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, February 27, 2021

Weekly Overseas Health IT Links – 27 February, 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/2021/02/tributes-paid-national-data-guardian-dame-fiona-caldicott/

Tributes paid to National Data Guardian Dame Fiona Caldicott

Tributes have been paid to Dame Fiona Caldicott, the first National Data Guardian (NDG) for Health and Social Care, who has passed away aged 80.

Hanna Crouch - 16 February 2021

Dame Fiona, who celebrated her 80th birthday in January, was appointed to the office of the National Data Guardian in November 2014 and was confirmed as the first statutory holder of the position in April 2019.

A tribute written by John Carvel on behalf of the NDG panel and office team was posted on the gov.uk website on February 15.

“As members of the team who supported Dame Fiona in her work as National Data Guardian for Health and Social Care, we are full of sorrow at losing our inspirational colleague,” Carvel wrote.

“She led us with unswerving integrity, modesty and a commitment to doing her best for patients and service users. Her name is well known across our sector and beyond, but we had the added privilege of knowing her personally and holding dear the thoughtful, compassionate person behind the public profile.”

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https://www.managedhealthcareexecutive.com/view/interoperability-is-coming-at-last

Interoperability is Coming — at Last

February 16, 2021

By Jared Kaltwasser

MHE Publication, MHE February 2021, Volume 31, Issue 2

Enforcement of rules to encourage the freer flow of healthcare data were delayed because of the COVID-19 pandemic. They are now scheduled to go into effect this year.

Perhaps no industry better straddles the dichotomy between cutting-edge technology and inefficient obsolete devices than the healthcare industry.

In one corner of a hospital, a physician in another room (or another state) can perform precision surgery using state-of-the-art robotics, while just down the hall a nurse receives the patient’s medical records via fax machine and the patient’s spouse uses a pen to fill out paperwork.

Those throwbacks exist for many reasons, but perhaps the most important is the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which requires providers and health plans to protect a patient’s health data. Say what you will about fax machines, but they are sturdily HIPAA-compliant.

But if government regulation to protect patient privacy is the root cause of the vestigial methods for transferring healthcare data, then new regulations might pull them into the 21st century.

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https://www.medscape.com/viewarticle/946100

CDC Chief Lays Out Attack Plan for COVID Variants

Marcia Frellick

February 18, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), on Wednesday walked through a multiagency attack plan for halting the spread of three COVID-19 variants.

As part of the Journal of the American Medical Association's (JAMA's) Q&A series with JAMA Editor-in-Chief Howard Bauchner, Walensky referenced the blueprint she coauthored with Anthony Fauci, MD, the nation's top infectious disease expert, and Henry T. Walke, MD, MPH, of the CDC, which was published on Wednesday in JAMA Network.

In the viewpoint article, they explain that the Department of Health and Human Services has established the SARS-CoV-2 Interagency Group to improve coordination among the CDC, the National Institutes of Health, the US Food and Drug Administration (FDA), the Biomedical Advanced Research and Development Authority, the US Department of Agriculture, and the US Department of Defense.

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https://www.healthcareitnews.com/news/experts-underestimated-ehrs-impact-burnout-after-hitech-act

Experts underestimated EHRs' impact on burnout after HITECH Act

With the benefit of hindsight, policy experts say the magnitude of the current burnout crisis was largely unforeseen when the law enabling the meaningful use program was passed in 2009.

By Kat Jercich

February 19, 2021 02:41 PM

A study published this week in the Journal of the American Medical Informatics Association found that policy experts underestimated the impact of widespread electronic health record use on clinician burnout at the time of the HITECH Act's passage in 2009.  

The retrospective look examined the discussions at the AMIA's 2009 Annual Health Policy Meeting, which focused on the unanticipated consequences that could occur with the large-scale, national implementation of health IT – especially EHRs – following the HITECH Act.  

That policy meeting included many fellows from the American College of Medical Informatics, which met in the winter of 2020 to discuss those 2009 predictions (among other issues).

"The collective opinion of the ACMI fellows participating in this session was that, while many consequences of the HITECH act were foreseen in 2009, the magnitude of the current burnout crisis largely was not," wrote the JAMIA paper authors.  

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https://www.healthcareitnews.com/news/using-natural-language-processing-unlock-sdoh-unstructured-ehr-data

Using natural language processing to unlock SDOH in unstructured EHR data

Social determinants of health can make a big difference in health outcomes. A physician expert in NLP highlights how the AI technology can unearth gold in EHRs.

By Bill Siwicki

February 19, 2021 01:26 PM

Medical care is estimated to account for only 10-20% of healthcare outcomes. As a result, healthcare executives who wish to deliver high-quality care have to consider other elements that impact patient health, including income, access to healthcare, racial discrimination, adequate medication and dietary intake.

These are social determinants of health. They offer a wealth of information about non-clinical factors that have an impact on a patient's wellbeing. But identifying a patient's SDOH can be challenging because details aren't always easily accessible, especially at the time when clinicians make key treatment decisions.

SDOH data often reside in EHRs, but are essentially trapped as unstructured text within clinical notes, patient-reported data, secure e-mail exchanges, patient portal messages and other places.

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https://www.healthcareitnews.com/news/how-north-dakotas-immunization-database-supporting-its-covid-19-vaccine-rollout

How North Dakota's immunization database is supporting its COVID-19 vaccine rollout

Good data management is essential to success in a major public health endeavor.

By Healthcare IT News

February 19, 2021 10:00 AM

With a small population distributed over a large geographical area, North Dakota doesn't lend itself to the easiest vaccine rollout. But the state has a secret weapon: a robust database called the North Dakota Immunization Information System (NDIIS). 

