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
-----
TPP boss Hester takes pot shot at ‘artificially inflated’ hospital EPR prices
Frank Hester, CEO of TPP, has accused NHS bosses of wasting hundreds of millions on over-priced IT systems, claiming that his company offers ‘another way’.
John Hoeksema 16 December, 2022
In an open letter he takes a pot shot at ‘epic price tags’, an apparent thinly veiled reference to the US electronic patient record (EPR) supplier Epic.
He goes on to claim that “for years, costs for hospital EPRs have been artificially inflated”.
In the open letter on Twitter the TPP boss catalogues the financial pressures the NHS faces and says over-priced IT is diverting hundreds of millions from patient care.
“What if there were another way?”, the letter asks, and then goes on to extol an alternative from TPP: “An IT system that won a HIMSS 2022 best solution award but costs a fraction of the international competition. A system designed for patient care, not billing”.
-----
https://www.digitalhealth.net/2022/12/digital-health-review-of-the-year-2022/
Digital Health Review of the Year 2022
Digital Health’s editor-in-chief Jon Hoeksma looks back at some of the key themes and stories in digital health across the past 12 months.
21 December, 2022
2022 was the year that saw Russia invade Ukraine, the biggest war in Europe since WW2; the departure, and almost return, of Boris Johnson; the death of Queen Elizabeth II; the utter swivel-eyed madness of Liz Truss and the Tories; the ongoing melt-down in the UK’s public finances; sky-high heating bills and rampant inflation squeezing living standards.
The country is in a recession that the Bank of England says could stretch through 2024; we have industrial action on a scale not seen since the 1970s with nurses, ambulance staff, rail workers, and post office staff all striking.
The country is a lot poorer, colder and less confident as the year ends. Oh, and England went out to France in Qatar on a penalty miss.
While NHS IT and digital health weren’t in the same league as the above litany of national woe it still had a pretty tough year of change, confusion and uncertainty, but also some notable successes.
-----
December 22, 2022
Fact checked by Richard Smith
Many TikTok videos present negative views of IUDs, distrust of health care professionals
Among the top content with the hashtag #IUD on TikTok, more videos were negative about IUDs than positive, and more than one in four discussed distrust of medical professionals, according to data published in Obstetrics & Gynecology.
“As a millennial who uses TikTok, I started to see these videos about negative IUD experiences on my own For You page,” Jenny Wu, MD, an OB/GYN resident at Duke University Health System in North Carolina, told Healio. “In my clinical practice as an OB/GYN, I also talked to patients who were not interested in getting the IUD because of what they saw online. We know that young people are increasingly turning to TikTok for their health information, and we wanted to understand what they were seeing.”
Wu and colleagues used a web-scraping app to extract information from the 100 most liked TikTok videos with the tag #IUD. For each video, the researchers used a modified 5-point DISCERN scale to assess information quality and the Patient Education Materials Assessment Tool (PEMAT) to assess understandability and actionability.
Video information
Cumulatively, the 100 videos assessed garnered 471 million views, 32 million likes and 1 million shares. Two videos were excluded from analyses because they did not use English.
-----
https://www.healio.com/news/psychiatry/20221222/telehealth-effective-for-treating-anxiety-depression
Fact checked by Shenaz Bagha
December 22, 2022
Telehealth effective for treating anxiety, depression
Telehealth interventions were as effective as in-person treatment for reducing anxiety and depressive symptoms, according to data published in BMC Psychiatry.
“Randomized control trials and subsequent reviews demonstrate the efficacy of telebehavioral health and have failed to detect significant differences between in-person and telehealth interventions,” Carly McCord, PhD, of the department of psychiatry and behavioral sciences at Texas A&M University, wrote. “However, many previous studies have limited generalizability and frequently lack diversity in patient populations, with rural and minority patients often being underrepresented.”
To evaluate outcomes in symptoms of depression and anxiety in patients treated in person vs. via telehealth, McCord and colleagues assessed data from 17 grantees and 95 associated sites that were funded by the Evidence-Based Tele-Behavioral Health Network Program and the Substance Abuse Treatment Telehealth Network Grant Program. For the analysis, they used data provided by grantees on nonrandomized convenience samples of telehealth patients and in-person comparison groups from sites with similar rural characteristics who were seen during the same time period.
The Patient Health Questionnaire-9 (PHQ-9) was used to measure depression symptoms, and the Generalized Anxiety Disorder-7 (GAD-7) scale was used to measure anxiety-related symptoms.
-----
KLAS: Quality of Health IT Implementation Key for Clinician Satisfaction
Healthcare organizations must focus on improving health IT implementation through effective end-user training to support clinician satisfaction.
December 22, 2022 - The quality of a health IT implementation may be more important for clinician satisfaction than the technology selected, according to a KLAS white paper based on data gathered from 2018 to 2022.
The report primarily focuses on solutions that require large-scale implementations, such as acute care EHRs, ERP solutions, patient accounting systems, and PACS solutions.
