Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


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

Saturday, October 10, 2020

Weekly Overseas Health IT Links – 10 October, 2020.

 Here are a few I came across last week.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.



Amid Rising Substance Abuse Rates, Treatment Centers Turn to Telehealth

Amid a surge in substance abuse issues caused by the coronavirus pandemic, the Desert Hope Treatment Center is using a telehealth platform to screen patients and expand access to sorely needed counseling.

By Eric Wicklund

October 01, 2020 - With the coronavirus pandemic curbing in-person care, substance abuse treatment programs are turning to telehealth to keep the channels of communication open with people struggling to stay clean and sober.

“It’s been a real challenge,” says Derek Price, CEO of the Las Vegas-based Desert Hope Treatment Center, part of the nation-wide American Addiction Centers network. “We’ve been trying to make things work. But this is the new expectation, and people have to accept the fact that the new existence is telehealth.”

Like so many other treatment centers, Desert Hope offers hands-on care, in both in-patient and out-patient programs that include detox and individual and group counseling sessions. It’s the nature of addiction treatment that sessions are personal, intense and face-to-face, requiring a closeness that can best be achieved with everyone in one room.

COVID-19 changed that dynamic, however.



Expanding Access to Mental Healthcare with Artificial Intelligence

Researchers at University of Illinois Chicago are testing a virtual agent powered by artificial intelligence to broaden access to mental healthcare.

By Jessica Kent

September 29, 2020 - Across the country today, it is widely acknowledged that access to mental healthcare is just as important as clinical care when it comes to overall wellness.

Mental health conditions are incredibly common in the US, impacting tens of millions of people each year, according to the National Institutes of Mental Health (NIMH). However, estimates suggest that only half of people with these conditions receive treatment, mainly due to barriers like clinician shortages, fragmented care, and societal stigma.

For the many individuals suffering from anxiety and depression, these existing barriers – coupled with the current healthcare crisis – can significantly interfere with the ability to carry out life activities.

“The prevalence of mental health disorders – particularly depression and anxiety – is high. If anything, the prevalence of these conditions has only increased as a result of COVID-19. The need is greater than ever now,” Jun Ma, PhD, Beth and George Vitoux Professor of Medicine at the University of Illinois Chicago (UIC) department of medicine, told HealthITAnalytics.



Machine Learning Can Streamline PTSD Diagnosis in Veterans

Machine learning could help providers diagnose PTSD more efficiently, both in veterans and the general population.

By Jessica Kent

October 01, 2020 - Using machine learning, researchers were able to cut six of the 20 questions used to diagnose post-traumatic stress disorder (PTSD) while still maintaining accuracy in a veteran population, according to a study published in Assessment.

PTSD impacts eight million adults in the US, the researchers stated, including hundreds of thousands of veterans of the conflicts in Iraq and Afghanistan. With the onset of the COVID-19 pandemic, PTSD symptoms are also increasing among the general population, the team noted.

However, diagnosing PTSD is time-consuming – the process typically takes 30 minutes or more, which is too long for most clinical visits.

To streamline PTSD diagnosis, researchers from the VA Boston Healthcare System and the Boston University School of Public Health (BUSPH) set out to develop a machine learning tool that would make the process more efficient.



Are old operating systems putting the NHS at risk in 2020?

With reports suggesting that Microsoft source code relating to Windows XP has been shared online, our cyber security columnist, Davey Winder looks into whether old operating systems are putting the NHS at risk in 2020.

Davey Winder 30 September 2020

The news that Microsoft source code relating to Windows XP had apparently been leaked to a number of file-sharing sites online may well have passed you by. After all, who uses Windows XP these days and what difference does it make if the source code is out there?

Although it has yet to be confirmed by Microsoft, which is investigating, if this is the actual source code to Windows XP Service Pack 1, there are potential security risks.

It would appear that the source code leak is actually a combination of various files, which would impact Windows Server 2003 and even Windows CE and MS-DOS. Most of these files had been floating around the dark web for some time, but this marks the first public distribution.

Windows XP itself was released way back in October 2001, with the final release in 2008. It reached end of life status on April 8, 2014, when general support, including security updates ceased. A security patch was later released by Microsoft in May 2017, in response to the WannaCry ransomware attack that hit the NHS so hard.



UHS says all U.S. facilities affected by apparent ransomware attack

Computer systems at Pennsylvania-based Universal Health Services began to fail over the weekend, leading to a network shutdown at hospitals around the country.

By Kat Jercich

October 02, 2020 11:53 AM

Universal Health Services said Thursday afternoon that it was continuing its efforts to recover from a security issue that led to a network shutdown throughout its United States facilities.   

"The UHS IT Network is in the process of being restored and applications are being reconnected," said a statement on the website of the King of Prussia, Pennsylvania-based hospital chain, which operates some 400 hospitals, outpatient clinics and behavioral health centers across the U.S and in the U.K.   

"We have a large number of corporate-level administrative systems, and the recovery process is either complete or well underway in a prioritized manner. We are making steady progress and are confident that we will be able to get hospital networks restored and reconnected soon," said the Pennsylvania-based system.

A spokesperson told the Associated Press that all 250 UHS facilities in the United States were affected. 



What’s your Vision for 2020 and Beyond?

October 2, 2020

Jumpstarting Healthcare’s Digital Transformation in the Year of Vision

The following is a guest article by Julie Mann, Chief Commercial Officer at Carium. Carium’s own Lygeia Ricciardi is one of our A-List speakers at our new EXPO.health Experience Series that will join Ed Marx and other health IT leaders in an interactive discussion about digital transformation in healthcare and how you can develop your digital strategy amidst all the changes that are happening in the world today. Learn more about this truly unique experience here

When the ball dropped in Times Square on New Years Eve, most were optimistic and embracing well-wishes and slogans that “20/20” would be the year of “vision.” I did a quick Google search and some evites for New Year’s parties popped up — one in particular caught my eye with the enticing, “2020 is the Year we have all been waiting for and the vision is clear!”. Well, here we are in October 2020 and it’s taken on a very different tone than those created-in-2019-invitations predicted.

