Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, January 18, 2020

Weekly Overseas Health IT Links – 18th January, 2020.

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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Three in ten GPs recommend apps to ease pressure on CAMHS

Three in 10 GPs are advising parents of children with mental health problems to use apps, as NHS services struggle to cope with a growing number of young patients, a survey has found.
Andrea Downey – January 9, 2020
Research conducted by mental health charity stem4 concluded mental health services for young people are “over stretched and underfunded”, with young patients often being rejected for treatment or placed on long wait lists.
In a survey of 994 GPs 31% said they recommend patients use one of the NHS-approved apps to manage poor mental health if they’re rejected by NHS child and adolescent mental health services (CAMHS), or face delayed treatment due to waiting lists.
“In the absence of highly trained therapists in the community, and in view of the consequent long waiting times and patients’ difficulties in accessing effective treatments, 44% GPs say that smart phone apps based on evidence based strategies could play an important role in the treatment and recovery of their young patients,” the survey found.
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From Google to the iPhone: How technology in healthcare has evolved

As we enter a new decade, Haidar Samiei, consultant in emergency medicine and clinical director at EMIS Health, takes us back to New Year’s Eve 1999 to reflect on how technology in healthcare has evolved. 
DHI News Team – January 7, 2020
Who remembers New Year’s Eve 1999?
For most it was a night of partying, for others a period of reflection, and for a few it was a time of uncertainty. We weren’t sure what the new millennium would bring, with crazy stories circulating that the world was going to end. Even if the apocalypse didn’t happen at midnight, the Millennium Bug might strike and we wouldn’t be able to turn on a computer.
As a junior doctor, I was working in A&E that night. I will have been an SHO 1 (FY2 in current terminology). It’s actually difficult to explain the intricate circumstances/interactions that show just how information poor life as a junior doctor was back then.
Not only was Google in its infancy, but the thought of using the internet to inform a decision on how to treat a patient was unthinkable.
We didn’t have an intranet brimming with up to date content either. Any specialist pathway or treatment regime had to be designed, photocopied, laminated, distributed and lord forbid should a pathway change, the whole process restarted.
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Mayo genomic database to use sequencing for 100K participants

January 10, 2020, 12:06 a.m. EST
The Mayo Clinic has teamed with population genomics vendor Helix to build a library of genomic sequencing data on 100,000 volunteers, who will be initially screened for three hereditary conditions.
The collaboration will leverage Helix’s clinical Exome+ sequencing technology, which reads all 20,000 genes that code for proteins, as well as Next Generation Sequencing technology to screen the exome for genetic variants that can significantly increase the risk for disease.
“We believe that whole exome sequencing has the potential to reveal predispositions to health problems and enable earlier use of preventive measures throughout a person’s lifespan,” says Keith Stewart, the Carlson and Nelson Endowed director of the Mayo Clinic Center for Individualized Medicine.
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Shared platform helps hospitals collaborate and better anticipate sepsis

January 10, 2020, 3:39 p.m. EST
More than 20 hospital associations across the nation are collaborating to develop protocols for rapid detection and treatment of sepsis.
Sepsis is among the leading drivers of hospital costs and accounts for more than one-third of hospital deaths, as well as being the most expensive all-payer condition in the nation, according to experts in the field.
The associations are using the event notification and care collaboration platform of software vendor Collective Medical, which is offering the technology at no charge. Among the platform’s services, it offers notifications to providers that identify patients with a history of sepsis so care teams can quickly intervene if necessary.
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Trends to look for in patient engagement in 2020

Healthcare providers will increasingly be seeking innovative technology as they develop new patient engagement and experience strategies to remain competitive.
January 10, 2020 10:00 AM

The recent growth in virtualized patient engagement, such as contacting a doctor through a mobile app, has created unprecedented access to healthcare providers and opened the floodgates for patients to initiate contact.
There is an increasing need for smart AI applications to ensure technology does not become a burden, but a relief, and a support to allow health professionals to do what they do best – deliver care.
In 2020, we'll see care plans and patient engagement become more specific to the individual, says Puneet Maheshwari, co-founder and CEO of DocASAP.
"Today's consumers expect companies to anticipate their needs and tailor their messages accordingly, leading patients to expect the same level of personalization from their healthcare providers," he noted.
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The Sneaky Genius of Facebook's New Preventive Health Tool

