Quote Of The Year

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

or

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

Saturday, November 28, 2020

Weekly Overseas Health IT Links – 28 November, 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.

-----

https://mhealthintelligence.com/news/geisinger-tests-mhealth-platform-for-chronic-pain-treatment

Geisinger Tests mHealth Platform for Chronic Pain Treatment

The Pennsylvania health system is participating in a study that uses VR glasses and an mHealth platform to help patients manage acute and chronic pain at home.

By Eric Wicklund

November 19, 2020 - Health systems looking for an alternative to opioids are testing out mHealth and telehealth tools to help patients living with acute and chronic pain.

The Geisinger Health System, for example, is using virtual reality (VR) headsets and a connected health platform designed by AppliedVR to treat patients, first training them on the technology at the hospital and then sending them home to continue treatment.

Chronic pain “can be insidious and long-lasting,” says Michaek Suk, MD, the chairman of Geisinger’s Musculoskeletal Institute and Department of Orthopedic Surgery. “We really want to add more arrows to the quiver when it comes to treating these conditions, and to make more of an impact in post-acute treatment.”

The Pennsylvania-based health system has been testing the platform in a study coordinated by AppliedVR, an LA company that received FDA Breakthrough Device designation just last month to use its platform, as a digital therapeutic to treat treatment-resistant fibromyalgia and chronic intractable lower back pain. Both Geisinger and the Cleveland Clinic are using the technology, with funding from a $2.9 million grant from the National Institute of Health’s National Institute on Drug Abuse (NIDA) awarded to AppliedVR.

-----

https://healthitanalytics.com/news/expanding-access-to-mental-healthcare-with-artificial-intelligence

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.

-----

https://healthitanalytics.com/news/machine-learning-predicts-how-cancer-patients-will-respond-to-therapy

Machine Learning Predicts How Cancer Patients Will Respond to Therapy

A machine learning model was able to predict which skin cancer patients will benefit from immunotherapies.

By Jessica Kent

November 18, 2020 - A machine learning algorithm accurately determined how well skin cancer patients would respond to tumor-suppressing drugs in four out of five cases, according to research conducted by a team from NYU Grossman School of Medicine and Perlmutter Cancer Center.

The study focused on metastatic melanoma, a disease that kills nearly 6,800 Americans each year. Immune checkpoint inhibitors, which keep tumors from shutting down the immune system’s attack on them, have been shown to be more effective than traditional chemotherapies for many patients with melanoma.

However, half of patients don’t respond to these immunotherapies, and these drugs are expensive and often cause side effects in patients.

-----

https://www.statnews.com/2020/11/18/interoperability-untapped-tool-fight-against-covid-19/

Interoperability: an untapped tool in America’s fight against Covid-19

By Bruce Broussard

November 18, 2020

As the coronavirus pandemic collides with flu season, barriers to accessing medical information could undermine not only individual patient care but public health. Our ability to successfully prevent, isolate, and control outbreaks of infectious disease will depend on how we leverage data and technology to track its spread and treat individual patients.

One lesson emerging from the Covid-19 pandemic is that we must seize the opportunity to modernize how Americans’ health information is managed. The flow of data between patients’ electronic health records and public health surveillance systems is often a manual process involving paper documents and fax machines. Broad adoption of interoperability — the secure sharing of health information across platforms — has the potential to dramatically improve not only our response to the pandemic but also individual health outcomes.

The urgent need is clear, and the technology is available. But interoperability isn’t happening.

At its core, interoperability is the requirement that all electronic health record systems (EHRs) “talk” to each other, so an emergency room in Wyoming can look up an ailing tourist’s health records in Alabama.

-----

https://khn.org/news/people-proving-to-be-weakest-link-for-apps-tracking-covid-exposure/

People Proving to Be Weakest Link for Apps Tracking COVID Exposure

By Rae Ellen Bichell November 19, 2020

The app builders had planned for pranksters, ensuring that only people with verified COVID-19 cases could trigger an alert. They’d planned for heavy criticism about privacy, in many cases making the features as bare-bones as possible. But, as more states roll out smartphone contact-tracing technology, other challenges are emerging. Namely, human nature.

The problem starts with downloads. Stefano Tessaro calls it the “chicken-and-egg” issue: The system works only if a lot of people buy into it, but people will buy into it only if they know it works.

“Accuracy of the system ends up increasing trust, but it is trust that increases adoptions, which in turn increases accuracy,” Tessaro, a computer scientist at the University of Washington who was involved in creating that state’s forthcoming contact-tracing app, said in a lecture last month.

In other parts of the world, people are taking that necessary leap of faith. Ireland and Switzerland, touting some of the highest uptake rates, report more than 20% of their populations use a contact-tracing app.

-----

https://www.reuters.com/article/us-health-coronavirus-apps-tracing/new-contact-tracing-apps-stir-hope-for-virus-fighters-in-u-s-states-idUSKBN27Z2SO

November 20, 20205:35 AMUpdated a day ago

New contact tracing apps stir hope for virus fighters in U.S. states

By Paresh Dave

OAKLAND, Calif. (Reuters) - A new wave of mobile apps that help track exposure to the coronavirus is coming to U.S. states ahead of the holidays as public health officials bet that recently introduced features from Apple Inc AAPL.O and Alphabet Inc's GOOGL.O Google will significantly boost adoption and impact.

The CA COVID Notify mobile app, an exposure notification app launched by California officials for tracing during the coronavirus disease (COVID-19) outbreak, is seen on an Android phone in a photo illustration in Oakland, California, U.S. November 18, 2020. REUTERS/Paresh Dave

Colorado, Maryland and District of Columbia launched exposure-notification apps with the new technology in the last month, garnering over 2.3 million users combined, according to their public health departments. California, Washington and other states expect to follow in the next month, officials said.

