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"


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

Saturday, February 29, 2020

Weekly Overseas Health IT Links – 29 February, 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.

Dr Google causes concern for Macmillan Cancer Support

Charity Macmillan Cancer Support has said it is concerned patients are turning to the internet for information about the disease, leaving them feeling confused and depressed.
Hanna Crouch February 19, 2020
Research from the charity, based on a YouGov survey of 2,000 people with cancer in the UK, revealed 39% look online for information about their diagnosis, and of these 27% feel anxious, depressed or confused afterwards.
Macmillan attributes the worrying habit of scouring the web to the confusion that comes with a diagnosis,highlighted by the fact that one in three people (34%) recently diagnosed felt overwhelmed by information and the top reasons for googling being to look for more information (75% of those who looked online gave this as a reason) and to find out about their prognosis (56%).

Can AI flag disease outbreaks faster than humans? Not quite

February 21, 2020
BOSTON (AP) — Did an artificial-intelligence system beat human doctors in warning the world of a severe coronavirus outbreak in China?
In a narrow sense, yes. But what the humans lacked in sheer speed, they more than made up in finesse.
Early warnings of disease outbreaks can help people and governments save lives. In the final days of 2019, an AI system in Boston sent out the first global alert about a new viral outbreak in China. But it took human intelligence to recognize the significance of the outbreak and then awaken response from the public health community.
What’s more, the mere mortals produced a similar alert only a half-hour behind the AI systems.

Pew to Develop Roadmap on Biometrics to Enhance Patient Matching

Biometrics has the potential to enhance patient matching, but there are privacy and technological concerns that need to be addressed; Pew will work with RTI International to explore these challenges.
February 21, 2020 - Pew Charitable Trusts and RTI International, a nonprofit research institute, announced a partnership to develop the use of biometric technology to enhance patient matching in healthcare settings.
Biometrics uses unique individual characteristics such as eye scans or fingerprints. For example, the technology is used by manufacturers to unlock smart phones using a fingerprint or an eye scan.
“In focus groups conducted by Pew, patients overwhelmingly cited a preference for using biometrics to improve patient matching rates,” wrote Ben Moscovitch project director health information technology at Pew and Robert Furberg, research health informaticist at RTI.
 “Unlike unique numbers or ID cards, a patient can’t forget or lose track of his or her fingerprints, and a facial scan doesn’t rely on a patient being responsive when wheeled into the emergency department,” the authors continued.

Aided by machine learning, scientists find a novel antibiotic able to kill superbugs in mice

February 20, 2020
For decades, discovering novel antibiotics meant digging through the same patch of dirt. Biologists spent countless hours screening soil-dwelling microbes for properties known to kill harmful bacteria. But as superbugs resistant to existing antibiotics have spread widely, breakthroughs were becoming as rare as new places to dig.
Now, artificial intelligence is giving scientists a reason to dramatically expand their search into databases of molecules that look nothing like existing antibiotics.
A study published Thursday in the journal Cell describes how researchers at the Massachusetts Institute of Technology used machine learning to identify a molecule that appears capable of countering some of the world’s most formidable pathogens.
When tested in mice, the molecule, dubbed halicin, effectively treated the gastrointestinal bug Clostridium difficile (C. diff), a common killer of hospitalized patients, and another type of drug-resistant bacteria that often causes infections in the blood, urinary tract, and lungs.

Final Report Delivers a Strategy to Reduce EHR Burden

Andrew Gettinger, M.D. and Thomas A. Mason, M.D. | February 21, 2020
Today, the U.S. Department of Health and Human Services (HHS) released a comprehensive strategy to reduce the regulatory and administrative burden related to the use of health IT, including EHRs. Reflective of public comment, the Strategy on Reducing Regulatory and Administrative Burdens Relating to the Use of Health IT and EHRs targets burdens tied to regulatory and administrative requirements that HHS can directly impact through the rulemaking process. The report’s strategies, recommendations, and policy shifts aim to give clinicians more time to focus on what matters – caring for their patients. The report is a collaborative effort between ONC and the Centers for Medicare & Medicaid Services (CMS).

The Burdens That Clinicians Face

Physicians and other healthcare providers have long identified regulatory and administrative burdens as a key contributor to the many challenges they face. They also note these burdens weigh down the overall healthcare delivery system as well. Clinicians have pointed to an ever-increasing and poorly coordinated set of requirements they must meet to deliver and receive payment for patient care.
In many cases, fulfilling these requirements takes a substantial amount of time away from actual care delivery, can interfere with the doctor-patient relationship, and can lead to burnout. The clinical community frequently links the increased burden of meeting these requirements with the tasks and use of health IT, such as EHRs.

