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.
Led by Newcastle Hospitals. the partnership will deliver connected care records across the region.
This announcement forms the “information exchange” element of the GNCR.
It means staff treating patients will have access to all the relevant information needed for their care, such as medications, test results, allergies, and other pre-existing conditions.
After a few minutes of frantic workarounds, the patient — actually a medical test dummy — was wheeled out the room (prognosis: survival, but serious brain damage). The flashing ransom note was part of a simulation, designed to expose physicians like Pugsley to the very real threat of cyberattacks on their hospitals.
Researchers designed, implemented, and tested a CTX system across six care sites part of the Accessible Research Commons for Health (ARCH) collaborative as part of a pilot study exploring the effect of CTX on EHR data integrity.
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Blockchain to emerge in healthcare in 5 to 10 years
Mackenzie Garrity – 5 April, 2019
There will be an emergence of a "blockchain ecosystem with healthcare-focused use cases" in the next five to 10 years, according to
research from Frost & Sullivan.
An influx in blockchain will be seen in health data exchanges, smart assets management and insurance and payment solutions. It is rumored that blockchain will store the sensitive DNA and healthcare data.
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HIT Think The biggest threat to your data is your staff: Here’s why
Published April 05 2019, 5:51pm EDT
It’s not only reasonable to be concerned about data security, but it also’s prudent. It’s becoming increasingly necessary as organizations become more reliant on clinical data and analysis as part of operations.
However, many entrepreneurs, CEOs and technical officers end up misplacing their concerns. In addition to worrying about hackers and cybercriminals trying to force their way into an organization, HIT executives should be proactively managing its biggest threat—its staff.
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Epic, Cerner and others reveal just how their EHRs are interoperable
April 05, 2019 12:02 PM
The companies also advise healthcare CIOs on some key interoperability questions to ask any EHR vendor when considering a purchase.
Many electronic health record vendors claim their technologies are interoperable with other healthcare information systems. And these claims can be true – or true to a point.
Healthcare IT News interviewed key interoperability executives with four high-profile EHR vendors – Cerner, DrChrono, eClinicalWorks and Epic Systems – to discuss how their systems are interoperable as well as health IT interoperability overall.
Interoperability at Epic
The first basic type of interoperability is health system to health system, to coordinate care for a patient across organizations, said Dave Fuhrmann, vice president of interoperability at Epic Systems.
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Physicians more likely to prescribe preventive therapy after EHR notification, study finds
Jackie Drees -
Monday, April 1st, 2019 Print | Email
An EHR extension that determines when a patient may benefit from preventive therapy may be more effective than prescribing based solely on education, according to a
study published in March in the
Joint Commission Journal on Quality and Patient Safety .
Philadelphia-based University of Pennsylvania Health System researchers analyzed interventions that used both education and an electronic "dashboard" system integrated with patients' EHRs to determine whether cardiac patients would benefit from acid suppression therapy, which reduces risk of gastrointestinal bleeding. The electronic system pulls information from patients’ EHRs to alert physicians when an individual would likely benefit from the therapy.
Researchers found that adding the dashboard technology to EHRs resulted in an 18 percent increase in necessary medication orders. Additionally, results showed education on acid suppression therapy did not present a noticeable effect on prescribing rates.
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Identity Theft Services Inefficient at Addressing Data Breach Risks, Watchdog Says
April 1, 2019
The Government Accountability Office also recommended that Congress should reconsider allowing federal agencies how much coverage is appropriate to offer.
The Government Accountability Office is doubling down on its recommendation that Congress reconsider the identity theft insurance it requires federal agencies to offer after data breaches.
In 2017, the office
recommended Congress should let agencies determine the right amount of identity theft insurance coverage. GAO renewed the recommendation this week after
new findings further suggest that identity theft services do not effectively alleviate all data breach risks that victims face.
