Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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A reflection on the state of the art by a CNIO
Following on from being crowned CNIO of the Year at the Digital Health Awards 2019, Natasha Phillips discusses her health informatics career. The CNIO at University College London Hospitals NHS Foundation trust explores why nurses are digitally interested and why the CNIO community should be nurtured.
DHI Admin – 5 November, 2019
On 31 March 2019 UCLH took the bold step of a big bang whole system digital transformation. For nursing, we took the decision not to just digitise what we already did but to change our practice.
We decided to return to and embed, nursing theory in the design of our electronic patient record, a move away from task orientated care and back to holistic nursing care. We also recognised the opportunity not to simply see our EHR as a tool for documenting care but as an intervention building in decision support underpinned by evidence-based practice.
We adopted a recognised evidence based standardised nursing terminology that would enable us to be frontrunners in generating evidence about nursing practice using the rich patient level data our EHR would contain.
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Real benefits of shared records explored at Digital Health Networks event
The benefits of sharing medical records was the theme of a Digital Health Networks event held in Maidenhead today (5 November).
Hanna Crouch – 5 November, 2019
Organised by Thames Valley and Surrey Care Records and Digital Health Networks, the event sought to explore how the real benefits from sharing data could be harvested.
The slogan for the day was “Accelerate, Enable and Disrupt to Innovate”.
Thames Valley and Surrey was one of the five first-wave Local Health and Care Record Exemplar sites announced in 2018, with Graphnet later selected to provide a new region-wide shared record platform and population health system.
Fiona Edwards, CEO at Surrey and Borders Partnership NHS Foundation Trust and lead for the Frimley Integrated Care System (ICS), kicked off the day setting out the “data story” in the Thames Valley.
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Focus on ED Utilization Misses Whole-Person Perspective
Data sharing between medical, behavioral, and social care data systems needed
WEDNESDAY, Nov. 6, 2019 (HealthDay News) -- There is a need for shared patient-level data across medical, behavioral, and social care systems to meet the medical needs of frequent emergency department users, according to a study published in the November issue of Health Affairs.
Hemal K. Kanzaria, M.D., from the University of California in San Francisco, and colleagues linked administrative data (fiscal years 2013 to 2015) for beneficiaries of the county's Medicaid managed care plan to county-level integrated data to compare medical, mental health, substance use, and social services use among nonelderly nonfrequent, frequent, and superfrequent emergency department users in San Francisco County.
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FCC panel lays out barriers to implementing telehealth nationwide
November 08, 2019, 1:12 a.m. EST
The successful implementation of telehealth nationally is dependent on broadband availability and access, as well as on updating laws, regulations and other restrictions impeding its adoption.
That’s the conclusion of the Federal Communications Commission’s Intergovernmental Advisory Committee, which issued a report on Thursday meant to help state, local, tribal and territorial officials to better promote the use of telemedicine.
The report finds that the “lack of access to adequate broadband presents a significant barrier to telehealth” while noting that “fundamentally all of the digital divide concerns and challenges that face urban and rural America, the U.S. territories and the tribal nations are applicable to telehealth.”
Specifically, the FCC panel identified two primary elements of broadband deployment that affect telehealth—an overall shortfall in rural areas of access to adequate broadband limits the ability to deploy telehealth, and a shortfall in implementing proper redundancies for broadband infrastructure to ensure around-the-clock connectivity to healthcare affects those areas where broadband access exists.
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HIT Think
Why interoperability matters to the current and future state of healthcare
November 08, 2019, 3:35 p.m. EST
In the modern world of healthcare, it’s critical for technology to be interoperable. Different EHR systems must have the ability to exchange information between providers. Offering better workflows, improved clarity, and better patient care, true interoperability between systems, however, remains elusive.
Fundamentally, interoperability delivers the opportunity for better care coordination and lower healthcare costs. The reality is that there are many different EHR systems, and when sharing patient data is vital to providing care, the inability of these systems to talk to one another results in hurdles and challenges.
Because of this, the Department of Health and Human Services (HHS) has identified interoperability as one of the most essential requirements to meet for verification in Meaningful Use Stage 2. HHS wants to ensure that patient information is accessible no matter where the patient is being treated.
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Opinion: Brexit and its impact on healthcare - What is happening now?
Dr Layla McCay, director of international relations at the NHS Confederation, warns that Brexit “should not hinder” the collaboration between the UK and other European countries in the field of health research.
November 08, 2019 07:13 AM
After several decades of EU membership, UK and EU co-operation in many mutually beneficial areas is strong, underpinned by European legislation and infrastructure such as shared regulatory standards, databases and networks. We therefore need to keep a watchful eye on the unfolding Brexit process, which aims to move us further apart from alignment with the EU, in order to understand its impact and find ways to continue to achieve our shared priorities. A key question from a health perspective is how we can maintain the common benefits of continued collaboration in pan-European medical research.
We have a strong partnership, particularly in health research
There is a strong partnership between the UK and Europe in ensuring access to affordable and high-quality healthcare and protection against epidemics and diseases. The fact that our societies are becoming older and need more complex and expensive treatments, highlights further the need to collaborate to find new ways of delivering on our priorities by investing in technology and cooperating more effectively with international partners. This is particularly true in health research, which is increasingly international and intrinsically collaborative as scientific breakthroughs are rarely developed in isolation. Patients across the EU, including the UK, have benefited from pan-European collaboration on medical research that investigates, develops and tests new treatments on a scale only achieved on an EU-wide basis.
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Few patients access EHR data despite widespread availability, says report
"Policy efforts have failed to engage a large proportion of patients in the electronic use of their data or to bridge the 'digital divide' that accompanies health care disparities," according to Health Affairs.
By Nathan Eddy
November 08, 2019 10:43 AM
Few patients access EHR data despite widespread availability, says report
"Policy efforts have failed to engage a large proportion of patients in the electronic use of their data or to bridge the 'digital divide' that accompanies health care disparities," according to Health Affairs.
A nationwide study of more than 2,400 hospitals indicates patients are not accessing the information provided through electronic health records, despite efforts to improve patients' ability to access and use EHRs.
WHY IT MATTERS
Although 95 percent of the hospitals provided outgoing patients with access to view, download, and transmit their EHRs, fewer than one in 10 actually took advantage of the possibility.
Although 95 percent of the hospitals provided outgoing patients with access to view, download, and transmit their EHRs, fewer than one in 10 actually took advantage of the possibility.
