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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Population Health Management – Advisory Series, July 2019
By Jennifer Trueland – Digital Health
Population health management is seen as a tool which could help the cash-strapped NHS. Jennifer Trueland reports that while uptake remains elusive, there are still green shoots of change emerging.
Twentieth century public health pioneers who wanted to know what was really going on in their local communities took to the streets and knocked on people’s doors – wearing out a lot of shoe leather in the process; today, however, they can let their fingers do the walking.
Population health management – that is, bringing together data from an ever-growing range of health and social care-related sources, and using it to determine the needs of a community – is the solution favoured by those following in the metaphorical footsteps of the likes of the late Julian Tudor Hart and other visionaries.
Advocates say it’s great for patients and for health services: identifying those at risk of ill health, and intervening at an early stage, can improve outcomes or even prevent illness in the first place – surely a boon for the cash-strapped NHS.
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12 things every computer security pro should know
Fighting the good fight takes specialized knowledge. Here's the baseline of what all security pros should know.
Columnist, CSO | 14 August 2019 03:00 PT
Few complex professions change with the velocity of IT security. Practitioners are faced with an average of 5,000 to 7,000 new software vulnerabilities a year. Last year that number was a gob smacking 16,555. That’s like springing 13-45 new leaks in your defenses every day, day after day, year after year. That’s on top of the tens of millions of unique malware programs that threaten your IT environment each year and all the human adversaries who are also trying.
Amid this deluge of constant threats, a single slip-up could compromise the crown jewels and put your company in an unwanted media spotlight, hurt your revenues, and get people fired.
This is not to say that your team can’t successfully fight back. Of course it can – and will.
Here are twelve things every computer security professional should know to successfully fight the good fight.
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Study: Hospital quality ratings mislead, misclassify performance
August 16, 2019, 12:17 a.m. EDT
Publicly reported hospital quality rating systems offer conflicting results that may only serve to mislead patients.
That’s at cross purposes to their intent of helping patients make informed decisions about medical facilities, according to the findings of an analysis, published this week in NEJM Catalyst, by “physician scientists with methodological expertise in healthcare quality measurement.”
In particular, the authors point out that “hospitals rated highly on one publicly reported hospital quality system are often rated poorly on another,” which “provides conflicting information for patients seeking care and for hospitals attempting to use the data to identify real targets for improvement.”
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Is Software the 'Weak Link' in Medical Device Safety?
Software issues are the top cause of medical device recalls for the 13th straight quarter, according to Stericycle Expert Solutions' Q2 recall index.
August 14, 2019
Software is a weak link for medical devices, according to Stericycle Expert Solutions' second-quarter recall index. The report found software issues to be the top cause of medical device recalls for the 13th straight quarter .
"As we become increasingly reliant on AI and data collection, software becomes an even bigger vulnerability for patients, physicians, and wrongdoers," said Chris Harvey, director of recall solutions at Stericycle. "If the software that is used to operate a device is inadequate, how can we be sure that it is protected from cybersecurity vulnerabilities? Add to that the fact that companies have only recently been laser-focused on mitigating cyber threats associated with medical devices. It's a recipe for disaster."
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The independent medical charity in London says the system has reduced incidents of prescription error since it was introduced in April.
Royal Hospital for Neuro-disability rolls out PatientSource EPR
By Tammy Lovell
August 16, 2019 05:00 AM
The Royal Hospital for Neuro-disability (RHN), an independent charitable institution in London, has introduced a bespoke electronic patient record (EPR) system created by PatientSource throughout all its wards.
In April, RHN initially implemented PatientSource’s e-prescribing solution in four wards. This system replaces drug cards charts by checking prescribed drugs against known patient allergies, checking for drug-drug interactions and indicating the appropriate dose, route and frequency of administration.
Following this successful pilot, the EPR was rolled out throughout the rest of the hospital and went live in July.
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Critical security tips for provider CIOs using public clouds
Two healthcare CIOs and one deputy CISO offer their expert advice to their peers, explaining how to ensure security is wrapped up tight when working with public clouds.
By Bill Siwicki
August 16, 2019 12:05 PM
Healthcare provider organizations are beyond the initial security fears when it comes to moving systems and data to a public cloud. There exists now a comfort level that simply wasn’t there even a few years ago.
But healthcare CIOs and CISOs still need to be quite prepared when it comes to using a public cloud. While public cloud operators have taken extraordinary steps when it comes to security, hospitals and health systems still have a job to do on their side when it comes to ensuring that their systems and data are protected.