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Cerner touts adoption of normative FHIR R4 standard
April 04, 2019 01:53 PM
The vendor, one of the first to use the new version of the HL7 standard, is also offering advice for how providers can take advantage of the spec for better interoperability.
Three months after it was first released, the most recent version of HL7's Fast Healthcare Interoperability Resources specification has been deployed by Cerner, which is touting the normative and backward-compatible FHIR R4 as key interoperaberability standard for healthcare app developers seeking to interface with its technology.
WHY IT MATTERS
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VA joins DirectTrust's provider network for PHI sharing: 3 notes
The U.S. Department of Veterans Affairs
joined DirectTrust's Accredited Trust Anchor Bundle Network, which will allow the agency to share protected health information with participating providers.
1. DirectTrust is a healthcare industry alliance that advocates for interoperable exchange of PHI between providers and patients.
2. Under DirectTrust's network, the VA will be able to use its direct messaging system to share veterans' and patients' PHI with hospitals nationwide using the providers' EHRs.
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Report: Health-Related Data Least Likely to be Encrypted
A Ponemon/nCipher report found despite the recent spate of breaches and sensitivity of information, health data was least likely to be encrypted than other data within an organization.
April 02, 2019 - Health-related information and non-financial data are the least likely type of data to be encrypted, despite the sensitivity of health data and the recent spate of high-profile healthcare breaches, according to a recent report from nCipher and the
Ponemon Institute .
The researchers surveyed nearly 6,000 individuals across multiple industries and countries to determine how encryption use has evolved over the last 14 years and its impact on organizations’ security posture. They found Germany had the highest prevalence of encryption strategies, followed by the United States.
Adoption of encryption strategies are increasing in all sectors, with protecting sensitive information as the primary driver for adoption, according to 54 percent of respondents. However, the global adoption rate for encryption is just 45 percent.
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Lawmakers ramp up scrutiny over VA’s IT challenges, including joint program with DOD
Apr 3, 2019 10:30am
The Department of Veterans Affairs' management of key IT projects is under close scrutiny from federal lawmakers who are frustrated with what they see as rushed efforts to roll out potentially flawed software tools as well as a lack of governance for the VA's interoperability projects.
The VA's slow progress to set up a joint program office with the Department of Defense to work out differences between their separate electronic health records implementations has prompted legislators to work on a draft bill to move these efforts along. During a House Subcommittee on Technology Modernization hearing Tuesday, subcommittee chairman Jim Banks (R-Ind.) said he was drafting a bill aimed at improving accountability for interoperability efforts between the DOD and the VA.
The interagency program office, as is, “is not living up to Congress’ vision for a single point of accountability.” Banks said.
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FDA mulls new regulatory framework for AI-based medical devices
Published April 03 2019, 7:40am EDT
The Food and Drug Administration is considering a new regulatory framework to promote the development of safe and effective medical devices that leverage artificial intelligence algorithms.
FDA Commissioner Scott Gottlieb, MD, issued a written statement on Tuesday announcing that the agency was “taking the first step toward developing a novel and tailored approach to help developers bring artificial intelligence devices to market” by releasing a
discussion paper on the topic.
“We anticipate several more steps in the future, including issuing draft guidance that’ll be informed by the feedback on today’s discussion paper,” said Gottlieb. “We encourage feedback and welcome a diversity of opinions and thoughtful discourse, which will contribute to building the foundation of this regulatory paradigm. As algorithms evolve, the FDA must also modernize our approach to regulating these products.”
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HIT Think Why providers must stop reacting and start acting on security
Published April 03 2019, 5:25pm EDT
People who work in the world of information security and technology—from helpdesk to security admin, IS/IT auditor to consultant penetration tester—know there has been one overarching theme that affects almost every organization in some way: the common practice of reactive security.
This means that instead of looking to constantly improve security, keep systems up to date, perform system upgrades and so on, most organizations wait until something breaks before they even think about fixing or replacing it.