In 2022, 81 percent of Best in KLAS winners were also the highest rated in their market segment for quality of implementation. In market segments that require enterprise-scale deployments, that number was 100 percent.
Additionally, interviewed customers were unlikely to report high satisfaction without an implementation rating of at least 7 out of 9. On the other hand, 85 percent of customers satisfied with the results report a good implementation.
-----
Editor's corner: Fierce Digital Health's 10 most-read stories of 2022 tracked a market cooldown
Dec 22, 2022 05:00am
For Fierce Digital Health readers, the top 10 stories of the year show a market in transition with headlines about record fundraising in 2021 and a few big cash infusions followed by news about layoffs.
And, also Google made a big healthcare hire.
Four of the top 10 digital health stories of the year covered hefty investments in startups or provided a look-ahead at the potential investor market in the midst of a downturn.
Employer-focused Lyra Health kicked off the year snagging $235 million in series G funding, sending the health tech unicorn’s valuation to $5.58 billion as the company said it would focus its efforts on global expansion.
-----
Virtual nurses, bots, AI: Digital health predictions for '23
– 21 Dec, 2022
A "headline-grabbing" health system/digital health company merger? Less digital health investment from hospitals? More virtual healthcare workers to meet staffing shortages?
These are some of the predictions health system chief digital officers made for the industry in 2023. Here are those digital health forecasts for the new year, as told to Becker's by nine executives:
Zafar Chaudry, MD. Senior Vice President, Chief Digital Officer and CIO of Seattle Children's: Moving into 2023, I anticipate expanded usage of artificial intelligence, robotic process automation; a move from predictive to prescriptive analytics; use of tools to drive better patient outcomes to include a rise in remote patient monitoring and wearables with a more personalized focus; and further growth in 3D printing technology.
I suspect we will continue to see a paradigm shift in the retail delivery of healthcare in primary services. Virtual health services will continue. New tools to help retain and attract top digital and technology talent will emerge.
-----
Digital Equity as a Social Determinant of Health – 3 Ways to Empower Patients
Social determinants of health reflect conditions in the environment where an individual is born, lives, […]
Dec 21, 2022 at 1:30 PM
Social determinants of health reflect conditions in the environment where an individual is born, lives, works, plays and worships. These conditions have a direct impact on an individual’s range of health, functioning and quality of life. Given the recent pandemic, there has been an increase in the need to meet people where they are and to facilitate proactive healthcare. The goal is to reduce healthcare costs, address health concerns at an early stage and most importantly make healthcare access more easy, affordable and equitable.
“We are just now beginning to think about the digital future for healthcare, and we ought to be thinking about interactivity more than just interoperability if we want to make data exchange more dynamic and inclusive,” says Micky Tripathi, National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services.
Technology innovations such as telehealth, virtual second opinions, health trackers, patient portals and remote monitoring devices have been a boon to the healthcare industry given their ease of use, affordability and proactive nature. But at the same time, these innovations have also created further disparities in the healthcare system, as 15-24% of Americans do not have the skill sets needed to use the technology or lack of access to broadband services. These issues persist in rural and urban areas where the incomes are less than $20,000 per year. Digital access must be considered as a social determinant of health in order to make healthcare more accessible and affordable.
-----
Sequoia Project publishes final implementation guide on data usability
The guide is meant to improve data sharing among providers and public health agencies and enable semantic interoperability between sending and receiving systems, helping healthcare organizations incorporate shared data more easily into clinical workflows.
By Mike Miliard
December 22, 2022 09:19 AM
The Sequoia Project this past week released the final version of its Data Usability Implementation Guide – a resource developed to offer guidance on improving the utility and value of data received by end users within clinical workflows.
WHY IT
MATTERS
A joint project created by more than 360 members of Sequoia's public Data
Usability Workgroup, the document (PDF) focuses on six topic categories: data
provenance and traceability of changes; effective use of codes; reducing impact
of duplicates; data integrity and trust; data tagging and searchability and
effective use of narrative for data usability.
The guide – developed with help from more than 120 comments from various healthcare stakeholders – focuses on priority use cases that can be adopted within health information exchange vendors, implementers, networks, governance frameworks and testing programs.
"This much-needed implementation guide delivers real-world data usability recommendations for health information networks and communities to enhance the usability of the health data shared by and between providers, public health, patients and others," said Mariann Yeager, CEO of The Sequoia Project.
-----
https://www.healthcareitnews.com/news/roundup-strategies-and-next-steps-improved-cybersecurity-2023
Roundup: Strategies and next steps for improved cybersecurity in 2023
This was another challenging year for healthcare information security – but there's hope for the year ahead as technology and policy leaders promote new ideas to reduce risk and strengthen resilience.
By Andrea Fox
December 22, 2022 11:51 AM
Healthcare government and industry leaders see national standards, federal agencies get involved, and technology plays a starring role in the fight against healthcare cyberattacks. Here's a brief roundup of some of those trends, based on what we've been reporting and reading in recent weeks.
