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, January 19, 2019

Weekly Overseas Health IT Links – 19th January, 2019.

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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Digitally enabled care to go ‘mainstream’ in the next decade, Long Term Plan promises

NHS England has pledged that digitally-enabled care will go ‘mainstream’ across the NHS over the next decade, and set eight milestones on the way to that goal.
Hanna Crouch, 7 January, 2019
The NHS Long Term Plan, published today, includes a chapter solely on digital technology which details aims for the coming years.
It states that, in 10 years’ time, the “NHS [in England] will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it”.
For primary care, the milestone states that by 2023/24, every patient in England will be able to access a digital first primary care offer.
According to NHS England, this commitment will be delivered via the creation of a new framework for suppliers, and by the adjustment of the GP payment formulae for digital first practices.
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NHS Long Term Plan: Reaction from healthcare IT leaders

A number of leading figures and companies in the health IT sector have been giving their thoughts on the NHS Long Term Plan.
Hanna Crouch, 8 January, 2019
Published on 7 January, the plan includes a chapter solely on digital technology which details aims for the coming years.
It states that, in 10 years’ time, the “NHS [in England] will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it”.
Following the publication of the document, a number of leading figures and digital companies posted their response.
This included Sarah Wilkinson, chief executive at NHS Digital, who said the plan offers a ‘hugely exciting vision’ for the health service.
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FDA issues 5-year plan to make its Sentinel system more robust

Published January 11 2019, 7:13am EST
The Food and Drug Administration wants to ensure that its post-market monitoring of drugs and biologics keeps pace with changing drug development and safety ecosystems.
Towards that end, the agency has developed a five-year strategy to grow the capabilities of its Sentinel system by 2023 into a “transformative, multi-purpose national data and scientific resource center for evidence generation that a wide array of stakeholders use to inform all aspects of healthcare decisionmaking.”
The announcement was made this week in a blog post by FDA Commissioner Scott Gottlieb, MD, and Gerald Dal Pan, MD, director of the Office of Surveillance and Epidemiology at the agency’s Center for Drug Evaluation and Research.
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Algorithm outperforms humans in identifying cervical precancer

Published January 11 2019, 7:28am EST
An automated artificial intelligence algorithm has been shown to accurately analyze digital images of a woman’s cervix and identify cervical precancer.
The AI approach, called automated visual evaluation, was developed by researchers at the National Cancer Institute and Global Good—a fund at Intellectual Ventures—whose results were published on Thursday in the Journal of the National Cancer Institute.
More than 60,000 cervical images from an NCI archive of photos—collected during a study conducted in Costa Rica from 1993 to 2000—were digitized and then used to train the AI algorithm to differentiate cervical conditions requiring medical treatment from those that did not.
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Austin Regional docs to use Apple Watch to record patient data

Published January 11 2019, 5:51pm EST
Austin Regional Clinic in Texas, with 25 locations in 10 cities, is live with software from Notable Health to automate and digitize physician-patient interactions, improve patient engagement and reduce the time physicians’ spend entering data into the Epic electronic health record system.
Notable Health’s solution uses Apple Watch to document physician-patient discussions and employs artificial intelligence, machine learning and natural language processing software to parse the conversation down to its relevant pieces to accurately record the conversation in patient files.
During in-office visits, doctors will use the Apple Watch to capture audio during and after the visit, and data will be automatically structured and entered into the correct EHR fields, ensuring zero workflow interruption.
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HIT Think How social determinants of health data can provide actionable insights

Published January 11 2019, 5:19pm EST
A large body of research now confirms what health practitioners have long known—social determinants like access to transportation and nutritious food—have a significant impact on patient outcomes.
A widely cited study by ICSI has estimated 80 percent of an individual’s health is influenced by social determinants. Consequently, a survey by Change Healthcare found that 80 percent of payers are investing in tools to address social determinants of health. Payers, hospitals and other healthcare organizations are eager to act on these recent findings and strategically invest in new social and community programs.
The Centers for Medicare and Medicaid Services (CMS) announced in May that Medicare Advantage plans could, in 2019, expand the health-related benefits they offer. If anything, Medicare Advantage would just be catching up to that reality.
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ONC to Congress: EHR adoption is widespread, but health IT progress is still stifled

