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, February 08, 2020

Weekly Overseas Health IT Links – 08 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.
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Another view: of IT knowledge in primary care

Though digital solutions exist in primary care, sometimes practice staff don’t know about them or don’t know how to implement them. Our GP columnist, Neil Paul, discusses whether a campaign to improve the IT knowledge in primary care is needed.
Neil Paul, 30 January, 2020
A couple of days ago, one of my partners came into my room almost bouncing with joy.
She and our deputy practice manager had sent 100 SMS messages to our ‘reluctant to attend the surgery’ asthmatic population. Within a few hours over 40 of them had replied giving the answers to the Quality and Outcome Framework (QOF) questions that we need to collect, saving us hours of work that we would usually have spent ringing around or seeing them.
Wins like these, I think, are the key to general practice’s survival, given the huge pressures we face with increasing demand and limited supply of staff.
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What happens to data sharing agreements with the EU after Brexit?

The UK will formerly leave the European Union on 31 January at 11pm – so what does Brexit mean for data sharing, health tech and the NHS?
Andrea Downey 31 January, 2020
As established in the Withdrawal Agreement Act 2020, the UK will enter into a transition period until 31 December 2020.
During this time the UK continues to participate in the EU Customs Union and Single Market, but new trading relationships will need to be established during the transition period.
What does the withdrawal agreement say about data sharing?
Neil Ross, programme manager for digital economy at techUK, told Digital Health said both sides will need to reach a data sharing agreement by the end of the Brexit transition period.
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Epic holds place atop 2020 Best in KLAS Rankings

That's 10 straight years for the IT giant, which in addition to Overall Software Suite won top marks for its acute care and ambulatory EHRs, application hosting, patient portal and more.
January 31, 2020 10:25 AM
For the 10th year in a row, Epic earned the top score for Overall Software Suite in the annual Best in KLAS 2020 Software & Services report.
Additionally, the Verona, Wisconsin-based health IT giant was named the top Overall Physician Practice Vendor, won Best in KLAS awards in eight segments, and won Category Leader awards in four segments.
Pivot Point Consulting was named the top Overall IT Services Firm thanks to consistently strong performance across several market segments, including HIT implementation, advisory services, HIT staffing, and technical services.
Meanwhile, Cerner was cited for the Most Improved Physician Practice Product, with satisfaction increasing in all areas measured by KLAS, and Accenture won a Best in KLAS award for Healthcare Management Consulting and also took top honors as the overall best healthcare  management consulting firm.
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5G is here: how health systems can capitalize on the new cellular standard

At HIMSS20, AT&T's global director of strategy and innovation will describe the advantages of 5G cellular and edge computing, and describe some of the best healthcare use cases for the next-gen communication specs.
January 31, 2020 02:16 PM
Rollout of 5G technology across the U.S. has begun in earnest. The cellular standard is already working in many major cities, and if isn't yet up and running in your hospital's hometown, it probably will be soon.
5G, especially when working as part of edge computing strategy, has some key advantages – low latency, reliability – that make it well-suited to enable big advances in efficacy and efficiency for a variety of healthcare use cases: in-building data management, easier handling of large imaging files, remote patient monitoring and virtual care, and leading-edge tech such as telerobotics and augmented reality.
Fairly soon, 5G could be as widespread and widely-used as WiFi and ethernet. Still, in the nearer term there are several challenges to ensure that healthcare organizations have the right infrastructure in place to take advantage of this cellular spec.
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Accenture sees big health IT roles for AI and emerging technologies in 2020

The medical doctor who heads the consulting giant’s global health practice foresees AI having a huge impact in healthcare this year, and is keeping his eyes on blockchain, extended reality and quantum computing.
January 31, 2020 12:12 PM
Accenture has a deep bench when it comes to healthcare expertise. And the consulting giant keeps a keen eye on healthcare information technology and the trends surrounding this IT.
This is why Healthcare IT News turned to Accenture for its view of trends in health IT this year and beyond. Dr. Kaveh Safavi, senior managing director, head of global health practice, at Accenture, offers his analysis and predictions, focusing on AI and emerging technologies.

AI will have the greatest impact

Accenture recently polled healthcare executives on trends they see on the rise in 2020. More than two-fifths (41%) of respondents ranked AI as the technology that will have the greatest impact on their organization in 2020 and beyond.
“In 2019, there was a fundamental shift in how AI is understood,” Safavi said. “People started to realize that AI is best used when augmenting the work of humans, rather than substituting them. This will have a tremendous impact on how AI is utilized in 2020, and I see it becoming a self-running engine for growth across healthcare, helping clinicians make better decisions and extending their reach.”
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Chronic Care-Focused ‘Genius Bars’ Offer Support For Wearables

January 31, 2020
While there are no signs a fully-fledged trend is emerging, at least a few healthcare organizations have established centers they compare to Apple’s Genius Bar stores.  The hospital outlets are designed to help patients learn how to use data-driven personal healthcare devices.
According to a piece appearing in Modern Healthcare, two technology and wearables centers were launched by New Jersey-based Inspira Health Network in 2017. Inspira CEO John DiAngelo told the magazine that the centers were dedicated to supporting its wellness program.
Anyone can come into one of the Health+ bars to try out and buy devices and wearables, all of which are vetted by Inspira staff working there.
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Fed rule on patient access to healthcare data gets EMR vendor pushback

A rule that would allow greater access to electronic healthcare information for patients and their doctors is being challenged by some of the vendors supplying the technology.