'Meaningful Protection' could drive healthcare cybersecurity transformation
Writing in Forbes, Ed Gaudet, CEO and founder of Censinet and member of the Health Sector Coordinating Council, suggests and describes what he calls a "Meaningful Protection" standard for healthcare cybersecurity, akin to the federal meaningful use program that spurred electronic health record adoption in the early 2010s. The goal would be to reduce patient safety risks and improve operational resilience through a "velvet hammer" approach, he said.
"It's time for the U.S. to implement an incentive-based program to drive the meaningful adoption of processes and technologies that protect patients and our healthcare infrastructure," Gaudet wrote.
Despite some debate over the details of the meaningful use program, implemented as part of the HITECH Act to ensure effective use of federal incentive dollars, Gaudet says it's hard to refute the impact the $27 billion program had on moving healthcare from paper to EHRs.
"To truly transform cybersecurity in healthcare, the U.S. government must consider modeling a cybersecurity investment program after Meaningful Use – namely, the 'meaningful protection' of patient safety, data and care delivery operations realized through a combination of incentives and penalties over time," Gaudet wrote.
-----
Tytocare is Making Home Medical Care Easier and More Accurate
December 22, 2022
Care-at-home is gaining momentum. Homecare services providers are growing. The demand for personal support workers (PSWs) as well as home nurses is rising. There number of medical devices designed specifically for home use are multiplying. In 2022, a lot of attention has been focused on devices for remote patient monitoring (RPM), but devices that enable clinicians to assess and diagnose patients at home are also needed to fully realize the promise of care-at-home.
TytoCare, a virtual care company, recently launched its Home Smart Clinic that enables primary care from home. Their offering includes:
- An FDA-cleared handheld solution for remote physical examinations and diagnosis
- An AI-powered diagnostic support tool that helps diagnose an array of conditions and guides patients through a physical exam at home
- Patient engagement services and apps
Hagai Heshes, Head of Product Marketing and Nate Danner, Director of Provider Solutions at TytoCare gave Healthcare IT Today a live demonstration of their solution at the recent #HLTH2022 conference.
-----
Sending Physicians the Right EHR Nudges Saves Money at Ardent Health
Analysis | By Scott Mace | December 21, 2022
Closing gaps in care requires knowing just when a technology-powered nudge will help, rather than cause more stress.
KEY TAKEAWAYS
· Ardent Health's use of Smart Ribbon technology has boosted med/surg discharges before 11 a.m. more than 175% since May.
· Chief Medical Officer FJ Campbell says clinicians must be involved in the development of new technology to ensure successful adoption.
· The pandemic accelerated clinicians' focus on operations and operational executives' focus on clinical imperatives.
At Ardent Health Services, physician burnout is a constant concern, and an issue that technology can address. The challenge for the Nashville-based healthcare organization, formerly known as the Behavioral Healthcare Corporation, is to find the right technology and not make things worse.
To thread that delicate needle, they're using a technology, developed in part by physicians, that identifies gaps in care and cost considerations.
Ardent deployed the IllumiCare Smart Ribbon in June and has found immediate benefits in a metric that often puts "lots of pressure" on its hospitalists, says chief medical officer FJ Campbell.
"The classic metric is discharges before 11 a.m.," Campbell says. "If you're moving your med/surg patients out by 11 a.m., then you're able to transfer your patients from your ICU to your med/surg units. We deployed IllumiCare, and discharges by 11 a.m. went up over 175%."
-----
https://ehrintelligence.com/news/hhs-proposes-new-data-standards-for-electronic-health-data-sharing
HHS Proposes New Data Standards for Electronic Health Data Sharing
The proposed data standards aim to create a consistent framework to support the needs for electronic health data sharing, including healthcare claims, prior authorization transactions, and signatures.
December 21, 2022 - The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have proposed a new rule to implement data standards, which would improve the electronic health data-sharing process.
The proposed “Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard (CMS-0053-P)” will specifically focus on “healthcare attachments” transactions, including medical charts, x-rays, provider referrals, and clinical documents.
Providers are required to fulfill health plan requirements to authorize healthcare services. Prior authorizations, for example, require providers to receive health plan approval before providing a patient with a specific service.
Often, health plans require a healthcare provider to submit information beyond the administrative data contained in a typical HIPAA transaction, such as medical documentation to support service claims or referral authorizations.
-----
https://healthitanalytics.com/news/foundation-models-could-help-advance-ai-in-healthcare
Foundation Models Could Help Advance AI in Healthcare
Experts argue that a new class of models may lead to more adaptable, affordable healthcare artificial intelligence tools.
December 21, 2022 - In a blog post published last week, experts from Stanford University’s Institute for Human-Centered Artificial Intelligence (HAI) discussed the opportunities provided by foundation models for AI in healthcare.
Foundation models are AI models trained on large, unlabeled datasets designed to be highly adaptable to new applications, according to the 2011 paper in which researchers coined the term. These models draw from fundamental ideas related to deep learning with two key differences: foundation models don’t require labeled datasets for model training, and they leverage a pretraining process to improve adaptability and sample efficiency.