NDIIS manager Mary Woinarowicz joins host Jonah Comstock to talk about the early days of the COVID rollout, and how having a robust data management system has helped the state to make the most of its allocated COVID-19 vaccine doses. 

Talking points: 

  • The NDIIS and its pre-COVID function
  • How NDIIS is supporting the COVID-19 vaccine rollout
  • Logistical challenges to vaccine administration, especially in rural areas
  • How data analytics help smooth out the rollout
  • The challenges of launching a state-level response that’s part of a national rollout
  • How NDIIS has responded to strong vaccine demand
  • Patient-facing tools to improve the vaccine rollout
  • Additional challenges related to the second dose
  • The NDIIS’s Immunization Forecasting tool
  • The slip in non-COVID vaccination during the pandemic
  • What still lies ahead for COVID-19 vaccination
  • Should people who have had COVID get the vaccine?
  • How to decide which vaccine patients get which vaccine

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https://www.healthcareittoday.com/2021/02/19/patients-are-hooked-on-telehealth/

Patients Are Hooked On Telehealth

February 19, 2021

Anne Zieger

Prior to the onset of the pandemic, many consumers had little interest in using telehealth services. However, having done so throughout the COVID-19 crisis, many Americans seem to be hooked.

A new survey by Telehealth.com surveying 1,000 Americans ages 18 to 54 and older has concluded that while uptake of telehealth-based services was already growing prior to the pandemic, acceptance by consumers has shot up since COVID-19 forced providers to shift their practice largely to virtual visits. (Here’s a look at why I personally want to stick with telehealth to access my own care.)

According to the survey, 60% of Americans were aware of telehealth services prior to the rise of the coronavirus pandemic, while 30% percent said they weren’t aware. (Another 10% weren’t sure or didn’t answer.)

Of the 30% of those not previously aware of telehealth services, 48% said they became aware of virtual care since the start of the pandemic, while 38% still haven’t heard of them.

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https://www.healthleadersmedia.com/innovation/mayo-clinic-and-google-take-relationship-next-level-google-opens-rochester-office

Mayo Clinic and Google Take Relationship to Next Level; Google Opens Rochester Office

Analysis  |  By Mandy Roth  |   February 19, 2021

Collaboration to transform patient care has already resulted in enhanced radiotherapy delivery processes, development of an AI factory, and moving 10 million patient records to the cloud.


KEY TAKEAWAYS

·         Collaboration accelerates innovation and movement towards data-centric care delivery.

·         AI factory enables innovators to progress from an idea to a breakthrough more quickly.

·         AI and machine learning are expected to deliver insights to accelerate and deliver more personalized care, and improve the patient and clinician experience.

In a move that further cements the growing relationship between Mayo Clinic and Google, the Mountain View, California-based tech firm announced it is opening a permanent office in Mayo Clinic's hometown of Rochester, Minnesota.

Since forging a partnership in 2019, "We've been hard at work laying the technical groundwork for a lot of innovation, with security and privacy foundational to everything we do," said Cris Ross, MBA, chief information officer, Mayo Clinic, during a press briefing on Thursday. "Having this new space to facilitate our collaboration will really help us accelerate innovation and work towards a shared vision of a data-centric future, which we think can transform patient, care, and provider experiences and reduce the cost of care."

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https://ehrintelligence.com/news/mitigating-specialty-clinician-burnout-with-a-customizable-ehr

Mitigating Specialty Clinician Burnout with a Customizable EHR

With clinicians across different specialties encountering separate issues, a bespoke EHR can mitigate clinician burnout.

By Christopher Jason

February 17, 2021 - A bespoke EHR system optimized around a clinician-centered, specialty design can mitigate clinician burnout, according to a study published in JMIR Publications.

EHRs are one of the top clinician burnout drivers, and especially so among specialists who might need different EHR functions. The study authors said this difference should reflect in EHR implementation and optimization.

“Specialty-specific or bespoke EHR is a promising approach to overcoming the limitations of general-purpose EHR and mitigating physician burnout,” explained the study authors. “A bespoke EHR is an EHR custom designed to meet the unique needs of providers in a specific specialty or care setting. Bespoke EHR can prevent clinicians from spending a significant portion of their workday sifting through large amounts of clinical data for the specific data elements they need.”

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https://www.healthcaredive.com/news/don-rucker-reflects-on-highs-and-lows-of-tenure-as-onc-head-and-the-future/594880/

Don Rucker reflects on highs and lows of tenure as ONC head and the future of health IT

Rucker has been national coordinator since 2017, and in this exit interview looked back and forecast what industry might expect from the Biden administration.

Author Rebecca Pifer @RebeccaMPifer

Published Feb. 17, 2021

The U.S. healthcare industry is notoriously slow to change, a fact evident in the country's outdated and clunky IT system. Patients' health data is siloed in various provider and payer databases, making it often extremely difficult to access and control.

Modernizing this system is spearheaded on the the federal side by the Office of the National Coordinator for Health IT, an HHS agency that regulates the nation's health information technology framework. Since April 2017, ONC has been led by longtime medical informatician and emergency physician Don Rucker.

Rucker's tenure has been characterized by efforts to leverage data standards to free up market forces in healthcare, hopefully triggering greater transparency and lower prices for care. The apogee of this work were two HHS regulations released in March prohibiting information blocking and revamping how providers, payers and other health companies exchange data, with the goal of making it easier for patients to control their health information.

The rules, which HHS worked on for more than half a decade, are largely bipartisan, but threaten entrenched business models and have faced industry pushback as a result, along with deadline delays during COVID-19. Proponents agree they've laid the groundwork for a freer IT infrastructure, but there's still room for additional growth.

