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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Why On Earth Are Physicians Still Collecting Patient Data Using Paper Forms?
July 11, 2019
As part of its “Patients over Paperwork” effort, CMS recently issued a Request for Information seeking new ideas on reducing levels of administrative burden.
The initiative seems to be making a serious impact. According to CMS, reforms identified by Patients over Paperwork since it launched in late 2017 should save roughly 40 million hours and $5.7 billion through 2021. This impact comes from changes such as streamlining documentation requirements and billing codes, changing the Medicare reimbursement model for skilled nursing facilities and adopting more meaningful areas for quality measurement and improvement.
That being said, CMS either isn’t considering or isn’t taking seriously an approach which could streamline virtually every patient’s experience and make it much simpler for providers to manage patient data. This magic trick is nothing more than making sure all data on patients is entered digitally the first time their provider collects it.
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Review Article
Targeting depressive symptoms with technology
1Department of Psychiatry and Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 2Contributing Writer, Medscape, Warwick, NY, USA; 3Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA; 4Chairman of the New England Healthcare Exchange Network, Boston, MA, USA
Correspondence to: John Torous, MD. Director of the Digital Psychiatry Program, Department of Psychiatry and Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Email: jtorous@bidmc.harvard.edu.
Abstract: Interest in digital mental health, driven largely by the need to increase access to mental health services, presents new opportunities as well as challenges. This article provides a selective overview of several new approaches, including chatbots and apps, with a focus on exploring their unique characteristics. To understand the broader issues around digital mental health apps, we discuss recent reviews in this space in the context of how they can inform care today, and how these apps fail to address several important gaps. Framing apps as either tools to augment versus deliver care, we explore ongoing struggles in this space that will determine how apps are used, regulated, and reimbursed for. Realizing that many mental health apps today exist in this still undefined space and often possess no evidence, we conclude with an overview of the American Psychiatric Association (APA)’s app evaluation framework with the goal of offering a more informed approach to these digital tools.
Keywords: Mental health apps; digital health; American Psychiatric Association (APA); chatbots; clinical depression; depressive symptoms
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Amazon Alexa partnership puts patient data ‘at risk’
A new partnership between the NHS and Amazon Alexa lacks a “concerning” amount of information around data protection, patient confidentiality and safety, it has been said.
Andrea Downey – 10 July 2019
The partnership, announced today, allows users to ask for health advice from verified NHS sources using their Alexa device with NHSX confirming in a tweet that the health service is not “paying Amazon a penny”.
While some within the NHS welcomed the news, others have raised concerns around patient safety and data protection.
A lack of detail about how patient data will be used and stored makes the deal appear like a “crazy PR stunt”, according to Phil Booth, a co-ordinator at medConfidential.
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Alexa will see you now: NHS partners with Amazon
A new partnership between the NHS and Amazon Alexa will bring verified health information to people’s homes.
Andrea Downey – 10 July 2019
It’s hoped the world-first collaboration will empower people to take greater control of their health and care.
Through simply asking Alexa questions about symptoms or treatments, the technology can provide qualified advice to users in the comfort of their own homes.
Amazon’s algorithms trawl information on NHS websites to provide answers to questions like: “How do I treat a migraine?”, “What are the symptoms of flu?” and “What are the symptoms of chickenpox?”.
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Medsphere adds AI tools to EHR platform
Healthcare IT provider Medsphere Systems Corp. has added artificial intelligence capabilities to its CareVue EHR platform.
The AI tools, developed by CloudMex, are designed to gather structured and unstructured data from medical records and use natural language processing and machine learning tools to provide clinical insights.
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3 ways a community HIE can help boost your practice’s revenue
July 8, 2019
Recent research points to how community health information exchanges (HIEs) help reduce the cost of care, improve patient safety and decrease utilization and duplication. However, one potential benefit of community HIEs is just starting to be explored: increased revenue.
In an era of value-based care, community HIEs present an attractive opportunity to protect and increase revenue for physician practices.
When it comes to improving value, community HIEs have an advantage over a proprietary HIE, including fewer duplicated procedures, reduced imaging, lower costs and improved patient safety, according to research from Indiana University. Community HIEs enable physicians and other providers to share information about any patient whose data is captured within the HIE, while proprietary HIEs limit access to patient data to certain providers.
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Over half of health organizations say patient portal security is above average
When it comes to the security of their patient portals, more than half of healthcare organizations consider theirs as above average or superior in comparison to other patient portals, according to a LexisNexis report.