Complementing human contact-tracers, the smartphone apps use Bluetooth signals to track when people are in close contact and anonymously alert users when a recent contact tests positive. They emerged as promising tools early in pandemic, but technical shortcomings, privacy concerns and dismissive attitudes in the United States toward safety measures undercut their benefits.

-----

https://healthitsecurity.com/news/50-of-advanced-phishing-attacks-evade-leading-secure-email-gateways

50% of Advanced Phishing Attacks Evade Leading Secure Email Gateways

A new IRONSCALES report finds as threat actors increasingly leverage social engineering scams, nearly half of these advanced phishing attacks bypass the leading secure email gateways.

By Jessica Davis

November 18, 2020 - Nearly half of all advanced phishing attempts, such as spear-phishing and social engineering attacks, bypass leading secure email gateways (SEGs), as hackers shift into more advanced schemes that prey on human nature, according to new research from IRONSCALES.

Researchers employed IRONSCALES Emulator, a breach and attack simulation tool, to assess the effectiveness of Microsoft ATP and other leading SEGs in stopping advanced email threats. 

IRONSCALES simulated real-world phishing attacks to test technical controls and review gaps in clients’ email security infrastructure, in an effort to address the shifting threat landscape as the majority of phishing emails do not contain malware via links or attachments.

Instead, most phishing emails leverage social engineering techniques, including business email compromise (BEC), impersonations of known contacts, and other techniques, like spoofing and fraud.

-----

https://healthitsecurity.com/news/millions-of-medical-images-exposed-as-us-fails-to-secure-pacs-flaws

Millions of Medical Images Exposed, as US Fails to Secure PACS Flaws

A year out from a shocking report that revealed massive PACS vulnerabilities were exposing millions of medical images and data, and NNT shows the US has failed to secure those flaws.

By Jessica Davis

November 19, 2020 - In the Fall of 2019, a damning report from ProPublica outlined a massive healthcare exposure: millions of medical images generated from Picture Archiving and Communication Systems (PACS) were left exposed and unsecured online. And the US was the biggest culprit.

One year later, and the US healthcare sector has still failed to close these major security gaps, where other countries took action.

The latest data shows that the largest offenders, just eight providers, are leaking more than 4 million medical images and records from about 1 million US citizens. These statistics do not include the remaining 162 healthcare entities that are also exposing this sensitive information.

-----

https://patientengagementhit.com/news/ama-joins-industry-efforts-against-medical-racism-implicit-bias

AMA Joins Industry Efforts Against Medical Racism, Implicit Bias

The industry group outlined five action items for unwinding medical racism and implicit bias, as well as policy recognizing race as a social construct.

By Sara Heath

November 18, 2020 - The American Medical Association (AMA) has renewed its pledge to combat racism and implicit bias in medicine by adopting new policy principles at a Special Meeting of its House of Delegates.

“The AMA recognizes that racism negatively impacts and exacerbates health inequities among historically marginalized communities. Without systemic and structural-level change, health inequities will continue to exist, and the overall health of the nation will suffer,” AMA Board Member Willarda V. Edwards, MD, MBA, said in a statement announcing the policy.

“As physicians and leaders in medicine, we are committed to optimal health for all, and are working to ensure all people and communities reach their full health potential. Declaring racism as an urgent public health threat is a step in the right direction toward advancing equity in medicine and public health, while creating pathways for truth, healing, and reconciliation.” 

-----

https://patientengagementhit.com/news/racial-health-disparities-worsened-over-20-year-period

Racial Health Disparities Worsened Over 20-Year Period

New research showed that racial health disparities between Black and White or Hispanic and White patients grew since the new millennium.

By Sara Heath

November 18, 2020 - Racial health disparities have only gotten worse in the past twenty years, new data shows, despite Congressional and research efforts to better understand and mitigate disparities.

The study, published in JAMA Network Open, showed that poor health indicators among Black patients have gotten worse since the turn of the new millennium. For Hispanic patients, diabetes, hypertension, and uninsurance disparities have worsened.

These results come after a two-decades-long push to address racial health disparities, the researchers from the Columbia University Irving Medical Center reported. In 1999, Congress requested the then Institute of Medicine (now known as the National Academy of Medicine) to allocate $35 billion in funding over 20 years to assess and address racial health disparities.

-----

https://hbr.org/2020/11/balancing-virtual-and-in-person-health-care

Balancing Virtual and In-Person Health Care

by  Adam Licurse, Kelly Fanning, Karl Laskowski, and Adam Landman

November 17, 2020

Summary.    As we transition to a new normal for healthcare delivery, how do we best continue virtual care alongside in-person care in the era of Covid-19? First, practices will need to develop criteria to triage and schedule patients for in-person or virtual visits; second, once...   

The 2020 Covid-19 pandemic has seeded the U.S. healthcare system with innovations across the care spectrum, largely focused on outpatient care delivery through virtual care tools. The Centers for Medicare and Medicaid Services reported over an 11,000% increase in virtual visits (i.e., video- or phone-based visits).  In our academic health system, Brigham Health in Boston, Massachusetts, we saw an overall increase in virtual visits from pre-Covid-19 to its peak in May of over 20,000% (roughly 80,000 virtual visits that month), offered by nearly all of our ambulatory providers, and representing roughly 70% of all outpatient care from a baseline of less than 1%.

After the May peak, health care facilities began to reopen for more routine care; in-person volume in our system slowly grew while virtual volume fell. While the current surge may reverse that pattern again, as of this writing virtual visits represent about 25% of overall outpatient care – and our clinicians, practices and colleagues across the country are asking common questions about what comes next: How much virtual care makes sense when we do return to a new normal state? What is the best approach to offering virtual care alongside in-person care?  How will we know whether virtual care is succeeding, and in particular that it is reaching all patients as safely and equitably as possible?