Here, two healthcare provider CIOs and a deputy CISO offer their expert guidance for working with public clouds based on their experience with these increasingly helpful technological tools.
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Barriers To Consumer Health Adoption Are Falling
August 16, 2019
A new survey has concluded that the bulk of Americans are not connected with or using telehealth services, including, notably, those in rural areas for whom telemedical services should be a lifeline. However, other details captured by the survey suggest that barriers to telehealth adoption are not as high as they may have been in the past.
The survey, by J.D. Power, found that roughly 10% of Americans have used telehealth, but that about 75% either don’t have access to or aren’t aware of such access options for them. A lack of telehealth awareness was especially noticeable in rural areas, accounting for 72% of respondents. Just 8.7% of rural residents had used such services, compared with 11.7% of suburban and 11% of urban residents.
Roughly 40% of consumers said their health system or insurance provider didn’t offer telehealth, with another 35% reporting that they didn’t know whether or not such services were offered by their health plan or system.
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NIH has more than 230,000 volunteers for PMI cohort
August 15, 2019, 12:19 a.m. EDT
The National Institutes of Health has recruited almost a quarter of a million participants—about 25 percent of its recruitment goal—as part of the Precision Medicine Initiative’s All of Us research program.
Leaders of the program provided an update in the New England Journal of Medicine, reporting that more than 230,000 Americans have enrolled as of July.
“Elements of the program protocol include health questionnaires, electronic health records (EHRs), physical measurements, the use of digital health technology, and the collection and analysis of biospecimens,” states the NEJM special report. “The All of Us data repository should permit researchers to take into account individual differences in lifestyle, socioeconomic factors, environment and biologic characteristics in order to advance precision diagnosis, prevention and treatment.”
When a consumer of health care – whether a member, patient or client – experiences mental health issues, when a consumer suspects he or she might have...
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HIT Think
Why unique patient identifiers are a key missing piece in healthcare
August 15, 2019, 3:48 p.m. EDT
Efficient patient identification is an area plaguing U.S. healthcare. In fact, the Joint Commission has named improving the accuracy of patient identification as the most important national patient safety goal since 2014. However, privacy concerns have been a barrier to their widespread implementation.
Unique patient identifiers are central to eliminating medical errors and costs resulting from slow or inaccurate patient identification and will contribute to better overall care coordination. That’s why the U.S. House of Representatives recently voted in favor of an amendment that would lift a ban on federal funds for the creation of patient identifiers. This will now go to the Senate for voting, and the debate is sure to continue.
But what are patient identifiers, and what are the potential implications of this pending policy?
A nationwide system of patient identification would provide each healthcare customer with a unique patient ID number for providers and payers to use in organizing patient information and coordinating with other institutions on care.
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Hackers Demand $1M in Grays Harbor Ransomware Attack
The Washington-based provider initiated EHR downtime in June, but remained mum on details; a report shows hackers demanded a $1 million ransom to unlock patient files after a cyberattack.
August 14, 2019 - Hackers infected Washington-based Grays Harbor Community Hospital and Harbor Medical Group with ransomware and demanded a payment of $1 million to unlock patient files, according to a report from the Daily World.
The report sheds light on the EHR downtime the provider put into place after experiencing persistent issues with its EHR systems in June. Both the hospital and HMG’s clinics were impacted by the issues with its MEDITECH EHR. However, officials did not explain the cause.
According to the latest, the hackers infected the computer systems with ransomware nearly two months ago when an employee clicked on a malicious link contained in a phishing email. The cyberattack began on a weekend when Grays Harbor IT staff was limited.
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All Your Data Is Health Data
And Big Tech has it all.
Mr. Warzel is an Opinion writer at large.
- Aug. 13, 2019
Here’s a terrifying sentence: Hackers are “becoming increasingly interested in the susceptibility of health data.”
At least that’s the takeaway from researchers at the University of Southern California’s Center for Body Computing. They were at the Blackhat hacker conference in Las Vegas recently, where programmers set up a fake hospital environment and invited medical tech companies to bring their devices for a live stress test. “There was a lot of talk about the ease of insurance fraud and blackmail with some of this legacy software that is very hard and frustrating to update,” Dr. Mona Sobhani, who is the head of research for the Center for Body Computing, told me.
I initially got on the phone with Sobhani to get a sense of how our medical devices might be compromised. But the discussion quickly veered into different territory. She argued that our focus on medical data as the information coming out of connected pacemakers isn’t nearly as vulnerable as the information coming from far less secure sources. There’s a bigger security risk here, she argued, saying “all our data is health data.”
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Doctors say most metrics provided by your Apple Watch, Fitbit aren't helpful to them
USA TODAY
With healthier living in mind, we purchase kid-friendly versions for our children and step-counting options for grandparents. Apple Watches, Fitbits and other fitness trackers are everywhere as data-obsessed users tap away at tiny screens from the gym to the doctor's office.
It's clear that consumers love wearables and the information they provide – but do physicians?
Doctors have mixed views on how patients gather and present information from gadgets with quasi-medical aspirations. Most say its a plus that patients can collect and curate more health-related data than ever before. However, bringing printed out pages of calories burned or counted steps to your next checkup isn't exactly advised.
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Most providers not fully compliant with HIPAA access requirements, research shows
Author Shannon Muchmore @stmuchmore
Published Aug. 15, 2019
Dive Brief:
- More than half of providers sampled in a recent study failed to comply with the HIPAA right of access, according to research published Wednesday on medRxiv, a free online archive for unpublished health-related manuscripts. The study has not been peer-reviewed.
- The most common problem was providers not sending health records via email when patients requested them. About a quarter were also potentially noncompliant with the health privacy law's fee limitations.
- The average wait for responses ranged from one to 26 days, with eight days being the average. More than 70% of requests would not have been fulfilled pursuant to HIPAA without some form of intervention, such as educating staff members on the law or calling supervisors.
Dive Insight:
The study authors said while efforts to digitize medical records and let patients access information through their phone or a patient portal are ongoing, "it will be years before seamless digital access by patients to all of their health information is a reality."
"In the meantime, requests to medical records departments (and Radiology) will still be required to enable patients to amass all of their health information. It is critical that these processes be compliant with HIPAA and responsive to patient needs," they said.
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Contract announced as figures reveal that NHS trusts have boosted IT spending by almost £152m [$183m] since the 2017 WannaCry attack.
Accenture to provide ‘world class’ perimeter cybersecurity services to the NHS
By Tammy Lovell
August 14, 2019 03:24 AM
US firm Accenture has signed a contract with NHS Digital to provide free-to-adopt perimeter cybersecurity services across the NHS.
The new offering will deploy technology from security firms Palo Alto and Imperva to build on the current provision from the Data Security Centre.
Hospital trusts and other care settings will be able to access security features, including next-generation firewall, secure filtering for web content, network intrusion detection and prevention capabilities, data loss prevention and secure domain name system (DNS) services.
NHS Digital told Healthcare IT News the contract value will be variable based on consumption by NHS organisations, but is forecast at around £40 million ($48 million). The new services will be available to trusts for five years from winter 2019/2020.
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Most hospitals are behind on finding, responding to threats
A new industry survey finds that a lack of network visibility is impairing already overworked cybersecurity teams.
August 15, 2019 12:17 PM
No good head of cybersecurity would ever describe a solution as being "set it and forget it," but there is a degree of automation that the modern healthcare IT network needs to have.
As new classes of devices expand daily, with them come new forms of vulnerabilities, attacks and threats to overall network security.
In its new State of Threat Detection Report, security firm Fidelis has found that as the network traffic in hospitals has grown, the security apparatus has struggled to keep pace.
This includes everything from automated threat detection and response to having a greater visibility of all devices on the network – a crucial security requirement in the ever-expanding world of connected IoT devices.
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Automated detection of wrong-drug prescribing errors
Abstract
Background To assess the specificity of an algorithm designed to detect look-alike/sound-alike (LASA) medication prescribing errors in electronic health record (EHR) data.
Setting Urban, academic medical centre, comprising a 495-bed hospital and outpatient clinic running on the Cerner EHR. We extracted 8 years of medication orders and diagnostic claims. We licensed a database of medication indications, refined it and merged it with the medication data. We developed an algorithm that triggered for LASA errors based on name similarity, the frequency with which a patient received a medication and whether the medication was justified by a diagnostic claim. We stratified triggers by similarity. Two clinicians reviewed a sample of charts for the presence of a true error, with disagreements resolved by a third reviewer. We computed specificity, positive predictive value (PPV) and yield.
Results The algorithm analysed 488 481 orders and generated 2404 triggers (0.5% rate). Clinicians reviewed 506 cases and confirmed the presence of 61 errors, for an overall PPV of 12.1% (95% CI 10.7% to 13.5%). It was not possible to measure sensitivity or the false-negative rate. The specificity of the algorithm varied as a function of name similarity and whether the intended and dispensed drugs shared the same route of administration.
Conclusion Automated detection of LASA medication errors is feasible and can reveal errors not currently detected by other means. Real-time error detection is not possible with the current system, the main barrier being the real-time availability of accurate diagnostic information. Further development should replicate this analysis in other health systems and on a larger set of medications and should decrease clinician time spent reviewing false-positive triggers by increasing specificity.
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Industry Voices—Electronic health records fraud often first identified by whistleblowers
Aug 13, 2019 11:03am
When billions of dollars are on the table in any industry, the risk for fraud, waste, and abuse rises significantly. In many cases, the only way fraud is reported is by whistleblowers who share their first-hand knowledge of potential fraud.
This is especially important in highly technical industries like the electronic health records space.
Significantly, a 2012 Health and Human Services Office of Inspector General report estimated that the Centers for Medicare and Medicaid Services inappropriately paid over $700 million in connection with EHRs. Furthermore, based on recent lawsuits settled by the Department of Justice (DOJ), there is reason to believe other EHR fraud is going undetected.
Left unchecked, EHR fraud not only defrauds American taxpayers but it also potentially puts patients at risk.
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Transitions hampered by info exchange between venues of care
August 14, 2019, 1:00 p.m. EDT
Transitions in care between providers offering different levels of care are still mired in manual processes that hampers the ability to coordinate care.
A new survey examines the processes of how patients are being transitioned from acute-care providers to the long-term and post-acute care treatment environments. The research suggests that the difficulties in moving patients from one setting to another may grow as a problem as Baby Boomers begin to enter into hospitals and post-acute care facilities in record numbers.
Combine that with a nursing shortage, razor-thin margins, the need to reduce readmissions and ever-increasing federal regulations, and it is imperative that the long-term market automate to deliver best practices for improving long-term care, says B.J. Boyle, vice president at PointClickCare, a vendor of platforms to eliminate data silos and enable collaboration and insights among various types of providers.
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AI more accurate than docs in challenging breast cancer diagnoses
August 14, 2019, 12:10 a.m. EDT
An artificial intelligence system has outperformed pathologists in differentiating atypia from ductal carcinoma in situ—considered to be the greatest challenge in breast cancer diagnosis.
In a diagnostic study involving 240 breast biopsy images, the performance of the AI system was compared with independent interpretations from 87 practicing U.S. pathologists.
“In the classification tasks of atypia and DCIS versus benign and DCIS versus atypia, the associated sensitivities are higher than the sensitivity of the practicing pathologists who independently interpreted the same specimens,” according to the study’s authors.
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Health Information Exchange After 10 Years: Time For A More Assertive, National Approach
Although most transactions in our modern world are electronic and automated, many health care professionals still exchange patient information through inefficient manual processes. In much of the US, health information exchange (HIE) requires a complex series of handwritten signatures and faxed requests, resulting in lengthy delays. The net result is frustration for clinicians and patients, as well as repetition of services and even medical errors.
In 2009, Congress attempted to modernize HIE processes by passing the HITECH Act, offering grants and incentives to states and municipalities for developing regional HIE initiatives. Although there has been some progress toward effective mechanisms for data exchange, in many regions of the country it is no easier to share medical information than it was a decade ago. According to a 2018 report, fewer than half of office-based physicians can exchange patient health information outside their organization electronically, and less than a third can automatically integrate this information into their electronic health record (EHR).
This spring, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) issued new draft guidelines in an effort to rejuvenate HIE efforts. The updated rules, once finalized, would mandate that all insurers and providers serving Medicare patients make their data electronically accessible by 2020. Already, the recommendations have received widespread praise, including from the former ONC national coordinators in a recent Health Affairs blog post.
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Major breach found in biometrics system used by banks, UK police and defence firms
Fingerprints, facial recognition and other personal information from Biostar 2 discovered on publicly accessible database
Wed 14 Aug 2019 17.11 AEST Last modified on Thu 15 Aug 2019 08.22 AEST
The fingerprints of over 1 million people, as well as facial recognition information, unencrypted usernames and passwords, and personal information of employees, was discovered on a publicly accessible database for a company used by the likes of the UK Metropolitan police, defence contractors and banks.
Suprema is the security company responsible for the web-based Biostar 2 biometrics lock system that allows centralised control for access to secure facilities like warehouses or office buildings. Biostar 2 uses fingerprints and facial recognition as part of its means of identifying people attempting to gain access to buildings.
Last month, Suprema announced its Biostar 2 platform was integrated into another access control system – AEOS. AEOS is used by 5,700 organisations in 83 countries, including governments, banks and the UK Metropolitan police.
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How healthcare CIOs and CISOs can handle identity and access management
An expert in the strategies and technologies surrounding identity and access management walks through today’s challenges and discusses how provider organizations can best secure this key area.
By Bill Siwicki
August 14, 2019 12:22 PM
Many patients have been through the registration process multiple times, as a guest, shopping for a specialist, or as a registered patient booking an appointment or getting information on their own EHR. Getting a single view of an identity while securing each identity is important to a quality patient experience.
Many healthcare organizations are managing multiple siloed identities for the same providers and patients, with identity support provided only on an application-by-application basis. As a result, multiple log-ins are often required to get common tasks done.
For example, a patient who wants to look up test results and then respond to a message from her clinician may have to access two different systems, with two different sets of login credentials.
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Cerner Partners With Duke To Create Data Sharing Network For Clinical Research
August 14, 2019
Earlier this month, I wrote a blog item laying out some of the problems Epic is facing in getting its clients to share de-identified patient data among themselves. In sum, I concluded that while it might have the right idea, getting providers to pony up their data is no picnic.
Of late, Epic has been selling its customers a vision of building “One Virtual System Worldwide,” a data-sharing network designed to support clinical science breakthroughs by making relevant data available. However, according to Chilmark Research analyst John Moore, the vendor has had trouble getting clients to participate.
Of course, that doesn’t mean Epic’s efforts are out of line. In fact, at least one of its major competitors seems to be on a related track.
Cerner has just announced that it’s launching a new initiative designed to give clinicians easier access to patient health data. Working in partnership with the Duke Clinical Research Institute, the vendor is rolling out its Cerner Learning Health Network, which is intended to automate data collection from EHRs and multiple additional sources.
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PHDA, Amazon Partner to Improve Care with Machine Learning
The Pittsburgh Health Data Alliance and Amazon Web Services will use machine learning to advance healthcare innovation.
By Jessica Kent
August 12, 2019 - The Pittsburgh Health Data Alliance (PHDA) is partnering with Amazon Web Services (AWS) to improve medical imaging, cancer diagnostics, precision medicine, voice-enabled technologies, and other areas of healthcare with machine learning.
The AWS Machine Learning Research sponsorship will enable PHDA scientists from the University of Pittsburgh and Carnegie Mellon University (CMU) to accelerate research and product commercialization efforts across eight projects.
Projects could have the potential to create an individualized risk score for every cancer patient, which will help providers better predict a patient’s response to treatment. Other projects will aim to use a patient’s verbal and visual cues to diagnose and treat mental health symptoms, and to reduce medical errors by mining all data in patient medical records.
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Could Your EHR Actually Help You? Yes, and Here's How
Patients often see multiple providers; technology could help link us all together
Collaboration is the key.
When I think about how hard it is to take care of our patients, and how many different people are involved in their care, it's a wonder that anything ever gets done.
We need to simplify systems, and harness the power of the information systems available to us, as well as the promise of the electronic medical record, to improve the lives of our patients, as well as make all of our lives, all of our jobs, a little bit easier.
This morning we got a stack of paperwork on a patient who is followed in our practice, who really only comes to see us to get his home care forms completed. He sees multiple other specialists who are in our institution, who care for the various diseases and complications he has that require their particular expertise.
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https://www.complianceweek.com/data-privacy/how-gdpr-ccpa-impact-healthcare-compliance/27558.article
How GDPR, CCPA impact healthcare compliance
Tony Howlett Tue, Aug 13, 2019 5:46 AM
Most healthcare organizations are familiar with the privacy and data security requirements of the landmark HIPAA, and then HITECH, so they have gotten their operations compliant long ago. This may lead people to assume complying with newer privacy laws will be easy given all they are already doing to meet current requirements.
These new statutes, however, could be the flies in their compliance ointment because they are fundamentally different than previous laws. The EU’s General Data Protection Regulation (GDPR) and the California Consumer Privacy Act (CCPA) are citizen privacy rights bills versus a cyber-security or data management-focused bill, like HIPAA.
These regulations assign new rights and ownership to data that wasn’t there before and require systemic rethinking of your data handling, not just its security. Before you just had to keep a patient’s records secured; now you might have to be ready to hand them over or destroy them at will. This has profound implications on medical records and the industries that depend on them.
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Reduce burnout by putting more doctors in leadership roles: Physicians Foundation
August 12, 2019
Last month, Medical Economics published an article summarizing the results of a study performed at the Palo Alto Medical Foundation examining the link between the number of EHR-generated messages doctors receive and job satisfaction levels and burnout.
As a follow-up to that story, we recently interviewed Gary Price, MD, president of The Physicians Foundation, about its efforts to combat burnout and train doctors for leadership positions in healthcare. Price is a plastic surgeon practicing in New Haven, Conn., and is on the clinical faculty of the Yale School of Medicine.
Excerpts from that interview appear below, edited for length and clarity.
Medical Economics: How long have you been using electronic health records?
Gary Price, MD: I’ve been using one now for 7 or 8 years.
ME: What system do you use?
GP: In my office, we use Nextech, which was originally designed for plastic surgery practices. And, in fact, when they were doing their design they actually came to my office and talked to me before they developed their beta version. And they were already doing our bookkeeping software and our practice management software, so we went with them. At the hospital, I have to use Epic.
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HITRUST program seeks to boost maturity of data security practices
August 13, 2019, 1:33 a.m. EDT
HITRUST has created a new program to incentivize information security teams in healthcare organizations to work on advancing their security control maturity.
Based on analysis of data that HITRUST has collected over a decade, the organization concludes that when a healthcare entity’s controls are operating at or above a HITRUST data security maturity level of 79, there is a 99 percent likelihood these controls will continue to operate going forward.
That means data security assessments that hit a level of 79 have fewer control failures and pose less risk to their customers, says HITRUST, a data protection standards development and certification organization.
HITRUST further is updating its Common Security Framework Assurance program (CFS) with guidance on what qualifies as mature information security control scores and is offering organizations that have obtained CSF control maturity an extended time period between additional security assessments, giving these organizations credit for implementing an effective continuous monitoring program.
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DoD, VA adopt single healthcare logistics information system
August 13, 2019, 1:53 a.m. EDT
Under a new strategic partnership, the Department of Veterans Affairs will have access to the Defense Logistics Agency’s worldwide procurement system to acquire medical and surgical products, among other items.
According to Monday’s announcement, the agreement will have a direct positive impact on quality of care, patient safety and access to care with the adoption of a single integrated end-to-end healthcare logistics information system, rather than operating two disparate systems currently used by the DoD and VA.
Further, the agreement combines resources from both agencies creating a centralized ordering system for VA, which is meant to reduce risk, waste, fraud and abuse in purchasing medical equipment and supplies as well as enhance the VA’s supply chain management modernization efforts.
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All DHBs are now being offered the chance to have an assessment using four HIMSS maturity assessments: EMRAM, O-EMRAM, CCMM and INFRAM.
Digital maturity assessments rolled out to all DHBs in NZ
August 13, 2019 05:16 AM
Eight more district health boards (DHBs) in New Zealand will be assessed on their digital maturity using HIMSS Analytics maturity assessments over the next 12 months.
The Ministry kicked off its digital health maturity model project early this year, with Southern DHB the first to complete the assessments, followed by MidCentral DHB, which is awaiting its report.
All DHBs are now being offered the chance to have an assessment using four HIMSS maturity assessments: EMRAM, O-EMRAM, CCMM and INFRAM.
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Tapping the Benefits of Targeted Automatic Electronic Consultations
Information drawn from a patient's electronic health record triggers virtual consultation with a specialist.
KEY TAKEAWAYS
· In the targeted automatic electronic consultation (TACo) approach, the electronic health record identifies patients who meet the criteria for automatic consults.
· TACo consultation opportunities include patients who do not require a detailed chart review or physical examination.
· The University of California San Francisco Diabetes Service's TACo approach to inpatient screening has improved control of hypoglycemia and hyperglycemia.
A new model for electronic consultations has the potential to improve care quality, reduce length of stay, and decrease hospital costs, according to a new journal article.
No single physician can know everything, which requires specialist consultation to effectively manage many conditions. But traditional consults—with chart review, patient history, physical exam, and recommendations—are time consuming and resource intensive. Targeted automatic electronic consultation (TACo) offers an efficient electronic health record-driven approach to specialty consultations.
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DNA Data Shared in Ways Patients May Find Surprising
Hospitals engaged in private deals with drugmakers don’t always disclose the ways the data will be used
By Melanie Evans
Updated Aug. 12, 2019 5:30 pm ET
Deals between drugmakers and hospital systems to mine the genetic profiles of hospital patients are triggering concerns over the control of valuable genetic data.
Drugmakers have been spending hundreds of millions of dollars for access to patient information because of the data’s potential to help unlock disease insights and discover new drugs. They are striking deals to sequence patients’ genetic code, including with hospital systems like Geisinger in Pennsylvania, Mount Sinai Health System in New York and Mayo Clinic in Minnesota.
For patients, the allure is the promise of free genetic testing that could indicate their risk of diseases and the opportunity to contribute to the advancement of science. Yet patients may not realize how else their genetic data is getting used and the ways hospital systems and drugmakers could profit from it, legal experts and patient advocates say.
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Viewpoint
August 9, 2019
Big Data, Big Tech, and Protecting Patient Privacy
The market for patient data has never been more active. Technology companies, from startups to giants, are eager to access electronic health record (EHR) data to build the next generation of health-focused products. Medical artificial intelligence (AI) is particularly data-hungry; large, representative data sets hold promise for advancing not only AI companies’ growth, but also the health of patients.1 Companies’ overtures to major hospitals about data sharing have highlighted legal and ethical uncertainties as to whether and how to undertake these relationships.
One such partnership is now being challenged in court. In June 2019, a patient sued the University of Chicago Medical Center and Google for alleged misuse of patient EHR data.2 This Viewpoint discusses the case and what it signals about the need for thoughtful governance of data sharing between health care organizations and technology companies.
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Updating HIPAA for the electronic medical record era
Journal of the American Medical Informatics Association, ocz090, https://doi.org/10.1093/jamia/ocz090
Published: 06 August 2019
Abstract
With advances in technology, patients increasingly expect to access their health information on their phones and computers seamlessly, whenever needed, to meet their clinical needs. The 1996 passage of the Health Insurance Portability and Accountability Act (HIPAA), modifications made by the Health Information Technology for Economic and Clinical Health Act (HITECH), and the recent 21st Century Cures Act (Cures) promise to make patients’ health information available to them without special effort and at no cost. However, inconsistencies among these policies' definitions of what is included in “health information”, widespread variation in electronic health record system capabilities, and differences in local health system policies around health data release have created a confusing landscape for patients, health care providers, and third parties who reuse health information. In this article, we present relevant regulatory history, describe challenges to health data portability and fluidity, and present the authors’ policy recommendations for lawmakers to consider so that the vision of HIPAA, HITECH, and Cures may be fulfilled.
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Telehealth use jumps at inpatient facilities while outpatient adoption remains flat: survey
Aug 12, 2019 11:44am
Telehealth adoption among hospitals and health systems is on the rise—up from 54% in 2014 to 85% in 2019—while adoption among outpatient healthcare facilities remains flat, according to two new reports.
Almost two-thirds of hospitals, health systems, and academic medical centers (70%) are using two-way video/webcam technology specifically between physicians and patients, up from 47% in 2016, according to Definitive Healthcare's fifth annual inpatient telehealth study based on responses from 175 C-suite leaders, directors/VPs of IT and department directors at inpatient facilities.
Health systems and hospitals also are increasingly using population management tools such as SMS text, with adoption of those tools growing from 12% in 2016 to 19% in 2019. Remote patient monitoring through clinical-grade devices also grew but at a slower pace, up from 8% three years ago to 14% in 2019.
Nearly a quarter of inpatient facilities (23%) are using mobile applications for concierge services, up from 17% in 2016.
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FCC deems cellphones with 5G tech safe
In a new proposal, the FCC concludes current radio frequency emission levels are OK.
August 8, 2019 2:23 PM PDT
Cellphones -- old and new -- are safe, including those that'll use new 5G technology. That's according to a new proposal that Federal Communications Commission Chairman Ajit Pai circulated Thursday. It would keep the agency's current safety limits for radio frequency exposure the same as they've been for 23 years.
Following more than six years of public input and review, the agency said the current exposure levels for cellphones, wireless towers, Wi-Fi routers and all other devices emitting RF signals are safe. Agency officials added that they don't have any concern for new gear using 5G technology, including gear that uses millimeter wavelength frequencies.
The FCC, which sets radio frequency limits in close consultation with the Food and Drug Administration and other health agencies, said that the other agencies were also in agreement on keeping the current limits in place.
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Wide Variety of Groups Support Standardizing Addresses in Electronic Health Records
Stakeholders also suggest additional data elements to improve patient matching
August 8, 2019
Clinical societies representing medical and health IT professionals, health plans, hospitals, software developers, and other groups agree: Commonsense changes to federal criteria for using demographic data—such as addresses—would make it easier to link patients’ health records across different providers.
Electronic health records (EHRs) can give clinicians vital information regarding medications, treatments, and laboratory results, but this capability depends on accurate patient matching, or successfully associating an individual’s charts held in the different places the patient gets care. Patient matching rates vary widely, with health care facilities failing to link records for the same patient as often as half the time. Deficiencies in matching patients to their records can lead to safety problems and increase health care costs.
Inadequate patient matching has garnered interest among federal policymakers. The Office of the National Coordinator for Health Information Technology (ONC), the federal agency that oversees EHRs, recently issued draft regulations to implement provisions from the 2016 21st Century Cures Act and solicited input on ways to address matching challenges. In response, a wide range of stakeholders—from technology developers to health care providers—signaled support for two critical concepts: requiring the use of better standards for demographic data already collected, such as adoption of the U.S. Postal Services (USPS) standard for addresses; and integrating other information—such as emails—to enhance matching across EHRs.
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Modelling the possible returns to the NHS from private sector use of the 100K genomes database
5 Aug 2019
Abstract:
The development of publicly-owned genomics databases linked to health records challenges the standard model of drug development. The usual assumptions of transferring intellectual property (IP) or other knowledge from the public to the private sector do not hold. This article models the possible returns such a database as that developed through the 100K Genomes project might return to the UK healthcare system if those in control of the database are willing to engage in new contractual arrangements. This is possibly the only time the public sector has the advantage in negotiating these relationships and structures put in place now will remain for many years to come.
Publication Details
Copyright: Bennett Institute for Public Policy 2019
Language: English
License Type: All Rights Reserved
Published year only: 2019
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Old and New Technologies Blur at EXPO.health Conference
August 12, 2019
Healthcare Scene’s recent Boston conference, EXPO.health, walked the audience through numerous innovations in health IT, especially where analytics give a boost to patient care. Still, I detected at the show, next to the crisp digital images of modern technologies, a sepia-toned photograph of older practices. The two stood out against each other in some ways, but could also be entwined. Sometimes one would encounter the hoped-for future on the conference stage and then walk into the tired reality of today’s health care on the showcase floor. This article will look at both sides and the way their interaction shapes health care.
Good Omens for Value-Based Care
I have expressed worries before about the measurement of quality in health care. At EXPO.health, I talked to Robin Roberts and Joy Rios, who consult with health care institutions about how to apply for quality-based payments, while also running the “HIT Like a Girl” podcast. Robin said that “we are still going at a crawl” in creating and using quality measurements properly. For instance, she confirmed the complaints by critical access hospitals that quality measures tend to underestimate the morbidities of low-income, vulnerable populations, and therefore to also underestimate the costs of treating them, thereby underpaying the hospitals.
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Weekly News Recap
- Allscripts announces mixed Q2 results, which include a $145 million charge toward settling any liability that results from the Department of Justice’s Meaningful Use investigation against its acquired Practice Fusion.
- CVS beats Wall Street’s quarterly expectations and announces plans to expand its HealthHubs concept and to implement “next best action” programs for chronic care management.
- England’s NHS announces plans to form an $300 million artificial intelligence lab.
- Truman Medical Center pays ransomware hackers to regain access to its systems.
- Duke Clinical Research Institute and Cerner announce a pilot project to study patient data from non-Duke sites as the initial step in forming Cerner’s Learning Health Network.
- The DefCon cybersecurity conference creates a mocked-up hospital full of medical devices for hackers to play with.
- A new funding round values London-based AI health services vendor Babylon Health at over $2 billion.
- Guidehouse will acquire Navigant for $1.1 billion.
- Beaumont Health responds to reports of IT-heavy layoffs and the recent departure of its CIO and CMIO.
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Enjoy!
David.
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