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 22, 2018

Weekly Overseas Health IT Links – 22nd 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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Blockchain use case: Electronic health records

Could distributed ledger technology offer the promise of real-time EHR updates, seamless interoperability and protection from from ransomware?
December 14, 2018 02:01 PM
Blockchain "is not meant to wipe out existing legacy systems," said Maria Palombini, director of communities and initiatives development at the IEEE Standards Association. In most cases, the idea is for the network approach to supplement IT applications and innovate the ways they manage data.
That's what Massachusetts General Hospital is hoping, for instance, with the partnership announced this past month with MediBloc, a Korean blockchain startup. The aim is to pilot new DLT-based storage and exchange mechanisms that complement, rather than supplant, its existing electronic health record.
The hospital plans to "explore potentials of blockchain technology to provide secure solutions for health information exchange," said Synho Do, director of MGH's Laboratory of Medical Imaging and Computation.
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AMIA supports new NIH data exchange policy

The informatics group says best practices for sharing of research data will boost the usefulness of NIH investments.
December 14, 2018 02:24 PM
The nation's biomedical and health informatics experts are calling for a more thorough evaluation of grant applicants' data plans, according to the American Medical Informatics Association.
In a Dec. 10 letter to Carrie Wolinetz, associate director for science policy at the National Institutes of Health, Office of Science Policy, AMIA said it "enthusiastically" supports the expansive update to a 2003 NIH data sharing policy.
AMIA recommends a phased approach to implementing a new data sharing and management policy for NIH-funded research. The phased implementation would only apply to new research funded after the DMSP is final. Here's what AMIA's recommendations look like:
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Lack of Progress on Interoperability Frustrates House Members

Subcommittee chairman says he is "extremely disappointed"

WASHINGTON -- Tuesday's House hearing on the progress of health information technology (IT) interoperability was marked by bipartisan frustration from members of Congress about how little has gotten done.
Michael Burgess, MD (R-Texas), chair of the House Energy & Commerce Health Subcommittee, which held the hearing, set the tone with his opening statement. He noted that a rule prohibiting "information blocking" -- the practice of electronic health record (EHR) vendors blocking access to patient records as a way to stifle competition -- had yet to be released.
"I am extremely disappointed that 2 years after the passage of the [21st Century Cures Act], we still do not have the regulations necessary to implement these [anti-information-blocking] provisions," Burgess said. "It is hard to explain to people that Congress provided the tools necessary for doctors and patients to better coordinate their care through the sharing of patient data, and nothing has changed."
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Feds, Philips Warn of Security Flaw in HealthSuite mHealth App

The Philips HealthSuite Health Android app, which enables users to track mHealth data from the company's digital health devices and coordinate with care providers, may be susceptible to hacking, according to federal and company officials.

December 12, 2018 - Philips and the Department of Homeland Security are issuing warnings about weak security features on an mHealth app that could make it susceptible to hacking.
The company and DHS Industrial Control Systems' Cyber Emergency Response Team (ICS-CERT) say the Philips HealthSuite Health Android app - which enables users to monitor heart rate activity, sleep, blood pressure, weight and body composition analysis through Philips digital health devices – contains “inadequate encryption strength.”
“Successful exploitation of this vulnerability may allow an attacker with physical access to impact confidentiality and integrity of the product,” the federal agency reports in its alert, posted on December 6. “The software uses simple encryption that is not strong enough for the level of protection required.”
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Can’t hack? You can buy the tools on the dark web instead

Written by Zaid Shoorbajee
You don’t have to be a hacker to hack.
Much like legitimate businesses must pay for the various inputs that make up their offerings, cybercriminals rely on products and services — some legitimate and some purchased on the dark web — to conduct their operations.
A report published Friday by Deloitte, titled “Black Market Ecosystem: Estimating the Cost of ‘Pwnership,'” paints a picture of an underground economy of tools for cybercriminals and assesses how actors in this space adapt and innovate much like legitimate businesses would invest in their own services.
“The underground economy is a diverse but interrelated ecosystem where nearly all criminal enterprises incorporate a mixed assortment of tools and services,” the report says. “This same concept is reflected in legitimate markets where businesses and economies focus their effort on the production of a limited scope of products or services to achieve productive efficiencies, increase quality, and reduce costs.”
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Research expected to help cull outcomes in claims and EHR data

Published December 14 2018, 5:28pm EST
The National Science Foundation has awarded a $224,793 grant to Vanguard Medical Technologies, an incubation firm, to find outcomes data for researchers.
The firm is charged with developing technology that will enable clinical trials to use artificial intelligence to dive into an electronic health records system and cull out useful data.
As regulatory bodies look to real-word evidence to improve the quality of care, pharmaceutical companies are exploring how to run studies to understand real-world impacts on clinical outcomes, according to the foundation. Too often, these companies find that outcomes are unavailable or inaccurate in claims and structured data within electronic health record systems.
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HIT Think Embracing machine intelligence in the enterprise

