Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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NHS organisations adopt clinical decision support tool during pandemic
A number of NHS organisations have adopted a clinical decision support tool to help during the Covid-19 pandemic.
Hanna Crouch – 24 August 2020
Wolters Kluwer Health’s UpToDate is an evidence-based knowledge system that helps clinicians make the right decisions at the point of care.
It contains more than 10,000 articles providing evidence-graded treatment recommendations, as well as diagnostic and other information for common and rare conditions.
During the crisis, Wolters Kluwer Health provided clinicians with access to its evidence-based information on Covid-19 topics free of charge.
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Oura ring: Improved accuracy of wearables promises better healthcare for all
The Oura ring's high accuracy in monitoring a person's biomedical signals might enable a prediction of a COVID-19 infection two to three days before symptoms appear.
By Tom Foremski for Tom Foremski: IMHO | August 28, 2020 -- 17:00 GMT (03:00 AEST) | Topic: Coronavirus: Business and technology in a pandemic
It's all about the finger -- it's much better than the wrist for tapping into bio-medical signals, says Oura Health CEO Harpreet Singh Rai. The signals are as much as 10-times stronger from a finger -- but the challenge is the tiny form factor of a ring compared with a wristband.
This is exactly what the Oura ring has managed to achieve with a normal-looking ring that is comfortable to wear -- a key goal for Singh Rai, who understands the value of continuous unobtrusive monitoring in evaluating personal healthcare because everyone is most definitely not the same. This is also a key part of the design philosophy of the Oura ring: The accuracy of the sensors is focused on detecting the minute differences in a person's signals -- because that's a highly personal marker of a person's health -- and not on averages based on a wide range of values.
The Oura ring is part of a next generation of wearables -- sold at consumer prices with testable claims of matching the performance of medical equipment costing tens of thousands of dollars.
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Clinical patient discharge summaries to be sent electronically to GPs
Clinical patient discharge summaries will soon be sent electronically to GPs from hospitals in England following a successful trial.
Andrea Downey – 28 August 2020
The first of its kind trial at Dorset County Hospital saw more than 4,000 structure Fast Healthcare Interoperability Resources (FHIR) messages sent to four GP practices, including outpatient letters, emergency care and inpatient discharge summaries.
It was run in with NHS Digital and TPP working with healthcare integration company Independent Systems Integrators.
The pilot aims to save GPs time in processing and clarifying patient information, allowing them to track changes and take necessary actions.
For example, it allows GPS to update information when a new or alternative medication has been prescribed for the patient, or action an onward referral request.
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Healthcare insecurity gets personal when you look beyond the big picture
In his latest column, our cyber security expert, Davey Winder explores why healthcare insecurity is about more than just protecting data, it’s about protecting lives as well.
Davey Winder – 25 August, 2020
When writing about cybersecurity it’s all too easy to focus on the big picture. That’s especially true when it comes to healthcare where the strategy for securing NHS data is, understandably, front and centre of my attention as a rule. However, every now and then, something crops up that reminds me that the devil can often be found in the smaller detail.
Sometimes stories that would otherwise swim unnoticed in the crowded cyber-ocean, float to the surface and expose a stark reality: healthcare insecurity is about more than just protecting data, it’s about protecting lives as well. This particular incident hit home on another level, a very personal one in fact.
Looking at smart tracker watches
The ethical hackers over at Pen Test Partners have something of a history of finding security problems with what you might call smart tracker watches. A smart tracker watch is a device aimed at the most vulnerable of users, be that young children or, as in this case, those living with dementia.
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Solving interoperability is not ‘a technical problem, it’s a social problem’
Solving interoperability is not “a technical problem, it’s a social problem”, the co-chair of INTEROPen has said.
Hanna Crouch – 21 August, 2020
Speaking to Digital Health News, David Hancock, was asked about whether he thought the Covid-19 pandemic would made interoperability in healthcare a higher priority.
Hancock, how is also a healthcare executive advisor at InterSystems, said: “People have been saying for the last how many years that interoperability is really important. The thing that we have got to recognise is that solving interoperability is not a technical problem, it’s a social problem.”
He added that he believes the introduction of Integrated Care Systems (ICSs) have helped with the drive for interoperability across the healthcare as trusts are no longer seen as “an individual island” but rather part of a group where they are “taking decisions as a collective”.
“This is a big, big deal, because with interoperability, we always think that the social problem we always face is this idea of the collective action dilemma,” Hancock added.
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https://healthitsecurity.com/news/cdt-ehi-unveil-draft-consumer-health-data-privacy-framework
CDT, eHI Unveil Draft Consumer Health Data Privacy Framework
Drafted in collaboration with providers, tech giants, and advocacy groups, the consumer health data privacy framework provides standards for health data not protected by HIPAA regulations.
August 27, 2020 - The Center for Democracy and Technology (CDT) and eHealth Initiative and Foundation (eHI) released its draft consumer health data privacy framework designed to define data in need of protection and the rules and standards needed to protect health information not protected by HIPAA.
The collaboration was funded by a grant through the Robert Wood Johnson Foundation.
As noted previously by the Department of Health and Human Services, HIPAA does not regulate the health data generated by third-party apps chosen by patients, if the app developer is not tied to the provider or their business associates.
