The COVID19 Rollout Is Going To Be A Pretty Large Exercise With Lots Than Go Amiss.

A good summary of what will happen is found in this transcript.

Acting Chief Medical Officer, Professor Michael Kidd's interview on 4BC Breakfast on 26 January 2021

Read the transcript of Acting Chief Medical Officer, Professor Michael Kidd's interview on 4BC Breakfast on 26 January 2021 about coronavirus (COVID-19).

Date published: 28 January 2021

Media event date: 26 January 2021

Media type: Transcript

Audience: General public

NEIL BREEN:

I've got the Deputy Chief Medical Officer, Professor Michael Kidd, on the line to explain. Good morning to you, Professor.

MICHAEL KIDD:

Good morning, Neil.

NEIL BREEN:

It was an exciting day, wasn't it?

MICHAEL KIDD:

It was a very welcome announcement, absolutely.

NEIL BREEN:

The plan for the roll-out - okay, I look at the numbers and they're eye watering. You've got 80,000 a week to start with, okay we'll eventually get more; then the Government's talking about four million by April. How on earth are you going to get needles into the arms of four million in a short space of time?

MICHAEL KIDD:

Well, you're exactly right. This is the largest mass immunisation programme in our nation's history. But, there has been a lot of work happening over recent months to prepare the nation to get the vaccines out and administered as quickly as possible. Clearly, what we're aiming to do with those people in the initial priority group is to protect the people who are most at risk, and particularly those who are most at risk of serious disease and deaths related to COVID-19 which, of course, includes the residents of aged care facilities and disability care facilities around the country. But, there's been a lot of work happening between the Australian government and with the states and territories identifying the initial hubs around the country where the Pfizer vaccine will be sent to, and from those hubs, people will either be coming to those hubs to receive their vaccines or the vaccine in smaller amounts will be transported out in the special containers to the residential aged care and disability care facilities to provide coverage to the residents and the staff.

NEIL BREEN:

I've read that there were about six hubs in, I'm not sure if it was Queensland or Brisbane. You're talking about that sort of number?

MICHAEL KIDD:

Yes. So we're looking at between 30 and 50 hubs right across the country.

NEIL BREEN:

[Talks over] Okay.

MICHAEL KIDD:

Many of those hubs - and it will depend on the state or territory - but many of them will likely be based within major hospitals because, of course, the facilities are there and the staffing is there to allow the vaccination programmes to roll out very quickly and efficiently.

NEIL BREEN:

I'm talking to Australia's Deputy Chief Medical Officer, Professor Michael Kidd. Are you thinking GPS and nurses and trained people for the Pfizer vaccine?

MICHAEL KIDD:

Certainly GPS and nurses who are involved in either working in hospitals, in emergency departments, or those who are running the 150 general practice led respiratory clinics across the country - and many of those clinics are also running in Aboriginal Community Controlled Health Organisations across the country. So, those people who are at risk of coming in contact with people infected with COVID-19 are in that 1a category of frontline health care workers; along with the people working in our hospitals, in intensive care units, in COVID-19 wards.

NEIL BREEN:

So five million Pfizer jabs we have - is that two and a half million Australians? Or is that five million times two jabs?

MICHAEL KIDD:

Yes. So it'll actually be 10 million doses of the Pfizer [indistinct]…

NEIL BREEN:

[Talks over] Okay, so it's five million Australians?

MICHAEL KIDD:

… five million Australians. We don't know how quickly those 10 million doses will come into the country, they'll probably come into the country sequentially over the coming few months. But, we also have the AstraZeneca vaccine which has been going through the Therapeutic Goods Administration approval process at the moment. If and when that is approved, we will- we expect to receive doses of that vaccine coming into the country in early March - it's being produced offshore. But, we also will be producing that vaccine onshore in Australia through CSL. So, from the middle of March, we expect that we will be producing in Australia the AstraZeneca vaccine. And this overcomes one of the very serious problems which has faced many other countries which have been rolling out the vaccines under emergency provisions over the last few months where they haven't had surety of supply of the vaccine. It's very important that people get two doses of the vaccine to make sure that they get the sustained immunity, and that has to happen within a recommended timeframe. So, once AstraZeneca is approved and is being produced in Australia, then we will have that surety of supply.

NEIL BREEN:

Is AstraZeneca two jabs as well?

MICHAEL KIDD:

Absolutely.

NEIL BREEN:

Okay, it's two jabs as well. Now, most of us will get AstraZeneca. So, if I pose a hypothetical, I'll pose it about myself. So, I'm a 52-year-old male in good health - when do you think I'll be getting my vaccine? And where will I get it?

MICHAEL KIDD:

Okay, so it's a little too early to speculate exactly when you'll get your vaccine, Neil. You'll you be in group 2a. So there's about seven million people in phases 1a and 1b who are ahead. The vaccine will likely be administered either through a general practice in your local area. By the time we get to phase 2a, we may well also have accredited pharmacies which are involved in administering the vaccine, and we'll have continuation of state and territory vaccination centres. We're looking at a booking process - so people will be looking for when they get the vaccine - very important that people do make an appointment to get the vaccine, that they turn up on that time on that day to receive their vaccine.

NEIL BREEN:

[Talks over] So, you'll make a booking?

MICHAEL KIDD:

You'll be making bookings to get your vaccine, that's right.         

NEIL BREEN:

And then it'll be hooked to your Medicare card so they know you've got it?

MICHAEL KIDD:

We will be following everyone who gets their vaccine, every dose of the vaccine will be will be introduced onto the Australian immunisation register. It'll also be on your My Health record if you've got a My Health record, and that way people can make sure that they are then followed up to make sure they get the second dose within the right time frame.           

NEIL BREEN:

I've definitely got My Health record. That scare campaign over that was disgraceful.

MICHAEL KIDD:

[Talks over] Good on you, Neil.          

NEIL BREEN:

Hey, Professor Kidd. I've got Bob on the line from Murrumba Downs. He's got a really good question to ask you, and I think the wider public would be thinking the same thing. Bob, go ahead with your question.

