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, September 25, 2021

Weekly Overseas Health IT Links – 25 September, 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/2021/09/patients-wait-longer-for-care-under-integrated-care-systems-analysis-finds/

Patients wait longer for care under integrated care systems, analysis finds

An analysis of integrated care systems has revealed patients waited longer than the national average for treatment under flagship plans to join up health and care.

Andrea Downey – Sep 10, 2021

The Centre for Policy Studies (CPS) looked at the performance of 13 pilot integration areas in England finding that delayed transfers of care increased by an average of 24% between 2016 and 2020.

The figure for the rest of England in the same time period was just 9%.

The think tank has warned the evidence base for Integrated care Systems (ICS) was “alarmingly thin” and called upon the government to scrap plans for them to become law until the is a more “robust” evidence base.

The upcoming Health and Care Bill will see Integrated Care Systems (ICS) enshrined in law, splitting the NHS into 42 ICSs in a bid to drive collaboration and more joined up care.

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https://www.beckershospitalreview.com/ehrs/stanford-medicine-develops-physician-consult-platform-that-mines-1m-ehrs.html

Stanford Medicine develops physician consult platform that mines 1M+ EHRs

Hannah Mitchell – 16 September,

Researchers from Stanford (Calif.) Medicine developed a new type of medical consult that uses millions of EHRs to bring insights to physicians.

Five study insights:

  1. The Clinical Informatics Consult Service is a platform for physicians looking for more information on illnesses that are hard to treat and diagnose, according to a Sept. 15 news release on the study. Physicians can use the platform to look at millions of deidentified cases for data that may help with treating their patients.
  2. The study detailed the results of the first 100 consults, which were conducted in 2017 and 2018.
  3. "Medicine has been dreaming about doing this for 50 years,'' said Nigam Shah, PhD, associate CIO for data science at Stanford Healthcare and professor of medicine and biomedical data sciences at Stanford University, who led the study.

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https://patientengagementhit.com/news/parents-viewing-teens-patient-portals-spur-talk-of-proxy-accounts

Parents Viewing Teens’ Patient Portals Spur Talk of Proxy Accounts

More than half of patient portals belonging to teens get seen by parents or guardians, prompting researchers to emphasize education about proxy accounts.

By Sara Heath

September 17, 2021 - More than half of adolescent patient portal accounts allow guardian proxy access, according to data published in JAMA Network Open, something the researchers said should be a consideration as organizations outline adolescent patient portal privacy items.

Managing the patient portal for a teenaged patient can be a challenging area for healthcare organizations. On the one hand, the teenager is technically still a child with a parent or legal guardian acting as that child’s healthcare proxy. With that logic, the parent or guardian can take a look at the patient’s medical records within the patient portal.

But teens are also quickly approaching adulthood, developing their own personal autonomy and responsibility while beginning to encounter more personal health matters. Having their parents or guardians review their patient portals could be a breach of that autonomy and, in some cases, discourage patients from disclosing sensitive health matters, like sexual activity.

“In many health systems, adolescents are permitted separate access to their electronic health record through an online patient portal,” the researchers said, outlining a common solution used across the country.

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https://www.healthcareitnews.com/news/majority-teen-patient-portals-accessed-guardians-raising-privacy-concerns

Majority of teen patient portals accessed by guardians, raising privacy concerns

In a new JAMA study, researchers found that parents and guardians may be using their adolescents' personal health records to communicate with clinicians, leading to questions about confidentiality.

By Kat Jercich

September 17, 2021 04:05 PM

A study published this week in the Journal of the American Medical Association Network Open found that more than half of adolescent patient portal accounts with outbound messages were accessed by guardians.  

The findings, say the researchers, could be useful in guiding health system approaches to protecting confidentiality with regard to patient portals.  

"Confidential communication is necessary for many adolescents to feel comfortable seeking care for sensitive health needs," read the study.  

"Although further studies with more data and control for confounders are warranted, our preliminary observation raises questions whether adolescents may be less willing to share sensitive health topics via the portal when aware that their guardians have access to their portal accounts," it continued.  

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https://ehrintelligence.com/news/directtrust-launches-consensus-body-for-sdoh-data-exchange-interoperability

DirectTrust Launches Consensus Body for SDOH Data Exchange Interoperability

DirectTrust has announced the launch of a consensus body to advance social determinants of health (SDOH) data exchange interoperability.

By Hannah Nelson

September 16, 2021 - DirectTrust has announced the launch of the Information Exchange for Human Services (IX4HS) Consensus Body to support social determinants of health (SDOH) data exchange interoperability.

The consensus body will evaluate the Direct Standard and other existing standards for SDOH data exchange between healthcare settings and human service organizations, creating new standards as needed.

Healthcare organizations are increasingly recognizing the value of SDOH data exchange to support care for populations served by human services providers such as state Medicaid programs, federally qualified health centers, and accountable care organizations.

Greater interoperability between healthcare organizations and human services providers is expected to streamline referrals, information exchange and requests, and care coordination, DirectTrust officials said.

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https://mhealthintelligence.com/news/mhealth-wearables-detect-pandemic-related-stress-in-healthcare-workers

mHealth Wearables Detect Pandemic-Related Stress in Healthcare Workers

Researchers using mHealth wearables to measure healthcare workers’ physiological responses found that a lack of resilience and emotional support increases stress.

