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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Electronic health records are still waiting to be transformed
By
April 11, 2019
Early in my career as an ear, nose, and throat physician and surgeon, two different patients came to me with the same set of bizarre symptoms. Certain noises made their eyes move involuntarily, and objects they were looking at appeared to move around in patterns. After months of careful investigation, these patients led me to discover a rare disorder called superior semicircular canal dehiscence and to develop a corrective surgery for it.
Today, anyone with Internet access can search the symptoms of superior semicircular canal dehiscence and get multiple hits for diagnosis and information about treatment. Yet most doctors who use electronic health records are years away from this kind of capability. There is no search engine to support our clinical decision making. That essential part of health care remains a practice of informed guesswork, and we are often unable to access information that could improve decisions in the moment of care and make health care far safer and more effective and efficient than it is today.
A recent article published jointly by Kaiser Health News and Fortune was a stark reminder for me that electronic health records have not yet lived up to their true potential. In addition to highlighting their inability to share information across proprietary platforms, as well as the fact that physicians report spending more time than ever on data entry rather than interacting with patients, the in-depth investigation uncovered thousands of incidents in which errors caused by faulty electronic health records harmed patients.
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Improve Medication Reconciliation, Postacute Handoff Using 2-Part Discharge Checklist
By Christopher Cheney | April 10, 2019
An effective hospital discharge process created by Cleveland Clinic is pivotal in the handoff of patients to postacute-care providers.
KEY TAKEAWAYS
· By including "the story" of a hospital stay in discharge summaries, clinicians can capture the complete picture of a hospitalization for the patient and care team.
· Implementing the discharge checklist into an EHR can support nursing staff to alert physicians about incomplete discharge documents.
· Multidisciplinary teams should be utilized to craft effective discharge checklists.
Hospital discharge is a complex process involving the primary care team, which can include residents, interns, fellows, nurse practitioners, physician assistants, and other staff members in addition to the attending physician.
Without a thorough discharge summary and completed medication reconciliation, postacute-care teams can be bewildered, and patients can be at risk of costly readmissions. Research has linked readmissions to poor communication and poor care coordination between hospitals and primary care providers.
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Is your pregnancy app sharing your intimate data with your boss?
As apps to help moms monitor their health proliferate, employers and insurers pay to keep tabs on the vast and valuable data
Like millions of women, Diana Diller was a devoted user of the pregnancy-tracking app Ovia, logging in every night to record new details on a screen asking about her bodily functions, sex drive, medications and mood. When she gave birth last spring, she used the app to chart her baby’s first online medical data — including her name, her location and whether there had been any complications — before leaving the hospital’s recovery room.
But someone else was regularly checking in, too: her employer, which paid to gain access to the intimate details of its workers’ personal lives, from their trying-to-conceive months to early motherhood. Diller’s bosses could look up aggregate data on how many workers using Ovia’s fertility, pregnancy and parenting apps had faced high-risk pregnancies or gave birth prematurely; the top medical questions they had researched; and how soon the new moms planned to return to work.
“Maybe I’m naive, but I thought of it as positive reinforcement: They’re trying to help me take care of myself,” said Diller, 39, an event planner in Los Angeles for the video game company Activision Blizzard. The decision to track her pregnancy had been made easier by the $1 a day in gift cards the company paid her to use the app: That’s “diaper and formula money,” she said.
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ACP Survey Shows Physician Interest in Implementing Telehealth
APRIL 11, 2019
Kevin Kunzmann
Telehealth has become an instrument in the majority of American College of Physicians (ACP) members’ practices—albeit by a thin margin.
New survey results presented at the ACP 2019 Internal Medicine Annual Meeting in Philadelphia, PA, today showed that 51% of ACP internal medicine physicians and subspecialists have at least 1 form of telehealth service available at their work.
The finding, which categorized telehealth services into being either video visits, e-consults, remote patient monitoring, remote care management/coaching, or patient wearable data integration, indicate the growing embrace of remote coverage measures provided by practices and institutions. The organization’s survey also showed increased interest from physicians looking to implement better telehealth practices into everyday care, President Ana Maria Lopez, MPH, said.
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New survey results presented at the ACP 2019 Internal Medicine Annual Meeting in Philadelphia, PA, today showed that 51% of ACP internal medicine physicians and subspecialists have at least 1 form of telehealth service available at their work.
The finding, which categorized telehealth services into being either video visits, e-consults, remote patient monitoring, remote care management/coaching, or patient wearable data integration, indicate the growing embrace of remote coverage measures provided by practices and institutions. The organization’s survey also showed increased interest from physicians looking to implement better telehealth practices into everyday care, President Ana Maria Lopez, MPH, said.
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Healthcare is No. 1 industry affected by data breaches: 3 cybersecurity trends
– 11 Apr, 2019
Hospitals and health systems within the U.S. account for around one-fourth of all U.S. cyberattacks, making healthcare the No. 1 industry targeted by data breaches, according to a survey from law firm Backer & Holster and cited by Corporate Counsel.
The publication interviewed healthcare attorney Lynn Sessions, who is an expert in healthcare cybersecurity. During her 20-plus year career, she has handled more than 550 industry data breaches.
