The consensus view, with which I concur, is that the leading standard to support interoperability between heterogeneous systems is HL7 FHIR.
The problem is that it’s not currently possible to specify FHIR compliance in any meaningful way as the necessary FHIR Profiles against which compliance is measured do not yet exist.
What I would like my NHS clients to be able to put into their contracts is this “The Vendor agrees to implement those FHIR profiles currently published by INTEROPen CIC that fall within the scope of their system. The Vendor further agrees to implement any changes to these Profiles or new Profiles within the scope of their system within six months of such changes or new Profiles being published by INTEROPen.”
March 4, 2020
Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, last month
suggested that businesses, schools, and government agencies take advantage of telecommuting and telehealth in the face of the COVID-19 outbreak. Judd Hollander, MD, an emergency department physician and the senior vice president for healthcare delivery innovation at
Jefferson Health in Philadelphia is ready. Under Hollander’s guidance JeffConnect, an umbrella name for
Jefferson’s telehealth services , in 2015 launched on-demand app allowing patients to connect with Jefferson emergency medicine physicians from home via their cell phones, tablets, or computers with a webcam. Jefferson officials say that the app encourages those who think they may have been exposed to the flu and/or COVID-19 to consult with an emergency medicine physician via a webcam.
Infection Control Today® caught up with Hollander recently to ask him about how telehealth can help combat COVID-19 spread.
Infection Control Today®
Hollander:
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35% of hospital execs regret their EHR choice, survey finds
Jackie Drees -
Wednesday, March 4th, 2020 Print | Email
If given the opportunity to go back in time, 35 percent of hospital executives said they would do so to choose a different EHR vendor, according to a recent Sage Growth Partners
report .
For its 2020 Hospital Technology Forecast report, Sage Growth Partners surveyed 100 hospital C-suite executives about their opinions on most pressing health IT priorities and challenges.
Three report insights:
1. If an EHR vendor doesn't provide the tool a hospital needs, 56 percent of respondents said they would seek out other health IT vendors to fulfill their needs rather than wait for their current vendor to offer the tool.
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Defending against the cyber threat
March 4, 2020
Any talk about cybersecurity in healthcare will undoubtedly cover one or more of a hacker’s favorite tactics: Ransomware, phishing, or exploiting poor device security.
While none of these threats are new, they continue to pose major risks to medical practices, partly because they are often not taken seriously enough by practice owners who think they will not become a target, according to experts.
“For hackers, money is the motivation,” says Kevin Haynes, chief privacy officer for Nemours Children’s Health System in Orlando, Fla. Hackers want patient’s health records because they can use them to order medical supplies or bill payers for services that weren’t provided.
A younger patient’s social security number might be used for years for fraudulent activity before anyone realizes it’s been compromised. “Small practices don’t have the same tools to manage risk, but they do retain personal information that can make cybercriminals money,” says Haynes.
Want to Know If Covid-19 Was There Before You?
Anjani Trivedi , Bloomberg News
(Bloomberg Opinion) -- Like it or not, we may have to submit to the intrusion of big data because of the coronavirus.
South Korea is at the cutting edge of how this could work in a democracy. Tracking down patient zeros — the first documented cases — and the ones that follow is becoming critical to containment and public safety. There won’t be a cure or vaccine anytime soon. The global number of cases is nearing 100,000. South Korea has the largest outbreak outside China, with almost 6,000 cases. The surge has largely been contained to the city where it erupted, Daegu, around a religious cult.
Central to South Korea’s approach has been the extensive collection and effective use of data as a public good – in this case, disease surveillance and testing. The Korea Centers for Disease Control and Prevention’s daily reporting details patients affected and being tested, connections between them and what provinces they’re in. It includes fatality rates by age and gender. Health authorities posted a detailed log of patients’ whereabouts prior to confirmation of infection. Their names weren’t given, but they were numbered. People were informed that this personal information was being collected and publicized. They didn’t have a choice. A Wall Street Journal report chronicled this: “Patient No. 12 had booked seats E13 and E14 for a 5:30 p.m. showing of the South Korean film, “The Man Standing Next.” Before grabbing a 12:40 p.m. train, patient No. 17 dined at a soft-tofu restaurant in Seoul. Patient No. 21 drove her car to attend a weekday evening church service.”
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AI Reveals Cellular Variants Between Black and White Cancer Patients
Case Western Reserve researchers have received a $3.2 million grant to uncover potential racial bias in cancer care using artificial intelligence.
March 06, 2020 - Researchers at Case Western Reserve University
are using artificial intelligence to reveal cellular distinctions between black and white patients with prostate cancer, and have received $3.2 million in federal grants to further examine potential bias in AI.
In a recent study, the team showed that AI analysis of digitized images of cancer tissues show critical variations between black and white male prostate cancer patients. The findings indicate that the new population-specific information could significantly improve care for black men with prostate cancer.
“On one level, we’re simply trying to understand and answer this question: ‘Are there biological differences in the disease, in the cancer, that are a function of your ethnicity or your race?’” said Anant Madabhushi, the F. Alex Nason professor II of biomedical engineering at Case Western Reserve and senior author on a study published today in Clinical Cancer Research,
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HIE, EHR Interoperability Ascending in Acute Care Hospitals
From 2017 to 2018, acute care hospitals had a 17 percent increase in their ability to integrate data into their EHR.
March 05, 2020 - EHR interoperability among acute care hospitals increased from 2017 to 2018,
according to the American Hospital Association (AHA) Annual Survey, which was published by the Office of the National Coordinator for Health Information Technology (ONC).