Providers, patients and payers all still lack access to patient where and when they need it, the Office of the National Coordinator for Health IT said.
January 11, 2019 02:23 PM
Despite the fact that 96 percent of hospitals and 78 percent of physician practices have adopted certified health IT — too many hurdles still stand in the way of progress, according to ONC’s “Annual Update on the Adoption of a Nationwide System for the Electronic Use and Exchange of Health Information”—the agency’s annual report to Congress mandated under the HITECH Act.
The report found that:
  • Despite HIPAA, patients still lack the ability to access health data and that makes it harder to manage their health and shop around for medical care
  • Providers also lack access to patient data at the point of care, particularly true when patients see multiple doctors
  • And payers often lack access to clinical data about populations of covered individuals
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Learning from the Estonian e-health system

Estonia’s Minister of Health and Labour Riina Sikkut tells Health Europa what we can learn from the Estonian e-health system.

The Estonian e-health system is among the world’s most ambitious and a clear example of why this small EU country is widely hailed as one of the most advanced digital nations on the planet. Already, more than 95% of the data generated by hospitals and doctors has been digitised, and citizens can enjoy easy access to their own medical records, prescriptions, and the most suitable health professional.
This system – which not only improves the cost-effectiveness, sustainability and efficiency of the Estonian healthcare service but also facilitates the transition to preventive, rather than curative, medicine – is underpinned by blockchain technology, a crucial pillar in ensuring the integrity and security of all patient data.
To find out more, Health Europa spoke to Riina Sikkut, the Minister of Health and Labour of the Republic of Estonia, who here discusses the main advantages of the Estonian e-health system, it’s e-health solutions, the move towards Healthcare 4.0, and what other countries can learn from Estonia’s example.
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How analytics can help boost the success of EHR go-lives

At HIMSS19, John Rekart, chief of quality management and informatics at the California Department of Corrections and Rehabilitation will show how homegrown analytics enabled a 25 percent post-implementation reduction in sentinel events.
January 10, 2019 01:52 PM
New electronic health record rollouts are infamously fraught with risk. At best, a they can cause workflow disruption, confusion among clinical staff and other minor inefficiencies. At worst, they can necessitate a temporary return to paper records, cost millions in remedial IT projects – or cause serious sentinel events.
As John Rekart, chief of quality management and informatics at the California Department of Corrections and Rehabilitation points out, "anywhere from 30 to 80 percent of EHR implementations over the past two decades failed and went back to paper."
Health systems have gotten much better at it in recent years, but challenges related to new workflows, spotty training and poor preparation continue to put go-lives at risk.
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Staff lapses and IT system vulnerabilities are key reasons behind SingHealth cyberattack, according to COI Report

The Committee of Inquiry (COI), which was convened on 24 July 2018, identified five key findings and a total of 16 recommendations for SingHealth and IHiS to improve its cybersecurity defences.
January 09, 2019 09:24 PM
After 22 days of public and private hearings involving 37 witness accounts from August to November 2018, the Committee of Inquiry (COI) convened to inquire into the events and contributing factors leading to the cyberattack on Singapore Health Services Private Limited (SingHealth)’s patient database system, has released its 454-page public report today.
Between late June to early July 2018, hackers breached SingHealth’s Sunrise Clinical Management (SCM) database with a “deliberate, targeted and well-planned” cyberattack, accessing the data of about 1.5 million patients, including Prime Minister Lee Hsien Loong.
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Diagnostic tool can detect blood infections in 20 minutes