Below are three cybersecurity trends noted by Ms. Sessions.
1. Phishing emails are the biggest source of data breaches, followed by inside jobs.
"The first trend is that healthcare continues to be under attack, both from outside sources such as hackers as well as through some inside jobs. Because HIPAA is the overarching law in this space, it sets a low threshold for notification purposes," Ms. Sessions told Corporate Counsel.
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Medicare ACO care coordination toolkit highlights value of health IT
Published April 12 2019, 7:33am EDT
Healthcare information technology is increasingly being leveraged by Medicare accountable care organizations to coordinate and manage care.
That’s the theme of a new Medicare ACO care coordination toolkit released by the Centers for Medicare and Medicaid Services.
“Some ACOs focus on facilitating the exchange of data between primary care providers and emergency departments, whereas others establish networks of post-acute care partners to support their mission of improving the quality and effectiveness of care,” states the toolkit. “Others developed initiatives that focus on managing the care of individual beneficiaries, such as launching a home visit program or using information technology to streamline referrals to community organizations.”
When it comes to coordinating care for beneficiaries after an emergency department visit, CMS reveals that multiple ACOs embed care managers within the ED to facilitate communication and collaboration between ED clinicians and primary care providers.
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MIT study finds decision support software trims imaging exams
By Fred Bazzoli
Published April 12 2019, 4:11pm EDT
Clinical decision support software may play a key role in helping physicians make decisions about expensive imaging exams, reducing their use.
A new study from the Massachusetts Institute of Technology finds that decision-support software could curb the overuse of costly diagnostic imaging tests by about 6 percent. The study, conducted by MIT’s Sloan School of Management, is believed to be the first large-scale randomized evaluation of the impact of CDS ; results of the initiative were published in the journal PLOS ONE.
The study is important for a couple reasons. First, the Centers for Medicare and Medicaid Services will implement new regulations next year that require imaging orders to be accompanied by a CDS recommendation in order for them to be reimbursed by Medicare. Second, there’s growing industry concerns about both the cost of the examinations and potential harmful physical effects from exposing patients to radiation from unnecessary procedures.
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HIT Think How long should it take to issue a breach notification?
Published April 12 2019, 4:29pm EDT
Notice of a new data breach is posted at least once a day. A frequent feature of many notices is the disclosure that the conduct giving rise to the breach happened months earlier, with the delay sometimes going into years in some instances.
The notices typically do not provide much insight into the reasoning for the delays, which gives rise to the question; when should notice of a data breach be provided?
The answer is seemingly straightforward. The HIPAA data breach notification rule states that, absent certain narrow exceptions, a covered entity needs to provide notice without unreasonable delay, which should be no more than 60 days following discovery of the breach.
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Ministry of Health in Germany officially launches Health Innovation Hub initiative
April 12, 2019 05:07 AM
The Health Innovation Hub will be the Ministry's bridge to the "digital scene," said health minister Jens Spahn.
In yet another step to drive the digital transformation of Germany’s healthcare system, the country’s minister of health, Jens Spahn, has now officially launched the Health Innovation Hub (HIH) in Berlin.
The HIH will be “a bridge from the Ministry of Health into the digital scene,” Spahn said. “It’s an idea factory for digital health solutions that aims at using digitisation to improve care for patients.”
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92% of Mount Sinai patients engage when prescribed an app
By Tom Sullivan
April 12, 2019 10:04 AM
Anyone paying attention is aware of the app explosion happening in healthcare today while questions persist about just how useful so many digital therapeutics actually are in a clinical setting. Work at Mount Sinai, however, is showcasing the promise of digital tools and apps.
Mount Sinai started by constructing a patient design group while developing a GI app — which ultimately lead to feedback that Atreja’s team used to flip the metrics of quality completely around. And it worked.
“We have a 92 percent engagement rate when prescribing a patient an app,” said Dr. Ashish Atreja, Chief Innovation Officer at Mount Sinai. “Now we can get their data back to engage them more.”
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What you need to know about healthcare APIs and interoperability
By Bill Siwicki
April 11, 2019 12:41 PM
Three experts discuss how application programming interfaces help enable system interoperability, and describe what the role of APIs will be in the future.
Application programming interfaces enable information systems to communicate and transfer data among each other. Depending how it is configured, an API can enable a system to send or retrieve data that can update an individual’s record or provide collective data that can be used to create reports. An API also can send information from one system to another.
A healthcare provider organization, for example, can input a patient’s information into a system that works with insurance companies and nearly automatically determine the patient’s coverage for a specific procedure or medication. That is enabled by an API.
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Two-thirds of hospitals report less than 25% of patients activated online patient portal
– 10 April, 2019
A report from the ONC found few hospitals — 8 percent — reported that 50 percent or more of patients have activated access to their patient portals.
To participate in the Medicare and Medicaid Electronic Health Record Incentive Programs, now called the Promoting Interoperability Program, hospitals must use certified EHR technology. In 2017, the program required hospitals to provide 50 percent or more of its unique discharged patients with timely access to view, download and transmit their health information.
The survey found nearly two-thirds of hospitals had fewer than 25 percent of patients activate access to the hospital's patient portal in 2017. On average, four in 10 hospitals reported that 0 percent to 9 percent of patients activated their patient portal.
