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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Further investment needed to defend NHS against growing cyber threats, researchers warn
A team from the Institute of Global Health Innovation at Imperial College London published a paper on NHS cybersecurity this week.
July 04, 2019 11:29 AM
With facilities around the world turning to technology in the hope of easing increasing pressures, healthcare is becoming a prime target for hackers.
Only last month, four hospitals in Romania were hit by cyberattacks, with the ransomware believed by experts to have spread through emails with infected attachments disguised as invoices and plane tickets, creating disruption and slowing down admissions and discharges.
Unless measures to strengthen cyber resilience are taken, this risk will only continue to grow, researchers from the Institute of Global Health Innovation (IGHI) at Imperial College London caution in a new paper that looked at the NHS in the UK, published this week.
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Caldicott calls for data discussion to guide future commercial partnerships
A new survey of over 2,220 people in England found support for collaborations resulting in access to the discoveries generated at less cost and improvements in the care provided.
July 05, 2019 07:32 AM
Dame Fiona Caldicott, national data guardian for health and social care, is calling for a further discussion with the public on the commercial relationships between the NHS and those wanting to innovate using patient data.
The call comes after more than a third of people in a new survey in England did not give their views on some of the ways the health service and patients could benefit from these partnerships, which aim to develop new technologies and medicines.
WHY IT MATTERS
The poll of over 2,220 people found that one in seven supported collaborations that resulted in access to the innovations created at less cost and improvements in patient care.
More than half of those surveyed also said it was “fair” that the partner university (58%) or private company (56%) made a profit from the discoveries made.
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OpenNotes notches another big milestone, with 40 million patients now seeing their EHRs
As more than 200 health systems have signed on with the patient empowerment movement, population health, patient safety and quality improvement gains are apparent.
By Mike Miliard
July 05, 2019 01:20 PM
OpenNotes has gained major momentum over the past decade in its efforts to convince providers that patients have the right to access the clinical notes in their electronic health records. This week, the initiative announced that more than 40 million patients across some 200 health systems are using secure portals to see their doctors' notes.
WHY IT MATTERS
OpenNotes has expanded broadly since it was launched in 2010 as a small pilot project at Beth Israel Deaconess Medical Center, Geisinger and Harborview Medical Center in Seattle.
OpenNotes has expanded broadly since it was launched in 2010 as a small pilot project at Beth Israel Deaconess Medical Center, Geisinger and Harborview Medical Center in Seattle.
And the patient empowerment "movement" hasn't just gained size and scope. It's continuing to show that fully transparent medical records are paying dividends for population health, patient safety and quality improvement.
"Our most recent research, published in the Annals of Internal Medicine and in the Journal of Medical Internet Research, shows that patients, particularly those from underserved populations, feel more engaged in their care and gain greater benefit from reading the notes their clinicians write," Catherine DesRoches, executive director of OpenNotes and a researcher at Beth Israel Deaconess, said in a statement.
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The effect of an mHealth clinical decision-making support system on neonatal mortality in a low resource setting: A cluster-randomized controlled trial
- Hannah Brown Amoakoh
- Kerstin Klipstein-Grobusch
- Irene Akua Agyepong
- Nicolaas P.A. Zuithoff
- Mary Amoakoh-Coleman
- Gbenga A. Kayode
Abstract
Background
MHealth interventions promise to bridge gaps in clinical care but documentation of their effectiveness is limited. We evaluated the utilization and effect of an mhealth clinical decision-making support intervention that aimed to improve neonatal mortality in Ghana by providing access to emergency neonatal protocols for frontline health workers.
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Digital health investments in 2019 poised to surpass 2018: Rock Health
Jul 2, 2019 2:06pm
Investors continue to have a strong appetite for digital health with investment in the sector totaling $4.2 billion across 180 deals through the first half of 2019.
If this pace holds steady, the sector is on track to raise $8.4 billion in 2019 and could top 2018's record-breaking annual funding total of $8.2 billion, according to Rock Health's midyear report.
Just in the first six months of 2019, the digital health sector is close to surpassing the $4.6 billion in funding raised in 2016.
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Hospitals Use mHealth to Keep Family In The Loop on Patient Care
Hospitals and health systems are using mHealth and telehealth to create an instant connection to family members, allowing doctors and nurses to post updates on surgical procedures and answer questions about patient care.
July 01, 2019 - Hospitals and health systems are now applying mHealth to the vital and often-sensitive process of keeping family members updated during a patient’s surgical procedure.