The authors posited that these differences could help foundation models advance AI in healthcare by providing opportunities to address gaps created by current models.
The authors stated that despite the widely held notion that data from EHRs can be used to build classification, prediction, and survival models, most models trained on these data do not currently translate into clinical gains. They further noted that the resources, financial and otherwise, required to create and manage AI models are unsustainable for health systems.
-----
Most Clinicians Say Telehealth Cannot Effectively Treat Older Patients
A recent survey indicates that despite some benefits, between 57 and 61 percent of clinicians believe that older populations cannot receive effective care through telehealth.
December 21, 2022 - A recent survey conducted by West Health and members of the Collaborative for Telehealth and Aging found that more than half of clinicians believe that telehealth is a poor care option for older populations, indicating room for improvement.
Amid the recent growth and expansion of telehealth, research surrounding its clinical applicability for various conditions and populations is growing.
For example, a study from October described how telehealth has expanded access, closed health equity gaps, and displayed great potential for future use among mental health patients.
But, another study from December showed that healthcare chief financial officers indicated that using telehealth has not helped improve the financial situation of rural facilities.
-----
https://healthitsecurity.com/news/key-medical-device-security-provisions-included-in-omnibus-bill
Key Medical Device Security Requirements Included in Omnibus Bill
The 4,100-page omnibus bill keeps the government funded through September 30 and includes key medical device security provisions.
By Jill McKeon
December 21, 2022 - The House and Senate Appropriations Committees released the text of an omnibus appropriations bill that would keep the government funded through September 30, 2023. The document is more than 4,000 pages long and contains a variety of provisions that will impact healthcare, including medical device security requirements for manufacturers.
As previously reported, lawmakers and healthcare leaders have been pushing for further guidance and regulations surrounding medical device security. Healthcare organizations often maintain thousands of medical devices, many of which are internet-connected and could pose security risks.
Ongoing struggles with securing and keeping track of medical devices, the industry's reliance on legacy systems, and an increased focus on cybersecurity at a federal level have prompted legislative action.
The omnibus bill would allocate $120.7 billion in total spending to HHS, signifying an increase of $9.9 billion, the American Hospital Association (AHA) noted in its bill summary. The funds will go toward a variety of HHS agencies, including CMS, the National Institutes of Health (NIH), and the Centers for Disease Control and Prevention (CDC), with an emphasis on medical research.
-----
Gaining insight, changing medical practice from large data stores
Using a large collection of data such as that contained in Epic’s Cosmos can give clinicians a quicker way to affirm others’ research or test hypotheses.
Dec 16 2022
While I’m not a research scientist, I can validate the fact that using aggregated data, in the form of the Cosmos database from Epic, has affected how I’ve practiced medicine. More importantly, I feel that it has the potential to democratize data exploration and knowledge discovery.
If you do not already know, Cosmos contains a data set that represents the largest integrated database of clinical information in the United States – it holds records from more than 167 million Epic patient records with in excess of 5.7 billion encounters – it has records from patients in all 50 states. It’s built on a data platform optimized to answer clinical questions – it enables clinicians and researchers at organizations using Cosmos to ask questions without needing to file a request with someone else in that organization.
Cosmos can play a role as a rapid knowledge generation tool that can help clinicians iterate and discover ways to increase medical knowledge base. But I believe its true value is more than just creating volumes of research publications – it can be a trusted digital colleague that a clinician can use to ping hunches or confirm findings of a publication. After all, research is necessary, but it only matters if it can affect patient care.
I find something empowering about doing self-research to better inform care. Even when I’m not necessarily generating new insights, I use Cosmos to confirm or perhaps refute things in recent studies or publications. In my experience, that investment of time and effort makes it more likely to impact care delivery.
-----
How to accelerate knowledge adoption in healthcare with data
Translating information into changes in medical practice traditionally has taken years, but the pieces are in place to speed up that critical process.
Dec 16 2022
Massive medical research efforts yield insights daily for medical care. But historically, changes in medical practice don’t occur quickly. This is rooted in history over hundreds of years, but even recent discoveries in medical care take a long time to reach common usage.
Just as a recent example, the Food and Drug Administration declared Vioxx safe and effective in 1999, and it subsequently became a blockbuster drug for Merck. Then the larger medical community started to become aware of scattered reports of cardiovascular complications due to the drug. In 2004, the evidence of cardiovascular risks became overwhelming, and the drug was removed from the market. But in those five years, it is estimated that Vioxx caused tens of thousands of myocardial infarctions, hundreds of thousands of other types of cardiovascular disease and similar numbers of deaths. What if there had been a mechanism to discover this more quickly? How many lives could have been saved?
The situation is ripe for technology that can gather information across large numbers of patients and can enable clinicians and researchers to look for patterns that can speed up the process.
The knowledge adoption problem
Why is knowledge adoption such a problem in healthcare?