As with anything in life, the reactive model rarely leads to any sort of success and frequently forces situations to remain static at best, and often makes things much worse. The difference between reacting to issues and threats and acting ahead of time to reduce the risk is often the difference between remaining solvent and going out of business.
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Survey: Telehealth on the rise in New Zealand
April 03, 2019 04:13 AM
The increased use of telehealth supports the Ministry of Health’s goal of more cost-effective care delivered closer to people’s homes.
Telehealth is increasingly being used to connect clinicians within and between New Zealand’s hospitals and to reach into people’s homes, a new survey revealed.
The Telehealth Leadership Group’s most recent stocktake questionnaire was sent to all 20 District Health Boards (DHBs) in October 2018.
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ONC chief Don Rucker on the current state and 'next frontier' of interoperability
April 03, 2019 09:15 AM
The National Coordinator talks 21st Century Cures, information blocking, Apple, consumerism, FHIR, open APIs and new business models he sees emerging amid the "overarching theme of human choice and freedom and dignity."
Healthcare has been striving for the Holy Grail of sweeping, seamless, semantic interoperability for a very long time. Progress has been achieved over the past decade, but it's been in fits and starts, and after many years of well-meaning policy prescriptions, too many major stakeholders – whether they're
health systems ,
payers or
vendors – still cling to old ways of doing business and often jealously guard the data they've amassed.
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Tech, Health Firms Race to Help Consumers Manage Personal Data
Apple, UnitedHealth are among companies rolling out apps to gather lab results, diagnoses and other health information
By Anna Wilde Mathews
April 2, 2019 5:30 a.m. ET
Technology and health-care companies are competing to develop new ways for consumers to corral their digital
health data , prompting questions about data privacy and control.
Companies such as
Apple Inc. AAPL 1.45% and
UnitedHealth UNH -0.46% Group Inc. are rolling out online tools that consumers can use to
bring together health information now siloed in the systems of hospitals, doctors and insurers. These personal health records aim to consolidate information like diagnoses and lab results for consumers to access easily via their smartphones or computers.
The rush to create personal health records was spurred by recent Trump administration moves to expand access to such data. Other tech and health firms working to create the records include giant insurer
Cigna Corp. , companies such as Epic Systems Corp. and
Cerner Corp. CERN -1.03% that make hospitals’ electronic medical records, and a growing array of smaller startups such as Seqster and PicnicHealth.
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Racial and ethnic disparities in use of a personal health record by veterans living with HIV
Published: 28 March 2019
Abstract
Objective
To examine sociodemographic characteristics associated with use of My Healthe
Materials and Methods
Veterans Health Administration administrative data were used to identify a cohort of veterans living with HIV in fiscal years 2011–2017. Descriptive analyses were conducted to examine demographic characteristics and racial/ethnic differences in MHV registration and tool use. Chi-Square tests were performed to assess associations between race/ethnicity and MHV registration and tool use.
Results
The highest proportion of registrants were non-Hispanic White veterans living with HIV (59%), followed by Hispanic/Latino (55%) and Black veterans living with HIV (40%). Chi-Square analyses revealed that: (1) MHV account registration was significantly lower for both Black and Hispanic/Latino veterans in comparison to White veterans and (2) Black MHV registrants were less likely to utilize any MHV tool compared with White MHV registrants including Blue Button record download, medication refills, secure messaging, lab, and appointment views.
Discussion
In line with prior research on personal health record (PHR) use among non-veteran populations, these findings show racial and ethnic inequities in MHV use among veterans living with HIV. Racial and ethnic minorities may be less likely to use PHRs for a myriad of reasons, including PHR privacy concerns, decreased educational attainment, and limited access to the internet.
Conclusion
This is the first study to examine racial and ethnic disparities in use of MHV tools by veterans living with HIV and utilizing Veterans Health Administration health care. Future research should examine potential moderating factors linked to decreased PHR use among racial and ethnic minority veterans, which could inform strategies to increase PHR use among vulnerable populations.