What once involved a series of phone calls – or a nurse and or/doctor sifting through a crowded waiting room looking for the right family members – can now be handled by an mHealth app. The connected health platform enables providers to send out alerts or updates at a moment’s notice, advising family members of the patient’s progress or asking them to call in.
“This cuts out a lot of the phone games,” says Courtney Schwartzkopf, Nurse Manager for Central Monitoring at HSHS St. Elizabeth’s Hospital in southern Illinois, which launched its mHealth messaging service in November of 2018 in its ICU and surgical units. “That (process) leaves a lot of room for error in communications.”
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Data breaches cost hospitals $408 per record: 5 things to know
– 3 July, 2019
The U.S. healthcare system lost $6.2 billion in 2016 due to data breaches, with the average data breach costing healthcare organizations' $2.2 million, according to an HHS report, which includes data between 2016 and 2018.
Five things to know:
1. Data breaches can be very costly for hospitals and health systems. A study from IBM Security cited in the report found that it cost healthcare organizations $408 per record in 2018. This is up from $380 per breached record in 2017.
2. Four in five U.S. physicians have experienced some kind of cyberattack.
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Implementation best practices: Making interoperability work
Three interoperability experts – from Boston Children’s Hospital, Holon Solutions and Payformance Solutions – discuss the most important tactics to employ when first working with interoperability technologies and standards.
By Bill Siwicki
July 03, 2019 12:57 PM
Interoperability in health IT is tricky, to say the least. It requires complex technologies, robust standards and solid strategies.
The government and the industry are working on interoperability solutions. On the industry front, healthcare organizations are focused on using technology to improve interoperability of existing services and capabilities, according to a new Proskauer survey of 100 C-suite healthcare executives.
Here, three experts in health IT interoperability offer their advice and tips on how best to launch interoperability efforts at healthcare provider organizations.
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EMR implementation for public hospitals and clinics to cost RM1.5B, says Malaysian Health Minister
Currently, 25% of all government hospitals are equipped with HIS while 7% of all government clinics are equipped with CIS.
By Dean Koh
July 03, 2019 02:58 AM
Malaysian Health Minister Datuk Seri Dr Dzulkefly Ahmad said that it would cost up to RM1.5B to implement an EMR system for the 145 hospitals nationwide in Malaysia over the next five years, according to an article by The Edge Markets.
Dr Dzulkefly last mentioned in November 2018 that it would take about three years to implement an EMR system across the country. Currently, 35 or 25% of the 145 government hospitals are already equipped with Hospital Information System (HIS), while 7% or 118 out of 1,703 government clinics have been equipped with Clinical Information System (CIS).
He said that among the HIS products being used currently are Cerner, iSoft, Fisicien, Profdoc, and Patient Management System for hospitals while clinics are using CIS products such as Teleprimary Care (TPC), Oral Health Care Information System (OHCIS) and TPC-OHCIS integrated system.
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HIT Think 3 key steps to liberate data without raising liability
Published July 03 2019, 3:59pm EDT
Medical data is only as valuable as the uses it’s put toward. When shared between patients, providers, and payers, data becomes a tool for improving health outcomes and the healthcare experience. But as we gather and use more data, we also create more risk.
Whenever data is transmitted between systems, there’s a chance it could be stolen or corrupted. In the case of healthcare, this possibility can have grave consequences. The theft of someone’s Social Security number can be consequential, but stealing that person’s entire medical history would be a tremendous invasion of privacy with immense potential for exploitation—not to mention a violation of HIPAA laws. And providers realize that a data breach of this sort would expose them to legal liability, negative publicity, and a loss of trust.
Medical information has been strictly protected by HIPAA since 1996 because it needs to be. For most of that time, the priority has been clear: Keep sensitive medical information secure. However, we’ve reached a point where there’s so much to be gained by opening that data up to wider uses that the benefits outweigh the risks— that is, if certain important safeguards are put in place.
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EHR 'Nudge' Slashed Unneeded Scans Before Palliative Radiation
Default orders can help physicians de-implement low-value treatments
- by Deputy Managing Editor, MedPage Today July 01, 2019
Adding a default order to the electronic health record (EHR) halved the use of unnecessary daily imaging before palliative radiation therapy in advanced cancer patients, a randomized trial found.
Before the EHR "nudge" at five University of Pennsylvania Health System radiation oncology centers, daily imaging was used 68% of the time prior to palliative care. This number dropped to 32% after implementation (adjusted OR 0.43, 95% CI 0.24-0.77), reported Sonam Sharma, MD, of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues in JAMA Oncology.