Everything has changed. Many are evolving. Most are revamping strategies. It seems as if everyone and every company in healthcare is scrambling to pull together a digital strategy — many while deploying pieces and parts along the way.

In September 2020, ZDNet published an article co-authored by Salesforce executives Dr. Geeta Nayyar and Vala Afshar with a powerful statement, “COVID-19 accelerated a shift that was long coming. Suddenly, patients had access to physicians through virtual care apps. Many started accessing retail clinics and urgent care centers. Healthcare largely went digital, and it reinforced a consumer preference in the process: Give me convenience or I’ll find a company that can. And part of delivering convenience is understanding that in the Next Normal, decentralized business models powered by digital technologies is the only viable path for sustained relevance.”



To Free Doctors from Computers, Far-Flung Scribes Are Now Taking Notes for Them

By Kaiser Health News  |   October 01, 2020

Remote scribes are patched into the exam room's sound via a tablet or speaker, or through a video connection.


·         Doctors find entering notes and data into poorly designed EHR software time-consuming. So scribing is a fast-growing field in the U.S., with the workforce expanding from 15,000 in 2015 to 100,000 this year. 

·         This year, as the pandemic led patients to shun clinics and hospitals, many scribes were laid off or furloughed. Many have returned, but scribes are increasingly working online — even from the other side of the world.

·         Some remote scribes create doctors' notes in real time; others annotate after visits. And some have help from speech-recognition software programs that grow more accurate with use.

This article was published on Thursday, October 1, 2020 in Kaiser Health News.

By Sarah Kwon

Podiatrist Dr. Mark Lewis greets his first patient of the morning in his suburban Seattle exam room and points to a tiny video camera mounted on the right rim of his glasses. "This is my scribe, Jacqueline," he says. "She can see us and hear us."

Jacqueline is watching the appointment on her computer screen after the sun has set, 8,000 miles away in Mysore, a southern Indian city known for its palaces and jasmine flowers. She copiously documents the details of each visit and enters them into the patient's electronic health record, or EHR.



Docs Expect More Telehealth Access, Ramp Up Patient Outreach

Thirty-eight percent said digital health literacy got in the way of telehealth access, opening the door for better patient outreach.

By Sara Heath

September 30, 2020 - More than half of healthcare executives said the recent boom in telehealth care access has improved patient care, but more work is necessary to improve patient experience with the technology, according to new survey data from Boston Digital.

The survey of 500 healthcare executives looked at their sentiments about and experiences with telehealth and other healthcare technologies at the height of the COVID-19 pandemic. Telehealth in particular played a big role in managing the onset of the crisis, with providers across the country leaning on the tool to triage patients displaying COVID-19 symptoms, manage those with the novel coronavirus outside of the hospital, and maintain chronic disease management and primary care visits.

Fifty-seven percent of the survey respondents said telehealth adoption has improved patient care, the survey showed. Sixty-three percent said telehealth is very important to the organization’s strategy moving forward, 55 percent have created new telehealth portals to ease patient care access, and 40 percent agree the technology boom is here to stay.

“Our survey indicates the habits and preferences that formed around telehealth during the early days of the coronavirus pandemic are, in large part, here to stay,” Peter Prodromou, president at Boston Digital, said in a statement.



HHS launching effort to better track office-based EHR use

Author Rebecca Pifer @RebeccaMPifer

Published Sept. 30, 2020

Dive Brief:

  • HHS is launching a program to revitalize data collection of and insights into office-based doctors' health IT use, the agency announced Tuesday.
  • The program, which will be run by the nonprofit medical group American Board of Family Medicine, will focus on software interoperability and burden on providers to inform future rulemaking.
  • Clunky IT systems are a major contributor to physician burnout and cost the healthcare system millions annually. The Trump administration released two rules meant to nudge the industry toward smoother data flow, but earlier this year pushed back compliance deadlines amid COVID-19 — and could do so again.

Dive Insight:

Information blocking has long been a problem in healthcare. Legislation and federal regulations meant to push the industry toward tech modernization didn't include provisions requiring EHRs to integrate with one other, incentivizing business models based on siloing data.

The Trump administration has made promoting interoperability a key tenet of its first-term health IT strategy, yet was forced to delay the culmination of a major effort — two rules forbidding information blocking between disparate vendors, providers and payers (with some exceptions) — amid COVID-19.



30 September 2020

Alexa, do I have COVID-19?

Researchers are exploring ways to use people’s voices to diagnose coronavirus infections, dementia, depression and much more.

Emily Anthes

In March, as the staggering scope of the coronavirus pandemic started to become clear, officials around the world began enlisting the public to join in the fight. Hospitals asked local companies to donate face masks. Researchers called on people who had recovered from COVID-19 to donate their blood plasma. And in Israel, the defence ministry and a start-up company called Vocalis Health asked people to donate their voices.

Vocalis, a voice-analysis company with offices in Israel and the United States, had previously built a smartphone app that could detect flare-ups of chronic obstructive pulmonary disease by listening for signs that users were short of breath when speaking. The firm wanted to do the same thing with COVID-19. People who had tested positive for the coronavirus could participate simply by downloading a Vocalis research app. Once a day, they fired up the app and spoke into their phones, describing an image aloud and counting from 50 to 70.

Then Vocalis began processing these recordings with its machine-learning system, alongside the voices of people who had tested negative for the disease, in an attempt to identify a voiceprint for the illness. By mid-summer, the firm had more than 1,500 voice samples and a pilot version of a digital COVID-19 screening tool. The tool, which the company is currently testing around the world, is not intended to provide a definitive diagnosis, but to help clinicians triage potential cases, identifying people who might be most in need of testing, quarantine or in-person medical care. “Can we help with our AI algorithm?” asks Tal Wenderow, the president and chief executive of Vocalis. “This is not invasive, it’s not a drug, we’re not changing anything. All you need to do is speak.”



Big tech, digital health coalition forms to undercut COVID-19 healthcare disparities

Formed under the banners of the Consumer Technology Association and the Connected Health Initiative, the coalition's membership includes big names like Google, Boston Children's Hospital, Microsoft, ResMed and others.