-----

https://healthitsecurity.com/news/hackers-hit-covid-19-biotech-firm-cold-storage-giant-with-cyberattacks

Hackers Hit COVID-19 Biotech Firm, Cold Storage Giant with Cyberattacks

Cold storage giant Americold and Global firm Miltenyi Biotec recently faced cyberattacks; ransomware, an email error, phishing, and an application hack complete this week’s breach roundup.

By Jessica Davis

November 18, 2020 - Two global firms with reported ties to the COVID-19 pandemic response faced cyberattacks within the last week. Miltenyi Biotec reported a system outage caused by a malware attack, while cold storage giant Americold, previously in talks to provide storage for the distribution of COVID-19 vaccines, experienced a “cybersecurity incident.”

Miltenyi is a global biotech firm based in Germany with offices in 73 countries, including several in the US. The company is responsible for supplying SARS-CoV-2 antigens for research firms tasked with working on COVID-19 treatments.

The attack struck Miltenyi’s IT infrastructure two weeks ago, which caused issues with some order and operational processes, including email and phone communications. The company has since fully restored its operations.

-----

https://www.healthcareitnews.com/news/cerner-says-new-video-visit-platform-will-help-rural-health-systems

Cerner says new video visit platform will help rural health systems

By Kat Jercich

November 19, 2020 02:29 PM

Cerner announced this week that it would be offering a new video care platform to its CommunityWorks clients at no cost through the end of next year.

The platform is aimed at addressing the healthcare needs of those living in rural areas. Cerner says its customers' patients can receive care using their modality of choice via the new program, which it's calling Video Visit. 

"Throughout the pandemic, we’ve seen a significantly increased desire from both consumers and healthcare providers for virtual health solutions and rapid innovation and adoption of existing products," said Mitchell Clark, president of Cerner CommunityWorks, in a statement.

-----

https://www.healthcareitnews.com/news/ama-passes-pro-telehealth-resolution

AMA passes pro-telehealth resolution

American Medical Association delegates adopted a policy this week directing the organization to keep working to support telehealth advancements during and after the COVID-19 pandemic.

By Kat Jercich

November 19, 2020 10:51 AM

The American Medical Association this week resolved to continue advocating for telehealth after the COVID-19 pandemic, particularly among underserved communities.   

After physicians and medical students gathered virtually for five days, delegates adopted a policy directing the AMA to continue working with legislators and regulators to support telehealth advancements.

"Telehealth and remote care services have proven critical to the management of COVID-19, while also ensuring uninterrupted care for 100 million Americans with chronic conditions. How telehealth will be used after the pandemic is in the balance, and no one wants to see new access to telehealth suddenly halted," said AMA president Dr. Susan R. Bailey in a statement earlier this week.

-----

https://www.healthcareittoday.com/2020/11/19/top-security-compliance-risks-in-telehealth/

Top Security & Compliance Risks in Telehealth

November 19, 2020

The following is a guest article by Donna Thiel, Chief Compliance Officer at ProviderTrust.

Although there may be numerous benefits to using telehealth services, patients and providers should also consider the substantial telehealth risks involved.

With the sudden uprising of COVID-19, the Department of Health & Human Services quickly took significant steps in securing better access to telehealth services. Now, with patients being able to talk to their doctor live through phone or video chat, send and receive messages through email, secure messaging, and secure file exchange, and use remote patient monitoring using home check-up devices, telehealth has become extremely popular due to its accessibility and safety from COVID-19.

By expanding U.S. telehealth offerings and utilizing such technology, this also presents potential severe liabilities, such as a laundry list containing cybersecurity, data, and compliance risks. As the regulations governing telehealth still remain to be relaxed, now is the time to be vigilant regarding various telehealth risks.

-----

https://www.healthleadersmedia.com/covid-19/take-it-expert-faucis-hierarchy-safety-during-covid

Take It From an Expert: Fauci's Hierarchy of Safety During COVID

By Kaiser Health News  |   November 19, 2020

All this time, the person I've most wanted to hear from is Fauci. He's a straight shooter, with no apparent conflicts of interest — political or financial — or, at 79, career ambition. He seemingly has no interests other than yours and mine.

This article was published on Thursday, November 19, 2020 in Kaiser Health News.

By Elisabeth Rosenthal

As a health journalist, a physician and a former foreign correspondent who lived through SARS in Beijing, I often get questions from friends, colleagues and people I don’t even know about how to live during the pandemic. Do I think it’s safe to plan a real wedding next June? Would I send my kids to school, with appropriate precautions? When will I trust a vaccine?

To the last question, I always answer: When I see Anthony Fauci take one.

Like many Americans, I take my signals from Dr. Fauci, the country’s top infectious disease expert and a member of the White House task force on the coronavirus. When he told The Washington Post that he was not wiping down packages but just letting them sit for a couple of days, I started doing the same. In October, he remarked that he was bringing shopping bags into the house. He merely washes his hands after unpacking them. (Me too!)

Now we are in a dangerous political transition, with cases spiking in much of the country and Fauci and the original task force largely sidelined. President-elect Joe Biden has appointed his own, but it can’t do much until the General Services Administration signals that it accepts the results of the election. And Fauci told me he has not yet spoken with the Biden task force. President Donald Trump has resisted the norms on government transition, in which the old and new teams brief each other and coordinate.

-----

https://www.healthleadersmedia.com/technology/contacting-patients-unencrypted-email

Contacting Patients via Unencrypted Email

By Revenue Cycle Advisor  |   November 19, 2020

It is important to ask the patient to sign a disclaimer that will protect your organization in the event of a breach. 

A version of this article was first published November 19, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What type of information can be sent to patients via unencrypted email?

A: If the email contains PHI, even if it includes only the patient’s name and email address, it needs to be encrypted.

These days, OCR enforces the encryption provisions in the HIPAA Security Rule as it is required.