The feature looks likely to fill gaps in care—and to further draw users into Facebook’s ecosystem.
In April 2018, Facebook sent the Yale cardiologist and researcher Freddy Abnousi on a strictly confidential assignment to liaise with medical groups across the country on behalf of Building 8, Facebook’s experimental research team. Building 8—which had originally been led by Regina Dugan, the former director of the Defense Advanced Research Projects Agency—worked on long-term, moonshot projects, such as developing devices that would allow people to type with their brain or hear through their skin.
Abnousi’s task was less radical: He was to get the Stanford University School of Medicine and the American College of Cardiology on board with a new project that would combine Facebook user information with hospital-patient data in order to influence patient outcomes. Facebook hoped it could leverage the cache of data users already give it—about their education, relationships, habits, spoken languages, employment status, and more, all of which have an enormous impact on health outcomes—to create a sort of subclinical health-care system, warning providers if, for example, a user recovering from surgery had a small support group.
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Clinician Engagement Key to Cutting Burnout from EHR Use

Primary care practitioners are experiencing clinician burnout and feeling undervalued due to increasing office work and EHR use.

January 09, 2020 - Primary care practitioners (PCPs) are struggling with a sense of low professional fulfillment and a high burnout rate due to high EHR usage and “office” work, according to a study in JAMA Internal Medicine.
Of the 26 PCPs (21 physicians, three nurse practitioners, and two physician assistants) from 15 primary care clinics that participated in the study, researchers found three internal and three external factors that caused burnout.
“Participants described their workloads as excessively heavy, increasingly involving less ‘doctor’ work and more ‘office’ work, and reflecting unreasonable expectations,” wrote the researchers. “They felt demoralized by work conditions, undervalued by local institutions and the health care system, and conflicted in their daily work.”
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Digital health M&A flatlines in 2019, but IPO activity promising

Author Nick Paul Taylor

Published Jan. 8, 2020

Dive Brief:

·         Digital health funding in 2019 suggests more companies will be looking to go public or be acquired in the coming years, according to a report Tuesday from seed fund and research firm Rock Health.
·         The number of acquisitions of digital health companies in 2019 was about 40% below the high seen in 2015, the analysis said.​ But IPO activity surged as six digital health companies listed their shares, ending a three-year wait for a business in the sector to go public. 
·         Funding activity suggests medical device companies interested in making digital health acquisitions will have plenty of options to choose from in the coming years. Investors pumped $7.4 billion into 374 digital health companies last year. Those figures are down slightly on 2018, when 380 companies received $8.2 billion in investment, but are well above levels seen from 2011 to 2017.​

Dive Insight:

Rock Health has tracked investment in its target industry nearly a decade, and the data paint a mixed picture.
M&A remains down on recent highs. In 2015, Rock Health tracked 188 takeovers of digital health companies. By 2019, the figure had fallen to 112, up just one deal over the previous year.
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New Epic EHR software update to target ICU delirium

January 08, 2020, 11:15 p.m. EST
A new software release by Epic Systems planned for next month is intended to help clinicians prevent delirium in intensive care unit patients by using a clinical protocol.
The protocol—called the ICU Liberation Bundle—is the basis for the Epic software update and in February will become a standard part of the vendor’s electronic health record system. In the meantime, it is available to Epic’s customers as an add-on.
E. Wesley Ely, MD, professor of medicine and critical care at Vanderbilt University Medical Center, was the principal investigator for a project sponsored by the Society of Critical Care Medicine to improve patient outcomes in U.S. hospitals by leveraging the ICU Liberation Bundle.
“New support from a major EHR company like Epic means that fewer patients stand to undergo ICU delirium and its harrowing consequences,” says Ely, co-director of VUMC’s Critical Illness, Brain Dysfunction and Survivorship Center. “This Epic Foundation System build allows streamlined implementation and better compliance, which, according to more than 20,000 patients’ worth of data we’ve published, yields less time on the ventilator, shorter ICU stays, reduced costs and improved survival.”
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Startup takes aim at treating mental health online

January 09, 2020, 3:44 p.m. EST
Bloomberg—A new San Francisco startup wants to make accessing mental healthcare almost as simple as ordering a ride to the airport on your phone.
Cerebral, which launched Wednesday, offers an online alternative for people who have been left without good treatment options for mental-health issues. The company is following the example of Silicon Valley-funded upstarts like Hims, Roman Health Medical and Nurx, which have widened access to baldness treatments, contraceptives and erectile-dysfunction drugs through discreet online interaction with doctors.
Even for the insured, mental health coverage in the U.S. can be hard to get. Wait times to see a provider can be months long and, in some places, care can’t be found at all. According to the National Alliance on Mental Health, 60 percent of U.S. counties in 2018 didn’t have a single practicing psychiatrist, and more than half of adults with a mental illness went untreated.
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DoD: EHR at new sites ‘running smooth’ 120 days after rollout

