Saturday, April 06, 2019

Weekly Overseas Health IT Links – 6th April, 2019.

Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Allscripts Partnership to Deliver Integrated Patient Portal Tool

The integration will allow patients to access the patient portal and other tools on one platform.

March 27, 2019 - EHR vendor Allscripts will be partnering with Ephraim McDowell Health to enhance its patient portal tool, FollowMyHealth, the company announced.
The enhancement efforts will center on creating a more holistic patient engagement technology experience. While the current patient portal model is useful for creating patient data access and facilitating secure direct messages with patients and providers, Allscripts and Ephraim McDowell Health plan to create an all-encompassing patient experience.
“Innovative providers across the United States are realizing that FollowMyHealth offers the most comprehensive and integrated enterprise and mobile patient engagement platform on the market,” said Allscripts senior vice president Raj Toleti. “By adopting a strategy that goes beyond the portal, they are significantly improving the patient experience for millions of people, driving digital transformation that enhances their health and the caregiver’s bottom lines.”
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Employee mistakes and system errors are a larger threat to data security than hackers or insiders

By James Sanders
Employee mistakes were ranked as the highest risk in the 2019 Global Encryption Trends Study, though employee-owned devices on company networks deserve more security scrutiny.
When it comes to assessing security risks, exposure of sensitive data is most likely to result from human error when handling data and malfunctions of systems and processes designed to protect data, according to the 2019 Global Encryption Trends Study, published Thursday by nCipher Security and the Ponemon Institute. More than half (54%) of respondents indicated employee mistakes were the largest risk, while 30% cited system or process malfunction in the survey question, for which more than one choice was permitted.
These concerns outweigh those of targeted attacks by hackers and malicious insiders, with 30% of respondents citing hackers, 22% citing temporary or contract workers, and 21% citing malicious insiders, the report found. Third-party service providers were cited by 19% of respondents. Concerns of government interference—both lawful and eavesdropping—were not priority concerns, cited by only 11% and 12%, respectively.
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HIT Think How health information exchange serves diverse New Mexico

Published March 29 2019, 5:20pm EDT
New Mexico is a place of contrasts. It has far more sheep and cattle than people—there are only about 12 people per square mile. By contrast, New Mexico is also the home to two large national laboratories that have provided innovations from the atomic bomb to national security, space exploration, nuclear fusion, renewable energy, medicine, nanotechnology and supercomputing.
As would be expected in this complex and rural place, there are challenges with access to healthcare. Many of the state’s healthcare locations are geographically dispersed, spanning a multitude of remote areas and sovereign nations. They use numerous forms of paper and electronic health records, and their willingness to share and collaborate varies widely. This effectively creates barriers to delivering high-quality, safe and coordinated care.
The New Mexico Health Information Collaborative (NMHIC) was created as a community resource with the goal of providing high-quality, comprehensive, secure information and knowledge when and where it is needed to facilitate optimal healthcare for state residents.
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Draft Global Strategy on Digital Health

From: Digital Health
Sent: Saturday, 30 March 2019 12:54 AM
To: Digital Health
Subject: WHO is launching virtual consultation on the Global Strategy on Digital Health on 29 March - 30 April
Dear all,
The World Health Organization would like to invite you to participate in a virtual public consultation on the Draft Global Strategy on Digital Health, which will take place over the course of a month, from 29 March to 30 April 2019.
Use of digital technologies to improve public health as well as individual health and well-being is growing rapidly. This field, also referred to as digital health, has been recognized as instrumental in delivering the Sustainable Development Goals (SDGs) and achieving universal health coverage (UHC).
WHO Member States reiterated the importance and role of digital health in the recent resolution WHA71.7 which highlights “recent progress in the development and implementation of digital health strategies, policies, legislation and programmes by Member States, WHO and partner organizations”.
At the same time, the resolution requests the development of a Global Strategy on Digital Health, in close consultation with Member States and with inputs from relevant stakeholders.
The field of digital health involves a wide range of stakeholders from policy-makers to technology developers, healthy individuals and patients. The target audience for this consultation is all stakeholders active in the digital health arena, who are welcome to submit their comments. These could include policy-makers and officials from governments and nongovernmental organizations, UN agencies, donors, health care professionals and their organizations, health managers, academic and research institutions, individuals, patients and their associations, youth groups, ICT professionals and their associations and private companies. All are invited to read the draft Strategy and encouraged to contribute comments.
The draft Strategy and the online consultation are available at https://extranet.who.int/digitalhealthstrategy-consultation.
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Workers Push Back as Companies Gather Fingerprints and Retina Scans