-----

https://patientengagementhit.com/news/social-determinants-of-health-food-insecurity-linked-to-cardiovascular-death

Social Determinants of Health, Food Insecurity, Linked to Cardiovascular Death

For every 1% increase in food insecurity, cardiovascular deaths go up by 0.86% for adults ages 20 to 64 based on 2011-2017 county-level data.

By Hannah Nelson

November 17, 2020 - Food insecurity is linked to a higher rate of cardiovascular death for adults between the ages of 20 and 64, according to a preliminary study that analyzed county-level data from 2011 to 2017.

This comes as medical professionals increasingly recognize the importance of the social determinants of health, which include issues like food insecurity. This finding gives providers stronger basis for referring patients to food programs to mitigate downstream health consequences, like cardiovascular disease.

Researchers used data from the National Center for Health Statistics and Feeding America’s “Map the Meal Gap” study to analyze the average annual percent change in food insecurity and cardiovascular mortality trends in the US.

Counties that had the largest increase in food insecurity levels had cardiovascular death rates that increased from 82 to 87 per 100,000 people. On the other hand, counties that saw a decrease in food insecurity over the six years had a cardiovascular mortality rate that remained stable at 60 per 100,000 people.

-----

https://healthitsecurity.com/news/ransomware-groups-team-up-as-hackers-shift-into-cloud-operations

Ransomware Groups Team Up, as Hackers Shift into Cloud Operations

A number of hacking groups, including those employing ransomware, are teaming up to expand the threat landscape and take advantage of stolen data troves in cloud-based operations.

By Jessica Davis

November 17, 2020 - Hackers are teaming up with other cybercriminals to increase the impact of attacks and to take advantage of troves of stolen data. Trend Micro and Intel 471 found ransomware groups are teaming up with lesser-known actors, while others are shifting operations to cloud-based services and technologies to increase the monetization of their hacking efforts.

Throughout the year—and in response to the global COVID-19 crisis, hackers have steadily worked to take advantage of the new threat landscape provided by the rapid adoption of remote technologies and heightened fears amid the pandemic.

Microsoft previously warned that attacks have significantly increased in sophistication, as healthcare continues to be a prime target for many of these attack vectors given its vulnerable infrastructure and the likelihood of providers will opt to pay hacking demands.

The latest report from Intel 471 warned that given the success of ransomware attacks, its hacking groups are steadily developing new variants—and offering access to corporate networks on the dark web.

-----

https://mhealthintelligence.com/news/telehealth-helps-the-mayo-clinic-adjust-to-a-new-healthcare-ecosystem

Telehealth Helps The Mayo Clinic Adjust to a New Healthcare Ecosystem

The Minnesota-based health system is using mHealth tools and telehealth platforms to re-imagine how it gathers data and delivers care, both inside and outside the hospital walls.

By Eric Wicklund

November 16, 2020 - Like so many other health systems, the Mayo Clinic ramped up its telehealth platform to address the coronavirus pandemic, adopting digital health tools and processes that normally would have taken a decade to put in place.

Now, the Minnesota-based health system is dealing with the challenges associated with sudden growth, and looking to create a connected health network that can seamlessly accommodate both in-person and virtual care. And that means making sure the consumer-friendly front door meshes with the clinician-friendly back end.

Cris Ross, the Mayo Clinic’s chief information officer, says the COVID-19 crisis forced the health system to adapt at a rapid rate, moving from about 4 percent of virtual visits before the pandemic to 85 percent during the roughest days of late spring and early summer. Supported by emergency federal and state mandates that loosened constraints on telehealth, they were able to create pathways that improved care management for patients outside the hospital.

“We learned a lot about what consumers like and don’t like,” Ross says, noting the Mayo Clinic mHealth app is now used by about 70 percent of the health system’s patients. “Now we really need to define consumer-friendly healthcare.”

-----

https://mhealthintelligence.com/news/covid-19-survey-doctors-like-telehealth-and-want-to-continue-using-it

COVID-19 Survey: Doctors Like Telehealth and Want to Continue Using It

A new survey from the COVID-19 Healthcare Coalition finds that providers have seen good results from using telehealth during the coronavirus, and more than half say connected health has improved their work satisfaction.

By Eric Wicklund

November 17, 2020 - A survey of roughly 1,600 healthcare providers finds that almost 70 percent are motivated to use more telehealth because of the experiences they’ve had during the coronavirus pandemic – and more than half say their outlook has improved because of connected health.

The survey, conducted in July and August by a workgroup of the COVID-19 Healthcare Coalition – comprised of the American Medical Association, American Telemedicine Association, Change Healthcare, Digital Medicine Society, Mayo Clinic, Massachusetts Health Quality Partners, MassChallenge Health Tech and MITRE – adds to the effort to continue telehealth expansion by making permanent many of the emergency measures designed to help providers during the crisis.

More than three-quarters of those survey respondents, in fact, said telehealth helped them to provide quality care for their patients.

“The strong support shown for telehealth, as evidenced in these results, reinforces the knowledge that telehealth is critical to how we deliver healthcare today,” Steve Ommen, medical director of the Mayo Clinic’s Center for Connected Care and one of the study’s investigators, said in a press release issued this morning. “The use of telehealth during the COVID-19 pandemic highlights its importance in care delivery. Its continued use will be instrumental in connecting to patients everywhere.”

-----

https://healthitanalytics.com/news/supporting-secure-data-sharing-patient-privacy-during-covid-19

Supporting Secure Data Sharing, Patient Privacy During COVID-19

Regenstrief Institute is partnering with NIH and other organizations to promote secure data sharing and enhance research related to COVID-19.

By Jessica Kent

November 17, 2020 - When COVID-19 began spreading across the US, the healthcare industry quickly moved to improve its secure data sharing practices in order to accelerate research efforts and treatment development.

