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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Digital is a valuable tool for prevention – and so rightly it’s at the heart of the long term plan
Digital
is at the heart of the NHS Long Term Plan. Quite right too, argues Tara
Donnelly, newly appointed interim chief digital officer at NHS England
– it can be the means of moving to prevention as a priority, something
that will benefit health service and patients alike.
DHI Admin – 15 January, 2019
The 10-year blueprint for the NHS was, I think, worth the wait. Published last week, the Long Term Plan
promises a major shift to prevention and supporting people stay
healthy, unlocked by the power of digital. In fact, the word digital
features 95 times in the 136-page document.
I’ve
worked in the NHS for 30 years and am a realist. I completely get how
hard it can be to imagine the bold commitments taking shape when days
are so busy clinically and operationally. But it is only by thinking
about the longer term and investing bravely that we can make the nearer
term much better for staff and patients alike.
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Two countries united by natural language processing?
George
Bernard Shaw famously quipped that the US and the UK were two countries
separated by a common language. But in natural language processing,
State-side hospitals are finding a means of better assesing the
appropriateness of specific tests or procedures – and Dan Kazzaz argues
the NHS could valuably follow suit.
DHI Admin – 17 January, 2019
Comparing
the US healthcare system to that of the UK is often great sport. Points
of comparison are frequently the cost of care, quality of care and
waiting times. Less obvious is that the US and UK systems actually have a
great deal in common, primarily how healthcare is funded.
The
largest US healthcare insurer is Medicare, which is comparable to the
NHS. Although Medicare is primarily for those over 65 years of age and
does not cover all items covered by the NHS, both are highly dependent
on the working population to support the retired population through
taxes.
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Special Report: Shared Care Records
Last
Spring, NHS England announced the latest initiative designed to
radically advance shared care records. The five Local Health and Care
Record Exemplars (LHCREs) are now starting to properly bed in. But how
much progress has been made on shared records, what obstacles remain,
and can the exemplars help other areas of the NHS progress? Maja
Dragovic investigates.
The
mission of the Local Health and Care Record Exemplars (LHCREs) cannot
really be seen as new. Indeed, to look at the five regions that were
selected – Greater Manchester, Wessex, One London, Yorkshire and the
Humber, and Thames Valley and Surrey – is to see areas in which, no
coincidence, some progress has already been made on constructing a
shared record.
In
Yorkshire and Humber, for example, the core software that underpins the
orchestration of data across the region’s health and care organisations
is based on software built for Worcestershire Health and Care NHS Trust
as part of its global digital exemplar (GDE) programme.
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How machine learning can reduce tests, improve treatments for ICU patients
Researchers from Princeton (N.J.) University are using machine learning
to design a system that could reduce the frequency of tests and improve
the timing of critical treatments for intensive care unit patients.
To
create the system, the researchers used data from more than 6,060
patients admitted to the ICU between 2001 and 2012. The research team
presented its results Jan. 6 at the Pacific Symposium on Biocomputing in Hawaii.
The
analysis looked at four blood tests measuring lactate, creatinine,
blood urea nitrogen and white blood cells. These indicators help
diagnose two serious problems for ICU patients: kidney failure or
sepsis.
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ONC: After EHR Adoption, Patient Data Access, Exchange Are Key
The 2018 ONC Report to Congress outlined current health IT limitations, such as poor patient data access and exchange.
By Sara Heath
January
10, 2019 - Although the US healthcare industry has nearly ubiquitously
transitioned to EHRs and other electronic documentation, challenges
remain for patient data access, according to the 2018 ONC Annual Report
to Congress.
The report, presented to Congress at the end of last year, outlined some of the progress made since EHRs became a mainstay in healthcare.
Since
2015, EHR use and patient portal access has been near universal. In
2015, Certified EHR Technology (CEHRT) adoption reached 96 percent in
non-federal acute care hospitals. For office-based physicians, that
number reached 78 percent.
Patient portal access also grew between 2009 and present day. Per a July 2018 MGMA report, patient portal adoption rates reached over 90 percent.
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More than 772 million email addresses affected in 'Collection #1' data breach
It's time to change your password again.
More
than 87GB of passwords and email addresses have been leaked and
distributed in a folder dubbed "Collection #1" by hackers in a
significant data breach.
As detailed by security researcher Troy Hunt,
the trove of nearly 22 million unique passwords and more than 772
million email addresses was hosted on cloud storage service MEGA.
The link to the dump was posted on a hacking forum, but has been since taken down from the service.
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“Revolutionizing” Healthcare: How Non-Traditional Players are Shaking Up the Sector
January 15, 2019
by Rajiv Leventhal, Managing Editor
Traditional
healthcare stakeholders will not be able to slow down new industry
entrants such as Amazon, one leading consultant attests
In late November
when Amazon announced that it was launching a machine learning service
that will aim to mine data from electronic health records (EHRs),
company officials, in a blog post,
noted that the software, Amazon Comprehend Medical, is “a
HIPAA-eligible machine learning service that allows developers to
process unstructured medical text and identify information such as
patient diagnosis, treatments, dosages, symptoms and signs, and more.”
Two
of Amazon’s specialists—Matt Wood, Ph.D., a machine learning expert,
and Taha Kass-Hout, M.D., a former FDA chief health informatics
officer—noted that a core issue in healthcare and health IT today is
that a large amount of critical data is stored as unstructured medical
text, such as medical notes, prescriptions, audio interview transcripts,
and pathology and radiology reports. “This means that being able to
identify this information can be a manual and time-consuming process,
which either requires data entry by high skilled medical experts, or
teams of developers writing custom code and rules to try and extract the
information automatically,” they outlined, adding that Comprehend
Medical will instead aim to specifically allow developers “to identify
the key common types of medical information automatically, with high
accuracy, and without the need for large numbers of custom rules.”
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Bioethicists say consumer neurotechnologies need more oversight
Published January 18 2019, 7:36am EST
While
direct-to-consumer neurotechnologies are popular, these products are
not fully supported by science and have little regulatory oversight.
