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.
-----
NHS bosses meet with tech giants to discuss commercial patient database
Key
players from the NHS, big tech and pharma have held meetings to discuss how to
commercialise tens of millions of medical records culled from a massive new
proposed national patient record database.
Andrea Downey
– 12 December, 2019
Papers from
the meeting organised by the Office of Life Sciences estimate the NHS patient
data could be valued at up to £10 billion a year.
NHS England
chairman, Lord David Prior, chief executive Simon Stevens and NHSX chief
executive, Matthew Gould, met with big tech and pharmaceutical companies to
discuss potential uses for patients’ personal records.
Documents
revealed plans for a “single, standardised, event-based, longitudinal patient
record” containing the data of 65 million patients, pulled together from GPs,
hospitals, mental health professionals, demographics registers, prescription
records as well as information from the private health sector.
-----
Different decade, same healthcare privacy and security problems?
As we
approach the end of 2019, our columnist, Davey Winder looks back at the last
year and explores whether anything has changed with regards to cybersecurity in
healthcare.
10 December,
2019
As we
approach the end of not only another year, but another decade, there are still
way too many outstanding “old” issues related to cybersecurity and privacy in
the health sector for my liking. Some of these, I really would have expected to
have become extinct by now; like the small problem of ad-tracking when it comes
to online health services.
Earlier this
month an investigation by the Financial Times, of all unlikely publications,
uncovered the true extent to which some of the most popular health websites in
the UK have been sharing sensitive medical data.
The reporters
found that everything from symptoms and diagnoses, to prescribed drugs and even
menstrual information were fair game for data-sharing. A total of 100 of the
top health websites were analysed, and the report reckons 79% were installing
cookies without the legal consent required in the UK.
-----
End of term report for healthcare IT
As 2019
draws to a close, Ade Byrne, CIO at Southampton University Hospital, looks back
at the year in healthcare IT.
DHI News Team
12 December, 2019
The year 2019
is nearly up and it’s a good time to reflect on how we are doing. Are we doing
the right things, and are we doing them correctly? I guess this is my end of
term report.
An
environment for innovation
Will so
called digital giants rule the world, in a set of virtual digital continents,
and will big IT vendors in health drive everyone towards having one of two, or
even one of one system within their domain? Sometimes the way we behave in
procurement has the opposite effect to competition, creating conditions that
allow monopolies to develop. This is nobody’s idea of a good thing, despite the
commonly held belief that “if the NHS was [insert large business type] they
would use the same system everywhere”.
“For every
complex problem there is an answer that is clear, simple, and wrong”. How many
times have you thought that recently?
Within
this, a very common recurring theme is just how do start ups and SMEs get
projects off the ground in the NHS. It’s really hard to break in to our market,
and I don’t think we do much generally to make it easier. Procurements require
reference-ability, at scale, and often a balance sheet that will dwarf any
start up.
-----
Machine Learning and the Cancer-Diagnosis Problem — No Gold Standard
- Adewole S. Adamson, M.D., M.P.P.,
- and H. Gilbert Welch, M.D., M.P.H.
Audio Interview
Artificial intelligence is a branch of computer science devoted to
the performance of tasks that normally require human intelligence. A major
subbranch of this field is machine learning, in which computers learn to
perform tasks by analyzing data rather than requiring specific programming
instructions from humans — that is, they generate their own decision-making
algorithms. The power of this technology lies in its ability to independently
identify patterns in millions of data points in order to make classifications
and predictions.
Machine learning has the potential to be extremely useful in
medicine, particularly in the interpretation of medical images. Speed is an
important asset: machine-learning algorithms can interpret CT scans after acute
neurologic events much faster than radiologists can, thereby reducing delays in
diagnosis.1
Automation of tedious and repetitive tasks, such as the examination of multiple
lymph nodes for histologic evidence of metastatic disease, is another benefit.1
Implementation of machine learning could also expand access to certain services
that usually require clinical expertise, such as the screening of retina scans
for diabetic retinopathy.1
Machine-learning algorithms promise to deliver faster and more consistent
diagnoses than humans and to ultimately improve patient care.
-----
Healthcare must look inward to better address social determinants of health, Berwick says
by Robert King
Dec 11, 2019
3:30pm
ORLANDO,
FLORIDA—The healthcare industry must explore how their own institutions are
contributing to major social issues such as institutional racism in
order to really tackle the “monsters” of social determinants on health.
That
was a key message from Donald Berwick, the president emeritus and senior fellow
at the Institute for Healthcare Improvement during the group’s annual forum this
week in Orlando, Florida. Berwick’s comments come as the healthcare industry is
taking a long look at social determinants such as food insecurity,
transportation and housing.
Berwick
made a plea to healthcare system leaders that it's a moral imperative to
tackle social issues inextricably linked to healthcare outcomes.
"I
think over the next decade we had better find a way to invest in working on
social determinants of health," Berwick told reporters during a briefing
Monday. "What would lead us to go through the dramatic changes,
business models, social investment, regulation and legislation that would allow
us to focus on true causes."
-----
Machine Learning Could Improve End-of-Life Communication
Using
machine learning, researchers were able to better understand what end-of-life
conversations look like, which could help providers improve their
communication.
By Jessica Kent
December 09,
2019 - Machine learning tools could analyze conversations between
providers and patients about palliative care, leading to improved communication
around serious illness and end-of-life treatment, according to a study
conducted at the University of Vermont’s (UVM) Conversation Lab.
Discussions
about treatment options and prognoses amid serious, life-threatening illnesses
are a delicate balance for nurses and doctors. Providers are communicating with
people who don’t know what the future holds, and these conversations are very
difficult to navigate.
Researchers
at UVM wanted to understand the types of conversations patients and providers
have around serious illness. The team set out to identify common features of
these conversations and determine if they have common storylines.
-----
Top 10 health questions America asked Dr. Google in 2019
Updated 1529 GMT (2329 HKT) December 13, 2019
(CNN)Google users in the United States had a lot of questions about
blood pressure, the keto diet and hiccups in 2019.
Those
topics were among the 10 most-searched health-related questions on the search
engine this year, according to new data from Google.
The list
was based on search terms collected between January and early December.
Last year,
the top health-related questions Googled by people in the US included what is amyotrophic lateral sclerosis, or ALS, what is
endometriosis and how long does weed stay in your urine.