Interoperability is a constant a challenge for many health systems across the country, but the report found that nearly half of acute care hospitals participated in all four domains (send, receive, find, and integrate) of interoperability. This number has
steadily increased from 23 percent in 2014, to 26 percent in 2015, to 29 percent in 2016, to 41 percent in 2017, and then 46 percent in 2018.
The greatest increase of the four main interoperability domains came from the integration of data, which was a 9-percentage point increase. The ability to send, receive, and find documents electronically all increased from 1 to 4 percent.
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Isn’t It Time We Figured Out What “Patient Engagement” Really Means?
March 6, 2020
As someone who contributes to a health IT publication, I get to see how a broad cross-section of the industry markets itself. This includes access to a plentiful helping of buzzwords.
These days, as most of you have seen, one of the hottest buzzwords in the health tech sphere is “patient engagement.” On the whole, this makes sense. Few would argue that the need to keep interested in their care is a pressing one.
However, it’s hard to solve a problem if you’re not sure how to define it. Until we can better specify what behaviors we’re trying to foster, what circumstances in which we’d like to foster them and how to measure the results, we’re pretty much floundering around out there.
Unfortunately, I’m not sure whether the industry has met even one of these criteria. Not only are vendors and providers using an elastic definition of the term, a passing look at academic studies also suggests that researchers aren’t agreed upon a shared definition either.
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Making digital the ‘new normal in healthcare’: Stockholm’s approach
An interview with Daniel Forslund, chairman of the innovation and development committee in the region of Stockholm, Sweden.
March 05, 2020
Given the pace of scientific and technological advancements, Sweden, one of the early adopters of digital, is well-positioned to leverage the opportunities of the transformation that we're seeing around the world.
But as Daniel Forslund [pictured on the right], chairman of the Stockholm region's innovation and development committee, explains, it's not all that simple.
Stockholm, the country's capital and largest city, is now making it mandatory for healthcare providers to offer digital services in an effort to tackle the gap between the expectations of consumers and the reality.
Ahead of HIMSS20, MobiHealthNews caught up with Forslund to talk about their plans.
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NHSX Consults on Draft Digital Health Technology Standard
On February 27, 2020 NHSX, the technology and digital unit of the NHS, published its
draft Digital Health Technology Standard (the “Standard”) for consultation to stakeholders in the digital health space (the “Consultation”). The Consultation is open until 22 April, 2020 (and is available
here ).
The Standard, which is based on existing industry and health standards, is intended to streamline how digital health technologies are reviewed and commissioned by the NHS and social care.
The Standard contains ten components that developers of digital health technologies should adhere to:
review, and adhere to, the Code of Conduct for Data-Driven Health and Care Technologies (available here );
ensure that the product is designed to achieve a clear outcome for users of the system;
ensure that the product is easy to use and accessible to all users;
ensure that the product is clinically safe to use;
ensure that the product collects, stores and processes users’ information in a safe, fair and lawful way;
ensure that the product meets industry best practice and security standards;
ensure that the product meets all regulatory requirements;
ensure that the product makes the best possible use of open standards and complies with all relevant technical standards;
ensure that the product is appropriately tested and fit for purpose; and
generate evidence that the product achieves clinical, social, economic or behavioural benefits.
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Stakeholders Offer Patient Safety Criteria for EHR Reporting Program
Pew Charitable Trusts and MedStar Health put together a list of four key criteria to further enhance patient safety in the EHR reporting program.
March 04, 2020 - Pew Charitable Trusts and Maryland-based MedStar Health have
proposed a list of criteria for the Office of the National Coordinator Health Information Technology (ONC) regarding its upcoming EHR reporting program that prioritizes patient safety.
With the 21st Century Cures Act currently in motion, Congress assigned the ONC to develop an EHR reporting program to dissect and distribute data on EHR performance and usability.
The
EHR reporting program asks EHR developers to submit data on the functions of their health IT products, thus contributing to the establishment of new EHR certification requirements.
To prioritize patient safety, the ONC asked for feedback from stakeholders.
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03-04-20
65 health apps on my phone let Facebook know when I used them
That included Planned Parenthood’s Spot On period tracker, home test kit company Everlywell, and hypnotherapy app Clementine.
Facebook knows every time I work out. It knows that I’ve considered a health savings account, bought prescription skincare, and done way too much research about psychedelics and mental health. And for a while, it also knew every time I opened Planned Parenthood’s Spot On app, which I only did to log my period.
That’s according to my “off Facebook activity,” a lengthy list of all the companies that
allow Facebook to track my interactions on their websites and apps in order to send targeted advertising. When I downloaded it a few weeks ago, it included some 65 health-related apps and websites that let Facebook know when I’m interacting with their products and services.
Some of this data was innocuous, such as that I visited the websites for American Cancer Society or Stanford Medical Center. But companies using Facebook’s advertising tools also share much more personal information, sometimes unknowingly. For instance, Facebook knows that I registered and looked at products on Hers.com, a site that sells remedies ranging from vitamins to libido enhancers. I was especially shocked to find that Facebook was being alerted when I opened the Spot On Period Tracker, a digital product from Planned Parenthood. I am consistent about only opening the app to log my period. Similarly, Sweat, the fitness app I use, lets Facebook know every time I open the app, providing Facebook with the time and date of my every workout.
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Mobile Attacks Outpace Desktop Assaults
For the first time in cybercrime's history, more attacks have been waged against mobile devices than have been hurled at desktops.
The report is based on the analysis of 19 billion transactions that took place on LexisNexis' Digital Identity Network between July and December last year. Among those transactions, researchers identified 401 million attacks, 264 million of which targeted mobile devices, while 137 million struck at desktops.