For its State of Patient Identity Management report, LexisNexis conducted an online survey about cybersecurity trends in healthcare with more than 100 participants from healthcare organizations including hospitals, physician group practices and payers. Information Security Media Group helped LexisNexis perform the survey.
Three notes:
1. Fifty-eight percent of participants said they think the security of their patient portal is above average or superior to other organizations' patient portals.
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One issue is probably to blame for your IT outages and data losses - and it's not hackers
The main causes of downtime remain prosaic, but cyber incidents are growing too.
A hardware failure is most likely to cause unexpected downtime or data loss, but the damage caused by security threats like viruses and ransomware continues to rise.
Broken equipment and human error remain the top causes of data loss over the last 12 months, while hardware failures, connectivity issues and problems caused by upgrades or patching are blamed as the biggest causes of downtime in a survey of 400 IT decision-makers.
But while those reasons for outages have held reasonably stable over the years, outages and data loss caused by cyberattacks have jumped significantly, according to the survey by security company Databarracks.
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Hospitals are paying for not vetting their vendors
More than half of hospitals say they've had one or more data breaches caused by third-party vendors in the past two years, with an average cost of $2.9 million per incident – but too many are still failing to do adequate risk assessments.
July 11, 2019 12:36 PM
No hospital is an island: from clinical software to data storage, there's a near-limitless number of vendors to serve up the necessary components of healthcare IT system. Every device or piece of software connected to the internet means another point of exposure to attacks and breaches.
A new study from the Ponemon Institute, sponsored by Censinet, shows that health systems' approaches to managing the risks of third-party vendors are falling short of what's necessary in this cybersecurity environment – and that many organizations are seeing an increase in HHS and OCR fines and investigations as a result.
WHY IT MATTERS
According to Ponemon report, The Economic Impact of Third-Party Risk Management in Healthcare, health systems on average have 3.2 FTE security employees who work full time, more than 500 hours per month, to handle vendor risk assessments.
According to Ponemon report, The Economic Impact of Third-Party Risk Management in Healthcare, health systems on average have 3.2 FTE security employees who work full time, more than 500 hours per month, to handle vendor risk assessments.
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Express Scripts Formulary for “Digital Health” Offers Long Overdue Info
July 10, 2019
In mid-May, Express Scripts announced that it plans to introduce what it says is the healthcare industry’s first stand-alone digital health formulary. This may not sound like much, but I’d argue that it’s a noteworthy development. After all, Express Scripts is a Cigna company now, which makes this notice interesting from both a health plan and a provider standpoint.
In its recent press release, the vendor said it was creating the new formulary to help consumers and payers sift through the hundreds of thousands of personal health technologies and interventions available. As with pharma formularies, it’s also intended to help payers identify safe, effective and usable digital health tools.
The formulary, which will be available in 2020, will be a curated list of technology- and software-enabled applications and devices intended to prevent, manage or treat a medical condition. When it launches, the formulary will offer tools to manage diabetes, cardiovascular, behavioral health and pulmonary conditions, and will include tools for treating other chronic and complex conditions over time.
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How to better integrate IT security and IT strategy
Organizations see a future in which IT security is deeply woven into their overall IT strategy. Here’s how they plan to get there.
By Bob Violino
Contributing Writer, CIO | July 10, 2019 03:00 AM PT
Information security has become such an integral part of IT that at a growing number of organizations, the two are virtually indistinguishable — from an organizational standpoint.
Many companies are attempting to more tightly integrate IT security strategy with IT strategy. That can mean blending departments, changing leadership structures, and embedding security earlier in the development pipeline, among other tactics.
[ Learn from your peers: Check out our State of the CIO 2019 report on the challenges and concerns of CIOs today. | Find out the 7 skills of successful digital leaders and the secrets of highly innovative CIOs. | Get weekly insights by signing up for our CIO Leader newsletter. ]
About two thirds of organizations say their IT security strategy and IT strategy are tightly integrated, with IT security being a key component of IT roadmaps and projects, according to CIO’s 2019 State of the CIO survey.
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What is FHIR? The eventual answer to healthcare interoperability
Fast Healthcare Interoperability Resources (FHIR) is a healthcare-specific standards framework for the same kind of RESTful APIs that underlie most internet commerce. In theory, it sounds like problem solved. But experts say there is still a long road ahead before FHIR is widely adopted for EHR-to-EHR interoperability.
CIO | July 10, 2019 03:00 AM PT
Fifteen years after President George W. Bush launched a nationwide campaign to computerize healthcare and give everyone access to their electronic health records (EHRs), the industry is finally starting to achieve some degree of interoperability among EHRs and other health IT systems. But much of the data is still locked up in documents, and the ability of healthcare providers to access discrete data from outside sources at the point of care remains limited.