Lawsuits challenge firms over how biometric data gets collected and stored

By Te-Ping Chen
March 27, 2019 10:52 a.m. ET
As more companies track their workers with fingerprint and facial scans, employees are increasingly challenging firms in court over how that biometric data gets used and stored.
Scores of lawsuits have been filed following a recent state Supreme Court ruling in Illinois, which has the most stringent privacy law protecting such information in the U.S. The suits assert that employees weren’t told what would happen to their biometric data and that it is being put at risk.
“The floodgates have opened up,” said Al Saikali, an attorney with Shook, Hardy & Bacon who heads the firm’s privacy and data security practice.
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ECRI Institute, EHR Association develop new opioid prescribing guidelines

Jackie Drees - Print  | Email
The ECRI Institute and EHR Association released new recommendations for safer opioid prescribing through EHRs.
To draw up the new guidelines, the EHRA sought expertise from EHR designers and developers. The experts analyzed data from the EHRA and ECRI Institute's joint collaborative, the Partnership for Health IT Patient Safety, as well as various patient safety organizations.  
The Partnership for Health IT Patient Safety issued three main recommendations for healthcare providers:
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Report: Global telemedicine market will hit $130B by 2025

Roughly half of the market will be within the US alone, although China and India are also poised for growth.
March 26, 2019
A recent report is projecting that the global telemedicine market will expand from its current $38.3 billion valuation to $130.5 billion by 2025.
According to the study by Global Market Insights, this 19.2 percent compound annual growth rate (CAGR) will be largely fueled by worldwide telecommunication network developments, market opportunities in rural areas or those without easy access to healthcare services, and the continuing integration of healthcare and IT market sectors.
However, inconsistent reimbursement for telemedicine services and little awareness of telemedicine among developing economies will hamper some growth opportunities.
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CMS launches Artificial Intelligence Health Outcomes Challenge

Published March 28 2019, 7:18am EDT
The Centers for Medicare and Medicaid Services, along with the American Academy of Family Physicians and the Laura and John Arnold Foundation, will award as much as $1.65 million for AI healthcare solutions.
According to CMS, the goal of the competition is to develop AI-driven predictions that providers participating in Center for Medicare and Medicaid Innovation models could use to reduce the burden to perform quality improvement activities and make quality measures more impactful.
“The Artificial Intelligence Health Outcomes Challenge is an opportunity for innovators to demonstrate how artificial intelligence tools—such as deep learning and neural networks—can be used to predict unplanned hospital and skilled nursing facility admissions and adverse events,” says CMS Administrator Seema Verma.
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CVS uses text messaging to save health plans money

Published March 28 2019, 7:37am EDT
To help fight the rising tide of specialty drug costs, CVS Specialty has been elevating its digital tool capability for drug management and integrating it with its care coordination programs.
A glimpse of the specialty drug cost burden is evident in recent reports. Ten countries, including the U.S. and European countries, will spend an estimated $318 billion on specialty medication in 2018, representing 41 percent of their overall drug spend, says a new report entitled, “2018 and Beyond: Outlook and Turning Points,” by IQVIA Institute.
Express Scripts’ latest Drug Trend Report says specialty medication spending increased 9.4 percent in 2018, with specialty medications now accounting for 44.7 percent of the total drug spend—an increase of 3.9 percent from 2017.
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HIT Think How AI is contributing to improvements in healthcare

Published March 28 2019, 5:41pm EDT
A recent trade news article suggests that current artificial intelligence applications in healthcare may not be “sexy,” but plenty of solutions are having a positive impact on healthcare delivery and operations.
Natural-language processing, for example, is an AI technology helping healthcare providers extract key information from unstructured text to glean quantitative, actionable insights. About 80 percent of clinical information is unstructured text, making a vast amount of rich patient data difficult to access for clinical decision-making or research studies.
NLP tools, however, make unstructured data usable by facilitating queries for the identification and extraction of key concepts from large volumes of data. Findings can then be transformed into structured data for analysis, visualization or integration with structured data in data warehouses.
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NHS Digital ‘not going anywhere’, says Hancock’s chief technology advisor

