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, January 02, 2021

Weekly Overseas Health IT Links – 02 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.healthleadersmedia.com/technology/qliqsoft-chatbot-helps-providers-handle-covid-19-vaccination-interactions-patients

QliqSOFT Chatbot Helps Providers Handle COVID-19 Vaccination Interactions With Patients

By Scott Mace  |   December 23, 2020

Tech aims to overcome vaccine hesitancy and provide self-scheduled vaccinations, travel directions, and digital proof of vaccination.

With the arrival of COVID-19 vaccinations, comes a new twist in the saga of the pandemic. The World Health Organization lists "vaccine hesitancy" as one of the top 10 threats to world health.

Could chatbots help overcome some people's objections?

The founder of QliqSOFT, which recently announced a chatbot called Quincy,  says that the company's innovation  not only helps healthcare providers with COVID-19 vaccine distribution, but also helps educate recipients about the safety and benefits of the medication.

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https://ehrintelligence.com/news/the-sequoia-project-adds-members-to-interoperability-matters-initiative

The Sequoia Project Adds Members to Interoperability Matters Initiative

Healthcare organization leaders, health IT developers, and health information exchanges will be chosen to participate in the Interoperability Matters initiative to prepare for the ONC’s interoperability rule.

By Christopher Jason

December 23, 2020 - The Sequoia Project added three subgroups, including healthcare providers, health IT developers, and health information exchanges (HIEs), to the existing Interoperability Matters Information Blocking Workgroup.

This initiative aims to help the three groups reach and maintain compliance with the Office of the National Coordinator for Health Information Technology’s (ONC) final interoperability rule.

Originally proposed in February 2019, the ONC interoperability rule supports patients accessing and sharing their own electronic health information, allowing individuals to coordinate their own healthcare. The rule also prohibits information blocking and aims to hold health IT developers accountable as a condition of certification.

“We’re hoping these subgroups help communities address specific operational issues and best practices regarding information blocking regulatory compliance and implementation,” Mariann Yeager, CEO of The Sequoia Project, said in a statement. “The Information Blocking Workgroup has done a great job setting up these subgroups, and we look forward to addressing the specific needs of our communities.”

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https://ehrintelligence.com/news/epic-systems-tops-major-ehr-vendors-in-health-it-interoperability

Epic Systems Tops Major EHR Vendors in Health IT Interoperability

Every top EHR vendor has its interoperability flaws, but Epic Systems and Cerner have made significant strides over the last few years.

By Christopher Jason

December 23, 2020 - Epic Systems is leading the way among EHR vendors and is making strides toward universal interoperability and patient data sharing, according to KLAS’s EMR Interoperability 2020 report.

Meanwhile, Cerner has made significant progress since KLAS’s prior interoperability report, with four times its customers reporting “deep interoperability” as they did roughly three years ago.

KLAS said it measures interoperability in four stages. “Deep interoperability” occurs when customers can:

  • Consistently access outside patient data
  • Easily locate patient records
  • View outside data within the EHR workflow
  • Experience positive impacts on patient care

In this report, KLAS interviewed over 200 healthcare organizations to gain insights into how their respective vendors guided them toward EHR interoperability.

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https://www.forbes.com/sites/marenbannon/2020/12/23/8-digital-health-predictions-for-2021/?sh=11ee01ba4976

Dec 23, 2020,06:23am EST|947 views

8 Digital Health Predictions For 2021

Maren Thomas Bannon

Venture Capital

One of the silver linings of 2020 is that digital health is finally coming into its own. Health is a huge and outdated industry, making up 17% of US GDP. During the pandemic, however, it has leapfrogged about a decade in terms of adoption of technology. The disruption created by the pandemic is creating new opportunities for digital health startups. 

I spoke with five leading early stage health tech investors across the US and Europe about the trends they are seeing and their predictions for the year ahead.

#1: The mobile phone will be transformed into an on-call care team

Kristin Baker Spohn, General Partner at CRV

“The pandemic has been an accelerant for digital adoption across the board, and healthcare is no exception. Heading into 2021 there are a few areas where I see those trends strengthening. 

The strain we’ve seen on our healthcare system heightens our need for tech that streamlines cumbersome processes to meet people where they are (patients and providers) and improve overall health. Viz.ai, software that leverages artificial intelligence of medical imaging to drastically reduce time to treatment for stroke victims, will likely continue to thrive in 2021. By making clinician’s mobile phones perform as a system of action, clinical teams will be able to help treat patients better and faster while also reducing the strain on staff and resources.” 

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https://healthitanalytics.com/news/population-health-app-may-facilitate-large-scale-data-sharing

Population Health App May Facilitate Large-Scale Data Sharing

A population health app could enable large-scale data sharing among providers, payers, and public health officials.