CALLER BOB:

Good morning, mate. Hey listen, I was just wondering, with all the hoo-ha with the COVID vaccine…        

NEIL BREEN:

[Talks over] Yes.

CALLER BOB:

… what's happening with the standard annual flu vaccine?

NEIL BREEN:

So are you asking whether you need to get that as well as the COVID vaccine?

CALLER BOB:

Well, I'm assuming you have to. And I'm just wondering whether - because I get it every year and have done for over 40 years - but, is it okay to get them both together?

NEIL BREEN:

Well, I'll tell you who's got the answer for you is Professor Kidd. Did you hear that question, Professor Kidd?

MICHAEL KIDD:

I did. Thanks, Neil, and thank you, Bob. That's a fantastic question. So, the annual influenza vaccine programme will be rolling out as normal. We expect that to roll out in April, May and June in preparation for the risk of getting seasonal influenza during the winter months in Australia. The important thing about the flu vaccine and the COVID-19 vaccines is they cannot be administered at the same time. And the recommendation that has come through from the Australian Technical Advisory Group on Immunisation, which advises the Australian Government, is that you need at least 14 days between having the COVID-19 vaccine and getting the influenza vaccine. And the reason for that is that if people did get an adverse reaction to one or other vaccine, it's very important that we know whether that adverse reaction was related to either the COVID vaccine or the influenza vaccine. If we give the two vaccines at the same time, of course, we don't know which vaccine caused problems.

Having said that, we are not expecting a lot of adverse reactions from the COVID-19 vaccine. People may get a bit of a sore arm, as you often do after you've had an immunisation. Some people may feel a little bit tired or achy after the vaccine, which can occur with the flu vaccine as well. We have seen some very rare cases of people getting an allergic reaction to the COVID vaccine, and there are going to be recommendations that people who are susceptible to having severe allergic reactions not get the vaccine at this time. But, we're waiting for those specific details to come out from the Therapeutic Goods Administration over the next couple of days. But, thank you, Bob. That's a great question.                       

NEIL BREEN:

Okay, good stuff, Bob. Well, Deputy Chief Medical Officer, Professor Michael Kidd, you know, we're so well blessed for medicine in this country. I did my bowel cancer screening, okay?

MICHAEL KIDD:

[Talks over] Good on you.                 

NEIL BREEN:

You know, you- I get it in the mail, I've done it because I turned 52 - it was my second one. I put it in the mail last Thursday and I got my result text to me yesterday. We live in a fantastic country, we're looked after. Trust people like Professor Kidd, get the vaccine. Thanks, Professor Kidd.

MICHAEL KIDD:

Thank you so much, Neil, and thanks to all your listeners.   

Here is the link:

https://www.health.gov.au/news/acting-chief-medical-officer-professor-michael-kidds-interview-on-4bc-breakfast-on-26-january-2021

You would have to say this is a pretty optimistic view of how it will go.

A slightly more sceptical view is found here:

The inside loop on the secret squirrel govt COVID vaccination booking system (not)

January 28, 2021       Jeremy Knibbs

As they say in the navy, loose lips sink ships. But that’s the navy. This is a national health crisis. Why is the digital health industry almost completely in the dark on the government’s plans (or even actions) to provide the country with a centralised COVID vaccination booking system?

Can the Department of Health really build a centralised booking system for GP COVID vaccinations within the next three weeks – or has it already built one?

That’s what it promised us all in last week’s release of expression of interest for GPs wanting to partake in the rollout.

Not that anyone actually understands yet what the DoH actually mean by a centralised government booking system for GP COVID vaccinations, as so far the only official words we have on the subject are:

• Participating GP clinics will receive “vaccine stock and access to a National Booking System”
• Said “National Booking System” will integrate with the major GP patient booking systems.

Three weeks?

OK, that feels ridiculous given that we’ve asked every major tech vendor how busy they are providing specifications and working on integrations, and none so far has a clue what the government actually wants or is doing. Our market leading GP patient management system Best Practice appears not even to have been contacted yet by the DoH, or any contractor working for it. Some of the major booking engines have had a chat to the DoH but they remain in the dark as to what the DoH actually is thinking or wants.

Let’s give them six to eight weeks for a fighting chance and call things even here.

They still need to do a hell of a lot to make such an idea work.

I’ve contacted a few serious healthcare software tech heads and they all agreed that if you were doing all of this, probably six to eight months might be a better timeline.

It’s not like the DoH or the government has a stunning track record on building software that works, especially cloud based software, which such a system would surely need to be. Perhaps unfairly, all that comes to mind for me is Robodebt and the My Health Record.

One government related agency person has claimed that they “have seen” the system, which is intriguing. When asked what they’d seen this person said that they shouldn’t be talking about it. Apparently the whole thing is top secret.

But why would such an important piece of COVID infrastructure be so secretive?

Why would most of the major PMS and booking engine vendors be so out of the loop? Surely you wouldn’t rewrite an entire booking engine yourself and bypass well established and working infrastructure and marketing distribution channel to patients like this.

Conspiracy theories have started, one being that one of the major consulting firms is busy at work building it behind the scenes. Really? Without any due diligence or public scrutiny the DoH has handed a pivotal piece of COVID logistics over to an Accenture or PWC? That would be odd, even for the DoH.

The description so far of said booking system is so vague that you can’t guarantee that all of the following shopping list  would be part of the functionality. But if you were after a central booking system you’d probably want the following as a minimum:

• Integration with all the major booking engines who already have patient access and marketing in their hands. All these systems have current and ongoing patient users, integrations to all the major PMS systems and robust working booking software.
• Integration with the major PMS systems for direct access to the Australian Immunisation Register, for booking the second dose for continuity and logistics planning, access to the MHR and – well, it would just be good hygiene to have each patient in the normal base infrastructure for GPs, especially given it wouldn’t be that hard to do.
• Something that takes GP COVID bookings and talks to a central government logistics group who is distributing the vaccine so they know how much each GP needs and when
• Something that is able to send a patient who is booking a screening check and consent forms so screening is automated and a patient can pre-consent and get electronically signed up before they turn up to clog already busy GP surgeries, (Note: the government has chosen quite deliberately to pay GPs less for a COVID vaccination than the base A consult and insist all COVID vaccinations are bulk billed, so essentially, GPs can’t afford to do vaccinations anyway. Having to get consent on site would be ridiculous in terms of ROI for any GP.)
• Clinical notes, which can talk not only to a GP patient management system when GPs are vaccinating, but of course, which hospitals can use, and which would be cloud based and be able to talk back to a local GP.