“If the individual's app – chosen by an individual to receive the individual's requested ePHI – was not provided by or on behalf of the covered entity (and, thus, does not create, receive, transmit, or maintain ePHI on its behalf), the covered entity would not be liable under the HIPAA Rules for any subsequent use or disclosure of the requested ePHI received by the app,” officials explained.
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Children’s National Study Ties Telehealth to Better Antibiotic Stewardship
A new study finds that pediatric doctors using a telehealth platform with clinical decision support tools have a lower percentage of prescribing antibiotics when they're not needed.
August 28, 2020 - A telehealth platform that includes clinical decision support tools can help care providers reduce inappropriate antibiotic prescribing rates, according to a study conducted at Children’s National Hospital.
The study, published this week in the Journal of General Internal Medicine, found that providers using a virtual care platform with real-time access to their own prescribing statistics as well as practice-wide statistics reduced their prescribing rates. That would help reduce the estimated 2.8 million antibiotic resistant infections that occur each year in the US.
“Telemedicine has the potential for even more inappropriate antibiotic prescribing than brick-and-mortar facilities because doctors aren’t physically examining patients and may not have the tools to accurately diagnose bacterial infections, such as looking in a patient’s ears to diagnose an ear infection, or performing a throat swab to accurately diagnose strep throat,” Rana Hamdy, MD, MPH, MSCE, an infectious diseases specialist and director of the Antimicrobial Stewardship Program at Children’s National, said in a press release.
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https://www.healthcareitnews.com/news/ai-assisted-ehr-documentation-will-need-human-help
AI-assisted EHR documentation will need human help
Although AI documentation assistants will likely be integral to future primary care consultations, they'll still need to be supervised by a human.
By Kat Jercich
August 28, 2020 02:59 PM
Artificial intelligence technologies are being increasingly relied upon in the healthcare domain, particularly when it comes to decision support, precision medicine, and the improvement of the quality of care. Regarding primary care specifically, AI also represents an opportunity to assist with electronic health record documentation.
A new study published in the Journal of American Medical Informatics Association this week shows that, although AI documentation assistants (or digital scribes) offer great potential in the primary care setting, they will need to be supervised by a human until strong evidence is available for their autonomous potential.
In workshops with primary care doctors, wrote researchers from the Australian Institute of Health Innovation, "There was consensus that consultations of the future would increasingly involve more automated and AI-supported systems. However, there were differing views on how this human-AI collaboration would work, what roles doctors and AI would take, and what tasks could be delegated to AI."
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Epic’s Decision To Put Its Voice Assistant Front and Center Could Have A Big Impact
August 28, 2020
As some of you may know, voice assistant technology is becoming one of the hottest new applications to hit the healthcare IT world. To be sure, many institutions are still trialing the use of voice assistants in clinical settings, but this also points up that we’re still in the early phase of adoption.
Now, however, Epic has made a move that may almost singlehandedly bring such technologies into the mainstream. Working closely with Nuance, which has not surprisingly made a number of moves in this direction, Epic is now putting Hey Epic! voice assistant technology in it’s desktop EHR and not just its mobile apps.
Epic had planned to hype its new VA at HIMSS20, which was of course superseded by the onset of the coronavirus pandemic. However, it seems to have bounced back with a bigger bet on this technology.
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Healthcare Executives COVID-19 Challenges via KLAS Survey
August 28, 2020
The KLAS Arch Collaborative has a really great community of Healthcare Executives that are charged with making the most of health IT solutions in healthcare organizations. As such, it’s not a surprise that the KLAS Arch Collaborative would publish a report with results from a survey they did of Healthcare Executives.
Two charts stood out to me in the report. The first looked at the biggest technology challenge for organizations during the COVID-19 Crisis:
Not too many surprises in this chart since telehealth and remote patient monitoring have been top of mind for most healthcare executives. Although, it was interesting to see interoperability, real-time data analytics, and surveillance on the chart as well. What might be even more challenging is that most healthcare organizations were dealing with all of the above all at once during COVID-19.
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https://ehrintelligence.com/news/what-is-eprescribing-and-why-is-it-vital-for-providers-patients
What is ePrescribing and Why is it Vital for Providers, Patients?
An increase in interoperability and access to patient data triggered an ePrescribing increase in 2019.
August 26, 2020 - The introduction of ePrescribing in 2003 brought a more convenient, cheaper, and safer prescribing alternative for doctors, pharmacies, and patients.
“With electronic prescribing, or ‘e-Prescribing,’ health care providers can enter prescription information into a computer device – like a tablet, laptop, or desktop computer – and securely transmit the prescription to pharmacies using a special software program and connectivity to a transmission network,” according to The Office of the National Coordinator for Health Information Technology (ONC).
Once a pharmacy receives a request for a prescription, it can start filling the medication immediately.
Momentum began for ePrescribing when it was introduced in the Medicare Modernization Act (MMA) in 2003. It then became more prevalent, and it garnered more publicity when a July 2006 Institute of Medicine report said it reduced medical errors, which helped build further awareness of ePrescribing’s role in increasing patient safety.
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https://healthitsecurity.com/news/key-needs-for-a-resilient-healthcare-information-security-program
Key Needs for a Resilient Healthcare Information Security Program
Impact Advisor’s Shefali Mookencherry examines the current threat landscape and the needed tools entities need to build a resilient healthcare information security program.
