Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, August 31, 2019

Weekly Overseas Health IT Links – 31st August, 2019.

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

Digital tools prevent hundreds of sepsis deaths across three hospitals

Three hospitals have reduced sepsis deaths and increased screening for the deadly condition using digital “alert and action” solutions.
Andrea Downey 20 August, 2019
Cambridge University Hospitals, Royal Berkshire NHS Foundation Trust and Royal Liverpool and Broadgreen University Hospital have each seen a reduction in mortality rates using algorithms to read patients’ vital signs and alert clinicians to worsening conditions that are a warning sign of sepsis.
In Cambridge, deaths from sepsis have fallen consistently over the last three years, with at least 64 lives saved in the past year thanks to the digital alert system.
In Berkshire the trust has increased screening rates by 70%, with nine in 10 patients now consistently screened for sepsis during admission as opposed to two in 10 beforehand.

AI pilot project to help CMS identify fraud deemed a success

Andrea Park -
Deep Labs, a San Francisco-based provider of artificial intelligence systems, announced Aug. 19 the successful completion of a pilot project to help CMS better detect potential fraud and abuse.
Deep Labs conducted the project with the help of Visual Connections, a Windsor Mill, Md.-based firm providing IT and data analytics services to state and federal clients. Together, the companies developed an advanced AI system able to proactively identify potentially fraudulent activity in records from CMS' Medicare Part D prescription drug benefit program.

Cybersecurity: The enemy is already inside the gate

The number one recommendation is to know all of the touch points for data: how it comes in, how it's used, where it's stored and how it goes out.

Susan Morse, Senior Editor
Recent reports show patient record breaches reached an all-time high in the first half of 2019 – specifically, in the form of hacking, according to Cheryl Martin, chief knowledge officer for the American Health Information Management Association.
To block the entry points for hackers, healthcare organizations need to look beyond plugging the gaps to block access.
"The enemy is already inside the gate," Martin said.
Cybersecurity strategy has evolved as the number of attacks has gone up with digital access to health records.

Robotic nurse that helps patients dress could address staffing shortage

August 23, 2019, 3:45 p.m. EDT
Amid a growing shortfall of qualified nurses in the U.K., students and professors at Imperial College London are developing a robot with dexterous 3D-printed fingers to assist the elderly or physically-challenged.
A modified version of a robot nicknamed Baxter, the machine has two mechanical arms, an animated face, as well as sensors to help it analyze patterns and detect if a human user is struggling to lift or move a limb.
“There’s an increasing need for technologies that will allow people to maintain their independence, and through that, satisfy their fundamental human desire for privacy and dignity,” Yiannis Demiris, the director of the personal robotic laboratory at Imperial, said in an interview.
Numerous challenges will hinder AI growth in healthcare unless the industry improves, a new scientific report finds.

AI’s future in healthcare is not entirely rosy

August 23, 2019 11:58 AM

A new report examines how under much of the veneer of process improvement and radical new discoveries in the field of medicine, the industry has too many entrenched systems to fully realize the advances artificial intelligence promises.
Writing for Nature partner journal Digital Medicine, Trishan Panch, Heather Mattie and Leo Anthony Celi outline the obstacles healthcare faces in implementing AI solutions.

Unlikely to take root

Business models and incentives remain tightly aligned with regional variations in common practices, making any sweeping “discoveries” AI might offer unlikely to take root in a meaningful, systematic way. Even more elemental than that is the way healthcare data and machine learning are at odds: The latter needs free and open access to large quantities of good data.
While AI may have the potential to discover new treatment methods, the report finds strongly entrenched “ways of working” in the healthcare industry that are resistant to change. The authors warn that “simply adding AI applications to a fragmented system will not create sustainable change.”
As long as financial incentives exist to preserve the status quo, physicians will still do battle with EHRs and large provider organizations that dominate the fields of cloud computing and data management, and that will continue to dictate the methods of practice.
Trust in how healthcare networks amass and handle data needs to be earned as well, the authors find. Plagued by numerous high-profile breaches, the industry’s use of health data has been eyed warily by the public and regulators.

Hospitals Still Struggling To Share Data Effectively

August 23, 2019
A new survey suggests that despite spending countless dollars and people-hours on the problem, hospitals and health systems are still struggling with data sharing. Of course, this is an issue worth discussing at any point, but especially noteworthy given that new regulations from CMS and ONC are soon to take effect.
The survey, which was conducted by the Center for Connected Medicine, reached out to 100 IT and business professionals at U.S. hospitals. The questions looked at how healthcare organizations are doing in their ongoing interoperability efforts and how this is affecting their priorities. The CCM is operated jointly by GE Healthcare, Nokia and UPMC.
When asked about their existing efforts, 56% of respondents strongly agreed that their organization was aligning its technology roadmap and spending plans with interoperability initiatives, 52% that it was staying up-to-date on changing interoperability regulations, 55% that it was adequately addressing policies and procedures related to data exchange and 46% that it was adequately addressing technical aspects.
Also, 60% of survey respondents said that they were highly effective at meeting regulatory and compliance requirements posed by interoperability.

Allscripts offers Apple Health Records to its clients and their patients

Apple Health Records gives patients a consolidated view of all of their data from participating health organizations.
By Stephanie Condon for Between the Lines | August 23, 2019 -- 00:12 GMT (10:12 AEST) | Topic: Digital Health and Wellness
The health care IT business Allscripts on Thursday announced that it's offering Apple Health Records to its clients and their patients. Health Records gives consumers a hand-held electronic health records (EHR) system that aggregates patient data from participating institutions, which could include hospitals, clinics or labs. It effectively saves a patient the hassle of having to log into each care provider's individual website to review their health information.  
Specifically, Allscripts said the service is now available for customers using Sunrise, its comprehensive EHR; TouchWorks, its EHR for for large ambulatory practices; or Professional EHR, its system for small to mid-size physician practices.