By Victoria Bailey

September 16, 2021 - Mount Sinai researchers used wearable devices to monitor physiological effects in healthcare workers during the COVID-19 pandemic and found that high resilience and emotional support are linked to a reduced risk of stress.

The study focused on 361 healthcare workers across seven hospitals in the New York City health system and leveraged a customized mHealth application along with the wearables.

Participants used the app to complete weekly surveys that gauged perceived stress, emotional support, optimism, quality of life, and resilience, which was defined as “the ability to overcome difficulty and a reduced vulnerability to environmental stressors.” The healthcare workers also wore an Apple Watch that measured their heart rate variability, a physiological marker of stress.

Researchers found that participants who reported high levels of resilience, optimism, and emotional support were less likely to experience perceived and longitudinal stress. 

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https://mhealthintelligence.com/news/ftc-emphasizes-security-standards-for-mhealth-apps-devices

FTC Emphasizes Security Standards for mHealth Apps, Devices

The Federal Trade Commission has issued a policy statement re-emphasizing that mHealth apps and devices must conform with the Health Breach Notification Rule.

By Eric Wicklund

September 16, 2021 - The federal government is strengthening efforts to ensure than mHealth apps and connected devices protect personal health information.

The Federal Trade Commission this week issued a policy statement affirming that connected health tools that collect or use consumer health information must comply with the Health Breach Notification Rule, which sets guidelines for notifying consumers and other groups when a platform is breached and data is accessed.

The policy covers and ever-growing market of mHealth apps and devices, not all of which are covered by the Health Insurance Portability and Accountability Act (HIPAA). It ensures that mHealth tools falling outside HIPAA’s purview still face accountability for data breaches.

“While this Rule imposes some measure of accountability on tech firms that abuse our personal information, a more fundamental problem is the commodification of sensitive health information, where companies can use this data to feed behavioral ads or power user analytics,” FTC Chair Lina M. Khan said in a press release. “Given the growing prevalence of surveillance-based advertising, the Commission should be scrutinizing what data is being collected in the first place and whether particular types of business models create incentives that necessarily place users at risk.”

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https://patientengagementhit.com/news/opennotes-patient-education-site-targets-access-to-clinical-notes

OpenNotes Patient Education Site Targets Access to Clinical Notes

The website offers patient education and navigation to help ease patient access to clinical notes, a key provision of the 21st Century Cures Act.

By Sara Heath

September 16, 2021 - OpenNotes, a leader in promoting patient access to clinical notes, and health IT vendor Ciitizen have teamed up to create WhereIsMyMedicalRecord.org, a website dedicated to helping individuals navigate patient data access.

This comes following implementation of the ONC information blocking final rule, which lists clinical notes as a form of data that cannot be withheld from relevant parties, including patients. Under the rule, which went into effect on April 5, patients must be able to immediately access their clinical progress notes in a digital format, usually via the patient portal.

But this can be a confusing process, OpenNotes and the vendor noted. Not every patient knows they have the right to see their progress notes, and even they do, the path to actually viewing them on the patient portal isn’t always intuitive.

And that’s not to mention the patient who opens her clinical notes but doesn’t understand them, potentially confusing the patient.

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https://patientengagementhit.com/news/a-third-of-seniors-saw-access-to-care-snags-during-pandemic

A Third of Seniors Saw Access to Care Snags During Pandemic

Thirty-seven percent of American seniors said they had access to care disruptions during the pandemic, fragmenting their chronic disease management.

By Sara Heath

September 16, 2021 - Older adults in the United States were more likely to have access to care problems during the pandemic than older adults in any other similarly developed nation, according to research from the Commonwealth Fund and SSRS, highlighting a slog of a pandemic for individuals over age 65.

In addition to the healthcare obstacles, older adults in the US were also more likely to experience economic and social struggles than those over age 65 in other similarly developed nations, the study added.

The study, fielded between March and June of 2021, adds to the Commonwealth Fund’s literature on the state of US healthcare as it compares to other developed nations. Those nations included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.

After nearly a year of the COVID-19 pandemic, for which adults over age 65 were largely at risk, the data shows considerable medical, economic, and social challenges not related to the novel virus. In other words, older adults in the US had more to contend with than just avoiding COVID.

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https://healthitsecurity.com/news/google-microsoft-amassed-the-most-vulnerabilities-in-h1-2021

Google, Microsoft Amassed the Most Vulnerabilities in H1 2021

Research revealed that tech giants Google and Microsoft accumulated the most vulnerabilities in the first half of 2021, leaving them open to potential cyberattacks.

By Jill McKeon

September 16, 2021 - Google and Microsoft amassed the most vulnerabilities compared to other major tech companies in the first half of 2021, research from Atlas VPN revealed. During the first half of 2021, Google accumulated 547 registered vulnerabilities. Microsoft followed close behind at 432.

Both Microsoft and Google maintain a vast suite of services, making them prime targets for cyberattacks. It also means that vulnerabilities are more common and can be more detrimental if left unchecked.

Google Chrome has more than 3 billion users, making it a lucrative opportunity for hackers. With more users comes more vulnerabilities and more potential cyberattack victims.

Bad actors also took advantage of Microsoft Exchange Server vulnerabilities and deployed ransomware, while other attackers planted cryptocurrency miners from the post-exploit web shells.