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Quality of initial training makes a big difference in EHR satisfaction, KLAS report finds
The research shows significant variability in EHR satisfaction among specialties, but high-quality training can help.
The analysis finds that strong initial training as well as ongoing follow-up are the most important factors in providers' overall EHR experience. This holds true even for specialties that generally report lower satisfaction with their organization's EHR system. Within those low-scoring areas, there is significant variation depending on training quality.
It works in the other direction, too. While pediatrics physicians have a high overall average Net EHR Experience Score of 24.0 on the KLAS ranking, poorly trained pediatricians have a score of -21.6.
WHY THIS MATTERS
The KLAS report, "Achieving EHR Satisfaction in Any Specialty," is based on survey data collected from 30,000 physicians nationwide. It finds the highest EHR satisfaction among hospital medicine, pathology, and pediatrics specialties, and the lowest overall satisfaction in the areas of orthopedics, cardiology, and plastic surgery.
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Tech Optimization: Getting the most out of AI
Six healthcare artificial intelligence experts offer best practice suggestions for CIOs and other health IT leaders seeking to fine-tune their AI systems.
By Bill Siwicki
November 08, 2019 12:21 PM
Artificial intelligence is a highly complex technology that, once implemented, requires ongoing oversight to make sure it is doing what is expected of it and ensure it is operating at optimal levels.
Healthcare provider organizations using AI technologies also need to make sure they’re getting the biggest bang for their buck. In other words, they need to optimize the AI so that the technologies are meeting the specific needs of their organizations.
We spoke with six artificial intelligence experts, each with extensive experience in healthcare deployments, who offered comprehensive advice on how CIOs and other health IT workers can optimize their AI systems and approaches to best work for their provider organizations.
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Big Tech: Google To Create Self-Aware Rooms Which Track Patients And Update Providers
November 8, 2019
Over the last couple of years, Google has offered intriguing glimpses at what it plans to do in the healthcare space, but has made few concrete product announcements.
The big G has apparently ruled out building its own EHR, at least according to Toby Cosgrove, MD, an executive advisor to Google and former president and CEO of the Cleveland Clinic. To my knowledge, though, virtually every other potential health IT option is still on the table.
That includes partnering with Fitbit on wearables data options (and then acquiring Fitbit), working with a Stanford University researcher to pilot-test “digital scribe” technology and moving ahead with healthcare projects based on its DeepMind AI platform. and a great deal more.
Despite this flurry of activity, however, it’s never been clear to me what Google’s larger strategies are in healthcare. While I know this is unlikely to be the case, on the surface Google’s entire healthcare effort comes across (to me at least) as a giant R&D effort with open-ended goals. Don’t get me wrong, even if Google has been in a comparatively loose experimental mode when it comes to healthcare technology, there’s always a method to its madness. It’s just that it hasn’t been making big, high-profile incursions into standard niches in the health IT arena.
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U.S. Consumer Adoption of Apps To Manage Chronic Conditions, Health and Fitness Activities
November 8, 2019
A solid minority of American consumers are adopting mobile health apps to manage chronic conditions or maintain their health and fitness, according to a new survey conducted by Redox.
The survey, which reached out to 1019 American adults, found that almost one-third of respondents either use or are open to using apps for these purposes.
One result from the survey was that Gen Xers were 37% more likely than baby boomers and 4% more likely than millennials to manage medical conditions with mobile apps. Gen Xers were 48% more likely than baby boomers, 15% more likely than Gen Z and 7% more likely than millennials to use mobile apps to manage health and fitness routines.
Among those who weren’t using or open to using health apps, worries over privacy and security were the top concerns cited by respondents. Baby boomers were particularly concerned about privacy and security risks, citing these worries 54% more often than millennials and 23% more often than Gen X.
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6 Nov 2019 News
Drone Wars: Experts Warn of Flying Network Security Threat
Phil Muncaster UK / EMEA News Reporter , Infosecurity Magazine
Drones could become a major network security threat from 2020, forcing organization to guard the airspace around their buildings, security researchers have warned.
Small unmanned aerial vehicles (UAVs) will increasingly evolve from novelty items to “ubiquitous business tools” over the coming years, explained defense contractor Booz Allen Hamilton in a new 2020 Cyber Threat Trends Outlook report.
However, as they do, cyber-criminals may also look to take advantage by flying them close to target networks and/or landing them in concealed locations such as on roofs. In this way, a UAV could be fitted with a Wi-Fi Pineapple and used as a rogue access point to harvest credentials, perform man-in-the-middle attacks against employees and carry out network reconnaissance, the report warned.
IoT devices such as smart light bulbs, or even wireless mice could also be targeted.
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KeyHIE Adds FHIR-Based Imaging App to Health Information Exchange
KeyHIE has implemented Life Image’s Viewer, the first FHIR-based imaging app, into its health information exchange.
November 07, 2019 - The Keystone Health Information Exchange (KeyHIE) has unveiled an imaging app that allows physicians to distribute medical images and associated reports to enable better care coordination, provide important clinical context for diagnostic interpretations, and improve outcomes.
The partnership with imaging tool Life Image aims to improve provider workflows.
“The integration of our Viewer app into the HIE brings a whole new level of seamless collaboration that harnesses the power of Life Image workflows and makes them available instantaneously in the portals and tools that our customers already use,” said Matthew A. Michela, President and CEO of Life Image.
The tool is the first of its kind and it was developed by Life Image using the SMART on Fast Interoperability Healthcare Resources (FHIR) application programming interface (API), which addresses the complexity of healthcare data for continuous on-demand exchange of health information.
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November 7, 2019 / 8:54 AM / a day ago
Most patients with access to electronic medical records not using it
(Reuters Health) - Only about one in 10 discharged hospital patients given access to their electronic medical records go online to take a look, a U.S. study suggests.
Widespread efforts to adopt electronic health records at hospitals have been underway for years, in part to improve the quality of care and help patients become more engaged, informed healthcare consumers. But it’s not clear how engaged patients really are with electronic records.
For the current study, researchers examined data collected from 2,410 hospitals nationwide between 2014 and 2016. Overall, hospitals gave 95% of discharged patients access to view, download and transmit their electronic health information, the analysis found.
But only about 10% of patients with access to their electronic medical records actually accessed their data.