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https://www.forbes.com/sites/robertpearl/2021/02/16/how-ai-can-remedy-racial-disparities-in-healthcare/?sh=2f0c96b330f6

Feb 16, 2021,05:00am EST|1,242 views

How AI Can Remedy Racial Disparities In Healthcare

Robert Pearl, M.D.

The story of American medicine is one of incredible scientific advancements, from the use of penicillin to treat syphilis and other bacterial infections to the countless biomedical breakthroughs made possible by cell-line research. 

Too often, however, these stories ignore an uncomfortable truth: Some of our nation’s most significant medical discoveries were made possible through the mistreatment of Black patients—from the exploitation of African American farmers during the Tuskegee Syphilis Experiments to the tragic case of Henrietta Lacks, a black patient whose cells were stolen by doctors and used for decades of cell-line research.

Racism is woven into our nation’s medical past but is also part of our present, as evidenced by the Covid-19 crisis. From testing to treatment, Black and Latino patients have received a lower quality and quantity of care compared white Americans.

As a country, we now have the opportunity to reverse course. Rather than advancing medicine through racist actions, we can combat racism in medicine with the use of science and technology. Artificial intelligence and data-based algorithms can help address health disparities and break down the barriers to healthcare equity, like these:

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https://www.healthcareitnews.com/news/cta-intros-new-trustworthiness-standard-healthcare-ai

CTA intros new trustworthiness standard for healthcare AI

ANSI/CTA-2090 puts the focus on three must-haves, according to the Consumer Technology Organization: human trust, technical trust and regulatory trust.

By Mike Miliard

February 18, 2021 11:05 AM

The Consumer Technology Association on Wednesday unveiled a new ANSI-accredited standard that it says represents the "baseline to determine trustworthy AI solutions in health care."

WHY IT MATTERS
More than five dozen healthcare and technology organizations helped develop the consensus-driven standard, according to CTA, which says the aim is to identify "the core requirements and baseline for AI solutions in health care to be deemed as trustworthy," as artificial intelligence and machine learning become "pervasive" across healthcare.

"Additionally, it explores the impact of the trustworthiness of AI in health care through the lens of the end user (e.g., physician, consumer, professional and family caregiver, public health, medical societies, and regulators) and will identify the unique challenges and opportunities for AI in the health care sector," according to CTA.

Known as ANSI/CTA-2090, "The Use of Artificial Intelligence in Health Care: Trustworthiness" – considers what the association says are the three key areas relating to how trust is created and maintained across stakeholders.

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https://www.healthcareitnews.com/news/telehealth-used-less-disadvantaged-areas-health-affairs-study-finds

Telehealth used less in disadvantaged areas, Health Affairs study finds

Although weekly telemedicine visits shot up twenty-three-fold during the first few months of the COVID-19 pandemic, overall visit volume decreased by 35%.

By Kat Jercich

February 18, 2021 12:45 PM

A Health Affairs study found that telemedicine use during the COVID-19 pandemic was lower in communities with higher rates of poverty – suggesting that the industry must address the digital divide in order to ensure widespread access to virtual care.

The study, which was conducted by researchers from Harvard and the RAND Corporation, examined the variation in total outpatient visits and telemedicine use among 16.7 million commercially insured and Medicare Advantage enrollees from January through June 2020.  

"Although the increase in telemedicine use during the pandemic is widely recognized, it is unclear how the use of telemedicine and in-person care has varied across patient demographics, clinical specialties, and medical conditions," wrote the research team.  

During the COVID-19 period of the study, researchers found that 30.1% of total visits were provided via telemedicine – with a whopping twenty-three-fold increase in weekly number of telemedicine visits, compared to the pre-COVID-19 period.   

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https://www.healthleadersmedia.com/telehealth/covid-19-prods-employers-explore-virtual-directed-health-plans

COVID-19 Prods Employers to Explore Virtual-Directed Health Plans

Analysis  |  By John Commins  |   February 18, 2021

The rapid rise of telehealth has led a growing number of employers to explore a virtual-directed health plan model with an online primary care platform.

The nation's employers are increasingly adding coverage for virtual and mental healthcare benefits in their employee insurance plans, Aon plc says.

The move is largely a response to the tremendous increase in virtual care visits during the coronavirus public health emergency, according to Aon's new report released Thursday.

That shift in consumer behavior has led 36% of employers to say they are interested in exploring a virtual-directed health plan model with an online primary care platform that directs all care, including coordination with traditional health providers.

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https://www.healthleadersmedia.com/telehealth/3-actions-health-systems-should-take-now-bolster-telehealth

3 Actions Health Systems Should Take Now to Bolster Telehealth

Analysis  |  By Mandy Roth  |   February 16, 2021

In the rush to quickly deploy virtual care programs during the pandemic, basic processes were sometimes overlooked. Experts say now is the time to take corrective action to ensure long-term success.


KEY TAKEAWAYS

·         Health systems should revisit telehealth training and education for physicians and consumers.

·         To position telehealth for long-term success, it's essential to determine how virtual care fits into the overall care delivery model.

·         It is paramount to build consumer trust, particularly as concerns about privacy and data breeches are growing.

In the quest to roll out telehealth initiatives to meet the needs of patients during the pandemic, many health systems rapidly launched solutions. There is nearly universal agreement that 2020 catapulted virtual care several years beyond strategic timelines.

While many health systems are looking into the future to determine how to continue acceleration of virtual care, experts say it is also essential to hit the pause button. To ensure long-term success, organizations should assess whether they are delivering the best experience, determine how telehealth fits into the overall care delivery model, and examine the role trust plays in their endeavors.