Published December 14 2018, 5:28pm EST
Artificial intelligence has been part of popular culture for as long as most people reading this have been alive—but it’s increasingly becoming a part of our actual culture, too.
We’re not talking about machines that can defeat humans in yet another game or even machines that help search engines to respond to the query “cat” with an appropriate set of feline images—though both of those things are impressive accomplishments. Rather, we’re talking about transformative change, the moment a technology tips from research and proofs-of-concept into widespread use.
Machine intelligence can now identify certain types of cancer as well or more reliably than human doctors, for example. These new machine skills include identifying some cancers’ mutations from mere images—a time-saving feat that humans could never achieve and that could help ensure treatments better match patients’ conditions.
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Major investment secured for mental health app

By Tim Sandle     15 December 2018
As part of the growing interest with health and well-being apps, there has been an increase in apps offering to assist with mental health issues such as depression. One example is Wisdo, which has secured $11 million in funding.

There’s an irony that digital media is seen as a source of mental health issues (Digital Journal recently ran a story about social media use leading to increased feelings of loneliness) and also a means to address mental health problems, especially in the form of self-help and guidance apps.
In recent years, there has been a proliferation of mental health apps available to smartphone users. These apps particularly appeal to those who cannot afford therapy. Such apps offer a wealth of resources that make therapeutic techniques more accessible. They also have the advantage of being portable and they are often cost-effective.
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Special Report: Medical Devices

Medical devices are a ubiquitous part of modern day healthcare – blood pressure monitors, infusion pumps, spirometers, the list goes on – and increasingly digital rather than analogue. Traditionally the data such devices collect has been held in something resembling isolation, but the growth of electronic patient records and data analytics holds the promise of being able to harness this information in a new way. Maja Dragovic reports.
The operating theatre is home to a number of medical devices which can seem startling to the casual observer. Traditionally anaesthetists would write down the mass of information which said devices generated. But in a theatre setting that has fully integrated medical devices, an anaesthetist can fully concentrate on monitoring the patient instead, knowing ventilator and other monitor readings are being automatically uploaded into other systems. It’s similar in intensive care and high dependency: integrated medical devices can significantly reduce the workloads of nursing staff.
And taking the next logical step, this data can also be used to drive better decision making. In some departments at Cambridge University Hospitals NHS Foundation Trust, for instance, the data collected by medical devices is automatically uploaded into the electronic patient record – allowing early identification of any serious patient deterioration by a dedicated team.
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64% of execs worry about losing their jobs throughout a new EHR rollout

Written by Julie Spitzer | December 12, 2018 | Print  |
More than half of healthcare executives — 64 percent — expressed concern about the future of their employment during an EHR implementation or replacement, according to a seven yearslong survey commissioned by Black Book.
Here are eight survey insights:
1. Most large health system providers (93 percent) reported few regrets over their EHR vendor selection.
2. However, 88 percent of respondents from modest-sized regional health systems were dissatisfied with their EHR selection, citing hidden costs, unexpected consultant fees, interrupted revenue cycles, consumer frustration, time-extended rollouts, physician and clinical burnout, system downtime, reliability issues, and mismatches in vendor-client cultures.
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FDA approves opioid use disorder app for outpatient treatment

Published December 13 2018, 7:31am EST
The Food and Drug Administration has granted clearance to a mobile medical app designed to help keep patients with opioid use disorder in recovery programs.
The app from Pear Therapeutics, called reSET-O, is meant to be used in outpatient treatment programs, serving as a training, monitoring and reminder tool for providers and patients.
“Often on the road to recovery, patients find their commitment to staying in treatment may wane,” said FDA Commissioner Scott Gottlieb, MD, in a written statement. “Providing Americans suffering from opioid use disorder with more options and proper support to address treatment challenges is key to helping them succeed. We know medication-assisted treatment works and we support novel ways to keep individuals more engaged in their treatment programs and to provide clinicians with new ways to intervene to help them remain in treatment.”
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HIT Think How to implement a successful care transition improvement plan

Published December 13 2018, 5:10pm EST
In 2014, there were 28 million patient discharges in U.S. hospitals. The Centers for Medicare & Medicaid Services estimates that in 2017, 6 million senior citizens were readmitted to hospitals.
Unfortunately, the readmissions problem was a similar one that our facility was experiencing.
Two particular cases come to mind:
  • We had one patient admitted to the hospital with a stroke. The speech therapist did an evaluation and said that the patient had dysphagia. They made diet recommendations and suggested safe swallow strategies, but they were not communicated or documented, or listed upon discharge. The patient was subsequently re-admitted.
  • In another instance, a patient with COPD, who was new to oxygen, was going home. The patient got home, and his oxygen had not been delivered. He didn’t know who was supposed to be delivering it, what time they were bringing it or other details. No coordination had been done on the patient’s behalf. The patient was readmitted.
These were scenarios that we knew we could fix. Our hospital has 225 members on the medical staff, and we have 40 specialties. There were many moving parts that were all responsible for patient safety and we knew we needed to do something.
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With eICU, physicians in Australia monitor patients in Atlanta

