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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NHS ‘risks repeat of care.data in talks to commercialise medical records’
The NHS risks repeating the failures of the care.data programme if it’s not transparent about meetings to potentially commercialise millions of medical records, a LCHRE lead has said.
Andrea Downey – 19 December, 2019
Professor Joe McDonald, director of the Great North Care Record, said “secretive” meetings with big companies to discuss how to monetarise patient data risked jeopardising patient trust.
Healthcare bosses, including NHS England chairman, Lord David Prior, chief executive Simon Stevens and NHSX chief executive, Matthew Gould, met with big tech and pharmaceutical companies in October to discuss potential uses for patients’ personal records.
Papers from the meeting, seen by Digital Health News, estimate the NHS data of 65 million patients could be valued at up to £10 billion a year.
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Blue Button breach stems from coding issue, data of 10K affected
December 19, 2019, 11:05 p.m. EST
A data breach at the Centers for Medicare and Medicaid Services has affected the protected health information of about 10,000 Medicare beneficiaries and 30 applications.
Early analysis suggests that the leak of information was a result of a series of missed opportunities by CMS and a third-party application partner.
For example, the code that caused the bug that created the breach was put in place on Jan. 11, 2018, and there were no follow-up checks for 11 months. “Based on check-in notes around the change, it appears that a comprehensive review was not completed,” CMS acknowledges. “A more comprehensive review may have identified this coding error.”
Medicare offers Blue Button, a service that enables beneficiaries to access their own claims data via an application. However, Blue Button has been getting an upgrade, and the code in question likely was installed as a result of this.
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Googling your symptoms? Here's how to avoid going down a self-diagnosis rabbit hole
Before you page Dr. Google, read this.
Dec. 20, 2019, 8:31 PM AEDT
By Vivian Manning-Schaffel
Beth Skrzyniarz from Franklin, MA was in the ER when she finally began to come to, having no recollection of calling her brother for help, going to the hospital or having a CAT scan. Luckily, her tests all came up clean, leading the doctors to discharge her concluding she’d had an episode of transient global amnesia (TGA). Though relieved her diagnosis wasn’t serious, the doctors didn’t really explain what caused her episode or what to expect going forward. “So, beginning at 1:30 a.m. the night I was admitted, I started reading online,” Skrzyniarz says, looking for anything and everything she could learn about TGA only to be horrified by some of the comments she found.
She’d also felt some numbness and tingling, which led her toward information about multiple sclerosis (MS) — and some intense anxiety. “I was convinced I might have another episode. I couldn’t sleep because how was I going to live alone, take care of my dogs, work with MS? I was convinced I had to sell my house and give my dogs away. I was terrified to leave my house or drive. What if I panic and don't react in time and cause an accident? The thoughts were endless and it was all I could focus on. When I found the-one-in-a million comment that someone posted, I clung to it as my reality.”
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Social media bots often tweet fake health claims about cannabis, USC study reveals
Researchers analyzed tens of thousands of tweets and found that social bots frequently shared false information about cannabis’s medicinal benefits.
BY Leigh Hopper
December 19, 2019
A USC analysis of tens of thousands of cannabis-related posts on Twitter found that social bots regularly perpetuated bogus health claims on the platform, illustrating how false statements may drown out solid science on social media.
The study appears today in the American Journal of Public Health.
“We’re in a period of time where these misleading messages are pervasive online,” said Jon-Patrick Allem, assistant professor of preventive medicine at the Keck School of Medicine of USC and lead author of the study. “We want the public to be aware of the difference between a demonstrated, scientifically backed piece of health information and claims that are simply made up.”
Posts from social bots suggested that cannabis could help with an array of health problems including cancer, plantar fasciitis and Crohn’s disease, among others.
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Study finds tech issues with ONC-certified EHRs that could cause patient harm
Dec 19, 2019 11:11am
Electronic health records products that have been certified by a federal agency may be causing issues that could lead to patient harm, according to a new analysis published in JAMA.
Among the examples of safety issues identified: an EHR deleted a decimal point from a drug dosage entry so 2.5 milligrams was changed to 25 milligrams.
"That could be a significant overdose, depending on the medication," said Raj Ratwani, Ph.D., an EHR safety researcher and co-author of the research letter published in the Journal of the American Medical Association.
Other issues the researchers flagged include vaccines wrongly coded in the EHR, inaccurate medication codes, and laboratory results failing to import into the EHR properly.
Ratwani, the director of the MedStar Health National Center for Human Factors in Healthcare, led the research team in examining EHR surveillance data collected by The Office of the National Coordinator for Health Information Technology (ONC) between January 2016 and June 2019.
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AI heart failure algorithm receives FDA ‘breakthrough device’ designation
December 19, 2019, 10:57 p.m. EST
An echocardiogram-based algorithm developed by digital health vendor Eko, in collaboration with the Mayo Clinic, has been granted “breakthrough device” designation by the Food and Drug Administration.
The FDA’s Breakthrough Devices Program—a voluntary program—was first authorized in late 2016 to preserve the statutory standards for premarket approval, 510(k) clearance and De Novo marketing authorization, while providing timely access to new solutions for treating or diagnosing disease or condition that have significant advantages over existing treatment or diagnostic alternatives.
The provider-vendor partnership has combined Mayo’s machine-learning algorithm and cardiovascular database—which contains millions of ECGs and healthcare screenings—with Eko’s DUO smart stethoscope and software platform.
The machine learning algorithm, which analyzes 15 seconds of ECG data collected from Eko’s digital stethoscope during a standard physical exam, screens patients for low ejection fraction to determine if there are problems with the heart’s pumping function.
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Threat intelligence analyst documents, assesses 117 healthcare ransomware incidents
For a variety of reasons, ransomware is difficult to comprehensively research, the expert notes. But he offers a look into the problem and has some advice for CISOs, and other security professionals.
By Bill Siwicki
December 20, 2019 01:21 PM
When a business system breaks due to patching malfunctions, they lose money. When a healthcare system breaks, it can put lives at risk. Ransomware attacks against healthcare providers can disrupt patient services, create confusion and force providers to shut down.