January 08, 2020, 11:05 p.m. EST
The Department of Defense contends that its implementation in September of a new Cerner electronic health record system at four more military medical facilities has gone off without a hitch.
DoD says that 120 days after its rollout of the Cerner EHR system, called MHS GENESIS, it is “running smooth” at one site in Idaho—366th Medical Group at Mountain Home Air Force Base—and three sites in California—David Grant USAF Medical Center at Travis Air Force Base, Naval Health Clinic Lemoore at Naval Air Station Lemoore, and U.S. Army Health Clinic Presidio of Monterey.
MHS GENESIS was first launched in 2017 at military medical facilities in the Pacific Northwest. However, the initial rollout of the Cerner Millennium platform to pilot sites was not without some major challenges.
The system was deemed “neither operationally effective nor operationally suitable,” according to a 2018 report from DoD’s director of operational test and evaluation (DOT&E) that was based on an assessment of three of four pilot sites in Washington state.
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Tech Optimization: Tips for making EHRs work for your staff and enable organizational goals

Five top electronic health record systems experts offer healthcare C-suite executives and IT leaders some valuable best practices for getting the most out of their EHR investments.
January 09, 2020 01:32 PM
A shifting competitive landscape, mergers and acquisitions and divestments are driving the need to implement, configure and reconfigure electronic health record systems faster and with shorter implementation cycles.
This is challenging, but also offers multiple opportunities for EHR optimization, chances to improve they systems for better clinical quality and cost efficiencies.
The term “optimization” in this instance typically is used to describe a variety of different classifications of post go-live improvement. In fact, EHR optimization should have its own strategic course – one that is separate from routine operational activities such as system upgrades, system maintenance and platform hygiene items.
The intent of EHR optimization should be viewed as an ongoing performance improvement program, working to get the most benefit possible for an organization’s EHR investment.
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Digital Health Study: Estonia overtakes Denmark as European eHealth Champion

“Annual European eHealth Survey 2019" from HIMSS, in cooperation with McKinsey, identifies key concerns in the European healthcare Industry

January 09, 2020 04:00 ET | Source: HIMSS
BERLIN, Jan. 09, 2020 (GLOBE NEWSWIRE) -- Cybersecurity, interoperability, and patient empowerment are major concerns in the European healthcare industry, according to the latest “Annual European eHealth Survey 2019" which surveyed over 500 professionals in the field. The study, which was conducted by HIMSS in cooperation with the management consultancy firm McKinsey & Company, also finds that  Estonia has swapped places with Denmark and is now perceived to be the leading eHealth country in Europe; EU citizens, for example, can retrieve medication prescribed electronically by doctors in Finland in Estonian pharmacies. 
Major Trends: Patient health records and telemedicine services
The Annual European eHealth Survey 2019, which has now been published in its 3rd edition, shows that the development of the eHealth industry in Europe is increasingly focusing on "patient empowerment", the ability of patients to not only access and use their own health records, but also to contribute to these records with self-generated data.
Digital patient empowerment requires a more advanced eHealth infrastructure. This seems to be the case in Italy (47%), Netherlands (39%) and the Nordics (34%); these countries are highlighting patient access to information as their key priority. The processing of patient generated data is particularly important to Spain (38%).
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Meet Ballie, Samsung's new AI-powered robot execs call the 'next evolution of wellness'

Jan 7, 2020 10:00am
LAS VEGAS—At the CES 2020 show on Monday, Samsung unveiled a new "personal care robot" that uses artificial intelligence to help seniors connect with smart devices in the home and can serve as a fitness assistant.
During a keynote speech at the conference, Hyun-Suk Kim, Samsung president and CEO, consumer electronics, said the AI-powered robot, called Ballie, represents the future of personalized care. The small, ball-shaped robot has sensors and cameras to patrol your home, keep an eye on your pets and communicate with other smart devices.
"Ballie understands you, supports you, and reacts to your needs to be actively helpful around the house," Kim said.
Samsung executives touted the potential for robotics, AI and wearables to enhance the health and wellness of consumers by focusing on their individual needs. The company is investing in AI capabilities combined with hardware, such as fitness trackers, to provide consumers with customized support for their health.
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A look at the most interesting health tech at CES 2020