76% of Indian healthcare professionals use digital health records: Report

Digital technology is revolutionising the paradigm of Indian healthcare sector with 76% of healthcare professionals already using digital health records (DHRs) in their practice, according to a 15-country Future Health Index (FHI) 2019 report by Royal Philips, a global leader in health technology.
The report released recently said India being forerunner in the adoption of digital health technology meets the 15-country average when it comes to the usage of AI within healthcare at 46%.
Providing Indian perspective of digital health, Rohit Sathe, President – Philips Healthcare, Indian Subcontinent said, “Philips’ Future Health Index 2019 report confirms that digital health technology is a pivotal pillar in delivering value-based care across the healthcare continuum in India. Tools including telehealth and adaptive intelligence (AI) solutions can help lower the barriers between hospitals and patients, thereby improving access to care and enhancing overall patient satisfaction, particularity in tier II & III cities in India.  We hope that the insights from this report will assist key stakeholders in designing and implementing robust and sustainable health systems in the country.”
August 21, 2019 / 11:30 PM / Updated 20 hours ago

Fitbit targets 1 million new users with Singapore government tie-up

 (Reuters) - Fitbit Inc (FIT.N) said on Wednesday it signed a contract with the Singapore government to provide fitness trackers and services in a health program it said could reach up to one million users.
FILE PHOTO: Visitors walk past an advertising billboard for Fitbit Ionic watches at the IFA Electronics Show in Berlin, Germany, September 1, 2017. REUTERS/Fabrizio Bensch
Fitbit will supply its trackers free of charge on the condition users spend S$10 ($7.22) each month, for a year, on the company’s premium subscription.
“The program’s goal is to ultimately reach up to one million people,” a spokeswoman for Fitbit said in an email.

Fitbit and Singapore to team up on 'smart nation' health project

It is the company's first major integration of its software and technology into a national public health program globally.
By Campbell Kwan | August 22, 2019 -- 02:43 GMT (12:43 AEST) | Topic: Innovation
Fitbit has been signed onto Singapore's Health Promotion Board (HPB) to undertake a healthy population project.
The project is part of the city-state's smart nation initiative that is aimed at future-proofing the economy and helping local enterprises "go digital".
The project, named Live Healthy SG, was uniquely designed for Singapore by Fitbit and the HPB to help motivate Singaporeans into adopting healthier habits in the areas of physical activity, sleep, nutrition, and emotional wellbeing.

6 tech initiatives with the biggest impact on patient engagement

Andrea Park -  
Though patients are playing a more significant role than ever in managing their own healthcare, this has, somewhat paradoxically, made it more difficult for providers to engage patients with their offerings.
However, there are several IT solutions that hospitals and health systems can implement to improve patient engagement. Here, according to a new survey from Medical Group Management Association and Cedar, are the six tech tools that healthcare leaders have found to have the greatest impact on both patient engagement and practice workflow in recent years:
  • Patient portals
  • Automated appointment reminder systems
  • Check-in technologies (e.g. kiosks, tablets, mobile apps)
  • Telehealth
  • Digital payment options
  • Data analytics

New Jersey Hospital Cuts Stroke Readmission Rate Through mHealth

Hackensack Meridian Health Jersey Shore University Medical Center has cut its readmission rate in half for stroke patients with an mHealth service that gives them on-demand access to discharge instructions and resources.

August 21, 2019 - An mHealth platform giving stroke survivors and their care providers on-demand access to discharge information and resources has helped a New Jersey hospital cut its readmission rate for stroke patients in half.
Officials at Hackensack Meridian Health Jersey Shore University Medical Center said the Vocera Care Inform connected health service enables providers to record discharge instructions while at the bedside. Patients and their families can then play back those instructions after discharge, as well as gaining access to other post-discharge educational resources.
“We are empowering stroke survivors and their families with personalized, rich educational resources to help manage stroke recovery after they leave the hospital,” Jackie Dwyer, RN, MSN, CNRN, the Stroke Program manager at Jersey Shore University Medical Center, said in a press release. “I think when patients hear discharge instructions and teach-back sessions that include their own voices and the voices of their nurses, it helps improve accountability and compliance.”

Social determinants of health program Gravity Project joins HL7 FHIR accelerator

The new effort will be focused on standardizing medical codes for social determinants of health.
August 21, 2019 02:09 pm
The Gravity Project, a social determinants of health program, is now being rolled into the HL7 FHIR Accelerator Program. The efforts, supported by the American Association of Family Physicians, will be focused on standardizing medical codes to be used for social determinants of health — meaning topics like work, lifestyle and socioeconomic factors. The program is also aiming to make data sharing easier for care communication. 
The Gravity Project came into fruition through conversations at The Social Interventions Research and Evaluation Network at the Center for Health and Community at the University of CaliforniaThe project is now focusing on creating documentation for screening, diagnosing, treating and planning in a patient's EHR. It will also be looking at ways to capture social determinant of health data and develop FHIR guidelines associated with the data set. 
“Progress in patient care and research has made significant strides with the emergence of the HL7 FHIR Accelerator Program,” HL7 International CEO Dr. Charles Jaffe said in a statement. “By incorporating the social determinants of health care into our decision process, the Gravity Project will help to transform care delivery and health analytics.”

Wearable device may enable screening for sleep apnea at home

August 22, 2019, 2:42 p.m. EDT
A New Jersey hospital is testing a device to screen patients with cardiovascular disease or atrial fibrillation for obstructive sleep apnea while they are in their homes.
The new wearable device is WatchPAT, which tracks a patient’s heart rate, blood oxygen levels, air flow and breathing patterns as the patient sleeps.
“Sleep apnea is very common in patients with atrial fibrillation, yet it is not uniformly diagnosed in part because it can be a major inconvenience and challenge for patients to stay overnight in a sleep lab at a medical facility,” says David Landers, MD, vice chair at the Heart and Vascular Hospital at Hackensack University Medical Center.
 “Sleep apnea is directly associated with cardiac disease,” Landers notes. “Getting treatment for this condition is key.”

Employers increase use of digital tech and wellness programs

August 22, 2019, 2:20 a.m. EDT
More than 80 percent of today’s employers are planning to increase their spending on health and wellness programs, according to a new study from Optum.
The findings come in sharp contrast to those Optum discovered 10 years ago when its similar survey found that only 34 percent of employees planned health and wellness budget increases.
Optum’s Tenth Annual Wellness in the Workplace Study also shows that the majority of employers plan to use digital technologies to engage their employees in those health and wellness programs.

Data lacking for national review of Medicaid opioid prescribing

August 22, 2019, 2:11 a.m. EDT
The lack of robust Medicaid data is preventing the Centers for Medicare and Medicaid Services from conducting a national analysis to identify beneficiaries potentially at risk of opioid misuse or overdose.
In particular, an audit by the Department of Health and Human Services’ Office of Inspector General found limitations in data from the national Medicaid claims database—the Transformed Medicaid Statistical Information System (T-MSIS).
While all states are reporting to the T-MSIS repository, the data are not sufficient for the identification of individual beneficiaries for a national review of opioid prescribing in Medicaid, according to OIG.