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https://healthitsecurity.com/news/61m-fitbit-apple-users-had-data-exposed-in-wearable-device-data-breach

61M Fitbit, Apple Users Had Data Exposed in Wearable Device Data Breach

An independent cybersecurity researcher discovered a wearable device data breach that exposed the records of 61 million Apple and Fitbit users.

By Jill McKeon

September 16, 2021 - Over 61 million fitness tracker records from both Apple and Fitbit were exposed online in a recent wearable device data breach, according to a report from WebsitePlanet and independent cybersecurity researcher Jeremiah Fowler.

Researchers found that the data breach stemmed from GetHealth, a New York-based health and wellness company that allows users to unify their wearable device, medical device, and app data. The exposed data belonged to wearable device users around the world and contained names, birthdates, weight, height, gender, and geographical location.

The database was not password-protected, and the information was clearly identifiable in plain text. Fitbit was listed in over 2,700 records, and Apple’s Healthkit was mentioned over 17,000 times.

It is also likely that other apps were impacted since GetHealth’s website states that it can sync data from other vendors such as 23andMe, GoogleFit, Microsoft, Runkeeper, Strava, Android Sensor, Daily Mile, and more.

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https://www.fiercehealthcare.com/practices/docs-press-cms-for-permanent-telehealth-flexibility-relief-from-pay-cuts-fee-schedule

Docs press CMS for permanent telehealth flexibility, relief from pay cuts in fee schedule comments

by Robert King 

Sep 14, 2021 11:40am

Several doctor groups are pressing the Biden administration to not just extend Medicare telehealth reimbursement flexibilities through 2023 but to be made permanent.

The Centers for Medicare & Medicaid Services proposed in the 2022 Physician Fee Schedule to extend telehealth flexibilities through 2023 instead of through the end of the COVID-19 public health emergency, which is expected to run through this year. Doctor groups in comments on the rule, the deadline for which expired Monday, called for a permanent solution and more flexibility for mental health telehealth services.

“Given the addition of a record number of eligible beneficiaries, telehealth may be the only way beneficiaries can gain access, especially those in rural or underserved communities,” according to a letter from 60 provider and health IT groups including the Health Information and Management Systems Society (HIMSS).

The Medical Group Management Association also commented that removing services after a “predetermined or prescriptive date” could create a major administrative burden for practices already strained financially by the pandemic.

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https://mhealthintelligence.com/news/ama-survey-charts-explosive-growth-of-telehealth-services-in-2020

AMA Survey Charts Explosive Growth of Telehealth Services in 2020

The American Medical Association's new Physician Practice Benchmark Survey shows a surge in telehealth adoption between 2018 and 2020, driven by the shift from in-person to virtual care during the pandemic.

By Eric Wicklund

September 15, 2021 - Telehealth use by physicians jumped from 25 percent in 2018 to almost 80 percent in 2020, while almost 85 percent of psychiatrists connected with the patients via video visit or telephone during the height of the pandemic, according to the American Medical Association.

The data contained in the AMA’s latest Physician Practice Benchmark Survey falls in line with dozens of similar studies and surveys, all showing that the use of connected health platforms soared last year as providers looked to shift as much care as possible from in-person to virtual care.

Drawing from the responses of thousands of post-residency physicians across the country, the survey found that video-based visits jumped from 14.3 percent in 2018 to 70.3 percent in 2020 while 67 percent connected with patients last year via phone. Almost 60 percent used telehealth in 2020 for chronic care management, up from about 20 percent in 2018, and the amount of physicians who used telehealth to diagnose or treat patients increased from 15.6 percent to 58 percent.

Remote patient monitoring jumped as well, with 20 percent of physicians say they used RPM in 2020, almost twice as many as in 2018. Broken down further, one-third of specialists used RPM, led by cardiologists (63.3 percent) and endocrinologists and diabetes care physicians (41.6 percent).

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https://www.healthcareitnews.com/news/emea/state-union-speech-outlines-eu-priorities-health-and-digital

State of the Union speech outlines EU priorities for health and digital

Ursula von der Leyen announced pandemic preparedness and cybersecurity plans.

By Tammy Lovell

September 16, 2021 12:05 PM

European Commission president Ursula von der Leyen outlined flagship initiatives for the European Union (EU) in her State of the Union address yesterday (15 Sept).

The EU’s vaccination efforts featured strongly in the address, with Von der Leyen stating that more than 70% of adults in the EU are fully vaccinated. She added that the EU had delivered more than 700 million doses to countries in the rest of the world and will increase its donation commitment by a further 200 million doses.

More than 400 million EU Digital COVID Certificates (EUDCCs) have been generated across Europe, according to von der Leyen, with 42 countries in four continents using the scheme.

She referred to digital as “the make or break issue,” and said that digital spending in NextGenerationEU recovery plan would overshoot the 20% target. The NextGenerationEU €800 billion temporary stimulus package contributes towards the EU4Health programme  and Horizon Europe research and innovation programme.

The EU will focus on digital transformation including investment in 5G, fibre and digital skills, von der Leyen said. She called for a new European Chips Act which will create a “state-of-the-art European chip ecosystem” to ensure security of supply and develop new markets for European tech.

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https://www.healthcareitnews.com/news/emea/skills-gap-healthcare-it-industry-cause-security-threats-according-new-report

EMEA

Privacy & Security

Skills gap in healthcare IT industry cause security threats, according to new report

New research shows that 40% of staff are missing cyber security expertise while 39% lack essential data protection knowledge.