Jan 7, 2020 8:22pm
CES 2020 featured digital health products that address aging issues, sleep health, health tracking through clothing sensors and even sex tech. (CES)
LAS VEGAS—Do you want an "intelligent" toilet you can talk to? You can get it—if you're willing to shell out about $10,000 for it. 
Kohler unveiled the Numi 2.0 intelligent toilet at CES 2020, which comes with heated seats and a warm air dryer, ambient lighting, warm water personal cleansing and integration with Amazon Alexa so you can find out the weather while you're taking your "bathroom time."
It was among hundreds of products aimed at health at this showcase of the latest gadgets, robots and home technology that could be coming to the market soon.
There were digital health products that address aging issues, sleep health, underwear wearables and even sex tech from companies like Lora DiCarlo. And there were Lamborghini massage chairs that looked very inviting after several hours of walking the show floor.
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How to Manage Secure Direct Messages, Patient Portal Inboxes

Clinicians are developing workarounds to manage patient portal inboxes as secure direct message guidelines remain elusive for patients.

January 06, 2020 - Secure direct messaging and patient portal communication has been a boon for patient-provider relationships, but have forced many clinicians to develop a web of workflow fail-safes to help them managing busy inboxes, according to a new report published in JAMA Network Open.
The secure direct messaging function, a stalwart on patient portals, has helped patient-provider relationships blossom, giving patients the ability to contact their providers outside the clinic walls. Using patient portal messages, patients can see easier access to care, may get answers to medical questions without having to make the trek to the clinic, and can obtain refills to prescriptions, experts say.
But there have been some observed downsides the technology, according to the report authors, who hailed from the Permanente Medical Group, which includes Kaiser Permanente.
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5 trends that will impact the adoption of artificial intelligence

January 08, 2020, 4:58 a.m. EST
As we enter into 2020 and make predictions on what lies ahead in the New Year, it’s time to look at how artificial intelligence could advance even more rapidly in the next 12 months.
During the past few years, AI garnered a vast amount of global attention and became the most buzzworthy term of the decade as tech’s next biggest thing. However, too much speculation led some to believe AI might not live up to its hype, and the workforce is eager to start seeing its potential and tangible results.
This past year saw a move toward more practical applications in response to this concern. We saw AI become tangible to the enterprise, providing an efficient and scalable method to gain value from information. AI applications started to more closely reflect its potential by more readily integrating capabilities and features that had a real impact on work across industry verticals.
However, the future will bring even bigger and more dramatic changes. Here are some anticipated AI trends we’ll likely see transpire in 2020.
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Burning for interoperability

An interview with Grahame Grieve, FHIR Product Director at HL7 International.
January 06, 2019 03:20 AM
Connected care needs technical standards and interoperability, otherwise there is a risk that it becomes a kafkaesque bureaucratic nightmare. This is especially true when the patient enters the connected care equation, and here is where the HL7 standard FHIR comes in. Healthcare IT News sister publication HIMSS Insights has talked to Grahame Grieve, the person who knows FHIR better than anyone else because he invented it, about a standard that might turn healthcare IT upside down.
Q: We are rapidly entering a new era in healthcare, with complex care networks and connected care scenarios that reach as far as the patients’ homes. What type of standards do we need for that?
Grieve: It is in fact a range of standards. We need basic IT standards that allow you to exchange information about patients, their schedules, and their drugs. This is where FHIR fits in. On top of that, we need a level of agreements about who has got access, about how access is administered and about security. We also need to make an agreement about how core clinical concepts that we have never formalised before are going to be formalised; we need agreements from the clinical parties, and also from the patients, about who has got what obligations in the system. And finally, we need to reach out to the payer and standardise the relevant processes on this side. The difficulty is that a lot of what I have just described is actually about having costs upfront to minimise overall costs in the end. 
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FDA real-world evidence to be made available on Google Cloud

The company is making the agency's open-source MyStudies platform available, enabling for easier access to data for research into new medications, devices and more.
January 08, 2020 02:48 PM
Google announced this week that it will make the U.S. Food & Drug Administration's open-source MyStudies platform available on the Google Cloud Platform.
WHY IT MATTERS
The goal, said Jameson Rogers, product manager at Google Cloud Healthcare & Life Sciences, is "stimulate an open ecosystem that will improve the ability of organizations to perform research that leads to better patient outcomes.
FDA's ongoing prioritization of real-world evidence means that "drug and device organizations are increasingly looking to incorporate patient-generated data into regulatory submissions for new products and treatment indications," as Rogers explained in a blog post.
To help researchers manage and submit that vast and disparate data, in a secure and compliant manner, FDA developed the open-source MyStudies – a platform aimed at helping drug, biologic and device organizations with the collecting and reporting of real-world data for regulatory submissions.
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Consumer Adoption of Health Tech Slowed by Privacy, Security Concerns

Kantar researchers showed that more than half of US consumers say privacy and security concerns, like data breaches, deter them from using health tech like wearable devices and telemedicine.