"I was surprised by how quickly these types of nudges can work," Sharma told MedPage Today. "Almost as soon as we implemented the nudge -- very, very quickly thereafter -- we saw large and sustained drops in the number of imaging orders that were used in palliative radiation."
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Providers aim to take decision support to the next level
By Linda Wilson
Published July 03 2019, 2:43am EDT
You might think of this as clinical decision support 2.0.
Healthcare systems are rethinking how they apply CDS tools to assist—and not hinder—clinicians in daily clinical care.
They are implementing CDS to help providers with decision-making in a variety of areas. When KLAS Research surveyed executives about the “core focus for your organization going forward” for CDS, 82 percent of survey respondents mentioned order sets, followed by surveillance (46 percent), care plans (43 percent), point-of-care disease reference (33 percent), infection control (26 percent) and diagnostic support (21 percent).
Many systems want to get more of their CDS tools from electronic health-records vendors. Most respondents using Epic (61 percent) and Cerner (58 percent) said they expect those vendors to play “very significant” or “significant” roles in their future CDS plans, KLAS found in its 2016 survey research. Far fewer respondents envisioned a “very significant” or “significant” role for other EHR vendors, including Allscripts (40 percent), Meditech (36 percent) and McKesson (33 percent).
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NIST offers guidance to aid security of IoT initiatives
Published July 02 2019, 5:20pm EDT
A new report aims to help healthcare providers manage cybersecurity and privacy risks when Internet of Things devices are linked to a network.
The advice comes from the National Institute of Standards and Technology, a federal agency in the Commerce Department with a mission to promote U.S. innovation and technology. The report, “Considerations for Managing Internet of Things Cybersecurity and Privacy Risks,” is the first in series of documents the agency is creating to help IoT users protect themselves, data and networks from possible compromise.
Initial guidance focuses on large agencies and organizations, including sizable healthcare entities that are incorporating IoT into the workplace, but the content is appropriate for a variety of entities.
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Kaiser finds portal use aids patients with complex needs
Published July 02 2019, 5:31pm EDT
Diabetic patients with multiple chronic conditions who use a patient portal can better self-manage and coordinate their healthcare services.
That degree of patient engagement may reduce the frequency of in-person healthcare visits, suggests a recent study at Kaiser Permanente’s Northern California Division of Research.
The increasing number of patients living with multiple chronic conditions come with coordination challenges for both patients and healthcare providers, often across several clinicians and sites of care. This complexity can lead to less than optimal treatment, potentially redundant care and preventable acute services, according to researchers at Kaiser. Patient portal tools that give access to patients’ own health information have become an important way to improve patient engagement.
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HIT Think How 2019 security trends anticipate 2020's worries
By John Nye
Published July 02 2019, 5:44pm EDT
For anyone who has been in business or IT, 2020 has taken on a semi-mythical place in our predicted futures, and not just in some of the amazing and fantastical predictions of the 19th century.
We’ve all seen countless estimates and predictions of what to expect in 2020. Now that we are nearly two decades into this century and in close proximity from the year 2020, we can take a look at what we’ve seen in 2019 so far and finally begin to predict more accurately some of the cybersecurity threats we will likely be facing in healthcare in 2020 and beyond.
Most definitive 2020 prediction possible
Windows 7 and Server 2003 will be deprecated by Microsoft on Jan. 14, 2020. As of now, many organizations are not shy about the fact that they intend to keep Windows 7 and Server 2003 around for some time past the end-of-life date. Based on this information alone, I can confidently predict that the vast majority of these organizations will still have Windows 7 and 2003 systems on their network five years from now.
Windows 7 and Server 2003 will be deprecated by Microsoft on Jan. 14, 2020. As of now, many organizations are not shy about the fact that they intend to keep Windows 7 and Server 2003 around for some time past the end-of-life date. Based on this information alone, I can confidently predict that the vast majority of these organizations will still have Windows 7 and 2003 systems on their network five years from now.
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Industry Voices—Here's how AI is impacting the delivery of cancer care right now
Jun 28, 2019 11:32am
Few ideas in the last decade have provoked as much excitement, or as much confusion, as the introduction of artificial intelligence (AI) in oncology.
From the first moment we announced our plans to apply our Watson technology to help oncologists, we were met with a stark dichotomy of emotion. The headlines ran the spectrum from hype (your next doctor might be a robot!) to cynicism (5 reasons AI in healthcare will fail).