By Dave Muoio

September 30, 2020 02:41 pm 

The Consumer Technology Association and the Connected Health Initiative announced this morning a new multi-sector initiative of private tech companies, healthcare providers and representatives of public agencies that aims to outline technology's role in addressing health disparities exacerbated by COVID-19.

To this end, the effort's first major project will consist of a white paper containing policy and operational recommendations to help best deploy novel health technologies, the industry groups wrote in their announcement. Examples of the types of tools being explored include wearables, remote monitoring, clinical decision support, telehealth and artificial intelligence.

The Health Equity and Access Leadership (HEAL) Coalition counts 17 organizations within its membership.

Hailing from the tech sector are Google, Microsoft, Best Buy Health, AT&T, Intel and HP. Provider representatives include Boston Children's Hospital, Cambria Health, University of Mississippi Medical Center, University of Virginia Center for Telehealth and MLEM. The coalition's digital and mobile health faction is staffed by Omron Healthcare, ResMed, Validic, Grapevine Health and Rimidi.



Controversy: Researchers claim hospitals face barriers to public health data reporting

Dueling letters published this week in JAMIA take issue with the degree to which public health agencies are able to receive information electronically.

By Kat Jercich

October 01, 2020 02:23 PM

A research team from the Harvard Business School's Wyss House has doubled down on its findings from earlier this year that hospitals are perceiving public health agencies' ability to receive data as a barrier to effective electronic exchange.

"Regardless of whether that barrier is technical in nature or related to a socio-technical process such as data governance, public health agencies should be aware that nearly 40% of potential exchange partner hospitals view their ability to receive data electronically as a barrier to effective exchange," wrote the researchers in a letter published Thursday in the Journal of the American Medical Informatics Association.

The Wyss House team was responding to a challenge to its study, also published Thursday in JAMIA and put forth by Catherine J. Staes of the University of Utah College of Nursing and cosigned by James Jellison of the Public Health Informatics Institute, Mary Beth Kurilo of the American Immunization Registry Association, Rick Keller from the Center for Connected Health and Hadi Kharrazi from the Johns Hopkins School of Public Health.  

In that challenge Staes and her coauthors say that the Harvard team's study does not match the situation on the ground at public health agencies and that the authors had overgeneralized survey findings.  



Machine learning-based CDS can accurately intercept Rx errors, study finds

The tool, developed by Lumio Medical, is a hybrid AI decision-support system trained on data from more than 10,000 patients.

By Kat Jercich

October 01, 2020 11:09 AM

Machine learning-based clinical decision support can be an effective way to review the accuracy of medical prescription orders, a study published this week in the Journal of the American Medical Informatics Association shows.

According to the Paris-based research team, a CDS tool trained on data from 10,716 patients was more accurate than existing techniques at intercepting potential prescription errors.

The technology, developed by Lumio Medical, is a hybrid AI decision-support software that combines machine learning and a rule-based expert system. It makes predictions at the patient level rather than focusing on individual prescription orders.

"Our findings confirm that the algorithm outperformed classic systems in its capacity to limit the number of false alerts without overlooking patients with prescription order errors," wrote the research team.



Using Telehealth to Make Patient Rounding More Efficient and Effective

In the latest Healthcare Strategies podcast, Sri Bharadwaj of Franciscan Health explains how the Indiana health system uses telehealth to improve patient care and care team collaboration.

By Eric Wicklund

September 28, 2020 - For hospitals across the country, rounding is both a vital and complex process, pulling together staff and specialists from across the enterprise to collaborate on patient care. At Franciscan Health, they’re using telehealth to make that process more efficient.

During a recent episode of Xtelligent Healthcare Media’s Healthcare Strategies podcast series Sri Bharadwaj, the Indiana health system’s vice president of digital information, explained how they use a connected care platform to bring the care team into one room, from where they can meet with and collaborate on care for any number of patients in their own rooms.

“When physicians typically round with patients, they (seek) to understand what's happening with the patients and at many points in time,” Bharadwaj said. “There are several physicians who are talking to patients, reviewing patients’ charts as part of the care team. For particularly an inpatient, you have a neurologist, a hospitalist, a pulmonologist. Particularly with COVID, we had a combination of pulmonologists (and) cardiologists taking care of patients. So we wanted to make sure that the patients were not disturbed as many times (by having) a way to … see them remotely.”



Can Social Informatics Improve Social Determinants of Health Data?

Gathering and integrating social determinants of health (SDOH) data are becoming more common, but the study of social informatics could help ease the integration process.

By Christopher Jason

September 28, 2020 - Social informatics could be the answer to some of healthcare’s social determinants of health (SDOH) data problems, according to an article published in the Journal of the American Medical Informatics Association (JAMIA).  

The rise of value-based reimbursement has led the medical field to increasingly recognize the importance of meeting not only patients’ clinical needs, but also their social needs. As social services and SDOH programming crop up in practices and hospitals nationwide, providers need the SDOH data itself to determine how to best refer patients to services.

But current health IT and data processing systems aren’t quite equipped to do that. Interoperability and integration from multiple data sources hamstring efforts to understand the full scope of SDOH and create appropriate social services recommendations to patients.



HHS launches initiative to alleviate health IT burdens for doctors

by Heather Landi 

Sep 29, 2020 12:06pm

The Trump administration plans to work with the American Board of Family Medicine to study how health IT tools can be improved for doctors.
The HHS’ Office of the National Coordinator for Health Information Technology (ONC) awarded a cooperative agreement to the American Board of Family Medicine to measure the use and potential burdens experienced by office-based physicians.

The evaluation will provide ONC with national-level data on how physicians use health IT, including key measures on interoperability and burden, the agency said.

The effort builds on prior research that found, in 2017, approximately 80% of office-based physicians used a certified electronic health record (EHR), but only one in ten of those physicians reported that they were able to electronically send, receive, find, and integrate health data from EHRs outside of their networks.