August 26, 2020 - The Office of Civil Rights recently shared ways an IT asset inventory can create a more effective risk analysis to close information security gaps and support HIPAA compliance. Given the sophistication of the current threat landscape, these functions will prove crucial in supporting an overall resilient healthcare information security program.
While cybersecurity awareness has drastically improved across the healthcare sector, Impact Advisor’s Shefali Mookencherry, Principal Advisor and Solution Leader of Information Security, Privacy, and Disaster Recovery, explained that has not translated into a more secure infrastructure.
Currently, there are far too many cybersecurity considerations when it comes to making a more secure healthcare system, as internal users continue to be one of the biggest risks to the healthcare system and hackers are increasingly improving the sophistication of their phishing campaigns, she added. And those threats have rapidly increased amid the COVID-19 pandemic.
In the last week alone, reports from security researchers, the FBI, the Department of Homeland Security, and others have warned of new phishing campaigns, targeted vishing attacks, and even brute-force peer-to-peer botnets targeting the SSH servers of medical centers.
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Aug 26, 2020,10:47am EDT
These Are The Startups Applying AI To Transform Healthcare
Healthcare is perhaps the most important sector in the U.S. economy. It is the largest: close to $4 trillion per year is spent on healthcare in the United States. It employs more people than any other industry, accounting for 11% of all American jobs. Nearly one quarter of all U.S. government spending is on healthcare.
At the same time, healthcare is the most broken sector in the U.S. economy. Healthcare costs have spiraled out of control in recent decades, from $355 per person in 1970 to $11,172 per person in 2018. Despite spending far more on healthcare per capita than any other country, the United States ranks 38th in the world in life expectancy, between Lebanon and Cuba. Access to healthcare remains worse in the U.S. than in any other developed country.
Artificial intelligence offers an unprecedented opportunity to cut this Gordian Knot and reshape the practice of healthcare. Of the many ways in which AI will transform our lives in the coming years, its impact may be more profound and far-reaching in healthcare than in any other field.
Machine learning and healthcare are in many respects uniquely well-suited for one another. At its core, much of healthcare is pattern recognition. A healthy human body and its various subsystems function in consistent, quantifiable ways. When a human organism is suffering from some affliction, it deviates from this homeostasis in ways that tend to be predictable across time and populations.
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Trump administration asks Supreme Court to reverse abortion telemed ruling
In July, a Maryland federal judge issued an injunction blocking the FDA's in-person abortion requirements for the duration of the pandemic.
By Kat Jercich
August 27, 2020 01:19 PM
The Trump administration this week asked the U.S. Supreme Court to reverse a lower court ruling that allowed for mail-order and telemedicine abortion during the COVID-19 crisis.
U.S. Food and Drug Administration regulations require mifepristone, which is used in medication abortion, to be dispensed at a clinic, hospital or medical office. In June, U.S. District Judge for the District of Maryland Theodore Chuang blocked the requirements during the pandemic, finding them to be a "substantial obstacle."
Mifepristone, in combination with misoprostol, is FDA-approved for abortions up to ten weeks' gestation. In 2017, a New England Journal of Medicine article argued against the FDA regulations for mifepristone given the drug's safety record.
WHY IT MATTERS
Acting Solicitor General Jeffrey B. Wall applied for a stay of Chuang's injunction on Wednesday as the case makes its way through the lower courts, arguing that the regulations do not represent an undue burden.
"The safety requirements here concern only medication abortions using Mifeprex, which is approved for use only during the first ten weeks of pregnancy. They have no effect on the availability of surgical abortions, a method that this Court has treated as safe for women," wrote Wall.
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https://www.mobihealthnews.com/news/amazon-releases-wearable-health-tracker-app-called-amazon-halo
Amazon releases wearable health tracker with app called Amazon Halo
The Amazon Halo app uses five health metrics designed to give users a comprehensive look at their health and wellness, and gives actionable recommendations to make improvements.
August 27, 2020 11:35 am
Amazon entered the wearable health-device market today with the release of Amazon Halo, an on-wrist health tracker with an accompanying app.
The device itself has a fabric band, is screenless and includes a compact sensor that tracks activity, temperature and heart rate. It is water-resistant and has a seven-day battery life.
The Halo app uses five health metrics designed to give users a comprehensive look at their health and wellness, and gives actionable recommendations to make improvements.
Instead of using steps as a measurement of activity, Amazon Halo awards points based on the intensity and duration of the movement. Following the American Heart Association’s recommendation that adults get at least 150 minutes of moderate aerobic activity a week, the device sets a baseline goal of 150 activity points measured weekly.
Amazon Halo tracks the duration and quality of user sleep with sensors that detect motion, heart rate, temperature and sleep phase. Every morning, the app generates a sleep score out of 100 and offers tips to improve the quality of sleep.
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Global healthcare needs to speak a common language to tackle the challenge of COVID-19
COVID-19 has reinforced the possibilities that open up when we collaborate, united towards a common cause; in this case, of defeating the spread of SARS-CoV-2 says Atif Al Braiki, CEO, Abu Dhabi Health Data Services LLC (Malaffi).