The largest electronic medical record (EMR) vendor in the U.S. is fighting a proposed government rule to allow patients and their physicians greater access to electronic health information – regardless of the technology platform – to promote data exchange.
According to a number of recent reports, EMR vendor Epic Systems is lookng to derail the finalization of a rule from the Department of Health and Human Services (HHS) that would implement some provisions of the 21st Century Cures Act. In particular, the rules governing information-blocking of patient healthcare information and EMR interoperability are at the heart of the fight.
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FDA’s mobile-friendly database to aid availability of HIV drug info

January 30, 2020, 3:32 p.m. EST
The Food and Drug Administration has launched a mobile-friendly database offering clinicians and patients information on antiretrovirals, which are HIV drugs.
These drugs are used to control HIV infection, and there are several different classes of antiretroviral agents that act on different stages of the HIV lifecycle.
“In my years as a practicing clinician, I spent time on the ground involved in a program for those impacted by HIV in Botswana, Africa,” says Stephen Hahn, MD, Commissioner of the FDA. “I saw first-hand how essential it is to have access to low-cost treatments for those impacted by HIV, regardless of where the patient may reside.”
The announcement makes ARVs eligible for purchase under the President’s Emergency Plan for AIDS Relief, known as the PEPFAR program. PEPFAR is not new, as FDA has had it on its website for a considerable time, but now the list has been transformed into a mobile-friendly database platform accessible to all entities across the globe with enhanced availability of information and data for each type of drug.
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One-third of U.S. facilities are using AI in aiding imaging studies

January 30, 2020, 2:03 a.m. EST
A third of American hospitals and imaging centers are already implementing artificial intelligence, machine learning or deep learning in radiology.
About another third plan on adopting it within the next two years, according to respondents to a survey, the results of which were recently released by an industry research organization.
The survey of 207 imaging leaders and professionals, conducted by healthcare data and analytics firm Definitive Healthcare from October through December, found that the use of AI was seen as “highly valuable” in enhancing patient care and business operations. The survey was Definitive Healthcare’s first study of AI use in imaging.
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4 steps to getting practical about scaling AI for success

January 30, 2020, 4:33 a.m. EST
Lately, everyone’s ‘doing AI.’
Leaders now understand the urgency, but the ‘how’ remains elusive: according to our research, more than 75 percent of executives know how to pilot but are struggling to scale AI across their businesses. But scaling well matters. Our data indicates Strategic Scalers (those who successfully scale their AI) are seeing as much as three times the return on investment, compared with their counterparts stuck in the Proof of Concept (POC) stage.
My experience on the ground confirms the stats. My clients frequently ask me how to become great at scaling AI. Here’s what I’ve learned about the key elements to consider if you want to scale AI well, repeatedly.
Focus on value: think of your business strategy and AI strategy as one and the same
If you can define what really matters to your business, you can align your AI agenda to the company’s highest-level strategic goals, e.g., organic growth, or development of new products. The trick is to focus intently on value as it stands today, while at the same time having a vision for tomorrow. Where is your organization and your industry headed, and what does value look like three to five years from now?
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Verma: Private actors are using privacy as pretext to hold patient data hostage

January 30, 2020, 1:47 a.m. EST
The Trump administration continues to circle the wagons in its defense of the federal government’s efforts to enable patient access to their electronic health information.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, is the third Department of Health and Human Services official in as many days to take healthcare stakeholders to task for their criticism of a proposed rule by the Office of the National Coordinator for Health IT to improve access to patient medical records.
“A truly interoperable healthcare system has the potential to deliver better access, safety and quality that patients need while unleashing data,” said Verma on Wednesday at the CMS Healthcare Innovation Industry Day in Washington. “We have made it clear to providers that they don’t own a patient’s data and they must give it to their patients.”
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Lurie Children's new CEO Dr. Thomas Shanley: We're starting to see the consequences of ignoring pediatrics

Emily Rappleye (Twitter) -  
Ann and Robert Lurie Children's Hospital of Chicago welcomed Tom Shanley, MD, to the role of president and CEO in December, after longtime leader Patrick Magoon retired.
A Chicago native dedicated to improving pediatric health outcomes in his community, Dr. Shanley told Becker's he was thrilled to take on the role. "It's been an extraordinary privilege to be given this leadership role for an institution that is so fundamentally critical to the city and to the future of the state," he said.
Dr. Shanley is a pediatric intensive care physician and researcher by background and spent the last four years leading the Stanley Manne Children's Research Institute at Lurie Children's and serving as chairman of pediatrics at the Chicago-based Northwestern University Feinberg School of Medicine. Before joining Lurie Children's in 2015, Dr. Shanley was a professor at University of Michigan Medical School in Ann Arbor, where he also served as associate dean for clinical and translational research and the director of the Michigan Institute for Clinical and Health Research.  
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Canadians seeing more doctors after hours but electronic medical-record use lags behind

Few doctors can share patients' lab and diagnostic test results because health systems are not fully connected

The Canadian Press · Posted: Jan 30, 2020 11:09 AM ET | Last Updated: 11 hours ago
Family doctors in Canada are providing increased access to care compared with most of their counterparts in 10 other countries but still lag behind when it comes to using electronic medical records, findings of a survey show.
The Commonwealth Fund Survey also found few doctors can share patients' lab and diagnostic test results because health systems are not fully connected.
It involved over 13,000 doctors, 2,500 of them from Canada, and was the basis of a report released Thursday by the Canadian Institute for Health Information.
Physicians from Germany, France, Australia, the United Kingdom, the Netherlands, New Zealand, the United States, Switzerland, Norway and Sweden also participated in the 2019 survey, which showed doctors in all the countries saw an average of 99 patients a week.
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Microsoft launches major $40M AI for Health initiative