By Jessica Kent

December 23, 2020 - A population health app may allow payers to access permitted data and metrics on covered populations, potentially creating a foundation for pay-for-performance and assessment of value-based care.

In a recent ONC blog post, Tracy Okubo and Kenneth Mandl describe the SMART-PopHealth app, a tool developed at Boston Children’s Hospital with a two-year, $1 million grant awarded through the Leading Edge Acceleration Projects (LEAP) in Health IT funding opportunity. LEAP supports innovation to address emerging challenges and advance interoperability in health IT.

The authors noted that apps could help promote large-scale data sharing among providers, payers, and public health officials.

“Because of advances in interoperability, it’s becoming increasingly common for people and their healthcare providers to access and share information from EHRs using apps.  An app providing shared insights into a common dataset could transform the way value-based care is delivered and measured,” Okubo and Mandl wrote.

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https://www.healthcareittoday.com/2020/12/24/like-epic-cerner-continues-to-build-on-platform-designed-to-manage-multiple-digital-health-tools/

Like Epic, Cerner Continues To Build On Platform Designed To Manage Multiple Digital Health Tools

December 24, 2020

Anne Zieger

A few months ago, we told you about Cerner’s partnership with a vendor, Xealth, which created a central platform allowing providers to connect multiple digital health solutions.

Xealth connects with about 30 digital solutions, including remote patient monitoring technology, virtual care platforms and e-commerce tools that make product recommendations. Perhaps the most compelling thing about the deal, from my perspective, was the fact that Epic was working with Xealth as well.

Now, Cerner is expanding its collaboration with Xealth to include centralized digital ordering and monitoring capabilities. As I noted earlier in the year, one of the things that makes this interesting is the extent to which the EHR giant is expanding the boundaries of its footprint among users.

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https://mhealthintelligence.com/news/cms-report-cites-benefits-challenges-for-telehealth-in-rural-hospitals

CMS Report Cites Benefits, Challenges for Telehealth in Rural Hospitals

The results of a 3-year demonstration project at several rural hospitals finds that telehealth can improve access to care, especially by reducing travel barriers and facilitating follow-up and specialist services.

By Eric Wicklund

December 22, 2020 - A three-year demonstration project at critical access hospitals in some of the country’s most rural regions found strong support for the use of telehealth to improve access to care.

The apparent success of the Frontier Community Health Innovation Program, run from 2016 to 2019 by the Centers for Medicare & Medicaid Services’ Innovation Center and the Health Resources and Services Administration, gives hope that CMS will continue to expand coverage for telehealth services in rural areas. At the end of the program, six of the eight hospitals involved who were using telehealth said they’d keep using connected health technology.

The Congressionally mandated program targeted 10 critical access hospitals in Montana, Nevada and North Carolina, with a goal of studying how one of more Medicare payment waivers could help those small, rural hospital improve access to care. CMS administered day-to-day operations, while HRSA focused of the operational changes and marketing to surrounding communities.

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https://mhealthintelligence.com/news/kaiser-to-offer-connected-health-apps-as-patient-care-plans

Kaiser to Offer Connected Health Apps as Patient Care Plans

Kaiser Permanente is integrating connected health digital therapeutics such as mental health apps into patient care plans at no cost to improve behavioral healthcare.

By Hannah Nelson

December 21, 2020 - Kaiser Permanente is integrating telehealth and connected health strategies in behavioral healthcare through digital therapeutic referrals from providers.

Physicians and therapists can now refer Kaiser Permanente patients to mindfulness and cognitive behavioral therapy apps through the organization’s electronic health record system at no additional cost. These mindfulness, meditation, and cognitive behavioral therapy apps have shown to be affective at alleviating symptoms of anxiety or depression.

A new case study published in the January 2021 issue of NEJM Catalyst Innovations in Care Delivery shows that patients are more engaged in using mental health and wellness apps when referred by a clinician than if they had sought out the app on their own.

“What we’re tapping into is the existing relationship people have with their Kaiser Permanente therapist,” said Don Mordecai, MD, national leader for mental health and wellness at Kaiser Permanente. “We know that our patients are more likely to use these digital resources if their provider refers them.”

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https://healthitsecurity.com/news/limited-security-privacy-budgets-impede-connected-health-growth

Limited Security, Privacy Budgets Impede Connected Health Growth

Small security and privacy budgets limit the growth of connected health solutions despite an increased use of these technologies during the COVID-19 pandemic, according to the latest Insights report from Xtelligent Healthcare Media.

