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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Is the third sector the solution to 24/7 mental health care?
In the last few years there has been significant progress in advocating against social stigma of mental health but could the third sector be the key to providing more convenient access to services? Ian Jackson, Medical Director and Clinical Safety Officer at Refero, explains how teaming telecommunications tech with third-sector services could enable joined-up, personalised mental healthcare.
DHI News Team – 26 November, 2019
Jeremy Corbyn has vowed to give every child access to mental health support by spending £845 million if Labour succeeds in December’s general election.
And the Conservatives have announced that new models of personalised care will be rolled out to tackle the serious issue of adult mental illness, as part of a “huge boost to community mental health services for adults which will see an extra £975 million going into these services every year.”
Team these announcements with events such as World Mental Health Day, and most recently, the Movember male suicide campaign, we can say that significant progress in advocating against social stigma, raising awareness, and offering crucial support to those in need, is being made. But there is still much work to be done when it comes to delivering effective, consistent, joined-up care through the NHS.
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A Roadmap To Welcoming Health Care Innovation
Health care systems are being flooded with a slew of digital innovations, both internally and externally sourced. The promise of remote sensors, machine learning, artificial intelligence, and personal health records, together with investment from the National Institutes of Health and private investors, has resulted in a tsunami of interest in these solutions. Yet, health care systems across the country are struggling with their approach to innovation, which has resulted in a tremendous proliferation of pilot studies but little adoption of solutions at scale. The mismatch between the promise of the technology and current organizational strategy requires further examination.
Why Is This So Hard?
The first challenge is that executing on innovation that impacts value (cost and quality) requires both technology and business model transformation. While we have had significant focus on the technology aspects of the digital revolution, the business model transformation aspect has received much less attention. Business transformation requires significant investment of time by senior leadership, resources, the development of new business models, and the retirement of legacy business models. Most organizations will not undertake this level of investment in a novel concept without significant justification.
Another dilemma stems in part from leadership’s inability to evaluate novel technologies and pilot studies appropriately from an investment perspective. Rather than being seen as a point solution, digital innovations should be viewed as a starting point for investment in novel business processes, novel business designs, and potentially, novel organizational structures. Senior leadership, which must assess whether the digital innovation has reached a level of maturation appropriate to this level of investment, is often the bottleneck in these decision-making processes. Leaders at lower levels of decision making are often not empowered to make decisions regarding business transformation, and few health systems have an alternative “strategic” decision-making pathway that includes alternative perspectives, leaders, and metrics.
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Amazon rolls out new Alexa feature to let consumers refill prescriptions
Nov 26, 2019 12:17pm
Amazon is rolling out medication reminders as a new feature of its Alexa device in partnership with pharmacy chain Giant Eagle.
The new feature, announced Tuesday, could be the first step in the tech giant's broader effort to use the voice assistant to help consumers manage their medications.
The new voice-enabled medication reminder feature represents "day one" for Amazon and healthcare, Rachel Jiang, who leads the Alexa health and wellness team, wrote in a blog post Tuesday.
But Amazon expects to learn from the initial launch and plans to expand the feature to more pharmacies next year, Jiang wrote.
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Vanderbilt Researchers Test mHealth Platform to Improve ED Hand-Offs
The project equipped EMS personnel with wearable mHealth sensors to create a log of procedures done during transport, so that ED and trauma care providers have a better idea of what happened on the way to the hospital.
November 27, 2019 - Researchers at Vanderbilt University Medical Center are piloting an mHealth wearable platform that aims to improve emergency care – by tracking how EMS providers move.
The researchers, working with the Nashville Fire Department, are using the connected health platform to track what paramedics and other care providers do in the ambulance prior to handing off a patient to the hospital’s Emergency Department. In doing so, they’re creating a digital log of in-transit procedures, including cardio-pulmonary resuscitation and intubation, that will help ED personnel better plan their course of treatment.