The five-year project will focus on enabling faster medical research innovations, protecting against global health crises and improving access to care, the company says.
January 30, 2020 02:26 PM
Microsoft on Tuesday announced AI for Health, a five-year, $40 million program that aims to help healthcare organizations leverage artificial intelligence and machine learning to boost the health of patients and populations worldwide.
WHY IT MATTERS
Microsoft says AI for Health – which is part of its $165 million AI for Good initiative – will help researchers, nonprofits and healthcare organizations around the world deploy with leading edge technologies in the service of three key areas:
  • Accelerating medical research to help improve prevention, diagnoses and treatment
  • Improving worldwide understanding of mortality and longevity to help protect against global health crises
  • Reducing health inequity and improving access to care for underserved populations
"AI for Health is a philanthropic initiative that complements our broader work in Microsoft Healthcare," said John Kahan, chief data analytics officer at Microsoft, in a blog post. "Through AI for Health, we will support specific nonprofits and academic collaboration with Microsoft’s leading data scientists, access to best-in-class AI tools and cloud computing, and select cash grants."
He said the program – which is "underpinned with a strong foundation of privacy, security and ethics" – will focus on tackling societal health issues, helping researchers unlock new medical and scale up new technology solutions.
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Healthcare IT Today Survey: Consumerism And Use Of Patient-Generated Data Are Lasting Trends

January 30, 2020
Consumerism and the use of patient-generated data are no fads, but rather a lasting change to the healthcare landscape, according to a new survey conducted by Healthcare IT Today of our readers.
According to the survey, perhaps the most-transformative trend emerging from healthcare consumerism was the use of consumer-facing health apps, which nearly half of respondents saw as a major force and nearly as many rated as very transformative.
Other hot areas identified by the survey include patient-driven insights and design, patient secure texting, price transparency and online self-scheduling. Only high-deductible plans got mixed reviews, with the highest number of votes falling into the “moderately transformative” range.
When asked whether consumerism and the use of patient-generated data were here for the long term, almost all of the respondents said that it was, a rare show of unanimity the demonstrates how strongly these concepts have worked their way into the industry mainstream.
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Adopting Standardized Workflow in Your Practice: The Resistance and How to Overcome It

January 30, 2020
The following is a guest article by Greg Sanders, MD, FACC and Founder of HybridChart.
Most companies strive for efficiency with a mission of continuous process improvement. This is a good way to lower overhead costs and reduce errors or waste. The ultimate goal is a higher level of satisfaction among customers and employees. Most industries have made significant progress in streamlining their internal workflows, so it is baffling to me how medicine seems to be stuck in a gridlock of poorly assembled methods, with a knee-jerk resistance to change.
You can only assume that doctors want that same improvement in satisfaction for their patients and for the brave souls who run the front and back office of medical clinics. Doctors also seem keen on trying the latest and greatest when it comes to therapeutics and new-age diagnostics. Yet somehow the thought of creating sensible workflows that everyone can agree upon is unthinkable.
This Is How It Has Always Been Done
Part of the problem lies in our training. In medical school residency rotations typically last a month. We have all started a rotation and been told, “This is how we do it,” referring to rounds, or some component of the workflow. And we have all at one time said to ourselves, “Why on earth would we do it this way?”  But alas, it is just for one month, and we do not want to be labeled as disruptive on our evaluations.
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The Other #myHealthRecord!

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Industry Voices—Is Dr. Alexa ready to see you now?

Jan 28, 2020 12:01am
Smart speakers have become a ubiquitous part of our lives. In fact, by 2022 analysts expect that voice technology will reach 55% of U.S. households. Whether it’s a gut check on the day’s forecast or it’s time to place a grocery order, consumers are accustomed to saying, “Hey, Alexa,” and receiving an answer in mere seconds. Now, with Amazon Alexa becoming HIPAA-compliant, voice technology’s intersection with modern healthcare is poised to explode.
The goal of a HIPPA-compliant Alexa is to give consumers the opportunity to ask a voice assistant questions about their health, refill a prescription or make an appointment with their provider—ushering in a whole new era of patient experience.
It’s no secret that the U.S. healthcare system today is confusing. The global lack of access to essential health services further exacerbates the situation, with at least 400 million people worldwide facing obstacles preventing them from receiving treatment. A harmless condition can become serious if a person doesn’t have access to the right resources, information or tools to help follow their treatment plan.
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Federal agency offers guidelines for businesses defending against ransomware attacks

Maggie Miller16
The National Institute of Standards and Technology (NIST) published draft guidelines Monday providing businesses with ways to defend against debilitating ransomware attacks.
The two draft practice guidelines to help firms create strategies to protect data in the event of an cyberattack.
Ransomware attacks, which involve an individual or group locking a network and demanding payment before giving the user access again, saw a spike in 2019, as multiple cities across the country were temporarily crippled by these types of attacks.
“Some organizations have experienced systemic attacks that force operations to cease,” the agency wrote in its guidelines. “One variant of a data integrity attack-ransomware-encrypts data, rendering it unusable. This type of impact to data affects business operations and often leads them to shut down.”
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Philips to Ditch Consumer Appliances Unit, Focus on Connected Care

The Dutch tech giant is shedding ancillary businesses to focus on the healthcare industry, where it has a hand in everything from tele-ICU programs to remote patient monitoring to telehealth and mHealth platforms.

