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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‘Skype doctors’ prevent 3,000 A&E visits in Manchester
Using Skype to help older patients get faster care has prevented 3,000 avoidable A&E visits, according to NHS England figures.
Andrea Downey – June 5, 2019
The video calls have also freed up 2,000 GP appointments by allowing elderly patients to get the care they need in the comfort of their own home.
The on-call Skype NHS team takes around 8,000 calls per year from wardens working in sheltered accommodation, care home staff and community teams.
In total it equals £1.3 million and hundreds of hours of NHS staff time saved.
Not only has the programme reduced distressing hospital visits for older patients, but it’s also reduced avoidable ambulance call-outs, freeing up paramedics for emergency cases.
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EHR Alerts Increase Blood Pressure Drug Rx in Diabetes
But vast majority of hypertensive diabetes patients still untreated, study finds
- by Joyce Frieden, News Editor, MedPage Today
WASHINGTON -- Prompting doctors via an electronic health record alert to prescribe blood pressure meds to diabetes patients with hypertension resulted in a modest uptick in prescribing, a researcher said here.
The probability of a diabetes patient receiving an antihypertensive during a physician visit increased from 11.46% before the intervention to 22.17% after the intervention, an increase of nearly 11 percentage points, which was statistically significant (P<0 .001="" assistant="" at="" health="" in="" magaly="" of="" p="" phd="" professor="" public="" ramirez="" said="" school="" seattle.="" services="" the="" university="" washington="">
At control sites, on the other hand, there was a non-significant decrease in prescribing probability during the same time period, from 16.16% to 15.04%, she said during a presentation at the AcademyHealth Annual Research Meeting.
She said the findings indicate that alerts can improve prescribing of antihypertensive medications, but cautioned that, even with the intervention, "the vast majority of patients are still going untreated."
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When order sets do not align with clinician workflow: assessing practice patterns in the electronic health record
Abstract
Background Order sets are widely used tools in the electronic health record (EHR) for improving healthcare quality. However, there is limited insight into how well they facilitate clinician workflow. We assessed four indicators based on order set usage patterns in the EHR that reflect potential misalignment between order set design and clinician workflow needs.
Methods We used data from the EHR on all orders of medication, laboratory, imaging and blood product items at an academic hospital and an itemset mining approach to extract orders that frequently co-occurred with order set use. We identified the following four indicators: infrequent ordering of order set items, rapid retraction of medication orders from order sets, additional a la carte ordering of items not included in order sets and a la carte ordering of items despite being listed in the order set.
Results There was significant variability in workflow alignment across the 11 762 order set items used in the 77 421 inpatient encounters from 2014 to 2017. The median ordering rate was 4.1% (IQR 0.6%–18%) and median medication retraction rate was 4% (IQR 2%–10%). 143 (5%) medications were significantly less likely while 68 (3%) were significantly more likely to be retracted than if the same medication was ordered a la carte. 214 (39%) order sets were associated with least one additional item frequently ordered a la carte and 243 (45%) order sets contained at least one item that was instead more often ordered a la carte.
Conclusion Order sets often do not align with what clinicians need at the point of care. Quantitative insights from EHRs may inform how order sets can be optimised to facilitate clinician workflow.
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Don’t let cybersecurity be driven by fear, warns NCSC chief
Scaring people about cybersecurity doesn’t work, says Ciaran Martin - particularly when it comes to 5G, Huawei and China.
As cyberattacks and hacking incidents increase in frequency and scope, it's important that organisations and governments don't revert to a fear-based approach to cybersecurity: it won't help users and it doesn't help to prevent attacks.
Reflecting on how cybersecurity guidance has changed since the UK's National Cyber Security Centre started operating in 2016, NCSC chief executive Ciaran Martin said the cyber-arm of GCHQ began as if its job was scaring people into staying safe online. But now the approach is based around promoting a deeper understanding of threats, he said.
"Four years ago, as GCHQ and government, we were still reluctantly in the role of the 'Monsters Inc' Top Scarcer. We still had to convince people about the threat and that it was all very scary and so forth," said Martin, comparing the government's approach to cybersecurity to that of the Pixar movie during a keynote address at Infosecurity Europe 2019 in London.
That created worry for organisations, Martin said, who for fear of cyberattacks, outsourced cybersecurity because they were concerned they couldn't get to grips with the problem – and that wasn't necessarily the correct approach.
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FTC: ONC rule could distort competition, impede innovation
Published June 07 2019, 12:04am EDT
The Federal Trade Commission has weighed in regarding a proposed rule on information blocking from the Office of the National Coordinator for Health IT.