A couple of other things you’d think the DoH would consider. Obviously the booking engines are important and you could go to just one of them and use that for your central system. But surely you’d go to the top three (HotDoc, HealthEngine and Appointuit) and build an API to each one because if you did that you’d have near national booking coverage for all GPs immediately. But we aren’t aware that any of the major booking engines are working with the DoH yet.

Vastly more here:

https://wildhealth.net.au/the-inside-loop-on-the-secret-squirrel-govt-covid-vaccination-booking-system-not/

As you read through the transcript you come away with a sense of just how large this vaccination task is and when you browse the second it becomes clear just how complex the task of matching a patient, a vaccination site and clinician and a dose of such fragile vaccines is going to be!

Of course you have to lock in a second dose in a reasonable time and then create a record to follow up any adverse side effects and so on.

The more you think about it the more difficult and complex the whole thing feels.

In passing I will choose to ignore Professor Kidd enthusiastic endorsement of the #myHealthRecord. From within the DOH he can hardly do otherwise!

I note that the ADHA is meant to be helping with all this and has received so funding to do so.

This rollout will bear close watching! Anyone with some insider details of what is actually going down?

David.

 

AusHealthIT Poll Number 564 – Results – 31st January, 2021.

Here are the results of the poll.

Do You Believe Joining The ADHA Would Be A Good Digital Health Career Move?

Yes 7% (4)

No 77% (44)

I Have No Idea 16% (9)

Total votes: 57

A strong majority view that it would not be a smart to join the ADHA at present.

Any insights on the poll welcome as a comment, as usual.

A poor number of votes, even given the time of year.  

It must also have been a very hard question as 9/57 readers were not sure how to respond.

Again, many, many thanks to all those who voted!  

David.

 

Weekly Overseas Health IT Links – 30 January, 2021.

Here are a few I came across last week.

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

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https://www.digitalhealth.net/2021/01/live-testing-of-digital-covid-19-immunity-passport-launched/

Live testing of digital Covid-19 immunity passport launched

The UK is one step closer to a digital Covid-19 immunity passport after live testing of the technology was launched.

Andrea Downey – January 18, 2012

Biometric and identity management companies Mvine and iProov announced the trials of their Covid-19 immunity and vaccination passport on 13 January.

The digital passport enables a person’s test results or vaccination status to be registered and proved on an app without disclosing their identity, the companies claim.

It is hoped the passport will enable people to safely return to work, school and travel. The development of the passport was part-funded with £75,000 investment from Innovate UK following a government drive for innovative technologies to manage the coronavirus pandemic.

The passport, which uses facial verification technology, is set to be tested by directors of public health within the NHS, with two trials expected to be complete by 31 March 2021.

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https://www.digitalhealth.net/2021/01/what-we-still-need-to-use-ai-safely-and-quickly-in-the-healthcare/

What we still need to use AI safely and quickly in healthcare

The use of artificial intelligence in healthcare is often touted as a technology which can transform how tasks are carried out across the NHS. Rachel Dunscombe, CEO of the NHS digital academy and director for Tektology, and Jane Rendall, UK managing director for Sectra, examine what needs to happen to make sure AI is used safely in healthcare.

DHI News Team – 19 January, 2021

When one NHS trust in the North of England started to introduce artificial intelligence several years ago, hospital clinicians needed to sit postgraduate data science courses in order to understand how algorithms worked.

Like most healthcare organisations, the trust didn’t have a uniformed approach to onboarding algorithms and applying necessary supervision to how they performed.

It became a manually intensive operation for clinicians to carry out the necessary clinical safety checks on algorithms, requiring a huge amount of overhead and in turn significantly limiting the organisation’s ability to scale the use of AI.

AI needs supervision

AI in many ways needs to be managed like a junior member of staff. It needs supervision. Hospitals need to be able to audit its activity, just as they would a junior doctor or junior nurse, and they need sufficient transparency of how an algorithm works in order to provide necessary oversight and assess if and when intervention is needed to improve its performance and ensure it is safe.

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https://www.healthcareitnews.com/news/new-ai-model-can-predict-length-covid-19-hospitalization

New AI model can predict length of COVID-19 hospitalization

By using patient age, sex and daily clinical state, the machine learning model also predicts the probability of in-hospital mortality.

By Kat Jercich

January 22, 2021 01:40 PM

A group of Israeli scientists published a paper in the Journal of the American Medical Informatics Association this week showcasing how a machine learning model can predict the illness trajectory of COVID-19 patients by using individual characteristics.  

The model predicts the patient's disease course in terms of clinical states – moderate, severe or critical – as well as hospital utilization.  

"Given the danger of unprecedented burden on healthcare systems due to COVID-19, there is a need for tools helping decision-makers plan resource allocation on the unit, hospital and national levels," wrote the researchers.  

WHY IT MATTERS  

The researchers aimed to track how hospitalized COVID-19 patients might transition between clinical states. Such evolution, they note, does not always travel in a linear manner: a patient might, for example, spend five days in the hospital in a "severe" state before deteriorating to "critical" and eventually recovering.  

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https://www.healthcareittoday.com/2021/01/22/numerous-announcements-of-covid-vaccine-solutions-is-encouraging/

Numerous Announcements of COVID Vaccine Solutions is Encouraging

January 22, 2021

Colin Hung

Over the past two weeks, Healthcare IT Today has received 100+ Press Releases and offers to interview executives from Health IT companies with COVID vaccine solutions. We have been deluged with information on apps, modules and platforms that will make the vaccination process smoother, faster, and more efficient. It is an encouraging sign.

We reached out to several companies to learn more about their solutions and to get a sense of where the industry is going.