January 28, 2020 - Stung by poor 2019 earnings in its connected care business, Philips is shedding its consumer appliances division to focus on healthcare, including telemedicine and mHealth.
The Dutch technology giant, which had already spun off its signature consumer electronics and lighting businesses, announced this week that it will either sell or spin off the appliances segment, which manufactures everything from coffee makers to air fryers. The company plans on directing all its resources to personal health, diagnosis and treatment technology, data management and connected care, including remote patient monitoring.
“Everybody’s going in that direction,” CEO Frans van Houten said during a conference call with new reporters. “As a technology company, we can do our part in helping providers optimize their processes, take waste out, and get a better return on capital equipment and staff utilization.”
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World saddled with ‘weak’ emergency preparedness as coronavirus spreads

January 29, 2020, 1:57 p.m. EST
Bloomberg—The outbreak of coronavirus that began in China and spread across the world, leaving more than 130 people dead, has raised alarm about the ability of countries to handle an epidemic or pandemic.
The recent Global Health Security Index gives insights into which of 195 nations are ready to fight a major health emergency that could wreak havoc on the global economy.
The report’s bottom-line conclusion is that national health security is “fundamentally weak around the world,” and no country is fully prepared for major disease disaster—although some, particularly in the developed world, are in a better position than others.
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Rucker: Patient data access, choice is at heart of ONC rule

January 28, 2020, 11:44 p.m. EST
The Office of the National Coordinator for Health IT is pushing forward with a proposed rule meant to ensure patient access to their electronic healthcare information.
The agency’s efforts come despite industry concerns that policies are not in place to prevent inappropriate disclosures of patients’ medical records.
Stakeholders have made the case that—absent appropriate privacy protections—the finalization of ONC’s proposed rule, as written, would put patient information at risk.
Specifically, the American Medical Association has charged that ONC is making a policy decision to “not prioritize patient privacy” and that patients’ health information will be vulnerable to inappropriate secondary uses and disclosures from third-party apps.
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IoT security and the psychology of supplier apathy

Dr Saif Abed, director of cybersecurity advisory services at AbedGraham, says it's high time suppliers invested in people and processes.
January 29, 2020 09:15 AM
Warnings about IoT vulnerabilities have resounded across 2020 cybersecurity predictions, but the greatest vulnerability of all is apathy. This charge can potentially be applied to anyone and everyone from healthcare providers to government agencies. What I want to focus on, however, is the supplier community. 
I increasingly talk to CIOs and CISOs that express a frustration with the behaviour of their suppliers. It seems that many are ambiguous about proactively addressing regulatory standards that are specific to preserving patient safety. As the leaders I talk to often point out to me – it would be a competitive advantage if they did (let alone be ethical)!
This all applies especially to IoT devices, what with increasing interoperability, mobility and the dawn of 5G where the scope for system failures that could affect patient care are greater than ever. As someone who works extensively with the supplier community, I must admit there are only a handful that I know that are actively involved with the development of security and patient safety regulations. Let’s be clear, I believe that the vast majority of medical device and IoT suppliers in healthcare want to enhance patient care yet security is persistently a sore point. Why is that?
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New German Digital Healthcare Act – What’s in it for the patient?

Angela Velkova, director of communities and strategic relations for EMEA at HIMSS, explains how the DACH delegation will prepare for HIMSS20 in the wake of the new Digital Healthcare Act.
January 29, 2020 06:00 AM
Healthcare IT News: You are currently setting up a multi-stakeholder group for German-speaking countries that will attend the global conference this March and learn from other healthcare systems around the world. What can you tell us about this?
Velkova: We are, yes. We engage our communities locally and provide important learning and networking experiences for all kinds of stakeholders – from clinicians, researchers to government, students, entrepreneurs, innovators and hospital management – outside their community in order to see how other countries are managing the digital transformation journey and how to learn from their examples. That is why each year a certain number of international including European delegations travel to the US. This year, we have assembled programmes for four HIMSS delegations: the Nordic, French, Dutch and the DACH delegation – with the highest participation coming from Germany following the adoption of the new Digital Healthcare Act (DVG). 
HITN: Who can join the DACH delegation and travel to HIMSS20?
Velkova: It is an open call for registration, however, only a limited number of about 40 participants, mostly from decision-making level, can attend the HIMSS20 conference in the US. For this annual highlight, we normally engage directly with groups of specific organisations or those that have a specific interest in participating. On the industry side, anyone can register independently, but on the community side, we work mostly with the ministries of health as well as local and regional authorities. In the case of Germany, a delegation from Berlin, Brandenburg and Saxony – comprised of industry experts, companies and research facilities – will be joining the DACH delegation to pursue their internationalisation efforts and collaborate with US healthcare players.
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Epic continues campaign for changes to forthcoming ONC info blocking rules

The company has been lobbying hospital leaders to oppose them – and has said it might sue HHS, depending on the final rules' data provisions. Meanwhile, some patient advocates are also speaking out.
January 29, 2020 11:50 AM
The proposed 21st Century Cures rules around information blocking, interoperability and patient access were released nearly a year ago – and the final rules are expected soon. But recently, a major healthcare player has been getting more vocal about how it thinks the forthcoming regulations need to be changed.
On Monday, Epic posted a long note to its homepage. It touts the company's support for the patient access goals of the soon-to-come ONC rules, with their focus on API-enabled data exchange – but also calls for new protections to patient privacy.
"By requiring health systems to send patient data to any app requested by the patient, the ONC rule inadvertently creates new privacy risks," according to Epic, which points to a recent study showing that 79% of healthcare apps resell or share data. "There is no regulation requiring patient approval of this downstream use."
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Providing a Great Patient Communications Experience May Be Easier Than You Think

January 29, 2020
The following is a guest article by Amit Modi, Chief Product and Technology Officer, Movius Corp.
Improving the ways in which patients communicate with their clinician may feel like sending a search party into a blackhole. With today’s preference for instant communication via text and the laundry list of app-based messaging services, patients are increasingly seeking this seamless experience in various aspects of their lives, including healthcare. In fact, one recent survey found 90% of respondents would like the ability to communicate via secure text messaging with a family member’s care team if that loved one were ill.
In highly regulated industries such as healthcare and financial services, being able to meet the public’s demand for faster and more instant forms of communication has historically proved to be a slow process. However, with the emergence of mobile banking in financial services and other innovations in adjacent industries, it is clear the communications needs of consumers are top-of-mind for industry leaders globally.
The Growth of Instant Messaging and the Healthcare Connection
According to research by Pew, 97% of smartphone owners text regularly. With Pew also finding 81% of Americans now own a smartphone, it is easy to understand why texting and SMS exchange would be sought after in the healthcare industry.
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Machine Learning Tool Predicts Hospitalizations for Asthma Patients

A machine learning algorithm was able to forecast hospital encounters among patients with asthma better than current predictive models.

January 27, 2020 - Using machine learning, researchers developed a more accurate model to predict hospital encounters for asthma patients, which could improve asthma outcomes and reduce care costs, according to a study published in JMIR Medical Informatics.
Asthma affects 8.4 percent of the US population, researchers said, and leads to 2.1 million emergency department (ED) visits and 479,300 hospitalizations annually. The condition costs the healthcare system $50.3 billion each year.
Current risk prediction models that identify high-risk asthmatic patients have significant gaps, leading to poorer outcomes, the group stated.
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Mobile apps may facilitate weight loss among adults with type 2 diabetes

January 27, 2020
Adults with type 2 diabetes may lose weight more effectively by including a weight-loss mobile app as part of their strategy, according to findings from a meta-analysis published in Obesity.
“Face-to-face tailored or supervised lifestyle modification programs with emphases on healthy diet and sufficient physical activity have been shown to be effective in facilitating weight loss,” Mingzi Li, PhD, RN, of the School of Nursing at Peking University in Beijing, and colleagues wrote. “Mobile apps, which can be installed on any mobile phone and accept data as well as provide professional feedback to patients without time limits or distance restrictions, may overcome these drawbacks.”
Li and colleagues compared changes in body weight, waist circumference and BMI among a combined cohort of 2,129 adults with type 2 diabetes (mean age, 58.4 years) who were randomly assigned to use or not use a weight-loss mobile app as part of one of 14 randomized controlled trials.
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Why cancer-spotting AI needs to be handled with care

Accelerating cancer diagnoses could hurt more than it helps
These days, it might seem like algorithms are out-diagnosing doctors at every turn, identifying dangerous lesions and dodgy moles with the unerring consistency only a machine can muster. Just this month, Google generated a wave of headlines with a study showing that its AI systems can spot breast cancer in mammograms more accurately than doctors.
But for many in health care, what studies like these demonstrate is not just the promise of AI, but also its potential threat. They say that for all of the obvious abilities of algorithms to crunch data, the subtle, judgment-based skills of nurses and doctors are not so easily digitized. And in some areas where tech companies are pushing medical AI, this technology could exacerbate existing problems.

The harms of finding more cancer

For Google’s mammogram paper, the main criticism is that the company is attempting to automate a process that’s already somewhat controversial. As Christie Aschwanden pointed out in Wired earlier this month, doctors have argued for years that early scans for breast cancer might harm as much as they help, and the introduction of AI could tip the balance.
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US attorney announces $145M settlement in opioid case

BURLINGTON, Vt. (AP) — A San Francisco-based health information technology company will pay $145 million to resolve criminal and civil charges that it helped set up an electronic health records system that encouraged physicians to prescribe opioids to patients who might not need them, federal prosecutors in Vermont said Monday.
Vermont U.S. Attorney Christina Nolan said the company Practice Fusion, Inc., took kickbacks from a major opioid company in exchange for using its software to influence physicians to prescribe opioid pain medication.
Court documents released at a Burlington news conference said that Practice Fusion solicited a nearly $1 million payment from a company identified only as “Pharma Co. X” in exchange for creating an alert in Practice Fusion’s electronic health record system. The alert would cause doctors to write more prescriptions for extended release opioids than were medically necessary.
“The companies knew all of this,” Nolan said. “The decision to contravene medical guideline was greed-driven and at the behest of Pharma Company X’s marketing department and Practice Fusion allowed it because it wanted $1 million.”
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Is Your Organization Prepared for Interoperability Compliance?

By Mandy Roth  |   January 28, 2020

The Sequoia Project releases a guidebook for the health IT community.

A guidebook to help healthcare organizations prepare for interoperability compliance is now available from The Sequoia Project, a non-profit dedicated to solving health IT interoperability issues.
Guidance to the Community and Implementation Feedback to HHS can be downloaded for free from the organization's website. The publication was prepared by workgroup of 31 representatives from the health information technology sector, including representatives from AHA, AHIMA, AMA, BCBSA, CARIN Alliance, Cerner, CHIME, CommonSpirit, Epic, Google, HIMSS, Humana, Kaiser Permanente, Microsoft, and more.
“This report aims to be a guide for the community,” Mariann Yeager, CEO of The Sequoia Project, said in a news release. “Implementation guidance is essential to reduce uncertainty and prepare for compliance.”
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Many cancer patients not benefitting from access, use of EHRs

January 28, 2020, 12:29 a.m. EST
Although leveraging electronic health records can help cancer patients manage their complex healthcare information needs, many are not able to access and use their online medical records.
That’s the finding of an analysis of data released by the Office of the National Coordinator for Health Information Technology.
“Approximately 40 percent of individuals with a previous cancer history reported not being offered access to their online medical record,” finds a new ONC data brief, based on results from the National Cancer Institute’s 2017 and 2018 Health Information National Trends Survey.
In addition, the agency reports that “a substantial portion of individuals with a previous cancer diagnosis did not view their online medical records when access was offered (to them).”
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15 views on why the message of Data Privacy Day is more important than ever

January 28, 2020, 6:23 a.m. EST
Today, January 28, 2020, marks International Data Privacy Day, a day meant to focus attention on best practices around protecting the privacy and security of customer data.
The importance of this observance grows with each passing year, as do the threats – both external and internal – to data privacy and security.
Consider the following data points gathered by Bitglass’ research team. The researchers have studied hundreds of thousands of companies worldwide, and the below stats demonstrate the pitfalls of the surveyed companies, and how organizations must rethink their current security strategies:
  • 86% of enterprises have deployed cloud-based tools, but only 34% have implemented single sign-on (SSO), one of the most basic and critically important cloud security tools - an indication that companies are not leveraging appropriate tools to keep consumer data safe.
  • 52% of the Fortune 500 do not have any language on their websites about how they protect the data of customers and partners (beyond a legally required privacy notice).
  • 75% of companies leverage multi-cloud solutions, but only 20% have visibility over cross-app anomalous behavior. With more organizations storing sensitive information in the cloud, adopting proper cloud security measures is critical to protecting data.
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Survey: 3 out of 5 Americans want stronger privacy protections

January 28, 2020, 12:58 a.m. EST
Most Americans want personalized, actionable healthcare information, but not if it puts their personal health data in peril.
In fact, more than three out of every five Americans want stronger protections for privacy, saying it’s more important than easier access to health data, according to results of a recently completed survey by Morning Consult, conducted on behalf of America’s Health Insurance Plans (AHIP).
The survey found that 62 percent of patients want their data and privacy protected at higher levels than now, even if that means that it will make it more difficult to access their health information.
In addition, three in four adults responding to the survey said they would not support a new federal regulation that makes it easier to find the cost of medical procedures if it also raises insurance premiums.
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Walmart health strategy may boost reliance on IT capabilities

January 28, 2020, 2:31 p.m. EST
The use of technology will be key to the success of Walmart health facilities that the retail giant is beginning to roll out.
Meanwhile, provider organizations responding to this potential competition see the integration of electronic information systems as one of the reasons why the fear factor over Walmart’s potential impact on competition may be blunted.
Results from a recent survey by Reaction Data show diverse opinions over how the rollout of Walmart health services could affect the competitive landscape within healthcare.
Last September, Walmart opened its first standalone clinic, called Walmart Health, in Dallas, Ga., and earlier this month, it opened a second clinic in Calhoun, Ga. Both offer a variety of services, including primary care and lab services.
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Research looks to explain why healthcare employees fall prey to phishing

January 28, 2020, 2:28 p.m. EST
Efforts by healthcare providers and insurers to improve information security are being thwarted because employees won’t stop clicking on phishing emails.
A study by researchers at Massachusetts General Hospital, the Massachusetts Institute of Technology and University of Muenster, Germany, investigates why clicking continues by analyzing the actual clicking data.
Researchers conducted surveys in hospitals to assess compliance intention of clickers, matching their results with their actual clicking data derived from phishing campaigns.
The research looked at the impact of the Theory of Planned Behavior (TPB), which aims to predict a person’s intention to engage in a behavior that will have an expected outcome after evaluating risks and benefits, according to the Boston University School of Public Health.
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Personalized eHealth interventions in adults with overweight and obesity: A systematic review and meta-analysis of randomized controlled trials

Preventive Medicine — Lau Y, et al. | January 28, 2020
In view of the limited effects of many existing electronic health (eHealth) interventions with a general approach, researchers identified the necessity for a personalized approach. In this work, they examined the effectiveness of personalized eHealth interventions in decreasing body weight and sought for the effective key features of such interventions. Searching seven databases from inception until September 6, 2018, they identified 26,733 records; of these, they included 15 RCTs were included. As per meta-analysis, the personalized eHealth intervention group exhibited a significant reduction compared with that observed in the control group. A statistically significant impact of age and year of publication was observed on the effectiveness of an intervention. Findings support a possible utility of personalized eHealth intervention for reducing weight. The inclusion of tailored content and customized feedback in future design elements is recommended.
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Allscripts to showcase move to human-centered design at HIMSS20

It’s a big change for the EHR giant. A company vice president and its external design expert explain what human-centered design is – and what it means for its healthcare customers.
January 28, 2020 02:42 PM
At HIMSS20 in March, Allscripts will be introducing a human-centered design approach and re-imagining of its physician experience for today’s highly mobile world. The company will showcase a prototype of the new solution for attendees to experience.
Human-centered design is a proven approach to solving problems of any size, explained Jenna Date of Jenna Date Design. Her firm helps companies design innovative futures for their clients with a deep focus in human experience. She currently is providing human-centered design strategy for Allscripts designers.