Written by Mackenzie Bean | January 09, 2019 | Print  | Email
Researchers at West Lafayette, Ind.-based Purdue University created a diagnostic tool that can detect blood infections in as little as 20 minutes, according to a study published in the journal Analytical Chemistry.
The tool visually identifies if an infection is present in a blood sample by referring to a digital library that researchers created of every infection's specific "fingerprint."
"In 20 minutes [the tool] identifies what kind of infection they have and what antibiotic or antifungal medication we should give them," study author Mohamed Seleem, PhD, a professor of microbiology in Purdue University's College of Veterinary Medicine, said in a press release. "Doing this without giving patients the wrong treatment or creating antimicrobial resistance is really novel."
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Tim Cook teases new Apple services to come in 2019

Published Tue, Jan 8 2019 • 6:35 PM EST | Updated Thu, Jan 10 2019 • 12:15 PM EST





Key Points
  • Apple CEO Tim Cook says his company will “announce new services” in 2019 in an interview with CNBC’s Jim Cramer.
  • “If you zoom out into the future, and you look back, and you ask the question, ‘What was Apple’s greatest contribution to mankind?’ It will be about health,” Cook tells the “Mad Money” host.
Tim Cook teases new Apple services to come in 2019
Apple will announce “material” new additions to its growing roster of services in 2019, CEO Tim Cook told CNBC on Tuesday.
“You will see us announce new services this year. There will more things coming,” Cook said in an exclusive “Mad Money” interview with Jim Cramer. “I believe it’ll be material over time.”
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HIT Think How successful interoperability begins within

Published January 10 2019, 4:53pm EST
The healthcare industry is undergoing massive modernization, and the first thing to go is the traditional manner of record keeping.
With more ways than ever to track data—from a primary physician, to an Apple watch, even to a hospital across the country—patient information often lives in multiple scattered places. To ensure this data remains accessible no matter where the location, implementing solutions that encourage cohesive and successful interoperability has never been so important.
Yet, the complexities of healthcare data make this near impossible. For example, different care centers may have variations in software that prevent seamlessly translating information from one source to another. It almost seems as though as technology becomes more advanced, the need for interoperability becomes more pressing and yet, sometimes more challenging to achieve.
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Former Apple CEO Praises Tech Giant's Healthcare Goals

By Jack O'Brien  |   January 10, 2019

John Sculley, who headed Apple Inc. from 1983 to 1993, believes the tech company is on the right track to make a significant impact in healthcare.

KEY TAKEAWAYS

Current CEO Tim Cook kicked off 2019 by announcing the company would continue its push into healthcare.
Sculley said the time is right for "consumer-facing tech companies."
Lately, much attention has been paid to the new Apple Watch, which features electrocardiogram capabilities.
Among the many corporate disruptors aiming to reshape the healthcare industry, Apple Inc. is in prime position to move the needle and meet consumer needs, according to former CEO John Sculley. 
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Google Knows You Better Than Your Doctor Ever Could

It's not intended as a substitute for medical professionals, but it has become one — free, convenient and crowdsourced.
By Elaine Ou
January 10, 2019, 1:00 AM GMT+11
Thanks to a combination of Google, WebMD and the $6,000 deductible on my health insurance, I haven’t been to a doctor to talk about an illness in years. Millions of Americans have similar habits; in fact, one in 20 Google searches are for health-related information. "Dr. Google" may not have an MD or a board certification, but it does have the clinical knowledge of a primary care provider who sees millions of patients a year.
With so much interest, it might be surprising how tentatively tech-driven efforts have entered the $3.5 trillion health care industry. After three years, IBM’s AI-driven Watson for Oncology not only had not delivered new insights on cancer treatments, but also in some instances even recommended unsafe and incorrect treatments. In fairness to Dr. Watson, it was working with the same scant medical records that limit human physicians. Artificial intelligence predictive capacity comes not from superior processing power itself, but from using that processing power to discover signals in vast quantities of data.
Insights often arise in unexpected places. Some years ago, Target attracted attention for identifying a teenager's pregnancy before the girl had informed her father. Turns out you can learn a lot from a person’s shopping history. A customer doesn’t need to do anything as obvious as buying diapers or maternity clothes; the store can make diagnoses based on subtle changes in shopping habits. Things like unscented lotions, vitamins and flu medicine all serve as leading indicators of an expectant mother. And a person’s shopping history is just one of millions of data points collected by ad platforms.
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EHR standardization strongly predicts advanced HIT adoption