ONC unveils new plan for combating clinician burnout

Its Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs aims to make changes that allow providers to focus on patients.
February 21, 2020 03:59 PM
With a new report from the U.S. Department of Health and Human Services, drawn up as required by the 21st Century Cures Act, the agency puts forth its plan to help alleviate the burden of documentation and reporting requirements, and boost EHR usability.
The strategic plan, developed by the Office of the National Coordinator for Health IT, with input from the Centers for Medicare & Medicaid Services, offers a series of recommendations to help clinicians focus their attention on patients and not administrative tasks.
The report lists three primary goals:
  • Reduce the effort and time required to record information in EHRs for health care providers when they are seeing patients;
  • Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and health care organizations; and
  • Improve the functionality and intuitiveness (ease of use) of EHRs.
"The strategy we are releasing today takes a hard look at ways that the federal government and stakeholders can work together to reduce the administrative and technological burdens experienced by healthcare providers," said National Coordinator Dr. Don Rucker in a statement. "Patients will benefit from these efforts because their physicians will spend more time focused on them instead of their keyboards."

How AI and machine learning are transforming clinical decision support

At HIMSS20, Mayo Clinic Platform President Dr. John Halamka and medical journalist Paul Cerrato will explore emerging technologies that are reshaping screening, diagnosis and treatment.
February 21, 2020 10:20 AM
"Between 12 to 18 million Americans every year will experience some sort of diagnostic error," said Paul Cerrato, a journalist and researcher.
"So the question is: Why such a huge number? And what can we do better in terms of reinventing the tools so they catch these conditions more effectively?"
Cerrato is co-author, alongside Dr. John Halamka, newly minted president of Mayo Clinic Platform, of the new HIMSS Book Series edition, Reinventing Clinical Decision Support: Data Analytics, Artificial Intelligence, and Diagnostic Reasoning.

HIE Integration Cuts ED Visits, Hospital Readmissions by Over 10%

HIE integration and utilization can decrease emergency department visits and unplanned 30-day patient readmission by 10 to 13 percent.

February 19, 2020 - Medical practices that integrate and utilize health information exchange (HIE) can decrease the number of emergency department (ED) visits and unplanned 30-day hospital readmission, according to a study conducted by HEALTHeLINK in partnership with researchers at University of Connecticut and the Brookings Institution’s Center for Technology Innovation.
Researchers showed employees practices in Western New York between November 2016 and January 2017, how to integrate HIE into their current workflow.
Once integrated and utilized, unplanned hospital readmissions dropped 10.2 percent, while ED visits decreased by 13.3 percent. Patient wait times also decreased by up to 40 minutes.
 “The study demonstrates that HIE can significantly enhance patient care if incorporated into practice workflow,” Niam Yaraghi, the author of the study, said in a statement.

GA Providers Now Capable to Share Patient Lab Results Under HIE

Georgia’s health information exchange (HIE) added a lab results exchange to improve care quality and lower costs for providers.

February 20, 2020 - Georgia Health Information Network (GaHIN), Georgia’s health information exchange (HIE), has released a new service that allows medical providers to securely share patient lab results, aiming to lower provider costs and improve the quality of care.
“We are pleased to expand the scope of GaHIN’s interoperable capabilities, but most importantly, provide access to additional patient laboratory results which is vital in the delivery of the best care possible,” said Pam Matthews, RN, executive operating officer of GaHIN.
“The ability to easily share a copy of test results across providers avoids unnecessary and duplicate tests while reducing overall costs,” Matthews added. “Patient satisfaction of the care process improves especially with the avoidance of non-reimbursable test procedures.”

Patients want a say in AI: 5 ways to help radiology get there

Matt O'Connor | February 18, 2020 | Artificial Intelligence
Radiology has not shied away from offering its viewpoint on artificial intelligence, but there’s been less attention paid to how patients see the technology altering their own imaging care.
That’s according to a trio of researchers from the University of Saskatchewan in Canada, who helped conduct roundtable discussions asking what patients thought about AI in radiology, their concerns related to the tech and how they believe it should evolve.
In total, 17 people participated in the discussions; and many expressed anxieties related to a fear of the unknown, lack of trust, human connection issues and cultural acceptability.
On top of their fears, patients also had a number of priorities they believe AI should address. Those have been summarized and are listed below.
February 20, 2020 / 1:56 AM / a day ago