“The resulting documentation will be extremely valuable for emergency room physicians and trauma surgeons who want to know what care has been provided,” Daniel Fabbri, PhD, an assistant professor of Biomedical Informatics and Computer Science at Vanderbilt, told the university’s news service.
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Heart Attack or Not? Apple Watch Might Give the Answer
MONDAY, Nov. 25, 2019 (HealthDay News) -- A doctor armed with your Apple Watch might be able to tell if you're suffering from a heart attack, researchers report.
A physician should be able to gather enough heart rhythm data by placing the watch's sensors on different parts of your body, to judge whether a person is in the middle of a heart attack, the study found.
"Any Apple Watch series 4 and 5 can be used," said report author Dr. Miguel Angel Cobos Gil, a cardiologist with the Hospital Clinico San Carlos in Madrid, Spain. "You don't need any modification or accessory."
However, you do need to be able to interpret an electrocardiogram (ECG), so this is a trick that Apple Watch owners won't be able to do on their own, Cobos Gill added.
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The 2020 state of cybersecurity: 2 ways enterprises need to prepare
November 27, 2019, 3:30 a.m. EST
Securing all forms of data is, and will continue to be, an ongoing challenge for individuals, organizations and enterprises as we head into 2020. Just look at the past year—one of the most notable cybersecurity threats that plagued cities, individuals and other organizations (especially healthcare) was ransomware.
And when you look at the numbers, they’re staggering. As of this past August, 140 ransomware attacks have targeted public state and local governments as well as healthcare providers this year, with two-thirds of publicly known attacks targeting the former. The point is that malicious actors are tenacious, creative, and will keep finding new ways to get what they want: your data.
And, as with every new year, comes new—and often unforeseen or even unfathomable—threats to cybersecurity and the data, apps and technology that we’ve all come to rely on every day. As someone who’s worked in cybersecurity throughout my entire career, there are two things I believe we’ll see make headlines next year that every enterprise should be aware of and prepare for.
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EHR ‘nudges’ increase clinician ordering of cancer screenings
November 27, 2019, 12:42 a.m. EST
The University of Pennsylvania Health System programmed a best-practice alert into its electronic health record to automatically prompt medical assistants to either accept or decline a cancer screening order.
The EHR “nudge” implemented at three different Penn primary care practices resulted in a 22 percent increase in screening order rates for breast cancer, compared with practices without the alert. In addition, the colorectal cancer order rate rose by almost 14 percent vs. the other practices.
“An active choice intervention in the electronic health record directed to medical assistants was associated with a significant increase in clinician ordering of breast and colorectal cancer screening tests,” finds a Penn Medicine study published in JAMA Network Open.
Because the intervention was directed only to medical assistants, the study’s authors contend that the EHR nudges reduced the burden on physicians to respond to the alerts, giving them more time to have discussions with their patients about screenings.
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Healthcare Companies Struggle With Implementing Digital Transformation
November 27, 2019
New research has found that healthcare organizations around the world have big plans for digital transformation but often stumble when it comes to implementing this process.
Global marketing strategy and marketing consulting firm Simon-Kucher & Partners surveyed more than 120 managers from the pharma and medtech industries in August and September of this year to get a sense of where these companies were headed within digital health activity.
Researchers found that 70% of respondents said that their companies were working to introduce digital add-on services and 38% standalone digital offers. In addition, half of those surveyed were working to collect customer data.
When examining their efforts, the firm found that in 56% of cases, respondents created a dedicated digital team to define the strategy, while in another 42% a new or existing commercial team carried on these efforts.
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Major Misconceptions About Machine Learning In Healthcare
November 27, 2019
Over the past few years, as some standout use cases began to emerge, enthusiasm for AI has grown among health leaders, to the point where you’ll hear little but positive thoughts about AI’s potential benefits.
Now that interest in AI has moved almost entirely into the mainstream, it’s probably time to look at areas in which the industry has gotten perhaps carried away with itself and lost sight of potential challenges to its use.