Rucker: APIs will empower consumers, transform healthcare

August 22, 2019, 2:29 a.m. EDT
Standards-based application programming interfaces, the way that computers “talk” to each other, are the technological enablers that will ensure consumer access to electronic health information.
That’s the vision of National Coordinator for Health IT Don Rucker, MD, who sees APIs as driving consumer empowerment in healthcare by enabling patients to share their data with third party API-based apps.
“That fundamental realignment based on APIs has transformed our financial, travel and entertainment industries,” said Rucker on Wednesday at ONC’s Interoperability Forum in Washington, who described the app economy. “We think this is happening in healthcare.”
With 75% of hospitals and 61 health information exchanges participating in eHealth Exchange, the evolution from point-to-point connections to a one-gateway solution will dramatically increase connectivity for the entire country, the exchange contended.

The VA and others pioneer eHealth Exchange health information network infrastructure

August 22, 2019 12:30 PM
The eHealth Exchange, the largest nationwide health information network connecting the public and private sectors, has announced the go-live of its new gateway technology that is designed to simplify connectivity for its participants via a single connection to the nation.
The benefits to members, the exchange said, will include reduced information-sharing expense, further expansion of its national footprint, and faster implementation of innovative capabilities such as real-time content quality validation and a national record locator service.

Supporting further innovation

When the eHealth Exchange was formed more than a decade ago by the Office of the National Coordinator for Health IT (ONC), the government opted for a federated exchange approach, stopping short of creating a required gateway. As the proposed national network for health information exchange, the government favored an open-market and decentralized approach that would support further innovation, much like the internet.
For a few hundred dollars, any hacker can buy their way into a healthcare network.

Cheap black market PHI drives ransomware, espionage

August 22, 2019 11:54 AM
Hospitals are a treasure trove of valuable information for a wide range of online actors. Data can be held hostage through ransomware or can even be sought after by other nations as a means of espionage.
Despite being uniquely appealing to thieves, hospitals are still struggling with security, and data still is exposed on a variety of fronts. A new study by the security firm FireEye examines how the healthcare industry is impacted by these threats and finds that there are key troves of information hackers are most likely to exploit.

Attacks can occur long after a breach

Compromised health information can be bought cheaply online and a malicious attack can occur long after any breach. Because of the disparity between different organizations’ network strengths, hospitals with poorly secured networks are more frequent targets.

DEFCON from a Healthcare CISO Perspective

August 22, 2019
The following is a guest write up by Mitchell Parker, MBA, CISSP (@mitchparkerciso), and Executive Director, Information Security & Compliance at Indiana University Health.  We asked Mitch to share some insights and perspectives on the DEFCON conference that just happened in Las Vegas.  DEFCON is known as a hackers conference, so we wanted to share a healthcare CISO perspective on the event.
What is it?
DEFCON is the largest pure hacking and security conference in the US.  It occurs annually in Las Vegas and over 30,000 people attend it and several other concurrent security conferences, including Black Hat, BSides Las Vegas, and Diana Initiative.  It is considered to be the premier security conference in terms of content and technical acuity of the attendees.  Some of the best security minds in the world present at this conference.  A number of healthcare IT and security professionals also attend.  This is considered the conference you should go to if you want to know how security works.  Additionally, the presentations and materials are heavily vetted.  This conference is open to whoever can pay the $300 cash to attend.

DirectTrust Working on Standard For Secure Instant Messaging

August 22, 2019
In recent years, instant messaging has taken its place alongside texting as a platform for quick ‘n dirty business communication. The thing is, instant messaging platforms generally haven’t been built for the privacy-critical information healthcare professionals share.
To address this gap, DirectTrust – the alliance behind the Direct Secure Messaging protocol – has starting developing a Trusted Instant Messaging+, a standard designed to allow safe real-time communication of health information. TIM+ is designed to allow secure transmissions between known, trusted entities within and across enterprises.
As we all know, there are already many ways to send quick text messages, including Messenger and enterprise collaboration systems like Slack. However, healthcare professionals use them at their potential peril, as transmitting patient information via these tools could easily violate HIPAA or other privacy regulations.

The “inconvenient truth” about AI in healthcare

·         Trishan Panch,
·         Heather Mattie &
·         Leo Anthony Celi 
As the UK sits in painful deadlock over Brexit, it is important to remember that governments are regularly faced with crises, and their responses can create enduring benefit for future generations. Back in 1858, for example, the UK parliament was dealing with another messy crisis: “the great stink.” In a world before sanitation, the river Thames had become an open latrine, and as summer blossomed parliament was engulfed in a pestilential stench. £2.5 million (about £300 million in today’s money) was hastily approved to build a network of sewers throughout the capital.1 This particular model of sanitation, developed by Bazalgette, was adopted by other cities around the world and the rest, as they say, is history. It is now unthinkable that a developed nation would not have sanitation infrastructure. However, back in 1858 the debate was whether sanitation infrastructure was worthy of investment and whether it was a public or private good. A similar debate has been simmering for some time regarding health data infrastructure, defined as the hardware and software to securely aggregate, store, process and transmit healthcare data. Is data infrastructure necessary for healthcare organizations and if so, is it the responsibility of individual healthcare organizations, of local health systems, or is it a public good?
In the 21st Century, the age of big data and artificial intelligence (AI), each healthcare organization has built its own data infrastructure to support its own needs, typically involving on-premises computing and storage.2,3 Data is balkanized along organizational boundaries, severely constraining the ability to provide services to patients across a care continuum within one organization or across organizations. This situation evolved as individual organizations had to buy and maintain the costly hardware and software required for healthcare, and has been reinforced by vendor lock-in, most notably in electronic medical records (EMRs). With increasing cost pressure and policy imperatives to manage patients across and between care episodes, the need to aggregate data across and between departments within a healthcare organization and across disparate organizations has become apparent not only to realize the promise of AI but also to improve the efficiency of existing data intensive tasks such as any population level segmentation4 and patient safety monitoring.5

Despite large investments in technology, healthcare still early in interoperability journey, BCBSNC executive says

Aug 21, 2019 11:36am
Payers and providers have made significant investments in digitizing the healthcare system but have yet to see a return on that investment with improved interoperability, according to industry leaders.
On a positive note, industry stakeholders have laid the foundation for interoperability with initiatives like CommonWell, Carequality and other data-sharing efforts.
"We're starting to make data interoperable, but we have tremendous work ahead" to make it easier for physicians, payers and patients to access and use data, said Philip Parker, CEO of Coral Health during a panel discussion on Wednesday at the Office of the National Coordinator for Health IT's third annual Interoperability Forum.