August 27, 2020 01:53 AM
The pandemic has drawn attention to the inadequacies of the world’s data sharing frameworks. It has highlighted the lack of interoperability (the ability of computer systems to exchange information and operate in conjunction with each other) of many medical systems used by public and private providers, laboratories, and pharmacies globally. As a result, data exchange within a healthcare system, which utilises different data sharing frameworks, is not as streamlined as it should be. From the number of beds to the level of occupancy, the world is struggling to pool data from disparate and complex systems into one centralised location. By reshaping the way this crucial data is collated, analysed and disseminated into a coherent and easily accessible system, we will give healthcare professionals the tools they need to tackle the current crisis, and any we may face in the future.
Speaking the same language
Effective communication is the road network that transports information between locations. By speaking the same language, important data can move and lead to solutions much faster. Introducing better data standardisation will allow the health industry to speak a common language, with all the parameters used and understood in the same way. If there is no common standard set between different entities, data sharing becomes a challenge.
Systems must be interoperable; however, data sharing must also be governed. We can learn much from the vast experience of our colleagues in the banking sector in this regard. Modern banking technology allows us to easily transfer money across borders from one bank to another in the knowledge that the required security and controls are in place to enable this to happen. In addition to governance that allows the exchange, the systems are interoperable. This vital element is sometimes lacking in the healthcare sector. Transferring encrypted personal medical data from one healthcare provider to another within a secure network can be challenging, because data is not always recorded in a way that it can be allow an easy exchange of medical records in a universal clinical language.
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https://healthitanalytics.com/news/geographic-data-uncovers-trends-in-covid-19-mortality-spread
Geographic Data Uncovers Trends in COVID-19 Mortality, Spread
Researchers are using geographic data at the state and county levels to uncover patterns in COVID-19 mortality and disease spread.
By Jessica Kent
August 24, 2020 - To further discover trends in COVID-19 mortality and the spread of the virus, researchers are increasingly leveraging geographic and population data for new insights on how the disease operates.
A team from the University of Minnesota and the University of Washington recently used state-level data to find a statistical relationship between the number of hospital beds occupied by COVID-19 patients in a state and reported mortality.
The results, published in the Journal of General Internal Medicine, showed that COVID-19 patients occupied nearly 20 percent of all ICU-bed use in all 23 states examined, as well as about five percent of non-ICU bed capacity.
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https://healthitanalytics.com/news/gaps-in-early-covid-19-data-contributed-to-surge-in-us-cases
Gaps in Early COVID-19 Data Contributed to Surge in US Cases
Limited testing and gaps in COVID-19 data during initial stages of the pandemic resulted in many cases going undetected.
By Jessica Kent
August 25, 2020 - Gaps in early COVID-19 data led to significant underreporting of coronavirus cases, ultimately contributing to a large number of infections in the US by early March, a study published in the Proceedings of the National Academy of Sciences revealed.
While awareness and concern over COVID-19 grew in the US from January to March, it wasn’t until February 29th that Washington became the first state to declare a state of emergency, researchers noted.
Although several states had followed by mid-March, but a lack of a coordinated national response created a number of variables as each state decided how to react to an increasing number of cases.
A team from the University of Notre Dame used a simulation model beginning on January 1, 2020, using data reported by Johns Hopkins University on confirmed cases and deaths – accounting for asymptomatic infections, case fatality rates, and local transmission.
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https://ehrintelligence.com/news/va-integrates-patient-scheduling-ehr-tool-as-ehrm-feature
VA Integrates Patient Scheduling EHR Tool as EHRM Feature
The new VA patient scheduling solution aims to cut administrative burden while it is utilized on a single EHR workflow.
August 25, 2020 - The US Department of Veterans Affairs (VA) has launched the Centralized Scheduling Solution (CSS), a new appointment scheduling EHR tool at the VA Central Ohio Healthcare System, as part of its Electronic Health Record Modernization (EHRM) endeavor.
The appointment scheduling solution aims to simplify the scheduling process to ensure efficiency for veteran patients and VA providers at medical visits. VA plans to implement the EHR tool at all VA health facilities to expedite patient care throughout the health facilities.
“VA has delivered an enhanced scheduling system that will benefit Veterans and health care providers,” acting VA Deputy Secretary Pamela Powers, said in a statement.
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https://ehrintelligence.com/news/ehr-interoperability-patient-data-access-key-to-precision-medicine
EHR Interoperability, Patient Data Access Key to Precision Medicine
The development of the ONC’s final interoperability rule could make precision medicine a reality in the future.
August 24, 2020 - While the majority of medical treatments are geared to the average patient, precision medicine aims to cater to the individual and connect each patient with personalized treatment. However, EHRs are currently incapable of providing this type of customized care, and further optimization and increased interoperability are needed to achieve this type of care.
As defined by the Precision Medicine Initiative (PMI), precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.”
This concept isn’t exactly new. For example, a patient who requires a blood transfusion is not given blood from a randomly selected donor. Instead, the donor’s blood type is matched to the recipient to reduce the risk of complications. But precision medicine takes this a step further, pushing healthcare towards personalized medicine.
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https://healthitsecurity.com/news/fbi-cisa-alert-of-surge-in-vishing-cyberattacks-on-remote-workers
FBI, CISA Alert of Surge in Vishing Cyberattacks on Remote Workers
Hackers are targeting remote workers through a voice phishing, or “vishing,” campaign in an effort to collect enterprise login credentials, later selling access to company networks.