In a letter to ONC, the FTC’s Office of Policy Planning, Bureau of Economics and Bureau of Competition recommends that the agency consider changes to ensure that its final rule “does not inadvertently distort competition or inhibit conduct that is affirmatively procompetitive and consumer friendly.”
ONC’s proposed rule seeks to implement the information blocking provisions of the 21st Century Cures Act and includes seven exceptions to the definition of information blocking—the act of intentionally interfering with the sharing of electronic health information.
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https://www.healthdatamanagement.com/news/cms-seeks-comments-on-ways-to-reduce-administrative-burden
CMS seeks comments on ways to reduce administrative burden
Published June 07 2019, 12:04am EDT
The Centers for Medicare and Medicaid Services on Thursday released a request for information soliciting stakeholder input on how providers can spend less time on paperwork and more time with patients.
As part of the agency’s Patients over Paperwork initiative, CMS is seeking public comment on ways to improve the healthcare delivery system by reducing unnecessary burdens for clinicians.
“Our goal is to ensure that doctors are spending more time with their patients and less time in administrative tasks,” said CMS Administrator Seema Verma in a written statement. “Since launching Patients over Paperwork in late 2017, CMS has worked closely with the healthcare community to relieve regulatory burden and maintain flexibility and efficiency in Medicare and Medicaid, and we’re excited about the innovative ideas that today’s RFI will bring as we build on our progress and continue to achieve cost and time savings.”
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HIT Think Powerful leadership is needed more than ever in health IT
By Carla Smith
Published June 07 2019, 3:27pm EDT
I am once again honored as one of the 50 women in the 2019 class of Health Data Management’s Most Powerful Women in HIT. I know and have worked with many of these executive leaders who, as my peers, share my passion to advance better health for all. I am honored to be part of this exceptionally talented group.
And, it brings to mind the topics of “power” and “success,” what it means to be powerful and how success can guide us. What does it take to become a powerful leader in today’s business world?
I’d like to offer the following characteristics:
Love, care and respect: A powerful leader cares deeply about solving problems that matter, and treating those around her with love and respect. She teaches people how to treat her, in part, by how she treats others. I firmly believe that leaders who treat people with respect have a better chance of earning respect from others. There's a great new business book out on this very topic that I encourage you to read: The 10 Principles of a Love-based Culture.
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Doctors rarely aware of online feedback from patients
By Nathan Eddy
June 07, 2019 11:20 AM
Moreover, the majority of respondents had never encouraged patients to leave online feedback in the first place, although feedback on reviews or ratings sites was seen as more useful than social media feedback to help improve services.
Doctors and nurses in the United Kingdom are largely unaware of the online feedback they receive from patients, though they assume the posted comments skew negative, a study has found.
What happened?
The National Institute for Health Research and the University of Warwick have published a survey of 1,001 registered doctors in primary and secondary care and 749 nurses and midwives in the United Kingdom.
Less than a third (28 percent) of doctors and around a fifth of nurses surveyed were aware of online feedback concerning the care they had given, and even fewer were aware of comments directed at them personally.
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Managing population health with analytics and social determinants of health
June 07, 2019 12:04 PM
Knowing more about a patient than ever before means healthcare providers are in a position to better serve high-risk populations.
Hospitals always want to do better. They keep tabs on the materials they use, the procedures they perform, and the patient outcomes after care.
What happened?
Factors like these help them assess risk when considering which actions to take later on. This kind of data gathering, however, doesn’t look at many of the upstream factors of the person receiving care that aren’t directly related to their health.
These social determinants of health don’t immediately impact clinical care but can inform on a patient’s life circumstances and ability to receive regular care, things which can greatly impact the cost and quality of their care overall.
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Cerner App Challenge Seeks Ways to Boost Patient Access to EHRs
Cerner launched the 2019 code App Challenge to motivate health IT developers to advance patient access to EHRs through innovation.
By Kate Monica
June 05, 2019 - Cerner Corporation recently announced the launch of its 2019 code App Challenge, which prompts developers to innovate new ways to help patients easily access and understand their own EHR data.
Innovators interested in participating in the challenge are encouraged to build apps on Cerner’s health IT platforms focused on facilitating patient data access and promoting efficiency.
“We challenge innovators and organizations across the industry to join us in advancing interoperability, secure data exchange and consumer access to health records,” said John Gresham, senior vice president of Health Networks at Cerner.
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Nearly 90% of healthcare orgs are experimenting with emerging tech: AI, VR, blockchain
Emerging technologies such as blockchain's distributed ledger technology, artificial intelligence, extended reality and quantum computing have been incorporated into a majority of healthcare organizations, according to Accenture's latest Digital Health Tech Vision report.