In 2003, the Institute of Medicine noted that it typically took 17 years after significant discovery to adoption into routine practice. This contention was sourced from an article two years earlier with this quote (Balas, 2001): "Relying on the passive diffusion of information to keep health professionals' knowledge up to date is doomed to failure."
-----
From telehealth to Medicare cuts: Here are the health policies in Congress' $1.7T omnibus
By Robert King
Dec 20, 2022 10:27am
A major end-of-the-year spending package released early Monday only gave partial relief to physicians seeking to get rid of a 4.5% pay cut set to go into effect next year, amid other major health policy reforms.
Congress is expected to pass the $1.7 trillion package by Friday to avoid a government shutdown.
Here is a list of the major health policies included in the package:
1. Partial relief from Medicare cuts
Providers received a mixed bag in the spending package. Congress agreed to stave off a 4% cut to Medicare payments under the PAYGO law, which calls for mandatory cuts if government spending reaches a certain level.
But physicians didn’t get everything they wanted. Several major groups were calling for Congress to step in and forestall a 4.5% cut to Medicare payments next year in the Physician Fee Schedule. Instead, Congress has decided to shave the cut to 2% next year and bump it up to 3.25% in 2024.
-----
2023 forecast: Why digital health is ripe for a new wave of M&A, including more 'disruptive' deals
Dec 21, 2022 05:01am
Going into 2023, be prepared for dealmaking activity to shake up the digital health market, analysts and investors say.
Market conditions are ripe for a new wave of digital health consolidation driven, in some part, by a more challenging funding environment, startup valuation declines and an unfriendly IPO market. With VC funding drying up compared to the heyday of 2021, M&A offers the opportunity for companies to expand their product offerings, keep shared service costs down and offer liquidity to impatient investors.
"There's a couple of factors that are really hinting to us that it's going to be an interesting year for M&A," said Adriana Krasniansky, an associate on Rock Health's research team. "We know that there are startups that are in need of capital and going to the private markets might be tough because it might require a valuation drop or a 'down round' that hurts them more materially. We imagine there are companies that are going to need some support in terms of cash runway, and acquisitions are, of course, one path to do that if it feels right."
A deal may not get done purely because a company needs cash but it is one factor that could tip the scales in favor of a transaction in today’s environment, said Danika Fry, executive director, healthcare investment banking at Morgan Stanley, in Rock Health's November report looking at M&A activity in 2022.
“Companies that foresee a capital shortfall before they reach profitability will have to be willing to look at a range of alternatives to bridge that funding gap," Fry said.
-----
Report: Telehealth Programs Increase Workload for Nurses and Support Staff
Many providers think their telehealth program increases the workload for nurses and support staff, according to a recent report. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators.
By Katie Adams
Dec 20, 2022 at 3:36 PM
Telehealth isn’t as widely utilized as it was at the dawn of the pandemic, but the care modality is definitely here to stay. However, many providers believe their telehealth program increases the workload for nurses and support staff, according to a recent report from research firm Sage Growth Partners. Providers also said they don’t think physicians enjoy using telehealth visits to treat patients.
In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators, the report said.
In September, Sage Growth Partners surveyed 95 health system executives and 75 leaders of physician practices. Practices with fewer than five physicians were excluded from the survey.
Most respondents said that their organizations will focus on optimizing and sustaining their current telehealth programs in 2023 rather than expanding them. In fact, only about 10% of participants — 11% of hospitals and 8% of practices — said they are looking to grow their telehealth offerings next year.
-----
Third-Party Risk Management Actions to Avoid Data Breaches
December 21, 2022
The following is a guest article by Aaron Kirkpatrick, CISSP, CRISC, CIPM, GCIH, GCC, Chief Information Security Officer at Venminder.
Without a doubt, the healthcare industry is growing and thriving. It’s one of the world’s largest and fastest-growing industries, and the global healthcare market will reach $665.37 billion by 2028. As the industry grows, more service and operational needs arise, resulting in increased outsourcing, and additional vendor risk.
It’s not uncommon for vendors to have access to sensitive patient data, such as electronic health records (EHRs) and patient communications. Therefore, you need to ensure your healthcare organization’s vendors and business associates, also known as high-risk vendors, have processes to protect data and prevent cybercriminals from hacking their databases.
Consequences of a Vendor Data Breach
It’s not IF your vendor is breached, but when. It’s important to consider this since a vendor data breach can have serious consequences. Here are some examples:
- Fines or other monetary consequences
- Losing the confidence and trust of patients
- Increased regulatory scrutiny
- Reputational damage
Protecting Your Organization Through Third-Party Risk Management (TPRM) Actions
You may be wondering, “what can I do?” To protect your healthcare organization from cyberattacks, lost patient trust, reputational damage, and the other negative consequences of a data breach, third-party risk management is essential. An effective third-party risk management program ensures there are documented and comprehensive response plans in case of a cyberattack. In the event of a breach, being prepared can greatly reduce the impact.