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Spiking health woes in millennials may make them poorer
November 07, 2019, 3:50 p.m. EST
More millennials in the U.S. are suffering from chronic health problems, potentially restraining the lifetime economic potential of a generation of young adults.
A spike in conditions like depression, hypertension and high cholesterol among younger people could increase health-care costs and lower incomes in coming years, according to a report Wednesday from the Blue Cross Blue Shield Association, a federation of 36 independent companies that together provide coverage for one of every three Americans.
Between 2014 and 2017, rates of depression among millennials surged by 31 percent, while hyperactivity rose 29 percent and hypertension increased 16 percent, according to the report. High cholesterol and tobacco-use disorder also increased.
Without change, the effects of those trends could be game-changing for the U.S. and its economy, the report warned. Healthcare costs in the U.S. are already high and climbing, on track to make up nearly 20 percent of gross domestic product in coming years.
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HIMSS annual survey finds renewed focus on patient empowerment, EMRs and health information exchange
An interview with Jörg Studzinski, director of research and advisory services at HIMSS Analytics.
November 07, 2019 07:02 AM
An interview with Jörg Studzinski, director of research and advisory services at HIMSS Analytics.
When looking at digitising healthcare, the challenges that European countries are grappling with are vast. While the lack of political direction is one of the main concerns for eHealth professionals in Italy, the UK, Germany and the Netherlands are struggling to hire and retain the right specialists.
This is according to the findings of a new study published by HIMSS today, which looks to shed light on the priorities and challenges faced by European countries.
Earlier this week, Healthcare IT News caught up with Jörg Studzinski, director of research and advisory services at HIMSS, to talk about some of the trends uncovered, and what Europe needs to prioritise in order to digitise faster.
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Estonia, the Netherlands & Nordics continue to drive eHealth adoption and use in Europe, study finds
A new report from HIMSS sheds light on the current state of eHealth in Europe.
November 07, 2019 06:40 AM
The world has long looked at the Nordics as an example for driving much of the innovation that is happening nowadays, and the situation is no different in digital health, according to a new study from HIMSS, in cooperation with McKinsey, published today.
Supported by international management consulting firm McKinsey & Company, it reveals that the Netherlands and the Nordics continue to be seen as “role models” for the adoption and use of eHealth in Europe, based on the responses of over 500 professionals in the field.
But Estonia has swapped places with Denmark and is now perceived to be the leading eHealth country in Europe, following the launch of an initiative that allows EU citizens to retrieve medication prescribed electronically by doctors in Finland in Estonian pharmacies through the new eHealth Digital Service Infrastructure.
TOPLINE DATA
Despite progress being made, findings indicate that eHealth professionals in Europe continue to grapple with many of the challenges seen in other regions around the globe, from the lack of funding or political direction to poor interoperability.
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A costly failure to encrypt for University of Rochester Medical Center
The health system will pay $3 million to settle with OCR and take corrective action after protected health information was left unencrypted on lost and stolen mobile devices.
By Mike Miliard
November 07, 2019 11:06 AM
A HIPAA violation is costing University of Rochester Medical Center, one of the biggest health systems in New York, $3 million as it settles with the U.S. Department of Health and Human Services for not encrypting its data.
WHY IT MATTERS
The flash drive was lost. The laptop was stolen. Both contained protected health information that was unencrypted, according to the HHS Office for Civil Rights, which in addition to the monetary settlement is requiring URMC to undertake a corrective action plan that includes two years of monitoring its HIPAA compliance.
The flash drive was lost. The laptop was stolen. Both contained protected health information that was unencrypted, according to the HHS Office for Civil Rights, which in addition to the monetary settlement is requiring URMC to undertake a corrective action plan that includes two years of monitoring its HIPAA compliance.
URMC notified OCR of the two breaches in 2013 and 2017 – after finding out about the loss of an unencrypted flash drive and theft of an unencrypted laptop, respectively.
Upon performing its audit, OCR found that URMC hadn't conducted an enterprise-wide risk analysis. Nor had it implemented security measures robust enough to reduce risks and vulnerabilities "to a reasonable and appropriate level," according to the agency.
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Know When to Hold ’em: The Legal Considerations for Healthcare Information Technology Data Retention and Purging
November 7, 2019
The following is a guest blog post by Justin Campbell, Vice President, Strategy, at Galen Healthcare Solutions.
Purging Guidelines & Criteria
HIPAA privacy rules do not address medical record retention requirements, and the guidelines from several states and the federal government are ambiguous at best. Healthcare organizations considering a purge of their archived data soon realize that errors made determining what should be retained and what can be purged may leave them with considerable legal risk. The variation in retention mandates has driven many organizations to individualize their purging policies, with some preferring to keep every patient record in perpetuity, and others following a purging strategy based on defined criteria. Those purging guidelines typically include date of last service, date of discharge, date of birth, and document or data type. But not always. Some may include RAC audit, clinical research or legal hold. In short, it’s not very clear.
Guidance from AHIMA on Retention and Destruction of Health Information
A provider or organization that destroys patient health information must do so and be carried out in accordance with federal and state law pursuant to a proper written retention schedule and destruction policy approved by appropriate organizational parties.
As with record retention, there is no single standard destruction requirement. Some states require organizations to create an abstract of the destroyed patient information, notify patients when destroying patient information, or specify the method of destruction used to render the information unreadable. Organizations should reassess the method of destruction annually based on current technology, accepted practices, and availability of timely and cost-effective destruction services.
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Report Cites Urgent Need to Secure Connected Medical Devices
November 07, 2019 02:09 pm News Staff – Last spring, the Washington, D.C.-based eHealth Initiative(www.ehidc.org) hosted a group of health care executives to discuss challenges and potential solutions for securing connected medical devices. The independent nonprofit organization -- of which the AAFP is a member -- is dedicated to transforming health care through the use of technology and innovation.
Fast forward to October -- National Cybersecurity Awareness Month --and the release of a new report that presents key takeaways from that meeting.
The report, Securing Connected Medical Devices, was released jointly by the eHealth Initiative Foundation and Booz Allen Hamilton,(wwwBoozAllen.com) a consulting and analytics firm, and is available for download.(www.ehidc.org)
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7 predictions from health IT execs about what lies ahead in 2020
Nov 6, 2019 10:48am
PHOENIX— As chief health information officers from around the country gathered in Phoenix this week, the conversations centered on everything from early clinical successes using artificial intelligence to evolving cybersecurity threats and what's ahead for virtual and precision medicine.