That’s
the contention of two bioethicists from Penn Medicine and the
University of British Columbia, writing this week in the journal Science.
The authors propose the creation of an independent working group to
study the poorly regulated market for these products—such as mental
health apps—which is predicted to reach $3 billion by 2020.
“A
growing ecosystem of neurotechnology products is being sold direct to
consumers (DTC) without necessitating the physician as intermediary,”
state the authors. “Yet there are good reasons to conclude that
regulatory oversight of DTC neurotechnologies is insufficient.”
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Gartner's top data and analytics predictions for 2019
Published January 18 2019, 4:00am EST
The
use of analytics to improve operations is growing, and healthcare
organizations are on the cusp of deriving increasing value from the data
they have. Gartner, a major consulting firm, has issued a set of
predictions for the implications that data and analytics will have
across all industries. This post originally published on Andrew White's
Gartner blog, which can be viewed here.
Predictions about data and analytics strategy
*
By 2022, 90 percent of corporate strategies will explicitly mention
information as a critical enterprise asset and analytics as an essential
competency.
* By 2022, 30 percent of CDOs will partner with their CFO to value the organization’s information assets for improved information management and benefits.
* By 2022, more than half of major new business systems will incorporate continuous intelligence that uses real-time context data to improve decisions.
* By 2023, data literacy will become an explicit and necessary driver of business value, demonstrated by its formal inclusion in over 80 percent of data and analytics strategies and change management programs.
* By 2023, 60 percent of organizations with more than 20 data scientists will require a professional code of conduct incorporating ethical use of data and AI.
* By 2022, 30 percent of CDOs will partner with their CFO to value the organization’s information assets for improved information management and benefits.
* By 2022, more than half of major new business systems will incorporate continuous intelligence that uses real-time context data to improve decisions.
* By 2023, data literacy will become an explicit and necessary driver of business value, demonstrated by its formal inclusion in over 80 percent of data and analytics strategies and change management programs.
* By 2023, 60 percent of organizations with more than 20 data scientists will require a professional code of conduct incorporating ethical use of data and AI.
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https://www.healthdatamanagement.com/opinion/how-an-omni-channel-approach-can-aid-patient-experience
HIT Think How an omni-channel approach can aid patient experience
By Dave Dyell
Published January 18 2019, 4:01pm EST
Patient
dissatisfaction often comes from wait times rather than from actual
clinical care. In healthcare, the complete consumer experience is
repeatedly overlooked as a critical component to building loyal, repeat
visitors.
With
smartphones in hand, we’ve gotten used to receiving instant information
and a seamless customer experience. Text messages and alerts telling us
that a package has just been delivered, or that our table is now
available, provide timely information in a way that enables us to do
more with the time we have.
And
yet, in healthcare, we wait. In many ways, the healthcare industry is
extremely advanced. In other areas, we are woefully behind. Customer
experience is one of the areas where most healthcare providers’
processes, procedures and technology are archaic compared to other
digital interactions. But it doesn’t have to be.
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Dutch govt to put EUR 90 mln into e-health for the elderly
Friday 18 January 2019 | 20:56 CET | News
The
Dutch government will in the coming years put EUR 90 million into
E-Health Home, a subsidy scheme aimed at stimulating e-health
applications for older people with chronic diseases or disabilities.
Providers of care and support for the elderly, together with the
purchasers of this care, will be able to submit plans this spring to
receive a subsidy. Over the next three years, EUR 30 million will be
available each year. A total of around 280 initiatives will be funded
from the scheme.
The
government believes the use of digital technology can help people live
independently and with a good quality of life. This would also reduce
pressure on health personnel.
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- 01.16.19
IoT security is so bad, many companies can’t tell when they’re hacked
And only 14% believe that IoT security is an ethical responsibility.
Internet of Things devices–like smart lightbulbs or ovens or even toilets–are notoriously susceptible to being hacked. But the security problems go much deeper than preventing your average smart toaster from becoming a foot soldier in a botnet army.
A new report from the security company Gemalto
surveyed 950 companies that both make and use IoT technology, and found
that 48% of companies that use IoT devices in the workplace don’t have
mechanisms in place to detect if any of their devices are hacked or not…
even though nearly all respondents believe that security is an
important way to win over customers and 65% believe security is a way to
differentiate from the competition.
As
the number of connected devices grows–the report states that the
industry is on track to see 20 billion IoT devices by 2023–the security
of these devices will only become more important. That growing
significance is reflected in the percentage of budget companies spend on
IoT security, which has increased from 13% in 2017 to 15% today. While
budget is increasing, 15% still seems like a laughably small amount to
be spending on security in a time when data breaches are in the news
every month.
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AJMC: Which HIE approach is best?
Approaches
to health information exchange that rely on shared EHRs or EHR vendor
alliances may disadvantage smaller healthcare organizations using less
popular IT systems, according to a study published in the American Journal of Managed Care.
Researchers
analyzed Medicare patient transitions and physician EHR adoption to
determine the proportion of transitions that could be covered by one of
the three approaches to data exchange. The three approaches were data
exchange between physicians who "are part of the same integrated
system," physicians who "use the same EHR" or physicians who "use an EHR
that participates in an EHR vendor alliance."
Three study findings:
- Thirty-three percent of transitions could be completed with one of the three proprietary data-sharing approaches listed above.
- Open data exchange methods, such as those offered by community HIEs, were still required for 45 percent of patients.
- Physicians who did not use a market-leading EHR, did not belong to a large integrated health system and shared patients with a broader network of physicians have the greatest need for an "open" HIE.
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How the government shutdown is putting national cybersecurity at risk
Published Mon, Jan 14 2019 • 3:14 PM EST | Updated Tue, Jan 15 2019 • 3:30 PM EST
Key Points
- The country’s cybersecurity stance has been weakened by the partial government shutdown, with both immediate and longer term negative consequences.