By Sara Mageit

September 16, 2021 07:09 AM

Research from European provider of cloud infrastructure and cloud services, IONOS Cloud, has found that 37% of healthcare IT decision-makers say their organisation is at risk of security threats due to skills gaps.

Additionally, four in 10 (39%) are facing a skills gap in data protection, with a quarter (25%) saying it means they are not adhering to necessary legislation or following the correct data protection procedures (21%).

The survey polled 203 healthcare IT decision-makers as part of a wider survey of 609 respondents.

WHY IT MATTERS

The aim of the report was to better understand the current challenges businesses are facing in the wake of the pandemic, and where cyber security and data protection standards are sitting on healthcare business’s IT priority lists.

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https://www.healthcareittoday.com/2021/09/16/how-virtual-assistants-and-artificial-intelligence-can-help-ensure-patient-information-is-secure-and-streamline-operations/

How Virtual Assistants and Artificial Intelligence Can Help Ensure Patient Information Is Secure – and Streamline Operations

September 16, 2021

The following is a guest article by Pranay Jain, CEO and Co-founder of Enterprise Bot.

The Health Insurance Portability and Accountability Act (HIPAA) was introduced in 1996 mainly to help migrate insurance coverage details of employees between organizations, prevent insurance fraud, reduce wastage of medical resources and eliminate improper payments. 

In a study by the Centers for Medicare and Medicaid Services (CMS), it was observed that over 8% of all healthcare payments were improper in 2018 alone.

To reduce all forms of erroneous payments, CMS introduced a testing practice known as Comprehensive Error Rate Testing (CERT). The methodology employs engineered AI algorithms and Predictive Analytics to detect fraudulent healthcare payments and other forms of payment-related errors. By doing so, the United States government has saved around USD 42 Billion in total.

Artificial Intelligence (AI), Machine Learning (ML), and Natural Language Processing (NLP) have made massive strides across the patient journey by improving R&D processes for Drug Discovery, eliminating errors in Drug Administration, and revolutionizing the world of Diagnostics/Medical Prognosis. By analyzing clinical data and physician notes across Electronic Health Records (EHRs), the quality of healthcare imparted has seismically elevated into a new era of patient care management.

However, the entire Patient Care Management (PCM) journey involves a list of backend operations across healthcare establishments. To avoid roadblocks and operational mismanagement, these backend/admin tasks need to be fluid and seamless. This would enable healthcare providers with the ability to provide better patient experiences. 

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https://mhealthintelligence.com/news/ama-survey-charts-explosive-growth-of-telehealth-services-in-2020

AMA Survey Charts Explosive Growth of Telehealth Services in 2020

The American Medical Association's new Physician Practice Benchmark Survey shows a surge in telehealth adoption between 2018 and 2020, driven by the shift from in-person to virtual care during the pandemic.

By Eric Wicklund

September 15, 2021 - Telehealth use by physicians jumped from 25 percent in 2018 to almost 80 percent in 2020, while almost 85 percent of psychiatrists connected with the patients via video visit or telephone during the height of the pandemic, according to the American Medical Association.

The data contained in the AMA’s latest Physician Practice Benchmark Survey falls in line with dozens of similar studies and surveys, all showing that the use of connected health platforms soared last year as providers looked to shift as much care as possible from in-person to virtual care.

Drawing from the responses of thousands of post-residency physicians across the country, the survey found that video-based visits jumped from 14.3 percent in 2018 to 70.3 percent in 2020 while 67 percent connected with patients last year via phone. Almost 60 percent used telehealth in 2020 for chronic care management, up from about 20 percent in 2018, and the amount of physicians who used telehealth to diagnose or treat patients increased from 15.6 percent to 58 percent.

Remote patient monitoring jumped as well, with 20 percent of physicians say they used RPM in 2020, almost twice as many as in 2018. Broken down further, one-third of specialists used RPM, led by cardiologists (63.3 percent) and endocrinologists and diabetes care physicians (41.6 percent).

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https://www.medpagetoday.com/special-reports/exclusives/94504

Open Notes Shines Light on Errors in Patient Medical Records

— Will the new rule lead to a flood of correction requests?

by Cheryl Clark, Contributing Writer, MedPage Today September 14, 2021

A retired San Diego physician sought a second opinion on some vision issues that had progressed.

But when the medical records from his first ophthalmologist were forwarded to the second -- after repeated requests -- he discovered an unwelcome surprise.

Absent was any description of the growth on the surface of his lens. Nor was there a reference to his progressive impairment, necessary to support his need for the intraocular implant the doctor had recommended.

Also missing was any note about his family history of macular degeneration. His medication list was wrong, as well. "The record was completely inaccurate," he said.

With the April 5 implementation of the federal Information Blocking rule -- also known as "Open Notes" -- "actors" defined as any health provider (including physicians) must make 16 categories of electronic records available electronically to the patient upon request as soon as they're available, with more categories qualifying in the future.

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https://www.medpagetoday.com/special-reports/exclusives/94502

Patients Can Get Medical Record Errors Amended, but It's Not Easy

— Technology is lacking, process may be unclear

by Cheryl Clark, Contributing Writer, MedPage Today September 14, 2021

Changing a medical record to correct an error is anything but an easy process.