It was all part of the College of Healthcare Information Management Executives (CHIME) Fall CIO Forum this week, which focused on the future of healthcare and innovation.
So we asked CHIME19 attendees to take out their crystal balls to predict what's ahead for healthcare and health IT in 2020. Here are seven predictions for trends that could impact your business in the next year.
Consumerism: "There is going to be more focus on consumerism and how to meet patients where they are outside the four walls of the hospital. And there will be a focus on meeting the technology demands to accomplish that. Amazon set the standard for consumer expectations, and that’s a new challenge for what IT has to deliver."
— Jennifer Stemmler, account IT executive, innovation and strategy at Adventist Health
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— Jennifer Stemmler, account IT executive, innovation and strategy at Adventist Health
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Apple expands health records app to millions of U.S. veterans
Nov 6, 2019 3:27pm
The U.S. Department of Veterans Affairs (VA) and Apple announced Wednesday that millions of U.S. veterans will now be able to access their medical records on their iPhones through the tech giant's health records feature.
The VA has been collaborating with Apple for months to roll out the new health record app after first announcing the initiative back in February. The app makes it easier for veterans to access their medical data across multiple providers by combining their VA health data alongside their health records from community providers, Apple and VA officials said.
The VA is the largest medical system in the U.S., providing service to more than 9 million veterans across 1,243 facilities, including hospitals and clinics.
The VA joins Johns Hopkins, University of California San Diego, Quest Diagnostics, Allscripts and 400 other health care provider organizations, laboratory networks, and electronic health records (EHRs) vendors who support the health records on iPhone feature, Apple executive said in a blog post.
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Early AI adopters beginning to see success predicting readmissions, ED visits
Nov 5, 2019 3:56pm
PHOENIX—Early adopters of artificial intelligence solutions are beginning to see success in clinical areas such as predicting readmissions and avoidable emergency department visits, according to a joint report from KLAS Research and the College of Healthcare Information Management Executives (CHIME).
KLAS and CHIME polled early adopter healthcare organizations using AI software, specifically machine learning and natural language processing, to evaluate the gains they’ve achieved in clinical, financial and operational areas.
"The most exciting insight from our research is that artificial intelligence (machine learning and natural language processing) has truly begun to make a difference in healthcare. It’s not all just smoke," Ryan Pretnik, director of research and strategy at KLAS and co-author of the study, said via email. "Artificial intelligence is driving outcomes, saving patient lives, and driving operational and financial efficiencies for providers and payers."
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More good news from DirectTrust as secure messaging soars
The number of healthcare organizations served by DirectTrust health information service providers and engaged in Direct exchange was up nearly 75% in Q3. New members include Konica Minolta and the Social Security Administration.
By Mike Miliard
November 05, 2019 01:52 PM
The cost-efficiency and ease of use of Direct message protocols seem to be catching on across healthcare, as the number of organizations using it continues to increase. There were more than 197 million Direct Exchange transactions during the third quarter of 2019 – three times as many as during the same quarter last year.
WHY IT MATTERS
That's according to the latest report from DirectTrust, the non-profit collaborative of more than 120 vendor, provider and government organizations seeking to advance the secure messaging protocol as a key driver of interoperability.
That's according to the latest report from DirectTrust, the non-profit collaborative of more than 120 vendor, provider and government organizations seeking to advance the secure messaging protocol as a key driver of interoperability.
DirectTrust is also seeing continuing and sustained growth in the number of DirectTrust network users, addresses, and transactions, it said, as more provider organizations see it as an easy to deploy means of exchanging protected health information among providers, and between providers and patients.
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HIEs boost efforts to form nationwide network for sharing patient data
November 05, 2019, 11:00 p.m. EST
As the healthcare industry seeks to achieve seamless nationwide interoperability, the Strategic Health Information Exchange Collaborative—representing HIEs across the country—sees itself as a critical component of the enabling infrastructure.
SHIEC, which is the largest U.S. consortium of its kind, represents almost 80 HIEs that combined cover more than 92 percent of the nation’s population.
“We have a lot that we do as an HIE community—we are already connected,” says Kelly Thompson, SHIEC’s CEO. “I feel so much responsibility as a leader in this space to work with my colleagues to try to get us to that next level and to make those connections, so we can get to that other 8 percent (of the population).”
According to SHIEC, its members support all four pillars of interoperability including data acquisition and access that facilitate information exchange, as well as delivering the episode-based alerts and meaningful data processes that make it usable in clinical settings.
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Healthcare transformation: 'We need to shift our mindset'
Digital leaders from Singapore, the Netherlands, Finland and more met in Berlin this week to talk about the transformation of their health systems.
November 06, 2019 02:26 AM
Change on many levels urgently required: This was the message brought forward at the Health 2019 conference of HIMSS and Handelsblatt in Berlin. Innovation-prone digital leaders from all over the world showed that healthcare transformation is doable and success measurable.
“Healthcare is moving beyond disease towards preserving health, it is moving beyond hospitals towards community-based care, and beyond quality towards value”, said Dr Eugene Fidelis Soh, CEO of Tan Tock Seng Hospital in Singapore. “Today we are still thinking very hospital-centric. We need to shift our mindset from patients to populations and define hospitals not by numbers of beds but by population served.”
The Singapore healthcare system was trying to move along this trajectory, according to Soh. Hospitals in Singapore have been supplemented by 80 community health posts that are digitally connected to the hospitals. Nurses in these community health posts look after patients post discharge, so that in-house treatment can be minimised. The barriers between ambulatory and hospital sector care are vanishing, and inside of the hospital, various AI tools and digitalised standard operating procedures allow for a much more coordinated patient management than before.
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With brand realignment, HIMSS positions for new era of disruptive innovation
A new website with a new look is only part of the larger transformation, as the information and technology leader aims to help a growing healthcare ecosystem build better health worldwide.
By Mike Miliard
November 06, 2019 02:51 PM
You might have noticed that the HIMSS website looks a bit different today. It's the latest new innovation from a global organization that has been innovating for more than half a century.
We checked in with Terri Sanders, senior vice president of enterprise marketing and communications at HIMSS (which is the parent company of Healthcare IT News) about how the new site is emblematic of something bigger: a new organizational vision, mission and strategy for helping its members improve health and healthcare worldwide.