The reason interoperability between computer systems is so difficult in health care—and the reason it’s so badly needed—is that health care is extremely fragmented. There are many different kinds of healthcare providers, including hospitals, doctors, nursing homes and urgent care centers, and they use many different types of EHRs. Health insurers use an array of other systems. Interfaces are expensive to build and difficult to maintain, and they don’t allow searches across networks.
Complicating this already complex scenario is the fact that, for their own business reasons, some EHR vendors and provider organizations have created barriers to electronic health data exchange. A recently proposed rule from the federal Office of the National Coordinator of Health IT (ONC) would prohibit such “information blocking” and would also make it easier to exchange discrete data by requiring that government-certified EHRs include APIs based on the emerging FHIR standard.
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https://www.healthdatamanagement.com/opinion/4-key-elements-to-a-successful-data-governance-strategy
HIT Think 4 key elements to a successful data governance strategy
Published July 11 2019, 5:32pm EDT
Does your executive team understand the importance of data management in today’s IT environment?
In short, of course they do. Data management is at the crux of today’s businesses. Externally, customers want to engage with businesses that guarantee data is protected, while internally, business leaders rely on data to update sales strategies, create targeted marketing campaigns, inform customer retention programs, and more.
But does your executive team understand exactly how data management works and the best practices and strategies to guarantee data is always safeguarded? Well, here it gets a little tricky. Despite its importance to business success, data management—particularly when it comes to backup and protection—can often be an afterthought.
Organizational leadership often underestimates the time, budget and effort that go into protecting their data. And because leadership teams are often preoccupied with time and budget, they can be hesitant to invest that time and budget into adopting the best data management strategies.
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'Big Three' Diagnostic Errors Account for Nearly 75% of All Serious Harm
One-third of malpractice cases for death or permanent disability began with an errant or delayed diagnosis, making it the biggest cause of serious harms among medical errors.
KEY TAKEAWAYS
· Diagnostic errors that led to death or permanent disability were linked with misdiagnosed cancers (37.8%), vascular events (22.8%) and infections (13.5%) — which led the researchers to refer to them as the 'big three.'
· Half of the most-severe harm cases ended in patient death and the other half resulted in permanent disability.
· Failures of clinical judgment caused more than 85% of the misdiagnosed cases.
Misdiagnoses in treatments for "big three" conditions – cardiovascular events, cancers and infections – comprise 74% of all serious harms from diagnostic errors, according to a new study published Thursday in Diagnosis.
The study also found that 34% of malpractice cases for death or permanent disability began with an errant or delayed diagnosis, making it the biggest cause of serious harms among medical errors.
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AI for all that ails American health care. But how smart is that?
The evidence base is wobbly, but artificial intelligence is coming on strong and the hype for it is even stronger. Screening for diabetic retinopathy is an early application. Lingering questions include whether the use of AI will contribute to health care inequities rather than solve them.
July 5, 2019
Sarah Kwon
With machine learning technology developed by a company called IDx, someone with just four hours of training can detect diabetic retinopathy in patients without having to have the diagnosis reviewed by an eye specialist. Real-world tested and FDA approved.
It seems like only several years ago, the health care industry was beginning to ask what problems could AI solve. Now, one might wonder what AI isn’t trying to fix.
Rock Health, a health technology investment and research company, reports that from 2011 to 2017, 121 digital health companies were showered with $2.7 billion in venture funding to apply AI to 19 areas, ranging from drug research and development to clinical-decision support to health benefits administration.
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How Clinical Communications Technology Connects the Care Team In Complex Cases
July 9, 2019
The following is a guest blog post by Mary Hatcher, Vice President of Product Development at PerfectServe.
When multiple specialists and post-acute providers are serving the same patient, getting the right information to the right person in a timely manner becomes more challenging. Dozens of nurses and therapists. Several doctors. Various settings. The complexity adds up, and in these scenarios, communication breakdowns are more likely to occur.
The stakes are high when it comes to healthcare delivery, so these cross-organizational communication challenges affect the clinical care team, the patient and the patient’s family all at once. Family members are often active participants in care, and rather than operating in siloes, physicians and nurses have to coordinate with other members of the care team. Patient information must be available to all parties to ensure the best outcome.