March 28, 2019 12:03 PM
The health secretary unveiled plans for the creation of a new unit called NHSX earlier this year.
NHS Digital “is not going anywhere” despite the creation of NHSX, promised Matt Hancock’s chief technology advisor, Hadley Beeman this week.
Speaking at the Digital Health Rewired conference, Beeman outlined the vision for NHSX, the new unit for digital data and technology announced by the health and social care secretary last month.  
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Implementation best practices: Clinical communication in the spotlight

March 27, 2019 04:45 PM
Three experts offer suggestions and tips for healthcare CIOs working with clinical communications hardware and software.
Communication between caregivers and others throughout a healthcare organization, be it a health system or hospital or group practice, is critical. Any hiccups in communications can directly impact patient care or even cause medical errors.
Healthcare communications technology has come a long way since the days of pagers and landline telephones. Today smartphones are everywhere, mobile apps and portals are connecting caregivers and caregivers not to mention caregivers and patients, and doctors and nurses are communicating via other healthcare information systems.
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Drone Delivers Lab Samples to WakeMed Hospital: Healthcare's Kitty Hawk Moment?

By Mandy Roth  |   March 28, 2019

WakeMed explores technology with UPS and Matternet, launching first FAA-sanctioned, revenue-generating drone flight in U.S.

KEY TAKEAWAYS

·         As it scales, technology presents opportunity for disruption of healthcare delivery and design.
·         First flight involved payload of lab samples transported across the WakeMed campus.
·         The vision is to create a network to transport materials throughout the WakeMed system to centralized locations, freeing up space at other facilities.
More than a century ago, the Wright Brothers launched the first manned aircraft flight, landing the plane 120 feet from its starting point on the beach at Kitty Hawk, North Carolina.                      
This week, 200 miles away, a Matternet drone bearing a load of lab samples flew from one building on the campus of WakeMed Health & Hospitals in Raleigh, North Carolina, across busy streets to the main hospital. The unmanned aerial transport, which is a new service launched by UPS, marks the first revenue-generating flight in the U.S. sanctioned by the Federal Aviation Administration.
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Who's Assessing the Quality of Quality Measures?

Studies call into question how well some of them work

  • by David Nash, MD, MBA, FACP March 25, 2019
Two decades ago, "To Err is Human" exposed egregious shortcomings in the quality and safety of U.S. medical care; its sequel, "Crossing the Quality Chasm," spurred an unprecedented stakeholder response.
What followed was a veritable explosion of quality and safety measurement and reporting, with the Centers for Medicare & Medicaid Services (CMS) as the movement's de facto epicenter; and, inevitably, provider performance on quality measures was tied to financial incentives and penalties.
Recently, one CMS quality incentive program has come under fire.
The Hospital Readmissions Reduction Program (HRRP) -- often cited as a success story for value-based payment -- was designed to reduce preventable hospital readmissions among Medicare beneficiaries by penalizing hospitals with higher-than-anticipated 30-day risk-adjusted readmission rates for targeted conditions -- i.e., acute myocardial infarction, heart failure, and pneumonia.
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61% of CIOs worry about malicious insider threats, survey finds

Published March 25, 2019

Dive Brief:

  • Though most IT leaders think accidental security risks are more likely, 61% believe there are employees "maliciously" putting them at risk, according to Egress' data breach survey of about 500 U.S. and U.K. tech leaders and about 4,000 U.S. and U.K. employees.
  • The majority of IT leaders, 79%, believe employees have unintentionally invited security risk at their companies in the last 12 months, according to the survey. Nearly half of IT leaders expect their company to experience a targeted data breach in the next year.
  • The bulk of insider data breaches, 60%, are a result of employees rushing or making mistakes, followed by a lack of awareness at 44%, lack of training or tools at 36% and intentionally leaking data "to harm the organization" at 30%.