The Ideal Vaccination Experience

Via email, Lisa Romano, CipherHealth‘s Chief Nursing Officer shared her 4-step ideal vaccination experience with us:

1. Providers need to create awareness of their vaccine policies and procedures
2. Providers need to prepare patients with proper information before they get vaccinated
3. Providers need to schedule and communicate exactly when patients need to get the second vaccination
4. Providers need to monitor patients after each round of vaccinations

Notice that Romano has 2 steps before allowing patients to schedule to get the vaccine. Step 1 is needed to ensure orderly administration of doses and step 2 is critical for patients to make informed decisions. Effective communication between providers and patients is key for both these steps.

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https://ehrintelligence.com/news/health-pros-pragmatic-over-perfect-for-increased-interoperability

Health Pros: Pragmatic Over Perfect for Increased Interoperability

Three healthcare professionals recommend a more pragmatic approach to functional interoperability, rather than chasing perfection.

By Christopher Jason

January 21, 2021 - Health IT experts should focus on identifying standards limitations and asking clinicians how to develop practical solutions to gain functional interoperability, according to University of California, San Francisco’s Julia Adler-Milstein, Aaron Neinstein, and Russell Cucina.

To ensure this happens, the trio wrote an op-ed in the Health Affairs blog that recommends a more pragmatic approach rather than attempting to perfect interoperability.

Interoperability allows clinicians to view outside patient data within their EHR. However, this data typically exists apart from their local patient data and it does not combine with the local medication lists, problem lists, or laboratory results.

According to the authors, when data is viewable but not combined, clinicians are not as likely to utilize outside data sources because of the effort it takes to combine local and outside data within the EHR.

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https://patientengagementhit.com/news/could-at-home-kits-overcome-covid-19-testing-access-hurdles

Could At-Home Kits Overcome COVID-19 Testing Access Hurdles?

Patients are overwhelmingly receptive to at-home test kits, something researchers said could improve COVID-19 testing access.

By Sara Heath

January 21, 2021 - Patients are remarkably receptive to both issuing and conducting an at-home COVID-19 test as part of contact tracing efforts, something experts pointed out could help expand COVID-19 testing access and prevent further logjams.

The data, presented in a research letter in JAMA Network Open, found that patients were especially willing to give at-home self-test kits to individuals in their orbit after they themselves have tested positive for the virus. This is notable, considering the stigma that could arise should someone test positive for the virus and have to tell their contacts they, too, may have been infected.

COVID-19 testing has presented something of a challenge during the pandemic. Although essential for identifying and ideally capping virus spread, COVID-19 testing access can be somewhat elusive. Appointment testing slots can be hard to come by, test sites may be geographically out-of-reach, and some tests are even cost-prohibitive, or at least the fear of high bills are prohibitive.

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https://patientengagementhit.com/news/low-patient-portal-adoption-could-stymie-covid-19-vaccine-rollout

Low Patient Portal Adoption Could Stymie COVID-19 Vaccine Rollout

Healthcare organizations leaning on the patient portal for COVID-19 vaccine rollout should assess which patients have and have not registered for the tool.

By Sara Heath

January 20, 2021 - Up to 45 percent of patients ages 50 and older don’t have a patient portal, the very tool most providers across the country are using to communicate with patients about the COVID-19 vaccine, according to new data out of the University of Michigan’s Institute for Healthcare Policy and Innovation.

This could seriously hamper provider efforts to notify patients as they become eligible for the COVID-19 vaccine and, at some organizations, take the next steps to schedule a vaccination.

The data, coming from U of M’s National Poll on Healthy Aging, showed that 45 percent of adults ages 65 to 80 don’t have a patient portal account; 40 percent of those between 50 and 80 don’t have an account.

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https://ehrintelligence.com/news/3-key-strategies-to-mitigate-health-it-ehr-clinician-burnout

3 Key Strategies to Mitigate Health IT, EHR Clinician Burnout

Researchers conducted a systematic review of multiple databases to uncover the top ways to mitigate EHR-related clinician burnout.

By Christopher Jason

January 20, 2021 - Clinician burnout can be mitigated by health IT and EHR optimization, EHR training, and care team expansion, according to a study published in the Journal of the American Medical Informatics Association (JAMIA).

Furthermore, other burnout factors such as physician specialty, practice setting, regulatory pressures, and how physicians spend their time can affect clinician burnout rates.

“Arguably, the primary drivers of burnout for physicians have been related to electronic health records and overwhelming inefficiencies in clinical practice that significantly and negatively impact workflow and patient care,” wrote the study authors. “Physicians experience high fatigue with short, continuous periods of EHR use, which is also associated with inefficiency of EHR use (ie, more clicks and more time) on subsequent cases.”

Because EHR design and usability are both leading causes for clinician burden, the study authors conducted a systematic review of multiple databases in 2018 and 2020 to identify potential workplace interventions to mitigate burnout. While many researchers have assessed the cause of burnout in the past, there’s been little evidence about mitigation strategies.

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https://healthitanalytics.com/news/data-analytics-shows-little-gain-in-covid-19-vaccine-prioritization

Data Analytics Shows Little Gain in COVID-19 Vaccine Prioritization

A data analytics model revealed that prioritizing vaccination of high-risk individuals has only a minimal impact on the number of COVID-19 deaths.

By Jessica Kent

January 20, 2021 - Using data analytics, a team of researchers simulated a representation of the COVID-19 pandemic in the town of New Rochelle, New York – and found that it may not be effective to prioritize high-risk individuals for vaccinations.

In a study published in Advanced Theory and Simulations, a group from the NYU Tandon School of Engineering describes the development of an open-source platform that comprises an agent-based model (ABM) for the entire town of New Rochelle.

New Rochelle was one of the first outbreaks registered in the US, the researchers noted. The size of the population in New Rochelle is also comparable to that of most American cities, making the town a crucial focal point for the study.

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https://www.healthcareitnews.com/news/bidens-covid-19-plan-depends-data-driven-approach-efficacy-equity

Biden's COVID-19 plan depends on a data-driven approach for efficacy, equity

The strategy includes a proposed executive order that will direct federal agencies to ramp up collection, sharing and analysis of data to "support an equitable COVID-19 response and recovery."