In these complicated medical cases, clinical communication technology must be flexible enough to support all departments and organizations, as well as their associated messaging preferences. Consequences can include mismanaged meds, duplicate tests, unnecessary costs, inaccurate diagnoses, and in some cases, even death. That’s why, in the ECRI Institute’s survey of Top 10 Patient Safety Concerns for 2019, the solution for the number one concern—diagnostic stewardship and test result management—is to “recognize the importance of clear communication, both among caregivers and between caregivers and patients.”
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Internet Of Things: Counting The Cost Of Cyberattacks
By
07/05/19 AT 6:00 AM
07/05/19 AT 6:00 AM
Connectivity is becoming ubiquitous in our daily lives, with appetite from consumers and businesses for connected devices and services sparking the rapid proliferation of the Internet of Things (IoT). According to IHS Markit, by 2025, it’s estimated that 73 billion IoT devices will be connected globally. The United States is ranked one of the earliest adopters of the IoT, with 69 percent of American households owning a connected device.
Yet, IoT is still in its infancy, and manufacturers have been neglecting to build in security measures at the point of design. So, as IoT devices become more commonplace in homes and businesses, the attack surface is only getting bigger – cybercriminals are recruiting our smart speakers, smart TVs and other smart devices for their own campaigns of cyber terror.
However, it’s not in these consumer devices where the biggest IoT cybersecurity threat could lie. Cybercriminals often operate as businesses themselves and will focus on targets that will provide the greatest return on their hacking investment. Therefore, as various industries become increasingly connected, this is where we could see an extremely costly impact of IoT-focused cyberattacks, if security is not prioritized. Insecure devices, and potentially companion apps, present a variety of risks to safety and privacy, especially as the IoT enters more critical industries such as healthcare, transport and manufacturing.
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Early-Onset Sepsis Risk-Calculator Curbs Antibiotic Overuse in Newborns
NEW YORK (Reuters Health) - Integrating an early-onset sepsis (EOS) risk calculator into the electronic health record (EHR) reduced antibiotic orders in a newborn nursery, with no increase in adverse events, researchers say.
Along with the usual consequences of antibiotic overuse, "For newborns, there are other important costs, such as separation of mother and infant, delayed initiation of breastfeeding, and painful blood draws," Dr. Carole Stipelman of the University of Utah School of Medicine in Salt Lake City told Reuters Health by email.
"Newborn sepsis screening and treatment guidelines have recommended a low threshold for initiating antibiotics for infants, based in part on subjective risk factors for the birth that do not take into account the clinical status of the infant," she said.
"The Neonatal Early-Onset Sepsis Calculator (https://k-p.li/2XTkwbs) provides a risk estimate of neonatal sepsis and recommendations for care by combining the birth risk factors with the infant's clinical status," she explained. "Even with some risk factors for infection at birth, antibiotics are often not recommended by the calculator if an infant remains well in the newborn period."
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Consumers Say Encrypting Medical Devices Is Needed for Security
A majority of U.S. consumers believe encrypting medical devices is the best way to prevent security flaws.
By Fred Donovan
July 08, 2019 - A majority of U.S. consumers believe encrypting medical devices is the best way to prevent security flaws.
Thirty-one percent of 1,300 consumers surveyed by nCipher believe medical devices should be independently certified.
Surprisingly, 18 percent of respondents support medical devices being controlled by the government.
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FCC approves $100M connected care pilot to benefit low income patients, veterans
Jul 10, 2019 3:44pm
The Federal Communications Commission is moving forward with developing a three-year, $100 million Connected Care Pilot program to support telehealth and remote patient monitoring services to improve healthcare access to underserved populations.
The Commissioners voted unanimously to adopt a notice of proposed rulemaking (PDF) calling for public comment on testing a new program, using the FCC’s existing Rural Health Care Program authority, that would defray the costs of purchasing broadband Internet access service necessary for providing connected care services directly to low-income patients and veterans.
The program, unveiled by FCC Commissioner Brendan Carr in July 2018, would establish a three-year pilot to be funded by the FCC's Universal Service Fund to help healthcare providers defray the costs of broadband service.
The proposed pilot program would cover up to 85% of certain internet connectivity costs for broadband-enabled telehealth services that connect patients directly to their doctors and are used to treat a wide range of health conditions.
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MU Health Care's 'EMR happy hours' help address documentation, workflow issues
-9 June, 2019
Once a month, University of Missouri Health at Columbia clinicians attend an "EMR happy hour" session to troubleshoot issues regarding charting, documentation and ordering within the EMR, according to a study published in Annals of Family Medicine.