This is why I was pleased to stumble across an article in Harvard Business Review which names what it sees as some bothersome myths about machine learning in healthcare which have already begun to take hold in the industry.
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Patient Safety Still Problematic 20 Years After 'To Err Is Human' Report
By Christopher Cheney | November 27, 2019
There have been leaps forward in patient safety over the past 20 years but harm remains far too common, two experts say.
KEY TAKEAWAYS
· In 1999, the landmark report To Err Is Human estimated that as many as 98,000 patients died annually from medical errors.
· Despite publication of To Err Is Human, estimates of deaths from medical errors have increased. In 2013, an article published in the Journal of Patient Safety estimated annual patient deaths from medical errors were as high as 440,000.
· High reliability in the commercial aviation industry provides guideposts for the healthcare industry to follow to achieve zero harm.
Progress has been made in patient safety improvements but many more advances are needed, a pair of experts say regarding the 20-year anniversary of the landmark report To Err Is Human: Building a Safer Health System.
The 1999 report included the alarming statistic that as many as 98,000 Americans were dying annually due to medical errors. Yet despite two decades of attention, estimates of annual patient deaths due to medical errors have since risen steadily to as many as 440,000 lives, a figure that was reported in the Journal of Patient Safety in 2013.
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Digital alert helps speeds sepsis treatment in test at London system
November 26, 2019, 3:38 p.m. EST
A London healthcare delivery system is using a digital alert to help remind physicians to look for signs of sepsis in the emergency department.
The technology-based reminder system speeds the time it takes for doctors to check for signs of sepsis early in an emergency department visit, which quickens the administration of antibiotics.
Sepsis is a common health issue in the U.K.; the nation has reported 123,000 cases and 46,000 deaths annually. Consequently, UK hospitals have a goal of administering antibiotics intravenously to suspected sepsis patients within one hour.
Embedding sepsis tools into the electronic health record enables use of digital alerts to physicians, based on current and past clinical measurements. For example, Cerner has developed a digital sepsis alert that has a silent running mode. Silent alerts are not visible to doctors at the front end of the system, but once an alert is turned on, nurses are notified of patients who have triggered the alert via a pop-up warning on the EHR.
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AMIA: FHIR is not suitable for research, needs NIH R&D funding
November 26, 2019, 12:07 a.m. EST
The American Medical Informatics Association wants the National Institutes of Health to fund research and development to advance HL7’s Fast Healthcare Interoperability Resources standard.
AMIA submitted comments to NIH in response to the agency’s request for information seeking input from stakeholders on how FHIR could be used to capture and share clinical data for biomedical research purposes.
According to AMIA, it is critical that NIH assume a leadership position to coordinate a research and development strategy for using FHIR for research and that the agency devote “substantial resources” to the effort.
Specifically, AMIA recommended that NIH directly fund FHIR research and development through grants; indirectly fund FHIR through special emphasis notices and project requirements that prioritize projects that will use FHIR; and educate the research community and help represent it in activities supported by HL7, the Office of the National Coordinator for Health IT and other standards developing organizations that have an interest in FHIR.
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Virtual Clinical Trial Aims for HF Drug Indication
ISCHEMIA's John Spertus, MD, MPH, calls it a dream come true
Could a drug get a new indication without ever having study participants step in a medical office?
CHIEF-HF will push the bounds on indication-seeking trial design. This "digital trial" is expected to launch early in 2020, accrue 1,900 heart failure patients with preserved or reduced ejection fraction, and potentially report results after 18 months.
MedPage Today spoke with the trial's primary investigator John Spertus, MD, MPH, of the University of Missouri Kansas City and St. Luke's Mid America Heart Institute there.
Tell us about the trial ...
Spertus: This is a trial of the impact of Invokana [canagliflozin], an SGLT2 inhibitor, on heart failure. The recent DAPA-HF study in heart failure with reduced ejection fraction had very compelling data.