The report surveyed 221 healthcare executives from the U.S. and Canada. Of those, 89 percent reported experimenting with one or more of these "DARQ" technologies.
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Machine learning model helps to predict hospital readmissions
Published June 06 2019, 12:05am EDT
A machine learning predictive scoring system is better able to determine the likelihood that discharged patients will be readmitted to the hospital than standard prediction methods.
The ML model, called the Baltimore score, mines hundreds of health data variables in real time and then calculates a score to predict a patient’s chance of returning to the hospital after discharge.
Developed at the University of Maryland Medical System, the algorithm was recently evaluated in a University of Maryland School of Medicine study.
In the study, the Baltimore score was matched against standard readmission risk-assessment scores in a cohort of more than 14,000 patients discharged from three hospitals in Maryland, with the goal of assessing their respective abilities at predicting 30-day unplanned readmissions calculated in real time.
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AHA calls on CMS to reduce clinical documentation burden
Published June 06 2019, 12:05am EDT
The American Hospital Association contends that the Centers for Medicare and Medicaid Services has not done enough to cut the documentation burdens that clinicians face.
AHA sent a letter to CMS on Wednesday with a number of policy recommendations that the hospital group believes the agency should include in its proposed rule for the Calendar Year 2020 physician fee schedule.
“The time spent documenting patient visits is time that providers cannot spend in face-to-face interaction with patients—negatively impacting patient care and provider well-being,” wrote AHA Executive Vice President Thomas Nickels to CMS Administrator Seema Verma.
“The patterns of EHR use that result from current documentation requirements are putting providers and patients at risk for real harm,” added Nickels. “We strongly encourage CMS to explore ways to return the medical record to a tool that captures patients’ dynamic narratives and supports communication between providers.”
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Senators query diagnostics companies victimized by data hacks
Published June 06 2019, 3:18pm EDT
A hack of healthcare data involving a medical bill collector and two major diagnostics companies is now attracting more questions from key members of Congress.
American Medical Collection Agency, an Elmsford, N.Y.-based collections firm, has now been identified by two large diagnostics companies as the victim in a large healthcare data breach. On Tuesday, Laboratory Corporation of America—widely known as LabCorp—reported that 7.7 million patients’ accounts at AMCA were stored in the vulnerable computer system. The disclosure follows a similar warning by Quest Diagnostics that 11.9 million people were exposed.
The exposed data includes names, dates of birth, addresses, financial and other personal information. LabCorp didn’t provide AMCA with any ordered test, diagnostic information or test results, the company said in a securities filing. Quest said in a statement that the hack may have included unspecified medical information, but not test results.
Three senators, including New Jersey Democrats Bob Menendez and Cory Booker, and Mark Warner, a Virginia Democrat, wrote Quest on Wednesday asking about the breach. Warner, a leading cybersecurity advocate in Congress, said in his letter to Quest that contractors like AMCA were a frequent target.
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WannaCry 2019: Ransomware is alive and well
June 06, 2019 11:25 AM
Because a new class of devices is emerging, WannaCry is very aggressive and a variety of other factors, the healthcare industry is still at risk from the ransomware.
Remember WannaCry? The ransomware worm attacked hospitals among other industries in 2017 by exploiting a weakness on Windows machines. Once in a network, the worm would encrypt files and hold them ransom.
What happened?
Security researchers eventually shut most of the worm down, but it is still rampant throughout the internet. Armis Security has found in a new study that the worm is not only healthy but continues to wreak havoc.
Armis’ Bern Seri, vice president of research, and Michael Parker, CMO, spoke about what made WannaCry so difficult to eradicate, why hospitals remain ripe targets, and what they can do to prevent attacks and the spread of ransomware.
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Challenging the lack of openness around taboo subjects impacting our health and wellbeing
The upcoming 'unmentionables' session at the HIMSS & Health 2.0 European conference will see innovators look at the role of digital tools in 'destigmatising' depression, loneliness and sexual health.
June 06, 2019
According to data from Public Health England released this week, the number of sexually transmitted infections (STIs) increased by five percent in England in 2018 in comparison to the previous year.
Although there are many factors at play here - including cuts to sexual health services - it is clear that some people might not be seeking the help they need because they feel embarrassed to do so.
And it’s not just about STIs; many topics gathered under the sexual health umbrella are still largely seen as taboos. At the HIMSS & Health 2.0 European conference in Helsinki, Finland next week, an ‘unmentionables’ session aims to put the spotlight on efforts to break down the stigma around sexual health, and Washington-based Advocates for Youth is using digital means to do just that.