By Kat Jercich

January 21, 2021 03:17 PM

President Joe Biden released a comprehensive COVID-19 national strategy on his first full day in office, providing a road map aimed at guiding the United States out of the pandemic.

The wide-ranging plan is organized around seven main goals, many of which rely on data-sharing as a core tactic.  

"We can and will beat COVID-19. America deserves a response to the COVID-19 pandemic that is driven by science, data, and public health – not politics," read the strategy's executive summary.  

WHY IT MATTERS  

Biden's plan hammers on the importance of data gathering and sharing as primary tenets of an effective COVID-19 response.  

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https://www.healthcareitnews.com/news/biden-plans-regulatory-freeze-amid-flurry-health-hires

Biden plans regulatory freeze amid flurry of health hires

The changes herald a major overhaul for agencies struggling to respond to the COVID-19 crisis.

By Kat Jercich

January 21, 2021 12:01 PM

President Joe Biden announced on Wednesday night that he plans to issue a regulatory freeze on many of former President Donald Trump's last-minute new or pending rules. 

The freeze is likely to affect a variety of much-publicized U.S. Department of Health and Human Services rulemakings – including proposed major HIPAA Privacy Rule changes, mandated regulatory reviews and efforts to streamline interoperability and prior authorization.

The Biden administration also announced a flurry of new HHS and other health-related hires, heralding a major overhaul for the agency.

WHY IT MATTERS

Trump's HHS enacted several rules after the former president lost the 2020 election, raising questions even at the time of their longevity.

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https://www.healthcareitnews.com/news/micky-tripathi-named-biden-administration-lead-onc

Micky Tripathi named by Biden administration to lead ONC

As National Coordinator for Health IT, the interoperability veteran will bring deep standards expertise as the rubber hits the road on nationwide API-based data exchange.

By Mike Miliard

January 21, 2021 09:37 AM

As the United States got a new president on Wednesday afternoon, it also got a new National Coordinator for Health IT. Longtime industry veteran and interoperability pioneer Micky Tripathi was named to the role January 20 as part of a slate of new HHS appointments.

He'll succeed Dr. Donald Rucker, who led ONC for four years as the agency made interoperability its mandate and crafted an ambitious set of new rules under the 21st Century Cures Act.

Tripathi has long been a familiar face as a proponent of standards-based interoperability – and an expert with deep knowledge of the nuts and bolts behind it.

He was the longtime CEO of the Massachusetts eHealth Collaborative, a pioneering group that launched way back in the pre-HITECH Act days of 2005 and became a national exemplar as the healthcare industry moved from manila folders to electronic health records.

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https://healthitsecurity.com/news/covid-19-vaccine-data-manipulated-before-leak-to-impair-public-trust

COVID-19 Vaccine Data Manipulated Before Leak to Impair Public Trust

The hackers who stole COVID-19 vaccine data last month, modified the information before leaking it online to undermine public trust; email hacks, a security incident, and data extortion complete this week’s breach roundup.

By Jessica Davis

January 19, 2021 - The hackers who stole COVID-19 vaccine data belonging to Pfizer and BioNTech from the European Medicines Agency (EMA), a regulatory agency, and leaked the information online in December, first manipulated the exfiltrated data beforehand to undermine public trust in the vaccine.

EMA confirmed the threat actors behind the attack had posted the stolen data online last week. Several days later, the investigation revealed the data had been altered prior to the leak.

The reports around the hacking incident came to light in early December, which found hackers accessed and exfiltrated data related to the first authorized COVID-19 vaccine from Pfizer and BioNTech. EMA is tasked with vaccine assessments and approvals for the EU.

The highly targeted attack struck on December 9, which gave the attackers access to some documents tied to the regulatory submission for the impacted pharmaceutical companies that were stored on the compromised server.

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https://healthitanalytics.com/news/in-brain-imaging-deep-learning-beats-standard-machine-learning

In Brain Imaging, Deep Learning Beats Standard Machine Learning

Deep learning models were able to detect patterns and discriminative features in brain imaging better than standard machine learning algorithms.

By Jessica Kent

January 15, 2021 - Properly trained deep learning models could offer better insights from brain imaging data analysis than standard machine learning approaches, according to a study published in Nature Communications.

Structural and functional MRI and genomic sequencing have generated massive volumes of data about the human body. Scientists can gather new insights into health and disease by extracting patterns from this information. However, this is a challenging task as the data is incredibly complex and relationships among types of data are poorly understood.

Deep learning technology can characterize these relationships by combining and analyzing data from many sources. While these algorithms have demonstrated their ability to solve problems and answer questions in several different fields, researchers noted that critical commentaries have negatively compared deep learning with standard machine learning approaches for analyzing brain imaging data.

But these conclusions are often based on pre-processed input that deny deep learning the ability to learn from data with little to no preprocessing – one of the main advantages of the technology.

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https://www.fiercehealthcare.com/tech/micky-tripathi-tapped-as-biden-s-national-coordinator-for-health-it

Micky Tripathi tapped as Biden's National Coordinator for Health IT

by Heather Landi

Jan 20, 2021 4:55pm

Micky Tripathi, a  recognized name in the health tech world, has been tapped as the new National Coordinator for Health IT under President Joe Biden's administration.

The Department of Health and Human Services (HHS) posted the leadership changes on its website Wednesday but has yet to issue a press release.

Tripathi will replace the outgoing Don Rucker, M.D., who held the position since April 2017. ONC provides counsel for the development and implementation of a national health information technology framework.

Tripathi could not be reached for comment.

Health IT executives welcomed the news of Tripathi's appointment on social media.

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https://apnews.com/article/new-york-jamaica-coronavirus-pandemic-new-york-city-74bbc1b8433e936ba6a31c25d5f36873

‘We know this is real’: New clinics aid virus ‘long-haulers’

By JENNFER PELTZ January 20, 2021

NEW YORK (AP) — COVID-19 came early for Catherine Busa, and it never really left.