Online privacy loss: another Covid-19 aftershock

By Matthew S. McCoy, Timothy Libert, and Ari B. Friedman

September 30, 2020

Since the coronavirus pandemic first emerged in the United States, millions of Americans have gone online to search for information related to the virus or Covid-19, the disease it causes. Most had no idea they were revealing information about themselves — not just to the government agencies, hospital systems, or media outlets whose websites they visited, but to third-party companies that surreptitiously track their activity and invade their online privacy.

Suppose you want to get tested for Covid-19. A quick web search might lead you to the Department of Health and Human Services’ testing information page. It offers a helpful state-by-state directory of community-based testing sites. What you don’t see is that the page includes hidden tracking code from 17 different third-party domains owned by companies including Google, Oracle, and Twitter.

As you scroll through the HHS webpage, these companies log information about your visit and then use it to send you targeted advertisements. They may also sell it to other companies.

That for-profit businesses are tracking your visit to a government-operated Covid-19 webpage may be shocking, but this loss of online privacy isn’t unusual.



Artificial Intelligence Platform Enables Data Analytics for Research

The new data analytics tool uses artificial intelligence to facilitate large-scale, data-driven biomedical research.

By Jessica Kent

September 29, 2020 - An artificial intelligence-driven program will help facilitate big data analytics research among scientists without specialized expertise, according to a study published in Cancer Cell.

The technologies used in modern biomedical research generate large, complex datasets that offer information about patients, animal models, or cell lines. These research efforts may include studying the whole of genetic information (genomics), gene expression, or protein expression.

Because these datasets are so complex, it is often challenging for researchers to answer specific biological questions without specialized analytical approaches. Scientists usually perform these analyses using a computer script written in a range of programming languages, which requires some understanding of both programming and bioinformatics.



How 5 health systems are tackling EHR snooping prevention

Jackie Drees – 29 October, 2020

While EHR snooping ultimately boils down to a human issue, some hospitals and health systems are turning to technology to mitigate cases of unauthorized record viewing. 

In September, Danville, Pa.-based Geisinger Health System began notifying more than 700 patients that a former employee wrongly accessed their medical records. As a result of the breaches, which occurred from June 2019-20, Geisinger terminated the employee.

In the same month, Montefiore Medical Center also notified about 4,000 patients that a former employee stole their protected health information; upon discovering the inappropriate EHR access, the New York City-based health system fired the individual.

While some EHR snooping cases involve a single employee who inappropriately views tens or hundreds or thousands of patients' medical records without proper cause, in other instances its multiple employees who access a single patient's record. In July, Hennepin Healthcare in Minneapolis fired five employees for inappropriately viewing the medical records of a "high profile patient" after George Floyd, who died in May while in police custody, was taken to the hospital, according to the Star Tribune.



Trump administration may push back interoperability rules, again: Rucker

The comments followed a rule quietly sent to OMB with a title implying extension of certain compliance dates.

Author Rebecca Pifer

Published Sept. 28, 2020

The Trump administration may push back deadlines for healthcare companies to comply with information blocking and interoperability regulations for a second time as providers face ongoing stress from COVID-19.

"We've had some adjustments to the timing of our rule and the companion CMS rule, and we're monitoring closely the situation in terms of further adjustments," Don Rucker, head of the Office of the National Coordinator for Health IT, said Thursday at CB Insight's Future of Health conference. "All I can say at this point is we're actively aware of the COVID pandemic and looking at any needed changes."

HHS has sent the Office of Management and Budget an interim final rule, called Information Blocking and the ONC Health IT Certification Program: Extension of Compliance Dates and Timeframes in Response to the COVID-19 Public Health Emergency, received on Sept. 17.

ONC declined to comment on the rule. But the title implies it will extend dates identified in the sweeping information blocking provisions — notably, the looming November compliance deadline for providers — and dates for the Conditions and Maintenance of Certification provisions requiring EHR platforms to be interoperable.



So you've been hit with a ransomware attack. What now?

With criminals taking advantage of the COVID-19 crisis, security experts show how health systems can respond to a cyber crisis at the same time.

By Kat Jercich

September 30, 2020 01:14 PM

The COVID-19 crisis has represented an enormous opportunity for cybercriminals. 

Rapid IT deployments, newly launched telehealth programs, sophisticated and fear-based phishing techniques, untested platforms and employees shifting to a work-from-home model have combined to make healthcare systems especially juicy targets for bad actors.

Most recently, Universal Health Services, a Pennsylvania-based system operating about 400 facilities, was hit with a massive cyberattack. The security incident, which NBC news referred to as "potentially [the] largest in U.S. history," has led to a multi-day offline IT network across UHS facilities throughout the country.

Although the company did not elaborate on the nature of the attack, sources told NBC that it "looks and smells like ransomware," which security experts predicted in May would continue to be an issue in years to come

Of course, there are a number of ways health systems can protect themselves against ransomware attacks



Healthcare IT News and MobiHealthNews expand into Europe, Middle East & Africa edition

HIMSS Media are expanding their Europe/UK editions to encompass MEA, with Healthcare IT News and MobiHealthNews now including a more comprehensive and inclusive Europe, Middle East and Africa (EMEA) edition.

By Dillan Yogendra

September 30, 2020 01:50 AM

The year 2020 will go down in history as one of the most challenging of our lifetime. Thinking back to January, none of us would have predicted the emergence of a pandemic-causing virus, let alone its devastating outcomes that have affected tens of millions of lives around the world so far. It has changed the way we do business, conduct events, and of course, report the news.

Closer to home, we’ve seen healthcare media shift, with the majority of our content now solely focusing on finding a way to protect the world against SARS-CoV-2. A multitude of projects are on hold while global entities focus on the race towards contributing to a vaccine or technology that can help lessen or eradicate the effects of COVID-19.

As the global media platforms of Healthcare IT News and MobiHealthNews, we’ve always reported on developments in the Middle East and Africa (MEA). However, the pandemic has reinforced just how important the region is to our readers, with its drive to improve healthcare – including digital health – during these times, as well as work on viable solutions for local and international communities.