- This is especially true as a longstanding “brain drain” of cybersecurity talent has turned into an open bleed.
- Many essential cybersecurity functions continue, but their jobs are made harder by the fact that other IT staff who would normally implement routine fixes are furloughed.
The
partial government shutdown is quickly turning into a nightmare
scenario for the country’s cybersecurity functions, and often in
unexpected ways. Even after Congress ultimately reaches a deal to end
the shutdown, these negative effects could last far into the future.
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Provider organizations look to tech to improve the patient experience
By Fred Bazzoli
Published January 17 2019, 7:49am EST
Novant Health understands the value of getting patients involved in their own care, and it’s using technology to lure them in.
The
four-state integrated network of physician clinics, outpatient centers
and hospitals has been offering portals since 2011 and was one of the
first in the country to have 100,000 patients using the technology to
look at their medical records. And Novant is doing more than just
providing access to health records. For example, it’s using its database
of patient information to initiate personal contacts, such as its
“birthday letters” to patients containing reminders about health
services and tests that patients need.
It’s
a key to the chain’s long-term strategy. “We’ve made it easier for
patients to address their needs,” added Ryan Neaves, director of IT
applications at Novant Health Lakeside Primary Care. “We can offer an
e-visit for patients, and that has really made it a more cohesive
experience for them.”
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AMIA: Clinical research and care need to be better aligned
Published January 17 2019, 7:43am EST
Despite
widespread adoption of electronic health record systems by providers,
data-driven healthcare remains “overwhelmingly” unrealized.
That’s the conclusion of a new American Medical Informatics Association paper, published on Wednesday in JAMIA Open,
which calls for better integrating clinical research and clinical care
to fully leverage America’s existing healthcare information technology
infrastructure.
“Increasingly,
all health stakeholders have the opportunity—and obligation—to leverage
health information technology systems, and the valuable data they
contain, for the development and delivery of new interventions,” state
the paper’s authors.
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Healthcare providers increasingly lucrative for pros’ ransomware attacks
Published January 17 2019, 6:06pm EST
Ransomware attacks are continuing to proliferate, as hackers have become professionals and are operating as a business.
Hackers
are no longer primarily acting alone, but in concert with each other
and sharing the rewards, according to Jason Green, chief revenue officer
at Trustifi, an email security vendor with products that include
256-bit military-grade email encryption, email tracking systems and
automated electronic postmarking of emails. Hackers are now acting as a
business and not just hacking for amusement.
“Phishing
attacks have become an economy in its own right,” Green contends.
“Providers have failed to know the value of data until patients become
victims of identity theft, because providers failed to protect patients.
It is cheap to encrypt data, but it is not done, even though providers
don’t have to worry if they just encrypt.”
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NHS Chair Lord Prior talks challenges, opportunities of digital health tech
Part
of the NHS's new 10-year plan is to make the organisation a testbed for
new health tech, such as the portal-like HealthTechConnect.
January 14, 2019
Lord Prior of Brampton, who took over last year as chair of NHS England,
has big plans for the organisation he now helps lead — many of which
were laid out in the 10-year plan announced last week. Lord Prior was
also on hand at the JP Morgan Healthcare Conference in San Francisco,
stopping by the StartUp Health Festival, where MobiHealthNews caught up
with him.
Broadly,
the organisation is working to better integrate different kinds of care
and to move its focus from treatment to prevention. Through its 100,000
Genomes Project, which met its eponymous milestone last month, he hopes
to make the UK a world leader in personalised medicine. And finally,
the NHS is increasingly focused on quickly and responsibly deploying
digital health services.
“We’re setting up what we call HealthTech Connect,
which is kind of a portal. Any digital product that any companies want
to introduce in the UK can come through HealthTech Connect straight into
the NHS,” Lord Prior said on stage at StartUp Health. “We want the NHS
to be sort of a testbed for new technology. And obviously it’s got to be
safe, it’s got to be approved and regulated, but we want the NHS to be
the most accessible healthcare system in the world for new technology.”
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Pew: Here's what APIs need to succeed for healthcare
The private sector and government have accomplished a lot and the next phase is critical to the best use of APIs.
By Tom Sullivan
January 17, 2019 09:41 AM
Application
programming interfaces are all the rage in healthcare and just about
every other industry undergoing digital transformation. And with the
release of Health Level 7’s Fast Health Interoperability Resources 4
earlier this month, the excitement around open APIs, FHIR and data
interoperability just kicked into a higher gear.
“Increasing
the use of APIs could represent a dramatic shift in how health data is
accessed, extracted, and utilized to improve patient care. APIs can help
get patients their data, support information exchange among healthcare
facilities, and enable enhanced clinical decision support tool,” said
Ben Moscovitch, project director of health information technology at Pew
Charitable Trusts.
Indeed,
the 21st Century Cures Act gives the Office of the National Coordinator
for Health IT the opportunity to advance standards around open API,
FHIR included, and to encourage vocabularies and code sets for clinical
concepts, Moscovitch added, while the private sector has been making
strides of its own.
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Here are 6 major issues facing healthcare in 2019, according to PwC
Connected
care, upskilled workers, tax reform, a Southwest Airlines approach,
private equity and the Affordable Care Act all will impact healthcare
organizations in 2019, a new PwC report says.
By Bill Siwicki
January 17, 2019 12:09 PM
The
U.S. healthcare industry is looking less like a special case, a large
segment of the U.S. economy with its own unique quirks, and is beginning
to behave like other industries, according to "Top health industry
issues of 2019: The New Health Economy comes of age," the 13th annual
healthcare report from consulting giant PwC.
So
for PwC Health Research Institute's latest report, rather than focusing
on issues only U.S. health organizations face, it for the first time is
examining how healthcare is adapting to factors common to all
industries: deals, business and tax strategy, risk and regulatory
issues, workforce trends and digital transformation. The details may be
specific to healthcare, but the business issues are shared with many
other parts of the economy.