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EHR Training Improves Physician Satisfaction & Physicians Don’t Want to Make Time for EHR Training
November 26, 2019
While at the CHIME 2019 Fall Forum conference in Phoenix, AZ, I had a great chance to sit in on one of the CIO focus groups at the event hosted by Optimum Healthcare IT. The session discussed a wide variety of topics including EHR optimization, EHR training, and other related topics. While listening to these discussions, I was struck be a certain irony that seemed to be experienced by almost every CIO I met at the CHIME Fall Forum and this focus group in particular. The irony is illustrated in these two statements.
EHR Training Improves EHR Satisfaction
and
Physicians Don’t Want to Make Time for EHR Training
These are pretty broad generalizations, but the beauty of a generalization is that it’s generally true. For the first statement, this has really been proven out by the great EHR Satisfaction research that KLAS’s Arch Collaborative has done along with Heather Haugen’s research in the book Beyond Implementation. If you’re not doing enough EHR training, then fixing it will help with physician satisfaction. If you don’t have great EHR trainers, getting better trainers will help with EHR satisfaction.
Given this is the case, it’s amazing how much push back CIOs get when it comes to EHR training from physicians. The stories I’ve heard are wide and varied. Everything from physician’s refusing to do EHR training and hospitals hiring a scribe to do all the EHR work for them through physician’s leaving organizations because they don’t want to train on the EHR. While those are the extremes, the most common request I’ve seen is doctor’s asking for as little EHR training as possible.
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Can Google “Restore the Joy of Caregiving”?
November 26, 2019
That’s quite an ambitious question. It’s a sentiment I’ve heard over and over from people who think that Google or Apple could enter healthcare and finally make the software a joy. However, what prompted the title of this article was Alvin Rajkomar, MD, Product Manager at Google Health who shared this as Google’s ambition in healthcare.
Alvin shared Google’s goal to “restore the joy of caregiving” in a video which showed the first demo of a Google Health product. Check it out below:
I have to admit that this is the closest I’ve seen to a big tech company putting together something that’s starting to look like an EHR. Props to Google for having this ambition. However, this demo falls flat on so many levels that it’s still hard to take serious. Plus, it doesn’t address the real underlying challenges that make clinician burnout a reality today.
The most glaring thing for me with the above demo is that it largely focuses on viewing EHR data as opposed to data entry. While there are certainly challenging nuances to viewing EHR data today, most of the “joy” is sucked out of healthcare thanks to data entry, not viewing data. Certainly, Google’s demo asserts that they can more effectively access and display data across multiple organizations which we all know would be great. However, it doesn’t share a compelling case for how they’ve really solved the healthcare interoperability problem. Remember that the problem is not a technical one, but a business one. Does a slicker interface do anything to solve the business problem here? Not even close.
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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.
By Laura Lovett
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.”
The new tool, which is still in the pilot phase, lets clinicians use shorthand to search and will bring up results that may have typos. Users can also jump to different parts of the chart, such as vitals or notes, by using the search feature. Doctors will also be able to search through scanned documents and faxes, both with handwritten and typed notes, for information.
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11/22/2019
04:40 PM
04:40 PM
Researchers Explore How Mental Health Is Tracked Online
An analysis of popular mental health-related websites revealed a vast number of trackers, many of which are used for targeted advertising.
Researchers who analyzed a collection of mental health-related websites found a vast majority embed "an impressive number" of trackers mostly used for marketing purposes. More than a quarter embed third parties engaged in programmatic advertising and Real Time Bidding (RTB).
Eliot Bendinelli, a technologist with UK non-profit Privacy International, says the organization wanted data protection agencies to take action because it believed there was a fundamental problem with the tracking industry. Its project began with an investigation into sales in the field of ad tech companies, credit rating agencies, ad blockers, and related organizations, he says.
"We were building a case, and basically we think what they're doing is unlawful," Bendinelli continues. While waiting for agencies to act, the research team wanted to find an example of how tracking is taking place on Web pages where people go to read and share sensitive data.