Survey finds alarming number of healthcare workers have not had cybersecurity training

Aug 21, 2019 9:59am
Healthcare cyberattacks are on the rise with nearly 32 million patient records breached in 2019—double all of 2018.
Even so, nearly a third of healthcare employees (32%) said they had never received cybersecurity training from their workplace, according to a Kaspersky report.
Nearly 1 in 5 respondents (19%) said there needed to be more cybersecurity training by their organization. When comparing the results by region, more than 24% of respondents in the U.S. noted they had never received cybersecurity training but should have, compared to 41% of respondents in Canada when asked the same question.
Kaspersky, a cybersecurity company, worked with research firm Opinion Matters to survey 1,758 employees in a variety of roles ranging from doctors and surgeons to admin and IT staff working at healthcare organizations in North America.
The survey results point to an alarming lack of awareness of federal privacy regulations in both the U.S. and Canada. 

Fewer than 4 in 10 health systems can successfully share data with other hospitals, survey finds

Aug 21, 2019 11:09am
Fewer than 4 in 10 health systems can successfully share data with other health systems and these ongoing interoperability challenges are limiting strategic efforts to improve workflow, improve population health and reduce the cost of care.
Only 69% of technology executives at U.S. hospitals and health systems reported that they are effective at sharing data within their own organizations, according to a survey from the Center for Connected Medicine.
Health systems continue to face challenges sharing data with payers and patients—with about 58% of technology and business leaders reporting that their organizations are highly successful in these efforts. About half said their health systems can successfully share data with pharmaceutical organizations. 

Apple health team faces departures as tensions rise over differing visions for the future

Published Tue, Aug 20 2019 11:17 AM EDTUpdated Tue, Aug 20 2019 3:30 PM EDT
Key Points
  • Apple has seen some high-profile departures in recent months from its health team.
  • The company has described health care as one of its focus areas, with CEO Tim Cook saying that he hopes it will someday be Apple’s “greatest contribution to mankind.”
  • Sources told CNBC that tension is rising internally in Apple’s health unit, which is prompting employees to leave for roles in companies including Anthem and Google.
Apple’s health team faces trouble amid departures
Apple’s health team has seen a slew of departures in the past year after a series of leadership changes and internal disagreements about direction.
Tension has been increasing within the team in recent months, according to eight people familiar with the situation, although that undercurrent started several years ago. Some employees have become disillusioned with the group’s culture, where some have thrived while others feel sidelined and unable to move their ideas forward, the people said.

The new innovation model: monetizing healthcare data

Healthcare enterprises are launching programs to monetize patient medical data by offering access to researchers and innovators. How these initiatives can benefit all stakeholders (or leave out some).

By Paddy Padmanabhan, Advisor, Contributor, CIO | 20 August 2019 08:17 PT
As digital health innovators and healthcare enterprises alike try to improve access, convenience, and outcomes for healthcare consumers, data is front and center in how the competitive landscape is reshaping for the future. As traditional healthcare enterprises confront emerging competition from non-traditional players, some of them have started realizing the competitive advantage they have in the form of vast amounts of data they have on healthcare consumers’ medical histories.
Consider the following examples:
  • Pittsburgh-based Highmark, one of the largest health plans in the country, has launched a program that turns its internal innovation program VITAL into a commercial offering meant to help digital health startups test their products in real-world clinical environments. The core value of this program for startups is access to claims data on 4.5 million members that Highmark serves in three states.
  • Mercy Health, based in St Louis, MO, has launched a real-world evidence network that will pool data from clinical networks across the country, starting with its database of clinical data from millions of patient records. Subscribers to the network, including researchers, regulators, Pharma and Medtech companies, will have access to this pool of de-identified data.
The American Medical Association and the Blue Cross Blue Shield Association have both had programs in place for a while that provide opportunities for startups and innovators to tap into their member base for testing, validating and commercializing innovation.

Rush launches new EHR app

Mackenzie Garrity – 21 August 2019
Chicago-based Rush University Medical Center unveiled its own EHR platform to patients, known as the My Rush mobile app, according to a Aug. 20 news release.
The app allows patients and providers to easily gain access to MyChart. Along with traditional MyChart features, the app also allows patients to access video visits, schedule appointments, check test results, refill prescriptions and communicate with providers.
Additionally, patients can use the mobile platform to find information about electronic visits and access a symptom checker.

Firms spend more on IT security, but can't measure tool effectiveness

August 21, 2019, 3:44 p.m. EDT
More than half of IT security leaders (53 percent) don’t know how well cyber security tools are working, despite an average of $18.4 million in average annual spending on these technologies.
The new report from the Ponemon Institute is based on a survey of 577 information technology and security practitioners in the United States. The report was sponsored by security company AttackIQ.
Despite the widespread uncertainty about the effectiveness of tools, 58 percent of companies will be increasing their IT security budget by an average of 14 percent in the next year, according to the survey.

AAFP, HL7 look to bolster use of SDOH data via FHIR

August 21, 2019, 12:20 a.m. EDT
The American Academy of Family Physicians and Health Level Seven International are teaming on a new project to improve the interoperability of social determinants of health data.
The Gravity Project, part of HL7’s program to accelerate the adoption of its Fast Healthcare Interoperability Resources (FHIR), is meant to standardize medical codes to support the use of SDOH-related data in patient care, care coordination, population health management, value-based payment as well as clinical research.
“Progress in patient care and research has made significant strides with the emergence of the HL7 FHIR Accelerator Program,” said HL7 CEO Chuck Jaffe, MD, in a written statement. “By incorporating the social determinants of health care into our decision process, the Gravity Project will help to transform care delivery and health analytics.”