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GAO: HHS Fails to Implement High-Priority Health IT Recommendations
The Department of Health and Human Services has not implemented four high-priority health IT recommendations by the Government Accountability Office.
By Fred Donovan
April 09, 2019 - The Department of Health and Human Services (HHS) has not implemented four high-priority health IT recommendations by the Government Accountability Office (GAO), according to a recent report by the government watchdog.
The four recommendations focus on improving healthcare data security at the Centers for Medicare and Medicaid (CMS), strengthening critical infrastructure protection, beefing up the public health alert network infrastructure, and improving performance measures for electronic health record (EHR) implementation.
In March 2018, the GAO recommended that the CMS administrator develop procedures to ensure that qualified entities and researchers implement robust IT security controls. CMS has hired a contractor to review its data security framework and make recommendations on how to improve IT security controls and implementation requirements that would be appropriate for those entities.
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Physician-researcher awarded federal grant to bridge evidence and practice for clinicians via electronic medical record
Northwell Health SVP working to reduce barriers and frustration faced by physicians seeking to provide the most current evidence-based care
Apr 10, 2019, 10:28 ET
MANHASSET, N.Y., April 10, 2019 /PRNewswire/ -- The US Department of Health & Human Services Agency for Healthcare Research and Quality (AHRQ) has awarded Thomas G. McGinn, MD, MPH, with a three-year, $1.14 million grant for a clinical decision support (CDS) system that reduces frontline providers' complications and frustrations. While clinical decision support has been widely available for years, healthcare providers have not adopted it widely because the systems are unwieldy and time-consuming for practitioners who are trying to access personalized clinical information and guidance in the real-time setting of patient encounters.
For more than a decade, Dr. McGinn, Feinstein Institute for Medical Research professor and Northwell Health senior vice president and deputy physician-in-chief, and his team at the Feinstein Institute's Center for Health Innovations and Outcomes Research (CHIOR) have been studying, testing, and disseminating CDS in electronic health records. They focus on clinical prediction rules (CPRs), a form of CDS that uses a variety of data, mechanisms, and patient-specific information to calculate patient-specific probabilities. CPRs increase diagnostic accuracy, reduce unnecessary testing and treatment, and enhance quality and safety. To date, however, critical variations in electronic health record systems between and even within institutions have severely limited dissemination of CDS and its adoption into provider workflow.
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Most studies evaluating AI in radiology didn’t validate the results
Published April 11 2019, 7:40am EDT
A new report has found that most research applying machine learning to review medical images never validated the outcomes obtained.
The revelation—contained in a report entitled Design Characteristics of Studies Reporting the Performance of Artificial Intelligence Algorithms for Diagnostic Analysis of Medical Images: Results from Recently Published Papers—casts doubt on whether AI research can be applied to actual patient care.
There has been tremendous interest in using artificial intelligence in radiology, primarily through convolutional neural networks. As a result, there have been thousands of studies on the subject.
However, to be useful clinically, the results need to be validated, or confirmed, using external data that was not part of the algorithm’s training, contends the report, published in KoreaMed Synapse, a journal of the Korean Society of Radiology.
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Typical data workloads increased by 569% in the past 2 years
By Bob Violino
Published April 11 2019, 4:16pm EDT
On average, organizations managed 9.7 petabytes of data in 2018, representing explosive growth of 569 percent, compared with the 1.45 petabytes managed in 2016.
That is the finding of a new study by Dell EMC. The data storage company surveyed 2,200 IT decision makers from public and private organizations across 18 countries and 11 industries, and found that the vast majority of them (92 percent) see the potential value of data and 36 percent are already monetizing it.
The bad news is most of the respondents said they are struggling to properly protect their data. About three quarters (76 percent) experienced a disruption in the last 12 months, and 27 percent experienced irreparable data loss—nearly double the 14 percent in 2016.
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HIT Think Why humans still hold the advantage in decision automation
Published April 11 2019, 4:11pm EDT
From retail to healthcare to consumer goods; from global businesses to regional operators to Etsy makers and food trucks, businesses of all sizes make a head-spinning number of decisions—using up stores of valuable and finite energy in the process. It’s not surprising then that we try to preserve this precious commodity by simplifying or automating as much as we can.
Refining a process, establishing preferred sources for raw materials and working with employees, partners and suppliers we know are all ways we “automate” decision making. In our modern era of decision automation, we increasingly use computers to process volumes of data not feasible for humans and to support decision making that we could not otherwise take on. Artificial intelligence holds the promise of computers making human-like decisions for us.
In the data and analytics business, we exist to help our clients make better decisions. Our approach embraces the reality that decision automation requires a partnership between technologists, data scientists, and business leaders (or those we like to call Geeks, Nerds and Suits). But which decisions can we automate, and what can artificial intelligence really deliver?
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Interoperability: Do we have the value proposition upside down?
By Mike Miliard
April 10, 2019 03:05 PM
AMIA CEO Doug Fridsma says healthcare should simplify its approach to data exchange: keeping a laser focus on worthwhile use cases, sharing first and standardizing later, while also taking some cues from the basic APIs that power the World Wide Web.