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Black Book™ Announces Top Client-Rated Software and Services Vendors for Achieving Financial Digital Transformation
In total, 484 hospitals and inpatient organizations and 713 physician practices were represented in the sweeping Q1-Q2 2019 series of polls.
Jun 06, 2019, 12:00 ET
TAMPA, Fla., June 6, 2019 /PRNewswire/ -- The highest rated vendors in customer satisfaction and client experience are announced by Black Book Research in 20 specific categories of financial digital transformation.
Black Book™ surveyed nearly 1,600 hospital and health system Chief Financial Officers, Vice Presidents of Finance and RCM, Controllers, Business Office Managers, Staff, Consultants and Directors to determine the top-performing vendors among in-demand financial software, systems and outsourcing services, and assess the gaps and urgencies of financial technology administration.
Additionally, 124 CEOs were polled to compare and contrast organizational viewpoints to the same situations and circumstances.
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LabCorp discloses data breach affecting 7.7 million customers
LabCorp, a medical testing company, said 7.7 million customers had their personal and financial data exposed through a breach at a third-party billing collections company.
The news came just days after the same contractor, American Medical Collection Agency, notified Quest Diagnostics about the full scope of a breach affecting 11.9 million of its patients. That breach allowed an “unauthorized user” to gain access to financial information, Social Security numbers and medical data but not lab results.
“AMCA has indicated that it is continuing to investigate this incident and has taken steps to increase the security of its systems, processes, and data,” LabCorp said in a filing Tuesday with the U.S. Securities and Exchange Commission. “LabCorp takes data security very seriously, including the security of data handled by vendors.”
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Lost in translation: Epic goes to Denmark
By ARTHUR ALLEN
06/06/2019 04:30 PM EDT
COPENHAGEN, Denmark — For three years, a dour anesthesiologist and computer architect named Gert Galster tunneled in the electronic guts of Epic Systems, trying to convert the premier U.S. digital health software into a workable hospital management system for Copenhagen and the surrounding region.
It nearly drove him mad.
After Galster and his colleagues had done what they could, 45,000 clinicians in eastern Denmark were plunged into the Epic system. Like the U.S. Department of Veterans Affairs, the Danes had expected that tech from a big IT vendor would make it easier for doctors in an excellent health care system to work, share patient information and keep tabs on costs. But the Danish experience produced results that varied from frustrating to disastrous — a sobering lesson for the VA, which recently began a transition involving another big vendor.
The problems were evident from the start. Epic’s medical terms were not tagged for easy translation, so Galster and his colleagues had to rely on Google Translate. There were howlers. “C-section,” in the Danish version, referred to an executive suite, not an emergency birth procedure. The American specialty “speech and language pathologist” does not exist in Denmark. The Danish system for a short time offered surgeons the choice of amputating the left leg or the “correct” leg.
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- Author: Adam Rogers
- 06.05.19 01:30 pm
Telemedicine Makes It Safe to Get Abortion Drugs in the Mail
Consulting with a doctor on the internet to receive abortion drugs can be an effective, practical alternative for women in areas where clinics are scarce.
Every restriction on access to abortion draws the metaphoric walls closer. On who can dispense drugs, on what clinical tests are required first, on how far along the pregnancy can be—the rules are all designed to delay, deter, and delegitimize. It’s a Death Star Trash Compactor. The box around abortion gets smaller and smaller.
That’s policymaking; technology, meanwhile, tends to see boxes as something to think outside of. A long-awaited study published this week in the journal Contraception offers a way around tightening regulations: telemedicine. Abortion medication provided by mail, administered by a practitioner working via videoconference, could safely enlarge the geographic footprint of clinics and providers. “Many clinics already use telemedicine for other services,” says Elizabeth Raymond, a researcher at Gynuity Health Projects who leads the project. “Our study validates that this is a feasible, safe, and effective approach.”
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U of Iowa researchers receive grant to study EHR information sharing patterns
– 4 June, 2019
The Agency for Healthcare Research and Quality awarded a research grant to the University of Iowa College of Public Health for its study on communication methods within EHR networks.
Iowa City-based University of Iowa researchers will analyze EHR-based communication among providers in virtual care teams. The study will also examine how EHR communication is related to patient outcomes, such as hospital re-admissions, emergency department visits and mortality.
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Jun 3, 2019, 07:19am
Walmart Extends Its Blockchain Reach, Joins Pharmaceutical-Tracking Consortium
© 2018 Bloomberg Finance LP
Retail giant Walmart, already renowned in the blockchain space for its work in the IBM Food Trust, is continuing to expand in the industry by joining a new consortium. Walmart has joined MediLedger, a consortium building a blockchain solution for tracking the provenance of pharmaceuticals.