Written by Anuja Vaidya (Twitter | Google+)  | January 07, 2019 | Print  | Email
A study published in the American Journal of Managed Care found adoption of advanced health IT capabilities among U.S. health systems is variable.
Researchers assessed responses from the 2017-18 National Survey of Healthcare Organizations and Systems. They studied the extent to which organizational structure, EHR standardization and resource allocation practices were associated with use of five advanced health IT capabilities.
The survey includes responses from 732 health systems, of which 446 responded, 425 met sample inclusion criteria and 389 reported consistent EHR use.
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FDA targets De Novo path to shepherd medical software through Pre-Cert

Author David Lim @LimOpinion

Published Jan. 8, 2019

Dive Brief:

  • FDA issued the third iteration of its Working Model for its Software Pre-Certification Program on Monday, outlining plans to utilize the De Novo pathway in the pilot program aimed at testing a regulatory model where firms are pre-cleared to market medical device software. 
  • Traditional marketing submissions will still be required for firms making Software as a Medical Device (SaMD), but the agency said additional legislative authority from Congress may be needed to enable direct market entry for low-risk products in the future by precertified manufacturers.
  • A proposed Pre-Cert pathway made up of an "excellence appraisal," review pathway determination, streamlined review and a real-world performance plan will run in parallel with FDA's traditional review process for each pilot test case. The aim is to see if its Pre-Cert program results in a comparable process for determining safety and effectiveness.
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The new ways we could get hacked (and defended) in 2019

Experts from the NSA and Darktrace discuss AI, invisible security, and why you really need to change your passwords.

By Ciara Byrne 9 minute Read
Cybercrime is in many ways the perfect crime: low risk, scalable, and highly profitable. As more of our lives migrate online, attacks on our cybersecurity by the agile, globalized, and outsourced cybercrime industry show no signs of slowing down.
Billions of people were affected by data breaches and cyber attacks in 2018, including up to 500 million Marriott customers. Incidents of cryptojacking (hijacking servers to mine cryptocurrency) experienced a meteoric rise, but those attacks dropped off towards the end of the year in line with cryptocurrency prices. In contrast, banking Trojans like Emotet and Trickbot, which steal banking credentials, experienced a resurgence. North Korea, Iran, Russia, and China continued to be the main actors in nation state attacks, such as the fake think-tank and Senate sites created by a Russian-linked hacking group ahead of the U.S. midterm elections.
So what’s in store for cybersecurity in 2019? If 2018 is any indication, threats are becoming more sophisticated, harder to detect, and potentially more dangerous, but the cybersecurity technology and talent arrayed against them is evolving too.
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AMIA Advises CDC to Start with Limited Pilot for Health IT Testing in the Field

January 8, 2019
by Heather Landi, Associate Editor
The American Medical Informatics Association (AMIA) supports health IT testing in the field, but is urging the Centers for Disease Control and Prevention (CDC) to initially use a limited scope for in the field testing to ensure the future success of the CDC’s National Test Collaborative (NTC).
AMIA submitted written comments to the CDC in response to the agency’s request for information (RFI) on its National Test Collaborative initiative. According to the CDC’s RFI, the agency is seeking input on the development of a national testbed (the National Test Collaborative) for real-world testing of health IT that enables improved delivery of best evidence to health care providers at the point of care as well as facilitates data created in the course of care provision to be available for appropriate research and public health purposes (e.g., clinical decision support (CDS), electronic clinical quality measures (eCQMs) and electronic health record (EHR) data extraction tools.)
The CDC also is asking for input on approaches for creating a sustainable infrastructure that can be leveraged to meet robust clinical testing needs in public and private sectors.
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Cerner vows to open EHR to third-party development