5 Universal Healthcare Project Goals via CIO Will Weider

September 30, 2020

John Lynn

One of my favorite early blogging compatriots is Will Weider, CIO at PeaceHealth.  While it seems like Will has largely moved his blog sharing to Twitter, he’s still one of the great healthcare CIOs to follow.  A great example of this was a recent Twitter thread he shared around project goals:

Will Weider @CandidCIO

Project goals, a thread... Recently I worked with a group to develop goals around a large project. I realized that these could apply to a lot of projects with little change. So, here are those 5 project goals:

2:45 AM · Sep 15, 2020

And then he shared the following 5 project goals:

Operational Excellence

First and foremost, seek to improve efficiency (work is completed with less human and financial resources) and effectiveness (work is completed more quickly and more accurately). The remaining goals are principles by which we achieve this primary directive


Develop and implement standard data and process flows.



AI Gets The Buzz, But Health IT Leaders Still Focused On The Basics

September 30, 2020

Anne Zieger

New research from a consulting organization suggests that while new technologies beckon and COVID continues to disrupt operations, healthcare leaders remain focused on the problems they’ve struggled with for many years.

Those participating in the survey, which was conducted by Stoltenberg Consulting, included 64% who worked in health systems and 26% in standalone hospitals. In addition, 8% reported working in ambulatory care settings and 2% in “other” settings.

Not surprisingly, COVID remains on the top of respondents’ minds. Fifty percent of those responding to the survey suggested that to tackle the pandemic threat, the best thing CIOs can do is to lead data collection efforts to provide the CDC and state with up to date information on the virus. (In some cases, healthcare organizations have decided to go well beyond this, making substantial shifts in their workflow and even their infrastructure to tackle their COVID-19 challenges, but this approach isn’t an option for everyone.)



How to Use Telemedicine With Your Older Patients

By Christopher Cheney  |   September 30, 2020

Contrary to popular perception, older patients appear ready to embrace telemedicine.


·         A new report from Strata Decision Technology shows utilization of telehealth visits by older patients has been comparable to utilization by younger patients during the coronavirus pandemic.

·         Dealing with the technology requirements of telehealth visits is the primary telemedicine challenge for older patients, according to a pair of experts.

·         Best practices for using telehealth visits with older patients include providing step-by-step instructions.

·         Telemedicine is a powerful tool in the clinical care of older patients, according to a pair of experts.

The COVID-19 pandemic has spurred widespread adoption of telemedicine along several fronts at health systems, hospitals, and physician practices—primarily over concern about the spread of the novel coronavirus in healthcare settings. Telemedicine visits for nonemergency care also have been shown to be efficient and effective from both the healthcare provider and patient perspectives.



Top Healthcare Cybersecurity Resources from NIST, HHS, OCR, HSCC

Staffing challenges and budget constraints make it difficult for some healthcare entities bolster enterprise security. Resources from NIST, HHS, OCR, HSCC, and others can support the development of cybersecurity plans.

By Jessica Davis

September 25, 2020 - Many healthcare providers struggle with finding and retaining security staff, as well as budget constraints, which make it difficult to properly secure the enterprise. In response, a host of industry stakeholders have provided free cybersecurity resources to support those organizations in shoring up vulnerabilities and keeping pace with the ever-evolving threat landscape. 

So far in 2020, some of the biggest data breaches were caused by ransomware, business associates, phishing, and hacking incidents. All have spotlighted the industry’s biggest vulnerabilities, while continuing to serve as a reminder of the need to find these gaps and strengthen the overall cyber posture across the sector. 

An abundance of resources provide healthcare entities with nearly step-by-step guidance on the biggest threats, including ransomware, telework, supply chain, and other significant risks. As industry stakeholders have continued to stress, providers can no longer take a reactive approach to cybersecurity. 


CynergisTek reported that just 44 percent of healthcare entities conform with the NIST cybersecurity framework standard. An alarming statistic, given NIST has released guidance for nearly all security challenges, programs, and needed policies. 



Carving Out a Future for Health Equity, Closing Health Disparities

In order to build a future defined by health equity, it's important to understand the past and how injustices have created health disparities.

By Sara Heath

September 28, 2020 - It’s not intuitive to crack open the history books to better understand modern medicine, but that’s where the industry is. As healthcare experiences a surge of energy around driving health equity and closing health disparities, public health experts are looking to the past to better understand how to shape the future.

Journey back to the early 20th century moving into the 1960s, Julie Smithwick, director at the Center for Community Health Alignment, encouraged during a recent episode of Healthcare Strategies, a podcast from Xtelligent Healthcare Media.

“For the African American community, for example, the Jim Crow Laws. It wasn't that long ago when Jim Crow Laws were still in place,” Smithwick pointed out, noting the unequal access to quality education, healthcare, and legal protection Black people faced under those policies.



Virtual Rollout: The New Face of EHR Implementation

The COVID-19 pandemic jolted the EHR implementation plans for many organizations. With flexibility from providers and their technology vendors though, remote implementations became a possibility.

September 25, 2020 - When COVID-19 hit the United States in late January 2020, the healthcare industry had no idea the impact the virus would have on the entire system. Frontline healthcare workers were overwhelmed, working in the dark to treat a disease they did not fully understand.

Researchers scrambled to develop a test to identify COVID-19 and work towards an effective treatment while payers struggled to cover these services and understand the pandemic’s impact on future costs of care.

While the industry was working tirelessly to quell the impacts of COVID-19, most innovative initiatives were placed on hold or cancelled completely. But, at several organizations, leaders made the difficult decision to continue plans for an EHR implementation. Many believed the benefits of integration would help their organization’s overall COVID-19 response.



Redfield voices alarm over influence of Trump’s new coronavirus task force adviser

Published Mon, Sep 28 20207:47 AM EDT

Monica Alba

WASHINGTON — The director of the Centers for Disease Control and Prevention has grown increasingly concerned that President Donald Trump, pushed by a new member of his coronavirus task force, is sharing incorrect information about the pandemic with the public.

Dr. Robert Redfield, who leads the CDC, suggested in a conversation with a colleague Friday that Dr. Scott Atlas is arming Trump with misleading data about a range of issues, including questioning the efficacy of masks, whether young people are susceptible to the virus and the potential benefits of herd immunity.