Today, five years into the journey to help improve cancer treatment through data, analytics and AI, while we’re still very much in the early stages, I’m happy to report that the real-world progress is far more encouraging than either of those early storylines would suggest.
In fact, not only is AI being used to support physicians in the delivery of cancer care today, it is producing quantifiable results while charting a course for the future.
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EHR messaging, workflow can be redesigned to address burnout, study suggests
Author Ron Shinkman
Published July 1, 2019
Dive Brief:
- A survey of 934 physicians with the Palo Alto Medical Foundation (PAMF) found they received an average of 243 electronic "in-basket" messages per week regarding their patients. Of those, nearly half were automatically generated by PAMF's EHR.
- According to the survey results, published Monday in Health Affairs, 36% of responding doctors reported symptoms of burnout, while 29% said they intended to reduce their clinical workload in the next year. Additionally, 42% of surveyed physicians received EHR-generated messages at higher-than-average volumes. Those doctors had a 40% greater likelihood of reporting symptoms of burnout and a 38% higher probability they wanted to cut their clinical work hours.
- The study's authors suggested shutting off automatic messaging to doctors when they're off work and altering EHR-related workflows so some tasks are delegated to other employees. They also urged EHR designers to rethink messaging algorithms, as "physicians might not be the most appropriate recipients of some system-generated messages."
Dive Insight:
When medical practices began deploying EHRs in the 1990s, the intent was to centralize patient medical histories to maximize efficiency and help avoid errors such as contraindicated medication orders. However, evidence continues to mount that physicians have had their workload divided between seeing patients and inputting data, a factor leading to costly burnouts.
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Report says docs are buried in messages, most from EHRs
Published July 03 2019, 3:44pm EDT
New published research shows a link between physicians’ well-being and the volume of messages that come in their inbox.
In-box messages generated by electronic health records systems accounted for nearly half of weekly messages received per physician, far exceeding the number of messages received from colleagues and patients, which further contributes to burnout.
The EHR potentially creates a 24/7 work environment for physicians, according to Ming Tai-Seale, a professor at University of California San Diego, along with colleagues who have published an article in Health Affairs on the onslaught of information that bedevils clinicians.
“Its impact on physicians’ wellness has become a challenge for most healthcare delivery organizations,” she notes. Understanding the relationships between physicians’ well-being and ‘desktop medicine’ work in the EHR and work environment is critical if burnout is to be addressed more effectively.’”
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June 27, 2019
Reimagining Specialty Consultation in the Digital Age The Potential Role of Targeted Automatic Electronic Consultations
The complexity of medical care ensures that no single physician can know everything, which makes specialist involvement essential for providing optimal management for many conditions. However, in many hospitals the only formal way to obtain specialty expertise is to request a traditional consult, which includes chart review, history, physical examination, and a detailed note with recommendations. Because such consults are time consuming and resource intensive, no health care system has the capacity to offer them for every patient who might benefit. This forced duality—traditional consult vs nothing—leads to a brisk market in “curbside consults,” which are limited by incomplete information exchange and can result in inaccurate recommendations.1
Although many of the anticipated benefits of electronic health records (EHRs) have been elusive, consultation offers a case in which the digitization of health care may be helpful. In this Viewpoint, we describe the potential benefits of a new option for specialty consultation: the targeted automatic electronic consult.
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6 ways smaller health systems are falling behind in cybersecurity: CHIME-KLAS survey
Jul 1, 2019 12:52pm
While large healthcare organizations are successfully adopting best practices for cybersecurity, smaller health systems and hospitals are falling behind as budget constraints and a lack of qualified talent hinder progress, according to a new survey.
College of Healthcare Information Management Executives (CHIME) and KLAS Research surveyed 647 healthcare organizations, representing 2,190 hospitals, as part of its Most Wired survey. They used those survey responses to gauge how well health systems are adopting voluntary cybersecurity best practices.
A task group within the Department of Health and Human Services (HHS) released the Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients (PDF) in December 2018 and the document outlines 10 recommendations to help healthcare stakeholders limit their cyber vulnerabilities. The HHS recommendations cover areas such as email protection systems, endpoint protection systems, access management, data protection and loss prevention, medical devices, and asset management.
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LabCorp faces lawsuits over data breach
Alamance County’s largest private employer is facing a number of lawsuits over hackers getting personal data on 7.7 million customers.
Three federal class-action suits have been filed against LabCorp in the U.S. District Court for the Middle District of North Carolina, but many more have been filed in federal courts all over the country.