January 07, 2020 - While more than half of American consumers believe that technology can shed light on their healthcare and foster strong relationships with their providers, privacy and security concerns have a direct impact on their willingness to use health technology, according to a recent Kantar study.
The results are concerning given that reports show health tech use can improve patient outcomes. For example, a recent Plos One report showed the use of patient portals cut emergency department visits, while driving more judicious healthcare utilization.
“Patient portal tools that improve patient access to their own health information, support self-management, and help patients communicate asynchronously with providers offer an additional mechanism for delivering high-quality guideline-recommended care that can improve patient health,” according to the report.
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Data privacy concerns hamper adoption, use of personal medical devices

While Americans think consumer tech is driving more connected relationships with their providers, they also see voice technology and AI with a skeptical eye.
January 08, 2020 11:04 AM
Despite the push towards healthcare digitalization and the rise of personal medical devices, just 38 percent of Americans believe proper safeguards are in place to protect their personal health data, according to recent survey of more than 1,000 American adults.
In addition, more than 60 percent of survey respondents pointed to privacy-related issues, such as data breaches, as having deterred them from using telemedicine or wearable fitness trackers, according to the survey, from market research firm Kantar.
More than a quarter of respondents to the poll said they didn’t even know whether proper data safeguards were in place, and 36 percent said they don’t believe those safeguards are in place.
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Stay Compliant After the Windows Deadline

January 8, 2020
What will your executives, board, and the public think if you report a breach that could have been prevented? If you have Windows 7 and Windows Server 2008 systems, doing nothing isn’t an option.
After January 14, 2020, Windows 7 and Server 2008 will no longer receive critical security patches and updates from Microsoft. That means systems running those operating systems will be vulnerable to newly-identified risks that will not be fixed with patches, and continued use will be non-compliant with HIPAA and other regulations. Other unsupported software, such as Microsoft SQL Server 2008, which was retired in July 2019, also presents security and compliance risks.
Fortunately, Microsoft has a way to buy extended support instead of replacing everything by the looming deadline.
For the next 3 years, Microsoft will sell Extended Support Updates (ESU) so you can still get critical security patches and updates for Windows7. For SQL Server and Server 2008, you must have Software Assurance licensing. Only Microsoft Cloud Service Providers (CSP) can sell the Extended Support Updates. Prices range from $ 25 – $ 200 per system, which will increase each year until the ESU program ends in 2023.
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Cleveland Clinic Creates Chief Research Information Officer Role to 'Drive Innovation'

By Mandy Roth  |   January 08, 2020

Lara Jehi, MD, appointed to position from within the system to create a 'bridge between research and patient data with clinical care.'

In recognition of the emerging value of healthcare data to drive innovation, Cleveland Clinic has created the executive position of chief research information officer and appointed an expert from within its ranks to fill the role.
As chief research information officer, Lara Jehi, MD, will establish and oversee Cleveland Clinic's research informatics environment to advance biomedical research, according to the organization. Her role involves working closely with information technology, research, finance, and other departments to optimize the enterprise’s digital infrastructure to support research activities and accelerate new patient treatments.
“As healthcare has become vastly more data-intensive, the chief research information officer role will bridge research and patient data with clinical care,” says James Young, MD, Cleveland Clinic’s chief academic officer in a news release. “Dr. Jehi’s expertise as both a data-based researcher and physician will provide strategic vision to leverage large clinical informatics systems to drive innovation.”
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A Nuts-and-Bolts Guide to AI

By Alexandra Wilson Pecci  |   January 08, 2020

At a recent HealthLeaders Exchange, Revenue Cycle leaders asked what exactly is AI, how it works, and how it can be used in the revenue cycle. We have answers.


KEY TAKEAWAYS

·         AI-powered software learns over time, identifying patterns and solving problems by mimicking human cognitions.
·         Robotic process automation software tools automate human tasks that are rule-based and repetitive.
·         AI revenue cycle applications include predicting claim denials, following up on submitted claims, and customizing patient financial encounters.
AI is touted as the latest, greatest advancement in healthcare. But revenue cycle leaders are more than a little skeptical of AI. They're also frustrated, annoyed, and cynical.
"Meaningless," "scary," and "shiny object" are just a few of the ways revenue cycle executives described AI at the recent HealthLeaders Revenue Cycle Exchange last month.
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Tackling transformative change: Investing in data, talent and technology