Q. Why is now the right time for HIMSS to update its brand? Is healthcare at a pivotal moment? Is HIMSS?
A. We are all in the midst of one of the most exciting and transformative periods in healthcare. The health ecosystem is undergoing unprecedented change, fueled by disruptive innovation and a renewed focus on patient-centered care. Healthcare has always been dynamic, but today, the pace of change, is virtually continuous.
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Telehealth helps Mayo Clinic neonatologists better treat newborns in emergencies
The new technology connects on the first attempt 96% of the time, compared with 73% for the previous telemedicine carts; with enhanced monitoring and support, tele-neonatology availability is 99%.
By Bill Siwicki
November 06, 2019 12:29 PM
The Mayo Clinic in Rochester, Minnesota, implemented tele-neonatology six years ago. Prior to that, Mayo Clinic neonatologists were assisting community hospital care teams via telephone when a newborn required advanced resuscitation or critical care.
THE PROBLEM
“Because we were unable to visually assess the newborn, this limited our ability to closely collaborate with the local team and guide care over the phone,” said Dr. Jennifer Fang, medical director, tele-neonatology, at Mayo Clinic. “This was especially relevant when our neonatal transport team was not present for a high-risk delivery due to weather or geography, and the local team had to resuscitate and stabilize the critically ill newborn independently.”
These challenges prompted Mayo Clinic to develop a tele-neonatology program that allows neonatologists to establish a real-time audio/video telemedicine connection with care teams in community hospitals during these high-risk, low-frequency neonatal emergencies.
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Consumers Interested In Using Voice Assistants for Healthcare, But Privacy Worries Remain
November 6, 2019
It’s becoming more common for consumers to use voice assistants for healthcare, but others are holding back due to privacy worries, according to the results of a new survey. The survey, which connected with 1,004 U.S. adults, was backed by AI vendor Orbita and conducted by Voicebot.ai. It focused on consumer adoption of voice assistants for healthcare functions.
One of the key results from the survey was that 7.5% of consumers had used voice assistants such as Alexa or Google Assistant as of September 2019. Also, nearly 52% reported that they wanted to use voice assistants when obtaining care in the future.
At present, the report notes, more consumers have tried out voice assistants via smartphone than in any other context, with 87.3 million being monthly active users. The top voice assistant used on smartphones was Apple Siri, cited by 46.2%, followed by Google Assistant (27.7%), Amazon Alexa (16.6%), Samsung Bixby (6.9%) and Microsoft Cortana (3.9%).
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How a CIO gained new insights as a patient
When the chief information officer of Mayo Clinic became a cancer patient, he got an up-close look at how technology can frustrate physicians. He described some of them at the HLTH conference, which concluded last week in Las Vegas.
By Josh Baxt
Nov 4, 2019 at 6:08 PM
Cris Ross is the chief information officer at Mayo Clinic, responsible for all information technology. By necessity, he is steeped in IT, but it wasn’t until he became a patient that he fully understood how his work affects providers and patients.
At HLTH’s Frontlines of Healthcare session, part of the Engage track created by MedCity News, Ross and MedCity News editor-in-chief Arundhati Parmar chatted last week about the lessons he learned from his experience as a cancer patient. Ross was diagnosed with stage 3 colorectal cancer and went through the customary trifecta: chemo, radiation and surgery.
“I had a routine exam and found out I had an advanced cancer,” Ross recalled. “I’m a CIO, so I’m used to bad news every day…The thing that came home for me the most was when I had a port placed for chemotherapy, and I realized: This is me and not somebody else.”
As Ross proceeded through his layers of treatment, he felt it was important to learn from his cancer, and he didn’t have to go far. Mayo had recently rolled out a new electronic health record and clinicians were still acclimating to the system. EHRs are complex, sometimes overwhelming, and they don’t always make it easier for providers. However, Ross was not prepared to see his clinicians stumbling so badly over his new system. It made him cringe.
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Malpractice Case: You're Liable, Even if Your EHR Malfunctions
Notwithstanding the usual suspects that hinder electronic health record (EHR) implementation—initial costs, interoperability problems, training burdens, and altered physician-patient dynamics—there's also the risk of a pure system malfunction. In a malpractice suit after an admitted malfunction, a physician's actions will still be scrutinized.
Dr. PC had been the primary care physician to her 80-year-old patient for more than a decade, and in the years leading up to the event, assessed her with hypotension, hypothyroidism, adrenal insufficiency, kidney disease causing anemia, Addison's disease, bipolar affective disorder, and GERD. The patient was on a regimen of 14 different medications to manage her complicated medical conditions.
Some 7 weeks following the patient's last visit, electronic records showed prescriptions ordered for her by Dr. PC. Those separate electronic prescriptions showed a lower than usual prescription for the patient's thyroid medication and a new prescription for glipizide. Both electronic prescriptions correctly listed the patient's lengthy "other meds."
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Google wants to create the ultimate medical record search tool for doctors
by Ravie Lakshmanan — 4 November, 2019
Google wants search to be the center of everything you do. Now, in a logical next step to make its search products the access point for all content on the web, the internet goliath is turning its focus to healthcare.
David Feinberg, the recently appointed head of its Google Health initiative, outlined plans to make it easier for doctors to search medical records, and improve the quality of health-focused search results across Google and YouTube.
“Imagine a search bar on top of your EHR (electronic health record) that needs no training,” Feinberg said at the HLTH health care conference in Las Vegas last week.
According to Feinberg, the search bar will supposedly allow doctors to type into it, with the system automatically displaying appropriate responses to the queries. For example, a doctor could just type the number “87” to return details about an 87-year-old patient with a history of stomach cancer.
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How the Worst Cyberattack in History Hit American Hospitals
NotPetya caused $10 billion in damage. But it may have also taken a toll on patients’ health across the U.S.
Nov 05, 20195:40 AM
Excerpt adapted from Sandworm: A New Era of Cyberwar and the Hunt for the Kremlin’s Most Dangerous Hackers by Andy Greenberg, out now from Doubleday. On Nov. 6, Greenberg will discuss Sandworm at a lunchtime event in D.C. For more information and to RSVP, visit the New America website.