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Prescription Checkups As A Tool For Appropriate Deprescribing
Carla’s* prescription checkup with her care team came at a crucial time. Just the previous week, she experienced a hypoglycemic (low blood sugar) episode overnight, during which her blood glucose level dropped to 53, dangerously low for an 89-year-old. Untreated, hypoglycemia can lead to dizziness, confusion, seizures, and even death. At her visit, Carla told the clinical pharmacist that she didn’t know why these events had been happening occasionally.
For older adults, the overprescribing of diabetes medications is a common cause of hypoglycemic events. According to a
recent Mayo Clinic study , older patients visit the emergency department or are hospitalized more than 4,750 times each year for hypoglycemia brought on by such diabetes drugs as glipizide, glyburide, repaglinide, and others. At Carla’s visit, the pharmacist noted that she was prescribed several doses of glipizide per day, which was likely the cause of her frequent low blood sugar episodes. Over time, Carla’s care team tapered her dose of glipizide to once per day in the morning. She hasn’t had any hypoglycemic events in the three years since and, at 92 years old, says she is feeling healthier than ever.
An Epidemic Of Medication Overload
Millions of older Americans like Carla would benefit from having care team visits focused on deprescribing (discontinuing or reducing doses of) medications that are unnecessary or harmful. A
large body of research , and our own experiences as family caregivers and clinicians, has shown that harm from too many drugs—or “medication overload”—is a significant problem for older adults.
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Coaching app similar to tracking app for hypertension control
March 4, 2020
Patients who received an at-home BP monitor and coaching via a smartphone app to promote healthy behaviors experienced similar reductions in BP as patients who used a BP tracking app and monitor, according to research published in JAMA Network Open .
Mean systolic BP among the intervention participants who received
smartphone coaching was 140.6 mm Hg at baseline and, after 6 months, decreased to 132.3 mm Hg. Among the participants in the control group who received the BP tracking app, mean systolic BP decreased from 141.8 mm Hg at baseline to 135 mm Hg at 6 months.
The between-group adjusted difference in systolic BP was 2 mm Hg (95% CI, 4.9 to 0.8).
At 6 months, the secondary outcome of self-efficacy in BP control was greater in the intervention group (0.36 points on a 5-point scale; 95% CI, 0.18-0.54).
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Technology can help diagnose, contain COVID-19 – within limits
Monitoring coronavirus patients remotely with clinical-grade sensors and collecting data on numerous physiological signals could improve clinical decision-making for providers.
March 05, 2020 11:11 AM
Digital tools such as telehealth, remote patient monitoring, data analytics and even consumer-facing AI-based chatbots could play a key role in containing the outbreak of COVID-19 and help people who think they've been exposed to the novel coronavirus – but experts warn that such tools are not a cure-all.
For example, AI-based algorithms could be most helpful in providing information about patients who have already been diagnosed with COVID-19 or who are suspected of being infected.
Monitoring these patients remotely with clinical-grade sensors and collecting data on numerous physiological signals could improve clinical decision-making for providers, and the process can also help them learn more about the disease so they can better treat it.
The learning from the AI-based algorithms could then be combined with other information such as laboratory and imaging tests to create a composite mechanism that could help clinicians understand the disease better, and ultimately lead to better detection or prediction of the early signs of infection.
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How Portugal is advancing the use of eHealth in Europe
An interview with Diogo Martins, international projects coordinator at the Portuguese health ministry's central purchasing and IT authority, SPMS.
March 05, 2020 10:47 AM
But these are only two initiatives of the kind. Ahead of HIMSS20, Healthcare IT News caught up with Diogo Martins, international projects coordinator at the Portuguese health ministry's central purchasing and IT authority, to find out more.
This interview has been edited for length and clarity.
Healthcare IT News: Could you give our readers an overview of the SPMS’ (Shared Services of the Ministry of Health or Serviços Partilhados do Ministério de Saúde) role in Portugal, where it fits into the healthcare system, and your work there?
Martins:
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HIMSS 20 Canceled Amid Coronavirus Concerns
Major companies like Microsoft, Cisco, and Amazon pulled out of the annual Orlando conference in recent days.
HIMSS 20, the annual meeting of the Healthcare Information and Management Systems Society (HIMSS),
has been canceled due to concerns surrounding the spread of coronavirus disease 2019 (COVID-19), according to a press release Thursday afternoon.
"Made apparent by recent reports from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), the virus continues to spread globally and the situation is so dynamic that each day brings a new development," the statement read. "It is clearly necessary to cancel the 2020 HIMSS Global Health Conference & Exhibition."
This is the first time HIMSS has been canceled since the conference began in 1962.
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Will Big Tech save the NHS – or eat it alive?
Technophile politicians and tech companies are making big promises. But the broader impact of the digital transformation of our health and public services has been too little examined.
3 March 2020
In her 2015 book Reclaiming Conversation , Sherry Turkle describes “one of the most gut-wrenching moments in my then fifteen years of research on sociable robotics”, one which “changed her mind” after years as an enthusiastic advocate of the emancipatory potential of connected technologies:
"One day I saw an older woman who had lost a child talking to a robot in the shape of a baby seal. It seemed to be looking in her eyes. It seemed to be following the conversation. Many people on my research team and who worked at the nursing home thought this was amazing. This woman was trying to make sense of her loss with a machine that put on a good show… I didn’t find it amazing. I felt we had abandoned this woman … It seemed that we all had a stake in outsourcing the thing we do best – understanding each other, taking care of each other…It is not just older people that are supposed to be talking. Younger people are supposed to be listening . This is the compact between the generations… [instead], We build machines that guarantee human stories will fall upon deaf ears."