Because the crisis is occurring at such a large scale, leaders had to come up with a way to safely share data related to the virus among different organizations.

“When the pandemic hit, it became obvious that we should have a large COVID-19 database that people could use for research,” Umberto Tachinardi, MD, MSc, chief information officer for the Regenstrief Institute and director of informatics for Regenstrief and Indiana Clinical and Translational Sciences Institute (CTSI), told HealthITAnalytics.

-----

https://www.pennmedicine.org/news/news-blog/2020/november/5-tips-for-making-the-transition-from-one-ehr-to-another-as-painless-as-possible

5 Tips for Making the Transition from One EHR to Another As Painless As Possible

November 16, 2020

by Frank Otto

Not too long ago, doctors’ poor handwriting was notorious and a staple for jokes. But now, most of the record-keeping in medicine has transitioned to digital means. Over the last decade, thanks in part to the Affordable Care Act, electronic health records (EHRs) are used in more than 98 percent of hospitals and almost all physicians’ offices. EHRs can significantly improve the accessibility of patient information, but have also spawned their own challenges.

One of those challenges is the fact that health systems will need to transition from their current system to another, a challenge which will become more and more common as EHRs continue to age out from first or even second generation software. In the same way that a business might find it more advantageous to use a more modern computer or brand, these transitions will happen. But unlike most businesses making technology upgrades or transitions, health care systems don’t have the luxury of making a change overnight or over the weekend when things close or slow down. And most businesses’ switch from PCs to Macs won’t have a potential effect on the health of their clients either.

With that in mind, a pair of Penn Medicine researchers, veterans of the health system’s shift to its own EHR, PennChart, took a look at the existing literature on how health systems handled their transitions. As they examined the understudied subject, John D. McGreevey III, MD, an associate professor of Clinical Medicine, and Ross Koppel, PhD, an adjunct professor of Sociology and a senior fellow of the Institute of Biomedical Informatics, developed a 10-point checklist for health care system leaders to guide them as they move into an EHR transition. Their findings were published in Applied Clinical Informatics.

-----

https://www.digitalhealth.net/2020/11/special-report-interoperability-5/

Special Report: Interoperability

2020 has seen the digital health landscape rapidly change in a matter of months, so what has this meant for interoperability in healthcare? Jennifer Trueland investigates.

Back in February when NHSX launched its Tech Plan, interoperability was understandably a key focus.

The events of the following few months have only served to make the case stronger by underlining the need for a system that ensures that a patient’s information can be accessed at the point where it is needed, no matter where it originated.

Connection is key

According to Luke Readman, regional director of transformation for NHS London and senior responsible officer for the OneLondon LHCRE, connection is key both in pandemic and “normal” times.

“At the point of care, any health professional with a legitimate right should be able to see what’s happening across the whole of that patient’s care, not just the bit they’re looking at currently,” he adds.

“We [at OneLondon] accelerated some of these connections in the first part of Covid, in six weeks we did maybe three or four or even six months of the work that was planned to drive the pan-London connections in particular, because we knew patients would be cared for in the Nightingale and the ExCel.

-----

https://hitinfrastructure.com/news/google-launches-new-artificial-intelligence-tools-for-healthcare

Google Launches New Artificial Intelligence Tools for Healthcare

The artificial intelligence tools for healthcare include natural language processing and machine learning, which Google says can help analyze medical texts.

By Samantha McGrail

November 12, 2020 - Google Cloud recently launched new artificial intelligence tools for healthcare users intended to combat challenges with healthcare data and unstructured digital text during the COVID-19 pandemic.

The suite of fully-managed artificial intelligence tools, which includes the Healthcare Natural Language API and AutoML Entity Extraction for Healthcare, will assist healthcare professionals with reviewing and analyzing large volumes of medication documents.

“We hope this technology will help reduce workforce burnout and increase healthcare productivity, both in the back-office and in clinical practice,” Google officials said in a new official blog post. 

-----

https://patientengagementhit.com/news/patient-satisfaction-surveys-fall-short-for-pediatric-patients

Patient Satisfaction Surveys Fall Short For Pediatric Patients

Pediatric patient satisfactions need to focus on elements of care important to children, like their fears or even whether or not they get bored in the hospital.

By Sara Heath

November 16, 2020 - Healthcare organizations need a better way to survey pediatric patient satisfaction that is inclusive and simple enough for a child—not her parent or guardian—to complete, a group for researchers from Auburn University said in new research.

The study, published in The Beryl Institute’s PX Journal, concluded that the existing, albeit few and far between, pediatric patient feedback questionnaires are too complex to yield meaningful insights into the pediatric patient experience, warranting work to develop a new one.

These findings come as more healthcare professionals focus on improving the patient experience as a part of their value-based care efforts. The transition from volume to value has placed heavy emphasis on a positive healthcare experience, with health payers reimbursing based on good patient reports and organizations using patient feedback for quality improvement projects.

-----

https://healthitsecurity.com/news/ssl-based-cyberattacks-increase-by-260-healthcare-most-targeted

SSL-Based Cyberattacks Increase By 260%; Healthcare Most Targeted

The number of cyberattacks leveraging SSL encrypted channels to bypass legacy security controls increased by 260 percent since 2019. And healthcare was the most targeted sector.

By Jessica Davis

November 16, 2020 - The number of cyberattacks leveraging encrypted channels to bypass legacy security controls has rapidly increased by a staggering 260 percent since 2019, with the healthcare sector as the leading target for these SSL-based attacks, according to a recent ZScaler ThreatLabZ report.

SSL/TLS encryption is the industry-standard method for protecting data in transit and is meant to protect traffic from unauthorized access. However, hackers have hijacked the tool to hide cybercriminal activity, “turning the use of encryption into a potential threat without proper inspection.”