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https://ehrintelligence.com/news/175-covid-19-vaccination-sites-tap-cerner-ehr-solution

175 COVID-19 Vaccination Sites Tap Cerner EHR Solution

EHR vendor Cerner said its solution streamlines the COVID-19 vaccination process by helping its users identify, register, and vaccinate patients across the country.

By Christopher Jason

February 16, 2021 - Cerner has announced 175 COVID-19 vaccination sites have leveraged its Mass Vaccination EHR solution to help clinicians identify, register, and vaccinate patients.

When COVID-19 began to spread in early 2020, the EHR vendor reached out to its customers across the country to ensure they had the necessary health IT to prepare for a large-scale COVID-19 vaccination effort.

Since many hospitals and health systems worked together to deploy the vaccination at community-based locations, Cerner leaders knew these vaccination sites would need a patient-first strategy that could work outside of each users’ EHR platform.

The EHR vendor compiled a list of various recommendations for its clients to utilize its health IT to boost billing, clinician administration best practices, patient outreach, scheduling opportunities, and both reporting and analytics following each vaccination.

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https://ehrintelligence.com/news/health-experts-misjudged-ehr-clinician-burnout-at-hitech-act-passage

Health Experts Misjudged EHR Clinician Burnout at HITECH Act Passage

Clinicians and healthcare experts did not fully grasp the high potential of EHR clinician burnout at the time of the HITECH Act passing in 2009.

By Christopher Jason

February 17, 2021 - Following the passage of the HITECH Act in 2009 and the subsequent increase in EHR adoption, clinicians and healthcare experts significantly underestimated the degree of clinician burnout and its contributing factors, according to a study published in the Journal of the American Medical Informatics Association (JAMIA).

On the contrary, healthcare professionals overestimated the concern over patient privacy and fraud.

After the HITECH Act passed, clinician burnout has run rampant across the country amidst poor EHR usability, unintuitive EHR design, and high clinician workload.

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https://www.newyorker.com/tech/annals-of-technology/who-should-stop-unethical-ai

Who Should Stop Unethical A.I.?

At artificial-intelligence conferences, researchers are increasingly alarmed by what they see.

By Matthew Hutson

February 15, 2021

In computer science, the main outlets for peer-reviewed research are not journals but conferences, where accepted papers are presented in the form of talks or posters. In June, 2019, at a large artificial-intelligence conference in Long Beach, California, called Computer Vision and Pattern Recognition, I stopped to look at a poster for a project called Speech2Face. Using machine learning, researchers had developed an algorithm that generated images of faces from recordings of speech. A neat idea, I thought, but one with unimpressive results: at best, the faces matched the speakers’ sex, age, and ethnicity—attributes that a casual listener might guess. That December, I saw a similar poster at another large A.I. conference, Neural Information Processing Systems (NeurIPS), in Vancouver, Canada. I didn’t pay it much mind, either.

Not long after, though, the research blew up on Twitter. ​“What is this hot garbage, #NeurIPS2019?” Alex Hanna, a trans woman and sociologist at Google who studies A.I. ethics, tweeted. “Computer scientists and machine learning people, please stop this awful transphobic shit.” Hanna objected to the way the research sought to tie identity to biology; a sprawling debate ensued. Some tweeters suggested that there could be useful applications for the software, such as helping to identify criminals. Others argued, incorrectly, that a voice revealed nothing about its speaker’s appearance. Some made jokes (“One fact that this should never have been approved: Rick Astley. There’s no way in hell that their [system] would have predicted his voice out of that head at the time”) or questioned whether the term “transphobic” was a fair characterization of the research. A number of people said that they were unsure of what exactly was wrong with the work. As Hanna argued that voice-to-face prediction was a line of research that “shouldn’t exist,” others asked whether science could or should be stopped. “It would be disappointing if we couldn’t investigate correlations—if done ethically,” one researcher wrote. “Difficult, yes. Impossible, why?”

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https://www.lexology.com/library/detail.aspx?g=0471d58c-7ec0-4214-953a-4173b4482c3e

Privacy in a Pandemic - the Conundrum of COVID-19 Check-in Solutions

FTI Consulting Asia Pacific  - V. Scott Foster Tim de SousaChristopher Hatfield and Min Cai

Australia February 16 2021

In the early days of the COVID-19 pandemic, when we were all grappling with the avalanche of concepts like ‘social distancing’ and ‘personal protective equipment’, the idea of contact tracing had many scratching their heads. In the age of automation, a manual process involving a team of people making calls and conducting interviews to find those exposed to the virus can seem almost counter-intuitive. Perhaps this is part of why, in 2020, we saw a dedicated push to find digital solutions to the challenges of COVID-19. This has included digital contact tracing solutions such as the Australian Government’s COVIDsafe app. However, the adoption of visitor registers that record which individuals have visited specific locations, and their contact details, have been far more helpful to contact tracers.

After the initial lockdowns, in an effort to get businesses like retailers, bars and restaurants back to work, a flurry of digital check-in solutions emerged to help businesses comply with contact tracing requirements. These systems provide QR codes, enable customers to sign in, maintain records and, if needed, disclose personal information to contact tracers. Many also request consent for direct marketing, either as an option or by bundled consent (that is, the customer must agree to receive marketing or they can’t check in). In some states, such as New South Wales (NSW), electronic check-in services are now mandatory.

But what about privacy? A recent study conducted by the Consumer Policy Research Centre found that 94 per cent of Australians are concerned about how their personal data is shared online. Can users trust the cavalcade of new app providers? Are these providers regulated? What happens to the data? Does keeping each other safe mean giving up our right to privacy – to not be tracked unnecessarily or receive unwanted marketing? And how do organisations that are using check-in apps manage the risks created by this new genre of service providers?