Walmart confirmed their participation in the consortium, which represents a deepening involvement in the technology, to Coindesk. The world’s largest retailer by sales has already filed for about 50 blockchain patents for everything from tracking shipments to operating drones.
The crossover to the pharmaceutical supply chain should carry an equal amount of sway as the work being done on food tracking through IBM’s Food Trust. This consortium will no doubt boost MediLedger, whose members already include pharmaceutical manufacturers such as Pfizer and the three largest pharmaceutical wholesalers, McKesson, AmerisourceBergen, and Cardinal Health.
It will also be a big boost to the pharmaceutical industry as the U.S. Food and Drug Administration (FDA) has been mandated by Congress to deliver an interoperable, digitized system for tracking and verifying prescription drugs by 2023.
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Threats, vulnerabilities of medical device cyberattacks: 4 Qs with UC Davis cybersecurity expert Dr. Jeff Tully
Jeff Tully, MD, pediatrician, anesthesiologist and security researcher affiliated with University of California Davis Medical Center, has extensive expertise in medical device cybersecurity.
Dr. Tully's research, along with his colleague Christian Dameff, MD, a clinical informatics fellow at UC San Diego, focuses on best prevention methods for medical device cyberattacks and preparing hospitals with proper cyber hygiene.
Here, Dr. Tully discusses motivations behind medical device cyberattacks and what devices present the greatest vulnerabilities.
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Pew Presses ONC to Boost EHR Usability in Interoperability Rule
In submitted comments, Pew urged ONC to take additional steps to improve EHR usability and safety in its proposed interoperability rule.
By Kate Monica
June 03, 2019 - Pew Charitable Trusts urged ONC to take additional steps to improve EHR usability and safety in its proposed interoperability rule by including appropriate end-users in health IT system development.
This recommendation and others came in Pew’s submitted comments weighing in on the ONC Interoperability proposed rule, which will soon be finalized.
The proposed rule is designed to implement provisions of the 21st Century Cures Act related to enabling seamless, secure health data exchange without special effort.
In the proposed rule, ONC developed recommendations for a voluntary pediatric EHR system certification program. ONC identified 10 clinical priorities where pediatric care differs from other care settings.
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Lawmakers fear lack of governance of DoD-VA EHR project will derail progress
Jun 5, 2019 4:07pm
The VA said in March it plans to pilot initial operating capabilities of its new Cerner EHR platform in March 2020 across three sites in the Pacific Northwest. ( JeffOnWire CC BY 2.0)
An executive from Cerner — the health IT company in charge of the Department of Veterans Affairs' $16 million medical records project — tried to assure members of Congress this week that the project is "on the right track" with the VA set to go live with pilot sites in less than a year.
But during a House Veterans’ Affairs Subcommittee on Technology Modernization hearing Tuesday, federal lawmakers indicated they are increasingly concerned about the lack of governance between the VA and the Department of Defense as it also rolls out Cerner's electronic health record (EHR).
The VA signed a deal with Cerner last May to move from the VA’s customized Vista platform to an off-the-shelf EHR to align the country’s largest health system with the DoD, which has already begun integrating Cerner’s MHS Genesis system. DoD signed its $4.3 billion contract with Leidos in 2015 for a Cerner EHR system.
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Analysis: Why Alexa's bedside manner is bad for healthcare
Jun 4, 2019 1:13pm
Amazon has opened a new healthcare frontier: Now, Alexa can be used to transmit patient data. Using this new feature—which Amazon labeled as a “skill”—a company named Livongo will allow diabetes patients—which it calls “members”—to use the device to “query their last blood sugar reading, blood sugar measurement trends, and receive insights and Health Nudges that are personalized to them."
Private equity and venture capital firms are in love with a legion of companies and startups touting the benefits of virtual doctors’ visits and telemedicine to revolutionize healthcare, investing almost $10 billion in 2018, a record for the sector. Without stepping into a gym or a clinic, a startup called Kinetxx will provide patients with virtual physical therapy, along with messaging and exercise logging. And Maven Clinic (which is not actually a physical place) offers online medical guidance and personal advice focusing on women’s health needs.
In April, at Fortune’s Brainstorm Health conference in San Diego, Bruce Broussard, CEO of health insurer Humana, said he believes technology will help patients receive help during medical crises, citing the benefits of home monitoring and the ability of doctors’ visits to be conducted by video conference.