Dive Insight:

 Ignorance is security's Achilles' Heel. Insider threats may be scarier when employees don't believe they're doing anything wrong. 
About one-third of companies view security as a threat to business growth, but a single cybercrime can rack up $13 million in cost, not to mention the cost of rebuilding brand trust and image.
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CMS offers up to $1.6M in AI challenge for better healthcare prediction tools

by Tina Reed 
Mar 27, 2019 3:18pm
Officials said the central goal of a new CMS AI challenge is to develop artificial intelligence-driven predictions that healthcare providers and clinicians participating in CMS Innovation Center models can use. It is open to innovators from all sectors, officials said. (Sergey Tinyakov/GettyImages)
Details are finally out about a new artificial intelligence challenge aimed at creating tools to better predict patient health outcomes. 
The Centers for Medicare & Medicaid Services (CMS) announced on Wednesday it is launching the CMS Artificial Intelligence Health Outcomes Challenge with the potential for projects to win up to $1.65 million. It was created in partnership with the American Academy of Family Physicians and the Laura and John Arnold Foundation.
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Securing data now means improving identity management

Published March 27 2019, 7:41am EDT
When he’s not starring on Shark Tank, Robert Herjavec is running a burgeoning data security company. And business is booming, especially in healthcare.
It’s well known that hackers are going for patients’ medical records and not credit card and Social Security numbers. The values on those have decreased to less than a dollar a number, while medical records have risen on the dark markets, Herjavec noted Tuesday at the InstaMed Healthcare Payments Summit in Philadelphia.
The risk for healthcare organizations goes beyond the damage to reputation and the direct cost of remediating the breaches, he says. The biggest fears he sees from healthcare organizations are the risks of running afoul of the Payment Card Industry Data Security Standard and the General Data Protection Regulation, says Herjavec, who heads Herjavec Group, a security solutions integrator that is one of Canada’s fastest growing technology companies.
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Improved outcomes, interoperability remain goal for Da Vinci Project

Published March 27 2019, 6:11pm EDT
A healthcare stakeholder initiative meant to address the needs of value-based care continues to make progress, according to Steve Lazarus, president of Boundary Information Group, a health IT consultancy.
The Da Vinci Project’s goal is to focus on patient outcomes by ensuring that physicians and other providers have access to the right clinical data at the right time as well as insurance benefits—all to enable effective care coordination.
Da Vinci stakeholders are leaders and health IT specialists working to accelerate the adoption of HL7’s FHIR and make it the standard to support value-based care across communities, which will promote interoperability.
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Understanding the role and need of a data protection officer

Published March 27 2019, 7:36pm EDT
Introducing the Data Protection Officer
Based on our experience in our law firm, you should be considering a data protection officer. As the name suggests, this is an officer-level position dedicated to the protection of your data. People typically confuse this role with the roles of the chief information officer, chief data officer, or chief technology officer.
Each position’s responsibilities are actually different, although one of those individuals could technically fulfill the role of DPO. If data protection is a clear part of their job this may make sense. The real difference though, is that none of those other C-level roles is mandated by Europe’s General Data Protection Regulation.
The GDPR applies to companies that market or sell to Europe, even if the company isn’t itself located in the European Union. And even if your company does not have a presence in Europe, the concept of appointing a competent, capable individual to oversee your data security and privacy policies is simple good sense, regardless of whether it is a legal requirement, for reasons we set forth below.
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Industry voices concerns about proposed HHS interoperability rules

Published March 27 2019, 7:17am EDT
Making electronic health information accessible to patients and providers is the goal of two proposed Department of Health and Human Services rules. However, stakeholders question whether the aims are achievable as currently written.
In accordance with provisions of the 21st Century Cures Act, the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT have released separate—but related—proposed rules pressing the healthcare industry to improve interoperability.
CMS is proposing requirements that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges must provide enrollees with immediate electronic access to medical claims and other health information electronically by 2020.
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HIT Think How to maintain security control with a mobile workforce

Published March 27 2019, 11:25am EDT
The Polar Vortex caused extreme weather across the U.S. in recent weeks, and along with it, an uptick in the number of remote workers.
The ability to do our jobs from outside the corporate walls keeps workers productive and helps businesses remain operational. Or in some cases, saves the organization travel fees, especially those caused by rescheduling or canceling hotels and airfare during inclement weather.
Beyond the seasonal spikes, many organizations are adopting more flexible work policies. The number of U.S. mobile workers is expected to grow to 105.4 million, or more than 70 percent of the population, by 2020.
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Researchers in the UK call for better use of tech in social prescribing