Mercy Becomes Latest Healthcare Player To Launch Data Sharing Initiative

August 21, 2019
The technology arm of Catholic health system Mercy has launched what it calls a “data orchestration and insights network” allowing it to use and share clinical data more effectively. In so doing, it joins a growing list of healthcare organizations moving in this direction.
Working in partnership with SAP, Mercy Technology Services is bringing together a consortium of providers willing to share clinical data with each other. Using its infrastructure, MTS will help participants pool data together and use it to conduct advanced analytics efforts. For the time being, the network will focus on gathering orthopedic, cardiology and oncology data.
This effort could offer not just access to research data but also provide a new revenue stream. Once they’ve contributed data to the network, providers who participate in this effort will get paid for each relevant query subscribers make.

Denmark still top in EU for eHealth

Danes rank first in the ‘Benchmarking Deployment of eHealth among General Practitioners’ report
August 21st, 2019 11:01 am| by Christian W
Denmark still leads the way in the EU when it comes to eHealth, according to a recently-published report, ‘Benchmarking Deployment of eHealth among General Practitioners (2018)’.
The report, which documented that electronic-based health treatment has increased among general practitioners across Europe since 2013, ranked Denmark first, followed by Spain, Finland and the UK.
 “On average, eHealth adoption is higher among countries with a NHS system compared to social insurance and transition countries. Denmark, Finland and Sweden are the countries with the highest scores among the NHS countries; Ireland, Belgium and France have the highest scores among the social insurance countries; and Estonia, Croatia and the Czech Republic are the leaders among the transition countries,” the report found.

Sparking a Digital Revolution within Canada’s Health System

July 01, 2019
by Michael Green, President and CEO, Canada Health Infoway; a HIMSS Board Member
Canadians are proud of our health system. It has stood for equality and compassion for more than 50 years. It’s also tied to our identity, and it’s one of the first things we mention when comparing Canada to other countries.
While we consider our health system among the best in the world, in the digital age, that’s no longer the case.
Canada’s health system has fallen behind peer countries in performance rankings, including indicators that measure access to care. In a Commonwealth Fund survey of 11 countries, Canada ranked ninth or lower in wait times in emergency departments, ability to get same-day appointments with a physician and the ability of patients to access their health information.

Impact of Artificial Intelligence on Clinician Training, Practice

The explosion of artificial intelligence has significantly altered the training providers need to integrate the technology into clinical practice.

August 20, 2019 - Proponents of artificial intelligence (AI) tout its potential to revolutionize healthcare delivery. Machine learning is identifying high-risk patients for preventive treatments, deep learning algorithms are scanning radiology images to spot cancer providers cannot see with their own eyes, and natural language processing is decreasing the time it takes providers to code for billing.
This is the second of two-part series on the implications of artificial intelligence on patient care.
With such broad potential impact, providers need to be prepared for their workflow to change as AI becomes more integrated into clinical practice. To do so, future and current providers will need training on how to better understand the tools and the ethical implications associated with adopting these technologies into clinical practice.
Some physicians argue that using AI is not what they went to medical school to learn. Training prepared them to make diagnostic decisions to treat their patients, not understand how to use computer algorithms. However, big data and AI are integrated into clinical practice more each day. It’s becoming impossible for providers to avoid understanding these methods.

Rapid growth in the healthcare cybersecurity market may not be enough to stop breaches

Aug. 16, 2019, 9:20 AM
The cybersecurity market for US health systems — which was valued at $8.2 billion in 2018 — is projected to grow at a 19% CAGR through 2025, per Global Market Insights. The report claims the steady rise in cybersecurity will be fueled in part by hospitals' sustained migration of on-site data to the cloud.
And this checks out with recent industry trends: Nearly 45% of healthcare CIOs who participated in a 2018 Datica survey said their organizations are developing cloud applications to improve population health — despite their concerns; over 50% of respondents said they were worried about the security and regulatory compliance of cloud vendors.
Here's what it means: While the cybersecurity market is set to swell — so is the number of breaches impacting health firms, and the amount of funding funneling into the space isn't enough to keep up.

Few Patients are Downloading Their EHR Data on Smartphones

In a given month, just 0.7 percent of patients who logged into their health system’s patient portal also used their smartphones to view their EHR data.

August 20, 2019 - Despite policy efforts to increase patients’ access to EHR information on their smartphones, few people are taking advantage of this ability, according to a study published in JAMA Network Open.
Health systems are increasingly allowing patients to download their health information on their smartphones, with the expectation that these third-party applications will help patients and providers convert data into health-improvement actions.
In 2018, Apple launched its Health Records application programming interface (API), allowing consumers to share patient data from third-party apps with their providers. Since then, several healthcare organizations have integrated Apple Health Records into their patient portals, and data has shown that the technology is generally well-received.
Researchers from the University of California, San Francisco (UCSF) and the University of California, San Diego (UCSD) sought to create national measures of patient uptake of third-party applications. The team identified 12 geographically diverse US health systems with at least nine months of experience allowing patients to download their EHR data to a smartphone.

UPMC clinic works to bring precision medicine to primary care

August 20, 2019, 1:35 a.m. EDT
While direct-to-consumer DNA tests are growing in popularity, patients are finding that their own primary care physicians lack training and background in genetics testing technology.
It’s a juxtaposition that Mylynda Massart, MD, an assistant professor of family medicine at the University of Pittsburgh, who teaches genomics and precision medicine, is well aware of and is looking to address.
“One out of four Americans have engaged in some form of direct-to-consumer genetic testing, and yet the primary care workforce is not yet prepared to integrate these services into every day practice,” she says. “There’s also a lot of potential information that somebody can get in a direct-to-consumer result they might not be fully prepared emotionally to receive.”
HIT Think

Why it's crucial to remember that healthcare is not a typical business

August 20, 2019, 3:46 p.m. EDT
Let’s say, for the sake of argument, that I have an extreme Diet Coke emergency. (I never have, but that’s beside the point.)
At 2 a.m. on a Wednesday, I awake with an unforgiving need to drink Diet Coke. I dress and head out to find the nearest 24-hour convenience store, where I can satisfy my damnable craving by paying a bit more for Diet Coke than I would at a grocery store.
I pay slightly more for a few reasons related to the cost of convenience, the lack of more affordable options at 2 AM, the high costs of urban real estate, etc. The point is that, while I will pay more for my Diet Coke, I won’t pay A LOT more, and I have the option of just waiting until morning or driving to someplace that sells soft drinks for less.
Compare that with the chain of events that could follow my awakening with excruciating abdominal pain at 2 a.m. on a Wednesday. In that case, fearing appendicitis, I want to be taken to the nearest hospital. I may not have any idea whether or not the nearest hospital has an agreement with my insurance carrier (if it’s San Francisco General, I am certain they don’t), and I don’t know how much my treatment will cost, but I’m suffering too much pain and fear to care.