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Here's what former national coordinators, health IT groups had to say on ONC's information blocking rules
Jun 4, 2019 10:22am
Of the hundreds of pages of comment letters from healthcare and health IT groups sounding off on the recently proposed information blocking rule, there seems to be one consistent theme: The timeline is too aggressive and will pose burdens to providers and vendors.
The Department of Health and Human Services (HHS) received 1,882 comments on the rule, which the Office of the National Coordinator for Health IT (ONC) unveiled back in February. The interoperability, information blocking and health IT certification rule (PDF) defines exceptions to data blocking as well as fines that may be associated with the practice, and was mandated by the 21st Century Cures Act.
There are six people, however, who are satisfied with the timing of the rule: six former national coordinators for health IT. In a joint letter, David Blumenthal, M.D.; David Brailer, M.D.; Karen DeSalvo, M.D.; Robert Kolodner, M.D.; Farzad Mostashari, M.D.; and Vindell Washington, M.D., said they offer "enthusiastic support" for the proposed rule.
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AMIA: CMS is ‘too aggressive’ on API timeline for health plans
By Diana Manos
Published June 05 2019, 12:47am EDT
The American Medical Informatics Association is warning the federal government to go slow in requiring federally funded health plans to use open application programming interfaces.
AMIA contends that demanding health insurers hit a rigid deadline for using APIs to share data with members will be nearly impossible for them to achieve.
Last February, under the Interoperability and Patient Access Proposed Rule, the Centers for Medicare and Medicaid Services called for Medicare Advantage (MA) and Qualified Health Plans (QHPs) to have APIs in place by January, and for Medicaid and Children’s Health Insurance Program (CHIP) agencies to have them in place by July 2021.
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Achieving a digital NHS: lessons for national policy from the acute sector
31 May 2019
Creating a digital NHS is a national policy priority. It promises to improve the quality of care, reduce duplication, drive efficiencies, empower patients and support joined-up services. The NHS Long Term Plan emphasised national policy’s commitment to the digital agenda and promised fully digitised secondary care services by 2024. This follows a host of other policy and funding initiatives in recent years, totalling national investment of over £4 billion since 2016.
Now the establishment of a new organisation to lead national policy for NHS technology, digital and data has been announced. NHSX will bring together digital leaders from NHS England, NHS Improvement, and the Department of Health and Social Care to lead on setting standards for technology use, championing and developing digital training and ensuring NHS systems can talk to each other across the health and care system. This is a clear sign of continued commitment to creating a digital NHS – including from the Secretary of State.
In this environment, we sought to understand how national policy for digitisation is working from the perspective of acute trusts. We wanted to know:
- How national policy impacted on a trust’s approach to digitisation
- How national policy was helping and hindering digital progress
- What national policy could do differently to better support digitisation on the ground.
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Quest Diagnostics data breach – the industry sounds off
By Bill Siwicki
June 04, 2019 02:10 PM
Cybersecurity experts from across health IT offer their opinions on the breach itself, what must be done for the lab company to fix security and regain trust – and how similar incidents can be avoided across healthcare.
The fallout continues. Quest Diagnostics, the medical testing behemoth, confirmed in a filing with the SEC that a third-party billing company was hit by a data breach that affects 11.9 million Quest patients.
The breach was a result of “malicious activity” on the payment pages of the American Medical Collection Agency and the unauthorized user was able to siphon off PII including, but not limited to, credit card numbers, medical information and Social Security numbers.
The data exposed dates back to August 1, 2018, until May 31, 2019. This is the second breach affecting Quest in three years after hackers gained access to the company’s “MyQuest” patient portal and accessed 34,000 patients’ names, dates of birth, lab results and phone numbers.
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How Bots Will Change the Doctor-Patient Relationship
June 04, 2019
It seems nearly everyone believes U.S. health care needs some transformative change to improve quality, expand access, or lower costs. Many of the contemporary approaches toward that change involve making it easier for patients to see doctors, particularly primary care doctors. While that seems intuitive, we think it is the wrong path.
Imagine it’s 1970 and commercial bank executives are deciding how to help their customers get the banking services they need. One executive remarks, “Most of our customers engage with us through our bank tellers–even if they’re later referred to someone behind a desk. To help our customers get the banking services they need, we must make it easier for them to get in front of bank tellers.”
Whether or not discussions like that really happened, that wasn’t the direction banks took. Instead, banks introduced automated teller machines to improve customer service. As a result of this unshackling of banking from tellers, 25-year-olds today find it unimaginable that their parents contorted their schedule to get cash during the Monday to Friday, 9 a.m. to 3 p.m. window. In the age of Venmo, they can’t imagine the need for cash in the first place.