Under federal HIPAA rules, patients have the right to request that doctors fix errors, but the provider has up to 60 days to respond, and can ask for a 30-day extension.

The provider also can refuse, but must specify the reason in writing.

If the fix moves forward, the doctor can't alter the original note, but the patient has the right to have an amendment with his or her version of the facts placed in their electronic medical record (EMR).

Most EMR program modules do not let the patient edit or question something in an electronic note, although software entrepreneurs are working on solutions that will enable that feature.

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https://www.beckershospitalreview.com/telehealth/va-requests-proposals-for-1b-telehealth-contract-4-takeaways.html

VA requests proposals for $1B telehealth contract: 4 takeaways

Hannah Mitchell – 15 September, 2021

The Department of Veterans Affairs is seeking contractors for a $1 billion telehealth contract as the department seeks to modernize its system, according to a Sept. 13 Bloomberg Law report.

Four takeaways:

  1. The contract, titled Veterans Affairs Remote Patient Monitoring - Home Telehealth, is a two-year base contract with six one-year options.
  2. The $1.032 billion opportunity covers hardware, software and patient data privacy protection, according to the report.

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https://www.healthcareitnews.com/news/taking-stock-sudden-evolution-telemedicine

Taking stock of the sudden evolution of telemedicine

A virtual care expert leads readers through the recent history of telehealth and offers tips on new medical services that can be delivered via telehealth while complying with HIPAA.

Bill Siwicki

September 15, 2021

Telehealth continues to grow as a crucial part of patient care, especially when supporting patients who live in remote areas and senior citizens. Research firm Frost & Sullivan forecasts a sevenfold growth in telehealth by 2025 – a five-year compound annual growth rate of 38%.

The bottom line is that people want to have access to healthcare anytime, anywhere, across multiple devices and in the language of their choice. In fact, many new areas of telehealth – such as tele-oncology and tele-stroke – have become part of the mainstream healthcare system.

The idea of triaging patient issues and prescribing medication or assigning tasks such as physical therapy is just a part of the picture. There also has been an uptick in the use of telepsychiatry, especially for patients who are suffering from anxiety, depression and isolation.

For healthcare providers, telehealth presents an opportunity to address patient care needs, improve the customer experience and reduce costs. Healthcare IT News sat down with Linda Comp-Noto, division president for healthcare enterprise operations at telemedicine technology and services vendor Teleperformance, to discuss the evolution of telehealth, unique aspects of supporting remote customers and senior citizens, approval of more than 80 new medical services that can be delivered via telehealth and the creation of new diagnostic codes, and tackling privacy issues related to HIPPA.

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https://www.healthleadersmedia.com/technology/cybersecurity-patient-safety

Cybersecurity Is Patient Safety

Analysis  |  By PSQH  |   September 15, 2021

Where healthcare and security meet.           

This article was originally published September 9, 2021 on PSQH by Matt Phillion.

Cyberattacks target every industry all the time, and healthcare is no exception. According to a recent IBM study, the average cost per healthcare cyberattack is a hefty $7 million. Despite numbers like this, cybersecurity often isn’t the C-suite’s top priority. How can CISOs in hospitals and other healthcare organizations demonstrate the value of strong cybersecurity while a host of other issues vie for leadership’s attention?

“To me, cybersecurity actually is a patient safety issue,” says Wes Wright, chief technology officer with Imprivata. “The industry did both areas a disservice long ago when they separated them.”

Clinicians and other professionals who see patients on a daily basis aren’t necessarily thinking about cybersecurity from a patient safety standpoint. That makes password requirements, security education and training, and other requirements seem less directly connected to patient care and safety—even though they actually are integral to both.

The way to fix this, Wright says, is to ensure that cybersecurity compliance and clinical efficiency improve together. Without the latter, staff will balk at the former. “Healthcare IT professionals were guilty of trying to make folks jump through some pretty onerous hoops in the name of cybersecurity,” he says. “The key is to make doing the right thing—and the right thing here is ensuring things are cyber-protected—as easy, if not easier, than doing the wrong thing.”

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https://ehrintelligence.com/news/api-ehr-integrations-grow-but-fhir-data-exchange-adoption-trails

API EHR Integrations Grow, But FHIR Data Exchange Adoption Trails

The number of API EHR integrations grew from 2019 to 2020, but the proportion of APIs that support FHIR data exchange remained about the same.

By Hannah Nelson

September 14, 2021 - While the number of application programming interfaces (API) EHR integrations increased from 2019 to 2020, the proportion of APIs that support the FHIR data exchange standard remained relatively the same, according to a study published in JAMIA.

Researchers gathered data from the public app galleries hosted by five of the leading EHR vendors: Allscripts, athenahealth, Cerner Corporation, Epic Systems Corporation, and SMART.

Cerner, Epic, and SMART had a net increase in the total number of apps in their galleries, while athenahealth and Allscripts had a net decrease in apps. The Epic App Orchard saw the largest net increase of 43 percent, adding 169 apps during the study period.

While support for FHIR increased from 19 percent of APIs at the end of 2019 to 22 percent of APIs at the end of 2020, the increase was not statistically significant.

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https://ehrintelligence.com/news/should-ehr-vendors-share-health-it-patient-safety-responsibility

Should EHR Vendors Share Health IT Patient Safety Responsibility?

CMS should require EHR vendors to conduct self-assessments on their health IT products to ensure patient safety, according to a JAMA op-ed.