-----
Spending Bill to Extend Telehealth, Hospital-at-Home Waivers for 2 Years
The year-end package includes two-year extensions for Medicare telehealth flexibilities enacted during the pandemic and the Acute Hospital Care at Home Program.
By Anuja Vaidya
December 20, 2022 - The year-end $1.7 trillion spending bill includes provisions to extend pandemic-era telehealth and hospital-at-home waivers for two years.
The legislation, released Tuesday, aims to avert a government shutdown and includes several healthcare provisions, including reducing the 2023 Medicare payment cuts to 2 percent from 4.5 percent.
In a win for telehealth proponents, the sweeping bill also includes a two-year extension of telehealth-related regulatory flexibilities for Medicare beneficiaries put in place during the COVID-19 pandemic. A previous bill extended these flexibilities for five months after the public health emergency expires.
Now, the waivers will remain in place through Dec. 31, 2024, if the legislation passes both the House and Senate and is enacted into law.
The flexibilities include eliminating geographic restrictions on originating sites for telehealth services, enabling Medicare beneficiaries to receive services from any location, and allowing federally qualified health centers and rural health centers to continue providing telehealth services.
-----
KLAS Ranks Practice Management Health IT for Large/Midsize Healthcare Orgs
Large healthcare organizations that use athenahealth practice management health IT said that the vendor addresses issues quickly, according to the KLAS report.
December 20, 2022 - athenahealth practice management (PM) health IT ranked first for overall performance among large and midsize healthcare organizations in a recent KLAS report.
Large practices that use athenahealth’s athenaIDX note that post-implementation updates have enhanced the user experience. Respondents said that they feel the health IT vendor is a proactive, supportive partner that can solve issues quickly.
Large practices using Epic’s PM solution also reported high satisfaction rates, emphasizing strong technology and constant upgrades. Additionally, respondents said that thorough training ensures users can work efficiently.
NextGen Healthcare’s solution performs well due to flexible EHR/PM software that can support complex multispecialty environments. Large practices noted robust reporting and improved executive involvement in recent years.
-----
https://www.healthcareitnews.com/news/which-practice-management-platforms-stand-out
Which practice management platforms stand out?
A new KLAS report examines which PM vendors best deliver on customers’ expectations for midsize and large practices, and for independent and owned practices, with athenaIDX, Epic and NextGen receiving high marks.
By Andrea Fox
December 20, 2022 03:43 AM
Practice management solutions entrenched in the marketplace do not always meet customer needs, according to the new Midsize/Large Practice Management 2022 report from the KLAS Arch Collaborative.
WHY IT MATTERS
To learn which PM products best deliver on customer expectations, KLAS interviewed healthcare professionals at more than 300 practices over a 12-month period.
They rated AdvancedMD, Allscripts, athenahealth, Cerner, CompuGroup Medical US, eClinicalWorks, Epic, Greenway Health, MEDITECH and NextGen Healthcare systems for overall product performance, culture, loyalty, operations, relationship and value.
Historically, KLAS had divided PM data by midsize – 11-75 physicians – and large practices – more than 76 physicians. However, independent practices – clinics not owned by a hospital/health system – and owned practices also have different needs, so KLAS split them out, the research organization said in its report.
-----
https://www.healthcareitnews.com/news/uchealth-slashes-code-blues-70-telehealth-technologies
UCHealth slashes code blues up to 70% with telehealth technologies
The academic medical center uses tele-sitter and virtual ICU platforms for a program it calls Virtual Deterioration.
December 20, 2022
UCHealth is a non-profit healthcare organization based in Colorado made up of 12 hospitals across the state.
THE PROBLEM
The organization had a new use case for virtual care, a program called Virtual Deterioration. Essentially, it was trying to find patients who were deteriorating in the hospital sooner in order to provide rescue and treatment faster to give them the best outcome.
"What we were seeing prior to this program was a lot of variability as we tried to detect deterioration, and then once we were detecting it, reaching out to the bedside caregivers as to what happened next," said Dr. Diana Breyer, chief medical officer of the Northern Region at UCHealth.
"And so, this was very much a part of our plan to decrease that variability for patients that were staying in place for us to be able to monitor them consistently with more frequent vital signs to make sure we really had rescued them and utilized technology to keep an extra set of eyes on them," she added.
PROPOSAL
UCHealth already had implemented vendor AvaSure's TeleSitter platform for patient safety and the vendor's Verify for virtual ICU. It expanded use of these technologies to Virtual Deterioration.
-----
https://www.healthcareittoday.com/2022/12/20/when-hipaa-becomes-criminal/
When HIPAA Becomes Criminal
December 20, 2022
Former Hospital Employees Accused of Selling Patient Information
Five former employees of Methodist Hospital in Memphis, TN, including a recently-licensed Registered Nurse, were indicted by a federal grand jury for allegedly selling medical information about car accident victims to personal injury attorneys and chiropractors. The hospital may be penalized for its HIPAA compliance based on the investigation caused by the alleged illegal activities of its rogue employees.