January 07, 2020, 3:30 a.m. EST
While it’s true that artificial intelligence and machine learning are not new concepts, the accumulation of huge stockpiles of data, coupled with rapid advances in distributed computing technology now widely accessible on cloud platforms at modest cost, have raised the field’s profile and rendered it a persistent, top-of-mind object of concern for senior financial executives.
The good news is that in the midst of relentless media attention concerning AI and machine learning, the “natural laws” of analytics remain intact.
In an era of accelerated progress and instability, how are best-in-class organizations positioning themselves to reap the benefits? The answer: They are shrewdly investing in three particular areas without losing sight of the fundamental, natural laws, as reinforced by the Aite Group’s October 2019 study, entitled Current State Assessment: Global Analytics Ecosystem, which focuses on the needs of the financial services industry.
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Adventures in Discharge (Mis)management

January 7, 2020
The following story concerns a small slip in discharge planning — really, a tiny issue in the grand scheme of things. But since I’m the patient affected by the slip, you won’t be surprised to learn that it feels pretty important to me. Also, given the extent to which niggling IT issues played a role, perhaps there’s something to learn here for readers of this site.
The incident took place after a recent hospitalization at Johns Hopkins Bayview, a sister facility to the Johns Hopkins mothership in central Baltimore. I generally don’t name the hospitals involved when I write about bad experiences, but in this case, the hospital involved is well, branded “Hopkins,” and I hold a facility with its reputation to a higher standard.
During the last week of December 2019, I was an inpatient at Bayview for just under a week to address a flare-up of a chronic illness. Nearly everyone I encountered during my stay was prompt, thorough, warm and upbeat.
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John Halamka, MD, Launches Mayo Clinic's 'Digital Data Business'

By Mandy Roth  |   January 07, 2020

The physician and innovator shares his vision as the new president of the Mayo Clinic Platform.

KEY TAKEAWAYS

·         Halamka will help Mayo Clinic expand from an empathetic care business to also a digital data business.
·         The Platform Halamka is developing will create convenience and access for patients, and focus on using technology to deliver in-home care.
·         Machine learning is poised to have one of the greatest impacts on healthcare delivery, says Halamka.
In an industry demanding change, one of healthcare's leading innovators is undergoing a personal transformation to accelerate innovation on a grander scale. On January 1, John Halamka, MD, assumed a new position as president of the Mayo Clinic Platform, which the Rochester, Minnesota, healthcare system says is a coordinated portfolio approach to create new platform ventures to take advantage of emerging technologies such as artificial intelligence, connected healthcare devices, and natural language processing.
Halamka is an emergency room physician and technology expert, who developed his first healthcare application 40 years ago at age 17 and later helped launch a technology startup in the basement of a Palo Alto, California, home. He leaves behind a 20-year career as chief information officer at Beth Israel Deaconess Medical Center, most recently serving as executive director of the Health Technology and Exploration Center for Beth Israel Lahey Health in Boston. He also was the International Healthcare Innovation Professor at Harvard Medical School, has served two U.S. presidential administrations, and consulted with governments around the world, planning their healthcare information technology strategies.
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January 03, 2020 12:36 PM

Hospitals, vendors question FDA's plan to oversee decision-support software

The U.S. Food and Drug Administration's latest plan for overseeing clinical decision-support software leaves too much room for interpretation over what types of software the agency intends to regulate, according to health systems and software vendors.
While stakeholders largely applauded the FDA's vision of a risk-based regulatory approach in theory, a major point of contention involves confusion over the FDA's definition of what software would be included under the FDA's oversight.
FDA released an outline in September for how it plans to regulate clinical decision-support software, or software systems that analyze data to help clinicians and patients make treatment decisions. The draft guidance uses a risk-based approach, with the FDA focusing its oversight based on the risk to patients if software malfunctions.
For categories deemed at low-risk to patients, the FDA won't enforce applicable regulatory requirements. FDA's principal deputy commissioner Dr. Amy Abernethy said that would give developers more room to create and adapt their software.
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AI can reinvent clinical decision support, but obstacles remain

January 06, 2020, 12:03 a.m. EST
While artificial intelligence has the potential to address the epidemic of diagnostic errors in healthcare, the industry must overcome the challenges and limitations of these new digital tools.
That’s the contention of a new book on clinical decision support co-authored by John Halamka, MD, president of the Mayo Clinic Platform, and healthcare writer Paul Cerrato.
“Algorithms that take advantage of machine learning, neural networks and a variety of other types of artificial intelligence (AI) can help address many of the shortcomings of human intelligence,” explain Halamka and Cerrato, who make the point that the complexity of medicine now exceeds the capacity of the human mind.
The book’s authors contend that such complexity “requires humility for clinicians with years of experience successfully diagnosing patients’ ills to admit that they may be missing as many disorders as they catch.”
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Top trends to expect in cybersecurity and artificial intelligence