Given that these attacks are such a persistent concern, Allan Liska, threat intelligence analyst at Recorded Future, a vendor of a threat intelligence system powered by machine learning, was surprised at the dearth of research into the actual scope of ransomware attacks against healthcare providers.
It turns out that collecting data on these attacks is more complex than it first appears. Because a number of incidents are not reported to HHS, which makes it very hard to determine how exhaustive the catalog of ransomware attacks is.
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Pharmacy IT Has Much In Common with Health IT in Hospitals and Clinics, but More Robots
December 20, 2019
I recently had the opportunity to attend the ASHP conference in Las Vegas. For those not familiar with the ASHP (I wasn’t before I attended), it’s the American Society of Health-System Pharmacists. Like most societies and associations, they hold regular meetings where pharmacists come together to learn the latest in what’s happening in pharmacology and in managing a health system pharmacy. I was also impressed by the number of pharmacy residents that were present at the event and how the conference embraced those residents.
Needless to say, as a techguy that’s covered the health IT industry, I was a bit like a fish out of water. While I’d helped do IT support for a small pharmacy as part of my day job, I was definitely far from an expert on pharmacy IT and related topics. However, I came to discover that even though the area is a bit different, there are a lot of principles that are very much in common between Pharmacy IT and the broader health IT in general.
In many ways, attending the event felt similar to how I felt when I started covering hospital IT. I’d been working in ambulatory healthcare for a while and so when I started learning the hospital side of things, much of it felt familiar, but there were definitely important nuances that were quite different. The same was true as I learned about pharmacy IT at ASHP.
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18 December 2019
Can AI Fix Medical Records?
Digitized patient charts were supposed to revolutionize medical practice. Artificial intelligence could help unlock their potential.
A young man, let’s call him Roger, arrives at the emergency department complaining of belly pain and nausea. A physical exam reveals that the pain is focused in the lower right portion of his abdomen. The doctor worries that it could be appendicitis. But by the time the imaging results come back, Roger is feeling better, and the scan shows that his appendix appears normal. The doctor turns to the computer to prescribe two medications, one for nausea and Tylenol for pain, before discharging him.
This is one of the fictitious scenarios presented to 55 physicians around the country as part of a study to look at the usability of electronic health records (EHRs). To prescribe medications, a doctor has to locate them in the EHR system. At one hospital a simple search for Tylenol brings up a list of more than 80 options. Roger is a 26-year-old man, but the list includes Tylenol for children and infants, as well as Tylenol for menstrual cramps. The doctor tries to winnow the list by typing the desired dose—500 milligrams—into the search window, but now she gets zero hits. So she returns to the main list and finally selects the 68th option—Tylenol Extra Strength (500 mg), the most commonly prescribed dose of Tylenol. What should have been a simple task has taken precious minutes and far more brainpower than it deserved. This is just one example of the countless agonizing frustrations that physicians deal with every day when they use EHRs.
These EHRs—digital versions of the paper charts in which doctors used to record patients’ visits, laboratory results and other important medical information—were supposed to transform the practice of medicine. The Health Information Technology for Economic and Clinical Health (HITECH) Act, passed in 2009, has provided $36 billion in financial incentives to drive hospitals and clinics to transition from paper charts to EHRs. Then president Barack Obama said the shift would “cut waste, eliminate red tape and reduce the need to repeat expensive medical tests.” He added that it would “save lives by reducing the deadly but preventable medical errors that pervade our health care system.”
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NAM: Healthcare must proceed with caution in adopting AI
December 19, 2019, 12:13 a.m. EST
Artificial intelligence has the potential to transform and disrupt healthcare. However, the industry must beware of unintended consequences and not give in to marketing hype and profit motives.
That’s the contention of a new National Academy of Medicine report, the authors of which describe the document as a “sober and balanced” assessment of the accomplishments, possibilities and pitfalls of AI in healthcare.
“While there have been a number of promising examples of AI applications in healthcare, it is imperative to proceed with caution or risk the potential of user disillusionment, another AI winter, or further exacerbation of existing health- and technology-driven disparities,” warn the study’s authors.
“Though there is much upside in the potential for the use of AI in medicine, like all technologies, implementation does not come without certain risks,” they add.
NAM study co-author Eneida Mendonca, MD, vice president for research development at the Regenstrief Institute, contends that AI has the potential to create unintended consequences and, as a result, must be subject to regulation and be ethically implemented.
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HIT Think
Healthcare IT security is only as good as the weakest link
December 19, 2019, 3:27 p.m. EST
Last fall’s breach of the federal Affordable Care Act healthcare signup portal serves as a wakeup call that no data is safe.
The Centers for Medicare and Medicaid Services detected anomalous activity in an enrollment pathway used by agents and brokers, affecting the files of 75,000 individuals.
The security of healthcare IT networks is no stronger than its weakest link, an area of increasing concern for chief information security officers. More healthcare providers, hospital systems, health information exchanges, health plans, accountable care organizations, state Medicaid agencies, and others are requiring vendors and other contracted entities to undergo third party assurance to address the number of data breaches and cyberattacks.
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House passes bill funding HIT-enabled medical research
December 19, 2019, 12:22 a.m. EST
The House of Representatives on Tuesday passed a Fiscal Year 2020 funding bill that includes $41.7 billion for the National Institutes of Health, including several critical health IT-enabled research initiatives.
The FY 2020 appropriation for NIH is an increase of $2.6 billion above the 2019 enacted level and $7.5 billion above the President’s budget request.
The bill supports several major NIH research initiatives that leverage HIT, including $500 million for the Brain Research through Application of Innovative Neurotechnologies (BRAIN) initiative, as well as $500 million for the All of Us research initiative—previously called the Precision Medicine Initiative.