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Artificial Intelligence May Boost Sleep Disorder Treatment, Diagnosis
Artificial intelligence has the potential to enhance sleep studies, improving the diagnosis and treatment of sleep disorders.
March 02, 2020 - Researchers could use artificial intelligence to boost efficiencies and precision in sleep disorder treatment, leading to improved care and better patient outcomes, according to a new
position statement from the American Academy of Sleep Medicine (AASM).
Published in the Journal of Clinical Sleep Medicine
Sleep centers collect massive amounts of data, the statement authors said, which could enable AI and machine learning algorithms to advance sleep care. These technologies have the potential to generate more accurate diagnoses, prediction of disease and treatment prognosis, classification of disease subtypes, precision in scoring, and sleep treatment optimization and personalization.
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How an EHR Risk Calculator Can Take Aim at Clinician Burden
Researchers at MedStar Health believe its new EHR-implemented cardiac tool can not only identify cardiac risk, but it also devises a plan of action for the patient.
March 02, 2020 - Heart disease is the number one cause of death in the US, a cause for alarm for many medical professionals. But a new risk calculator tool from MedStar Health could make a dent in those numbers.
According to the CDC, cardiovascular-related death rates are rising among people age 45 to 64. The high death rate, coupled with the high costs of treating full-blown cardiovascular disease, are pushing this issue to the forefront, asking providers to drive more intensive care for patients.
Central to doing so is understanding who might be at risk of cardiovascular disease in the first place, and then ramping up preventive measures to mitigate that risk.
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Judge Finalizes Quest Diagnostics Settlement Over 2016 Data Breach
First proposed in October, a judge has finalized the data breach lawsuit settlement between Quest Diagnostics and the patients impacted by a 2016 hack of the testing giant’s patient application.
March 03, 2020 - The US District Court in New Jersey issued a final
approval of a class-action lawsuit settlement between Quest Diagnostics and the patients impacted by a 2016 data breach. The testing giant will pay $195,000 to resolve claims the data of 34,000 patients were compromised during the hack.
First disclosed in
November 2016, a hacker breached the MyQuest by Care360 web application to then access and steal data. Patient names, dates of birth, contact details, and medical test results, including HIV status were compromised for an undisclosed period of time, as officials did not outline when the unauthorized access began and when it was first discovered.
In response, patients filed a lawsuit against Quest in 2017 claiming the testing giant failed to protect their health information and did not provide patients with a timely, accurate notification that a potential breach had occurred.
The lawsuit was amended twice during the litigation period, before both parties came to a settlement agreement in
October 2019 .
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VA wants to be a leader in using artificial intelligence
March 2, 2020 12:23 pm
Best listening experience is on Chrome, Firefox or Safari. Subscribe to Federal Drive’s daily audio interviews on Apple Podcasts or PodcastOne .
Veterans Affairs last fall launched a new office with the goal of establishing the department as a leader in the use of artificial intelligence. It named Dr. Gil Alterovitz, formerly a health informatics researcher at the Harvard-MIT Health Sciences and Technology Division, as its director. For a progress report,
Federal Drive with Tom Temin caught up with Alterovitz at an ACT-IAC artificial intelligence shared interest group meeting. He explained how the National Artificial Intelligence Institute is organized.
Interview transcript:
Dr. Gil Alterovitz:
Tom Temin:
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For Federal Healthcare Agencies, a Case for Better AI Outcomes
As officials increasingly turn to algorithms for assistance, they should be wary of tools that make harnessing artificial intelligence look easy.
March 3, 2020
On Dec. 31, a Toronto-based company called BlueDot—which created and runs a global health monitoring platform driven by artificial intelligence—alerted its government and commercial clients that an unusual form of coronavirus was spreading rapidly in the Chinese port city of Wuhan.
This was almost a full week before the Centers for Disease Control and Prevention reported the outbreak of what is now known as COVID-19, and nine days before the World Health Organization reported it.
This anecdote reminds us that artificial intelligence is assuming an ever-larger and more critical role in public health. Private healthcare organizations have been employing artificial intelligence capabilities for years for a wide variety of use cases, and now we see federal civilian and defense healthcare agencies following suit.
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March 3, 2020 / 3:03 AM
4 of 5 transgender youths want preferred names, pronouns in health records
Feb. 27 (UPI) -- What's in a name? When young transgender people seek healthcare services, how physicians refer to them can affect their comfort level -- which influences whether they receive proper care.
Nearly 80 percent of transgender youths want electronic medical records, or EMRs, to reflect their preferred names and pronouns, according to a survey published in JAMA Pediatrics this month.
"Most transgender youths in this study use a name that is different from their legal name and want their affirmed name and pronouns clearly documented in electronic health records," Kacie Kidd, a fellow in adolescent and young adult medicine at the UPMC Children's Hospital of Pittsburgh, told UPI. "Few are given the opportunity to discuss this critical part of their identity outside of specialized gender centers."
A study
published in February , also by Kidd and her colleagues, showed more than half of transgender youth feel uncomfortable sharing their gender identity with healthcare providers over fears they will be stigmatized. For many, this anxiety means hesitance to pursue necessary medical treatments.
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As Coronavirus Spreads, Should Travel History Be in Your Medical Records?
TUESDAY, March 3, 2020 (HealthDay News) -- Including travel history in patients' medical records could help slow the spread of coronavirus and future infectious outbreaks, two experts say.
Adding travel history to routine information such as temperature, blood pressure, heart rate and respiratory rate in patients' electronic medical records could help put a patient's symptoms in context for health care providers, they explained.