Verma: U.S. healthcare system is a communication disaster

August 20, 2019, 1:27 a.m. EDT
Despite the federal government spending more than $36 billion to get providers to adopt electronic health records, data is trapped in siloes which is hindering the industry’s transition to value-based care.
That’s the message Seema Verma, administrator of the Centers for Medicare and Medicaid Services, delivered on Monday to the annual conference of the Strategic Health Information Exchange Collaborative (SHIEC), representing health information exchanges across the country.
“We are not able to fully leverage our $36 billion investment and the full potential of EHRs to transform the United States healthcare system,” Verma told the SHIEC audience. “Imagine if the government paid for everyone to have a cell phone, but you could only call people who had the same carrier. It would be a communication disaster. That is what we have today in our healthcare system, a communication disaster.”
Health IT vendors are building greater flexibility into clinical decision support systems so they can optimally function in a dynamic healthcare environment, Frost & Sullivan finds in a new report.

Clinical decision support systems will surpass EHRs as prime caregiver interface: report

August 20, 2019 03:35 PM
Clinical decision support systems are poised to become the user interface of choice for clinical interactions with health IT, ultimately supplanting the electronic health record system as the primary health IT point of interface for clinicians, research and consulting firm Frost & Sullivan contends in a new report.
Today, Frost & Sullivan released the new report, entitled “U.S. Clinical Decision Support Systems Market, Forecast to 2024.”
The report analyzes the latest trends affecting the clinical decision support systems space. It forecasts market growth in clinical knowledge and medical evidence, healthcare analytics, workflow solutions, EHRs, medical devices, data support, clinical surveillance, and clinical decision support platforms. It also studies the impact of changes in regulation and technologies on the market outlook.
According to the report, as decision support becomes a critical component of both healthcare delivery as well as regulatory compliance, the decision support systems market is forecast to grow from $3.79 billion in 2018 to $6.4 billion in 2024, at a compound annual growth rate of 9.3%.

Healthcare organizations must lock down identities and access to PHI

An identity and access management expert illustrates this critical area of information security and offers tips on how to best control who is accessing protected health information (PHI).
August 20, 2019 01:39 PM
The principle of least privilege or “minimum necessary” access rights for accounts use in a healthcare setting – such as access to electronic health records or payment information – often is overlooked, inappropriately configured, and not consistently measured and managed.
This “state” can lead to accidental disclosure, data spillage/leakage, or a crime of opportunity. In 2019, an organization should have a mature level of control for who has access to what and an understanding of when/how the access is used (auditing), said Ray Hillen, managing director of cybersecurity at Agio, a managed IT and cybersecurity company.
There should also be a framework for adapting these access rights based on personnel changes within the organization – for example, if an employee is promoted, or if one departs the organization, he added. Anything less can be seen as willful neglect, subject to the highest level of civil money penalties, and may rise to a criminal level, he stated.

Realizing the Promise of Technology at the Point of Care

By Jon Wells  |   August 08, 2019

Midmark is focused on developing innovative technology and new approaches that enrich experiences between caregivers and their patients at the point of care in ambulatory environments.

Jon Wells, chief commercial officer for Midmark Crop., offers some thoughts on challenges and opportunities the industry faces when it comes to integrating new technology.
  1. In terms of technology, what is the biggest change happening in healthcare?
When it comes to technology, one of the biggest changes is the pace of change itself. In prior years, change occurred at a pace that enabled organizations, caregivers and patients to adapt over time. Today, it has accelerated to a point where each month brings new developments. Rapid innovation is imperative for realizing a better care experience and outcomes.
At the same time, we are seeing an alignment between patients, payers and providers in terms of healthcare delivery. The importance of all stakeholders driving to improved outcomes at lower costs as a unified goal is quite new to healthcare and engenders optimism for our collective future. More so than ever, all stakeholders, no matter their role in designing care delivery, are collectively part of the solution to ‘fixing’ healthcare.

Machine Learning, Wearable Devices Give Shot in the Arm to Flu Forecasting

By Mandy Roth  |   August 20, 2019

HHS grants a research award to California-based company to develop and test a new model that could contribute to more rapid and accurate flu surveillance.

The effort to curtail the impact of influenza just got a shot in the arm with a research award from a division of the U.S. Department of Health & Human Services (HHS) to a company that's testing a machine learning model to improve flu forecasts based on data gathered from wearable devices.
Current forecasting initiatives lag behind actual incidence because of reporting delays, says Ernesto Ramirez, PhD, senior data scientist for Evidation, a San Mateo, California-based company. The health and measurement company, which uses data to better understand the connection between everyday behaviors and health, hopes its work will accelerate the reporting process, says Ramirez, leading to more accurate, timely forecasts, plus earlier intervention and treatment.

UCSF, UCSD study finds few patients downloading health records via smartphone apps

Aug 17, 2019 7:20am
Federal healthcare policymakers are pushing to give patients easier access to their electronic health data via smartphone apps. The private sector also is playing a role in these efforts—Apple launched its health records feature in January 2018, and now more than 200 healthcare providers have joined the project. 
Are patients actually using these apps to get their health records? At this early stage, uptake has been modest, but the numbers are growing, according to an assessment looking at 12 early-adopter health systems published in JAMA Network Open.
Julia Adler-Milstein, Ph.D., an associate professor of medicine at the University of California (UC), San Francisco School of Medicine and Christopher Longhurst, M.D., chief information officer and associate chief medical officer at UC San Diego Health, evaluated the use of health record application programming interfaces (APIs) with the aim of creating baseline national measures of patient uptake against which to track future progress.

Radiologists ill-prepared for how AI will impact the profession

August 19, 2019, 3:44 p.m. EDT
Many radiologists are not ready for the changes that big data and artificial intelligence will bring to their lives, says Paul Chang, MD
For now, Chang—a professor of radiology and vice chair of radiology informatics at University of Chicago Pritzker School of Medicine—asks radiologists to consider a simple yet crucial question: Who is in control of the custody of images of patient care? It needs to be the radiologist protecting the integrity of images and data, Chang contended during a recent web seminar.
Currently, some radiologists are more open to change than others, but for all of those in the profession, incorporating big data and AI in radiology will be disruptive, and some will become disillusioned. What’s needed is some impetus—a driver to foster interest in disruptive technology—but it will take considerable time to leverage big data and AI in current health IT infrastructures.
But this is where the hype comes in, Chang notes. “We as radiologists need help, we’re barely hanging on,” he says. "We have too much ‘busy work,’ and we’re consuming too much time on image manipulation.