Four steps to human-centered design

“It is a series of methodologies and practices that use divergent thinking to solve for intrinsic human needs, rather than the ‘asked for’ answer,” she continued. “There are four key steps to the process: setting scope, gathering insights in context, envisioning a possible future based on those insights, and then iteratively prototyping and testing the new solution.”
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Data science, prescriptive analytics poised for big advances in 2020

Improvements in patient outcomes and population health will be enabled as a culture of data-driven decision making takes root and quality improvement processes mature.
January 28, 2020 11:13 AM
Healthcare has had higher barriers to adopting data science than other industries. And while state-of-the-art analytics solutions are already available, few of them are actually in use by clinicians.
That's something that the industry could start to see change in 2020, as a culture of data-driven decision-making among clinicians begins to mature, and the quality improvement process improves.
Data science will increasingly guide clinicians in finding opportunities for improvement, designing and implementing interventions, and evaluating impacts.
Jason Cooper, chief analytics officer at HMS, said AI-driven prescriptive analytics and other advanced analytical techniques can process what can easily be 1,000 or more predictors from claims, self-reported consumer data, electronic health records, census, and social determinant data.
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Social Insecurities: How Do Technology and Other Interventions Impact Clinician, Patient, and Care Partner Dynamics?

January 28, 2020
Health is social. And healthcare occurs in a web of social dynamics.
We create technology and resources to improve healthcare conversations and relationships, but they can also have unexpected effects and stymie those dynamics: like the way the electronic record can steal eye contact and focus during appointments. Other times, they have unexpected positive effects. For example, I was surprised when family caregivers of heart failure patients explained they appreciated daily automated phone calls asking to report their family member’s weight. The automated calls meant they didn’t have to be the annoying caregiver telling the patient to get on the scale each day.
Any technology or intervention has some kind of effect. How deeply do we delve into these dynamics? I recently found myself sorting through the dynamics and emotions of a series of care conversations.
My mom has been recovering pretty well after breaking her hip. She’s in her late 80’s. And she’s physically, mentally, and socially active. I often forget her age because she doesn’t seem old, let alone “elderly.”
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PULSE Supports Health Care During Disasters

Rachel Abbey and Leslie Witten-Rood | January 24, 2020
When disaster strikes, most of us think about how we can best protect ourselves and our loved ones. We can’t always think about our health records though. Disasters can often aggravate chronic disease and cause disruptions at hospitals, clinics and other health care and social service facilities. If we even have them, very few of us think about taking our health records when evacuating, but that’s where health IT can help.

Using Health IT During a Disaster

PULSE – the Patient Unified Lookup System for Emergencies – is an electronic health information system designed to help people manage their health care during and right after a disaster. PULSE allows authorized disaster health care volunteers, including first responders, to query and view evacuees’ medical records from all connected health care organizations using nationally recognized standards. In 2015 the Office of the National Coordinator for Health Information Technology (ONC), through a cooperative agreement, collaborated with the California Emergency Medical Services Authority (EMSA) to pilot PULSE in California. PULSE is a health IT disaster response platform that can be deployed at the city, county, or state level.
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Industry Voices—There's a vast amount of new tech for hospitals. Let's not repeat the mistakes of the EHR

By Jon Ault 
Jan 27, 2020 12:01am
The U.S. healthcare system has many problems, but a lack of data isn’t one of them. 
Since the rise of electronic health records (EHRs) more than a decade ago, hospitals and doctors have been inundated with data on patients’ health. Studies show that 96% of hospitals have adopted EHR systems. Yet that digitalization hasn’t yet led to the leaps in efficiency, safety and improved patient care that its advocates hoped it would. 
That’s partly because most hospitals and health systems haven’t worked out how to use the data to connect the dots and gain actionable insights into their processes. Critics of the $36 billion government-backed EHR drive say that, among other problems, it has overwhelmed doctors with data entry demands, reducing the time they have to focus on patients. It’s also failed to provide the promised insights that were supposed to reduce costs and improve patient satisfaction.
As new technologies become available to hospitals, clinics and senior care facilities, it’s important to not repeat the mistakes of EHR. It’s not enough to merely have the data; it’s what you do with it that makes a real impact on efficiency and patient outcomes. 
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Apple, Cerner call for interoperability rule release 'without further delay' highlighting industry rift

Jan 27, 2020 12:06pm
Big tech giants Apple and Microsoft are joining health IT vendors and health plans to meet with federal officials today to voice strong support for efforts to give patients access to their health data.
The Carin Alliance, a private sector collaboration made up of major health insurers, providers, health IT companies and tech giants, announced last week that it is meeting with the Office of Management and Budget (OMB) OMB to request the agency to finalize and release the proposed interoperability rules "without further delay."
It came just days after the head of electronic health record (EHR) vendor Epic emailed CEOs and presidents of hospital systems urging recipients to sign a letter alongside Epic that voices disapproval for proposed interoperability rules from the Department of Health and Human Services (HHS).
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Most Orgs Lack Health IT Infrastructure for Value-Based Care

Healthcare executives agreed in a recent survey that data analytics and technology are key to value-based care success, but most organizations do not have the health IT infrastructure.