Speed science: The risks of swiftly spreading coronavirus research

LONDON (Reuters) - One scientific post suggests links between the new coronavirus and AIDS, a second says it may have passed to people via snakes, while a third claims it is a pathogen from outer space.
The emergence in China of a new human coronavirus that is causing an epidemic of flu-like disease has sparked a parallel viral spread: science – ranging from robust to rogue  - is being conducted, posted and shared at an unprecedented rate.
While speedy scientific analysis is highly useful if it’s good, flawed or misleading science can sow panic and may make a disease epidemic worse by prompting false policy moves or encouraging risky behaviour.
A Reuters analysis found that at least 153 studies - including epidemiological papers, genetic analyses and clinical reports - examining every aspect of the disease, now called COVID-19 - have been posted or published since the start of the outbreak. These involved 675 researchers from around the globe.

Not All Command Centers Are Created Equal

By Bob Gettings  |   February 11, 2020

Are you looking for a command center for your hospital, or possibly one for your region?  If so, you need to ensure that the model you choose has the right functionality.

Are you looking for a command center for your hospital, or possibly one for your region?  While you’re probably a bit too late to be considered an early adopter, you’re definitely in the mainstream.  Command centers are showing great potential, positively impacting metrics related to patient transfers, ED holds, quality, patient progression, discharges, etc.  You might also guess, however, that not all command centers are created equal.

Psychiatrists Decry Barriers to Wider Adoption of Telemedicine

By MedPage Today  |   February 20, 2020

Well-intended laws on remote prescribing stand in the way.


·         The panel's core recommendations included eliminating what are known as "originating geographic site requirements" and relaxing restrictions on in-home telehealth visits.
·         Panelists also highlighted difficulties related to remote prescribing and obtaining licensure in other states.
This article was first published on Wednesday, February 19, 2020 in MedPage Today.
By Shannon Firth, Washington Correspondent, MedPage Today
WASHINGTON -- Psychiatrists urged lawmakers to support the expansion of telepsychiatry and to remove barriers to care for patients in remote and underserved areas, during a Capitol Hill briefing on Tuesday sponsored by the American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry.
The panel's core recommendations included eliminating what are known as "originating geographic site requirements" and relaxing restrictions on in-home telehealth visits. Panelists also highlighted difficulties related to remote prescribing and obtaining licensure in other states.

ONC's Don Rucker says Interoperability Ruling is 'Coming Relatively Soon'

By Mandy Roth  |   February 19, 2020

Issues are 'complicated,' and it's necessary to balance the needs of multiple stakeholders.

It's complicated, said National Coordinator Don Rucker, MD, of the Office of the National Coordinator for Health Information Technology (ONC), this morning during a regularly scheduled meeting of the Health IT Advisory Committee, but confirmed, "It's going to be coming out relatively soon."
The proposed rule, which was announced over a year ago and is designed to give patients access to information that resides inside their electronic health records (EHR), is governed by the Administrative Procedures Act, which prohibits anyone from releasing information about when the rule is finalized, said Rucker.

Rucker: HHS wrestling with transparency, privacy balance in interoperability rule

Feb 19, 2020 12:57pm
National Coordinator for Health IT Donald Rucker, M.D., said the use of application programming interfaces will help bring healthcare into the modern app economy. (Getty/BrianAJackson)
As the industry waits for a landmark rule aimed at opening up access to patient data, Donald Rucker, M.D. said Wednesday that regulators are challenged with balancing data privacy and transparency.
The proposed interoperability rule will be coming out "relatively soon," Rucker, who is head of the Office of the National Coordinator for Health IT (ONC), said during a Health IT Advisory Committee meeting Wednesday.
Many have speculated that the rule will be released during the Healthcare Information and Management Systems Society conference in March.