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Physicians' trust in one another is a care safety and quality issue, experts find
If doctors don't value and trust each other, the safety and quality of patient care could potentially be compromised.
While the importance of trusted relationships between patients and their physicians is taken for granted, little attention has been given to the relationships among physicians themselves.
Yet the interactions between, for example, a patient's primary care physician and cardiologist, or between a patient's pediatrician and an oncology team, are essential to the safety and quality of care for patients and the resilience of physicians and other healthcare professionals.
In a Viewpoint article,"
Physicians' Trust in One Another ," several authors write that while trust in the physician-to-physician relationship hasn't been closely examined, it appears increasingly to be at risk.
If doctors don't value and trust each other, the safety and quality of patient care could potentially be compromised, the authors found. Trust has to be infused at every level of a health system in order for it work and function successfully.
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Tool helps prostate cancer patients make quality-of-life decisions
Published April 02 2019, 7:37am EDT
An interactive decision support platform is enabling prostate cancer patients to make more informed treatment choices based on highly personalized estimates of outcomes.
The WiserCare decision aid leverages an evidence-based data model that provides a patient-specific view of likely outcomes, risks as well as benefits so that, working with providers, they can tailor treatment options to their quality-of-life priorities.
Outcome data from a PCORI-funded Comparative Effectiveness Analysis of Surgery and Radiation for localized prostate cancer (CEASAR) study, coordinated by Vanderbilt University Medical Center, is being integrated into the WiserCare platform.
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App eases patient-doctor communication during office visit
Published April 02 2019, 5:22pm EDT
A new free mobile app from the Agency for Healthcare Research and Quality aims to help patients prepare questions for their next physician appointment.
The app, called QuestionBuilder, then helps the patient through the questions during the visit to ensure the conversation with the doctor is meaningful and informative.
AHRQ director Gopal Khanna has downloaded the app and will use it during his next appointment. “Spending just a couple minutes with the app before an appointment can maximize the time you spend with your provider at a medical encounter and help you get an accurate and understandable diagnosis quickly,” “he writes in a blog posting.
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Trim Expensive ECG Overuse with EHR Order Sets
Inappropriate electrocardiographic monitoring results in wasteful spending and decreased quality of care.
KEY TAKEAWAYS
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·
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Following
practice standards through an electronic order set boosts the appropriate use of electrocardiographic monitoring without increasing adverse events,
recent research shows.
Earlier research demonstrated that inappropriate use of cardiac telemetry results in significant wasteful spending. Over monitoring has also been associated with quality and safety concerns such as clinician
alarm fatigue .
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Eric Topol is one of the highest-value of the few people I follow on Twitter. He consumes information voraciously and summarizes it well without talking down to his audience. He loves technology, hates EHRs, and weighs in on the practice of medicine even though I suspect his practice isn’t very much like that of the typical doctor or even the typical cardiologist. He is quick to point out those seemingly great ideas that have had zero real-world validation in a healthcare setting. He also holds researchers accountable for proving improvement in outcomes – just making a lab value move in a seemingly good way doesn’t cut it with ET.
I have mixed feelings about this book. Topol provides an exhaustive (and sometimes exhausting) review of all the work that’s being done with artificial intelligence in healthcare. Trust me, it’s a lot. The downside is that this book was nearly obsolete the moment the first copies rolled of the presses, meaning I had better get return on investment for my $20.69 quickly.
“Deep Medicine” is a firehose of who’s doing what with AI. By nature, a lot of that work is early-stage, experimental, and unlikely to see front-line use for a long time. Most of all, we have no idea of how it will integrate with the US healthcare industry (and make no mistake, it’s an industry). We’re not really that much different than other industries no matter what we would like to believe.
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Nurses generally satisfied with EHRs, but key pain points persist
April 01, 2019 01:51 PM
A new KLAS and Arch Collaborative report finds that RNs generally like their electronic health records more than physicians, perhaps offering hints at improved usability.
