation of innovation, she said. "It's part of our larger vision of moving to a system that is value based—that rewards value over volume by bringing the best to patients.  When we start paying for value, we will foster innovation as providers look for ways to compete for patients by providing the highest quality care at the lowest cost." 

Health Systems Work with Epic on Electronic Patient-Reported Outcomes for Oncology

November 18, 2018
by David Raths, Contributing Editor
With eSyM app, patients will provide feedback to their cancer care team via the EHR
Six U.S. healthcare systems are sharing a $9 million grant to research introducing electronic patient-reported outcomes (ePROs) into the routine practice of oncology providers to improve symptom management and to decrease hospitalizations.
The National Cancer Institute, in association with the Beau Biden Cancer Moonshot Initiative, recently announced the funding of the collaboration, the SIMPRO (Symptom Management IMplementation of Patient Reported Outcomes in Oncology) Research Center. The SIMPRO team will work with Epic, the EHR system used by all six participating institutions, which are New Hampshire-based Dartmouth-Hitchcock, Dana-Farber/Brigham and Women’s Cancer Center in Boston, Baptist Memorial Medical Center in Memphis, Lifespan Cancer Institute in Rhode Island, West Virginia University Cancer Institute, and Maine Medical Center in Portland.

Theft and disclosures account for most healthcare data breaches. But hackers took 3 times as many records

Nov 19, 2018 2:19pm
Over the last decade, healthcare organizations have been far more likely to report a data breach due to theft or an unauthorized disclosure.
Hacking, meanwhile, is much less common. But attackers make off with far more patient records.
In a new study published in JAMA Internal Medicine on Monday, researchers analyzed 1,138 healthcare breaches reported to the Department of Health and Human Services between 2009 and 2017. Two-thirds of those incidents were the result of theft—typically by an outsider or unknown party—or unauthorized disclosure, such as mailing mistakes that inadvertently disclosed sensitive information.

Why Toby Cosgrove thinks voice recognition is healthcare's next 'killer app'

Nov 19, 2018 8:03am
In addition to new technologies like artificial intelligence that are already gaining a foothold in healthcare, former Cleveland Clinic CEO Toby Cosgrove, M.D., said he thinks the next big technology in healthcare will be voice recognition. 
“Voice recognition is the killer app,” said Cosgrove, who was offering his perspective on the future of healthcare delivery and innovation during the U.S. News & World Report Healthcare of Tomorrow conference on Friday. Cosgrove, who now advises Google on its healthcare initiatives, was offering his first-hand look at how tech can transform the industry, even though Google itself is still settling on the exact role it wants to play. 
Of course, these voice recognition tools are already being developed and improved by Silicon Valley’s biggest names, including Google, Amazon and Apple, with tools such as Google Home, Alexa and Siri. But their applications could offer the path to simplifying the administrative burdens caused by electronic health records, Cosgrove said. 

Telehealth is not just a rural healthcare issue, Verma says

Published November 19 2018, 7:21am EST
The Centers for Medicare and Medicaid Services is intent on removing restrictions that prevent Medicare providers from leveraging telehealth services to improve health outcomes for beneficiaries.
Speaking at last week’s Alliance for Connected Care Telehealth Policy Forum for Health Systems, CMS Administrator Seema Verma pointed out that Medicare’s rules and governing statutes have often served as barriers to leveraging telemedicine.
However, with enrollment in Medicare Advantage eclipsing 20 million people last year, she said that the agency understands that it must embrace telehealth technology to reduce healthcare costs by lowering readmissions rates, as well as unnecessary hospital visits through better care coordination.

Amazon takes first steps to expand PillPack online drug presence

Published November 19 2018, 7:39am EST
Amazon is slowly expanding efforts to build online retail pharmacy operations in a growing number of states.
The online retailer is finally making moves to expand PillPack, which it acquired this past summer, according to analysts at Jefferies, an investment banking firm.
Amazon is beginning to seek licenses for PillPack to operate in more states beyond those that PillPack had at the time of the acquisition, says Jefferies analysts, who have been tracking Amazon’s efforts to gain additional licenses, which states issue to enable pharmacy organizations to sell drugs within their borders.