“Cybercriminals know what security experts know: that SSL/TLS encryption is the industry-standard way to protect data in transit,” researchers explained. “Those same cybercriminals use industry-standard encryption methods themselves, devising clever ways to hide malware inside encrypted traffic to carry out attacks that bypass detection.”

-----

https://healthitsecurity.com/news/nation-state-hacking-campaigns-targeting-covid-19-research-firms

Nation-State Hacking Campaigns Targeting COVID-19 Research Firms

Microsoft has observed several hacking campaigns led by nation-state actors with ties to Russia and North Korea, actively targeting COVID-19 research, including firms developing vaccines.

By Jessica Davis

November 13, 2020 - COVID-19 vaccine developers and research firms are again facing targeted cyberattacks, with an ongoing campaign led by nation-state hackers with ties to North Korea and Russia, according to Microsoft.

Researchers have observed nation state threat actors targeting seven firms leading COVID-19 vaccine and treatment research, including pharmaceutical companies and researchers in the US, Canada, France, India, and South Korea.

The campaigns are led by the Russian hacking group known as Strontium and North Korean hackers, Zinc and Cerium.

Cybercriminals have ramped up their malicious attacks throughout the pandemic, from phishing attacks and fraud schemes tied to the coronavirus, to nation-state attacks on coronavirus research and human-operated ransomware attacks on the healthcare sector.

-----

https://healthitanalytics.com/news/predictive-analytics-identifies-infants-at-risk-of-drug-withdrawal

Predictive Analytics Identifies Infants at Risk of Drug Withdrawal

Predictive analytics models were able to determine which infant patients would go on to develop a drug withdrawal syndrome after exposure to opioids during pregnancy.

By Jessica Kent

November 16, 2020 - Predictive analytics tools could help providers identify infants at risk of developing neonatal abstinence syndrome (NAS) after being exposed to opioids during pregnancy, potentially reducing hospital costs, according to a study conducted by a team from Vanderbilt University.

Recommendations from the American Academy of Pediatrics (AAP) suggest that most newborns exposed to opioids should be kept in the hospital for four to seven days to be monitored for development of NAS, as opposed to one to three days for infants who have not been exposed, researchers noted.

This standard approach can result in excessive hospital stays and increased costs, as well as interrupted bonding time between infants and their mothers. Additionally, providers’ inability to identify infants at high risk of NAS at the time of birth could lead to treatment delays.

“We estimate that around 100,000 opioid-exposed infants are born each year and many are observed excessively,” said Stephen Patrick, MD, MPH, MS, a neonatologist at Monroe Carell Jr. Children’s Hospital at Vanderbilt and associate professor of Pediatrics and Health Policy.

-----

https://ehrintelligence.com/news/integrating-patient-photos-into-the-ehr-increases-patient-safety

Integrating Patient Photos into the EHR Increases Patient Safety

After integrating a patient photo into the EHR, wrong-patient order entry errors decreased by 35 percent at a major Boston-based hospital.

By Christopher Jason

November 16, 2020 - Integrating patient headshots into the EHR decreased wrong-patient order entry by roughly 35 percent, increased patient identification, and boosted patient safety in the emergency department, according to a study published in JAMA Network Open.

On a yearly basis, clinicians at Brigham and Women’s Hospital in Boston, MA place over a million orders through the EHR system. While past studies have shown clinicians place the correct order 99.9 percent of the time, an error rate of less than one in 1,000 orders would result in roughly 600,000 wrong-patient orders.

Patient safety is an ongoing epidemic that healthcare organizations, stakeholders, and EHR vendors are trying to fix. 

-----

https://www.healthcareitnews.com/news/emea/nhs-england-report-calls-law-require-greater-sharing-patient-data

NHS England report calls for law to require greater sharing of patient data

The draft report leaked to HSJ examines how doctors and pharmacists can be supported to review prescriptions.

By Tammy Lovell

November 17, 2020 06:05 AM

 A draft NHS England report on overprescribing leaked to HSJ [paywall], proposes that the law should require wider access to healthcare data, in a bid to improve patient safety.

The review carried out for health secretary, Matt Hancock, highlights the issue of poor interoperability between NHS computer systems, which means clinicians cannot see or understand what medications patients are taking or when a medication should be reviewed.

According to report author, chief pharmaceutical officer Keith Ridge, prescribers should be identified in the electronic health record (EHR) so they can be contacted by other clinicians. He adds that a free-text box should be created in EHRs so clinicians can explain why a certain medication has been prescribed.

In the report, Ridge calls for “wider access” in order to ensure that “many eyes” view prescribing data and spot any problem and for prescribing apps to make their data openly available.

-----

https://www.healthcareitnews.com/news/most-clinicians-cant-access-telehealth-directly-ehrs

Most clinicians can't access telehealth directly from EHRs

Although most providers say telehealth is positively influencing clinical outcomes, many say challenges remain – from workflow to reimbursement rates.

By Kat Jercich

November 17, 2020 02:42 PM

According to a survey released Tuesday by the COVID-19 Healthcare Coalition, the majority of physicians and other qualified healthcare professionals say telehealth is positively influencing clinical outcomes, patient experience, cost and professional satisfaction.

Still, challenges remain: respondents are concerned about payment rates, technology and workflow issues that continue to present barriers to seamless virtual care.  

The survey is part of the Telehealth Impact Study prepared by the COVID-19 Healthcare Coalition Telehealth Workgroup, which includes the American Medical Association, American Telemedicine Association, Digital Medical Society, Massachusetts Health Quality Partners, MassChallenge Health Tech, Mayo Clinic and MITRE Corporation.   

"The strong support shown for telehealth, as evidenced in these results, reinforces the knowledge that telehealth is critical to how we deliver healthcare today,” said Dr. Steve Ommen, medical director of the Mayo Clinic Center for Connected Care, and one of the study’s coinvestigators, in a statement.   