By Emily Sokol, MPH

December 22, 2020 - Security and privacy remain high priorities for hospitals and health systems. Yet small budgets to invest in that security protocol impede progress towards a more connected health experience, uncovered Insights by Xtelligent Healthcare Media in its latest report.

Connected health solutions including telehealth technologies have exploded amidst the COVID-19 pandemic, allowing providers to continue delivering care while keeping patients safe at home. Many patients have now even begun to expect a more digitized patient experience. But these solutions open organizations to more security and privacy breaches.

To understand the growing impact of connected health solutions across the industry, the research division of Xtelligent Healthcare Media, Insights, conducted a survey of provider organizations. The goal was to understand how hospitals and health systems, primary care physician groups, behavioral health facilities, and other care organizations are overcoming security and privacy challenges when rolling out connected health solutions.

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https://healthitsecurity.com/news/fed-cybersecurity-advisory-alerts-to-abuse-of-authentication-mechanisms

Fed Cybersecurity Advisory Alerts to Abuse of Authentication Mechanisms

The Russian hackers behind the SolarWinds’ attack have claimed multiple victims in the government sector, with the latest efforts concentrated on the abuse of authentication mechanisms.

By Jessica Davis

December 21, 2020 - The Department of Homeland Security is again urging organizations to review insights around the ongoing cyberattacks based around the SolarWinds' hack. The latest alert provides NSA guidance on the abuse of authentication mechanisms, as the extent of the malware attack rapidly expands.

The attacks are based on an exploit of a SolarWinds Orion Platform software update versions 2019.4 HF 5 through 2020.2.1 HF 1, released between March 2020 and June 2020. The threat actors hijacked the updates and installed malware, meaning that any customer that applied the update, installed a Trojan.

As a result, a massive range of public and private sector organizations have been hacked. The extent of which is still unclear.

The ongoing global supply-chain tacks led by hackers with likely ties to Russia have already claimed multiple victims within the government sector, including DHS and the Departments of Treasury and Commerce's National Telecommunications and Information Administration (NTIA), along with the National Institutes of Health, technology firms, and even educational organizations.

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https://ehrintelligence.com/news/how-health-information-exchange-addresses-rural-sdoh-data-hangups

How Health Information Exchange Addresses Rural SDOH Data Hangups

Idaho’s statewide health information exchange (HIE) integrated two valuable platforms to address SDOH data challenges and ease patient care access.

By Christopher Jason

December 21, 2020 - Interoperability is critical for ensuring patient medical records are available across the healthcare sector. However, interoperability and patient data exchange are often difficult to achieve in a rural state, such as Idaho, that spans from the border of Canada, all the way down to the border of Utah.

Rural states do not have great data repositories and it’s difficult for rural providers to exchange social determinants of health (SDOH) data. Leaders at Idaho Health Data Exchange (IHDE) aimed to improve its data repositories by uncovering and integrating SDOH for its users across the state.   

“We have 1.7 million individuals that reside in some very remote places and are receiving healthcare,” Prudence Benson, director of customer operations and engagement at IHDE, said in an interview with EHRIntelligence. “For them to be able to share records across facilities becomes extremely important to making sure that they have the right care at the right time and in the right place.”

As value-based care brings more focus to patient social needs, health information exchanges (HIEs) allow organizations such as first responders, blood banks, schools, and drug and alcohol treatment centers to connect and share patient information.

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https://www.fiercehealthcare.com/practices/some-doctors-are-zooming-improv-actors-here-s-why

Some doctors are Zooming with improv actors to get better at delivering bad news. Here's why

by Heather Landi 

Dec 22, 2020 11:47am

As doctor appointments have shifted from in-person encounters to video visits during the COVID-19 pandemic, some physicians have little choice but to break bad news to patients over Zoom.

Telling a patient that she has cancer or that a family member faces a terminal illness is a stressful moment for physicians even when the patient is sitting a few feet away. Delivering that news remotely brings a whole new set of communication challenges.

"I have two personal friends who both lost parents to COVID-19 and the doctors told them over telehealth. There is a need to effectively and compassionately break bad news and it's even harder to do that through a computer screen or an iPad," Anthony Orsini, M.D., a practicing neonatologist, told Fierce Healthcare.

In turns out, most physicians, nurses, and first responders receive very little training on how to effectively communicate and convey compassion when telling patients tragic news.

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https://www.fiercehealthcare.com/tech/doctor-demand-study-finds-covid-19-telehealth-surge-driven-by-behavioral-health-chronic

Doctor On Demand, Harvard study finds telehealth surge driven by behavioral health, chronic illness visits

by Heather Landi

Dec 23, 2020 9:00am

It's not surprising that the COVID-19 pandemic drove a huge surge in telehealth visits as patients avoided in-person care in favor of remote consultations.