Jan 9, 2019 2:45pm
As Cerner prepares to massively grow its electronic health record system over the next several years, top executives are starting to acknowledge that the EHR vendor can't do it all in-house.
At a recent appearance at J.P. Morgan's Healthcare Conference, Cerner CEO Brent Shafer spoke broadly about the need for digital transformation in healthcare in the coming years.
And while Cerner has a history of keeping development like that close to the chest, Shafer argued that to do everything it wants to, the company needs to look outward. That means it needs to become the "partner of choice" for third-party development of healthcare innovation, he said.
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Change in EHR default orders helps reduce inpatient sleep interruptions

Published January 09 2019, 6:54am EST
A tweak to default orders in the University of Chicago Medical Center’s electronic health records system is letting patients sleep more soundly at night.
Inpatient sleep deprivation is a serious problem at hospitals because of frequent nighttime awakenings by clinicians to measure vital signs or administer medications.
However, researchers at the University of Chicago Medicine conducted a prospective study—called Sleep for Inpatients: Empowering Staff to Act (SIESTA)—combining electronic “nudges” in the EHR to forgo nocturnal vitals and medications, as well as physician education on how to use the sleep-friendly tools in the Epic EHR system.
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FDA lays out plan for improving its regulatory processes

Published January 09 2019, 5:29pm EST
As digital health tools rapidly evolve, the Food and Drug Administration is acknowledging it must modernize its approach to regulation.
The agency, via a new Digital Health Precertification Program, or Pre-Cert, is taking a new look at its oversight of new health tools and policies to become more efficient and promote patient safety throughout the product lifecycle.
“We’ve seen the promise of innovation in products like artificial intelligence software that can help alert physicians to a potential stroke, and smart watches that can help identify atrial fibrillation,” says FDA Commissioner Scott Gottlieb, MD, in a statement to the industry.
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HIT Think How the shift to the cloud could affect 3 data security trends

Published January 09 2019, 5:52pm EST
The year 2018 proved to be unlike any other for security professionals. From high-profile breaches and heavy government scrutiny to new data privacy regulations, the year ended up being quite eventful.
A key theme from 2018 was the ongoing rise of cloud adoption. Organizations everywhere are continuing to migrate because of the cloud’s ability to provide increased efficiency, collaboration, and flexibility.
Fortunately, with this continued adoption of cloud has also come an emphasis on cloud security. In particular, the enterprise is focusing more than ever on using and securing cloud infrastructure. As a result, Gartner projects that infrastructure as a service (IaaS) will grow to be a $39.5 billion market by the end of this year.
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High-performance medicine: the convergence of human and artificial intelligence

Nature Medicine volume 25pages44–56 (2019) | Download Citation

Abstract

The use of artificial intelligence, and the deep-learning subtype in particular, has been enabled by the use of labeled big data, along with markedly enhanced computing power and cloud storage, across all sectors. In medicine, this is beginning to have an impact at three levels: for clinicians, predominantly via rapid, accurate image interpretation; for health systems, by improving workflow and the potential for reducing medical errors; and for patients, by enabling them to process their own data to promote health. The current limitations, including bias, privacy and security, and lack of transparency, along with the future directions of these applications will be discussed in this article. Over time, marked improvements in accuracy, productivity, and workflow will likely be actualized, but whether that will be used to improve the patient–doctor relationship or facilitate its erosion remains to be seen.
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Stress from using electronic health records is linked to physician burnout

  Media contact: Mollie Rappe   401-863-1862
Researchers found that health information technology-related stress was most common among primary care doctors.
PROVIDENCE, R.I. [Brown University] — While electronic health records (EHRs) improve communication and access to patient data, researchers found that stress from using EHRs is associated with burnout, particularly for primary care doctors such as pediatricians, family medicine physicians and general internists.
Common causes of EHR-related stress include too little time for documentation, time spent at home managing records and EHR user interfaces that are not intuitive to the physicians who use them. 
“You don’t want your doctor to be burned out or frustrated by the technology that stands between you and them,” said Dr. Rebekah Gardner, an associate professor of medicine at Brown University’s Warren Alpert Medical School. “In this paper, we show that EHR stress is associated with burnout, even after controlling for a lot of different demographic and practice characteristics. Quantitatively, physicians who have identified these stressors are more likely to be burned out than physicians who haven’t.”
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Top-Funded Digital Health Companies And Their Impact On High-Burden, High-Cost Conditions