Would you tell secrets to Alexa or Siri? How AI therapists could save you time and money on mental health care

Published: Feb 19, 2020 12:27 p.m. ET

People reveal more personal and intimate details to human-like apps and bots that can ‘sense’ emotions and concerns

Asst. commentary editor
“Alexa, I’m depressed.” The idea that a tabletop virtual assistant such as Alexa or Siri knows or cares how you’re feeling sounds straight out of some neurotic comedy. Today, at least.
Mental health is a brave new frontier for artificial-intelligence and machine-learning algorithms driven by “big data.” Before long, if some forward-looking psychologists, doctors and venture-capital investors have their way, your therapist could be a virtual human able to listen, counsel and even bill for that 50-minute hour.
“AI will be a game-changer,” says James Lake, a California psychiatrist and author of a series of self-help e-books showing individuals how to integrate a broad-based plan for their mental health. AI tools, he adds, will allow mental-health providers to “optimize patient care on the basis of each individual’s unique history, symptoms, needs, financial constraints and preferences.”
What if you need an anti-depressant or another psychiatric medication? AI can help a psychiatrist pinpoint the exact drug or drug class that your body will respond to, shortening or even eliminating the trial and error — and its side-effects — that frustrates both patients and doctors. Algorithms also can tell, based on someone’s age, gender, responses to questions and other factors, if that person is about to attempt suicide; Facebook FB, -0.14%, for example, uses an algorithm that flags a post if it contains words that suggest suicidal thoughts or self-harm.
February 18, 2020

Lifestyle Intervention via Smartphone App Effective for Pregnant Women With Obesity

A continuous behavioral lifestyle intervention supported by a smartphone app can assist in improving dietary intake and physical activity among pregnant women with overweight and obesity, according to study results published in Frontiers in Endocrinology.
Previous studies have reported that approximately 20% of all women meet the recommendations for physical activity during pregnancy, and despite positive results, many potential behavioral lifestyle interventions aimed at this population would be too expensive or burdensome to incorporate into routine practice. Mobile-health technologies, including smartphone apps, may assist in these efforts, but limited data are available.
The goal of the current study was to assess the impact of the Pregnancy Exercise and Nutrition Research Study (PEARS) behavioral lifestyle intervention, supported by a smartphone app, on diet, physical activity, and motivation to engage in exercise among pregnant women with overweight or obesity.

Leveraging the value of data

Priit Tohver, advisor for e-Services innovation at the Ministry of Social Affairs in Estonia, speaks to Healthcare IT News ahead of HIMSS20.
February 19, 2020 06:51 AM
Dr Priit Tohver is on a mission to make health data more usable.
The man overseeing the digital transformation and innovation of health and welfare systems in Estonia, became inspired as a medical student when he tried to use electronic health records (EHRs) for a study on ocular melanoma.
“That showed me how unsuitable the current health data is for any kind of analytics,” he explains. “To this day it drives me to make the health data we gather more structured and useful, not only to researchers and innovators but to physicians themselves, so that it can feed back into the healthcare system and we can learn as we go.”
At the HIMSS20 conference, Tohver will talk about a subject close to his heart – social determinants of health.
Since 2018, the Ministry of Social Affairs has been undertaking a project to identify disadvantaged youths aged 16-26 that are at danger of falling through the cracks of society.

Providers struggling to give patients useful digital tools

Just four in 10 providers say digital technology is being successfully integrated into the overall patient experience, a UPMC survey shows, and when it is, it's mostly basic functionality.
February 19, 2020 10:58 AM
Despite patients' high hopes for digital health technologies, the tools they're being offered aren't often keeping pace with those expectations – even as health systems continue to prioritize patient engagement and experience.
These were among the findings of a survey of more than 100 health system professionals by UPMC's Center for Connected Medicine, which also found only a third of respondents believe their organization is providing a top-quality consumer experience with the digital health tools they provide.
The report findings also suggest traditional organizations may be left behind by others who have created a stronger digital experience, with fewer than one in three respondents believing their organization is providing a best-in-class digital experience for patients.
Just four in 10 respondents reported digital tools being successfully integrated into the overall patient experience, and those that are offer mostly basic functions.

Anthem Testing Blockchain Tech As Backbone Of Patient Health Data Access Controls

February 19, 2020
While there’s been a lot of talk about the use of blockchain technology in healthcare, there haven’t been as many concrete options deployed as one might think. However, efforts underway at health insurance giant Anthem seem likely to bear fruit.
According to an item in FierceHealthcare, the giant health insurer has big plans for blockchain, including technology which would allow patients easier and finer-grained control of who can access and share their personal health data.
As Anthem senior vice president and chief digital officer Rajeev Ronanki told FH, currently it’s difficult to track who has rights to what information. Meanwhile, creating a trusted information-sharing system putting the consumer at the center has been problematic.
To date, there have been few high-profile deployments of blockchain tech dedicated to helping patients manage their health data. In recent times, we’ve reported on efforts like the one at UC San Francisco, where researchers have created a blockchain-based model for sharing clinical trial data, and late this year, shared the story of how Intermountain Healthcare was leveraging a mix of blockchain technology and AI to find waste in its hospitals.