The malware known as NotPetya hit Ukraine on June 27, 2017, and quickly became the most devastating cyberattack in history. The virally spreading code, created by a group of Russian military intelligence hackers known as Sandworm, was intended as a climactic strike against Ukraine in the years-long cyberwar Russia had carried out against its southwestern neighbor. But within hours, the malware spread beyond Ukraine’s borders to networks around the world, hopping in seconds from computer to computer using a combination of a stolen National Security Agency hacking technique, an open-source password-grabbing tool, and the hijacked updates of a common piece of Ukrainian accounting software used by practically every company that filed taxes or had business ties in the country. NotPetya ravaged every machine it touched, saturating networks and permanently encrypting PCs and servers, destroying their data. Among its victims: Maersk, the world’s largest shipping firm, lost $300 million. FedEx lost $400 million. Drugmaker Merck would eventually tally its losses at $870 million. In total, NotPetya would be responsible for $10 billion in damage, more than any other cyberattack before or since.
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As cyber risks grow, provider preventive measures still falling short
November 04, 2019, 11:49 p.m. EST
Hospitals are ramping up spending on cybersecurity, but physician practices have scaled back their investments on protecting data.
Despite all these protection efforts, healthcare data breaches likely will cost the industry as much as $4 billion by the end of this year, and 2020 is likely to be even worse, contends an industry research firm.
Black Book Market Research released an annual report on data security Monday, identifying provider organizations as the most likely target for breaches in the industry—thus far in 2019, providers have suffered nearly four out of five breaches. By contrast, health insurers and plans were targeted less often. Insurers have stepped up data protection efforts by implementing more sophisticated information security solutions.
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Database enhances sharing of complex functional genomic data
November 05, 2019, 10:36 p.m. EST
For the first time, researchers are able to easily share datasets that reveal the function of genomic variants in health and disease—thanks to the launch of a new, open-source database.
Developed by American, Australian and Canadian researchers, the database is the first publicly accessible repository for multiplex assays of variant effect (MAVE) data, used to interpret the results of experiments that systematically measure the impact of thousands of individual sequence variants on a gene’s function.
Previously, MAVE data from experiments has existed in silos. However, MaveDB, which is supported and developed by the University of Washington, the Walter and Eliza Hall Institute of Medical Research and the Brotman Baty Institute, is meant to enhance researchers’ ability to access and interpret complex functional genomic data and yield discoveries into their roles in disease.
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HHS offers free data security risk assessment tool
November 05, 2019, 3:36 p.m. EST
The Office of the National Coordinator for Health Information Technology is offering its security risk assessment tool free to all industry stakeholders.
“Conducting a security risk assessment is one way to identify and assess risks to electronic protected health information within your organization, check if your organization has appropriate safeguards in place, and reveal any areas where ePHI may be at risk,” says Kathyrn Marchesini, chief privacy officer at ONC, and Ali Massihi, information technology specialist at the Department of Health and Human Services.
Further, assessing security risks can help reduce the chance of being impacted by a variety of cyberattacks and online scams, they add.
The assessment also aids documentation of the risk identification and analysis process such as vulnerability scans and site walk-throughs.
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Opinion: IoT - A world of hurt for healthcare, maybe
How concerned should clinicians and IT leaders be with the current state of IoT? Dr Abed, medical doctor and healthcare cybersecurity expert, explains.
November 05, 2019 03:24 AM
Not a day seems to go by when IoT doesn’t hit the security headlines as a terrible source of vulnerabilities waiting to be targeted and exploited. In fact, only recently did the FDA issue advisory warnings about a whole suite of vulnerabilities in IoT devices that could affect everything from neonatal incubators through to anaesthesia machines. These were dubbed “The Urgent 11”, which for some reason seems like it should be the title of a Quentin Tarantino movie, but I digress.
The fact of the matter is the state of IoT is acknowledged as being woeful from a security perspective. As attackers start to focus even more on healthcare, the vulnerabilities to exploit this will be bountiful. Here’s the problem though. All this fear isn’t necessarily reflecting the actual risks that clinicians, IT leaders and hospital management need to be concerned with. Just because a vulnerability exists doesn’t mean a medical device will become a prime target.
In my experience, attackers, whether for financial or purely disruptive purposes, are not interested in harming patients in precise targeted attacks. Yes, a vulnerable pacemaker could be used to harm an individual, but this is very specific blackmail or, some would say, an assassination attempt, and I think that should stay in the realm of the movies for the most part.
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Testing: An Undervalued Aspect of a Successful EHR Implementation
November 5, 2019
The following is a guest article by Matt Hawkins, EVP Sales and Marketing at Boston Software Systems.
A large regional health system implemented a “Top 5” EHR solution for their Gynecologic Oncology department. However, three years after implementation, staff were still using paper charts while the EHR sat virtually untouched. Why? The new system was missing several key components including: specialty specific templates, medications, chemotherapy infusions, and billing codes. How were such critical features missed? A lack of user testing.
Testing is an often overlooked and underappreciated aspect of any systems implementation. Because it is often the final step before a Go-Live, it is often rushed in an effort to bring the project over the finish line. When planned and executed properly, testing can add tremendous value to a project AND can de-risk your technology investments. Had this Gynecologic Oncology department adopted a solid testing plan, they would have uncovered the missing features early, not three years into the project plan.
So what are the keys to a successful testing phase? Here are four.
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Algorithmic Bias In Health Care: A Path Forward
Our recent paper in Science showed that an algorithm widely used for population health management has significant racial bias. The scale of impact is large, affecting health care decisions for at least tens of millions of patients every year. The magnitude of bias is also large: removing bias from the algorithm would more than double the number of Black patients eligible for a program that gives extra medical help to the neediest patients.
Media coverage of our findings (in the Wall Street Journal, Washington Post, LA Times, Wired, and other outlets) has focused on the scale and impact of bias we uncovered. This doesn’t apply to just one algorithm or one manufacturer, but the general approach to predicting risk used by nearly all health systems and insurance companies.
A New Initiative to Address Bias in Health Care Algorithms
What’s next for the health care system? We need algorithms to help with the critical work of population health management: scaled decisions for millions of patients are not a suitable task for human doctors or policy makers alone. But how do we ensure that these algorithms are doing their job fairly?
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How CVS is using digital tools to boost specialty pharmacy adherence
Nov 4, 2019 3:45pm
As specialty pharmacy becomes an increasing focus for cost management, CVS has deployed a number of digital tools aimed at improving adherence and patient outcomes.
The results of its first pilot of remote monitoring for patients with chronic myeloid leukemia (CML) were released late last week. And so far, researchers say, they've found participants in the two-way secure texting program were 22% more likely to be optimally adherent to their medications.