The hour-long sessions are designed to focus on minimal-effort, yet highly effective, solutions that can be achieved quickly by peer-to-peer collaborations instead of consulting with the vendor, according to the report. The sessions are held among the family medicine department at MU Health Care, which uses a Cerner EMR system.
Each session typically comprises three to 10 physicians in attendance, who are encouraged to bring a laptop to practice new skills in real time. A member of the EMR training staff as well as one to three clinical faculty members usually facilitates the session to achieve a small teacher-to-student ratio. Each meeting is tailored to address the participating clinicians' needs and questions, which define the agenda for the session.
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Cybersecurity incidents led to $45 billion in losses in 2018: report
Cyber incidents in the U.S. led to an estimated loss of $45 billion in 2018, according to a report released Tuesday by the Internet Society’s Online Trust Alliance (OTA).
OTA’s Cyber Incident and Breach Trends report found that the financial impact of ransomware cyberattacks rose by 60 percent, while financial losses from the compromise of business emails doubled and cryptojacking incidents more than tripled from the year before. The report looked at the financial fallout from about 2 million cyber incidents including record exposures, ransomware attacks, data breaches and others.
“All of this begs the question ‘are things getting better or worse?' ” OTA wrote in the report. “The answer is ‘both’ – as some types of attacks wane, others rise. What is very clear is that there are too many cyber incidents creating an unacceptable level of financial impact.”
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New NHS digital reporting system will allow safety concerns to be reported via mobile phones
The Patient Safety Strategy says new system will use AI to improve learning from care incidents.
By Tammy Lovell
July 10, 2019 06:52 AM
A new national patient safety reporting system will allow staff, patients and families to report care incidents on their mobile phones.
The system will replace the “outdated technology” currently being used to report incidents, according to the recently published NHS patient safety strategy.
Since 2003, the National Reporting and Learning System (NRLS) has been the main system for reporting and reviewing patient safety incidents. The database receives around two million incidents a year and is used to develop NHS policy and guidance.
But the outdated system will now be replaced by the Patient Safety Incident Management System (PSIMIS), which will use technology such as data-cleansing algorithms to protect patient anonymity and artificial intelligence (AI) to process incident data in new ways.
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Data governance in the age of AI: Beyond the basics
By Gienna Shaw
Published July 10 2019, 12:06am EDT
If you want some basic advice about launching a data governance program, it’s easy to find: Get leadership buy-in, appoint some data stewards or champions, and make sure everyone meets regularly to talk about it.
But there’s a lot more to it than that, especially in the age of data-hungry tools borne from artificial intelligence. When you’re dealing with data on a machine learning scale, you’re dealing with “garbage in, garbage out” on steroids.
“The only thing worse than not having enough data is having too much,” says Colin Zick, who co-chairs the healthcare data privacy and security group at the law firm Foley Hoag. “That’s the challenge as we move into a world where there are increasingly large data sets—the data governance. How do you manage the data, how do you ensure its quality?” With AI, he adds, “you really have to get into making sure the data and the analysis and the quality are there, because, if not, you’re just going to make bigger mistakes.”
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Providers need contingencies if the power goes out
Published July 09 2019, 12:01am EDT
There are all variety of reasons why power blackouts happen. Some can be foreseen, while other times, there’s no way a healthcare organization can anticipate, and prevent, the lights going dark and a data center going still.
For example, one hospital lost power after Mylar balloons from a nearby party landed on a power line, says Ed Spears, a technical manager at Eaton, a global power management company that tracks outage information to educate entities on the causes and impacts of outages.
What many healthcare providers don’t know is how finicky power can be. If power goes out for three seconds, it could take five hours to bring it back, Spears contends.
That could be five hours that the imaging systems and other critical applications are out of commission, with open data lost or needing to be regenerated via backup systems, and patients possibly being sent home with their appointments rescheduled. That all adds up to significant lost revenue and potential major expenses for hospitals.
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HIT Think How precision medicine and genomics aid in cancer care
Published July 09 2019, 5:12pm EDT
Cancer specialists have long been the standard-bearers of precision medicine. Oncology was one of the first clinical areas to recognize the role genetic variations play in disease risk and causation. Subsequent progress has brought us to our current state, where oncologic therapies are targeted based on the tumor’s genetic profile, rather than on the site where the disease presented itself.
Consider these realities:
- BRCA 1 (associated with breast cancer) was discovered in 1994—a full 25 years ago—and BRCA 2 was identified just a year later.
- Since then, it has been discovered that more than 50 cancer syndromes are affected by mutations in specific genes.