The 54-year-old New York City school secretary didn’t have any underlying health problems when she caught the coronavirus in March, and she recovered at her Queens home.

But some symptoms lingered: fatigue she never experienced during years of rising at 5 a.m. for work; pain, especially in her hands and wrists; an altered sense of taste and smell that made food unappealing; and a welling depression. After eights months of suffering, she made her way to Jamaica Hospital Medical Center — to a clinic specifically for post-COVID-19 care.

“I felt myself in kind of a hole, and I couldn’t look on the bright side,” Busa said. She did not feel helped by visits to other doctors. But it was different at the clinic.

“They validated the way I felt,” she said. “That has helped me push through everything I’m fighting.”

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https://ehrintelligence.com/news/hhs-to-award-funding-to-boost-immunization-information-systems-hies

HHS to Award Funding to Boost Immunization Information Systems, HIEs

HHS will allocate upwards of $20 million in investments to increase patient data sharing between immunization information systems and health information exchanges (HIEs).

By Christopher Jason

January 19, 2021 - The US Department of Health and Human Services (HHS) has announced it will distribute funds across the country to enhance patient data sharing between health information exchanges (HIEs) and immunization information systems.

Under the Strengthening the Technical Advancement and Readiness of Public Health Agencies via Health Information Exchange (STAR HIE) Program, each recipient aims to boost HIE services and specifically vaccination services. As a result, their respective connected public health agencies can exchange, access, and utilize crucial patient data during public health emergencies. 

Additionally, it aims to support communities that were hit hard by COVID-19.

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https://healthitanalytics.com/news/data-analytics-tool-distinguishes-cancer-cells-from-normal-cells

Data Analytics Tool Distinguishes Cancer Cells from Normal Cells

The tool leverages data analytics technology to accurately differentiate between cancer cells and normal cells found in tumor samples.

By Jessica Kent

January 19, 2021 - A data analytics tool can evaluate complex gene expression information and distinguish cancer cells from normal cells in tumor samples, according to a study published in Nature Biotechnology.

Researchers have historically studied tumors as a mixture of all cells present, many of which are not cancerous. With the emergence of single-cell RNA sequencing in recent years, researchers are able to analyze tumors in much greater resolution. Scientists can examine the gene expression of each individual cell to better understand the tumor landscape, including the surrounding microenvironment.

However, it’s difficult to distinguish between cancer cells and normal cells without a reliable computational approach, researchers noted. To improve upon older methods, a team from The University of Texas MD Anderson Cancer Center developed a new data analytics algorithm called the CopyKAT (copy number karyotyping of aneuploid tumors) model.

CopyKAT increases accuracy by adjusting for the newest generation of single-cell RNA sequencing data. The tool could help researchers more easily evaluate the complex data obtained from large single-cell RNA sequencing experiments, which deliver gene expression data from many thousands of individual cells.

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https://www.healthcareitnews.com/news/cerner-pac-stops-donating-elected-officials-who-incited-violence-capitol

Cerner PAC stops donating to elected officials who 'incited violence' in Capitol

The company had donated to the 2020 campaigns of a dozen federal legislators who went on to object to the presidential election results.

By Kat Jercich

January 20, 2021 12:49 PM

Cerner confirmed this week that it had suspended political donations to any "candidate or official who took part in or incited violence last week in Washington D.C."  

"Cerner continuously evaluates its bipartisan political contributions, ensuring the candidates and officials we support align with our values and vision for the future of healthcare," a Cerner spokesperson told Healthcare IT News.

Cerner did not respond to requests for comment about which specific candidates it was no longer supporting.  

WHY IT MATTERS  

Questions have continued to swirl around the insurrection in the U.S. Capitol on January 6, in which hundreds of violent rioters stormed the building and forced federal legislators to temporarily halt the certification of the presidential election results.

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https://www.healthcarefinancenews.com/news/president-joe-biden-will-begin-his-plan-control-covid-19-pandemic-day-one

Jan 20 2021

President Joe Biden's plan to control the COVID-19 pandemic on day one

Biden is expected to issue a national mask mandate and create an office of COVID-19 response, headed by the new coronavirus czar.

Susan Morse, Managing Editor

As President-elect Joe Biden is sworn into office today, he begins an aggressive agenda as president, including a number of executive orders aimed at getting the COVID-19 pandemic under control.

One is a national mask mandate on federal property and on airlines, trains and other public transit systems. 

Another executive order Wednesday will create an office of White House COVID-19 response, headed by Jeffrey Zients, the new coronavirus czar, according to The Wall Street Journal, goals include securing more protective equipment for workers, increasing testing and vaccinations, and reopening schools.

The first 100 days of Biden's presidency is expected to include a push for his previously announced $1.9 trillion COVID-19 relief plan, which calls for investing $20 billion in a national vaccine program and $50 billion for testing.

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https://hitinfrastructure.com/news/yale-develops-mobile-app-to-boost-patient-care-access

Yale Develops Mobile App to Boost Patient Care Access

The mobile app will offer Yale Health System patients and visitors access to their medical records, virtual care, and directions to guide them to select care locations.

By Samantha McGrail

January 19, 2021 - Yale New Haven Health System recently tapped Gozio Health to develop a digital mobile app so patients can access virtual visits, book appointments, and view their electronic health records, physician databases, and more. 

The app will offer a GPS-like experience for Yale New Heaven Health patients and visitors with directors to guide them from their home to their parking spot and on to their point-of-care at select locations. 

Additionally, patients will have access to their MyChart patient portal, medical records, and virtual care. 

“Yale New Haven Health recognizes the intrinsic value of building a mobile solution that serves as a direct conduit to patients and provides them with immediate access to health care services,” Lisa Stump, CIO of Yale New Haven Health System and Yale School of Medicine, said in the announcement.  

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https://patientengagementhit.com/news/clinicians-most-trusted-for-covid-19-vaccine-patient-education

Clinicians Most Trusted for COVID-19 Vaccine Patient Education

Patients trust clinicians for COVID-19 vaccine patient education more than public health or government entities.

By Sara Heath

January 15, 2021 - Most Americans want to hear from their medical providers about the COVID-19 vaccine, with recent polling showing that patients trust their providers the most for driving vaccine patient education and scheduling outreach.