In 2017, what is lupus, how long does the flu last and what causes
hiccups were some of the health-related questions that had internet surfers
turning to Google.
-----
HIT Think
Beyond integration: how APIs can form a platform for connected health
December 13,
2019, 3:47 p.m. EST
In
the 1990s, the use of HL7v2.x messaging standards became widespread, and to
simplify the development of connections (primarily) between departmental
systems within the four walls, the healthcare integration engine was born.
The
primary model of data exchange supported was and is an event-based push model
of high-volume, low-latency transactions. The integration engine gave
healthcare organizations one place to build connections, to secure those connections,
to monitor those connections, and a locus of governance and accountability for
keeping the data flowing at scale.
In
the early 2000s, in response to the need to efficiently exchange summarized
clinical information between EHRs, the Continuity of Care Document (CCD) and,
later, the Consolidated Clinical Document Architecture (C-CDA) were created.
-----
Express Scripts to launch its first digital health formulary in 2020
December 13,
2019, 4:09 p.m. EST
Express
Scripts, the largest independent manager of pharmacy benefits in the U.S., has
announced it will add digital offerings to its health formulary next year.
Express
Scripts is “going full steam ahead” with digital health, says Mark Bini,
Express Script’s chief patient experience officer. It’s Sure Script’s job to
find the right digital health solutions for its clients and patients, and then
to make sure patients use the solutions effectively, he adds.
"With
the Express Scripts Digital Health Formulary, we've created more than just a
list of approved programs or a vendor management process,” Bini says. “We built
a foundation for the future of care and pharmacy that will deliver better
access, affordability and health."
In
2020, Express Scripts will provide a data-backed digital health formulary to
make it easier for consumers to connect with tools that work best for them,
according to Bini.
-----
Technology optimization: Enriching healthcare communications
Four experts
in communications tech discuss best practices for optimizing these systems in
hospitals, health systems and group practices.
By Bill Siwicki
December 13,
2019 12:47 PM
Timely
and effective communication is absolutely crucial in healthcare. So making sure
the technologies that support healthcare communication are working optimally is
a key task for CIOs and other health IT workers.
Physicians
and nurses must be connected at all times. Health systems must be able to link
to all the various provider organizations that make up the delivery system. And
clinical and business leaders must be able to efficiently converse with their
teams, large and small.
Here,
four experts from healthcare communications technology companies offer best
practices for optimizing these technologies to work most effectively within
CIOs’ and other health IT leaders’ provider organizations.
-----
EHRs in 2019: Still a source of frustration, but getting better bit by bit
As healthcare
moves further into the post-electronic health record era, approaches to one of
its foundational technologies have been slowly evolving to fit the times.
By Mike Miliard
December 13,
2019 03:09 PM
For
years now, health IT professionals have been speaking of the post-EHR era. And indeed, for most hospitals and health
systems, that's where they are.
The
basic blocking and tackling of electronic health record implementation now
behind them, they've pivoted toward a future of advanced analytics, population
health, telemedicine, connected devices and artificial intelligence.
Nonetheless,
EHRs are still here. And, for many clinicians, they're a daily annoyance – a
reminder that, for all its potential to improve quality and improve safety,
health information technology can also contribute to frustrating workflow
impediments, alert fatigue and burnout.
But EHRs are
not the enemy. Or shouldn't be, at least, as long as they're designed and deployed correctly
-----
Gingrich & DeSantis: A health care revolution is coming – It could give you 24/7 access to a doctor
By Newt Gingrich, Joe
DeSantis | Fox News
How health care is benefiting from telemedicine
InTouch CEO Joe DeVivo on the benefits of telemedicine, the
company's acquisition of TruClinic and efforts to make health care more
efficient.
In Washington’s increasingly toxic atmosphere – filled with
impeachment hearings, the jostling of the Democratic primary, and an obsession
with trivial gaffes and scandal over substance – it can be hard to notice
when members of both parties collaborate to try and achieve something positive.
Fortunately, it does still happen.
One example is a bipartisan bill in the House and Senate to expand
telehealth services in Medicare.
Currently, few Americans qualify to have telehealth
services covered under Medicare. Those who do must live in remote locations,
and the number of services they can access is limited.
-----
This new ransomware is targeting companies across Europe and the US
Zeppelin
ransomware is highly customisable and researchers believe the attacks are of
Russian origin.
By Danny Palmer
| December 11, 2019 -- 16:00 GMT (03:00 AEDT) | Topic: Security
Cyber
criminals using a new form of ransomware are going after healthcare and
technology companies across Europe, the US and Canada in what researchers
describe as 'carefully chosen' attacks.
Named
Zeppelin, the
ransomware appears to be based on another family of network-encrypting
malware – VegaLocker
– but has been built upon and improved to such an extent that the security
analysts at BlackBerry Cylance who discovered it have classed it as a new form of ransomware.
Analysis
of the code reveals that Zeppelin was first compiled in early November this
year, but in the space of a month alone it has been discovered targeting
networks of tech and healthcare companies across Europe and North America.
-----
Rethinking Patient Data Privacy In The Era Of Digital Health
Over
the past 10 years, US health care has gradually shifted toward digital record keeping
in the professional realm—the world of hospitals, health plans, and physician
practices. That transition occurred under the umbrella of privacy and security
rules rooted in the Health Insurance Portability and Accountability Act of 1996
(HIPAA), a law which predates most modern online and mobile services, and
explicitly excludes health information created or managed by patients
themselves. As federal and state lawmakers look to revamp privacy rules, this
post outlines a proposal to adapt and extend the familiar HIPAA framework, and
some of the fiduciary principles embedded in that framework, for a new era of
digital-first health care. We suggest that Congress could enact a package of
incremental reforms to ensure the privacy of health data, while broader debates
about online consumer data protection continue.
Personal
health information is no longer private. Social media platforms, wearable
fitness trackers, and apps to manage pregnancy and mental health all collect
health data that can be shared for advertising purposes and appended to medical
records and other consumer information. Ovia, an app women can use to track
their fertility, pregnancy, and childbirth, has created paid services that
exposes such data to employers in de-identified form. Dozens of depression and smoking cessation apps share data with third
parties for advertising and other purposes, often without any disclosure to, or
consent from, the individuals using the applications. Moreover, even when
health information is stripped of personal identifiers, it can often be
re-identified with low effort. —In one 2018 study, researchers were able to re-identify 95
percent of individual adults from the National Health and Nutrition Examination
Survey using machine learning techniques.