- In 2017, pembrolizumab became the first tumor-agnostic drug approved by the FDA. Since then, several more have entered the market, including nivolumab and larotrectinib. The trend towards targeted molecular therapy is expected only to accelerate.
Somatic results are not enough
The results of somatic testing, which reveals genetic markers of the tumor tissue, has added great value to cancer treatment. Oncologists use these insights to more precisely diagnose a patient’s disease and devise a care plan tailored to the unique molecular profile of the cancer. While incredibly important in the treatment of a specific incidence of cancer, somatic information does not provide information about the patient’s “native” genetic profile; a tumor’s characteristics are unique unto itself. Therefore, somatic data provides limited information about the overall patient and other factors that might affect their care and wellbeing now and into the future.
The results of somatic testing, which reveals genetic markers of the tumor tissue, has added great value to cancer treatment. Oncologists use these insights to more precisely diagnose a patient’s disease and devise a care plan tailored to the unique molecular profile of the cancer. While incredibly important in the treatment of a specific incidence of cancer, somatic information does not provide information about the patient’s “native” genetic profile; a tumor’s characteristics are unique unto itself. Therefore, somatic data provides limited information about the overall patient and other factors that might affect their care and wellbeing now and into the future.
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Special Report: Digital Imaging
Adopting an enterprise image management approach can, proponents argue, lead to widespread benefits for NHS organisations. But is this enough to encourage trusts to embrace such a strategy? Maja Dragovic finds out.
In 2017, Stephen Townrow went to the board of The Princess Alexandra Hospital NHS Trust with a request. He wanted to consolidate all the organisation’s different types of imaging into one single solution.
“Before we had a different cardiology system, they weren’t storing any images from the theatre, it was all over the place,” explains Townrow, the trust’s imaging systems manager.
“There were situations where they wanted to look at imaging in A&E, but cardiology was shut so they couldn’t look at the imaging. Hence, they couldn’t make a clinical decision based on that – which affects patient care.”
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Electronic Health Record–Related Events in Medical Malpractice Claims
Graber, Mark L., MD, FACP*; Siegal, Dana, RN, CPHRM†; Riah, Heather, MBA†; Johnston, Doug, MTS*; Kenyon, Kathy, JD‡
Journal of Patient Safety: June 2019 - Volume 15 - Issue 2 - p 77–85
doi: 10.1097/PTS.0000000000000240
Original Articles
Background There is widespread agreement that the full potential of health information technology (health IT) has not yet been realized and of particular concern are the examples of unintended consequences of health IT that detract from the safety of health care or from the use of health IT itself. The goal of this project was to obtain additional information on these health IT–related problems, using a mixed methods (qualitative and quantitative) analysis of electronic health record–related harm in cases submitted to a large database of malpractice suits and claims.
Methods Cases submitted to the CRICO claims database and coded during 2012 and 2013 were analyzed. A total of 248 cases (<1 80="" a="" accounted="" all="" although="" ambulatory="" an="" and="" as="" care="" cases="" coded="" complication="" diagnosis="" dimensions="" error="" etiologic="" factors.="" factors="" filed="" for="" from="" harm="" health="" identified.="" identified="" identifies="" in="" involved="" involving="" it="" less="" lethal="" likely="" many="" medications="" moderate="" more="" most="" of="" or="" p="" patterns="" proprietary="" recurring="" result="" settings.="" severe="" sociotechnical="" spanned="" system-related="" taxonomy="" than="" that="" the="" treatment="" typically="" user-="" using="" were="">
Conclusions Adverse events associated with health IT vulnerabilities can cause extensive harm and are encountered across the continuum of health care settings and sociotechnical factors. The recurring patterns provide valuable lessons that both practicing clinicians and health IT developers could use to reduce the risk of harm in the future. The likelihood of harm seems to relate more to a patient's particular situation than to any one class of error.
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Global EHR market hits $31B but faces usability, interoperability challenges
Jul 8, 2019 1:17pm
The worldwide electronic health records market faces intensifying criticism related to usability and interoperability as well as slowing growth due to market saturation.
Despite these challenges, the EHR market topped $31.5 billion in 2018, according to a report from market research firm Kalorama Information.
The market for EHRs, which includes revenues for EHR systems, computerized provider order entry systems, and directly related services, such as installation, training, servicing, and consulting, grew 6% from $29.7 billion the previous year, the report said.
The market report does not include picture archiving and communication systems or hardware.
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Kaiser Permanente develops machine learning tool to predict HIV risk
Jul 8, 2019 11:55am
Researchers at Kaiser Permanente developed a machine learning algorithm officials say could ultimately help prevent HIV transmission.