-----

https://www.healthcareitnews.com/news/fauci-touts-importance-data-sharing-amidst-covid-19-vaccine-news

Fauci touts importance of data sharing amidst COVID-19 vaccine news

At the American Medical Informatics Association virtual annual symposium this week, Dr. Anthony Fauci raised the possibility of registries to track which patients had received which vaccine doses.

By Kat Jercich

November 17, 2020 11:34 AM

Top infectious disease expert Dr. Anthony Fauci said on Monday that, although the prospect of a COVID-19 vaccine is heartening, the recent news from Pfizer and Moderna shouldn't mean a relaxation of vigilance over the coming weeks.

"The cavalry is coming, but the cavalry is not here yet," Fauci said at the American Medical Informatics Association virtual annual symposium.

"What we should do is we should make the hope of a vaccine motivate us even more to be very, very stringent and very, very attentive to fundamental, simple, doable public health measures," said Fauci. 

During his fireside chat, Fauci stressed the importance of data sharing and tracking as integral parts of the COVID-19 response.

-----

https://www.healthcareittoday.com/2020/11/17/epic-health-research-network-a-near-real-time-medical-journal/

Epic Health Research Network – A Near Real Time Medical Journal?

November 17, 2020

John Lynn

One of the biggest efforts coming out of Epic recently and one of the things Judy Faulkner, Founder of Epic, is most excited about is their Epic Health Research Network.  One of the major items that has come from the COVID-19 crisis, Epic and Judy decided that it would take too long to get the information they had available published in a journal.  Instead of waiting, they decided to start publishing their data and findings to the Epic Health Research Network.  As Judy said, “COVID couldn’t wait months for the respected journals to publish the data.”

In a recent interview, Judy shared that they have 100-200 million patients right now, but no doubt this will continue to grow and has likely already grown.  One of the early findings they shared was that kids with asthma got COVID worse than those without.  Although, that doesn’t seem to apply to older patients with asthma.  While it’s understandable that a finding like this might not be journal ready, in a pandemic where things are moving so quickly and no one has information on it, this information is better than flying blind.

We’ve heard many calls for a new model of publishing for a long time.  Everyone has known that the current medical journal model took forever and often discouraged people from publishing.  However, there’s also a reason that medical journal publishing takes so long.  They want to verify the findings and have third party experts examine the research to make sure the data matches the results that are being presented.  This is likely why no one has tried it earlier.  Although, almost everyone has recognized that the process is causing us to miss opportunities to get data out sooner.

-----

https://www.healthleadersmedia.com/innovation/himss-ceo-standard-language-and-national-patient-identifier-are-essential

HIMSS CEO: Standard Language and National Patient Identifier Are Essential for Interoperability

By Mandy Roth  |   November 16, 2020

Further interoperability work is necessary to fuel telehealth, care at home, and social determinants of health initiatives, says HIMSS leader Hal Wolf.


KEY TAKEAWAYS

·         A standard language for interoperability is essential for healthcare to move forward.

·         Resistance to a national patient identifier is softening, but legislation is currently stuck in the Senate. Support is moving in favor of this measure, and HIMSS expects action following the election.

·         The Global Consortium for eHealth Interoperability is bringing together stakeholders from around the world to address interoperability issues in unison.

Last March, the U.S. Department of Health & Human Services released two final rulings designed to enhance healthcare interoperability. While it was a much anticipated milestone moment, it only marks the beginning of a long road ahead, says Hal Wolf, president and CEO of the Healthcare Information and Management Systems Society (HIMSS).

HealthLeaders recently spoke with the healthcare and informatics expert. In Part 1 of this story, Wolf explains the gaps that the pandemic revealed and the role healthcare IT and HIMSS will play in bridging the divide. In Part 2, he explores how interoperability and a national patient identifier are key elements in paving the way forward, and he peers into the future, offering his predictions about how healthcare will change in the next three years. Following are excerpts from the interview, edited for space and clarity.

-----

https://www.fiercehealthcare.com/tech/why-experts-say-healthcare-needs-to-extend-interoperability-conversation-to-public-health

Why experts say healthcare needs to extend the interoperability conversation to public health

by Paige Minemyer

Nov 13, 2020 2:26pm

Interoperability has been a buzzword in healthcare for some time. But experts say it's critical to look beyond medical care when thinking about sharing data.

Jacob Reider, M.D., CEO of the Alliance for Better Health and former acting national coordinator for health IT, said during an event hosted by Fierce Healthcare that public health organizations need to be a part of the conversation, but it's crucial to be cognizant of where they are in terms of ability to share data.

And for most, that's not very far down the path to data sharing, he said.

Bringing these groups into the fold is beneficial both to providers' work but also to their own efforts, he said. For example, a food pantry would benefit from having data on people's allergies, and a homeless shelter should have access to information on medication regimens for people staying there.

-----

https://www.blackenterprise.com/meet-the-man-behind-the-countrys-first-telehealth-company-for-marginalized-groups/

Meet The Man Behind The Country’s First Telehealth Company for Marginalized Groups

Dana Givens

Telehealth services have seen a giant increase in use since the spread of the COVID-19 pandemic. With social distancing and quarantine restrictions now the norm, it has made it very difficult for marginalized populations to get access to adequate health services. According to a study published by the Journal of the American Medical Informatics Association, Black people were more likely to self-report telehealth use as a result of the public health crisis.

After seeing the struggles of those around him, one Black male entrepreneur decided to help by creating his own telehealth service.

Benjamin Lefever is the founder and CEO of Certintell, the country’s first telehealth company that provides remote patient monitoring for marginalized populations. Lefever says that he was inspired to start his business after seeing members of his family struggle with health issues and their limited options.