The BRAIN Initiative is a large-scale NIH program to push the boundaries of
neuroscience research and equip scientists with insights from big data necessary for treating a wide variety of brain disorders, such as Alzheimer’s disease, autism, epilepsy and schizophrenia. Funding is being used to create a network of integrated centers, collaborating laboratories and data resources to make molecular, anatomical and functional data about brain cells available to the broader research community.
neuroscience research and equip scientists with insights from big data necessary for treating a wide variety of brain disorders, such as Alzheimer’s disease, autism, epilepsy and schizophrenia. Funding is being used to create a network of integrated centers, collaborating laboratories and data resources to make molecular, anatomical and functional data about brain cells available to the broader research community.
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Data Standards, Governance Will Address Social Determinants of Health
To better address the social determinants of health, HHS should develop industry-wide data standards and improve data governance, a new report says.
By Jessica Kent
December 18, 2019 - Improved data standards, data governance, and infrastructure could help the Department of Health and Human Services (HHS) and other stakeholders better leverage social determinants of health data, according to a recent report from HHS.
The report includes input from the Center for Open Data Enterprise (CODE) and the Office of the Chief Technology Officer (CTO) at HHS. The organizations recently co-hosted a roundtable on how to leverage social determinants of health (SDOH) data, with CODE recommending that HHS develop a SDOH strategy that helps coordinate action among different stakeholders.
“Health-focused organizations across the private sector and civil society are now realizing the potential of SDOH data. Healthcare providers and payers are using the data to better understand and address their patients’ needs. Health management companies are applying the social determinants of health to predict health risks like opioid overdose and target preventive interventions,” CODE wrote.
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Consumers Worry More About Privacy Than Any Other Issue Except Healthcare
- by Richard Whitman , Columnist, December 16, 2019
Wunderman Thompson Data is out with a new study that found privacy and security of personal information and data is the second most worrisome issue to consumers behind healthcare.
Some 58% of 1,500 U.S. respondents indicated they are very concerned about the privacy and security of their personal information and data.
Other key findings from the survey include:
· 85% agree: “It’s difficult to know just what to do to protect your personal information and data these days”
· 82% recognize they should be more diligent in protecting their personal data and information
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Congress Directs ONC to Support National Patient Identifier Efforts
While the appropriations bill left out language to allow the development of a national patient identifier, Congress directs ONC to report on and support patient identification efforts.
December 19, 2019 - An explanatory statement included with the Congressional Appropriations Agreement directs the Office of the National Coordinator to work with private sector initiatives focused on the development of a national strategy to improve patient identification across the healthcare sector.
The appropriations bill left out language that would allow the Department of Health and Human Services to use public funds for the development of a national patient identifier. For the last 20 years, the ban has been included in every appropriations bill, despite language in HIPAA that directs HHS to develop a unique patient identifier.
In June, the House of representatives signaled support to remove the provision and included an amendment that would permanently remove the ban in the its Departments of Labor, Health, and Human Services, and Education, and Related Agencies Act of 2020.
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NHSX reviews staffing needs after five team members leave in one month
The project team responsible for digital urgent and emergency care is down to just four employees.
By Tammy Lovell
December 19, 2019 01:29 AM
A further four members of the digital transformation projects team have left since director of digital development Dr Sam Shah quit in October, NHSX has confirmed.
Other staff members will pick up ongoing work “where appropriate” in the originally nine-strong team, which is responsible for multiple projects, including the development of digital urgent and emergency care and digital eye care, a spokesperson said.
Dr Shah, who quit the role after six months, was also clinical lead supporting the urgent and emergency care programme. He was appointed in April, one month before NHSX officially launched. He had previously held the same role at NHS England.
An NHSX spokesperson told Healthcare It News that it was reviewing staffing needs “with the aim of driving value for money” after the four employees’ contracts ended. They also confirmed that the departures would not affect any ongoing projects.
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A look back at the past decade in UK health informatics
From the rise of CCIOs to networks promoting diversity in the industry, the UK has seen a fair amount of change, writes Health Education England CIO James Freed.
By James Freed
December 19, 2019 01:30 AM
In the last few weeks of 2019 I found myself buying my first pair of reading glasses. My brother tells me that average age for this need is 45, so I’m a couple of years early. Two weeks later and I’m writing this blog, predicting what life will be like for us all next year and beyond. I’m finding this difficult, after all, as I don’t have 20/20 vision (awful joke - I am so sorry).
As we move into the third decade of the noughties, it is the right time to look back and reflect on the changes our industry has made and what the world has in store for our workforce in 2020 and beyond.
I think I will start, as so many of our conversations seem to, with the UK National Programme for IT, also known as the “£12 Billion failed NHS Supercomputer” programme. NPfIT, latterly entitled Connecting for Health, did a great deal of good, but it failed to keep its main promises. Its legacy however, at least for our workforce, is very much still felt. NPfIT centralised IT for the NHS. In so doing it sent out a very strong message: IT is too hard for you to do.
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Tech Optimization: secrets to getting the most from IT consulting engagements
Five health IT consultants with decades of experience offer healthcare C-suite and IT leaders expert advice on how best to work with outside consultants and get the most bang for the buck.
By Bill Siwicki
December 19, 2019 12:30 PM
Healthcare provider organizations often rely on consultants to bring expertise and talent to the table during challenging IT implementations or projects. Consultants can mean a successful implementation, a well-managed project, meeting users’ needs and making budget.
Executives in the C-suite, and especially the CIO in health IT matters, must first know how best to use a consultant. They must know how to optimize their time with a consultant or team of consultants for successful outcomes while keeping the bill down.
In this feature story, part of an 18-part special report on technology optimization, five health IT consultants with long resumes offer provider organization CIOs and other executives and leaders best practices for optimizing health IT consulting engagements.
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10 Years Since HITECH: The Good, the Bad and the Ugly
December 19, 2019
The following is a guest article by John D’Amore, President and Chief Strategy Officer, Diameter Health.
Almost every article on the 10 years since the passage of the HITECH Act mentions the over $35 billion spent to incentivize the implementation of electronic health records. Most go on to conclude either “We failed!” because there are still plenty of barriers to truly sharing health records, or “We succeeded!” because we are now almost 100% digital.
In my view, it’s more like The Good, the Bad and the Ugly.