January 06, 2020, 3:30 a.m. EST
As a cybersecurity and artificial intelligence innovator, we are often asked about our predictions for the year to come. AI, in all its flavors, is a hot technology and it is being applied in many fascinating and powerful ways. Our focus, of course, is on using deep learning to advance the standards in malware detection (and we see a lot of good happening in that regard) so we bring a unique perspective to these two areas.
And not to brag, but when the question came up last year we provided a modest forecast that turned out to be fairly accurate. Here’s a quick recap:
  • We said that AI would be a key component to the delivery and management of 5G wireless services, which is in-line with what the industry is now saying about its roll-out.
  • Our bet was behind the emergence of AI-as-a-Service. It’s comforting to know that Microsoft CEO Satya Nadella agrees, and sees a $77 billion market by 2025, according to Motley Fool.
  • Last year we predicted the emergence of more sophisticated learning techniques, advancing the capabilities and efficacy of machine learning and deep learning algorithms, and that has been happening.
  • We’ll even take credit for our prediction that AI in all its forms would see greater commercialization and consumerization, even though that one was probably self-evident in hindsight. Development and improvement in products like smart assistants, smartphones, autonomous vehicles, medical devices and more will continue apace now that AI is mainstream.
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Employee snooping causes breach at Chicago Children’s Hospital

January 06, 2020, 3:41 p.m. EST
Patient records at Ann and Robert Lurie Children’s Hospital of Chicago were apparently compromised when an employee accessed records without a valid business reason.
“On November 15, 2019, we discovered that between September 10, 2018, and September 22, 2019, an employee accessed records without a business reason,” the organization is telling affected patients in a breach notification letter.
“We immediately terminated the employee’s access to all patient information and began a thorough investigation. We addressed this issue in accordance with disciplinary policies and the employee no longer works for the hospital,” the letter noted.
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AI and machine learning trends to look toward in 2020

As artificial intelligence and robotic process automation are more widely deployed, they will help rehumanize medicine by allowing doctors to focus less on paperwork and administrative functions, and more on patient care.
January 06, 2020 11:05 AM
Artificial intelligence and machine learning will play an even bigger role in healthcare in 2020 than they did in 2019, helping medical professionals with everything from oncology screenings to note-taking.
On top of actual deployments, increased investment activity is also expected this year, and with deeper deployments of AI and ML technology, a broader base of test cases will be available to collect valuable best practices information.
As AI is implemented more widely in real-world clinical practice, there will be more academic reports on the clinical benefits that have arisen from the real-world use, said Pete Durlach, senior vice president for healthcare strategy and new business development at Nuance.
"With healthy clinical evidence, we'll see AI become more mainstream in various clinical settings, creating a positive feedback loop of more evidence-based research and use in the field," he explained. "Soon, it will be hard to imagine a doctor's visit, or a hospital stay that doesn't incorporate AI in numerous ways."
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Health and Wellness Was Strong at CES 2020 Unveiled

January 6, 2020
I must admit that it’s kind of crazy to look back at the first CES I attended about 15 years ago. I was a techguy that had just started in healthcare. So, I really just wanted to go to CES regardless, but I did keep my eyes open for any sort of technology that could help healthcare. Outside of some new workstations and desktops, the closest I found was a cool ball with a gyroscope inside that might have had some health properties (I still love that ball and think it helps me avoid wrist issues with all the typing I do).
Needless to say, 15 years later CES has seen a digital health explosion. Sure, there are still plenty of TVs, phone cases, and other consumer tech. Plus, other areas have exploded as well like robotics, cars, 3D printing, and virtual reality to name a few, but healthcare has a strong place at CES.
This was particularly evident at CES Unveiled, a media only event where some of the hottest things are “unveiled” before the show. My non scientific take was that about half or more of what was shown at CES Unveiled was health and wellness related.
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During Brain Surgery, This AI Can Diagnose A Tumour In 2 Minutes

Jan 7, 2020, 3:00am
Expert human pathologists typically require around 30 minutes to diagnose brain tumours from tissue samples extracted during surgery. A new artificially intelligent system can do it in less than 150 seconds—and it does so more accurately than its human counterparts.
New research published today in Nature Medicine describes a novel diagnostic technique that leverages the power of artificial intelligence with an advanced optical imaging technique. The system can perform rapid and accurate diagnoses of brain tumours in practically real time, while the patient is still on the operating table. In tests, the AI made diagnoses that were slightly more accurate than those made by human pathologists and in a fraction of the time. Excitingly, the new system could be used in settings where expert neurologists aren’t available, and it holds promise as a technique that could diagnose other forms of cancer as well.
During cancer surgery, it’s not uncommon for surgeons to extract some potentially problematic tissue for lab analysis. These intraoperative biopsies allow for more accurate diagnoses and to help the medical team devise next steps, such as scheduling a subsequent surgery to remove the tumour.
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Health systems should update computer systems in wake of Iran tensions, H-ISAC says