What’s A Virtual Reality Telehealth Clinic? This Company Says It’s Built One

February 19, 2020
I’ve written about telehealth for more than a decade. I’m familiar with VR and most of its cousins as well. And most everyone knows what a clinic is. But until today, I’d never heard of a vendor mashing up telehealth and VR and calling it a clinic.
A few months ago, I wrote up a study concluding that the healthcare virtual reality market would hit $30 billion within six years. This sounded like a very large number to attach to such a nascent market, but perhaps I was wrong.
One precursor of this growth streak comes from a company known as XRHealth, which says that it has created a virtual reality telehealth clinic whose services it says are covered by Medicare and most major insurance providers. It also reports being certified in eight states along with the District of Columbia. The clinic, which will open for business on March first, is currently accepting consumer applications to be treated by clinicians using the platform.
XRHealth says that it’s using virtual reality to make treatment a “fun activity,” something most of us would agree isn’t characteristic of visiting a brick-and-mortar medical office. The new clinic uses unspecified “therapeutic” software — most likely proprietary software from what I see here — and combines it with VR technology to deliver care.

Special Report: Epic Uproar Exposes Conflict Between Data Privacy and Innovation

By Mandy Roth  |   February 11, 2020

Many healthcare leaders agree that Epic has valid concerns about open APIs, but some question whether the company has underlying motivations for delaying ONC's proposed patient data-sharing ruling.


·         Industry experts agree that open APIs could compromise patient privacy if protections aren't in place to guide third-party developers.
·         While there are risks, many healthcare leaders feel that patient access to their data is paramount to move to a digitally based healthcare system.
·         Healthcare and consumer protections differ; some advocate that government agencies should marshal a coordinated approach to safeguard health data in the consumer sector.
·         Some question whether Epic has underlying motivations to protect its business model.
It's been exactly a year since the U.S. Department of Health & Human Services (HHS) released two proposed interoperability rulings, designed to give patients access to information that resides inside their electronic health records (EHR) and take advantage of new tools that could expand their care and treatment options.

Are ICU Patients' End-of-Life Plans Being Ignored?

— Study: More than a third who asked for limited treatment still got intensive care

ORLANDO -- Among patients with chronic illnesses nearing the end of life who had physician orders to limit treatment, more than one in three received ICU care that appeared inconsistent with their written wishes, a researcher reported here.
In the retrospective cohort study, 18% patients hospitalized within 6 months of death whose Physician Orders for Life-Sustaining Treatment (POLST) requested "limited additional interventions" or "comfort measures only" received POLST-discordant life-sustaining treatments, according to Robert Y. Lee, MD, of the University of Washington in Seattle.
And 38% of patients with POLST received intensive care that was potentially discordant with their stated wishes, Lee reported at the Society of Critical Care Medicine (SCCM) congress, and simultaneously in JAMA.

Patients Reticent to Share Health Data with Tech Companies

Patients aren't willing to share their health data with tech corporations, unless they can get $100,000 for it.

February 18, 2020 - Nearly all patients are unwilling to share their health data with large technology companies for free, with most saying they’d demand upwards of $100,000 for their coveted health records, according to data from the University of Chicago Booth School of Business and Northwestern University’s Kellogg School of Business.
This finding comes as the healthcare industry grapples with big tech companies and their emergence in the healthcare sector. The likes of Google, Amazon, and Facebook have all announced their own forays into healthcare technology, and questions have arisen about how these companies have developed their tools.
“Algorithms without data are useless; therefore, corporations need to have access to medical records,” writers from the Booth School of Business’s blog, ProMarket, wrote in a new post.
The blog specifically tackles the question of whether patients are willing to share their medical data for the sake of large technology corporations developing new healthcare tools. The answer, the post authors said, is an overwhelming, “no.”

Without oversight, electronic prescribing can harm patients

By Jason N. Doctor and Liisa T. Laine
February 18, 2020
The use of electronic health record systems in doctors’ offices and hospitals has hit a major speed bump, and rightly so, with the federal government winning a $145 million civil and criminal settlement against Practice Fusion, a San Francisco-based electronic health record company. The company admitted to taking payments from a major drug company in exchange for dropdown menus that persuaded doctors to prescribe opioid medications to their patients.
Practice Fusion estimated internally that the drug company — reported by Reuters and STAT to be Purdue Pharma — could gain nearly 3,000 new customers and increase opioid sales to the tune of $11.3 million by implementing the change.
The power of the alert was greater than anticipated. Between 2016 and 2017, more than 700,000 unique “pain care plans” were started because of the alert, and 20% to 33% of them involved opioids. More than 140,000 patients were prescribed opioids following an alert.