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https://www.forbes.com/sites/jenniferhicks/2021/02/14/how-hardware-data-and-artificial-intelligence-are-changing-diabetes-care/?sh=6336012e1a77

Feb 14, 2021,03:06pm EST|2,229 views

How Hardware, Data And Artificial Intelligence Are Changing Diabetes Care

Jennifer Kite-Powell Consumer Tech

According to Søren Smed Østergaard, Vice President, Digital Health of Novo Nordisk, the most significant innovations in the diabetes space centered around hardware, artificial intelligence (AI) and data. He believes that having access to more accurate data on individual behavior and medication usage could positively impact people living with diabetes.

"We know there is a huge discrepancy between how people should use medication and how they're using it," said Østergaard. "In 2003, the World Health Organisation (WHO) said improving medication adherence will have a more significant impact on the population's health than improvements to specific medical treatments.

"With new digital health devices, we will be able to get accurate data on how people are taking their medication," added Østergaard.

"Healthcare data today is often incomplete and too sparse to use for effective decision-making; we need to solve that first, but with this comes a plethora of ethical implications," said Østergaard. "People must have confidence that their data is being kept secure and used responsibly. Data sharing – creating a complete picture using data from different parties and devices – has the potential to revolutionize healthcare and outcomes, but robust data privacy policies must underpin it.

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https://www.beckershospitalreview.com/public-health/who-to-develop-agreed-clinical-description-for-long-covid-19-diagnosis.html

WHO to develop 'agreed clinical description' for long COVID-19 diagnosis

Erica Carbajal - Print  | Email

The World Health Organization is working to establish a clinical description for the lingering symptoms, known as long-COVID, some people experience months after being cleared of their initial COVID-19 illness, CNBC reported Feb. 13. 

WHO recently held a global meeting that involved "patients, clinicians and other stakeholders" to gain a clearer picture of long-COVID, Tedros Adhanom Ghebreyesus, PhD, the organization's director-general, said during a Feb. 12 news conference. 

The global meeting was the first in a series of upcoming meetings which will focus on "working towards an agreed clinical description of the condition," Dr. Tedros said. WHO also released a case reporting form meant to standardize data collection on post-COVID, he added. 

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https://www.healthcareitnews.com/news/cybersecurity-pandemic-year-one-cisos-perspective

Cybersecurity in a pandemic year: One CISO's perspective

Christiana Care Chief Information Security Officer Anahi Santiago says she's drawn some lasting lessons from the hectic past 12 months, which offered a powerful reminder that "the human component is integral to the success of information security."

Bill Siwicki

February 17, 2021

In a recent Healthcare IT News feature story, health IT leaders talked about some of the lessons they've learned from a very busy and tumultuous year – and how they're applying those lessons for 2021 and beyond.

Among the many lessons they described – many having spent 2020 waging a two-front battle against the COVID-19 pandemic itself and a related cyber pandemic – was the need for a renewed focus on cybersecurity.

We recently spoke with a prominent chief information security officer to get some of her takeaways from the busy past year – a time when telehealth was scaled up at rapid pace, whole workforces went remote and ransomware ran rampant – and asked how she's applying those lessons today and beyond.

Here's what Anahi Santiago, CISO at Wilmington, Delaware-based ChristianaCare, had to say.

Q. What is a cybersecurity lesson you have learned during the past year, which was so disruptive for the healthcare industry?

A. Even in the face of elevated threats, information security teams have risen to exceptional levels to support their organizations. The speed at which our team had to move to support virtual care and pandemic-related activities while meeting pre-pandemic operational demands demonstrated agility and commitment to the mission. It also enabled us to assert our position as a true partner to our business and clinicians.

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https://www.healthcareittoday.com/2021/02/17/more-healthcare-data-means-growth-for-switch/

More Healthcare Data Means Growth for Switch

February 17, 2021

Colin Hung

Healthcare applications are increasing in complexity. Health data continues to grow exponentially. To avoid being drowned in this technology deluge, healthcare providers and health IT vendors are turning to 3rd party infrastructure providers for their systems + data needs.

IDC predicted that healthcare data would grow 11,000% from an estimated 153 exabytes of data (153,000,000 terabytes) in 2013 to over 2,314 exabytes in 2020. They also predicted that by 2025 healthcare would be the fastest growing source of data worldwide. The healthcare industry currently generates 30% of the world’s data volume.

With this expected growth, it is no surprise that data center providers are putting more focus on healthcare. Switch, a data center and technology solution provider based out of Las Vegas, Nevada is one of the companies placing a big bet on healthcare.

Healthcare IT Today sat down with Dr. Quinn Pauly, Chief Medical Officer at Switch to talk about the need for better technology infrastructure in healthcare and why the company chose to have a CMO.

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https://www.healthcareittoday.com/2021/02/17/health-systems-come-together-en-masse-to-gather-health-insights-from-anonymized-patient-data/

Health Systems Come Together En Masse to Gather Health Insights from Anonymized Patient Data

February 17, 2021

Anne Zieger

Demonstrating once again that for health systems, it’s the data, stupid, fourteen US health systems have come together to sell anonymized versions of the vast stores of patient information they collect and maintain.

The group, which is led by the Providence system, also includes AdventHealth, Advocate Aurora Health, Baptist Health of Northeast Florida, Bon Secours Mercy Health, CommonSpirit Health,  Hawaii Pacific Health, Henry Ford Health System, Northwell Health, Novant Health, Sentara Healthcare, Tenet Health and Trinity Health.

The health system partners will structure, normalize and de-identify their data using a new platform leveraging AI and machine learning technology. (The group doesn’t identify a technology vendor in its announcement, so it’s likely that the platform will be proprietary.)