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Nov 24, 2019, 12:47pm
10 Predictions How AI Will Improve Cybersecurity In 2020
Cybersecurity is at an inflection point entering 2020. Advances in AI and machine learning are accelerating its technological progress. Real-time data and analytics are making it possible to build stronger business cases, driving higher adoption. Cybersecurity spending has rarely been linked to increasing revenues or reducing costs, but that’s about to change in 2020.
What Leading Cybersecurity Experts Are Predicting For 2020
Interested in what the leading cybersecurity experts are thinking will happen in 2020, I contacted five of them. Experts I spoke with include Nicko van Someren, Ph.D. and Chief Technology Officer at Absolute Software; Dr. Torsten George, Cybersecurity Evangelist at Centrify; Craig Sanderson, Vice President of Security Products at Infoblox; Josh Johnston, Director of AI, Kount; and Brian Foster, Senior Vice President Product Management at MobileIron. Each of them brings a knowledgeable, insightful, and unique perspective to how AI and machine learning will improve cybersecurity in 2020. The following are their ten predictions:
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Nov 23, 2019, 07:00pm
Concrete Problems: Experts Caution on Construction of Digital Health Superhighway
I write critically about U.S. health care
If you’re used to health tech meetings filled with go-go entrepreneurs and the investors who love them, a conference of academic technology experts can be jarring.
Speakers repeatedly pointed to portions of the digital health superhighway that sorely need more concrete – in this case, concrete knowledge. One researcher even used the word “humility.”
The gathering was the annual symposium of the American Medical Informatics Association (AMIA). AMIA’s founders were pioneers. Witness the physician featured in a Wall Street Journal story detailing his use of “advanced machines [in] helping diagnose illness” – way back in 1959.
That history should provide a sobering perspective on the distinction between inevitable and imminent (a difference at least as important to investors as intellectuals), even on hot-button topics such as new data uses involving the electronic health record (EHR).
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Breaches in 2018 exceed previous year; affected patient records soar
November 25, 2019, 3:12 p.m. EST
The healthcare sector continues to be a highly valued target for hackers and other malicious attackers at the rate of one breach per day, according to a new report.
The research, published by Protenus, a healthcare compliance analytics company, and DataBreaches.net, a web site devoted to reporting on data security breaches, found that, out of all breaches reported last year, 353 (or 70 percent) involved healthcare providers, 62 (or 12 percent) involved health plans, and 39 (or 8 percent) involved some other type of entity.
The latest Breach Barometer report was based on an analysis of 503 health data breaches reported to the Department of Health and Human Services, the media or some other source during 2018. The number of breaches was up slightly from the 477 breaches reported in 2017. Protenus and DataBreaches.net have information on the majority of the breaches in 2018, which affected more than 15 million patient records, the companies said.
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New fed guidance helps providers, stakeholders avoid phishing attacks
November 25, 2019, 3:26 p.m. EST
A report from CISA, a cybersecurity and Infrastructure Security Agency within the Department of Homeland Security, offers a number of tips to beat phishing attacks.
The agency is aiming the report to share ways that healthcare providers, business associates, consultancies and other stakeholders can avoid social engineering and the phishing attacks that likely would occur.
In a social engineering attack, the offender employs human interaction social skills to get information on the organization or its information systems. Acting unassuming and respectable and passing off as a new employee, repair person or researcher, the offender may even offer credentials to support the identity deception.
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https://www.healthdatamanagement.com/news/va-reports-235-increase-in-video-telehealth-visits-in-fy19
VA reports 235% increase in video telehealth visits in FY19
November 24, 2019, 10:57 p.m. EST
The Department of Veterans Affairs, which already has the country’s largest telemedicine program, delivered more than 2.6 million episodes of telehealth care in Fiscal Year 2019.
The milestone—reached between October 2018 and September 2019—represents a 17 percent increase in overall telehealth visits over the previous fiscal year, according to new data released by the VA.