By Hannah Nelson

September 14, 2021 - While a new CMS policy aims to improve patient safety through hospital self-assessment of EHR systems, EHR vendors should also be responsible for assessing their products to ensure they meet federal health IT standards, according to a new Journal of the American Medical Association (JAMA) op-ed.

In August, CMS published new rules regarding the Medicare Promoting Interoperability Program and its Protect Patient Health Information Objective. Beginning in 2022, eligible hospitals will have to attest to having completed an annual self-assessment of their EHRs using the ONC SAFER (Safety Assurance Factors for EHR Resilience) Guides.

In the op-ed, Dean F. Sittig, PhD, professor at the University of Texas Health Science Center at Houston, argued that EHR vendors should be responsible for conducting self-assessments of their products.

“Over the past decade, emerging evidence has suggested that unsafe EHRs and unsafe use of EHRs has continued and could lead to harm or potential harm that potentially affects large numbers of patients,” he wrote.

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https://healthitanalytics.com/news/predictive-model-projects-cervical-cancer-elimination

Predictive Model Projects Cervical Cancer Elimination

A predictive model indicates the elimination of cervical cancer in low-poverty areas 14 years before high-poverty areas.

By Erin McNemar, MPA

September 13, 2021 - A predictive model estimated that cervical cancer could be virtually eliminated in the United States by 2030 in communities with low poverty rates, but not until 2044 in communities with high poverty rates.

There are approximately 14,000 cases of cervical cancer diagnoses each year in the United States, leading to about 4,000 annual deaths. Over 90 percent of cervical cancers are caused by certain types of human papillomavirus (HPV) infections.

HPV vaccines became available in 2006 and currently protect against nine HPV types, including seven of the 14 known to increase cancer risk. The vaccine regimen is recommended for all adolescents and consist of two doses for children aged nine to 15 or three doses for individuals ages 15 to 26.

With the vaccine being 90 percent effective at preventing HPV-related cancers, vaccination efforts could lead to “near-elimination” of cervical cancer.

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https://www.healthcareitnews.com/news/epics-director-nursing-discusses-new-research-its-sepsis-early-warning-model

Epic's director of nursing discusses new research on its sepsis early warning model

The study, from MetroHealth and Case Western Reserve University, suggests the AI-powered EHR system can help alert clinicians before symptoms become visible and potentially deadly to patients.

By Bill Siwicki

September 14, 2021 12:12 PM

A new independent study in the Journal of Critical Care Medicine found that Epic's sepsis early warning system led to faster antibiotic administration and better patient outcomes without an increase in harmful clinical interventions, like antibiotic or IV fluid overdose.

The model, used by hospitals nationwide, detects the first risk factors of infection in patients, allowing clinicians to enact early treatment measures and save lives.

Earlier this summer, a study in JAMA Internal Medicine using retrospective data found that prediction algorithms included as part of Epic's electronic health record may poorly predict sepsis.

But the new independent study, conducted by MetroHealth and Case Western Reserve University, shows the use of EHR sepsis warning systems flags clinicians before symptoms become visible and potentially deadly to patients. Sepsis contributes to one in three deaths in U.S. hospitals today.

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https://www.healthaffairs.org/do/10.1377/hblog20210909.961330/full/

Seizing The Moment For Telehealth Policy And Equity

For years, the story of telehealth in the United States had been one of unfulfilled promise and limited niche market use. The extraordinary circumstances surrounding the COVID-19 pandemic, and the urgent need to provide safe access to medical care for millions of Americans during the public health emergency, led to the rapid decision by the Centers for Medicare and Medicaid Services (CMS) and private insurers to begin reimbursing virtual telephone (audio only) and video visits in March 2020. Since that moment, telehealth has been suddenly and irrevocably transformed into a ubiquitous and indispensable part of our health care system.

According to multiple surveys, patients report high levels of satisfaction with telehealth visits, which can help reduce barriers associated with in-person care. And although the majority of health care visits in the US have transitioned back to in-person, telehealth is expected to continue to play an important role moving forward. Virtual visits can offer convenience and improved access for patients by reducing the need to take time off work, secure child and elder care, and find transportation. Higher uptake of patient portal use can improve patient engagement and activation and reduce burdens on practices by giving patients the agency to self-schedule appointments, request refills, review test results, and communicate asynchronously with care teams using secure messaging and eVisits. Telehealth also offers wide-ranging opportunities for flexibility and innovative improvements in health care delivery by enabling new models for low-acuity care and chronic disease management.

However, virtual care can also exacerbate existing health disparities, as access to the requisite technology, broadband, and digital literacy vary widely among patient populations. Without intentional action to help mitigate digital barriers associated with age, race, location, preferred language, and socioeconomic status, permanent expansion of telehealth could have the unintended consequence of reinforcing existing inequities in health access in our highest risk and most underserved communities.

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https://www.bioworld.com/articles/511393-austro-japanese-team-developing-e-health-patches-that-can-monitor-pulse-and-blood-pressure?v=preview

Austro-Japanese team developing e-health patches that can monitor pulse and blood pressure

Sep. 14, 2021

By Bernard Banga

PARIS – Researchers at the Institute for Surface Technologies and Photonics in Weiz, Austria, and the Institute of Scientific and Industrial Research Osaka University, Japan, have invented new ultra-flexible health monitoring patches that use harvested bio-mechanical energy. “These new devices represent a wireless e-health patch for accurate pulse and blood pressure monitoring,” Andreas Petritz, from the Institute for Surface Technologies and Photonics (the materials research unit of Joanneum Research FmbH), told BioWorld.