"The current outbreak is an opportune time to consider adding travel history to the routine. The COVID outbreak is clearly moving at a tremendous pace, with new clusters appearing daily," said Dr. Trish Perl, chief of infectious diseases and geographic medicine at University of Texas Southwestern Medical Center in Dallas. She wrote a commentary with Dr. Connie Savor Price, from the University of Colorado School of Medicine.
"This pace is a signal to us that it is a matter of time before we will see more of these infections in the U.S.," Perl said in a UT Southwestern news release. "What is different with this outbreak is that this virus is more fit and transmissible and hence there has been much more transmission."
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Health Catalyst points HIMSS20 attendees toward three AI trends
The artificial-intelligence-powered healthcare information technology vendor discusses delayed AI results, algorithmic bias and attracting data science talent.
March 04, 2020 01:09 PM
Healthcare IT News
A dearth of healthcare AI results
Jones said the industry is not seeing healthcare AI results in the timeframe and to the magnitude hoped for. On a related note, there is the question of how healthcare-provider organizations deal with the crush from AI-powered health IT vendors in the space.
"It is very easy for individuals or organizations to get excited about their first AI project," Jones said. "It is new, exciting and a bit magical. Out of dreams of doing good or pressure to perform, people would like to believe there is a solution. What is the problem? Building predictive models is very quick and easy."
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Travel Times Still a Challenge for Rural Health, Access Disparities
Some rural-dwelling breast cancer patients saw 40.8 miles of travel to radiation treatment, underscoring a key problem with rural health.
February 28, 2020 - Women with breast cancer living in rural areas can travel up to 2,000 miles over the course of their treatment, according to
research out of the University of Minnesota School of Public Health, underscoring the care access disparities faced by individuals living in rural parts of the country.
Individuals with breast cancer typically undergo extensive radiation treatment up to five days each week, usually on an outpatient basis. As such, patients must drive or obtain transportation to and from treatment.
But that’s a lot easier said than done for patients living in a rural setting, where radiation facilities may be few and far between. Patients who live far away from these facilities face tremendous geographic barriers that make it challenging and cumbersome for them to actually access their care, the researchers found.
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Patient Engagement Technology Must Incorporate Patient Needs
A new KLAS report shows some disconnect between patient needs and vendor offerings for patient engagement technology.
February 27, 2020 - Patient engagement technologies need to do more to integrate the patient voice, working to serve the patient – not just the provider – throughout the healthcare experience, according to a recent KLAS
report obtained via email.
The Patient Engagement 2020 report, which leaned on survey responses from 300 patients across the country, specifically looked at patient experiences with patient engagement technologies. This comes as the healthcare industry works to incorporate the patient as a member of the care team and recognize the growing role of consumerism in healthcare.
“In recent years, provider organizations have increased their investment in patient engagement technologies, but the outcomes they report are often provider-centric and don’t necessarily benefit patients directly,” KLAS wrote in the report’s introduction. “It is becoming increasingly important for the patient voice to be at the center of vendor development and provider deployment efforts.”
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ONC Addresses Health IT Infrastructure Challenges in New Agenda
Despite the growth electronic health data has seen, ONC addresses various challenges health IT infrastructure and lack of quality health data has brought to scientific research.
February 27, 2020 - Innovative research and scientific breakthroughs may remain stagnant due to difficulties with health IT infrastructure and the lack of quality data, but ONC articulates ways to address these challenges in its new policy and development
agenda .
A new blog post written by the National Coordinator Don Rucker, MD, and ONC staffers Teresa Zayas Caban, Kevin Chaney, MGS, highlighted the efforts ONC is making to advance the nation’s health IT infrastructure to specifically achieve two goals: leveraging high-quality electronic health data for research and advanced health IT infrastructure to support research.
ONC developed the goals following a review of relevant literature and programs, key interviews, and a workshop to pinpoint electronic health and health IT infrastructure gaps. Attendees of the workshop included representatives from federal agencies, technology vendors, researchers, and other stakeholders. The updated Federal Health IT Strategic Plan touched on two specific goals to modernize our nation’s health IT infrastructure and re-enable research and breakthroughs. The first goal was to leverage high-quality electronic health data for research and the second goal was to advance health IT infrastructure to support research.
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Arizona HIE Adds Health Data Hub to Improve Interoperability
Since the launch of NextGen Healthcare’s Health Data Hub (HDH), Arizona’s HIE has seen an improvement in EHR interoperability and patient and clinical searches.
February 26, 2020 - Arizona’s statewide health information exchange (HIE), Health Current, has
launched NextGen Healthcare’s Health Data Hub (HDH), a cloud-based platform that aims to support the interoperability and secure sharing requirements of participating health systems.
Health Current is the first HIE to implement the HDH data solution, which the company says allows users to create, optimize, and manage their workflow, while also optimizing data aggregation and providing patient data from across the network.
“Participation in the Arizona HIE has grown ten-fold since 2015. To keep up with demand, it was critical that we transition to a more robust platform—that’s why we partnered with NextGen Healthcare,” said Melissa Kotrys, CEO of Health Current.
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Feb. 27, 2020
Health Care System Underused in Addressing Social Isolation, Loneliness Among Seniors, Says New Report
WASHINGTON — Seniors who are experiencing social isolation or loneliness may face a higher risk of mortality, heart disease, and depression, says a new
report from the National Academies of Sciences, Engineering, and Medicine. Despite the profound health consequences — and the associated costs — the health care system remains an underused partner in preventing, identifying, and intervening for social isolation and loneliness among adults over age 50.
For seniors who are homebound, have no family, or do not belong to community or faith groups, a medical appointment or home health visit may be one of the few social interactions they have, the report notes.
The report outlines five goals that the health care system should adopt to help address the health impacts of social isolation and loneliness. It also offers recommendations for strengthening health workforce education and training, leveraging digital health and health technology, improving community partnerships, and funding research in understudied areas.
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Facebook has a prescription: More pharmaceutical ads
Pharmaceutical companies are ramping up their spending on social media, triggering some patient advocate concerns about privacy
March 3, 2020 at 11:00 p.m. GMT+11
Jordan Lemasters keeps seeing ads in his Facebook app for an attention-deficit/hyperactivity disorder drug called Vyvanse. When the Chicago-based audio branding consultant recently clicked on the ad’s drop-down menu and selected “Why Am I Seeing This Ad,” a pop-up said it was because of his age range, because he lives in the United States and because he may have visited Vyvanse.com.
But Lemasters felt spooked. The 29-year-old had used another ADHD drug, Adderall, but never publicized it. The ads “just felt invasive,” says Lemasters, who says he quit Adderall in 2017 because it made him feel like a zombie. “What bothers me is how powerful those drugs are and how it’s pushed, rather than a doctor actually assessing a patient and suggesting a proper solution."
After years of avoiding social media, drug companies are growing bolder about advertising on Facebook and other social networks, according to interviews with advertising executives, marketers, health-care privacy researchers and patient advocates. That is exposing loopholes around the way data can be used to show consumers relevant ads about their personal health, even as both social networks and pharmaceutical manufacturers disavow targeting ads to people based on their medical conditions.
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Allscripts announces fourth quarter 2019 results and outlook for 2020
Fourth quarter 2019 bookings of $312 million, up 6% year-over-year Extended Allscripts Managed Services Agreement with Northwell Health through 2026 Contract revenue backlog up $500 million to $4.4 billion as of the end of the fourth quarter
March 02, 2020 04:01 PM Eastern Standard Time
CHICAGO--(
BUSINESS WIRE )--Allscripts Healthcare Solutions, Inc. (Nasdaq: MDRX) (Allscripts) announced its financial results for the three and twelve months ended December 31, 2019.
“Our fourth quarter results show continued strength in new bookings which positions us well for growth across our platforms”
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Pharmacy IT helps Vanderbilt save $35 million annually on inpatient drugs
Vanderbilt University Medical Center’s pharmacy and therapeutics committee and health IT teams worked together on getting optimal drugs prescribed and dispensed.
March 03, 2020 11:53 AM
Vanderbilt University Medical Center knew that transitioning biosimilars – a biologic medical product highly similar to another already approved biological medicine – into the various workflows of a health system was a critical yet complex challenge that had to be tackled quickly. It needed to find a behind-the-scenes technology that prioritized efficacy, safety and cost savings, because the health system found that just adding the biosimilar into the formulary did not mean that people would order or use it.
THE PROBLEM
“That realization spurred us to think critically and collaboratively as the pharmacy and therapeutics committee and the health IT team about what kind of elegant, high-tech solution could increase the use of biosimilars, which when first released carry the opportunity for cost savings and incented reimbursement,” said Bob Lobo, PharmD, director, clinical programs, and secretary, PT&D committee, at Vanderbilt University Medical Center.
“But the first biosimilar added to the formulary and added to the ordering system just sat there. There were no orders, even though the evidence and safety were there,” he added.
There was a natural time element. There is a relatively brief window in which staff can take advantage of CMS’ incentive to use biosimilars.
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Amazon Alexa now using First Databank drug information to answer med questions
Specialized answers about medication information were created specifically for the ambient voice-enabled service.
March 03, 2020 11:31 AM
First Databank, a vendor of drug and medical device knowledge that helps healthcare professionals make decisions, announced today that consumers now have access to a wide variety of drug information from FDB through simple queries via Alexa, Amazon’s cloud-based ambient voice service.
A subset of FDB’s drug information, used for more than 40 years by healthcare professionals, now can be accessed by consumers from any Alexa-enabled device.
First Databank is debuting this technology the week before the big HIMSS20 Global Conference and will be highlighting it in booth 2559 at the event, March 9-13 in Orlando.
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NHS needs a ‘postmodern EHR approach’, says founder of openEHR vendor Better
Tomaž Gornik calls on trusts to start moving data onto open platforms.
March 03, 2020 12:11 PM
A “postmodern EHR approach” can benefit the NHS by avoiding the need to be locked into one supplier, according to Better founder and chief executive Tomaž Gornik.
Speaking at the Digital Health Rewired conference in London tomorrow, Gornik will argue that trusts which do not want the cost of working with a single vendor must first move their data onto an open platform that can feed the different applications clinicians need.
“The key concepts are a standards-based, vendor-neutral clinical data repository with a strong interoperability layer and low-code toolkits that can support an ecosystem of best of breed applications.
“Organisations can then deploy these applications according to their resources and the needs of clinicians and patient,” Gornik is expected to say.
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How Can We Make MIPS Reporting Easier? Seema Verma Has A Plan For That
March 3, 2020
For what seems like an eternity, providers have been struggling with quality reporting requirements imposed by the MIPS program. Now, at long last, CMS seems to be taking steps to ease the MIPS burden via the magic of EHRs.
According to a piece in
Fierce Healthcare , CMS administrator Seema Verma has a
plan to shift MIPS reporting from a labor-intensive headache to an essentially hands-free process. In her vision, providers will use EHRs to report quality data and clinicians “don’t have to lift a finger,” Verma told the audience at the CMS Quality Conference held in late February.