Over the past fiscal year, more than 900,000 veterans availed themselves of the agency’s telemedicine services in a clinic or at home, enabling real-time interaction with VA care teams.
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VA sees a surge in veterans' use of telehealth services
More than 900,000 veterans used the agency's virtual care in 2019, with their use of the VA's Video Connect app up 235% in the same period.
By Nathan Eddy
November 25, 2019 12:53 PM
The U.S. Department of Veterans Affairs has announced a 17 percent jump in telehealth visits compared with the previous fiscal year, and says the VA delivered more than 2.6 million episodes of telehealth care in FY 2019.
WHY IT MATTERS
The VA report revealed more than 900,000 veterans used the agency's telehealth services in 2019, with their use of the VA Video Connect app, which connects Veterans to their care teams through a secure video session, jumping 235% in the same period.
The VA report revealed more than 900,000 veterans used the agency's telehealth services in 2019, with their use of the VA Video Connect app, which connects Veterans to their care teams through a secure video session, jumping 235% in the same period.
"More than 200,000 or approximately two-thirds of the 294,000 VA Video Connect appointments in FY 2019 were for tele-mental health visits," said VA officials.
The agency noted that more than 99,000 Veterans used the app, which connects Vets with their health care team using encryption to ensure a secure and private session, at home, thereby saving a trip to a medical facility.
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Providers Increasing Adoption of AI-Fuelled Clinical Documentation Technology
November 25, 2019
The use of computer-assistant coding has been percolating along for a while now but hasn’t taken over the healthcare industry. However, it could find a much more extensive place in the industry in coming years as AI becomes more widely accepted within healthcare organizations, a new survey suggests.
According to Black Book Research, which conducted the survey, the clinical documentation tech market should hit $5.2 billion by 2022, up from $3.2 billion at the end of fiscal 2018. That represents a 10.2% compound annual growth rate.
The survey, which connected with 3,300 coding and health records professionals, found that 44% of respondents already use AI in some form and that 88% of C-suite officers surveyed expected to see wide AI implementation within the next five years. Black Book also found that 93% of healthcare professionals were optimistic that AI technology will be able to streamline document creation.
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Weekly News Recap
- The American Medical Association calls for EHRs to be fully inclusive for transgender patients and expresses its support for government funding to improve public health technology, including EHR integration.
- Government officials in Bahamas scramble to dodge blame for signing an $18 million contract with Allscripts in 2016 that was supposed to transform healthcare, but has yet to result in any installed software.
- HHS expands its price transparency plans by proposing that both hospitals and insurers be required to publicly post their negotiated contract prices.
- The Spokane VA hospital hires more than 100 new employees to cover its expected productivity losses during its Cerner go-live in March.
- Kareo sells its revenue cycle management business.
- Stanford Hospital opens its $2.1 billion, 368-bed hospital that incorporates extensive technology.
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Doctors give electronic health records an 'F'
Date: November 14, 2019
Source: Yale University
Summary: The transition to electronic health records (EHRs) was supposed to improve the quality and efficiency of healthcare for doctors and patients alike -- but these technologies get an 'F' rating for usability from health care professionals, and may be contributing to high rates of professional burnout, according to a new study.
Full Story
The transition to electronic health records (EHRs) was supposed to improve the quality and efficiency of healthcare for doctors and patients alike -- but these technologies get an "F" rating for usability from health care professionals, and may be contributing to high rates of professional burnout, according to a new Yale-led study.
By contrast, Google's search engine earned an "A" and ATMs a "B" in similar but separate studies. Like EHRs, the spreadsheet software Excel got an "F."
"A Google search is easy," said lead author Edward R. Melnick, assistant professor of emergency medicine and director of the Clinical Informatics Fellowship at Yale. "There's not a lot of learning or memorization; it's not very error-prone. Excel, on the other hand, is a super-powerful platform, but you really have to study how to use it. EHRs mimic that."
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Enjoy!
David.
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