December 13, 2018

Andis Robeznieks

Senior News Writer

American Medical Association

There is concern that care in some hospitals may lag years behind. For the night shift at some Emory Healthcare hospitals, it literally runs 12 hours ahead thanks to the electronic ICU (eICU).
Emory has a team of intensivist physicians and nurses based in Australia’s Royal Perth Hospital who start a 7 a.m. shift as their colleagues in Atlanta are clocking in at 7 p.m.
The eICU staff in Australia can communicate with physicians, other caregivers, patients and patient family members via high-definition televisions. The Perth team has access to the electronic health records of the ICU patients in Georgia, including x-rays and other imaging, and all the data from bedside physiologic monitors.
The AMA’s Digital Health Implementation Playbook packages the key steps, best practices and resources to accelerate the adoption of these and other digital health innovations and helps physicians extend care beyond the exam room.
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HHS Asks Whether, How HIPAA Privacy Rule Should Change

By Revenue Cycle Advisor  |   December 12, 2018

The rule lets providers use and disclose the minimum amount of personal health information needed to treat patients, receive payment, and conduct certain other functions. The RFI asks whether some portions of the rule should be modified. 

This article was originally published December 12, 2018, by HCPro's Revenue Cycle Advisor.
The Health and Human Services Office for Civil Rights has issued a request for information (RFI) seeking input from the public on how the HIPAA Privacy Rule could be modified to meet HHS' goal of promoting coordinated, value-based care.
According to the announcement, OCR has gotten feedback in recent years calling on it to revisit aspects of HIPAA that may limit or discourage information sharing, without compromising the privacy and security of protected health information (PHI) and/or patient rights with respect to their PHI.
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The British are axing the fax. Will Canada follow suit?

10 December, 2018
It’s not often that a seemingly mundane ministerial announcement reduces one to jealous tears, but this one fits the bill.
On Sunday, Matt Hancock, the British health and social care secretary, banned the purchase of facsimile machines by the National Health Service effective Jan. 1, 2019. He also ordered that faxes be phased out completely in hospitals and physicians’ offices by April, 2020.
Oh, but how Canada – a country even more in the poisonous grip of the fax than Britain – could use this common sense initiative.
“We don’t underestimate the enormity of the challenge to remove all our machines in such a short time, but we cannot afford to continue living in the dark ages,” Mr. Hancock said in the release.
Amen.
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Prescription Drug Monitoring Programs: The Role of Asymmetric Information on Drug Availability and Abuse


https://doi.org/10.1162/ajhe_a_00101

American Journal of Health Economics

Volume 4 | Issue 4 | Fall 2018
p.504-00000
The diversion of controlled prescription drugs can arise through “doctor shopping,” where a patient obtains multiple prescriptions from different health-care providers without the providers' knowledge of the other prescriptions. Prescription Drug Monitoring Programs (PDMPs) aim to address this problem of asymmetric information. In this paper, I exploit cross-state variation in PDMP implementation dates to estimate the effect of PDMPs on drug quantities and deaths. I expand upon previous work by analyzing outcomes for prescription drugs within and outside the opioid class, by considering spillovers into the illegal drug market, and by relying on high-frequency administrative data spanning the years 2000–13. I also estimate the effect of two PDMP characteristics with the potential to narrow information asymmetries among providers: direct PDMP access and required PDMP use. I find that neither PDMP implementation nor direct PDMP access had a significant effect on outcomes. These findings hold across drug classes, drug markets, and specifications. I find evidence, however, suggesting that required PDMP use reduced prescription opioid and stimulant quantities by 9 percent and 11 percent, respectively. In turn, prescription opioid and benzodiazepine deaths decreased by 9 percent and 13 percent, respectively. I also find evidence, albeit weak, suggesting that illegal drug deaths increased.
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Many smaller providers regretting EHR switches

Black Book survey shows that some were wooed by brand names, instead of seeking core functionalities that give ROI – and wish they'd gotten more bang for their buck.
December 11, 2018 02:47 PM
Findings from a recent Black Book survey shouldn't be much of a surprise to anyone in the healthcare IT world: changing electronic vendors is expensive, time-consuming and full of hidden challenges.
Bigger health systems usually weather the disruption more easily and come out happier on the other end. Smaller providers, however, struggle to cope with hidden costs, user frustration, and longer than expected downtime, among other things.
Brand-name recognition and overeager sales pitches hid some of the most significant challenges providers encountered. Black Book found that 71 percent of providers who switched EHRs saw a drop in interoperability.
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Germany: Studies show lack of patient engagement in digital health adoption