HealtheLink study shows savings of time, money

By Tracey Drury  – Reporter, Buffalo Business First
18 February, 2020
When hospitals and health care providers began sharing health information on patients, the main goal was to cut down on unnecessary or duplicative testing and make sure caregivers had a fuller picture of their patients’ health.
A new study shows local efforts are doing just that: Saving both patients and the health care community time and money.
The study, conducted by HealtheLink in conjunction with the University of Connecticut and the Brookings Institution’s Center for Technology Innovation, analyzed whether the integration of health information exchange services had an impact on emergency department visits and unplanned readmissions after 30 days for patients who were treated at a practice.
Practices that were trained on how best to use the technology and integrate it into their workflow saw a reduction by 10.2 percent of unplanned hospital readmissions; while the rate of ED visits fell by 13.3 percent. Results were published in the January edition of Information Systems Frontiers, a journal that examines new research and development in IT and information systems.

Machine learning and clinical insights: building the best model

AI is helping clinicians better predict and treat conditions such as surgical hypotension, and at HIMSS20 experts will show how more sophisticated future models could have even broader healthcare applications.
February 18, 2020 10:53 AM
At HIMSS20 next month, two machine learning experts will show how machine learning algorithms are evolving to handle complex physiological data and drive more detailed clinical insights.
During surgery and other critical care procedures, continuous monitoring of blood pressure to detect and avoid the onset of arterial hypotension is crucial. New machine learning technology developed by Edwards Lifesciences has proven to be an effective means of doing this.
In the prodromal stage of hemodynamic instability, which is characterized by subtle, complex changes in different physiologic variables unique dynamic arterial waveform "signatures" are formed, which require machine learning and complex feature extraction techniques to be utilized.

Dutch minister pledges €75 million to make medical data available to patients online

Bruno Bruins to present a bill requiring hospitals and clinics in the Netherlands to enable digital data exchange.
February 18, 2020 11:04 AM
Hospital patients in the Netherlands will soon be able to view and share medical data about themselves online, following a bill to be presented later this year.
Under the initiative announced by Dutch minister for medical care Bruno Bruins, hospitals and health clinics will receive €75 million to help meet the new legal obligation to make medical data available.
The bill will also require hospitals and clinics to digitally exchange data with each other.
Under the plans, hospitals and other medical specialist care organisations sharing data will be required meet the safety requirements of MedMij, the Dutch technical framework for personal health environments.

Patient Matching Errors Continue To Be Common

February 18, 2020
Patient matching problems are persistent across healthcare organizations and continue to pose patient safety risks, according to a new survey addressing these issues.
The survey, which was conducted by the eHealth Initiative and commissioned by NextGate, included 118 respondents, roughly two-thirds of which were providers. Just over one-third were C-Suite executives, 31% were upper or middle managers, 26% were directors and 7% fell into an “other” category.
According to the survey report, roughly 38% of U.S. healthcare providers have incurred an adverse event in the last two years resulting from patient matching issues.
It’s not that healthcare leaders aren’t aware of this problem. In fact, the bulk of HIEs and providers responding to the survey said that they’d dedicated employees to resolve problems with potential duplicates and mismatches. The records they flag are often addressed on either a daily or weekly basis.

3 Ways to Tame Chronic Disease With Technology

By Mandy Roth  |   February 18, 2020

How health systems are using apps, at-home monitoring, and virtual care to bring chronic disease management into control.  


·         Advancements in technology are enabling health systems to change their approach to chronic disease management, lowering costs and improving patient outcomes.
·         Providers who are exploring new technology solutions and approaches to care could gain a competitive edge in the future, says one CDC director.
This article appears in the January/February 2020 edition of HealthLeaders magazine. We invite you to also read a companion article, Reimbursement: The Key to ROI.
In the quest to lower healthcare costs and simultaneously improve patient outcomes, healthcare organizations are turning to high-tech initiatives to monitor, treat, and control chronic disease.
Today's marketplace is flooded with wearable and biometric devices that allow individuals to measure vital signs, blood glucose levels, and more from the convenience of their home.
However, the challenge for health systems and hospitals is collecting and analyzing that data in real time so care teams can intervene before problems escalate and result in office or emergency department visits, hospitalizations, or readmissions. Some healthcare organizations are leading the way by using technology to develop new models of chronic disease management. That could mean breaking into territory where healthcare doesn't typically operate, amping up resources, or investing in innovations that can scale across an enterprise.