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MGMA Warns of Administrative Burden of Information Blocking Rules
Requirements tied to proposed API and information blocking regulations may overwhelm clinicians and put patient data at risk, MGMA said.
By Kate Monica
May 31, 2019 - The Medical Group Management Association (MGMA) is concerned proposed regulations related to application programming interfaces (APIs) and information blocking may increase administrative burden on clinicians and threaten health data security, according to comments submitted to ONC.
MGMA submitted its feedback in response to ONC’s proposed rule on interoperability and information blocking released in February. The rule is intended to fulfill the aims of the 21st Century Cures Act by supporting the patient access and exchange of clinical information.
“The Administration is playing a pivotal role in the move towards interoperability as it works to implement the 21st Century Cures Act,” said Anders Gilberg, Senior Vice President of Government Affairs at MGMA, “but we’re concerned that the proposed approach goes too far, too fast.”
The association supports ONC’s efforts to increase patient access to health information, but cautions that ONC should keep health data security as a top priority during rulemaking.
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The growth of ransomware extortion demands
Ransomware is becoming an increasingly common cause of cyber loss for both healthcare and non-healthcare businesses. According to the NAS Insurance 2019 Cyber Claims Digest, which analyzed data from 2018 claims, ransomware was the second most common cause of cyber claims last year – just as it was in 2017.
“In 2017 and 2018, ransomware events were front and center as an area of great concern for our insureds and remained the second-most cause of loss among all of our cyber claims in each year,” says Jeremy Barnett, senior vice president of marketing at NAS Insurance. “Over the past two years, we resolved over 90 ransomware incidents among a broad range of businesses and with various ransom demands. Payment demands were wide-ranging and topped out over $30,000, and in a variety of currencies.”
Costs go much further than just the ransom payment itself. The technical and legal expenses associated with negotiating and paying the ransom, which are often demanded in cryptocurrency, can triple or quadruple the cost of resolving the issue. It’s not uncommon for expenses to go beyond $70,000.
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NIH touts potential of IT to address healthcare disparities
Published June 03 2019, 12:12am EDT
Health information technology remains an untapped opportunity with great promise for reducing disparities in healthcare delivery and outcomes in the clinical environment.
That’s the contention of 12 original research papers and five editorials and commentaries published in the June supplement to the journal Medical Care.
The supplement, supported with funding from the National Institute on Minority Health and Health Disparities, is based in part on presentations made at an NIMHD-funded workshop in collaboration with the National Science Foundation and the National Health IT Collaborative for the Underserved.
“Health IT tools such as EHRs, patient portals, patient-monitored health behaviors and clinical decision support (CDS) systems may yield population health benefits for underserved populations by enhancing patient engagement, improving implementation of clinical guidelines, promoting patient safety and reducing adverse outcomes,” according to an editorial by NIMHD Director Eliseo Pérez-Stable, MD, with NIMHD Health Scientist Administrator Beda Jean-Francois and NIMHD Chief of Staff Courtney Ferrell Aklin.
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Analysts Uncover 4.4M Medical Imaging Files Exposed Online
Analysts found 4.4 million medical imaging files exposed in online file stores, double the number uncovered last year, according to a new report by Digital Shadows.
By Fred Donovan
May 30, 2019 - Analysts found 4.4 million medical imaging files exposed in online file stores, double the number uncovered last year, according to a new report by Digital Shadows.
In total, analysts found 4.7 million medical files exposed online.
The medical imaging files mostly were stored using the Digital Imaging and Communications in Medicine (DICOM) standard for handling, storing, printing, and transmitting information in medical images. Other standards used for exposed medical files included Health Level Seven (HL7) and the HIPAA Electronic Data Interchange (EDI) transaction format X12.
“The sheer amount of information exposed violates individuals’ privacy as well as regulations like HIPAA in the United States,” the report commented.
Overall, Digital Shadows analysts detected 2.3 billion exposed files, 750 million more than last year's report.
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Geisinger COPD study to test vocal biomarker algorithm
Published June 03 2019, 12:33am EDT
Patients with chronic obstructive pulmonary disease experience exacerbations caused by an infection in the lung. But a novel technique is being studied by Geisinger Health System to detect these flare-ups.
Geisinger’s Voice Analysis of COPD Patients with Exacerbations (VOICE) study, supported by a grant from pharmaceutical company GlaxoSmithKline, will evaluate an algorithm for vocal biomarkers that gives clinicians the ability to assess the voice of their patients wherever and whenever they speak on their smartphones.
The algorithm, developed by Israeli artificial intelligence vendor Healthymize, transforms smartphones into remote patient monitoring devices for voice-affecting diseases such as asthma, COPD and pneumonia.