January 23, 2020 - Having the right health IT infrastructure in place is critical to succeeding under value-based care, but organizations are still lacking key technological components, according to a new survey conducted by Innovaccer.
The survey of 2,900 healthcare executives over the course of a year found that most healthcare facilities lack the infrastructure to effectively integrate their patient data, which means that patients are continuously missing out on the benefits of consolidated-activated data and value-based care. 
Organizations must move to more patient-centered care to tackle patient data integration, which calls for things to be done differently. Organizations must improve efficient healthcare data integration where technology can flag care gaps, high costs, and out-of-network utilization in order for patients to receive private and customized care plans and improve overall population health. 
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An AI Epidemiologist Sent the First Warnings of the Wuhan Virus

The BlueDot algorithm scours news reports and airline ticketing data to predict the spread of diseases like those linked to the flu outbreak in China.
On January 9, the World Health Organization notified the public of a flu-like outbreak in China: a cluster of pneumonia cases had been reported in Wuhan, possibly from vendors’ exposure to live animals at the Huanan Seafood Market. The US Centers for Disease Control and Prevention had gotten the word out a few days earlier, on January 6. But a Canadian health monitoring platform had beaten them both to the punch, sending word of the outbreak to its customers on December 31.
BlueDot uses an AI-driven algorithm that scours foreign-language news reports, animal and plant disease networks, and official proclamations to give its clients advance warning to avoid danger zones like Wuhan.
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28 ways to reduce EHR inbox fatigue

·         Drew Boxler
·         Logan Lutton
January 24, 2020
Electronic health records (EHRs) have contributed to physicians’ increased reports of burnout and reduction in autonomy. Most studies examining the effects of these systems have focused on the introduction of EHRs to physician practices as a whole, but a recent study in JAMA Open Network Health Informatics focused on an often-overlooked aspect of EHR systems: the messaging inbox.
The researchers compiled a list of 28 recommendations for healthcare organizations, EHR vendors, and researchers to reduce the growing onslaught of EHR messages for physicians.
Below are the recommendations which are organized into five categories: messaging complexities, inbox interface, cognitive load, team communication, and message content.
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Z code use inches up as Medicare providers document SDOH data

January 26, 2020, 10:39 p.m. EST
Progress is being made in the Medicare program to document a subset of ICD-10-CM codes used to capture social determinants of health data.
While Z codes did not exist prior to implementation of the ICD-10-CM codes in 2015, a new report from the Centers for Medicare and Medicaid Services finds that providers used the SDOH-associated coding for 467,136 Medicare fee-for-service beneficiaries in 2017—nearly 5 percent more beneficiaries than in 2016.
At the same time, CMS notes that this represents just 1.4 percent of the 33.7 million total Medicare FFS beneficiaries in 2017.
 “This data highlight provides insight into the limited documentation of social determinants of health for Medicare FFS beneficiaries,” states the report, which is the first analysis of claims data to determine the extent to which Z codes are being used.
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Epic arms clinicians with software update to detect coronavirus cases

January 26, 2020, 10:46 p.m. EST
With concern growing about the spread of the coronavirus, healthcare IT vendor Epic has updated its standard travel screening questionnaire to identify possible cases.
The number of confirmed cases of the new coronavirus in the United States has risen to five, the Centers for Disease Control and Prevention said Sunday. The first U.S. case was reported on January 20, and the second case was announced on January 24.
Between the two confirmed U.S. cases, on January 22, Epic sent an automatic software update to healthcare organizations around the country to “remind clinicians and other front-line staff to ask patients about recent international travel.”
The five persons in the U.S. who tested positive for the novel coronavirus had recently returned from Wuhan, China, where an outbreak of respiratory illness caused by the coronavirus has been ongoing since December.
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The Dutch way: What the Netherlands can teach us about digitisation

Chief pharmacy informatics officer Pieter Helmons will be talking about St Jansdal's approach at a HIMSS event in Cambridge later this week.
January 27, 2020 03:17 AM
It's a familiar scene: at the end of an appointment, a doctor scribbles out a prescription on a notepad and sends you away. But when it comes to prescribing practices, the Netherlands has torn up the paper and opted for digital.
And it's no secret the Dutch are a rising star in the digital health game. In a recent survey from HIMSS Analytics, the Netherlands, Nordics and Estonia were identified as the countries driving adoption of digital technology in European healthcare.
With most organisations “pretty well” digitised, according to Pieter Helmons, chief pharmacy informatics officer at Dutch hospital St Jansdal, a strong foundation to transform the healthcare system and provide services that are fit for today’s world is now in place.
But one area that could use some improvement is patient engagement.
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Weekly News Recap

  • Epic updates its software to include travel screening prompts for patients who may have traveled from China or who are experiencing symptoms of the coronavirus.
  • Columbus, OH-based analytics company Aver raises $27 million in a Series C round led by Cox Enterprises.
  • Judy Faulkner urges CEOs at some of Epic’s largest hospital customers to sign a letter to HHS Secretary Alex Azar protesting the proposed interoperability rule published last year.
  • Consumer DNA testing company 23andMe lays off 100 employees as it struggles with declining sales.
  • Epic decides to stop pursuing integrations with Google Cloud based on a lack of customer interest.
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Enjoy!
David.

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