The new report identifies six overarching issues facing healthcare in 2019:
- Digital therapeutics and connected care reshape the life sciences industry
- Your company's new, upskilled health worker of the future is you
- Tax reform has only just begun for healthcare companies
- Creating the Southwest Airlines of healthcare
- Private equity – healthcare's new growth accelerator
- The Affordable Care Act in 2019 – still alive
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Singapore’s Minister for Health outlines key responses to COI report’s recommendations
Some
of the key responses include enhancing governance and organisation
structures, a cybersecurity model with multiple lines of defence and
considerations for a tiered model of Internet access.
By Dean Koh
January 16, 2019 09:23 PM
Minister
for Health Gan Kim Yong delivered a ministerial statement on the
Committee of Inquiry (COI) report on the SingHealth cyberattack in the
Singapore Parliament on January 15 2019. In the statement, he said that
the Ministry of Health (MOH) has appointed a Cybersecurity Advisory
Committee to conduct a horizontal review of the cybersecurity governance
structures and processes across the public healthcare clusters and
Integrated Health Information Systems (IHiS), the IT agency for the
Ministry.
He also outlined four key responses to the COI report’s recommendations. The first is enhancing governance and organisational structures
as there is a “need for clearer cybersecurity risk ownership and
accountability between IHiS and the public healthcare clusters,
underpinned by a strong relationship to avoid fragmenting the Ministry’s
healthcare IT strategy.”
At
MOH, the Chief Information Security Officer (CISO) is currently also
the Director of Cyber Security Governance at IHiS but these roles will
be separated. The MOH CISO will be supported by a dedicated office in
MOH and report to the Permanent Secretary. The MOH CISO office will be
the cybersecurity sector lead for the healthcare sector. It will
coordinate efforts to protect Critical Information Infrastructure in the
healthcare sector, and ensure that the sector fulfils its regulatory
obligations under the Cybersecurity Act. For its part, IHiS will have
its own separate Director of Cyber Security Governance.
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Virtual video visits give patients more flexibility without diminishing care quality: 7 survey findings
A
majority of patients and providers agree that virtual video visits do
not offer lower care quality when compared to regular office visits,
according to a study published in the American Journal of Managed Care.
Researchers
from Boston-based Massachusetts General Hospital surveyed 254 patients
after their first virtual visit via the MGH TeleHealth Program, which
was launched in 2012 and began offering video visits in 2013. They also
polled 61 clinicians who participated in the first full year of the
program.
Seven key findings from the survey:
1. Sixty-two percent of patients reported virtual video visit quality was similar to that of office visits.
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Hospitals with value-based care contracts more likely to use emerging tech
Hospitals
that have implemented value-based payment models are more likely to
adopt technologies for population health, care coordination, data
management and analytics, according to Deloitte's "Beyond the EHR" report.
For
the report, researchers from professional services firm Deloitte
analyzed data from 4,500 U.S. hospitals between 2012 and 2016. The
analysis centered on two key questions:
1.
"Were hospitals that receive a higher share of revenue from quality and
value contracts more likely to adopt technology that supports new
required capabilities?"
2. "Which technologies were hospitals with quality and value incentives more likely to adopt?"
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Industry Voices—EHRs causing undue physician burden? Give me a break
Jan 16, 2019 12:13pm
As we enter 2019, I have been reflecting on a great couple of days I spent in DC at the ONC annual meeting in November. A major part of the focus of the IT-focused meeting was on a relatively newer topic: “physician burden.”
I get it.
The
feds have been pounding at physicians for years with the Meaningful Use
program, which has been great at gaining EHR adoption and needed
digitization of a paper-based industry, but it seems the pendulum has
finally hit a wall. There was precious little time to spend with
patients in the past and now there’s even less.
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GAO: Patient matching hampered by demographic data
Published January 16 2019, 7:20am EST
While
healthcare providers are increasingly sharing electronic health
records, they continue to face challenges in matching patients to their
EHRs, according to the Government Accountability Office.
Patients
are matched to their medical records—either manually or automatically
via software—through demographic information, such as name, date of
birth or sex.
However, a GAO audit
based on stakeholder interviews found that “inaccurate, incomplete or
inconsistently formatted demographic information in patients’ records”
is posing challenges to matching medical records. Particularly
problematic is the matching of medical records for newborns and
multiple-birth siblings such as twins, according to the report.
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GAO Highlights Need to Better Match Patient Records
Assessment spotlights Pew-backed strategies to boost electronic match rates and promote quality care
January 15, 2019
A
federal report released Jan. 15 underscores the need to improve how
patients’ electronic health records are linked among the various
doctors’ offices and hospitals where they receive care. Better matching
of these records would enhance the quality of that care and help reduce
costs.
The Government Accountability Office (GAO) report
makes clear that problems with patient matching persist and examines
strategies to address them. The 21st Century Cures Act, a wide-ranging
health bill enacted in late 2016, required the agency’s review of
current practices and ways the federal government could improve match
rates.
In its health information technology work, The Pew Charitable Trusts has identified two key opportunities to
improve matching: standardizing the way that demographic data, such as
addresses, are used by electronic health record (EHR) systems; and
examining how biometrics, such as fingerprint or iris scans, can help
link patient records. The GAO report highlights both.
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National Institutes of Health asks Fitbit users to share data
Published January 16 2019, 5:26pm EST
The
National Institutes of Health and Fitbit are encouraging users of the
activity technology to supply data to find linkages between health and
personal activity data
NIH
and Fitbit—a vendor of wearable technology –want Fitbit users to sync
their Fitbit accounts to help researchers find insights into
relationships between health indicators that include physical activity,
heart rate, sleep patterns and health outcomes.
Data
from Fitbit users will support one of the largest precision medicine
studies by building diverse data sets for research. Fitbit is the first
wearable to be used in the project, but others will be included.