Dr. Doug Fridsma, CEO of the American Medical Informatics Association, has been working on the nuts and bolts of interoperability for a very long time. Prior to joining AMIA, he served as chief scientist at the Office of the National Coordinator for Health IT, leading management of the Federal Health Architecture and Standards & Interoperability Framework during the pivotal post-HITECH period.
Since then, Fridsma and his AMIA colleagues have been vocal proponents of a forward-thinking and creative approach to interoperability, with an eye toward the health system of the future – one fed as much by data from medical devices, apps and other consumer-facing technology as by the clinical elements of the electronic health records.
In a future driven by new types of patient-generated information and social determinants data, most of it coming from outside of traditional health systems, Fridsma says it's critical to think of interoperability not as a goal to be strived for, but as an ongoing process, driven by diverse stakeholders, that will continue to evolve and be reshaped by emerging developments.
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Community Health Systems makes Apple Health Records available at 100 affiliated hospitals
By Nathan Eddy
April 11, 2019 10:11 AM
The iPhone app enables patients to access data about medications, immunizations, labs and receive notifications.
Community Health Systems (CHS) announced that the Apple Health Records app for iPhones is now available to patients at approximately 100 CHS-affiliated hospitals.
WHY IT MATTERS
Apple Health Records helps users to visualize and securely store their health records, allowing them to aggregate records from multiple institutions alongside their patient-generated data, creating a more holistic view of their health.
Patients who have received care from a CHS-affiliated participating hospital can use their iPhones to receive and store details from their medical records, ranging from allergies and conditions to procedures and vitals.
Patients can also include information about immunizations, labs, and medications, as well as receive notifications whenever their data is updated.
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Why information security should be every hospital CEO's No. 2 priority (at least right now)
By Tom Sullivan
April 11, 2019 11:22 AM
Infosec is a patient safety issue and it’s critical that customers trust you. But many health systems have been investing too little for years. It’s time for that to change.
Health systems have been underinvesting in information security for a decade, some even longer, but the threat landscape has now reached a critical point. Hackers, cybercriminals and nation states are increasingly sophisticated, and have access to the same cutting-edge machine learning technologies that security teams use to protect their data. Malware has been weaponized. Grimly, there’s no end in sight.
But how to get from today’s underfunded and risk-filled reality to a more secure future state in short order?
It starts with moving infosec higher up on the CEO’s agenda – something that will in all likelihood be a difficult maneuver, but a transformative one.
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2 Apr 2019 | 15:00 GMT
How IBM Watson Overpromised and Underdelivered on AI Health Care
After its triumph on Jeopardy!, IBM’s AI seemed poised to revolutionize medicine. Doctors are still waiting
Editor’s Picks
In 2014, IBM opened swanky new headquarters for its artificial intelligence division, known as IBM Watson. Inside the glassy tower in lower Manhattan, IBMers can bring prospective clients and visiting journalists into the “immersion room,” which resembles a miniature planetarium. There, in the darkened space, visitors sit on swiveling stools while fancy graphics flash around the curved screens covering the walls. It’s the closest you can get, IBMers sometimes say, to being inside Watson’s electronic brain.
One dazzling 2014 demonstration of Watson’s brainpower showed off its potential to transform medicine using AI—a goal that IBM CEO Virginia Rometty often calls the company’s moon shot. In the demo, Watson took a bizarre collection of patient symptoms and came up with a list of possible diagnoses, each annotated with Watson’s confidence level and links to supporting medical literature.
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Provider, health IT groups praise proposed bills to change patient privacy regulations
Apr 10, 2019 8:10am
Healthcare and health IT groups are supporting recently proposed legislation aimed at reforming a patient privacy regulation by aligning it with the Health Insurance Portability and Accountability Act (HIPAA).
Healthcare provider groups and health IT associations say the confidentiality statute, known as 42 CFR part 2, can hinder care coordination and patient access. Last year, Congress reached consensus on a legislation package aimed at the opioid crisis, but the update to that regulation was not included.
Two bills have been reintroduced in Congress to renew the push to align 42 CFR Part 2 with HIPAA. Representatives Earl Blumenauer, D-Oregon, and Markwayne Mullin, R-Oklahoma, introduced the Overdose Prevention and Patient Safety (OPPS) Act in the House of Representatives and Senators Shelley Moore Capito, R-West Virginia and Joe Manchin, D-West Virgina, introduced the Protecting Jessica Grubb's Legacy Act in the Senate.
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AI systems should be accountable, explainable, and unbiased, says EU
The European Union has published new guidelines on developing ethical AI
The European Union today published a set of guidelines on how companies and governments should develop ethical applications of artificial intelligence.
These rules aren’t like Isaac Asimov’s “Three Laws of Robotics.” They don’t offer a snappy, moral framework that will help us control murderous robots. Instead, they address the murky and diffuse problems that will affect society as we integrate AI into sectors like health care, education, and consumer technology.
So, for example, if an AI system diagnoses you with cancer sometime in the future, the EU’s guidelines would want to make sure that a number of things take place: that the software wasn’t biased by your race or gender, that it didn’t override the objections of a human doctor, and that it gave the patient the option to have their diagnosis explained to them.