March 27, 2019 03:40 AM
Tech could be used to tackle the UK's loneliness epidemic, according to a new report.
Smart devices should be used in social prescribing schemes in the UK to improve the quality of life of older people suffering from loneliness, according to a new report by consultancy WPI Economics, commissioned by Vodafone.
"GPs and health services should include technology (for example wearable devices, monitoring systems or classes providing lessons on how to use technology) in social prescribing schemes. 
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John Halamka: Japan to emerge as the leading learning lab for digital health innovation

March 27, 2019 09:01 AM
As the world deals with aging populations, the Harvard professor and veteran CIO looks at how Japan has the urgency, vision and support to change care delivery models in ways that other countries would be smart to emulate.
As the International Healthcare Innovation Professor at Harvard Medical School, I travel 400,000 miles each year, studying the social, cultural, political, economic, and technological aspects of healthcare delivery throughout the world. In the past year, I visited 14 countries.
Every society has unique strengths, weaknesses, opportunities, and threats. However, healthcare challenges are very similar around the globe. In my view, Japan will emerge as the leading learning laboratory for digital health innovation, providing the world with technology and policy lessons learned.
In most countries, societies are aging. Japan, Sweden, Germany, Italy, and the U.S. have or will soon have more than 25 percent of their populations over the age of 65. At the same time that the population is aging and consuming more healthcare, birth rates are falling such that there will be fewer young workers paying for the care of the aging. And to make matters worse, medical schools are not graduating enough general practioners (also called primary caregivers) to meet the rising demand for care management.
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As patients tell apps they’re feeling suicidal, digital health startups scramble to respond

March 25, 2019
SAN FRANCISCO — Digital health apps, which let patients chat with doctors or health coaches or even receive likely medical diagnoses from a bot, are transforming modern health care. They are also — in practice — being used as suicide crisis hotlines.
Patients are confessing suicidal thoughts using apps designed to help them manage their diabetes or figure out why they might have a headache, according to industry executives. As a result, many digital health startups are scrambling to figure out how best to respond and when to call the police — questions that even suicide prevention experts don’t have good answers to.
“To be honest, when we started this, I didn’t think it was as big an issue as it obviously is,” said Daniel Nathrath, CEO of Ada Health.
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Most Young Patients Say EHR Technology Improves Care Quality

Only 6 percent of surveyed patients reported that EHR technology has worsened care quality, and 57 percent of young patients say care has improved.

March 25, 2019 - The majority of patients aged 18-29 say EHR technology has improved care quality, while nearly half of young patients say EHR use has improved provider communication.
These findings come from a recent data note from the Kaiser Family Foundation, which draws upon survey responses from nearly 2,000 patients.
The survey used data from the January 2019 Kaiser Family Foundation Tracking Poll to analyze patient opinions of EHR systems. While most young patients maintain EHR technology has improved care delivery, general public opinion about the benefits of EHR use has dipped since EHR adoption became mandatory in 2009.
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IT needs to make mobile unified communications a priority

As more corporate workers rely on mobile devices, enterprises need to adopt mobile unified communications, which is easier to scale and manage than wired UC.

The need for safe, reliable, and easy-to-use communications tools has given rise to unified communications (UC), a strategy that integrates multiple communications modalities under a single management and security umbrella. The result is more effective communication, improved collaboration, and a boost to security and regulatory policies. Now that mobility is the primary networking vehicle for end users, it’s time for IT departments to make mobile unified communications (MUC) a priority.
The most important benefit of MUC is the ability of organizations to finally leave behind the uncontrolled, untracked mish-mash of consumer-centric, carrier, and third-party communications tools traditionally applied over the years. Communications are a critical organizational resource; MUC is a much easier vehicle to manage and scale, and MUC offers the visibility and control that’s essential to enterprise IT deployments. These advantages will enable MUC to become the dominant provisioning strategy and mechanism for organizational communications over the next five to 10 years.
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How can boardrooms effectively manage cyber risk?