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HIT Think Why healthcare has an unhealthy detection and protection problem
By John Nye
Published January 16 2019, 5:00pm EST
This
past year has been an eventful one for the world of healthcare, and we
have made some massive strides in improving the overall security
posture. As a result, many of the year-end reports and statistics are
showing that healthcare is the fastest improving vertical in terms of
information security.
Unfortunately,
this is an honor that was bestowed on healthcare because the industry
was (and still is) by far the furthest behind in the security and
privacy of networks.
The
security elements that are most lacking in the healthcare industry are
directly related to the detection of threats and protection of
information and systems. Criminals worldwide have come to the
realization that the American healthcare industry has loads of
incredibly valuable information that is not as well protected as the
less-valuable information that other industries store and protect. This
is a problem that started with the forcing of EHR adoption over a decade
ago and has only grown as healthcare has struggled to figure out how to
secure their systems with less resources than most other verticals.
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Definitive Healthcare Acquires HIMSS Analytics' Data Services
The move will allow HIMSS Analytics' clients to access HIMSS' data as well as Definitive's proprietary data.
Framingham,
Massachusetts-based Definitive Healthcare has bought HIMSS Analytics'
vendor data services business, the health information services company announced Wednesday morning.
As
part of the deal, Definitive has purchased HIMSS' subsidiaries
including Logic, Predict, Analyze, and additional custom research
products.
The
acquisition is final and Definitive will now undergo the process of
integrating HIMSS' "datasets and platform functionality," while also
improving "coverage of IT purchasing intelligence."
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Definitive Health acquires HIMSS Analytics’ data business
Published January 16 2019, 5:11pm EST
Definitive
Healthcare has purchased the vendor data services business line of
HIMSS Analytics, which includes its product lines and customized
research capabilities.
Definitive
Healthcare is a vendor of data and intelligence on hospitals,
physicians and other types of healthcare providers. The HIMSS Analytics
purchase includes research products called Logic, Predict and Analyze,
as well as customized research products.
Terms of the deal were not disclosed.
The
companies started talking some time ago about ways to give providers
the data they need via an online platform, says Jason Krantz, Founder
and CEO at Definitive Healthcare. The goal of the combination is to
enable providers to run their own data analytics to gain insight on
initiatives such as mergers and acquisitions, helping them identify
physicians they want to recruit, physician referral patterns, patient
leakage, network growth strategies and new partnerships,
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Artificial intelligence, bias and clinical safety
- Robert Challen1,2,
- Joshua Denny3,
- Martin Pitt4,
- Luke Gompels2,
- Tom Edwards2,
- Krasimira Tsaneva-Atanasova1
Introduction
In
medicine, artificial intelligence (AI) research is becoming
increasingly focused on applying machine learning (ML) techniques to
complex problems, and so allowing computers to make predictions from
large amounts of patient data, by learning their own associations.1
Estimates of the impact of AI on the wider economy globally vary
wildly, with a recent report suggesting a 14% effect on global gross
domestic product by 2030, half of which coming from productivity
improvements.2 These predictions create political appetite for the rapid development of the AI industry,3 and healthcare is a priority area where this technology has yet to be exploited.2 3 The digital health revolution described by Duggal et al 4
is already in full swing with the potential to ‘disrupt’ healthcare.
Health AI research has demonstrated some impressive results,5–10
but its clinical value has not yet been realised, hindered partly by a
lack of a clear understanding of how to quantify benefit or ensure
patient safety, and increasing concerns about the ethical and
medico-legal impact.11
This
analysis is written with the dual aim of helping clinical safety
professionals to critically appraise current medical AI research from a
quality and safety perspective, and supporting research and development
in AI by highlighting some of the clinical safety questions that must be
considered if medical application of these exciting technologies is to
be successful.
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IHiS and SingHealth fined S$1 million in total by PDPC for data breach arising from cyberattack
The financial penalties on the two organisations involved are the highest ever imposed by PDPC to-date.
By Dean Koh
January 15, 2019 02:10 AM
Following the release of the public report
by the Committee of Inquiry (COI) for the SingHealth cyberattack which
occurred in July 2018 and Integrated Health Information Systems (IHiS)
taking disciplinary action
on staff members involved in the incident and senior management team
staff, the Personal Data Protection Commission (PDPC) has imposed
financial penalties on both IHiS and SingHealth, according to an
official statement.
The
PDPC administers the Personal Data Protection Act 2012 (PDPA) in
Singapore, which aims to safeguard individuals’ personal data against
misuse and promote proper management of personal data in organisations.
PDPC’s investigations into the data breach arising from a cyberattack on
SingHealth’s patient database system, found that IHiS had failed to
take adequate security measures to protect the personal data in its
possession. PDPC has imposed a financial penalty of S$750,000 on IHiS.
-----
HIMSS19 looks at lessons learned in accelerating innovation in England
Chief
Information Officer Adrian Byrne will provide an update on University
Hospital Southampton NHS Foundation Trust's journey as a Global Digital
Exemplar.
January 15, 2019 05:41 AM
With a new Debut Square exhibit, a Developer Innovation Lab or a Healthcare of the Future
pavilion, HIMSS19 is fast approaching. This week, we caught up with
Adrian Byrne, Chief Information Officer at the University Hospital
Southampton NHS Foundation Trust, to find out how policy and technology
advances are accelerating sharing of health IT innovation in England,
and what is next for the flagship Global Digital Exemplar programme.
Q.
How is the Global Digital Exemplar (GDE) programme driving digitisation
of mental health, acute trusts and ambulance trusts in England?
A.
I am only directly involved in the acute programme. The GDE programme
has accelerated the plans of a number (16 plus Fast Followers) of acute
trusts. These were already comparatively quite advanced in terms of
digital maturity, yet it was clear the NHS does/ did not have any true
exemplars. The programme will show that full digitisation of
organisations can work in the NHS, and will show that lessons learned
can be replicated, or blueprinted.