To sell the data, the systems have formed a new venture, dubbed Truveta, which according to a Bloomberg article will bring together records representing roughly 13% of all US hospitals.  If this stat is anywhere near correct, it represents that kind of volume that could truly be a game-changer for the industry. The group says the sheer scale of its efforts is one of its key benefits, as its combined population – which cuts across 40 states – will better represent diverse populations than other data-sharing efforts.

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https://www.healthleadersmedia.com/covid-19/linkedin-unveils-vaccine-distribution-features

LinkedIn Unveils Vaccine Distribution Features

Analysis  |  By Jack O'Brien  |   February 17, 2021

LinkedIn's effort to help the troubled rollout of the COVID-19 vaccines comes shortly after the Biden administration announced that it had secured another 200 million doses.

LinkedIn announced Wednesday morning that the company is now using its platform to connect vaccination volunteers with "paid support opportunities" in an effort to mitigate the damage of the ongoing COVID-19 pandemic.

The San Francisco-based technology stated that its rollout will follow a two-pronged approach as healthcare organizations, pharmacies, and government agencies that support vaccine distribution can post jobs for free through May 15.

Some healthcare roles that can be posted for free: 

  • Registered nurses
  • Nurse managers
  • Patient service specialists
  • Medical assistants
  • Health services managers
  • MAs 
  • LPNs
  • Urgent care techs
  • Patient access representatives
  • Pharmacy technicians
  • Certified nursing assistants

LinkedIn stated that the most in-demand jobs for vaccine administrators are pharmacists, registered nurses, vaccine support staff, and medical assistants.

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https://hitinfrastructure.com/news/humana-taps-ibm-watsons-ai-solution-to-improve-member-care

Humana Taps IBM Watson’s AI Solution to Improve Member Care

An artificial intelligence-enabled virtual agent from IBM Watson will provide Humana Employer Group members with accurate information about benefits and costs.

By Samantha McGrail

February 16, 2021 - Humana recently tapped IBM Watson’s artificial intelligence (AI) solution to provide its members with an improved member experience and greater transparency around overall benefits.

Under the agreement, Humana will deploy IBM Watson Assistant for Health Benefits, an AI-enabled virtual assistant built in the IBM Watson Health cloud. 

The IBM Watson Assistant for Health Benefits solution is designed to uncover the logic of health plan eligibility and include it in the member conversation, an IBM Watson spokesperson explained.  

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https://hitinfrastructure.com/news/fda-approves-clew-medicals-artificial-intelligence-icu-solution

FDA Approves CLEW Medical’s Artificial Intelligence ICU Solution

The artificial intelligence ICU solution monitors and categorizes patient risk levels, helping providers identify patients whose health conditions are likely to deteriorate.

By Samantha McGrail

February 09, 2021 - CLEW Medical recently announced that FDA granted clearance and authorization for the use of its artificial intelligence-based ICU solution, used to predict hemodynamic instability in adult patients. 

The solution, CLEWICU, continuously monitors and categorizes patient risk levels. This information provides clinicians with physiological insight into a patient’s likelihood of future hemodynamic instability. 

The clearance follows FDA's emergency use authorization for CLEWICU's respiratory deterioration model granted in June 2020. The solution has been used for the predictive screening of COVID-19 and other ICU patients.

“We are proud to have received this landmark FDA clearance and deliver a first-of-its-kind product for the industry, giving healthcare providers the critical data that they need to prevent life-threatening situations,” Gal Salomon, CLEW CEO, said in the announcement. 

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https://healthitsecurity.com/news/cdt-ehi-share-proposed-consumer-health-data-privacy-framework

CDT, eHI Share Proposed Consumer Health Data Privacy Framework

The proposed consumer health data privacy framework from eHI and CDT builds on a previous release and is designed to protect health information not covered under HIPAA regulations.

By Jessica Davis

February 12, 2021 - The Center for Democracy & Technology and the eHealth Initiative & Foundation (eHI) released a newly proposed consumer health data privacy framework, which aims to better secure the privacy of health information that falls outside of HIPAA regulations.

The guidance outlines much-needed standards for the collection, disclosure, and use of consumer health data that falls outside of HIPAA. As previously explained by the Department of Health and Human Services, HIPAA does not apply to apps that aren't directly connected to or recommended by providers for use of data sharing, health outcomes, and the like.

Developed with support from the Robert Wood Johnson Foundation, the proposed guidance builds on an earlier release and is meant to address the increasing concerns around underprotected health data in lieu of federal privacy legislation.

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https://www.healthcareitnews.com/news/cerner-ai-expert-discusses-important-misconceptions-about-technology

Cerner AI expert discusses important 'misconceptions' about the technology

Dr. Tanuj Gupta, vice president at Cerner Intelligence, talks gender and racial algorithm bias, whether AI could replace clinicians, and how machine learning should be regulated.

By Bill Siwicki

February 16, 2021 12:24 PM

Dr. Tanuj Gupta, vice president at Cerner Intelligence, is an expert in healthcare artificial intelligence and machine learning. Part of his job is explaining, from his expert point of view, what he considers misconceptions with AI, especially misconceptions in healthcare.

In this interview with Healthcare IT News, Gupta discusses what he says are popular misconceptions with gender and racial bias in algorithms, AI replacing clinicians, and the regulation of AI in healthcare.

Q. In general terms, why do you think there are misconceptions about AI in healthcare, and why do they persist?

A. I've given more than 100 presentations on AI and ML in the past year. There's no doubt these technologies are hot topics in healthcare that usher in great hope for the advancement of our industry. 

While they have the potential to transform patient care, quality and outcomes, there also are concerns about the negative impact this technology could have on human interaction, as well as the burden they could place on clinicians and health systems.