Europe’s largest health system lags far behind in digital health adoption and more patient engagement is needed to make significant progress.
December 12, 2018 10:22 AM
Digital transformation is not reaching the patients yet – this is the key result of an international comparative study published by German foundation Bertelsmann Stiftung towards the end of November.
In the study, Germany scores low and ranks 16th out of 17 countries surveyed worldwide regarding the digitization of their healthcare systems.
Estonia, Canada, Denmark, Israel and Spain are in the first ranks of the comparison.
The study finds that one of the major barriers to digital health adoption in Germany is the lack of a national coordination agency.
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Threats and benefits of cloud-based storage systems: Penn Medicine’s CISO shares insights

Written by Jackie Drees | December 10, 2018 | Print  | Email
Dan Costantino, chief information security officer at Philadelphia-based Penn Medicine-University of Pennsylvania Health System, shares his thoughts on cloud-based storage versus in-house systems as well as critical points of cybersecurity health systems should tackle after a cyberattack.
Responses have been lightly edited for clarity and length.

Question: What are your thoughts on cloud-based storage systems?

Dan Costantino: In general, from a security perspective, moving to cloud-based storage really does depend on two different things. The first is how early in the adoption or migration process a security team becomes involved. This significantly drives the decision between whether it's a good idea, from a security perspective, or a potential risky move for an organization to make. If you know the security team is involved very early on, there's some merit to the migration and probably a reasonable level of security that will come with it. Too often security teams get involved or pulled in after a migration has already taken place or the decision has been made. We're fortunate here compared to most of our peers in medicine because we have made zero cloud migrations without full security involvement up front. I think that's rare to happen these days, so we're one of the fortunate organizations.
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Process to set electronic transaction standards is 'broken,' says MGMA

Dec 11, 2018 2:41pm
The nation's largest group representing physician medical practices says the process to set electronic transaction standards between providers and health plans is "broken" and the government is failing to protect practices from unfair business practices.
In a letter to the National Committee on Vital and Health Statistics (NCVHS), the Medical Group Management Association (MGMA) outlined a series of recommendations to revise the process for the development and adoption of new and revised HIPAA administrative simplification standards.
The trade association said improvements are needed to streamline communications between providers and health plans. Its critique came in response to a request for public comments on draft recommendations for a “predictability roadmap” published in August by a NCVHS subcommittee on standards.
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ONC focused on privacy and usability in new app-based healthcare ecosystem

Dec 11, 2018 2:50pm
The Trump administration’s top health IT official told lawmakers his agency is acutely focused on ensuring that privacy and security remain pillars of future rulemaking as the healthcare industry transitions to an app-based economy.
Lawmakers in the House Energy and Commerce Subcommittee on Health pressed Donald Rucker, M.D., who leads the Office of the National Coordinator for Health IT (ONC) at the Department of Health and Human Services (HHS) to explain how the agency plans to protect consumers from rogue actors stealing their health data. Rucker acknowledged that the agency must walk the line between privacy and accessibility, but said he was “extremely optimistic” that provisions of the 21st Century Cures Act would improve interoperability and allow patients to access health data on their smartphone.
Tuesday’s hearing came as the industry awaits a proposed rule from ONC on information blocking. That rule is currently under review at the Office of Management and Budget (OMB), which left Rucker constrained in many of his answers.
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National Coordinator for HIT gives country C- grade on interoperability

Published December 12 2018, 7:19am EST
Health information exchange nationwide has been patchy at best, according to National Coordinator for HIT Donald Rucker, MD, who gives the country a C-minus grade when it comes to interoperability.
In his testimony on Tuesday before the House Energy and Commerce Subcommittee on Health, Rucker commented that HIE is “highly patchy” on a national level, with “A students and F students” in different regions—that, in his estimation, “averages out to a C-minus” overall.
 “There are more than 100 regional networks and multiple national-level organizations that support health information exchange,” testified Rucker. “While these organizations have made significant progress to expand interoperability, connectivity across networks has been limited due to variations and gaps in technical specifications, and in the participation and data use agreements that govern the secure exchange of health information.”
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HIT Think Why there are no good alternatives to holding data hostage