Her plans rely on the transfer and sharing of data using FHIR standards, which should pave the way for stakeholders to submit data to a centralized data submission system. This dovetails nicely with a proposed rule from ONC which would also call for FHIR use by providers.
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ONC: Data Standards, Security Key to Precision Medicine Success
ONC is establishing data standards and security initiatives to accelerate precision medicine research.
February 27, 2020 - ONC
is working to advance precision medicine research by supporting projects that improve health data standards, adopting policies that support data security and privacy, and promoting data sharing among researchers.
As part of the Precision Medicine Initiative (PMI), a federal effort to accelerate the next generation of health research, ONC and its collaborators are seeking to rethink data access, storage, aggregation, and analysis.
“The increasing availability of electronic health data in the 21st century has tremendous potential to ignite a new era of inquiry and discovery. With precision medicine, researchers will be able to make new discoveries about health and illness to bring a more personalized approach to patient care,” Teresa Zayas Caban, Kevin Chaney, MGS, Stephanie Garcia, MPH, Tracy Okubo, PMP and Robert Carroll, PhD wrote in a recent blog post.
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Here are the top 5 things that will be generating buzz at HIMSS 2020
Mar 2, 2020 12:01am
The Healthcare Information and Management Systems Society (HIMSS) conference will kick off in Orlando on March 9. (Tina Reed)
The Healthcare Information and Management Systems Society (HIMSS) Conference is only a week away from kicking off in Orlando.
The annual event, which brings tens of thousands from the worlds of healthcare tech together with payers, providers and policy experts to a single place, typically offers a barometer for where the industry is going in the year ahead.
Here's a look at our predictions for what will be generating the most buzz—or perhaps overhype—at this year's HIMSS.
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Machine Learning, EHR Data Reveal Chronic Disease Associations
A machine learning tool mined EHR data to uncover novel chronic disease associations, which could help identify new research paths.
March 02, 2020 - A machine learning algorithm can mine EHR data and discover novel associations between common chronic diseases and lesser-known conditions, which could support earlier monitoring or medical intervention, according to a
study published in
PLOS One .
The use of EHRs in large health systems offers the opportunity to conduct population-level analyses that explore disease progression. The team wanted to identify novel comorbidities from routinely collected, anonymized EHRs.
Researchers developed a machine learning algorithm, called the Phenome-Disease Association Study (PheDAS), to perform association studies and identify comorbidities across time in EHRs. The team validated the tool using three example conditions: Alzheimer’s disease, autism spectrum disorder, and optic neuritis, which can be the first indication of multiple sclerosis.
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To Measure The Burden Of EHR Use, Audit Logs Offer Promise—But Not Without Further Collaboration
Unfortunately, collecting data on user behavior in EHR systems has been a historically expensive and onerous process, relying on time and motion studies, observation, surveys, and interviews. These methods also risk adding to burden by imposing on clinicians’ time.
Audit logs, sometimes referred to as audit trails, are an automated tracking feature that monitors access to and activity within EHR systems to document who may have accessed the record for administrative, clinical, and security/privacy purposes, and offer a potentially valuable alternative source of information. While there is some variation in the information stored in different vendors’ audit logs, a vendor must track every action taken in the EHR (such as the addition, deletion, or querying of information) along with contextual information (date/time, user, and patient) to achieve
2015 EHR certification .
As of 2017 , 96 percent of hospitals and 80 percent of practices used EHRs in compliance with these criteria.
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Apple Watch Can't Catch Fast Afib
— The Skeptical Cardiologist has good news about another wearable, though
by Anthony Pearson, MD February 29, 2020
Apple Watch ECG is inherently limited in diagnosing AF above 120 beats per minute (BPM). This guarantees a substantial number (possibly the majority) of AF episodes will not be recognized. Such false negative notifications may falsely reassure patients that they don't have AF and delay them seeking medical attention.
Recently, I saw a patient who was referred to me for an abnormal 12-lead ECG. While reviewing his symptoms we discovered that his Apple Watch had registered high heart rates, sometimes up to 150 BPM, which lasted for several hours.
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How health officials and social media are teaming up to fight the coronavirus 'infodemic'
Updated 2312 GMT (0712 HKT) March 1, 2020
New York (CNN Business) As health officials in a growing number of countries fight to slow the spread of the novel coronavirus , they're also working to stem a secondary issue that the World Health Organization is calling an "infodemic."
The WHO defines an infodemic as "an overabundance of information — some accurate and some not — that makes it hard for people to find trustworthy sources and reliable guidance when they need it." The problem is aided by the ease and speed with which false or misleading information can spread on social media .
Coronavirus, also known as COVID-19, emerged in China in January and now has spread to more than 85,000 global cases with infections on every continent except for Antarctica. As the disease has spread, so too have false claims online about how it began, the number of people infected and promises of magical cures.
"In this particular case, with COVID-19, because of the growth of social media platforms in recent years, information is spreading faster than the virus itself," Aleksandra Kuzmanovic, social media manager for the WHO, told CNN's Brian Stelter on "Reliable Sources" Sunday.
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Transfer center tech boosts Banner Health’s revenue by $26.4 million
The health system estimates referral volume grew 16.5% last year, adding 3,308 more patients than the previous year.
March 02, 2020 12:49 PM
Headquartered in Arizona, Banner Health is one of the largest nonprofit health systems in the country. The complex system owns and operates 28 acute-care hospitals. It also has Banner Health Network, an accountable care organization (ACO) of physicians, hospitals and services caring for local communities. Further, it operates Banner University Medicine, academic and employed physician groups, long-term care centers, outpatient surgery centers and an array of other services.