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DirectTrust gets accreditation to develop health data exchange standards
News Writer
DirectTrust, a nonprofit association of health IT and healthcare organizations, has taken a step forward in developing health data exchange standards.
The nonprofit announced Tuesday that it has been accredited by the American National Standards Institute (ANSI) to develop health data exchange standards to increase data sharing using Direct exchange and trust frameworks.
DirectTrust has created a trust framework, which extends data exchange to more than 106,000 healthcare organizations and supports provider-to-provider information exchange, as well as data exchange between patients and providers.
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AI, Deep Learning Start to Tackle Common Problems in Healthcare
Deep learning is moving out of the realm of the theoretical and is starting to help physicians treat everyday conditions that affect millions of patients.
April 09, 2019 - No longer the exclusive provenance of researchers and academics, artificial intelligence is quickly filtering into the everyday clinical setting.
From supporting radiologists to enhancing the impact of the patient’s voice in her own care, AI is already producing meaningful impacts on the quality and accuracy of care.
Connecting human intelligence and clinical expertise with the unparalleled data processing power of deep learning algorithms and advanced neural networks is opening up a new frontier for precise, personalized diagnostics and treatment – but not just for rare cancers or one-in-a-million genetic conditions.
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5 medical schools join AMA effort to transform doctor education
Published April 10 2019, 7:34am EDT
An American Medical Association consortium focused on developing a modernized curriculum to better prepare future physicians for the 21st century healthcare system continues to gain momentum.
AMA announced on Tuesday that five additional medical schools have joined its Accelerating Change in Medical Education consortium, bringing the total number of institutions to 37.
The 37-member consortium will support training for an estimated 24,000 medical students who will one day care for 41 million patients annually, according to the AMA.
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Apple consumer base could fuel digital disruption in care
Published April 10 2019, 5:14pm EDT
Apple’s healthcare ambitions go beyond wearables like the Apple Watch, with the company poised to soon emerge as a leader in consumer health, according to Morgan Stanley.
The company’s healthcare market opportunity ranges from at least $15 billion to a whopping $313 billion in revenue by 2027, according to estimates from a team of 14 analysts. The wide difference is appropriate given the early opportunity, they said.
“Healthcare is a market where Apple has the potential to lead digital disruption—much like what iTunes did for music or the App Store for mobile services,” analysts wrote in a 56-page report on Monday. “Based on what it has done over the last five years, we see Apple creating the building blocks of another ecosystem” that puts the consumer at the center.
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Researchers confirm hackers could tinker with medical images
Published April 10 2019, 5:00pm EDT
Research indicates that hackers can use deep learning technology to add or remove evidence of medical conditions from existing medical scans.
Researchers at Ben-Gurion University and Soraka University Medical Center in Israel have demonstrated that they are able to remove a lung cancer image from a CT scan. They intercepted and manipulated CT scans in an active hospital network with a covert penetration test.
“An attacker may perform this act in order to stop a political candidate, sabotage research, commit insurance fraud, perform an act of terrorism or even commit murder,” the researchers warn.
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Patient monitoring is evolving with artificial intelligence, sensors, smart technology, more
By Mike Miliard
April 09, 2019 03:11 PM
From brain-computer interfaces to nanorobotics, a new report from Frost & Sullivan explores leading edge developments and disruptive tech.
A new study from Frost & Sullivan takes stock of some of the rapid-fire developments in the world of patient monitoring, which is expanding its capabilities by leaps and bounds with the maturation of sensors, artificial intelligence and predictive analytics.
WHY IT MATTERS
"Patient monitoring has evolved from ad hoc to continuous monitoring of multiple parameters, causing a surge in the amount of unprocessed and unorganized data available to clinicians for decision-making," according to F&S researchers. "To extract actionable information from this data, healthcare providers are turning to big data analytics and other analysis solutions.
"Patient monitoring has evolved from ad hoc to continuous monitoring of multiple parameters, causing a surge in the amount of unprocessed and unorganized data available to clinicians for decision-making," according to F&S researchers. "To extract actionable information from this data, healthcare providers are turning to big data analytics and other analysis solutions.
The ability of such analytics to both assess patients in the moment and point toward their potential future condition had health systems investing more than $566 million in the technology during 2018, the report notes.
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WHO Drafts Global Strategy on Digital Health
Posted 08 April 2019 | By Ana Mulero
The World Health Organization (WHO) released a newly drafted four-year global strategy on digital health, with an aim to “improve health for everyone, everywhere by accelerating the adoption of appropriate digital health.”
As more health care delivery systems look to digital health to address emerging challenges, such as the rise of noncommunicable diseases, clinician workforce shortages and the aging population, barriers to the adoption and application of such tools persist due to information fragmentation, a lack of institutional support, and interoperability and security concerns, among others.
For a more integrated approach for applying information and communication technologies (ICT) to health care delivery and patient care, the global strategy on digital health was developed based on guiding principles. These call for advocating for a unified strategy to digital health initiatives, acknowledging that the adoption process is a country’s decision and promoting appropriate use.
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As more health care delivery systems look to digital health to address emerging challenges, such as the rise of noncommunicable diseases, clinician workforce shortages and the aging population, barriers to the adoption and application of such tools persist due to information fragmentation, a lack of institutional support, and interoperability and security concerns, among others.