The Good
EHR adoption. The most important development related to healthcare technology is the digitization of health records. EHRs are foundational for other technology-driven innovations including clinical decision support, electronic prescribing, predictive analytics – and the list goes on. The HITECH Act accelerated the industry’s adoption of EHRs because of the financial incentives for Medicare/Medicaid providers that it contained. Maybe it was brute force, but it worked. Adoption of EHRs jumped from a meager 10-20% in 2008 to over 75% adoption in just six years. Adoption of Certified EHRs today reaches virtually every hospital and over 90% of ambulatory physicians.
No other technology has had faster adoption rates — even the things we can’t imagine life without. Not personal computers (8-75% over 26 years). Not the internet (10-75% over 18 years). Not even our highly addictive smart phones (35-75% over seven years). And consider this: when the HITECH Act was passed in 2009, 84% of households already had a cellphone. So, it was high time for EHRs.
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LifeLabs cyberattack one of 'several wake-up calls' for eHealth security and privacy
CEO says information related to about 15 million customers may have been breached
The data breach of the Canadian laboratory testing company LifeLabs is one of "several wake-up calls" for security and privacy challenges that come with the push for a medical system in which eHealth plays a significant role.
"The medical field for us is one of the worst when it comes to cyber security practices," said David Kennedy, cyber security expert and founder and CEO of TrustedSec, an information security consulting firm.
"What's interesting about the large push for electronic patient health-care information that you put online is that a lot of these organizations are not designed to withstand attacks."
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Identifying Potential Patient Safety Issues From the Federal Electronic Health Record Surveillance Program
Author Affiliations
Full Text
Health care facilities adopting electronic health record (EHR) systems have realized several benefits, but there have also been patient safety risks.1,2 Similar to US Food and Drug Administration postmarket safety surveillance of medical devices, the Department of Health and Human Services’ Office of the National Coordinator (ONC) has the authority to conduct EHR surveillance.3 The ONC’s surveillance investigations seek to determine whether EHR systems, referred to as vendor products, which were certified as meeting specific design, functionality, and security standards set forth by the ONC, still meet those standards when implemented and used. Electronic health record surveillance of vendor products may occur in response to a reported issue (reactive) or can be randomly selected for investigation (randomized).4 Randomized surveillance was formerly required of at least 2% of certified products, although this is no longer mandated.5
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Population health management: The key to value-based care
The Affordable Care Act was passed in 2010 with the goals of controlling healthcare costs and decreasing the number of people without health insurance.
While progress has been made to expand coverage (the percentage of uninsured Americans dropped from 17% in 2003 to 12% in 2018), overall expenditures continue to rise.
In the United States today, healthcare comprises about 17.9% of GDP vs. 17.3% prior to the Affordable Care Act, consistent with what has occurred over the last 50 years. This is a frequent topic of discussion on the 2020 campaign trail and there are many varied proposals.
Exactly what form our healthcare payment system will take is an open question, but a continual increase in the percentage of GDP devoted to healthcare isn’t sustainable. Payers, led by CMS, are continuing to look for ways to control costs and the move from a fee-for-service reimbursement system to one focusing on outcomes, commonly referred to as value-based care, is a key component of that strategy.
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CURE ID crowdsources novel uses of existing drugs
December 16, 2019
The FDA recently announced the launch of CURE ID, an online repository where clinicians can report novel uses of existing drugs for difficult-to-treat infectious diseases. The program was developed in collaboration with the NIH’s National Center for Advancing Translational Sciences.
“I would definitely use this platform,” Infectious Disease News Editorial Board Member Raghavendra Tirupathi, MD, FACP, medical director of Keystone Infectious Diseases/HIV, chair of infection prevention at Summit Health and clinical assistant professor of medicine at Penn State University School of Medicine, told Healio.
According to a news release, users can access CURE ID on a computer, smartphone or other mobile device, allowing them to crowdsource medical information and promote the expansion of novel treatments for neglected diseases. The app records and stores when a drug is used for a new indication, among a new population, in a new dose or in a new combination.
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Hospital execs say they are getting flooded with requests for your health data
Published Wed, Dec 18 20198:27 AM EST
Christina Farr
Key Points
- Hospitals have access to a trove of patient health information.
- Tech companies are pitching them relationships and deals that involve gaining access to that data.
- Some health system execs say they’re overwhelmed by the deluge of requests.
Hospitals, many of which are increasingly in dire financial straits, are weighing a lucrative new opportunity: selling patient health information to tech companies.
Aaron Miri is chief information officer at Dell Medical School and University of Texas Health in Austin, so he gets plenty of tech start-ups approaching him to pitch deals and partnerships. Five years ago, he’d get about one pitch per quarter. But these days, with huge data-driven players like Amazon and Google making incursions into the health space, and venture money flooding into Silicon Valley start-ups aiming to bring machine learning to health care, the cadence is far more frequent.
“It’s all the time,” he said via phone. “Often, once a day or more.”
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Amazon Comprehend Medical Adds Ontology Linking to Help Clinicians Detect Medication and Medical Conditions in Unstructured Clinical Text
by Fred Pennic 12/18/2019
– Amazon Comprehend Medical, Amazon’s HIPAA eligible natural language processing service that uses machine learning to find insights in unstructured texts, announced a new capability of linking information to medical ontologies.
– The new ontology-linking feature will help clinicians to detect medication and medical conditions in unstructured clinical text. Amazon will now support ICD-10-CM and RxNorm ontologies through Comprehend Medical.
Amazon Comprehend, a HIPAA eligible natural language processing service that makes it easy to use machine learning to extract relevant medical information from unstructured text. has announced a new capability of linking the information extracted by Comprehend Medical to medical ontologies. Using Comprehend Medical, you can quickly and accurately gather information, such as medical condition, medication, dosage, strength, and frequency from a variety of sources like doctors’ notes, clinical trial reports, and patient health records. The new ontology-linking feature will help clinicians to detect medication and medical conditions in unstructured clinical text. Amazon will now support ICD-10-CM and RxNorm ontologies through Comprehend Medical.