The survey of over 2,000 US adults, conducted by Harris Poll on behalf of Updox, revealed that 87 percent of patients want hear from their healthcare providers about the COVID-19 vaccine. Thirty-four percent of patients said they trust their providers the most when it comes to vaccine information, making medical providers the most trusted entities in the race to get the public vaccinated, the survey showed.

This is a key finding, as healthcare leaders across the country attempt to tap into patient engagement and empowerment strategies that could spark vaccine uptake. The COVID-19 vaccine rollout is underway, albeit at a walk more than a run, and medical providers are working to motivate their patients to get the two-doses that could yield a herd immunity and a light at the end of this pandemic tunnel.

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https://patientengagementhit.com/news/how-to-overcome-mistrust-for-lasting-community-health-partnership

How to Overcome Mistrust for Lasting Community Health Partnership

A consistent presence helped VCU Massey Cancer Center overcome mistrust and build a strong community health partnership during the pandemic.

By Sara Heath

January 19, 2021 - At the onset of the COVID-19 pandemic, it was difficult to discuss the public and population health toll without hearing about community health partnership.

Across the nation, medical leaders sought to connect with patients—especially those who had been traditionally underserved by healthcare—and deliver them messages about the novel coronavirus and how to prevent spread in their communities.

That type of connection is important, according to Robert Winn, MD, the only African American director of the Richmond-based VCU Massey Cancer Center, because it gives medical experts the chance to meet patients where they are.

And he should know.

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https://ehrintelligence.com/news/ehr-vendor-cerner-eyes-developing-a-1-billion-data-business

EHR Vendor Cerner Eyes Developing a $1 Billion Data Business

Cerner exceeded its data business goals in 2020 and is looking to explode in 2021 and beyond.

By Christopher Jason

January 15, 2021 - For the last 18 months, Cerner has focused on developing a category-defining data business and as the company continues to attack that sector, the EHR vendor executives said they are striving towards building a $1 billion data business.

Cerner executives joined the 39th Annual J.P. Morgan Healthcare Conference to look back at its 2020 accomplishments during COVID-19 and what the vendor is working on for 2021.

With Cerner EHRs implemented in one-third of US hospitals, the vendor believes it can bring compelling points of differentiation when it comes to a data-based strategy.

“We think that the profile of our client base is particularly differentiated, including the fact that we have a high density of community hospitals and health systems that don't traditionally have an opportunity to participate in clinical trial activity,” said Donald Trigg, president of Cerner.

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https://healthitsecurity.com/news/560-healthcare-providers-fell-victim-to-ransomware-attacks-in-2020

560 Healthcare Providers Fell Victim to Ransomware Attacks in 2020

In 2020, Emsisoft data shows 560 healthcare provider facilities fell victim to ransomware attacks, of an overall 2,354 US entities hit by the malware variant.

By Jessica Davis

January 19, 2021 - In the midst of responding to COVID-19, the healthcare sector faced a significant number of ransomware attacks in 2020 with 560 healthcare provider facilities falling victim to the malware variant, according to the latest Emsisoft State of Ransomware report.

The last quarter of 2019 saw an unprecedented number of ransomware incidents in the healthcare sector. And while the number of reported successful attacks petered off during the first half of 2020, those numbers drastically increased through a coordinated ransomware wave that began in September.

Overall, Emsisoft data shows at least 2,354 US government, healthcare, and schools were impacted by ransomware attacks in 2020.

The education sector saw the greatest number of successful attacks with 1,681 schools, colleges, and universities impacted by the threat. Federal, state, and municipal governments and agencies reported 113 successful attacks.

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https://www.statnews.com/2021/01/16/slippery-slope-territory-health-officials-propose-waiving-regulatory-review-of-medical-ai-tools/

‘Slippery slope territory’: Health officials propose waiving regulatory review of medical AI tools

By Casey Ross

January 16, 2021

Days before leaving office, President Trump’s top health official is proposing to permanently exempt from regulatory review a wide swath of artificial intelligence products used to help physicians detect serious conditions such as cancer and respiratory disease on medical images.

The proposal, posted to the Federal Register on Friday and signed by Health and Human Services Secretary Alex Azar, asserts that FDA review of several categories of products, including AI imaging devices, is not necessary because they are seldom associated with reports of adverse events.

But notice of the proposed policy change raised alarms among health technology experts who said careful review of these products is essential to ensuring they meet basic performance standards before they are adopted in clinical practice.

“It seems like very slippery slope territory to remove regulation,” said Karandeep Singh, a physician and professor at University of Michigan Medical School who researches the use of artificial intelligence in health care. He said adverse events in such products can be difficult to detect and are seldom reported, because they are used to help guide clinicians, rather than directly diagnose or treat a patient.

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https://www.healthcareitnews.com/blog/emea/creating-sustainable-healthcare-solutions-and-addressing-1090-gap

Creating sustainable healthcare solutions and addressing the 10/90 gap

The right to health, not just the access to healthcare, requires a holistic understanding of how we can provide a better quality of life for the individual and society, argues Bogi Eliasen, director of health, Copenhagen Institute for Future Studies.

By Bogi Eliasen

January 19, 2021 02:01 AM

The COVID-19 pandemic has reached all parts of the globe, affecting tens of millions of people: healthy and unhealthy, rich and poor. However, the most badly affected parts of the world are also the ones where access to healthcare is not universal and is often tied to financial capacity. This has clearly highlighted the weaknesses of health systems throughout the world, but especially those that provide universal health coverage (UHC) in legislation (de jure) rather than in practice (de facto) to their populations. It is important to highlight the fact that this revelation is not new, as health challenges have always disproportionately affected those in weaker positions in terms of socioeconomic standing, especially in countries with less developed health systems.

'Vaccine nationalism'

Fortunately, towards the end of 2020, multiple COVID-19 vaccines were approved and are beginning to be distributed across the globe. However, the distribution presents its own set of challenges due to both cooling requirements as well as inequalities. Richer countries were and still are generally faster to negotiate access to vaccines with providers. The WHO has warned against “vaccine nationalism” as high-income countries are much better positioned than their less fortunate counterparts. The tragic reality is that it will take years to vaccinate poorer parts of the world because of lack of both resources to negotiate purchasing and infrastructure to distribute the vaccines.