The analytical tool more effectively identifies people at risk of contracting HIV compared to other HIV risk prediction tools to enable more at-risk patients to be referred for preventive medication, according to a study describing the prediction tool published July 5 in The Lancet HIV.
Investigators at Kaiser Permanente San Francisco, the Kaiser Permanente Division of Research, Beth Israel Deaconess Medical Center, and Harvard Medical School analyzed medical records of 3.7 million Kaiser Permanente patients and developed a machine learning algorithm to predict who would become infected with HIV during a three-year period.
The algorithm flagged 2.2% of all patients as high or very high risk, the study found.
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With Rural Health Care Stretched Thin, More Patients Turn To Telehealth
July 7, 20198:09 AM ET
Telehealth turned Jill Hill's life around.
The 63-year-old lives on the edge of rural Grass Valley, an old mining town in the Sierra Nevada foothills of northern California. She was devastated after her husband Dennis passed away in the fall of 2014 after a long series of medical and financial setbacks.
"I was grief-stricken and my self-esteem was down," Hill remembers. "I didn't care about myself. I didn't brush my hair. I was isolated. I just kind of locked myself in the bedroom."
Hill says knew she needed therapy to deal with her deepening depression. But the main health center in her rural town had just two therapists. Hill was told she'd only be able to see a therapist once a month.
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Fujitsu supercharges healthcare AI
By Michael Moore July 4, 2019
New text mining system will cut down on processing and wait times.
Fujitsu has revealed a new AI system which could lead to patient wait and processing times being slashed.
The new system is able to process medical notes and health records in much faster time than a human eye - achieving more than 90 percent improvement in terms of time saved.
It may be a staple of medical comedy that doctors have traditionally bad handwriting, but Fujitsu says that its system can examine and extract information in less than a minute, compared to the 15 minutes normally required for manual analysis.
With medical professionals increasingly stretched for time when dealing with multiple patients, this technology could greatly improve patient care quality, but also allowing for more patient data to be stored for more in-depth diagnosis.
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Voice assistant offers remedy for physician burnout
Saykara's digital assistant is aimed at freeing doctors from time-consuming EHR data entry and improving their interactions with patients.
Senior Reporter, Computerworld | July 03, 2019 03:00 AM PT
As the likes of Amazon Alexa and Apple’s Siri have gained popularity in our personal lives, the healthcare industry has been at the forefront in adopting voice-driven AI assistants in the workplace. And for good reason: exponents of the technology claim it can boost productivity and help avoid physician burnout.
Speech-to-text applications are not new to medical staff, who have used transcription software to digitize voice notes recorded on a dictaphone for some time now. However, advances in AI have enabled the creation of virtual assistants that can understand context and intent better.
Voice assistants are now available that can input patient notes directly into electronic health record (EHR) systems automatically when dictated by a physician, potentially saving a significant amount of time and effort.
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KLAS: More than half of healthcare organizations practice surprise phishing email exercises
- Monday, July 1st, 2019
More than 50 percent of small, medium and large healthcare organizations have implemented unannounced email phishing exercises to train their employees, according to a recent KLAS and College of Healthcare Information Management Executives report.
For its "How Aligned are Provider Organizations with the Health Industry Cybersecurity Practices Guidelines?" report, KLAS analyzed results of CHIME's 2018 Healthcare's Most Wired survey. Survey responses included more than 600 healthcare organizations, which were asked about their adoption of cybersecurity recommendations made by an HHS task group.
Because email is the most common attack vendor that puts healthcare organizations at risk of cyberattack, the HHS task group recommends practicing monthly phishing simulations to enhance employees' cybersecurity hygiene, the report states.
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Jon White departs ONC, Steve Posnack to take over as Deputy National Coordinator
White's areas of focus at the agency included the Shared Nationwide Interoperability Roadmap, the recently proposed information blocking rules.
By Mike Miliard
July 08, 2019 01:19 PM
Deputy National Coordinator for Health IT Dr. Jon White is leaving the agency next month for a position at the Veterans Administration Salt Lake City Health Care System, where he'll be Associate Chief of Staff of Research.
WHY IT MATTERS
White has been at ONC for five years. Steve Posnack, who has spent more than 14 years at the agency – he's been there almost since its inception – will take over in White's role on August 19. In his previous position, Posnack served as executive director, focused on the ONC Health IT Certification Program and the standards and technology investments of ONC Tech Lab.