Understanding the Importance of Ontology
An ontology provides a declarative model of a domain that defines and represents the concepts existing in that domain, their attributes, and the relationships between them. It is typically represented as a knowledge base and made available to applications that need to use or share knowledge. Within health informatics, an ontology is a formal description of a health-related domain.
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Groups contend ‘Cures Act 2.0’ must address HIT challenges
December 18, 2019, 12:12 a.m. EST
As Congress looks to draft follow-up legislation to the 21st Century Cures Act, industry groups want to see lawmakers institute wide-ranging reforms to advance digital health and biomedical research.
Responding to a public request from Reps. Diana DeGette (D-Colo.) and Fred Upton (R-Mich.) for stakeholder input, these associations contend that barriers remain to the widespread and effective use of health information technology—challenges that “Cures 2.0” must address.
The 21st Century Cures Act, signed into law by President Barack Obama in December 2016, was meant to ensure greater patient access to healthcare records—and the sharing of such information—as well as to accelerate the development of medical innovations and breakthroughs.
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NLP tool combs EHRs, predicts onset of dementia
December 18, 2019, 12:00 a.m. EST
Researchers from Massachusetts General Hospital have used natural language processing and electronic health records to identify patients at risk for dementia up to eight years in advance.
“We need to detect dementia as early as possible to have the best opportunity to bend the curve,” says Roy Perlis, MD, director of the MGH Center for Quantitative Health. “With this approach, we are using clinical data that is already in the health record, which doesn’t require anything but a willingness to make use of the data.”
A study, published in Alzheimer's & Dementia, leveraged data on 267,855 patients and utilized NLP to comb through EHRs looking for key clinical terms associated with cognitive symptoms. The method extracts the relevant symptoms from information in the notes recorded by clinicians in patients’ EHRs.
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HIT Think
How edge computing will accelerate the data revolution in healthcare
December 18, 2019, 3:30 p.m. EST
Digitization in healthcare is arriving so fast that it’s hard to keep track. In fact, venture capitalists poured $5.1 billion of funding into digital health companies in the first half of 2019, with the largest sums going to analytics, telemedicine and mobile apps.
Investment priorities have shifted in the second half of 2019 to aspects like digital mental health and data-driven personalization. However, no matter where investment dollars are going, all aspects of digital healthcare have one thing in common—the need for ample processing power.
If digital healthcare is going to fulfill expectations, it must be able to provide instant feedback on massive datasets. Currently, huge files like medical images are sent to the cloud for analysis. Moving the information back and forth creates latency issues—this translates to physicians having to wait longer for pertinent information. If the healthcare industry can’t overcome these issues, digitization will not have the impact that it could potentially have.
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Hong Kong’s Hospital Authority launches HA Go mobile app
Besides integrating several HA apps that are currently in use, the newly developed HA Go has new added features.
By Dean Koh
December 17, 2019 10:36 PM
Hong Kong’s Hospital Authority (HA) announced the launch of its HA Go mobile app last week, which is aimed to improve patients’ experience when using public hospital services and facilitate the management of their own health. Through the use of the app, members of the public can view their scheduled appointments anytime, pay hospital bills without queuing and access their dispensing records, drug information and allergy records.
The app adopts the real-name registration system to safeguard data privacy. After the app is downloaded and personal information is entered, the user is required to activate the account in person at hospitals with the Hong Kong identity card and the 2D barcode issued by HA Go for identity verification.
Activation centers with the HA Go logo has been set up at most public hospitals in Hong Kong. Patients can choose to complete the activation during their next visits to the hospitals for appointments.
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NHS trust goes live with Allscripts Sunrise EPR
Gloucestershire Hospitals NHS Foundation Trust announced back in May that it would be working with Allscripts.
December 18, 2019 06:15 AM
One of the largest NHS trusts in England has gone live with the Allscripts Sunrise EPR, five months after signing a contract with the US health IT giant.
WHAT HAPPENED
Located in the south west, Gloucestershire Hospitals NHS Foundation Trust provides acute services from two hospitals, Gloucestershire Royal and Cheltenham General, in addition to maternity services at Stroud Maternity.
The organisation announced that it would be working with the Chicago-headquartered company in May this year. It initially planned to start the implementation process the following summer, however, the deployment was later moved to an earlier date to help its staff cope with the demand expected by the NHS this winter.
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Better Management of High Utilizers and the Impact on the Overall Costs of Care
December 18, 2019
The following is a guest article by Manjula Julka, MD, MBA, Vice President, Clinical Innovation at PCCI.
For safety-net healthcare systems, helping patients with social needs such as transportation, food or housing, just makes sense from a mission perspective. But when it comes to creating a business case, it gets more complicated.
A recent Kaufman Hall survey of CFOs cited cost reduction, managing changing payment models and improving performance management as the top three challenges for health systems. So, while research may show impacts on costs and utilization from interventions that address social determinants of Health (SDoH), some organizations may not be willing to take the risk of investing in strategies that are outside their scope of service and may not show immediate financial returns. But I would argue that the impact of social determinants of health are everywhere in current health system operations and costs.
“High-utilizers”, individuals who suffer from a multitude of chronic diseases and often complex social/economic challenges, require intensive primary care, and frequently have issues with access, often gain the attention of financial and operational leadership, particularly if the organization has value-based contracts or large uninsured populations. In my experience, to truly manage this population requires addressing the upstream issues that are preventing them from leading and maintaining a healthy life. But with limited resources and time, health systems need to develop a clear strategy by understanding exactly which individuals to treat, and what intervention will best address their healthcare and social needs.
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Partners Announces Five-Year Digital Health Effort
December 18, 2019
Partners HealthCare has announced the start of a five-year digital health initiative, part of a broader set of steps it will take as part of its system-wide strategic plans. The digital health effort comes as the organization prepares to rebrand itself as Mass General Brigham, a name that reflects the renowned hospitals (Massachusetts General and Brigham and Women’s) which founded the system in 1994.
It would’ve been fun to learn more about what the Boston-area giant is planning, but in the release at least, we’re only getting hints of what’s come. They’re tantalizing, though.