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https://www.healthcareitnews.com/news/new-wearable-patch-can-monitor-blood-pressure-caffeine-levels

New wearable patch can monitor blood pressure, caffeine levels

The device is said to be the first that can track cardiovascular signals and multiple biochemical levels in the body at the same time.

By Kat Jercich

February 16, 2021 03:50 PM

University of California San Diego engineers have developed a skin patch that can be worn on the neck to track blood pressure and heart rate while monitoring the user's glucose, lactate, alcohol or caffeine levels.  

"Intertwined with concepts of telehealth, the Internet of medical things, and precision medicine, wearable sensors offer features to actively and remotely monitor physiological parameters," wrote the research team in a study published in Nature Biomedical Engineering this week.  

"Wearable sensors can generate data continuously, without causing any discomfort or interruptions to daily activity, thus enhancing the self-monitoring compliance of the wearer and improving the quality of patient care," they continued.  

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https://www.healthcareittoday.com/2021/02/16/allow-lists-and-aligned-communications-why-cios-cant-turn-a-blind-eye-to-companies-that-want-to-send-all-emails-without-security/

Allow Lists and Aligned Communications – Why CIOs Can’t Turn a Blind Eye to Companies That Want to Send All Emails Without Security

February 16, 2021

Mitch Parker, CISO

One of the calls that a CISO hates getting is the one from a customer who just received documentation from a vendor they have contracted to allow all of their emails coming from a certain domain through to an allow list so they don’t end up in the spam folder.  The reason why we dislike these calls is because we have invested significantly in adding protection.  This is because a significant amount of the Phishing, Business Email Compromise, and Malware emails come from computers that don’t have email security controls or are set to bypass them.

Asking us to remove protection for a domain is asking us to give an avenue to allow phishing emails in from it that put the entire network at risk.  Many of us discuss disciplining team members who click on the links in phishing email tests.  However we don’t hold the team members who bring in third parties to send bulk messages to the workforce that bypass security controls accountable.  These messages often have links to click in them that go to web sites that are indistinguishable from real phishing sites.  This is an incongruence we have to also address.

Any message that comes from these allowed domains instantly bypasses security controls, even if they come from a malicious source.

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https://www.healthleadersmedia.com/technology/cyber-security-report-finds-30-popular-mobile-health-apps-are-vulnerable-api-attack

Cyber-Security Report Finds 30 Popular Mobile Health Apps are Vulnerable to API Attack

Analysis  |  By Scott Mace  |   February 15, 2021

Patient records, including x-rays, pathology reports, and full PHI are vulnerable to these attacks.

Each of 30 popular mobile health applications are vulnerable to attacks via their application program interfaces (APIs), according to findings released last week by a security hacker and author, working with a threat protection technology company.

The study, All That We Let In, raises concerns that increasing reliance on mobile health apps during the pandemic is drawing threat actors to mobile health applications as their preferred attack surface.

The attacks described can permit unauthorized access to full patient records, including protected health information (PHI) and personally identifiable information.

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https://healthitanalytics.com/news/real-time-data-dashboard-tracks-quantity-of-vaccines-administered

Real-Time Data Dashboard Tracks Quantity of Vaccines Administered

The real-time data dashboard tracks and updates the number of COVID-19 vaccines administered at the region, state, and country levels.

By Jessica Kent

February 12, 2021 - The University of Alabama at Birmingham (UAB) and PathCheck Foundation have developed an interactive, real-time data dashboard to track the quantity of COVID-19 vaccines administered in the US and around the world.

The vaccination dashboard is maintained using completely anonymous data collected from more than 60 governmental agencies and other publicly available data sources. The dashboard tracks and updates the quantity of vaccines administered on a state level, as well as on an international level.

The dashboard also breaks down the quantity of specific brands of vaccines administered, inoculated population percentages, and data broken down into first- and second-dose categories.

“As we shift from focusing on the spread of COVID-19 to balancing the return of our lives to normal, vaccinations are one of the key components. The vaccination dashboard provides information to everyone, regardless of who you are or where you live,” said Sue Feldman, PhD, professor and director of graduate programs in health informatics in UAB’s School of Health Professions.

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https://mhealthintelligence.com/news/nasas-new-mhealth-program-tracks-employee-health-through-wearables

NASA’s New mHealth Program Tracks Employee Health Through Wearables

NASA is partnering with Fitbit on a new program aimed at monitoring the health of 1,000 employees - including 150 astronauts - with mHealth wearables and a telehealth platform.

By Eric Wicklund

February 12, 2021 - NASA is launching an mHealth program to help its employees – including astronauts – identify and treat illnesses like COVID-19 as quickly as possible.

The organization is giving 1,000 employees at six locations across the country Fitbit Charge 4 wearables and access to a corresponding telehealth platform. In the pilot program, those employees will log their temperature and other health metrics and access resources that include identifying COVID-19 symptoms.

With evidence growing that mHealth wearables can spot early biometric signs of viruses like COVID-19, health systems, businesses, schools, police, fire and EMS companies and other organizations are using connected care platforms to monitor employees and staff in a bid to curb outbreaks.

Projects like these also have long-term implications. While most are being tested on COVID-19 now, telehealth advocates see a day when these types of platforms can be used to spot any irregular health trend, or to identify warning signs – either internally or externally – for people with chronic conditions or other health concerns.

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https://www.healthcareitnews.com/news/mit-researchers-use-ai-find-drugs-could-be-repurposed-covid-19

MIT researchers use AI to find drugs that could be repurposed for COVID-19

The research team noted that lung tissue gets stiffer as a person gets older, showing different patterns of gene expression than in younger people.

