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, September 28, 2019

Weekly Overseas Health IT Links – 28 September, 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.

How a daughter’s cancer treatment inspired an interactive app for sick kids

After watching his 13-year-old daughter go through a gruelling year of cancer treatment Dom Raban realised more could be done to help children feel at ease in hospital.
Andrea Downey, 17 September, 2019
Now his app, Xploro, has been trialled at The Christie NHS Foundation Trust  and Royal Manchester Children’s Hospital, with further plans to expand it across the NHS.
The app provides an interactive experience for young patients receiving hospital treatment, allowing them to interact with a personally designed avatar that can explain treatments, machines that will be used and answer any questions they have about their hospital stay.
With more than 10 years experience as the managing director of an interactive design company, Raban set about looking at digital solutions that would provide important information about care and treatment to young patients.

Period tracking apps caught sharing medical data with Facebook

Period tracking apps are sharing sensitive medical data with Facebook, an investigation has found.
Andrea Downey – 13 September, 2019
Data, including menstruation frequency, use of contraception and symptoms like blood pressure and acne, are being shared directly with the social media company.
In some cases, data is shared from the moment a user opens the app.
UK-based advocacy group Privacy International scrutinised six period tracking apps and found that five shared their data with Facebook, some before a user even agrees to privacy settings.
The apps, Maya by Plackal Tech, MIA by Mobapp Development Limited, My Period Tracker by Linchpin Health, Ovulation Calculator by Pinkbird, Period Tracker by GP International LLC and Mi Calendario by Grupo Familia, have been downloaded several million times between them.

You Don’t Want Facebook Involved With Your Health Care

Big tech companies want to share data about you with your doctors.

7:30 AM
Could your Netflix viewing habits predict that you will develop inflammatory bowel disease? Might your use of religious language in Facebook posts signal that you have diabetes? Could Amazon’s Alexa start telling you when you are getting sick and offer to sell you medicines?
All of the big technology companies have been moving into health care recently, making investments that mobilize their vast troves of consumer data. Amazon is selling software that can mine patient records and is expanding Alexa’s health and wellness capabilities. Google is developing A.I.-powered voice recognition software called “Medical Digital Assist” to help doctors dictate medical records. Alphabet, Google’s parent company, has a partnership between Verily (the company’s life sciences arm) and Walgreens to monitor patient medication “adherence.” Apple has been steadily developing health and medical apps for its smartwatches that can integrate personal health tracking data with electronic medical record systems at partner hospitals. Microsoft is developing A.I. software for medical records through the Azure for Health cloud. Even Uber and Lyft are getting into the game with “non-emergency medical transport.”

The founders of Robin Healthcare think doctors need smart assistants, too

Jonathan Shieber@jshieber / 12:16 am AEST September 19, 2019
Robin Healthcare, a new startup founded by serial entrepreneurs Noah Auerhahn and Emilio Galan, is hoping to harness the power of personal assistants to make the business of healthcare easier for the physicians who practice it.
The company’s technology, which works much the same way as a Google Home or Amazon Alexa or Echo, is placed in hospital rooms and transcribes and formats doctor interactions with patients to reduce paperwork and streamline the behind-the-scenes part of the process that can drive doctors to the point of distraction, the company’s co-founder said.
“I had a background doing claims data work in healthcare at UCSF finishing my clinical training,” says Galan. “And I was hearing lots of doctors telling me not to practice.”
HIT Think

How to hardwire quality measure capture at the point of care

September 20, 2019, 3:50 p.m. EDT
Some 60 percent of health plans report that they review gaps in care based on manual requests to providers. Only 9 percent of health plans can identify gaps in care in real time, according to the Workgroup for Electronic Data Interchange in its report entitled “Closing Gaps in Care through Health Data Exchange.”
Most organizations work through manual processes to improve quality measures and performance ratings. As a result, payers and providers report spending millions of dollars on tasks such as the following:
  • Chasing supplemental data feeds
  • Requesting extracts from the EMR
  • Scrubbing patient charts
Provider organizations sometimes fail to deliver (and payers fail to receive) consistent and accurate clinical data captured through professional billing. As a result, they run the risk of diminished performance on various pay-for-performance incentive programs.

Free federal tools available to aid physicians treating chronic pain

September 20, 2019, 3:27 p.m. EDT
A new tool from the federal Agency for Healthcare Research and Quality can help physicians find pain-related information on a particular patient.
The agency says the tool consolidates information scattered in the electronic health record into a single view or dashboard.
AHRQ estimates that 50 million American adults have chronic pain on a daily basis, which interferes with daily life or work for 20 million individuals.

Providers aren’t consistently screening for social determinants of health

September 20, 2019, 12:29 a.m. EDT
Few physician practices and hospitals in the United States screen patients for all five key social needs associated with health outcomes.
That’s the finding of a cross-sectional study conducted by The Dartmouth Institute for Health Policy and Clinical Practice.
Researchers leveraged national survey data from 2,190 physician practices and 739 hospitals to assess the prevalence of screening for five social needs—food insecurity, housing instability, utility and transportation needs, and experience with interpersonal violence.