Coronavirus outbreak used by hackers to spread malware

One sophisticated attack method takes advantage of the trusted World Health Organization name to distribute an attachment that will install the AgentTesla Keylogger.
February 17, 2020 11:10 AM
Malicious actors are using the outbreak of the Wuhan novel coronavirus, or 2019-nCoV, as an opportunity to launch emailed-based cyber attacks, according to security specialist Proofpoint.
The company uncovered a continuing expansion of cyber attacks themed around the Coronavirus, including a new campaign promoting conspiracy theory-based fears around "unreleased cures," and dupes multiple users into accepting malware by abusing perceived legitimate sources of health information.
While the attacks initially targeted people in the United States and Japan, Proofpoint noted recent examples are targeted at Australia and Italy, where Italian-language lures are being used.

The emerging digital landscape of the 2020s

What are the issues that will make up the agenda over the next few years?
February 17, 2020 11:39 AM
Health and care are going through a very accelerated phase of change. There are various drivers causing these changes and these are starting to demonstrably exert their influence as well as start to act synergistically. Among these changes:
  1. Aging and accompanying multimorbidity, both of which drive increases in activity in existing health and care systems as they strive to manage noncommunicable diseases. This increase in activity puts further financial pressures on these systems which are already “over- trading” and further encourages the adoption of value-based solutions where prevention of disease becomes at least as important as treatment of existing conditions.
  2. The explosion of availability of data and the deployment of processes that allow for interoperability. This drives the potential to develop more customized treatment plans for people. This availability of data is likely to be further enhanced once 5G networks are employed and the internet of things enabled.
  3. The availability of genomic information around individuals which is becoming more commonplace and enables people to better assess their likelihood of developing disease and thus better target their efforts towards risk mitigation in situations where we understand the pathophysiology of disease and the behaviors we need to adopt to lessen the likelihood of developing these. 
  4. The potential for us to be able to measure the epigenetic biomarkers that act as “switches” amplifying or turning off the effect of our genes and the increasing affordability of access to these biomarkers. At present these are mainly concentrated around the cardiovascular space, but no doubt the range will widen as science advances. Also the fact that the cardiovascular contribution to cardio-metabolic disorders is now understood to have an even more ubiquitous role is an added factor to take into consideration
  5. The increased understanding around the role of behavioural sciences in the management of risk reduction of noncommunicable disease and the increased ability to access this data on a personalized basis.

How training investments can boost EHR satisfaction

How one health system’s investment in provider satisfaction measurement tools improved communication between providers and patients and helped combat clinician burnout.
February 17, 2020 10:27 AM
As part of the merger of five independent orthopedic practices to form Virginia’s largest provider of orthopedic and therapy care, OrthoVirginia, a large investment was made implementing a new electronic health record system.
A survey gauging physician satisfaction with the system, however, showed an overall poor experience, which led the CIO and CMIO to work together to implement and show measurable improvements across a range of areas, including more efficient usage of the technology.
Among the most important decision made was to use provider satisfaction measurement tools, to better understand the most impactful EHR related elements that drive provider satisfaction.
A structured onboarding process, including an explanation of the organization’s culture, also helps sets expectations for what will be required of the provider to achieve EHR mastery.

A brief history of artificial intelligence

Despite huge advances in machine learning models, AI challenges remain much the same today as 60 years ago
Contributing Editor, InfoWorld | Feb 13, 2020
In the early days of artificial intelligence, computer scientists attempted to recreate aspects of the human mind in the computer. This is the type of intelligence that is the stuff of science fiction—machines that think, more or less, like us. This type of intelligence is called, unsurprisingly, intelligibility. A computer with intelligibility can be used to explore how we reason, learn, judge, perceive, and execute mental actions.
Early research on intelligibility focused on modeling parts of the real world and the mind (from the realm of cognitive scientists) in the computer. It is remarkable when you consider that these experiments took place nearly 60 years ago.
Early models of intelligence focused on deductive reasoning to arrive at conclusions. One of the earliest and best known A.I. programs of this type was the Logic Theorist, written in 1956 to mimic the problem-solving skills of a human being. The Logic Theorist soon proved 38 of the first 52 theorems in chapter two of the Principia Mathematica, actually improving one theorem in the process. For the first time, it was clearly demonstrated that a machine could perform tasks that, until this point, were considered to require intelligence and creativity.