CFOs must help devise and enable strategies that promote cyber security, says Neil Hare-Brown, CEO of consultancy STORM Guidance.
Neil Hare-Brown
The frequency and severity of cyber attacks are on the rise around the world, making it more important than ever for finance directors to be involved in the fight back.
No longer is it acceptable for CFOs to focus purely on numbers, they must help devise and enable strategies that keep the business profitable. This must include promoting cyber security; the consequence of an attack could be disastrous.
Within the financial director’s remit is a responsibility to alert the board on the financial impact of a potential breach, while also ensuring that a budget is allocated for preventing and containing incidents. As most financially focused attacks directly threaten the company balance sheet, it is vital that CFOs are aware of those strategies which make their organisations resilient to cyber-attack.
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EHR vendor Medhost disputes its product is flawed

Published March 26 2019, 5:54pm EDT
A whistleblower lawsuit filed against Community Health Systems charging the company with defrauding the United States Government of hundreds of millions of dollars is not the first time that CHS has agreed to a huge settlement for misconduct, imposed by the Department of Justice.
Health Management Associates, a subsidiary of CHS, in September 2018 agreed with the Department of Justice to pay more than $260 million for misconduct in emergency departments that included engaging in unnecessary admissions to CHS hospitals.
In a new lawsuit that until now has been filed under seal, two former employees of Community Health Systems contend that the electronic health record product of software vendor MEDHOST, which CHS uses, has flaws that could endanger patients.
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Standardizing data in EHRs could improve patient matching, study says

March 25, 2019 11:43 AM
Agreeing to the same format for demographic data would boost patient safety, according to research from Indiana University and Pew.
The standardization of demographic data like home addresses or last names could boost patient matching accuracy, according to a new report.
WHY IT MATTERS
The study, recently published the Journal of the American Medical Informatics Association, was led by researchers at Indiana University and supported by The Pew Charitable Trusts.
The report also noted that while many of the standards, such as the U.S. Postal Service address, are already in use in other settings, they are not consistently used when it comes to matching in healthcare.
THE BIGGER TREND
Standardization and commitment from both the private and public sector to make changes to advance patient safety is practically a must as inaccurate patient medical histories and duplicate charts currently plague the U.S. healthcare system.
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5 Ways Health Systems Can Use a Clinical Decision Support Tool to Provide Better Care

By Mandy Roth  |   March 26, 2019

Improve the patient experience and help physicians become more efficient and effective using an innovative diagnostic tool.


KEY TAKEAWAYS

·         VisualDx provides a way to keep up with current protocols and practice evidence-based medicine.
·         The tool delivers an effective way for PCPs and ED physicians to deal with dermatological issues.
·         The tool helps guide diagnostic processes in a way that EHRs cannot.
In an era when physicians are burdened by the complexity of the electronic health record (EHR), adding another tool to their clinical practice mix is sometimes met with resistance. VisualDx appears to be one innovation cutting through the clutter and is used by physicians at health systems because it provides ways for them to perform their jobs more efficiently and effectively, some physicians say.
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As 5G looms, most hospitals watch from the sidelines

Published March 21, 2019
As Rush University Medical Center prepares to unveil preliminary results from the first hospital 5G network in a matter of months, health systems are in limbo, waiting to see which way the wind blows on the technology before taking any major strides for adoption.
AT&T's January announcement that it was bringing 5G coverage to Rush was one of the first concrete forays of the tech into the healthcare space.  While experts predict little industry-wide change anytime soon, potential benefits include increased use of telemedicine, firmer patient control over personal health information, streamlined hospital communications and lower costs.
"If you don’t have a reliable network that takes in information in lickety-split time, how are you going to do healthcare?" Shafiq Rab, SVP and CIO at Rush, told Healthcare Dive.
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Medical Device Risk Extends to Network, Apps, CHIME tells FDA

In its response to the FDA draft guidance on premarket medical device cybersecurity, CHIME urged the FDA to expand its definition of medical device risk to include more of the health IT ecosystem.

March 20, 2019 - Threats to patient safety extend beyond medical device risk, and the Food and Drug Administration should expand its definition of devices to include the whole health IT ecosystem, CHIME told the FDA in its response to draft guidance on premarket medical device cybersecurity.
CHIME CEO, President Russell Branzell and Sean Murphy, AEHIS Chair, on behalf of CHIME and AEHIS members, wrote that the groups support several FDA policy proposals, including the draft guidance that will address the “serious threats to patient safety stemming from cybersecurity threats to medical devices.”
However, medical devices are part of a healthcare organization’s ecosystem, and, as such, the FDA should expand its definition of medical device risk to capture all risks posed by medical devices.
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4 IT Trends from the HIMSS 2019 Forecast