But what is unexpected? The growth in telehealth was not fueled by COVID-19 concerns but by visits for behavioral health issues and chronic conditions, according to a new study of Doctor On Demand data.

The largest increases in telemedicine visits during the COVID-19 pandemic were attributable to scheduled behavioral health appointments, such as therapy and psychiatry visits, and chronic illness visits, according to a peer-reviewed study published in the Journal of Medical Internet Research this month.

"We see many people turning to telemedicine including a broader range of ages, urban and rural residents and lower-income households," said Ian Tong, M.D., chief medical officer at Doctor On Demand, in an exclusive interview with Fierce Healthcare about the study results.

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https://www.geekwire.com/2020/microsoft-unleashes-death-star-solarwinds-hackers-extraordinary-response-breach/

Microsoft unleashes ‘Death Star’ on SolarWinds hackers in extraordinary response to breach

by Christopher Budd on December 16, 2020 at 3:20 pm

[Editor’s Note: Independent security consultant Christopher Budd worked previously in Microsoft’s Security Response Center for 10 years.]

“Now witness the firepower of this fully armed and operational Battle Station.” – Emperor Palpatine, Return of the Jedi

Analysis: This week Microsoft took a series of dramatic steps against the recent SolarWinds supply chain attack. In the size, speed and scope of its actions, Microsoft has reminded the world that it can still muster firepower like no one else as a nearly-overwhelming force for good.

Through four steps over four days, Microsoft flexed the muscle of its legal team and its control of the Windows operating system to nearly obliterate the actions of some of the most sophisticated offensive hackers out there. In this case, the adversary is believed to be APT29, aka Cozy Bear, the group many believe to be associated with Russian intelligence, and best known for carrying out the 2016 hack against the Democratic National Committee (DNC).

While details are continuing to emerge, the SolarWinds supply chain attack is already the most significant attack in recent memory. According to SolarWinds, Microsoft, FireEye, and the Cybersecurity and Infrastructure Security Agency (CISA) the attackers compromised a server used to build updates for the SolarWinds Orion Platform, a product used for IT infrastructure management. The attackers used this compromised build server to insert backdoor malware into the product (called Solorigate by Microsoft or SUNBURST by FireEye).

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https://www.healthcareitnews.com/news/mayo-clinic-covid-19-patients-likely-had-better-outcomes-thanks-rpm

Mayo Clinic COVID-19 patients likely had better outcomes thanks to RPM

The health system found that patients who received care at their facilities had lower observed mortality rates than the national average, and remote patient monitoring may have been one difference-maker.

By Kat Jercich

December 23, 2020 01:21 PM

Research published this week in Mayo Clinic Proceedings found that COVID-19 patients who received care at Mayo Clinic had favorable outcomes compared to those reported nationally.

One factor contributing to those favorable outcomes, said researchers, was the clinic's remote monitoring capabilities allowing for early detection of complications or clinical deterioration.

"By including subject matter experts from a range of disciplines in our treatment teams, and having those treatment teams reviewing the care and progress of each patient daily, our outcomes were better than what had previously been reported," said Dr. Andrew Badley, chair of Mayo Clinic's COVID-19 Research Task Force, in a statement.

WHY IT MATTERS

Health systems have routinely turned to remote monitoring for patients as clinical resources thinned. 

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https://patientengagementhit.com/news/connected-health-solutions-support-patient-engagement-health-outcomes

Connected Health Solutions Support Patient Engagement, Health Outcomes

Organizations are rolling out connected health platforms, from telehealth to patient portals, to support patient engagement and improve health outcomes, according to the latest report from Insights by Xtelligent Healthcare Media.

By Emily Sokol, MPH

December 21, 2020 - From hospitals and health systems to small physician groups and behavioral health facilities, provider organizations are primarily leveraging connected health solutions to support patient engagement and health outcomes, research from Insights by Xtelligent Healthcare Media uncovered.

Connected health is a broad buzzword many throughout the industry use to describe the gamut of technologies available to them and health consumers. To discover what specific solutions organizations are implementing and the motivations behind rolling out these technologies, Insights, the research division of Xtelligent Healthcare Media, fielded a survey of provider organizations. The goal of the survey was to uncover the impact of connected health solutions on these organizations and challenges to successful rollout.