-----
Machine learning for clinical decision-making: pay attention to what you don’t see
By
December 12,
2019
Even as
machine learning and artificial intelligence are drawing substantial attention
in health care, overzealousness for these technologies has created an
environment in which other critical aspects of the research are often
overlooked.
There’s no question that the increasing availability of
large data sources and off-the-shelf machine learning tools offer tremendous
resources to researchers. Yet a lack of understanding about the limitations of
both the data and the algorithms can lead to erroneous or unsupported conclusions.
Given that machine learning in the health domain can
have a direct impact on people’s lives, broad claims emerging from this kind of
research should not be embraced without serious vetting. Whether conducting
health care research or reading about it, make sure to consider what you
don’t see in the data and analyses.
-----
Dec 11
Telehealth laws and regulations in 2019 have set the stage for increased access and use
As the care delivery platform becomes more legitimate and accepted, governments, payers and providers are coping with the changes it will bring.
In
some ways, 2019 has been a banner year for telehealth. The remote care delivery
model has been gaining traction among patients, particularly those who have
grown up with technology. As the model becomes more legitimate in the eyes of
providers and consumers, it becomes more widespread, and could help to mitigate
the effects of physician shortages that have had an especially hard impact on
rural areas.
As
telehealth takes center stage, though, there emerges the need for laws,
regulations and industry practices that ensure its feasibility from a
reimbursement, procedure and clinical care perspective. And that's what has
made 2019 such an interesting year for telehealth: A framework is starting to
emerge, and while it's not fully mature, it's no longer the nascent healthcare
delivery approach it once was.
-----
6 ways healthcare organizations can deter medical identity theft
How
healthcare organizations can deter medical identity theft
Medical
identity theft is a growing problem—about 15 million patient records were
compromised in 2018, according to Experian Health, a company that helps
providers and payers improve efforts to safeguard data. Criminals are getting
through cracks in organizations’ cyber defenses to steal patient data and
profit from vulnerable health systems. Here are six ways a healthcare organization
can safeguard patient data from identity theft.
Tell
patients how the organization is protecting their data
Patient trust
is at the heart of a successful patient-provider relationship. Share the steps
the organization is taking to secure patient information so patients feel
reassured and confident in using their portal. Data security should be a key
part of patient engagement messaging.
Verify
patient identities to protect access to medical records
-----
AMA: ONC proposed rule leaves patients’ data, privacy vulnerable
December 12,
2019, 12:09 a.m. EST
While
the American Medical Association supports enabling patient access and sharing
of their own electronic healthcare information, the physician group is
concerned that a proposed federal rule will put sensitive data at risk.
AMA
charges that the Office of the National Coordinator for Health IT is making a
policy decision to “not prioritize patient privacy” and that—if the rule is
finalized as proposed by the agency—patients’ health information will be
vulnerable to inappropriate secondary uses and disclosures from third-party
apps.
“The AMA supports and encourages the right of
a patients to access their medical record—what we do not support is a policy
that enables third parties to monetize patients’ data,” says Jesse M.
Ehrenfeld, MD, chair of the AMA Board of Trustees. “ONC’s proposals will allow
apps to use, package, and sell patient information—which could contain
financial and family information—to the highest bidder. Patient privacy will be
violated and could break the bonds of trust that exists between patients and
their physician.”
-----
Partners launches expansive 5-year digital health innovation plan
The
enterprise-wide effort, which comes as part of the Boston health system's
larger five-year strategic plan and rebranding, is aimed at improving patient
experience.
By Mike Miliard
December 12,
2019 03:12 PM
Partners
HealthCare on Thursday announced a new five-year technology initiative designed
to drive digital innovation, improve clinical care and enhance the patient
experience.
WHY IT
MATTERS
Partners officials say the program – as part of its five-year systemwide strategy and rebranding designed to position it as "health care system of the future" – will focus on digital innovations for diagnostics, therapeutics, medical devices, analytics and population health.
Partners officials say the program – as part of its five-year systemwide strategy and rebranding designed to position it as "health care system of the future" – will focus on digital innovations for diagnostics, therapeutics, medical devices, analytics and population health.
Patient
engagement through leading-edge digital tools will be a key component of the
effort, which will include advancements in online scheduling, telehealth and
virtual care, access to clinical records through OpenNotes and easier options
to see cost estimates for procedures and imaging.
The
initiative will also work to improve interoperability and aggregation of
medical records for Partners and non-Partners health care sites; lower wait
times for all Partners Emergency Departments and Urgent Care centers and
customize patient communication options, including text, email, call or direct
mail, according to Partners officials.
-----
Providers innovated patient engagement and experience in 2019
Whether
enabling patients to understand costs, helping them manage billing or reminding
them to get to the doctor, healthcare organizations are harnessing technology
to more effectively engage patients.
By Bill Siwicki
December 12,
2019 01:32 PM
2019
has seen the continuation of a healthcare trend that has been hot for many
years: Patients becoming more involved in their own care, and IT that can help
boost this engagement.
Patient
engagement, empowerment and experience are becoming key imperatives of modern
healthcare delivery. And healthcare provider organizations are reaching out to
patients in many and varied ways to get them in line with their care teams to
enable the best possible patient outcomes.
This
year saw a variety of hospitals and health systems deploying innovative
strategies and technologies in the field of patient engagement. And their
efforts are achieving positive results.
-----
Company’s Struggles Point Out Roadblocks to Digital Therapeutics Progress
December 12, 2019
Digital
therapeutics — therapeutic interventions driven by software rather than
pharmaceuticals – have been on pharma’s viewscreen for quite some time. It’s
not hard to see the appeal of such technologies, which stand to meet the
objectives of many groups within healthcare.
For
the pharmas, digital therapeutics offer a new product option well-suited to an
emerging digitally-driven healthcare environment. Meanwhile, providers get
tools that can help them scale up their capacity to track individuals across
populations, patients can expect additional support in meeting their health
goals and insurers may be able to keep patients healthier without making big
investments.