Published December 12 2018, 5:15pm EST
It had been a while since an electronic medical record vendor—or any other vendor—has withheld access to data, but it has happened again. As first reported here, there is a brewing dispute between Key Dental Group of Pembroke Pines, Fla., and MOGO of Westmont, Ill. The issue was revealed in a breach notification posted by Key Dental.
As set forth in the breach notification, it appeared that Key Dental would no longer use the services of MOGO. Per Key Dental, the end user license agreement provided that all data stored in the EMR was to be returned. Without more detail at the moment, MOGO refused to return any of Key Dental’s data. The decision was allegedly communicated to Key Dental by MOGO’s attorney on October 19.
Before getting into the issues surrounding holding data hostage, why did Key Dental wait a month before sending out notification? As set forth the notice, Key Dental sent the notice because it could no longer verify that the data was secure or otherwise not subject to inappropriate access because MOGO was denying access. However, that situation existed for a month once MOGO sent official notice that it would not let Key Dental access the database. As soon as that correspondence from MOGO was received, the underlying basis for Key Dental’s notice existed. Accordingly, if Key Dental intended to send a breach notification for inability to access, then those facts existed back in October.
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Biometric Technology for Patient Identity: 4 Things to Know

By Mandy Roth  |   December 11, 2018

Northwell Health launches an iris recognition technology with the hope of enhancing the patient experience.



KEY TAKEAWAYS

Biometrics offers an opportunity to enhance the patient experience.
The need for patient record matching will not go away for at least a generation.
These solutions help ensure data integrity and increase the value of investments in population health and data analytics initiatives
In the not-too-distant future, patients entering Northwell Health facilities will be recognized and logged into the system before they are ever greeted by a human, touch a computer keyboard, or handle a piece of paper. Northwell anticipates that with biometric facial recognition technology there will be minimal need for data entry or exchange, offering the potential to enhance the patient experience.
One of the primary reasons hospitals explore biometric technology to identify patients is to reduce duplicate patient records, a pervasive conundrum, which costs large systems like Northwell millions of dollars each year to rectify. Duplicate records also pose patient care and safety issues, cause unnecessary testing when providers are unable to access a patient's complete record, and delay reimbursement.
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Allscripts to net $525M after selling off Netsmart stake

Dec 10, 2018 12:49pm
Allscripts said it will make $525 million in post-tax net proceeds after selling off its ownership stake in a behavioral health EHR.
The EHR vendor announced on Monday that it signed a definitive agreement to sell its interests in Netsmart Technologies, a company that it invested $52.7 million into in 2016. According to Netsmart, the stake was purchased by two private equity firms, TA Associates and GI Partners. 
According to the company’s most recent financial filings, it owns a $468 million stake in Netsmart. During a third-quarter earnings call, executives said the company was finalizing late-stage negotiations with “a group of financial sponsors."
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European perspective: How hospitals should be approaching GDPR compliance

Two healthcare leaders from Germany offer best practices for assessing privacy and security posture – not just for EU legal requirements, but because it's the right thing to do.
December 11, 2018 04:01 PM
Since the European Union enacted its General Data Protection Regulation law this past May, it's probable that many healthcare organizations in the U.S. have been trying hard not to think much about it.
But most should be paying a lot more attention to the rules since, even if the exact mechanisms of U.S. enforcement are still somewhat unclear, it's likely they're expected to follow they law if they handle any data of EU residents.
GDPR has a higher compliance threshold than HIPAA, since it defines personal data as anything connected to an "identified or identifiable natural person" – and that could be a photograph or an IP address, not just protected health information as most U.S. hospitals think of it.
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Health IT remains top sector for industry investment, survey says

Written by Julie Spitzer | December 10, 2018 | Print  | Email
Healthcare investors say health IT is their No. 1 sector for investment in 2019, according to KPMG-Leavitt Partners 2019 Investment Outlook.
For the outlook, KPMG and Leavitt Partners surveyed 175 healthcare investment professionals from corporations, health systems, investment banks, venture capital and private equity firms about their investment plans for 2019.
Here are the top five subsectors investors say they are in investing in during 2019:
  1. Healthcare IT: 34 percent
  2. Care management: 31 percent
  3. Home health services: 23 percent
  4. Retail-centric medical groups: 22 percent
  5. Primary care physician medical groups: 21 percent
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VA Rolls Out APIs to Improve Interoperability, EHR Data Access

VA is rolling out standards-based APIs to improve interoperability, EHR data access, and health IT innovation.