The primary solution organizations are rolling out is real-time or live telehealth technologies, according to 85 percent of survey respondents. Respondents are also offering the following connected health solutions:

  • Patient portals (71 percent)
  • Secure messaging tools (61 percent)
  • Mobile applications (51 percent)
  • Remote patient monitoring tools (31 percent)
  • Store-and-forward or asynchronous telehealth (20 percent)

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https://ehrintelligence.com/news/pew-urges-health-data-exchange-interoperability-from-biden-admin

Pew Urges Health Data Exchange, Interoperability from Biden Admin

Pew recommended the Biden Administration can utilize health IT to look at information blocking, patient matching, and patient data access to streamline telehealth.

By Christopher Jason

December 16, 2020 - Pew Charitable Trusts penned a letter to President-elect Joe Biden and his administration to advance health IT, potentially within the first 100 days of taking office. Specifically, Pew called for a focus on health data exchange and interoperability that can help mitigate the current COVID-19 crisis.

“To slow the growth of new cases and deaths in the short term and ensure the success of a vaccination drive in 2021, the incoming administration should focus on optimizing the use and exchange of available data to ensure that public health authorities get the information they need to effectively manage the COVID-19 response,” wrote Ben Moscovitch, project director of Health Information Technology at Pew.

Moscovitch called on the Administration to enforce information blocking regulations, improve patient matching to support COVID-19 vaccine rollouts, and boost telehealth capabilities with patient data access.

Enforce information blocking regulations

COVID-19 response efforts include collecting and analyzing individual and community EHR data from healthcare organizations, public health departments, and socioeconomic indicators. This information helps track the coronavirus spread and it identifies at-risk populations.

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https://healthitsecurity.com/features/biggest-healthcare-security-threats-ransomware-trends-into-2021

Biggest Healthcare Security Threats, Ransomware Trends into 2021

Much like the previous year, ransomware was one of the healthcare sector’s biggest cybersecurity threats seen in 2020; spotlighting the need for proactive measures.

December 18, 2020 - In 2020, the resiliency of the healthcare industry was tested in terms of its response to two national crises: a global pandemic and hackers taking advantage of an oft-weakened workforce. Ransomware was yet again the biggest cybersecurity threat, a further reminder of the need for proactive security measures.

This evolution of ransomware is a sign of what’s to come in 2021, and those continuing a reactive cyber posture are at the greatest risk.

As the year draws to a close, the threat landscape for the healthcare sector mimics that of 2019: an overabundance of ransomware attacks and a range of phishing campaigns designed to give hackers a foothold onto the network.

Ransomware reached its highest numbers in late 2019, but COVID-19 seemingly gave the sector a reprieve as the number of reported victims quickly diminished long into the spring. At the time, researchers warned hackers were still targeting the sector in great force and to expect a resurgence of victims as the year progressed.

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https://www.healthcareitnews.com/news/top-10-telehealth-stories-2020

Top 10 telehealth stories of 2020

The COVID-19 crisis prompted an enormous uptick in virtual care use from patients and providers – but it has also raised a number of questions about telehealth's security, accessibility and longevity.

By Kat Jercich

December 22, 2020 09:14 AM

There's no question that the COVID-19 crisis ignited unprecedented patient interest in telehealth. But along with the skyrocketing appointment rates and glowing reports about patient and provider satisfaction came concerns about security, accessibility and longevity.

Many of those questions are still unanswered as we turn the corner into 2021. But to gain a sense of the landscape going forward, here's a refresher of Healthcare IT News' top 10 telehealth stories from 2020:  

Telemedicine during COVID-19: Benefits, limitations, burdens, adaptation. As the pandemic began to spread across the country in March, no one was sure exactly what virtual care would, or could, look like. Industry leaders offered an early glimpse into the ways they were using telemedicine in their own systems – and vendors noted how their technology could be used to bridge the gap between clinicians and patients.  

A guide to telehealth vendors in the age of COVID-19. Companies – many of which had been in the virtual care space for years – jumped at the chance to demonstrate their products' usefulness in these unprecedented times. Some even gave away their services for free. This guide, routinely updated with additional vendors, offered a snapshot of the wide variety of telemedicine tools available.  

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https://www.healthcareitnews.com/news/epic-leads-way-ehr-interoperability-says-klas

Epic leads way on EHR interoperability, says KLAS

Customers report that Cerner has made notable progress on fluid record-sharing, while Meditech and Greenway Health lag behind.

By Kat Jercich

December 22, 2020 12:23 PM

A KLAS report released this week took a deep dive into how healthcare organizations perceive their electronic health record vendors' role in helping them to achieve meaningful interoperability.

While all vendors have room to improve, the report found that Epic stands out as the leader, with almost all customers saying they have access to outside data.

"Both Epic and non-Epic customers feel the vendor’s commitment to outside sharing has grown," wrote KLAS researchers.