Roderick Harvey, 40, was charged with conspiracy and multiple counts of obtaining patient information with intent to sell it for financial gain. Harvey allegedly received patient information from Kirby Dandridge, 38, Sylvia Taylor, 43, Kara Thompson, 30, Melanie Russell, 41, and Adrianna Taber, 26, who were all charged with violating HIPAA. Harvey could receive up to 70 years in prison, pay a fine of $1.75 million, plus supervised release. Dandridge, Taylor, Thompson, Russell, and Taber each face a maximum penalty of one year imprisonment, a $50,000 fine and a one-year period of supervised release. According to the Tennessee Board of Nursing website, Taylor was recently licensed as a Registered Nurse, and could lose her license if convicted.
Most HIPAA violations result in civil penalties against organizations for not adequately protecting patient information or by violating a patient’s right to access their medical records. HIPAA becomes criminal when someone violates HIPAA for personal gain (usually financial) or to harm a patient.
Because this took place at Methodist Hospital in Memphis, the healthcare provider will be investigated for its HIPAA compliance, and not just the parts of HIPAA specific to the alleged crime. The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) that enforces HIPAA will send a letter to the hospital demanding evidence of its compliance with all the HIPAA Rules – the Privacy Rule, Breach Notification Rule, and Security Rule. It will require that the hospital provide its ‘accurate and thorough’ HIPAA Security Risk Analysis (SRA) and evidence that it has remediated its identified cybersecurity risks. The hospital’s entire HIPAA program will be scrutinized because of an alleged crime related to part of the HIPAA Privacy Rule.
-----
https://www.healthleadersmedia.com/innovation/using-digital-health-fight-healthcare-misinformation
Using Digital Health to Fight Healthcare Misinformation
Analysis | By Eric Wicklund | December 20, 2022
Researchers at the University of Illinois and OSF HealthCar are working on a digital health app that would enable providers to better combat false rumors and malicious reports that hinder public health efforts.
KEY TAKEAWAYS
· Researchers at the University of Illinois and OSF HealthCare have received a $100,000 grant to continue research supported by the National Science Foundation targeting misinformation that was spread during the pandemic.
· The new effort aims to develop a digital health app that identifies misinformation and helps providers, expecially those in public health, combat it with accurate data.
· Misinformation not only affects public health programs such as vaccinations, but damages the repution of healthcare providers and sows distrust in the healthcare industry.
Researchers at the University of Illinois are working on a digital health app that would alert providers to healthcare misinformation circulating on social media.
Kevin Leicht, PhD, a sociology professor at UI, and Mary Stapel, MD, community care lead physician for OSF HealthCare Saint Francis Medical Center and assistant program director for the combined Internal Medicine-Pediatrics Residency at the University of Illinois College of Medicine Peoria (UICOMP), are using a $100,000 grant to develop the resource, which would give users real-time alerts about rumors and malicious reports that impact public health efforts.
"What our project actually does is take not only the pre-existing fact-checked data and query it all in one place, it brings it forward in a user-friendly fashion," Leicht said in a press release from OSF Healthcare. "But then it's also trying to come up with a way of adding to this data in a way that's faster than having a human fact checker just scan the web all the time, looking for what the new piece of misinformation is."
-----
https://patientengagementhit.com/news/poor-health-data-integration-harms-the-patient-experience
Poor Health Data Integration Harms the Patient Experience
Four in five patients said having to repeat their medical history detracts from a good patient experience.
By Sara Heath
December 19, 2022 - The lack of data integration is starting to wear on the overall patient experience, with new survey data showing that 83 percent of patients have to provide the same health histories they have in the past. That process makes four in five less likely to return to that provider, the survey added.
The survey, completed by Propeller Insights on behalf of Carta Healthcare, showed that 42 percent of patients spend up to six minutes recounting their medical histories each time they go to their medical appointments.
That redundancy is getting in the way of a good patient experience, with around 80 percent of respondents saying the burden of duplicative data entry discourages them from visiting that particular provider again.
But those trends weren’t the same across gender. Men, for example, were more likely to have to repeat basic medical history compared with women, shaking out to 24 and 14 percent having to do so, respectively.
-----
Decision aids help patients better understand imaging procedures
Amerigo Allegretto, AuntMinnie.com staff writer
December 16, 2022 -- Decision aids with lay-friendly language help improve patients' understanding of image-guided procedures without needing additional clinician time or effort, a study published December 14 in the American Journal of Roentgenology has found.
A team led by Dr. Shanmukha Srinivas from the University of California, San Diego also found that patients were more satisfied with consent conversations with their clinicians after being provided with decision aids.
"These findings are important in light of studies suggesting that consent practices are often limited by time constraints and variable health literacy among decision-makers," Srinivas and colleagues wrote.
While patient decision aids have been shown to improve informed consent practices, their quality regarding image-guided procedures has been criticized, with some noting that aids for imaging have poor readability scores and use language above average health literacy levels.