Relying on bug bounties 'not appropriate risk management': Katie Moussouris

Bug bounties are useful, but according to one of their greatest advocates they're no silver bullet. They have a low signal-to-noise ratio and can be poor value for money.
By Stilgherrian | August 19, 2019 -- 06:12 GMT (16:12 AEST) | Topic: Security
If you expect a bug bounty to find and fix your organisation's hidden cybersecurity problems, you're wrong. To steal a line from the late John Clarke, you're a fool to yourself and a burden to others.
Bug bounties are certainly sexy. You'll look like you're engaging with the wider cybersecurity community, and you'll get great media coverage when a hacker strikes it rich.
There's also the belief that if your organisation doesn't pay to know about the bugs, then organised criminals and nation-states will.

Adopting Agile Principles In Health Care

The ever-increasing pace of technological advancements, rising costs, and new entrants into the health care marketplace are part of the challenge health care incumbents face today. With no alternative but to adapt, health care organizations must find effective methods to embrace innovation, which we define as the delivery of new patient and clinician value. Embedding and accelerating innovation in health care, however, has proven to be difficult. In health care, most current processes of governance, business planning, and information technology implementation are designed to minimize risk to organizations and are often inflexible to adapt quickly to new technological changes, netting incremental changes that fail to deliver much needed transformation.
To address this complexity and speed up effective innovation, we propose that health care organizations critically look at adopting a novel set of principles, initially promulgated within the software industry, called “Agile.” We have found that using Agile for important transformative projects has enabled several health care organizations, including ours, to begin to effectively adapt and adopt innovation in patient experience, clinical workflows, and digital health technology with the ultimate goal of improving care. Because the core tenets of Agile include addressing the needs of customers and embracing change, we see Agile being useful beyond projects related to information technology to other health care domains such as organizational strategy and clinical operations.  

Kaiser Permanente reduces patient mortality with predictive analytics

The managed care consortium's Advance Alert Monitor early warning system uses predictive analytics to identify patients at risk of deterioration within the next 12 hours.

In healthcare, early intervention can be the difference between life and death. Healthcare giant Kaiser Permanente has put that principle into action with a hospital workflow tool, supported by predictive analytics, that it uses to identify non-intensive care unit (ICU) patients that are likely to rapidly deteriorate.
The integrated managed care consortium, based in Oakland, Calif., has more than 12 million health plan members and employs more than 217,000 people, including nearly 60,000 nurses and 23,000 doctors. It operates 39 medical centers and 690 medical facilities in eight states and the District of Columbia.
"Patients who are in the hospital but outside the intensive care unit sometimes deteriorate in the hospital and have to be transferred to the ICU unexpectedly. These patients have far worse outcomes than patients who are admitted to the ICU directly," says Dr. Gabriel Escobar, research scientist, Division of Research, and regional director, Hospital Operations Research, Kaiser Permanente Northern California.

Outlook is Good for Health Care, Thanks to Big Data

Technology improvements in recent years are making it possible to overcome the decades of siloed, inaccessible, consumer data.
IT leaders have fueled the evolution of various industries all over the U.S. by extracting meaning from a sea of data and turning it into actionable insights. But one industry has lagged to the detriment of consumers: health care. Being an especially change-averse industry, health care has not yet adapted the technological skill set to deliver the personalization and care consumers expect. IT leaders across the health care industry recognize change is coming, and it will be powered by data coupled with person-to-person interactions to effect real change and transform health care into a personalized, consumer-centric experience.
IT professionals in any sector need data to innovate -- our strategies, solutions and any AI-enabled efforts are only as good as the data we have. The issue is that although data is abundant in the health care system, it is difficult to access and share. Consumer experience also suffers without data. Check one website to figure out if your doctor is in-network, call this number to check your claim status, ask this pharmacy about prescription costs, use another app to pay your bills. These arduous data silos present big barriers for consumers who are short on time, trust and understanding of the system.   
Technology improvements in recent years are helping bridge this gap by making it possible to overcome the decades of siloed, inaccessible, consumer data. IT leaders need to help consumers easily access their personal health data across all payer and provider networks and share it as needed. While we aren’t there yet, it’s happening. 

Privacy beyond HIPAA in voice technology

Industry players warn that while voice technology has the ability to reach a larger audience, it must be implemented with privacy as a top priority.
August 16, 2019 04:07 pm
While voice has been touted as an emerging technology with the ability to lower the bar to entry, industry players are now starting to warn of privacy gaps. Amazon Alexa and Google Home devices are now becoming a frequent household item, used for everything from ordering a new wardrobe to helping with homework. 
But when used in the medical industry, the technology needs to be administered differently than in the consumer world. 
“When it comes to healthcare and voice design, we have several challenges we face every day,” Freddie Feldman, voice design director at Wolters Kluwer Health, said at The Voice of Healthcare Summit at Harvard Medical School last week. “HIPAA is a big topic on everyone’s mind nowadays, and it is one we take seriously. The first thing most people think about when they hear HIPAA is securing servers platforms, but there is more to it. We have to consider things like the unintended audience for a call.”
The next generation of doctors is going to be able to more easily separate the advantages and disadvantages of cloud technology and be able to embrace these technologies because they help them do their jobs better, an expert says.

How the cloud impacts the day-to-day lives of physicians

August 19, 2019 11:51 AM
The multiple tools cloud-based technology enables are having a radically transformative effect on healthcare provider organizations, which simultaneously is affecting physicians – and not always for the good.
While the cloud brings improvements in efficiency and can help streamline formerly time-consuming tasks like data entry or medical research, the consumer-facing applications providers now are expected to provide can bring additional stress to healthcare professionals.

Care around the clock

“There are some questions around boundaries that physicians have to deal with, because the practice travels with you now,” explained Deloitte’s chief digital officer for healthcare Jason Wainstein. “With the cloud enabling things like virtual healthcare and telehealth, you can essentially provide care around the clock if you chose to – so when do you leave the office, when do you go home?”
A new Center for Connected Medicine/HIMSS Media survey of healthcare tech leaders shows that most hospitals and health systems are depending on a single, integrated EHR to solve their interoperability woes.

