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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https://www.digitalhealth.net/2020/10/special-report-vna-and-data-storage-3/
Special Report: VNA and Data Storage
The last seven months has seen the world deal with a number of rapid changes as Covid-19 spread across the globe, with one of the biggest changes being a switch to remote working as the default. In light of this, Jennifer Trueland investigates whether demand for vendor neutral archives (VNA) has increased across the NHS.
Vendor neutral archiving is a medical imaging technology which allows images and documents to be stored in a standard format so they can be accessed by all clinicians regardless of what system they are using.
Regardless of what you call it (vendor neutral archive or independent clinical archive), the Covid-19 pandemic has resulted in a greater urgency for technology that allows images and documents to be stored in a standard format so that they can be accessed by any clinician, regardless of the software they are using.
This need has been emphasied during the Covid-19 pandemic with John McCann, global senior director of marketing at BridgeHead Software, pointing out this could be down to the fact that coronavirus cases are not simple and sometimes require a number of clinicians from different departments.
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https://www.scientificamerican.com/article/ai-assesses-alzheimers-risk-by-analyzing-word-usage/
AI Assesses Alzheimer’s Risk by Analyzing Word Usage
New models used writing samples to predict the onset of the disease with 70 percent accuracy
By Jeremy Hsu on October 22, 2020
Artificial intelligence could soon help screen for Alzheimer’s disease by analyzing writing. A team from IBM and Pfizer says it has trained AI models to spot early signs of the notoriously stealthy illness by looking at linguistic patterns in word usage.
Other researchers have already trained various models to look for signs of cognitive impairments, including Alzheimer’s, by using different types of data, such as brain scans and clinical test results. But the latest work stands out because it used historical information from the multigenerational Framingham Heart Study, which has been tracking the health of more than 14,000 people from three generations since 1948. If the new models’ ability to pick up trends in such data holds up in forward-looking studies of bigger and more diverse populations, researchers say they could predict the development of Alzheimer’s a number of years before symptoms become severe enough for typical diagnostic methods to pick up. And such a screening tool would not require invasive tests or scans. The results of the Pfizer-funded and IBM-run study were published on Thursday in EClinicalMedicine.
The new AI models provide “an augmentation to expert practitioners in how you would see some subtle changes earlier in time, before the clinical diagnosis has been achieved,” says Ajay Royyuru, vice president of health care and life sciences research at IBM. “It might actually alert you to some changes that [indicate] you ought to then go do a more complete exam.”
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https://ehrintelligence.com/news/best-ehr-safety-practices-proposals-for-accreditation-program
Best EHR Safety Practices, Proposals for Accreditation Program
Medical experts put together a list of recommendations and best practices for The Joint Commission to integrate into its hospital accreditation program.
October 22, 2020 - The Pew Charitable Trusts, MedStar Health, and the University of Utah School of Medicine have urged The Joint Commission, the largest hospital accreditor, to help boost EHR usability and safety by requiring hospitals to conduct EHR safety reviews and improving health IT error reporting.
“The use of EHRs introduces dual opportunities to enhance safety and contribute to patient harm,” wrote Ben Moscovitch, The Pew Charitable Trusts; Raj M. Ratwani, MedStar Health; and David Classen, University of Utah School of Medicine.
“Hospitals’ use of the NQF endorsed Leapfrog CPOE Tool to test for medication errors and the adoption of best practices for how they customize, implement, and monitor health IT systems can help mitigate patient safety risks. As The Joint Commission considers future updates to its accreditation program, the organization should prioritize patient safety by focusing on the use of EHRs.”
The three medical experts recommended The Joint Commission launch an effort to assess the inclusion of health IT requirements into its hospital accreditation program.
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https://ehrintelligence.com/news/docs-add-1-hour-of-administrative-work-for-ehr-inbox-management
Docs Add 1 Hour of Administrative Work for EHR Inbox Management
Patient-initiated messages made up the majority of physician EHR inbox messages.
October 22, 2020 - Primary care physicians (PCPs) spend roughly an hour on EHR inbox management per day, and the majority of this time is spent outside of scheduled work hours, according to a study published in the Journal of the American Medical Informatics Association (JAMIA).
Patient portal messages and results consume the highest proportion of PCP EHR inbox time.
Managing an EHR inbox has become a regular part of clinician workflow, often resulting in clinician burden.
The inbox receives patient portal messages and messages from other clinicians, the pharmacy, laboratory, and other medical departments. Most clinicians should reply to messages within two business days, according to study authors.
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FDA leader talks evolving strategy for AI and machine learning validation
"As these machines learn, we feel like there is going to be a change in expectation," said Bakul Patel, director of the FDA's Digital Health Center of Excellence.
By Mike Miliard
October 23, 2020 04:19 PM
At a virtual meeting of the U.S. Food and Drug Administration's Center for Devices and Radiological Health and Patient Engagement Advisory Committee on Thursday, regulators offered updates and new discussion around medical devices and decision support powered by artificial intelligence.One of the topics on the agenda was how to strike a balance between safety and innovation with algorithms getting smarter and better trained by the day.
In his discussion of AI and machine learning validation, Bakul Patel, director of the FDA's recently-launched Digital Health Center of Excellence, said he sees huge breakthroughs on the horizon.
"This new technology is going to help us get to a different place and a better place," said Patel. "You're seeing a great opportunity. You're seeing automated image diagnostics. We have seen some advanced prevention indicators. Data is becoming the new water. And AI is helping healthcare professionals and patients get more insights into how they can translate what we already knew in different silos into something that's useful."
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74% of Healthcare Organizations Are Confident Data and AI Tools Will Be the Key to COVID-19 Treatment
October 23, 2020
The following is a guest article by David DeAngelis, Healthcare General Manager at Dell Technologies.
The COVID-19 pandemic is accelerating the pace of digital transformation in several industries. From retail and manufacturing to technology and financial services, every market sector is working to adapt to ongoing disruptive circumstances. Healthcare providers continue to face unique challenges as they balance the delivery of safer patient care with financial realities, while improving work-from-home capabilities for clinical and business staff and virtual care options.
At the same time, the worldwide population continues to age with more than 700 million people over the age of 65 today (9% of the global population) with one in three suffering with one or more chronic conditions such as cancer, chronic lung disease and heart disease. As chronic disease management and treatment is imaging-intensive, the need to better manage and gain intelligent insights from this growing patient data becomes even more critical. With new data types and the changes in healthcare that COVID-19 has brought, healthcare organizations are quickly moving into a new phase where they need to manage the short-term spikes in activity with continuous patient care.
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https://healthitsecurity.com/news/nsa-warns-chinese-nation-state-actors-exploiting-vulnerabilities
NSA Warns Chinese Nation-State Actors Exploiting Vulnerabilities
DHS CISA is encouraging organizations to prioritize patching of 25 common vulnerabilities, as an NSA alert shows Chinese nation-state actors are actively exploiting those flaws.
October 21, 2020 - Chinese nation-state actors are actively scanning for and exploiting 25 common vulnerabilities and exposures (CVEs), which enabled multiple successful hacks on a range of victims, according to an alert from the National Security Agency and highlighted by the Department of Homeland Security.
Calling it one of the greatest threats to US security, Chinese backed hackers are leveraging a range of tactics and techniques to exploit networks that store or managed sensitive intellectual property, as well as economic, political, and military information.
The alert joins three other warnings from the FBI, DHS, and the Department of Justice regarding the threat of hackers with ties to China. In May, the agencies warned of an active campaign against research facilities working on the COVID-19 response and that some had already been compromised.
By August, federal agencies had identified a new malware variant called Taidoor, tied to the Chinese government, which targets US organizations to maintain a persistent presence on victim networks and for other malicious activities.
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Ensuring Transparency: Language to Avoid in HIPAA Breach Notifications
In the wake of a breach or ransomware, healthcare entities must be transparent with patients to protect privacy, prevent further crimes, and ensure compliance in HIPAA breach notifications.
October 21, 2020 - HIPAA-required breach notifications in the wake of a security incident continue to be an Achille’s heel for the healthcare sector. Many notices appear laden with flowery language that make light of an incident to protect an entity’s reputation, rather than transparent phrasing to protect patient privacy.
In age where double extortion, i.e. data exfiltration, runs rampant in the industry, it’s never been more crucial for providers to provide notifications that not only tick the boxes for compliance purposes, but give patients a chance to fully comprehend an incident and potential impact for future cybercrimes.
Transparency Failures and Privacy Implications
Reports show that data is taken in more than one out of every 10 ransomware attacks. However, upon reviewing subsequent notifications to patients, that language is often omitted. A prime example is seen with the recent notification from the AAA Ambulance Service.
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https://ehrintelligence.com/news/real-time-patient-data-access-is-linked-to-telehealth-follow-up
Real-Time Patient Data Access is Linked to Telehealth Follow-Up
Clinicians are more likely to schedule a telehealth follow-up if they have immediate access to patient data.
October 19, 2020 - Clinicians with access to a shared inpatient-outpatient EHR were more likely to schedule a telehealth follow-up appointment or conduct laboratory monitoring, rather than an in-person visit, according to a study published in the American Journal of Managed Care.
Additionally, enhanced interoperability and patient data exchange can boost follow-up care efficiency.
“For the growing number of patients with chronic conditions, care transitions, such as those after hospital discharge, require coordination among multiple clinicians practicing in different settings,” the researchers explained.
Seamless data exchange and interoperability are important for making that level of care coordination and follow-up care happen, but for many outpatient clinicians that’s not always the case. Outpatient clinicians do not always have real-time access to patient data from recent hospitalizations.
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https://ehrintelligence.com/news/texas-launches-pulse-platform-for-emergency-health-data-exchange
Texas Launches PULSE Platform for Emergency Health Data Exchange
Texas looked to adopt the Patient Unified Lookup System for Emergencies (PULSE) platform after Hurricane Harvey to boost health data exchange.
October 21, 2020 - The Texas Health Services Authority (THSA) has launched the Patient Unified Lookup System for Emergencies (PULSE) platform to enhance health data exchange during emergencies.
Developed by the Office of the National Coordinator for Health Information Technology (ONC) in 2014, Texas adopted PULSE after the state endured tropical storm Marco, the COVID-19 pandemic, and Hurricane Laura.
PULSE, a cloud-based solution, enables emergency responders to search for health information, such as medications, diagnoses, allergies, and lab results on disaster victims. The solution limits access to only authorized personnel and a “view only” format for medical information.
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https://www.medscape.com/viewarticle/939499
Patients Can Read Your Clinical Notes Starting Nov 2
"Open Notes" Mandates Access to Writings, Test Results
Nick Mulcahy
October 21, 2020
Starting November 2, all patients in the United States will have immediate access to clinical notes and thus will be able to read their doctors' writings, as well as test results and reports from pathology and imaging.
The 21st Century Cures Act mandates that patients have fast, electronic access to the following types of notes: consultations, discharge summaries, history, physical examination findings, imaging narratives, laboratory and pathology report narratives, and procedure and progress notes.
But this federal mandate, called "open notes" by many, is potentially confusing and frightening for patients, say some physicians. Others worry that the change will increase workload as clinicians tailor notes for patients and answer related questions.
The law means that inpatient and outpatient notes will be released immediately and that patients will have immediate access to testing and imaging results, including results from sexually transmitted disease tests, Pap tests, cancer biopsies, CT and PET scans, fetal ultrasounds, pneumonia cultures, and mammograms.
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https://www.healthcareitnews.com/news/fda-highlights-need-address-bias-ai
FDA highlights the need to address bias in AI
At a meeting of the agency's Patient Engagement Advisory Committee, officials stressed the necessity of ensuring there's diversity in the data used to train algorithms.
By Kat Jercich
October 22, 2020 04:56 PM
The U.S. Food and Drug Administration on Thursday convened a public meeting of its Patient Engagement Advisory Committee to discuss issues regarding artificial intelligence and machine learning in medical devices.
"Devices using AI and ML technology will transform healthcare delivery by increasing efficiency in key processes in the treatment of patients," said Dr. Paul Conway, PEAC chair and chair of policy and global affairs of the American Association of Kidney Patients.
As Conway and others noted during the panel, AI and ML systems may have algorithmic biases and lack transparency – potentially leading, in turn, to an undermining of patient trust in devices.
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Norton Healthcare integrates Epic with PDMP tools, cuts opioid Rx in half
The Kentucky health system turned a highly manual search process entirely automatic – and is gaining some major rewards.
By Bill Siwicki
October 22, 2020 01:00 PM
In 2012, the state of Kentucky passed a law similar to those in many other states requiring physicians prescribing controlled substances to check their state’s prescription drug-monitoring program database. The database enables providers to view a patient’s controlled substance prescription history to identify potential signs of opioid use disorder or doctor shopping.
THE PROBLEM
Kentucky has been particularly hard hit in the opioid epidemic. More than 1,500 Kentuckians die each year from drug overdoses. A contributor is the state’s opioid prescribing rate, which is 55% higher than the rest of the U.S.
Norton Healthcare is the largest health system in Kentucky, with more than five hospitals and a total of 250 care locations. Staff members say they have a medical and moral responsibility to serve as leaders in the state’s fight against this crisis.
“We’re based in Louisville, which is right on the Indiana border, and serving patients in a metro area spanning two states often means that our physicians are tasked with querying both Kentucky’s PDMP, KASPER, and Indiana’s PDMP, INSPECT, before prescribing controlled substances,” said Dr. Steven Heilman, senior vice president and chief health innovation officer at Norton Healthcare.
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https://www.healthcareittoday.com/2020/10/22/massive-telehealth-fraud-charges-may-be-first-of-many/
Massive Telehealth Fraud Charges May Be First Of Many
October 22, 2020
The US Department of Justice has filed charges against 345 defendants, including more than 100 medical professionals, accusing them of engaging in healthcare fraud schemes. And while this batch of alleged fraud may be pretty old-school, telemedicine’s growth now offers a big fat target which may spark new types of telehealth-specific schemes in the future.
The charges, which detail $6 billion in false and fraudulent claims submitted to federal healthcare programs and private insurers, include more than $4.5 billion connected to telehealth. Under the terms of the scheme, the telehealth executives allegedly got the providers to order unnecessary durable medical equipment, genetic and other diagnostic testing and medications, either without patient interactions whatsoever or only conducting a short phone call. Executives participating got kickbacks after the pharmacy, lab or DME firm billed Medicare or Medicaid.
Some observers have suggested that these deceptions might have been in response to the relaxation of HIPAA rules and the DEA permission for providers to prescribe controlled substances in the wake of COVID. However, according to analysts from Credit Suisse, a number of these frauds may well have emerged prior to the onset of the pandemic.
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Bridging the Miles — And the Pandemic — Teledentistry Makes Some Dentists Wince
By Kaiser Health News | October 21, 2020
Teledentistry allows dental professionals like Planerova to remotely review records and diagnose patients over video.
KEY TAKEAWAYS
· Some smile about teledentistry's promise, seeing it as a way to become more efficient, to reach the one-third of U.S. adults who haven't seen a dentist in the previous year and to practice more safely during the pandemic.
· But others see it as lesser-quality care that's cheaper for dental professionals to provide, allowing them to make more money.
· At the same time, widespread adoption is hindered by issues such as spotty internet and insurance companies unwilling to reimburse for teledentistry procedures.
This article was published on Wednesday, October 21, 2020 in Kaiser Health News.
By Eric Berger
Donella Pogue has trouble finding dentists in her rural area willing to accommodate her 21-year-old son, Justin, who is 6 feet, 8 inches tall, is on the autism spectrum and has difficulty sitting still when touched.
And this summer, he had a cavity and his face swelled. Pogue, of Bristol, New York, reached out to the Eastman Institute for Oral Health in Rochester, which offers teledentistry.
Dr. Adela Planerova looked into his mouth from 28 miles away as Pogue pointed her laptop's camera into her son's mouth. Planerova determined they did not need to make an emergency one-hour drive to her clinic. Instead, the dentist prescribed antibiotics and anti-inflammatory drugs, and weeks later he had surgery.
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https://www.healthleadersmedia.com/innovation/best-practices-storing-passwords
Best Practices for Storing Passwords
By Revenue Cycle Advisor | October 22, 2020
Security reminders are important communication vehicles in addition to formal training.
A version of this article was first published October 22, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.
Q: We recently took a survey and many of our employees admitted to saving their passwords in a Word® document or a Notes® file on their phone. Is this riskier than having passwords written down on paper and stored in a safe place at work or home? How can we discourage employees from writing down their passwords anywhere?
A: Both are risky propositions unless the files are encrypted and protected with a strong password or PIN. As long as the passwords are secure, it is not likely that someone could capture them.
Keep in mind, though, the HIPAA Security Rule requires covered entities (CE) and business associates (BA) to implement a process that supports emergency access.
If the password cannot be easily reset, you may find yourself at odds with the Office for Civil Rights (OCR). Also, it becomes more difficult to access important information if the employee is terminated without communicating his or her password.
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How an EHR Documentation Assistant Helped Mitigate Clinician Burnout
The implementation of an EHR documentation assistant had made life much easier for clinicians during COVID-19, resulting in less writing and more time at home.
October 20, 2020 - For Neesha Patel, MD, establishing and following a weekly routine is crucial to juggling her life as a physician at Cooper University Healthcare and Abigail House for Nursing and Rehabilitation, and an assistant professor at Cooper Medical School of Rowan University.
Prior to COVID-19, Patel spent hours outside of work handwriting her clinical notes, which can ultimately lead to clinician burnout.
Clinician burnout is a common issue tied with EHR usability, EHR emergence, and EHR prevalence. Poor EHR usability leads to high levels of physician attrition, depression, dissatisfaction, and burnout. The pressures of EHR use and documentation led Patel to carve out a strict weekly routine.
“Certain times during the evenings or on the weekends, I make sure I spend a couple of hours prepping for the week to make sure my inbox is cleared out, all my refills are done, all my results are reviewed, patient charts are completed prior to their office visit, and ensuring I get my notes done within 24 to 48 hours,” Patel said in an interview with EHRIntelligence.
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https://healthitanalytics.com/news/artificial-intelligence-method-builds-in-error-for-better-models
Artificial Intelligence Method Builds in Error for Better Models
The approach builds uncertainty, expert knowledge, and missing data into calculations, leading to more accurate artificial intelligence models.
By Jessica Kent
October 19, 2020 - An emerging method builds error and uncertainty into artificial intelligence models, ultimately leading to more efficient, precise tools in many areas of research – including healthcare.
Researchers at the University of Delaware and the University of Massachusetts Amherst discuss the new approach in a paper published in the journal Science Advances. The method aims to teach AI and machine learning models to integrate and organize information from a range of different sources, resulting in more trustworthy calculations.
Because AI doesn’t know if information is missing, or whether the data it draws on is incorrect, these tools can’t deal precisely with random events or uncertainty. The new mathematical framework combines data, expert knowledge, multiscale knowledge, and information theory through uncertainty quantification.
The method provides a powerful way to analyze data, study materials and complex interactions, and tweak errors virtually instead of in a lab.
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How COVID-19 shifted healthcare executives' technology priorities and what to expect in 2021
Oct 21, 2020 7:10am
When the COVID-19 pandemic hit earlier this year, health system executives had to shift their priorities to fast-track innovations such as virtual care services and artificial intelligence tools.
About a quarter of healthcare executives (26%) said the shift to telehealth and virtual care was a top innovation priority at their organizations prior to the pandemic, according to a survey of 117 executives conducted at the beginning of the year by the Center for Connected Medicine (CCM).
That has now jumped to 49% of executives who say virtual care is a top innovation priority, according to CCM's follow-up survey from this summer.
Prior to the pandemic, executives said their organizations had run into challenges with tight regulations and low reimbursement that made progress in the shift to telehealth difficult. When the pandemic occurred, leaders experienced rapid progress as regulations were loosened and reimbursement was increased.
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https://healthitanalytics.com/news/leveraging-data-analytics-tools-to-address-health-disparities
Leveraging Data Analytics Tools to Address Health Disparities
Parkland Center for Clinical Innovation is using data analytics technologies to identify at-risk individuals and alleviate health disparities during the COVID-19 pandemic.
By Jessica Kent
October 20, 2020 - The COVID-19 pandemic has shined a spotlight on the health disparities that pervade the industry, with the virus widening the gaps between advantaged and disadvantaged patient populations.
Identifying these gaps – and working to close them – is critical for improved outcomes among all individuals, especially during the current healthcare crisis.
At Parkland Center for Clinical Innovation, leaders took action to get ahead of growing care disparities.
“We intuitvely knew as the disease started to progress across communities and various parts of the country that certain ethnic groups were going to be disproportionately impacted. And there were a lot of different factors that were contributing to that,” Steve Miff, PhD, president and CEO of the Parkland Center for Clinical Innovation, said during a recent episode of Healthcare Strategies, an Xtelligent Healthcare Media podcast.
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CDC Report Finds Nearly 300,000 Excess Deaths During Pandemic
Although more deaths from all causes occured in older populations, the highest average percent increase in the number of fatalities relative to previous years was among adults aged 25-44 years.
By Cecelia Smith-Schoenwalder, Staff Writer Oct. 20, 2020, at 5:34 p.m.
Nearly 300,000 more Americans died from late January to early October than expected during an average year, the Centers for Disease Control and Prevention found in a report published Tuesday.
The majority of the excess deaths – 66% – are due to the coronavirus, the report found. Examining the estimates "can provide a comprehensive account of mortality related to the COVID-19 pandemic, including deaths that are directly or indirectly attributable to COVID-19," the report said.
While it's not surprising that a pandemic that has killed more than 220,000 Americans would lead to higher-than-usual mortalities, the report did find an unexpected trend. Although more deaths from all causes occured in older populations, the highest average percent increase (26.5%) in the number of fatalities relative to previous years was among adults aged 25-44 years.
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https://www.healthcareittoday.com/2020/10/21/data-protection-and-privacy-key-theme-at-ahima20/
Data Protection and Privacy key theme at AHIMA20
October 21, 2020
Last week John Lynn and I had the opportunity to attend the annual AHIMA conference (#AHIMA20) which was held virtually. After attending numerous sessions over the three-day event, it was clear that data privacy and protection was on the minds of event attendees.
In addition to the dedicated privacy and security track, a quick scan of the other presentations showed that protecting patient data was a key topic in the AI, SDOH and Informatic/Analysis and Data Use tracks. It’s not surprising given the growing awareness of health data security amongst patients and regulators.
Surprising source of breaches
One surprising fact that many patients may not realize is that the most common form of privacy breach remains paper records. Yes, that’s right PAPER records.
In her session “Data Breaches & Privacy Officers: Studies of Their Characteristics and Those Who Report”, Amanda Walden, a faculty member at the University of Central Florida in Orlando, FL presented the slide shown on the right.
You could almost hear jaws dropping over the Internet.
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https://www.healthcareittoday.com/2020/10/21/data-protection-and-privacy-key-theme-at-ahima20/
Data Protection and Privacy key theme at AHIMA20
October 21, 2020
Last week John Lynn and I had the opportunity to attend the annual AHIMA conference (#AHIMA20) which was held virtually. After attending numerous sessions over the three-day event, it was clear that data privacy and protection was on the minds of event attendees.
In addition to the dedicated privacy and security track, a quick scan of the other presentations showed that protecting patient data was a key topic in the AI, SDOH and Informatic/Analysis and Data Use tracks. It’s not surprising given the growing awareness of health data security amongst patients and regulators.
Surprising source of breaches
One surprising fact that many patients may not realize is that the most common form of privacy breach remains paper records. Yes, that’s right PAPER records.
In her session “Data Breaches & Privacy Officers: Studies of Their Characteristics and Those Who Report”, Amanda Walden, a faculty member at the University of Central Florida in Orlando, FL presented the slide shown on the right.
You could almost hear jaws dropping over the Internet.
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https://www.healthleadersmedia.com/telehealth/telehealth-global-market-hit-1855b-2026
Telehealth Global Market to Hit $185.5B by 2026
By John Commins | October 21, 2020
Report credits rapid technological advances and improved access and availability for exponential growth.
KEY TAKEAWAYS
· The projected growth over the next six years marks a five-fold increase from the $34.5 billion global market in 2018.
· Teleradiology, teledermatology, telepathology, and telepsychiatry services are projected to lead the market over the forecast period.
· In addition, the entry of new players and the increased adoption of real-time communication are driving the sector.
· Healthcare providers are increasingly adopting PACS to securely store and transmit electronic images from anywhere in the world.
· The U.S. will play a dominant role in the growth of telehealth, thanks to favorable reimbursements, an aging patient mix, and improving practice standards.
The global telemedicine market will see at an exponential compounded annual growth rate of 23.5% over the next six years, reaching $185.5 billion by 2026, according to an analysis from Fortune Business Insights.
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https://patientengagementhit.com/news/what-is-implicit-bias-how-does-it-affect-healthcare
What Is Implicit Bias, How Does It Affect Healthcare?
Healthcare leaders working toward health equity will need to recognize their own implicit biases to truly enhance patient care.
By Sara Heath
October 16, 2020 - The recent focus on racial health disparities and health equity has brought to the forefront another key concept in healthcare delivery and patient care: implicit bias.
Implicit bias, a phrase that is not unique to healthcare, refers to the unconscious prejudice individuals might feel about another thing, group, or person.
According to the Kirwan Institute for the Study of Race and Ethnicity at the Ohio State University, implicit bias is involuntary, can refer to positive or negative attitudes and stereotypes, and can affect actions without an individual knowing it:
Also known as implicit social cognition, implicit bias refers to the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. These biases, which encompass both favorable and unfavorable assessments, are activated involuntarily and without an individual’s awareness or intentional control. Residing deep in the subconscious, these biases are different from known biases that individuals may choose to conceal for the purposes of social and/or political correctness. Rather, implicit biases are not accessible through introspection.
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https://ehrintelligence.com/news/va-dod-make-commonwell-connection-prep-data-for-ehrm-launch
VA, DoD Make CommonWell Connection, Prep Data for EHRM Launch
Integrating CommonWell increases the military’s joint health information exchange to an additional 15,000 hospitals.
October 19, 2020 - The Federal Electronic Health Record Modernization (FEHRM) program office announced the Departments of Veterans Affairs (VA), Defense (DOD) and Homeland Security’s U.S. Coast Guard (USCG) has connected its joint health information exchange (HIE) to the CommonWell Health Alliance.
VA and DoD also announced they have transferred patient data to the new Cerner software in preparation for the October 24 EHRM go-live at Mann-Grandstaff VA Medical Center.
While VA is increasing its interoperability and patient data exchange, the agency is also driving interoperability between itself, the DoD, the USCG and community healthcare partners through the CommonWell connection.
The joint HIE launched in April to boost interoperability between the agencies and their healthcare partners. The departments’ collaboration allows VA, DoD, and USCG providers to securely access EHR data for their patients.
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https://www.healio.com/news/primary-care/20201016/ai-predicts-postoperative-opioid-use
October 16, 2020
AI predicts postoperative opioid use
An artificial intelligence tool based on data from patients’ electronic medical records correctly identified which patients would need high doses of opioids after surgery, according to findings presented at Anesthesiology 2020.
“Being able to target the right treatment to the right patient is important to not only to reduce opioid use, but also to ensure that patients receive the treatment that is right for them,” Mieke S. Soens, MD, an instructor of anesthesia at Brigham and Women's Hospital, told Healio Primary Care.
In a two-part study, Soens and colleagues gathered data from 5,994 patients scheduled to receive general anesthesia and undergo surgical procedures without a peripheral nerve block. Of these, 1,287 were administered more than 90 morphine milligram equivalents in the first 24 hours after surgery.
In the first part of the study, the researchers used 163 potential factors to predict high pain after surgery based on a literature search and input from experts. Based on those factors, they created three machine learning algorithm models — logistic regression, random forest and artificial neural networks. The algorithms compiled data from patient medical records and shortened the list of predictive factors down to 21 that most accurately predicted patients’ pain severity and their potential need for opioids after surgery.
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https://www.statnews.com/2020/10/20/cell-phone-numbers-match-patients-health-records/
Cell phone numbers could provide a fast-track solution to matching patients with their health records
By
October 20, 2020
When the U.S. House of Representatives voted in August to overturn a ban on using federal funds to establish a national patient identifier — a unique health ID number for every U.S. resident — the move was widely lauded by health care groups.
A national patient identifier could be the unambiguous thread that would tie all medical records across all health care organizations to the correct person. It would provide the basis for improved care coordination and enhanced patient safety by ensuring that physicians have access to comprehensive medical data at the point of care.
It’s certainly a step in the right direction. Today, 30% of patient records are linked to the wrong people for a variety of reasons, such as when data in health care databases is incomplete or out of date. A universal patient identifier (UPI) would help ensure that the right records are matched to the right patient.
Even if the Senate also threw its support behind a universal health ID, it would be five years or more before we’d see an improvement in patient-matching accuracy because of the length of time it would take to create, implement, and distribute these identifiers. But there is a data source that could more quickly provide a fast-track solution to patient-matching challenges: cell phone numbers.
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https://www.medpagetoday.com/patientcenteredmedicalhome/patientcenteredmedicalhome/89199
Let's Make Electronic Data Collection Work for Us
— Why can't we easily find out how many patients are food insecure, or how much money our practice generates?
by Fred N. Pelzman, MD October 19, 2020
Tell me just what I need to know, just when I need to know it.
The other day one of the partners in our practice said, in the middle of a conversation about something else, "I wonder how much money our practice generates for the hospital?"
It was an interesting question, one I didn't immediately know the answer to, and as he and I explored his reasons for wondering, and ways to calculate this, I thought, "Shouldn't this be something that I can easily get my hands on?"
Not that this is the reason we are doing what we do, but every patient we see not only brings in direct money for the hospital from reimbursement for their visit, but generates downstream effects, through labs, imaging, consults, training for trainees, and future surgeries that help keep the place afloat.
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'Hey Cerner': Company seeks health systems to help test new Voice Assist tech
St. Joseph’s Health and Indiana University Health have already enlisted to help refine the EHR voice command tool, and the company has put out the call for other hospitals to do the same.
By Mike Miliard
October 20, 2020 03:50 PM
As Cerner gears up to launch its new natural language processing technology, Voice Assist, it is asking for healthcare providers to sign on as new testing partners.
WHY IT
MATTERS
The company says Voice Assist will enable easier interaction with Cerner
electronic health records, enabling clinicians – by simply
saying "Hey Cerner" – to query and retrieve patient data from
the EHR, place orders, set up reminders and more.
The goal is time savings, burden reduction and improved provider experience, as EHR clinical end-users can more easily document while navigating the patient record
Cerner says Voice Assist – which is powered by Nuance speech recognition technology and should be available by 2021 – can respond to phrases such as "Remind me to call the patient in six months about their high cholesterol," "Order Lipitor 40 mg oral tablet" and "What is the latest white blood cell count?"
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https://www.healthcareitnews.com/news/ai-and-machine-learning-gift-and-curse-cybersecurity
AI and machine learning: a gift, and a curse, for cybersecurity
When it comes to keeping data safe, experts say artificial intelligence can be a "double-edged sword."
By Kat Jercich
October 20, 2020 04:26 PM
The Universal Health Services attack this past month has brought renewed attention to the threat of ransomware faced by health systems – and what hospitals can do to protect themselves against a similar incident.
Security experts say that the attack, beyond being one of the most significant ransomware incidents in healthcare history, may also be emblematic of the ways machine learning and artificial intelligence are being leveraged by bad actors.
With some kinds of "early worms," said Greg Foss, senior cybersecurity strategist at VMware Carbon Black, "we saw [cybercriminals] performing these automated actions, and taking information from their environment and using it to spread and pivot automatically; identifying information of value; and using that to exfiltrate."
The complexity of performing these actions in a new environment relies on "using AI and ML at its core," said Foss.
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https://www.healthcareitnews.com/news/healthcare-c-suite-bullish-ai-telehealth
Healthcare C-suite bullish on AI, telehealth
Hospital and health plan leaders also see revenue cycle management as an area of innovation that's stood out during the COVID-19 pandemic, according to a report from KLAS and CCM.
By Kat Jercich
October 20, 2020 01:05 PM
A Center for Connected Medicine report released this week in consultation with KLAS Research found that a majority of healthcare leaders say they're most excited by artificial intelligence as an emerging technology.
Healthcare organizations say that clinical decision support is their most common use case for AI, while they're likely to move toward using it for revenue cycle management in the future.
Half of the respondents reported using AI technology to help respond to the COVID-19 pandemic.
However, most respondents said they use less than 20% of their data for AI.
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https://mhealthintelligence.com/news/jd-power-survey-charts-the-top-12-reasons-for-using-telehealth
JD Power Survey Charts the Top 12 Reasons for Using Telehealth
The survey identifies what factors are most important to consumers when they choose telehealth, and it shows how the coronavirus pandemic has changed some of those priorities.
October 16, 2020 - Healthcare providers and payers looking to drive sustainability in a telehealth platform in a world affected by the coronavirus pandemic should focus on safety, quality and insurance coverage.
That’s the take-away from J.D. Power’s second annual Telehealth Satisfaction Study, released earlier this month. According to the consumer advisory company’s survey, respondents showed increased attention in those three topics this year, as opposed to last year’s pre-COVID-19 survey.
By far, consumers are most interested in connected health platforms that protect them from exposure to the coronavirus (as are the providers themselves). According to the survey, 46 percent listed safety as a reason for using telehealth, compared to just 13 percent last year – an increase of roughly 250 percent.
That’s an obvious answer. The coronavirus pandemic prompted most providers to restrict in-person care to necessary issues and push as many service as possible into virtual care. In doing so, they emphasized that telehealth and mHealth platforms allow patients to access care from the safety of their own homes, thereby reducing the risk of exposure. In the past, that point had been made by hospitals and health plans looking to avoid a surge of traffic during flu season.
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Using AI, Data Analytics to Enhance Person-Centered Care for Seniors
Artificial intelligence and data analytics tools could help one of the nation’s fastest-growing population groups actively participate in their own care.
Jessica Kent
Site Editor
jkent@xtelligentmedia.com
October 16, 2020 - Right now, there are more than 46 million older adults age 65 and older living in the US. By 2050, that number is expected to grow to almost 90 million.
This means that in just ten years, one in five Americans is projected to be 65 or over.
With the population of older individuals rapidly growing, healthcare leaders are beginning to brace themselves for the wave of challenges that will inevitably crash over every part of the industry. Older adults need increasing amounts of clinical care and social services to stay well, and in a system where resources are already strained, this surge could put overwhelming burdens on care providers.
The National Council on Aging (NCOA) reports that approximately 80 percent of older adults have at least one chronic disease, and 77 percent have more than one. These patterns also extend into realms beyond physical health: NCOA notes that one in four older adults experience some mental illness, including depression, anxiety disorders, and dementia.
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Global healthcare funding hit a record in Q3. Here's how much digital health companies raised
Oct 19, 2020 11:00am
Global healthcare funding soared in the third quarter, hitting a new record of $21.8 billion across 1,539 deals.
Healthcare investments were up 18% from $18.4 billion in the second quarter of 2020.
Funding for healthcare sectors including digital health, telehealth, artificial intelligence and women's health all set new highs during the third quarter, according to a report from CB Insights.
North America-based healthcare companies raised nearly $13 billion in the third quarter of 2020, the highest quarterly level on record and a 21% increase from the second quarter. Asia-based companies saw a 20% uptick quarter over quarter, raising over $6 billion. This was driven by a record-high number of mega-rounds in the U.S. and China, with 48 total rounds, according to the report.
Investor interest in digital health companies shows no signs of letting up as the COVID-19 pandemic has driven demand for virtual care and digital health tools.
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https://pharmaphorum.com/news/boehringer-yale-trial-digital-tech-in-heart-failure/
Boehringer, Yale trial digital tech in heart failure
October 16, 2020
Patients with heart failure often have a dismal prognosis as the condition usually worsens over time, but a new study aims to see if digital health technologies can improve their prospects.
The trial – run by Boehringer Ingelheim and Yale University – will test a smart bathroom scale device that has cardiac monitoring built in, as well as an app to help patients improve their diet and lose weight and a digital assistant designed to motivate them to actively manage their health.
The investigators hope the digital tools will encourage people with heart failure to make and adhere to changes in their lifestyle that will improve “patient outcomes, clinical efficiencies and…quality of life.”
If it works, the approach could have a significant impact on the care of people with heart failure, which is a massive problem worldwide. In the US alone there are six million people with failing hearts, leading to a million hospitalisations each year.
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COVID-19: What is different in our understanding of this pandemic to the accepted wisdom in the spring of 2020?
As we have heard repeatedly over the past few months, there is a need to think of managing this pandemic in the same way we prepare for a marathon rather than a sprint, says Dr Charles Alessi, chief clinical officer, HIMSS.
October 19, 2020 08:16 AM
Adopting this approach occasionally may lead us to think that we all need to re-evaluate what lessons we think we have learnt, as what may seem like success in the short-term may not seem quite as successful in the longer-term as the pandemic goes through a series of waves.
So, what have we really learnt about the virus and how it is transmitted and behaves?
- Who transmits the virus? In the early months of 2020, we did not appreciate the extent to which this virus has the potential to be transmitted asymptomatically. The fact that asymptomatic transmission is a significant factor changes the whole way we need to think of this virus, as well as manage it. As the head of one of the national systems told me in frustration in March of this year: “Ebola was easy – you knew who was sick and who was not – and you knew that there were not going to be significant numbers of people around who were totally asymptomatic. The implication of this is that we do not know how best to deploy what resources we have.” Personally, I was shocked to hear this. Ebola was the condition we all fear more than any other and to describe it as “easy” to manage is an understatement of course, but the point made is relevant.
- How does this virus get transmitted? We know it's a respiratory virus, and so we also know that we need to manage transmission using hygiene like washing hands and wearing masks in enclosed places – but what are the viruses it behaves like? How does it appear to operate? Initial approaches in early 2020 were based on our response to the flu virus, including atypical flu viruses like H1N1. What is becoming clearer is that it is becoming more likely that this virus spreads most efficiently in a different way. Thus, the most “efficient” spread is not necessarily the more predictable linear spread of flu viruses, but a more random spread. One which is more dependent on the environment – and where certain factors like crowded places, close contact and closed places can give rise to “superspreading” events. We have certainly seen this happen in churches, markets and other places.
The implications around our better understanding of the virus are significant when it comes to how best to manage a test and trace system, as well as messaging. In this context, Japan has been a place where all of this has come together. The public messaging around the “three Cs” – avoiding crowded places, close contact and closed places, and the use of artificial intelligence and data to perform 'retrograde contact tracing' which identifies common places and people within them that seem to be present in high numbers of infected people. This approach then leads to meticulous and exhaustive approaches to manage to identify anyone who was in these places, thus potentially extinguishing transmission emanating from the superspreading events or places.
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COVID-19 hasn't just spotlighted healthcare inequity – it's made it worse
Experts at a recent HIMSS Global Health Equity Week webinar say that technology can play a role in bridging the care gap, but it can also be used in a harmful context.
By Kat Jercich
October 19, 2020 03:28 PM
The COVID-19 crisis has shined a light on the existing discrepancies in the healthcare system, with patients of color more likely to test positive for and suffer more severe health consequences from the novel coronavirus.
In addition, said panelists at Equal Access to Care for All Communities, a recent HIMSS Global Health Equity Week webinar, the bias faced by people in vulnerable communities makes it harder to fight the disease.
"The stress of being discriminated against your entire life, working and fighting and struggling to get access to income, to get access to education, to get access to care … those things mount up to potentially, maybe thwart our ability for our immune system to fight something like COVID," said Carladenise Edwards, senior vice president and chief strategy officer at the Henry Ford Health System.
"That cortisol release that individuals have over their lifetime is going to change the ways in which they can respond," agreed Sam Shah, founder and director of the Faculty of Future Health at Ulster University in Northern Ireland.
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Two healthcare apps available for prescription in Germany for first time
Eleven months after the German federal government passed the Digital Healthcare Act (DVG), two health apps are now officially available for prescription.
By Sara Mageit
October 19, 2020 06:22 AM
On 5 October, the Digital Healthcare Act (DVG) officially granted doctors in Germany permission to prescribe apps to their patients for the first time.
Currently, two apps have been approved, making it the first country to prescribe insured health apps.
The first apps were unveiled last week after making it through the test procedure from the Federal Institute for Drugs and Medical Devices (BfArM). They are the Kalmeda app, which aims to help with tinnitus, and Velibra, a therapy programme for anxiety disorders.
WHY IT MATTERS
While only 6% of patients have used paid medical apps in the past, almost 60% would use these digital tools if their physician prescribed them and the costs were covered by the payer.
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Identifying Effective Digital Mental Therapy in a Fast-Growing Pandemic Market
October 19, 2020
The following is a guest article by Ken Cahill, Chief Executive Officer, SilverCloud Health.
The COVID-19 pandemic has imperiled our communities on a scale that we rarely witness, and the pressure we’ve felt from a public health and economic standpoint cannot be understated. As a leader of a digital mental health company, I’ve experienced the pandemic through the lens of our emotional wellbeing, and it’s been difficult to watch unravel.
In the United States, our mental health system already had its deficiencies – the most obvious of which is that we have a shortage of mental health professionals. Per 100,000 people, we are equipped with 30 psychologists and 15.6 psychiatrists, and over 115 million people reside in designated Health Professional Shortage Areas – areas in which the ratio of mental health professionals to residents is smaller than 1 per 30,000 people. When those circumstances are paired with the fact that 53% of adults in the U.S have reported that their mental health has been negatively impacted due to worry and stress over the coronavirus, we are left with a mental health pandemic in and of itself.
It’s no surprise then, that digital mental health has been thrust into the limelight as evidenced by the industry’s growth so far in 2020. It’s more easily accessible, it’s affordable, and it can be scaled. However, what’s been nebulous amid this public health crisis is the difference between meditation and mindfulness applications and digital therapeutics under the digital health umbrella – where the variable is the clinical efficacy of the service. This conflation emanates from marketing tactics; for example, some services claim they deliver clinically validated and measurable outcomes by citing their articles in predatory journals where the merit of publishing depends on payment versus a formal peer-review process. In a time where mental health demand is at its pinnacle, it’s important for organizations to understand how to vet the efficacy of each.
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https://mhealthintelligence.com/features/factoring-in-caregivers-adds-value-to-a-telehealth-program
Factoring in Caregivers Adds Value to a Telehealth Program
Telehealth programs that include the caregiver in the care management process stand a better chance of improving outcomes and quality of life.
Eric Wicklund
- Editor
ewicklund@xtelligentmedia.com
October 16, 2020 - Telehealth programs are so focused on connecting the patient with the provider that they sometimes forget about the other person in the room: the caregiver.
And that’s a problem. Family members and friends who care for loved ones can help improve care management at home by playing an active role in telehealth, either through helping the patient or contributing their own insights.
In addition, the growing ranks of caregivers in the US are facing their own health issues, particularly stress, and could greatly benefit from telehealth services that address their needs. Those services, in turn, would greatly improve the caregiving process, leading to better health outcomes for both patient and caregiver.
According to a May 2020 study released by the National Alliance for Caregiving (NAC) and the AARP, the number of family caregivers in the US has increased by 9.5 million in the last five years, due in part to an older generation that wants to stay at home and healthcare costs that prevent families from putting loved ones in an assisted living facility or even hiring help around the home.
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https://healthitsecurity.com/news/top-strategies-for-implementing-multi-factor-authentication
Top Strategies for Implementing Multi-Factor Authentication
Establishing multi-factor authentication in the healthcare setting is not as challenging as many organizations assume.
October 13, 2020 - Multi-factor authentication (MFA) can block more than 99 percent of automated cyber attacks, yet healthcare organizations often wait until their security has already been breached before turning to this protective tool.
“The two main obstacles organizations say hinder them from implementing MFA is this misconception that implementing the tool will require an external hardware device and concerns that it will disrupt users or cause the technology to malfunction,” Jessica Davis, senior editor of HealthITSecurity.com, explained on an episode of Healthcare Strategies.
However, these are invalid excuses when placed in the contexts of the threat that hackers pose to healthcare organizations today and the ease with which these organizations can implement MFA.
To start with, MFA will ask a user-specific question after an attempted login and the answer is typically not something hackers can generate on their own, making it a very effective tool for protecting data, even if the attacker has compromised user credentials.
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https://histalk2.com/2020/10/16/weekender-10-16-20/
Weekly News Recap
- Private equity firm JLL Partners acquires analytics solution vendor MedeAnalytics from Thoma Bravo.
- Digital check-in vendor Clearwave acquires Odoro.
- Allscripts announces plans to sell its CarePort Health care coordination business to WellSky for $1.35 billion.
- Providence forms Tegria, a healthcare services business comprised of nine companies that the health system has invested in or acquired.
- HealthStream acquires ShiftWizard.
- Online texting-only mental therapy provider Talkspace tells providers it will cover their legal costs if they are caught providing services in states where they aren’t licensed.
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Enjoy!
David.