For a more integrated approach for applying information and communication technologies (ICT) to health care delivery and patient care, the global strategy on digital health was developed based on guiding principles. These call for advocating for a unified strategy to digital health initiatives, acknowledging that the adoption process is a country’s decision and promoting appropriate use.
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How EHR downtime affects clinical outcomes
EHR downtime does not affect 30-day mortality rates, according to research published in the Journal of the American Medical Informatics Association.
EHR downtime is a planned or unplanned period when the information system is unavailable, typically for maintenance and updates. Most hospitals and health systems have downtime procedures, though if these procedures are not followed or updated regularly, downtime can pose risks to patient safety.
Researchers set out to determine what, if any, effect downtime had on clinical outcomes. They looked at episodes of EHR downtime lasting 60 minutes or more in a six-year period. They collected data on adult patients who underwent a surgical procedure at least 60 minutes long and who stayed in the hospital for more than 24 hours. This was compared to data from patients whose hospital visit did not coincide with EHR downtime.
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Study Links Enhanced EHRs to Reduced Cognitive Workload
APRIL 05, 2019
Patrick Campbell
Records (EHR) has found that basic enhancements to the EHR system could be associated with better physician cognitive workload and performance.
Investigators found that physicians who used a system with enhanced longitudinal tracking had appropriately managed significantly more abnormal test results compared with physicians using baseline EHRs.
Investigators from the University of North Carolina sent out invitations to all residents and fellows enrolled in the school of medicine at a large academic institution, stating the need for experience with using the Epic EHR software in reviewing test results to undergo the study’s simulated situations. Investigators offered a $100 gift card as an incentive for participation. A total of 40 individuals were recruited to participate, but 2 of them were excluded due to numerous cancellations. Between April 1, 2016 and Dec. 23, 2016, those 38 participants were enrolled and blindly allocated to a simulated EHR environment. Of those 38, 20 were assigned to use a baseline EHR and 18 were assigned to enhanced EHRs, which included changes intended to enhance longitudinal tracking of abnormal test results in the system.
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Investigators found that physicians who used a system with enhanced longitudinal tracking had appropriately managed significantly more abnormal test results compared with physicians using baseline EHRs.
Investigators from the University of North Carolina sent out invitations to all residents and fellows enrolled in the school of medicine at a large academic institution, stating the need for experience with using the Epic EHR software in reviewing test results to undergo the study’s simulated situations. Investigators offered a $100 gift card as an incentive for participation. A total of 40 individuals were recruited to participate, but 2 of them were excluded due to numerous cancellations. Between April 1, 2016 and Dec. 23, 2016, those 38 participants were enrolled and blindly allocated to a simulated EHR environment. Of those 38, 20 were assigned to use a baseline EHR and 18 were assigned to enhanced EHRs, which included changes intended to enhance longitudinal tracking of abnormal test results in the system.
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Partners HealthCare plans AI rollout to all its clinicians, researchers
Published April 09 2019, 7:20am EDT
Boston-based Partners HealthCare, which includes Brigham and Women’s Hospital and Massachusetts General Hospital, intends to put artificial intelligence in the “toolbox” of every clinician and researcher.
Led by the MGH & BWH Center for Clinical Data Science, Partners HealthCare plans to provide clinicians and researchers throughout the enterprise with the data, computing capacity and software needed to ensure they can develop their own AI algorithms for use in the clinical environment.
“Currently, focused and siloed pockets of domain expertise in AI reside within specific departments or labs at several large academic medical centers, but making AI an enabling technology across the field of healthcare has been a challenge for many facilities,” said Keith Dreyer, Partners HealthCare’s chief data science officer. “The truth is, you don’t have to be a computer scientist or data scientist to participate in the creation of AI—we are just starting to see increasing availability of tools to enable on-premises development of AI models by clinicians.”
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Telemedicine visits increase overprescription of antibiotics for children
Published April 09 2019, 7:29am EDT
Researchers at UPMC Children’s Hospital found that pediatric patients with acute respiratory infections were prescribed antibiotics more often during virtual visits than in-person appointments.
Their analysis of claims data in a national health plan database, published on Monday in the journal Pediatrics, show that children received antibiotic prescriptions during 52 percent of telemedicine visits, compared with 42 percent of urgent care and 31 percent of primary care visits.
In addition, UPMC researchers discovered that clinical guidelines for antibiotic prescriptions were only followed 59 percent of the time after telemedicine visits, while 67 percent of the time urgent care and 78 percent of the time primary care visits followed the guidelines.
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Specialty-specific EHR enables urgent care group to slash patient throughput time
By Bill Siwicki
April 09, 2019 03:02 PM
Among other improvements, the EHR and other systems in the suite enabled Yucaipa Urgent Care to cut patient throughput time from two hours to 30-45 minutes.
While working in the emergency room, Dr. Brian Bearie realized that perhaps 80 percent of ER activities could be done more efficiently, affordably and with a better patient experience in an urgent care setting. So he founded Yucaipa Urgent Care Center, a six-location provider organization headquartered in Yucaipa, California.