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https://ehrintelligence.com/news/ehr-vendor-epic-unveils-website-for-health-it-best-practices-education

EHR Vendor Epic Unveils Website for Health IT Best Practices, Education

EHR vendor Epic has created a new website that gives healthcare stakeholders a place to share best practices to maximize their health IT investment.

By Hannah Nelson

September 13, 2021 - EHR vendor Epic Systems has launched a new website to support healthcare stakeholder understanding of its health IT, according to reporting from the Wisconsin State Journal.

EpicShare.org. also aims to provide healthcare stakeholders and the public a place to exchange ideas and best practices for the use of health IT.

The website has gained thousands of subscribers in its first few weeks post-go-live, Leela Vaughn, Epic senior executive, told the news outlet.

“We’ve been working on EpicShare for just about a year, and this is one of the things that came out of the early days of the pandemic,” said Vaughn.

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https://healthitanalytics.com/news/why-genetic-testing-is-key-to-advancing-precision-medicine

Why Genetic Testing Is Key to Advancing Precision Medicine

Increased genetic testing is essential to improving the health of senior populations using precision medicine.

By Erin McNemar, MPA

September 13, 2021 - Due to genetics, not every patient responds the same to medications. With genetic testing, providers can better determine the best treatment options for individuals, advancing precision medicine. 

Jacob Johnson, MD, a practicing otolaryngologist and president of San Francisco Otolaryngology, spoke with HealthItAnalytics about the importance of genetic testing in senior populations and the role associated with genetics in medication relations.

"The medications we take are primarily metabolized by our kidney and our liver. We have enzymes in our liver that metabolize these medications. And each of us is given a set of them, and they are genetically determined," Johnson said.

Depending on the patient's genes, the enzymes could have low, medium, high functions, leading to different metabolizing rates. According to Johnson, these differing rates create problems for physicians when trying to prescribe medications.

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https://healthitsecurity.com/news/az-ransomware-attack-leads-to-unrecoverable-ehrs-data-loss

AZ Ransomware Attack Leads to Unrecoverable EHRs, Data Loss

An Arizona medical center will have to rebuild thousands of patient records after a ransomware attack resulted in corrupted EHRs and data loss.

By Jill McKeon

September 10, 2021 - Arizona-based Queen Creek Medical Center, also known as Desert Wells Family Medicine, will have to rebuild patient medical records from scratch after a ransomware attack corrupted and destroyed EHRs. Desert Wells began notifying 35,000 patients of the breach and made plans to implement a new EHR system.

The practice’s IT staff discovered suspicious activity on May 21 and immediately reached out to cybersecurity experts, an incident response team, and law enforcement.

A third-party forensics firm found no evidence that any protected health information (PHI) was stolen. However, the bad actor managed to corrupt the provider’s medical records system, resulting in significant data loss.

The records contained information including patient names, addresses, Social Security numbers, driver’s license numbers, patient account numbers, health insurance plan member IDs, medical record numbers, treatment information, and billing account numbers.

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https://www.beckershospitalreview.com/ehrs/onc-70-of-hospitals-have-issues-with-public-health-data-reporting.html

ONC: 70% of hospitals have issues with public health data reporting 

Jackie Drees -

Seven in 10 hospitals experience at least one challenge with reporting health information to public health agencies in 2019, according to a recent ONC data brief. 

ONC analyzed survey data from the 2019 American Hospital Association Information Technology supplement to get a better understanding of the number and types of challenges that hospitals have experienced when electronically reporting to public health agencies prior to the COVID-19 pandemic. 

Here are the top challenges hospitals cited with public data reporting in 2019: 

  • Lack of capacity to electronically exchange information among hospitals and public health agencies: 50 percent 
  • Interface-related issues, such as costs and complexity: 40 percent 

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https://www.healthcareitnews.com/news/how-robotic-assisted-surgery-can-improve-patient-outcomes

How robotic-assisted surgery can improve patient outcomes

A pioneer in robotics and surgery discusses the genesis, the state of the art and the future of the technology and techniques – and where AI fits in.

By Bill Siwicki

September 13, 2021 12:36 PM

Robotics has started boosting surgery in ways not dreamed about not so long ago. Robotic-assisted surgical systems have claimed a space in healthcare and are evolving before surgeons' very eyes.

Brian Miller is chief digital officer at Intuitive, a medical technology company known for its da Vinci robotic-assisted surgical systems. He is one of the leading experts in the field.

Healthcare IT News sat down with Miller to discuss the genesis of the robotic surgery industry and how new technology combined with AI will transform what's possible in healthcare.

Q. You started your career in robotics developing software for robotic surgical systems such as AESOP and ZEUS. What were the early capabilities of these systems?

A. We always knew we were onto something in those early days – but it is humbling to see how far the robotic surgical field has grown. With AESOP and its successor, ZEUS, our goal was to help enhance the ability of laparoscopic surgeons, who spent long days standing next to – and over – patients, and had to hold the endoscope and multiple instruments for very long stretches of time.