-----
Montana Senator to VA CIO: “EHR Modernization Cannot Fail”
January 14, 2019
by Rajiv Leventhal, Managing Editor
Senate VA (Department of Veterans Affairs) Committee Ranking
Member Jon Tester has urged new VA CIO James Gfrerer to avoid past
failures as he helps to move forward the department’s EHR (electronic
health record) modernization project.
Gfrerer, an ex-marine and former executive director at Ernst & Young, was recently confirmed
by the Senate to serve as assistant secretary of information and
technology and CIO (chief information officer) at the Department of
Veterans Affairs.
One
of Gfrerer’s top tasks will be helping to update hospitals’
infrastructures as the VA continues to work on replacing the
department’s 40-year-old legacy EHR system, called VistA, by adopting
the same platform as the U.S. Department of Defense (DoD), a Cerner EHR
system. That contract was finally signed last May and the implementation project is scheduled to span over 10 years.
-----
ONC releases 'snapshot' of new interoperability standards: 4 notes
The ONC has released the 2019 reference edition of its interoperability standards advisory, according to an agency blog post published Jan. 14.
Four notes:
1.
The interoperability standards advisory conveys the ONC's latest
thinking around standards development to the rest of the healthcare
industry. It is updated throughout the year.
2.
The 2019 reference edition is a "snapshot" view of the current
interoperability standards advisory, which was updated after the 2018
comment period closed in October.
-----
NHS England digital chief moves to digital GP company
Ben Heather11 January 2019
- Juliet Bauer to join Livi as an executive
- Ms Bauer was NHS England’s first chief digital officer
- Livi holds NHS contracts to provide video GP consultations
NHS
England chief digital officer Juliet Bauer is leaving to work for one
of the new digital GP companies working on NHS contracts, focusing on
NHS partnerships.
According to an internal memo obtained by HSJ,
Ms Bauer will leave “with immediate effect” and move to the digital
company Livi in April, where she will be an executive with
responsibility across Europe and NHS partnerships. Livi, also known as
Kry in its native Sweden, holds several contracts in the NHS to provide
video GP consultations.
Ms
Bauer was NHS England’s first chief digital officer and had
responsibility for digital projects focused on patients, including the
NHS app, NHS 111 online, the NHS app library, and widening digital
patient participation.
-----
VC funding for digital health reaches $9.5B in 2018
Published January 15 2019, 7:15am EST
Last
year was a record-breaking year for venture capital funding for
healthcare IT companies, reaching $9.5 billion for the first time,
according to research firm Mercom Capital Group.
Overall,
2018 saw 698 deals with U.S. digital health companies, raising close to
$7 billion; the remaining $2.5 billion was raised by companies from
other countries. All told, there was a 32 percent increase from the
previous record set in 2017 of $7.2 billion in 778 deals.
In
particular, the highest funded tech categories last year included data
analytics ($2.1 billion), mHealth apps ($1.3 billion), telemedicine
($1.1 billion), mobile wireless technology ($847 million), clinical
decision support ($714 million) and wearable sensors technology ($703
million).
-----
IT execs see rising need to achieve interoperability
By Fred Bazzoli
Published January 15 2019, 7:22am EST
Interoperability efforts for electronic health systems in the U.S. are mired in mediocrity.
That’s
the assessment of Donald Rucker, MD, the country’s National Coordinator
for Health Information Technology. In testimony before the House Energy
and Commerce Subcommittee on Health, Rucker graded the nation’s
interoperability at, well, less than average.
In
fact, Rucker told representatives that health data exchange graded out
at C-minus overall. He said health information exchange 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.
-----
Walgreens Boots Alliance and Microsoft form digital health link
By Fred Bazzoli
Published January 15 2019, 12:08pm EST
Walgreens
Boots Alliance and Microsoft have entered a seven-year agreement to
form a strategic partnership to build digital healthcare solutions.
The
companies say they are joining forces to develop new healthcare
delivery models, technology and retail innovations. The intent is to
combine Microsoft’s Azure cloud and AI platform—as well as its ability
to make healthcare investments and retail solutions—with Walgreeens’
customer reach, retail pharmacy locations, outpatient services and
industry expertise.
As
part of the strategic partnership, the companies have committed to a
multiyear research and development investment to build healthcare
solutions, improve health outcomes and lower the cost of care. This
investment will include funding, subject matter experts, technology and
tools.
-----
Microsoft, Walgreens team up to develop new healthcare delivery models
by Tina Reed
Jan 16, 2019 10:19am
There's a new team in the race to bring innovation into the consumer healthcare space.
Walgreens Boots Alliance Inc. (WBA) and Microsoft Corp. announced
on Tuesday that they will team up to develop new healthcare delivery
models, including technology and retail innovations to disrupt the
healthcare delivery space.
The
partnership will combine Microsoft Azure—which is Microsoft's cloud and
AI platform—with Walgreens' outpatient healthcare and retail footprint,
officials said. Both companies have committed to a multiyear research
and development investment to build new healthcare solutions aimed at
improving outcomes and lowering the cost of care.
-----
HIT Think Why 2018 offered key HIPAA insights for providers
Published January 15 2019, 4:34pm EST
With
the holidays quickly receding, there was some time for reflection. I
spent some time considering different issues about HIPAA. Here are some
of my various musings about HIPAA.
- Why is it assumed that HIPAA and the goals of value-based care cannot co-exist with HIPAA as currently in place? The permissible uses and disclosures under treatment, payment and healthcare operations are quite extensive. In fact, in beginning to work on comments for submission to Office for Civil Rights (OCR) in response to the request for information, population health style concepts are already included in the definition of health care operations. Further, sharing of information among healthcare providers and payers is clearly permissible. If other parties are brought into the fold, then those parties will likely fit into one of those categories or be a business associate. In all instance, HIPAA allows utilization of the data.