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https://www.healthdatamanagement.com/news/study-shows-ai-beats-radiologists-in-detecting-lung-cancer
Study shows AI beats radiologists in detecting lung cancer
Published June 03 2019, 4:24pm EDT
Testing has shown that a deep learning algorithm developed by scientists at Google and Northwestern Medicine appears better at spotting lung cancer than experienced radiologists.
Lung cancer is the most common cause of cancer death in the United States, with about 160,000 deaths occurring in 2018. Lung cancer screening using low-dose computed tomography (CT) can reduce mortality by 20 percent to 43 percent and is now included in U.S. screening guidelines. However, screening error rates can be high, resulting in delayed or missed diagnoses and unnecessary biopsies and follow up procedures, all of which come at high clinical and financial costs.
In a recent study, scientists at Google developed a large-scale deep learning algorithm that uses a patient’s current and prior CT volumes to predict a patient’s risk of lung cancer. They applied the model to 2,763 de-identified CT scan sets provided by Northwestern Medicine to validate the accuracy of the new system.
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HIT Think How IT collaboration changes prospects for high-risk babies
Published June 03 2019, 5:10pm EDT
Hundreds of babies are born addicted to drugs every day. According to estimates from the National Council on Drug Abuse, 32,000 babies were born with neonatal abstinence syndrome between 2004 and 2014—that’s one baby every 15 minutes.
Infants with neonatal abstinence syndrome (NAS) experience intense symptoms during periods of withdrawal and are often completely inconsolable. In extreme cases, complications can include respiratory problems, feeding difficulties, GI disorders, seizures or death.
Caring for these complex newborns poses a unique challenge, but during the last four years, healthcare providers have made significant progress understanding NAS. Identifying NAS patients is half the battle, and diagnostic tools such as the Finnegan Neonatal Abstinence Scoring Syndrome (FNASS) and heightened cognizance of symptoms has been massively effective.
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This doctor is recruiting an army of medical experts to drown out fake health news on Instagram and Twitter
Published Sun, Jun 2 2019 9:30 AM EDTUpdated Sun, Jun 2 2019 11:11 AM EDT
Key Points
- Austin Chiang is a doctor with a passion for Instagram and Twitter.
- He has a unique role as a chief medical social media officer at Jefferson Health.
- His mission is to get more doctors and other health professionals on social media to drown out health misinformation.
The antidote to fake health news? According to Austin Chiang, the first chief medical social media officer at a top hospital, it’s to drown out untrustworthy content with tweets, pics and posts from medical experts that the average American can relate to.
Chiang is a Harvard-trained gastroenterologist with a side passion for social media. On Instagram, where he refers to himself as a “GI Doctor,” he has 20,000 followers, making him one of the most influential docs aside from TV personalities, plastic surgeons and New York’s so-called “most eligible bachelor,” Dr. Mike.
Every few days, he’ll share a selfie or a photo of himself in scrubs along with captions about the latest research or insights from conferences he attends, or advice to patients trying to sort our real information from rumors. He’s also active on Twitter, Microsoft’s LinkedIn and Facebook (which owns Instagram).
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Weekly News Recap
- The latest funding round of precision medicine platform vendor Tempus values the company at $3.1 billion
- Cerner initiates a $0.18 quarterly dividend for shareholders, its first
- Cincinnati-based Bon Secours Mercy Health announces plans to sell its majority share in a revenue cycle management subsidiary, netting $1.2 billion on its 2016 investment of $60 million
- Cardinal Health makes a $10 million investment in home medical monitoring technology and monitoring services vendor Medically Home Group
- Change Healthcare files an amended prospectus for a $200 million IPO that doubles the value indicated in its mid-March filing
- The VA opposes a Senate bill that would create an independent advisory committee to oversee its $10 billion Cerner implementation
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Why are so many doctors burning out? Tons of real and electronic paperwork.
Last year, a friend took her dream oncology job in a big academic medical center on the East Coast. After a decade of medical school, residency and specialized fellowship training, she was treating and conducting high-level research on rare and complex adrenal cancers.
She was living in her perfect city and loved her patients and the other physicians in the department. But when I called recently, she told me she was quitting in two weeks. She’d decided to start over in a different practice halfway across the country.
Why was she walking away from something she enjoyed so much? Because the work that she loved was only a fraction of her job — glimpses of patient care were lost in a sea of administrative tasks. She told me about hours spent on the phone waiting for patients’ tests to be approved by insurance companies and falling asleep in front of her laptop trying to finish the day’s clinic notes.
And she wasn’t alone.
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Enjoy!
David.
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