A new report from KLAS and the Arch Collaborative finds that nearly three times as many nurses are satisfied with their electronic health record experience as those who are frustrated. Those findings suggest their may be a way to improve EHRs for physicians, who tend to be more pessimistic in general about the technology.
WHY IT MATTERS
Of the nurses polled by KLAS and the Arch Collaborative, 62 percent said they're pleased with their EHR, 20 percent said they're frustrated with the technology and 18 percent were indifferent.
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Interoperability: 3 charts take the pulse of health data sharing today
April 01, 2019 09:03 AM
New HIMSS Media research finds that nearly 75 percent of hospitals are beyond the basic level of interoperability, that best practices for information sharing are emerging and half are gearing up for APIs and FHIR.
Interoperability is at an intriguing intersection right now.
In one corner are the people suggesting that despite some $35 billion and 10 years of work since the HITECH Act under the American Recovery and Reinvestment Act kicked off the widespread digitization of healthcare very little actual progress has been achieved in terms of making data and electronic health records interoperable in actionable formats.
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Stymied by a wealth of health information: how viewing conflicting information online diminishes efficacy
Published online: 01 Mar 2019
Background: Confusing information about cancer screening proliferates even within credible sources online, particularly around mammography and prostate antigen testing. One story may emphasize the benefits of screening while another focuses on its risks. How does this contradiction affect readers of these stories?
Method: Survey participants were recruited online via social media. Across two experiments, one focusing on breast cancer risk perception and the other on prostate cancer, we randomized participants into four groups to see social media posts that contained conflicting information with or without the element of potential harm. The control group saw messages supporting preventive screening tests without conflict between posts.
Results: In both experiments, conflict was shown to reduce both self-efficacy and response efficacy. Men and women responded differently to messages that included the potential of harm from screening tests.
Conclusions: We found support for the notion that exposure to conflicting information decreases self-efficacy and response efficacy, potentially discouraging the likelihood of behavior change that could prevent cancer. The additional finding that women’s self-efficacy was reduced by uncertainty but not by the potential for harm – while men’s self-efficacy was conversely reduced by harm potential but not uncertainty – may be an important consideration in communication efforts to encourage screening.
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Identifying Priorities Is First Step to Better Outcomes
Patient Focus Begins in Waiting Room
March 27, 2019 12:17 pm
Sheri Porter – Family physicians everywhere can relate to that sinking feeling when, just as a medical visit has seemingly concluded and the physician turns to exit, the patient says, "Doc, there's just one more thing …"
It's widely recognized among primary care physicians as the "hand on the doorknob phenomenon," said Richard Grant, M.D., M.P.H., lead author of a study related to the topic that was published in the March/April issue of Annals of Family Medicine.
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KLAS Report: Nurse EHR Satisfaction Significantly Higher Than Physicians
On average, nurses report significantly higher EHR satisfaction than physicians, according to the latest
KLAS report . Today, nurses outnumber physicians in the United States four to one. The report,
The Nurse EHR Experience: An Arch Collaborative Impact Report 2019 measures the nurse
EHR experience and identifies opportunities for improvement in the nurse experience and what the nurse experience can teach other groups of clinicians about how to succeed with the EHR.
Nurses EHR Experience Difference Between Other Clinician Groups
KLAS reveals that the feedback from these nurses shows that they have a different experience with the EHR than do other clinician groups, and overall, nurses achieve significantly higher levels of EHR satisfaction than physicians—of the nurses surveyed to date, 62% are pleased with their EHR, 20% are frustrated, and 18% are indifferent. For an undetermined reason, nurses appear to get more patient-focused insights from the EHR than providers.
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March 30, 2019 01:00 AM
Healthcare leaders must embrace change or be left behind
Optum mines insurance claims and clinical data to try to reorient its healthcare operations and stem chronic diseases. The pharmacy benefit management, analytics and care-delivery division of UnitedHealth Group aims to leverage artificial intelligence and machine learning to determine who may develop atrial fibrillation, a hard-to-predict heart rhythm condition. This required a more proactive approach to healthcare, said Patty Horoho, CEO of OptumServe.