PUBLISHED: No Access https://doi.org/10.1377/hlthaff.2018.05081

Abstract

Digital health companies hold promise to address major health care challenges, though little has been published on their impact. We identified the twenty top-funded private US-based digital health companies to analyze their products and services, related peer-reviewed evidence, and the potential for impact on patients with high-burden conditions. Data analytics (including artificial intelligence and big data) was the most common company type. Companies producing biosensors had the greatest funding. Publications were concentrated among a small number of companies. Healthy volunteers were most commonly studied. Few studies enrolled high-burden populations, and few measured their impact in terms of outcomes, cost, or access to care. These data suggest that leading digital health companies have not yet demonstrated substantial impact on disease burden or cost in the US health care system. Our findings indicate the importance of fostering an environment, with regard to policy and the consumer market, that encourages the development of evidence-based, high-impact products.
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Most Physicians Not Aware of CMS’s Expanded Virtual Care Provisions, Survey Finds

January 7, 2019
by Heather Landi, Associate Editor
For the first time, starting in 2019, the Center for Medicare & Medicaid Services (CMS) will reimburse healthcare providers for certain virtual care visits with patients, regardless of the patient’s location—a move that has drawn praise from many healthcare leaders as helping to advance telehealth.
On Nov. 1, CMS published its final rule providing updates to the Physician Fee Schedule (PFS) and calendar-year 2019 Quality Payment Program (QPP), and while there were no big surprises as many of CMS’ changes and updates were originally proposed in the agency’s draft rule, published back in July, healthcare industry groups quickly praised the virtual visit provisions contained in the final rule—specifically, reimbursing doctors for virtual check-ins, remote image evaluation, and other technology-enabled services.
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AI-enabled EKG proves powerful screening tool for heart disease

Published January 08 2019, 7:03am EST
Researchers at the Mayo Clinic have applied artificial intelligence to a routine method of measuring the heart’s electrical activity to identify patients with asymptomatic left ventricular dysfunction.
According to Mayo officials, until now there hasn’t been an inexpensive, noninvasive, painless screening tool for asymptomatic left ventricular dysfunction—a precursor to heart failure—available for diagnostic use.
However, they contend that an AI-enabled electrocardiogram (EKG) has proven to be a “powerful screening tool” for individuals with ALVD, demonstrating accuracy on par with other common tests, such as prostate-specific antigen for prostate cancer, mammography for breast cancer and cervical cytology for cervical cancer.
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HIT Think How blockchain could make an impact in healthcare

Published January 08 2019, 5:34pm EST
Blockchain, like other young and disruptive technologies, offers wide opportunities to impact healthcare, an industry that is primed for disruption. Despite being the largest sector of the U.S. economy, healthcare is plagued by slow systems, wasteful financing, and resource utilization and operational inefficiencies.
To address these issues, innovative solutions like blockchain can alter the arithmetic of healthcare delivery, and the solution set is wide ranging. Blockchain can secure sensitive research and clinical data while ensuring its’ responsible access among a broader range of involved stakeholders. It promotes a true linear patient record and the Internet of Healthy Things (IoHT), which includes wearables, nearables, invisibles and sensors. It creates an efficient framework of asset and supply chain management and establishes the security and authenticity of medications. It is a rich field for innovation - companies like IBM, Oracle, Microsoft and Change Healthcare are developing blockchain solutions to augment patient health records, asset management, licensing and credentialing, data sharing, revenue cycle and more.
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Digital health market is frothy, but it doesn’t look like a bubble