- Control and use of data are essential components of most contracts. Almost every analytics, consulting or similar vendor wants to retain and keep using patient data even once a contract ends. While most such vendors are aware enough to request continued use of only de-identified data, that is not always the case. When a vendor wants to keep identifiable patient data, it suggests that the vendor does not accurately understand HIPAA. However, retention of de-identifiable data is strongly argued for since it can enable development of new tools or refinement of existing ones. To the vendors, there is an arguable tradeoff that the fees charged will be less if data can be kept or some other argument. These arguments counter the often default position of covered entities that de-identification and subsequent use can only occur with explicit permission. As with all things, neither side is right or wrong, but it is an unavoidable debate.
-----
Health-care data in the cloud? Early adopter took a giant leap, and it paid off
The
decision to go with the cloud may seem like a no-brainer now, but for
Think Research there were pros and cons to consider back in 2010
Updated January 14, 2019
A
doctor examines an X-ray on a digital tablet. This is how medical
charts could look in the digital age. Founded in 2006, Think Research
consolidates and provides data to doctors and other health-care
providers and administrators.
The
series: We look at decision makers among Canada’s mid-sized companies
who took successful action in a competitive global digital economy.
Living
up to the company’s name, Think Research’s Sachin Aggarwal thought
ahead to what the future of health-care data could look like. But the
outcome took a leap of faith.
“We
took health-care data and put it into the cloud back in 2010, when that
was completely unheard of,” says Mr. Aggarwal, who became the
Toronto-based company’s chief executive officer in September of that
year.
-----
January 11, 2019
Personal Health Records More Promising in the Smartphone Era?
As
health care delivery organizations shift from implementation of
electronic health records to optimization of these systems, the
persistent problem of patient data interoperability is becoming
increasingly relevant. Interest in accessing medical information from
hospital records and databases and providing convenient
patient-controlled portable records is increasing. Technology companies
are seeking to develop innovative solutions to meet these demands.
Interoperable
personal health records are not a novel concept; unsuccessful attempts
to collect digital patient records have been pursued by several major
technology companies. As 1 of the first 12 health care organizations to
integrate one company’s next-generation approach (Apple Health Records)
into a patient portal, UC (University of California) San Diego Health is
assessing whether this new functionality can overcome prior challenges
and catalyze systemic change toward meaningful patient-controlled
interoperability.1
Personal
health records, which are distinct from patient portals tethered to
health system electronic health records, are repositories of clinical
data managed and maintained by patients.2
These records can contain many of the same types of data as hospital
medical records including medical history, diagnostic test results, and
clinician documentation. Paper repositories have transitioned to digital
platforms that are accessible by personal computers or mobile devices
over the internet.
-----
An overview of Thailand’s healthcare sector
The
healthcare sector is poised to be one of the key economic drivers in
Thailand in the coming years, with government-led incentives and an
increasing private-sector interest moving in tandem.
By Dean Koh
January 13, 2019 10:05 PM
One
of the fast-growing sectors that have been identified in Thailand is
healthcare and it is expected to be a key driver of the country’s
economy. Deloitte estimates that the health care spending in Thailand
would have reached $18.7bn last year, growing by 8% between 2014 and
2018. The consultancy added that total spending was $12.8bn in 2013. The
medical equipment market is growing quickly as well, having risen in
value from BT25.92bn ($780.2m) in 2010 to BT38bn ($1.1bn) in 2015.
Nearly 80% of this medical equipment is imported.
The
government’s share of sector spending is the second highest in the
region, at 77%, yet private sector spending is on the rise. In 2008, the
Thai government spent BT8.2bn ($246.8m) on health care while the
private sector spent BT2.6bn ($78.3m). By 2015, the government was
spending BT12.5bn ($376.3m) for health care, while the private sector
spent BT4bn ($120.4m). Private hospitals have benefited from government
efforts to provide universal health care. Local hospitals report having
experienced sharp increases in patient numbers, and this has led
patients with the financial means to seek treatment at privately run
establishments.
-----
AI and the physician: A blessing or a curse?
HIMSS Chief Clinical Officer Charles Alessi looks at the role of AI in the digital transformation of health and care.
January 14, 2019 04:39 AM
The
interface between AI and the physician is a complex one. Some view AI
as part of the digital transformation of health and care and leverage it
as a clinical extender, while others think that all it will bring is a
damaging change to the existing role of the physician.
Like
most innovations, AI can be deployed in a variety of ways and can be
viewed as a positive development or the converse. Our attitude to change
in healthcare to innovation does however skew our stance in many
instances.
We
tend to view changes to the existing business model as potentially
deleterious unless proved otherwise, and, although there are merits to
us being cautious, mainly because we need to make sure we satisfy safety
and consistency of outcome, perhaps we sometimes overshoot the balance
between assurance and innovation and end up not innovating at all.
-----
E-Health cards to be issued from February
Monday, January 14, 2019 - 12:05
Minister
of Health, Nutrition and Indigenous Medicine, Dr. Rajitha Senaratne,
said that issuing an eHealth card in Sri Lanka would commence in
February.
As the preliminary stage it is planned to issue e-Health cards at Kalutara General Hospital, Bandaragama Regional Hospital.
The e-Health card is to be given to the public within a period of six months. The Health Ministry said,that the issuing of the e-health card allows the patient to receive treatment in any part of the country with complete patient reports of patients.
The e-Healthcare Card was introduced to Sri Lanka at the 71st anniversary of the World Health Organization on April 7, 2018. It was held at the Nelum Pokuna Theater in Colombo under the auspices of the President. The minister further stated that the people will be able to provide services sooner with the introduction of new technology.
-----
As the preliminary stage it is planned to issue e-Health cards at Kalutara General Hospital, Bandaragama Regional Hospital.
The e-Health card is to be given to the public within a period of six months. The Health Ministry said,that the issuing of the e-health card allows the patient to receive treatment in any part of the country with complete patient reports of patients.
The e-Healthcare Card was introduced to Sri Lanka at the 71st anniversary of the World Health Organization on April 7, 2018. It was held at the Nelum Pokuna Theater in Colombo under the auspices of the President. The minister further stated that the people will be able to provide services sooner with the introduction of new technology.