CML patients must maintain 90% or better adherence to their medication regimens in the first year after diagnosis to significantly boost their chances at readmission. In the program, patients were offered education and coaching on their medication through secure messaging.
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Sequoia Project Deal Supports Emergency Health Data Exchange
A collaboration between The Sequoia Project and Audacious Inquiry to expand PULSE to other regions across the country.
November 04, 2019 - The Sequoia Project announced a partnership with Audacious Inquiry (Ai), a leader in connected care, to support the Patient Unified Lookup System for Emergencies (PULSE) platform, which was developed by the Office of the National Coordinator (ONC) in 2014 to provide secure health data exchange during an emergency.
PULSE enables emergency responders to search for health information on disaster victims, such as medications, diagnoses, allergies, and lab results. It limits access to only authorized personnel and to a “view only” format for medical information.
“Using our health IT expertise to support disaster relief is aligned with our core mission to solve interoperability challenges for the public good,” said the Sequoia Project Chief Information Officer, Debbie Condrey. “We've seen first-hand how PULSE can provide meaningful, even lifesaving, support at times of crisis and we're determined to bring this vital tool to every community in America. The national networks and Advisory Council experts will provide critical support for local response planning.”
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ONC Highlights Key Benefits of Security Risk Assessment Tool
To close National Cyber Security Awareness Month, HHS ONC reminds healthcare providers of its Security Risk Assessment Tool, which can effectively identify, assess risks to patient health data.
November 01, 2019 - The Office of the National Coordinator is reminding healthcare organizations to leverage its Security Risk Assessment Tool, in closing out National Cyber Security Awareness Month.
Developed in collaboration with the Department of Health and Human Services and the Office for Civil Rights, the tool was updated in October 2018. The updates included an enhanced user interface, modular workflows, custom assessment logic, progress tracker, threats and vulnerabilities rating, and detailed reports.
ONC also added business associate and asset tracking, an area that many providers have struggled to keep pace of in the current expansive digital health environment.
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HIT Think
How providers can use social determinants of health to improve care
November 04, 2019, 3:41 p.m. EST
Most healthcare provider organizations readily admit that they are overwhelmed by data.
Patient encounter data in EHRs, imaging and lab results, and billing data from claims have generated a venerable sea of complex and disparate information, and organizations strive to harness it to enhance decision-making in the optimal treatment of patients.
This is, in part, why some providers are hesitant to take on yet another data asset, such as social determinants of health (SDOH), and put it in the hands of clinicians who already operate in a world busy with electronic documentation and clinical decision support alerts.
SDOH data garnered great interest in its potential for developing both efficacious and personalized treatment plans. Its value has also been lauded for helping to improve the impact of care by addressing barriers keeping patients from fulfilling their care plan.
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EHRs help to identify symptom clusters in cancer patients
November 04, 2019, 12:22 a.m. EST
Researchers from the Regenstrief Institute and Indiana University–Purdue University Indianapolis have developed novel methods for extracting data on patient symptoms from electronic health records.
By analyzing free text clinical notes and extracting information from structured entries in EHRs, investigators were able to identify symptom clusters—those symptoms that tend to go together and are associated with disease.
“EHR data has not been extensively used to understand patient-reported symptoms for individuals with chronic diseases,” says Xiao Luo, assistant professor of computer and information technology in IUPUI’s School of Engineering and Technology. “Utilizing EHR data obtained from the Indiana Network for Patient Care, we developed a framework that employs components of data mining, NLP and machine learning to explore clinical information accumulated throughout the course of these diseases.”
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CMS final rule aims to reduce physician billing, coding burdens
November 04, 2019, 12:39 a.m. EST
The Centers for Medicare and Medicaid Services on Friday issued a final rule reducing clinician burden regarding billing and coding requirements for evaluation and management services.
Evaluation and management (E/M) coding is the process by which physician-patient encounters are translated into five-digit Current Procedural Terminology (CPT) codes, which are submitted for payment to Medicare for common office visits.
As part of a new Medicare Physician Fee Schedule final rule, CMS has made changes—effective Jan. 1, 2021—to the “burdensome and overly complicated” E/M documentation and coding framework that dates back to the mid-1990s.
“Clinician burnout is high because outdated government regulations are diverting their attention from what matters—patient care,” said CMS Administrator Seema Verma in a written statement. “The Trump Administration’s final rule brings antiquated requirements, which are over 20 years old, up to date with the current practice of medicine and will impact the current and future generation of clinicians.”
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New study provides insights into how Germans see the digitisation of healthcare
Findings suggest Germans are not satisfied with the progress that the health and care system in their country has made so far.
By Anna Engberg
November 04, 2019 04:30 AM
European management and technology consultancy Sopria Steria Consulting (SSC) has released a new study examining the attitudes of Germans with regard to the progress of the health and care system’s digital transformation, assessing it in a six-country comparison.
Findings from the survey indicate that people see an added value in the use of digital health tools such as the EHR, health apps, telemedicine and other medical online services. However, the results of the study, carried out from July 2018 to March 2019, indicated that those polled tended to be disappointed about the progress made in the digitisation of healthcare services.
In addition to the 200 respondents from Germany, as many citizens from France, Spain, Great Britain, Belgium and Norway took part in the survey, called the European Study on the Digitalisation of Healthcare Pathways.
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KLAS-CHIME report offers AI insights from early adopters
In addition to gathering opinions on vendors including Health Catalyst, IBM Watson and Jvion, the research clears up some misconceptions about artificial intelligence systems and offers some best practices for safe and effective deployment.
By Mike Miliard
November 04, 2019 03:01 PM
A new joint report from KLAS and CHIME polled some early adopters of artificial intelligence and machine learning tools, and asked how the technology is impacting their clinical, financial and operational goals.
WHY IT MATTERS
The study is based on interviews with IT leaders at 57 organizations – CIOs, CMIOs, data scientists and more – that are using AI across a variety of different cases, from clinical decision support to patient engagement to revenue cycle management. It asked them about some tangible gains the technology has helped them achieve. It also gleaned some insights about a handful of leading vendors, and found some common best practices for AI adoption.
The study is based on interviews with IT leaders at 57 organizations – CIOs, CMIOs, data scientists and more – that are using AI across a variety of different cases, from clinical decision support to patient engagement to revenue cycle management. It asked them about some tangible gains the technology has helped them achieve. It also gleaned some insights about a handful of leading vendors, and found some common best practices for AI adoption.