-----
10 healthcare companies that hit $1B valuations in 2022
Dec 19, 2022 03:00am
Health tech had a wild ride in 2021 as venture capital dollars flooded into the market.
Digital health funding reached a fever pitch in 2021 with startups raising an eye-popping $29.1 billion across 729 deals, according to Rock Health, a venture fund dedicated to digital health.
But the high-flying startup ecosystem has come back down to Earth as part of an overall market reset.
Health tech companies are raising far less this year than in 2021. With the third quarter included, 2022 year-to-date funding totals $12.6 billion across 458 deals, raising doubts that this year’s digital health pot will reach even half of last year’s haul, according to Rock Health.
Despite the market downturn and investor caution amid an unstable market, there are health tech companies bucking the trend and raising significant amounts of cash. According to CB Insights, 23 healthcare-focused startups crossed the $1 billion valuation threshold to become "unicorns" in 2022.
-----
A staffing expert shows how telehealth is stepping in to fill the staffing shortage
"As clinicians are passionate about patients receiving quality healthcare delivered in a timely manner, I see telehealth programs being the key to improving patient outcomes and the overall healthcare experience," he says.
By Bill Siwicki
December 19, 2022 10:35 AM
The staffing shortage is a huge challenge in healthcare today. Another challenge is finding a solution to this vexing problem.
But telehealth may be becoming an emerging strategy to help fill in gaps within hospitals and health systems, contended Chris Franklin, president of LocumTenens.com, a self-service job board and a full-service physician and advanced practice recruitment agency working in high-demand medical specialties.
Healthcare IT News sat down with Franklin to discuss changes occurring in healthcare staffing, what he calls hybrid staffing strategies, and the results of a new LocumTenens.com survey.
Q. Overall, what changes are you seeing occurring in healthcare staffing?
A. The changes we've seen in the broader economy regarding contingent employment over the past three years are incredibly impactful on healthcare staffing. There are a few key numbers that tell the story.
-----
Most Telehealth Visits Do Not Require In-Person Follow-Up Visits Within 90 Days
Analysis | By Christopher Cheney | December 19, 2022
In some specialties such as nutrition and genetics, telehealth visits can often replace in-person visits, researchers found.
KEY TAKEAWAYS
· The two specialties that showed the fewest in-person follow-up visits in the 90 days after a telehealth visit were genetics (4% of telehealth visits) and nutrition (10% of telehealth visits).
· The two specialties that showed the most in-person follow-up visits in the 90 days after a telehealth visit were obstetrics (92% of telehealth visits) and fertility (54% of telehealth visits).
· In a new study that looked at more than 30 specialties, most patients who had a specialty telehealth visit did not require an in-person follow-up visit in that specialty over the next 90 days.
Since the beginning of the coronavirus pandemic, telehealth visits have increased dramatically. The millions of telehealth visits that have been conducted since the beginning of the pandemic are an opportunity for researchers to assess the utilization of telemedicine.
The new study, which was conducted by Epic Research, examined more than 35 million telehealth visits conducted between March 1, 2020, and May 31, 2022. The research includes several key findings:
- The two specialties that showed
the fewest in-person follow-up visits in the 90 days after a telehealth
visit were genetics (4% of telehealth visits) and nutrition (10% of
telehealth visits)
·
In specialties that often involve consultations
such as genetics and nutrition, telehealth visits could replace the need for in-person
visits
-----
https://www.bmj.com/content/379/bmj.o3019
Editorials
Patient access to full general practice health records
BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o3019
(Published 19 December 2022) Cite this as: BMJ 2022;379:o3019
1. Tessa Richards, associate editor1,
2. Angela Coulter, chair2,
3. Brian McMillan, senior clinical lecturer3,
4. Maria Hagglund, associate professor4
1. Correspondence to: T Richards trichards@bmj.com
The UK government’s commitment to provide it should be realised
Many countries empower patients to take on a larger role in their care by providing them with online access to their health records.12 Transparent records, and patient access to them, are also key to improving the safety of care.3 Approaches to sharing records differ internationally. Sweden rolled it out region by region from 2012.1 The US mandated it nationally from April 2021.4 The UK government planned to do the same in England but its programme has foundered.5
NHS England’s programme to provide citizen access to general practice records was due to go live in December 2021, following a 2019 pledge to provide all patients with full digital access by default by 2020.6 But launch was put back to April 2022 and then 1 November, after the Royal College of General Practitioners said practices needed more time and training to implement it.7 In July, the college updated its online services toolkit and NHS England circulated guidance and resources for general practice staff based on the experience of 16 early adopter practices.89
Two days before the 1 November deadline, the BMA called for a total rethink of the programme.10 Practices who were not ready to implement it asked their software suppliers (most use EMIS or TPP) not to enable default access. In December, one supplier (EMIS) restarted the default access option, but NHS England has told us that only a minority of practices will be enabled by the end of 2022 (personal communication). It remains unclear when default access will be available for everyone.
-----
Enjoy!
David.