THE PROBLEM
"For this new urgent care business, I knew we needed an electronic health records company that specialized in the urgent care space to provide the functionality and efficiency required to make it work," said Bearie, president and medical director of Yucaipa Urgent Care Center. "In my experience, working with hospital-associated urgent care clinics, many were using EHR solutions built to serve larger health systems and it was clear that the ‘one-size-fits-all’ approach wouldn’t be enough."
It was important to choose technology that would serve the unique needs of the urgent care business, as the wrong EHR could result in time-consuming delays, decreased patient volumes and poor patient satisfaction, he added.
To stay competitive in the increasingly popular and competitive on-demand healthcare space and to best serve the needs of the evolved consumer patient, Yucaipa Urgent Care needed a purpose-built platform designed to serve its needs, he said.
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ePrescriptions are finally crossing borders in Europe
9th April 2019
Did you know that Croatia can now send and receive ePrescriptions across borders? Could this be the catalyst to start the exchange of ePrescriptions and Patient Summaries across Europe?
For the summer season, Croatia will dispense ePrescriptions for Finnish citizens and allow the access of Czech Patient Summaries, while Croatians travelling to Estonia can get their ePrescriptions dispensed there also.
The vast world of digital health
These exchanges will now be possible as the eHealth Network, comprising e-health agencies in Europe, agreed on 2 April 2019 that Croatia can send and receive ePrescriptions across borders and receive the patient summaries of citizens coming from other European countries.
This decision was supported by a positive vote of eHealth Member State Expert Group (eHMSEG) on 11 March 2019.
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Executive Spotlight—Karen DeSalvo on what 'frustrates' her most about healthcare—and why she gives props to the Trump administration
Apr 8, 2019 6:00am
As a former Obama administration official, Karen DeSalvo, M.D., has devoted much of her career to the dream of true interoperability.
If there's anything she learned, it's that the healthcare system won't be able to get there on its own.
"It’s a lot about technology, but where we need to get to as a country is truly putting the person first," said DeSalvo, who served as acting assistant secretary for health at the U.S. Department of Health and Human Services (HHS) in the Obama administration from 2014 to 2017. She also served as the National Coordinator for Health Information Technology from 2014 to 2016, where she set national strategy and policy on health IT.
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mHealth Data to Play Big Role in Artificial Intelligence, Analytics
mHealth data from wearable devices and patient monitoring tools will increasingly feed artificial intelligence and analytics technologies.
By Jessica Kent
April 08, 2019 - mHealth data, extracted from wearable devices and patient monitoring tools, will play a critical role in powering artificial intelligence and analytics technology in the future, according to a recent analysis from Frost & Sullivan.
The mHealth industry is expected to grow rapidly in the coming years, with people using these tools to seek solutions for common health issues.
“As mHealth rapidly gains traction, wearables, telehealth, social media, and patient engagement are expected to find adoption among more than half of the population in developed economies by 2025,” said Sowmya Rajagopalan, Advanced Medical Technologies Global Director.
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Practices risk hefty fines when employees snoop in EHRs
April 5, 2019
I recently conducted a HIPAA audit for a medical practice that came under scrutiny by its local hospital affiliate.
The issue arose after a disgruntled employee posted online comments and sent a letter to the hospital’s compliance officer indicating that the practice was in breach of HIPAA. In particular, the employee alleged that passwords were shared, information on non-patients was accessed, and employees viewed patient information beyond the scope of their employment. Such conduct, if it had occurred, would breach the practice’s own policies as well as its agreement with the hospital.
A thorough investigation found there had been some sharing of passwords but no HIPAA breach. Not a single employee had looked at a record that fell outside their job description, and not a single employee looked at a medical record outside of the practice’s own patients. At the end of the day, those individuals who shared passwords were disciplined and/or terminated. The practice also provided employees with additional training.
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Data standardization can improve EHR matching, study finds
Standardizing patients' last names and address information in EHRs can lead to more effective matching of an individual's health records, according to a paper published in the Journal of the American Medical Informatics Association.
A team of researchers from Indianapolis-based Regenstrief Institute, Indiana University-Purdue University Indianapolis, Indiana University School of Medicine in Indianapolis and The Pew Charitable Trusts analyzed four health datasets to identify a baseline matching accuracy: health information exchange records, public health registry records, Social Security death master file records and newborn screening records. Researchers then tested standardized addresses, last names, Social Security numbers, telephone numbers and full birthdates.
To evaluate match performance, the research team used four metrics: sensitivity, specificity, positive predictive value and accuracy. Results of the study showed standardizing last names and address information combined improved the matching of patient EHRs by 8 percent.
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Amazon’s Alexa can now handle protected health info
By Fred Bazzoli
Published April 08 2019, 7:05am EDT
Amazon’s Alexa voice-activated virtual assistant technology is now HIPAA-eligible, enabling healthcare organizations to build applications with the technology.
Amazon announced that the Alexa Skills Kit can be used by some covered entities and their business associates, subject to provisions of the Health Insurance Portability and Accountability Act of 1996 to build Alexa “skills” that transmit and receive protected health information.
The determination means that the new version of the Amazon technology can be used for applications that are subject to the data privacy and security requirements of HIPAA.