Pop health IT helps Partners in Recovery reduce psychiatric hospital admissions by 50%

Combining psychiatric and primary care data, including social determinants of health, has also helped reduce ER spending from $2,265 per patient per month to just $875.
September 20, 2019 11:43 AM
Partners in Recovery, based in Peoria, Arizona, is an outpatient behavioral health provider organization serving more than 8,000 patients in the Phoenix area. The organization’s unique service focus is treatment for persons with chronic and severe mental illnesses, including conditions such as schizophrenia and schizoaffective disorder, bipolar disorder, and major depressive disorder.
Partners in Recovery recognized that a large portion of its patients also had undiagnosed and untreated chronic medical conditions, including hypertension, respiratory illness, diabetes, heart disease and obesity. Together, these factors contributed to significant overutilization of the emergency department and hospitals – with some Partners patients visiting EDs 70 or more times per year.
“A high rate of undiagnosed and untreated health conditions is common among individuals with mental and behavioral health conditions, with one study attributing 60% of premature deaths to these causes,” said Christy Dye, CEO of Partners in Recovery.

Patients Fear That Medical AI Can’t Handle Their Unique Needs

September 20, 2019
A new study has concluded that patients are skittish about interacting with medical AI technology in part because they fear that AI won’t address their unique characteristics adequately.
The study looked at how receptive consumers were to the use of “medical AI,” which researchers defined as any machine using an algorithm or statistical model to perform perceptual, cognitive and/or conversational functions in patient care.
To conduct their research, the study authors looked at consumer preferences regarding medical AI. A central focus of the study was the impact of “uniqueness neglect,” patient belief that their medical AI wouldn’t take their unique issues into account when making judgments.
HIT Think

Why there is no reason to overpay for AI, no matter how exciting it is

September 19, 2019, 3:49 p.m. EDT
Eventually, many conversations about artificial intelligence include HAL.
An acronym for Heuristically programmed ALgorithmic computer, HAL played a prominent and disconcerting role in Stanley Kubrick’s mind-bending 1968 film 2001: A Space Odyssey. In the film, sentient computer HAL learns that the humans suspect it of being in error and will disconnect it should that error be confirmed. Of course, HAL is having none of that, and terror ensues.
So influential was Kubrick’s adaptation of an Arthur C. Clarke short story that HAL is now a part of the ways in which AI is often conceived.
So, given that it is 2019, a full 18 years past the marvelous technological era predicted by Kubrick’s title, we must be well beyond HAL. Right?
Not even close, as it turns out. Nothing like HAL exists in any industry. Sure, IBM’s Deep Blue defeated chess champion Garry Kasparov in 1997, and Watson emerged victorious on Jeopardy in 2011, but efforts to revolutionize oncology using Watson have not come to fruition. The self-aware supercomputer that talks to us like a brilliant sidekick is not on the horizon. (Sorry, Janet.)

ED patient encounters not accurately documented in EHR

September 19, 2019, 12:08 a.m. EDT
Documentation in electronic health records did not match observed and recorded physicians' behaviors during patient encounters, according to a study of emergency department residents.
The study, published on Wednesday in the journal JAMA Network Open, involved emergency departments in two academic medical centers where residents’ patient encounters were observed to compare real-time performance with EHR documentation.
 “No other study has attempted to quantify the accuracy of electronic physician documentation using concurrent observation,” the authors contend.
In the study, nine residents were shadowed by trained observers for 20 encounters—10 encounters per physician per site—to gather real-time observational data, with the associated EHR data subsequently reviewed.

Ransomware: Cyber-insurance payouts are adding to the problem, warn security experts

"It seems like a fix but it really isn't". Paying the ransom might be the cheapest short-term option to get your data back, but it causes long-term problems.
By Danny Palmer | September 17, 2019 -- 14:24 GMT (00:24 AEST) | Topic: Security
Cyber-insurance companies that encourage ransomware victims to give into the demands of hackers and pay for decryption keys are making the problem of file-locking malware attacks much worse in the long run, cybersecurity experts have warned.
This year has seen a rise in the number of ransomware attacks, with cities and local governments – in the US in particular – regularly falling victim to ransomware attacks.
In a number of cases, the victims have given in to the extortion demands of the attackers, often paying cyber criminals hundreds of thousands of dollars for systems to be restored.

How cloud hosting can help with management of SDOH data

Two consultants explain how the agility of remote hosting can boost readiness for social determinant of health initiatives – and spotlight the privacy and security concerns that must be prioritized.
September 18, 2019 03:41 PM
With the shift to value-based care, many healthcare providers are discovering a more direct focus on addressing social determinants of health is a way to tackle some of the root causes of illness, behavioral health challenges, readmissions and emergency room overuse.
Data generated "in real life" in consumer tracking apps and social networks can be especially useful for informing and bolstering population health as well as screening for and managing social determinants of health risks.
A valuable asset
The cloud can, in turn, be a valuable asset in allowing healthcare providers and health systems, as well as other organizations, to collect, analyze and share that data. But that means taking a different view toward non-traditional "health data" that will be used to SDOH ends.