WHY IT MATTERS

KLAS defines "deep interoperability" as providers' ability to have consistent access to outside data; easily locate patient records; view outside data inside their EHR workflows; and experience positive, frequent impacts on patient care.

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https://www.healthcareittoday.com/2020/12/22/what-makes-specialty-acute-care-telehealth-different/

What Makes Specialty Acute Care Telehealth Different?

December 22, 2020

John Lynn

I’m always slightly bothered when people say that telehealth has seen a massive explosion thanks to COVID-19.  While it’s true that live video telehealth visits have seen hockey stick style growth because of COVID-19, there are actually a wide variety of telehealth options.  Although, each of these areas of telehealth are quite different and have been impacted by COVID-19 in really different ways.  Two that I think are particularly interesting are remote patient monitoring which often just uses telehealth as a component of the care they provide and specialty acute care telehealth.

Pre-COVID-19, specialty acute care telehealth was one of the bright spots of telehealth.  Turns out there’s a lot of value in how timely a specialist is able to see a patient who is dealing with a very emergent health need.  The best example of this is Tele-Stroke where the ability to administer a treatment quickly has a long lasting impact for good or bad on a patient.  Plus, give the physician shortage and the lack of specialty physicians in rural environments, specialty specific acute care telehealth had seen quite a bit of success even before COVID.

To learn more about what makes this area of telehealth unique and how it’s been impacted by COVID-19, we sat down with John Kalix, CEO at SOC Telemed.  We ask Kalix what makes specialty specific telehealth solutions like there’s unique and what nuances and features make it wise to invest in a true specialty telehealth platform vs a generic live video telehealth vendor (Spoiler Alert: Workflow!).

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https://www.fiercehealthcare.com/hospitals/from-covid-19-to-retail-health-fierce-healthcare-s-biggest-stories-2020

From COVID-19 to retail health: Fierce Healthcare's biggest stories of 2020

by Paige Minemyer, Heather Landi 

Dec 21, 2020 12:52pm

2020 was a year dominated by the fallout from a generational global pandemic.

So perhaps it's no surprise that COVID-19 headlines also governed much of our coverage over the course of this year, as we shared the latest on how the coronavirus pandemic was impacting you.

However, over the course of the year, other key topics of interest emerged: including a contentious presidential election, new models for health insurance, and tech giants' continued push into the market.

Here's a look at some of the topics that made headlines this year.

COVID-19 driving significant industry change

Over the course of the year, COVID-19 touched every facet of the healthcare industry. And the pandemic's reach forced providers, payers, and health tech companies alike to rethink their approach in a number of areas.

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https://www.reuters.com/article/us-health-coronavirus-usa-vaccine-cdc/cdc-issues-guidelines-on-covid-19-vaccination-after-allergic-reactions-idUSKBN28T0ZO

December 20, 202010:04 AM

CDC issues guidelines on COVID-19 vaccination after allergic reactions

(Reuters) - The U.S. Centers for Disease Control and Prevention (CDC) on Saturday said it was monitoring reports of allergic reactions to the COVID-19 vaccination and made recommendations on how people with histories of allergies should proceed.

Anyone who had a severe reaction to a COVID-19 vaccine should not get the second dose, the agency said, defining severe as needing the medication epinephrine or treatment in a hospital.

People who have had a severe allergic reaction to any ingredient in a COVID-19 vaccine should avoid the vaccine formulation containing the ingredient, CDC said. Two vaccines have been approved in the United States under emergency use authorizations.

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https://www.crn.com/news/security/vmware-flaw-used-to-hit-choice-targets-in-solarwinds-hack-report

VMware Flaw Used To Hit Choice Targets In SolarWinds Hack: Report

A VMware vulnerability that allowed federated authentication abuse was used by the SolarWinds hackers to attack valuable targets, KrebsOnSecurity said. VMware said it didn’t have any indication of this happening.

By Michael Novinson December 18, 2020, 03:52 PM EST

A VMware vulnerability that allowed access to protected data and federated authentication abuse was used by the SolarWinds hackers to attack high-value targets, KrebsOnSecurity reported.

The U.S. National Security Agency (NSA) warned on Dec. 7 that a flaw in the software of Palo Alto, Calif.-based VMware was being used by Russian hackers to impersonate legitimate users on breached networks. In order to exploit this vulnerability, the NSA said hackers would need to be on the target’s internal network, which KrebsOnSecurity pointed out would have been the case in the SolarWinds hack.

VMware told CRN that it has received no notification or indication that this vulnerability “was used in conjunction with the SolarWinds supply chain compromise.” After being tipped off to the flaw by the NSA, VMware released a software update Dec. 3 to plug the security hole.