December 10, 2018 - VA is rolling out standards-based application programming interfaces (APIs) designed to enable health IT developers to build tools that improve interoperability, EHR data access, and health data exchange for veterans and their providers.
The federal agency detailed its plans to engage with developers through APIs on its webpage and offered information about several different API offerings.
VA’s health API offering allows health IT developers to build tools that help veterans manage their health, view their EHRs, schedule appointments, find specialty facilities, and exchange health information with caregivers and providers.
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Report: 30 Percent of Healthcare Databases Exposed Online

December 10, 2018
by Heather Landi, Associate Editor
Hackers are using the Dark Web to buy and sell personally identifiable information (PII) stolen from healthcare organizations, and exposed databases are a vulnerable attack surface for healthcare organizations, according to a new cybersecurity research report.
A research report from IntSights, “Chronic [Cyber] Pain: Exposed & Misconfigured Databases in the Healthcare Industry,” gives an account of how hackers are tracking down healthcare personally identifiable information (PII) data on the Dark Web and where in the attack surface healthcare organizations are most vulnerable.
The report explores a key area of the healthcare attack surface, which is often the easiest to avoid—exposed databases. It’s not only old or outdated databases that get breached, but also newly established platforms that are vulnerable due to misconfiguration and/or open access, the report authors note.
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MD Anderson using NLP to automate radiology reporting

Published December 11 2018, 7:14am EST
The interpretative reports that radiologists issue for imaging studies tend to vary in format and in the information included. Even the terms used to describe specific clinical findings or categorize a patient’s disease risk may differ from one radiologist to another.
In an effort to standardize radiology reporting, the American College of Radiology (ACR) has developed Reporting and Data System (RADS) frameworks, which serve to guide radiologists in assessing, categorizing and reporting imaging findings and recommendations. To date, 10 ACR-RADS have been released, including breast imaging (BI-RADS), head injury imaging (HI-RADS) and coronary artery disease (CAD-RADS).
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Rural critical access hospitals benefit from telemedicine in EDs

Published December 11 2018, 7:09am EST
The use of telemedicine in emergency departments operated by rural critical access hospitals is not only saving healthcare costs for these facilities but is helping them to recruit and retain physicians.
That’s the finding of a new study from the University of Iowa published in the December issue of the journal Health Affairs.
“In a sample of 19 hospitals, coverage schedules in 2016 showed that seven had begun the use of tele-ED physician backup for advanced practice providers, decreasing local physician coverage in their EDs,” state the authors. “These seven hospitals tended to have decreasing ED staffing costs, while the hospitals not applying this policy showed continually increasing staffing costs over time. Telemedicine also provided other benefits, such as improved physician recruitment and retention.”
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Feds fine hospital that didn’t cut data access to former employee

Published December 11 2018, 6:00pm EST
Pagosa Springs Medical Center in Colorado, a critical access hospital, will pay $111,400 to the HHS Office for Civil Rights.
The small provider is being hit after neglecting to terminate access to protected heath information after an employee left the practice.
A complaint sent to OCR alleged the former employee continued to have access to a web-based scheduling calendar, which resulted in the hospital the protected health information of 557 individuals being disclosed to the former employee.
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HIT Think Two takeaways from RSNA that will shape enterprise imaging

Published December 11 2018, 3:59pm EST
As with every year, RSNA provided a glimpse into the future of radiology. Undoubtedly, AI was the most discussed and debated topic, though for imaging informatics there were some other less obvious trends on show that will have a significant bearing on the future of the market. Here’s my top two takeaways from the show:
One of the most striking observations from wandering the exhibit halls was the almost non-existence of “PACS” and “RIS” in any marketing—“enterprise imaging” has very much taken on “AI” and “VNA” for the most over-used and often under-deserved product title. Does this signal that PACS and RIS has finally been confined to the annals of informatics past? Or is there more to the sudden explosion of enterprise imaging products than meets the eye?
Put simply, PACS is still very much alive and kicking and still forms the core of most imaging informatics platforms that were on show. However, because of increasing integration and crossover with allied products such as advanced visualization, universal viewers, VNAs and workflow tools, the definitions between distinct product groups have become blurred.
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U.S. Healthcare Spending Slowed to 3.9% in 2017

By Jack O'Brien  |   December 06, 2018

Newly released data from CMS found that national healthcare spending totalled $3.5 trillion in 2017 but grew at a rate almost 1% slower than it did in 2016, due in part to reduced hospital and retail prescription drug spending.


KEY TAKEAWAYS

The biggest drivers were a deceleration in the use of hospital care, physician and clinical services, and retail prescription drugs.
This marks the second consecutive year of healthcare spending growth slowing, reaching the lowest level of annual growth since 2013.
Healthcare still maintains a sizable portion of the national GDP, registering at 17.9% last year.
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This patient's medical record said she'd given birth twice — in fact, she'd never been pregnant

  • Morgan Gleason is a college student with a rare autoimmune disease.
  • Two years ago, she found a mistake in her record. It said she had had two children, and that one of them died. Gleason had never been pregnant.
  • A Johns Hopkins study estimates that more than 250,000 people in the U.S. die every year from medical errors.
Published 12:02 PM ET Sun, 9 Dec 2018 Updated 8:25 PM ET Sun, 9 Dec 2018
Morgan Gleason has had a lot more experience with the health-care system than most college students. Nine years ago, she was diagnosed with a rare autoimmune disease called Juvenile Dermatomyositis, which causes symptoms like weak muscles and skin rashes.
Like many patients with a chronic illness, Gleason sees a lot of doctors. So she and her mother, Amy, who works at a health IT company called CareSync, always make it a point to request her medical records after a visit so they can store a copy of all her records in one place.
Two years ago, Gleason requested her records after visiting a women's health clinic in Florida. To her surprise, she found a note in the record saying she'd had two children. One was apparently still living and the other had died shortly after she gave birth.
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NHS banned from buying any more fax machines