With pressures like value-based care and the silver tsunami coming to a head, this year is likely to be an eventful one for healthcare providers and IT teams.
by Juliet Van Wagenen
Healthcare is zooming forward at an accelerated rate of change, facilitated by a number of factors that make traditional healthcare models impossible to maintain.
Perhaps no one says it better than Russell Branzell, president and CEO for the College of Healthcare Information Management Executives, who recently told HealthTech that the healthcare industry at large is at a major inflection point.
“Alongside large-scale changes like payment reform, the shift toward consumerism and globalization, we’re entering a new era of technology, fourth-revolution technology, which encompasses 5G, artificial intelligence, neural networking, drones and chatbots — not to mention that mobile devices have matured to the point where there are very few, if any, communication limitations,” he says.
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Kaiser Permanente's Bernard Tyson makes case for technology in the wake of viral telemedicine story

Mar 25, 2019 8:39am
NEW YORK CITY—About one in five Americans experience a mental illness in a given year, and Kaiser Permanente is working to use analytics to better predict when patients who suffer from depression or other mental health issues might need targeted services and support.
It's just one of the examples where Kaiser sees technology playing a crucial role in helping better address the needs of patients, CEO Bernard Tyson told FierceHealthcare at the Total Health Forum. The forum, sponsored by Kaiser Permanente and the National Basketball Association, focused on strategies to address mental health as part of overall health with a specific focus on adverse childhood experiences.
His talk came just weeks after another use of technology at a Kaiser facility sparked a firestorm of criticism after the story about a family incensed with the use of telehealth to tell a patient about his terminal illness went viral.
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HIStalk Interviews Grahame Grieve, FHIR Architect and Interoperability Consultant

March 25, 2019 Interviews, Investor's Chair No Comments
Grahame Grieve is a principal with Health Intersections of Melbourne, Australia and was the architect-developer of HL7’s Fast Healthcare Interoperability Resources (FHIR, pronounced “fire”) specification that allows EHRs to exchange information.
Was it weird to see FHIR as the only universal topic of HIMSS19?
Not so much weird. Obviously it was gratifying for us to see the community investment that so many people have made becoming justified. It’s definitely worth saying that we really value HIMSS’s active participation in driving the conference in that direction. There was an organicness to the fact that FHIR became the big issue given the way the industry overall is, but HIMSS definitely actively drove that and that was an important part of the picture. I thank Hal for pushing that.
I thought there was maturity at the HIMSS meeting this year. You and I talked about bad FHIR puns and expected to see them all over the place, but we didn’t actually see anything like that. We saw instead quite a lot of maturity around the discourse and the challenges of sharing data. I thought that was really good.
I always call you the father of FHIR without asking you if you accept that title. Is it fair or unfair to call you that?
I did initially draft it and propose it and I’ve curated the passionate community input over the years. If that makes someone the father, then I guess I am. The community is the real father. I get undue attention as if it was some magic that I achieved, where actually it’s just thousands of people passionately contributing to the common values that we hold.
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HIT Think What healthcare can learn from Facebook’s privacy-focused vision

Published March 25 2019, 5:47pm EDT
Mark Zuckerberg recently wrote a blog post detailing Facebook’s future plans around privacy and product direction. In his post, Zuckerberg drops some keywords that also show up in healthcare, especially in the new ONC and CMS rules—interoperability, security, and safety.
I previously used Facebook as an example of what we should not do in healthcare. I thought Zuckerberg’s post was a good opportunity to contrast social media and healthcare, since we aspire to the same principles.
Zuckerberg lays out six principles from which the future of Facebook, Instagram and Whatsapp will be driven. Three of these principles don’t really apply to healthcare—secure data storage is already highly regulated in healthcare; reducing permanence doesn’t really apply (you don’t want your lab results to disappear); and private interactions are typically the default (but I’m sure we could dig into that more). Right now, I want to focus on encryption, interoperability and safety.
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With the Silver Tsunami on its way, telehealth is ready for its moment