“Everything he says is false,” Redfield said during a phone call made in public on a commercial airline and overheard by NBC News.

Redfield acknowledged after the flight from Atlanta to Washington, D.C., that he was speaking about Atlas, a neuroradiologist with no background in infectious diseases or public health. Atlas was brought on to the White House task force in August.



UHS hospital chain hit with apparent ransomware attack

Universal Health Services, which operates about 400 facilities, was targeted with a cyberattack over the weekend that has triggered a multiday IT outage.

By Kat Jercich

September 29, 2020 10:35 AM

Universal Health Services, a Pennsylvania-based health system that operates about 400 facilities throughout the country and overseas, was hit with a cyberattack early Sunday.

Computer systems for UHS began to fail over the weekend, with some hospitals forced to return to documenting patient information with pen and paper, according to reporting by NBC News, which called it "potentially [the] largest in U.S. history."

UHS posted a statement on Monday morning confirming that the IT network across its facilities was down. 

On Tuesday, it published a follow-up statement saying that the system had experienced an "information technology security incident," and that it had suspended user access to IT applications related to U.S. operations. 



Building a solid technology foundation enables transformation

As IT professionals, we need to be ahead of the game in terms of establishing and maintaining the capabilities of our technology foundation. This means being smart about understanding the business and staying ahead of its needs.

By John P. Donohue

September 29, 2020 04:13 PM

Building a solid technology foundation enables transformation

As IT professionals, we need to be ahead of the game in terms of establishing and maintaining the capabilities of our technology foundation. This means being smart about understanding the business and staying ahead of its needs.

In more than 35 years of experience in healthcare IT, I have learned the importance of building a solid technology foundation. Much like setting the foundation of a house or a large building, one needs to plan and implement a structural foundation that is robust enough for day one requirements but scalable and extensible enough to support long term stability and future needs.

This is a complicated goal in a business where capital budgets are finite and you are competing for dollars against projects that are seen to grow the business or be transformative. However, the ability to design and implement a technology infrastructure that can support future requirements can actually enable your organization to make investments that are competitive differentiators.

The trick here is telling the story and selling the investments to your key executives in advance of the actual need.



Patient Interest in Digital Communication Is Growing

September 29, 2020

Guest Author

The following is a guest article by Dan Simenc, Chief Revenue Officer, SR Health by Solutionreach. Dan is one of our A-List speakers at our new EXPO.health Experience Series. Dan will join Ed Marx and other health IT leaders in an interactive discussion about digital transformation in healthcare and how you can develop your digital strategy amidst all the changes that are happening in the world today. Learn more about this truly unique experience here

Healthcare is slowly moving out of crisis mode. The world will be dealing with COVID for quite some time to come, but healthcare organizations aren’t scrambling to set up new technology to see patients or processes to keep patients and staff safe. Instead, healthcare is moving into the time when everyone needs to think about how to sustain some of the recent changes for the long term.

Supporting these changes is critical because revenue is down an average of 36 percent for healthcare organizations, and patients are delaying needed care. A recent MGMA study found that 87 percent of patients say safety is the reason they are reluctant to visit the doctor.

Healthcare organizations will need to do two things to get patients to come in for the care they need—communicate better and offer a seamless virtual care experience. The latest research suggests that communicating better will require more digital options and automated communication.



What 15 Medical Specialties Are Most Interested in Telehealth?

Doximity's annual report ranks the top 15 specialties interested in telehealth job listings, and reflects a growing interest in chronic care management and remote patient monitoring.

By Eric Wicklund

September 25, 2020 - Radiologists and psychiatrists are most interested in telehealth jobs, according to a new report from Doximity, while anesthesiologists and surgeons are showing the least interest.

The 2020 State of Telemedicine Report, released this month by the online professional medical network, includes its second annual list of top 15 medical specialties engaged in telemedicine postings. The list paints an interesting picture of how the industry is evolving and how it’s been affected by the coronavirus pandemic.

As with last year’s list, the presence of radiologists and psychologists point to two of the most common uses for telehealth, and the interest on telemental health correlates with an ongoing mental health crisis that has been exacerbated by the COVID-19 emergency. Other popular connected health services on the list include telestroke (neurologists), dermatology, pediatrics and – in a nod to the pandemic – infectious diseases.

Beyond that, this year’s list is populated with a variety of specialists, many focused on chronic conditions, indicating a surge of interest in telehealth and remote patient monitoring programs that offer care management at home for people with chronic conditions who can’t or don’t want to visit the doctor’s office.



3 Ways Healthcare is Using Predictive Analytics to Combat COVID-19

Predictive analytics tools are helping healthcare organizations stay ahead of poor outcomes, resource shortages, and other impacts of COVID-19.

By Jessica Kent

September 25, 2020 - Throughout the COVID-19 pandemic, predictive analytics tools have played an integral part in healthcare organizations’ response to and defense against the virus.

The enormous amount of data the pandemic has generated has given researchers and providers the opportunity to analyze trends, monitor patient populations, and begin to rectify longstanding issues in the healthcare industry. Having the ability to anticipate future events is critical in the midst of a healthcare crisis, and predictive analytics tools can help healthcare entities do just that.

Organizations are increasingly turning to predictive models to better understand which patients are at risk, where resources are most needed, and where the disease is likely to spike next.

Forecasting disease severity, risk

Determining which patients are most at risk for contracting the virus – as well as which individuals are likely to experience poor outcomes from COVID-19 – is perhaps the most important use case for predictive analytics during the pandemic.



UHS hit with massive cyber attack as hospitals reportedly divert surgeries, ambulances

by Heather Landi 

Sep 28, 2020 3:01pm

A major hospital chain has been hit by a massive cyber attack that reportedly has taken down all of its IT systems.

Computer systems at Universal Health Services (UHS), which operates 400 hospitals and behavioral health facilities in the U.S. and the U.K., began to fail over the weekend, and some hospitals have had to resort to filing patient information with pen and paper, according to multiple people familiar with the situation, NBC reported Monday.

UHS hospitals in the U.S. including those from California, Florida, Texas, Arizona, and Washington D.C. are reportedly left without access to computer and phone systems. Affected hospitals are redirecting ambulances and relocating patients in need of surgery to other nearby hospitals, according to media reports.

UHS has more than 90,000 employees and provides healthcare services to approximately 3.5 million patients each year.



Malware Attacks Declined But Became More Evasive in Q2

Most of the malware used in attacks last quarter were designed to evade signature-based detection tools, WatchGuard says.

9/24/2020 06:40 PM

Jai Vijayan

A new analysis of malware activity during the second quarter of this year uncovered some mixed news for enterprise organizations.

While malware detections in Q2 decreased 8% compared with the previous quarter, attacks involving malware that were not detectable by signature-based antivirus systems jumped 12% during the same quarter. Some seven in 10 attacks that organizations encountered in Q2, in fact, involved malware designed to circumvent antivirus signatures.

Security vendor WatchGuard recently analyzed malware attack data gathered from nearly 42,000 of its Firebox appliances at customer locations worldwide. Together, the devices blocked more than 28.5 million malware samples representing some 410 unique attack signatures — a 15% increase from Q1.

Corey Nachreiner, CTO of WatchGuard and co-author of the report, says the biggest takeaway from the analysis was the increase in attacks involving malware variants that used so-called "packers" or "crypters" to evade detection mechanisms.



Feeling anxious? Why online therapy might work better than an office visit

For CNET's Now What series, telemedicine expert Dr. Peter Yellowlees explains why telemedicine for mental health is better for patients and doctors, pandemic or not.

Sarah Mitroff

Sept. 26, 2020 9:00 a.m. PT

If you ask Dr. Peter Yellowlees, professor of psychiatry at UC Davis, about the future of medicine, he'll tell you that it's online. "The new normal is that people are going to increasingly obtain health care through the internet," he says. Rather than sitting in a waiting room, and then going into a physical exam, we will eventually be more likely to meet with a doctor through a video call.

In the early 1990s, long before Zoom and FaceTime existed, Dr. Yellowless used video conferencing to meet with and treat patients in Australia, so it's safe to say he's one of the early pioneers of telemedicine. Though the technology has changed, today there are many companies and providers offering the same experience.

Dr. Yellowlees likens telemedicine to house calls, a practice that largely died out last century. While the experience isn't exactly the same, most of the benefits of house calls still remain. "We're seeing people in their own environments [and] it actually improves the relationships we have with them," he says. 



CONSORT-AI sets standards for reporting on artificial intelligence in trials

Posted 25 September 2020 | By Mary Ellen Schneider 

A new consensus statement, dubbed the CONSORT-AI extension, lays out the rules of the road for clinical trial reports on interventions involving artificial intelligence (AI).
The statement, which was published in Nature Medicine and written by an international working group, includes 14 new items for researchers to routinely include in their manuscripts when reporting on AI interventions.
The statement calls on researchers who report on trials that include AI to fully explain the algorithm version, input and output data, integration into trial settings, expertise of the users, and the protocol for acting upon the AI system’s recommendations.
The idea is to promote transparent reporting of AI interventions and to build on the checklist outlined in the CONSORT 2010 statement, which provides minimum guidelines for reporting randomized trials. That statement, which was originally introduced in 1996 and has been widely endorsed by medical journals, has been updated over the years.
The CONSORT-AI extension (Consolidated Standards of Reporting Trials – Artificial Intelligence) was developed alongside a companion statement for clinical trial protocols, the SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials – Artificial Intelligence).


8 must-know lessons from telehealth's new normal

From managing cybersecurity imperatives with at-home patients as a new X factor, to surfing the data tsunami of remote patient monitoring, experts from NIST, FCC, Mount Sinai, Yale, Leapfrog and others offer insights on demand.

By Mike Miliard

September 28, 2020 11:53 AM

Telehealth has been around for a long time, but only recently has it gained the critical mass that most have long expected. "It's the overnight success story that was 30 years in the making," said Atrium Health Chief Strategy Officer Dr. Rasu Shrestha.

He said that in January 2019 – more than a year before the COVID-19 pandemic necessitated, in short order, an even bigger, more sustained and more widespread scaling up of virtual care services than could ever have been imagined two years ago.

Over the past six months, as hospitals and health systems have pursued telemedicine and remote patient monitoring programs in earnest – whether launching new ones or expanding existing ones – they've all had some learning curves and growing pains to manage.



Majority of health execs say telemedicine has improved patient care

While more than half of the leaders polled say their telehealth experience has been a positive one, they saw some barriers too, including some patients' challenges using the new technologies.

By Kat Jercich

September 28, 2020 03:29 PM

A new survey of 500 executives in the healthcare industry found that the switch to telehealth necessitated by the COVID-19 pandemic has been a largely positive one, and the majority said at least some of the changes would be permanent.  

The survey, conducted by marketing agency Boston Digital and released Monday, found that 57% of executives said telehealth had increased the quality of patient care. But the results weren't all rosy: About a quarter said it had no impact, and 15% said it had decreased the quality of patient care.  

"Even as patients begin to schedule in-person appointments once again, our survey indicates that not only are telehealth programs here to stay, but also that most healthcare organizations plan on investing in the expansion of telehealth capabilities," said Peter Prodromou, president at Boston Digital, to Healthcare IT News.   



What do CIOs want to see from telehealth apps? More than a dozen weigh in

Seamless workflow integration, better patient engagement, artificial intelligence utilization and "multidisciplinary group chat" – the sky's the limit when it comes to potential telemedicine innovations.

By Kat Jercich

September 28, 2020 12:55 PM

When the COVID-19 pandemic began to spread around the country, health systems had to pivot quickly – many within a few days – to respond to the skyrocketing need for telemedicine.

For some, this meant there wasn't time to think deeply about which vendors were best suited to their needs; it was a question of speed and necessity.

Although the specifics are still fuzzy, it's been made evident that telehealth isn't going anywhere. Now that we've all had half a year to get used to the idea, the advantages of the modality are clear, as are the areas in which it still needs to improve.