Health secretary rules out further purchases in bid to move to modern IT methods, such as email
Press Association
Fax machines will be banned across the NHS under plans to overhaul outdated technology and IT systems.
The health secretary, Matt Hancock, has banned the purchasing of fax machines in the health service from next month, and has ordered the NHS to phase out the outdated machines by 31 March 2020.
By then, all NHS organisations will be required to use modern communication methods, such as secure email, to improve patient safety and cyber security, the Department of Health said.
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'Praying they would make it out of there'

12/07/2018 08:16 AM EST
As burning ash and black smoke eclipsed six lanes of terrified motorists fleeing the worst fire in California history, Elizabeth Steffen was driving in the wrong direction.
Steffen, the director of the SacValley Medshare health information exchange, rushed down Route 99 to Oroville Hospital last month on a single-minded mission: to turn an electronic switch enabling medical records to follow 200 patients evacuated in a mad scramble from a burning hospital and nursing home in Paradise, a town that would soon be annihilated by the Camp Fire.
If there are trenches in health IT, she was in them. “I never once thought of turning around, and I’d do it again,” Steffen said. “That’s the kind of person I am.”
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Banner achieves HIMSS Davies for intensivist tact to improve outcomes, shorten length-of-stay

With a tele-ICU program, A/V tech and predictive analytics, the system reported 297,613 fewer ICU days and saved an estimated 15,000 lives.
December 10, 2018 08:52 AM
Banner Health is using two-way A/V technology, predictive analytics, data visualization and advanced reporting to tackle its patient volume challenges, while at the same time improving the care of high-acuity patients.
The health system’s use of IT and efficient daily use of intensivists for critically ill patients has led to improved survival, shortened length of stay and reduced complications — all without increasing the number of doctors and nurses needed.
Banner reported 297,613 fewer ICU days than expected and an estimated 15,000 lives saved between 2006 and 2018.
These achievements earned Banner one of this year’s HIMSS Davies Awards for Excellence.
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What social determinants of health need next: personalization, science and ROI

SDOH will require a new education approach, platform and principles akin to personalized medicine.
December 10, 2018 11:18 AM
Social determinants hold the potential improve care, reduce costs and enhance the lives of individuals, but so far the business and financial incentives haven't existed for putting them to widespread use. With the transition to value-based care and population health programs, however, social determinants are on the verge of becoming more mainstream.
But that will require new technologies, education and operational strategies from hospitals and the industry at large amid the broader digital transformation – as well as new thinking about what exactly counts as a social determinant of health.
"We haven't yet touched the surface on the social and emotional dominants of health," said Jitendra Barmecha, CIO at Saint Barnabas Health System, during a panel discussion at the Digital Medicine Conference in New York. "Unless we tackle all of those we have not become patient centered."
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Survey Weighs Effects of Patient Access to Health Info Online

'Dr. Google' Has Changed How FPs Practice, Interact with Patients

December 05, 2018 10:25 am Michael Devitt – Twenty years ago, obtaining the latest information on health and well-being meant a trip to the library or the family physician's office for most people. But today, finding up-to-date health information can be as easy as tapping on a smartphone or clicking a mouse.
Having greater access to health information online has affected much more than how people take care of themselves. The results of a survey of family physicians conducted during the AAFP Family Medicine Experience in New Orleans in October show that easy access has substantially changed the ways FPs practice and communicate with patients.
"Our survey uncovered an interesting dynamic at play," said Robert Porter, M.D., editor-in-chief of the Merck Manuals, which conducted the survey, in a news release.(www.prnewswire.com) "While the ease and availability of online medical information instills confidence in family physicians, they believe 'Dr. Google' has the potential to introduce anxiety among patients."
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EHR integration is the next looming challenge for telehealth vendors

Dec 10, 2018 1:54pm
The telehealth industry is riding a wave of satisfaction from healthcare clients that say virtual care vendors are generally worth the money.
But a looming challenge around EHR integration could set some companies apart.
That’s according to a new analysis released by KLAS Research which evaluates some of the top telehealth companies including MDLive, American Well and Epic.
Of the 10 companies evaluated by KLAS, the most common type of visit varied widely. Most of American Well’s visits, for instance, are associated with on-demand urgent care, while the vast majority of Epic’s visits are tied to its virtual clinic.
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Recycled medical records result in a data breach