-----

https://www.fastcompany.com/90555218/google-amazon-nvidia-ai-medical-transcription

·         11-13-20

Why Google, Amazon, and Nvidia are all building AI notetakers for doctors

Automated medical transcription that’s actually accurate could save doctors a huge amount of time, and the tech giants are getting in on the action.

By Ruth Reader

For doctors, taking notes and inputting them into electronic medical records is so cumbersome that they often have to use human medical scribes to do it for them. That’s changing as more hospital systems turn to artificial intelligence-based transcription tools.

However, some doctors feel the tools available today are just not accurate enough. “If there were a really smart voice transcription service that was 99% accurate, I would definitely use it,” says Bon Ku, an emergency room doctor at Thomas Jefferson Hospital University and director of the university’s Health Design Lab. “A lot of times, I feel like I’m a data-entry clerk.”

For the last several years, big tech companies have been jockeying to be the one who finally delivers the kinds of tools doctors have been craving.

This week, Google launched open source machine learning software to help doctors make sense of patient medical records. The platform is composed of two programs. One, an API for healthcare-related natural language processing, scans medical documents for key information about a patient’s journey, puts it into a standard format, and summarizes it for the doctor. It can pull from multiple sources of information like medical records as well as transcribed doctors’ notes. The goal is to create an easy way for doctors to review a patient’s past care. The second, called AutoML Entity Extraction for Healthcare, is a low-code tool kit that helps doctors to pull out specific data from a patient’s record, like information about a genetic mutation. Both tools will be available for free until December 10, 2020 for doctors, insurers, and biomedical companies.

-----

https://www.healthcareitnews.com/news/change-healthcare-unveils-new-sdoh-analytics-tools

Change Healthcare unveils new SDOH analytics tools

Social Determinants of Health Analytics is meant as a resource to help health systems plan for and implement community programs as part of their population health management efforts.

By Mike Miliard

November 16, 2020 03:46 PM

Change Healthcare on Monday announced the launch of a new resource, Social Determinants of Health Analytics, that's designed to help providers, payers, life science companies and others make better use of socioeconomic and geodemographic information.

WHY IT MATTERS
SDoH Analytics is a HIPAA-compliant dataset that links deidentified claims data with information on other factors such as education level, ethnicity, financial stability, housing status and more – mapping the correlations between social determinants, clinical care and patient outcomes. 

Change Healthcare, the new offering, is designed to help organizations across the healthcare ecosystem to better assess and implement social programs to help reduce costs and improve patient outcomes. It can be used in three ways:

First, customers can receive customized reports that spotlight SDoH factors that can impact emergency room utilization, and inpatient and ambulatory visits across different segments of patient populations.

Second, the tool can be added to existing systems that track social-determinant data to help close information gaps and improve patient engagement and quality outcomes.

-----

https://www.healthcareitnews.com/news/frontline-workers-say-they-spend-more-time-ehrs-patient-care

Frontline workers say they spend more time on EHRs than patient care

Clinicians struggle with connectivity, integration and system failures, according to a new report from SOTI.

By Kat Jercich

November 16, 2020 01:12 PM

Although frontline health workers tend to be well-connected, they spend significant time fixing technical problems and attending to patient records – cutting into their time caring for patients themselves. 

According to a report this week from IoT vendor SOTI, a third of respondents to a wide-ranging survey on frontline workers said their employers had introduced new systems and technologies to help cope with the global COVID-19 pandemic.

Still, said the report, the clinicians struggled with connectivity, integration, glitches and system failures.

"The picture that emerges is of a system which, due to a lack of integration, is not fulfilling the potential of what is possible with existing devices and platforms," wrote report authors.

-----

https://www.healthcareitnews.com/news/emea/better-tech-improves-patient-care-two-thirds-uk-healthcare-workers

Better tech improves patient care for two-thirds of UK healthcare workers

Sixty-four per cent of UK healthcare workers experience IT issues during their working week, only a third of their time is actually spent helping patients.

By Sara Mageit

November 16, 2020 05:35 AM

Findings from the new Critical Technology for Critical Care: The State of Mobility in Healthcare 2020/21 Report, commissioned by enterprise mobility and IoT management provider, SOTI has been released, showing the impact of outdated technology on healthcare workers during the pandemic.

The report shows that more than two-thirds (68%) of UK healthcare workers (55% globally) agree that investment in new or better technology could help save lives.

WHY IT MATTERS

During the COVID-19 pandemic, many healthcare providers have turned to technology to help ease the burden caused by the virus, while also enforcing social distancing measures. In fact, the report found that 23% of UK healthcare workers (33% globally) said that new systems and/or technology have been introduced by their employer during the pandemic.

-----

https://histalk2.com/2020/11/13/weekender-11-13-20/

Weekly News Recap

  • Health Catalyst announces Q3 results that beat Wall Street expectations for revenue and earnings.
  • Providence will implement Nuance’s Dragon Ambient Experience for EHR documentation and will co-develop solutions covering other areas.
  • Australia’s SA Health is given another $146 million to complete its years-overdue implementation of Allscripts Sunrise.
  • Ambulatory surgery center software vendors HST Pathways and Casetabs announce plans to merge.
  • Managed care company Centene will acquire AI-powered healthcare analytics vendor Apixio.
  • HHS OIG imposes additional Corporate Integrity Agreement terms on EClinicalWorks, including requiring the company to notify customers that its EHR creates a material risk of patient harm.
  • Sky Lakes Medical Center says that its October 27 ransomware attack, recovery from which is continuing, will hit its bottom line hard and will require replacing 2,000 computers.
  • University of Vermont Health Network, whose systems remain offline from an October malware incident, has regained access to a week’s worth of patient schedules.
  • The VA’s 16,000-employee Office of Information and Technology publishes its fiscal year report, which primarily addresses the COVID-related challenges it met.

-----

Enjoy!

David.

No comments: