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, November 30, 2019

Weekly Overseas Health IT Links – 30 November, 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.

Will Smart: The NHS has proven it can do digital well

When Will Smart took up the role of NHS England CIO in 2016, he did so with the view that three years would be enough time to make a different to the NHS’s technical landscape.
Owen Hughes – 21 November, 2019
Having played a central role in both the Global Digital Exemplar (GDE) and Local Health and Care Record Exemplar (LHCRE) programmes, it’s fair to say that Smart has overseen some of the most ambitious and influential digital change programmes in the NHS’s recent history.
For him, the GDE programme in particular served as proof that NHS organisations were capable of massively shaking up their approach to care delivery, with digital at the forefront.
“To be blunt, I think three years ago it wasn’t clear that the NHS could really do this stuff,” Smart tells Digital Health News.
“Cambridge [University Hospitals NHS Foundation Trust] was the only example of an organisation that had really digitised – and that was not without its problems.

How IoT is improving patient care

The Internet of Things (IoT) is starting to make breakthroughs in the healthcare sector but what does the future hold? Jonathan Palmer, senior director for product strategy and digital trials at Oracle explores the benefits IoT technology could bring.
DHI News Team – 21 November, 2019
Until recently, if a patient was ill or experiencing symptoms, they had to visit a doctor or hospital for treatment. Any notes from that visit went into the patient file, which has evolved over the years from an actual paper file into an electronic dossier that theoretically follows the patient throughout their life. Yet this change from the analogue to the digital is a drop in the ocean compared to what the future holds.
The Internet of Things (IoT) is gradually transforming the healthcare sector, in the same way it has opened up possibilities in industries such as manufacturing, marketing and financial services. A range of connected medical devices are appearing on the market, from equipment trackers and wearable monitors through to digital health assistants, all promising a range of benefits for practitioners and patients alike.
Efficient equipment
Many healthcare practices possess a range of mobile devices that practitioners can use in their daily consultations, including digital x-ray equipment, ventilators and other moveable resources. However, studies have found that usage rates for these devices hover around 42%[1]. What’s more, nurses reportedly waste up to 10% of their day searching for equipment.
Perspective Global Health

Artificial intelligence for global health

1.       Ahmed Hosny1,2,
2.       Hugo J. W. L. Aerts1,2,3
Science  22 Nov 2019:
Vol. 366, Issue 6468, pp. 955-956
DOI: 10.1126/science.aay5189
Artificial intelligence (AI) has demonstrated great progress in the detection, diagnosis, and treatment of diseases. Deep learning, a subset of machine learning based on artificial neural networks, has enabled applications with performance levels approaching those of trained professionals in tasks including the interpretation of medical images and discovery of drug compounds (1). Not surprisingly, most AI developments in health care cater to the needs of high-income countries (HICs), where the majority of research is conducted. Conversely, little is discussed about what AI can bring to medical practice in low- and middle-income countries (LMICs), where workforce shortages and limited resources constrain the access to and quality of care. AI could play an important role in addressing global health care inequities at the individual patient, health system, and population levels. However, challenges in developing and implementing AI applications must be addressed ahead of widespread adoption and measurable impact.
Health conditions in LMICs and HICs are rapidly converging, as indicated by the recent shift of the global disease burden from infectious diseases to chronic noncommunicable diseases (NCDs, including cancer, cardiovascular disease, and diabetes) (2). Both contexts also face similar challenges, such as physician burnout due to work-related stress (3), inefficiencies in clinical workflows, inaccuracies in diagnostic tests, and increases in hospital-acquired infections. Despite these similarities, more basic needs remain unmet in LMICs, including health care workforce shortages, particularly specialist medical professionals such as surgical oncologists and cardiac care nurses. Patients often face limited access to drugs, diagnostic imaging hardware (ultrasound, x-ray), and surgical infrastructures (operating theaters, devices, anesthesia). When equipment is available, LMICs often lack the technical expertise needed to operate, maintain, and repair it. As a result, 40% of medical equipment in LMICs is out of service (4). Conditions are exacerbated in fields that require both specialized workforce and equipment. For example, delivering radiotherapy requires a team of radiation oncologists, medical physicists, dosimetrists, and radiation therapists—together with sophisticated particle accelerator equipment. Consequently, 50 to 90% of cancer patients requiring radiotherapy in LMICs lack access to this relatively affordable and effective treatment modality (5).
, 2019

Blue Cross Blue Shield of Massachusetts adds Learn to Live

The web and mobile delivery technology provides self-directed information to help individuals with stress, depression, social anxiety, and insomnia.

Susan Morse, Senior Editor
Blue Cross Blue Shield of Massachusetts announced this week they have added Minneapolis-based Learn to Live – a digital delivery of evidence-based cognitive behavioral therapy tools –  to provide online support for members struggling with concerns such as depression, insomnia, stress and anxiety.
BCBSMA employer clients with 500 or more members will have the option to engage Learn to Live's interactive programs that help with emotional health issues in a confidential digital experienced. The programs provide access and affordable concepts and tools which are based on the proven fundamentals of cognitive behavioral therapy, the insurer said.
The consumer-centered technology is available through both web and mobile delivery. Their programs are self-directed, providing self-help information and skill-building lessons designed to help individuals with stress, depression, social anxiety, and insomnia.
The company designs solutions that reduce stigma, alleviate access barriers and limit financial concerns for those seeking help.

European data law is impeding studies on diabetes and Alzheimer’s, researchers warn

By Tania Rabesandratana Nov. 20, 2019 , 12:25 PM
For many people, the most apparent effect of the European privacy law called the General Data Protection Regulation (GDPR) has been a flourishing of website pop-ups, demanding your consent to store browsing behavior as cookies. An annoyance, perhaps, but hardly more than an inconvenience. For Francis Collins, director of the U.S. National Institutes of Health (NIH), however, the regulation has turned out to be a serious impediment to research.
Since 1993, Collins has been principal investigator for a project studying type 2 diabetes in Finnish people, who have relatively homogenous genetics and detailed health records. Finland's National Institute for Health and Welfare has sent 32,000 DNA samples to Collins's laboratory. He and his U.S. collaborators used the data to discover more than 200 places in the genome where variants increase the risk of illness. But in May 2018, when GDPR came into force, the Finnish institute stopped all data sharing on the project, because NIH could not provide guarantees that would satisfy the institute's interpretations of the law's requirements. Progress has since "slowed to a crawl," Collins says.
This week in Brussels, representatives from NIH, academia, industry, patient advocacy groups, the European Commission, and data protection authorities met to share their GDPR frustrations. They hope to highlight the obstacles it creates for some international collaborations and explore possible responses. "I hope this is only a temporary slowdown, and that the meeting in Brussels opens the way to a solution," Collins says.

Most organizations say cybersecurity risk levels are on the rise

November 19, 2019, 3:30 a.m. EST
More than half of risk professionals worldwide say their organization’s risk levels have increased in the past 12 months, according to new research from IT organization ISACA, its best practices subsidiary CMMI Institute and security education provider Infosecurity Group.
The organizations surveyed more than 4,500 specialists worldwide involved in risk decisions, and found that only 29 percent have a high degree of confidence that their enterprise can accurately predict the impact of threats and vulnerabilities associated with emerging technologies.
Fewer than one third (31 percent) of security professionals surveyed said their organizations can respond quickly when new threats are identified, which the report noted is problematic given today’s fast pace of business and technology-driven change.

Google demos its EHR-like clinical documentation tool

News of the tool, currently in clinical pilots, comes a week after reports circulated that Google was working with healthcare system Ascension on a controversial project involving patient data.
November 21, 2019
Google Health has offered a peek at what it's planning for its next set of clinical digital tools. It includes a more integrated charting system that aims to make it easier for doctors to search for a variety of metrics and notes. 
“With a single login, doctors can access a unified view of data normally spread across multiple systems. All the types of information clinicians need are assembled together such as the vitals, labs, medications and notes,” Dr. Alvin Rajkomar, product manager and practicing physician, said in a demo video
“Clicking on any value will start a deeper exploration showing recent and historical trends both graphically and with tables," he explained. "Doctors can query the entire chart with their own words and typos. Results are not strict keyword matches. A variety of Google technologies are used to identify related concepts.”

We Should Keep An Eye On Healthcare AI Medical Liability Risks

November 22, 2019
Today, most health IT leaders seem sold on the potential healthcare AI deployment can offer, as its benefits are becoming clearer every day.  It’s becoming almost a no-brainer to believe that AI can do great things for the practice of predictive analytics, for example.
In a recent survey by medical malpractice insurer The Doctors Company, 53% of physicians it contacted are optimistic about the prospects for AI in medicine, and 35% of physician respondents reported that they were using AI in their practices.
Not only that, 66% of physicians surveyed believe that AI will lead to faster diagnoses, and 66% predicted that the use of AI would lead to more accurate diagnoses.
Specific benefits they see from healthcare AI include assistance with case triage, enhanced image scanning and segmentation, improved detection, decision support, integration and improvement of workflow, personalized care, automated tumor tracking, disease development prediction and making healthcare delivery more accessible, humane and equitable.

Your Health Data Isn’t as Safe as You Think

Silicon Valley’s rush into the health-care business is challenging the antiquated protections of Americans’ medical histories

By  Katherine Bindley
Updated Nov. 22, 2019 1:15 pm ET
We relinquish all kinds of data to tech companies in exchange for convenience. We hand over our location, our heart rates and even imprints of our eyeballs because we want to order an Uber, track a workout or get through airport security faster. But we expect one thing to be mostly kept private: our medical histories.
In a way, our health information is the last sacrosanct piece of personal information. That’s why people were so surprised to learn Google had a deal with Ascension to handle tens of millions of patient records, including full names, test results and diagnoses.
They’re right to be confused: Aren’t there laws that protect patients when it comes to health information? Multiple people tweeted: What about HIPAA? Not everyone is familiar with the particulars of the Health Insurance Portability and Accountability Act but most people have sat in a doctor’s office and filled out a pile of paperwork that seemed to suggest we have some control over who sees our medical information.
The answer: Technology is moving faster than regulation. HIPAA was written, and has been amended, with a few objectives in mind: Allowing people to keep their insurance coverage if they change or lose their jobs; developing a set of standards that would allow health-care providers to adopt new technologies, such as electronic medical-record keeping, while still protecting patient privacy; and giving patients the right to request and direct their electronic health information to third parties.

Artificial Intelligence Could Help Solve America's Impending Mental Health Crisis

Five years from now, the U.S.' already overburdened mental health system may be short as many as 15,600 psychiatrists as the growth in demand for their services outpaces supply, according to a 2017 report from the National Council for Behavioral Health. But some proponents say that, by then, an unlikely tool—artificial intelligence—may be ready to help mental health practitioners mitigate the impact of the deficit.
Medicine is already a fruitful area for artificial intelligence; it has shown promise in diagnosing disease, interpreting images and zeroing in on treatment plans. Though psychiatry is in many ways a uniquely human field, requiring emotional intelligence and perception that computers can't simulate, even here, experts say, AI could have an impact. The field, they argue, could benefit from artificial intelligence's ability to analyze data and pick up on patterns and warning signs so subtle humans might never notice them.
"Clinicians actually get very little time to interact with patients," says Peter Foltz, a research professor at the University of Colorado Boulder who this month published a paper about AI's promise in psychiatry. "Patients tend to be remote, it's very hard to get appointments and oftentimes they may be seen by a clinician [only] once every three months or six months."

Could health data privacy kill you?

The views expressed by contributors are their own and not the view of The Hill
Last week, the Wall Street Journal reported on Project Nightingale — a controversial initiative spearheaded by Google’s parent company Alphabet and its health-care cloud-computing customer Ascension Health. 
Millions of patient records had been copied to Google servers and were viewable by hundreds of Alphabet employees. This was done without the knowledge of the patients or their physicians. 
While both Ascension and Google claim they abided by the law, Project Nightingale has raised serious concerns and sparked federal inquiry
Why would Alphabet and Ascension engage in a deal with such regulatory risk? Health data has enormous value. The data Ascension turned over to Alphabet may be worth billions of dollars, if prior health-care data transactions are any indication. This value is rooted in medical data’s ability to drive innovation and fuel artificial intelligence-assisted medicine.

DEA to Launch Registration Process for Prescriptions by Telemedicine

Federal officials are finally moving forward with a registration process for healthcare providers who want to prescribe controlled substances through telemedicine, as outlined in the Ryan Haight Act.

November 21, 2019 - Healthcare providers may soon be able to register with the federal government to use telemedicine to prescribe controlled substances.
The Justice Department has issued a long-awaited – and overdue – proposed rule to create a special registration process for providers looking to expand their telehealth platform to, among other things, improve treatment for people struggling with substance abuse issues.
The “Special Registration to Engage in the Practice of Telemedicine” was called for in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which strongly regulated a provider’s ability to prescribe controlled substances. Under the Ryan Haight Act, providers are required to conduct an in-person examination before prescribing or otherwise dispensing controlled substances “by means of the Internet,” except when engaged in the practice of telemedicine. The definition of “practice of telemedicine,” meanwhile, includes seven categories in which a provider could meet the in-person requirement through a virtual care platform – including under a special registration granted by the US Drug Enforcement Agency. But that registration process was never created by the DEA.

Senators press Google on handling of health data for millions of Americans

November 21, 2019, 12:00 a.m. EST
Three U.S. senators are demanding that Google account for the company’s reported efforts to obtain the health records of millions of Americans without their awareness or consent.
Senators Richard Blumenthal (D-Conn.), Bill Cassidy (R-La.) and Elizabeth Warren (D-Mass.) wrote a letter to Google this week in response to a Wall Street Journal piece published earlier this month that detailed Project Nightingale—a business partnership that began in secret last year—in which the tech giant has been reportedly developing and managing the infrastructure of healthcare provider Ascension.
 “We write with concern over reports that Ascension has entered into a partnership that provides Google with the health records of tens of millions of Americans without their awareness or consent,” states the letter. “Health information and records of medical care are exceptionally sensitive information that, when mishandled, expose patients to embarrassment, discrimination, exploitation and other harms. Based on prior privacy violations and security failures from the company, we have substantial concerns about how Google will handle patient data and use health records for other purposes.”

4 key job roles for success with artificial intelligence initiatives

November 21, 2019, 3:30 a.m. EST
The field of artificial intelligence has witnessed a huge renaissance in the past decade because of significant advancements in specialized computing, and better ways to collect, process and store large volumes of data. The continued diversity in AI projects, products and deployment models, combined with a requirement for rapid time to production, will require proper skills to meet these demands.
A recent Gartner survey revealed that leading organizations expect to double the number of AI projects in place within the next year. At this rate, the lack of AI skills will continue to be the No. 1 challenge for enterprises looking to succeed in their AI initiatives through 2025. Herein lies the value of engaging an AI architect and other related roles to do so.
Defining and Engaging the AI Architect
Today, enterprise architecture and technology innovation leaders, including CIOs and CTOs, view AI as a cornerstone of their innovation strategy. Although the 2019 Gartner CIO Survey reveals significant impending investments in AI and strong growth in deployments year-over-year, very few enterprises have realized its full potential because of process immaturity, diversity and complexity of the AI technology stack.

Opinion: An NHS fit for 2030 - Delivering value to citizens

Dr Charles Alessi, chief clinical officer at HIMSS, outlines how the 2030 patient would have access to their customised care and wellness record.
November 21, 2019 06:55 AM
The NHS is one of the most efficient health systems in the world and delivers more activity per unit of funding than many other similar systems. 
It is also a product of its age. Ideated in the late 1940s and having been through countless reorganisations, it remains an institution whose focus is the curing or amelioration of illness.
As we move to a health and care system which is more based on personalised interventions which also encompass wellness and more active personal involvement, it would be useful to describe what the NHS would look like in this new world and how it would differ from the old NHS. In this context , it would also be useful to describe this from the perspective of both hospitals and primary care as well as local government as in essence all would be driven to achieve the same aims, albeit the financial metrics to drive each this convergence of purpose would differ.

Retention of Audit Trails and Other Metadata are Critical to Limit Risk When Retiring Legacy Healthcare Systems

November 21, 2019
The following is a guest blog post by Justin Campbell, Vice President, Strategy, at Galen Healthcare Solutions.
Successful healthcare data archiving with minimal risk requires preservation of the legal medical record (as defined by the organization), data sets such as contextual audit trails, referenced data in ancillary systems, data change and version history, and even database metadata. A navigable audit trail is essential if we want to relate the precise sequence of events; this trail provides evidence that justifies and/or explains what actions have occurred. It is also vital to satisfy e-Discovery requests.
In retiring clinical systems, it is essential to evaluate the data that must be archived and equally crucial to assess the workflows driving interaction between systems. From a legal perspective, when providers use either primary (EHR, EMR) or ancillary (LIS, RIS, PIS, PACS, Perinatal) clinical systems as a diagnostic reference for clinical decision making, the data becomes part of the longitudinal medical record. Providers may not see a need for preservation of a particular workflow in ancillary systems, but the Health Information Management department should.

No Safety Switch: How Lax Oversight Of Electronic Health Records Puts Patients At Risk

By Kaiser Health News  |   November 21, 2019

Plans for putting patient safety first — and for building a comprehensive injury reporting and reviewing system — have stalled for nearly a decade.


·         Over the past 10 years, stakeholders have squabbled over how best to collect injury data, over who has the power to require it, over who should pay for it, and over whether to make public damning findings and the names of those responsible.
·         In 2015, Congress derailed a long-planned EHR safety center, first by challenging the government's authority to create it and later by declining to fund it.
·         A year later, Congress stripped the FDA of its power to regulate the industry or even to track malfunctions and injuries.
This article was first published on Thursday, November 21, 2019 in Kaiser Health News.
In fall 2009, several dozen of the best minds in health information technology huddled at a hotel outside Washington, D.C., to discuss potential dangers of an Obama White House plan to spend billions of tax dollars computerizing medical records.
The health data geeks trusted that transitioning from paper to electronic records would cut down on medical errors, help identify new cures for disease and give patients an easy way to track their health care histories.
But after two days of discussions, the group warned that few safeguards existed to protect the public from possible consequences of rolling out the new technology so quickly. Because this software tracks the medicines people take and their vital signs, even a tiny error or omission, or a doctor's inability to access the file quickly, can be a matter of life or death.

Lawmakers push HHS for more clarity, stronger data privacy protections in federal data sharing rules

Nov 19, 2019 4:05pm
Federal lawmakers are putting pressure on the Department of Health and Human Services (HHS) to make big changes to forthcoming rules on data sharing and information blocking.
A bipartisan group of senators sent a letter to HHS Secretary Alex Azar Nov. 15 urging the agency to provide more clarity about which data must be shared to comply with the information blocking rule.
Sen. Mark R. Warner, D-Virginia, wants to see HHS put in stronger controls and standards to safeguard patient data as the rule pushes insurers to make records accessible through application programming interfaces (APIs), according to a letter (PDF) he sent to Azar, also on Nov. 15.
Warner, co-founder of the Senate Cybersecurity Caucus, is a frequent critic of poor cybersecurity practices in healthcare.

Providers face challenges with tech essential for value-based care

November 19, 2019, 11:29 p.m. EST
Patient engagement, data aggregation and analytics, and precision medicine are critical for value-based care, but limited resources and lack of reimbursement pose significant barriers to the adoption of these technologies.
That’s the finding of the third annual Top of Mind for Top Health Systems survey from the Center for Connected Medicine, which is jointly operated by GE Healthcare, Nokia and UPMC.
The survey of 70 leaders at 65 health systems nationwide, nearly half of which were chief information officers, was conducted by health IT research and consulting firm KLAS.
According the survey’s results, only 17 percent of surveyed healthcare organizations report a high level of patient participation with engagement tools. While patients’ age and socioeconomic status were identified by respondents as the biggest barrier to the adoption of patient engagement technology, reimbursements were the second most commonly reported barrier—with telemedicine called out as an area in which payer buy-in is lacking.

AMA calls for fully inclusive EHRs for transgender patients

November 19, 2019, 11:39 p.m. EST
The American Medical Association has adopted a policy supporting the voluntary inclusion of a transgender patient’s preferred name and clinically relevant sex-specific anatomy in electronic health records.
At its interim meeting in San Diego this week, AMA’s House of Delegates called for creating EHR documentation that is fully inclusive of transgender patients.
 “Failure of electronic health records to promote inclusive medical documentation is a major barrier to providing quality care to transgender patients,” contends the AMA, the nation’s largest physician group. “To fill the gap in needed information on transgender patients, the AMA today strengthened its existing policy promoting inclusive gender, sex and sexual orientation options in medical documentation for LGBTQ patients.”

AI poised to impact high-skill U.S. jobs, including finance

November 20, 2019, 3:45 p.m. EST
 (Bloomberg) Artificial intelligence is coming for America’s high-paid professions as it creates winners and losers across the labor market like never before.
White-collar jobs and better-educated occupations along with production workers are among the most susceptible to AI’s spread into the economy, according to a Brookings Institution report, released Wednesday, that draws on a new analysis of patent data by Stanford University graduate student Michael Webb.
“Webb’s modeling suggests that just as the impacts of robotics and software tend to be sizable and negative on exposed middle- and low-skill occupations, so AI’s inroads are projected to negatively impact higher-skill occupations,” researchers Mark Muro, Jacob Whiton and Robert Maxim wrote, noting that their analysis shows potential impacts can be both positive and negative. Workers with graduate or professional degrees will be almost four times as exposed to AI as workers with just a high school degree, the report showed.
The researchers also concluded that AI appears most likely to affect men, prime-age, and white and Asian American workers. Business, finance, and technology will be more exposed, along with natural resource and production industries, they found. Farming, one of humanity’s earliest jobs, may also be affected by AI as drones and precision agriculture help boost productivity. Farming, fishing and forestry had the top exposure score of any occupational group.

Senator Urges HHS to Add API Privacy Standards to Data Sharing Rules

In his latest push to bolster cybersecurity across the healthcare sector, Sen. Mark Warner is urging HHS to add data standards to its data sharing rules to bolster patient privacy protections.

November 20, 2019 - The Department of Health and Human Services is once again being asked to add data standards to its proposed data sharing rules to ensure the protection of patient privacy as interoperability increases throughout the healthcare sector.
Sen. Mark Warner sent a letter to HHS stressing the need for changes to its upcoming rules on information blocking and interoperability. CHIME has made similar recommendations to the Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee.
Meanwhile, the American Academy of Neurology recommended the Centers for Medicare and Medicaid Services create a standard for third-party application use, as both rules propose the use of APIs to support data sharing.

Windows security warning: Ransomware is growing fastest, and just got harder to tackle

Crypto-locking malware attacks are growing, and could become more dangerous after the apparent departure of a big player.
By Steve Ranger | November 18, 2019 -- 15:07 GMT (02:07 AEDT) | Topic: Security
Ransomware is growing fast and could become more difficult to tackle as the criminal ecosystem shifts from a few dominant players to many smaller ones.
Tech security company Bitdefender analysed Windows security threats including ransomware, coin miners, fileless malware, PUAs ('potentially unwanted applications' that can compromise privacy or security), exploits (attacks based on unpatched or previously-unknown vulnerabilities) and banking Trojans.
Bitdefender found that of all these threats, ransomware reports saw the biggest year-on-year increase – 74.2%. Ransomware also ranked first in terms of the total number of reports.
According to the security company, the number of ransomware reports actually dropped during the first half of 2019, largely because the group behind the GandCrab ransomware throttled down their operation.

Voice-Enabled AI App May Reduce EHR Documentation Time

Ken Terry
November 20, 2019
A new effort to enlist artificial intelligence (AI) to improve the usability of electronic health records (EHRs) and reduce the administrative burden on physicians is starting to bear fruit, but at least one expert considers the effort to be "shortsighted."
A year into the American Academy of Family Physicians' (AAFP) 42-month Health IT Innovation Project, a voice-enabled AI assistant called Suki has cut EHR documentation time by more than 50% in some pilot family practices, Steven Waldren, MD, AAFP vice president and chief medical informatics officer, told Medscape Medical News.
Leading EHR vendors are developing similar enhancements to their products, Waldren said. "There's a significant amount of [research and development] in this space. We've had conversations with Epic and Cerner, and both are working on AI-powered, voice-enabled clinical assistants for documentation and order entry. Those EHR products are a couple of years out, potentially."

Digital monitoring system helps improve hospital care of sepsis patients

Ingrid Torjesen
Wednesday, 20 November 2019
A digital alert system to monitor patients with sepsis has led to a reduction in deaths and hospital stays, and improved timely use of antibiotics during a trial at Imperial College Healthcare NHS Trust, a study* published in the Journal of the American Medical Informatics Association has shown.
The system monitors a range of changes in patients such as temperature, heart rate and glucose levels and alerts doctors and nurses if they fall outside safe parameters so they can investigate further. Clinicians are notified of patients who have triggered the alert either through a pop-up warning on their electronic health records and/or on a dashboard, which highlights any patient with an active alert when they open a patient's record.
In addition to the alert, Imperial College Healthcare NHS Trust designed a multidisciplinary care plan which is launched in the electronic patient record system when a clinician confirms a diagnosis of sepsis. This prompts the clinical team to determine the best options from a range of treatments, such as fluids, oxygen, diagnostic tests and early antibiotics, and ensure they are given to patients within one hour - in line with national targets.

Amazon Web Services Offers Subscription Access To Third-Party Data

November 20, 2019
Amazon Web Services has announced the launch of a new service designed to allow its customers – including healthcare organizations – to find, subscribe to and use third-party data.
Healthcare members already involved with the new AWS Data Exchange include Change Healthcare, which processes and anonymizes more than 14 billion healthcare transactions and $1 trillion in claims each year. Its roster also includes Deloitte, whose ConvergeHealth Miner platform helps life sciences and healthcare organizations move toward more personalized medicine by offering cloud-based analytics, knowledge management and collaboration tools.
Data Exchange customers will be able to use its API or console to pull data to which they subscribe directly into Amazon’s Simple Storage Service. Each time data providers publish a new revision of their data, the platform will notify all subscribers, allowing customers to automatically suck new revisions into data lakes, applications, analytics and machine-learning models running on AWS.

Consumers Like Generating Health Data, But Are Careful of How They Share It

November 20, 2019
New research suggests that while consumers are continuing to expand their use of digital health technologies, they’re still careful about with whom they share their health data. It also exposes an unexpected trend in which younger consumers are less trusting about such sharing than older ones.
The survey, which was backed by Rock Health and Stanford Medicine, reached out to 4,000 US adults, querying them about their engagement with various forms of digital health information.
One key takeaway from the survey was that as with the previous two years, four out of five respondents used either analog or digital methods to track at least one health indicator, with the proportion of consumers using digital tools increasing.  Specifically, 42% of respondents use digital tools to track a health indicator in 2019, up from 33% two years ago.

AI Can Help Identify Potential Adverse Effects from Drug-Drug Interactions

2019-11-18 15:00:00
Patients who take multiple medications are at an increased risk of experiencing negative effects from drug combinations, particularly when they are prescribed drugs and then take additional OTC medications on their own. However, new machine learning system may help identify potential negative adverse effects from drug-drug interactions, according to a study published in IEEE Journal of Biomedical and Health Informatics.

For the study, the authors designed an algorithm that analyzes data on drug-drug interactions cited in reports from the FDA and other organizations. Using this information, the algorithm was designed to act as an alert system that could warn patients when a drug combination may have potentially dangerous adverse effects.

“Let’s say I’m taking a popular over-the-counter pain reliever and then I’m put on blood pressure medicine, and these medications have an interaction with each other that, in turn, affects my liver,” study author Soundar Kumara, Allen E. Pearce and Allen M. Pearce professor of industrial engineering, Penn State, said in a statement. “Essentially, what we have done, in this study, is to collect all of the data on all the diseases related to the liver and see what drugs interact with each other to affect the liver.”

IT execs call for HIPAA overhaul in 'Project Nightingale' wake

Author Rebecca Pifer

Published Nov. 18, 2019

It could be time for stricter personal health information protection laws in light of Google collecting the data of more than 50 million Americans from provider giant Ascension, health IT experts say.
The partnership, called Project Nightingale, came to light last week and involves the nation's second-largest health system sharing data from patients from 21 states with the Mountain View, California-based tech giant — without patient consent or knowledge. In return, Ascension gets access to any software or services Google develops, such as an omnibus search tool integrated into the EHR that aggregates all PHI in one location.
"HIPAA was crafted many decades ago now and it's probably time for it to be updated for the current world," Dan Nigrin, SVP and CIO at Boston Children's Hospital, said Monday at U.S. News & World Report's Healthcare of Tomorrow conference. "The safeguards provided for in HIPAA probably lack specific granularity and detail for the instances like the one we just saw unfold before us."
There's no dispute both actors are compliant with the 1996 patient protection and privacy law.

Oregon Health System Implements Drug Pricing Tool into Epic EHR

OHSU Health is the first health system in Oregon to utilize a price transparency tool embedded in the EHR.

November 19, 2019 - Oregon Health & Science University Health system implemented a drug pricing tool into its Epic Systems EHR that will help providers discuss medication costs with patients.
The price transparency tool automatically factors in information that is not typically available to the patient right away such as the price of the co-pay, deductibles, and need for prior authorization. The clinician can readily compare the price of the medications and the patient will have the price as soon as the prescription is written.
“Patients will ask me, ‘Is it expensive?’ And my answer is usually, ‘That’s difficult to say,’” said Steve Kassakian, MD, a primary care physician and assistant professor of medicine at OHSU School of Medicine. “Medication costs are really, really challenging. There’s never been an ability for me to see the cost in real-time.”
The tool is implemented into OHSU Health’s Epic Systems EHR, which makes real-time price transparency more accessible. Ultimately, Kassakian believes the tool will force clinicians into selling more affordable medication to the patients.

OIG: HHS data silos impede efforts to improve nation’s health

November 18, 2019, 11:21 p.m. EST
How the Department of Health and Human Services manages, shares and secures its data is among the top management and performance challenges facing the agency.
That’s the assessment of the HHS Office of Inspector General, which contends that failure to modernize the agency’s data practices will severely limit its ability to improve the health and well-being of Americans.
“HHS operations depend on the effective collection and use of a large amount of sensitive and important data about individuals, healthcare providers, key public health assets, and other entities and actors, which are vital to improving the health and welfare of individuals in the nation,” states an OIG report released on Monday. “However, having large amounts of data does not mean that the data can be used efficiently and effectively.”

Mount Sinai awarded $2M to build supercomputer for medical research

November 18, 2019, 11:14 p.m. EST
The Department of Health and Human Services has awarded Mount Sinai Health System a $2 million grant to build a new “big omics” supercomputer to better understand complex diseases.
The system—a Lenovo ThinkSystem SR360 called Big Omics Data Engine 2—will replace a previous Mount Sinai supercomputer by the end of the year, providing the computing power necessary to offer insights into a wide range of diseases including Alzheimer’s disease, autism, influenza, prostate cancer, schizophrenia and substance use disorders.
“Supercomputers have become essential in biomedical scientific discovery, and Mount Sinai has been a leader on this front, making investments in computational and data science that are advancing our understanding of and ability to treat complex diseases,” says Dennis Charney, MD, dean of the Icahn School of Medicine and president for academic affairs at Mount Sinai Health System.

Clinical notes technology helps bring order to ER, clinic

Horrid handwriting, redundant EHR tasks and lengthy documentation plagued Falls Community Hospital and Clinic. Not anymore, thanks to new note templates and tools.
November 19, 2019 11:42 AM
There is an old joke about doctors having the worst handwriting in the world. And there is an old adage that there is a kernel of truth in all humor.
At Falls Community Hospital and Clinic in Marlin, Texas, it was much more than just a kernel of truth.
“We had totally illegible handwriting on the T-Sheets used in the emergency room, which made reading and deciphering a scanned document nearly impossible,” said the hospital’s CEO Jeffery Lyle. “This made it very difficult for the next provider seeing the patient, especially if the patient could not provide the information.”
Further, caregivers had to close the patient record to go back and forth between different sections of the medical record for needed information.

Security Budgets Level, Attacks Increasing – No Wonder Healthcare Cybersecurity Efforts Are Inadequate

November 19, 2019
While their leaders know the potential of a breach remains high, few hospitals are focused on methodically beefing up their cybersecurity as of yet, according to a new survey.
The survey, which was conducted by Black Book Market Research, connected with 2,876 security professionals from 733 provider organizations to discuss gaps, vulnerabilities and deficiencies they see in their cybersecurity plans.
This year, just 41% said they hadn’t formally identified specific security objectives and requirements in a strategic and tactical plan, a big improvement from 60% in 2018. In addition, 27% of hospitals reported that a Q3 2020 assessment of their cybersecurity efforts will show improvement.

Analytics, precision medicine key to value-based care, but health systems struggle with funding: KLAS survey

Nov 18, 2019 3:05pm
Limited funding and lack of reimbursement from payers are the top hurdles to patient engagement technologies, analytics and precision medicine, according to a survey of chief information officers.
Healthcare providers plan to ramp up investments in telemedicine, patient portals and data aggregation capabilities but continue to struggle with how to fund these investments, a survey report from KLAS Research and the Center for Connected Medicine (CCM) found.
The "Top of Mind for Top Health Systems 2019" survey from KLAS Research and CCM surveyed 70 healthcare executives, including CIOs and IT directors, from 65 health systems.
"Health systems are moving toward a risk-based world where they will have a bigger financial stake in better managing the health of their patients. Having access to complete patient data and analyzing it, keeping patients engaged in their health and delivering more effective treatments, are essential to managing risk,” Pamela Peele, Ph.D., chief analytics officer of UPMC Health Plan and UPMC Enterprises, said in a statement.

New York hospital IT professional accused of stealing co-workers' passwords, information

by Tina Reed 
Nov 15, 2019 2:00pm
A former health IT employee at a New York City-area hospital was charged in Manhattan federal court with compromising dozens of co-workers' email accounts and stealing their confidential information, the Department of Justice announced Friday
Richard Liriano, 33, of the Bronx is accused of installing a malicious software program known as a keylogger on dozens of computers and online accounts between 2017 and 2018, officials said. The program recorded and sent victim employees’ keystrokes to Liriano, officials said.
Liriano allegedly used the stolen credentials to repeatedly compromise password-protected online accounts such as social media and personal email accounts and is accused of pilfering through sensitive personal photographs and other documents such as tax records. 
"As information technology increasingly becomes an integral part of our workplaces, ensuring the integrity of those systems becomes even more critical," said U.S. Attorney Geoffrey Berman in a statement. "The arrest of Liriano should serve as an error message to any information technology professionals seeking to capitalize on their trusted access to information: As in this case, you will be caught and prosecuted.”

This 5G ambulance could be the future of emergency healthcare

Connected ambulance using VR technologies could allow doctors to diagnose patients remotely and speed up treatment.
By Daphne Leprince-Ringuet | November 18, 2019 -- 11:01 GMT (22:01 AEDT) | Topic: Digital Health and Wellness
Ever since 5G was announced, connected ambulances have been hyped as the application of superfast connectivity that will bring about the next revolution in healthcare.
Today, University Hospitals Birmingham (UHB) performed a live demonstration in which a clinician based at a workstation in a hospital assessed and diagnosed a patient in an ambulance located two miles away, over BT's 5G network, which was deployed to Birmingham last May.
The patient, of course, was made of foam and plastic; and neither BT nor UHB have announced a launch date for the project yet. Earlier this year, O2 also announced that it will provide connectivity for tests simulating smart ambulance responses to emergency calls in Bedford, albeit without providing exact timeline details. 

FHIR at core of Humana’s strategy for data sharing with providers

November 18, 2019, 1:50 a.m. EST
HL7’s Fast Healthcare Interoperability Resources standard is the linchpin of health insurer Humana’s efforts to support data sharing with provider organizations to improve care for its members.
Humana CEO and President Bruce Broussard told an earnings call earlier this month that interoperability is at the core of the payer’s corporate strategy, “which facilitates our relationship with our provider partners, while simplifying the experience of our members.”
As one of the nation’s largest health insurance companies, Humana is looking for ways to better leverage data as the healthcare industry moves from fee-for-service to value-based care.
FHIR is the standard that enables real-time exchange of data using the latest web standards, according to Patrick Murta, Humana’s solutions architecture fellow. By leveraging RESTful application programming interfaces, he contends that FHIR is starting to serve as the core functionality to support data access in healthcare and enabling health information exchange.

UK regulator to assess claims that UK health websites shared users’ sensitive data with third parties

An investigation by the Financial Times found popular sites disclosed personal information to third party companies.
November 18, 2019 11:28 AM
UK data protection regulator, the Information Commissioner’s Office (ICO), is assessing a  Financial Times (FT) investigation which claimed UK health websites share people’s sensitive data with third party companies.
The FT study, which used open-source tools to analyse 100 health websites, found 79% dropped cookies allowing third-parties to track individuals around the internet, without the consent legally required in the UK.
According to the report, sites such as WebMD, Healthline, Babycentre and Bupa, shared medical symptoms, menstrual and fertility information, diagnoses and drug names, with companies, including Google, Amazon, Facebook and Oracle.
Simon McDougall, the ICO’s executive director for technology policy and innovation, said the regulator “will be assessing the information provided by the FT before considering our next steps.”

Penn Medicine uses EHR notifications to boost cancer screening orders

The nudges in reprogrammed electronic health records prompt medical assistants to set up a screening order for doctors to sign once they see the patient.
November 18, 2019 10:24 AM
Although early cancer detection can lead to improved outcomes, cancer screening tests are often underused. But a research team at the University of Pennsylvania is using electronic health records to change that.
The Penn Medicine specializing in nudges reprogrammed EHRs to prompt medical assistants to set up a screening order for doctors to sign once they see the patient, which had a positive effect on an increase in screening orders.
However, the results of the study also indicated this type of nudge is a two-step process--first the doc, then the patient.
"There were two surprising findings in this study," Dr. Mitesh Patel, director of the Penn Medicine Nudge Unit and an assistant professor of Medicine, as well as the senior author of the study, told Healthcare IT News.

Can EHR prompts improve cancer screening rates?

By Abraham Kim, AuntMinnie.com staff writer

November 15, 2019 -- Programming the hospital electronic health record (EHR) system to notify clinicians if and when patients are due for breast or colorectal cancer screening exams increased the exam ordering rate, but not the screening completion rate, in a new study published online November 15 in JAMA Network Open.
The researchers, led by Dr. Esther Hsiang from the University of Pennsylvania School of Medicine, developed an automated prompt, or a "nudge," that requires medical assistants to accept or decline an order for breast or colorectal cancer screening when meeting with patients who fit eligibility requirements.
They implemented their EHR prompt at three hospitals within the Penn Medicine health network from September 2014 to August 2017 to support the preliminary screening process. Currently, primary care physicians need to perform manual checks of each patient's medical records to determine whether the patient is eligible for certain cancer screening exams.

In EMR Market Share Wars, Epic and Cerner Triumph Yet Again

By Mandy Roth  |   April 30, 2019

Epic experienced the greatest gains overall last year, largely influenced by M&A activity among provider organizations.

The market share battle among electronic medical record (EMR) providers saw a lot of activity in 2018, much of it stimulated by mergers and acquisitions (M&A) among health systems, as well as a deal finalized between Cerner and the U.S. Department of Veterans Affairs last spring.
Yet after the dust settled, the victors were fairly predictable, with Epic having a slight edge over Cerner in terms of overall market share—28% and 26%, respectively. Epic reigns supreme in the over 500-bed category with a 58% share of the market, compared to Cerner's 27%.
KLAS, the Salt Lake City-based research and insights firm, released its annual report today, U.S. Hospital EMR Market Share 2018, detailing the ups and downs of activity in this competitive market sector. The report is based on based on acute care EMR purchasing activity in the U.S. last year, characterizing 2018 as the "the busiest of the past three years."

Weekly News Recap

  • HHS OCR will review the HIPAA compliance of the “Project Nightingale” data-sharing agreement between Ascension and Google.
  • NextGen Healthcare announces plans to acquire patient portal vendor Medfusion for $43 million.
  • Ontario, Canada announces a Digital First for Health strategy that will give patients more online access.
  • Results of the Apple Heart Study find that 0.5% of 400,000 enrolled users received an irregular heartbeat notification, most of whom were found to have atrial fibrillation.
  • Premier launches Contigo Health, which will connect participating employers and health systems to optimize employee care using EHR-integrated clinical decision support.
  • Kaiser Permanente Chairman and CEO Bernard Tyson dies unexpectedly at 60.
  • University of Chicago asks to have its medical center to dismissed from a class action lawsuit that was brought by a patient who says its data-sharing agreement with Google violates his HIPAA rights.