Interoperability: Health data-sharing is lacking inside and outside of hospitals, survey says

August 19, 2019 10:51 AM
A new survey of tech executives at U.S. hospitals and health systems finds nearly a third indicate their data-sharing efforts are insufficient, even within their own organizations, and fewer than four in 10 say they are successfully sharing data with other health systems.
Additionally, the most popular solution being pursued to address the interoperability challenges that have long plagued healthcare is switching to a single, integrated electronic health record system, according to the survey, conducted by HIMSS Media and sponsored by the Center for Connected Medicine.
Jointly operated by GE Healthcare, Nokia and UPMC, the Center for Connected Medicine facilitates connections and provides resources that support executives pursuing healthcare improvement and innovation through technology.
The new research, which surveyed 100 information technology and business professionals at U.S. hospitals, examined how well healthcare organizations are prepared to advance interoperability and how those challenges are affecting organizational priorities. Healthcare interoperability is widely seen as essential to improving healthcare for patients, caregivers, health systems and payers, while lowering the cost of care.

Danish doctors among best users of eHealth in EU: report

Source: Xinhua| 2019-08-18 23:16:27|Editor: Mu Xuequan
COPENHAGEN, Aug. 18 (Xinhua) -- Danish doctors remain as one of the leaders in the European Union (EU) when it comes to eHealth -- healthcare services provided electronically via the internet, said a new report by the European Commission released recently.
The report of Benchmarking Deployment of eHealth among General Practitioners (2018) took a random sample of 5,793 General Practitioners from the 27 member states.
The intended purpose of the report was to "understand and measure the current use of information and communication technology and eHealth applications by general practitioners in the European Union."
Denmark came in high in the use of electronic patient records: the collection of patient and population electronically-stored health information in a digital format, which is second to Estonia.

Delivering the benefits of digital health care

This report sets out the possibilities to transform health care offered by digital technologies, with important insight about how to grasp those possibilities and benefits from those furthest on in their digital journey.


Published: 17/02/2016
ISBN: 978-1-910953-08-2

Health bosses apologise after patients receive letters wrongly stating they have cancer 

16 August 2019 • 4:01pm
Health bosses have apologised to devastated patients after they wrongly received discharge letters indicating they had cancer. 
Nearly 400 patients discharged from the Forth Valley Royal Hospital, near Falkirk, were sent apology letters for the mistake which occurred due to a computer glitch. 
The discharge letters were also sent to the patient’s GP, but an updated version has since been issued to their surgery electronically. 
Forth Valley NHS Trust said the error did not affect all of the 386 patients who were sent an apology, but they did not know how many discharge letters had been altered by the glitch. 
When switching over the trust’s computer system, an error caused some patients previous medical history - which appeared on the bottom of the letter - to indicate they had cancer or endometriosis, a condition which affects the womb. 

How digital services are transforming UK mental healthcare

Start-ups such as Kooth cut down waiting times by connecting people to real-life therapists

Ping An Good Doctor’s Private Doctor service officially launched

The new service is a step towards a more personalised healthcare experience and greater healthcare data integration.
August 19, 2019 02:55 am
China’s one-stop healthcare ecosystem platform Ping An Good Doctor, officially launched its Private Doctor service last week in China on August 13. On the same day of launch, the company also entered into partnership with 29 companies including China Mobile Internet, BAIC Group, China CITIC Bank, Wyeth Nutrition, China Everbright Bank, Minsheng Life, Pearl River Life and PKU Founder Life. The 29 enterprises operate in industries such as banking, insurance, automobile, communications, and maternity services with a total contractual amount of over RMB300 million.
Ping An Good Doctor - Private Doctor was first announced in June 2019, as reported earlier on MobiHealth News. By partnering with 1-to-1 private doctors and renowned doctors from national top 100 hospitals, Ping An Good Doctor - Private Doctor will provide users with such all-round active medical and healthcare service as 24x7 online consultation, second-round consultation with renowned doctors, offline clinical arrangement, health management and chronic disease management.
In addition, Ping An Good Doctor - Private Doctor has also partnered with third party insurance companies to provide aged people who suffer from disease with high-value assurance, for supporting economically those patients suffering from serious diseases. Ping An Good Doctor has cooperated with nearly 2,000 laboratories and test centers to provide each user with E-health files and year-round tailored health management service to boost one-stop service.

Health informatics and health equity: improving our reach and impact

Journal of the American Medical Informatics Association, Volume 26, Issue 8-9, August/September 2019, Pages 689–695, https://doi.org/10.1093/jamia/ocz132
14 August 2019


Health informatics studies the use of information technology to improve human health. As informaticists, we seek to reduce the gaps between current healthcare practices and our societal goals for better health and healthcare quality, safety, or cost. It is time to recognize health equity as one of these societal goals—a point underscored by this Journal of the American Medical Informatics Association Special Focus Issue, “Health Informatics and Health Equity: Improving our Reach and Impact.” This Special Issue highlights health informatics research that focuses on marginalized and underserved groups, health disparities, and health equity. In particular, this Special Issue intentionally showcases high-quality research and professional experiences that encompass a broad range of subdisciplines, methods, marginalized populations, and approaches to disparities. Building on this variety of submissions and other recent developments, we highlight contents of the Special Issue and offer an assessment of the state of research at the intersection of health informatics and health equity.

Is It Time For The Federal Government To Create A National HIE?

August 19, 2019
Earlier this year, ONC and CMS issued new draft guidelines requiring that all insurers and providers serving the Medicare population make their data available electronically by 2020.
The new rules will establish penalties and fines for providers and health plans that don’t make health records available via a standard API by 2020 and as well as penalties for providers who create obstacles to data sharing. They would also require hospitals and emergency departments to notify patients’ primary care providers about admissions, transfers or discharges and use HL7 FHIT and the US Core Data for Interoperability.
According to some critics, however, the guidelines don’t go far enough. In a new article appearing in the Health Affairs blog, for example, authors Michael Hochman, Judith Garber and Edmondo Robinson argue that it’s time to switch to a “more assertive” approach to data sharing.
However, the authors contend that these guidelines won’t be sufficient to jump-start further data sharing. Among other issues, they say, there are too many opportunities for regional HIEs to butt heads and engage in turf wars. Also, they note that while effective HIEs need specialized tools and processes for exchanging data, only a small number of regional HIEs have such tools in place.