Published Sat, Jan 5 2019 • 3:07 PM EST





Key Points
  • In 2018, digital health companies received $7.9 billion in venture funding.
  • Challenges in the public market could trickle down into private financing rounds.
  • The Theranos debacle does not appear to suggest more general problems of fraud in the market. 
Since my company, Rock Health, began researching and tracking funding into the digital health space in 2011, we’ve reported steady growth nearly every year. 2018 was no different, with a massive $7.9 billion in venture filling start-ups’ coffers. But the signals we’re seeing — large, late-stage rounds at high valuations and shorter periods between early rounds — are those of an investment cycle nearing its peak.
Does this peak signal a “bubble?” The so-called b-word has been sneaking into conversations with our fellow investors, so we dedicated our year-end number crunching to measuring the froth.
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Tech to play “central role” in delivery of NHS long-term plan in England

Digitally-enabled care is expected to become a "mainstream part" of the NHS in England under a 10-year plan unveiled today.
January 07, 2019 10:43 AM
Secondary care providers in England are expected to be “fully digitised” by 2024, according to the 10-year NHS plan released today.
NHS leaders were asked to develop the blueprint following an announcement in the summer of 2018 that the NHS would receive increased funding of £20.5bn per year in real terms by 2023/24, which applies to NHS England’s budget and not the overall health budget.
The new plan outlines a series of “practical priorities” to ensure that digital services become a “mainstream” part of the NHS, and the new secondary care digitisation “milestone” covers “clinical and operational processes across all settings, locations and departments".
It includes a focus on ensuring that clinicians can access and interact with patient records and care plans “wherever they are”, protecting patients’ privacy and putting them in control of their records, while encouraging a “world leading health IT industry in England with a supportive environment for software developers and innovators”. 
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Vocera unveils Smartbadge combining mobile phone and clinical communications features

New device brings a larger screen, integration with more clinical systems, a panic button and do not disturb features.
January 07, 2019 09:00 AM
Vocera on Monday announced Smartbadge, a new version of its communications tool that brings a larger screen and access to more clinical data systems as well as other new features.
WHY IT MATTERS
The device now features a touch screen that is 2.4-inches, diagonally, to offer more context for patients and caregivers, according to Vocera CEO Brent Lang.  
“This is not a replacement for a smartphone but it’s big enough to send and receive texts,” Lang said. “It’s still lightweight and wearable so users don’t have to stop what they’re doing, reach in their pocket and pull out a phone.”
Instead, they can communicate via voice with the device and do not need to know a doctor’s contact information to reach her or him, it just takes a name to get connected.
The larger screen also enables the device to show its integration with some 140 clinical systems, which the previous version’s interface was too small to display, Lang added.    
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Cerner adds drug pricing tool

Written by Julie Spitzer | January 03, 2019 | Print  | Email
Cerner teamed up with CoverMyMeds to provide clinicians and patients with the cost of prescription drugs from within the Cerner ePrescribe workflow.
Under the partnership, Cerner will integrate patient-specific benefit information into its EHR so clinicians can review cost information before prescribing medications. The new service will integrate information from businesses, such as pharmacy networks and payers to provide patient payment details at the point of care.
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California panel recommends EHR plan to boost precision medicine

Jan 7, 2019 3:42pm
Unified electronic health records could go a long way toward unlocking the potential of precision medicine if a California advisory committee's recommendations play out.
After a year of study commissioned by former Gov. Jerry Brown's office, the Precision Medicine Advisory Committee recommended that the state set up a working group to examine the feasibility of such a system.
"Much better integration of various data sources is possible (including the social, economic, and environmental data) and beneficial, and can be activated through state leadership," the committee wrote.
A unified patient record system would be a dramatic leap forward for interoperability. Thus far, EHRs have been siloed by different private companies, and most of them aren't compatible with each other. The "California Patient Record" envisions a universally compatible health record in the state—one that patients can update as well as providers.
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Telemedicine improves patient postoperative care