According to its announcement, Partners will build on its history in diagnostics, therapeutics, devices and data analytics for use in improving patient care. Its initial self-service programs will include online appointment scheduling, 24/7 video and text-enabled virtual care, online access to medical records, cost estimates for procedures and diagnostic imaging, aggregation of medical records from outside Partners with its existing medical records, wait times for all Partners EDs and urgent care centers and customized patient communication options.
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80% of healthcare pros believe AI is reducing burnout, survey finds
Artificial intelligence may help to inject more humanity back into the medical profession, despite concerns that it may make medicine colder and more sterile.
About 80% of healthcare professionals also believe such technology is helping to reduce burnout, according to a new survey of more than 900 individuals in the U.S. and U.K. The MIT Technology Review poll finds widespread optimism among medical ranks, contrasting concerns from some radiology corners that AI could largely replace the specialty.
“Of any industry, AI could have the most profound benefits on human lives if we can effectively harness it across the healthcare system,” Kieran Murphy, president and CEO of GE Healthcare, which commissioned the survey, said in a statement. “As this research shows, we are already beginning to see its progressive effect – with AI not only fueling efficiencies within health systems, but also truly evolving the healthcare experience for medical professionals and patients.”
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Microsoft: We never encourage a ransomware victim to pay
Microsoft advocates for organizations to take preemptive measures. Says companies should treat cyberattacks "as a matter of when" and not "whether."
Ever since ransomware became a top threat in the mid-2010s, people have been arguing about the proper way of dealing with a ransomware attack and the merits of paying or not paying a ransom demand.
A big point of contention has been "the official advice" that various companies or government agencies give out to victims.
For example, in late 2015, the FBI found itself in the middle of a controversy when one of its agents publicly admitted that the bureau was, in many cases, recommending that victims pay ransom demands.
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Cerner EHR Immunization Tool Cuts Costs and Saves Time for Docs
Boston Children’s Hospital has been able to cut roughly 80 percent of its previous costs since implementing Cerner’s Immunization Forecaster in 2018.
December 16, 2019 - Providers know that childhood vaccinations are a key component of preventive care, but changing recommendations for certain immunization schedules can pose a challenge. Implementing a clinical decision support (CDS) tool into the EHR has helped some organizations address the issue.
Since Boston Children’s Hospital implemented Cerner’s Immunization Forecaster in August 2018, the hospital has saved money and time with the tool that was embedded into the EHR, while also keeping their patients current on vaccinations that are recommended by the Centers for Disease Control and Prevention (CDC).
“There is now less guesswork in determining if and when immunizations are due,” said Brenda Dodson, PharmD, clinical integration architect. “It’s much easier to figure out the next best time for an immunization visit because you get a good view of future appropriate dates.”
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Why Big Tech Companies Won’t Solve Healthcare’s Biggest Challenges
With a combined market cap of more than $2 trillion, technology giants Google and Apple are placing big bets on disrupting the $3.6 trillion healthcare industry.
Earlier in the year, Apple CEO Tim Cook repeated a claim that “there will be a day we look back and say Apple’s greatest contribution to mankind has been in healthcare.” Meanwhile, Google Cloud CEO Thomas Kurian wrote in September that “we can transform healthcare and improve lives.”
Based on their past innovations (and earnings), there are very few things Apple and Google can’t do. One of those things, I predict, will be transforming healthcare.
Three announcements last month suggest that Google and Apple stand to make a lot of money on health-related products and services. But none of their recent acquisitions or consumer plays will make a substantial impact where it matters most: On the quality and cost of U.S. healthcare. Here’s why.
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How data compliance challenges emerge in an as-a-service world
December 17, 2019, 5:01 a.m. EST
Organizations are increasingly coming to rely on software as a service, replacing applications that have previously been hosted on-premises.
In April, for example, Gartner predicted SaaS global revenue would grow 18.5 percent over 2018 to more than $94 billion this year and that, by 2022, it would grow to $143.7 billion. And while there are many benefits to a SaaS approach—lower costs, no on-premises equipment or software to operate, no updates or patches to manage—it does raise significant questions around compliance with GDPR, HIPAA, Sarbanes-Oxley and other regulatory schemas that govern company data.
So, who owns the data? Who has responsibility for compliance? And what questions should customers ask a potential SaaS vendor to determine whether their data will be compliant in their service?
Let’s address data ownership first. When it comes to security (and security is an important part of compliance) SaaS services typically operate on a shared responsibility model. The provider takes responsibility for securing its own infrastructure and environment, while the customer is responsible for ensuring access to the service is locked down.
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Hospital patient portals lack guidance on how to use them
December 17, 2019, 12:26 a.m. EST
Using online portals can give patients access to health information and secure messaging. However, hospitals are not properly preparing patients to take advantage of the platforms.
That’s the result of a new study, conducted by researchers from the Indiana University School of Medicine and Regenstrief Institute, who gathered data from a random sample of 200 acute-care hospitals nationwide.
They found that while 89 percent of hospitals had patient portals and 66 percent of these platforms included secure messaging, 58 percent of the secure messaging portals did not detail how patients were supposed to use them.
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Digital health predictions for 2020 from industry experts
More scrutiny, regulation, open standards: 16 specialists tell us what they expect to see in 2020.
December 17, 2019 05:04 AM
Over the past year, we've seen a number of initiatives that aim to accelerate the use of digital tools and services for healthcare announced in Europe and the Middle East.
Most recently, the Mayo Clinic revealed that it would be working with the Abu Dhabi Health Services Company to bring the latest technologies to Shaikh Shakhbout Medical City.
Meanwhile, the federal parliament in Germany passed in November the Digital Supply Law proposed by health minister Jens Spahn. This means that doctors will be able to prescribe apps to their patients, which can be reimbursed by German statutory health insurance, a step forward for a country that has not been seen as a frontrunner in this race so far.
But these are just a few examples of the work that is being carried out to ensure clinicians no longer have to struggle with outdated technology, and patients have better access to care.
With 2019 drawing to an end, we reached out to 16 experts from Europe and the Middle East to find out what they think the year ahead will bring to the digital health space.