What’s
more, in recent times this approach has steadily been gaining clinical
credibility, including with regulators. For example, in November of 2018,
partners Pear Therapeutics and Novartis division Sandoz announced
that the FDA had cleared substance use disorder treatment reSET for clinical
use.
-----
This Robot Helps Kids Relax at the Doctor's Office
By S.C. Stuart
10 Dec 2019,
1:33 a.m.
Doctors have used everything from cartoons to bubbles to help RXRobots, wants to add the MEDi robot to the mix.
Making
kids feel comfortable at the doctor's office is a delicate dance—one that Dr.
Tanya Beran believes could be enhanced with small, sympathetic robots that
coach young patients through procedures and appointments.
Dr.
Beran—Professor of Community Health Sciences at the University of Calgary's
School of Medicine—runs a medtech startup, RXRobots. In 2014, she created a software program called
MEDi to make Softbank's NAO humanoid robots medically and socially
appropriate to help children manage pain during medical procedures. It's now in
over 20 hospitals across the world, and counting.
We
spoke to Dr. Beran recently to find out more. Here are edited and condensed
excerpts of our conversation.
-----
Artificial Intelligence Recognizes Cancer Cells in Pathology Slides
An artificial intelligence tool could help detect cancer cells in digital pathology slides, allowing clinicians to accurately predict patient outcomes.
By
Jessica Kent
December
10, 2019 - A software tool that leverages artificial intelligence was able
to recognize cancer cells from digital pathology slides, leading to more
customized treatment plans, according to a study
published in EBioMedicine.
The
spatial distribution of different types of cells could reveal a cancer’s growth
pattern and they body’s immune response, researchers noted. However, the
process of manually identifying all the cells in a pathology slide is
labor-intensive and prone to error. It’s hard for the human brain to pick up
subtle patterns, so a major challenge is automatically classifying different
types of cells and quantify their spatial distributions.
“As
there are usually millions of cells in a tissue sample, a pathologist can only
analyze so many slides in a day. To make a diagnosis, pathologists usually only
examine several ‘representative’ regions in detail, rather than the whole
slide. However, some important details could be missed by this approach,” said Dr.
Guanghua Xiao, corresponding author of the study and Professor of Population
and Data Sciences at UT Southwestern.
-----
·
12.11.19
·
7:00 am
Amazon and Apple will be our doctors in the future, says tech guru Peter Diamandis
“Do I think Apple and Google and Amazon can do a better job? A thousandfold.”
“Healthcare
is the biggest business in the world, and it is phenomenally broken,” says
Peter Diamandis, cofounder of the X-Prize, Singularity University, and Health
Longevity Inc. “So, do I think Apple and Google and Amazon can do a better job?
A thousandfold.”
In
his upcoming book, The Future Is Faster Than You Think, which will hit bookshelves in late January
2020,
Diamandis makes the case for why he believes big tech companies are
going to be running healthcare by 2030. In December, he came to Fast
Company’s offices to make the case for why Big Tech is the doctor
of the future.
“We’re
going to see Apple and Amazon and Google and all the data-driven companies that
are in our homes right now become our healthcare providers,” he says, referring
to smart speakers such as Google’s Assistant, Amazon’s Alexa, and Apple’s
HomePod. While many of these home voice assistants started with simple tasks
like restocking home pantries and surfacing cooking tutorials, they’re already
starting to move into the business of managing family well-being.
-----
Meaningful Use of Health Information Is Meaningless For Patients
A
new paper in Health Affairs demonstrates the separate universes of patients and
information technology policymakers. Before you decide this does not affect
you, consider that these "Meaningful use" programs have already
cost the taxpayer $38 billion.
The
Meaningful Use programs were designed to nudge hospitals and physicians, with
carrots and sticks, to digitizing medical records and other aspects of care.
One key metric was that patients should have access to their medical records,
from physician offices, outpatient facilities, and hospitals.
The
particular meaningful use requirement at issue is the ability of a patient to
access their hospital record and then "use" that information. Of the
over 5,000 hospitals in the US, the researchers identified the 2,410 who had
met that requirement during the period 2014 to 2016. If only half of the
hospitals meeting this condition is not of great concern, understand that the
hospitals were in compliance if one patient, accessed and used their record in
any 90-day period. I think that is a fairly low bar.
The
researchers created a dataset, including hospitals' structural characteristics,
e.g., ownership, location, and their patient's sociodemographics based upon
hospital-specific information as well as the county in which the hospital was
located. Let's get the good news out of the way,
-----
Research for AZ Blues plan show patients want digital offerings
December 11,
2019, 3:41 p.m. EST
Patients
appear willing to pay extra for digital healthcare services, but they aren’t
ready to rate those encounters as better than a one-on-one encounter with a
doctor.
The
results come from an October survey of 1,531 residents of Arizona, believed to
be reflective of the general population. They study was aimed at evaluating
consumer interest in digital offerings, as well as their overall priorities and
preferences in care.
Technology
and innovation are flourishing, offering promise for improving care and
lowering costs, yet health plans are increasingly stumped on how to get the
equation right for consumers and on which digital offerings to cover, according
to USC Schaeffer Center for Health Policy & Economics, which partnered on
the survey with Blue Cross Blue Shield of Arizona.
The
study revealed that respondents are eager for digital services and willing to
pay for them. More than half of the respondents said they want virtual office
visits to get immediate answers to urgent healthcare issues. Almost seven out
of 10 respondents said they would prefer an app or online system for
appointment scheduling and healthcare reminders. And 45 percent said they would
be willing to pay an average of $25 more per month to have these extra virtual
benefits.
-----
What we learned at the HIMSS Healthcare Security Forum
As the role
of the CISO evolves, so too does the threat landscape, the infrastructure that
needs safeguarding and the policy imperatives shaping the mission of data
protection.
By Mike Miliard
December 11,
2019 03:59 PM
BOSTON
– After two days of wide-ranging and detailed discussion about the
multi-faceted challenges of healthcare cybersecurity, data privacy and patient
safety, some themes have emerged from the HIMSS Healthcare Security Forum,
which took place earlier this week.
Here
are a few top-level takeaways.
The role of the chief information security officer is changing
The
challenges of the CISO (and all healthcare infosec professionals) are many.
Whether it's getting adequate resources from cost-conscious CFOs – one speaker
suggested leaders communicate the stakes in business terms, framed as the catchall
term of "risk," rather than the specialized field of
cybersecurity – or gaining clinician buy-in, the CISO has many more jobs than
just keeping ones and zeroes on lockdown.