By Kat Jercich

February 15, 2021 12:07 PM

The Massachusetts Institute of Technology announced this week that researchers had used machine learning to identify medications that may be repurposed to fight COVID-19.  

"Making new drugs takes forever," Caroline Uhler, a computational biologist in MIT's Department of Electrical Engineering and Computer Science and the Institute for Data, Systems and Society, said in a press statement. "Really, the only expedient option is to repurpose existing drugs."  

The research from Uhler's team, which appears in the journal Nature Communications, notes that the novel coronavirus tends to have much more severe effects in older patients.  

"Since the mechanical properties of the lung tissue change with aging, this led us to hypothesize an interplay between viral infection/replication and tissue aging," wrote the researchers.  

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https://www.healthcareitnews.com/news/ecri-ehr-association-put-forth-safety-practices-behavioral-health-it

ECRI, EHR Association put forth safety practices for behavioral health IT

Their five recommendations and strategies for integration with primary care focus on new approaches to patient screening, clinical documentation and data sharing.

By Mike Miliard

February 15, 2021 11:25 AM

ECRI's Partnership for Health IT Patient Safety is working with the HIMSS Electronic Health Record Association to chart some of the common challenges involved in integrating behavioral health systems with primary care EHRs.

WHY IT MATTERS
In a recent white paper, Optimizing Health IT for Safe Integration of Behavioral Health and Primary Care, the two groups outline some recommendations to help support and improve such IT integrations.

Among the EHR challenges explored in the report, ECRI and EHRA focus on use of consistent terminology standards for documentation; incorporation and integration of screening tools; segregation of behavioral health records from other medical records (due, for instance, to regulatory requirements or privacy considerations); and barriers to information sharing between primary care and behavioral health providers.

A joint ECRI-EHRA workgroup developed five recommendations – with practical strategies for achieving them – focused across three areas: screening, documentation and information sharing.

  • Ensure integration and easy accessibility of validated and clinically accepted behavioral health screening tools in the EHR 
  • Enable decision support triggers associated with those screening tools to link behavioral health and primary care 
  • Optimize clinical documentation for behavioral health and primary care integration
  • Enable easier data sharing across care settings, via patient portals, secure messaging and HIEs 
  • Enable EHRs to segment patient data consistent with organizational policies, patient requests and state and federal laws and regulations

"While technology cannot solve every issue, its development and implementation has the potential to better facilitate the integration of behavioral health and primary care," said workgroup co-chair Patricia Giuffrida, RN, senior patient safety and health IT safety analyst at ECRI, in a statement.

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https://www.healthcareitnews.com/news/epic-cerner-offer-updates-covid-19-vaccine-rollout-efforts

Epic, Cerner offer updates on COVID-19 vaccine rollout efforts

The electronic health record giants began preparing their systems to assist with COVID-19 vaccination efforts this past year.

By Kat Jercich

February 15, 2021 02:44 PM

Cerner and Epic each announced this past week that they've hit milestones in their efforts to assist with COVID-19 vaccinations.  

On Friday, Cerner announced that 175 clients across 11 countries had installed its Mass Vaccination solution.  

Epic, meanwhile, said on Thursday that it was supporting 100 community-based vaccination locations across the country, with the capacity to administer 300,000 shots a day.  

"We are proud to help the health systems supporting the national goal of vaccinating 100 million Americans in the [Biden] administration's first 100 days," said Judy Faulkner, founder and CEO of Epic, in a statement.   

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https://www.healthcareittoday.com/2021/02/15/healthcare-security-success-requires-engagement-and-mutual-understanding-of-risk-tolerance/

Healthcare Security Success Requires Engagement and Mutual Understanding of Risk Tolerance

February 15, 2021

John Lynn

We all know that security attacks are at an all-time high. While there was some talk of hackers giving healthcare a break amidst COVID, it’s clear that hackers are calling fair game on healthcare institutions now whether they took a slight break or not.  Is your healthcare organization ready for these attacks?

The unique security challenges healthcare organizations face was highlighted really well on a recent CIO and CISO roundtable with a wide variety of healthcare organizations we hosted with Dell Technologies and VMware.  Whether it’s the need to share data in healthcare that’s opened us to new vulnerabilities, or the explosion of new endpoints being used by patients and staff, there’s an important learning curve healthcare’s going through to securely allow for these new modes of providing care.

Plus, it was aptly pointed out that healthcare clinicians largely got into healthcare because they want to help people.  When a phishing email gets sent to a nurse or doctor, their natural instinct is to want to “help” by clicking on that link.  Needless to say, securing a healthcare organization is a challenge.

Everyone in the roundtable agreed that you can’t create a completely fail-safe environment.  In fact, one CISO suggested that you kind of have to choose the punches you are going to take since you can’t block everything.  In fact, he took it one step further and offered a great framework for discussing and building a mutual understanding of risk tolerance when it comes to your security efforts.

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https://histalk2.com/2021/02/12/weekender-2-12-21/

Weekly News Recap

  • Fourteen large health systems form Truveta to provide anonymized patient data for research.
  • Value-based care coordination and payments vendor Signify Health prices its IPO at a valuation of $5.3 billion.
  • Cerner meets Q4 earnings expectations, beats on revenue.
  • CPSI misses Wall Street’s expectations for both revenue and earnings.
  • HHS OCR enters its 15th settlement involving providers that failed to provide patients with timely copies of their medical records.
  • Nuance acquires Saykara.
  • A security researcher finds problems with 30 popular health apps and their APIs.
  • Duke spinout Clinetic, which monitors EHR activity to identify patients for clinical trials and next care steps, raises $6.4 million in equity.

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Enjoy!

David.

 

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