August 25, 2020 - Hackers are targeting employees working remotely amid the COVID-19 pandemic with a voice phishing, or “vishing,” campaign to obtain enterprise login credentials for mining company databases for personal information that can be used in later cyberattacks, according to a joint alert from the FBI and the Department of Homeland Security Cybersecurity and Infrastructure agency.
This is the second massive vishing campaign reported amid the pandemic. In June, IRONSCALES determined remote healthcare workers were being targeted with a vishing campaign designed to exploit legacy technology used to send voicemail messages to employees.
Remote work has surged amid the coronavirus crisis, resulting in massive number employees leveraging corporate Virtual Private Networks (VPNs) and a lack of in-person verification. In response, hackers launched a vishing campaign in mid-July, targeting employee tools across a range of sectors to monetize access.
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Credential Theft Via Spoofed Login Pages Increase, Healthcare Top Target
Hackers are drastically increasing credential theft attempts through social engineering and spoofed login pages, and healthcare recipients are the biggest target, IRONSCALES finds.
August 25, 2020 - A new IRONSCALES report found a drastic increase in successful credential theft attempts sent through spoofed login pages and social engineering attacks during the first half of 2020. And the most common recipients targeted with these attacks were those in the healthcare sector.
Researchers identified and analyzed fake login pages sent during the first half of the year, which are commonly used in support of spear-phishing campaigns and other hacks. In total, they identified more than 50,000 fake login pages, which spoofed login pages from over 200 prominent global brands.
Outside of healthcare, other leading recipients were those in financial services, government agencies, and technology industries.
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Covid-19 Pandemic Drives Patients—and Deal Makers—to Telemedicine
Several remote-care services are selling themselves or going public amid a telehealth boom
By Aug. 25, 2020 8:33 am ET
By Sarah Krause
Aug. 25, 2020 8:33 am ET
The coronavirus pandemic has put the once-niche category of telemedicine in the spotlight and is now driving a flurry of deal activity involving virtual health-care providers.
Telehealth company American Well Corp. in recent months explored a sale in lieu of going public, according to a person familiar with the matter. The company, known as Amwell, is one of several remote-care companies seeking ways to capitalize on a surge in usage during the coronavirus pandemic and on Monday filed a registration statement for an initial public offering.
At the same time, MDLive Inc., a rival telehealth company, is preparing for an IPO early next year, and Talkspace, the text-based therapy company, is seen by some as a target for companies interested in expanding their behavioral health platforms.
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Lyra Health gains unicorn status as demand for teletherapy soars
Aug 26, 2020 10:19am
The demand for teletherapy services is soaring, particularly as employers look to better support workers during the COVID-19 pandemic.
For employer-focused startup Lyra Health, business is booming. The company, which provides mental health benefits for large employers, has added more than 800,000 new members since the start of the pandemic.
The Burlingame, California-based startup has now joined the ranks of other health technology unicorns on the heels of a $110 million Series D funding round disclosed this week.
Lyra Health projects it will hit more than $100 million in revenue by the end of the year, and the latest funding round brings its valuation north of $1 billion, according to a company representative.
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3 new health features part of Fitbit's latest smartwatch rollout
Aug 25, 2020 9:00am
The Fitbit Sense smartwatch features sensor and software technology including the first electrodermal activity sensor that can help detect small electrical changes in the sweat level of users' skin. (Fitbit)
Fitbit has rolled out more advanced health monitoring features including an ECG app and sensors to track stress levels and changes in skin temperature.
It's part of the wearable giant's transition from fitness tracking to being a platform that puts consumers in control of their health, said James Park, Fitbit co-founder and CEO, during a virtual presentation for reporters Monday.
"We are redefining what wearables can do," Park said.
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https://www.fastcompany.com/90542626/telehealth-has-a-hidden-downside
· 08-24-20
Telehealth has a hidden downside
In a rush to roll out telemedicine, doctors have starting moving faster than regulators, putting patients’ privacy at risk.
By Albert Fox Cahn and Melissa Giddings4 minute Read
Doctors are quick to adopt new technologies when they are used to treat illnesses, but they are practically luddites when it comes to the technology used to communicate with us, their patients. But one of the pandemic’s more surprising side effects has been the new drive to treat patients remotely via telemedicine. Now, in the rush to expand contactless medicine, doctors are moving much faster than the regulators, potentially leaving some patients at risk.
Routine appointments that once happened in person are moving onto digital platforms, raising the risk of hacking in real time and threatening doctor-patient confidentiality. Telehealth was a multibillion-dollar industry before the arrival of COVID-19, but use increased nationally by more than 5,000% in both April and May 2020 when compared to the prior year. The money involved is staggering. Earlier this month virtual healthcare provider Teledoc announced the purchase of Livongo, a mobile health management platform, for $18.5 billion in what amounted to the largest digital health deal in history. But there was consolidation even prior to the pandemic.
In 2019, Amazon purchased PillPack for $753 million, giving the tech behemoth an entry point to the consumer prescription delivery sector. Google attempted to snap up Fitbit for a cool $2.1 billion, but the acquisition is delayed pending a European Union investigation into data protection.