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https://www.healthcareitnews.com/news/groups-recover-together-sees-great-success-treating-opioid-use-disorder-telehealth

Groups Recover Together sees great success treating opioid use disorder via telehealth

Eighty-seven percent of its members said they felt as supported or more supported in a virtual care model.

By Bill Siwicki

September 13, 2021 11:47 AM

Groups Recover Together is a national healthcare company for individuals with opioid use disorder. It's based in Burlington, Massachusetts.

THE PROBLEM

Addiction is a disease of isolation. The success of Groups Recover Together's care model relies heavily on building a supportive community for its members.

Before COVID-19, this was in the form of weekly, in-person group therapy. In March 2020, Groups Recover Together closed its physical locations, stood up a telehealth platform and transitioned to 100% virtual care. It completed the transition in just four days – no small feat considering it served more than 5,000 members across six states at the time.

Staff did all this with great uncertainty about what the future might look like. Their "keep us up at night" questions were:

●        Will members have sufficient technology or broadband access?

●        Will staff be able to perform their jobs at a high level?

●        Will members continue to engage in treatment?

●        How will members do in a virtual setting?

●        Will staff see a degradation of outcomes?

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https://www.healthcareitnews.com/news/jama-report-calls-ehr-vendors-do-annual-safety-self-assessments

JAMA report calls on EHR vendors to do annual safety self-assessments

With new CMS rules, researchers say electronic health records should be more easily configurable with ONC's SAFER Guide recommendations – which in turn should be reviewed and updated by the agency each year.

By Mike Miliard

September 13, 2021 03:41 PM

A new op-ed published in the Journal of the American Medical Association offers some suggestions for a "shared responsibility" for electronic health record safety.

WHY IT MATTERS
This past month, the Centers for Medicare and Medicaid Services updated its Medicare Promoting Interoperability Program – adding a new measure requiring eligible hospitals, starting in 2022, to attest to having completed an annual self-assessment of their EHRs using the SAFER Guides sponsored by the Office of the National Coordinator for Health IT.

While that's a big deal for patient safety policy, however, "additional steps are required to strengthen the effects of these rules," write patient safety researchers Dean F. Sittig of University of Texas Health Science Center and Dr. Hardeep Singh of Baylor College of Medicine, in JAMA.

Going forward, as hospitals work to comply with the new CMS rules, they'll need to have help from their EHR vendors, they write, since many SAFER recommendations depend on EHR features that must be provided by developers.

"For example, one recommendation states, 'Information required to accurately identify the patient is clearly displayed on all portions of the EHR user interface, wristbands, and printouts,'" they point out. "The hospital cannot comply with that recommendation if the developer has not implemented the feature(s)."

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https://jamanetwork.com/journals/jama/fullarticle/2784288

Viewpoint

September 10, 2021

Policies to Promote Shared Responsibility for Safer Electronic Health Records

Dean F. Sittig, PhD1; Hardeep Singh, MD, MPH2

Author Affiliations Article Information

JAMA. Published online September 10, 2021. doi:10.1001/jama.2021.13945

On August 13, 2021, the Centers for Medicare & Medicaid Services (CMS) published new rules regarding the Medicare Promoting Interoperability Program and its Protect Patient Health Information Objective.1 Specifically, CMS added an unscored, attestation-only measure that requires eligible hospitals to attest to having completed an annual self-assessment of their electronic health record (EHR) using the Office of the National Coordinator for Health Information Technology (ONC)–sponsored SAFER (Safety Assurance Factors for EHR Resilience) Guides2 beginning in 2022. This is a major development in health information technology (IT) and patient safety policy, but additional steps are required to strengthen the effects of these rules.

Historical Context

A decade ago, health IT–related errors were defined as “anytime health IT is unavailable for use, malfunctions during use, is used incorrectly by someone, or when health IT interacts with another system component incorrectly, resulting in data being lost or incorrectly entered, displayed, or transmitted.”3 Over the past decade, emerging evidence has suggested that unsafe EHRs and unsafe use of EHRs has continued and could lead to harm or potential harm that potentially affects large numbers of patients.4 For example, Pacheco et al5 determined that 275 of 697 (39.5%) EHR-related products surveilled had “nonconformities” with existing EHR certification regulations that were associated with possible patient harm. Many nonconformities could have been identified by the developer prior to product release. However, best practices for safe EHR configuration, implementation, and use have not been widely promulgated; health care organizations (HCOs), users, developers, and government regulators often attribute EHR-related safety problems to one another.6

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https://histalk2.com/2021/09/10/weekender-9-10-21/

Weekly News Recap

  • Intelerad acquires Insignia.
  • Sanford Health (SD) will use a $350 million donation to develop a virtual care center.
  • Period and ovulation tracking app vendor Flo raises $50 million, valuing the company at $800 million.
  • TransUnion is reportedly seeking a buyer for its TransUnion Healthcare business for up to $2 billion.
  • Invitae announces that it will acquire Ciitizen for $325 million.
  • A review finds that 34 of 36 systems that use AI for breast cancer screening are less accurate than a single radiologist.
  • The VA renews its CliniComp contract for another five years.
  • Four of six traveling nurses at a California hospital quit on their first day when faced with using Meditech, which the hospital is replacing with Epic.
  • Baxter announces that it will acquire Hillrom for $12.4 billion.
  • Accenture acquires Gevity.
  • Healthcare Triangle announces plans for an IPO that will raise up to $50 million.

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Enjoy!

David.

 

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