Whether it's after-hours coverage at skilled nursing facilities or connected tools for home health monitoring, remote care technology is reaching maturation just when it will be needed most.
March 25, 2019 09:23 AM
Browse the education sessions scheduled for the American Telemedicine Association's annual conference and expo in New Orleans next month, and you'll notice that many of them are geared toward elderly patients, home-based care and aging in place.
There's one session titled, "From Preventative To Proactive: How Partnerships are Reimagining Telehealth's Role In Healthy Aging." There's another about "inspired aging and virtual care transformation" and another touting home care successes thanks to a "virtual care-enabled remote monitoring program."
None of that is a coincidence, of course. As the "Silver Tsunami" swells, with more than 75 million Baby Boomers set to avail themselves of their Medicare benefits and put strain on an already overstretched health system, telehealth and remote care technologies will be key to helping deliver appropriate care to these aging patients while keeping costs under control.
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NZ e-Prescription service makes progress toward paperless future

“The NZePS reduces a pharmacy’s administrative workload and increases efficiencies in the dispensary, allowing pharmacists to spend more time with patients,” said Andrew Gaudin, CEO, Pharmacy Guild of New Zealand.
March 25, 2019 01:50 AM
Unsigned prescriptions are now legal when created with an electronic system that is integrated with the New Zealand e-Prescription Service (NZePS).
The Director General of Health Ashley Bloomfield has approved a waiver for unsigned prescriptions to be recognised as legal prescriptions when strict criteria are met, including the use of an electronic system that is integrated with NZePS.
Ministry of Health Group Manager of Digital Strategy and Investment Darren Douglass says the Ministry is working with partners across the health system on pilot implementations to “ensure that processes fully comply with the legislation and maintain patient safety and confidentiality."
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There's a dark side to AI in healthcare

This is an excerpt from a story delivered exclusively to Business Insider Intelligence Digital Health Briefing subscribers. To receive the full story plus other insights each morning, click here.
AI has made a splash in the healthcare industry, with a flurry of hospitals rushing to deploy AI technologies.
But the tech’s also littered with potential pitfalls, the consequences of which could have adverse effects on all players in the healthcare system, per research cited in The New York Times.
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March 25, 2019

FDA Warns of Potential Cybersecurity Threat with Some Heart Devices

By Amy Orciari Herman
The FDA has issued a warning about potential cybersecurity vulnerabilities with Medtronic's implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds).
In its safety communication, the agency noted that the Conexus wireless telemetry system that's used for communication across Medtronic's ICDs, CRT-Ds, clinic programmers, and home monitors "does not use encryption, authentication, or authorization." This "could allow an unauthorized individual (for example, someone other than the patient's physician) to access and potentially manipulate an implantable device, home monitor, or clinic programmer."
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Reader Survey Results: How I Would Change EHRs

Mr. HIStalk
I asked readers how they would change EHRs to improve outcomes and reduce costs while still meeting the requirements imposed by the US healthcare system. That’s the basic question EHR vendors face every day. Some of the excerpted answers I received are as follows. Non-clinician responses are indicated with an asterisk.
* Keep them headed in the direction they’re on: platforms supporting standardized open APIs. The Fortune article was hysteria-feeding bias by writers who don’t understand economics, technology, or healthcare. Chopra had the best take in the article: MU was a messy process but it was a necessary down payment that will yield benefits to patients for years to come.
Create true app store-type environment being opened up by the recent mandate for FHIR APIs,  a way to totally separate the data entry issue from the clutches of current vendors. The most practical complementary situation in the interoperability realm would be a timeline approach to presenting links to patient specific information for the caregiving team. There are many candidates whose product offerings could be customized to fulfill this.
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Weekly News Recap

  • A Reddit “Ask Me Anything” with Providence St. Joseph Health EVP / Chief Digital Officer and venture fund manager Aaron Martin gets ugly with charges of layoffs and a hostile work environment for female employees
  • A France-based online medical appointment app vendor’s funding round values it at more than $1 billion
  • Fortune’s cover story, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong,” says EHRs are an “unholy mess” after taxpayers spent $36 billion on their use
  • Health Catalyst hires investment bankers to begin its IPO process
  • The payment model of England’s NHS, which is based on a medical practice’s location, raises concern as the private company behind the GP at Hand video consultation app draws 40,000 Londoners to its practice
  • Change Healthcare files IPO documents
  • A survey finds that nurses who work in a positive work environment like their EHRs better and have a higher appreciation for their role in patient care
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Enjoy!
David.

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