Published January 07 2019, 6:17am EST
Patients recovering from vascular surgery say that telemedicine has improved their satisfaction with postoperative care as well as their quality of life.
That’s the finding of a recent study published in the Annals of Vascular Surgery. The study compared outcomes between patients who received telehealth remote monitoring with those who received standard treatment, including routine discharge instructions and no electronic monitoring.
Of the 30 participants in study, 16 patients received tablets running the Enform Care Management Platform—a telemedicine app developed by TeleMed 2020—which enabled communication with nurses.
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Machine learning software can easily gauge brain atrophy

Published January 07 2019, 4:49pm EST
Artificial intelligence can quickly and accurately rate the amount of atrophy in parts of the brain, which can help in the diagnosis and research of dementia.
A new study reported in arXiv.org, part of the Cornell University Library, is suggesting that the assessment of structural changes in the brain can be made clinically by visually rating brain atrophy from radiological images. It is an inexpensive way to quantify brain atrophy and helps improve the specificity and sensitivity of diagnosis.
These visual atrophy ratings aren’t used widely because the ratings are inherently subjective, researchers note. Radiologists performing them need to be experienced in such work, and the assessments are tedious and time consuming—it takes several minutes per image for a neuroradiologist to perform the rating. And while the rating is potentially useful in a clinical setting, the current process does not easily enable the study of larger groups of images, which is important for research purposes.
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HIT Think Why patient matching is key to interoperability and patient safety

Published January 07 2019, 4:35pm EST
While technological advances in healthcare continue to be mainly positive, increased risk as part of digitization continues to burden hospitals entangled in troves of data, and definitive steps to confront the biggest barrier to interoperability¬—patient identification—remains a critical challenge.
Without consistently and correctly matching individuals to their data to enable a complete record of a one’s health history, patients will continue to suffer the consequences (and in the worst cases, die) due to preventable medical errors and patient misidentification.
Two recent reports highlight this problem. In October 2018 the Joint Commission issued a national safety advisory on avoiding patient identification and matching errors. The alert cautions that while health IT can provide ready access to and facilitate the sharing of data, it can also cause patient identification problems, such as providing treatment to the wrong patient and mistakenly putting a test into another patient’s electronic health record (EHR). Recommended safety actions to avoid inaccurate patient identification include standardized processes for identifying patients and data capture, improved EHR configurations, and implementing systems to detect duplicate medical records.
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Millions of patients to see doctor by Skype under NHS plan

May wants digital consultations to be NHS norm
Chris Smyth, Health Editor
January 8 2019, 12:01am, The Times
Millions of patients will use Skype for hospital appointments in a “wholesale transformation of the NHS” intended to reduce face-to-face consultations by a third and save billions of pounds.
Digital appointments with consultants will become the norm under a plan for the future of the health service revealed yesterday. Thirty million hospital visits a year will be avoided by use of Skype calls, smartphones and other ways to talk to a doctor.
Simon Stevens, head of NHS England, has promised to end the “outdated and unsustainable” model of hospital appointments that has persisted for 70 years. He argues that online efficiencies would help to close a funding gap and deliver pledges to improve GP care and outcomes for cancer, mental health and heart disease.
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Billions of dollars are pouring into digital health, but Americans are still getting sicker and dying younger

January 4. 2019





Key Points
  • Venture investors are chasing digital health companies that promises to improve care and lower costs.
  • Experts give their take on why it’s not working.
Silicon Valley has spent years promising to disrupt the $3.5 trillion health-care industry.
In 2018, venture investors — from the Bay Area, Boston and elsewhere — poured billions of dollars into the sector, funding start-ups that aim to bring down the costs of care while improving quality and access to the right providers. Some of the hottest trends include virtual care solutions, wearables, medication management apps and new tools that allow physicians to engage with their patients between visits.
That all sounds great. And software is supposed to improve every industry. But when it comes to health care, it leaves one important question unanswered: Why aren’t we getting any healthier?
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Enjoy!
David.

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