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Augusta Health has saved 282 lives with AI-infused sepsis early warning system
The hospital developed the system that gathers data from the EHR, runs it through artificial intelligence, and delivers real-time warnings to clinicians.
By Bill Siwicki
December 17, 2019 12:01 PM
In Virginia, the statewide mortality rate for sepsis was 13.2% in 2016. Sepsis is the body’s life-threatening response to infection that can lead to tissue damage and organ failure. In the U.S., 1.5 million people develop sepsis each year, and about 17% of those die. Early detection of sepsis is critical to decrease mortality.
THE PROBLEM
Clinical and IT staffs at Augusta Health, an independent, community-owned, not-for-profit hospital in Virginia, knew that studies have shown that though treatments are available in a general hospital setting, they are rarely completed in a timely manner.
“Our nurses are highly trained and are skilled at detecting early symptoms of sepsis based on standard indicators, but they are also very busy,” said Penny Cooper, a data scientist at Augusta Health. “Aware of how many patients our nurses care for and the many tasks nurses juggle at once, leadership formed a sepsis taskforce with the goal of providing staff with the resources to identify symptoms of sepsis sooner.”
PROPOSAL
For sepsis, it’s all about early detection. Mortality from sepsis increases by as much as 8% for every hour that treatment is delayed.
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Don’t Blink: Healthcare Orgs Using AI, Data Analytics To Speed Up Digital Transformation
December 17, 2019
Over the next five years, healthcare and life sciences firms will ramp up their digital transformation efforts, driven at least in part by AI and data analytics tools, according to a recent research report. In fact AI, in particular, should revolutionize the nature of work in one in three health systems within a few years, the researchers say.
According to the report, which was written up in HIT Infrastructure, market research firm IDC predicts that 30% of all business and clinical decisions made by these companies will be informed if not dictated by AI technologies. IDC projects that worldwide spending on AI for diagnosis and treatment will grow at a compound annual growth rate of 24% and should hit $4.9 billion by 2023.
As the article notes, these decisions will be driven by a wide range of steadily richer data sets, including EHR data, lab results, medical images, clinical research and more, with the long-term vision being to develop personalized treatment plans for every patient. (Apparently, IDC didn’t cite wearables and remote monitoring data as specific examples of soon-to-be-leveraged data, but these data sources are very likely to play an increasingly important role as well.)
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Would You Let a Robot Take Care of Your Mother?
Robotic companions are being promoted as an antidote to the burden of longer, lonelier human lives. At stake is the future of what it means to be human.
By Maggie Jackson
Ms. Jackson is the author of “Distracted: Reclaiming Our Focus in a World of Lost Attention.”
· Dec. 13, 2019
After Constance Gemson moved her mother to an assisted living facility, the 92-year-old became more confused, lonely and inarticulate. Two full-time private aides, kind and attentive as they were, couldn’t possibly meet all their patient’s needs for connection.
So on a visit one day, Ms. Gemson brought her mom a new helper: a purring, nuzzling robot cat designed as a companion for older adults. “It’s not a substitute for care,” says Ms. Gemson, whose mother died last June at age 95. “But this was someone my mother could hug and embrace and be accepted by. This became a reliable friend.” When her mom was upset, her family or helpers brought her the cat to stroke and sing to, and she grew calmer. In her last days “what she could give, she gave to the cat,” says Ms. Gemson.
An aging population is fueling the rise of the robot caregiver, as the devices moving into the homes and hearts of the aging and sick offer new forms of friendship and aid. With the global 65-and-over population projected to more than double by 2050 and the ranks of working age people shrinking in many developed countries, care robots are increasingly seen as an antidote to the burden of longer, lonelier human lives.
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Evaluating Improvements and Shortcomings in Clinician Satisfaction With Electronic Health Record Usability
Introduction
With the widespread adoption of electronic health records (EHRs), there is increased focus on addressing the challenges of EHR usability, ie, the extent to which the technology enables users to achieve their goals effectively, efficiently, and satisfactorily.1 Poor usability is associated with clinician job dissatisfaction and burnout and could have patient safety consequences.2-4
The US Department of Health and Human Services Office of the National Coordinator for Health Information Technology established safety-enhanced design certification requirements for EHRs to promote usability. These requirements stipulate that vendors must conduct and report results of formal usability testing, including measuring satisfaction with the EHR system.5 Results are publicly available. While some vendors use a 5-point, ease-of-use rating scale, most vendors use the system usability scale (SUS), which is a validated posttest questionnaire that measures user satisfaction with product usability.6 The questionnaire provides a score (range, 0-100) based on a participant’s rating of 10 statements regarding a product’s usability.6 Higher scores indicate greater satisfaction with usability.6 Based on an analysis of more than 200 studies of various products in various industries, an SUS score of 68 is considered the average benchmark, and an SUS of 80 is considered the above-average benchmark.6 Recognizing the importance of satisfaction with EHR usability to clinician burnout and patient safety, reported product 2015 SUS scores for EHR systems were compared with 2014 SUS scores and with benchmarks to evaluate whether satisfaction is improving.2-4
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IT experts urge stronger oversight of patient data in the 'Wild West' of consumer apps
Dec 16, 2019 4:39pm
A leading organization for chief information officers in healthcare is urging Congress to take action to protect patients' data privacy as proposed federal rules aim to open up medical data to third-party apps.
In a letter sent to Reps. Fred Upton, D-Colorado, and Diana DeGette, D-Colorado on Monday, the College of Healthcare Information Management Executives (CHIME) warned about a proposed interoperability rule does not provide sufficient safeguards to prevent patients' sensitive information from being misused by consumer apps, they said.
The lines between health data and consumer data in the proposal from the Office of the National Coordinator for Health IT (ONC) are too blurred, CHIME said.
"It is imperative that Congress continue its oversight of privacy and security issues that fall outside of the Health Insurance Portability and Accountability Act (HIPAA) regulatory framework," the organization said.
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mHealth Tools Improve Discharge Planning for Patients and Providers
With CMS' new discharge planning rule giving patients more control over their post-acute care options, hospitals are using mHealth to make that process more effective and less costly.
December 13, 2019 - Hospitals and health systems are finding that mHealth tools come in quite handy for meeting the requirements of the government’s new discharge planning policy. And they may also improve outcomes over time.
Issued in September, the Center for Medicare & Medicaid Services’ final rule on planning for post-acute care requires hospitals to fully map out the patient’s transition from hospital to post-acute care site, be it the home (through a home health agency), rehab facility or long-term care facility. That includes taking into account patient preferences, ensuring that patient records are accessible in an electronic format, and providing up-to-date research on the PAC care provider.
In the past, discharge planning included many phone calls, paper forms and research – a process that might take hours, if not days, and possibly delay discharge or result in placement in an inappropriate or sub-standard program. But with mHealth tools, a hospital might be able to call up the information on a laptop, table or smartphone within minutes, share that data with patients and care providers and seal the deal on PAC transfer in less than an hour.
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Virtual reality, robots, interactive apps, other new tech help people with dementia and their caretakers
Virtual reality allows seniors to expand their world
By
Dec. 16, 2019 at 12:30 a.m. GMT+11
Doris Moss has always loved dancing. Now in her 80s and suffering from a form of dementia, it has become more important than ever, as hearing a good beat will spur her to get up and move around.
And so her daughter, Angela Pearson, who lives with her mother in Ellenwood, Ga., and is her primary caretaker, has turned to a new technology for people with Alzheimer’s and other forms of dementia: a touch-screen application known as SimpleC Companion, that can be set to play some of Moss’s favorite music — along with recorded reminders to drink water and take medication — at various points of the day when Pearson is away from the house.
The touch-screen app — classified by the Food and Drug Administration as a “daily activity assist device” — runs about $90 per month to provide reminders, music, videos, and connections to caregivers and doctors. It is one of a growing number of technological interventions that have emerged in recent years to help people with dementia and their caretakers.
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7 ways radiologists can harness imaging informatics to reduce burnout
Technology may have been a key contributor to the growing epidemic of burnout among radiologists, but it could also end up being the cure.
Informatics-based changes to imaging tech, when deployed correctly, could end up reducing time spent away from interpreting, while also decreasing interruptions and fueling connections with other clinicians. Experts from Seton Hall University and Penn’s Perelman School of Medicine recently made their pitch for informatics as a burnout-buster in a new analysis, set to be published in February’s Clinical Imaging.
Addressing this surge of workplace fatigue will require organizational changes, they argue, and not simply yoga sessions or reminding employees to take better care of themselves.
“While technological advances have yielded tremendous upsides, they are not always utilized in ways that best serve radiologists,” wrote Andrew Simon, PhD, a psychology professor at Seton Hall, and colleagues. “We suggest that improvements to the workplace can be found through informatics-based strategies.”
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National hospital data shows patients not accessing EHRs
December 16, 2019, 12:05 a.m. EST
While more than 95 percent of patients discharged from hospitals were able to view, download and transmit their electronic health records, just 10 percent actually used the information, according to national hospital data.
A study published in the journal Health Affairs leveraged nationwide data from 2,410 hospitals and found that patient use of EHRs was disproportionately low across all hospital types—although access rates were highest among system-member, teaching and for-profit hospitals.
“In contrast, access rates were lower for hospitals in the highest quartile for disproportionate share hospital status and for hospitals located in counties with high proportions of residents who were dually eligible for Medicare and Medicaid; use rates were lower for hospitals in counties with a high proportion of residents who were dually eligible, lacked computer or internet access or were Hispanic,” state the study’s authors.
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Looking Back at the Last Decade of Health IT – Healthcare IT Today Podcast Episode 26
December 16, 2019
For the 26th episode of the Healthcare IT Podcast, and we’re taking a look back at the last decade of Health IT. Hard to believe that it’s almost 2020, but as we enter the new decade join us as we look back.
Another decade is almost in the books and so we take a look back at some of the major trends we saw in healthcare IT in 2020. Plus, we dive into the last year and what themes and topics really dominated the industry. We’d love to hear your thoughts and hear what topics you think we should have talked about. Let us know in the comments or on social media.
Here’s a quick rundown of the main topics we’ll discuss in this episode:
- Last Decade
- Government Regulations – Meaningful Use
- Cloud Acceptance
- Cybersecurity Explosion
- Healthcare Consolidation
- Last Year
- Physician Burnout
- Big Tech Entering Healthcare
- Data Blocking & Interoperability
- Legal Cases & Violations
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Information technology as a foundation for growth
By Christopher Cheney | December 16, 2019
Examples of electronic health records promoting growth include using EHRs to manage patient bed utilization.
KEY TAKEAWAYS
· Most healthcare organizations are not leveraging the full potential of their electronic health record systems.
· Novant Health is deploying machine learning and predictive analytics technology that can manage patient flow.
In a recent HealthLeaders survey, 63% of healthcare executives said their organization plans to increase investments in analytics.
Information technology such as electronic health records—particularly as they mature with new capabilities—can support growth strategies at health systems and hospitals as they grapple with business challenges including reduced reimbursement rates.
"I always look at information technology initiatives as a way to enable growth. Basically, these initiatives give you the tools and resources to achieve the outcomes that you need. Electronic health records definitely fit in that category," says Michael Browning, MBA, CFO of OhioHealth in Columbus, Ohio.
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Weekly News Recap
- Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.
- Former Outcome Health EVP Ashik Desai pleads guilty to wire fraud and agrees to cooperate with prosecutors.
- Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.
- Proteus Digital Health’s previously announced restructuring will include eliminating 292 jobs and closing several facilities by January 18.
- The DoJ will look into Google’s $2.1 billion acquisition of Fitbit for possible antitrust violations.
- Partners HealthCare (MA) will spend $100 million on a five-year digital health initiative focused on developing self-service technologies for patients.
- BJC HealthCare (MO) lays off 200 employees as it outsources some IT services to an unnamed managed service provider.
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Enjoy!
David.
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