The medical testing company based in Burlington announced June 4 that millions of its customers were caught up in an eight-month breach of the American Medical Collections Agency, which collected delinquent bills for LabCorp, its competitor Quest Diagnostics and other companies, like Optum 360. According to Classaction.org, which is recruiting plaintiffs, as many as 20 million patients could be affected across all of AMCA’s client companies.
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EHR default order cuts unnecessary imaging in half for cancer patients
Published July 01 2019, 12:48am EDT
Thanks to a “nudge” introduced into electronic health records, daily imaging was reduced by about 50 percent for patients with advanced cancer during palliative radiation therapy sessions.
Despite the fact that daily imaging is often used for curative radiotherapy, national guidelines consider it unnecessary for palliative radiotherapy because it can increase treatment time and expense for patients in distress, according to a study published last week in JAMA Oncology.
The study, involving five Penn Medicine radiation oncology practices in New Jersey and Pennsylvania, showed that the implementation of a default order within the EHR that specified no daily imaging during palliative radiotherapy resulted in a decrease in daily imaging to 32 percent of treatment courses from 68 percent.
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https://www.healthdatamanagement.com/news/more-states-turn-to-e-prescribing-to-better-manage-opioids
More states turn to e-prescribing to better manage opioids
Published July 01 2019, 4:10pm EDT
More than half of all states in the nation now require electronic prescribing of opioids, other controlled substances or all prescriptions.
In June 2018, governors Greg Abbott of Texas, Ron DeSantis of Florida and John Carney Jr., of Delaware signed state legislation to reach the milestone.
“To combat the opioid crisis, one of the biggest issues in healthcare today, we must all work together to digitize prescriptions and arm care providers with the actionable intelligence they need to make optimal care decisions and deliver adequate pain management,” says Tom Skelton, CEO at Surescripts, which operates a nationwide health information network.
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Google, University of Chicago named in suit charging misuse of patient data
The class action complaint alleges that, despite being deidentified, Google's expertise in data mining and AI make it "uniquely able to determine the identity" of the medical records shared with it by the university.
By Nathan Eddy
July 01, 2019 04:03 PM
Google, the University of Chicago Medical Center and University of Chicago are listed as defendants in a class action suit that alleges they failed to properly de-identify sensitive patient medical data.
WHY IT MATTERS
The complaint, filed by Matt Dinerstein in the U.S. District Court for the Northern District Of Illinois, claims UChicago "promised in its patient admission forms that it would not disclose patients' records to third parties, like Google, for commercial purposes."
The complaint, filed by Matt Dinerstein in the U.S. District Court for the Northern District Of Illinois, claims UChicago "promised in its patient admission forms that it would not disclose patients' records to third parties, like Google, for commercial purposes."
Instead, the university "did not notify its patients, let alone obtain their express consent, before turning over their confidential medical records to Google for its own commercial gain," the document states.
The suit alleges that "Google and the university claimed the medical records were de-identified. But that’s incredibly misleading. The records the University provided Google included detailed datestamps and copious free-text notes."
Google's expertise in data mining and artificial intelligence, Dinerstein charges, means it is "uniquely able to determine the identity of almost every medical record the university released."
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Weekly News Recap
- Change Healthcare goes public on the Nasdaq exchange.
- Providence St. Joseph Health acquires Bluetree Network.
- Sansoro Health and Datica announce plans to merge.
- Vyne is acquired by PE firm The Jordan Company.
- The director-general of Australia’s Queensland Health announces plans to resign following problems with its Cerner implementation.
- UnitedHealth Group acquires PatientsLikeMe in a government-ordered fire sale.
- The White House issues an executive order requiring providers to disclose pricing information.
- Phreesia files for an IPO.
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Five Countries On The Frontline Of Tech
A new report has identified the most highly connected countries, where innovation, online services and digitally forward-thinking lifestyles are drawing expats from across the globe.
- By Lindsey Galloway
1 July 2019
Connectivity shapes culture around the world, and in many places digital life has become indivisible from day-to-day living. High-speed internet, mobile accessibility and cashless payments increasingly drive the global economy, and some countries are heavily leaning into this digital future with improved online services and accessibility.
To uncover which countries rank highest when it comes to next-generation connectivity, global community network InterNations recently released a report on Digital Life Abroad, ranking countries for expats based on the availability of government online services, the ease of getting a local mobile number, the availability of high-speed internet at home, cashless payments and open access to the internet.
We spoke to residents in the places that ranked among the highest in each of the five categories to discover what it’s like to live in a highly connected country.
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Enjoy!
David.
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