AHA: Standards for capturing social risk factor data in EHRs need work

Published November 19 2018, 7:28am EST
The Department of Health and Human Services should support efforts to create standards for capturing social risk data in electronic health records.
That information is critical for providing effective care to patients, according to the American Hospital Association. The national organization included the suggestion in response to an HHS request for information on provider and health plan approaches meant to improve care for Medicare beneficiaries with social risk factors.
The AHA contends that while social risk factors—such as access to food, and safe and stable housing—can impede a person’s ability to maintain or return to a state of health, collecting social risk factor information in the EHR and using it to shape the care plan is a complex and dynamic process.

ECRI practice guidelines to replace AHRQ clearinghouse

Published November 19 2018, 5:10pm EST
The ECRI Institute is looking to pick up the slack from the now-defunct National Guideline Clearinghouse by continuing to offer providers evidence-based clinical practice guidelines.
Funding cuts to the Agency for Healthcare Research and Quality forced AHRQ to shutter the National Guideline Clearinghouse in July.
While ECRI developed and maintained the National Guideline Clearinghouse for 20 years, it has to start from scratch in order to fill the gap.

HIT Think How does Google want to apply artificial intelligence in healthcare?

Published November 19 2018, 2:30pm EST
Recently, DeepMind's leaders announced its healthcare team will be combined into Google to help them become the "AI-powered assistant for nurses and doctors everywhere."
Observers say the move is part of a broader effort within Google to boost collaboration and communication among health projects.
In a statement, DeepMind leaders said the company has "made major advances in health care in AI research," including advances related to "detecting eye disease more quickly and accurately than experts; planning cancer radiotherapy treatment in seconds rather than hours; and working to detect patient deterioration from electronic records."

Why Apple is on a slow death spiral

In August 2018, Apple stock hit an all time high of US$233.47, today it is 20% lower and it is unlikely to reach its August peak ever again. Why? In a nutshell, Apple is no longer an innovator.
Whatever one may think of Steve Jobs, there can no longer be any doubt that he was the driving force behind the company he co-founded. Under Jobs’ two stints at Apple, it introduced the Mac, Mac OS, Mac OS X, iPod, iTunes, iPad, Apple TV, iPhone, iOS, Siri (acquired in 2010) and the App Store.
Between 1985 when Jobs was forced out of Apple and his return in 1995, Apple stopped innovating and was on the verge of bankruptcy. Since the death of Jobs in 2011, Apple has given us the Apple Watch, a product of limited appeal, and not much else.

Need to Train Nurse Practitioners About Telehealth? Use Robots

By Michelle Clarke  |   November 16, 2018

The RoboAPRN program gives APRN students experience in telehealth and mental healthcare.


·         Telehealth should be part of APRN education.
·         Robotics help give APRNs autonomy when providing telehealth services.
·         Telehealth can help increase access to behavioral health services.
As telehealth becomes increasingly more common in healthcare, the need to train providers in this technology and care delivery is also rising. So how can nursing school educators train their APRN students about telehealth in an effective way?
Use robots.
Last November, the University of Texas at Austin did just that. It introduced a new project to the School of Nursing’s Simulation & Skills Center—RoboAPRN: Telepresence Robots in Healthcare Education.

1 comment:

Marcus wigan said...

I was pleased to see the NHS app validation program.id love to see a similar program here. There is so much to be gained from self management via certified apps. Its so sad that ADHA has abandonded credibility and trust in its misrepresentation of the MHR, aa a now sadly essential requirement of any such app certification will now have to have an independently validated (and monitored) NON connection to MHR, covert ir overt, or trust will simply not be possible. The collateral of the outdated MHR and the appalling “marketing” is already negatively affecting other worthwhile and more forward looking ehealth initiatives.