“Getting the data into the hands of clinicians so they can proactively reach out to the patients allows us to change the equation of when a disease is going to occur, to if a disease is going to occur,” she said at Modern Healthcare’s Leadership Symposium.
Harnessing the power of an ever-increasing amount of new data will shape healthcare organizations, panelists said. Crunching numbers as part of an accountable care organization helped Cleveland-based University Hospitals reveal snags in patient workflow, CEO Thomas Zenty said. Fixing those bottlenecks can guide more patients to primary-care settings rather than the emergency department, for example, he said.
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How Can Doctors Be Sure A Self-Taught Computer Is Making The Right Diagnosis?
April 1, 2019 6:14 AM ET
Some computer scientists are enthralled by programs that can teach themselves how to perform tasks, such as reading X-rays.
Many of these programs are called "black box" models because the scientists themselves don't know how they make their decisions. Already these black boxes are moving from the lab toward doctors' offices.
The technology has great allure, because computers could take over routine tasks and perform them as well as doctors do, possibly better. But as scientists work to develop these black boxes, they are also mindful of the pitfalls.
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Regulators get industry guidance for the future of ICD-10 updates
Published April 01 2019, 7:32am EDT
The National Committee on Vital and Health Statistics is suggesting recommendations to simplify adoption of future code sets and standards.
NCVHS, a public advisory body to the Department of Health and Human Services, is offering ideas for changes that would affect adoption of future versions of the code sets and related health terminology and vocabulary standards.
The HIPAA law requires HHS to review adopted standards and make modifications when appropriate, but not more frequently than annually to avoid disruptions and costs of compliance within the industry. Consequently, NCVHS has identified three recommendations for the government regarding ICD-10 version updates.
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Hospitals with breaches spend more on ads to mitigate damage
Published April 01 2019, 5:29pm EDT
Hospitals that have experienced a data breach often boost their advertising budget as part of the effort to regain the trust of patients.
The increased costs of marketing is often tied to efforts to keep patients from going to other provider organizations, according to recent published research.
Sung Choi, an assistant professor of health administration at Penn State University, and Eric Johnson, a professor of strategy at the Owen Graduate School of Medicine at Vanderbilt University, found a link between a breach and outreach to the community.
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HIT Think Why it’s essential to solve all causes of physician burnout
Published April 01 2019, 5:46pm EDT
A new Twitter account called @EPICEMRparody is garnering a lot of attention for its comments about the burdens placed upon physicians and other clinicians connected to the use of electronic medical records.
The account not only skewers the frustrating tedious work and additions to work created by EMRs, but it also recounts other points of frustration to daily practice among physicians.
As can often be said about satire, it is an easy way of getting to inconvenient and harsh truths. Cloaking an issue in humor will draw attention and quick understanding. However, when satire is all too close to the real world, then the frustration can become all too apparent.
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Enhanced data sharing and continuity of care in Denmark
1st April 2019
MedCom’s Anna Seeberg Hansen and Janne Rasmussen present an overview of MedCom’s role in the Danish healthcare system and its priorities in the area of digital health.
The demographic changes most countries are facing make healthcare a topic with extraordinarily high priority these years. At the same time, advances in, for example, medicine and technology provide new opportunities but also complexity to the present and future health and wellness domain. One aspect, which is currently prevailing in Denmark, is enhanced continuity of care, especially considering a growing elderly population, a specialisation of hospital services and increased area of responsibility for other healthcare providers such as general practitioners and homecare.
Many initiatives at national and local level have been started to develop and implement solutions for this situation, and a common agreement is that an even stronger patient-centred focus and better cross-sectorial collaboration and communication are of the essence. In this context, information and data sharing between relevant actors in a pre-agreed, structured and technically supported way plays a fundamental role.
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Enjoy!
David.
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