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Aug 25 2020
COVID-19 highlights need for more efficient and safer hospital communications
Communication technology should be viewed as part of personal protection equipment, says Vocera president and CEO Brent Lang.
Susan Morse, Managing Editor
COVID-19 has put a focus on the need for a more expedient and safer way for hospital staff to talk to one another, according to executives for Vocera, which provides hands-free communications technology.
A Vocera wearable badge can be worn under personal protection equipment. Caregivers don't have to leave a room and remove their PPE to talk to other staff, according to the HIMSS20 Digital session, Protect the Safety & Well-Being of Your Staff and Patients.
More effective communication is needed to move information more quickly about a patient who is in the emergency room to the electronic health record and to the proper caregiver, in order to know what level of care is required and if an isolation room is necessary.
If a patient is positive for COVID-19, numerous staff members are dealing with the information on one call, according to Dr. M. Bridget Duffy, chief medical officer for Vocera.
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https://www.healthcareittoday.com/2020/08/26/ehr-data-is-like-500-people-sharing-a-closet/
EHR Data is Like 500 People Sharing a Closet
August 26, 2020
I always like to gather insights from practicing clinical informaticists, whose job puts them at the crossroads where health IT and care delivery meet. I particularly like doing so when they find a way to share these insights in a user-friendly way. For this reason, I was delighted to discover a recent blog entry by Dirk Stanley, a board-certified hospitalist and informaticist who serves as CMIO for UConn Health. (Side Note: Check out this amazing story of Dirk Stanley during 9/11)
In this article, Dr. Stanley explains why it’s important to give careful consideration to terminology when managing your EHR. In doing so, he uses some metaphors which get his point across even to people like me who sit in the penny gallery observing what happens in HIT.
Dr. Stanley starts out with a storage image. “Managing an enterprise EMR is a lot like owning a closet,” he writes. “Information is stored in certain virtual ‘drawers’ where people (users) get used to storing and finding the information they need to do their jobs.”
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https://www.healthleadersmedia.com/clinical-care/how-build-successful-virtual-primary-care-services
How to Build Successful Virtual Primary Care Services
By Christopher Cheney | August 26, 2020
The essential elements of providing primary care to patients via telemedicine include an affordable financial model and exceptional patient experience.
KEY TAKEAWAYS
· Plushcare's "wow" patient experience has helped the telehealth provider attain a 90 net promoter score.
· To achieve a positive physician experience, Plushcare designed a physician-friendly electronic health record, removed physicians from the billing process as much as possible, and promoted a sense of community among clinicians.
· To foster a strong physician-patient relationship, a Plushcare patient has ongoing interactions with a specific primary care provider.
A San Francisco–based telehealth provider is on a mission to transform primary care services for patients and their physicians.
The coronavirus disease 2019 (COVID-19) pandemic has accelerated adoption of telehealth services at health systems, hospitals, and physician practices. Many payers, including the Centers for Medicare & Medicaid Services, have expanded coverage of telemedicine.
PlushCare has been providing primary care telehealth services to patients since its founding five years ago.
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https://ehrintelligence.com/news/how-va-is-attempting-to-increase-interoperability-boost-ehr-system
How VA is Attempting to Increase Interoperability, Boost its EHR System
Although VA has faced scrutiny from OIG and the public, the agency is attempting to mend its interoperability and EHR issues by developing new health IT platforms and optimizing its existing platforms.
August 19, 2020 - While the Department of Veterans Affairs (VA) has faced considerable health IT challenges in the past few years, the VA is attempting to increase its interoperability and enhance its health information exchange and new EHR system.
Recent reports from the Office of Inspector General (OIG) have put a spotlight on significant issues surrounding VA’s health information exchanges and its new Electronic Health Record Modernization (EHRM) program.
The OIG HIE report found training challenges, the need for increased community partners, the use of community coordinators, and technology issues that need to be addressed to enhance the VA’s ability to effectively utilize its HIEs and the ability to exchange patient data.
These reports and a basic need for increased interoperability have triggered a series of VA health IT advancements and optimizations over the past few months.
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https://www.managedhealthcareexecutive.com/view/hipaa-compliance-in-the-age-of-covid-19
HIPAA Compliance in the Age of COVID-19
August 23, 2020
Now is the time for compliance officers to get a better grasp on compliance and continuity across the organization.
It’s been 24 years since the Health Insurance Portability and Accountability Act (HIPAA) was signed into law. Designed to protect the privacy, security and integrity of protected health information (PHI), the law has been notoriously difficult to comply with and requires organizations to have specific measures in place to safeguard this information. Combine these challenges with a global pandemic, and compliance officers across the globe are stretched thin as they work to ensure their organization is fully compliant.
Dramatic shifts in virtual work and a rise in telehealth appointments seemingly happened overnight, leaving many health care providers and related organizations unprepared. These types of occurrences can leave both small and large organizations vulnerable to a myriad of outside and inside threats, as well as reputation-damaging fines. Now is the time for compliance officers to get a better grasp on compliance and continuity across the organization. Let’s explore just how to achieve this:
COVID-19’s Impact on HIPAA
In March, the U.S. Department of Health and Human Services (HHS) chose not to impose penalties for noncompliance around telehealth during COVID-19. While this has allowed health care providers to deliver care from wherever they are, organizations that handle protected health information (PHI) must remain vigilant. Telehealth services have been critical to providing continuity of care but this efficiency can put personal patient information at higher risk of unauthorized access leading to a greater number of data breaches.