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https://fusion.inquirer.com/health/expert-opinions/health-information-insurance-confidentiality-pennsylvania-jersey-20201218.html

When confidentiality is not guaranteed, young patients miss out on essential health care | Expert Opinion

Unfortunately, young adults who remain on their parents’ insurance in Pennsylvania have limited capacity to prevent their health information from being shared.

“I can’t have my parents finding out that I’m gay.” That is what I heard from a young man in clinic while discussing PrEP, a medication that protects people from contracting HIV. This medication has kept thousands of individuals like this patient safe and healthy. But he was worried his parents would discover this medication, and therefore his sexual orientation, when his insurance company sent out an explanation of benefits (EOB) to his parents.

No one should live in fear of being “outed.” It is even worse that health insurers may be the cause of this worry. Unfortunately, young adults who remain on their parents’ insurance in Pennsylvania have limited capacity to prevent their health information from being shared. These privacy concerns can lead to gaps in care, not only in the area of sexual health, but also in treating mental illness and substance abuse. We need to strengthen state and federal legislation to help young adults access the care they deserve.

Following Joe Biden’s victory in the presidential election, efforts to adapt and expand the Affordable Care Act (ACA) will likely inform health policy decisions in the next administration. The ACA transformed health care for young adults, and it is important to celebrate its successes. By allowing young adults under age 26 to remain on their parents’ health insurance, the ACA greatly increased medical access for this vulnerable population. Nearly 3 million people gained coverage between 2010 and 2011 alone. But we must also acknowledge the ACA’s flaws. By not providing stronger privacy protections, the ACA may paradoxically prevent some young adults from receiving necessary health care.

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https://www.theverge.com/2020/12/20/22191749/stanford-medicine-covid-19-vaccine-distribution-list-algorithm-medical-residents

Stanford algorithm decided to vaccinate only seven of its frontline COVID-19 workers, out of 5,000 doses

Stanford has apologized and is re-evaluating its plan

@jaypeters

An algorithm determining which Stanford Medicine employees would receive its 5,000 initial doses of the COVID-19 vaccine included just seven medical residents / fellows on the list, according to a December 17th letter sent from Stanford Medicine’s chief resident council. Stanford Medicine leadership has since apologized and promised to re-evaluate the plan.

“We take complete responsibility for the errors in the execution of our vaccine distribution plan,” a Stanford Medicine spokesperson said in a statement to The Verge. “Our intent was to develop an ethical and equitable process for distribution of the vaccine. We apologize to our entire community, including our residents, fellows, and other frontline care providers, who have performed heroically during our pandemic response. We are immediately revising our plan to better sequence the distribution of the vaccine.”

The initial plan led to demonstrations from medical staff in addition to the letter sent by the chief resident council.

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https://www.healthcareitnews.com/news/himsscast-hipaa-privacy-rule-proposed-changes-what-they-mean-and-what-expect

HIMSSCast: HIPAA Privacy Rule proposed changes - What they mean and what to expect

Healthcare lawyer Matt Fisher breaks down how the changes could affect patient privacy and access.

By Healthcare IT News

December 21, 2020 03:44 PM

Healthcare IT News Executive Editor Mike Miliard speaks with Matthew Fisher, a partner at Mirick O'Connell and a specialist in healthcare law, about the proposed HIPAA rule changes. They discuss the content of the rules, what effect they're likely to have and the timing of the rules as the presidential administration changes over.

This will be the last episode of the year. We'll be back with more podcasts in 2021.

Talking points: 

How big are these changes?

  • How the right of access is being strengthened
  • Alignment with the info-blocking rules
  • Expanded definitions for care coordination and care management
  • The extent to which the rule is playing catch-up with current practices
  • Reducing HIPAA’s role as a blocker of legitimate information access
  • The impact of the new rules on HIPAA’s privacy protections
  • The timing of this announcement and the presidential transition
  • Advice for providers and vendors

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https://www.mobihealthnews.com/news/amazon-dives-deeper-health-2020

Amazon dives deeper into health in 2020

From expanding its employee health offerings to launching its first health wearable, Amazon had a busy 2020.

By Mallory Hackett

December 21, 2020 11:08 am 

All eyes have watched to see what Amazon’s next move in the health space would be ever since its collaboration with Berkshire Hathaway and JPMorgan Chase was announced in 2018.

The joint venture, however, has been fairly quiet since its announcement. It took more than a year for the company to announce its name – Haven. Other than that, the only word from Haven was the appointment, and eventual stepping down, of Dr. Atul Gawande as CEO.

Haven’s lack of activity, paired with the departure of numerous executives, has led some to question the viability of the venture.