Mackenzie Garrity – January 6, 2020
The Health Information Sharing and Analysis Center is recommending hospitals and health systems update their systems with security patches as tensions between the U.S. and Iran rise, according Politico's Morning eHealth newsletter.
In an email shared with Morning eHealth, the nonprofit warned that there is a "significant risk that Iran will target critical infrastructure though cyberspace." Tensions between the U.S. and Iran flared when a drone strike killed Iranian Gen. Qassem Soleimani.
Although Iran has not targeted healthcare organizations in cyberattacks, the possibility still exists.
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eHealth hit by ransomware attack but personal health data is secure, says CEO

Attack on computer system storing personal health data of Sask. people began Sunday morning

Geoff Leo · CBC News · Posted: Jan 06, 2020 11:53 AM CT | Last Updated: 2 hours ago
The computer system that stores the confidential medical data of Saskatchewan residents was hit by a ransomware attack on the weekend but the CEO of eHealth Saskatchewan says patient data is secure. 
"It certainly looks like someone has found their way to tinker with our system and began encrypting some of our information," said Jim Hornell in a phone interview. 
"They put a lock on it and they say if you want to unlock this again to get back to your information you'll pay us some money," Hornell said, noting that the organization has contacted the RCMP about this attack. 
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NHS gets £40m to cut login times on its IT systems

Switch to single sign-on system at one hospital alone saved 130 staffing hours a day
Sat 4 Jan 2020 18.00 AEDT
The NHS is to receive £40m in funding to try to cut login times on IT systems across the health service – a move the government says could free up thousands of staffing hours a day as the saved seconds add up.
In a typical hospital, staff need to log in to as many as 15 systems when tending to a patient. As well as taking up time, the proliferation of logins requires staff either to remember multiple complex passwords or, more likely, compromise security by reusing the same one on every system.
The health secretary, Matt Hancock, said: “It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. As I visit hospitals and GP practices around the country, I’ve lost count of the amount of times staff complain about this. It’s no good in the 21st century having 20th-century technology at work.
 “This investment is committed to driving forward the most basic frontline technology upgrades, so treatment can be delivered more effectively and we can keep pace with the growing demand on the NHS.”
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AMIA Announces Departure of President and CEO, Douglas B. Fridsma

Friday, January 3, 2020
The American Medical Informatics Association (AMIA) announces the departure of President and CEO Douglas B. Fridsma, MD, PhD, FACP, FACMI, FAMIA, effective January 1, 2020. Fridsma had served in the role since 2014.
“Doug’s leadership as AMIA’s longest serving CEO over the past five years has resulted in significant positive impacts to the association, our members and the profession,” said outgoing AMIA Board Chair, Peter J. Embi, MD, MS, FACP, FACMI, FAMIA, and incoming AMIA Board Chair, Patricia C. Dykes, PhD, RN, FAAN, FACMI, in a joint statement. “As we begin our strategic planning process that will anchor AMIA’s critical role advancing informatics over the next decade, we will build upon the strong foundation that has been expanded under Doug’s leadership. In particular, we look forward to continuing important work across AMIA’s educational offerings, impacts on policy, advancements in applied informatics, and focus on AMIA’s diversity and inclusion initiatives. On behalf of the Board, we extend our appreciation to Doug for his years of service and wish him well in his future endeavors.”
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Calls for NHS 111 helpline probe after claims 'toddlers died from treatable diseases'

The 24-hour NHS111 was accused of failing to identify 'red flag' warnings after coroners received reports of missed chances to save lives by the helpline staff
By Tiffany Lo
  • 03:24, 5 JAN 2020
A NHS helpline has been accused of using inexperienced call handlers which has lead to multiple deaths.
Experts are now calling for an investigation into the nurse-led NHS111 service after at least five toddlers died in potentially avoidable incidents.
Two-year-old Myla Deviren, from Peterborough, died from an intestinal blockage in August 2015, according to the coroner's report.
Mum Natalie, 31, said she spoke to NHS 111 for 40 minutes describing symptoms including a lack of lip colour until a nurse told her Myla had gastroenteritis.
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Enjoy!
David.

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