One
consistent theme was the shift in how the CISOs are perceived – not just as
security scolds who run phishing tests and shut down shadow IT, but as active
strategic leaders, communicating regularly with other stakeholders across the
enterprise to help with innovation and business transformation.
-----
Forward-looking providers made strides with AI in 2019
Most
healthcare provider organizations have yet to dip their toes into artificial
intelligence. But some are using AI to reap rewards in everything from checking
symptoms to diagnosing lung nodules.
By Bill Siwicki
December 11,
2019 01:48 PM
Artificial
intelligence has been near the top of many healthcare CIOs’ wish lists in 2019.
It’s more than a bright, shiny object – it’s a set of technologies that can
help healthcare provider organizations accomplish quite a bit on both the
clinical and business sides of operations.
But
not many provider organizations have made much progress with AI yet. Still,
2019 has seen a lot of progress being made by some forward-looking providers
dipping their toes into the AI waters. And some of these providers have results
to brag about.
Dealing with lung nodule findings
Summa
Health is a nonprofit health system in Northeast Ohio. The Greater Akron
Chamber documents Summa Health as the largest employer in Summit County with
more than 7,000 employees. Summa Health provides comprehensive emergency, acute,
critical, outpatient and long-term/home care.
-----
Navigating the Healthcare System is Miserable – Can AI Bots Help?
December 11, 2019
Regardless
of whether you’re a chronic patient or a casual visitor to your doctor,
navigating the healthcare system is miserable. I saw this first hand recently
when I and then my daughter got a simple wart on our hand. You’d think this
wasn’t a big deal, but as usual we put off treating it. We weren’t even sure it
was a wart and so we left it and it got to the point that it was painful. We
started to feel like we needed to get some real medical care before it got even
worse and we lost a finger. Ok, that’s probably an exaggeration of what would
have really happened, but what do we know about how bad it could get? In fact,
that’s really the point. We aren’t doctors and we didn’t know how to evaluate
how bad it had really gotten and if medical care was needed or not.
Turns
out. I learned that I’m terrible at this type of triage. On myself, I can kind
of deal with my bad decisions. With my kids, it’s even worse. I feel like I
need to be a great parent and have regularly taken them to the doctor for
something that didn’t need a doctor, urgent care, or ER visit just because I
needed to alleviate that parent guilt that says “What if?” Although, that
feeling is also battling against the dread of going to the doctor combined with
the cost. Notice that I added dread before cost. You probably know what I mean
since everyone goes through these situations. The decision to get medical care
or not is hard.
This
is why I was so intrigued when I came across a company called Buoy Health who’s created an AI chatbot
that basically checks your symptoms and helps you through your triage efforts.
Rather than telling you what it’s like, you can go and check out their symptom checking AI bot for
free.
-----
Will Providers See ROI on Digital Investments in 2020?
By Jack O'Brien |
December 11, 2019
Returns from digital investment is one of the top concerns for providers in 2020, according to PricewaterhouseCoopers.
Provider
organizations are looking at whether digital health investments will yield a
significant return on investment (ROI), according to a PricewaterhouseCoopers'
(PwC) 2020 health industry forecast released Wednesday morning.
Hospitals
and health systems hope to see ROI related to electronic medical record system
(EMR) implementations, the report found, as well as from more recent
investments in medical technology, data analytics, and artificial intelligence
(AI).
Focus
on digital transformation ROI will be a top line concern for provider
executives next year alongside other issues like the regulatory push for
greater price transparency and pressure from employers to address cost
concerns.
Ben
Isgur, HRI leader at PwC, told HealthLeaders that providers are facing
increased pressure from employers, consumers, and the federal government
related to improved price transparency going forward.
-----
Data protection in the healthcare sector
December 11, 2019
Data protection in the healthcare sector is an increasing cybersecurity concern: What will happen next with the regulation of this industry?
In
fact, there is an increasing need to exchange and share patients’ health related information among different
countries in order to provide better health services to citizens. The European
Commission is committed to this approach, and they launched an initiative
promoting the exchange of health records among European countries. This
initiative is being carried out under the eHealth Digital Service
Infrastructure (DSI) Operations2 from the European Commission.
The
eHealth DSI (eHDSI) is the initial deployment and operation of services for
cross-border health data exchange under the Connecting Europe Facility (CEF).
The aim of this platform is to connect different national health systems by
using standards1 to exchange eHealth record’s patient data, among other data.
In addition, there are several European research projects focused on improving
this kind of platforms. This is the case of the SHiELD (European Security in
Health Data Exchange) project, which will unlock the value of health data to
European Citizens and businesses by overcoming security and regulatory
challenges that today prevent this data being exchanged with those who need it.
-----
HHS cybersecurity leader describes the active threats on agency's radar
VPN
vulnerabilities, variations of "the Blues" and PACS imaging servers
are among the risks the Health Sector Cybersecurity Coordination Center, or
HC3, is tracking.
By Mike Miliard
December 09,
2019 03:54 PM
BOSTON
– At the HIMSS Healthcare Security Forum on Monday morning, Greg Singleton,
director of the Health Sector Cybersecurity Coordination Center at the U.S. Department
of Health and Human Services, described how HC3 sees the current threat
landscape – and explained how HHS can help the private sector manage myriad
cyber risks.
Singleton
acknowledged that some folks in attendance might be wondering what the government
is doing at an event like this one.
"You
regulate us. Why would I talk with you?" he said, imagining the question
of a provider-side attendee.
But
Singleton had handy a bit of regulatory language, U.S. Code 6 U.S.C. subsection
1501(3), which holds that "any non-federal organization that shares cyber
threat indicators with an appropriate federal entity is deemed voluntary data
sharing."
-----
Patients, Providers Must Remain at Center of AI, Officials Say
VA and DHA
heads prioritize end users throughout the research, development and
collaboration going into AI.
Mon,
12/09/2019 - 14:05
When
developing artificial intelligence-based platforms in health care, leaders from
the Defense Health Management Systems and Veterans Health Administration said that
building trustworthy AI that put the patients and their providers first is most
important.
At
the GovernmentCIO Media & Research AI & RPA CXO Tech Forum Dec. 5,
DHMS Chief Medical Informatics Officer Cmdr. Alex Holston and VA AI Director
Gil Alterovitz provided examples of how they aim to use AI in simplifying
patient and provider connections and services in defense and veterans health
care.
Holston has
seen growing benefits in deploying AI to take over backend processes at
the Defense Department’s health care system. The tech would ultimately
help physicians provide care faster and more efficiently to patients.
-----
FDA Unveils mHealth App to Crowdsource Elusive Disease Treatments
The FDA's new CURE ID mHealth app will allow clinicians to post their own experiences in treating complex and unusual diseases, find relevant studies and collaborate with their peers across the globe.
December
06, 2019 - Federal officials have unveiled an mHealth platform that will
allow healthcare providers to share ideas on treating complex infectious
diseases.
The
CURE ID platform, unveiled this week by the US Food and Drug
Administration, collects case reports from clinicians using FDA-approved drugs
and allows clinicians to chat with peers and review ongoing and proposed
clinical trials. The global connected health service was created by the FDA in
collaboration with the National Institutes of Health’s National Center for
Advancing Translational Sciences (NCATS).
“The
CURE ID application focuses on drugs for infectious diseases lacking adequate
treatments, including neglected tropical diseases, emerging infectious threats
and infections caused by antimicrobial-resistant organisms,” Amy Abernethy, MD,
PhD, the FDA’s Principal Deputy Commissioner, said
in a press release. “When health care professionals directly input their
clinical cases into the app, CURE ID allows these real-world experiences to be
organized and analyzed much faster, making it easier to spot promising new uses
for existing drugs.”
-----
VA personal health record, patient portal exceed 5 million users
December 09,
2019, 11:25 p.m. EST
More
than 5 million American veterans have registered for the My HealtheVet
personal health record and patient portal to enable them to better manage their
healthcare.
The
Department of Veterans Affairs announced on Monday a “record landmark” for the
online tool, which is designed to refill prescriptions, view scheduled VA
appointments, send secure messages to care givers, as well as download personal
health records.
Developed
by the Veterans Health Administration and launched in 2003, My HealtheVet
has enabled veterans to refill more than 148 million prescriptions, send in
more than of 86 million secure messages, view upcoming VA appointments more
than 74 million times and download more than 37 million health data reports.
“My
HealtheVet is a shining example of how veterans can play a more active
role in their healthcare journey,” said VA Secretary Robert Wilkie in a written
statement. “VA is committed to providing the necessary technologies to ensure
that veterans receive care when and where they need it.”
-----
Amazon’s machine learning transcription service aims to ease docs’ tasks
December 09,
2019, 11:14 p.m. EST
Amazon
Web Services is rolling out an electronic health record-supported machine
learning transcription service that uses speech recognition applications to
ease physician documentation.
The
product is Amazon Transcribe Medical, which automatically translates audio
streams into medical speech, enabling affordable, secure and accurate note
taking for clinical staff, researchers and other stakeholders.
Cerner,
for example is using the product in an initial development of a digital voice
scribe that automatically listens to clinician and patient interactions and
captures the conversation in text form. The service enables developers to add
medical speech-to-text capability to their applications.
-----
HIT Think
How to empower patients and providers with more data, technology
December 10,
2019, 3:50 p.m. EST
As
a data junkie, I am no stranger to numbers. My late father’s life story was
comprised of 60 years fighting Type 1 diabetes.
He
managed over 600 dialysis appointments in his last four years alone. His body
received more than 70,000 insulin shots, two kidney transplants and two
pancreas transplants. He tested his blood sugar five to seven times every day.
He had to manage the disease 24 hours a day, like the 30 million others in the
U.S. who suffer from diabetes.
I
miss my dad, and I hate these numbers. They don’t tell the whole story of a humble
man who never once asked, “Why me?” He took an active role in managing his
care, much like so many other patients today who use sleep, heart rate
monitoring, and fitness apps to track their conditions, regimen changes and how
they feel when they do things differently. Numbers don’t show my dad’s amazing
resilience amid hardship. They also don’t show the challenges he faced managing
his chronic, complex disease—many of which stemmed from lack of data
integration among his providers.
My
dad often had to consult with new physicians about his symptoms and challenges.
Each time he’d visit a provider, he would bring a paper book that he personally
compiled and organized to show his clinical history, current medications and
dosages, lab results, procedure details, and more. He shouldered the
responsibility and the burden of integrating all his health data from various
providers and his own daily glucose monitoring to get the best care. The
healthcare technology ecosystem did not support his communication needs with
physicians.
-----
Privacy organisations raise concerns about Amazon’s use of NHS data
A report from
charity Privacy International claims that a DHSC contract lacks transparency
and prioritises commercial interest.
By Tammy Lovell
December 10,
2019 07:22 AM
Privacy
campaigners have raised concerns about a deal between the Amazon and the
Department of Health and Social Care, which allows the US firm to use NHS data
free of charge.
The
DHSC announced
in July that it was working with Amazon to make verified health information
available through its AI-powered voice assistant Alexa
Privacy
International used freedom of information laws to obtain a copy of the
commercial contract,
which states that Amazon will be able to access all “healthcare information,
including without limitation symptoms, causes, and definitions, and all related
copyrightable content, data, information and other materials” on the nhs.uk
website.
-----
Dec 10
Machine learning, AI, telemedicine and other technologies will pose data security risks, says Dr. John Halamka
While the shift is necessary, the transition period will likely see hackers targeting newly vulnerable information, said Halamka.
BOSTON,
Mass. - Healthcare is at the cusp of transformative change, and in few areas is
this more manifest than in data security, with the next several years seeing
the accelerated proliferation of aggregated data, machine learning,
telemedicine and heath-enabled mobile devices. There's great opportunity here,
but also more risk, as hackers and malicious actors will have new targets in
the war for data.
Delivering
a keynote address at the Healthcare Security Forum in Boston on Tuesday, Dr.
John Halamka, the newly-named president of the digital health initiative Mayo Clinic Platform, said more data is being used for more
purposes by more people -- and healthcare will have its work cut out for it in
order to be ready.
The
problem of data aggregation in particular is that it begets the need for cloud
storage, which potentially makes data more exposed. Currently, companies like
Google and Microsoft -- which can have upwards of 5,000 data security
professionals on the task -- are better at handling aggregated data than the
typical health system, which by comparison may have a dozen or so people
assigned to be stewards of digital patient information.
That
means a significant migration of data to the cloud, but that presents problems
of its own.
-----
Former Twitter CISO: Biggest cybersecurity threats are old problems, not new ones
Security pros
are being outmaneuvered, not outsmarted, said Michael Coates at the HIMSS
Healthcare Security Forum in Boston
December 10,
2019 08:00 AM
BOSTON
– It’s perhaps not surprising that many cybersecurity conferences focus
discussion on the newest ingenious ways hackers are launching attacks, and the
equally ingenious ways security professionals must find to defend against them.
But
while it's important to prepare early for the threats of the future, it’s even
more important to be vigilant in protecting against long-existing threats such
as phishing scams, exploitation of known vulnerabilities and brute-force
credential-stuffing attacks.
"No
one is going to do the hard thing to breach your organization when the easy
thing is going to work every single time," said Michael Coates, CEO and
cofounder of Altitude Networks, who previously served as CISO at Twitter and
head of security for Mozilla.
Keynoting
the opening day of the HIMSS Healthcare Privacy and Security Forum on Monday,
Coates pointed out that major breaches in recent years – the Equifax breach,
the Target breach – were not especially sophisticated attacks. For
instance, the Target attack could have been stopped with better phishing
protection strategies and by improving access management for vendors.
-----
Provider Adoption Across Clinical Technology Platforms – Why Is It Sometimes So Difficult?
December 10, 2019
Over
the years, I’ve participated in a number of clinical technology rollouts.
As I’ve taken part in clinical workshops, discovery sessions, and training and
go-live activities, providers are often conspicuously absent. At
the same time, as I’ve talked to many clinical leaders, nurses and support
staff, they all have unanimously expressed a strong desire that the providers
are included in the technology offerings.
When
I’ve inquired as to the reasons providers are not more involved, the reasons
range from, “Well, they don’t work for our organization directly so we have
limited ability to require participation,” to “The providers don’t have time”.
Over the last few years, I’ve been involved in a few rollouts where providers
were included and the adoption rate of the technology was quite good. As
I’ve gone back over those particular projects, a few key elements seem to stand
out.
Identify
ways the technology can benefit them – A few years ago, I was
responsible for rolling out a Real Time Locating System (RTLS) solution across
a large oncology MOB. RTLS was a new technology that was included in the
technology offerings and the staff expressed a strong desire to have the
providers wear the badges so that they could more easily locate them.
-----
Despite Use of Health IT Tools, U.S. Primary Care Physicians Struggle With Care Coordination
December 10, 2019
A
new survey has drawn conclusions that, while infuriating, probably won’t
surprise anyone working in the U.S. healthcare system today. The survey, which
reached out to primary care physicians around the world, found that despite
having powerful health IT tools at the ready, U.S.-based PCPs are still finding
it difficult to coordinate care with other care providers and social service
agencies.
Researchers
conducting the Commonwealth Fund’s International Health Policy Survey reached
out to more than 13,000 PCPs in 11 high-income countries, specifically
Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway,
Sweden, Switzerland, the United Kingdom and the U.S.
When
they analyzed the data, researchers found that U.S.-based primary care
physicians were behind the other countries studied when it came to
provider-to-provider communications. For example, at least seven in 10
physicians in the other countries receive updates from specialists when there
are changes to their patients’ medication or care plans, while just 49% of U.S.
respondents do.
-----
The Rise of AI. Well, Almost
By Jonathan Bees |
December 10, 2019
Jonathan
Bees is a research analyst for HealthLeaders.
KEY TAKEAWAYS
·
AI use has been steadily growing, with 22% of
healthcare leaders saying that their organization uses a software program that
provides AI capability, according to a new HealthLeaders Intelligence Report, Investing
For the Future: Analytics, AI, and ROI.
·
Another 31% of respondents say they don't
currently have AI capability but plan to within the next three years.
While
people and processes are critical in applying analytics to healthcare industry
data, the growing use of artifical intelligence (AI) solutions has the
potential to change the equation. For now, AI is in the early stages of
development and application, and its impact is still playing out.
-----
Big Tech Should Stay Out of Healthcare
Why the promise of a digital revolution comes with a
dark side.
by Matthew
Buck
December 2,
2019
Big
Tech is moving into health care. Google has announced an intention to buy
Fitbit and is also poised to collect health data on tens of millions of
patients through a deal with the St. Louis-based hospital chain Ascension. In
March, Amazon, Berkshire Hathaway, and J.P. Morgan announced their health venture, Haven.
Apple is using its devices to help academics run studies
with millions of participants. And Microsoft and IBM are using artificial intelligence and machine
learning to help researchers develop better cancer
treatments.
The
use of digital technology in health care has enormous promise, to be sure. But,
as the Wall
Street Journal’s coverage of Google’s Project Nightingale revealed,
there is also a potential dark side to these projects. Ascension, it noted,
“also hopes to mine data to identify additional tests that could be necessary
or other ways in which the system could generate more revenue from patients,
documents show.”
That
detail raises a key question that’s largely overlooked in our health care
debates: should the drive to maximize corporate revenues determine how health
information technology develops and becomes integrated into medical practice,
or should that be determined by medical science and the public?
-----
Epic's Judy Faulkner: ONC data blocking rule undermines privacy, intellectual property protections
Dec 9, 2019
3:14pm
Judy
Faulkner, the CEO of electronic health records giant Epic, has big concerns
that an upcoming federal interoperability rule will undermine patient
privacy.
The
Office of the National Coordinator for Health IT's (ONC) interoperability
and information blocking rule, which is now
under federal review, will have the unintended consequence of sharing family
members' health data without their consent, Faulker said during the Forbes
Healthcare Summit in New York City last week.
ONC's
information blocking rule defines the demands on healthcare providers and EHR
vendors for data sharing, outlines exceptions to the prohibition against
information blocking and provides standardized criteria for application
programming interface (API) development.
-----
Dec 6, 2019,
11:30am
Real Ways To Implement Solutions For Healthcare Disparities
Should your
health insurance company build a movie theater? Should your physician buy you a
refrigerator?
Kevin
E. Lofton, CEO of CommonSpirit Health, shared that’s exactly what CommonSpirit
Health did in a community in Minnesota and Calorado. Teens were traveling 70
miles to catch a movie—and also endangering their health while driving in
unsafe weather. So they built a movie theater in the community. At Forbes Healthcare Summit yesterday, Lofton shared the story
of a patient who kept going to the ER. Then, he enrolled in the “Total Health
Roadmap,” a program where patients are cared for by social workers, health
coaches, and nurse practitioners. He received a home visit and was found to
have a broken refrigerator and no access to healthy food. A new refrigerator
was installed and voila, the expensive emergency room visits ended.
The
social determinants of health may be more important than you think; Dr Stephen
Klasko, M.D., M.B.A., calls this phenomenon “When your zip code is more
important than your genetic code.” In an era of rapid innovation in healthcare,
Dr Klasko interviewed four healthcare leaders about their solutions to
improving the social determinants of health, i.e., the barriers to overall good
health that are due to social factors.
-----
Dec 06 2019
Patients intrigued by digital health services, but still value face-to-face interactions
Most patients showed willingness to use apps and online scheduling systems, but they were a lower priority than quality interactions.
Rising
healthcare costs are at the core of the national healthcare debate. Many have
pinned their hopes on new digital technologies to help reduce costs and expand
access, but while patients are interested in using digital healthcare services,
they still value high-quality interactions with their doctors, shows a survey
conducted by the USC Schaeffer Center for Health Policy and Economics, in
collaboration with Blue Cross Blue Shield of Arizona.
Health
plans increasingly vary in what combination of traditional and digital services
or features they offer members, especially as new technologies and innovations
are introduced by the healthcare industry. With this in mind, BCBSAZ and the
USC Schaeffer Center collaborated on the survey to better understand consumer
priorities in this new environment.
The
survey was aimed at evaluating consumer healthcare priorities, demand for
health plan features, and interest in using digital healthcare services.
-----
Geisinger-AI vendor aim to reduce adverse events, avoid readmissions
December 09,
2019, 12:21 a.m. EST
Israel-based
Medial EarlySign and Geisinger Health System have partnered to apply advanced
artificial intelligence and machine learning algorithms to Medicare claims data
to predict and improve patient outcomes.
An
EarlySign-Geisinger proposal has been selected as one of 25 participants to
advance to Stage 1 of a technology challenge from the Centers for Medicare and
Medicaid Services to accelerate the development of AI and machine learning
solutions for healthcare.
“Approximately 4.3 million hospital
readmissions occur each year in the U.S., costing more than $60 billion, with
preventable adverse patient events creating additional clinical and financial
burdens for both patients and healthcare systems,” says David Vawdrey,
Geisinger’s chief data informatics officer.
-----
App could help identify risk of relapsing from opioid addiction treatment
December 09,
2019, 3:16 p.m. EST
Researchers
at NYU Langone Health want to see whether a computer betting game could predict
the risk that a person recovering from opioid addiction will relapse.
The
game, which researchers now are developing as an app, tests a patient’s
willingness to take risks, producing mathematical scores called betas that
economists use to measure consumer willingness to try new products.
The
researchers then employed a statistical test to determine whether changes
in risk-taking tracked with opioid reuse and found that people who placed
higher-risk bets had higher beta scores.
When
combined with other test scores that quiz a patient about recent drug use or
desire to use drugs, as many as 85 percent of patients who showed sharp
increases in their total beta scores were likely to relapse during the next
week.
Those whose beta scores did not show a spike were much less likely to use during treatment, which generally includes a combination of therapy and drugs to wean patients off their addiction.
Those whose beta scores did not show a spike were much less likely to use during treatment, which generally includes a combination of therapy and drugs to wean patients off their addiction.
-----
Researchers call on regulators to reduce risks of AI in medicine
December 09,
2019, 12:31 a.m. EST
Continuous
monitoring is critical if regulatory agencies such as the Food and Drug
Administration are to reduce the risk in artificial and machine learning-based
medical technology.
That’s
the contention of researchers who make the case that, to manage the risks and
regulatory challenges of AI and machine learning in medicine, regulators like
the FDA should primarily focus on continuous monitoring and risk assessment—and
less on planning for future algorithm changes.
In
an article published in the journal Science,
researchers from INSEAD and Harvard Law School's Petrie-Flom Center for Health
Law Policy, Biotechnology and Bioethics point out that regulatory bodies such
as the FDA have approved medical AI and machine learning-based software with
“locked” algorithms that provide the same result each time and do not change
with use.
-----
Cybersecurity needs to be put in business terms
IT security is a legacy word, says Brian Selfridge: "This isn't cybersecurity, this is risk."
BOSTON,
Mass. - A cultural and communication shift is needed to get cybersecurity
specialists out of the technology basement and around the hospital's leadership
table, according to risk management specialists speaking during HIMSS'
Healthcare Security Forum.
"We
need to put cybersecurity in business terms," said Brian Selfridge, a
partner with Meditology Services, which does healthcare privacy and security
consulting.
Cybersecurity,
as part of a system's total enterprise risk, means looking at the need for
protection in terms of how much money a hospital stands to lose.
IT
Security has become a legacy word, Selfridge said.
-----
Healthcare cybersecurity employee training best practices for CIOs and CISOs
A security
expert offers a variety of suggestions for how to improve security training to
effectively beat the threat of ransomware and other criminal mischief.
By Bill Siwicki
December 09,
2019 12:19 PM
Ransomware,
in all of its pervasive forms, is associated with the vast majority of
healthcare cyber incidents, and it is often a simple result of inadequate
security training. Because of that inadequate security training, employees are
using and re-using weak or already compromised passwords, clicking links they
shouldn’t be, leaving databases unsecured, not applying security patches, or
storing protected health information on USB drives and losing them.
Of
those mistakes, weak passwords, phishing attacks and a lack of security
patching are most often the root cause of most, if not all, of the ransomware
attacks health IT leaders read about. Healthcare organizations can fix at least
a big part of the problem by implementing employee security awareness training
that is both engaging and consistent.
Easy to digest, and concise
“Any
employee training provided should be easily digestible and to the point,”
advised Kevin Lancaster, general manager of security solutions at Kaseya, a
vendor of IT management software. “I have seen many training videos that were
desperate to be hip and engaging, but wound up coming across as a bad joke.”
-----
Enjoy!
David.
No comments:
Post a Comment