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The Impact on Provider Selection and Appointment Booking Amidst COVID-19
August 25, 2020
As healthcare has had to adapt to COVID-19, one of the areas impacted most was how and when patients schedule appointments. To better understand some of the changes that COVID-19 has brought to healthcare, we interviewed Puneet Maheshwari, Co-founder and CEO of DocASAP, to learn what he’s seeing with their customers when it comes to patients searching for providers and scheduling appointments.
Tell us about yourself and DocASAP.
I am a technologist and entrepreneur on a mission to break down barriers to care. Prior to founding DocASAP in 2012, I worked in various Silicon Valley startups as well as in the business technology office of McKinsey & Company, where I advised Fortune 500 companies. I have a bachelor’s degree in computer engineering and earned a master’s degree in finance and entrepreneurial management from The Wharton School of Business.
The idea for DocASAP was sparked after my own family’s frustrating experience accessing care. I knew there had to be a better way for patients to find the right, available provider. From there, I set out to create a solution that would streamline the process by navigating patients to the right provider and care setting at the right time.
Today, DocASAP provides the industry’s most advanced patient access and engagement platform, serving some of the largest health systems and health plans, thousands of providers and millions of healthcare consumers across the U.S.
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The Difference Between HL7 and APIs: What CIOs Need to Know to Succeed with the 21st Century CURES Act Final Rule
August 25, 2020
The 21st Century CURES Act Final Rule is a major change for healthcare data interchange. The reason being is because patients are now entitled to use Application Programming Interfaces to download their health data into their application of choice. Further reinforcing the original intent of HIPAA, this empowers patients to download their data and use it as they see fit. This legislation demonstrates an evolution of technology since the original HIPAA Security Rule.
How does this fit in with what CIOs need to know? Since this is an evolution, there are new technologies that have to be integrated into the stack to be able to appropriately use this and provide our patients with the assurance that we are securing their data. We’re going to go over the history of the Security Rule, its intent, and take a tour through how we’ve leveraged technologies over the years to gradually support more and more of it. We’re then going to cover the core technologies and principles behind a successful Fast Health Interoperability Resources (FHIR) implementation to support patients’ needs securely. These technologies, OAuth2, FHIR, and a robust API Security Program, support the intent of the 21st Century CURES Act Final Rule. Our goals here are to be able to assist in understanding the gaps between the protection we have now, and what we need in the future.
The intent of the HIPAA Security Rule is to enforce the confidentiality, integrity, and availability of healthcare data using authentication, cryptographic hashing, and encryption. Data has to be restricted to only those who have a defined need in payment, treatment, or operations. Patients also have access to those records. However, at the time it was written, many of those records were still paper. People carried around bad faxes, printouts, or bad data.
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A Pandemic Gives Telehealth a New Purpose With Community Paramedicine
With COVID-19 still rampant, health systems and EMS providers are partnering in mobile integrated health programs that stress telehealth and mHealth in the home.
August 21, 2020 - The coronavirus pandemic is helping to shine the spotlight on the use of telehealth and mHealth to improve care coordination in places ranging from a patient’s home to an accident scene.
With COVID-19 patients, providers are using a teletriage platform to diagnose patients at home and develop care management plans that can evolve into remote patient monitoring programs. These same tools have been used by first responders, meanwhile, to improve care coordination in the field, reducing ER transports and improving care outcomes for people who spend a lot of time going to and from the hospital.
“First responders have a great opportunity to use telehealth in ways that we really haven’t seen before,” says Carl Marci, chief medical officer for Ready, a two-year-old provider of mobile healthcare services that has seen business skyrocket during the coronavirus. “We’re redefining the house call for a whole generation who doesn’t even know what a house call is.”
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How Healthcare is Leveraging Real-World Data to Improve Outcomes
To improve outcomes during the COVID-19 pandemic and beyond, organizations are using real-world data for efficient and effective decision-making.
August 21, 2020 - When describing the state of healthcare in the last few months, people have used certain words over and over again.
Unprecedented, crisis, rapid, and novel have become staple terms in the nation’s vocabulary, highlighting both the anomalous nature of the COVID-19 pandemic and the need for quick, innovative solutions.
At a time like this, researchers and leaders have to look beyond time-intensive, expensive randomized controlled trials. In order to find the answers to a question that is always evolving, the industry will need to examine information that is similarly ever-changing: Real-world data.
Defined by the FDA as data relating to patient health status or the delivery of healthcare routinely collected from a range of sources, real-world data is increasingly being used in clinical decision-making. Organizations are leveraging EHR data, patient registries, and mobile device information to better understand trends and outcomes, leading to improved care delivery.
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https://www.healthimaging.com/topics/imaging-informatics/vague-language-hurts-radiology-reporting
Vague language plagues radiology reporting, with chest and inpatient imaging the top offenders
Matt O'Connor | August 21, 2020 | Imaging Informatics
Ideally, a radiologists’ report should be as clear as possible to help guide patient care. But new research has found substantial variation in how the specialty conveys its uncertainties in these documents, which may lead to negative downstream consequences.