Weekly News Recap

  • CVS talks up its in-store HealthHubs in its earnings call, saying its Aetna customers are interested in engaging with health navigators and its pharmacists can review a patient’s medical issues using both pharmacy and claims data.
  • CPSI’s Q4 results beat expectations as the company says it is benefitting from Athenahealth’s withdrawal from the inpatient market and Cerner’s declining interest in selling to small hospitals.
  • AdventHealth, which operates 67 hospital and ED facilities, announces that it will drop Cerner and several other EHRs and systems and replace them with Epic.
  • The VA pushes back its planned March 28 Cerner go-live at Mann-Grandstaff VA Medical Center (WA) until at least the end of April, saying integration isn’t ready.
  • Open Source Electronic Health Record Alliance announces that it will shut down on February 14.
  • Imprivata’s private equity owner is reportedly preparing the company for sale at a price in the $2 billion range.
  • An article whose author includes the AMA’s burnout expert calls for EHRs to report standard efficiency metrics using their log data, including measures of how doctors spend their time.
  • Nuance says in its earnings call that it will roll out its ambient clinical intelligence “exam room of the future” for five medical specialties in Q2.

Friday, February 28, 2020

I Am Not Sure The AFP Is Looking For A Digital Health Record Of The Type We Might Imagine!

This appeared a few days ago.

AFP searches for digital health record system

By Justin Hendry on Feb 18, 2020 6:55AM

Will replace disparate databases, paper-based records.

The Australian Federal Police is set to introduce an agency-wide electronic health records system to better manage the health information of its 6000-plus staff.
The national policing agency revealed plans for the “organisation health solution” in a request for tender on Friday in a bid to better identify officers at risk of injury or illness.
The solution, which will consist of a “central repository” for personnel health information, will replace “multiple disconnected databases, based on Microsoft Access, and paper documents”.
The AFP has blamed these “siloes of information” for “making it difficult for organisation health practitioners to obtain a consolidated single view of an AFP or family member’s health information”.

It is a view shared by the national auditor, which in 2018 found disconnected systems and multiple hard copy records contributed to major shortcomings in the way AFP mental health is managed.
“The AFP’s information on employee mental health is held across a range of disconnected information systems and multiple hardcopy records which makes it difficult for the AFP to monitor and respond to emerging issues in employee mental health,” the audit said at the time.
The audit recommended the AFP “consolidate disparate systems and hardcopy records in order to establish an electronic health records management system”.
The end-to-end solution is expected to help the AFP “better manage the information it holds about AFP personnel (and their family members where appropriate in order to identity and minimise as much as possible the risk of injury to them”.
“The AFP does not currently have a consolidated ICT solution for managing health related information and activities such as work health and safety, health record information, case management, workers compensation or return to work activities,” tender documents state.
The e-health record component, dubbed the One AFP health record, will be used as the AFP’s “single access point for all captured information pertaining AFP personnel health records, including historic case files”.
It is also envisaged that end users will be able to access to their personnel health information, as well as use the health record to submit health documents such as medical certificates.
More here:
I suspect this system is intended to be way different to the #myHealthRecord – even if that could be kept complete, accurate and current – but it also has a quite different purpose.
You can read – after registration – from the Austender site all the documents that comprise the tender and associated requirements :
Here is the link:
Reviewing the requirements found here it seems clear that when the term “health record” is used, what is intended is a record to manage occupational health, provide case management but not dive to deeply into clinical matters as such, – except for psychological matters which relate to employment etc.
The system seems also to anticipate a large number of users accessing the system.
Clearly this system will not be patient controlled and one really does wonder who are the intended users for what will be a mix of both clinical (from medical certificates etc.), psychological  and occupational health and safety information.
The more you think about it the more complex issues of privacy and employee information security would appear to become and you really wonder just how access would be controlled, and who should access the system.
Thinking about it, the record, built up over years, may have a huge amount of personally very sensitive information on an individual. Just how they would feel about sharing and to whom is an interesting question!
Yet again we see how the sharing of personally sensitive information needs to be carefully thought through. I am not sure the AFP really understands how bringing  all this information together may turn out to be a rather dangerous thing for officer privacy.
The intent is to get this new system up by September, 2020 and I have to say that also seems like quite a challenge! I can’t imagine there is an off the shelf application that will do what they need for a start…
Overall a slightly lateral tender to the ones we usually see on the blog.