White has been at ONC for five years. Steve Posnack, who has spent more than 14 years at the agency – he's been there almost since its inception – will take over in White's role on August 19. In his previous position, Posnack served as executive director, focused on the ONC Health IT Certification Program and the standards and technology investments of ONC Tech Lab.
During his tenure at ONC, White – who had previously served as director of the Division of Health IT at the Agency for Healthcare Research and Quality – focused on major interoperability initiatives such as the Shared Nationwide Interoperability Roadmap and the information blocking rules that were recently put up for public comment.
White also served as acting head of the agency in the months between the tenures of National Coordinators Dr. Vindell Washington and Dr. Donald Rucker.
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Hospital-based pharmacists spearhead opioid stewardship
Published July 08 2019, 12:44am EDT
In the nation’s fight against the opioid epidemic, pharmacists in hospital settings are on the front lines in detecting drug diversion and identifying ways to foster appropriate prescribing.
A new survey of pharmacy directors in more than 800 of America’s hospitals finds that most large health systems have active stewardship programs to prevent the misuse of opioids.
“Opioid stewardship programs are emerging in many U.S. hospitals, with pharmacists participating or taking the lead in program implementation,” according to the findings of the National Survey of Pharmacy Practice in Hospital Settings, published in the American Journal of Health-System Pharmacy.
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HIT Think Why Washington wants more input on health IT initiatives
Published July 08 2019, 3:33pm EDT
Health IT executives: Washington needs your help.
That message rang loud and clear from both sides of the aisle and across federal agencies at the second annual CHIME Advocacy Summit on June 26 to 28 in Washington. Whether it is providing supporting data, sharing anecdotes, responding to requests for information or taking the ultimate step of becoming a politician, CIOs and other health IT leaders can help shape policies affecting telehealth, cybersecurity, interoperability and the opioid epidemic.
“We are still lacking cost-effectiveness data,” said Rep. Doris Matsui (D-Calif.), author of the bipartisan Excellence in Mental Health Act and sponsor or co-sponsor of numerous bills promoting telehealth, cybersecurity and the use of 5G. Although there has been some progress recently, reimbursement for telehealth visits has been stymied without data that shows telehealth lowers costs and improves quality – or at least is on par with in-person care. “I need your support going forward,” she said.
Rep. Greg Gianforte (R-Mont.), echoed Matsui’s request. A strong proponent of telehealth to serve his largely rural constituency, he pointed to the Congressional Budget Office (CBO) as a hurdle that health IT leaders could help overcome. CBO has voiced concerns that more accessibility to healthcare through telehealth will increase use and therefore costs. That calculation doesn’t account for savings from alternative choices such as costly emergency room visits. “We need to educate CBO so they can score properly,” he said.
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Upcoming Sequel To Cult Classic 'House Of God' Skewers Money And Screens In Medicine
I'd like to apologize to all my newsroom neighbors for the loud "Yes!" that escaped me earlier this week when I opened a big yellow envelope and pulled out "Man's 4th Best Hospital."
But I couldn't help it. The Fat Man is back!
Not the film noir character but the unforgettable, infinitely and cynically wise and crude senior resident from the cult classic, "The House of God," which has sold more than 2 million copies.
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Algorithms developed to diagnose disease
Sarah Ward
Computer algorithms are being developed to diagnose diseases by Scotland’s largest health board.
The NHS Greater Glasgow and Clyde project, named iCaird, will enable computers to scan digital images of biopsies and tissue samples for anomalies.
The goal is to improve the turnaround times for pathology results so that patients can get faster diagnosis and treatment. It should also ease the workload for pathologists by enabling them to focus on priority cases.
William Edwards, NHS GGC’s director of e-health, said that the board was developing a way of taking digital images of tissue samples rather than making them available on glass slides to be looked at under a microscope.
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NHS Glasgow eHealth projects target pathology and COPD
Helen McArdleHealth Correspondent
COMPUTERS will be trained to spot disease from pathology samples in the latest ehealth initiative designed to speed up diagnoses and ease pressure on doctors.
The three-year project is one of a number of areas where Scotland's largest health board is turning to technology and artificial intelligence to 'future-proof' the service to cope with increasing demand.
Experts working on the iCAIRD project at NHS Greater Glasgow and Clyde are in the process of developing algorithms which can mimic pathologists' knowledge of disease, enabling computers to scan for anomalies using digital images of biopsies and tissue samples.
William Edwards, NHSGGC's director of eHealth, said: "Rather than slices being made available on glass slides and looked at under a microscope, what the board is keen to do in put in place the ability for these images to be captured digitally. That way you can look at the pathology sample on a computer.
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Enjoy!
David.
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