Published December 07 2018, 5:11pm EST
Poor handling of paper medical records at San Mateo (Calif.) Medical Center led to a data breach for 5,000 patients.
While frequent breaches affecting electronic protected health information have become the norm, there remains a lot of paper-based medical records that can be just as vulnerable and the following of HIPAA rules for mitigation of paper breaches are required just as they are for electronic breaches.
On November 6, an employee at the Daly City Clinic affiliated with the medical center left a box containing paper medical records under her desk before leaving work.
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VA launches its first health API based on FHIR standard

Published December 10 2018, 7:05am EST
The Department of Veterans Affairs has launched its first health application programming interface based on HL7’s Fast Healthcare Interoperability Resources standard.
The VA Health API, which enables veterans to view their medical records, schedule an appointment, find a specialty facility and securely share their information with providers, is the latest effort by the VA to map healthcare data to industry standards.
 “We are excited to announce this advancement in the way we deliver services,” said VA Secretary Robert Wilkie in a written statement. “Healthcare data interoperability plays a key role in all four of VA’s top priorities, from implementing the MISSION Act and modernizing our electronic health record, to transforming our business systems and delivering better customer service. VA is proud to serve as a leader and example in this field.”
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Hospital bed integrates with monitoring software to identify risks

Published December 10 2018, 5:31pm EST
Hospital bed manufacturer Hill-Rom has integrated continuous monitoring of heart rate, respiratory rate and analytics into its Centrella bed.
The Centrella bed now captures rates more than 100 times per minute without touching the patient, alerting clinicians to potential patient deterioration events quicker than traditional monitoring methods, enabling health teams to intervene faster. It achieves the integration by using the technology of vendor EarlySense.
“No patient should deteriorate without prior warning in the hospital environment,” says Frank Overdyk, MD, a user of the joint technology and a professor of anesthesiology at Hofstra North Shore-LIJ School of Medicine.
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HIT Think Why it's possible to make interoperability happen now

Published December 10 2018, 5:41pm EST
As a child raised in a military family, I vividly remember my mother carrying our family’s medical records around in a cardboard box each time we moved across the country. My father, Master Sargent Charles Miller, was a 22-year Air Force veteran, and I am the oldest of his six children.
Moving around so much meant that having an up-to-date vaccination record was an important part of starting in any new school. I recall travelling from Randolph Air Force Base in San Antonio, to Edwards Air Force Base in California, in a Rambler station wagon with my siblings, a dog, and all of our medical records in that cardboard box on the floorboard.
That experience helped guide me to where I am today, leading the effort at Children’s Health System of Texas to ensure patients’ care journey includes the seamless exchange of their important health care data.
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Healthcare IT Investment is Overvalued, But Will Increase Next Year

By Jack O'Brien  |   December 10, 2018

While most healthcare industry players believe healthcare IT is an overvalued subsector, they still expect investment to rise in 2019, according to the KPMG-Leavitt Partners 2019 Investment Outlook survey.

More than 60% of healthcare professionals view healthcare IT asset prices as overvalued but also expect the subsector to grow faster than the overall healthcare market, according to a new survey released by KPMG-Leavitt Partners Monday morning. 
Thirty four percent of respondents favored investing in healthcare IT, leading the way over subsectors such as care management, home health services and retail-centric medical groups, among others. Additionally, 62% of respondents expect healthcare IT investment to outpace the overall healthcare market and 75% describe the current healthcare IT market as increasing in competition.
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The most screwed-up employee perk in America (and the man who just might fix it)

By Elijah Wolfson December 10, 2018
The last time Atul Gawande started a company, he named it after a Greek myth.
Ariadne Labs, based in Boston, Massachusetts—where Gawande also works as a surgeon at Brigham and Women’s Hospital and teaches at Harvard—has been trying since 2012 to innovate in an area that has historically resisted innovation: healthcare delivery. You may not have heard of Ariadne, but you’ve certainly heard her story. It’s the one about the Labyrinth and the Minotaur.
If you don’t know her name, it’s because most tellings cast Theseus, the prince of Athens who eventually slays the monster, as the hero of the tale. But a closer read makes clear that, really, it’s Ariadne, the princess of Crete and the minotaur’s half-sister, who matters. She falls in love with Theseus, and saves his life by wisely instructing him to take a ball of twine and attach the thread to the labyrinth’s entrance so he can find his way through the maze, and by bravely risking her life to hide his sword so he can retrieve it in time. Theseus kills the minotaur, escapes the labyrinth, and leaves Crete with Ariadne, bound for Athens and marriage.
Explaining his new company’s name and mission in 2013,  Gawande told WBUR public radio, “We’re in the simple threads business, to show there are ways out of the labyrinth of healthcare complexity.”
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Enjoy!
David.

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