THE PROBLEM
Banner Health manages approximately 70,000 referrals per year, including approximately 34,000 incoming patients from community hospitals and competitors. Transfer volume growth since 2016, however, had started to decline from 13.7% to 2.4% in 2018. Staff noticed this decreasing referral volume and set out to determine its causes and identify ways to reverse the trend.
“We discovered that transfers on average took more than three hours – 198 minutes – due to the lack of standardized processes and communication difficulties,” said Charley Larsen, RN, RN senior director at Banner Health Transfer Services. “This included multiple phone calls between our physicians until the right physician at the appropriate facility would receive the necessary information to approve the admission.”
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Trump Is Slated to Speak at HIMSS 20; Could Interoperability Be the Topic?
The Orlando conference, which expects 45,000 attendees, is scheduled to proceed as planned; precautions will be taken following confirmed cases of coronavirus in Florida.
President Donald Trump is slated to speak at
HIMSS 20 , the annual meeting of Healthcare Information and Management Systems Society (HIMSS) scheduled in Orlando March 9–13. His remarks are tenatively scheduled for 4:00 p.m. on Monday, March 9. Although the topic has not been confirmed, he is likely to address interoperability, a subject that federal government officials have spoken about during previous HIMSS conferences.
During HIMSS 19, 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. Two years ago senior Trump advisor Jared Kushner spoke at HIMSS 18 about this same topic.
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Family Partnerships
Teenager, Parent, and Clinician Perspectives on the Electronic Health Record
Jennifer L. Carlson , Rachel Goldstein , Tyler Buhr and Nancy Buhr
Pediatrics March 2020, 145 (3) e20190193; DOI: https://doi.org/10.1542/peds.2019-0193
Management of adolescent confidentiality and sensitive services has always posed challenges to medical clinicians. State and federal laws, as well as institutional policies, may dictate what information can or cannot be shared by a clinician with a parent or guardian of an adolescent. Clinicians concerned about diagnosis disclosure via insurance notifications may limit their testing or prescription, refer sensitive services to more specialized reproductive health clinics, or appeal to noninsurance funders to cover sensitive testing and confidential prescriptions. All factors may be burdensome to patients, families, and/or clinicians.
With the advent of electronic health records (EHRs), clinicians face additional challenges for preserving adolescent confidentiality.
1 Clinicians are frequently in the difficult situation of balancing their patient’s need for confidentiality with creating an accurate and complete medical record that enhances coordination of care with families and other clinicians.
2 Current EHR systems are often extremely limited in their ability to ensure confidentiality of items such as medications or problem lists across the many interfaces in which these items could be disclosed (such as after-visit summaries, shared or open notes, problem and medication lists within the portal system).
3 Whereas some institutions have a practice of using confidential note types or confidential encounters for sensitive information, this practice relies on clinicians to consistently document the appropriate information in the appropriate location. Institutions have also used custom-built functionality for excluding specific laboratory values or medications from being shared within the portal, but this is a labor-intensive undertaking that requires constant upkeep for ever-changing diagnostic codes, medication, and laboratory orders. Because of these challenges, and as a way to protect adolescent confidentiality, many institutions have defaulted to portal systems that share limited information with patients and families by blocking access to medications, laboratory values, notes, and/or problem lists.
4 , 5 Unfortunately, this has resulted in the limitation of meaningful use of the EHR for these users.
6
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How HIEs Are Promoting Interoperability for Rural Providers
From natural disasters to underpopulated hospitals, rural providers are facing the challenges and getting the help they need from their local HIEs.
February 28, 2020 - Health information exchanges (HIEs) are crucial for connecting communities and ensuring patient medical records are available at all times. However, for rural hospitals and providers, participating in an HIE is not always a reality.
As value-based care brings more focus to patient social needs, HIEs allow organizations such as first responders, blood banks, schools, and drug and alcohol treatment centers to connect and share patient information.
In a
survey conducted by Strategic Health Information Exchange Collaborative (SHIEC), 92 percent of the US population is covered by HIEs.
But
according to the most recent ONC data brief in late 2018, small and rural hospitals were about half as likely to share records compared to their larger counterparts. In total, only 62 percent of small hospitals shared this information.
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Coronavirus Reveals Limits of AI Health Tools
Makers of ‘symptom checker’ chatbots struggle to update algorithms to respond to epidemic
By Parmy Olson
Feb. 29, 2020 8:00 am ET
Technology and health-care companies are racing to roll out new tools to test for and eventually treat the coronavirus epidemic spreading around the world.
One sector that is holding back: Makers of artificial-intelligence-enabled diagnostic tools, increasingly championed by companies, health-care systems and governments as a substitute for routine doctor-office visits.
In theory, such tools—sometimes called “symptom checkers” or health-care bots—sound like an obvious short-term fix: They could be used to help assess whether someone has Covid-19, the illness caused by the novel coronavirus, while keeping infected people away from crowded doctor’s offices or emergency rooms where they might spread it.
These tools vary in sophistication. Some use a relatively simple process, like a decision tree, to provide online advice for basic health issues. Other services say they use more advanced technology, like algorithms based on machine learning, that can diagnose problems more precisely.
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Weekly News Recap
HIMSS announces that HIMSS20 will continue as scheduled with added on-site precautions to address coronavirus-related concerns.
Medical chat service K Health raises $48 million in a Series C funding round.
MIT Technology Review announces its 10 most promising breakthrough technologies, which include hyper-personalized medicine and AI-discovered molecules.
The VA says it hopes to go live with Cerner at its first site in July 2020, months after the originally announced date.
AMA releases a patient records access guide for medical practices.
HHS and ONC publish a report on reducing the provider burden of health IT.
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Enjoy!
David.
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