Pandemic-era burnout: Healthcare CIOs talk stress, and offer tips for a cure

For the latest in our series on burnout during the age of COVID-19, six hospital chief information officers discuss the daily stressors that push them toward exhaustion – and describe the strategies they use to manage their workloads.

By Bill Siwicki

September 28, 2020 01:33 PM

Chief information officers are under immense pressure every day. They must keep the central nervous system of a hospital or health system up and running at peak performance 24 hours a day, seven days a week, 365 days a year. That is not an easy task in the best of times.

Add to that all the demands of working through a deadly pandemic, with patient volumes increasing, information systems needing to be optimized (and often reconfigured for new clinical tasks) and much of a hospital’s IT workforce working remotely.

We spoke with six healthcare CIOs from across the country – New York to Hawaii – to learn how they’re managing these pressing demands on a day-to-day basis. They discuss the aspects of their jobs that cause them stress and can lead to burnout – but also offer plenty of actionable tips for their peers about how to combat stress and meet the challenges of a demanding job.

Remote workforce challenges

David Chou, chief information officer at Harris Health System in Houston, Texas, said the need to suddenly support a virtual workforce has been a big source of stress during the COVID-19 pandemic.



How Are Healthcare Institutions Being Attacked and What Can You Do About It?

September 28, 2020

John Lynn

Seems like a week doesn’t go by with at least one or multiple healthcare systems being compromised by hackers.  As we talk with hundreds of healthcare organizations, they’re all in universal agreement that healthcare organizations are under attack by hackers more now than they’ve ever been before and that trend seems likely to continue.  Understanding all of the various ways your healthcare organization is being attacked today is the first step and then you can work to combat against it.

To get a better understanding of how healthcare institutions are being attacked and how to combat these attacks, we sat down with the following panel of cybersecurity experts in a discussion hosted by Proofpoint:

  • Chris Baldwin- Chief Information Security Officer at Hartford HealthCare
  • Ryan Witt – Managing Director, Healthcare Industry Practice at Proofpoint

One of the great comparisons in this discussion is how previously CISOs and CIOs were extremely worried about attacks to their network and now they are much less of a risk to a healthcare organization.  While these types of physical device attacks are still happening today and are important to include in your cybersecurity efforts, the methods of combatting and preventing those attacks are now widespread and can largely be dealt with using the right strategy and technology.  Put more simply, pretty much every healthcare organization now has a firewall, network segmentation, and other basic block and tackling cybersecurity.



A Look at Unexpected Benefits of User Experience Design in Health Care

September 28, 2020

Andy Oram

By thrusting millions of new users onto online tools such as Zoom, the COVID-19 pandemic shutdown has highlighted the importance of easy-to-use tools for communication and coordination. The health care field has lagged in its digital tool designs. (For an example, let me take you on a tour of the Epic patient portal, Mychart.) So I talked recently with Jennifer Dadagian, Director of UX, Content Strategy & Research at Tank Design about user experience (UX) design for health care.

UX design, which I’ve covered in the context of the former HxRefactored conferences, goes much deeper than many observers think. UX is not just about where the buttons go on the screen, or how deep the user should have to dive through layers of menus. Good designers will rip open the organization for which they’re creating an interface, to determine the values, goals, and working methods of that organization.

So UX designers are not just forging a path through the menus and screens of an application; they are redesigning relationships and workflows in the organization.



Intermountain Telehealth: A Million Virtual Connections and Counting

By Mandy Roth  |   September 28, 2020

The Utah-based healthcare system's experiences provide a blueprint for other organizations seeking to scale their virtual care initiatives.


·         By the beginning of June 2020, the health system surpassed a million telehealth interactions

·         To accelerate the practice of virtual care during the pandemic, Intermountain trained thousands of clinicians.

·         The organization purchased 600 computer tablets and distributed them to the system's hospitals and clinics.

·         A new use for the technology emerged when the ER began conducting video handoffs to critical care units to ensure continuity of care.

How does a healthcare system achieve a milestone of one million telehealth interactions? You get a significant head start before a worldwide pandemic impacts your 23-hospital organization operating in three states. 

Like many large healthcare systems, Salt Lake City–based Intermountain Healthcare already had a solid telehealth program in place before the coronavirus pandemic. Yet the dynamics of the disease rapidly accelerated adoption of the technology.



NYC Hospitals Create Blueprint for COVID-19 Triage By Telehealth

The report, recently published in Medicina, was prepared by clinicians at NYU Langone Health and the NYU Long Island School of Medicine, both of which used telehealth to treat hundreds of thousands of patients this summer.

By Eric Wicklund

September 21, 2020 - Two New York health systems have published a blueprint for using telehealth to diagnose and treat patients infected with the coronavirus.

The report, “A Telemedicine Approach to COVID-19 Assessment and Triage,” was published earlier this month in the scientific and medical journal Medicina by researchers and clinicians from NYU Langone Health and the NYU Long Island School of Medicine. It offers guidelines on how to triage patients who may have COVID-19 and use virtual care platforms to treat them in isolation.

Those involved with the report are speaking from experience. Telehealth visits at the two health systems jumped from 50 a day to more than 7,000 from March to April, when New York City was at the center of the coronavirus pandemic in the US. By this past August, more than 550,000 patients had been screened through a virtual platform.



Weekly News Recap

  • CMS is reportedly preparing to notify the 76% of US hospitals that aren’t submitting daily COVID-19 reports to HHS’s new reporting system that their Medicare payments may be halted.
  • A business associate of Community Health Systems will pay $2.3 million to settle charges that it failed to secure its systems even after the FBI warned it that hackers had penetrated them.
  • FDA launches the Digital Health Center of Excellence that will advise it on digital health policies and regulatory approaches.
  • Microsoft launches Cloud for Healthcare.
  • A KLAS Arch Collaborative survey finds that EHRs are not a significant cause of nurse burnout.
  • The Carlyle Group acquires a majority stake in global health research network TriNetX.
  • Healthcare robotic process automation vendor Olive raises $106 million.
  • Informatics pioneer Bill Stead, MD announces that he will retire from Vanderbilt University Medical Center’s senior leadership team after a 29-year career.




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