Outside of Haven, Amazon has made its own moves in the health space. The online retail giant made a splash last year with news ranging from automated voice medication reminders on the Amazon Alexa to a feud between Amazon’s PillPack and Surescripts.

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https://www.healthcareitnews.com/news/top-10-ehr-stories-2020

Top 10 EHR stories of 2020

From pandemic-necessitated go-live pauses to major rip-and-replaces, FHIR-based efficiencies to interoperability strides, digital records are evolving.

By Mike Miliard

December 21, 2020 11:57 AM

Like 'em or hate 'em, electronic health records are here to stay. Now it's just a matter of making them work to the best of their ability for patients and clinicians.

Some recent efforts are afoot to rethink the approach to these glorified billing systems from the bottom up. Others are focused on refining and streamlining their user experience to combat the scourge of burdensome charting and alleviate burnout.

In the meantime, with more than 18 million COVID-19 cases and counting so far in the U.S., it's never been clearer that interoperable, ideally telehealth-connected digital records are essential for quality care and public health going forward.

Here are some of the most-read EHR stories of the past year.

EHRs are still a mess for physicians, but change is coming. The top-grossing article on this topic for 2020 was a hopeful piece written on Dec. 31, 2019. (And we all know how most of those hopeful New Year's Eve wishes went by now.) Still, progress has been made on some of the issues it highlights: taming an "avalanche of data," enabling easier voice documentation and streamlining clinician workflows.

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https://www.healthcareitnews.com/news/how-top-ehr-vendors-are-prepping-their-systems-covid-19-vaccines

How top EHR vendors are prepping their systems for COVID-19 vaccines

Allscripts, athenahealth, Cerner, DrChrono, Epic, Greenway Health, Meditech and NextGen offer an up-to-the-minute look at how they’re enabling complex immunization recordkeeping for their health system customers.

By Bill Siwicki

December 21, 2020 12:23 PM

Never in the history of electronic health records has there been a more important public health recordkeeping task than the one that is at hand at this very moment in the nation’s history: tracking COVID-19 vaccinations.

As a result of this all-important development, EHR vendors from across the industry have been preparing their products and their healthcare provider organization users to make sure that when a patient receives this critical vaccination, it is recorded correctly, pushed to the necessary parties, and is accessible now and in the future by all the appropriate caregivers.

Healthcare IT News discussed this huge issue with top executives at Allscripts, athenahealth, Cerner, DrChrono, Epic, Greenway Health, Meditech and NextGen Healthcare.

They offered insights into preparations that began earlier this year, described the changes they’ve made to their EHR systems and discussed how they’ve been rolling out – and helping train for – these new design and workflow changes.

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https://www.healthcareittoday.com/2020/12/21/what-do-board-members-of-smaller-healthcare-organizations-need-to-know-about-healthcare-information-security/

What do Board Members of Smaller Healthcare Organizations Need to Know About Healthcare Information Security?

December 21, 2020

Mitch Parker, CISO

During a conversation with a friend earlier this week discussing healthcare information security, she made one very important point.  She is concerned about her personal data being taken or exposed in a ransomware attack or data breach if she decides to get treatment at one of the facilities near her house.  With the numerous ransomware attacks on healthcare facilities, this is now a major concern.

There has been a lot of publications on what to say to the board to discuss cyber security programs.  We have not observed anything aimed at the board members themselves to educate them on what to look for.  This is something that we want to change with this article.  Many of the hospitals that take care of patients do not have members with IT skills on their boards like large academic health centers or for-profit health systems do.

When I spoke at the American Hospital Association’s Rural Health Summit in 2019 in Phoenix, AZ, the moderator, John Riggi, asked how many board members were attending our cybersecurity session.  Over a quarter of the attendees raised their hands.  These are not people that fit the stereotype of senior executives of large companies.  They are often local or state government employees, elected officials, local businesspeople, or physicians that practice locally.  Many are retired.  They do not get stock options or compensation.  Their mission is to help their neighbors, friends, and people that cannot help themselves in rural areas.

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https://histalk2.com/2020/12/18/weekender-12-18-20/

Weekly News Recap

  • Verily announces a $700 million funding round.
  • Diameter Health raises $18 million.
  • Kyruus acquires HealthSparq.
  • Report: Amazon will expand its employee-only telehealth program to other companies.
  • Cerner acquires Kantar Health.
  • KLAS finds patient accounting from Epic and Meditech to be strong, Cerner and Allscripts less so.
  • Sonoma Valley Hospital notifies 67,000 patients of an October 11 ransomware attack.
  • CMS announces a rule that requires Medicaid managed care and insurers that sell products on the Exchanges to facilitate the exchange of patient data between payers.

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Enjoy!

David.

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