KLAS focused on purpose-built AI vendors – those focused primarily on analytics and AI, with dedicated, standalone product – and analytics platforms with AI infrastructure. It did not assess EHR vendors with AI capabilities or other vendors whose IT applications that have some AI capabilities but aren't meant to be standalone AI applications.
The research firm defines AI as software that "provides machine learning or natural language processing capabilities for healthcare-related clinical, operational, or financial areas."
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Health systems upping investments in remote patient monitoring
Smartphones and tablets are among the mobile technologies in focus, which can be combined with telehealth video conferencing and healthcare wearables, as well as the deployment of electronic health record-based patient portals.
By Nathan Eddy
November 04, 2019 11:03 AM
The vast majority of hospitals and health systems – 88 percent – have invested in or plan to invest in remote patient monitoring technologies as part of their transition to a value-based care model, a new report shows.
WHY IT MATTERS
The findings come from a Spyglass Consulting Group report derived from more than 100 interviews with clinical informatics and health IT thought leaders.
The findings come from a Spyglass Consulting Group report derived from more than 100 interviews with clinical informatics and health IT thought leaders.
Survey respondents say RPM solutions will be used to help care managers monitor and manage high-risk patients with chronic conditions who are considered unstable and at-risk for hospital readmissions.
The Spyglass study also found nearly nine in 10 providers surveyed are in the process of developing, or have already begun development of engagement strategies to encourage patients, family members, and caregivers to take a proactive role in managing their chronic conditions.
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Automated text messages, calls drop Eisenhower Health no-show rate from 8% to 2.3%
The California health system is projecting an annualized net income of more than $75,000 from using the technology. This could increase to more than $260,000.
By Bill Siwicki
November 04, 2019 12:46 PM
Eisenhower Health in Rancho Mirage, California, serves residents of the Coachella Valley, where as many as 70% of its patients are seniors. The health system is a healthcare complex comprised of a 463-bed hospital, the Annenberg Health Sciences Building at Eisenhower, and the Barbara Sinatra Children’s Center at Eisenhower, in addition to its outpatient facilities in Palm Springs, Cathedral City, Rancho Mirage, Palm Desert and La Quinta.
THE PROBLEM
The clinic division reports approximately 500,000 outpatient visits annually, including areas of oncology, cardiology, orthopedics, primary and urgent care, as well as several specialty clinics.
“One of the primary challenges faced in the clinic division was addressing a no-show rate of 8% across all outpatient services — 5% within the clinic division alone,” explained Mark Steffen, chief administrative officer, primary and specialty care clinics, at Eisenhower Health.
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More Research Concludes That Healthcare AI Adoption Is Expanding Rapidly
November 4, 2019
Not long ago, I shared a survey documenting a big year-to-year jump in the number of healthcare execs who reported having implemented an AI strategy. Now, I have another set of data points on healthcare AI adoption to share with you, and I’m sure you won’t be surprised to learn that they, too, document an increasingly rapid AI uptake of these technologies.
As I should have done last time, I’d like to offer a clarification. For those who aren’t following AI’s emergence too closely, it should be noted that most of this growth seems to arise from enterprise use of machine learning and related technologies. To date, I’ve seen few examples of, say, chatbots being put in place. I base this assertion primarily on my own observations, but they’ve been pretty consistent so far.
That being said, it’s still worth noting that healthcare organizations are getting comfortable with some forms of AI, especially as a data analytics tool. The latest evidence for this comes from RELX, which surveyed more than 1,000 U.S. senior executives across seven industries on their take on AI technologies.
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Data Breaches Cost Hospitals $4B Annually
Provider organizations are expected to struggle to protect healthcare data in 2020, according to a Black Book survey.
The total cost of data breaches at healthcare organizations is projected to reach $4 billion by the end of 2019, according to a Black Book survey released Monday morning.
Nearly all information technology (IT) professionals at provider organizations believe that data hackers are outpacing organizational efforts to protect sensitive healthcare data, a trend which is expected to worsen in 2020.
Ninety-three percent of healthcare organizations reported a data breach in the past three years and 57% of respondents said their respective organizations experienced more than five data breaches over the same period of time.
For 2019, respondents estimated that data breaches cost organizations $423 per record.
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Why Computerized Medical Records Are Bad for Both You and Your Doctor | Opinion
On 11/1/19 at 12:41 PM EDT
For several years I have asked people "Why, in your appointment with your doctor, is his or her back turned to you, working on a computer?" The common answers: "She's writing down my words to remember them," "He's ordering tests," or "To get me better health care."
No, no and no: the primary purpose of the computer is billing. The Electronic Medical Record (EMR) is essentially a cash register. It was developed by technocrats as part of a mandate of the Obama administration in 2008, to help make medical records more efficient. It was a good idea: to make all clinical data from a patient's medical history readily available electronically to doctors and other health care workers. It would have worked, if it were used only for that.
But somehow the for-profit insurance industry got into the EMR, and linked the medical data part tightly to the money part—through billing. Its core function became coding diagnoses and treatments for payment. The EMR became ubiquitous.
The result is that there's a war taking place across the screen. Like all wars, this one is about money. On one side, your doctor is being forced by the hospital billing team—which actually monitors her EMR screen—to click on various boxes, which lead to another array of boxes, and another, to bill the most for your treatment. On the other side of the screen, an insurance worker's job depends on paying out the least.
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Weekly News Recap
- UnitedHealth’s Optum acquires remote patient monitoring startup Vivify Health.
- Waiting room advertising company Outcome Health pays $70 million in customer restitution to settle Department of Justice advertising fraud charges.
- Australia’s Queensland Health confirms media reports that it ordered its IT department to perform no software upgrades, including to its problematic Cerner system, while parliament is in session to avoid embarrassment.
- Premier acquires purchased services management technology vendor Medpricer.
- Medecision acquires GSI Health.
- ESolutions acquires Medidal.
- Facebook launches a program in which user demographics will trigger preventive health information and reminders.
- Google parent Alphabet is rumored to have made an offer to acquire Fitbit (the companies announced Friday that the acquisition is set for $2.1 billion).
- Cerner says in its earnings call that it will no longer offer outsourced revenue cycle management services after Adventist Health terminate its contract, which triggered a $60 million charge and an annual revenue reduction of $170 million.
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Enjoy!
David.
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