-----
Want to give blood? There’s an app for that.
It happens every two seconds: a person needs donated blood or platelets to survive a surgery, cancer treatment, a traumatic injury.
But
blood stocks aren’t always high enough, especially during the winter
when the holidays and nasty weather make some donations drop off. And
each year, only 3 percent of the population actually gives blood,
according to the American Red Cross, the organization responsible for 40
percent of the nation’s blood supply.
If you’ve been meaning to donate blood but haven’t, give the Red Cross Blood Donor App a try. Available for iPhone and Android, the app makes the process more convenient.
-----
Three healthcare IT trends to watch in 2019
January 11, 2019
By Morris Panner
We’re starting to see significant initiatives in Healthcare IT take shape that are fundamentally changing both the way healthcare consumers interact with providers and how providers administer care across their networks.
Consolidation of regional health systems and major mergers such as the CVS-AETNA deal continue to push forward demands for improved and streamlined Health IT systems supported by modern cloud technology. Just a few years ago, the cloud was still treated with suspicion in healthcare, and it now has moved to be a key way that health systems solve complex workflow challenges and extend medical imaging access. We’re also starting to see the spoils of tech titans such as Google, Amazon, and Apple making further inroads in Health IT, especially in the academic and research fields.
We’re starting to see significant initiatives in Healthcare IT take shape that are fundamentally changing both the way healthcare consumers interact with providers and how providers administer care across their networks.
Consolidation of regional health systems and major mergers such as the CVS-AETNA deal continue to push forward demands for improved and streamlined Health IT systems supported by modern cloud technology. Just a few years ago, the cloud was still treated with suspicion in healthcare, and it now has moved to be a key way that health systems solve complex workflow challenges and extend medical imaging access. We’re also starting to see the spoils of tech titans such as Google, Amazon, and Apple making further inroads in Health IT, especially in the academic and research fields.
As
our world becomes more global and more millennials become the
decision-makers in the workplace, healthcare may be placed with a new
set of demands to increase data access, availability, and promise secure
recovery. Here are three trends to watch in 2019:
-----
6 barriers to healthcare interoperability, according to ONC
There
are six overarching barriers limiting the electronic exchange of health
information between hospitals today, according to a report prepared by the ONC.
The
ONC filed the 22-page report to Congress as a year-end summary on
nationwide trends in health information exchange in 2018, including the
adoption of EHRs and other technologies that support electronic access
to patient information.
"HHS
is committed to the use of health IT to support the free flow of health
information for patients, healthcare providers and payers as well as to
promote competition in healthcare markets," the report reads.
Six challenges inhibiting electronic data exchange in healthcare, as described by the ONC:
-----
Health IT Roundup—Report to Congress from ONC finds too many interoperability hurdles
by Tina Reed
Jan 14, 2019 3:29pm
ONC: Too many barriers to interoperability
Patients
still often lack access to their own records, and providers often
struggle to find patient data at the point of care when multiple
healthcare providers maintain different pieces of data, according to a report to Congress from the Office of the National Coordinator.
Released
last week, the report updated Congress on the status of
interoperability efforts in health IT. Among the report's
findings, payers often lack access to clinical data on groups of covered
individuals to assess the value of services provided to their
customers. Hurdles included technical barriers, financial barriers and
trust barriers. (Report)
-----
AI combined with EHR and other data improves influenza forecasting
Published January 14 2019, 7:18am EST
With
influenza cases elevated nationally and widespread throughout the
country, researchers led by Boston Children’s Hospital contend that
machine learning can produce highly accurate local flu surveillance.
In
fact, they say that combining two forecasting methods with artificial
intelligence produces the most accurate estimates of flu activity
available to date—a week ahead of traditional healthcare-based reports,
at the state level across the United States.
While
the Centers for Disease Control and Prevention monitors influenza-like
illnesses (ILI) in the U.S. by gathering information from physicians’
reports about patients with ILI seeking medical attention, the
availability of the data has a lag time of as much as two weeks.
-----
HIStalk Announcements and Requests
A
convincing 88 percent of poll respondents who self-identify as
longstanding HIMSS members say their feelings about the organization are
less-positive now than five years ago.
Gerald
says that at least HIMSS now acknowledges that the annual conference is
a “trade show” (or a “boat show,” as Jonathan Bush always said,
although at least boat show attendees are spending their own money
instead of someone else’s) instead of claiming that its primary purpose
is education. He says he hasn’t attended a provider’s educational
session there in the past five conferences, which is about the same as
my own record.
A reader asked via a poll question what’s wrong with HIMSS. My answer as a longstanding member, off the top of my head:
- They run their operation like a dues-funded vendor, maximizing revenue at every opportunity.
- In fact, they really are a vendor, having acquired for-profit companies, conferences, and publications while somehow remaining a non-profit.
-----
January 13 2019, 12:01am, The Sunday Times
Doctor, doctor, I’m being diagnosed by robot and I’ve a bad feeling about it
Adam Kay
The Sunday Times Magazine’s new columnist thinks apps such as Babylon are dangerous for patients and the NHS
I
am a great believer in technological advances. Almost every aspect of
my home (which I found on an app, naturally) is controlled by my phone,
from my lights to the heating and the locks. I don’t always get it right
— ask the Google Glass lying forgotten in a drawer — but you can’t win
’em all with new gadgetry.
In
medicine you have to win ’em all — you’d never expose a patient to a
drug or a procedure that hasn’t been rigorously tested. These stringent
in-depth studies and strict regulatory checks exist because when things
go wrong, they can be life-altering. Life-ending, even.
It’s puzzling, then, to see the space-shuttle trajectory of the healthcare app Babylon. For the uninitiated, Babylon aims to cut
through pesky waiting times and those hours spent on hold when you call
your GP by hooking up patients with an artificially “intelligent”
Symptom Checker for the price of a Netflix subscription.
-----
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