Researchers from institutions in California and Colorado collected more than 600,000 reports over a five-year period to reach their conclusions, published Aug. 19 in the Journal of Digital Imaging. They found marked reporting differences among individual practitioners and subspecialties regarding diagnostic uncertainties.
For example, vague terms such as “likely” and “nonspecific” were more often used in chest imaging reports compared to musculoskeletal documents. Such rates of variation also held true across patient admission status and anatomic imaging subsections, the authors noted.
Ambiguous terms can result in poor patient care, overutilization of resources and may open radiologists up to potential litigation, according to Andrew L. Callen, with University of Colorado Anschutz Medical Campus in Denver, and colleagues. The group suggested moving toward more basic, universal language to remedy the problem.
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https://www.healthcareitnews.com/news/first-component-va-ehr-modernization-goes-live-ohio
First component of VA EHR modernization goes live in Ohio
The Centralized Scheduling Solution from Cerner will enable better care coordination for 60,000 vets at that location, and will eventually be rolled out to all Veterans Affairs facilities nationwide.
By Mike Miliard
August 24, 2020 01:58 PM
In a first step for its long-planned, decade-long, $16 billion Electronic Health Record Modernization program, the U.S. Department of Veterans affairs announced today that it has gone live with a scheduling tool that will, eventually, find its way into VA facilities across the country.
WHY IT
MATTERS
The new Cerner-developed Centralized Scheduling Solution is up and running at
VA Central Ohio Healthcare System in Columbus, and will enable more efficient
patient scheduling by offering visibility into clinician availability within a
unified system.
Cerner says it has migrated and tested demographic information for the 60,000 veterans who receive care at the facility. The CSS will be integrated with the full EHR systems set to be implemented at the next go-live site, Mann-Grandstaff VA Medical Center in Spokane, Washington, this autumn.
The new implementation will make it so VA staff in Columbus doesn't have to log in to multiple applications to coordinate calendars, clinicians, rooms and equipment, eliminating time-intensive manual data entry and workarounds to finalize appointments.
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https://www.healthcareitnews.com/blog/europe/riding-digital-wave-through-covid-19
Riding the digital wave through COVID-19
One of the more remarkable features of the NHS’s response to the coronavirus pandemic has been its rapid uptake of technology in the UK says director of international relations at NHS Confederation, Dr Layla McCay.
By Layla McCay
August 24, 2020 03:18 AM
As the first wave of infections arrived, we saw near-instant digital innovation that might otherwise have taken years: the rapid roll-out of remote working platforms, shared care record projects, electronic patient record configurations, and virtual clinics and consultations. NHS Digital increased the capacity and range of NHS 111 (the 24/7 telephone and online service for people who need advice and information about urgent medical problems), and NHSX (which focuses on the digital transformation of health and social care) launched a competition for remote monitoring technology.
The adoption of digital tools was seen across all sectors; it has been particularly accelerated in primary care. More than 70% of GP consultations in England were carried out face-to-face prior to the coronavirus outbreak but within weeks that figure had become 23%, according to a recent report from the Royal College of GPs (RCGP).
In addition, digital solutions enabled strong links to be created between health and research, providing valuable understanding of the impact of coronavirus, including treatment pathways and mortality. During the pandemic some data sharing restrictions were relaxed. These included data from the RCGP research and surveillance centre which saw the number of participating practices double. Other programmes, including Public Health England’s COVID-19 Observatory, were also able to collect and analyse coronavirus data.
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Case Study: One Medical Practice’s Experience Transitioning to Telemedicine
August 24, 2020
Anyone reading Healthcare IT Today is probably aware that during the first six months of the year, we saw a telemedicine boom unlike any before. This, of course, was courtesy of the pandemic, which closed most offices and made delivering in-person care almost impossible
While most available evidence suggests that the volume of telehealth visits will fall substantially over the next year or so, as the pandemic (hopefully) loses its grip on the world, in some cases delivering telehealth services during lockdown has fostered acceptance of virtual care among providers as a long-term strategy.
If you are among this inspired minority, you’ll probably find the following case study to be of interest. It describes how one UK-based practice created a model for implementing virtual visits and began preparing for a telehealth-driven future.
When COVID-19 hit, leaders at sports medicine-focused Wimbledon Clinics decided to get into telemedicine as quickly as possible. In fact, once they made the decision to pull the trigger, the group transitioned to virtual care in less than a week. The practice’s leaders were motivated, in large part, by insurers being willing to pay for telehealth services during the pandemic lockdown.
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https://histalk2.com/2020/08/21/weekender-8-21-20/
Weekly News Recap
- HHS denies a Wall Street Journal report that says COVID-19 hospital data reporting will revert back to CDC’s control using a new system.
- Bankrupt smart pill developer Proteus Digital Health sells its assets to Japan-based pharmaceutical company Otsuka for $15 million.
- Clinical communications vendor Vocera acquires EASE Applications, which offers messaging tools to connect family members and a patient’s care team.
- Health IT vendor TeleTracking refuses to answer the Senate Health Committee’s questions about its $10.2 million contract to develop a HHS COVID-19 hospitalization reporting database.
- HHS CIO Jose Arrieta resigns unexpectedly after 16 months on the job
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Enjoy!
David.
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