Within 24 hours, six healthcare payers, pharmacy benefit managers, digital health coaching companies and providers released consumer-focused uses for Alexa.
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HIT Think How to use data, IT systems to address social determinants
Published April 08 2019, 5:38pm EDT
We are seeing a fundamental shift in healthcare delivery from sick care to whole person care. The increasing emphasis on wellness and the transition from fee-for-service to value-based care is an opportunity to help populations focus on prevention and holistic care.
Moreover, most of a patient’s health journey occurs outside the hospital, with 80 percent of health experiences occurring outside of inpatient settings. With medical care accounting for a small portion of a patient’s health, healthcare providers are being forced to deeply consider and incorporate the social determinants of health in practice, especially when looking at high-impact interventions.
Healthcare professionals are problem solvers—they triage regularly and hope to effectively solve healthcare challenges. How can they be sure they solve the correct ones? Data collected today often reveals key problem areas within the hospital’s continuum of care, but it does not always address the root cause of a health issue.
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Teledentistry trialled in New Zealand’s Northland DHB
April 08, 2019 02:48 AM
The service is targeting children and adolescents initially but will expand to adult services in time.
New Zealand’s Northland District Health Board (DHB) is trialling an oral telehealth service for children and adolescents with plans to expand it to adult services over time.
The DHB is piloting the use of Zoom video conferencing technology and a specialised intraoral camera to allow dentists at Whangarei Hospital to do examinations and consultations on children at remote locations.
The first trial involved an oral health therapist operating the camera at Kaitaia District Hospital. The therapist sees the images live so is able to adjust the camera as needed and on instructions from the dentist.
Previously, the dentist would have travelled to Kaitaia and seen the patients in person.
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Nordic innovation – cross-border connected care
April 08, 2019 02:31 AM
The collaboration between Estonia and Finland was showcased in the newest issue of the HIMSS Insights eBook.
The X-Road infrastructure, implemented as a national data exchange layer in Estonia in 2001 and Finland in 2015, is facilitating the transfer of data between various information systems used across public services.
The Nordic Institute for Interoperability Solutions has been, since 2018, in charge of developing the X-Road core software for the two European countries, providing multiple solutions out-of-the-box for data exchange.
“X-Road is special because it’s an out-of-the-box solution for a national data exchange layer. It’s one of the few technologies that are ready to be implemented on a national level,” said Ville Sirviö, chief executive of the organisation.
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Forget Amazon and Google — Apple is the tech giant to watch in healthcare, according to Morgan Stanley
Apple has been getting into healthcare for years, from the iPhone to the Apple Watch and more. Investors are too focused on healthcare efforts from other tech companies like Amazon and aren't taking Apple's opportunity seriously enough, a new Morgan Stanley report says.
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Weekly News Recap
- PatientsLikeMe seeks a a buyer after the federal government’s foreign investment review committee demands that its majority investor, a China-base firm, divest its holdings
- Amazon announces the availability of six new HIPAA-compliant Alexa healthcare skills
- GAO officials tell the House Veterans Affairs Committee that the VA’s poor track record of CIO leadership has harmed its IT modernization projects and will continue to do so
- FDA names Principal Deputy Commissioner Amy Abernethy, MD, PhD to the additional role of CIO
- Walgreens says it will accelerate digitalization of the company, make executive team changes, cut costs, and redesign stores following poor quarterly results that sent shares down sharply
- A two-doctor ENT practice in Michigan closes for good and its partners retire after they refuse to pay a hacker $6,500 to restore their ransomware-encrypted systems
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World Health Day 2019: Technology, analytics are revolutionising healthcare in India
Not without its challenges, technological innovations have made leaps in healthcare in the past few years.
Rohit MA Apr 06, 2019 21:11:38 IST
The global healthcare industry is going through a transformation. There is a growing emphasis on improving the quality of care being delivered. Among other key developments, "data analytics" and "digital health" are arguably the most significant.
Wearables, sensors, artificial intelligence, blockchain and robotics, internet of medical things (IoMT), digital and virtual reality are just some of the technologies disrupting health care around the world. These technologies are helping diagnose and treat diseases, making massive improvements in the speed, quality, and accuracy of diagnosis, treatment and a better experience for patients.
All this is enabling more connected, remote and personalised services that are empowering citizens, reducing hospital admissions and deliver better health outcomes at a lower cost. The conversation is shifting increasingly towards how outcomes of healthcare can be measured. Everyone looks at access to healthcare services that isn't just easy and simple but accessible. It has become increasingly necessary for healthcare data to be digitized, since it facilitates ease in searching, accessing and retrieving crucial medical information and more.
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Free GP care to be extended to more children under agreed reforms
Saturday, April 06, 2019 - 06:06 PM
Major reforms to GP contracts will encourage more doctors to enter general practice, the Taoiseach has predicted.
Leo Varadkar said the package agreed with the Irish Medical Organisation (IMO), including a 40% funding boost of €210m over the next four years, would make being a GP a more attractive career option.
Mr Varadkar joined Health Minister Simon Harris at a healthcare centre in Dublin today as they announced details of the contractual reforms.
The agreement includes proposals to extend free GP care to children aged six to 12 on a phased basis, starting in 2020.
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Enjoy!
David.
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