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https://www.healthcareitnews.com/news/addressing-telehealths-cybersecurity-risk-will-be-industry-wide-problem

Addressing telehealth's cybersecurity risk will be an industry-wide problem

Experts at the American Telemedicine Association's EDGE policy conference on Tuesday said that cybersecurity is a shared responsibility and should be treated as such.

By Kat Jercich

January 19, 2021 03:19 PM

Experts have repeatedly predicted that telehealth would present a major challenge for healthcare cybersecurity in the coming year.  

But it's not enough to know telehealth is likely to be an issue. The real task is working collaboratively to address those dangers.  

At the second installment of the American Telemedicine Association's EDGE policy conference on Tuesday, leaders in the healthcare space reiterated the importance of cybersecurity as a patient safety issue.  

"We've been measuring the risks and the threat for telemedicine-type services for many years," said Christopher Logan, director of healthcare industry strategy at VMWare.

Even before the COVID-19 pandemic, "healthcare already had a cyber target on its back," said Logan.

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https://www.healthleadersmedia.com/covid-19/how-operation-warp-speed-created-vaccination-chaos

How Operation Warp Speed Created Vaccination Chaos

Analysis  |  By ProPublica  |   January 19, 2021

States are struggling to plan their vaccination programs with just one week's notice for how many doses they'll receive from the federal government. The incoming Biden administration is deciding what to do with this dysfunctional system.

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KEY TAKEAWAYS

·         The problem of unpredictable numbers has persisted as states continue to grapple with last-minute adjustments to their allocations.

·         The states are responsible for deciding how to distribute their doses to local vaccination sites, and they usually have only two days to figure that out.

·         After receiving their allocations on Tuesday, each jurisdiction must then submit its orders in VTrckS by Thursday. Shipments arrive the following week.

This article was published on Tuesday, January 19, 2021 in ProPublica.

By Caroline Chen, Isaac Arnsdorf and Ryan Gabrielson

Hospitals and clinics across the country are canceling vaccine appointments because the Trump administration tells states how many doses they'll receive only one week at a time, making it all but impossible to plan a comprehensive vaccination campaign.

The decision to go week by week was made by Operation Warp Speed's chief operating officer, Gen. Gustave Perna, because he didn't want to count on supplies before they were ready. Overly optimistic production forecasts turned out to be a major disappointment in the rollout of the H1N1 vaccine more than a decade ago, also leading to canceled appointments and widespread frustrations with the government's messaging.

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https://mhealthintelligence.com/news/osf-healthcare-develops-telehealth-protocols-for-sepsis-treatment

OSF Healthcare Develops Telehealth Protocols for Sepsis Treatment

The Illinois health system has created a toolkit that addresses how rural hospitals and clinics can use a telehealth platform to connect with specialists for the treatment of sepsis and septic shock.

By Eric Wicklund

January 15, 2021 - OSF Healthcare and Northwestern University have developed a protocol for using telehealth to treat patients with sepsis in rural hospitals.

Using a four-year, $750,000 grant from the Agency for Healthcare Research and Quality, the Peoria, IL-based health system partnered with Northwestern and the University of Illinois College of Medicine at Peoria’s Jump Simulation program to develop a toolkit that addresses how a telemedicine care can be used in a small Emergency Department or ICU to connect with specialists to help treat patients dealing with severe sepsis and septic shock.

The research may provide a model for hub-and-spoke telemedicine networks like eICUs that help small and rural hospitals treat acute care patients on-site.

William Bond, MD, an emergency department physician and Jump Simulation’s director of research, says the program’s goal is to “better connect patients in the ER to caregivers in the telehealth realm who would eventually be overseeing their care in the intensive care unit at those sites.

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https://www.healthleadersmedia.com/strategy/stakeholders-discuss-biden-healthcare-agenda-ahead-inauguration-day

Stakeholders Discuss Biden Healthcare Agenda Ahead of Inauguration Day

Analysis  |  By Jack O'Brien  |   January 18, 2021

Ahead of his swearing-in ceremony, HealthLeaders spoke with numerous stakeholders about the Biden healthcare agenda and what actions to expect from the new administration.

President-elect Joe Biden will be sworn in as the 46th president Wednesday afternoon and healthcare executives are paying careful attention to how the incoming administration will address the ongoing COVID-19 pandemic along with other outstanding issues facing the industry.

Biden has already given indications for what his administration will prioritize on its healthcare agenda, namely introducing a $1.9 trillion COVID-19 relief package, a plan to distribute 100 million vaccines in the first 100 days, and building on the existing structure of the Affordable Care Act (ACA).

On Friday, the Association of American Medical Colleges released a statement that the organization was "grateful" for the Biden administration's recognition of the "immediate need to combat the coronavirus pandemic" through its proposed stimulus package.

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https://histalk2.com/2021/01/15/weekender-1-15-21/

Weekly News Recap

• Health and technology leaders, including Epic and Cerner, announce their participation in the Vaccination Credential Initiative, which hopes to provide patients with digital proof of their COVID-19 vaccination.
• QGenda acquires Shift Admin.
• Walgreens announces plans to develop an extensive customer engagement, care integration, and health marketplace platform.
• Flo settles FTC charges that it shared the ovulation data of 100 million users with Facebook, Google, and other companies while telling them it was keeping that information private.
• AdventHealth says its replacement of Cerner, Athenahealth, and Homecare Homebase will cost $660 million.
• Federal prosecutors say that Theranos destroyed its laboratory information system database that it had hoped to use to prove fraud and use of unreliable tests.
• ONC releases United States Core Data for Interoperability Draft Version 2 for public comment.
• Central Logic acquires Acuity Link.
• Tech-enabled Medicare Advantage insurer Clover Health begins trading on the Nasdaq in a reverse merger with a SPAC that values the company at $7 billion.

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Enjoy!

David.