Widespread Support for Adopting Tools Needed to Tap Potential of Electronic Health Records

Stakeholders laud federal agency for advancing standardization, improvements in data sharing

Article September 18, 2019
Widespread Support for Adopting Tools Needed to Tap Potential of Electronic Health Records
Dozens of organizations representing electronic health record (EHR) developers, health information technology professionals, doctors, and other relevant interests recently backed draft government regulations that would give patients and providers easier access to medical records. Given the widespread support, the Office of the National Coordinator for Health Information Technology (ONC) should finalize its proposed regulations as soon as possible so that patients and clinicians can reap the benefits of new tools to foster greater data exchange.
Although EHRs are now used in nearly every U.S. hospital and physician’s office, many patients seeing a new doctor or specialist may still need to bring paper medical records. Too often, current systems cannot easily share information with each other—a concept known as interoperability—or translate the data received into the proper format.
Application programming interfaces (APIs) already allow services, such as travel and personal finance websites and smartphone applications, to organize and display information from multiple sources. If broadly used in health care, APIs based on common standards could also sync data across EHR systems and feed that information into apps that let patients share their medical records with caregivers or alert clinicians to best practices for treatment.

Google is finally absorbing a healthcare business 10 months after the move was first announced

Shona Ghosh
Sep 19, 2019, 1:04 AM
  • Google has finally absorbed the healthcare arm of AI firm DeepMind, the British company it acquired in 2016 for £400 million ($US500 million). The integration is happening some 10 months after Google originally announced it.
  • DeepMind Health is now officially part of Google’s dedicated healthcare unit, Google Health, which is headed up by big-name healthcare CEO David Feinberg.
  • The announcement comes one month after the DeepMind cofounder who had headed up its health business, Mustafa Suleyman, confirmed he was on a leave of absence from the business for reasons that are unclear.
  • The integration brings DeepMind’s controversial Streams app, a non-AI service that helps medical practitioners monitor patients with a kidney condition, under Google Health’s management.

Google has finally absorbed the healthcare unit of its artificial intelligence company DeepMind, the British company it acquired for £400 million ($US500 million) in 2016.
The change means that DeepMind Health, the unit which focuses on using AI to improve medical care, is now part of Google’s own dedicated healthcare unit. Google Health was created in November 2018, and is run by big-name healthcare CEO David Feinberg.

Healthcare cybersecurity – the impact of AI, IoT-related threats and recommended approaches

An interview with Richard Staynings, Chief Security Strategist, Cylera.
September 18, 2019 05:28 AM
Currently leading healthcare security strategy at Cylera, a biomedical HIoT security startup, Richard Staynings has more than two decades of experience in both cybersecurity leadership and client consulting in healthcare. Last year, he served on the Committee of Inquiry into the SingHealth breach in Singapore as an expert witness. He recently spoke to Healthcare IT News on some of the current developments in healthcare cybersecurity.
Q. Artificial intelligence (AI) applications in healthcare are all the rage now, and so are cybersecurity threats, given the frequency and intensity of healthcare-related incidents. In particular, some of the cyberattacks have become more sophisticated through the use of AI to get past cyber defenses. On the medical devices front, AI is also being used to constantly manage and secure the rising number of healthcare IoT devices as they connect and disconnect from hospital networks. What do you think the application of AI in healthcare cybersecurity will be like in the next few years?
A. Healthcare is widely considered to be an easy and soft target because “who in their right mind would attack the weak and defenseless?” … or so the thought goes! The fact is that healthcare presents a rich target for cyber criminals because of the value of the data hosted and processed. When you couple that with a chronic historical underinvestment in the development of capable cybersecurity teams and tools across healthcare, you can see why perpetrators are so keen to break walk in. But it’s no longer the theft of medical records, or PII that concerns me, it’s the wholesale theft of intellectual property from research universities and pharmaceuticals by rogue nation states, (one in particular) and the potential to hold both hospitals and their patients to ransom by just about anyone. That’s what really worries me most.

10-hospital health system adds evidence-based clinical decision support tech

The clinical pathways system is designed to help make appropriate decisions related to specific clinical questions. The drug tool is designed to help pharmacists, physicians and nurses with access to point-of-care drug information.
September 19, 2019 05:11 AM
Covenant Health, a 10-hospital health system based in Knoxville, Tennessee, has added UpToDate Advanced and Lexicomp systems – evidence-based interactive clinical decision support and drug information tools, respectively – to its health IT line-up. The systems are from vendor Wolters Kluwer Health.
The regional health system opted to expand its longtime access to UpToDate at one hospital to all 10, as well as to approximately 100 clinics, spanning 23 counties in East Tennessee.
UpToDate Advanced equips Covenant Health caregivers with interactive clinical pathways to help make appropriate decisions related to specific clinical questions. The system’s Lab Interpretation feature is designed to help clinicians quickly analyze abnormal lab results and decide on next steps while helping to reduce unnecessary testing and prevent missed diagnoses.

How one provider org used SDOH, analytics and texting to help reduce pre-term births

The Parkland Center for Clinical Innovation increased prenatal visit attendance by 24%, reduced early preterm delivery by 27%, and reduced first-year baby costs by 54%.
September 19, 2019 11:01 AM
The Parkland Center for Clinical Innovation aims to improve health for underserved, vulnerable populations. Its staff says health begins where people live, learn, work and play, so they endeavor to bring together data science and social determinants of health to create connected communities of care.
“One of the vulnerable populations we’ve been focusing on are women at risk of pre-term delivery since their health and pregnancy is heavily influenced not only by their medical history, but their social and economic situation and environment,” said Dr. Steve Miff, president and CEO of the Parkland Center for Clinical Innovation. “Our data scientists and clinicians took a fresh look at this challenge and explored how data science and SDOH can drive better segmentation, engagement, and ultimately better outcomes and lower costs for those who need help the most.”
As top healthcare problems go, pre-term birth is a big one because one in 10 children in the United States is born prematurely. This challenge is even more significant among inner city African-American and Hispanic women due to SDOH challenges.

Group To Offer Health Data Access To Android Phone Users

September 19, 2019
In recent times, Apple has been making a number of public moves focused on getting its customers to pull their health data onto their iPhone. Using Apple’s Health app, consumers can have their health data downloaded automatically from any institution with which it has partnered.
To date Apple’s list of partners stands at more than 200, including scattered individual medical practices and a wide range of health systems, including Allina Health, Baptist Health, Baylor, Scott & White Health, Catholic Health Initiatives, Christiana Care Health System, Cone Health,  Emory Healthcare, Erlanger Health System, Geisinger, Henry Ford Health System, Inova Health System, Johns Hopkins, Legacy Health, Mary Washington Healthcare and MedStar Health.
Not only that, there’s every reason to believe Apple’s health data sharing universe will continue to expand.  Though iPhone adoption still lags behind Android adoption, it still controlled 47% of the mobile OS segment as of March 2019, compared with 52.1% of phones using Google Android, according to Statista.

Special Report: Cloud

Cloud seems to offer enormous potential benefits for healthcare – from unlocking a new wave of innovation to big data. But where is the NHS at with regards to the cloud, what has changed and has the mood towards it shifted? Jennifer Trueland investigates.
It’s almost exactly a year since the UK Government published its vision for digital, data and technology in health and care. One of the key architectural principles is that we should “start with the assumption that all our services should run in the public cloud, with no more locally managed servers”.
At the moment this is more aspiration than reality. Though cloud-based services are far more prevalent in the health services of all four UK countries than they were a couple of years ago, they are still far from mainstream.
But all this could be about to change as more and more healthcare organisations recognise the benefits.

CMS official notes proposed interoperability rule will impact health plans, too

September 18, 2019, 3:08 p.m. EDT
The federal government expects to use its leadership, clout and some emerging federal regulations to push health payers to share more data.
Those regulations, now open for comment, lay out crucial first steps that will engage health plans in nationwide interoperability efforts, said Alexandra Mugge, deputy chief health informatics officer for the Centers for Medicare and Medicaid Services at the AHIMA19 Health Data and Informatics Conference in Chicago.
Speaking at the annual conference of the American Health Information Management Association, Mugge says CMS’ Interoperability and Patient Access Proposed Rule is a first step in an effort to improve data sharing among all healthcare entities while increasing the pressure against those that block information exchange.

Mayo Clinic CIO: 'This artificial intelligence stuff is real'

"And it is coming quickly to a care setting near you," said Cris Ross at Health 2.0 on Tuesday, touting "small AI and big AI" tools that can help revamp IT systems to improve the experience of clinicians and patients alike.
September 18, 2019 08:56 PM
SANTA CLARA – Mayo Clinic Chief Information Officer Cris Ross put it plainly during his keynote speech at Health 2.0 this week: "Our systems are not adequately supporting our doctors, in lots and lots of ways."
And he counts his own world-class health system as one of them. Mayo Clinic completed a landmark four-year, 90-hospital, $1.5 billion Epic implementation in 2018. But while it was "an enormous project and by all objective measures we did just fine," said Ross, "we're also still at place where our doctors are frustrated and our patients are not seeing a particular difference by us doing that."
Providers want to know that they have meaningful work, where they are operating in an efficient and effective way and that they're delivering the best treatment that's appropriate, he explained.
"But they're also looking for joy in practice," said Ross. "Being a provider is hard. And we make the bar even harder by layering on unbelievable levels of complexity and regulation, which makes their work incredibly hard. We have to help them with that and try to find a way to bring some joy back to their work."

Sepsis Quality Care: How Is the U.S. Performing?

September 18, 2019
The following is a guest article by Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse, Health Learning, Research & Practice, Wolters Kluwer.
Sepsis affects 1.5 million people in the U.S. annually, and it is a leading cause of morbidity and mortality, attributing over $20 billion in annual hospital fees. As hospitals and health systems focus on this deadly and preventable condition during Sepsis Awareness Month, it’s important to reflect on the state of the industry and how the nation is performing following increased regulatory attention in recent years.
Sepsis in not a new diagnosis. In fact, the third definition of sepsis and septic shock was published in 2016. As an industry challenge, the complexities of getting out in front of sepsis and reducing its impact have plagued healthcare organizations for years. Too often clinicians fail to recognize the severity of an infection and that the patient actually has sepsis. The failure to recognize and diagnose sepsis can lead to a deadly outcome.
The key to sepsis survival is early detection and intervention, and research has demonstrated that decreasing variability of care positively impacts patient outcomes. Recognizing that the sepsis challenge requires a multi-pronged, multi-disciplinary approach that draws on the latest industry evidence, the Centers for Medicare and Medicaid Services (CMS) instituted a program in 2015 to put standardized protocols to the test through a sepsis treatment bundle. These standards of practice have been implemented and supported nationally to improve the outlook, and hospitals are wise to prioritize implementation of the protocols as sepsis performance scores are now published on the publicly-available Hospital Compare website.
Sep 16, 2019, 08:00am

IT Technologies Intersect To Transform The Health Care And Pharmaceutical Sectors

Vishal Gupta
Global CTO and senior vice president of technology at Unisys. Leads the global technology and product organization across six global centers
The World Health Organization (WHO) is celebrating seven decades of public health progress, which it says, "Have added 25 years to global life expectancy, saved millions of children’s lives, and made huge inroads into eradicating deadly diseases."
As WHO notes, there’s still a long way to go. One of the ways forward is via the intersection of various IT technologies. These technologies have the potential to help the health care and pharmaceutical industries -- and those they serve -- to continue moving in the right direction to build a healthier, secure and more convenient world.
Clinics and hospitals are clearly big users of technology. They regularly employ systems like ultrasound and X-ray machines. The global diagnostic ultrasound market alone is expected to surpass $7 billion by 2024. Yet the health care vertical spends just 3 to 5.9% of its revenue on IT, while the financial services sector spends 4.4 to 11.4% of its revenue on IT solutions. No wonder that nearly two-thirds of health care providers say they are behind the curve on their digital health initiatives. The good news is that some of the innovative technologies below can help the health care vertical make significant progress.

The Apple Watch's Next Trick Could Be Battling Pseudoscience, But Questions Remain

Sep 16, 2019, 1:30pm
Before launching into its battery of Apple Watch announcements on Wednesday, Apple set the tone, as it often does, with a moving promotional video. Among the many characters featured was a mother who described how the Apple Watch helped catch a pregnancy-endangering heart condition. She rushed to the hospital, and her baby was saved. Later, Apple announced it would expand its health initiatives by embarking on three new health research studies in the U.S. that will use data gathered by its smartwatch. The Apple Watch, like most wearables, is billed as a product that can help you live a healthier life. These studies are Apple’s latest effort to prove that’s more than marketing bluster.
Though the announcement was light on details, we know the company is partnering with a half-dozen top medical institutions in America to investigate a range of topics including women’s health, the effect of mobility on cardiovascular health, and the impacts of everyday sound exposure on hearing.
The studies will be conducted through Apple’s upcoming Research app, and they have the potential to be some of the largest-ever studies involving worn sensors. Don’t be surprised if these studies ultimately breed new features. In fact, all this altruistic-sounding research is probably a shrewd business decision since the company can’t legally market medical capabilities without research and health authority clearance in the U.S. Even if they don’t turn into features, the studies lend Apple credibility and goodwill.

HHS wants to give you your health data — do you want it?

09/16/2019 02:48 PM EDT
Encouraging patients to access and share detailed health records is one of the Trump administration’s major health care policy goals. So far, though, patients aren’t really responding.
HHS may soon begin to understand why as it pursues plans to force insurers and providers to adopt new data standards that, in theory at least, should allow more people shift their health information to their smart phones and laptops.
The technology allowing patients to grab their own data — application programming interfaces, or APIs — is already used in e-commerce and to power businesses like ride share networks. But patient access to APIs is "pretty far from the mainstream" despite a decade of development efforts, said A. Jay Holmgren, a Harvard health policy researcher who has studied adoption rates. A recent JAMA study found only about 0.7 percent of patients who log into patient portals where they can access records wind up sending them to their smartphones.

VA starts training program for new Cerner EHR system

September 17, 2019, 12:49 a.m. EDT
The Department of Veterans Affairs wants to ensure that VA personnel are properly trained to support the agency’s 10-year Electronic Health Record Modernization initiative.
Under the newly launched VA Innovative Technology Advancement Lab (VITAL) training program, the agency has selected 76 initial trainees for advanced training; they will support continuous performance improvement and seek to address real-world healthcare challenges. As the decade-long deployment continues, participants will be added, according to the VA.
For the first cohort of VITAL, 76 trainees were selected from among more than 40 point-of-care clinical and support roles at the Electronic Health Record Modernization’s initial operating capabilities sites, including Mann-Grandstaff VA Medical Center in Spokane, VA Puget Sound Health Care System in Seattle and Tacoma, and other Veterans Integrated Service Network facilities in Alaska, Idaho, Oregon and Washington state.

NHS trust deploys clinical messenger solution from Dutch startup Siilo

The announcement comes as hospitals become increasingly aware of the need to share patient information over secure platforms.
September 17, 2019 04:51 AM
St George’s University Hospitals NHS Foundation Trust in London has begun the rollout of the secure clinical messenger solution Siilo enabling healthcare professionals to share patient information.
The hospital trust sees the Siilo messaging app as a way to not only provide a safe, secure and easy way to share information about patients, but also eradicate the use of WhatsApp.
The app, which is used by more than 150,000 healthcare professionals across Europe, is being made available to consultants, junior doctors, specialist physician associates, specialist nurses and other staff at the hospital.

Health system takes an ‘Epic first’ approach to integrating all data, including SDOH

Contra Costa Health Services takes on whole person care by gathering every bit of data, not just medical care data, and getting it into its Epic EHR. The results have been startling.
September 17, 2019 03:48 PM
Recognizing that medical services only address part of a person’s overall health, the California Department of Health Care Services (DHCS) designed the Whole Person Care (WPC) program to address the physical health, behavioral health and social needs of high-need, high-cost Medi-Cal beneficiaries.
DHCS negotiated the program as part of its Medi-Cal 2020 Section 1115 waiver renewal with the Centers for Medicare & Medicaid Services (CMS). The WPC pilots are testing whether local initiatives coordinating physical health, behavioral health and social services (housing supports, food assistance, other public benefits, etc.) can improve health outcomes and reduce medical costs.
Up to $1.5 billion in federal funds are available over the five years of the program, matched by $1.5 billion in local funds from the pilots. Each WPC pilot differs in size, target population(s) and interventions based on community needs, priorities and resources.

Medical images and details of 24.3 million patients left exposed on the internet

When we think about our data being leaked onto the internet, we often picture it as our financial records, our passwords, our names and addresses… but what about our private medical information?
Researchers at Greenbone Networks discovered that confidential images of X-rays, CT and MRI scans related to millions of patients has been left unprotected on hundreds of servers used by health providers worldwide.
Analysing 2,300 medical image archive systems around the world in the last two months, Greenbone’s team found 590 were freely accessible, containing records of 24.3 million patients in 52 different countries.
Exposed information included patients’ names, dates of birth, dates of examination, the attending physician, and some medical information about the purpose of the examination. In addition, 13.7 million of the compromised records included the social security numbers of American patients.

AHRQ Encourages Use of Fast Healthcare Interoperability Resources (FHIR®) Standard

Notice Number: NOT-HS-19-020
Key Dates
Release Date: September 9, 2019
Related Announcements
Issued by
The purpose of this notice is to encourage the Agency for Healthcare Research and Quality (AHRQ)-funded researchers to explore the use of the Fast Healthcare Interoperability Resources (FHIR®) standard to capture, integrate, and exchange healthcare data for research purposes and to enhance capabilities to share research data.
The Health Level Seven International (HL7®) FHIR is a standard for exchanging health information electronically. FHIR specifies the content of the data exchanged between healthcare applications, and how the exchange is implemented and managed, typically through an application programming interface (API). Software developers can seamlessly connect their application to another through a FHIR API to transmit electronic healthcare data. FHIR enables the exchange of many different healthcare data types such as clinical information, demographics, and billing and claims data.

Israel Prepares to Unleash AI on Health Care

In a small country with digitized records, big data could make medicine cheaper and more effective

By Dov Lieber
Sept. 15, 2019 10:01 pm ET
Israel is becoming a testing ground for the power of artificial intelligence to improve health care.
Digital medical records for the vast majority of Israelis are currently stored in databases maintained by the handful of semipublic HMOs that provide most health care in Israel. While the biggest health-maintenance organizations already leverage their records in partnerships with private companies to develop technology for more advanced health care, Israel’s government wants to take such efforts to a new level.
The government last year announced a $264 million initiative to begin to combine those millions of records into a giant unified system, one that takes decades of individual patients’ information and puts it all in the same format so medical data looks the same across all health-care institutions. Corralling the records and organizing them in ways that maximize their usefulness to AI programs and data analytics, the government hopes, will make the data of even greater value to researchers and health-care companies. And the greater goals, officials say, based largely on the promise of AI technology, are to make health care less expensive, more effective and better tailored to individuals everywhere.

Emory, Purdue accelerator programs join HHS initiative to address health security threats

Sep 16, 2019 12:57pm
The U.S. Department of Health and Human Services wants to tap into startups and entrepreneurs to help solve systemic health challenges. 
The federal agency is expanding its innovation accelerator network that supports small and start-up biotechnology innovators to accelerate the development of products for biodefense and other health security needs. HHS' Office of the Assistant Secretary for Preparedness and Response (ASPR) unveiled the network last year with eight accelerators. The network is spearheaded by ASPR's Biomedical Advanced Research and Development Authority (BARDA).
The five new accelerators include Emory University & Georgia Institute of Technology (Coulter Translational Program) in Atlanta; Plug and Play Tech Center in San Francisco; University of Missouri Midwest BioAccelerator (MU-MBAr) in Columbia, Missouri; University Enterprise Labs in partnership with gener8tor in St. Paul-Minneapolis; and Purdue University in West Lafayette, Indiana.
These organizations expand the existing network, providing geographic coverage into areas of the country previously under-represented in the network, HHS officials said.

Moody's: Cyberattacks could cause significant financial disruption for hospitals

Sep 12, 2019 3:47pm
Cyberattacks pose a greater fiscal and credit risk to nonprofit hospitals than any other sector of municipal finance due to the increasingly interconnected nature of hospital operations and information technology.
Hospitals with strong risk management strategies will be better positioned to respond to these operational and financial disruptions, according to a report from Moody's Investors Service.
Small hospitals face the biggest risk, because many lack the necessary cybersecurity resources and will be less able to absorb any financial impact, according to report authors Jennifer Barr, a Moody's analyst, and Lisa Goldstein, Moody's associate managing director.

Beth Israel, Dana-Farber leaders offer a prescription for better digital health: Actionable data at the point of care

Sep 13, 2019 10:40am
BOSTON—With an all-time high $14.6 billion in funding going toward digital health startups globally last year, investors are betting big on the promise of tech to address major healthcare challenges and disrupt the industry.
Are these digital solutions delivering?
They could be doing more, according to John Halamka, M.D., chief information officer at Beth Israel Deaconess Medical Center and professor of medicine at Harvard Medical School.
There are early successes, such as artificial intelligence and machine learning that are aiding radiologists, pathologists, and oncologists by analyzing reams of data and providing more effective clinical decision support. And physicians—armed with data from wearables and medical devices—can diagnose and treat patients quickly using telehealth visits, Halamka said while speaking at the Digital Health Impact conference in Boston this week.
By Paddy Padmanabhan, star Advisor, Contributor, CIO | Sep 13, 2019 5:29 am PDT

Healthcare data’s moment of lift

The unlocking of patient data is leading us to a future when health care will be a vastly improved experience with superior outcomes. However, there will be guard rails around consumer access to personal health records.

Data wants to be free. Data also wants to be in free markets.
A slew of newly announced initiatives points to the inexorable shift of data away from walled gardens and tightly controlled environments into the world of free markets. Consider these:
  • A group of healthcare institutions and technology providers has launched an open-source initiative titled CommonHealth to let Android-powered device users gain access to medical records. The initiative will dramatically increase the number of consumers who will have access to their medical records, essentially replicating Apple’s remarkably successful efforts to give iOS users access to health records from over a hundred participating hospitals and health systems.
  • Allscripts, a health IT company, has opened up access to their Electronic Health Records (EHR) system to Apple, enabling patients from hospitals using the Allscripts platform to access their records over their iOS devices such as iPhones.
  • Epic has launched a massive data compilation effort entitled Cosmos to aggregate over 20 million patient medical records from providers in a participation agreement designed to make the data pool available for analysis in improving care decisions.
OK, I'm not so sure about the last one, but you get the drift. Patient medical information is being set free so that their rightful owners, i.e., consumers, can access and share them freely. ET go home. At last.

US needs cyber-savvy doctors as connected device use rises, FDA panel says

Author Maria Rachal

Published Sept. 11, 2019

Thinking about medical device cybersecurity risk is a little like considering a potential airplane crash, Thermo Fisher Scientific cybersecurity researcher Jay Radcliffe told FDA's Patient Engagement Advisory Committee Tuesday.
The impact if the risk played out could be high, but the probability of it being realized is low.
Unlike a plane crash, it's usually difficult for patients to conceptualize these risks, which underscores the importance of training healthcare providers in cybersecurity to help guide patients, presenters and panelists advised the agency.
And the fact that risks are difficult to quantify or mitigate doesn't change the responsibility FDA and manufacturers have to inform patients and providers of all known vulnerabilities through well-tailored communications, the panel said.

Cybercriminals shop for admin access to healthcare portals

by Jonathan Greig Security
Administrator access to backend systems is becoming the holy grail for attackers.
When people think about hackers and their targets, most assume cybercriminals are after bank account numbers or financial institutions. But a new study from cybersecurity firm IntSights shows hackers are now honing in on healthcare institutions for lucrative information to steal.
IntSight's new research report "Chronic [Cyber] Pain: Exposed & Misconfigured Databases in the Healthcare Industry" looks at what methods cybercriminals are using and what healthcare organizations can do to protect themselves. 
"If you would have told me 15 years ago, 'Hey let's go target the database manager for this insurance company,' I wouldn't even know where to begin," said IntSight chief security officer Etay Maor. 

Amazon's battle for pharmacy business is fought over phone, fax

September 16, 2019, 3:42 p.m. EDT
Getting into the pharmacy business was easy for Amazon.com: It paid $753 million to buy the mail-order startup PillPack. The hard part has been prying patients away from their local drugstore.
Since being acquired by the internet giant, PillPack has run into stiff opposition, from chains like CVS with thousands of stores to family-owned operations with a single shop. Having seen their business of selling shampoo and razor blades chipped away by online sellers, the drugstores are trying to keep Amazon from wresting away their piece of the $333 billion U.S. prescription-drug industry.
PillPack’s selling point is simple. For people who take multiple medicines a day, it will replace a confusing jumble of pill bottles with neatly sealed packets stamped with the time they’re supposed to be taken. But to make the process seamless for customers, PillPack needs to ask a patient’s pharmacy or doctor to transfer their prescriptions. While it’s always faced some pushback, PillPack contends that after Amazon said it was buying the startup in June 2018, its faxed requests for prescription transfers started being slow-walked or even completely disregarded.

New guidance available to help improve cyber recruiting

September 16, 2019, 3:47 a.m. EDT
The Healthcare and Public Health Sector Coordinating Council has released a new toolkit to help a variety of healthcare organizations recruit and retain cybersecurity personnel.
The initiative is designed to address the growing need for cyber talent faced by healthcare providers, insurers and other stakeholders as threats to data systems continue to grow. The council worked with the federal government to produce the toolkit.
HSCC also has created a Cybersecurity Working Group (CWG), as threats have become more numerous, more frequent and more severe, requiring concerted and coordinated mitigation efforts across the healthcare industry.
Guidance is particularly aimed at small to mid-sized health delivery organizations and companies that don’t have extensive resources for security but need a place to start.

Mobile tech, IoT and AI driving the need for next-generation storage

September 16, 2019, 3:26 p.m. EDT
There’s an insatiable demand for data storage, fueled by the ongoing rise in mobile devices and apps, the Internet of Things, artificial intelligence and many other factors. Not surprisingly, demand is up for next-generation storage technologies.
In a recent report, Zion Market Research said the global next-generation data storage market totaled $50.4 billion in 2018 and is expected to reach about $114.9 billion by 2025, growing at a compound annual growth rate (CAGR) of 12 percent between 2019 and 2025.
Next-generation data storage involves technically-advanced products that are more efficient than conventional products at handling voluminous information on a daily basis, the report said.

Clinician burnout: Physicians name the technologies they think could best solve it

At Health 2.0, National Coordinator for Health IT Dr. Don Rucker and other clinical IT leaders explore the root causes of the burnout epidemic – and offer a wishlist of tech innovations that could help.
September 16, 2019 06:56 PM
SANTA CLARA – At Health 2.0 on Monday, National Coordinator for Health IT Dr. Don Rucker listed a litany of challenges faced daily by physicians and nurses, and contributing to the ongoing scourge of clinician burnout: onerous documentation requirements, boilerplate electronic health records and the "monster burdens" of prior authorization and compliance with too many overlapping quality measures.
A lot of people single out suboptimal EHR experience as as root cause of the burnout epidemic, and it certainly is one of them. But "burnout is multifactorial," said Dr. Michael Pfeffer, chief information officer at UCLA Health.
It can be caused by EHR frustrations, admin burdens, regulatory headaches, malpractice concerns and the rise of consumerism: Pfeffer says he hears often from physicians dismayed by poor online reviews from patients that they're powerless to fix.
Ultimately, burnout is about "loss of control," added HIMSS Chief Clinical Officer, Dr. Charles Alessi. The EHR may have become the "epithet to hang everything on," he said, but this deep satisfaction among so many clinicians has a wide array of contributing factors.

Health 2.0: Providers must reinvent themselves to achieve quadruple aim

Dr. Albert Chan, chief of digital patient experience at Sutter Health, says health systems have to get better at interpreting data in novel ways to make good on their promise to patients.
September 16, 2019 01:24 PM
SANTA CLARA – At the Health 2.0 Provider Symposium on Monday, one physician leader opened the morning by taking a trip back in time, to 1999.
It was a year of red pills (The Matrix, where Neo gulped down a tablet that showed him the true nature of reality) and blue pills (Viagra, which earned Pfizer $281 million that year, boosting its profits by 14%).
It was a year of a technology panic that wasn't (Y2K) and of the first major warnings about a different sort of emergency: the Institute of Medicine's landmark '99 report, "To Err is Human: Building a Safer Health System," which shocked the world by showing 44,000-98,000 people die each year as a result of avoidable medical errors.

Michigan HIE Group Creates Shared Environment For Modeling Interoperability

September 16, 2019
If you’re running an HIE, you’re always hoping to see your participants step up their interoperability game. The thing is, few HIEs go the extra mile to make it happen, in many cases because they just don’t have the resources to tackle the problem.
Given this fact, I was interested to see the recent announcement by a Michigan HIE which is taking a far more hands-on approach to helping participants develop better interoperability capabilities.
Michigan Health Information Network Shared Services (MiHIN) is launching a new not-for-profit organization dedicated to supporting research on national interoperability.
MiHIN is Michigan’s state-designated entity for sharing electronic health information statewide. It’s a non-profit, public-private collaboration whose participants include the State of Michigan, other state HIEs, health systems, providers, health plans, pharmacies and the Governor’s Health Information Technology Commission.

Time To Get Clear About Digital Care Limitations

September 16, 2019
Today. I stumbled across a story featuring what has to be one of the more unfortunate uses of digital health technology I’ve ever encountered.
According to a news item, Ernest Quintana, a 79-year-old grandfather who was an inpatient at Fremont, Calif-based Kaiser Permanente Medical Center, was in the ICU because his lungs were failing.
At one point during his stay, the report says, a hospital robot entered Quintana’s room and a video visit with an off-site doctor began. (The hospital uses the robot to allow physicians to go on virtual rounds.)
During the consult, the physician told Quintana that his condition was terminal, apparently for the first time, a message which the family felt should never have been delivered via video. Adding insult to injury, his granddaughter had to pass along the bad news, because the dying man had trouble hearing the doctor.

EY Participatory Health Framework

A report from the American Hospital Association and consulting firm EY says that participatory health, or “healthcare with no address,” is coming. It predicts that health systems will respond to consumers who want on-demand, connected, and data-driven services.
The report says a participatory health framework will require health systems to offer:
  • Health and wellbeing support.
  • A personal health cloud containing the patient’s own data, including biometrics.
  • AI analysis of the data to create new insights and solutions.
  • A demand-driven global marketplace.
The report predicts that physicians will become “data-driven conductors” who will take responsibility for managing the lifestyle and wellness of patients.
The authors observe that while the future is more patient-centric and participative, health systems must move toward value while continuing to earn most of their revenue for volume.

Weekly News Recap

  • Surescripts cuts off prescription data access to Amazon’s PillPack mail order pharmacy.
  • The premier of Queensland, Australia promises to investigate a 14-hospital downtime of several hours that was caused by a Cerner upgrade.
  • Apple announces that it will partner with several high-profile healthcare institutions to conduct studies related to hearing, women’s health, and heart health using its new Research app.
  • Mayo Clinic signs a 10-year partnership with Google in which Google Cloud will provide Mayo with data hosting, cloud computing, analytics, and machine learning and AI.
  • Bayfront Health St. Petersburg (FL) pays $85,000 to settle HHS OCR’s first case under the Right of Access requirement to give patients complete copies of their medical record within 30 days.
  • Hackers breach DDS Safe, a cloud-based records retention and backup solution that is sold to dental practices, and use it to install ransomware on the computers of hundreds of dental practices.

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